Comment: This is relevant to Wilson's later stroke(s) because poor dentition has been suspected to increase the risk of atherosclerotic disease.

Wilson's first stroke was in May 1896. It caused marked weakness of the right upper limb plus sensory disturbances in the fingers. The finger problems were mis-diagnosed as neuritis. Wilson was unable to write normally for almost a year afterwards. Comment: There may be some dispute about this event, in a later article in the New England Journal of Medicine.

• November 1907 -- Developed weakness and numbness of fingers or right upper limb that lasted several months;
• July 1908 -- Two attacks of "neuritis" affecting the right upper limb;
• December 1910 -- Transitory weakness of the right hand.

• April 1913 -- Attack of "neuritis" involving right upper limb;
• May 1914 -- Abnormal retinal arteries observed;
• May-Sept. 1915 -- Episodes of transient weakness in his right hand.

Dr. Grayson sat up with Wilson all night. Vomiting and diarrhea developed. The fever did not break. Wilson could not sleep, which was unusual for him. Grayson decided it was influenza. The President stayed in bed the next day and from there even held meetings with rulers who braved the sick room. 1b

A night of burning fever followed, after which Grayson and Mrs. Wilson forbade all work. Wilson then slept for three days, fitfully. 1c

He awoke a subtly changed man. He suspected the French servants were spying. He worried that furnishings were being stolen. He scrutinized his delegation's use of automobiles to make sure they were used only for official purposes -- he had previously encouraged the cooped-up staff to take them for relaxing drives and trips. With his physician, he rearranged furnishings in his room. He suspected his closest aide of trying to subvert him. He was dour, secretive, impatient, and petulant, yet continued to do brilliant work. 1d

Comment: What happened to Wilson's cognition? Possibilities include a stroke-like event or encephalitis (brain inflammation) from what appears to have been an infection with the fearsome 1918 influenza virus. No matter what the cause, this change in Wilson has come to be viewed as an inciting event for World War II -- the theory being that Wilson lost the political astuteness that would have enabled him to presuade the Senate to ratify the League of Nations Treaty, which Wilson viewed as the sole means to prevent another global conflict within a generation.

With his long history of arterial disease in the brain and eye, Wilson was not healthy when he set out. He was to get much worse during the trip, experiencing severe headaches, double vision, difficulty breathing, and signs of a weakened heart. The tour was canceled when he developed unmistakable signs of a stroke, though these later eased 5.

Wilson's wife called the journey "one long nightmare" 1f. Dr. Cary Grayson, who was on the trip, described it as "a prolonged agony of physical pain"  1f -- pain that he was unable to treat (no physician in that era could have).

Wilson's condition was hidden from his Cabinet, from the Vice President and, of course, from the public. This could only be done by keeping Wilson physically isolated. Some members of the Cabinet were uneasy. On Oct. 5, 1919, ex-President Taft wrote to A. L. Lowell 11a:

[Secretary of the Treasury] McAdoo says the President [Wilson] is in a state of collapse -- that his mind is clear but that he is so weak that his doctors would not permit him to discuss or think about any of these matters. ... He says that he would like to help, but he is in a delicate situation, being the son-in-law of the President.

The White House maid, too, thought Wilson's mind was clear, but agonized at the twisted smiles that he would give her -- only half of his face worked. The Secret Service would seat him in his car so the public could not see the paralyzed side. 7d

The stroke was first disclosed to the public four months later, by Dr. Hugh Young who had consulted on Wilson's inability to urinate 12.

This may be an exaggeration, however. Dr. Mark Benbow of the Woodrow Wilson House reports that "He didn't actually try to catch speeders himself, but he did send his secret service agents after them in their separate car. They would usually come back and claim that the speeder was going too fast so they could not catch them. Wilson also asked his Attorney General if he had the power to give speeding tickets. The Attorney General said no. This probably started before Wilson had his stroke. The speed limit in Washington then was 22 mph" 13 [? source = "Starling of the White House"]. Wilson used to tease his family and friends at the dinner table asking "Well, who's been pinched today?" 5a.

Questions about Wilson's sanity entered the public sphere, including a rumor that iron bars had to be installed on his bedroom windows. In actuality, the bars had been installed years earlier to protect Theodore Roosevelt's children. Another disparaging report misquoted the Queen of Belgium saying Wilson was dressed in a torn wool sweater during her White House visit. She had said warm wool sweater. 7e

Still, there were noticeable changes in Wilson's personality after the stroke. The White House maid described a childish irritability, and pouting when he would not get his way 7d.