William Henry Harrison was 68 years old when he became the ninth president of the United States and the oldest US president until Ronald Reagan was elected nearly a century and a half later. He was sworn into office on 4 March 1841. Exactly one month later, he was dead. Since his death on this day 175 years ago, it has been taken for granted by even the most eminent presidential historians that an overly long inaugural address delivered in freezing weather without a hat, overcoat, or gloves led to a fatal case of pneumonia. Fatal pneumonia, however, is a diagnosis in several respects at odds with the detailed description of Harrison’s final illness left by his personal physician, Dr. Thomas Miller.
Although Harrison developed symptoms of pneumonia during the course of his final illness (i.e., fever, difficulty breathing, and cough productive of small amounts of blood-tinged sputum), they were intermittent rather than progressive and didn’t begin until two days after the onset of gastrointestinal complaints, which proved to be both relentless and progressive. Harrison’s initial complaints were constipation and abdominal distension, which persisted for 5 days in spite of repeated laxatives and enemas administered by Dr. Miller. On the sixth day of illness, Harrison’s bowels finally opened, producing a flood of “foetid,” watery diarrhea, a sinking pulse, cold blue extremities, and, ultimately, death. The character and course of the illness, including the pulmonary complaints, are typical of typhoid fever. Moreover, given the dominance of Harrison’s gastrointestinal complaints during the course of his fatal illness, it is more likely that he died of a gastrointestinal infection–specifically typhoid fever–with secondary involvement of his lungs than of a pulmonary infection (i.e., pneumonia) with secondary involvement of the intestine.
In fact, there is ample reason to conclude that Harrison’s move into the White House placed him at considerable risk of contracting a gastrointestinal infection such as typhoid fever. In 1841 the nation’s capital had no sewer system (nor, for that matter, did any other American city). Until 1850, sewage from nearby buildings simply flowed onto public grounds a short distance from the White House, where it stagnated and formed a marsh. Even more ominous, the White House water supply, which came from springs in the square bordered by 13th, 14th, I, and K streets NW, would have been prone to contamination during heavy rain by pathogenic bacteria contained within Washington DC’s night soil depository situated just seven blocks above the springs. This might explain why three antebellum presidents – Harrison, James Polk, and Zachary Taylor – each developed severe gastroenteritis while residing in the White House. Polk recovered only to die of presumed cholera three months after leaving office. Taylor, like Harrison, succumbed to his episode of gastroenteritis while president.
If Harrison had survived long enough to serve out his term as president, the course of US history would have been different. How different will never be known, because he was unfortunate enough to have moved into the White House before the advent in Washington, DC of modern sanitation.
Featured image credit: Death of Harrison, April 4, 1841 by N.Y. : Lith. & pub. by N. Currier – This image is available from the United States Library of Congress’s Prints and Photographs division under the digital ID cph.3a06021. Public Domain via Wikimedia Commons.