Poor camp hygiene resulted from overcrowding, difficulty disposing of waste, food spoilage and exposure to parasites such as lice, fleas and mosquitoes. Common diseases included smallpox, typhus, malaria, dysentery, venereal disease and pneumonia.
Smallpox was highly contagious and killed about one in four infected individuals. The disease was introduced to the Americas by Europeans and devastated Native American populations who had no prior exposure.
An early form of prevention, inoculation, involved introducing material from a smallpox sore into a healthy person to trigger a mild infection and immunity. Because the material contained a live virus, the procedure sometimes caused severe illness or death.
Even so, the mortality rate was about 2%, or one in 50, far lower than natural infection.
Inoculation was introduced in Boston by Cotton Mather, who learned of the practice from an enslaved man named Onesimus, who had seen it used in Africa.
During the war, George Washington and the Continental Congress ordered widespread inoculation of troops. This helped reduce the impact of smallpox on the Continental Army, which suffered fewer losses than British and Hessian forces.
At the same time, advances in anatomy led to more frequent post-mortem examinations. Physicians observed direct physical damage to organs, including brain hemorrhages, tumors and lung infections. These findings challenged the humoral theory and contributed to the development of the study of pathology.
However, these advances came too late for Washington. After developing a severe throat infection, he was treated with repeated bloodletting. Physicians removed about 2.5 quarts of blood in 12 hours, which contributed to his death.
It was not until the 19th century that the true causes of infectious disease were identified. Scientists discovered bacteria and viruses and began to understand how infections spread, particularly through the work of Louis Pasteur.
Colonial American medicine lagged behind Europe’s, particularly in France, Germany and Scotland. However, it was improving. The emphasis on observation, experimentation and inquiry aligned with the period’s Enlightenment ideals, characterized by reason, empirical evidence and the scientific method, setting the stage for rapid advancement.
— Peter J. Ward is a professor of neuroscience at the West Virginia School of Osteopathic Medicine (WVSOM) in Lewisburg, W.Va. He earned a Ph.D. degree in anatomy education at Purdue University. Ward joined the WVSOM faculty in 2005 and has taught gross anatomy, neuroscience, embryology, histology and the history of medicine. He has received numerous teaching awards, including the WVSOM Golden Key Award and the American Association of Anatomists’ Basmajian Award, and has been a three-time finalist for the West Virginia Merit Foundation’s Professor of the Year selection. Ward has served as a council member and association secretary for the American Association of Clinical Anatomists. He has also served as a consulting editor, senior associate editor, lead editor and contributor for multiple medical publications, including the Netter Atlas of Human Anatomy.
