El " in ii i ii iii ! nil ii *B 114 575 O o •:■:• AN - ::■ EXPOSITION UNJUST AND INJURIOUS RELATIONS U.S. NAVAL MEDICAL CORPS, V A MEMBER " There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." . BALTIMORE: PRINTED BY JOHN MURPHY, 146 MARKET STREET. 1842. /. fir** EXPOSITION, &c. " There are more things in heaven and earth, Horatio, Than are dreamt of in your philosophy." Since the entrance of the present head of the Navy Department upon the duties of his office, he has manifested such a knowledge of the various interests and necessities of the service committed to his charge, and such an energetic spirit of improvement and re- formation, that to address him with a view to impart- ing information, or stimulating his action, may have the appearance of presumption; but his course has so far inspirited the almost wasted hopes of the va- rious branches of the service, that those who hereto- fore have shut their eyes to error, from despair of its correction, now feel encouraged to point it out, and they confidently rely upon the courtesy which marks his official intercourse with the members of the ser- vice, to view their intentions graciously, although they may be superfluous. Although his comprehensive views of naval re-or- ganization, may have been suggested by the general wrong existing in the service, important and injurious details may have escaped his observation ; indeed, it would be a matter of surprise, if they had not : for error, too often, becomes sanctioned by time, as ruins grow venerable beneath the moss, which, at once, con- ceals and ornaments their rottenness. It is the pur- port of this communication to strip the covering from such errors and to call his attention to them: to show that the medical corps of the U. S. Navy, is, by the usages of the sea service, placed in a position, inconsistent with the arrangements and intentions of the government in relation to that corps, degrading to the character of the profession to which it belongs ; opposed to the true interests of the corps, and to the interests of the service in general, so far, as those interests depend upon the medical department. Each one of these assertions will become manifest from an examination of the real position and relations of medical officers in service. It would be an insult to the intelligence of any one, to enter into an argument to show the high character of the profession of medicine, both from its own nature and from its relations with society. Its object, being the good of mankind, there is no science, moral or physical, which is not made tributary to it ; and there is no human intellect so gigantic, but it will find full scope and employment for all its powers in the pro- fession of medicine : hence, its general claim to respect and consideration. The duties of the medical profession in the naval service, are, not only to reme- dy the diseases and injuries to which the officers and men of that service are exposed, but to carefully observe those influences, on the one hand, which pro- duce disease, or on the other, preserve the health and efficiency of a ship's company ; and also to mark the effect of climate and habits upon diseases and the human constitution, thus becoming valuable con- tributors to the general stock of useful knowledge. By the greater or less skill of the medical officer, lives, valuable to the country, may be preserved or destroyed ; an important action may be won or lost. In the performance of their duties, as great an amount of moral and physical courage is required as in any other department of the service; in truth, greater, for they are called upon to exercise skill and coolness in the midst of danger, and without the excitement of combat. Finally, medical officers are held strictly accountable for all the requirements which a military service exacts from its members, as officers and gen- tlemen. Toward a body of men from whom such duties are expected, and such a character required, it is not only a narrow and illiberal policy, but great- injustice, to pursue any course but such as accords it a corresponding degree of respect. Pay is the lowest reward of an officer of proper feeling, and is a secon- dary consideration to those usages, which ought to protect, if not add to, the respect due his station. In our naval service, the pay of the medical officer is a pittance, and the usages of the sea service rank him with his predecessors of the days of Roderick Ran- 6 dom. Our first position is, that those usages are opposed to the intentions of the government. In the selection of its medical officers, the laws of the United States look to the highest degree of pro- fessional capability, as a condition of their admission into the first grade of the corps. Having obtained his education at his own expense, and by what labor and application it is unnecessary to state ; and being twenty-one years of age, though many enter at a much later period of life ; the applicant is submitted to the scrutiny of a national board of medical officers, and so rigid is the test, that only an average of one-fourth of those examined, though generally graduates of our most eminent medical schools, are found qualified. It is evident that the government expects its young- est medical officer to be fully qualified as a physician and surgeon ; to have his mind maturely formed and well cultivated; being properly satisfied of this, the legislature and executive of his country fulfil the promise made to his hopes, for although they do not give him the pay of a respectable clerkship, the Pres- ident and Senate confer upon him an honorable com- mission, consistent with the character they have required him to meet. But here all justice stops; he has a commission in his pocket, it is true, but none in fact ; caprice and usage are more powerful than his country's will. His commission is never known again while he is an assistant surgeon, perhaps, for ten or twelve long years of his life. On ship- board the privileges of that commission are violated ; he is at once, suddenly, thrust from the station to which his profession, his age, the interests of the service, and the intentions of the government entitle him. Simple warrants given by the department, without the con- currence of the senate, take precedence of him ; aye ! even temporary appointments, made or destroyed by the breath of the ship's captain, are, in all the usages of sea life, superior to the rank of his commission. Upon reporting himself on ship-board, the assistant surgeon is assigned to the narrow limits of the steer- age, crowded with boys about entering upon their nautical education ; full of fun and frolic, and merry with the noisy hilarity of youth. This is his home, and these are his associates. If he is admitted into the society of those more nearly his equals in years, it is as a concession to which his rank, implied from his apartment, does not entitle him. Upon descend- ing to this apartment, perhaps, the first salutation that he meets, is a laugh at his trunk of books. Where is he to put them ? No trunks are allowed there, and the only accommodation that he has, is a "stow-hole" for his clothes. But it would be idle to make any provision for professional studies, in a place so little suited to their prosecution. The student who has for years taught his mind to seek pleasure in the pur- suit of knowledge, and strengthened it by converse with those of the highest order ; regarding every day as lost in which he does not add to his own ability to 8 be useful, finds himself compelled to recede from the station he had acquired, to return to his forgotten juvenility, and either, to repress all social feeling, or, to find its enjoyment by becoming again a boy. He is also compelled to submit to all the minute regula- tions established to restrain his more youthful asso- ciates. Human nature finds it easier to yield to sur- rounding circumstances, than, continually, to resist them, and the foregoing relations are sufficient to diminish the tone of thought and feeling of any mind. But the medical officer is expected to make bricks out of straw. Notwithstanding the adverse circum- stances in which he is placed, and that such usages debar him of the means of improvement, he is ex- pected, daily, to increase in knowledge, and at the end of five years, is submitted to another rigid examina- tion to test his progress, and should he be again suc- cessful, is rewarded by a very slight increase of pay ; but his station is in no wise changed. His apartment and his associations are still the same, save, that a new and more juvenile set may take the place of many of his former companions, who have now T grown past him, and are occupying separate apartments in the ward-room, with all the concomitant honors of ward-room officers; some of them, as has been the case, may be acting commanders, while yet he is the humble steerage officer. During the years that he passes in the rank of an assistant-surgeon, heretofore, and most likely hereafter, seldom less than ten, there are constantly presented to him the following con- trasts with his own situation. The commander of a squadron has a young friend who, before settling in life, wishes to see a little of the world ; the commodore of his own free will makes him his secretary for the cruise, and he passes at once from civil life to the occupation and comforts of his own state-room, and to the honors and asso- ciations of the ward-room. All the other appoint- ments from civil life, and which are made without any test of qualification, are also admitted at once to these superior honors and comforts ; the professor of mathematics from his college or school room, the chaplain from his desk, the purser from his counting room, and a second lieutenant of marines from any occupation in life, from the mechanic's bench to the military academy. We do not adduce these as any instances of impropriety, so far as the officers named are concerned, but only to show the great wrong done the assistant-surgeon, who enters the service as a commissioned officer, to become permanently identi- fied with it; with a professional education, tested by rigid scrutiny, and who on the day that each of the above named officers is first admitted, may have been devoting his time and his talents to the service for five, eight or ten years. Not only do the superior advantages awarded these commissioned, warranted, and temporarily appointed officers over the assistant surgeons, give them greater 10 comforts ; but, they are by consequence, entitled to certain little ceremonies of honor which, shadowy and unsubstantial though they be, by being withheld from the medical officer, serve to mark the humility of his position. When named, these ceremonies be- come triflingly ridiculous, and to estimate them with becoming gravity, it is necessary to consider, that they make part and parcel of an isolated society, made up of ceremonies as appeals to those who are accustomed to regard symbols as substance;, and when such trifles confer honor, they imply correspond- ing degradation where they are withheld. The fol- lowing are some of the observances alluded to : when a ward-room officer passes out of, or into the ship, a boatswain's mate attends the side and chirps him a note of honor ; he approaches the ship on the star- board side, that sacred to rank; descends to his apartments by the after ', instead of the forward hatchway; has the privilege of answering a proud "aye, aye" to the sentry's hail, and is lighted over the gangway by two lanterns. On the contrary, the assistant-surgeon, after years of service, passes out of or into the ship in silence and unhonored, must ap- proach it on the larboard side, or be regarded as a trespasser, and, to thejsentry's hail, answer an humble "no, no ;" must puff his cigar on the larboard side in company with his friends the middies, some of whom are now but little older than his own children ; the sacred starboard being tabooed to his humility ; and 11 he must be careful to select the forward hatchway in descending to his apartment. As these rituals and petty distinctions are in inces- sant action, and are insisted upon, the whole life on shipboard is one of continued and systematic insult to the medical officer. So great is the sense of injustice done to this class of officers, that in many instances it is attempted to be done away with by those, who are called "sea officers," particularly where these latter are of a lib- eral and enlightened character, (and to the honor of the service of the present day, the majority of them are found to be such,) by inviting the assistant-surgeon into the ward-room ; but it is an exceedingly unplea- sant position for an officer, to receive as a concession and indulgence, to be withdrawn at pleasure, what by every principle of justice he has a right to claim *, and moreover, this indulgence is contingent upon the characters of the officers composing the ward-room mess and upon the impression the medical officer may make upon them. At length, after years of habituation to such indig- nities so as almost to lose sensibility to them, however keenly he might have felt them at first, the assist- ant is promoted to the rank of full surgeon, and enters the ward-room. It is well for his feelings that the edu- cation of humility he has passed through, has pre- pared him for a patient endurance of its continuance. Although the chief object of our remarks is not in 12 reference to pay, still the great injustice with which the medical officer is treated, as regards compensation, requires a passing notice. Now that he is promoted to a full surgeoncy, his pay is less than that of the young- est lieutenant in service, and there are surgeons, who have for years occupied the highest rank of their corps, receiving less compensation than lieutenants, who, long after the admission of these surgeons, entered the ser- vice as youths, (of course, received their education in it,) and are now not older in years than the medical officers were at their original admission. It would seem that to name such injustice would be to secure its correction. The surgeon has now become a w T ard-room officer, and, excepting a trifling increase in his pay of two hundred dollars, for every five years of service, his position is stationary; and stationary, at the most humble point; the respect he receives is dependent entirely upon the character or the whim of his asso- ciates : none is guaranteed him by regulation, and he is generally compelled to yield precedence in all points of etiquette to the youngest of his associates, and even has his seat at the mess table assigned him upon this estimate of his rank. Gradually, and by the lapse of time, his brethren the "sea officers" pass from the ward-room to the rank and honors of com- manders, and to the occupation of their own cabins, but the old surgeon, though grey hairs and an enfee- bled body mark the length and fidelity of his service, 13 finds no increase of comfort, the same position and the same limited apartment which he entered on the first day of his promotion, are all that he can claim, on the last day of his service, and he passes to his grave unhonored, save by the spontaneous award of those who knew him. Such treatment and such relations are assigned to the medical officers of no other service in the world. In our own army, the medical officers have a rank and comforts allotted them fairly proportioned to the respectability of their pro- fession, and the importance of their duties, and due to the self-respect which, it should be the principle of the government, to encourage in every officer : and among their brother officers of the army, they hold those social relations which cultivated minds always acknowledge as the claim of their education and profession. Surgeons in the army are assimilated to the rank of major, and have choice of quarters after the commanding officer of the post. The following is the relation of their compensation with that of naval officers of the same grade ; the highest and lowest pay of each grade being taken. It will be observed that assistant- surgeons in the army receive more pay than a surgeon of ten years 1 standing in the navy, although the naval surgeon may have been twenty years a commissioned officer. TABLE. Army. Navy. Surgeons of ten years' standing,. . . .$2519 83 to $2884 83 $1400 to $2172 « Under ten years, 1794 00 to 2227 83 1000 to 1572 Assistant Surgeons, 1083 00 to 2439 37 650 to 1272 14 The British Government, ever vigilant of the inter- ests of the navy in all its branches, fosters the medi- cal department with care proportioned to that of every other branch of the service. By Her Majesty's Order in Council, issued in 1840, which grants certain privileges to naval assistant- surgeons in regard to pay, it is further ordered that, "naval medical officers are to be henceforth placed, in respect to rank, designation, pay, and retirement, on a scale more nearly assimilated to that assigned officers of the army medical department." Having shown that the usages applied to naval medical officers on ship-board are inconsistent with the intentions of the government, so far as those in- tentions can be known from its acts, injurious to the interests of the corps, and to those of the service, and inconsistent with the usages of corresponding ser- vices; we propose further to show that they have no foundation in utility, discipline, or subordination. The object of all government regulations is, to se- cure the greatest degree of efficiency of its agents, and all officers are alike servants of the government, re- sponsible to it and entitled to its protection; all are alike important in their vocation, and efficiency being provided for, and the interests of the country secured, no regulations are necessary to add to the ascendancy of one class by the degradation of another. Officers are not the servants of officers ; and regulations are necessary and required by subordination, to do away 15 with such an idea, which has become too prevalent from the use of the possessive pronoun my— as, for instance, my ship — my officers, and my surgeon. If officers are left thus at loose ends, with no limit to subordination but individual will, and which will may not discriminate between subordination to law for its appropriate ends, and unbounded servility to the individual, insubordination must result, or self- respect be lost. It is as necessary to control the uses of power for its legitimate purposes, as it is to secure obedience from subordinates ; mutual aggres- sion should be guarded against. No one class of officers is to be supposed to feel a greater regard for the interests of the country, or the good of the ser- vice, than another; and this feeling of love of country and "esprit du corps" should be allowed its full influ- ence in securing the performance of its duties. The most noble influences of action run the risk of de- struction by such unnecessary regulations, as never suppose the possibility of their existence. The officer who would conscientiously and rigidly obey the strictest exactions of law, and who would be most worthy of his country's service, would be the first to resist a servile and degrading personal domination. "I'll break you, sir," may be, as it often is, the threat and the result, and it is cruel that the country should leave any of its officers to an un- aided contest between his bread and his honor ; but there will always be some found, ready to sacrifice 16 their commissions to the preservation of their self- respect, and the only way to guard against such in- subordination is for the country, by proper regulation, to prevent its necessity. In a military service, a tame and cringingly servile character is as destructive of the force and energy of such a service, as is insubor- dination, and one or the other must result, unless subordinates are protected in all consistent rights and privileges. An eloquent writer remarks upon one of the most brilliant courts of Europe, " There was combined with all the external grace and noble- ness, a frequent meanness of sentiment, a cringing servility, and calculating self-seeking, among many of the most dazzling courtiers ; attributes and qualities from which, perhaps, the regions of no despotism, however polished, are exempt." We need have no such results in our navy, for no such irresponsible despotism is necessary to the good of the service, or to discipline and subordination. Discipline and sub- ordination, are the talismanic words, which have lent the sanction of their names to oppression and insult, as the cross has been held aloft to call for approba- tion upon murder and rapine. The foregoing principles being true, how unneces- sary, how injurious, is the humble and unprotected position of the medical corps! Its duties being entirely out of the line of military routine, never commanding, save within itself, and necessarily ac- knowledging the superiority, upon duty, of the repre- 17 sentative of the law, be he the youngest midshipman or the oldest commodore, no honors or rank conferred upon that corps could militate with discipline ; and the government having, by law, secured the qualifica- tions of the medical officer, guaranteed his proper attendance, and conferred power sufficient upon the commander, to execute the law in relation to that attendance, should protect him from vexatious an- noyances, and, by proper regulation and liberal pro- visions and honors, sustain the respectability of the corps, to which he belongs ansUrender the performance of his duties a matter of pride, instead of humiliation. It should be a corps, into which, the best professional talents of the country should have inducements to enter, for those, who endure the privations and en- counter the dangers of the naval service, should have the most competent agents allowed them, for the mit- igation of the suffering of disease and injury, and the preservation of their lives and health. Hence, it is not only the duty of the government, but it is the personal interest of every officer in the service to lend his influence, to give character and standing to the medical corps. The natural position of the medical corps, and the improbability of its coming in collision with the dis- cipline of the ship, is shown from the fact, that those commanders, who are most distinguished for intelli- gence, mental cultivation and liberal views, have no difficulties with their medical officers, for such com- 3 IS manders award to these officers, spontaneously, their proper position, a full confidence in their sense of professional responsibility, and find, that they can seek their familiar companionship without any inter- ruption of military subordination. But as men glide into the rank of commander, by the lapse of time, independently of ability or merit, it is not strange that some are found of views so narrow and illiberal as to feel jealous of all who breathe without their permission, and think themselves insulted, if thought is exercised without th^sanction of their will. Such men by a continual and vexatious interference with the duties of the medical officer, or a cruel annoy- ance to the sick committed to his charge, give rise to difficulties ; and of such a character is almost every difficulty in which a medical officer has been con- cerned. We never hear of such collisions in the army. In a contest with such men, in the navy, the case is carried before a partial tribunal, one of com- manders, and the result may generally be anticipated, previous to the trial. Not, that we mean to assert, that they would, deliberately, render a verdict con- trary to their consciences and oaths, but no man is superior to the weaknesses of human nature, and in- voluntarily, unconsciously to themselves, they arrive at the conclusion, that their own rule of safety, is that of irresponsibility; each one feels, that he may be brought into a similar collision, and a decision, always on the side of power, diminishes the danger of his 19 being held responsible for its improper exercise. Justice has ever been found a small mouthful in the way of a voracious self-interest. It is unnecessary, at this time, to say more upon a wrong to which facts are opening the eyes of all men. It is in the power of the Department, to do much, to place the naval medical service upon a proper footing, the rest depends upon the justice of the na- tional legislature. To the head of the Department and to the legislature of their country, the subordi- nate branches of the service look for care and pro- tection : they have no other dependance for the preservation of their rights or a correction of their wrongs. One of the first steps of improvement is to assign the assistant surgeons a position, consistent with their character, their age, and their profession — another, and an important one, w T ould be to define, as has been done in the British service, the rank and privi- leges of the medical corps in general ; to make them proportioned to the important duties and high re- sponsibilities of its station, and corresponding to that occupied in other military services. It is not only due, but necessary to those, who are part of a military system, and held amenable to all the requirements and etiquette of that system, that they have their own position defined and guarded by corresponding symbols and honors. In the third place, medical offi- cers should compose, at least a part, of military courts, 20 before which a medical officer is brought for trial. This is right, in obedience to the just principle, that a man shall be tried by his peers. They are compe- tent by law; there is precedent for their appoint- ment ; and no one will say, they are not as capable as others, from their intelligence and integrity, of render- ing an enlightened and righteous verdict. It is no argument, in favor of the continuance of the marked wrongs, or the humiliating official relations of the medical corps, that its members have won for themselves a character of honor and respectability ; on the contrary, it is an additional evidence of their claim to their country's support and protection. This general reputation, so far as the corps may pos- sess it, has been won, by individual force of character, in opposition to adverse regulations, and unaided by the support and protection, which they w T ere entitled to receive from their country. But the history of the success of the medical corps, is not its whole history ; there is a counter narration, unrecorded and undi- vulged. Who takes note of those, whose talents would have been an honor and benefit to the coun- try's service, but, who, from familiarity with its injus- tice, shrink from its employ? We can adduce, at least one eminent professor, who carefully guards his students from the navy, as the mselstrom of talents, fame and fortune. Of those in the service, how many are there, who finding themselves in a false position, remain as a matter of bitter expediency, awaiting 21 the first favorable moment, to quit a service, which neither rewards their labors, nor respects their pro- fession ? How many, who gradually lose the spirit of professional pride, whose impulse was onward, and philosophically, though naturally, fall into the same estimate of their profession, as is taken by the usages of the service, and learn to regard it with too much contempt, to make any effort for its advance- ment. Although, some by force of character, or fa- voring circumstances, or both, have established a reputation of honor for themselves and for the service of which they are members, is it worthy of the gene- rosity, the dignity, or the justice of their country that this has been accomplished in struggling opposition to every official impediment 7 Opposition or neglect may retard the advance of the naval medical corps to its proper position, but sooner or later, despite of opposition or neglect, that position it must reach. Principles of a permanent character may be covered up, by temporary circum- stances, but eventually will rise superior to them, and the present relations of the medical corps, in the navy, are so contrary to its own nature, to its relations with society in general, to the interests of the service, and to the common sense of the people, that those rela- tions cannot endure. "History is philosophy teaching by example," and the history of what has been done in other services, and in the services, too, of those countries, whose conventional arrangements exclude 22 the profession of medicine, from the relations with gene- ral society, which it holds in ours, teach us, in the most forcible manner, that an end must come to the present false and unnatural arrangements. By using the powers intrusted to them, to hasten the arrival of that period, the legislative and executive departments will be putting an end to long continued and gross injus- tice, and while restoring an important class of public agents to their natural relations and position, they will be, at the same time, increasing the efficiency of those agents, advancing the objects of their creation, and rendering them doubly valuable to the country's ser- vice and their country's good. In this case, justice is harmoniously invited onward by the public weal, and need not push its way under the sanction of that principle whose mandate is, "Fiat Justitia, ruat ccelum." ■■■•.. UNIVERSITY OF CALIFORNIA LIBRARY BERKELEY Return to desk from which borrowed. This book is DUE on the last date stamped below. tNlar'SOBZ l0 Jurt50R» LD 21-100m-ll,'49(B7146sl6)476 Stockton, Calif. W. )AN. 2\, 1908 965191 THE UNIVERSITY OF CALIFORNIA LIBRARY