Sunday, March 9, 2014

Dr. Charles A. Leale’s Report on the Assassination of Abraham Lincoln

By Helena Iles Papaioannou and Daniel W. Stowell

In May 2012, Helena Iles Papaioannou, a research assistant with the Papers of Abraham Lincoln, was systematically searching the Letters Received series of the Records of the Office of the Surgeon General at the National Archives in Washington, D.C. Proceeding through correspondence filed under the letter “L,” she located a twenty-two-page report by army surgeon Dr. Charles A. Leale about his role as the first physician to tend the wounded Lincoln after the president’s shooting at Ford’s Theatre on April 14, 1865. Papaioannou brought the document to the attention of the director of the Papers of Abraham Lincoln, Daniel W. Stowell. After consulting several scholars who specialize in the events surrounding the Lincoln assassination, Papaioannou and Stowell concluded that the 1865 report from Dr. Leale was generally unknown. Certainly no such report has been presented in its entirety or compared with Leale’s later account from 1867.

This 1865 report is significant because it gives us a window into Leale’s experience that is immediate and untarnished by the passage of time. In a cover letter for his 1867 written account of Lincoln’s assassination to a congressional committee, Leale stated that he had “principally copied it from (a never-published) one written by me a few hours after leaving his death bed.” We believe this 1865 report to be a copy of the account Leale wrote immediately after leaving Abraham Lincoln’s bedside. Leale rarely spoke of his actions on the night of April 14, but in 1909, the centennial of Abraham Lincoln’s birth, the Military Order of the Loyal Legion of the United States prevailed upon him to give them his memories. By then, Leale’s account was rich in sentimentality, and he had an acute sense of his own importance in the Lincoln story. His 1865 report offers a first draft of history by a man who had little time to ponder the life-changing events he had just experienced.

Dr. Charles Augustus Leale was born in March 1842, making him just twenty-three years old on April 14, 1865. Indeed, he had graduated just six weeks previously, on March 1, with a medical degree from Bellevue Hospital Medical College in New York City. Leale had, however, been around the medical profession for most of life. During the 1850s Leale’s father oversaw the United States Marine Hospital in Portland, Maine, and Leale recounted receiving his first surgical instruction at that hospital as he visited the wards. In 1860 he began attending university, where he studied chemistry and medicine. In 1863 Leale moved to New York City and began private instruction before matriculating at Bellevue. In 1864 Leale served at the U.S. army hospital in Elmira, New York, as a medical cadet, working his way up to overseeing two wards. In that position Leale tended both wounded Union soldiers and Confederate prisoners. After his graduation near the end of the Civil War, Leale became a commissioned officer in the medical department of the army and worked as the surgeon in charge of the wounded commissioned officers’ ward at the U. S. Army General Hospital in Armory Square, Washington, D.C. He held that position in April of 1865.

Charles Leale’s involvement in the events surrounding the Lincoln assassination was not entirely coincidental. A few days earlier, on April 11, Leale had been walking along Pennsylvania Avenue when his interest was piqued by crowds rushing towards the Executive Mansion. When he arrived, Lincoln was just beginning what was to be his last public address. Leale was profoundly impressed by ­Lincoln, later ­­describing his “divine appearance as he stood in the rays of light, which penetrated the windows of the White House.” When Leale heard that Lincoln would be attending the theatre on the night of April 14, 1865, he decided to do the same.
There are seven extant accounts by Leale of his experience as one of Lincoln’s final doctors. Five date from 1865, one from 1867, and one from 1909—forty-four years after the assassination.

Three of the additional 1865 accounts that have surfaced since the discovery of the report described are nearly identical copies, each in the hand of a clerk (though the handwriting indicates different clerks). None of the additional reports has been presented in its entirety nor have they received much scholarly attention. One report in addition to the one here resides at the National Archives in Washington, D.C. Originally located in the Records of the Adjutant General, it is now housed in the vault. The third and fourth 1865 reports are in the records of the United States Sanitary Commission (USSC) at the New York Public Library. The variations among the accounts are minimal. There are a very few slight word changes or added words, some punctuation differences such as ampersands used in place of “and,” commas instead of semi-colons, and variant capitalizations. The adjutant general and USSC reports both have titles, but the surgeon general report does not (other than a clerk’s note on the reverse of the final page). All of these differences can be attributed to the work of four different clerks in transcribing the reports. Other than these minor differences, the copies are identical. It is impossible, therefore, to determine the sequence of copies, whether any were made from others, or whether the clerks independently copied each from a lost original in Leale’s hand.

Leale’s other versions of Lincoln’s assassination are far more distinct from one another than are the 1865 reports. One final account from 1865 is a letter Leale wrote to his friend and fellow physician Dwight Dudley late in May of that year. His description of the events of April 14 and 15 is an abbreviated and less formal recounting that in its details is very similar to the reports he wrote in 1865 and 1867. The letter is noteworthy, however, in that Leale briefly mentions Lincoln’s funeral and also recounts attending part of the trial of John Wilkes Booth’s co-conspirators. Memorably, he describes them as a “very inferior-looking set of men.”

The 1867 report and its cover letter are addressed to Representative Benjamin F. Butler, chair of a committee in the United States House of Representatives investigating Lincoln’s assassination. For his written report to Congress, Leale drew heavily from the report he wrote in April 1865, just hours after the attack. As the annotations demonstrate, Leale made various additions to his 1867 account. In February 1909 Leale gave a speech to the Military Order of the Loyal Legion of the United States in New York City, outlining his role in caring for Lincoln after he had been shot. Leale gave this speech amidst the commemorations of the one-hundredth anniversary of Lincoln’s birth, and it was later published in pamphlet form as Lincoln’s Last Hours.

Presented below is the complete text of the copy of Leale’s 1865 report housed in the Surgeon General’s records. Notes indicate where the text differs significantly from Leale’s 1867 report to Butler’s assassination committee. Annotations provide definitions of medical terms and brief biographical information for individuals mentioned in Leale’s account.
Having been the first of our profession who arrived to the assistance of our late President, and having been requested by Mrs. Lincoln to do what I could for him I assumed the charge until the Surgeon General and Dr Stone his family physician arrived, which was about 20 minutes after we had placed him in bed in the house of Mr. Peterson opposite the theatre, and as I remained with him until his death, I humbly submit the following brief account.

I arrived at Fords Theatre about 8¼ p.m. April 14/65 and procured a seat in the dress circle about 40 feet from the Presidents Box. The play was then progressing and in a few minutes I saw the President, Mrs Lincoln, Major Rathbone and Miss Harris enter; while proceeding to the Box they were seen by the audience who cheered which was reciprocated by the President and Mrs Lincoln by a smile and bow.

The party was preceded by an attendant who after opening the door of the box and closing it after they had all entered, took a seat nearby for himself.

The theatre was well filled and the play of “Our American Cousin” progressed very pleasantly until about half past ten, when the report of a pistol was distinctly heard and about a minute after a man of low stature with black hair and eyes was seen leaping to the stage beneath, holding in his hand a drawn dagger.

While descending his heel got entangled in the American flag, which was hung in front of the box, causing him to stumble when he struck the stage, but with a single bound he regained the use of his limbs and ran to the opposite side of the stage, flourishing in his hand a drawn dagger and disappearing behind the scene.

I then heard cries that the “President had been murdered,” which were followed by those of “Kill the murderer” “Shoot him” etc, which came from different parts of the audience.

I immediately ran to the Presidents box and as soon as the door was opened was admitted and introduced to Mrs. Lincoln when she exclaimed several times, “O Doctor, do what you can for him, do what you can”! I told her we would do all that we possibly could.

When I entered the box the ladies were very much excited. Mr. Lincoln was seated in a high backed arm-chair with his head leaning towards his right side supported by Mrs. Lincoln who was weeping bitterly. Miss Harris was near her left and behind the President.

While approaching the President I sent a gentleman for brandy and another for water.

When I reached the President he was in a state of general paralysis, his eyes were closed and he was in a profoundly comatose condition, while his breathing was intermittent and exceedingly stertorous. I placed my finger on his right radial pulse but could perceive no movement of the artery. As two gentlemen now arrived, I requested them to assist me to place him in a recumbent position, and as I held his head and shoulders, while doing this my hand came in contact with a clot of blood near his left shoulder.

Supposing that he had been stabbed there I asked a gentleman to cut his coat and shirt off from that part, to enable me if possible to check the hemorrhage which I supposed took place from the subclavian artery or some of its branches.

Before they had proceeded as far as the elbow I commenced to examine his head (as no wound near the shoulder was found) and soon passed my fingers over a large firm clot of blood situated about one inch below the superior curved line of the occipital bone.

The coagula I easily removed and passed the little finger of my left hand through the perfectly smooth opening made by the ball, and found that it had entered the encephalon.

As soon as I removed my finger a slight oozing of blood followed and his breathing became more regular and less stertorous. The brandy and water now arrived and a small quantity was placed in his mouth, which passed into his stomach where it was retained.

Dr. C. F. Taft and Dr. A. F. A. King now arrived and after a moments consultation we agreed to have him removed to the nearest house, which we immediately did, the above named with others assisting.

When we arrived at the door of the box, the passage was found to be densly crowded by those who were rushing towards that part of the theatre. I called out twice “Guards clear the passage,” which was so soon done that we proceeded without a moments delay with the President and were not in the slightest interrupted until he was placed in bed in the house of Mr. Peterson, opposite the theatre, in less than 20 minutes from the time he was assassinated.

The street in front of the theatre before we had left it was filled with the excited populace, a large number of whom followed us into the house.

As soon as we arrived in the room offered to us, we placed the President in bed in a diagonal position; as the bed was too short, a part of the foot was removed to enable us to place him in a comfortable position.

The windows were opened and at my request a Captain present made all leave the room except the medical gentlemen and friends.

As soon as we placed him in bed we removed his clothes and covered him with blankets. While covering him I found his lower extremities very cold from his feet to a distance several inches above his knees.

I then sent for bottles of hot water, and hot blankets, which were applied to his lower extremities and abdomen.

Several other Physicians and Surgeons about this time arrived among whom was Dr. R. K. Stone who had been the President’s Physician since the arrival of his family in the city.

After having been introduced to Dr. Stone I asked him if he would assume charge (telling him at the time all that had been done and describing the wound,) he said that he would and approved of the treatment.

The Surgeon General and Surgeon Crane in a few minutes arrived and made an examination of the wound.

When the President was first laid in bed a slight ecchymosis was noticed on his left eyelid and the pupil of that eye was slightly dilated, while the pupil of the right eye was contracted.

About 11. p.m. the right eye began to protrude which was rapidly followed by an increase of the ecchymosis until it encircled the orbit extending above the supra orbital ridge and below the infra orbital foramen.

The wound was kept open by the Surgeon General by means of a silver probe, and as the President was placed diagonally on the bed his head was supported in its position by Surgeon Crane and Dr Taft relieving each other.

About 2 a.m. the Hospital Steward who had been sent for a Nelatons probe,arrived and examination was made by the Surgeon General, who introduced it to a distance of about 2½ inches, when it came in contact with a foreign substance, which laid across the track of the ball.

This being easily passed the probe was introduced several inches further, when it again touched a hard substance, which was at first supposed to be the ball, but as the bulb of the probe on its withdrawal did not indicate the mark of lead, it was generally thought to be another piece of loose bone.

The probe was introduced a second time and the ball was supposed to be distinctly felt by the Surgeon General, Surgeon Crane and Dr Stone.

After this second exploration nothing further was done with the wound except to keep the opening free from coagula, which if allowed to form and remain for a very short time, would produce signs of increased compression: the breathing becoming profoundly stertorous and intermittent and the pulse to be more feeble and irregular.

His pulse which was several times counted by Dr. Ford and noted by Dr King, ranged until 12 p.m. from between 40 to 64 beats per minute, and his respiration about 24 per minute, were loud and stertorous.

At 1 a.m. his pulse suddenly increasing in frequency to 100 per minute, but soon diminished gradually becoming less feeble until 2.54 a.m. when it was 48 and hardly perceptible.

At 6.40 a.m. his pulse could not be counted, it being very intermittent, two or three pulsations being felt and followed by an intermission, when not the slightest movement of the artery could be felt.

The inspirations now became very short, and the expirations very prolonged and labored accompanied by a gutteral sound.

6.50 a.m. The respirations cease for some time and all eagerly look at their watches until the profound silence is disturbed by a prolonged inspiration, which was soon followed by a sonorous expiration.

The Surgeon General now held his finger to the carotid artery, Col. Crane held his head, Dr Stone who was sitting on the bed, held his left pulse, and his right pulse was held by myself.

At 7.20 a.m. he breathed his last and “the spirit fled to God who gave it.”

During the night the room was visited by many of his friends. Mrs Lincoln with Mrs. Senator Dixon came into the room three or four times during the night.

The Presidents son Captn R. Lincoln, remained with his father during the greater part of the night.

Immediately after death had taken place, we all bowed and the Rev. Dr. Gurley supplicated to God in behalf of the bereaved family and our afflicted country.
True copy.
(signed) Charles A. Leale M. D.

Leale’s 1909 account of the events of April 14–15, 1865, is substantially different from those he wrote more than forty years earlier. By the early twentieth century, Leale had a keen sense of the importance of his role in the events of that night. Although his speech included a distinct sentimentality absent from his accounts in the 1860s, the version of events Leale presented in 1909 accords with those of his earlier accounts, with a few notable exceptions.

In 1909, Leale told a broader story of his involvement in the passion play of Lincoln’s death and burial. He described hearing Lincoln speak at the White House a few days before his death, as well as his attendance at Lincoln’s funeral and the relics he kept from that night, including his blood-stained cuffs. He also recounted the words of a wounded soldier, when learning of Lincoln’s death, “Doctor, all we have fought for is gone. Our country is destroyed, and I want to die.”

Leale also added details that are not present in his 1860s accounts. He mentioned, for example, how the other doctors present had wanted to administer more brandy and water to the President, but Leale resisted. In contrast to his description in 1865, Leale stated that “I ordered the foot of the bed to be removed. . . . Then I requested that it be broken off; as I found this could not satisfactorily be done, I had the President placed diagonally on the bed.” While Leale composed most of his 1860s report in passive voice, his 1909 speech placed him in a much more active and commanding role. For example, in 1865, Leale recounted that when Dr. Stone, the Lincoln family physician, arrived, he asked Stone to take charge of the president. By 1909 Leale stressed how late Dr. Stone arrived and made no mention of asking him to take charge. In a final example, Leale claimed to have performed a form of cardiopulmonary resuscitation on the stricken Lincoln. However, doctors did not begin performing chest compressions to stimulate the heart until the 1890s.

In 1866, Leale received an honorable discharge from the army with the rank of brevet captain. He traveled to Europe, where he studied Asiatic cholera, married in 1867, and fathered six children. He was active in philanthropic causes, serving for twenty years as trustee of the New York Institution for the Instruction of the Deaf and Dumb. Leale continued to practice medicine until his retirement in 1928 at the age of eighty-six. He maintained his affiliations with numerous medical societies until his death in 1932, sixty-seven years after the death of the president whom he could not save.



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