Dangers of Disease in American Revolutionary War

As America celebrates 250 years of independence, here is a look back at the price the Revolutionary War service members paid for freedom.

Besides being killed by the enemy, the thing most feared by soldiers during the war was dying from disease - and with good reason. Historians have said that many more died from disease than from combat.

In November 1775, soldiers, led by Continental Army Col. Benedict Arnold, marched on Quebec City. The following month, an outbreak of smallpox occurred preventing the Americans from taking the city.

As smallpox was quickly spreading in America, Gen. George Washington, Continental Army commander, ordered his troops to be immunized against the disease.

"Necessity not only authorizes but seems to require the measure," he said. "For should the disorder infect the Army, in the natural way, and rage with its usual virulence, we should have more to dread from it, than from the sword of the enemy."

The inoculation procedure involved inserting an active smallpox pustule into the skin of a healthy soldier and then quarantining him for a period of time. This proved successful and enabled the Americans to have battlefield successes.

Besides smallpox, bringing soldiers together in close quarters with poor nutrition and sanitation caused diseases such as dysentery, typhus, typhoid, dengue fever, cholera, fever and diarrhea to spread.

The procedure for extracting a musket ball from a soldier involved the surgeon extracting it with forceps - if it could be reached. The forceps were usually never cleaned and the surgeon operated without gloves, spreading germs and causing infections.

Since there was no anesthesia available then, surgeons gave the soldiers alcohol to drink - if they had any - to help ease the pain.

The vast majority of surgeons didn't go to medical school, learning instead through apprenticeships. Dubious treatments included treating the sick by balancing the body's four fluids - blood, yellow bile, black bile and phlegm. Rebalancing was done through bloodletting and purging through various teas and medicines.

Today's military medicine has come a long way since that war.