The Indianapolis journal. [volume] (Indianapolis [Ind.]) 1867-1904, 1901-10-18
DIR. VI. ID. Mann's Operation Immedi-
ateIy After the President Was
Shot Down by the Assassin.
LITTLE NEW LIGHT ON CASE
GANGRENE PROBABLY WAS NOT DUE
TO BACTERIAL INFECTION.
Condition of the wounds and the Pam
creas as shown by the Autopsy
Bullets Not Poisoned.

NEW YORK. Oct. 1.-THE New York
Medical Journal for Saturday. Oct 10, will
contain the full official report Of the sur
geons who attended President Mckinley
in Buffalo. The report contains upwards
of fifteen thousand words and constitutes
the official record of the case. The re-
port is signed by Drs. p. NJ. Rixey, NJ. u.
Mann, Herman Mynter. Roswell Park,
Eugene Wasdn. Charles McBurney 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, patholoSist TO the
New York State pathological laboratory.
while the report of the meteorological eN-
animation bears the signature of DR.. Her
man G.. Matzinger. bacteriologist to the
New York State pathological laboratory.
The important feature of the report in
the New York Medical Journal is the
emphasis with which DR.. Matthew d.
Mann. speaking for his colleagues. declares
that there never under like circumstances
was a more harmonious and better-agreed
band of consultants," thus setting aside
the rumors of disagreement among the at
tending physicians and surgeons.
The report describes in detail the events
Immediately following the shooting which
are already familiar to the public. Then
follows a description of the operation in
all its technical mnutiae The utmost care
was used 10 prevent infection of the alb
dominal cavity and of the wound by the
most approved modern methods of surgical
cleanliness. The wounds in the stomach
were sutured with silk, using double rows
of stitches so arranged that the greatest
spots. The application of these stitches
was accompanied by great difficulties, es-
pecially the suturing of the opening in the
posterior wall of the stomach. The chief
trouble was the depth of the abdominal
cavity, the lack of instruments to draw the
edges of the wound apart during the sew
ing, and the lack of good light. In his
comments on the report of the operation,
DIR. Mann particularly emphasizes the dis
advantages under which he labored when
suturlnS the wounds in the stomach with
the failing light of a September after
noon Later on in the operation movable
electric light was used with advantage.
SEARCH FOR THE BULLET.
Speaking of the search for the bullet dur
ing the operation, the report says: ''The
operation on the stomach now being fin
ished, Dr. Mann introduced his arm so
as to palpate carefully all the deep struc-
lures behind the stomach. No trace of
the bullet or of the further track of the
bullet could be found. AS the introduc-
ton OF the hand in this way seemed to
have a bad influence on the Presidents s
pulse, prolonged search for further in
jury done by the bullet or for the bullet
itself was oeslsted FROM
l. urther search might have caused the
death of the Presiuent on the operating
table At the close of the operation the
surgeons present unanimously assured DR.
Mann In answer TO his questions, that they
We're perfectly satisfied that everything
that was possible had been done and that
they had no further suggestions TO make
1t was also decided not TO introduce any
gauZe or tubes into the abdomen for drain
age, as this was not necessary, but the
wound was not sewed up so tightly that
no drainage could take place naturally
The report then continues in the history
or the case after the operation. The prog
ress of the illness is given day by day and
the bulletins as given out by the physicians
are incorporated in the report.
on the NTH day, Sept. 10, took place the
much discussed removal of stitches from
the wound in the abdominal wall The
report says: In the evening the dressings
were examined, and, as there was consid-
cradle staining from the discharges it was
thought best to remove four stitches and
to separate the edges of the wound a
little slough was observed near the bullet
wide, the thickness of the flaps"
The remainder of the wound looked
healthy, and ii was thought that the in
fection was due to the bullet or TO a
piece of clothing which had been carried
into the wound at the time of the shoot
ing. The wound was then dressed and on
the following day the patients condition
was very much improved.
The findings a the autopsy. as well
as the developments of the case during
the last days. exclude all possibility Of ab
stomach hX-
giving of solid food. as was alleged ar
the time when unfavorable symptoms cane
on after change to solid diet. ON the f;fth
day the President slipped hot wafer. on
the sixth he had beef Juice the first food
taken by mouth since the operation. In
the meantime nutritive enemas were con
tinued, but were not well retained A.
$50 In the morning of the seventh ds,.
he was allowed chicken broth. very small
piece or toast and small cup of coffee
He did not care for the toast and ato
scarcely any of it The wound had in tbe
meantime been doing very well, and had
been dressed daily after the removal %
the stitches and the sloughing tissue Tbe
President seemed at his best. and a favor
able result was now confidently predictad
of Inflammation of the perit6neHImri 7rioF PP
only alarming symptom was his ranid
pulse. but as the President had naturaIiy,
OF fairly good quality right along. the sI,rl
geons did not attribute very great imnor-
tance TO this sign.
THE LAST DAY.
On the seventh day towards noon the
pulse began To grow weaker and grew
rapidly worse. Simulants were given and
the food was discontinued. while castor oil
and an enema Of OK gall were given IN
move the bowels At midnight there was
some Improvement in the pulse after an in
lection OF salt solution into the subcutan-
eo.s tissues. On the eighth day the condi-
ton Of the President was described as very
serious. as he did not respond TO stinnuIa-
ton. StimuIants and !uisctions of salt