Lancaster daily intelligencer. [volume] (Lancaster, Pa.) 1864-1928, 1881-10-03
THE FINAL REPORT.
DETAILED OFFICIAL RECORD OF
THE POST-MOk fem EXAMINATION
OF PRESIDENT GARFIELD.
Cause of the Fatal Hsmorrhase.

organ for several generations of the pro-
fession in America-will contain the official
record of the post-mortem examination of
the body of President Garfield. 1t is a
minute technical description of the pathol-
ogy of the case AID supplies the details Of
the brief outline published on the evening
after the examination. 1t does not change
any of the statements made in that bulle-
tin, however, lexcept in one unimportant
detail-the name of the ruptured artery.
The report is signed by Drs. Bliss, Barnes,
Woodward, Reyburn and Lamb. AS it
contains paragraphs detailing the observa
tions made at Washington on pathological
specimens preserved for that purpose, the
names of Drs. Hamilton, Agnew and Smith
are not appended to it, but it has been sub
mitted to them and they have given their
assent to the other portions of the report.
The record begins, after stating the
| methods of examination agreed upon, by
describing the external appearances OF the
body, the discolorations, sores and so forth
observed, and then relates minutely the
examination Of the abdomen. The import
ance of this record justifies full quotations,
| in spite of its technical language:
The Appearance OF the Abdomen.
On inspection of the abdominal viscera,
| in stu, the transverse colon was observed
| to lie little above the line Of the umbili-
Gus. 1t was firmly adherent to the an
terror edge of tho liver. The greater
| Omentum covered tho intestines pretty
| thoroughly from the transverse colon al
most to the pubs. 1t Was still quite fat
and was very much blackened by venOus
congestion. On both sides its lateral mar
gins were adhcrent to the abdominal
particles opposite the eleventh and twelfth
ribs. On the left side the adhesions were
numerous, firm. we'll organized and prob
ably old ; on the right side there were a
few similar adhesions and number of
more delicate and probably recent ones.
A mass Of black, coagulated blood COW
cred and concealed the spleen and the left
margin of the greater omentum. On rails
ing the Omentum, it was found that this
blood-mass extended through the left lum-
Der and lilac regions and dipped down in
to the pelvis, in which there was some
clottcd blood and rather more than pint
| ing been turned out and collected meas
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 abdominal cavity being now washed
out as thoroughly as possible, fruitless
| attempt was made to obtain some indica-
| tions of the position of tho bullet before
| making any further incisiOn. BY pushing
| the intenstines aside the extremity of the
catheter, which had been passed into the
wound, could be felt between the pcriton-
cum and the right lilac fascia but it had
evidently doubled upon itself, and al
though prolonged search was made moth
| ing could be seen or felt to indicate the
presence Of the bullet, either in that region
| or elsewhere.
The Organs Exs mined.
The abdominal viSccra were then care
fully removed from the body, placed in
| suitable vessels and examined seriatim,
with the following result:
The adhesion between the liver and the
| transverse colon proved to bound an ab.
scess caDay between the under surface of
the liver, the transverse colon, and the
transverse meso- o-cOlOn, which involved the
gall bladder, and extended to about the
| same distance on each side of it, measur-
ing six inches transvcrsely aud four inches
from before backward. This cavity was
lined by thick pyOgenic membrane which
completely replaced the capsule Of that
| part of the under surface of the liver oc.
| cupied by the abscess. 1t contained about
two ounces of greenish- yellow tluid-a
mixture of pus and hillary matter. This
abscess did not involve any portion of the
substance of the liver except the surface
with which it was in contact, and no CON-
munication could 6e detected between it
and any part of the wound.
Some recent pcritoneal adhesion existed
between tho upper surface of the right
lobe of the liver and the diaphragm. The
Nrer was larger than normal, weighing
| eighty-four ounces; its substance was
firm, but of pale, yellowish color on its
surface and throughout the interior Of the
organ, from fatty degeneration. No evi-
dencc that it had been penetrated by the
bullet could be found, nor were there any
assesses or infarctions in any part of its
| tissue.
The spleen, which was abnormally large,
was connected to the diaphragm by firm,
probably old peritoneal adhesions, it con-
| tanned no assesses or infarctions. There
were recent peritOncal adhesions between
the posterior wall of the stomach and the
posterior abdominal particles, but with
this exception no abnormities were discov
cred in the stomach or intestines, nor were
any other evidences Of general or local
peritonitis found.
Just beneath the capsule of the left kid.
ney, at about the middle of its convex
border, there was q little abscess one
third of an inch in diameter there We're
three small SerOus cysts on the convex
border of the right kidney just beneath its
capsule in other respects the tissue of
both kidneys was normal in appearance
and in texture.
The Track of the Bullet.
Behind the right kidney, after the re-
mOval Of that organ from the body, the
dilated track Of the bullet was desected into
1t was found that from the point at which
it had fractured tho right eleventh rib
(three inches aud 4 half to the right Of the
vertebral spines) the missile had gone to
tho left, obliquely forwards, passing
through the body of the first lumbar ver-
tebar, and lodging in the adipose connective
tissue Immediately below the lower border
ofthe pancreas, about two inches and a
half to the left of tho spinal column and
behind the peritOneum. 1t had become
complete encysted.
The track of the bullet between the
point at which it had fractured the eleventh
rib and that at which it entered the first
lumbar vertebra was considerably dilated,
and tho pus had burrowed downwards
through the adipose tissue behind the
right kidney. and thence had found it's
way between the peritoneum and the right
iliad fascia, making descending channel
which extended almost to the groin. The
adipose tissue behind the kidney in the
= ~.