Medical Discovery News
By Norbert Herzog and David Niesel

On July 2, 1881, President James Garfield walked into the waiting room of the Baltimore & Potomac Railroad terminal in Washington, D.C., with his two sons ready to start his summer vacation in New England.

But he had no idea what, or rather who had been waiting for him. Suddenly, shots were fired at point-blank range behind the president, hitting him in the back. The assassin, Charles J. Guiteau, was an escaped mental patient suffering from delusions.

After superficial examination, physicians agreed that a bullet had hit the liver and lodged in the front wall of the abdomen. They decided the wound was not necessarily fatal and the president was moved back to the White House.

Surviving a bullet wound depends upon the path of the bullet and where it ended up. If it was lodged in an organ, removing it through surgery was the only option. Otherwise, surgery was delayed until the patient was more stable or the bullet was simply left in the body.

Since X-rays had not yet been invented, physicians would manually probe for a bullet with unwashed fingers and unsanitary instruments, raising the risk of infection.

The physician Willard Bliss took control of President Garfield’s care. Bliss delayed the surgery to remove the bullet. Several times a day, he probed the wound in attempts to locate it. Even though English surgeon Joseph Lister had been promoting hand washing and the use of sterile instruments, many physicians, including Bliss, resisted this “as too much trouble.”

Newspapers, physicians and citizens across the country weighed in on how to best treat the president. Even Alexander Graham Bell, who had recently invented the telephone, stepped in. He collaborated with Simon Newcomb to develop a device that could detect metal objects in the body.

They tested their device by hiding bullets in bags of grain, sides of beef and on themselves. As a final test, they took their device to the Old Soldiers Home in Washington, D.C., and successfully detected bullets inside Civil War veterans.

On July 26, they went to the White House to try to locate Garfield’s bullet. Bliss insisted that Bell only look for the bullet on the wrong side of Garfield’s body. But the metal detector went off everywhere they tested on him. What Bell did not know was that Garfield was lying on a new type of bed with coiled metal springs.

With Bliss continuing to probe for the bullet still inside, the president developed a fever and other signs of infection. He lingered in agony until his death from a massive infection on Sept. 19, 1881.

Surprisingly, the autopsy revealed that the bullet had missed his spinal cord and all vital organs and came to rest in the fat tissue of his back, a very different location from his abdominal wall which was the prevailing opinion of his physicians confirming that this was not a fatal blow.

President Garfield’s story ends with Vice President Chester Alan Arthur sworn in on the night of his death and the execution of Guiteau on June 30, 1882.

However, it was not Guiteau’s bullet that killed the President, but the physician’s incompetent attempts to care for him.

Professors Norbert Herzog and David Niesel are biomedical scientists at the University of Texas Medical Branch. Learn more at medicaldiscoverynews.com.