WASHINGTON’S MEDICAL KNOWLEDGE AND ITS SOURCES* By WYNDHAM B. BLANTON, M.D. RICHMOND, VA. THE versatile Washington Like most of his generation, Wash- touched medicine in many in ington was a firm believer in blood teresting particulars. He saw letting. The rationale was simple. The and heard a great deal of the cause of disease, peccant or morbific medicine of his day. He knew inti- matter, had to be evacuated. With- mately most of the best doctors of his draw a little blood and the thing was generation, and he acquired ideas of accomplished. His life-long friend and his own relating to the cause and cure counselor, Dr. Craik, tersely expressed of disease—perhaps no more than the it in a letter to Washington, then average eighteenth century colonial suffering from dysentery: “your dis- planter, but he had a straightforward- order hath been of long standing and ness and simplicity in the use and hath corrupted the whole mass of expression of his medical knowledge blood.” What nurses, barbers and that was rare at that period. overseers could do, what every doctor supported by the authority of Syden- i. Was hin gto n ’s Medic al Know ledge ham did for nearly every disease, From time immemorial the gentry what was practiced on himself and on of lowland Virginia spent their sum- Mrs. Washington repeatedly, Wash- mers at the springs. When other ington did not hesitate to order on his measures failed the healing waters of own initiative. The occasion arose in mineral springs were always sought. February, 1760, at Williamson’s Quar- In 1748 the sixteen-year-old Washing- ter, one of his plantations, when he ton first “call’d to see y. Fam’d found two of his negroes sick. Without Warm Springs.’’ In 1750 with his more ado he directed them to be invalid brother Lawrence, and in “blooded.” In May of the same year 1761 suffering with fevers, pains and his diary records: . Lightning insomnia, he sought “what effect wch. had attended a good deal of Rain the waters may have upon me,” has struck my Quarter and near 10 adding, “I expect nothing from the Negroes in it, some very bad; but air this certainly must be unwhole- with letting Blood they recoverd.” some.” He and Mrs. Washington went Washington’s own fatal illness devel- there in 1767, and two years later oped with alarming suddenness in the from the Springs he wrote: “I came middle of the night. Before the phy- to this place with Mrs. Washington sicians arrived the patient ordered and her daughter, the latter being his overseer to bleed him. The troubled with a complaint, which the modest pint of blood then with- efficacy of these waters it is thought drawn initiated a series of hopeless might remove. ...” phlebotomies. *Read before the Section of Medical History of The College of Physicians of Philadelphia, February 8, 1932. With many of his friends along the by vegetables or vinegar, or by any banks of the James and the Rappahan- kind of Drink but water, and eating nock, and his neighbors on the Poto- indifferent Bread . are to be as- mac, Washington had an abiding cribed the many putrid diseases inci- faith in the virtues of quinine. Writing dent to the Army. ...” to his secretary, Tobias Lear, in Smallpox attacked Washington early August, 1798, he cautioned: “If you in life, repeatedly visited his planta- have missed the ague care, and Bark is tions and was all too common among necessary to prevent a relapse. ’’ his soldiers. He always exhibited a Not many days passed before he most energetic attitude towards this reported to his nephew Bushrod that eighteenth century scourge. His Rev- Dr. Craik had “to dose me all night olutionary correspondence with Con- on Thursday with Bark.” And Dr. gress, with the governors of the Craik gave it in large doses and fre- several states, and with his own quently. To two of Washington’s subordinates, is full of very definite nephews he administered 13 ounces in ideas concerning communicability, the the course of a year. Bark was a need for isolation hospitals and “the popular remedy on W ashington’s plan- amazing success” of inoculation. The tations as frequent entries in his prevention of smallpox in the Con- account books show. tinental Army he assumed with the Intestinal worms explained to the directness of one confident whereof satisfaction of eighteenth century par- he spoke. “I have been particularly ents many otherwise inexplicable ab- attentive to the least symptom of dominal symptoms. Mrs. Washington smallpox,” he wrote, and at another expressed what was probably her time: “I have therefore determined husband’s theory also when she wrote not only to inoculate the troops now in a delightfully candid letter to Mrs. here but shall order Dr. Shippen to Lear: “I am sorry to hear by your inoculate the recruits as fast as they Letter . that your little girl has come to Philadelphia.” He gave over been so ill ... I have not a doubt the winter spent at Morristown to a but worms is the principle cause of general inoculation of the whole army. her complaints. Children that cat How different was the attitude of everything as they like and feed as General John Thomas, who opposed heartily as yours does must be full inoculation, saw smallpox ravage his of worms ...” Her own son, Jacky command and died of it himself. Custis, on one occasion developed “a Other opposition was closer at hand. pain in his stomack,” at first taken He had to keep the fact of Jacky for colic, but later satisfactorily ex- Custis’s inoculation from the anxious plained as “owing to worms.” Martha until it was safely over, and Washington believed firmly in the he almost despaired of ever getting dietary cause of disease. Perhaps this her to undergo the ordeal, declaring: accounts for his frugal breakfast of she “talks of taking the smallpox: hoc cakes, honey and tea. To Congress but I doubt her resolution.” The he explained “the lamentable mortal- deed was finally accomplished by ity that attended us last Campaign.” Dr. John Morgan. He said: “ . to devouring large Washington considered the pro- quantities of animal food, untemper’d cedure a very simple one, claiming: “The whole art” lies “in keeping the seized (if more than a slight indisposi- Patient rather low in diet, and cool, tion) should be closely watched, and especially at the period of the eruptive timely applications and remedies ad- fever . and my own People (not ministered; especially in the pleurisies, less I suppose than between two and all inflammatory disorders accom- and three hundred), getting happily panied with pain, when a few days’ through it by following these direc- neglect, or want of bleeding, might tions, is no Inconsiderable proof of it.” render the ailment incurable. In such He berated the Virginia Assembly cases sweeten’d teas, broths and . in no uncertain terms: “Surely that sometimes a little wine, may be neces- Impolitic Act, restraining Inocula- sary to nourish and restore the pa- tion in Virginia, can never be con- tient. ...” tinued ... If I was a Member of Washington was several times the that Assembly, I would rather move victim of quackery. He sent a servant for a Law to compel the Masters of all the way to Lebanon, Pennsylvania, Families to inoculate every child born to a hex-doctor “celebrated for curing within a certain limited time under persons bitten by mad animals,” Severe Penalties.” The influence of and paid five dollars for “the pre- Washington in the prevention of small- scription & application.” In the case pox in America was probably as great of Patsy Custis (Mrs. Washington’s as that of Cotton Mather, Benjamin only daughter), whose illness had Franklin, or Thomas Jefferson. baffled most of the best physicians in For the common cold Washington the colony and whose fits were always seems to have had little concern, sending messengers hurriedly for help, although he appears to have had many desperation led to the trial of a time- himself. To a suggestion of Colonel honored cure for epilepsy. Washington Lear’s that he take something for a wrote in his diary on February 16, cold, he answered: “No, you know I 1769, “Joshua Evans, who came here never take anything for a cold. Let it last Night, put an Iron Ring upon go as it came.” Patcy (for Fits) and went away after There is little to show that Wash- Breakfast.” Two years later another ington thought much on the phil- expedient was tried and this time the osophy of disease. To him it was a very diary records that “Mr. J no. Johnson, simple process. Writing to his overseer who has a nostrum for Fits, came here about malingering slaves, he said: in the Afternoon.” Later the quack “Nobody can be very sick without was paid fourteen pounds for his having a fever, nor will a fever or frequent visits. any other disorder continue long upon any one without reducing them. Pain 11. Plant ation Medic ine at Moun t also, if it be such as to yield entirely Ver no n to its force, week after week, will Washington’s medical knowledge appear by its effects. ...” Further was not derived from books. His light is thrown on his naive conception library contained but nine volumes of disease in another letter: “ . in any way relating to medicine. the first stage of, and the whole What he knew came out of the school progress through the disorders with of hard knocks, long and trying ex- which they [the slaves] might be perience on the frontier, in war, on a plantation, and as a patient.