Health and Medical History of President

George Washington

President #1
Lived: 1732-1799 Served: 1789-1797

Timeline from 1776: ← 2013

"Washington died exceedingly hard." 13a

UNDER CONSTRUCTION
Maladies and Conditions

multiple serious infections
Although Washington was physically strong, he was not the indomitable 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 4a. The rest of this page has details about each illness.

Age Year Disease
--- ---- -------
 ?? ???? diphtheria 18
 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).

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 4b MORE. To add to the mystery, soldiers in the Revolutionary Army were treated for malaria as early as 1776 4c.

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. 4d 8a. Comment: It is possible that his sterility (see below) resulted from this episode of smallpox 14.

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 8b 9a MORE.


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. 4d He had another episode of fever and pleurisy at age 25, in conjunction with an attack of dysentery 4e.

It has been proposed that tuberculosis of the vas deferens caused Washington's sterility (below) and that tuberculosis of the gut caused his multiple episodes of bloody diarrhea (below) 1.


diphtheria
Washington "had also apparently had diphtheria" 18.

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 8a MORE.

After his death, Washington's frozen corpse was measured as 6 feet 3.5 inches in length 18a. The body was 1 foot 9 inches across at the shoulders and at the elbows. Another reference cites Washington as 6 feet 2 inches tall 16a. Comment: A post-mortem frozen 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.


recurrent 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 4f. Ultimately, he followed, riding painfully in a wagon, and caught up with the army near Fort Duquesne (present-day Pittsburgh) on July 8 8c.

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'" 8c.

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" 8c.

Braddock died, and Washington staggered home to Mount Vernon on July 25, "weak and feeble" 8c. 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 4e. Less severe attacks continued 4c.

Tuberculosis of the gut has been blamed for these episodes of "dysentery" 1.


"gloomy apprehensions"
Washington had a tendency to become depressed when ill 4g. 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" 4c.

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" 4h. Comment: It is unclear how specific was the meaning of the word "quinsy" in the 1700s.

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 17a. 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. 8d
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 3a. There is speculation that the lack of an heir made it difficult for Washington to accept an offer of Kingship 16b.

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 16c. 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" 16b. There are also speculations 19 -- dismissed by some 1. -- that Washington had Klinefelter syndrome, which is associated with an XXY karyotype. At least one historian believes that Martha was the cause of the marriage's childlessness 11, but his reasoning is unsupported and arrogant MORE.


"Stallion"
Was known as "The Potomac Stallion" 8e.

snored
Reliability of this information is uncertain. 7

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 8f

deafness
Washington's hearing worsened in 1789 to the point where he could not hear ordinary conversation 2.

pneumonia
Washington almost died of pneumonia in 1790. He was unable to function as Chief Executive for several weeks. 15a

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. 12
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. 12

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 4i MORE. Paul Revere made him a set of false teeth 5a. There is a set of Washington dentures in the University of Maryland Dental Museum in Baltimore 21.

Washington's clumsy, ill-fitting dentures distorted his lips. This contributed to the dour expression Washington has in various portraits 4j. Also, painter Gilbert Stuart disliked Washington and accentuated the distortion in what became the most famous of all Washington portraits 3b. The Peale portrait of 1776 shows a long scar along Washington's left cheek. This resulted from an incision to treat an abscessed tooth 4j.


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 18 -- 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 18 (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" 18.  (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.


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" 18.

Martha Washington vetoed the plan. Interestingly, Washington had once revived a slave thought to be dead 18.

Odds & Ends
Resources
 
Chernow
246 reviews
 
Ellis
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Fischer
165 reviews
Burns
18 reviews
 
Schecter
8 reviews
McDonald
7 reviews
Flexner
 
 
Flexner
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Flexner
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Flexner
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Flexner
9 reviews
Cited Resources
  1. Amory JK. George Washington's infertility: why was the father of our country never a father?. Fertility and Sterility. 2004; 81: 495-499.
    Comment: Reviews the differential diagnosis of Washington's sterility, and identifies genitourinary tuberculosis as the most probably cause. Fails to consider smallpox as a possible cause. Also identifies enteric tuberculosis as a possible cause of Washington's recurrent "dysentery," and expresses skepticism that he had Klinefelter syndrome.
  2. Blinderman A. George Washington's health. NY State Med J. 1975;75:122-132. Pubmed 1089222.
  3. Boller, Paul F. Jr. Presidential Anecdotes. New York: Oxford University Press, 1981.0195029151 Libraries 80-27092. app. 13-14 bp. 6
  4. 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, 1994.0899509568 Libraries 93-42000. app. 1-8 bpp. 1, 4, 6 (year might have been 1786) cp. 4 dp. 1 ep. 3 fp. 2 gpp. 3, 4 hpp. 4-5 ipp. 5-6 jp. 6
    Comment: 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.
  5. Cooper, Pauline. The Medical Detectives. New York: David McKay, 1973.067950382X Libraries 73-79947. ap. 96
  6. Donald, David Herbert. Lincoln. New York: Touchstone / Simon & Schuster, 1996.068482535X Libraries 95-4782. app. 38-39
  7. Dugan, James. Bedlam in the boudoir. Colliers. 22 Feb. 1947; pages 17, 69-70.
    Comment: 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."
  8. Flexner, James Thomas. Washington: The Indispensible Man. Boston: Little, Brown, 1974.0316286168 Libraries 74-7235. ap. 8 bp. 132 cp. 24 dp. 42 ep. 198 fpp. 165-175
    Comment: Distillation of Flexner's four-volume biography of Washington published from 1965 to 1972.
  9. Gabriel, Richard A.; Metz, Karen S. A History of Military Medicine, Volume 2. Westport, CT: Greenwood Press, 1992.0313284032 Libraries 91-32404. ap. 108
  10. Grusin, Sarah. The root of the matter. Washington Post Magazine. Feb. 27, 1994;9.
    Comment: Part of the "J Street" column.
  11. Harden B. First President's childlessness linked to disease. Washington Post. Feb. 29, 2004; A3.
  12. Hayes H, Talbert G. The facial lesion of George Washington. Plast Reconstructive Surg. 1987;80:133-136. Pubmed 3299417.
  13. Henriques, Peter R. The Death of George Washington: He Died as He Lived. Mt. Vernon, VA: The Mount Vernon Ladies' Association, 2000.09319170352 Libraries. ap. . vi (introduction by Philander D. Chase)
  14. Kar JK, Phadke AM. Vaso-epididymal anastomosis. Fertil Steril. 1975; 26: 743-756. Pubmed 1157961.
  15. MacMahon, Edward B. and Curry, Leonard. Medical Cover-Ups in the White House. Washington, DC: Farragut, 1987.0918535018 Libraries 87-81241. app. 15-16
  16. Marion, Robert. Was George Washington Really the Father of our Country?. Reading, MA: Addison-Wesley, 1994.0201622556 Libraries 93-26588. ap. 67 bp. 72 cpp. 41-74
  17. Montgomery-Massingberd, Hugh (ed). Burke's Presidential Families of the United States of America. 2nd ed. London: Burke's Peerage Limited, 1981.0850110335 Libraries. ap. 16 bp. 45
    Comment: Enumerates the ancestors and descendants of American presidents up through Ronald Reagan.
  18. Morens DM. Death of a President. New Engl J Med. 1999:341;1845-1849. Pubmed 10588974. aTobias Lear recorded these measurements in his journal. He does not say the corpse was frozen.
  19. Smith, MJV. The father who was not a father. Virginia Medical Monthly. 1976;103:14-16, 21-22, 33. Pubmed 1106028.
  20. 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.
    Comment: From the papers of George Washington at the University of Virginia. Accessed 17 December 2002 at:  http://www.virginia.edu/gwpapers/articles/wallenborn/index.html
  21. Web page: http://www.virginia.edu/gwpapers/faq/gwteeth.html
    Comment: Picture of a set of Washington's dentures, complete with springs.
Other Resources
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