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{
    "localId": "7268611",
    "label": "Official Report of the Case of President William McKinley",
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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
        }
    ],
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{
    "seq": 7,
    "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_004.jpg",
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    "ocrText": "506 AMERICAN JOURNAL OF THE MEDICAL SCIENCES.\nCASE OF PRESIDENT MC KINLEY.\n507\nstomach contained food, and also with the hope that possibly the bullet\nbeen done which should be done, and whether he had any further\nmight be in the stomach. The stomach was found to be half-full of\nsuggestions to make. Each replied that he was satisfied. The question\nliquid food, but no evidence of the ball was discovered. In pulling up\nof drainage was also discussed. Dr. Mynter was in favor of a Mikulicz\nthe stomach a small amount of liquid contents escaped, together with a\ndrain being placed down behind the stomach wall. Dr. Mann, with the\ngood deal of gas. The tissues around the wound were carefully irri-\nconcurrence of the other surgeons, decided against this, as being\ngated with hot salt solution and dried with gauze pads. The perfora-\nunnecessary.\ntion in the anterior stomach wall was then closed with a double row of\nAs the last step in the operation the tissues around the bullet track\nsilk sutures (Czerny-Lembert). The sutures were not interrupted with\nin the abdominal wall were trimmed in order to remove any tissue\neach stitch, but four stitches were introduced before the ends were tied.\nwhich might be infected. The abdominal wound was then closed with\nThe loop was then cut off and the sutures continued. About eight\nseven through-and-through silkworm-gut sutures, drawn only moder-\nstitches were used in each row. The silk used was fine black silk, the\nately tight, the superior layer of the fascia of the rectus muscle being\nneedle being a straight, round sewing needle.\njoined with buried catgut. The edges of the skin were brought\nIn order to examine the posterior wall of the stomach it was necessary\ntogether by fine catgut sutures. Where the bullet had entered there\nto enlarge the incision, which now reached about 15 cm. in length. The\nwas slight gaping of the tissues, but it was not thought advisable to\nomentum and transverse colon were pulled well out of the abdomen.\nclose this tightly, as it might allow of some drainage. The wound was\nThe omentum was enormously thickened with fat and very rigid. In\nthen washed with hydrogen dioxide and covered with aristol powder\norder to reach the back wall of the stomach it was necessary to divide\nand dressed with sterilized gauze and cotton, which were held in place\nabout four inches of the gastrocolic omentum, the cut ends being tied\nwith adhesive straps. Over all was put an abdominal bandage.\nwith strong black silk in two masses on each side. In this way the\nThe President boré the operation very well. The time from the\nstomach could be drawn up in the operation wound and the bullet\nbeginning of the administration of the anzesthetic until its discon-\nwound in its posterior wall reached. This opening was somewhat\ntinuance was exactly an hour and thirty-one minutes; the operation was\nlarger than that in the anterior wall of the stomach, and had frayed\ncompleted at 6.50 P.M., having lasted from the time of the first incision\nand blood-infiltrated edges. Its exact location was impossible to deter-\nan hour and twenty-one minutes. At the beginning of the operation\nmine, but it appeared to be near the larger curvature.\nPresident McKinley's pulse was 84. At 5.38, 0.002 gramme of strychnine\nThis opening was closed in the same way as the anterior wound, but\nwas administered hypodermically. At 5.55 the respiration was 32 and the\nwith great difficulty, as the opening was down at the bottom of a deep\npulse 84-both good in character. At 6.09 the pulse was 88. At\n6.20\npocket. A short curved surgical needle was necessary here. Little or\nit was 102, fair in character; respiration 39. At 6.22, 1.50 gramme\nof\nno gastric contents appeared around this opening, but after it had been\nbrandy was administered hypodermically. At 6.48 the pulse was 124,\nclosed the parts were carefully irrigated with hot salt solution.\nthe tension good but quick; respiration 36. At 7.01, after the bandage\nThe operation on the stomach being now finished, Dr. Mann intro-\nwas applied, the pulse was 122 and the respiration 32. At 7.17, 0.004\nduced his arm so as to palpate carefully all the deep structures behind\ngramme of morphine was administered hypodermically.\nthe stomach. No trace of the bullet or of the further track of the\nAt 7.32 the patient was removed from the hospital in the ambulance.\nbullet could be found. As the introduction of the hand in this way\nDr. Rixey asked Drs. Park and Wasdin to go in the ambulance, as his\nseemed to have a bad influence on the President's pulse, prolonged\nduty called him to go at once to inform Mrs. McKinley of her husband's\nsearch for further injury done by the bullet, or for the bullet itself, was\ncondition and to prepare a room for his reception. Drs. Mann and\ndesisted from. The folds of the intestine which had been below the\nMynter, with friends of the President, followed in carriages immediately\nstomach were inspected for injury, but none was found. The entire gut\nafter. President McKinley had not then recovered from the anzesthetic.\nwas not removed from the abdomen for inspection, as the location of\nHe bore the journey to Mr. Milburn's house exceedingly well, but it\nthe wound seemed to exclude its injury. To have made a satisfactory\nwas found necessary to give him a small hypodermic injection of mor-\nsearch for wounds in the President's back it would have been necessary\nphine during the transit, as he was becoming very restless. On arrival\nto have entirely eviscerated him. As he was already suffering from\nat the house of Mr. Milburn, 1168 Delaware Avenue, he was removed\nshock, this was not considered justifiable, and might have caused his\nfrom the ambulance on the stretcher, and carried to a room in the\ndeath on the operating-table.\nnorthwest corner of the house, where a hospital bed had been prepared\nBefore closing the abdominal wound Dr. Mann asked each of the\nfor him.\nsurgeons present whether he was entirely satisfied that everything had"
}