Abe's Malady

Was it Marfan's syndrome?

To Dr. Harold Schwartz, the signs left little doubt. The seven-year-old boy visiting his Huntington Park, Calif., office in 1959 had Marfan's syndrome, a genetic disorder of the connective tissue that can cause heart and eye problems, affect skeletal growth and occasionally be fatal. A few months later, the boy's grandmother dropped in to inquire about his condition and revealed that her husband had died of Marfan's. The grandmother's married name was Lincoln.

Says Schwartz: "I call that my 'burning bush' moment. I had read Carl Sandburg's biography of Abraham Lincoln, which contains a great deal about Lincoln's physical characteristics." Suddenly everything connected. The Great Emancipator, Schwartz realized, was probably afflicted by Marfan's syndrome.

Since then, Schwartz, now 60, has traced the Lincoln Marfan gene back to 16th century England and now is more certain than ever about his theory. In the Western Journal of Medicine, he strongly suggests that had John Wilkes Booth not fired the fatal shot on April 14, 1865, Lincoln would have died within a year from complications of Marfan's syndrome--for which there is still no cure.

Schwartz points to the well-documented fact that Lincoln had disproportionately long arms, legs, hands and feet, even for a man of his height. While watching a regiment of Maine lumbermen during the Civil War, the President himself noted: "I don't believe that there is a man in that regiment with longer arms than mine." In 1907 a sculptor working with Lincoln casts observed that "the first phalanx of the middle finger is nearly half an inch longer than that of an ordinary hand." The President sometimes squinted with his left eye. All of these characteristics, according to Schwartz, are typical of Marfan's syndrome. In fact, Lincoln's "spiderlike legs," a phrase used by one of the President's contemporaries, was the very simile used in 1896 by French Physician Bernard-Jean Antonin Marfan when he described the syndrome that was named for him.

Schwartz has also presented an ingenious bit of evidence that Lincoln had a specific cardiovascular problem also associated with Marfan's syndrome: imperfect closure of the valves of the aorta, the large artery that carries blood from the heart. The clue appeared in a picture of the President taken in 1863. Lincoln had his legs crossed, and in an otherwise sharp photo, the left foot--suspended in the air --is blurred. When viewing the print. Lincoln asked why the foot was fuzzy. A friend familiar with physiology suggested that the throbbing arteries in the leg might have caused some movement. Lincoln promptly crossed his legs and watched. "That's it!" he exclaimed. "Now that's very curious, isn't it?" Not to Schwartz. The Marfan-caused defect, he points out, results in "aortic regurgitation," which causes pulses of blood strong enough to shake the lower leg.

Schwartz has also found in the President's own words what he believes to be good evidence that before Lincoln was shot he was "in a state of early congestive heart failure"--brought on by his aortic condition. About seven weeks before Lincoln's assassination, for example, he told his friend Joshua Speed: "My feet and hands of late seem to be always cold, and I ought perhaps to be in bed." Though he was only 56 in 1865, Abe was also easily fatigued toward the end. "There is only one word that can express my condition," he said, "and that is 'flabbiness.' " Once, shortly before his death, he tried to get out of bed but fell back, too weak to rise. Only a day before Lincoln was shot, his wife Mary wrote of the President's "severe headache" and indisposition. Concludes Schwartz: the faulty aortic valves resulted in "a decompensating left ventricle which was the undiagnosed or concealed cause of the President's failing health."

Schwartz, who teaches medicine at the University of Southern California, concedes that his 20-year study is an "obsession." When his five children visited Disneyland with him, he recalls, he used to have Lincoln-head pennies in his pocket; they would be awarded to the first child who could identify "a Marfan" in the crowd. His office is cluttered with busts of Lincoln. In 1976 he abandoned private practice and joined the geriatric department of a state mental hospital. Reason: so that he could have nights and weekends free to search Lincoln literature for more clues to Marfan's syndrome.

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