The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (12 page)

The family’s concern over Abigail’s recovery was pervasive. In early February 1843, Millard Fillmore feared that his wife was “apprehensive that she will never be well until she keeps still.” Abigail wrote her daughter in late July of the following year: “You must be a housekeeper, if I should never walk again, you are all I have to depend upon and for your own sake I wish you to undertake domestic business.” Millard Fillmore did not return to the House of Representatives in 1843, possibly to tend to his crippled wife.
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Eventually Abigail was able to stand and walk, but with some difficulty. Her other medical complaints during the 1840s included frequent head colds and a cough. An 1842 letter written by her husband stated that Abigail had a bilious fever, the frequent contemporary name for malaria. However, the illness was not recurrent, and in the absence of a further description, a malaria diagnosis is unlikely. In 1846 she consulted a physician complaining of noises in her ear. She was informed the problem was “mainly a sensation of the nerves and no evidence of apoplexy … no disease … inconvenience.”
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Unfortunately the fall and winter (1848–1849) was a period of serious illness. In a January 1849 letter the incoming vice president fretted to his daughter over “a lameness that may arise from the spine or rheumatic” affliction. “I almost despair of her ever enjoying health again. it is a melancholy and painful thought. I think she will not go to Washington.” Persistent cough and headaches complicated back and hip problems, which forced Mrs. Fillmore to her bed for days. Although the family blamed a spinal disorder or rheumatism, a more reasonable explanation would conclude that a postural imbalance due to her injured ankle caused the back and hip pain.
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Her cough progressed to bronchitis and possibly pneumonia, leading Abigail to write the following depressing sentiment to the vice president on his inauguration day, March 4, 1849: “[P]erhaps another anniversary I shall be numbered with the dead. I feel a presentiment that I shal
l
not see many more.”
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The first lady’s health actually was quite good during her relatively brief White House tenure, at least until her last winter as its tenant. In a written letter to his sister after Abigail’s death, Fillmore elaborated: “Mrs. Fillmore had not been quite as well as usual during the winter. She suffered considerable pain in her back and the back of her head, and she was restless, and often suffered from want of sleep. A slight cold gave her a cough, and she was occasionally troubled as she had before been for want of breath. The least exertion overcame her and [she exhibited] fatigue.”
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However, despite her less than hardy health, the now former first lady Fillmore was the first in her position to attend the inauguration speech by her husband’s successor. Franklin Pierce, the newly elected fourteenth president of the United States, gave a short speech under a grey sky: “A raw northeasterly wind made the thousands of spectators shiver, and snow fell continuously, melting almost as quickly as it struck the ground.”
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It was on the public stand, in the open, raw air that Abigail caught a chill which progressed to pneumonia followed by death. It was the second first family death resulting from a presidential inauguration.
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She attended the ceremony accompanied by her literary friends, Washington Irving, the American literary figure, and William Makepeace Thackeray, the English novelist. Washington Irving, in an April 4, 1853, letter to a friend, wrote: “I almost think poor Mrs. Fillmore must have received her death warrant while standing by my side on the marble terrace of the Capitol, exposed to chilly wind and snow, listening to the inaugural speech of her husband’s successor.”
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When the Fillmores vacated the White House, they moved to a suite in the nearby elegant Willard Hotel. Mrs. Fillmore’s rapid and fatal progression is best chronicled in Millard’s letter to his sister, shortly after his wife’s demise. (Fillmore [Buffalo] to Julia, April 12, 1853) His narrative is summarized below.
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Two days after the Pierce inauguration, Sunday, March 6, Abigail felt “unwell” and ran a high fever. The next day she attempted a shopping trip but became seriously ill and was forced to return to the Willard. Without any improvement by Wednesday, March 9, the renowned District physician James Crowdhill Hall was asked to make a house call. There is no record of any previous medical relationship with this doctor. Hall returned the following day and after his examination, informed the Fillmores “she had taken cold which had settled upon the lungs, or rather upon the bronchial tubes leading to and perforating the lungs, and should soon be better.” He optimistically prescribed medicine and bed rest. Hall’s positive prognosis was faulty, as over the subsequent three or four days the patient’s cough worsened. A sitting position became necessary for comfort. Hall, alarmed, requested the consultation of a respected colleague, Dr. Thomas Miller. Abigail was subjected to cupping of her back and sides and blistering of the chest with no improvement. Thereafter Drs. Hall and Miller examined the patient once or twice daily. They noted “there was a suffusion of water in the cellular membranes of the lower part of the lungs.” This is a classical description of pneumonia.
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The pneumonic lungs caused great difficulty in breathing. For the last two weeks of life, sleep occurred only when her head was upon a table, thus keeping the chest upright. Fever continued and fatigue worsened.
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On the suggestion of John Kennedy, Fillmore’s former navy secretary, Dr. Buckley from Baltimore was summoned. He arrived, examined the patient and consulted with the attending physicians. His astonishing conclusion was that in a few days the patient would be restored to health.

The seriousness of the illness finally was revealed in a
New York Daily Times
piece that appeared on March 23, 1853: “On account of the continued severe indisposition of Mrs. Fillmore, the ex–President’s Southern tour will be postponed till next month. Perhaps abandoned altogether.”
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The medical condition remained desperate over Sunday and Monday, March 27 and 28, leading to the following letter from Millard Fillmore to his successor, Franklin Pierce, written March 28, 1853:

“She is indeed very sick and I entertain the most painful apprehension of the result. She has not been able to lie down for near two weeks but her strength holds out beyond all expectations and I hope and pray that it may continue until her lungs shall be so far restored as to enable her to take rest in a reclining posture.”
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Another physician, Dr. Riley of Georgetown, was called to the bedside. Over the next two days Riley cupped and blistered Mrs. Fillmore and applied poultices. Perhaps as a result, her overall condition worsened greatly and the prognosis was that the illness was terminal. Only then were her physicians correct. Former first lady Abigail Fillmore died from pneumonia on Wednesday morning, March 30, 1853,

Thus was the famous Dr. Crowdhill Hall on his way to assume the image of a Zelig or a Forrest Gump. He already had been present at the deathbeds of Presidents William Henry Harrison and Zachary Taylor. Now he was around when Abigail Fillmore died. Later he would be seen at the deathbed of the assassinated Abraham Lincoln.

Dr. James Crowdhill Hall, prominent Washington physician. He attended the deaths of Presidents Harrison, Taylor, and Lincoln (courtesy National Library of Medicine).

A curious note, found years later in the Fillmore papers, accounted the payments attached to Abigail’s final illness. Dr. Hall, the principal attending physician, was paid $75; his Washington colleague Dr. Miller $103; Dr. Buckley, who traveled from Baltimore, was awarded $75; Dr. Riley was paid $5 for his deathbed examination. The largest payment was to the undertaker, Mr. S. Kirby, for $116.
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These four antebellum first ladies left little mark on American history. Due either to illness or disinterest, they often employed surrogates, usually a daughter, to conduct the social and ceremonial functions of a first lady. Their illnesses varied: malaria, rheumatoid arthritis, unspecified gastrointestinal problems, a chronic foot injury, and, probably, epilepsy. Their medical problems had little effect upon the presidential performance of their husbands.

The Sad Stories of Jane Pierce, Louisa Johnson Adams and Mary Todd Lincoln

Jane Pierce harbored a melancholy personality that was exaggerated by her stern Congregationalist New England upbringing. Her clinical depression was fueled by her husband’s political career and by the devastating loss of the Pierces’ only surviving son in January 1853, just prior to Franklin Pierce’s presidential inauguration. Mrs. Pierce shunned her first lady’s responsibilities during the first half of the Pierce presidency, and her disposition negatively affected her spouse’s performance as president.

In contrast, Louisa Johnson Adams had a happy upbringing, excellent schooling and a loving family. Her marriage to presidential scion John Quincy Adams brought her irregular intimacy, twelve pregnancies and increasing self doubt. Despite this she was a charming hostess both as the wife of the secretary of state (1818–1823) and as the first lady in the White House (1823–1827).

Mary Todd Lincoln’s psychological balance was shattered during her husband’s presidency. It was cracked with the death of her favorite son, Willie (February 1863), and was broken completely by the assassination of her husband (April 1865). She was diagnosed as a manic depressive and institutionalized by her son.

The diagnosis and treatment of mental disease was rudimentary during the first two-thirds of the nineteenth century. The celebrated and aforementioned Doctor Benjamin Rush was a pioneer whose “An Inquiry into the Effects of Ardent Spirits Upon the Human Body and Mind,” published in 1804, earned him the posthumous accolade of Father of American Psychiatry.
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John Quincy Adams referred this book to his wife when Louisa was experiencing an episode of emotional disturbance. Otherwise, few physicians possessed any insight into the character and assuagement of mental disease. It was not until the 1870s that specialists in psychiatry undertook the care of Mary Todd Lincoln. Previously clergy and spiritualists had attempted to fill this void.

“Mrs. Pierce found Benny lying by his side and saw that something, a seat perhaps … had taken off the back of Benny’s head and killed him instantly.” “It destroyed her forever as a functional member of society during the last ten years of her life.” (1853–1863)
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The role of the first lady in the mid-nineteenth century consisted of managing the household of the executive mansion, supporting the work of the president by maintaining a rigorous social schedule, and attending ceremonial functions. Jane Appleton Pierce fell far short in fulfilling this role. The death of her only surviving son in a train accident made the White House an unshakable burden.
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On January 6, 1853, President-elect Franklin Pierce, his wife, Jane, and their almost twelve-year-old son, Bennie, were aboard a train from Andover to Concord, New Hampshire. They were returning to their home after attending a family funeral. The train suddenly lurched and the Pierces’ rail car was overturned. Bennie was struck on the head by a flying chunk of metal that shattered his skull. The boy died instantly. His mother saw it all. A strict Calvinist upbringing led her to see everything as the will of God. She rationalized that Bennie’s sudden death must have been God’s way to relieve her husband of any concern for his child’s welfare so he could devote full attention to the presidency.
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The tragedy emotionally destroyed the physically and mentally fragile Jane Pierce. She was in a catatonic state for days after the accident, unable to function or even speak. Unable to attend her husband’s inauguration, she remained in Baltimore for several weeks and was completely gripped by fear. But finally she was able to take residence in the White House as first lady.
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Upon her delayed arrival at the White House, the first lady selected two rooms on the second floor for her suite, then closed the door and for the first year was seldom “at home” for anyone. Her depression was overwhelming. She confined herself to her rooms in the White House and became progressively withdrawn and reclusive and increasingly detached from reality. She passed her time sitting at a table almost in a trance, writing notes to Bennie, lamenting his death. Her depression was evident to everyone with whom she came in contact. A longtime friend of the Pierces, Nathaniel Hawthorne, would refer to her as “that death’s head” in the White House.
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For the first two years of the Pierce presidency, hostess duties fell largely upon Mrs. Abby A. Means, who was Jane’s girlhood friend. Abby Means consoled the distraught first lady on her journey from Concord to Baltimore and then to Washington. Abby was widowed, a lady of independent means and social experience. She was persuaded to remain in order to assist the president and first lady. She became one of the first first lady surrogates, but, unlike the earlier Priscilla Tyler, she was not a success. Means held regular receptions and a few socials, but social dysfunction and a somber tone permeated the White House, still in mourning for the president’s son.
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