Doctors Discuss Autopsy
GENERAL AGREEMENT THAT THE PRESIDENT’S SURGEONS
FOUGHT AGAINST INEVITABLE DEATH.
The report of the autopsy performed
on President McKinley was thoroughly discussed by many leading physicians
in this city yesterday. To these men the autopsy revealed the fact
that the physicians who attended the President were trying to conquer
inevitable death, for in the tract of the bullet gangrene developed,
and this gangrene involved the pancreas. In the opinion of some
of these men the formation of gangrenous processes in the stomach
following gunshot wounds is an unusual thing. These processes gave
rise to no symptoms which would cause alarm or give warning that
they were doing deadly work. Some thought the theory that the bullet
was poisoned might prove to be well founded. Dr. George G. Van Schaick,
visiting surgeon to the French Hospital, said:
The injuries to the pancreas
and kidney were such as it was practically impossible to recognize
at the time of the operation. It is evident that the President’s
general condition was rather below par, and that his system
made little or no effort toward repairing processes. The President
did well for a time, because the early operation prevented peritonitis
and general sepsis. Death was due to the same lack of vital
power which precluded repair and allowed the formation of gangrenous
processes, together with the effusion of pancreatic juices within
the neighboring parts.
POISONED BULLET THEORY.
If there be any truth in the
poisoned bullet theory, this would of course have a most important
bearing on the case.
There is very little, however,
in the report of the autopsy to indicate that the bullet was
poisoned, excepting the fact that the tract of the bullet seemed
to have undergone a gangrenous transformation. The case altogether
presents most puzzling features. Gangrene of the stomach is
a very unusual thing. I have never known it to occur without
the presence of some severe injury, excepting in cases of ulcers,
in which there is a death of a certain area of the stomach tissues.
It is impossible to tell how soon
this gangrene began to develop. It probably began to develop
very early. The wound of the pancreas and the wound of the kidney
are also very important factors contributory to the fatal end.
We don’t know much about wounds of the pancreas. The pancreas
is a small organ, and it is one of the most important concerned
in digestion. It gives out the pancreatic juice, which is important
in intestinal digestion. Wounds of the pancreas are not necessarily
fatal. There are no parts of the body that cannot be injured
by a bullet and recover.
MORE DETAILS NEEDED.
Dr. Edward J. Donlin, who is said
to have had as large an experience in autopsical work as any physician
or surgeon in this city, said:
I am of the opinion that the
report of the autopsy is incomplete, and that a fuller one will
probably be issued in a few days. I do not incline to the theory
that the bullet was poisoned. This theory is not well founded,
to my mind. In fact, I can see nothing on which to bas[e] such
a theory. I believe the bullet caused the gangrenous processes,
but that the bullet carried no poisonous matter. It caused the
gangrenous or sloughing condition primarily by its impact on
live tissues. Nature, in her endeavor to repair the diseased
or injured tissues, caused a sloughing, which presented that
appearance of the body as shown by the autopsy. This appearance
of the body in no sense resulted from any poiso[n]ous matter
on the bullet, but was simply a result of the passage of the
bullet into the body.
THE PROCESS OF SLOUGHING.
Sloughing is a process of throwing
off dead tissue. When a bullet enters the body it kills all
tissues which it touches, and within an area of about a quarter
of an inch of the tract of the bullet there is caused a hemorrhage.
Nature in trying to repair such injury to tissues first causes
a sloughing or disintegration of the injured or diseased parts
in its efforts to bring about a healing process. If the vitality
of the patient is at par, nature will heal the wound kindly
and quickly, but if the patient’s system is impaired from any
cause, nature is slow to bring about a union of healthy tissues,
and gangrene is liable to occur, as it did evidently occur in
the President’s case.
The report says that both holes
were found to be perfectly closed by the stitches, but the tissues
around each hole ha[d] become gangrenous. I interpret this to
mean that the sutures closed those holes in the stomach, but
complete union did not take place, as evidenced by the gangrenous
condition around those holes. This condition about the area
of the holes made by the bullet leads me to think that President
McKinley was in impaired health at the time of the shooting;
but there is no doubt, judged from the report of the autopsy
as printed, that everything was done for the President that
could possibly have been done, and that his death was only a
question of time.
HEART WALL WEAK.
The report of the autopsy plainly
shows that the wall of the heart was thin and weak, and could
not bear for a long time a severe strain of sickness. The only
organs shown by the report to have been injured are the stomach
and the upper end of one of the kidneys. The pancreas showed
evidences of gangrene, but no signs, according to the report,
of having been struck by a bullet. The pancreas is a small organ
back of the stomach, and its purpose is the emulsification of
fats. As a rule, injuries to the pancreas are fatal.
The gangrenous condition involving
the pancreas impaired its functions, but I do not think that
symptoms of such impairment could have been determined. Few
cases of diseased pancreas are recognized in life.
If the bullet had been poisoned
the poison would have manifested itself, I think, early in the
case. The injury to the kidney was not fatal.