Mr. M’Kinley’s Doctor Reads His Report

Dr. Mann Says He Does Not Know What Caused Death.
——
Thinks It Was Atrophy of the Walls of the Right Ventricle of the Heart.

Special to The New York Times.

     ROCHESTER, N. Y., Oct. 15.—It was the privilege of the physicians of Rochester, or, rather, those doctors who belong to the Academy of Medicine, to hear first the official report of Dr. Matthew D. Mann of the Buffalo Medical College, who performed the operation on President McKinley.
     This report was read last Wednesday, but only after Dr. Mann had insisted that no part of it be published. The local physicians agreed to this, but to-day one of them consented to give a synopsis of the report. Dr. Mann took up the history of the case from the time he was called to attend Mr. McKinley on the Pan-American grounds, until the patient died. The [most] significant statement made by Dr. Mann was this:
     “Gentlemen, I do not know what killed the President, but I think that the cause of death was the fact that the walls of the right ventricle of the heart were very thin and atrophied.”
     Dr. Mann laid particular stress upon the fact that the right ventricle was afflicted with acute brown atrophy, and he seemed to wish the physicians to infer that this trouble was the real cause of death. He said that he had been sent for immediately after Czolgosz had fired the fatal bullet, and that he arrived at the Pan-American Emergency Hospital wholly ignorant of what was expected of him.
     Dr. Mann found that the Emergency Hospital was not equipped with the necessary instruments for the performance of a difficult operation. The lack of these aids to efficient surgical work hampered Dr. Mann and his assistants considerably, although he did not think that the case was prejudiced by the fact. He said that all during Mr. McKinley’s illness his pulse was rapid, but this symptom was not considered to be alarming, because Dr. Rixey had stated that Mr. McKinley possessed a normal pulse of 80, which became more rapid under the least excitement. He also emphasized the fact that the President had never taken any exercise beyond that obtained in walking.
     The doctor said that on the morning of the day before Mr. McKinley died the latter was very cheerful, asking one of the doctors for a cigar. Dr. McBurney said to the President: “No, Mr. President, you cannot have a cigar to-day.” “Very well,” said Mr. McKinley. “There are some cigars down stairs [sic], and you gentlemen may smoke, if I cannot.”
     On the second day after the shooting Dr. Mann said he found that two of the stitches in the President’s abdomen had pulled out. Nothing was thought of this fact, because the spreading of stitches is common in such wounds. Dr. Mann’s report also touched upon the failure of the surgeons to use the X-ray in their endeavor to locate the bullet.
     He did not think that it would have been wise to use the X-ray under the circumstances, holding that it would have put the President to a great deal of inconvenience, and that there was not one chance in twenty of the machine’s revealing anything of importance. Dr. Mann said that if the bullet had lodged against the spine, for instance, the X-ray would not have disclosed it. The use of the machine would without doubt have killed the President at the time, without disclosing anything of value to the surgeons.
     Dr. Mann, in his report, gave the President’s blood count day by day, and said that all during the Chief Magistrate’s illness the physicians felt uneasy because of the fact that the patient’s blood condition remained normal. Under the circumstances, and if the patient was making favorable response to treatment, there should have been a noticeable increase in the white blood corpuscles. This was not the case, and the lack of such an increase gave the doctors their first scare.
     The autopsy revealed several important facts that helped in a way to explain Mr. McKinley’s demise. In searching for the bullet the surgeon’s knife revealed, back of the stomach and in the region of the spleen, a small pocket containing necrotic tissue, the origin of which remains a mystery to the physicians. Even in the bacteriological examination following the autopsy no evidence of septic poisoning was found, disproving the assertion that surgery could have prevented death. None of the germs usually responsible for death from blood-poisoning were found even in the pocket containing the dead tissue.
     Twice during the reading of his report the doctor called attention to the fact that the President’s blood count failed to show the desired increase in the white corpuscles, which was absolutely essential to recovery in a body undergoing a process of repair. He also laid particular stress upon the fact that the wall of the right ventricle was atrophied, but he did not state what, in his opinion, caused the atrophy.
     He stated, however, that the failure of the surgeons to find the bullet in the autopsy was due to the fact that the relatives of the President positively forbade them to go any further after they had only fairly begun their exploration. He said that it was the physicians’ desire to find the bullet and that had they not been molested the autopsy would have revealed its location.
     Dr. Mann considered the necrotic condition of the kidney, which was lacerated by the bullet, and the atrophy of the heart chiefly responsible for death. He did not think that it lay within the power of any surgeon to save Mr. McKinley’s life in view of the defects in his bodily organism mentioned above.