The Examination of the Blood in President M’Kinley’s
By the death of President
McKinley, on September 14th last, the nation has lost a man whose
inner life was little understood or appreciated by the vast majority,
even of those who respected him and thought that he never erred.
While it may seem strange to many
that his name should be mentioned in a work of this kind, on reconsidering,
it will be remembered that the consulting physicians submitted his
blood to a miscroscopic [sic] examination.
At the time of Garfield’s assassination,
the examination of blood was not much thought of. In the past few
years, however, this line of work has made great strides; and blood
examination to-day is carried on systematically in every large hospital.
The question naturally arises: What
could have been indicated by the blood in the President’s case that
would in any way have been of value?
Theoretically, everything should be
told, while practically a blood examination is of more service than
would be imagined by those who are not familiar with this line of
The statement made in another part
of this work is applicable here, that when one part of the body
is “sick” the whole suffers with it. An experienced diagnostician,
by means of the blood alone, can often tell when parts of the body
are “sick.” The condition may be recent, or it may have been coming
on for years.
I say the blood will often tell the
inner story; as the old quotation says: “Every action of our lives
touches on some chord that will vibrate in eternity.”
So, to a greater or less degree, every
action makes some change in the body. There may be no practical
way of determining the finer effects; but if a definite action of
mind or  body is kept up,
in time the change is perceptible to the eye. And so, for health
or disease, this change takes place, and sometimes it is years in
showing evidence. This evidence to-day can be seen by one experienced
in blood diagnosis. For example, gangrene will show changes in the
blood, and the physicians resorted to a blood examination in the
Both a fresh and a dry blood examination
should always be made if everything is expected to be found that
is determinable by this diagnostic method.
William McKinley, like all public
men, was cartooned, criticised and misrepresented for years, even
by many who now see their mistake. All men who have a conscience
are aware that much criticism on a sensitive man is not only wearing,
but when joined with the great weight that falls on our Chief Executive,
from such sources, would rip the very nervous tissue—say nothing
of the nervous energy—in a man of McKinley’s sensitive parts.
And such changes can be seen in a
fresh or living blood examination. The poikilocytes and the microcytes,
either one or both together, might be present in the blood. When
such changes take place in the nerve elements, the blood corpuscles
have not their proper form; they should all be round and elastic,
but instead they are elongated, angular and flabby, and often the
number of dwarf cells are increased because the system does not
have time to manufacture strong, full-sized cells.
The nervous energy is used up too
fast, and this latter condition is especially perceptible to the
diagnostician when the crenated red cells are abundant. These cells
can be seen easily in the fresh blood, and that there be no mistake
as to what is meant by fresh or living blood, we refer the reader
to the introduction. Of course, if the blood stands half an hour
or so, all the cells get more or less crenated. But they should
be  seen floating around
in the serum as soon as the drop is placed on the slide (see Fig.
93). That then indicates the condition of the system. Fig. 81 illustrates
These things that have been pointed
out are seldom thought of by the majority of blood examiners. More
often, an increase in the number of white cells is what is looked
for. Normally, there is one to about every four hundred red ones;
but, as a rule, these are counted by the dry method of examination¹.
One examination by this latter method is often of no avail. In the
President’s case there were found, according to the physicians’
report, 6,752 white and 3,920,000 to the cubic millimetre of the
red cells, which is below normal. In each it was expected that there
would be an increase in these white cells, or more than normal.
The only way for the dry method to be of any definite value would
be by reference to a previous examination.
If the President six months before,
or even a month before, had had his blood cells counted, a comparison
of that condition with the one at the time of his sickness would
have been of some value one way or another. There will be a time
when people will have their blood examined as regularly as they
go, or ought to go, to their dentist. If a photograph is taken,
there is a defienite [sic] record to look back to.
Therefore, as it happened, the blood
examination of the President threw no light on the case.
The fresh blood examination, however,
in the hands of a diagnostician—and every physician should be his
own—should have at least revealed his weak condition—this lack of
In President Garfield’s case, if blood
examinations had then been in vogue, it would have told much, but
not without a previous record (or a photograph) to compare. It was
found at  the autopsy that
he had an abscess² cavity, which had nothing to do with the wound
caused by the bullet. This, in itself, would show leucocytosis,
or increase in the white cells.
The pyemia, which afterward developed
in Garfield’s case, from the destruction of tissue, would have shown
marked increase in the white blood cells, and probably much tubercular
This statement on McKinley’s case
from a blood standpoint is simply to show some things that all do
not think of, and to indicate what often can be told from a fresh
blood examination, in contradistinction to the dry.
It is not in any sense intended as
According to the report of the physicians,
the President died directly as a result of the gunshot wound.
When the nervous energy in a man is
exhausted, the result is just as bad as though his blood vessels
were empty. The preservation of the vitality in the human economy
is to-day not appreciated by the majority of men and women. This
energy can leak from its channels in the body in many ways, the
same as steam can leak from the boiler or cylinder of the steam
engine. If you shoot a boiler full of holes there will be no steam
left to make the engine go; and so McKinley was shot, and his already
weak vital system was drained still more (of energy).
The fact that the bullet affected
the pneumogastric-nerve and, perhaps, passed close to the solar
plexus, is what did the damage. This, in itself, often kills. Pugilists
are aware of this, and use a belt to guard this location. Attention
enough is not given in our post-mortem examinations to the nervous
tissues that are affected by shocks, due to either wounds or surgical
operations. For when the nervous energy is low, or there is a great
loss of blood, which is often dangerous; poikilo- 
cytes or flabby red cells are often present in proportion to the
weakness, and these cells would always be of great aid in diagnosing
The shock in this case dissipated
what nervous force the President had left, by shutting off one of
the main channels through which this energy travels in going from
the head to the feet. This shock can be compared to the breaking
or short-circuiting of the main wire of a dynamo-electric machine
under full load. The result here would be the stopping of the machine.
In the body, the only thing that could happen would be death of
tissue, mortification or death of the man as a direct result of
the shock. Again, often in connection with the nervous shock, the
dwarf cells make their appearance in the blood and we have nerve
weakness, indicated especially when these dwarf cells are mixed
with the poikilocytes. In order to see these latter well, a large
drop of blood must be had and the cover glass must be laid on gently,
for the ability to perceive and judge this condition cannot be gained
in a night; it cannot be learned in the laboratory; but the ability
to see these peculiar red cells slowly floating about in the watery
portion of the blood can only be learned at the bedside of the patient.
When these two kinds of cells described
are present in abundance, the blood supply is distributed slowly
to any part because the heart action is weak. Death of tissue in
this state of the system must result somewhere. When gangrene sets
in, even in a moderate degree, there will generally be found an
increase in the white blood cells. Germs of various kinds, then
begin their work; if present, bacillus coli communis and gas germs,
in connection with the others, call for more fuel; the continual
lowering of the vitality allows the fuel to be supplied;
and so the germs multiply and gangrene goes on.
President McKinley’s death was due
primarily to the gunshot wound, and, secondarily, to the low state
of his nervous energy. 
There have been only a few recoveries
from similar wounds—such is never expected. Dr. Van Hoevenberg³
reported since McKinley’s death one such in a man aged 33. The young
man was strong and vigorous, his vitality or nervous energy was
high; he withstood the operation well, but possibly the ball did
not strike in as vital a part as in the case of McKinley. Still,
it is generally considered that bowel wounds, such as that reported
by Dr. Van Hoevenberg, are the more dangerous.
Still more plainly does this lack
of vitality stamp its fatal mark when it is remembered that the
President’s whole body began to mortify in a very few days. This,
again, will confirm the opinion that there was lack of vitality,
due to the wound, and the long strain under which McKinley had been
To some it will appear out of place,
nevertheless medical periodicals throughout the country have been
eulogizing President McKinley more or less. We therefore say, without
fear of controversy, that William McKinley was one of the few modern
public men that had lived and knew how to die.
He probably, for the time, saved the
life of the man who slew him. “Be easy with him, boys.”
Plutarch says, when speaking of the
personality of Phocion, the great Greek general: “That a word or
a gesture from a truly good man carries more weight than ten thousand
eloquently argued speeches.”
And so in the President’s last hours
upon earth—just as natural as though he were going to live for twenty
years to come—McKinley (as James G. Blaine said of Lincoln in his
debates) said: “The things that would stand the test of time and
square themselves with eternal justice,” more truly and more as
he lived, than any public man of whom we have record in modern days.