Lincoln Letter to John Stuart

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For Lincoln, ancient cure worse than his malady
Depression treated with mercury pills

By Jeremy Manier
Tribune staff reporter
July 17, 2001

Before Abraham Lincoln became president, his Illinois friends and colleagues noted that the lanky lawyer was prone to sudden mood swings and angry outbursts--one story claims he grabbed a bystander at a political debate, lifted him up by the collar and shook him violently.

Now researchers believe those flashes of temper may have been symptoms of mercury poisoning, brought on by a common remedy for depression.

A study published Tuesday gives a new perspective on a president revered for his calm and focused leadership through the historic crisis of the Civil War. That steady temperament appears to have emerged only after Lincoln stopped taking the pills that his law partner William H. Herndon described as "blue mass."

Several historians have recorded that Lincoln took the pills, which were as widely used in the 1800s as Prozac is today, said Dr. Norbert Hirschhorn, a New York medical historian and lead author of the study. But many Lincoln scholars appear not to appreciate the dangers blue mass posed.

Hirschhorn and researchers at the University of Minnesota used a common 19th Century formula for blue mass to re-create the concoction, which contained about 65 milligrams of elemental mercury per pill. They found that a typical regimen of two to three such pills each day would have exposed Lincoln to mercury levels nearly 9,000 times what current federal rules allow.

In addition to outbursts of rage, the researchers believe the mercury
Lincoln ingested may have caused insomnia, forgetfulness and possibly a hand tremor. One historical account suggests he quit the blue pill regimen about five months into his presidency because it "made him cross."

"He stopped taking this medicine at the most crucial time in our history, when we needed his saintliness the most," said Hirschhorn, whose study appears in the journal Perspectives in Biology and Medicine.

It may be impossible to prove Lincoln's mercury poisoning without a hair sample from the period when he took the pills, experts said. But historians said the diagnosis fits much of what is known about the former president's behavior.

"I think they make a compelling case," said Robert John, a professor of 19th Century history at the University of Illinois at Chicago. "We know so much about Lincoln--there's probably no American figure about whom more is written. To have what could be a fresh insight about him is remarkable."

Historians without backgrounds in medicine traditionally have not delved into the detailed clinical problems of figures such as Lincoln, said Thomas Schwartz, state historian with the Illinois Historic Preservation Agency.

Schwartz said although it's still unclear how much of Lincoln's behavior can be traced to mercury poisoning, it would make sense if he stopped the regimen because it kept him from thinking clearly.

"It's certainly an interesting hypothesis," Schwartz said. "It's something historians are going to be more mindful of."



Analyzing Lincoln's health

Lincoln's health has been more scrutinized in recent decades, as some scientists have sought to show that he inherited a genetic ailment called Marfan Syndrome, which can lead to a gaunt frame, slender fingers and internal bleeding.

The hypothesis that he also suffered from mercury poisoning puts him in a roster of historical figures who may have felt its effects, including President Andrew Jackson, physicist Isaac Newton and author Charlotte Bronte. Last year, a study of composer Ludwig van Beethoven's hair indicated that he had lead poisoning.

In Lincoln's case, the mercury poisoning may have been a side effect of medicine he took in his lifelong battle against depression. One of the worst early episodes of his "constitutional melancholy" began on Jan. 1, 1841, when an engagement to his future wife, Mary Todd, was broken off.

The incident sent Lincoln into a state that physicians of the time knew as hypochondriasis.

Many medical experts in the 1800s still believed that such mental conditions were linked to the ebb and flow of bodily fluids that the ancient Roman physician Galen had outlined. In that system, hypochondriasis stemmed from a buildup of black bile in the liver.

One of the most common treatments for the disorder called for stimulating the liver and getting black bile moving again through use of mercury pills--the so-called blue mass.

"It really was the Prozac-plus of the time, because they used it to treat a lot of conditions," Hirschhorn said. "They used it for anything they thought was related to the liver. But that was based on a faulty theory. It only poisoned you."

Mercury's effects can include decreased brain-wave activity, irritability, depression, memory loss and impaired kidney function.

There are no records showing when Lincoln started taking his blue pills, though many friends knew he used them. Ward H. Lamon, a bodyguard of Lincoln's, wrote that "blue pills were the medicinal remedy which he affected most."

Hirschhorn believes some of Lincoln's most unusual behavior linked to the blue pills came during the 1850s.


Wild, incoherent nonsense

One of Lincoln's fellow Illinois lawyers and traveling companions, Henry Clay Whitney, described awakening before daylight one morning to see Lincoln sitting up in bed and "talking the wildest and most incoherent nonsense to himself."

Another incident recounted by Lamon's daughter supposedly occurred during one of the famous 1858 Senate debates between Lincoln and Stephen Douglas.

In response to an accusation by Douglas about Lincoln's record in Congress, Lincoln furiously grabbed the collar of a former congressional colleague who, Lincoln said, knew the charge was false. While making his point, Lincoln shook the man "until his teeth chattered."

The effects of mercury on the brain can be reversed, and that was fortunate for Lincoln, Hirschhhorn said.

"He recognized that it wasn't doing him any good during his first months in the White House," Hirschhorn said. "I think that was a crucial decision. Who knows what would have happened if he had continued taking it?"