The Death of George Washington (1732–99) and the History of Cynanche

Abstract

George Washington died in the winter of 1799 from acute epiglottitis during an epidemic of influenza. The details of the illness were fully recorded by his secretary, Tobias Lear, and this is the first published description in English of this condition. An account is given of the medical treatment and controversies that arose in criticism of the attendant doctors.

A Lesson on Human Factors in Airway Management Learnt From the Death of George Washington

“…1 Dr James Craik (age 70), Dr Gustavus Brown (age 52), and Dr Elisha Dick (age 32) were all highly respected doctors. 2 Craik was Washington’s friend and personal physician, and together with Brown, they both qualified from the prestigious Edinburgh University. Dick graduated from the much smaller and newly established medical school of Philadelphia and was considered a brilliant young doctor.…”

“…Dick graduated from the much smaller and newly established medical school of Philadelphia and was considered a brilliant young doctor. 2…”

“…The evening before, he complained of having a sore throat and mild hoarseness but he “made light of it.” 3 He woke up after midnight with an “inflamed throat” and progressive difficulty in breathing, speaking, and drinking. 2,3 The 3 doctors were summoned one after the other by Washington’s secretary and closest aide, Tobias Lear, who wrote a detailed account on the events that day. 3 Craik, who arrived first, followed the common medical practice of that time and performed bloodletting and blistering, as well as gave calomel and enemas.…”

“…2,4 It is well documented he was willing to assume full responsibility for all possible consequences. 1,2,4…”

“…Dick went out to fetch his surgical instruments, but upon his return, he found out that Brown managed to persuade Craik, and both senior doctors eventually overruled his proposal. 1,2 The agreement was finally reached to bleed Washington for a fourth time, and 32 ounces of blood were withdrawn. 1,3,5 Washington was rapidly deteriorating after losing a total of 40% to 50% of his blood in a short period of less than 12 hours and the severe diarrhea caused by the laxatives and enemas he was given earlier.…”