The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (8 page)

Letitia Christian married John Tyler in 1813. By 1830 she had given birth to eight children.
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John Tyler was an absentee father, his political career being nearly continuous. He was gone much of the time during his service in the Virginia house of delegates (1811–1816), the United States House of Representatives (1816–1821), as a returnee to the Virginia house (1823–1825), as governor of Virginia (1825–1827), in the United States Senate (1827–1836), and back again to the Virginia house of delegates (1838–1840) before his selection as William H. Harrison’s vice president.
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Unlike the growing number of wives who traveled to Washington with their husbands to participate in the congressional social season, Letitia chose to accompany her husband to the District only once. She rarely traveled to Richmond when Tyler served in the Virginia legislature. (Williamsburg, Virginia, was the Tylers’ home.)
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However, when John was Virginia governor, she “presided over the governor’s mansion with charm and set a high standard for social life” in Richmond. An interview with a Richmond woman of the time appeared in the
Washington Globe
, and the woman recalled she was “then in perfect health and adorned with beauty.”
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Yet Letitia was plagued by ill health for most of her marriage to John. Tyler was very concerned about his wife’s physical condition but not to the extent that he abandoned his political career. Instead the husband relied on their oldest child, Mary, to look after her sickly mother. As time passed, Mary became her mother’s caretaker: “Letitia’s health worsened with each passing year; she was ever more prone to excruciating headaches and debilitating illness as she got older. After her husband’s election to the [United States] Senate in 1827, she never seemed well.”
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Her symptoms, other than severe headaches and a nonspecific debility, were undefined. One biographer ascribed her condition to “difficult pregnancies and the demands of a large family.” Mrs. Tyler’s condition continued to cause Tyler a great deal of unease, and he worried about her delicate health constantly. However, he hewed to his climb up the political ladder. “He relied on Mary to look after her mother when she suffered from headaches and to keep him apprised of her condition.” Tyler purchased a large bathtub for his wife and converted their farm’s dairy to a room where she could soak in salt water for some relief: “Mary enjoined a slave to fill the tub with salt water once or twice a week, whenever her mother appeared to need treatment.”
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In a June 16, 1832, letter to his daughter, Tyler, then a United States senator wrote to her, somewhat condescendingly: “[I am] concerned to learn from your mother that she had suffered from a severe headache the day after…. This proceeds from over anxiety on her part, aided by a predisposition to disease. Tell her that Doctor Gaither says a free use of the pills I gave her would serve to keep off those attacks, and that she would derive great benefit by using the bath.”
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The Tylers employed another tactic to fortify Letitia’s declining health. On several occasions when her health required it, Mrs. Tyler sought a respite at the Greenbrier in the (then) Virginia mountains.
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Ironically Greenbrier became the site of President Tyler’s honeymoon with his second wife, less than two years after his first wife’s demise. (The Greenbrier resort in White Sulphur Springs, West Virginia, continues as a famous vacation destination today.
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In 1839, shortly before the wedding of the Tylers’ oldest son, Letitia suffered a stroke in Williamsburg, Virginia. Its extent was “extremely severe.” She was partially paralyzed and lost her powers of speech: “She could not express her joy in words when she heard the news of the happy outcome of her son’s courtship.” It is unclear whether she regained her ability to speak, either partially or completely. Despite medical care, “her system remained greatly shattered and her health continued evermore precarious.” It is also unclear whether she overcame the partial paralysis, but it is unambiguous that Letitia Tyler was even more physically dependent after this medical emergency.
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The identities of the treating physicians are unrecorded, as was the nature of their treatments. John Tyler, at the time a delegate to the Virginia house, should have understood the gravity of his wife’s condition, since in April 1797, when Tyler was seven, his mother died of a paralytic stroke.
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The new Tyler daughter-in-law, Priscilla Cooper Tyler, wrote about her mother-in-law’s partial recovery in a letter to her sisters: “[She reads] her bible and her prayer-book—with her knitting usually in her hands…. Notwithstanding her very delicate health, mother attends to and regulates all household duties…. All the clothes for the children, and for the servants, are cut out under her immediate eye, and all the sewing is personally superintended by her.” “She must have been very beautiful in her youth, for she is still beautiful in her declining years and wretched health.” Unfortunately Mrs. Tyler remained in her bedchamber after this illness.
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Motherhood in the Old South was both difficult and demanding. Women approached their due date in fear of pain and death for either themselves or their infants. Southern mothers emerged from their repeated pregnancies with physical ailments, infections, and debilitating illnesses. Southern families, as in the case of the Tylers, were large, thereby increasing a woman’s physical risks. “Malaria was another danger for Southern women during and after childbirth. For the most part it did its harm by causing debilitation and a susceptibility to other diseases.”
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Letitia Tyler’s debility was no doubt in part a result of physical exhaustion from her repeated pregnancies. However, hypertension may be linked to grand multiparity; additionally a salient symptom in this patient was recurrent, frequently severe, headaches, another linkage with hypertension. The rudimentary medicine of the era could not document her blood pressure or laboratory values. However, one may speculate strongly that an elevated blood pressure would explain her medical problems, at least in part.
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John Tyler, after his election (November 1840) as William Henry Harrison’s vice president, planned to continue living in his Williamsburg home. He decided that the ailing Letitia would be more comfortable there than in Washington. Such an arrangement was possible since the vice presidency continued to remain a nonessential office.
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This plan dramatically changed with President Harrison’s death one month after his inauguration. Tyler became the first vice president to succeed to the presidency upon the death of a president. Daniel Webster’s son, Fletcher, chief clerk in the State Department, and Mr. Beall, an officer of the Senate, interrupted the Tylers’ rustic peaceful existence with the shocking news. It was then decided that Letitia would move to the White House, but it was apparent that she was unequal to the role of first lady. Her daughter-in-law Priscilla, a former actress, became the social mistress of the executive mansion, the second of the surrogate first ladies. Fortunately, an old and successful hand was available for guidance, as we shall see.
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As President Tyler had the social intuition to select as his official White House hostess one who could match his easy informality, he accordingly asked his daughter-in-law Priscilla to perform this responsibility and took her consent for granted as his wife was an invalid; his two older daughters were married; and his two younger daughters were either inexperienced or too young. Priscilla’s responsibilities included presiding at biweekly receptions, triweekly dinners, monthly public levees, and the entertainment of callers who every night crowded the White House Green Room. Occasionally one or several of the Tyler daughters would assist, but from April 1841 to March 1844 the responsibility was chiefly that of Priscilla Cooper Tyler.
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When in doubt, she had that most experienced of White House hostesses available for advice. Dolley Madison had returned to Washington and subsequently assisted Priscilla in her social duties. The widow Madison, “turbaned, painted, powdered, and dipping snuff was in and out of the White House like a good neighbor.” Mrs. Madison, who had frequently served as the hostess for the widower Thomas Jefferson, was the first surrogate first lady
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: “After a short time she became more accustomed to her stellar role and pleased the President and amazed herself by performing her duties with what seemed easy grace.”
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Priscilla continued in this role until her husband accepted a government job in Philadelphia. The Tylers’ second daughter, Letitia Semple, briefly acted as hostess until the president’s young wife, Julia Gardiner, took on the role after her wedding in June 1844. John Tyler’s new bride was thirty-one years his junior. The ex-president went on to sire seven more children with his much younger wife.
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Elizabeth Tyler, the third Tyler daughter, married William Waller in a White House ceremony on January 31, 1842. The wedding and the reception afterwards were the only public occasions at which Letitia Tyler appeared. She generally remained in her room, an invalid who avoided excitement of any kind. However, on the night of the wedding, she emerged, beautifully dressed, to celebrate with the bride and groom.
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Mrs. Tyler’s death was both unexpected and sudden. Daughter Letitia wrote her brother: “From the time she had been first stricken with paralysis, her health had been frail, but none of us anticipated an immediate, or even an early renewal of an attack, and far less, a sudden dissolution of her system.”
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On the morning of Friday, September 9, 1842, Dr. Thomas, the family physician, noted a significant change in the first lady and became alarmed that a recurrent stroke was imminent. He immediately called for the consultation of Dr. Sewall. The methods used by these practitioners to prevent a cerebrovascular accident are unrecorded. Whatever treatments that were employed were unsuccessful. Mrs. Tyler declined rapidly and expired at 8:00 p.m. on Saturday, September 10, 1842.
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President John Tyler, by all accounts, was healthy during his White House tenure (1841–1845). There is no record either of illness or of professional medical care during his presidency. However, his term in office was not tranquil. Tyler was confronted by contentious foreign issues, domestic policy disputes, political disappointments, and the illness and demise of his wife. After he departed from the White House, he devoted himself to his much younger second wife, a growing family, and his Virginia farm. He occasionally involved himself in politics, the most notable example his election to the Confederate House of Representatives in 1862. He died in Richmond, the capital city of the confederacy, seventeen years after leaving the presidency.
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John Moylan Thomas and Thomas Sewall were the two District physicians who attended the first lady at the end of her life. Moreover Dr. Thomas had made “almost daily visits” to the failing first lady for many months prior to her demise. Thomas was also the doctor to President Tyler, although any medical care for the president is undocumented.
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Thomas was well trained, receiving his medical degree from the University of Maryland. He started a medical practice in Washington, D.C., and also became involved in the profession’s organizational and academic activities. He was active in the District of Columbia Medical Society and represented the society at the 1848 inaugural meeting of the American Medical Association in Baltimore. He later became a professor at Washington’s Columbian Medical College.
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However, Dr. Samuel Busey, a contemporaneous practitioner in the District, was very critical of Thomas’ personal character. He recollected that Tyler “came leisurely, after time, to his lectures on physiology (at the Columbian College), which were brief, polished, and unsatisfactory. He was always neatly dressed in the latest style, dignified, polite, but very reserved. At that time he had a very large business among the better class of citizens, and lived sumptuously.” A later citation by Busey even suggested an addiction to alcohol: “Some years later I parted with him in front of John Foy’s saloon about one hour before he wrote a prescription, it was alleged, killed a porter at Fuller’s Hotel, and the last time I saw him he was struggling, with assistance, to respond to a summons to see Mrs. Adams.”
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Dr. Busey was more complimentary of Dr. Thomas Sewall, the second physician present at Mrs. Tyler’s deathbed: “In 1825 Thomas Sewall, a native of Massachusetts and a graduate of Harvard University, delivered the first lecture in the Medical Department of Columbian University. From that date until his death in 1845, at the age of fifty-nine years, Sewall was one of the most conspicuous and popular physicians of the city.” Sewall’s professional career in Washington was both prominent and successful: Charter professor of Anatomy and Physiology at Columbian University, the predecessor of the George Washington School of Medicine; astute promoter of William Beaumont’s groundbreaking experiments on gastric physiology; and assistant surgeon in the 1839 removal of a seven-and-a-half pound tumor of the jaw of a prisoner at the Washington almshouse.
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Sewall’s civic accomplishments were also numerous. He had been known to President Tyler since the chief executive appointed him as one of the three medical inspectors of the federal penitentiary in the District and reappointed him in 1844.
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During his career, Sewall was involved with some of the more colorful aspects of nineteenth-century medicine in America: grave robbing (body snatching), phrenology, and temperance. The unavailability of bodies for medical teaching purposes was decidedly an impediment to eighteenth- and nineteenth-century physicians in England and the United States. The number of legally available cadavers was greatly inadequate for the development of anatomical familiarity and surgical skill. The only lawful sources of bodies were executed criminals and bodies bequeathed to medical schools for study. As a consequence there was an enormous imbalance between what numbers were available and the numbers required. It was estimated that in 1878 in the United States, at least half of the cadavers studied in medical schools were illegally acquired: “A body will sell for five dollars anywhere, and in Ohio and other states thirty dollars is the usual price.”
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