Chester Arthur

"Arthur's administration was the first to systematically mislead the public about the President's health." [1a]

President #21.

Lived: 1829·1886.		Served: 1881·1885.

Timeline:

<== 2009
|<== 1776

Maladies = trim as youth · lavish lifestyle · abdominal troubles · Bright's disease · malaria? · cardiovascular disease · mental changes · snored · heart failure · cerebral hemorrhage ·· Odds & Ends ·· Resources

Maladies and Conditions

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trim as youth	Arthur was about 6 feet 2 inches tall. As a young man he weighed a trim 175-185 pounds [1b].
lavish lifestyle	Later in life, Arthur was described as a "high liver who ate and drank excessively" [1b]. He was enthusiastic about fine wines and after-dinner liqueurs [1b]. His love for rich foods and his sedentary lifestyle ultimately added weight, at some point reaching 220 pounds [1a]. As President, he "pursued a lavish social life, entertaining ... friends smoking, drinking, and conversing. It was said that no human being could withstand the stress produced by such socializing combined with the extreme pressures of his official office" [1a]. Despite his appetites and his being a widower President, "his personal life was impeccable" [3a].
abdominal troubles	Arthur was unwell by March 1882 (i.e. 6 months after his swearing-in). He had indigestion, sometimes accompanied by colicky abdominal pain. Some have suggested gallstones as the cause [1c]. There are references to "nervous indigestion" toward the end of his life [1d].
Bright's disease	Arthur was fatigued, irritable, and physically ill during 1882. There are reports that the Surgeon General examined Arthur in October (i.e. about a year after becoming President) and diagnosed the kidney affliction known as "Bright's disease" [1a]. (Bright's disease is no longer a recognized concept in medicine, because it lumped too many different kidney disorders into one "disease." Thus, the exact nature of Arthur's ailment is unknown. But because Bright's disease was considered uniformly fatal, Arthur knew he had a death sentence.) New York specialists examined the President, but all they could do was advise rest and relaxation [1a]. A cover-up began. When the New York Herald reported the story, an Arthur spokesman specifically denied the President had Bright's disease or any kidney complaints. The spokesman claimed the President had a mild form of malaria [1c] (then endemic in Washington DC).
malaria?	It's not clear to Dr. Zebra whether Arthur really did have malaria on top of his other medical problems in late 1882 (see "Bright's disease" entry, above).
cardiovascular disease	By March 1883 Arthur's steadily worsening physical problems now involved his heart. He probably had hypertension and cardiac complications of hypertension [1c].
mental changes	Arthur took a vacation in Florida in April 1883, but the hot humid weather increased his fatigue and irritability. He had periods of sullen withdrawl and was described as "not himself" [1e]. In the winter of 1883-1884, "his associates noted that late at night while socializing his face was lined, his eyes dulled, and his mind much less acute than it had been" [1a].
snored	Reliability of this information [2] is uncertain, but given his obesity it would hardly be surprising.
heart failure	Arthur practiced law and business after leaving the Presidency in March 1885, but was advised to retire for medical reasons in February 1886 [3b]. His last months were miserable. He was recognized as having cardiac problems in early 1886. The symptoms were those of heart failure: dyspnea, orthopnea, edema, cachexia. He needed opiates to sleep. In June 1886 Arthur tried relocating from New York to the cooler climate of Connecticut, but found no relief. He returned to New York and told a friend "After all, life is not worth living. I might as well give up the struggle for it now as at any other time and submit to the inevitable" [1d]. Comment: His terminal symptoms are also consistent with end-stage renal disease. It would be interesting to know more about his mental status during these final months.
cerebral hemorrhage	Arthur died of a cerebral hemorrhage on November 18, 1886, about 24 hours after being found unconscious by his nurse [1d]. Comment: Given his history of hypertension, this was most likely a hypertensive bleed.

Odds & Ends

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There is no record of any significant illness during Arthur's childhood or youth [1b].
"The President was accustomed to retire very late, and sometimes the day would be pretty well advanced before he would get his breakfast. He gave a great many swell dinner parties, and the guests used to enjoy themselves hugely. He generally attended the church right across from the White House, St. John's Episcopal Church. Often in good weather he would walk over and walk back; if it were disagreeable, he would have the carriage ordered and go over in that." [4a]
Arthur demonstrated as President that he was above factions within the Republican Party, if indeed not above the party itself. Moreover, as a long-time beneficiary of the corrupt "spoils" civil service system, Arthur astonished by reforming it. All in all, Arthur as President exceeded expectations. One wonders if knowing he had a terminal condition helped Arthur rise above the limitations of his pre-morbid character.

Resources

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Disclosure: Doctor Zebra gets a few pennies if you click & buy from Amazon.

Books (ranked by Amazon.com sales)		More


Chester Alan Arthur (The American Presidents) Zachary Karabell; Arthur M. Schlesinger	Gentleman Boss: The Life of Chester Alan Arthur ([Signature series book]) Thomas C. Reeves	The Presidencies of James A. Garfield and Chester A. Arthur (American Presidency Series) Justus D. Doenecke

Resources used by Dr. Zebra

Bumgarner, John R. The Health of the Presidents: The 41 United States Presidents Through 1993 from a Physician's Point of View. Jefferson, NC: MacFarland & Company, 1994. ISBN 0-89950-956-8 @ Amazon [a] p. 132 [b] p. 131 [c] p. 133 [d] p. 134 [e] pp. 133-134
Devotes one chapter to each President, through Clinton. Written for the layperson, well-referenced, with areas of speculation clearly identified, Dr. Zebra depends heavily on this book. Dr. Bumgarner survived the Bataan Death March and has written an unforgettable book casting a physician's eye on that experience.
Dugan, James. Bedlam in the boudoir. Colliers. 22 Feb. 1947; pages 17, 69-70.
Credibility is dubious. Just before a list of Presidents, the article states: "Twenty of the 32 Presidents ... are proved or believed on a thick web of circumstance to have been nocturnal nuisances in the White House."
Montgomery-Massingberd, Hugh (ed). Burke's Presidential Families of the United States of American. 2nd ed. London: Burke's Peerage Limited, 1981. ISBN 0-85011-033-5 @ Amazon [a] p. 354 [b] p. 356
Enumerates the ancestors and descendants of American presidents up through Ronald Reagan.
Pendel, Thomas F. Thirty-Six Years in the White House. Washington: Neale Publishing Company, 1902. [a] p. 128
Pendel was door-keeper at the White House from the time of Lincoln to the time of Theodore Roosevelt. Full text is available on-line at loc.gov. It's a rather dry book, and reads as if it were written by an old man. http://memory.loc.gov/cgi-bin/query/D?lhbcbbib:1:./temp/~ammem_rEou::
The Chester Arthur web page at the White House.
(0 matches when checked in November 2003)

Alternate index terms: Medical history of President Arthur, Medical history of President Chester A. Arthur, Medical history of President Chester Alan Arthur.

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