“Unfit for Duty”: Medicine and Illness in the Revolutionary War

This week, I finished writing biographies for Maryland 400 soldiers. Over the course of my research on various soldiers, I have written about quite a few who fell sick during their service, including the soldier I am currently researching, Christopher Richmond, who was furloughed from May to October in 1778. Since I have encountered so many soldiers who were ill during their service, I decided to look into what kind of medical conditions and treatments faced the American troops during the war.

The Battle of Brooklyn witnessed many American soldiers captured by the British. Maryland prisoner Thomas McKeel noted that he “remained a prisoner on board of a Prison Ship until the British troops got possession of New York.” [1] Neglected by their captors and forced to endure extremely poor conditions, prisoners often died in captivity. Lack of protection from the weather, bad treatment from officials with no formal medical training, cold, and hunger were among the conditions prisoners were subjected to. [2] The overall mortality rate of prisoners who died of malnutrition or disease following their release reached approximately 60 percent. [3]


A physician wraps the foot of an injured soldier.  From National Park Service.

In the fall of 1776, the Maryland troops faced the severe problem of growing numbers of sick soldiers with declining medical supplies and proper medical officials. With hundreds of men unfit for duty, Captain John Allen Thomas of the Fifth Independent Company wrote to the Maryland Council of Safety about the “unhappy situation of the Maryland Troops” and to report that there were “near two hundred Men unfit for duty, and most of them without any assistance from the Doctor.” [4] However, no remedy was provided for the Marylanders. [5]

By October, the First Maryland Regiment’s paymaster Christopher Richmond requested that instead of paying them, money be put towards sending more clothes to the troops to protect them from the cold. Colonel William Smallwood also reported that his men were forced out of the hospital due to negligent doctors and moved them to a house in the country for their recovery. [6] 

Conditions worsened in 1777 with the increase of sick soldiers in Philadelphia and the spread of smallpox. Hundreds of soldiers were sent to Philadelphia to recover at an almshouse known as the Philadelphia Bettering House, including around thirty Marylanders. [7] Soldiers who suffered from battlefield wounds, swelling, fever and related illnesses, and jaundice among other illnesses were sent to Bettering House. [8] In the spring of 1777, after a portion of soldiers fell ill with smallpox, General Washington ordered all troops and recruits inoculated. This practice was soon implemented across the colonies, with army physicians inoculating veterans who weren’t exposed to the disease yet. [9] By that fall, after the capture of Philadelphia, the Bettering House was taken over by the British to use for their own sick soldiers. [10]

Recovering American soldiers were then sent to recover elsewhere or cared for in camps. Because the regiments were rarely in Maryland, sick and wounded soldiers received medical care from surgeons and surgeon’s mates in temporary hospitals. Soldiers were presumed to fall sick as a result of poor diet, inadequate clothing and shelter, and poor sanitary conditions. [11] Once in hospitals, soldiers were treated with a variety of medicines carried in the field by the regiment, including rhubarb, opium as a painkiller, and quinine as a fever reducer. [12] Some were so sick that they were furloughed, such as Private Lawrence Connelly

Sickness and supply shortages would continue to be a problem not only for Maryland troops, but for the whole Continental Army for the duration of the war. Soldiers who recovered from their illness were able to return to the battlefield, but many died as a result of their sickness.

– Cassy

Notes: |

1. Pension of Thomas McKeel, National Archives and Records Administration, Revolutionary War Pension and Bounty-Land Warrant Application Files, NARA M804, S 34977. From Fold3.com.

2. George C. Doughan, Revolution on the Hudson: New York City and the Hudson River Valley in the American War of Independence (New York: W.W. Norton & Company, 2016); Patrick O’Donnell, Washington’s Immortals: The Untold Story of an Elite Regiment Who Changed the Course of the Revolution (New York: Atlantic Monthly Press, 2016), 96-98;  Mark Andrew Tacyn, “To the End: The First Maryland Regiment and the American Revolution,” (PhD diss., University of Maryland College Park, 1999), 84-87; Pension of Elijah Wright, National Archives and Records Administration, Revolutionary War Pension and Bounty-Land Warrant Application Files, NARA M804, S 1273. From Fold3.com.

3. Edwin G. Burroughs, Forgotten Patriots: The Untold Story of American Prisoners During the Revolutionary War (New York: Basic Books, 2008), 281, n40.

4. Journal and Correspondence of the Maryland Council of Safety, September 4, 1776, Archives of Maryland Online, vol 12, p. 256-257.

5. For more information on Captain Thomas and his letter, see “The Unhappy Situation”  on the Finding the Maryland 400 research blog.

6. Archives of Maryland Online, vol 12, p. 366; Archives of Maryland Online, vol 12, p. 357-363.

7. Maryland 400 soldiers such as Michael Nowland, John Booth, and John Price were some of those recovering in the city’s Bettering House. Richard L. Blanco. “American Army Hospitals in Pennsylvania during the Revolutionary War.” Pennsylvania History vol. 48, no. 4 (1981), 347- 354; Mary C. Gillett, The Army Medical Department 1775-1818 (Washington D.C.: Center of Military History, 1981), 70. 

8. List of Sick Soldiers in Philadelphia, December 1776.” Pennsylvania Archives Second Series Vol I. From Fold3.com.

9. Elizabeth Anne Fenn, Pox Americana: The Great Smallpox Epidemic of 1775-82, (New York: Hill and Wang, 2001), 35; “Disease in the Revolutionary War,” Mount Vernon: Washington Library, 2018, https://www.mountvernon.org/library/digitalhistory/digital-encyclopedia/article/disease-in-the-revolutionary-war/

10. For more information on the Bettering House, see “Sickened Marylanders and the Philadelphia Bettering House” on the Finding the Maryland 400 research blog.

11. Tacyn, 171.

23. “List of Medicinal Items,” 1776, Maryland State Papers Series A [MSA S1004-2-12, 01/07/03025]. 

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5 Responses to “Unfit for Duty”: Medicine and Illness in the Revolutionary War

  1. Great article and the references are very useful for us that are interested in reading further on these topics of interest. It sounds like you are learning more about the times of these men and not just their lives and military service and by sharing you are enlightening many more about the era and the sacrifices that made on and off the battlefield. Thank you for sharing your research.


    • cassysottile says:

      Thank you so much! I found it very interesting to look into what conditions and times were like for the men as a whole and not just the individual soldiers affected.


    • Mary Margaret Revell Goodwin says:

      Chris is correct. Actually the records both for the Council of Maryland and for many of the Counties are replete with the problems that smallpox, measles caused the troops, as well as many other diseases brought on by terrible camp conditions and lack of sanitation. Here from 1781, well after these problems began to appear is one statement in the archive records: April 11, 1781
      Liber No. 78
      p. 435 [G. Duvall, Prest in Council to The Honorable The Intendant]
      The Board having received Information from Doctor Thomas
      and Lt Pendergast of the Distressed Situation of the Soldiers of the
      Maryland Line, now at Frederick Town, think it necessary to re-
      quest you will furnish the Sum of £50 to be paid to Doctr Thomas
      for the purpose of purchasing Necessaries to alleviate their Dis-
      tresses. Upwards of fifty are now ill with the Small pox, Measles
      and putred remittent fever, which is said to be contagious, and must
      in a Short time prove fatal to many of them if Measures are not
      taken to Supply them with Medicines and proper Diet. Humanity
      will dictate to you the Necessity of procuring without delay the Sum

      Also, as Chris knows, I have been working for some time on the story of smallpox remediation by inoculation where men who would be or wanted to be officers in the Maryland Line cane to Baltimore to be deliberately subjected to the smallpox so they could become immune. There are well known stories about this. Even after Washington got Congress to understand that it was crucial for all men to be inoculated, many did not make it through the inoculation. The stories for this out of Alexandria, Va where there were also inoculation houses are so gruesome it is some of the toughest reading about the times of 1776 forward you will ever read.


      • Mary Margaret,
        It’s good to hear from you, and thanks for your comment. If you haven’t read Pox Americana by Elizabeth Fenn, it will be well worth you time!



      • Mary Margaret Revell Goodwin says:

        Owen I have indeed read her, spoken with her and this is included in my work on smallpox and the impact on men willing to sign up, or NOT (mostly NOT) here on the Eastern Shore. They had already heard the stories and in 3 meetings the numbers needed for agreeing to sign up was so low and they specifically stood and spoke that smallpox was their reason for so few being willing to sign up! I know this story very well.
        Further, one of the most controversial women in Maryland’s history, if not THE MOST, Anna Ella Carroll was the great granddaughter of a Tory who, in spite of his allegiance to GB and fighting for it, returned to Baltimore to help inoculate ALL men, and housed them at his house as he did the inoculations. That alone save thousands of Maryland lives. Men came to him from all across the State just to go through the inoculations in a safe manner.
        Good to hear from you. Hope to see you soon.


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