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The practice of medicine on encampments sites had to contend with several environments and their possible relationships to disease.  There were the soldiers’ barracks, the officers’ quarters, the commons and public buildings, several occupational settings like those of the butcher, craftsmen and medical officers, the official hospital, a number of cabins or lodges serving special medical needs, such as for patient overflow, quarantine, and inoculation services, and for Fishkill, the large storage facility.

Anywhere there is crowding of people, there is an increased likelihood for endemic and diseases to occur.  Similarly, anywhere there is an aggregate of environmental changes induced by crowded living conditions, landuse patterns, deforestation and the production of contaminated water and soil beds, diseases are likely to change in this setting from mostly endemic diseases normal to these wilderness-like or young farming settings into lands that are heavily modified, with a build up of food, lifestyle and occupation related sanitation changes brought on by build-ups of refuge and decaying animal food or hide carcass materials, human waste materials, and the build up of plant and tree refuge in previously unimpacted wetlands and water edge regions.  All of these have impacts on the quality of life in an encampment setting.  Add to this the poor health policing and sanitation engineering practices, and we have a new place with new diseases able to erupt. 

When the war began, disease was interpreted locally as a product of the individual and his/her environment.  People had poor temperament, imbalanced humors, the inability to mange the severe climate changes, unable and unwilling to engage in the appropriate foodways practices.  During the war, your nearest neighbor was no long living 6 miles from your home on the next lot of land allocated for farming purposes, your nearest neighbor was either in the cabin or temporary lodge, or even residing on the cot right next to you just a few feet away.  And in the nearby quarters where still other potential disease victims resided, the likelihood that you became infected by the small pox brought in by another soldier, or a member of his family visiting from afar, was pretty high.  If people a few lots down had the dysentery, chances are so do you.  If the nurse managing your case managed to engage in unhealthy forms of contact with the soldier a few cots away by way of sharing blood-soaked linen towels or using the same ladle provide for you your hourly drink, then you were more than likely going to experience the same diseases as many others in the facility in need of surgery,  or worst yet, amputation of a soon-to-be gangrenous appendage.  The flies that passed through tight quarters, the mosquitoes making use of your still body for its next feed, each of these only added to the problems at hand due to the war and living conditions.  None of these diseases were due just to the miasma that surrounded you along the flood plains of local creeks and waterways.  But miasma was often left to blame for these deaths, even those due to such obvious causes and direct contact with measles and small pox victims, or close relationships with other infected people.

The following article is an example of this problem as it was known to exist just prior to the initiation of the Revolutionary War.  This type of view of disease and the environment is matched by the research into developing fans to circulate the air about the larger buildings, and the needs for proper cleaning and sanitation practices engaged in by the staff of the camp and hospital.   

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