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: Edward Maurice Stein
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.
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
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].
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 . 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:
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.
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]:
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
Contact Dr. Arbittier or Dr. Echols
Last update: Monday, December 12, 2016