Friday’s “the good old days…” feature is about a classic American adventure. Two hundred years ago, between 1804 and 1806, a brave group of explorers, under the leadership of Meriwether Lewis and William Clark, and with the blessing of President Thomas Jefferson, set out to discover the American West. The expedition had no doctor as a member of the crew. It is amazing that only one member of the crew died during the expedition.
Anthony L. Kovac, M.D. from the Department of Anesthesiology, University of Kansas Medical Center has investigated medical issues surrounding the Lewis and Clark Expedition, and has published an abstract on the use of antiemetic and analgesics during the voyage. From the abstract:
The medical practice of the early 1800s, during the time of the Lewis and Clark Expedition 1804-1806, reflected the practice of the leading physician of the day, Dr. Benjamin Rush of Philadelphia. As there would be no physician on the expedition, Thomas Jefferson asked Dr. Rush to educate Meriwether Lewis on the medical practice of the time and to suggest the medical supplies that would be needed on the Corps of Discovery expedition in 1804. In addition to his position as co-captain, Lewis was the “physician” of the expedition.
Doctors in the 1800s closely observed the patient, noting a rapid pulse or red flushed face. They believed that various medical conditions were the result of an imbalance of the “humor of the blood, choler, black bile and phlegm.” As a medical treatment to rid the body of disease, referred to as “noxious humors,” blood-letting and use of laxatives and purgatives were common practices.
It is believed that Dr. Rush taught Lewis his thinking that all diseases were related to tension in blood vessels, and his prescribed therapy for diseases was blood-letting to help a slow or fast pulse, open or close the bowels, decrease coma and induce sleep! Similarly, purgatives were used to get rid of “bad humors” and vomiting was believed to be a treatment as well as a symptom. The expedition’s medical pharmacy included 600 of Rush’s pills (“Bolts,” “Thunderclappers”) which were combined calomel and Jalap, causing an explosive cathartic. Calomel as a cathartic was 6 parts mercury to one part chloride, and Jalap was a laxative. The depleting action of these medicines was thought to rid the body of any “morbid” elements contained mainly in the blood.
According to a bill of sale, Lewis bought medical supplies from a general store in Philadelphia called Gillespay and Strong located at 103 South Second and 243 High Streets. The bill of sale listed 1/2 lb of Jalap, 1 lb of mercury, and 4 oz of Ipecacuan. Lewis bought 4 oz of Laudanum (tincture of opium) for its analgesic and sedative properties, and 1/2 lb of Opii Truk to supplement the Laudanum. Many of the medicines could be found in most family medicine cabnets of the time. In addition, 30 gallons of strong wine and a supply of whiskey was purchased for medicinal and recreational use. Even though medical practice at that time was primitive and often based more on superstition than science, only one member died during the expedition.
The Claude Moore Health Sciences Library at the University of Virginia has a website dedicated to medicine & health on the Lewis and Clark expedition…
More at Lewis and Clark on PBS…
Have a great holiday weekend and see you next week!