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George Washington

  ========> UNDER CONSTRUCTION <========
   
"Washington died exceedingly hard." [11a]
 
President #1. 
 Lived: 1732·1799.   Served: 1789·1797.  
Timeline:  <== 2009
|<== 1776

Maladies = multiple serious infections · malaria · smallpox · tuberculosis · diphtheria · height · dysentery · "gloomy apprehensions" · quinsy · sterile · "Stallion" · snored · presbyopia · deafness · pneumonia · skin lesion · teeth · epiglottitis, doctors · proposed reanimation  ·· Odds & Ends  ·· Resources

     Maladies and Conditions[Top]
Infections
multiple serious infections
Although Washington was physically strong, he was not the indominatable human force that popular history paints. He was often sick, particularly with infections. These were serious infections, many of them life-threatening. The table below is an overview [3a]. The rest of this page has details about each illness.

Age Year Disease
--- ---- -------
 ?? ???? diphtheria [15]
 17 1749 malaria
 19 1751 smallpox
 19 1751 tuberculosis
 30 1752 malaria
 33 1755 dysentery (+)
 35 1757 dysentery (*)
 35 1757 tuberculosis (*)
 39 1761 malaria (**)
 39 1761 dysentery (**)
  Age Year Disease
--- ---- -------
 47 1779 quinsy
 52 1784 malaria
 57 1789 carbuncle
 58 1790 pneumonia
 59 1791 carbuncle
 66 1798 malaria
 67 1799 epiglottitis[?]
+ = multiple episodes
* = simultaneous illnesses
* * = simultaneous illnesses

It was fortunate for the country that Washington's health was comparatively good during the Revolutionary War (1776-1783).
Infections
malaria
From the age of 17 to almost the end of his life, Washington had recurrent attacks of malaria. Malaria was then common in Virginia. Interestingly, an effective treatment for malaria had been discovered in the previous century. But for some reason, Washington did not receive the treatment until 1784, when he was in his 50s [3b]. [More] To add to the mystery, soldiers in the Revolutionary Army were treated for malaria as early as 1776 [3c].
InfectionsSkin
smallpox
At age 19 Washington and his half-brother Lawrence spent time on the island of Barbados, hoping the climate would benefit Lawrence. Lawrence was ill with tuberculosis. Around this time George developed a severe case of smallpox, which ultimately left his skin scarred for life. [3e] [7a].

Later, as Commander in Chief of the Continental Army in the 1770s, Washington took an unprecedented step by insisting that no recruit could join the army until vaccinated against smallpox [7b] [8a]. [More]

InfectionsLungs
tuberculosis
Shortly after returning to Mount Vernon from Barbados, Washington developed tuberculosis. (Tuberculous pleurisy, to be precise.) This, no doubt, he caught from Lawrence. It occurred soon after the smallpox. Washington took two years to recover fully. [3e] He had another episode of fever and pleurisy at age 25, in conjunction with an attack of dysentery [3f]
Infections
diphtheria
Washington "had also apparently had diphtheria" [15].
Anthropometrics
height
"Very tall for his generation -- over six feet -- with reddish hair and gray-blue eyes, his face massive, his shoulders narrow for his height but his hands and feet tremendous, George exuded such masculine power as frightens young women just wakening to the opposite sex." His half-brother was rather short. [7a] [More]

After his death, Washington's frozen corpse was measured as 6 feet 3.5 inches in length [15a]. The body was 1 foot 9 inches across at the shoulders and at the elbows.   Comment: One reference cites Washington as 6 feet 2 inches tall [13a]. A post-mortem height would be greater for at least two reasons: (1) If the corpse really was frozen, a frozen Washington would be taller because our bodies are 70% water and because water expands as it freezes -- the only liquid with this property. (2) A laid-out corpse would be relieved of gravity pressing on the spine. As astronauts know, people "grow" a few inches when weight on the spine is removed.

InfectionsGastrointestinal
dysentery
In 1755 Washington, then 23, was aide to British General Edmond Braddock, who was to lead an expedition against the French in Pennsylvania. But, as the army began its 100-mile trek from Virginia, Washington was ordered to stay behind because he developed severe dysentery [3g]. Ultimately, he followed, riding painfully in a wagon, and caught up with the army near Fort Duquesne (present-day Pittsburgh) on July 8 [7c].

On July 9, "the most catastrophic [day] in all Anglo-American history," Washington was so ill that he had to tie pillows to his saddle in order to ride his horse. As the army rode through a 12-foot-wide road cleared through the thick woods, the French and their Indian allies engaged the English, firing unseen from the surrounding trees. The English regulars, accustomed to fighting on open ground in formation, panicked, and the carnage began. "Braddock indignantly denied Washington's request to lead troops into the woods and `engage the enemy in their own way'" [7c].

The officers, perfect targets atop their horses, went down in succession. Washington had two horses shot out from under him. Braddock crumpled. Washington's hat was shot off. Bullets tore his coat. Washington was left as the only person able to distribute the wounded general's orders, and led the retreat. Somehow Washington was then able to ride 40 miles through darkness to summon reinforcements, though he occasionally had to crawl on his hands and knees to find the road. He later admitted that the ride left him "in a manner wholly unfit for the execution of the duty" [7c].

Braddock died, and Washington staggered home to Mount Vernon on July 25, "weak and feeble" [7c]. He continued to have attacks of fever and dysentery the rest of the year. In 1757 he had a severe recurrence of dysentery, accompanied by fever and pleurisy. He became "acutely and dangerously" ill from dysentery (and malaria) in 1761 [3f]. Less severe attacks continued [3c].

Psychiatry
"gloomy apprehensions"
Washington had a tendency to become depressed when ill [3h]. He was haunted by premonitions of death, perhaps because his father and half-brother Lawrence both died prematurely. Thomas Jefferson wrote that Washington was, in all aspects of his life, "inclined to gloomy apprehensions" [3c].
InfectionsOral
quinsy
While the revolutionary army was camped at Morristown, New Jersey in spring 1779, Washington developed a severe attack of quinsy (an abscess of the tonsils). "He was so weak and feverish that he feared for his own survival. He instructed General Nathaniel Green to take over if he failed to survive" [3i].   Comment: It is unclear how specific was the meaning of the word "quinsy" in the 1700s.
ReproductiveFamily history
sterile
Washington married Martha Dandridge Custis in 1759. He was 26. She was a 28 year old widow who had borne four children during her eight year marriage to Daniel Custis [14a]. Yet Martha never became pregnant during her 40-year marriage to Washington. Given her previous fertility,
it could well be concluded that the difficulty was not in her but in her husband. However, [Washington,] the magnificent athlete, who possessed in abundance every other physical prowess, could not altogether admit to himself that he was sterile. He believed, even when approaching old age, that if Martha died and he became remarried to a "girl," he might father an heir. In the meanwhile, his lack was a grievous one. [7d]
Given the way the Custis children turned out [More], Washington may have been lucky. The United States may have been lucky, too. The lack of an heir made it difficult to anoint Washington as King, which some elements favored at the time [2c]. There is speculation that the lack of an heir made it difficult for Washington to accept an offer of Kingship [13b].

Washington's height, sterility, large hands, pockmarks, plus certain personality features and even his dental problems have led to the suggestion he had a syndrome associated with an XYY chromosome karyotype [13c]. A geneticist concludes, however, "although there does seem to be a strong case that George Washington was affected with XYY syndrome, the evidence is just not conclusive" [13b]. There are also speculations that Washington had Klinefelter syndrome (associated with an XXY karyotype) [16] -- a separate condition.

ReproductiveAnthropometrics
"Stallion"
Was known as "The Potomac Stallion" [7g].
Sleep
snored
Reliability of this information is uncertain. [6]
Eye
presbyopia
Presbyopia (the need for reading glasses) affects all humans as they age. Presidents are no exception. An argument can be made, however, that Washington's presbyopia saved the United States of America. [More] [7h]
Ear
deafness
Washington's hearing worsened in 1789 to the point where he could not hear ordinary conversation [1].
LungsInfections
pneumonia
Washington almost died of pneumonia in 1790. He was unable to function as Chief Executive for several weeks. [12a]
Skin
skin lesion
On February 25, 1795 Washington wrote a testimonial letter on behalf of a Dr. James Tate. The letter described a skin lesion that Tate had treated:
I have, myself, experienced the fruits of his skill, in this art; being cured by him of an irritable spot on my right cheek which had for years been increasing in pricking and disagreeable sensations; and in June last assumed the decided character of a Cancer; of which I was perfectly relieved by Doctr. Tate in about two months by an easy course, under the operation of which I felt no confinement, or other inconvenience at that time, nor any injury to my constitution since. [10]
Modern commentators speculate that the lesion might have been an actinic keratosis which underwent an acute solar degeneration. They also speculate that the treatment was most likely repeated application of an escharotic or paste. [10]
Oral
teeth
By middle age Washington had no teeth left. But he did have several sets of dentures, made from such materials as hippopotamus ivory, seahorse ivory, and lead. Other sets used the teeth of pigs, cows, elks, and humans [3j] [More]. Paul Revere made him a set of false teeth [4a]. There is a set of Washington dentures in the University of Maryland Dental Museum in Baltimore [19].

Washington's clumsy, ill-fitting dentures distorted his lips. This contributed to the dour expression Washington has in various portraits [3k]. Also, painter Gilbert Stuart disliked Washington and accentuated the distortion in what became the most famous of all Washington portraits [2d]. The Peale portrait of 1776 shows a long scar along Washington's left cheek. This resulted from an incision to treat an abscessed tooth [3k].

DeathInfectionsDoctorBlood
epiglottitis, doctors
No one is quite sure what killed Washington. He was in fine health at age 67 when he contracted hoarseness and a sore throat a few days after helping to move a snow-mired carriage near his home. There was little alarm until he awoke in the middle of the night with difficulty breathing, almost unable to talk. A doctor was summoned, but Washington did not wait, ordering an employee to bleed him. The doctor arrived and, according to the principles of the day, bled him again. Eventually, Washington requested no further bleeding be performed, but he was bled again anyway.

First suggested in 1838, most authorities today believe Washington's final illness was acute bacterial epiglottitis [15] -- an infection of the small tissue flap that plugs the entrance to the lungs during swallowing. Since the invention of antibiotics, this infection has become rare, but even now its occurrence is exceedingly serious. When the epiglottis swells (as it will do in response to an infection) it can block airflow into the lungs -- an obviously fatal outcome.

The bleedings inflicted by Washington's doctors hastened his end. Some 80 ounces of blood were removed in 12 hours [15] (this is .63 gallons, or about 35% of all the blood in his body). One of the three doctors atteding him, Elisha Cullen Dick, objected to continued bleeding, arguing instead for tracheotomy. Tracheotomy is a surgical procedure recognized today as potentially life-saving in epiglottitis, but was then almost unworkable. Dick was overruled by the senior physician, James Craik. "Undoubtedly, the specter of failure with a grisly, painful (in the absence of anesthesia), and untried surgical experiment on the former president weighed heavily in Craik's decision to veto this radical suggestion" [15].  (It should also be remembered that "former president" does not begin to describe Washington's stature. He was the most famous man in the world, for 20 years the pre-eminent man in American life, and was held in almost religious esteem by his countrymen.)

A detailed description of Washington's agonizing final hours survives [More].

DeathDoctor
proposed reanimation
A fourth physician, William Thornton, arrived at Mount Vernon on Dec. 15, the day after after Washington died. Thornton hoped that Washington was in a suspended state, from which he could be aroused and then treated with tracheotomy.

Thornton "proposed that the body be thawed gradually, first in cool water and then with warm blankets and rubbing of the skin, with the subsequent performance of a tracheotomy, artificial respiration at the tracheotomy site, and transfusion of lamb's blood" [15].

Martha Washington vetoed the plan. Interestingly, Washington had once revived a slave thought to be dead [15].


     Odds & Ends[Top]

     Resources[Top]

Disclosure: Doctor Zebra gets a few pennies if you click & buy from Amazon.
Books (ranked by Amazon.com sales)More  
 
His Excellency: George Washington
Joseph J. Ellis
Washington's Crossing (Pivotal Moments in American History)
David Hackett Fischer
Revolutionary War On Wednesday (Magic Tree House 22, paper)
Mary Pope Osborne
 
DVDs (ranked by Amazon.com sales)
 
George Washington's First War: The Battles for Fort Duquesne
Biography - George Washington: Founding Father
Biography - George Washington: American Revolutionary
 
Resources used by Dr. Zebra
  1. Blinderman A. George Washington's health. NY State Med J. 1975;75:122-132. Pubmed.

  2. Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University Press, 1981. ISBN 0-19-502915-1 @ Amazon   [a] p. 22 [b] pp. 22-23 [c] pp. 13-14 [d] p. 6

  3. Bumgarner, John R. The Health of the Presidents: The 41 United States Presidents Through 1993 from a Physician's Point of View. Jefferson, NC: MacFarland & Company, 1994. ISBN 0-89950-956-8 @ Amazon   [a] pp. 1-8 [b] pp. 1, 4, 6 (year might have been 1786) [c] p. 4 [d] pp. 1-6 [e] p. 1 [f] p. 3 [g] p. 2 [h] pp. 3, 4 [i] pp. 4-5 [j] pp. 5-6 [k] p. 6
        Devotes one chapter to each President, through Clinton. Written for the layperson, well-referenced, with areas of speculation clearly identified, Dr. Zebra depends heavily on this book. Dr. Bumgarner survived the Bataan Death March and has written an unforgettable book casting a physician's eye on that experience.

  4. Cooper, Pauline. The Medical Detectives. New York: David McKay, 1973. ISBN 0-679-50382-X @ Amazon   [a] p. 96

  5. Donald, David Herbert. Lincoln. New York: Touchstone / Simon & Schuster, 1996. ISBN 0-684-82535-X @ Amazon   [a] pp. 38-39

  6. Dugan, James. Bedlam in the boudoir. Colliers. 22 Feb. 1947; pages 17, 69-70.
        Credibility is dubious. Just before a list of Presidents, the article states: "Twenty of the 32 Presidents ... are proved or believed on a thick web of circumstance to have been nocturnal nuisances in the White House."

  7. Flexner, James Thomas. Washington: The Indispensible Man. Boston: Little, Brown, 1974. ISBN 0-316-28616-8 @ Amazon   [a] p. 8 [b] p. 132 [c] p. 24 [d] p. 42 [e] p. 43 [f] p. 165 [g] p. 198 [h] pp. 165-175 [i] p. 174
        Distillation of Flexner's four-volume biography of Washington published from 1965 to 1972.

  8. Gabriel, Richard A.; Metz, Karen S. A History of Military Medicine, Volume 2. Westport, CT: Greenwood Press, 1992. ISBN 0-313-28403-2 @ Amazon   [a] p. 108

  9. Grusin, Sarah. The root of the matter. Washington Post Magazine. Feb. 27, 1994;9.
        Part of the "J Street" column.

  10. Hayes H, Talbert G. The facial lesion of George Washington. Plast Reconstructive Surg. 1987;80:133-136. Pubmed.

  11. Henriques, Peter R. The Death of George Washington: He Died as He Lived. Mt. Vernon, VA: The Mount Vernon Ladies' Association, 2000. ISBN 0-931917-035-2 @ Amazon   [a] p. vi (introduction by Philander D. Chase) [b] pp. 70-75

  12. MacMahon, Edward B. and Curry, Leonard. Medical Cover-Ups in the White House. Washington, DC: Farragut, 1987. ISBN 0-918535-01-8 @ Amazon   [a] pp. 15-16

  13. Marion, Robert. Was George Washington Really the Father of our Country?. Reading, MA: Addison-Wesley, 1994. ISBN 0-201-62255-6 @ Amazon   [a] p. 67 [b] p. 72 [c] pp. 41-74

  14. Montgomery-Massingberd, Hugh (ed). Burke's Presidential Families of the United States of American. 2nd ed. London: Burke's Peerage Limited, 1981. ISBN 0-85011-033-5 @ Amazon   [a] p. 16 [b] pp. 16, 24 [c] p. 45
        Enumerates the ancestors and descendants of American presidents up through Ronald Reagan.

  15. Morens DM. Death of a President. New Engl J Med. 1999:341;1845-1849. Pubmed.   [a] Tobias Lear recorded these measurements in his journal. He does not say the corpse was frozen.

  16. Smith, MJV. The father who was not a father. Virginia Medical Monthly. 1976;103:14-16, 21-22, 33.

  17. Smith, RN. The Surprising George Washington. Prologue: Quarterly of the National Archives and Records Administration. 1994 (Spring);26 (1).
        Available on the web at: http://www.archives.gov/publications/prologue/spring_1994_george_washington_1.html

  18. Wallenborn, White McKenzie. George Washington's terminal illness: a modern medical analysis of the last illness and death of George Washington. [on line]. 31 March 1999.
        From the papers of George Washington at the University of Virginia. Accessed 17 December 2002.  http://www.virginia.edu/gwpapers/articles/wallenborn/index.html

  19. Web page: http://www.virginia.edu/gwpapers/faq/gwteeth.html
    (From the papers of George Washington at the University of Virginia)
        Picture of a set of Washington's dentures, complete with springs.

  20. The George Washington web page  at the White House.

  21.  (59 matches when checked in November 2003)
Alternate index terms: Medical history of President Washington.  [Top]

<== Presidential RosterPresidential RosterJohn Adams ==>

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