Born in Harm’s Way: The Advent of Navy Medicine
by André Sobocinski, U.S. Navy Bureau of Medicine and Surgery
October 24, 2022
"I wish to
have no connection with any ship that does not sail fast, for I
intend to go in harm's way." Captain John Paul Jones
Today’s U.S. Navy recognizes October 13th
as its official birthdate.
It was on this day in 1775 that the
Continental Congress authorized the construction of the first Navy
ships as well as a special committee to oversee the administration
of this service. The provision for medical care followed soon after.
The Rules and Regulations of the Navy of the United Colonies of
North-America, issued by Congress on November 28, 1775, mandated the
role of shipboard medical providers as well as a place on each Navy
vessel to care for the sick and injured (Article 16).
Bonhomme Richard vs. HMS Serapis during the Battle of Flamborough Head on September 23, 1775 with reference to 'Born In Harm's Way: The Advent of Navy Medicine'. (Illustration by André Sobocinski, U.S. Navy Bureau of Medicine and Surgery)
Throughout the American Revolutionary War,
Navy surgeons and surgeon’s mates ... those first representatives of
what we call Navy Medicine today ... could be found on almost every
ship of the Continental Navy, as well as colonial privateers and
state vessels. During the heat of battle, the need for their
services rang as loud as any bell announcing a declaration of
freedom and independence from Great Britain. And some 247 years
since this mission first commenced, remains as relevant as ever.
Navy Medicine’s Charter Members:
From 1775 until 1783, a total of 136 surgeons and surgeon’s
mates served in the Continental Navy. Whereas the surgeon was a
commissioned officer who rated a wardroom aboard the ship, the
surgeon’s mate was a warrant officer who held the same status as
masters-at-arms and sail-makers and typically shared the steerage
with midshipmen. Regardless of rate, surgeons and surgeon’s mates
were akin to contractors signed to a particular ship for a specific
deployment. If their ship was destroyed or decommissioned, they
would be permitted to leave service and “sign” elsewhere. And many
did. Throughout the war, Continental Navy surgeons and surgeon’s
mates could be regularly found moving from ship to ship, from the
Continental Navy to privateering vessels, and even to ranks of the
The first Navy physicians on record were
Dr. Joseph Harrison of Kent County, Delaware and an 18-year old
Surgeon’s Mate Henry Hendren Tillinghast of Providence, Rhode
Island. Both reported aboard Commodore Ezek Hopkins’s flagship
Alfred in November 1775. Other Navy physicians soon followed
reporting as plankowners aboard the Navy’s first ships. They
included Surgeon Thomas Kerr and Surgeon’s Mate Michael Jennings of
the 14-gun brig Andrea Doria (December 1775); Surgeon John Ernest
Kessler and Surgeon’s Mate Thomas Burns of the 24-gun Columbus
(January 1776); Surgeon Henry Malcolm of the 12-gun sloop-of-war
Providence (January 1776); Surgeon John (Johan) Wiesenthal (Wisenthall)
of the 8-gun sloop-of-war Wasp (January 1776); Surgeon William Adams
of the 10-gun sloop of war Hornet (January 1776); and Surgeon Robert
Wilcox of the 14-gun brig Cabot (February 1776).
September 30, 1776, there was no requirement for these physicians to
prove their qualifications or medical acumen. On this date, Congress
stipulated that the colonies appoint physicians to examine
prospective Navy surgeons and surgeon’s mates prior to receiving
their commissions and warrants. By 1777, all prospective surgeons
and surgeon’s mates seeking appointments were required to provide a
certificate of this examination.
Holding a medical degree
was not a requirement for Navy physicians in the Revolutionary War,
but it was expected that most applicants would have been apprenticed
to a practicing physician for a period of two-years and be familiar
with existing medical literature. Medical degrees were still
uncommon at the start of the war. Of the roughly 3,500 practicing
physicians in the 13 colonies only about eleven percent or 400 had
MDs. Most of these degreed physicians were graduates from the
European medical schools like the University of Edinburgh. At the
time only two medical schools existed in the colonies ... the
College of Philadelphia (later University of Pennsylvania) and
King’s College (later Columbia University of Medicine). In 1775,
about 13 percent (or 50) of MDs in the colonies were graduates from
these American schools.
Operational Medicine in its Heroic Age:
In January 1776, Commodore Ezek
Hopkins led a fleet consisting of the ships Alfred, Andrea Doria,
Cabot, Columbus, Providence, Hornet, Fly and Wasp to attack forts at
New Providence, Bahamas and seize much needed gunpowder for the
Continental Army. This Raid on Nassau, as it was later known, and
the fleet’s return voyage presented many of the first medical
challenges to Navy Medicine’s charter members.
Harrison, Tillinghast and the other naval physicians taking part in
this operation the practice of shipboard medicine required the
treatment of an assortment of diseases, shipboard occupational
injuries, and ... during combat ... wounds caused by gunshot,
cannon, and burns. Medical care was still in its heroic age where
venesection (bloodletting), blistering, and purging were the rule.
Shipboard medical chests contained the usual assortment of anodynes,
antiarthritics, astringents, cathartics, emetics, diaphoretics,
diuretics, rubefacients, stimulants and tonics ... some of which
were equipped to induce a host of iatrogenic disorders such as
mercury poisoning and dehydration. Calomel (mercury chloride) and
jalap (a poisonous root) were commonly used to stimulate the
intestinal tract and rid intestinal irritation. Peruvian bark (later
known as quinine) was ever-present and used in the treatment of
malaria and other malignant fevers. Opium and laudanum (tincture of
opium in alcohol) were used to relieve pain and induce sleep. Teas
and tonics were commonly used to settle digestive complaints.
Infection remained a chief concerned for these shipboard
physicians. During the Revolutionary War, infections led to 90
percent of war deaths. In the decades before the discovery of
antisepsis and germ theory, there was little shipboard physicians
departed New Providence with 24 casks of gunpowder, 47 cannons, and
five mortars. Many of the Sailors and Marines that took part in the
landing party seizing the stores, later fell ill with a fever and
delirium that was described by Hopkins as a “new malignant fever.”
When the fleet landed in New London, Connecticut, Navy physicians
helped offload over 200 sick Sailors and Marines, many with
At the time, our Navy physicians typically
inoculated crews through the practice of variolation. By the 1770s
this method was widespread throughout the American Colonies as a
means of immunizing against smallpox. Even Benjamin Franklin and
General Washington were among its greatest advocates. Variolation
gets its name from variola (Latin for smallpox) and refers to the
process of taking pus, vesicles or ground scabs from individuals
exhibiting mild cases of small pox and introducing it to others
through the nose or skin. Before the advent of the smallpox vaccine
in 1796, one to two percent of those variolated died compared with
30 percent of those with smallpox.
Navy Medicine at the Battle of
On September 29, 1779, the
Continental Navy ship Bonhomme Richard engaged in one of the most
iconic sea battles in history when it fought against HMS Serapis in
Flamborough Head, off the coast of York, England. Commanding the
42-gun Bonhomme Richard was the fierce, and determined Captain John
Paul Jones, a seasoned sailor who had already established a
reputation for his daring victories and raids. But it was his
actions in the bloody battle of Flamborough Head that cemented his
place in the pantheon of naval heroes and earned him the moniker the
“Father of the U.S. Navy.”
Jones was far from alone in this
fight. The Bonhomme Richard included 347 crewmembers on board
including physicians Surgeon Lawrence Brooke and Surgeon’s Mates
Elijah (Elisha) Perkins and John Peacock.
Richard had originally been built a merchant ship named Duc de Duras
by the French East India Company 12 years before the battle. When
her owners went bankrupt in 1769, the ship was used by the French
Crown as a troop transport before being acquired by a merchant and
used for shipping goods. Through Benjamin Franklin’s influence as
the first American ambassador to France it was gifted to the United
States and refitted as a warship. Franklin selected Jones as its
first Captain in February 1779. And in tribute to his benefactor,
Jones named it in honor of Franklin’s nom-de-plume, “Poor Richard”
(known as “Good Man Richard” or “Bon Homme Richard” in France).
Among the ship’s plankowners was Dr. Lawrence (Laurence) Brooke
who Jones appointed as ship surgeon in April 1779. A native of
Virginia, Brooke was born 4-miles outside of Fredericksburg on the
Rappahannock River. There is possibility that either he or his
family had known Jones in Fredericksburg prior to hostilities. In
1774, at the age of 15, Brooke and his younger brother Robert ... a
future Governor of Virginia ... left the colonies to study at the
University of Edinburgh. When colonists became barred from studying
at University of Edinburgh, Lawrence fled to Paris where he may have
continued his medical education. On April 5, 1779, Brooke offered
his services to Jones as surgeon of the newly acquired Bonhomme
Richard. Brooke’s name appears in the correspondence of several
dignitaries and it is said that he dined with both Franklin and John
Adams and earned a reputation for skill and comportment. As one
naval officer who encountered Brooke later wrote, “He was . . .a
great favorite, an agreeable, cultured gentleman as well as a
The Bonhomme Richard was part of a
squadron of ships that also included the 36-gun Alliance, the 32-gun
Pallas, and the 12-gun brig Vengeance. Each ship also included a
complement of its own surgeons and surgeon’s mates. On the morning
of September 23, 1779, the squadron encountered two British warships
... the 20-gun Countess of Scarborough and the 44-gun British
warship Serapis ... escorting a convoy of merchant ships. As the
Vengeance targeted the merchant ships, and Pallas set out in pursuit
of the Scarborough, Jones set his sights on the Serapis.
Bonhomme Richard approached the Serapis on his larboard bow at 1920
in the evening. Captain Richard Pearson of Serapis called out to the
ship to identify itself to which Jones replied, “The Princess
Royal.” Pearson then asked, “Who do you belong to?” When he did not
get a reply he asked again stating that if they did not answer that
the Serapis would “fire into them.” Bonhomme Richard then fired a
broadside, which was answered by the Serapis.
On the first
broadside, two of Richard’s 18-pound cannons exploded leading to
massive carnage on the gundeck. With the help of available
crewmembers, Surgeon’s Mates Perkins and Peacock went into immediate
action carrying wounded to the orlop deck. There Surgeon Brooke
helped stabilize the wounded, working quickly to remove gunshots,
splinters, controlling bleeding, setting fractures, and when nothing
could be done to salvage the wounded limbs, performing amputations
through use of tourniquets, surgical saws and knives. The location
and type of wound was key ... and there was nothing any Navy surgeon
could do for injuries to the abdomen and thoracic cavity other than
administer opium for pain relief. In treating burns, Brooke would
likely have adhered to the practice of the time ... using linseed
oil, cerate of oil, or spermaceti on the burn before applying an
The repeated exchange of cannon fire
left a gaping hole in Richard’s side forcing the crew to abandon the
lower decks. Bonhomme Richard was every bit the sinking wreck and
any opposing ship captain would have surely expected Jones to
“strike the colors,” meaning to surrender. Pearson of the Serapis
asked Jones if he was was ready to “strike” to which he is said to
have defiantly answered, “I have not yet begun to fight!”
Brooke reported to Jones about the flooding in the lower decks and
that water was coming in so fast that the wounded were “being
floated out of the cockpit.” Jones is said to have replied, “What!
Would you have me strike to a drop of water, doctor?”
two ships maneuvered for strategic advantage they collided. Jones
used this as an opportunity to grapple onto the Serapis hooking into
the ship’s bulwark rails and rigging and ultimately linking their
fates. Richard’s Marines strategically positioned topside began
using muskets to pick off enemy combatants while an enterprising
seaman climbed to the ship’s mainyard and began dropping grenades
onto Serapis’s decks. These actions turned the tide of the battle
and forced Pearson to surrendering the Serapis.
totals on both ships was significant. Eighteen percent (63) of
Bonhomme Richard’s company were killed and 25 percent (87) were
wounded; the Serapis suffered 19 percent (54) killed and 27 percent
The 1783 Treaty of Paris formally ended the Revolutionary War,
and with it the Continental Navy. With war’s cessation and a
depleted treasury, Congress began selling off what was left of its
fleet. On August 1, 1785, the frigate Alliance ... the last of the
Navy’s ships ... was sold into private hands.
gradual resurgence was spurred by the signing of the Naval Act of
1794, ongoing difficulties with the Barbary States and a “Quasi-War”
with our former ally France. This new Navy, formally established on
April 30, 1798, came with similar requirements for shipboard medical
personnel and the care of Sailors and Marines as its Continental
Over the ensuing years, through wars, conflicts
and peacetime operations, the Navy built an impressive legacy. Every
step of way there have been representatives of Navy Medicine working
to provide our warfighters the care they need while ensuring that
they remain ready for the fight. And for as long there is a Navy
Medicine this will remain our North Star guiding us.
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