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

As the night advanced it became evident that he was sinking, and he seemed fully aware that ‘his hour was nigh’. He inquired the time, and was answered a few minutes to ten. He spoke no more — the hand of death was upon him, and he was conscious that ‘his hour was come’. With surprising self-possession he prepared to die. Composing his form at length and folding his arms on his bosom, without a sigh, without a groan, the Father of his Country died. No pang or struggle told when the noble spirit took its noiseless flight; while so tranquil appeared the manly features in the repose of death, that some moments had passed ere those around could believe that the patriarch was no more.

George Washington, a giant man of 6 feet 3¹/2 inches, had been drained of half his blood in less than a day. The doctors responsible for treating Washington claimed that such drastic measures had been necessary as a last-ditch resort to save the patient’s life, and most of their colleagues supported the decision. However, there were also voices of dissent from within the medical community. Although bloodletting had been an accepted practice in medicine for centuries, a minority of doctors were now beginning to question its value. Indeed, they argued that bloodletting was a hazard to patients, regardless of where on the body it took place and irrespective of whether it was half a litre or 2 litres that was being taken. According to these doctors, Dr Craik, Dr Brown and Dr Dick had effectively killed the former President by needlessly bleeding him to death.

But who was right — the most eminent doctors in the land who had done their best to save Washington, or the maverick medics who saw bloodletting as a crazy and dangerous legacy of Ancient Greece?

Coincidentally, on the day that Washington died, 14 December 1799, there was effectively a legal judgement on whether bloodletting was harming or healing patients. The judgement arose as the result of an article written by the renowned English journalist William Cobbett, who was living in Philadelphia and who had taken an interest in the activities of a physician by the name of Dr Benjamin Rush, America’s most vociferous and famous advocate of bloodletting.

Dr Rush was admired throughout America for his brilliant medical, scientific and political career. He had written eighty-five significant publications, including the first American chemistry textbook; he had been surgeon general of the Continental Army; and, most important of all, he had been a signatory to the Declaration of Independence. Perhaps his achievements were to be expected, bearing in mind that he graduated at the age of just fourteen from the College of New Jersey, which later became Princeton University.

Rush practised at the Pennsylvania Hospital in Philadelphia and taught at its medical school, which was responsible for training three-quarters of American doctors during his tenure. He was so respected that he was known as ‘the Pennsylvania Hippocrates’ and is still the only physician to have had a statue erected in his honour in Washington DC by the American Medical Association. His prolific career had allowed him to persuade an entire generation of doctors of the benefits of bloodletting, including the three doctors who had attended General Washington. For Rush had served with Dr Craik in the Revolutionary War, he had studied medicine with Dr Brown in Edinburgh, and he had taught Dr Dick in Pennsylvania.

Dr Rush certainly practised what he preached. His best-documented bloodletting sprees took place during the Philadelphia yellow fever epidemics of 1794 and 1797. He sometimes bled 100 patients in a single day, which meant that his clinic had the stench of stale blood and attracted swarms of flies. However, William Cobbett, who had a particular interest in reporting on medical scandals, was convinced that Rush was inadvertently killing many of his patients. Cobbett began examining the local bills of mortality and, sure enough, noticed an increase in death rates after Rush’s colleagues followed his recommendations for bloodletting. This prompted him to declare that Rush’s methods had ‘contributed to the depopulation of the Earth’.

Dr Rush’s response to this allegation of malpractice was to sue Cobbett for libel in Philadelphia in 1797. Delays and distractions meant that the case dragged on for over two years, but by the end of 1799 the jury was ready to make a decision. The key issue was whether Cobbett was correct in claiming that Rush was killing his patients through bloodletting, or whether his accusation was unfounded and malicious. While Cobbett could point to the bills of mortality to back up his case, this was hardly a rigorous analysis of the impact of bloodletting. Moreover, everything else was stacked against him.