Infectious Diseases Case of the Month #14

4th of July Special Edition

Zachary Taylor, "Old Rough and Ready," 12th president of the United States, became ill shortly after attending a ceremony dedicating the construction of the Washington Monument on a swelteringly hot July 4th 1850. Five days later, July 9th 1850, he succumbed to the progression of this illness.

A hero of the Mexican War, President Taylor had been elected in 1848 as a candidate of the Whig Party. His election occurred in the midst of the deepening sectional crisis between North and South that ultimately would result in the American Civil War. His candidacy had been attractive because of his status as a war hero and to southerners because he was a slave holder on his Louisiana property. Although he had never himself even voted in a presidential election, he defeated Lewis Cass, Democratic Senator from Michigan, and Martin Van Buren, candidate of the Free Soil Party.

The acquisition of vast new former Mexican territories deepened the divisions between North and South as debate centered on whether slavery would be permitted in these lands. Much of the brief Taylor presidential tenure centered about this issue. President Taylor confounded and angered his fellow southerners with his staunch opposition to the extension of slavery to these regions where it had previously been abolished by Mexico and his adherence to Union. At one time when prominent southerners threatened secession, President Taylor is alleged to have threatened to "hang them with less reluctance than he had hung deserters and spies in Mexico."

In the midst of all the stresses of these and other issues it was likely a welcome diversion to attend July 4th stone laying ceremonies dedicating the construction of the Washington Monument. President Taylor listened to a long oration under a blazing sun. Afterwards he consumed considerable quantities of cold liquids including iced milk and like quantities of raw fruit, likely cherries. Within hours he was ill with nausea and cramps.

Over the succeeding days he had persistent intestinal symptoms including diarrhea and was said to have intermittent fevers. He was treated by his doctors with calomel, opium, and quinine. By July 6 he seemed better only to relapse with progressive diarrhea and prostration despite his doctors continued ministrations. By July 9 he appeared moribund. Last minute bleeding and blistering by his doctors was of no avail and he passed away at 10:35 P.M. that night.

       
What was the most likely cause of President Taylor's illness and death?
   
     
Diagnosis: Cholera morbus
   

President Zachary Taylor died of cholera morbus according to his treating physicians.

In reality, of course, it is not known what was the cause of President Taylor's death in a modern sense. His prominent gastrointestinal symptoms suggest an acute gastroenteritis, and the consumption of iced milk and raw cherries could have certainly provided him with a food/beverage-borne pathogen. It is quite possible that the treatments he received could likewise have contributed to his death.

Cholera morbus is a now archaic medical term that referred to intestinal illness in which diarrhea was a prominent feature. It was an illness distinct from the disease, cholera, (the illness now known to be due to Vibrio cholera) which featured more profound dysentery. Other informed speculation has suggested that President Taylor may have suffered from heat stroke, but the absence of prominent neurological symptoms makes this seem unlikely. Salmonella species could have been the cause of diarrheal illness, but typhoid fever would have been unlikely as its incubation period is usually longer than was observed in the case of President Taylor.

This case illustrates limitations of 19th century medicine and the profound effects of infectious diseases historically. A male born in 1850 had a life expectancy of 38.3 years, and the leading cause of death at that time was infectious disease. The life of Zachary Taylor is very instructive in respect to this. He was born in Virginia in 1784 and was a lifelong soldier. During his career he often encountered illness including dysentery, yellow fever (acquired either in Kentucky or Louisiana in 1809) and malaria (Kentucky 1810 and likely in Florida in 1839 during the Seminole War and in Louisiana in 1844). Taylor's daughter, Knox, who married Jefferson Davis, died of malaria. During the great congressional debates of Taylor's presidency between Henry Clay, John Calhoun, and Daniel Webster, Calhoun was dying of consumption (tuberculosis) but still made appearances on the floor of Congress. (Imagine the infection control violations!)

Taylor was succeeded to the Presidency by his vice-president, Millard Fillmore. A northerner, Fillmore was much more accommodating to southern interests than had been Taylor, a southerner. There followed the Compromise of 1850 with the ultimate sectional crisis therefore postponed until the election of Abraham Lincoln to the Presidency in 1860.

Posterity would not let Zachary Taylor rest in peace. Modern conspiracists speculated that he may have died from arsenic poisoning perhaps by southern sympathizers for his "betrayal" of the cause of extending slavery to the territories. His body was exhumed in 1991. Analysis revealed only traces of arsenic making this an unlikely possibility.

That Zachary Taylor's illness began on July 4th is a historical coincidence in company with others. Presidents John Adams and Thomas Jefferson, architects of our system of govern- ment, both died within hours of one another July 4th 1826.

Happy 4th! --  but watch what you eat!

Ref: Bumgarner, The Health of the Presidents, McFarland & Co., Jefferson, NC, 2003


 

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