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)
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: Titus M. Coan, M.D.
To the Board of Naval Surgeons,
U.S. Naval Asylum, Philada:
I have the
honor to state, in conformity with the requirement of the Board, that I
was born on the 27th day of September, 1836, in the town of
Hilo, on Hawaii, one of the Hawaiian Islands. At the American schools
of those Islands I pursued a course of study identical with the ordinary
academic course of similar schools in United States.
In the year 1856 I
came to the United States, and during the following autumn entered the
Junior Class of Williams College. I completed the regular course
classical, mathematical, and other studies, in 1859; the commenced the
study of medicine with Dr. Elijah Harris, of New York. I was graduated
at the College of Physicians and Surgeons in the same city. Immediately
after graduation I was examined as a candidate for medical service in
the Hospitals under the control of the New York Commissioners of Public
Charities and Correction, viz.: the Bellevue, Blackwell’s Island, Small
Pox, and Randall’s Island Hospitals. In these I spent seventeen months
as interne [sic, underlined a different ink], – the greater part
of the time at the Bellevue Hospital; and was house-surgeon or
house-physician during twelve months of this period. Surgical and
medical cliniques were held almost daily in the wards by professors of
the various medical schools of the city.
I took the
opportunity, from time to time, of compounding medicines, and of
acquiring some acquaintance with druggists’ duties.
I have studied
the French and German languages; and while at college I claimed some
knowledge of Botany, Geology, and Conchology.
I am, very respectfully, your
obedient servant,
T. M. Coan.
September 29th, 1863.
Questions by the Board:
Questions to be answered in writing,
by Dr. Titus M. Coan.
1. What are the different means of
arresting hemorrhage?
2. What is hydrocele, and what is
the diagnosis?
3. Give a description of Dislocation
of the thigh on the Dorsum Ilii, + mode of reducing by manipulation?
[sic]
4. What is cinchona – describe it –
giving its source, nature, preparations uses etc – write a prescription
without abbreviation.
5. What is the composition of
alcohol + describe chemically the process by which it is obtained from
corn.
6. What is the sense of hearing?
Describe the parts involve + the properties and action of the air in
audition.
7. Describe the deep perineal
fascia.
8. What are the causes, symptoms,
lesions, + treatment of Asiatic Cholera?
9. What are causes, symptoms,
lesions + treatment of Puerperal Peritonitis?
Answers by Coan:
1. The different means of
arresting hemorrhage may be divided into I. Temporary; II. Permanent.
I The Temporary means are (a)
manual pressure – (b) pressure applied by bandages and compresses (which
may also be a permanent means when the hemorrhage is moderate in amount)
– (c) the tourniquet.
II The Permanent means are (a)
the ligature, applied to the proximal or to both the distal and proximal
side of the arterial wound - (b) torsion, in the case of the smaller
arteries – (c) the actual cautery - (d) styptics, applied externally or
internally – (f) cold – (g) exposure to the air.
2. Hydrocele is a serous
effusion into the tunica vaginalis testis. It is diagnosticated from
hernia by its gradual enlargement from below upwards; by its less rapid
development; by its irreducibility; by the lack of a communication of
impulse to the tumor when the patient coughs; by its pyriform shape,
with larger extremity downward; and, most certainly, by its translucency
when held between the surgeon’s eye and a candle, in a darkened room, in
such a manner as to render the scrotal integument tense.
From cirsocele its diagnosis
is similar. From haematocele it presents the same points of difference,
excepting in its shape. From syphilitic disease of the testis, whether
constitution or local, and from malignant invasion, it can be
discriminated by the softer feel the tumor, but the absence of any high
degree of sensitiveness in it, and by attention to the history of the
case, as well as to the 3d, 4th, and 6th
points enumerated in the diagnosis from hernia.
3. In dislocation of the thigh
on the Dorsum Ilii the symptoms are (a) shortening of the length of a
limb, from 1 ½ to 2 inches in extent; (b) eversion [“x” mark and
underlined] of the foot; (c) adduction the limb ports the opposite one
the; (d) nil a complete loss of power to move the limb.
To reduce this dislocation by
the method of manipulation, the patient should first be anaesthetized to
an extent sufficient to produce complete muscular relaxation. The
surgeon should then flex the thigh upon the body, carrying the knee
inward and upward, or, in general, following the direction which
presents the least obstacle to flexion. Upon making a moderate
oscillating movement of the thigh the head of the bone will now return
to the acetabulum with a distinct snap, the sensation of which is not
easily confounded with any other. Perfect rest in bed for a couple of
weeks or more should now be directed. A splint is not usually necessary
to the cure.
4. Cinchona is the bark of
various species of the C. Calisaya, a South American tree, of which a
large number of species and of varieties have been described by Humboldt
and later explores. The usual commercial varieties of cinchona are the
red and the white [“x” mark and underlined], of which the
chemical composition differ slightly; but both contain those vegetable
alkaloids which are among the first in value known to the Materia
Medica, - Quinia and Chinchonia. Of these the former is the most
potent, and its disulphate is by far the most extensively used
preparation of the drug. Its effects upon the system are those of a
simple bitter tonic; but it also possesses, in a marked degree, the
power of controlling those diseases in which periodicity is a
characteristic element, and which generally depends upon miasmatic
poisons for their development in the human subject. Quinine possesses
also an almost certain power of prophylaxis against these diseases, when
properly administered (Trans. N.Y. Med. Soc. 1861). Taken in overdose,
it induces the condition termed cinchonism, – characterized by an
excited state of the arterial circulation, by ringing of the head, and
by impaired sight and hearing.
A convenient form of
administering quinine, in combination, as a tonic, is the following
Recipe
Quiniae disulphatis
Ferri Sulphatis,
ana, grana viginti;
Extracti Vernicae
Trucis [?, unclear] grana quinque;
Misce. Fiat massa in pilulas
viginti dividenda.
Signa – Capiat unum, ter in die.
5. The
chemical composition of Alcohol is C4H6O3;
it is obtained from corn by subjection to the successive processes of
saccharine, acetoris [unclear], and vinous fermentation, and from the
product of the last it is separated by distillation and rectification.
6. The sense of hearing
is a reception of impressions of sound by the organs and the faculties
which they are designed to affect.
The parts involve
are the External Ear, or Concha; the Middle Ear; and the Internal Ear,
or Labyrinth.
T
The External Ear
consists of a cartilaginous expansion for the convergence of sound
toward the meatus auditorius; and comprises Pinna, Tragus, Antitragus,
and Lobe
The Middle Ear
consists of the Meatus, Tympanum, and Ossicula Auditis, which include
the Incus, the Malleus, + the Stapes.
The Internal
Ear consists of the Labyrinth, a complicated system of osseous channels
of which the function is imperfectly understood; and is in near relation
with the Eustachian tube, a conical canal, having its larger extremity
directed anteriorly to the posterior nares.
In audition
the tympanum and ossicula auditis are thrown into vibration which
correspond in intensity and in duration with those of the air which
produce them. The pitch of the resulting sound, as recognized by the
sense, is exactly determined by the number of these vibrations in a
second, and is constant for each number. The quantity of these
vibrations determines the character of the sonorous body.
7. The deep perineal fascia
extends transversely across the floor of the perineal space, underlying
the muscular structures of the region – the acceleratori urinae, the
compressor urethrae, the transversus perinea; and is encountered after
these in the operation of perineal section.
8. Asiatic cholera is
considered by some writers to have its cause in the presence of minute
floating sporules of vegetable origin which fill the atmosphere of the
infected region; and by others to be excited by deleterious gases
diffused throughout it; but no satisfactory theory, to my knowledge, has
been announced. The attack is sudden; there is great weakness and
prostration, often accompanied by alarm; watery stools are frequent.
This formative stage, if not checked in its progress soon passes into
the colliquative stage; the surface is cold and moist; the face has a
pale, haggard, and anxious look; the discharges assume a peculiar
character which has procured for them the name of “rice-water
dejections”; the other symptoms deepen; and death, often preceded by
delirium, closes the scene.
The treatment is
infinitely varied; but the most approved plans advise the exhibition of
mild astringents and of simple nutrients during the first or formative
stage; and of stimulants and tonics during the later stages. There is
no very satisfactory treatment.
9. The causes of Puerperal
Peritonitis are (a) The poison of decaying animal substances introduced
into the circulation of the mother, either from without or from retain
portions of the uterine contents – (b) An infection poison which lurks
in fomites or in the air, and is thought to be of a nature similar to
the former. The symptoms are acute tenderness of the abdomen, the
febrile condition, chills, suppression of the lacteal and of the lochial
discharge, mental agitation, and insomnia. The lesions are those of
acute inflammation of the peritoneum, is of one or more of the pelvic
organs; the inflammation varies widely in its locality, the amount of
fibrine in the blood is diminished. The treatment is (a) Warm
fomentations or turpentine stupes to the abdomen; (b) Opium, in quantity
almost unlimited, except by the effect it produces upon the disease. – I
have seen the Tr. Virat. Virid. exhibited in Dr. B. F.
Barker’s service at Bellevue with results hardly inferior to those of
opium.
T. Munson Coan
11 Lafayette
Avenue, Brooklyn, N. Y.
Certificate of Physical Capacity
I declare on
honor that my health at this time is good and robust; and that, to the
best of my knowledge and belief, I am free from any accidental or
constitutional defects, and without any predisposition to Epilepsy,
Phthisis, Gout, Apoplexy, or chronic disease of any kind. I am not at
present affected with Varicocele, disease of the urinary organs, Hernia,
or Hemorrhoids; nor am I aware that there is anything hereditary in my
constitution which would hereafter be likely to incapacitate me, for the
arduous duties of a Medical Officer of the Navy.
All my organs of
sense are without imperfection.
T. M. Coan
Candidate for
the office of Assistant
Surgeon in the Navy
of the United States
U.S. Naval Asylum,
Philadelphia.
September 29th,
1863.
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