McGarrity 1 of 7 Mary McGarrity Revolutionary War Residency Ann Becker November 21, 2020 George Washington: The Right Choice for the Revolution The Second Continental Congress began preparing for the inevitable war as the British army increased its forces by almost five thousand during 1775. On June 15, there was a unanimous decision among the delegates to appoint George Washington, the delegate hailing from Virginia, to command all the continental forces.1 There were many motivations for choosing Washington for this post; however, his health history may have made him the perfect appointee. Although the British and their Loyalists were the stated opponent, the constant task of keeping the militia healthy was just as essential a fight as any battle. Some of the nation's earliest recorded programs promoting health in the United States were those enacted regarding military troops during the Revolutionary War. Because soldiers were more likely to die of infections caused by communicable diseases and bacterial contaminations, a plan needed to be directed and carried out by a commander with the authority to prevent and avoid these situations. Is having survived smallpox what made George Washington the perfect appointee for commanding the continental army's general based upon his health history? No, but in combination with his family's mediocre lifespan, he was influenced by the Enlightenment philosophers, believing in science over religion, and he had his episodes of illness and disease, which shaped a well-rounded attitude on the subject. Author Jeanne E. Abrams states of Washington's understanding of medicine, "...he appreciated both the value of preventative health measures and the need for prompt medical intervention for sickness".2 He wanted to live longer and read extensively on science and medicine subjects but was friends with the top physicians of his time, like Drs. James Craik and Benjamin Rush.3 1 Risjord, Norman K. 2002. Jefferson's America, 1760-1815. p. 122 Abrams, Jeanne E. 2013. Revolutionary Medicine. p.78 3 Abrams, Jeanne E. 2013. Revolutionary Medicine. 2 McGarrity 2 of 7 George was born of his father's second marriage in Wakefield, Virginia, on February 22, 1732. He was the first of the children in the second marriage and the fifth of his father's ten children. Washington had his bouts with malaria, pleurisy, influenza, and dysentery throughout life, in addition to the more severe afflictions suffered in his youth.4 In his youth, it is assumed that he had survived both the measles and the mumps because he did not get the diseases later in life when he was exposed.5 Washington's father died at forty-eight, and he outlived all his siblings leading him to say, "though I was blessed with a good constitution, I was of a short-lived family".6 The belief that Washington's father and the males in the family had a paternal predisposition to tuberculosis led young George's fixation on moderation and stoicism to live a long life.7 Perhaps Washington's preoccupation with illness and the depression that would come with such a preoccupation caused him to be conscious of the troops' health when he said, "The General has nothing more at heart than the Health of the Troops".8 It may have been a trip to Barbados in 1751 with his brother Lawrence that gave him the most perspective on diseases relevant to the war. The trip's purpose was to go to a more temperate climate to ease the coughing and congestion associated with Lawrence's consumption. Consumption, now known as tuberculosis, was thought to be hereditary and possibly alleviated by a climate change more suitable to the individual, most often seaside or mountainside.9 Shortly after the Washington brothers arrived in Barbados, they were invited to the home of Gedney Clarke on November 3. However, George wrote of his hesitation to go, "We went, -myself with some reluctance, as the smallpox was in his family."10 For the next two weeks, George and Lawrence were active members of the Barbados social life, when on November 17, the smallpox infection hit George with wrath.11 The seventeen-year-old George survived smallpox and returned to Virginia with a pockmarked face and lifelong immunity from Variola. From his personal experience with smallpox came the perspective of how bad smallpox could render the afflicted and for how long. 4 Ibid p. 34 Ibid p. 35 6 Ibid p. 35 7 Ibid p. 34 8 Ibid p. 33 9 Fenn, Elizabeth A. 2002. Pox Americana. p. 13 10 Fenn, Elizabeth A. 2002. Pox Americana. p. 14 11 Ibid p. 14 5 McGarrity 3 of 7 Smallpox had been of epidemic proportion in the colonies throughout the 1700s. However, the repeated outbreaks of 1721, 1752, 1764, and 1775 were especially severe in Boston. In the 1700s, the only preventative act people could take for smallpox was inoculation, though it was not without controversy. To inoculate a person, the person would have a small incision cut in their skin, and discharge from the pus-filled scabs of a smallpox victim would be introduced in the hope of getting a milder form, yet severe enough to make the individual immune. Smallpox inoculation had been practiced in Greece, Armenia, and northern Africa for centuries before being introduced in Boston by Dr. Zabdiel Boylston during the 1721 epidemic. In response to an inquiry on the efficacy of inoculation being used as a preventative of death, Benjamin Franklin responded, in 1759, "that among 5059 un-inoculated white people, 452 had died (a death rate of 8.9%), whereas among 1974 inoculated individuals, only 23 (1.2%) had died. The corresponding mortality rates among blacks were 12.8% and 5.0%, respectively".12 There were strict rules and laws in the states that permitted the inoculation procedure to prevent outbreaks caused by the inoculations.13 The scourge of smallpox was such a factor for Washington's army in the Canada and Boston campaigns that he saw the need for addressing it during a time of war (Becker 2004).14 The British troops had mostly been exposed during childhood while in Britain. However, they would inoculate when the need arose since it was not a large scale operation like what had to happen for the Patriots, who had no immunity. For Washington to inoculate his troops, it would put the colonists at a disadvantage. However, he had decided to inoculate as written in his correspondence to Dr. William Shippen Jr. on January 6, 1777.15 From January to March 1777, the Continental Army was at a disadvantage with many of the troops undergoing inoculation. Strategically the decision to inoculate was a crucial one. As historian Dr. Ann Becker writes, "Washington's desire to have an army healthy and ready to fight...explains his insistence on having the inoculations done as soon as possible...". 16 12 Hasselgren, Per-Olof. 2020. "The Smallpox Epidemics In America In The 1700S And The Role Of The Surgeons: Lessons To Be Learned During The Global Outbreak Of COVID-19". World Journal Of Surgery 44 (9): 2837-2841. 13 Becker, Ann. 2004. "Smallpox In Washington's Army: Strategic Implications Of The Disease During The American Revolutionary War". 14 Ibid 15 Becker, Ann. 2004. "Smallpox In Washington's Army: Strategic Implications Of The Disease During The American Revolutionary War". 16 Ibid McGarrity 4 of 7 Washington had the foresight to understand that without defeating the unrelenting spread of smallpox amongst his militia, he would never defeat the British, therefore developing and enforcing a program for inoculation was essential. George Washington saw the need and began programs to keep diseases and contaminations from collapsing troop encampments. He issued directives on camp hygiene, both the soldiers' hygiene and sanitation, as evidenced in one of his first directives on July 4, 1775.17 One read, "All officers are required and expected to pay diligent Attention to keep their Men neat and clean . . . and inculcate upon them the necessity of cleanliness".18 He went on to say, "They are also to take care that necessarys [latrines] be provided in the camps".19 Washington's statement is most interesting because it confers his belief that fecal matter may have something to do with disease spread. Smallpox was not the only threat to health during the revolution. At that time, fevers were believed to be the result of bad air (miasmas) or humor imbalances. The term fever was broad for any illness with a fever, though it may have been one of many diseases.20 Fevers were caused by insects, bacteria, contaminated food and water, and crowded living conditions. Washington had joined the Virginia militia and risen to the ranks to lieutenant-colonel in 1754 when he fought for the British against the French's infiltrations into the area. The military camps were over-crowded, and the unhygienic conditions led to sickness and disease among the troops, not sparing Washington and those of rank.21 Though the thinking was that imbalances in the bodily fluids caused illnesses, correspondences show that there may have been thoughts that camp overcrowding may be involved. Dr. Benjamin Rush wrote of his concerns on overcrowding in December of 1777 to General Washington that "Too many sick are crouded together in One house. I have seen 20 sick men in One room ill with fevers & fluxes, large eno' to contain only 6 or 8 well men without danger to their health".22 Washington's faith in doctors conjugated with his unacknowledged personal experience with an infectious disease may have precipitated the second portion of his July 4, 1775 directive, which read, "They are also to take care that necessarys [latrines] be 17 Wilcox, Lynne S. 2005. "Preventing Chronic Disease: Special Issue, November 2005: 05_0134". Cdc.Gov Ibid 19 Ibid 20 Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. 21 Abrams, Jeanne E. 2013. Revolutionary Medicine. p. 39 22 Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. 18 McGarrity 5 of 7 provided in the camps".23 Washington's statement is most interesting because it confers his belief that fecal matter may have something to do with disease spread. This connection between cause and effect, though not acknowledged as the causation for disease, was essential. Washington's ability to see the need for a plan in addressing the military health and the understanding of when to take action made him an essential leader for the tasks that were to present themselves as the war pressed on. The programs he instilled in the military were for the common good of the militia and the nation. 23 Wilcox, Lynne S. 2005. "Preventing Chronic Disease: Special Issue, November 2005: 05_0134". Cdc.Gov. McGarrity Page 1 of FOOTNOTES 1. Risjord, Norman K. 2002. Jefferson's America, 1760-1815. p. 122 2. Abrams, Jeanne E. 2013. Revolutionary Medicine. p.78 3. Ibid 4. Ibid p.34 5. Ibid, p.35 6. Ibid, p.35 7. Ibid, p.34 8. Ibid, p.33 9. Fenn, Elizabeth A. 2002. Pox Americana. p. 13 10. Ibid, p.14 11. Ibid, p.14 12. Hasselgren, Per-Olof. 2020. "The Smallpox Epidemics In America In The 1700s And The Role Of The Surgeons: Lessons To Be Learned During The Global Outbreak Of COVID-19". World Journal Of Surgery 44 (9): 2837-2841. 13. Becker, Ann. 2004. "Smallpox In Washington's Army: Strategic Implications Of The Disease During The American Revolutionary War". 14. Ibid 15. Ibid 16. Ibid 17. Wilcox, Lynne S. 2005. "Preventing Chronic Disease: Special Issue, November 2005: 05_0134". Cdc.Gov 18. Ibid 19. Ibid 20. Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. 21. Abrams, Jeanne E. 2013. Revolutionary Medicine. p. 39 22. Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. 23. Wilcox, Lynne S. 2005. "Preventing Chronic Disease: Special Issue, November 2005: 05_0134". Cdc.Gov. McGarrity Page 1 of BIBLIOGRAPHY Abrams, Jeanne E. 2013. Revolutionary Medicine. New York: New York University Press. Becker, Ann. 2004. "Smallpox In Washington's Army: Strategic Implications Of The Disease During The American Revolutionary War". Jstor. https://www.jstor.org/stable/3397473. Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. https://allthingsliberty.com/2015/11/fever/. Burdick, Kim. 2015. "Fever - Journal Of The American Revolution". Journal Of The American Revolution. https://allthingsliberty.com/2015/11/fever/. Fenn, Elizabeth A. 2002. Pox Americana. New York: Palgrave Macmillan. Hasselgren, Per-Olof. 2020. "The Smallpox Epidemics In America In The 1700S And The Role Of The Surgeons: Lessons To Be Learned During The Global Outbreak Of COVID19". World Journal Of Surgery 44 (9): 2837-2841. Risjord, Norman K. 2002. Jefferson's America, 1760-1815. 2nd ed. Lanham, Md.: Rowman & Littlefield Publishers. Wilcox, Lynne S. 2005. "Preventing Chronic Disease: Special Issue, November 2005: 05_0134". Cdc.Gov. https://www.cdc.gov/pcd/issues/2005/nov/05_0134.htm.
