by Edward J. Kempf, M.D. Wading River, N.Y.

Diplopia and Astigmatism

The earliest evidence of Lincoln's visual decoordination has been recorded by Shastid,{23} as told to him by his father, Dr. Shastid, an oculist who practiced in Pittsfield, Ill. The elder Dr. Shastid, when a boy, lived in New Salem and knew Abe Lincoln, then in his mid-twenties, as the storekeeper and postmaster of the town. He described him as a melancholy but kindly spoken person, who liked to amuse children, as well as grown-ups. Abe would sit on a box in front of the store when not waiting on a customer, generally with a dejected and abstracted expression. He would sometimes lie on the ground near the store, with his bare feet elevated against the trunk of a tree, and read. Shastid noticed that Lincoln's left eye looked queer at times and would suddenly get crossed and turn upward.

Some 20 years later, when a physician and oculist, Shastid saw Lincoln in several debates with Douglas and in several trials in court as a lawyer. He then recognized the ocular condition as hyperphoria from a certain weakness of the muscles of the left eye, which continuously caused the eyeball to turn upward. Upon excitement this condition would suddenly increase and produce a severe cross-eyed effect. Dr. Shastid suggested that the hyperphoria caused intense eyestrain and uneasiness and was at least partly the cause of Lincoln's moodiness or "chronic inexpressible blues." He thought that Lincoln possibly was also color-blind, for Lincoln once said to his (Shastid’s) mother, when she showed him her flower garden, that flowers and sunsets had no beauty for him, as they did for other people.

Lincoln's right eye was dominant and was always used for vision, while the tendency of the left eye to turn upward and outward produced more or less over lapping of visual images. Like most such persons whose diplopia begins in youth, he soon adapted to this condition by reacting attentively to the imagery that he saw more clearly, that is, the image of the right eye, while ignoring what the left eye saw. This required more or less volitional brainwork, which was carried on easily enough until manhood, when at times mental visual fatigue or emotional strain became too severe.

Through the adult years Lincoln had many nervous attacks, characterized by eyestrain, headache with nausea, and indigestion, so severe that he often became unable to work and had to lie down with a cold compress over his eyes. He had couches in his law office, at home, and in the White House for this purpose.

Probably in youth and maturity Lincoln was unable to focus both eyes for any length of time without volitional effort. Herein existed an unconscious, self protective influence on conscious learning. He must not only use right-eyed instead of left-eyed vision, but he must consciously and conscientiously see mentally the right side and better side of things in order to reduce the emotional strain of being wrong. His highly persistent work in developing a clear thinking, logically visualizing, auditizing, and verbalizing mind counteracted the mentally befuddling effects of diplopia and protected him against the tendency toward gloomy mental visualizing.

In 1857, at the age of 48, while shopping in a jewelry store, he bought, upon the recommendation of a friend, his first pair of "spectacles" for reading. He tried on several pairs and paid 37 ½ cents for the glasses that he read best with. Until a few years before he had probably normal vision and effective accommodation of the right eye, although the accommodation was always attended by more or less strain from decoordination of the left eye.

The following reports on Lincoln's eyes and glasses are taken from several later authoritative sources. The glasses were reported by Almer Coe, of Chicago, to have in each lens the strength of +6.75 D. This indicated that Lincoln probably had 4 or 4 ½ D. of hypermetropia, or farsightedness, at the age of 48. This severe disability had no doubt been developing for a number of years and required constant effort to produce sufficient accommodation for reading.

Dr. W.H. Crisp, {12} an ophthalmologist, recorded the following observations: Full-face photographs show an upward deviation of the left eye, great enough to produce a lack of fusion of its images with those of the right eye. The two eyes did not work together, possibly as a result of a vertical strabismus of the left eye.

Dr. S. Mitchell {13} found evidence of left hyperphoria and hypertropia and suggested that the corrugations of his brow and the crow's-feet at -the corners of the eyes showed that Lincoln habitually used auxiliary facial muscles to support the external muscles of the eyes in the work of visual coordination.*

Dr. K.C. Wold {3} suggested that the diplopia was caused by a decoordination of the external muscles of the left eye, which was inherently connected in some way with the other facial asymmetries.

No physician on record, so far as I know, has attempted to explain the origin and nature of the asymmetrical functioning of the facial and ocular muscles on the left side, although some have discussed the nervous effects of eyestrain.

All the known symptoms are grossly explainable, I think, as the result of a cerebral injury attending the fracture of his skull in boyhood, and producing permanent, specific forms of nervous decoordination (organic neurosis).

*Dr. Frechette's emphasis

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