Brian Altonen, MPH, MS

The Revolutionary War

       On April 19, 1775, official preparation for the Revolutionary War officially began.  On the 15th of August, “A return made…at the house of Jacob Griffen, of persons who signed the Association” was signed by “Cornelius Osborne” and his son “James Osburn” [1].  Two months later, Cornelius Osborne enlisted as a Surgeon to serve as a minuteman [2].  His sons, James (28 years old) and Peter (17 years old), were also enlisted, serving as privates in Van Wyck’s and Brinckerhoff’s Regiments respectively [3,4].    

When the Revolutionary War began its actual skirmishes in 1776, early attempts to prepare for the medical needs related to War were made in the City of New York.  During the spring and summer of 1776, Samuel Loudon was publishing his newspaper the New York Packet, in which  he included numerous articles and announcements regarding the Continental Army.  On July 29, for example, came the following announcemest 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, he 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 for members of the public to suply his teacm 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.”

This request gives us a hint at how medicines were obtained by physicians during the war.  Of course many medicines could be obtained from foreign sources, the war had not totally disrupted the international shipment of products by way of local merchant vessels.  Nevertheless, due to the war and the local reduction in shipping activities and capacity, some of these medicines were scarce and would remain so for years to come.  This required that local substitutes had to be relied upon at times.  These herbs and tree products were grown in colonial yards and herb gardens or were gathered in the wild by local herbalists which Carnes, for wrote the following announcement: 

“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”

Soon after, the local hospital in New York was established, the city of New York was forced to concede to British forces, forcing Loudon and his newspaper to retreat northward into the Valley.  Loudon ultimately settled in the town of Fishkill, and reopened his printing business at the corner of two well-travelled roadways for the time.   During this time, Fishkill had been selected as the place for important stores to be held by the Continental Army.  This included both military and hospital stores, along with the establishment of a sizeable field hospital. 

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] 

Prior to his acceptance as a Field Surgeon for the Army, Dr. Osborn’s played an important role in ensuring that adequate medical facilities were established for the local hospital.  During the early Spring months of 1776, he and his associate local beer brewer Matthew Dubois 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].   In the months ahead, the establishment of these local hospital settings continued, and Osborn began to consider the upcoming need for fever remedies due to the developing Autumn climate.

 During the first months of 1776, Cornelius Osborn was not officially serving as a physician for the Fishkill hospital.  The duty of ordering medicines was most probably controlled by one or two members of the local administrative staff and several officers travelling to and from the various  encampments positioned throughout the region.  There is some evidence that other places came to serve as military hospital bases that were not included on many maps of these locations, one of the best known of which was situated along the Oblong Patent close to its north end where a large Quaker establishment resided.  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.  Other potential hospice and hospital settings in this part of New York included a number of churches, especially the larger churches like the the Dutch Reformed Church in the village of Fishkill and the nearby Trinity Church. 

According to other documents, there were also encampments set up here and there along both sides of the Hudson River, with some of these camps positioned as far south as Haverstraw.  There were of course strategically placed encampments along both sides of the Hudson River at this point, next to Anthony’s Nose and Storm King Mountain and two others just across the river from each other near West Point.  In the months to come this was where still more special provisions needed to be established in order to prevent British Fleets from ascending the River at the worst of strategic times.   By the summer of 1776, the next phase in the establishment of the Continental Army’s Medical Services, setting the stage for Osborn’s recruitment as a Field Surgeon. 

The Continental Army’s Medical Services

There was a particular order to which the Continental Army’s medical units and leaders were established.  This part of the war plan began as early as July 3, 1775, when George Washington for the first time witnessed the medical disposition of many of his recruits.   One of the concerns the Continental Congress had was the fact that in many cases, members of the staff in charge of medical services knew very little about medicine and dealing with sickness.  Due to poor leadership and planning, this resulted in medical supplies remaining quite low.  For soldiers living in barrack settings, they survived the conditions left to them by poor or inadequate personal clothing and supplies, minimal food stores, and the lack of management of their poor hygiene practices.   By July 27th, just 24 days later, this led the Continental Congress to establish rules that assisted in the making of the first military hospital settings and define the staff requirements fo9r each of these facilities. 

This overall medical program would service approximately 20,000 members of the army.  It was supposed to consist of a Director General and Chief Physician assigned to each of the Northern and Southern Divisions of the Continental Army. These administrators in turn would be answered to by their subordinates in charge of the Medical Facilities for their part of the Northern or Southern Division.  For each region in which a hospital facility was established a team of local physicians were selected from the population and assigned Regimental physicians, one in charge of the hospital facility, the other to serve primarily as a Field Surgeon.  These rules were not steadfast, and in fact weren’t fully established over the next couple of months, but they were enough to start the growth of the regional medical facilities for each of the established regiments.  The order in which the ruling positions were to be decided were as follows (order of data: date, highest authority established; major subordinates;highest authority in underlying regimental system;  method of presentation modified from Gillett, 1981, p. 23) [8]:

• July 1775-assign Director General and Chief Physician positions, in charge of surgeons and apothecaries, answered to by Regimental Surgeons.
• September 1775-retain Director General and Chief Physician, assign or develop similar positions for the Northern portion of this Army, in charge as above, answered to as above.
• June 1776-As above, add Director General and Chief Physician in the South assignments, positions to be primarily in charge of as above, answered to as above.
• July 1776-As above, add surgeons who function as hospital directors to Major Subordinates itinerary; “Regimental Surgeons must submit medicine chests for inspection to Hospital Department’s hospital directors.”
• September 1776-as above, as above, with heads of Hospital Departments established for all Regimental Surgeons to answer to.
• April 1777-Major duties maintained as above, Physicians and Surgeon general for each army answer to Deputy Directors of each District.
• September 1780-Highest authorites as above; 3 Chief Hospital Physician major subordinates defined for North, South and new settings established just south of Virginia.
• March 1781-command structures for hospital remain unchanged from this point forward.

This calendar of events provides us with an itinerary that was followed during the establishment and early growth of the Fishkill hospital setting.  This helps to better define the associations within this facility as told to use by the numerous government documents detailing only a few of its staff members at any one time.  It also helps to set in place many of the documents pertaining to Osborn’s service in the local army, along with those uncovered pertaining to many other physicians working by his side.  Even though we know there were approximately 40 physicians working the Fishkill hospital and medical medical facilities, the identification of everyone who served the immediate Fishkill hospital setting is lacking, with the unique exception of Cornelius Osborn. 

Duncan provides us with insight into the possible make-up of these military hospital settings.  There were several types of hospitals developed including the transportable flying hospitals, the fairly stable regimental hospital settings usually in the form of large buildings, the stable but temporary local hospital-like settings that made use of such local settings as churches and public gathering indoor places, and finally there were the numerous temporary hospitals that were established due primarily to the needs of the time.  These temporary hospital-like settings were not as well documented as the prior three types of facilities, and were established and used only when such a need arises.

For this reason, the exact staff makeup of any given health care facility can be quite variable.  For the smallest of official medical teams, one would expect a Surgeon or Physician to be present along with at least one assistant, usually an individual serving as an apprentice.   In slightly larger settings, an apothecary is typically added to the scenario, followed by adjunct medical staff such as nurses and the like, and then followed by even more subordinate assistant positions like that of an individual in charge of domestic supplies, an individual in charge of patient cleaning and special care, and patient-related dietary and personal health practices.  In the ideal setting according to Pennsylvania Physician and Surgeon James Jackson, there should be 6 medical officers and 48 hired assistants.  The 6 officers consisted of a physician and two assistants, a surgeon and one assistant, and an apothecary.  The 48 hired assistants included 1 steward, 3 wardmasters, 2 dispensers, 1 “surgery man” with “attendants as needed”, 1 sempstress, 5 laundresses, 3 barbers, 3 cooks with “laborers as needed”, 7 servants, 1 keeper of the packs, 2 bathers, and “1 man for Itch ward.”  This served mostly as a general rule for establishing the medical team for a given hospital setting; meeting these numbers was not required.  A team of this size was set up to serve 400 hospital beds and patients. [9]

These positions had little to do with Cornelius Osborn’s placement and role in the local regiment.  We know from Duncan’s writing that for each principal hospital there had to be at least one physician and several assistants to assist the patient with medication regimens, bathing, eating and drinking recommendations or requirements, wound redresses, etc.   Each hospital had to have two surgeons as well, one for hospital work and one for field work if so required.  Each regiment during wartime was required to have a surgeon and two assistants.  According to Duncan [10]:

“The regimental surgeon held a commission and was called “Mister” or “Doctor” but had no real rank.  On the regimental list he was named, if at all, after the last ensign.  He ranked somewhat with the chaplain and quartermaster and was overlooked on ceremonial occasions.”

Aside from the required hospital setting, each Regiment was required to have another facility in which patients could be housed or kept.  This could be some sort of home or sizeable facility with other uses such as a church or a public gathering place.   At times, Osborn’s own home was used to meet these needs and requirements.  Serving as well as a member of the Committee on Safety, this practice was not unusual for Osborn, and even supports the notion that Osborn had a little bit more personal and professional support from local and regional Revolutionary War staff members.

To get further insight into what was expected of a regimental physician, a review of Dr. John Morgan’s decisions about this partocular issue help to shed some light.  In early July of 1776, when King’s Hospital was established as the primary Continental Army hospital for the militia, Medical Director for the Grand Continental Army Dr. John Morgan gave a speech to the New York City residents about to serve in the nearby hospital setting.  As part of this speech he noted the following requirements of the regimental surgeon medicine chest [11]:

• Instruments on hand for uses: Amputating instruments.  Trepanning instruments.  Incision knives.  Pocket instruments.  Bullet forceps.  Crooked needles.  Straight needles.  Pins.
• Number and kind of bandages, ligatures, etc.: Simple rollers. Double rollers. Foliated bandages. Splints.  Tourniquets.  Ligatures.  Tape. Thread.
• Old Linen and other Implements:  Quantity of linen or weight of rags.  Weight or quantity of lint.  Tow[el?] or sponges.

The Colonel of the Regiment was required to sign a document indicating these were present and provide the names of the “Surgeon” and his “Mate” who were in possession of these required requisitions.

Injury and Disease

The purpose of the medical staff and facilities was twofold.  First, they had to provide hospital and field support for the war victims.  Second, they had to maintain the health of the militia in periods between war as well as during the active periods of this war.  A significant numbers of policies were established to make sure provisions were used appropriately, maintaining the health of members of its militia.  As early as Fall of 1776 this was not the case however.  Numerous storage sites were short on both amounts and types of medical provisions available.   Individuals were rapidly becoming ill.  Campsites and barrack locations were often intolerable when it came to sanitation practices.  Food and clothing supplies were at a miminum.  Throughout all of these public health related problems, there was the constant fear or concern regarding wartime injuries.  In 1776, a treatise on the wartime injuries that physicians and surgeons were expected to treat was produced by Dr. John Jones of Philadelphia.  This book noted the following types of problems physicians were expected to deal with pertaining to war-related injuries and medical conditions:

• Inflammation
• Abscess
• Gangrene
• Incised wounds in need of sutures
• Puncture wounds in need of opening or enlargement for drainage
• Lacerations in need of reconstruction and preservation
• Severe contusions with the development of pus , in need of opening and suppuration
• Cut tendons
• Chest and abdomen wounds, with potential organ damage
• Abdominal excision or organ-omentum display
• Bayoent and Sabre wounds of the chest
• Simple and Compound Fractures, with potential for inflammation and development of infection or gangrene 
• Limb or part in need of amputation
• Gunshot wounds, with potential for extensive hemorrhaging, infection or gangrene
• Knife, hatchet or club wounds

Some stereotyped wartime injuries like the crushing force of a cannonball or the loss of life due to explosion were very infrequent.  Some of these unique wartime problems were even not at all covered in Jones’s book, examples of which include:

• Cannon-ball, or other form of weighted trajectory induced damage
• Fire-induced burns
• Weapons-induced burns
• Gunpowder and weapon burns

In a review of the infectious disease problem within encampment settings, the physician/surgeon had different set of maladies to contend with.  Those diseases which produced the greatest reductions in active militia populations were common chronic conditions like a long term disease history related to heart and lung disease, ongoing rheumatic joint pains, diabetes, seizures, consumption, and various forms of physical debility.   The most common chronic disease problems asssociated with hospital cases are noted in the Albany hospital records of mid-August 1777 (case counts included) [12] :

• dysentery (81)
• intermittent fever (79)
• diarrhea (61)
• cough (25)
• rheumatism (22)
• convalescence (17)
• debility (17)
• lues venerea (14)
• fever(13)
• whooping cough (10)
• head itch (9)
• measles (8)
• putrid fever (camp, jail, hospital fever) (6)
• bilious (yellow) fever (4)
• dropsy (4)
• scorbutus (vitamin c deficiency) (4)
• pleurisy (3)
• nephritis (3)
• scrofula (3)
• jaundice (2)
• rupture (2)
• hemoptysis (spitting of blood) (2)
• paralysis (2)
• hemorrhoids (1)
• asthma (1)
• cholera (1)
• hypochondria (1)
• ophthalmia (1)

According to the discussions of diseases of a chronic or debilitating nature provided by the citation found in Duncan, the following may also be added to this list:

• small pox
• typhus
• typhoid fever
• spotted fever
• remittent fever

 

Osborn’s Prerequisites for the Field Surgeon Position

According to Osborn’s vade mecum or pocket recipe book, Osborn had a fairly decent background in the local disease history.  He had some familiarity to treating the majority of diseases referred to in Gillett’s and Duncan’s writings.  But fails to mention anything about measles or small pox, a reason for which is uncertain.  But it is possible that like many other physicians he combined this form of disease with others, considering it not that different from these others due to the shared dermatologic signs and symptomas.  This means that Osborn may have related measles adn small pox to other febrile disorders such as the “spotted fever” (dengue, which was imported by merchant ships), and from there to the less symptomatic non-remittent  or non-ague forms.  Incidentally, this behavior of merging diseases together that today we know are quite different was also practiced by Cadwallader Colden of Newburgh-Coldengham, who felt the Boston 1720 Small Pox epidemic was related to the 1739 Kingston Diphtheria epidemic (which Colden termed “Throat Distemper”); both had a characteristic red rash that formed on the neck (although the pox usually spread much further around the body).

Osborn also fails to mention scorbutus, an expected problem of the valley throughout Colonial years.  We might expect to see this whenever hard times had set in locally or in association reduction in the normal merchantile shipping activities.  Preventable with good diet, the likelihood that such diets actually existed throughout the Fishkill hospital history seems unlikely.  However, since Osborn’s pocket book was written before the Revolutionary War, and since the local population may have been small enough for Osborn not to see many cases of scorbutus, if any at all, it is likely Osborn simply did not write about scorbutus because it was not a disease typical to the local vicinity.

Osborn may have linked lues venera (venereal disease, in particular syphilis) to the “Whites or Fluor Albes” discussed in his vade mecum.  The Gonorrhea was not mentioned at all by Osborn.  The chancre of syphilis, typically related to canker and cancer, was probably prevalent during the war and camp years, but again either not reported by the soldiers that had it, or not documented by physicians trying to treat it.

As for injuries and the need for surgery, all we can tell from Osborn’s pocket book is that he was trained in surgery.  He mentions the use of several therapeutic devices or objects that required a certain amount of surgical skills and a good amount of knowledge about human anatomy (esp. female anatomy).  In his pocket book, he refers to the possibility that another writing was in the works for his skills and recommendation in surgery.  Such a document has never been found.  It is also possible that several of the medical conditions, considered common but missing from Osborn’s pocket guide, were in fact included in this other document he claims to have produced.  Such conditions include cancer, due to the need for surgery rather than just poultices and decoctions like most of the conditions in his pocket guide on medicine and disease.

Exactly what questions Osborn was asked about disease and treatments, in order to become a doctor for his regiment, remain uncertain.  More than likely Osborn would have even been prepared for this review by his professional peers well before he met with the authorities to be considered for such a position.  What might Osborn have been told?  More than likely he already knew, and if he did not was told, not to mention much about his ens veneris recipe.  This recipe was too metaphysical in nature and more than a century outdated.  He might also have been told not to disclose anything about his use of patent medicines.  Most of his chemical terminology was still acceptible.  Some of his plants name a bit outdated (but others locally used these references to New Spain as well, like Colden).  So all in all, most of what Osborn had to tell Samuel Bard and his descriptions about the various steps he took to treat were probably not at all that different from the norms. 

In spite of any minor differences Osborn had regarding his professional opinions about disease form, cause and types, Osborn met the requirements for becoming a local Regimental Physician or Field Surgeon.  This was not always the case.  Other individuals trying to obtain such position did not succeed according to Thacher.  According to Thacher’s dates regarding his official date of acceptance, and War historians Duncan’s and Gillette’s notes on the same, the right events took place at the right time in the staff recruitment calendar to suggest that Dr. Osborn was selected to become a Field Surgeon.  This event took place right on time according to the above Military Facilities events calendar by Gillette.

The Application and Testing Process for Field Surgeons

In mid-summer of 1776, Osborn’s experience and expertise secured him a position as Field Surgeon for the Second Regiment.  The process by which this was done required some local assistance.  The elder of his daughter’s husband’s family, Colonel Jacobus Swartout,  played an important role in seeing to Osborn’s enrollment and Field Surgeon for Fishkill hospital.  On July 25, 1776, Colonel Swartwout wrote and then dispatched a letter to the New-York Convention in which he included the following recommendation [13]:

“GENTLEMEN: In these times of distress and danger, when the lives and health of the soldiers are daily exposed, and, for want of good doctors, are often rendered incapable of doing the publick services, loudly calls upon every well-wisher to the cause now embarked in, to recommend such persons whose skill and abilities are known and can be depended upon; and as the bearer hereof, Dr. Osborn hath for many years resided near me, and hath been respected as a person having skill and abilities in that profession, I humbly pray the honourable Convention of the State of New-York will take the matter into their consideration, and if they think Dr. Osborn capable, that they will appoint him Doctor to my Regiment.  I am, gentlemen, with great respect, your very humble servant.         

                              Jacobus Swartwout”

 Over the next two days, aside from handling typical administrative procedures, the Convention had to assign individuals to their new military positions and define their responsibilities.   This process required not only a discussion amongst Convention members about potential recruits, but also one-on-one interviews and peer reviews with some of the individuals about to be accepted due to their questionable knowledge and skills.  This meant that Cornelius Osborn possibly underwent a certain amount of questioning and scrutinizing regarding his medical and surgical training, education and knowledge, either prior to this meeting date or during the three days his requirements for this positions were discussed and decided upon by members of the Convention.  In William Thacher’s Diary, the details of such a meeting between a physician and the Convention are provided in significant detail. 

Suffice it to say that these experiences were most likely very similar if not identical to those experienced by Dr. Osborn.  Thacher’s experience occurred about the same time as Osborn’s.  Were this examination and peer review signficantly earlier than Osborn, this probably meant his position would be of slightly higher caliber in terms of types and amounts of responsibility.   The date for Thacher’s entry for this experience was not provided with enough detail to be certain whether he was review before Dr. Osborn or after.

[Thacher Diary note]

“On the day appointed, the medical candidates, sixteen in number, were summonsed before the board for examination.  This business occupied about four hours; the subjects were  anatomy, physiology, surgery, and medicine. It was not long after, that I was happily relieved from suspense, by receiving the sanction the acceptance of the board, with some acceptable instructions relative to the faithful discharge of duty, and the humane treatment of those soldiers who may have the misfortune to require my assistance. Six of our number were privately rejected as being found unqualified. The examination was in a considerable degree close and severe, which occasioned not a little agitation in our ranks.

“But it was on another occasion, as I am told, that a candidate under examination was agitated into a state of perspiration,  and being required to describe the mode of treatment in rheumatism, among other remedies be would promote a sweat, and being asked how he would effect this with his patient, after some hesitation he replied, “I would have him examined by a medical committee-“ I was so fortunate as to obtain the office of surgeon’s mate in the provincial hospital at Cambridge, Dr. John Warren being the senior  surgeon. He was the brother and pupil of the gallant General Joseph Warren, who was slain in the memorable battle on Breed’s hill. This gentleman has acquired great reputation in his profession, and is distinguished for his humanity and attention to the sick and wounded soldiers, and for his amiable disposition.

“Having received my appointment by the Provincial Congress, I commenced my duty in the hospital, July 15th. Several private, but commodious houses in Cambridge are occupied for hospitals, and a considerable number of soldiers who were wounded at Breed’s hill, and a greater number of sick of various diseases, require all our attention.”

 

Working against Osborn’s recruitment could have been his lack of a formal college education in medicine as well as writing and spelling skills.  Nevertheless this did not result in a refusal of this position for Osborn, most likely because more than just on occasion could such problems be matched other military physicians possibly already recruited for these services. 

The way in which age played into Osborn’s eligibility dealt more with his type of medical knowledge and form of practice rather than any specific age-related health or medical feature.  Osborn was just one month short of exactly 54 years of age.   This means he learned medicine in some form and fashion that was popular several generations before, and perhaps not at all accepted by “modern” physicians and surgeons.  (A number of Osborn’s medicines and philosophy in fact did not match the contemporary military medical training, but maybe he was somewhat kept up in these writings.)  Did Osborn keep up with the current writers of this field?  Who were his mentors or favored writers.  Who were his advocates and were they practititioners of medicine?

Osborn was most likely put under some scrutiny by administrators concerning how he was trained in medicine, and whether or not he was able to keep up with the changes and progress made in the medical field.  This kind of query may have also been followed by questions regarding his knowledge of how disease occurs and progresses, what his take on the small pox problem was and whether or not he supported the use of immunization of soldiers, an issue undergoing intense arguments amongst military and medical professional at the time.  Finally, they needed to know from Osborn who was willing to serve as his reference or recommendation as a practitioner of the fields of  surgery and medicine.   One has to wonder just who Osborn might have referred to in response to such a question.

It is possible that Osborn had some of the shared knowledge travellng about regarding the injuries and illnesses associated with the recent French and 7-years Wars that took place just a few years before.   Had he been in close communication with other Osborns who served as physicians and surgeons in New York, Connecticut, and Long Island, chances are that these family elders may have given him addition insights into the medical problems offered suffered by military and navy settings and may have supported his placement in a regimental position simply for family’s sake.  Osborn work alongside Jewish physician Isaac Marks for Governor Clinton (ca. 1745) was most certainly in his favor.  His association with or possible familiarity with the works of former Governor  Cadwallader Colden and or Cadwallader’s botanist daughter Jane may have also assisted him in staking his claim as a local physician of choice, so long as he didn’t stretch these connections too far in the wrong direction, due to a certain amount of public dissent that has existed since Colden’s gubernatorial performance a while back.  Osborn’s value to the community as a grantor of two sizeable Mortgages for a couple of important community leaders also provided him with some political clout (even though one of these, Bartholomew Crannell, was a loyalist.).

After two days of inquisition and formal queries, it was determined that Dr. Osborn was well prepared to serve as a Field Surgeon in and around the Fishkill hospital area.  At a meeting of the Convention in White-Plains on July 27th, Osborn was assigned the position of Field Surgeon for his regiment.  The Convention’s record states [14]:

      “A Certificate of Dr. Samuel Bard, dated this day, was read and filed.  He thereby certifies that he has examined Dr. Cornelius Osborne, respecting his knowledge in Physick and Surgery, and thinks him qualified for the office of Surgeon to a Regiment.

      “Resolved.  That the said Cornelius Osborne be, as is hereby, appointed Surgeon to the Regiment of Militia, now in Continental Service under the command of Cornelius Swartwout, of Dutchess County.”

 This was then followed by the oath administered to Dr. Osborn by Dr. Samuel Bard:

      “I hereby certify that I have examined Dr. Cornelius Osborne respecting his knowledge in Physick and Surgery, and that I think him qualified for the office of Surgeon to a Regiment.

                                    Samuel Bard, M.D.”

Following this meeting, Doctor Osborn returned to the Fishkill where the encampment site was already established and the Trinity Episcopal Church also prepared for use as a hospital should such a need arise.   Osborn was just one of the forty “Physicians” that served this setting in the months and years to come.  Fortunately, just how Osborn would work in the Field as a surgeon and physician would not be put to the test too much during the next few years.  His major clientele of wartime patients would have been victims of the White Plains battle of the first year of the Revolution.  Based on the information regarding the patients he would have to serve in the Fishkill hospital setting,  it appears the bulk of these problems related mostly to domestic disease and health-related issues, much like those noted in the Albany report earlier described.  Thes problems ranged from infections and colds, to commonplace injuries and poor hygiene related disorders.  During the White Plains related military confrontations, were Osborn involved with field medical activities this would have been the peak of his military medical experience.

At this point in time it becomes important to understand Osborn’s knowledge, educational upbringing, intellectual skills, and ability to practice both surgery and medicine.  Working in a military hospital setting like the one in Fishkill would require that Osborn be well-trained in the practice of Surgery, along with traditional medicine and apothecary.  the most like patients then expected by hospital staff were the battle injury patients, suffering everything from simple sword slashings and musketball penetration wounds, to simple and compound fractures, debilitating cannon ball injuries, and occasional weapon burns and even more commonplace injuries induced by poor marching or running and charging routines.  Ultimately, it was infectious disease that became the major epidemics the military had to face.  Everything from simple measles and dysentery produced by contaminated water to the simple results of malnourishment and hypothermia and frostbite onsets brought about by poor clothing in combination with one of the coldest winter climates experienced by this region in decades.

The Wartime Pharmacy

The first major epidemic to hit the Fishkill troops came in December 1776.   This led members of the local militia to write a letter requesting assistance from upper authorities, in particular Dr. McKnight, the Surgeon of highest authority and with the best chance of improving upon local regimental hospital operations.  This letter states [15]:

Dec 28th 1776, Fishkill

       Your Committee to whom was referred the request of Dr Osborn, for Medicines for the use of the Regiment Commanded by Colo Jacobus Swartwout, beg leave to report:

      Whereas your Committee are informed by Dr Osborn, that part of the men under the command in Continental service, are in great distress of Medicines & that Colo Swartwout had requested Dr McKnight one of the Continental Hospital Surgeons to supply his regiment with the same, who hath requested said Dr Osborn to apply to the Convention.  Your Committee, agreeable to the powers given by the Convention have thot proper to supply, and have supplied, said Dr Osborn with lb vi sal cathartics and lb ss Cortex Peruviana out of the Store of Medicines belonging to this Convention, for which your Committee have taken a Receipt from Dr Osborn, which have said reseipt, amounting to the sum of L3.6.0, together with the orders of Colo Swartwout & Dr McKnight, your  committee now here produce.

       Ordered that the said Receipt & orders be filed with the Treasurer of this State & that he charge the said L3.6.0 to the Continental Account.

                                       Fishkill, Decmbr 28th 1776

       Received of the Convention of the State of New York lb vi sal cathartic and lb ss Cortex Peruviana on Continental acct for the use of the men under the command of Jacobus Swartwout in General Clinton’s Brigade.

             Witness:  John J. Myers       pr Me: Cors Osborn

                        John McKesson 

 

In late 1776, as the requested shipments of medicines came to Fishkill, the following listing of medical supplies was produced:  several salts, Sulphur, Cantharides, Opium, Myrrh and Guaiac gums, Balsam Copaiba, Chamomile, Senna, Aloe, bark of Canella alba (White Cherry), and roots of Gentian, Jalap, Rhubarb, Licorice, and Ipecac.  Also ordered and received were 100 “Cotts”, surgical instruments, and food and drink items including molasses and vinegar.  Barley and wine were ordered in exceptionally large quantities. (Beer and wine were considered important for the preparation and administration of many medicines, for food preservation, and, perhaps most importantly, for morale) [16]. 

Osborn was probably familiar with most if not all of the medicines he had to order.  Many of these are contained in the vade mecum he produced just eight years earlier.  Several of them are under names that were quite different than those found in his writings.  Nearly all of the Revolutionary War medicines ordered in upcoming months and years were in Osborn’s own personal inventory of materia medica, with the possible exception of Ipecac, a strong South American emetic used to purge the system in cases of severe illness of various sorts.   Another plant not found is the vade mecum was Canella alba , but its identifiable chemical  features as a tonic and its related uses, made Canella very much like other tonics Osborn makes mention of locally.  Canella alba or the White Cinnamon bark common to the Carribean may not grow locally, but had its important local equivalents, namely the Lindera benzoin or Spicebush tree  (which legend says that even George Washington came to respect and like as a cinnamon or spice substitute, especially for tea), and the Sassafras tree (Sassafras albidum), the local panacea and once-famous miraculous cure for lues venerea (ca. 1695-1710). 

The Order of medicines by Osborn also mentions the Gentian, the root of Gentiana lutea, of Southern to central European origin used to make a bitter, drying tonic.  Although there were local wild varieties of potential use, these were typically not searched for.   Likewise the Senna had its local equivalent as well, in the form of a Rhamnus species.  The uses for Aloe had its local Mallows (Malva spp.) substitutes.   Jalap and Rhubarb, since they were  fairly drastics or strong laxatives used to purge the body, could not be as easily replaced.  Rhubarb could be cultivated within the local gardens, Jalap (Exogonium purga and E. jalapa) could not; the closest sources for each of these were Central America and Brazil respectively. (Two or three  local substitutes were later discovered, probably after the War, Euphorbia correlata or ipecacuanha, and Gillenia trifoliata (Porteranthus trifoliatus).

Cantharides was a blueish coarse powder formed by the drying and pounding of a particular insect dried beneath an intense sun.  This product of Central America discovered approximately one or two centuries before would be consumed, leading to the release and later expulsion of a particular chemical through the urinary tract.  This effect of the medicine suggested to physicians that this medicine had the ability to purge the blood in yet another way aside from sweat and the use of latrines. 

For guaiac, a similar result took place in the respiratory tract, resulting in an increase in coughing and expectoration of phlegm, the perfect way to treat pulmonary and respiratory conditions like influenza, colds and the early onset of consumption.   The uses for Myrrh gum and Balsam Copaiba were similar, although each had its own special applications and diseases to treat.  The use of Opium latex by physicians was not for the reduction in pain, as later Opium use history suggests, but rather as a “cure” to severe diarrhea cases the soldiers would experience due to poor sanitation practices.  Since opium was the cure for all sorts of severe diarrhea, and most importantly an effective remedy for dysentery, its use was apparently fairly common for soldiers camped close by the Fishkill creek, the water of which was a common source of contamination and the cause for most dysentery cases. 

Finally, the sulphur and salts noted in the Hospital Drugs list were used for the same various purposes as they have for centuries.   A number of other complex formulas and recipes noted in osborn’s vade mecum, did not appear on the listings of drugs used by the Revolutionary War medics for treating the militia.  These older, and much more archaic or primitive remedies, were finally removed from the list of Official Medicines to be used for years to come.  Those that did survive were often given the official chemical name provided by apothecaries, instead of the traditional which included the inventor’s name for most of these recipes.

It is important to note at this point that most of these medicines ordered by Osborn were for treating illness and disease, and not the traumatic consequences of engaging in the war itself.   In James Tilton’s recollection of the camp experience along the East River prior to their movement to White Plains, he noted the following about his experience [17]:

“In the year 1776, when the army was encamped at King’s Bridge in the State of New York, our raw and undisciplined condition at that time, subjected the soldiers to great irregularity.  Besides a great loss and want of clothing, the camp became excessively filthy.  All matter of excrementitious matter was scattered indiscriminantly throughout the camp, insomuch that you were offended by a disagreeable smell, almost everywhere without the lines.  A putrid diarrhea was the consequence.  The camp diseases as it was called, became proverbial.  Many die melting as it were, and runnign off at thebowels.  Medicine answered little or no purpose.”  A billett in thec ountry was only to be relied on.  When the enemy moved to the East River, our army moved to White Plains and left their infectious camp and the attendant diseases behind them.”

In the nearby Morrisania setting, similar sanitation problems existed.    This led local General Greene to post the following Order [18]:

“Orders:–the shameful inattention, in some camps, to decency and cleanliness, in providing necessaries, and picking up the offal and filth of the camp, have been taken notice of before in general; after this time particular regiments will be pointed out by name when such practice prevails.”

Even though soldiers did make their way at times into the Fishkill hospital settings, the least common treatments were for the war injuries themselves.  The treatments hospital physicians had to be able to engage in were the typical day-to-day medical operations required for the treatment of typical colonial diseases.  The crowding of the Fishkill region only increased the likelihood that typical population based diseases would take place, disabling the Fishkill forces more than most military encounters.  If we look at recruitment rates and changes for this Fishkill setting, we find that by the end of just the first year alone, more than one-third of the enlisted men became sick and were released to undergo their recovery at home, for fear of otherwise infecting the remaining healthy troops living nearby. 

At the end of the first winter in military camp, on December 28, 1776, Dr. Osborn ordered a substantial amount of this medicine due to the rising demand for fever medicines, which came about due to a fairly local small pox epidemic.  On this day Osborn placed an order  for “sal cathartics and lb ss Cort Peruviana” (saline cathartics and one-half pound of Peruvian bark, respectively) for the price of 360 Pounds [19].  The cathartics served to cause a puke and thereby purge the system, the Cortex Peruviana (bark of Cinchona peruviana), a term Osborn never used to refer to this medicine in his vade mecum (he referred to it as Quin Quina), served to break the fever and induce a sweat. 

For various reasons, Osborn and his comrades in medicine never really understood the use and value of Cortex peruviana.  It was an effective remedy for a febrile disease later known as Malaria, but not the bulk of diseases that were fever related within the Fishkill camp setting.  It wasn’t until the discovery of quinine in Cinchona decades later, and the ability of chemists to related this compund to the effectiveness of treating Malaria, that a more accurate understanding of the relationships between drug chemicals and disease could be established.  For Osborn and other Revolutionary War medics, such a discovery was generations away.

References

1.  E.B. O’Callaghan, M.D.(ed.). The Documentary History of the State of New York.  (Albany: Charles Van Benthuysen). 1851. Vol. IV, pp. 75-83.

2.  Philip H. Smith.  General History of Dutchess County; from 1609 – 1876, inclusive. (Philip H. Smith: Pawling), 1877.  p. 481-482.

3.  Berthold Fernow (ed.).  New York in the Revolution.   (Albany: Weed, Parsons and Company, Printers) 1887. p. 285.

4.  Berthold Fernow (ed.).  New York in the Revolution.   (Albany: Weed, Parsons and Company, Printers) 1887. p. 439.

5.  James Thacher.  Military Journal of the American Revolution.  Hartford, Ct.: Hurlburt, Williams & Co., 1862.  pp. 256-8.

6. Louis Duncan.  Medical Men in the American Revolution, 1775-1783.  The Army Medical Bulletin Number 25.  Medical Field Service School, Carlisle Baracks, Pennsylvania.  1931. p. 188 (map).

7.  Hugh Hastings, State Historian (ed.)  Public Papers of George Clinton.  (Albany, New York: Wynkoop, Hallenbeck, Crawford & Company)  1899. Volume I. [No. 89], p. 230-231.

8. Mary C. Gillett.  The Army Medical Department.  1775-1818. Center of Military History, United States Army, Washington DC. 1981.

9.  Opcit Duncan. p. 19.

10. Ibid.

11.  Ibid. p. 119.

12.  Opcit Gillett, p 96.

13.  Peter Force. American Archives…. (Washington) April 1848.  Vol. 1. p. 1450.

14.  Ibid.  Vol. 1. p. 1452.

15.  O’Callaghan, E.B. (Ed.)  Calendar of Historical Manuscripts in the Office of the Secretary of State. Vol. 2. English Manuscripts. 1664-1776.  (Albany: Weed, Parsons & Company, 1866).  See Vol. 2, p. 578. Report on Furnishing Medicines [Miscel. Pap. 35:452]

16. Erastus C. Knight, New York (State) Comptroller’s Office.  New York in the Revolution as Colony and State, Supplement. (Albany, N.Y.: J.B. Lyon Co.), 1904.  pp. 44-45.

17.  Opcit Duncan, p 142.

18.  ibid.  p. 143.

19.  Opcit Knight, p. 578.