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Medicine Practices ~ Dr. Benjamin Rush

President Thomas Jefferson knew that no doctors would accompany the expedition and that there were no hospitals to be found once the crew left the St. Louis area. He therefore sent Capt. Meriwether Lewis to Philadelphia to spend three months learning not just the scientific subjects of biology, botany, zoology and map making, but how to take care of his expeditions health needs.

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Medicine Practices Continued ...

Dr. Benjamin Rush was Lewis' contact with the American Philosophical Society
Dr. Rush was considered to be one of the leading physicians and thinkers of his time. Dr. Rush had signed the Declaration of Independence as a Pennsylvania delegate in 1776, was instrumental in stopping a yellow fever outbreak in Philadelphia in 1793, and with John Adams was thought to have authored several of the so-called "Federalist Papers" in support of the US Constitution as it was being ratified by the states after the Constitutional Convention. Dr. Rush is also generally recognized as the father of American psychiatric care because he was the first to look at why people acted like they did, not just respond to the symptoms that they would present. His ground breaking treatise Medical Inquiries and Observations Upon Diseases of the Mind, published in 1804, offered new theories describing the causes and treatment of mental illness. Lewis spent three months with Dr. Rush learning when and how to bleed, purge, or otherwise treat a variety of conditions he expected to face the Corps of Discovery. (More on this later!)  


Rules for preserving good health
In a letter to President Jefferson (June11, 1803) found among President Jefferson's papers in the Library of Congress' archives, Dr. Rush listed his "Rules for preserving good health." Among the theories Dr. Rush proposed were:

1. When you feel the least indisposition, do not attempt to overcome it by labor or marching. Rest in a horizontal position. Also, fasting and diluting drinks for a day or two will generally overcome an attack of fever. To those preventatives of disease may be added a gentle sweat obtained by warm drinks, or gently opening the bowels by means of one, two or more of the purging pills.

2. Unusual costiveness is often a sign of an approaching disease. When you feel it, take one or more of the purging pills.

3. Want of appetite is otherwise a sign of approaching indisposition. It should be banished by the same method.

4. In difficult and laborious enterprises or marches, eating sparingly will enable you to bear them with less fatigue and more safety to your health.

5. Flannel should be worn constantly next to the skin, especially in wet weather.

6.  The less spirits you use, the better.

7.  Molasses or sugar victuals with a few drops of the acid of vitriol will make a pleasant and wholesome drink with your meals.

8.  After having your feet much chilled, it will be useful to wash them with a little spirit.

9. Washing your feet every morning in cold water will fortify them against the notion of cold.

10.  After long marches or much fatigue from any work, you will be more refreshed from lying down in a horizontal position for two hours than by resting a much longer time in any other position of the body.

11. Shoes made without heels by affording equal action to all the muscles of the legs will enable you to march with less fatigue than shoes made in the ordinary way.

Awkward and Strange?
As awkward and strange as these rules seem today, you must remember that only one man died (Only One Man Died: The Medical Aspects of the Lewis and Clark Expedition (LARGE PRRINT) on the trip and conventional theory suggests his appendix burst and there wasn't too much that Lewis could have done to help him.
A list of medical supplies for the expedition ~ Total Cost of $90.69
Dr. Rush prepared a list of medical supplies for the expedition with a total cost of $90.69. 
Among the items purchased in St. Louis were:
Clysters Syringes
Gonorrhea syringes
Peruvian bark (quinine-3500 doses)
Jalap (purgative)
Glauber salts (sodium sulfide)
Niter (potassium nitrate/saltpeter)
Tartar emetic (1100 doses)
mercurial ointment
Rushes Thunderclappers
Chief among the medicines was 50 dozen Dr. Rush's patented pills (also known as 'Thunderclappers'). The pills that Dr. Rush refers to were concocted by him as a means of purging the system.  Author Steven Ambrose in  Undaunted Courage: Meriwether Lewis Thomas Jefferson and the Opening of the American West  wrote: "Dr. Rush thought these pills would cure any number of ills. The pills were composed of calomel (a mixture of six parts mercury to one part chlorine), and jalap (eds note: jalapeno is a form of jalap). Each portion of the concoction was a purgative of explosive power...the combination was awesome."  Dr. Rush suggested that if one pill didn't do the trick, you could take two or three.
References to health care are frequent
In their early journals, references to health care are frequent. 

Capt. William Clark recorded that: "I have a bad cold with a sore throat." June 3, 1804.

On June 16th, Clark observes: "the Mosquitoes and Ticks are noumerous & bad."

On June 17th, Clark writes: "the party is much aflicted by boils and several have deassentary which I contribute to the water (which is muddy)."

On July 4th (near present day Atchison, Kansas), Sgt. Ordway wrote: "Fields got bit by a snake, which was quickly doctored by bark by Cap. Lewis. A poultice of bark and gunpowder was sufficient to cure the wound."

Also on July 4th, Pvt. Whitehouse noted: "The day mighty hot when we went to toe the Sand, (s)calded our (feet) some fled from the rope...had to put on our mockisons."

On July 7th, near St. Michael's Meadow (present day St. Joseph, Missouri), Clark wrote: "...one man verry sick, struck with the Sun. Capt. Lewis bled him and gave Niter which has revived him much."

July 8th saw  "...five men sick today with a violent head ake &c."

By July 10th Clark had written:  "our men all getting well but much fatigued."

And, so it goes ...
The men were chased by bears, teased by prairie dogs, fell off river bluffs, suffered mild frostbite, and acquired a variety of other ills and complaints along the way.  Lewis nearly died on the return trip when he was accidentally shot in the hip (buttocks) by Pierre Cruzatte during an elk hunt. He writes on October 18, 1806:
"...with the assistance of Sgt. Gass I took off my cloaths and dressed my wounds myself as well as I could, introducing tents of patent lint in the ball holes, the wound blead considerably but I was hapy to find that it had touched neither bone nor artery...my wounds being so situated that I could not move without infinite pain...as it was painful to me to be removed I slept on board the perogue; the pain I experienced excited a high fever and I had a very uncomfortable night."
Meriwether Lewis state of mind
One other area that we have researched, but have not found too many direct references to was Lewis state of mind. Ambrose hinted at a possible problem, and Clark noted in the collection of correspondence published in 2002 (Dear Brother: Letters of William Clark to Jonathan Clark , edited by James J. Holmberg) that Lewis had been acting suicidal and in a "state of derangement" while staying in the Memphis area on his way to Washington, DC in 1809 to publish the journals. It was shortly thereafter that Lewis died near Grinder's Stand, about 70 miles southwest of present day Nashville from apparently self-inflicted gunshot wounds.
Our research premise was that perhaps President Jefferson was well aware of Lewis' melancholy or depression and sent him to Dr. Rush because Jefferson knew that Rush was seriously researching mental illness and could possible provide some help. There are no references to Lewis' state of mind in any correspondence from Rush to Jefferson, or back. Perhaps we will never know for certain.
Lost and Found
Rush's "Rules to preserve Good Health" were supposedly lost-at least according to medical examination of the journals published in 1975. But, we found that document easily in the Library of Congress archives. Other documents may surface in the future describing Lewis and his state of mind.

The Glore Psychiatric Museum is a certified site on the Lewis and Clark National Historic Trail. Located at 3406 Frederick Avenue, St. Joseph, MO 64506.

Guest Author: Scott Clark - Glore Psychiatric Museum in St. Joseph, Missouri

Medicine and Health on the Lewis and Clark Expedition - University of Virginia

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