The evening times. [volume] (Washington, D.C.) 1895-1902, 1901-10-18
Mr.. M'KINLEY'S CASE.
The Surgeons in Attendance Publish
Full Report

| The report contains upward of 1890
] words. and is signed by Drs- =. NJ Rixey,
| Matthew d. Mann. Herman Mynter, Ros-
/ wei Park, Eugene Wasdin, Charles Nc
( Burney. and Charles G. stockton. as
members OF the medical staff attending
| the late President.
The report Of the autopsy is signed by
DR.. Harvey r. Gaylord pathologist to the
| New York State Pathological Laboratory,
| while the report on the archaeological yN-
animation bears the signature of Dr. Her
man @. Matzinger bacterioioEist to the
! New York State Pathological Laboratory.
The important feature Of the report is
| the emphasis with which DR.. Matthew D.
| Mann, speaking for his colleagues. de
| clares that never under like circum-
stances was there more harmonious and
| better agreed band OF consultants. thus
setting aside an -rumors Of disagreement
among attending physicians and surgeons
In his comments on the report OF the
operation, Dr. Mann particularly empha-
/ sizes the disadvantages under which h.
labored when suturIng the wounds in the
/ stomach. with the falling light Of a Sep
TENDER afternoon. Later on IN the opera
ton movable electric light was used
with advantage.
Speaking Of the search for the bullet
| dUring the operation. the report says
| The OPERATION on the stomach now being
| finished. DR. Mann introduced his arm so
as 20 paIate carefully all the deep struc-
! lures be md the stomach No trace Of
the bulle.. or Of the further track Of the
bullet could be found. As the inr0duc-
ton Of the hand in this way seemed TO
have a bad influence on the Presidents
pulse prolonged search for further In
. "a
| 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
Or. Mann, in answer to his questions.
that they were perfectly satisfied jhat
everything that was possible had been
done. and that they had no further suE-
grstions to maxi
The findings at the autopsy, as well as
the developments Of the case during the
last days exclude all possibility Of abb
solute injury to the stomach By prcma-
tuTe giving Of solid food. as was alleged
at the time, when uufavOrable symptoms
came on afte~ change 10 solid diet
On the NTH day the President slipped
hot water. on the sixth day n had beef
juice the FIRST food taken by mouth since
the operation In the meanwhile uutTiLiv-
. ent'nas were continued. but were not
wei retained At SO ia The morning Of
the seventh day he was allowed chicken
/ nrOih. very small piece Of toast, and q
Sudu cup Of coffee He did not care for
me toast and ate scarcely any of it.
The wound had in the meanwhile been
. epluS very well and had been dressed
-ally after the removal of the stitches
and the sl0ughiug tissue. The President
seemed at his best and a favorable result
was now spIuCcLtly predicted. There was
no sign of blood poisoning or OF iuriau-
nation of the peritOueum. The only alarm
ing - mplOm was his rapid pulse bur as
the President naturally had "a rather ran
III pulse. and as il had been a fairly good
quality right along. the surgeons dil not
attribute very great Importance 10 this
on thc seventh day, toward noon. the
pulse began TO grow weaker and grew
rapidly worse. Stimulauts were given and
the food discontinued, while castor oil and
an enema Of oXgaIl were given 10 move
the. bowels. At midnight there was an
Improvement in the pulse, after an injec-
ton OF salt solution into the subcutaue-
Gus tissues.
on the eighth day the condition Of the
President was described as very serious,
as he did not respond to stimulation
SumulantS ana injections Of salt S0iu-
ton, coffee, and broth We're given. but
without much effect At . o'clock oxygen
was given and continued Tor some hours.
At 6-50 the President was restless. al 10
p m he lost Consciousness -Hnd COuuH-
ued 70 sink until he died at -.I5 a. m. Or
September j.
In speaking OF the criticism that Rocnt-
gen rays should have been used 10 locate
the bullet, DIT Mana says IN his report
We were often asked why. after the
operation. We did not use the &-r1y 10
md the bullet. In tn nrst place, there
were al 40 time any signs that the bullet
was doing harm To have used the N-ray
simply To- have satisfied uCr curiosity
would not have been NarrauUoDle, as iC
would have greatly disturbed and annoy
I'd the patient. and would have subjected
Eim 10 certain risk Had there bee
s. gls OF aISr.~s formation then the X
Ia -s could and would nave been used"
DR.. Gaylord s. report OF the autopsy Is
lengthy and detailed. Nothing Of import
ance was noticed about the wound on the
chest caused by Tho first shot, except that
the area OF skin affected was found 10
De- diScOlored. greeuiSb yellow and mot
Isd, and that there was "a htu3Thas-
into the fat under the skin beneath this
The abdominal wound showed no evil
GeECes Of necrosis or sioughilg SO il-
uammatioE OF The peritcIslm was found
The wound I'm the front wall Of the Stum-
aCh was found held intact by silk sI-
lures" but the area Of stomach wall
around it was Gisc0lured Sruyish green,
and easily torn The AREA around the
wound on the pOsttrior wall of the stam-
ach was also dun grey color. but tie
suturss held the wound intact
Behind the latter wound there was
spot Of disc Dlnration which showed THAI
the slouGhIng process had gone backward
in the track of the bullet. The gaugTcu-
Gus cavity found behind the stomach In
VOWED The Daucreas and the surrounding
loose tissues. the bottom OF the blind
pocket being formed boy the upper end of
the left kidney. which was found 20 be-
lacsrated AT that point 10 the extent Of
ab0u, two ccntimctres-
The track of the bullet was then traced
through gangrenous tissue m the fat be
hind the kidney o. the muscles Of the
back wall Of the abdomen. the direction
Of the bullet. however could not boz trac-
rd any further The search for the bull
let was most thorough ana uaiustakiug-
but g. spite Of AN efforts it could not be
found and the autopsy had 90 be- di-cDu-
tined, because the time allotted by the
family of The late President had already
been exceeded
Dr. Gaylord adds As We were satisfied
that uOt hing could De- gained by locating
tho bullet, which had set zap no reaction
search for 10 was discontinued
"EEamiuati0H Of tho heart muscle
showed that il was affected with wei
marked fatty degeneration and I'm some
places the muscle uhTns showed gT.F-..-
Of dark brown graDTIeE. GtWuuSTratiug
diseased cond ton on tn cardiac muscle
DIT GAYLORD believes that the repair 90
tho stomach wounds had been effective
and that the gaUgrHn. around those
wounds does not seem % Rave been the
result Of any wsll-dehu'd cause. He at
tributes the gaugrruDUS con .rfru of rH.
parts. The appearance of the g1usreuous
tissues shows that the rruz-reue took
place shortly before death
In speaking OF the CausaTiou Of the cav
lily behind the stomach. he saws 10 must
Doe largely attributed 10 the action Of the
missile. II may have resulted from the
rotation Of q nearly spent ball or from
the simple conclusion Of the bullet as il
passed into the soft tissues
The injury to- the paUcreas producing a
Il ID 1rf.