REPORT 
UPON TII F, 
RANK OF THE NATAL MEDICAL STAFF. 
BY 
W. M. WOOD, M.D. 
EXTRACTED FROM THE 
TRANSACTIONS OF THE AMERICAN MEDICAL ASSOCIATION. 
PHILADELPHIA: 
COLLINS, PRINTER, 705 JAYNE STREET. 
1868. REPORT UPON THE RANK OF THE NAYAL MEDICAL 
STAFF. 
From the many subjects which must of necessity engage the 
attention of the American Medical Association, it may be supposed, 
at first sight, that the question of the rank of a few medical men 
now engaged in the naval service of the United States is not entitled 
to enlist the consideration of this medical congress. But if it can 
be shown that our national legislation and existing usages in regard 
to medical officers are pervaded by a spirit of contempt for the 
medical profession and outrage of their honor, then will the ques- 
tion which we present be recognized as one of paramount import- 
ance not only by this learned association, but by all the medical 
men in the country, to whom, through you, we desire to address 
this appeal; and neither they nor you can fail to do all in your 
power to redress the wrong, without a compromise of the dignity 
of the profession and a sense of personal humiliation. We feel 
that we are in the midst of the chivalry and independence, and high 
honor of our fraternity, and that the prompt sympathy and support 
which our cause demands will be cheerfully given to us. What 
is due to the credit of our cause is all we ask, and that you will be 
the last to withhold. You have never, in other times, in the most 
pressing of your duties, failed to offer us the aid we sought, and we, 
therefore, look to you with renewed hopefulness now. What we 
want is a fair hearing of our grievances, and a bold, persistent, and 
united advocacy of our claims, provided our cause is just and right. 
Your Committee propose to show, as briefly as possible, that the 
claims we have upon your sympathy and support are higher than 
any mere personal interest we have in this question, and conse- 
quently demand the most respectful consideration and the promptest 
action. If the members of your profession, in the naval service, 
were left as free to establish their individual position, by either per- 
sonal or official merit, in accordance with the unquestioned value 4 
of the duty performed, as those who are in civil life, there would 
be no necessity for an appeal to others to redress their wrongs. 
This is not the case, however. For the very fact that we are your 
representatives, medical men, is made the occasion of our degrada- 
tion. For no other reason that human ingenuity can discover, are 
we deprived of those decent privileges which belong of right to 
the humblest social position which a gentleman can be called to 
occupy. Your Committee are satisfied that they are not stating the 
case too strongly, and this they will now proceed to prove. 
The spirit that has thus far pervaded American military usages 
and legislation in reference to naval medical men, seems to be 
derived from the days of barbarism, when the “Leech” was the 
menial servant of some unlettered chief; and is it a matter of sur- 
prise that we should ask you to remand it back to its enlightened 
source, and relieve us of the odium under which we are now rest- 
ing ? Surely it is unworthy of this age to continue to treat the 
medical officer as the plebeian inferior to a chief, however cultivated 
and accomplished he may be, since it can be demonstrated that 
in no department of the service have the moral and intellectual 
qualifications of a corps been proportionably raised. 
In the minds of many who take words for ideas, certain cant 
terms imply and keep up this impression of inferiority and vassal- 
age. To call a medical man a non-combatant, has been thought 
to be the strongest argument against any claim he may advance. 
And yet every naval officer knows that so far as such a phrase 
implies that the medical officer is not exposed to the risks and 
hazards of battle, it is flagrantly false. On shipboard there is no 
place of security, even for those whose security is a necessity. It 
is not so much the officers and the men who are the objects of the 
missiles of war, as the vital parts of the ship. It is the heart at 
which the fire is directed. During the first two years of our 
blockade of the coast of the Carolines, the only commissioned 
officers killed were medical officers; and in the action between the 
Merrimac and the Minnesota, the only shell which came below the 
gun-deck tore open the berth-deck into the cockpit, and by the con- 
cussion knocked down one of the medical officers and wounded in 
its track more men than were wounded in all the action on the upper 
decks. But are the risks and hazards of the battle the only true 
criterion of merit in an officer; and are they alone worthy of recog- 
nition by the government he serves ? So far from it, they are not 
even the highest duties of a line officer, nor are they to be adopted 5 
as the standard of the measurement of his ability. In these he may 
find superiors among the rank and file of the ships’ company. The 
success of a commanding officer does not depend upon his exposure, 
but upon his skill, his weight of brain, and moral power, his ability to 
keep up the discipline of his ship, and prepare for every emergency. 
Why then should the risks and hazards be made the standard of 
measurement to the medical corps! The administration of a naval 
medical charge requires an education of the highest finish, and an 
experience peculiarly its own. Its duties are not discharged by a 
mere prescription, or an operation in surgery. They range higher, 
and reach results infinitely more important. At sea they are mul- 
tiform ; and on shore they are such as are only confided to honor- 
able boards, or state and municipal officers. On the medical 
officer depends the efficiency or inefficiency of fleets in peace and 
in war. True it is that in these things, which give eclat to an 
officer of the line, the medical officer can have no participation. 
His is the calm quiet sphere of duty in which there is no room for 
dramatic display. The failure to make an official recognition of 
public duties, because they are in their nature quiet and unob- 
trusive, is more than an injustice. It is to some extent an evidence 
of an imperfect civilization. 
When the foundation of the Legion of Honor was under discus- 
sion, it was proposed that it should be confined exclusively to 
military men. The first Napoleon combated such a narrow and 
invidious policy. “ Such ideas,” said he, “ might be more adapted 
to the feudal ages, when the chevaliers combated man to man. 
What is it now which constitutes a great general ? The habit of 
foresight, the power of calculation, in a word, civil qualities such as 
are found in a knowledge of human nature. The general who can 
now achieve great things is he who is possessed of shining civil 
qualities.” 
“ The tendency of military men is to carry everything by force, 
the enlightened civilian, on the other hand, elevates to a percep- 
tion of the general good. The first would rule only by despotic 
authority. The last subject everything to the test of discussion, 
truth, and decision. I have no hesitation, therefore, in saying that 
if a preference was to be awarded to one or the other, it belongs 
to the civilian.” 
Those views of the great Napoleon, which are eminently wise 
and just, do not seem to have impressed themselves on the consti- 
tuted authorities. In no conflict in which our country has been 6 
ever engaged has there been a whisper of suspicion against any of 
your brethren in the naval service, on the score of a neglect of 
duty, or a shrinking from the hazards of battle, or, what is 
infinitely more to be dreaded, from the pestilence and plague. 
They have gone beyond the calls of duty to encounter those 
hazards. During the siege of Charleston, it was reported by Ad- 
miral Dahlgren to the department, that Assistant Surgeon Long- 
shaw, of the Nahant, volunteered, with two sailors, to carry a line to 
the Lehigh, grounded, under the fire of the batteries in Charleston 
harbor, and did it. Subsequently this gallant officer lost his life 
while performing duty on the field of battle. The following extract 
from the official report of the late Dr. Whelan, the chief of the 
Naval Medical Bureau, offers testimony honorable to your brethren 
in the naval service pertinent to this report, and your Committee 
believe gratifying in all but its fatalities to this body. 
He says, “I deem it not only a grateful office, but a positive duty 
to bear testimony to the faithful and efficient service of medical 
officers of the navy since the outbreak of the war. In consequence 
of their comparatively small number, their service has been more 
continuous than has fallen to the lot of most others, from the 
inability of the department to afford timely relief or even much 
interchange of station.” 
“ The war brought its trials and novelties to the medical officer 
as to those of other grades, and it affords me the highest satisfaction 
to state, as I think I can do with entire truth, that as a body they 
have proved themselves equal to every emergency; indeed it is 
remarkable that the long interval of peace in which most of them 
had grown up found one and all so fully prepared for all the con- 
tingencies of battle. Not only have they served efficiently on ship- 
board, but the calls of the army, whenever made, have been prornptl v 
and cheerfully answered. During the year two young officers of 
promise, Assistant Surgeons J. H. Gottwold and Edward A. Pier- 
son, were killed in battle, eleven were taken prisoners by the enernv, 
seven have been exchanged, four are still retained.” 
Such is the record of the duties and responsibilities, the risks and 
hazards of your naval representatives. The whole country has 
seen what richly-deserved honors have been heaped on the officers 
of the line, how rapid has been their promotion, and how new 
grades have followed in the track of their brilliant achievements, 
while in the army even medical officers have had the compliment 
of brevet rank. But in the navy, not one medical officer has re- 7 
ceived the slightest acknowledgment or distinction at the hands of 
the country. This negative mortification, the result of the neglect 
experienced, is of little consequence, however, compared with the 
position and aggressive annoyances to which they have been sub- 
jected, and which it is our duty to expose. 
It will be remembered that after a long struggle against preju- 
dice and misconception, numbers, and power, the medical corps, by 
the aid of this Association, won from both the legislative and execu- 
tive branches of the government an established nominal rank. And 
yet the acknowledgment of the true principle was not the full 
measure of the justice; the smallest possible relief was extended 
to our corps. At that time the highest rank known in the navy 
was that of captain, equivalent to that of colonel in the army. The 
next rank below it was that of commander, and nominally the rank 
of the Senior Surgeons was assimilated with that of commander, 
leaving their highest rank the second known to the service. Since 
then the rank of commodore, rear-admiral, vice-admiral, and admi- 
ral, has been given to the officers of the line, and the senior medical 
officers nominally advanced to the rank of captain, so that the 
apparent position relatively reduces them three degrees, leaving 
them now the fifth, instead of the second, in the naval scale. 
It is not, however, so much the nominal rank which makes the 
greatest wrong in our case, as the fact that it is a grant only in form 
and not in substance. The higher the title, the greater the satire 
upon our profession, for its destitution of all those practical advan- 
tages which the same title confers on officers of the line is its most 
taunting insult. 
This can only be made clear by a brief statement of the domestic 
arrangements on shipboard life, and its bearing on medical officers, 
which is in disgusting incongruity with the whole theory of no- 
minal rank. 
Our service is overgrown wfith usages which sprung up in the 
earlier and ruder ages of naval life, and still cling to it with a 
power and tenacity which almost defy modern enlightenment, pro- 
gress, and even law. It is probable that the national authorities, 
which authorized the existing rank of medical officers, intended to 
confer a more substantial fact than the usages of shipboard life 
have permitted. 
Among the usages of the service is that which limits and re- 
stricts an officer’s rights and comforts to the apartment in which 
he messes, even though his rank actually entitles him to higher 8 
privileges and greater comforts than belong to those of an inferior 
rank, who make np the majority of the inmates of that apartment. 
The steerage is the most humble of those apartments, and is the 
dwelling place of the very young, or those of no responsibility. 
The wardroom gathers in it most of the commissioned and some 
warrant officers, and was originally occupied by none of‘higher 
rank than lieutenants. All its usages and government are still 
conformed to the scale of that grade. Now make a medical officer 
in name an admiral, and leave him to be a wardroom officer, and the 
title becomes ridiculous. It is sunk below the usages and restric- 
tions originally designed for those of junior years and inferior rank. 
There is only one mess which is superior to these trivial restric- 
tions, and that is the mess or messes of the commanding officers 
and their associates, who may range in rank from a lieut.-com- 
mander to an admiral. Sometimes there is one, sometimes there 
are two of these messes. This is very properly left to the will of 
the coraraander-in-chief, who may choose that he and his captains 
may have one or separate establishments. 
The assistant surgeon enters the service with the rank of “master.” 
That this title may not be misunderstood, it may be necessary to 
explain, that it is the lowest rank in the wardroom, for the incum- 
bent is in modern times generally a graduate of the naval academy; 
awaiting his promotion to a lieutenancy. Like the master, the as- 
sistant surgeon at once becomes a member of the wardroom mess, 
and, unless the number of partitioned-off sleeping berths contained 
in the wardroom are occupied by his seniors, he may have the 
good fortune to occupy one of those ventilated and dimly lighted 
by an air-port of six inches diameter. This space is so restricted, 
and the separation from the common apartment is so slight, that 
words in an ordinary voice in either become common property. 
It is not possible to express, to those who know nothing of ship 
life, the luxury of a state-room. 
With youth and all its hopes, the novelty of naval life, the 
promise of new scenes and adventures, the companionship of those 
of congenial tastes and correspondent ages, all to the young 
medical officer is rose-colored. But, as years roll away, this sub- 
jection to petty rules and restrictions, without a place or an hour 
of privacy, becomes painful beyond the conception of those who 
have not experienced it. 
The line officer passes beyond and above these things before he 
has lost the compensation of youth and novelty. His tenancy 9 
closes with his career as a lieutenant, or at most that of a lieut.- 
comraander, the seventh in degree from the highest rank. Even 
in this grade he may make only one cruise as the executive officer 
of a large ship, or continue for a brief period in the wardroom on 
some special and temporary duty. 
But more often from the time he becomes a lieut.-commander, he 
has the independence of his own cabin. His comforts and conve- 
niences increase as he advances in rank, and through all coming 
years he is the associate of those of corresponding position and age. 
When we turn to medical officers the contrast is very great. As 
assistant surgeon, passed assistant surgeon, surgeon, and fleet sur- 
geon, he has had the assimilated rank of master, lieutenant, lieu- 
tenant-commander, commander, and captain; but with all these 
lapsing years, increasing rank and responsibilities have brought no 
practical change in his shipboard existence. His sleeping berth or 
room may be a few feet further forward than it was when he was 
an assistant surgeon, thirty or forty years before. It is the same, 
however, he occupies as a fleet surgeon. He is still the ward- 
room officer, subject to the same restrictions that fettered him when 
he was new to the service, and in training for its duties. With the 
failing eyesight of increasing years, the clerical duties of his posi- 
tion are to be performed, even in the daytime, by candlelight in this 
cell, while probably there are in the air and light of the upper deck 
ample rooms devoted to the pantries, water-closets, bath-rooms, and 
domestics of the commanding officers. 
An humble though striking illustration of the domestic life of 
the medical officer on shipboard and its contrast with that of the 
line officer is shown by the fact that, should the Doctor feel inclined 
to solace his cares by a pipe or cigar, he must do so, no matter 
what his age or rank, or the state of the weather, in the bow of the 
ship, among the chicken-pens and pig-sties, or hovering among the 
cooks over the galley or cooking stove. At the other end of the 
ship those who entered the naval service with him, or perhaps years 
since he did, and who may be not only his juniors in rank, but 
young enough to be his children or even his grandchildren, are free 
to enjoy the same indulgence in the privacy and comfort of their 
own cabin, and, if need be, by the warmth of their own fireside. 
Such a contrast might have been seen during our late unhappy 
war, when, during the most inclement wintry weather on our coast 
an old fleet surgeon was limited to such comfortless and degrading 
restrictions, whilst by the three commanding officers this luxury was enjoyed in their own cabins in the same ship. The first, the com- 
mander-in-chief, was the nominal junior of the medical officer; the 
second had been a midshipman in a squadron of which this medical 
officer was fleet surgeon twenty years before ; and the third was not 
born until years after the Doctor had been actually engaged in the 
naval service. Could such a scene as this be imagined in any civil- 
ized association, where the ordinary influences of decency and pro- 
priety were left free to act ? And yet there is no medical name 
known to this Association which officially, in the naval service, 
would have any higher privileges. 
Whilst the medical officer has thus been growing old amid the 
restrictions of the wardroom, the young gentlemen who started 
with him have gone up to the rank of commodores and admirals; 
so that with each cruise he finds himself in the midst of a younger, 
and a still younger association, each in turn leaving him behind. 
It is no disparagement to the gentlemen themselves, but it is 
nature’s law that, however agreeable they may be, there is a want of 
congeniality between the sentiment, the tastes, the impulses, and 
topics of conversation of those so widely separated by years, and in 
an apartment where there is no privacy amid incipient guitar, flute, 
and banjo-players, the old fleet surgeon may well wish himself a 
boy again, or in some other region. 
A very marked discrimination is made against senior medical 
officers in the laws upon prize money. The general law is that no 
officer shares in prize money, unless his name be borne upon the 
books of the vessel making the captures; but the admiral or com- 
mander-in-chief has a percentage upon all prizes made. The fleet 
surgeon, as a member of the commander-in-chief’s staff, must be 
with him in the flagship, and, as a rule, at the post of greatest risk, 
responsibility, and hazard; consequently he is not likely to have 
his name borne upon the books of the subordinate vessels making 
captures, and yet no share of prize money is allowed him. Fleet 
surgeons have been authorized by law for thirty-nine years, and yet 
no provision has been made for a share of prize money accruing to 
squadron officers, but a few years ago fleet captains were for the first 
time authorized and at once provision was made for their sharing in 
the squadron captures. In a squadron in which the admiral’s share of 
prize money was one hundred thousand dollars, the fleet captain, a 
young lieutenant-commander, had his share, and the fleet surgeon, an 
officer of over thirty years’ service and of higher nominal rank than 
any other officer of the squadron, was not entitled to and did not 11 
receive one cent. This subject is alluded to not for its pecuniary- 
interest, but as another illustration of the marked discrimination be- 
tween line and medical officers. Such being the actual condition of 
a medical officer in the navy, a condition diminishing with increas- 
ing years, responsibilities, and rank, their appropriate rewards and 
privileges; what are the remedies? Few, simple, just, all of them 
within the power or the influence of this Association to effect. 
Let the rank given to medical officers be real and correspond- 
ent to its name and degree, as is the case with line officers; and 
let it be proportioned to length of service and responsibility. So 
far as the interests of the service may not positively forbid, place 
medical officers under the command of their seniors only, or if 
from the exigencies of the service this may at times be inexpedient, 
let them as surgeons of single ships be subordinate and responsible 
only to the commanding officer of the ship, and as fleet surgeons 
to the commanding officer of the squadron. 
After they have reached the rank of commander, or are filling 
the position of fleet surgeon, let them be by right, as they often 
have been by courtesy, members of the cabin mess. If the mess 
of the coramander-in-chief be too exalted a social position for the 
members of your profession, who are filling the important position 
of fleet surgeon, then let them be members by right of the mess 
of the commander of the ship, and the fleet captain. In most 
instances they will be younger in age and lower in rank than the 
fleet surgeon. These few, simple, wise, and just arrangements are 
within the will of the navy department, and can be effected at any 
moment. 
An equitable arrangement of prize money most important in 
principle, your Committee hope to see effected. It will, however, 
require future legislation. 
If it should be thought that in these views the medical profession 
is asking something novel and unusual, we call your attention to 
the remarkable fact that, among the aristocracies and under the 
royalties of Europe, much higher acknowledgments are made to 
the value and honor of your profession. In the British navy, 
medical men are advanced to the rank of rear-admiral; and before 
the reforms which were introduced into the military services of 
Great Britain, Lord Dalhousie, Governor General of India, remarks 
upon the subject: “It is impossible to imagine what serious justi- 
fication can be offered for a system which, in respect for external 
position, postpones service to inexperience, age to youth, a system 12 
which treats a member of a learned profession, a man of ability, 
skill, and experience, as inferior to a colonel of cavalry, just enter- 
ing on the study of the pay and audit regulations; a system which 
thrusts down gray-headed veterans below beardless boys.” 
In the French navy, promotion extends to the rank of rear- 
admiral, and the fleet surgeon not only messes with the commander- 
in-chief, but the government pays his mess bill in addition to his 
regular pay. 
In the Spanish navy, medical officers are eligible to the highest 
rank and honors. 
In democratic America alone is your profession legislated into 
inferiority. 
It would be unjust to our brethren of the line if this report was 
construed as charging this false position of medical officers upon 
their action or hostility to our rights. On the contrary, the most 
intelligent and liberal-minded officers of the service recognize and 
deplore the position of medical officers. There are, unfortunately, 
others, who imagine that they have no rights of their own, unless 
they possess the power of trampling upon others, but while those 
who give us their good opinion are satisfied with doing so passively, 
those who are hostile to us are active and aggressive. It is natural 
that those brought up under the power and prejudices of an insti- 
tution, would carry out the behests of that institution, as a duty, 
even contrary to their opinion of right. 
The late Admiral Foote, so justly distinguished for his large 
minded liberality, professional skill, and undaunted courage, advo- 
cated the highest rank for naval medical officers. An admiral 
among the most distinguished in the service has authorized it to 
be officially said that he thought the fleet surgeon should, in our 
service, as in the French, be a member of the commander-in-chiefs 
staff and family. 
Such, gentlemen, is the present condition of our profession in 
the United States navy. We respectfully suggest that, however 
undesigned, it is inconsistent with the respectability that should 
ever characterize a profession, which in point of intelligence, useful- 
ness, and moral elevation, is second to no other, however exalted that 
other may be. We regard it as opposed to the public interest of 
the service, which can never be sacrificed to gross indignity with- 
out detriment. We regard it as offensive to personal self-respect, 
which no class of men should be required to forfeit. It is con- 
demned by common sense, common decency, common justice, and 13 
is as repulsive to the feelings of the most distinguished of our naval 
service as it must be to you. Does it find more favor with you ? 
Does it excite less indignation in you ? Will it be less emphatically 
resisted by you than by us ? The whole power and influence of 
the profession should be brought to bear, and, if earnestly exerted, 
the wrongs we complain of will be redressed, our honor vindicated, 
while the just rights of the line officers will be in no sense invaded. 
Your Committee press this question upon your attention at this 
time, not so much from any personal interest they have in it, as 
from their allegiance to the profession.