United States. Navy Dept.

Annual report of the Secretary of the Navy online

. (page 40 of 49)
Online LibraryUnited States. Navy DeptAnnual report of the Secretary of the Navy → online text (page 40 of 49)
Font size
QR-code for this ebook


one likely to turn out a gun that would give a good account of itself in
actual warfare — for which it was really intended.

So it is with the units of personnel that come out of the Naval
Academy. If high specialization in athletics at the Naval Academy
by a small group of men each year leads to an undue proportion of
disability in this "twice-picked" group afterwards, then it is a matter
for serious consideration, aside from tne tendency of those not athlet-
ically inclined to stagnate on the side lines. It is desirable to develop
the kind of courage that leads to victory as well as the kind of courage
that bears defeat manfully. Service conditions attend to this feature
of the development of officers afterwards. The immediate hazards of
sport are inconsequential as compared with the future effects of
overtraining and overstraining for brief periods, to be followed by
years of relative physical quietude. The records naturally fail to
take into account those whose physical disabilities are of such a
character as not to cause their admission to the sick list, yet whose
efficiency has been impaired by them. There are many such officers
in the service who consult medical officers for cardiac irregularities,
obesity, or physical staleness — in other words, for conditions that it



Digitized by



Google



tions. These cases do not become matters of record unless they are
of such moment as to render the officers wholly unfit for duty, yet
such influences in many instances materially affect the military effi-
ciency of the individual and should be averted if possible.

In my opinion professional coaches should not Ibe employed at the
Naval Academy. Physical training and athletics should be so tem-
pered as to be beneficial to all. They should produce a supple,
agile, all-around well-developed individual, not a muscle-bound mass
of brawn. The man who steps out of a boat, comes off the football
field, or leaves the track should feel exhilarated by his exercise. Is
it logical to suppose that the man who is lifted out of a boatj collapsed,
or is carried off a football field or track in the same condition is not
harmed thereby? Physical training and athletics should be under
the direction of a properly qualified medical officer, who would be
able to avert the narmful effects of abused athleticism, and who
would be properly aualified to institute exercises beneficial in char-
acter. Those who nave not been trained in anatomy, physiology,
and pathology as well are not qualified to direct these exercises.

In studying naval statistics it must be borne in mind that mid-
shipmen are carefully selected at the outset on the score of their
physical makeup; in other words, they are picked men, while the
athletic stars, we might say, are twice-selected picked men. They
are the men, it would be reasonable to suppose, who would be best
able to resist the ill effects of overtraining and overstraining, and who
should, other conditions being equal, possess a comparatively greater
expectation of health and longevity.

Twenty years ago the mad rush for athletic excellence had not
reached its present pace; consequently, as sufficient time has not
elapsed, we are not able to say definitely what the future has in
store for this group. It might be well for athletic directors to point
out to those who aspire to enter the mad race for lowering athletic
records the penalty that will be likely to come in later years.

In previous reports to the department, the bureau has given at
Borne length its attitude in regard to this subject. Included in
these reports were certain data obtained from an examination of the
medical records of 622 star, or specialized, athletes of the classes of
1892 to 1911, inclusive, at the Naval Academy, for the purpose of
ascertaining the incidence of certain disabilities or abnormal phys-
ical conditions among them. These data and the opinion expressed
by the bureau relative to the inadvisability of high specialization in
service athletics, particularly at the Naval Academy, have aroused
such interest both within and without the service that this examina-
tion has been extended to include a similar inquiry into the records
of 580 of the nonathletic midshipmen, covering the same period of
time. This was undertaken not so much in the expectation that the
physiological question involved is susceptible at present of being
answered definitely by mathematics alone as in response to a general
request for further information. Given an equal number of special-
ized and nonspecialized athletes recruited from individuals of similar
physique, subjected to a continuous system of training through a
given period, a comparison of the two groups in reference to their
morbidity and mortality would be of markedf statistical value.



casualties for the athletes, derived from the examination of 625
records, which shows that, despite the handicap in regard to sup-
posedly better physical material, the casualty Est for the athletes
about equals that of the nonathletes. Further, it has been found
that from those diseases selected to which athletics have a possible
or probable causative relation, there has been but 1 death among
nonathletes as compared with 6 for the athletic group. The number
still in the service whose medical records show the listed abnormal
physical conditions is 187 for the nonathletes as against 198 for the
athletes. The following conditions or disabilities show an excess
amounting to 50 per cent or more among the athletes: Arterio-
sclerosis, valvular disease of the heart, cardiac irregularity, cardiac
dilatation, cardiac hypertrophy, gastric disturbances, albuminuria,

f general poor health, obesity, and tuberculosis, and various traumatic
esions as well. It seems reasonable to suppose that the disabilities
among the athletic class are largely- due to spectacular athleticism
and would not have been acquired, had the overstraining and over-
training not been indulged in.

It is therefore recommended that athletics in the Navy be so
regulated as to avoid these deleterious conditions by the prohibition
of endurance contests where the ability to win is largely, if not
entirely, dependent upon brute force, and that rather the maximum
effort be made to develop a symmetrical, normal physique in the
many instead of a highly specialized human machine in a few. The
adoption of the Swedish system of physical training is earnestly
recommended for use not only at the Naval Academy, but throughout
the entire service, as its effectiveness has been demonstrated not only
at the Naval Academy during the past year, but in the Marine Corps
at those stations where it has teen employed. This system of
physical training leads to a well rounded out development, alertness,
and agility, particularly desirable in a naval military organization.
Since the system was nut into use at the Naval Academy, the pre-
vious tendency of the first and second classes of midshipmen to retro-
grade in strength and weight has not only been checked, but an actual
gain has been made. There has also oeen an improvement in the
average weight and strength of the lower classes. These notable
advances indicate that the trend of physical training at the academy
is in the right direction — i. e., the muscular development of the
entire personnel to a higher but rational standard, rather than the
production, from material already fit, of a comparatively few special-
ists, which from a service utilitarian point is useless, if not actually
harmful.

Section II. — Operations.

I. POLICIES.
A. ESTABLISHED.

1. Educational. — a. Naval Medical School : This institution proves
of increasing value to the service, not only in rounding out the

Eractical education of medical officers recently admitted to the coips,
ut also by performing export laboratory examinations, by carrying



Digitized by



Google



the peculiar conditions found in the JNavy. In audition, a valuable
collection of pathological, helminthological, and miscellaneous speci-
mens is being accumulated and classified, and the large library of
bound volumes and current literature is being carefully indexed.
Only seven assistant surgeons were graduated in April of this year,
and there are only seven in the present class, although there are 53
vacancies in the corps (November 15, 1912). It was with regret that
the spring course, devoted to the instruction of officers of higher rank,
had to be abandoned again, owing to the deplorable shortage and
the increasing demands of the service at large.

b. Medical and surgical conferences in the Atlantic Fleet: The con-
ferences of the medical officers of the Atlantic Fleet were an inter-
esting and valuable feature of the winter mobilization at Guantanamo
Bay, Cuba. Between January 14 and March 14, 1912, eight meetings
were held, with an average attendance of 20 medical officers. A
number of valuable and instructive papers were read and discussed,
some of which have been published in the Naval Medical Bulletin
-with a view of making tnese important matters more generally
available.

c. Instruction of medical officers of the Naval Militia: This
summer (1912), for the first time in the history of the Navy, a mem-
ber of the Medical Corps was specially assigned to the duty of in-
structing medical officers of the Naval Militia in naval customs and
methods during their practice cruises. It is the intention to assign a
medical officer in the bureau to the additional duty of corresponding
with the medical officers of this branch of the service, in order that
they may be kept informed of the routine and usages of the corps and
to supply them with available literature, so that they may be in
closer touch with the regular Naval Establishment and more fully
cognizant of their duties in time of war.

d. First-aid instruction of enlisted men by divisional officers:
The establishment of this system is a marked advance and the benefit
derived therefrom would nave been more pronounced had officers
fully appreciated its intent and the improved military efficiency

xirKiir»li wrmlf? result, Tf ia rannrt.Arl thnf. in th« abqa nf nriA fiViin nf tViA



Digitized by



Google



the work may be extended.

g. Instruction in hygiene for the rising generation of Chamorroe:
An elementary course in hygiene and sanitation has been introduced
into the curriculum of the common schools of Guam.

h. Medical circulating library: This feature of medical education,
established on the hospital ship Solace, has proven of great value to
the medical officers of the Atlantic Fleet.

i. Open-shelf library: This system has worked admirably on the
hospital ship Solace, with very trifling losses. It would be a distinct
advance if established on all vessels.

2. Economical— a. New accounting system for hospitals: This
plan has for its object the establishment of a definite and uniform sys-
tem of accounting, an accurate classification of expenditures, and an
authoritative record of current expenses and permanent construction-
Certain new forms have been instituted, e. g., bill book, commissary
ledger, receipt and expenditure voucher, and ration record, which
replace the old order book and all other forms previously used in this
connection.

b. New bureau forms and methods: (1) Statistical — (a) A sheet
form for returns of enlistments and admissions to the service (abol-
ishes Form X card), (b) A card form for combining detailed, quar-
terly statistical reports, relative to diseases and injuries, from indi-
vidual hospitals, ships, and stations, (c) A sheet form for combining
all statistical reports by diseases and injuries, (d) Graphic statistical
charts of all important or prevalent diseases kept up to date, (e)
A system has been established whereby an accurate record is kept of
all sick days resulting both from admissions of naval personnel to
hospitals other than naval hospitals, and from sick leave. (/) The
report of medical survey has been rearranged and simplified.

(2) Records of personnel — (a) Medical officers. The Rand adjus-
table index, a system of loose slips forming panels arranged in book
form, has been substituted for the old card index for keeping the
temporary record of ever-changing duties and stations, (b) Hos-
pital Corps men. In the future the duty of attending to these records
will be performed by a medical officer.

c. Naval insane: Hereafter, in appropriate cases, insane patients
during transportation will be accompanied by a hospital steward *nd
such attendants as may be necessary. Doubtful and obscure cases
will be sent to the naval hospitals at Caflacao, P. L, or Washington,
D. C, where special psychopathic wards have been established for
the purpose of treatment and the application of expert diagnostic
methods. All cases in which there is good evidence tnat the disease
or a predisposition thereto existed prior to enlistment are surveyed
and discharged from the naval service soon after their commitment to
the Government Hospital for the Insane, Washington, D. C.

d. Abandonment of naval hospitals: (1) Washington, D. C. — By
reason of the completion of the new hospital and the uselessness of
the old one, the latter was abandoned May 26, 1911. Since that
time an effort has been made to sell both building and property, but
the necessary legislative authority has not as yet Tt>een obtained.



Digitized by



Google



SUBGEON GENERAL, U. S. NAVY. 461

(2) Puget Sound, Wash. — The old building formerly used as naval
hospital and yard dispensary was abandoned for hospital purposes
February 2, 1912, upon completion of the new hospital.

(3) The naval hospitals at Pensacola, Fla., San Juan, P. R., and
Sitka, Alaska, were all abandoned during the year by order of the
Navy Department.

e. Inspections of hospitals and of medical departments at navy
yards and stations: These inspections, made by the Surgeon General
at various times during the year, were of inestimable value in gaining
accurate information whereby the affairs of these institutions could
be more efficiently directed.

3. General. — a. Liability act of May 30, 1908: The first aid ad-
ministered and house visits required under this act have again made
great demands upon the medical departments of the navy yards,
necessitating the detail of two medical officers to these stations.

b. Division surgeon: The assignments of medical officers to the
Atlantic Fleet have been so arranged as to place the senior of each
division on the flagship, and. as tneir duties simulate those of the
fleet sureeon, these officers snould exercise more active supervision
of the affairs of the group of vessels to which they are detailed.

c. Analytical chemical laboratory on hospital ship Solace: For
the purpose of making chemical examinations of any material sub-
mitted, but more particularly for the testing of food supplies for
adulterants and preservatives, an elaborately equipped chemical
laboratory has been established on the hospital ship Solace, with an
expert chemist in immediate charge.

a. Marine detachments at naval hospitals: The establishment of
this policy has proven most beneficial, and efforts are being made to
enhance the comfort of and better the hygienic conditions sur-
rounding the personnel composing these guards.

e. Strong wards in naval hospitals : Most of the hospitals are now
fitted with strong wards for the care of court-martial prisoners and
mental defectives, and all will be so provided in the near future.

f . Attendance upon f amilies by medical officers : This practice has
grown enormously at some stations and is encouraged by the bureau
in that it is helpful to medical officers professionally and gives efficient
medical and surgical attendance to tne families of officers, bringing,
as well, the different branches of the service into closer touch with
the Medical Corps. There has been a good deal of abuse of this
service and a lack of consideration in some instances. The bureau
has under consideration the establishment of two wards for women
and children, one on the Pacific coast and one on the Atlantic,
where the families of officers can be cared for in surgical crises.

£. Outfits on ships in reserve: Formerly the medical outfit of a
ship placed in reserve was transferred to another vessel going into
full commission. The present arrangement of keeping many vessels
in reserve, fully equipped for instant use, renders this plan imprac-
ticable, and a heavy expense has been incurred as a result, by reason
of the necessity for leaving the outfits on board such ships. This

Solicy, put into effect soon after the establishment of the reserve
eets, has since become mandatory by reason of a recent general
order.

h. Entries "not in line of duty " on health records: The regulation
requiring that medical officers enter on the health record the state-



Digitized by



Google



conscientiously following out this order.

B. INAUGURATED. BUT NOT ESTABLISHED.

1. Educational. — Revision of the Instructions for Medical Officers,
to be called in the future the Manual for the Medical Department,
has been taken up and will be rapidly completed subsequent to the
issue of the new Navy Regulations.

2. Economical. — a." Naval dispensary, Washington, D. C: The
change in location and organization of this dispensary will be com-
pleted in the near future, thereby making it more central and con-
venient and doing away with the necessity for two dispensaries. A
large, well suited building, which will be arranged to meet the re-
quirements most satisfactorily, has been selected and will be devoted
to this purpose onlv. The equipment will be modern in every way,
and provisions will be made to deal with cases suffering from the
special diseases as well as for the large general dispensary practice.

b. New bureau forms and methods: (1) Statistical. — (a) The
nomenclature of diseases and injuries used in the Navy will in the
future conform to the Bellevue Nomenclature. (6) A form for the
quarterly return of patients on the loose-leaf system will soon replace
the former quarterly statistical report, (c) A new form for reporting
operations has replaced the former report by a much simpler and more
valuable return.

(2) Administration of hospitals: More systematic and complete
regulations for the internal administration of hospitals have oeen
completed and will be submitted to the department in the near
future.

C. CONTEMPLATED.

1. Educational. — a. Medical and surgical conferences in the Pacific
and Asiatic Fleets and at the larger shore stations would prove of great
interest and value, and medical officers should actively cooperate in
the attainment of this end.

b. Instruction of medical officers: (1) It is urged that medical
officers of the Atlantic Fleet bo detailed, from time to time^ for tem-
porary duty on the hospital ship. Such assignments, lasting about
two weeks, would afford valuable opportunity for clinical and labo-
ratory work otherwise unobtainable during a cruise. (2) The success
attending the development of the laboratory work, in connection with
the course in tropical medicine at the Naval Medical School, has led
to a decision to institute practical instruction in physical diagnosis,
thus largely replacing the former method of didactic lectures.
, c. Laboratory instruction for Hospital Corps: Certain members
of the Hospital Corps, selected for special aptitude, are to receive a
course in laboratory methods at the N aval Medical School, and they
will subsequently continue this work at the large hospitals.

d. Training native nurses, Tutuila, Samoa: A svstem of training
Samoan women for the duties of nurse should be established at
Tutuila, similar to that now in existence at Guam, and the assign-
ment of members of the Navy Nurse Corps to this station will make
this practicable.



Digitized by



Google



Eertaining to neaJtn by tne introduction 01 an elementary course in
ygiene and sanitation into the curriculum of the common schools
of Tutuila, Samoa, should be put into effect.

2. Economical. — a. New bureau forms and methods: Revision
of the Medical Supply Table.— A thorough revision of the supply
table will be undertaken in the near future, and already much pre-
liminary work has been accomplished in the revision of Form B
(requisition form) which is based upon this table.

b. Abandonment of naval hospitals: Olongapo, P. I.: By reason
of rapid deterioration and excessive expense involved in repairs, it
will become necessary to abandon the station hospital (formerly the
hospital ship Belief) within the next few years. v

c. Field tourniquet: This type of tourniquet will not be issued in
future. It is difficult of adjustment and, improperly applied, is not
only useless, but harmful.

3. General. — Embalming of naval dead at sea: Provisions should
be made for embalming the bodies of those who die at sea, the pro-
cedure being carried out by Hospital Corps men under the guidance
of a medical officer. Caskets and other necessary equipment will be
provided on the bureau supply table as soon as funds are available
to carry this 'measure into effect.

II. CONSTRUCTION.

All extensive new construction under the Bureau of Medicine and
Surgery will be suspended until specific appropriations are provided
by act of Congress, as the naval hospital fund is now fully obligated.
However, certain new buildings were considered of such immediate
necessity that the bureau has undertaken them at once, namely:
(1) Temporary heating plants for the preservation of the hospital
buildings at Chelsea, Mass., and Newport, R. I. ; (2) contagious-disease



Digitized by



Google



464 BEPORT OF THE SECRETARY OF THE NAVY.

b. Puget Sound, Wash.: This hospital, occupied January 3^ 1912,
although ultimately to conform to the plans of the type hospital, at
present consists only of an administration building, operating and
subsistence building, and one wing for wards, with a normal capacity
of 63 beds. It was built under contract with the W. N. Concannon
Co.. dated March 29, 1909, for $149,820 (naval acts of Mar. 7, 1907,
and May 13, 1908).

2. Dispensaries and sick quarters. 1 — Naval station, Tutuila, Samoa:
The dispensary at this station was occupied in August, 1911, but
the volume of work has so increased that an addition is necessary.
The present structure consists of a main building (ward, dispensary,
laboratory^ surgeon's office, and Hospital Corps auarters), a subsist-
ence building, an operating building, and toilet building, and has a
normal capacity of 12 beds.

8. Contagious disease buildings. — Hospital, Brooklyn, N. Y.: Pro-
vision for contagious diseases was made oy the conversion of a build-
ing formerly occupied as auarters by the medical officer in command
of the medical supply depot. It consists of isolation space for
four different contagious diseases and rooms for hospital corpsmen
in attendance; also, through necessity, quarters for three meipbers
of the Nurse Corps. Its normal capacity is about 30 l^eds.

4. Quarters (separate buildings). — a. For medical officers, Great Lakes
Hospital, 111.: There were ttiree buildings erected for this purpose,
one for the commanding officer and two for junior officers. These
quarters and the " laundry and disinfecting building," mentioned
under " 5. Other accessory Duildings" of " Completed construction,"
were built by the contract dated June 11, 1909, at a contract cost of
$79,000 (naval hospital fund).

b. For Nurse Corps, Brooklyn Hospital, N. Y. : These quarters are
the result of remodeling and enlarging the building formerly used as
a contagious disease building, and contain accommodations for 10
nurses.

5. Other accessory buildings. — a. Laundry and disinfecting building,
Great Lakes Hospital, 111. (See "4. Quarters. — a. For medical offi-
cers" above.)

b. A mortuary and a building for the high-pressure steam disirvfector
have been recently completed at the hospital, Brooklyn, N. x .

c. An ice house, two 3-room cottages, a stone hose-cart house,
a stone house over the power-house well, and a new sputum and dress-
ing incinerator have been erected at the hospital, Las Animas, Colo.

6. Improvements. — a. Additions: (1) Laboratory facilities. — A bac-
teriological room has been equipped at the dispensary, navy yard,
Boston, Mass. A satisfactory animal house has oeen constructed at
the dispensary, Olongapo, P. I., while that at the hospital, Guam,
has been extended.

(2) Eye, ear, nose, and throat rooms. — Dark rooms for use in con-
nection with work in these specialties have been provided at the dis-



Online LibraryUnited States. Navy DeptAnnual report of the Secretary of the Navy → online text (page 40 of 49)