Washington, Smallpox, and the Fight for Independence

Living in Colonial America, disease and illness were defining challenges and perpetual threats of human existence.   At the time, there was no concept of infection or germ-theory, no vaccines, no really effective treatments for infectious disease and few public health measures that could reliably curb epidemics.[1]  For colonial Americans, it was not a matter of “if” you would get sick but rather when and would you be strong enough to survive.

George Washington contracted many of the epidemic diseases like malaria, dysentery, and smallpox that plagued colonists and survived despite limited medical intervention.  As a young man in the prime of his life, standing 6’2”tall and weighing over 200 pounds, his body fought a host of illnesses that killed most.  Still, these diseases had lasting effects on Washington’s body and one of the diseases he suffered led to a controversial decision that may have even saved America in its fight for independence.

Smallpox no longer terrifies humanity because it was eradicated in 1977 through a global program of vaccinations.  The devastation this disease caused through history is unrivaled.  By the 17th century, smallpox surpassed all other pandemic diseases as the swiftest and most deadly.[2]

The earliest conclusive evidence for smallpox dates back to 4th century China. It quickly spread through Asia and reached Europe around the 10th century. By the 18th century, it accounted for an estimated 8 to 20% of all deaths.[3] Upon its arrival in the New World, it decimated the Native American population, which had never faced the horrible and highly contagious disease.

Smallpox spread easily through overcrowding and unsanitary conditions.  Symptoms include fever, intense headaches, pains in the back and legs, vomiting, and eruptions of seeping, smelly pustules on the body.  While left with immunity, survivors face debilitating after-effects like disfiguring scars and blindness.[4]

Smallpox pustules on hand

Smallpox pustules on hand. Credit: Centers for Disease Control

While smallpox was a reoccurring problem for larger coastal cities in British North America, it was less prevalent in more inland rural areas. Virginia experienced only minor outbreaks prior to 1747 when large outbreaks hit Williamsburg and Norfolk County causing panic, public unrest, and eventually public health proclamations.[5]

At the time, many offered advice on how to stave off or even cure the disease.  Recommendations in popular medical manuals, like Domestic Medicine, advocated rest, liquids, and various regimens of blistering, purging, and bleeding but not much more.[6] A particularly interesting remedy Virginian planter William Byrd II advocated included drinking large amounts of water “that had stood two days upon tar”.  These methods perhaps relieved symptoms but did little to prevent one from catching the disease.

Inoculation was the one way available to try and prevent smallpox.  A doctor took a bit of infected matter (i.e. pus from a pustule) from a person suffering from a mild case of smallpox and inserted it under the skin of a healthy patient.[7]  Theoretically, the newly infected patient would then develop a mild case of the infection and after recovery be immune to further breakouts.

Inoculation against smallpox in Paris (1807) by Louis Léopold Boilly

Inoculation against smallpox in Paris (1807) by Louis Léopold Boilly. Credit: Public domain / Wikipedia.

Many physicians supported this new technique but inoculation had serious drawbacks.  One of the biggest was the mild case of smallpox in the newly infected patient could become a full-blown attack.  Additionally, people who were inoculated became carriers of the disease, capable of infecting individuals who had never had smallpox or who had not undergone inoculation.  This became a volatile issue because of a lack of understanding of population immunity and ineffective quarantine protocols.[8]

Anti-inoculation sentiments rose in Virginia after people recently inoculated returned to the community and outbreaks followed.  Full-scale riots and protests were seen in Norfolk County  and Williamsburg which led to petitions to ban inoculation. In 1769, Virginia prohibited inoculation unless specifically approved by the county courts.[9]

But how does smallpox and inoculation relate to George Washington, Virginia’s most famous son, and America’s fight for independence?

The connection began on November 2, 1751 when George Washington landed in Bridgetown, Barbados with his half-brother Lawrence. They had come from Virginia to the tropical island seeking relief for Lawrence’s tuberculosis.  Two weeks later, George wrote in his journal that he “was strongly attacked with the smallpox”.  He was confined to his sickbed for nearly a month being too ill to keep his daily journal.[10]  After his battle with smallpox, however, Washington became a major proponent of inoculation even though his support ran counter to most of his fellow Virginians.

Washington House, Barbados

Home of Captain Croftan where Washington lived during the several months he visited Barbados in 1751. Credit: Wikipedia / Jerry E. and Roy Klotz

With the Revolutionary War, smallpox increasingly became a deadly complication for the new United States in its fight for independence.  Where soldiers go plagues follow and when Washington took command of the Continental Army in summer of 1775 he wrote to the president of the Continental Congress that he had been, “particularly attentive to the least Symptoms of the Smallpox” and he would “continue the utmost Vigilance against this most dangerous enemy”.

Outbreaks were particularly common when there was a large buildup of troops in an area like during the Siege of Boston in 1774 or after the battles of Lexington and Concord in April 1775.[11]  Epidemics also broke out in Boston and Philadelphia in summer of 1776 and the attempt by American forces to take Quebec was greatly hindered by smallpox among the soldiers.

In the winter of 1777, Washington decided to have all troops and new recruits inoculated.  As stated in his letter to Dr. William Shippen Jr., “finding the Small pox to be spreading much and fearing that no precaution can prevent it from running through the whole of our army, I have determined that the troops shall be inoculated.  This Expedient may be attended with some inconveniences and some disadvantages, but yet I trust in its consequences will have the most happy effects.  Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army in the natural way and rage with it usual virulence we should have more to dread from it than the Sword of the Enemy.”

Washington understood the great risk he was taking in instituting mass inoculation and effectively incapacitating large numbers of soldiers while they recovered.   The operation was kept secret and done during the winter in the hope that his forces would be healthy and ready to fight in the anticipated summer campaign. Despite some setbacks, Washington’s efforts to eliminate smallpox in the army were largely successful.  While the disease continued to affect soldiers, there were no further epidemic outbreaks among the troops.[12]

Reconstructed winter cabins at Morristown NHP

Reconstructed winter cabins at Morristown National Historical Park in Morristown, New Jersey, where the Continental Army quartered for the winter of 1776-77 and where a large portion of Washington’s troops were inoculated. Credit: National Park Service / Steve Santucci

George Washington’s insistence in these preventive health measures and his belief in the effectiveness of inoculation helped the Continental Army conquer smallpox and become a more reliable military force.  Additionally, the success of mass inoculation within the fledgling nation’s military helped encourage the civilian population to use these preventative measures. Inoculation began to gain popularity with Virginians and all of the American people.  So, young Washington’s trip to Barbados when he was nineteen was unsuccessful in helping his brother’s tuberculosis but it did end up giving him a greater appreciation for preventive medicine and the devastating power of epidemic disease.

Heather Baldus
Collections Manager

[1] “The Perpetual Challenge of Infectious Diseases”, Anthony S. Fauci and David M. Morens, The New England Journal of Medicine, 2 February 2012.

[2]  Kotar, S.L., and J.E. Gessler. Smallpox: A History. McFarland, 2013. pg 11

[3] The Seat of Death and Terror: Urbanization, Stunting, and Smallpox by Deborah Oxley, The Economic History Review, November 2003,  pg 5, 627

[4] Kotar, pg 4; Oxley, 628

[5] Kotar, 41

[6] Domestic Medicine, William Buchan, 1769

[7] Oxley, 629

[8] Kotar, 13

[9] Kotar, 41

[10] Kotar, 40

[11] Kotar, 42

[12] “Smallpox in Washington’s Army: Strategic Implications of the Disease during the American Revolutionary War”, Ann M. Becker, The Journal of Military History, Vol. 68, No 2. (Apr. 2004), pg. 424-430

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George Washington’s Troublesome Teeth

It’s probably the myth that is more enduring and widespread than any other about George Washington.  At some point from someone, you have heard that George Washington’s false teeth were made of wood.  It is not true.  In reality, his dentures and dental tribulations were more complex than the familiar myth says.  The true story, even when it is uncertain, reveals much more about his life and about life in general in the 18th century.

George Washington by Gilbert Stuart (1798)

George Washington by Gilbert Stuart (1798). Washington’s dental troubles are even apparent on his face. As the result of his dentures, he kept his mouth closed tightly and the false teeth caused the area around his lips, his lower jaw, and his chin to protrude slightly. Credit: Clark Art Institute

George Washington had a tooth pulled for the first time in 1756 at the age of 24.  Four years later, George Mercer described Washington’s appearance in a letter, saying “His mouth is large and generally firmly closed, but which from time to time discloses some defective teeth.”   By the time of his first inauguration as president in 1789, George had only one tooth left.

John Adams by Gilbert Stuart (1821)

John Adams by Gilbert Stuart (1821) Credit: National Gallery of Art

The causes of George’s dental problems will never be known with certainty.  According to John Adams, Washington himself “attributed his misfortune to cracking of Walnuts in his Youth.”  Furthermore, Adams hints at one additional potential factor: the common use of mercury in medicine during the 18th century.  Adams described how his doctors gave him sizable quantities of mercury when he was inoculated for smallpox.  The result was, he said, “that every tooth in my head became so loose that I believe I could have pulled them all with my Thumb and finger.”  Adams complained that his doctors “rendered me incapable  …of speaking or eating in my old Age, in short they brought me into the same Situation with my Friend Washington.”

Washington House, Barbados

Home of Captain Croftan where Washington lived during the several months he visited Barbados in 1751. Credit: Wikipedia / Jerry E. and Roy Klotz

For what it’s worth, nineteen-year-old Washington contracted smallpox in November 1751 during a stay in Barbados.  Constantly attended by Dr. John Lanahan, he was sick for 25 days before finally fighting off the deadly disease.  We have no records to tell us precisely how Lanahan treated Washington.  If we consult pages 28-29 of A Rational and Mechanical Essay on the Small Pox published in 1735 by Dr. William Hillary, we find a three-phase course of treatment for pox sufferers. “The first, by bleeding in the first Stations of the Disease; when the Fever is violent: The second by introducing the Practice of Purging, (and Bleeding) in the most dangerous Circumstances attending the second Fever.”  The third phase was employing all known methods to reduce inflammation.  All phases were typical medical practice at the time.

The purging phase of smallpox treatment is when mercury may have become involved.  The most popular concoction to induce purging in the 18th century was called calomel.  It “was a white tasteless powder which consisted of mercury chloride. When taken in small doses calomel led to the evacuation of the bowels.  If taken over time or in heavier doses, calomel induced heavy salivation, bleeding gums, mouth sores, tooth loss.”  Again, in describing his own brush with smallpox, John Adams noted that his doctors “salivated me to such a degree” with “Milk and Mercury” that all his teeth became terribly loose.

Young Washington survived his smallpox attack but literally carried the scars of the illness for life.  Back at Ferry Farm in January 1752, Mary Washington twice purchased some ointment from Dr. Sunderland (Sutherland?) to deal with George’s pox-caused facial scars.  The same bill also included a “mercurial purging” for someone. [1]  We should not definitively conclude that medicinal mercury caused George’s life-long dental troubles.  Like most things in history, his difficulties probably had a mix of causes common to the 1700s, including diseases and  “ poorly balanced diet . . . as well as genetics.”

Regardless of the reasons for George’s defective teeth, Washington ultimately proved “very wise about the message an image can send, and knew that . . . he had to look the part of a leader… which meant at least having teeth.”

George Washington - Full Dentures, Now Incomplete Set

A set of Washington’s dentures as once owned by the Baltimore College of Dental Surgery, Dental School, University of Maryland. This older image shows both the lower and upper portions. Only the lower portion of these dentures is now present and on display at Baltimore’s Dr. Samuel D. Harris National Museum of Dentistry. Credit: National Museum of Dentistry

Baker's Ad in the VA Gazette

John Baker advertised his services as a Surgeon Dentist in the January 2, 1772 edition of the Virginia Gazette.

Accordingly, as he lost more teeth, George replaced them with partial dentures and then eventually full dentures.  Surgeon Dentist John Baker, who we first wrote about here, became George’s regular dentist in 1772.  Baker stayed at Mount Vernon in October 1773 and received two substantial payments of £8 total from Washington that same month.  Baker was the first to make false teeth for George, creating a partial denture of ivory for wiring to his natural teeth.

The tooth loss continued, however.  In 1783,Washington asked Baker “for some of the Plaister of Paris, or that white powder with which you take (in wax) the Model of the Mouth for your false teeth—and directions how to mix, & make use of it—When you have done this, I can then give you such a Model as will enable you to furnish me with what I want.”  It seems it was time for another new set of dentures.

A month later, though, Washington took on a new dentist: Jean-Pierre Le Mayuer, who probably made him another partial denture.  Additionally, Le Mayuer practiced the relatively common 18th century dental technique of transplanting, in his words, “good living teeth in the Room of those which were broken or otherwise decayed.”  At first, Washington seemed skeptical about the practice.  He needed to replace his teeth but “(not by transplantation, for of this I have no idea, even with young people, and sure I am it cannot succeed with old).”  Eventually, his mind seemed to be changed somewhat by Richard Varick’s testimony of Le Mayuer’s skills.  That said, there’s little recorded describing the care Le Mayuer provided Washington.

Despite George’s skepticism, Le Mayeur’s use of human teeth in his practice was not unusual for the time. A patient’s own pulled teeth might be used in their dentures.  Teeth from other people, especially the poor and enslaved, were bought and even harvested from the dead for use in dentures or transplanting.  In fact, “Wherever Dr. Le Mayuer practiced, he sought out through newspaper ads ‘Persons who are willing to dispose of their Front Teeth.’  While in New York, he advertised that he would pay two guineas each for good front teeth; in Richmond, he stipulated ‘slaves excepted.’”  Did this mean Le Mayeur would not pay for teeth from slaves or is it a Frenchman’s corruption of the word “accepted”?  It seems, in fact, he was willing to pay for the teeth of enslaved people for, in May 1784, Lund Washington, who was managing Mount Vernon while George commanded the Continental Army, recorded just over £6 “cash pd Negroes for 9 Teeth on Acct of Dr. Lemoire.”

Washington definitely used human teeth in his dentures but we do not know if they were teeth from slaves.  He probably did use his own in some dentures.  Back in 1782, when John Baker was still his dentist, George wrote to Lund Washington instructing him that “In a drawer, in the Locker of the Desk which stands in my Study, you will find two small (fore) teeth; which I beg of you to wrap up carefully, & send inclosed in your next Letter to me. I am positive I left them there, or in the secret drawer in the locker of the same desk.”  It is believed “Washington hoped that these original teeth could be used within new dentures that were being fitted for his use.”

George Washington - Full Dentures, Complete Set

Washington dentures made by John Greenwood. Courtesy of Mount Vernon Ladies’ Association.

John Greenwood

Engraving of John Greenwood by Roy Peintre. Credit: Library of Congress

“The only complete set of Washington’s dentures that still survives . . . is made of animal and human teeth, lead, and ivory.”  John Greenwood, who served as Washington’s dentist throughout the 1790s, made them out of hippopotamus ivory, horse or donkey teeth, human teeth, gold wire springs, brass screws, and lead.  Greenwood left a gap in this set for the one remaining tooth Washington had left.  Inevitably, that tooth finally had to be pulled and Washington presented Greenwood with this tooth as a gift, which hung on his watch chain inside a glass locket.

 

George Washington suffered a lifetime of dental troubles.  The causes of those troubles and the attempted solutions were typical of the 18th century and teach us much about both Washington’s life and the lives of his fellow early Americans. The real story of Washington’s false teeth, even when uncertain, reveals more about his life and his times than any stale wooden myth.

Zac Cunningham
Manager of Educational Programs

[1] Paula Felder, Fielding Lewis and the Washington Family: A Chronicle of 18th Century Fredericksburg, The American History Company, 1998: 103.