The Blood Count in President McKinley’s Case
Before closing this series of articles,
we feel that attention should be called to the blood count in the
case of President McKinley.
The President was shot on Sept. 7,
and died on Sept. 14. The temperature rose for two days but fell
on the third day from 102°8 [sic] to 101° in a few hours.
From this date on there was a steady decline to the end, the temperature
being higher mornings than evenings; this latter fact is worthy
The pulse reached 145 on the second
day, Sept. 8th. It dropped in an irregular fashion to 106 on Sept.
10th, and then rose irregularly until the Presidents [sic]
death, reaching 128 on Sept. 12th and 13th.
The President complained of fatigue
in the latter days of his illness and his rapid irregular pulse
led to anxiety on the part of the attending surgeons, before it
was communicated to the public. The question of injury to the solar
plexus was set aside because of the regression and later acceleration
of the pulse rate. As regards the question of sepsis, there was
no abdominal tenderness, no gaseous distention, no muscular retraction,
and the temperature was continually falling. Dr. Wasdin then made
a blood count, and reported that there was no leucocytosis; and
in consequence of this sepsis was excluded.
Just here in regard to the blood count
a false conclusion was reached, 
and it is especially worth noting in connection with the subject
of these papers. We have repeatedly called attention to the fact
that in pneumonia, an absence of leucocytosis is an omen of a fatal
issue of the case. We also note that in sepsis an absence of leucocytosis
meant a speedy death.
In our article in the June number
of The Medicus we quoted Dr. Deaver of Philadelphia, as saying:
“Leucocytosis is the most significant
fact which a blood examination will give a surgeon. High leucocytosis
is in general a favorable sign as it usually foreshadows a reaction
and may express the fact that nature is able to cope with the inflammation.”
The condition of affairs was simply
this in President McKinley’s case: His general health and strength
was really at a low ebb, so low that he only gave the slightest
evidence of reaction against the invasion of septicaemia on the
third day when the temperature rose to 102.°8 [sic]. It is
likely that a slightly increased white blood count would have been
found at this time. But nature was physically unequal to the task,
the few extra white cells soon fell victims to the bacterial invasion,
and general sepsis followed. The lack of leucocytosis was a sign
of impending death.
But who thought of President McKinley
as in such poor general health. An old drunkard takes phenmonia
and dies without reaction in a few days. There is no leucocytosis
in his case, and we easily explain the results by saying exposure
and debauching had so exhausted his vital powers that no reaction
would take place. We are now warned that hard mental affliction,
great stress of brain work, great care and great responsibility,
not to mention the care of a sickly wife to pull at the heart strings,
many [sic] so debilitate an apparently healthy man that no
reaction may take place in opposition to septic invasion.
The giving of a little solid food
may have hastened the end slightly. It seems ill advised, but it
in no way aided to determine the final result. The case was otherwise
well handled, but nature was incompetent to accomplish the desired