Page 153 - JSOM Spring 2020

Medicine and the American Revolution

How Diseases and Their Treatments Affected the Colonial Army

Reiss O. Medicine and the American Revolution: How Diseases and Their Treatments Affected the Colonial Army. Jefferson,
NC: McFarland & Company; 1998. ISBN 978-0-7864-2160-2. Paperback, 280 pages.
Review by COL (Ret) Warner “Rocky” D. Farr, MD, MPH

ny of us who have studied military medicine or even into New England. Although quinine had been discovered
casually been exposed to it know that the percentage malaria was often lumped together with other febrile diseases
Aof DNBI (disease, nonbattle injury) exceeds KIA (killed and not separately treated. At least one British general died of
in action) plus DOW (died of wounds). In the American Rev- an acute malarial attack, however most malarial fevers were
olution it was an astounding 9:1 ratio. Death from illnesses clinically low-level chronic disease.
vastly outnumbered death from war wounds. We tend to look
at the American Civil War when we wish to see the first effects Smallpox has a detailed chapter including the steps of inocula-
of military medicine making a difference in soldier survival tion itself in a pre-vaccinia age where inoculation was with the
numbers. actual smallpox virus, usually causing a milder
case. Standard medical practice needed a pre-
Some 80 years before the American Civil War, inoculation 2-week regimen of diet, rest, and
poor diet, bad sanitation, and the absence of cathartics. On a whole, the British army had
even rudimentary medical care led to deaths much more resistance from exposure as children
in epidemic proportions during the American and from British army vaccination. Washington
Revolutionary War. The tiny military medical sometimes picked smallpox- resistant troops for
corps dealt with epidemics of dysentery, scurvy, missions into smallpox-virulent areas.
malaria, smallpox, typhus, scabies, respiratory
illness, and various other diseases busy deci- As a bonus in the book, completely against to-
mating the American ranks. Book chapters in day’s HIPAA health privacy standards, are ap-
this volume include ones on smallpox (in the pendices with copies of comprehensive medical
invasion into Canada), syphilis in New York histories for both George Washington (18 pages
City, scabies at Valley Forge, and malaria in the long) and of King George III (22 pages). They
“southern campaign.” Malaria trumps out to be not only cover a comprehensive, for the times,
the severest malady with the most cases. medical history but also discuss both protagonists’ states of
heath at important points, such as Washington before several
Syphilis was a seaport disease; yes, blame the Navy. A law crucial battles. George III most probably had porphyria with
from the Continental Congress mandated a $10.00 fine from assorted multisystem signs and symptoms, to include psychiat-
officers and $4.00 fine from enlisted. The “profits” were used ric, on and off his entire life.
to source blankets and bedclothes for American military hos-
pitals. The section on malaria dos an excellent job describing This thin volume packs a large amount of medicine into a
the history of malaria in the world and its disappearance from small space while being enjoyable. One walks away thinking
part of North America. We always think of malaria as a tropi- of all the advances physicians will soon make between the
cal disease when in the late 1700s it was well established even Revolutionary War and the American Civil War.

147