The Contagious City: The Politics of Public Health in Early Philadelphia

6. “A Fine Field for Professional Improvement” : Sites and Sources of Medical Authority in the Revolutionary War

86 6 “A Fine Field for Professional Improvement” Sites and Sources of Medical Authority in the Revolutionary War When General Howe’s army descended upon the revolutionary capital, “great numbers” of wounded Continental troops swarmed into Philadelphia , leaving a scattered trail of “hundreds of their muskets laying in the road,” dropped by the fallen and the fleeing. Elizabeth Drinker recalled that in the days that followed, she heard nothing but “carriages constantly passing with the Inhabitants going away.” Some wanted to get themselves safely within Patriot-held territory. Some feared another round of the pillaging that both armies practiced in whatever towns they occupied. Some, however, went to join with the Continental Army, to serve as nurses, surgeons, and other guardians of the army’s health.1 Medicine played a pivotal role in the War of Independence. Throughout the conflict, disease killed far more Americans than combat, and commanders were keenly aware of the need to preserve the health of the soldiers. They depended on medical professionals, like physicians and surgeons, as well as informal practitioners, like nurses and laundresses and military disciplinarians who could enforce compliance with hygienic measures.2 Because Philadelphia was home to the nation’s most celebrated hospital and most prominent medical faculty, Pennsylvania would exert an outsize influence on the development of American military medicine, hosting more military hospitals with more patients than any other state and producing three of the four directors of the army’s medical department.3 The war played an equally crucial part in transforming Philadelphia’s medical community. First, it plunged them into hands-on medical practice, Sites and Sources of Medical Authority in the Revolutionary War 87 instilling in medical professionals a specificity of knowledge they simply did not possess before the ordeal. Second, their wartime experiences endowed medical men with the prestige associated with revolutionary service and made their names known to the thousands of men they treated. Third, it connected them to generals and civilian leaders, allowing them to develop the political alliances and acumen that would serve them in their later careers . Last, and most important, the war taught these men to think in terms of populations. Because their greatest task was not the treatment of wounds but the maintenance of health, the medical men were habituated to think about how environmental and social vectors spread illness. Moreover, they grew accustomed to having their thinking noted, if not always heeded, by military commanders. In some rare cases, their prescriptions were enforced through military discipline.4 It taught them how to think about their profession as one not merely concerned with the healing of individual bodies, but with promoting and preserving the health of entire populations. When the medical men returned to the city at war’s end, they came with a new confidence and a new sense of purpose. They left wanting to save Philadelphians; they returned wanting to save Philadelphia.5 Cities on the March: Military Medicine and the Clinic Born on a Battlefield More than a thousand physicians, surgeons, surgeon’s mates, apothecaries, nurses, and others worked to attend sick and wounded American soldiers over the course of the Revolutionary War, bloodying their hands in numberless bodies. Hutchinson wrote to his uncle of the aftermath of the battle of Germantown, being “so engaged in Dressing wounded men, that I have scarce time to look around me.”6 If he had, he would have seen his brethren similarly engaged. The battlefields of the revolution confronted young surgeons and physicians with more varieties of maiming, and in greater numbers, than their previous careers possibly could have. As the historian Randolph Klein argued, the revolution “created an exciting and often grisly arena in which to develop and demonstrate talents.”7 Of course, the medical men did not enter the fray as complete naïfs; they were armed with their own experiences and with the knowledge of their elders who had served in the Seven Years’ War. Military medical manuals, especially those by British authorities John Pringle and Richard Brocklesby, also offered guidance to American medicos at the war’s outset and served as the model for John Jones and other Americans to compile their own manuals.8 Whatever they learned from books or from previous training, nothing prepared Hutchinson and his comrades for the shocking carnage they witnessed at war. We know this because he and his cohort reported as much in 88 “A Fine...