Saturday, May 19, 2018

The Unintentional Killing of George Washington


Note:  George Washington was a large man.  Measurements taken on his death bed showed he was 6 feet 3 1/2" tall and measured 22" from shoulder to shoulder.
George Washington's Final Hours
In the afternoon of Friday, Dec. 13, 1799, a little more than 30 months into his retirement, President George Washington complained about a cough, a runny nose and a distinct hoarseness of voice. He had spent most of the day on horseback in the frigid rain, snow and hail, supervising activities on his estate. Late for dinner and proud of his punctuality, Washington remained in his damp clothes throughout the meal.

By 2 a.m. the following morning, Washington awoke clutching his chest with a profound shortness of breath. His wife Martha wanted to seek help but Washington was more concerned about her health as she had only recently recovered from a cold herself. Washington simply did not want her leaving the fire-warmed bedroom for the damp, cold outside. Nevertheless, Martha asked her husband’s chief aide, Col. Tobias Lear, to come into the room. Seeing how ill the general was, Col. Tobias immediately sent for Dr. James Craik, who had been Washington’s physician for more than 40 years, and the estate’s overseer, George Rawlins, who was well practiced in the art of bloodletting. 


Bloodletting was a brutal yet common practice that had been used for centuries. The procedure called for the patient to place his arm over a basin used to collect the blood. A device resembling a pocketknife (a Fleam) with spade shaped cutting blades was then used to cut a vein in the wrist and draw off a pint or so of blood. The more serious the illness, the more blood was taken. It was thought that doing so would help rid the body of disease.  

It was not uncommon for the patients to die from a lack of blood rather than the illness for which they were being treated. In fact, many historians believe that excessive bloodletting may have actually contributed to the death of President George Washington.

Bloodletting Kit

A Fleam
Blood was removed from a patient to reduce fever and to
treat a variety of illnesses.  A patient's symptoms usually changedafter this treatment, which made it seem affective.

Bleeding a Patient
By 6 a.m., Washington had developed a pronounced fever. His throat was raw with pain and his breathing became even more labored. 

At 7:30 a.m., Rawlins removed 12 to 14 ounces of blood, after which Washington requested that he remove still more. Following the procedure, Col. Lear gave the patient a tonic of molasses, butter and vinegar, which nearly choked Washington to death, so inflamed were the beefy-red tissues of his infected throat. 

Dr. Craik entered Washington’s bedchamber at 9 a.m. After taking the medical history, he applied a painful “blister of cantharides,” better known as “Spanish fly,” to Washington’s throat. The idea behind this tortuous treatment was based on a humoral notion of medicine dating back to antiquity called “counter-irritation.” The blisters raised by this toxic stuff would supposedly draw out the deadly humors causing the General’s throat inflammation.

At 9:30 a.m., another bloodletting of 18 ounces was performed followed by a similar withdrawal at 11 a.m. At noon, an enema was administered. Attempts at gargling with a sage tea, laced with vinegar were unsuccessful but Washington was still strong enough to walk about his bedroom for a bit and to sit upright in an easy chair for a few hours. His real challenge was breathing once he returned to lying flat on his back in bed.

Dr. Craik ordered another bleeding. This time, 32 ounces were removed even though Elisha Cullen Dick, the second physician to arrive at Mount Vernon, objected to such a heroic measure. A third doctor, Gustavus Richard Brown, made it to the mansion at 4 p.m. He suggested a dose of calomel (mercurous chloride) and a tartar emetic (antimony potassium tartrate), guaranteed to make the former president vomit with a vengeance.

After the fourth bloodletting, Washington appeared to rally somewhat. At 5 p.m., he was having an easier time swallowing and even had the energy to examine his last will and testament with Martha. Soon enough, he was again struggling for air. He told Dr. Craik: “Doctor, I die hard; but I am not afraid to go; I believed from my first attack that I should not survive it; my breath can not last long.” Ever the gentleman, even in extremis, the General made a point of thanking all three doctors for their help.

By 8 p.m., blisters of cantharides were applied to his feet, arms and legs while wheat poultices were placed upon his throat with little improvement. At 10 p.m., Washington murmured some last words about burial instructions to Col. Lear. Twenty minutes later, Col. Lears’ notes record, the former president settled back in his bed and calmly took his pulse. At the very end, Washington’s fingers dropped off his wrist and the first president of our great Republic took his final breath. At the bedside were Martha Washington, his doctor, James Craik, Tobias Lear, his valet, Christopher Sheels, and three slave housemaids named Caroline, Molly and Charlotte.

Washington’s physicians, as doctors are wont to do, argued heatedly over the precise cause of death. Dr. Craik insisted that it was “inflammatory quinsy,” or peritonsillar abscess. Dr. Dick rejected such a possibility and offered three alternative diagnoses: stridular suffocatis (a blockage of the throat or larynx), laryngea (inflammation and suppuration of the larynx), or cynanche trachealis. The last arcane medical diagnosis (from the Latin, for “dog strangulation”), which prevailed as the accepted cause of Washington’s death for some time, referred to an inflammation and swelling of the glottis, larynx and upper trachea severe enough to obstruct the airway.

Back in 1799, Washington’s physicians justified the removal of more than 80 ounces of his blood (2.365 liters or 40 percent of his total blood volume) over a 12-hour period in order to reduce the massive inflammation of his windpipe and constrict the blood vessels in the region. Theories of humoralism and inflammation aside, this massive blood loss — along with the accompanying dehydration, electrolyte imbalance, and viscous blood flow — could not have helped the president’s dire condition.

A fourth physician, William Thornton (who also designed the U.S. Capitol building), arrived after Washington succumbed. Thornton had expertise in the tracheotomy procedure, an extremely rare operation at the time that was performed only in emergencies and with occasional success. Dr. Dick, too, advocated this procedure — rather than the massive bloodletting — but given the primitive nature of surgical science in 1799, it is doubtful it would have helped much.

In the 215 years since Washington died, several retrospective diagnoses have been offered ranging from croup, quinsy, Ludwig’s angina, Vincent’s angina, diphtheria, and streptococcal throat infection to acute pneumonia. But Dr. Morens’s suggestion of acute bacterial epiglottitis seems most likely. In the end, we will never really know, which constitutes half of the fun enjoyed by doctors who argue over the final illnesses of historical figures.

At this late date, it is all too easy to criticize Washington’s doctors. Indeed, even in real time and for decades thereafter, critics complained that the physicians bled Washington to death. But the truth of the matter is that they did the best they could, against a pathologically implacable foe, using now antiquated and discredited theories of medical practice.

The president’s last hours must have been agonizing to watch and, of course, to experience. Like any human being, General Washington hoped his physicians would help him to an easy death. Between the massive bloodletting, the painful blistering treatments, and the awful sensation of suffocation, this was not at all possible.

Note: According to The Red Cross, it takes 4 to 6 weeks for red blood cells to be completely replaced after giving just one pint of blood. Based on witness accounts that night, Dr. Howard Markel of the University of Michigan estimated that approximately 5 pints (40% of his blood supply) was drained from his body over a 12-hour period.  Washington died a short time later.  The question still lingers to this day; “Did George Washington die from the throat infection, or did he die from lack of blood?”
"First in war...………"
Excruciating though his death was, George Washington’s life continues to teach us valuable lessons of citizenship, leadership and devotion to duty. In an era when there are so few heroes in public life, it remains inspiring to recall the Henry (“Light-horse Harry”) Lee Jr.’s famous phrase from the eulogy of Washington he delivered to the U.S. Congress on Dec. 26, 1799: “First in war, first in peace, and first in the hearts of his countrymen.” 

Frontier Medicine

One of the many things people can be thankful for today is how the practice of medicine has progressed in the past century.   If you lived in the Ohio frontier during the War of 1812, treatment for common ailments were, in addition to being painful in many cases, simply gross; the application of leeches, enemas, vomit inducing concoctions and a long list of others too graphic to mention here.

First Aid Treatments at Fort Amanda
In 1813, Medical practices, particularly on the frontier, were still in their infancy stage and more often than not individuals had to depend on home remedies mostly derived from nature. The most common types of remedies involved emetics to induce vomiting, laxatives and bloodletting. To induce vomiting, the men were given a tartar emetic made up of warm water and honey. If a laxative was needed, a mixture of calomel, jalap, niter, Peruvian bark, and snakeroot were taken orally. Enemas were also a common remedy if one was needed.

The remedy for nosebleed  

A snuff of the red birth root may be occasionally used. Cold water sprinkled on the back of the patient, so as to occasion shivering often affords relief. Catnip, bruised, and moistened with spirits or vinegar, and applied across the center of the nose, gives relief.  Should these fail, a general operation of medicine may be tried.            

            For burns and scalds 

The immersion of the part in cold water immediately after the accident, affords relief.  It should be kept several hours in this situation. The application of a plaster of the small life and everlasting swamp snake root, or the anti-scrofulous plaster, or the emollient poultice. A ligament of linseed oil and lime water, applied with a soft linen answers a very good purpose.”

"Nurse" William Schillinger
Schillinger’s duties at Amanda were not limited to paperwork duties. He often acted as chief cook and bottle washer and at times the company nurse. A number of men had reported sick at morning muster on April 25, most likely suffering from the flu, colds, strep throat or bronchitis. Schillinger helped administer medicines throughout the day. As the Summer wore on, one illness in particular ravaged the forts along the Auglaize River; measles. On July 19th, Schillinger wrote:

Monday July the 19, 1813
This morning clear & pleasant, something better myself, but many of our men Sick.  on examination to day, found that 24 of our Company and me had, had the meazels a number of them are quite sick yet & but 2 or 3 fit for Duty,  
NOTE: Schillinger’s company at Fort Amanda (at full strength) was made up of 3 officers, 8 non-commissioned officers, 2 musicians and 63 private soldiers; a total of 76 men. What Schillinger is telling us is that nearly 1/3 of the soldiers at Amanda had had the measles and 21 of them were still to sick for duty.

Treatment for Measles
Measles: The stomach must first be cleansed by an emetic (to induce vomiting), after which a moisture should be produced on the surface and kept up by stimulants for which use the diaphoretick tea, cayenne, cough powders or composition. Use the whole or a part.  The patient must carefully avoid taking cold.  This treatment will seldom or never fail of producing happy effects; its utility has been evinced by the success uniformly attending it

Measles can affect the eyes, causing them to become red and swollen, which creates extreme sensitivity to light. In 1812, the common treatment was a potion called “eye water.” At Fort Amanda, soldiers made eye water by taking the scrapings from a green ozier root, mixing it with water and dropping it into the patient’s eyes several times a day. 

How to Make Eye Water

Take the green ozier, the the back scraped fine, one ounce; add three gills of soft water; infuse or steep them a few minutes; and wet the eye affected with this decoction, several time as a day, applied either warm or cold.  It will remove both inflammation and humours of the eyes. 
"The Indian Physician" by Dr. Jonas Rishel (1828)
On Tuesday afternoon, June 29th, Schillinger and Sgt. Bradbury went into the woods and found some of the green ozier plants and on their way back to the fort, they came upon a large beehive in a tree. 
Schillinger’s journal entry about the incident shows that he may have had a good sense of humor. He wrote; “found A Bee Tree or swarm of bees in a tree.” 
My interpretation of this journal entry is that Schillinger was jokingly telling us that while he was looking for a "bee tree," a swarm of bees found him.  I may be mistaken however I'd like to think that Schillinger had a little sense of humor. 
Whatever the case, Schillinger and Bradley took their precious roots back to the fort and madeup a batch of the eye water and dispensed it among the men.   
Fort Amanda's Doctor - Dr. Jacob Lewis
Jacob Lewis was born Oct. 13, 1767, in Somerville, N. J. son of Zephaniah and Anna (Ayers) Lewis. In the spring of 1791, 23-year-old Lewis visited a sister in western Virginia. While he was asleep, three Indians broke into the house, kidnapped his sister and killed his brother-in-law, a niece and a neighbor’s daughter. Lewis eventually returned to New Jersey, where he began his medical studies. Two years later, in the fall of 1793, he received a letter his sister had somehow sneaked past her Indian captors. The letter included instructions on how to contact an Indian trader in Detroit who would know where she was. Lewis left home Nov. 1, 1793, and reached Detroit on Feb. 3, 1794, where he contacted several people who agreed to help him find his sister. The squaw who “owned” Lewis’ sister also had a cow. Lewis’ sister was asked to translate during the exchange. During the translation, she was able to give Lewis information on how to help her escape. The plan worked. They returned to New Jersey in mid-October 1794. In 1796, after finishing his professional studies, Dr. Lewis married Deborah Fitz Randolph. In 1796, Lewis and his wife left New Jersey and moved to Pennsylvania. In 1802, Lewis and Deborah traveled to Hamilton County, Ohio where he practiced his profession there until 1813, when he was appointed surgeon of the First Regiment, Third Detachment of Ohio Militia. The 46-year-old doctor traveled between forts tending to the sick and injured. Ensign Schillinger wrote in his journal that Dr. Lewis visited Fort Amanda several times in 1813.

Saturday April the 10
This morning Dull rainy weather  Our Men employ,d making cartridges.  12 oclock Doctor Lewis came to fort from St. Mary

Tuesday the 4th
Light Showers, Our men making cartridges,   7 oclock P.M. our Capt Lieut, & Men came Down in a boat from fort Logan.  Note  Doctor Lewis Came to fort to Day, to visit some of our sick.

Sunday June the 20th
This morning the Brigade Major (robison, Inspected the company,  give them credit for their good appearance,  Left the fort in company with Major Kain, (who is ordered to fort Winchester)  Milikin & Heaton left 10 A.M.  At 2 o’clock, Lieut Davis Left the fort for to go home for A few Days,  took a number of Letters from the company  Doctor Lewis accompanied him as far as St. Marys,  

Monday the 5th
This morning Cool & Pleasant  Our men some of them on the mend & some sickening for the meazels,   11 A.M.  Mr. Kerchard arrived at fort from the rappids  Informed us that the coast was clear of the enemy.  that there was none of them about fort meigs,  Dr. Lewis came to fort with Mr. Benagh, 

Tuesday the 6th July
Fine Pleasant weather,  our men recruiting, this morning our cook kill,d A fawn 12 oclock Gen Wingate and suite came to the fort.  Doctor Lewis, left fort for St. Marys

Monday July the 19th 1813
This morning clear & pleasant, something better myself, but many of our men Sick.  on examination to day, found that 24 of our Company and he had, had the meazels a number of them are quite sick yet & but 2 or 3 fit for Duty,  3 PM Sergt Whelen Return,d from St. Marys  Brought A Letter from Doctor Lewis informing me of his going to Loramies, from whence he would immediately come to this fort

Wensday the 21st July
This morning Mr. Bracken left this place for St. Marys  A number of the K.M.M. of the aforementioned Det, came to fort to Day & Left here in the afternoon, quite unwell yet,  Dr Lewis came to fort this evening

Gravesite of Dr.  Jacob Lewis

After the War, Lewis and his wife settled on a farm in Fairfield Twp. (on Morris Road, north of Tylersville Road) in Butler County, Ohio. Deborah died between 1830 and 1840. On July 19, 1850, Jacob died of apoplexy (stroke) at the age of 83. Both are buried in the Greenwood Cemetery, 1602 Greenwood Ave, Hamilton, Ohio, Sec. E H Lot 148 Space 1.  (N39°24'20.46”,W84°32'29.31)

End of Blog