"THE TIMES OF THIS
IGNORANCE"
JUST at the turn of the nineteenth century George Washington was stricken with a sickness that in a few days was to prove fatal. As soon as he realized that he was seriously ill, he sent—not for a physician—but for a "bleeder," who took from his veins about fourteen ounces of blood. The next morning the family physician was called, who, discovering the case to be highly alarming, called two other doctors for consultation. While waiting for them, he directed a second copious bleeding. Upon the arrival of the first of his consultants in the afternoon, it was agreed "to try the result of another bleeding, when about thirty-two ounces of blood were drawn, without the slightest alleviation of the disease."—Kennebec Intelligencer, January 11, 1800.
This debilitating treatment was supplemented by the application of blisters, the administration of calomel, repeated doses of tartar emetic, and frequent inhalations of "vapors of vinegar and water." It is not surprising to learn from a contemporary report that Washington's last request, understood with great difficulty because of his weakness, was to be permitted to die without further interruption.
Details of the progress of the illness, and particularly of the methods employed for the relief of the famous patient, were made public, not in any wise as a reflection upon the skill of the attending physicians, but, on the contrary, to give assurance that the beloved leader had received the best of care, and that his untimely death occurred in spite of all that human knowledge and skill could devise to arrest the course of the disease.
Drugs and Opiates Used
The first quarter of a century after the death of George Washington witnessed but very little advance in the general methods of therapeutic practice. Medical books of that period abound with evidence that the strongest drugs and opiates were freely prescribed, and that little attention was given to the causes of disease or to rational methods for its alleviation. In 1810 the senior physician in the Manchester Infirmary issued a book giving the case histories of hundreds of his patients. Here is a condensed report in which he related the experience of James Johnson, a youth of twenty-three years, who came to the hospital for relief from dropsy (Johnson was admitted on August 15):
"After trying some other diuretics, took the infusorum nicotiance in the quantity of eighty drops in twenty-four hours, for three days together." This "produced sickness," but did not produce the desired effect. "Fifteen grains of jallap and two drachms of cream of tartar given at bedtime, vomited him briskly, and reduced the swellings for a time." However, strange to say, "the most powerful diuretics given in large doses" proved ineffective. Toward the end of September he was given, "after a gradual augmentation, one hundred and twenty of the tonic pills in one day."
This treatment brought on a "degree of vertigo," and the pills were therefore "omitted, and some wine prescribed. Thirty drops of spiritus aetheris vitriolici were likewise ordered to be given four times a day," The day after this, "pain in the bowels and a diarrhea came on," so "the vitriolic spirit was omitted." "Opiates and astringents were now given, but with little success." On the fifth of November the patient "was ordered three grains of digitalis, which on the seventh were augmented to four."
By this time the patient was desirous of "returning to his native air," and he was dismissed from the infirmary before there was time to "experience the effect" of the new course
of drugging. Though "much relieved," according to the physician, he deemed that Mr. Johnson had "little prospect of being ultimately cured."—John Ferriar, M.D., Medical Histories and Reflections, pp. 93-95. London: Cadell and Davis, 1810.