Was Lincoln Dying Before He Was Shot?

John Sotos is a physician well known in medical circles for his book, ZEBRA CARDS: AN AID TO OBSCURE DIAGNOSIS. We tell our medical students, "When you hear hoofbeats think horses, not zebras," or, common things occur commonly. But John has had a lifelong interest in rare diseases--zebras.  (He is also a medical consultant for the TV show HOUSE.)

Recently, I heard John make the case in a lecture that Abraham Lincoln suffered from a rare endocrine disorder called MEN2b (Multiple Endocrine Neoplasia Type 2b)  in which most patients will die of cancer of the thyroid if the thyroid is not removed. John argues that at the time of his death, Lincoln was dying.  Indeed, if one looks at Lincolns pictures
 from January 1864 lincoln.JPG

and then a few months later in February 1865,lincoln1.JPG  it does appear that he has lost weight and reports from that time suggest he was greatly fatigued. One characteristic of this syndrome is the presence of mucosal neuromas--little bumps on the lips. Close examination of photographs such as the one below suggests that he did have these.lincoln2.JPG John's talk provoked some heated debate. For  more details see John's book THE PHYSICAL LINCOLN. Photographs are courtesy of John Sotos. 

The Grand Army of the Republic museum in Philadelphia has a pillowcase with Lincoln's blood on it, and DNA from that could conceivably prove or disprove this hypothesis. (It could also prove or disprove another hypothesis that states Lincoln had another condition, namely Marfan's syndrome.)  For now, the museum has decided to wait on DNA testing.

There have been hundreds of books about Lincoln. In fact, the Library of Congress catalog suggests that a new book about Lincoln comes out every 5 days or so.  If indeed Lincoln had a disease whose manifestations had much to do with his behavior, and which might explain the early deaths of his mother and of his son--seminal events in any life--then in a sense, all  previous biographies are inaccurate.

But is this a slippery slope? Are historians to become forensic anthropologists?

Would Abe have wanted the DNA testing done?

One day there might be a test that could tell us what he would have decided. 

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Abraham Verghese is an author, physician and med school professor. He is the author of Cutting for Stone and his writing has appeared in many major publications. More

Abraham Verghese is a physician and writer. His third book and first novel, Cutting for Stone, was published by Knopf in 2009. He is also known for two acclaimed non-fiction works, My Own Country, which was based on his experiences working with persons living with HIV in Johnson City, Tennessee; that book was a finalist for the National Book Critics Circle award and was made into a movie. He followed that with The Tennis Partner, also a New York Times notable book and a national bestseller. His writing has appeared in The Atlantic, The New Yorker, The New York Times , The New York Times Magazine, Sports Illustrated, and The Wall Street Journal as well as many medical journals. Verghese is board-certified in internal medicine, pulmonary medicine and infectious diseases. He attended the Iowa Writers Workshop at the University of Iowa where he earned his MFA. He currently practices and teaches at Stanford University School of Medicine where he is a tenured Professor and Senior Associate Chair for the Theory and Practice of Medicine in the Department of Internal Medicine.

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