Caregiving, Crisis and Coercion in the American Revolutionary War

Abstract

This dissertation uses the health crisis of the American Revolutionary War to interrogate the coercive labour dynamics underpinning care work in early America. It examines the Continental Army’s efforts to utilise existing coercive labour regimes (including enslavement, indentured servitude and gendered wage work) and military medical structures inherited from the British Army to provide nursing care for sick and wounded American soldiers. Between 1775 and 1783, the conflict’s violence and disease produced upwards of thirty thousand sick and wounded soldiers. Each case of illness or injury could result in days, weeks or months of care, requiring the sustained labour of caregivers. Simultaneously mundane and urgent, intimate and dangerous, care work underpinned the very survival of the army. Though historians of both medicine and war increasingly recognise the impact of health and disease in the Revolutionary War, few linger on the dynamics and social, political and medical implications of the basic care work that underpinned medical practice – including intimate interactions with a patient’s body, administering medicines, sourcing heat and water, changing linens or emptying chamber pots after evacuative treatments. The activities of Continental Army nurses, for example, are usually summarised fleetingly with three verbs: ‘washing’, ‘cooking’ and ‘attending’ the sick. A crucial question is buried beneath the archival fragments of their lives: under what social conditions were caregivers motivated or compelled to perform the gruelling labour that few of us want to consider? The Revolutionary War, as a social and medical crisis, offers insight into the usually opaque labour dynamics of bodily care for the sick. Focusing predominantly on the ‘care communities’ of Philadelphia and rural Pennsylvania as case studies, the dissertation demonstrates the dominance of informal community care in early American healthcare, but argues that the flexibility and reciprocity of these localised care networks was facilitated by coercive labour regimes.