POX: Genius, Madness, and the Mysteries of Syphilis

Excerpt from Lincoln chapter:

Syphilis was suggested in Mary Todd’s medical history when Norbert Hirschhorn and Robert Feldman published an article in 1999 reviewing the work of the four doctors who had diagnosed her progressive spinal trouble. Finding a clear case of tabes dorsalis, Hirschhorn and Feldman argue convincingly that the doctors would have known very well by then that tabes was caused by syphilis in the majority of cases and would have opted to save her reputation (and to assure a benefit that might have been withheld by a censorious Congress) by stating that her tabes dorsalis was caused by an injury to her spine when she fell from the French chair. “Given the widespread medical knowledge about tabes dorsalis at the close of 1881 and what then was considered its most likely cause [syphilis], it was inevitable that the four physicians chose the least pejorative diagnosis, however marginally acceptable it was to progressive medical opinion.” Jonathan Hutchinson concluded that it was generally accepted that tabes occurs “almost solely” in those who have previously suffered from syphilis. P.J. Möbius went one step further: “The longer I reflect upon it, the more firmly I believe that tabes never originates without syphilis.”

The tabes diagnosis gives a fresh interpretation to the reasons for Mary Todd’s incarceration: “Symptoms imputed to insanity at her trial clearly had their origin in the organic disease of tabes dorsalis.” The authors point out that the lightning pains of tabes were often described with vivid images appropriate to such extreme agony, such as having wires taken out of the eyes or, as Mary also complained, of being hacked to pieces by knives, or of having a sharp, burning agony in the back, or feeling as if one were on fire.