A Cryptic Record of a Family Tragedy: The Unhappy Progression of Patsy Custis’s Epilepsy

TOPICS: 50 Years of Editing, Featured Document(s), Financial Papers, George Washington, Health and Medicine, Martha Washington, Washington or Custis Family

by Philander D. Chase, Former Editor in Chief (1998-2004)
November 28, 2018

When George Washington married the widow Martha Dandridge Custis on Jan. 6, 1759, he acquired not only a wife but also two stepchildren, four-year-old John Parke “Jacky” Custis and two-year-old Martha Parke “Patsy” Custis. By 1772, when Charles Willson Peale painted a miniature portrait of Patsy, she had grown to become an attractive young girl on the verge of womanhood.¹ She also was a wealthy heiress. Her share of the large Custis estate was £2,250 sterling in bank stock and bonds, a substantial liquid asset in the cash-starved economy of colonial Virginia.² Wealth bought Patsy many luxuries: fine clothes and jewelry, a harpsicord and dancing lessons, excursions to Williamsburg, a pet parrot, and other pleasant things.³ It could not buy her good health, however. From a very early age, Patsy was afflicted with epilepsy.⁴ As she entered adolescence, the disease began to grow ominously worse, much to the distress of her family.

The progression of Patsy’s epilepsy can be traced in George Washington’s diaries but only with some effort. Washington’s diary entries, for the most part, are sparse records of crops, weather, and routine daily occurrences. Seldom does he offer explanations and rarely does he confide his innermost thoughts. In only two of his entries does Washington explicitly mention his stepdaughter’s “fits,” the 18th-century term for epileptic seizures. On Feb. 16, 1769, he wrote that Joshua Evans came to Mount Vernon and “put an Iron Ring upon Patcy (for Fits).”⁵ According to an old English folk tradition, a “cramp ring” worn on a finger would alleviate epileptic seizures. Its futility was soon evident. In his diary entry for April 14, 1769, Washington noted that the family set out to visit a neighbor, “but Patcy being taken with a fit on the road by the Mill we turnd back.”⁶

Desperate to stop Patsy’s terrible seizures, George and Martha Washington were willing to try almost anything, even an improbable folk remedy. They mainly relied, nevertheless, on conventional 18th-century medical treatments for epilepsy. Of the several physicians whom they consulted about Patsy’s condition, two served as her primary caregivers: Dr. William Rumney of Alexandria, Va., and Dr. John Johnson of Maryland.⁷

Doctor Rumney, a former British army surgeon, appears in Washington’s diaries as a frequent visitor to Mount Vernon during the late 1760s and early 1770s. Rarely does Washington indicate the purposes of the doctor’s visits. Only when Washington Papers editors found some of Rumney’s medical bills in the Custis Papers at the Virginia Historical Society, did they determine that he came to Mount Vernon to treat Patsy for her seizures at least ten times between February 1768 and June 1772. Rumney prescribed most of the standard epilepsy medicines of the time: valerian, musk, Peruvian bark, and various “nervous” pills, powders, and drops.⁸ He bled her at least once, and it was probably Rumney who recommended that the Washingtons take Patsy to Berkeley Springs in western Virginia during the summer of 1769 to try “the effect of the Waters on her Complaint.”⁹

Although Patsy derived no benefit from the waters, it was at Berkeley Springs that the Washingtons learned from Thomas Johnson of Annapolis that his brother John “had obtained the Secret of curing Fits by simples [herbal medicines].” In June 1770 Thomas wrote Washington that John “is now fully satisfied of the salutary Effects of <the> Medicine which has been considerably improved lately from his own actual Experiment on several Subjects.”¹⁰ Although Dr. Johnson visited Mount Vernon only once or twice, packets of his medicines frequently arrived from Annapolis during the early 1770s. They included ether, which like valerian and musk was thought to be a strong antispasmodic, and an assortment of drops, ointments, and decoctions.¹¹

Eighteenth-century medical remedies for epilepsy, however, were no more effective than Joshua Evans’s iron ring. Patsy’s seizures worsened.

Washington knew precisely how serious that change in severity was. During the summer of 1770, he kept a careful, cryptic record of Patsy’s seizures with a few brief notations written on the margins of the printed monthly calendar pages of the almanac in which he kept his diary. During the 86 days between June 29 and Sept. 22, 1770, Patsy had “fits” on 26 of those days, sometimes twice a day. For July 29 Washington entered the notation “1 Fit,” and for July 31 he wrote “1 very bad D[itt]o,” to indicate an exceptionally severe attack.¹² Although Washington may have shared this information with Martha or with Patsy’s doctors, there is no evidence that he did so, and the obscurity of the record suggests that it was a strictly private one.

The family’s worst fears were realized on June 19, 1773. “About five oclock,” Washington wrote in his diary, “poor Patcy Custis Died Suddenly.”¹³ He conveyed more details and emotion in his letter of the next day to his brother-in-law Burwell Bassett:

It is an easier matter to conceive, than to describe, the distress of this Family; especially that of the unhappy Parent of our Dear Patcy Custis, when I inform you that yesterday removd the Sweet Innocent Girl into a more happy, & peaceful abode than any she has met with , in the afflicted Path she hitherto has trod. She rose from Dinner about four Oclock, in better health and spirits than she appeard to have been in for some time; soon after which she was sized with one of her usual Fits, & expird in it, in less than two Minutes without uttering a Word, a groan, or scarce a Sigh.¹⁴

1. “[Diary entry: 22 May 1772];” “Guardian Accounts, 3 November 1773,” Founders Online, National Archives, last modified June 13, 2018. Also available in print: The Diaries of George Washington, 3:109; and Colonial Series, 9:366–374.
2. “IV-C. Martha Parke Custis’s Estate Account, c. November 1761;” “III. Guardian Accounts, 12 April 1762,” Founders Online. Also available in print: Colonial Series, 6:275–276; and 7:86–93.
3. “[Diary entry: 27 February 1768],” “[Diary entry: 20 September 1768],” “[Diary entry: 2 December 1769],” “[Diary entry: 18 April 1770],” “[Diary entry: 18 June 1770],” “[Diary entry: 7 August 1770];” “Cash Accounts, April 1773,” Founders Online. Also available in print: The Diaries of George Washington, 2:40, 94, 199-200, 229, 247, 262; and Colonial Series, 9:207–209.
4. “[Diary entry: 24 February 1768];” “From George Washington to Burwell Bassett, 20 June 1773,” Founders Online. Also available in print: The Diaries of George Washington, 2:39; and Colonial Series, 9:243–244.
5. “[Diary entry: 20 February 1769],” Founders Online. Also available in print: The Diaries of George Washington, 2:128.
6. “[Diary entry: 14 April 1769],” Founders Online. Also available in print: The Diaries of George Washington, 2:141.
7. Others included Hugh Mercer of Fredericksburg, John de Sequeyra of Williamsburg, and Arthur Lee and George Steptoe, both of Westmoreland County.
8. “[Diary entry: 14 April 1769],” “[Diary entry: 12 March 1768],” “[Diary entry: 31 March 1768],” “[Diary entry: 11 July 1768],” “[Diary entry: 9 November 1768],” “[Diary entry: 6 January 1769],” “[Diary entry: 31 January 1769],” “[Diary entry: 16 February 1769];” “[Diary entry: 2 January 1771],” “[Diary entry: 23 February 1771],” “[Diary entry: 12 June 1772],” Founders Online. Also available in print: The Diaries of George Washington, 2:39, 45, 47, 76, 108, 119-20, 123, 128; and 3:1, 9, 114.
9. “[Diary entry: 9 November 1768],” “[Diary entry: 31 July 1769],”  “[Diary entry: 6 August 1769],” “[Diary entry: 23 August 1769],” “[Diary entry: 15 September 1769];” “From George Washington to Burwell Bassett, 18 June 1769,” “Cash Accounts, 31 July–17 September 1769,” Founders Online. Also available in print: The Diaries of George Washington, 2:108, 168-69, 174, 177, 180; and Colonial Series, 8:217, 238-40.
10. “To George Washington from Thomas Johnson, 18 June 1770,” Founders Online. Also available in print: Colonial Series, 8:352-53.
11. “[Diary entry: 3 February 1771],” “[Diary entry: 29 November 1771],” “To George Washington from Thomas Johnson, 26 March 1772,” Founders Online. Also available in print: The Diaries of George Washington, 3:7, 71; Colonial Series, 9:28.
12. “[Diary entry: 13 June 1764];” “[Diary entry: 31 July 1770],” Founders Online. Also available in print: The Diaries of George Washington, 1:329-30; 2:257.
13. “[Diary entry: 19 June 1773],” Founders Online. Also available in print: The Diaries of George Washington, 3:188.
14. “From George Washington to Burwell Bassett, 20 June 1773,” Founders Online. Also available in print: Colonial Series, 9:243.