It appears that Jefferson had begun to doubt the efficacy of physicians and their methods by the time of Rush’s death in 1813. Yet, just ten years earlier he had decided to send Meriwether Lewis to study with one. But, Jefferson and Rush were good friends, with a longstanding relationship and respect for one another. This no doubt influenced the president’s decision to have Rush tutor his personal secretary. Lewis traveled to Philadelphia in the spring of 1803. His mission was to gather supplies for his upcoming expedition, and to study under a number of members from the American Philosophical Society. He would study:
The use of the chronometer, sextant, and artificial horizon with Dr. Andrew Ellicott, in order to insure that he could accurately take measurements of longitude.
Fossils and medicine with Dr. Caspar Wistar.
Information on the description and taxonomy of plants and animals with Dr. Benjamin Smith Barton.
The practice of medicine and related topics with Dr. Benjamin Rush.
Jefferson sent letters of introduction to all of Lewis’s teachers prior to his visit, and on February 8, 1803, he wrote to Dr. Rush stating that, “Captain Lewis is brave, prudent, habituated to the woods, & familiar with Indian manners & character. He is not regularly educated, but he possesses a great mass of accurate observation on all subject of nature which present themselves here. . .” In addition to schooling Lewis in the modern medical arts, Jefferson asked Rush to provide him with questions on the natural history of American natives to help guide the expeditions’ collection of information. He asked the other members of Lewis’s teaching team to do the same. Rush presented his questions to Lewis on May 17, 1803. Most of them dealt with medical issues and cures, but Rush also sought information on child rearing, religious and death rituals, sexuality and vice, even diet and “blood letting” among the Indians.
By early June, “the shortest medical apprenticeship in American history – about two weeks” was finished and Dr. Rush wrote to Thomas Jefferson, “I have endeavored to fulfill your wishes by furnishing Mr. Lewis with some inquires relative to the natural history of the Indians . . . a few short directions for the preservation of his health, as well as the health of persons under his command.” Rush went on to tell the President that Lewis seemed to be “admirably qualified” to lead the expedition.
With Rush’s advice in hand, Lewis purchased the medical supplies needed for the expedition. He spent $90.60 (of the total $2,324 spent) at the apothecary shop of Gillaspy & Strong in Philadelphia. Given Rush’s penchant for bleeding and purgatives, Lewis’s medical kit was well stocked with items for performing both functions, but there would be more. The medical kit contained many different kinds of medicine, which can be categorized by their general uses:
· Herbal Cathartics: medicines which act on the intestines to stimulate the bowels, these were also called purgatives. Medicines in this category included Dr. Rush’s Bilious Pills, Calomel, jalap, rhubarb, and Galuber’s Salts.
· Emetics: medicines which produce vomiting. In this category Lewis purchased ipecacuan, and antimony-potassium.
· Topical analgesics: Medicines used on the skin to ease pain. Drugs like gum camphor, tragacanth, and calamine ointment were used. Ingredients for eyewash were also taken, and would be especially helpful in treating the natives of the Columbia River Valley.
· Pain relievers: Medicines used to reduce pain or “nervous excitement”. Lewis packed one half pound of Turkish opium, in addition to laudanum (an alcoholic tincture with about 10% opium content), and 30 gallons of medicinal wine (in addition to the whiskey taken for the men).
· Fever Reducers: Medicines to combat ague (intermittent fever and chills, probably malaria). Lewis took Peruvian bark, which contained quinine.
Lewis also packed fifty dozen of Dr. Rush’s “caomel and jalap Bilious Pills” which became a favorite treatment on the expedition. Lewis and Clark used calomel as a purgative on many occasions, but they also used it in the treatment of syphilis. If we look at the medical purchases, we can tell that Lewis was thinking ahead to his men’s sexual exploits. In addition to the mercury based calomel, he purchased “four pewter penile syringes” which would have been used “to treat gonorrhea by injecting a solution up the penile urethra. This solution could have been made from the medications that Lewis bought for the expedition; they however had no need of it since the men contracted syphilis and not gonorrhea. Lewis also purchased tools for blood letting, “three best lancets”, in addition to mosquito netting, material for packing wounds, a tourniquet, bottles for holding his medicines, and two wooden medicine chests.
Dr. David Peck, in his book Or Perish in the Attempt, made it clear that “the lessons from Dr. Rush and his colleagues could not provide Lewis with medical skills equivalent to his naturalist and leadership abilities. Lewis’ practice would consist of the use of a few herbal and chemical medications, some of his mother’s medical-herb knowledge, and some practical medical skills acquired during his army career.” Dr Rush added a “pinch of European medical theory” and a “generous dose of blood-letting into the explorer’s medical bag.” He also provided Lewis with a list of eleven “Rules of Health” which were meant to preserve the health of the Corps.
When you feel the least indisposition, do not attempt to overcome it by labour or marching. Rest in the horizontal posture.
Unusual costiveness is often a sign of approaching disease. When you feel it take one or more of the purging pills.
Flannel should be worn constantly next to the skin, especially in wet weather.
The less spirit you use the better.
Washing the feet every morning in cold water, will conduce very much to fortify them against the action of cold.
Though the modern reader might wonder at the sense of making cold feet colder, or of wearing wet flannel the idea of resting when one felt fatigued seems like good advice. It is also interesting to note that Rush made a “pitch” for his own pills! In reading the journals, we can not assess whether Lewis followed Rush’s helpful hints. He certainly used Rush’s Pills, and he did purchase 45 flannel shirts for the journey, but he doesn’t mention the advice that he was given specifically. With supplies purchased, the time had come for Lewis to make his way to St. Louis.