Minuteman, November 2018
Following lunch, President Tim Ernst introduced our special guest speaker, Dr. Matthew Stiles , an allergist and clinical immunologist from Rocklin, California. Dr. Bowdish graduated from Humboldt State University with a BS in cellular-molecular biology, and minors in chemistry and political science. He graduated from Northeastern Ohio University’s College of Medicine with an MD degree. He completed his training in allergy and clinical immunology from Yale University School of Medicine. He has published on the subjects of allergy, asthma, HIV immunology, immunodeficiency, and cancer gene therapy in a number of scientific journals and textbooks. He is a member of over 65 hereditary societies, including the Society of the Cincinnati, Sons of the Revolution, and Society of Colonial Wars. Dr. Bowdish presented a program on the health of George Washington. Dr. Bowdish stated that as a physician, he was very interested in the medical history of his ancestors, since many diseases run in families. He researched the causes of death as part of his family history and genealogy research.
Dr. Bowdish started the program by asking the audience what are the physical characteristics of George Washington. People responded that he was tall (he was 6 feet, 2 inches tall), had false teeth, was very robust, was a skilled horseman and dancer, and was athletic. Dr. Bowdish stated that you could learn a lot from the portraits of George Washington. He displayed a picture of the William Joseph Williams portrait of George Washington in 1794 that is displayed in the Masonic Temple in Alexandria, Virginia. The Masons requested a very detailed and accurate picture of George Washington, and it was considered scandalous at the time because George Washington was not depicted in an idealized manner. Since it was a harshly accurate picture of Washington, Dr. Bowdish asked the audience what they noticed about his face. His cheeks were red (possible rosacea), he had a receding hairline, he had a mole (possible basal cell carcinoma) under his right ear, he had a scar on his left cheek (from an operation to drain a dental abscess), he had small scars on his face from smallpox, he had sun damage on his forehead, his jaw and mouth look like there were some serious dental issues, and he had 5 o’clock shadow.
Dr. Bowdish discussed health care delivery in the 17th and 18th century. Most health care was provided in the home by the mother – nutrition and herbal remedies. Gervase Markham published a book in 1615: The English Hus-wife, Contayning, The inward and outward vertues which ought to be in a compleat woman. As, her skill in Physicke, Cookery, Banqueting-stuffe, Distillation, Perfumes, Wool, Hemp, Flax, Dayries, Brewing, Baking, and all other things belonging to a Houshould. A Work very profitable and necessarie, gathered for the generall good of the kingdome. The book went through nine editions by 1683. The book had many herbal remedies for the housewife, who was the medical first responder of the family. There were very few medical professionals at the time, and most doctors trained from reading textbooks written by Hippocrates of Kos (who died around 370 BC), known as the “father of medicine,” and by Galen of Pergamum (who died around AD 210), a physician in the Roman Empire. Galen taught that there were four humors – black bile, yellow bile, phlegm, and blood – which corresponded to the four elements – air/dry, fire/hot, earth/cold, and water/wet. Galen believed that disease was caused by an imbalance in the humors of the body, and could be cured by rebalancing them. Medical treatments consisted of cupping/blistering (cupping is still done today by swimmer Mike Phelps and other famous athletes), purgatives/emetics, poultice/cataplasm, and venesection (bloodletting) to rebalance the humors. Dr. Bowdish passed around a fleam (bloodletting lancet) from 1810. He said the patient’s arm would be placed in a bowl of warm water to dilate the blood vessels, and then the lancet would cut the skin to bleed the body. Life back then was “short, nasty and brutish.” There was high mortality, especially among children. In the 17th century, the English life expectancy was 35 years, and in Virginia, it was only 25 years. In New England, about 40% of children died before reaching adulthood. Despite that, some people lived into their 100’s.
Dr. Bowdish discussed the Washington family medical history. George Washington’s great grandfather, the immigrant ancestor, settled in Virginia, and died at age 46 from respiratory ailments. His paternal great grandmother Anne Pope died at age 33 of unknown causes. His grandfather Lawrence Washington died at age 37 from respiratory ailments. His paternal grandmother Mildred Warner died at age 30 of unknown causes. His father Augustine Washington died at age 48 from “gout of the stomach.” His mother Mary Washington died of breast cancer at the advanced age of 81 years. By the age of 15, George Washington had suffered from measles, mumps, and “black canker” (diphtheria). While he was surveying the swamps around Alexandria, Virginia, in 1749, George Washington contracted the “ague” (malaria). Because he was from a wealthy family, George Washington was treated with Peruvian Jesuit Bark (cinchona), which contained quinine. In later life, Washington had severe hearing loss, which was likely caused by the cinchona he received as a treatment for malaria.
George Washington’s father Augustine Washington died when George Washington was eleven years old. George’s older half-brother, Lawrence Washington (1718-1752), took the young George Washington under his wing as a father figure.
In 1731, Spanish Captain Juan de León Fandiño cut an ear off of British Captain Robert Jenkins when Jenkins was caught smuggling goods illegally into Spanish Florida, which eventually precipitated the War of Jenkins’ Ear (1739-1742). Lawrence Washington volunteered for Colonel William Gooch’s Regiment of Foot, and served in the war. Later, he was appointed “Captain of the Soldiers acting as Marines” on Admiral Edward Vernon’s flagship, the HMS Caroline. After the war, Lawrence Washington was granted land in the Colony of Virginia, and he named his plantation “Mount Vernon” in honor of his commanding officer, Admiral Edward Vernon. Lawrence was elected to the Virginia House of Burgesses in 1744 as a representative for Fairfax County. Lawrence Washington contracted tuberculosis in Virginia in 1749, and he went to England for medical advice. In 1751, George Washington took him to Barbados because it was believed the warm, tropical climate would help Lawrence in his struggle with tuberculosis. While visiting Barbados, George Washington contracted smallpox. Throughout human history, smallpox killed about 20% of the human population, and it was a scourge in colonial times, with a 40-95% mortality rate. After four weeks, George Washington survived his bout with smallpox, and they returned to Virginia. Smallpox left him with scars on his face, but gave him immunity against the disease. Lawrence Washington finally succumbed to tuberculosis in 1752. After the deaths of Lawrence’s wife and daughter, George Washington inherited the Mount Vernon plantation.
George Washington was afflicted by chronic diseases and bouts of depression. In 1751-52, he had tubercular pleurisy; in 1754, he had malaria again; and in 1755, he had influenza. During the French and Indian War, Washington served under Major General Edward Braddock in the campaign to capture French Fort Duquesne in 1755. He developed “bloody flux” (dysentery), and was treated with “Dr. James Powders,” which contained salt, mercury, and bark. He recovered, and fought in the Battle of Monongahela. General Braddock was killed, and Washington recovered his body under fire. After the war, Washington’s health problems continued: in 1757-58, he was afflicted with the “flux with pleurisy and fever;” in 1761, he had malaria again; and in 1767, he had dysentery again. Because of his chronic illnesses, Washington was ridiculed for his inability to serve in the military. While running Mount Vernon, Washington provided medical care for his family and slaves. He set up infirmaries, learned venesection (bloodletting), and inoculated his family and slaves for smallpox.
George Washington’s health during the American Revolution is not known as it was a state secret. The British had a greater immunity to smallpox than the Continentals, so in 1777, General Washington ordered the first military mass inoculations.
At Valley Forge, 10,000 troops arrived in December 1777, and 30% contracted diseases there – frostbite, gangrene, smallpox, pneumonia, typhoid, typhus, and dysentery. One quarter of the soldiers died at Valley Forge.
George Washington’s dental hygiene was bad, which he attributed to cracking nuts with his teeth in his youth, but the reason was probably more complicated. He had his first tooth pulled at age 22, and only had one tooth remaining by the time he was president. One of his dentures was made by Paul Revere. They were made of human teeth, whalebone, and hippopotamus teeth. He saved some of his extracted teeth for the dentures, and bought some teeth from slaves (he paid 122 shillings for 9 teeth). His dentures were ill-fitting and clicked, so he never smiled and never gave long speeches. In 1781, Washington’s letters were intercepted by the British, and among them was a request for teeth scrapers. General Clinton read the letters, and decided not to reinforce Yorktown, which contributed to the American victory.
When Washington was president, his health problems continued. Six months after his inauguration, he developed fever, chills, cramps, and had a carbuncle on his leg. His surgery to remove the carbuncle required six weeks to recover. Washington developed conjunctivitis and pneumonia. He was unable to perform his duties for 109 days. In 1797, George Washington retired to Mount Vernon.
Dr. Bowdish recounted George Washington’s final illness. On Thursday, December 12, 1799, Washington was inspecting his lands in the snow, hail and freezing rain. He returned home late and did not change out of his clothes before dinner. He developed a sore throat, and dysphonia, and retired early thinking he had a cold. On Friday, December 13, 1799, Washington woke up at 2 AM with a sore neck, stridor (harsh noise caused by obstruction of the windpipe), and fever. Martha Washington called for his personal secretary, Tobias Lear, who recorded Washington’s final moments, and last words in his journal. At 7 AM, Washington called for overseer George Rawlings to perform bloodletting and apply blisters, over Martha’s objections. He took ½ quart of blood, and gave Washington a formula of molasses, butter, and vinegar, but there was no improvement. At 9 AM, Surgeon General Dr. James Craik came to Mount Vernon and bled a quart of blood from Washington, but there was still no improvement. At 11 AM, Dr, Craik bled another quart of blood, applied blisters to the neck, gave him a gargle of sage tea and vinegar, and gave him an enema. At this point, half of Washington’s blood had been removed. With no improvement, Martha sent for more physicians. At 3 PM, Dr. Elisha Dick and Dr. Gustavius Brown arrived at Mount Vernon, and he was bled of another quart of blood, over Dr. Dick’s objection. Dr. Dick wanted to perform a tracheotomy to improve Washington’s breathing, but the procedure had not yet been performed in the New World. Washington probably had acute epiglottitis, which was restricting his airway. The older doctors overruled Dr. Dick, and prevented him from trying the experimental procedure. With only 1½ quarts of blood left in his body, Washington was very weak. At 4:30 PM, he called for Lear so he could review his two wills. He tossed one into the fire, and signed the other one. At 5 PM, he changed into his bedclothes realizing he was about to die. Cataplasms and more blisters were employed.
In the early evening, Washington requested that all treatments stop. He stated, “Doctor I die hard, but I am not afraid to go. I believed from my first attack that I should not survive. My breath cannot last long.” Washington uttered his last words – “Tis well” – and died at 10:22 PM on December 13, 1799. On Monday, December 16, 1799, Dr. William Thornton sent a message to Martha Washington offering to perform a postmortem tracheotomy in an attempt to revive the deceased Washington, but Martha declined. There was an inquest into Washington’s death, and the inquest found that although the older doctors did nothing wrong, they probably should have permitted Dr. Dick to try the experimental tracheotomy. Dr. Bowdish stated that doctors should be humble, and be open to new procedures. Had Dr. Dick prevented the last quart bloodletting, and been allowed to perform the tracheotomy, Washington may have survived his illness. The combination of a restricted airway, and the severe loss of blood assured his demise. The fascinating presentation resulted in many questions, and a strong ovation. President Tim Ernst presented Dr. Mathew Bowdish with the SAR Certificate of Appreciation for the entertaining and informative history of George Washington’s health.