Marine Hospital Service

The Marine Hospital Service was an organization of Marine Hospitals dedicated to the care of ill and disabled seamen in the United States Merchant Marine, the U.S. Coast Guard and other federal beneficiaries. The Marine Hospital Service evolved into the U.S. Public Health Service.

It was the point of origin for several components of the current Public Health Service, including the Public Health Service Commissioned Corps, the National Institutes of Health, and multiple programs now incorporated into the Health Resources and Services Administration.

The origins of the system of Marine Hospitals can be traced to the passage, by the 5th Congress of the United States, of "An Act for the Relief of Sick and Disabled Seamen" in 1798. This act created Marine Hospitals to care for sick seamen. The Marine Hospital Fund was placed under the Revenue Marine Service (a forerunner of the present-day Coast Guard) within the Department of the Treasury.

It was the first federal health law. It authorized a tax, which was the deduction of twenty cents per month from the wages of the seamen. This tax raised funds for physicians and to support the network of hospitals. The tax was about 1% of the wages of maritime sailors. (In 1884, the tax was abolished and in 1906 funds were dispensed by Congress.)

The act led to the gradual creation of a network of hospitals along coastal and inland waterways. They were initially located along the East Coast, at the harbors of the major port cities, with Boston being the site of the first such facility, followed later by others including in the Baltimore vicinity at Curtis Bay. As the boundaries of the United States expanded, and harbors were built on other coasts, so too were marine hospitals. In the 1830s and 1840s they were built along inland waterways, the Great Lakes, and the Gulf of Mexico. After the acquisition of the Oregon Territory (1846) and California (1848) hospitals were built in 1850s at Pacific Coast harbors.

Following the Civil War, public outcry and scandal surrounded the Marine Hospital Fund. In 1869, Dr. John Shaw Billings, 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 disorganized.

In June 1870 the 41st Congress formally converted the loose network of locally controlled marine hospitals, the Marine Hospital Fund, into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. This reorganization made the Marine Hospital Service into its own bureau within the Department of the Treasury.

Dr. John Maynard Woodworth was subsequently appointed to the Service as "Supervising Surgeon." He transformed 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 Corps. Dr. Woodworth, using Army-style heraldry, created the Marine Hospital Service fouled anchor and caduceus 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 States.