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“The President is Worse Today:” Madison’s 1813 Illness

The illness of an American President is always cause for national concern. William Henry Harrison’s pneumonia in 1841 and Zachary Taylor’s “cholera morbus” (gastroenteritis) in 1850 led to their untimely deaths in office – and to the inauguration of new Presidents. Even non-fatal presidential illnesses have the potential to disrupt the process of governance. Woodrow Wilson’s 1919 stroke and Dwight D. Eisenhower’s 1955 heart attack raised worrisome questions. Was the President well enough to carry out his duties? Who was acting on the President’s behalf? (We’re looking at you, Edith Bolling Wilson.) How long would it be before things returned to normal in the White House?

President James Madison himself had a life-threatening bout of illness at a nationally-inconvenient time – during the War of 1812. Madison had been prone to various types of fever throughout his life, and tried to preserve his health by returning to the mountain climate of Montpelier each summer. However, Madison had worked relentlessly since the approach of the War of 1812. He had left Washington for only two weeks in almost two years. In the summer of 1813, he had a serious attack of remittent bilious fever – a term doctors used at the time for a recurring fever accompanied by diarrhea and/or vomiting of bile. Since the term is a simply a description of symptoms, it is difficult to say whether Madison’s symptoms were caused by malaria, typhoid, influenza, or another fever-inducing illness.1

The contents of a drawer at Montpelier suggest Madison working tirelessly at his desk.
Curatorial Collections photo, courtesy of Montpelier, a National Trust site.

The Illness Begins

The first indication that Madison was unwell came on June 14, 1813, when Dolley Madison told Vice President Elbridge Gerry that “the President was sick in his chamber & could not meet his friends that day.”2 Madison may have anticipated a quick recovery when he wrote to a Senate committee on June 15, proposing a meeting at the President’s House the following day to discuss diplomatic appointments.3 (Both the House and Senate had objected to Madison’s nomination of Jonathan Russell as minister to Sweden, as well as his nomination of Treasury Secretary Albert Gallatin to the commission that would negotiate with Great Britain to end the war.)4

Madison missed the June 16 meeting (blaming “the error of his watch, and the precipitancy of his servant”). His offer to reschedule to June 17 hinted that his symptoms lingered: “If the state of his health should not permit him to see the committee, he will apprize them of it in time.”5 (Madison likely dictated this message to a secretary, although he often wrote formal notes in the third person.) On June 17, the President sent a message that, “James Madison being too much indisposed to see the committee this morning, is obliged to postpone it until to-morrow, at 11 o’clock.”6 On June 18, the President gave up any attempt to reschedule:

“James Madison is sorry that a continuance of his indisposition will not permit him to see the committee of the Senate to-day, nor can he at present fix a day when it will be in his power.”7

In mid-June 1813, Madison took to his bed at the President’s House, sick with a bilious fever.
Benjamin H. Latrobe, View of the east front of the President’s House, 1807, courtesy of the Library of Congress.

Congressman Daniel Webster noted Madison’s condition in his letters. “Madison has been several days quite sick – is no better – has not been well enough to read the resolutions [of] the Senate,” he reported on June 19. Madison was “still sick” on June 24 when Webster took the House resolutions to him in person: “the President was in his bed, sick of a fever – his night cap on his head – his wife attending him.”8

Secretary of State James Monroe described Madison’s situation to their mutual friend Jefferson on June 28: “the President has been ill of a bilious fever, of that kind called the remittent. It has perhaps never left him, even for an hour, and occasionally the simptoms have been unfavorable. This is I think the 15th day. … [The doctors] think he will recover. … [Dr. Elzey] reports that he had a good night, & is in a state to take the bark, which indeed he has done on his best day, for nearly a week.”9 Peruvian bark, a source of quinine, was commonly used for recurring fevers. It apparently provided insufficient relief at this point, however, for on June 29 Webster observed:

“the President is worse today.”10

Rumors, Plans, and Plots

The National Intelligencer newspaper published regular bulletins on Madison’s condition, but speculation still abounded. John Adams reported hearing a rumor that Madison “lives by laudanum and could not hold out for four months.”11 Comte Louis Barbe Sérurier, the French minister to the United States, wrote:

“The thought of [his] possible loss strikes everybody with consternation. His death, in the circumstances in which the Republic is placed, would be a veritable national calamity.”12

James Monroe was well aware that plans were being made in the event that Madison died. Monroe wrote to Jefferson in late June, “The federalists aided by the Malcontents have done, and are doing, all the mischief that they can. … These men have begun to make calculations, & plans, founded on the presum’d deaths of the President & Vice President, & it has been suggested to me that [William Branch] Giles, is thought of to take the place of the President of the Senate, as soon as the Vice President with draws.”13

It may seem alarmist to imagine that Vice President Gerry might also die, but it was not entirely unrealistic. Gerry was in poor health at age 69, and only 16 months later, would suffer a fatal heart attack while in office. Gerry, however, made his own plan to thwart the Federalists and malcontents. Although it was customary for the vice president to withdraw as the presiding officer of the Senate during the summer recess, Gerry deliberately decided not to step down. In case both Madison and Gerry died, Gerry did not intend to leave the “malcontent” Senator Giles next in line for the Presidency.14

The Turning Point

By early July, after three weeks of nearly constant fever, Madison seemed to have passed the crisis. Dolley Madison wrote to Edward Coles, her cousin who served as Madison’s private secretary, “I have the happiness to assure you my dear Cousin that Mr Madison recovers. for the last 3 days, his fever has been so slight as to permit him to take bark every hour, & with good effect. it has been three weeks since I have nursed him night & day – sometimes in dispair!” Dolley then confessed to feeling the stress of being a caregiver: “now that I see he will get well I feel as if I should die myself, with fatigue.”15

Madison began to resume presidential business from his sickroom. On July 6 he dictated a letter expressing his views on Jonathan Russell’s contested nomination. Madison later noted on the draft letter: “written down by J.G. Jackson as dictated by J.M. sick in bed in 1813.” 16

Madison noted in the top line on this draft letter that he had dictated it to his brother-in-law, Congressman John G. Jackson while “sick in bed in 1813”.
James Madison to U.S. Senate, July 6, 1813, courtesy of Library of Congress, James Madison Papers.

Madison wrote a note to Monroe on July 19, remarking that “I am going forward, but very slowly in my return to health.”17 Dolley Madison also commented on the slowness of her husband’s recuperation in a letter to her friend Hannah Gallatin (wife of the Treasury Secretary): “You have heared no doubt, of the illness of my Husband but can have no idea of its extent, and the dispair, in which I attended his bed for nearly five weeks! even now, I watch over him, as I would an infant, so precarious is his convalessence – added to this, the disappointments & vexations, heaped upon him by party spirit.”18

Two Months on the Mountain

The next phase of Madison’s recovery would take place at Montpelier, once Madison was well enough to travel. Madison wrote to Albert Gallatin on August 2, “I have just recovered strength enough, after a severe and tedious attack of bilious fever, to bear a journey to the mountains whither I am about setting out. The Physicians prescribe it as essential to my thorough recovery and security against a relapse at the present season.”19 The Madisons started the four-day journey on August 10. Madison wrote to Monroe from the road, “I bear the journey as well as I expected, tho’ my influenza is no better.”20 Arriving home, Madison wrote to Secretary of the Navy William Jones, “I gained strength on the road, notwithstanding its fatiguing badness, and the continuance of my influenza, from which I am not yet entirely freed.”21

Poulson’s American Daily Advertiser, a Philadelphia newspaper, reprinted a Washington DC news item regarding Madison’s arrival at Montpelier.
MRD-S 39657, Montpelier Research Database.

Congress had recessed shortly before Madison left for Montpelier. Madison had few presidential duties to attend to while at home, other than corresponding with his Cabinet members and staying abreast of war news. By the end of August, Madison found that his health was “greatly advanced towards its usual standard,” but continued:

“I am reminded however by occassional touches of fever, produced I believe by the dregs of the Influenza, that some precautionary attentions continue to be proper.”22

Dolley Madison seemed to agree, writing to Hannah Gallatin on August 30, “Mr. M is now perfectly well but will be the better for another Month on the Mountain.”23 By September, Vice President Gerry was glad to hear that Madison’s “health was restored in so great a degree, as to enable you to mount a gay saddle horse, & to veiw your Plantation.”24

Madison left for Washington around October 20. Richard Rush wrote, “The little President is back, and as game as ever,” reporting with pleasure that Madison had ridden his own horse to watch a horse race at the race course with Monroe and others.25

Madison’s personal health crisis was resolved, as was the challenge to his Presidency. Both he and Vice President Gerry had survived the summer, and no change of administration was necessary. Madison would not be the last President to face a life-threatening illness, but thanks to the Constitution which he helped to create, the United States would be prepared to meet the challenge of any future Presidential health crisis.