The Condition of the President’s Heart

     In a man of the late, lamented President’s age there are a number of factors to be considered by way of accounting for the heart failure, or weakness, which was a source of continued anxiety to his attending physicians. There were, it appears, no signs indicating the lesion of the pancreas or the gangrene which followed the course of the assassin’s bullet.
     The blood counts which were made revealed nothing, and the important index in the lack of correlation between the pulse and the temperature was not regarded seriously, owing to the fact that the President was known to have a most erratic pulse. In a man of Mr. McKinley’s obese frame and full, sedentary habit, fatty degeneration of the organ was to be expected. This would naturally have followed the hypertrophy succeeding his active army life. Granting the absence of organic valvular disease, as medical men we are interested in speculating as to what might have produced the asthenic condition. In addition to the cause of the original hypertrophy present, the arduous life of the President’s younger manhood, he is said to have [462][463] been an habitual user of tobacco. The effect of tobacco is to cause nervous over-action, which will in time lead to a hypertrophic condition of the heart, owing to the extra work it throws on the organ. This hypertrophy in time naturally underwent changes of fatty infiltration and degeneration, and consequently dilatation. These may be accounted for by the increased obesity of the distinguished patient and the condition of arteriosclerosis, to be expected in a man of his years and affecting to some extent the coronary arteries.
     The effect of the long continued, general anesthesia is not to be overlooked. It has been shown quite conclusively that blood inspissation, a condition of anhydremia, is present after etherization. The hemoglobin is reduced absolutely and a general hemolysis of varying degrees occurs.
     These conditions would throw increased work on the already weakened muscular structure, oxygenation requiring so much more effort. If we add to this the effect of the shock, and the toxemia induced by the pathological processes within the abdominal cavity, it is easy to understand how tired nature was beaten in the heroic battle and how one of God’s noblemen was lost to a sorrowing people.