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

fracture of skull and injury of brain in boyhood

All these differences in the development of the facial muscles and bones, and the weakened functioning of the ocular and facial muscles on the left side in particular, indicate that Lincoln suffered a serious injury to his brain before adulthood. The sharp depression in the forehead above the left eye with a definitely palpable edge in the life mask, previously described, shows where his skull had been fractured, and the permanent differences in the nervous tone of the muscles of the two sides indicate that his brain was then permanently injured.

With this conclusion in mind, I searched the history of Lincoln’s childhood for evidence of such an accident and found that it occurred in his 10th year. He was driving an unshod horse hitched in a circular mill for grinding corn or sugar cane; and, growing impatient of her slow pace he shouted, "Get up, you hussy," and gave her a whack with a stick. She kicked back, hitting him in the forehead. He was knocked unconscious for many hours and was thought for a time to be dead. He seems to have recovered without apparent serious after-effects, since he received no special medical attention for the head injury, the doctor living many miles away. Fracture of the skull and cerebral after-effects were never suspected, or at least never reported, by any of his physicians, although after the age of 30 he consulted several for treatment of melancholia and other nervous symptoms. This omission is not surprising, for it was not until after 1890, upon application of x-ray photography, that neurophysiology learned how to explain some of the cerebral effects and nervous consequence; of fractures of the skull {Mock 9}.

Ample recording methods now show that an appalling amount of damage to the brain follows blows on the head, at the point of impact and from hydrostatic repercussion (contrecoup), through the production of petechial internal hemorrhages, as well as larger subdural blood clots, without external evidence of fracture. Blows on the forehead in boxing have been found to bruise by concussion the frontal lobes of the brain, sometimes with permanent, stupefying, "punch-drunk" effects, without visible injury on the outside of the head.