SICKNESS AND MEDICINE AT
VALLEY
FORGE
In the late fall of 1777, the outcome of America’s
Revolutionary War was uncertain. Washington’s Continental Army had not fared
well, and the British had occupied the new nation’s capital, Philadelphia. Washington chose Valley Forge as a place to winter his approximately 12, 500 exhausted troops. The area was situated on an elevated plateau, bordered by rivers and hills for defense.
Ample trees provided firewood and small farms dotted the area. And being close to Philadelphia, Washington could keep an eye on the British.
On December 19, the troops marched in over an icy trail in frigid weather. About 2,000 arrived barefoot but the soldiers otherwise in generally good health. Snow blanketed the ground, food supplies were limited, and meat sources sparse. The main fare was “fire cakes,” a mixture of flour and water baked in fire to produce a hard, blackened biscuit. Clothing was threadbare and shoes wearing out. The French patriot, Lafayette, who commanded a division, wrote to his wife that, “The unfortunate soldiers are in want of everything: they have neither coats, hats, shirts, or shoes.” The men shivered in tents until wooden cabins were built, the latter with a fireplace.
Washington knew the value of health in troops. Early in the war he had insisted that medical officers receive pay comparable to upper-level officers and he restrained army brass from interfering with measures ordered by medical officers. Congress had established the Medical Department of the Army, but chaos ruled in the institution much of the time. The first two medical directors had been dismissed, one on charges of spying for the British. The third, Dr. William Shippen, Jr., a highly educated surgeon and gynecologist,
was medical director during the Valley Forge layover. But disorganization, lack of funds and supplies, constant turnover of personnel, and frequent pilfering continued to hamper the medical-surgical aspect of the war.
Three available works on military medicine provided information on prevention of “camp diseases,” a major cause of death and disability in armies of the time: Sir John Pringle’s Diseases of the Army, Baron van Swieten’s The Diseases Incident to Armies with the Method of Cure, and John Jones’ manual of military surgery that included a section on preventive measures. Without knowledge of germ theory, all furnished sound advice on preserving troop health.
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| Diagram of Valley Forge (From Duncan, Medical Men of the Revolution, Internet Archive) |
Ample trees provided firewood and small farms dotted the area. And being close to Philadelphia, Washington could keep an eye on the British.
 |
| Washington's Army marching to Valley Forge (painting by William Trego. Wikipedia) |
On December 19, the troops marched in over an icy trail in frigid weather. About 2,000 arrived barefoot but the soldiers otherwise in generally good health. Snow blanketed the ground, food supplies were limited, and meat sources sparse. The main fare was “fire cakes,” a mixture of flour and water baked in fire to produce a hard, blackened biscuit. Clothing was threadbare and shoes wearing out. The French patriot, Lafayette, who commanded a division, wrote to his wife that, “The unfortunate soldiers are in want of everything: they have neither coats, hats, shirts, or shoes.” The men shivered in tents until wooden cabins were built, the latter with a fireplace.
 |
| Soldier's Hut, reproduction (Wikipedia) |
Washington knew the value of health in troops. Early in the war he had insisted that medical officers receive pay comparable to upper-level officers and he restrained army brass from interfering with measures ordered by medical officers. Congress had established the Medical Department of the Army, but chaos ruled in the institution much of the time. The first two medical directors had been dismissed, one on charges of spying for the British. The third, Dr. William Shippen, Jr., a highly educated surgeon and gynecologist,
 |
| William Shippen, Surgeon General (Wikipedia) |
was medical director during the Valley Forge layover. But disorganization, lack of funds and supplies, constant turnover of personnel, and frequent pilfering continued to hamper the medical-surgical aspect of the war.
Three available works on military medicine provided information on prevention of “camp diseases,” a major cause of death and disability in armies of the time: Sir John Pringle’s Diseases of the Army, Baron van Swieten’s The Diseases Incident to Armies with the Method of Cure, and John Jones’ manual of military surgery that included a section on preventive measures. Without knowledge of germ theory, all furnished sound advice on preserving troop health.
Washington ordered hospitals, called “regimental hospitals,” to be built. They housed men with short-lived medical problems, while more serious cases went to a middle stage, the “flying hospital” and the most serious to “general hospitals” outside Valley Forge*. Medical supplies were scarce. As the cold weather ground on, many doctors disappeared on unauthorized leaves, cattle and grain had to be “requisitioned” from local farmers, and soldiers caught fish in the nearby rivers.
Washington enacted several measures to prevent “camp
diseases.” He ordered latrines and holes for fecal matter to be dug at least
200 feet away from living quarters and any man found defecating elsewhere was
subject to five lashes. The frosted ground made this difficult and time-consuming,
and camps needed to be moved occasionally due to offensive smell. The troops
were to wash and shave regularly and launder their scanty clothing. In the
hospital, straw from discharged patients was burned and their bedding washed.
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| Hospital, Valley Forge (from Gillette, The Army Medical Department) |
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| Washington (left) and Lafayette at Valley Forge (by John Ward Dunsmore. Wikipedia) |
By mid-January most of the men had left the tents for smoke-filled huts and the hospitals were functioning. Frostbite was common, requiring amputations for many. Respiratory illness, including pneumonia, predominated during cold weather. Simple lack of clothing occasioned three to four thousand men to be reported as unfit for duty. With warmer spring weather, dysentery and “putrid fever,” probably a mixture of typhoid and typhus, appeared. A major problem affecting most of the troops was “the itch,” or scabies. Caused by a small mite, it is highly contagious in close quarters. Constant scratching leads to open sores, secondary abscesses and other infections. Sulfur applications, in lard, along with bathing and laundering of clothing generally resolved it. Venereal disease, as usual, was another problem, though the records do not suggest it as a major one. Scurvy was not recorded, possibly related to large amounts of lime juice ordered.
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| Schoolhouse converted to a hospital (from Gillette, The Army Medical Department) |
Washington had seen the devastating effects of smallpox on fighting ability earlier in the war and determined to prevent future cases. All soldiers who had not had smallpox underwent compulsory inoculation with a small amount of material from an active lesion. Many of the roughly 4,000 inoculated soldiers sickened with the disease, creating a great strain on the hospitals, but only 10 died.
During the stay at Valley Forge, France entered the war as an ally. By April and May 1778, shoes, clothing, and supplies began arriving from French ships. Finally, on June 18 the rehabilitated army left Valley Forge for new maneuvers, in generally good condition, though many were still recovering from inoculated smallpox. The overall mortality for the winter stay is quoted as 3,000 men (out of 12,500), but an accurate figure is not available.
Life was harsh and uncertain at Valley Forge that winter, but the hygienic measures and smallpox inoculations ordered by George Washington saved many lives.
*The hospital terminology is from Pringle. A quote from the 1775 edition, “Among the chief causes of sickness and mortality in an army, the reader will little expect that I should rank the hospitals themselves…”
SOURCES:
Reiss, O, Medicine and the American Revolution. McFarland & Co. 1998.
Gillett, M C, The Army Medical Department 1775-1818. Center of Military History, United States Army. 1981.
Trussell, J B B Jr, Birthplace of an Army: A Study of the Valley Forge Encampment. Pennsylvania Historical and Museum Commission. 1976.
Duncan, L C, Medical Men of the American Revolution, 1775-1783. The Medical Field Service School, Pennsylvania. 1931.
Middleton, W S, “Medicine at Valley Forge.” Ann Med Hist 1941; 3, 3rd ser (6): 461-486.
Waldo, A, “Valley Forge: 1777-1778, Diary of Surgeon Albigence Waldo, of the Connecticut Line.” Pennsylvania Magazine of History and Biography, 1897; 21 (3): 299-323.
Atkinson, R, The Fate of the Day: The War for America, Fort Ticonderoga to Charleston, 1777-1780.
Pringle, Sir John, Diseases of the Army. 1775; London.
A full index of past essays is available at: https://museumofmedicalhistory.org/j-gordon-frierson%2C-md
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