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  L&C Information
  The Medical World of Lewis and Clark

Life during the time of Lewis and Clark, was obviously much different than what we experience during our daily lives in the 21st century.  Perhaps using the words “much different” is to vastly understate the situation; life was vastly different.  Daily life was difficult for many rural Americans, with their days being spent gathering and preparing food and protecting themselves from a frequently harsh environment.  City-dwellers had things a bit easier, but both groups faced the threats of diseased with little help from the medical profession.  Life expectancy was not much more than three decades.

Medial practice during that era was a fascinating mixture of philosophical doctrine and attempts to apply early and fundamental basic medical science.  The basic medical sciences, (chemistry, biology) were in their infancies and an understanding of the scientific world was simply not available to medical practitioners.  Isolated scientific discoveries, frequently led to changes in medical philosophy but in many ways, in spite of the dawning of scientific knowledge, ancient medical therapies intended to rid the body of”morbific matter”, (disease producing matter), by bleeding, purging, sweating, blistering and vomiting, among other treatments.  Basic medical science was making great progress, but the practice of medicine was stuck in the past.

Only about 10% of the physicians practicing in the United States at the time of the Lewis and Clark Expedition had any formal medical training.  Qualifications for a physician in that time were basically a desire to be an apprentice and the ability to find a practicing physician who agreed to train the novice in an apprenticeship.  There were only a hand full of medical colleges in the U.S. and the vast majority of American physicians were trained as apprentices; usually serving about a five year course of study with their preceptor.  A luck few traveled to Europe and studied in the hallowed halls of European medical schools.  Such ws the case with one of America’s leading physicians and the medical advisor to Meriwether Lewis.  This famed American physician was Benjamin Rush. 

Theories of disease that were popular during this era, centered around the theory that disease was caused by the nervous system supplying either an excess or deficiency in “nervous excitation”.  These theories were made popular in the mid to later part of the 18th century by the Scottish physicians, William Cullen and John Brown.  Cullen believed that health consisted of a state of appropriate nervous excitation, and Brown built on this philosophy and believed that disease was caused either by insufficient, or excessive nervous excitation.  Brown’s therapies, were, at least in his own mind, meant to correct these “problems”.  His two favorite medications were whiskey and opium.  Brown believed that opium was a terrific “stimulant” for a system suffering from some “nervous deficiency”.  Brown is said to give lectures in London concerning his method of medical treatment, with bottles of laudanum (opium and whiskey)/ and whiskey, rarely getting through one of his lectures without taking at least several doses from both flasks!

When Rush attended medical school in the 1760s in Edinburgh, Scotland, he studied these theories and made many of them part of his medical philosophy. Rush further developed his theories through years of observations of patients and their various illnesses.  Rush believed that illness was preceded by a state of “debility”, or lack of generalized nervous excitation.  The body attempted to correct itself, and sometimes provided an over-stimulation to the system.  Rush further philosophized that the nervous system interacted with the circulatory system, producing a “spasm” within the blood vessels.  This would lead to fever and illness.  Disease could be brought on by such phenomena as “violent passions”, cold air, breathing bad fumes coming from rotting vegetation/coffee, etc.  Some physical signs such as constipation was to be avoided, or treated with vigorous laxatives, both herbal and chemical compounds such as rhubard or calomel (mercurous chloride).

Physicians would diagnose disease at this time by a combination of feeling the patient’s pulse (both rate and strength) feeling the skin for signs of fever, determining the state of the bowels (any constipation?), state of the appetite, and then prescribing a treatment plan for the problem.  Invariably, the treatment was some combination of fresh air, diet, purging, bloodletting, blistering and medication.

Herbal medications were widely used at this time.  Many plants produce physiologically active chemical compounds.  Meriwether Lewis’s mother, Lucy Marks, was an accomplished herbal doctor in Virginia and probably taught the young Lewis a good deal about “the simples”.  Some plants can aid in healing; others can kill.  Many early American physicians experimented with and actively searched for new herbal medications.

It was a staggering challenge for Lewis and Clark to act as the physicians for the expedition.  Their basic medical training as U.S. Army officers, included practical knowledge of basic treatment of gunshot wounds, reducing (relocating) dislocated joints, the establishment and planning the layout of the company’s camp and the separation of the latrine facilities from the main camp.

The collection of knowledge of a physician in the day of Lewis and Clark was extremely limited.   Except for a knowledge of human anatomy, a well educated 6th grader in the world of today, knows more basic medical science than any physician alive in 1804.  The physician of that day knew nothing of bacteria/viruses.  They knew very little physiology and very little accurate chemistry.  The basic medical sciences of  biochemistry/microbiology, were still 50 years in the future.  Without a knowledge of these sciences, very little progress could be made in the world of medicine.

Article by David J. Peck, D.O.  copyright 2010

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Oregon Public Broadcasting
Produced by Oregon Public Broadcasting and Lewis and Clark College, Unfinished Journey, The Lewis and Clark Expedition is a 13 part series, narrated by Peter Coyote.  This landmark series was carried nationally on over 80 NPR stations and covered a diverse number of topics relating to the Lewis and Clark Expedition.  Dr. Peck was a featured participant in two of the episodes.  These episodes are featured here in their entirety for your pleasure, courtesy of Oregon Public Broadcasting, Portland Oregon.
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