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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",
    "ocrSource": "nara-archive"
}

{
    "seq": 14,
    "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_011.jpg",
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    "ocrText": "520 AMERICAN JOURNAL OF THE MEDICAL SCIENCES.\nCASE OF PRESIDENT MCKINLEY.\n521\ngastric wall is exposed. On the posterior wall, a distance of 2 cm. from the\nwhich were removed, including the intestine, were likewise examined and\nline of omental attachment, is a wound approximately 2 cm. long, held\npalpated, without result.\nintact by silk sutures. The gastric wall surrounding this wound is dis-\nThe great amount of fat in the abdominal cavity and surrounding the\ncolored. On the surface of the mesocolon, which is posterior to the gastric\nkidney rendered the search extremely difficult.\nwall at this point, is a corresponding area of discoloration, the portion com-\nThe right kidney is embedded in a dense mass of fat; capsule strips freely;\ning directly in contact with the wound in the gastric wall being of dull gray\nit weighs 5 ounces; measures 11.5 cm.; substance is soft; cortex is 6 mm.\ncolor. The remainder of the surface of the posterior wall of the stomach is\nin thickness; rose-red in color; cut surface slightly dulled. There are a\nsmooth and shiny. Beyond the surgical wound in the posterior wall of the\nfew depressions of the surface, and the stellate veins are prominent.\nstomach is found an opening in the retroperitoneal fat large enough to admit\nThe liver is dark red in color; the gall-bladder distended. The organ was\ntwo fingers. This opening communicates with a track which extends down-\nnot removed.\nward and backward as far as the finger can reach. The tissues surrounding\nThe autopsy continued for a longer period than was anticipated by\nthis track are necrotic. On removing the descending portion of the colon a\nlarge, irregular cavity is exposed, the walls of which are covered with gray,\nthose who had charge of the President's body, and we were requested\nslimy material, and in which are found fragments of necrotic tissue. Just\nto desist seeking for the bullet, and terminate the autopsy. As we were\nat the superior margin of the kidney is located a definite opening, which\nsatisfied that nothing could be gained by locating the bullet, which had\nforms the bottom of the track traced from the stomach. On stripping the\napparently set up no reaction, search for it was discontinued.\nleft kidney from its capsule it is found that the superior portion of the cap-\nAnatomical Diagnosis. Gunshot wound of both walls of the stomach and the\nsule is continuous with the cavity. The weight of the left kidney is 5 OZ.,\nsuperior aspect of the left kidney extensive necrosis of the substance of the\n1 g. The kidney is readily stripped from its capsule; is dark red; the stel-\npancreas; necrosis of the gastric wall in the neighborhood of both wounds;\nlate veins are prominent, and along its greater curvature are numerous dark\nfatty degeneration, infiltration, and brown atrophy of the heart muscle;\nred depressions. On the superior aspect of the kidney is a protrusion of the\nslight cloudy swelling of the epithelium of the kidneys.\ncortex, dark red in color, and in this protrusion is a laceration, 2 cm. long,\nA matter of no inconsiderable embarrassment to us arose in the objection\nextending across the superior border, approximately at right angles to the\nto our removing sufficient portions of the tissues for examination. We were\nperiphery of the kidney and from before backward. On incising the kidney\nable to secure only two small fragments of the stomach wall; tissue from\nthe cortex and medulla are not easily distinguishable from one another;\naround the wound upon the chest wall ; a portion of fat from the wall of the\nboth are of rose-red color, the cortex measuring approximately 6 mm. in\nnecrotic cavity; a small piece of each kidney, that of the left kidney including\nthickness. The vessels in the pyramids of Ferrein are very prominent.\nthe portion involved by the original wound; and pieces of heart muscle from\nBeneath the protruding portion of the surface the cortex is dark red in\nthe right and left ventricles. The microscopical examination of these tissues\ncolor. This discoloration extends downward in pyramidal form into the\nfollows:\nmedulla. The laceration of the surface marks the apex of the protrusion\nThe piece of retroperitoneal fat, where it forms part of the necrotic cavity,\nof the kidney substance. Between the spleen and the superior aspect of the\nis seen on section to be covered with a thick gray deposit, which has an\nkidney is a necrotic tract which extends down and backward and ends in a\naverage thickness of from 4 mm. to 6 mm. Beneath this, and separating it\nblind pocket. The tract which included the superior aspect of the kidney\nfrom the fat, is a well-defined area of hemorrhage, from 1 mm. to 2 mm. in\ncan be traced into the perinephritic fat to a point just above the surface of\nthickness. The appearance of this piece of tissue is characteristic of the fat\nthe muscles of the back.\ntissue surrounding the entire cavity. A section made perpendicular to the\nThe necrotic cavity which connects the wound on the posterior wall of the\nsurface, and stained with heematoxylin-eosin, shows the following charac-\nstomach and the opening adjacent to the kidney capsule is walled off by the\nteristics: Under low power there is no evidence of round-celled infiltration\nmesocolon, and is found to involve an area of the pancreas, approximately\nbetween the fat cells or of fat necroses. The surface of the tissue, which in\n45 mm. in diameter, and extending about half through the organ. This\nthe microscopical specimen was covered by a layer of grayish material, proves,\norgan, at its centre, forms part of the necrotic cavity. Through its body\nunder low power, to consist of a partly organized fibrinous deposit. At the\nare found numerous minute hemorrhages and areas of gray softening, the\nbase of this deposit is evidence of an extensive hemorrhage, marked by\nsize of a pea or smaller. These are less frequent in the head portion of the\ndeposits of pigment. The surface of the membrane is of rough and irreg-\npancreas.\nular appearance, and contains a large number of round cells, with deeply\nA careful examination of the track leading down toward the dorsal muscles\nstained nuclei. Under high power the organization of the membrane may\nfails to reveal the presence of any foreign body. After passing into the fat\nbe traced from the base toward the surface. The portion immediately adja-\nthe direct character of the track ceases, and its direction can be traced no\ncent to the fat tissue consists of a network of fibrin inclosing large numbers\nfurther. The adjoining fat and the muscles of the back were carefully\nof partly preserved red blood-corpuscles. In many areas the red blood-\npalpated and incised without disclosing a wound or the presence of a foreign\ncorpuscles are broken down, and extensive deposits of pigment are found.\nbody. The diaphragm was carefully dissected away, and the posterior por-\nExtending into the fibrin structure of the membrane are numerous typical\ntion of the thoracic wall likewise carefully examined. All fat and organs\nfibroblasts and round cells. In some regions pigment is evidently deposited\nin the bodies of large branching and spindle cells. Here and there, included"
}