Lincoln's Craniofacial Microsomia: Three

SPECIAL ARTICLE Lincoln’s Craniofacial Microsomia Three-dimensional Laser Scanning of 2 Lincoln Life Masks Ronald S. Fishman, MD; Adriana Da Silveira, DDS, MS, PhD xamination of 2 life masks of Abraham Lincoln’s face was performed by means of 3-dimensional laser surface scanning. This technique enabled documentation and analysis of Lincoln’s facial contours and demonstrated his marked facial asymmetry, particularly evident in the smaller left superior orbital rim. This may have led to ret- Eroplacement of the trochlea on the left side, leading, in turn, to the mild superior oblique paresis that was manifested intermittently during adulthood. Arch Ophthalmol. 2007;125(8):1126-1130 Abraham Lincoln cooperated on 2 occa- METHODS sions in the making of plaster casts of his face, so-called life masks. The first was A bronze copy of the 1860 mask (Figure 1A) made in Chicago, Illinois, in April 1860 and a plaster copy of the 1865 mask (Figure 1B) by the sculptor Leonard Volk. Pledgets of were made available for study at the Chicago His- cotton were placed on the eyes before ap- tory Museum (formerly known as the Chicago plication of the plaster; any details of the Historical Society). We investigated Lincoln’s facial contours by photographing the masks from eyelids were lost, but the overall techni- various angles including those particularly use- cal quality was deemed excellent. Be- ful in comparing the orbits on the 2 sides cause this plaster cast was made before (Figure 2). We then applied, for the first time, Lincoln grew his beard, details of the man- 3-dimensional laser surface scanning for analy- dible are not obscured. Bronze copies from sis of the 2 masks, according to established tech- this mold were not made for more than 20 nique.3,4 years, when a few were sold for $25 000 The laser scanner used (VIVID 700; Konica in an early attempt to raise funds for a Minolta Sensing Americas Inc, Ramsey, New Jer- Lincoln memorial.1 sey) operates on the principle of a light-stripe tri- The second life mask was made by the angulation range finder. The subject’s facial surface is scanned from top to bottom with a class sculptor Clark Mills on February 11, 1865, 2 laser light stripe projected from a distance just before Lincoln’s 56th birthday and 2 of at least 1 m. The position of an illuminated months before he was assassinated. This surface point relative to the viewpoint is ob- time, the plaster was applied directly to the tained by triangulation. The resolution in the closed eyelids and details of the eyelids can x and y coordinates is 200ϫ200 range points be seen. Mills evidently applied a rela- per scan. The reliability of this method has been tively thin layer to the face in a newer tech- tested and found to be good.5 Scanning of the nique that enabled the subject to remove masks from at least 3 different views, that is, the mold with less discomfort by twitch- from the front and to each side, was necessary ing the face muscles; this broke the mask to enable the computer program (Polygon Editing Tool software; Konica Minolta) to re- into pieces, which were then gathered gen- construct a 3-dimensional image, or moulage, tly into a cloth and reconstituted later into of each of the masks. One facial scanning may a whole mold. However, this technique in- contain 40 000 points, and a polygonal mesh troduced opportunity for artifacts in any is formed of all these points, representing the casts made from the mask.2 facial surface. Cartesian coordinates (x, y, and z) from facial landmarks can be identified and the surface distance between them calcu- lated using computer software (Geomagic Studio, version 9; Geomagic Inc, Research Author Affliliations: Dr Fishman is retired. Craniofacial Center, University of Triangle Park, North Carolina). These land- Illinois, Chicago (Dr Da Silveira). Dr Da Silveira is now with Dell Children’s marks are standardized points used in physi- Craniofacial Center, Austin, Texas. cal anthropology, and their use in 2- and 3-di- (REPRINTED) ARCH OPHTHALMOL / VOL 125 (NO. 8), AUG 2007 WWW.ARCHOPHTHALMOL.COM 1126 ©2007 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 A B Figure 1. A, Bronze cast of the 1860 Lincoln life mask by Leonard Volk. B, Plaster cast of the 1865 mask by Clark Mills. Specimens from the Chicago History Museum, Chicago, Ill, November 2005. Figure 2. The 1865 mask as seen from below, a view that throws the orbits into relief and makes the Figure 3. Frontal view of a computer-generated smaller left orbit more apparent. 3-dimensional reconstitution, or moulage, of the 1865 Lincoln life mask shows marked facial mensional analysis of facial shape is lateral facial asymmetry is evident in asymmetry. Lines show the boundaries of the well accepted. With the software, 3-di- the following ways: right, left, and frontal scans, which are merged mensional images can be analyzed in to form the 3-dimensional moulage. Gross inspection of the overall full 3 dimensions, superimposed, and orange, and red areas reveal where rotated for better visualization. This tech- face shows that the left half is smaller these images are mismatched. Sub- nique, with its accuracy, ease of use, and than the right half (Figure 2 and convenience, has proved particularly use- stantial asymmetry is apparent at the Figure 3). When a mirror image of superior orbital rim, especially the ful clinically in documenting and analyz- the right half of the 3-dimensional ing craniofacial anomalies of various types, medial half, where a dark blue area particularly cleft lip, in children.6 In ana- digital moulage is superimposed on shows a large degree of mismatch. lyzing the Lincoln masks, it provided the original 3-dimensional image, The anterior left orbital aperture views from any desired angle and en- additional details appear. Using the is larger than that on the right, pri- abled measurements to be made so as to software for superimposition and marily because of rounding of the left quantify the degree and nature of the fa- analysis, a color diagram is gener- superior rim compared with the rela- cial asymmetry. ated demonstrating where compo- tively flattened rim on the right, which nent mini-areas of the 2 images do also appears to be thicker than its RESULTS not match (Figure 4). The col- counterpart on the left. This pro- ored area is coded so that green in- duces, in turn, upward displace- The following statements apply to dicates where the superimposed im- ment of the left superior palpebral sul- both the 1860 and 1865 masks. Bi- ages match fairly well; blue, yellow, cus (evident only on the 1865 mask). (REPRINTED) ARCH OPHTHALMOL / VOL 125 (NO. 8), AUG 2007 WWW.ARCHOPHTHALMOL.COM 1127 ©2007 American Medical Association. All rights reserved. Downloaded From: https://jamanetwork.com/ on 09/26/2021 told about it by his father, who re- membered Lincoln from the days they shared in New Salem, Illinois, in the 1830s when Lincoln was a shop- keeper and postmaster. The elder Shastid had also seen Lincoln during the 1858 debates and in several trials as a lawyer, and noted the ten- dency for Lincoln’s left eye to roll upward when he was excited.12 A rare straight frontal view in a photograph taken in November 1863 shows a manifest hyperdeviation of Lincoln’s left eye (Figure 5). This strabismus has been discussed several times over the years.13-15 Goldstein16 takes special note of other photographs of Lincoln that show a right-sided head tilt and makes a convincing case that Lincoln Figure 4. A mirror image of the right half of the face is superimposed on the moulage. Blue, yellow, had a slight paresis of the left supe- orange, and red areas reveal where these images are mismatched. Substantial asymmetry is obvious at rior oblique muscle. the superior orbital rim, especially the medial half, where a dark blue area shows a large degree of mismatch. The cause of this paresis is less certain. It is tempting to relate it to the trauma Lincoln suffered at the Incidentally noted is absence of the right of the midline.8 Artists and age of 10 years when he was kicked the flattening of the left side of the sculptors were also aware of it; in the head by a horse and was un- forehead, a sign seen in unicoronal Gutzon Borglum, the sculptor re- conscious for several hours. Previ- synostotic plagiocephaly. sponsible for the Mount Rushmore ous writers have raised the possibil- Soft tissue asymmetries evident in likenesses, remarked that the left side ity of indirect trauma to the fourth the nose, lips, and ears have been dis- of Lincoln’s face was “primitive,” cranial nerve or to direct injury to counted as either extraneous or the “immature,” “unfinished.”9 the trochlea itself.15 Complicating result of technical factors. Facial asymmetry to some de- this scenario is the familial occur- rence of hypertropia, as docu- Direct examination of the masks gree is so common that it can be con- mented in photographs of Lincoln’s for the dent in the forehead above the sidered normal. That it is obvious in cousin John Hanks and especially of left eye as described by Kempf7 could some certified beauties shows that, in Lincoln’s son Robert Todd Lincoln, not confirm this defect in either of the itself, it does not preclude the pur- 10 the only Lincoln child to survive to masks available for study.

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