Despite the nation's preoccupation with presidential health, some of the greatest leaders to occupy the White House have also been the sickest.

George Washington was, with good reason, a hypochondriac. His chest was hollowed out by tuberculosis, his face deeply cratered by smallpox. He had a tumor hacked out of his thigh without anesthesia. His ill-fitting wooden dentures gave him a constant toothache, and he suffered frequent bouts of fevers, chills and pain. In all, he was disabled 109 days during his first year in office.

Yet he had the image of vigor, which in politics is often more important than health itself. It was General Washington, after all, who, according to legend, threw a silver dollar across the Delaware River.

Another disabled president who made an indelible mark on history was Andrew Jackson. Born a "drooler," our seventh president was always spitting and dribbling, and he constantly itched from head to toe with chronic urticaria -- hives. His teeth were so bad he couldn't eat solid food. He nearly died from smallpox, and a bout with dysentery left him with cramps and bleeding for the rest of his life. When he was shot in the chest in a duel, the bullet lodged in the left lung, causing him to cough up blood and pus until he died at age 78.

Yet "Old Hickory" managed to bully the banks that threatened the young republic and is credited with bringing popular democracy to the land.

One of the greatest White House giants was Abraham Lincoln. But he, too, had many disabilities. He apparently suffered severe depression, perhaps due to a childhood concussion. With his long, spidery legs and bulging eyes, Lincoln is thought by a number of specialists to have had Marfan's syndrome, a fatal genetic disorder that affects the heart, eyes and skeleton. As Wilbur Cross and Dr. John B. Moses point out in their book "Presidential Courage," it's unlikely Lincoln would have lived out the year had he not been assassinated on April 14, 1865.

Washington, Jackson and Lincoln all had a vigorous image. Washington was taller than the average man of his times, and he had the macho general image -- as did "Old Hickory." Lincoln, too, was tall and had the here's-the-beef image of the Rail Splitter.

Some presidents just never thought of themselves as sick, even though they had health problems. Thomas Jefferson was an optimist, and at age 76 he wrote a glowing description of a life free of disease. "I enjoy good health," he wrote. Yet he had many episodes of dysentery, was plagued by headaches and rheumatism and suffered several major falls from horseback.

A century and a half later, Gen. Dwight D. Eisenhower brought his can-win reputation to the White House -- and was stricken with a heart attack, operated on for ileitis and suffered a stroke while in office. Although he recovered quickly from the stroke, he was so disoriented for two days that he talked gibberish. Still, he said to his wife and doctor: "There is nothing the matter with me . . . I am perfectly all right."

For presidents in this century, the vigor image has become a vital part of the Madison Avenue package for seeking office. John F. Kennedy, the youngest president to be elected, was always photographed sailing in a boat or playing touch football with his family -- despite the fact that he had a bad back and was thought to be suffering from Addison's disease, which caused him to take steroid drugs while in office.

In contrast, some of the healthiest presidents never seemed to achieve the vigor image -- and suffered politically as a consequence. John Adams, for example, rarely missed a day of work and lived to be 90. But he lost to Thomas Jefferson in his bid for a second term. Martin van Buren, too, didn't have a major illness until after he was 70. Diminutive James Madison, who weighed barely 100 pounds, was president during the divisive War of 1812 and lived to be 85.

In more recent times, Jimmy Carter was one of the healthiest men to occupy the White House -- but he never captured the vigor image despite his efforts at jogging and keeping fit. In fact, his collapse during a marathon would become a metaphor of his political collapse in the polls.

A great deal of effort goes into making the president look vigorous, which in turn has paved the way for a white gauze curtain to fall between the White House and the public when a president becomes seriously ill. A number of medical coverups in the White House now are well-known: Woodrow Wilson, who suffered a disabling stroke; Franklin D. Roosevelt, who was crippled by polio and suffering dangerously high blood pressure; Grover Cleveland, who underwent a secret operation on a boat in the mistaken belief that he had cancer.

Yet perhaps the national mood is changing after the let-it-all-hang-out era of the 1980s. The experience of illness might well be used as a political tool. Ronald Reagan, despite the lack of details provided to the public, is a president who has undergone major health crises in the White House -- from being wounded by an assassin's bullet to being treated for cancer.

In the current campaign, several of the candidates have faced severe illness either in themselves or in a member of their families. Republican candidate Bob Dole talks about the 39 months he spent in hospitals, recovering from war wounds. Vice President George Bush cites the death of his daughter from leukemia as one of his darkest periods. Democrat Richard Gephardt's son Matthew was diagnosed with terminal cancer as an infant but survived and is now 16, an incident the candidate says has given him strength.

In some ways, the example of George Washington may help set the political tone for the next presidential race to look at illness as a character-building experience. As historian Rudoph Marx in "The Health of the Presidents" put it: "The loneliness of the sickbed gives the patient an opportunity to know himself, take stock of his capabilities and to crystallize his dreams and ambitions. Long periods of physical disability gave Washington the time to find himself, and to plan his role in life."