Dr. Peck provides a thorough medical analysis of the illness and death of Sergeant Charles Floyd on August 20, 1804, near present-day Sioux City, Iowa. Drawing on the detailed symptom descriptions recorded in the journals of Lewis, Clark, Floyd himself, and other expedition members, Peck evaluates the traditional diagnosis of a ruptured appendix against modern medical knowledge. The article examines the progression of Floyd’s symptoms — severe abdominal pain, fever, and rapid deterioration — and considers alternative diagnoses including peritonitis from various causes. Peck concludes that the most likely cause of death was indeed acute appendicitis leading to peritonitis, a condition that would have been fatal regardless of medical intervention available at the time. The article also discusses the expedition’s medical practices and the limitations of early 19th-century medicine.
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