The Act for the Relief of Sick and Disabled Seamen

From 1 September 1798 the master or owner of every American vessel arriving from a foreign port had to give the customs collector a true account of the seamen employed since the ship last entered a US port, and pay twenty cents a month for each of them, a sum he could keep back from their wages. Coasting vessels paid the same when their licenses were renewed. A master who gave a false account forfeited one hundred dollars.

Collectors made quarterly returns of the sums to the Secretary of the Treasury. The President was to use it for the temporary relief and maintenance of sick or disabled seamen in hospitals or other institutions already open in the ports, or in some other way where there were none, and money collected in a district had to be spent there. Any surplus, with private donations, was to be invested in United States stock until it was large enough to buy ground and build marine hospitals, and the President could appoint directors of the marine hospital in such ports as he thought proper.

The National Library of Medicine explains the law as an expression of the new nation's belief that a healthy merchant marine was needed for prosperity and defense. In Boston, Castle Island in the harbor was the temporary site, and Thomas Welsh, a veteran of the battles of Lexington and Bunker Hill, took charge in 1799; the hospital moved to Charlestown in 1804. The first marine hospitals stood in East Coast ports, and as trade spread along the inland waterways and the Great Lakes, new ones followed.

Until the 1870s caring for sick seamen remained the service's main work. An act of 1870 centralized it under a Supervising Surgeon, the post now called Surgeon General, and the first holder, John Maynard Woodworth, organized its physicians as a mobile, uniformed corps on a military model. It was renamed the Public Health and Marine Hospital Service in 1902 and the Public Health Service in 1912.