A Representation to improve Accommodation of Assistant Surgeons with a view to Aiding their Study

The following appeared in the Artizan No. VIII, Third Series, for 1 Aug 1847.

An act of justice still remains to be performed towards a very respectable class of men - Assistant Surgeons. Let the various medical journals advocate their cause as we have advocated the cause of Engineers. The following letter has been sent to The Times on the subject:

Sir,- I beg permission to address you on the position of the assistant surgeons of the Royal navy.

Without a cabin, and messing in the gun-room, they are unable to prosecute the study of their profession, or to extend their knowledge of the sciences. I need not dwell on the necessity of study to enable the medical man to infer principles from facts acquired by observation and experiment.

Assistant surgeons are 20 or 21 years of age on entering the service, and are fully qualified to perform their duties. They ask the cause of their exclusion from the ward-room and its privileges. The public have witnessed exertions by medical men, but are, perhaps, unacquainted with the difficulties under which they were made.

Unless an assistant surgeon possess the power of abstraction of mind, it is vain for him to attempt to study in a berth common to many.

Dispirited and. dejected, the young medical officers of the navy earnestly look to the Admiralty for a cabin and the ward-room mess.

I am, Sir, your obedient servant,

An Assistant Surgeon, R.N.

A Representation in the Lancet of 30 Apr 1853 from a former Assistant-Surgeon regarding Unqualified Assistant-Surgeons in the Royal Navy being responsible for the Health of some RN Ship�s Companies.

To the Editor of the Lancet.

Sir,�I beg you to grant me space for a few remarks on the Admiralty circular, dated 1 March 1843, relative to candidates for the office of assistant-surgeon in the Royal Navy.

I purpose noticing only one portion of the regulations at present � namely, the admission of gentlemen that have fulfilled the prescribed curriculum, and have obtained a certificate, but that have no diploma ; or, in other words, the admission of certified medical students.

The Royal Navy of Great Britain is the only public service for which students are considered by the Government as sufficiently good ; and her Majesty's navy must certainly take rank below the merchant navy in this matter, inasmuch as qualified surgeons are required for the care of merchant seamen and of emigrants. So also must the royal naval service occupy a less dignified position than the Poor-law service, for qualified surgeons, and not medical students, are appointed to attend upon sick paupers.

The seamen and marines of the royal navy are so little cared for by their natural protectors, the Admiralty, that a diploma (constituting a gentleman a surgeon) is unnecessary for an assistant-surgeon ! Assistant-surgeons have not unfrequently the sole charge of a ship's company ; and at all times, in the absence of the surgeon, they have the care of the men and officers. The life of the surgeon will henceforth be a matter of vital importance to the crew of a man-of-war, for the surgeon's substitute will be a medical student ! The surgeon may be sick or may be invalided, and months may elapse before another surgeon can join the ship ; meanwhile yellow fever, cholera, or some other severe malady may decimate the unfortunate ship, left unprovided with medical aid. I say advisedly a certified medical student is not a medical man. I speak now of the future, for surgeons will not be found to offer themselves as candidates for so disgraceful an appointment as that of assistant-surgeon in a service in which they are placed on an equality with medical students, and treated like midshipmen. It is an insult to the medical profession : it is an insult to the royal navy. Let both the professions look to it.

First.�I counsel that the medical colleges do decline to give certificates of fitness to serve in her Majesty's navy to any gentleman that may not hold a diploma. ; also that the Colleges do demand for every assistant-surgeon, on his entry to the service, the ward-room mess.

Second.�I counsel that the medical profession throughout the United Kingdom do petition Parliament on this subject, praying that no persons, excepting qualified surgeons, be permitted to act in the capacity of assistant-surgeon.

Third.�I further counsel that the officers of the royal navy and of the Royal Marine Corps do petition the Admiralty to place the medical arm of the sea service on an equality with that of the land service.

Fourth.�Lastly, I counsel the Admiralty to render the preceding counsels unnecessary by immediately issuing an order requiring a diploma from every candidate for the office of assistant-surgeon; and by granting to every assistant-surgeon admission to the ward-room mess simultaneously with admission to the service.

In conclusion, I beg to remark that this country would look foolish if the medical profession in the United States were to petition the British Government to do justice to the profession in England in this matter. This is not an unlikely measure.

I am, Sir, your obedient servant,

Fred. J. Brown, M.D. Lond. & Edin.,

Chatham, April, 1853.

Late Assistant-Surgeon, R.N.

A Representation regarding Leave or Rather Lack of it for 'Civil' Officers in the Royal Navy.

To the Editor of The Lancet.

Sir,�The following is extracted from the Western Daily Mercury, and is also copied by the United Service Gazette of July 21st [1866] :�

"Considerate Treatment or 'Civil' Officers in the Royal Navy.� On board H.M. �, in a home port, we are informed the captain has decided that the surgeon, paymaster, and chief engineer shall not go on shore, save on three nights in the week, and then only after four o'clock in the afternoon. Such treatment of officers, who are, we learn, over thirty-five years of age, and of something like fourteen years' service in her Majesty's navy, cannot fail to be appreciated by the three so-called 'non-executive' branches of the service, and in our opinion, tends to explain why there is such difficulty in recruiting the ranks of these branches of the public services, and of retaining the gentlemen who are already in commission in them. We are not aware that any such restrictions as to leave exist in the 'Queen's Regulations and Admiralty Instructions,' and must therefore attribute them, to the discretionary power with which the above instructions credit the captains of the ships of the Royal Navy. The instance we here adduce shows how this discretionary power may be abused, and so furnishes a reason why it should be altogether dispensed with. As far as we can judge, the less discretionary power that is placed in the hands of naval commanders the better; for nothing has more effectually worked to the disorganization from which the navy is now suffering than this said power has done."

While comment on the harsh treatment of a medical officer above related is needless, it is proper that the attention of young medical men thinking of entering the navy should be drawn to the illiberal and vexatious regulations which exist with respect to the leave of absence of staff and senior surgeons. Surgeons on attaining staff rank are usually appointed to harbour ships at one of the principal ports. Now as such ships bear only two medical officers one or whom is always expected to be on board, the staff surgeon can spend only three or at most four evenings in the week with his family. Such is the otium cum dignitate he attains to after twenty or perhaps twenty-five years' sea service.

In the French navy, so celebrated for the perfection of its organization, medical officers are treated with more consideration and liberality as regards leave. When two or more ships are at anchor in the same harbour, the surgeon or assistant-surgeon of the ship having the guard always remains on board to afford assistance in the event of accident or sudden illness on board the other ship or ships; all the other medical officers, if they have no serious cases demanding their personal attention, can, if they feel inclined, go on shore for recreation and exercise.

You can imagine. Sir, how vexatious it must bo for veteran surgeons to be cooped up on board their ships within a few yards of each other, aud denied the society of their families, when there is not the slightest probability of their services being required, as the majority of tho crews of harbour ships go on shore on leave from five P.M. till seven A.M. the next morning.

Thanking you for your untiring and able exposition of our grievances,

I am, Sir, your obedient servant,
London, August 1st, 1866,
Medicus, R.N.

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