Lincoln's Medical History

I stumbled upon a couple of very interesting articles pertaining to Abraham Lincoln’s medical history.

The most recent issue of the Journal of Medical Biography contains an article detailing Lincoln’s bout with smallpox in November 1863.

Researchers Armond Goldman and Frank Schmalstieg reviewed Lincoln’s symptoms and found that the president complained of being weak and dizzy in the days prior to delivering the Gettysburg Address. His condition worsened. He developed a high fever, severe headache, and backache. His skin soon broke out into scarlet blisters. In all, the president was sick for three weeks, during which time he became “emaciated.”

Historians have acknowledged that Lincoln’s doctors diagnosed him with “a mild form” of smallpox just after he delivered the Gettysburg Address. However, Goldman and Schmalstieg believe the president’s doctors deliberately downplayed his illness, hoping not to alarm the country during the Civil War. Because his skin erupted in blisters, they believe his condition was much more serious; in fact, they suggest the president could have died from the disease in late 1863. Indeed, one-third of all smallpox patients in the mid-19th Century did not survive.

Certainly future studies of the Gettysburg Address, need to acknowledge the president’s fragile health at the time; however, Goldman and Schmalstieg raise important questions that are usually relegated to the “alternate history” bin. How might American history have been different if President Lincoln died of smallpox in November 1863?

The second article comes from a University of Maryland School of Medicine conference, which examines the deaths of historic figures. This year, they focused on Lincoln’s assassination. They wanted to know two things: first, could today’s medical technology have saved Lincoln? Second, if so, could Lincoln have recovered well-enough to resume his duties?

“I don’t believe that the president had a uniformly fatal injury,” said Dr. Thomas Scalea, the physician in chief at the University of Maryland’s Shock Trauma Center. Scalea described how he would have treated the president’s wound and concluded that he could have lived.

So modern medical technology could have saved Lincoln’s life, but what about his recovery? Scalea said all brain injuries are different, but he suspected Lincoln would “have been left with substantial disability.” The bullet did not damage Lincoln’s frontal lobes, which are responsible for language, emotion, and problem-solving. However, it is unknown if Lincoln might have ever recovered well-enough to communicate again.

If Lincoln had survived, but could not immediately communicate, who would have ran the country? Apparently, not Vice President Andrew Johnson. The 25th Amendment, which deals with the transfer of power when a president is incapacitated, was not yet part of the U. S. Constitution. Historian Steven Lee Carson suggested that Secretary of War Edwin Stanton, who made several key decisions in the hours after the assassination, would have played a much greater role.

Again, neither of these two articles really asked new questions, but advances in medical technology have certainly offered new answers.