Audio version is not yet available By Finn J.D. John January 26, 2025 AS LEWIS AND CLARK’S Corps of Discovery made its way across the continent to Oregon, the men (and woman) of the party probably weren’t thinking much about their place in history. So they weren’t taking any particular pains to document their every movement. There were, however, some particular pains they were experiencing with every movement, so to speak ... as a result of a relentlessly low-fiber diet: Everyone was constipated, all the time. Luckily, they had something that helped with that — a lot. The Corps of Discovery left on its journey with a trove of 600 giant pills that the men called “thunder-clappers,” which the soldiers and travelers used to jump-start things when they got bound up. And everyone used them pretty regularly. The reproduction of Fort Clatsop, built at or near the site of the Corps of Expedition's original buildings. Dr. Rush's Bilious Pills have not been particularly helpful in locating the original Fort Clatsop, long since rotted away — either because it hasn’t been found yet, or because the site of the old pit latrine has been disturbed by farming or logging activities in the years since. (Image: National Parks Service) And, strange as it seems, that fact is why we know several of their campsites along the way. The main active ingredient in “thunder-clappers” was a mercury salt, which is a pretty stable compound. Archaeologists simply have to search for dimples in the ground — which is what old latrine pits often end up looking like, hundreds of years later, after Nature has partly filled them in — and take samples of the dirt in them. If it comes up with an off-the-charts reading for mercury, well, that’s a Corps of Discovery pit toilet — and the layout of the rest of the campsite can be extrapolated with considerable precision by consulting the military manuals they used to lay out their camps. THESE PILLS WERE the pride and joy of Dr. Benjamin Rush, one of the Founding Fathers and a signer of the Declaration of Independence. Rush was also the man President Thomas Jefferson considered the finest physician in the republic. In that opinion, Jefferson was probably alone, or at least in a small minority. Dr. Rush’s style of “heroic medicine” had caused his star to fall quite a bit by this time — especially after the Philadelphia yellow fever epidemic of 1793, when his patients died at a noticeably higher rate than untreated sufferers. At the time, of course, very little was known about how the human body worked. Physicians were basically theorists, who made educated guesses and did their best. The problem was, the education on which those educated guesses were based varied pretty wildly depending on what school you came from. Homeopathic physicians theorized that giving patients a tiny amount of something that mimicked their symptoms would stimulate the body to cure itself. Eclectic physicians sought cures from herbs and folk remedies. Hydropathic physicians believed hot and cold water, applied externally or internally, was all that was needed. Dr. Rush wasn’t from one of these schools. He was from the school of mainstream medicine — also known as allopathic medicine (although that term is a perjorative today). Allopathic medical theory, in the early 1800s, dated from the second century A.D., courtesy of a Roman doctor named Galen. Galen theorized that the human body ran on four different fluids, which he called “humours”: Blood, phlegm, yellow bile, and black bile. All disease, he claimed, stemmed from an imbalance in these humours. Thus, too much blood caused inflammation and fever; the solution was to let a pint or two out. Too much bile caused problems like constipation; the solution was to administer a purgative and let the patient blow out some black bile into a handy chamber-pot, or vomit up some yellow bile — or both. These interventions sometimes helped, but most of the time they had little or no good effect. So by Rush’s time, a number of physicians were going on the theory that what was needed was a doubling-down on their theory — in a style of practice that they called “heroic medicine.” If a sensible dose of a purgative didn’t get a patient’s bile back in balance, a “heroic” dose might. If a cup or two of blood didn’t get the fever down, four or five surely would.