James Garfield

========> UNDER CONSTRUCTION <========

President #20.

Lived: 1831·1881.		Served: 1881.

Timeline:

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|<== 1776

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

Maladies and Conditions

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writing	Could simultaneously write Greek with one hand and Latin with the other. [2a]
"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. [3]
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." [3]
anal fissure	Garfield developed a painful anal fissure in 1875 that kept him in bed for several weeks. Ultimately, John Shaw Billings (later the Surgeon General of the US Army, and the architect of the Johns Hopkins Hospital) operated on him. [3]
"weak stomach"	Garfield had a "weak stomach" for years. [3]
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." [3]
assassination	On July 2, 1881, Leon F. 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. (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 [6].) 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. [2b]
rectal feeding	For some period after the shooting, Garfield was fed rectally [2c]. 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. [3] [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. [2d] [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: It seems reasonable to suppose that Garfield had anemia of chronic disease, which would have lowered the ischemic threshold. 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. 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 & Ends

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Both Garfield and his wide 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. [3]
"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 [1a]. (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. [2e] [But the Roos article says he died in 1889...]
Garfield's medical bill was $18,500. [2d]

Resources

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Disclosure: Doctor Zebra gets a few pennies if you click & buy from Amazon.

Books (ranked by Amazon.com sales)		More


The Fatal Bullet: The True Account of the Assassination, Lingering Pain, Death, and Burial of James A. Garfield, Twentieth President of the United States (Treasury of Victorian Murder (Paperback)) Rick Geary	The Dark Horse: The Surprise Election and Political Murder of President James A. Garfield Kenneth D. Ackerman	Crete and James: Personal Letters of Lucretia and James Garfield John Shaw

Resources used by Dr. Zebra

Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University Press, 1981. ISBN 0-19-502915-1 @ Amazon [a] p. 171
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
LCC call number R703 B873 1966.
Deppisch, LM. Homeopathic medicine and presidential health: homeopathic influences upon two Ohio presidents. Pharos. Fall 1997;60:5-10. Pubmed.
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."
Halstead, Murat. The Illustrious Life of William McKinley, Our Martyred President. 1901. [a] p. 312 [b] pp. 312-313
Pendel, Thomas F. Thirty-Six Years in the White House. Washington: Neale Publishing Company, 1902. [a] pp. 115-116
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's 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::
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.
Reyburn, R. The case of President James A. Garfield -- an abstract of the clinical history. American Medicine. 1901;2:498.
Rutkow, Ira. James A. Garfield (American Presidents Series). New York: Times Books, 2006. ISBN 080506950X @ Amazon
Rutkow is described as a surgeon and a historian. Very favorably reviewed in the New England Journal of Medicine: http://content.nejm.org/cgi/content/full/355/19/2053
The James Garfield web page at the White House.
(16 matches when checked in November 2003)

Alternate index terms: Medical history of President Garfield, Medical history of President James A. Garfield, Medical history of President James Abram Garfield.

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