Doctor's Review: Medicine on the Move

January 24, 2022
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The First Lady of lunacy

Did loss and grief drive Mary Todd Lincoln insane or was it simply syphilis?

For countless Americans, Abraham Lincoln (February 12, 1809 to April 15, 1865) endures as the country's greatest president ever. His personal integrity, commitment to abolitionism, wartime leadership and inspired oration are disputed by few. Honest Abe's wife, however, was a far more controversial figure, due in most part to the spectre of mental illness which lingered over her throughout her troubled life.

Next year will mark the 125th anniversary of the death of Mary Todd Lincoln (December 13, 1818 to July 16, 1882). It should come as no surprise that her husband's near-mythical status overshadows her own life story. Today, most think of Mary as an unlucky witness to American history rather than a participant in it, or at best, the butt of some seriously dark comedy ("Aside from that Mrs. Lincoln, how did you enjoy the play?"). Like Jacqueline Kenney, she was indeed with her husband the moment he was shot, but unlike the beloved Jackie O, Mary somehow became a national embarrassment instead of a national icon. But was her history of mental illness organic in nature or was it a result of the series of devastating tragedies which defined her life?

Even before April 14, 1865 -- the night John Wilkes Booth fatally wounded Abraham Lincoln in Washington DC's Ford's Theater -- Mary was no stranger to tragedy. She was born to a wealthy family from Lexington, Kentucky and lost her mother when she was only six. In 1842, Mary married the self-taught, young legal star Abraham Lincoln in Springfield, Illinois, after they were introduced by her sister, Elizabeth. By all accounts, Mary was vivacious, smart and ambitious: the perfect wife for an aspiring young politician. Soon after her marriage, however, life took a calamitous turn.

Between 1843 and 1854, Mary and Abraham had four sons -- Robert, Edward, William and Thomas. Only the eldest, Robert, survived to adulthood. Even by 19th-century standards, it was a poor showing. Edward died of tuberculosis at age three in 1850. William, born later that year, succumbed to typhoid fever at 11. Their fourth child, Thomas, made it to 18, when he also succumbed to tuberculosis in 1871. Mary was devastated (she'd already lost her husband by that point and was extremely devoted to Thomas). Her firstborn, Robert, was by then 28 years old, a successful lawyer in his own right, with a family of his own. But instead of being his mother's comfort, he would become her sworn enemy.

Hints of Mary's erratic personality appeared early in her adult life. She'd always been a nervous person, very impulsive, and prone to lavish spending sprees and grandiose thinking. As First Lady, she fell out of public favour quickly, since many believed her over-the-top redecorating and entertaining schemes at the White House were wasteful and unnecessary (it didn't help that many of her relatives were devout Confederates either). In one four-month period, for example, Mary bought herself 400 pairs of gloves. She refused to tone it down, and Abe himself was forced to defend her publicly on several occasions.

Despite all this, Mary was a very sweet and loving mother. After young Edward died in 1850, she began to exhibit increasingly depressive symptoms. A year and half later, Mary was involved in a carriage accident. She was thrown from the vehicle and hit her head on a rock so hard that she was incapacitated for nearly a month. Her son Robert would later say that his mother was never quite right afterwards. Within three years, more tragedy befell her family, as three half-brothers and a brother-in-law were all killed in the war.

Things worsened once 11-year-old William passed away, less than a year after Lincoln was elected. Mary's grief was so unrelenting that she was nearly institutionalized. Never happy with the First Lady, the public criticized her newfound antisocial side just as they had her earlier extravagance. In desperation, Mary looked towards the growing trend of spiritualism to find relief. She hosted several séances at the White House, hoping to reach her children beyond the grave. Mediums and known quacks were coming and going at all hours; the public, however, reserved judgment, even though the President himself was rumoured to be dabbling in the supernatural fun.


Her husband's assassination was an ordeal from which Mary never entirely recovered. Somewhat surprisingly for a lawyer and sitting president, Lincoln didn't leave behind a will, and it took several years for his finances to be resolved and the money distributed. In the meantime, Mary became increasingly paranoid about financial matters, fearing that she'd end up flat broke and on the streets. (Of course, this never would have happened, since she did stand to inherit almost $40,000). At first, the public was sympathetic, since Lincoln's devotion to her was well-known, but her increasingly bizarre behaviour eventually left her a laughing stock.

At one point, Mary committed a very public gaffe when she tried to sell her entire wardrobe, sincerely believing she was on the brink of poverty. Her son Robert was mortified, and, to add insult to injury, the clothes didn't sell. After Thomas died in 1871, Mary's eccentricity morphed into delusion. She became terrified of fire, illness and theft, so much so that she began to keep wads of cash stuffed under her petticoats. Though she was understandably afraid that her last remaining child would die, her irrationality on this matter sometimes bordered on obsession. Robert, for his part, had little patience for his mother's concern.

Robert Lincoln instituted commitment hearings against his mother in May of 1875, insisting she was unable to manage her own affairs. A string of witnesses testified against her, including five physicians and her own son, revealing both private and public follies. Mary bitterly (and perhaps correctly) accused Robert of being after her money. The strange details of her obsessions became a matter of public record.

Some said that Mary claimed to hear voices through the walls; servants were forced to stand guard over their fearful mistress while she slept. Her alternating habits of wasteful spending and frugal saving were exposed before the court. Some historians believe she may have had bipolar disorder, though few would go so far as to diagnose schizophrenia, despite the fact that she seemed to suffer at times from psychosis and delusions.

One of Mary's doctors, Willis Danforth, was the star witness. He reported that Mary had told him that an evil Indian spirit was pulling wires out of her left eye, that she was distracted by premonitions of her own death and that she was prone to vomiting up her meals to foil imaginary poisoners. The manager of the Chicago hotel she lived in explained how Mary had shown up in the elevator half-naked, and sent all her belongings to Milwaukee one day believing the city was being consumed by a raging fire.

The jury sided with her son, and Mary Todd Lincoln, former First Lady of the United States of America, was committed against her will. She spent three months at Bellevue Place, an upscale women's insane asylum in an imposing old mansion outside of Chicago. Mercifully, she was allowed to live separately from the other patients while she was there. The public was greatly divided as to the justness of her trial and confinement. She was eventually declared sane enough to take care of her own financial affairs, and the humiliated Mary Todd Lincoln was released into the custody of her sister Elizabeth.

Robert's motivation was always presumed to have been financial. But Mary was also an embarrassment to him. Perhaps he genuinely wanted to help her, or perhaps he wanted to get rid of her and advance his own political career. The year before her death in 1882, mother and son made an uneasy peace, but it was too late. Mary had lived the final years of her life in lonely seclusion.

After Mary died of what was thought to be a stroke on July 16, 1882, an autopsy revealed a brain tumour. How long it had been there is unknown, but it might have explained her mood swings and eccentricities. During her later years, Mary had become nearly blind, as well, and had lost a great deal of weight. Diabetes certainly may have been the cause. She was also known to depend on a wide variety of medicines prescribed by various doctors, including generous amounts of chloral hydrate for her unrelenting insomnia.

Another likely explanation, however, is one which her doctors would have tried to hide during her lifetime: that both she and her husband suffered from syphilis, and that Mary's delusions resulted from tabes dorsalis, a degeneration of the nerve cells and fibres that carry information to the brain. All this is caused by untreated syphilis. Indeed, Mary displayed all the main symptoms of that disease and tertiary syphilis: knife-like back pain, dementia, impaired coordination, weight loss and, eventually, blindness and death.

Any one of these factors surely could have contributed to her strange habits and declining mental health. But even in the absence of all of these possible causes, if Mary Todd Lincoln had encouraged her husband to stay home that fateful April evening in 1865, her life -- and those of countless others -- might have turned out quite differently. Indeed, Mary was reported to have been holding the President's hand the moment he was shot. That alone would be enough to drive anyone insane.


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