The Milan exchange. (Milan, Gibson County, Tenn.) 1874-1978, 1881-10-08
OFFICIAL REPORT.
by the Surgeons OF the Re-
suits of the POst-Mortem Rxamina-
ton of the Body OF President Car
AaI
PHILApyr,ruIA, October /.

following official report of the autopsy
OF President Garfield. prepared by the
surgeons in charge:
OFFICIAL RECORD or THE PosT~MoRTEM EN-
ANIMATION OF the body of President J. A.
Garfield, made September 20, 1881, com
mencng at ABB y. m, eighteen hours after
DEATH at Francklyn Cottage. Elbernn, n. j.,
present and assisting, DIR. ID. w. Bliss, sur
geon-Geueral J. X. Barnes U. S. A, Surgeon
}. J. Woodward, U. S. A., Dr. Robert Rey-
burn, DIR. Frank IL. Hamilton, Dr. d. Hayes
Agnew, Dr. Andrew II. Smith, of Elberon
aud New York, and Acting Assistant-Sur-
geon d. 5. Lamb of the Army Medical Mu-
scum Of Washington. ID. O.:
Before commencing the examination con-
sultation was held by these physicians in
room adjoining that in which the body lay,
and 1t was unanimously agreed that the dis
section should be made by Dr. Lamb, and that
Surgeon Woodward should record the observa-
lions made. 1t was further unanimously
agreed that the Uranium should not be opened
Surgeon Woodward then proposed that the
examination should be conducted as follows
That the body should be viewed externally
and any morbid appearances existing re-
corded.
That the catheter should then be passed in
to the wound, as was done during life, to wash
it out for the purpose of assisting to find the
position of the bullet.
That long incision should next be made
from the superior extremity of the sternum
to the pubis and this crossed by transverse
one just below the umbilicus.
That the abdominal flap thus made should
then be turned back and the abdominal WIS.,
cera examined.
That, after the abdominal cavity was opened,
the position of the bullet should be ascer-
tanned, if possible, before making any further
incision, and that, finally, the thoracc viscera
should be examined.
This order of procedure was unanimously
agreed TO.
The examination was then procee led with,
and the following external appearances were
observed:
The body was considerably emaciated but
the face was much less wasted than the limbs.
A preservative fluid had been injected by the
embamer a few hours before into the left
femol al artery. The pipes used for this pur.
pose were still in position. The interior sur
face of the body presented no abnormal APP
pearances, and there was no ecchymosis, or
other dscOloration of any part of the abdo-
men. just below the right car and n little be-
hind it. there was an oval liberated opening,
about half an inch in diameter from which
some sanious pus was escaping, but no tune
faction could be observed in the parotid re-
gion. A considerable number of purpura-like
spots were scattered thickiy over the left
scapula, and thence forward as far as the
axilla. They ranged from oue-eighth to
one.fourth of an inch in diameter, were
slightly elevated and purpuraceous on
the surface, and many of them were
continent in groups of two to four or more. A
similar but much less abundant eruption was
observed sparsey scattered over the cores
ponding region on the right side An oval,
excavatcd ulcer about an inch long, the re-
suit of a small carbunolc, was seated over the
spinOus process of the tenth dorsal vertebra.
Over the saCum there were four small bed
Sores the largest about half an inch in dame
ter. few acne pustules and number of
irregular spots of post-mortem hypostatic con-
gcstion were scattered over the shoulders,
back, and butocks. The interior part OF the
scrotum was much discolored by hypostatic
congestion. A group of hemorrhodal tu-
mOES, rather larger than Il walnut, protrudcd
from the anus. The depressed cca-
trix of the wound made by the
pistol bullet was recognized over the tenth
intercostal space, three and a half inches 10
right of the Vertcbral spine. a deep linear
inCision (nade in part by the operation of July
q, and extended by that OF August 81 ocCu-
pied position closely corresponding to tho
upper border of he right lwclr rib. 1t COM
mcnccd poStcrorly NhuuttwO inches from tho
VcttcUgai spine and extended forward II little
moro than three inches. At the interior cX-
tremity Of this ncslon there was deep,
nearly square, abradcd surface about an inch
across. A wcll-oiled, flexible cnthCter, four
teen inches long, was then passed into this
wound, rs had been done to wash it out dur
ing life More resistance was mt first cncoun-
tered than had usually been the case hut
after several trials the cathctcr entered with
out any violence to the full length. IL was
then left in psition, and the body disposed
supincly for the examination of the viscera.
The Uranium was not opened. A long Incl
sion was made from the superior extremity of
the sternum to the pubis, followed by trans
verse incisiOn crossing the abdomen just be-
low the umbilicus The four flaps thus formed
were turned back and the abdomin | viscera
exposed. The simultaneous adipose tissue
divided by the missions was q little more than
one eighth of an inch thick over the thOraX,
but was thicker over the abdomen, being
about n quarter of an inch along the Inca
alba and as much as half an inch thick toward
the outer extremity of the transverse incision
On inspection of the abdominal viscera
situa, the transverse colon was observed to lie
little above the line of the umbilicus. 1t
was firmly adherent to the anterior edge Of
the liver. The greater omentum covered the
intestines pretty thoroughly, from the trans
verse colon almost to the pelvis 1t was still
quite fat and very much blackened by venous
congestion. On both sides its lateral margins
were adherenU to the abdominal parietie5,
opposite the eleventh and twelfth ribs, on the
left side, the adhesons were numerous, firm,
well-organized and probably, o d.
"A fout-note hero says: "Fhcse adhesions
and the firm ones on the right side rs well rs
those of the spleen, possible date back to an
attack of chronic dysentery, from which the
patient is said to have suffered during the
Civil War On the right side there were few
similar adhesious and number of more
delicate and probably recent onos."l
A mass of black, cOagulated blood covered