Lewis and Clark

Harold E. Kleinert, MD
Clinical Professor of Surgery
University of Louisville School of Medicine
Clinical Professor of Surgery
Indiana University-Purdue University School of Medicine 
Presented to the Innominate Society

Dr. Harold Kleinert
2/15/03 and 3/23/03 

          “The 200th Anniversary of the Lewis and Clark Expedition-Some Medical Aspects and Interpersonal Connections” 

            Dr. Kleinert’s personal connections with Lewis and, especially, Clark fueled his interest in their historic expedition. He was delivered by Dr. Thomas L. Clark in Sunset, Montana in 1921. Dr. Clark was born in Kentucky in 1869, attended Louisville Medical College 1895-1896, and practiced in Shelby, Montana for about 50 years, died of heart failure while visiting KY in 1949. He encouraged Dr. Kleinert’s medical interests and gave him his medical books. The Kleinert family had homesteaded in Montana where Harold played with the Clark Children. After attending Northern Montana University and the University of Michigan, Harold went to Medical School in Philadelphia where President Jefferson had sent his Secretary, Meriwether Lewis, for medical, botanical, and navigational training to prepare for the historic 1803 Western Expedition to cross the USA, newly enlarged by the Louisiana Purchase. Also, Harold’s destiny was to live and have an office in Clarksville, Indiana.

             Meriwether Lewis, born in Virginia in 1774, joined the Army at age 20, and was Jefferson’s Secretary prior to leading the Western Expedition. He died at age 35 by suicide or, possibly murder. William Clark was born in Virginia in 1770, joined the Kentucky Militia in 1789, and later was commissioned a lieutenant in the regular army. He died of natural causes in 1838.

             The primary aim of the Lewis and Clark Expedition was to map the fabled Northwest Passage that would link the Atlantic and pacific Oceans. The possible existence of such a waterway had fascinated explorers for centuries and had been one of Jefferson’s special interests, one of the chief reasons to conclude the Louisiana Purchase. On February 28, 1803, at Jefferson’s urging, congress appropriated $2500 for a small U.S. Army unit to explore the Northwest and find a navigable water route from the Atlantic to the Pacific Ocean. He appointed Lewis Captain and William Clark, an experience frontiersman, co-captain. Their orders were to make a detailed report on the geography, climate, plants, and animals and study the Indians’ customs and languages.

             Lewis went to Philadelphia for scientific instruction and lessons in astronomy, and to purchase supplies and medicines. He met Benjamin Rush who gave him rules such as: wear flannel next to the skin, take raw spirits after being wet or fatigued, take 2 large purge pills q4h “at the least indisposition,” wash feet with spirits when chilled and also every morning in cold water, and lie down when fatigued. Some medicines Lewis purchased were Jalap, Ipecac, Gum camphor, Laudanum, mercurials, Peruvian bark for fevers, and Rush’s Bilious Pills containing calomel. Also he bought small dental and medical instruments, including urethral syringes for treating gonorrhea. Other purchases were 30 gal. strong wine ($77.20) and 193 lb. portable soup.

            They constructed a Keelboat and the expedition departed 8/31/03 with 7 soldiers, a pilot, and 3 trial members. The river was often so shallow that they had to hire horses and pull the boat. At the end of September they picked up Captain Clark at the home of his famous brother, George Rogers Clark, in Clarksville, In. On October 26, the expedition, now with “9 young men from Kentucky”, departed on its historic mission.

             On November 11, 1803 they picked up George Druillard, a civilian scout, hunter, and tracker who could “speak” the Plains Indians’ sign language, and French and English, as well as Shawnee. They wintered on the U.S. side of the Mississippi River opposite the mouth of the Missouri. Their diary notes that they purchased castor oil. They came to the last white settlement of 7 families near La Charatte may 25, 1804.

             The daily routine consisted of stopping three times for meals and to dry their clothes and equipment. At those times they posted sentinels and waited for their hunting teams to return. Major ingredients in their menu were lye corn and grease, pork and flour, and Indian meal and pork, but no pork when fresh meat was available.

            The party suffered from repeated, sometimes nearly fatal infections, especially boils and dysentery. There was a precarious balance between their diet and infections; their jerked meat was probably almost always contaminated although that prepared by the expedition was cleaner than the meat and grease bought from the Indians. There was a lack of fresh fruit and of hygienic conditions.

             Medically, the Indian’s practices were equal to those of the Colonials’, which was a combination of the Europeans and Indian’s practices. Some advantages of Indian medicine were that they were treated in their own lodges and not subject to hospital gangr3ene. Also, they treated fractures by immobilization, added 59 drugs, such as quinine and ipecac, unavailable in the Old World, to the pharmacopeia, and used sweat baths. They used horns and animals’ bladders to hold water to give enemas and, when necessary, suffocation to produce unconsciousness for labor and surgery. Generally, the Natives were healthy until they were exposed to the white man’s diseases, especially smallpox, which had killed 400 Omahas just four years earlier. Unfortunately, the Expedition’s smallpox vaccine had lost it’s potency.

             Diaries of the trip up the Missouri include references to accidents, snakebites, and floods, and many observations about the beauty of the prairies and the excellence of the fresh fruits. On October 11, 1804 they arrived at what is now Council Bluff near Fort Calhoun, Nebraska, and had some of their first meetings with the natives.

             On August 15, 1804 Sgt. Charles Floyd became “very sick with a violent cholick.” He developed severe nausea, vomiting, and diarrhea and by August 20 was “as bad as he can be, no pulse and nothing will stay on his stomach or bowels…He died with a great deal of composure and was laid out in the most decent manner possible…He was buried with the Honors of War.” He probably had low-grade appendicitis that became fulminating, ruptured, and produced fatal peritonitis.

             In a few days, the expedition had a Council with the Yankton Sioux, who offered them their first dog meat; some preferred it to the elk they had been eating. They were warned that they would soon be encountering unfriendly Indian Tribes. In early September, many of them became ill from drinking the water of the Missouri River. On September 23, they were near Pierre, SD where they met the Teton Sioux who called themselves the Lakota. They smoked the ceremonial pipe, but then the Indian warriors seized the cable of the pirogue and refused to leave. They wanted to trade. On shore, Clark drew his sword and Lewis aimed the cannon while the Sioux notched their arrows. But, Chief Black Buffalo intervened and freed the cable.  The Sioux performed a scalp dance. Clark said: “A bad night’s sleep.”

             The expedition proceeded up the Moreau River and then the Grand River near Mobridge, SD where they met the Arikara Indians who had a land culture and provided them with squash, corn, and dried pumpkin. The Indians were “durty, pore, and extravagant.” One of their customs was to give a “handsom” squaw to a guest they wished to acknowledge.

             One of the soldiers got drunk and made “expressions of a highly criminal nature” against the Captains; he was court-martialed, received 75 lashes on his bare back and arms, and dismissed from the permanent party. The episode brought memories to Lewis of an occasion during the Revolutionary War when he became drunk and disorderly and was reassigned to another unit-one under William Clark—that is how they first met.

              On October 22, 1804, they came to an abandoned Mandan double Ditch Village that had been decimated by smallpox. On November\ 2 they found the site for Fort Mandan, ND where they spent the extremely cold 1804-1805 winter (T-30-40 degrees below zero). Many had colds and/or rheumatism; Sgt. Pryor dislocated a shoulder and had to be treated for pleurisy with bleeding and sage. On Nov.13, Lewis returned fatigued from hunting and from being in icy water for 2 hours, and having his clothes frozen to his legs. Treatment with whiskey revived him. Fortunately, a hunting party returned with 32 deer, 12 elk, and a buffalo to be hung in the smoke house.

             Soldier York was a special attraction to the Indian maidens who gave him the name “Big medicine.” His kinky haired progeny can still be traced all the way to the Pacific Ocean. Christmas Dinner 1804 consisted of gifts of corn, flour, and dried apples from the Indians. The party celebrated with dancing, cannon firing, and flag raising. New Years 1805 was celebrated with the buffalo dance; the young Indian men gave their wives to the older men. Lewis was concerned about venereal disease.

             Sacagawea, whom Lewis and Clark wanted for a guide and interpreter, joined the party at Fort Mandan. As a child she had been kidnapped from the Shoshone Nation. She had two dependents, her husband, Charbonneau, and her baby, to whom she had given birth Feb. 11, 1805. During her ten minute labor, the pain was relieved by giving her ground rattle snake rattles as had been suggested by the French trader, Jessome.

             The party departed Fort Mandan April 7, 1805; it consisted of 32 persons: Lewis, Clark, 3 sergeants, 23 privates, York, Drouillard, Charbonneau, Sacagawea, and her baby. They met the Shoshones in the Rocky Mountains. On April 8, Sacagawea found wild artichokes, onions, wild geese feeding, and wildflowers blooming. They went down the Knife River, reached the Yellowstone River April 25, and the Missouri River May 25. On June 13, 1805 they discovered the Great Falls of the Missouri-5 sets of falls over 12 miles that “roared tremendously”. On June 14, they came to Rainbow Falls, and had to portage for 18 miles. On June 17, Sacagawea became very ill and had to be bled and given laudanum and mineral water. The Captain “feared for her life;” the diagnosis was most likely P.I.D.

             The party reached the Three Forks of the Missouri July 27, 1805, and Beaverhead Rock on August 8, where Sacagawea recognized her people’s summer retreat. On august 12, they came to the source of the Missouri; Lewis met the Shoshones and Sacagawea found her brother, chief Comeahwait. On August 30, they started to cross the Rockies with Old Toby as the Shoshone guide. Several horses fell and ‘gave out”, and they broke their last thermometer. By September 6 their food was exhausted; supper consisted of berries, but the next day at Bitterroot River, they obtained 2 deer, 2 cranes, and 2 pheasants. On September 14, they had to kill one of their colts to eat. On September 16, they came to the Nez Perce Trail; the ascents were difficult because of the snow and fallen timbers. They went down the Koos Koos River on October 29-saw Mount hood and reached the Columbia River where they started using canoes. After more hardships, on November 18, 1805, they reached the Pacific Ocean at Cape Disappointment-there was no ship in sight! They were forced to winter there, but left the pacific Shoes in March 1806 to retrace their steps to the continental Divide where they split into two groups. Clark led one party down the Yellowstone River and Lewis led the other down the Missouri River. They rejoined August 12, 1806 on the Missouri and returned to St. Louis on September 23, 1806. They had successfully completed their mission by mapping the new lands Jefferson had purchased that doubled the size of our country and thus opened the West to pioneers.