Saturday, October 3, 2015

Dr Benjamin Church, Jr Appointed "Surgeon General"

   Meeting in Philadelphia in July, 1775, the Continental Congress was faced with the reality of forming a means to govern the newly united colonies and to establish a Continental Army to defend them, where none had existed before. Previously, all armies were provincial and controlled by the individual colonies or, on needed occasions, by the British Army. In a letter dated July 20, 1775,  the new Commander-in Chief, writing from Cambridge, Massachusetts was pleading for the establishment of a paymaster and :

 I have made Inquiry with respect to the Establishment of the Hospital and find it in a very unsetled Condition. There is no Principal Director, or any Subordination among the Surgeons; of consequence Disputes and Contentions have arisen and must continue until it is reduced to some System. I could wish that it was immediately taken into consideration as the Lives and Health of both Officers and Soldiers so much depend upon a due regulation of this Department.
   Washington was also in correspondence with Benjamin Harrison, a Virginia delegate to the Congress, on the subject and Harrison advised Washington in a letter dated July 21st, 1775:

Nothing is as yet done as to the Hospitall, but I will bring it on very soon. 

   On Thursday, July 27,1775, The Continental Congress voted to establish a hospital for an army of 20,000 men to be headed by a "Director General and Chief Physician",  with a staff of four surgeons, one apothecary, twenty surgeons mates, one clerk. two storekeepers, one nurse to every 10 sick,  and "labourers  occasionally."  The Director was to "furnish medicines, Bedding and all other necessaries, to pay for the same, superintend the whole, and report to and receive orders from the Commander-in-Chief.

  Dr.  Benjamin Church, Jr.  was unanimously elected to the position of "Director General and Chief Physician" of the new hospital and was given authority to appoint the four surgeons and apothecary, the two storekeepers, one clerk, and one nurse to every ten sick. A parsimonious Congress, totally unfamiliar with the nature of an army in the field, also resolved that the  surgeons mates should only be paid for days when the number of sick should justify their attendance.

   Dr. Church's pay was fixed at $4 per day ($120 per month). A Major General in the Continental Army was paid $166 per month, the Commissary General of Stores and Provision $80 a month, and the Paymaster General $100 per month. Dr. Church's pay was twice that of a Colonel in the Massachusetts Militia.

   In addition, note the patronage positions Dr. Church controlled and the fiscal responsibilities of his position. Given the culture of British procurement under which all of the officers of the Continental Army had previously operated under and the opportunities for  enrichment it represented, the position of Director General certainly, despite its many drawbacks, could be seen as a very desirable one.

   There is a general misunderstanding of Dr. Church's titles and duties as the Director General of the Continental Army's Hospital. He was not the first Surgeon General of the United States, a position under the US Public Health Service and not established until many years later, and which position, during my lifetime, has been held  by some of the strangest physicians imaginable,  and he is not, in actuality, the first Surgeon General of the United States Army. In April 1777, the Continental Congress superseded the Hospital organization it created in July 1775 with the establishment of a Medical Department based on the British model. After the War, the US Army consisted of short service troops with no provision for medical services above the regimental level. Subsequent legislation in 1802 and 1808 authorized the employment of  permanent peace time physicians and surgeons for the Army, but it wasn't until 1818 that this Medical Department was given a permanent Director under the title "Surgeon General."  However, Church was referred to as "Surgeon General" and so titled in several contemporaneous letters by John Adams.

   I could find no correspondence or diaries, etc. which would indicate just why Benjamin Church was elected as the new Director General of the Continental Army's Hospital; but, one can, through the review of several of John Adams' letter from the days surrounding the vote to establish the Hospital and appoint Church Director, that it was the Adams cousins, John and Samuel, along with Elbridge Gerry, who were responsible. In the days preceding Church's appointment the journal of the Continental Congress indicates a flurry of activity to establish new positions to conduct the affairs of the united colonies and concomitant with that, there had to have been enormous politicking to get favored candidates appointed to those positions to advance personal interest as well as the interests of one's colony. And there was the issue of providing geographical balance to the army as well as the government. And John Adams was in the midst of it. Sometimes for good (e.g. George Washington's appointment as Commander-in-Chief) and sometimes for the not so good. A perfect illustration of this can be found in a letter from Adams to James Warren  dtd. July 26, 1775:

I can never Sufficiently regret that this Congress have acted so much out of character as to leave the appointment of the Quarter Master General, Commissary of Musters and Commissary of Artillery to the General [Washington]. As these officers are checks upon the General and he a check upon them, there ought not to be too much connection between them. They ought not to be under any dependence upon him or so great obligations of Gratitude as those of a Creature to the Creator.

    Only John Adams could write something this obtuse.

  John Adams was determined to get his friend James Warren, newly elected President of the Massachusetts Provincial Congress and husband of Mercy Otis Warren, appointed Paymaster of the Continental Army at the same time he and Samuel Adams were, I believe, championing Church as Director of the Hospital. John Adams would later distance himself from James and Mercy Warren, but at this time, he was determined to get him the position of Paymaster. John Adams had a long doctor-client relationship with Benjamin Church and only recently, upon Dr. Church's June visit to the Continental Congress on the business of  the Massachusetts Provincial Congress, Church prescribed a lotion for Adams' eyes.*

   Samuel Adams, of course, had a strong relationship with Church as a fellow Whig and one of the real stalwarts in pressing the British for colonial rights before war broke out in April 1775. Whereas John Adams only became very important to the cause after war broke out, Church along with Dr. Joseph Warren, William Molineux (until his death in October 1774)  and  Dr. Thomas Young stuck with Samuel Adams throughout the dark days when the Whig cause was in decline. Church, it must be remembered  had prominence in his own right, not only as an orator and pamphleteer, but also as a Poet.

   I can find no record of any reaction to Dr. Church when he visited the Continental Congress but he must have made a favorable impression and, just as important, the delegates had a face to put to his name when his name was mentioned. Benjamin Harrison may also have played a role in Church's appointment since he knew of Washington's desire to get a Hospital established as soon as possible. Harrison was described by John Adams as a "Falstaff-like" character and indeed, he was big, friendly and very rich. All of which Adams was not. At some point Adams came to really detest Harrison but what his attitude was in July 1775 is not known., I doubt that any dislike would have prevented Adams from working with Harrison. In any event, I believe it was an easy sell. No one nominated could possible match Church in stature or prestige.

 * Dr. Church was something of an eye specialist and advertised himself as such. Cataract surgery was practiced at this time and ,without anesthetic, must have been a very painful business. On April 8, 1747, Jacques Daviel, a French physician, performed the first modern cataract surgery by purposefully making a corneal incision to remove the lens.

Illustration from Daviel's paper to the
French Academy of Surgery.


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