Political appointments in the United States federal government until 1883. In 1820 Congress limited federal administrators to four-year terms, which led to constant turnover; by the 1860s and the Civil War, patronage had led to widespread inefficiency and political corruption. Although it used to be confined to cabinet positions, department heads, and foreign ambassadorships, by the 1860s patronage had spread to low-level government positions. This meant that when the incumbent political party lost a presidential election, the federal government underwent wholesale turnover. On July 2, 1881, Charles J. Guiteau, a disaffected and mentally unstable political office seeker, assassinated President James Garfield. This highlighted how much the
Charles J. Guiteau probing the wound with unwashed hands and non-sterilized instruments, Garfield died on September 19, eleven weeks after being shot. Most modern physicians familiar with the case state that Garfield would have easily recovered from his wounds with sterile medical care, which was common in the United States a decade later, while Candice Millard argues that Garfield would have survived Guiteau's bullet wound had his doctors simply left him alone. However, Garfield's biographer Allan Peskin stated that medical malpractice did not contribute to Garfield's death; the inevitable infection and blood poisoning that would ensue from a deep bullet wound resulted in