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William Henry Harrison, the ninth U.S. president, holds a distinction that with luck will never be equaled: He was our shortest-serving president, dying April 4, 1841, after just a month in office. What killed him? Historians have long accepted the diagnosis of Harrison’Äôs doctor, Thomas Miller: ‘ÄúPneumonia of the lower lobe of the right lung, complicated by congestion of the liver. ’Äù

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What really killed U.S. president No. 9?

  • Article by: JANE McHUGH and PHILIP A. MACKOWIAK
  • New York Times
  • April 5, 2014 - 4:17 PM

William Henry Harrison, the ninth U.S. president, holds a distinction that with luck will never be equaled: He was our shortest-serving president, dying April 4, 1841, after just a month in office.

What killed him? Historians have long accepted the diagnosis of his doctor, Thomas Miller: “Pneumonia of the lower lobe of the right lung, complicated by congestion of the liver.”

The pneumonia was thought to be a direct result of a cold Harrison, 68, caught while delivering a numbingly long inaugural address (at 8,445 words, the longest in history) in wet, freezing weather without a hat, overcoat or gloves. But a new look at the evidence through the lens of modern epidemiology makes it far more likely that the real killer lurked elsewhere — in a fetid marsh not far from the White House.

Harrison summoned Miller to the White House on March 26, complaining of anxiety and fatigue. But Miller may have overlooked a clue that was in front of his nose. In those days the nation’s capital had no sewer system. Until 1850, some sewage simply flowed onto public grounds a short distance from the White House, where it stagnated and formed a marsh.

That field of excrement would have been a breeding ground for two deadly bacteria, Salmonella typhi and S. paratyphi, the causes of typhoid and paratyphoid fever — also known as enteric fever. Two other antebellum presidents, James Polk and Zachary Taylor, developed severe gastroenteritis while living in the White House. Taylor died, while Polk recovered, only to be killed by what is thought to have been cholera a mere three months after leaving office.

In 1841 there was no effective treatment for enteric fever. Miller gave him a host of toxic medications that were then considered the standard of care — including opium, which retards the intestine’s ability to rid itself of microbial pathogens, facilitating their invasion into the bloodstream. As he lay dying, Harrison had a sinking pulse and cold, blue extremities, two classic manifestations of septic shock. Given the course of his illness, his death is best explained by enteric fever.

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