26. The board will examine the applicant orally as to his proficiency in general literature, language, history, and geography of the United States in particular, and such branches of general science as they may in their discretion think pertinent.

27. The written examinations of applicants for appointment will begin with a short autobiography of applicant, in which he will concisely state: Whether married or single; the date and place of his birth; the school, institution, or college at which he received his general education; the several branches studied, including his knowledge of general literature and of the ancient and modern languages; the exact title of the medical school or schools at which he received instruction, and the date of his graduation; the name and place of residence of his preceptor and the time when he commenced the study of medicine: also the titles of the text-books studied on chemistry, anatomy, physiology, histology, materia medica, pharmacy, therapeutics, theory and practice of medicine, principles and practice of surgery, medical jurisprudence, toxicology, obstetrics, hygiene, biology, pathology, bacteriology, and physics; the opportunities he has had of engaging in the practice of medicine, surgery, and obstetrics, or of receiving clinical instruction; and whether he has been a resident physician or interne in a civil or military hospital; and the number of cadavers or parts of cadavers he has dissected while at college or elsewhere. The candidate will append to this statement his name in full, post-office address, and his local address at the date of the examination.

28. The remainder of the written examination of applicants for appointment will consist of questions on: (1) Anatomy; (2) physiology; (3) chemistry; (4) materia medica and therapeutics; (5) practice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene; (9) pathology and bacteriology; (10) reports on selected cases at a hospital. These cases will be selected by the examiners so as to give at least two-one medical and one surgical case-to each applicant.

⚫ 29. This examination will further consist of such inquiries as may tend to develop the general aptitude of the person for the special duties required of a commissioned officer in the Service and to show his moral qualifications for the position of trust and responsibility which he will assume when appointed.

30. When practicable, applicants for appointment will be required to perform such surgical operations on the cadaver as may be directed by the examiners.

31. The passing of an examination will not be considered as giving assurance of appointment, as, in case there should be more successful candidates than vacancies, the Secretary of the Treasury will select for recommendation to the President those of the highest attainments, as shown by their relative standing on the roll reported by the board of examiners.

32. No qualified applicant will be eligible for appointment more than one year. If not appointed within that time he may be reexamined, unless he has passed the limit of age, as provided in paragraph 20, when, if successful, he will take position with the class last examined.

33. An applicant for appointment failing at one examination may be allowed a second examination after one year if he has not passed the limit of age, as provided in paragraph 20, but he shall not be allowed a third examination.

34. When an applicant for appointment has shown by his papers on the four branches-anatomy, physiology, chemistry, and materia medica—during the progress of his examination that he is deficient to such an extent that it would be impossible for him to reach the required general average in all branches, the board of examiners may, in its discretion, reject this applicant without further examination.

35. Before the applicant has demonstrated his inability to pass the examination the board, in its discretion, may accord the applicant privilege to withdraw, but in this event the applicant shall not be eligible for another examination for a period of one year.

EXAMINATION OF CANDIDATES FOR PROMOTION.

36. A board of commissioned officers will be convened from time to time by the Supervising Surgeon-General for the purpose of examining candidates for promotion. This board shall consist of three commissioned officers, of whom the senior shall be chairman and the junior recorder of the board. The board will make a true report on the merit roll (Form 1936) of the actual and relative standing of the candidates for promotion, and transmit the examination papers, with its recommendations, to the Secretary of the Treasury, through the Supervising SurgeonGeneral.

37. Examinations for promotion will be made chiefly in writing, but may be supplemented, in the discretion of the examiners, by an oral examination on any subject connected with the official and professional duties of the officer. Candidates for promotion, of whatever rank, must show themselves proficient in all the regulations governing the Service. The examiners will also examine carefully the record of the service of the officer as furnished from the Bureau, and shall give due consideration thereto in making their recommendations. No officer will be recommended for promotion who shall be found physically disqualified.

40. When an officer fails to pass the physical examination required for promotion, the board of examiners shall report in detail the physical condition of said candidate, and if it shall appear that his condition is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accordance with paragraph 248. If it is the result of disease or disability contracted in the line of duty, he shall be recommended for "waiting orders" or special duty of a light character.

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42. Assistant surgeons, at the expiration of five years' service, shall be entitled to an examination for promotion to the grade of passed assistant surgeon, as hereinafter specified, and they will be ordered to appear before a board of commissioned officers for this purpose. Failing to pass the first examination, they shall be allowed a second examination, but not until after the expiration of one year, and shall be ordered to appear for said examination as soon after the expiration of the year as practicable.

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44. An assistant surgeon, in order to be recommended for promotion, must obtain an average mark of 80 per cent and not less than 70 per cent in any of the following branches: (1) Anatomy; (2) physiology; (3) chemistry; (4) materia medica and therapeutics; (5) practice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene; (9) pathology and bacteriology. The examination to be written, and he must satisfy the board that he has been diligent in keeping himself informed of the progress and improvements in the practice of his profession since his appointment into the Service, and, in addition to the above, he must pass a physical examination.

47. A vacancy in the grade of surgeon will be filled by promotion from among the passed assistant surgeons who shall be eligible to promotion to the grade of surgeon in the order of seniority, but such officer will not be promoted until he shall have passed a satisfactory professional examination in writing in the practice of medicine, surgery, hygiene, hospital and quarantine management, and regulations of the Service, in addition to a physical examination. He shall

be required to make an average marking of 80 per cent on the above-mentioned subjects.

Passed assistant surgeons who are eligible for promotion to the grade of surgeon shall be ordered to appear before a board of commissioned officers for that purpose. Failing to pass this first examination, they shall be allowed a second examination after the expiration of one year, and shall be ordered to appear for said examination as soon thereafter as practicable.

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49. When an officer reports himself or is reported unfit to perform his official duties by reason of disease, injury, or age, he shall be ordered by the Supervising Surgeon-General, if in his opinion it is necessary, to appear before a board of commissioned officers, who shall thoroughly examine him, and if it shall appear that the disability is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accordance with paragraph 248. If it be the result of disability in the line of duty, the board shall recommend him for "waiting orders" or for special duty of a light character. 70. The compensation of commissioned officers, when not provided for by statute, shall be fixed at a uniform annual rate for each rank as follows, viz: Surgeons shall receive $2,500 per annum; passed assistant surgeons shall receive $2,000 per annum, and assistant surgeons shali receive $1,600 per annum; and after five years' service an additional compensation of 10 per cent on the annual salary for each five years' service shall be allowed commissioned officers above the rank of assistant surgeon, but the maximum rate shall in no case exceed 40 per cent. Said officers placed on "waiting orders" for a period longer than two months shall receive 75 per cent of the pay of their respective ranks while so placed.

93. When a commissioned officer is serving at a station on active duty where there are no quarters belonging to the Service, he shall receive commutation for quarters at the following monthly rate, allowed medical officers of the Army of the same relative rank, viz: For surgeons, for 4 rooms, fuel, and lights, commutation, $50 a month; for passed assistant surgeons, for 3 rooms, fuel, and lights, $40 a month; and for assistant surgeons, for 2 rooms, fuel, and lights, $30 a month. When on duty on board a revenue cutter or quarantine vessel or on waiting orders officers will not be allowed commutation.

On appointment, the young officers, as a rule, are first assigned to duty at one of the large marine hospitals, as at Boston, New York, Baltimore, New Orleans, Chicago, or San Francisco. Officers traveling under orders are allowed actual expenses. Boards of examiners are usually called once a year, and appointments are not influenced by politics.

Approved:

O. L. SPAULDING,

WALTER WYMAN, Supervising Surgeon-General M. H. S.

Acting Secretary.

APPLICATION FOR EXAMINATION.

(town or city)

SIR: I have the honor to make application for examination for appointment as assistant surgeon in the United States Marine-Hospital Service. I was born

at

and graduated at
(name of medical schoool or college of which candidate is a graduate)
I am a legal resident of the State of

in

(State)

(year)

I inclose two testimonials as to my professional and moral character.

Respectfully, yours,

(Christian name in full) (middle name in full)

(surname)

SUPERVISING SURGEON-GENERAL, M. H. S.,
Washington, D. C.

SPECIMEN LIST OF WRITTEN QUESTIONS USED IN AN EXAMINATION FOR ADMISSION TO THE GRADE OF ASSISTANT SURGEON, MARINE-HOSPITAL SERVICE.

Questions on preliminary education and collateral branches are included in the oral examination.

Hospital cases are given for examination and report.

ANATOMY.

1. What nerves are distributed to the eye and eyelid, and what is the distribution of each?

2. Name the branches of the internal iliac artery, and give the origin of the obturator artery and the relation it bears to the femoral ring.

3. Describe the middle ear and the Eustachian tube.

4. Describe Scarpa's triangle, and name the important structures contained therein.

5. Describe the temporo-maxillary articulation and its relations.

PHYSIOLOGY.

1. What is volition as applied to locomotion? Give the route it travels to develop motion.

2. Explain arterial blood tension and the method of measuring it. Mention the circumstances which cause it to rise or fall.

3. What constitutes vision, and what audition?

4. How is animal heat developed?

CHEMISTRY.

1. Define chemical affinity and state the various circumstances or influences that modify it.

2. Calculate the weight of each element in 98 milligrams of sulphate of lime. 3. Describe some method of determining the quantity of HNO3 in river water. 4. What group of metals is precipitated by HCI?

5. Describe the methods of determining the specific gravity of solid bodies.

MATERIA MEDICA AND THERAPEUTICS.

1. Describe the action of antipyretics, and name some of the principal substances used as such.

2. Describe the difference of action between digitalis, aconite, and veratrum viride.

3. Where is cinchona bark found and what are its principal alkaloids?

4. What is atropia, eserine? Give the action of each.

SURGERY.

1. Describe the operation of ligation of the lingual artery and name the parts incised.

2. Describe the operation of lumbar nephrectomy. For what diseases is this operation warranted?

3. What is the pathology of piles? Mention the various operations for relief

or cure.

4. What are the indications for enterotomy and enterectomy? Describe the operations and give your method of making the toilet.

5. Give etiology, pathology, and treatment of the various kinds of aneurysm.

PRACTICE.

1. Define neuralgia and enumerate the etiological factors, and give symptoms and treatment.

2. What parasites, animal and vegetable, infest the skin, intestines, blood, and muscles? What diseases do they cause and what is the treatment?

3. Describe the exanthematous diseases.

4. Give the various reasons for believing that certain diseases are caused by certain microorganisms.

OBSTETRICS AND GYNECOLOGY.

1. Give the pathology, symptomatology, and treatment of vaginismus.

2. How would you manage a case of threatened abortion and one of inevitable abortion?

3. Describe the anterior and posterior lateral inclined planes and their relation to the mechanism of labor.

4. Give the various displacements of the uterus, their causes, symptoms, and treatment.

HYGIENE.

1. How would you detect sewer gas in a room?

2. In hospital practice what precautions would you take against the spread of typhoid fever from a patient in a ward?

3. Name the best disinfectants and deodorizers, and give the mode of action. 4. Describe the changes which take place in a human dead body for the first ten years after ordinary inhumation.

AID TO OTHER BRANCHES OF THE GOVERNMENT SERVICE.

AID TO THE UNITED STATES ARMY AND NAVY.

The benefits of the United States Marine-Hospital Service were, after the commencement of hostilities with Spain, extended to the United States Army and the United States Navy, the Marine-Hospital Service to be reimbursed the actual cost of maintenance.

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