George Washington and 18th Century Medicine Bloodletting,

(Part Two; added on 4/8/98 Click Here, if you have already read
the First Part and wish to skip to the second)

(Part Three; added on 4/17/98 Click Here, if you have already read
the First Two Part and wish to skip to the Third)

Brought to you from the Powell Valley News, a Weekly News paper serving Lee County, Virginia and surrounding communities, since 1920.

Bloodletting, blistering, enemas, emetics and purgatives were medically in vogue early in our country's history and patients had to overcome these treatments as well as the malady or injury which they supposedly treated.

George Washington, the first U. S. president and "father of our country" is well know for his heroic exploits but little is known of his struggles with his health and the archaic medical practices which led to his death.

Washington is pictured as a strong man of action. Although six feet four inches in height, his life was also a continuous bout with physical problems and the "cures of the day." Most men would not have survived.

An early struggle with rickets left the president-to-be flat-chested and sunken in the middle. His coats were well padded and disguised his shoulders which were not as broad as they appeared.

Modern dentistry was in its infancy at the time. The remedy for a toothache was to have the tooth pulled. Washington had his first tooth pulled at 21 or 22. He lost additional teeth through the years until, at age 57, he had few teeth left. Six years later, while still president, the remainder of his teeth were pulled.

Artist Gilbert Stuart concealed many of Washington's physical faults in his famous portrait in 1796 when the president was 64. Somewhat sunken cheeks were bolstered by a set of ivory dentures. It was reported that his cheeks were also filled with cotton.

Washington's brother (and guardian), Lawrence, was stricken with tuberculosis, called the White Plague. George, age 19 at the time, joined him on a visit to Barbados where he hoped the temperate climate would be beneficial. George was strongly attacked by smallpox while in Barbados, leaving him bedridden for three weeks and his face and much of his body pockmarked for life.

He was also exposed to the deadly tuberculosis bacteria. While weakened from his bout with smallpox George contracted TB in the form of acute pleurisy after they returned to Mount Vernon. He suffered for many months and Lawrence died from the disease.

Stuart intentionally omitted these blemishes from the portrait and added strokes of pinkish gloss to Washington's normally pale, sallowy complexion. He lost most of his reddish hair while serving his country and the remainder turned gray prematurely. In sitting for the famous portrait the president wore a white wig.

Washington was stricken with several diseases in his life which brought him near death. This predated the science of bacteriology at a time when medical men thought major diseases were spread through fog, or miasma. Modern science has since relegated a number of diseases to the history books.

Bloodletting as a form of treatment began in prehistoric times. Medical men of the 18th century continued the ancient practice which had its roots in magic and religion. Supposedly the bad blood or sickness was allowed to escape with the bloodletting. Perhaps originally it was to appease the spirite by sacrificing blood, the fluid of life.

During Washington's day it was felt that one's blood was a carrier of the impurities of disease and with bleeding, new healthy blood would replace what was lost.

'The more serious the health problem the more blood would be taken. It was erroneously felt at the time that the blood would be replaced in the body in a few hours.

Patients were actually bled to death or weakened to the point that death ensued.

"Nearly all men die of their remedies and not of their illnesses," French dramatist Moliere wrote in
the 17th century.

George Washington died at the age of 67 due to the mistreatments of the day, mistreatments that were used to treat a throat infection.

George Washington and 18th Century Medicine, Part Two

George Washington studied public surveying at William and Mary College and following his graduation he worked several years in the fields and swamps of Fairfax County. Much of Virginia was swampy at the time and they were infested with mosquitoes carrying malaria.

Naturally George was bitten and came down with malaria. He suffered from recurring bouts of this disease for the remainder of his life.

I mentioned last week about George developing smallpox at age 19 while in Barbados with his brother. Lawrence was hoping the temperate climate would benefit his fight against tuberculosis. George, weakened from smallpox following their return to the states, soon developed TB. His brother later succumbed to the disease.

Two years later George entered military service and following a defeat against the French at Fort Duquesne had one of his recurring bouts with malaria.

A year later he joined an expedition of English soldiers under General Edward Braddock against the French and Indians. He was stricken with a type of influenza.

"I was seized with violent fevers and pains in my head," Washington wrote in his diary. "Gen. Braddock ordered the physicians to give me Dr. James' Powders, one of the most excellent medicines in the world. It gave me immediate ease and removed my fevers and other complaints within four days. My illness was too violent to suffer me to ride therefore I was indebted to a covered wagon for some part of my transportation."

The Battle of Monongahela followed. Washington was hardly able to sit on his horse which was killed beneath him during battle. George mounted a second horse and it too was killed. Four balls pierced his uniform yet he suffered no serious injury. Gen. Braddock fared much worse. He was slain during the battle. George is credited with saving much of Braddock's routed army by leading their retreat.

"I am not able to meet you in town," he wrote one of his brothers. "I have so much difficulty and fatigue after a sickness of five weeks duration."

A couple years later young Washington had an intestinal inflammation and high fevers lasting for several months. Washington actually thought he may die.

General John Forbes replaced Braddock and when he planned a campaign against the French at Duquesne a mending George Washington couldn't resist joining the effort. The French were defeated and Duquesne was taken and renamed Fort Pitt.

A wedding was next in the offing for George and Martha Custis and there were no references to illnesses for several years. His malaria recurred at age 29 and he was bedfast with pain for several weeks. Some doctors feel it may have been typhoid fever. When he was nearly recovered he was overtaken again and became very fearful of dying writing he may be near his "last gasp.

One must keep in mind that medicine was still, largely, in the dark ages at the time. Medical experts didn't understand diseases or where they came from nor did the doctors have specific remedies. It is due to Washington's youthfulness and strength that he survived his early years.

George then went through a lengthy period, including the Revolutionary War, free from sickness or injury. Day after day, even at Valley Forge, he manned his post. Yet his lengthy illnesses helped mold his character and his months in sickness surely taught him patience.

Washington's deep felt concern with his mortality and near-death fear of dying as cited in his diary, may have given him greater determination and courage as allies in his earthly battles which were so important in winning independence and in forming our young country.

Washington had another of his recurring bouts with malaria in 1786 and was treated by his doctor of 32 years, Dr. James Craik. Dr. Craik used powder of the bark of the chinchona tree and it proved immensely successful. The remedy, one of the first used for specific diseases, had long been used in Europe for over a century.

George Washington and 18th Century Medicine, Part Three

George Washington became "desperately sick and septic" during the first year of his presidency after what doctors called "a malignant carbuncle" developed on his hip. He was incapacitated for six weeks and when he was well enough to go out his coach had to be redesigned so he could lay down.

In 1789 he visited New England and while near Boston he was caught unprepared in a storm. In the days that followed he developed a bad cold which included inflammation of his eyes. An epidemic of respiratory infections followed which became popularly known as "the Washington Influenza."

Washington developed a hearing problem in addition to having to wear glasses. His hearing made it difficult to carry on conversations during the later years of his presidency. Some thought he was disinterested, cold or aloof. In that era it was somewhat unfashionable to wear glasses and was considered to be a disfigurement. George was careful to wear his glasses only in private or in the company of his closest friends or family.

When the federal capitol was moved from Philadelphia to Washington in 1790 Washington developed pneumonia.

"I have already within less than a year had two severe attacks," Washington wrote in his diary. "the last was worse than the first. A third attack will probably put me to sleep with my fathers."

The stress of the presidency drained Washington's energy and made him susceptible to illnesses and relapses. At age 65 he was tired of the rigors of the presidency He refused to be drafted for a third presidential term and retired to Mount Vernon.

Malaria returned for another bout with George the following year It was more difficult to overcome this time. On December 12, 1799, George was riding horseback on his farm with the weather continuously changing from snow to rain to hail, all with a brisk cold wind.

"Sir you need a change of clothes," friend and servant Colonel Lear told him as he returned for 3 p.m. dinner as was his practice. Your clothing is wet from the elements and you have snow melting in your hair."

Washington said, "Dinner's already getting cold. I'll change later."

George woke up the following morning with a sore throat but he went out to mark some trees that he wanted to cut down. He became very hoarse that evening and Col. Lear suggested that he take something for his cold.

"No, Colonel," he answered. "You know I never take anything for a cold. I'll let it go just as it came."

He awoke Martha very early the following morning and complained that he could hardly breathe. Martha noticed that his voice was nearly gone as well. She wanted to get the servants.

"Don't get up Martha," he told her. "It's cold and you'll get a death of cold."

At daylight one of the servants lit the fire. Col. Lear arrived and found the former president unable to speak. Lear mixed a concoction of molasses, vinegar and butter. George choked and nearly suffocated when he attempted to swallow it. He sent for Rawlins, his farm overseer who had some practice in veterinary medicine.

Washington asked Rawlins to "bleed" him, an acceptable medical practice at the time. A pint of blood was taken from Washington. Col. Lear applied a menthol vapor rob to his throat when the bloodletting gave the sick man no relief.

Dr. Craik, Washington's doctor of many years arrived just four hours later and took more of the former president's blood. In that era medical men though erroneously that the body replaced the blood within a few hours. He had George gargle with a mixture of vinegar and sage tea. When the results were unsatisfactory Washington was bled for the third time that morning. Two additional doctors were also summoned.

When they arrived three hours later Washington's skin was blue. He was having great difficulty breathing and he emitted shrill sound each time he attempted to inhale.

Initially Dr. Gustave Brown and Dr. Elisha Dick diagnosed peritonsillar abscess and later changed that to cyanche trachealis, or severe sore throat involving the voice box. Dr. Brown suggested the standard treatment of the day - substantial bleeding.

"Doctor he has already been bled three times today," Dr. Dick cautioned. He needs all of his strength and further bleeding will diminish it."

The two older doctors overruled him and Washington, though having no medical training, concurred with them. The flow became very slow and thick as Doctor Brown took a full quart of Washington's blood.

Calomel and tartar were also administered to the former general. Calomel is a strong laxative while tartar is an emetic which causes vomiting.

Washington became weaker and weaker, giving instructions about his will. Throughout the afternoon he remained in much discomfort and finally the younger Dr. Dick suggested a revolutionary "tracheotomy" in order to save the patients life. The two senior doctors thought the idea was too daring and, instead applied blistering agents to his legs and feet.

Washington's breathing finally eased somewhat later in the afternoon when his breathing rate diminished. The first U.S. president died soon thereafter. It was December 14, 1799.

Some attribute his death to a sore throat. Actually George Washington died from the treatments rather than from his illness.

As Moliere wrote, "Nearly all men die of their remedies and not of their illnesses."

We are fortunate that the last two centuries have brought many strides in medicine and the prevention of illness.

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