A Medical Profile Of George Washington

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There is no doubt that the responsibility and the nervous strain connected with the Presidency were a great drain on the physical strength and stamina of Washington, as on all other Presidents since. Sixty-five years old, sick, and tired of public service, he declined to be nominated for a third term and retired to the privacy of Mount Vernon in the spring of 1797. He was allowed only two and a half years of well-deserved rest at his beloved Mount Vernon. In 1798 his old nemesis, malaria, recurred and responded only tardily to “the bark.”

On the day of December 12, 1799, as was his custom, Washington was riding about his farm from 10 A.M. until 3 P.M. The weather on this day was bad; rain, hail and snow falling alternately, driven by an icy wind. Washington was a stickler for punctuality in all his activities, including his meal hours. On this December day in 1799, Washington was late for dinner. Served promptly at three o’clock, the meal was on the table when he entered the house. Colonel Lear, his faithful friend and secretary, observed that the neck of the general appeared wet and that snow was sticking to his hair, but Washington refused to change his clothes and sat down to the dinner.

The next day he complained of a cold and sore throat and did not go out as usual in the morning. In spite of his cold he went outside in the afternoon to mark some trees which he wanted cut down. In the evening a severe hoarseness developed, but he made light of it. Upon retiring, Colonel Lear suggested that the general take something for his cold, but Washington answered, “No, you know I never take anything for a cold; let it go as it came.”

On the following day at three o’clock in the morning Washington told Martha that he was very unwell, that he had the ague. He could scarcely speak and breathed with difficulty. Martha begged him to let her awaken the servants and fetch him a home remedy. But Washington sternly refused to let her get up for fear she, too, would catch a cold.

At daybreak a servant came and lighted the fire. Soon Colonel Lear arrived and found the general voiceless, hardly able to utter an audible sound. A loathsome mixture of molasses, vinegar and butter was offered to Washington but he could not swallow a drop. As he tried harder to get it down, he started to cough convulsively, and almost suffocated. Rawlins, the overseer of the farm, was sent for with Washington’s request to bleed him.

The overseer had acquired his surgical acumen in the practice of veterinary medicine. He took a pint of blood from Washington, but there was no relief. Colonel Lear next applied “sal volatile,” the menthol-vapor rub of the time, to the throat of the sick man, rubbing it gently with his hand, upon which the patient complained that his throat was very sore. A piece of flannel saturated with the same evil-smelling salve was wound around his neck, and the feet bathed in warm water, all to no avail.

About eight o’clock Washington got up for two hours, but obtained no relief from the changed position. Dr. Craik arrived shortly after nine o’clock. He applied a blister of Spanish flies (derived from dried and powdered blister beetles) to the throat, took some more blood, and prescribed a gargle of vinegar and sage tea. He also ordered vinegar and hot water for steam inhalation. In attempting to use the gargle, the patient almost choked and regurgitated the liquid. At eleven o’clock the bleeding was repeated but the difficulty in swallowing and breathing did not improve. In the meantime Dr. Gustave Richard Brown, of Port Tobacco, and Dr. EIisha Cullen Dick, of Alexandria, had been summoned as consultants.

Both consultants arrived around three o’clock and sat down at the bedside of the patient. The clinical diagnostic methods of percussion and auscultation, tapping the chest and listening to the breath sounds, were not yet practiced at that time. Neither is there any record that the interior of the throat of Washington was ever inspected by the attending physicians. A diagnosis was arrived at by watching the patient and observing his external symptoms. The three doctors attending Washington saw their patient struggle for breath, each inspiration producing a shrill, harsh sound as the air was painfully sucked in through the obstructed air passage. His skin was blue and the nostrils dilated and contracted with the effort of breathing. In addition to this, the patient had great difficulty in swallowing.

The first diagnosis thought of was quinsy, which means “peritonsillar abscess.” Later on the diagnosis was changed to “cyanche trachealis,” an indefinite medical term of the time for a severe sore throat involving the voice box, in which the inflammatory swelling of the vocal chords encroaches upon the breathing space. Dr. Brown suggested using the standard treatment for this condition; namely, to resort to a more copious bleeding. The young American doctor, Dick, objected. He argued, “He needs all his strength—bleeding will diminish it.” He was overruled by his two senior colleagues who were supported by the good soldier, Washington. A whole quart of blood was taken this time and it was observed that the blood came “slow and thick,” the effect of dehydration.