lessons learned ’s Last Breath

HOW LINCOLN’S DEATH HELPED REVIVE THE PRACTICE OF MOUTH-TO-MOUTH RESUSCITATION

By Aizita Magaña

“In no respect do men come nearer to God than house across the street from Ford’s Theatre, where in restoring life to those who seem to be dead.” Lincoln had been watching a performance of the British comedy Our American Cousin. Lincoln —Dr. Anthony Fothergill had appeared dead after being shot by John Wilkes Translated from a Latin phrase, quoted in Booth, but a young Union Army surgeon named “On the Art of Restoring Animation,” 1802 Charles A. Leale had resuscitated him almost immediately. Only 23 years old and just weeks out of medical school, Leale had gone to the theater to get he President still breathes,” began a glimpse of Lincoln and ended up responding to the dispatch sent to the press be- ’s cries for help. He had vaulted fore dawn on April 15, 1865. Just over rows of seats to gain entry into the presidential hours after had box. As Leale recounted in 1909 on the centennial “Tbeen shot, Edwin M. Stanton, Lincoln’s secretary of Lincoln’s birth, when he reached the president, of war, provided ongoing updates from the boarding “he appeared to be dead. His eyes were closed and

In The Last Hours of Abraham Lincoln, artistic license allows artist John B. Bachelder to depict all 47 people who visited the dying president over the course of the night in one fantastical scene. Among those shown is Army surgeon Charles A. Leale, the doctor who rushed to Lincoln’s side after the fatal shot by . The Huntington Library, Art Collections, and Botanical Gardens. (For a larger image of the detail outlined in white, see pg. 28.) his head had fallen forward. He was being held had been widely renounced by the medical com- upright in his chair by Mrs. Lincoln, who was munity and more or less abandoned. The practice weeping bitterly.” was likened to breathing “dead air” into an already Leale initially thought the president had been non-breathing victim. stabbed but then quickly found the gunshot wound At the time of Lincoln’s death, “the correct ideas in the back of the head, behind Lincoln’s left ear. of resuscitation,” including mouth-to-mouth, which Using only his fingers, Leale attempted to relieve had previously been accepted and practiced in the pressure from the president’s brain by removing an 18th century, had been, wrote one physician, “dis- obstructing clot of blood from the wound. Leale then credited, discontinued, and then largely forgotten.” initiated a form of manual artificial resuscitation Leale, however, had studied under progressive popular at the time called the Silvester maneuver. physicians who were expert in gunshot and head He cleared Lincoln’s airway, manipulated his arms, wounds. His training at Bellevue Hospital Medical and pressed on his diaphragm to draw air in and College, in New York City, was exceptional for the out of the lungs. time, and it is safe to assume Leale had been exposed to the mouth-to-mouth method in principle, if not in practice. The young doctor concluded, Leale wrote several reports about his response “Something more must be done that night, including a version that was lost to history to retain life.” until an archivist named Helena Iles Papaioannou discovered it in 2012 at the National Archives in Washington, D.C. While Papaioannou’s discovery Leale repeated the maneuver several times but thrilled historians, the more detailed paper trail got nothing more than “a feeble action of the heart for the history of resuscitation may well be a public and irregular breathing.” The young doctor con- address delivered by Leale in 1909 on the 100th cluded, “Something more must be done to retain life. anniversary of Lincoln’s b