Health and Medical History of President

Ulysses Grant

President #18: 1869-1877
Lived 1822-1885
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Health and Medical History of President

Ulysses Grant

President #18: 1869-1877
Lived 1822-1885
Lived 1822-1885 2023 1776
Revolutionary War
War of 1812
Mexican-American War
Civil War
Spanish-American War
World War 1
World War 2
Korean War
Viet Nam War
Desert Storm
Bush's Wars

Maladies & Conditions  · malaria · small · alcohol use · tobacco use · snored · seasick · leg cramps · horse fall · severe cold · tooth extraction · chills and fever · headaches and fever · small but strong · malaria, probably · ankle injury · multi-system misery · horse fall · boils and headaches · ankle injury · worn · strong · fall, immobility, embolism · oral cancer, yet assiduous

Odds & Ends · Doctors · Resources · Cited Sources

Maladies and Conditions
When Grant developed a year of fever and chills in 1858 (age 36) he stated, "I had suffered very severely from this disease while a boy in Ohio" 1a. This was likely malaria.
Grant was 5' 1'' and 117 pounds when he started at West Point, and 5' 7'' when he finished. His weight, however, was again 117. He had been suffering from a respiratory ailment that suggested tuberculosis, but likely was not. 1b.
alcohol use
Alcohol plagued Grant, as chronic disease plagues any human. His disease pattern was consistent: "a solitary binge drinker who would not touch a drop of alcohol, then succumb at three- or four-month intervals, usually on the road" 2a. MORE

A modern biographer, Ron Chernow, concludes:

Alcohol was not a recreation selfishly indulged, but a forbidden impulse against which he struggled for most of his life. ... While drinking almost never interfered with his official duties, it haunted his career and trailed him everywhere, an infuriating, ever-present ghost he could not shake. It influenced how people perceived him and deserves close attention. As with so many problems in his life, Grant managed to attain mastery over alcohol in the long haul, a feat as impressive as any of his wartime victories. 2a
Chernow admits, however, that this is not the last word: "a thoroughgoing account is needed to settle the matter" 2a.
tobacco use
How much tobacco did Grant use? We see him chewing tobacco as early as 1845 1b. During the first Battle of the Wilderness, he was seen to smoke 20 cigars from sunup to sundown 1c. In a May 1866 newspaper interview, Grant said "When I was in the field I smoked 18 to 20 cigars per day, but now I smoke only nine or ten per day" 1d. MORE

Like so many tobacco users, Grant gave up smoking when it was too late. Suffering chronic pain and diagnosed with an incurable oral cancer that was caused by tobacco, Grant was racing against his disease to finish writing his memoirs, so that his wife would not be destitute. Grant told friends on November 20, 1884:

Gentlemen, this is the last cigar I shall ever smoke. The doctors tell me that I will never live to finish the work on which my whole energy is centered these days... if I do not cease indulging in these fragrant weeds. It is hard to give up an old and cherished friend, that has been your comforter and solace through many weary nights and days. But my unfinished work must be completed, for the sake of those that are near and dear to me. 2b

He would die in nine months.

Reliability of this information is uncertain. 3
Became seasick during a 3-day gale on the Pacific in September 1852 2c.
leg cramps
Developed cramps in his legs and feet in December 1852 2c.
horse fall
While riding a pony on a muddy road, circa 1853, it slipped and fell atop Grant, "leaving him bruised and disheveled and giving rise to reports that he was drunk." This led to formal accusations in the Army. Grant protested that he had not been drinking, but ended up agreeing not to drink any more 2d.
severe cold
Suffered from a severe cold in July 1853 2e.
tooth extraction
Had a troublesome tooth extracted in the first half of 1854. His face afterwards swelled up until it was "as round as an apple." He thought he looked 45 years old 2f. (He was then 32.)
chills and fever
In February 1854 he developed chills and fever and had to be treated for "severe attacks" (but of what, is not said) 2f.
headaches and fever
He was "beset by ailments, including migraine headaches and fever" in spring 1854, while stationed at Ft. Humboldt 2g.
small but strong
According to Henry Clay Wright in spring 1855, Grant was "a small, thin man" 2h. In late 1856 his mother-in-law told her daughters "That small man will fill the highest place in this government" 2i.

Yet, according to his adoring wife, he could lift 200-pound beams and could ride 50 miles in a day without breaking a sweat 2j.

malaria, probably
Grant was sick with fever and chills for a year in 1858, and said it was the same illness that "severely" afflicted him as a boy in Ohio 1a. Bumgarner recognizes that a year of illness would then have been unusual for malaria because it was easily treated with quinine... if the treatment is done correctly. Grant's son had typhoid fever during this interval, and his wife was also affected with fever and chills 1a, so there could have been multiple diseases circulating in the household, or he could have been infected with malaria more than once.

It is also likely that Grant's illness contributed to his failures in life at that time 1a.

ankle injury
Grant injured his ankle a few days before the battle of Shiloh, in April 1862. It was still swollen and painful on the morning the battle began. 1e
multi-system misery
In the preliminaries to Vicksburg, in 1863, Grant was suffering from boils, indigestion, a sore mouth (his servant threw away his only set of false teeth, requiring him to gum his food), and headaches. 1e
horse fall
The organizer of a troop review near New Orleans on September 4, 1863 gave Grant a horse to ride -- a "vicious and but little used" animal, according to Grant. Various recollections describe different events, but Grant said a locomotive whistle startled the horse, who dashed off, then crashed into a carriage. Grant, an excellent rider, remained in the saddle, but the horse fell with its entire weight onto his leg, also knocking him unconscious. 2k

Carried on a litter to a nearby inn, Grant was put to bed, unable to move the leg. He recalled, "My leg was swollen from the knee to the thigh, and the swelling, almost to the point of bursting, extended along the body up to the arm-pit. ... The pain was almost beyond endurance." Grant was confined to bed until the end of the month, when he started using crutches for the next two months. 2l

Whether alcohol contributed to the accident is unclear. Persons hostile to Grant certainly said so. Friendlier generals, even in private correspondence, did not mention alcohol. 2l
boils and headaches
At the Wildnerness (May 5-7, 1864), and after Spotsylvania (May 8-21) and Cold Harbor (May 31-June 12), Grant suffered from boils and headaches. 1d
ankle injury
Headaches afflicted Grant both the day before and the day of Robert Lee's surrender at Appomattox Courthouse. Six hours before the surrender, Grant's aide found him pacing outdoors, holding his head with both hands. Coffee provided some relief. 1d
Within weeks of taking office, the throngs of office-seekers were wearing him down, Harper's Weekly having observed that "The chief business of the executive had become the distribution of patronage" 2m -- an example of why civil service reform under Chester Arthur was so important. Grant complained that he could "scarcely get one moment alone" and that he had "no peace" 2n.
According to his less-than-objective wife, Grant could perform 25 or 30 chin-ups without exertion even while President 2j.
fall, immobility, embolism
At age 61 Grant was still physically robust, although 30 pounds overweight. Then, on Christmas eve 1883 he slipped on ice in Manhattan and fell, severely injuring his left thigh 1f 2o. Days later he developed pleurisy (pain with each inhalation, caused by inflammation of the sac that wraps the lungs). He was unable to walk for several weeks, and was further beset by headaches, boils, bedsores, insomnia, and "rheumatism" in his legs 2o.

Comment: As Bumgarner recognized 1f, pleuritic plain after a protracted period in bed raises the possibility that Grant developed a blood clot in one of his legs. (The bedsores alone indicate the extent of his time in bed, and the "rheumatism" in his legs could have been the pain of a deep vein thrombosis, i.e. blood clot.) If the blood clot dislodged and traveled ("embolized") to his lungs, pleurisy could result.
    There is a second possibility. Given that Grant's cancer became symptomatic six months later, a blood clot in the lungs could have been a side effect of the cancer, a combination known as Trousseau syndrome. This can occur before a cancer becomes symptomatic. However, Trousseau syndrome seems less likely because there are no reports of later clots, which would be expected, and because Grant's tumor was "epithelial" rather than a mucin-producing adenocarcinoma.

This episode altered Grant. He continued to be stoical and uncomplaining, but "he had grown very old-looking ... and his face looked as though some great sorrow had befallen him," according to an acquaintance. By February he was moving about the house on crutches, still bothered by leg pain. 2p

Even into July (1884) he remained weak and lame, using crutches 2q. At least through October he was still using crutches 2b.

oral cancer, yet assiduous
On June 2, 1884 Grant stopped and winced as he swallowed a peach during lunchtime, saying "Oh my. I think something has stung me from that peach." He left the table, paced back and forth on the porch in distress (limping), and rinsed his throat multiple times, but remained in great pain, saying "water hurt like fire." The pain persisted all summer, intensifying in July. About then, Dr. Jacob Mendez Da Costa examined him and found a growth on the roof of the mouth. He prescribed pain medication and recommended Grant consult his family physician, Dr. B. Fordyce Barker, as soon as possible. Dr. Barker was on a European trip, however, and so Grant did not see him until October 2r

After discovering a suspiciously swollen area on the back of the tongue, Barker referred Grant to Dr. John Douglas, a throat specialist. Douglas, too, found a hard, swollen area on the back of the tongue and, using a mirror, saw three lesions on the roof of the mouth. Grant asked, "Is it cancer?" Douglas replied, "General, the disease is serious, epithelial in character, and sometimes capable of being cured" ("epithelial" being a euphemism for "cancer" in that era). Douglas lessened the pain by topical application of cocaine and swabbed away tissue debris and mucus from the area, recommending that Grant return twice daily for repeat treatments. He did this, for a time riding a public streetcar to and from Douglas's office, no doubt startling his fellow passengers with his presence. 2s

In Chernow's unforgettable phrase, "Gradually Grant was ground down into a mass of pain" 2b. After a severe attack of neuralgia, his dentist extracted three teeth without anesthesia; this facilitated Douglas's cleanings, but did not lessen the pain 2b.

In November an eminent pathologist, Dr. George Shrady, reviewed some tissue Douglas took from Grant's tumor and was "perfectly sure" that it was "a lingual epithelioma -- cancer of the tongue." He forecast that Grant would endure agonizing pain and die within a year. Shrady told Grant himself that he suspected a connection between Grant's smoking and his cancer, and advised Grant to smoke at most one cigar a day. Grant lost his taste for tobacco soon after, and gave up smoking (see above). 2t

What followed was tragic and triumphant. Grant had recently been swindled and was broke. To provide for his soon-to-be widowed wife, he resolved to write his memoirs for publication, racing against the cancer. Despite suffering unrelenting pain and harboring a baseball-sized tumor in his neck, for four to six hours a day he would sit and write in an overstuffed chair, his legs up, a wool cap on his head, and a muffler around his neck. When he could not sleep, he wrote. 2u

He reluctantly took opiates to ease the pain, but that slowed his work. Because swallowing magnified the pain, he went without water and food for extended periods, to swallow less. His valet applied hot compresses to Grant's head and sprayed his throat with numbing "cocaine water." To spare his family, Grant maintained a stoic face... during the day. 2v

Despite all this, Grant's output was phenomenal, in both quantity and quality. Although a man of lifelong taciturnity, Grant could produce 10,000 words of superb, lean prose in a day (that's 40 double-spaced typewritten pages). All told, he wrote 336,000 words in one year. 2w

By May 1885, he was forced to dictate. His friend and publisher, Mark Twain, described Grant "never pausing, never hesitating for a word, never repeating" as he dictated 9000 words describing Lee's surrender at Appomattox Court House -- in one sitting. The quality of Grant's writing astonished Twain. "There is no higher literature than these [memoirs]... Their style is flawless... no man can improve upon it." 2v

Grant died July 23, 1885 -- a week after finishing the manuscript. He weighed 90 pounds. He had already told a pastor, "I am ready to go. No Grant has ever feared death. I am not afraid to die." 2x

Twain thought the book had kept him alive for several months 2x. It was an explosive, record-setting best-seller, providing his wife the modern equivalent of $14 million 2y. Grant's memoirs are recognized today as the greatest presidential autobiography ever written -- and one of the greatest autobiographies written by anyone, anay time.

Odds and Ends
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Cited Sources
  1. Bumgarner, John R. The Health of the Presidents: The 41 United States Presidents Through 1993 from a Physician's Point of View. Jefferson, NC: MacFarland & Company, 1994.
    a  p.105  b  p.103  c  p.109  d  p.110  e  p.107  f  p.111

    Comment: Devotes one chapter to each President, through Clinton. Written for the layperson, well-referenced, with areas of speculation clearly identified, Dr. Zebra depends heavily on this book. Dr. Bumgarner survived the Bataan Death March and has written an unforgettable book casting a physician's eye on that experience.

  2. Chernow, Ron. Grant. New York: Penguin Press, 2017.
    a  p.xxiii  b  p.931  c  p.76  d  p.80  e  p.81  f  p.83  g  p.88  h  p.93  i  p.99  j  p.96  k  p.302  l  pp.302-303  m  pp.640-641  n  p.641  o  pp.xvii, 920  p  p.920  q  p.929  r  pp.xviii-xix, 928-930  s  pp.930-931  t  p.931. Chernow has an error on pages 931-932 when he describes Julia Grant's 1876 praise of smoking as occurring after her husband's death. It was nine years *before* his death in 1885.  u  pp.xix, 931  v  pp.xix-xx  w  p.xix  x  p.954  y  p.953; conversion to 2023 dollars per:  z  p.78
  3. Dugan, James. Bedlam in the boudoir. Colliers. 22 Feb. 1947; pages 17, 69-70.

    Comment: Credibility is dubious. Just before a list of Presidents, the article states: "Twenty of the 32 Presidents ... are proved or believed on a thick web of circumstance to have been nocturnal nuisances in the White House."

  4. Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University Press, 1981.
    a  p.161  b  p.157
  5. Gary, Ralph. Following Lincoln's Footsteps. New York: Carroll & Graf, 2001.
    a  p.68
  6. Anonymous. Scanning a brain that's out of tune. Science News. 2002 Nov 23;162(21):334.

    Comment: Reports the results Catherine L. Reed and colleagues: To not hear music: A case of congential amusia. Society for Neuroscience meeting. November 2-7, 2002. Orlando, Fla.

  7. Pendel, Thomas F. Thirty-Six Years in the White House. Washington: Neale Publishing Company, 1902.

    Comment: Pendel was door-keeper at the White House from the time of Lincoln to the time of Theodore Roosevelt. Full text is available on-line at It is a rather dry book, and reads as if it were written by an old man.

  8. Stoddard, Henry L. It Costs to Be President. New York: Harper & Brothers, 1938.
    a  pp.236-238

    Comment: Stoddard was editor and owner of the New York Evening Mail from 1900 to 1925.

  9. Montgomery-Massingberd, Hugh (ed). Burke's Presidential Families of the United States of America. 2nd ed. London: Burke's Peerage Limited, 1981.
    a  p.323  b  p.322

    Comment: Maps -- in great detail -- the ancestors and descendants of American presidents through Ronald Reagan. They would have had an exhausting time with President Obama's family tree! MORE

Other Sources
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