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.
Naval Asylum
Philadelphia
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.
Very respectfully
S D Kennedy
Assnt Surgeon
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
Very respectfully
S D Kennedy
Assnt Surgeon
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.
Very respectfully
S D Kennedy
Assnt Surgeon
