Original Autopsy Report and Unpublished Lab Notes from the Assassination of the Fallen President McKinley: From the Desk of a Surgeon Who Performed It

The Final Bacterial and Chemical Autopsy Report ruling out initial infection and poison

Previously unknown to exist and never before offered for sale, it is accompanied by an archive including the surgeon’s manuscript notebook, with revisions and notes, documenting his work to determine McKinley’s cause of death

This archive contains the momentous news conveyed to the nation of the likely cause of McKinley’s death, which included neither poison bullet nor infection at the original wound site: “Bacterial infection was not a factor in the production of the conditions found at the autopsy.”

This material, which is part of a larger archive of relevant letters and printed material, has been with the descendants of the surgeon, Dr. Herman Matzinger, since its creation and has never been offered for sale.

On Sept 6, 1901, President William McKinley was attending the Pan-American Exposition being held in the Temple Of Music in Buffalo, New York. Leon Czolgosz waited for hours to assassinate McKinley. He had a pistol in his hand wrapped up in cloth to hide it. When Czolgosz got to McKinley he put out his hand and shook hands with McKinley and then pulled the trigger twice at close range. One bullet bounced harmlessly off his sternum and did not enter his body. The other entered the left upper quadrant of his abdomen, piercing the front and back walls of the stomach.

A team of doctors was hastily assembled. Dr. Matthew Mann took the lead in bringing McKinley to the hospital and operating on him. McKinley survived the operation and appeared to be getting better but on the 12th or so began to deteriorate. He died on Sept 14, 1901. Mann had decided to leave the bullet in the body, did not clean the wound and sewed up McKinley using decidedly non surgical techniques. Later, Mann was called on to give reports of McKinley’s last words. He said that McKinley repeated portions of the hymn ‘Nearer, my God, to Thee.’”

On the morning of September 15, 1901, McKinley’s body lay in state and was viewed by thousands of mourners until midnight, when the horse-drawn hearse bore the casket to Union Station. The body was kept overnight at the White House where it again lay in state. A special train then took the President’s remains to Canton, Ohio, McKinley’s home, the night of September 17. The funeral was held on September 19.

McKinley did not have a Secret Service agent with him. When he was shot, he became the last president to walk through a crowd of people without a member of the Secret Service by his side.

The days and weeks after McKinley’s death brought an onslaught of critics from prominent medical schools and practices, doctors criticizing the skills of the attending professionals. And a rumor developed and spread rapidly that the nature of the wound and prolonged death, and evidence of infection, meant that the assassin had put poison on the tip of the bullet, killing McKinley by the use of a topical agent.

Today, it is believed that McKinley died from pancreatic necrosis, a condition which is still difficult to treat today, and which the surgeons of McKinley’s time could not have treated or prevented. An infection developed later along the bullet pathway and around the pancreas. But they knew none of that at the time.

A formal, official report was commissioned by the medical professionals at the behest of the government; and it would be broken into two parts. This would be the official report of the assassination of President McKinley, the last such presidential death for more than half a century until John F. Kennedy. The first part was the account of the shooting and surgical operations, lasting until his death. This primarily involved Drs. P. M. Rixey, Matthew D. Mann, Herman Mynter, Roswell Park, Eugene Wasdin, Charles McBurney, and Charles G. Stockton, McKinley’s attending physicians.

The second part, which was widely anticipated and came later, consisted of the autopsy and the bacteriological report, which would do much to shed light on the cause of death and whether foul play was involved.

Drs. Harvey Gaylord and Herman Matzinger conducted the autopsy together. Dr. Matzinger alone conducted the analysis of the bacteria and other materials taken from the wound of President McKinley. The day of his death, Dr. Mann and the other physicians took samples from the wound and sent them to Matzinger. They also sent Matzinger samples from the weapon and bullets.

From September 14 through September 30, Matzinger set about his task, analyzing the results of bacteriological results of his experiments, breaking his work into component parts. He looked at the surface samples taken from the wound, injecting elements of it into rabbits and a dog; he looked at the samples taken from the bullets; and he looked at the blood samples. There were of course other elements he considered.

At the turn of the month, he sent his final report to his colleagues, and it contained the famous statement that left no doubt: there was no poison; and it would not be so easy to call this a bacterial infection; indeed no surface wound evidence existed to point to that. In a line widely published in newspapers, he wrote that “bacterial infection was not a factor in the production of the conditions found at the necropsy.”

The reports filed by Drs. Gaylord and Matzinger consisted primarily of the statement recounting the autopsy of President McKinley and the Report on the Bacteriological Examination.

The archive

The archive consists of the retained material of Dr. Matzinger, his original report with his edits, the final submitted, his notebook used during the examination of the materials, his analysis of the factors that caused the death of the president, and other germane information. The archive came to us directly from the Matzinger heirs and has never before been offered for sale.

The surgeons attending the body of the ailing McKinley send samples to Matzinger to understand what is going on with him and how to heal him. These samples end up being used to determine cause of death.

Dr Eugene Wasdin was one of the consulting physicians at the bedside of President McKinley, and primary Anesthesiologist for the surgery. Autograph letter signed to Matzinger dated 2:40 PM on September 12th: “I send two tubes made from a loop of serum from the wound. I kept them to see the appearance of the colonies. Much like streptococci, but fast grown. Will you kindly plant one gelatin, and in glucose agar, and let us know your results. Also the morphologic features. I write for the consulting physicians.” An accompanying note from himself and “the consulting surgeons” states, “I send the three tubes made from the gauze packing. Will you kindly cultivate for the consulting surgeons.”

A notebook with 17 pages annotated, labeled on the front Dr. Matzinger’s Notes on President McKinley’s Case, in Matzinger’s hand, dated September 14 through September 30.

The notebook is split into the work as he did it, reflecting his analysis of the tissue residue from the wound; the results from the slug and other firearm materials; the blood.

On September 14, he notes the “material obtained from necrotic cavity through hole in mesocolon when knuckle of small intestine removed”. He notes the acidity, odor and texture. “Neutral if not alkaline in reaction. No free HCL.” He notes his microscopic analysis. “Fat globules broken down tissue – nature unrecognizable. Many crystals of fatty acids…” And the nature of the bacteria: “Bacilli & cocci.” On September 17, he injects a culture made from the residue into a dog. “Injected 2 c.c. of the mixture into space between stomach and mesocolon..” Over the next couple days he monitors the dog. “Temp. 40 c but acting well.” He notes in the margins here a handful of notes as other cultures return. The results from his test with the dog, along with the absence of more aggressive, atypical bacteria from his cultures, would help lead to his conclusion.

The next section is headed “Cartridges and Pistol” and begins on September 17. He is evidently in possession of this material. He notes his introduction of the materials into a culture he has prepared. “Touching bullet on surface of media….” “Cartrdige dropped in boullion.” The next page notes on his experiments on the “barrell.” “Still here. No growth,” he notes. Ditto the chamber, he notes.

The next few pages note in more detail the results of his test of the cartridges and related material. On the 23rd, he notes no growth for chambers 1, 5 and the barrell. “Plate cut from bullet direct by touching surface shows 1 colony of staphylococcus… Plate from Bul. tube of Cart. 4 shows small line of colonies apparently of some nature but not developed sufficiently to examine.”

The next section is headed simply “blood” and begins on September 29. He notes the analysis of the blood cultures taken on th 14th and 16th from the “auricle’, as well as “cultures from intestines” and “cultures taken by Dr. W. 9/11 of dressings and base of wound.” He finds no growth on the former several. In regard to the wound, he finds normal growth.

The next few pages are very detailed analyses of the bacteria composition of “Wasdin’s cultures.” He discusses the reaction of the cultures and goes dish by dish showing what growth is present. It is a fascinating densely scientific set of data.

On September 29, he notes from tubes “Inoculated at autopsy 9/14”, going tube by tube to note the presence or absence of growth. For instance: “Chest wound, no growth.” The “wound bullet” he notes developed a whitish color. “Growth on agar Staph.” “Base of wound (gelatin)” he notes some growth, which he briefly describes. And at the “Base of wound agar” a “white growth, Staph.”

The final page, dated September 30, is labeled “Cultures from Cavity Contents.” “Plates made 9/30 show numerous whitish slow growing colonies – morphologically stumpy short bacillus or bacterium – does not stain well. Colonies all seem to be alike and larger on surface than in medium.”

The surgeons request rapid return of analysis and give an update on Mrs. McKinley.

Telegram to Matzinger dated September 20, 1921, saying “Dr. Rixey requests me to ask you to send to him at Canton as soon as possible your chemical bacteriological and microscopical report. Mrs. McKinley is bearing up as well as could be expected.”

Matzinger’s typed and manuscript draft report that formally cast light on the cause of death: “Report on the Bacteriologic Examination of President McKinley,” with Matzinger’s handwritten notes.

He has crossed out the word “Preliminary” before “Report.” Typed and manuscript document signed, with extensive manuscript edits, 4 pages, September 30, 1901, the day his journal entries end, setting forth in manuscript format his conclusions. In this document, which contains extensive changes in his own hand, he walks through in sentence form the process of receiving the samples, the creation of the cultures, and the nature of the bacteria that developed. These mirror the scientific observations he observes in the journal above but are related in terms meant to be understood by the lay person. In some areas the edits are more extensive than the original section. He notes that in areas around the internal portions of the chest wound, a special kind of bacterium developed, but in a separate manuscript amendment, states: “It must be stated that there is occasion for suspecting that this was by a contamination either from the outer wound or elsewhere, because…. the technique of obtaining the material and cultures from the necrotic cavity was not absolutely correct”.

This remarkable manuscript, which was not previously known to exist, ends with the conclusion that the country awaited. Here Matzinger writes in his own hand, above his dateline and signature: “The significant absence of known pathogenic bacteria, particularly in the necrotic cavity, warrants the conclusion that bacterial infection was not a factor in the production of the conditions found at the autopsy.” In other words, any infection developed later, and were a result of trauma and complications from the shooting. There was not, furthermore, any evidence of poison.

Matzinger’s final typed report, his retained typed copy, with his handwritten notes: “Report on the Bacteriologic Examination in the Case of the Late President McKinley,” 5 typed pages, This contained the finalized version of the above report, with a few small manuscript changes.

Dr. Matzinger’s Carbon Copy: “Notes on the Autopsy of President McKinley,” September 14, 1901, 5 long typed pages, representing a sizable portion of the remainder of the after death report, incorporated into the final version, one of the copies sent to the consulting medical team.

The Government Acknowledges Receipt of McKinley’s Death Certificate from Matzinger

Dr. P.M. Rixey was the Naval Medical Inspector, and assigned as the personal physician to First Lady Ida McKinley in 1899 and spearheaded her improved health during the following few years, and to President McKinley as well. As he traveled with the McKinleys during this time providing personal care to Mrs. McKinley, he was present when President McKinley was shot in Buffalo, and attended to him. He was appointed Surgeon General in 1902 by President Roosevelt. He was the one who spearheaded the final official report. Typed letter signed from Rixey dated October 4, 1901 to Matzinger. “Your letter enclosing copy of death certificate, and yours of October 2, received. I knew that you had your hands full and upon receipt of your letter of Sept. 24th I quoted from it and sent the report in. I now propose, with the permission of the surgeon general, to add to those quotations the last paragraph of your report of Oct. 2. Your report in full, with those special accounts of the operation, etc, can be added before publication, if desired by my colleagues.”

Matzinger’s copy of the final, full, official report. “Medical and Surgical Report in the case of the Late President of the United States” by Rixey, 24 printed pages, dated 1901.

Official programs of the Pan-American Exposition, one in English and one in Spanish.

Invitation to “Services in Memory of William McKinley, Late President of the United States” in Buffalo on September 15, 1901 at Eleven o’clock.” With the ticket to the services.

This is a treasure. Autopsy reports for assassinated presidents, written by the autopsy surgeons, are more than rare, they are virtually impossible to find. This is the first we have had, and in fact the first we have ever seen on the market, in our 34 years in this field. The Matzinger descendants did a public service in keeping these autopsy materials all these years.