Chapter IIIHEALTH 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.83Then 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 enemy84, and on October 17, 1775, Dr. Morgan was elected in his stead.85But 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.87There was to be a director and under him the directors of the various departmental hospitals.88But sincethere 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.89These 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 building92to a log hut,93including private homes,94church,95barns, and court house,96depending upon what happened to be nearthe 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 huts97only larger with furnishings as meagre, straw for the bed98tells the tale of equipment.
But the hospitals were of little value if there were not able physicians99and 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.100Of 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."101This 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 andwarm, 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
July 13 to September 22 1779
November 1 to 7 1779
January 24 to 31 1980
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.108The 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 hisMilitary Journalemphasizes 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,112and the soldiers own personal cleanliness.113
83.Journals of Congress, Vol. II, pp. 209, 210, 211.84.Journals of Congress, Vol. III, p. 294.85.Ibid., p. 296.86.Ford,Writings of Washington, Vol. V, p. 204.87.Journals of Congress, Vol. II, p. 568.88.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.89.Coit,Orderly Book, (June 7, 1775) p. 36.90.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution" inPenn. Mag.Vol. XV, p. 137.91.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution" inPenn. Mag.Vol. XX, p. 137.92.Lewis,Orderly Book, (June 11, 1776) p. 49.93.Chastellux,Travels in America, p. 70.94.Thacher,Military Journal, p. 31.95.Ibid., p. 112.96.Jordon, "Continental Hospital Returns, 1777–1780,"Penn. Mag.Vol. XXIII, p. 38.97.Chastellux,Travels in America, p. 70.98.Elbert,Orderly Book, (Feb., 11, 1778) p. 101.99.American Archives, Ser. V, Vol. III, Col. 1584.100.Goodale,British and Colonial Army Surgeon, p. 10.101.Dr. Waldo,Diary(Dec. 25, 1777) p. 31.102.Thacher,Military Journal, p. 112.103.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution"Penn. Mag.Vol. XV, p. 137.104.Jordon, "Continental Hospital Returns 1777–1780",Penn. Mag.Vol. XXIII, p. 219.105.Jordon, "Continental Hospital Returns 1777–1780".Penn. Mag., Vol. XXIII, p. 211.106.Jordon, "Continental Hospitals Returns, 1777–1780",Penn. Mag.Vol. XXIII, p. 216.107.Ibid., p. 217.108.Sermon quoted inMass. Hist. Soc. Pro. Ser. 1, Vol. IX, p. 275.109.Shreve,JournalInAm. Hist. Mag., Vol. III, p. 565.110.American Archives, Ser. 5, Vol. I, p. 145.111.Ford,Writings of Washington, Vol. III, p. 447.112.Ford,Writings of Washington, Vol. III, p. 5.113.Coit,Orderly Book, (June 1, 1775.), p. 15.
83.Journals of Congress, Vol. II, pp. 209, 210, 211.
84.Journals of Congress, Vol. III, p. 294.
85.Ibid., p. 296.
86.Ford,Writings of Washington, Vol. V, p. 204.
87.Journals of Congress, Vol. II, p. 568.
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.
89.Coit,Orderly Book, (June 7, 1775) p. 36.
90.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution" inPenn. Mag.Vol. XV, p. 137.
91.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution" inPenn. Mag.Vol. XX, p. 137.
92.Lewis,Orderly Book, (June 11, 1776) p. 49.
93.Chastellux,Travels in America, p. 70.
94.Thacher,Military Journal, p. 31.
95.Ibid., p. 112.
96.Jordon, "Continental Hospital Returns, 1777–1780,"Penn. Mag.Vol. XXIII, p. 38.
97.Chastellux,Travels in America, p. 70.
98.Elbert,Orderly Book, (Feb., 11, 1778) p. 101.
99.American Archives, Ser. V, Vol. III, Col. 1584.
100.Goodale,British and Colonial Army Surgeon, p. 10.
101.Dr. Waldo,Diary(Dec. 25, 1777) p. 31.
102.Thacher,Military Journal, p. 112.
103.Jordon, "Military Hospitals at Bethlehem and Lititz during the Revolution"Penn. Mag.Vol. XV, p. 137.
104.Jordon, "Continental Hospital Returns 1777–1780",Penn. Mag.Vol. XXIII, p. 219.
105.Jordon, "Continental Hospital Returns 1777–1780".Penn. Mag., Vol. XXIII, p. 211.
106.Jordon, "Continental Hospitals Returns, 1777–1780",Penn. Mag.Vol. XXIII, p. 216.
107.Ibid., p. 217.
108.Sermon quoted inMass. Hist. Soc. Pro. Ser. 1, Vol. IX, p. 275.
109.Shreve,JournalInAm. Hist. Mag., Vol. III, p. 565.
110.American Archives, Ser. 5, Vol. I, p. 145.
111.Ford,Writings of Washington, Vol. III, p. 447.
112.Ford,Writings of Washington, Vol. III, p. 5.
113.Coit,Orderly Book, (June 1, 1775.), p. 15.