Echoes of Navy Medicine’s Past
Part III: Enter the All Steel Navy (1866-1917)
By Jan Herman and Mr. Grog
If he were still alive in the years immediately following the American Civil War, French magistrate Alexis de Tocqueville may have observed a nation devoted to uniting its “house divided” through free enterprise and Western expansion. The U.S. Navy did not fit into this equation for national healing. After the Civil War, it lapsed into a period of dramatic decline as naval appropriations were cut and the number of ships and men on active duty shrank dramatically. The Navy and Navy Medical Department were, in a true sense, landlocked.
Medical Department resources were deemed “entirely inadequate to the proper support of the naval medical service, however prudently administered.” Because of inadequate remuneration in pay, low entry rank, and scant opportunity for promotion, few young physicians joined the Navy.
In his 1867 annual report to the Secretary of the Navy, Chief of the Bureau of Medicine and Surgery, Dr. Phineas Horwitz (1822-1904), complained bitterly about the Medical Department’s immediate prospects. He pointed out that 48 vacancies existed in the Medical Corps which were impossible to fill “properly.” The number of unfilled vacancies since the end of the recent war had grown to such a degree that according to some, the Navy Medical Department would simply disappear. Horwitz urged Congress to pass legislation immediately to increase the opportunities for promotion in respect to both rank and pay.
On 3 March 1871, Congress acted, granting medical and other staff officers of the Navy “relative rank” with grades “equal to but not identical with the grades of the line.”
This Act went further than any previous Congressional action in strengthening and transforming the Navy Medical Department. The Chief of the Bureau of Medicine and Surgery now held the additional title “Surgeon General,” with the relative rank of Commodore.” Surgeon General William Maxwell Wood (1809-1880) stood at the helm of this “revitalized” organization. At the time, Wood was a man entering his 42nd year of a naval career as unusual and varied as could be. He had served aboard USS Poinsett, one of the first steam vessels of the Navy, and designated flagship during the “expedition for the suppression of Indian hostilities on the coast of Florida” (a.k.a. the Seminole War). Wood served shore duty at Sackett’s Harbor, NY, Baltimore, was Fleet Surgeon of the Pacific Fleet, and served under Commodore Sloat in California during the Mexican War. Despite his credentials as the first Navy Surgeon General, he served less than two years.
The health of the Navy’s personnel steadily improved following the war partly due to the new emphasis on preventive medicine and hygiene. This was attributable, at least in part, to the transition from wooden hulls and sail to the all-steel, steam-powered Navy. The storage of coal in below-deck bunkers and the exhaust gases generated by its combustion required adequate ventilation. Moreover, the foul condition of many ships’ bilges had become a regular theme of reports from the Navy Surgeon General to the Secretary of the Navy. Conditions aboard many naval vessels were blamed for yellow fever outbreaks and led to the establishment of the short-lived and seldom used Navy quarantine hospital on Widow’s Island in Maine’s Penobscot Bay (1887).
On 20 March 1878, the Navy Department created a board of naval officers to solve the ship ventilation problem. The board advocated a ventilation plan consisting of a tube network running through every part of the ship and terminating in a large main through which air was drawn by a steam blower. In 1879, Surgeon General Phillip Wales urged the rapid installation of this new ventilation system throughout the fleet
During the 1870s the naval hygiene movement was promoted by Medical Directors Joseph Wilson, Jr., author of Naval Hygiene (1870), and Albert L. Gihon’s Practical Suggestions in Naval Hygiene (1871). As early as 1879, the Bureau of Medicine and Surgery (BUMED) established a laboratory for investigating hygiene-related issues and began collecting items which would comprise the collection of the Navy Museum of Hygiene, established in Washington, DC, in 1882. Until it merged with the Naval Medical School in 1905, the Museum exhibited ship’s ventilation systems and housed displays illustrating disinfection techniques. It also was a leader in promoting environmental and occupational medicine. The institution went beyond its museum role by becoming an education center for the promotion and development of laboratory research, particularly with chemical, bacteriological, and microscopic investigations.
As American interests in the Pacific and the Far East became more prominent in the 1870s, so did the scope of the Navy Medical Department. Between 1867 and 1869, USS Idaho, which had been converted into a hospital ship and kept at anchor in Nagasaki, served as a floating hospital for the American Squadron in the Far East.
To provide more adequate medical facilities for the U.S. Navy’s Pacific activities, the Navy constructed new hospitals at Mare Island, CA (1870) and Yokohama, Japan (1872), which became the first U.S. Navy hospital in Asia.
Throughout the 1880s and 1890s U.S. Navy presence became increasingly evident throughout the world as Navy vessels were being assigned to the North Atlantic, South Atlantic, European, Pacific, and Asiatic stations. In addition to routine cruises, the Navy was frequently called upon to protect American citizens and American interests; to give assistance to victims of shipwrecks, earthquakes, fires, floods, and civil war; and to carry out special explorations in the Arctic, Alaska, Central America, and elsewhere.
As Navy medical officers went ashore at hundreds of ports throughout the world, many of them wrote detailed observations of climate and medical conditions, the people, quality of medical facilities available, endemic diseases, and the methods being employed to combat them. Many of these narratives were published in volumes of the Annual Reports of the Navy Surgeon General (1871-1859).
On 17 June of that year, a century after the “first” loblolly boy reported for duty aboard USS Constellation, an Act of Congress established the Navy Hospital Corps. Navy Surgeons General had long promoted a well-trained professional corps to provide medical care in the field. However, it was only after the outbreak of the war with Spain that Congress finally acted. The first group of hospital corpsmen numbered only 25 pharmacists (apothecaries) with rank, pay, and privileges of warrant officers.
The Hospital Corps came just in time. Following the Spanish-American War, the world’s newest colonial power had “spoils” to administer—Guam, the Philippines, Puerto Rico, Cuba, and Samoa. The United States was now a Pacific naval power with new ships, new stations, and enlarged hospitals. Navy medical officers had to confront tropical diseases few Western physicians had ever seen before—dengue, yaws, leishmaniasis, leprosy, yellow fever, intermittent fever, filariasis, dysentery, elephantoid fever, not to mention venereal afflictions sailors acquired in exotic liberty ports.
The Navy Medical Department dealt with these issues through training. In 1902, the Navy Medical School, then located at the U.S. Naval Laboratory in Brooklyn, NY, relocated to the Naval Museum of Hygiene in Washington, DC. Its mission was straightforward: The new school was “for the instruction and training of newly appointed medical officers in professional branches peculiar to naval requirements.” Here was an institution where newly commissioned physicians could learn the kind of medicine they would not have been exposed to in civilian medical schools—tropical medicine, the treatment of ballistic wounds, burns—in short, the grist of naval medicine. A five-month course had a curriculum covering microscopy, naval hygiene, military law, and a program of physical exercise and military drill akin to what any student might experience in a military school or service academy.
Because tropical disease had accounted for many of the casualties suffered by troops in Cuba during the recent war with Spain, it was a chief focus of attention at the school. Indeed, future Surgeon General of the Navy Edward Rhodes Stitt (1867-1948), today considered the pioneer in tropical medicine, taught at the school and was one of its first commanding officers.
Following the establishment of the Army Nurse Corps in 1902 by Congressional Act, BUMED campaigned for its own nurse corps. This effort paid off on 13 May 1908, when the U.S. Navy Nurse Corps was established. The first nurses in the Navy—a.k.a. the “Sacred Twenty”—reported for orientation and duty later that year at the new U.S. Naval Hospital, Washington, DC. The site also housed the Museum of Hygiene and Navy Medical School. On 8 August 1908, former U.S. Army nurse, Esther Voorhees Hasson (1867- 1942) became the first superintendent of the Navy Nurse Corps.
The Medical Department continued to expand. On 22 August 1912, President William Howard Taft signed a bill authorizing “not more than 30 acting assistant dental surgeons to be part of the Medical Department of the United States Navy.” By the beginning of World War I, the Navy Medical Department had grown in size to four separate corps. The Surgeon General, now with the rank of rear admiral, was at its helm. The Medical Department had 2 hospital ships and 17 naval hospitals to administer.
On 9 April 1914, Mexican soldiers arrested U.S. Navy personnel seeking supplies in Tampico, Mexico. The Mexicans released the soldiers but without the apology President Woodrow Wilson demanded. Wilson ordered RADM Frank F. Fletcher to occupy the Mexican port of Vera Cruz with the naval forces under his command. The U.S. intervention and occupation fomented fierce Mexican resistance and generated casualties on both sides. For their heroic actions treating the wounded under fire, Navy surgeons Middleton Elliott (1872-1952), Cary Langhorne (1873-1948), and Hospital Apprentice 1st Class William Zuiderveld (1888-1978) were awarded the Medal of Honor. Shortly thereafter, there would be ample opportunities for heroism. Just four years after the Mexico intervention, Navy Medical personnel would find themselves braving U-boats in the North Atlantic German soldiers on the Western Front.