The Present and the Past

     IN THIS week’s issue of the MEDICAL NEWS we present to our readers a short authentic account of the surgical features of the recent shooting of President McKinley, gathered by one of our staff from those in charge of the patient at Buffalo. We also publish a short summary of the illness of President Garfield and wish here to point out some of the more important differences which come to mind in comparing two somewhat analogous surgical incidents.
     From the very beginning the cases are not comparable, within strict lines, but there are undoubtedly certain features which reflect a great difference in surgical procedures of the present day and those of twenty years ago.
     The modern modes of conveyance whereby an injured man is readily and easily conveyed to a hospital equipped with all necessary appliances suggest one phase of difference in the treatment of President McKinley in contrast with that of President Garfield. No surgeon in a large city at the present day, save in the most extreme emergency, would think of examining a wound without the proper facilities and under the strictest antiseptic precautions.
     Temporary expedients are rejected by the modern operator who has, under the teachings of antiseptic surgery, practically no dread of doing almost anything in the way of operative interference. The immediate and fearless opening of the abdominal cavity, with the direct desire of seeing with the eyes the damage done by the missile, marks another step which the methods of twenty years ago would not permit.
     Should it subsequently become necessary to find and extirpate the bullet in President McKinley, physical science has placed in our hands the means whereby it may be located with an accuracy beyond a doubt. Had the use of the Roentgen ray been among the acquisitions of a former generation, it is more than probable that the secondary hemorrhage which took the life of President Garfield would not have occurred and that the removal of the bullet in the early days of his illness, and the appreciation of the injury to the bony structures of the spinal column, which also might have been detected by the use of these light rays, would have resulted in more radical and successful surgery.
     The surgeons of that day lived up to the fullest of their opportunities. Let us be thankful that medical research has raised the level of the opportunities of the present generation to a much higher plane.