Lincoln's Last Hours

by Charles Augustus Leale

As the symptoms indicated renewed brain compression, I again cleared the opening of clotted blood and pushed forward the button of bone, which acted as a valve, permitted an oozing of blood and relieved pressure on the brain. I again saw good results from this action.

After doing all that was professionally necessary, I stood aside for a general view and to think what to do next. While thus watching several army officers anxiously asked if they could in any way assist. I told them my greatest desire then was to send messengers to the White House for the President's son, Captain Robert T. Lincoln, also for the Surgeon General, Joseph K. Barnes, Surgeon D. Willard Bliss, in charge of Armory Square General Hospital, the President's family physician, Dr. Robert K. Stone, and to each member of the President's Cabinet. All these desires of mine were fulfilled.

Having been taught in early youth to pay great respect to all religious denominations in regard to their rules concerning the sick or dying, it became my duty as surgeon in charge of the dying President to summon a clergyman to his bedside. Therefore after inquiring and being informed that the Rev. Dr. Gurley was Mrs. Lincoln's pastor, I immediately sent for him.

Then I sent the Hospital Steward for a Nelaton probe. No drug or medicine in any form was administered to the President, but the artificial heat and mustard plaster that I had applied warmed his cold body and stimulated his nerves. Only a few were at any time admitted to the room by the officer, whom I had stationed at the door, and at all times I had maintained perfect discipline and order.

While we were watching and letting Nature do her part, Dr. Taft came to me with brandy and water and asked permission to give some to the President. I objected, stating as my reason that it would produce strangulation. Dr. Taft left the room, and again came to me stating that it was the opinion of others also that it might do good. I replied: "I will grant the request, if you will please at first try by pouring only a very small quantity into the President's mouth." This Dr. Taft very carefully did, the liquid ran into the President's larynx producing laryngeal obstruction and unpleasant symptoms, which took me about half a minute to overcome, but no lasting harm was done. My physiological and practical experiences had led to correct conclusions.

On the arrival of Dr. Robert K. Stone, who had been the President's family physician during his residence in Washington, I was presented to him as the one who had been in charge since the President was shot. I described the wound and told him all that had been done. He said he approved of my treatment.

Surgeon General Joseph K. Barnes' long delay in arriving was due to his going first to the White House, where he expected to find the assassinated President, then to the residence of Secretary Seward and his son, both of whom he found requiring immediate attention, as they had been severely wounded by the attempts of another assassin to kill them.

On the arrival of the Surgeon General and Assistant Surgeon General, Charles H. Crane, I reported what we had done and officially detailed to the Surgeon General my diagnosis, stating that whenever the clot was allowed to form over the opening to the wound the President's breathing became greatly embarrassed. The Surgeon General approved the treatment and my original plan of treatment was continued in every respect until the President's death.

The Hospital Steward arrived with the Nelaton probe and an examination was made by the Surgeon General and myself, who introduced the probe to a distance of about two and a half inches, where it came in contact with a foreign substance, which lay across the track of the ball; this was easily passed and the probe was introduced several inches further where it again touched a hard substance at first supposed to be the ball, but as the white porcelain 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 the second time and the ball was supposed to be distinctly felt. 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 short time, produced signs of increased compression, the breathing becoming profoundly stertorous and intermittent, the pulse more feeble and irregular. After I had resigned my charge all that was professionally done for the President was to repeat occasionally my original expedient of relieving the brain pressure by freeing the opening to the wound and to count the pulse and respirations. The President's position on the bed remained exactly as I had first placed him with the assistance of Dr. Taft and Dr. King.

Captain Robert T. Lincoln came and remained with his father and mother, bravely sustaining himself during the course of the night.