- The Washington Times - Friday, January 19, 2007

A day after the 200th anniversary of Robert E. Lee’s birth on Jan. 19, 1807, it is interesting to look at his health prob-

lems and do some reading between the lines in the light of current medical knowledge.

Writers and historians are prone to stick to the subject at hand — the battles — while other subjects, such as the health of the leader, are given short shrift. Thus it was with Lee, who all his adult life was beset by physical problems that were given scant diagnosis and treatment.

Lee’s stamina may have appeared hearty during the war years, but it had always been unpredictable at best.

During the Mexican War, the seemingly healthy and robust Lee fainted for the first and only time in his life. He had been, in his own words, “almost paralyzed” by the strain of battle and a lack of sleep during preparations for the attack on Chapultepec. However, he looked strong and ruddy. These adjectives would recur time and time again, and yet their seeming innocence hides deeper problems.

It was the forerunner of things to come. Two years later, while supervising construction of Fort Carroll in Baltimore harbor, Lee developed a fairly high fever, which temporarily debilitated him. It was most likely a malarial strain, and it would recur later in his life, although at the time he seemed to regain full strength.

In March 1863, not too long before the Battle of Chancellorsville, he developed a very sore throat, then stabbing pains in his chest, back and arm. Moved from headquarters to a private home on March 30, he tried to recover, writing to his wife that he was simply “suffering with a bad cold.”

Doctors thought the throat infection had settled into pericarditis, or an inflammation of the pericardium — the sac surrounding the heart. He continued to complain of “paroxysms of pain,” or stabbing sensations, recognizable now in many cardiac patients.

Though he seemed to recover, he suffered all through the Battle of Gettysburg from the loosely diagnosed “rheumatism.” Some records indicate that the malaria had returned.

The Chancellorsville illness was particularly significant, and though it seemed to disappear, Lee’s health was erratic thereafter, alternating between periods of almost debilitating discomfort and relative good health.

On Aug. 8, 1863, he felt that his health was problematic enough for him to write President Jefferson Davis, asking that he be relieved of command. Davis declined the request.

Less than a month later, Lee suffered violent pains in his back, which were attributed to lumbago, sciatica or — again — rheumatism. In light of current medical knowledge, they probably were precursors to angina pectoris, a temporary decrease in blood supply to the heart, with resulting pain and discomfort.

It was at this time that horseback riding became almost unbearable for the general best known astride Traveller. Many campaigns were conducted with Lee riding in a wagon.

Several other attacks occurred during the Wilderness Campaign. Still, he attempted to continue his position of leadership. Incidents of illness and near collapse continued, often attributed to “bad food and long hours.” The duration and effect seem to have been more in line with a primary intestinal infection such as bacillary dysentery rather than just “bad food.”

From June 1864 through Appomattox, Lee seems to have been in relatively good health, including during the nine-month siege of Petersburg. He had gained weight, and his face looked “ruddy” again — a description that should be remembered.

When after the war Lee became president of Washington College (later Washington and Lee), he again seemed in fairly good health, but the so-called rheumatism of old continued.

As early as 1868, he began talking of getting old and having just a short span of life left. In March 1869, he suffered a severe respiratory infection, and although he seemed to recover, records indicate that, in reality, his health steadily declined.

He had some strong reservations about attending the college’s graduation ceremony in 1869 for fear that the happy proceedings might prove his undoing. He seemed more aware of the serious state of his health than did his physicians.

A year passed, and doctors again diagnosed the problem first mentioned at Chancellorsville — inflammation of the heart sac, or pericarditis. He again had pain on the right side, chest and back, and difficulty breathing. His walking was restricted to about 200 yards.

He decided to take a trip as a rest, going on a six-week tour through North and South Carolina, Georgia and Florida. Instead of resting, the famous general was overwhelmed by crowds everywhere he went, complete with receptions and dinners. He began having worse chest pain. He was examined in Savannah and then back home in Richmond and also in Norfolk, and “chronic pericarditis” was the confirmed diagnosis.

Sept. 28, 1870, was the beginning of the end.

He had left a faculty meeting and insisted on walking in the rain to a 4 p.m. vestry meeting at an unheated church. Around 7 p.m., he walked back home through the rain, and though Mrs. Lee noticed that he looked unwell, she only chided him gently that he rarely made them late for dinner.

Sitting down in his chair, he bowed his head to say grace but was unable to speak. He leaned back further in his chair, and still he could not say a word. Mrs. Lee was stricken with concern and fear for her beloved husband. Sensing the seriousness of his condition, servants carried him to a couch, and physicians were called immediately.

Modern-day physicians, reviewing all the records in the light of current knowledge, think that a cerebral thrombosis (a clot in a blood vessel of the brain) had occurred. This, they believe, was the result of a degree of atherosclerosis (or thickening of the arterial walls, the buildup of plaque), which he probably had had for years.

This would have led to the description of his complexion as being “ruddy” or “florid.” What people of his time saw as a healthy appearance we know can be symptomatic of medical trouble brewing. Most likely hypertension accompanied this, but in that era, the taking of blood pressure was unknown — sphygmomanometers had yet to be invented.

He would never rise from his bed again. The doctors came and went; his family attended closely, but life was ebbing from the valiant general. He spoke only occasionally, and that in a delirious state. He was attended by Drs. Robert Lewis Madison and H.T. Barton of Lexington, Va., who waited by his bedside, unable to minister further. It was said by those who watched that their anguish was palpable. They could do nothing for Lee.

At the very end, at 9:30 a.m. on Wednesday, Oct. 12, 1870, the noble General of the South breathed his last. His final words were clear: “Strike the tent.” Gen. Robert E. Lee had gone home.

Martha M. Boltz is a member of the Montgomery County Civil War Round Table and a frequent contributor to the Civil War page.

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