Initially the drug supplies for the American Revolutionary Army had
come from stocks largely in the hands of private druggists. However,
this source of supply was totally inadequate for a war that attained
such proportions as the Revolution. Even if stocks of drugs in the
Colonies had been far greater than they were, there is little reason
to believe that shortages would not have developed. After all, a good
many of the suppliers were Loyalists, and others were indifferent to
the cause of American liberty. Even the most patriotic pharmacists
were faced with a complete financial suicide, caught between a
spiraling inflation and a Congress that had no money and only a
promise for the future.
As if all these problems were not bad enough, the internal
organization of the medical department of the army was so chaotic
that, even if adequate supplies were available and if the almost
insurmountable problems of communications and transportation were
solved, it is almost certain that shortages would have developed at
least during the campaign of 1776. Add to this the fact that any
retreating army is subject to loss of supplies and the reasons for the
shortages become very obvious.
The encouragement which Congress, through its Secret Committee, gave
to private shippers for the importation of vital war materials offered
little relief in the field of medical supplies. Importation was, of
course, cut off from England, and France did not directly export any
quantity of medical supplies, at least until 1778. American privateers
found it much more profitable to prey on British shipping than
initiating trade channels with countries which prior to the Revolution
were prohibited from shipping directly to the Colonies. These channels
of commerce did not develop extensively until well after the
Revolution.
Hence the most immediate relief from medical supply shortages was
provided by the American privateers. Drug cargoes from British prize
ships, many of which were en route to New York, served as a most
important source of supply, particularly in 1777 and 1778.
However, even with the most adequate supplies, competition between
different branches of the army and navy and the confiscation of
supplies destined for Continental troops by state militias further
encouraged inflationary trends.
The number of individual drugs mentioned in various inventories was
considerable, as evidenced by the listing on page 130. However, of
these, only about a dozen constituted the really critical shortages.
Heading the list of these "capital articles" was Peruvian or Jesuits'
bark, the same cinchona from which quinine was later discovered. Tons
of bark were used during the Revolutionary War, and the price more
than quandrupled between June 1776 and September 1777.
The most prominent group of drugs on the list of capital articles
consisted of cathartics and purgatives. Jalap, ipecac, and rhubarb
were the botanical favorites, while bitter purging salts (Epsom salts)
and Glauber's purging salts were the chemical choices for purging.
Tartar emetic (antimony and potassium tartrate) was the choice for a
vomit, and cantharides (Spanish flies) was the most important
ingredient of blistering plasters. Gum opium was administered for its
narcotic effects, while gum camphor, nitre (saltpetre or potassium
nitrate), and mercury (pure metal as well as certain salts) were
employed for a variety of purposes. Lint, a form of absorbent material
made by scraping or picking apart old woven material, also often was
short in supply.
Equipment shortages included surgical instruments and mortar and
pestles for pulverizing the crude drugs. Glass vials for holding
compounded medicines were also a supply problem, especially after
essential drugs were again available.
Some of the shortages were eased, if not solved, by local
manufacture. Lint was produced in large quantities in the Colonies,
and glass vials were manufactured in numerous glasshouses. Even local
manufacture of the purging salts and nitre aided in eliminating
shortages of these essential items, and at the same time initiated the
first large-scale pharmaceutical manufacturing in America.
Numerous botanicals indigenous to the Colonies were widely employed in
medicine of the period, and certain ones such as snakeroot (seneka),
which was widely found growing in Virginia, would have been very
scarce had not an adequate supply been immediately at hand. However,
attempts to substitute other indigenous plants for scarce drugs like
Peruvian bark were largely unsuccessful. There is no indication that
hysop, wormwood, and mallows called for during the New York crisis
were ever found to be suitable replacements for any of the capital
articles. Wine apparently was more useful as a substitute for bark
than the bark of butternut recommended by the _Lititz Pharmacopoeia_.
Peruvian bark, jalap, ipecac, camphor, opium, cantharides--these are
the drugs which the American army physicians wanted, and these
constituted the most serious shortage problems.
The medical supply problem was placed on relatively firm ground by the
summer of 1778, having been established on the principles proven in
the Northern Department under the guidance of Drs. Potts and Craigie.
Furthermore, the turning point in the war had been reached. Even
before Washington's forces went into winter quarters at Valley Forge,
Burgoyne[153] had surrendered at Saratoga, on October 17, 1777; and,
before the cold bleak winter at Valley Forge was over, the treaty of
French alliance was signed on February 6, 1778. The torments at Valley
Forge proved to be the birth of a new Continental Army.
The War was still a long way from being over, and a variety of
problems were yet to face the Continental Army. Inflation was yet to
deal its hardest blow to the supply problem, but not even this could
produce the chaos of 1776. The worst of the drug supply problem was
over.