The Death of George

Washington:
A Medical Perspective
 A Timeline of His Life
1732: George Washington is born in Westmoreland
County, Virginia
1749: George Washington is appointed county

surveyor of the frontier county of Culpeper.

1753 -1755: Washington fights in the French and

Indian War.
1759: On January 6, 1759, George Washington

married Martha Dandridge Custis. Martha was a

young widow who had inherited an enormous
amount of wealth from her first husband.
A Timeline of His Life contd
1775: The newly formed Congress appointed
George Washington to be the commander of the
Continental Army.
1783: Washington resigned his commission on

December 23rd.
1789: George Washington is unanimously elected

as first President of the United States.

1797: Washington retired from public life

1799: George Washington died December 14th .

Fateful Rides

On Thursday, December 12, 1799,

Washington spent five hours surveying
his farms in a mix of rain, sleet and snow.
Fateful Rides

Arriving home,
the General
declines to
change out of his
wet clothes and
heads to dinner.
Fateful Rides
On Friday, even
though the
symptoms of a
cold were upon
him, he spent
several hours
outside in the
damp and cold to
mark a few trees
he wanted to cut
down.
 Fateful Rides
That evening after
dinner and even
though he was getting
very hoarse, he
insisted on reading
parts of the newspaper
to Martha and his
secretary, Tobias Lear
 Fateful Rides
His symptoms
worsening, Lear
suggested that he
might take something
for cold before he
headed to bed. The
General, who rarely
took any medication,
stated Let it go as it
came.
What befalls the General?
Early Saturday morning,
Washington awakes
feverish and with labored
breathing. Martha wanted
to go for help but
Washington afraid for her
health (she had recently
recovered from a serious
illness herself)would not let
her go. At approximately
7 am, their servant arrived.
She was immediately sent
to find Lear who would
send for Dr. James Craik.
What befalls the General?

While awaiting the

arrival of Craik,
Washington
summons one of this
overseers, George
Rawlins, to bleed
him.
What befalls the General?
Additionally, Lear
prepared a medicinal
mixture of molasses,
vinegar and butter
for Washington.
When he tried to
swallow it, the
General choked on
the concoction.
What befalls the General?
Afterwards, Lear
applied Salve
Latola to
Washingtons Throat
as well as wrapping a
piece of flannel
impregnated with
the same concoction
while soaking his feet
in warm water.
 Arrival of the Physicians
One of Washingtons closest
friends, Craik was born in Scotland
around 1730, educated at
Edinburgh and came to America in
1750 while serving in the British
Army. Washington and Craik met
while fighting in the French and
Indian War. Washington described
Craik in his will as compatriot in
arms, and old and intimate friend.
He served in the American
Revolution becoming Chief
Physician and Surgeon of the
Dr. James Craik
Continental Army in March, 1780.
Arrival of the Physicians
In an emergency, Craik
had instructed Martha to
send for Dr. Gustavus
Brown in Port Tobacco,
Maryland. Brown was an
well- respected
Edinburgh-trained
physician who co-
founded the Medical and
Chirurgical faculty of
Maryland.
Dr. Gustavus Brown
 Arrival of the Physicians
Once learning of
Washingtons situation,
Craik himself sent for
prominent physician Dr.
Elisha C. Dick of
Alexandria, a graduate
of the University of
Pennsylvania and a
student of the renowned
Dr. Elisha Cullen Dick
Dr. Benjamin Rush.
Washingtons Symptoms
Rapid onset of the
illness
High fever

Extremely sore throat

Drooling

Great difficulty

speaking without
hoarseness
Increased airway

obstruction
Persistent restlessness
 Diagnosis

Drs. Craik and Dick

diagnose Washington with
Cynanche Trachealis
which was described by
famed Scottish Physician
William Cullen as the
inflammation of upper
part of the trachea
 Diagnosis
Modern physicians who
have looked at the
evidence diagnosed
Washingtons condition as
acute bacterial epiglottitis
caused by either
Hemophilus Influenza or
Streptococcal Bacteria
either which can rapidly
obstruct the respiratory
passage thus resulting in a
suffocating death.
Treatment

Bleeding
Purging

Blistering
Bleeding

Remove diseased
matter from the
body
Reduce
inflammation
How Much?
12-14 ounces G. Rawlins
20 ounces Dr. James Craik
20 ounces Dr. James Craik
40 ounces Dr. James Craik
32 ounces Dr. Elisha C. Dick
Total within 12 hour period =
124-126 ounces
How Did Bleeding Affect
Washington?

Bleeding compromised his

circulation. He was
already suffering from
hypoxia (deficient
oxygenation of the blood)
which bleeding further
complicated.
Purging

Another method by
which diseased
matter is removed
from the body
Purging
Repeated doses of Tartar
Emetic (Antimony and
Powdered Tartar) to
induce vomiting
Two doses of Calomel
(powdered form of
Mercury) which resulted
in a copious discharge
of the bowels
Blistering

Powdered
Spanish Flies
which were used
to raise blisters as
a counter-irritant
Rejected Treatment:
Tracheotomy
Dr. Dick proposed this
procedure. Upon
discussion with the
other physicians, it
was deemed too risky.
Complications that
could result include
severing a major blood
vessel and cutting in
the wrong location.
His Passing
As he neared the end of
his life, his breathing
became much easier and
his struggling ceased.
This isnt surprising as
he was probably
suffering from carbon
narcosis (a buildup of
carbon dioxide in the
body which can act
much like anesthesia).
His Passing
His step-grandson,
George Washington
Custis, described
Washington in his last
moments as someone
who knew his hour was
nigh. At 10:10 pm, he
lifted hand to check his
own pulse and then
expired without a
struggle or a sigh.
His Passing
Martha, who was
sitting at the foot of the
bed as he passed away,
replied upon being
informed he was dead,
Is he gone? Tis well.
All is now over. I shall
soon follow him. I
have no more trials to
pass through. (Martha
dies on May 22, 1802)
He Died as He Lived
Interesting Reading
The Death of George Washington: He Died As
He Lived by Peter R. Henriques
A Physician Looks at the Death of Washington,

an article by Vibul V. Vadakan, M. D.

The Papers of George Washington: Retirement

Series
George Washingtons Terminal Illness: A Modern

Medical Analysis of the Last Illness and Death of

George Washington By White McKenzie
Wallenborn, M.D.