SPECIAL REPORT 
OP THE 
Chief of Bureau of Medicine and Surgery, 
ON THE 
DIFFICULTY OF OFFICERING THE MEDICAL CORPS OP THE NAVY, 
ITS CAUSES AND THE REMEDY. 
In the report of the Bureau of Medicine and Surgery, for the 
present year, I have been compelled to call attention to the diffi- 
culty of officering the Medical Corps of the navy, and I now ask 
leave, respectfully, to point out what I think to be the causes of 
the difficulty, and to suggest the remedy. 
The chief difficulty lies in the fact that the usages of the naval 
service and the want of proper legislation place medical men in 
the navy below the average respectability of the profession in 
civil life. Individual respectability being the same in both cases, 
the position of respectability which is obtained in civil life from 
popular approbation, can only be secured in military life by 
legislative enactment, and is known under the term of Medical 
Staff rank, when applied to medical men. I shall not present 
any views in the interest of any class or section in the navy, but 
only such as seem to me to be essential to the good of the whole 
navy, so far as the medical corps is related to that good. 
My aim will be to set forth in this report only those general 
principles and elements which make Medical Staff rank a law of 
necessity in military service, and define the limits of that necessity. 
Having presented the principles, the responsibility of their appli- 
cation rests with those who, also, having the welfare of the ser- 
vice at heart, have the power of controlling it. 
An analysis of these principles will show that they have the 
force of natural and moral laws, from which there is neither 2 
escape or evasion. All experience, little and great, proves that 
any agreements or compromises which endeavor to avoid the 
full demands of principles, no matter how sincere or unanimous 
the agreement may be, end only in disappointment, confusion, 
and continued agitation, destructive of the prosperity and useful- 
ness of the community in which the attempts are made. In our 
great national convulsion we had an illustration of that fatal 
experiment with all its stupendous results, only proving the 
power of a truth universally existing. 
Efforts to ignore instead of utilizing as a power, the strongest 
influences of human nature, or to satisfy them by putting shadowy 
forms for substantial rights, have agitated our naval service from 
its beginning. They have interfered much, not only with its 
efficiency, but also with that harmony which among gentlemen 
of equal social position, cultivation, and refinement, might be 
some compensation for the exactions and dangers which belong 
to the naval service, and are shared together. 
It is a subject of much regret, and perhaps of reproach, that 
the United States naval service alone should continue the agita- 
tion of failing experiments, while every other military service in 
the world has reached harmony and efficiency, by a full acknowl- 
edgment of the principles of Medical Staff rank. 
That gentlemen of all ages, and with every variety of mental 
endowment and moral discipline, embraced by the medical corps, 
have, with unbroken unanimity, from generation to generation, 
and despite the discouragements of failure, still contended unflinch- 
ingly for the protection of staff rank, proves that the claim 
embodies a life and dignity which no unmeaning vanity could 
assume or persistingly maintain. 
The principles of staff rank are simple, clear, and broad; among 
them is the important question which has invoked the most per- 
sistent contests in history, for it is the same in fact, whether 
religion, birth, race, or profession is recognized as a disqualifying 
characteristic, and made the subject of depressing legislation. 
The overthrow of such class obstruction in communities or 
institutions, is a measure of civilization and progress. Such 
discriminating legislation exists in regard to the medical profes- 
sion, so long as the members of that profession in the naval ser- 
vice are excluded from those routine honors which are secured 
to officers of the line, not as special distinction for special merit, 
but as a reward for the dangers which line and staff equally 8 
encounter, and a testimonial to the fidelity of service which both 
equally render. 
The first practical object of all legislation and regulation rela- 
tive to the Medical Corps, is to secure for the officers and men of 
the navy the best average medical skill and ability which our 
country, or, indeed, any country, can afford; for, in the shrink- 
ing of our own people from the naval service, we have been 
indebted to the aid of able foreigners. Those who encounter 
naval hazards are entitled to the most capable medical and sur- 
gical aid; the Government also has a pecuniary and natural inter- 
est in providing every security for the efficient physical and 
moral ability of those whom it educates and employs. 
One other consideration, demanding a high order of profes- 
sional ability, is incident to our influence among the peoples of 
the world, and found in the fact that the Medical Officers of the 
navy come in contact with the professional men of other coun- 
tries and other navies, therefore national self-respect should 
require the naval Medical Corps to be especially of such a char- 
acter as would, in such circumstances, honorably represent their 
country. It is certain none of these requirements can be met 
unless the Government offers to medical men such inducements 
to enter its service as will compete with the fair hopes and 
inducements of civil life, and be some compensation for their 
surrender, which is largely made, of that personal liberty and 
privilege which, under other circumstances, are the natural right 
of every adult. 
The medical men who, by the ability and devotion of their 
professional labors in civil life, have earned rank and honorable 
distinction from their fellow-men, are those who should form the 
standard by which to measure the official rank of naval medical 
men, because none wdio would not present a fair promise of 
reaching honorable positions in civil life should be in the naval 
service. 
All these essential considerations are embraced by a memorial 
signed, in 1816, by a majority of those distinguished captains, 
among them such names as Bainbridge, Hull, Rogers, Trenchard, 
Jones, and Warrington, whose deeds made their own fame and 
the glory of our navy in the war of 1812, and expressed in the 
following words: 
“We feel it, therefore, as a duty incumbent on us to state that 
we consider the Medical Department of such great importance 4 
the navy of our country that no reasonable measures ought to be 
omitted which could have a tendency to retain in the service the 
professional ability of those gentlemen who, by their experience, 
knowledge, zeal, and humanity have procured the esteem and 
confidence of those with whom they have been associated; and 
we also beg leave to express our belief that no reasonable induce- 
ments would be objected to by Congress to procure for those 
who are engaged in a perilous service, and who are constantly 
exposed to the diseases of all climates, the best medical aid which 
the country affords. To effect this, it must be obvious that the 
rank and pecuniary emolument of Medical Officers ought to bear 
some proportion to what gentlemen of professional eminence 
would be entitled in private life.” 
These conditions being true, the next practical question is, 
what routine naval rank would measure the social status and 
respectability of medical men who have earned rank, honors, and 
respectability from the opinion of their fellow-men. It ought to 
be borne in mind that those who withdraw themselves from the 
field of popular approbation to enter the Government service, 
should be encouraged to look for approval of the Government as 
a substitute for that which they have relinquished, and it is 
respectfully suggested that the Government has an implied 
obligation not to disappoint these just hopes of faithful servants. 
Both in civil and military life, the best incentive to duty, 
outside of a conscientious conviction of duty, is the hope of the 
approval of that judgment or authority under which life is lived 
and duty done. In this hope the Government has a large power 
to secure, by a just distribution of its honors, a high order of 
professional ability and character, and to substitute a cheerful 
and proud performance of duty for the cheerless and despondent 
spirit which now overshadows the senior officers of the Medical 
Corps who are fixed in the service, and has almost annihilated 
the junior branches of the corps. Mo young men who are com- 
petent to pass the modern examinations of the naval board are 
seeking admissions to the navy, and those who were successful 
in entering are rapidly escaping from it. 
There have been fifty-three resignations among the Medical 
Officers for the last four years from a corps of two hundred; but 
one of them discreditably to the officer, and only one of them has 
been filled, and it is impossible now properly to officer the ships 
and.hospitals. 5 
These losses are greatly to be deplored, as many of these young 
officers had the experience of the war, and had displayed emi- 
nent ability, and, should the proper remedy be now applied, it 
will be years before the loss can be recovered. 
The administration of a naval medical charge requires an edu- 
cation of its own, only to be acquired practically on ship-board, 
embracing the subjects of pensions, malingering, nautical hygiene; 
and as the officer advances in the service, and has his sphere of 
duties enlarged, having charge of our large hospitals and medical 
charge of squadrons, they become administrative as well as pro- 
fessional, and have within them the direction of large fiscal 
interests, requiring intelligence, experience, and probity. 
The losses we have sustained, and the existing aversion to the 
naval service, are the natural and inevitable results of the infrac- 
tion of the laws I have endeavored to point out. If the Medical 
Corps is not honorably and efficiently maintained by a just share 
of the routine honors of the navy, it can only be done by lower- 
ing the standard and taking men who will accept professional 
humiliation as a means of livelihood. 
I respectfully submit that a high protective rank is essential 
to proper military subordination. Men are thrown arbitrarily 
in the naval service into the relations of commander and subor- 
dinate, without respect to those qualities which, in civil life, 
might change the relation; therefore, all subordinate officers 
should have the guarantee that their subordination is not to be 
made the measure of personal inferiority, an application which 
the yoimg in authority, or those otherwise of defective judg- 
ment, are too apt to make 'in all institutions. It needs no argu- 
ment to show the superior efficiency of that cheerful and 
willing subordination, which is rendered under the guarantee 
that it implies no personal humiliation, and that reluctant and 
contestant obedience which naturally results from a suspicion 
that it marks individual and personal inferiority. 
It will scarcely be asserted that any military organization can 
exist without a Staff Corps, nor will it be denied that the effi- 
ciency of the organization is proportioned to the ability of the 
Staff Corps. This fact is evident from the term used, meaning 
a sustaining power. 
It is proved by the prominence given Staff Corps by all the 
military heroes of history, and by the high rank given Staff 
Officers in every perfect military institution. No such institu- 6 
tion can rise above the depressing weight of an inferior Staff 
Corps. 
The commissioned officers of line and staff on the active list 
in the United States navy are numerically equal, or nearly so, 
there being six hundred and eighty-eight line officers, and six 
hundred and twenty staff, of which the Medical Officers make 
one-third. 
It is, therefore, evident that one-half of a body cannot be iso- 
lated from the whole in its deterioration, but all must rise or fall 
together. 
Therefore, the substantial question is, what measure will give 
to the naval service Medical Officers of such skill, capacity, and 
character as are required for the performance of their professional, 
nautical, military, and administrative duties ? As the field placed 
under the observation of naval Medical Officers is very extensive, 
it would seem to be a judicious political economy to secure men 
of such ability as could utilize it for the benefit of science and 
humanity. 
Whatever is done, it is clear should be done in so earnest and 
significant a manner as to have a substantial meaning. Better 
that no rank whatever be given than a rank in words, to be nul- 
lified in practice, or made to have only an exceptional use. Such 
a hybrid combination is barren of all fruitfulness. Why, for in- 
stance, should it be said that any class of officers should have 
such a rank, but not its indications and honors, unless the occu- 
pation of the officer works stain and corruption to the honor he 
has earned? Better say frankly, the service rendered merits 
the honor, but the occupation is beneath it. Why should the 
rank of a Medical Officer in our naval service be made to yield 
to that of a junior line officer, unless that line officer be in the 
position of command? 
Such restrictions effectually nullify the meaning of all rank, 
and are not necessary to subordination; they multiply causes of 
confusiorf, set up rival authorities, of varying and undefined juris- 
diction, embarrass the performance of duty, and suggest contempt 
for the rank they vitiate. It would be an offence to the good 
sense and ability of any commanding officer to suppose that, 
with all the authority and physical power entrusted to him, he 
could not preserve the subordination of the Staff Officers of his 
command. There is probably no line officer who will admit that 7 
he could be so powerless, especially when, in addition to his own 
authority, he would have the good judgment and sense of duty 
of the Staff Officers themselves, inclining them to subordination. 
The commission which each Medical Officer holds from the 
President and Senate of the United States is the same as that 
given to the most exalted officer of the service. In both it 
reposes “special trust and confidence in the patriotism, valor, 
fidelity, and abilities ” of the officer named, and “ all officers, 
seamen, and marines are charged and required to be obedient to 
his orders” in his special vocation. 
No authority has a right or a reason to have less trust in the 
patriotism, honor, and fidelity of a naval officer, because he is of 
the medical profession, than is avouched by the President and 
Senate of the United States, and no officer with prudent and 
discreet modesty can claim to be of a specially appointed and 
holier priesthood of patriotism. 
Medical equality with all other officers may be relied upon for 
that fidelity to their oath of office, which makes them obedient 
to the laws. In their combined relations as citizens of the repub- 
lic, representatives of a large and honorable profession, and 
officers of the navy, none can have a greater interest in the 
prosperity of the service to which they belong, or a more sensi- 
tive regard for the honor of their country. 
It is much to be feared that this subject, like many others, has 
been obscured by the tendency of men’s minds to take the long 
usage of a wrong as an argument for its continuance. 
As some testimony to the truth of the views I have offered, 
and also that they do not originate in a spirit of professional 
partizanship, I am able to refer to the late Admiral Foote as 
very much dissatisfied with the existing condition of the Medical 
Corps, and as an earnest advocate for giving it high staff rank. 
It was by his advice that the Navy Department gave the Staff 
Corps, as a war acknowledgment, that increase of rank which 
has recently been pronounced invalid for want of legislation. 
Also, I have the authority of a distinguished rear-admiral, now 
on the active list, for saying, after severe comment upon the 
position of senior Medical officers in the United States Navy, 
that, in his opinion, “the fleet-surgeon should be in our service, 
as in the French, exclusively a member of the Commander- 
in-Chief s Staff and family.” 8 
If the authorities who control this subject could he influenced 
by such liberal views as these, there would be no difficulty in 
honorably officering the Medical Corps, and class dissentions 
would end. 
Yery respectfully, your obedient servant. 
W. M. WOOD, 
Hon. George M. Robeson, 
Chief of Bureau. 
Secretary of the Navy.