Uncle Sam: Uncle Sam (U.S.), who represents the United States, looks happy and unintimidated by the "doctors" who are attempting to make him better.
McKinley the Tailor: President McKinley (indicated by the name on the apron) is portrayed as the tailor who is more than happy to accommodate Uncle Sam's expanding size.
Tailor's Material: The tailor's materials are labeled "enlighten and rational expansion," which indicates a positive view of his foreign policy.
Expanding Stripes: Notice the stripes on Uncle Sam's expanding pants. They include the names of land/territories added to the United States throughout the 1800s, like Texas, Alaska, Hawaii, and Puerto Rico.
Name on the Door: In case you missed the initials on his apron, the door indicates "McKinley and Company National Tailors".
The Doctors: The "doctors" represent anti-imperialists who are against expansion. They are trying to cure U.S. of his expansion.
Title: "Declined with Thanks" is the title of the cartoon. Clearly, Uncle Sam does not want the "anti-expansion" medicine the anti-imperialists are offering.
