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Venereal Disease and the Lewis and Clark Expedition

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It was entirely because of the incongruity in the title that I picked up the book _Venereal Disease and the Lewis and Clark Expedition_ (University of Nebraska Press) by Thomas P. Lowry. Surely, I thought, this little book can't be a serious evaluation of the conjunction of two never-to-be united subjects. I was completely wrong. Dr. Lowry, a retired psychiatrist and a historian of aspects of the Civil War, has thrown light on his two subjects, both of which are fascinating looked at in the light of the other. Lowry points out that the subject of sex has been broached by historians of the famous expedition, but having been broached, it is mentioned in passing, as if to say, "Sure, they had syphilis, but on to our real story." This has meant that not all of the history of the expedition could be written, because: "The role of sex and venereal disease on the expedition has been trivialized, marginalized, downplayed." Venereal disease was not downplayed by the explorers themselves, who anticipated it realistically and treated it as best they could. It was their way of facing a danger to their corps, "one that was in many ways as dangerous as grizzly bears, snakes, warfare, and slippery trails." They wrote about sex and venereal disease frequently in their journals, but their remarks are often not included in the many books about them. This is especially ironic in that venereal disease may have played a role in Meriwether Lewis's ultimate sad deterioration and death.

Lowry gives a brief history of gonorrhea and syphilis, especially of the latter, and says that they were most likely given to the Indians by the French, British, and Spanish adventurers that had visited the area. Lewis and Clark knew this, and they took pains to be prepared. They were professional soldiers, but as leaders of the expedition, they were expected to be physicians and pharmacists, too, although they had no training in the medical arts. By the time of the expedition, the standard treatment was mercury in some form, which we now know as a poison. It had side effects that were horrible, but it did seem to subdue the symptoms of syphilis which were more horrible still. Lewis and Clark had to be prepared for all medical eventualities, as they would not find drugs or doctors on the way. But a full fifteen percent of the drugs they brought with them were for gonorrhea or syphilis. They were realists, who knew that the Indians had a far different view of sexuality than members of their expedition had, that there were many young men traveling with them, and that they would be gone for years. The Indians continuously surprised them with open sexuality meant for barter or for ceremony. A chief pleased with medical assistance, for instance, might offer the nighttime companionship of his wife or daughter. Such companionship might simply be offered as hospitality to the newcomers. The Indians were fascinated by York, Clark's slave, and on one occasion York was invited to a native home to convey his magic to the wife, while the husband stood guard outside to make sure the magic went on uninterrupted.

The historical evaluation of the medical condition of the men is complicated, in that although there were voluminous notes and memoirs of the expedition, not all symptoms or medical problems are documented. Also, of course, exact diagnosis (with, say, blood tests) could not be done then and cannot be done retrospectively. Lowry has tried to run down the medical fates of all the participants, some of whom certainly got venereal disease and were treated for it. He can only speculate about what happened to Meriwether Lewis, but the intrepid hero did live only a few years after the expedition's return, years that were complicated by mood problems and confusion. He was governor of Missouri during some of the time, but he was often absent from office, possibly taking a secret mercury cure. He was seen by others as having a derangement, and toward the end suffered from psychotic delusions. Lowry speculates that there may have been other causes, such as a mood disorder or alcoholism, but makes a reasonable case for neurosyphilis playing a role in Lewis's tragic early death. Such a conclusion can only increase a reader's admiration for the courage these men showed in the service of their country, braving so many dangers that have long been acknowledged, and also the heretofore unacknowledged danger of the microorganisms they tried to fight as best they could.

Dr. Lowry is a consistently fascinating author. Branching out from his breakthrough research on the Civil War (Stories the Soldiers Wouldn't Tell and other classics), Lowry examined the medical challenges faced by Lewis and Clark's Corps of Discovery in their journey to plot and open the great "unknown" west. Yet, above the many startling facts and insights Lowry offers in this book, a great realization emerges--globalization is not a new phenomenon, and globalization has always had a dark side. Native Americans, varied and complex, had one unifying experience: The devastation they suffered from the arrival of European diseases, not least venereal infections. Setting aside the debate as to the geographic origins of syphilis, it appears incontestable that the spirochetes were delivered to the Indians of the Great Plains and the Pacific northwest by French, Spanish, Russian, English and American trappers, explorers, wanderers...often indirectly, through other tribes. We all have heard the tales of smallpox and its morbidity, but, until Dr. Lowry blazed this new trail, few of us grasped the extent to which VD ravaged and undermined Native American culture. Further, the Corps of Discovery itself suffered serious debilities, thanks to such infections--in a historical turnabout, American explorers were infected by Indians, rather than the other way around (although some members of the Corps doubtless carried such ailments with them when they embarked). Lowry tells a taut, lucid, compelling and peculiarly inspiring story. On top of all the other adversity faced by Lewis and Clark, this, too. Without sensationalism or lurid nonsense, Lowry deepens and enriches our appreciation of the very human men who made history--and of the nameless Indians with whom they interacted, for better and worse. Lowry also writes splendidly of the state of early 19th-century medicine, a subject for which his own background eminently qualifies him. All in all, this book may be small in size, but it's huge in its implications and understanding. A very valuable read, consistently interesting, and very highly recommended.

Dr. Lowry does an excellent job discussing the diseases and treatments of syphilis and gonorrhea and that alone makes the book worth buying. However with about 20 entries of venereal diseases in the journals he manages to misinterpret some of the entries, provides misleading information and some of his conclusions are not suportable by the entries in the journals.
J.W.F.
author "Medical Appendices of the Lewis and Clark Expedition"

On January 24, 2011, it was announced in the Washington Post that the author, Tom Lowry, had just confess to Federal authorities to having criminally altered an important Lincoln document in the National Archives in the 1990s in order to pad his reputation. Regrettably, the statute of limitations has run out.

Sen. Rick Santorum would not endorse this review, but I am voting against this book since there surely cannot be enough material in L&C's journals for a full book on this subject. I recommend instead the book "Disease and History" (1972) by Frederick F. Cartwright, which explains how various diseases helped change or form history. Also I will point out that some have said there's people relating to this book "suffering from delusions of grandeur fed by sycophants". I don't know, I'm just repeating this slander here. BTW I have not read this book.