Sick Call

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by Ronald V. Loge, M.D.

Sick Call

At the mouth of the Marias River on June 10, 1805, just before setting out to explore the "Southerley" fork of the Missouri, Lewis noted, "Sah-cah-gah, we a, our Indian woman is very sick this evening: Capt. C. blead her." Indeed, Clark's concern for her was conspicuous in his daily journal entries, which described her serious condition and his repeated bleeding therapy.

Moving the expedition upstream on June 13th, Clark again commented, "the Indian woman Verry sick I gave her a doste of Salts." On the fifteenth, Clark noted that Sacagawea was still "Sick & low Spirited," so he "gave the bark & apply it exteranaly to her region." By evening she was much worse and would not take any of the medicines he offered her.

On the sixteenth, returning to the party's main camp after his triumphant discovery and exploration of the Great Falls of the Missouri River, Lewis found that "she now lay gravely ill, delirious, and much reduced by her indisposition." He gave her "two dozes of barks and opium,"1 and soon noted an improvement in her pulse. He had his men cross the river "to procure the water of the Sulpher2 spring," "the virtues of which," Lewis asserted, "I now resolved to try on the Indian woman." The men who obtained this water were said to "drink freely of it."

Lewis may have recognized the smell and taste of this mineral spring because it reminded him of a medicinal spring back home in Virginia. Expecting a therapeutic benefit for Sacagawea, he "caused her to drink the mineral water altogether." In addition, Captain Lewis continued Clark's previous treatments of compresses of bark (Peruvian bark, or cinchona) over her lower abdomen, plus laudanum (tincture of opium) administered orally, and she seemed to improve.

Quick Recovery

The following day Lewis continued the same treatment course, and Sacagawea became free of fever and was at last able to eat some buffalo soup. With ongoing therapy she seemed to recover quickly until the 19th when she had a brief relapse. This time Lewis induced a therapeutic sweat with dilute potassium nitrate and relieved her pain with more laudanum. In a few days she was taking part in the difficult portage around the falls. Her illness was not mentioned in the journals again.

In considering Sacagawea's illness and the Captains' treatments, four questions arise: 1) What was the exact nature of her illness? 2) What minerals were in the Sulfur Spring water? 3) Did Lewis correctly anticipate the medicinal effect of the water? 4) Did the mineral water cure her illness?

There is general agreement by most who have analyzed Sacagawea's illness, which was manifested by prominent pelvic pain, fever, anorexia and delirium, that these symptoms represented an illness now known as pelvic inflammatory disease, or PID, an infection of the ovaries and fallopian tubes caused by a sexually transmitted agent such as gonorrhea or chlamydia. This is one illness known in the pre-antibiotic era from which a woman could recover spontaneously. Because it typically causes either temporary or permanent infertility, this might explain why it was several years until Sacagawea is believed to have borne another child–an unusual hiatus for an otherwise healthy young woman.

1. See Ronald V. Loge, M.D., " 'Two dozes of barks and opium': Lewis and Clark as Physicians," We Proceeded On, Vol. 23, No. 1 (February 1997), 10-15, 30. Reprinted from The Pharos of Alpha Omega Alpha, Vol. 59, No. 3 (Summer, 1996), 26-31.

2. Lewis's spelling, "Sulpher"—he meant "sulphur"—is the British form of the word.

Funded in part by a grant from the Montana Committee for the Humanities