Before the actual skirmishes of the Revolution began in the New York City area in 1776, attempts were being made to prepare for future medical needs in the City of New York area. This led the local hospital and very young medical school to begin making arrangement for the acquisition of hospital supplies, in particular valuable medicines. Since these initial attempts to secure drugs occured close to the New York City area and its fairly modern medical school, there were a number of medicines the staff would be most interested in obtaining. Unfortunately, a lot of the essentials required for running a hospital were imported medicines like peruvian bark, opium, jalap root, balsam peru and balsam tolu. A number of others could be grown locally in gardens, and a select few could be gathered locally and relied upon as official medicines with already well-documented uses pertaining to the health of soldiers during the war.
During the spring and summer of 1776, within the New York City setting, Samuel Loudon was publishing his newspaper the New York Packet. This paper included an number of articles providing us with important insights into the war in general. This paper also included early announcements regarding the Continental Army. On July 29, this led to the posting of the following announcemest in the Packet, written by Thomas Carnes, Stewart and Quartermaster to the General Hospital of King’s College, New York. Anticipating an increase demand for medically trained staff, Quartermaster Carnes filed the following request for volunteers:
“GENERAL HOSPITAL
New-York, July 29, 1776 Wanted immediately in the General Hospital, a number of women who can be recommended for their honesty, to act in the capacity of nurses: and a number of faithful men for the same purpose…
King’s College, New York”
In addition to this request for volunteers, Carnes also asked the public to supply his team with “a large quantity of dry herbs for baths, fomentations, etc., etc. …particularly baum, hysop, wormwood and mallows for which a good price will be given.”
“The good people of the neighboring towns and even those who live more remote from this city, by carefully collecting and curing quantities of useful herbs, will greatly promote the good of the many, and considerably benefit themselves.
Thomas Carnes
Stewart and Q. Master to the G. Hospital”
This request provides us with the second hint as to how medicines would be obtained during the war. As this review of Revolutionary War apothecarian medicine will demonstrate, the majority of medicines utilized by the hospitals during the war would only be of several classifications: official foreign well-documented and typically traditional colonial remedies, unofficial foreign and domestic well-documented colonial herbal remedies grown by the local apothecary or as part of a typical domestic gardening setting, official or semi-official native herbal and mineral remedies either gathered or prepared using local natural resources, and a select few unofficial, well-documented local herbal remedies readily available due to the local ecological setting.
Of course, the first order was to obtain as many of the highly reliable medicines that could be obtained from foreign sources, since the war had not totally disrupted international shipping trade and commerce. Nevertheless, the war had its impact on local shipping activities by reducing the numbers of ships involved and the amounts of their holdings. At various times throughout the war this meant that some of crucial medicines would at times become scarce, even remaining so for years to come in some of the settings. This might have even required that local substitutes be relied upon at times, although the evidence for such within the military documents rarely cites or described any examples of this kind of behavior.
Equally unfortunate perhaps is the fact that the local hospital set up in Fishkill, New York, built soon after the city of New York was conceded to British forces between November and December 1776, also lacks much detailed documentation regarding the specifics of its pharmacal and medical holdings. Innumerable copies of military records, orders, reports, and brief notes passed between staff provide enough to inform us sufficiently about how physicians, surgeons, and apothecaries engaged in their skills in association with the field hospital set up in Fishkill. For this reason, the following sources were reviewed to document the practice of colonial pharmacy within the Continental Army setting.
- A review of the related Military records.
- A review of books related known or strongly suspected to be directly related to the apothecarian practices of the War.
- A review of relevant professional, science, philosophy, engineering and economic trade journals pertaining to the war or its most active years.
- A review of local primary (and some secondary) writings related to this portion of local Revolutionary War history.
- A review of the diaries and journals of physicians and other higher level staff members engaged in the medical and pharmacal management process.
- A review of the popular press for the time regarding medicine uses during the War.
- A review of the diaries of soldiers and others who participated in the war, in which valuble medical information can be found.
- A review of the immediately post-war writings in professional books and professional journals pertaining to the medical and pharmacal history of the War.
- A review of reminiscences of any or all of the above.
Military Documents
Primary sources for military documents potentially pertaining to the Fishkill Hospital include the multiple volume series on the War documents.
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Medical/Pharmacal Books or Texts
The primary medical texts for the time pertaining to the war were mostly of European origin, although at the dawn of the war a small book was written by a Philadelphia doctor meant to serve as a brief instruction book on how to deal with war-related injuries or problems.
The most important references published with direct relevance to the War, published prior to or about the time of the war are as follows:
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The most important references published during the immediate post-war period, ordirect relevance to the War, include the following American medical publications, with sections that focus specifically on medicine possibly used or useful during the Revolutionary War:
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Professional Journals and such
Limited information was produced during the war pertaining to Revolutionary War medical information or needs. The majority of journals or magazines produced during this time, like the books, were mostly products of the European press.
The most important journal-related items to consider for review are articles pertaining to specific fairly new medicinal substances and their uses.
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see also
DRUG SUPPLIES in the AMERICAN REVOLUTION. Paper 16, pages 109-133, from CONTRIBUTIONS FROM THE MUSEUM OF HISTORY AND TECHNOLOGY. United States National Museum, BULLETIN 225. SMITHSONIAN INSTITUTION. WASHINGTON, D.C., 1961 at http://www.gutenberg.org/files/27076/27076-h/27076-h.htm
Primary Medical Resources
As mentioned elsewhere throughout my reviews of Dutchess County medical history, Dr. Cornelius Osborn provides us with some of the best insight regarding the local influences of physicians on this aspect of medical practice within the Fishkill Hospital setting. A number of other historical documents in the immediate locality also provide important insights in materia medica as well. The notes of Dr. Stephen Thorne provide some insight into this part of local history, but since thorne’s work seemed to be somewhat basic, and often simplified, written in the form of basic ledger-style brief one-line entries, they provided limited insight. More importantly, the lack of availability of this important Colonial-Revolutionary War-and Post-Colonial medical document represents a major loss of this important piece of local medical information.
Dr. Cornelius Osborn’s recipe book (vade mecum) was written just a few years prior to the initiation of the Revolutionary War. Even though it does provide us with some insight into Dr. Osborn’s personality and upbringing, for comparison with the training and knowledge base for the local military staff medical leaders, there are some important differences between local physician Osborn and the locally assigned military medical leaders. For one thing, there are some significant vocabulary related differences that Osborn had to correct for when working alongside these physicians and surgeons, such as the use of the 50 year old term New Spain-related term quinquina, instead of the more contemporary peruvian bark or cortex peruviana.
Diaries and Journals of Staff and Physicians
The single best source providing us with insight into the practice and experience of the Fishkill (and other nearby) hospital setting(s) is the Diary of James Thacher. Several other Directors in Charge of Medical or medical-related wants, needs and issues produced valuable insight into this part of the local medical history. The most informative of such writings in a post-war autobiographical work produced by Dr. John Cochran, who served under George Washington during the later years of the War. Two other highly important members of the medical staff were John Bard and Benjamin Rush, both of whom we can deduce much about regarding their underlying trainings and beliefs, but little in terms of drug-related specifics. Since many of these diaries were published post-war, the versions available for review are best interpreted as reminiscences, keeping in mind that the text and verbiage contained therein may be more of a post-war form of professional vocabularyand reasoning at times, wording which can often make it difficult to decipher the exact reasons why certain actions may have been taken years prior to their publication.
William Thacher
In William Thacher’s Journals there are notes pertaining to locally grown medicine that he felt were worth trying to incorporate into the Continental Army’s materia medica supplies. Dr. Thacher makes special notes about the potential usefullness the bark and nut-hulls of Butternut tree, which he considered to be a highly effective blistering agent:
“The extract of butternut is made by boiling down the inner bark of the tree, this discovery of this article is highly important, and it may be considered as a valuable acquisition to our materia medica.”
Recalling its previous recommendations by Benjamin Rush and others of the Hospital department, he defined its therapeutic values accordingly as “a mild yet sufficiently active cathartic, and a valuable and economical substitute for jalap. It operates without creating heat or irritation, and is found to be efficacious in cases of dysentery and bilious complaints. . . . As the butter-tree abounds in our country, we may obtain at a very little expense a valuable domestic article of medicine.” [5]
Thacher’s example of how Butternut may be employed as a medicine relates to the treatment of small pox, for which the traditional protocol was to administer Mercury and to prescribe a “low diet.” Thacher recommends a dose of Jalap and Calomel (a mercurial), or an extract of Butternut as a substitute for this, prior to when the signs and symptoms of small pox have finally set in.
Other field hospitals then had to take on the responsibility of the New York Hospital, one of the most important of which was the field hospital in Fishkill, New York. Other hospitals were set up in Haverstraw, Orange County, near where Cornelius Osborn’s father lived and served. [6]
Dr. Osborn and Local Need for Medicines
Prior to his acceptance of the Regimental Field Surgeon position for the local Regiment he was serving in, Dr. Osborn’s played an important role in some activities required to ensure that adequate supplies were being stored for future needs. During the early Spring months of 1776, several months before he was offered his Regimental Surgeon position by Samuel Bard, Dr. Osborn and his associate local beer brewer Matthew Dubois Jr. worked to obtain sources of food and clothing for the local militia. On May 3rd, 1776, “A Bill of Sale of Crops on the Ground” involving “Corl Osburn” and Matthew Dubois was produced. This Bill made mention of 12 English Pounds of currency “hand paid” by George Clinton to Osborn and Dubois for the purchase of “One Equal Third Part of Twelve Bushels, sowen of Wheat, now standing and Growing on the Ground it being on the farm of Stephen Peit” from David Hamon of New-Windsor. [7]
By the end of the summer, local physicians and Osborn would most likely be considering whether or not there might be an upcoming need for fever remedies, due to the developing Autumn climate and the tendency for Autumnal fevers to begin producing very local epidemics. One at least one occasion, this time of the year led Osborn to place an order for Peruvian Bark (cinchona or quinine), a proven remedy for certain types of late summer and early autumn diseases (malaria, or what they called ‘fever with agues’ around this time), but less so for the others (bilious or what was later called yellow fever). By the time winter was approaching, physicians like Osborn had to deal with the rise in numbers of Camp, “Typhus” or Spotted Fever cases. These diseases were brought on by unsanitary living conditions (rodents and Salmonella, since the two types of fever, typhus and typhoid, were not yet adequately differentiated), in combination with crowding within protective buildings or dwellings.
By the end of the first year, the effects of crowding within the encampment site were already influencing local public health conditions. In just a few months, one of the most deadly and highly contagious diseases, small pox, made its debut in this local setting, forcing the staff to relocate these individual to a separate facility to prevent the disease from spreading to other soldiers. As a precaution to becoming ill with small pox, inoculation was often the option made available for such situations. During the first few months of this period in local history, Directors in charge of the health of the militia were against the initiation of such a program. At the time, the practice of inoculation meant that a soldier had to be infected with the discharge of a pox removed from an already infected individual. The exact rates for fatality of such a procedure remain uncertain to this day in Revolutionary War medical history, but are estimated to be somewhere between 1 in 5 and 1 in10 deaths for each inoculation series initiated on local soldiers.
The fact that several epidemics or clusters of cases erupted locally, requiring hospitalization by additional facilities reassigned and revamped for use as emergency hospitals, suggests that at time times the demands for medicine must have been close to a peak, even extending well beyond the official provisions locally stored for when such needs arise. In the Dutchess County area, we find evidence for this involving the the emergency military hospital established at a Quaker church situated on the Oblong Patent, close to its north end of the county. These Quakers allowed their church to be used for harboring the sick and injured; although they were most likely against the war, their concern for the sick and injured remained very much at part of their philosophy and war-related activties. Closer to the Fishkill setting, there were several other potential hospice or hospital settings, including a number of larger churches like the the Dutch Reformed Church in the village of Fishkill or the nearby Trinity Church.
In the subsequent pages of this section the following questions are answered and the related topics are reviewed:
- What diseases or medical conditions were there to treat?
- Why did they select the medicines they did for use in the hospital and/or by local physicians at home or out in the field?
- Where did these medicines come from and how much did they have on store for later months and years? How long did they last in storage or on the shelves?
- Were any medicines manufactured locally in a semi-industrial fashion?
- How much of a role did local herbs and mineral remedies play in the Fishkill hospital?
- Which medicines were in highest demand and why?
- Were any of the local herbs used on occasion as substitutes?
- Based on the materia medica and the uses of these medicines for the time, what diseases and medical conditions were the physicians who placed wthese orders trying to prepare for?
An additional review has to take place at somewhat of an axial level, meaning there are some questions regarding the local uses of herbs and how these took place during the war, even though there is little to no circumstantial evidence suggesting these forms of medicines were formally in demand by the local administrators. It is possible for example that some physicians may have preferred the use of local remedies as substitutes, an action that one would expect might result in immediate discharge from their medical services position. Away from the encampment, and in some cases back home, it is possible that alternative methods of medicine were once again employed whenever the actions taken were not official in nature. For the individual soldier, this type of reaction to illness and disease might be expected, but for more important local staff members who are also serving as minutemen, such as Dr. Osborn, such may not be the case, for he remained fairly active at some sort of administrative level during much of the War.
To review the local plant medicines, those for which uses were known to exist at the time will be the focus. The second listing of plants reviewed are those with immediate post-war related popularity, suggesting their use was in the common public’s mind but not in the minds of medical professional and military leaders. For this reason there are a number of these that need to be reviewed in relation to Fishkill Hospital practices, due to their close proximity to the hospital, depot and encampment sites. Based upon a preliminary review of this very local aspect of Revolutionary War medical history, it appears that one to two hundred local plants of medical value were available and of potential value for use as medicines. Only several of these appear to have been used or considered for use. Several others were possibly or probably used, when supplies were exceptionally low sand the right circumstances and needs prevailed. There are also numerous domestic herbs that could be used when needed, on a supply-related per need basis, as evidenced by the advertisement noted earlier that was placed by Stewart and Quartermaster of the New York hospital setting, Dr. Thomas Carnes.
There were also a number of local herbs of potential value to medicine that were almost certainly not used by physicians during the war. These also need to be listed and briefly discussed. These plants of potential value were more than likely not used by hospital for a variety of reasons ranging from lack of awareness and knowledge of their identification and use, to a total lack of professional support for their uses, in particular by fellow physicians of higher ranks within the local military setting. These remaining local medicines are also reviewed in their entirety in a separate sections, but some are covered whenever they seem relevant to the specific medicine or topic at hand.
Brian Altonen, MPH, MS 