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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.[1]

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.[2]

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.[3]

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.[4]

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.[5]

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.”[6]

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.[7]

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[8] and Dr Stone[9] his family physician arrived, which was about 20 minutes after we had placed him in bed in the house of Mr. Peterson[10] opposite the theatre, and as I remained with him until his death, I humbly submit the following brief account.[11]

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.[12] The play was then progressing and in a few minutes I saw the President, Mrs Lincoln, Major Rathbone[13] and Miss Harris[14] enter; while proceeding to the Box they were seen by the audience who cheered[15] which was reciprocated by the President and Mrs Lincoln by a smile and bow.[16]

The party was preceded by an attendant[17] 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,[18] when the report of a pistol was distinctly heard and about a minute after a man of low stature with black hair and eyes[19] 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[20] and disappearing behind the scene.[21]

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.[22]

I immediately ran to the Presidents box and[23] 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”![24] I told her we would do all that we possibly could.[25]

When I entered the box the ladies were very much excited.[26] 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.[27]

While approaching the President I sent a gentleman for brandy and another for water.[28]

When I reached the President he was in a state of general paralysis,[29] his eyes were closed and he was in a profoundly comatose condition, while his breathing was intermittent and exceedingly stertorous.[30] 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[31] 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)[32] and soon passed my fingers over a large firm clot of blood situated about one inch below the superior curved line[33] of the occipital bone.[34]

The coagula[35] I easily removed and passed the little finger of my left hand through the perfectly smooth opening made by the ball,[36] and found that it had entered the encephalon.[37]

As soon as I removed my finger a slight oozing of blood followed and[38] his breathing became more regular and less stertorous.[39] The brandy and water now arrived and a small quantity was placed in his mouth,[40] which passed into his stomach where it was retained.

Dr. C. F. Taft[41] and Dr. A. F. A. King[42] now arrived and after a moments consultation we agreed to have him removed[43] to the nearest house, which we immediately did, the above named with others assisting.[44]

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[45] 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.[46]

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[47] 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.[48]

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[49] for bottles of hot water, and hot blankets, which were applied to his lower extremities and abdomen.[50]

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.[51]

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.[52]

The Surgeon General and Surgeon Crane[53] in a few minutes arrived and made an examination of the wound.

When the President was first laid in bed a slight ecchymosis[54] was noticed on his left eyelid and the pupil of that eye was slightly[55] 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.[56]

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.[57]

About 2 a.m. the Hospital Steward who had been sent for a Nelatons probe,[58] 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[59] 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[60] 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.[61]

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.[62]

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.[63]

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,[64] 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.[65]

At 7.20 a.m.[66] he breathed his last and “the spirit fled to God who gave it.”[67]

During the night the room was visited by many of his friends.[68] Mrs Lincoln with Mrs. Senator Dixon[69] came into the room three or four times during the night.[70]

The Presidents son Captn R. Lincoln,[71] remained with his father during the greater part of the night.

Immediately after death had taken place, we all[72] bowed and the Rev. Dr. Gurley[73] supplicated to God in behalf of the bereaved family and our afflicted country.

True copy.

(signed) Charles A. Leale M. D.

[File Note:]

L. 262. S. G. O. 1865

Chas A Leale,

Report on death of President Lincoln[.]

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.[74]

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.”[75]

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.[76] 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.”[77] 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.[78]

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.[79]

Notes

    1. The Papers of Abraham Lincoln is a long-term project dedicated to identifying, imaging, and publishing all documents written by or to Abraham Lincoln during his lifetime (1809–1865). The report is in the hand of a clerk and marked “True Copy.” Charles A. Leale, “Report on the Death of President Lincoln,” RG 112, Records of the Office of the Surgeon General (War), entry 12: Central Office, Correspondence, 1818–1946, 1818–1890, Letters Received, box 56, National Archives and Records Administration, Washington, D.C. (NARA). The authors appreciate the assistance of John Elliff; Edward Steers Jr.; Natalie Sweet; Bill Stingone and Susan Waide of the New York Public Library; and Jack House of the National Archives.return to text

    2. Charles A. Leale to Benjamin F. Butler, July 20, 1867, Benjamin Butler Papers, box 43, Manuscript Division, Library of Congress, Washington, D.C.; Charles A. Leale, Lincoln’s Last Hours: Address Delivered Before the Commandery of the State of New York Military Order of the Loyal Legion of the United States (New York: Privately published, 1909).return to text

    3. Charles A. Leale, “Medical Autobiography of Charles A. Leale,” RG 94, Records of the Adjutant General’s Office, 1800–1947, entry 561: Records of Divisions of the Adjutant General’s Office, Records Concerning Medical Personnel, 1839–1914, box 334, NARA, 1–7; Leale, Lincoln’s Last Hours, 3.return to text

    4. Leale made these comments on the centennial of Lincoln’s birth, when such religious imagery was common. John Wilkes Booth was also present when Lincoln made this final speech. Leale, Lincoln’s Last Hours, 3; Michael Kauffman, American Brutus: John Wilkes Booth and the Lincoln Conspiracies (New York: Random House, 2004), 209–10; Edward Steers Jr., Blood on the Moon: The Assassination of Abraham Lincoln (Lexington: University of Kentucky Press, 2001), 91.return to text

    5. The following example provides a single sentence from three of the copies of the 1865 report: “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” (Surgeon General report). “I then heard cries that the ‘President had been murdered’, which was followed by those of ‘kill the murderer’, ‘Shoot him’ etc. which came from different parts of the audience” (Adjutant General report). “I then heard cries that the ‘President has been murdered’ which was followed by those of ‘kill the murderer’ & etc, which came from different parts of the audience” (USSC report). Charles A. Leale, “The Assassination and Death of Abraham Lincoln, President of the United States,” RG 94, Records of the Adjutant General’s Office, 1800–1947, entry 286: Reference Aids and Other Special Files, 1790–1946, file 14, Medical Records Pertaining to the Assassination of Abraham Lincoln, NARA; Charles A. Leale, “The Assassination and Death of Abraham Lincoln, President of the United States,” United States Sanitary Commission Records, Medical Committee Archives, document number MCCXXXII (1232), New York Public Library, New York, N.Y. Earl Hess, Professor at Lincoln Memorial University, discovered the USSC report at the New York Public Library. His student, Natalie Sweet, wrote an article comparing Leale’s 1865 and 1867 versions with the 1909 speech. See Natalie Sweet, “‘Sustaining the Vital Force’: New Evidence in Dr. Charles Leale’s Care of Abraham Lincoln,” Lincoln Herald 112 (Fall 2010): 181–95. While no historian has seemingly used the adjutant general copy of the report, a photocopy of this version resides at Georgetown University and was used by John Sotos in 2008. See John G. Sotos, The Physical Lincoln Sourcebook (Mount Vernon, Va.: Mt. Vernon Book Systems, 2008).return to text

    6. Charles A. Leale to Dwight Dudley, May 28, 1865, 7, Shapell Manuscript Foundation.return to text

    7. Leale to Butler, Butler Papers. Leale, Lincoln’s Last Hours. return to text

    8. Joseph K. Barnes (1817–1883) was twelfth surgeon general of the United States army. Barnes received his medical degree from the University of Pennsylvania in 1838. Appointed to the medical corps of the army in 1840, Barnes served in Florida during the Seminole War and then in Texas and Mexico during the Mexican-American War (1846–48). In May 1862 he became attending surgeon for the city of Washington, succeeding to acting surgeon general and then surgeon general after William A. Hammond’s dismissal in August 1864. James M. Phalen, comp., “Chiefs of the Medical Department, U.S. Army, 1775–1940, Biographical Sketches,” Army Medical Bulletin 52 (April 1940): 47–51.return to text

    9. Robert King Stone (1822–1872) was a highly regarded physician in the District of Columbia and served as the Lincoln family’s physician from their arrival in Washington in 1861. Steers, Blood on the Moon, 125, 133, 269; Jean H. Baker, Mary Todd Lincoln: A Biography (New York: Norton, 1987), 209.return to text

    10. William (born Wilhelm) Petersen (1816–1871) was a German-born tailor who emigrated to the United States in 1841 and who owned the boardinghouse directly across Tenth Street NW from Ford’s Theatre. George J. Olszewski, House Where Lincoln Died: Furnishing Study (Washington, D.C.: National Park Service, U.S. Department of the Interior, Division of History, Office of Archeology and Historic Preservation, 1967): 2–7.return to text

    11. Leale’s 1867 report begins with a different paragraph: “On the evening of the 14th April 1865 while engaged with the executive duties of the United States Army General Hospital Armory Square Washington I was requested to visit Ford’s Theatre, being told that President Lincoln, General Grant and staff were to be there.”return to text

    12. The 1867 report adds that Leale “endeavored to procure a seat in the orchestra but it being densly crowded I left it for the dress circle where I found a vacant seat on the same side and within 40 feet of the presidents’ box.”return to text

    13. Henry Reed Rathbone (1837–1911) was a major in the United States army and the fiancé of Clara Harris. After practicing law in Albany, New York, Rathbone enlisted in the army during the Civil War, rising from captain to major. Rathbone and Harris attended Our American Cousin that night in place of General Ulysses S. Grant and his wife. After shooting the president, Booth slashed Rathbone’s arm in a brief struggle. Edward Steers Jr., ed., The Trial: The Assassination of President Lincoln and the Trial of the Conspirators (Lexington: University Press of Kentucky, 2003), 78–79; Gene Smith, “The Haunted Major,” American Heritage 45 (February/March 1994); Steers, Blood on the Moon, 104–5, 120.return to text

    14. Clara Harris (1834–1883) was the daughter of United States Senator Ira Harris of New York. She later married Henry Rathbone. Edward Steers Jr., The Lincoln Assassination Encyclopedia (New York: HarperCollins, 2010), 268.return to text

    15. The 1867 report amends the remainder of this sentence to read “which was responded to by the President with a smile and a bow.”return to text

    16. The 1867 report has additional sentence here: “The President as he proceeded to the box looked expressively mournful and sad.”return to text

    17. Charles Forbes (1835–1895) was Lincoln’s personal valet and messenger. Forbes ultimately allowed Booth to enter the president’s box. Steers, Blood on the Moon, 116, 120; Steers, Lincoln Assassination Encyclopedia, 211–12.return to text

    18. The 1867 report says “until about 5 minutes past 10 when on looking towards the box I saw a man speaking with another near the door and endeavouring to enter, which he at last succeeded in doing after which the door was closed.

      “I again looked towards the stage and was pleased with the amusing part then being performed. . . .”return to text

    19. The 1867 report describes Booth as “a man with dark hair and bright black eyes.”return to text

    20. The 1867 report: “raised his shining dagger in the air, which reflected the light as though it had been a diamond.”return to text

    21. The 1867 report adds, “when he struck the stage he stumbled a little forward but with a bound regained the use of his limbs and ran to the opposite side of the stage. . . .”return to text

    22. The 1867 report adds the sentence, “I remained in my seat not believing it until I saw some one open the door of the box, and heard him call for a Surgeon and help.”return to text

    23. The 1867 report reads here “upon saying that I was a Surgeon, was immediately admitted.”return to text

    24. The 1867 report reads here, “‘Oh Doctor do what you can for my dear husband’ ‘do what you can for him’ and ‘send for Dr Stone’”return to text

    25. The 1867 report changes this sentence from first person plural to first person singular: “I told her that I would do all which was in my power to do.”return to text

    26. This sentence is absent from the 1867 report.return to text

    27. The 1867 report adds, “Major Rathbone was at the door of the box.”return to text

    28. The 1867 report reads here, “While approaching the President I was told that he had been murdered, and I sent for some Brandy and water,”return to text

    29. The 1867 report describes Lincoln as “almost dead.”return to text

    30. Respiration that is strained, labored, or loud.return to text

    31. Two major arteries in the upper chest below the collar bone. The two subclavian arteries receive blood from the aorta and supply it to the arms. Further branches supply blood to the head and elsewhere in the chest.return to text

    32. The 1867 report adds, “I lifted his eyelids and examined his eyes, the pupil of one of which was dilated.”return to text

    33. The 1867 report adds, “and an inch and a half to the left of the median line.”return to text

    34. Single trapezoid-shaped bone at the base of the cranium.return to text

    35. Clot, in this case of blood; the 1867 report adds, “which was firmly matted with the hair.”return to text

    36. The 1867 report has “he was then apparently dead” in place of “and found that it had entered the encephalon.”return to text

    37. Contents of the cranium, i.e. the brain.return to text

    38. The 1867 report has “and he soon commenced to show signs of improvement” in place of “his breathing became more regular and less stertorous.”return to text

    39. The 1867 report adds, “I believe that he would not have lived five minutes longer, if the pressure on the brain had not been relieved and if he had been left that much longer in the sitting posture.”return to text

    40. The 1867 report has here, “which was the only thing that passed into his stomach from his assassination until his death.”return to text

    41. The 1867 report has proper initials, “C. S.” Charles Sabin Taft (1835–1900) was an acting assistant surgeon. Taft qualified just after the start of the Civil War and in 1865 was working as a surgeon at the army’s Signal Camp of Instruction in Georgetown. Steers, Lincoln Assassination Encyclopedia, 529. Charles S. Taft, “The Last Hours of Abraham Lincoln,” The British Medical Journal 231 (June 1865): 569–70; W. Emerson Reck, A. Lincoln: His Last 24 Hours (Jefferson, N.C.: McFarland, 1987), 119; “Dr. Charles S. Taft Dead,” New York Times, December 19, 1900.return to text

    42. Albert Freeman Africanus King (1841–1914) was a physician in the District of Columbia. King graduated in 1861 from the National Medical College in Washington, D.C. (now part of George Washington University). During the Civil War, King tended wounded soldiers, including at the First Battle of Bull Run (1861). In 1865 he received a degree in medicine from the University of Pennsylvania and was appointed the same year as a lecturer in toxicology at the National Medical College. Dictionary of American Biography, s.v. “King, Albert Freeman Africanus.”return to text

    43. The remainder of this sentence is not in the 1867 report.return to text

    44. The 1867 report adds, “While in the theatre, I was several times asked the nature of the wound, and said that the ball had lodged in the encephalon and that it was a mortal wound. We now commenced to remove him carefully, I ascending the steps first while supporting his head and shoulders.”return to text

    45. The 1867 report adds, “towards the stairs leading to the hall which is entered from the street, when we arrived at the head of the stairs we turned around those holding his lower extremities descending first.

      “There was an officer present who rendered great assistance in making a passage through the crowd.

      “When we arrived to the street I was asked to place him in a carriage and remove him to the White House, this I refused to do being fearful that he would die as soon as he would be placed in an upright position. I said that I wished to take him to the nearest house, and place him comfortably in bed.

      “We slowly crossed the street there being a barrier of men on each side of an open passage towards the house.

      “Those who went ahead of us reported that the house directly opposite was closed.

      “I saw a man standing at the door of Mr. Peterson’s house holding a lighted candle in his hand and beckoning us to enter which we did and immediately placed him in bed. . . .”return to text

    46. This sentence is not in the 1867 report.return to text

    47. The 1867 report reads, “removed, which then made it so that his body and limbs were straight upon the bed.”return to text

    48. According to the 1867 report, Leale had to repeat his request that all except the “medical gentlemen” leave the room “to give the President a little fresh air.” The 1867 report adds, “An officer now came to me and said ‘Doctor you point out those who you wish to remain, and I will see that the others leave’ which he did. he then came to me and said that all others with the exception of Mrs Lincoln and Miss Harris had left and that he would rather have me speak to them,

      “I went to Mrs. Lincoln and asked her if she would have the kindness to step into the next room for a few minutes while we examined him, removed his clothes and placed him more comfortably on the bed.

      “Mrs. Lincoln readily assented.”return to text

    49. The 1867 report adds that Leale sent “the Hospital Steward who had been of great assistance to us while removing him from the theatre.”return to text

    50. The 1867 report adds, “I asked again to have the Surgeon General and Dr Stone sent for also sent a special messenger for Surgeon D. W. Bliss then in command of Armory Square Hospital.”return to text

    51. The 1867 report adds the names of Dr. Lieberman and Dr. Ford, and notes that “on looking around I saw Senator Sumner.”return to text

    52. The 1867 report doesn’t mention Dr. Stone’s assessment of Leale’s treatment of Lincoln.return to text

    53. Chares H. Crane (1825–1883) was assistant surgeon general of the United States army. Crane received his medical degree from Harvard in 1847 and enlisted in the army in 1848. By 1865 Crane had advanced to the rank of brevet lieutenant colonel. Steers, Lincoln Assassination Encyclopedia, 160; James Lorenzo Brown, Massachusetts in the War, 1861–65 (Springfield, Mass.: Clark W. Bryan, 1889), 905–6.return to text

    54. Medical term for a bruise, formed when blood from ruptured vessels flows into the tissue just below the skin.return to text

    55. The 1867 report does not include “slightly” here.return to text

    56. The supraorbital ridge is the ridge on the frontal bone above the eye sockets. Infraorbital foramens are openings in the skull just below the eye sockets that allow for the passage of an artery, vein, and nerve.return to text

    57. The 1867 report does not include “relieving each other.”return to text

    58. A Nélaton probe is a metal device equipped with a porcelain knob, used to locate bullets within wounds. The probe is named for its inventor Auguste Nélaton (1807–1873), a French physician and surgeon. As Leale describes, if the porcelain knob did not indicate the presence of lead, then it likely had not touched a bullet.return to text

    59. The 1867 report does not include “several inches” here.return to text

    60. The 1867 report has “stain” in place of “mark.”return to text

    61. The 1867 report does not include pulse or respiration rates.return to text

    62. This sentence is not in the 1867 report, but the 1867 report adds, “As morning dawned it became quite evident that he was gradually sinking, . . .”return to text

    63. The 1867 report reads, “The inspirations now became very prolonged accompanied by a guteral sound.”return to text

    64. The left and right common carotid arteries (on either side of the neck) supply oxygenated blood to the head and neck regions. The common carotid arteries divide in the neck into the internal carotid artery (supplying blood to the brain and eyes) and external carotid artery (supplying blood to the face, scalp, and mouth).return to text

    65. The 1867 report adds, “A short time before death occurred his pastor the Rev. Dr Gurley said ‘let us pray’ when we all knelt down upon our knees around his dying bed, while he offered a most solemn and impressive prayer. After which we arose to witness the struggles between life and death.”return to text

    66. Difference from the traditional time of 7:22 a.m.return to text

    67. Leale quotes a portion of Ecclesiastes 12:7: “Then shall the dust return to the earth as it was: and the spirit shall return unto God who gave it.” The 1867 report does not include this quotation but reads, “At 7.20 a.m. he breathed his last, not having been conscious one moment one moment [sic] from the time of being shot until his death.”return to text

    68. The 1867 report does not include this sentence.return to text

    69. Elizabeth L. C. Dixon (1818–1871) was the wife of Senator James Dixon of Connecticut and a close friend of Mary Lincoln. Steers, Blood on the Moon, 124–25, 269.return to text

    70. The 1867 report adds, “Mrs. Lincoln at one time exclaiming ‘Oh that my Taddy might see his Father before he died’ then fainted and was carried from the room.”return to text

    71. Robert Todd Lincoln (1843–1926) was Abraham and Mary Lincoln’s oldest son. Lincoln graduated from Harvard University in 1864 and briefly attended Harvard Law School before taking a position on General Ulysses S. Grant’s staff. Jason Emerson, Giant in the Shadows: The Life of Robert T. Lincoln (Carbondale: Southern Illinois University Press, 2012), 5, 89–91, 411.return to text

    72. The 1867 report adds “knelt down around that death bed and.”return to text

    73. Phineas Densmore Gurley (1816–1868) was the pastor of the New York Avenue Presbyterian Church, Washington, D.C., where the Lincolns rented a pew, and chaplain of the United States Senate. Gurley graduated from Princeton Theological Seminary in 1840 and was the pastor of Presbyterian churches in Indiana and Ohio before relocating to Washington in 1854. Steers, Lincoln Assassination Encyclopedia, 254–55; Edgar DeWitt Jones, Lincoln and the Preachers (New York: Harper & Brothers, 1948), 177; Allen C. Guzelo, Abraham Lincoln: Redeemer President (Grand Rapids, Mich: Eerdmans, 1999), 321.return to text

    74. Leale, Lincoln’s Last Hours.return to text

    75. Ibid., 14.return to text

    76. Ibid., 9.return to text

    77. Leale, “Report on the Death of President Lincoln,” 11; Leale, Lincoln’s Last Hours, 8.return to text

    78. Leale, “Report on the Death of President Lincoln,” 13; Leale, Lincoln’s Last Hours, 14, 9; Sweet, “Sustaining the Vital Force,” 187, 190–91.return to text

    79. “Dr. C. A. Leale Dies; Saw Lincoln Shot,” New York Times, June 14, 1932, 21.return to text