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ACCESS TO CARE
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Chapter XI |
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276 CHAPTER XI Dr. William Shippen, Medical Director of the Army William Shippen, the son of a physician, was born in Philadelphia in 1736. Like Rush, he studied at Mr. Finley’s Academy, and later attended Princeton College. Here he became a fine classical scholar and also developed oratorical ability of a high order. He graduated under President Burr in 1754. The next three years were spent in the study of medicine with his father; and then in 1757 he embarked for Europe. He studied with John and William Hunter in London, and also with Sir John Pringle. He made a special study of anatomy, surgery and midwifery. He then went to Edinburgh, graduated in medicine there, and later studied in Paris, returning to Philadelphia in 1762. He soon began a course of lectures on anatomy, the forerunner of the medical school which he assisted Morgan in founding in 1765. This was the first medical school in America. Shippen was made professor of anatomy and surgery, and lectured regularly until 1775, when the college suspended on account of the war. In 1776 he entered the army as surgeon of the Flying Camp, and on October 9th was made Director of Hospitals west of the Hudson. In 1777 he became Medical Director of the army, which post he filled until 1781. From 1777 on he continued his anatomical lectures. Dr. Shippen came of a distinguished family and was a cousin of the Peggy Shippen who married Benedict Arnold in 1777. He was said to have been of such beauty of countenance, elegance of person and ease and gracefulness of deportment as to have attracted the eye of every beholder. He was a fascinating speaker and admired by Whitfield. He had married a Miss Lee, daughter of Governor Lee of Virginia, and continued to move in the best circles of society. The statement that he was a fascinating 277 speaker leads one to wonder if he might not have been one of those who, as Lord Fisher says, had talked himself into a job. Yet he had the necessary ability and energy to do that job, had he so determined. That he made any such efforts to do it is not apparent from the records, leaving his character somewhat of a puzzle. While Dr. Shippen viewed and helped to further the complaints against Dr. Morgan’s administration of the hospitals, he was no sooner installed in that officer’s position than loud and numerous complaints were heard against his own administration. And these complaints were even more reasonable; for if Dr. Morgan had been unable to secure satisfactory conditions in the army hospitals, he had at least been continually in the field, actively present at every battle, and energetically laboring in the hospitals afterwards; not infrequently with his own hands. During the next winter of 1777-78, the hospitals were if possible worse than before, while Dr. Shippen, comfortably settled in quarters at Bethlehem, not only was present on no field of battle, but if we may believe several sworn statements of medical men, scarcely ever visited the suffering hospital in the small town where he dwelled; but, spent his evenings in social enjoyment; or even in gambling and convivialities. But that was not all; it was soon rumored, and stated with confidence by responsible men that he was dealing in hospital property, to his own profit while the sick suffered for the very stores he trafficked in. His reports were to say the least not frank and straightforward. On November 24th, 1777 he made the following return of the sick to Congress. The statement that no fatal disease raged is misleading, as typhus, the most fatal of all diseases of the armies, was then prevalent in the hospital at Bethlehem, as well as at Princeton, and probably in nearly all the large hospitals: 278
1777—GENERAL HOSPITAL BETHLEHEM—Nov. 24.
Dear Sir: I have the honor of sending your Excellency the above exact
Return of the Sick and Wounded in the Armies of the United States, and
you may depend on it there are not more than 2784 sick absent in the
Middle Department, and there are never many allowed to continue long
sick in Camp. If we can be furnished with Blankets and Cloathing our
Sick will soon be again fit for Duty, as no fatal disease rages. This return does not include the hospital at Ephrata, which had several hundred patients at this time. Nor does it include either the sick in regimental hospitals or the hundreds who had been allowed to go to their homes. The total was well over 5000 in an army of no more than 25000. The Southern Department is not included. Saal and Sisters' House, Ephrata At this time the Medical Director had charge of supplies as well as hospitals. Shippen had the opportunity, and men, even those not his enemies, as Tilton, believed that he profited by the occasion. He was soon charged with irregularities in handling hospital stores. 279 One of the first to report the irregularities was the most eminent medical man produced by the Revolutionary period, Dr. Benjamin Rush, Physician General of the Army. On December 8th, 1777, he addressed a letter to Mr. Duer, for the information of Congress. In this letter he strongly recommended that the business of the purveyor (purchasing agent) be separated from that of the medical director; a thing which shortly afterwards was done by an act of Congress. This recommendation, though containing no open charge, could not but mean that Shippen was profiting by the property passing through his hands. It should be said that such things were so common as to be almost customary in the British Army; Pepys winked at gifts; the first Lord Holland made his fortune as Paymaster General of the Forces; even the great Duke of Marlborough accumulated much wealth in manners not favored at the present day. Rush in his first letter only left an inference; he soon made direct charges. Letter of Dr. Rush. Princeton, Dec. 8, 1777. I beg leave to trouble you for a few minutes with some remarks upon the medical establishment, which in spite of the munificince of good intention of the Congress has not produced that happiness which was expected. The reason of it appears from my experience to be owing to your having deviated from the plans used in all European Armies and in particular from that most excellent one which is now in use in the British Army. It is as follows. 1. There is an Inspector General & Chief Physician whose only business it is to visit all the hospitals—to examine into the quantity and quality of the medicines—stores—instruments &, and to receive & deliver reports of the number of sick and wounded to the Commander in Chief. 2. There is a Purveyor general, whose business it is to provide hospitals and Medicines—stores—beds—blankets—straw & necessaries of all kinds for the sick and wounded. He is allowed as many deputies as there are hospitals. He has nothing to do with the care of the sick. 3. There are physicians and surgeons general, whose business it is to administer the stores provided by the purveyor general, & to direct everything necessary for the recovery—the convenience—and happiness of the sick. The purveyor is subject to all their orders, which are always made in writing, to < 280 serve as vouchers, for the expenditures of the purveyor. As an additional check upon the purveyor, none of his accounts are payed until they are certified by the Physicians and Surgeons general. This renders it impossible to defraud the sick of anything prescribed or purchased for them. The Physicians and Surgeons general have deputies under them, who are called Seniors and mates. This is a short account of the outlines of the British system which is said to be the most perfect in the world. I shall now compare it with the establishment now in use in the American hospitals. The Director General possesses all the powers of the above officers. He is chief physician—Inspector general—Purveyor or Commissary general—Physician and Surgeon general. All reports come through his hands by which means the number if his wounded and dead may always be proportioned to his expenditures and to his fears of alarming Congress with all of the mortality of diseases. He can be present only in one place at a time, but is supposed to be acquainted with all the wants of his hospitals. This is impossible. The sick therefore must suffer for the surgeons of the hospitals have no right to demand supplies for them, the Director-General being the only judge of their wants. Lastly, his accounts are not certified by the Physicians and Surgeons general, so that the sick have no security for the stores & medicines intended for them. A Director General may sell them to the amount of a million a year, without a possibility of being detected, by your present establishment. All that the Congress requires of him are receipts for the purchase of the articles intended for the sick. These ample and incompatible powers thus lodged in the hands of one man appear to be as absurd as if General Washington had been made quartermaster—commissary—& adjutant general of your whole army. And your having invested him with a power to direct the physicians and surgeons in everything, while he acts as purveyor, as absurd as it would be to give the commissary a power to command, your commander in chief. To do the duty of purveyor general only requires a share of industry and a capacity for business which falls to the lot of few men in the world. What can be expected then from one who, added to that office, is responsible for every life in the army? Give me leave to mention what Dr. Monroe, the best writer on military hospitals in our language and who served during the whole of the last war in Germany at the head of the British hospitals, says upon this subject: “The directing & purveying branches ought never to he entrusted to the same person, as the temptation for accumulating wealth has at all times & in all services given rise to the grossest 281 abuses, which have been a great detriment to the service, as well as to the poor wounded and sick soldiers, and has occasioned the loss of many lives.
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* * * *” No man can suspect I wish for any alteration in the System from a desire of holding a higher or more lucrative office in it than one I have received from Congress. I would not accept of the directorship of our hospitals upon its present footing for the riches of India. On the contrary I am resolved to retire as soon as the campaign is closed, since I cannot act agreeable to the dictates of my conscience & judgment. If you adopt the British plan (and without it you will waste your treasure to no purpose and destroy the lives of half your soldiers in another campaign) I wish you would call upon Dr. Walter Jones of your state (Virginia) to fill the office of Inspector general. For industry— humanity—and skill he has few equals in America. His integrity and impartiality where justice, and his country are at stake, cannot be called in question; and I am told he will not object to an honorable appointment in our department in the line of his profession. His health will be promoted by the gentle exercise and change of air which will be necessary for him in doing the duty as Inspector general. Let me conjure you my dear sir by your love of human nature to direct your attention to this important subject. Our cause suffers—the Congress suffers by the many monuments of sickness and distress which are to be seen in most of the villages in Pennsylvania & New Jersey, destitute of a hundred of those necessaries & comforts with which our country abounds. 282 Dr. Shippen has taken pains to represent my complaints of the sufferings of the sick as intended to displace him. This method of rising into importance I know has been practiced with success in our department. But I despise it, and to that, I aimed only at the happiness of my distressed countrymen & the honor of my country. I shall seal my disapprobation of our medical establishment, as well as of its administration, with my resignation. A battle is inevitable. Nothing but a desire of assisting the poor fellows who are to suffer in it detains me a moment in the department. With compliments to Mr. Morris and Mr. Duane (to whose good sense and impartiality I beg you would submit this letter) I am sir your most humble servant B. Rush. A letter of December 13th following is similar. In it he speaks well of Drs. Craik and Bond. On January 25th, 1778, Dr. Rush asked a hearing of Congress, and resigned on January 30th. (His commission is in Paper of C/C. No. 78 XIX f. 209). On January 3rd, 1778, a committee consisting of W. H. Drayton, Samuel Huntington and John Bannister, was designated to inquire into the charges (made more definite in the later letters) of Dr. Rush. Dr. Shippen was informed of the complaints and, on January 18th, wrote the Congress in his own defense. The statement “that very few die—that no fatal disease prevails,” is now more irreconcilable with the facts that when made in December, for typhus was now at its height, and men were dying daily of it in the hospitals before his eyes at Bethlehem. At least they would have died before his eyes had he taken the trouble to visit the hospitals. Dr. Rush did “hit upon” one of them, the separation of the duties of medical director and purveyor, thus removing temptation from the director.
General Hospital, Lancaster Sir: 283 the Head of that department to wait on Congress to show them that there is not the least cause for these complaints, as far as the establishment or officers of it are concerned. If the physician and Surgeon general is of any use there may arise some cause of complaint at Princeton, from his long absence from his duty without leave at this important period. I think it my duty rather to run the risk of suffering in my reputation, than that the sick soldiers should suffer by my absence. Next week I shall do myself the honor of sending or carrying a return of all the sick & wounded—by which I flatter myself it will appear that our sick are not crowded in any hospital, that their number is not much if any larger than in my last return—that very few die—that no fatal disease prevails and that the hospitals are in very good order. These things being so, I rest satisfied that this hon’able body will not make any alteration in the medical department, or suffer measures to be adopted that may reflect on my own or any of my officers reputations, till I can be heard. I must add some amendments to our system may be made, but Doctor Rush, from his ignorance of the state of our Hospitals and not knowing his duty, has not hit upon any of them. If the Congress will give me leave I will point them out for their consideration next week.-
I have the
honor to be
Letter from Dr. Rush Dr. Shippen, I hear, is at last arrested. The public begin now to expect that justice from the army which they have in vain looked for from Congress. They expect soon to see that solecism explained—how the Director General of the Hospitals of the United States is enabled with 6 dollars a day to vie with the minister of France in magnificence of his Equipage & feasts. Dr. Morgan is so well furnished with evidence to support all his charges, that I am not sure that he will require my Attendance at his trial . . . . . . Some of Dr. Shippen's sycophants talk loudly of the liberal sentiments of the Gentlemen of the army, who will never condemn a man for trifles, such. as loving a good glass of wine, or a game of whist. True! But there are two crimes that never yet found pity or favor in our army—viz. Cowardice in an Officer of the line, and fraud in an 284 officer; Dr. Shippen’s guilt with respect to the last crime is as clear as the noonday Sun. The consequence of it you know has well nigh proved fatal at one time to our army & cause. But of this prepare yourself to hear tales that will make “each particular hair to stand on end” in a few weeks.
. .
. . .
. . . Dr. Rush, who had resigned on January 30th, 1778, addressed the following letter to Washington on February 25th. In the letter he was free to state in detail some of the irregularities in the hospitals and the faults of the Medical Director.
Princeton, Feb. 25, 1778. I should think myself inexcusable in leaving the army by resigning my commission without informing your Excellency that I was compelled to that measure by the prevalence of an opinion among some people that the distresses and mismanagement of the hospitals arose from a “want of harmony between Dr. Shippen and myself.” Next to the conviction of my own soul that this was not the case, I wish to have it known to Your Excellency that none of them originate in that cause. So anxious was I to cultivate harmony with Dr. Shippen while in Office with him, that I laid none of the abuses which prevailed in the Hospitals directly at his door. But as my obligations to living in harmony with him upon that account have not ceased, justice to my country—a regard to the honor of the army, as well as my duty to your Excellency call upon me to lay the following facts before you.- Bethlehem Hospitals, Feb. 17th. “This is to certify that the wine allowed to the Hospital at Bethlehem under the name of Madeira was adulterated in such a degree as to have none of the qualities or effects of Madeira. That it was a common practice with the Commissary General to deduct one third—sometimes more—sometimes less from the orders for wine—sugar—molasses—and other stores ordered for the sick by the surgeon. That none of the patients in the hospital under our care eat of venison—Poultry—or wild Fowl (unless purchased by themselves) and that large quantities of those articles were bought by Mr. Hasse, the assistant commissary of the hospitals, by order of the director General. 285 That the director General never entered the hospital but once during about six weeks residence in the village of Bethlehem, although the utmost distress and mortality prevailed in the hospital at that time. That a putrid Fever raged for three months in the hospital— and was greatly increased by the sick being too much crowded, and by their wanting Blankets—Sheets—Straw and other necessaries for sick people. That so violent was the putrid Fever in the hospital, that 9 out of 11 surgeons were seized with it—one of whom died— that one of 3 stewards 2 died and 3rd narrowly escaped with his life, and that many of the Inhabitants of the village caught and died with the said putrid Fever. That there have died in this place 200 soldiers, 8/10 of whom with a putrid Fever caught in the hospital within the space of 4 months.
(Signed) Wm.
W. Smith (Dr) (Surgeon, Pa.) This is to certify that the return for the hospital at Bethlehem for the month of December was 420* Patients, and that there died within the same month alone 40.**
(Dr.) Samuel Finley.” I am not acquainted with the number of deaths in all the hospitals in the department for these last four months. In Reading there have died 100—in Lancaster 120—in Princeton between 80 and 90 (60 of whom died in December and January). These returns are only from one fourth of the hospitals which have existed within the four last months. I think from the best general accounts I can collect that the number of Deaths in the hospitals from which I have obtained no returns, cannot amount to less than seven or eight hundred more. 286 This account will appear to be the more distressing when I add that the mortality was chiefly artificial, and not the consequence of disease contracted at camps. Eight tenths of them died with Putrid Fever, caught in the hospitals. In the height of the calamities and mortality which have been enumerated, the Director General wrote a letter to the Congress with the following declaration, “No fatal disease prevails in the hospitals—very few die and the hospitals are in very good order.” This letter was dated on the 18th of January last. This extraordinary mortality among our soldiers is not necessarily entailed upon military hospitals. Dr. (Jonathan) Potts lost only 203 men between the 1st of March and the 10th of December last, inclusive of all those who died of wounds. He suffered his patients (who were at one time very numerous) to want for nothing. The putrid Fever never made its appearance in any one of his hospitals. What satisfaction can be made to the United States? What consolation can be offered to the Friends of those unfortunate men who have perished—or rather who have been murdered in our hospitals, for the injustice and injuries that have been done to them? One half of the Soldiers who have been sacrificed might have proved hereafter the pride of a victory that might have established the victories of America. While our brave countrymen were languishing and dying from the total want, or scanty allowance of hospital Stores, I am sorry to add that the director General in a manner wholly unbecoming the dignity of his office and the liberality of his profession, is selling large quantities of Madeira wine, Brown and Loaf Sugar & &, which has been transported through the country in hospital waggons & received as hospital stores under the name of private property. I have only to congratulate your excellency on the change which the Congress have made in the Medical System, whereby the business or providing for the sick is put into the hands of Dr. Potts, a gentleman of established character for integrity— humanity—and—capacity in the management of that part of the duty of a hospital. I beg your Excellency's acceptance of the inclosed little pamphlet & am with warmest sentiments of regard and attachment, your Excellency's most affectionate humble servant B. Rush. P.S. I beg your Excellency’s Pardon for not acknowledging before this time your ready attention to my application for General and a military inspector for each hospital. The instruction given by Your Excellency to the Inspectors are excellent & have already produced the most salutary effects in the hospitals. 287 This letter was forwarded by Washington to the Congress. Another letter from Princeton, of date March 9, 1778, to a member of Congress, repeats the charges of the letter of February 25th, and gives some additional evidence.
Lancaster, Feb. 12, 1778.
Dr. Potts informed me that he knew of Dr. Shippen's
having sold several hogsheads of brown sugar to a person in Reading. 288
The sick of the army died from the want or scanty allowance of those
articles, from the sale of which Dr. Shippen has made a fortune.”
After a considerable argument he concludes: 289
should be removed; for which consummation he was pressing Congress to
long delayed action on his complaint. That information has been given to the Board of the Treasury that Alexander McKallaher, the deputy commissary of the hospital at the Yellow Springs, has made a practice of exchanging the hospital stores, such as sugar, molasses &c. for butter, poultry, eggs &c. for his own and the doctors’ table: that he keeps a blooded horse in the guardhouse, and a mare and a colt; that he entertains all people who come to the hospitals with wine and toddy, alleging that he is allowed to do so by Congress or Dr. Shippen, the informant is not certain which.
That these circumstances have given occasion to
great clamours among the inhabitants in the very neighborhood. 290 tion and restore his standing theoretically. His first memorial to Congress resulted in the following report by the medical committee. Its injustice will be apparent when it is recalled that in January 1777 and for two months previously the army had been west of the Hudson and not under Morgan's jurisdiction. East of the Hudson there was little complaint.
August 9, 1777. “That though no cause is assigned for his discharge, yet, your committe in inquiry, find that the general complaints of persons of all ranks in the army, and not any particular charge against him, together with the critical state of affairs at that time (January 1777), rendered it necessary for the public good and the safety of the United States, that he should be displaced, and were the reasons for his dismission; and that the doctors memorial appears to your committee to be a hasty and intemperate production, notwithstanding which, as he conceives himself injured, and requests an enquiry into his conduct, your committee are of the opinion that a committee of Congress should be appointed for that purpose.
Resolved, That Congress concur in the said report. 291
Resolved,
That Congress are satisfied with the conduct of Dr. John Morgan while
acting as director general and physician in chief in the general
hospitals of the United States, and that this resolution be published.” 292 June 30, 1778, and its late earnest address to the Inhabitants of the United States of America, May 1779. Assured moreover that it is the Intention of Congress vigorously to execute a Resolve of that Consequence, so warmly enforced in the constituents, without respect of persons, and that it will therefore give immediate orders for a Trial, free from the embarrassments of any tedious delay, from which innocent men sometimes suffer inconceivable hardships and distress and the guilty are enable to check and baffle the testimony of witnesses wearied out in a faithful attempt to bring them to Justice. I do hereby charge Dr. William Shippen, Jun. in the service of the United States with Malpractice and Misconduct in Office. And whereas Congress by a resolve of the House, has subjected a Director of the General Hospital on any accusation of Misconduct, to be tried by a Court Martial, I therefore now declare my readiness, to give before the proper Court having Jurisdiction, the necessary Evidence in the premises against the said Dr. Wm. Shippen.
I remain with warm devotion to my Country's
Liberties and Welfare, Sir, In obedience to the Invitations and commands of Congress, I stepped forth, on the Principles of Love to my Country and the public good, and charged Dr. Wm. Shippen, jun. in the Service of the United States with Malpractice and Misconduct in office, and pledged myself to appear in support of the charges, when called upon before the proper court having Jurisdiction in the premises. I expected that on such declaration Dr. Shippen would have been immediately brought to trial. More than a Month however is since elapsed and the Movements of the Enemy have made it impracticable for the General to appoint an early Court Martial for that purpose. How long the state of affairs may occasion his trial to be postponed is not known. Perhaps it may be during the whole of the ensuing campaign. I therefore deem it my duty to represent to Congress that those charges which I mean to bring against Dr. Shippen (part of which are contained in the enclosed Papers, marked No. 1 and No. 2) appear to be of such a nature that for the Honor of Congress and the Service of these States, the putting in arrest and immediate Suspension of Dr Shippen from Office is absolutely necessary, being a practice founded upon the Usages of War in all old es- 293
tablish Governments, and in our own Army, that where a person of
whatever rank is charged with Crimes of Office, and a Court Martial is
called for, he be forthwith put under arrest, and suspended from all
further Command and authority till he has undergone his trial and is
acquitted. The Propriety of the Measure is founded in the dearest
Reason and Nature of things. Can it be supposed just or rational that
an officer accused of Breach of Trust shall still be continued in the
exercise of that Trust as tho he were innocent?
Sirs: 294
Dr. Morgan appears to have written to Benjamin Rush,
asking him as to what testimony he could give regarding the misconduct
of Shippen. 295
As the matter seemed to drag, on October 25th Dr.
Morgan again wrote to Samuel Huntington, President of Congress,
regarding the charges. He stated that he had had a conference with
Washington on the subject, and that he (Washington) said that he would
order a court martial at the end of the campaign. He had also conferred
with the Judge Advocate General and laid his charges and the evidence
before him. He requested aid in procuring the attendance of witnesses. 296
gress that Dr. Shippen had not settled his accounts, although directed
to do so two years previously. He then went on to state his charges. 297
Dr. Morgan then wrote Congress (on March 28th) as to
new depositions, said that Dr. Shippen's course was evasive and
unworthy a sincere man or a man of honor: using artifices to weary a
prosecutor who had employed months of time when duty to his family
required him to be at home. 298 citizens of my innocence & my acquittal by the Court Martial? Will they not rather hasten to join their approbation of my faithful services? that I may maintain that unspotted character among my countrymen, I have so constantly & to the best of my abilities endeavored to deserve? I have the utmost confidence in the sense, justice & humanity of this honorable body & am with the most perfect consideration
Sir 299
Although the case was finally disposed of in August,
Dr. Shippen appears to have remained in Philadelphia as was his custom.
On November 24th the Congress again took action: 300 habits of mind were far better suited to the peaceful life of a Quaker community than to the rough action of an army in the field. As to his peculations, they were not proven beyond a doubt. In any case his long and useful life must overbalance a single departure from the straight path of integrity. NOTES.
1 STRENGTH OF CONTINENTAL ARMY IN 1778.
STRENGTH OF CONTINENTAL ARMY 1779.
The average for the two years is 31,099. 301
EXPENDITURES FOR THE YEAR 1780.
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