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The Standardization of Medicine in Revolutionary America

As the colonies drifted ever closer towards their war for Independence, the overall health of the masses continued to be in a dismal state. Diseases such as smallpox, yellow fever, typhys, the measles and dysentery continued to ravage the population and the incredible demand for healthcare gave birth to an infestation of self-trained quacks, and home remedies coupled with a lot of prayer. This era also offered the perfect platform for puritan pastors to take the reins of medical research and innovation. Even though global efforts to improve collective health (such as improvements in sanitation and the employment of inoculations) helped to decrease mortality, it would still take many more years to see the emergence of hospitals and standardized medical education.

By 1750, there were approximately 3000-4000 legitimate (not considered quacks by definition) physicians of whom only 10% had medical degrees from colleges such as Edinburgh, Oxford or Cambridge. Apprentices, who made up the other 90%, had the same privileges as those who were formally trained. “after their apprenticeship to a physician, they received a certificate of proficiency and could practice medicine. Their strength was in the development of a practical bedside approach, under the eye of a father-figure.” (Eichner 92) As the demand increased for a unified approach to medicine, it seemed natural that the colonies should acquire their very own hospitals and local medical universities.

In the early 18th century, the facilities which most resembled a hospital were hastily built in port cities and used to confine persons with contagious diseases who had recently arrived from overseas. A few decades later, the almshouse became a common sight in larger cities. These facilities were aptly named as they only tended to “the city’s poor, as the better financially-situated chose to be treated in their homes.” William Penn organized the first almshouse in 1713 but it was exclusively for impoverished Quakers. (Eichner 93)

America’s first hospital was founded in 1751 by Dr. Thomas Bond and Benjamin Franklin. Since Philadelphia was the largest and fastest growing city in the colonies, and therefore a melting pot of disease and poverty, it seemed the perfect home for the new Pennsylvania Hospital. In fact, “the inscription ‘Take care of him and I will repay thee’ was chosen and the image of the Good Samaritan was affixed as the hospital seal.” (Penn Medicine 2) The Pennsylvania Hospital would prove to be a very useful facility for the training of America’s first local medical students.

The Pennsylvania Hospital ca. 1755

The University of Pennsylvania School of Medicine was founded by Dr. John Morgan in 1765. Since he and the other early faculty were trained at Edinburgh College, they thought it best to establish their school of medicine into an already existing school of higher learning: The College, Academy and Charity School of Philadelphia, which had been established for over a decade. (McConaghy 1)

At the University of Pennsylvania, the path to a medical bachelor degree consisted of a two-year classroom phase followed by an examination. The first year offered preparatory courses such as mathematics, history, Latin and French. “The second year included anatomy, materia medica, botany, chemistry, physics, pathology and clinical medicine.” (Eichner 91) This bachelor degree was usually followed up with a three year intern phase and an examination that was not only more difficult than the first; it had to be written in Latin. Finally, a thesis that had to be defended before the faculty which, at the time, consisted of Dr. Morgan (theory and physic), Dr. William Shippen Jr. (anatomy, surgery and midwifery), Dr. Adam Kuhn (botany and pharmacology) and Dr. Benjamin Rush (Chemistry). (McConaghy 2)  

The University of Pennsylvania ca. 1766

A few years later, King’s College in New York City would offer a medical degree. “By 1776, only 51 degrees had been conferred by these schools, and then classes were suspended because of the war.” (Eichner 91) Even though the Revolutionary War would disrupt medical education, there were some very important medical innovations that were born on the battlefield and paved the way for modern healthcare standards.

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Medical shortcomings and advancements in the Revolutionary War

There were really only three types of treatment that surgeons executed on the battlefield. If the wound was minor and the surgeon wanted to control the bleeding, he would place lint into the wound to promote clotting and wrap it with a bandage. Larger wounds such as cut tendons and large lacerations were treated with plaster and bandages to hold the wound together. Sutures were typically used exclusively for transverse (those that go across a limb rather than down its length) wounds. (Lathrop 71-3) Finally, amputation, which was often used for major injuries to extremities, carried with it a 65% mortality rate. Even though the unfortunate soldier was often given a large quantity of alcohol or a tobacco juice concoction as “anesthesia”, he still had to be held down as the procedure was performed.

In the early stages of the war it was not uncommon for a soldier to be left injured in the field for three days. The Battle of Bunker Hill, with its heavy casualties, prompted the Continental Congress to establish a medical department which they called a “Hospital for the Army.” The purpose of this department was to establish permanent and mobile hospitals for the wounded and ill soldiers as well as acquiring appropriate personnel and standards. On July 25th, 1775, Congress appointed Dr. Benjamin Church as the first Director General. Under the Director General was the chief surgeon followed by “four surgeons, twenty surgeon’s mates, one apothecary, one nurse for every ten men, a clerk to keep accounts, and two storekeepers to serve a total of 20,000 men.” (Eichner 96) A few months later, Dr. Church was replaced by Dr, John Morgan who had no idea of the mess into which he was walking. (Phalen)

Dr. John Morgan

On October 17, 1775, Dr. Morgan left his successful practice at the Pennsylvania Hospital when the Continental Congress elected him as the new Director General and Physician-in-chief of the Army Hospital. Very quickly, he found overcrowded hospitals manned by incompetent physicians. Patients with diseases such as smallpox and dysentery were not segregated and the lack of sanitation was appalling. Immediately, he collected and distributed “medicines and hospital supplies, instituted new examinations for medical officers and brought about the beginning of system in the medical organization.” The following is a list of orders Morgan issued which led to improvements in medical care:

1.    Dress the wounded by a hill 3000 to 5000 yards to the rear of the battlefield

2.    Regimental surgeons are to be stationed with their militiamen when in a fort or on a defense line.

3.    Give emergency care only. In the heat of battle, amputation or any capital operation is best avoided. Duties include: Stop bleeding with lint and compresses, ligatures, or tourniquet. Remove foreign bodies from the wound. Reduce fractured bones. Apply dressings to wounds. If the dressings are too tight, blood flow is decreased and will increase inflammation and excite a fever. If the dressings are too loose, fresh bleeding may occur or set bones may displace.

4.    Regimental surgeons and mates are ordered to the general hospital if it becomes overcrowded with new casualties.

5.    Before battle, check with the regimental officers to carry off the wounded [with] a supply of wheelbarrows, other convenient biers, or whatever other transport available to carry off the wounded.

These recommendations greatly improved the efficiency and treatments of the army surgeons under his charge, but the most significant campaign that he spearheaded was one which targeted smallpox.

Before Dr. Morgan took the position of Director General, smallpox in the army was handled by quarantine alone. The following is a set of orders from General Washington on July 4th, 1775:

“A smallpox hospital had been established for the army near Fresh Pond, which lies about a mile and a half west of the Cambridge common. On 19 June 1775 General Ward directed that a sentry be posted constantly at the gate to the smallpox hospital with orders ‘to permit no person to go in or out except the Doctor & such as the Doctor shall permit to pass.’ On 2 July Ward ordered each company in the army to be inspected daily for smallpox symptoms. Any man suspected of having the disease was to be removed at once.”

Though they were addressing the disease, this reactive approach left the army weakened and posed a threat of spreading the disease from town to town as they marched.

Less than a year from obtaining his new post, Morgan published Recommendation of Inoculation According to Baron Dimsdale’s Method. In it he outlines the benefits of the procedure, stating that those cities in the middle colonies which have made inoculation a standard practice have all but eradicated the disease. He also makes a startling claim that, due to improvements in the technique, the mortality ratio for the persons who receive the inoculation is 1 in every 1,000. This is an extraordinary success compared to the impressive 2% mortality brought on by Boylston’s technique in 1721 (see Making History One). Morgan owes this success to the candidates they choose from which to extract the specimen. “In the first place then, it is highly beneficial to the patient that he has it in his power to receive the disease from a healthy subject, in its mildest state, and in the safest manner, and in the absence of every other disease.” (3) Aside from this newer technique, Morgan had another benefit in using Baron Dinsdale as his model for inoculating the soldiers.

He recounts how Dinsdale was commissioned by the Empress of Russia to inoculate her family. After her successful experience, she ordered that he inoculate those in her army as she was planning on going to war with the Turks in which they would prove to be victorious. Owing their success to Dinsdale, he was sent back to England with high honor. Finishing this story he states, “In that particular, she has held forth an example worthy of our imitation, and which by the event proved the wisdom of the measure.” (14) Finally, he closes by saying:

“From the experience I have had of the good effects of Dimsdale’s method of inoculation, I imagine, in recommending it to such practitioners as may be shortly engaged in taking care of those amongst whom the small-pox may spread, and particularly to the surgeons of the hospital and those in the army under my own direction, I am performing one of the most important services a person in my station can well render to them, or to the country and people he is amongst.” (18)

Morgan’s campaign was an obvious success because it became a standard exercise in the army within a year.

In an order from Washington on Feb 5, 1777 he states, “The small pox has made such Head in every Quarter that I find it impossible to keep it from spreading thro’ the whole Army in the natural way. I have therefore determined, not only to innoculate all the Troops now here, that have not had it, but shall order Docr Shippen to innoculate the Recuits as fast as they come in to Philadelphia. They will lose no time, because they will go thro’ the disorder while their cloathing Arms and accoutrements are getting ready.”

Despite Morgan’s contributions to the improvements of the Army’s Medical Department, he was removed from office on January 1st, 1777. A few months prior, Congress had decided to split the jurisdiction of the army hospitals; the Eastern half remained in Morgan’s control while those west of the Hudson River were given to Dr. Shippen. Morgan was upset by this change but was denied a hearing to inquire as to why the decision was made. In the surrounding months, Dr. Shippen, who was a colleague of Morgans in the Pennsylvania Hospital and College, stirred up a message of discontent regarding Morgan’s ability and accomplishments. Morgan was dismissed from the army without a hearing and without prior approval from Washington. (Lathrop)

Very soon, the conditions of the soldiers’ health and the resulting medical care would reach an all-time low. The declining health and resulting morale was certainly on display in General Washington’s six month encampment at Valley Forge. During those six months, one fourth of the 10,000 where were camped there died of disease or exposure. (Eichner 98) In a diary from army surgeon Albigence Waldo, he laments the conditions of the camp:

“There comes a soldier, his bare feet are seen thro’ his worn out shoes, his legs nearly naked from the tatter’d remains of an only pair of stockings, his breeches not sufficient to cover his nakedness, his shirt hanging in strings, his hair dishevell’d, his face meager; his whole appearance pictures a person forsaken and deiscouraged. He comes, and crys with an air of wretchedness and despair, I am sick, my feet lame, my legs are sore, my body cover’d with this tormenting itch-my cloaths are worn out, my constitution is broken, my former activity is exhausted by fatigue, hunger and cold, I fail fast I shall soon be no more! And the reward I shall get will be-‘Poor Will is dead.’” December 14,1777.

This particular surgeon, Albigence Waldo had fervently asked for a furlow multiple times but had been denied until they completed a round of smallpox inoculations and the building of the local hospital. (Waldo 316)

Aside from the cold, rainy weather and lack of sufficient food, a lack of sanitation was perhaps the biggest culprit for the high mortality rates. Vermin (including lice) were present in great numbers and the soldiers rarely used the latrines, even though they had the order to “shoot on sight if a man relieved himself elsewhere in the encampment area.” Many of the horses and cattle who had died were left unburried which led to an increase of pathogens and polluted water. (Eichner 99)

The hospitals were in even worse condition than the camps. Benjamin Rush claimed, “’Hospitals are the sinks of human life in the army. They robbed the U.S. of more citizens than the sword.’ A soldier had a 2% chance of dying in battle, but when admitted to a crowded army hospital the likelihood of death rose to 25%.” The soldiers, as well as their clothes and bedding were never washed. The straw that a deceased patient slept on and the water used to clean wounds was often reused, greatly spreading disease. (Eichner 100)

Though these conditions were grim, they signaled innovative physicians like James Tilton to devise better ways to care for the wounded and ill soldiers. Instead of huts with their floors below ground level which were often very cold and wet, he devised a model fashioned after the Native American wigwam with a hole in the roof which allowed a fire to be properly ventilated while keeping the inhabitants warm. (Eichner 102)

There were also publications by Dr. John Jones, Baron von Steuben and Benjamin Rush that addressed the concerns raised by the Valley Forge encampment. Benjamin Rush advocated for patient hygiene including washing the entire body every and receiving a close shave at least three times a week. He also pushed for a frequent change of clothes and waterproof shoes. Other recommendations included, raising bedding off the ground, ideal settings for camp installations and purifying drinking water with vinegar. (Eichner 103)

Though formal medical education was put on hold for the duration of the Revolutionary War, physicians and surgeons were able to hone their skills under the watchful eye of the newly created Health Department (the Hospital for the Army). For the first time in American history, medical standards were imposed and collective problems were witnessed and addressed. Even today, much of the innovation we see in the ambulances and emergency departments (such as tourniquets, triage, nerve toxin antidotes and quick clotting bandages) find their origins on the front lines of military operations. The Revolutionary War was no different. With a special thanks to physicians like John Morgan and Benjamin Rush and even with a nod to the despairing conditions of Valley Forge, we can reap the benefits of clean hospitals and competent physicians of which we so often take for granted.

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Works Cited

Eichner, Skip. “Medicine in the Revolutionary War.” Tredyffrin Easttown Historical Society History Quarterly Digital Archives, Vol. 26: Num. 3, July, 1988.

Lathrop, Jessica. “Medical Services Available During the Revolutionary War Including Treatment for Soldiers Wounded in Action.” Saber and Scroll, Vol. 5: Is. 3, Article 8, 2016.

McConaghy, Mary D. “School of Medicine: Historical Development, 1765-1800.” University of Pennsylvania Archive, November, 2010

Morgan, John.  A Recommendation of Inoculation According to Baron Dimsdale’s Method. Boston, MA: J. Gill in Queen Street, 1776.

Penn Medicine. “In the Beginning.” 2017. http://www.uphs.upenn.edu/paharc/features/creation.html

Phalen, James. “Chiefs of the Medical Department, U.S. Army 1775-1940, Biographical Sketches.” Army Medical Bulletin, No. 52, April 1940, pp.5-9.

Shyrock, Richard. “Eighteenth Century Medicine in America.” American Antiquarian Society, October, 1949.

Waldo, Albigence. “Diary of a Surgeon Albigence Waldo.” The Pennsyvania Magazine of History and Biography, Vol. 21: Num. 3, 1897.

Washington, George. The Papers of George Washington Digital Edition.  Charlottesville: University of Virginia Press, Rotunda, 2008.

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Professor Young:

Please note that my story is broken into two parts. Please continue reading after the map of Boston.

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Her physician advised her to swallow a couple of leaden bullets; upon which after some time, her pain was abated and the use of her limbs returned to her

Rev. Cotton Mather

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Body and Soul: The Rise of the Pastoral Physician in Colonial America

The life of an early North American settler was often a perilous one. With a constant threat of Indian attacks, disease and starvation, the initial mortality rate was as high as 80% (especially in the southern colonies). In a letter from the Lord De-La-Warre to the Lords of the Council of Virginia he explains why he decided to return to Europe after a short and miserable stay in Jamestown. “I must informe your Lordships, that presently after my arrival in James Towne, I was welcomed by a hote and violent Ague, which held mee a time, till by the advice of my Physition, Doctor Laurence Bohun, (by blood letting) I was recovered”. This brief abatement was followed by a relapse of severe fever, the flux, cramping, the gout, Scurvy and an extreme weakness from which he barely escaped with his life. Unfortunately, many never had a similar opportunity or desire to leave Virginia and perished as a result. (Hawke 72) (De-La-Warre)

Though sickness was rampant, especially in the Chesapeake, it is the general theory of medical historians that all diseases (save the bubonic plague) were simply “imported” from the Eastern Hemisphere only to be exacerbated by harsh climates, poor sanitation, improper diets and a lack of efficient medical care. With the introduction of apple orchards (to ward off scurvy) and other improvements to their lifestyles, the collective health of the southern settlers began to improve by the 1650s. Unfortunately, due to many roadblocks such as religious superstition, personal agendas and other factors unique to the colonies, it would take another one hundred years for medical theories and practices to begin to depart from their medieval roots of humors and bloodletting. Perhaps the greatest example of medical innovation in Colonial America (and the devastating social backlash that ensued) is the inoculation of Smallpox in Boston in 1721. (Hawke 73, 80)

Breathing a Vein by James Gilray, 1804.

In the early colonies, physicians usually fell into one of two groups: Those who were formally trained in England and those who attempted to earn a living by generating their very own brand of medical theories and remedies. The formal physician was a rare sight because those with a successful medical practice in England had no cause to give it all up for a fresh, precarious start in America. The physicians that did decide to brave the harsh journey required such exorbitant fees for their services that hardly anyone could afford them. “The trained physician had invested many years of his life to obtain his degree, and there was no one in the colonies who could pay his fees.” In 1655, a visit to a doctor could be two to four times more expensive than having a carpenter build a house. Also, due to their often aggressive techniques, “The learned physician was actually more dangerous to his patients in some ways than was the self-trained man.” For these reasons, many turned to home remedies, self-help guides and fervent prayer to cure their ailments.                      (Pereyra 3-4) (Balkin 84) (Shyrock 281)

In 1727, a Virginian physician by the name of John Tennent published a “do-it-yourself” medical guide for those who could not afford the services of a doctor. In the introduction of Every Man His Own Doctor: Or, The Poor Planter’s Physician Tennent writes, “Indeed, some would be glad of assistance if they did not think the Remedy near as bad as the Disease, for our Doctors are commonly so exorbitant in their fees, whether they kill or cure, that the patient had rather trust his constitution than run the risk of beggaring his family.” The main complaints, as well as their remedies, listed in this book include a cough, “Palsy” (stroke), “Vapours” (anxiety), bladder/kidney stones, the “King’s Evil” (swollen glands), the bite of a mad dog, and “film” (a corneal abrasion of the eye). Though some of the remedies are ridiculous at best (and dangerous at worst), there are a few that, even from a modern medical standpoint, appear to have sound reasoning. (Tennent 1)

For example, in the treatment of a “Palsy” (stroke), the advice is to induce vomiting, followed by dunking the head in cold water repeatedly, then rubbing a tonic on the head and arms to restore movement and packing the nostrils with tobacco to “drive the clammy phlegm from your brain.” Since today the causes of a stroke are well known, it is pretty unlikely that any of the above procedures could relieve a blood clot in the brain or improve the devastating results of paralysis. The remaining advice, on the other hand, to reduce one’s salt intake and to roll a ball made of crushed rosemary in one’s hands every day mirror today’s sound concepts of prevention and physical therapy. The last few lines of his text certainly illustrates the contradicting practices of 18th century physicians as he writes, “In the mean time, there is no question but some of my brother quacks will make themselves merry with these prescriptions. Let them shoot their harmless bolts.” (Tennent 2,5)

It would still be many more years before anything resembling formal medical training, licenses or regulations would manifest in the colonies. In 1700, the only licensing body was the London College of Physicians, which limited their certifications to the graduates of Oxford and Cambridge. The number of approved physicians could not even meet the needs of a tenth of England’s population, let alone the American colonies; meanwhile, very few Americans traveled to London for training. Even as late as the 1760s, a New York critic remarked, “Few physicians among us are eminent for their skill. Quacks abound like locusts in Egypt…This is the less to be wondered at, as the profession is under no kind of regulation.”  For these reasons, there was a significant increase in the number of Pastoral physicians. (Shyrock 279-280)

View of Oxford College ca. 1675

The concern and care for the physical constitution of the members of their community seemed a natural inclination for the colony’s clergymen. Their further involvement in the medical arts was also due to the fact that “Ministers were frequently the only ones who could ‘read medicine,’ since before 1700 the greater part of the literature was in Latin”. Some medical historians even claim that colonial preachers have compiled far more abundant, thorough and accurate medical data and have contributed more to the advancement of medicine than any of their physician contemporaries.  This can be attributed to three factors:  They were objective, their sermons contained a treasure trove of medical data and they had time to devote to the study and advancement of medical theories. (Shyrock 280)

The colonial “physician” often had their own theories to advance and/or defend. For this reason, many historians do not find their journals to be a reliable source of data in determining which diseases were afflicting the colonies at certain times. In discussing the challenges of historically identifying a particular disease based on its description, Caulfield writes, “This does not mean that it is necessary to have exact descriptions written by doctors; on the contrary descriptions written by laymen and particularly by clergymen are much more valuable because medical men usually had theories to prove, treatments to justify, or (more often than not) reputations to establish.” (Caulfield 25)

Transcribed sermons are even more valuable than journal entries due to their tendency to discuss events from a community rather than an individualistic approach. It is also a fair assumption that the epidemic of the day was a common sermon theme due to its tendency of making parishioners mindful of their sins and bringing them to repentance. Caulfield continues by claiming “the epidemiological parts of the sermons are so valuable as to make them worthy to be considered among the foremost scientific contributions of the times.” (22)

Another roadblock to the advancement of medical theory was due to the immediate demand for treatment and the limited time a physician had to actually study the disease process. “The only men who investigated disease were practitioners: there were no scientists who, as in astronomy, could give themselves primarily to research…[therefore] The busy American doctor wanted therapeutic short-cuts, and had no time for a meditation on the circumstances of death.” In the meantime, church Pastors like Cotton Mather and others dedicated significant time and energy into determining disease pathologies and developing a more scientific approach to their treatments. (Shryock 286)

Caulfield, James. “The Pursuit of a Pestilence.” American Antiquarian Society, April, 1950.

De-La-Warre. “A letter to the Lords and Others of the Counsell of Virginia.” 1611. http://www.virtualjamestown.org/exist/cocoon/jamestown/fha/J1034

Hawke, David. Everyday Life in Early America. New York: Harper & Row Publishers, Inc., 1988.

Shyrock, Richard. “Eighteenth Century Medicine in America.” American Antiquarian Society, October, 1949.

Tennent, John. Every Man his own Doctor: or, The Poor Planter’s Physician. Williamsburg, VA: 1727.

Pereyra, Luis. “Origins of Surgery in British Colonial America.” Journal of Investigative Surgery, 16:3-6, 2003.

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Cotton Mather and the Inoculation of Smallpox in Boston, 1721

Of every ailment that afflicted the colonies, smallpox was perhaps the most frighteningly visible and deadly epidemic diseases of that time. Highly contagious and often compared to the bubonic plague of Europe in terms of its intensity, the savage disease covered the body with hundreds to thousands of puss filled bumps which often left the surviving victim with scarred skin. The intense fever proved fatal in approximately 15-30% of its victims.  (Burh 66)

The city of Boston had an intimate relationship with the disease as it raged through the community at the rate of at least every twenty years. According to the 1722 map of Boston above (fig. 1), there was a Smallpox outbreak in 1640, 1660, 1680, 1702 and 1721 (with a few small outbreaks in-between). During these outbreaks, the quarantine of ports, homes and infirmaries was proven to be the only effective means of controlling the spread of the smallpox.  It was not until the outbreak of 1721 that a large-scale inoculation against a disease would be attempted for the first time in America. Unfortunately, this innovation was met with fervent resistance from the medical and religious communities. (Shryock 278)

Cotton Mather, a puritan minister in Boston who had lost his wife and several children to smallpox, learned of the procedure of inoculation from his slave named Onesimus who claimed to have received the “operation” in Africa. Mather then confirmed his story by speaking to other Africans throughout the city. Soon after, he read an account of successful inoculations in Turkey and decided to promote the procedure when the next wave of smallpox reached Boston. (Buhr 62) (Mather 1-2)

Mather commissioned Zabdiel Boylston to perform the inoculations throughout the city. Perhaps to gain credibility, Boylston decided to start with his own household, which included two slaves (ages 36 and 2) and his five year old son. The procedure he used was as follows: “He makes usually two incisions, (tho’ sometimes but one) in the two arms (or an arm, or a leg) of his patients; and then he puts into them a little bit of lint…warm from the pustules of one who has the small-pox of a good sort, now turning upon him. This he covers with a little plaister of diachylon, to keep it close for two or three days in its operation there.” In about three to seven days, a fever begins and the patient usually has a small number of pustules compared to the “common way”. According to Mather, the second fever, which usually kills the victim, never returns with the inoculation. (Boylston 2) (Mather 9, 20)

Even though his first attempt was a success, an outcry of criticism followed the  inoculation of Boylston’s household. “It is incredible, what a storm was rais’d, and very much of it principally owing to some of our enrag’d physicians, on this occasion.” Many of the Bostonians believed if any of Boylston’s patients died as the result of inoculation, he should receive the death penalty.                  (Mather 11) (Buhr 64)

The two most fervently vocal antagonists to inoculation were Dr. William Douglass (one of the few men in Boston with a medical degree) and Rev. John Williams. “Douglass believed that it was not the place of the clergy to interfere in professional matters…[and that] before the public was exposed to this technique, qualified medical professionals should subject it to increased experimentation.” In the minds of Douglass and many others, there was a fear that inoculation would lead to a greater transmission of the disease and possibly even help to usher in a deadlier enemy such as the Bubonic plague. (Buhr 62) (Mather 14)

Rev. John Williams used scripture in an attempt to prove that Inoculation was unlawful, unholy and “not contained in the rules of natural Physick.” Quoting Matthew 9:2 (“They that are whole need not a Physician, but they that are sick”) Williams claims that purposefully administering an illness to a healthy person is contrary to the words of Christ and violates the “golden rule” of “do unto your neighbor as you would have done to you.” He also believes that, since inoculation is not mentioned is scripture and that God has used disease in the past to punish sinners, “inoculation cannot be according to the will of God, nor according to knowledge.” He also claims that there has been an increase in mortality and a larger number of smallpox cases as a direct result of the inoculation. (Williams 1-4)

The outbreak of 1721 would prove to be the largest in Boston’s history.  Of the 10,600 people who lived in the city, almost 6,000 contracted the disease and nearly 900 (15%) succumbed to it. In stark contrast, of the 287 people inoculated, only 6 did not survive. Boylston dismisses these cases by claiming that these subjects had already contracted the disease in the “Common way” while attending to the ill, before they underwent the procedure. In most of the cases of inoculation, the symptoms were much less intense than from a natural contraction of the disease. Cotton Mather proudly proclaims that the subjects who received the inoculation “seriously profess’d to their neighbours, that they had rather suffer the operation twice every year, than once to undergo the small pox, as it is most commonly suffer’d, tho’ they should be sure of surviving it.” (Mather) Regardless of how it all truly occurred, the impressive results that came from Boylston’s efforts caused many (including Douglass) to change their views on inoculation and prompted the wide-spread use of the procedure throughout the colonies.(Burh 66) (Boylston 34) (Mather 15)

Unfortunately, it would still take many years for the characteristics of modern medicine to infiltrate America. The enticement of adventure and a fresh start offered by the colonies did not appeal to the average London physician. The outrageous fees that the few colonial physicians demanded prompted many to seek assistance from home remedies and spiritual leaders. In this professional vacuum, against a backdrop of medieval scientific thought, a series of social and geographical roadblocks severely halted the progress of medicine in the 17th and 18th century. Thankfully, by introducing sound medical research and taking a few chances, pastors such as Cotton Mather helped pave the way for a new era of health and prosperity for all Americans.

Boylston, Zabdiel. An Historical Account of the Smallpox Inoculated in New       England. London: at the Cros-Keys in the Poultry, 1727.

Buhr, Sean. “To Inoculate of Not to Inoculate?: The Debate and the                    Smallpox Epidemic of Boston in 1721.” Constructing the Past,  Vol. 1: Iss. 1, Article 8, 2000.

Mather, Cotton. An Account of the Method and Success of Inoculating the Small-Pox in Boston New England. London: Lock’s Head in Pater Noster Row, 1722.

Shyrock, Richard. “Eighteenth Century Medicine in America.” American Antiquarian Society, October, 1949.

Williams, John. “Several Arguments Proving that Inoculating the Small Pox is not Contained in the Law of Physick,” 1721. http://quod.lib.umich.edu/e/evans/N29903.0001.001?rgn=main;view=fulltext