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Jackson's illness rethought

Andrew Jackson survived the War of 1812 and many campaigns against American Indians only to be felled by his own physicians _ at least, that is what many historians have long believed. The seventh president's doctors, they argued, subjected him to decades of ill health and may even have hastened his death by overdosing him with the mercury-containing medications of his time.

But scientists analyzing long-treasured snippets of Jackson's hair now have come up with evidence that gets his doctors off the hook. Their findings, they report in today's issue of the Journal of the American Medical Association, suggest instead that the former president's chronic health problems were partly caused by lead poisoning from a bullet that lodged in his left shoulder in 1813 and stayed there for almost 20 years.

Analysis of two samples of Jackson's hair, clipped in 1815 and 1839, failed to show toxic levels of mercury, despite Jackson's heavy use of calomel, a mercury-containing medication he took for constipation, wrote Dr. Ludwig Deppisch, professor of pathology at the Northeastern Ohio Universities College of Medicine and lead author of the study.

Nor were the mercury levels in Jackson's hair high enough to account for many of the symptoms _ including severe mood swings, irritability, paranoia and eventual kidney failure _ that plagued Jackson for the last 30 years of his life and often have been ascribed to chronic mercury poisoning.

Deppisch's team did find high lead levels, however, in the sample of Jackson's hair clipped in 1815, when Jackson was 48, 13 years before he was elected president.

Two years earlier, in 1813, a lead bullet had shattered Jackson's left shoulder, and he began complaining of severe abdominal cramps and constipation around that time.

Symptoms of lead poisoning may be seen when blood lead levels reach the level found in two tests on a lock of Jackson's hair from 1815, said David Gemmel, director of research at Forum Health hospital in Youngstown, Ohio, who collaborated with Deppisch on this project.

Dr. John Rosen, a professor of pediatrics at Montefiore Medical Center in New York and an expert on lead poisoning, who was not involved with the study, said that hair lead levels are "difficult to interpret because of analytic concerns" and that it is impossible to reliably correlate blood and hair lead levels. Still, he said, Jackson's history and symptoms are very consistent with adult lead poisoning.

Although Jackson lived to be 78, by his early 50s his health had deteriorated so profoundly that "there wasn't a day of his life that he wasn't uncomfortable," said Dr. Robert Remini, an emeritus professor of history at the University of Illinois at Chicago, who is the author of many books about Jackson, including a three-volume biography.

"The man was in constant pain throughout his administration," Remini said. Jackson served as president for two terms, from 1829 to 1837. During the last six months of his administration, in the winter of 1836-1837, he was so ill that he conducted matters of state from his bed and left his bedroom only twice, Remini said.

He added that although the lead bullet that destroyed Jackson's shoulder was surgically removed in 1832, at the midpoint of his White House years, the operation occasioned only a transient improvement in Jackson's health.

In Deppisch's study, a sample of Jackson's hair clipped in 1839, seven years after the bullet was removed, showed that the lead had decreased substantially, to safe, though slightly elevated, levels.

By this time, however, Jackson was suffering from swelling of the legs and abdomen caused by the kidney and heart failure that eventually killed him in 1845.

"It's always important to know more about the physical and mental conditions of our presidents," Remini said. "Andrew Jackson could be very angry. His treatment of the Indians sometimes, I think, reflected his own physical pain and discomfort. That's my guess."