Revolutionary War Historical Article
A Modern Medical Report on
By Donald N. Moran
Editor's Note: This article was reprinted from the October 1999 Edition of the Liberty Tree and Valley Compatriot Newsletter
During the French and Indian War George Washington, then a Colonel in the Virginia Militia, achieved a place in history. He was only twenty three. Most historians agree that Washington was aware of this, hence took particular care of his correspondence. Fortunately for future generations, we know a great deal about him. Among the things known, is a comprehensive personal history, which has enabled doctors to reconstruct his medical record. This article is the result of their efforts.
It is well known that Washington suffered from dental problems. It has been written by foreign observers that Colonial Americans generally had bad teeth. This is probably because of the availability of sugar, which was at a premium in Europe.
There was no dentistry as we know it today. When a tooth started to ache, the only cure was extraction. Washington had his first tooth pulled when he was 22, and over the years the rest were removed one at a time.
Dentures at the time were used for appearances only, and not for eating. Therefore, we can assume that the meals prepared for Washington were more often then not stews or boiled soft foods - akin to today's baby foods. Eating under these circumstances leads to gastric and indigestion problems.
Washington wrote in his diary that he was "strongly attacked" by small pox and was bedridden for three weeks. This occurred while he was attending his older half-brother Lawrence, who was suffering from active tuberculosis, and had traveled to Barbados in hopes that the climate would help. When Washington recovered, his face bore the scars of his illness, which he would carry to his death. Being pockmarked was so common in the 18th century that references can be readily found that mention, not that a person was disfigured by the disease, but that he was not!
In spite of being extraordinarily tall and strong, Washington suffered from several serious illnesses during his lifetime. We know of at least ten such sicknesses and several of those were life threatening.
No records exist that tell which childhood diseases Washington had - but probably the usual. At age 16 Washington graduated from William and Mary College as a surveyor. He practiced this profession for several years and on one trip he was bitten by a malaria carrying mosquito and suffered his first bout with that disease, then called "Ague". He suffered repeated attacks of malaria for the rest of his life.
We already mentioned Washington's having contracted small pox while tending his ailing brother. Being weakened by the small pox probably led to his coming down with the virulent tuberculosis bacilli as he nursed Lawrence. All his efforts were in vain as Lawrence died a few months later, and Washington had barely returned to Mount Vernon when he fell victim to the dreaded disease. Washington recovered, but it took many long months.
Two years later, Washington was strong enough to join the Virginia Militia. He campaigned against the French for a year, but then was again stricken with malaria. As soon as he was strong enough, he joined General Edward Braddock and began another campaign. He was stricken again, this time by what is thought to have been influenza. He described his illness in his diary: "Immediately upon leaving camp at George's Creek on the 14th, I was seized with violent fevers and pains in the head which continued without intermission until the 23rd following when I was relieved by General Braddock's absolutely ordering the physicians to give me Dr. James' powders, one of the most excellent medicines in he world for it gave me immediate ease and removed my fevers and other complaints in four days time. . . ." Barely able to sit on his horse, Washington rejoined Braddock and at the battle of the Monongahela, is credited with saving much of the badly defeated British force. After the battle he returned to Mount Vernon, and wrote his half brothers that he had been ill for "five weeks duration".
Two years later Washington contracted a severe type of dysentery. It was accompanied by high fevers and lasted several months. His recovery was so slow that he became very depressed and concerned about his health. When General Forbes arrived from England to lead yet another expedition against the French, Washington became so invigorated about the campaign, that he became well enough to join the expedition.
In January of 1759, Washington took as his wife Martha Danridge Custis. She must have taken very good care of the ailing Colonel, as he does not mention being sick until two year later. In 1761, he was stricken with another attack of malaria. He wrote in his diary that he was "bedfast" for several weeks and became depressed and was afraid he was near his "last gasp".
For the next six years he does not mention being sick, then he suffered an attack of dysentery. Following that attack he enjoyed the longest period of good health, which lasted through the eight long years of the Revolutionary War. Some medical experts believe that this was a classic case of mind over matter, as it is difficult, even today, for a man to be engulfed in the hardships of continual campaigning for eight years without becoming sick - at least once!
Doctor Rudolph Marx, in his book on the medical profiles of the Presidents of the United States, wrote: "It can be assumed that other qualities which the mature Washington exhibited, his courage and unyielding determination, were also conditioned by his medical history. A man who had repeatedly faced death when attacked by unknown diseases, encounters with a feeling of relief enemies whom he can see and understand. Washington's singleness of purpose may have derived its force from the store of energy dammed up by the frustrations of sickness."
There is no record of Washington having been ill for a single day during the entire war! Some medical experts believe that the continual stress and heavy responsibilities stimulated his adrenal glands, increasing his regular powers of endurance, resistance and enhancing his immune system. It was a blessing for our Country that the only man capable of leading us to victory was spared from the ravages of disease during those troubled times.
It was not until 1786, three years after the war, that he was again stricken with, Ague (malaria) and fever. His Doctor of thirty-two years, James Craik, treated him. Craik administered "the bark" on Washington. It was a powder made from the bark of the Chinchona tree, which had been successfully used in South America for 140 years to treat malaria. As far as is known this was the first time a specific medicine was used for a single disease. It is known today as quinine.
During George Washington's first year of his presidency, he developed what his doctors called "a malignant carbuncle" on his left hip. His Doctor, Samuel Bard, well known in New York City, attended him for several days. Bard finally operated and removed the carbuncle, without benefit of any anesthetic. Washington immediately started to improve, however it took several weeks before the President was back on his feet.
In 1789, President Washington went on an official tour of New England. The weather was bad, cold and stormy, and Washington contracted a bad cold and inflammation of the eyes. He was delayed because the Massachusetts State government and the City of Boston Government were in the midst of a debate on the protocols of receiving the President of the United States. There was no precedent. Shortly after Washington left Boston, an epidemic broke out and the diehard Loyalists promptly named it "The Washington Influenza".
The colds which Washington contracted apparently were accompanied by ear infections, The large doses of quinine he took to control his malaria, also caused the deterioration of his hearing. His deafness made it extremely difficult for him to carry on a conversation at public gatherings, explaining how he obtained the unjustified reputation of being "cold and aloof".
When the United States Government moved from New York to Philadelphia in 1790, Washington contracted pneumonia, which almost proved fatal. He wrote in his diary: "I have already within less than a year had two severe attacks, the last worse then the first. A third probably will put me to sleep, with my fathers."
Few historians doubt that the strain of being President of the United States is awesome, and drains the physical strength of the office holder. Washington, age 65, tired, and sick, decided to not run for a third term, but rather retire to his beloved Mount Vernon. The year was 1797, and Washington was to have only two and one half years to enjoy his well deserved rest. In 1798 he was again stricken with malaria, and the quinine was slow in helping.
On December 12th 1799, Washington, then 67, was riding around Mount Vernon. The weather was terrible, rain, sleet and hail, all driven by an icy wind. The next day, the 13th, he complained of a cold and sore throat and decided not to go outside, a sign he was sicker then he had let on. Later that evening, his hoarseness developed. That night, at 3:00 a.m. he woke Martha and told her he was very unwell.
Several so-called remedies were prepared, but he couldn't swallow them. Finally Doctor Craik was sent for. Several bloodletting sessions were conducted. Another Doctor, Gustave Brown, suggested continuing traditional treatment, and more blood letting, but the third and younger Doctor, Elisha Dick, objected, suggesting that Washington needed his strength. He was out voted by his two senior colleagues, and an entire quart of blood was taken! To further "help" the former President, laxative calomel, and the emetic Tartar, were given to him. The total effect was to weaken Washington even further.
As a last resort, Doctor Dick proposed a radical new procedure, a tracheotomy, the surgical method of opening the windpipe to allow breathing. Again, the older physicians overruled him. In lieu of the treatment that may have saved his life, the older Doctors applied blistering agents and cartaplasms of wheat bran to the legs and feet. This did nothing but add to the discomfort of the dying Washington. He died between 10 and 11 p.m. on December 14th, 1799.
Today, we look upon 18th century medicine with total astonishment and disbelief. We have a difficult time believing that a civilized society could be so backward about something as important as medicine.
The number one killer in the 18th century was the "white plague" - tuberculosis. The Washington family appears to have been particularly susceptible to it as it killed several family members. Another illness that was very common was malaria. George Washington suffered from both.
Medical historians are still not sure what the exact diagnosis of Washington's last illness is. One of the most widely accepted is the study made by Dr. W. A. Wells, of Washington, D.C., in 1927. Until then most believed that Washington died from diphtheria, which was called "croup" in the 18th century, and suggested by Dr. Dick, one of Washington's attending physicians. There is no method of making an absolute diagnose without bacteriological confirmation however, Dr. Wells concluded that George Washington died from a streptococcic laryngitis, which is an inflammation of the larynx and the vocal cords, caused by a strain of virulent streptococci. It is also impossible to estimate how much the treatment Washington received contributed to his ultimate death.
18th century doctors could not give a scientific explanation for the numerous diseases that plagued the population. They had no concept of bacteria or for that matter germs. They had few remedies for most of these diseases. They had found that quinine was effective against malaria, but it was the exception rather the rule.
One of the more popular beliefs of the day was that blood was the carrier of the "poisons of disease". Hence blood letting released the bad blood and allowed the body to produce good blood and regenerate itself. We now know the fallacy of this thinking, but it is based on logic, and that is always difficult to overcome. The amount of blood removed was approximately one pint, however for more serious illness more was taken, as was the case in Washington's death, where a full quart was taken. It appears that they had no idea that blood made up only only seven percent of the body weight, but worse yet, it was thought that the removed blood would be replenished within a few hours, instead of the weeks it actually takes.
If the bloodletting didn't kill the sick, then the extensive use of laxatives and emetics did. It is generally believed that more patients succumbed to dehydration and weakening by these "cures", than the diseases themselves would have.
Another delightful "cure" was blistering. Colonial Doctors would raise blisters on the skin in the belief that the inflammatory process could drawn from the inside to the outside. This practice inflicted a great deal of unnecessary pain on patients. With all things considered, it is no wonder that few people lived to "old age". Washington's grandfather died when he was 37, his father at age 49. His mother at 82. George Washington apparently inherited his strong constitution and endurance from his maternal side.