Trick or Treatment—The Undeniable Facts about Alternative Medicine (Electronic book text)

When Europeans colonized the New World, they took the practice of bloodletting with them. American physicians saw no reason to question the techniques taught by the great European hospitals and universities, so they also considered bloodletting to be a mainstream medical procedure that could be used in a variety of circumstances. However, when it was administered to the nation’s most important patient in 1799, its use suddenly became a controversial issue. Was bloodletting really a life-saving medical intervention, or was it draining the life out of patients?

The controversy began on the morning of 13 December 1799, the day that George Washington awoke with the symptoms of a cold. When his personal secretary suggested that he take some medicine, Washington replied, ‘You know I never take anything for a cold. I’ll let it go just as it came.’

The sixty-seven-year-old former president did not think that a sniffle and a sore throat were anything to worry about, particularly as he had previously suffered and survived far more severe sicknesses. He had contracted smallpox as a teenager, which was followed by a bout of tuberculosis. Next, when he was a young surveyor, he caught malaria while working in the mosquito-infested swamps of Virginia. Then, in 1755, he miraculously survived the Battle of Monongahela, even though two horses were killed beneath him and four musket balls pierced his uniform. He also suffered from pneumonia, was repeatedly afflicted by further bouts of malaria, and developed ‘a malignant carbuncle’ on his hip that incapacitated him for six weeks. Perversely, having survived bloody battlefields and dangerous diseases, this apparently minor cold contracted on Friday 13th would prove to be the greatest threat to Washington’s life.

His condition deteriorated during Friday night, so much so that he awoke in the early hours gasping for air. When Mr Albin Rawlins, Washington’s estate overseer, concocted a mixture of molasses, vinegar and butter, he found that his patient could hardly swallow it. Rawlins, who was also an accomplished bloodletter, decided that further action was required. Anxious to alleviate his master’s symptoms, he used a surgical knife known as a lancet to create a small incision in the General’s arm and removed one-third of a litre of blood into a porcelain bowl.

By the morning of 14 December there was still no sign of any improvement, so Martha Washington was relieved when three doctors arrived at the house to take care of her husband. Dr James Craik, the General’s personal physician, was accompanied by Dr Gustavus Richard Brown and Dr Elisha Cullen Dick. They correctly diagnosed cynanche trachealis (‘dog strangulation’), which we would today interpret as a swelling and inflammation of the epiglottis. This would have obstructed Washington’s throat and led to his difficulty in breathing.

Dr Craik applied some cantharides (a preparation of dried beetles) to his throat. When this did not have any effect, he opted to bleed the General and removed another half a litre of blood. At 11 a.m. he removed a similar amount again. The average human body contains only 5 litres of blood, so a significant fraction was being bled from Washington at each session. Dr Craik did not seem concerned. He performed venesection again in the afternoon, removing a further whole litre of blood.

Over the next few hours, it appeared that the bloodletting was helping. Washington seemed to recover and for a while he was able to sit upright. This was, however, merely a temporary remission. When his condition deteriorated again later that day, the doctors conducted yet another session of bloodletting. This time the blood appeared viscous and flowed slowly. From a modern perspective this reflects dehydration and a general loss of bodily fluid caused by excessive blood loss.

As the evening passed, the doctors could only watch grimly as their numerous bloodlettings and various poultices failed to deliver any signs of recovery. Dr Craick and Dr Dick would later write: ‘The powers of life seemed now manifestly yielding to the force of the disorder. Blisters were applied to the extremities, together with a cataplasm of bran and vinegar to the throat.’

George Washington Custis, the dying man’s step-grandson, documented the final moments of America’s first President: