This week in Revolutionary War history, let’s check up on what was going on 250 years ago in and around the colonial Province of Massachusetts Bay. Last week, smallpox continued to spread among the Continental Army, beginning to be taken seriously by those in command. Reports out of Boston show a startling reality, as refugees flee the city. Thousands are sick on both sides, just as Martha Washington arrives to winter with her husband. Colonel Henry Knox sent George Washington a list of artillery pieces in Ticonderoga that will soon be on the way to the outskirts of Boston.

            On December 17, 1775, Knox writes to Washington from Fort George, New York. The colonel has made it down the long Lake George to the southern tip; using sleds! He says, “It is not easy to conceive the difficulties we have had in getting them over the lake owing to the advanced season of the year & contrary winds – three days ago it was very uncertain whether we could have gotten them over until next spring, but now please God they shall go.”

            He details the use of 42 sleds, pulled by oxen, leading thousands of pounds of artillery across the frozen lake. Also mentioning the difficulties ahead, he finishes, “I hope in 16 or 17 days to be able to present to your excellency a Noble Train of Artillery,” the grandiose title being that often used even today to describe Knox’s journey. He signs off the letter, saying, “There are some timid & some malevolent spirits who make this matter much worse – from the different accounts which I have been able to collect I have very little doubt that General Montgomery has Quebec now in his possession.” Far from the truth.

            At this time, around 1,200 Americans, led by Colonel Benedict Arnold and Brigadier General Richard Montgomery, are “dug in” outside Quebec City. Due to the frozen ground, they are not, however, able to dig trenches and to cover themselves or their artillery. They piled snow earthworks around themselves instead. The small size and insignificant number of cannons possessed by the Americans made a breach of the city’s walls practically impossible. On December 17, the British destroyed two American cannons from the city, leading to a pullback of forces. Times were dire, and time is of the essence. When the Saint Lawrence thawed, British reinforcements would arrive. Washington received no updates from the northern front at this time, as Arnold and Montgomery planned their next move.

            Also on December 17, Washington receives reports from spy Captain Richard Dodge that British supplies in Boston are extremely low. He says, “Sir I am credibly informed that the soldiers have nothing but the 4 pounds of pork & bread delt out to them.” That’s 4 pounds of pork per week. Not great. The next day, to add to that, the Continental Navy Captain John Manley of the schooner Lee captured the British supply ship Betsey before it arrived in Boston.

            On December 19, Governor Nicholas Cooke of Rhode Island wrote to Washington, expressing fear of the island’s capture. At the time, Rhode Island mainly referred to the island now called Aquidneck Island, with the colony’s main population center and capital being the trading hub of Newport. The city was the fifth most populous city in the 13 Colonies and the second most populous in New England after Boston. Cooke wrote from the much better defensible Providence, saying, “Should the force sailed from Boston be destined for Rhode Island I tremble for the Consequences, as the colony in its present exhausted state cannot without assistance defend the island.” Washington responded the next day, “I could not justify the sending of a regiment from these lines to you unless there was an apparent design of landing a body of ministerial troops on Rhode Island; at present, I do not think this is to be apprehended.” The general knows the state of the men in Boston and knows they will not be mounting an amphibious invasion from the city any time soon.

            On December 22, John Hancock of the Continental Congress writes to Washington. The siege of Boston has now lasted over six months, beginning the same day as the Battles of Lexington and Concord, April 19. That same day, Congress had passed a resolution giving Washington approval to assault the city. The resolution stated, “if General Washington and his council of war should be of opinion, that a successful attack may be made on the troops in Boston, he do it in any manner he may think expedient, notwithstanding the town and the property in it may thereby be destroyed.” Hancock adds to the general personally, “You will notice the last resolution relative to an attack upon Boston, this passed after a most serious debate in a committee of the whole house, and the execution referred to you, and may God crown your attempt with success, I most heartily wish it, though individually I may be the greatest sufferer.” He says that referring to the potential destruction of his property in the city.

This Week in Revolutionary War History

By Sam Bishop

About 20% of Americans 45 and older have osteoarthritis of the knees, a condition which does not kill you, but which decreases your quality of life.

            Osteoarthritis, by far the most common form of arthritis, is more than simple “wear and tear.” It does involve wearing away of the cartilage, the smooth “cushions” that cover the ends of the bones. It also involves the bone itself and the synovium, the lining of the joint.

            Obesity is a risk factor for osteoarthritis of the knees and hips, but recreational running is not – it may even be protective. Both sedentary lifestyle and very high volume competitive running do increase the risk.

            If you have it, what can you do to decrease your pain and be more active?

            Rule number 1 is to stay active. Exercise such as walking lubricates the knees and lessens stiffness. If you enjoy running, keep at it. You may find that running on grass is easier than pavement, and be sure to experiment with different shoes.

            In addition to aerobic exercise, strengthen your quads. Exercises such as straight leg raises with ankle weights and squats will build up the muscles that support the knee.

            Tai chi has also been found to decrease pain and increase quality of life.

            Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen can be very helpful, but have side effects on the stomach, kidneys and heart. If you use them, use the lowest dose that works for as short a time as possible.

            If you find yourself needing NSAIDs daily, ask your doctor for a prescription for a topical (gel or cream) NSAID, which is much safer. The only one available in the U.S. is diclofenac.

            If these measures are not adequate, injection of cortisone-type drugs into the knee will usually give quite a bit of relief. The problem with “cortisone shots” is that the relief is temporary, rarely lasting more than 2-3 months, and repeated injections contribute to worsening of the underlying arthritis.

            Hyaluronic acid injections are controversial. There are many trials comparing it to placebo injections and while the majority show benefit, many show no advantage of hyaluronic acid. Insurance companies may cite lack of proven benefit and refuse to pay for these injections. It does appear to be safe should you opt to try this.

            If nothing works and you are willing to have surgery, knee replacement is the ultimate choice. This has good results for most people, but not all. Before opting for surgery, it is critical that you are willing to commit to a vigorous physical therapy program. The surgery is the start, but not the end.

            To get the optimal benefit from a “total knee” (or a partial one), expect to spend 4 to 6 months of demanding PT; if you are half-hearted with your exercise program, you will be left with a so-so result. You will still probably have less pain than pre-surgery, but you will not have full knee motion.

            Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.

What Does The Doctor Say?

By Dr. Edward Hoffer

In the absence of flowers and leaves, let there be lights! Strung around trees and shrubs, wound around railings and arbors, adding sparkle to this special season.

            Lights are the most vibrant part of holiday apparel, filling the dark, empty void and making everything a lot less gloomy. Variations on the theme are as diverse as the gardens out there, ranging from a plain spotlight shining on a tree to the soft candle glow in a window to colorful extravagant shows that blink and pulsate into the night.

            As a kid, I was drawn to the latter style of holiday decorating – large and plastic and alive: Santa in his sleigh with his team of reindeer, Nativity scenes, snowmen, gingerbread people. … Let’s face it, these were the ones that you could see out of the steamy, rear car window! My parents’ sedate setup of a spotlighted wreath and colored bulbs on the shrubs paled in comparison. Of course, my tastes migrated in that department as they did in other things, softening to the point where I have a tendency to keep things simple.

            Maybe not as simple as my husband. Years back when I deigned to let him string the lights on the Christmas tree, I couldn’t help noticing that he began at the bottom, draping it with a certain caprice, and ignored the section that ran along the wall. “Er, aren’t you going to clip the light to the branches?” I asked. “And you can’t just leave the back naked!” Needless to say, I took over and did it my way. He didn’t seem to mind, relieved to go back to his football game. Since then, I am the stringer of the lights, something I rather enjoy.

            My children, over the years, have been wowed by Christmas lights – dating back to when I put up colored lights on a hemlock tree in the backyard each Christmas season. Until alas I recalled how the ladder sank into the mud one March as I de-strung them. Thenceforth lighting was scaled back of indoor candles, tree lights and a splash of lighting on the shrubbery out front that remains in place all year.

            Once when they were probably too young to appreciate such things, I brought my children to the shrine of Our Lady of La Salette in Attleboro. Volunteers work through the year to put the impressive Christmas Festival – which today is even more impressive – 400,000 to more than 1 million lights including over 100 new displays for the 2025 season, over 10 acres. That display is open until January 4, from 5:00 pm to 9:00 pm. The core experience of seeing the lights and the Nativity Museum costs nothing, making it a popular, accessible holiday destination.

            Even as we are carried along by the torrent of the present moment, in the midst of some perfunctory activity, memories surface unexpectedly, offering moments of joy… as I place the Santa Claus doll with the wonky arm (by now an antique) on the model sailboat as I do each Christmas, my mind goes back to our annual pilgrimage to the city of Boston (where the doll was first gifted to me.) I, perhaps 8 years old, joined my grandmother, great aunt and mother for our highly anticipated Christmas shopping spree in Boston.

            We would head from my grandmother’s in Uxbridge following the back roads through towns that included Holliston, Natick, Sherborn, Wellesley – through town centers, past old historic churches and town commons so much the fabric of New England small towns. We followed Route 16 and then onto Route 9 to Huntington Ave. and Copley Square. I would vividly remember the stretch up Commonwealth Ave. up to Boston Common where we would park before embarking on the stores that included Filene’s and Jordan Marsh. The three women were armed with their handwritten lists, and I was barely counter height, but very observant, watching as the lady salesclerks would assist the polite hordes of shoppers. The displays within the stores dazzled, and the crowds of people in their winter coats cast an indelible impression on this small-town girl. (At the time I of course had no idea that I would one day live and work in this same city.)

            I recall the drive through the small towns going in and the utter majesty of Commonwealth Avenue Mall with its elegant Back Bay brownstones set against the parklike backdrop. On the ride home, everything glistened prettily with lighting – streetlights, shop windows, residences, even the trail of taillights added to the beauty of the scene. By then I was tired of being dragged from store to store, but I carried the magic of having visited Santa’s Village and enjoyed a special lunch surrounded by my matriarchal womenfolk. Looking back, I see that it was a time of bonding, and our relationships only grew stronger. It was a special closeness – female, caring, and warm.

            As Christmas draws near and the days fill with hurried shopping and festive preparations, let us remember to pause. In the midst of the noise and motion, make space for stillness, reflection, and quiet moments of introspection, for these are the gifts that carry the deepest meaning.

            “And Mama in her ‘kerchief, and I in my cap, Had just settled down for a long winter’s nap” – from Clement Clarke Moore’s “’Twas the Night Before Christmas/A Visit from St. Nicholas”

The Seaside Gardener

By Laura McLean