The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama

by Deppisch, Ludwig M. , M. D.

  Margaret Taylor: The Reluctant First Lady

  “Betty Bliss agreed to serve as the official hostess in her mother’s stead.”40

  Margaret Taylor was another presidential wife during the antebellum period who delegated the performance of her social and ceremonial roles to a family member. Other first ladies of the first half of the nineteenth century were hobbled by physical or mental disability: Elizabeth Monroe was disabled by rheumatoid arthritis and a mystery illness, possibly epilepsy; Letitia Tyler by a stroke; Mildred Fillmore by a leg injury; and Jane Pierce by a crippling depression. None of the members of this quiescent quintet is ranked high in polls of the most successful first ladies.41

  Twenty-one-year-old Margaret Mackall Smith married Lieutenant Zachary Taylor in Louisville, Kentucky, on June 21, 1810. The Taylors raised a family of five daughters and one son in a series of frontier army posts that stretched from Minnesota to the Deep South. Although the Taylors were determined to remain together, several extended periods of separation were inevitable. One such period was during the Mexican War. General Taylor commanded the United States forces that successfully battled the enemy in northern Mexico. The public fame that resulted from his victories made him a candidate for the 1848 Whig nomination for president. However, Margaret was ready for retirement and so strongly opposed her husband’s nomination that she prayed that Henry Clay would get the nod.42

  Margaret Smith Taylor, this wife of thirty-eight years of an itinerant United States army officer, decided that a public role in the political glare of the nation’s capital was not what she fancied as the capstone to a successful and devoted marriage. She designated her twenty-four-year-old daughter, Mary Elizabeth (Betty) Bliss, as her substitute in the spotlight. Betty had recently married Zachary Taylor’s military aide, Colonel William Bliss.43

  As First Lady

  Mrs. Taylor was first lady for a brief sixteen months (1849–1850), until Zachary Taylor died suddenly from an intestinal ailment in July 1850. Because she was seldom seen in public, historian Carl Anthony colorfully named her the “Phantom in the White House.” Mrs. Taylor discourteously turned down a dinner invitation from the departing James and Sarah Polk the night before Zachary Taylor’s inauguration. Moreover, she did not appear at either of the Taylors’ two inauguration balls. She did attend the public swearing in of her husband as president.44

  In private, Mrs. Taylor was the matriarch, but to the press and public she was a nonentity. She ran the business of the White House and focused on the maintenance of the presidential mansion. Her social activities were inconspicuous. The first lady quietly invited a few select friends to visit in the White House and also participated in the informal family dinners. A social excuse of “indisposition” to avoid tiring and frivolous—in her mind—ceremonial events was justified.45

  It is very unlikely that Margaret took any interest in public affairs, with one exception. She may have influenced her husband to appoint Senator Reverdy Johnson, the husband of her cousin, as attorney general.46

  Medical History

  When Margaret Taylor entered the White House in March 1849, she was already sixty years old. She had previously accompanied her husband to inhospitable military commands around the United States and had borne six children, two of whom died in early childhood and a third shortly after that daughter’s marriage. Medical problems did not affect this first lady’s behavior or influence her husband’s performance and decision making as president.

  Malaria, the affliction of many Americans in the late 1700s and the 1800s, affected Mrs. Taylor. She was only one of several future and sitting first ladies of the period to be sickened by this mosquito-borne illness.47

  Margaret Taylor, her sister, and her four daughters spent the summer and early autumn of 1820 in Louisiana, where both swamps and mosquitoes were commonplace. The entire family contracted “bilious fever,” then a popular synonym for malaria, probably of the plasmodium vivax strain. Margaret was so dangerously ill that her soldier-husband rushed to her side, arriving on September 8. Upon seeing his gravely ill wife, he feared for her survival, since “at best her [prior] condition is remarkably delicate.” Zachary Taylor’s anxiety was merited since two of his daughters perished from the disease in Louisiana shortly thereafter. Octavia, almost four years old, died on July 8, 1820; fifteen-month-old Margaret died on October 22, 1820. Taylor’s wife and his daughters Ann Margaret and Sarah Knox recovered. A cryptic remark noted that Margaret pulled through, “though with her health permanently impaired.” But afterwards Margaret was healthy enough to become a mother twice more—to another daughter and the Taylors’ first son.48 Fifteen years later a third daughter died from malaria. Sarah Knox Taylor had married United States army officer Jefferson Davis and died in Louisiana shortly thereafter. Her husband also contracted malaria but recovered to lead the Confederacy several decades later.49

  This first lady-to-be might have had recurrences. In May 1828, she accompanied her husband on a Mississippi River steamer that traveled from St. Louis to his new post at Fort Snelling, Minnesota. While aboard, she was confined to her cabin with the signature malarial symptoms of chills and fever. Other references to Mrs. Taylor’s health are few. She reportedly was ill in Louisville in 1830 and was described “in feeble health” in late 1847.50

  The identity of any physicians either before or during her time in the White House is unrecorded. The Taylors’ oldest daughter, Ann, married a military surgeon, Doctor Robert Crooke Wood, who was a graduate of Columbia College of Medicine in New York. Wood was frequently assigned to Taylor’s military command during the latter’s military career and accompanied President Taylor on his August 1849 political trip to Pennsylvania and upper New York State. It is logical to assume that her son-in-law treated Margaret whenever she was ill.51

  The ex-first lady’s life was brief and inconspicuous to the public. She lived for a time in different locations with several of her children. Her only public appearance as a widow was at her son’s wedding in 1851 in Mississippi. She died on August 14, 1852, in East Pascagoula, Mississippi, of an unknown cause. “All of the Taylor family’s personal correspondence was stored at her last home which was burned by Union troops during the Civil War.” The loss of this primary source material accounts, at least in part, for the dearth of material from Margaret’s personal history.52

  Abigail Fillmore: The Lame First Lady

  Millard Fillmore wrote to his daughter Abbie regarding his wife’s illness the previous fall and winter and called it “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” (January 1849).53

  Abigail Fillmore, wife of Millard Fillmore. Her health limited her activities (Library of Congress).

  Abigail Fillmore was fifty-two years old when her husband, vice president Millard Fillmore, became America’s thirteenth president on July 10, 1850. He succeeded Zachary Taylor, who died of an intestinal illness. Mrs. Fillmore was first lady for 32 months54 and was a more active first lady than several of her predecessors.

  Her social appearances, although limited, were more frequent than those of Elizabeth Monroe, Anna Harrison and Margaret Taylor. “Abigail is typical of those first ladies who did not give social affairs a high priority. She minimized her social calendar but still obliged the public and White House guests by offering such popular events.” She held receptions on Friday evenings and Tuesday mornings and dinner parties on Thursdays. She hosted New Year’s Eve receptions in 1851 and 1852. In addition to the large Thursday dinners, Abigail also hosted smaller dinners for about twenty-nine guests on Saturdays.55

  A disabling ankle injury made prolonged standing very painful. This prohibited dancing and restrained her ability to receive the numerous guests who attended large official receptions. Sometimes, before a scheduled levee that she could not avoid, she would spend the previous day in bed to buttress her strength for the upcoming
ordeal. For some social engagements she pled ill health.56

  For these events, Mrs. Fillmore enlisted a substitute, which was a common practice of her predecessors. Abbie, her young daughter, age eighteen, became her proxy. Mary Abigail Fillmore was vivacious, well educated, fluent in French, conversant in Spanish, Italian and German, and an accomplished musician. It was an excellent choice by her mother.57

  A second factor determining which rare public events Mrs. Fillmore would attend was its intellectual benefit to her. Therefore she presided at formal political dinners.58 More intellectual and learned than her husband, Abigail was an inveterate reader. An intimate of hers remarked, “What Mrs. Fillmore most enjoyed was to surround herself with a choice selection of congenial friends in her own favorite room—the library.” Her early reaction upon entering the White House was astonishment that it possessed no library. She immediately set out to correct that and initiated a congressional appropriation of two thousand dollars. Mrs. Fillmore’s establishment of a library was a major White House innovation. Upon its completion, she conducted salons where family, friends, and those interested could converse and listen to discussions by prominent authors. These included Charles Dickens, William Thackeray, and Washington Irving.59

  The first lady’s influence upon the president was profound, and her greatest role was as a political advisor to the president, who had “been heard to say he never took any important step without her counsel and advice.” She had some influence over his political appointments. However, there was on instance when Fillmore disagreed with the first lady’s advice, to his own political peril. She opposed, and he supported, the Fugitive Slave Law as part of the Compromise of 1850. As a result he lost his previous northern antislavery supporters and was defeated for renomination in 1852.60

  There is no evidence that his wife’s illness or physical disability affected Millard Fillmore’s conduct of his presidency or his decision making.

  Medical History

  Abigail Powers was born in upper New York State on March 13, 1798, the youngest of seven children. She was unique among antebellum presidential wives in that she practiced a profession, that of a schoolteacher in Sempronius, Lisle and Aurora, New York. The tall, red-headed Abigail had as one of her students the unschooled carpenter Millard Fillmore. She taught her future husband how to write and speak properly and to use a map to study geography. This first lady’s intellectual curiosity never waned, as noted above. In middle age, she learned French and began piano lessons.61

  The Fillmores’ marriage was delayed until after Abigail’s thirtieth birthday. The couple had two children: Millard Powers Fillmore (born April 25, 1828) and Mary Abigail “Abbie” Fillmore (born March 27, 1832). Both children lived in the White House during their father’s presidency. The future first lady remained in the Fillmore’s Buffalo, New York, home during part of Millard’s political career in Washington. She did not attend her husband’s 1849 inauguration as vice president and, except for a single brief visit to the District of Columbia, she remained in Buffalo while Fillmore was vice president. An ankle injury was a likely reason she remained in her home.62

  Abigail Fillmore had a significant physical disability that had some effect on the completion of her social and ceremonial responsibilities as first lady. On July 4, 1842, while walking in Washington, she slipped on an uneven sidewalk and turned her foot inward. Her ankle became swollen and very painful; the problem delayed the Fillmores’ return to Buffalo at the conclusion of the session of Congress. In Buffalo the injury was exacerbated by a too hasty attempt to walk. The ankle never healed completely and worsened over the months. Mrs. Fillmore was confined to bed for months and, later, for two years she required crutches in order to walk. Pain never disappeared completely for the rest of her life.63

  Various treatments were tried and then discarded: the application of external liniments; the wearing of silk stockings; the use of oil of Origanian; trips to the sulphurous springs of Avon, New York, in 1844, and Saratoga Springs, New York. The only treatment that was completely effective was bed rest: “The more quiet I was the more comfortable my foot would be.”64 In the era prior to diagnostic X-rays, it was not determined whether the ankle injury was a fracture or a severe sprain.

  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.65

  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.”66

  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.67 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 shall not see many more.”68

  Abigail’s Death

  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.”69

  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.”70 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.71 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.”72

  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 de
mise. (Fillmore [Buffalo] to Julia, April 12, 1853) His narrative is summarized below.73

  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.74

  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.75 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.”76 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: