On Presidential Deaths and Economic Growth February 19, 2015

In honor of the recent Presidents’ Day — which we used to correctly acknowledge as Washington’s Birthday before political correctness — let us play a little trivia game.  How many presidents died in office other than those who were assassinated?  Give up?  The correct number is four, five if you count James K. Polk (more on that later).

They are, in chronological order:  William Henry Harrison, Zachary Taylor, Warren G. Harding, and Franklin D. Roosevelt.  The latter two did not die of pathogen-caused disease, but rather of other maladies.  In Harding’s case, it was a heart attack.  In FDR’s case, it was a cerebral hemorrhage brought on by, well, being in office for three terms and change.

So what of the first two?  Harrison, for example holds two dubious distinctions as President:  the first to die while in office, and shortest length of time while in office, at about 30 days.  But why?  We have been conditioned to think it was on account of pneumonia.  Turns out that is not the case.  Yes, he did himself no favors by giving an 8,445-word Inaugural Address (still a record to this day for Inaugural Addresses, making the Hero of Tippecanoe a holder of three Presidential records!), which he did in the freezing rain without a hat, overcoat, or gloves.  Not the smartest of moves, and he actually did catch a cold from it.  But he recovered from the cold, and it never grew into pneumonia.  So what happened?

A fascinating article published in the New York Times last year sheds new light on Harrison’s untimely death.  It details the findings of a new medical investigation in that year, which followed the clues and concluded that the cause of death was typhoid, not pneumonia.  The latter was merely a guess from Harrison’s attending physician who, understandably, had comparatively limited medical knowledge.  Even then, the doctor acknowledged pneumonia to be a secondary diagnosis.

Typhoid actually makes all the sense in the world.  The disease is bacterially-based, and the pathogens in this case ravage the gastrointestinal tract, particularly the stomach, until they do their damage which allows them to enter the bloodstream, causing sepsis.  In the middle part of the 19th Century, not far from the White House was a man-made fetid swamp produced on account of daily deposits of, er, night soil — at government expense, of course.  This fetid, man-made marsh became a breeding ground for the bacteria that cause typhoid and paratyphoid fevers (both of which, interestingly, belong in the same genus of Salmonella).  It claimed two other presidents, too.  James K. Polk contracted severe gastroenteritis  (a variation on the exact same theme, practically tomayto-tomahto) while in the White House but he somehow recovered, only to die of cholera — the nature of the infection is practically the same, as they are often brought on my contaminated food and water — merely three months after leaving office in 1849.

Polk’s successor, Zachary Taylor, also died in office, having contracted Salmonella-caused gastroenteritis during the 4th of July celebration in 1850.  He died just five days later.

Frankly, it is a wonder that more of our presidents did not die of similar causes.  Antibiotics, which would have stopped these pathogens in their tracks, were not available until WWII, roughly a century’s span from this time.

So how come subsequent presidents in the remaining 19th Century avoided meeting such an untimely demise?  George Will’s insight provides an answer, and does so within the context of marking the 25th anniversary of AIDS in a 2006 article:

“AIDS arrived in America in the wake of the Salk vaccine, which, by swiftly defeating polio, gave Americans a misleading paradigm of how progress is made in public health. Pharmacology often is a small contributor. By the time the first anti-tuberculosis drugs became available in the 1950s, the annual death rate from TB had plummeted to 20 per 100,000 Americans, from 200 per 100,000 in 1900. Drugs may have accounted for just 3 percent of the reduction. The other 97 percent was the result of better nutrition and less urban crowding. Thanks to chlorination of water and better sanitation and personal hygiene, typhoid, too, became rare before effective drugs were available.”

“Which suggests,” he adds, “that the most powerful public health program is economic growth.  And the second most powerful is information.”

Indeed.  Economic growth provides the resources necessary to better dispose of human waste as well.  DC introduced its first sewer system in 1885, for example, thus greatly reducing the chance of Presidents Cleveland through [Franklin] Roosevelt contracting the same maladies that felled two, if not three, of their predecessors in the mid-19th Century.

That said, as an aside, there seemed not to be a universal utilization of Washington, D.C.’s sewer system as recently as 1941, as George Will points out in an article seven months prior to the aforecited one.