Journeying up the Natchez Trace in Tennessee on a lovely October day in 1995 I reflected on how it must have looked to Meriwether Lewis on October 10, 1809, as he rode along the same 18 miles from Dogwood Mudhole, where he had camped the previous night, to Grinder's Stand, a rustic inn along the Trace where he would spend his last night.
He must have been agonizing over his desperate decision to end his life that night, seeking but not finding an alternative solution to his problem. For Lewis, I am convinced, was suffering from an episodically progressive and inexorable syphilitic infection probably acquired four years earlier on his epochal exploration of the American West with the famous Corp of discovery. Because of the spirochetes rotting his once-powerful brain, Lewis was no longer able to handle the many urgent pressures plaguing him.
As a protégé of Thomas Jefferson and a national hero after the epic Lewis and Clark Expedition, he was well-positioned to compete for the presidency of the United States. But if he continued on to Washington and his disease progressed as it had during recent weeks, he would become an object of derision and scorn, an increasing burden to family and friends, and his lustrous reputation would be destroyed. In deference to his mentor, President Jefferson, his loyal partner and friend, William Clark, and his valiant mother, Lucy Marks, he apparently perceived but one terrible solution.
In 1990 when I was reading Richard Dillon's biography, Meriwether Lewis, in which he details Lewis's last days, the realization that he must have suffered from neurosyphilis came strongly to mind. Over the years as an epidemiologist I have investigated many infectious diseases, including syphilis. Lewis's symptoms were classic. It seemed such an obvious diagnosis that I was puzzled that no one had made it before. During the past six years as my research into Lewis's life intensified, the following scenario has evolved.
How Lewis must have castigated himself for having succumbed to the charms of the Shoshone Indian women in 1805. Thomas Jefferson's sage warnings, his own considerable medical training, and the obvious prevalence of syphilis among the Mandan Indians they lived with the previous winter should have deterred him from sexual intercourse with any Indians on the long expedition across the Louisiana Territory. But months of arduous, celibate struggle left him inordinately susceptible. Also, as he was negotiating with Chief Cameahwaite for horses desperately needed for crossing the mountains, he could ill afford to be rude by refusing the chief's hospitable offer of a teepee and pleasing female company. Furthermore, his wariness of syphilis and other sexually transmitted diseases (STDs) was no doubt lulled by the extreme isolation of the Shoshones; the expedition had encountered no other Indians during the four previous months while voyaging two thousand miles up the Missouri from Fort Mandan. Lewis may have believed the Shoshones an unlikely source of venereal disease. Another possible factor in causing him to relax his guard was that the camp in the meadow along the banks of the Lemhi River was the birthplace of the Corp's popular Shoshone guide, Sacagawea. And, finally, he was in a celebratory mood from having crossed the Continental Divide-from the headwaters of the Missouri to those of the Columbia.
That he did spend two nights with the Shoshones, August 13 and 14, is indicated by his diary entries:
13 August 1805: This evening the Indians entertained us with their dancing nearly all night. At 12 o'clock I grew sleepy and retired to rest leaving the men to amuse themselves with the Indians. I observe no essential difference between the music and manner of dancing among this nation and those of the Missouri. I was several times awoke in the course of the night by their yells but was too fortiegued to be deprived of a tolerable night's repose.
14 August 1805: Not withstanding the extrem poverty of those poor people they are very merry they danced again this evening untill midnight.
Even five days later he was musing over the visit:
19 August 1805: the chastity of their women is not held in high estimation, and the husband will for a trifle barter the companion of his bed for a night or longer if he conceives the reward adiquate; tho' they are not so importunate that we caress their women as the siouxs were. and some of their women appear to be held more sacred than in any nation we have seen. I requested the men to give them no cause for jealousy by having connection with their women without their knowledge, which with them, strange as it may seem, is considered as disgracefull to the husband, as clandestine connections of a similar kind are among civilized nations. To prevent this mutual exchange of good offices altogether I know it impossible to effect, particularly on the part of our young men whom some months abstanence have made very polite to these tawney damsels....I was anxious to learn whether these people had the venerial, and made the inquiry through the interpreter and his wife; the information was that they sometimes had it but I could not learn their remedy; they most usually die with it's effects, this seems a strong proof that these disorders bothe ganaraehah and Louis Venerae (syphlis) are native disorders of America. tho' these people have suffered much by the smallpox which is known to be imported and perhaps those other disorders might have been contracted from other Indian tribes who by a round of communications might have obtained it from the Europeans since it was introduced into that quarter of the globe, but so much detached to the other had from all communication with the whites that I think it most probable that these disorders are original with them.
Whether Lewis's "anxious" concern for the STDs status of the Shoshone tribe was triggered by symptoms in himself or a companion, or was simply due to apprehensive introspection, we cannot know. Gonococcal urethritis may become apparent within several days, but a syphilitic chancre would not appear for at least ten days. Significantly, although Lewis became ill with a disabling illness a month or so later, which afflicted him during subsequent months and years, he wrote no description thereof except, perhaps, on September 19th:
Several of the men are unwell of the dysentery. brakings out, or eruptions of the skin, have also been common with us for some time.
After the primary chancre, the chief secondary manifestations of syphilis are cutaneous lesions that ordinarily appear about one month after infection. Hence, this mention of unusual skin eruptions a little more than a month after the Shoshones visit supports the view that Lewis and companions probably acquired syphilis then. It is significant that Lewis wrote: "have been common with us for some time": probably the beginning of "his" secondary stage syphilis, which incapacitated him considerably.
Lewis's entry three days later on September 22 was his last until November 29, but Clark documented his illness to some extent:
24 September 1805: Capt Lewis Scerceley able to ride on a gentle horse which was furnished by the chief....
25 September: Capt Lewis verry sick.
27 September: Captain Lewis very sick.
4 October: Capt Lewis still sick but able to walk a little.
During the fall months when Lewis was not making diary entries, the expedition reached the Clearwater River, built five canoes, then proceeded down the Clearwater, the Snake and the Columbia Rivers to the Pacific Ocean. They constructed a substantial winter abode, Fort Clatsop, remaining there until March 23, 1806, when they began the homeward journey.
It was not until January 1, 1806, when established at Fort Clatsop, that Lewis resumed regular diary entries-noting that he had been very ill. Significantly, the nature of his illness and the reason for the long hiatus in diary entries were not explained.
During the months at Fort Clatsop, the corps was sometimes besieged by Chinook women offering sexual services, which were generally, though not always, declined because of fear of venereal disease and the unattractiveness of the women. Lewis recorded treating at least three corps members with mercury for syphilis including Hugh McNeal, who was with him during the Shoshone visit.
On the return, Lewis treated his patients during a pause by Great Falls, made an unwise exploratory trip to the north, then boated down the Missouri to rendezvous with Clark at the Yellowstone confluence. The group proceeded to St. Louis, arriving on September 23, 1806.
Upon arrival, Lewis delayed the departure of the mail a day so he could include a report to President Jefferson. For the next six weeks he and Clark wrote letters, settled accounts, bought clothes, and socialized with friends. It is noteworthy that Lewis and Clark lingered so long in St. Louis instead of proceeding, during favorable October weather, to Washington to report in person to President Jefferson, the Congress, and the nation. Everyone was eagerly awaiting them.
But the long delay in St. Louis is understandable when one realizes that all those having acquired syphilis on the expedition would have required month-long treatment and that Dr. Antoine Francois Saugrain, one of the top syphilologists in America, lived there.
Meriwether Lewis and William Clark had become well-acquainted with Saugrain during the five months they lived at Wood River and St. Louis in 1803-04. He had helped them prepare for the expedition, both medically and scientifically, improving Clark's knowledge of diagnosis and treatment, and preparing a medicine chest for the expedition. He also introduced them to friction matches made from sulfur and phosphorus and made them a thermometer, using mercury from his wife's Parisian mirror. The instrument was used by the expedition for making twice-daily temperature measurements from September 19, 1804, until it was broken in the Rockies on September 6, 1805.
The fact that Saugrain is not mentioned by Lewis after their return to St. Louis and during residence there from September to November, 1806, may well be a case of "the dog that didn't bark." But that a professional relationship did exist subsequent to the expedition, is indicated by Lewis's notation in September 1809 that he owed Dr. Saugrain $30-a considerable sum of money at the time.
In early November, 1806, Lewis and Clark left St. Louis. Arriving at the White House on December 28, Lewis helped the president celebrate the New Year. He lived in the White House three months while enjoying a well-deserved hero's welcome, and worked with the Congress and officials to secure appropriate compensation for all members of the Corps of Discovery. In March Lewis's appointment as Governor of the Territory of Louisiana, and Clark's as Superintendent of Indian Affairs and a brigadier general of Militia, were confirmed by the Senate.
Lewis returned to St. Louis as governor in March 1808. He was able to work effectively most of that year, but both Secretary of War Henry Dearborn and President Jefferson complained that his letters were inadequate and did not inform them fully. Late in that year he made unwise and somewhat grandiose real estate investments, suggestive of lessening judgment, and in 1809 his relationship with secretary Frederick Bates, his chief assistant, deteriorated rapidly. It seems likely that it was mainly the advancing neurosyphilis that troubled and destroyed the relationship between Lewis and Bates.
In 1809 Lewis's health deteriorated and he became deeper in debt. In July a clerk in Washington rejected a bill for $18.70; and by letter of July 18th, President Madison's Secretary of War William Eustice rejected a bill for $500. Lewis reported to the Secretary that the two contested claims had "sunk his credit and brought in all his private debts, totaling $4,000, on the run." In fact, Lewis had been living far beyond his income for almost two years. In August, to do justice to his creditors, Lewis handed over to them, as security, what land he had acquired in Louisiana; and as he hurriedly prepared for travel to Washington, he assigned power of attorney to his three most intimate friends so they could sell any of his properties to settle bills.
On September 4, 1809, attended by his servant, a free man of color named John Pernia, Lewis departed St. Louis by riverboat. On September 11, perhaps at New Madrid, Lewis made out his last will and testament, witnessed by F.S. Trinchard: "I bequeath all my estate, real and personal, to my mother, Lucy Marks, after my private debts are paid, of which a statement will be found in a small minute book deposited with Pernia, my servant."
On September 15th, the boat reached Fort Pickering at Chicksaw Bluffs (Memphis). The fort's commandant, Captain Gilbert Russell, met Lewis, who had commanded a company at Fort Pickering in 1797 and was a friend of Captain Russell. According to Russell's statement, made in 1811:
On the morning of 15th of September, the boat in which he was a passenger landed him at Fort Pickering in a state of mental derangement, which appeared to have been produced as much by indisposition as other causes. The subscriber being then the commanding Officer of the Fort on discovering his situation, and learning from the crew that he had made two attempts to kill himself, in one of which he nearly succeeded, resolved at once to take possession of him and his papers, and detain him until he recovered, or some friend might arrive in whose hands he could depart in safety.
Russell forbade Lewis all grain spirits and confined him to light wine while he was at the fort. Lewis remained in bad mental and physical health for five days, but on the sixth day, according to Russell, "all symptoms of derangement disappeared and he was completely in his senses and this continued for ten or twelve days."
Captain Russell protected his friend until he could entrust him to the care of Major James Neelly, the Chickasaw Indian Agent, who had arrived on the 18th. As Lewis prepared for departure from Chicksaw Bluffs, accompanied by Major James Neelly, he borrowed $100 from Russell and secured a saddle horse and two pack animals from Neelly and Russell. The pack animals carried his two trunks and portfolio, jammed with public and private papers, including 16 red morocco-bound journals of the expedition. On September 29 he, Neelly, Pernia, Neelly's servant, an Indian interpreter, and several Chickasaws set out on the Memphis Road southeasterly toward the Chickasaw Agency and the Natchez Trace.
It took three days to reach the Chickasaw Agency, where the Indians left the party. Lewis was now drinking, and when they arrived at the agency, Neelly thought he was deranged again. They rested two days until Lewis had recovered sufficiently, then proceeded up the Natchez trace to the Tennessee River. Ferrying across the river, probably on the eighth, they reached Dogwood Mudhole on the ninth. On the morning of the tenth, two horses were missing. Neelly stayed behind to find them while Lewis proceeded ahead. Neelly reported that Lewis promised "to wait for me at the first house he came to that was inhabited by white people."
About 60 miles above Colter's Ferry, 18 miles above Dogwood Mudhole where he had left Major Neelly that morning, Lewis turned his horse off the Natchez Trace toward a pair of rude log cabins, joined by a dogtrot or breezeway. He was greeted by a lone woman and learned that this was Grinder's Stand, 72 miles from Nashville.
The woman, Mrs. Robert Grinder, told him that her husband was helping with the harvest at their Duck River farm some 20 miles distant. Lewis asked for lodging, to which Mrs. Grinder assented, but asked, "Do you come alone?" Lewis replied that two servants would be along shortly. He took his saddle into the cabin which the woman indicated would be his. He then asked for some whiskey, but drank little of what Mrs. Grinder gave him. When the servants rode up, Lewis asked them for powder for his pistols, saying that he was sure he had some in a canister. The servants gave no distinct reply, and Lewis began pacing forth and back before his cabin, obviously upset, talking to himself. At times he would walk up almost to his startled hostess, then wheel away, apparently wrapped in thought and anger.
Mrs. Grinder began preparing a bed for Lewis but he stopped her, explaining that he preferred to sleep on the floor. He sent his servant for his bearskins and buffalo robe, which were spread on the floor. She made a bed for herself and her children in the kitchen cabin, while the servants went to sleep in the stable, 200 yards away. But Mrs. Grinder did not sleep, lying awake for a long time, listening to Lewis talking aloud, "like a lawyer" as he walked about in the adjacent cabin. Later, while dozing, she was startled by the loud report of a firearm nearby. It was followed by a thud in Lewis's cabin, like a heavy object falling. Then she heard the words "Oh, Lord!", soon followed by the sound of another shot. A few minutes later, she heard her guest at the kitchen door, crying out pitifully, "Oh, Madam! Give me some water and heal my wounds!"
It was about 3 a.m. She looked through the chinks in the log wall and saw Lewis staggering and falling between the kitchen and sleeping cabin. Mrs. Grinder was too terrified to help. With two small children, her first responsibility was to them-to protect them from the guns of a crazy guest. At daybreak she sent the children to the barn to arouse the servants who had apparently heard nothing.
Pernia and Neelly's servant found Lewis lying on the bed which he had spurned the night before. He had bullet wounds in the head and body, with knife cuts about the throat, was in great pain, and only fitfully conscious. Lewis showed them where a bullet had entered his body, and where it had emerged from his back near the spine. The other bullet had torn off a portion of his forehead, not causing much bleeding but exposing part of the brain. According to Mrs. Grinder, Lewis begged them to take his rifle and blow out his brains. If they would do this for him, he said, he would give them all the money he had in his trunk.
Meriwether Lewis's last words on earth came as the rising sun tinged the treetops to the east with light. They were, "I am no coward, but I am so strong. So hard to die."
Because Major Neelly arrived on the scene a few hours after Lewis died, and had immediate opportunity to question the eyewitnesses, both individually and collectively, he could have obtained accurate knowledge of what happened. As he prepared the body for burial, he studied the wounds and satisfied himself that they matched the stories told him by Mrs. Grinder and the two servants. And if he had further questions, he had ample opportunity to question Pernia on their 72-mile trip to Nashville.
Likewise, Thomas Jefferson would have questioned Pernia at length when he arrived at Monticello: not only concerning the terminal events along the Natchez Trace, but also what he had observed of Lewis's behavior during recent months in St Louis, and the two suicide attempts while boating down the Mississippi. And Meriwether's mother, Lucy Marks, would have questioned Pernia concerning her son's last days until satisfied that she knew the truth. The fact that they and William Clark unanimously concluded that it was suicide, should enable everyone to agree that the immediate cause of Meriwether Lewis's death was suicide.
This, then, leads to the key question with which this investigation is concerned: Why would a very intelligent and outstandingly able 35-year-old man, who had won great fame, and had an important position and a great future, commit suicide? Syphilis is the most likely answer. A brief account of Paretic Neurosyphilis from an excellent text may help the reader judge the appropriateness of the diagnosis:
Paretic Neurosyphilis is a chronic spirochetal meningoencephalitis which severely disturbs the function of the cerebral cortex and thereby leads to a general dissolution of mental and physical capacities. Insidious Onset of Paretic Neurosyphilis: Often it is only in retrospect, after the nature of the disorder is apparent, that the slight defects in critical faculties and minor peculiarities of conduct are appreciated. Then the relatives remember numerous small incidents that take on a new meaning. They may recall that the patient may have been less aggressive, less competent, and less interested in his affairs. Mistakes in business will be found to have crept into this man's dealings for quite a little while before recognizable symptoms appear. Other symptoms of early mental deterioration may have been present, such as forgetfulness, tardiness, discourtesy, carelessness of personal appearance, unsound judgment, undue suggestibility, irascibility, and self-assertiveness. Periods of depression with undue sensitivity, suspiciousness, and ideas of guilt may occur and sometimes alternate with periods of elation, undue optimism, sense of well-being, and over-activity. Sleep is at times disturbed, restlessness appears, and bodily complaints are mentioned, occasionally leading to erroneous diagnoses of neurasthenia. These alterations of personality and conduct may be of a minor degree, occurring only at intervals and covering a time expanse of many months, or they may progress very rapidly.
Some researchers have felt that the death of Lewis must have been a homicide because they could not believe that anyone as capable as he and with so much to live for would commit suicide. But the diagnosis of neurosyphilis overcomes that objection. The fabric of evidence includes these evidential threads:
Of the three comrades with Lewis at the Shoshone village on August 13-14, 1805, McNeal was diagnosed with syphilis, John Fields died in 1809-before Lewis-cause not given, and Drouillard was killed by Blackfeet Indians in 1810 near where the Expedition battled the Blackfeet in 1806.
Reimert
T. Ravenholt, MD ('71) is president of Population Health Imperatives in Seattle,
WA. A distinguished career in epidemiology and public health worldwide whetted
his curiosity about the travels and mysterious death of Meriwether Lewis. He
previously published on the death of Meriwether Lewis in the May 1994 Epidemiology.
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