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Origins of the National Institutes of Health
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Independent Marine Hospitals

A white mortar with the letters U.S.P.H.S. in blue below the rim of the mortar and a wooden pestle from a Marine Hospital.
Mortar and pestle from a Marine Hospital.

From 1798 until 1870 there was no central supervisory authority over the efforts of the Marine Hospitals. The authority was in the President, who seemed to have delegated it to the Secretary of the Treasury. Marine hospital matters at the Treasury Department were handled by an official designated as 'Marine Hospital Clerk.' As part of the Revenue Marine Division of the Treasury Department, each hospital operated independently. The hospitals were always hard pressed. The Staten Island Marine Hospital and Quarantine Station was planned for 200 patients, yet even before it was officially opened 945 patients were admitted between May and December 1801. For example, the ship Penelope arrived on June 10 with 262 persons with yellow and ship fever, smallpox, and dysentery, of whom 74 died.

A customary marine hospital pattern was the privately-built and owned hospital whose proprietor, under contract, took only sick seaman as patients and received pay from the federal government. Such a new hospital was started in Apalachicola, Florida, under contract with Dr. John Gorrie. He conceived the idea of artificially cooling the air of hospitals and sick rooms with the hope of curing and preventing yellow fever. Eventually he perfected the process of manufacturing ice and was granted a United States patent on artificial refrigeration in 1851. This was the forerunner of the modern refrigerator and air conditioning.

Before the Civil War there were great epidemics and recurring invasions of Asiatic Cholera, smallpox, and yellow fever. Generally it was thought that cleanliness was the best defense -- and it was against some diseases such as typhus. Despite its vulnerability, the U.S. did not suffer two of the great scourges of mankind -- bubonic plague and cholera. But in 1832 Asiatic cholera (not the same disease as cholera) entered the U.S. In this, disease death strikes quickly. A perfectly well family is at peace in its home. A stranger asks for a drink of water and falls dying at their feet. The next day the whole family sickens. The following day all are dead. The U.S. had four invasions each lasting about three years in 1832, 1849, 1854, and 1866.

Growth and Criticism

A black and white image of the Marine Hospital, Staten Island, N.Y.
The Marine Hospital, Staten Island, N.Y.

Frustration over the epidemics lead to criticism of the Marine Hospital Service for the lack of coordination in fighting diseases. Overcrowding and low pay for physicians were also cited. In 1848 the Navy Department asked Congress to place the Marine Hospitals under the Navy hospital system. A Congressional study, costing $1,000, was commissioned but a change of Administration kept the Marine Hospital Service in the Treasury Department. There were questions about the Marine Hospital Fund. After 1804 it was so poorly collected that the Congress had to make up the deficits. The growing number of hospitals, in part, made collections difficult. By 1843 the Marine Hospitals were spreading so far west that there was even one in the Hawaiian Islands. Despite its problems, the Marine Hospital Service was flourishing. On December 12, 1943, an immense 700 patient Marine Hospital was completed in San Francisco at a cost of $250,000.