U.S. Navy Assistant Surgeon Application
By Norman L. Herman, M.D., Ph.D.
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: Stephen Dandridge Kennedy, M.D.
Dec. 18th 1863.
Gentlemen of the Board
I received my commission as an Assistant Surgeon in the United States Navy, about the thirteenth of May 1861, and, on the twenty fourth of that month reported for duty on board the U. S. Steamer Colorado. On the twenty eighth of June we left Boston, and went directly to Fort Pickens Fla. I remained in the vessel for six months, during which time her principal stations were, the mouth of the Mississippi, Ship Island, and Pensacola. While I remained in her there was but little sickness of any sort, and, with the exception of a few Gun Shot wounds no surgical cases of importance.
On the seventh of November I was detached and to report on board the Steamer Mohawk, then stationed at St Marks, on the West Florida Coast. At the end of five months and a half, during which time but few cases of disease presented themselves. I joined the Sloop of War Preble off Fort Morgan.
For six months the Preble blockaded the entrance to Mobile Bay, and then went to Pensacola. After the establishment of the Naval Hospital at the Navy Yard I was ordered by Admiral Farragut to report for duty to Surgeon Gibbs, then in charge. This hospital was established for the benefit of the west Gulf and Mississippi Squadron.
While I remained at the Navy Yard there were numbers of men sent from the different vessels along the coast, and up the river. The diseases were, as a general rule of long standing, the results either, of old wounds, or exposure to climacteric influences.
On the twenty second of February 1863, I was ordered to the Flag Ship Hartford then making arrangements to engage the batteries at Port Hudson, Louisiana. The Hartford succeeding in grasping the fortifications went up to Vicksburg, and returning to the mouth of the Red River remained between that point and Port Hudson until the seventh of June, when, I was detached, and returned North in the Steamer Burmuda.
While up the river, the diseases that came under treatment were principally those incident to the climate, as, Diarrhoea, Dysentery, Intermittent fever etc – together with some few Surgical cases, resulting from engagements with the enemies [sic, correction marks in pencil] batteries at different points.
Shortly after returning home I was ordered to the Navy Yard at Washington, to which post I am still attached.
S D Kennedy
Questions by the Board:
Questions to be answered in writing, by Asst Surgn S. D. Kennedy
1. How does rubeola differ from Scarlatina?
2. What are the diameter is of the pelvis at the superior strait?
3. What is the diagnosis of real from fictitious insanity?
4. What arteries are given off by the abdominal aorta?
5. What are the symptoms and treatments of Erysipelas?
6. How may the femur be dislocated?
7. What are the preparations of lead used in medicine, give the Chemical Symbols, also their action, tests etc _
8. Give a classification of the elements of food
9. What is the function of the liver? Give the nature of its secretion, its uses etc
Answers by Kennedy:
1. Rubeola and Scarlatina principally differ from one another in the symptoms developed upon the Cutaneous and Mucus surfaces. Each has a characteristic eruption. That of Measles commences on the third day, upon the upper extremity. It consists of small, red, points, which arrange themselves in crescents, more or less distinct, over the surface. The fever does not abate upon its approach. In Scarlatina the eruption commences on the second day, except in some cases of the anginose form, when it appears on the third. Its color varies from a purplish red, to a bright arterial hue. It is diffused generally over the skin, there being no interspaces. In Rubeola there is Coriza [sic], in Scarlet fever sore throat, especially in the anginose and malignant forms, where it is a most dangerous complication. These are the most marked points in the differential diagnosis. While many of the prodromic symptoms are alike, Scarlatina is usually much more prompt, and powerful in its impression upon the system then Rubeola. There is much greater danger in the complications of Scarlet fever as well as its sequelae: such as dropsy etc.
2. The diameters of the pelvis at its superior strait are The antero postereior, which is the shortest. Transverse, next in length. Oblique, which are the longest.
3. The diagnosis between real and fictitious insanity is often almost impossible. The history of the case, the condition in life of the patient, and a suspicion as to whether any motive exists for the pretense, may assist in the decision. Any one of its forms, whether moral, mania, or incoherence may be successfully imitated as to intellectual disturbance, action, or even, expression of countenance. Probably the circulation and other functions, furnish the best guides. In most all forms of insanity, specially after existing for a time, all of the functions, digestion, nutrition, secretion, circulation, and innervation, are impaired. The pulse assumes assumes [sic] a peculiar character. The skin is different in color, the appetite variable, tongue coated (the appetite may be voracious, or the reverse). Nutrition is impaired. Secretions are abnormal. Bowels either very loose, or, constipated. At times there is preternatural strength, or great dibility [sic]. A want of impressibity [sic] by external impressions such as heat and cold etc. Patient endurance of hunger and thirst. In addition to these, a watch set upon the patient may detect some incoherence in the symptoms, as well as liability through hereditary transmission, blow on the head, disease etc.
4. The branches of the abdominal aorta are, Phrenic, Coeliac axis giving off, Gastric, Hepatic (right gastroepiploic). Splenic (giving left gastroepiploic and vasa brevia). Superior Mesenteric, Capsular, Renal, Spermatic, Inferior Mesenteric, Hemorrhoidal Superior, Common Illiacs [sic].
5. Erysipelas is divided to Cutaneous and Phlegmonous, or, Cellulo Cutaneous. The first form is preceded by a chill followed by thirst, fever, headache, and disordered bowels + nausea. At the same time, or in a very little while after, effusion takes place. There is redness and swelling of the skin. White pits are left after pressure with the finger. Pulse is quick and irritable. Tingling, and burning of skin, and great pain, sometimes exists. This form generally appears about the face and upper extremity. If complicated with cerebral disturbance it is very dangerous. Treatment. Cathartics, Lime washes etc to allay the irritability of stomach. Muriated tincture of iron internally. Painting surface with Tinct Iodine, + Argenti Nitras. In the second case the general symptoms are of typhoid character, with a tendency to a gangrenous sloughing of the tissues of the part. There is livid swelling with pain, and a disposition to form abscesses. The treatment consists of cold applications to the part in the first stages. If these do not prevent inflammation, free incisions for the escape of pus, and sloughs, and general Tonic treatment, as Bark, beef tea etc.
6. The dislocations of the femur are 1st In the dorsum of the Illium [sic]. The head of the bone being felt under the muscles, than knee, and toes, turned in towards the opposite instep. 2nd Into the Sachro [sic] Sciatic foramen. The thigh drawn from the opposite one, the foot some what advanced + resting on the toe. 3rd Into the obturator foramen. The leg is somewhat lengthened and toes turned out. 4th On the body of the Pubis. The head of the bone is felt in this position; leg is shortened and everted.
7. The preparations of lead used in medicine are. Acetate, used as an astringent – in Gonorrhea, when injected, in addition to astringent properties it is supposed to form a pellicle the inflamed surface, protecting it from air and irritant substances. In large doses, or prolonged, it is a poison, producing Colica Pictonum, lead palsy etc. Nitrate, Pb.NO5. Now chiefly used as a disinfectant. Its properties are analogous to the other salts. Carbonate Pb:CO3 – Used in manufacture of plasters etc. The Chloride Pb.Cl. Bromide Pb.B and Iodide Pb.I are chiefly and used in the arts. These all have the poisonous properties; the carbonate is probably the most so. In addition to these there are the Protoxide Pb.O. Litharge, which is used in plasters, and is the Semivitrified oxide. Liquor Plumbi Subacetatis (Goulards Extract), and Liquor Plumbi Dilutus – Applied as Lotions.
The tests for Lead are, Sulphureted Hydrogen, throwing down the black Sulphuret; and the Iodide of Potassium, the yellow Iodide.
8. The elements of food are either Nitrogenized, or Non Nitrogenized. The principal constituents are – The Proteine [sic] Compounds, Albumen, Fibrin, Casein, Fatty Matters, Alkaline, and extractive matters, Starch Sugars, oils etc, all of which undergo changes during digestion.
9. The liver seems to be both in incrementitial and an excrementitial organ. Assimilating certain portions of the circulation to repair the waste of tissue; to get rid of other portions which are no longer of use to the economy. It also assists the lungs as a carbonizing agent. From it is secreted the bile, which possesses peculiar characters. On being agitated it foams like soapy water. It consists of cholesterine, or bile fat, which is analogous to Spermaceti. It is composed of Carbon and Hydrogen. Of Bilin – a combination of Soda and an organic compound called Coleic [sic, should be “holeric”] acid or pycromel. And of Biliveridin which is analogous to the Carophyll or clouring [sic, should be “colouring”] matter of plants. These are the principal constituents of the bile. It mixes with oil forming an emulsion which does not separate on standing. Mingling with the Pancreatic secretions it assists in the latter stages of digestion, acting upon substances that have not been acted upon in the stomach. It also has the power of converting starch into sugar. It assists in the formation of fat, and, although subsidiary to the lungs as a carbonizing agent contributes to calorification. Another of its functions is to eliminate, and carry from the system had a, useless excrementitious material.
Rx cipe –
Massa Hydrargei [?] granea duodecimo
Pulvis Aloes – granae octo
Saponis – granae quatuor
Misce. Et fiat pillulae quatuor
Signat. Duo sumendum nocte
S D Kennedy
Gunshot Wounds –
Essay, by Asst Surgn S. D. Kennedy.
A gunshot wound (Vulnus Sclopeticum) is one inflicted by a projectile large or small, discharge from any class of gun, by the explosion of gunpowder. Recently it has been proposed to include under this head all injuries, as resulting from splinters etc. as a result of the explosion of powder.
In their character, gun shot wounds bear some resemblance to lacerated and contused, as regards hemorrhage, and disorganization of the parts involved. Hemorrhage in these cases is slight, from the laceration and bruising of the vessel; their broken coats, and the rapid formation of plastic lymph quickly blocking them up. The difference between the orifice of entrance, and that of exit, is an important feature in these wounds. The former is larger, round, with smooth inverted edges – the latter smaller, the edges everted and ragged. The communication between these is very rarely direct, as the most minute cause; the border of the tendon, resistance of fascia some small substance entering at the same time, etc, being sufficient to turn the projectile from its course. This is not only a marked characteristic of this class of injuries, but greatly complicates the diagnosis and treatment. It is often impossible to follow the course of the ball or determine; unless it reveal itself by the phenomena resulting from its pressure upon some particular point, what direction it has taken in the body. On board of the Santee; a man who had been shot in the lower part of the right lung; the ball not having been discovered; one day presented himself complaining of loss of voice, and pain in the neighborhood of the Thyroid cartilage. Upon exploring, the ball was found, and extracted just to the right side of the Pomum Adami. In some cases a bullit [sic] will traverse the circumference of some portion of the body and return to the wound of entrance, in such cases a purple tract will generally marked its course. Two wounds may occur just opposite to each other caused by different balls, yet apparently the result of one; here the character of the edges is a means of discrimination, when the probe fails to discover the true nature of the injury. In another case, the same projectile may pass through some of the part of the surface, and reter [sic, correction marks in pencil, insert “en” above] it. These peculiarities are cause, not only by the class of tissues and organ with which it comes in contact; but by the nature of the ball itself. The recent changes in ordnance have done much to change the character of gun shot wounds. The shock and disorganization inflicted by a minnie bullet owing to its rotary motion is much greater than that resulting from those formally used. The same is the case with other varieties of amunition [sic, correction marks in pencil]. It is stated that the percentage of death has not been increased by these changes, owing mainly to a greater range, and less accuracy. The shock in gun shot wounds is peculiar, and not always in proportion to the amount of injury. It is partly mental as well as corporeal. Often, men are utterly unconscious of a wound for some time after its infliction, and experience no shock until their attention is called to it. Its symptoms are a sense of faintness, and sinking about the preacordial region, the surface cold and livid, an alarmed expression a thin weak and rapid pulse, and the respiration somewhat sighing. This condition last a greater or less length of time according to the organs involved, and the extent of the injury. In some cases no effort at reaction takes place, and in others it is slow and difficult. Gun shot wounds are either simple and uncomplicated; as, were a musket ball passes through some fleshy part, involving no important vessel or organ, and carrying no foreign body with it; or destroying an extensive surface, complicated with portions of dress etc, and injuring the nervous centeres [sic]. Gun shot wounds of the abdomen, and chest, although not necessarily fatal in all cases, nevertheless, present most great features owing to the vital importance of the enclosed organ. Patients have recovered who have been shot through the lungs. If death were not to result from a bullet entering the substance of the heart, that end might ensue from ulceration of the surrounding tissues and its falling into its cavity. Passing through the aorta, “fatal Hemorrhage”, inflammation of wounded membranes, and the entrance of the air, constitute the great risks run in this region. In the abdomen, wounds of the liver are almost surely fatal. Those of the spleen and kidney next in point of danger; and those of the stomach and intestines, although, not always resulting in death are very serious. In wounds of the extremity their gravity, and the shock experienced are in proportion to the injury done the vessels, nerves, and bones. When the spine is injured; if the ball remains in any portion of its course impinging upon the nerves, constant and great pain remains, as well as complications; such as, paralysis of the bladder, rectum, lower extremities etc. In addition to this other sequelae remain: as, Necrosis, Caries, (from injury to the bones) Neuralgia, artificial limbs, and others resulting from the presence of a foreign body at some point in the body.
In the treatment of the simpler forms of Gun shot wounds; having either ascertained that the ball has passed out, or extracted it, and removed any foreign substance that remained, a simple dressing will be all that is required at the time. If there is much nervous shock, some stimulus, and an opiate are required. As reaction comes on, inflammation is to be watched, and kept down by antiphlogistic treatment, light dressings etc. The discharge of puss [sic, correction mark in pencil] ought to be looked to, in order to prevent the burrowing of abscess, and this treated as in other cases. Where the injury to the part is extensive, and the shock great, a more positive plan of treatment is to be pursued, stimulation, and opiates, must be given with reference to the succeeding reaction. In dressing the wound it must be carefully cleansed, all irritant substances removed, parts that have lost their vitality removed, and emollient warm dressings applied. If the system is much much [sic] broken down, Bark, Tonics, and good diet, are required. Should the wound be indolent stimulating applications should be applied. Primary amputations are those performed before reaction has come on. They are required where there has been extensive injury to the bone soft parts, vessels and nerves; where a limb has been nearly carried away, and where joints are involved. The question of amputation, at other times, is determined by the health, age and habits of the patient and the facilities at hand for treatment. The object of a primary amputation, is, to avoid a double shock to the patient.
When Mortification, Gangrene and Tetanus occur, they are to be treated as in other cases. I neglected to mention these among the Sequelae of these wounds.
S D Kennedy
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