Excerpt from The Physical Lincoln
This is the Preface from The Physical Lincoln 1.0a. End-notes are omitted.
The Library of Congress' catalog shows that a new book about Abraham
Lincoln appears every 5 1/2 days. Can anything new be said about this man?
With only one old exception, all existing books about Lincoln discuss
"the mental Lincoln," meaning his thoughts, speeches, politics, jokes,
emotions, and so on. These characteristics are responsible for his reputation, of
course, but they are only part of his story.
The book you hold in your hands completes the story. It unveils "the
physical Lincoln" -- his body.
Some bits of the physical Lincoln are well known. He is history's tallest
President, at 6-feet 3 3/4-inches. He was strong, and a good wrestler. He grew
a beard to disguise his ugliness. These few facts, however, no more reveal
the full physical Lincoln than the Gettysburg Address reveals the full mental
In short, The Physical Lincoln analyzes Abraham Lincoln as a physical
organism. It takes you on a tour of his body, starting with his height, but going
further. What were his feet like? What is that "mole" on his cheek? What did
his voice sound like? Could he really do that? (See Chapter 8.) No such
analysis has been published before now.
Ultimately, the tour leads to a new diagnosis. The Physical Lincoln proposes
that Lincoln suffered from a very rare genetic disorder that affected
him, literally, from toe to skull. The physical Lincoln was just as rare as the
The ramifications of the diagnosis are many, and they extend beyond
medicine. Dozens of observations about Lincoln, previously thought to be
just personal quirks, are now explainable as products of his disease. Some of
the early deaths in his family are similarly explainable.
The diagnosis also provides fresh perspectives on questions old and new,
such as: Was Lincoln depressed? Was the Presidency killing him? If he had
not been shot, would he have lived another six months?
Some of these perspectives will be controversial. Nevertheless, one of the
book's most interesting conclusions is that misinterpretations of the physical
Lincoln have led to misinterpretations of the mental Lincoln. The physical
Lincoln is, after all, the vessel that housed and supported the mental Lincoln.
* * *
If you want to read about Lincoln now, please turn to page 23. In the
remainder of this Preface, I want to say a few things about the book itself.
The Physical Lincoln is written for laypersons, not professors or physicians.
This is the audience Lincoln always tried to reach.
I tried writing for a physician audience, but found I could not effectively
present the evidence for the new diagnosis in only 2000 words, the usual
length of an article in a medical journal. Worse, I could not even present it
in a single book!
The Physical Lincoln has a dense companion book, written for scholars,
called The Physical Lincoln Sourcebook. The Sourcebook is a compendium
of raw historical data, organized as a physician would organize any patient's
medical history. (Lincoln's medical records, if any, have not survived. His
autopsy was limited to the brain.)
The syntheses and assertions in The Physical Lincoln derive from it. Readers
seeking the basis for any statement herein will often find a pointer to a
specific entry in the Sourcebook, where the raw material may be reviewed.
No such compendium has previously been assembled.
The companion book attempts to be exhaustive -- to cover all aspects of
Lincoln's medical history, including the medical histories of his close blood
relatives. It follows the physician's approach of recording all data on the first
pass -- no matter how dubious or inconsistent -- to await a later sorting-out.
By contrast, The Physical Lincoln is selective. It is, effectively, the
sorting-out of Lincoln's genetic disorder. This genetic focus is not as narrow as it
seems, because Lincoln's disorder affected many bodily systems, had numerous
observable manifestations, and afflicted some of his close blood relatives.
The book is more like the explanation that a physician would give to
a (very patient) patient, but without the requisite solemnity, and certainly
without technical language. I have also added stories from my own voyage of
Unfortunately, even two books cannot completely cover the topic of the
physical Lincoln. There are simply too many sources to read and too many
avenues to explore. It would take years (or decades) for me to produce a book
that tied down every loose end about Lincoln's health -- if possible at all.
Thus, in the parlance of software development, this book is very much a
1.0 release. What does that mean? It means the book, in its current state, tells
the story I want to tell, and, most importantly, tells it now. It also means the
book could be better in a thousand ways, from deeper research to sterling
prose to glossy photos. Before investing a thousand hours to make it better,
however, I would like to see how it does.
Readers are advised that The Physical Lincoln is in no way a medical textbook.
The book presents a great many medical concepts, but only those
needed to explain the Lincoln story. Omissions are the rule, and
over-simplifications are used without apology. Anyone looking for a rigorous treatment
of medical concepts should look elsewhere, potentially guided by the book's
legion of reference notes. The emphasis here is on Lincoln.
* * *
Some of the many people who revere Lincoln may be offended by this
book's apparent disregard for his dignity. Please be assured that medical
detachment, not disrespect, is the only intent (Figure xvii).
||It is difficult to remain an
emperor in presence of a
physician... the professional
eye saw in me only a mass of
humors, a sorry mixture of
blood and lymph.
|-- The Memoirs of Hadrian
It may be worthwhile, therefore, to emphasize that this book is largely an
entertainment. It solves a puzzle. Lives do not hang on its contents, nor even
reputations.* Lincoln has no living descendants. Physicians have an obligation
to investigate everything that may shed light on their patient's health; I
have simply approached Lincoln as if he were my patient.
* * *
Finally, a note about the book's design. Just as Lincoln was famously
indifferent to his personal appearance and knew that the true measure of a person
comes from inside, I have been somewhat indifferent to the physical appearance
of this book. The book is designed for function, not beauty. It benefits hugely
from TeX, LaTeX, and the memoir.sty typesetting software, but has
warped their fine designs to its own purposes.
How to Read This Book
If you like, read this book for fun: ignore the footnotes and end notes. If,
however, you are a scholar, a student seeking a project, or a Lincoln aficionado,
you may occasionally want to look at those items because they point to more
information. Every annotation's prefix (or lack of prefix) tells you where to
turn for this additional information, as follows:
Mud spattered on the President. Lincoln visited the battlefield at
Antietam, Maryland on October 3, 1862 and posed for several pictures. Dirt or
mud is visible at the bottom of his overcoat. Pointing this out does not
subtract from the dignity of the man. Dirt is dirt, and there was plenty of it
at Antietam. The officer at far right, wearing the cavalry hat, is
George Armstrong Custer. See also page 46.
"Extra-notes" are categorized separately from reference notes because
they contain a comment over and above a simple reference citation. In other
words, if you look up a reference note, you will get only a reference citation.
If you look up an extra-note, you will get something more.
"Projects" are areas of investigation that I would someday pursue, were
time and resources unlimited. I print them for readers needing things to do!
Dividing end-matter into these categories increases reading efficiency (by
helping the reader decide whether to turn to the back of the book) and reduces
the physical size and cost of the book (by enabling space-conserving
text layouts in the appendices).
Readers may also notice -- and, I hope, forgive -- a few crotchets:
||Pointer to an "extra-note" -- see Appendix B
||Pointer to a reference note -- see Appendix C
||Pointer to a paragraph in The Physical Lincoln Sourcebook
|* , † , ...
||Pointer to a footnote at page-bottom.
The Physical Lincoln and The Physical Lincoln Sourcebook owe their
existences to immensely helpful people, organizations, and technology.
People. My greatest thanks goes to those who read the entire manuscript
of The Physical Lincoln and provided detailed, page by page comments: William
Petros, Georgette Sotos, and George P. Sotos. Their improvements to the
book cannot be underestimated, and my gratitude to them knows no bounds.
Drs Kevin Olden, Jeffrey Jones, and Hugh Rienhoff, Jr. read the entire
manuscript and provided invaluable suggestions. Hugh has been my guide in all
things TGF-beta, but, more than that, has for 28 years been a fount of
encouragement and a treasured friend. Olden I have learned to tolerate. :-)
A beer with him and Dr. Fergus Shanahan got me going on the Presidents.
Many other physicians contributed their expertise in helpful discussions,
for which I am grateful: David Walton, Thomas Traill, George A. Sotos, Mindy
Shapiro, Chad Prodromos, John Mulliken, Neil Miller, Victor McKusick, Justin
MacArthur, Richard Lange, Douglas Jabs, Tripp Heard, Henry Halperin, William
Gottesman, Robert Gagel, Ronald Fishman, Charis Eng, Hal Dietz, Kevin
Boylan, Kenneth Baughman, Douglas Ball, and Stephen Achuff. Dr. Lori Marion was my
refraction-tutor. Please do not assume that these professionals endorse my conclusions!
Many other friends & family generously gave guidance, inspiration, and
moral support: Carol & Rob Younge, Dr. James Weiss, Dr. Charles Wiener,
Susan Weiner, Bruce Tognazzini, Dr. David Thiemann, Barbara Schroll, Marilyn
Prodromos, Jacqueline Parker, the Litt family, Dr. Paul Ladenson, Dr. Kathryn
Hodge, Dr. David Herrington, Al Henning (and the Dartmouth Club of Silicon
Valley), Judge Lauren Heard, Dr. Nicholas Fortuin, Doris Egan, John Catsis,
David Brown, John Branscum, and Peter Blake.
To a greater extent than all these people realize, this book is a smorgasbord
of their ideas (and restraints!). Many I know from Johns Hopkins, where
the pervasive spirit of inquiry allows anyone to walk up to anyone else and
begin a conversation, saying: "I've been working on this idea..."
The special roles of Richard Benson and James Mellon are discussed on
page 251. Richard went above and beyond, graciously helping me understand how
he did what he did, and explaining the subtleties of 19th century
photography. For supplying images, I am grateful to Gabor Boritt, Eugene
Knox III, Dr. Ronald Fishman, Dan Ostendorf (and family), and to Keya Morgan,
who also took time to dispel some of my misconceptions about Lincoln
photographs. Suzanne Walsh taught me the rudiments of graphics processing long
ago; I wish she had taught me some of her artistic skill!
Professional advice from DeAnna Gibbons, Jonathan Baruch, and Richard
Abate was much appreciated. Jason Emerson greatly helped my search for
sources. Cindy VanHorn and Jane Gastineaux at the Lincoln Museum were
unfailingly good-humored about my requests. Cindy, especially, helped in
so many ways over a period of several months. Sue Cornacchia and Hallie
Brooker of the U.S. Coast Guard Academy and Museum were nicer to me than
I had any reason to expect. Carol Johnson at the Library of Congress went out
of her way to answer my questions about Mary Lincoln photographs.
Heroically, George P. Sotos read a thick draft of The Physical Lincoln Sourcebook,
cover to cover. That is a real example of parental love! He and my
mother are the best parents imaginable; I owe everything to them.
Organizations. I am grateful for the services provided by · Stanford University
Libraries · the Library of Congress · Palo Alto City Library · Lincoln
Museum of Ft. Wayne, Indiana · National Portrait Gallery · San Francisco
Public Library · Welch Medical Library and Eisenhower Library of the Johns
Hopkins University · National Archives and Records Administration · Holt-Atherton
Special Collections at the University of the Pacific Library · Georgetown
University Library Special Collections · Waupaca Area Public Library
(Wisconsin) · Lincoln Shrine and A.K. Smiley Public Library of Redlands,
California · Abraham Lincoln Presidential Library and Museum of Springfield,
Illinois · United States Coast Guard Museum · Medical Society of the State
of New York · Massachusetts Medical Society · Smithsonian Institution.
Of these, Stanford University deserves special thanks for its policy of giving
the community access to the vast majority of their libraries. My thanks to
the staffs of the Green, Lane, SAL, art, SAL3, and Falconer libraries.
Technology. Software has played a huge role in the books. I am happy to
say that the books were developed entirely with open-source software. To all
who contributed to developing these systems, thank you. · TeX · TeXShop
· LaTeX · memoir.sty · the GIMP · Python
· PIL · Mediawiki + Apache (to organize Lincoln photographs).
The Internet Archive (archive.org) and Google Books (books.google.com)
are fantastic resources for anyone needing access to out-of-copyright books.
I used both heavily, with gratitude at every download.
Finally. The errors in this book are mine alone -- but if you don't tell me
about them, they will be your errors in future editions. :-)
- Figures and tables are numbered according to the page on which they
appear. This makes it easier to find them within the book.
- The name "Lincoln," used without qualification, refers to Abraham Lincoln,
the 16th President of the United States.
- Original sources are quoted exactly, preserving their errors.
- British-style hyphenation is occasionally noticeable.
* Well, maybe my reputation is at stake: there is a nonzero risk of looking like an idiot if,
after 310 pages of text, I have missed the diagnosis. Theodore Roosevelt spoke memorably about
taking such risks, but I prefer the view of one of the greatest physicians I know: "No balls, no