Monday, January 18, 2016

Did Mercury in "Little Blue Pills" Make Abraham Lincoln Erratic?

By Hillary Mayell for National Geographic News, 7-17-01

Tales of the melancholia that dogged U.S. President Abraham Lincoln at various times during his life have been documented by historians and biographers and in Lincoln's own correspondence.

Whether he suffered from a full-blown case of what today is called clinical depression is unknown. What is known, however, is that for a while, Lincoln took little blue pills to treat his condition.

Known as "blue mass," the little blue pills were a 19th-century staple. They were prescribed for a host of ailments, including apoplexy, worms, child-bearing, tuberculosis, toothaches, and constipation.

The key ingredient was mercury—and the medication was well on its way to poisoning Lincoln when he stopped taking it in 1861, says a team of researchers in a study published in the Summer 2001 issue of Perspectives in Biology and Medicine.

"Cave of Gloom"
Lincoln lived in what a friend called "a cave of gloom." His melancholy "was a matter of frequent discussion among his friends," wrote William H. Herndon, Lincoln's law partner and biographer.

Norbert Hirschhorn, a medical historian and the lead author of the new study, said of Lincoln: "There seem to be clear, qualitative changes in his underlying behavior during the 1850's. The gloom becomes impenetrable. He becomes subject to towering rages and outbursts of bizarre behavior—jumping up suddenly and running out of the house for no reason, bursts of inappropriate laughter."

To document the changes in Lincoln's behavior, the authors of the study cited numerous accounts of friends and fellow lawyers who traveled the legal circuit with the man who became the 16th U.S. President.

Lincoln's leaps to rage could be terrifying. One contemporary described his face in anger as "lurid with majestic and terrifying wrath." Another described him as "so angry that he looked like Lucifer in an uncontrollable rage."

During an 1858 debate with Stephen Douglas, his rival for a seat in the U.S. Senate, Lincoln became so enraged that he grabbed a former aide and shook him until his teeth chattered.

As President during the U.S. Civil War, Lincoln was known for his steady hand, patience, and wisdom. The authors believe the difference between Lincoln the statesman and the earlier Lincoln lies in the "blue mass" pills.

"Mercury poisoning certainly could explain Lincoln's known neurological symptoms: insomnia, tremor, and the rage attacks," said Robert G. Feldman, a professor of neurology, pharmacology, and environmental health at Boston University's School of Medicine and Public Health, who was a co-author of the scientific report.

Hirschhorn said: "In the absence of a hair sample from 1855 to 1861, which I don't think exists, we can't absolutely prove mercury poisoning. But it's a very good clinical suspicion."

Reconstructed Formula
A few months after his presidential inauguration in 1861, Lincoln told his good friend John T. Stuart that he had quit taking the little blue pills because they made him "cross."

Ian A. Greaves, an associate dean at the University of Minnesota's School of Public Health, reformulated "blue mass" using a 19th-century recipe, which included mercury, liquorice root, rosewater, honey, sugar, and dead rose petals. The ingredients were combined using a traditional mortar and pestle, and then shaped into the early pill's typical size.

The reconstructed "blue pill" was a round gray pellet the size of a peppercorn. If taken at the normally prescribed dose of the time—one pill two or three times a day—it would deliver nearly 9,000 times the amount of mercury that is deemed safe for people by current health standards.

Because the effects of mercury poisoning are reversible, Lincoln's decision to quit taking the little blue pills had extremely important consequences, said Hirschhorn.

"Faced with as great stresses as any President, Lincoln demonstrated incredible maturity, calm, and steadiness at the helm," Hirschhorn said. "He might not have had that capacity if he had continued taking blue mass. That insight may have been crucial to the outcome of the Civil War."



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