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{
    "localId": "7268611",
    "label": "Official Report of the Case of President William McKinley",
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    "id": "7268611",
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    "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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    "naId": 7268611,
    "levelOfDescription": "item",
    "productionDates": [
        {
            "day": 19,
            "logicalDate": "1901-10-19",
            "month": 10,
            "year": 1901
        }
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{
    "seq": 10,
    "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_013.jpg",
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    "ocrText": "524 AMERICAN JOURNAL OF THE MEDICAL SCIENCES.\nCASE OF PRESIDENT MCKINLEY\n525\ntion of the epithelium from the margins. Stains for bacteria give negative\nlesions of this organ. One experiment of this nature reported by\nresults.\nFlexner (Journal of Experimental Medicine, vol. ii.) is of interest.\nIn summing up the macroscopical and microscopical findings of the\nThe fact that concussion and slight injuries of the pancreas may be a\nautopsy the following may be stated The original injuries to the\nfactor in the development of necrosis is indicated by the researches of\nstomach wall had been repaired by sutures, and this repair seems to have\nChiari (Zeitschrift fur Heilkunde, 1896, vol. xvii., and Prager med.\nbeen effective. The stitches were in place, and the openings in the\nWochenschr., 1900, No. 14), who has observed (although a comparatively\nstomach wall effectually closed. Firm adhesions were formed both upon\nrare condition) extensive areas of softening and necrosis of the pancreas,\nthe anterior and posterior walls of the stomach, which reinforced these\nespecially of the posterior central portion which lies directly over the\nsutures. The necroses surrounding the wounds in the stomach do not\nbodies of the vertebra, where the organ is most exposed to pressure or\nseem to be the result of any well-defined cause. It is highly probable\nthe effects of concussion. The wound in the kidney is of slight impor-\nthat they were practically terminal in their nature, and that the condition\ntance, except as indicating the direction taken by the missile. The\ndeveloped as a result of lowered vitality. In this connection there is no\nchanges in the heart, as shown by the macroscopical inspection and the\nevidence to indicate that the removal of the omentum from the greater\nmicroscopical examination, indicate that the condition of this organ was\ncurvature and the close proximity of both of these wounds to this point\nan important factor. The extensive brown atrophy and diffuse fatty\nhad any effect in bringing about the necrosis of the gastric wall, although\ndegeneration of the muscle, but especially the extent to which the peri-\ncirculatory disturbances may have been a factor. The fact that the\ncardial fat had invaded the atrophic muscle fibres of the right ventricular\nnecrotic tissue had not been affected by digestion strongly indicates that\nwall, sufficiently explain the rapid pulse and lack of response of this\nthe necrosis was developed but shortly before death. The excavation\norgan to stimulation during life.\nin the fat behind the stomach must be largely attributed to the action\nof the missile. This may have been the result of unusual rotation of a\nnearly spent ball, or the result of simple concussion from the ball passing\nREPORT ON THE BACTERIOLOGICAL EXAMINATION. By HERMAN\ninto a mass of soft tissues. Such effects are not unknown. The fact\nG. MATZINGER, M.D.,\nthat the ball grazed the superior aspect of the left kidney, shown by the\nBacteriologist to the New York State Pathological Laboratory.\nmicroscopical investigation of that organ, indicates the direction of the\nIt is obvious that the short space of time which has elapsed since the\nmissile, which passed in a line from the inferior border of the stomach\ndeath of the President has hardly been sufficient to prepare a complete\nto the tract in the fat immediately superior to the kidney. There was\nand thorough bacteriological report. This report contains all the obser-\nevidence that the left adrenal gland was injured.\nvations which have been made up to this time.\nThe injury to the pancreas must be attributed to indirect, rather than\ndirect, action of the missile. The fact that the wall of the cavity is\nOn September 11th, during the life of the President, cultures were made\nlined by fibrin, well advanced in organization, indicates that the injury\nby Dr. Wasdin from the base of the abdominal wound and from dressings\nto the tissues was produced at the time of the shooting. The absence of\nremoved at the same time. These were submitted to me for examination,\nbacteria from the tissues indicates that the wound was not infected at\nand showed the presence of the ordinary pus organisms Staphylococeus\npyogenes aureus and staphylococcus cereus albus, with a gas-forming bacillus\nthe time of the shooting, and that the closure of the posterior gastric\nwhich, in pure anaërobic culture on glucose gelatin, forms small, pearly,\nwound was effectual. The necrosis of the pancreas seems to us of great\ntranslucent colonies, with no liquefaction. In litmus milk it produces acid,\nimportance. The fact that there were no fat necroses in the neighborhood\nbut no coagulation. Morphologically, it is apparently a capsulated, short\nof this organ indicates that there was no leakage of pancreatic fluid into\nbacillus, which takes stain poorly and which does not stain by Gram's\nthe surrounding tissues. It is possible that there was a leakage of pan-\nmethod. Inoculated into the ear vein of a rabbit, which was killed imme-\ncreatic fluid into the cavity behind the stomach, as the contents of this\ndiately afterward, it produced, after twenty-four hours in the body of the\ncavity consisted of a thick, grayish fluid, containing fragments of con-\nrabbit, a marked accumulation of gas in the organs, and again grew out in\nnective tissue. In this case the wall of fibrin would have been sufficient\npure culture. As yet the organism is not fully identified.\nto prevent the pancreatic fluid from coming in contact with the adjacent\nNone of these cultures showed streptococci. A bacterium which appears\nto be one of the proteus group was, however, isolated, which does not stain\nfat. The extensive necrosis of the pancreas would seem to be an\nby Gram and appears in varying forms, sometimes small, oval, and again\nimportant factor in the cause of death, although it has never been\nquite rod-shaped and in short chains. Sometimes it is surrounded with\na\ndefinitely shown how much destruction of this organ is necessary to\nslimy covering, which remains clear like a capsule when the organism is\nproduce death. There are experiments upon animals upon record in\nstained. On slanting agar it produces a whitish, slimy growth, which gradu-\nwhich the animals seem to have died as à result of not very extensive\nally runs to the bottom of the slant and produces an odor of decomposition."
}