"In his waning days as an artillery captain, Hamilton confirmed his reputation for persistence despite recurring health problems. He lay bedridden at a nearby farm when Washington decided to recross the Delaware on Christmas night and pounce on the besotted Hessians drowsing at Trenton. Hamilton referred vaguely to his ‘long and severe fit' of illness, but he somehow gathered up the strength to leave his sickbed and fight." (Alexander Hamilton by Ron Chernow)
Alexander Hamilton's health experiences during December of 1776 were familiar to many of the soldiers of the American Revolution. Disease/illness accounted for more loss of life to the Continental army than battle casualties — estimated at 10,000 to 6,500 respectively. Doctors saw a variety of illnesses from dysentery to smallpox and everything in between. The common problems of malnutrition and exposure could have fatal results to soldiers on fatiguing marches and in camp environments. Though the military tried desperately throughout the war to regulate cleanliness of camps and bedding as well as provide what was considered a balanced diet in the form of rations, keeping the camps supplied with a proper diet and clean and substantial clothing was difficult throughout the War's duration. In this environment, diseases ran through the camps at an alarming pace.
The medical treatment/official medical department in the army was still being organized and fully developed in the early part of the Revolutionary War. Each soldier's experience with medical treatment may have been different depending on where they were and who was attending them. In general, some soldiers were treated in their own regimental/brigade hospitals along with other individuals they knew from their units. This hospital environment was usually set up in a local home or community near the army's encampment. (Local citizenry could also have taken in a soldier or two, simply aiding a fellow human being and without being designated as a "hospital" location.) Other soldiers were sent to an official hospital/general hospital like the one that was set up in Yellow Springs, PA, during the Valley Forge encampment. This type of hospital treated all regiments and illnesses and was set up for longer term care. These types of hospitals (though not specifically the one at Yellow Springs) could be dreaded places to recuperate as contagious diseases, over crowding, lack of supplies and often lack of cleanliness made the mortality rate higher in the hospitals compared to the other types of care offered. Many soldiers were sent to a type of "flying hospital" which treated soldiers from various regiments near the location of a battle very similar to the field hospital we know today. After being treated in a field hospital, soldiers could return to their unit, be transferred to a general hospital or be accepted into a type of "invalid corps."
As the hospitals differed, so did the types of medical practitioners. Doctors had various degrees of training during this time. Some were well known physicians who had studied in Europe and continued working under the best surgeons in the colonies in their day such as Dr. Benjamin Rush. Rush had attached himself to the Philadelphia Associators and assisted with medical treatment at the Second Battle of Trenton and Princeton. There were others like Dr. John Cochran who had apprenticed with a Lancaster doctor in the Colonies and served as a surgeon's mate during the French and Indian War giving him vast experience in battle wounds. Cochran joined the army as a volunteer as Washington's troops retreated across New Jersey in 1776 and crossed the Delaware River in December. Both Rush and Cochran, known to be part of the medical department during the Crossing and subsequent battles, went on to great notoriety in their field. Other doctors had received little training and simply learned on the job.
The Thompson Neely House of Washington Crossing Historic Park was one of the local houses used for medical treatment of sick and convalescing soldiers during the winter campaign of 1776/1777. The use of the home can be considered along the lines of a regimental/brigade hospital as it met a specific need at a specific time and was not set up as a permanent hospital location nor as a hospital to take those with immediate battle wounds. It may be reasoned that it was the hospital attached to Lord Stirling's brigade. (A regimental hospital is not to be confused with a regimental headquarters. No documentation states that Lord Stirling had his headquarters at the Thompson-Neely House.) The home was used prior to Washington's crossing of the Delaware to care for ill soldiers. Some of the soldier's died during the encampment and were buried near the house. A Captain James Moore of the New York artillery is the only known soldier to have been buried there. The total number of soldiers treated and or buried at the home is unknown.
After the first Battle of Trenton, James Monroe and William Washington, of Lord Stirling's Brigade, were believed to have been brought back to the Thompson-Neely House to heal from the wounds they received in battle. Immediately after their wounding, they were treated in the flying hospital by Dr. Cochran and a Dr. Riker. James Monroe, according to tradition, had met Dr. Riker on the road to Trenton where Riker saw the army passing and joined the march. He supposedly saved Monroe's life from his battle wound and was held in high esteem by the would-be President for life. (Years later, Monroe was said to have searched for Dr. Riker or his descendants to honor the doctor's kindness to Monroe, but neither Dr. Riker nor any descendants were ever found.) Unable to remove the ball that pierced him, Monroe lived with the reminder of the Battle of Trenton for the rest of his days.
A risk of infection from wounds is still a concern today, but in the 18th century, gangrene and cross contamination were highly likely. However, as the military as a whole increased their sanitary conditions, discipline, and organizational skills, the mortality rates in the hospitals did decline in comparison to the earlier part of the war. A strong small pox inoculation initiative by General Washington also accounted for a lower mortality rate. Trenton, Newtown, Valley Forge and Morristown can all claim to have been used as inoculation sites for the soldiers. (Inoculation in the 18th century was highly controversial and innovative. The Continental Army was an excellent case study to show the benefits of this newer form of preventative medicine in the colonies.) Also, in the earlier parts of the War, as many soldiers left their homes/regions for the first time, they were highly susceptible to diseases they had never before encountered. With the duration of the war, it is believed that soldiers began to naturally increase their immune systems and thereby built-up a tolerance to some of the diseases that had earlier put the army in dire straits.
With this in mind, one can only imagine the duress of the civilian population as the soldier's came through their area often bringing diseases that were not common to their region and potentially infecting an entire community. Though the concept of germs did not exist in the 18th century mind, they did know that diseases could be transferred from one person to another. As no known documentation exists as to how the Thompsons and Neelys viewed the soldiers in their area, we cannot truly understand how they viewed this use of their home by the army. However, their story would not have been an isolated tale in the Bucks County region during the winter of the Crossing of the Delaware River.