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John L. Parascandola, Public Health Service, pp. 487-93 in ed. George Thomas Kurian, A Historical Guide to the U.S. Government. New York: Oxford University Press, 1998.

The origins of the United States Public Health Service may be traced to the passage of an Act in 1798 that provided for the care and relief of sick and injured merchant seamen. The leaders of the young American nation recognized that a healthy merchant marine was necessary to protect the economic prosperity and national defense of the country. The 1798 law created a fund to be used by the federal government to provide medical services to merchant seamen in American ports.

The marine hospital fund was administered by the Treasury Department and financed through a monthly deduction from the wages of the seamen. Medical care was provided through contracts with existing hospitals and, increasingly as time went on, through the construction of new hospitals for this purpose. The earliest marine hospitals were located along the Atlantic coast, with Boston being the site of the first such facility, but later they were also established along inland waterways, the Great Lakes, and the Gulf and Pacific coasts. The marine hospitals hardly constituted a system in the antebellum period. Funds for the hospitals were inadequate, political rather than medical reasons often influenced the choice of sites for hospitals and the selection of physicians, and the Treasury Department had little supervisory authority over the hospitals. During the Civil War, the Union and Confederate forces occupied the hospitals for their own use, and in 1864 only eight of the twenty-seven hospitals listed before the War were operational. In 1869 the Secretary of the Treasury commissioned an extensive study of the marine hospitals, and the resulting critical report led to the passage of reform legislation in the following year.

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