By Michael Williams
It seems inconceivable that a man of George Washington’s stature, who has become iconic in American history, would die in such an inglorious manner as medical bungling, but, such was the case. This was due to the primitive methods and lack of understanding of human physiology at the time.
On the afternoon of December 13, 1799, former President George Washington was returning home from a long, cold, wintry horse-back ride across his vast Mount Vernon Estate. He was achy, felt feverish and was hoarse. He had dinner with his wife, Martha, before retiring to the upstairs bedroom of his palatial home to get a good night’s sleep. Early the following morning chills awakened Washington. He awakened Martha who summoned Washington’s long time personal secretary, Tobias Lear, who immediately came to the aid of the stricken former president.
Lear found Washington experiencing difficulty breathing and almost unable to speak. Lear began to administer treatment to the ailing Washington and made careful detailed notes of the final agonizing hours.
During the 18th century, bleeding was a common practice. The belief was that infected blood would be removed from the body, which will regenerate new, healthy blood. Quite often, leeches were used for the practice, but, if there were no leeches available, then a vein would be cut open with a knife and blood would then be drained.
Lear then sent a servant to summon Dr. James Craik. Lear gave the patient a mixture of molasses, vinegar and butter. But, Washington’s throat was closing up and he was having difficulty swallowing. Researchers believe he was suffering from epiglottitis, a condition that inflames the small tissue flap that blocks the entrance to the lungs during swallowing.
A string was tied around Washington’s arm and the doctor sliced into a vein to remove a half pint of the patient’s blood.
Washington showed no signs of rallying and a piece of flannel was dipped into a boiling pot of water and herbs. The hot, steaming poultice was then applied to Washington’s neck in an attempt to draw out infection. By some accounts the hot poultice scalded the ailing president.
Shortly afterwards, Martha summoned a Dr. Haywood, a family friend who had experience at performing tracheotomies. Haywood lived a considerable distance from Mount Vernon and there was concern that he might not arrive in time.
Craik diagnosed the condition as quinsy, a condition now referred to as strep throat. Many modern scholars disagree with Craik’s diagnosis in support of the epiglottitis theory.
Craik then applied a blister of cantharides to Washington’s throat. Cantharides are Spanish flies ground up and boiled in water. They are used as a counter irritant in hopes of drawing out the infection. Too much of the chemical can result in kidney failure.
He then ordered a gargle of vinegar and sage tea. He then asked Washington to inhale some vinegar and hot water steam. While attempting to use the gargle Washington almost suffocated.
Craik ordered a second bleeding. Again, a pint of blood was drained from the president. Craik then waited for approximately an hour. Washington’s condition seemed to be deteriorating. In response, the doctor performed a third bleeding. By now, the patient was in great discomfort and very weak. Craik examined his throat again and realized it was beginning to close up. Craik then sent for Dr. Brown and Dr. Elisha Dick to ask their opinions. They arrived by 3 a.m. Brown wisely advised against further bleeding.
Brown recommended a tracheotomy. The two other doctors were adamant and a fourth bleeding was performed. This time an entire quart of blood was removed. Lear observed that the blood was slow and very thick. Washington was now extremely weak from the loss of blood and barely able to remain conscious. The end was near.
Modern historians estimate the doctors foolishly removed 80 ounces (.63 gallons) of the president’s blood in 12 hours. This was about 35% of the blood in his body.
At approximately 4 a.m. Washington summoned Martha to his bed and instructed her to get his will from his desk.
The three doctors wanted to remove yet another pint of blood but Washington refused. “I cannot survive another bleeding” he said.
At 5 a.m. Craik returned to the patient’s bedside and Washington told him “Doctor, I die hard but I am not afraid to die. I believed from my first attack that I should not survive it. My breath cannot last long. Tis, well,” said Washington. Moments later he gasped his last breath and died on December 14, 1799.
Dr. Haywood arrived shortly after Washington passed away. He was certain a tracheotomy would have saved him. He suggested he could give Washington lamb’s blood to resurrect him and then perform the tracheotomy. Martha politely refused.
Dr. Craik immediately realized that mistakes had been made in Washington’s care. Twenty years later, in a letter to a colleague, he wrote, “Had we not taken that last quart of blood our friend, George, might have been alive now. But we were governed by the best light we had.”