Full Disclosure of Candidates’ Medical Histories Urged : Politics: Experts say that the responsibility to inform the public transcends the right of the three to privacy.

Among the 17 American presidents this century, Warren G. Harding and Franklin D. Roosevelt died of natural causes while in office. Nine presidents had heart disease. Some, such as Ronald Reagan, had cancer or major operations. President Bush has thyroid disease.

In many of these past instances, voters were unaware of the presidential health problems. For instance, it was not known during his presidency that John F. Kennedy had Addison’s disease, a life-threatening illness caused by failure of the adrenal gland.

Occasionally, the public has been led to believe that the ailments were less debilitating than they really were. One of the most serious cover-ups involved Woodrow Wilson, whose capacity to govern was severely diminished when he suffered a massive stroke in 1919. The extent to which Wilson’s wife and aides made important decisions during the last year-and-a-half of his second term was not revealed until decades later.

The record shows that presidents “are at risk because of their age and because of their position,” said Dr. Herbert L. Abrams of Stanford University’s School of Medicine. Abrams and others believe that presidential candidates have a responsibility to inform the public about their health and medical histories, and that this obligation transcends issues of confidentiality and invasion of privacy.

Said Abrams: “There should be complete disclosure of detailed medical information.”

At various times during this year’s presidential campaign, spokespersons for Bush, Democrat Bill Clinton, and independent Ross Perot have pronounced each of them to be in “excellent” health. But none of the candidates has provided anything close to the type of specific data Abrams calls for.

In the 1988 campaign, a New York Times medical reporter was given permission to interview both Bush and Democratic candidate Michael S. Dukakis about their health, as well to interview their respective physicians.

This year, both Bush and Clinton campaign officials declined requests for interviews with the candidates’ physicians. A spokeswoman for the Perot campaign said she does not know who his physician is. His campaign has released no specific information about his medical history.

Based on the general information provided by the campaigns, previous reports and other sources, here is what is known about the health of the three White House contenders.

As a 68-year-old white male, Bush has a life expectancy of 13 years, according to actuarial life tables based on the Vital Statistics of the United States. At 62, Perot has a life expectancy of 17 years, while Clinton, at 46, has a life expectancy of 30 years. (An adult’s life expectancy increases slightly with advancing age because of a statistical correction for people who have died.)

Bush and Perot are also at increased risk on a statistical basis for problems that become more frequent with advancing age, such as prostate disease, eye and hearing difficulties, heart disease and some forms of cancer.

Over the summer, reports surfaced that raised concerns about Bush’s health, including conjecture that he was mentally disengaged. In response, Dr. Burton Lee III, his personal physician, and Dr. Lawrence C. Mohr, the executive physician to the White House, went public to dismiss the allegations. A statement from Mohr called Bush’s health “excellent overall.”

Since then, they have declined comment; a campaign aide said Lee was giving no interviews at this time. The White House has also refused reporters’ requests to release the President’s medical records.

Bush’s best-known medical problem is Grave’s disease, a disorder of excess thyroid hormone production. The condition, which developed in 1991, was diagnosed after the President experienced an irregular heartbeat, known as atrial fibrillation, while jogging.

Bush was treated with radioactive iodine, which destroyed the abnormal thyroid tissue. Subsequently, his physicians placed him on a daily dose of synthetic thyroid hormone, a standard regimen following radioactive iodine treatment. His physicians also prescribed a baby aspirin each day, a common measure to reduce the risk of heart attack in older men, as well as the risk of stroke.

Now that Bush’s Grave’s disease has been successfully treated, it is not expected to have any long-term health effects.

The President also had a public vomiting episode in January. During a state dinner in Tokyo, he became ill and vomited and fainted at the elbow of Japanese Prime Minister Kiichi Miyazawa.

Bush’s illness was captured on videotape and shown repeatedly around the world. Medical experts attributed the collapse to a gastrointestinal virus. While the episode was highly embarrassing, the experts have expressed doubt that it would have any long-term medical consequences.

The President also had duodenal ulcers twice during the 1960s. The ulcers have not recurred.

Bush is well-known for his long hours of work and his passion for aerobic exercise, such as jogging. In his acceptance speech at the Republican National Convention, Bush said, “I feel great.” He quipped that he was “heartened by the polls, the ones that say I look better in my jogging shorts than the governor of Arkansas.”

Relatively little is known about Perot’s medical history.

Sharon Holman, a spokeswoman for the campaign, said that “Perot jogs regularly. He works out in a gym. He goes horseback riding almost every morning. He is in excellent health. He watches his diet. He is a healthy eater.”

When asked if Perot has had any significant medical or surgical problems, Holman responded: “Not that I can recall.”

The Clinton campaign in June released two-paragraph “to whom it may concern” letters from three of the candidate’s doctors in Little Rock, Ark.: Dr. Andrew G. Kumpuris, a cardiovascular specialist; Dr. Kelsy J. Caplinger, an allergist, and Dr. James Y. Suen, a head and neck specialist. The letters characterize the health of the Arkansas governor in very positive terms. But they lack the level of detail characteristic of medical reports that physicians normally prepare on their patients.

“At the governor’s instructions,” Clinton’s physicians do “not talk to the press,” said Avis LaVelle, a Clinton spokeswoman. When asked why, LaVelle said: “People have reason to be concerned about President Bush’s health. There is no reason to be concerned about Gov. Clinton’s health.”

Clinton’s health problems include severe allergies, chronic hoarseness during the earlier stages of the campaign and a generous waistline.

Reporters who travel with Clinton note that he is often sniffling, sneezing and red-nosed during his long hours of campaigning.

According to the June letter from Caplinger, the Little Rock allergist, Clinton has “allergic rhinitis,” a swelling of the nasal passages that can cause nasal discharge as well as itchiness of the nose and eyes. He is sensitive to house dust, mold, weed and grass pollens, cats and caffeine, among other things. In recent years, he has been treated with regular injections of allergy extracts to ameliorate his symptoms.

Clinton’s voice problems began in February and persisted throughout the spring. While not serious from a health standpoint, the chronic hoarseness interfered with his ability to communicate.

The condition was attributed by Suen, the Little Rock specialist, to overuse of his voice and “gastroesophageal reflux,” a back flow of stomach contents into the esophagus which can irritate the throat. The reflux condition, a common malady, is typically caused by inappropriate relaxation of the lower part of the esophagus. The hoarseness improved once Clinton rested his voice more often.

Clinton has also fought a longtime battle against excess calories. On the campaign trail earlier this year, he gained at least 20 pounds. He has since lost weight and kept most of it off. Clinton has done this by cutting down on late-night snacks and exercising more regularly. Most days, he jogs at least several miles.

According to the June letter from Kumpuris, the Little Rock cardiologist, Clinton had an “entirely negative” medical evaluation on Aug. 27, 1991. “His laboratory tests were all within normal limits. . . . A treadmill stress test was performed. His exercise tolerance was excellent and there was no evidence of any cardiac problems. In summary, his general health is excellent.”

In an era where presidential candidates have grown to expect exacting scrutiny of their finances as well as many aspects of their personal lives, many wonder why the health of the candidates should be held to a lesser standard.

Nevertheless, politicians and their families often maintain that they are entitled to greater privacy with respect to their medical care than to other potentially sensitive matters. For instance, media discussion of Reagan’s 1985 colon cancer surgery so upset his wife that she refused to allow the Mayo Clinic surgeons who performed his 1987 prostate surgery to talk to reporters.

Concerns about medical candor among aspirants to the White House were underscored earlier this year.

In response to press scrutiny, physicians for former Democratic presidential candidate Paul E. Tsongas acknowledged that he had suffered a recurrence of his lymph node cancer in 1987. Previously, his physicians repeatedly maintained that Tsongas had been cancer-free since undergoing a bone-marrow transplant in 1986.

After the controversy erupted, Tsongas wrote an op-ed article in May for the New York Times in which he declared “that if I should surface again politically, I will make available all my medical records for public inspection. This will set a precedent that all candidates will have to follow, even though their previous health history seems perfectly normal.”

Stanford’s Abrams--the author of “The President Has Been Shot,” a 1992 book which argues that the public was largely kept in the dark about how close Reagan came to dying when he was wounded in a 1981 assassination attempt--believes that presidential candidates should have “full and complete” medical evaluations early in the campaign coordinated by the chief of medicine at a respected institution, such as the Bethesda, Md., Naval Medical Center or Johns Hopkins Hospital in Baltimore.

All of the results, including relevant past medical histories, should be available to the public at a level of detail reflecting “what a good internist would want” or what an insurance company “would want to know about somebody who is getting a million bucks worth of life insurance,” Abrams said.

Abrams also advocates that the candidates have an MRI scan of their brain, a sensitive radiologic examination that can detect many abnormalities. Such an exam is normally not recommended for individuals unless they are experiencing significant brain-related symptoms because of the expense and the possibility of inaccurate results. But Abrams contends that presidential candidates are a legitimate exception to the usual recommendations.

“Sooner or later, a President will have a brain tumor or Alzheimer’s disease,” Abrams said.

Another scholar of presidential health, Robert H. Ferrell, an emeritus professor of history at Indiana University, suggests that the qualifications and accountability of presidential physicians should receive greater scrutiny.

Ferrell is the author of the 1992 book “Ill-Advised,” which is about medical cover-ups in the White House. In it, he recommends that the President’s choice of personal physician be subject to confirmation by the Senate, as is the case for many high executive branch officials.

Times political writer Cathleen Decker contributed to this story.