Alexandria One of the most significant decisions that General Washington made during the Revolutionary War was to inoculate the army against smallpox. Without doing so, it is not likely that Washington could have kept his army in the field.
In Europe there were outbreaks of smallpox in every generation. It is a disease that confers lifelong immunity to survivors. In America the population was widely scattered and therefore with few such outbreaks. That all changed during the war. Concentration of large numbers of men created the environment for smallpox epidemics to ravage the army and threatened its existence.
The question was whether to try to inoculate the Continental Army. Inoculation required taking a bit of matter from one of the pustules of a smallpox victim and introducing it under the skin of someone who had never had the disease. The resulting case of smallpox was much lighter and greatly decreased the chances of death and scarring. The process was serious in that, unless isolated, those who had received inoculation would be contagious to others, and one out of 20 who were inoculated actually died of the disease they were trying to avoid.
There was another major problem with inoculations: the process took weeks to accomplish and had to be done in isolation. It meant that large portions of the army would be out of commission and vulnerable to British attack for many weeks. Washington decided to make inoculation mandatory in great secrecy of all troops who had not had the disease. This decision is viewed by historians as a pivotal one that enabled the Continental Army to return to the field at full strength.
This is the subject of “The Great Smallpox Epidemic of 1775-82” by Elizabeth A. Fenn, a past speaker at the GW Chapter of the SAR.