| MEN 2B |
A 2008 book by Dr. Zebra proposes that Lincoln and several of his family members had a hereditary cancer syndrome called multiple endocrine neoplasia, type 2B (MEN2B) [34]. The diagnosis strongly suggests that Lincoln was dying of cancer in his last months, and also explains many previously mysterious Lincolnian characteristics:- Lincoln's body shape, i.e. his height, long limbs, big feet, leanness, high voice, flat feet, sunken chest.
- Lincoln's sagging face, that witnesses mistakenly thought was sadness or depression.
- Lincoln's bumpy lips and big lower lip.
- The large bump on Lincoln's right cheek.
- Lincoln's fatigue, headaches, fainting, and cold hands & feet in his last months.
- Lincoln's intermittently drooping eyelids.
- Lincoln's constipation.
- Lincoln's high voice.
- Lincoln's propensity to lie on the floor when reading, and rest his feet on a table when sitting.
- Lincoln's asymmetric face and homeliness.
- Lincoln's loose-jointedness.
- The death of three of Lincoln's sons before age 20, and, probably, his mother's death at 34.
These topics are explored in more detail below. |
| 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 (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 [35a]. |
| 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. [9a] |
| concussion |
At age 9, Lincoln was driving an old horse in a grist mill. Impatiently, he applied the whip and was rewarded with a kick square to the forehead. He was unconscious for several hours, and there were fears for his life. The kick came at a moment when Lincoln was halfway through speaking a sentence. Remarkably, his first words upon regaining consciousness were the completion of the sentence [9] [35b]. |
| 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 -- probably vivax malaria. They treated it with Peruvian bark and whiskey, and resolved to leave the area [35c]. (Peruvian bark contains quinine, which is an effective anti-malarial.) Lincoln, having reached the age of 21, settled in New Salem, IL. |
| frostbitten feet |
During the famous "deep snow" winter of 1830-1831, still remembered even 100 years later, Lincoln's feet were badly frozen while crossing the Sangamon River. He was marooned for weeks in the cabin belong to the Warnick family. Mrs. Warnick treated Lincoln by putting his feet in the snow, "to take out the frost-bite" [33a] [35d]. |
| malaria - 1835 |
The summer of 1835 in New Salem, IL was hot and followed a wet spring -- perfect conditions for malaria. Lincoln had chills and fever on alternate days (i.e. malaria) for at least a month, and took "heroic doses" of quinine and cathartics, but irregularly [34a] [35e]. Then his near-fiancee Ann Rutledge died of "brain fever" (perhaps typhoid). Claims that this triggered an episode of major depression in Lincoln [32] rest on incomplete analysis of the historical record. A neighbor couple treated the bereaved Lincoln, who returned to work no later than three weeks after Rutledge's death [34a] [35e]. |
| marfanoid habitus |
Lincoln was 6 feet 3.75 inches tall, had long legs, long arms, long thin feet, long hands, a long thin face, a long thin neck, flat feet, and a "sunken breast" (in the words of his law partner William Herndon) [34b]. All of these characteristics are typical of persons with Marfan syndrome [8]. This does not mean Lincoln had Marfan syndrome, however. More than a dozen different 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. For his time, Lincoln was about 7.5 inches taller than average [34c]. His height came from his legs. Sitting, he was no taller than the average man [34d]. (See photo.) 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 [14] [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 [34e]. Evidence for other features of Marfan syndrome (ocular, cardiovascular, familial) in Lincoln has been presented, but found weak [34f] [17a]. 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 [17b]. Although the world's greatest authority on Marfan syndrome thinks it's "50-50" that Lincoln had the condition [35f], other geneticists (and Dr. Zebra) think it unlikely [17c] [27] [34g]. |
| pectus excavatum |
Lincoln's chest was, according to his law partner, thin and had a "sunken breast" [17d]. (None of the several physicians who saw Lincoln's naked body at autopsy remarked on a sunken chest [17e]. It is difficult to attach much significance to the effusive, hyperbolic, nonspecific statements of these physicians [34h].) |
| pseudo-depression |
Much has been written about Lincoln's "melancholy" [32], but the evidence is not convincing [16a]. Advocates of the theory claim Lincoln had several periods of major depression: (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 mentioned 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). [2b] Much of the evidence for Lincoln's depression derives from observations of his facial expression. This is unreliable, however. Lincoln's low muscle tone (a consequence of MEN 2B) made his face sag whenever he was disengaged from his surroundings. This gave him a profoundly sad appearance, regardless of his internal mood. Dr. Zebra calls this phenomenon "pseudo-depression" [34i]. |
| vertical strabismus |
Lincoln's intermittently-upturned left eye is consistent with failure of the left superior oblique muscle [6]. Proposed causes of this malfunction are: (1) the horse kick (see above) damaged the trochlear nerve, which controls the muscle, (2) a malformation of his skull in which the size of the eye's bony socket is mismatched to the length of the muscle [4]. The intermittent drooping in his right eyelid may actually have resulted from hyper-elevation of his *left* eyelid, i.e. had he allowed his left eyelid to droop, it would have blocked his vision in that eye. |
| presbyopia |
Lincoln did not wear eyeglasses until age 47. He then got reading glasses -- a completely normal occurrence for people at that age [34j]. The spectacles that were in his pocket when he was shot have been analyzed. Their prescription is consistent with simple aging of the eye (known as presbyopia). [34j] [2c]. |
| jaw fracture |
A dentist broke off part of Lincoln's jaw bone while pulling a tooth -- without anesthesia [2c]. The extraction may have taken place in Louisville, KY in Sept. 1841 [5a]. |
| penetrating voice |
Lincoln had a high-pitched voice that could be heard over great distances. When excited, the pitch went higher still, and sometimes became unpleasant. Still, his voice was an asset because it could be heard by all the crowds that gathered outdoors to hear him speak. (Microphones did not yet exist.) For example, at least 15,000 people heard him give the Gettysburg Address (photo) and "acres of people" heard his first inaugural address (photo) [34k] [35g]. |
| 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. [5b] |
| scarlet fever? |
In July 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 might have had a form of the same disease. [2c] |
| asymmetries |
A detailed analysis [34l] of photographs and casts of Lincoln's head & face discloses several asymmetries. Specifically, his eye-sockets, cheek bones, ears, nose, chin, forehead, and skull vault were all asymmetric. These multiple asymmetries fit the pattern seen in a mild case of left synostotic frontal plagiocephaly. (This is too complicated to explain here. See The Physical Lincoln.) This is a type of craniosynostosis caused by the early fusion of the left frontal and parietal bones during growth of the skull. Abnormal skull shapes are part of the MEN2B syndrome. |
| premature aging |
Lincoln was called "Old Abe" as early as age 30 [34m]. Friends commented that his facial skin was creased and yellow from a young age. The cause of this is unknown [34n]. |
| face, neck, 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 4 brother's [sic] and part of them will vote for you any way 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." [34o] New York Republicans had written Lincoln about the same time also urging a beard, to disguise his long neck [34o]. |
| corns |
Biographers sometimes say things like Lincoln "suffered mightily" from corns and bunions [23]. This is overblown. It derives from a letter Lincoln wrote for podiatrist Isachar Zacharie, saying "he has operated on my feet ... with considerable addition to my comfort." The nature of Lincoln's foot ailment(s) are unknown, beyond having flat feet [34p]. |
| constipation |
At least four people close to Lincoln (John Stuart, Henry Whitney, Ward Lamon, and William Herndon) testified that Lincoln was constipated. It seemed almost an idée fixe with Stuart, who urged Lincoln to take mercury-containing "blue mass" pills. Lincoln did this for several months, but stopped, saying that they made him "cross" [34q]. Comment: Reports that Lincoln took blue mass pills for melancholy [10] are unconvincing. |
| 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" [2c]. |
| cancer |
Multiple endocrine neoplasia type 2b (MEN2B) is a genetic cancer syndrome. Its most common cancers occur in two endocrine glands: the thyroid (medullary carcinoma of the thyroid) and the adrenal (pheochromocytoma).Did Lincoln have cancer? If he had MEN2B, the answer is certain: yes. The historical record also suggests he had cancer. 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. In his last months, Lincoln had headaches, cold feet & hands, exercise intolerance & sweating, pervasive fatigue that a work respite did not ease, fainting, and nausea. These findings are compatible with a pheochromocytoma [34r]. 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 [34] and in [35]. |
| Willie's death |
Lincoln's son Willie died in 1862. One of Lincoln's friends described the aftermath [12a]: "[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 [23]. |
| pulsations |
A photograph taken November 15, 1863 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 [34s]. This incident is cited as evidence that Lincoln had aortic regurgitation [29] [30] -- too credulously. 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, other photographs demonstrate that Lincoln's foot was simply out of focus [34t]. Second, such pulsatile foot movement is normal (even Dr. Zebra has it). 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 |
After delivering the Gettysburg Address on Nov. 19, 1863, Lincoln developed a severe headache on the train ride back to Washington. He did not miss work over the next couple days, but his sense of humor vanished. He went to bed early on Nov. 25, with a headache, and was sick in bed the next day. From Nov. 26 to Dec. 1, he issued no official correspondence [35h]. A scrawled note on Nov. 27 shows the shaky handwriting of a very sick man [34u]. With some difficulty, smallpox was eventually diagnosed. It was reported to the public as "varioloid," which is the mildest of the four clinical syndromes of smallpox. Clearly, however, Lincoln had full-blown smallpox, not varioloid. Although the acute crisis had passed by early December, he is described as still recovering through the entire month. Only on January 1, 1864 does someone observe: "he has a hue of health to which he has long been a stranger" [35h]. During the whole of his presidency, Lincoln was beset by people asking for jobs, commissions, pardons, and other favors. When informed that his disease was highly contagious, Lincoln remarked "There is one good thing about this. Now I have something I can give everybody" [1a] [35i]. |
| 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 [5c]. Yet, just two years before, he was described as "cadaverous and emaciated" in appearance [5d]. Lincoln performed the "horizontal" feat several times, e.g. at Milwaukee, WI on Sept. 30, 1859 [5e]. 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 [21]. (I'd appreciate it if anyone having another reference to this incident would let me know. Thanks.) |
| upset stomach |
On Mar. 24-25, 1865, Lincoln had an upset stomach for at least 24 hours while sailing to City Point, VA to visit the headquarters of General Ulysses Grant. Sea-sickness and bad drinking water on-ship were suspected causes. Arriving at City Point on the 25th, Lincoln refused a drink of champagne, saying many people get "sea-sick ashore from drinking that very article" [35j]. |
Death:
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 [11a], 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 [13]. 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 (restricted to the head only), as was the embalming [35k]. |
