A Senior Army Physician Who Became a Critic

By the winter of 1777-1778, Dr. Benjamin Rush was one of the most prominent physicians in the Revolutionary generation and served as Physician General in the Continental Army’s medical establishment. Official Army medical history describes him as “the most eminent medical man produced by the Revolutionary period” and identifies him as Physician General of the Army when he began to question how hospitals were run under Director General William Shippen Jr.

Rush watched conditions in the general hospitals during the Valley Forge campaign, especially at Bethlehem and other Pennsylvania sites, and concluded structural flaws in the medical system, combined with Shippen’s control of both care and supplies, were harming soldiers.

The December 1777 Letter: A Structural Indictment

On December 8, 1777, Rush wrote to Henry Duer for the information of Congress. In that letter, preserved in the Army’s Office of Medical History, he laid out the British model for military hospitals, which separated three key roles: an inspector of hospitals, a purveyor for supplies, and physicians and surgeons in charge of patient care.

Rush contrasted that with the American system, where the Director General acted as chief physician, inspector, purveyor, and reporting officer all at once. He warned this concentration of power made it “impossible” for one man to know the needs of every hospital and created a situation where a Director General could, in his...

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