Rare Disease Report

Did Mary Todd Lincoln Have a Rare Disease?

JULY 18, 2016
James Radke, PhD
A new book and article suggested that Mary Todd Lincoln’s litany of mental and physical health problems were largely due to a rare autoimmune blood disorder – perniculous anemia.
 
The book by cardiologist and medical historian John G. Sotos, MD provides as much detail as possible into Mary’s symptoms throughout her life and concludes that perniculous anemia may explain most of her symptoms.

 Perniculous anemia

Perniculous anemia is due to to vitamin B12 deficiency which can result in a plethora of symptoms, including glossitis, anemia, pigmentary changes, edema, fever, and multiple neuropsychiatric abnormalities, such as affective disorders, thought disorders, paresthesias, ataxia, muscular weakness, urinary dysfunction, and optic neuropathy.
 
And according to Soros, Mary had all of those symptoms. In an article for Project MUSE, Sotos wrote ‘her physical ailments spanned 30 years and included sore mouth, pallor, paresthesias, the Lhermitte symptom, fever, headaches, fatigue, resting tachycardia, edema, episodic weight loss, progressive weakness, ataxia, and visual impairment. Long thought hypochondriacal, these findings, plus their time course and her psychopathology (irritability, delusions, hallucinations, with preserved clarity), are all consistent with vitamin B12 deficiency.”
 
Sotos cites numerous historical documents to back his theory, including reports of hallucinations (in late 1863, she earnestly described her recently deceased son appearing nightly as a comforting, speaking apparition), and several incidences of uncontrolled affect (fits of rage, public loss of self-control, and incessant run-on speech).  Sotos also noted that later in her life, Mary complained of a “great & burning pain in my spine” and “A fearful cold, appeared to settle in my spine & I was unable to sit up, with the sharp, burning agony, in my back.”

"pulling wires out of her eyes”

And as she aged, the symptoms – both physical and psychological – only got worse. Sotos said that in her itinerant years (1873–1875), Mary had auditory hallucinations, paranoia, confusion, somatic delusions, and other delusions, sometimes with fever. For example, she complained there “was an Indian removing the bones of her face and pulling wires out of her eyes” and “that someone was taking steel springs from her head.”
 
While we will never know if any one ailment could explain the complex women that was Mary Todd Lincoln, Sotos article and book could help explains some of the unique stories that have labeled Mary has a troubled First Lady.


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