New-York tribune., 1901-10-27
TREATMENT OF MKINLEY.
DIR. RIXEYs REPORT TO THE SURGEON
GENERAL OF THE NAVY.
CAUSE OF DEATH GIVEN AS GANGRENE OF
THE STOMACH AND PANcREAs-cASE
REVIEWED IN MINUTE DETAIL.


Washington, Oct. 2s-"In the line OF duty, while
receiving the people. was shot by Leon r t"Oi-
gosz" IS the official statement fled with the sur
geon General of the navy by Dr. Presley NJ RiNey'
medical inspector United States Navy, as the lhtro
duction for his report the wounding illness ana
death Of President Mckinley. The cause OF "e"lN
is thus stated: "Gangrene OF both walls ot S'oih
ach and pancreas. following gunshot wouha'
The report Is remarkable for its exhibition In the
closest possible detail OF the exact state OF the
patient during his mortal illness 1t Is almost II.
the shape of a ships log showing at intervals OF
a few minutes sometimes a single minute ra'elE
more than an hour the patients progress toward
the end. But perhaps the most valuable part from
a medical point OF view is the accurate regls'eflhe
Of the medication Of the case. Not single ihorsei
OF food nor a dose Of medicine nor bA Is omit
ted Included in the running story at the proper
intervals are the bulletins which were given to the
public.
The report begins with an account Of the first
operation at the Emergency Hospital on Septem-
Der s. the two wounds being described exactly as
they have been treated in the preceding medical
reports Or. RiXey, saving that all the physicians
present agreed 10 immediate laparotomy' makes
his first entry at $50 p m when DR. Mann mace
a vertical incsion passing through the wound, ana
found at the very beginning piece OF cloth carried
in by the bullet Eight minutes later strychnine
was administered hypodermically. Some time after
that brandy was administered in the same man
ner and then morphine likewise was given This
same application became necessary five minutes
after the patient arrived at the Miburn mousse me
result being an improved pulse. but slight nausea
The first bulletin issued the public was dated az
D. m. II described the character Of the wound
and the general outline of the operation, ana spoke
Of the condition of the patient as gratifying ana
sustifyinR hopes Of recovery. The next entry. at
s43 declares that he rested quietly for eight MN
utes but at 9:l5 vomited small quantity OF partly
digested foot and blood clot. Vomiting also fol-
lowed at $40 At 1o40 the bulletin was Issued
saving that the President rallying satisfac-
tahl. u m
were occasional twinges of pain and slight disco-
oration Of dressings At midnight saline enema
was retained At ] a. the bulletin described the
President free from pain and resting well
The notes follow at intervals OF less than an
hour until 4:55 a m the second day, September I.
Tho patient sleeping. but at the latter hour a
large amount OF was expelled. and at 6:oo a. m
the entry reads. PAIN on deep inspiration"
At $50 O'Clock the patient is said TO be restless
after retaining pint of saline enema. At
a. m the official bulletin announced The Presi-
dent has passed good night" Fifteen minutes
later injection Of morphine was given, and al
a m IL announced that the President had
passed a fairly comfortable night and no serious
symptoms had developed At on the second
day morphine was administered hypoder-
Tnically, at lI5 O'Clock there was saline enema
and 4:30 there hypodermic injection OF
digitalis the patient passing much gas by the
mouth The first alcohol bath was given al $50 OF
this day while the patient sleeping. but pass
ing gas by the mouth. At $50 the patient COM
plained of intense pain in the pit Of the stomach.
A hypodermic injection OF morphine was given 10
him No pain. but restless. Sponged with alcohol
and rested quietly for half an hour The official
bulletin announced change for the worse Al
r:40 y. m. digitalis administered hypoder-
mically. and the bulletin $50 declared that the
conditions continued much the same, the President
responding well 10 medication. He had fifteen
minutes quiet sleep. when saline enema, with
somatoz was administered. part OF which was re-
Jected. Then there was another hypodermic injec-
OF digitals 1870 and fifteen minutes later
of morphia. the patient being very restless.
The third day. September S, began with the entry
at 1890 Restless during sleep Limbs sponged
with alcohol. Quiet and slept from 10 ; o'clock
The $40 a. m. bulletin said the President had
passed fairly good night. At $3.50 there was an
other enema OF salt and somatoz From 10 4:30
the patient said 10 be confused and very rest
less" At 3 a. m Complains Of feeling chilly, but
IL passed in moment" The patient was restless
and talkative from TO a. m. expelling brown
fluid and gas There are frequent entries Of these
quotations and before o'clock there were two
hypodermic injections Of morphia and digitalis.
hypodermic injection Of strychnine was followed at
1890 p. m. by saline enema with somatoZ, which
was not retained and alcohol rub At AS p. m.
the patient was restless and taikauEe alu % . TOT e
first time water was given to him by the mouth
brought away some slightly colored fluid and
very a'6e ~ asr gSu5 from , + bowels and The patient
was set down very restless" At $50 a great
0eS on q tbe ea fourth dav september the patient is
recorded as Restless from to 20 O'Clock At
disturbed codea phos was administered hypo::
dermically After an hours sleep the record
The patient drank water frequently in small guam
titles At go the bulletin issued, The Presi-
dents condition is becoming more and more salts
factory" etc. At 10 O'Clock this morning the doc
tors began administer hourly doses of calomel.
Meanwhile. following a nutritive enema Of egg
with soap. water and OK gall, which brought
away a copious discharge with gas. AZ p m The
improves, and ne is comfortable without pain or
unfavorable symptoms Bowel ana kinney f9hc-
tions normally performed" etc At 40 OF this day,
following a dressing Of the wound OF about an
Ho: water given $50. and half an hour later
the patient complained OF nausea
The fifth day. September 10. began at l:s6 a. m,
after a short sleep, with this entry II ncomforta-
bic. turning frequently" There are three entries
OF sleeping, and then the $40 bulletin saying
that the President had passed the most comforta-
bic night since the attempt on his life The a. m
complications. The bulletin 1890 said the Presi
dents condition was unchanged and descrlned the
removal OF the stitches and the cause therefor.
The sixth days treatment was marked by the ad-
beef juice which the note says tastea Sood
There seven administrations OF this beef
Juice between midnight and o'clock the next
morning. The patient complained Of feeling chilly.
but is recorded as sleeping more than usual, and
fortabiy and his condition was excellent. The pa
tient complained OF headache at 2l5 and cam
phor was applied TO the head. The bulletin at 3:O
said that the President continued 10 gain, and the
wound was becoming healthy.
OF beef Juice, and the diet varied this time dhe
patient complaining OF pain In the abdomen by
D m dieitaIis and strychnne having been in
5ected approximately in the mean time. the pa
The entry reads: did not relish II and ate very
little. Queter and more cheerful since having
ing and restless" Calomel. whiskey and water
and digitalis were again administered. The skin
was moist and cold and the $50 bulletin reported
that the Presidents condition was not quite so
lnpla hrSz- - nd Gold