As we have noted previously, upon assuming his duties as the Director, Dr. Church recruited surgeons who met his rather strict conditions for competence, moved to consolidate hospitals, and ordered regimental surgeons to send their patients, unless their ailments were minor, to these hospitals. Massachusetts surgeons generally cooperated with Church but surgeons from other colonies did not. This opposition is something that anyone appointed as Director General, no matter who, would have faced.
There would be natural opposition not only to a colony's belief that its political authority was being usurped and that a colony's soldiers where being attended by surgeons from another colony, but there was also a philosophical dispute involved. Many believed that a smaller hospital established to care for the sick and wounded of a four to five hundred man regiment was less hazardous to the health of its patients than a large hospital. It is also only natural that soldiers felt more secure and confident when cared for by their own doctors among the men of their own units. These were militia units composed of men who cam from the same town or area and had not traveled much beyond their towns. General Hospitals, on the other hand, were believed to be more efficient and to have better staffs since regimental surgeons and mates were a motley crew named by their respective colonels and competence as a surgeon may not have been a prerequisite for their appointment.
Church believed that, upon examination, the costs of running the regimental hospitals were extremely high and came to believe that "inexcusable neglect" on the part of regimental surgeons was the reason for these high costs. Therefore, he directed that patients be moved to general hospitals rather than have medicines issued to regimental surgeons for treatment of their patients.
Church also wished to take advantage of the fact that there were already excellent general hospitals, one at Cambridge and one at Roxbury, already in existence. The Cambridge General Hospital was the larger and more important of the two since it was more centrally located.. (For a discussion of the Continental Army Hospital complex in August 1775, see my Oct 6, 2015 blog post.) Church immediately incorporated these two hospital complexes into the new Continental Army Hospital Department.
One of Dr Church's innovations was to designate one building at Cambridge and one building at Roxbury as a convalescent hospital/barracks. Church noticed that the rapid increase in the number of sick had overstrained the hospital's resources and, as a result, physicians were sending patients back to the lines too quickly thus contributing to a high rate of relapse. In the convalescent wards, patients recuperated on a regimen of rest, diet, and large doses of tonic medications until they were strong enough to return to active duty. This resulted in a marked decline in the number of relapses. These convalescent barracks were entrusted to the supervision of a hospital mate rather than a surgeon; however, one or more surgeons visited each day.
Church succeeded in getting Washington's cooperation in regulating the visiting of the sick in the two hospital complexes. An August 22,1775 general order asserted that no private or non-commissioned officer was to visit patients in the two hospitals without the permission of the attending surgeon or a written pass from the commanding officer of the regiment. This was an attempt to put a stop to the highly popular practice of unregulated visits to the sick that had been a major source of contagion and had disrupted the hospitals' routine as well as the recovery of the patients. Washington backed up this order with the following:
Church's success in organizing and administering the two hospital complexes and in combating the spread of disease was offset by his failure to solve two very difficult problems he had inherited - obtaining sufficient medical stores and regulating the anarchic and wasteful practices of the regimental surgeons. The problem of obtaining supplies, most of which had to be imported, was a serious one throughout the siege of Boston. There was no shortage, however, of largely useless patent medicines, most of them imported for the newspapers of Eastern Massachusetts and Rhode Island were full of advertisements for these products.
There were limited supplies of vital medicines in nearby Connecticut and Rhode Island but, for some reason, these were not purchased by the Continental Army. The need for medicines after Bunker Hill was acute and the regimental commanders and surgeons put great pressure on Andrew Craigie, the medical commissary and apothecary of the Massachusetts Army. Craigie is a rather interesting character about whose efforts in 1775 and 1776 little is known. In any event, the problem of obtaining medicines was transferred from Craigie to Church in his new position as Hospital Director. Church then turned around and appointed Craigie as the Hospital apothecary with the very able John Brown Cutting as Craigie's assistant.
(Craigie is a fascinating and a rather shady character who made fortunes, lost them and, in his later years, lived in Cambridge as a virtual recluse to avoid debtors prison. After his death, his widow had to take in boarders, one of whom was Henry Wadsworth Longfellow who later obtained the house as a marriage gift. It's the same house that George Washington used as his HQs in Cambridge.)
An illustration of just how serious the medical supply problem is demonstrated by the fact that, in late August 1775, when several hundred soldiers were diagnosed with highly contagious dysentery, the hospital at Cambridge had, on hand, only three pounds of ipecac, an essential ingredient of Dover's Powder, the chief remedy than employed against that disease. There was a severe shortage of such basic items as old linens for bandages and compresses, tapes, threads, needles, adhesive plaster, blankets, sheets, and pillows. Surgical instruments were desperately needed but in short supply.
As if Church didn't have enough problems, the Continental Congress added to them when, in September 1775, Dr Samuel Stringer was appointed "Director of the Hospital and Chief Physician and Surgeon for the Army in the Northern Department." Stringer was to be paid a salary equal to Church's, and had the right to appoint four men to serve under him. These men, however, were to be surgeon's mates, not surgeons, implying that Stringer's position was not comparable to that of Church but to that of a surgeon. Although Church was clearly supreme in Cambridge, the Congress had failed to define either the relationship of the new department in the north, to be located in Albany, to the Hospital Director in Cambridge or Stringer's position in the chain of command. It just was not clear if Stringer was subordinate to Church or precisely what the chain of command was. This would create serious problems in the future for Church's successors but, for now Church had more immediate problems.
At the end of August Church began to face an open revolt from the Regimental Surgeons against his efforts at reform. He began to face an organized resistance. Church believed that the soldiers appreciated the advantages of the general hospitals. In early September, Washington expressed support for the general hospital concept, commenting "there is no need of regimental Hospitals without the Camp when there is a general Hospital so near and so well appointed."
The opposition from the Regimental Surgeons continued until Brigadier General John Sullivan of New Hampshire got involved. Gen Sullivan had a very long and somewhat controversial career
during and after the Revolutionary War, but in September 1775, he was a 35 year old successful lawyer and mill operator from New Hampshire who was elected a delegate from New Hampshire to the Second Continental Congress. Although he had been a Major in the New Hampshire Militia and was an active Whig, Sullivan had no real military experience. He did lead the assault party that managed to seize 16 cannon, powder, and small arms from the King's Armory stored in Fort William and Mary in Portsmouth Harbor. Surely a rebellious and treasonous act for which Sullivan was hardly repentant.Yet, in June 1775, the Continental Congress appointed him as a Brigadier General in the Continental Army.
To Be Continued
There would be natural opposition not only to a colony's belief that its political authority was being usurped and that a colony's soldiers where being attended by surgeons from another colony, but there was also a philosophical dispute involved. Many believed that a smaller hospital established to care for the sick and wounded of a four to five hundred man regiment was less hazardous to the health of its patients than a large hospital. It is also only natural that soldiers felt more secure and confident when cared for by their own doctors among the men of their own units. These were militia units composed of men who cam from the same town or area and had not traveled much beyond their towns. General Hospitals, on the other hand, were believed to be more efficient and to have better staffs since regimental surgeons and mates were a motley crew named by their respective colonels and competence as a surgeon may not have been a prerequisite for their appointment.
Church believed that, upon examination, the costs of running the regimental hospitals were extremely high and came to believe that "inexcusable neglect" on the part of regimental surgeons was the reason for these high costs. Therefore, he directed that patients be moved to general hospitals rather than have medicines issued to regimental surgeons for treatment of their patients.
 |
| Plan of the town of Boston and Environs 1775. |
Church also wished to take advantage of the fact that there were already excellent general hospitals, one at Cambridge and one at Roxbury, already in existence. The Cambridge General Hospital was the larger and more important of the two since it was more centrally located.. (For a discussion of the Continental Army Hospital complex in August 1775, see my Oct 6, 2015 blog post.) Church immediately incorporated these two hospital complexes into the new Continental Army Hospital Department.
One of Dr Church's innovations was to designate one building at Cambridge and one building at Roxbury as a convalescent hospital/barracks. Church noticed that the rapid increase in the number of sick had overstrained the hospital's resources and, as a result, physicians were sending patients back to the lines too quickly thus contributing to a high rate of relapse. In the convalescent wards, patients recuperated on a regimen of rest, diet, and large doses of tonic medications until they were strong enough to return to active duty. This resulted in a marked decline in the number of relapses. These convalescent barracks were entrusted to the supervision of a hospital mate rather than a surgeon; however, one or more surgeons visited each day.
Church succeeded in getting Washington's cooperation in regulating the visiting of the sick in the two hospital complexes. An August 22,1775 general order asserted that no private or non-commissioned officer was to visit patients in the two hospitals without the permission of the attending surgeon or a written pass from the commanding officer of the regiment. This was an attempt to put a stop to the highly popular practice of unregulated visits to the sick that had been a major source of contagion and had disrupted the hospitals' routine as well as the recovery of the patients. Washington backed up this order with the following:
A Serjeant, Corporal & nine Men, to mount Guard to morrow morning, at Mr Fainweathers House, lately converted into an Hospital. The Serjt to receive his Orders from Dr Church, Director of the Hospital.
There were limited supplies of vital medicines in nearby Connecticut and Rhode Island but, for some reason, these were not purchased by the Continental Army. The need for medicines after Bunker Hill was acute and the regimental commanders and surgeons put great pressure on Andrew Craigie, the medical commissary and apothecary of the Massachusetts Army. Craigie is a rather interesting character about whose efforts in 1775 and 1776 little is known. In any event, the problem of obtaining medicines was transferred from Craigie to Church in his new position as Hospital Director. Church then turned around and appointed Craigie as the Hospital apothecary with the very able John Brown Cutting as Craigie's assistant.
 |
| Vassall-Craigie-Longfellow House |
An illustration of just how serious the medical supply problem is demonstrated by the fact that, in late August 1775, when several hundred soldiers were diagnosed with highly contagious dysentery, the hospital at Cambridge had, on hand, only three pounds of ipecac, an essential ingredient of Dover's Powder, the chief remedy than employed against that disease. There was a severe shortage of such basic items as old linens for bandages and compresses, tapes, threads, needles, adhesive plaster, blankets, sheets, and pillows. Surgical instruments were desperately needed but in short supply.
 |
| Dr Samuel Stringer |
At the end of August Church began to face an open revolt from the Regimental Surgeons against his efforts at reform. He began to face an organized resistance. Church believed that the soldiers appreciated the advantages of the general hospitals. In early September, Washington expressed support for the general hospital concept, commenting "there is no need of regimental Hospitals without the Camp when there is a general Hospital so near and so well appointed."
The opposition from the Regimental Surgeons continued until Brigadier General John Sullivan of New Hampshire got involved. Gen Sullivan had a very long and somewhat controversial career
during and after the Revolutionary War, but in September 1775, he was a 35 year old successful lawyer and mill operator from New Hampshire who was elected a delegate from New Hampshire to the Second Continental Congress. Although he had been a Major in the New Hampshire Militia and was an active Whig, Sullivan had no real military experience. He did lead the assault party that managed to seize 16 cannon, powder, and small arms from the King's Armory stored in Fort William and Mary in Portsmouth Harbor. Surely a rebellious and treasonous act for which Sullivan was hardly repentant.Yet, in June 1775, the Continental Congress appointed him as a Brigadier General in the Continental Army.
To Be Continued
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