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)

 Cambridge





Henry Vassal House
HQs and Hospital
Residence of Director General Church

Hooper-Lee-Nichols House (Lee Mansion)
Hospital



Ruggles-Fayerweather Mansion (Fayerweather House)
Hospital

Since I am not certain which building should be identified  as Washington, Lee, and Putnam Hospital, respectively, I have not done so.                                                                                

Surgeons

     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.                                                                

                                                            





Roxbury

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

Surgeons

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 houses are depicted as they exist today. They have had many owners and many renovations since 1775. And, each was considered a country estate which meant they had lots of land attached to them.

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 took 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.

  

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.