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{
    "localId": "7268611",
    "label": "Official Report of the Case of President William McKinley",
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    "citationUrl": "https://catalog.archives.gov/id/7268611"
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    "id": "7268611",
    "sourceUrl": "https://catalog.archives.gov/id/7268611",
    "contentType": "document",
    "title": "Official Report of the Case of President William McKinley",
    "description": "This excerpt from the American Journal of the Medical Sciences gives an account of the shooting, operation, treatment, and autopsy of President William McKinley from the physicians that treated the President.",
    "citationUrl": "https://catalog.archives.gov/id/7268611",
    "collections": [
        "Papers of Ethan Allen Hitchcock",
        "Communications with the Executive Department"
    ],
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{
    "url": "https://catalog.archives.gov/id/7268611",
    "naId": 7268611,
    "levelOfDescription": "item",
    "productionDates": [
        {
            "day": 19,
            "logicalDate": "1901-10-19",
            "month": 10,
            "year": 1901
        }
    ],
    "recordType": "description",
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{
    "seq": 13,
    "pageIndex": 0,
    "type": "photo",
    "url": "https://s3.amazonaws.com/NARAprodstorage/opastorage/live/11/2686/7268611/content/arcmedia/dc-metro/HITCH/ud-8300-b/Box-1/6850595/HD1-129497211_2010_010.jpg",
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    "ocrText": "518\nAMERICAN JOURNAL OF THE MEDICAL SCIENCES.\nCASE OF PRESIDENT MC KINLEY\n519\ncrust formation covering it, 5.5 cm. from the suprasternal notch; from the\nan incision through the subcutaneous fat, directly through the wound upon\nright nipple, 10 cm.; from the line of the right nipple, 8.25 cm. Surround-\nthe chest, a small cavity is exposed, about the size of a pea, just beneath\ning this spot, at which point there is an evident dissolution of the continuity\nthe skin, which is filled with fluid blood. The subcutaneous tissue underly-\nof the skin, is a discolored area of oval shape extending upward and to the\ning the area of discoloration on the surface of the chest wall shows hemor-\nright. In its greatest length it is 11 cm., and in its greatest width 6 cm.\nrhagic infiltration.\nIt extends upward in the direction of the right shoulder. The skin within\nOn removing the sternum the lungs are exposed, and do not extend far\nthis area is discolored, greenish-yellow, and mottled.\nforward. A large amount of pericardial fat is exposed. Pleural surface\nThe surface of the abdomen is covered with a surgical dressing, which\non both sides is smooth. There are no adhesions on either side within the\nextends down to the umbilicus and upward to just below the nipples. The\npleural cavities. The diaphragm on the right side extends upward to a\ninnermost layer of cotton is covered or stained with balsam of Peru and\npoint opposite the third rib in the mammary line. No perceptible amount\nblood. On removing this dressing, a wound, parallel to and somewhat to\nof fluid in either pleural cavity. On opening the pericardial cavity the sur-\nthe left of the median line, is exposed, inserted in which are two layers of\nface of the pericardium is found to be smooth and pale. The pericardium\ngauze, likewise impregnated with balsam of Peru. The wound is 14.5 cm.\ncontains approximately 6 c.c. of straw-colored, slightly turbid fluid. (Some\nin length, and is open down to the abdominal muscles. The layer of abdom-\ntaken for examination.)\ninal fat is 3.75 cm. in thickness. The appearance of the fat is good, a bright\nOn exposing the heart it is found covered with a well-developed panniculus.\nyellow in color. No evidence of necrosis or sloughing. In the left margin\nThe heart measures, from the base to the apex on the superficial aspect, 10.5\nof the surgical wound, lying 1 cm. to the right of a line drawn from the\ncm. The right ventricle is apparently empty. The heart feels soft and\numbilicus to the left nipple, 15.5 cm. from the nipple and 16.5 cm. from\nflaccid. On opening the left ventricle a small amount of dark red blood\nthe umbilicus, is a partly healed indentation of the skin, and an excavation\nis found. The muscle of the left ventricular wall is 1.5 cm. in thickness ;\nof the fat immediately beneath it (this is the site of the entry of the bullet),\ndark reddish-brown in color; presents a shiny surface. The average thick-\nextending down to the peritoneal surface. On making the median incision,\nness of the pericardial fat is 3.5 mm. (Cultures made from the auricle.)\nstarting from the suprasternal notch and extending to a point just below the\nThe left auricle contains but a small amount of dark, currant-colored blood.\nsymphysis, the subcutaneous fat is exposed, which is of bright yellow color\nThe mitral valve admits three fingers. The right ventricle, when incised in\nand normal in appearance, except in an area which corresponds superficially\nthe anterior line, is found to be extremely soft; the muscular structure is\nto the area of discoloration described as surrounding the wound upon the\n2 mm. in thickness. The panniculus measures 7 mm. The muscle is dark\nchest wall. This area marks the site of a hemorrhage into the subcutaneous\nred in color, very shiny, and the pericardial fat invades the muscular wall\nfat. The remainder of the subcutaneous fat is firm, and measures 4.75 cm.\nat many points.\nin thickness on the abdominal wall. On opening the sheath of the right\nOn opening the right auricle it is found to be filled and distended by a\nrectus muscle it was seen to be of dark red color. (Culture taken from\nlarge currant-colored clot, which extends into the vessels. The tricuspid\necchymotic tissue under the upper bullet hole and from between the folds\norifice admits readily three fingers. The coronary arteries are patulous and\nof the small intestine. Three tubes from each locality on agar and gelatin.)\nsoft; no evidence of thickening.\nOn opening the abdominal cavity the parietal surface of the peritoneum\nLungs are gray color, and contain a moderate amount of coal-dust pig-\nis exposed, and is found to be covered with a slight amount of bloody fluid\nment. Slight amount of frothy fluid escapes from the bronchi; but the\nis perfectly smooth and not injected. The great omentum extends down-\npulmonary tissue is crepitant and free from exudate.\nward to a point midway between the umbilicus and the symphysis. It is\nOn unfolding the folds of intestine there is no evidence of adhesion until\nthick, firm; its inferior border is discolored by coming in contact with the\na point just beneath the mesocolon is reached, when, on removing a fold of\nintestines. Below the umbilicus a few folds of intestine are exposed.\nsmall intestine, a few spoonfuls of greenish-gray thick fluid flows into the\nThese are likewise covered with discolored blood, after the removal of\nperitoneal cavity.\nwhich the peritoneal surface is found to be shiny. On the inner aspect of\nOn the anterior gastric wall is an area to which a fold of the gastrocolic\nthe abdominal wound the omentum is found to be slightly adherent to the\nomentum is lightly adherent. On breaking the adhesion there is found a\nparietal peritoneum, and can be readily separated with the hand from the\nwound about midway between the gastric orifices, 3.5 cm. in length, parallel\nedge of the wound. At this point the omentum is somewhat injected. This\nwith the greater curvature of the stomach, 1.5 cm. from the line of omental\nadhesion to the omentum is found to extend entirely around the abdominal\nattachment. This wound is held intact by silk sutures. There is no evidence\nwound. The parietal peritoneum immediately adjacent to the inner aspect\nof adhesion at any other point on the anterior wall. The gastric wall sur-\nof the abdominal wound is ecchymotic.\nrounding the wound just mentioned for a distance of 2 cm. to 3 cm. is dis-\nOn removing the subeutaneous fat and muscles from the thoracic wall, the\ncolored, dark greenish-gray in appearance, and easily torn. On exposing\npoint which marks the dissolution of continuity of the skin upon the surface\nthe posterior wall of the stomach from above, along its greater curvature,\nis found to lie directly over the margin of the sternum and to the right side\nthe omentum is found to be slightly adherent, a line of silk ligatures along\nbetween the second and third ribs. There is no evidence of ecchymosis or\nthe greater curvature of the stomach marking the site where the omentum\ninjury to the tissues or muscles beneath the subcutaneous fat. On making\nhad been removed. On throwing the omentum downward the posterior"
}