One of the three doctors atteding Washington, Elisha Cullen Dick, objected to continued bleeding, arguing instead for tracheotomy. Tracheotomy is a surgical procedure recognized today as potentially life-saving in epiglottitis, but was then almost unworkable. Dick was overruled by the senior physician, James Craik. "Undoubtedly, the specter of failure with a grisly, painful (in the absence of anesthesia), and untried surgical experiment on the former president weighed heavily in Craik's decision to veto this radical suggestion" 1 . (It should also be remembered that "former president" does not begin to describe Washington's stature. He was the most famous man in the world, for 20 years the pre-eminent man in American life, and was held in almost religious esteem by his countrymen.)

A British physician of the era, John Reid, estimated that up to 90 ounces had been removed, and sarcastically remarked that the "current of blood" drained from Washington reflected the mighty currents of American rivers. 2 ! Reid also criticized the heavy dosing of calomel plus the administration of emetics, vinegar vapors, and blistering to a man in his late 60s.

First suggested in 1838, most authorities today believe Washington's final illness was acute bacterial epiglottitis 1 -- an infection of the small tissue flap that plugs the entrance to the lungs during swallowing. Since the invention of antibiotics, this infection has become rare, but even now its occurrence is exceedingly serious. When the epiglottis swells (as it will do in response to an infection) it can block airflow into the lungs -- an obviously fatal outcome.

No one is quite sure what killed Washington. He was in fine health at age 67 when he contracted hoarseness and a sore throat a few days after helping to move a snow-mired carriage near his home. There was little alarm until he awoke in the middle of the night with difficulty breathing, almost unable to talk. A doctor was summoned, but Washington did not wait, ordering an employee to bleed him. The doctor arrived and, according to the principles of the day, bled him again. Eventually, Washington requested no further bleeding be performed, but he was bled again anyway.

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