Newly Discovered and Unpublished: General George Washington Manages the First Major Inoculation Campaign in American History and the Continental Army Medical Department

The General also announces the arrival of one of the first French troops and the first French general “of military rank” to serve alongside the Americans; he arrived 2 months before Lafayette

 

He writes his old friend, Dr. James Craik: “I have referred the request [to remain with your patients] contained in your letter to the Director General who knows how far it is in his power consistently with the good of the service to prolong your absence for an answer, & with best wishes for the health & felicity of Mrs. Craik and the rest of your family…”

 

This letter is unpublished and previously unknown; we obtained it directly from a family that had had it for generations

 

 

Smallpox was the scourge of the 17th and 18th centuries in America. Efforts to inoculate against it involved a process called variolation, where people who had never had smallpox were exposed to material from smallpox sores by scratching the material into their arm or inhaling it through the nose. After variolation, people usually developed the symptoms associated with smallpox, such as fever and a rash, and were for a while under a doctor’s care. However, these symptoms were milder than those of smallpox, and many fewer people died from variolation than if they had acquired smallpox. The inoculated then had antibodies and were immune to smallpox thereafter. Efforts to encourage inoculation commenced in America when Cotton Mather, a distinguished American churchman, campaigned for inoculation during an outbreak of smallpox in Boston and met with some success – but also much disbelief and outright hostility.

Among the Continental Army regulars in the American Revolution, 90 percent of deaths were caused by disease, and the smallpox virus was the most vicious of them all. The Army’s leader, George Washington, was a strong proponent of inoculation, an invisible killer that he had battled as a teenager. But he had opposition, as in 1776 the Continental Congress issued a proclamation prohibiting Surgeons of the Army to inoculate. Meanwhile, the smallpox plague affected the Continental Army as well as the civilian population. Epidemics broke out in both Boston and Philadelphia in the summer of 1776, and the retreat of an American force sent to take Quebec was blamed in large part on the high prevalence of smallpox amongst soldiers.

So Washington made the controversial decision to order the mass inoculation of his soldiers, in an effort to combat spread of the disease that was at the time a major deterrent to enlistments and posed the risk of debilitating his army and tipping the balance of power against America’s cause. On the 6th of January 1777, Washington took matters into his own hands and wrote to Dr. William Shippen Jr., Director General of Hospitals of the Continental Army, ordering him to inoculate all of the forces that came through Philadelphia. This was his first inoculation program. He explained that, “Necessity not only authorizes but seems to require the measure, for should the disorder infect the Army…we should have more to dread from it, than from the Sword of the Enemy.” Then, on February 5, Washington finally committed to the open and public espousal of the still-unpopular policy of mass inoculation by writing to inform Congress of his plan. Throughout February, Washington, with no precedent for the operation he was about to undertake, covertly communicated to his commanding officers orders to oversee mass inoculations of their troops on the model of Philadelphia.

But Washington was also concerned about his family, and Martha Washington was inoculated early in the Revolution so that she would be able to be with her husband in his military camps. Other members of the family and the Washington’s slaves were inoculated, as well.

Dr. James Craik studied medicine at the University of Edinburgh, went to the West Indies as a British army surgeon in 1751 and soon moved to Virginia, where in 1754 he was appointed surgeon of Washington’s Virginia Regiment. During the ensuing campaigns Craik and Washington became close friends. Craik served with the Virginia Regiment until it was disbanded in 1762; he subsequently settled on a plantation near Port Tobacco, Md., where he established a profitable private medical practice. In April 1777, Washington offered him the post of Assistant Director General of the hospitals in the middle department, saying “You know how far you may be benefitted, or injured, by such an appointment; and you must know, whether it is advisable, or practicable, for you to quit your Family, and practice, at this time. All these matters I am ignorant of; and request, as a friend, that my proposing this matter to you may have no influence upon your acceptance of it. I have no other end in view than to serve you; consequently, if you are not benefitted by the appointment, my end is not answered.”

On May 13, 1777, Craik accepted Washington’s offer, but made it clear he hoped he could delay leaving to take up the post right away. The reason: He was inoculating patients against smallpox, and felt keenly the need to monitor their condition as they recovered. “At the Same time that I Solicit for this Appointment,” he wrote, “I must inform you that in case my immediate attendance at Camp is necessary, it will not be in my power to Comply with it as I have Some familys under Inoculation near Fredericksburgh whom I am not certain that I could leave under three or four Weeks from this time.”

But that letter contained additional important and fascinating information about inoculation. Craik indicated that he had inoculated Washington’s own family, and his slaves, against smallpox. At about the same time he inoculated George Mason, later author of the Bill of Rights. Craik continued, “I have the Pleasure to inform you that Mrs Custis’ Child has got over the Small Pox very well, and all your Negroes who have been Inoculated, and all others in that Neighbourhood whom I have Inoculated. Coll Mason has had it very favourably and is now well—It is expected every day to be in Fredericksburgh where I am Solicited to Inoculate but I shall obey your Commands by the time I have mentioned if you think proper to order me.” Thus we see that many of the Washington slaves had been inoculated. The child Craik referenced was Martha Washington’s granddaughter, Elizabeth Parke Custis, daughter of John Parke Custis and Eleanor Calvert Custis, who was born on August 21, 1776.

In 1776, the American diplomat Silas Deane went to France to recruit skilled military talent, particularly engineers, for the colonial cause. Impressed by Philippe Charles Jean Baptiste Tronson du Coudray, whom he described as the “first engineer” of the French military establishment, Deane agreed to hire du Coudray into the Continental Army with the rank of major general and command of the Continental Army’s artillery and engineering corps. Du Coudray was to recruit engineers in France, and deliver 200 French cannons to the American forces. The methods by which du Coudray went about recruiting alarmed the French court, which wanted to maintain secrecy in its dealings with the Americans, and du Coudray was ordered to stay in France. He ignored the order, and slipped out of France, arriving in North America in May 1777, 2 months before Lafayette. Coudray arrived with 20 men. This news had been related to him the week before by General Heath.

This is Washington’s response to Craik’s letter. The letter is unpublished and previously unknown.

Autograph letter signed, Camp at Middle Brook, May 31, 1777, to Craik, telling him he is sending on to the Director General his application for a late arrival, which meant that the application had Washington’s approval. Washington’s forces were encamped at Middlebrook in 1777 and again in 1778–79. The position provided a natural fortress not only protecting the Continental Army but also overlooking the plains towards New Brunswick, where the British forces were stationed. “Doctor, I had just sat down to acknowledge the receipt of your letter of the 13th instant (which never reached my hand til yesterday), and to write pretty fully to you on the subject of it, when the arrival of Monsr. Coudrey, a French gentleman of military rank was announced. This, and the necessity of writing by the post, who is just setting out, will apologize for the shortness of this letter.”

Washington continued, “I have referred the request [to remain with your patients] contained in your letter to the Director General who knows how far it is in his power consistently with the good of the service to prolong your absence for an answer, & with best wishes for the health & felicity of Mrs. Craik and the rest of your family…” His wishing the Craiks good health was an unusual sentiment for Washington to add at the end of a letter.

The letter since 1935 has been the property of a family named Moore, one of whom, Alexander, wrote his name at the lower left of the letter many years ago. It comes with a certificate gifting the letter from a father to son on the son’s college graduation in 1935. We obtained it directly from the Moore family.

Dr. William Shippen, the Director General, agreed to allow Craik time to take up his post, but in the meanwhile he hoped Craik could assist with patients under inoculation near Craik’s location. Shippen wrote Washington on June 2, 1777, saying “I have enclosed his commission & desired him till he can come on, to assist & direct Dr. Tilton one of our senior Surgeons who writes me he has near 1100 Carolinians, officers included, under inoculation at Dumfries, Alexandria & Georgetown…” The Tilton referred to was head of the Continental Army’s military hospitals first as Hospital Physician from 1777 to 1780 and Hospital Physician and Surgeon from 1780 until the end of the war.

Craik arrived in camp and assumed his post as Assistant Director General of the Medical Department of the Continental Army on time to be with Washington at Valley Forge. It was he who in 1778 warned Washington of the so-called “Conway Cabal” to make General Gates Commander-in-Chief. Craik had attended the wounds of General Mercer on the battlefield of Princeton and of Lafayette at Brandywine. When the French under Rochambeau landed at Newport, RI, Craik established the hospital service for their sick and wounded. In 1780 a reorganization of the medical department made Craik the senior of four holding the title of chief hospital physician and surgeon, and in 1781 became chief physician and surgeon of the army. He served until the close of the war, participating in the final campaign against Yorktown. After the war Craik moved to Alexandria, Va., and he was one of the physicians who attended Washington during his last illness in 1799.