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

Peck, David

Primary Category: Literature / Nonfiction

Genre: History

Annotated by:
McEntyre, Marilyn
  • Date of entry: Jan-19-2004
  • Last revised: Sep-05-2006


This lively volume of medical history chronicles the forms of suffering, illness, injury, and treatment endured by the members of the Lewis and Clark expedition of 1805. Beginning with three chapters of political and medical history to set the context, the story follows the adventures of the extraordinarily fortunate "Corps of Discovery" among whom Lewis was the most trained in the medicine of the time (having studied in preparation for the trip under Dr. Benjamin Rush of Philadelphia), and he only an amateur. Even professional medicine of the time was approximate and largely ineffectual, limited mostly to purgatives, opiates and laudanum for pain relief, bleeding, and topical applications of various compounds or herbal substances.

The story chronicles the main events of the trip based on the extensive journals of Lewis and Clark as well as other historical account, maintaining focus in each chapter on the medical incidents including gastrointestinal distress from parasites and contaminated water; effects of overexposure like hypothermia and exhaustion; infections from wounds and scratches; syphilis; dislocations; muscular spasms; mosquitoes and other insect bites; snakebites and other animal attacks.

Along the way Peck pauses to explain the rather rudimentary medical theories upon which treatments were based, the effects of particular known treatments, and what Lewis and others likely knew, guessed at, or didn’t understand about lead, mercury, opium, and certain herbal substances they used. He speculates about the contexts of their medical decisions and offers occasional contemporary analogies to help readers imagine the circumstances and tradeoffs the explorers faced.


The book offers a useful and memorable model of medical history in context. It is engagingly anecdotal and conversational in that the author pauses now and then to muse, speculate, or wonder about how the explorers might have felt about particular problems. Though the story lacks the critical framework an academic historian might be expected to provide, it does do a great deal of teaching in the context of skillful storytelling and is enlivened by the writer’s own enthusiasm for the Pacific Northwest and the adventure story that is so key to understanding its history.

Accompanied by a brief history of medical theories and a glossary of medicinal substances in two appendices, it provides much specific information that deepens readers’ understanding of the harsh terms on which any life was lived on the frontiers of the expanding 18th and early 19th century U.S. It concludes with a postscript describing the eventual deaths of the various key players, including speculation about Lewis’s presumptive suicide after a struggle with depression and probable opium addiction in the wake of his highly successful and exhausting years of exploration. A fine contribution to American medical history, very accessible to general readers.


The author holds a degree in osteopathic medicine.



Place Published

Helena, Mont.



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