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| Lincoln Diagnosis -- Breaking News | |
| Doctor Zebra > Presidential health > List of Presidents > Abraham Lincoln | [Text Version] |
| The Health and Medical History of President | ||||||||
Abraham Lincoln |
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| ========> UNDER CONSTRUCTION <======== | ||||||||
| "He may be President of the United States, but he has dirty fingernails." [31a] |
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| President #16. |
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| Timeline: | |<== 1776 | |||||||
Maladies = NOTICE · not color blind · near-drowning · concussion · malaria - 1830 · malaria - 1835 · marfanoid habitus · habitus - ?Stickler · pectus excavatum · depression · vertical strabismus · presbyopia · jaw fracture · penetrating voice · snored · swollen feet · scarlet fever? · unusual face and head · face & beard · corns · constipation · dentist phobia · cancer · Willie's death · pulsations · smallpox · upset stomach · very strong · receding hairline · gas leak · assassination & resuscitation ·· Odds & Ends ·· Resources |
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| Maladies and Conditions | [Top] |
![]() NOTICE |
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![]() ![]() not color blind |
For many years Dr. Zebra reported, as have several others, that Lincoln was color blind. Recently, however, he reviewed the original evidence behind this assertion, e.g. Thomas Shastid's 1929 article in The Nation, and found it completely worthless. There is no good reason to believe Lincoln had defective color vision. | |
![]() near-drowning |
As a child Lincoln almost drowned in Knob's Creek, Kentucky. A neighbor boy saved him. [2a] Austin Gollaher ... claims to have saved Lincoln from drowning one day as they were trying to 'coon it' across Knob Creek on a log. The boys were in pursuit of birds, when young Lincoln fell into the water, and his vigilant companion ... fished him out with a sycamore branch. [8a] | |
![]() concussion |
As a youth Lincoln was driving an old horse to turn a grist mill. Losing his patience at one point, Lincoln applied the whip and was rewarded with a kick square to the head. He was knocked unconscious for several hours. [2b] | |
![]() malaria - 1830 |
Lincoln's father moved the family to Macon County, Illinois in 1830. All of the family members developed "ague and fever" that autumn and resolved to leave the area. This was undoubtedly vivax malaria. Lincoln, having reached the age of 21, settled in New Salem. [34] | |
![]() malaria - 1835 |
The summer of 1835 in New Salem was hot and followed a wet spring -- perfect conditions for malaria. Lincoln developed malaria that summer, about the same time his near-fiancee Ann Rutledge became ill with "brain fever" (probably typhoid). He took "heroic doses" of quinine and other anti-malaria medications then in use. (Quinine is effective.) Rutledge's death greatly affected Lincoln, but there is no record on whether his unusual behavior afterwards was due to grief, to malaria, or to the treatments being inflicted upon him. [34] | |
![]() ![]() marfanoid habitus |
Lincoln was 6 feet 3.75 inches tall, had long legs, long arms, long thin feet (about size 12 today), long hands, a long thin face, a high pitched voice, a long thin neck, flat feet, and a "sunken breast" (in the words of his law partner William Herndon). All of these characteristics are typical of persons with Marfan syndrome.This does not mean he had Marfan syndrome, however. Several distinct medical conditions cause this same type of body shape. It is proper to say that Lincoln was "marfanoid," meaning he was shaped like a person with Marfan syndrome, but it is unlikely that he had Marfan syndrome. Diagnosis of Marfan syndrome must be addressed separately. [33] [34] A sample of men from about the same geographic area and the same era as Lincoln averaged 5 feet 8.5 inches in height. Thus, Lincoln was about 7 inches taller than average. It is interesting to note that Lincoln's height came from his legs. Sitting, he was no taller than the average man. [33] It has been said that a cast of Lincoln's hands show them to be muscular and powerful, not the slender hands of Marfan syndrome [13] [24]. This is not correct. True, the casts show that Lincoln did not have the classic long, graceful hands and fingers of Marfan syndrome. But they also show that his hands were longer than normal and that his fingers were longer than normal. It is important to remember that Lincoln used an axe more or less all day every day from the time he was about 8 years old until he was 23. No physician practicing today knows what that level of hand exertion does to the hands of someone with Marfan syndrome. [33] Evidence for other features of Marfan syndrome (ocular, cardiovascular, familial) in Lincoln has been presented, but found weak [33] [16a]. In 1959, Marfan syndrome was diagnosed in a distant relative of Lincoln's (a third cousin four times removed) on his father's side [28]. Sharing 1/4096th of Lincoln's genetic material, it is difficult to ascribe much significance to this fact [16b]. Although the world's greatest authority on Marfan syndrome thinks it's "50-50" that Lincoln had the condition, other geneticists think it unlikely [16c] [27]. | |
![]() ![]() habitus - ?Stickler |
J. Hermann et al wonder whether Lincoln and his son Tad had Stickler syndrome, "the most common autosomal dominant connective tissue dysplasia in the North American Midwest" [17a]. This is thought unlikely, however [16d]. | |
![]() pectus excavatum |
Lincoln's chest was, according to his law partner, thin and had a "sunken breast" [16e]. Yet, none of the several physicians who saw Lincoln's naked body at autopsy remarked on a sunken chest [16f]. Comment: Given the multiple unusual features of Lincoln's body that are clearly documented in photographs, and the fact that the physicians remarked on none of them, the statements of these physicians cannot be accepted as a detailed clinical evaluation. | |
![]() depression |
Much has been written about Lincoln's "melancholia," but the evidence is not convincing [15a]. Advocates of the theory point to several periods of major depression in Lincoln's life: (1) After the death of his mother, (2) After the death of his fiancee, Ann Rutledge (see Malaria/1835, above), and (3) About the time of interpersonal difficulties with Mary Todd in early 1841. Other cited instances are: after the terrible Union loss at the battle of Chancellorsville (he is widely quoted as entertaining suicide, but there is no way to know if this was serious or just Lincoln speaking in a vivid metaphor) and after the death of his son Willie (he signed no official documents for four days). [2c] Lincoln's depression has been variously ascribed to familial tendencies (his mother and sister had "melancholy dispositions," as did first cousins afflicted with the "Lincoln horrors" [5a]), to the horse-induced concussion, and to neurosyphilis. The last of these is generally discounted ("not a shred of truth"). [2c] A book devotes 350 pages to Lincoln's melancholy [32]. That's a lot of melancholy. | |
![]() vertical strabismus |
Lincoln's intermittently-upturned left eye is consistent with weakness of the left superior oblique muscle. See: Goldstein JH. Lincoln's vertical strabismus. J Pediatr Ophthalmol Strabismus 1997 Mar-Apr;34(2):118-20. It has been speculated that the horse-kick to his head damaged his trochlear nerve, which controls the muscle, or that a malformation of his skull was responsible (R Fishman, Arch Ophthalmol). | |
![]() presbyopia |
Lincoln did not wear eyeglasses until he reached the approximate age when all persons with normal vision need to start wearing reading glasses. The spectacles in his pocket at the time of his death have been analyzed. They are reading glasses (to correct for far-sightedness) and their strength is consistent with simple aging of the eye (which is known as presbyopia). [33] [2d]. | |
![]() ![]() jaw fracture |
A dentist broke off part of Lincoln's jaw bone while pulling a tooth -- without anesthesia [2d]. The extraction may have taken place in Louisville, KY in Sept. 1841 [5b]. | |
![]() penetrating voice |
Lincoln had a "penetrating and far-reaching" voice that could be heard over great distances [23a]. It was high-pitched and "tended to become even more shrill when he became excited. At times, it was even unpleasant. But his voice was a great asset because it could be heard at the farthest reaches of the crowds that gathered outdoors to hear him speak" [23b]. "For example, everyone present heard the Gettysburg Address, and there were at least 15,000 people in attendance" [23a]. | |
![]() snored |
Reliability of this information is uncertain [4]. Comment: Its credibility is somewhat enhanced by the description of Lincoln's breathing as "exceedingly stertorous" (i.e. loud) as he lay comatose and dying in Ford's Theater [6a]. Snoring sounds are a sound of an endangered airway, and Dr. Zebra guesses that anyone can be made to snore if coma is deep enough. Lincoln was not a good sleeper [22]. | |
![]() swollen feet |
In 1858 Lincoln walked from the Danville, IL train depot to the home of Dr. William Fithian (116 Gilbert St.), with a crowd in tow. Lincoln went upstairs, took off his boots to relax, but the crowd insisted on a speech. Unable to easily get his boots on over his swollen feet, Lincoln, at Fithian's suggestion, spoke from the window, so the crowd could not tell he did not have his boots on. [5c] | |
![]() scarlet fever? |
While campaigning for the Presidency in 1860, Lincoln developed sore throat, headache, fever, and malaise which lasted for a few days. Simultaneously, his son Willie was in bed with scarlet fever. Lincoln felt he had a form of the same disease. [2d] | |
![]() ![]() ![]() unusual face and head |
A single photograph of Lincoln (before he grew a beard) [More] shows numerous unusual features: (1) his eyes appear smaller than they should be, (2) he has ptosis (drooping eyelids), (3) large ears that protrude, (4) a long straight nose, and (5) heavily wrinkled skin, even at an early age [16g]. These features pertain to the discussion of Lincoln's body habitus. | |
![]() ![]() face & beard |
Lincoln began growing his beard about the time he was elected President in November 1860. On Feb. 16, 1861 his inauguration train stopped in Westfield, NY where he sought out 11 year old Grace Bedell, who had before written to advise him to grow a beard: "I have got four brothers and part of them will vote for you anyway and if you let your whiskers grow I will try and get the rest of them to vote for you; you would look a great deal better for your face is so thin." [5d] | |
![]() ![]() corns |
In the words of a biographer, Lincoln "suffered mightily" from corns and bunions. He obtained some relief at the hands of a "chiropodist" named Isachar Zacharie [22]. Comment: Lincoln's large feet doubtlessly complicated the acquisition of well-fitting shoes, but this biographer has gone well beyond what the historical record actually says. There are no records that Lincoln ever complained about his feet. | |
![]() constipation |
Neely [22] quotes Lincoln's law partner as saying Lincoln took "blue mass" pills for constipation. Comment: Reports that he took the mercury-containing blue mass pills for melancholy are not credible [9]. | |
![]() ![]() ![]() dentist phobia |
It has been said that Lincoln was afraid of dentists (see episode above for a good reason why he might have been). In 1862 Lincoln developed a severe toothache and consulted Dr. G. S. Wolf, who had an office near the White House. As Wolf prepared to pull the tooth, Lincoln asked him to wait. Lincoln "took a container of chloroform from his pocket, inhaled it deeply, and sleepily gave the signal for the dentist to proceed" [2d]. | |
![]() cancer |
Multiple endocrine neoplasia type 2b (MEN2B) is a genetic cancer syndrome. The most common cancers are medullary carcinoma of the thyroid and pheochromocytoma. Did Lincoln have cancer? If he had MEN2B, the answer is unambiguous: yes. Lincoln began losing weight in 1860. There is no quantitative data about his weight after becoming President, but many people wrote of his declining appearance and increasing thinness. Casts of his face in 1860 and 1865 show a striking loss of soft tissue. Temporal wasting is present on the 1865 cast. MEN 2B is rare -- perhaps about one in a million people have it -- and there are no large studies on survival statistics. Lincoln lived to be quite old for someone with MEN2B. This topic is discussed in great detail in [33] and in [34]. | |
![]() Willie's death |
Lincoln's son Willie died in 1862. One of Lincoln's friends described the aftermath [11a]: "[It] wellnigh broke the President's heart, and certainly an affliction more crushing never fell to the lot of man. ... Strong as he was in the matter of self-control, he gave way to an overmastering grief, which became at length a serious menace to his health. ... A deep and settled despondency took possession of Mr. Lincoln; and when it is remembered that his calamity -- for such it surely was -- befell him at a critical period of the war, just when the resources of his mighty intellect were in most demand, it will be understood how his affliction became a matter of the gravest concern to the whole country."In fact, Lincoln went only four days without writing official documents [22]. | |
![]() pulsations |
A photograph taken November 15, 1863 by Alexander Gardner shows Lincoln sitting with legs crossed. The image of the left foot -- the one nearest the camera -- is blurry, however. Lincoln noticed this and wondered why. Newspaperman Noah Brooks suggested it was because throbbing of the arteries may have imparted a slight motion to the foot. To test this idea, Lincoln crossed his legs, watched his foot, ... and saw that it moved. "That's it! That's it! Now that's very curious, isn't it?" he exclaimed [16h]. This incident is cited as evidence that Lincoln had aortic regurgitation [29] [30]. Comment: Aortic regurgitation is caused by a leaky heart valve. When severe, large swings in blood pressure occur with every heartbeat, causing structures in the body to pulsate. Diagnosing aortic regurgitation from photographic blurriness is a clever idea, but, in this case, wrong. First, Lincoln's foot may simply have been out of focus. Second, such foot movement is normal: Dr. Zebra's foot moves in a similar way, and he does not have aortic regurgitation or Marfan syndrome. Third, Lincoln was incubating smallpox when the photograph was taken, so possibly he was vasodilated for that reason and more prone to foot movement. | |
![]() smallpox |
The story is usually told this way: Shortly after delivering the Gettysburg Address on November 19, 1863 [2d] Lincoln became ill with red blotches "all over" his skin. Lincoln's physician arrived while an office-seeker was with Lincoln. The doctor made the diagnosis of varioloid, a mild type of smallpox, and informed Lincoln the disease was highly contagious. The office-seeker made excuses and left immediately, causing Lincoln to remark: "There is one good thing about this. Now I have something I can give everybody" [1a]. The historical record shows that Lincoln's course was not typical of the mild smallpox form, but was instead completely typical of the usual form of smallpox. In other words, Lincoln had a major illness. There is evidence that the diagnosis was delayed. The first reports of illness appeared in the newspapers on Nov. 28. On Dec. 2 the press learned it was varioloid. They were never told it was more serious than that, and the myth that this was some kind of vacation for Lincoln persists to this day. Lincoln did not recover an air of health until early January 1864. [34] [33] | |
![]() upset stomach |
Lincoln and son Tad visited the battlefield area near Petersburg, VA on June 21-22, 1864. When Lincoln and General Grant steamed part way up the James River the next day, Lincoln had an upset stomach. He was offered champagne, but declined, noting that many people get "seasick ashore from drinking that very stuff" [5e]. | |
![]() very strong |
Lincoln was immensely strong. As a young adult he was rarely bettered in wrestling. While visiting troops in the field, less than a month before his death, Lincoln picked up a heavy axe, chopped wood for several minutes, then held the axe "straight out horizontally, steady without a quiver." Several soldiers, strong ones, tried to duplicate his feat, but could not [5f]. Yet, just two years before, he was described as "cadaverous and emaciated" in appearance [5g]. Lincoln performed the "horizontal" feat several times, e.g. at Milwaukee, WI on Sept. 30, 1859 [5h]. Comment: I accept some stories of Lincoln's strength in youth, but I have been unable to find the primary reference for the 1865 wood-chopping performance. | |
![]() receding hairline |
Lincoln is generally not thought of as bald, but a photo showing the top of his head in November 1863 (while giving the Gettysburg address) discloses significant temporal recession of his hairline. [See photo [More] ] | |
![]() gas leak |
On Sept. 9, 1864 Lincoln was almost overcome by gas leaking from lighting fixtures in his White House office [20]. (I'd appreciate it if anyone having another reference to this incident would let me know. Thanks.) | |
![]() ![]() assassination & resuscitation |
The bullet from the assassin's gun entered behind the left ear and lodged behind the right eye. When Dr. Charles Leale arrived in Lincoln's box at Ford's Theater, he found the President without a radial pulse and breathing laboriously, still sitting upright in his chair. Leale, just two months out of medical school [10a], laid Lincoln onto the floor, and resuscitated him using various "physiological" techniques. Modern authors speculate that the technique of anal dilation, popular at the time, may have been used [12]. Eyewitness accounts of the shooting and its immediate aftermath are available from Dr. Leale [More] and from Dr. Charles Taft [More]. An autopsy was performed in the White House, as was the embalming [5i]. |
| Odds & Ends | [Top] |
that he tended to consumption, and, if removed to a city like Chicago, he would have to sit down and study harder than ever. The close application required of him and the confinement in the office, he contended, would soon kill him. [8b]It is hard to know if Lincoln was being diplomatic or was referring to his leanness.
| Resources | [Top] |
| Alternate index terms: Medical history of President Lincoln, Medical history of Honest Abe, Medical history of Abe Lincoln. | [Top] |
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