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. 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!)
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
> 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. > Unusual costiveness is often a sign of an approaching disease. When
you feel it, take one or more of the purging pills. > Want of appetite is otherwise a sign of approaching indisposition. It
should be banished by the same method. > In difficult and laborious enterprises or marches, eating sparingly
will enable you to bear them with less fatigue and more safety to your
health. > Flannel should be worn constantly next to the skin, especially in wet
weather. > The less spirits you use, the better. > Molasses or sugar victuals with a few drops of the acid of vitriol
will make a pleasant and wholesome drink with your meals. > After having your feet much chilled, it will be useful to wash them
with a little spirit. >Washing your feet every morning in cold water will fortify them against
the notion of cold. > 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. >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.
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. Dr. Rush prepared a list of
medical supplies for the expedition: total cost $90.69. Among
the items purchased in St. Louis were:
Peruvian bark (quinine-3500 doses)
Glauber salts (sodium sulfide)
Niter (potassium nitrate/saltpeter)
Tartar emetic (1100 doses)
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.
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
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."
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
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.
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.