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At Journey's END

"The debt of nature…must be paid by us all"

By the end of the century, the first American medical schools were founded, quarantine hospitals were established to isolate and treat those with contagious diseases, and inoculation was known to be an effective treatment for smallpox. Yet the standard medical treatment of Washington's era was not able to save him from his final illness, and some have suggested that bloodletting, purgatives, emetics, enemas, and blistering may even have hastened his death.

Having returned to Mount Vernon after John Adams was sworn in as the country's second president, Washington spent much time outside, making the rounds of his estate. Washington endured five hours of rain, snow, hail, and high winds on Thursday, December 12, 1799, and didn't change his wet clothes before dinner. The next day, Washington was outside in poor weather again, marking some trees for removal. That evening, unconcerned with his sore throat, he told Tobias Lear, his personal secretary, "You know I never take anything for a cold. Let it go as it came."

Above quote from a letter from George Washington to George Lewis, April 9, 1797

  • George Washington in His Last Illness

    George Washington in His Last Illness attended by Docrs. Craik and Brown, etching by an unidentified artist, early 19th century

    Courtesy Mount Vernon Ladies' Association

    Color print showing George Washington, on his deathbed in the background, attended by Doctors Craik and Brown beside him in the foreground, as well as Martha Washington. Text at the bottom of the print reads: G. Washington in His Last Illness attended by Docrs. Craik and Brown Americans behold & shed a grateful tear For a man who has gained you freedom most dear And now is departing into the realms above Where he may ever rest in lasting peace and love.

  • George Washington by Charles Willson Peale

    George Washington, by Charles Willson Peale, 1795

    Courtesy Mount Vernon Ladies' Association

    The portrait depicts George Washinton as an older man. His head and shoulders are turned three quarters and he is shown against a dark color baclgrpimd. Washington appears somber, gazing into the distance. He is shown wearing a dark coat and a white lace cravat.

    Late in life, George Washington sat for portrait artist Charles Willson Peale at Philosophical Hall in Philadelphia.

  • Portrait of Tobias Lear

    Tobias Lear, Washington's personal secretary, 1869

    Courtesy Mount Vernon Ladies' Association

    This black-and-white portrait of Tobias Lear, George Washington's personal secretary, is from an etching. The portrait is head-and-sholders profile from the sitter's left side. Lear wears his hair in a queue [ponytail], and is dressed in a high-collared coat with a white cravat.

    Lear provided the most detailed description of the general's last days. On Saturday, December 14, Washington awoke, feverish and with labored breathing. While he awaited the assistance of a physician, he tried home remedies. He instructed his overseer to bleed him and Lear applied a menthol vapor rub to his throat.

  • A page from Tobias Lear's account of the death of Washington

    A page from Tobias Lear's The last illness and Death of General Washington, December 14, 1799

    Courtesy Historical Society of Pennsylvania

    A photograph of a hand-written letter by Tobias Lear. The text reads: Saturday, December 14th 1799. This day being marked by an event which will be memorable in the history of America, and perhaps of the world, I shall give a particular statement of it, to which lives and eye witness. The last illness and death of George Washington. On Thursday, December 12th, the general rode out to his farms about ten o'clock, and did not return home 'till past three. Soon after he went out, the weather became very bad, rain hail and snow falling alternately with a cold wind: When he came in…

    Lear provided the most detailed description of the general's last days. On Saturday, December 14, Washington awoke, feverish and with labored breathing. While he awaited the assistance of a physician, he tried home remedies. He instructed his overseer to bleed him and Lear applied a menthol vapor rub to his throat.

  • Breathing a Vein by James Gillray

    Breathing a Vein by James Gillray, 1804

    Courtesy National Library of Medicine

    This illustrated caricature shows a patient and practitioner participating in a bloodletting procedure. The seated patient, wearing a white shirt and red vest, blue knee breeches with white stockings and red slippers, and a blue cap looks to his right as he submits his left arm to the doctor standing ready to bleed a vein. The doctor wears a brown coat with matching breeches, black boots and a brown wig. The artist shows blood spurting from the patient's arm into a small bowl held by the doctor.

    Phlebotomy or, bloodletting, was common in the 18th century. It was based on the belief that excessive blood, phlegm, and bile caused fever and inflammation. To balance the body's humors, these fluids were purged using cutting tools, such as lancets and fleams, and the fluids were collected in bleeding bowls. Washington lost three quarts or half his blood volume during his final illness.

  • Newspaper notice of George Washington's death, 1799.

    Newspaper notice of George Washington's death, 1799

    Courtesy Mount Vernon Ladies' Association

    Washington was attended by his close friend, Dr. James Craik, who perceived the gravity of the situation and enlisted the assistance of Dr. Gustavus Brown from Fort Tobacco, Maryland, and Dr. Elisha Dick, a young doctor from Alexandria, Virginia. While Dr. Dick opposed the excessive bleeding and proposed a tracheotomy, a new surgical procedure to relieve Washington's labored breathing, he was overruled on both opinions by the senior doctors in attendance. He was bled four times in the last day of his life. Evidence suggests that Washington died from swelling and obstruction of his airway.

    With the news of Washington's death, the country went into mourning and hundreds of eulogies were delivered.

  • A funeral oration on the death of George

    A funeral oration on the death of George Washington, by Major-General Henry Lee, 1799

    Courtesy Mount Vernon Ladies' Association

    Play audio of transcript

    Washington was attended by his close friend, Dr. James Craik, who perceived the gravity of the situation and enlisted the assistance of Dr. Gustavus Brown from Fort Tobacco, Maryland, and Dr. Elisha Dick, a young doctor from Alexandria, Virginia. While Dr. Dick opposed the excessive bleeding and proposed a tracheotomy, a new surgical procedure to relieve Washington's labored breathing, he was overruled on both opinions by the senior doctors in attendance. He was bled four times in the last day of his life. Evidence suggests that Washington died from swelling and obstruction of his airway.

    With the news of Washington's death, the country went into mourning and hundreds of eulogies were delivered.

  • A contemporary color photograph of Mount Vernon, the home of first president of the United States, George Washington, with

    George Washington's Mount Vernon estate, Photograph by Carol Highsmith

    Courtesy Mount Vernon Ladies' Association