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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
To add insult to injury, the laxative, calomel, and the emetic, tartar, were administered, weakening the patient still further. About half past four Washington gave instructions about his will, and about five o’clock he tried to sit up, but was too weak to remain upright for more than half an hour. In the course of the afternoon he appeared in great distress and pain, and frequently changed his position in bed, struggling for breath.
As a last resort Dr. Dick suggested the use of a new, revolutionary method, the only one available which could have saved the patient from slow suffocation caused by the obstruction of the larynx, “tracheotomy”—the surgical cutting of an opening into the windpipe below the point of obstruction. In a communication several years later Dr. Dick reasoned, “I proposed to perforate the trachea as means of prolonging life and of affording time for the removal of the obstruction to respiration in the larynx which manifestly threatened immediate dissolution.”
The older colleagues refused to take a chance on their illustrious patient by using such an unproved and daring procedure, which, in the annals of medicine, had been employed in only a few instances up to this time with success. The urgent entreaties of Dr. Dick were in vain. Instead of it, the polypragmatic senior physicians continued their futile measures by applying blisters and cataplasms of wheat bran to the legs and feet of the dying patient. The process of gradual suffocation progressed inexorably until about ten minutes before the general expired, when the breathing became easier. The exhausted heart stopped beating between ten and eleven o’clock on the evening of December 14, 1799.
From the first, Washington as usual had been exceedingly pessimistic about his illness. He had made up his mind that he was going to die and did what he could to dissuade his doctors from making special efforts for him, and begged them to let him die in peace.
“I find I am going,” he whispered to Colonel Lear. “My breath cannot last long. I believed from the first that the disorder would prove fatal.” And a little later he repeated the same conviction to Dr. Craik: “Doctor, I die hard, but I am not afraid to go.” And later when Dr. Brown came into the room: “I feel myself going; I thank you for your attention but I pray you to take no trouble for me. Let me go quietly. I cannot last long.”
The exact diagnosis of George Washington’s last sickness is still a matter of dispute among medical historians. The most convincing study was made by Dr. W. A. Wells of Washington, D. C., in 1927. Up to that time it was believed that Washington had died from diphtheria, corresponding to the diagnosis of “croup,” which Dr. Dick had suggested in retrospect. A final diagnosis cannot be made with certainty, as no clinical description of the appearance of the inflammatory process has been given, and bacteriological confirmation of a diagnosis was unknown. In spite of this lack of evidence, Dr. Wells concluded from all the known data that Washington died from a streptococcic laryngitis, an inflammatory swelling of the larynx and the vocal chords caused by a strain of virulent streptococci. We are unable to estimate how much the treatment with depleting venesections and dehydrating cathartics and emetics contributed to the fatal outcome.