George Washington's Final Illness

Overview of George Washington's Final Hours

• Date: December 14, 1799; George Washington was 67 years old.
• Context: Washington was at home in Mount Vernon after over 30 months of retirement.

Initial Symptoms

• December 13, 1799: Washington experienced:
  • Cough
  • Runny nose
  • Hoarseness
• He had spent the previous day outdoors in poor weather, supervising estate activities.
• Dinner was late; he chose to stay in wet clothes throughout the meal.

Health Decline

• Early Morning of December 14:
  • Washington awoke with severe symptoms:
  • Shortness of breath
  • Clutching his chest
  • Martha Washington, concerned for his health, insisted on seeking medical help.
  • Washington prioritized her well-being, not wanting her to venture outdoors in the cold.

Medical Response

• 6 a.m.:
  • Washington’s fever intensified and his breathing worsened.
• Bloodletting:
  • Initial procedure removed 12-14 ounces of blood, requested by Washington to continue.
• Tonic administered:
  • Col. Lear gave him a mixture of molasses, butter, and vinegar, aggravating his sore throat.

Treatment Measures

• Medications and Interventions:
  • Dr. James Craik (primary physician) arrived at 9 a.m.:
  • Applied cantharides (Spanish fly) blister to the throat.
  • Bloodletting at 9:30 a.m. (18 ounces) and at 11 a.m. (another 32 ounces).
  • An enema was performed; unsuccessful gargling attempts with sage tea and vinegar.
  • Dr. Gustavus Richard Brown recommended emetic treatments with calomel and tartar emetic.
• Results: Washington showed a brief improvement around 5 p.m. but ultimately struggled for air.

Last Moments

• Washington communicated with the doctors, acknowledging his condition:
  • “Doctor, I die hard; but I am not afraid to go… my breath cannot last long.”
• Final treatments included cantharides on limbs and poultices on the throat.
• Death: 10 p.m., Washington took his last breath in the presence of Martha, doctors, and aides.

Controversies and Theories of Death

• Physician Disagreements:
  • Causes of death were debated:
  • Dr. Craik: Inflammatory quinsy (peritonsillar abscess).
  • Dr. Dick: Suggested alternatives like stridular suffocatis or laryngea.
• Massive blood loss: 80 ounces of blood was removed throughout the day, impacting his critical condition.
• Reflection on Medical Practice:
  • Historical criticism directed at treatment methods of 1799, which were based on discredited theories.
• Retrospective Diagnoses:
  • Various theories have been proposed over 215 years, including acute bacterial epiglottitis being most probable.

Legacy

• Final Reflection: Washington’s death highlighted the struggle between the limits of medical science and a patient's suffering.
• Quotations:
  • Remembered as “First in war, first in peace, and first in the hearts of his countrymen.”
• Learning Point: Washington’s experiences underscore enduring themes of leadership, citizenship, and the sacrifices made in public service.