U.S. Navy Assistant Surgeon Application
By Norman L. Herman, M.D., PhD.
The following is a dictated translation of the hand-written application to the U. S. Navy Examination Board during the Civil War by a civilian physician/surgeon for a position as a medical officer in the Federal Navy or for promotion to Assistant Surgeon by an Acting Assistant Surgeon. The actual applications are in the possession of the author and presented to enlighten the general public and other researchers as to the education process before and during the Civil War, the personal history of the applicants, as well as to show their personal level of medical knowledge in answering the questions asked by the Navy Board of Examiners. (Some applicants failed to pass and did not serve or served in the Union Army.)
This written presentation was first of a part of a two-part exam consisting of a written exam and an oral exam. Many of these applications are rich with highly detailed medical content offering an interesting perspective on the medical knowledge and practices of the period. A broad sampling of these exams is presented to give you a 'picture' of the type of applicant being examined and admitted to or rejected by the Federal Navy in 1863. Much more detail on the individuals and their personal and naval history will be presented in a forth-coming book by Dr. Herman.
(The actual written exam photos are available, but not presented on these pages due to the size of the files. An example of a hand-written exam is on the List of all Applicants page)
(The actual written exam photos are available, but not presented on these pages due to the size of the files. An example is on the List of all applicants page)
If you have additional information or images for any of these doctors, please contact us.
A list with links to all applicants in this survey of U.S. Navy Applicants for 1863
Example of a handwritten exam given by the Navy Examination Board
Applicant: Christopher J. Cleborne, M.D.
10th September 1863.
In obedience to orders received on the 18th May 1861, I reported for duty on board the U.S. Sloop of war “Jamestown” of which vessel Dr. Jno Rudenstein was Surgeon. On the 8th of June 1861, we sailed for Charleston S.Ca, on 20th June, sailed from the blockade at Charleston to Fernandina Fla. + returned the Hampton Roads in Sept 1861.
On 27th Sept. we left Hampton Roads for the blockade off Wilmington N.Ca. In January 1862, I was detached from the “Jamestown”, + ordered to relieve Passd. Asst Surgeon A. M. Vedder on the Sloop “Dale” at Helena Sound S.Ca. On the 20th July 1862, I was surveyed, + sent North to recruit my health. I reached home in August 1862. On the 17th of Sept 1862, I received orders to join the U.S. Gun-boat “Aroostook” at Washington D.C. and left the same month for the blockade off Mobile Ala. On the 5th August 1863, I was detached from “Aroostook”, and preceded North pr [sic] Steamer ‘Creole’, arriving in N. York 21st Aug 1863.
The “Jamestown,” being a remarkably healthy vessel, afford one but few opportunities for observing or treating disease; - Some few cases of Rheumatism, Catarrh, Bronchitis + minor Surgery. - The same remarks apply to the class of diseases met with on board the “Dale.” + “Aroostook.”
I met with some cases of gun-shot + other wounds @ the “Hospital” of the 145th regt. Tenth Vol. (stationed [sic]@ Otter Isld. St. Helena Sound S.Ca. The Surgeon of that regiment Regt (Dr. Potter) having been taken sick, was removed to the “Dale”, and duties of the Army Hospital devolved upon me for some time, this together with my practice among some 250 Contrabands, (refugees) afford me the only opportunities I had for observation.
All of which is respectfully submitted for your consideration.
I am Gentleman, your obedt. Sert
C. J. Cleborne Asst Surg. U.S.N.
To the ‘Board of Med. Examiners’
Questions by the Board:
Questions to be answered in writing, by, Asst Surgn Christopher J. Cleborne
1. What are the accidents or injuries which requiring amputation of the thigh?
2. What is the best mode of controlling the circulation in amputation of the thigh?
3. What is flooding? – how produced? – and how arrested? ….
4. Give in brief the cartilages, muscles, and ligaments of the Larynx.
5. Describe the physiology of digestion.
6. What are the constituents of Blood?
7. Describe the poisonous effects of strychina, the treatment of such poisoning + the mode of proving the presence of this substance.
8. Write without abbreviations, a complete prescription containing colchicum with directions for its use.
9. How would the presence of hydrocyanic acid be proven in a case of fatal poisoning?
Answers by Cleborne:
1. Accidents requiring Amputation of the thigh are such as may arise from Railroad, Steamboat + Mechanical injuries – gun-shot, cannon ball, + other wounds, involving destruction of the tissues, sufficient to produce extensive sloughing – very severe comminuted fracture of the bones – injury to the femoral artery, nerves, + veins – Secondary hemorrhage, severe form of compound fracture of thigh bone,-
2. The best mode of controlling the circulation in amputation of the thigh – is to compress the femoral artery, as it passes over the brim of the pelvis, + under pouparts [sic, unusual swirl with a dot over the “p” in pen by Cleborne] ligament by means of the thumbs of an Assistant, one thumb being placed upon the other, in order to increase the amount of pressure a large key handle well padded, will do equally well, and is much less tiresome. – a clamped tourniquet may also be used. To compress artery on thigh, use Petits tourniquet or some of its modifications._
3. Flooding, may occur before – during – or After labor, and may be divided into Accidental, + un-avoidable hemorrhage.
Causes.- are numerous, such as Shocks, falls, irritability of System, detachment of part, or the whole of placenta, etc_
Treatment. When it occurs before labor, the indications are, rest, sedatives, tonics, astringents (as Infusi Rosæ Comp.) + the tampon_ during labor, we must hasten birth of child, + produce expulsion of placenta, + contraction of womb as soon as possible_ After labor – clear the uterus of all coagula, of any adherent portion of placenta, + produce contraction of the organ by friction externally, sponge dipped in vinegar, or peeled lemon and inserted into cavity of the womb, rest, quiet good diet etc.
4. Cartilages of Larynx are 5 in number Thyroid – Cricoid – two arytenoid + Epiglottic cartilages together with cornicula laryngis_ Ligaments are the Crico-thyroid – Thyreo-epiglottidean – aryteneo-epiglottidean, vocal ligaments. _ The muscles are the Thyreo-hyoid – crico-thyroid – crico-arytenoid, transverse, Thyreo-arytenoid, Epiglottic._
5. The Digestive function physiologically considered, is a very complicated one. It may be divided into many parts – 1st The process of Mastication, – insalivation – deglutition – Chymification – chylification – Absorption, + Defecation. = In the mouth, the food is well comminuted by means of the teeth, + mixed with the Saliva (a compound secretion obtained from the Parotid, Submaxillary + Sublingual glands + containing water, Salivin or ptyalin, Salts of Soda, Sulpho-cyanide of Ammonia etc.) Starchy matters by means of the Saliva, may be turned into Sugar, but in order to effect this change the Saliva must be in apeculiar [sic] condition. Deglutition is performed by means of the superior, middle + inferior constrictor muscles of the pharynx, the food is carried downward, by the contractions of the longitudinal + circular fibres of the Oesophagus_ In the Stomach, the food is kept in continual motion, + triburated well, with the Gastric juice, containing Pepsin, lactic + hydro-chloric acids _ chyme (a gray pulpy mass) + chyle are formed, + the food thus prepared enters the small intestines, here it comes in contact with the bile, + the pancreatic juice; the latter acting upon the oily matters, forming them into an Emulsin [sic] capable of being absorbed. The albumen [sic] of the food is turned into Albuminase etc + thus the food is presented in a proper form to the Villi of the intestines, lacteals etc for absorption. The coloring matter of the bile is the only one of its principle that passes off with the feces. (biliphæn.) The feces derives their odor from the large intestines, some say from the Appendix Vermiformis.
6. The Blood of the human body is of two kinds, Venous, and Arterial- + is composed of water 700 parts, albumen [sic] 65 to 75 parts, fibrin 3 parts (increased in inflammations sometimes to 10 + 11 parts) Extractive matters, Red + white corpuscles_of the former about 150 parts in dry state, about 500 floating) [sic] proportion of white to red corpuscles about 1 of the former to 50 or 60 of the latter. Coloring matter of the blood is called Hæmatin, or Hæmatosin (ήμα or ήιμα) Globulin + hæmato-globulin_ size of corpuscles about 1/3000th_of white about 1/5000th of an inch – circular in shape – bi-concave in arterial, + bi-convex in Venous blood_ blood corpuscles of all mammals circular, except those of the Camel, which are oval in shape.- In addition we find salts of soda + Potassa + Iron (supposed to exist in form of an oxide.)
7. Strychnia is procured from the Strychnos Mix Vomica, + other varieties of Strychnos – It is poisonous in very small doses ½ gr having produced death. the [sic] usual dose is 1/32 to 1/16th gr its effects being carefully watched. It is a cerebro-spinal poison, affecting principally the nerve centres, + through them the muscles of the body. The Symptoms of poisoning by strychnia show themselves within two hours – sometimes in 15 to 25 minutes the patient feels peculiarly, his sensations not being always describable, nervous twitchings of the muscles are soon felt, especially of the muscles of the neck, chest + extremities, these twitchings are increased by the slightest movement of the patient, difficulty in respiration, headache (not common) full pulse slow, sense of impending danger, anxiety, difficulty in swallowing liquids or solids, the pulse now becomes fuller slower, dysphagia increases, muscular movements are now violent + rapid, Opisthotonas [sic], Episthotonas [sic] etc sometimes so powerful as to throw patient off the bed, finally the patient dies exhausted with the excessive convulsive movements produced by the poison.
Treat. The Stomach pumped or an Emetic should be had rescource [sic] so immediately_After clearing out Stomach give Tannin in large doses_Chloroform to relieve the spasm – Opium etc. Various remedies have been suggested as Lard, Charcoal, Curara, Tr Iodine in 20 gtt doses etc.
Strychnia may be detected by means of the Colour test – ie mixing a sol of SO3 with the suspected liquid, + adding a crystal of Bi-Chromate of Potassa when a play of color takes place_ “Spas” method, consists in treating with Acetic Acid + Ether_evaporating, + adding an alkali – water dissolves but a small part of strychnia.
8. Colchicum – The root of Colchicum Autumnale or Meadows Saffron. The root + seed are used in Medicine, useful in Rheumatism – Arthritis etc. Some consider its specific effect in Rheumatism, injured by combination with Cathartics as in Scudamore mixture etc_
Rx Tinctura Colchici - drachmas duas
Potassa Acetatis - drachmam unam
Tintura Opii - Semi drachmam
Aqua Menthis Piperitæ - uncias septem
Misce_ fiat mistura.
Signetur _ Simat cochleare amplum ter in die
Die Luna, decimo quarto, Septembris 1863.
9. Hydro-cyanic acid if is a powerful poison, very volatile and consequently very difficult of detection [sic] after death. It may be prepared by the action of a weak acid on Ferrocyanide of Potassa, or from Bi-cyanide of Mercury by Hydrochloric acid. The Acid of the Shops, is called the 2 pr ct acid_containing but two drops of the pure acid in the 100 of water. Its presence as a poison, may be detected by its peculiar odor_ or by means of its effects on a Solution of the persulfate of Iron, with which it combines, forming Prussian blue. This poison would be difficult of detection [sic] after a lapse of even a few months_
All of which is respectfully submitted
Dysentery = Inflamation [sic, correction mark in pencil] of the mucous membrane of the large intestines.
Inflamation [sic, correction marks in pencil] of the Colon is a disease very common in this Country, depending on a variety of causes, and assuming in a short time, a serious + often fatal form.
In the United States, this disease is not confined to any one portion of the Country, though in [sic, correction marks in pencil] occurs in a more severe form in the South, + South-western states, a fact which may be readily accounted for, by the greater length of the hot season, + malarial influences peculiar to that climate.
In England, the largest cities suffer most; though London (the healthy city in Europe) shows a smaller average return of deaths from that disease (Dysentery) than Bristol, Birmingham, or Liverpool. Ireland, has suffered much from its ravages, due no doubt to the state of distress to which many of her people have been subjected, from famine, + other causes. Returns from Scotland, show a small percentage of deaths from this disease, the same may be said of France. (Except in her sea port towns.) In Russian it is quite common, but seldom assumes a chronic form. But the place where we find Dysentery in its worst form, is in the East Indies_ In China, nearly all European residents are liable to it in consequence of their mode of living, or miasmatic influence. The disease as it exists @ Hong Kong; is very fatal, completely breaking down the System, producing ulceration of the coats of the intestine, perforation, peritonitis, + death!!- In such cases a slight alteration of “Chapmans” advice in Cholera Infantum would be advisable, minus the lancing of the gums + instead of “sending the patient into the Country” – send him out of it as speedily as possible. Persons who have been attacked with East Indian dysentery, + recovered from it, always show great susceptibility to intestinal disorders throughout life.
Anatomy = Before proceeding further with the subject it will be one well to consider the anatomy of the viscus involved.
The intestinal tract of the Mammalia, extends from the mouth to the Anus! In man + and in some of the higher classes of this order it has numerous divisions, + subdivisions, to which various names have been given. The intestines proper, extend from the pyloric extremity of the Stomach, to the anus – in length about twenty five feet – divided into larger + smaller intestine the former measuring about five feet, the latter twenty feet (according to some authors 25 ft – ‘Chesselden + Cruvelhier’ [sic, should be Cruveilhier]). The Colon[sic, correction marks in pencil] is divided into Cæcum (blind.) Ascending, transverse + descending portions. Sigmoid (ζ) flexure + anus! The small intestines into duodenum, (12) jejunum (jejunus – empty) + ileum
Structure. The intestines are composed of four coats = Serous muscular mucous + Cellular. – The Serous layer is derived from the peritoneum – the Cellular, contains the vessels. – the muscular is composed of two layers – longitudinal + circular, + the mucous membrane contains glands, secretes Succus Entericus, performs the office of absorbing etc etc. [sic] = Of glands – we find Brunner’s in duodenum agminated or Peyers, in ileum – glandula solitariæ in whole tract, besides Follicles of Lieberkuhn, Rivinus etc. The Villi of the intestines are its absorbing medium – The Epithelium (tessellated) of the intestines – of the whole tract) [sic] is said to be thrown off every twenty four hours.
Causes. Like all other diseases, the cause of dysentery is frequently of obscure. Climateric [sic, correction marks in pencil] influences + miasmata are in most cases the predisposing causes – Of the exciting causes it may be said there named is legion! Sudden changes of heat + cold, bad food, checked perspiration, the emotions,- joy – hope – fear – anxiety of mind, taking cold drinks while the body is over-heated, fresh fruit, Vegetables – unchecked diarrhoea – tuberculous diathesis, improper clothing certain kinds of water, containing alluvial, decaying vegetable + other deposits. The poor are generally most attacked though all are liable, but ill-ventilated apartments, bad un-wholesome food, habits of intemperance, un-cleanliness etc must soon produced disease
Pathology. The changes which are found to have taken place, are not very diversified in their nature.
Usually however we find in Acute dysentery, the purplish red appearance so characteristic of inflamation [sic, correction marks in pencil] in mucous membranes extending throughout the colon – obliteration in some part of the rugæ of the intestines, thickening of the mucous coat, deposits of coagulable lymph, extravasation of blood under mucous coat etc. In severe cases – abrasion of mucous membrane, ulcerated patches involving even muscular coat, shreds of mucous membrane + lymph hanging from coat of intestine, soft and mushy feel of mucous coat etc.
There is great emaciation over whole body – the adipose tissue is rapidly absorbed, even to absorption of Appendices Epiploicæ etc.
Symptoms. Dysentery may occur in two forms – either Acute, or Chronic! the latter usually the result of the former.
The disease is usually ushered in by an attack of ordinary diarrhoea, or dysenteric symptoms may immediately present them selves. The patient has a general feeling of malaise sometimes has a decided chill, followed by headache, full + quick pulse, loss of appetite (anorexia) tongue covered with a heavy creamy fur, edge + tip frequently red, fugitive pains in back, legs, side etc, mind dull, temper irritable, skin generally warm + moist, urine moderate in quantity + usually high colored frequent desire to go to stool, copious evacuations from the bowels, accompanied with tenesmus, (straining at stool) and tormina (twisting and griping of the bowels) – the former is very distressing to the patient, giving him a feeling of fullness in the anal region, + keeping up the desire to continually evacuate the bowels; in addition to the disagreeable sensation produced, it causes hæmorrhoids, or sometimes even a prolapse of the gut.
The griping pains are excruciating, and this symptom together with the tenesmus, would alone be sufficient to proclaim the disease. The fecal matters evacuated are at first diarrhoeal, + consist of the ingesta, but they rapidly change their character, + become thin, bloody + fetid - the dysenteric odor is one that cannot be described, but after being once recognized is not readily forgotten – The discharges finally become almost entirely hæmorhagic [sic, correction marks in pencil], sometimes appearing like the washings of flesh, + filled with shreds of mucous membrane.
Diagnosis. Dysentery may be confounded with Cholera Morbus, or the severe form of Diarrhoea Crapulosa, from both of these it made be distinguished by the greater severity of the symptoms, bloody discharges, tormina + tenesmus, odor of egesta. Peritonitis is marked by excessive + sudden severity of pain, the decubitus of patient, + perforation by the sudden prostration. From the paroxysmal non-inflamatory [sic] pain of Colic it is readily distinguished in fact dysentery per se is too well marked a disease, for the merest tyre in Medicine to mistake. Intercurrent inflamations [sic, correction marks in pencil] are apt to ensue. Pneumonia, Bronchitis, Gastritis, Enteritis etc, we must be on the qui vive for at all times.
Prognosis. When taken in its first stage it is very favorable, but when allowed to run un-checked even for a short time, it becomes a formidable opponent. Usually however it may be considered in this Country favorable!
Treatment. In this, as in all other diseases Remove the cause! this is the primary consideration, having done so, clear the prima via of all offending matters, by means of a mild cathartic combined with some Anodyne, such as, (Mist. Ol. Ricini), or a seidlity powder combined with 15 or 20 gtts Tinctura Opii, then commence with astringents as Rx Plumbi Acetatis gr xij Pulvis Opii gr vj Misce. Fac pilulas duodecine – Signetur – Unum omni tertius hora sumendus – In case the disease does not give way by the 5th day, try small doses of blue mass, Ipecac + opii.
In cases depending on miasmatic influence, Calomel + Quinine will have to be used. Sometimes the vegetable astringents will alone answer very well, + maybe the Dovers powder at bed-time. Hope’s Camphor Mixture – composed of ℥viij Camphor (Water [sic], gtts XI Nitrous Acid (the nitrosi – nitric acid of the shops) + / Ʒi of Tr Opii. gtt. – Dose f℥ss t.d. This is an excellent remedy in some cases. In dysentery depending on Malarial influence, remove the patient to some better climate if possible. The rest of the treatment, will consist in farinaceous diet, good ventilation, fresh air, clean linens etc. Disinfectants must be freely used, and all evacuations of patient at once removed.
A list with links to all applicants in this survey of U.S. Navy Applicants for 1863
Example of a handwritten exam given by the Navy Examination Board
Contact Dr. Arbittier or Dr. Echols
Last update: Monday, December 12, 2016