American Civil War Medicine & Surgical Antiques

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Joseph Warren Shively, M.D. 

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:  Joseph Warren Shively, M.D.

                                                            

U.S. Naval Asylum

Philadelphia Penna

September 2nd 1863

 

Gentlemen:

                          

I received my Commission, as Asst Surgeon in the United States Navy, on the 4th of March 1861, and on the 28th day of April following, I received orders to report for duty, on the late, U.S.S.  “Mississippi”, then fitting out at Boston.  I reported on the 10th of May agreeably to the order.  On the 27th of the same month, we sailed for the ‘Gulf’, being one of the first vessels to leave for the blockade.  We arrived on our station on the 10th of June following.  And from that period until the 1st of April 1862, we successively blockaded off Pensacola, Mobile, Ship Island and Pass à l’outre.  We succeeded in crossing the “bar” on the 10th of April, and took part in the taking of forts Jackson and St. Phillipe, as well as New Orleans.  During the summer of 1863 we did service in the river.

 

About the 1st of March 1863, I left the vessel in consequence of sickness and remained at New Orleans.  On the 21st of the same month, I was ordered North, in the Naval Transport “Fair Haven”, in charge of the sick of the squadron, and as medical officer to the paroled crews of the “Harriet Lane” and “Queen of the West, ” who was sent home in that vssel [sic].

 

I arrived in New York on the 10th of April 1863, and was granted leave of absence for six weeks, in which time I regain my health completely.  On 28th of May last, I reported for duty on board the U.S.S Ironclad Frigate “Roanoke”, and preceded in her to Fortress Monroe.  I was detached on the 22nd day of July, and reported on the 24th for duty at the U.S. Naval Asylum Hospital, Philadelphia, agreeably to orders.

 

Very Respectfully

Your Obt Servt

J. W. Shively, Asst. Surgeon, U.S. Navy

 

Surgeons

Pres. of Med. Board of Exam

James M. Greene   

Members

A. A. Henderson 

Benj. Vreeland      

 


Questions by the Board:

Questions to be answered in writing, by  Asst Surgeon Joseph W. Shively U.S.N.

1.  Give a brief description of the operation of castration.

2.  Write a formula without symbols, or abbreviations, for a compound infusion of senna.

3.  What is it differs between a furuncle + anthrax?

4.  What is the composition of Ammoniae Carbonas (U. S.) + mode of preparation?  How and for what conditions is it prescribed?

5.  What is the treatment for poisoning by Bichloride of Mercury?  What steps will prove the presence of this substance?

6.  Describe the nature and purposes of the urinary secretions.

7.  Give the anatomical structure of the testis.

8.  What are the symptoms of Podagra?

9.  Give the symptoms of Posterior Dislocation of the Femur.

 


Answers by Shively:

 

1st  Separate the testicle to be operated on, from its fellow, and make tense the skin, make an incision from the external abdominal ring downwards, over the tremon [?], of sufficient length, separate the cord from its accompanying structures and divide it.  Then dissect the testicle from the scrotum.  The cord may be included in a ligature en masse, as the artery separated and tied with a fine ligature.  –

 

2nd         Recipe   Sennae        unciam

               Magnesiae Sulphatis   semi unciam

               Foeniculi            drachmas quatuor

               Aquae bullientis        Octarium

               Mascera per horas duas

 

3rd     A furuncle is a circumscribed inflammation of the skin, or cellular tissue proceeding to suppuration.  The pus being contained within the cavity formed by the liquefication of the tissues.  In anthrax the inflammation leads to gangrene of the cellular tissue, which separates in shreds or masses.

 

4th      The composition of carbonate of ammonia is expressed by the following formula 2NH3HO.3CaO2.  It may be obtained by subliming carbonate of lime and chloride of ammonium.

   It is given in the form of a solution, in doses from two to ten grains, every two, three or four hours.

In sudden prostration, in pneumonia when support and stimulation become necessary.  In cases where some accustomed stimulus has been withdrawn, sickheadache, and in cases where a diffusible stimulant it is indicated.  He

 

5th       Administer the white of eggs, or gluten obtained by washing flour, or flour itself in large quantities.  Emetics and the stomach pump may likewise be employed, and afterwards a dose of castor oil. 

Corrosive sublimate is directed in solution, by adding a solution of nitrate of silver, a white precipitate – chloride of silver – is thrown down, which soon blackens on exposure.  This proves the presence of chlorine.  A few drops placed on a polished metallic surface, and touch with the point of a knife, if it be gold forms an amalgam with the metal, volatilized by heat.  This proves the presence of Mercury.

 

6th      The urine is a liquid product, separated from the system by the kidneys.  It consists mainly of water, holding in solution various salts, and mucus.  In health it has an acid reaction and average specific gravity of 1020.  It subserves the important purpose of separating the waste products generated within the system, from the blood, and such foreign substances, as may gain entrance from time to time into the body through food and drink.

 

7th      The testis is composed of tunics, blood vessels, and glandular structure.  The tunica albuginiea surrounds the gland, and is composed of a serous and fibrous layer.  The latter enters the testis posteriorly, and traverses the organ in various directions, forming spaces in which the tubuli semmiferi are found.  These tubes interlace posteriorly, and formed the rete testis, and by their union and convolutions convolutions [sic, on prior page] the epididymitis, – composed of the globus major and minor – and finally the vas deferens.

 

8th     Gout usually begins, after some excess in eating or drinking, during the night, with violet pains, usually seated in the ball of the great toe.  The parts soon becomes red, swollen and excessively tender on pressure.  The constitutional symptoms are fever, furred tongue, scanty and high colored urine.  After a variable time the paroxysm subsides, with an interval of comparative rest.  These paroxysms follow each other, gradually becoming less and less severe, until the disease passes off.

 

9th     In the Illeo-sciatric variety, which is upward + backwards, there is inversion of the limb, the great toe of injured side pointing to the ankle of sound limb, the axis of the femur pointing to sound knee – shortening from two to three inches or more.     When the head of the femur is thrown into the sciatic notch the axis of the femur of the injured side points to the middle of sound one.  There is inversion and shortening, but not so great as in the proceeding.  In both cases the hip is distorted, and the trochanter and head of the bone are felt out of their usual position.

 

Respectfully  Submitted

J. W. Shively,  Asst. Surgeon,  U.S. Navy.

 

Naval Asylum                                       

Sept. 4th 1863.                                           


Pericarditis

Asst Surgn Joseph W. Shively, U.S.N

  

Pericarditis is an inflammation of the pericardium.  It likewise involves the muscular substance of the heart to a greater or lesser degree.  It may exist as a single disease, or be a concomitant of Endocarditis, Rheumatism or Bright's Disease of the kidney.  As connected with rheumatism, it may be metastatic from some other structure, as a joint, or may arise from the same caused that produces inflammation in other parts.  Its existence when associated with rheumatism is liable to be overlooked, unless special attention being directed to the heart.

  

It may be ushered in with a chill, followed by fever, with its usual symptoms, as dry hot skin, lightly furred tongue and loss of appetite.  There is usually more or less pain referring to the pericardia, increased on pressure or deep inspiration.  The pulse, if the fever be sthenic, is accelerated and full, feeble and compressible in the opposite condition.  It may be a regular and intermittent likewise.  Dyspnoea is often severe and paroxysmal in its character.  The nervous symptoms are often distressing, headache, perspiration, and restlessness.  The countenance is anxious.  The physical symptoms as revealed by auscultation are conclusive.  They consist of murmurs, or sounds produced by the rubbing together of the roughened opposite surfaces of the pericardium.  The sounds thus produced are termed "friction sounds".  Dr. Watson terms them the " to and fro" sounds.  The same sound is produced by the pleura under similar conditions.  The one produced by the pericardium, is distinguished from the pleural, by continuing, when the patient holds his breath.  This sounds ceases on the gluing together of the opposing surfaces, by the lymph thrown out between them, or when they are separated by the effusion of liquids

 

Percussion is valuable in the later stages of the disease, revealing the existence of the effusion, or the progress of its absorption.  When effusion exist [sic], the pyriform sac enveloping the heart becomes distended, and the apex instead of being below, as in health, becomes reversed.

The adhesion between the two layers may be partial or complete.  Watson and some other authors regard the adhesion as ultimately leading to a fatal end, while Flint and others believe life to be in no great degree shortened thereby.

 

Treatment.    If the character of the affection be sthenic, with high inflammatory symptoms, blood may be taken from the arm, or locally by means of cups.

Mercury may be given with a view of preventing the effusion, or hastening the absorption of lymph.  It may be combined with opium.  An active purge in the beginning of the disease is always proper.  Tarter emetic may be given in 1/12 or 1/8 grain doses every hour or two if the fever is considerable. Veratrum viride might likewise be given under the circumstances. Digitalis is a very important remedy.  Care should be exercised that its depressing effects not be carried too far.

 

For the nervous symptoms, opium, velarium and assafoetida can be employed.  When the disease occurs in connection with rheumatism the remedies proper for that disease may be given.

Blisters are important agents in the treatment of this disease.  They should be employed in the beginning of the disease.  They may be placed over the heart, or perhaps preferably to one side, to allow physical exploration of the organ.

     

When liquid has accumulated in the pericardium, diuretics and hydrogogue cathartics are called for, or paracentesis cordis performed.

 

Respectfully Submitted

J. W. Shively

Asst Surgeon

U.S. Navy


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

 

 

 

 

Topical Index for General Medical Antiques

 

Civil War Medicine & Surgical Antiques Index

 

Alphabetical Index for American Civil War Surgical Antiques

 

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