What was James Madison sick with?
It’s unclear. Historians have their theories (including some people who say he wasn’t sick at all he was “just a hypochondriac,” which is... an awful take. for several reasons), but there’s obviously no real way to confirm them & medical science wasn’t advanced enough for them to understand anything too complicated, so the notes we do have aren’t that much help.
Some historians have labeled Madison’s issues as “hysteria” because Madison tended to surround himself with doctors & complain of issues that he ended up not having. After all, he couldn’t have been that sick--he lived to 85! He outlived all the other Founding Fathers! He was lying the whole time, right?
People tend to use hypochondria (an obsession over your health to the point you think any change is indicative of a serious problem--like thinking a headache lasting more than a few hours is brain cancer) as a passive-aggressive way of saying “you’re faking it.” It’s synonymous with people who worry about nothing & do shit for attention. This is particularly true if your problem is so rare that there isn’t a lot of accurate ways to test for it, so results either come up as inconclusive or negative.
But the main thing that people don’t like to talk about when discussing hypochondria is that it doesn’t just... happen at random. I would know. I have it.
I’ve been sick since I was a newborn; I’ve had 4 brain surgeries, 5 broken arms, 3 bone marrow transplants, bone cysts, 3 eye surgeries (about to be 4), Shunt placements, ETV placements, Hydrocephalus, Osteopenia, brain damage, scars all over my body & 11 surgeries before I was 12 years old. Hypochondria is often the result of legitimate medical episodes, particularly if it’s something traumatizing--directed towards yourself, or towards a close family member.
It’s valid trauma just like anything else, and is oftentimes only “cured” through things like mood stabilizing medication, lifestyle changes, or behavioral therapy.
So, Madison having hypochondria or not is irrelevant to the whole discussion, because (as I can attest) it’s entirely possible to be suffering from hypochondria, & still have “real” medical issues.
All of the physical descriptions of Madison we have tell us that he is 5″4′’ & “never weighted over 100lbs,” which... is probably true, but I wouldn’t say never because that’s immediately disprovable once you start looking around; apparently his official weight during his presidency was 122bs. But at that point he was 57, so things could have changed.
Hell, I was 130lbs three years ago & only RECENTLY got to that number again; it’s hard to keep on weight when you’re struggling with health issues.
Madison’s immune system has been implied to be very weak. We don’t have that many examples of childhood illnesses or such things like that, but a particularly telling example is how his family discouraged him from attending a local college in Virginia.
He wanted to go to William & Mary, but was dissuaded by his doctors due to malaria outbreaks being very common in the South during the summer. So the assumption there is Madison (who lived in Virginia all his life, summers & all) probably went through something severe recently? Maybe? It’s unclear.
So he went to Princeton (Class of 1771) in New Jersey instead, & was actually one of the first graduates to peruse extra education... but only because he was too sick to travel home & decided to stay a while longer.
Though, there’s also apparently a legend that Madison (because he finished his courseload in 2 years, instead of 3) had a mental breakdown over it & therefore needed to recuperate (with... more work?), but I’ve never been able to find that much information on it.
Following college, in July 1775 Madison attempted to volunteer as a soldier. But during a routine training exercise, Madison all the sudden collapsed (or fainted) & was reportedly unresponsive for several minutes. This would be a common occurrence for pretty much the rest of his life.
Episodes tended to be accompanied by what Madison described as mild delirium, memory loss & a suspension of “intellectual function.” It’s led some people to theorize he suffered from epilepsy, since it’s common for sufferers to be confused, agitated or upset following an episode—because you often have no memory of it after ‘waking up’. Specifically, the behavior is theorized to be petit mal or “absence” seizures.
Accounts of what Madison was like as a public speaker all seem to agree that he spoke so softly that it was oftentimes difficult to hear him; it was oftentimes shrill, but quiet & he reportedly had trouble raising his voice to a decent volume.
This one is a bit of a mystery, but Madison had been complaining about a “vocal impairment” as early as his teenage years, in what I can only assume to be some sort of vocal chord issue, or a respiratory problem (like trying to speak when you have something stuck in your throat.)
As much as I dislike Hamilton, the play actually hints at this in a clever way by having the Madison character speak minimally (as well as carry a handkerchief around). Well done, I guess.
Later in his life, Madison started suffering from something called “biliousness,” which is just an outdated term for conditions that cause gastrointestinal problems, like chronic stomach inflammation or etc.
In the end, James Madison died of (we assume) congestive heart failure at the age of 85, remaining pretty alert up until the last few months before his death. He outlived nearly all of his peers (if we’re counting Burr) & probably did a lot better than what his doctors expected out of him.
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