During the smallpox epidemic of 1764 in Massachusetts, Adams, pressured by his mother 2b, decided to be inoculated. This was no small matter, as vaccination eventually became in the 20th century. Patients prepared themselves days ahead of time, and were often sick for weeks afterwards 3. Comment: Inoculation is different from vaccination. Inoculation introduces smallpox virus into the recipient. Vaccination introduces vaccinia virus into the recipient. Vaccinia confers protection against smallpox infection, but with far fewer side effects, since it is a much less virulent virus. Edward Jenner, the inventor of vaccination, should be high on everyone's list of greatest-ever human beings.

Ultimately, Adams was inoculated and spent three weeks in the hospital, suffering headaches, backaches, kneeaches, gagging fever, and eruption of pock marks MORE.

Adams kept a diary, wrote many letters, and wrote an autobiography. "On or near his birthday in most years, Adams reflected in his diary on the previous twelve months. During his twenties and early thirties, he never mentioned ill-health; 'feel well,' he sometimes observed in these annual inventories" 4a.

Comment: Ferling and Braverman 4 appear to have missed the 1756 episode of illness, related below.

There may have been some hair loss during his Presidency 3a.

Fourteen years later, Adams was still on this "milk and toast" diet 2c, leading to one description of him as a "food faddist" 3b. "Sometimes Adams would purge himself by taking a vomit of tartar emetic and turpeth mineral, a cathartic prepared from East Indian jalap" 3c. This preparation, Adams lamented, "worked seven times and wrecked me" 3c.

A descendant noted that during the time Adams lived in Philadelphia, he "throve well on turtle, jellies, varied sweetmeats, whipped syllabubs, floating islands, fruits, raisins, almonds, peaches, wines, especially Madeira" 3d.

The next day Adams felt well enough to theorize: "The Ship rolls less than Yesterday, and I have neither felt, nor heard any Thing of Sea Sickness, last night nor this Morning.... The Mal de Mer seems to be merely the Effect of Agitation. The Smoke and Smell of Seacoal, the Smell of stagnant, putrid Water, the Smell of the Ship where the Sailors lay, or any other offensive Smell, will increase the Qualminess, but do not occasion it.

Adams also chewed tobacco, at one point betting a pair of gloves with his landlady (Mrs. Willard, 1856) that "she would not see me chew tobacco this month." The result: "Adams loved tobacco too much to give up the weed" 3e.

The symptoms would cluster in time. The shortest of these clusters lasted weeks. The longest lasted years. The 1781 episode supposedly had him comatose for 5 days.

Dr. Zebra spent a huge amount of time trying to convince himself that hyperthyroidism was responsible for these illnesses, as per the theory of Ferling and Braverman 4, but remains unconvinced. Blinderman 3 labels many of these episodes merely as "colds" and accepts that Adams was susceptible to catching cold. Bumgarner 2d suggests that allergies may have been involved.

Comment: There is no obvious way to make sense of it all on the basis of organic illness. Read the tabulation of Adams's ailments and judge for yourself, remembering that the man lived to age 90 -- clearly the [non-]hypochondriac's epitaph ("I told you so") did not apply to Adams. Still, "hard findings," such as Adams' 5-day coma in 1781, cause Dr. Zebra to keep an open mind. For example, Adams had several features of variegate porphyria, a protean disease that can be triggered by psychological stress. The "hard" features that Adams had include coma, weakness, a chronic skin disorder, and a relapsing-remitting course over decades 8. MORE

Far more common than variegate porphyria, however, is somatization -- a disorder in which psychological ailments are translated into physical ailments. It is not an intentional process. No doubt Adams did have episodes of organic disease between 1756 and 1800, but the signal-to-noise ratio is too low to tease them out 200 years later.

As President, Adams was once again able to step back from work and politics. He left the capital when Congress was not in session, spending as much as two-thirds of each year at Peacefield, his home in Massachusetts 4b. This conduct was criticized, including accusations of "a kind of abdication." In 1799 a loyal supporter from Baltimore told Adams outright that the public was outraged by his continued absence: "The people elected you to administer the government. They did not elect your officers ... to govern, without your presence or control" 4c.

Adams had several classic signs and symptoms of hyperthyroidism, including: weakness, heat intolerance, sweating, tremor, protruberant eyes, weight loss despite eating well, and a growth in his neck (perhaps a goiter).

Comment: Their hypothesis is tenable because hyperthyroidism is one of the few disorders that can produce enough different symptoms to rival the symptoms Adams displayed. It is weakened, however, by the clear association of mental stress with the waxing and waning of Adams' illnesses. There are some reports that Graves disease (a common cause of hyperthyroidism, as George H.W. Bush discovered), can flare during stress, but the stress correlation in Adams is too profound to be explained by Graves disease. There is also the question of Adams' apparently complete remission from his unusual symptoms once he began the transition out of political life in 1800. Ferling and Braverman mention that little is known about the natural history of untreated Graves disease, so their hypothesis is not clearly able to explain this striking feature of Adams' history.

I would give three guineas for a barrel of your cyder. Not one drop of it to be had here for gold, and wine is not to be had under sixty-eight dollars per gallon, and that very bad. I would give a guinea for a barrel of your beer. A small beer here is wretchedly bad. In short, I am getting nothing that I can drink, and I believe I shall be sick from this cause alone. Rum is forty shillings a gallon, and bad water will never do in this hot climate in summer where acid liquors are necessary against infection 2e.

It is often related that Adams' last words were: "Thomas Jefferson survives." In fact, "the last word was indistinct and imperfectly uttered" 3a.