Death of President McKinley
and queens and men of note, in former days, have died because their
exalted position paralyzed the arms that would have gladly aided
one of lower degree, but in recent times surgical skill has been
more ready to disregard the rank of the sufferer and to do its best,
alike for prince and pauper. We in America have had our share of
such emergencies, and the last one—the wounding of President McKinley
while visiting the Pan-American Exposition at Buffalo, on September
9, 1901—will linger long in the memory of the public and be recalled
by the profession as a celebrated case of prompt, brave surgery
that deserved, it would seem, a better reward.
The only wound of the President that
needed any special care was the one made by the ball which penetrated
the left hypochondriac region; the other was trivial. This wound
showing no point of exit of the ball, it was determined, after a
necessarily brief consultation among the surgeons who could be immediately
obtained, that it should be followed, and that the proceedings proper
in penetrating wounds of the abdomen should be carried out as soon
In about an hour after the shot was
fired (Dr. Wasden giving ether, for the President’s heart was known
to be weak), Drs. Mann and Mynter, assisted by Drs. Lee and Parmenter,
opened the peritoneal cavity and discovered a bullet wound of the
anterior wall of the stomach, near the greater curvature; the edges
were clean-cut, and were approximated by the Czerny-Lembert suture.
The abdominal incision was slightly enlarged and about four inches
of the gastro-colic omentum divided to reach the posterior wall
of the stomach. Here a second somewhat larger wound was found, with
frayed and infiltrated edges; these were united by a double row
of sutures, but further search for the bullet was discontinued on
account of the condition of the patient’s pulse. The operation lasted
an hour and a half, and the President was then carried to a private
house in Buffalo and put in charge of Dr. Rixey, U. S. N., who was
later assisted by Dr. Wasden. For a while the 
President’s condition seemed to improve, and daily and favorable
bulletins were in consequence issued by general consent of the attending
physicians; these often expressing great hope of his recovery. Dr.
McBurney and Dr. Stockton were later added to the staff of consultants
(Dr. Janeway and Dr. Johnson, who were summoned still later, did
not arrive until after the President’s death). The patient’s temperature
during the days following the injury ranged from 100 to 102 degrees,
but his pulse (thin most of the time) was disproportionately high,
ranging between 140 and 145. The urine was scant, with a trace of
albumin, some casts, and much indican. Nutritive and saline enemata
were employed to sustain him, and on the seventh day the patient
was given nourishment by the mouth. The intense pain was controlled
by morphine and such cardiac tonics and stimulants as met the needs
of the hour; but the President’s heart began to fail on the evening
of the eighth day, and, stimulants no longer availing, he died in
the early morning of September 14.
The autopsy was performed by Drs.
Gaylord and Matzinger, nine hours after death. Rigor mortis was
marked; sternal wound superficial, cultures from it showing Staphylococcus
epidermides albus of Welsh. Abdominal fat well developed and
normal in color; ventral wound showed little effort at repair; cultures
showed Staphylococcus albus, and a short encapsulated bacillus
thought to belong to the proteus group, but no streptococci here
or elsewhere. The stitches uniting the wounds of the stomach were
intact, surrounded by discolored friable areas, and each had been
reinforced by adhesions.
Behind the stomach was a large necrotic
cavity, fibrin-lined, involving the pancreas and extending downward
and backward towards the left kidney, where it ended in a cul-de-sac.
Tissue elements from it were unrecognizable. Neither leucocytes
[sic] nor pus-corpuscles were found, but an abundance of
fat-like crystals. The left kidney was congested and lacerated,
and the adrenal gland seemed injured; but there was no sign of peritonitis.
The heart-walls were thin and surrounded by much adipose tissue;
other organs normal.
Bacterial examination of the weapon
(a 32-calibre revolver) from which the fatal shot had been fired
showed simply the presence of staphylococci. Dr. Hill, by chemical
analysis, disproved the current suspicion that the cartridges had
That the autopsy was abruptly concluded
and the bullet left undiscovered was owing to the wishes of the
family of the deceased President. It is to be regretted that the
autopsy was not thoroughly completed and material allowed to be
taken as a basis for further scientific study.
The assassin of the President (Leon
F. Czolgosz, aged twenty-eight, 
and an American by birth), after speedy trial, was executed at Auburn
Prison in the electric chair. The autopsy was immediately thereafter
made by Drs. McDonald, Spitzka, and Guerin, but neither abnormality
nor lesion was found; his brain was slightly above the average,
and the conclusion reached was that his intellect was not impaired,
confirming the opinion of Fowler, Crego, and Putnam, who examined
him prior to his trial.
C. K. Mills believes from the evidence
that he was mentally sound at the time of the assassination, but
that had he lived longer he would probably have developed tendencies