Or Perish in the Attempt: Wilderness Medicine in the Lewis and Clark Expedition

Abstract

David Peck, MD, has provided us with a most readable and scholarly contribution to the relatively small body of literature that examines the medical aspects of the famous Lewis and Clark expedition (1804–06), a 28- month, 8000-mile round-trip over the Rocky Mountains to the Pacific Ocean from St. Louis, MO, via the Missouri and Columbia Rivers. This expedition has for many decades been popularly recognized as a classic odyssey and adventure saga. Additionally, through extensive primary documentation of the details of the journey, Captains Lewis and Clark have provided enough information and intrigue to keep generations of specialist scholars fully occupied. Dr E.G. Chuinard set a high standard in the medical history realm when he produced the first book strictly devoted to the expedition's health care experiences with his scholarly Only One Man Died: The Medical Aspects of the Lewis and Clark Expedition in 1979. More than 20 years passed with no additional book-length contributions to this topic concerning the expedition. Then, within just a few months of each other in 2001 and 2002, two books concentrating on the medical history of the Lewis and Clark expedition were published. Peck's Or Perish in the Attempt was preceded (just barely) by Bruce Paton's Lewis and Clark: Doctors in the Wilderness (Golden, CO: Fulcrum Publishing, 2001). Fortunately, Peck and Paton each use a different approach to the medical aspects of the expedition, making them complementary works in many respects. Or Perish in the Attempt is organized in a fashion that heightens its readability, beginning the story with a picture of the United States, and particularly the status of medicine, at the turn of the 19th century. One of the strongest and perhaps most interesting elements of Dr Peck's book is that as he notes significant illnesses the members suffered, he compiles documentation from the expedition's journals and other writings, reviews treatments administered, and then compares and contrasts what was done during the expedition with modern-day treatments for the same problem. Though he aims to be understood by nonmedical readers, which he admirably accomplishes with the exception of a few eclectic phrases or expressions, he cites established modern medical sources and has provided the book with a comprehensive bibliography that will be useful to future Lewis and Clark scholars. Peck's detailed discussion of diseases not recognized by Chuinard in Only One Man Died (such as chlamydia and trichinosis) are also an important contribution to the medical history of the expedition. Peck's mix of personal opinion, quotes from the journals of Lewis and Clark, and references to the medical literature generally paint a very coherent picture of the challenges faced by the captains as they struggled to treat serious wounds, infectious disease, and assorted lesser maladies with the limited resources and knowledge (at least by modern standards) that they possessed. Although this work is by and large comprehensive in its coverage of the medical aspects of the Lewis and Clark expedition, there is no discussion of possible depressive episodes suffered by Captain Lewis during the expedition (although this has been often mentioned elsewhere) or of the implications such an illness may have had throughout the course of the journey. Other topics, such as nutrition, could have been discussed at greater length, but this may well have made the book less interesting for the general reader. However, the reviewer believes that this entertaining and informative book is well worth reading by anyone with even a passing interest in the status of medicine at the turn of the 19th century in general or on the Lewis and Clark expedition in particular.