London, Saturday, March 13, 1847.
We direct attention to an excellent letter in another column, from an assistant-surgeon in the navy, complaining of the injury and indignity suffered by young medical men, in being located in the gun-room as long as they remain assistant-surgeons. All candidates, before they can obtain the post of assistant-surgeon, must undergo the special examination required of them, and obtain a certificate of qualification from one of the British Colleges of Surgeons; they must have undergone a lengthened course of professional preparation, including an apprenticeship, or pharmaceutical engagement; a lengthened attendance upon lectures on anatomy surgery, military surgery, theory and practice of medicine, clinical medicine, chemistry, materia medica, midwifery, and botany, and must have attended a recognised hospital for two years subsequently to the age of eighteen. At the time they are admitted, after all this preliminary education and examination, to the examination of the Inspector-General of Naval Hospitals and Fleets, they must be between twenty and twenty-four years of age. And, after all this, when they enter the service, though highly educated, they are only on a par with naval youngsters, boys who have just commenced their emancipation from school. The raw midshipman is practically put on a par with the scientific man, upon whom the preservation of the health of the whole ship, in case of death or accident among the other medical officers, may depend.
Viewed in any light, this is an evil which loudly calls for remedy. It interferes, as our correspondent points out, with the professional studies of the young naval surgeon. Though a special set of certificates are required for the naval service, the great proportion of those applying for the post of assistant-surgeon have already obtained their ordinary and legal qualifications for practice. When thrown on shipboard the immediate opportunities of seeing extensive practice are seldom very great. It becomes, therefore, the more necessary for the assistant to cultivate his opportunities to the utmost by reading and study. Study is indeed enjoined as a part of his career; he is expected to prepare himself, while at assistant, for the examination he will have to undergo as full surgeon, when his time of promotion may come round. But how obviously unfitted must the noise and bustle of the gun-room be for pursuits of this kind. How impossible that any-
REGULATIONS OF THE NAVY.
To the Editor of THE LANCET.
Sir,- My object in troubling you with these lines is to direct your attention to the injustice sustained by the medical profession in the Royal Navy, in being obliged to pass through the gun-room.
Having completed their professional education, and arrive at adult age, they are placed on an equality with young officers who are learning seamanship, or clerk's duties, who have been afloat from their boyhood, and are unacquainted with the necessity of retirement for the purpose of study. Being without a cabin, they are obliged to spend their time with these young gentlemen, in whose society they too frequently neglect scientific pursuits, and the prosecution of their professional studies.
The assistant-surgeon is the only officer entering the service at an adult age who is placed in the gun-room; for the chaplain, naval instructor, and second lieutenant of marines, go into the ward-room at once, and have a cabin; and efforts are now being made to put the first engineer into the same mess, and give him the rank of a commissioned officer.
Surely it is time that young medical men should receive their due. They are an educated and a gentlemanly class, and of all the officers in the service, the most capable of advancing our knowledge of natural history; but to do this effectually, they require encouragement; for in their present position, retirement and study are almost impossible.
If placed in the ward-room, and granted a cabin, the assistant-surgeon in the navy would only be on an equal footing with his brother officer in the army.
No inconvenience could follow this arrangement, unless a respectable uniform and increased pay might succeed to it, and be so considered; whilst the service would be benefited by the entry of gentlemen of property, as well as of talent, as is the case in the army.
There are many of high attainments now in the navy list; but the number would be increased by the alteration, and the country repaid by the prevention, perhaps cure, of the diseases of our stations, as the pathology of these fevers, so necessary to a rational mode of treatment, would be studied with that ardour characteristic of scientific men.
I beg leave, Sir, to request that, being a member of the medical profession yourself, and the editor of a journal devoted to the support and improvement of that profession, both in itself and its external relations, you will advocate the rights of the assistant-surgeons of the Royal Navy, asserting their claims to be made ward-room officers, with a cabin, and a respectable uniform.
Changing the title to second surgeon might contribute to overcome that jealousy which would exclude an assistant-surgeon from the upper mess.
In concluding, I venture to predict as great an improvement among the medical officers of the service, as first and second surgeons, as that which has already taken place since the days of the old surgeons and their mates.
I enclose my name and address in confidence, and beg to subscribe myself your humble servant,
AN ASSISTANT-SURGEON IN THE ROYAL NAVY.
The Lancet, 1847, vol I, page 345:
THE NAVAL MEDICAL SERVICE.
To the Editor of THE LANCET.
Sir, - Your very admirable article in THE LANCET of Saturday last, on the position which naval assistant surgeons hold in service afloat, must call forth the gratitude of every member of your profession in that department of the public service, and lead them to augur much good from such powerful advocacy.
For every unprejudiced mind the force and truth of your remarks must be apparent, and the necessity and justice of granting assistant-surgeons ward-room rank undoubted. So long this is withheld, the Admiralty regulations relative to education are worth so much waste paper; for men possessing a high standard of education will not enter - nor, indeed, will any other, unless compelled by sheer necessity; and a service that might, without costing the country one shilling, be made the most popular, is, by the present unwise regulations, at a considerable discount.
This, Sir, is impolitic and unjust - first, as regards science; and secondly, as regards those who are, or may be by the necessity of the case, unable to make choice of a medical attendant - a deprivation I feel sure my lords of the Admiralty would not like to have inflicted upon themselves.
The only serious objection ever urged by the Board of Admiralty against the claims of assistant-surgeons to ward-room rank, was the difficulty of providing them, in the event of its being granted, with suitable accommodation. Yet, strange as it may appear, cabins have been erected for the naval instructor, engineers, and additional lieutenants, since that objection was first started; and so may assistant-surgeons also be provided with cabins, even at this the eleventh hour, if the Admiralty could be impressed with the necessity of giving encouragement to education and talent, as they have been in the case of naval instructors and engineers.
A deputation from the Medical Association once waited upon the hon. member for Marylebone (Sir C. Napier) on this very subject, who stated, in reply to some question put to him, that, indeed, the position of an assistant was much improved since mates had received rank. I remember at the time feeling surprised and annoyed, that a reply so palpably absurd could have been received by grave and sober men as a sufficient answer; and only mention it now to show that even the gallant commodore is not free from the prejudices of his class - prejudices which allot less pension to the widow of a surgeon than to a lieutenant's or master's - which cut down a surgeon's share of prize-money to one-half that of a lieutenant - which allow him to rank with, but after, a lieutenant; which have called for a commission - now sitting - with the view to deprive medical officers of the epaulettes the late Board granted; and which still withhold from my junior brethren the position they are so justly entitled to.- I am, Sir, yours very gratefully,
A NAVAL SURGEON.
The Lancet, 1847, vol I, page 680:
In another column will be found a letter from "An Assistant-Surgeon, R.N.," describing the position of the young medical man on shipboard. The details are not less disgraceful to the entire naval service than it is a stigmata to the medical profession. On a former occasion we pointed out the high qualifications demanded of the medical man before he enters the navy, and the treatment to which he is afterwards obliged to submit. In age he must be from twenty to twenty-four, on his admission; in intellect and professional acquirement he must be ripe and cultivated; yet the moment he gets his commission, he is made the companion and equal of boys both in years and education. He is obliged, before his admission to the service, to have learned his profession, and to have obtained his full professional diploma, (for the second examination, on becoming full surgeon, is little but matter of form,) yet he is herded with youths who are learning the alphabet of theirs. In the navy regulations, much is said about the importance of extra-certificates and diplomas, and the preference accorded to their possessors, but as regards treatment they have to submit to exactly that which an apprentice or medical pupil might expect. The navy demands a maximum of qualification, and then treats it with a minimum of respect. Those in authority do their best to quench all self-respect, and the honourable feeling in the young medical officers, and then they look for such noble and devoted services as those rendered by M'WILLIAM on the Niger, and at Bona Vista, and by SIDNEY BERNARD on board the Eclair.
On every side, the just rights of professional men are trampled on, but this state of things in the navy cannot last; it will not bear public exposure, and that, at least, we are determined it shall have.
The higher men in the medical department of the navy ought to exert themselves to remove the gross injustice practised towards the assistant-surgeons. Not a single medical man who has been, or who now is, connected with the service, but would be the more respectable for the removal of this evil. We should have thought the men of our profession, who either are or have been in the naval service, sufficiently influential to have brought about so just and necessary a reform without public discussion. Surely such men as Sir JAMES CLARKE, Sir WILLIAM BURNETT, Sir D. DICKSON, and Sir RICHARD DOBSON might, we should imagine, do much towards remedying the just complaints of the assistant-surgeons. Their present situation ought not to render them indifferent to the welfare and credit of their younger brethren.
No excuse can be drawn from the class of men who form the body of assistant-surgeons. They are such as to deserve liberal treatment from Government, and from the naval service. As our correspondent remarks, "they are all members of some of the Royal Colleges of Surgeons, and many of them in addition, have obtained the degree of doctor of medicine". Some of the best educated young men in the profession are at present acting as naval assistant-surgeons, and "denizens of the midshipman's berth," if their service is on shipboard. On looking over the navy list, we find, that such men as the younger HOOKER, the botanist, and HARRY D. GOODSIDE are assistant-surgeons; and also several graduates and undergraduates of the University of London. Among them, we may mention, T. H. HUXLEY, a medallist of 1845; ALFRED JACKSON, M.B., and University Exhibitioner of 1843; and F.J. BROWN, M.D, both of London and Edinburgh; and many others, with different diplomas, who have distinguished themselves during their educational career, might be mentioned.
When the matter is thoroughly exposed, the interests of the navy will demand a reform in this matter. After it's public discussion, young medical men of spirit and acquirement, such as are needed for the navy, will not enter the service so freely as they have hitherto done. There is something which would be positively grotesque, if it were not an insult to our profession, in the disparity between the official announcement from the "medical department of the navy" that in the selection of assistant-surgeons "a favourable consideration will be given to the cases of those who have obtained the degree of M.D. at either of the universities of Oxford, Cambridge, Edinburgh, Dublin, or London,." and the rules of the naval service, which, after the said M.D.s are caught, shut them out from the ward-room and the society of officers equal to them in rank, consigning them to the midshipmen's berth, and the luxury of "a chest of three feet six in length," to serve for "library and wardrobe;" while a cabin is given to the gunner, boatswain, carpenter, and engineer.
Expediency, no less than justice, imperatively demands that such disgraceful anomalies should be amended.
ASSISTANT-SURGEONS IN THE NAVY.
To the Editor of THE LANCET.
Sir,- It is unnecessary to allude to our professional qualifications, further than to state, that we are all members of some of the Royal Colleges of Surgeons, and many of us, in addition, have obtained the degree of doctor of medicine. Previous to our admission into the service, we are compelled to submit to another examination before our talented director-general, Sir William Burnett. We are then sent on board ship, and thrust into a filthy, dark den, called the midshipmen's berth, among a set of noisy, half-educated school-boys. We are excluded from the ward-room mess, and denied the use of cabins, not being deemed suitable company for second-lieutenants of marines and naval schoolmasters, and who, strange as it may appear, nominally rank below us in the service.
Let me now contrast our degraded position with that of our more fortunate brethren in the army, &c. They have all comfortable apartments, and mess with the field-officers and captains of their respective regiments.
Why, then, are these marked distinctions allowed to exist in our service? Will any one be rash enough to say, that the medical officers of her Majesty's navy are in any respect inferior to those of the army, &c.? Our greatest enemies dare not say so.
We are told, indeed, that there is no place to put up cabins for us: then why and where is there space found for the cabins of the gunner, boatswain, carpenter, and engineer, in all ships and steamers. All these officers are non-commissioned, except the engineer; whilst we are commissioned officers, and rank with lieutenants in the army. The first engineers have lately been very deservedly admitted to the ward-room. May I ask, what are we inferior to them? Is not our education superior to theirs in every respect, except mechanics?
Such partiality would be most unaccountable, were it not too well known that a deep-rooted prejudice exists against our oppressed class throughout the service. We are envied our paltry pay of seven shillings and sixpence per diem, and exposed to the low scurrility of every parish boy who finds his way into our service as clerk's-assistant, &c. Situated as we are, without a cabin, where we can retire for study, we can make no farther progress in our profession, so far as books are concerned; we must make up our minds to close them for ever, and of necessity forget much of that valuable information which we have toiled so hard to acquire.
We are allowed a chest of three feet six in length, and this must serve for library, wardrobe, and toilet, &c. If we are sick during the day, we may sleep on the lid of it, if we can.
In this state of things, it may appear strange, that any young medical man of spirit would enter the navy; nor would they, if they only knew half the indignities they have to endure.
In conclusion, allow me to entreat you, and every conductor of the medical press of Great Britain, to urge the great body of the profession to call on Government to place us on a perfect equality with assistant-surgeons in the army, &c. We will never be content with less.
AN ASSISTANT-SURGEON R.N.