Almost a Comedy of Errors

     Viewing the case of President McKinley through surgical eyes the ADVANCE cannot but feel that the operative and after-treatment were not of a character to justify the approval which has been accorded by Eastern medical journals, especially since the autopsy has revealed conditions altogether unlooked for during the week of invalidism which followed the assassin’s attack upon the chief executive.
     So far as they went in their primary operative work the attending surgeons did all that could be demanded of them in an emergency case. It was a plain duty to repair the wounded stomach and it was artfully done. It was also a duty to flush the abdominal cavity thoroughly before closing the incision they made, and this was done. It was likewise demanded that they examine the intestines carefully, for bullet injury, and this was not neglected. But the autopsy revealed an injury to the pancreas and also to the left kidney, and it is not recorded that either of these wounds were discovered and attended to at the time the stomach was repaired. Failure just here was a vital mistake, the fluid from either of these organs being sufficient to cause necrosis of the wound-track. There may have been reasons why the wounds of the pancreas and kidney were not discovered which would free the attending surgeons from censure, but none has been offered up to this moment which relieves them of this responsibility. An error of over-sight seems certainly to have been committed.
     As to the after care of the case and the interpretation [445][446] which was placed upon the symptoms presenting throughout the week, perhaps the veil of charity had best be drawn. Either the attending corps must have known that something deadly was going on, or their eyes were blinded, to a degree amounting to stupidity, by their optimism and their heartfelt desire that the president should recover. The continuedly high pulse-rate and the steadily though moderately elevated temperature portended danger to thousands of physicians over the country, who were not at all surprised when the “unexpected at Buffalo” happened. It certainly is not to the credit of our art that such a blunder in prognosis should have been made, nor is it excusing that it was made by eminent men. It simply should not have occurred, and the public will not be quick to forgive the doctors in attendance for the rude and apparently needless shock it received at their hands.
     But if this was carelessness in not ascertaining all the injury the bullet had done, and if a serious error in prognosis was committed, what shall be said of the blundering resort to medical practice—the administration of calomel and oil for purgative purposes, upon the wounded chieftain? Small wonder that a sudden and violent collapse followed. The giving of food to the wounded stomach on the sixth day was enough of an error; the administration of purgatives could only add to the complication. Lavage would have been infinitely more innocent and judicious.
     All told a number of discreditable procedures are offered for review in this lamentable misfortune which the nation has been called upon to suffer.