organization it is not unlikely that the personnel in some instances fell below the standard of earlier years.

The division of responsibility between the three organizations concerned with soldier relief was the greatest difficulty in the way of efficient administration and it became evident that steps must be taken to effect unification. Therefore, on April 19, 1921, the Secretary of the Treasury issued an order which transferred to the Bureau of War Risk Insurance all the activities of the Public Health Service affecting the beneficiaries of the Bureau of War Risk Insurance, except the management of hospitals and dispensaries which were operated by the Public Health Service.

The effect of this order was to transfer to the Bureau of War Risk Insurance the offices of the district supervisors, the medical examination of claimants, the assignment of beneficiaries of the Bureau of War Risk Insurance to hospitals, and the supervision of private hospitals giving medical treatment to discharged soldiers. The Public Health Service still continued to operate its own hospitals and to supervise private hospitals having contracts for the medical relief of seamen and beneficiaries other than those of the Bureau of War Risk Insurance. The district supervisors were by this order directed to continue all work previously done by them for the Federal Board for Vocational Education.95

As the Federal Board for Vocational Education was not under the supervision of the Secretary of the Treasury, he had no authority to control its activities. His authority as regards this organization was limited to prescribing the subdivision of the Treasury Department that should conduct the work being done by the Department for the board.

The unification of facilities for the relief of disabled soldiers had now progressed as far as was possible without legislation. A bill for the establishment of a Veterans' Bureau was introduced in the House of Representatives on May 95 For text of this order see foot-note on page 238.

25, 1921, and was approved by the President on August 9, (Public Act No. 47, 67th Cong). This act created an independent establishment to be known as the Veterans' Bureau, to which were transferred the Bureau of War Risk Insurance and the activities of the Federal Board for Vocational Education dealing with the vocational rehabilitation of disabled soldiers authorized by the act of June 27, 1918. The act also specifically affirmed the transfer to the Veterans' Bureau of the offices of the district supervisors and the supervision of contract hospitals as provided in the order of the Secretary of the Treasury of April 19, 1921. The Director of the Veterans' Bureau is made "responsible for the proper examination, medical care, hospitalization, dispensary, and convalescent care" of discharged soldiers, but the act does not transfer the hospitals of the Public Health Service to the Veterans' Bureau, although the President is authorized to transfer specifically designated hospitals if he deems such action necessary. The Director of the Veterans' Bureau is authorized to utilize the facilities of the Public Health Service and other specified government agencies, and these agencies are authorized and directed to furnish such hospital services and supplies as the director may deem necessary; if the hospital facilities of the Government are not sufficient for medical care and treatment the director is authorized to improve or extend existing hospitals, acquire additional hospitals, or to contract with state, municipal, or private hospitals.

It should be noted that this act does not set up a separate hospital organization in the Veterans' Bureau, but gives the director of that organization authority to take this action if he deems such a course necessary. The Director of the Veterans' Bureau is made primarily responsible for the medical treatment of beneficiaries and to accomplish this purpose he is authorized to use the facilities of the Public Health Service or any other government organizations. The Public Health Service became in effect a contracting agency for giving hospital treatment. The detailed hospital management still re

mained for a time under the Public Health Service, but the Director of the Veteran's Bureau is directed to maintain an inspection service, which is authorized to examine all facilities and services utilized for medical relief.

The President was authorized to transfer to the Veterans' Bureau specifically designated hospitals under the control of the Public Health Service, and by the executive order of April 29, 1922, there were transferred to the Veterans' Bureau the annexes to the Marine Hospitals at Mobile (No. 13) and New Orleans (No. 14) and all Veterans' Hospitals.96 The noncommissioned personnel was transferred to the Veterans' Bureau, but the commissioned personnel of the Public Health Service on duty in the hospitals was detailed for similar duty under the Veterans' Bureau. By this order the Public Health Service was relieved of all responsibility for the treatment of veterans of the War with Germany, and the nature of the hospital work reverted approximately to the condition in the early part of 1917 although greater in extent.

Revision of Salaries of Commissioned Officers, 1922. On June 10, 1922, there was approved an act (Public No. 235, 67th Congress) which established a new basis for fixing the salaries of the commissioned officers of the Public Health Service, Army, Navy, Marine Corps, Coast Guard, and Coast and Geodetic Survey. By this act the pay is fixed by rank and length of service, while the allowances for subsistence and quarters are determined by the rank, length of service, and whether or not the officers have dependents. Details regarding the pay and allowances of the several grades are given on page 169.

96 Prior to January 17, 1922. the hospitals which had been opened after 1918 had been known as Public Health Service Hospitals, while the older hospitals were known as Marine Hospitals. On January 17, 1922 the hospitals at Sewall's Point, Virginia, Ellis Island, New York, Carville, Louisiana, and 67 Hudson Street New York, which had been known as Public Health Service Hospitals were designated Marine Hospitals, all the other hospitals were designated Veterans' Hospitals. A complete list of the hospitals is given on page 254-257; the executive order of April 29, 1922, is given in full on page 244.

CHAPTER II

ACTIVITIES

Medical Treatment. Medical treatment for merchant seamen was the purpose for which the Marine Hospital Service was created in 1798, and this continued to be its only function for over three-quarters of a century. Gradually the service enlarged its activities in the field of quarantine, medical inspection of immigrants, sanitation, hygiene, and general investigations relating to the public health, until by 1918 the hospital work, measured by personnel and expenditures, was a relatively minor activity of the service. By 1920 the medical and hospital treatment of patients of the Bureau of War Risk Insurance had become the major activity of the organization in terms of persons employed and money expended. In the spring of 1922, the treatment of discharged soldiers was transferred to the Veterans' Bureau, and the hospital work was materially reduced although it still has an important place in the activities of the service.

Beneficiaries. Hospital treatment and out-patient relief are given to the classes of persons listed below. If hospital treatment for any class of patients is specifically authorized by law the date of the act and the references to the statute are given. If not specifically authorized by law, reference is made to the earliest regulations authorizing treatment. It will be noted that treatment for seamen on several classes of government vessels is not provided for specifically by statute, these patients presumably being treated under the general authority of Section 6 of the Act of March 3, 1875 (18 Stat. L., 486), which is as follows:

That sick and disabled seamen of foreign vessels and of vessels not subject to hospital dues may be cared for by the

Marine Hospital Service at such rates and under such regulations as the Secretary of the Treasury may prescribe.

In view of the fact that men on these vessels were given treatment under the general authority of the act of March 3, 1875, the special legislation relative to seamen on vessels of the Bureau of Fisheries appears to have been unnecessary. In the case of the Coast Guard and the Lighthouse Service persons other than seamen are made beneficiaries. The expenses of treatment are borne by the Public Health Service unless otherwise indicated.

1. Persons employed on vessels registered, enrolled, or licensed under the laws of the United States (July 16, 1798, I Stat. L., 605; June 29, 1870, 16 Stat. L., 595; March 3, 1875, 18 Stat. L., 485). Persons employed on canal boats are denied the privilege of relief by the act of July 20, 1846 (9 Stat. L., 38), and the joint resolution approved February 10, 1871 (16 Stat. L., 595).

2. Seamen employed on yachts which are enrolled, licensed, or registered under the laws of the United States. (Same acts as above.)

3. Seamen employed on vessels belonging to the Army, when not enlisted men of the Army (Regulations of 1902).

4. Officers and enlisted men of the Coast Guard (August 4, 1894, 28 Stat. L., 229; January 28, 1915, 38 Stat. L., 801).

5. Officers and men employed on vessels of the Bureau of Fisheries (July 1, 1918, 40 Stat. L., 694).

6. Officers of the Public Health Service and employees devoting all their time to field work (January 23, 1913, 38 Stat. L., 24).

7. Seamen employed on vessels of the Mississippi River Commission (Regulations of 1897).

8. Seamen employed on vessels of the Engineer Corps of the Army (Regulations of 1897).