Again we have been on the move, this time north to the small town of Carlisle, in the Pennsylvania wilderness.  Troops have been amassed here, for what purpose, I am not in a position to discuss, as no one has yet truly discussed it with me.  Clearly the French must be on the move again, however, I have not heard any full explanation as to our march here.

Upon arrival I was ordered off to the general hospital area, with a Doctor Bloodsworth, quite the knowledgeable gentleman from Virginia, near Williamsburg if memory serves me.  Together we have formed a formidable hospital, able to see all of the forces amassed without much delay or trouble.  Battallions from many different regions are arriving daily, and with them varying illnesses and melancholies, dropsies, and injuries that we have been tirelessly seeing to.  I dare say there’s been at least 2 nights I recall where we have been woken from sleep to ply our trade.

Doctor Bloodsworth has been most generous in providing me with some of the supplies I have been lacking, which are not easily obtained here on the frontier, which I am sure he will soon learn as well. Turpentine has been the most useful, but i do use it sparingly.  He has also provided me with additional Opium for which to make more laudanum, should the Men from Maryland be in the fray once again.

The most unfortunate case I have had thusfar while here has been one of the men who seems to have the symptoms of advanced consumption. While previously he had just been diagnosed with a persistent cough, he has started to spit blood more frequently.  He had been hiding it from his superior officers because of his sense of duty to King and Country, however, he ended up in my care when he passed out on the field during a troop assembly. I am most distressed to have to tell him that he will not be moving on with the troops, wherever we shall be on the march to next, but shall however be sent back to his home for treatment, which I hope for his sake will heal him and make him well enough again to fight.

Consumption is a horrible illness.  It begins with a simple cough, but then leads to blood in the spittle, trouble breathing, and if not treated appropriately, will lead to death, and a seemingly frightening death as well.  The body seems to waste away to nothingness, and the person can do naught but be attended to with comfrey tea and various poultices and balms, as well as bleeding in order to try to pull the humours back in order and restore the man’s spirits.  However, I am of a mind that perhaps there is more to this illness, as most of the individuals I have seen with this malady never seem to recover, and eventually perish as the illness assuages them.  A most distressing illness, if I dare say.  It truly makes you wonder what is on that person’s soul, that would keep that illness assaulting them.  Few things I’ve seen but a scar on the soul as well as the imbalance of humours seems to kill as harshly.

With all of the various battalions and regiments here, there has been the common practice of an Officer’s Mess for meals, and I have been so honored as of late to be allowed to dine with these Gentlemen.  At the fort, there is little ceremony to be stood upon, so it is nice for a few moments to have some Civility about, especially with such men of distinction.  Saturday night I had the great honor to dine with Mr. Washington, Commander of the Regiment of Virginia, as well as our fine Captain, and other Commanders, Sargents, etc.  The food was exceptional compared to our meager meals at Cumberland, and the wine was strong and full of flavor.  It was a much welcomed change, but even  as we enjoyed each other’s company, the somber cloud of why we are all brought together still hangs over the candles and dining table.  Many late night discussions have been had about if we are winning or losing this great war, as well as the general questions we all seem to ask ourselves in our quite moments.  What is Parliament saying about this engagement, when will more supplies and troops arrive, and what will our next move be?  There are already rumblings that we will be sent home for the winter, and I am curious as to the validity of those rumblings.  It would be nice to return to the shop for the winter months to assist Charlotte, as well as to make sure the books are in proper order and perhaps take on a partner and subsequently an apprentice.  However, that would then make me wonder if I should return to the Fort when spring begins to come, and I’ve no doubt that Charlotte would make protestations to that effect, strictly for her fear of my death.

The candle grows dim, and I must yet check on the Consumption patient once more tonight before retiring fully to my  slumbers.

I returned to Fort Frederick last week to check on the patients from the past engagement, who were recovering much faster than I could have anticipated.  I attribute it to the fresh medicinal supplies and the deft hand of the fine Midwife who had been checking on them.  A few minor bleedings for various ailments, and I was more than ready to return to Cumberland, where activity seemed to be in place for us to be on the march again soon.

However, a unit of men who had gone out on a ranging mission returned with a request from a Mr. Rohrer, who owned Hagers Fancy- a tract of land not far from the Fort, with a request for our Surgeon or Doctor to come to his house to see a daughter who seemed to be dreadfully ill with an unknown malady.  She had not been roused from her bed for almost a weeks time.  Captain Hager, who previously owned the house, is the lead of a ranging unit in these localities, and sent a letter to me personally with the request.  Most honored, I received dispensation from our Captain to take 2 of his men with me, and my satchel of equipment and essential medicines, and headed to the house with Captain Hager.

The young lady was in a dreadful state.  She was pale and gaunt, and had a severe ague.  Immediately I bled several ounces, while I tried to assess her other states. Hot water was put upon the fire, and Pennyroyal tea was mixed for her.  In her weakened state, her mother provided me with a small pap boat from which to provide her the elixir.  I imagine it was being used for the infant she had, but it proved most useful to me at this moment.  The girl, Elizabeth she was called, had a primary complaint of great gripes in her stomach, and had lost considerable weight in a short time.  I deduced that she had a great worm, and immediately called for another tea to be made with Wormwood, which I’ve had much success with in removing worms from a person.  Some rest was then to be had for her, and the men and I decided to stay for a night or two at the behest of  Mrs. Rohrer.  She was a most gracious hostess, and fed us a great meal of roasted chicken, cheese, fresh bread, and vegetables.  It was a most filling meal and a great different from the sparse rations we receive at the Fort.

Saturday I believe it was, I was treating the young Elizabeth with another dose of bleeding and wormwood, which seemed to be working, when a great commotion was made outside of the house.  Once finished with my patient, I headed out to see what the commotion was.  Several savages had arrived at the house, with a horse laden with many furs, hides, and other goods for trade.  As I stood in the doorway watching, Mrs. Rohrer explained to me how they tended to come to the house to trade with the locals pretty regularly.  As they arrived, I saw some of the other local farmers and land owners come through the woods on another path, carrying some of their own goods to trade with the savages.

I watched intently, suprised at this action I hadn’t yet seen here on the frontier.  I had only heard of the savages raiding and wreaking havoc on behalf of the French, but here were peaceful Savages!  My soldier escort from the fort was as confused as I- they stood off to one side, bayonets fixed, waiting cautiously should the savages try to do harm to the landowners.  Mr. Rohrer went to the head of the natives, and showed them a strand of colored beads.  The savages murmered in their language, clearly enamored with the little pieces of glass or shell or what have you, and one of them pulled a sizeable beaver’s hide from the pack on their horse’s back.  He pointed to it, then back to the beads in Rohrer’s hand, to which Rohrer shook his head and made a finger gesture of 2.  He clearly wanted 2 hides for the precious strand of color.

The Indians looked at each other, conversing low again in their own language.  It was interesting in sound, as I could not make out any word similar to our own.  Even with the French language, there seem to be some words in common, but this language was completely foreign to my ears.  Finally the man who was clearly the leader of this trading party, then took another hide- this one a bit smaller but still a beautiful beaver fur, from the pack, providing both to Mr. Rohrer.  He, in return, handed the beads to the man, then they shook hands in a strange manner- grasping each others forearms and nodding approvingly.  This must have been a signal for the others, for then they began to pull packs out in earnest, and the other local dwellers brought their goods up as well to trade.

I watched from the house for a few moments, then a hide of deer, or perhaps elk, caught my attention.  It was just a good size for a new apron to be made, and so I searched my pockets and satchel for anything that might prove trade worthy for the savages.  In the bottom of my satchel I happened upon one small piece of eight, probably a pay from a house call made in months past when I was starting the shop in Frederick.  I saw some of the local men trading pieces of silver for the goods they required, mostly hides as winter is approaching, and I thought to do the same.  So I joined in the Fray around the natives, and began to eye the hide.

One native saw me approach and watched me almost as intently as I watched them.  Clad in a simple pair of leggings, cloth, and a white shirt, he seemed to stand out from his brothers.  A single great locke of black hair flowed down his back, the rest of his head being completely shaved, he stood firmly as he watched the goings on.  His eyes grew wide when I showed him the small silver piece, and then I pointed at the piece of hide I wanted.  He picked it up, looked at it for a moment, and then looked at me, almost sternly for a moment.  He then held the hide out for me, and I took it, then handing him the small piece of silver from my hand.  He nodded and grunted, smiling in approval, and then turned to another man standing near me who was eyeing up some other piece of animal they had on hand.  So now I have a nice piece of deer hide with which to make myself a new apron, and perhaps a cover for one of my knives.

After the natives left, some of the farmers and locals stayed behind, they had heard a doctor was about and did ask me for more services.  So that evening I did several bleedings, and basic diagnosis of minor illnesses and melancholies of the local people. I didn’t have to use any of my medicines for them- most of them know the area and can provide themselves with them, but they did offer me items in trade for my services.  I did get a very nice pair of gloves, and some more fresh herbs for my stores for my trouble.  Again Mrs. Rohrer did feed us well, and the next morning we began our return to Fort Frederick, the worm having been extracted from her daughter early that morning.

The Captain, upon our return, has stated we shall be departing again at once for points north before returning to Cumberland.  Our battalion has been called to rendezvous with others in the Pennsylvania territories for some reason yet to be explained to me.  But as we are called, so shall we go.

Perhaps its been the recent exertions of the men, or the rumors that the French are on the move again, but Fort Cumberland has been bustling since we returned from Fort Frederick earlier this week.  The days have passed so quickly, that I have not even had a few minutes of leisure time to sit and update my notes on my travels with the forces.  Tending to the wounded and sick from the trip back, as well as those who took ill during my absence has been my priority, and thanks to the change in the weather here, it seems as if the humors have taken to moving improperly in many of the men.  However, today things are calmer, as most of my patients are at rest presently, and again the Matron has taken good care with her ministrations to give me leave to enjoy my afternoon in peace.

Events at Fort Frederick were much busier than anticipated.  It turned out that the rumors of French soldiers in the wood was most accurate, and a small unit of our men met them and some savage raiders in the woods due west of the fort’s walls while on patrol.  The skirmish was short lived, but not without casualty and injury. I dare say some of the French soldiers are quite good shots, and took out several of our men during the fray.  I was able to spare a few, with one amputation, one bullet extraction, and the setting of one broken bone where a man tripped over a log when they gave chase to the retreating foes. The bullet extraction and amputation did stay behind under the ministrations of the good midwife at the Fort until they are much more resolved in constitution, and she sends correspondence regularly on their status.  I shall return there again in a week or so’s time with the ranging unit to check on their status and see to anyone else there at the time.  Most of the farmers have returned to their fields as the Indians will not come close again to raid for some time, and it is getting close to the harvest season for them.

One afternoon while there, I myself came down with a bit of the melancholy, with a mild fever and some tiredness that was unbecoming of me, so I did take a brief respite from my duties to bleed myself and rest.  I only bled about 4 ounces, but it seemed to be enough to bring me back into better humours.

Bleeding, I truly believe, is the greatest cure for almost all illnesses, even as I prescribe the apothecaries medications, and ply Boils upon the men.  It seems to resolve most minor melancholies faster than anything else I could offer them, and in many cases of a more serious nature, it does assist greatly the medication prescribed.  It is truly amazing to me how easy the humours do become even the slightest bit off, and require this process, as out of a hundred men, I will see about 40-50 per day for the process.  I should write to Charlotte and have her send to me a new set of lancets to augment my old pair.  They are starting to wear, which makes it hard to cut the skin open appropriately to retrieve the necessary amount of blood.  I dare say, I have often thought of even using my shaving razor to do so, as it does hone better than these flimsy pieces of steel, but think better of it because of that very sharpness.  I would not do well should I bleed someone to death!

A Mrs. Riley, one of the farmer’s women with a fairly sizable garden saw fit to augment my meager supplies of herbs this trip to the fort as well with additional supplies of wormwood, feverfew, and chamomile, which will be of most use here.  I have hung them up in the hospital to continue keeping them in a dry and clean state, to pull from when necessary, and have added them to the records of my medicinal stores.  I have heard that some doctors have been recently accused of stealing from their own stores and accusing others, and I dare say I do not want to be one of those to be accused.  i must be diligent in my recordkeeping, lest I find myself accused of such impropriety.
As quickly as it has begun, my leisure time has surely left for now, and I must attend to tending to the shaving of the men this day.

We arrived at Fort Frederick late this past evening, barely being settled in the barracks there before a great rainstorm barraged us.  Today I will be attending to the men who are stationed here with their general maladies, as well as receiving the meager provisions for medicines sent from Annapolis towne.  The trip from Cumberland was mostly uneventful, if not long.  At night I would sit around the fire with the enlisted men to sing and tell stories of home, but as I have no wife to speak of, nor children to reminisce about, I was mostly a listener, rather than a teller.

Some of the locals around the Fort have heard rumors of a French troop wandering the woods with some of the Indians who raid these regions.  They have sought solace in the Fort, in anticipation of the raids that will surely follow if the rumors are true.  They are gracious people, offering to cook and do laundry and other tasks for the soldiers here, and for myself in exchange for medical services.  One of the good ladies has offered her services as a midwife and general herbal woman to provide me with additional supplies from the woods surrounding the fort, if I’ll just look at her son’s condition- I believe it to be a whooping cough, but it could possibly be consumption.  The supplies she’ll be gathering will be a welcome relief however- some of these local herbs seem to be more effective than what I have been receiving from England.
I dare say that I hope the rumors are true- what a show it would be for the French if they were to show up in the protectorate of the Fort, only to find an extra detachment of men to defend it.  And for myself, it would be exciting to deal with some true surgical injuries.  I find myself growing nervous as to my skills, not having been in practice of them for some weeks, with only minor illnesses to care for.  I should mentally go through the tasks of bullet extraction, and make sure my tools are at the ready at the hospital.

For bullet extraction, I will have need for my probe, forceps, extractor, needles, and tow and bandages.  In most cases, I’ve found that my fingers will suffice for extracting the bullet and whatever detritus has followed it in- bits of shirt, tree, grass, et cetera, but at times the probe and forceps are necessary to find the offending bit of lead. Once removed, I can then fill the wound with tow, which the patient will have to pull a small bit out of daily, then put a minor stitch in the wound, depending on the size.  A bandage to stem the bleeding, and then a course of rest, and a sparse diet of broth and beer for a week should have the soldier on the mend.   If the bullet is particularly lodged deep, then the bullet extractor- a great iron screw which I insert into the wound, and work into the bullet to grasp it and pull it out, is required.  In those cases however, I find more complications and infections.  It seems rather odd for it to be so, but I would imagine that the screw may interfere with the humours in a way that has not shown itself in more general situations.
It does amaze me for the strong constitutions the men have when I am performing these procedures upon them- even their mates who do hold them steady while I ply my ministrations upon them- nary a one will look pale or feel faint of heart.  In many cases, the men I am extracting the bullet from do have a fit of hysterics with screaming and crying, but for the pain they are experiencing at that point, I do have a sympathy for.  I do not use the Laudanum as liberally as some of my counterparts, but I do dose appropriately to try to ease the suffering of the wounded man.  However, some men do faint and lose their consciousness before I ply them with the Laudanum, which does make it ever so easy for me to finish my work quickly without struggle.
I have been fortunate as of yet to only have a few deaths under my care, but I tend to not blame myself- rather to blame those who are causing this war to happen, which is truly the real cause of the surgeries I am required to perform.  I wonder if those Surgeons in the French Employ have a similar outlook, and blame us as we blame them?

The Captain has just sent his steward for me to come to his Quarters for he has a bit of the melancholy about him.  I must take my bleeding implements with me.