Health of Abraham Lincoln
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Abraham Lincoln Abraham Lincoln ( ; February 12, 1809 – April 15, 1865) was an American lawyer, politician, and statesman who served as the 16th president of the United States from 1861 until his assassination in 1865. Lincoln led the nation thro ...
's health has been the subject of both contemporaneous commentary and subsequent hypotheses by historians and scholars. Until
middle age In the history of Europe, the Middle Ages or medieval period lasted approximately from the late 5th to the late 15th centuries, similar to the post-classical period of global history. It began with the fall of the Western Roman Empire a ...
, his health was fairly good for the time. He contracted
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
in 1830 and 1835; the latter was the worse of the two cases. He contracted
smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
in 1863 during an 1863 to 1864 epidemic in Washington, D.C. Throughout his life he experienced periods of depression, which could have been genetic, due to life experiences or trauma, or both. Lincoln took
blue mass Blue mass (also known as blue pill or ''pilula hydrargyri'') was the name of a Mercury (element), mercury-based medicine common from the 17th to the 19th centuries. The oldest formula is ascribed to one Hayreddin Barbarossa, Barbarossa, in a lett ...
pills, which contained
mercury Mercury commonly refers to: * Mercury (planet), the nearest planet to the Sun * Mercury (element), a metallic chemical element with the symbol Hg * Mercury (mythology), a Roman god Mercury or The Mercury may also refer to: Companies * Merc ...
. Based on his behavior and physical condition while taking the pills and after he quit taking them, Lincoln may have suffered from
mercury poisoning Mercury poisoning is a type of metal poisoning due to exposure to mercury. Symptoms depend upon the type, dose, method, and duration of exposure. They may include muscle weakness, poor coordination, numbness in the hands and feet, skin rashe ...
. It has been theorized that Lincoln had
Marfan syndrome Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints a ...
or Multiple endocrine neoplasia type 2B, both rare genetic diseases.


Health and trauma

Despite the following occurrences, Lincoln's health up until middle age was fairly good for his day.


Trauma

When he was nine years old, Lincoln was kicked in the head by a horse at the Noah Gordon Mill and was knocked unconscious for several hours. Other injuries or trauma throughout his life include almost severing one of his thumbs with an axe, incurring frostbite of his feet in 1830–1831, being struck by his wife (apparently on multiple occasions), and being clubbed on the head during a robbery attempt in 1828. Lincoln was assassinated in 1865, dying from a bullet wound.


Infectious disease

* Malaria: Lincoln had
malaria Malaria is a mosquito-borne infectious disease that affects humans and other animals. Malaria causes symptoms that typically include fever, tiredness, vomiting, and headaches. In severe cases, it can cause jaundice, seizures, coma, or death. S ...
at least twice. The first was in 1830, along with the rest of his family. They had just arrived in
Illinois Illinois ( ) is a U.S. state, state in the Midwestern United States, Midwestern United States. Its largest metropolitan areas include the Chicago metropolitan area, and the Metro East section, of Greater St. Louis. Other smaller metropolita ...
that year. The second episode was in the summer of 1835, while living in New Salem. Lincoln was then so ill that he was sent to a neighbor's house to be medicated and cared for. * Smallpox: November 18, 1863, while at the dedication of the
Soldiers' National Cemetery Gettysburg National Cemetery is a United States national cemetery created for Union casualties from the Battle of Gettysburg in the American Civil War. The Battle of Gettysburg, which was fought between July 1 to 3, 1863, resulted in the larges ...
, Lincoln was quite ill with
smallpox Smallpox was an infectious disease caused by variola virus (often called smallpox virus) which belongs to the genus Orthopoxvirus. The last naturally occurring case was diagnosed in October 1977, and the World Health Organization (WHO) c ...
. Long thought to have been only a mild case, recent work suggests it was a serious illness. Although it did not debilitate Lincoln, the disease did significantly affect his White House routine, and limited the advisors with whom he could meet. While caring for him, Lincoln's valet William H. Johnson contracted the disease and ultimately died in January 1864. Lincoln arranged and paid for Johnson to be buried. Some sources state his grave is at
Arlington National Cemetery Arlington National Cemetery is one of two national cemeteries run by the United States Army. Nearly 400,000 people are buried in its 639 acres (259 ha) in Arlington, Virginia. There are about 30 funerals conducted on weekdays and 7 held on Sa ...
, but some recent investigators have argued that this is not the case.


Mental health

Lincoln was contemporaneously described as suffering from melancholy, a condition that modern mental health professionals would characterize as
clinical depression Major depressive disorder (MDD), also known as clinical depression, is a mental disorder characterized by at least two weeks of pervasive low mood, low self-esteem, and loss of interest or pleasure in normally enjoyable activities. Introdu ...
. Lincoln suffered from a depressed mood after major traumatic events, such as the death of
Ann Rutledge Ann Mayes Rutledge (January 7, 1813 – August 25, 1835) was allegedly Abraham Lincoln's first love. Early life Born near Henderson, Kentucky, Ann Mayes Rutledge was the third of 10 children born to Mary Ann Miller Rutledge and James Rutledge ...
in August 1835, the cessation of his (purported) engagement to Mary Todd Lincoln in January 1841 (after which several close associates feared Lincoln's suicide), and after the
Second Battle of Bull Run The Second Battle of Bull Run or Battle of Second Manassas was fought August 28–30, 1862, in Prince William County, Virginia, as part of the American Civil War. It was the culmination of the Northern Virginia Campaign waged by Confederate ...
. During his life Lincoln experienced the death of multiple close family members, including his mother, his sister, and two of his sons, Eddie and
Willie Willy or Willie is a masculine, male given name, often a diminutive form of William or Wilhelm, and occasionally a nickname. It may refer to: People Given name or nickname * Willie Aames (born 1960), American actor, television director, and scree ...
. Mary Lincoln felt her husband to be too trusting, and his melancholy tended to strike at times that he was betrayed or unsupported by those in whom he put faith. Whether he may have suffered from depression as a genetic predilection, as a reaction to multiple emotional traumas in his life, or a combination thereof is the subject of much current conjecture. Lincoln often combated his melancholic moods by delving into works of humor, likely a healthy coping mechanism for his depression.


Medication

The recollections of Lincoln's legal colleagues ( John T. Stuart,
Henry Clay Whitney Henry Clay Whitney (23 February 1831 – 27 February 1905) was a United States lawyer who was a close friend of President Abraham Lincoln, and later a biographer of the president. Life Henry Clay Whitney was born on 23 February 1831 in Detroit, ...
, Ward Hill Lamon, and William Herndon) all agree that Lincoln took
blue mass Blue mass (also known as blue pill or ''pilula hydrargyri'') was the name of a Mercury (element), mercury-based medicine common from the 17th to the 19th centuries. The oldest formula is ascribed to one Hayreddin Barbarossa, Barbarossa, in a lett ...
pills, "Sourcebook". paragraphs 612-626. which were commonly prescribed for hypochondriasis and
melancholia Melancholia or melancholy (from el, µέλαινα χολή ',Burton, Bk. I, p. 147 meaning black bile) is a concept found throughout ancient, medieval and premodern medicine in Europe that describes a condition characterized by markedly dep ...
. It has been used since the 16th century to treat syphilis and by the mid-19th century was prescribed for a wide variety of ills. The active ingredient of blue mass is elemental
mercury Mercury commonly refers to: * Mercury (planet), the nearest planet to the Sun * Mercury (element), a metallic chemical element with the symbol Hg * Mercury (mythology), a Roman god Mercury or The Mercury may also refer to: Companies * Merc ...
– a substance now known to be a
neurotoxin Neurotoxins are toxins that are destructive to nerve tissue (causing neurotoxicity). Neurotoxins are an extensive class of exogenous chemical neurological insultsSpencer 2000 that can adversely affect function in both developing and mature ner ...
in its valproic state and which has been known to be poisonous for centuries. Lincoln may have taken the blue mass pills for constipation, as well as hypochondriasis, or what has been called persistent constipation-melancholia complex. Both conditions were well known by his friends and family to have significantly affected Lincoln throughout his life. Authors of ''Abraham Lincoln's Blue Pills: Did Our 16th President Suffer from Mercury Poisoning?'' find that it is a reasonable assumption that Lincoln had experienced mercury poisoning due to the differences in his behavior and physical condition when he was taking the blue mass pills versus when he stopped taking the pills. When he was taking the blue mass pills, he was prone to outbursts of rage, bizarre behavior, memory loss, and insomnia. His hands trembled when he was under stress. Taking the medicine made Lincoln feel "cross". These issues, described in detail by those who were close to him, are common symptoms of mercury poisoning. When he stopped taking the medicine, and during a period of profound personal and professional stress, he "behaves like a saint". Lincoln may also have had long-term effects as the result of mercury poisoning, such as nerve damage that affected his gait. Shortly after his 1861 inauguration, Lincoln had a sudden and disquieting outburst of rage during a White House conversation. Finding that the blue mass pills made him "cross", Lincoln stopped taking them about August 1861 (5 months after his March inauguration). Then his anger greatly diminished, so much so that he rarely expressed anger and then only when it was situationally appropriate.


Body habitus

The habitus, or structure, of Lincoln's body attracted attention while he was alive, and continues to attract attention today among medical professionals. Sotos, "The Physical Lincoln", pages 194-204. * Height: as a child, Lincoln was tall, describing himself as "though very young, he was large of his age." He reached his adult height of no later than age 21. * Weight: although well-muscled as a young adult, he was always thin. Questionable evidence says Lincoln weighed over in 1831, but this is inconsistent with the emphatic statement of Henry Lee Ross ("The facts are Lincoln never weighed over 175 pounds in his life"), the recollection of David Turnham ("weighed about 160 lbs in 1830"), and a New Salem neighbor named Camron ("thin as a beanpole and ugly as a scarecrow"). Lincoln's self-reported weight was in 1859. He is believed to have weighed even less during his presidency. The theory that Lincoln's facial asymmetries were a manifestation of craniofacial microsomia has been replaced with a diagnosis of left synostotic frontal plagiocephaly, which is a type of
craniosynostosis Craniosynostosis is a condition in which one or more of the fibrous sutures in a young infant's skull prematurely fuses by turning into bone (ossification), thereby changing the growth pattern of the skull. Because the skull cannot expand perpe ...
.


Genetic disorder theories

Several claims have been made that Lincoln's health was declining before the assassination. These are often based on photographs of Lincoln appearing to show weight loss and muscle wasting. The theories are that he suffered from multiple endocrine neoplasia type 2B (MEN2B) or
Marfan syndrome Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints a ...
, rare genetic disorders.
DNA analysis Genetic testing, also known as DNA testing, is used to identify changes in DNA sequence or chromosome structure. Genetic testing can also include measuring the results of genetic changes, such as RNA analysis as an output of gene expression, or ...
of a pillowcase stained with Lincoln's blood, currently in possession of the
Grand Army of the Republic The Grand Army of the Republic (GAR) was a fraternal organization composed of veterans of the Union Army (United States Army), Union Navy (U.S. Navy), and the Marines who served in the American Civil War. It was founded in 1866 in Decatur, Il ...
Museum and Library in Philadelphia may be able to resolve open questions about Lincoln's health.


Marfan syndrome

Based on Lincoln's unusual physical appearance, Dr. Abraham Gordon proposed in 1962 that Lincoln had
Marfan syndrome Marfan syndrome (MFS) is a multi-systemic genetic disorder that affects the connective tissue. Those with the condition tend to be tall and thin, with long arms, legs, fingers, and toes. They also typically have exceptionally flexible joints a ...
. Testing Lincoln's DNA for Marfan syndrome was contemplated in the 1990s, but such a test was not performed. Lincoln's unremarkable cardiovascular history and his normal
visual acuity Visual acuity (VA) commonly refers to the clarity of vision, but technically rates an examinee's ability to recognize small details with precision. Visual acuity is dependent on optical and neural factors, i.e. (1) the sharpness of the retinal ...
have been the chief objections to the hypothesis, and today geneticists consider the diagnosis unlikely.


Multiple endocrine neoplasia type 2B

In 2007, Dr. John Sotos proposed that Lincoln had multiple endocrine neoplasia type 2B (MEN2B). This hypothesis suggests Lincoln had all the major features of the disease: a
marfanoid Marfanoid (or Marfanoid habitus) is a constellation of symptoms resembling those of Marfan syndrome, including long limbs, with an arm span that is at least 1.03 of the height of the individual, and a crowded oral maxilla, sometimes with a high a ...
body shape, large, bumpy lips,
constipation Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement ...
,
hypotonia Hypotonia is a state of low muscle tone (the amount of tension or resistance to stretch in a muscle), often involving reduced muscle strength. Hypotonia is not a specific medical disorder, but a potential manifestation of many different diseases a ...
, a history compatible with
cancer Cancer is a group of diseases involving abnormal cell growth with the potential to invade or spread to other parts of the body. These contrast with benign tumors, which do not spread. Possible signs and symptoms include a lump, abnormal b ...
—to which Sotos ascribes the death of Lincoln's sons Eddie,
Willie Willy or Willie is a masculine, male given name, often a diminutive form of William or Wilhelm, and occasionally a nickname. It may refer to: People Given name or nickname * Willie Aames (born 1960), American actor, television director, and scree ...
, and Tad, and probably his
mother ] A mother is the female parent of a child. A woman may be considered a mother by virtue of having given childbirth, birth, by raising a child who may or may not be her biological offspring, or by supplying her ovum for fertilisation in the cas ...
. The mole on Lincoln's right cheek, the asymmetry of his face, his large jaw, his drooping eyelid, and wikt:pseudodepression, pseudodepression are also suggested as manifestations of MEN2B. MEN2B is a genetic disorder, and recently it has been demonstrated that Lincoln's biological mother,
Nancy Lincoln Nancy Hanks Lincoln (February 5, 1784 – October 5, 1818) was the mother of U.S. President Abraham Lincoln. Her marriage to Thomas Lincoln also produced a daughter, Sarah, and a son, Thomas Jr. When Nancy and Thomas had been married for j ...
, had many of the same unusual facial features as her son, as well as a marfanoid appearance. Lincoln's longevity is the principal challenge to the MEN2B hypothesis: Lincoln lived long enough to be assassinated at age 56. Untreated MEN2B is generally understood to result in death by the patient's mid-thirties, but there are several reported cases of MEN2B patients surviving into their 50s with no or little treatment. The hypothesis could be proven by DNA testing.


Debunked theories


Syphilis

Claims that Lincoln had
syphilis Syphilis () is a sexually transmitted infection caused by the bacterium ''Treponema pallidum'' subspecies ''pallidum''. The signs and symptoms of syphilis vary depending in which of the four stages it presents (primary, secondary, latent, an ...
around 1835 have been controversial. Syphilis was a common worry among young men before the introduction of
penicillin Penicillins (P, PCN or PEN) are a group of β-lactam antibiotics originally obtained from ''Penicillium'' moulds, principally '' P. chrysogenum'' and '' P. rubens''. Most penicillins in clinical use are synthesised by P. chrysogenum using ...
because syphilis was somewhat common in that era. Physicians likened the fear of syphilis, syphilophobia, to the modern fear of
AIDS Human immunodeficiency virus infection and acquired immunodeficiency syndrome (HIV/AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV), a retrovirus. Following initial infection an individual m ...
, which is also deadly and incurable. Writing in 2003, biographer David Donald declared, "Modern physicians who have sifted the evidence agree that Lincoln never contracted the disease." For instance, he did not have any of the signs of
tertiary syphilis Tertiary ( ) is a widely used but obsolete term for the geologic period from 66 million to 2.6 million years ago. The period began with the demise of the non-avian dinosaurs in the Cretaceous–Paleogene extinction event, at the start ...
. Physicians suggest that he had syphilophobia.


Spinocerebellar ataxia

The theory that Lincoln was afflicted with type 5 spinocerebellar
ataxia Ataxia is a neurological sign consisting of lack of voluntary coordination of muscle movements that can include gait abnormality, speech changes, and abnormalities in eye movements. Ataxia is a clinical manifestation indicating dysfunction of ...
is no longer accepted.


Notes


References


Bibliography

* * * * * Full-text inde
here
*


External links

* {{DEFAULTSORT:Medical And Mental Health Of Abraham Lincoln Abraham Lincoln Lincoln, Abraham Lincoln, Abraham