Critical Medical Observations in the Wild

On the Lewis and Clark expedition, the men in the crew had to face incredible hardships while traveling across North America looking for a northwest passage to the Pacific Ocean. They suffered from sore muscles and raw feet from walking and traveling the immense distances daily. Some of the men were unable to wear even moccasins because of the pain. Their feet could be soothed by soaking them in hot or cold water baths. However, in addition to the physical exertions they went through, the life endangering feats, wild animals encounters, and meeting the dangers of the lands ahead of them, they met and suffered numerous medical casualties both among their own crew and also in the Indian tribal nations.

        The most common illnesses encountered by the crew on the expedition were rheumatism, frost bite, venereal diseases, dysentery, tumors, and fever. There is a major case of rheumatism described in the journals that inflicted Clark on the expedition early on in the fall of 1804. “I was violently and suddenly attacked with the Rheumatism in the neck which was so violent that I could’t move.” Spasms were also symptoms of the affliction. Captain Lewis administered a hot stone wrapped in flannel to Clark’s neck that gave him temporary ease. The rheumatism prevents Clark from eating a welcoming dinner with the Mandans. While Clark is inflicted, other members of the group are also stricken with rheumatism, namely Fields and Crusat. (53, 55, 58)

             Frost bite was a common occurrence during the cold wintery seasons of the expedition for the crew members as well as for the Indians. Clark recalls during December of 1804: “This day brin Cold several men returned a little frost bit, one of the men with his feet badly frost bit. My servant’s feet also frosted and his penis a little.” (72) This example shows the severity of the conditions in which these men stayed. The Indians too, were not exempt from sickness. They were also affected by the cold conditions of winter. In January of 1805, the journals mention a Mandan boy getting stuck outside all night with thin clothing and no fire. He returned in the morning with frost bitten feet which Lewis placed in a cold water bath. A few weeks later, Lewis removed the boy’s toes on one of his feet because the frost bite had rendered them unusable. (78) However, there was another example of another Indian man staying out that very same night under the same conditions and returning perfectly fine. Clark comments: “Customs and habits of those people has allowed them to bare more cold then I thought it possible for men to endure.” (p. 76)

             The most common and seemingly the easiest disease to prevent was the spread of venereal disease between the Indians and the crew men. Gonorrhea, syphilis, a disease called Louis Veneri, were common for the men to experience on the expedition. On March 31st, Clark wrote: “all the party in high Sperits... Generally helthy except Venerials Complaints which is verry common amongst the natives and the men Catch it from them.” (90) There were also some accounts of Lewis administering treatments for the diseases. In January of 1806 Goodrich recovers from Louis Veneri, a type of venereal disease, that he contracted from a Chinnook woman, when Lewis gives him Mercury to make it subside. Lewis had used the same treatment on Gibson the previous winter. Lewis and Clark realize that the cause of these diseases are the crew’s interactions with the Indians and they accept that they are very common amongst the tribal members. Clark mentions a Mandan tribal ritual that definitely would give cause to the spreading of sexually transmitted diseases. A dance called the Buffalo Dance, or possibly the Medicine Dance, is performed by the tribe. The elder men sit in a circle and the younger married men dance around the older men and offer their wives to them. The wives then go off with the elders and have sex, and then the elder men must go and thank the couple for the experience. A member of the crew participated in this dance and was given four women. (76) Apparently, the act of offering the women, girls, or wives of the tribe to the crew members as gifts as they pass through was common practice for a number of Indian tribes. These kinds of practices make it incredibly easy to spread disease.

             Dysentery struck the crew in the fall of 1805. Lewis is the first person mentioned to be the carrier of it: “...to add to my fatigue in this walk of about 11 miles I had taken a doze of glauber salts in the morning in consequence of a slight desentary with which I had been afflicted for several days; being weekened by the disorder and the opperation of the medicine I found myself almost exhausted before we reached the river.” (174) Later, when the crew arrives at a village of the Nez Perces, it seems that the entire crew falls ill with dysentery. According to Clark, “a universal ‘lax and heaviness in the stomach’, may have been due to bacteria in the dries salmon but the Nez Perces did not suffer from it and they could hardly have developed immunity to amoebic dysentery, probably the camass was responsible.” (p. 241) All of the men were sick “complaining of their bowels and stomach”. Some could not’t walk or even ride because of the pain, having to lie on the side of the trail. When Clark is attacked with dysentery, he takes doses of Rush’s pills, which consist of ten grains of calomel and ten grains of jalop. These are not powerful enough, so Clark then supplements them with large doses of glauber salts and emetics. Clark’s case lasts for over a week and he is unable to eat even boiled root stew because the effects of dysentery affect one’s ability to take in foods. (240)

In addition to the recurring diseases that afflicted the crew members, Lewis and Clark also had to deal with cases of fever, fatigue, and other illnesses of which the causes were unknown. For example, one man was stricken with pleurisy and Clark, to relieve the man of the illness, bled him, sweat him, and also applied the corresponding remedies. The common remedy for an illness whose symptoms included fever and abnormal pulse rate was to bleed the person in the hopes that whatever ailing virus or germ would come out in the blood that is let out of the body. This remedy was used repeatedly over the course of the expedition. For example, when Whitehorse became hot and felt fatigued, he drank lots of water and suddenly fell extremely ill. Lewis bled him plentifully using nothing except his penknife from which he felt great relief. (150)

             Two mysterious illnesses that occur on the expedition inflict Sacajawea and Private Bratton. In June of 1805, Sacajawea became very ill. Lewis tried giving her water from Sulfur Spring with no effect. He then tried administering two doses of barks and opium which improved her pulse rate, however, she complained of pain in her lower abdomen. Lewis continued to give her doses of barks and laudanum, and also bled her, until the pain receded.

             Private Bratton’s mysterious case consisted of symptoms of weakness and lower back pain. The Scott’s pills given to him by Clark had no effect. Bratton’s illness evolved into an obstinate cough, more back pain, and more weakness which led to violent back pain prohibiting him from sitting up. Lewis applied a bandage of flannel to his back and rubbed it well with volatile liniment which Lewis prepared with wine, camphor, Castile soap, and laudanum. Bratton suddenly recovered, seemingly not as a result of the treatments, and Lewis thought the illness was caused by an inflammation or sprain of the sacroiliac joint, which is debatable among modern medical experts. (313-314)
As a final note about the medical dealings with the crew specifically, Lewis and Clark were able to use wild herbs and plants in their medical practices. They had in their possession a specific root that was used as a cure for bites from mad dogs and snakes, etc. The wound would first be cleaned and then a section of the root taken and ground up and applied to the bite twice a day. The bitten person must not chew or swallow any part of the root for it might have contrary effects. (p.83) Lewis became ill while on the expedition and being without his medical bag, he used his medical resourcefulness. Overcome with “violent pain in the intestines” and “having brought no medicine with me i resolved to try an experiment with some simples.” Using the abundant choke cherry, “I directed a parcel of small twigs to be geathered [and] stripped of their leaves, cut into pieces of about two inches in length and boiled in water untill a strong black decoction of an astringent bitter taste was produced.” (135) He took a pint of it, and repeated an hour later, and was entirely relieved of all pain and symptoms by that night. He then had a refreshing and comfortable night’s rest. (135)

             Lewis was the primary physician on the expedition, and he administered most of the medical treatments and performed most of the medical procedures to cure the ailments. However, Clark did assist, administer medicine, and perform some procedures as well. There are several accounts of him treating tumors and abcesses. In fact, there are two instances in May of 1806 where Clark acted as physician. The first patient was an Indian man who complained of knee and thigh pain. Clark gave the man some Volatile liniment to rub onto the painful areas. The second patient was a man with a tumor in his thigh. Clark purged him, meaning he opened the tumor with a knife of some kind, cleansed the wound, and dressed the sore. He gave the man some Castile soap to wash the sore with until after it had healed a bit. These two instances raised Clark’s reputation in the eyes of the natives as a skilled physician. “In our present situation I think it pardonable to continue this deception for they will not give us any provisions without compensation in merchandise.” (373) The fact that Clark acted here as the more skillful physician reveals the underlying practice of using their medicinal knowledge to help the Indians and cure some of their symptoms and ailments in exchange for food and hospitality.

At times, Clark refused to treat Indian patients without getting food or horses or something in exchange. After receiving food, bread, dogs, or horses, Clark treated an abcess by opening it, dressing it with bisilican, and prepared some doses of flour of sulfur and cream of tartar to be taken each morning. He treated a native stricken with rheumatism by bathing him in warm water and prescribing some balsam capivia. He also treats shhrofla, ulcers, sore eyes, and loss of the use of limbs. He gives a depressed woman thirty drops of Lodomem, and some volatile leniment to natives who have pain in their backs, hips, legs, thighs or arms. (381, 382, 389)

             Apart from the usual spreading of venereal diseases and the appearances of abcesses and such, Lewis and Clark discovered medical regularities in each of the tribes they met. For example, each tribe had its own history and it usually contained some record of an infection by some disease causing its population to drop drastically. The Mandans were reduced by a smallpox epidemic in 1782. Venereal disease struck the Clatsop, as well as the Chinnooks, and their numbers were reduced from the epidemic. As much as past epidemics were a part of some tribal histories, so were cultural traditions that involved artificially deforming the human body. For example, the Flatheads were known as the flatheads because traditionally they would artificially obtain the flat foreheads by compressing the head during infancy between two boards from which the baby never perfectly recovers. This is done in order to give a greater width to the forehead, which s much admired in the tribe. The Flathead women have the swollen leg traits from similar body sculpture. The swollen legs are obtained by tying a tight cord around the ankle which prevents the free circulation of blood. (332-333)

             A commonality in the Nez Perces tribe was sore eyes. This was more of an ailment than the flatheads, and they had no true relief of it. Clark observed that both the Indian men and women were affected, and the soreness eventually led to blindness. It was common among all the tribes along the Columbia River. The soreness was also present at all stages of life among the Indians; it was common for a native to be blind by middle age. Clark guessed that this eye deficiency was attributed to exposure to the reflection of the sun on the water when they are constantly fishing. (344) Lewis and Clark administer eye water, or eye drops to those who complain of the sore eyes.

             As far as Indian medical practice is concerned, the journals mention a couple instances where their methods have proved very successful. One instance describes a Chippewa cure for venereal disease. The Chippewa’s, in Lewis’ opinion, are better at making these cures than any other “savages in North America”. They used a concoction of the Lobelia and that of a sumac species. These concoctions were drank freely and without limitation to expel the disease from the body. (315)

             An Indian practice proved useful for the crew was a method of quick childbirth used on Sacajawea when she delivered her son. Mr. Jessome administered a small portion of a rattlesnake rattle added to a small quantity of water. Whether the medicine was the cause or not, the baby was delivered within ten minutes. (80)

             However, Indian medical practice, though it may have proved successful, was believed to be the result of spiritual intervention. The natives prayed to their gods and spirits for health and they believed that if someone was spared from illness that it was the work of the Medicine Spirit. For example, a young boy, half white, half Indian, was not burnt in a fire because he took shelter under a Green Buffalo Skin, yet his tribe believed that he was saved by the Medicine Spirit because he was white. (60)

             The medical problems that Lewis and Clark encountered while on the expedition were illnesses that they treated with primitive forms of medicine. A lot of it was dangerous, like the bleeding, for example, and most of the ailments were constructed from simple elements. However, despite the lack of modern medicine and medical knowledge, Lewis and Clark, using their brief training, field knowledge, knowledge from the Indians, did manage to handle the medical problems that came their way.