Woodrow Wilson's Neurological Illness

Abstract

W OODROW Wilson had a long history of cerebral vascular disease, beginning when he was a professor at Princeton and culminating in September 1919, when he had a massive stroke which paralyzed the left side of his body and affected his vision and sensation on that side. His illness was also associated with alterations in behavior and personality, and there is a relationship between these changes and the events of Woodrow Wilson's later professional and political careers. This study is limited by the paucity of medical records, by the state of medical knowledge in his time, and by the circumstances connected with the unique office of President of the United States. Following his major stroke, President Wilson was not hospitalized; case records were not kept (or they may have been kept and subsequently destroyed); no technical procedures to define the exact location and extent of the brain lesion were carried out; and no tests to evaluate mental function were made. The medical data are restricted further by the nature of the relationship of the President's physicians to their patient, and some of the observations of other persons on the scene are biased for personal and political reasons. There is also the methodological problem of clinical versus historical evidence. The report of one observer may be credited more than that from a more qualified source if the event fits into some clinical syndrome or meets with medical expectations. The demonstration on neurological grounds of impaired brain function does not necessarily mean that such impairment will contribute in a major way to political inefficiency. In a political system with checks and correctives an executive may respond to reduced capacity by accepting more help and delegating more responsibility. The behavioral sequelae of brain damage, also, may appear predominantly in the area of private activity rather than in the political sphere. Moreover, grossly irrational political behavior