George Washington's military genius is undisputed. Yet American
independence must be partially attributed to a strategy for which
history has given the infamous general little credit: his controversial
medical actions. Traditionally, the Battle of Saratoga is credited
with tipping the revolutionary scales. Yet the health of the Continental
regulars involved in battle was a product of the ambitious initiative
Washington began earlier that year at Morristown, close on the heels
of the victorious Battle of Princeton. Among the Continental regulars
in the American Revolution, 90 percent of deaths were caused by disease,
and Variola the small pox virus was the most vicious of them all.
(Gabriel and Metz 1992, 107)
On the 6th of January 1777, George Washington wrote to Dr. William
Shippen Jr., ordering him to inoculate all of the forces that came
through Philadelphia. He explained that: "Necessity not only
authorizes but seems to require the measure, for should the disorder
infect the Army . . . we should have more to dread from it, than
from the Sword of the Enemy." The urgency was real. Troops were
scarce and encampments had turned into nomadic hospitals of festering
disease, deterring further recruitment. Both Benedict Arnold and
Benjamin Franklin, after surveying the havoc wreaked by Variola
in the Canadian campaign, expressed fears that the virus would be
army's ultimate downfall. (Fenn 2001, 69)
At the time, the practice of infecting the individual with a less-deadly
form of the disease was widespread throughout Europe. Most British
troops were immune to Variola, giving them an enormous advantage
against the vulnerable colonists. (Fenn 2001, 131) Conversely, the
history of inoculation in America (beginning with the efforts of
the Reverend Cotton Mather in 1720) was pocked by the fear of the
contamination potential of the process. Such fears led the Continental
Congress to issue a proclamation in 1776 prohibiting Surgeons of
the Army to inoculate.
Washington suspected the only available recourse was inoculation,
yet contagion risks aside, he knew that a mass inoculation put the
entire army in a precarious position should the British hear of his
plans. Moreover, Historians estimate that less than a quarter of
the Continental Army had ever had the virus; inoculating the remaining
three quarters and every new recruit must have seemed daunting. Yet
the high prevalence of disease among the army regulars was a significant
deterrent to desperately needed recruits, and a dramatic reform was
needed to allay their fears.
Weighing the risks, on February 5th of 1777, Washington finally
committed to the unpopular policy of mass inoculation by writing
to inform Congress of his plan. Throughout February, Washington,
with no precedent for the operation he was about to undertake, covertly
communicated to his commanding officers orders to oversee mass inoculations
of their troops in the model of Morristown and Philadelphia (Dr.
Shippen's Hospital). At least eleven hospitals had been constructed
by the year's end.
Variola raged throughout the war, devastating the Native American
population and slaves who had chosen to fight for the British in
exchange for freedom. Yet the isolated infections that sprung up
among Continental regulars during the southern campaign failed to
incapacitate a single regiment. With few surgeons, fewer medical
supplies, and no experience, Washington conducted the first mass
inoculation of an army at the height of a war that immeasurably transformed
the international system. Defeating the British was impressive, but
simultaneously taking on Variola was a risky stroke of genius.
Fenn, Elizabeth. Pox Americana: the Great Smallpox Epidemic of 1775-82.
New York: Hill and Wang, 2001. 370 p.
Gabriel, Richard, and Karen Metz. A History of Military Medicine.
New York: Greenwood Press, 1992. 2 v.