VIII INTRODUCTORY. 



A comparative view of the instructions issued hy the United States Government and hy the 

 principal {jovernments of Europe for the guidance of the medical officer in the exami- 

 nation of recruits. 



In the United States, as in most of the great kingdoms of Em'ope, tlie limitations 

 as to heioflit and ag-e of the recruit have varied with the uro-encv of 'the demand for 

 men. The rejection for physical disqualification, such as disease or deformity, how- 

 ever, has admitted of no such variation. The experience of all nations has demon- 

 strated the uselessness of attempting to conduct military operations to advantage 

 unless the rigid scrutiny of the surgeon has been exerted to exclude such men as were 

 subjects of or pi'edisposed to disease, or were unfitted to sustain the continued fatigue 

 and exposure of the march. It has been estimated by an eminent English statistician 

 that in time of peace 7 per cent, of the fighting-men of tlie army are habitually in 

 hospital. In the peninsular war 21 per cent, of the British forces were constantly in 

 hospital; "but the Crimea was the culminating point, for there 39 per cent, of the 

 force was sick on an average during seven months, and the destruction of life was 

 enormous." Well may Dr. FaiT add, "Nothing is so expensive as an unhealthy mili- 

 tary force." '■ 



The sickness-rate for the troops generally in the United Kingdom from 1860 to 

 1869 averaged 4.782 per cent., and in 1870 only 3.858 per cent- 

 It is known that the French troops engaged in the Crimea were better cai:ed for 

 by their officers and were more judiciously provided with comforts than either the 

 English or Sardinian forces ; yet an army of 50,000 French soldiers on their way to 

 Sebastopol, before the advent of the cholera, left 5,500 men in hospital on the way.^ 



It is difficult to make any comparison with these figures of the constant sickness- 

 rates of our forces in the late war, as the casualties from wounds were generally 

 included in the returns. Mr. Elliott's tables show that for a period of about six months 

 the sickness-rate varied from 7 to nearly 17 per cent., the larger rate occurring among 

 the western forces."* These rates are probably underestimated. The complaints of 

 commanding generals and the experience of regimental surgeons demonstrated a 

 lamentable discrepancy between the force on paper and the number of men ready for 

 duty In the field. 



The success of an army depends so largely upon the fidelity and capacity of the 

 recruiting surgeon that It becomes interesting to compare the regulations established 

 for his guidance in different, nations ; and with this view application was made, through 



tlie State Department; to the governments of Great Britain, France, Austria, Russia, 



* 



' Tha lieaVli of the Britiah arnvj, and the effect of recent sanUarij measures on its mortality and sickness, by Dr. Fahh. — 

 Journal of the Statistical Socicti/, vol. xxiv, p. 480, I^iiiuluii, 18G1. 

 -Army Medical Report fur 1870, [1.37. 



' Hccrulcnunt di: VarmiT ct piiiidalion ile la France, ir.iv h: Dr. J. C. Ceikn'ij, 4to, Paris, 1937, p. 6. 

 * On the military slaiislics nf lite Cintcd States of America, 4to, Berlin, IStiS, x'- "• 



