The physical and mental health of Abraham Lincoln has been the subject of both contemporaneous commentary and subsequent hypotheses by historians and scholars.
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Despite the following occurrences, Lincoln's health up until middle age was fairly good for his day.[1][2]
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]
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]
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]
The shape ("habitus") of Lincoln's body attracted attention while he was alive, and continues to attract attention today among medical professionals.[16] Geneticists are now skeptical of the hypothesis that Marfan syndrome was the cause of his unusual habitus (see below).
Height. As a child, Lincoln was tall, describing himself as "though very young, he was large of his age."[17] 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,[18] but this is inconsistent with the emphatic statement of Henry Lee Ross ("The facts are Lincoln never weighed over 175 pounds in his life"),[19] the recollection of David Turnham ("weighed about 160" in 1830),[20] 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.[21] He is believed to have weighed even less during his presidency.[22]
Marfan syndrome. Based on Lincoln's unusual physical appearance, Dr. Abraham Gordon proposed in 1962 that Lincoln had Marfan syndrome.[23] Lincoln's unremarkable cardiovascular history and his normal visual acuity have been the chief objections to the theory, and today geneticists consider the diagnosis unlikely.[24] 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).[25] 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. [26]
The theory that Lincoln was afflicted with type 5 spinocerebellar ataxia[27] is no longer accepted.[28] The theory that Lincoln's facial asymmetries were a manifestation of craniofacial microsomia[29] has been replaced with a diagnosis of left synostotic frontal plagiocephaly,[30] which is a type of craniosynostosis.
Lincoln was contemporaneously described as suffering from "melancholy," a condition which modern mental health professionals would characterize as clinical depression.[31] Whether Lincoln may have suffered from depression as a genetic predilection, as a reaction to multiple emotional traumas in his life,[32] or a combination thereof is the subject of much current conjecture.[33]
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,[34] the cessation of Lincoln's engagement to Mary Todd Lincoln in January 1841 (after which several close associates feared Lincoln's suicide),[35] and after the Second Battle of Bull Run.[36] 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.[37]
Lincoln would often combat his melancholic moods by delving into works of humor, likely a healthy coping mechanism for his depression.[38]
It has been proposed that Lincoln took "blue mass" pills to improve his mood.[39] There is, however, no support for this in the written record.[40] 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[41] (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.[42] 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.[43] Lincoln's only known assessments of the medication are that it made him "cross" and that he preferred it above others.[44]
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