John Adams, the second President of the United States, suffered throughout his life from a tremor in his hands. A pair of doctors in New York City recently undertook an examination of Adams’ penmanship to better understand the development of his tremor. The researchers noted evidence of a slight kinetic tremor in his writing from the 1760s, that became more pronounced over time. By the early 1800s, the tremor was quite strong, so much so that, beginning in 1812, Adams started to deliberately modify his penmanship, writing in a slow, labored manner. The letters themselves, two of which are displayed here, make for an entertaining read, from his youthful courtship with Miss Abigail Smith, to his one term as president, and later-in-life friendship with Thomas Jefferson.
Throughout his life, John Adams (1735-1826) kept up a series of correspondences with his close friends and family. Many of these missives survive, kept safe in Boston at the Massachusetts Historical Society and at the Library of Congress in Washington, D.C. One of Adams’ first letters to the future Mrs. Abigail Adams, dating from 1762, begins with “Miss Adorable” and charges her to give him “as many Kisses, and as many Hours of your Company” as he “shall please to Demand”. During his one term as President, from 1797 to 1801, Adams continued to correspond with his wife during the time that he was in Washington while she remained in Quincy. He writes of trivial details, but also reveals illuminating insights about his role as president, such as (in a letter from 1801) “The Burden upon me in nominating Judges and Consuls and other officers.” In that same correspondence, written less than a month before the end of his presidency, Adams reveals to his wife that “The Election will be decided this day in favour of Mr. Jefferson as it is given out by good Authority.” Even though Adams and Thomas Jefferson were political rivals at the time, they kept up a lively correspondence, and, as they grew older and left public office, seem to have become close friends.
In a lengthy letter from Adams to Jefferson in 1812, Adams broaches a good many topics, ranging from the inefficiency of the Milton post office, to Plato and Hobbes, Burr and Hamilton, and both their families. Towards the end of the missive Adams’ writes “I have a Complaint that Nothing but the Ground can cure; that is the Palsy; a kind of Paralytic affection of the Nerves, which makes my hands tremble, and renders it difficult to write at all and impossible to write well.” In a recent article, Dr. Elan Louis and Dr. Patricia Kavanagh examined Adams’ penmanship over the course of his life to better understand the development of his tremor. They discovered early evidence of a low-amplitude kinetic tremor in a diary entry from 1760, with the tremor much more pronounced in his correspondence from the last decades of the eighteenth century and the first decade of the nineteenth. By the 1810s, his characters were becoming less clear, with smaller spaces between the lines on a page. For the final eight years of his life, his tremor had reached such a debilitating state that Adams was forced to dictate his letters. The letter cited above, from 1812, was the first instance of Adams complaining in writing about his condition, something that he then comments on a number of times over the next year in his correspondence with Jefferson. Though some have suggested that Adams may have developed a form of parkinsonism, Drs. Louis and Kavanagh believe the more likely diagnosis is that of an essential tremor.
Tremor belongs to the category of hyperkinetic (too much movement) disorders. Everyone has a tremor as can be demonstrated by holding a laser pointer and aiming it at a wall across the room: the light is never completely still. You can show the same thing by balancing a piece of paper on the back of your open hand with your arm outstretched—the paper will never be entirely still. This normal, or “physiological,” tremor can be accentuated by several things. Drugs such as caffeine, antidepressants, asthma inhalers, or nicotine can make it more noticeable. Anxiety or stress (like public speaking), hypoglycemia, alcohol withdrawal, or an overactive thyroid can also make it more prominent. Around five percent of the population have an “essential tremor,” or ET, which is an increase in the baseline, normal physiological tremor. It typically starts in the hands but can also affect the head or the voice. A notable example is Katherine Hepburn who continued to act in films despite her prominent voice and head shaking. You will notice in this video that she does not have the other features of Parkinson Disease (which is commonly misdiagnosed in ET patients), such as decreased facial expressions, decreased volume of the voice, and slowed movement. ET tends to run in families—some tremor-related genes have been identified. There are effective treatments including medications and, for some severe cases, brain surgery. However, sometimes it is difficult to treat with complete satisfaction.
The P.S. is particularly entertaining, for Adams’ writes “I forgot to remark your Preference to Savage over civilized Life. I have Something to Say upon that Subject. If I am in Error, you can Set me Right, but by all I know of one or the other I would rather be the poorest Man in France or England with Sound health of Body and Mind than the proudest King, Sachem or Warriour of any Tribe of Savages in America.”
Louis, Elan D. and Kavanagh, Patricia. “John Adams’ Essential Tremor.” Movement Disorders Vol. 20, No. 12 (2005): 1537-1542.