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Graham 1 Ashley M. Graham FYW 1182 Dr. Lloyd Benson 27 April 2010 Lincoln's Medical Mysteries Abraham Lincoln, 16th President of the United States of America, endured both harsh and trying obstacles during his time in office. Not only did he withstand the hardships of the Civil War, but was also known to endure physical and emotional maladies as well. The President suffered from countless bouts of depression, as well as, physical problems, such as headaches, fatigue, fainting, cold hands and feet, loose-jointedness and more. While appearing strong for the sake of the people, Abraham Lincoln was in fact weak when speaking of his failing health. If the President had not been assassinated by John Wilkes Booth, it is not known how much longer he would have been able to live. My research question revolves around the theory of whether or not President Abraham Lincoln suffered from a genetic condition known as Marfan Syndrome. Many researchers believe this condition was inflicting pain upon the President before the assassination, and would have killed him if he had not been shot by John Wilkes Booth. At the time of the assassination, the medical practices were both barbaric and highly unsanitary, when scrutinized by the eyes of current doctors. When Dr. Leale, one of the first Doctor's to examine Lincoln on the balcony at Ford's Theatre, first inserted his finger into the Graham 2 gunshot wound on the back on Lincoln's head, he not only welcomed the spread of germs and the beginning of an infection, but could have potentially caused more harm than good. Using this sort of probe could have easily ruptured blood vessels in the brain that had not been hit, or crossed into the path of the projectile during the assassination. Dr. Leale stated, "I believe that he would not have lived five minutes longer if the pressure on the brain had not been relieved and if he had not been left that much longer in the sitting posture."1 This statement reveals a complete misunderstanding of the extent of damage caused during brain trauma injuries. The blood that exited after removing his finger could have very well been from damage caused by the doctor himself, rather than from the actual previous injury. In addition to this, the prevalence and supply of information regarding antiseptic measures was not yet established during the time of the assassination. Most doctors were generally unaware of the dangers of infection, although there were many articles published providing guidelines for hand washing and regulations for surgical procedures. One such guideline was established, that insisted that doctors must wash their hands in chlorinated lime before entering a surgical room, thus reducing the risk of puerperal fever and the spread of germs and disease. Although it cannot be certain that Abraham Lincoln would have even survived this injury using current medical practices, there was not much more that the doctors of the time could have done for the dying President, even with the barbaric procedures used by Dr. Leale and the others.2 One practice commonly used to study the physical features and intellect of the people of the mid 1800's, was through the science of phrenology. Phrenology is the study of the shape of the skull, in relation to certain personality traits that a person possesses. The size of specific areas of the skull, correspond to the person's capacity to contain explicit character traits. The 1 2 Fraser,Richard A.R.. "How Did Lincoln Die?." American Heritage 46.1 (1995):63. Ibid. Graham 3 idea behind this concept is that the brain is the central organ of the mind, and there are certain, assigned areas that have specific logical functions. German physician Franz Joseph Gall was one of the first researchers to study the different areas of the skull, and was the first real practitioner of phrenology.3 Reports on Lincoln have been published in the American Phrenological Journal of October of 1864, critiquing the shape of the president's head, in relation to the traits that these areas contain. One such critique is that: “He has large Benevolence, large Conscientiousness, and large Hope. His Veneration is full, and his Spirituality average. His religion consist more in kindness and justice than in faith, humility, or devotion. To do right and to do good are his leading moral characteristics. Socially, he is strong in his attachments, constant in his affections and well adapted to wedded life. Intellectually, there is nothing wanting. His Causality is full, Comparison is large, and nearly all the perceptives large and active."4 Each of the characteristics described, pertain to a specific location on the skull. The areas that have been described are in fact the largest areas on Lincoln's head and are therefore stated to be his most revealing character traits. With the prevalence of phrenology of the time, it was a popular tradition to cast moldings of the face, so as to easily measure the specific regions and determine a person's character traits. Abraham Lincoln had not only a molding made of his face, but also of his hands too. These relics have become key pieces of evidence for investigating the theory insisting that Abraham Lincoln possessed Marfan Syndrome (arachnodactyly). Marfan Syndrome is an inherited birth defect in which the skeletal, visual and cardiovascular systems are all affected. Victims of the disease possess long arms, legs and fingers, loose joints, poor musculature, dislocation of the eye 3 John van Wyhe. "What Was Phrenology?." The History of Phrenology on the Web. http://www.historyofphrenology.org.uk/overview.htm (accessed April 13,2010). 4 Fowler & Wells "Abraham Lincoln: Portrait, Character, and Biography." American Phrenological Journal and Life Illustrated (1864). Graham 4 lens, an absence of a fatty layer under the skin, slender appearance, and abnormalities of the heart and blood vessels. This disease is inherited through an autosomal inheritance pattern, meaning that the gene can be passed down from either father or mother, but does not have to be inherited from both parents.5 One such doctor that has taken a keen interest into the former president's health, is Dr. Harold Schwartz, MD of Huntington Park, California. While treating a young male patient suffering from Marfan syndrome in the early 1960's, Schwartz discovered a common lineage between the boy and Lincoln. This breakthrough sparked an interest in Schwartz's mind that led the doctor to do some digging into Lincoln's past. The correlations between Abraham Lincoln's health and the findings of other Marfan syndrome patients were almost identical. Lincoln possessed similar skeletal system structures as well as optical discrepancies. He too had a sunken breast, possessed overly large extremities, was loose-jointed, and suffered from an optical dislocation of the lens causing the left eye to droop. While examining portraits of the time, Lincoln too appears to have elongated arms, that are explicitly longer than the average humans by as much as two full inches. During the Civil War, while seated with a group of Maine Lumbermen, Lincoln remarked "I don't believe that there is a man in that regiment with longer arms than mine." In addition to looking at the former president's arm span, the structure of Lincoln's hands have also been reviewed by analyzing the molds created by Volk, a popular artist of the time. While comparing Lincoln's hands to the size of an average hand, Bartlett, a sculptor and Lincoln scholar, has found that "they are large long hands. The first phalanx of the middle finger is nearly half an inch longer than that of an ordinary hand." Lincoln's two hands were also disproportionate to one another, which is an unusual trait for the average healthy 5 Beck, Joan. "Joan Beck's Mail: Diagnosing Marfan's Syndrome." Chicago Tribune, July 5, 1970. Graham 5 person. This description accurately depicts the common features associated with a person suffering from Marfan syndrome.6 With continual research of both Dr. Schwartz current patient of the time, as well as the Lincoln ancestors of the past, Schwartz was able to piece together a theory leading the origins of the Marfan syndrome gene to Abraham Lincoln's Great-Great Grandfather Mordecai Lincoln II. With researching Lincoln's mother, Nancy Hanks, it became apparent that Lincoln must have inherited the gene from her, which in turn was inherited from his ancient ancestors, although it cannot be absolutely certain that his Father was not a carrier himself. When looking at the medical ailments that have afflicted the Lincoln family tree, the presence of eye problems became one of the number one commonalities between the early and later generations of Lincolns. Not only did Abraham Lincoln suffer from severe hyperopia himself, but he appears to have passed it onto his children as well. Thomas "Tad" Lincoln, Abraham Lincoln's youngest son, was blind in one eye, with the other being extremely weak. Robert Lincoln, Abraham's Lincoln's oldest son, too possessed an eye problem that appeared to have caused him a degree of difficulty. Additional connections are being made that link together alternate members of the Lincoln ancestry to the Marfan gene, but at this point, Mordecai Lincoln II is the oldest connection that researchers have been able to accurately assure.7 With the information that has been gathered by researchers from multiple ages, it is curious to see the strong popularity and interest in the health of Abraham Lincoln, thriving to this very day. The quest to collect a sample of Lincoln's DNA is still undergoing review from the relics owners, and the process is being drawn out to debate the historical, as well as medical, 6 7 Schwartz, Harold. "Abraham Lincoln and the Marfan Syndrome." JAMA 187 (1964): 473-479. Ibid. Graham 6 purposes surrounding the history of the evidence. Many Doctors would love to test the DNA to see if Abraham Lincoln really did have Marfan syndrome, or if this is all just some false rumor started to spark interest in Lincoln. From the historical standpoint, historians do not want to see a priceless piece of history destroyed, never to be seen again. Scientific doctor, Dr. Darwin J. Prockop, chairman of biochemistry and molecular biology at Jefferson Medical College in Philadelphia, is looking to find a solution that fits both of the criteria. Dr. Prockop is hoping to get approval from a private owner to analyze a small sample of bone in order to clone Lincoln's DNA for further, widespread examination. The scientist states that he would only need a testing sample of bone weighing one one-hundredth-thousandth of a millionth of a gram in order to test for DNA. To clone the DNA, Dr. Prockop is hoping to use a process known as polymerase chain reaction to make millions of copies of Lincoln's DNA for further testing. With taking this into consideration, a review board was created and has been skeptical on allowing this procedure to take place. Dr. Marc S. Micozzi, director of the Washington Museum stated "While I think there is historical and educational value in learning about Lincoln's health, we think there are ethical, political and scientific questions that should be considered before making available material we are charged with preserving to be destructively tested." While each side has a valid point, it will be curious to see what the final outcome of the struggle is.8 Marfan syndrome today differs very little from the Marfan syndrome cases of the past. Today, an approximate 40,000 Americans are afflicted with this disease, affecting one in every 20,000 people. In an attempt to lower this statistic and provide options for potential carriers, scientists have finally developed a method for testing the presence of the gene, before the infected child is born. The scientists are hoping to be able to implement prenatal tests to probe 8 Leary, Warren E. "A Search for Lincoln's DNA." New York Times, February 10, 1991. Graham 7 and diagnose if the carriers children will be affected. Priscilla Ciccariello of the Marfan Foundation in Port Washington stated, "It means accurate diagnosis for the family members. You can identify it at once and end the terrible uncertainty." The gene responsible for this lifethreatening disease was initially thought to be held on Chromosome 15, but it is now known that Marfan syndrome, and the production of the fibrillin gene, is controlled by a family of several fibrillin genes. These genes are located on several chromosomes, rather than just the one, making the process all the more complicated.9 Abraham Lincoln is still to this day one of the most popular presidents of all time, and continues to spark the interest of the public eye. In addition to the theories of cancer, Marfan syndrome, MEN2B, and aortic heart insufficiency afflicting pain upon the president's health, Lincoln has experienced a wide array of additional medical ailments that catch the eye of even the younger generation. Researchers have come to connect to Lincoln through his neardrowning experience as a boy, his concussion from being kicked in the head by a horse at age 9, being clubbed in the head by a band of robbers while returning from New Orleans, or almost cutting off his finger while chopping wood. While reading about his continuous battle with syphilis throughout his lifetime, as well as his fatal jaw fracture that occurred after a dentist broke off a portion of his jaw bone while pulling out a tooth (without the aid of anesthesia), the entire population can find a common connection with the early president. Whether it be through a laugh or a cringe, Abraham Lincoln is still to this day known as a man of the people.10 9 Washington, Liz Hunt. "Scientists Discover Gene Linked to Marfan Syndrome: Prenatal Tests Possible." The Washington Post, July 25,1991. 10 Dr. Zebra "The Health and Medical History of President Abraham Lincoln." The Physical Lincoln. http://www.doctorzebra.com/prez/g16.htm (accessed April 14,2010).