200 surgeons' reports — Massachusetts — third district. 



Miuter, sin-ing, and summer, when we often have cold easterly winds and storms supervening sud- 

 denly upon very mild weather. Atmospheric changes in autumn are less frequent. Notwithstand- 

 ing these apparently unfavorable conditions of climate, such is the general attention to preventive 

 and protective measures in the appointments of dwelling-houses, coniforta.ble clothing, and other 

 sanitary regulations, that it is believed the general health of the people will compare with that of 

 any community of equal population in the country. 



In regard to the general character of the inhabitants of this district, it may with jiropriety be 

 said of them that they are intelligent, industrious, thrifty, and sober, and temperate in their habits 

 and modes of life. Their occupations are those of merchants, professional men, mechanics, and 

 laborers, the two latter classes being largely represented. Very few of the adult population are 

 classilied as having no occupation. 



* * * In this district are many extensive mechanical establishments, as machine- 

 shops, founderies, India-rubber, carpet, and cordage manufactories, employing large numbers of 

 men, who, from the nature of their occupation, are peculiarly liable to the occurrence of hernia, 

 large varicose veins, chronic rheumatism, and serious injuries from accidents resulting lu per- 

 manent delormities and lameness. Another class, quite numerous in the district, are clerks in 

 mercantile houses, banks, and ofQces, many of whom, in consequence of their sedentary habits, are 

 predisposed to the occurrence of various ibrms of cachexia, usually terminating either in tuber- 

 culosis or contirmed feebleness of constitution. 



Defective teeth, or entire loss of them in one or both jaws, is a disability quite prevalent. 

 Why this defect should so generally prevail among our native population is a subject upon which 

 there is difference of opinion between authorities. Unquestionably neglect of cleanliness and use 

 of deleterious preparations, falsely claimed as the " best teeth cleansers," are instrumental in depriv- 

 ing our people of these important and useful appendages to the animal economy. These disabili- 

 ties add largely to the percentage of disqualifications for military service. 



* * * The different sections of paragraph 85, Eevised llegidations, Provost- 

 Marshal-Geueral's Bureau, iu my opinion cannot be further restricted or modified unless with a 

 certainty of impairing the efficiency of the Army for active field-operations. In carefully examin- 

 ing those sections of paragraph 85 which refer to other than positive disqualifications, such as 

 epilepsy, hernia, &c., 1 do not see one that should be dispensed with. 1 have found them invalu- 

 able as a guide iu the discharge of the duties devolving upon me. The proper application of the 

 difl'erent sections depends upon the accuracy of judgment of the examining-surgeon iu estimating 

 the degree of disability arising from a given cause. Perversities of human nature which lead men 

 to attempt deception cannot be foiled by any formal regulation, but must be met by the tact and 

 experience of the surgeon. 



* * * If the i^rescribed regulations for examining men are strictly observed, 

 I think, the maximum number of drafted men that can be carefully examined by one surgeon is 

 fifty per day. Much time is necessarily occupied in listening to their statements, and in examin- 

 ing certificates of physicians. Especially is this the case with those who endeavor to procure ex- 

 emption for causes which are not clearly manifested. It is important that the surgeon should 

 devote a reasonable portion of time to each man, that none may have cause to complain of not 

 being allowed opportunity to state a claim for exemption, or of not being carefully examined. 



* * * Many drafted and enrolled men exaggerate the effects of previous 

 attacks of disease, old fractures and injuries, or claim that they are afflicted with obscure diseases 

 of various organs, as the kidneys, liver, lungs, &c., requiring patient investigation, and all the tact 

 and shrewdness of the surgeon that he may not be deceived. A frequent claim for cxemi)tion is 

 impaired vision, for which with drafted and enrolled men (iu doubtful cases) no satisf;ictory test of 

 the degree of impairment has as yet been devised. If a man is determined he will not see, it is 

 impossible to make him do so. We cannot retain drafted and enrolled men under observation, as 

 the regimental or hospital surgeon does the soldier whoiu he suspects to be a malingerer; conse- 

 quently we gain nothing iu these cases by applying the usual tests of vision. The surgeon must 

 decide such claims for exemption almost irrespective of any test he may be able to apply. In this 

 district there were honorable exceptions among drafted and enrolled men, who did not claim ex- 

 emption by reason of disability or other cause, but, if declared fit for service, met the requirements 



