The Lewis and Clark Expedition Meets Medical and Health Challenges As They Go West
The Corps of Discovery Becomes a “Walking Hospital”
William Clark complained in one journal entry, “I am verry Sick all night … pane in Stomach & the bowels.” On the same day Meriwether Lewis recorded, “for my own part I suffered a sever Indisposition for 10 or 12 days, sick feeble & emiciated.” Such journal entries were exceedingly common.
When the explorers left Fort Mandan for the Pacific Ocean, they were healthy and strong. Lewis had written Thomas Jefferson before departing, “every individual of the party are in good health, and excellent sperits.” By the time the men forged the Rocky Mountains and set up camp at Fort Clatsop, the men’s health had become a major problem. When the expedition started their return journey, Lewis noted, “many of our men are still complaining of being unwell; remain weak …”
The journey eastward saw an ill crew struggling to put one foot in front of the other. The Corps of Discovery was becoming a “walking hospital” plagued with exhaustion, dysentery, skin diseases, constipation, malaria, fevers, boils, strained muscles, sore eyes, and venereal disease.
That only one man died was luck indeed for Lewis and Clark.
Diseases on the Lewis and Clark Expedition
Rheumatism, exacerbated by the cold winters the men endured, was another frequent affliction. Rheumatism caused soreness and stiffness of the muscles and pain in the joints, making the daily work of the expedition extremely difficult. Clark was crippled with rheumatism throughout the journey. One particularly “violent” attack occurred in the middle of the night, leaving Clark’s neck immobile. Lewis’s treatment involved wrapping a hot stone in flannel giving Clark only “temporary ease.”
The chastity of their woman is not held in high estimation, and the husband will for a trifle barter the companion of his bed for a night or longer if he conceives the reward adequate … I requested the men to give them no cause for jealousy by having connection with their women without their knowledge, which with them, strange as it may seem is considered as disgracefull to the husband, as clandestine connections of a similar kind are among civilized nations. To prevent this mutual exchange of good offices altogether I know it impossible to effect, particularly on the part of our young men whom some months abstinence have made very polite to these tawney damsels … I was anxious to learn whether these people had the venereal, and made the inquiry through the interpreter and his wife; the information was that they sometimes had it … — Meriwether Lewis, August 19, 1805
In March 1805, Clark casually writes in his journal, “Generally healthy except venerials complains which is verry Commion.” Three men are mentioned by name in the journals of the expedition as being treated for syphilis, although many historians believe the majority of the men suffered from sexually transmitted diseases. Sexual contact did occur between the Corps of Discovery and some of the Native American women.
The standard treatment of syphilis was the application of mercury. It was given either as a salve to the lesion or as a pill. It was stopped when excessive salivation and sore gums occurred, signs of mercury poisoning. It was then resumed until the lesion was cured. Some medical historians propose that Meriwether Lewis suffered from neurosyphilis, causing mental derangement leading to his suicide.
The Near Death of Sacagawea
The Indian woman verry bad … if She dies it will be the fault of her husband …
—William Clark, June 1805
In June 1805, Sacagawea was very ill for nearly one week. Her symptoms included a high fever, weak pulse, irregular breathing, and alarming twitching of her fingers and arms. (Some medical historians speculate Sacagawea was suffering from chronic pelvic inflammatory disease or gonorrheal infection.) Clark oversaw medical care for Sacagawea while Lewis was on a brief exploratory trip. Clark bled her and applied a poultice of Peruvian bark and laudanum. Sacagawea’s condition only worsened. When Lewis returned, he examined her and determined she faced an “obstruction of the mensis.” He prescribed two doses of bark and opium and gave her water containing high levels of sulphur and iron. Sacagawea’s health improved.
Accidents and Injuries on the Lewis and Clark Expedition
In addition to disease the men suffered from various wounds and injuries. This is not surprising since the expedition traveled 8,000 miles in uncharted territory over treacherous mountains and raging rivers, was absent from civilization for over two years, and performed strenuous manual labor under difficult conditions.
Boating accidents were mentioned a number of times in the journals kept by expedition members. Some of the men could not swim, and it is fortunate that no person drowned. One of the most serious mishaps occurred on April 13, 1805, when a pirogue containing the medicines, instruments, merchandise, Sacagawea and her child, and three men who could not swim went out of control. Water was within an inch of the gunnels, and precious articles were floating away. Lewis describes Sacagawea’s calm response in his journal, “The Indian woman to whom I ascribe equal fortitude and resolution, with any person on board at the time of the accedent, caught and preserved most of the light articles which were washed overboard.”
Lewis writes of a later incident in August 1805:
One of their canoes had just overset and all the baggage wet, the medicine box among other articles … Whitehouse had been thrown out of one of the canoes as she swing in a rapid current and the canoe had rubed him and pressed him to the bottom as she passed over him and had the water been 2 inches shallower must inevitably have crushed him to death.
… I heard a voice behind me cry out ‘god god Capt. what shall I do’ on turning about I found it was Windsor who had sliped and fallen …
—Meriwether Lewis, June 7, 1805
Several expedition members experienced serious falls in the rugged mountainous terrain, and Lewis had more than one that could have ended in tragedy. The first occurred within days of his departure from the winter camp near St. Louis. While examining Indian pictographs on rocks soaring three hundred feet above the Missouri River, he slipped and fell twenty feet before stopping himself.
About a year later, in June 1805, incessant rain made the route through the Rockies dangerous and slippery. Lewis recorded his and Private Richard Windsor’s near-death experience in his journal. After slipping at a narrow pass, Lewis saved himself by means of his espontoon from being “precipitated into the river down a craggy precipice of about ninety feet.” He had scarcely reached a place of safety when he heard a voice cry out. Windsor was prostrate on his stomach with his right arm and leg dangling over the precipice. He was barely holding on with his left arm and foot. Lewis calmly directed Windsor to use his right hand to take his knife out of his belt, dig a hole for his right foot to support himself, and crawl to safety.
Foot injuries were particularly common because of rough terrain that was frequently laden with prickly pear cacti. In his journal entry dated June 3, 1805, Lewis writes:
Those who have remained at camp today have been busily engaged in dressing skins for cloathing, notwithstanding that many of them have their feet so mangled and bruised with the stones and rough ground over which they passed barefoot, that they can scarcely walk or stand; at least it is with great pain they do either. For some days past they were unable to wear their mockersons.
The next day Lewis refers to the “great abundance of prickly pears which are extremely troublesome; as the thorns very readily perce the foot through the Mockerson; they are so numerous that it requires one half of the traveler’s attention to avoid them.” The men soon learned to put a double sole on their moccasins to gain some protection from the sharp spines. This was not an option for Lewis’s dog Seaman who, “suffers with them excessively, he is constantly binting and scratching himself as if in a rack of pain.” Clark also complained of prickly pears and one evening pulled out seventeen thorns by the firelight.
The Corps of Discovery encountered this plant throughout the Plains where Lewis wrote that it, “forms one of the beauties as well as the greatest pests of the plains.” The cacti became even more problematic when they left the Missouri and traveled overland around Great Falls in present-day Montana. The ten-mile portage required eleven days and four trips to transport supplies and boats. The explorer’s thin moccasins were not sufficient protection from the sharp spines of the cacti.
While wintering on the west coast, the expedition members sewed 338 pairs of new moccasins to counteract the cold and cacti that they would face on the return journey. In spite of their preparation the travelers suffered on the trip home. In April 1806 Clark states, “most of the party complain of their feet and legs this evening being very sore.” Evidently the Corps of Discovery followed Benjamin Rush’s suggestion to wash their feet in cold water. Clark found this practice provided him with “considerable relief” from the pains and aches of his feet.
Cuts and Lacerations
The men routinely used axes, knives, and adzes. Not surprisingly, they occasionally suffered from self-inflicted lacerations. John Potts badly cut his leg on the return journey, and Lewis had difficulty stopping the bleeding until he applied pressure. According to John Ordway, “Lewis Sowed up the wound and bound it up.” Within four days Pott’s leg was inflamed and painful, but after another five days Lewis was able to write, “Pott’s legg which has been much swollen and inflamed for several days is much better this evening and gives him but little pain, we applied the pounded roots and leaves of the wild ginger from which he found great relief.”
Accidents with Horses
Horses were indispensable to the men for transportation and as a source of food, but also were associated with accidents. On the journey home George Gibson fell while mounting his horse and landed on a snag that penetrated two inches into his thigh. Clark writes that he, “rose early and dressed Gibsons wound … complains of great pain in his Kne and hip as well as his thy … conclude to take Gibson in a litter if is not able to ride on down the river … I derected [John] Shields to … hunt for some Wild Ginger for a Poltice for Gibson’s wound.” A later journal entry indicates that Gibson recovered and resumed walking within two weeks.
On June 30, 1806, in the Bitter Root Mountains Lewis’s horse slipped and fell. Lewis was thrown off the horse backwards and slid forty feet before he grabbed a branch and stopped himself from going further down the steep side of a high hill.
A month and a half before his return to St. Louis, on August 11, 1806, Lewis suffered the only gunshot wound of the expedition. He was hunting elk with Peter Cruzatte, a nearsighted private. Lewis describes the incident in his journal:
I was in the act of firing on the Elk a second time when a ball struck my left thye about an inch below my hip joint, missing the bone it passed through the left thye and cut the thickness of the bullet across the hinder part of the right thye; the stroke was very severe. I took off my cloaths and dressed my wounds myself as well as I could, introducing tents of patent lint into the ball holes, the wounds blead considerably but I was hapy to find that it had touched neither bone nor artery.
Lewis suspected Cruzatte had fired the shot, but Cruzatte did not answer his calls. Lewis then assumed that an Indian had injured him. He raised a general alarm, but within twenty minutes a worried Cruzatte confessed, declaring it had not been “his intention.” Clark continues the journaling and on September 9th states that Lewis, “has entirely recovered his wounds are heeled up and he can walk and even run nearly as well as ever he could, the parts are yet tender.”
“Rained all the last night … I lay in the wet verry cold … The winds violent Trees falling in every direction, whorl winds, with gusts of rain Hail & Thunder, this kind of weather lasted all day, Certainly one of the worst days that ever was!” —William Clark, December 16, 1800
The expedition members were exposed to extreme weather conditions and wild animals. They suffered cold and frostbite, survived hailstorms, tolerated endless days of rain, and endured blowing sand. The explorers’ encounters with living creatures ranged from the annoying gnat to the dangerous grizzly bear. Able to carry only a small portion of the food for their journey, the men were dependent upon their hunting skills and sufficient game. Their diet was frequently inadequate in variety or quantity.
Cold, Wet, and Windy Weather
“Cold,” “verry Cold,” and “excessively Cold” are the words Clark uses to describe the weather during a five day period of the winter of 1804-05. With temperatures dipping to 45 degrees below zero it is not surprising that a number of the expedition members suffered frostbite during their residence at Fort Mandan, located in present day North Dakota. One cold and stormy November day a group led by Lewis searched for game and were stranded on a sand bar. According to John Ordway, they, “had to be out in the water abt 2 hours. The Ice running against their legs. Their close froze on them. One of them got 1 of his feet frost bit.”
The following month another party was out on the prairie, and both Ordway and Clark note the occurrence of frostbite. Ordway writes that two men had frostbitten feet and another a frostbitten ear. Clark records that it was one degree below zero. The next day the temperature registered twelve degrees below zero when Clark led fifteen men on a buffalo hunt and, “Several men returned a little frost bit, one of [the] men with his feet badly frost bit my Servents [York] feet also frosted & his P—s a little.” Evidently York’s afflictions were temporary. In future years his descendents could be found among the Indian tribes along the path of the expedition.
Clark’s journal entry for January 10, 1805, reports that an Indian boy came to the fort with his feet “frosed” after being out all night with only a buffalo robe and no fire. He was treated by putting his feet in cold water with the result of them, “Comeing too.” Unfortunately Lewis had to amputate the boy’s toes from one foot about two weeks later. Not long after Clark notes that he “sawed off the boys toes” from the other foot.
On June 29, 1805, Clark, Charbonneau, and Sacagawea were in a ravine when they narrowly escaped a violent flash flood. The storm also produced hailstones that Clark describes as “7 Inches in circumfrence & waied three ounces.”
The time spent on the west coast was particularly difficult because of the combination of wet and cold. Patrick Gass notes that there were only twelve days without rain from November 4, 1805, to March 25, 1806. He postulates that “rheumatick pains” were a result of the foul weather.
I have been wet and as cold in every part as I ever was in my life.
In the spring of 1805 the expedition was near the Yellowstone River. The winds blew so much sand from the sandbars that visibility was limited and, “so penitrating is this sand that we can not keep any article free from it; in short we are compelled to eat, drink, and breath it very freely.” Sore, irritated eyes became a common complaint, attributed to the sand.
Animal Threats: Bears, Wolves, Buffalo and Snakes
Animals were crucial to the success of the Lewis and Clark Expedition. Horses were vital for transportation and hauling loads. Deer, buffalo, elk, pheasants, rabbit, prairie dogs, wild turkeys, and beaver were hunted for food and pelts. However, encounters with certain animals posed definite risks for the expedition’s men. A wolf bit a slumbering Nathaniel Pryor and then turned to attack Richard Windsor before it was shot. Lewis writes of a near tragedy when a buffalo charged through camp at night while the men were sleeping, “my dog saved us by causing him [the buffalo] to change his course a second time.”
Grizzly bears were a source of more than one frightening experience. Taking a bear down often required multiple shots with muzzle-loaders that took a minute to prime and fire. William Bratton shot a bear through the lungs, but it chased him for half a mile before collapsing. Hugh McNeal was sent to inspect a cache on the return journey and was thrown off his horse in front of a grizzly bear. Unable to fire, he clubbed the bear with his gun, climbed a tree, and waited for the bear to leave before retrieving his horse and returning safely to camp.
The expedition had to contend with rattlesnakes. In Montana, John Ordway accidentally grabbed one as he was reaching for a towing line caught in bushes but escaped unharmed. Three days later Lewis writes of his own encounter, “when I awoke from my sleep today I found a large rattlesnake coiled on the leaning trunk of a tree under the shade of which I had been lying at the distance of about ten feet from him. I killed the snake.” Joseph Whitehouse actually stepped on a rattlesnake and records, “it bit my leggin on my legg I shot it. It was 4 feet 2 Inches long, & 5 Inches & a half round.” Fortunately no rattlesnake seriously injured a member of the expedition. A nonpoisonous snake bit Joseph Field but he, “was quickly doctored by bark by Cap. Lewis.”
Insect Misery: Mosquitoes, Gnats, Flies, and Fleas
… our trio of pests still invade and obstruct us on all occasions, these are the Musquetoes eye knats and prickley pears.
—Meriwether Lewis, July 24, 1805
Insects inflicted misery upon the explorers. In July 1806 Ordway expresses his difficulties as he traveled down the Missouri River, “the Musquetoes and Small flyes are verry troublesome, my face and eyes are Swelled by the poison of those insects which bite verry severe indeed.” Clark describes a miserable night of practically no sleep because of the tormenting mosquitoes. The insects were no less annoying two days later when he writes, “the Musquetors was so noumerous that I could not keep them off my gun long enough to take sight.” Fleas were a troublesome addition acquired from the Indians. They were difficult to eradicate since the men did not have a change of clothes.
Meriwether Lewis did not know that mosquitoes carried disease, however, he did recognize that mosquitoes would be a pesky problem on the journey. While in Philadelphia the spring of 1803, Lewis purchased provisions to arm his men against the war of the mosquito. He bought mosquito curtains and catgut and tallow mixed with hog’s lard to act as an insect repellant. Mosquitoes plagued the expedition and are frequently mentioned in the men’s journals. Interestingly, neither Lewis nor Clark knew how to spell mosquito. Lewis’s most frequent spelling was “musquetoe,” while Clark came up with twenty creative variations such as “mesquetors,” “misqutr,” and “musquetors.”
Malaria and Quinine
“Air tainted by deleterious emanations from animal or vegetable matter, especially noxious exhalations of marshy districts, capable of causing fever or other disease.” — Appletons Medical Dictionary, 1904
A century following the Lewis and Clark Expedition, physicians still assumed that malaria was caused by bad air. Benjamin Rush strongly believed that bad air came from swamps, but he never made the connection that a swamp dweller, the mosquito, carried the disease. Malaria, referred to in the nineteenth century as the “ague,” was the most common disease in the country. Malaria’s symptoms include three stages. In the cold stage the victim faces a sudden onset of fever accompanied by rigor and extreme cold. In the hot stage the sufferer’s temperature can rise up to one hundred and five degrees bringing on an intense headache. In the final stage, extreme and profuse sweating lasting for up to two hours decreases the victim’s temperature. Malaria can continue to affect the victim throughout his or her lifetime.
Historian Stephen Ambrose, writing about the time period of the Lewis and Clark Expedition, states malaria was so “inescapable that many refused to regard it as a disease; like hard work, it was just a part of life.”
There is only one personal reference to malaria in all the journals. Lewis pens, “I was seized with a violent ague which continued about four hours and as usual was succeeded by fever which however fortunately abated in some measure by sunrise the next morning.” In the morning Lewis took a dose of “Rush’s pills” and expressed his satisfaction that he was “entirely clear of fever by the evening.”
Quinine was a necessary staple in the pharmacy brought on the expedition. One third of the total money used to purchase medicines was spent on Peruvian or Cinchona bark. Peruvian bark was first discovered in Peru and was used by seventeenth century Jesuits as medicine. The active ingredient, quinine, does not cure malaria, but rather copes with the disease by interfering with the growth and reproduction of malaria-causing parasites in red blood cells.
On the day the Corps of Discovery departed from Fort Mandan, Lewis writes Jefferson that successful hunting has enabled them, “to reserve the parched meal, portable soup, and a considerable portion of pork and flour, which we had intended for the more difficult parts of our voyage.” The exact composition and consistency of the “portable soup” are unknown, but 193 pounds of it were procured for the trip, and it became a critical source of food, particularly during the men’s return journey through the Rocky Mountains. The pork remained edible for fifteen months because in August 1805 Lewis records, “as we had killed nothing during the day we now boiled and eat the remainder of our pork, having yet a little flour and parched meal.”
Mainly the men subsisted day-to-day on an uncertain and unbalanced diet based on what they could shoot, trade, or forage. At times they were able to supplement their high-protein diet that included dog and horse with berries, wild apples, plums, and vegetables. To feed the forty-five men at Fort Mandan required a buffalo, or an elk and a bear, or four deer each day. Buffalo supplied the most meat, and each man could eat nine pounds of it a day when available. When the hunting was very successful, the Corps dried the extra meat for later use. This jerked meat was probably frequently infected with bacteria and a source of gastrointestinal disorders.
Sometimes the diet was lacking in quantity as well as quality. Traveling westward through the Rockies was particularly difficult as food was meager. Gass writes, “the men are becoming lean and debilitated, on account of the scarcity and poor quality of the provisions on which we subsist.” Whitehouse concurs with, “most of the party is weak and feeble Suffering with hunger.” Lewis mentions dysentery and skin eruptions, probably both related to malnutrition.
… we suffered everything which hunger, cold and fatigue could impose.
—William Clark to George Rogers Clark upon his return to St. Louis, September 23, 1806