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Excerpts from: Medical Aspects of the Lewis and Clark Expedition (1804–1806)☆☆☆◊

2003; Elsevier BV; Volume: 14; Issue: 4 Linguagem: Inglês

10.1580/1080-6032(2003)14[265

1545-1534

O. Larsell,

Plant-Derived Bioactive Compounds

THE Lewis and Clark Expedition (1804–1806), sent by President Thomas Jefferson to the Columbia River, has had so important an effect on the subsequent history of the Pacific Northwest that all aspects of this epochal journey are of great interest. As leader of the Expedition, President Jefferson selected Captain Meriwether Lewis (1774–1809), of the United States Infantry. Lewis was an educated man with unusual qualities of leadership, and had been Jefferson's private secretary. He asked that William Clark (1770–1838), a 2nd lieutenant in the United States Artillery and a brother of George Rogers Clark, the well known Indian fighter, be appointed co-leader. Both men were born near Charlottesville, Virginia. Clark served as equal to Lewis in command of the Expedition and the leaders are referred to as Captains Lewis and Clark in historical records. Clark was a frontiersman and soldier of much experience and contributed greatly to the success of the venture. No regular physician was provided, but Lewis had sufficient medical knowledge to treat many of the ills of his company and Clark knew the simple medical practices of frontier life. After collecting the necessary supplies and selecting a personnel of 27 men, the captains placed the Expedition into winter quarters at River du Bois, near St. Louis, late in 1803. Rigorous training during the winter fitted the men for the anticipated hardships of the journey. The party, with 15 or 16 additional men 1Clark, Charles G. Oregon Historical Quarterly, 1944, 45: 289–305.1Clark, Charles G. Oregon Historical Quarterly, 1944, 45: 289–305. who were to go only part of the way, started up the Missouri River in three boats on May 14, 1804. Its instructions were to make a geographical exploration of the country they were to traverse and to gather information about its natural history and the Indian tribes. Lewis wrote to President Jefferson on May 29, 1803, as follows:“Dr. Rush has favored me with some abstract queries under the several heads of Physical History, Medicine, morals and religion of the Indians, which I have no doubt will be serviceable in directing my inquiries among that people. Drs. Barton and Wister have each promised to contribute in like manner anything, which may suggest itself to them as being of any importance in furthering the objects of this expedition.” 2Original Journals of the Lewis and Clark Expedition, 1804–1806. Thwaites ed. New York: Dodd, Mead and Co., 1905, 7: 224.2Original Journals of the Lewis and Clark Expedition, 1804–1806. Thwaites ed. New York: Dodd, Mead and Co., 1905, 7: 224. The physicians to whom Lewis refers were Dr. Benjamin Rush (1745–1813), Dr. Benjamin Smith Barton (1766–1815), and Dr. Caspar Wistar (1760–1818), all of Philadelphia. Dr. Rush was the outstanding American physician of that day and was professor of the institutes and theory and practice of medicine in the University of Pennsylvania. Dr. Barton 3Middleton, William S. Ann. M. History, 1936, 8: 477–491.3Middleton, William S. Ann. M. History, 1936, 8: 477–491. was professor of natural history and botany, succeeding to Dr. Rush's chair at the death of the latter in 1813. He had become greatly interested in the Indians as a young man and was an authority on the subject. Dr. Wistar was professor of anatomy in the university and wrote the first American textbook on anatomy. To aid in obtaining information about the Indians, the following list of queries resulted, as recorded by Captain Clark under the heading of “Physical History and Medicine”: 4Lewis and Clark Expedition, 7: 283.4Lewis and Clark Expedition, 7: 283.“What is their State of Life as to longivity?“At what age do both sexes usually marry?“How long do the Woman usually succle their Children?“What is the diet of their Children after they wean them?“Is polygamy admitted among them?“What is the State of the pulse in both Sexes, Children, grown persons, and in old age, by feeling the Pulse Morning, Noon & Night & c.?“What is their most general diet, manner of cooking, time and manner of eating; and how do they preserve their provisions?“What time do they usually consume in Sleep?“What are their acute diseases?“Is rheumatism, Pluricy or bilious fevers known among them? & does the latter ever terminate in a vomiting of black matter?“What are their chronic diseases—are palsy, apoplexy, Epilepsy, Madness, the goitre (or Swelled Neck) and the Venereal disease known among them?“What is their mode of treating the Smallpox particularly?“Have they any other disease amongst them, and what are they?“What are their remidies for their different diseases?“Are artificial discharges of blood used among them?“In what manner do they generally induce evacuation?“Do they ever use Voluntary fasting?“What is the nature of their baths, and at what time of day do they generally use them?“At what age do their women begin and cease to menstruate?” In addition to preparing for his inquiries among the Indians, Lewis made provision against illness in his own party. In 1803 he estimated that the expense of the expedition would be $2500, of which $55 was for medicines and packing. He drew up a list of items needed as medical supplies. The items actually purchased represent some modification of the original list and are indicated in the following statement: 5Lewis and Clark Expedition, 7: 236.5Lewis and Clark Expedition, 7: 236.“Bill of Gillaspy & Strong for Medicine“Israel Wheelen Purveyour Bought of Gillaspy & Strong the following articles for the use of M. Lewis Esquire on his tour up the Missisipi River & Supplied by his Order:—Viz. The total bill was somewhat in excess of the original estimate. While in St. Louis the Expedition was supplied by Dr. Antoine Francois Saugrain with additional packages of medicines, a home-made thermometer, and some experimental Lucifer matches. Saugrain was a pioneer among the scientists of the Ohio and Mississippi Valleys, with hobbies of chemistry and electricity. 6E. S. Meany, Washington Hist. Quart., 1931, 22: 295–311.6E. S. Meany, Washington Hist. Quart., 1931, 22: 295–311. He no doubt attracted Meriwether Lewis, especially, who was near him from December 12, 1803, to May 20, 1804, the party having started nearly a week before Lewis himself left St. Louis. Very likely Lewis added considerably to his own stock of medical knowledge from contact with the doctor. At the beginning of their travel up the Missouri River the men were in fine condition. In the early part of the journey there is but little mention of medical matters, but on July 23, Clark wrote in his journal 7Lewis and Clark Expedition, 1: 89.7Lewis and Clark Expedition, 1: 89. that one man had a tumor on his breast, which he later opened. A week later several of the men had bad boils. Near the present site of Dakota City, Nebraska, on August 14, Clark makes mention of a village of Indians which had been wiped out by smallpox 4 years earlier, stating that the huts had been burned and the wives and children had been put to death “with a view of them all going to a better country.” 8Lewis and Clark Expedition, 1: 110.8Lewis and Clark Expedition, 1: 110. Four days later, near the present site of Sioux City, Iowa, he wrote: “Serjeant Floyd is taken verry bad all at once with Biliose Chorlick we attempt to relieve him without success as yet.” The patient died on the 20th “with a great deal of Composure.” 9Lewis and Clark Expedition, 1: 114.9Lewis and Clark Expedition, 1: 114. This was the only death suffered by the party during the entire expedition. On August 22, there is the item that the men had been troubled with stomach disorders, since leaving the Sioux River, from using water of the Missouri River on which floated a scum of mineral matter from a bluff upstream. According to Clark this scum contained alum, copperas, cobalt and pyrites. Lewis took a “Dost of Salts” to work off the effects of tasting some of the rock from which the material came. The fall of 1804 found the party at the site of Bismarck, North Dakota, where it prepared to winter among the Mandan Indians. Clark's journal contains a notation, dated October 22, stating: “last night at 1 oClock I was violently and Suddenly attacked with the Rhumetism in the neck [probably spasmodic torticollis] which was So violent I could not move. Capt [Lewis] applied a hot Stone raped in flannel, which gave me some temporey ease.” 10Lewis and Clark Expedition, 1: 202.10Lewis and Clark Expedition, 1: 202. Clark suffered from this attack for several days and on the 25th he adds: “R. Fields with Rhumitism in his neck, P. Crusat with the Same complaint in his Legs—the party other wise is well, as to myself I feel but slight Simptoms of that disorder at this time.” 11Lewis and Clark Expedition, 1: 206.11Lewis and Clark Expedition, 1: 206. A more serious problem, however, soon confronted the leaders, namely, venereal infection of the men from the Mandan women. This involved diplomacy in dealing with the Indians as well as medical treatment and discipline of the men, who were ordered not to touch the wife of any Indian. The orders apparently were disobeyed, or unmarried squaws were available, and on January 14 (1805), Clark writes of sending Sergeant Pryor and five men, with some Indians, to hunt several men who had become infected. On the 21st he writes: “One man verry bad with the pox.” 12Lewis and Clark Expedition, 1: 250.12Lewis and Clark Expedition, 1: 250. On November 29, 1804, there is a brief note: “Sergeant Pryor in takeing down the mast put his Sholder out of Place, we made four trials before we replaced it.” 13Lewis and Clark Expedition, 1: 229.13Lewis and Clark Expedition, 1: 229. Cold weather also brought frostbite to several of the men and on January 26 Clark wrote: “one man taken violently Bad with the Plurisie, Bleed & apply those remedies Common to that disorder.” 14Lewis and Clark Expedition, 1: 251.14Lewis and Clark Expedition, 1: 251. On February 11, 1805, Sacajawea, one of the wives of Toussaint Charbonneau, an interpreter engaged by the captains at the winter camp, “was delivered of a fine boy.” 15Lewis and Clark Expedition, 1: 257.15Lewis and Clark Expedition, 1: 257. Charbonneau had two other wives among the Mandans but only Sacajawea accompanied him with the Expedition when it resumed its journey. This Shoshone girl, who was the only woman with the Expedition, had been purchased by Charbonneau from Indians who had taken her captive from her tribe as a little girl. She played a role in the later history of the Expedition by gaining a friendly reception for the half-starved party when it reached her own country of the Shoshone Indians, in southwestern Montana. The boy born at Mandan was Sacajawea's first child and the labor was tedious and painful. Clark continued:“Mr. Jessome informed me that he had frequently administered a small portion of the rattle of the rattle-snake, which he assured me had never failed to produce the desired effect, that of hastening the birth of the child; having the rattle of a snake by me I gave it to him and he administered two rings of it to the woman broken in small pieces with the fingers and added to a small quantity of water. Whether this medicine was truly the cause or not I shall not undertake to determine, but I was informed that she had not taken more than ten minutes before she brought forth; perhaps this remedy may be worthy of future experiments, but I must confess that I want faith as to it's efficacy.” 16Lewis and Clark Expedition, 1: 258.16Lewis and Clark Expedition, 1: 258. The last item of medical interest noted by Clark at the Mandan village bears the date of February 15. He wrote:“one Chief of the Mandans returned from Capt. Lewises Party nearly blind, this Complaint is as I am informed Common at this Season of the year and caused by the reflection of the Sun on the ice & Snow, it is cured by jentilley swetting the part affected, by throwing Snow on a hot Stone.” 17Lewis and Clark Expedition, 1: 202.17Lewis and Clark Expedition, 1: 202. The journey up the Missouri was resumed on April 7, 1805, but little of medical interest is recorded. On May 14, while on the Yellowstone River, one of the boats which contained the medical supplies was swamped. 18Lewis and Clark Expedition, 2: 37.18Lewis and Clark Expedition, 2: 37. Much of the material was damaged and some was destroyed. Between Maria's River and the Great Falls of the Missouri, on June 10, Sacajawea fell ill. Clark wrote: “I blead her.” 19Lewis and Clark Expedition, 2: 141.19Lewis and Clark Expedition, 2: 141. Four days later Clark noted:“the Indian woman complaining all night & excessively bad this morning. her case is somewhat dangerous. two Men with the Toothake, 2 with Tumers & one man with a Tumer & a slight fever.” 20Lewis and Clark Expedition, 2: 159.20Lewis and Clark Expedition, 2: 159.On June 16 Lewis wrote in his journal concerning Sacajawea, who had not yet recovered, that two doses of barks and opium had slowed and strengthened her pulse and made it more regular. He had found it almost imperceptible, or very fast and irregular when it could be felt. There also was twitching of the fingers and of the “leader” of the arm. In addition to “barks” and opium, Clark prescribed mineral water for her. The pulse improved, the twitching was reduced and a gentle perspiration came on, with much relief from pain. The woman complained chiefly of distress in the lower abdomen, Clark ascribing it to “an obstructions of the mensis in consequence of taking could.” 21Lewis and Clark Expedition, 2: 104.21Lewis and Clark Expedition, 2: 104. He continued treatment with barks and laudanum. The party reached Sacajawea's people in the middle of the summer of 1805, its food supplies exhausted, and in serious straits because of this and the scarcity of game. The Shoshone chief proved to be Sacajawea's brother, and a touching story of the reunion is related. The half-starved explorers were supplied with the provisions enough to meet their immediate needs from the Shoshone's own meager store, and the expedition, which had found itself in an almost desperate situation, was enabled to continue its journey. The party pushed westward through the Rocky Mountains in September. Food was scarce, due to the lack of game, which was limited to a few pheasants and squirrels. Fish and roots formed a large part of the diet. The going became more and more difficult and the men became weak and debilitated, many suffering from dysentery and skin eruptions. Finally they were obliged to kill a colt for food. On September 21 Clark wrote: “I am very sick today and puke which relive me.” 22Lewis and Clark Expedition, 3: 82.22Lewis and Clark Expedition, 3: 82. On the 24th he continued: “Capt. Lewis sick all Complain of a Lax & heaviness at the stomack. I gave rushes Pills to several,” eight or more of the men also being ill. On the following day he wrote that Lewis was very sick, and most of the party was complaining. He gave them salts and tartar emetic. He added, “Several men So unwell that they were compelled to lie on the Side of the road for Some time, others obliged to be put on horses. I gave rushes Pills to the Sick this evening.” 23Lewis and Clark Expedition, 3: 86, 87, 88.23Lewis and Clark Expedition, 3: 86, 87, 88. Several deer were killed on September 30 and the condition of the men immediately improved with better food. However, in a few days the party was obliged to return to dried salmon and roots, with renewed gastrointestinal disorders. Not until they reached the Columbia, near the junction of the Snake River, on October 16, were they able to obtain fresh meat, in the form of “some nice fat dogs” which they purchased from the Indians. Everyone's health immediately improved. One of the leaders notes that he came to like the meat of “nice fat puppies.” While in western Montana, Lewis wrote that he tried to learn if the Shoshones had venereal disease among them, and to find out their remedies. Through the interpreter and his wife he was informed that sometimes they were affected, but he was unable to learn of any remedy they employed. “They most usually died of its effects.” The captain thought that, because of the isolation of this tribe, both gonorrhea and syphilis must be native to America although he recognized that smallpox, from which the Shoshones as well as most of the other tribes had suffered severely, was an imported disease. He also made some observations regarding standards of sexual morality, stating that “some of their women appear to be held more sacred than in any nation we have seen.” However, this was but comparative, and control appeared to be entirely in the hands of the husband, who for a suitable reward would barter his wife “for a night or longer.” With reference to childbirth among the natives, Lewis comments on the ease of delivery when the father was an Indian. He notes that when one of the Shoshone Indian women who had been helping the party transport its baggage had halted at a little stream, he inquired of the chief as to the reason. The latter informed him that the woman had stopped to deliver her fourth child and would soon overtake the party. This she did in about an hour, with her newborn babe, apparently as well as ever. Clark wrote on October 17, 1805, of the numerous cases of sore eyes which he encountered among the natives, not only in the region of Kennewick, Washington, where the party then was, but among the Flatheads on the Kooskooske and Lewis Rivers which they had left some time earlier. Many of the Indians were blind in one or both eyes. Many of the natives also had lost their teeth at middle age, and in others the teeth were worn to the gums, especially in the upper jaw. He ascribed the bad teeth, in part, to the habit among the Indians of eating the “rine & scales” of the dried salmon, which constituted a large item of their diet, along with the flesh, and to sand attached to the edible roots which supplemented the salmon. 24Lewis and Clark Expedition, 3: 126.24Lewis and Clark Expedition, 3: 126. On November 15, 1805, the Expedition arrived at the mouth of the Columbia River after traveling 4134 miles, according to Lewis's estimate. 25Elliott Coues, ed., History of Lewis and Clark Expedition (1893), 6: 74.25Elliott Coues, ed., History of Lewis and Clark Expedition (1893), 6: 74. Alexander MacKenzie had reached the western ocean through Canada in 1793, but Lewis and Clark were the first explorers to reach the Pacific by crossing the continent between the Canadian boundary and Mexico. Valuable observations and collections had been made and Indian tribes never before seen by the white man had been encountered. After crossing to the south side of the river they built winter quarters at Fort Clatsop, south of the present city of Astoria. The party reached the mouth of the Columbia at the worst part of the rainy season and was faced with a good deal of discomfort until quarters could be completed. Dated December 11 we find this entry: “rained all last night moderately. We are all employed putting up huts or Cabins for our winter quarters.” 26Lewis and Clark Expedition, Thwaites ed., 3: 277.26Lewis and Clark Expedition, Thwaites ed., 3: 277. Several of the men were beginning to suffer from the excessive dampness; four of them had violent colds, one had dysentery, a third had tumors on his legs, and two had been injured by dislocations and strains. Here again the problem of food obtruded itself. The Indians, who had learned to barter with the Boston ships and other fur traders, demanded high prices for everything they sold. On December 3 an elk was brought in, providing a much needed change of diet. Seven more elk were killed shortly afterward, but because of unusually warm weather much of the meat spoiled and the party had to resort to pounded fish again, resulting in the usual dysentery and weakness. On December 30 four more elk were shot, but the animals became scarcer as colder weather came on so that dog meat, blubber from a stranded whale, roots and berries served as food for a time. The captains remark that the men had acquired a taste for the flesh of dogs and that while living on it they were in better condition and health than at any time since leaving the buffalo country. In the early spring the annual run of the smelt or eulachon into the rivers from the ocean brought a welcome change of diet in great abundance. From this time on the food supply appears to have been adequate, both for the short remaining time at Fort Clatsop and on the journey eastward. A salt cairn, for the purpose of obtaining salt from sea water, had been built by the party at the site of the present town of Seaside, Oregon, some miles from Fort Clatsop. There is also complaint about the incessant rain and the innumerable fleas. The Indians and their lodges abounded with these vermin which could not be kept out of the crowded quarters of the party. Other discomforts are mentioned by Clark as follows: “Sergeant Pryor unwell from dislocation of the shoulder, Gibson with the dysentery, Jo Fields with biles on his legs and Werner with a strained knee.” The sexual standards of the women of the Chinook tribe were unusually lax and venereal disease, already introduced by sailors from the fur trading ships, is frequently mentioned. While on a short journey on November 18, Clark encountered some Chinook Indians and noted that he saw four women and some children covered with sores, scabs and ulcers, which he regarded as due to venereal disease. The Clatsop Indians also were commented on. The young women, many of whom were handsome, sought the men of the exploring party, apparently with the approbation of their friends and relatives. To save the party's supply of knives and other more valuable articles, the captains divided some ribbon among the men of the party to “bestow on their favorite lassies.” Several of the men soon became infected with venereal disease. They were treated with mercury, some to the point of salivation. Although Lewis and Clark found venereal disease very prevalent among the Chinooks and Clatsops who inhabited the region about the mouth of the Columbia River, the early explorers and fur-traders make no mention of it or of other diseases among the Oregon Indians, save smallpox. Robert Gray, in 1792, does not mention it, and Captain Bishop of the ship Ruby, who spent some time among the Chinooks in 1795 and described the natives in detail, does not refer to syphilis. Yet 10 years later it was widespread, and by 1814 had reached epidemic proportions among the fur-traders from their contact with native women. Undoubtedly syphilis and its companion, gonorrhea, were introduced by the crews of the fur trading ships that came in increasing numbers. Spread of these diseases was facilitated among the Clatsops and Chinooks, especially, by the low sexual standards of these tribes on which comment was made by virtually all of the earlier writers. Regarding the Indians, Lewis stated that once contracted by them venereal disease continued during life, always ending in decrepitude, death or premature old age, although as he thought, from the use of certain plants, together with their diet they did not suffer great inconvenience. He regarded this as especially true among the Chippewa Indians, farther east, who used a decoction of lobelia and of a species of sumac. These decoctions were drunk in liberal quantities and were regarded by Lewis as effective both in syphilis and gonorrhea. Under the date of February 7, 1806, Lewis wrote that the smallpox had carried off a large number of natives near the mouth of the Columbia. The disease had prevailed 4 or 5 years earlier among the Clatsops and destroyed several hundreds of them. He regarded this epidemic as accounting for the deserted villages along the coast toward the Tillamook district. During the stay of the party at Fort Clatsop the Indians frequently brought their sick to the captains for treatment. Many of the natives benefited from the medicines administered. One young Clatsop chief, cured of some ailment, brought his sister to Captain Lewis as a reward. The captain refused her, much to the chagrin of the chief as well as of the damsel, who after remaining about the door of Lewis's quarters for some time departed, as had the brother earlier. The party began its homeward journey on March 23, 1806. It explored the Williamette River as far as the present site of Portland, and continued eastward along the south bank of the Columbia. The large number of eye ailments among the Indians again impressed the leaders. Clark wrote on April 8, when the party was between the Sandy River and The Dalles, concerning an Indian woman who was blind in one eye, and of a man nearly blind in both eyes. He stated that blindness appeared to be more common among the natives of the Columbia than among any other people he had ever observed, and that they almost invariably had sore eyes at all ages, with the loss of one eye very common, and complete blindness almost invariable in old age. Clark, like others who commented on this affliction among the Columbia River Indians, was inclined to ascribe it to the reflection of the sun on the water to which the Indians were constantly exposed while fishing and to the fine sands carried by the wind. It is now known that trachoma was very prevalent among many Indian tribes. This disease no doubt caused the eye conditions which the explorers commented upon. The contact with the white men the previous fall had evidently given the Indians along the Columbia a great deal of confidence in the medical ability of the captains. On April 28, between The Dalles and Walla Walla, Clark stated in his journal that several sick persons were brought to the captains for medical aid. One had a knee contracted by rheumatism, another had a broken arm, etc. All were treated, much to their gratifications. They were given some eye water which Clark thought would be of more help to them than any other article the party could offer them. They continued their search for answers to the questions concerning medical matters among the Indians. Lewis wrote on April 30 of trading one of their poorest horses for a very good one with a Chopunnish Indian. He commented on the practice of segregation of menstruating women from the remainder of the family. The daughter of this Indian, having arrived at the age of puberty, was obliged to sleep at a distance from her father's camp and when travelling to follow at some distance behind. At other camps of this Chopunnish tribe he observed a small lodge with one fire which served as a retreat for the women during menstruation. The men were permitted to approach no nearer than fifty to sixty paces from this lodge, and if they desired to convey anything to the occupants they would throw it toward the hut as far as they could and retire. Clark wrote May 5 of giving a native some volatile liniment to rub on his knee and thigh for pain. The Indian soon recovered and “has never ceased to extol the virtue of our medicine.” The previous fall, near Kooskooske River, an Indian had been encountered who could not walk because of a tumor on his thigh. Clark wrote on the return trip that he gave him a gentle purge, cleaned and dressed his sore and left him some castile soap to wash the sore, which soon got well. This man also credited the captain with curing him, the two cures having given the natives an exalted opinion of Clark's skill as a physician. They came to him in considerable numbers for relief from various ills. The captains considered it pardonable “to continue this deception,” namely that they were skilled healers, for the Indians would not furnish any provisions without compensation in merchandise and the party's stock of goods by now was greatly reduced. Clark added that he and Lewis took care to give the Indians nothing which could possibly injure them, and that many times medical and surgical relief was afforded “in simple cases.” Lewis noted that scrofula, ulcers, rheumatism, sore eyes and the loss of use of their limbs were the most common types of ailments among the Indians of the Columbia. Regarding paralysis of the extremities he wrote that he had seen three instances among the Chopunnish. A chief of considerable note had been afflicted with it for 3 years, being incapable of moving a single limb and lying like a corpse in whatever position he was placed. Yet he ate heartily, assimilated his food, and was in a good state of nutrition. His pulse was good and he understood what went on about him. Lewis thought that the natives’ diet of roots and other plants was in part responsible for some of their ailments. While the party was on the upper Kooskooske River (in Idaho), Clark wrote on May 24 that one of his men (Bratton) was very low, eating heartily, but being so weak in the small of his back as to be unable to walk, although every remedy had been employed. One of the men stated that he had seen similar cases restored to health by violent sweats, so at the request of the patient this treatment was undertaken. A hot fire was made in a hole four feet deep and three feet in diameter, dug for the purpose. After burning long enough to thoroughly heat the ground, the fire was withdrawn, a seat was placed in the hole, the patient being placed thereon, with a board under his feet for protection. The hole was covered with blankets, supported by hoops, and a receptacle of water was handed the patient, with instructions to throw the water on the bottom and sides of the hole. After about twenty minutes in the steambath thus produced the patient was removed and placed into cold water for a few minutes. He then was returned to the hole for about an hour, removed again and covered with blankets which were removed one by one until the man cooled off. The account concludes: “This remedy took place yesterday and Bratton is walking about today and is much better than he has been.” The Indians requested that the same treatment be applied to the paralyzed chief previously mentioned. The latter was so disabled that he could not sit up at the first attempt, but by arranging a system of thongs, and guy ropes to support him, a second attempt was successful. He suffered some shock, and was given twenty drops of laudanum. The following day he could use his hands and arms. After several repetitions of the treatment he became able to use his legs and felt perfectly well. There is little in the description of either of these cases or their treatment to aid in diagnosis. Since the sweat-bath treatment was widely used by the Indians themselves in all parts of the continent, it could hardly have been new to this tribe in the Rockies, but perhaps the white man's modifications of it and the results they had seen on Bratton caused them to have it tried on the chief. On reaching the Bitter Root Mountains the party divided into two groups for further exploration and to recover supplies and canoes cached at different points on the westward journey. It was reunited on August 12, 1806, near the junction of the Yellowstone and Missouri Rivers, according to plan. Just before the two groups were joined, Captain Lewis was accidentally shot in the leg, while hunting, and for a time was seriously ill. Captain Clark was obliged to assume responsibility for the rest of the journey which was resumed on August 17, the party proceeding down the Missouri River. Five days after he was injured Lewis recovered sufficiently to be able to walk for the first time. After crossing the continental divide and leaving the Oregon Country on the eastward journey, the medical notes, as well as notes on other matters, are scanty. The effects of contact with the luetic Mandan, Chinook and Clatsop women remained with some of the men, who were taken to the Great Falls of Missouri for rest and treatment with mercury. This item and the wound received by Lewis constitute the chief entrees of medical interest. The party visited a few days with the Mandan Indians with whom it had spent the winter of 1804–05, and then continued the journey down the Missouri, reaching St. Louis on September 23, 1806. The epochal journey, planned by the far-seeing Jefferson, and so important in establishing the claims of the United States to the Great West was brought to a successful conclusion with the loss by death of only one man. Judging from the simple narrative of the journals, the party faced a number of serious medical problems. Thanks to the hardiness of the men and the healthy life of the trail, supplemented by such stock of medical knowledge as the captains possessed, there is no indication of permanent disability, save of course the effects of venereal disease which must have remained with many of the men in spite of the drastic treatment employed.