Disease, War, and the Imperial State: The Welfare of the British Armed Forces during the Seven Years’ War by Erica Charters (review)

Hitherto, an excellent avenue for examining early modern medicine has received far too little attention, for the voluminous records and contemporary publications produced in association with Europe’s wars of this period have not been satisfactorily exploited. In recent years a number of scholarly articles and essays have dealt with medical issues in the context of eighteenth-century warfare, but monographs have been few.

Disease, War, and the Imperial State narrows this gap in scholarship. Erica Charters, a rising scholar who teaches medical history at Oxford, has provided the first book-length study to focus on the medical aspect of any of the four major wars that Britain engaged in between 1701 and 1783. That she has done so in reference to the Seven Years’ War is particularly ambitious, for this conflict was arguably the first global war, being fought out in three primary theaters: North America and the West Indies, Continental Europe, and India. Charters herself points out (p. 20) that her book is not a study of military operations during the Seven Years’ War, nor of grand strategy and diplomacy, topics that have been dealt with at length by generations of historians. Instead, the author examines medical issues in both the British Army and the Navy, and in all three of the theaters, while also finding time and space to discuss the impact of these issues on British politics and imperial perspectives.

As is characteristic of her growing body of published work, Charters exhibits fine scholarship. She synthesizes well the secondary literature that relates to her project. Nevertheless, her sources are predominantly archival, and she also makes use of the wealth of published treatises by medical officers of the period, some of whom served in the Seven Years’ War.

The war saw several medical disasters, such as the outbreak of scurvy that decimated the British forces that occupied Quebec during the winter of 1759–60 and the devastating epidemic of yellow fever that within a few months of 1762 took the lives of more than half the men who had recently seized Havana. These disasters Charters explores, providing not only narrative but a sense of how contemporary medical opinion understood the diseases that killed so many. While the control of yellow fever lay many decades in the future, the eighteenth century saw developments that promised to reduce the threat posed by scurvy and by another killer, smallpox. Nevertheless, as the author notes, inoculation for smallpox was not widely used in the army during the Seven Years’ War and the antiscorbutic most widely given to the troops in North America, spruce beer, was ineffective compared to the lemon rob that Lind was already advocating.

Charters also devotes significant attention to how colonists and native peoples were viewed through an imperialist lens. She persuasively argues that the British imagined their regulars were constitutionally different from American provincials and that these differences made them more resistant to disease and more capable of adjusting to hot climates. However, the sickness that they experienced in India and the West Indies severely crimped these optimistic estimates.

As Charters notes, sickness among the troops had a political dimension as well as a medical one. The high mortality suffered by provincial troops who served in the West Indies caused resentment in British North America, while in Britain itself opponents of the ruling ministries took political advantage of the epidemics of typhus and dysentery that afflicted troops on the Continent.

Charters views naval medicine primarily in terms of the Western Squadron, a fleet that during the war stayed at sea, maintaining a blockade on France. She discusses the administration of medical services, the role the squadron played in pursuing clinical trials, and the implementation of policies intended to foster the health of seamen.

Finally, Charters deals with how the British treated some...