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John L. Parascandola, Public Health Service, pp. 487-93 in ed. George Thomas Kurian, A Historical Guide to the U.S. Government. New York: Oxford University Press, 1998.

The 1870 reorganization converted the loose network of locally controlled hospitals into a centrally controlled Marine Hospital Service, with its headquarters in Washington, D.C. The position of supervising surgeon (later surgeon general) was created to administer the Service. John Maynard Woodworth was appointed as the first supervising surgeon in 1871, and he moved quickly to reform the system. In 1872 he began publishing annual reports of the Service. He also adopted a military model for his medical staff, instituting examinations for applicants and putting his physicians in uniforms. Woodworth created a cadre of mobile, career service physicians who could be assigned and moved as needed to the various marine hospitals. The uniformed services component of the Marine Hospital Service was formalized as the Commissioned Corps by legislation enacted in 1889. At first open only to physicians, over the course of the twentieth century the Corps expanded to eventually include dentists, sanitary engineers, pharmacists, nurses, and other health professionals.

The scope of activities of the Marine Hospital Service also began to expand well beyond the care of merchant seamen in the closing decades of the nineteenth century, beginning with the control of infectious disease. Responsibility for quarantine was originally a function of the states rather than the Federal government, but an 1877 yellow fever epidemic that spread quickly from New Orleans up the Mississippi River served as a reminder that infectious diseases do not respect state borders. The epidemic resulted in the passage of the National Quarantine Act of 1878, which conferred quarantine authority on the Marine Hospital Service. Since the Service already had hospitals and physicians located in many port cities, it was a logical choice to administer quarantine at the Federal level. Over the course of the next half century, the Marine Hospital Service increasingly took over quarantine functions from state authorities.

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