“The President is Somewhat Restless…”: Languishing

By Lenore Barbian and Jeffrey S. Reznick

During the days and weeks following the shooting, Bliss dutifully reported the details of the President’s vital signs.  The President’s temperature, respiration rates, attacks of vomiting and profuse sweating were all shared with the American people.  Yet through it all, Bliss maintained an air of confidence about the President’s recovery.  While the details provided in his daily bulletins elicited fear among many, Bliss continued to assure the public of Garfield’s health whenever he was questioned by members of the press.  Whether Bliss’s confidence was simply misplaced hope, a failure to understand the seriousness of the President’s condition, or a deliberate attempt to mislead the American people, we can only speculate.  To anyone allowed access to the President, the outcome seemed only too clear.  The only question was whether infection or starvation would claim Garfield first.

INFECTION

Germs had been introduced into Garfield’s wound the second the bullet penetrated his body.  The repeated probing of his wound—which had begun just minutes after he was shot—not only failed to locate the bullet but also almost certainly guaranteed that a life threatening infection would follow.  The small, pus-filled sacs that Bliss reported appearing on the President’s back and arms were irrefutable proof of a systemic infection.  Known as septic acne, they were just one of the signs that the infection was spreading throughout Garfield’s body.  Other, more ominous, signs were also present.

Portraits of Agnew and Bliss look in on the scene of Garfield on his sickbed

Dr. D. Hayes Agnew, President Garfield on his sickbed, Dr. D. Willard Bliss
National Library of Medicine #b01104, #a012838, #b06279

On August 8th, Bliss instructed Dr. Agnew to operate on Garfield to relieve the build-up of pus near the bullet’s entry.  Making a long incision near the twelfth rib, following what the doctors believed to be the path of the bullet, Agnew inserted two drainage tubes which quickly discharged large amounts of pus and blood.  While the doctors were satisfied with the results of this procedure, it would do nothing to alleviate the growing infection.  Within two weeks, a large abscess would form on Garfield’s right parotid gland.  The inflammation of this large salivary gland became so severe that it resulted in paralysis to the right side of his face.  In fact, the abscess grew so large that when it spontaneously ruptured, Garfield nearly choked to death on the blood, pus, and saliva that flooded his mouth.

The infection that was ravaging through Garfield’s body was a hazard not only to himself but also to those who treated him.  Bliss had firsthand experience of how a caretaker could contract a deadly infection from the bodily fluids of those they cared for.  During the Civil War while serving as the Chief Surgeon at Armory Square Hospital, he witnessed one of his nurses sicken and die from a small cut on her hand.  He must have wondered if a similar fate would befall him when he accidentally cut his right middle finger when dressing the President’s wound.  Bliss would fully recover, but his hand would become painfully swollen causing him to carry it in a sling.

STARVATION

Vomiting was an almost immediate side effect of the gunshot wound, and one that would continue to plague Garfield throughout his ordeal.  Not only did Garfield have trouble keeping down the food he did consume, he soon lost all interest in eating.  Realizing the serious of the situation, Bliss resorted to an alternative in order to provide the President with the nourishment necessary for his recovery.  Bliss mixed together beef bouillon, milk, egg yolk and a bit of opium which he administered as an “enemata” or rectal feeding every four hours.  Over time, Bliss would vary the composition of the mixture, including substances such as whiskey or charcoal in an attempt to provide the most efficacious mixture.  At first, this routine seemed to have a beneficial effect, and Garfield appeared to rally.  But as the days and weeks passed, Garfield continued to lose weight.  At the time of the shooting, Garfield was a robust and healthy 210 pounds; by the end, he would weigh a mere 130 pounds.

This post is one of a series reenacting the official bulletins released to the public by the physicians to President Garfield during his illness after the shooting on July 2, 1881.

 Lenore Barbian, PhD, is Associate Professor and Anthropology Program Director at Edinboro University of Pennsylvania. She is author of numerous articles, including “Remains of War: Walt Whitman, Civil War Soldiers, and the Legacy of Medical Collections”, co-authored with Jeff Reznick and Paul Sledzik, which received the 2013 best article award from the Archivists and Librarians in the History of the Health Sciences (ALHHS).  Jeffrey S. Reznick, PhD, is Chief of NLM’s History of Medicine Division and author of two books and numerous articles on the cultural history of war and medicine.