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Circular No. 31.-N.

Admiralty, 23rd August 1866.

My Lords Commissioners of the Admiralty are pleased to issue the following regulations for the Medical Examination of Officers, Men, and Boys for the Royal Navy and Marines, in lieu of those contained in article 34, pages 397 and 398 of the Queen's Regulations and Admiralty Instructions, and in article 14 of the Instructions to Surgeons and Agents of Sick Quarters.

When a Medical Offioer is directed to examine any person for admission into the Naval Service, or into the Royal Marines, he is first to observe whether he has any marks of wounds, or injuries of the bones of the head, whether his eyesight or hearing is defective, whether he is deformed, lame, or has an impediment of speech, or weakness of intellect, and should any of these or other mental or physical defects exist to such an extent as might, in the opinion of the Examining Officer, disqualify him for the efficient discharge of his duty, he is at once to report him unfit without carrying the examination further.

On the contrary, should the person present no outward appearance of unfitness, he is to be directed to divest himself entirely of his clothes ; and the Medical Officer is then to satisfy himself, by a careful inspection of the entire cutaneous surface, that it is not only in itself free from disease, but that it shows no evidence or sign of the existence of any internal complaint or constitutional derangement.

He is to ascertain that there is a proper and just proportion between the different members of the body, that there is no spinal weakness or deformity, that the limbs are of equal length, strong, and well developed, that there are no visible marks of previous fracture, depression, or disease of the bones of the head, nor adherent cicatrices, that the eyes are clear, intelligent, and expressive of health, the eyesight good, and the hearing perfect in both ears, that there is no defect or deformity of the bones of the nose, and that the teeth are good, strong, and sufficient in number.

The chest should be carefully examined in reference to its form and capacity, and the condition of the heart and lungs ascertained by percussion and auscultation.

The abdomen is next to be examined for the purpose of detecting any enlargement or disease of the contained viscera, or predisposition to hernia from whatever cause.

The Examining 'Officer' shall next direct the person to extend, and slowly raise his arms until the hands meet above his head ; he is then to perform the various movements of the shoulder, elbow, and wrist joints ; to flex and extend, supinate and pronate the forearm ; to flex and extend the fingers and thumbs; and by holding on by a rope, show that he can bear the weight of the body clear of the ground without any difficulty, with each hand, for at least five second.

In the examination of the lower extremities, the person is to be made to walk backwards and forwards, to hop first on one foot, and then on the other, to flex and extend the limbs and feet to show that the movements of the various joints call be freely and rapidly performed.

Persona of whatever class, or age, who are found to be labouring under any of the undermentioned physical defects or infirmities, are to be considered unfit for Her Majesty's Service:

1. A weak constitution arising from imperfect development, or weakness of the physical powers of the body, or from chronic disease, constitutional depravity, wounds or injuries.

2. Chronic eruptions on the skin or scalp ; syphilis, primary or constitutional ; gonorrhœa; extensive marks of cupping, leeching, or blistering, or of issues. Marks of punishment are to be reported to the Commanding Officer.

3. Malformation of the head, with a dry, harsh, divergent state of the hair of the scalp, fracture or depression of the bones of the skull, disordered intellect or imbecility, epilepsy, paralysis, or impediment of speech.

4. Blindness or defective vision in one or both eyes, fistula lachrymalis, and ptosis.

6. Impaired hearing, or discharge from one or both ears, disease or thickening of the lining membrane of the external ear.

6. Disease of the bones of the nose or of its cartilages, and polypus.

7. Disease of the throat, palate, or tonsils; unsound teeth, offensive breath from constitutional causes, unhealthy gums, scrofulous disease of the glands of the throat or neck, external cicatrices, whether from scrofulous sores or suicidal wounds.

8. Functional or organic disease of the heart or blood vessels, deformity or contraction of the chest, flattening of the sub-clavicular regions, phthisis, hœmoptysis, bronchitis, dyspnœa, aphonia, chronic cough, or other symptoms of tubercular exudation into the pulmonary tissues.

10. Swelling or distension of the abdomen, undue obesity, disease or enlargement of the liver, spleen, or kidneys. Rupture, weakness or distention of the abdominal rings ; stricture of the urethra, incontinence of urine or urinary fistula.

11. The non descent of one or both testicles, varicoce!e, hydrocele, and sarcocele.

12. Fistula or fissure of the anus, haemorrhoids, condylomata, or prolapsus of the rectum.

13. Paralysis, weakness, impaired motion, or contraction of the upper or lower extremities from whatever cause ; aneurism, a varicose state of the veins, especially of the leg. Chalky deposits, bunions, distortion, deformity, or malposition of the fingers or toes ; nodes ; flat-footedness.

14. Distortion of the spine, of the bones of the chest, or pelvis, from injury or constitutional defect.

No person is to be admitted into Her Majesty Service unless he has had smallpox, or has been vaccinated, and should the vaccine cicatrix not be considered satisfactory, he is to be reported fit only on condition that he immediately submit to the operation.

As it is clearly possible that some of the preceding defects or disabilities may exist in a very minor degree, the Examining Officers must necessarily, in such cases, be guided by their own judgment as to whether they are of such importance as entirely to disqualify a man or boy for the Service; observing, however, that no person is to be reported fit unless he is likely to continue efficient and serviceable in any climate, and under all the vicissitudes of the Service for a period of not less than ten years.

All persons examined for entry into the Naval Service or Marines by a Medical Officer, are to be entered on a list in the Medical Journal of the ship, in the Nosological Returns from Hospitals and Marine Infirmaries, and in the Weekly Returns rendered by Surgeons and Agents ; and no man or boy who has been reported fit for the service by a Medical Officer of the Royal Navy or of the Royal Marines is to be again subjected to examination, unless he re-enters for continuous service, or there is reason to believe that he is labouring under some disability contracted or sustained since his entry, - or, on going on foreign service.

By command of their Lordships,

Henry G. Lennox

To all Commanders-in-Chief. &c.

Source: Navy List for June 1870

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