June 1776 - Surgeon General’s War Report ~ A Letter from a Surgeon’s Mate

Dear Fellow Surgeons:

Allow me to share a letter I received from Dr. James Thatcher as of the month past in 1776.  Dr. Thatcher is a surgeon and part of the siege force that has surrounded Boston.  He is now stationed within Boston as a surgeon’s mate to Dr David Townsend with part of his regiment.

“Dear Surgeon Driscoll - As the small-pox is in many parts of the town of Boston, among both the inhabitants and soldiers, I was advised by my friends to have recourse to inoculation for my own safety, though contrary to general orders. I was accordingly inoculated by my friend Dr. John Homans, and have passed through the disease in the most favorable manner, not suffering one day’s confinement.  Should you wish the soldiers in Virginia to be a ready fighting force it would behoove you to begin your own inoculations soon.”   

Fear of small pox has led Continental soldiers to inoculate themselves without supervision since the beginning of the Revolutionary War. Though many times successful, this practice has been accompanied by unnecessary loss of life lacking supervision by a physician.  Mandating physician-only inoculation of soldiers would undoubtedly be safer.  May I take the liberty to refresh you on the proper technique.

1. We shall utilize the technique of variolization. Variolization is not without a fatality rate of 5 to 10 percent, however, the patient is to be informed of the successes rather than the failures.  He should be told that the technique is attendant with a mild case of small pox and a 90-95% success rate of being resistant to further disease.
2. First, medical personnel should examine each individual to determine if they had contracted the disease in the past.  Examine for the significant scarring of the flesh.
3. Using a lancet cut an incision in the flesh of the person being inoculated and implant a thread laced with live pustular matter into the wound.
4. Variolization procedure is followed by a month-long quarantine for the recovery process attended by teams of nurses.
5. Conduct inoculations in total secrecy. If the British caught wind that large numbers of American soldiers were laid up in bed with smallpox, it could be the end.

Your obedient servant 

Surgeon Driscoll, 2nd Virginia Continentals

Dr. James Thatcher