LINCOLN'S PHYSICAL CONSTITUTION

The biographical analysis of the development of the personality and political philosophy of Abraham Lincoln is simplified and best facilitated by first considering his physical make-up and constitutional energic type as an adult, for evidence of genetic, endocrine, neural and other bodily determining factors. We can then advantageously follow his family origin and cultural development, with the decisive experiences of his life in correlation with his physical constitution.

Hereditary Determination

Lincoln's unusual bodily and personal characteristics, particularly his long legs and arms relative to a torso of average length, his large hands, long fingers and flat feet, narrow stooped shoulders and misshapen chest, the longish dimensions of his face and upward deviation (hyperphoria) of left eye,* melancholy disposition and relaxed social attitude, have long been taken, in the medical sciences, as associated characters indicating an unusual hereditary (genic) and congenital and later environmental determination.

As in the growth of any unicellular or multicellular organism, the biological question is, what bodily characters are hereditary and what characters are acquired from environmental nutritional and stressing energic effects on growth. Each gene in an hereditary chromosomal complement produces highly specific enzymatic action on the cytoplasmic differentiation of cells and on the growth of tissues and organs, and the effects of these specific actions are qualified by allied and antagonistic actions of many other genes. Moreover, as cells must work to maintain equilibrating cytoplasmic interactions with other cells of their bodily environmental and with external environmental energies, the specific cytoplasmic qualitative genic effects become differentiated by environmental action in quantities, ratios, timing and positions, throughout embryonic and postnatal development. As the specific effects of any form of hereditary determination vary more or less in each organism at different ages in interaction with other genic determinants and with its environmental energies, inferences of hereditary effects in Lincoln's case must include environmental modifications of these effects.

Upon finding "a classic example of the Marfan syndrome" in a male (7 to 11 years of age) in Lincoln's lineage, Schwartz (1964) compared measurements of his subject's hands and head with Lincoln's as taken from casts and photographs and descriptions of his bodily and personal characteristics by contemporaries, particularly Herndon, and assumed that Lincoln likewise had a similar syndrome "derived from an ancestor common to both individuals." The last ancestor in common was Mordecai Lincoln 11, born in Massachusetts in 1686. He was the fourth antecedent (great-great-grandfather) of Abraham Lincoln by his first wife, and the eighth antecedent of the Marfan boy by a male line of descendents from a second wife. The transmission of a special autosomal genic mutation has been assumed to have been repeated through four generations of four male and four female antecedents of Lincoln in one line, and eight generations of eight male and eight female antecedents of a distant relative in another line. As genic mutations may arise in reproduction of the germ plasm sperm and ova of one generation, and be transmitted, modified, or eliminated by chance in crossing in the next, the assumption of a genic determination common to both individuals, as the basic factor producing assumed similarities of body growth is questionable.

The Marfan syndrome was first described by A. B. Marfan in 1896, as a set of bodily and personal characteristics, defined now (American Medical Dictionary) as "a congenital and hereditary condition characterized by arachnodactyly with bilateral ectopia lentis," meaning long, thin, spiderlike fingers and toes and tendency to pathological displacement of the lens of both eyes, leading to reduction of vision and eventual blindness. As the effects attributed to a Marfan mutation vary greatly in individuals of the same pedigree and immediate family, the formerly limited syndrome has been enlarged to include other abnormal bodily and personal characteristics. The mutation seems to produce the growth of distrophic, inelastic connective tissue which is attended by long thin growth of arms, legs and ribs, with tendency to deformation of the sternum making a bulging "pigeon" breast or a concave breast with malposition of lungs and heart, flabby skin with little subcutaneous fat, loose joints, hernia, arterial aneurism, and, generally, an apathetic, listless, doleful personality with weak mental integrity and social indifference. Gothic palate and myopia, hyperopia, strabismus, and tendency to glaucoma have recently been included in the syndrome by some observers. Death follows frequently in youth from respiratory or cardiac disease or, later, from rupture of an aneurism. As an intellectually superior mind and socially active disposition with normal eyes have been observed in otherwise typical cases of long, thin body growth; and low energy, myopia and other anomalies appear in short thick persons of the same family; such opposite characters have been assumed by some medical geneticists to be variations of the effects of the same mutation.

A.M. Gordon (1962) described a case of Marfan's syndrome in a young male, and compared such bodily characteristics with Lincoln's. He chose to attribute the latter to an hereditary genic determination transmitted by his mother, Nancy Hanks, as she had a long thin body seemingly more like the Marfan type although she was socially energetic and intelligent, whereas his father, Tom, who had a average short, thick, powerful physique, was lazy, ill-tempered and unintelligent.

Schwartz and Gordon have both freely interpreted Herndon's description of Lincoln's bones, particularly of his arms, legs and hands and head and face, as being long and thin and characteristic of Marfan genic determination, whereas Herndon described him as being "thin, wirey, sinewy, raw and heavy boned." Neither Schwartz or Gordon has given due consideration to comparative anthropological measurements and environmental modifications of Lincoln's physique.

H.L. Shapiro (1953), Chairman of the Department of Anthropology, American Museum of Natural History, has pointed out that "the tall, gaunt figure [of Abraham Lincoln], with its cadaverous face" was of "the type" now recognized in anthropology as "the Southern Mountaineer." Lincoln, he said, was perhaps "more the product of the Kentucky Hills where he was born and of the people that first settled there than we realize."

Shapiro made a series of significant measurements from a bronze cast of a life mask of Lincoln taken in 1865, on his 56th birthday, by Clark Mills. Comparison of these measurements with a composite of measurements of 272 skulls of "Old Americans" of comparable native origin led Shapiro to a number of significant inferences. He found that Lincoln's height was seven and one-half inches above this average and his face was "exceedingly wide at the cheekbones" and his jaw was "rarely matched in width," his forehead was high, wide and sloping and the face above the mouth was long and the nose long but wide, and the mouth wide. The unusual width of the jaw so overbalanced that of the forehead that the latter seemed to be narrow. Shapiro said that "some of Herndon's observations were sound" but he "was wrong" in describing Lincoln's forehead as "narrow." "Among the racial strains to be found in Lincoln's geography," he said, "one could match these dimensions easily only among Indians." The American ancestry of Lincoln includes English, Scotch and probably Dutch, and they have undergone a marked increase in height in successive generations in the Appalachian country, Shapiro said. Particularly in Kentucky where Lincoln was born, and in Tennessee, unusually tall, lanky, powerful men like Lincoln and the Enloes and Brownfields were so common that the type has become established in anthropology and in the public mind as typical of the mountains of the limestone country.

Schwartz has presented an interesting chart of an "inferential pedigree" of the male line of antecedents and descendents of Lincoln and of his Marfan relative. It includes a number of males and a female who seem to have had some anomalous physical condition that might be assumed, regardless of long-thin or short-thick physiques, as possibly to have been a more or less vigorous or submerged effect of a Marfan mutation.

In Lincoln's case, Schwartz has included the unusual length of his arms and legs relative to the torso, unusual length of the fingers relative to the breadth of the hands, with anomaly of the fingers of the left hand being longer than the right whereas the right thumb was longer than the left. He also emphasized the leathery skin with little subcutaneous fat, protruding ears, asymmetrical differences in growth of the bones of the right and left sides of his face, hyperopia. and strabismus of the left eye, as possible Marfan characters.

Asymmetrical differences in growth of bilateral organs are not infrequent in the Marfan syndrome but this does not permit the geneticist to attribute them entirely to genic determination. Possible effects of special environmental stresses must be included. Lincoln, from early youth throughout his physical development, chopped wood with a heavy axe daily for many hours, and in such occupation the left hand in a right handed person carries more stress and does more work than the right hand. Whereas Marfans are usually long thin-boned and muscularly weak and mentally dull, socially withdrawn and apathetic, Lincoln, as a boy and man, had unusually heavy, long bones, powerful arms, legs, hands and back, large head and face, and an intelligently active mind with endless drive at self-education and improvement toward giving social service.

An environmental cause of the asymmetrical development of the right and left bones of Lincoln's face and the subnormal neuromuscular tonus of the left side, and hyperphoria of the left eye, his melancholy disposition and euphoric compensation will be shown later in this and other chapters to have followed after the accidental fracture of his skull and probable injury of his brain in childhood.*

Lincoln's face gave evidence of unusual hereditary genetic predispositions in its embryonic development, hence in the later development of his brain and personality. The creases in the skin of the human face are produced principally by the activities of the facial muscles with attachments to the skin. In most faces, the creases that run on each side from the nose continue around the upper lip and back of the corners of the mouth, and then pass more or less distinctly around the lower lip and under the chin. In Lincoln's face, as shown by two life masks and photographs, the creases on each side of the nose run halfway around the upper lip and then turn sharply backward, above the corners of the mouth. Here they join deep creases that run downward in front of the cheekbones, between the muscles of the cheek and the muscles of the mouth, and then curve forward to pass under the chin where they meet, giving the mouth and chin strong expression. The expressive effect of this unusual, though not rare, type of facial creasing was enhanced by the unusual length and breadth of his face.

A second cousin, David Lincoln, had facial creases similar to those of Abraham. Also a third cousin, Jonas Basham, whose grandmother, Mimi Hanks, was a first cousin of Lincoln's mother, Nancy Hanks, inherited facial creases remarkably similar to those of Abraham Lincoln, indicating maternal as well as paternal hereditary factors for this unusual characteristic.

Three genetic moles, one on the right side and two on the left side of the face, gave, in relation to these creases, a distinguishing quality to Lincoln's face which, once seen, was not likely to be forgotten, and was, therefore, socially and politically invaluable. The largest and most prominent mole was located on the right side, just above the crease as it turns backward from the upper lip to join the crease lying between the muscles of mastication and the mouth. The mole actually divided the crease producing a perpetually dimpled, smiling effect on that side of the face. On the left side of the face, one of the other two moles lies on the cheek above the crease where it turns backward from the upper lip, and the other lies lower down on the side of the face, in back of the crease, after it joins the mouth muscle-cheek muscle crease. Their positions in relation to the right mole indicate that early in embryonic development, when the head was very small and the face was beginning to form, the right and left moles appeared in symmetrically opposite positions. If so, one later became divided and the two parts separated progressively as the muscles and bones of the face enlarged.

Although the psychological effect of these facial characteristics is now unknowable, they gave his face a ready-to-smile set and an unusually comical quality that surely must have reinforced the development of his great sense of humor and propensity for laughing. They probably also combined with other unusual, inherited and acquired facial and bodily qualities, in reinforcing the formation, in his boyhood, of the conviction that he was an unusual person, predestined to perform some great mission to be revealed to him, that developed later into his unique, fixed lifelong, humanitarian inspiration and compulsion.

When an adult, his hair was coarse and black, and his eyes were small, gray, and deeply set. His ears were large, thick-lobed, and extended out at almost right angles to his head. His usually long and generally disheveled hair hid this grotesque, comical inferiority. His nose was not relatively oversized, but it looked large because of his thin face. The nostrils did not extend as far into the tip of the nose as in most people, which made the end look heavy. Lincoln was said, when young, to have been somewhat sensitive about his nose, but not about his ears.

Hypersensitive Hypokinetic Constitution

Lincoln's body growth and energic constitution show evidence of some endocrine imbalance. He was a long, thin baby at birth, with unusually long arms and legs. Lincoln grew to six feet four inches in height and generally weighed less than 180 lbs. His legs and arms were disproportionately long for his body, which when seated was about the length of an average six footer. His chest was narrow and described as flat.

The skin of his face was weather-beaten, coarse, deeply grained, dark and generally had a sallow or muddy color. Many years of close exposure in youth before an open wood fire, where he read, possibly left a permanently dystrophic effect. Deep creases over the forehead and at the outside corners of the eyes and around the mouth indicate an unusual amount of facial work in using the eyes, and in talking and laughing.

The neuromuscular tonus of his body was more relaxed than in the average man. This was shown in the slow, drawling, staccato monotone of his speech, and the deliberate, contemplative, meditative manner and slow mental reaction time, and flat feet. He seems also to have had lower blood pressure than normal, which probably, when too low, contributed to the production of nervous depression. Self-conscious of his height, he tended to slouch in posture, with stooping at the shoulders and bending slightly at the knees, but he characteristically held his chin up; indicating an ego-attitude of humility counterbalanced with well-determined self-reliance and self-respect.

Dr. K.C. Wold has also reviewed the evidence on Lincoln's physical constitution in relation to his health. He concluded that any endocrinopathy was limited to indications of some thyroid disfunction and possibly a slight postpubertal overactivity of the pituitary which might account for his disproportionately long legs and arms. Attempts to explain Lincoln's melancholic disposition on an endocrinological basis would be, he says rightly, "merely a venture in the realm of fancy."

However, even though not fully known, it would be more erroneous to disregard the indications of some degree of pituitary, thyroid and gonadal endocrinopathy, than not to consider these factors as having possibly contributed to his hypokinetic constitution. Many years of hard farm work and wood chopping from childhood to manhood, out of dire necessity for living, gave him an unusually large and powerful muscular development of hands and arms, back and shoulders. His neck, though strong, was long and scrawny looking in relation to his head and sloping shoulders. His lower jaw was long and heavy and inclined to the acromegalic form.

His constitutional morphology was predominantly Kretschmerian (1936) asthenic, or Sheldonian (1940) ectomorphic and cerebrotonic, and his energic constitution was Kempfian (1941) hypokinetic. These qualities indicate that Lincoln was probably somewhat hyperpituitary and hypogonadal in endocrine ratio. His constitution disposed toward some reduction of autonomic pressure of energy in sexual directions and tended to produce shyness with women and a preference for the company of men, factors endlessly contributory and determinative in influence on the social conditioning and development of his personality.

His slow, drawling speech, slow reaction time and mental deliberateness, and pedestrian rhythm in style of speaking and writing were so consistent with his energic constitution and morphology that the latter, obviously, largely determined the former. In Lincoln the physiopsychological order of reactions dominated the psychophysiological. In other words, he must be and was always guided by his feelings. in what he said and did, for if they did not support him in the work of fulfilling certain self-commitments he would become miserable, if not melancholic.

Plate 2. Volk's Life Mask of Lincoln, 1860.

Meaning of Facial Asymmetries

If we examine the full face photographs{1} of Lincoln, and of the Volk (1860) life mask,{2} and the Mills (1865) mask,{3}  we see that the forehead is wide, high and bulges slightly in the middle.

Plate 3. Mill's Life Mask of Lincoln, 1865.
Courtesy of Mr. Clarence L. Hay and the American Museum of Natural History.

There is an unusual depression in the Volk mask with a palpable edge near the midline above the left eye. I have examined the Mills mask and found a similar depression in its forehead.

In Lincoln's photographs and both masks the left eye sets higher than the right. His left eyebrow is usually elevated more than the right to keep the upper lid retracted and the pupil of the left eye exposed. The tendency of the left eye to turn upward uncovered more of the white surface of the sclera below the iris, giving a slightly dull, weak, staring effect on that side, in strong disharmony with the more active right eye and face. The left eye in the best frontal photographs is shown definitely to be out of focus and turned reflexly slightly upward and outward. This effect is due to the inferior oblique muscle of the eye being stronger than the weakened superior oblique which turns the eye inward and downward. Lincoln's right eye functioned normally and dominantly for general vision and reading. Further examination of the face shows that the left half of the upper lip is somewhat thicker than the right and less expressive, that is, less involitionally and volitionally active. The right half of the lower lip protrudes markedly and is pulled toward the right by the mouth and cheek muscles. This action also characteristically pulls the nose definitely toward the right. The right side of the chin is larger than the left, indicating stronger muscle tonus and development from more active use.* Although his larynx was large, he had a rasping, high pitched voice that grew shrill and squeaky upon emotional excitement, indicating some imbalance of vocal cord or pharyngeal muscle tension.

Further examination of the Volk mask, especially when measured for similar right and left points from the midline, also shows marked differences in the growth of the bones.* Although such differences may be genetic, or developmental in relation to loss of teeth and use, and cannot be taken as definitely indicative of the effects of an injury of the brain in youth like the differences in tonic contraction of the ocular and facial muscles, they should be considered and functionally correlated. His cheek bones were unusually high and prominent. The right was larger than the left, and the right orbital ridge and lower jaw were more heavily developed than the left, giving the whole face a decided morphological curve toward the right.*

This deformation becomes distinctly visible when the full face photographs are turned upside down. When the Volk mask is turned upside down, or viewed from below upward, the larger size of the face and the greater prominence of its lip, chin and lower jaw, and the greater depression of the face under the cheekbone, on the right side, is impressive.*

Fracture of Skull and Injury of Brain in Boyhood

All of these differences in facial muscle and bone development, like the weakened functioning of the left ocular and facial muscles in particular, indicated to me that Lincoln had suffered a serious injury of his brain in childhood. The sharp depression in the forehead above the left eye with a definitely palpable edge, in the life masks, shows where his skull had been fractured, and the permanent differences in the nervous tone of the ocular and facial muscles of the two sides indicate that his brain was then permanently injured.

Evidence that such an accident occurred was given by Lincoln in his letter to Scripps (1860), where he told that "in his tenth year he was kicked by a horse and apparently killed for a while." More extensive descriptions of the accident by Lincoln to Herndon, and by Dennis Hanks who was living with the Lincolns at the time, provide details of what happened. Although descriptions in Herndon's several accounts (Herndon, 1889; Hertz, 1938) are slightly different, their essentials coincide as combined here.

"Mr. Lincoln told me," Herndon said, "that he had to shell corn with his hands and take it to mill in a sack on horseback, corn in one side and rocks in the other [to balance]. He went to the mill on his father's old [unshod] mare [and] had to wait his turn to grind. It was getting late in the evening and he was some two miles from home ... ; he hitched in his old mare to the sweep-pole or lever that turned the wheel and, being in a hurry to get through with his grist, he urged her to full speed, round and round, ... faster and faster, ... [and as] he struck her with a stick ... [he started] to say: 'Get up-you old hussy.' ... Just as he uttered: 'Get up,' [he] was kicked in the forehead." "Miller Gorden picked up the bleeding, senseless boy, whom he took for dead and at once sent for his father ...." "Abe lay unconscious all night." As he regained consciousness he blurted out 'You old hussy.' "He finished the sentence just as he intended to speak it, commencing where he left off. Lincoln told me this and he and I used to speculate on it."

Young Abe was said, many years later by a cousin, Dennis Hanks, who lived with the Lincolns at the time and was 10 years older, not to have regained consciousness until the next day. He seemed to have recovered without serious mental or physical after-effects since he received no medical attention for the head injury (see Chapter V).

Fractures of the skull and cerebral after-effects were never suspected, or at least never reported by any of Lincoln's physicians although, after 30, he consulted several for treatment of "hypochondria" and other nervous symptoms. This is not surprising for it was not until after 1890, upon application of X-ray photography and neurophysiology that we learned how to explain some of the cerebral effects and nervous consequences of fracture of the skull.

Lincoln was also struck on the head with a club in a fight with Negro marauders while taking a flatboat down the Mississippi, when either 19 or 22. This blow, he said, left a permanent scar. However, it probably did no further damage, for he routed the hoodlums, saved his cargo and continued the journey.

Congenital injury of the nervous system has also been suggested to account for the ocular and facial symptoms but this is discredited by the definite history of a blow on the head in childhood that knocked him unconscious for many hours.{4}

Diagnosis of Cerebral Lesion

Although modern neurology requires a far more complete examination of the living subject for positive and negative evidence of nervous impairment to make a diagnosis, consideration of several places of brain injury that might have produced the unusual complex of symptoms, as far as known in Mr. Lincoln's case, is highly desirable.

The kick on the forehead over the left eye evidently fractured the skull at the point of impact and must have violently snapped the head and neck backward. The size and depth of the depression is evidence of its severity. It is most likely that a subdural hemorrhage of considerable size developed here, besides points of hemorrhage elsewhere. The left frontal lobe was certainly damaged, which, in a right-handed, right-eyed person, would have modifying after-effects on his personality, which will be considered later.

The evident, permanent weakness of conjugate movements of the left eye, with tendency to turn slightly upward and outward, and weakness in tonus of the left facial muscles, constitutes a symptom complex that cannot be satisfactorily explained by a single area of permanent brain injury. The lifelong discordance of functioning of the laryngeal muscles is also indicative of additional involvement of involitional nervous action, as is also his daily mental distractibility and moody frustration, as will be seen in many later chapters.

Hydrostatic repercussion within the skull on the opposite side might have, damaged (by shock, if not by another subdural hemorrhage) the right cerebral-cortex in the middle area of the precentral gyrus, supplying motor impulses to the left eye, eyelid, face and pharynx. Penfield and Rasmussen (1950) state that elimination of the precentral gyrus below the arm area produces temporary paralysis of the opposite side of the face, which recovers leaving a residual minor weakness of the lower part only. It sometimes also interferes with mastication and pharyngeal movement and speaking, but functional recovery to normal generally follows here also. Since the facial muscles on both sides have bilateral cortical innervation, the effects of such an injury in a boy would probably have been largely compensated for within a few months, hence more permanent damage probably occurred in some other area.

Several small hemorrhages in the brainstem would have produced the particular permanent ocular and facial effects. If one partly damaged the nucleus of the left fourth nerve to the superior oblique muscle, so as to weaken it, the left eye would then tend continuously to turn more or less upward and outward, as shown in many of Lincoln's photographs, while leaving some degree of volitional coordination. If another point of hemorrhage damaged the nucleus of the left seventh nerve, the left facial muscles would be permanently weakened, likewise with some retention of volitional control. Persistent laryngeal tensions, producing a rasping, high pitched voice, might have also followed from another petechial hemorrhage that impaired vagus innervation.

The weakening of the left facial muscles would probably have only minor, secondary effects on the personality. The production of a high pitched, rasping voice was more important, but Lincoln largely overcame this professional deficiency by speaking thoughtfully, slowly and deliberately, always with the intention of expressing himself simply and directly so as to be clearly understood. However, he spoke in a slow staccato monotone, indicating deficiency in sense of inflection, a serious impairment in a public speaker.

Frontal lobe impairment on the left side (of a right-eyed and right-handed person) of the corticothalamic system of integration of nervous interactions would have reduced the egoistic volitional production of conscious visual imagery of self-in-its-environment, requiring compensatory development of the right corticothalamic connections to serve this indispensable function. More stimulation than in normal people would then be necessary in order to remain mentally acutely active. A person with such a cerebral lesion would have, in order to keep his mind working at a highly attentive sensory discriminating level, to keep himself involved in emotionally stimulating situations by cultivating exciting social interests and objectives. As will be seen in later chapters, Lincoln did just this, constantly, through his passion for realistic accuracy and simplicity of reasoning, truth, directness, honesty, kindness and friendliness of self-expression, and upholding the equalitarian moral and legal rights of all people, cultivating a moralizing sense of humor, and challenging illegally exercised political and judicial authority.

The most significant of his symptoms was the repetitive tendency, when not being stimulated by environmental activities to lapse automatically into a lower conscious state of mental detachment, tending to sadness and gloominess, with characteristic facial expression. This was described by some of his friends as "ugly and stupid looking" and others as "dull," "sad and abstract," "detached" and "withdrawn." When a man in his forties, he told his friends that he was never without "melancholy." Upon being stimulated in a way that aroused emotivating interest, such as some incident or some interpersonal talk, his facial expression was observed to change quickly from dull indifference to animated interest, with a tendency to smile and laugh.

As a humorist telling moral stories of frustrated vanities and a humanist seeking freedom and peace of mind for all people as well as himself, he carried on endlessly to overcome his subconscious tendency to lapse into a rut of sad, gloomy, visual, mental preoccupation over the fateful futility of life. He also intentionally cultivated special forms of self-stimulation in habits of reading aloud to himself and other people, memorizing, and writing out his reasonings. By reading aloud, he told Herndon, he gained the benefit of hearing as well as seeing what he read, enabling him thereby to remember more easily. By writing out his reasons for and against making decisions he formed stable convictions.

Records of descriptions of Lincoln's physical and personal disabilities as a boy and man, by himself and neighbors and friends, are numerous, many of which are presented in later chapters. The earliest is that of Josiah Crawford in Gentryville, Ind. He employed the boy Lincoln, loaned him books for study and liked to jest him about the way he "stuck out" his lower lip, apparently regarding it as a boy's eccentric habit. When Lincoln returned to southern Indiana in 1844, age 35, to make a speech, his lower lip still protruded abnormally. When Crawford asked him about his books for making the speech, Lincoln, remembering his joking, replied humorously, "I haven't any. Sticking out my lip is all I need." Tarbell (1924) who has retold the story, saw in it evidence that "this habit, fallen into in youth, resulted in that protruberance of the lower lip which is a distinguishing characteristic of his face," an interpretation held generally by his medical and lay biographers.

Diplopia and Eyestrain

Decoordination of the left eye with dominant right eye was more serious in Lincoln's case than usual in that his persistence in reading tended to produce severe eyestrain that increased upon fatigue, moral frustration or emotional excitement, with the sequelae of headache, nausea, indigestion, chills, mental distraction and gloominess. In youth and maturity Lincoln was unable to focus both eyes for any length of time without volitional strain. Herein existed a definite unconscious involitional determinant of a special form of self-righting compensation on conscious learning. He must not only use right eye vision against out-off-focus left eye vision, but he must consciously and conscientiously see in his mind's eye the morally right and better side of himself in sympathetic interaction with other people, in order to reduce the stress of visualizing himself as being wrong, unkind or unjust in ways that caused gloomy frustration of his egoistic self-respect and will to live.

The continuous tendency of visual decoordination was sufficient to increase nervous fatigue and depression of mood or "spirit" upon prolonged use of the eyes, particularly for reading. Such conditions tend in most youths to induce discouragement of reading, and lethargy with laziness. Despite this impairment, young Lincoln was an eager student and liked to lie on the floor and read aloud by the light of the open wood fire. Later, as a man, he often read in a reclining position on a couch or the floor. His work as a lawyer and politician required him to read excessively, and he adapted to this by learning to scan pages rapidly for essentials and by developing a highly retentive memory. When it was unnecessary to use his eyes or mind he would lapse into a characteristic, disinterested mental state.

The earliest definite evidence of observation of Lincoln's visual decoordination has been recorded by Dr. T. H. Shastid (1929), an oculist who practiced in Pittsfield, Illinois. It was described to him by his father who, when a boy, lived in New Salem and knew Abe Lincoln, storekeeper and postmaster of the village. Shastid described him as a melancholy but kindly spoken person who liked to amuse children as well as grownups. "Abe" would sit on a box in front of the store when not waiting on a customer, generally with a dejected and abstracted expression. He liked in summer to lie on the ground near the store, with his bare feet elevated against the trunk of a tree and read.

Shastid noticed that Lincoln's left eye looked queer at times and would suddenly turn upward. Some 20 years later he saw Lincoln in several debates with Douglas and in several trials as a lawyer. He then recognized the eye condition as being produced by a weakness of the left eye muscles that turned the eyeball upward. Upon excitement this condition would suddenly increase and produce a severe divergent squint.

Dr. Shastid diagnosed Lincoln's eye condition, from his father's description, as hyperphoria. The continuous eyestrain, he pointed out, was at least partly the cause of moodiness or "chronic inexpressible blues." He thought that Lincoln was possibly also color blind, for he said to Dr. Shastid's grandmother that he did not enjoy beauty in flowers and sunsets like other people. However, Lincoln's description, in this period, of colors in the scene of an Indian massacre (see later chapter) indicate that his perception of colors was not entirely deficient.

In 1857, at 48, he bought, upon the recommendation of a friend while shopping in a,jewelry store, his first pair of "spectacles" for reading. He tried on several pairs and paid 37-1/2 cents for the glasses that he liked best. Until a few years before, he probably had effective accommodation of the right eye, although it was always attended by more or less strain from decoordination of the left.

The following reports on Lincoln's eyes and glasses are taken from several later authoritative investigations. The glasses were reported by Almer Coe of Chicago to have in each lens the strength of plus 6.75 diopters. This indicated that Lincoln probably had four or four and a half diopters of hyperopia or far sightedness at 48. This severe disability had no doubt been developing for a number of years and required constant effort to produce sufficient accommodation for reading.

Dr. W. H. Crisp (1932), opthalmologist, recorded the following observations. Fullface photographs show an upward deviation of the left eye, great enough to produce a lack of fusion of its images with the right eye. The two eyes did not work together, possibly as a result of a vertical strabismus of the left.

Dr. S. Mitchell (1914) found evidence of left hyperphoria and suggested that the corrugations of his brow and crow's feet at each corner of the eyes showed that he habitually used auxiliary facial muscles to support the external muscles of the eyes in the work for visual coordination.

Dr. K. C. Wold (1948) has suggested that the diplopia was caused by a decoordination of the external muscles of the left eye which was inherently connected in some way with the other facial asymmetries.

No physician of record, in so far as I know, has offered an explanation of the nervous origin and nature of the asymmetrical functioning of the left facial and ocular muscles, although some of the nervous effects of eyestrain have been discussed.

Most people with diplopia learn how to disregard the dimmer visual image by concentrating mentally on the image of the dominant eye. When both eyes are used in focal coordination, volitional effort is necessary, and this eventually produces mental visual fatigue and organic eyestrain tending to cause headache. Under mental or physical fatigue or emotional excitement, visual decoordination increases (as noticed at times in Lincoln by his contemporaries) and the stronger image is underlapped by more or less of a shadowy, weaker image, increasing mental confusion and uneasiness. Lincoln learned in boyhood to cultivate a calm, humorous, patient, kindly attitude and friendly interpersonal assurances, and a common-sense philosophy of life that generally protected him from emotional provocation and increase of this distress. However, he had a singularly impressive mystifying experience with more persistent diplopia after a fatiguing day upon the evening of his election as President. His description and interpretation of this experience to Ward Lamon and Noah Brooks is given in Chapter XLII. The strange mystery of his double vision and its superstitious meaning for him has been cited by many biographers as an indication that Lincoln had clairvoyant sensitivity. It seems evident now that it was the simple result of an old injury of his brain in childhood.

Through his adult years Lincoln had many nervous attacks, characterized by eyestrain and headache with nausea and indigestion, so severe that often he became unable to work and had to lie down with a cold compress over his eyes. He had couches in his law office, at home, and in the White House, for this purpose.

Borglum's Interpretation of Lincoln's Face

Gutzon Borglum, sculptor of the great marble head of Lincoln in the Capitol rotunda at Washington, made extensive comparative measurements of the photographs and masks of Lincoln, and studies of his notes, letters, speeches and life history before attempting the portrait.

In an essay on Lincoln, Borglum gave interpretations of the relative meanings of the right and left sides of his face as indicated by its lines and measurements. He saw the greater strength of functioning of the right side relative to the left. The lines around the right eye and its direct convergence showed that it was more active, that is, dominant, and that he naturally thought and planned with the visualized imagery of this eye. He was "naturally a merry soul changed by sadness." The lines around Lincoln's mouth and its displacement towards the right indicated that "he smiled very, very often when his nature took no part in it."

Borglum noticed that the tip of the nose was also turned toward the right but he did not give any particular significance to this. However, he saw that the left eye was "wide open" and out of focus, "indecisive," "noncommittal and dreamy." The left side of the face seemed "primitive," "immature" and "unfinished." Its weak expression was "sad and undetermined" in contrast to the determined strength of the right side. The left brow was "anxious, ever slightly elevated and concerned."* Written on his face was "humor, pathos, half-smile, half-sadness; half-anger, half-forgiveness, half-determination, half-pause; .... a dual Nature struggling with a dual problem delivering a single result."

Borglum's description of Lincoln's face is the most careful and thorough given heretofore by any artist or biographer, but he made no attempt to find why the left side was characterless, weak and undeveloped and the right side expressed the real personality and state of mind of Lincoln.

Enigmatical Character of Facial Expression

The right side of Lincoln's face was animated and normally emotionally expressive, whereas the left side functioned more weakly, looked duller and strangely out of harmony. The meaning of the duality and uncoordinated changes in his facial expression baffled everyone.* Strangers who estimated the man by his dull, perplexed face and sad, tired eyes were always astonished by the quick change of his expression to alertness when he became interested in their conversation and wanted to make some contribution to it. Many officials, including lawyers, generals and members of his cabinet, upon first acquaintance, thought themselves superior to this ugly, dull, sad, weak man, only to find themselves amazed and mastered by his ready wit, common sense, logical intelligence and strength of character upon being required to look out for himself.

Herndon was no doubt the most frequent, intimate and interested daily observer of Lincoln's personality and physical constitution, as his law partner, through the years of 1843 to 1861. He has stated (1889) that Lincoln's most marked and persistent characteristic was a predisposition to become melancholy or sad and abstracted. This attitude showed in his facial expression when sitting alone or in a group and not taking an active interest in the conversation. Many other intimate friends of Lincoln were similarly impressed, as recorded in various biographies. Some of his friends thought, because of the muddy, leathery condition of his skin, this facial lapse was due to chronic indigestion and "insufficient secretion of bile." The morbidity was caused, Herndon said, by some "occult condition" that could not be explained by observation or reasoning. It was "ingrained, necessarily hereditary a part of his nature." "Lincoln was a sad looking man whose melancholy dripped from him as he walked." "The look of sadness was more or less accentuated by a peculiarity of one eye [left], the pupil of which had a tendency to turn or roll slightly toward the upper lid, whereas the other one maintained its normal position equidistant between the upper and lower lids." He also noticed that the tip of his nose and mouth turned toward the right. "Mr. Lincoln was a peculiar, mysterious man . . . had a double consciousness, a double life." He "quickly passed from one state of consciousness to another and different state."(Letter to J. Weik, February 21, 1891; Hertz, 1938.)

Actually, as Lincoln's life mask and photographs show, the right half of the lower lip always protruded more than the left half and was pulled with the other muscles of the mouth slightly to the right side. When reading intently or thinking actively the degree of dominance in neuromuscular activity of the right side of his face tended generally to increase over that of the relatively hypotonic left, which gave his expression a perplexed quality that was misunderstood as a sign of mental confusion by those who would read his face. (See additional information by Herndon in Chapter XIX.)

Preference for Photographs of Right Side of Face

The collected photographs of Lincoln published by Frederick Hill Meserve and Carl Sandburg (1944), and by Stefan Lorant (1952), show that in many of them he has a similar, serious, solemn, dignified, unsmiling but kindly, reposeful, mentally inactive facial expression. In a few, the face is so moody and depressed and unusually perplexed, and the eyestrain so marked, that many people doubt if they are authentic reproductions. Not until one examines the lines of the eyes, mouth and skin closely in such photographs is the identity fully established.

The differences in expression of the two sides of his face seem to have influenced Lincoln, or his photographers, to prefer the right side since most photographs were taken from the right quarter or profile. Only a few were taken from the left side or in front. Although a laugher, he tended to keep his mouth closed firmly, with more protrusion of the right side of the lower lip than the left. Even though Mrs. Lincoln often chided him for persisting in looking too solemn, he could not be persuaded to smile freely before the camera. Herndon (Hertz, 1938) said that from the moment Lincoln faced the camera his face would grow serious and sad.

Lincoln's face was completely shaven until, in his campaign for the presidency in 1860, he was persuaded by a young girl's suggestion to grow a beard. The numerous changes in the style of cutting his beard and hair indicate that he and his barbers or Mrs. Lincoln indulged in no little experimenting for satisfactory effects. His photographs show how they tried a number of different trimmings with one constant feature, namely, shaving of the upper lip and lower lip and upper half of the chin, while letting a beard grow on the lower half of the chin and throat and sides of his face. The coarse, black hair of his head was generally cut so as to remain unusually long, probably for reducing the prominence of his ears. He was self-conscious about his hair, and parted it on either side as he fancied, but it was soon disheveled by the nervous habit of running his fingers through it.

* (Dr. Frechette's emphasis)

{2} Illustration No. 2. Life Mask by Volk, 1860.

{3} Illustration No. 3. Life Mask by Mills, 1865.

{4} Mock (1950) reports that about seven per cent of untreated fractures of the skull in children end fatally. Most such fractures were caused, before the automobile, by being kicked in the head. Electronic recording has now shown that an appalling amount of damage to the brain, heretofore unsuspected, follows from blows on the head, at the point of impact and from hydrostatic repercussion (contra-coup), and through the production of numerous, small (petechial) internal hemorrhages as well as subdural blood clots, without external evidence of fracture.