Washington’s cure fatally worse than his disease

Writer E. B. White once wrote, “Analyzing humor is like dissecting a frog. Few people are interested and the frog dies of it.” Now I have always thought that dissecting a frog was pretty interesting. But his reference to dissecting, in conjunction with humor, is not all that farfetched.

Early Greek, Roman and Islamic physicians all thought that humans were composed of four bodily humors, and that an illness was evidence that these humors were out of balance. Remedies to illnesses were directed at somehow balancing these humors. We find their ideas humorous today, but originally humor was considered a liquid, not a joke.

Later the humor idea was simplified to mean that an ill person had “bad humor.” (This seems a little more understandable. When I am ill, I am seldom in good humor.) But for several centuries physicians thought they could make someone well by removing the bad humor. That is how the practice of blood-letting became popular.

Physicians removed one’s blood in several different ways. Sometimes they used leeches, but more often they simply nicked a convenient vein. Of course, not every community had a physician, and so the practice of nicking veins often fell to the person with the sharpest instruments, the local barber. Only the barber and the butcher had a motive for buying only the best steel, and keeping it sharp.

Stopping the bleeding after a bloodletting was a challenge. Of course, this was before the days of hypodermic syringes and plastic bandages. So physicians and barbers often had to keep a large supply of linens on hand to stop the flow of blood. These linens were expensive, so they were consistently reused. In those days the barber shops could often be identified by the bloodied white linens drying on the front porch. These were sometimes wrapped around the porch poles by the breezes. Perhaps you can visualize where the barber’s pole image of red and white stripes came from.

The average person has about 70 ml of blood per kg of body weight. Therefore a man 6 feet 3 inches tall and weighing about 230 pounds (104 kg) would have about 7 liters of blood. Losing a portion of this amount isn’t detrimental. People routinely give about 500 ml of blood (about a pint) when they donate to their blood bank. This only comes to about a tenth of their blood volume.

On Dec. 14 of 1799, our first president, George Washington, a man of the above proportions, rode his horse out to inspect his plantation from about 10 a.m. until 3 p.m. on a cold, wet, windy day. The following day he had a sore throat but went riding again to mark some trees for cutting. That evening he was hoarse, but in good humor (pardon the pun). However, somewhere between 2 and 3 a.m. on the 16th, he awoke in some distress and told his wife he was not well.

When morning came he asked to have a bloodletting, a practice he believed in, from his estate overseer. Because he was in such distress, three different physicians were summoned to attend him. Each of them also performed bloodletting to remove the bad humor. Here is a calculation of how much blood was let over the course of that day:

12–14 ounces in the early morning by the overseer.

20 ounces when the first doctor arrived.

20 more ounces an hour or so later.

40 ounces after lunch.

32 ounces when a second doctor arrived about 3 p.m.

The president was a sick man of 69 years of age, and he’d had over 120 ounces of blood, or about 3.75 liters, removed in fewer than 12 hours. That was about half of the estimated blood volume for a man his size. He died peacefully at about 11:30 p.m. that night, probably of severe hypotension and shock, after just two short days of illness.

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Gary McCallister is professor of biology at Mesa State College.


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