The Lesson of the Late President’s Case

UP to Friday, Sept. 13, six days after the late President McKinley was shot, everything pointed to his recovery. The patient was being well fed; fresh water, the true physiologic diet for one in his condition, was sustaining him admirably; each day he gained in comfort and strength. Even the small dose of beef-juice, occasionally administered after the first few days, though to my mind contraindicated, seemed not to occasion distress. The first four days he was given water only and his improvement amazed us all; not that to the skilled dietist the amazement was due to the fact of the patient’s growing stronger on a water diet, but the progress seemed extraordinarily rapid. Alas! that the attending physicians did not let well alone. It seems that they were misled by two circumstances: first, inexperience with therapeutic fasting and its entire safety for any reasonable length of time; second, they were deceived by the patient’s rapid progress and his apparent capacity for digesting food if given.
     But what of the kind of “food” allowed when the physicians concluded to begin feeding? As an expert dietist, I almost gasped with astonishment when I read that they had given the President a breakfast of toast, chicken broth and coffee. This in face of the fact that thousands of hardy, robust men have been compelled to abandon the use of coffee. In truth it is a drug, of course, and in no sense a food; it is a drug that tends strongly in every instance to prevent the digestion of even the best food accompanying it. Then, the toast, doubtless white bread, scarcely more nutritious than none at all. A lot of starch, partially transformed into charcoal by toasting, and a dose of caffeine; such a breakfast for such a patient! A nice, juicy pear or peach might possibly have been managed without harm, but, in fact, the safer way would have been to just hold him rigidly to the water diet. Had they done this, it is my conviction that yesterday would have been a good day with the President, and to-day a better one still.
     After this breakfast, which for the moment acted as a “bracer” and made the President feel something like his old self, he asked if he could have a cigar, naturally enough. Seldom does even the most inveterate smoker care to smoke on an empty stomach. He will drink to eat; that is, take a nip of whisky to secure a simulation of hunger, or to give him an appetite, and then eat to smoke. The President was not a tippler; but he has been a smoker of heavy black cigars. The physicians denied him the cigar, though it would have been less mischievous by all odds than the breakfast which gave rise to the desire for it. Later in the day it became evident that the breakfast “disagreed.” This was on Wednesday, Sept. 12. Even at this, had he been rationally treated for the indigestion, there was still more than an even chance for him to emerge from the difficulty. For example, had he been given moderate portions of hot water at short intervals to dissolve and wash away the irritating food-stuff and maintain normal fluidity of the blood, he would thereby have been given a fair chance for his life. But what was the course taken? A calomel purge was administered, a bulldozer to the stomach and bowels even in case of a healthy man; it would greatly deplete [59][60] the vital forces of a robust man. “I am so tired; I am so tired,” murmured the dear sufferer.
     To meet this symptom, for which the attending physicians were responsible, stimulants were given with a temporary effect that deceived the people and possibly the doctors. But at about 2 a. m. on Friday, the natural “reaction” from stimulation came and the President had a sinking spell, and the following is the chief bulletin: “Milburn House, Buffalo, N. Y., Sept. 13. President McKinley experienced a sinking spell shortly after 2 o’clock. The physicians are administering restoratives with the hope of reviving him. . . . Digitalis was being administered”—a drug that has stilled many a heart, as it has now helped to still that of the President. Surely the ministrations and incantations of a Christian Science “fakir” would have been incomparably less absurd and less harmful.
     Our greatest sympathy is now for the bereaved wife who so recently was herself dragged through a course of drug treatment such as has terminated the lives of thousands upon thousands of men, women and children. Mrs. McKinley evinced a tough fibre which enabled her to withstand her serious illness and the more serious treatment. The lesson of her case written by the present writer was published in Woman’s Physical Development for August. It did not at that time occur to him that he would so soon be trying to teach the lesson of her dead husband’s case. This lesson should sink deep in the heart of every reader of this magazine, of every thinking person, indeed, who may have the opportunity of considering it.
     Shall we fail in sympathy for the thousands at present lying in sick-beds that will sooner or later become death-beds owing to the same treatment herein condemned? And what shall we say of those honest, honorable sympathetic medical men who have had the management of the President’s case? In very truth they need and are entitled to our sympathy. They tried to do the best they knew, or rather they honestly practised in this case the teachings of the regular schools. But they are blind leaders of the blind.
     Now, let us go back a few days in the history of the President’s case. The surgeons performed their task admirably; no fault in the technique, and it was fortunately done almost immediately after the shooting. Then came therapeutic fasting for several days, with the natural result, increasing comfort and strength. The daily bulletins gave the world glorious accounts of the President’s convalesence [sic]; each day he was better and better, without a skip while the water diet was held to. The physicians should have let well enough alone. But it seems that none of them have learned the lesson of the hundreds of fasts since the Tanner episode; fasts of scientists, pseudo-scientists; persons aiming at an engagement in some museum as a fasting freak; others, insane, believing that they could live forever without food, and “proving” it, too—for thirty, forty or more days; others still who wished to die and essayed to end their lives by starvation (a case of this kind was recently reported, that of a poor bedridden lady who succeeded in starving herself to death in 55 days). If the President’s attendants had been wise in this matter they would not have made the talk they did about the “long period without nourishment,” and which induced them to begin feeding prematurely.
     He was gaining strength every day, as scores of fasters have done during periods varying from six to thirty days when fasting for therapeutic purposes. The President was an over-fed man, fat and ill-conditioned, and at no time during the past five years could he have helped receiving great benefit from a week or two or three of fasting; this while his stomach was in fairly good condition and his life somewhat active. But when stricken down by the assassin, and all the energies of his body having to do with repairing the wounded tissues, with no capacity whatever for digestion and assimilation, all thought of food and feeding, either by mouth or rectum, should have been put aside. It is more than doubtful if rectal feeding is ever of use; surely not in such a case as the one under consideration. Food to be nutritive must be digested and assimilated in the natural way. There is nothing like digestion possible in rectal feeding. Physicians have been misled in this matter all the way along; their rectal-fed patients (so fed, usually, from such excessive feeding by mouth as to provoke the stomach to re- [60][61] volt) continue to thrive for several days together in spite of so-called nutritive enemata, and, lo! they think their patients have been fed. Many individuals, as already remarked, have continued to live and improve in strength from day to day for longer periods than the aforesaid patients have been said to live by rectal feeding; but this phase of the question does not occur to either the patient or doctor.
     It was better, if the President had to die, that he died quickly, rather than suffer for months, as happened in the case of President Garfield, another distinguished martyr to forced-feeding. Garfield was fed for pus day after day for many weeks, the pus escaping in quarts daily. He was fed by mouth ad nauseum; that is, till the nausea and pain were so severe as to forbid feeding, when opiates were administered to deaden his sense of pain, lowering his vitality with every dose; then, as a temporary relief to the stomach, the lower bowel was filled for the continued manufacture of pus. This hideous treatment accomplished what the lunatic’s bullet failed to do directly.
     “In the medical profession a carriage is more essential than skill,” was the dictum of the great novelist, Balzac, who himself died finally from the effects of excessive coffee drinking, as we learn from his biographers who quote the statement of his physicians. Balzac, as we learn from his own statement in a letter to the lady who subsequently became his wife, was once cured of a most desperate attack of illness by means of an absolute fast of three weeks and appropriate bathing. “I emerged from this somewhat heroic treatment with a clear skin, a clear eye and a clear brain and with fresh strength and courage for renewed endeavor,” he wrote.
     Directly after the President’s death, there was evidence of a strong effort on the part of some of the physicians to shift the blame for the premature and bad feeding of their patient. It was intimated that McBurney directed the coffee and toast to be given and that they acquiesced against their judgment, “yielded to his great fame,” or something like that. But the following, from the evening papers of the 12th, would imply cordial unanimity among the attending physicians on this point: “About 8.30 the doctors arrived for the regular consultation. The consultation was brief, and when the physicians came out their elation was evident from their smiling countenances. Dr. Mynter paused after he jumped into his buggy to announce that everything continued ‘eminently satisfactory.’
     “‘The President has had a piece of toast and a cup of coffee this morning,’ said he, ‘in addition to a cup of broth. He will want a cigar soon.’”
     If it be assumed that the distinguished physicians in attendance upon the late President in his last illness represent the highest skill in the medical profession, the query very naturally presents itself: What must we think of the attainments of the ordinary city, village or cross-roads doctors? Well, my reply would be, that any one of these good men, being possessed of good sense and having been, in addition to the routine teachings of the schools, an intelligent student of the health-laws of nature, as interpreted, let us say, by such journals as PHYSICAL CULTURE, for example, would always be a safer attendant in any sick-room than any one, or all together, of the eminent men who attended President McKinley up to the time of his death. In no other profession is it, in my belief, quite so generally true, as in that of medicine, that “great reputation is the product of getting oneself overestimated.”