James Madison and His “Sudden Attacks”

The 4th president’s neurologic condition kept him frequently bedridden.

Photo courtesy of History.com

James Madison was known for many things throughout his illustrious political career. The 4th president was the US Constitution’s biggest contributor, a fierce intellectual, a writer of the Federalist Papers, a representative from Virginia, Secretary of State, founding member of the Democratic-Republican Party, and ultimately the top executive of the United States. Many recognize Madison for these accomplishments, but few know of his suffering at the hands of his neurologic disorder.

Madison’s Debilitation

James Madison began experiencing what he termed “sudden attacks” early in his life. The Princeton educated man self-described his condition as rendering him with an intellectual suspension. This manifestation caused Madison to be frequently confined to his bed and stay away from politics. Those studying Madison have suggested that he probably suffered from a form of epilepsy. Madison’s “attacks” closely resemble what we now know as complex partial seizures or focal impaired awareness seizures. This form of seizure affects a specific lobe of the brain but is confined to that lobe. It is suspected that Madison’s temporal lobe may have been the one affected during his episodes.

Health Consequences

Madison is well-known for being the shortest president in American history, only measuring in between 5’4” and 5’6”. While his height was dwarfed by other Founding Fathers, Madison’s intellect garnished much respect among his peers. Madison was also frequently described as frail in stature and has been noted to be under 100 lbs. Moreover, he suffered from arthritis and chronic cholecystitis, or gallbladder inflammation. Madison’s neurologic disorder was just an additional deterrent to many activities that would have been normal at the time.

Madison, as a Virginian, would have naturally attended college at William and Mary, but it was suggested that he did not due to fear of malaria. Therefore, Madison studied farther north in New Jersey.

Another activity Madison was kept out of was the military. During his early 20s, Madison collapsed at a military drill in response to one of his “sudden attacks”. The timing of this spell kept the frail future president out of the military. Who knows what may have come of the Constitution and the country if Madison had been killed during the Revolution.

Closing Thoughts

James Madison was quite an inspirational figure. For the times, it is quite remarkable that he managed to stay alive given all of his ailments. However, despite adversity, Madison was able to make a very successful career in politics. His “sudden attacks” may have changed his predetermined path, but that may have been for the better. Thankfully, we now have the resources to better understand what may have plagued him.

Grant Fuerstenau is a Medical Student at the University of Louisville School of Medicine and the editor of The Biographical Historian.



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Grant Fuerstenau

Grant Fuerstenau

Medical Student | Medicine, Science, History, Geography, and Sports | Editor of The Biographical Historian