and the principal means of commerce and communication over a vast territory. Often a flatboat starting from the upper river would lose its entire crew of five or six men by disease before reaching New Orleans. During the severe cholera epidemic of 1832 and 1834 the lot of the rivermen was especially severe.
It became necessary for congress to assist the service work by annual appropriations. In 1837 the original Marine Hospital was built in New Orleans and provision was made for purchasing sites for hospitals in three inland zones. Along the Mississippi River stations were located at Natchez, Miss.; Napoleon, Ark., and St. Louis, Mo. On the Ohio, the chosen points were Paducah, Louisville and Pittsburgh. The center for the Lake Erie sailors, was at Cleveland. The first Marine Hospital at Chicago dates from 1848 and was built on land adjacent to old Fort Dearborn. The second hospital, the present one, was authorized in 1864 and opened for patients in 1873. It occupies a beautiful location on the lake shore five miles north of the harbor.
The first service establishment on the Pacific Coast, at San Francisco in 1851, was on the contract basis. A hospital was erected three years later, a commodious and well-built structure, doomed to serious injury in the severe earthquake of 1868. The contract system with other hospitals was then resumed and continued until the completion of the present building in 1875. During the Civil.War many marine hospitals in both the north and the south were converted into military hospitals. Those at Boston and Norfolk were used in this capacity in the war of 1812.
In 1870 congress reorganized the service and Dr. John M. Woodworth, of Illinois, was appointed supervising surgeon. Within the next three years, the service began to attract considerable attention in foreign countries. London medical journals bestowed lavish praise on this uniquely American institution. At this time service officers were requested by the supervising surgeon to inform themselves fully as to local health regulations and to assist, when requested, in their enforcement.
Upon Dr. Woodworth's death in 1879 President Hayes appointed Dr. John B. Hamilton to succeed him. The year before Dr. Woodworth's death marked the occurrence of a terrible epidemic of yellow fever in the Mississippi Valley. With this freshly in mind, congress added quarantine control to the growing functions of the Marine Hospital Service, but failed to make any appropriation for its operation. Then a year later, in 1879, a law was passed creating a National Board of Health to exercise quarantine functions for four years. At the end of that period, the law of 1878 was revived, and national quarantine passed permanently into the hands of the Marine Hospital Service. The entire development of the quarantine service took place under the wise guidance of Dr. Hamilton.
