Medical Supplies of the Lewis and Clark Expedition

In 1803-06, medicine and medical knowledge was primitive, with no internal surgery being performed. Many doctors had no medical training at all, and even the ones who had gone to a medical school knew relatively little about what made a person sick or well. Doctors in 1804 diagnosed by evaluating the individual symptoms displayed by a patient rather than what those symptoms might mean in combination. Operations consisted of amputations of limbs, pulling teeth or trepanning, a procedure by which a hole was cut in the skull to relieve pressure on the brain. Doctors still felt that all disease was caused by an imbalance of "bodily humors." The four "humors" were blood, saliva, urine and feces. If a person was sick, it was likely (according to this theory) that their body had produced too much of one of the bodily humors. This is why doctors resorted to bleeding and purging their patients - that is, actually taking blood from a person's arm or giving them medicine to make them vomit or creating a case of diarrhea - or both. When bleeding a patient, the doctor would cut into a vein on a person's arm with a razor-sharp instrument that looked much like a scalpel or "x-acto" knife. The doctor took a measured amount of blood before bandaging the wound. The use of leeches to remove blood had gone out of fashion with University-trained doctors, but doctors without academic backgrounds continued to use them into the 19th century. Doctors at the time believed that there was more blood in the human body than there really is - in fact, they believed that there was twice as much blood in each person. Needless to say, taking blood from a person fighting an infection is not helpful; taking copious amounts of blood will eventually kill the patient. People who had simple maladies were often killed by doctors who drained them of too much blood. Bleeding and purging did little to help a sick person, but many survived despite their medical treatment.

Other treatments included blistering and the use of counter-irritants. Blistering was an effect caused by using a heated glass cup and applying it to the surface of the skin, usually on the chest. It was believed that cupping would draw phlegm from the lungs when a person had pneumonia. A counter-irritant was often a simple needle placed under the skin, which would sometimes cause an infection and fester. Some physicians of the period believed that such an "irritant" drew off pus from other more serious infections. Of course, these doctors were really just creating yet another infection that their patient's body had to try to fight.

Altogether, the major thrust of medical knowledge at the time was aimed at controlling the amount of humors a patient had in their body, and restoring what they believed was a "balance" of these humors to make a patient well again. Doctors believed that the body was - and this is true to an extent - a fluid mechanism through which the humors could be drawn from place to place, site to site. Their task was to draw off excess amounts of these humors through orifices like the mouth, or when they were inaccessible as with the blood supply, by making an entrance of their own with a lancet.

The only disease that medical science knew how to prevent in 1803 was smallpox. In a process called variolation a patient was scratched with a needle which infected them with a small dosage of smallpox; after a brief illness the patient recovered with an immunity to the disease without having a full-blown case or the terrible sores and resulting scars and pock marks. Prior to 1800, Edward Jenner in Great Britain had discovered a safer way of immunization called inoculation. Jenner's method involved scratching the patent with a needle exposed to cowpox, a disease similar to smallpox contracted by cattle. This inoculation allowed the patient to get an even milder form of the disease with no danger that it might spread and become a full-blown case of smallpox (as sometimes happened with variolation).

It was also known that certain barks from trees which grew in South America could take away malarial fevers. These barks contained quinine, although it would be many years before physicians would understand that this ingredient was the specific reason for their patient's cure. Often called "Peruvian barks," these medicines were first discovered by American Indians in Peru and Brazil who passed their knowledge along to Spanish and Portuguese missionaries.

In the spring of 1803 Meriwether Lewis traveled to Philadelphia for instruction in medicine and the natural sciences. Lewis met with Dr. Benjamin Rush to learn about medicine. Dr. Rush was the most eminent American physician of his day. A leading patriot during the Revolution, Rush was a signer of the Declaration of Independence. Rush not only gave Lewis a crash course in medicine, but also instructed him about American Indian history. Rush was apparently impressed with Lewis; he wrote Jefferson that "Mr. Lewis appears eminently qualified for it [his mission]." As we have seen, it was the duty of the physician to assist the body of the patient to regain a balance of the four humors. This is why Dr. Rush advised Lewis to purge himself and his men for most problems, including fatigue. To do so Rush gave him strong laxative pills the men called "Rush's thunderbolts." He taught Lewis how to bleed a patient, and recommended washing their feet in cold water each morning "to fortify them against the action of the cold." Rush urged Lewis to make sure all the men wore flannel next to their skin at all times, particularly in wet weather.

It is not known why a physician was not taken on the expedition. It might have been due to Jefferson's prejudice against doctors, or perhaps because he felt Lewis qualified, with instruction, to perform the necessary tasks. Lewis' mother, Lucy Marks, was a well-known herb doctor in Virginia, and she had taught her son much about her trade. As you will see from the list of Lewis' medicines and medical instruments, he was prepared to meet most medical emergencies of the day. Luckily, he never had to amputate a limb, pull a tooth or trepan a skull, but he often gave the men medicines to purge them and also bled them for illness.

Joseph Carlisle, Lewis and Clark Bicentennial Exhibition researcher compiled the following information for the Missouri Historical Society, from Gary E. Moulton, Ed. The Journals of the Lewis and Clark Expedition. Lincoln: University of Nebraska Press 1983-2000, and Donald Jackson, ed. Letters of the Lewis and Clark Expedition, with Related Documents, 1783-1854. Urbana: University of Illinois Press, 1962. As you will see, nearly all of the medicines brought on the expedition by Meriwether Lewis were somehow related to bleeding or purging through vomiting or an enema. Many medicines were also used to treat venereal disease. Medicines were taken orally or injected into the penis or anus with instruments called clysters, which looked very much like cake decorators - for putting messages or flowers on cakes in frosting. Clysters were made of a metal called pewter.

(Purchased of George Gillaspy and Joseph Strong of Philadelphia 5/26/1803):

Medical Equipment of the Lewis and Clark Expedition
(purchased of George Gillaspy and Joseph Strong of Philadelphia 5/26/1803)