Editor Detroit Medical Journal:
D S —I
read with considerable satisfaction your editorial anent the “Demise
of President McKinley.” I had followed the case, as best I could,
in the newspaper reports, and was awaiting an intelligent history
of the symptoms, and the result of the autopsy, as I desired full
light as to the cause of death.
I cannot, however, agree with your
remarks as to the selection of a nurse. After an experience of over
thirty years’ practice I am compelled to conclude that the crucial
point in many a case is that of the nurse, and if Doctor Mann felt
as I have, on many an occasion, he would, particularly, under the
circumstances portrayed by you, be justified in selecting the individual
(be her nationality what it may), who would implicitly carry out
his directions and conserve his professional interests. Indeed I
am of the opinion that if there was any chance of the nurse falling
short in her duty on account of sympathy for the patient, it would
be quite proper for Doctor Mann to do as he did.
By the way, can you throw any light
upon the case as regards the result to the supra-renal capsule?
The top of the kidney was pierced, and the gangrene extended to
about one inch on each side of the bullet’s track. Would this not
destroy the whole of the capsule, and, in that way, cut off from
the economy one-half of the service (whatever it be), that is evidently
essential, as we know already, to the continuance of health and
I find that only one instance is recorded
in the medical literature at my command, that in the “Medical and
Surgical History of the American War of the Rebellion,” of injury
to the capsule, so that the profession has but little data to act
upon in dealing with any such supposed injury, and I feel that the
surgeons in attendance upon this case owe it to the profession at
large to supply all the information relating thereto in their hands.
Kindly, then, supply all the light that you can command on this
almost unique case, and oblige,
R. C .