Chapter 1: Bloodletting and Malariatherapy: Treatment Methods of the Past 1
Those interested in the history of medicine should read the details surrounding President
George Washington’s therapy by his physicians in December 1799.1 Purging, bloodlet-
ting and other methods were employed, which hastened his death.
His treatment was discussed recently in the New England Journal of Medicine’s 200th
Anniversary issue.2 The authors used Washington’s experience as a benchmark for mea-
suring the remarkable progress medicine has made in the past two centuries.
Washington’s Experience
Three physicians were responsible for Washington’s medical care and each knew him well.
The first doctor to arrive took the president’s medical history. He found the president had
mild hoarseness, difficulty breathing and was feverish and unable to swallow. A bloodlet-
ter was called to assist in treatment, and 12 to 14 ounces of blood were withdrawn.
Washington also was administered molasses, vinegar and butter, and near fatal
choking ensued. The doctor then applied a blister of cantharides (Spanish flies) to the
president’s throat, followed by more (18 ounces) bloodletting in the morning. This was
followed by the same blood removal less than two hours later.
Washington repeatedly gargled sage tea with vinegar. A fourth bleeding (32 ounces)
was performed in the afternoon. Calomel (mercurous chloride) and tartar emetic (anti-
mony potassium tartrate) were also given to the president. Both are extremely potent
laxatives (purgatives).
After the fourth bloodletting, Washington’s condition improved, and he was able to
swallow. He returned to bed and was helped into an upright position, but he continued
to struggle for air. His condition began to deteriorate.
Later that day, the physicians applied blisters of cantharides to his feet, arms and
legs, and then applied wheat bran poultices to his throat. Despite all of the heroic treat-
ment, George Washington died later that evening.3
According to some 19th century historians, Washington’s physicians might have
reasoned that because bloodletting (about 80 ounces) caused visible dermal vasoconstric-
tion, it would also constrict the vessels associated with swelling in the windpipe.4,5 In
1
Bloodletting and
Malariatherapy: Treatment
Methods of the Past
Those interested in the history of medicine should read the details surrounding President
George Washington’s therapy by his physicians in December 1799.1 Purging, bloodlet-
ting and other methods were employed, which hastened his death.
His treatment was discussed recently in the New England Journal of Medicine’s 200th
Anniversary issue.2 The authors used Washington’s experience as a benchmark for mea-
suring the remarkable progress medicine has made in the past two centuries.
Washington’s Experience
Three physicians were responsible for Washington’s medical care and each knew him well.
The first doctor to arrive took the president’s medical history. He found the president had
mild hoarseness, difficulty breathing and was feverish and unable to swallow. A bloodlet-
ter was called to assist in treatment, and 12 to 14 ounces of blood were withdrawn.
Washington also was administered molasses, vinegar and butter, and near fatal
choking ensued. The doctor then applied a blister of cantharides (Spanish flies) to the
president’s throat, followed by more (18 ounces) bloodletting in the morning. This was
followed by the same blood removal less than two hours later.
Washington repeatedly gargled sage tea with vinegar. A fourth bleeding (32 ounces)
was performed in the afternoon. Calomel (mercurous chloride) and tartar emetic (anti-
mony potassium tartrate) were also given to the president. Both are extremely potent
laxatives (purgatives).
After the fourth bloodletting, Washington’s condition improved, and he was able to
swallow. He returned to bed and was helped into an upright position, but he continued
to struggle for air. His condition began to deteriorate.
Later that day, the physicians applied blisters of cantharides to his feet, arms and
legs, and then applied wheat bran poultices to his throat. Despite all of the heroic treat-
ment, George Washington died later that evening.3
According to some 19th century historians, Washington’s physicians might have
reasoned that because bloodletting (about 80 ounces) caused visible dermal vasoconstric-
tion, it would also constrict the vessels associated with swelling in the windpipe.4,5 In
1
Bloodletting and
Malariatherapy: Treatment
Methods of the Past