Report on the Bacteriologic Examination

     It is obvious that the short space of time which has elapsed since the death of the President has hardly been sufficient to prepare a complete and thorough bacteriologic report. This report contains all the observations which have been made up to this time:

     On September 11, during the life of the President, cultures were made by Dr. Wasdin from the base of the abdominal wound and from the dressings removed at the same time. These were submitted to me for examination, and showed the presence of the ordinary pus organisms: Staphylococcus pyogenes aureus and S. cereus albus, with a gas-forming bacillus which, in pure anærobic culture on glucose gelatin, forms small, pearly, translucent colonies, with no liquefaction. In litmus milk it produces acid, but no coagulation. Morphologically, it is apparently a capsulated, short bacillus, which takes stains poorly, and which does not stain by Gram’s method. Inoculated into the ear vein of a rabbit, which was killed immediately afterward, it produced, after twenty-four hours in the body of the rabbit, a marked accumulation of gas in the organs, and again grew out in pure culture. As yet the organism is not fully identified.
     None of these cultures showed streptococci. A bacterium which appears to be one of the proteus group was, however, isolated, which does not stain by Gram, and appears in varying forms, sometimes small oval, and again quite rod-shaped and in short chains. Sometimes it is surrounded with a slimy covering, which remains clear like a capsule when the organism is stained. On slanting agar, it produces a whitish, slimy growth, which gradually runs to the bottom of the slant and produces an odor of decomposition. On gelatin, it grows very slowly with slight and slow indication of liquefaction. In litmus milk, it produces acid and rapid coagulation.
     At the time of the autopsy, September 14, inoculations were made by myself. From the base of the wound there was again obtained a number of pus organisms, principally a white staphylococcus and the bacterium described above, but no streptococci. Cultures made from the peritoneal surface of the intestines were entirely negative. Cultures made from the under surface of the omentum near the colon were entirely negative, both with and without oxygen. Cultures from the blood of the right auricle were likewise negative. A very careful and extensive search for microorganisms in the contents of the necrotic cavity behind the stomach reveals nothing but a short stumpy bacterium which, as far as the work has been carried at present, appears to belong to the proteus group, and is very like Proteus hominis capsulatus, described by Bordoni and Uffreduzzi.
     Morphologically it is not uniform, and sometimes appears almost encapsulated, being surrounded by material that does not stain; is quite refractory to Gram, and produces an odor of decomposition as it grows. It does not liquefy gelatin rapidly and grows slowly, as a glistening white elevated surface growth which slowly sinks; but on agar in the thermostat it grows very rapidly as a moist, grayish-white, translucent mass. Colonies on gelatin plates have a clean circumference, are granular and quite refractive. In litmus milk it produces acid and rapid coagulation. Animal experiments are still incomplete, and cannot be published at this time.
     It must be stated that there is occasion for suspecting that this may be a contamination, either from the outer wound or elsewhere, because, quite unavoidably, the technic of obtaining the material and cultures from the necrotic cavity was not absolutely correct.
     Cultures made from the small area of the broken-down tissue under the chest wound at the time of the autopsy [609][610] grew what appears to be Staphylococcus epidermidis albus, described by Dr. Welch.
     The slimy, gray, necrotic material from the cavity above the transverse mesocolon behind the stomach was carefully examined microscopically, with the result that very few microorganisms were found in the fresh state, and no recognizable tissue elements of any kind, no leukocytes or pus-corpuscles, but an abundance of crystals which appeared more like fatty acid than fat crystals. It contained no free hydrochloric acid, and was alkaline in reaction. Experiments as to its digestive power were negative. About 2 cc. of this material was injected into the space behind the stomach of a dog (still living), with no results except quite an elevated temperature for three or four days. Other animal experiments are also still incomplete.

     It might be well to state here that the bacteriologic examination of the chambers and barrel of the weapon used, as well as the empty shells and cartridges, ordered by the District Attorney, was entirely negative, except that from a loaded cartridge there was grown an ordinary staphylococcus and a mould. The chemical examination of the balance of the loaded cartridges, made by Dr. Hill, chemist, was also negative.
     The absence of known pathogenic bacteria, particularly in the necrotic cavity, warrants the conclusion that bacterial infection was not a factor in the production of the conditions found at the autopsy.