George Washington is a mainstay of history books for fighting everything from the British Empire to a cherry tree, but his private battles may have been the fiercest. Tuberculosis. Malaria. Smallpox. Dysentery. Some of the deadliest ailments of the 18th century attacked him early and often.
"There are many points before and after the Revolutionary War when he could have died," said Dr. Howard Markel, director of University of Michigan's Center for the History of Medicine. "He was really quite ill, even when he was president."
A look back at Washington's medical chart offers both a snapshot of America's original biological villains and a progress check on its medical advances.
Today, Washington would probably take a preventive shot for diphtheria, pop some pills for tonsillitis, and skip the deadly blood-letting procedure for epiglottitis. Yet he would be even more susceptible to skin cancer in the 21st century and the pneumonia would likely be just as unpleasant. Washington ultimately died of a throat infection at age 67 -- but his relative health amid other sicknesses offers a lesson, Markel says.
"His body won more times than not. There's a million and one things that could have killed him, that could kill any of us, but they didn't," he said. "And that's the wonder of the human body."
Part 1: Explore the history of these 9 deadly diseases including when they were first identified, proposed treatments and current outbreaks.
- Diptheria - "This was a very common infection, particularly in childhood. Washington may have had it when he was about 15. It strikes in two stages, first with a terrible sore throat and then a pseudo-membrane over the back of the throat which poses a risk of suffocation. It also creates a toxin which circulates around the body, weakening the heart and sometimes causing a person to drop dead several weeks later. As early as 1895, we were able to treat the second stage of the illness with a diphtheria antitoxin. Since the late 1930s, we don't have to worry about treatments or side-effects, we just prevent it with a vaccine. In the U.S., we only have about a half dozen cases per year - in kids who are not immunized."
- Tuberculosis - "Washington's brother had this and a common treatment back then was for a doctor to prescribe 'breathing in fresh air.' So they went on a sea voyage to Barbados and on that trip, Washington ended up contracting it himself. It's an infection of the lining that coats the lungs. Like malaria, it's one of those diseases that can go quiet but continue to come back throughout life. Still today, tuberculosis is extremely common. There are about 15,000 to 20,000 cases of it in the U.S. every year. Globally, 8.5 million people will contract TB and roughly a million or more will die of it. We have many wonderful antibiotics to treat it, but in recent years we've found drug resistant strains that may prove to be very deadly. And that may yank us back to where we were in the 1940s."
- Smallpox - "Washington was infected by smallpox at about age 19. This is a serious, serious disease, where you get blistery lesions all over the face. Its effects on the internal organs are what kill 1 out of 3 victims. Washington survived but he did have serious scarring pock marks on his face for the rest of his life. Knowing how bad it could be, he played a revolutionary role by having all of the Colonial Army's soldiers vaccinated. Smallpox is one of the diseases we've conquered. Unless some bio-terrorist has a supply of it, we're not going to see this anymore."
- Dysentery - "Today dysentery is typically defined as bloody diarrhea, which may also contain mucous in the liquid-like stools. Washington had this many, many times, including when he was fighting in the French & Indian War in the 1750s. At one point when he was fighting, he was in such agony from diarrhea and intense rectal pain that he needed to put a pillow underneath him on his horse. He was in a terrible battle and sitting erect on the pillow. That in itself put him at terrible risk. He could have easily been shot and things might have turned out very differently for this country. Today, the most important form of treatment is first, rehydration either with an oral rehydration solution or with intravenous fluids. The other modern treatment is an antibiotic, if it is caused by a bacteria; and specific anti-parasitic drugs if it is caused by parasites such as amoebas."
- Malaria - "Washington probably got malaria at age of 17. It strikes, the fever will come, and then it goes away. It's active, quiet, active and quiet - and so Washington had bouts of it throughout his life. We tend to think of it now as a developing-nation disease but well into the early 19th century, malaria was extremely common in the United States, even in places like Michigan and Minnesota. The greatest prevention for malaria is mosquito control. The United States has paved over and drained all the stagnant water that bred malaria-infected mosquitoes. But it continues to be one of the leading killers in the world today - about a million people die from it each year."
- Quinsy - "This is sort of an antiquated 18th century term that generally refers to tonsillitis or an infection of the tonsils in the back of the throat. Washington was diagnosed with this entity on several occasions. His quinsy attacks do not seem to have been life-threatening, but in the event of infection with dangerous bacteria, such events could prove fatal. Today, if you come down with something like Strep throat, we have antibiotics for that."
- Carbuncle - "He got his carbuncle sometime in 1795. It was a bump on his face that some thought was a cancerous tumor. But it could have been caused by streptococcal or staphylococcal. We just don't know. If it was melanoma, a deadly form of skin cancer, we still don't have good treatments for that. On the other hand, if it was a pre-skin cancer from sun exposure, we remove it and tell you to slather on the sunscreen. We're seeing more of those skin cancers today because of what we've done to the ozone layer."
- Pneumonia - "There are great antibiotics for this today. If you get pneumonia, you have a very high fever, great difficulty breathing, and you just feel sick as can be. But if you take antibiotics, you'll feel better in 48 hours. If you're hospitalized, you can be hooked up to a machine like a respirator to help you breathe. Today, most people will tend to survive unless you get a hospital acquired version, which are very hardy infections from hell."
- Epiglottitis - "This is something more commonly found in kids and tends to be caused by Haemophilus influenzae. We don't know exactly what happened but Washington was out riding on Mount Vernon on a cold winter day. When he came in, he had somewhat of a sore throat and within hours he developed a lot of problems swallowing. A few days later, it got worse, and they thought it might be due to an excess amount of blood. Within 12 hours, they took out about 80 ounces of blood, which is 35 percent of the blood in an adult's body. That's huge. They bled him quite a bit, and finally Washington did die. We don't see this at all anymore because we have an H. flu vaccine. We also have things like respirators and antibiotics. Or we could support that patient with a tracheotomy - a tube coming out of your neck to help you breathe. Today, blood-letting is not something we would recommend. That's easy to say in 2011, but the best doctors in the world prescribed it then."
Part 2: Using this map, identify which of the nine deadly diseases listed above are still prevalent in parts of the world. Then locate your state and/or country and identify any other outbreaks of disease. Using the Center for Disease Control website, learn how to prevent the spread of several of these infectious diseases.