After 1880, the neurologists never again mounted a serious threat to the asylum superintendents. Their position was further weakened in 1881 when President James Garfield was shot by Charles Guiteau. At Guiteau's trial, Gray was the chief prosecution witness, and he argued that Guiteau had been perfectly sane when he shot the President. Spitzka, Hammond and other neurologists argued that Guiteau was affected by "reasoning mania" and thus was insane. The vast majority of the public, as well as the jury, sided with Gray. Guiteau was found guilty and was hung on June 30, 1882. On autopsy, evidence was found of what today would be diagnosed as brain syphilis; thus, the neurologists won the battle, but they had lost the war.
Hammond and Spitzka went on to have successful careers as prominent neurologists. Gray, ironically, was himself shot to death by one of his patients two months after he had testified regarding Guiteau's sanity. And Grissom, whom Hammond had suggested might be insane, did indeed become insane from brain syphilis and, in 1902, committed suicide "by firing a pistol into his brain" (Werman, 1973).