By Phyllis Chapman
Of the estimated 250,000 men who served as soldiers, either long-term or for short periods, there were those who fulfilled Patrick Henry’s impassioned “Give me Liberty or give me Death!” with the ultimate sacrifice. With pictures of battle scenes in one’s head, two massed armies facing each other in an open field, it is easy to visualize the gallant soldier falling on that field; however, the reality of casualties in the Continental Army was considerably more complicated.
As it was in the Civil War 85 years later, far more Continental soldiers died from disease than from wounds. Even hardy American men, accustomed to hard work and open spaces, were quickly brought down by ailments such as smallpox, typhus, typhoid fever, malaria and pneumonia once camped together in close quarters. Poor diet, exposure to weather, and communicable diseases they had not encountered before brought many down before they even reached the battlefield. Combat and its peril was a far more episodic affair; sickness and malnutrition was chronic.
It is estimated that about 1200 men served as physicians and surgeons for the Continental Army. Only about 100 had earned medical degrees from European or the early American medical schools. Most carried credentials earned from apprenticing to a practitioner for an unspecified period. Unfortunately, many of the best qualified ended up in administrative posts, leaving the soldiers to “doctors” who may have had as little as 1 year of apprenticing.
18th century medicine chest
Even highly qualified physicians, such as Dr. Benjamin Rush, had no knowledge whatsoever of germs and their connection with disease. Consequently, treatments were directed to alleviating a particular symptom. “Fever” was considered a disease, often relieved with bloodletting, the resulting pallor and clamminess of the patient after the procedure considered a sign that he was cured! (Dr. Rush was a staunch supporter of bleeding.) Heroic medicine of the period relied upon purges, laxatives, and skin irritants to produce violent reactions that at least convinced doctor and patient that “it must be doing something!”
The connection between hygiene and health was beginning to be understood; Dr. Rush advised that soldiers not be allowed to sleep in wet clothing, that camps be kept clean of animal and human waste and garbage, and take a “complete bath” twice a week. (Bathing was not widely practiced at home on a bi-weekly basis-this recommendation must have been met with incredulity.) Diseases such as typhus, dysentery, scabies, and typhoid fever were caused by poor hygiene, parasites and unsanitary conditions. Pneumonia, either by itself, or occurring during recovery from surgery, was particularly devastating in an era long before antibiotics.
The medications prescribed is hair-raising to those of us in modern times. Compounds we know as poisons today were routinely used as ingredients: mercury, arsenic, and sulphur. “Calomel”, considered a miracle drug, is chemically a combination of mercury and chloride.
Herbal medications were plentiful; some did actually help. (They were, at least, not as poison- ous!) Malaria, a scourge in the Southern Colonies, was effectively treated with Peruvian Bark, which contains quinine. Primitive forms of opiates could slow down dysentery and relieve pain. Many herbs,
in decoctions or infusions, were used as anodynes (pain relievers); valerian, willow bark, and thornapple. Other herbs present in medicine chests were jalap, rhubarb, juniper berries, comfrey, bee balm (monarda), and black cohosh. Herbalists today warn that many of these herbs, while
potentially beneficial in small quantities, are toxic in large doses! Revolutionary era medicine often was truly a case of “the cure being worse than the disease.”
However, one major advance in disease prevention was newly available to the Revolutionary soldier: innoculation for smallpox. The killer disease, today largely eradicated, killed millions before it was discovered that a small amount of pus from an infected person, introduced into a small opening in the skin, would generally result in a mild case of the disease giving lifetime immunity to later contagion. Gen. Washington ordered all Continental soldiers to be innoculated, and private citizens followed suit.
Demonstrating inoculation of The 18th century
Infectious disease remained the leading cause of death in America well into the 20th century. The development of antibiotics and vaccinations for childhood diseases such as diptheria, whooping Cough, measles, and tetanus saved many lives that would have been lost in the 18th century.