The
Marine-Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the
U.S. Merchant MarineThe United States Merchant Marine refers to the fleet of U.S. civilian-owned merchant vessels, operated by either the government or the private sector, that engage in commerce or transportation of goods and services in and out of the navigable waters of the United States. The Merchant Marine is...
, U.S. Coast Guard and other federal beneficiaries.
The Service was created by
the actAn Act for the relief of sick and disabled seamen was passed by the 5th Congress. It was signed by President John Adams on July 16, 1798. The Act authorized the deduction of twenty cents per month from the wages of seamen, for the sole purpose of funding medical care for sick and disabled...
of the 5th United States Congress, which was signed into law on 16 July 1798 by President
John AdamsJohn Adams was an American lawyer, statesman, diplomat and political theorist. A leading champion of independence in 1776, he was the second President of the United States...
. The Act required the Department of the Treasury to "provide for the relief and maintenance of disabled seamen." This Act led to the formation of several loosely-controlled hospitals at sea and river ports all across the United States, which was officially the Marine-Hospital Fund. The Act specified the revenue for the Hospital Fund to come from the merchant seamen. Merchant seamen that used the early hospital fund hospitals were charged "20 cents per month." This series of hospitals to care for merchant seamen was based on the British practice of establishing hospitals to care for sailors and merchant seamen. The British established their first hospitals in 1588, shortly after their victory over the Spanish Armada. The Marine Hospital Fund was a unique and early mechanism to provide the first
publicly-funded health carePublicly funded health care is a form of health care financing designed to meet the cost of all or most health care needs from a publicly managed fund. Usually this is under some form of democratic accountability, the right of access to which are set down in rules applying to the whole population...
and disease prevention federal agency in the
United StatesThe United States of America is a federal constitutional republic comprising fifty states and a federal district...
.
Following the
Civil WarThe American Civil War was a civil war fought in the United States of America. In response to the election of Abraham Lincoln as President of the United States, 11 southern slave states declared their secession from the United States and formed the Confederate States of America ; the other 25...
, public outcry and scandal surrounded the Marine Hospital Fund. In 1869, Dr.
John Shaw BillingsJohn Shaw Billings was an American librarian and surgeon best known as the modernizer of the Library of the Surgeon General's Office of the Army and as the first director of the New York Public Library.-Biography:...
--a prominent Army surgeon—was appointed to head an investigation of the Marine Hospital Fund. Dr. Billings found the hospital fund to be inadequate and completely unorganized. In 1871, the Marine Hospital Fund was formally reorganized as the Marine Hospital Service, under the direction of Dr.
John Maynard WoodworthJohn Maynard Woodworth was an American physician and member of the Woodworth political family. He served as the first Supervising-Surgeon General under U.S. president Ulysses S. Grant, then changed to Surgeon General of the United States Marine Hospital Service from 1871 to 1879.-Early...
. Dr. Woodworth was appointed to the Service as "Supervising Surgeon." He reorganized the service into a disciplined organization based on his experience in the Union Army as a surgeon. Dr. Woodworth required his physicians to be a mobile work force stationed where the service was in need, and he mandated the daily wear uniforms. This eventually led to the creation of the modern-day
Public Health Service Commissioned CorpsThe United States Public Health Service Commissioned Corps is the federal uniformed service of the United States Public Health Service and is one of the seven uniformed services of the United States....
. Dr. Woodworth, using Army-style heraldry, created the Marine Hospital Service fouled anchor and
caduceusThe caduceus is the staff carried by Hermes in Greek mythology. The same staff was also borne by heralds in general, for example by Iris, the messenger of Hera. It is a short staff entwined by two serpents, sometimes surmounted by wings...
seal which is used to this day by the Public Health Service. In 1873, Dr. Woodworth’s title was changed to "Supervising Surgeon General," a forerunner of the modern-day office of
Surgeon General of the United StatesThe Surgeon General of the United States is the operational head of the Public Health Service Commissioned Corps and thus the leading spokesperson on matters of public health in the federal government...
.
It was the point of origin for the Public Health Service and the
Public Health Service Commissioned CorpsThe United States Public Health Service Commissioned Corps is the federal uniformed service of the United States Public Health Service and is one of the seven uniformed services of the United States....
of the present-day Department of Health and Human Services, and current Operating Divisions (OPDIV) and Staffing Divisions that include the
National Institutes of HealthThe National Institutes of Health are an agency of the United States Department of Health and Human Services and are the primary agency of the United States government responsible for biomedical and health-related research. Its science and engineering counterpart is the National Science Foundation...
, the
Centers for Disease Control and PreventionThe Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
,
Indian Health ServiceIndian Health Service is an Operating Division within the U.S. Department of Health and Human Services . IHS is responsible for providing medical and public health services to members of federally recognized Tribes and Alaska Natives...
, and a host of other federal-level health programs. The Marine Hospitals, as their name suggests, were hospitals constructed at key sea and river ports across the nation to provide health care for merchant marine sailors. Aside from the well-being of these sailors, the hospitals provided a key monitoring and gate-keeping function against pathogenic diseases.
As the nation grew, the scope of Marine Hospital Service's scope of duties grew to include domestic and foreign quarantine and other national public health functions. In 1902, the Marine Hospital Service was renamed the "Public Health and Marine-Hospital Service." In 1912, the name of the service was changed to the Public Health Service to encompass its diverse and changing mission. Over time, the hospitals of the service were also expanded to include research and prevention work as well as the care of patients. Aside from merchant seamen, members of the
militaryA military is an organization authorized by its greater society to use lethal force, usually including use of weapons, in defending its country by combating actual or perceived threats. The military may have additional functions of use to its greater society, such as advancing a political agenda e.g...
, immigrants,
Native AmericansNative Americans in the United States are the indigenous peoples in North America within the boundaries of the present-day continental United States, parts of Alaska, and the island state of Hawaii. They are composed of numerous, distinct tribes, states, and ethnic groups, many of which survive as...
, other federal beneficiaries, and people affected by chronic and
epidemicIn epidemiology, an epidemic , occurs when new cases of a certain disease, in a given human population, and during a given period, substantially exceed what is expected based on recent experience...
diseases found a source for health care in the PHS and its hospitals.
The hospitals themselves were, by the middle of the 19th century, fairly imposing and architecturally grand structures in many cases. As long as ample federal funding was available for their construction, these hospitals were impressive examples of government-provided health care. The hospitals of the early 20th century in major port cities such as
New OrleansNew Orleans is a major United States port and the largest city and metropolitan area in the state of Louisiana. The New Orleans metropolitan area has a population of 1,235,650 as of 2009, the 46th largest in the USA. The New Orleans – Metairie – Bogalusa combined statistical area has a population...
,
San FranciscoSan Francisco , officially the City and County of San Francisco, is the financial, cultural, and transportation center of the San Francisco Bay Area, a region of 7.15 million people which includes San Jose and Oakland...
, and
SavannahSavannah is the largest city and the county seat of Chatham County, in the U.S. state of Georgia. Established in 1733, the city of Savannah was the colonial capital of the Province of Georgia and later the first state capital of Georgia. Today Savannah is an industrial center and an important...
displayed ornate architectural detail and reflected many of the changes sweeping medicine at the time. During the
NixonRichard Milhous Nixon was the 37th President of the United States, serving from 1969 to 1974. The only president to resign the office, Nixon had previously served as a US representative and senator from California and as the 36th Vice President of the United States from 1953 to 1961 under...
administration, funding was cut to the PHS hospitals program and many of these institutions closed or were turned over to local public health offices. Eight survived as federal institutions until the early 1980s, when further budget cuts put an end to their funding. Some, such as the one in Savannah,
GeorgiaGeorgia is a state located in the southeastern United States. It was established in 1732, the last of the original Thirteen Colonies. The state is named after King George II of Great Britain. Georgia was the fourth state to ratify the United States Constitution, on January 2, 1788...
, continued as outpatient low-income health clinics up to 2003 while others, such as the large hospital in San Francisco on the grounds of the
US Army PresidioThe Presidio of San Francisco is a park on the northern tip of the San Francisco Peninsula in San Francisco, California, within the Golden Gate National Recreation Area...
, were diverted to other Federal and military uses. In the case of the Presidio, the PHS Hospital was used as a site for language training for military officers in the late 1980s.
Today, the records for these institutions sit in storage at the National Library of Medicine in
Bethesda, MarylandBethesda is a census designated place in southern Montgomery County, Maryland, United States, just northwest of Washington, D.C. It takes its name from a local church, the Bethesda Meeting House , which in turn took its name from Jerusalem's Pool of Bethesda...
and the National Archives in College Park, Maryland.
External links
- The National Library of Medicine has a guide to the documents culled from various PHS hospitals when these closed.
- marinehospital.org- Website of the U.S. Hospital Foundation, which is restoring the Marine Hospital in Louisville, Kentucky
Louisville is the largest city in the U.S. state of Kentucky, and the county seat of Jefferson County. Since 2003, the city's borders have been coterminous with those of the county because of a city-county merger. The city's population at the 2010 census was 741,096...
.