The history of the Hospital Department of the army commences with the siege of Boston in 1775, for the first legislative enactments of the Colonial Congress only legalized what was already in existence, and gave a fixed organization to what the emergencies of the occasion had called into being months before. The army which gathered at Cambridge, after the battle of Lexington, was assembled almost without any effort of public authority; it was rather the spontaneous result of the burst of patriotism and alarm which extended throughout the country, calling the farmer from his plough, the mechanic from his shop, the clergyman from the pulpit, and the physician from the sick bed. Few of these, who thus responded to the call upon their loyalty, had any idea that there would be a war; or, they thought that at worst it would be one of but short duration. Far the larger portion of them looked forward to a compromise with the Mother country, and as a consequence had made arrangements for leaving their homes for but a short period. The parties of men collected at Cambridge formed consequently but a heterogenous mass, without brigade or regimental organization, and as a necessary sequence, without any staff establishment. Among them were many physicians who had come from their native towns, like the rest ready to do anything to assist the cause of liberty; but they held no appointments, except perhaps from the Captains of companies or self-elected Colonels of regiments, and had not the means for establishing a hospital.

The Second Provincial Congress of Massachusetts Bay was at this time in session and earnestly occupied in the organization of the troops, and early

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foresaw the necessity that existed for action looking towards the proper care of the sick and wounded. With rare common sense, their first enactment provided for an examination of all persons asking appointment as surgeons. On the eighth of May, 1775, they ordered:

"That the President pro tempore, Doctor Church, Doctor Taylor, Doctor Holten and Doctor Dunsmore be a committee, to examine such persons as are, or may be recommended for Surgeons for the Army, now forming in this Colony.

Resolved; That the persons recommended by the Commanding Officers of the several regiments, be appointed as Surgeons to their respective regiments, provided, they appear to be duly qualified, on examination."

Doctors Whiting, Bailies, Hall and Jones were subsequently added to this committee, and a proviso adopted that any three present should constitute a quorum.

The following extract from Thacher's "Military Journal during the Revolutionary War, from 1775 to 1783," will show the manner in which this original board of medical examiners performed their duty.

"On the day appointed, the medical candidates, sixteen in number, were summoned before the board for examination. This business occupied about four hours; the subjects were anatomy, physiology, surgery, and medicine. It was not long after, that I was happily relieved from suspense, by receiving the sanction, and acceptance of the board, with some acceptable instructions, relative to the faithful discharge of duty, and the humane treatment of those soldiers, who may have the misfortune to require my assistance. Six of our number, were privately rejected as found disqualified. The examination was in a considerable degree close, and severe, which occasioned not a little agitation in our ranks."

After the battle of Breed's Hill a hospital was established at Cambridge, in several private but commodious houses," and Dr. John Warren, a brother and pupil of Dr. Joseph Warren, who fell while commanding the troops in that battle, was placed in charge. This gentleman had already acquired a fine reputation, both for professional skill and humanity to the sick. He was soon after succeeded by Dr. Isaac Foster, of Cambridge, who was afterwards Deputy Director General. About this same time a hospital was also established at Watertown, and another at Roxbury under charge of Dr. Isaac Rand, and on the twenty-seventh of June a fourth, for the exclusive care of small-pox patients.

It may be mentioned here, that in all the legislative enactments of this period, the word "hospital" is not used in the sense of a building for the treatment of the sick and wounded, but in a wider signification, as denoting the whole medical management of the war, or in other words, that "department" or "bureau" of the service having charge of all matters pertaining to medicine and surgery.

The regulations of this hospital at Cambridge were very simple. On the first of July, the Provincial Congress passed the following preamble and resolutions:

In order that all the sick and wounded of the Army may be provided for,and taken care of, in the best way and manner possible;

Resolved, and it is hereby ordered ;—

That, when any person in the Army is so ill,-either by a wound, or otherwise, that the Surgeon of the Regiment to which the sick or wounded person belongs,finds the sick or wounded as abovesaid, cannot be properly taken care of in the regiment to which he belongs,--said surgeon shall send the sick, or wounded as abovesaid, to the hospital provided for the use of the camps to which they belong; and a certificate of the man's name, and the company, or regiment to which he belongs;-and in that case, the Surgeon of the said hospital, shall receive the said sick or wounded, under his care; and in case said hospital shall become too full, the Surgeon of the said hospital, shall send such of his patients, as may with safety be moved, to the hospital at Watertown, and a certificate setting forth the man's name, what company and regiment each belongs to; and in that case,-the Surgeon of the Watertown hospital, shall receive such sick or wounded under his care."

The allowance of medical officers to a hospital was fixed at two surgeons and two surgeon's mates, and for a regiment in the field at one surgeon and two mates. For fear that persons might be appointed who were not agreeable to the officers and men, it was advised by the Committee of Safety, and resolved by the Congress, that surgeons should be nominated by the Colonels of regiments to which they were to be attached, and surgeon's mates by the surgeons.

The pay of hospital surgeons was fixed at eight pounds per month, and that of mates at four pounds ten shillings per month.

To each medical officer, thus appointed, a warrant was issued in the following form.

"THE CONGRESS OF THE MASSACHUSETTS BAY,

To A. B., Greeting;

Being informed of your skill in Surgery, and reposing especial trust in your ability, and good conduct; we do by these presents, constitute, and appoint you,the said A. B. to be Surgeon of the Regiment of foot,-whereof is Colonel, raised by the Congress aforesaid, for the defence of said Colony. You are, therefore, carefully, and diligently, to discharge the duty of a Surgeon to the said Regiment, in all things appertaining thereunto,-observing such orders, and instructions, as you shall from time to time receive, from the Colonel of said regiment, according to military rules and discipline, established by said Congress, or any your superior officers,-for which, this shall be your sufficient warrant. BY ORDER OF THE CONGRESS,

Warrants or commissions of a similar character, with the necessary alterations in the phraseology, were also issued to hospital surgeons.

Notwithstanding, however, the anxiety of the Provincial Congress (as evinced by their numerous enactments on the subject) to provide for the welfare of the sick and wounded soldiers, the plan adopted by them did not work well in practice. The vicious privilege, so fatal to all discipline, had been permitted of allowing the soldiers to choose their own officers, and these officers in turn had the nomination of surgeons, and too often personal popularity was sought for rather than professional fitness; a defect which was not entirely obviated by the examination to which all candidates were subjected. Again, surgeons and patients came from the same country village or town, and it took them a long time to appreciate the fact that the social equality which was to be admired in civil life, was incompatible with the discipline of the field. Medical supplies of all kinds were extremely scarce and the army ill supplied, as we learn incidentally from a resolution of Congress, authorizing two surgeons, who were so fortunate as to possess medicine chests, to lend them to those of other regiments that were not so well supplied. The Provincial Congress had done all that they could in this particular, but they could exercise no supervision except over the troops from Massachusetts, while as time passed, the forces from other States had assembled at Cambridge, and added to the aggregate of the army.

What was wanted was a general head, and that the Hospital did not have, and the Provincial Congress could not give it. For the correction of this, and all other defects, only one body was competent, and that was the Colonial Congress, then in session at Philadelphia.

This assemblage commenced its second session on the tenth of May, and was occupied in devising ways and means for carrying on the approaching war.

They had selected Washington as Commander-in-Chief, and passed an act for the appointment of General Officers and officers of the General Staff, but strangely enough this bill made no provision for the Hospital Department. Washington had arrived at Cambridge and assumed command, and his first inspections convinced him of the necessity for some action on the part of the Colonial Congress. On the twenty-first of July he thus expressed himself, in a letter to the President of Congress.

"I have made enquiry into the establishment of the hospital, and find it in a very unsettled condition. There is no principal director, nor 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 it was immediately taken into consideration, as the lives and health of both officers and men so much depend on a due regulation of this department."