In this period of his life, Madison escaped the scourges of his day, i.e. malaria, smallpox, tuberculosis, and yellow fever, but was neurotically convinced that his body harbored some insidious disease -- an obsession he overcame only after tremendous determination 1.

After his death, his brother-in-law attempted to describe this illness in the best possible light. In three drafts, he descibed Madison's "constitutional liability to sudden attacks" variously as: "of the nature of epilepsy, " "of a character and effect which suspended his powers of action," and as the reason Madison did not enter military service 4b. Comment: Imagine if Madison had joined the military and been killed before writing the Constitution!

Writers since 1940 have spilled much ink debating whether Madison's spells were a psychiatric illness or a physical illness. Psychiatrically, labels such as "doubtless hysteric" 1, "epileptoid hysteria" 5a, "conversion reactions" 3b, and panic attacks 4c have been proposed -- all of which may be classed as "psychogenic non-epileptic seizures" 4c. Others believe that Madison had the physical illness of epilepsy, perhaps with petit mal seizures 2b. Comment: It would be interesting to tabulate all eye-witness accounts of Madison's spells, looking for the motor and autonomic epiphenomena that typically accompany petit mal seizures 6a.

My dear Husband is still confined to his bed -- In addition to a disabling Rheumatism throughout the winter, he has had a bilious fever, which has reduced him so much that he can only walk from one bed to another. I never leave him, more than a few minutes at a time, and have not left the enclosure around our house for the last eight months on account of his continued indisposition ... Our Physicians have advised the warm springs for Mr Madison, and we hoped to have him taken there, but as he could not travel unless conveyed in his bed, we dare not think of it for the present. 1