3

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

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.

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.