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: David Mack, Jr., M.D.
To the Board of Naval Surgeons.
U.S. Naval Asylum, Philadelphia.
Gentlemen,
I was born in Wrentham, in the county
of Norfolk, State of Massachusetts, on the 22d day of
September, 1836.
The course of study which I followed
while a boy was intended to fit me for a collegiate education. It
consisted, as usual, besides the common English branches, of Algebra,
Geometry, French, Latin and Greek.
When about 15 years of age, my father
sent me to Germany to a boarding school, where I continued these same
studies, with the addition, of course, of German. After having been
abroad nearly two years and a half, I returned home expecting to enter
the Sophomore class of Harvard College at the next commencement, which I
was about fitted to do, when an attack of measles left me with such weak
eyes that I was obliged to give up the plan. As soon as I was able, I
went to study what of the Zoölogy and Geology I could with Professor
Agassiz. I was with him as a student about a year and a half, attending
his lectures on those subjects, which I learn what I could of them in
his laboratory, and also attended the lectures of Prof. Wyman on
Comparative Anatomy of Vertebrates and of Prof. Gray on Botany –
Since leaving the Scientific School at Cambridge, I had little
opportunity pursue the studies.
In November, 1858, I began the study
of Medicine with Dr. L. Clary, of Syracuse, N.Y. and continued with him,
giving a part of my time only to medicine, till following September,
when I joined the Harvard Summer Medical School in Boston. I studied
there one year, attending lectures at the Massachusetts Medical College
in the winter months. During the winter of 1860 – 61, I attended a
second course of lectures in Boston; but being in poor health on the
following spring, left off study till the next September, when I became
a student with Dr. F. Winsor, Superintendent of the State Hospital at Rainsford Island, Boston. I staid [sic] with him till the following
April, when I went on board of a hospital boat for the Western Sanitary
Commission, where I acted as Assistant Surgeon and had charge of a ward
for somewhat more than two months. In September, 1862, I return to
Rainsford Island, where I remained till July 6th, 1863, when,
having graduated in Medicine at the Massachusetts Medical College, I
left.
Dr. Windsor having left the hospital
in the beginning of December, 1862, I was a pupil, during the rest of my
stay there, of Dr. G. L. Underwood, who was Dr. Windsor’s successor.
During a fifteen months, that I was at Rainsford Island, I an entire
charge, though under the supervision of the Superintendent, of between
twenty and fourty [sic] patients. Some of the time I put up only a
part, but for a while the whole of my own prescriptions, and also had a
part of the making of tinctures, infusions, etc, to do. The patients
were men, women and children; the diseases both medical and surgical,
chiefly chronic and there was some midwifery. There were few surgical
injuries and fewer operations. While study in Boston, I attended the
medical and surgical cliniques and also the surgical operations.
I feel nearly as well equated with
German as with English. French I have not studied for some time, and
should have to refer to the dictionary often to read it.
I am staying at present at 926 Spruce
St. My post-office address is Belmont, Mass.
I am respectfully
David Mack, Jr. M.D.
Questions by the Board:
Questions to be answered in writing,
by Dr David Mack Jr.
1. What is the duration of
pregnancy?
2. Describe the symptoms and causes
of Tetanus.
3. In what ordered do the infantile
teeth appear, and what is the number?
4. Give the symptoms of paroxysm of
Intermittent fever.
5. Describe the axilla, it’s [sic]
boundaries and contents + their relations.
6. What are the constituents of the
bile?
7. What are the effects of Mercurial
preparations on the system and what their uses? Write a prescription
without abbreviation.
8. Enumerate preparations of
antimony used in medicine giving their composition in symbols.
9. What is the spleen? Give some
account of its structure and supposed uses.
Answers by Mack, Jr.
1. Nine calendar or ten lunar month;
or two hundred and eighty days.
2. Tetanus consists of tonic spasms
of the voluntary muscles and generally begins in the facial muscles,
producing of an unnatural and prolonged grin. It is followed by a
similar affection of the muscles of mastication, which prevent food
being taken: this is called trismus, or locked jaw. As the attack
progresses, the muscles of the limbs and trunks become involved and the
limbs are rigid; the fingers and thumb are firmly flexed on the palm,
and the toes bent towards the sole of the foot; the trunk may be bent
forwards, when it is called emprosthotonos; backwards, when it is called
opisthotonos; or to one side, when it is called pleurothotonos. These
spasms give the patient much pain and frequently produce a certain
amount of laceration of the muscles. They continue with but slight
remission and tend to destroy life by the exhaustion of nervous force
and the prevention of nutrition. The mind is very little affected
during the course of the attack.
Tetanus is classified according to
its cause into idiopathic and traumatic. It is generally of the latter
variety being caused by surgical injuries, especially those of the foot
or hand, which lacerate or partially destroy some nerve. Exposure to
dampness and cold by night and the heat by day aids greatly in its
production. A debilitated constitution would be more subject to it than
a robust one.
Idiopathic tetanus is neither very
common, nor as dangerous as the traumatic, it occurs in newborn
children, when it is called trismus monatorum.
3. The number of the infantile teeth
is twenty. They begin to appear at about the seventh month, and sooner
in the lower than in the upper jaw; as a general rule, during the whole
course of their eruption. The first to appear are the middle incisors,
first of the lower, then of the upper jaw; then the latteral [sic]
incisors, in the same order; then the first molars; I believe the next
to follow are the second molars, and lastly the canines – the first
dentition is completed at about two and a half years –
4. After a preliminary period of
languor, during which the patient loses his vigor and appetite, has
creeping sensations running over his body, has chills and pains in his
back, the cold period or true chill sets in. During it, the surface is
pale and cold; the skin contracts around the hair follicles, leaving
them prominent, and producing the appearance called goose flesh, or
cutis anserine; violent shivering comes on, the teeth chatter and the
patient feels extremely cold, and it is almost impossible to warm him in
a severe attack. Owing to the congestion of the internal organs, their
secretions are more or less suppressed or disordered; the urine is not
secreted. If the malarial poison be very strong the patient may be
overcome in this stage, it being impossible to bring on a reaction.
This is called pernicious fever. Usually, after this stage has lasted
an hour or two, it is succeeded by a stage of reaction, or the hot
stage. During this stage, the surface is flushed and hot, the pulse
rapid and full, and the patient is as uncomfortably hot as he was before
cold. Delirium may occur as a consequence of the general excitement; it
may also occur in the cold stage, but is, I think, much less common.
The hot period lasts longer than the cold and terminates in a profuse
perspiration, with copious secretion of urine, after which the patient
feels relieved and soon recovers in a considerable degree his former
condition. The period between the end of one paroxysm and the beginning
of another is called the intermission; that from the commencement of one
to the commencement of a second is called the interval.
5. The axilla is situated below the
shoulder and between the upper parts of the chest and arm. It is
bounded below by the pectoralis major in front, and the teres major and
latissimus dorsi behind; the serratus magnus covers the chest; and the
coraco-brachialis, the long and inner heads of the triceps cover the
humerus. Its shape is pyramidal with the base downwards and outwards
formed by the skin between its lower boundaries, while its apex lies
between the chest, upper part of the arm, clavicle and first rib – The
pectoralis minor forms a part of its anterior wall above.
The contents of the axilla are,
internally, the axillary vein, next external to it the axillary artery,
then the axillary plexus of nerves, which in the middle or lower parts
surrounds the artery. The structures are surrounded by a large mass of
cellular tissue, which contains a considerable amount of fat in its
meshes, and in which several lymphatic glands are imbedded. These lie
mostly in the lower and inner part of this region, though some extend
high up and are near the vessels. Some of them receive the lymphatics
from the breast and become affected in consequence of troubles there.
6. The principal ingredients of the
bile are cholesterol which is the great part of biliary calculi;
glycocholate and glyco-taurate of soda; the coloring matters biliverdine
and bilifulvine, animal matter and water.
7. Mercurials to act must be
absorbed, after which they stimulate all the excretory and secrotory
[sic] organs, being foreign to the system, which in this manner tries to
get rid of them. When given moderately, their effect is noticed
principally in the liver, which, being the largest gland of the body
does the large is part towards their elimination. This effect is known
to be produced by the evacuations being lighter colored than before or
perhaps greenish and liquid, showing a large excess of bile. Blue mass,
in the dose of from five to ten grains, produces these effects mildly,
and calomel in the same amount, more decidedly. These forms of mercury
are used in about the dose mentioned as laxatives or cathartics and are
more especially indicated in torpor of the liver.
If the action of these medicines be
long continued and if the amount given is greater than the emunctories
can remove, the blood becomes poisoned, or injured in quality, its
fibrine loses in a great degree its power of coagulating, the globules
diminish and the water increases in proportion. The disintegration of
tissue is hastened and the quantity of salts present in the blood
increased. Salivation is produce, owing to the increase of secretion,
which the salivary glands are called upon to perform. If this is severe
the glands may be destroyed and large, foul ulcerations occur on the
gums and inside of the cheeks; the teeth become loose and a dark line
forms around their base. If pushed to the extreme the exhaustion
becomes very great the pulse is weak and irritable and the patient is in
a condition similar to hectic fever which is called erithismus
mercurialis. The salivation, which was formally more frequent than now,
employed in the treatment of disease was produced rapidly by giving one
or two grains of calomel every hour or two till it took place,
regulating its action in the bowels by combining it with opium or other
narcotics. If given as the best physicians directed, their effects,
were not as severe as I have described; but they were intended to keep
up an impression on the gums for a greater or less time according to the
object in view. In inflammations they were universally, and are
considerably now, used to prevent the forming of false membranes and
exudations. I think that the best authorities now believe that the
injury to the general health by this course of treatment is greater than
the good gained by the prevention of the organization of fibrine.
Syphilis was treated formerly in this way more than at present.
The last effect of mercurials is
called their specific or alterative effect – In order to get the
alternative effect, however it is not considered necessary to produce
salivation and it is believed that the exhibition of small amounts of
mercurials in doses insufficient to salivate, or to produce any
perceptible physiological effect, still produces favorable changes in
disease, which would not take place without it. This is the true
alternative action. It is generally considered better to treat syphilis
in its secondary and primary forms by this method rather than by
salivating.
The mercurials have been used for the
most various purposes, but I believe I have given their chief
indications.
The following I consider a good
recipe to give a patient affected with secondary syphilis.
Recipe Hydrargyri Chloridi
Corrosivi
Ammoniae Muriatis ana
granum
Spiritus Rectificati
fluidrachmam
Aquae
fluidrachmas septem
Misce. Fiat solutio. Capiat fluidrachmam post cibum, ter die –
8. The only preparation of antimony
which is necessary in medicine, and the one which is almost altogether
used is the tartrate of antimony and potassa. Its formula is Sb.O3,
T+KO, T. There are other forms of antimony such as Kernes mineral,
golden sulphuret of antimony and others but they are not necessary in
medicine and I do not know their symbols.
9. The spleen is the largest of the
ductless or blood glands. It is surrounded by a dense fibrous envelope,
which throws off partitions into the substance of the organ; these
surround and enclose the peculiar corpuscles of the organ, which consist
of ductless, glandular cavities largely supplied with bloodvessels. The
fibrous envelope has some elastic fibers in it. In some of the lower
animals these are thought have considerable influence on the portal
circulation as they exist in large amount.
The function of the spleen, as of the
other blood-glands, is not known. It is thought that they made generate
the corpuscles of the blood.
David Mack, Jr.
Naval Asylum, Philadelphia.
September 26th, 1863
Certificate of Physical Capacity
I declare on honor that my health at
this time is good and robust; and, 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
All of which is respectfully
submitted by.
David Mack, Jr. M.D.
Candidate for the office of
Ass’t. Surgeon in the Navy
of the United States.
U.S. Naval Asylum, Philadelphia.
September 25th1863
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
