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

by Deppisch, Ludwig M. , M. D.

  “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.”77

  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 $116.78

  Conclusion

  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.

  Chapter Five

  Depression in the White House

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

  Nature, Nurture or a Combination?

  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.1 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.

  Jane Appleton Pierce

  “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)2

  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.3

  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.4 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.5

  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.6

  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.7

  Jane did not appear at the dining table when company was present. Neither did she give any attention to Washington society nor accompany the president to the customary ceremonial events. Only rare private outings with select intimate friends and her husband occurred.8 Instead Jane spent her time either in writing to her dead Bennie asking his forgiveness or participating in spiritualist activities in attempting to communicate with Bennie’s spirit. She may have held White House séances; there is an uncorroborated report that the infamous Fox sisters visited Jane to conduct a such a session. Reports also claim that she actually was successful in communicating with her three deceased children. A prior psychic premonition had warned that a tragic event would befall the family after Franklin Pierce was elected president. The death of Bennie fulfilled this prediction.9

  Jane Pierce, wife of Franklin Pierce. Her White House years were marked by deep depression (Library of Congress).

  Seventeen days after Bennie’s death, his distraught mother wrote: “Oh! You were indeed a part of mine and of your father’s heart. When I have told you dear boy how much you depended on me, and fe
lt that you could not do without me—I did not say too much how I depended on you and oh! My precious boy how gladly would I recall all that was unreasonable—or hasty—or mistaken in my conduct toward you. I see surely and I did frequently see afterward that I had wronged you.—and would have gladly acknowledged if only that I feared it might weaken your confidence in me and perhaps on that account not be as well for you.”10

  On New Year’s Day 1855, after two years of mourning, Mrs. Pierce finally made a social debut, receiving with her husband at the annual White House reception. In August she was well enough to travel to White Sulphur Springs for a week’s respite. She again received with her husband at the 1856 New Year’s reception. Jane finally had assumed her first lady responsibilities, but only as much as her physical and mental heath would allow.11

  Jane Pierce’s psychotic depression while grieving Bennie’s death transpired amid a life of darkness, sadness and disappointment. She suffered from poor physical health, a strict New England Calvinist upbringing, and an austere childhood. In addition, her disappointments were major, including the early deaths of the Pierces’ first two sons, her marital mismatch with Franklin, and an alienation from the politics that were the core of her husband’s adult lie. Mrs. Pierce was chronically ill, from her childhood through her marriage, in the White House and beyond. Family letters mention her frailty, vulnerability to winter colds, digestive and eating disorders, melancholy, anxiety and sleeplessness. At the time of the Pierce’s 1834 wedding Jane was described as tubercular, frail, and in poor health.12

  From the beginning, Jane Pierce hated the political life of Washington she was compelled to experience during Franklin Pierce’s terms as a U.S. congressman and a senator. Her customary reaction was immediate retirement to her room with a bad cold upon her Washington arrival. Her Washington stays were often marked by digestive complaints, vomiting and a lack of appetite. Respiratory infections with cough and fever were frequent. For a considerable part of the 1837–1838 congressional session she was ill, confined to her boardinghouse room. Mrs. Pierce complained at the time: “Oh. how I wish he was out of political life! How much better it would be for him on every account!” She did not recover until reaching “the refuge of the New Hampshire hills.”13

  The only named physician who treated Mrs. Pierce during this Washington illness was Dr. Thomas Sewall, who, according to Jane, “did his best.” Sewall had previously attended both first lady Letitia Tyler and her husband, Franklin Pierce. Neither Sewall’s treatment nor his diagnosis is recorded. In retrospect Venzke proposed that Jane’s respiratory symptoms suggested tuberculosis. Though not a physician, Venzke’s diagnostic acumen was expert, since Jane died from tuberculosis in 1863.14

  Away from Washington when Congress was out of session, Jane visited her sisters in Massachusetts to seek “modern medical treatments” for her physical ailments. One treatment was the application of leeches to remove her “blood toxins.” The use of leeches was common during the eighteenth and nineteenth centuries as a form of bloodletting, much milder than either venesection or blistering and cupping. (Medical interest in leech therapy recurred in the 1980s with its use in reconstructive and plastic surgery.)15

  There is no record of physicians or medical treatment during the Pierce presidency. After the Pierces left the White House they remained in Washington as the guests of William Marcy, Pierce’s secretary of state. In the summer, they visited several locations in New England. The death that same summer of Jane’s good friend and companion, Abby Means, added to her gloom.16

  Back home in Concord, New Hampshire, Jane’s condition grew steadily worse and a diagnosis of tuberculosis was confirmed. At the time, the only treatment for tuberculosis was a change of climate and, after consulting with her physicians, the Pierces set out in search of a cure. They sailed for Europe in the fall of 1857 and stayed for six months on the Portuguese island of Madeira. For the next few years, they sought respite in Spain, France, England, and Italy. But even the most famous European spas could not restore Jane’s health and eventually they stopped in the Bahamas. “All during her travels, Jane thought of her dead children. She always carried a little box containing locks of their hair. She always kept Bennie’s Bible with her wherever she went.” She died on December 2, 1863, in her Concord home at the age of fifty-seven years, nine months.17

  Jane Pierce was born into a strict Calvinist New England family. Her father was the pastor of the local Congregational church when, at age thirty-five, he was elected as the second president of Bowdoin College in Brunswick, Maine. Jesse Appleton was driven by duty, first to God, then to the students and responsibilities at the college, and only then to his family. His mission was “to cultivate moral and religious feeling, and to lead them to the knowledge and acceptance of the Savior.” His life was austere, his diet sparse, and his sleep limited. He died from tuberculosis at age forty-three in 1815 when Jane was nine. Her mother, Elizabeth Means Appleton, “devoted herself solely to the severer aspects of her religion and to contemplation of the awful fate of those who died without due preparation for the judgment of God.” Jane Pierce was familiar with death at a young age, as both her young brother and father died. Her Calvinistic belief in predestination may have tempered her sorrow.18

  In 1835 Jane was pregnant with the Pierces’ first child but was too frail to accompany her husband to Washington when he departed for the new term of Congress. On February 2, 1836, Franklin Pierce, Jr. was born, only to die just three days later. Congressman Pierce remained in Washington and never saw his son. On June 2, 1839, Jane’s younger sister Francis Packard died. At the time Jane, confined to a Concord rooming house, was pregnant with the Pierces’ second child. On August 27, 1839, when the Pierces’ second son, Frank Robert, was born in Concord, his father again was absent in Washington. Their third son, Benjamin (Bennie), was born on April 13, 1841. When Frank died from typhus at age four in Concord, Franklin was mostly absent, tied up with the U.S. Senate’s business in the nation’s capital. “The loss of their third and last son unquestionably caused the ultimate destruction of Jane Pierce as a functional member of society.”19

  Jane Appleton was 28 years old when she married Franklin Pierce, a marriage described as a “disaster almost from the start. The couple was completely mismatched—she, a shy reclusive sickly introvert and he an outgoing robust extrovert.” The Pierce family was the polar opposite to the Appletons; the good humor of the Pierces contrasted with the Appletons’ somberness: “Her husband presented quite a contrast, buoyant, vain, and social, at home in political caucus and tavern…. They were illmated, but for thirty years they lived together.”20

  Politics was completely incompatible with Jane’s retiring personality. Over her objections, Pierce was elected to the United States Senate and began his six-year term in 1837. Her importuning to abandon politics finally had success when her husband retired from the Senate in March 1842, one year before his term’s expiration. For the next ten years Jane was spared the disruption of shuttling with her children between the Pierce’s New Hampshire home and Franklin’s political responsibilities in Washington.21

  Jane Pierce’s hatred and fear of politics restrained her husband from accepting attractive governmental opportunities. He turned down an appointment to return to the Senate when Levi Woodbury’s appointment to the Supreme Court created a vacancy. Subsequently he refused the nomination for governor of New Hampshire, a post his father had held. In August 1846, President James Polk invited Pierce to be attorney general of the United States. He took a week to think it over before he declined. At the time, Jane was in worse health than she had been when he left public life.22

  Pierce’s quest for the 1852 Democratic nomination for the presidency was a shock to his wife, who fainted when informed of his nomination. She fervently prayed for his defeat. Pierce was haunted by his son Bennie’s response to the news of his nomination: “[I] hope that we won’t be elected for I should not like to be in Washington and I know you [his mother] would not eit
her.” When Franklin Pierce was elected the 14th president of the United States “Mrs. Pierce could not stand it; the results were too dreadful.”23

  The presidency of Franklin Pierce (1853–1857) has been universally considered a failure, due in great extent to his inability to prevent the secession of the Confederate states a few years later. Gara, in his history of the Pierce presidency, concluded: “In light of subsequent events, the Pierce administration can be seen only as a disaster for the nation.”24 The C-SPAN rankings of presidential leadership, according to 65 historians and professional observers of 42 presidents, rated Franklin Pierce number 40 and 39 in its 2009 and 2000 polls respectively.25 “Franklin Pierce … was bereaved and guilt ridden. This, of course, affected his ability to perform his official responsibilities…. [I]llness, both physical and mental, at times seriously interfered with Franklin Pierce’s Presidential duties and responsibilities…. As a result Pierce was a guilt ridden, vacillating and ineffective President. He was one of the least effective in our history [at a] period when strong and effective leadership was desperately needed.”26

  The full extent to which Jane’s emotional and physical collapse contributed to President Pierce’s inability to thwart the rush to secession and war may never be known. By blaming their son’s death on her husband’s presidency, Jane caused Pierce to be preoccupied by guilt and sapped of any real motivation. Throughout his administration, as a result, Pierce lost all interest in the presidency and the burning issues of the day. His term unfortunately occurred during a critical and extremely grave period of sectional crisis. By failing to act, he allowed the country to drift toward civil war.27 “It is probable that he found difficulty dealing with many of the resulting problems, including his wife’s persistent depression and almost total withdrawal, exacerbation of his long-standing misuse of alcohol.” “Pierce forever had to face Jane’s bitterness that his presidency had been ‘purchased by the sacrifice of Benny.’”28