Evening times-Republican. [volume] (Marshalltown, Iowa) 1890-1923, 1901-10-18
OFFICIAL REPORT AlIE
Medical Journal Publishes the
Doctors Report on the CaseD
Of Mckinley.
The Operation Fully and Com
pletely Described For the
First Time.
Everything Possible Done to
Save the Life Of the
Patient.

pAthOlOglcal LABORATORY, WPlle tne reIsoTl
OF the archaeological examination bears
the signature of DR.. Herman G. Hat
Finger bacteriologist 10 the New York
state meteorological laboratory.
The important feature of the report In
the New York Medical Journal is the
emphasis with which DR.. Matthew ID.
Mann, speaking for his colleagues, de-
cares that there never under like cir
cumstances was a more harmonious and
better agreed band OF consultants." thus
setting aside the rumors of Disagree
ment among the attending physicians
and surgeons.
The report describes in detail the
events Immediately following the shoot
ing. which are already familiar to the
spublic. Then follows q description OF
the operation in all its technical minu-
tiap. The utmost care was used to pre-,
vent infection Of the abdominal cavity
and of the wound, by the most approved
modern methods of surgical cleanliness.
The wounds in the stomach were SUI
tered with silk, using double rows OIL
stitches SO arranged that the greatest
possible security was given to the su-
'tnred spots. The application OF these
stitches were accompanied by great dit-
f,clrfties. especially the suturing OF the
rnening in the posterior wall OF the
stomach. The chief trouble was the
.deptl, OF the abdominal cavity, the lack
nf instruments to draw the edges OF the
wound apart during the sewing, ana the
Ioek OF good light. In his comments on
.he report OF the operation DR.. Mann
,narticularly emphasizes the disndvan-
tares under which he labored when SUI
curing the wounds in the stomach. With
the falling light of q September AFTER
noon. Later on In the operation q NOV
able electric light was used with laoSaH-
tage. Speaking OF the search sor the
bullet during the operation, the report
says:
.The operation on the stomach now
hAine a s,isi,nd, DIR Mann introduced his
arm so as to; 'palpate carefully all the
deep structures behind the stomach. No
trace of the bullet. or OF the further
track of the bullet, could be found. As
the introduction of the hand III this way
seemed to have bad influence on the
pulse, prolonged search for
further Injury done by the bullet, or for
the bullet itself, was desisted from.
Further search might have caused the
death of the patient upon the operating
table. AT the close of the operation the
surgeons present unanimously assured
DIR. Mann, in answer to questions, that
they were perfectly satisfied that every
thing that was possible had been done,
and that they had no further sugges-
lions to make. 1t was also decided not
tic introduce any gauze or tubes into the
abdomen for drainage, as this was not
up too tightly that no drainage could
take. place naturally.
The report then continues In the his
tory of the case after the operation. The
progress OF the illness is given day by
day and the bulletins as given out by
the attending physicians are incorpo-
rated in the report.
On the fifth day, September 10, took
place the much discussed removal of
stitches from the wound in the abdc-
nlinal wall. The report says. "In thu
evening the dressings We're examined,
and, as there was considerable. staining
from the discharges, 1t was thought
best to remove four stitches and separ
ate the edge Of the wound. A little
slough was observed near the bulle.
track, covering a space nearly an inch
wide, the thickness of the flaps. The
seemed to extend down to
the muscle"
The remainder OF the wourld looked
healthy, and it was thought that the in
lection was due to the bullet or to u
piece of clothing which had been car
Of IA.
shooting. The wound was then dressed.
and on the following day, the patients
condition was very much improved.
The findings at the autopsy, as we'll
as the developments of the case during
the last few days. excluded all possibil-
ity of absolute injury to the stomach by
premature giving of solid food as was
alleged at the time when unfayorable
came on after change to SOL
i'd diet. On the fifth day the president
slipped hot water, on the sixth he had
beef juice, the first food taken by mouth
since the operation In the meantime
nutritive enemas were continued. but
were not well retained. AT $3.50 in the
of the seventh day, he was al
lowed chicken broth, very small piece
of toast and small cup OF coffee. He
did not care for the toast and ate
scarcely any of 1T. The wound had in
the meanwhile been doing very we'll and
had been dressed daily after the remoy-
al of the stitches and the sloughing tis-
sue. The president seemed at his best,
and a favorable result was now conf
IDENTIFY predicted. There was no sign OF
blood poisoning or of Inflammation of
the peritonenum The only alarming
symptom was liis rapid pulse, but as the
president had naturally rather rapid
pulse, and as 1t had been OF a fairly
good quality right along, the surgeons
did not attribute very great Importance
to this sign. On the seventh day, to-
wards noon. the pulse began to grow
weaker, and he grew rapidly. worse
Stimulants were given and the food
was discontinued, while castor oil and
an enema OF oxgall We're given to move
the bowels At midnight there was
some Improvement in the pulse, after
an injection Of salt solution into the sub