James A. Garfield photo

Official Bulletin of the Autopsy on the Body of President Garfield

September 20, 1881

The following official bulletin was prepared by the surgeons who have been in attendance upon the late President:

By previous arrangement a post-mortem examination of the body of President Garfield was made this afternoon in the presence and with the assistance of Drs. Hamilton, Agnew, Bliss, Barnes, Woodward, Reyburn, Andrew H. Smith, of Elberon, and Acting Assistant Surgeon D. S. Lamb, of the Army Medical Museum, of Washington. The operation was performed by Dr. Lamb. It was found that the ball, after fracturing the right eleventh rib, had passed through the spinal column in front of the spinal cord, fracturing the body of the first lumbar vertebra, driving a number of small fragments of bone into the adjacent soft parts, and lodging below the pancreas, about 2 1/2 inches to the left of the spine and behind the peritoneum, where it had become completely encysted.

The immediate cause of death was secondary hemorrhage from one of the mesenteric arteries adjoining the track of the ball, the blood rupturing the peritoneum and nearly a pint escaping into the abdominal cavity. This hemorrhage is believed to have been the cause of the severe pain in the lower part of the chest complained of just before death. An abscess cavity 6 inches by 4 in dimensions was found in the vicinity of the gall bladder, between the liver and the transverse colon, which were strongly adherent. It did not involve the substance of the liver, and no communication was found between it and the wound.

A long suppurating channel extended from the external wound, between the loin muscles and the right kidney, almost to the right groin. This channel, now known to be due to the burrowing of pus from the wound, was supposed during life to have been the track of the ball.

On an examination of the organs of the chest evidences of severe bronchitis were found on both sides, with broncho-pneumonia of the lower portions of the right lung, and, though to a much less extent, of the left. The lungs contained no abscesses and the heart no clots. The liver was enlarged and fatty, but not from abscesses. Nor were any found in any other organ except the left kidney, which contained near its surface a small abscess about one-third of an inch in diameter.

In reviewing the history of the case in connection with the autopsy it is quite evident that the different suppurating surfaces, and especially the fractured, spongy tissue of the vertebrae, furnish a sufficient explanation of the septic condition which existed.

D. W. BLISS.

J. K. BARNES.

J. J. WOODWARD.

ROBERT REYBURN.

FRANK H. HAMILTON.

D. HAYES AGNEW.

ANDREW H. SMITH.

D. S. LAMB.

(SEPTEMBER 20, 1881.)

James A. Garfield, Official Bulletin of the Autopsy on the Body of President Garfield Online by Gerhard Peters and John T. Woolley, The American Presidency Project https://www.presidency.ucsb.edu/node/203816