"Disease has destroyed ten men for us, where the sword of the enemy has killed one" -wrote John Adams to his wife Abigail, April 13, 1777.
During the Revolution, soldiers camped in close quarters were plagued by typhoid, yellow fever, and particularly, smallpox, of which an estimated 30 percent of soldiers became infected.
Though the New England colonies had experienced occurrences of the disease, which was thought to have been brought by travelers from the Caribbean, a major smallpox epidemic began in 1775 when the British evacuated Boston, which they had occupied for 9 months, and left their infected soldiers behind.
Spread only by direct human contact, in the next seven years, smallpox dispersed from Boston across the continent, reaching as far away as New Orleans, Mexico, areas of Texas, and the Great Plains.
Smallpox killed an estimated 145,000 settlers and Indians.
The migrating Shoshone are thought to have carried it to the Pueblos territory of New Mexico.
It showed up in tribes of the Pacific Northwest, in the Canadian interior at trading posts of the Hudson's Bay Company, and even in Alaska.
Fortunately for the purpose of American independence, George Washington was immune to smallpox as he had contracted it at the age of 19 when he traveled to Barbados with his older half-brother Lawrence in 1751.
On July 4, 1775, Washington cautioned against travel around Boston:
"... as there may be danger of introducing smallpox into the army."
Churches and homes were used as hospitals.
On July 20, 1775, Washington wrote to Congress, that he had:
"... been particularly attentive to the least symptoms of the smallpox ... We shall continue the utmost vigilance against this most dangerous enemy."
Washington directed Lieut. Col. Loammi Baldwin to prevent officers from meeting:
"... with the people who ... came out of Boston ... There is great reason to suspect that the smallpox is amongst them, which every precaution must be used to prevent its spreading."
In November of 1775, Washington noted:
"... smallpox is now in Boston, I have used the precaution of prohibiting such as lately came out from coming near our camp."
On December 15, 1775, Washington explained to Joseph Reed that:
"... smallpox is in every part of Boston ... a surety against any attempt of ours to attack.
If we escape the smallpox in this camp ... it will be miraculous. Every precaution that can be is taken to guard against this evil."
On December 4, 1775, Washington informed Congress that the British were sending civilians infected with smallpox out of the city:
"By recent information ... General Howe is going to send out a number of the inhabitants ... A sailor says that a number of these coming out have been inoculated with the design of spreading the smallpox through this country and camp."
Washington then wrote:
“The information I received that the Enemy intended spreading the smallpox amongst us, I could not suppose them capable of; I now must give some credit to it, as it has made its appearance on several of those who last came out of Boston.”
The death rate of smallpox was significantly higher than more recent viruses.
In contrast to modern gene-altering therapy, colonial Americans introduced a simple preventative measure -- a weakened strain of the disease would be exposed to a healthy person's body, allowing their own immune system to build up an effective natural immunity.
Initially, the method of preventative inoculation was scrapping a dried scab into fine powder, then blowing it up a person's nose.
This was first recorded in 1716 by Cotton Mather, who gave credit to his slave, Onesimus, for sharing it.
In 1721, a British ship docked in Boston, resulting in half of the city, nearly 11,000, contracting smallpox.
The method described by Mather was used by Zabdiel Boylston, resulting in only one in 40 dying of smallpox, as compared to one in seven who did not use it.
It was not until 1796, that English physician Edward Jenner successfully documented smallpox immunity from his cowpox vaccine.
Many of the Continental Army officers' wives decided to be inoculated with weakened smallpox.
On May 23, 1776, Martha Washington was inoculated by a doctor in Philadelphia.
John Adams described in a letter to his wife the crude invasive inoculation he endured in July of 1764:
"Dr. Perkins demanded my left arm ... They took their lancets and with their points divided the skin about a quarter of an inch and just suffering the blood to appear, buried a thread (infected) about a quarter of an inch long in the channel.
A little lint was then laid over the scratch and a piece of rag pressed on, and then a bandage bound over all, and I was bid go where and do what I pleased ...
Do not conclude from any thing I have written that I think inoculation a light matter --
A long and total abstinence from everything in nature that has any taste; two long heavy vomits, one heavy cathartic (to purge bowels), four and twenty mercurial and antimonial pills, and, three weeks of close confinement to an house, are, according to my estimation, no small matters."
On December 3, 1775, Robert H. Harrison wrote of what appeared to be an instance of biological warfare:
“Four British deserters have just arrived at headquarters giving an account that several persons are to be sent out of Boston . . that have lately been inoculated with the smallpox, with the design, probably, to spread infection to distress us as much as possible.”
On January 1, 1777, British ships sailing under the flag of truce released 200 American prisoners at Connecticut's Milford Harbor -- all suffering from smallpox.
Within a month, 46 had died along with one of their caregivers, Captain Stephen Stow.
British officer Robert Donkin had suggested that the contagious disease be used as a bioterrorism, as cited in Military Collections and Remarks, published in New York, 1777:
"Dip arrows in matter of smallpox, and twang them at the American rebels ... This would sooner disband these stubborn, ignorant, enthusiastic savages ... Such is their dread and fear of that disorder"
Quebec might have been captured by Americans in December of 1775, which would have possibly resulted in Canada becoming part of the United States, had it not been for smallpox.
British soldiers faced earlier accusations.
In 1763, during the French and Indian War, Chief Pontiac's uprising laid bloody siege to British Fort Pitt and decimated surrounding farms.
Sir Jeffrey Amherst suggested a biological weapon, July 7, 1763:
“Could it not be contrived to Send the Small Pox among those Disaffected Tribes of Indians? We must, on this occasion, Use Every Stratagem in our power to Reduce them.”
Whether authorized or not is unclear, but a local trader, William Trent, reportedly initiated a biological attack among the Indians, writing in his diary:
"Out of our regard for them, we gave them two Blankets and an Handkerchief out of the Small Pox Hospital. I hope it will have the desired effect."
General Benedict Arnold reported that nearly 1,200 American troops at Montreal were also suffering from smallpox:
"From the 1st of January to the 1st of March, we have never had more than seven hundred effective men on the ground, and frequently not more than five hundred."
Washington quoted from a letter by General Sullivan that:
"The army is sickly, many with the smallpox, and he is apprehensive the militia ordered to join them will not escape the infection."
General Gates conceded:
"As fine an Army as has ever marched into Canada has this year been entirely ruined with smallpox. The line of retreat extended near 13 miles distance and a great part of them sick with smallpox."
John Adams wrote from Philadelphia, June of 1776:
"Our misfortunes in Canada are enough to melt a heart of stone. The smallpox is ten times more terrible than Britons, Canadians, and Indians together. This was the cause of our precipitate retreat from Quebec."
George Washington wrote his concerns regarding inoculating his troops:
"Should we inoculate generally, the enemy, knowing it, will certainly take advantage of our situation."
The threat of smallpox did not lessen until widespread inoculations were called for by Dr. Benjamin Rush, born January 4, 1745.
Dr. Benjamin Rush was a surgeon general of the middle department of the Continental Army, tending to wounded soldiers during the Battle of Princeton, including General Hugh Mercer.
Dr. Rush personally inoculated Virginia Governor Patrick Henry against smallpox, as well as Pennsylvania troops, resulting in their low rate of illness.
Skepticism of vaccines haunted the British in other colonies.
A century later, the British faced an accusation in India, as recorded in The Indian Medical Gazette, “Dr. K. C. Bose on Small-pox in Calcutta” (March 1890, 82):
“The affection for their children has driven them to regard vaccination as an operation intended by government to thin the number of its poor subjects.”
Trinidad and the West Indies continued this skepticism, as William Tebb's The Recrudescence of Leprosy and Its Causation: A Popular Treatise (1893) recounted Dr. Bakewell's testimony before the Select Vaccination Parliamentary Committee in 1871:
"There is a very strong opinion prevalent in Trinidad, and in the West Indies generally, that leprosy has been introduced into the system by vaccination."
Dr. Benjamin Rush had studied medicine in Philadelphia, then in Europe under the world's foremost physicians, and then returned to Philadelphia in 1769.
Though his practices were archaic by today's standards, he is considered by some as the "Father of American Medicine" for his work on staff at the Pennsylvania Hospital, where he opened the first free medical clinic.
He was among the first to recognize alcoholism as a disease and began to promote temperance.
Dr. Rush wrote the first textbook on mental illness and psychiatry, recommending treatment with kindness, earning him the title "Father of American Psychiatry."
He was a member of the Continental Congress and signed the Declaration of Independence.
His wife was Julia, was the daughter of Richard Stockton, also a signer of the Declaration of Independence.
Thomas Paine consulted with Dr. Benjamin Rush when writing his stirring pamphlet Common Sense.
Rush helped write Pennsylvania's Constitution and was as a member of the Pennsylvania State Convention which ratified the U.S. Constitution in 1787.
He was Treasurer of the U.S. Mint.
During the dread summer of 1793, Dr. Rush stayed in Philadelphia battling the disease of Yellow Fever which killed thousands.
He was the first to recognize that yellow fever was not contagious, leading to the later discovery that it was spread by mosquito bites.
Dr. Rush and other founders, including George Washington, donated to Richard Allen, founder of the African Methodist Episcopal Church.
Dr. Benjamin Rush supported ending slavery prior to the Revolution, forming a Society for the Abolition of Slavery.
Perhaps Dr. Benjamin Rush's most beloved contribution to American history was in 1812 encouraging John Adams to write to Thomas Jefferson, breaking the silence which had existed between them for years due to earlier political differences.
A proponent of public education for young women as well as men, Dr. Benjamin Rush wrote his Thoughts Upon the Mode of Education Proper in a Republic, 1786:
"I proceed ... to inquire what mode of education we shall adopt so as to secure to the state all of the advantages that are to be derived from the proper instruction of the youth;
and here I beg leave to remark that the only foundation for a useful education in a republic is to be laid on the foundation of religion.
... Without this there can be no virtue, and without virtue there can be no liberty, and liberty is the object and life of all republican governments.
But the religion I mean to recommend in this place is that of the New Testament ... Its doctrines and precepts are calculated to promote the happiness of society and the safety and well-being of civil government."
Dr. Benjamin Rush founded a Sunday School Union and the Philadelphia Bible Society.
He wrote in A Plan for Free Schools, 1787:
"Let the children ... be carefully instructed in the principles and obligations of the Christian religion. This is the most essential part of education."
Rush wrote to Jeremy Belknap, July 13, 1789:
"The great enemy of the salvation of man, in my opinion, never invented a more effectual means of extirpating (removing) Christianity from the world than by persuading mankind that it was improper to read the Bible at schools."
Dr. Benjamin Rush wrote in an essay, "A Defense of the Use of the Bible as a School Book," included in his 1798 work, Essays, Literary, Moral and Philosophical:
"The Bible, when not read in schools, is seldom read in any subsequent period of life ...
It should be read in our schools in preference to all other books from its containing the greatest portion of that kind of knowledge which is calculated to produce private and public temporal happiness."
Rush wrote in Essays, Literary, Moral, and Philosophical, 1798:
"I know there is an objection among many people to teaching children doctrines of any kind, because they are liable to be controverted. But let us not be wiser than our Maker.
If moral precepts alone could have reformed mankind, the mission of the Son of God into all the world would have been unnecessary.
The perfect morality of the Gospel rests upon the doctrine which, though often controverted has never been refuted: I mean the vicarious life and death of the Son of God."
"Vicarious" is defined in Merriam-Webster's Dictionary as: "suffered by one person as a substitute for another or to the benefit or advantage of another: substitutionary."
Dr. Rush stated:
"Without religion, I believe that learning does real mischief to the morals and principles of mankind."
He wrote his Thoughts Upon the Mode of Education Proper in a Republic, 1786:
"A Christian cannot fail of being a republican ... for every precept of the Gospel inculcates those degrees of humility, self-denial, and brotherly kindness which are directly opposed to the pride of monarchy ...
A Christian cannot fail of being useful to the republic, for his religion teaches him that no man 'liveth to himself.'
And lastly a Christian cannot fail of being wholly inoffensive, for his religion teaches him in all things to do to others what he would wish, in like circumstances, they should do to him."
Dr. Benjamin Rush explained in Essays, Literary, Moral, and Philosophical, 1798:
"Christianity is the only true and perfect religion, and that in proportion as mankind adopts its principles and obeys its precepts, they will be wise and happy ...
In contemplating the political institutions of the United States, I lament that we waste so much time and money in punishing crimes and take so little pains to prevent them.
... We profess to be republicans, and yet we neglect the only means of establishing and perpetuating our republican forms of government, that is, the universal education of our youth in the principles of Christianity by the means of the Bible.
For this Divine book, above all others, favors that equality among mankind, that respect for just laws, and those sober and frugal virtues, which constitute the soul of republicanism."
On July 9, 1788, in a letter to Elias Boudinot regarding a parade in Philadelphia, Dr. Benjamin Rush stated:
"The Rabbi of the Jews locked arms of two ministers of the Gospel was a most delightful sight. There could not have been a more happy emblem."
Dr. Benjamin Rush wrote:
"I have been alternately called an Aristocrat and a Democrat. I am neither. I am a Christocrat.
I believe all power ... will always fail of producing order and happiness in the hands of man. HE alone who created and redeemed man is qualified to govern him."
Rush died in Philadelphia on April 19, 1813, and was buried in the yard of Christ's Church.
John Adams wrote:
“Another of our friends of seventy-six is gone, my dear Sir, another of the co-signers of the Independence of our country ...
... A better man than Rush could not have left us, more benevolent, more learned, of finer genius, or more honest. I know of no Character living or dead who has done more real good in America.”
Memorials to Dr. Benjamin Rush stand on Navy Hill in Washington, D.C., and near the Harvard Square Library.
During his final illness, he wrote to his wife:
"My excellent wife, I must leave you, but God will take care of you.
By the mystery of Thy holy incarnation;
by Thy holy nativity;
by Thy baptism, fasting, and temptation;
by Thine agony and bloody sweat;
by Thy cross and passion;
by Thy precious death and burial;
by Thy glorious resurrection and ascension, and
by the coming of the Holy Ghost, blessed Jesus, wash away all my impurities, and receive me into Thy everlasting kingdom."
Read as PDF ... "Smallpox is ten times more terrible!" -Diseases during the Revolution, Dr. Benjamin Rush