In the preface Brown explained that there were two types of formulas contained in the _Lit.i.tz Pharmacopoeia_; one was the "medicaments which must be prepared and compounded in a general laboratory; the others are to be mixed, as needed, in our hospital dispensaries."

The main store of drugs was housed at Manheim until late March, when Shippen ordered Apothecary Cutting to pack the medical stores there and proceed on to Yellow Springs.[133] Cutting wrote Potts on March 30 that

... the articles that we have in store are now ready to put on board the waggons excepting the want of cases to contain them....

Paper, Twine, Square Snuff Bottles & Corks are so essentially necessary to take with us, to fit up the Regimental Chests that I wish your order to buy them at Lancaster immediately. I never heard what place in the vicinity of Camp has been chosen for our temporary Medicine Shop, nor what quant.i.ties the Regimental Surgeons are to be supply'd when we get there....[134]

On April 16 Cutting[135] wrote that the

... dispensing store is open'd here [at Yellow Springs] and we have begun to supply the Regiments in Camp.... Dr. Cochran has given orders to the Division on the left to bring their Chests first, and we propose going through the whole Army in the order in which they lay.... The best method I can think of is to act immediately about preparing new Chests upon the Northern Plan at some convenient place for all such Battallions as did not get chests from Dr.

Craigie [in the] last campaign. When these new parcels are ready, let us call all the large chests into the Stores ... which are too compleat & capacious for Field Service, & in lieu of them give out our smaller ones. By this exchange, the Genl. Hospital will be well supplied with standing Chests & acquire a great variety of useful articles which are not essential in Camp.

Apothecary Cutting was concerned, however, over supplies and

... very apprehensive that the several Hospitals in this vicinity will render a further reinforcement necessary before we shall be able to compleat the whole.... To give only a few of the Capitals to each will be a work of Time, & a much more intensive piece of business than I at first imagined.

Meanwhile, Potts had sent Apothecary Craigie to Baltimore to obtain a fresh stock of drugs, and probably to prevent further friction between Craigie and Cutting. This feud started early in 1777 when Apothecary Cutting, serving with Shippen in Philadelphia, was named, over his preceptor Craigie, to head the newly organized "Apothecary department"

of the army.[136] On March 27 Craigie wrote from Annapolis advising Potts that he had been in Baltimore

... not long since and waited on Messrs. Lux & Bowly. The medicines were not come to hand but were expected.... I have engaged the whole invoice which contains several important medicines not mentioned in your list. I think the prices are full high, tho'

somewhat less than Dr. Shippen affixed, and it was not in my power to procure them at a cheaper rate. They were offered 20 per lb.

for all the Cantharides and much higher price for the Bark. They are not yet arrived from some place in Virginia where they were first landed. I shall examine them immediately on their arrival, and if good forward them on to Manheim, if they prove not good shall reject them, as the engagement is conditional.[137]

Then on April 4, Craigie wrote from Chester Town:[138]

I this day received a letter from Messrs. Lux & Bowley informing me, the waggons were arrived, but to their great surprise with only two packages of medicines, the others being seized near Williamsburg for the use of Virginia State. Those arrived contain but a very small share of any of the articles mentioned in your list and I believe none of the Bark and Cantharides. I shall immediately proceed to Baltimore and examine those two packages & if good send them on to Manheim, provided the price is agreeable.... I shall inquire into the circ.u.mstances of the seizure and endeavor to find out if there has been any unfair play which I can hardly suspect from the character of the Gentlemen.

Just prior to May 1, Craigie returned to Carlisle, where the "Elaboratory and Stores for the reception of the medicines &c.

belonging to the military hospitals" was established,[139] and complained that he did not find the medicinal store in the order which he expected to find it:

We have many important medicines but by no means an a.s.sortment sufficient for the Army. I speak only of what is now in store.

There are Medicines in different places of which I have no list.

Craigie further noted that Cutting had come up from Yellow Springs on May 1 to confer regarding plans for completing medicine chests, and would leave the following day for Baltimore where he obviously was going to try to purchase more drugs.

Craigie was puzzled by the establishment of a dispensing store at Yellow Springs, and asked whether or not the plan was

... to have the principle Store at Carlisle, where all the medicines shall be prepared, and the Chests compleated supposing the Genl. Hospitals will be more collected, and the number lessened. I would propose that an Apothecary attend each with a compleate Chest of Medicines; that the Surgeon & Physician Genl of the Army be attended by an Apothecary with good Chest, and the Regiments supply'd upon the Northern Plan. I would have an Issuing Store established at a convenient distance from the Army, from which the Hospital and Regimental Chests might occasionally be replenished.[140]

A sizable stock of drugs was finally received from Baltimore,[141] and a fairly good stock was brought down from the stores in the Northern Department, which were left well supplied by Craigie and Potts.[142]

An improved plan for obtaining lint from the Moravian Sisters at Bethlehem and Lit.i.tz was proposed by Dr. Brown,[143] and "the propriety of setting the gla.s.s works at Manheim agoing" was offered as a solution by Craigie for obtaining much needed vials.[144] Local manufacturing at Carlisle[145] and "in the Jersies"[146] was used as a source of volatile and purging salts.

Gibson records[147] that between April 19 and May 3, 1778, the commands of Generals Patterson, Leonard, Poor, Glover, Scott, and Woodward turned in their medicine chests to Apothecary Cutting at Yellow Springs, and that every regiment received a standardized field box containing a definite list and quant.i.ty of necessary drugs and supplies. However, it appears likely that the project started by Cutting and continued by Craigie was not completed until late June at the earliest.[148] The "invoice of those things thought essential for the protection and health of soldiers in the field or camp" presented by Gibson[149] is actually an "Invoice of a Chest of medicines &c.

compleated in the medicinal Store, N[orthern] D[epartmen]t for Thos.

Tillotson Esq."[150] Inasmuch as the plan used in the Northern Department was employed by both Craigie and Cutting, the items on this invoice may serve as a reasonably good picture of the medicine chests of '78 as compared with those of '76 (see page 130).

One of the reasons for better supplies at a time when other conditions were even worse than they were in 1776 is the fact that Congress was advancing sizable, if not always completely adequate, amounts of money for the cash purchase of supplies instead of seeking credit or expecting those responsible to procure supplies by using their personal money and waiting on Congress to reimburse them. During 1778, Congress advanced some $940,000 to Purveyor General Potts alone for the exclusive use of the hospital department, and these funds were in turn distributed to the proper medical procurement officers, including the apothecaries. It is significant to compare the sum of $1,095,000 provided by Congress in 1778 with 10,000 (about $27,000) which, according to Morgan, was the limit for medical and hospital supplies in 1776.[151] True, inflation had set in by 1778, and the value of money had declined greatly. For example, cantharides purchased from the Marshalls' apothecary shop in Philadelphia in 1776 cost 10 shillings per pound as compared with the cantharides Craigie purchased in Baltimore in 1778 at 20 per pound. However, the worst of the inflation was yet to come.[152]

In Summary

Initially the drug supplies for the American Revolutionary Army had come from stocks largely in the hands of private druggists. However, this source of supply was totally inadequate for a war that attained such proportions as the Revolution. Even if stocks of drugs in the Colonies had been far greater than they were, there is little reason to believe that shortages would not have developed. After all, a good many of the suppliers were Loyalists, and others were indifferent to the cause of American liberty. Even the most patriotic pharmacists were faced with a complete financial suicide, caught between a spiraling inflation and a Congress that had no money and only a promise for the future.

As if all these problems were not bad enough, the internal organization of the medical department of the army was so chaotic that, even if adequate supplies were available and if the almost insurmountable problems of communications and transportation were solved, it is almost certain that shortages would have developed at least during the campaign of 1776. Add to this the fact that any retreating army is subject to loss of supplies and the reasons for the shortages become very obvious.

The encouragement which Congress, through its Secret Committee, gave to private shippers for the importation of vital war materials offered little relief in the field of medical supplies. Importation was, of course, cut off from England, and France did not directly export any quant.i.ty of medical supplies, at least until 1778. American privateers found it much more profitable to prey on British shipping than initiating trade channels with countries which prior to the Revolution were prohibited from shipping directly to the Colonies. These channels of commerce did not develop extensively until well after the Revolution.

Hence the most immediate relief from medical supply shortages was provided by the American privateers. Drug cargoes from British prize ships, many of which were en route to New York, served as a most important source of supply, particularly in 1777 and 1778.

However, even with the most adequate supplies, compet.i.tion between different branches of the army and navy and the confiscation of supplies destined for Continental troops by state militias further encouraged inflationary trends.

The number of individual drugs mentioned in various inventories was considerable, as evidenced by the listing on page 130. However, of these, only about a dozen const.i.tuted the really critical shortages.

Heading the list of these "capital articles" was Peruvian or Jesuits'

bark, the same cinchona from which quinine was later discovered. Tons of bark were used during the Revolutionary War, and the price more than quandrupled between June 1776 and September 1777.

The most prominent group of drugs on the list of capital articles consisted of cathartics and purgatives. Jalap, ipecac, and rhubarb were the botanical favorites, while bitter purging salts (Epsom salts) and Glauber's purging salts were the chemical choices for purging.

Tartar emetic (antimony and pota.s.sium tartrate) was the choice for a vomit, and cantharides (Spanish flies) was the most important ingredient of blistering plasters. Gum opium was administered for its narcotic effects, while gum camphor, nitre (saltpetre or pota.s.sium nitrate), and mercury (pure metal as well as certain salts) were employed for a variety of purposes. Lint, a form of absorbent material made by sc.r.a.ping or picking apart old woven material, also often was short in supply.

Equipment shortages included surgical instruments and mortar and pestles for pulverizing the crude drugs. Gla.s.s vials for holding compounded medicines were also a supply problem, especially after essential drugs were again available.

Some of the shortages were eased, if not solved, by local manufacture. Lint was produced in large quant.i.ties in the Colonies, and gla.s.s vials were manufactured in numerous gla.s.shouses. Even local manufacture of the purging salts and nitre aided in eliminating shortages of these essential items, and at the same time initiated the first large-scale pharmaceutical manufacturing in America.

Numerous botanicals indigenous to the Colonies were widely employed in medicine of the period, and certain ones such as snakeroot (seneka), which was widely found growing in Virginia, would have been very scarce had not an adequate supply been immediately at hand. However, attempts to subst.i.tute other indigenous plants for scarce drugs like Peruvian bark were largely unsuccessful. There is no indication that hysop, wormwood, and mallows called for during the New York crisis were ever found to be suitable replacements for any of the capital articles. Wine apparently was more useful as a subst.i.tute for bark than the bark of b.u.t.ternut recommended by the _Lit.i.tz Pharmacopoeia_.

Peruvian bark, jalap, ipecac, camphor, opium, cantharides--these are the drugs which the American army physicians wanted, and these const.i.tuted the most serious shortage problems.

The medical supply problem was placed on relatively firm ground by the summer of 1778, having been established on the principles proven in the Northern Department under the guidance of Drs. Potts and Craigie.

Furthermore, the turning point in the war had been reached. Even before Washington's forces went into winter quarters at Valley Forge, Burgoyne[153] had surrendered at Saratoga, on October 17, 1777; and, before the cold bleak winter at Valley Forge was over, the treaty of French alliance was signed on February 6, 1778. The torments at Valley Forge proved to be the birth of a new Continental Army.

The War was still a long way from being over, and a variety of problems were yet to face the Continental Army. Inflation was yet to deal its hardest blow to the supply problem, but not even this could produce the chaos of 1776. The worst of the drug supply problem was over.

Contents of Army Medicine Chests

The following listing is an example of the contents of medicine chests ordered by the Continental Congress. The chest for the Pennsylvania 4th Battalion was filled for "Samuel Kennedy Surgeon" by the pharmacy of Christopher Jr. and Charles Marshall of Philadelphia in May 1776.

The medicines are listed on an invoice in the Marshalls' waste book in the possession of The Historical Society of Pennsylvania. The contents of the Northern Department chest, compiled in the Northern Department's "Medicinal Store" for "Thos. Tillotson Esq. Surgeon & Physician General to the Army," probably was filled by Andrew Craigie at Fort George in 1778. (_Italics_ denote capital article; asterisk indicates that the drug is mentioned in _Lit.i.tz Pharmacopoeia_.

Contemporary English names are in parentheses following the Latin listings.)

Pennsylvania Northern 4th Battalion Department Chest Chest BOTANICALS

*_Cort[ex] Peruv[ianum]_ (Peruvian bark; Jesuits' bark; or bark) 4 lb.

*_Pulv[is] Cort[icis] Peruv[iani]_ (Powdered Peruvian bark) 2 lb. Opt.; 6 lb.

2 lb. 2nd *_Pulvis Rad[ix] Jalapii_ (Powdered jalap) 2 lb. 2 lb.

*_Pulv[is] Rad[ix] Ipecacuan[hae]_ (Powdered ipecac) 8 oz. 12 oz.

*_Pulv[is] Rad[ix] Rhaei_ (Powdered rhubarb) 1 lb. 4 oz. 4 lb.

Rad[ix] Rhaei (Rhubarb root) 2 lb.

*Fol[ia] Sennae (Sennae or sena) 2 lb.

*Rad[ix] Gentian[ae] (Gentian root) 1 lb. 2-1/2 lb.

*Rad[ix] Seneka (Senega; rattlesnake root; or snake root) 1 lb.

*Rad[ix] Scillae Sict. (Squill; or sea-onion) 6 oz.