The Report of the Autopsy in the President’s Case

     In our issue of October 19, 1901, there appeared the report of the case of President McKinley contributed by his attending physicians. This report was awaited with great interest by the profession, and indicates what has been remarked a number of times, that much of the criticism and comment made upon the conduct of the case might have been deferred with much better taste until the facts were laid before the profession as has now been done. The condition of the President’s heart, as shown by both the macroscopic and the microscopic examination, indicates clearly, as was pointed out in our previous editorials dealing with this possibility, that the condition of this organ had a most important bearing upon the fatal outcome. The report of Dr. Gaylord mentions particularly the extensive brown atrophy and the diffuse fatty degeneration of the muscle, and calls attention to the extent to which the pericardial fat had invaded the atrophic muscle fibres of the wall of the right ventricle. Dr. Gaylord remarks that this pathological condition explains, in part at least, the rapid pulse and the lack of response of this organ to the stimulants which were administered. The necrotic condition of the pancreas was a factor of uncertain power in the possible fatal termination. We are not in possession of sufficient facts to decide the precise amount of necrosis of this organ which is necessary to induce death.
     On the superior aspect of the left kidney there was found a protrusion of the cortex, dark red in color, [664][665] and in this protrusion there was a laceration 2 cm. long, extending across the superior border, approximately at right angle with the periphery of the kidney, and from before backward. Dr. Gaylord gives it as his opinion that the wound of the kidney was of slight importance, save that it indicated the direction taken by the bullet.