West Wing Continuity Guide
path: Home / #37 "Ellie" * What Uniform Does the Surgeon General Wear?
Most of the country seems fairly unaware that there is a uniformed, commissioned service with military ranks, etc. called the "U.S. Public Health Service Commissioned Corps" and that this service is headed by the appointed office of the Surgeon General and like the members of the service, she/he can wear their uniform. The following is from the Public Health Service, Commissioned Corps website:
Since its origin in l798, PHS has been making important contributions to the health of the Nation. The young Nation depended, to a large degree, upon the sea for both trade and protection. To encourage expansion of the existing, small merchant marine and to protect ill and injured seamen, the 5th Congress enacted legislation to establish a Marine Hospital Service under the Treasury Department. For health care, the seamen were to contribute 20 cents a month to finance the hospitals. The first temporary hospital was started in rehabilitated barracks in Boston Harbor in 1799.

Following the establishment of the hospitals on the East Coast, a chain of new hospitals began to follow the route of shipping and commerce - down to the mouth of the Mississippi and up inland waterways. As seamen and pioneers reached the Pacific Ocean, a hospital was built at San Francisco. In the War of 1812, the Marine Hospitals cared for wounded American seamen, as well as British prisoners. During the Civil War, the hospitals provided medical care for both North and South.

1870 - 1916 A New Commissioned Corps in the Country's Service

During these decades, the Service began to develop as a national health force. Outbreaks of smallpox in the North and yellow fever in the South, and an investigation of the Marine Hospital Service, lead to a reorganization of the Service in 1870. A central administration was established, headed by the first Surgeon General, Dr. John N. Woodworth. He reorganized the Service along military lines, provided for uniforms, established entrance examinations, and put tenure and promotion on a merit basis free from politics. Gradually, he abandoned the employment of local physicians, replacing them with medical officers who were admitted only after examination and were subject to assignment wherever required.

Public health work was undertaken because of the prevalence of major diseases such as smallpox, yellow fever, cholera, typhus fever, and bubonic plague. To provide further protection, Congress, in 1878, enacted a Federal law to prevent the introduction of contagious and infectious diseases into the United States, later extending it to prevent spread of disease among the States. In this law were the seeds of the modern health program -- preventive medicine.

In 1889, Congress officially established the commissioned corps along military lines, with titles and pay corresponding to Army and Navy grades.

In attempting to treat contagious disease, it was natural that research should become a significant part of the work of the Service. As a result, a bacteriological laboratory was established in the Staten Island Marine Hospital in 1887 and moved to Washington in 1891 to form the Hygienic Laboratory -- forerunner of the National Institutes of Health.

The face of the land and the nature of its society were changing, and the concept of public health was changing with them. Within a few years, after the turn of the century, the Nation began its rapid evolution from a rural to an urban civilization. Questions of water supply and pollution, sanitation, and hygiene grew more important as people crowded together in the cities. The Service began to see public health as the study of people in their relationship to each other and their environment; the place they lived -- the home, the neighborhood, the city; the place they worked; their water; their food; their air; their sanitary facilities; in short, their total environment.

In 1912, Congress enacted legislation to reorganize the Service and enlarge its powers. It was renamed the Public Health Service. The Act also granted the Service authority for pursuing studies of the "diseases of man and conditions affecting the propagation and spread thereof."

1917 - 1944 New Professions and a Reserve Corps

The outbreak of World War I imposed new demands upon the Service. The responsibilities involved medical and surgical aid to sick, wounded, or disabled soldiers or sailors; supervising health conditions around military camps and war plants; draining malarial swamps; disseminating health information; laboratory operations including research and manufacture of serums and vaccines; controlling venereal disease; and care of veterans.

The epidemic of influenza in 1918, which affected over four million and killed more than one half million Americans, further alerted the Nation to the need for a more effective national health force. Meanwhile, emergency war conditions had convinced Congress that the regular Commissioned Corps of the PHS should be strengthened with a reserve corps.

In the early 1920's approximately 50 hospitals were transferred from the PHS to the newly created Veterans Administration, concentrating all health care and services for veterans in a single Agency. In 1930, the Hygienic Laboratory was renamed the National Institutes of Health.

For expanding responsibilities, the Corps found that it needed men and women of other professions to serve with its commissioned medical officers. For this reason, Congress opened officer ranks to sanitary engineers, dentists, pharmacists, and later added scientists, nurses, dietitians, physical therapists, veterinarians, sanitarians and health services officers.

As advances in public health increased life expectancy, the degenerative diseases of the aged such as arthritis, cancer, and heart disease came to the foreground. After 141 years in the Treasury Department, the Service, in 1939, became a part of the newly created Federal Security Agency, later to become the Department of Health, Education and Welfare, and subsequently in 1980, the Department of Health and Human Services.

During the World War II, the use of science required the diversion of the National Institutes of Health research to war problems: studying effects of high altitude flying, improved yellow fever and plague vaccines, improved antimalarial drugs, and developing better methods for purifying water for fighting men in tropical countries. Thanks to a vaccine developed by the Service before the war, not one death from typhus fever among our own troops occurred during the wars, in spite of frequent exposure to this disease.

In 1944, Congress consolidated all laws relating to PHS (i.e., The Public Health Service Act -- P.L. 4l0, 78th Congress). It was the first Act of record which codified all legislation pertaining to a Federal Agency. Executive Order 9575 declared "the Commissioned Corps of the Public Health Service to be a military service and a branch of land and naval forces of the United States. . . ." This status existed until the cessation of hostilities in the Korean conflict.

The websites:

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