The illnesses of George Washington

THE ILLNESSES OF GEORGE WASHINGTON

What is it about our first President, George Washington?  At times, we seem to glorify him as though he was a superhuman.  He lived in tough times, to be certain, perhaps more than you have considered.  But without him, our nation would not have started.

He was born at Pope’s Creek on the Potomac River, in Virginia, on February 22, 1732.  He died on December 14, 1799, at the age of 67.  Do you know what killed him?  He did not die in battle, although his horse had been shot from under him!

Washington was a strong man, who suffered through a lot of sickness. At the age of 15, he developed Diphtheria [called “Black Canker” back then].  He first contracted Malaria at age 17.  It would reoccur five more times in his life, the last time at age 66, the year before his death. At age 19, he contracted Smallpox [which pockmarked his face] and Tuberculosis.  Tuberculosis was often generally included in what was then called “Consumption” [because of the wasting and weight loss].  And it would reoccur again, when he was 35.  That was in 1767, when the Mason-Dixon Line was surveyed.

He was also afflicted by Dysentery [called “Bloody Flux”], which could have been caused by the Shigella bacterium or the amoeba, Entamoeba histolytica.  That happened four times in his life.  Bloodletting was the common form of foolish treatment.  He first contracted dysentery at age 23, causing him to ride his horse on a pillow into Braddock’s defeat!

He had Tonsillitis [called “Quinsy”] at age 47.  And boils under his skin [“Carbuncles” (don’t even ask how those can form!)] twice in his life, and at one time on his jaw.  He contracted Pneumonia, once that we know of, when he was 58.

And then there were his teeth.  He had exceptionally weak teeth, losing many to tooth disease.  He had only one of his own left when he died.  By age 44, his cheeks appeared sunken due to gum abscess.  That was in 1776, the year of our nation’s Revolution, which he so successfully concluded.  He had dentures made that pushed out his upper lip.  But his fallen teeth were too weak to reuse, so he paid his slaves for some of theirs, along with other bone or ivory pieces.

Did he contract Cholera?  No.  He missed that one.  He died of “Epiglottitis.”  Here’s how it happened.

Washington had been outside in rain, hail and snow in December of 1799, inspecting his estate lands down at Mt. Vernon.  He had “taken cold and complained of a sore throat.”  Washington had become hoarse, but said, “you know I never take anything for a cold … let it go as it came.”  He had labored breathing during the evening, and he had difficulty speaking.  Dr. James Craig, who had been with Washington at Fort Necessity and Braddock’s Defeat in the French and Indian War, was Washington’s personal physician, and was called for.  Washington could not swallow, and appeared to be suffocating.  Washington asked one of his servants to bleed him from a cut on his arm.

Craig then arrived and applied a poultice to his throat that contained “blister beetles.”  These insect creatures, when crushed, cause blisters when rubbed on the skin.  They were well known in antiquity.  Such beetles, reduced to a green powder, were used for a host of ailments, for poison, and even as a supposed aphrodisiac [the supposed Spanish Fly].  The active chemical is “cantharidin” [built up from isoprene, a 5-carbon molecule].

The toxin is produced by the blister beetles of the Insect Family Meloidae [a family that contains about 7,500 worldwide species] as a defensive secretion.  Bright colors often warn predators of its production.  The term “Spanish Fly” is most often associated with the metallic emerald-colored blister beetle, Lytta vesicatoria, of Europe and Asia.  Only males produce the chemical, which is shared through mating and the production of their “triungulin” larvae that parasitize bees in an awful fashion!

Additional doctors arrived and administered an enema of “calomel” [mercurous chloride, Hg₂CL₂] and a “tartar emetic” [antimony potassium bitartrate, K₂Sb₂ (C₄H₂O₆)₂], which increased Washington’s dehydration from both ends.  Then they continued his bloodletting.  After much suffering, Washington died the next evening uttering these last words, “tis well.”  It wasn’t.  Today, it would be characterized as “medical malpractice.”

The cause of Washington’s death was considered, at the time, to be swelling of the throat and trachea.  But it is consistent with “Epiglottitis,” where the flap at the base of the tongue swells and blocks your windpipe from breathing.

Now, there is a link to the flu here.  In the past, the “flu” was considered to be caused by “Pfeiffer’s bacillus” [Haemophilus influenza].  It was described as such in a 1892 flu epidemic by Richard Pfeiffer, a Berlin doctor working with the famous Robert Koch [Pfeiffer worked with Cholera and, arguably, developed the first Typhoid vaccination in the 1890s].  The “Spanish Flu” pandemic of 1918, however, demonstrated that his bacterium was not the cause of that infection, when the causative agent [a virus] passed through a filter, trapping the bacteria.  But the bacteria could cause the swelled up closing of a windpipe!  So it was probably the reason for Washington’s death.

It is worthwhile to examine life expectancy in America in the 1700s.  That will help to understand Washington’s life and accomplishments.  There were around 3 million people of European descent in the English colonies in 1780 [about 4 million in 1790, counted in our first national census].  The substantial Native American population, already here when the colonists landed, had been decimated by European diseases brought along with them.  Philadelphia was the largest city (30,000 citizens?) in the nation.  There were also more than 600,000 black slaves [Pennsylvania began gradual abolishment of slavery in 1780, but the new Constitution barred Federal action to prohibit slave importation for 20 years (Article 1, Section 9)].

But many of these diseases still plagued the colonists, especially at childbirth and at very young ages.  The average life expectancy was about 37 years in 1787.  Washington understood this fact acutely.  His father, Augustine, died at age 48, when George Washington was 11.  George then inherited slaves, but not Mt. Vernon.  That was passed to his half-brother, Lawrence, who had named the homestead at Little Hunting Creek on the Potomac River after British Admiral Edward Vernon, with whom he had once served.  George Washington greatly admired his brother, Lawrence, perhaps substituting his affection for a more distant father, now dead.

But Lawrence Washington was sick.  Tuberculosis.  He went to England for treatment, but returned still infected. In order to find a moderate climate, and more treatment, he traveled with George to Barbados [in the British Lesser Antilles off the coast of Venezuela].  It was the only time George Washington traveled outside of the United States.  Lawrence would die in Bermuda of Tuberculosis, at age 34.  George Washington returned home with two things, both important to his career and our nation.  Mt. Vernon and the results of a smallpox infection!

First, Mt. Vernon.  It is a holy place to many of us, and the home where George Washington breathed his last.  And it is a complicated place, where he lived with his wealthy wife, Martha Custis.  At his death, he oversaw five farms, totaling about 8,000 acres, and worked by 317 black slaves [living in “villages” on the farm], and 25 white servants.

But Mt. Vernon was not originally his.  It had been given, in his father’s will, to Lawrence, who died nine years later.  Young George Washington was Lawrence’s executor and partial inheritor.  He would inherit Mt. Vernon only after Lawrence’s wife’s life, and only after her daughter died, if without issue.  Lawrence’s daughter, Sarah, died within two years at the age of four, and his wife, Anne, having remarried, leased Mt. Vernon to George.  Washington became sole owner of Mt. Vernon when Lawrence’s wife died in 1761, herself an interesting story [she was the sister-in-law of George Washington’s first love, Sally Fairfax].  His land, like the man, would become a complicated entity.

George Washington had a severe fight [“strangely attacked”] with smallpox, contracted while accompanying Lawrence to Barbados.  It left his face pockmarked.  But it provided him with the resistance to withstand that disease when it swept through his troops in the Revolution.

Smallpox was then uncommon in America.  That would change in the war years that were coming.  The British troops would bring it with them into the battle.  Washington called smallpox, “this most dangerous enemy.”  He wrote to Horatio Gates, “I am very much afraid that all the troops on their march from the southward will be infected with the smallpox, and that, instead of having an army here, we shall have a hospital.”  But not with Washington as a patient, for he was now immune to that pestilence!

The only protection from smallpox, then known, was to knowingly infect a person with the smallpox germ from a pustule (variolation).  If it didn’t kill you, you would become immune to its later presence.  The Virginia Legislature banned the practice for fear of spreading the disease, but Washington ordered the mass inoculation of his troops, instead.

Although fearful, Martha Washington also consented to being inoculated.  Washington wrote, in a letter to her brother, that the treatment was successful.  “Fever and not more than about a dozen Postules [sic] appearing.”  These were truly fearful times in the making of our nation!

Thankfully, George Washington lived a long and productive life.  He died at the age of 67.  He learned much in his living that we still benefit from in our form of government.  He outlived all of his siblings and had no natural children.  But his mother lived until 1789, dying just after Washington became our first President.

It was George Washington who brought our nation to fruition.  But he had to defeat more than the British Regular Army to do it.  He had to defeat all of the diseases that first attacked him!

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