150 Years Ago: Congress Passes Thirteenth Amendment

For the next few months, we'll be covering the final days of the Civil War exactly 150 years later. This is the first installment of the series.

January 31, 1865: Congress Passes Thirteenth Amendment

“Section 1. Neither slavery nor involuntary servitude, except as a punishment for crime whereof the party shall have been duly convicted, shall exist within the United States, or any place subject to their jurisdiction. Section 2. Congress shall have power to enforce this article by appropriate legislation.”

In a mere 47 words the Thirteenth Amendment, passed by the U.S. House of Representatives on January 31, 1865, in the waning days of the Civil War, completed the rupture with pre-war America, liberating millions of black slaves and erasing forever the traditional foundation of the Southern economy. Passed at the urging of President Abraham Lincoln, the amendment banning slavery completed the task he’d begun with the Emancipation Proclamation two years before. Where the Emancipation Proclamation only freed slaves in the rebellious Southern Confederacy, the Thirteenth Amendment was universal, applying equally to those held in bondage in the Union “border states” of Delaware, Maryland, West Virginia, Kentucky, and Missouri.

Total abolition of slavery had long been the chief goal of the Radical wing of the Republican Party, the result of an alliance between crusading evangelical Christians from New England, who believed slavery was a sin exposing the nation to God’s wrath, and independent Midwestern farmers who feared the economic clout of Southern plantation owners. As a moderate Republican, Lincoln had avoided committing himself to this sweeping goal before the war in order to avoid alienating northern Democrats, who were ambivalent about slavery but wanted to preserve the Union – Lincoln’s main aim as well. However once war broke out the Radical Republicans urged Lincoln to seize the opportunity to end slavery forever.

The Thirteenth Amendment was the product of a tortuous legislative journey, the final stages of which formed the subject of Steven Spielberg’s 2012 epic Lincoln. After being passed by the Senate in April 1864, the amendment stalled until after the elections that following November, when Lincoln returned to the attack, hoping to steer it through the House with the support of lame-duck Democratic congressmen who could now vote their conscience – or in some cases their pocketbooks, secured by the promise of cushy federal jobs.

Indeed, scraping together the votes to achieve the needed two-thirds majority in the House called for a degree of logrolling, horse-trading, and backscratching that might strike contemporary Americans as questionable at best. But it’s worth noting that many practices deemed unethical or worse nowadays were considered an ordinary part of politics in the nineteenth century (some would argue modern politicians are just more subtle, as well as shamelessly hypocritical, in their corruption). In fact, in early 1865 Lincoln’s associates worried he was about to collapse from sheer exhaustion, due not so much to the war as the endless stream of place-seekers petitioning for federal jobs in return for political favors in the last election.

The passage of the Thirteenth Amendment in the House allayed Radical Republican fears that Lincoln would fail to follow through on the Emancipation Proclamation and maybe even cut a deal with the South over slavery in order to end the war; as the president himself told a cheering crowd in front of the White House the next day, there could be no backtracking now, as the Thirteenth Amendment would “wind the whole thing up.” But a huge gulf remained between Lincoln and the Radical Republicans over the closely related issues of Reconstruction, including the rights of freed black people, the form of administration for the conquered Southern states, and the conditions of their eventual readmission to the Union.

Lincoln Meets Confederate Peace Envoys

At least they were in agreement on one basic principle: peace could only follow the Southern states’ unconditional surrender. This was the jarring message Lincoln delivered to three high-ranking Confederate politicians who crossed the frontline at Petersburg, Virginia, to meet with him and Secretary of State Seward aboard the steamboat River Queen at Hampton Roads, a harbor in eastern Virginia, on February 3, 1865 (the location chosen for the meeting allowed the crafty president to deny, with literal precision, claims by Northern Democrats that Confederate peace envoys were coming to the capital).

The Confederate commissioners – Vice-President Alexander Stephens, Assistant Secretary of War John Campbell, and Senator Robert Hunter – were hopeful going into the conference. First of all, both sides were eager to end the war before spring came and major combat operations resumed, adding to the already astronomical body count. The Southerners also assumed that Lincoln and Seward wanted to turn their attention to foreign policy, specifically the French invasion of Mexico, where Emperor Napoleon III had taken advantage of American discord to install a puppet leader, Emperor Maximilian, in violation of the Monroe Doctrine. In return, they sought concessions on slavery, including compensation for lost “property.”

However they overestimated Lincoln’s endurance, fortified by support (or pressure) from the Radical Republicans and the acquiescence of public opinion. As long as the country remained divided, Mexico was a side issue. And while ordinary Northerners longed for peace, they also understood that the Union armies under Ulysses S. Grant finally had the main Confederate army under Robert E. Lee by the throat at the siege of Petersburg, Virginia, where the latter were forced to fight to defend the Confederate capital of Richmond. After four years of bloody sacrifice, with victory in sight, now was not the time to settle for an easy peace.

Although no one knows exactly what passed between the attendees (there may have been talk of a compromise on the issue of compensation for the loss of slaves), it’s clear the Confederate commissioners were shocked by Lincoln’s demand for unconditional surrender before any other issue could be discussed. Hunter summed up their unwelcome apprehension: “Mr. President, if we understand you correctly, you think that we of the Confederacy have committed treason; that we are traitors to your government; that we have forfeited out rights, and are proper subjects for the hangman. Is that not about what your words imply?” With brutal frankness Lincoln replied: “Yes, you have stated the proposition better than I did. That is about the size of it.” Lincoln had no intention of actually hanging Confederate leaders as some Radical Republicans demanded, hoping instead for quick reconciliation – but he also made it clear that immediate submission to the Union was the only way to take themselves out of jeopardy.

In fact the whole episode had a somewhat theatrical quality to it, as both sides were using the meeting to achieve their own domestic political aims. Lincoln couldn’t be seen to reject a potential peace offer out of hand, and was also responding to pressure from a Republican grandee, Francis P. Blair of Missouri (although it’s not clear whether he agreed to meet the Confederate commissioners as a quid pro quo for Blair supporting the Thirteenth Amendment, as laid out in Spielberg’s Lincoln). Similarly, Lincoln’s refusal to negotiate allowed Confederate President Jefferson Davis to claim he had offered an olive branch and been rejected, silencing his own critics in the Confederate Congress and giving him the justification he needed to fight to the bitter end. The war wasn’t over yet.

Sherman Marches North

The brunt of the fighting would fall squarely on one Southern state that had so far avoided the worst depredations of war: South Carolina, the cradle of the Confederacy. Its scourge would be the Union army under William Tecumseh Sherman, whose recent march through Georgia had already acquired a mythic status akin to a Biblical plague. Having spent the winter in Savannah, Sherman now headed north to crush the remaining Confederate forces between him and Grant, wreaking retribution along the way. He confided in his diary: “The truth is the whole army is burning with an insatiable desire to wreck vengeance upon South Carolina. I almost tremble at her fate, but feel that she deserves all that seems in store for her.” And one of his officers wrote home to Illinois: “I want to see the long deferred chastisement begin. If we don’t purify South Carolina it will be because we can’t get a light.”

Sherman’s advance would be opposed by a ragtag force centered on the Confederate Army of Tennessee, first under Pierre G.T. Beauregard and later under Joe Johnston, who’d angered Jefferson Davis but was rescued from the political penalty box by Robert E. Lee, newly (and belatedly) appointed to overall command of the Confederate armies on February 7. However this force of 20,000 tired, ill-equipped rebels was hugely outnumbered by Sherman’s army, now around 60,000 strong; in fact the main obstacles in South Carolina were natural features including swamps and rivers, which failed to stop Sherman’s advance but did put his cold, muddy soldiers in a particularly vindictive mood.

After sending several units ahead in mid-January as feints to distract the enemy and sow confusion, the main body of Sherman’s force headed north from Savannah on February 1, 1865. On crossing into South Carolina they immediately set about destroying the railroad connecting Charleston to Augusta, Georgia, and this was just a taste of what was in store for the rest of the state, as Sherman’s army advanced, destroying everything on value on a 60-mile-wide front. One of Sherman’s officers, Lieutenant Colonel George Nichols, wrote in his diary:

The actual invasion of South Carolina has begun... The well-known sight of columns of black smoke meets our gaze again; this time houses are burning, and South Carolina has commenced to pay an installment, long overdue, on her debt to justice and humanity. With the help of God, we will have principal and interest before we leave her borders. There is a terrible gladness in the realization of so many hopes and wishes.

A correspondent for the New York Herald, David Conyngham, reported the horrible, spectacular sights for its readers:

… the country was converted into one vast bonfire. The pine forests were fired; the resin factories were fired; the public buildings and private dwellings were fired. The middle of the finest day looked black and gloomy, for a dense smoke rose on all sides clouding the very heavens – at night the tall pine trees seemed so many huge pillars of fire. The flames hissed and screeched, as they fed on the fat resin and dry branches, imparting to the forest a most fearful appearance... The ruins of homesteads of the Palmetto State will long be remembered.

As in Georgia much of the destruction was fueled by copious quantities of alcohol, as Union soldiers ransacked towns and plantations for hidden stores of hard liquor. Nor were Confederate troops, faced with the same trying conditions, immune to its charms – again leading to destructive behavior, even though they were supposed to be better behaved as they defended their own people. Meanwhile the residents of the state capital, Columbia, dreaded the approach of the Yankees, keenly aware of their own helplessness. In January one resident, Emma LeConte, wrote in her diary:

I am constantly thinking of the time when Columbia will be given up to the enemy. The horrible picture is constantly before my mind… How long before our beautiful little city may be sacked and laid in ashes. Dear Columbia, with its lovely trees and gardens. It is heart-sickening to think of it… Yet all this does not rouse us. We seem sunk in an apathy.

The Plight of Prisoners and Wounded

As the siege of Richmond ground on and Sherman’s forces rolled north, hundreds of thousands of captured soldiers languished in prisoner-of-war camps across the North and South Although Confederate prison camps like Andersonville went down in history with a worse reputation, conditions were wretched on both sides, and by the end of the war around 56,000 men had died in prison camps from starvation, disease, and exposure.

In January 1865 Sergeant Henry W. Tisdale, a Union soldier held prisoner in Florence, South Carolina, noted the toll inflicted by the weather in his diary: “The cold snaps multiply and little patches of ice fringe the edges of the creek, and with each cold wave one or more poor fellow gives up the fight, and in prison phraseology is ‘mustered out.’” However a month later he noted that prisoners on labor battalions were receiving some covert help from sympathetic local black people: “Thanks to the negroes who always have something for us as they slyly stray in upon us in our wood-cutting expeditions, and handing us a few sweet potatoes, or a little bag of beans, and often refusing any pay.”

About 800 miles to the north, Louis Leon, a Confederate soldier from North Carolina held captive in New York, described conditions in this Union prison camp in February 1865: “The smallpox is frightful. There is not a day that at least twenty men are taken out dead. Cold is no name for the weather now. They have given most of us Yankee overcoats, but have cut the skirts off. The reason of this is that the skirts are long and if they left them on we might pass out as Yankee soldiers.”

Harsh punishments were also meted out to deserters and soldiers found guilty of cowardice on both sides, generally by a court martial. One Confederate soldier, Sam R. Watkins, recalled seeing a botched execution in late 1864:

While I was standing looking on, a file of soldiers marched by me with a poor fellow on his way to be shot. He was blindfolded and set upon a stump, and the detail formed. The command, “Ready, aim, fire!” was given, the volley discharged, and the prisoner fell off the stump. He had not been killed. It was the sergeant's duty to give the coup d'etat, should not the prisoner be slain. The sergeant ran up and placed the muzzle of his gun at the head of the poor, pleading, and entreating wretch, his gun was discharged, and the wretched man only powder-burned, the gun being one that had been loaded with powder only. The whole affair had to be gone over again.

And even these miseries paled in comparison to the prolonged suffering of thousands of mortally wounded men dying every month. Watkins also described visiting a field hospital around this time:

Great God! I get sick today when I think of the agony, and suffering, and sickening stench and odor of dead and dying; of wounds and sloughing sores, caused by the deadly gangrene; of the groaning and wailing. I cannot describe it. I remember, I went in the rear of the building, and there I saw a pile of arms and legs, rotting and decomposing; and, although I saw thousands of horrifying scenes during the war, yet today I have no recollection in my whole life, of ever seeing anything that I remember with more horror than that pile of legs and arms that had been cut off our soldiers.

Chemung County Historical Society, Elmira, NY
John W. Jones: The Runaway Slave Who Buried Nearly 3000 Confederate Soldiers
Chemung County Historical Society, Elmira, NY
Chemung County Historical Society, Elmira, NY

John W. Jones was as close to a sinless man as you could find—with the exception of the time he lied to his mother.

It was a late June evening in 1844 and the 26-year-old enslaved man, who lived on a plantation near Leesburg, Virginia, told his mother that he was leaving to attend a party. His real plans were much riskier. Jones slipped outside, grabbed a pistol, and rendezvoused with four other enslaved men. With starlight as their guide, they crept through the Virginia woods. Their destination: North.

The men hiked approximately 20 miles every day, dodging slave catchers in Maryland and crossing the Mason-Dixon Line into the free state of Pennsylvania. Following a major route along the Underground Railroad, they needled through Harrisburg and Williamsport and traced a path along what is now State Route 14. When the exhausted men snuck into a barn near the New York border to sleep, Jones kept guard as the others rested: He sat down, laid a shotgun on his lap, and kept his eyes peeled.

“He was serious about getting his freedom,” says Talima Aaron, President of the John W. Jones Museum Board of Trustees. “He understood the danger, and he constantly took responsibility for others. You’ll notice that was a thread for him—responsibility for others.”

Jones never had to use the gun. When the barn’s owner, Nathaniel Smith, discovered the five men on his property, he invited them into his home. His wife Sarah served the group hot biscuits and butter and cared for them until their strength returned. It was the first time many of them had ever been inside a white person’s home. According to an 1885 profile in The Elmira Telegram, the gesture brought the men to tears.

On July 5, 1844, Jones crossed a toll bridge into Elmira, New York, with less than $2 in his pocket. Unlike most runaways bound for Canada, Jones decided to stay in Elmira. It’s here that Jones would become one of the country's most successful Underground Railroad conductors, one of the richest black men in the state of New York, and the last earthly link for nearly 3000 dead Confederate soldiers.


Living in the north did not mean Jones had it easy. He could not vote. He still shared sidewalks with former slave-owners. When he asked to receive an education at the local schools, he was denied.

But Jones had a knack for cracking ceilings. After earning the admiration of a local judge, he was allowed to study at an all-women’s seminary, exchanging janitorial work for reading and writing lessons. He joined a church with abolitionist leanings and become its sexton, maintaining its cemetery. Then he became the sexton of a second cemetery, and then a third. The community quickly grew to respect his work ethic and, eventually, Jones had earned enough money to buy a small house—a house that he transformed into a vital hub for the Underground Railroad.

At the time, the Underground Railroad—an informal network of trails, hiding places, and guides that helped slaves escape northward—was under intense scrutiny. The 1850 Fugitive Slave Act had created financial incentives to report runaways living in free states. “Slave catchers from the south could come up to a place like Elmira and claim that a person of color was a runaway slave, and they could haul them back into slavery—even if that person had been born free,” says Bruce Whitmarsh, Director of the Chemung County Historical Society. There were steep penalties for aiding a person’s escape.

Jones didn’t care. Not only did he join the Underground Railroad, he was openly vocal about it, loudly pledging his opposition to the Fugitive Slave Act in a message that was published in abolitionist newspapers across the region: “Resolved, that we, the colored citizens of Elmira, do hereby form ourselves into a society for the purpose of protecting ourselves against those persons, (slave-catchers) prowling through different parts of this and other States.” Jones committed to resisting the law, even at the risk that “everyone of us be assassinated.”

The Underground Railroad in Elmira was unique: Since the town included the only train stop between Philadelphia and Ontario, it actually involved locomotives. Jones communicated regularly with William Still, the chief "conductor" of the Underground Railroad in Philadelphia, and built a cozy network of abolitionists who worked on trains passing through town. He provided runaways with housing, food, and even part-time jobs. “Runaways usually came in groups of four, six, or 10,” Aaron says. “But he had up to 30 at once in his little house.” Jones arranged hiding space for all of the escapees on the 4 a.m. “Freedom Baggage Car” to Canada, as it was unofficially known.

Over the course of nine years, Jones aided the escape of around 800 runaway slaves. Not one was captured.

During the last years of the Civil War, the same railroad tracks that had delivered hundreds of runaways to freedom began to carry thousands of captive Confederate soldiers to Elmira’s new prisoner of war camp. Once again, Jones would be there.


Of the 620,000 Civil War deaths, approximately 10 percent occurred at prison camps. The most notorious P.O.W. camp—in Andersonville, Georgia—saw 13,000 Union troops, or approximately 29 percent of the prison population, perish. After the war, Andersonville's commander was tried for war crimes. The camp is now a National Historic Site.

Meanwhile, the prison camp in Elmira has been largely forgotten. Today, the riverside site is little more than an unremarkable patch of dandelion-speckled grass; a small, easy-to-miss monument is the only marker. It belies the fact that while Elmira's camp was noticeably smaller than Andersonville's—only one-quarter its size—it was just as deadly: If you were a prisoner at “Hellmira,” there was a one-in-four chance you would die.

Elmira Prison Camp
Chemung County Historical Society, Elmira, NY

Elmira was never supposed to have a prison camp; it was a training depot for Union soldiers. But when the Confederacy began refusing to exchange African-American soldiers—who it considered captive slaves, not prisoners of war—the Union stopped participating in prisoner exchanges. “Both sides started scrambling for places to expand, and that’s how Elmira got caught up in the web,” says Terri Olszowy, a Board Member for the Friends of the Elmira Civil War Prison Camp.

The rollout was ill-planned, Olszowy explains. When it opened in July 1864, the camp had no hospital or medical staff. The first prisoners were already in rough shape and deteriorated quickly. Latrines were placed uphill from a small body of water called Foster’s Pond, which quickly became a cesspool. A shelter shortage meant that hundreds of soldiers were still living in tents by Christmas. During spring, the Chemung River flooded the grounds. Rats crawled everywhere. When authorities released a dog to catch them, the prisoners ate the dog.

The camp grew overcrowded. Designed to hold only 5000 prisoners, it saw approximately 7000 to 10,000 men confined there at its peak. Across the street, an observation tower allowed locals the opportunity to gawk at these prisoners through a pair of binoculars. It cost 10 cents.

It must have been a depressing sight, a scene of men stricken with dysentery, scurvy, typhoid, pneumonia, and smallpox. Many prisoners attempted to escape. One group successfully dug a 66-foot tunnel with spoons and knives. One man fled by hiding in a barrel of swill. Another hid inside a coffin, leaping out as he was being hauled to Woodlawn Cemetery.

It’s said that 2973 Confederate prisoners left the Elmira prison camp in coffins for real. The job to bury them belonged to the town’s sexton: John W. Jones.


The P.O.W. cemetery in Elmira is unique. The dead at many prison camps were buried in mass graves; Chicago’s Oak Woods Cemetery, for example, contains a plot filled with the remains of prisoners detained at Camp Douglas that is believed to be largest mass grave in the western hemisphere. All 2973 of the dead at Elmira, however, received an individual, marked grave in a special section of Woodlawn Cemetery. Only seven are unknown. Jones's effort to give each soldier an individual grave, as well as his meticulous record-keeping, were a big part of why the federal government designated the P.O.W. portion of Woodlawn a "National Cemetery" in 1877—a status awarded to veterans' cemeteries deemed to be of national importance, and which has only been awarded to 135 cemeteries nationwide.

Jones treated each dead soldier with superhuman levels of grace. Overseeing a crew of 12, he managed the burial of about six soldiers every day, treating each body as if that person had been a member of his own church. He kept detailed records of each soldier’s identity by creating improvised dog tags: Around each person's neck or under their arm, Jones tucked a jar containing a paper detailing their name, rank, and regiment. That same information was neatly scrawled on each coffin. When the dirt settled, Jones marked each plot with a wooden headstone.

“No one told him how to do that job, he did it in the way that he thought was right—even though the people he buried were fighting a war to keep people like him enslaved,” Aaron says. “He even knew one of the young men who had died, and he reached back to the South and told the parents so they knew where their child was buried. That speaks to his compassion.”

According to Clayton W. Holmes’s 1912 book Elmira Prison Camp, “History does not record anything to challenge the assertion that at no prison, North or South, were the dead so reverently cared for, or a more perfect record kept.” In fact, when representatives of the Daughters of the Confederacy came to Elmira at the turn of the century to consider repatriating the remains, Jones’s handiwork convinced them to touch not a blade of grass. Instead, a monument in the cemetery commemorates the “honorable way in which they were laid to rest by a caring man.”

Aaron sees a second moral in the story. “People always talk about the tension between him being an escaped slave and burying with respect and dignity these Confederate soldiers fighting to keep people like him as slaves,” she says. “But to me there’s a subtext: Here is a grown man who escaped slavery, and the first thing he wanted to do when he reached freedom was get an education. Because of that, he was able to keep these meticulous records that later led to this national designation: It became a historical moment because this man, who was denied an education, got one.”

John W. Jones
Chemung County Historical Society, Elmira, NY

It also made a mark on Jones’s bank account. Jones earned $2.50 for each soldier he buried. It wasn’t much, but by the time he had finished burying nearly 3000 Confederate dead, he had become one of the 10 richest African-Americans in the state of New York. With that money, he bought a handsome farm of at least 12 acres.

It was a bittersweet purchase. Not only is it believed that parts of his home were built from wooden scraps of the disassembled Elmira prison camp, Jones had purchased the home when New York state law stipulated that black men must own $250 worth of property in order to vote. His home—today listed on the National Register of Historic Places [PDF]—earned Jones that right to vote.

For the remainder of his life, Jones continued working as a sexton and church usher. In 1900, he died and was buried in one of the cemeteries that had become his life’s work.

Incidentally, his death also marked the end of a local mystery: For nearly two decades, fresh flowers kept appearing on the freshly manicured grave of a woman named Sarah Smith. Nobody knew why the flowers appeared there or where they originated—until the decorations stopped appearing immediately after Jones’s death. Residents later realized that the grave belonged to the same Sarah Smith who, 56 years earlier, had invited John W. Jones and his friends into her home for butter, biscuits, and a good night’s rest.

Library of Congress // Public Domain
The Key to Robert E. Lee's Puzzling Death Might Be Hidden in a Photo of His Earlobe
Library of Congress // Public Domain
Library of Congress // Public Domain

When Confederate Army general Robert E. Lee died five years after the Civil War ended, the cause of his death had doctors stumped. He had been in poor health, but his specific illness was a mystery; there weren't many clues beyond symptoms Lee had described in letters. “The troops are not encamped near me and I have felt so unwell since my return as not to be able to go anywhere,” he wrote to his wife in 1863.

This was before electrocardiograms and x-rays existed. There were no obvious physical findings to support a formal diagnosis, either. Lee’s doctors made some educated guesses based on his gripes and treated him with everything but the kitchen sink: hot mustard plasters and footbaths, doses of turpentine or ammonia, and enemas, all of which were standard medical treatments in the Civil War era. Without a robust medical history to guide them, the doctors diagnosed stroke, rheumatism, and pneumonia in the months leading up to Lee's death.

Now, new research from East Carolina University sheds light on the age-old question of what actually caused Lee's demise, thanks to the discovery in a photograph of a crease running diagonally across Lee’s right earlobe. According to the case study, recently published in the American Journal of Cardiology, the crease is a physical sign that Lee likely died from heart disease.

Richard Reinhart, an emeritus professor of medicine at East Carolina University and author of the paper, says earlobe creases can help detect heart disease. Some previous reports have pointed to heart disease as the cause of Lee’s death based on written evidence, but “until now there hadn’t been an actual physical finding supporting this diagnosis,” Reinhart tells Mental Floss. “His earlobe crease is the only piece of objective physical evidence that helps back it up.”

Photo of Robert E. Lee showing a crease in his right earlobe
Virginia Historical Society

The possible connection between earlobe creases and heart disease was first made in 1973, and there have since been more than 120 studies investigating the link. Scientists aren’t sure why creases appear in the earlobes of some heart disease patients, but researchers have suggested that a heart condition may affect the blood vessels and elasticity of the earlobe in a way that forms a crease over time.

Reinhart, a history buff who has a particular interest in the life of Lee, saw a close-up photo of the general at the Virginia Historical Society one day and noticed the wrinkle on his ear. Aware of the possible link between earlobe creases and heart disease, he began poring through Lee’s personal letters and attending physicians’ notes, as well as previous reports of Lee’s illness, to see if his symptoms jibed with a failing heart.

It turned out the symptoms correlated well: Lee initially had an episode of chest pain in 1863, which progressively worsened when he exerted himself and eventually took on characteristics that would be recognized today as heart disease. And in the months before his death in 1870, he began to have chest pain even at rest, which suggests a heart attack was imminent.

“The constellation of symptoms, I believe, are readily explained by heart failure due to progressive coronary artery disease,” Reinhart says.

In an age where advanced medical diagnostic tools weren’t yet in play, a physical feature like an earlobe crease would have been a useful visual cue had doctors known it might signal heart trouble. But even if they had known, could they have done anything to help Lee? One option—a nitroglycerin-based substance called amyl nitrite, which dilates the coronary artery for better blood flow to the heart—had been documented in the British medical journal Lancet in 1867 but wasn’t used much clinically. Salicylate, the precursor to aspirin, which today's physicians recommend for preventing heart attacks, had been around since before the Civil War. But the idea of using it as an anti-platelet drug wouldn't occur for decades.

“Understanding heart disease back then was in its relative infancy, and I don’t think there’s anything that would have turned Lee’s condition around,” Reinhart says. “Even today, I believe the outcome from his final illness—end-stage heart failure—may not have been much better, given that the mortality rates for it are still significant.”


More from mental floss studios