Because 18th century American populations were essentially stationary—a
majority of the population never ventured more than a few miles from home in
the course of a lifetime—they rightfully feared the invasion of outsiders.
Traveling armies carried with them a potpourri of communicable diseases and
there were few means to combat the ailments these soldiers brought.
There were approximately 3500 doctors in America just before the American
Revolution. Most had more in common with a medieval barber than a modern M.D.
A colonial doctor's principal role was to provide comfort and support, set
broken bones, and prescribe occasional herbal remedies. Opiates were used to
alleviate pain, and quinine was known to be an effective treatment for malaria.
But each group of drugs tended to be overused. Appropriate dosages and
applications (quinine, for instance, was called upon for a wide-variety of
fever-related ailments) would need to be measured by future generations.
Theories of medicine at the time were based on the notion that disease was
caused by an imbalance in bodily "humors," or fluids. To treat an illness, you
either added fluids, or drained them away. Contained in a doctor's little black
bag were implements designed to purge, sweat and bleed infected fluids from the
body. There were emetics and diuretics, scalpels and leeches. Steaming hot
poultices were used to intentionally create infections on scalded skin. The
drainy pus that flowed afterward was thought to ooze beneficially.
South of New England, malaria had a devastating effect on the population,
particularly to newcomers to the climate, who had no acquired immunity to the
The most feared ailment north and south, however, was smallpox, which could be
both disfiguring and fatal. The roughened skin of facial smallpox scars were a
common sight in Revolutionary America, though artists tended to render these
blemishes as rosier-than-normal cheeks in portraiture of the time.
Smallpox inoculation had existed in America since the early part of 18th
century. It was not until the Revolutionary War that the practice became
widespread, however, when Congress ordered the inoculation of all troops in the