Two weeks short of the end of the 18th century and a little more than a month short of his 68th birthday, George Washington died on December 14, 1799. This week marks the 212th anniversary of his passing
Upon receiving the news of the death days later, President John Adams wrote this letter to the Congress:
Gentlemen of the Senate and Gentlemen of the House of Representatives:
The letter herewith transmitted will inform you that it has pleased Divine Providence to remove from this life our excellent fellow-citizen, George Washington, by the purity of his character and a long series of services to his country rendered illustrious through the world. It remains for an affectionate and grateful people, in whose hearts he can never die, to pay suitable honors to his memory.
Americans expressed their esteem of General Washington by participating in over 400 funeral processions and memorial services during 69 days of the “National Day of Mourning” which ended on February 22, 1800. Thousands of them wore mourning clothes for months. Throughout the capitals of the world, citizens were saddened to learn that this citizen of the world had passed from their midst. Napoleon ordered ten days of mourning throughout France.
Tobias Lear was Washington’s personal secretary and an eye witness to his last 30 hours of life. Lear’s account gives us these insights.
Washington had ridden out around 10 a.m. to inspect his farms on Thursday December 12th and didn’t return until after 3 p.m. The weather was cold – a mixture of snow, hail, and rain with temperatures around 28 degrees in a hard wind. Returning home, Lear asked Washington to frank some letters so they could be mailed. When finished, his dinner was waiting for him, which he took without changing out of wet clothes. Lear noticed there was snow hanging from his hair.
A heavy snow fell Friday. Washington had developed a “cold” and complained of a sore throat – quite possibly from his exposure the previous day. He did not venture out until the afternoon and then only to mark some trees between the house and the Potomac River that he wanted cut down to improve the view. By evening his voice had become hoarse though he made light of it.
Washington, Lear, and Martha retired to the parlor to read the newspapers that had been brought from the Post Office. After Martha excused herself around 9 p.m. to go upstairs, Washington continued to read and when he found articles of interest, he read them out loud to Lear, who noticed his voice was becoming squeaky. Otherwise, Washington was in cheerful spirits. When he retired to go upstairs, Lear suggested that he take something for his cold. Washington fobbed it off; "you know I never take anything for a cold. Let it go as it came."
Between 2 a.m. and 3 a.m. Saturday morning Washington awoke Martha and told her that he didn’t feel well. He complained of the ague – a commonly-used 18th century medical term for conditions of fever, chills, and sweating. She wanted to summon a servant but he would not let her go outside lest she catch a cold. At sun up, Caroline, a woman servant, appeared to start the fires in house. Martha sent her immediately to fetch Lear who rushed to Washington’s bed chamber. He found Washington in a state of labored breathing and hardly able to utter a word intelligibly. He was able to tell Lear that he wanted Mr. Rawlins, one of the overseers of the plantation, to be sent for to bleed him. Lear complied and also sent for the family physician, Dr. James Craik. In the course of the day, Dr. Elisha Cullen Dick of Alexandria and Dr. Richard Brown of Port Tobacco were also summoned.
Eighteenth century medicine was pre-scientific and the rationale for phlebotomy was based on a belief that the blood of an ill patient was contaminated by morbid matter. If it was bled out, it would be shortly replaced by healthy blood to heal the patient. Further it was believed that the more acute the condition of the patient, the more blood had to be removed. The physicians of the day knew little about the true volume of blood in the body – believing it was twice the six quarts which the average male body holds – and they believed blood regenerated in hours instead of the weeks actually required. The noted physician of that time, Benjamin Rush, a signer of the Declaration of Independence, believed 80% of a man’s blood volume could be safely removed when in fact 40% can be fatal. Decades would pass before this practice would be discredited.
While awaiting the arrival of Dr. Craik, Lear mixed molasses, vinegar, and butter to soothe Washington’s throat, but Washington could not swallow it and further attempts caused him to convulse and suffocate.
Rawlins arrived and prepared to bleed Washington, though he was agitated to be called for such a task. “Don’t be afraid,” Washington assured him. The venesection, however, did not produce the blood volume Washington wanted removed and as he called for more, Martha intervened that bleeding might not be appropriate for her husband’s condition. Only a half-pint of blood was removed and Washington’s condition remained unchanged. The ever-resourceful Tobias Lear, seeing that Washington couldn’t swallow and hadn’t improved with bleeding, called for Washington’s feet to be immersed in warm water while he applied a “salve latola” to the neck – first by hand rubbing and then soaking a flannel scarf in it which was wrapped around Washington’s neck. Neither produced any relief.
Dr. Craik arrived and, after examining Washington, applied a blister of cantharidin to his throat. It was a mainstream medical practice of the day consisting of a poultice of Spanish fly beetle parts ground into powder which became a powerful skin irritant. The poultice intentionally produced blisters which were believed to have a medicinal effect. Craik also took more blood and made an inhalant of vinegar steam for Washington to breathe. When Washington attempted to gargle vinegar water, he almost suffocated and gagged up heavy phlegm. More bleeding and blister packs followed.
The other two physicians summoned, Dick and Brown, arrived around 3 p.m. After consulting among themselves, Washington was bled again and given an emetic of calomel (mercurous chloride) and tartar (antimony potassium tartrate).
Around 4:30 p.m. Saturday afternoon Washington asked his wife to retrieve two wills from his desk. One superseded the other, which he wanted burned. Lear was summoned to the bedside and Washington took his hand. "I find I am going, my breath cannot last long; I believed from the first that the disorder would prove fatal.” He asked Lear to arrange and record all of his military letters and papers and arrange his accounts and books since he knew more about the plantation’s affairs than anyone. He wanted Rawlins to continue recording his letters – a task he had apparently begun. Washington’s pain and breathing distress was increasing and Lear had to turn him on the bed several times so he could breathe.
About 5 p.m. Dr. Craik returned to the bed chamber and Washington said to him, "Doctor, I die hard; but I am not afraid to go, I believed from my first attack, that I should not survive it; my breath cannot last long.” Craik held his hand for a while and then sat by the fire in the chamber absorbed in grief.
Between 5 p.m. and 6 p.m. the three doctors convened again at Washington’s bed and asked if he could sit up. They raised him but Washington said, "I feel myself going, I thank you for your attentions; but I pray you take no more trouble about me, let me go off quietly; I cannot last long."
Dr. Dick, the youngest of the three doctors, objected to more bleeding of the dying man and argued instead for a tracheotomy – a procedure in which an incision is made in the neck near the larynx or Adam’s apple. That would open a direct airway into the trachea. Tracheotomy is an old procedure dating back centuries but it hadn’t entered mainstream medical practice in Washington’s day. Years later Dr. Dick gave his rationale for proposing the procedure in a personal correspondence:
I proposed to perforate the trachea as a means of prolonging life and of affording time for the removal of the obstruction to respiration in the larynx which manifestly threatened speedy resolution.
But Dr. Craik, the senior physician and Washington’s family physician, vetoed the idea. Dr. Brown concurred with him. Craik was unmoved when Dick offered to be personally responsible for the outcome. Neither Craik nor Brown was concerned about their personal reputation in treating this particular patient. Rather, they may have been overly awed by the fact that this was George Washington, a man of international reputation as evidenced by the god-like esteem paid in foreign capitals when Washington’s death was announced. Moreover, as family physician, Craik would have been concerned that his 67-year old weakened patient would have to endure the pain of a ghastly emergency procedure of unproven efficacy without anesthesia. Even if the procedure succeeded in opening an airway, 18th century ignorance of antiseptic techniques would have likely led to infection of the wound site that would be every bit as life-threatening as Washington’s undiagnosed malady.
Poultices of wheat bran were applied to Washington’s legs and feet around 8 p.m. and more blister poultices were applied to his neck. The families – Martha’s grandchildren – were summoned.
Lear was called to the bedside again around 10 p.m. although Washington could barely speak. After several attempts, he managed to tell Lear, "I am just going! Have me decently buried; and do not let my body to be put into the vault less than three days after I am dead.” Lear nodded his understanding because his grief kept him from speaking. Washington looked at him again and said, "Do you understand me?" Lear replied that he did and Washington settled back on his bed pillow and said, “’Tis well.”
Years before Washington had revived a slave long thought dead and that experience haunted him for the rest of his life with a morbid fear that some day he might be buried alive.
Lear remained at the bedside holding Washington’s hand. His breathing calmed. At 10:10 p.m., Washington slipped his hand out of Lear’s to check his own pulse; his countenance changed, and he expired peacefully. Dr. Dick stopped the clock in the bed chamber to fix the time. Craik, who was sitting by the fire, came to the bedside. He confirmed that Washington was dead and closed his eyes.
While all in the room were fixed in silent grief, Martha Washington, who was sitting at the foot of the bed, asked, “Is he gone?” Lear could not speak and simply held up his hand instead. “'Tis well,” she said. “All is now over, I shall soon follow him! I have no more trials to pass through.” Indeed, three years later she followed her husband.
Thus departed the spirit of George Washington who 30 hours before was in robust health, leaving us to wonder how his body systems could have failed so rapidly.
Most modern diagnosticians would translate Washington’s symptoms – severe sore throat, hoarseness, cough, chills, breathing distress, difficulty in swallowing (dysphagia) leading to spitting or drooling, fever, loss of voice, and episodes of suffocation, in that progression – as symptoms of epiglottitis. Due to juvenile vaccinations, it is an uncommon affliction today but not so in the 18th century when it was fatal and untreatable with the methods of that time. If contracted today a hospitalization most certainly would be required, usually in ICU, and often needing intubation (breathing tube) because the patient would otherwise slowly asphyxiate as Washington did. Asphyxiation was likely the primary cause of his death. It is a frightening way to die and the fact that he could bear it with such resignation is remarkable.
The epiglottis is a stiff but still flexible piece of cartilage at the back of the tongue. It closes the trachea (windpipe) when food or liquid is swallowed to prevent either from entering the airway, causing coughing or choking. Epiglottitis is a severe inflammation of the epiglottis. The infection progresses rapidly and infiltrates the surrounding tissue, quickly causing that tissue to swell and obstruct the respiratory airway. It is acutely painful and causes the patient to struggle in breathing, swallowing, and speaking – all the symptoms Washington presented.
But a likely contributing cause of death was the amount of blood taken from Washington. Shortly after death, his body was carried downstairs and placed on the dining room table. He measured 6 feet and 3.5 inches. A man of his height and body mass probably weighed around 230 pounds, and from height and weight it’s probable that his total blood volume was about seven quarts. Adding up the various bloodlettings he suffered in his final hours – estimated to be about 82 ounces – Washington lost about 37% of the blood in his body within a 16 hour period, which is a remarkable blood loss for a critically sick patient. Tobias Lear described Washington’s final moments as “calm” which may have been due to the fact that he was entering a profound state of shock and hypertension brought on by blood loss.
Ironically, even as Washington lay dying, his friend and the colleague of his doctors – Dr. Benjamin Rush, a champion of bloodletting – was fighting the allegation of medical malpractice because of it. William Corbett, a Philadelphia journalist, had objected to Rush’s overzealous use of the practice, saying Rush had killed more patients than he had saved. Rush sued for libel and won on December 14, the day of Washington’s death.
In the weeks following Washington's death, the three attending physicians became embroiled in criticism which grew worse over the years. They were condemned for their reliance on bloodletting, one critic even going as far as to accuse them of murder.
And indeed, the doctors began to have second thoughts concerning their treatment of Washington’s condition. Dick had originally argued against bleeding and diagnosed that Washington suffered a "violent inflammation of the membranes of the throat" rather than Craik’s diagnosis of an attack of quinsy, an antiquated 18th century medical term for tonsillitis or strep. Dick’s diagnosis was essentially correct although he couldn’t have understood epiglottitis or its aetiology. Craik later mused that he had been inclined to consent to Dick’s recommendation for a tracheotomy before having second thoughts. Brown, writing later to Craik, had reflected on Dick’s diagnosis and treatment assessment, saying “I have often thought that if we had acted according 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.”
However, it is unfair to hold Washington’s doctors to a higher standard than the medical practices of their day. From the perspective of 212 years later, we modern heirs of MRIs, laparotomies, and pharmacotherapies might condescend to treatments of beetle powders, blister poultices, purges with lethal mercury concoctions, and therapeutic bleeding. But Washington himself was an advocate of these practices and used them on himself, his wife, servants, and slaves. They were the therapies he knew and believed to be the best available, just as we today submit to invasive and mutilating surgeries, radiation treatments, and debilitating chemotherapy – practices that the beneficiaries of future therapies may deign to be marginally effective and barbaric.
Despite advances in modern diagnosis and treatment, we still don’t have a scientifically empirical understanding of the origin and progression of many diseases. Until we do, the practice of medicine will be more art than science, not unlike its application in Washington’s day
Upon receiving the news of the death days later, President John Adams wrote this letter to the Congress:
Gentlemen of the Senate and Gentlemen of the House of Representatives:
The letter herewith transmitted will inform you that it has pleased Divine Providence to remove from this life our excellent fellow-citizen, George Washington, by the purity of his character and a long series of services to his country rendered illustrious through the world. It remains for an affectionate and grateful people, in whose hearts he can never die, to pay suitable honors to his memory.
Americans expressed their esteem of General Washington by participating in over 400 funeral processions and memorial services during 69 days of the “National Day of Mourning” which ended on February 22, 1800. Thousands of them wore mourning clothes for months. Throughout the capitals of the world, citizens were saddened to learn that this citizen of the world had passed from their midst. Napoleon ordered ten days of mourning throughout France.
Tobias Lear was Washington’s personal secretary and an eye witness to his last 30 hours of life. Lear’s account gives us these insights.
Washington had ridden out around 10 a.m. to inspect his farms on Thursday December 12th and didn’t return until after 3 p.m. The weather was cold – a mixture of snow, hail, and rain with temperatures around 28 degrees in a hard wind. Returning home, Lear asked Washington to frank some letters so they could be mailed. When finished, his dinner was waiting for him, which he took without changing out of wet clothes. Lear noticed there was snow hanging from his hair.
A heavy snow fell Friday. Washington had developed a “cold” and complained of a sore throat – quite possibly from his exposure the previous day. He did not venture out until the afternoon and then only to mark some trees between the house and the Potomac River that he wanted cut down to improve the view. By evening his voice had become hoarse though he made light of it.
Washington, Lear, and Martha retired to the parlor to read the newspapers that had been brought from the Post Office. After Martha excused herself around 9 p.m. to go upstairs, Washington continued to read and when he found articles of interest, he read them out loud to Lear, who noticed his voice was becoming squeaky. Otherwise, Washington was in cheerful spirits. When he retired to go upstairs, Lear suggested that he take something for his cold. Washington fobbed it off; "you know I never take anything for a cold. Let it go as it came."
Between 2 a.m. and 3 a.m. Saturday morning Washington awoke Martha and told her that he didn’t feel well. He complained of the ague – a commonly-used 18th century medical term for conditions of fever, chills, and sweating. She wanted to summon a servant but he would not let her go outside lest she catch a cold. At sun up, Caroline, a woman servant, appeared to start the fires in house. Martha sent her immediately to fetch Lear who rushed to Washington’s bed chamber. He found Washington in a state of labored breathing and hardly able to utter a word intelligibly. He was able to tell Lear that he wanted Mr. Rawlins, one of the overseers of the plantation, to be sent for to bleed him. Lear complied and also sent for the family physician, Dr. James Craik. In the course of the day, Dr. Elisha Cullen Dick of Alexandria and Dr. Richard Brown of Port Tobacco were also summoned.
Eighteenth century medicine was pre-scientific and the rationale for phlebotomy was based on a belief that the blood of an ill patient was contaminated by morbid matter. If it was bled out, it would be shortly replaced by healthy blood to heal the patient. Further it was believed that the more acute the condition of the patient, the more blood had to be removed. The physicians of the day knew little about the true volume of blood in the body – believing it was twice the six quarts which the average male body holds – and they believed blood regenerated in hours instead of the weeks actually required. The noted physician of that time, Benjamin Rush, a signer of the Declaration of Independence, believed 80% of a man’s blood volume could be safely removed when in fact 40% can be fatal. Decades would pass before this practice would be discredited.
While awaiting the arrival of Dr. Craik, Lear mixed molasses, vinegar, and butter to soothe Washington’s throat, but Washington could not swallow it and further attempts caused him to convulse and suffocate.
Rawlins arrived and prepared to bleed Washington, though he was agitated to be called for such a task. “Don’t be afraid,” Washington assured him. The venesection, however, did not produce the blood volume Washington wanted removed and as he called for more, Martha intervened that bleeding might not be appropriate for her husband’s condition. Only a half-pint of blood was removed and Washington’s condition remained unchanged. The ever-resourceful Tobias Lear, seeing that Washington couldn’t swallow and hadn’t improved with bleeding, called for Washington’s feet to be immersed in warm water while he applied a “salve latola” to the neck – first by hand rubbing and then soaking a flannel scarf in it which was wrapped around Washington’s neck. Neither produced any relief.
Dr. Craik arrived and, after examining Washington, applied a blister of cantharidin to his throat. It was a mainstream medical practice of the day consisting of a poultice of Spanish fly beetle parts ground into powder which became a powerful skin irritant. The poultice intentionally produced blisters which were believed to have a medicinal effect. Craik also took more blood and made an inhalant of vinegar steam for Washington to breathe. When Washington attempted to gargle vinegar water, he almost suffocated and gagged up heavy phlegm. More bleeding and blister packs followed.
The other two physicians summoned, Dick and Brown, arrived around 3 p.m. After consulting among themselves, Washington was bled again and given an emetic of calomel (mercurous chloride) and tartar (antimony potassium tartrate).
Around 4:30 p.m. Saturday afternoon Washington asked his wife to retrieve two wills from his desk. One superseded the other, which he wanted burned. Lear was summoned to the bedside and Washington took his hand. "I find I am going, my breath cannot last long; I believed from the first that the disorder would prove fatal.” He asked Lear to arrange and record all of his military letters and papers and arrange his accounts and books since he knew more about the plantation’s affairs than anyone. He wanted Rawlins to continue recording his letters – a task he had apparently begun. Washington’s pain and breathing distress was increasing and Lear had to turn him on the bed several times so he could breathe.
About 5 p.m. Dr. Craik returned to the bed chamber and Washington said to him, "Doctor, I die hard; but I am not afraid to go, I believed from my first attack, that I should not survive it; my breath cannot last long.” Craik held his hand for a while and then sat by the fire in the chamber absorbed in grief.
Between 5 p.m. and 6 p.m. the three doctors convened again at Washington’s bed and asked if he could sit up. They raised him but Washington said, "I feel myself going, I thank you for your attentions; but I pray you take no more trouble about me, let me go off quietly; I cannot last long."
Dr. Dick, the youngest of the three doctors, objected to more bleeding of the dying man and argued instead for a tracheotomy – a procedure in which an incision is made in the neck near the larynx or Adam’s apple. That would open a direct airway into the trachea. Tracheotomy is an old procedure dating back centuries but it hadn’t entered mainstream medical practice in Washington’s day. Years later Dr. Dick gave his rationale for proposing the procedure in a personal correspondence:
I proposed to perforate the trachea as a means of prolonging life and of affording time for the removal of the obstruction to respiration in the larynx which manifestly threatened speedy resolution.
But Dr. Craik, the senior physician and Washington’s family physician, vetoed the idea. Dr. Brown concurred with him. Craik was unmoved when Dick offered to be personally responsible for the outcome. Neither Craik nor Brown was concerned about their personal reputation in treating this particular patient. Rather, they may have been overly awed by the fact that this was George Washington, a man of international reputation as evidenced by the god-like esteem paid in foreign capitals when Washington’s death was announced. Moreover, as family physician, Craik would have been concerned that his 67-year old weakened patient would have to endure the pain of a ghastly emergency procedure of unproven efficacy without anesthesia. Even if the procedure succeeded in opening an airway, 18th century ignorance of antiseptic techniques would have likely led to infection of the wound site that would be every bit as life-threatening as Washington’s undiagnosed malady.
Poultices of wheat bran were applied to Washington’s legs and feet around 8 p.m. and more blister poultices were applied to his neck. The families – Martha’s grandchildren – were summoned.
Lear was called to the bedside again around 10 p.m. although Washington could barely speak. After several attempts, he managed to tell Lear, "I am just going! Have me decently buried; and do not let my body to be put into the vault less than three days after I am dead.” Lear nodded his understanding because his grief kept him from speaking. Washington looked at him again and said, "Do you understand me?" Lear replied that he did and Washington settled back on his bed pillow and said, “’Tis well.”
Years before Washington had revived a slave long thought dead and that experience haunted him for the rest of his life with a morbid fear that some day he might be buried alive.
Lear remained at the bedside holding Washington’s hand. His breathing calmed. At 10:10 p.m., Washington slipped his hand out of Lear’s to check his own pulse; his countenance changed, and he expired peacefully. Dr. Dick stopped the clock in the bed chamber to fix the time. Craik, who was sitting by the fire, came to the bedside. He confirmed that Washington was dead and closed his eyes.
While all in the room were fixed in silent grief, Martha Washington, who was sitting at the foot of the bed, asked, “Is he gone?” Lear could not speak and simply held up his hand instead. “'Tis well,” she said. “All is now over, I shall soon follow him! I have no more trials to pass through.” Indeed, three years later she followed her husband.
Thus departed the spirit of George Washington who 30 hours before was in robust health, leaving us to wonder how his body systems could have failed so rapidly.
Most modern diagnosticians would translate Washington’s symptoms – severe sore throat, hoarseness, cough, chills, breathing distress, difficulty in swallowing (dysphagia) leading to spitting or drooling, fever, loss of voice, and episodes of suffocation, in that progression – as symptoms of epiglottitis. Due to juvenile vaccinations, it is an uncommon affliction today but not so in the 18th century when it was fatal and untreatable with the methods of that time. If contracted today a hospitalization most certainly would be required, usually in ICU, and often needing intubation (breathing tube) because the patient would otherwise slowly asphyxiate as Washington did. Asphyxiation was likely the primary cause of his death. It is a frightening way to die and the fact that he could bear it with such resignation is remarkable.
The epiglottis is a stiff but still flexible piece of cartilage at the back of the tongue. It closes the trachea (windpipe) when food or liquid is swallowed to prevent either from entering the airway, causing coughing or choking. Epiglottitis is a severe inflammation of the epiglottis. The infection progresses rapidly and infiltrates the surrounding tissue, quickly causing that tissue to swell and obstruct the respiratory airway. It is acutely painful and causes the patient to struggle in breathing, swallowing, and speaking – all the symptoms Washington presented.
But a likely contributing cause of death was the amount of blood taken from Washington. Shortly after death, his body was carried downstairs and placed on the dining room table. He measured 6 feet and 3.5 inches. A man of his height and body mass probably weighed around 230 pounds, and from height and weight it’s probable that his total blood volume was about seven quarts. Adding up the various bloodlettings he suffered in his final hours – estimated to be about 82 ounces – Washington lost about 37% of the blood in his body within a 16 hour period, which is a remarkable blood loss for a critically sick patient. Tobias Lear described Washington’s final moments as “calm” which may have been due to the fact that he was entering a profound state of shock and hypertension brought on by blood loss.
Ironically, even as Washington lay dying, his friend and the colleague of his doctors – Dr. Benjamin Rush, a champion of bloodletting – was fighting the allegation of medical malpractice because of it. William Corbett, a Philadelphia journalist, had objected to Rush’s overzealous use of the practice, saying Rush had killed more patients than he had saved. Rush sued for libel and won on December 14, the day of Washington’s death.
In the weeks following Washington's death, the three attending physicians became embroiled in criticism which grew worse over the years. They were condemned for their reliance on bloodletting, one critic even going as far as to accuse them of murder.
And indeed, the doctors began to have second thoughts concerning their treatment of Washington’s condition. Dick had originally argued against bleeding and diagnosed that Washington suffered a "violent inflammation of the membranes of the throat" rather than Craik’s diagnosis of an attack of quinsy, an antiquated 18th century medical term for tonsillitis or strep. Dick’s diagnosis was essentially correct although he couldn’t have understood epiglottitis or its aetiology. Craik later mused that he had been inclined to consent to Dick’s recommendation for a tracheotomy before having second thoughts. Brown, writing later to Craik, had reflected on Dick’s diagnosis and treatment assessment, saying “I have often thought that if we had acted according 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.”
However, it is unfair to hold Washington’s doctors to a higher standard than the medical practices of their day. From the perspective of 212 years later, we modern heirs of MRIs, laparotomies, and pharmacotherapies might condescend to treatments of beetle powders, blister poultices, purges with lethal mercury concoctions, and therapeutic bleeding. But Washington himself was an advocate of these practices and used them on himself, his wife, servants, and slaves. They were the therapies he knew and believed to be the best available, just as we today submit to invasive and mutilating surgeries, radiation treatments, and debilitating chemotherapy – practices that the beneficiaries of future therapies may deign to be marginally effective and barbaric.
Despite advances in modern diagnosis and treatment, we still don’t have a scientifically empirical understanding of the origin and progression of many diseases. Until we do, the practice of medicine will be more art than science, not unlike its application in Washington’s day
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