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instance, while there can be little question regarding the nature of the disease entered as "typhus,” which caused the death of Wm. Rysela on July 6, 1809, since Barton has added “sick two months,” what did James Williams, ist, really succumb to on August 17, 1809, under the designation "nervous fever,” when on the previous day he first appears as “very ill, typhus?”

Barton mentions in his work on hospitals that he checked several cases of sea-scurvy on the “United States” by the liberal administration of lime juice. He had much to say later, after his cruise abroad in the “Essex,” of its virtues as an anti-scorbutic, and urged its adoption by our Navy, in an

official report.

occasional sudden demise of a patient with "typhus fever” suggests typhus exanthematicus. In those days, as now, itch and venereal diseases occupied a conspicuous position in the sick returns, and the occasional appearance of midshipmen with the latter class of disease, with the added remarks, “reported to the commodore as rheumatism,” denoted a kindly intention on the part of the surgeon to shield them from the stigma attaching to these affections.

On July 15, 1810, for the first time, Dr. Barton makes extended “Remarks,” at the end of the day's record, as follows: "The dysentery and diarrhoea are now and have been for the last ten days the prevailing diseases on board the ship. Most of the patients on the sick list with other diseases are more or less afflicted with these complaints in a slight degree. Neither of these diseases, however, are of a very violent nature.” This constitutes the only clinical observation of any moment which I could discover in a review of the seventeen months' record contained in these reports. It is also quite remarkable how seldom mention is made of the transfer of patients to hospital. However, considering the character of the so-called hospitals then available, it is perhaps not surprising that he preferred to retain the sick aboard ship. Later in his career he urged improvement of naval hospitals with characteristic vigor, and a critical reference in his book on “Marine Hospitals”, published in 1814, with respect to the hospital at the Navy Yard, Philadelphia, was the basis of charges, made by a brother medical officer, which resulted in the court-martial of Barton. The court, however, perhaps realizing the justice of his criticism, ruled that the specification covering the alleged offense need not be answered or refuted, and thus virtually exonerated Barton of this specification of the charge. Some of the entries in the “Sick Reports” are very obscure in their clinical and pathological significance. For

In the preface to the first edition of his work on “Marine Hospitals,” Dr. Barton refers to his attempts to bring about correction of the abuses and irregularities then prevailing in the medical department, by reason of what he terms “loose administration.” As his statement there fully reflects his attitude toward the problems confronting him on the frigate“United States,' and his grave concern for the welfare of the sick, and the improvement of medical supplies, I cannot do better than quote it at length:

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“Having entered the navy as a surgeon when very young, and having been ordered to one of the largest ships in it, with a complement of 430 men, stationed in a warm and variable climate-I soon found myself not a little embarrassed by the perplexities that I daily met with in my practice on board. The unhealthiness of the climate, operating upon a variety of different constitutions in an entirely new crew; the change of diet and mode of life; the necessary and unavoidable exposure of boats' crews to the fervid rays of a vertical sun, as well as to the damp and heavy dews of night, and at all times to the insalubrious exhalations of marsh miasma-all combined to generate such perpetual sickness, that the frigate might almost have been called a hospital ship, the average number on the daily sicklist, of fevers and fluxes, being about 40. In this situation, on board of a ship just refitted, commissioned, and equipped, I found myself without half the comforts and necessaries for the sick that the hospital department should have been supplied with; yet this department had been reported as replenished with every requisite article for a cruise of two years, and together with the medicine chest, had cost the government fifteen hundred dollars. There were neither beds for the sick, sheets, pillows, pillow-cases, nor nightcaps--nor was there a sufficiency of wine, brandy, chocolate, or sugar; and that portion which the storeroom contained of these articles, was neither pure nor fit for sick men. The medicine chest was overloaded with the useful, and choked up with many useless and damaged articles. Such was the state of the medical department of this ship! Upon a representation of it however to her commander, Com. Decatur, he generously allowed me all the necessaries I stood in need of, and thus enabled me to administer those comforts to my patients, which they so much required. What would have been my situation, had the ship immediately proceeded to sea, for a cruise of eight or ten months, upon my joining her, and before I had an opportunity of examining into the condition of the medicine and store chests which might have been the case, these having been reported as sufficiently furnished? What the consequence would have been must be obvious! The other ships were not better furnished than the one of which I am speaking--and I perpetually heard of complaints on this score.

“What was the cause of these abuses? The want of a regular board of medical

commissioners, whose peculiar province it should be, to order the proper proportions and quantities of medicine, comforts, and necessaries, for the publick ships, and who should have no interest, directly or indirectly, individually or collectively--in the furnishing of articles thus ordered.

“As I was at that time a perfect novice in the routine of ship duty, and having then but recently left the Pennsylvania Hospital, an institution in which order, system, and punctuality, render the practice of medicine a pleasure, I was overwhelmed with the difficulties I had to encounter in the performance of professional duties, where every species of inconvenience and disadvantage that can be imagined was opposed to the exertions of the surgeon. My feelings revolted from the idea of continuing in such a perplexing and distressing situation--and I became disgusted with the unavailing toil attendant upon ship-practice. I communicated my sentiments on this subject unreservedly to my lamented friend, the late captain Wm. Henry Allen, then first lieutenant of the ship. I ventured even at that early period of my naval service, to condemn the flagrant irregularities and abuses, that I could not but believe existed to a ruinous extent. In my conversations with him I often declared, that if such was always the deplorable condition of sick men on shipboard, I wished not longer to be their medical attendant; for my feelings were every moment in the day subjected to harassment and pain, from contemplating afflictions I was unable to relieve, for the mere want of comforts so easily procured on shore. He encouraged me, however, to persevere, and at the same time that he lamented with me the want of a superintending medical board, he tendered an offer of his assistance in making any arrangements compatible with the internal economy of the ship,

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that I might deem calculated to meliorate the condition of the sick. I soon found that their situation was susceptible of much relief, even on ship-board-and I was not long concluding, that if proper steps were taken to furnish the ships with sick-necessaries of a proper kind, the practice of medicine and surgery in the navy could be rendered not only more beneficial to the sick, but less offensive to the humane feelings of the medical officer. I never lost sight of the opinion I had conceived, that the errors of the medical department of the navy might be easily corrected, and its abuses abolished.”

Surgeon Barton's relations with Commodore Decatur and with the first lieutenant of the “United States," William Henry Allen,appeared to have been most cordial and harmonious. This is evidenced by the fact that Decatur, in 1813, applied to the Secretary of the Navy for Barton to be returned to the “United States,” and in 1817 he gave him a strong letter of recommendation to the then Secretary of the Navy, and both he and Captain David Porter of the “Essex” came to his aid in support of many of the reforms he had projected. Decatur in the letter of recommendation above-mentioned testified “to the great skill and attention and success with which he (Barton) practised during the above period.” (1809– 1810) Late in 1810, however, Barton appears to have had some disagreement with certain officers on the “United States,” the nature of which is not revealed, but the resulting situation made it expedient for him to leave the ship. About this time the “Essex,” was preparing to sail for Europe, and since her surgeon, Dr. Stark, was on leave at some distant point inland and could not

This is the same Captain Allen who commanded the "Argus" in her encounter with the British Brig “Pelican,” August 14, 1813. The "Argus" had sunk twenty-two vessels off the British coast, but was defeated and captured by the “Pelican." Allen died of his wounds at Mill-Prison Hospital, Plymouth, England.

return in time to reach the ship before sailing, with Decatur's approval, and as a convenience to Capt. Smith of the “Essex,' Barton left the “United States" and joined the “Essex.” It was during this cruise that he gathered much of the information regarding naval hospitals, and naval medical

practice abroad, both in the navies of Great Britain and France, which appeared later in his writings. His observations covered a wide range of subjects, including the construction and arrangement of all the principal naval hospitals of England and France, their organization and administration; sanitary matters touching the naval services; methods of training medical officers; rations; character of supplies furnished ships, their construction, etc. He appears to have visited London from Cowes, Isle of Wight, where the ship was lying, and, while there, to have met the celebrated Dr. Lettsom through an introduction from Dr. Rush, and to have inspected several hospitals. He mentions the homeward bound voyage of the “Essex," which lasted two months, and speaks of the efficacy of an effervescing mixture of lime juice and salt of tartar for seasickness. This he administered to two passengers on board with great success. Other than the above, surprisingly few details of this period of his career were to be found in available material.

On June 30, 1811, he addressed a letter to the Hon. Paul Hamilton, Secretary of the Navy, requesting relief from sea duty and assignment to the Navy Yard, Philadelphia. He mentioned that he had been on sea service without any intermission since April, 1809, and had just returned on the "Essex.” He asserted his willingness to act in concert with, or subordination to, Dr. Cutbush, the surgeon in charge at Philadelphia, and although a surgeon himself, was agreeable to service in a position, which ordinarily would be assigned to a surgeon's mate. His extreme anxiety to return to Philadelphia apparently arose from a desire to establish himself in

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practice there, “the accomplishment of judge of the quality of juice used in the which is his dearest wish," to supplement Royal Navy, which is the kind he wishes to his income, and help support his aged father recommend for our own. He also mentions and seven brothers and sisters. This he de- his intention to submit a report on this subsired to do, moreover, while his uncle (Ben- ject. This letter indicates that he had been jamin Smith Barton), who was in a precari- in Washington, and was on his way to Lanous state of health, was still able to take him caster, but had been delayed in Baltiby the hand and introduce him into practice. more on account of an attack of "summer He refers to his uncle as a man "the tenure complaint.” On August 26, 1811, writing of whose existence is fragile indeed ... thus from Lancaster he requests two months' exthere is the brightest prospect of my pro

tension of leave, and to be assigned to duty fessional success subject to the constant at the Navy Yard, Philadelphia. In this shadow of a very near cloud.” His family is letter he makes the first reference to his inconstantly in mind, and as the eldest son, tention of writing at length upon his obserhis concern for their welfare is often re- vations abroad and upon a plan for the better flected in his letters. The pay of a surgeon .

government of the Medical Department of at this time, including the value of two ra- the Navy, and puts this intention forth as a tions, was sixty-two dollars per month, a reason for the change of duty requested. He sum wholly inadequate to the value of the also states his desire to take courses of service performed, and of course, not suffi- study in the Pennsylvania Hospital. A cient to enable him to contribute materially reference is made in this letter to Mr. to the support of his family. He speaks Latrobe, whom he has asked to see the further of the difficulty aboard ship of keep- Secretary and support his request. But it is ing himself abreast the times professionally. all to no avail, for a peremptory order from “The unsettled and wandering life on board the Secretary, dated August 29th, is sent to ship not only deters the gratification of pro- him to return as soon as possible to his ship fessional ambition, but absolutely generates the “Essex,” at Norfolk. Barton answered an inanition of mind very inimical to solid this letter from Lancaster on September improvement of any kind. The sea does not 4th, and voiced his disappointment at not subject me to any corporeal malady, but being accorded the leisure to complete his really produces a spiritless inaction and report, but states his intention of doing so mental debility which all the resolution I at Norfolk. This letter reveals grave dishave been able to exert for better than two content at being continued on duty in the years has not afforded me the power to Essex," a vessel "smaller than the one he overcome.” His appeal, however, appears to first joined when he entered the service,” have fallen on deaf ears, for he was not de- where "his services gave the greatest satistached from the “Essex,” but did manage to

faction to Commodore Decatur and the get leave until September ist. A letter dated officers generally.” As respects the latter, July 11, 1811, written from Baltimore, ad- with some of whom he had been in disagreedressed to the Secretary of the Navy,refers to ment, he states that there has been a recona bottle of lime juice which he is sending him ciliation and he desires his transfer from by Lieut. Ballard for trial “in the form of a the smallest frigate in the Navy, back to the lemonade, after allowing it to settle for a day or two.” This is one of four dozen bottles

5 Benjamin Henry Latrobe, 1764-1820. An English

architect who settled in this country in 1796. He which Barton brought back from England

became identified with the Navy Department as an and he explains that his object in sending engineer, and designed the first Hall of Representathe lime juice is to enable the Secretary to tives at Washington.

“United States." He endeavors to reinforce of the service hospitals, which the Secretary his argument by adding that, “the present was required to submit to Congress at its surgeon of the ‘United States' was a surgeon next session. The Act of February 26, 1811, of a cutter at the time I was in the station he

had separated the navy from the conjoint now occupies.” It is not unlikely that he control of marine hospitals for merchant received still another order from the Secre- seamen and had authorized the establishtary to expedite his return to the “Essex,' ment of distinct institutions for the navy, for Barton wrote from Philadelphia Septem- but nothing was done until 1832 toward ber 18, 1811, explaining the delay in his furnishing these hospitals, except to rent journey to Norfolk, as being due to a con- temporary structures near the principal tinuance of the affection which overtook navy yards. From that date naval hospitals him at Baltimore two months previously, slowly arose at the principal stations. It was and that he has written Captain Porter of this report containing suggestions for the the “Essex" to that effect. He encloses a internal organization and government of physician's certificate in support of his hospitals, requested by the Secretary, which statement.

Barton refers to in the preface of his book, A letter written October 25, 1811, from as having been written “during a tempestuNorfolk, transmits to the Hon. Paul Hamil

ous passage from Norfolk to New York, in ton, secretary of the Navy, a number of the Hornet sloop of war, with the ever to be sheets containing a plan for the internal ar- lamented captain Lawrence, under the disrangement of marine hospitals. This evi- advantages, too, of sea-sickness and acute dently is a further development of his mental affliction from the recent loss of a proposed report, which finally grew into the friend-a brother." book he published in 1814. The term “ma- On November 18, 1811, Barton writes rine” hospital as used frequently by him was from Lancaster, where he had gone after equivalent to the naval hospital of the pres

his brother's funeral, renewing his request ent day. At that early period a distinction to be ordered back to the “United States, such as prevails at present did not exist. stating that his action had the approval of There were, it is true, “Marine” hospitals Commodore Decatur, and quoting from a for merchant seamen, available to the Navy, letter received from Mr. Allen, first lieuwhich became separated from the Navy by tenant, in substantiation of their desire to the Act of Feb. 26, 1811.

have him. This letter, which is addressed On November 2, 1811, Dr. Barton is back to the Secretary, also mentions the intention in Philadelphia, on leave, in order to attend of the writer to leave Lancaster for Philathe funeral of a brother. He appears to have delphia on November 19th, on his way to travelled by water from Norfolk to New Norfolk. His failure to return promptly York, on this occasion, in the U. S. S. “Hor- to his post of duty called forth peremptory net,” then under command of Captain James orders from the Secretary, dated November Lawrence, thence by stage to Philadelphia, 23, and Barton replied from Philadelphia leaving Norfolk October 26, and arriving in on November 27th, in effect, that he conPhiladelphia November 2, which for the siders the Secretary's reprimand for not times was quite rapid travelling. In the obeying orders as entirely unmerited, and preface to his 1814 publication he refers to he enters into a long explanation of the the trip on the “Hornet” and to his visit to circumstances surrounding his transfer from Washington in July, 1811, when Mr. Hamil- the “United States” to the “Essex” in ton called

upon

him to submit his ideas re- November, 1810. His delay at Philadelphia, specting the proper rules for administration he states, is due to information received

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