Phimosis US president James Garfield was assassinated by Charles Guiteau in 1881. Guiteau's autopsy report indicated that he had phimosis. At the time, this led to the speculation that Guiteau's murderous behavior was due to phimosis-induced insanity. Phimosis Phimosis is a condition in which the foreskin of the penis cannot be pulled back past the glans. A balloon-like swelling under the foreskin may occur with urination. In teenagers and adults, it may result in pain during an erection, but is otherwise not painful. Those affected are at greater risk of inflammation of the glans, known as balanitis, and other complications. In
Charles J. Guiteau had been legally insane at the time of the shooting (because God had taken away his free will), he was not really medically insane, which was one of the major causes of the rift between him and his defense lawyers. Edward Charles Spitzka, a leading alienist, testified as an expert witness. Spitzka had stated that it was clear "Guiteau is not only now insane, but that he was never anything else." While on the stand, Spitzka testified that he had "no doubt" that Guiteau was both insane and "a moral monstrosity". Spitzka came to the conclusion that Guiteau had "the