XL INTRODUCTORY. 



The following order will be observed for the examination of the upper extremities; 

 The surgeon will cause the recruit to extend both arms in such a manner that the 

 palms of the hands will touch. This will enable him to judge of the equal length of 

 both arms. He will next direct him to cross the arms on the breast, on the back of 

 the neck, and then to extend them straight over his head. This will enable him to 

 judge of the equality or inequality of the shoulders. Finally, he will desire him to 

 cross the hands on the back. The recruit will also be made to move the hands in 

 every direction, to close his fingers and extend them again, during which time the 

 number, position, and condition of the fingers will be observed. 



As to the lower extremities the surgeon will observe if the knees are in a straight 

 jjosition or bent iuAvard or outward ; if they be not enlarged from disease ; if one leg 

 be not shorter than the other, or if either be crooked or atrophied. He will observe 

 the existence of club-foot, horse-foot, or flat-foot. Doubtful cases of shortness of one 

 of the lower extremities he decides by placing the recruit in a horizontal position, both 

 in supine and prone positions. To satisfy himself of the full mobility of the limbs, he 

 directs the recruit to kneel alternately on each knee and afterward on both knees, 

 and directs him to walk up and down while he observes his gait and the position of 

 the toes. 



By a system of gentle and encouraging questions, the surgeon will endeavor to 

 form a judgment of the mental capacity of the recruit and to detect infirmities Avhich 

 might not be discoverable by external signs. 



The surgeon will make a report as to the result of the examination of the recruit 

 under the following general heads : 



1. Fit for service : 



a. without infirmity. 



h. with infirmity, (which is to be described.) 



2. Temporarily unfit on account of (described disease.) 



3. Permanently unfit on account of (described disease.) 



As fit for service will be considered all those possessing a strong constitution and 

 who are not afflicted with any infirmity, or with only such minor infirmity as does not 

 interfere with bodily or mental activity and witli the free use of the senses and organs 

 of the body. Infirmities of this class will be found described in Appendix A. 



As temporarily uiifiifor service will be considered all those Avho possess weakly 

 constitutions, but in whom there is reasonable expectation for a complete restoration 

 to health ; also those who are afflicted with diseases or infirmities which will idtimately 

 yield to the curative power of nature, or to appropriate medical treatment, or the 

 violence of which can be so diminished, at least, that tlie person affected may }^et 

 become fit for service. 



As fermancnihi unfit for service are to be considered all those who are afflicted 

 with such infirmities as will interfere with the free movements of the body, and 

 especially with the fi-ee use of the limbs ; such as interfere with important functions 

 of the organism ; such as render impossible the necessary exertion of mental and 

 bodily vigor ; in fact, all disorders which are undoubtedly grave and incurable. In 

 Appendix B these infirmities and diseases will be envimerated. Appendix (,• contains 



