Medical Practice During the Revolution
Medical Practice during the Revolution
MEDICAL PRACTICE DURING THE REVOLUTION. On both sides in the American Revolution, many more soldiers died from disease than in combat, and many more died from wounds than were killed outright. The most feared killer in North America at this time was smallpox, which played a critical role in defeating the American invasion of Canada. As a result of that disaster Washington instituted a requirement in the winter of 1776–1777 requiring all new recruits to undergo inoculation for that disease before reporting to the army. This was one of the first instances, worldwide, of that now-common practice. Other diseases swept through eighteenth-century army camps, including diphtheria, dysentery, malaria, measles, and even scurvy. Surgery was primitive, and because microbes and sterilization were not yet understood, those who survived the shock and the bleeding risked lethal infections.
Armies at the time of the Revolution provided a surgeon and surgeon's mates at the regimental level and a more extensive medical staff charged with operating hospitals—both fixed ones at major bases and field hospitals that accompanied forces on military operations. The regimental personnel provided battlefield triage and critical care; the hospitals conducted long-term treatment with a staff of trained medical personnel (physicians, the lower-status surgeons, and apothecaries) supplemented by civilians employed as nurses, orderlies, cooks, and individuals performing any other appropriate support functions. Most combat medical care came after the shooting stopped. The regimental quartermaster would search for the wounded using the regiment's fifers and drummers as stretcher-bearers. Naval vessels of any size also carried a surgeon and sometimes an assistant; large squadrons, or more commonly their bases, would also have hospital ships, which were most often converted obsolete warships.
British military medical practices were quite conventional and operated with the disadvantage that all supplies and replacement personnel had to come three thousand miles from the British Isles. The Hesse-Cassel contingent of Germans also had its own medical staff that operated a hospital; the smaller German forces had much more modest provisions. All of the German regiments had a slightly different arrangement than those of the British or Americans. They would have a surgeon for the regiment but provided a surgeon's mate (Feldscher) for each company, although this individual had far less training than his Anglo-American counterparts.
Within the Continental Army treatment tended to be easier because inoculation centers and hospitals could be placed almost anywhere except on the immediate front lines. The army had a much more difficult time creating an effective and efficient medical administration. The colonies had excellent doctors, including some who had trained in London and Edinburgh. Although in many ways the American doctors were more skillful than the Royal Army's, they lacked infrastructure and a logistical system that could provide specialized medicines. The Continental Congress also had trouble finding a proper head for its medical program. The first choice was Benjamin Church of Massachusetts, who turned out to be a British spy. John Morgan succeeded Church; although a good doctor and administrator, he had an abrasive personality and made so many enemies that he had to be relieved. The third head, William Shippen Jr., was also relieved, a victim of professional back-stabbing. Both of those men were Philadelphians. Benjamin Rush, like his two predecessors a Philadelphian, became mixed up in political intrigue and also had to be jettisoned. On 17 January 1781 Congress appointed John Cochran of New Jersey, a veteran of the French and Indian War, and in him finally found a competent head who served until the end of the war. The head of the Continental Army medical department carried the title of director general.
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revised by Robert K. Wright Jr.