Monday, October 12, 2015

Dr Church's Surgeons

   Dr Church hired a staff of seven surgeons to run the Hospital he established for the Continental Army and I thought it would be interesting to provide some background on a rather interesting staff of surgeons.

 1. Dr. Isaac Foster, Jr. was born in Charlestown, was a graduate of the Harvard class of 1758 ( four years after Dr. Church) and was elected to the Massachusetts Provincial Congress in October 1774 as a representative of Charlestown. After the battles of Lexington and Concord, the Massachusetts Provincial Congress
Isaac Foster, age 15,
 Joseph Badger,
was faced with the problem of wounded soldiers, British and American that had fallen on a very long battle front. Orders were given by the Congress to take care of them and Dr. Foster responded to the call. He set up a temporary hospital in the Vassall House and collected a number of wounded, apparently, most of them British soldiers. On April 29, 1775, Dr. Foster was given an order to relocate all of the sick and wounded, whose conditions permitted, and who were scattered amongst a number of houses in the local area, to the Vassall House. The Vassall House soon filled with militia men suffering from fever, dysentery and the other diseases that would naturally arise from the hastily constructed and apparently not too clean camps of the Yankee militia. Until the middle of June, Dr. Foster devoted most of  his time to the Hospital but made no attempt to obtain a regular staff, medical supplies, or additional hospital space. He was assisted by one of his apprentice doctors. However, any physician was free to visit the hospital and attend and/or prescribe medicines for any of the patients. In Dr. Foster's defense, he was merely a contract physician and had not been given any authority or direction to take charge. But then, he apparently made no attempt to convince the Provincial Congress to do anything further.

    Dr. Foster's world was shattered by Bunker Hill in mid-June 1775. All of a sudden, there were approximately 300 wounded that had to be treated. Confusion reigned. And to add to that confusion, a rumor spread that the British were about to attack Cambridge. Many of the wounded were carried to Watertown and to farm houses in the adjacent country. Dr. Foster enlisted the aid of Harvard undergraduates, probably all of whom had absolutely no medical training. After the initial chaos had abated, the wounded were brought back to the Vassall House and other locations in Cambridge. The Provincial Congress energized itself and arrangements were made to establish branch hospitals in Cambridge and Roxbury, and to deal with the ever present fear of smallpox. But then, there was still no formal organization and no one in authority. That was changed when Dr. Church was named Director General of the Hospital and he began to bring his organizational and executive skills to bear in a rather chaotic situation in which there were more than thirty hospitals.

   Dr. Foster remained in residence at The Vassall House and was hired by Dr. Church (probably the first hire) as one of his surgeons. After Dr. Church was removed from his position, Dr. Foster became Director General until he lost out to John Morgan of Pennsylvania and he apparently became Deputy-Director. I lost touch with Dr. Foster who apparently left the Army and returned to Charlestown where he died in February 1782.

2.  Dr. John Warren, younger brother of Dr. Joseph Warren, was born in Roxbury in 1753. While attending Harvard (class of 1771), he started an "Anatomical Society" amongst the undergraduates in which they studied a skeleton and dissected whatever they could get their hands on; e.g. horses, dogs. Cadavers were impossible to obtain although the "Society" did concoct an elaborate plan, never consummated, to secure the body of a hung criminal. After graduating from Harvard, John, and almost all the members of his "Anatomical Society" AKA "Spunkers", studied medicine. John, obviously, under his brother Joseph. After two years, John moved to practice in Salem, apparently believing that the competition for physicians was rather too intense in Boston. He joined Col Timothy Pickering's Salem militia regiment in 1773 as a surgeon and marched with the regiment when the battle at Lexington broke out. However, the regiment arrived too late to take a major role in the battle. John was in Salem when he received the news of  Bunker Hill and, at 2 AM the following day, he set off for Cambridge. On the way, he heard that his brother was reported missing in the battle. He then made an attempt to look for his brother on the battlefield where, according to John, he was turned back by a thrust from a bayonet from a British sentry. ( A tale I view with extreme skepticism.) He was said to bear a scar from that thrust for the rest of his life.
John Warren by Rembrandt Peale
ca 1806

   Dr. Warren then accepted a post as a surgeon under Dr. Foster, apparently heeding the entreaties of his mother not to enlist as a soldier in the militia. At 22 years of age, Warren's views of his abilities did not quite match those held by his seniors and he appears to have been somewhat frustrated in the practice of his profession. Warren continued to serve as a surgeon with Washington's Army and was present at Long Island, Trenton, and Princeton. He returned to Boston in 1777 to continue his service as a military surgeon. After the war, he became a very successful doctor and helped to found the Harvard Medical School in 1782. He died at the age of 61 in 1815.

3. Dr. Samuel Adams, Jr. The only son of Samuel Adams was born in Boston in 1751 and attended Harvard, graduating with the class of  1770. He has been described as academically undistinguished and somewhat of a troublemaker. This, despite the fact that he was a sickly child suffering from tuberculosis and apparently sick for much of his life. After graduating from Harvard, young Samuel studied medicine with Dr. Joseph Warren, perhaps more as a favor to his father than to young Samuel's abilities. After Lexington and Concord, young Samuel was trapped inside Boston and was only released by General Gage with some reluctance. Finding employment  as a regimental surgeon in Cambridge, Adams continued to serve the wounded after Bunker Hill. Adams continued to serve the Continental Army as a surgeon in the New York and  other areas, returning to Boston after the war, apparently in very poor health since he did not resume the practice of medicine. He died at the age of 36 in  January 1788, pre-deceasing his famous father.

4. Dr. Charles McKnightwas born in Monmouth County, New Jersey on October 10, 1750 and graduated from Princeton in 1771. At Princeton, McKnight was a member of the American Whig Society along with fellow classmate James Madison. McKnight's father, the Irish immigrant Rev Charles McKnight, was an ardent patriot who reportedly received a severe sabre cut to the head  in the same skirmish that saw General High Mercer, George Washington's good friend, die at the battle of Princeton. He later was imprisoned on a British Prison ship in New York harbor and died on January 1st, 1778.
    After graduation, McKnight studied medicine under the distinguished physician of a well connected Pennsylvania family and a trustee of Princeton, Dr. William Shippen. Before he could complete his studies, the Revolutionary War broke out and Dr. McKnight joined the Continental Army along with a number of medical students. It is not clear as to how McKnight came to Dr. Church's attention or precisely which Continental Army unit he was associated with. But given Dr. McKnight's later career, it is obvious that he was a doctor of some talent and would quickly be noticed wherever he was assigned. McKnight later founded the "flying hospitals" for the Continental Army which allowed for a more rapid response to wounded soldiers. McKnight served throughout the Revolutionary War as a senior physician, establishing a good reputation. Immediately after the war, McKnight was appointed to the position of Professor of Surgery and Anatomy at Columbia and was considered one of  the foremost surgeons in the United States until his death at the age of 41 in November 1791.

5. Dr. William Aspinwall, was born in Brookline in May 1763, descending from one of the first
Dr William Aspinwall
Gilbert Stuart, circa 1815
English settlers of Massachusetts. After graduating from Harvard in 1764, Aspinwall studied medicine in Connecticut with the famous small pox expert Dr. Benjamin Gale and in Pennsylvania. with Dr John Morgan.  He received a medical degree from the University of Pennsylvania Medical School, at that time the only medical college in the colonies.  He became the first physician resident in Brookline where, after  practicing medicine for some years, and after hostilities broke out, Aspinwall decided to join the army. Dr. Joseph Warren, however, persuaded him to serve as a physician instead. Aspinwall received a commission as a surgeon under Brigadier General  William Heath and then was appointed as Deputy Director of the Hospital on Jamaica Plain. Aspinwall fought as a soldier in the battle of Lexington and followed the retreating British to Charlestown. He served as a surgeon throughout the war and, at one time, served with General John Sullivan in Rhode Island. After the war, Dr. Aspinwall returned to Brookline where he resumed his medical practice and became renowned for the treatment of small pox. Dr. Aspinwall lost sight in an eye as a child and later suffered from a cataract in the other eye. Cataract surgery proved unsuccessful and he was totally blind  for the waning years of his life. He lived to be 80 years old, dying in 1823.

6. Dr. Lemuel Hayward was born in Braintree in 1749 and graduated from Harvard in 1768. He was one of the many who studied medicine under Dr. Joseph Warren. After Lexington and Concord, Hayward and Aspinwall both served militia units and were then contracted by the Massachusetts Provincial Congress to serve the wounded. Both received warrants as  surgeons from the Provincial Congress in late June 1775. When Dr. Church was appointed as Hospital Director, both Hayward and Aspinwall were in a kind of limbo. Their warrants from the Massachusetts Provincial Congress had been superseded by the Continental Congress. Church asked them to stay on since there was a dire need for their services and told them he would obtain warrants for them as surgeons from the Continental Congress. Before that could be accomplished, however, Dr. Church was arrested and their status had to be sorted out by General Washington. After the siege, Dr. Hayward returned to his civil practice and like Aspinwall, specialized in the inoculation and treatment of smallpox. Hayward retired in 1798, living a very comfortable life until his death in 1821. He lived his final years in a mansion in Boston on Washington Street, between Bedford and Essex, that had an acre of garden with it. It is reported that in addition to being a successful physician, part of Dr. Haywards's wealth derived from the sale of a rather non-descript one story and a half house in Jamaica Plain, but with extensive land and mature Linden tress to John Hancock as a summer home in 1800. Hancock paid for the home with four and a half shares in the Long Wharf, which proved to be very valuable.

7. Dr. Elisha Perkins. Elisha Perkins was born in Plainfield Connecticut in January 1741, the son of a physician. He briefly matriculated At Yale and then studied medicine under his father. After practicing in his hometown and surrounding area, Dr. Perkins joined a Connecticut militia unit and served at the siege of Boston. However, I cannot place Dr. Perkins in the Boston area prior to January 1776, some six months after he is reported to be attending to the sick and wounded in Roxbury. On the other hand, I can find no physician of the same name on the rolls of any militia unit and the name would indicate that there can't be more than one. I am reasonably certain that the Dr. Elisha Perkins I describe is the same one hired by Dr. Church. Dr. Perkins is notorious in American medical history.

   After the war, Dr. Perkins returned to his medical practice in Connecticut, supplementing his income (he had ten children to support) by buying and selling mules. Sometime in the late 1790s, while in his forties, Perkins developed a theory that pain was caused by "a surcharge of electric fluid in the affected areas" and that metal could be used to draw off the electric fluid and cure the patient. In 1796, Dr. Perkins patented his " Metallic Tractors." The tractors consisted of two 3-inch metal rods with a point at the end. Although they were made of steel and brass, Perkins claimed that they were made of unusual alloys and he used his rods to cure inflammation, rheumatism and pain in the head and the face. He applied the points on the aching body part and passed them over the part for about 20 minutes. Perkins claimed they could "draw off the noxious electrical fluid that lay at the root of
Modern Replica of Dr Perkins Tractors

   Perkins treated all kinds of illnesses and numbered among his patents George Washington and Supreme Court Chief Justice Oliver Ellsworth. He sold his "tractors" by the score and became quite wealthy from the sales. George Washington was reported to have purchased a set for his family. Perkins  collected hundreds of testimonials from leading citizens, all claiming that his "tractors", not only relieved pain and suffering, but actually saved lives. (Imagine what Dr. Perkins could have accomplished if only Cable TV and the infomercial had been invented.)  His fame and his "tractors" spread to England and the Continent.

  Dr. Perkins then turned his attention to developing an antiseptic remedy which he claimed  could be used in the treatment of diphtheria and typhoid dysentery. Anxious to try out his newly developed antiseptic in treating yellow fever Dr. Perkins traveled to the city and treated patients with it for four weeks only to die of the disease in September 1799 at the age of 59.

  After his death, the use of his tractors and antiseptic faded into oblivion. It should be noted that not all were taken in by Dr. Perkins and he was expelled by the Connecticut Medical Society in 1797.


Tuesday, October 6, 2015

Continental Army Hospital - August 1775

   Using Benjamin Church's letter to Samuel Adams and other research, the following is the best reconstruction I can attempt of the Hospital that Church established for the Continental Army in the late summer of 1775 in and around the Continental Army's Headquarters in Cambridge, Massachusetts:

Director General and Chief Surgeon
Dr. Benjamin Church, Jr.
(no known likeness)


Henry Vassal House
HQs and Hospital
Residence of Director General Church
Hooper-Lee-Nichols House (Lee Mansion)

Ruggles-Fayerweather Mansion (Fayerweather House)
Since I am not certain which building should be identified  as Washington, Lee, and Putnam Hospital, respectively, I have not done so.                                                                                
     1. Dr. Issac Foster - Succeeds Church as Director until replaced on 29 Nov, 1775
    Lives with Church in the Vassal House.                                                                    
           2. Dr. John Warren, younger brother of Joseph Warren.                                               
                 3.  Dr. Samuel Adams, Jr. son of Samuel Adams.                                                               
                                                      4.  Dr. Charles Mc Knight, very distinguished and connected surgeon.                                                                



Loring- Greenough House (Loring House)
Ward's Hospital
St Thomas Hospital*
Barnard House
Parker Hill, Brookline
Wooden Barracks No Longer Extant
Later Used to Inoculate Troops for Smallpox
Causing Great Consternation to the Local Residents
1. William Aspinwall, Harvard graduate and friend of Dr. Joseph Warren              
         2. Elisha Perkins, Attended Yale and inventor of "Perkins Tractors" (Quack medicine)
(I am not certain of this identification)
  3. Dr. Lemuel Hayward, studied medicine under Dr. Joseph Warren                       
   It is possible that the three surgeons in Roxbury were paid by their respective colonies rather than the Continental Army.      
   St Thomas Hospital is a very famous London Hospital that can trace its roots to at least the twelfth century. Could it be that Church walked its halls while studying medicine in London?
N.B. All of the house are depicted as they exist today. They have had many owners and many renovations since 1775. And, each was considered a country estate which mean they had lots of land attached to them.

Monday, October 5, 2015

Dr Church Takes Charge

   We do not know precisely what day Benjamin Church was notified of his appointment as Director General of the newly established Hospital in Cambridge or the day that he assumed his duties. But we know that he was in place and functioning in mid-August from letters he sent to his old friend and compatriot in the Whig cause, Samuel Adams. On August 22nd, 1775, he wrote Adams requesting some drugs. A list of drugs was enclosed in the letter but it is now lost. On the following day, Church again wrote Adams and it is worth quoting that letter (with some editing for clarity) in full. There is no better account of the medical situation in Cambridge in the Continental Army two months after Bunker Hill and the actions Dr. Church to correct it.

Continental Hospital, Cambrige, Aug 23,1775
 Honoured & dear Sir!
Accept my most sincere acknowledgements for the honour and favour of my late appointment., derived from you my Friend! and the rest of that august body, for whom (abstracted from Self-Consideration) I have ever felt the warmest Devotion, the most heart-felt Reverence: the most acceptable Expressions of my Gratitude, I am assured will be a zealous Application of myself to discharge the important Duties of my Commission
  An acquaintance with the economy of Hospitals derived from a Residence of almost three years in the London Hospitals, made the Task before me very acceptable, but I confess the extreme Disorders in which I found matters upon a closer scrutiny, rendered the attempt to effect a Change a very formidable One; a total Revolution was necessary, to fix upon any Principles at all: there existed near 30 Hospitals, each distinct and independent, and some of them under the Guidance and uncontrouled Jurisdiction of Surgeons who had never seen an Hospital; the demands yon the Commissary General and Quarter-master were so extremely frequent and rapid that they informed me, the Expense of supplies for the Surgeons exceeded all the other Expenses of the Army: a matter so ruinous to the Cause demanded, an instant remedy.
I immediately procured two good Houses in Cambridge, the one already improved as a Colony Hospital, the other a regimental sick-House, a perfect sink of Putrescence, filth and Disease; to these I have since found it necessary to add a third viz the House of the fugitive Judge Lea,
I found little difficulty with the Surgeons of this Colony, for having examined and appointed them, they considered me in the light of a Master or Director before, and readily conceded to my Orders; but I have had much difficulty with my Brethren of Connecticut &c, they viewed themselves as Lords of their little Dominions; each Surgeon had his Hospital, to which the officers submitted as matters of Right, already established by uninterrupted usage, and hugged as a Benefice by each distinct, some Surgeons divided the Regiments with their Col'., their Orders were undisputed at the publick stores: The Officers indeed groaned that Diseases became so grassant, the Committee of Supplies and the Commissary groaned with good Reason that they should never be able to answer the Demands.
a cabal has been formed against me, which now exists in a crumbling situation, I still persevere in demolishing these little Pagoda's, and altho much Art and much malice  have been exercised to discredit the American Hospital, it is now arrived to such a degree of reputation that the Soldiers bless the happy Institution, and several of the Regimental Surgeons are soliciting mates Birth, at the loss of 30/pr Month, to improve themselves in the Practice of the Hospital.
We have now 200 Patients in three Houses, which go under the Denomination of Washington's Hospital, Lee's Hospital and Putnam's Hospital.[illegible] to the Brigade on this Quarter. We have likewise three Houses at Brookline to accommodate Roxbury Camp in which are 170 Patients, but these I am reducing to 2 Houses Loring's and Barnard's which I shall call Ward's Hospital and St Thomas's Hospital in honour of the two Generals on that Quarter.
I should be happy could every purpose be effected agreeable to the Disposition of Offices made by the Honle Congress, with the Allowance annexed to sundry of them. The number of Surgeons I apprehend must be enlarged  to three more.
The Houses at Cambridge now improved for Hospitals are most advantageously situated to accommodate the Camps on Prospect Hill, Mystick, &c. And in the course of two days by which time I hope to compleat the Number of Beds & Slaw bunks [ some type of a bunk bed with straw as near as I can determine], will be filled and will contain about 240 Patients with their proper number of attendants. These Hospitals are not only insufficient to hold all the sick of both Camps, but they are so remote from Roxbury being 6 miles at least, that in many Cases it would be greatly inconvenient, and in case of an Engagement totally impracticable to remove the wounded men so far;
the Houses lately the property of Barnard and Loring are already made use of for the sick, stand very conveniently, and are sufficiently elevated & capacious these will accommodate the Camp at Roxbury, and the disposition of the Surgeons could stand thus: [Church names his seven surgeons] 
I must entreat your Indulgence to mention one or two other matters - the sick thicken upon us so rapidly, that we are obliged to send the Recovering Men too early to the Camps; being obliged to do duty immediately, and being thereby exposed to all Weathers in their weak state, they frequently relapse; 4 out of 5 generally return to the Hospital within a Week after their Dismission. An Airing house, or as 'tis usually called a Convalescent Hospital is a wise and salutary Provision; here the Patients upon their recovery ought to be sent, to be kept upon a half-Diet and tonic medicines, till they have recovered such a degree of firmness, as to be able to do their duty in Camp without hazard - these Houses require nothing more than a good careful Mate or two to attend them, and to be daily visited by the Hospital Physician.........
I must here renew my solicitation to be supplied with Medicines, I will particularly attend to eke out the few on hand, to prevent distress for want of medicines before the rest arrive. 3 lb of Ipecac is our whole stock, for 400 sick men, and great part of them Dysenteries, and no more to be obtained this way. Tow-Cloth for Beds I am much embarrassed for, the stores are exhausted and none can procure as yet elsewhere.
Thus sir, I have led you thro' a tedious dry detail. I know you adopt the generous sentiment of Terence...Homo sum, et nil humanum a me alienum puto*,
this shall be my only Apology; being an Exile and in distress, I am doubly compassionate, I view every Child  of Sorrow as my Brother - nevertheless Sir! I am fortified daily with the glad presage of future and fast approaching happiness, a thorough Restoration to Liberty & Peace. When Shall we commence the song Deo Redemptori [God the Redeemer], when shall we, as we have been wont mingle together 'the Feast of Reason & the Flow of Soul'. **
Your affectionate Friend & Humble Servant
Benja Church junr 
* I am a human being: I regard nothing of human concern as foreign to my interests.
** Alexander Pope, Imitations of Horace
Siege Lines 1776
   This letter is typical Church. The effusions in the beginning of the letter are standard for the eighteenth century even if Church does go a little overboard ( to our modern sensibilities) sometimes. The concluding paragraphs with the poetic quotations are also typical of Church, an educated man of his day with a serious familiarity with the classics and poetry. Church's letters [ those that remain] are full of classical and poetical quotes; and, he is writing to a fellow Harvard Graduate well versed in his Latin.

  But the body of this letter shows a very professional and very capable physician with real executive ability who found a chaotic situation, in which soldiers were suffering, and created a functioning hospital exercising the best possible care considering the limitations of supply and professional knowledge. Indeed, one can characterize some of Church's ideas as modern. For this alone, Dr. Church deserves enormous credit, yet it is totally ignored and/or dismissed.

   Dr Church did step on some toes in setting up the Continental Army's Hospital and those he offended will attempt to get their revenge.