Washington is regarded as the father of our country, and indeed he was a brilliant leader and strategist who bedeviled the British and carried the Patriot cause that led to our independence from British rule. He became an international symbol for liberation and nationalism, especially in France and Latin America. He is consistently ranked among our best presidents and even turned down the opportunity to be crowned king of our new nation.

George was a tall (6’ 3”) redhead with gray-blue eyes and a pockmarked face caused by a severe case of smallpox he contracted in Barbados when he was 19. This left Washington immune to future exposure to the deadly disease. It also may have led him to insist that all recruits who joined the army be vaccinated against smallpox. Washington was prone to bouts of malaria, diphtheria, and dysentery. It is also suspected he was sterile as he desired heirs and his wife Martha had already conceived and delivered four children in her first marriage.

Contrary to popular belief, Washington never wore wigs, which were in fashion in his day. He did, however, powder his hair to achieve the silvery-white effect we are familiar with from portraits.

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Surviving documents indicate George may have been in love with Sally Fairfax, who was the wife of a close friend. There wasn’t much of a future there, so he married the rich girl, Martha Custis, a 28-year-old widow. This marriage greatly increased George’s social standing and made him one of the wealthiest men in Virginia. The estimated worth of his estate was $1 million in 1799 dollars.

Washington had dental problems for most of his life. He lost his first adult tooth at 22, and by the time he became President, he had only one tooth in his head. Historians attribute his drastic tooth loss to mercury oxide, which he was given to treat malaria and smallpox. He had a dentist, John Greenwood, who carved several sets of false teeth for him out of elephant and hippopotamus ivory, held together with gold springs. The plate was made of ivory, which held human teeth and pieces of horse, pig, cow, and donkey teeth. Contrary to myth, none of Washington’s sets of false teeth were made of wood. Dental issues left George in constant pain, which often gave him a dour expression.  

On Thursday, December 12th, 1799, a retired, 67-year-old Washington went out on horseback to inspect his farm, Mount Vernon, in the freezing rain. The day was dark and an ice storm made inspection difficult. He spent several hours on his tour then returned home to eat dinner with guests without changing out of his wet clothes. The next day he complained of a severe sore throat and became more and more hoarse as the day went on. Later that night, he awoke Martha to complain about feeling ill and difficulty breathing.

Early the next morning, the estate overseer was called to initiate bleeding, a common practice at the time. A mixture of molasses, vinegar, and butter was prepared but George could not swallow it. Washington’s physician, Dr. James Craik, arrived and he immediately assessed the situation to be life threatening. He called for help from two other physicians. Their initial diagnosis was “inflammatory quinsy,” (today called PTA or peritonsillar abscess) and their first line of treatment was additional bleeding. The youngest physician, Elisha Cullen Dick, proposed a tracheostomy, practically unheard of at the time, but he was quickly overruled by the other two doctors who felt the procedure would be too risky. In total, they drained Washington of 3.75 pints—approximately 80%—of his blood. Washington sat upright while beetles were applied to his legs to raise blisters, his neck was burned, and calomel, a mercury compound, was administered. Finally, George ordered his doctors to let him go in peace. He muttered “I die hard, but I am not afraid to go.” He expired on Saturday, December 14, 1799 at around 10 p.m., only 2 days after riding out in the rain and sleet. His illness lasted 21 hours.

Joseph Ellis, author of the biography His Excellency: George Washington, states “modern medical experts have concluded that Washington most probably suffered from a virulent bacterial infection of the epiglottitis,” which is the cartilage flap that prevents food from entering the airways when swallowing. If severely infected, the epiglottitis can swell and lead to suffocation. Dr. Heinz H.E. Scheidemandel, writing in the Archives of Otolaryngology (September 1976), supported this diagnosis, noting the rapid onset of the disease, difficulty in swallowing, sore throat, muffled voice, a desire to sit up even when weak, and persistent restlessness. Scheidemandel wrote, “in spite of all the advances of modern medicine…only the rapid establishment of an airway guarantees survival in acute epiglottis, while a ‘quinsy’ may have drained itself and ‘croup’ would never have led to death in a patient 67 years of age.”

Young Dr. Dick, who suggested a tracheostomy, was right.

However, Dr. Michael Herbert, a Mississippi-based general internist, disputes the epiglottitis theory supported by most historians. Dr. Herbert claims that infection of the epiglottitis is a condition almost exclusive to young children. Additionally, the Haemophylis influenzae type B virus, which causes this type of infection, is easy to acquire an immunity to as a young child. Dr. Herbert believes it was quinsy (peritonsillar abscess) that took Washington’s life. When a strep infection of the throat works its way down and infects the mediastinum (heart cavity) bringing about peritonsillar abscess, the result can be lethal.

Interestingly, when Washington was in Morristown, New Jersey in the spring of 1779, he suffered from a severe case of quinsy. He was reported to be so weak and feverish that he feared for his life, and instructed General Nathaniel Green to assume command if he indeed died.

We may never know for sure what caused the illness that took George’s life– peritonsillar abscess or epiglottitis. But we can almost certainly state that his death was hastened by excessive bleeding, which Martha opposed. Had George only listened to his wife, he might have been around for a few more years.

Upon Washington’s death, thousands of people in the US wore mourning clothes for months, and Napoleon ordered 10 days of mourning in France. To sustain his mystique, Martha destroyed all correspondence between the two of them. In 1800, a year after his death, a bill was passed by the US government to build George a mausoleum, 100 feet square, in the shape of a pyramid. Southern opposition defeated the bill as they wanted his body to remain at Mount Vernon. To this day, his remains at rest in Mount Vernon.

Reference

  1. Herbert M. What killed George Washinton? Medical Gumbo. http://open.salon.com/blog/michael_hebert/2009/02/16/what_killed_george_washington.Published February 16, 2009.
  2. FDA Consumer. What killed George Washington? Even death didn’t stop the diagnosing. Published March 1985. http://findarticles.com/p/articles/mi_m1370/is_v19/ai_3664128/.
  3. George Washington. Wikipedia. en.wikipedia.org/wiki/George_Washington.
  4. The Health and Medical History of President George Washington. DoctorZebra.com. http://www.doctorzebra.com/prez/g01.htm.