The Health Of The President: James Madison

James Madison (1751 — 1836)

When James Madison was President, Washington Irving described him as a “withered little Apple-John.” He meant the exquisite kind of apple which attains its finest flavor when it looks wrinkled and shrunken. Since early childhood Madison appeared delicate and fragile and never displayed youthful vigor and exuberance. He had the high, bald forehead and the worried look of a premature infant born into a world for which it is not ready.

Madison was about five feet six inches tall. His weight hardly ever exceeded a hundred pounds. The smallest of all American Presidents, he was one of the mental giants among them. On the other hand, his emotional range was limited. He seems to have been incapable of the fire of passion or of suffering on the rack of guilt, like Jefferson and Lincoln.

The flame of his life burned slowly within his meager frame and could rarely be fanned to a faster pace by the whirlwinds that shook the world around him. He was one of the Presidents who had to bear the crushing responsibility of a war of life and death. And the War of 1812 was possibly the most ill-prepared and inconclusive of all American wars and the most unnecessary. The frail President often looked gloomy and exhausted from his labors and disappointments but never seems to have lost his composure, remaining at all times calm and dignified.

In 1817, sixty-six years old, Madison retired from the Presidency, emotionally unscarred and physically none the worse for having given almost forty-one years of toil to his country. He lived nineteen years longer, most of them in comparative good health and comfort, to the age of eighty-five, the second oldest President up to recent times.

The principal factor influencing a man’s life expectancy is heredity. We do not know the ages of Madison’s four grandparents, but we know that his mother reached the age of ninety-seven and his father seventy-eight. Contributing to Madison’s longevity was the economy of circulatory and caloric energy with which his small thin body could be sustained, also his calm disposition.

Helping him to preserve his emotional equilibrium and physical stamina was his extraordinary wife, who was his perfect foil. He had the unusual good sense, at the age of forty-three, to fall in love with the widow Dolley Payne Todd, about seventeen years his junior, after having been jilted by two other women nine and eleven years previously. Dolley Madison gave him the companionship and affection that most men need in order to be at their best. She had a great and kind heart, unusual thoughtfulness and tact, as well as an extraordinary memory for names. The society women of Washington, D.C., at first looked down their noses at the President’s wife, who used snuff and rouge and wore flamboyant oriental headdress and French gowns; but her popularity soon silenced them.

A Quaker’s daughter, the widow was the mother of two children. Her first husband and the younger child were victims of the yellow fever epidemic in Philadelphia in 1793. Dolley herself was reportedly stricken by the fever. Her elder child, a son, appears never to have amounted to much, sponging on his mother up to her death at eighty-one in Washington, D.C. It was Aaron Burr who introduced the voluptuous-looking young woman to his austere, apparently sexless classmate from Princeton, and James Madison, with unusual speed, overcame his shyness and proposed. He was accepted after the proper waiting period.

It is not impossible that Dolley married the old bachelor, who was a head shorter than herself, for the sake of security and social prestige. After all, Madison came from a prominent family; he was a gentleman; and had already made a name for himself as the chief author of the American Constitution and the Bill of Rights. Apparently he faced a great political future. Dolley soon learned to admire her husband’s mind and to love his sweetness and considerate nature. They had no children, but with the years she bestowed all her maternal affection upon her “Little Jemmie,” who returned her love in his unostentatious way.

Madison was born in Montpelier, Orange County, Virginia, the eldest of twelve (?) children. From early infancy his frail and puny appearance deceived his parents and doctors, who believed that he was doomed to fall early prey to the host of diseases surrounding him. With these forebodings, his family, being in comfortable circumstances, gave the firstborn son all possible care and protection. Surviving the critical first decade, he received an excellent education in the classics, French and Spanish.

At eighteen James was considered ready for college. Doctors advised against sending the delicate youth to William and Mary, located at Williamsburg on the swampy peninsula between the James and York Rivers—the fashionable college, where the sons of Virginia landowners acquired their education and the germs of malaria. In order to avoid exposure to the “bilious fever” of the southern lowlands, James was sent north to the healthier climate of the College of New Jersey at Princeton. He became an outstanding student, working so hard and sleeping so little that he could finish the three-year course within two years. After his graduation, he continued his studies, taking Hebrew and Ethics, which was construed as an indication that he contemplated entering the ministry.

However, Madison was full of indecision and returned home. He was twenty-one years old and probably in the stage of delayed adolescence, deeply disturbed and unsure of himself, his emotional equilibrium oscillating with the changing balance of his hormones. He felt unable to tear himself loose from the close family ties and strike out on his own. Added to these conflicts was the primitive sense of physical inadequacy felt by every man deficient in the male attributes of size and strength compared with his competitors.

The stress of all these factors was too much for him and resulted in a depressive reaction characterized by brooding inertia, hypochondria, and wishful expectation of an early death. Contributing to his depression was the shocking news that his roommate and best friend at Princeton, Joseph Ross, had suddenly died. In the summer of 1772, he wrote to another friend, “As to myself, I am too dull and infirm now to look out for any extraordinary things in this world, for I think my sensations for many months have intimated to me not to expect a long or a healthy life . . . therefore have little spirit or elasticity to set about anything that is difficult in acquiring, and useless in possessing after one has exchanged time for eternity.”

At the same time Madison suffered from strange seizures during which he suddenly appeared to be frozen into immobility. These attacks were diagnosed by his doctors as epilepsy. Modern historians assumed these episodes to have been of a psychophysiologic nature and manifestations of epileptoid hysteria. In psychoanalytic terms, they probably represented a “conversion reaction” whereby some of the patient’s frustrations are relieved by conversion into physical disability.

Madison had the good fortune of having an unusually progressive family physician who did not resort to the customary practice of draining depressed patients of several pints of blood, supposedly containing the mythical black bile of melancholia. The doctor tried to strengthen his patient by physical exercise, like horseback riding and walking. He encouraged him in all kinds of diversions which might take his mind off himself and reawaken his interest in the world around him, and finally sent him away to another climate, to Warm Springs in western Virginia.

Eventually, chance provided Madison with the shock he needed to be jolted out of his depression. It was the cry of a persecuted minority of Baptists in Virginia which stirred his sympathy. The ideal of religious freedom was closest to his heart, and its violation by his very neighbors aroused in him a healthy indignation. In Princeton he had learned to consider the ideals of humanism as embodied in the principles of democracy, not as nebulous theories but as guiding stars toward human progress.

A veil fell from his eyes and suddenly he knew what he must do with his life. He would devote it to working for his ideals and the betterment of his fellow man. In vigorous language he wrote a pamphlet contrasting the religious freedom in Pennsylvania with the intolerance in Virginia. Soon after, he accepted the election to the Committee of Safety in Orange County, his first office in public service.

In 1775, an epidemic of enteric fever swept over the colonies. Madison, twenty-four years old and considered unfit for military service, was one of the few members of his family who did not contract the violent infection which carried away a younger brother and a sister.

The following year he was elected delegate from Orange County to the Virginia constitutional convention, charged with framing a new constitution. He introduced a resolution for religious freedom, which was rejected at the time. He had the hearty support of Thomas Jefferson, already well known for the Declaration of Independence. During their close cooperation in the governors’ council in 1778, Jefferson recognized the great potentialities of Madison and the kinship of their minds. Thus began their lifelong friendship.

In 1787, Madison reached the climax of his career, framing the American Constitution in which he reconciled the states’ rights ideas of Jefferson with the Federalist tendencies of Hamilton. Convinced of the necessity for a strong central government, he cooperated with the latter in advocating it. During the next year he saw himself forced to fight for the adoption of the Constitution and achieved a great political triumph by overcoming the violent objections of the diehard states’ righters of Virginia, led by Patrick Henry, whose booming oratory Madison refuted by the cold facts in his barely audible speeches.

At the time of the crucial debates, Madison was handicapped and enfeebled by an attack of malaria, a disease his parents had endeavored to spare him but which nevertheless plagued him repeatedly during his later life.

In October 1788, Madison campaigned for election to the first U.S. Congress against James Monroe, who had voted against the ratification of the Constitution. The weather was unusually cold and during a long ride, his ears and nose were severely frozen resulting in open sores followed by visible scars—Madison afterward pointed to them with pride as his battle scars. Unquestionably, this was his way of answering the election propaganda of Monroe’s supporters, who vaunted their hero’s war record and the scars won by shedding his blood for his country, while Madison stayed at home spilling ink. But in spite of “waving the bloody shirt” that all through history proved to be a magic lure in attracting votes, this time the pen was mightier than the sword; the statesman Madison won over the soldier Monroe by a wide margin.

In the fine spring weather of 1791, Thomas Jefferson, Secretary of State, and James Madison, member of Congress, rode northward from Philadelphia on a “botanizing” excursion. In Vermont, they were arrested for riding in a carriage on Sunday. Actually, they wanted to clear their brains from the poisonous political atmosphere of Philadelphia. On this trip their plans matured for the founding of a new party which would uphold the democratic principles of the Revolution against Hamilton’s cynical depredations and the reactionary drift of his Federalist Party. No politics were mentioned in their letters; when they wrote letters home about strawberries in bloom and the speckled trout they caught, they were really pondering how to catch the souls of men.

During the Federalists’ heyday in 1797, Madison, in disgust, tried to retire from the bedlam of politics and bury himself at his farm in Montpelier. But like Jefferson, he was not granted his wish for very long, but was summoned again by the call of his conscience. In 1798, the Alien and Sedition laws compelled the two friends to break their silence and draw up a resolution declaring these acts unconstitutional and not binding upon the states, a resolution adopted by Kentucky and Virginia.

In March 1801, to his deep regret, Madison was unable to witness the crowning reward of a decade of unstinting labor: the inauguration of his friend Jefferson as the first President from the “new Republican” Party—their creation. He could not leave Montpelier because his father was critically ill, to die soon after. For the same reason he was unable to take up his duties as Secretary of State until May 3.

In October 1805, Dolley Madison wrote of a recurrence of her husband’s “old complaint.” “I saw you in your chamber, unable to move.” The immediate cause of this symbolic expression of frustration at that time is unknown, but quite likely it followed one of the humiliating acts of piracy by the English navy against American ships, acts of violence against which the Secretary of State lacked any stronger means of retaliation than futile paper protests.

President Jefferson’s choice of Madison as his successor was not as much motivated by friendship as by his belief that Madison would be able to maintain the uneasy peace with England and France. He hoped that Madison could muddle through long enough, keeping the nation out of war until the holocaust in Europe had burned itself out and the threat of its sparks had passed. On the occasion of his inauguration Madison appeared for once to be overcome by the grave responsibility thrust upon him. He was extraordinarily pale and visibly trembling when he began to speak.

In June 1813, after a year of war disasters, Madison was seized by a severe febrile disease which was diagnosed as malaria. Preceding his sickness, sleepless nights and loss of appetite had wasted him, robbing him of his physical reserves. Monroe, then his Secretary of State, reported that for two weeks “The fever has, perhaps, never left him, even for an hour, and occasionally the symptoms have been unfavorable.” The fever continued for more than three weeks, and the physicians did not dare, during his high temperature, to give their patient the bark of quinine.

Like his friend Jefferson, Madison felt greatly relieved when he could retire from the toil of the Presidency into the well-deserved peace of his country home. But also for him there was to be no peace, and the last years of his life were clouded by a continuous struggle for economic survival. Again and again, he had to sell parcels of his land to meet his most pressing debts. His residence fell into disrepair. Like Jefferson, Madison up-held the tradition of Virginia hospitality, and treated his friends and visitors to the best he could provide. According to a friend’s description, the host’s conversation was rich in sentiment and facts, “enlivened by episodes and epigrammatic remarks . . . His little blue eyes sparkled like stars under his bushy gray eyebrows and amidst the deep wrinkles of his face.”

Occasionally, as in 1821 and 1832, he suffered chills and fever, thought to be relapses of malaria, and was treated with quinine. He was quite ill in 1827, and also in 1829 before he served once more as delegate to the state convention. Gradually his little body shrank more and more to skin and bone. In 1834 his eyesight began to fail and he became deaf in one ear.

For several years preceding his death, Madison was plagued by rheumatism, affecting especially his arms and his hands. He was suffering from some kind of deforming arthritis, a chronic inflammation and degeneration of the ligaments, cartilages and bones connected with the joints. This condition gradually grew worse by periodic exacerbations. Scar tissue formed about the diseased joints, causing painful limitation of motion and increasing stiffness. The arthritis crippled the wrists and the fingers of the right hand so severely that with the narrowing arc of mobility Madison’s handwriting shrank to minute size. Eventually, he was unable to manage the knife, and the food had to be cut for him.

In time he had to give up all his customary physical activity, his daily drive and even his walk to the porch, and spent all of his time in the bedroom. Here he had his meals on a small table placed near the door of the dining room so that he could chat with his guests. As in most people with superior intelligence, his mind and his memory never deteriorated. His listeners found him bright and alert up to the last.

Unquestionably, he was suffering from the aging process of progressive arteriosclerosis—degeneration and narrowing of the arteries of the brain, kidneys and heart that gradually impaired the function of these organs. The ultimate outcome of this process is the progressive restriction of the vital functions, often accelerated by occlusion of essential blood vessels by blood clots.

As his helplessness increased, Dailey Madison, aided by his favorite niece, devoted more and more of her time to his care. The stoic patient never complained. During the last week of June 1836, it became apparent to his doctors that the end was only a question of days, and they advised Madison to take stimulants which might prolong his life to July Fourth. But, true to his unpretentious sincerity, Madison declined to meddle with his destiny for the sake of vainglory.

On the morning of June 28, 1836, he was moved from his bed to his table as usual. His niece brought him his breakfast, urging him to eat, and left. When she returned after a few minutes, he was dead. He died as he had lived, simply, undramatically.

Comments 6
  1. Yes, excellent article. And well written; no small thing these days, unfortunately. It really humanizes Madison; it’s a portrait of a real, living person, not just one of the great, larger than life iconic figures of the founding of the nation.

  2. I have read extensively on Madison without gaining insight to his aliments. William James said that the physical, psychological, and spiritual are inseparable. Your article has helped me see the man better as a whole.

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