Volume 1 — THE RESULT OF OBSERVATIONS MADE UPON THE DISEASES WHICH OCCURRED IN THE MILITARY HOSPITALS OF THE UNITED STATES, DURING THE REVOLUTIONARY WAR BETWEEN GREAT BRITAIN AND THE UNITED STATES.

1. The army when in tents, was always more sickly, than in the open air. It was likewise more healthy when it was kept in motion, than when it lay in an encampment.

2. Young men under twenty years of age, were subject to the greatest number of camp diseases.

3. The southern troops were more sickly than the northern or eastern troops.

4. The native Americans were more sickly than the natives of Europe who served in the American army.

5. Men above thirty, and five and thirty years of age, were the hardiest soldiers in the army. Perhaps the reason why the natives of Europe were more healthy than the native Americans, was, they were more advanced in life.

6. The southern troops sickened from the want of salt provisions. Their strength and spirits were restored only by means of salted meat. I once saw a private in a Virginia regiment, throw away his ration of choice fresh beef, and give a dollar for a pound of salted bacon.

7. Those officers who wore flannel shirts or waistcoats next to their skins, in general escaped fevers and diseases of all kinds.

8. The principal diseases in the hospitals were the typhus gravior and mitior of Doctor Cullen. Men who came into the hospitals with pleurisies or rheumatisms, soon lost the types of their original diseases, and suffered, or died, by the above-mentioned states of fever.

9. The typhus mitior always prevailed most, and with the worst symptoms in winter. A free air, which could only be obtained in summer, always prevented, or mitigated it.

10. In all those cases, where the contagion was received, cold seldom failed to render it active. Whenever an hospital was removed in winter, one half of the patients generally sickened on the way, or soon after their arrival at the place to which they were sent.

11. Drunken soldiers and convalescents were most subject to this fever.

12. Those patients in this fever who had large ulcers on their back or limbs, generally recovered.

13. I met with several instances of buboes, also of ulcers in the throat, as described by Doctor Donald Monro. They were mistaken by some of the junior surgeons for venereal sores, but they yielded to the common remedies of the hospital fever.

14. There were many instances of patients in this fever, who suddenly fell down dead, upon being moved, without any previous symptoms of approaching dissolution. This was more especially the case, when they arose to go to stool.

15. The contagion of this fever was frequently conveyed from the hospital to the camp, by means of blankets and clothes.

16. Those black soldiers who had been previously slaves, died in a greater proportion by this fever, or had a much slower recovery from it, than the same number of white soldiers.

17. The remedies which appeared to do most service in this disease were vomits of tartar emetic, gentle dozes of laxative salts, bark, wine, volatile salt, opium, and blisters.

18. An emetic seldom failed of checking this fever if exhibited while it was in a forming state, and before the patient was confined to his bed.

19. Many causes concurred to produce, and increase this fever; such as the want of cleanliness, excessive fatigue, the ignorance or negligence of officers in providing suitable diet and accommodations for their men, the general use of linen instead of woollen clothes in the summer months, and the crowding too many patients together in one hospital, with such other inconveniences and abuses, as usually follow the union of the purveying and directing departments of hospitals in the same persons. But there is one more cause of this fever which remains to be mentioned, and that is, the sudden assembling of a great number of persons together of different habits and manners, such as the soldiers of the American army were in the years 1776 and 1777. Doctor Blane informs us, in his observations upon the diseases of seamen, “that it sometimes happens that a ship with a long established crew shall be very healthy, yet if strangers are introduced among them, who are also healthy, sickness will be mutually produced.” The history of diseases furnishes many proofs of the truth of this assertion[51]. It is very remarkable, that while the American army at Cambridge, in the year 1775, consisted only of New-Englandmen (whose habits and manners were the same) there was scarcely any sickness among them. It was not till the troops of the eastern, middle, and southern states met at New-York and Ticonderoga, in the year 1776, that the typhus became universal, and spread with such peculiar mortality in the armies of the United States.

20. The dysentery prevailed, in the summer of 1777, in the military hospitals of New-Jersey, but with very few instances of mortality. This dysentery was frequently followed by an obstinate diarrhœa, in which the warm bath was found in many cases to be an effectual remedy.

21. I saw several instances of fevers occasioned by the use of the common ointment made of the flour of sulphur and hog's lard, for the cure of the itch. The fevers were probably brought on by the exposure of the body to the cold air, in the usual method in which that ointment is applied. I have since learned, that the itch may be cured as speedily by rubbing the parts affected, two or three times, with the dry flour of sulphur, and that no inconvenience, and scarcely any smell, follow this mode of using it.

22. In gun-shot wounds of the joints, Mr. Ranby's advice of amputating the limb was followed with success. I saw two cases of death where this advice was neglected.

23. There was one instance of a soldier who lost his hearing, and another of a soldier who had been deaf who recovered his hearing, by the noise of artillery in a battle.

24. Those soldiers who were billetted in private houses, generally escaped the hospital fever, and recovered soonest from all their diseases.

25. Hospitals built of coarse logs, with ground floors, with fire-places in the middle of them, and a hole in the roof, for the discharge of smoke, were found to be very conducive to the recovery of the soldiers from the hospital fever. This form of a military hospital was introduced into the army by Dr. Tilton of the state of Delaware[52].

26. In fevers and dysenteries, those soldiers recovered most certainly, and most speedily, who lay at the greatest distance from the walls of the hospitals. This important fact was communicated to me by the late Dr. Beardsley of Connecticut.

27. Soldiers are but little more than adult children. That officer, therefore, will best perform his duty to his men, who obliges them to take the most care of their HEALTH.

28. Hospitals are the sinks of human life in an army. They robbed the United States of more citizens than the sword. Humanity, economy, and philosophy, all concur in giving a preference to the conveniences and wholesome air of private houses; and should war continue to be the absurd and unchristian mode of deciding national disputes, it is to be hoped that the progress of science will so far mitigate one of its greatest calamities, as to produce an abolition of hospitals for acute diseases. Perhaps there are no cases of sickness in which reason and religion do not forbid the seclusion of our fellow creatures from the offices of humanity in private families, except where they labour under the calamities of madness and the venereal disease, or where they are the subjects of some of the operations of surgery.

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