有关华盛顿的死亡，一直是美国医史学界讨论的问题之一。

     

2008年8月Am Surg发表了一篇文章，仍然在分析导致华盛顿的死因。
（Cheatham ML. Am Surg 2008; 74:770-774）

The controversy surrounding the death of George Washington was immediate, intense, and continues today. After a horse ride in sleet and snow, Washington developed fulminant acute epiglottitis that rapidly claimed his life within 24 hours. In treatment, he endured phlebotomy of over 2500 mL as well as various other painful therapies that were the standard practice of the day. Over the years, numerous criticisms have been lodged against the care his three physicians rendered. Although the marked bloodletting has been most heavily scrutinized, others have argued that Washington could have survived had a tracheostomy been performed. Delayed presentation, prolonged Class IV hemorrhagic shock, acute respiratory failure, and probable septic shock in a 67 year old with preexisting medical comorbidities has a high mortality rate today and would have been irreversible in 1799. George Washington’s inevitable death was assured by his own initial actions compounded by the treatments initiated by his physicians.

 

分析一下华盛顿死亡当日和前一日的医疗档案，我们可以排列出一个时间表。

 

 

结合既往史，华盛顿的死因是综合的：

1. 患者的基础情况：67岁高龄，有比较多的基础疾病；

2. 患者的心理状况表现为倔犟的个性：感咽痛后仍然在风雪中骑马，发病后两次拒绝治疗；

3. 直接导致死亡的疾病：急性会厌炎，既便在现在，若诊断治疗不及时，死亡率也较高；

4. 当时西医的主要治疗手段：先后放血约2500ml，造成失血性休克；

5. 临床医师的责任：3位临床医师（Dick、Craik和Brown）对实施气管切开的意见不统一。

 

这些因素最终造成了华盛顿不可挽回的死亡。




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