Smallpox During the War
During the Revolutionary War, poor conditions on the battlefield and in hospitals often led to soldiers dying from diseases or infections. There were two types of hospitals at the time: general hospitals and regimental hospitals. Regimental hospitals suffered from poor staffing, while general hospitals were criticized for being overcrowded, which allowed diseases to spread quickly. The overcrowding in general hospitals was the typical cause of a raised the mortality rate as medical resources were already limited.
Many surgeons criticized general hospitals, despite them having more qualified medical staff. British surgeon Robert Jackson, who served with the 71st Regiment, wrote in his journal, “Where sick men are crowded together in narrow space, the air is contaminated; where air is contaminated, the progress in the recovery of health is low.”1Jackson believed that separating sick soldiers into smaller, detached buildings would improve their chances of recovery. Similarly, John Pringle, a British military physician, noted in his work Observations on the Diseases in the Army that diseases worsened in crowded hospitals due to poor air quality, which led to “jail fever”— a common result of overcrowded, unsanitary conditions.“To this was added a still more alarming distemper, namely the jail, or hospital-fever, the common effects of foul air from crowds and animal corruption2.The observations from these war surgeons highlighted the need for better hospital practices, influencing medical care in the years to come.
Smallpox, which had spread from Europe to the Americas, quickly became a serious and deadly threat to the Continental Army. In Smallpox in Washington’s Army, Ann Becker explains soldier recruitment was adversely affected, desertions increased, and commanding officers were forced to proceed with inadequate numbers 3 because of smallpox. George Washington understood the importance of protecting his soldiers from smallpox. He ordered soldiers to be sent to Philadelphia for vaccination and urged officers such as Lt. Colonel James Mitchel Varnum to ensure that the troops were immunized. Washington wrote to Varnum, stressing the urgency of inoculation: “With every inclination imaginable to overlook omissions, I cannot find a good excuse for this delay—such dilatoriness must increase our difficulties"4. Vaccinating soldiers helped Washington maintain a more effective fighting force and also promoted inoculation to the public as a way to fight the disease."By the spring of 1777, the Continental Army had inoculated about 40% of its soldiers in an attempt to control the disease. The decision to inoculate was one of the most important medical and military strategies of the Revolution."5 The experiences of these surgeons and physicians during the Revolutionary War played a key role in shaping the development of medical practices. Their observations on hospital conditions and disease control laid the groundwork for advances in healthcare and medicine in the years that followed.
1 Jackson, Robert. 1803. “Remarks on the Constitution of the Medical Department of the British Army: With a Detail of Hospital Management, and an Appendix, Attempting to Explain the Action of Causes in Producing Fever and the Operation of Remedies in Effecting Cure by Robert Jackson M.D.” Wellcome Collection. 1803. https://wellcomecollection.org/works/nkejqhw5/items?canvas=367.
2 Pringle, John. 1810. “Observations on the Diseases of the Army by Sir John Pringle, Bart.” Wellcome Collection. 1810. https://wellcomecollection.org/works/xh37sa3v/items?canvas=66
3 Becker, Ann. 2004. “Smallpox in Washington’s Army: Strategic Implications of the Disease during the American Revolutionary War.” Msu.edu. 2004. https://www-jstor-org.proxy2.cl.msu.edu/stable/3397473?seq=1
4 Smallpox Inoculation Letter | George Washington’s Mount Vernon. 1777. Www.mountvernon.org. April 3, 1777. https://www.mountvernon.org/education/primary-source-collections/primary-source-collections/article/smallpox-inoculation-letter
5 Fenn, Elizabeth A. Pox Americana. Hill and Wang, 2001