Dark Banquet - Bill Schutt [32]
A pint of blood was removed.
In Colonial America (as well as throughout Europe), a bladed instrument called a lancet was commonly used during bloodletting. Lancets were produced in huge numbers and often stored in ornate cases. Their importance can be demonstrated by the fact that England’s premier medical journal took its name from the instrument. After tying off the arm at the elbow, the lancet was applied lengthwise to the now bulging vein, which prevented the vessel from being severed in two. A number of spring-loaded mechanical devices (called scarificators) were also concocted to facilitate the drawing of blood, which was often collected in specially designed bleeding bowls. Some of these were quite beautiful, and they were often marked with inner concentric rings arranged in one-ounce increments.
When Washington’s wife, Martha, came upon the gory scene she begged that the procedure be stopped, but her husband insisted that the bleeding continue.
“More, more,” he said, hoarsely, after complaining that the cut Rawlins had made wasn’t large enough.
After the bleeding, Washington’s neck was wrapped in flannel soaked in hartshorn ammonia*43 and his feet were bathed in warm water.
Dr. James Craik had been treating George Washington for over thirty years, and when he arrived, at around 9 a.m., he knew immediately that he was dealing with a potentially fatal illness. He applied a blister of cantharides to Washington’s throat,*44 then instructed his famous patient to gargle with yet another mixture—vinegar and sage tea this time. The results must have been terrifying to those standing by. The former president, who was already struggling to breathe, nearly suffocated on the concoction. Alarmed that Washington could not swallow and was having great difficulty breathing, Dr. Craik sent messengers calling for two additional physicians, Dr. Elisha Dick and Dr. Gustavus Brown. Following this, Craik bled the former president and repeated the procedure at eleven o’clock.
By the time the two additional doctors arrived later that afternoon, Washington had been bled a total of three times. Although Washington’s skin was blue when they arrived, to the physicians of his time this would have indicated an improvement in their patient’s condition (except for the fact that the man was unable to speak, swallow, or breathe without great effort). Medical men of the day often sought to reduce fever or a high pulse rate by decreasing the volume of body fluids. It appears that as far as a patient’s condition was concerned, cool, calm, and cyanotic was preferable to feverish, frenetic, and flushed. Inflammation and fever were not yet recognized as the body’s attempt to combat infection, and so patients were typically bled to alleviate the heat, redness, and pain that were thought to result from “abnormal vascular congestion.”
According to George Washington Custis (Martha’s grandson from her first marriage), the three physicians held a brief consultation: “The medical gentlemen spared not their skill, and all the resources of their art were exhausted.”
What course of treatment had the three doctors agreed upon? Additional bloodletting, and their patient (who had no medical training) agreed with them.
Another full quart of blood was removed, so that by early evening George Washington had been drained of eighty ounces within a thirteen-hour period. Much to the dismay of everyone present, Washington’s blood flow was so weak (and his blood so “thick”) that physicians were unable to induce him to faint, the long-sought end point for most bloodletting treatments.
Deeply distressed at his rapidly deteriorating condition (he was reportedly in great pain and having tremendous difficulty breathing), the doctors administered calomel, a strong laxative and emetic tartar.*45 These purges were as commonly administered as bloodletting in the eighteenth century, but in