The Portland daily press., 1881-10-03
aUITEAU'S BULLET.
Official Report of the Autopsy OF
President Garfield.
SECONDARY HEMORRHAGB THE d.
RECT CAUSE OF DEATH.
Tracing the Course of the Deadly Mis-
sile.

Tracing the Course Of the Deadly his.
sile.
PHILADELPHIA, Pa, Oct 1.-The October
issue of the A rican Journal Of Medical Sci
ence contains The following official reportof
the autopsy of President Garfield, prepared by
the surgeons in charge:
Official record of the post mortem examlpa-
ton of the body of President James A Gar
field, made Sept. 20, 1881, commencing at & 81
o. m 18 hours after death, at FraDklyn cot
tage, Elberon. N. j. Present and assistant,
DIR d. w. Bliss, Surgeon General .. n
Barnes. u. S. A., Surgeon j. j. woodward,
II s. A.. DR.. Robert Reyburn, DIR. Frank d.
Fl amiton, Dr. D. Hayes Agrew, Or. Andrew
Ell Smith of Elberon and New York, and act
ing assistant surgeon, and d. S. Lamb OF the |
Armv Medical Museum, Washington, u. ".
Before commencing he examination, con-
sultarou was held by the ply sicans in room
adjoining that in which the body lay, and IL
was unanimously agreed that the dissection
should be made by DR.. Lamb, and that Sur
gson Woodward should record the onserva-
lions made II was unanimously agreed that
rhe Uranium should not be opened. Surgeon
Woodward then proposed that the examlIla-
ton should be made as fol ows: That The
body should be viewed externally, and any
morbid appearance existing recorded; that
as was done during life to wash 1t out, or the
purpose of assisting TO find the position OF the
bullet that a long iDclslon should next pc
made from the superior extremity OF the ster-
mum to the pubs, and this crossed by trans
Vel SO one lust below the umbicus; that the
abdominal flaps thus made should then be
turned back and the abdominal viscera exam
ined; thai, after the abdominal cavity was
opened, the position of the bullet should be
asce rtained, if possible, before making any
f..n 49,. ion at.h hat
cic viscera should be examined This orderiof
procedure was unanimously agreed 10.
THE EXAMINATION ia.
was then proceeded with, and the following
external appearance were Observed The body
was considerably emaciated, but the face was
much less wasted than the limbs. preserva-
tive fluid had been injected by the embaimer
a I, W hours before in the fenroral artery. The
pipes used for he purpo 9 were still IN posi-
ZION. The anterior surface of the body pre-
scented no abnormal appearances. and there
was no echymos or other discoloration of any
part Of the front of the abdomen. just below
me ght ear and little behind it, there was
an oval liberated opening about half an inch
in diam ter, from which some saniouS pus was
escaping, but no tumefaction could DC OBJ
served in the parotid region A considerable
number of purpera-like spots We're scattered
thiekly over the lett scapula and thence for
ward as far as the axilla. They ranged from
one-eighth to one fourth or an inch in diame-
Ter were slightly elevated and furfuraciouS on
the surface, and many of them were contluent
i'll groups oI two to four or more. A similar,
but much less abundant, eruption was observed
sparse ly scattered over the corresponding re-
glon on the right side. An oval excayated al
Ger, about an inch long, the resat of small
carbunce was seated over the splnouS process
OF he 10 h dursai vertebra. Over the sacrum
there were four small bed sores, the largest
about hall an inch ia diameter A lew acute
pustules and number of irregular spots of
post mortem hypostatic congestion were scat
tered over the shoulders, back aud buttocks.
The inferior part of the scrotum was much
discolored by hypostatic congestion. A group
of hemorrhodal tumors rather larger than
walnut protruded from the anus. The de-
pressed cicatrix of the wound made by the
pistol bullet was recognized over the 10Th in
iercostaI space at three and half inches to
right of the vertebral spines.
ADEEP LINEAR INcIsIoN,
m sde in part by the operation o July oath
aud extended by that of Aug 9th, occupedia
position closely corresponding to the upper
b, rider of the right 18TH rib. 1t commenced I
10 tively about Two inches from the vertebral
cpInes and extended forward little more
than three inches. At the anterior extremity
of this incision there was a deep,nearly sqaaTe,
abraded surface about an inch across. A well
oiled flexible catheter, Ia inches long, was
then passed into this wound, as has been done
to wash it out during life. More resistance
the case, but after several trials the catheter
entered without any violence its full length.
Ii was then left in position and the body dis
posed supinely for The examination OF the
viscera The Uranium was not opened. "a
long inclsion was made from the superior ex
tremity OF the Eternum to the pubs, followed
by transverse incison crossing the abdomen,
just below the umbilcus The four flaps thus
formed were turned back and the abdominal
viscera exposed. The subcutaneous adpOse
divid.d 10 the iunisans- wHq IIrfiA more
than one-eighth of an inch tn ok over the
thorax, but was thicker over the abdomen, be-
Ing ABOUT quarter of an inch thick along TIE
iuea alba ,and as much as bali an inch thick to-
ward the outer extremity of the Transverse in
cison. On inspection of the abdominal viscera
iu stu, the transverse colon was observed 10
lie little above The line of the umbilicus. IL
was firmly adbeIent to The anterior edgeof
the liver. The greater omentum covered the
iutestines pretty thoroughly from the trars-
verse colon almost to the pubs. 1t was sull
quite fat and was very much blackened by
venous congestion. On both sides lis lateral
margins were adherent 10 The abdominal
uarieies opposite the 18th and 18th ribs On
the left side the aohesions were numerous
firm. weli-Jrganized and probably old. Ia
fnot pote here says: These adhesions and The
firm ones OH the right side, as well as thoseof
oil the spleen, possibly date back to an
ATTACK OF CHRONIC DYsENTERY.
from which the patient is said to have suffer
ed during the civil war. 4
On the right side there were few SINH lar
adbtsions ano number of more delicate al d
probably recent ones. mass OF black, Goa
gulated blood covered and concealed the spleen |
and the LETT margin Of the greater omentuln,
On raising the cmentum it was found that q
blood mass extended Trough the left lumbar
and lilac regions, and dipped down into the
peivis, in which there was some clothed blopd
and rather more than a pint of bloody fluid.
A foot note here says: A large part of this
huid had probably transuded from the inlSc-
ton material Of the embalmer The blood
coag ula, having been turned out and collected,
measured very nearly pint. 1t was now evil
dent that secondary hemorrhage had been the
immediate cause of death, but the point from
which The blood had escaped was not at once
apparent. The oinentum was not adherentsto
The intestines, which were moderately distend-
cd with gas. No intestinal adhesions were
iOund other Than those between the transverse
colon and the liver already mentioned The
abdominal cavity being now washed out AS
thoroughly as possible, fruitless attempt was
made to obtain some indication OF the pres
ence of the bullet before making any further |
incision. By pushing the iDtestines aside the
extremity of the catheter, which had been
dressed into the wound, could be felt between
the perituneum ana the right lilac fascia, but
il had evidently doubled upon itself, and, al
though prolonged search was made, nothing
could be- seen or felt to indicate the presence OF
tie bullet either in that region or elsewhere.
The abdominal vScera were then Carefully re- |
moved from the body, placed in suitable YES !
s.is aud examined seriatim, with the follow
ing resuit:-The adhesions between the liver
aid transverse colon proved to m
BOUND AN ABsCEss CAVITY 1
between the undsr surface of the liver. the
transverse colon and the transverse meso colon |
which involved the gail bladder, aud extended |
I o about the same distance on each side of IL, |
measuring six inches lransversely, aud four |
inches from before backward. This cavity was |
lined by a thick pyogenic membrane, which |
completely replaced the capsule OF that part |
of thu under surface of the liver occupied by |
he aDscess 1t contained about two ounces of |
,reenish-yellow fluid, a mixture of pus and |
hillary matler.
The abscess didnot involve any portion of tho
substance of The liver, except the surface with
which it was i'll contact. No communication
could be- traced between it and auy part OF the
wound. Some recent peritonea adhesions ex- |
listed between the upper surface OF the lobe OF
he liver and the diaphragm. The liver was
larger than normal, weighing 81 ounces; ms
-ubsIance was nrm, but OF pale, yeliowish
color OIL its surface and throughout the interior
Of the organ from fatty degeneration. No evi-
dence that 1t had been penetrated by the bull
let could be found nor were there any assesses