The Health of the First Ladies: Medical Histories from Martha Washington to Michelle Obama (28 page)

The homeopathic principles of similia and infinitesimals, while perhaps ineffective, at least did no harm. In contrast, the hallowed treatments of nineteenth century orthodox medicine—cathartics, emetics, scarification and bleeding—often did. This kinder, gentler form of medicine attracted many patient-adherents, especially in urban areas and among the well-to-do. Orthodox-homeopathic strife was kindled with the transplantation of the unorthodox philosophy in America, smoldered while homeopathy increased in popularity, and burst into flames during the 1880s and 1890s. The American Medical Association forced its members to avoid all contacts with all practitioners of the Hahnemann school. If this prohibition were violated, the transgressor was punished. An example was that of Ellen Wilson’s New York gastroenterologist, William Van Valzah, who was chased out of Philadelphia by his orthodox medical colleagues because he preferred the personal care of a homeopathic physician. Whether the AMA’s motivation was primarily philosophical or financial is unknown.
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The much-overlooked 1901 memorial statue on Scott Circle in Washington, D.C., that depicts Samuel Hahnemann, the founder of the homeopathic medical discipline (Library of Congress).

At the turn of the twentieth century, American homeopathy peaked in influence and adherents. In 1900 between 8 and 10 percent of physicians were homeopaths. Twenty-two homeopathic medical schools were extant in 1900, and in 1898 American homeopathy hosted nine national medical societies, thirty-three state medical societies, eighty-five local societies, sixty-six general homeopathic hospitals, seventy-four specialty homeopathic hospitals, fifty-seven homeopathic dispensaries, and thirty-one medical journals. Towards the end of the nineteenth century, orthodox doctors discovered a need to cooperate with homeopaths in order to effect meaningful state licensure laws. Both groups of physicians realized that unity was required to ensure a system of quality health care, The coalition’s goals were twofold: To drive incompetent doctors from the practice of medicine and to limit the prerogatives of newer medical sects—chiropractors, osteopaths and Christian Scientists.
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Drs. Sawyer (62 years old) and Boone (32 years old) were trained during different eras; both were involved in the care of first lady Florence Harding, and Boone treated first lady Grace Coolidge. Their White House tenures provided opportunities to contrast their medical knowledge and degree of homeopathic parochialism.

Dr. Charles Sawyer was an 1881 graduate of the Homeopathic Hospital College of Cleveland. Sawyer was very prominent in homeopathic circles, as president of the Ohio State Homeopathic Medical Society and the American Institute of Homeopathy. In addition he authored articles that appeared in the
Journal of the American Institute of Homeopathy
.
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His connection to the Harding family dated to July 1897. Future president Warren Harding’s mother, Phoebe Harding, was a practicing homeopathic physician who was accused of negligence in the death of a patient. Sawyer, then a prominent physician in the same Ohio town, was called in as a consultant in the legal controversy. His testimony supported Dr. Harding’s professional performance, saving her practice from ruination. The local newspaper commented, “This statement, from a man of Dr. Sawyer’s ability and standing in the community, relieves Mrs. Harding from all responsibilities in the affair.”
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Subsequently “Doc” Sawyer and his wife became very friendly with Warren Harding and his wife, Florence. Their friendship was possibly due to the homeopath’s beneficial intervention in the Phoebe Harding malpractice case, or perhaps it was a natural result of social companionship between two “power couples” in a small mid–America town. Both Hardings became increasingly dependent upon Sawyer for their medical care, Florence, almost obsessively so. Sawyer’s medical responsibility for Mrs. Harding lasted until his death in 1924.
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Florence Kling DeWolfe, a determined and independent single mother of one, married up-and-coming Warren Gamaliel Harding, a man five years her junior, in July 1891. Called the Duchess by her husband and many others,
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she was forceful, competent and smart. The Duchess effectively managed Harding’s career as a newspaper publisher and a politician. Her thirty-three-year marriage with Harding produced no children.

Florence Harding’s first recorded battle with kidney disease forced the cancellation of the Hardings’ planned cruise to Cuba. In early 1905 Florence was admitted to Grant Hospital, Columbus, Ohio, with acute renal failure. The diagnosis was a “floating kidney” with obstruction of its ureter. “Floating kidney” was then a somewhat popular diagnosis; it referred to an abnormal descent of a kidney from its normal position when the patient was recumbent upon the patient’s standing upright. More common in women, it rarely produced sufficient ureteral kinking or bending to cause an obstruction to the normal flow of urine into the bladder. Complications included infection of the affected kidney with severe cramping pain, and more serious, the retention of toxic products, so-called uremic poisoning.
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Unfortunately for Mrs. Harding, severe ureteral blockage had occurred and uremic poisoning ensued. On February 24, 1905, Dr. James Fairchild Baldwin elected to wire the affected kidney in place. He did not perform a nephrectomy because of previous “heart damage.” Heart disease, without any specificity or documentation, became a frequent allusion during the rest of the Duchess’s life.
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Her postoperative convalescence was lengthy, requiring hospitalization for eight months. The surgical wound required dressings twice daily. Her surgeon, Dr. Baldwin, a graduate of Jefferson Medical College, was considered “in his day … the equal of any surgeon in America.” He was the founder of Grant Hospital, then the largest hospital in the United States.
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A minor relapse of Mrs. Harding’s kidney ailment occurred in spring 1908. It placed the Duchess once again under Doc’s care: “As the summer wore on, she grew increasingly dependent upon his homeopathic concoctions for all her physical problems, real and imagined, believing Doc was the one man who could keep her alive…. It was the beginning of her complex emotional yet unromantic entanglement with him.”
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Florence Harding, the wife of Warren Harding. She was a strong believer in homeopathic medicine (Library of Congress).

Four years later, in 1912, the Duchess made frequent visits to the Sawyer-owned White Oaks Sanatorium for physical and psychological respite.
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The entrepreneurial Sawyer moved his health care facility from downtown Marion, Ohio, to the rural White Oaks Sanatorium, where he constructed fourteen bungalows placed around a central courtyard. An enclosed hall called the Cloister encircled the courtyard and connected all of the buildings. Sawyer promoted White Oaks “as a haven from the cares of the world, a place where patients could relax and reap the full benefits that nature’s bounty and modern medicine could provide.” His enterprise was advertised as a respite for those afflicted by nervous diseases and mental disorders. Treatments included “rigorous outdoor exercise, light therapy, hydrotherapy, massage and electrotherapy.”
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Sawyer’s son, Carl, a 1906 graduate of the allopathic Rush Medical School in Chicago, joined his father at White Oaks, and thereby became involved in the care of Florence Harding. The younger Sawyer eventually was certified by the American Board of Psychiatry and Neurology. Carl Sawyer’s transition from homeopathy to orthodoxy reflected the friendly coexistence of the two branches of medicine that began around 1900.
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Another serious kidney attack occurred in December 1912 and persisted into 1913. The Sawyers treated the Duchess with unspecified measures at White Oaks. The gravity of the attack was underscored by the senior Sawyer’s prognosis that his patient was not expected to live. Doc attributed its onset and severity to an underlying cardiac condition. References to Mrs. Harding’s diseased heart abound, but its nature was never clarified.
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An episode in autumn 1915 was treated by the elder Sawyer. This was considered mild, since Mrs. Harding insisted in journeying to Washington, D.C., to witness her husband take the oath as the new United States senator from Ohio. This proved to be unwise, as a relapse occurred.
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In January 1916, the then-senator’s wife became ill with heart palpitations, acute indigestion, pain, abdominal swelling and severe “flu.” Residing in the District of Columbia and distant from the amenable ambience of the Sawyers and their White Oaks Sanatorium, the Hardings elicited the services of the esteemed Washington practitioner Dr. Sterling Ruffin. The doctor was nonpartisan, treating both the Democratic Wilsons and the staunch Republican Duchess. Ruffin’s examination detected no evidence of renal dysfunction. However, in Florence’s opinion, Ruffin did not measure up to Sawyer’s talents. In a dismissive tone she opinion: “This Washington doctor … I never want to see him.” Sawyer, summoned from White Oaks, arrived in Washington and dosed his loyal patient with his homeopathic regimen of “dark pellet,” “green medicine,” “flat white tablets,” and “yellow pellets.” Mrs. Harding recovered.
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Another severe attack occurred in November 1918, the most menacing since the initial episode in 1905. The kidney had swollen to ten times its normal size and, in the words of her husband, was “far more painful than you can imagine.” The diagnosis was hydronephrosis secondary to obstruction of the ureter. Carl Sawyer, then stationed as an army doctor at nearby Fort Meade, attended, together with Dr. Bernard Hardin, who practiced in several District hospitals. Surprisingly, Mrs. Harding liked Hardin. Four years later, she sent him flowers and also a letter of concern over the doctor’s ill health, possibly as a reflection of her satisfaction and appreciation for his earlier service to her. Despite this, she took only the pills prescribed by the senior Dr. Sawyer.
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Since Mrs. Harding was convinced that only Doc Sawyer could keep her alive in the White House, her husband insisted that Sawyer become the White House physician. However, the inducements of a brigadier general’s appointment and additional bureaucratic titles were required to lure Sawyer from his lucrative White Oaks practice to Washington, D.C.
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Doc Sawyer kept the first lady alive during a near-fatal medical emergency during August and September of 1922. While on an August 25–27 cruise aboard the presidential yacht the Duchess developed indigestion. Fortunately, Sawyer correctly suspected a recurrence of kidney disease and confined his patient to her White House bed.
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Initially the illness was described as “an ailment neither alarming nor serious … due to the effects of a cold complicated with a recurrence of a hydronephrosis.” The patient’s condition gradually worsened until September 7, when great pain caused President Harding to summon Dr. Joel Boone, then Sawyer’s assistant, to her bedside. The following day Florence Harding developed uremic toxicity and nearly died. The alarmed president said to a friend, “I am afraid that Florence is going.”
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Sawyer, frightened as his patient’s condition worsened, relied heavily on Dr. Boone and, in addition, urged both his son Carl and the president’s cardiologist brother, George Harding, to hurry to Washington from Ohio. In this VIP’s medical emergency Doc sought both safety and solace in numbers. He enlisted expert surgical consultations from the renowned Rochester, Minnesota, surgeon, Dr. Charles Mayo, who in turn brought in Dr. John Finney, chief of surgery at Baltimore’s Johns Hopkins.

President Harding insisted on full transparency for his wife’s medical condition. This was one of the few times that the seriousness of a first lady’s illness was presented to the country in complete detail. Harding was mindful of the recent political controversy attached to the secrecy of President Woodrow Wilson’s stroke.
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On September 8, Sawyer released the following statement to the press: “Mrs. Harding, whose illness is a recurrence of attacks before coming to the White House developed complications Thursday and Thursday night which made her condition critical. These complications are so serious that recovery is not yet assured. Doctor John Finney of Baltimore was called in consultation tonight and Dr. Charles Mayo is en route from Rochester, Minnesota. Doctor Carl W. Sawyer and Doctor Joel T. Boone have joined in the attendance of Mrs. Harding today.” After this announcement, twice daily medical bulletins were released until the first lady was out of danger. A Philadelphia newspaper editorialized that such disclosure was “striking in comparison with the attitude of the previous Administration as to compel notice.”
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