On December 12, 1799, George Washington returned to Mount Vernon after several hours on horseback in snow, hail, and freezing rain. The next day he developed a sore throat and hoarseness, and in the early morning of December 14 he awoke struggling to breathe and swallow. Doctors were called, and what happened next is now one of the most talked-about medical cases in American history.
Washington did not lack medical care. In fact, he received a lot of attention from three skilled physicians, who used the treatments they thought best for someone as sick as he was, such as repeated bloodletting and other methods meant to reduce inflammation and restore balance. Late that night, Washington died.
Even now, more than 200 years later, we are not sure exactly what disease killed Washington. Some experts have suggested acute bacterial epiglottitis, severe pharyngitis, peritonsillar infection, or other causes of upper-airway blockage [1]. What is clear is that Washington lost a large amount of blood, by most estimates about 80 ounces, through repeated bloodletting while he was already very sick. His doctors did not mean to harm him. They thought removing blood would control the inflammation, but it made him worse. Their actions followed a long-standing medical tradition, supported by accepted theories, experience, and the authority of many generations of doctors.
It is easy to look back at this story and feel superior because of our modern knowledge. Today, we understand things like oxygen delivery, blood volume, shock, infections, airway care, IV fluids, antibiotics, and advanced life support. Washington’s doctors did not have this knowledge. But calling them primitive misses the real point. They were trained doctors using the best knowledge they had to try to save their patient. The real question is not why doctors in 1799 believed bloodletting would help. Instead, we should ask which treatments we use today with the same confidence that future doctors might find hard to believe.
