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: Edward Maurice Stein
Naval Hospital
New York
July, 1861
Gentleman
I was born April 19th, 1839
I am a native of Hungary. I came to
this country in 1850. I was educated in the grammar school of Dr.
Prentice at Geneva, N.Y. I studied medicine under Dr. Dunbar at Balt.,
Md. and under Joseph Carson, Prof. of Nat. Med. in the University of
Pennsylvania. After studying medicine for 4 years, I graduated at the
University of Pennsylvania, March before last. Since my graduation I
was assisting my father in the practice of medicine. Of the physical
properties of drugs I have acquired considerable information from my
preceptors above named. I studied Nat.[ural] Hist.[ory] while engaged in
my academic studies. Besides the English, I can read & write German and
Latin & have some knowledge of Greek.
Respectfully yours
E.M. Stein, M.D
No. 106 Grand St., New York
Questions by the Board:
Questions to be answered in writing
by E. M. Stein.
1. Enumerate the muscles of the leg
and foot.
2. What operations are performed on
the leg and foot?
3. Describe the pathological anatomy
of Dysentery.
4. What are the medical uses of
mustard (Sinapis)?
5. What symptoms distinguished
inflammation of the membranes of the brain from lesions of its
substance?
6. Describe puerperal fever and
lesions found after death..
7. What are the metallic bases of
the Earths?
8. What are the physiological
functions of the Mesenteric Glands, and what effects are produced by
disease of those glands?
Answers by Stein:
1. The muscles of the leg + foot (as
far as I can remember) are the tibialis anticus, on the anterior aspect
of lamb, posteriorly the gastrocnemius inserted into the os calcis by
means of the tendo achillis; likewise the peroneus longus et brevis.
The extensor digitorum communis.
The extensor pollicis Soleus
The flexors.
2. The following are among the
principal operations performed on the leg + foot.
I Amputation of the leg:
sometimes it is necessary to amputate the lamb a few inches below the
tubercle of the tibia; sometimes neck to the ankle joint, + sometimes in
the metal.
II Operations for to close is of
the tibia + exostosis tumors.
III It some does becomes
necessary to tie the arteries of the lamb as the anterior tibial, either
near its exit from the interosseous membrane or lower down. Ligature of
the posterior tibial artery + the plantar near the interior maleolus.
IV The operations for fracture of
Tibia or Fibula.
V Operations for the rupture of
the tendo achillis. VI Dislocation of the ankle joint.
The operations on the foot are: I
Amputations of the toes; Chopart’s amputation of the foot; Syme’s
amputation of the tarsus.
II Treatment for dislocations; as
for ankle joint.
III Ligature arteries as of the
dorsalis pedis or the plantar.
IV Operations for inverted toe
nails.
3. Dysentery (from δύς and έυτερσυ).
Dysentery is an inflammation of the rectum + colon. The pathological
anatomy varies with the different stages of the disease.
In the first stage the mucous
membrane is of a high red color, swollen, congested sometimes there is
in exudation of fibrin upon the mucous membrane; as the inflammation
advances ulceration becomes visible, also excoriations. In some fatal
cases even mortified patches of the membrane have been found.
Thickening of the bowel.
4. Sinapis (Σιυάπι) or mustard
possesses stimulant properties. Its uses are various. It may be
employed as an emetic; it has also cathartic properties, probably by
exciting the exhalations of the mucous membranes of the intestines.
But the principal use to which it is
put is as a plaster (mustard plaster). It is very efficiently employed
in cases of inflammation, after the fever has been allayed + the
inflammation is less intense. Its use is to derive to the surface as in
peritonitis, gastritis, enteritis; it is sometimes applied to the scalp
to derive to the surface in case of cerebritis.
5. The symptoms that must
particularly serve to distinguish meningitis from cerebritis, are that
in the former, the pain is more acute, the excitement attending the
inflammation more intense. In cerebritis the pain is more dull + at the
patient is more inclined to stupor whilst in Meningitis he is more
delirious.
In a lesion of the brain (as rupture
of its tissue) the symptoms are not as marked as in meningitis. The
patient is comatous [sic] the pulse instead of being full + bounding, is
more irregular. The symptomatic fever in Meningitis is very marked, not
so in a lesion of the brain.
The pupils in meningitis at its
height, are contracted in a lesion of the brain more insensible to
relaxed.
6. Puerperal fever generally comes
on a few days after delivery. It is an extremely formidable disease.
We are, for the most part, ignorant of the real cause of this
affection. It is generally fatal. Sometimes it commences with
delirium, nausea, violent vomiting. The pain in the abdomen is extreme
increased by the slightest touch or even by the weight of the
bedclothes. The vomiting it is in many cases very frequent. The system
in this affection is often in a adynamic condition. The face has the
Hippocratic appearance, the surface is in some cases dry + hot; in
others cold with a cold perspiration upon it. Post mortem appearances.
The peritoneum affords evidence of the severest inflammation.
Exudations of fibrin of a yellowish or greenish color. Sometimes pus is
found in the cavity of the peritoneum. The membrane is sometimes
ulcerated. Metastatic abscesses have also been found. The uterus is
sometimes [unreadable] disorganized by the inflammation.
7. The metallic bases of the earth
are: Alumina, Potassa, Oxide of Calcium, Tellurium, Manganum, Platinum.
[Entire answer bracketed in pencil].
8. The mesenteric glands, which
received the chyle after it has been absorbed by the lacteals of the
intestines, tend further to elaborate the chyle and sends it more
assimilable to the blood. That these glands are of the highest
importance, appears from the fact, that when they are deceased (as in
scrofula) the patient rapidly emaciates, loses his vigor, and is very
apt to fall a victim of Phthisis.
Edward Maurice Stein M.D.
Certificate of Physical Capacity
Brooklyn July 17th 1861
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 constitutional defects, and without any
predisposition to Epilepsey, Phtisis, Pulmonalis, Gout, or chronic
disease of any kind. I have neither vircocele, stricture of the Urethra,
Hemorrhoids, nor Hernia. Each and all my organs of sense are without
imperfection.
E M Stein M.D.
Candidate for the office of Assistant
Surgeon
in the Navy of the United States
Application for promotion in 1864
U.S. Naval Asylum,
Philadelphia, May 6th 1863 [sic,
should be 1864].
Gentlemen:
My commission as Assistant Surgeon in
the Navy is dated July 30, 1861. I was ordered to the Frigate,
“Wabash,” on the 13th of October, 1861. My duties were, for
the most part, confined to that vessel, but I have seen considerable
service whilst accompanying boat expeditions, etc, that were sent from
the ship. On the 7th of September, 1862, I was detached from
the “Wabash”, having been condemned by medical survey, and sent home on
sick leave. On the 22d of November, 1862, I was ordered to
the U.S. Ironclad Steamer, “Weehawken” in which I served until she
foundered on the 6th of last December [1863]. On the 22 of February I
was detached from the L.A.B. Squadron and ordered North. On the 12th
of March I was ordered to the receiving ship N. Carolina at New York and
on the 3d of May I was ordered to Philadelphia to present
myself for examination for promotion.
I have the honor to be, Gentlemen,
Your Obdt. Servt.
Edw M Stein, Asst. Surg., U.S.N.
To the Gentleman
of the U.S. Medical Examining board
Naval Asylum, Philadelphia Penn.
Questions by the Board:
Questions to be answered in writing,
by Asst Surgeon Edwd M. Stein U.S.N.
1. What is Congestive Fever, + in
what consists the danger?
2. How is pneumonia distinguished
from pleurisy?
3. Give the distinction between
Typhoid + Typhoid Fevers.
4. What are the relations and
branches of the abdominal aorta?
5. What are the dislocations of the
hip joint?
6. What is aneurism, the varieties;
and the Medical and Surgical treatment?
7. What are the theories of light?
describe the laws of reflection, refraction + polarization and the
nature of the optical instruments required in defective vision.
8. What is Belladonna? Give the
name and place of growth of the plant, the preparations used, their
effects and uses.
9. What are the salivary glands?
What their structure [sic], and the nature and uses of their secretions?
Answers by Stein:
1. When the malaria is poison which
causes the intermittent and remitting fevers is unusually intense, it
produces a variety of paludal fever known as the Gongestive [sic]. The
principal symptoms are: (1) Great prostration, (2) Great internal venous
congestion. The ganglionic system is principally affected, and no
doubt, it is the perverted action of the sympathetic system which causes
the great internal congestion. Congestion is an exciting cause of
inflammation. Hence one danger. Inflammation of the Brain, Liver, may
cause death. Congestion itself may kill by oppression of the brain
without inflammation. The great indication therefore is, to relieve the
great internal congestion by determining [unclear] to the surface and
this may be done in various ways.
2. The pathognomonic symptoms of
Pneumonia and pleurisy, when these diseases are well developed, are
marks and unmistakable. I will take the liberty of presenting the chief
symptoms of these two affections in this wise:
Pneumonia Pleurisy
1st
stage 1st
stage
Primary fever: pain heavy dull.
Primary fever stong. Severe
Crepitates rale
characteristic lancinating
No perceptible change
in pain great dyspnœa
percussion. Sputa
viscid. because of pain. Little or
no cough and
expectorating
Dullness on
percussion Friction sound.
2d stage
2d stage
The fever subsides
Great dyspnœa because
when this stage is
at of effusion. Decubitus on affected side.
its height.
Dullness Sputa frothy and
on percussion, bronchial
streaked with blood.
rale pectoriloquy
marked dullness in
The Chloride of Sodium
percussion, perhaps
disappears from
urine bulging of intercostal
Sputa very
viscid spaces. Splashing sound
of the proverbial
rust on seccussion.
color. Great dyspnœa.
3d
stage 3d stage
Either death, reso-
The effusion is either absorbed
lution, or
gangrene. or the patient dies by
if the latter.
Feted apeœa compression of
expectoration
collapse the lung.
and death.
3. There are certain symptoms which
characterize these two varieties a continued fever so markedly as to be
unmistakable.
Typhoid fever comes on insidiously,
typhus advance more markedly. There is not that perfect apathy,
listlessness and dull expression of countenance in typhoid which
characterizes typhus. Delirium may occur in both fevers, but in Typhus
it is dull low and muttering, in Typhoid is apt to be more wild.
There is not that coma vigil neither
that calor mordax in typhoid fever, as a general thing. The eruption
that shows itself in these fevers about the close of the second week is
different. In typhoid they look like flea bites and always disappear on
pressure – they are rose-colored. In Typhus they have a more dull color
like mulberry juice, and although they disappear on pressure when they
first come out, the [sic] soon cease to do sell, and remained even after
death.
But the most striking distinction is
the state of the bowels. In typhoid fever diarrhea shows itself often
at the very eruption of the fever. The pea soup discharges are
proverbial. There may tympanitis or hœmorrhage from the bowels in
typhoid fever, in Typhus the bowels are generally locked up + cathartics
act with difficulty and this depends on this fact: the morbid poison
which causes typhoid fever attacks the peyerian glands of the small
intestines particularly about the ileocœcal valve. The system seeks to
rid itself of the poison by eliminating it through these glands. Is the
poison be discharged from these glands naturally the patient recovers;
if by means of ulceration, hœmorrhage ensues which may be fatal or
perforation which kills by peritonitis. The poison of Typhus attacks
the serous membranes principally.
4. The abdominal aorta of lies on
the left side of the vertebral column – it has the inferior vena cava to
its right; it as the stomach duodenum, pancreas, before it. It has the
left emulgent vein before it. Its branches are, 1st. The
arterial phrenical 2d The cœliac axis which gives off the
gastrica, hepatica and plenica [sic, should be “splenica’], 3rd
The superior mesenterica, 4th The spermaticae, 5th
The inferior mesenterica, 5 [sic] The supra renales et renales 6 [sic]
The lumbar, 7th the sacra media. It terminates by
bifurcating into the two common iliacę
5. The hip joint may be dislocated
upon that dorsum ilii; into the sciatic notch; in the foramen obturator;
on the os pubis. These different dislocations are determined by the
position which the dislocated limb assumes.
6. An aneurism is a sac filled with
blood communicating with an artery. There is the true variety it has
all the coat of the artery investing it. The sacculated. When an
account of atheromatous degeneration the interna is destroyed, the
natural the resiliency of the arteries gone. At each impulse of the
heart the diseased artery is distended and remain so – hena [sic, should
be “henna”] aneurism. There is the fusiform, when the artery is
enlarged and hypertrophoid all around. If an aneurysm burst into the
neighboring cellular tissue it may give rise to the diffuse form.
Aneurismal varix is cause [sic] when an artery is punctured through vein
– the arterial blood, in these cases, enters the vein and causes a
varicose appearance. Varicose aneurysm is caused similarly but a false
aneurysm exists between the artery and vein.
The treatment aneurysm is both
constitutional and surgical. The impulse of the heart must be moderated
if excessive. Good diet – rest – Digitalis in cautious doses. The
surgical treatment consist on causes [sic] a laminated deposit in the
aneurysm by moderating the flow of blood into it; either my [sic]
compression or by ligature.
7. Newton was of opinion that very
minute atomic particles, molecules, emanated from the luminous body in
straight line which impinging on the retina caused the sensation of
light. It is new generally assumed that light is a vibration of the
ubiquitous ęther. Light striking a body is either absorbed, or partly
absorbed, reflected or transmitted. (1) The angle of incidence (in case
of reflection) is always equal to the angle of incidence. When light
passes from a thin into a denser medium it is reflected towards a line
which in perpendicular to the surface of the medium. When light is
reflected from a surface at a certain angle and received upon another
surface it is dispersed by the latter.
Light may become polarized either by
transmission or reflection.
The structure of certain substances
cause the phenomena of polarization as tourmaline. Biconcave lenses
cause a divergence of the rays of light hence they are of use in
myopia. Biconvex lenses cases [sic] them to converge, hence they are
used in presbyopia.
8. Atropa Belladonna is a plant
growing in shady places in various parts of Europe and also in America.
From the peculiar effects which it possesses of dilating the pupils it
was used by the Italian ladies to give their eyes that peculiar
attractive appearance, hence its name Bella Donna, beautiful Lady. The
powder of Belladonna is sometimes used, more frequently the extract, and
tincture. Belladonna is a narcotic poison in large doses, causing,
asthenia, paralysis, coma and death.
It [sic] therapeutic uses are as an
alterative, hypnotic, anodyne, antispasmodic and mydriatic.
9. The salivary glands are racemose
glands. There is the parotid, the submaxillary, the sublingual. It has
been supposed that besides the solvent action of these glands (or rather
of their secretions0 they caused the transformation of starch into
sugar. The [sic] do so. But their principal use is the solution of the
food, because the food does not remain sufficiently long in the mouth
for this peculiar catalyzing action to take place. This is principally
effected by the intestinal glands of the duodenum
Edw M Stein, Asst Surg
Navel Asylum, Phild,
May 7th 1864
Thesis: Assistant Surgeon Edwd
M. Stein, USN
Asphyxia from Drowning.
Asphyxia, or more properly speaking,
apnœa is essentially a non aeration of the veonus blood in the
capillaries of the lung. This may be bought about in several different
ways. (1) Paralysis of the respiratory nerves, either of the
pneumogastric phrenic or intercostals as cause, e.g., by several
narcotic poisons, such as Opium, Conium, Hyosciamus [sic] or spasm of
the intercostals as caused by Strychnia. (2). Spasm of the glottis
because of the pressure of foreign bodies in the larynx. (3.) The
presence of foreign bodies in the air passages, or effusions in the more
minute structure of the lungs as in Pneumonia or apoplexy of the lung.
Compression of the lung has caused by the pressure of effusions in the
pleural sac.
The blood in the pulmonary
capillaries is, under these circumstances, not arterialized. In short,
there is more venous blood in the lung then air to arterialize it. The
hypercarbonized blood acts as a sedative poison on the nerve centres and
if the blood be not speedily purified death soon supervenes.
Asphyxia from drowning has nothing
essentially different from asphyxia caused by other means. So highly
sensitive is the larynx that it is immediately thrown into spasm on the
application of any foreign substance on its surfaces, such as water. If
a person enters a cold bath or stands under a shower bath, increase
respiration ensues because more blood arrives at the lungs from the cold
surface and consequently there is more demand for air in the lungs. Now
if water enter his air passages, his nose and mouth, spasm ensues of the
glottis. If he be submersed in the water, the spasm continues and soon
terminates life – he dies by asphyxia the result of spasm of the
glottis. Water is found in the air passages of those dead by drowning.
The water is inhaled with the air, but it is the spasm which killed
them. If a person, when submersed in water, attempt to breathe, water
will enter his alimentary canal and he may feel it, coursing along the
intestine, (haud inexpertus loquor) but little will find its way into
the lung. Under these circumstances the air passages are shut up by the
spasm, the blood is not arterialized, and acting on the brain as a
sedative poison, it kills by coma.
The postmortem revelations in those
dead from drowning show great venous congestion of the interior organs
particularly of the lungs. Congestion of the brain. Water in the
Pulmonary passages and in the alimentary canal.
To recall life to a person apparently
dead from drowning it is necessary not to be officious but persevering.
I am be fairly dried, wrapped up in dry blankets, ruffed well with dry
coarse towels unremittingly, let him be placed now on the left side and
now on the right, artificial respiration by manual means must be
resorted to. If the patient has recovered sufficiently to swallow than
cordials, stimulants etc are applicable.
Edw M Stein
Asst Surg, U.S.N.
Naval Asylum }
May 5th 1864. }
[A prescription dated 7 days later
found inverted on reverse Q & A page 5 – presumably at oral evaluation]:
Recipe
Extracti Colocinthis grana
triginta
Pulveris (Ipomoae [sic,
should be ‘Ipomoea’]) Julapae grana quindecim
Hydrargyri chloride Mite
grana sex
Misce bene demi divide massam in pilulas tres
Edw M Stein
May 12th 1864
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
