The Cause of President McKinley’s Death

     We have never altogether shared the opinion of those who professed to see an unsolved mystery in President McKinley’s death, and since we have read Dr. Gaylord’s report of the autopsy we are still less inclined to see any ground for mystification in that sad event. In our judgment the immediate cause of death was a degenerated heart muscle. The clinical progress of the case pointed to that condition, and the autopsy confirms it. We have pointed out from the first in these columns that the President suffered from the effect of shock—shock caused not only by the assault but especially by the operation. This was inevitable. It would have been so in the hands of any surgeon. The patient, as shown in the report, went on the operating table with a pulse of 84 and left it with a pulse of 124. His pulse never really rallied after the operation; it never, according to the bulletins, regained anything like a satisfactory tone. This was evidently because there was back of it a heart muscle which was undergoing fatty and granular degeneration. This is by no means the first case in abdominal surgery, in which such a heart has baffled the best skill.
     The devitalization of wounded tissue under such circumstances is not a cause for wonder. Such tissue requires the best sort of blood supply for its repair: it cannot secure it from a debilitated and deteriorated heart muscle. Surgeons are more particular to ascertain the state of the kidneys than they are of the heart, and even in the case of the heart, the absence of a valvular lesion is supposed to be a guarantee of safety. This dictum is erroneous. The most serious affection of the heart in advancing years is a sclerosis of the coronary arteries and a degeneration of the muscle. These President McKinley evidently had.