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Medicine

Washington University


Lewis and Clark: Doctors in the Wilderness

By:
Tracy K. Nondorf

A Research Paper and Final Examination
Presented to: Dr. Robert Moore
Lewis and Clark: Encounter, Culture, and Discovery
AMCS / MLA 5163

May 12, 2004

Contents

1. Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

2. Meriwether Lewis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

3. Benjamin Rush and the State of Medicine in 1803 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

4. Lewis in Training. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

5. Lewis and Clark: Doctors in the Wilderness. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Reference List / Works Cited. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Introduction

Americans will hear a great deal about Lewis and Clark in 2004 as they commemorate the 200th anniversary of this history making expedition. Indeed, there is already a great deal of excitement surrounding the anniversary, with countless books being published, museum exhibitions opening, re-creations of the journey getting underway, even university courses being taught! As Americans we seem to revel in the story of how the Corps of Discovery opened the West. We are awed by all that the expedition accomplished. On their two year and nine month journey, Lewis and Clark catalogued hundreds of new plant and animal species, made political and commercial contact with numerous native tribes, and created maps that would encourage later exploration and settlement of the Louisiana Territory and beyond. Yet, as we glory in the heroic exploits of the Corps, we may forget the daily challenges and dangers that they faced, and the many times that they came close to death or failure.

“One of the things most difficult to understand is that an expedition as well equipped as this one . . . should have gone out upon a journey of eight thousand miles, to be absent from civilization for two years and a half, without a physician as a member of the party.”[1] Elliot Coues, writing in 1893, referred to the lack of a doctor as the expedition’s “most serious defect.”[2] Olin Wheeler, in The Trail of Lewis and Clark added, that “of the soldiers, hunters, rowers or watermen, interpreters, there were enough, but not one man of the medical profession to bind up the wounds, mend broken limbs, or cure fevers. . .”[3] Was this a grave omission? Was the expedition poorly planned? Had President Thomas Jefferson, who seemed to think of everything in his long list of instructions to the explorers, forgotten this important detail? Or was there a reason for the exclusion of a professional physician on the Lewis and Clark expedition?

Historian Gary Moulton, in his edition of The Journals of Lewis and Clark, noted that in the spring of 1803 Thomas Jefferson sent Meriwether Lewis to Philadelphia to purchase supplies, and to “complete training in astronomy, natural history, health, and ethnology by consulting with the leading lights of the American Philosophical Society.”[4] Instead of hiring a physician to accompany the expedition, Jefferson opted to have Lewis take a “crash course” in medicine from Dr. Benjamin Rush, a member of the American Philosophical Society, his friend, and the “most eminent physician of the day.”[5] Modern Americans might wonder at the wisdom of this choice. Could Meriwether Lewis, a soldier and personal secretary to the President, possibly have learned enough in a few weeks to enable him to care for the men (and woman) of the expedition? Historians and doctors today seem to agree with physician / historian Eldon Chuinard that “. . . the generally non –scientific basis of medical practice at the time permitted these two men [Lewis and Clark] of natural ability to care for their men as well as a graduate physician of the day might have done.”[6] What was the status of American medicine in 1804? Would the education that Dr. Rush provided on the common medical practices of the day, contribute significantly to the Lewis and Clark expedition? Or, would Lewis’ lack of medical education be more likely to insure that the expedition would return home in relatively good health in 1806?

Meriwether Lewis
Born in 1774, Meriwether Lewis lived in Virginia, the state of his birth and his home for the first eight or nine years of his life. He was an independent child, who enjoyed hunting and the outdoors. After his father’s death in 1779, Lewis’ mother Lucy remarried and the family moved to Georgia. By the time Lewis was thirteen or fourteen he returned to Virginia and began his formal education. He started his studies in 1788 under the tutelage of Parson James Maury. In 1789, he gained a new tutor, Dr. Charles Everett, and finished his education with Dr. James Waddell from 1790 to1792. At the age of twenty Lewis joined the army where he met William Clark, his future partner in exploration. In 1801, Thomas Jefferson hired Lewis (who had been a neighbor in Virginia) to be his personal secretary; Lewis was then twenty-seven years of age.[7]

Lewis’ education and background were typical of a man of means in the early 19th century, but did this instruction prepare him to act as a “doctor” for the Corps of Discovery? Though it may not be apparent, Lewis received some training in the medical arts prior to his formal preparation with Dr. Rush. His first “medical instructor” was his mother, Lucy Lewis Marks. Historian Stephen Ambrose noted in Undaunted Courage, that Lucy had a “strong constitution” and that she was “stern, Spartan, and a devoted Christian” who lived to the ripe old age of eighty-six.[8] Lucy Marks was “known far and wide for medicinal remedies [or simples], [and] she grew a special crop of herbs which she dispersed to her children, her slaves, and her neighbors.”[9] Dr. Chuinard in his book Only One Man Died remarked that Lucy “rode horseback with her medicines to serve the countryside.”[10] Lewis learned the medicinal value of local plants from his mother, and showed his propensity for using natural remedies on the Lewis and Clark expedition. On June 11, 1805 for instance, Lewis wrote in his journal that he “experimented” with the chokecherry plant and that he “. . . resolved to try an experiment with some simples, and the Choke cherry which grew abundantly.”[11] On the day of the experiment, Lewis cut some “twigs” off a chokecherry tree, removed the leaves and brewed a “strong black decoction of an astringent bitter taste” which he took to combat the ravages of fever and a “violent pain in the intestines.” [12] Chokecherry was, according to physician/historian David J. Peck, “a well known herbal medication on the frontier for the treatment of diarrhea and other ailments” and the experiment seems to have worked well for Lewis who noted that “by 10 in the evening I was entirely relieved from pain . . . and every symptom of the disorder forsook me.”[13] It should be noted, however, that chokecherry seeds contain a poisonous element, amygdalin. If crushed the seeds can cause a toxic reaction that can produce deadly results, Lewis avoided the use of the seed bearing berries in his decoction, perhaps because he had been taught that they were potentially poisonous, or perhaps because he was lucky!

In addition to learning about herbal remedies in his home, Lewis received basic medical training in the army, as would his future partner William Clark. In 1793, prior to the expedition, Clark wrote in his journal that “he was equipped with a lancet and bled men on several occasions.”[14] Dr. James Tilton, who wrote about medical practices during the Revolutionary Era, noted that it was the responsibility of every “commanding officer to be equipped with medicines and supplies to care for the illness and trauma of their men.”[15] Though military hospitals in that period were probably the cause of more deaths than battle, there was a growing understanding of the importance of cleanliness and good nutrition which led military camps to develop “rules” to insure better sanitation. Dr. Tilton noted that there were “means by which military officers have it in their power to prevent and alleviate the ordinary sicknesses and distress of the army.”[16] Tilton noted that to insure health on an army post the following things should be done:


Cleanliness is essential in all conditions of life . . . officers therefore, should be very solicitous to protect their men . . . from the dreadful effects of filth.

That the camp may be kept free from excrementitious filth of every kind. . .

If adjacent to a river . . . everything of this sort [waste] may be thrown into it and swept away.

When privies are sunk into the earth, they should always be to the northward and eastward of the camp.

Diet is another article of immense consequence.

A delicate soldier is ridiculous indeed – Hardihood to resist smaller accidents is essential.[17]

Tilton and many others of his age understood that cleanliness was a factor in health. Though people of the colonial era had little understanding of the causes of disease, common thought dictated that “miasma” or the “smell of decaying food, foliage, bodies, or the smell of excrement” promoted and spread illness.[18] Thus, by cleaning up military outposts to eliminate odors, camp commanders were able to curb the spread of disease. By the time Lewis set out for Philadelphia to begin his formal “scientific” training for the expedition in 1803, he had already acquired a vast amount of basic, “common sense” medical know-how! What then would the eminent Dr. Rush, a well-known and highly trained physician, have to teach him?

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Did You Know?

Dinosaur cartoon

On September 10, 1804 on Cedar Island, in South Dakota, William Clark discovered the fossilized remains of the ribs, backbone and teeth of a plesiosaur. Plesiosaurs were animals who lived at the same time as the dinosaurs, but swam rather than walking on land. Clark thought it was a giant fish bone! More...