medical Sailors was hereby increased. Surgeon’s stewards ranked second in seniority among the ship’s petty officers, next only after the master-at-arms. SURGEON’S STEWARDS AND NURSES The year 1861 brought civil war to this country, and—due to the enormous expansion of the Navy because of the war—changes and developments in the medical department ensued. On June 19, 1861, a Navy Department circular order established a new name for the loblolly boy. In addition to a surgeon’s steward, 1 nurse would be allowed for ships with a complement of less than 200; 2 nurses would be allowed for ships with a complement of more than 200; and sufficient nurses would be allowed on receiving ships in a number proportionate to the necessities of the vessel. While the shipboard medical department changed the titles of its personnel, new techniques in mass care of the sick and wounded were also developed. A captured sidewheel steamer was repaired and modified to care for patients. Refinements to the ship included bathrooms, kitchens, and laundries—even elevators and the facilities to carry 300 tons of ice. On December 26, 1862, the USS Red Rover became the first Navy vessel specifically commissioned as a hospital ship. The medical complement included 30 surgeons and male nurses, as well as four nuns. APOTHECARIES AND BAYMEN Postwar reductions in the size of the Navy brought new classifications to enlisted medical personnel. The title “surgeon’s steward” was abolished in favor of three grades of apothecaries in 1866. Those selected as apothecaries had to be graduates of a course in pharmacy or possess the same knowledge gained through practical experience. The Apothecary, First Class, ranked with a warrant officer, while the second and third classes were petty-officer equivalents. The three rates were reduced to one petty officer apothecary on March 15, 1869. “Nurse,” as a title for junior enlisted medical personnel, was replaced by the title “bayman” (defined as one who manned the sick bay) in the early 1870s. U.S. Navy Regulations of 1876 used the title officially, and it remained valid for 22 more years. An apothecary of the 1890s mixed and dispensed all medication aboard a ship. He was responsible for all medical department reports, supply requests, and correspondence, and he helped maintain medical department records. The apothecary administered anesthesia during surgery and was the primary instructor for new baymen. The apothecaries’ responsibilities did not end there, however. (See figure APP-I-1.) During shipboard surgery, the bayman focused an electric light on the incision site while the surgeon did his work on what served as a combination of both writing and operating table. He sterilized surgical instruments by boiling them, then stored them in a solution of 5 percent phenol. Bandages and dressings were sterilized by baking them in a coffee can in the ship’s oven. Sick bay itself was prepared for surgery by wiping the entire room down with a chlorine solution. On days when the ship’s routine called for scrubbing bags and hammocks, a bayman was responsible for washing those of the sick. When required, he painted the ship’s medical spaces. During the last two decades of the 1800s, many in the naval medical establishment called for reforms in the enlisted components of the medical department. Medicine had by now progressed far more as a science, and civilian hospitals all had teaching schools for their nurses. Foreign navies had trained medical Sailors, and the U.S. Army had established its own Hospital Corps of enlisted men on March 1, 1887. Navy Surgeon General J. R. Tryon argued, in his annual report of 1893, against the practice of assigning landsmen to the medical department with nothing more than on-the-job-training. He advocated the urgent need for an organized hospital corps. Physicians in the fleet were equally certain of the need for changes. Surgeon C. A. Sigfried of the USS Massachusetts made his views known in his report to the Surgeon General in 1897. The importance of improving the medical department of our naval service is more and more apparent, in view of the recent advances in the methods and rapidity of killing and wounding. The great want is a body of trained bay men or nurses, and these should be better paid and of better stamp and fiber. Now and then we procure a good man, and proceed with his training as a bay man. He soon finds opportunity for betterment in some one of the various departments of the ship, in the matter of pay and emolument, either in some yeoman’s billet or in some place where his meager per month can be suddenly AI-2