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HEALTH AND MEDICAL HISTORY OF PRESIDENT

JAMES GARFIELD

President #20: 1881-1881
Lived 1831-1881
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HEALTH AND MEDICAL HISTORY OF PRESIDENT

JAMES GARFIELD

President #20: 1881-1881
Lived 1831-1881
↓ Lived 1831-1881 2023 1776
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2001-2021


UNDER CONSTRUCTION



Maladies & Conditions  · writing · "ague" · bad cold · anal fissure · "weak
stomach" · height & weight · assassination · rectal feeding · abdominal cramping
· foot pain · infarct · malpractice

Odds & Ends · Doctors · Resources · Cited Sources

Maladies and Conditions
writing
Could simultaneously write Greek with one hand and Latin with the other. 1a

"ague"
For six weeks when he was 15, Garfield drove horses along the narrow towpaths
running beside the Ohio canal network. After falling into the water for
literally the 14th time, Garfield developed fever, chills, exhaustion, and
became bedridden for weeks. This illness was diagnosed as an "ague," which was
then a term applied generically to any malaria-like illness. He was treated with
large doses of calomel, a chloride of mercury with cathartic properties. At that
time it was the standard treatment for any fever. 2

bad cold
Garfield had a bad cold in 1851 that was treated by a homeopathic practitioner,
Alpheus Morrill, with "cold cloths applied to the chest and infinitesimal doses
of medicine." 2

anal fissure
Garfield developed a painful anal fissure in 1875 that kept him in bed for
several weeks. Ultimately, Dr. John Shaw Billings (later the Surgeon General of
the US Army, and the architect of the Johns Hopkins Hospital) operated on him. 2

"weak stomach"
Garfield had a "weak stomach" for years. 2

height & weight
"Garfield was elected president at age 49. He was six feet in height and weighed
185 pounds, and was characterized as 'very strong, atheletic and energetic." 2

assassination
On July 2, 1881, Charles J. Guiteau fired two bullets from his Bulldog .44 at
Garfield. One caused a superficial arm wound. The other entered in the right
posterior thorax, fractured rib 11, traveled leftward and anteriorly into the L1
vertebral body, then lodged about 2.5 inches to the left of the spine, below the
inferior border of the pancreas.



3 (President Garfield's spine is held by the National Museum of Health and
Medicine. It was on display in 2000, and apparently shows the path of the bullet
4.)

The whereabouts of this second bullet was a mystery until the autopsy, despite
even the efforts of Alexander Graham Bell. Bell used his newly invented
"induction balance," better known now as a metal detector, to attempt locating
the bullet. 1b


rectal feeding
For some period after the shooting, Garfield was fed rectally 1c. Comment: It
would be interesting to know if this was an innovation at the time and whether,
due to absorptive peculiarities of the rectum, this could have led to a
deficiency state of any kind.

abdominal cramping
After the shooting, Garfield was treated with high maintenance doses of quinine
(5 to 10 grains per day) and morphine (one-fourth grain daily), frequent sips of
brandy, and a single dose of calomel. Garfield had chronic abdominal symptoms
during his convalescence. They were ascribed to the calomel by one of the
homeopathic practitioners attending him. 2 MORE

foot pain
Pendel 5a heard this from a White House steward, Mr. Crump, hours after Garfield
died:

> He was always so cheerful and had so much nerve. Why, he used to astonish me
> with his jokes, even while he was suffering horribly. Suffer? I should say he
> did. The first week or ten days it was his feet. He kept saying, "Oh, my God!
> my feet feel as though there were millions of needles being run through them."
> I used to squeeze his feet and toes in both my hands, as hard as I possibly
> could, and that seemed the only relief he could get.

Comment: This presumably relates to a post-shooting time. It is difficullt to
know what to make of this symptom. It doesn't sound like gout (squeezing would
be excruciating). Vascular or neurological causes seem most likely.

infarct
Garfield died 80 days after being shot. The cause of death has usually been
described as either: (1) rupture of a splenic artery aneurysm, or (2) pyemia. In
fact, his death was probably due to ischemic heart disease. 1d MORE

malpractice
At his trial, the assassin Guiteau admitted shooting the President, but denied
killing him. Instead, he claimed that Garfield's physicians killed him. Although
Guiteau was executed because his defense was not strong enough, he was probably
correct.

Garfield's original wound was 3.5 inches long, and ended with the bullet lodged
in a harmless part of the abdomen. The wound was probed by the fingers of
numerous physicians during the rest of Garfield's life so that, by the time of
his death, the wound track was 20 inches long and oozing pus.

It seems reasonable that the terminal event in Garfield's life was a myocardial
infarction. However, the wound could have contributed to the terminal event in
three ways, all of them derived from the fact that Garfield was mightily
infected for a period of 3 months:

 1. It seems reasonable to suppose that Garfield had anemia of chronic disease,
    which would have lowered the ischemic threshold.
 2. Chronic infection could have led to amyloidosis. If it affected the heart,
    then it is not surprising that an ischemic event would have been so rapidly
    fatal.
 3. It is becoming increasingly clear that coronary atherosclerosis is an
    inflammatory, perhaps infectious, disease. It is possible that Garfield's
    chronic inflammation and infection could have accelerated atherosclerosis.


Odds and Ends
 * Both Garfield and his wife were particularly sympathetic to homeopathy. His
   first cousin, and boyhood neighbor, Silas Boynton, was a homeopathic
   practitioner. In 1875 Garfield asked Boynton to consult with the physicians
   caring for his dying mother-in-law. In 1881, while living in the White House,
   Garfield's wife Lucretia developed malaria, and Boynton was summoned again.
   Boynton recommended that Mrs. Garfield, who was severely ill, be transferred
   to the New Jersey seashore, away from the malarious swamps that reached the
   backyard of the White House. During Garfield's final illness, Boynton and
   another homeopath (Susan Edson) attended Garfield, but as nurses. 2
 * "Some people say that prayer has saved the President. They may think so. In
   my opinion it was whiskey." Dr. -- D. W. Bliss, physician caring for Garfield
   after the shooting 6a. (Interestingly, Grant's physician once said just the
   opposite.)
 * Dr. Bliss later died of sepsis (blood poisoning), contracted when he cut his
   hand while dressing one of Garfield's wounds. 1e [But the Roos article says
   he died in 1889...]
 * Garfield's medical bill was $18,500. 1d

Doctors
Before Presidency
 * Jedediah Hyde Baxter
 * John Shaw Billings

During Presidency
 * Jedediah Hyde Baxter

Assassination
 * Smith Townshend
 * Charles Burleigh Purvis

Shooting (First Day)
 * Doctor Willard Bliss
 * Smith Townshend
 * Nathan Smith Lincoln
 * Basil Norris
 * Philip Skinner Wales
 * John Brown Hamilton
 * Charles Mason Ford
 * DeWitt Clinton Patterson
 * Charles Burleigh Purvis
 * Robert Reyburn
 * Joseph Janvier Woodward
 * Susan Ann Edson
 * Joseph K. Barnes
 * Seth R. Beckwith
 * William James Chamberlain Du Hamel
 * Francis M. Gunnell
 * David Low Huntington
 * Joel Pomerene

Shooting (in Washington)
 * Doctor Willard Bliss
 * Joseph K. Barnes
 * Robert Reyburn
 * Joseph Janvier Woodward
 * David Hayes Agnew
 * John H. Girdner
 * Frank Hastings Hamilton
 * Silas A. Boynton
 * Susan Ann Edson

Shooting (in New Jersey)
 * Doctor Willard Bliss
 * Joseph K. Barnes
 * David Hayes Agnew
 * Frank Hastings Hamilton
 * Silas A. Boynton
 * George Frederick Shrady

Post-mortem
 * Joseph K. Barnes
 * Joseph Janvier Woodward
 * Robert Reyburn
 * Daniel Smith Lamb
 * Andrew H. Smith
 * Frank Hastings Hamilton
 * David Hayes Agnew
 * Silas A. Boynton

Resources
Ampres Series
Rutkow

40 reviews
 
Millard

1576 reviews
Kansas Series
Doenecke

4 reviews
Signature Series
Taylor

0 reviews
Cited Sources
    
 1. Brooks, Stewart M. Our Murdered Presidents: The Medical Story. New York:
    Frederick Fell, 1966.
    a  p.56  b  p.89  c  p.85  d  p.??  e  p.125
    
    Comment: LCC shelving code R703 B873 1966.

    
 2. Deppisch, LM. Homeopathic medicine and presidential health: homeopathic
    influences upon two Ohio presidents. Pharos. Fall 1997;60:5-10. Pubmed:
    9385827.
    
    Comment: Discusses the relationships of Garfield and Harding with
    homeopathy. Also reprints a Currier & Ives drawing of "The Death of General
    James A. Garfield, Twentieth President of the United States."

    
 3. Drawing by Duncan Winter.
    
 4. Reif, Wanda. Medical curiosities in cabinets. Out of the blue cabinets.
    Exhibition at the National Museum of Health and Medicine Washington, DC,
    USA, showing until May 21, 2000. (Review). Lancet. 2000;355:1467.
    
 5. Pendel, Thomas F. Thirty-Six Years in the White House. Washington: Neale
    Publishing Company, 1902.
    a  pp.115-116
     
    
    Comment: Pendel was door-keeper at the White House from the time of Lincoln
    to the time of Theodore Roosevelt. Full text is available on-line at
    loc.gov. It is a rather dry book, and reads as if it were written by an old
    man. http://memory.loc.gov/cgi-bin/query/D?lhbcbbib:1:./temp/~~ammem_rEou::

    
 6. Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University
    Press, 1981.
    a  p.171
     

Other Sources
Pubmed Search   (30 matches when checked in March 2013)

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