Letter to the Editor: Lincoln's Gait

Lincoln's Gait

Our article in your journal, "Abraham Lincoln's Blue Pills" (co-authored with the late Robert G. Feldman) proposed that Lincoln suffered mercury poisoning from elemental mercury in the 19th-century medication called the blue pill, or blue mass (Hirschhorn, Feldman, and Greaves 2001). His symptoms included bizarre behavior and outbursts of rage (known as erethism when caused by mercury), insomnia, forgetfulness, and hand tremor under stress. We also noted Lincoln's odd gait, as described by his long-time law partner William Herndon: "When [Lincoln] moved and walked along . . . he put his whole foot down flat at once, not rising from the toe, and hence he had no spring to his walk." We took this as a possible indication of sensory nerve damage related to mercury. Now for this latter sign comes a more intriguing explanation. Laura Ranum and colleagues have found mutations in b-III spectrin associated with spinocerebellar ataxia type 5 (SCA5) in a family descended from Abraham Lincoln's paternal grandparents (Ikeda et al. 2006).

Descriptions of Lincoln's gait are similar to gait abnormalities found in the early stages of SCA5 (Ranum, personal communication), such as this eyewitness account from the London Times journalist William Russell in March 1861: "Soon afterwards [Lincoln] entered, with a shambling, loose, irregular, almost unsteady gait. . . ." (Views of President Lincoln, 1861). Other eyewitnesses reported similarly: "His left shoulder was higher than his right and his walk was undulating and slightly off balance, making him resemble, someone said, 'a mariner who had found his sea legs but had to admit there was a rough sea running.' The Reverend Dr. Phineas D. Gurley, his pastor, said when Lincoln walked, he looked as if 'he was about to plunge forward, from his right shoulder, for he always walked, when he had anything in his hand, as if he was pushing something in front of him'" (Kunhardt, Kunhardt, and Kunhardt 1992, p. 321). It would be interesting to know if SCA5 somehow makes persons more susceptible to heavy metal poisoning.

Abraham Lincoln, arguably our greatest president, remains endlessly fascinating. Ranum's findings should reinvigorate the call to test Lincoln's DNA (from existing hair and bone fragments) for SCA5, among other diseases proposed (McKusick 1991).