Medical and mental health of Abraham Lincoln

The physical and mental health of Abraham Lincoln has been the subject of both contemporaneous commentary and subsequent hypotheses by historians and scholars.

Physical health

Despite the following occurrences, Lincoln's health up until middle age was fairly good for his day.^[1][2]

Childhood

There were fears for young Lincoln's life during a 24-hour period of unconsciousness that followed a horse kicking him in the head. He was nine years old. On another occasion, he fell into a creek and almost drowned.^[1]

Infectious Disease

Malaria. Lincoln had malaria at least twice. The first was in 1830, along with the rest of his family.^[3] They had just arrived in Illinois 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.^[4]

Syphilis. Claims that Lincoln had syphilis about 1835 have been controversial,^[5][6][7] but a recent analysis finds them credible.^[8]

Smallpox. Shortly after delivering the Gettysburg Address in November 1863, Lincoln contracted smallpox. Long thought to have been only a mild case, recent work suggests it was a serious illness.^[9][10][11] Although it did not debilitate Lincoln, the disease did significantly affect his White House routine, and limited the advisors with whom he could meet.^[1]

Trauma

Lincoln died from a bullet wound to the head in 1865. His other episodes of adult trauma were minor. He was clubbed on the head during a robbery attempt in 1828,^[12] was struck by his wife (apparently on multiple occasions),^[13] cut his hand with an axe at least once,^[14] and incurred frostbite of his feet in 1830-1831.^[15]

Body Habitus

Height. As a child, Lincoln was tall, describing himself as "though very young, he was large of his age."^[16] He reached his adult height of 6 feet 4 inches (1.93 m) no later than age 21.

Weight. Although well muscled as a young adult, he was always thin. Questionable evidence says Lincoln weighed over 200 pounds in 1831,^[17] but this is inconsistent with the emphatic statement of Henry Lee Ross ("The facts are Lincoln never weighed over 175 pounds in his life"),^[18] the recollection of David Turnham ("weighed about 160" in 1830),^[19] and a New Salem neighbor named Camron ("thin as a beanpole and ugly as a scarecrow"). Lincoln's self-reported weight was 180 lbs in 1859.^[20] He is believed to have weighed even less during his presidency.^[21]

Marfan syndrome. Based on Lincoln's unusual physical appearance, Dr. Abraham Gordon proposed in 1962 that Lincoln had Marfan syndrome.^[22] Lincoln's unremarkable cardiovascular history and his normal visual acuity have been the chief objections to the theory, and today the diagnosis is considered unlikely.^[23] Testing Lincoln's DNA for Marfan syndrome was contemplated in the 1990s, but such a test was not performed.

MEN2B. In 2007, Dr. John Sotos proposed that Lincoln had multiple endocrine neoplasia, type 2B (MEN2B).^[24] This theory suggests Lincoln had all the major features of the disease: a marfan-like body shape, large, bumpy lips, constipation, hypotonia, a history compatible with cancer – to which Sotos ascribes the death of Lincoln's sons Eddie, Willie, and Tad, and probably his mother. The "mole" on Lincoln's right cheek, the asymmetry of his face, his large jaw, his drooping eyelid, and "pseudo-depression" are also suggested as manifestations of MEN2B. Lincoln's longevity is the principal challenge to the MEN2B theory, which could be proven by DNA testing. ^[25]

Other

The theory that Lincoln was afflicted with type 5 spinocerebellar ataxia^[26] is no longer accepted.^[27] The theory that Lincoln's facial asymmetries were a manifestation of craniofacial microsomia^[28] has been replaced with a diagnosis of left synostotic frontal plagiocephaly,^[29] which is a type of craniosynostosis.

Mental health

Lincoln was contemporaneously described as suffering from "melancholy," a condition which modern mental health professionals would characterize as clinical depression.^[30] Whether Lincoln may have suffered from depression as a genetic predilection, as a reaction to multiple emotional traumas in his life,^[31] or a combination thereof is the subject of much current conjecture.^[32]

What is clear is that Lincoln suffered depressed mood after major events of his life, such as the death of Ann Rutledge in August 1835,^[33] the cessation of Lincoln's engagement to Mary Todd Lincoln in January 1841 (after which several close associates feared Lincoln's suicide),^[34] and after the Second Battle of Bull Run.^[35] It is also clear that Mary Lincoln felt her husband to be too trusting, and that his melancholy tended to strike at times that he was betrayed or unsupported by those he put faith in.^[36]

Lincoln would often combat his melancholic moods by delving into works of humor, likely a healthy coping mechanism for his depression.^[37]

It has been proposed that Lincoln took "blue mass" pills to improve his mood.^[38] There is, however, no support for this in the written record.^[39] The recollections of Lincoln's legal colleagues (John Stuart, Henry Whitney, Ward Lamon, and William Herndon) are clear that Lincoln took them because of constipation^[40] (constipation is a troubling symptom in MEN2B, above). The active ingredient of blue mass is elemental mercury – a substance now known to be a neurotoxin in its vaporic state.^[41] Whether mercury poisoning may have affected Lincoln's demeanor before or after he ceased its use in 1861 is unknown, but still remains the subject of conjecture by some historians.^[42] Lincoln's only known assessments of the medication are that it made him "cross" and that he preferred it above others.^[43]

References

1. ^ ^{a b c} "Abraham Lincoln's Health". The Lincoln Institute. http://www.abrahamlincolnsclassroom.org/Library/newsletter.asp?ID=25&CRLI=105. Retrieved 2009-10-12. 
2. ^ Shutes, Milton H. (1957). Lincoln’s Emotional Life. Dorrance & Company. p. 103. ASIN B001OKE1F0. 
3. ^ Sotos, "Sourcebook", paragraphs 2001-2007.
4. ^ Sotos, "Sourcebook", pages 385-386.
5. ^ Vidal, Gore (February 1991). "Communications". American Historical Review: 324–326. 
6. ^ Fehrenbacher, Don E. (February 1991). "Communications". American Historical Review: 326–328. 
7. ^ Lincoln's law partner and biographer William Herndon wrote that Lincoln admitted contracting the disease around 1835. Hayden, p. 126.
8. ^ Sotos, "Sourcebook", pages 390-400.
9. ^ Goldman AS, Schmalstieg FC Jr. (2007). "Abraham Lincoln's Gettysburg illness.". J Med Biogr. 15 (2): 104–110.. PMID 17551612. 
10. ^ Sotos, "Sourcebook", pages 411-431.
11. ^ Bryner, Jeanna (2007-05-21). "Study: Abraham Lincoln Nearly Died From Smallpox in 1863". FoxNews.com. http://www.foxnews.com/story/0,2933,273560,00.html. Retrieved 2009-10-13. 
12. ^ Sotos, "Sourcebook", paragraph 3582.
13. ^ Sotos, "Sourcebook", paragraph 3589.
14. ^ Sotos, "Sourcebook", paragraph 1490.
15. ^ Sotos, "Sourcebook", paragraph 930.
16. ^ Sotos, "Sourcebook", paragraph 478.
17. ^ Sotos, "Sourcebook", paragraph 363.
18. ^ Sotos, "Sourcebook", paragraph 368.
19. ^ Sotos, "Sourcebook", paragraph 361.
20. ^ Sotos, "Sourcebook", paragraph 369.
21. ^ White, p. 108.
22. ^ Gordon, Abraham M. (March 1962). "Abraham Lincoln – a medical appraisal" (Free full text). Kentucky Medical Association 60 (60): 249–253. ISSN 0023-0294. PMID 13900423. http://www.nlm.nih.gov/medlineplus/marfansyndrome.html. 
23. ^ Marion, Robert (1993). Was George Washington Really the Father of Our Country?: A Clinical Geneticist Looks at World History. Addison-Wesley. pp. 88–124. ISBN 9780201622553.  See also: Ready, Tinker (1999). "Access to presidential DNA denied". Nature Medicine 5 (859). 
24. ^ Sotos, JG (2008). The Physical Lincoln: Finding the Genetic Cause of Abraham Lincoln's Height, Homeliness, Pseudo-Depression, and Imminent Cancer Death. Mount Vernon, VA: Mt. Vernon Book Systems. ISBN 9780981819327. http://www.physical-lincoln.com/. 
25. ^ "Scientist Wants to Test Abraham Lincoln’s Bloodstained Pillow for Cancer". Discover Magazine. April 20, 2009. http://blogs.discovermagazine.com/80beats/2009/04/20/scientist-wants-to-test-abraham-lincolns-bloodstained-pillow-for-cancer/.  "Lincoln'd Shroud of Turin". Philadelphila Inquirer. April 13, 2009. 
26. ^ Ikeda Y, Dick KA, Weatherspoon MR et al., Y (Feb 2006). "Spectrin mutations cause spinocerebellar ataxia type 5". Nat Genet 38 (2): 184–90. doi:10.1038/ng1728. ISSN 1061-4036. PMID 16429157. Lay summary – University of Minnesota Medical Bulletin (Spring 2006). 
27. ^ Sotos JG. (2009). "Abraham Lincoln did not have type 5 spinocerebellar ataxia.". Neurology 73 (16): 1328–1332. doi:10.1212/WNL.0b013e3181bd13c7. PMID 19841386. 
28. ^ Fishman RS, Da Silveira A. (2007). "Lincoln's craniofacial microsomia: three-dimensional laser scanning of 2 Lincoln life masks.". Arch Ophthalmol. 125 (8): 1126–1130.. doi:10.1001/archopht.125.8.1126. PMID 17698764. 
29. ^ Sotos, "The Physical Lincoln", pages 194-204.
30. ^ Shenk, Joshua Wolf (October 2005). "Lincoln's Great Depression". The Atlantic. http://www.theatlantic.com/doc/200510/lincolns-clinical-depression. Retrieved 2009-10-08. 
31. ^ During his life Lincoln experienced the death of multiple close family members, including his mother, sister, close confidant Ann Rutledge, and two of his sons, Eddie and Willie. Warren, Louis Austin (1959). : Lincoln's Youth: Indiana Years: Seven to Twenty-One. Indianapolis: Indiana Historical Society Press. p. 175. ISBN 9780871950635. 
32. ^ Donald, p. 27.
33. ^ Donald, p. 57.
34. ^ Donald, p. 88.
35. ^ Donald, p. 371.
36. ^ Schreiner, p. 154.
37. ^ Shenk, Joshua Wolf (2006) [2005]. Lincoln's Melancholy: How Depression Challenged a President and Fueled His Greatness. New York: Houghton Mifflin Harcourt. p. 116. ISBN 9780618773442. 
38. ^ Hirschhorn N, Feldman RG, Greaves IA. (2001). "Abraham Lincoln's blue pills. Did our 16th president suffer from mercury poisoning?". Perspect Biol Med. 44 (3): 315–322. doi:10.1353/pbm.2001.0048. PMID 11482002. 
39. ^ Sotos, "Physical Lincoln", pages 137-139.
40. ^ "Sourcebook". paragraphs 612-626.
41. ^ Hayden, p. 130.
42. ^ Mayell, Hillary (July 17, 2001). "Did Mercury in 'Little Blue Pills' Make Abraham Lincoln Erratic?". National Geographic News. http://news.nationalgeographic.com/news/2001/07/0717_lincoln.html. Retrieved 2009-10-12. 
43. ^ Wilson, DL (1998). "Herndon's Informants". University of Illinois Press. http://durer.press.illinois.edu/wilson/html/632.html. Retrieved 2010-09-22. 

Bibliography

• Donald, David Herbert (1996) [1995]. Lincoln. New York: Simon and Schuster. ISBN 9780684825359. 
• Hayden, Deborah (2003). Pox: Genius, Madness, and the Mysteries of Syphilis. New York: Perseus Publishing. ISBN 9780465028818. 
• Schreiner, Samuel Agnew (2005) [1987]. The Trials of Mrs. Lincoln. University of Nebraska Press. ISBN 9780803293250. 
• Sotos, John G. (2008). The Physical Lincoln Sourcebook. Mt. Vernon Book Systems. ISBN 9780980119334.  Full-text index at: [1].
• White, Jr., Ronald C. (2009). A. Lincoln: A Biography. Random House, Inc.. ISBN 9781400064991.