This Year’s Event

The 28th Historical Clinicopathological Conference

The 2023 Program
Our annual conference is devoted to the modern medical diagnosis of disorders that affected prominent historical figures. Below is the case presentation for this year’s program.

An American Colossus
May 5, 2023 | 1:30pm
Davidge Hall

            On Thursday, December 12, 1799, the patient rode out on horseback to his farms in weather marred by rain, hail and snow. When he returned 5 hours later, he was wet with snow hanging from his hair and came to dinner without changing his clothes. Nevertheless, he appeared well when he retired for the evening.

            The next morning the patient complained of a sore throat. Though a heavy snow had fallen overnight, he went out again in the afternoon to mark some trees he intended to have cut down. By then he had become hoarse but made light of it. When he was urged to “take something to remove his cold,” the patient replied: “You know I never take anything for a cold. Let it go as it came.”

            Between two and three o’clock on Saturday morning the patient awoke feeling “very unwell.” He could barely speak and was having difficulty breathing. When offered a mixture of molasses, vinegar and butter to sooth his throat, he ”could not swallow a drop.” At the patient’s request, one of his overseers, removed approximately a half pint (250 ml) of blood from the patient’s arm.

            A physician arrived between 8:00 and 9:00 am, examined the patient, and placed a blistering agent of cantharides (Spanish fly) on his throat. He then took some more blood from the patient (amount not specified) and ordered a gargle of vinegar and sage tea (which the patient was unable to tolerate) along with a mist of vinegar and hot water. Two hours later, the patient was bled again (amount not recorded) to no effect. A clyster (enema) was administered at noon, which produced an evacuation but no improvement in the patient’s symptoms.

            Two additional physicians arrive, and after consulting with the first, bled the patient a fourth and final time [the amount reported as 32oz [960 ml)]. This time, according to a witness, “the blood came very slow, was thick, and did not produce any symptoms of fainting.” The patient could now swallow. Calomel & tarter emetic were administered without apparent effect. One of the physicians suggested opening the patient’s trachea to relieve his respiratory distress, but was over-ruled by his two older associates, who deemed the procedure too risky. Meanwhile, the patient told his doctors: “I believed from my first attack that I should not survive it.”

            At 8:00pm, “blisters and cataplasms (dressings) of wheat bran [were applied] to the patient’s legs and feet.” Between 10:00 and 11:00pm, his “breathing became easier; he lay quietly…felt his own pulse and died.” He was 67 years old. His physicians diagnosed his fatal disorder as cynanche trachealis  (inflammation of the tonsils, throat and/or trachea).

            The patient’s enjoyed excellent health throughout his life, except for his final illness and the disorders summarized in the following table:

Table. The Patient’s Illnesses Prior to His Final One

1The duration of the patient’s dysentery suggests that he was infected with an intestinal pathogen capable of causing chronic recurrent colitis – possibly Entamoeba histolytica. One of the physicians who cared for him during his final illness, treated the dysentery with bleedings and Dr. James Powder (antimony).

2The abscess was deep and fast growing. Incision and drainage produced pus and dead tissue.

3Whatever the original illness, this one was complicated by tachypnea, chest pain and hemoptysis.

4This abscess appeared at the same site as the one of 2 years earlier and produced pus when lanced.


2023 Participants 

 

Clinical Presentation


Rodney J. Taylor, M.D.,
is the Bruce and Isobel Cleland Professor and Chairman of the Department of Otorhinolaryngology – Head & Neck Surgery at the University of Maryland. He joined Maryland in 2001 and is a surgeon-scientist whose clinical practice is dedicated to the comprehensive care of head and neck cancer patients, patients with Sinus and Skull base disease, thyroid and parathyroid conditions and performs minimally invasive, robotic, endoscopic and complex surgical procedures for the management of diseases of the head and neck. He is a graduate of both Harvard College (1991) and Harvard Medical School (1995). Upon medical school graduation, he completed training at the University of Michigan and later earned a master’s degree from Michigan’s school of public health in clinical research design and statistical analysis. He also has basic science and translational interests, which include studying ZSCAN4 as part of a system that confers and maintains cancer cell immortality in HNC.  

 


Historical Presentation

Denver Brunsman, Ph.D., is associate professor and associate (vice) chair of the history department at The George Washington University, where his courses include “George Washington and His World,” taught annually at the Mount Vernon estate. He is the author of the award-winning book, The Evil Necessity: British Naval Impressment in the Eighteenth-Century Atlantic World (2013), and coauthor of a leading college and AP U.S. History textbook, Liberty, Equality, Power: A History of the American People (2016; 2020), as well as the e-books Leading Change: George Washington and Establishing the Presidency (2017) and George Washington and the Establishment of the Federal Government (2020), among other publications. His honors include the Oscar and Shoshana Trachtenberg Prize for Teaching Excellence at George Washington University (2018) and selection as the higher education chair of the College Board AP U.S. History Development Committee (2021). Brunsman earned his Ph.D., from Princeton University in 2004.