Abraham Lincoln's life has provided material for scores of historians. But one aspect of his history is being investigated by a very different kind of expert: geneticists. Lincoln’s appearance and medical history have some convinced that he had a condition called Marfan syndrome.

Marfan syndrome is one of a family of connective tissue disorders—that is, conditions that affect the glue that holds the body together. It affects many body systems and can be quite serious, but its most obvious signs are external: an unusually tall, lanky stature; and long limbs, hands, and feet—and if that doesn’t describe Abraham Lincoln, nothing does. 

The condition affects about 1 in every 5000 people, but because the syndrome is frequently inherited, many of the people who have it are related. And when one person is diagnosed, physicians frequently start looking at that person’s ancestry. Such was the case of a 7-year-old boy diagnosed in 1964. The diagnosing physician, a man named Harold Schwartz, had traced his patient’s family tree back more than 200 years, all the way to Mordecai Lincoln II, Abraham’s great-great-grandfather. 

Two years before Schwartz’s discovery, a doctor named A.M. Gordon developed a similar theory, which he published in the Journal of the American Medical Association. Schwartz added his new evidence to the academic literature, and the debate began in earnest.

Opponents of the theory argued that Lincoln had never shown any other symptoms of the condition. He had no heart problems, no lung issues, no eye trouble, and no overtly loose joints. He was 56 years old when he was assassinated, which would have been a pretty decent lifespan for anyone in those days. (Medicine has made great progress in its investigation of Marfan syndrome since Lincoln’s day. While there is no cure, the syndrome is treatable, and people who have it can expect to lead long, full lives.) And besides, the nay-sayers said, if Lincoln inherited the condition from his paternal great-grandfather, how do we account for his mother's looks?

This artist may have taken the resemblance a little too far. Painting by Lloyd Ostendorf via Wikimedia Commons // Public Domain

By most accounts, Nancy Hanks Lincoln was the spitting image of her son, with long limbs and a sad, melancholic face. A minister who was a friend of the family described her as “quite tall…bony, angular, lean…She had long arms, large head, with the forehead exceedingly broad … with chest sunken.” Nancy died at the age of 34, either from “milk sickness” or “wasting disease,” depending on which records you read. Whether there were other elements involved in her death, we’ll likely never know.

Her son is another story. Scientists discovered the gene associated with the condition in the 1990s, which suggested to them that genetic testing was possible, as long as you had a sample of someone’s DNA.

As it so happens, we’ve got that. Historians have preserved a number of grisly artifacts from the night of Lincoln’s assassination, including locks of hair, skull fragments, and even his blood, which soaked into his surgeon’s shirt sleeves.

Once scientists realized that they could potentially test the former president's DNA, a second question arose: Should they? In the 1990s, the National Museum of Health and Medicine created a committee of geneticists, lawyers, and forensic scientists, and left the decision up to them.

Those in favor of proceeding argued that, as an American hero, Lincoln could be a beacon and an inspiration for people living with the condition today. Addressing the committee, one person with Marfan syndrome said, “The fact that Lincoln may have had Marfan syndrome shows those of us that we too can contribute something of value to society … It’s time that all people, especially medical ethicists, realize that having the Marfan syndrome is not shameful, it’s just darned inconvenient.”

Those against emphasized how private Lincoln was in life, and stressed that to conduct medical tests on him without his consent would be a huge invasion of that privacy.

The committee eventually decided that, had he been alive, Abraham Lincoln would have consented to testing if the results could have helped other people. Unfortunately, their decision was moot. Additional Marfan-related genes had been discovered during their deliberations, and a definitive diagnosis would not really be possible.

Did Abe Lincoln have Marfan syndrome? We still don’t know for sure. But even without an answer, the debate about Abraham Lincoln’s appearance continues to raise public awareness of a condition affecting thousands of Americans.