- Email: [email protected]
NAVAL ASSISTANT-SURGEONS.
875
twenty-eight years, was placed
in my esta- medical officer in the service as at present constituted, not only with reference to his own peculiar duties, but as a subordinate officer in the navy ; both having to be carefully considefed before taking the first decisive step in life under his own sole
blishment ; she had previously been confined in a county asylum : she spoke of her miserable situation there in corresponding terms with the lady before-mentioned. She was discharged cured from hence in the month of April following. She has continued on the most friendly terms with the female managers in this asylum ever since. But what says " A LOOKER-ON," " the remuneration of the superintendents must cease
guidance.
I commence with his entry as assistantsurgeon ; his position as such has been much canvassed lately, especially in a terse and well-written letter byDr.Tweeddale: to be dependent upon the continuance of the my statement will, therefore, prove to some disorder." Why, if he were not absolutely extent a repetition, but as I wish to embody stone blind," he would perceive that the the whole of my own impressions of the serremuneration of the superintendents is de- voice,I must in this one instance solicit some pendent upon the celerity with which they forbearance to all which may seem like discharge their patients cured, and upon the iteration. It would appear that the especial wish of humane treatment they bestow upon them the magtiates of the navy, is to render their whilst in confinement. In the course of this present summer, the medical officers unfit for any other mode of wife of a medical practitioner of consider- professional life ; at once to check their able eminence and large practice was placed progress in, and to damp their zeal for, prounder my care, afflicted with puerperal fessional acquirements; or why place the mania ; in a few weeks she recovered, and man, to whom study should be as regtdar as his daily food, in a midshipman’s berth ? a now again presides over and guides her domestic affairs as usual. She came here place generally well crowded in the smaller on a visit a very few days since, bringing rates, not allowing him two feet space which handsome presents for all my children (six he can call his own, and so surrounded by of them), and expressing the warmest feel- boys and young men, that if one among ings of gratitude and attachment to those them only choose to be noisy, he could ladies in this establishment who watched hardly read a novel to understand it, much In addition to the over and consoled her during the continu- less a medical work. ance of her malady. Has A LooKER-ON" essential privations and rliscomforts of such seen results as gratifying in any large public a dwelling, one very moderate-sized chest is asylums? I am far from denying that they the only space allotted for his clothes, and do occur, but that the very reverse prevails in small vessels for his books and instrnto a large extent I can prove; yet " A ments also ; the size of this not being at all LOOKER-ON" would sweep this private esta- regulated by the instructions, but left enblishment from the face of the earth : let tirely to the caprice of the captain, or rather him" look on this picture, then on that," to the first lieutenant, to whom all power is and it is to be hoped he may give us some- now-a-days delegated, and whose generic thing practical, some foundation on which he characteristic is, to sacrifice every comfort would " effect those changes," which are to of his subordinates to smartness and show. give to the wealthy the blessings of the Such, sir, is the first position of a gentleman humane system enjoyed by the pauper pa- of liberal education and acquirements; of mature years ; the member of a highly imtients in county and large public asylums. Feeling conscious of no ill-intentions in portant profession ; and such, considering these remarks, I shall not seek to screen present appearances, will be the fate of all myself from the responsibility of them un- those who are unwary enough to choose der any feigned signature, but beg to sub- such a home. From his status in general scribe myself your very obedient servant, society, he has a right to expect some degree of consideration in the arrangements made GEORGE BODINGTON. for him ; on his arrival on board, however, Driffold House, Sutton Coldfield, he finds himself but little better treated
Warwickshire.
Morgans"
than the 11 of " the old school :" he can demand nothing specific as a right, for if allowed a chest for his clothes, and a NAVAL ASSISTANT-SURGEONS. hammock for his night’s repose, it is very common in the service to be ordered to dock To the Editor of THE LANCET. both the one and the other-the chest, SIR:—In answer to your invitation to because it is somewhat larger than accords with the captain’s or first lieutenant’s idea give you my reasons for having mended the junior members of the profession of neatness ; the second, because it is too to avoid the navy, allow me, in the first in- large in circumference, as compared with stance, to apologise for the length of the the men’s, with which it is stowed in the details I shall be obliged to send you, in hammock.netting, and is, therefore, un. order to show you the position of the naval sightly.
recom-
876 In a short time he begins to find out all ten shillings in the ward-room, of course exthe agrèmens of his appointment ; he finds clusive of wine and spirits in both, is by no that the marine officer, with rank of ensign means important to the assistant-surgeon: in the army, frequently fresh from some indeed, it is more than saved by the differcountry school, and some four or five years ence of comfort ; for I have always found his junior in life, has a cabin, a man-servant that the deprivation of this on board leads (a marine of his own choice), a place at the to a more reckless expenditure on shore : ward or gun-room table; and, what is in- while in the article of wine and spirits much finitely more galling, when he first goes to depends upon the individual, as is proved sea, he having rank as lieutenant in the by the marine officers meeting all their ex. army, is thrust to leeward ; while the penses upon five shillings and threepence marines, and some lieutenants younger than a-day, their uniform being much moreexhimself, are proudly parading the weather pensive than the assistant-surgeon’s. Those side. It is true, that he has sometimes the who wish for economy may practise it in the if not more, facicompany of some unfortunate old mates, or ward-room with as clerks, who are deficient in the required in- lity than in the midshipman’s berth. terest, and to whom the service is even less " A Surgeon of the Old School" has enalluring than to him; but this diminishes deavoured to answer Dr. Tweeddale’s plain not the hardship of his own position. Thus facts on some of these points, and instead of situated, the knowledge he has already ac- fairly arguing the propriety or impropriety quired must be gradually diminished, for no of the present arrangements with reference memory can retain all the facts of the vari. to the whole corps, advocates the present ous sciences which constitute the physician system upon a series of contingencies merely, and surgeon, without constant exercise by and those by no means very reputable to a practice, and frequent reference to books. medical officer ; and were they so, not likely In ships of the line, the assistant-surgeon to affect the many : thus, /i6 could read for may do much in the latter way in the sick an hour after turning in, by the sentinel’s bay; in the lesser rates, let the advocates of lantern ; and by being on friendly terms the present plan say what they may, he with the boatswain, he enjoyed the felicity cannot: and with reference to the former, I of a curtain of her Majesty’s bunting; the sincerely believe that to gain much either in loblolly-man hung up his cot (it was not his the taleut of observation, or in the know- duty, and the first lieutenant or surgeon ledge of experience, is, from the very nature might have prevented him doing it). Again, of our practice, impossible, as all our most the assistant-surgeon might have aged paserious cases in the smaller rates go to the rents, and by sending them a remittance hospital whenever an opportunity occurs of might render himself an object of greater sending them ; and, injustice to the patients interest and merit to his "superior officers. themselves, it should be so ; and from the And then he talks about crude and inexcare taken in entering sailors, chronic cases perienced opinions;" I can fancy, sir, that are comparatively rare; besides which our in the times of " the old school," the assistpharmacopoeia is very limited. ant-surgeon might have crude and inexpeDeprived thus during his earlier servitude rienced opinions : but in later times I have of all personal comfort, unable to console known many, and I have never met one himself for these privations by a conscious- among them likely to express such crude ness of advancement in professional or other opinions or argument as the " Surgeon of acquirements, and living from hand to the Old School" has advanced ; and with mouth (for that assistant-surgeon is econo- reference to drunkards, I can truly say that mical who can lay by a sufficient fund to I have met with more belonging to " the old meet the contingencies of hdif-pay, and school" than to the new. In one point I can, re-stock himself with clothes, &c., for liowevei-, agree with the 11 Surgeon of the another appointment), he is at length, after Old School," that the assistant-surgeon an average of twelve or fifteen years,, under might make enemies of some of his elders, the new arrangements of pay, &c., promoted whose excellent for study had not been sufficiently improved ; the senior in to the rank of surgeon. But, before considering him in his new such case might not like many of his crude position, allow me to meet one objection, opinions so freely canvassed as they would which might, from the tenor of the last necessarily be, were the assistant-surgeon a paragraph, be raised to his entry to the member of the ward-room mess. That the ward-room mess while assistant; viz., that parade and etiquette of a ward-room mess if he find it so difficult to keep within would prove a serious drawback to an bounds while messing with the midshipmen, assistant’s improvement, is to me quite unthis difficulty would be increased in the intelligible; one would think that the greater ward-room. This, however, is not the fact ; part of the ward-room officers’ time is taken the generality of ward-room messes are by up in dressing, and that we have more forno means extravagant ; and the difference malities and compliments to interchange between thirty shillings per month in the than a set of Chinese mandarins. What midshipman’s berth, and about two pounds parade ?-w bat etiquette? Howinthe name
much,
opportunities
877 a serious drawback? Or should the assistant-surgeon’s inexperience in discipline, render him subject to the penalties of a court-martial ? when the veriest youngster learns and knows his true position with reference to his superiors in less than a week after joining. Believe me, sir, there is nothing so very mysterious in
of patience, prove
why
sloops; in the new ones (much larger vessels) the surgeons’ cabins are hot, narrow, and confined, something like large coffins, and placed in the centre of the ship gun
at the fore part of the gun-room ; and this is done in order to give the captain’s steward
large berth abaft : the captains will soon have half the ship to themselves. In ships our etiquette, parade, or discipline, as to of the line, the surgeons are stowed in the prevent the initiation of even one of the old cockpit ; in frigates, right aft, close to the school in less than a week. That some gun-room and steward’s berth : all the best medical pupils may deserve the castigation cabins being assigned to the executives, received in the " Heads of the People" I am although the civilians may be old and greyaware ; but that this is their characteristic headed, and may have had their present rank as a class, still less that it generally applies before half the lieutenants were breeched. to those who enter either of the services, I In the army, on the contrary, executives and utterly deny. The whole letter appears to civilians choose their own quarters by seme an attempt to cast an unmerited slur niority in their respective ranks. He is now upon that class of the profession to which entitled to a second-class boy, as servant, he belongs ; the very tenor of it is a great one under thirteen, and who must leave him proof that he cannot advance one single when rated as first-class boy, which is reason, applicable to the corps as a body, usually when he is just becoming large why they should not at once be admitted to enough to be of service. This boy is always the just rights of their rank and position in employed when the idtos are called ; has to in the morning ; life. As my object, however, is not so much clean gun-screws, &c. &c., to advocate the cause of those who already and the surgeon may consider himself lucky belong to us, as to prevent disappointment if the first lieutenant is gerttlemanly or conto those who may think of becoming so ; siderate enough to allow the boy time in the and convinced that during the present gene- morning to clean his shoes and bring him ration, at least, the admirals who may be water. In this mal-arrangement, however, appointed lords of the Admiralty will nei- the executives (with the exception of the ther have liberality nor judgment enough to marine officers) suffer as well as the civiagree to any change, I shall proceed to de- lians. It is magnificently asserted in the pict the medical officer advanced to the rank instructions, that dispensaries are now fitted of surgeon. If by long service in small up for the reception of medicines on board vessels he has been absolutely prevented of all ships, sloops included ; and, as might from continuous study, and has thus ob- have been expected, they are all, except in tained fixed but contrary habits, is he likely ships of the line, placed in the worst possiWhile our modern architect to retrace his steps, and to endeavour to ble situations. make up for lost time by becoming studious can find room for splendid cabins for the and devoted to his profession ? Such a case captain’s steward, with a view, I presume, may be, and I dare say often does arise from of gaining the favourable opinion of those a principle of rectitude only; but is it wise captains who command his vessels, and that in our rulers to trust to this ? But consider- too by removing certain subordinate officers ing his status in a more worldly and selfish further forward, the surgeons are forced to point of view, what advancement has he see their patients, and dispense their medimade in life? Just so many of the best cines in any hole or corner in which he may years of his existence are past, and lost- think fit to stow them. Thus, in some of the years in which he can scarcely recall one new-built sloops, there is a chain-locker really pleasurable, because satisfactory, re- conveniently placed under the dispensary ; miniscence : if he have not retrograded in and the cable runs through it. In the sixth professional knowledge, he has but little ad- rates, the dispensary is in the cockpit, withvanced-he has lost all the enthusiasm of out inclosure, and very small ; and around his student’s life; and the chief store he has this are the doors of the purser’s, captain’s, laid up, in a worldly point of view, is the marines’, and other store-rooms. Hence accumulation of so many years’ servitude: flour, peas, chakos, and physic, are frean accumulation which is of no use to him, quently distributed simultaneously, to the unless he complete the full term of twenty- great augmentation of the surgeon’s and his five years. And how few of those who assistants’ respectability; and yet in these embark in the pursuit do so ?-how many ships the captain’s clerk has a good cabin on die on the road, to enable one survivor to the lower deck. In surveys upon invalids, reap his thirteen shillings a-day fo: the short the captains are seated, and their clerk ; but remainder of a frail existence? His personal I have never known a surgeon asked to take comforts, however, are somewhat enlarged ; a chair. Nor can I see what captains have he is entitled to a cabin, but which with the to do with invaliding : if the Admiralty purser’s is invariably the worst in the ship : cannot trust a board of three surgeons to the only exception was in the old eighteen- invalid those who require it, I should re, a
878 commend them to enter some that they could tenure than a life under the ordinary risks have confidence in. In their own ships, on shore; that this tenure may be made captains frequently assume a power never still more frail by the avaricious motives of contemplated by the service; viz., that of superior officers ; that the nature of the serdictating to the surgeon what officers or vice at present is all but a perfect despotism, men shall be invalided, whether in health from the very slight responsibility of supeor not ; and this notwithstanding an annual rior officers, that thus when serving under affirmation which the surgeon has to make, unpleasant or unprincipled characters, he, that he has neither invalided nor sanctioned the medical officer, may, like other subordithe invaliding of any one whom he did not nate officers, suffer much injustice, much consider a proper object. Let an officer, vituperation, and abuse, without the power therefore, commit himself, or a man or boy of retaliation, or the hope of satisfaction ; prove himself useless or stupid, and the that if, on the contrary, when thus perse. surgeon is very coolly told that they must cuted, he in the very slightest degree lose be invalided ; and if he demur, that he is the command of his temper, and betray such impeding the service. impatience, either in language or deport. Down to the fifth rates, the surgeon is ment, as to be construed into contempt of his allowed a man as sick-bay attendant; in superior officer (and a very slight expression lesser vessels he is entirely subject to the will serve this purpose in the navy), he will caprice of the captain, or first lieutenant ; inevitably lose all his previous servitude, and the most stupid and useless boy in the and thus find annihilated the only principle which he ventured into the service, ship is invariably given him : this boy’s duty is to cook the victuals of those the sur- viz., the certainty of his position and emo. geon thinks fit to diet himself ; to make luments, however disagreeable the one and attend to small the other. If I prove these things, sir, their poultices, fomentations, &.c.; the wants of those in their hammocks ; give I think I shall prevent those from entering them drink, &c. &c. ; but he is one of those the service who are not entirely dependent. called idlers also, and called on deck when- These shall be the subjects of my next ever they are, and the patients of course letter. I am, Sir, your obedient servant, suffer. It is a monstrous absurdity in the A SURGEON OF THE NEW SCHOOL. Admiralty to leave any civilian’s duties subject to the caprice or discretion of the capDISLOCATION OF THE WRIST, tain ; he is much too avaricious of men upon deck to allow a man to the sick unless in To the Editor of THE LANCET. dangerous cases. In many ships there is SIR :-I am much obliged to both 11 Butyet a good deal of the " whiffle" principle existent. ler’s Ghost" and to Mr. Robert Hancorne, Of the emoluments of the assistant and arcades ambo," for their correction of my surgeon I shall say but little, as every one misquotation from Butler. I am quite willcan judge of these for himself; it is merely ing to " stand corrected" by these " wordnecessary to remark, that to the last day of catchers," and beg merely to observe, that his servitude they will not permit him to if neither of these writers should commit any keep two messes respectably ; ergo, he must greater blunder than I have done in this innot marry unless he get money : and if he stance, they need not be ashamed of themdo marry, he must live apart from his wife selves, particularly if they should have eleven months out of every twelve on the written, as I have done, nearly a thousand average. I think, sir, that I have thus far pages in a jotirnal like THE LANCET. Allow proved that the naval medical officer derives me to tell Mr. Hancorne, " for his future no advantage from his rank as assistant- information," that the nonsense or 11 twaddle" surgeon, and but little as surgeon ; that the of the quotation in question does not consist former is entirely nominal, the latter nearly in the first line, for if Mr. Hancorne has so ; that ou his entry he must give up every never known an instance of a man being hope of life beyond a mere competence, and " convinced against his will," he is a person that for himself only ; that for this compe. of much less " experience" than he protence he must necessarily subject himself to fesses to be. 1 also beg to inform him for " future information," that the nonsense many privations and discomforts throughout his his (course, and that these, by the present of the distich as quoted by me, consists in regulations, are very unnecessarily aug- the man being of the same opinion, after he mented ; that his duties are throughout has been convinced that it is wrong. Perunsatisfactory, and in some instances de- haps Mr. Hancorne might advantageously grading ; and that under the present im- have Johnson beside him, when he turns proved regulations he must not expect to be critic again. With regard to the question of dislocation free’d from this thraldom, unless by death, in much less than thirty years, it not being of the wrist and its possible occurrence, and possible to employ all surgeons continu- of my 11 determination that the controversy ously. If, sir, I further prove that even this should stand still," I have merely to remark, sort of existence is by much more frail in its that the question theoretically is valueless ;;
upon
"
twenty-eight years, was placed
in my esta- medical officer in the service as at present constituted, not only with reference to his own peculiar duties, but as a subordinate officer in the navy ; both having to be carefully considefed before taking the first decisive step in life under his own sole
blishment ; she had previously been confined in a county asylum : she spoke of her miserable situation there in corresponding terms with the lady before-mentioned. She was discharged cured from hence in the month of April following. She has continued on the most friendly terms with the female managers in this asylum ever since. But what says " A LOOKER-ON," " the remuneration of the superintendents must cease
guidance.
I commence with his entry as assistantsurgeon ; his position as such has been much canvassed lately, especially in a terse and well-written letter byDr.Tweeddale: to be dependent upon the continuance of the my statement will, therefore, prove to some disorder." Why, if he were not absolutely extent a repetition, but as I wish to embody stone blind," he would perceive that the the whole of my own impressions of the serremuneration of the superintendents is de- voice,I must in this one instance solicit some pendent upon the celerity with which they forbearance to all which may seem like discharge their patients cured, and upon the iteration. It would appear that the especial wish of humane treatment they bestow upon them the magtiates of the navy, is to render their whilst in confinement. In the course of this present summer, the medical officers unfit for any other mode of wife of a medical practitioner of consider- professional life ; at once to check their able eminence and large practice was placed progress in, and to damp their zeal for, prounder my care, afflicted with puerperal fessional acquirements; or why place the mania ; in a few weeks she recovered, and man, to whom study should be as regtdar as his daily food, in a midshipman’s berth ? a now again presides over and guides her domestic affairs as usual. She came here place generally well crowded in the smaller on a visit a very few days since, bringing rates, not allowing him two feet space which handsome presents for all my children (six he can call his own, and so surrounded by of them), and expressing the warmest feel- boys and young men, that if one among ings of gratitude and attachment to those them only choose to be noisy, he could ladies in this establishment who watched hardly read a novel to understand it, much In addition to the over and consoled her during the continu- less a medical work. ance of her malady. Has A LooKER-ON" essential privations and rliscomforts of such seen results as gratifying in any large public a dwelling, one very moderate-sized chest is asylums? I am far from denying that they the only space allotted for his clothes, and do occur, but that the very reverse prevails in small vessels for his books and instrnto a large extent I can prove; yet " A ments also ; the size of this not being at all LOOKER-ON" would sweep this private esta- regulated by the instructions, but left enblishment from the face of the earth : let tirely to the caprice of the captain, or rather him" look on this picture, then on that," to the first lieutenant, to whom all power is and it is to be hoped he may give us some- now-a-days delegated, and whose generic thing practical, some foundation on which he characteristic is, to sacrifice every comfort would " effect those changes," which are to of his subordinates to smartness and show. give to the wealthy the blessings of the Such, sir, is the first position of a gentleman humane system enjoyed by the pauper pa- of liberal education and acquirements; of mature years ; the member of a highly imtients in county and large public asylums. Feeling conscious of no ill-intentions in portant profession ; and such, considering these remarks, I shall not seek to screen present appearances, will be the fate of all myself from the responsibility of them un- those who are unwary enough to choose der any feigned signature, but beg to sub- such a home. From his status in general scribe myself your very obedient servant, society, he has a right to expect some degree of consideration in the arrangements made GEORGE BODINGTON. for him ; on his arrival on board, however, Driffold House, Sutton Coldfield, he finds himself but little better treated
Warwickshire.
Morgans"
than the 11 of " the old school :" he can demand nothing specific as a right, for if allowed a chest for his clothes, and a NAVAL ASSISTANT-SURGEONS. hammock for his night’s repose, it is very common in the service to be ordered to dock To the Editor of THE LANCET. both the one and the other-the chest, SIR:—In answer to your invitation to because it is somewhat larger than accords with the captain’s or first lieutenant’s idea give you my reasons for having mended the junior members of the profession of neatness ; the second, because it is too to avoid the navy, allow me, in the first in- large in circumference, as compared with stance, to apologise for the length of the the men’s, with which it is stowed in the details I shall be obliged to send you, in hammock.netting, and is, therefore, un. order to show you the position of the naval sightly.
recom-
876 In a short time he begins to find out all ten shillings in the ward-room, of course exthe agrèmens of his appointment ; he finds clusive of wine and spirits in both, is by no that the marine officer, with rank of ensign means important to the assistant-surgeon: in the army, frequently fresh from some indeed, it is more than saved by the differcountry school, and some four or five years ence of comfort ; for I have always found his junior in life, has a cabin, a man-servant that the deprivation of this on board leads (a marine of his own choice), a place at the to a more reckless expenditure on shore : ward or gun-room table; and, what is in- while in the article of wine and spirits much finitely more galling, when he first goes to depends upon the individual, as is proved sea, he having rank as lieutenant in the by the marine officers meeting all their ex. army, is thrust to leeward ; while the penses upon five shillings and threepence marines, and some lieutenants younger than a-day, their uniform being much moreexhimself, are proudly parading the weather pensive than the assistant-surgeon’s. Those side. It is true, that he has sometimes the who wish for economy may practise it in the if not more, facicompany of some unfortunate old mates, or ward-room with as clerks, who are deficient in the required in- lity than in the midshipman’s berth. terest, and to whom the service is even less " A Surgeon of the Old School" has enalluring than to him; but this diminishes deavoured to answer Dr. Tweeddale’s plain not the hardship of his own position. Thus facts on some of these points, and instead of situated, the knowledge he has already ac- fairly arguing the propriety or impropriety quired must be gradually diminished, for no of the present arrangements with reference memory can retain all the facts of the vari. to the whole corps, advocates the present ous sciences which constitute the physician system upon a series of contingencies merely, and surgeon, without constant exercise by and those by no means very reputable to a practice, and frequent reference to books. medical officer ; and were they so, not likely In ships of the line, the assistant-surgeon to affect the many : thus, /i6 could read for may do much in the latter way in the sick an hour after turning in, by the sentinel’s bay; in the lesser rates, let the advocates of lantern ; and by being on friendly terms the present plan say what they may, he with the boatswain, he enjoyed the felicity cannot: and with reference to the former, I of a curtain of her Majesty’s bunting; the sincerely believe that to gain much either in loblolly-man hung up his cot (it was not his the taleut of observation, or in the know- duty, and the first lieutenant or surgeon ledge of experience, is, from the very nature might have prevented him doing it). Again, of our practice, impossible, as all our most the assistant-surgeon might have aged paserious cases in the smaller rates go to the rents, and by sending them a remittance hospital whenever an opportunity occurs of might render himself an object of greater sending them ; and, injustice to the patients interest and merit to his "superior officers. themselves, it should be so ; and from the And then he talks about crude and inexcare taken in entering sailors, chronic cases perienced opinions;" I can fancy, sir, that are comparatively rare; besides which our in the times of " the old school," the assistpharmacopoeia is very limited. ant-surgeon might have crude and inexpeDeprived thus during his earlier servitude rienced opinions : but in later times I have of all personal comfort, unable to console known many, and I have never met one himself for these privations by a conscious- among them likely to express such crude ness of advancement in professional or other opinions or argument as the " Surgeon of acquirements, and living from hand to the Old School" has advanced ; and with mouth (for that assistant-surgeon is econo- reference to drunkards, I can truly say that mical who can lay by a sufficient fund to I have met with more belonging to " the old meet the contingencies of hdif-pay, and school" than to the new. In one point I can, re-stock himself with clothes, &c., for liowevei-, agree with the 11 Surgeon of the another appointment), he is at length, after Old School," that the assistant-surgeon an average of twelve or fifteen years,, under might make enemies of some of his elders, the new arrangements of pay, &c., promoted whose excellent for study had not been sufficiently improved ; the senior in to the rank of surgeon. But, before considering him in his new such case might not like many of his crude position, allow me to meet one objection, opinions so freely canvassed as they would which might, from the tenor of the last necessarily be, were the assistant-surgeon a paragraph, be raised to his entry to the member of the ward-room mess. That the ward-room mess while assistant; viz., that parade and etiquette of a ward-room mess if he find it so difficult to keep within would prove a serious drawback to an bounds while messing with the midshipmen, assistant’s improvement, is to me quite unthis difficulty would be increased in the intelligible; one would think that the greater ward-room. This, however, is not the fact ; part of the ward-room officers’ time is taken the generality of ward-room messes are by up in dressing, and that we have more forno means extravagant ; and the difference malities and compliments to interchange between thirty shillings per month in the than a set of Chinese mandarins. What midshipman’s berth, and about two pounds parade ?-w bat etiquette? Howinthe name
much,
opportunities
877 a serious drawback? Or should the assistant-surgeon’s inexperience in discipline, render him subject to the penalties of a court-martial ? when the veriest youngster learns and knows his true position with reference to his superiors in less than a week after joining. Believe me, sir, there is nothing so very mysterious in
of patience, prove
why
sloops; in the new ones (much larger vessels) the surgeons’ cabins are hot, narrow, and confined, something like large coffins, and placed in the centre of the ship gun
at the fore part of the gun-room ; and this is done in order to give the captain’s steward
large berth abaft : the captains will soon have half the ship to themselves. In ships our etiquette, parade, or discipline, as to of the line, the surgeons are stowed in the prevent the initiation of even one of the old cockpit ; in frigates, right aft, close to the school in less than a week. That some gun-room and steward’s berth : all the best medical pupils may deserve the castigation cabins being assigned to the executives, received in the " Heads of the People" I am although the civilians may be old and greyaware ; but that this is their characteristic headed, and may have had their present rank as a class, still less that it generally applies before half the lieutenants were breeched. to those who enter either of the services, I In the army, on the contrary, executives and utterly deny. The whole letter appears to civilians choose their own quarters by seme an attempt to cast an unmerited slur niority in their respective ranks. He is now upon that class of the profession to which entitled to a second-class boy, as servant, he belongs ; the very tenor of it is a great one under thirteen, and who must leave him proof that he cannot advance one single when rated as first-class boy, which is reason, applicable to the corps as a body, usually when he is just becoming large why they should not at once be admitted to enough to be of service. This boy is always the just rights of their rank and position in employed when the idtos are called ; has to in the morning ; life. As my object, however, is not so much clean gun-screws, &c. &c., to advocate the cause of those who already and the surgeon may consider himself lucky belong to us, as to prevent disappointment if the first lieutenant is gerttlemanly or conto those who may think of becoming so ; siderate enough to allow the boy time in the and convinced that during the present gene- morning to clean his shoes and bring him ration, at least, the admirals who may be water. In this mal-arrangement, however, appointed lords of the Admiralty will nei- the executives (with the exception of the ther have liberality nor judgment enough to marine officers) suffer as well as the civiagree to any change, I shall proceed to de- lians. It is magnificently asserted in the pict the medical officer advanced to the rank instructions, that dispensaries are now fitted of surgeon. If by long service in small up for the reception of medicines on board vessels he has been absolutely prevented of all ships, sloops included ; and, as might from continuous study, and has thus ob- have been expected, they are all, except in tained fixed but contrary habits, is he likely ships of the line, placed in the worst possiWhile our modern architect to retrace his steps, and to endeavour to ble situations. make up for lost time by becoming studious can find room for splendid cabins for the and devoted to his profession ? Such a case captain’s steward, with a view, I presume, may be, and I dare say often does arise from of gaining the favourable opinion of those a principle of rectitude only; but is it wise captains who command his vessels, and that in our rulers to trust to this ? But consider- too by removing certain subordinate officers ing his status in a more worldly and selfish further forward, the surgeons are forced to point of view, what advancement has he see their patients, and dispense their medimade in life? Just so many of the best cines in any hole or corner in which he may years of his existence are past, and lost- think fit to stow them. Thus, in some of the years in which he can scarcely recall one new-built sloops, there is a chain-locker really pleasurable, because satisfactory, re- conveniently placed under the dispensary ; miniscence : if he have not retrograded in and the cable runs through it. In the sixth professional knowledge, he has but little ad- rates, the dispensary is in the cockpit, withvanced-he has lost all the enthusiasm of out inclosure, and very small ; and around his student’s life; and the chief store he has this are the doors of the purser’s, captain’s, laid up, in a worldly point of view, is the marines’, and other store-rooms. Hence accumulation of so many years’ servitude: flour, peas, chakos, and physic, are frean accumulation which is of no use to him, quently distributed simultaneously, to the unless he complete the full term of twenty- great augmentation of the surgeon’s and his five years. And how few of those who assistants’ respectability; and yet in these embark in the pursuit do so ?-how many ships the captain’s clerk has a good cabin on die on the road, to enable one survivor to the lower deck. In surveys upon invalids, reap his thirteen shillings a-day fo: the short the captains are seated, and their clerk ; but remainder of a frail existence? His personal I have never known a surgeon asked to take comforts, however, are somewhat enlarged ; a chair. Nor can I see what captains have he is entitled to a cabin, but which with the to do with invaliding : if the Admiralty purser’s is invariably the worst in the ship : cannot trust a board of three surgeons to the only exception was in the old eighteen- invalid those who require it, I should re, a
878 commend them to enter some that they could tenure than a life under the ordinary risks have confidence in. In their own ships, on shore; that this tenure may be made captains frequently assume a power never still more frail by the avaricious motives of contemplated by the service; viz., that of superior officers ; that the nature of the serdictating to the surgeon what officers or vice at present is all but a perfect despotism, men shall be invalided, whether in health from the very slight responsibility of supeor not ; and this notwithstanding an annual rior officers, that thus when serving under affirmation which the surgeon has to make, unpleasant or unprincipled characters, he, that he has neither invalided nor sanctioned the medical officer, may, like other subordithe invaliding of any one whom he did not nate officers, suffer much injustice, much consider a proper object. Let an officer, vituperation, and abuse, without the power therefore, commit himself, or a man or boy of retaliation, or the hope of satisfaction ; prove himself useless or stupid, and the that if, on the contrary, when thus perse. surgeon is very coolly told that they must cuted, he in the very slightest degree lose be invalided ; and if he demur, that he is the command of his temper, and betray such impeding the service. impatience, either in language or deport. Down to the fifth rates, the surgeon is ment, as to be construed into contempt of his allowed a man as sick-bay attendant; in superior officer (and a very slight expression lesser vessels he is entirely subject to the will serve this purpose in the navy), he will caprice of the captain, or first lieutenant ; inevitably lose all his previous servitude, and the most stupid and useless boy in the and thus find annihilated the only principle which he ventured into the service, ship is invariably given him : this boy’s duty is to cook the victuals of those the sur- viz., the certainty of his position and emo. geon thinks fit to diet himself ; to make luments, however disagreeable the one and attend to small the other. If I prove these things, sir, their poultices, fomentations, &.c.; the wants of those in their hammocks ; give I think I shall prevent those from entering them drink, &c. &c. ; but he is one of those the service who are not entirely dependent. called idlers also, and called on deck when- These shall be the subjects of my next ever they are, and the patients of course letter. I am, Sir, your obedient servant, suffer. It is a monstrous absurdity in the A SURGEON OF THE NEW SCHOOL. Admiralty to leave any civilian’s duties subject to the caprice or discretion of the capDISLOCATION OF THE WRIST, tain ; he is much too avaricious of men upon deck to allow a man to the sick unless in To the Editor of THE LANCET. dangerous cases. In many ships there is SIR :-I am much obliged to both 11 Butyet a good deal of the " whiffle" principle existent. ler’s Ghost" and to Mr. Robert Hancorne, Of the emoluments of the assistant and arcades ambo," for their correction of my surgeon I shall say but little, as every one misquotation from Butler. I am quite willcan judge of these for himself; it is merely ing to " stand corrected" by these " wordnecessary to remark, that to the last day of catchers," and beg merely to observe, that his servitude they will not permit him to if neither of these writers should commit any keep two messes respectably ; ergo, he must greater blunder than I have done in this innot marry unless he get money : and if he stance, they need not be ashamed of themdo marry, he must live apart from his wife selves, particularly if they should have eleven months out of every twelve on the written, as I have done, nearly a thousand average. I think, sir, that I have thus far pages in a jotirnal like THE LANCET. Allow proved that the naval medical officer derives me to tell Mr. Hancorne, " for his future no advantage from his rank as assistant- information," that the nonsense or 11 twaddle" surgeon, and but little as surgeon ; that the of the quotation in question does not consist former is entirely nominal, the latter nearly in the first line, for if Mr. Hancorne has so ; that ou his entry he must give up every never known an instance of a man being hope of life beyond a mere competence, and " convinced against his will," he is a person that for himself only ; that for this compe. of much less " experience" than he protence he must necessarily subject himself to fesses to be. 1 also beg to inform him for " future information," that the nonsense many privations and discomforts throughout his his (course, and that these, by the present of the distich as quoted by me, consists in regulations, are very unnecessarily aug- the man being of the same opinion, after he mented ; that his duties are throughout has been convinced that it is wrong. Perunsatisfactory, and in some instances de- haps Mr. Hancorne might advantageously grading ; and that under the present im- have Johnson beside him, when he turns proved regulations he must not expect to be critic again. With regard to the question of dislocation free’d from this thraldom, unless by death, in much less than thirty years, it not being of the wrist and its possible occurrence, and possible to employ all surgeons continu- of my 11 determination that the controversy ously. If, sir, I further prove that even this should stand still," I have merely to remark, sort of existence is by much more frail in its that the question theoretically is valueless ;;
upon
"