Martyn Hooper MBE – Chair of the PAS

~ The Chair’s Blog ~

Mary Todd Lincoln

by | Jul 14, 2016 | 1 comment

Back in the early ’80’s, when I wore a younger man’s clothes, I was an undergraduate reading Politics.

Thereused to be a dreadful joke doing the rounds that centred on the assassination of President Lincoln – the author of the Gettysburg Address. And one day I remember promising myself that I would read Lincoln’s Gettysburg Address in preparation for a lecture I was attending the next day.
So off I went to the library and found what I thought was a copy of the address. Unfortunately all I could find was a condensed version. And so I sought the help of one of the Librarians.

“Where can I get a copy of the full address?” I asked.

“That’s it” he said.

“No, no no, this must be the condensed version – it’s only 200 odd words long”

“That’s it”

And so I read the Gettysburg address on the way home on the bus. Now stay with me – this does get interesting I promise.

A few years later I visited Gettysburg (it has one of the few proper roundabouts in the States – you could buy a fridge magnet with ‘I rode the Gettysburg Rotary’ on it). Anyway what’s this got to do with Pernicious Anaemia? It’s all to do with the wife of the 16th President – Mary Todd Lincoln whose erratic behaviour has now been attributed to….Pernicious Anaemia. The ‘First Lady’ was prone to “A history of mood swings, fierce temper, public outbursts”. And she also imagined all manner of things happening to her.

When she visited one of her sons she told him that someone had tried to poison her on the train and that “a wandering Jew had taken her pocketbook but returned it later”. She was given to spending large amounts of money on refurbishing the Whitehouse and spent vast sums of money on clothes that she didn’t wear. Her behaviour became more unpredictable and after she nearly jumped out of a window to escape a non-existent fire,her son Robert determined that she should be institutionalised, which she was.

After she had witnessed her husband being assassinated in Ford’s Theatre in Washington DC in 1865 her behaviour became even more bizarre. This was just ten years after Thomas Addison had began his investigations into Pernicious Anaemia (Addison’s Disease) and so it was unlikely that anyone would have diagnosed her with the condition.

Now, there’s something that bothers me about all of this. We know from contemporary accounts that Mary was prone to violent outbursts and sudden mood swings. And we know that she was a spendthrift and imagined things. She also suffered from a wide range of other symptoms that indicate Pernicious Anaemia including ‘weakness, fatigue, fevers, headaches, gait problems, rapid heartbeat, mouth soreness, swelling and vision trouble’. Now all of these can be seen as indicators of Pernicious Anaemia but there doesn’t seem to be any evidence that she displayed the most common symptoms of PA – tiredness, fatigue, shortage of breath etc. Indeed contemporary authors talk of her ‘enormous energy’. Indeed, when her husband was assassinated (the President’s bodyguard had decided that the play wasn’t for him and that he’d pop next door for a cold one) it was 10:15 in the evening which is way past the bedtime for most patients with the disease. So whilst her behaviour and other physical symptoms can be attributed to being caused by PA it seems odd that nobody had ever commented on any tiredness of fatigue. If they had suspected Pernicious Anaemia there wouldn’t have been a reliable test to confirm the diagnosis; some things never change eh? Anyway Mary died of a stroke in 1882.

And the awful joke? Well here it is, just a little shorter than the Gettysburg Address:

“Apart from that Mrs. Lincoln, what did you think of the play?”

Told you it was awful…..

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1 Comment

  1. Marlene Jenkin

    Looking at her photo she looks VERY Hypo – which could also explain some of the symptoms. Increasingly I read on the PAS Forum on HU of people with PA mentioning – eventually – that they take Levo/T4 for thyroid treatment. Sometimes only when asked. Many people mention they have been tested and they are * normal * – further questioning reveals an issue or others do not reply. Having to deal with a B12 deficiency is enough and some do not want to add to their woes.

    Sadly the testing and treatment of Thyroid issues is a problem – just like PA/B12. Often the TSH is the only thing tested – which tells you so very little. The FT4 AND FT3 results are needed for the FULL story. As PA is auto-immune it is possible that people have auto-immune thyroid too – aka Hashimotos – so the anti-bodies TPO and Tg should be tested. There are millions of people walking around with an undiagnosed thyroid problem – as indeed there are with a B12 issue.

    Being told one is normal when the Doc means in range is not good enough. It is where we are in the range that is key for the optimal workings of the Thyroid – a gland that effects every cell of the body.

    In a way I am surprised her symptoms were missed – after all those were the days before testing and Docs had to diagnose by looking at and listening to the patient !


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