The origins of the Public
Health Service (PHS) 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 earliest marine hospitals
created to care for the seamen were located along the East
Coast, with Boston being the site of the first such facility;
later they were also established along inland waterways,
the Great Lakes, and the Gulf and Pacific Coasts. Reorganization
in 1870 converted the loose network of locally controlled
hospitals into a centrally controlled Marine Hospital Service,
with its headquarters in Washington, D.C. The position
of Supervising Surgeon (later Surgeon General) was created
to administer the Service, and John Maynard Woodworth was
appointed as the first incumbent in 1871. He moved
quickly to reform the system and adopted a military model
for his medical staff, instituting examinations for applicants
and putting his physicians in uniforms. Woodworth created
a cadre of mobile, career service physicians who could be
assigned as needed to the various marine hospitals. The
uniformed services component of the Marine Hospital Service
was formalized as the Commissioned Corps by legislation enacted
in 1889. At first open only to physicians, over the
course of the twentieth century, the Corps expanded to include
dentists, sanitary engineers, pharmacists, nurses, sanitarians,
scientists, and other health professionals. The scope of
activities of the Marine Hospital Service also began to expand
well beyond the care of merchant seamen in the closing decades
of the nineteenth century, beginning with the control of
infectious disease. Responsibility for quarantine was
originally a function of the states rather than the Federal
Government, but the National Quarantine Act of 1878 conferred
quarantine authority on the Marine Hospital Service. Over
the course of the next half a century, the Marine Hospital
Service increasingly took over quarantine functions from
state authorities. As immigration increased dramatically
in the late nineteenth century, the Federal Government also
took over the processing of immigrants from the states, beginning
in 1891. The Marine Hospital Service was assigned the
responsibility for the medical inspection of arriving immigrants
at sites such as Ellis Island in New York. Commissioned
officers played a major role in fulfilling the Service's
commitment to prevent disease from entering the country.
Because
of the broadening responsibilities of the Service, its name
was changed in 1902 to the Public Health and Marine Hospital
Service, and again in 1912 to just the Public Health Service. The
Service continued to expand its public health activities
as the nation entered the twentieth century, with the Commissioned
Corps leading the way. As the century progressed, PHS
commissioned officers served their country by controlling
the spread of contagious diseases such as smallpox and yellow
fever, conducting important biomedical research, regulating
the food and drug supply, providing health care to underserved
groups, supplying medical assistance in the aftermath of
disasters, and in numerous other ways. As we embark upon
a new century, the PHS continues to fulfill its mission to
protect and advance the public's health.
It
has grown from a small collection of marine hospitals to
the largest public health program in the world. Today,
a part of the Department of Health and Human Services, the
PHS consists of the Office of Public Health and Science (headed
by the Assistant Secretary for Health and including the Surgeon
General), ten Regional Health Administrators, and eight operating
divisions. For further information on the history of PHS
and the Commissioned Corps, see Ralph Williams, The United
States Public Health Service, 1798-1950 (1951);
Bess Furman, A Profile of the United States Public Health
Service, 1798-1948 (1973); Fitzhugh Mullan, Plagues
and Politics: The Story of the United States Public Health
Service (1989). Prepared by the Office of the
Public Health Service Historian, 5600 Fishers Lane, Room
695, Rockville, MD 20857 (tel: 301-443-5363; http://lhncbc.nlm.nih.gov/apdb/phsHistory/).
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