George Washington - Death by Malpractice

Source: The George Washington Memorial

Date: Feb. 29, 2004

Dr. Dick's opinion was that the symptoms suggested, not quinsy, but a violent inflammation of the membranes of the throat. Dr. Dick proposed a tracheotomy to relieve the General's difficulty in breathing, but he was overruled by the older doctors as being too radical. That procedure was newly reported from England, but had never been done in America. It is interesting to note that both Craik and Brown were educated at the University of Edinburgh in Scotland, and were much older than Dr. Dick. Dick was born in Pennsylvania and was 37 years old when Washington died. After rejecting Dick's proposal to perform the tracheotomy, the General was bled again; this was about 32 ounces for a total of over five pints of blood. Historians generally agree that Washington was bled on four occasions: first by Albin Rawlins at dawn; Dr. Craik did two more bleedings at midmorning and early afternoon; and a final bleeding was done at about 3:30 PM. One can only speculate about the actual cause of death, but excessive bleeding was at least partially responsible. There are those in the medical profession today who offer this probability: Washington died of asphyxia - he couldn't breathe due to a swollen larynx. This condition was the result of a violent inflammation of the epiglottis, shock from loss of blood, and dehydration. One can empathize and appreciate the agonizing frustration and sense of helplessness those three doctors must have felt.

At about 10:00 o'clock, the General spoke his last words. After several attempts and with difficulty, he was able to give his final instructions for his burial to his secretary, Tobias Lear. It was reported that about ten minutes before he expired, his breathing became easier. He lay quietly. He felt his own pulse and then expired at 10:20 o'clock. Dr. Dick is reported to have cut the catgut cord that suspended the pendulum weight of his bedchamber clock at precisely that time, thus stopping the clock forever.

Comment: Whatever was the direct cause of General Washington's death, there can be little doubt that excessive bleeding reduced him to a low state and very much aggravated his disease. According to Mr. Lear, the lancet was applied three times, and other authorities inform us that thirty-two ounces of the life-giving fluid were taken from the General in the last application. This vile practice of bleeding an enfeebled patient was a subject of much criticism even in that day. Many of the advanced thinkers in the medical profession, particularly Dr. Elisha Cullen Dick, were beginning to seriously doubt the wisdom of such treatment.

The following is an abstract of a letter to Dr. James Craik written by him shortly after Washington's death. The abstract referred to was published in the "American Historical Records" by Lossing, 1873, vol. 11, page 506.

Port Tobacco, January 21, 1800

Sir:
I have lately met Dr. Dick again in consultation and the high opinion that I formed of him when we were in conference last month, concerning the situation of our illustrious friend, has been confirmed. You remember how, by his clear reasoning and evident knowledge of the cause of certain symptoms, after the examination of the General, he assured us that it was not really quinsy, which we supposed it to be, but a violent inflammation of the membranes of the throat, which it had almost closed, and which if not immediately arrested would result in his death. You must remember he was averse to bleeding the General, and I have often thought that if we had acted accordingly to his suggestion, when he said, "he needs all his strength - bleeding will diminish it," and taken no more blood from him, our good friend might have been alive now. But we were governed by the best light we had; we thought we were right, and so we were justified.

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