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“I Gave Him Barks and Saltpeter...”
Medicine was primitive and their knowledge of it limited, but in their hazardous journey to the Pacific, Lewis and Clark lost only one patient
December 1963 | Volume 15, Issue 1
Although from here on the Indian woman’s recovery was rapid and uncomplicated, her case seems to have been a prime example of the patient’s recovering in spite of the treatment. Certainly the purging and bleeding could have had no effect upon the cure except to retard it. How much blood Clark withdrew is speculative. Some of the doctors of the day removed only four to eight ounces; others were not satisfied until they had siphoned off from a pint to a quart. Only a few casehardened dissidents were dead set against withdrawing any at all. The removal of a quart is enough to cause grogginess in an individual, and taking any more induces fainting spells. Phlebotomists probably did not often measure the blood accurately; when they had taken what they thought was enough they applied a tight bandage to stop the flow. Very serious infection sometimes set in at such wounds, and it was by no means unheard of to have the patient die as a result.
One harmful effect of excessive bleeding is to reduce the quantity in the blood of calcium, magnesium, and potassium. The muscle twitching reported by Lewis in Sacagawea may very well have been induced by a deficiency of such important minerals. Also, bleeding in conjunction with purging and fever produces dehydration. If the considerable amount of mineral water Lewis had his patient drink benefited her at all, it was because it relieved dehydration and restored vital minerals.
The journals carry many references to dysentery and constipation, “cholick & griping,” “lax” and “relax,” “heaviness of the stomach”—all debilitating conditions referable to the gastrointestinal tract. Happily for Lewis and Clark, Missouri River water was not then the devil’s brew of topsoil, sewage, and industrial waste it is today. They drank it neat for months on end. Only now and then did they suspect that it might be the cause of any of their gastric or intestinal troubles.
For disorders of the digestive tract, Lewis and Clark dispensed pills and doses of salts as they saw fit. On May 4, 1805, above the mouth of the Yellowstone, Lewis wrote, “Joseph Fields was very sick today with the disentary had a high fever I gave him a dose of Glauber salts, which operated very well, in the evening his fever abated and I gave him 30 drops of laudnum.” Glauber’s salt (from J. R. Glauber, the German chemist who originally prepared it) was sodium sulphate and was, like Epsom salts, a well-known physic. Lewis and Clark had six pounds of it, which cost ten cents a pound, and they did not hesitate to use it.
Early in June, 1805, Lewis, with four of his best men, left the mouth of the Marias River and started on foot up the north bank of the Missouri. Clark and the rest of the party followed by boat. Lewis had been “somewhat unwell with the disentary,” but he set out nevertheless. As the day advanced, he developed a violent pain in the intestines and a high fever. Since the medical supplies had been left with the main party, Lewis “resolved to try an experiment with some simples,” these being the medicinal plants with which any good herb doctor would be familiar. His eyes soon fell on the chokecherry, a small shrub (probably Prunus virginiana ) that he had encountered frequently along the Missouri. He had his men gather a number of the twigs and, after stripping off the leaves, cut the twigs into pieces about two inches in length. These were then boiled in water “untill a strong black decoction of an astringent bitter tast was produced.” At dusk Lewis drank a pint of this, and about an hour later downed another. By ten o’clock he was perspiring gently, his pain had left him, and his fever had abated. That night, all symptoms which had disturbed him having disappeared, he slept soundly. The next morning at sunrise, fit and refreshed, he took another stiff swig of the drink and resumed his march.
In late July the party arrived at Three Forks, that geographically important site in southwestern Montana where the Jefferson, Madison, and Gallatin rivers (as Lewis and Clark named them) unite to form the Missouri. Clark was sick, “with high fever … & akeing.” Upon learning that Clark had not had a bowel movement for several days, Lewis prevailed upon him to bathe his feet and legs in warm water and to take five Rush’s pills, which he had “always found sovereign in such cases.” The next morning, the medicine having “opperated,” Clark felt better.
Rush’s pills, a product of the “genius” of Dr. Benjamin Rush, were well-known in those days and referred to, often with some feeling, as Rush’s “thunderbolts.” Each consisted of ten grains of calomel and fifteen of jalap (a powdered drug prepared from the purgative tuberous root of a Mexican plant of the morning-glory family); they were a powerful physic. Lewis and Clark carried fifty dozen of these pills and, in treating gastrointestinal disturbances, it seems to have been a coin-tossing proposition whether they used the “thunderbolts” or Glauber’s salts.