Medicine: How Eighteenth Century Medicine Killed George Washington

By Sandy Frykholm

When I get a sore throat, I stay at home, gargle warm salt water, and choose some of the various potions in my home ‘medicine chest’ for pain relief, fever, and decongestion. If there’s no improvement within a few days, I visit my doctor, and sometimes get antibiotics to treat a bacterial infection. End of story.

In December of 1799, at age 67, George Washington got a sore throat. It developed in just the circumstances that mothers still warn their children about today: He spent five hours outdoors in sleet and cold rain. He was riding around checking on his five farms near Mount Vernon on horseback, and returned home for the mid-day meal damp to the skin, and chilled.

The next day, though he was hoarse and congested, he hiked down the slope from Mount Vernon toward the Potomac River and marked out the location for a gravel walk and fishpond he planned to install. Tobias Lear, who had been Washington’s personal secretary for the previous fifteen years, urged him to take some medicine, but Washington told him, “You know I never take anything for a cold.” He stayed up late writing letters that evening.

He woke during the night with his throat inflamed, having difficulty breathing. His slaves built up the fire and tried to make him comfortable, but turned down Martha’s entreaties to send for a doctor. Lear was awakened at dawn, and wrote this account:  

“I found the General breathing with difficulty, and hardly able to utter a word intelligibly. He desired that Mr Rawlins (One of the overseers) might be sent for to bleed him before the Doctors could arrive. I dispatched a Servant immediately for Rawlins, and another for Dr. Craik, and returned again to the General's Chambr, where I found him in the same situation as I had left him -A mixture of Molasses, vinegar & butter was prepared to try its effects in the throat; but he could not swallow a drop; whenever he attempted it he appeared to be distressed, convulsed and almost suffocated. Rawlins came in soon after Sunrise, and prepared to bleed him. When the Arm was ready the General observing that Rawlins appeared to be agitated said, as well as he could speak

"Don't be afraid." And after the incision was made, he observed "The Orifice is not large enough. However the blood ran pretty freely. Mrs. Washington not knowing whether bleeding was proper or not in the General's situation, begged that not much be taken from him lest it should be injurious, and desired me to stop it; but when I was about to untie the string, the General put up his hand to prevent it, and as soon as he could speak, said "more, more." Mrs. Washington being still very uneasy lest too much blood should be taken, it was stopt after about half a pint. Finding that no relief was obtained from bleeding, and that nothing would go down the throat, I proposed bathing it externally, with salve latola, which was done; and in the operation, which was done with hand, in the gentlest manner, he observed, " 'tis very sore." A piece of flannel dip'd in salve-latola was put around his neck, and his feet bathed in warm waters; but without affording any relief.

In the meantime, before Dr. Craik arrived, Mrs. Washington desired of me to send for Dr. Brown of Port Tobacco whom Dr. Craik had recommended to be called if any case should occur that was seriously alarming. I dispatched a messenger (Cyrus) immediately for Dr. Brown (between 8 and 9 o'clock). Dr. Craik came in soon after, upon examining the General, he put a blister of Cantharides, [Cantharides, in case you didn’t know, is derived from a beetle, has been used to treat warts, and is used as an aphrodisiac, a.k.a. Spanish fly. I’m not sure what Dr. Craik’s goal was in this instance] on the throat, took some more blood from him and some Vinegar and hot water for him to inhale the steam, which he did, but in attempting to use this gargle he almost suffocated. When the gargle came from the throat some phlegm followed it, and he attempted to cough, which the Doctor encourage him to do as much as possible; but he could only attempt it. About 11 o'clock Dr. Craik requested that Dr. Dick might be sent for, as he feared Dr. Brown might not come in time. A messenger was accordingly dispatched for him. About this time the General was bled again. No effect, however, was produced by it. A Blister was administered about 12 o'clock, which produced an evacuation....

Doctor Dick came in about 3 o'clock, and Dr. Brown arrived soon after. Upon Dr. Dick's seeing and consulting a few minutes with Dr. Craik, he was bled again. The blood came very slow, was thick and did not produce any symptoms of fainting. Dr. Brown came into the Chamber soon after; and upon feeling the General's pulse, the physicians went out together. Dr. Craik returned soon after. The General could now swallow a little. Calomel [mercury chloride, a laxative] and tartar em [antimony potassium tartrate, a poison, used at one time to induce vomiting] were administered....”

By late afternoon, Washington had resigned himself to his imminent death, and in his usual pragmatic way, set about finalizing his affairs. He saw that an older version of his will was destroyed to establish clearly his final wishes, and gave instructions about his burial. At 10:10 p.m. George Washington breathed his last.

“Blood-letting is a remedy which, when judiciously employed, it is hardly possible to estimate too highly,” according to Dr. Henry Clutterbuck, writing in 1838. However, it is possible that Drs. Craik, Dick, and Brown did estimate too highly the value of bloodletting. According to Dr. Vibal Vadakan, a pediatric oncologist and hematologist from Los Angeles, the former president was relieved of more than half his blood in the twelve hours or so before his death, in addition to the various toxic purgatives used on him.

Dr. Vadakan is not the first to question the value of the treatments given George Washington. Just six weeks after Washington’s death, Dr. James Brickell wrote an article—which remained unpublished until 1903—critical of the procedures. Vadakan quotes the following from Brickell:

“... I think it my duty to point out what appears to me a most fatal error in their plan ... old people can not bear bleeding as well as the young ... we see ... that they drew from a man in the 69th year of his age the enormous quantity of 82 ounces, or above two quarts and a half of blood in about 13 hours.

Very few of the most robust young men in the world could survive such a loss of blood; but the body of an aged person must be so exhausted, and all his power so weakened by it as to make his death speedy and inevitable.”

From firsthand accounts, Dr. Vadakan estimates: “The total quantity of blood taken amounted to 124-126 ounces or 3.75 liters, drawn over a period of nine to ten hours on Saturday, December 14, 1799.

General Washington was a physically impressive man measuring 6 feet 3 inches in height and weighing 230 pounds. Because adult blood volume is 70 ml/kg, one can estimate the blood volume of President Washington at seven liters. The extraction of more than half of his blood volume within a short period of time inevitably led to preterminal anemia, hypovolemia, and hypotension. The fact that General Washington stopped struggling and appeared physically calm shortly before his death may have been due to profound hypotension and shock.”

While it is easy to criticize the physicians of the 18^th century, they were following the best medical practices of their time, and all had the former President’s best interests at heart. I can only say, I’m glad that any illness I suffer is taking place in the 21^st century, when, though not every attempted cure is successful, at least I am not likely to be bled to death by my doctor. 

Feasts: Medieval Feasting in the 21st Century

By Sandy Frykholm

With most of the people I talk with about things medieval, any glimmer of interest they have is satisfied by a sentence or two of describing research I’ve done, books I’ve enjoyed, or places and people I find intriguing. If I go on, more often than not their eyes begin to glaze, they feel a sudden need for something from the kitchen, or spot another person they meant to talk with. Papal politics of the late 13^th century seems to leave them cold.

I shared my excitement with some friends after attending the International Congress on Medieval Studies in Kalamazoo, Michigan as a treat for my fiftieth birthday. One friend stared, incredulous, as I described the delights of the world’s largest gathering of medieval historians. “When I turned fifty,” she said, “I went to Disneyland.”

Same thing, really. To me.

Count Thomas the Heartless Bastard and
Lady Winnifred the Longsuffering,
with Brother Vern and the hostess,
Lady Alessandra of Frykhaven

However, one effort to share my medieval mania was a smashing success: a Michaelmas feast. Using a fancy font like Old English Text, I sent this invitation: “Lord Vern and Lady Alessandra of Frykhaven request your company for a celebration to mark Michaelmas, the feast day of St. Michael the Archangel.” Following the details of date, time, and location, I included this note: “Medieval garb is encouraged, but not required.”

Perhaps you should know that I don’t take readily to playing dress up myself. My husband is the actor—in fact he is on stage tonight in the leading role of a play about Vince Lombardi, the legendary football coach. But I was determined to be as medieval as I reasonably could, and began sewing a bodice as the basis of a costume I planned to wear. Then I found some maroon Naugahyde and made a hat, and ordered a costume Vern chose: a Franciscan monk’s robe.

The menu was developed mainly from sources on the internet, and was provided to the guests.

* First Remove  *

Bread, butter, blackberry jam

Cheese selection

Figs and dates

*  Second Remove  *

Roast Chicken with Cameline Sauce

Wortes in Marrow Boats

Gingerbread and walnuts

*  Third Remove  *

Pork loin with Blackberry Sauce

Frumenty

Brie Tarts

Pickled onions

Sotelte

*  Fourth Remove  *

Blackberry-Apple Crumble

Blackberry Pie

Apple Rice Pudding

St. Michael slaying the dragon;
Source - Wiki Commons

The emphasis on blackberries in the menu allowed me to explain the legend—the medieval truth—that when Michael the Archangel cast Satan from heaven, he landed on earth in a blackberry bramble, and cursed the berries. It became the rule of thumb that blackberries must be picked prior to Michaelmas, September 29.

The menu called for some additional explanations of medieval food. What is frumenty, anyway? It’s a cracked wheat dish, something like bulgur, though I omitted the porpoise one recipe called for. Cameline sauce? A spicy wine sauce thickened with bread crumbs. Wortes are green leafy vegetables, and I served them in giant zucchini (marrow) boats.

The costumed revelers enjoyed the feast
perhaps a bit more than the others!

I had the most fun making the sotelty, or “subtlety”, a sculpture made from edible ingredients, not necessarily intended to be eaten, but meant to delight the guests with a visual treat. I made a castle of sugar cubes, topping the towers with bright striped candles.

Perhaps you are wishing—I certainly am!—that I had taken photos of the food, but sadly I did not. I was distracted by the demands of serving a four course meal to 35 guests. But neither the guest list nor the menu need to be so elaborate, to create a fun evening when your medieval enthusiasms can have free reign. And there are plenty of feast days throughout the year to play with.

I also prepared a quiz of ten questions about Michaelmas.

1.       Michaelmas has been celebrated since:

a.      Daniel prophesied about Michael (Daniel Chapter 10).

b.      he appeared to an Italian bishop in 492 on Mount Gargano.

c.       the French chivalric “Order of St. Michael” was founded in 1469.

d.      Michaelmas daisies were discovered in Africa.

2.      The traditional meat for Michaelmas is:

a.  rabbit stew             b.  wild boar    c. goose     d.  venison

3.      Michaelmas was one of the medieval “quarter days” of the year when:

a.      rents were collected

b.      debts were paid

c.       fairs were held

d.      all of the above

4.      The angel Michael is known for:

a.      leading the worship of God in heaven.

b.      announcing Mary’s pregnancy to her.

c.       wrestling with Jacob.

d.      casting Satan out of Heaven.

5.      Michaelmas marked:

a.      the end of fishing season.

b.      the completion of the annual harvest.

c.       the beginning of winter curfew.

d.      the time to hire new servants and laborers.

6.      True or False?  Michael is recognized in Christian, Jewish, Islamic, and New Age religions.

7.      True or False?  The name Michael means “Who is like God?”

8.     True or False?   Michael is commonly depicted is artwork with a raised sword, holding Satan to the ground with his foot on Satan’s neck.

9.   True or False?   “Harvest Moon” is the full moon nearest to Michaelmas.

10.  True or False?   Michael is the patron saint of England, grocers, paratroopers, the German people, soldiers, the city of Brussels, Papua New Guinea, and the Archdiocese of Seattle, Washington.

The kitchen staff, Vassal Braden von Dungeness
and Sir Soren of Queen Anne,
provided vital help with serving the meal.

As our guests arrived, we were delighted to see how many had made some concession to costume, and for those who hadn’t, we provided hats for a medieval photo op anyway. I loved having the opportunity to immerse my friends in the medieval history I enjoy so much, and to have the extra reward of their enjoyment too!

(Answers to the quiz: 1-b, 2-c, 3-d, 4-d, 5-b, 6-T, 7-T, 8-T, 9-T (but keyed to equinox, not the feast), 10-F (but yes to grocers, paratroopers, Brussels, and Papua New Guinea)

Women Who Ruled: Joanna I of Naples - Queen in her own right

By Sandy Frykholm

Orphaned by the age of five, Joanna was raised by her grandfather, Robert “the Wise”, the King of Naples. She was his heir, and when he died in 1343, Joanna, at the age of 17, became Queen of Naples. Her grandfather left her with a boatload of trouble, however.

To forestall conflict with the King of Hungary, who claimed the throne of Naples because he was descended from Robert’s elder brother, Robert arranged for Joanna’s marriage to her Hungarian cousin, Prince Andrew. Andrew, younger than Joanna, unsophisticated, and unhappy that he was not to be a ruling king, was not well-received in Naples. Joanna faced threats to her sovereignty from various branches of her family who would take advantage of her youth, those who didn’t want to be ruled by a girl. She needed a strong partner, and Andrew didn’t qualify.

Rumors that Joanna had taken various lovers were circulated by those wanting to discredit her, and her marriage suffered for it, though nothing was proven. When she became pregnant, the prospect of an heir strengthened Joanna’s position—and Andrew’s—and provoked her cousins to the desperate act of murdering Andrew.

The kingdom went from difficulty to chaos. Joanna was besieged by one cousin, demanding she marry him; by the church, investigating Andrew’s death; and by the Hungarians who were not satisfied that their claim to the throne would be settled through Andrew and Joanna’s son—whose birth in December of 1345 brought a male heir to the line.

Public dissatisfaction with the lengthy murder investigation reached the level of riots as a long list of Joanna’s trusted servants were accused. The queen escaped to her most secure fortress, while those demanding justice tortured the accused courtiers.

The kingdom was in shambles. The church sent a cardinal to sort out the criminal inquiry and return some stability to Naples. But in early 1347, Louis of Hungary formed an alliance and declared war on Joanna’s kingdom, seeking to avenge Andrew’s death and claim the throne.

In a period of history when arranged marriages look suspiciously like bribes, Joanna worked the system as she had been trained to do at the knee of her grandfather. Negotiating with popes and barons, Joanna married her cousin Louis of Taranto, an able defender of her kingdom who was put to the test when the Hungarians attacked. She secured further support through arranged marriages for her son, as well as a niece.

When the Hungarians, with an impressive army, defeated Benevento—just three days from Naples—several of the Neapolitan princes betrayed their queen and led the Hungarians into Naples. In the dark of a January night, Joanna fled for her life, setting sail for Provence and the papal court at Avignon. The victorious Hungarians in Naples sent demands to the pope that Joanna be arrested and executed. The pope heard her case, and declared her above suspicion.

The King of Hungary terrorized Naples through the early months of 1348, making himself very unpopular. And then, in April, the Black Death arrived. Within three months, half the population of Joanna’s kingdom was dead. Before the end of May, the King of Hungary slipped out of the country and headed home. Joanna and her husband Louis of Taranto returned to Naples, preparing to vanquish the remaining invaders and restore unity to the Kingdom.

The pace of Joanna’s first five years of rule continued through four decades and four husbands. Her three children all died in early childhood. She reigned for nearly forty years over the Kingdom of Naples. Joanna was also Countess of Provence, titular Queen of Jerusalem, and Princess of Achaia.

When the western schism occurred in the late 1370s, Joanna supported Pope Clement in Avignon over Pope Urban in Rome. Pope Urban excommunicated her, calling her “the new Jezebel”, and bestowed her kingdom on Charles of Durazzo. She was secretly assassinated in the castle of Muro Lucano in 1382, defending her kingdom to the end.

You can learn more about Joanna’s life in “The Lady Queen: The Notorious Reign of Joanna I” by Nancy Goldstone, a biography I highly recommend.

Villains: Pope Boniface VIII

By Sandy Frykholm


No man in the thirteenth century rose to a greater height of power than Pope Boniface VIII. Born Benedict Gaetani, he came from a noble family and was related to three earlier popes. He studied law, and was made a cardinal before he was fifty years old.

Pope Boniface VIII

I consider him a villain primarily for his dealings with his predecessor, Pope Celestine V, and Charles II, King of Naples, a vassal of the church. These three figures are tied together in a strange triangle of historical relationship. Charles was a prisoner in Aragon when his father died, leaving the crown of Naples to him. Naples and Aragon were at war over the island of Sicily, but after years in prison, Charles came to an agreement with the King of Aragon—an agreement which required the consent of the pope. Charles arranged for three of his sons to go to Aragon in his place while he took the treaty to Pope Nicholas in 1289.

Nicholas refused to sign the agreement, and Charles’ sons—ages 8, 12, and 14—remained prisoners.  After a couple of years, Pope Nicholas died. The cardinals split into two camps and for two years they argued, but failed to elect a pope. When they convened in Perugia in 1294, King Charles came to them and asked them to ratify his treaty with Aragon. Though they had the power to do it, the cardinals refused. Cardinal Gaetani, who had dealt with the royal family of Naples since Charles was a child, berated him for bringing his request to the curia, and they parted in anger.

King Charles II of Naples

Charles stopped at an abbey in Sulmona on his way to Naples, and shortly thereafter the retired founder of the abbey, Peter of Morrone, wrote to the cardinals urging them to speed the election, because the church needed a leader. One of the cardinals was a longtime friend and admirer of Peter, and taking his letter as a sign from God, proposed Peter of Morrone as a papal candidate.

Peter, in his mid-eighties, had lived a rustic life, often as a hermit, in the rural mountains of central Italy, part of Charles’ kingdom. He had founded a monastic order and several churches, and his spiritual life was greatly admired by those who knew him.

The cardinals found it expedient to elect him pope, considering his great age and the limited time he was likely to serve. No doubt many of these sophisticated men, including Cardinal Gaetani, believed that a rustic hermit like Peter of Morrone could be used for their own ends.

King Charles heard of Peter’s election within days, and raced back to Sulmona. He arrived at the hermitage before the cardinals’ delegation, and pleaded for his sons’ release. Peter promised to help him, and in fact agreed to visit Charles’ court in Naples before going to Rome.

The cardinals were furious, but Peter was crowned Celestine V, went to Naples, and set up his papal court in King Charles’ castle. By December it was clear to Celestine that he was ill-equipped for the job, essentially a political position. He wanted to resign, withdraw back to his hermitage. With no precedent for the resignation of a pope, Celestine called on Cardinal Gaetani for legal advice.

Ambitious for the ultimate advancement, Gaetani saw the possibilities. He went to King Charles, promising to free his sons if Charles would support Celestine’s resignation and Gaetani’s election. Charles knew Gaetani had the political savvy to fulfill his promise, but did not trust Gaetani. Still, his sons had been prisoners nearly six years.

Pope Celestine V

Gaetani arranged the legal aspects of Celestine’s resignation, and the next day he was elected pope, taking the name Boniface VIII. Celestine’s supporters were convinced that Boniface had coerced the resignation—which I doubt. Boniface requested Celestine to join him in Rome for the coronation, to convince the public that the new election was legitimate. However, as Celestine was traveling to Rome he learned that Boniface planned to imprison him. Celestine escaped with a friend, and for months hid in the mountains and forests.

In May, Pope Boniface heard rumors of Celestine’s whereabouts, and immediately called on King Charles. His assignment: Capture Celestine, and then I’ll sign your treaty with Aragon and free your sons.

Charles had looked to Celestine for spiritual advice, and counted him a good friend. Now he had to capture him, ensuring he would end his life a prisoner of Pope Boniface.

This had to be the bitterest of conflicts for King Charles. He sons had grown to manhood as prisoners in Aragon. To free them, he had to betray his friend. In fact, Pope Boniface did free Charles’ sons, and he kept Celestine in a family castle south of Rome until his death.

Villains come in many forms, some from the low-life criminal element, from whom you would expect no good thing. Others, like Pope Boniface VIII, come from places of privilege and honor, and their villainy is all the more contemptible because of the power they have to do good.