The “young lady” Speed so desired was almost certainly Matilda Edwards. His interest in her was known around Springfield. In December 1840, Mary Todd noted that “Mr Speed’s ever changing heart I suspect is offering its young affections on her shrine, with some others.” Ninian Edwards noticed Speed’s crush, too, and he encouraged it, believing that Speed would be a good, pragmatic match for “policy reasons.” It is hard to imagine a more painful situation for Abraham Lincoln. All at once, he faced the prospect that his political career was sunk; that he might be inextricably bound to a woman he didn’t love; that his best friend was going to either move to Kentucky or stay in Illinois and marry the woman whom Lincoln really wanted.
On top of everything else, in late December 1840 the weather turned bitterly cold. On the prairie of central Illinois, where no hills or valleys break the landscape, dark winters made one feel as though the world were covered in a shroud. “I am sure I have seen colder weather in Connecticut,” wrote one newcomer to Illinois in 1837. “But I have never seen a place where cold is to be dreaded so much . . . Imagine yourself in the middle of a large prairie where you might look East, West, North or South and where the eye could rest upon nothing above but clouds curtaining down to the earth on every side and the earth covered with snow.” That, plus the “keen piercing wind,” he added, created “a dread of cold which words cannot express.” After a respite in mid-December, temperatures dropped below zero by New Year’s. Freezing temperatures and snow would continue through January. It was colder in Illinois, said Lincoln’s friend David Davis, than anyone could remember.
Thus we arrive at the first of January 1841—“that fatal first.” What happened on that day remains a mystery. In addition to the traditional story, that the phrase referred simply to a breakup between Lincoln and Mary Todd, we should now consider three other possibilities.
For one, January 1 was the day that Speed’s partnership in his store officially dissolved, ending his business ties with Springfield and allowing him to depart. Speed certainly knew about this in advance, and it is possible that “fatal first” was a phrase used between the friends to signify the end of an era. Speed lived above the store as its co-owner and, whether or not he stayed in Springfield, he—and Lincoln—would have to move out.
Second, January 1 was also the deadline on which the state of Illinois owed $175,000 in debt interest. This was the immediate reason why the legislature had been called into special session. If the state didn’t make its payments, it would go into receivership. Given how Lincoln’s political fate had become tied to the debt debacle, and given the practical necessity of securing the funds to pay the debt, this deadline would have been an actual source of stress and also a symbol of a political nightmare.
Third, as anyone who has nursed a hangover on New Year’s Day can attest, the first of the year is a time to dwell on the painful, embarrassing, and regretful occurrences of the night before. In Victorian America, New Year’s Eve held an even more prominent place in the social calendar than it does today. And on the last night of the leap year of 1840, according to tradition, male suitors were supposed to declare their intentions for betrothal. It may have been that on New Year’s Eve, or on “that fatal first” itself, Lincoln learned of Speed’s intention to propose to Matilda Edwards.
Two more factors bear mention. One is a young woman named Sarah Rickard, the sixteen-year-old sister of Mrs. William Butler, at whose home Lincoln boarded. At some point in the winter of 1840–1841, Lincoln proposed to her, but she turned him down, saying that she was too young to marry. And for some reason Sarah Rickard was a mutual concern of Lincoln and Speed’s. Lincoln wrote to his friend in March 1842, “One thing I can tell you which I know you will be glad to hear, and that is that I have seen Sarah—and scrutinized her feelings as well as I could, and am fully convinced she is far happier now than she has been for the last fifteen months past.” Fifteen months before March 1842 was January 1841.
Another factor: some people believe that Lincoln’s stress had to do with venereal disease. According to Herndon, Lincoln believed he might have contracted syphilis in 1835 or 1836. If he did have such a worry, it might have contributed to his anxiety about marriage. It was a common worry: as many as half of the men in Lincoln’s day had some kind of sexually transmitted disease, and even more feared that they did. According to a leading physician of the time, fear of syphilis was a typical feature of hypochondriasis.
Though it would be satisfying to know for sure what Lincoln meant by “that fatal first,” the lingering mystery of the phrase serves as a reminder that history is not what happened in the past, but the best story we can tell with the available material. When there are conflicting narratives, we sometimes must admit our ignorance and live with the frustration. But just as controversy over Lincoln’s relationship with Ann Rutledge does not diminish the significance of his first breakdown, the uncertainties around the “fatal first” ought not distract us from the fact of his collapse. Whatever the reasons, in early January 1841, Abraham Lincoln was in very poor shape. He began to miss votes in the legislature. Several times on Saturday, January 2, the clerk called the roll and he didn’t answer. He missed eight votes on Monday the fourth, and three on Tuesday the fifth. The next week, he missed many sessions. Then, beginning on Wednesday, January 13, he was absent for an entire week.
By this time, Lincoln’s illness was the talk of the town. The Register poked fun at his “indisposition.” And letters came from out of town inquiring about him. “We have been very much distressed on Mr. Lincoln’s account,” a woman in Jacksonville wrote to her brother in Springfield, “hearing that he had two Cat fits and a Duck fit . . . Is it true?” It was true. “Lincoln you know was desponding & melancholy when you left,” wrote Edwin Webb to O. H. Browning on January 17. “He has grown much worse and is now confined to his bed sick in body & mind.”
Lincoln was not only confined to his bed. He submitted himself to the care of a medical doctor. In the week that he was absent from the legislature, he spent several hours a day with Dr. Anson Henry. When he emerged, on January 20, he wrote that he had a disease called “hypochondriaism” and that he had “got an impression that Dr. Henry is necessary to my existence.” A tall, fastidious thirty-six-year-old man, Anson Henry had grown up in New York and studied medicine at the Ohio Medical College in Cincinnati—though the full course comprised only two three-month semesters. Like Lincoln, Henry settled in central Illinois in the early 1830s. And like Lincoln, he was a politically ambitious Whig. The two were close allies. The political and social tie—not Henry’s medical expertise—is the probable explanation for why Lincoln went to Henry during his crisis.
The traditional narrative of this period places Lincoln’s treatment by Dr. Henry at the end of his troubles, suggesting that it set him on the course of recovery. But a close look at events shows that Lincoln hardly improved during his week of treatment. Before, he was depressed, agitated, and “crazy.” After his treatment he looked beaten down, weak, almost inhuman. “Poor L!” wrote James Conkling, a young lawyer in town, on January 24, “how are the mighty fallen! He was confined about a week, but though he now appears again he is reduced and emaciated in appearance and seems scarcely to possess strength enough to speak above a whisper. His case at present is truly deplorable but what prospect there may be for ultimate relief I cannot pretend to say.” “Poor fellow, he is in rather a bad way,” a Springfield woman named Jane Bell wrote of Lincoln on January 27. “Just at present he is on the mend now as he was out on Monday for the first time for a month dying with love they say. The Doctors say he came within an inch of being a perfect lunatic for life. He was perfectly crazy for some time, not able to attend to his business at all. They say he don’t look like the same person.”
Lincoln was “reduced and emaciated” and didn’t “look like the same person” probably because he had spent a week being subjected to what a medical authority of the time called “the desolating tortures of officious medicatio
n.”
Hypochondriasis was a form of melancholia, less severe than others, though still serious enough to demand medical attention, lest the patient succumb to insanity or suicide. Literally, the word refers to a disease of the organs below (hypo) the cartilage of the rib cage (khondros)—that is, the liver, gallbladder, spleen, stomach, and intestines. In practice, following the theory that black bile resided naturally in the gut, hypochondriasis became the term for melancholia that fell short of full-scale madness.
A treatment regimen was readily available to a physician like Dr. Henry, in the form of the first American textbook on mental diseases, written by Dr. Benjamin Rush, the preeminent physician of the early republic. Titled Medical Inquiries and Observations upon the Diseases of the Mind, the 367–page book—printed on thick linen paper and bound in leather—devoted its third chapter to hypochondriasis.
Rush favored “direct and drastic interferences” with patients’ bodies and minds. Doctors at the time “literally assaulted their patients,” writes the historian Robert C. Fuller, “in an effort to stimulate and reinvigorate their constitutions.” Rush’s main treatment strategy for hypochondriasis was to “plumb” patients’ systems by, to start, bleeding them severely. “The quantity of blood drawn should be greater than in any organic disease,” Rush wrote, noting a case of hypochondriasis in which he drew 200 ounces (12½ pints) in less than two months, and another case in which he drew 470 ounces (about 29 pints) in ten months. (Adult bodies have ten to twelve pints of blood.) The next step was to blister a patient, or “cup” him, by applying small heated glass cups at the temples, behind the ears, and at the nape of the neck. This brought blood to the surface of the skin. “Leeches may be used for the same purpose, and in the same places,” Rush advised. The next step was to give the patient drugs that induced vomiting and diarrhea. While emptying the body of its contents, doctors were enjoined to keep their patients on strict diets—fasting for two or three days, Rush said, was efficacious, noting how elephant tamers made their beasts less ferocious by starving them. Once the body had been cleaned out, Rush prescribed stimulants: sherry or red wine; tea and coffee; ginger and black pepper in large doses; tar pills in water; garlic or peppermint tea; magnesia, limewater, and milk; and mustard rubs. Quinine, derived from a South American tree bark, was widely used. Rush also suggested a warm bath to induce sweats, followed by a cold bath. Rubbing the trunk of the body and the limbs was helpful, as was exercise, especially on horseback.
Most of these treatments were physically punishing. Mustard rubs produced terrific pain. Black pepper drinks were like a bomb in the stomach. Mercury, the principal substance used to purge the stomach and the bowels, poisoned the body. (Arsenic and strychnine were also used.) Doctors approved of the green stools that resulted, believing that black bile was being cleared out. Actually, we now know that mercury was killing the healthy intestinal bacteria that make stools brown. Since it binds to the central nervous system, mercury also produces quick effects on mood: depression, anxiety, irritability.
The torturous quality of these treatments did not diminish them in the eyes of physicians. To the contrary, the more a patient suffered, the more evidence that the body was being stirred up and cleaned out. Unless a doctor was imaginative enough to buck conventional wisdom, “treatment” was hell. Dr. Henry’s record, left in medical opinions published in the Sangamo Journal, showed him to be an eager adherent of the aggressive mode of treatment advocated by Dr. Rush. All we know for sure of Henry’s treatment is that he put Lincoln to bed and kept him isolated. But if Dr. Henry followed the standard course with Lincoln, he would have bled him, purged and puked him, starved him, dosed him with mercury and pepper, rubbed him with mustard, and plunged him in cold water.
It has long been a footnote in the study of Lincoln’s life that, in the winter of 1840–1841, he wrote a lengthy letter to Dr. Daniel Drake, describing his case. Lincoln read the letter to Joshua Speed—except for one section, which he skipped over—and he showed his friend the reply, in which Drake suggested a personal interview. Speed later urged a biographer to find Lincoln’s letter: “It would be worth much to you if you could procure the original . . . I would advise you to make some effort.” Neither Lincoln’s letter nor Drake’s reply has been found, however, which is the main reason this exchange has remained a footnote. The other reason is that Lincoln scholars have not appreciated Drake’s significance, and so have not appreciated the potential impact of even a brief contact between these two men.*
Drake was one of the top American doctors of his time, and no medical man was better known or regarded in the American West. The founder of six medical schools, the editor of journals, and the author of books, Drake was considered a leading public intellectual. One nineteenth-century historian called him “the Benjamin Franklin of the West.” Lincoln’s known contact with Drake naturally heightens our interest. What did the great medical man think about depression, and what did he suggest for its treatment? These questions become all the more interesting when we see how clearly he answered them.
Drake wrote widely on mind diseases, and he bemoaned “the long and frightful train of distempers, known under the names of dyspepsia, hypochondriaism, hysteria, palpitation of the heart, and weakness of the nerves.” These diseases, he noted, did more to detract from the happiness of society than any others, “infusing poison into every cup of enjoyment, and rearing spectres in all our paths;—transforming courage into cowardice,—and that period of our lives, which on the plan of nature should be most gay and enterprising, into a state of debility and gloom.” He knew mind diseases better than most, for he had cared for many patients with such “frightful diseases”—among them, himself.
About twelve years before Lincoln wrote to him, a ire broke out in Daniel Drake’s house. He was forty-three years old and recently widowed. His late wife’s sister, a twenty-year-old woman named Caroline Sisson, who was living in the house, was sleeping in her bedroom when her mosquito netting caught on fire. The flames leaped to her calico bedcovers and then her nightgown. Hearing her screams, Dr. Drake rushed into the room, pulled the woman from the bed, and pressed his bare hands against her clothes to put out the fire. Severely burned—she had been in the flames for as long as half a minute—Sisson soon fell into a coma. Drake, too, was badly hurt. The skin on his hands had been seared off, and the layer beneath had turned black. He plunged his hands first into a bowl of whiskey, then into a mixture of flaxseed oil and limewater. Then he wrapped them in rags, which he’d treated with oil and white lead. For several hours the pain was excruciating, despite the use of laudanum (opium and alcohol).
The cause of Drake’s injury—an attempt to save the life of his sister-in-law—proved in vain. She died eight hours after the fire had started. In the wake of her death, suffering from the pain in his hands and unable to work, Drake fell into a deep depression. He found his own case intriguing enough that, when he had recovered several years later, he wrote about it in a journal he edited.
For years, Drake had experienced milder depressions—afternoon attacks of what he called “cerebral oppression,” accompanied by drowsiness and a sinking feeling in his gut. But after the fire he sank into despondency. “None of the ordinary stimuli of life, either moral or physical, produced their characteristic effects . . . In short every sensation both of mind and body, was unpleasant if not painful.”
At first, he treated himself aggressively. He bled himself and gave himself “pukes,” which he knew often “revives and regulates the sensibilities of the system.” He swallowed various tonics, including large doses of quinine sulfate. He also used sulfuric ether, ammoniated alcohol, piperine (a crystal extracted from black pepper), opium, and morphine. None of this helped his “nervous depression and perversion.” He felt “a sense of muscular debility and a consciousness of mental imbecility, extreme restlessness, and morbid vigilance . . . In short every sensation both of mind and body, was unpleasant if not painful; and this continued to be the case for at le
ast five weeks.” Drake concluded that his aggressive self-treatment not only failed to help; it added to his problems. It took several years for the depression to fully lift, and when it did, he owed his recovery not to any of the medicines but to fresh air and exercise. So long as the body hasn’t been permanently damaged, he concluded, such movement will bring benefits and eventually a restoration of health.
Drake had one other positive recommendation, which was that victims of depression, when in the worst of their pain, should use opium, long considered “the medicine of the mind.” Drake himself used opiates for about five weeks, and while they didn’t fix the problem, they greatly helped him to endure it. And he urged that virtually all other treatments not be used. States of chronic nervous irritation, he concluded, “are not uncommon; may spring from various causes, afflict persons of both sexes and of different ages; subject the unfortunate patient to the derision of his acquaintances, and too often bring upon his constitution the desolating tortures of officious medication. I have seen many persons in this sad and pitiless state of physical and moral imbecility.”
Apparently, when he emerged from “treatment” in late January 1841, Lincoln was one of those persons. He seemed as desperate as ever—and it wasn’t just his observers who thought so. On January 20, right around the time that Lincoln got out of bed and “appear[ed] again,” he wrote to his law partner John Stuart in Washington, D.C., “I have, within the last few days, been making a most discreditable exhibition of myself in the way of hypochondriaism . . . Pardon me for not writing more; I have not sufficient composure to write a long letter.”
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