“I Gave Him Barks and Saltpeter...”

On February 23, 1803, Thomas Jefferson wrote the following letter to Dr. Benjamin Rush, professor of the Institute of Medicine at the University of Pennsylvania and the foremost American physician of his day:

Dear Sir: I wish to mention to you in confidence that I have obtained authority from Congress to undertake the long desired object of exploring the Missouri & whatever river, heading with that, leads into the Western ocean. About 10 chosen woodsmen headed by Capt. Lewis my secretary will set out on it immediately & probably accomplish it in two seasons. … It would be very useful to state for him those objects on which it is most desirable he should bring us information. For this purpose I ask the favor of you to prepare some notes of such particulars as may occur in his journey & which you think should draw his attention & enquiry. He will be in Philadelphia about 2 or 3 weeks hence & will wait on you.

As Jefferson stated to Rush, he had just obtained from Congress the necessary authorization to send a party to explore the unknown reaches of the Missouri River and to find a route to the Pacific. To lead this parly he had selected Captain Meriwether Lewis—who would, in turn, ask William Clark, the brother of George Rogers Clark, to share the demanding duties of command. Jefferson’s letter to Dr. Rush also suggests that the President, who planned each step of the expedition with almost preternatural care, gave no serious thought at any time to engaging the services of a physician, being content to let Lewis and Clark handle whatever ills and miseries might befall the party.

This decision may have been made easier by his familiarity with Lewis’ family background. Lewis’ mother was a well-known Virginia herb doctor who had her own herb garden, grew and dispensed her own simples, and ministered regularly and faithfully to the sick of Albemarle County. Lewis shared his mother’s interest in herbs and herb therapy and had acquired much of her knowledge. Clark also had medical training of sorts. Like Lewis, he carried in his head the usual frontiersman’s storehouse of medical information: how to set a broken limb or remove an imbedded bullet, how to cope with croup, dysentery, and a wide range of other ailments. Being often closer to disease and disaster than to doctors, he found it imperative to know such things.

As Jefferson originally planned it, the expedition was too small to include a doctor; but his willingness to entrust medical matters to Lewis and Clark was no doubt also inspired by his own lack of sympathy with the physicians of his day. Living in the era of depleting remedies—purges, vomits, sweats, blisters—and of the bloodletting lancet, which was still by far the most-used medical instrument, Jefferson had good reason to distrust doctors. And yet, he did not hesitate to ask Dr. Rush to advise Lewis on medical matters relating to the expedition. Not long after the President had done so, Rush wrote back to say that he had furnished Lewis with “some inquiries relative to the natural history of the Indians,” and “a few short directions for the preservation of his health.” The latter present an interesting lesson in personal hygiene as it obtained early in the last century:

When you feel the least indisposition, do not attempt to overcome it hy labour or marching. Rest in a horizontal posture. Also fasting and diluting drinks for a day or two will generally prevent an attack of fever. Io these pre ventatives of disease may be added a gentle sweat obtained by warm drinks, or gently opening the bowels by means of one, two, or more of the purging pills.

Unusual costiveness [constipation] is often a sign of approaching disease. When you feel it take one or more of the purging pills. Want of appetite is likewise a sign of approaching indisposition. It should be obviated by the same remedy.

In difficult and laborious enterprises and marches, eating sparingly will enable you to bear them with less fatigue & less danger to your health.

Flannel should be worn constantly next to the skin, especially in wet weather.

The less spirit you use the better. After being wetted or much fatigued, or long exposed to the night air, it should be taken in an undiluted state …

Molasses or sugar & water with a few drops of the acid of vitriol [sulphuric acid] will make a pleasant & wholsome drink with your meals.

After having had your feet much chilled, it will be useful to wash them with a little spirit.

Washing the feet every morning in cold water, will conduce very much to fortify them against the action of cold.

After long marches, or much fatigue from any cause, you will he more refreshed hy lying down in a horizontal posture for two hours, than by resting a longer time in any other position of the body.