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Williamson was born in Chester County in what was then the frontier region of Pennsylvania. His fragile health as a youth weighed against his beginning a career in the family's clothier business. His parents instead sent him to a private academy and, in 1754, to the College of Philadelphia (today's University of Pennsylvania). Williamson graduated in the school's first class[1], on May 17, 1757[2], five days before his father died[3]. After teaching Latin in Philadelphia Academy, Williamson moved to Connecticut and obtained a preacher's license, but factional disputes among the local clergy and a resurgence of ill health led him to abandon a career in the ministry. Upon completing a master's degree at Penn in 1760, Williamson joined his alma mater's faculty as a professor of mathematics.

In another career shift four years later, Williamson turned to the study of medicine. Armed with a degree from the prestigious University of Utrecht in the Netherlands, he returned to Philadelphia to open a private practice. At the same time, he pursued a number of independent scientific and educational projects, and his work in these areas eventually led to membership in the American Philosophical Society as well as acclaim in Europe's intellectual circles.

Interest in science and education indirectly led Williamson to politics and the Patriot cause. Sailing for England in 1773 to raise funds for a local educational project, Williamson stopped en route at Boston. There he witnessed the famous Boston Tea Party, in which Patriots dressed as American Indians destroyed a cargo of tea in protest over a newly enforced Parliamentary tax on imported commodities. On reaching London he was summoned before the Privy Council to testify on this act of rebellion and on colonial affairs in general.

Williamson came of age politically during this encounter. In response to questions by Council members, who were in the process of formulating punitive measures against Massachusetts, he bluntly warned that repression would provoke rebellion. He then went on to express the argument that was becoming the core of the Patriot position: Americans were entitled to the full rights of Englishmen, including representation in the decisions of the English government. This testimony brought him to the attention of other Americans in London. A mutual interest in scientific matters cemented a solid working relationship with Benjamin Franklin, and Williamson soon found himself joined with the famous American scientist and others in appealing for support among those Englishmen who, in opposition to their own government, sympathized with American claims.

Williamson continued on to the Netherlands where, taking advantage of the cover afforded by his attendance at meetings on scientific and educational subjects, he organized the publication of pamphlets and other papers that supported the Patriot cause. While there he learned that the colonies had declared their independence. Narrowly avoiding capture at sea, he rushed back to Philadelphia in early 1777 and volunteered for service in the Medical Department of the Continental Army. The Department had no opening at that time, so Williamson decided to form a partnership with a younger brother to import medicines and other scarce items from the West Indies through the British blockade. Believing that he could best contribute to the war effort by using his contacts and reputation in this manner, Williamson made Edenton, North Carolina, his base of operations. Settlement in North Carolina soon led to his establishing a medical practice to serve the planters and merchants of the region.

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