204 surgeons' reports — Massachusetts — fourth district. 



leiirn from Mr. Ai)i)olonio, our able and well-skilled city registrar, that the death-rate in these same 

 parts is fearful, and quite equal to any in the worst jwrtions of New Tork City. For 1863 the pro- 

 portion of exeiuptious from these causes in one thousand men was 86.72. Taking the whole period 

 of the board's existence, we find 90.33 per thousand, or 9.63 per cent. ; in other words, one third 

 more than the average of the State for 1863, and a still higher proportion for the whole period. 



Chronic rheumatisni. — The ratio per thousand of exemptions in this district from rheumatism 

 (which I never allowed as a cause for exemption except under the fullest proof) has been large. I 

 know of nothiug to cause this, except the exposure to northern and easterly winds and the hy- 

 gienic influences already described. Table 5 makes the proportion for all the States reported from 

 only i.GT per thousand ; for Massachusetts, 8.01. For this district in 1863 it was 21.69, and for the 

 whole time, 21.10 per thousand. Whole number exempted for this disability was thirty-eight. 



Partial loss of the sight of both eyes, serious permanent disease of the eyes or eyelids. — Although 

 jii this district the number exempted for these causes falls far below the average of the States gener- 

 ally, and of Massachusetts, the returns, compared as per table below, become interesting. For 1863 

 we exempted only 4.32 per thousand. For the whole period of service of the board, 8.45 was the pro- 

 portion ; whereas, for 1863, it was, for all the States reported on, 12.45, and for Massachusetts at 

 large, 18.30 per thousand. From Table 5, Provost Marshal-General's report, I make the following 

 table : 



Table shoicing the number of men per thousand exempted for the above disabilities. 



Maine 14. 54 



New Hampshire 15. 48 



Vermont 8. 04 



Massachusetts IS. 36 



Ehode Island 14. 64 



Connecticut 13. 87 



New York 14. 54 



Michigan 12. 64 



•Total average - 14. 01 



Pennsylvania 8. 55 



Delaware 8. 28 



Maryland 7. 05 



District of Columbia _ 8. 62 



Wisconsin 7. 68 



Total average 8. 03 



Is there any reason why this difference should exist ? It would seem that this disability would 

 be more likely to exist where reading and printing were most flourishing ; and, on the contrary, 

 where heavy mechanical and out-of-door pursuits were carried on, there would be less of the same 

 disability. Whether the former part of this statement may be predicated of those States in the 

 first half of the table, and the latter of it be applicable to the latter half of the table, I leave 

 others to judge. The curious exception of Vermont to the usual average is remarkable, while it is 

 equally strange that in exemptions from hernia, an affection peculiarly liable to occur in a labor- 

 ing community, Vermont goes vastly ahead of the average from the States, and still more in 

 advance of all its sister New England States, save Maine. 



Loss of teeth. — We exempted for this cause much more than the average, as will be seen by the 

 following statement; 



Esemi)tioiis i)er thousand from all the States noted , 20. 55 



Exemptions per thousand from Massachusetts 33. 19 



Exemptions per thousand from fourth district Massachusetts, (1803) 59. 09 



Exemptions per thousand from fourth district Massachusetts, (whole time) GO. 28 



