10 October 2014

President James Madison may have had epilepsy

I recently skimmed through Lynne Cheney's new biography of James Madison and was particularly interested in the evidence she presents of Madison's seizures, here summarized in her interview by the American Enterprise Institute:
He was not sickly, but he was sidelined from time to time. At the end of his presidency he drafted an autobiography explaining that he had a “constitutional liability to sudden attacks, somewhat resembling epilepsy, and suspending the intellectual functions.” Madison’s principal biographer deduced from this that he suffered “epileptoid hysteria,” but it is much more likely that he suffered what physicians today call complex partial seizures, in which those afflicted can hear, but not understand, speak but not make sense. The seizures can be disabling. Madison apparently experienced one while in militia training, and it kept him from serving in the Revolutionary War.
That last-mentioned episode has been judged by other biographers as being evidence that Madison's "bilious episodes" were psychogenic or a conversion disorder.  From the evidence Cheney cites at numerous places in her book, I'm convinced that he did have an organic seizure disorder.


  1. Let's not give Lynne Cheney credit for discovering this interesting theory. I did a google search and saw sources as far back as 2002.

    1. She provides citations going back way further than that.

  2. Complex partials manifest in so many different ways that it's hard to describe them in summary. A very brief description is that the person, for a brief period of time, seems to drop into a dream or nightmare, with associated nonsensical actions or vocalizations. Mechanical ability is limited; they may be able to open a door and run through, but they'd be unlikely to throw a bolt, open a door and run through. After the episode is over, a period of confusion may remain as the person tries to figure out where they really are and what's really going on. This post-ictal confusion can last from a few seconds to as much as an hour.

    Sometimes the patient will have some knowledge of what's going on, sometimes there's no memory of the event at all.

    Back in Madison's day, they probably (somewhere in the world) still burned these people as witches and sorcerers. Even today, the spouse--who suffers from this--has been called "demon-possessed" by the religious who've never been taught any better. She was even refused membership in a church one time as the pastor feared that, whilst in an episode, profanity might come out of her mouth. I've always wondered what he'd have done with a Tourette's sufferer.



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