Hello. My name is Nate Hess and I'm 
a park guide with the Lewis and Clark
National Historic Trail. The purpose of
the Lewis and Clark National Historic
Trail is to commemorate the 1803 to 1806
Lewis and Clark expedition. Now as you
can probably see I am actually sitting
at my kitchen table at home I've got a
mug rack back here behind me as well as
a portrait - a picture up here on my
side as well. That's because at the
moment I am currently teleworking I'm
basically working from home and that is
due trying to stay safe from the Covid
-19 pandemic trying to slow the spread of
that pandemic. The doctors, nurses, and
other medical professionals at the
forefront of fighting the Covid-19
pandemic are what I like to think of as
helpers, they are out there trying to
help people stay healthy, they are out
there trying to save lives, they're doing
a lot of good for our community. Doctors,
nurses, other medical professionals they
are helpers. That is true today, that is
also true over 200 years ago at the time
of the Lewis and Clark expedition. Now on
the Lewis and Clark expedition there was
not a devoted doctor brought along on
the expedition. Both Meriwether Lewis and
William Clark had some rudimentary
medical training from their time in the
United States Army. Army officers at that
time were expected to be able to at
least assist in caring for their men if
they got sick, so both Meriwether Lewis
and William Clark brought along a bunch
of medicine and medical tools to help
try and keep the men of the Lewis and
Clark expedition safe and healthy. They
did actually a very good job of that on
the expedition, over the course of the
expedition only one man, Sergeant Charles
Floyd, passed away due to medical issues
on the expedition. We don't know what
killed Sergeant Charles Floyd, it was
likely some sort of massive internal
infection, some historians have written
that it was appendicitis, but to be
perfectly frank we don't know what
killed Sergeant
Charles Floyd, likely it's something that
had he even been in Philadelphia or in
one of the other major cities at the
time it would have been something that
the doctors were hard-pressed to save
him from death. But Lewis and Clark, William
Clark, excuse me,
Meriwether Lewis, William Clark, they did
a very good job of keeping their men
healthy on the expedition. Most of the
medicine that they brought along on the
expedition would be called purgatives,
basically it's trying to get something
inside of you,
out of you in some way shape or form. A
lot of the predominant medical thought
at that time thought that purgatives
would help keep people healthy if they
got sick. In order to make some of those
medicines a bit more palatable, Lewis and
Clark actually brought along a few
spices that you guys all probably have
in your own kitchen,
to this day. Something that I have here
I've got some ground cinnamon, that I've
got in my got in my kitchen back here,
I've got some nutmeg as well, that's
something that Lewis and Clark brought
along, and I've also got some cloves as
well, this was all listed in the supplies
that Lewis and Clark brought along with
their medical supplies on the Lewis and
Clark expedition, so that's a little bit
about some of the medicine that Lewis
and Clark brought along, but they also
brought along a full surgical kit on the
expedition in case one of their men was
injured, if in case they needed to
perform something as drastic as an
amputation, something along those lines.
They brought along a lot of tools that
can be used for an amputation as well,
and I've got many of those items,
reproduction items, up here in front of
me right now, and I'd like to chat with
you guys a little bit about some of
these tools of what they would be used
for. Now on the Lewis and Clark
expedition they really didn't get to use
the whole amputation kit there is at one
point where they - where Meriwether Lewis
actually does amputate the toes of a
young American Indian boy
up in North Dakota, who got frostbite on
his toes and in order to try and save
that young man's life, Meriwether Lewis,
basically it says in the journals
that they sawed the toes off of that
young boy and in order to do that he
probably used something kinda like
this, the proper term for this is a
metacarpal saw, this is a type of bone
saw that would be used on something
small, something like a finger or a toe,
not nearly anything as big as an arm or a
leg, there was a different saw for that,
and we'll come up to that a little later on
in this talk. As you can see here it's
got a wooden handle, it's got a long
curved apparatus here, and it's got a
blade on it that almost kind of looks
like a hacksaw blade between these two
spanners on it as well and, this is likely
like I said the type of bone saw
that would be used on a smaller part of
the body such as a finger or a toe, other
than that there's not going to really be
a whole lot of use for the amputation
kit during the actual Lewis and Clark
expedition. Now after the Lewis and Clark
expedition, one of the members of the
expedition actually does undergo a full
amputation, his name is George Shannon,
he was one of the youngest members of
the Lewis and Clark expedition, and after
the Lewis and Clark expedition he will
be involved in a small battle, trying to
return an American Indian chief by the
name of Sheheke-shote back to his tribe
in North Dakota, and during that battle,
Sheheke-shote,
excuse me, George Shannon, is going to be
injured in the leg he's actually going
to be shot in the leg, with a, one of the
soft lead bullets that were used at the
time, and it's going to be weeks later
that George Shannon gets back down to
St. Louis where he's going to need to
receive medical treatment for that nasty
injury. By this time gangrene has begun
to affect that leg, a very very nasty
infection, and in order to save his life
a helper is going to come along, and that
helpers name is
Bernard Farrar he's a physician that
works in St. Louis, and he's going to be
the physician that actually amputates
George Shannon's leg, and to do that he
will use most of the full kit here of
which I'm about to show you for an
amputation. Now one of the first things
that Dr. Farrar would have used is
this metal rod right here, it might not
look exactly like this, remember these
items that I have here are all
reproduction, but this is what is called
a bullet probe, this is basically an old
time x-ray. Dr. Farrar would have used
this to poke around in the wound,
remember this is basically just a metal
rod and he's trying to figure out where
the bullet actually went in that injury,
he needs to find, figure out where
that bullet is, if that bullet just went
into a fleshy part of the body, it's
likely that he would have been able to
just extract the bullet using a pair of
forceps kind of like that, they're almost
kind of like big scissors, but instead of
cutting their purpose is to grab as you
can see here, you can just grab onto
something,
and unfortunately though for George
Shannon that bullet likely hit the bone
in his leg, and also by this point his
leg was developing gangrene remember
that's a very nasty infection that sort
of eats away at flesh, and does all sorts of
other nasty things, and in order to save
George Shannon's life, to keep that
gangrenous leg from becoming any worse
really the only thing that Dr. Farrar
can do to save George Shannon's life, to
help George Shannon at this point is to
take the entire leg off. Now he would
have poked around in that wound trying to
find the bullet, once Dr. Farrar had
decided that he needed to take the
entire leg off, he would have worked very
quickly, he would have used one of these,
he would have applied it to George
Shannon's leg, this is a tourniquet with
a metal screw up on the top as you can
see here, it's got a long cloth strap
that you would use to hook around the
patient's leg, and then by using this
screw this metal screw up on top
you can actually screw the cloth band
here make it very very tight, and what
you're trying to do with this is cut off
most of the blood flow to the leg, so
that your patient doesn't pass away or
go in to shock from blood loss during
the operation. Also before the operation
Dr. Farrar likely would have given
George Shannon a dose of what is called
laudanum, now laudanum while it's not an
actual type of anesthesia it's not
going to knock George Shannon out,
laudanum is basically a mixture of
alcohol and opium. Opium's what
modern-day morphine is made out of and
basically it is an incredibly strong
painkiller, so while the operations going
on hopefully George Shannon's not really
going to really know or care what is
going on during that operation, so after
Dr. Farrar had applied the tourniquet
and after he had applied the laudanum,
given George Shannon a dose of laudanum,
at that point he would have gone in and
started to use some things very familiar
to a medical professional today, really a
lot of the things that I have here on
this table, the materials haven't changed
excuse me, the materials have changed a
lot since the time of the Lewis and
Clark expedition, but the purpose really
hasn't, many of you will recognize what
this is, this is something that would
have been in an amputation kit of the
time, and this is a scalpel, something
that you might have used dissect a frog
in middle school with, something along
those lines, it's got just a very short
sharp blade on it as well as a long
handle, a long wooden handle that the
doctor can use to cut skin and flesh.
Something else that Dr. Farrar would
have used is something a little bigger,
and this is another type of amputation
knife, it is much bigger, this would have
been known as a capital amputation knife,
it's got a long curved blade on it, it
almost looks like a bit of a sickle,
with that long curved blade, and it's
also got a wooden handle like many of
these instruments do down here at the
bottom,
and it's the point of this amputation
knife to basically cut all the way
around an arm or a leg, after that you do
have to cut through the bone. Well I
already talked a little bit about the
metacarpal saw, I'd like to talk a little
bit now about the capital saw, and the
capital saw is much bigger, basically
looks like a modern-day hacksaw that you
would use to cut through metal, it's got
a long metal spanner on it, as well as a
long metal blade on this as well, as well
as a large wooden handle much like many
of these other instruments that I have
up here, and this is the type of large
amputation saw, bone saw that would be
used on something as large as an arm or
a leg and this is the type of bone saw
that Dr. Farrar would have used to cut
through the bone in George Shannon's leg.
Now after that there are a few other
things that you need to do in order to
make sure that that stump gets stitched
up nicely, and one of the things that you
would use is something along the lines
of this, this is a metal rod with a sort
of metal sharp hook down at the end, it
does have a wooden handle as well, and
that type of hook it would be called a
tenaculum, now with the tenaculum
basically you would take long silken
thread, you would tie it around the stem
of the tenaculum down here and then you
would slip it down and over the end of
the tenaculum onto blood vessels, even
though you've got a tourniquet on George
Shannon at this point, blood vessels are
very powerful, and Dr. Farrar, once more
he doesn't want George Shannon to bleed
to death, he would have used that
tenaculum in order to tie long black
silken threads onto the ends of those
blood vessels, in the leg in order to
make sure that George Shannon didn't
bleed to death. After that he would have
stitched George Shannon up and hopefully
no infection develops, doctors at that
time thought that infection was a very
common occurrence because that's just
what they saw most of the time when they
performed
a large surgery such as an amputation,
that being said George Shannon does
survive his surgery, he is saved from
that gangrenous leg, and George Shannon
goes on to have a very successful life
he goes on to assist with some of the
publication of the Lewis and Clark
journals, he eventually goes on to law
school, he goes on to a bit of a
political career, and he goes on to have
a large family as well, and none of that
would have been possible if Dr. Farrar
hadn't been there to help George Shannon,
if he hadn't been there to operate on
George Shannon in his time of need, and
that just reminds me of a quote that I'm
rather fond, of it's from a Pennsylvania
native, guy by the name of Fred Rogers,
you guys probably know him from the
show Mister Rogers Neighborhood, and one
of the things he said once was, "When I
was a boy and I would see scary things
in the news, my mother would say to me,
look for the helpers, you will always
find people who are helping." Dr. Farrar
was a helper to George Shannon, all of
the doctors, nurses, medical professionals
that are out there today fighting
against Covid-19, they are helpers too.
They are out there, doing the good fight
to try and keep people like you and me
safe, they are out there trying to help,
and that is true both today, that's true
over 200 years ago at the time of the
Lewis and Clark expedition, doctors and
nurses are helpers. Thank you so much
ladies and gentlemen and have a
fantastic rest of your day. Bye-bye now!
