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: John Crawford Spear, M.D.
Philadelphia,
September 10, 1863.
Sir:
I have the honor to inform you that I
reported for duty on the USS Frigate Roanoke, in May 1861, at New York,
and remained attached to her until she was put out of commission in
March 1862. During this cruise we did blockade duty at several places
along the Atlantic Coast. I served was Surgeons Clymer and Gilchrest on
board the ship.
After leaving the Roanoke I joined
the U.S. Gunboat Mahaska at Portsmouth, N.H. She was attached to the
North Atlantic Blockading squadron and was stationed in the James and
York rivers.
In March 1863 was detached from the
Mahaska and ordered to the U.S.S. Frigate Minnesota where I remained
until a few weeks since when I was ordered home for examination. I
served with the Fleet Surgeon W. Maxwell Wood while attached to the
Minnesota. The ship remained at anchor off Newport’s News, Va. all the
time I was attached to her.
I am, very respectfully,
Your obedient servant,
John C. Spear,
Assistant Surgeon.
Surgeon
James M. Greene, U.S.N.,
President of Naval, Medical Board,
Naval Asylum,
Philadelphia.
Questions by the Board:
Questions to be answered in writing,
by Asst Surgn John C. Spear.
1. How is the fœtus in utero
nourished. [sic]
2. What is syphilis, and how do
Surgeons class the symptoms?
3. In what form, and to what extent
is mercury prescribed for the cure of syphilis?
4. Give the morbid appearances in
the different stages of Pneumonia.
5. What are the constituents of
the urine?
6. Give the symptoms of
Diphtheria.
7. Give, the forms of cell genesis +
describe the nature + offices of cells—
8. Write a prescription for
compound infusion of senna without abbreviation
9. Describe the nature,
physiological effects medical properties, preparations + uses of
Belladonna
Answers by Spear:
1. The foetus in utero is nourished
during the first part of gestation from the ovum, and the last part from
the mother by means of the placenta and its connections.
2. Syphilis is a disease the result
of a specific cause. It is contagious by contact and commences by a
peculiar ulcer, which will, is not destroyed, usually infect the system
and produce a number of other symptoms. Surgeons class the symptoms as
follows: Primary, secondary and tertiary, or primary and constitutional.
3. Mercury for the cure of syphilis
is most frequently prescribed in the form of the iodide, biniodide,
chloride, bichloride, or in the form of blue mass. In the treatment
syphilis it is enough to affect the system vary slightly by this agent.
4. In the first stage of pneumonia
the lung is congested and its color is more red then in health, and
lymph is effused into the aircells; in the second, the lung is very much
congested and looks like the healthy liver, in color, and the air cells
are closed; in the third, the lung looks like liver tissue partly
covered with pus. Abscesses form in this stage.
5. The constituents of urine are as
follows: In health – water, mucus, urea, urate of soda, phosphate of
lime, phosphate of magnesia and urate of ammonia, and perhaps several
other salts in small quantity. In disease – in addition to the above
mentioned, constituents, there may be albumen blood, pus, cells, uric
acid, oxalate of lime, and phosphates of lime, magnesia, ammonia, and
grape sugar.
6. The patient is usually attacked
with a chill and fever; and exudation appears in the throat and air
tubes, commencing below and going upwards, and this exudation will
appear on any wounded or ulcerated surfaces about the body; there is
often swelling and suppuration of the salary glands; the disease is one
in which there is great prostration. This affection is a blood disease
and not be local disease of the throat.
8. [sic] Cells are formed either by
the division of a primary cell, or according to some, from a matter
called “blastoderma”. Cells are of different kinds, some are composed
of a membrane or cell wall, enclosing the cell matter, while others are
more complex. The whole body is developed from, and nourished by cells,
and all the secretions and excretions are made by these agents.
8. Recipe
Sennae unciam unam,
Magnesiae sulphatis uncias
duas,
Olei menthae piperitae,
guttas, decem, et
Aquae fluidas uncias octo –
fiat infusum.
9. Belladonna is obtained from the
leaves of the atropa belladonna. When given to a person in health, it
produces marked dilatation of the pupils and sleep. It is a cerebral
stimulant, an expectorant and a narcotic without producing constipation
of the bowels. The preparations of belladonna are the extract and
tincture.
John C Spear, Assistant Surgeon
Naval Asylum, Philadelphia,
September 12, 1863.
Hospital Gangrene
Hospital gangrene is a disease which
attacks wounded surfaces, ulcers and the like, and is found generally in
the hospitals where a number of wounded are crowded together.
Symptoms.
The disease sometimes commences with
a chill and fever. A wound which was previously healthy suddenly
appears red, irritated and inflamed, and the patient complains of a
burning pain in the disease spot. In a short time the tissues about the
wound commenced to ulcerate and slough. The areolar tissue is the part
first attacked and if the disease is not soon arrested the sloughing
process will extend along the course of the muscles along the wound,
destroying the cellular tissue composing the sheath of the muscles. The
discharge from wounds affected with this disease, is irritating, bloody
and of a peculiar odor.
Cause.
It has been observed that this
disease is never found except in hospitals where the wounded or diseased
are crowded together in small rooms, badly ventilated, and filthy.
These then are perhaps the conditions which produce the cause of
Hospital Gangrene.
Nature.
Some suppose it is caused by a
cryptogamic growth which finds its way to the wounded surface, and by
its presence and growth, causes the disease. This opinion was advanced
or, rather suggested, a few months since, by Dr. [William Ludwig]
Detmold of New York, during an epidemic of hospital gangrene in one of
our army hospitals, near Washington. Dr. [Joseph Janvier] Woodward
examined with a powerful microscope a number of cases, but he concluded
that the growth was the result and not the cause of the disease. The
growth found in scald-head is, by some recent pathologists believe to be
only the result, and not the cause of that affection. This may be the
case in hospital gangrene. If not arrested by medical treatment it will
spread over a large ward in a very short time, and from this fact it is
usually considered contagious. Concerning the nature of this disease we
must confess that we know nothing.
Diagnosis.
The diagnosis is easy. The sudden
attack, the burning pain, the characteristic sloughing and ulcerating
process, the peculiar discharged and the appearance of the same disease
in a number of others about the same time, will generally be sufficient
to make a correct diagnosis.
Prognosis.
This is influenced very much by
different epidemics. It is a disease in which treatment can do very
much to save life. Generally it is considered a very serious affection,
and is much feared both by the surgeon and patient. The disease was
very fatal in the army hospital above referred to, but in the army
hospitals of the West, the surgeons have been very successful, losing
but very few patients.
Treatment.
The first and most important step is
to remove the patient from the infected wards into new, clean quarters
where there is a good supply of fresh air. It's nothing else can be
obtained put the patient in tents, and not many together. No bedding,
nor clothes of any kind should be brought to the new quarters from the
infected building. The wounds and dressings should be well cleaned
before the patients are placed in the tents. All wounded man, even if
not attacked, should be removed from the old wards. The next thing to
be done is to destroy the specific character of the disease by the
application of some a medical agent, and one of the oldest and best is
nitric acid. It should be diluted and applied so as to come in
contact with all the disease surface however deep seated. The acid,
where timely and properly applied, generally converts the disease mass,
after sloughing has taken place, into a healthy, granulating surface,
which should then be treated as an ordinary ulcer, or granulating
wound. Other caustic agents have been used and recommended, as
sulphuric acid, caustic potash, and the nitrate of silver. Tincture of
iodine was at one time much lauded as an application in this disease.
Dr. Goldsmith, Surgeon U.S.V. has used, in the army hospitals, the
bromide of potassium as an application, and after a large experience
with it he considers it almost a specific in hospital gangrene; others,
however who have used it think it inferior to nitric acid.
The patient should have a good diet;
tonics and stimulants are also usually required, but of course their
administration would depend upon the general condition of the system at
the time. Perhaps it would be well to remember that the disease it is
asthenic and tonics and stimulants might be useful at an early period.
John C. Spear, Assistant Surgeon