This piece has been updated with reactions from Karl Rove and former White House Communications Director Nicolle Wallace.
It's only 2014, but the 2016 presidential race has already taken an ugly turn.
According to the New York Post's Page Six, Republican strategist Karl Rove suggested last week that former Secretary of State Hillary Clinton may have sustained brain damage after suffering a blood clot in her skull.
Clinton was admitted to the hospital in late December 2012, where doctors discovered a blood clot related to a concussion she had suffered earlier in the month. She was released from the hospital several days later.
Rove, however, apparently thinks her stint in the hospital left some questions unanswered.
"Thirty days in the hospital?" Rove said, according to Page Six. "And when she reappears, she's wearing glasses that are only for people who have traumatic brain injury? We need to know what's up with that.”
Clinton's doctors, however, debunked Rove's theory long ago. Prior to her release from the hospital in January 2013, Clinton's physicians at a New York hospital said the clot did not cause Clinton to suffer a stroke, and did not result in any neurological damage.
“Please assure Dr. Rove she’s 100 percent," a Clinton representative told the Post's Emily Smith.
The remark reportedly came during an appearance at a Los Angeles conference with former White House press secretary Robert Gibbs. The Harry Walker Agency, which represents a long list of political heavyweights now on the paid speaking circuit, advertises Gibbs and Rove as a duo that provides "intimate and insightful commentary as they both speak with great authority and accuracy from a White House insider's perspective."
Former White House Communications Director Nicolle Wallace, who worked with Rove in the George W. Bush administration, called Rove's comments "off the wall."
“I worked with Karl for a long time. This was a deliberate strategy on his part to raise her health as an issue and, I think in his view, a legitimate line of questioning ahead of the next campaign," Wallace said on MSNBC Tuesday.
She added that Rove's “attack seemed out of place, out of time and some of the basic facts seemed to be wrong.”
Rove appeared on Fox News Tuesday to defend himself against the alleged comments, saying, “I never used that phrase." But he doubled down on his questions about Clinton's health, saying her spokespeople have not been "particularly forthcoming."
Rove said that the status of Clinton's health is also a personal issue that should be addressed by the presumptive presidential candidate.
"When you go through a health incident like this," he said, "any presidential candidate has to ask themselves, 'Am I willing to do this for eight years of my life, to serve, to run for two years and then serve for eight?'"
Rove has been accused of using smear tactics in past campaigns. A 1994 Alabama judicial campaign under Rove's stewardship was reportedly behind a whisper campaign claiming that the rival candidate was a pedophile. And ahead of the 2000 South Carolina presidential primary, Rove used a push poll to suggest Bush rival John McCain had fathered "an illegitimate black child."
While Clinton insists she hasn't made a decision on whether to run for president in 2016, Republicans like Rove began campaigning against her as early as last year. In May 2013, the Rove-led American Crossroads super PAC released an ad questioning Clinton's handling of the 2012 attack in Benghazi.