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Reviews
VENEREAL DISEASE AND THE LEWIS AND CLARK EXPEDITION
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by Thomas Lowry
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University of Nebraska Press, Lincoln, 2004. Photographs, maps, tables, index. 117 pages. $21.95 cloth..
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| DR. THOMAS LOWRY, a retired psychiatristfrom the University of California, San Francisco, has written a book that, although slim, is packed with information and delightful to read. The various chapters deal with the current state of knowledge of venereal disease; the origin of syphilis, which is still a matter for lively discussion; what Lewis and Clark were likely to know about venereal disease and how they prepared for it by buying the appropriate medicines; Indian medicine; accounts from the journals; and a final chapter on possible indications that the men of the Corps suffered from the late manifestations of syphilis after the expedition ended. |
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In the early 1800s, the distinction between syphilis and gonorrhea was vague, but the treatment for both was the same — mercury. Lewis notes in many places in his journals that men were being treated for "the venereals," but only mentions three men by name. He writes about the incidence of infection among Indian women, but does not suggest that any of his own men came on the expedition already infected. Considering the high incidence of venereal disease in all armies at that time, it does not seem unreasonable to think that some of the men were already infected. |
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Lowry discusses the possible origins of syphilis in some detail, although he does not mention the suggestive finding from the north of England that syphilis in other parts of Europe preceded its appearance in Italy in 1494–1495 by several hundred years. (See Claude Quétel, trans. Judith Bradock and Brian Pine, The History of Syphilis, Johns Hopkins University Press, 1992 and http:///www.pbs.org/wnet/secrets/case_syphilis/intex.html for more on this debate.) |
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One of the most intriguing discussions concerns the possibility that Lewis was suffering from tertiary syphilis when he died. Reimert Ravenholt, writing in 1994, even suggested that he could pinpoint the night on which Lewis acquired the disease — August 13, 1805. This would imply that he developed tertiary cerebral syphilis in four years. This is theoretically possible, but unlikely, as the final stages of the disease usually take fifteen to twenty years to develop. Some symptoms can develop as early as within six months of infection. Perhaps a more controversial (and less provable) suggestion would be that he acquired syphilis long before the expedition and was in a latent phase while the expedition was proceeding. |
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As a psychiatrist, Lowry's conclusion that Lewis suffered from some form of depression must carry considerable weight. |
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Lowry spends several pages describing the later lives of as many expedition members about whom something is known. None seem to have died from tertiary syphilis. Some of them did not live long enough, having been killed in battles with the Indians, or they simply disappeared from the public record. So, apart from the remote possibility that Lewis had syphilis, the long-term effects of the men's indulgences seem to have been remarkably slight. Perhaps one could argue that this was due to Lewis's prompt treatment with mercury. |
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Was Sacagawea suffering from a flare-up of gonorrhea when she fell sick just before the portage around the Great Falls? Or, did she have a urinary tract infection or a miscarriage? All of these conditions might have been made worse by the bleeding and purging administered by Lewis and Clark. Clark blamed Charbonneau for her illness, suggesting that if she died he was responsible. The meaning of Clark's remark is obscure. Did Clark blame Charbonneau for giving her gonorrhea, for making her pregnant, or just for allowing her to eat the "white apples" that made her sick? |
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While there have been at least three books dealing with the medical aspects of the expedition, this is the first devoted to the important topic of venereal disease. There is no doubt that at times Lewis regarded it as a disciplinary problem, but not an unexpected one. The morale-building effects of sexual contact with Indian women were probably great. And this must account for Lewis's generally lax attitude towards these relationships. The price of venereal disease may have been small compared with the maintenance of the spirits of the men. At no point was the progress of the expedition marred by the presence of infected men, although many of the men must have felt quite sick from the mercury treatment. Fortunately, almost all the venereal disease occurred while the expedition was stationary at the Mandan Fort or Fort Clatsop. |
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This is a well-written book: compact, informative, sticks to the narrative, and is a valuable contribution to the burgeoning literature on America's most famous expedition. |
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| BRUCE C. PATON, M.D.
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| Denver, Colorado |
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