MONDAY, July 17, 2001 (HealthDayNews) -- History remembers President Abraham Lincoln as a patient, reserved and even-tempered man whose steady hand guided America through the chaos of the Civil War.
But it also paints a radically different picture before he took office --as a man with violent mood swings, tremors and a fearsome temper.
A new study, reported in the Summer 2001 issue of Perspectives in Biology and Medicine, suggests that the interlude of Lincoln's life marked by bizarre behavior may have been the result of mercury poisoning, courtesy of pills prescribed for his "melancholia," which now would be diagnosed as depression.
The idea for the research began during a casual conversation between Dr. Norbert Hirschhorn and Dr. Ian Greaves at the University of Minnesota. Hirschhorn, a medical historian, had read an essay on Lincoln by Gore Vidal, which said Lincoln took "blue mass," a mercury-based medicine commonly prescribed in the 19th century.
Hirschhorn asked Greaves, an associate professor of environmental and occupational health, what ingesting mercury would do. Greaves said it would cause bizarre emotional problems, mood swings, tremor and other neurobehavioral abnormalities. Together, they began to suspect that for several years leading up to and just after his inauguration, Lincoln suffered from mercury poisoning.
With Boston University neurologist Dr. Robert Feldman, Hirschhorn and Greaves studied Lincoln's life from the 1830s onwards. Initially, friends and colleagues described Lincoln as quite even-tempered and alternately happy or slightly absorbed or abstracted. However, in the 1850s Lincoln's behavior changed dramatically.
Observers said Lincoln's mood swings went from periods of intense withdrawal and gloom to manic hilarity or vicious, violent fury. In 1859, Lincoln's law partner and biographer William Herndon described Lincoln as "so angry that he looked like Lucifer in an uncontrollable rage."
But the researchers didn't know whether Lincoln could have absorbed enough mercury -- or, to be precise, enough mercury vapor -- from the pills to develop such symptoms.
Dr. Robert Perlman, professor of neurobiology at the University of Chicago and editor of Perspectives in Biology and Medicine, says, "If you just swallow solid mercury, like mercury in a thermometer, it's not terribly toxic, because it's so insoluble that it just passes through the intestine without being absorbed."
"What gets absorbed is the mercury vapor that gets released from the surface of the mercury. It becomes volatile and gaseous, and, in the gas form, it can easily cross the stomach or intestine and get into the body," Perlman says.
The researchers decided to recreate the pills using a recipe from Lincoln's time. (Although the aim was historical accuracy, the scientists who recreated the pills wore modern protective gear and worked under a fume hood that whisked away mercury fumes.)
Ingredients of the pills included mercury, licorice root, rose water, honey, sugar and confection of dead rose petals. The 1879 recipe called for pounding the mercury and other ingredients into tiny fragments with a mortar and pestle, then rolling the gray powder into a pellet the size of a peppercorn.
When the pill was tested in a solution mimicking digestive juices, the levels of mercury vapor released went off the scale, meaning more than 1.99 milligrams per cubic meter. The usual dose of blue mass was one pill two or three times a day, the equivalent of 130 to 185 milligrams of mercury. The researcher calculated that someone taking such a dose would have absorbed 9,000 times the amount of mercury currently allowed daily by the U.S. Environmental Protection Agency.
"Mercury vapor attacks mainly the nervous system and the kidneys," says Greaves. "In very severe poisoning, people may actually start having fits and go into convulsions, and, at times, they may even die during periods of convulsions or from marked central nervous system depression, including difficulty breathing. Mercury is a potent toxin."
But Lincoln seemed to have been aware of the effect that the pills were having. John Todd Stuart, the cousin of Lincoln's wife, Mary Todd Lincoln, reported President Lincoln stopped taking the blue pills about five months after his March 1861 inauguration because they "made him cross." Thereafter, his temper became less violent, and he became the even-keeled "Patient Abe" known to history. His handwriting, which had shown signs of tremor, became noticeably steadier after the inauguration.
"He no longer had these outbursts of rage and deep depression," says Greaves. "Instead, he was able to assume a demeanor that was much better capable of dealing with the presidency than if he had been the person he was few years earlier ... . He was able to function and steer the nation through a very, very difficult political crisis."
Greaves and Hirschhorn say Lincoln appears to have stopped consuming mercury before he caused irreversible physical harm to himself.
Hirschhorn says, "This man was perceptive enough to recognize what was happening. He needed all [his] resources of personal strength and saintliness that he had at his disposal to conduct our country through the war and in the face of all his personal tragedies during the White-House years."
What To Do
For information about mercury and mercury poisoning, check this mercury fact sheet from the Office of Radiation, Chemical and Biological Safety at the Michigan State University, the California Poison Control System Web site or the Agency for Toxic Substances and Disease Registry.
The Mad Hatter character in Lewis Carroll's Alice in Wonderland was exposed to mercury. For the whole story, check World Wide Words.
