Early in 1992, President George H.W. Bush embarked on a pan-Asia trip that included a stop in Japan. The nominal goal was to reach an agreement addressing America’s trade deficit. But all anyone remembers of the visit is that Bush, stricken with the stomach flu, tipped over during a state dinner and vomited in Prime Minister Kiichi Miyazawa’s lap. How did the coverage of that incident compare with the reporting on Hillary Clinton’s wobble on Sunday?

The New York Times offered reassurance. Bush had succumbed to a “Benign, but Sometimes Scary, Illness,” it comforted readers in a gastroenteritis explainer. This was the prevailing tone of all the coverage of Bush’s hurling, despite the widely aired and alarming footage of the president appearing to lose consciousness at the dinner table.

Where was the panic? Where was the speculation? Clinton wobbled, and the media freaked. Bush ralphed, and the media cooed. He was 67 years old on the day he puked all over the Japanese premier. There’d been a health scare the year before when Bush was hospitalized with an irregular heartbeat, later diagnosed as a symptom of Graves’ disease, a thyroid condition. Last year, Bush biographer Jon Meacham revealed that the president suffered a second, unpublicized cardiac episode, also attributable to Graves’, in July 1992, and that the condition and his medications for it kept him under the weather for the rest of the year.

But Bush, running for re-election in 1992, managed to avoid having his health become a matter of significant political concern, even after fainting face-first into Miyazawa’s pants. This was partly because Bush, unlike Clinton, lacked partisan enemies willing to whip wild conspiracy theories about his well-being into a national frenzy and partly because Bush had cultivated an impression of vigor in the political press. It was his reflexive concern for appearing healthy, as Andy Card—then Bush’s acting chief of staff—recalled recently to Politico, that prevented him from taking the ambulance offered after leaving the dinner, even though he was sick enough to continue vomiting in the presidential limo all the way back to his hotel.

That impression of good health was built on less dramatic days, photograph by photograph and video clip by video clip: Bush hunting, Bush fishing, Bush golfing, Bush running, Bush playing tennis. In fact, just hours before the dinner, he and the U.S. ambassador to Japan, Michael Armacost, had played two doubles sets with the Japanese emperor and crown prince, which doctors suggested to the media might have aggravated his fatigue and illness. As it happened, the day of the dinner was among the lighter ones on the president’s schedule during the trip, which, as Reuters breathlessly reported, spanned 10 days and nearly 20,000 miles:

Since leaving Washington Dec. 30, he has worked 16-hour days, including official dinners every night, eaten exotic foods, gone from sweltering temperatures to frigid weather and taken rides on boats and helicopters. It has been vintage George Bush, and there has been no stopping him.

This zeal worried reporters more than Bush losing his dinner. “Listen to your doctor, Mr. Bush,” a Hartford Courant editorial cautioned. “No one will think that you’re over the hill if you skip a set of tennis or retire early.”

“Why doesn’t George Bush slow down a bit?” the Associated Press’ Marcy Gordon asked in a report. “No one is suggesting that Bush retreat to a rocking chair, but should he cut back on his heavy schedule and strenuous exercising?”

Naturally, the dinner was comedy fodder for the rest of the year. Bush’s critics, though, homed in on the substance of the Japan trip and refrained from any dark speculation about his health. “Millions of Americans have got the flu right now, so people will be sympathetic,” an adviser to Democrat Bob Kerrey’s presidential campaign told Newsday. “But it’s the metaphor that is so bad for him. It’s the metaphor of our country’s economy, being wobbly and being sick and needing some help from the Japanese. That’s an image the American people probably find distasteful.”

The ready metaphor of Bush’s illness probably mattered less to Americans in 1992 than the literal and lingering impact of the recession that had opened the decade. This was, after all, the election that birthed the phrase, “It’s the economy, stupid.” And yet it’s hard to wave away Bush’s age as an irrelevancy, especially given the contrast the race offered between him and a relatively youthful, charismatic Bill Clinton, who told voters he was running against a “tired, old” Republican Party. Today, one nominee uses a sledgehammer on his counterpart: “I don’t think she’s all there,” he says. Twenty-four years ago, a wink was as explicit as things got.

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