Monday, August 2, 2010

Guest Blog: Would modern medicine have helped our early patriots?

Dr. Ed Pullen is a family physician who sees patients at Sound Family Medicine in Puyallup, WA. The following post was previously published on July 4, 2010 in The Health Care Blog and



On Independence Day, I thought it would be interesting to look at the causes of death of some of our famous Revolutionary era patriots. When I started researching this, I anticipated early deaths from infections and untreatable chronic diseases like diabetes and hypertension. Interestingly, many of the famous early Americans lived to a ripe old age, and died of causes that even today may well have been their demise.

George Washington: Washington is an exception to the comment above. Washington died at age 67, likely of a pharyngeal infection, possibly streptococcal disease. Today he would likely have received antibiotic treatment and survived this illness.

Thomas Jefferson: Jefferson really died of old age, living to age 83 and dying on July 4, 1826. He survived to be the third-to-last signer of the Declaration of Independence to pass. He had uremia, nephropathy, and may have died of dehydration from amoebic dysentery. The most interesting thing I found about his death was the he wrote his own epitaph, and insisted that it include “not a word more.” It did not mention his governorship of Virginia, vice-presidency or presidency:


John Adams: Fittingly died on July 4, 1826, just hours after Jefferson, at age 88 making him the next-to-last Declaration of Independence signer to die. He also died of old age, suffering from congestive heart failure and likely coronary disease. At age 88 he may have lived longer with the excellent heart failure treatments of today, but he certainly lived a long life. When told it was July 4th, it is rumored in his last hour of life he said: “It is a great day. It is a good day.” His last words have been reported as “Thomas Jefferson survives” (not knowing that Jefferson had died hours earlier).

Benjamin Franklin: Although famous for having syphilis, Franklin likely died of empyema, an infection of the space between the lung and the chest wall. He was bedridden for the last year of his life, and likely contracted pneumonia. Empyema sometimes complicates pneumonia, and though we are often able to treat pneumonia and empyema successfully today, at age 84 pneumonia is still often the “old man’s friend.”

John Hancock: Hancock died at age 56, reportedly of gout. Most likely the gout led to him being bedridden, and he died of complications of bed rest. Today we are very good at treating gout, so he would likely have lived both a better quality and longer life with modern medicine. Of note, Hancock’s funeral was the most lavish in the new America as of his death on October 8, 1793.

Samuel Adams: Samuel Adams lived to age 81, dying on October 2, 1803. He suffered from what is now felt to be essential tremor, making him unable to write in his last decade. This is a condition we have pretty good success with treating today, and he would have likely had a better quality of life with modern medical help for this condition. I’m unable to find information about his cause of death, but he certainly did not die prematurely.

James Madison: Madison was the last of our Founding Fathers to die on June 26, 1836, at the age of 85. As the primary author of our Constitution, a major contributor to the Federalist Papers, and a key early legislator and later President, he had a brilliant mind. He seemed to struggle in his later years with anxiety and dementia, and may well have benefited from an SSRI. At times his anxiety, and probably depression, left him essentially bedridden. He died at an old age, at the time simply called “debility.”

John Paul Jones: The naval hero of the Revolutionary war is famous for saying, “I have not yet begun to fight,” during the engagement with the British ship Serapis in the North Sea in 1779. He died of a brain tumor at age 45. The big advantage Jones would have had today would have been a long US military career, with military health care. We still often are not terribly successful at treating brain tumors, so he may still have died at a young age.

Alexander Hamilton: Hamilton, felt by some to be our greatest Secretary of the Treasury, died after a well known duel with Aaron Burr. The bullet apparently entered in the right lower abdomen, ricocheting off the pelvis and causing liver, diaphragm, other internal organ damage and also spinal cord injury at about the L2 level, leaving Hamilton paralyzed. He died the next day. The bullet wound may have still killed him today, although duels are thankfully a thing of the past. With modern surgery he may well have survived as a paraplegic.

- Ed Pullen

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