Savannah morning news. [volume] (Savannah) 1868-1887, 1881-10-03
AFTER THE AUTOPSY.
OFFICIAL REPORT OF THE POST
MORTEM.
Revelations of the Knife-Deduc-
tIOns of he SurgeOns-Why Doc
tors Ag0eW and Hamilton Did
Not sligo the Report.


Journal Of Medical Sciences contains an off
cial report of the autopsy of President Gar
field, prepared by the surgeons in charge.
After stating that a consultation
was held and made of the pro-
ceedure adopted, the report says: The
examination was then proceeded
with and the following external appearances
were observed: The body was consider
ably emacisted, but the face was much less
wasted than the limbs. A preservative
fluid had been injected by the emboalm
few hours before into the left femoral
artery. The pipes used for the purpose
were still in position. The anterior sur.
face Of the body presented no abnormal
appearances, and there was no
ecchvmosis, or other discoloration of any
part of the front of the abdomen. Just be-
low the right ear, and little behind it,
there was an oval liberated opening about
half an inch in diameter, from which some
pus was escaping, but no tumefaction could
be o served in the parotid region. A con-
siderable number of purpura like spots
were scattered thickly over the left scapuls,
and thence forward as far as the axilla.
They ranged from one eighth to one fourth
of an inch in diameter, were slightly eleva-
ted on the surface, and many of them were
continent in groups of two to four or more
Similar but much less abundant eruD-
tions were observed sparsely scattered
over a corresponding region OF the right
side and an oval eXcavated ulcer, about an
inch long, the result OF q small carbuncle,
was seated over the spinous process Of the
tenth dorsal veTtebrs. Over the sacrum
there were four small bed sores, the largest
about half an inch in diameter. A
few acne pustules and a number of
irregular spOts of post mortem hypo-
static congestion were scattered
over the shoulder, back and buttocks The
inferior part OF the scrotum was much dis
colored by hYpOstatic congestion. A group
of hemorrhoidal tumors, rather larger than
usual, protruded from the anus The de-
pressed cicatrix of the wound made
by the pistol bullet was recognized
over the tenth intercostal space three
and q half inches to the right
OF the vertebral spines. A deep linear in
cisiOn, made in part by the operation of
July 24th, and extended by that of August
Sth, occupied position closely correspond
ing to the upper border of the right twelfth
rib. 1t commenced pOsteriorly about two
inches from the vertebral spines and ex-
tended forward a little more than
three inches. At the anterior extremity OF
this incision there was a deep nearly square
abraded surface about an inch across. A
well oiled flexible csthe;er, fourteen inches
long, was then passed into this wound, as
bad been done to wash it out during life
More resistance was at first encountered than
had usually been the case, but after several
trials the Gather entered without any vio-
lence to its foil length. 1t was then left In
position and the body disposed supinely for
the examination of the viscera. The era
mum was not opened. A long incision was
made from the superior extTemity of the
sternum to the pubs, followed by
transverse incision, crossing the
abdomen Just below the umbill Gus
Four laps, thus formed, were turned back,
and the abdominal viscera exposed. The
subcutaneous sdipose tissue, divided by the
incisions, was little more than one eighth of
an inch thick over the thorax, but was
thicker over the abdomen, being
about a quarter of an inch along the
liuea alba, and as much as half an inch
thick towards the outer extremity of the
transverse incision. On au inspection OF
the abdominical viscera in sitve transverse
colon was observed to lie little above the
line of the umbillicus. 1t was firm
lY adherent to the anterior edge Of
the liver. The greater omentum
covered the intestines pretty thoroughly
from the transverse colon almost to the
pubs. Il was still quite fat, and was very
much blackened by veuous congestion on
both sides. Its lateral margins were ad-
herent to the Abdominal particles opposite
the eleventh and twelfth ribs. On the left
side the adhesions were numerous, firm,
well organized and probably old.
A foot note here says: "These adhesious
and firm ones on the right side, as well as
those of the spleen, possibly date back to
the attack of chronic dysentery, from which
the patient is said to have suffered during
the civil war. On the right side
there were a few similar sdhesions
and a number of more delicate
and probably recent ones. A mass of black
coagulated blood covered and concealed the
spleen and the left margin of the great
omentum. On raising the omentum it was
found that this blood was extended through
the left lumbar and lilac regions and dipped
down into the pelvis, in which there was
some clotted blood, and rather more than
pint Of blood"
The second foot note here says: ga large
part of this had probably transRded from
the injecting material OF the embalmer
The blood coagulation, having been turned
out and collected, measured very nearly a
pint 1t was now evident that the secOnda-
ry hemorrhsge had been the immedi-
ate cause of death, but the
point from which the blood
had escaped was not at once
apparent. The omertuim was not ad-
herent to the intestines, which were moder-
ately distended with gas. No intestinal ad-
hesions were found, other than those be-
tween the transverse colon and the
liver, already mentioned. The alb
dominal cavity being now washed
out as thoroughly as possible,
q fruitless attempt was made to obtain some
indication of the bullet before making any
further incision. By pushing the intestines
aside the extremity of the catheter, which
had been passed into the wound, could be
felt between the peritonium and the right
lilac, but 1t had evidently doubled upon
itself, and although a prolonged search
was made, nothing could be
seen or felt to indicate the presence of
the bullet, either in that region or else
where. The abdominal viscera were then
carefully removed from the body, placed in
suitable vessels and an examination made
seriatim, with the following result: The
adhesions between the liver and the trans
verse colon proved to be an alb
scess cavity between the under
surface of the liver, transverse colon and
the transverse mesO-cOlOn, which involved
the gall and bladder, and extended to
about the same distance on each side OF it,
measuring six inches transversely aud four
inches from before backwards. This cavity
was lined by a thick pyogenic mem
brane, which completely replaced
the capsule of that part Of the under sur
face of the liver occupied by the abscess.
II contained about two ounces of greenish
yellow fluid, mixture of pus and hillary
matter. This sbscess did not involve any
portion of the substances of the liver except
the surface, with which 1t was in
contact, and no communication
could be detected between It
and any part of the wound. Some recent
peritOnial adhesions existed between the
upper surface of the right lobe of the liver
and the diaphragm. The liYer was larger
than normal, weighing 81 ounces.
It's substance was firm, but of a pale,
yelloWish color on its surface
and throughout the interior of
the organ, from fatty degeneration. No
evidence that it had been penetrated by the
bullet could be found, nor were there any
assesses or infraction in any part of its
diaphram by firm, probably old peri
tonsl adhesions. There were several
rather deep congenital assures in
its margins, giving it lobulated appear.
ance 1t was abnOrmally large, weighing
eighteen ounces, Of very dark lead red color,
both on the surface aud on the section. Its
parsnchyma was soft and flabby, but con
tanned no assesses or infractione.
There were some recent peritonal
well of the stomach and the posterior alb
dominal parties. With this exception no
abnormities were discovered In the stomach
or intestines, nor were any other evidences
of general or local peritonitis found besides
those already specified. The right kidney
weighed six ounces, the left seven.
just beneath the capsule OF the