Disease ruled the battlefield regardless of the weapons combatants wielded, and the number of troops only compounded its power to kill. Thus, as Erica Charters's Disease, War, and the Imperial State: The Welfare of the British Armed Forces during the Seven Years’ War argues, the health of combatants shaped and drew concern from the British empire economically, racially, politically, and morally. Focusing on just under a decade of war, the scope of her book is impressive, encompassing the British state's reaction to disease in soldiers and sailors across the world on all the major fronts of the Seven Years’ War. She traces the British response to disease during the war, arguing that the welfare of British combatants fashioned the nature of British imperial authority. Symbolized by Edward Penny's The Marquis of Granby Giving Alms to a Sick Soldier and His Family (1764), Charters argues, the welfare of soldiers and sailors shaped military strategy during the war, demonstrating that contemporary medical theory was idiosyncratically combined with various cultural practices on each war front in hopes of promoting healthier troops.

Charters discusses the fact that the British state depended upon the welfare of British combatants, examining the ways in which their health equated capital—socially, politically, and actually. She argues with clarity that partisan politics understood the link between death and disease during war and that their cognizance of that idea maintained a certain political reality that the welfare of the troops mattered to the administration's success. She writes, “Because disease was widely recognized as resulting from administrative failure and political weakness, this study is concerned with the role of political debates and public opinion concerning war policy and hence, focuses on representations and reports of military operations in both the colonies and Britain” (5). Like Penny's depiction of Granby, her argument is at its best where the rubber meets the road, in her demonstration of the organization and implementation of welfare to soldiers and sailors from the commanding officers. Though the state clearly garnered social and political power through their lip service of the troops and benefited deeply from the spoils of war, Charters argues that the state was only able to “portray itself as a credible and just imperial authority” (5) through the sentimental and medical measures of military leaders.

As such, Charters argues that the British state had a major role in shaping eighteenth-century medicine and scientific innovation. For example, in chapters 1 and 2 she examines the North American and West Indian colonial campaigns, which required distinctly different medical methodologies and theories in response to tropical climates. The raw statistical data derived from Havana in 1762, for example, demonstrated that by October most of General George Keppel's (3rd Earl of Abernarle) troops were sick and most of the fatalities were from sickness. This led to future developments in medical reform, especially in improved hygiene. Additionally, “[t]racing the details of medical care demonstrates that British officials were willing to expend significant resources on the health of the armed forces, informed by contemporary medical knowledge” (84). Her analysis demonstrates that the British state responded to differences of climates across the world and the variances in combatants like an Indian sepoy or a British regular, and it was those responses that led the state to intentionally control its colonies with medical initiatives in future conflicts.

Perhaps her most profound, if not overarching, argument is that the British state's strength and success was predicated upon “its ability to portray itself as a credible and just imperial authority” by addressing the public demand for the welfare of its armed forces. She writes, “Medicine is used to assess the extent to which authorities were willing to invest time, energy, and resources in the welfare of the armed forces, regardless of whether modern biomedicine vindicates the methods of eighteenth-century medicine” (6). She gathers her fascinating, diverse, and rich British-based research in order to examine it under the assumption that the British state's use of contemporary medicine was a sign of the state's concern for welfare. “The care of the British state for the welfare of its armed forces was thus not only a sentimental response, but also a pragmatic effort designed to ensure victory” (199). Her argument is convincing: eighteenth-century warfare was an important cog in the process of state formation and its global scale in the Seven Years’ War demonstrates the complex task of managing manpower under siege by virulent disease, driven by public opinion, and complicated by political opposition.