HEALTH AND SANITATION
The health of the soldier was not entirely forgotten. Those in
authority made an attempt to prevent or at least to lessen the pain
and suffering of those who were taken sick or were wounded in army
service, but often the measures of prevention instituted, the methods
of checking contagion and the means of allienating pain were of the
crudest sort and to us of the twentieth century they seem almost
inhuman. It must be remembered that not even our simple remedies of
today were known then, not to mention our modern methods of combating
disease.
The continental congress thought of that phase of army conditions and
on July 25, 1775, the following provisions were made. For an army
of twenty thousand men a hospital was to be established under the
direction of a Director General, his salary was to be four dollars per
day. He was to superintend the whole, furnish the medicines and bedding
and make a report to and receive orders from the commander-in-chief.
Under the director there were to be four surgeons, one apothecary and
twenty surgeons' mates, each receiving two-thirds of a dollar per day,
whose duty it was to visit and attend the sick. There was also to be a
matron who had under her direction the nurses, one for every ten sick
soldiers.[83] Then in July 1776, the resolution was passed that the
number of hospital surgeons and mates was to be increased in proportion
to the increase in size of the army not to exceed one surgeon and five
mates to every five thousand men and to be reduced as the army was
reduced.
Dr. Church was appointed by congress as director, but before October
14, 1775, he had been taken into custody for holding correspondence
with the enemy[84], and on October 17, 1775, Dr. Morgan was elected in
his stead.[85] But even after the new director was appointed there was
still room for complaint for Washington wrote to Congress "I am amazed
to hear the complaints of the hospital on the east side of Hudson's
river. * * * I will not pretend to point out the causes; but I know
matters have been strangely conducted in the medical line. I hope your
new appointment when it is made, will make the necessary reform in the
hospital, and that I shall not, be shocked with the complaints and
looks of poor creatures perishing for want of proper care, either in
the regimental or hospital surgeons".[86]
Congress had made several attempts to organize the hospitals and in
July 1776, resolutions had been passed which defined more fully the
duties of the various officials both of the departmental and the
regimental hospitals.[87] There was to be a director and under him
the directors of the various departmental hospitals.[88] But since
there were only a few departmental hospitals and those few often a long
distance from the scene of battle it became necessary to have branch
hospitals or regimental hospitals. At the head of those were persons
known as regimental surgeons, who were to make reports of expenses,
and lists of the sick to the director of the departmental hospital and
receive supplies from him.
The plan was then that the soldiers were to be cared for by the
regimental surgeon as long as it was possible and then they were to
be sent to the departmental hospital for further care.[89] These two
systems seemed to interfere with each others work and there was always
jealousy existing between the director of the general hospital and
the surgeons of the regiment. "There will be nothing but continued
complaints of each other; the director of the hospital charging them
with enormity in their drafts for the sick and they him with the same
for denying such things as are necessary. In short there is a constant
bickering among them which tends greatly to the injury of the sick * *
* The regimental surgeons are aiming, I am persuaded, to break up the
general hospital."
The two most representative departmental hospitals were, it might be
said at Bethlehem and Sunbury, but there were others at Reading, Lititz
and Ephrata. Bethlehem was a Moravian village and was in the midst of
military affairs almost continually from 1775 to 1781; in fact it was
twice the seat of a hospital. On December 3, 1776, an order was sent to
the committee of the town of Bethlehem as follows:
"Gentlemen,—According to his excellency General Washington's Orders,
the General Hospital of the Army is removed to Bethlehem and you
will do the greatest Act of humanity by immediately providing proper
buildings for their reception the largest and most capacious will be
the most convenient. I doubt not, Gentlemen but you will act upon this
occasion as becomes men and christians * * * "[90]
It was by the above process that the little peace loving village of
Bethlehem and many others like it were thrown into confusion and
dwelling houses or other buildings were turned into hospitals, the men
began to play the part of nurses, to help care for the sick and dying
sent from camp, and the women prepared lint and bandages. The buildings
which under ordinary circumstances could accommodate about two hundred
were made to accommodate five or six hundred.[91]
The housing accommodations of the regimental hospitals were even more
varied, for they were housed in any thing from a capital building[92]
to a log hut,[93] including private homes,[94] church,[95] barns, and
court house,[96] depending upon what happened to be near the camp. A
hut or group of huts were sometimes built for the purpose in or near
the camp. They were built in a manner similar to the dwelling huts[97]
only larger with furnishings as meagre, straw for the bed[98] tells the
tale of equipment.
But the hospitals were of little value if there were not able
physicians[99] and antiseptics and anaesthetics were almost unknown.
Besides the lack of skill and proper medicine and instruments, for some
of the instruments described are almost unconceivable, there was a lack
of cleanliness in conducting the operations for that was not insisted
upon then as it is today.[100] Of hospital methods Dr. Waldo wrote
December 25, 1777, "But we treat them differently from what they used
to be at home under the inspection of old women and Doct ----, We give
them mutton and Grogg and avoid pudding, pills, and powders."[101] This
perhaps was a little extreme, but it at least reflects the conditions.
Thacher described the awful condition in which soldiers came to the
hospital with wounds covered with putrified blood and full of magots
which were destroyed by the application of tincture of myrrh.[102]
Director-General Shippen, in explaining the causes of the mortality
among the soldiers attributed it to; "The want of clothing and covering
necessary to keep the soldiers clean and warm, articles at that time
not procurable in the country;—partly from an army being composed
of raw men, unused to camp life and undisciplined; exposed to great
hardships and from the sick and wounded being removed great distances
in open wagons."[103]
As to the kind of disease most prevalent and the number in the
hospitals because of sickness in proportion to those there because of
injuries, some idea can be formed from the hospital reports sent in
weekly from the departmental hospitals.
Although some of the diseases listed in the reports are unknown to us
now and there is no way of knowing what the proportion the sick was
of the entire army in that section. However, the returns do state the
number sick during the various seasons, and show in which season of the
year there was the most sickness.
The following are the returns from the Sunbury hospital for the four
seasons of the year, spring, summer, fall and winter.
_March 6 to 13, 1780_
"Wounded 4
Dysenteria 1
Diorrhoea 0
Rheumatism 2
Ophthalmia 1
Asthma 1
Ulcers 1
---
Total 10"[104]
_July 13 to September 22 1779_
"Pleurisy 0
Peripneumony 2
Angina 1
Rheumatism 14
Bilious fever 8
Intermitting fever 0
Putrid fever 0
Dysentery 19
Dyarrhea 11
Gravel 12
Cough and Consumpt. 4
Hernia 5
Lues 14
Epilepsy 2
Itch 2
Ulcers 9
Wounded 33
---
Total 126"[105]
_November 1 to 7 1779_
"Dysentery 5
Diorrhoea 2
Rheumatis 2
Intermit. 2
B. Remit. 5
Asthma 1
Ophthalnia 2
Ulcers 2
Wounded 11
---
Total 30"[106]
_January 24 to 31 1980_
"Wounded 6
Intermitting fever 0
Dysenteria 1
Diarrhoea 1
Asthma 1
Ophthalnia 1
Rheumatism 3
Ulcers 2
---
Total 15"[107]
If the above tables are any index at all the most dangerous season was
summer in spite of the crowded unsanitary conditions of the winter
quarters. They also show that the number in hospitals due to sickness
was larger that the number due to injuries received in battle.
Smallpox was one of the most dreaded of all the diseases, mostly
because there were few ways of combating the disease. Inoculation was
only slightly known and there was much opposition to it, even sermons
were preached on the question it was so much discussed.[108] The
British knew the New England people were especially opposed to it and
were known to send out spies to spread the disease in the American camp
which Shreve wrote "killed more Yankees than they did".[109]
The disease was especially serious in the Northern army causing greater
dread than the enemy.[110]
Thacher in his _Military Journal_ emphasizes another disease which
caused a great deal of suffering but strange to say there was only
one remedy for it and that was a furlough for the disease was
home-sickness. In reality that was a fact which caused anxious moments
for General Washington for the men were continually trying to bribe the
physicians to declare that they were unfit for duty.[111]
Other provisions were made for the health of the soldiers besides
the establishment of hospitals. The others were along the line of
prevention, such as keeping the tents and huts clean and dry, the
careful preparation of food, the washing of clothes, caring for
refuse,[112] and the soldiers own personal cleanliness.[113]
[Footnote 83: _Journals of Congress_, Vol. II, pp. 209, 210, 211.]
[Footnote 84: _Journals of Congress_, Vol. III, p. 294.]
[Footnote 85: Ibid., p. 296.]
[Footnote 86: Ford, _Writings of Washington_, Vol. V, p. 204.]
[Footnote 87: _Journals of Congress_, Vol. II, p. 568.]
[Footnote 88: The country was divided into departments or divisions and
in each department there was what was called a general departmental
hospital, in distinction to the regimental hospitals where the soldier
received immediate care, before being sent to the general hospital.]
[Footnote 89: Coit, _Orderly Book_, (June 7, 1775) p. 36.]
[Footnote 90: Jordon, "Military Hospitals at Bethlehem and Lititz
during the Revolution" in _Penn. Mag._ Vol. XV, p. 137.]
[Footnote 91: Jordon, "Military Hospitals at Bethlehem and Lititz
during the Revolution" in _Penn. Mag._ Vol. XX, p. 137.]
[Footnote 92: Lewis, _Orderly Book_, (June 11, 1776) p. 49.]
[Footnote 93: Chastellux, _Travels in America_, p. 70.]
[Footnote 94: Thacher, _Military Journal_, p. 31.]
[Footnote 95: Ibid., p. 112.]
[Footnote 96: Jordon, "Continental Hospital Returns, 1777-1780," _Penn.
Mag._ Vol. XXIII, p. 38.]
[Footnote 97: Chastellux, _Travels in America_, p. 70.]
[Footnote 98: Elbert, _Orderly Book_, (Feb., 11, 1778) p. 101.]
[Footnote 99: _American Archives_, Ser. V, Vol. III, Col. 1584.]
[Footnote 100: Goodale, _British and Colonial Army Surgeon_, p. 10.]
[Footnote 101: Dr. Waldo, _Diary_ (Dec. 25, 1777) p. 31.]
[Footnote 102: Thacher, _Military Journal_, p. 112.]
[Footnote 103: Jordon, "Military Hospitals at Bethlehem and Lititz
during the Revolution" _Penn. Mag._ Vol. XV, p. 137.]
[Footnote 104: Jordon, "Continental Hospital Returns 1777-1780", _Penn.
Mag._ Vol. XXIII, p. 219.]
[Footnote 105: Jordon, "Continental Hospital Returns 1777-1780". _Penn.
Mag._, Vol. XXIII, p. 211.]
[Footnote 106: Jordon, "Continental Hospitals Returns, 1777-1780",
_Penn. Mag._ Vol. XXIII, p. 216.]
[Footnote 107: Ibid., p. 217.]
[Footnote 108: Sermon quoted in _Mass. Hist. Soc. Pro. Ser. 1_, Vol.
IX, p. 275.]
[Footnote 109: Shreve, _Journal_ In _Am. Hist. Mag._, Vol. III, p. 565.]
[Footnote 110: _American Archives_, Ser. 5, Vol. I, p. 145.]
[Footnote 111: Ford, _Writings of Washington_, Vol. III, p. 447.]
[Footnote 112: Ford, _Writings of Washington_, Vol. III, p. 5.]
[Footnote 113: Coit, _Orderly Book_, (June 1, 1775.), p. 15.]