On August 9, 1773, a Town Meeting in Marblehead was held to debate the construction of a public inoculation hospital on one of the nearby islands.

The proposal was rejected, but the majority did agree to allow a private funding of a hospital as long as the Marblehead Selectmen could regulate it.

[1] On August 17 a petition to build a private inoculation hospital on an island was sent to Governor Hutchinson who approved the measure.

No boat other than the hospitals' were to approach the island, and once returned to Marblehead were to dock only at approved locations within the harbor.

Another room in the building, the shifting-room, as where at the end of their island stay they would strip, wash, and be fumigated before entering the clean-room and getting dressed in the previously left, uncontaminated clothes.

The hospital itself was located on the southwestern section of the island, was three stories high, had ten rooms each with four beds, a kitchen, and accommodations for a steward, the physicians, nurses, and their assistants.

[1] Ashley Bowen, exemplifying some of the bitter feelings toward the hospital, sarcastically noted in his journal on October 19: This day at noon Colonel Orne with a body of volunteers and a number of invalids landed at Cape Pus on the NW end of the Isle of Catt and laid siege to the Castle of Pox, General Jackson, commander-in-chief; General Randall, leftenant general of Castle Pox; Arnaold Martin Esq., chief admiral of the white, in sloop Ashley.

By an expressed from Castle Pox General Jackson had a smart engagement and wounded nearly a 100 of Colonel Orne's body of volunteers the first evening they landed, of both sexes from the age of 3 years to 60 first day, and that General Randall engaged the Colonel himself.Since those exposed to smallpox (including recently inoculated) are not contagious for 10 days, visitors were allowed during this time.

[6] A newspaper article at the time notes, the patients "are indeed confined to a strict regimen; but they may every day be seen walking the island, shooting wild fowl, playing at quoits, etc.

"[7] On November 5, 1773 the patients and staff on the island celebrated Pope's Day (a colonial variant of Guy Fawkes Day) by lighting tar barrels "and a large fire displayed from the middle of the Island; the hospital was likewise illuminated, and made a most beautiful appearance here.

One of the members of this second group was Captain Lowell of Newburyport, who on December 4, 1773 was severely injured while loading a four-pound cannon on the island.

[1] One week later four townsmen were caught stealing contaminated clothing from the island while attempting to smuggle them into Marblehead.

The following morning the four were tarred and feathered and paraded through Marblehead into Salem, a source of much entertainment to those witnessing the spectacle.

To quell the inevitable violence, the four owners of the Essex Hospital nobly dropped all charges and refused to pursue the matter further.