Of the many problems facing the newly formed Continental Army surrounding Boston in the summer of 1775 the most vexing was how to keeping the men healthy. In addition to finding ways to feed, clothe, arm and train these new recruits, it was essential to prevent the spread of diseases in the encampments.
Every European army during this period had to deal with the usual gamut of infectious camp illnesses such as typhus, typhoid, dysentery as well as other sickness caused by scabies and malaria. However the disease that was the most deadly and that struck fear everywhere was smallpox. This highly contagious virus had been around for centuries and seemed to occur in two forms, one much more virulent that the other. The most dangerous cases occurred when someone inhaled airborne particles from an infected person.
Anyone who had contracted smallpox and survived however, acquired a life-long immunity. The death rate among previously unexposed populations could reach as high as twenty to thirty percent. The British soldiers who were sent to America at the start of the War for Independence were primarily, older, experienced men, often veterans of European campaigns. Most of them had encountered smallpox by the time they were adults and having survived were now immune. On the other hand the vast majority of the young men now joining George Washington’s army outside Boston had seldom travelled more than a few miles from their rural villages and farms. As a result, almost none of them had acquired immunity to the dreaded pox. Consequently smallpox was a major cause of deaths at Quebec during the Canadian campaign and by the spring of 1776 the virus was spreading like wildfire through the vulnerable new recruits now also arriving from other states. If the epidemic could not be contained Washington’s army could be devastated and even the civilian population threatened.
There was one possible remedy, but it was risky, uncertain, and possibly dangerous. Since early in the 18th century a few Britons and Europeans had experimented with a process call inoculation, which provided some immunity from the pox. Learned from medical men in the eastern Mediterranean, inoculation involved making a small incision in someone’s arm and deliberately introducing pus or other material from someone who had a “mild” case of the virus. The person was then isolated until the disease had run its course and they had recovered. As opposed to catching the pox the “natural” way – i.e. through the lungs by inhalation, the death rate from inoculation was reduced to less than two percent.
Although many colonists in British North America were aware of inoculation, it was still controversial and distrusted – it seemed counter-intuitive to deliberately infect someone with this deadly virus – and what if it escaped and spread? By the winter encampment of 1776-1777 at Morristown, New Jersey, Washington was being urged by some of his officers to take measures to prevent smallpox from decimating his fledgling army. Washington himself had survived the pox as a teenager with only a few scars on his face to show for it. In January 1777 Washington made the risky, brave, but ultimately crucial decision to inoculate all the soldiers in the American army.
Done during the off campaign winter season, the inoculated men were kept in strict quarantine while they were recovering and to prevent spreading the virus to the civilian population. By the time the campaign season began in the spring, Washington could be assured that the pox would not rage through his army possibly killing as many as a third of his men.
Throughout the remainder of the Revolution, Washington made sure new recruits were inoculated for smallpox before they were mixed in with his seasoned veterans. By 1800, Edward Jenner, an English doctor, had discovered that exposing people to cow pox, a mild infectious disease, gave them a lifelong immunity to smallpox. From this time on, riskless “vaccination” became the common way of protecting people from dying of smallpox. By taking this bold action in early 1777, Washington displayed, once again, his unmatched leadership abilities. Knowing when to be cautious and when to be daring, Washington was truly the leader the new nation needed.
Edward Ayres, Historian
American Revolution Museum at Yorktown