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A Medical Profile Of George Washington
Stalwart as he was, the general was often ill. A doctor studies his record and notes shortcomings in Eighteenth-Century medical care.
August 1955 | Volume 6, Issue 5
Uncontrolled by antiseptics were the septic bacterias, the staphylococci and streptococci, which had a field day feasting in every wound. Like other disease germs, these shock troops of death can also enter the body through microscopic channels through the apparently unbroken skin and mucous lining.
Doctors of Washington’s time were incapable of giving a scientific explanation of most disease phenomena. The medical concepts of the time were based upon a hodgepodge of ancient beliefs, timehonored traditions, and the doctrines formulated over the centuries by the accepted authorities of medicine.
Unknown was the science of bacteriology. The causes of most diseases were absolutely obscure, as were the pathways of their transmission. A contamination of the air by a miasma was blamed for the spread of the majority of diseases. The miasmas were thought to emanate from putrescent matter and from swamps, and to float in the air. Some diseases were believed to be transmitted by polluted water, a theory which came close to the truth in the case of typhoid.
No specific remedies against most infections were known, except for quinine which had been found effective against the rigors of malaria, as had mercury against the sores of syphilis.
In his last play, Le Malade Imaginaire , Molière wrote the lines, “Nearly all men die of their remedies and not of their illnesses.” The medical therapy of Washington’s time had changed very little in the hundred years since Molière. It still used the same murderous arsenal consisting mainly of bloodletting, purgatives, emetics, enemas and blistering.
In order to understand some of the theories and methods of pre-scientific medicine as it was still practiced in Washington’s time, we have to realize that the first concepts and practices of the healing art originated in magic and religion in ancient times. Beneath the surface the doctors took over from the medicine men some of their rituals, and rationalized them as therapeutic measures. The most dramatic of these was the ceremony of bloodletting which had been performed by savage tribes since prehistoric times. The object of this rite was either to let the bad demons escape with the flowing blood, or to appease the spirits and gods by the sacrifice of blood.
Superstitions and traditions die hard, especially when they take the disguise of reason. Medicine justified the practice of bleeding by adopting the popular belief that blood was the carrier of the impurities and poisons of disease, and that by the removal of “bad” blood, the formation of new healthy blood would be engendered.
At the time of Washington the average amount removed in one bloodletting was one pint. The more serious the illness, the more blood was taken. It was then unknown that the mean blood volume of a person measures not more than seven per cent of the body weight, which meant about fourteen pints for a man of Washington’s weight at the age of 67. It was believed that some glandular secretion in the body could replace the amount of drained blood within a few hours, instead of the weeks that are actually required.
Since the dawn of history people have used laxatives and emetics, in the majority of cases doing more harm than good by dehydrating and weakening the patient. Laxatives have killed thousands of victims suffering from appendicitis by distending an inflamed and brittle appendix. Enemas were somewhat less dangerous if used with discrimination, but repeated colonic flushings as practiced by the doctors of the Seventeenth and Eighteenth Centuries weakened and exhausted the patient and seriously strained his tired heart.
Another practice often used by colonial physicians was the raising of blisters on the skin. This was based on the belief that an inflammatory process could be “drawn” from the inside to the outside by counterirritation. As it was usually done with caustic concoctions, it often produced severe chemical burns and inflicted unnecessary pain on the sufferer.
Altogether, if we consider the primitive state of preventive and therapeutic medicine in Washington’s time, it is small wonder that few persons reached old age. In the case of Washington, we know that his grandfather died at 37, his father at 49, probably from infectious diseases; on his maternal side we only know that his mother reached the age of 82.
From his mother, her first-born son George inherited not only his physical features but also his unusually strong constitution and powers of endurance. However, if we consider his medical history, we marvel that he ever reached the age of 67, when he succumbed to a streptococcic throat infection and to the medical mistreatment he received.