surgeons' reports — MASSACHUSETTS — FOURTH DISTRICT. 205 



To exi)liii)i tliis fiict tliere are several reasons. In the early reriods of tbe drafting it was con- 

 sidered tliat a uian unable to "tear a cartridge" should be exempted. Hence, I have no doubt 

 that men were often exempted who would, later, Lave been held to service. But this will not 

 explain the difficulty, because I find that, although I really examined afterward with great care, 

 and am not aware of exempting any save those who were totally unfit to be soldiers from want of 

 teeth sufficient even for mastication, yet I find that during 1864 I exempted in the proportion of 

 60.27 per thousand, or about in the same proportion as at the previous time. 



I would suggest the following as perhaps explaining in part, at least, these proportions: 

 («) The average- age of our exempted men was 35 years ; whereas, according to Table 20, (Pro- 

 vost-Marshal-General's report,) the average age in sixty-two districts was 30.59 years. 



(b) The hygienic conditions named as characteristic of our climate. 



(c) At a meeting of the Suttbliv District Medical Society, it was stated by respectable dentists 

 that the large number of irresponsible and unscrupulous dentists was producing a very deleterious 

 influence in persuading many persons to have imperfect teeth extracted in order that the dentists 

 migiit themselves liave business. How far this cause may have any influence, or whether it has 

 any, I cannot say. 



Hernia.— This cause of exemption rated higher than in the districts in general, and in Massa- 

 chusetts as a State. The proportions are as follows : For 1863, 53.72 per thousand were exempted- 

 for the whole time, 08.73 per thousand were exempted in our district ; while in the States gen- 

 erally, and in Massachusetts alone in 1863, we have 30.93 and 26.35 respectively, or about twice as 

 many in our district as elsewhere. The only explanation to be suggested is the laboring and 

 mechanical kinds of work performed by our citizens. I am quite sure no one was exempted unless 

 on the fullest proof of the existence of the difiBculty. In 1804 the varieties of hernia ran as fol- 

 lows : Eight inguinal and scrotal hernia occurred thirty-three times to eighteen of the left side, 

 and one umbilical. 



" The general character of the inhalitants of the district.'''' Some idea has been given of the 

 proper answer to this part of the question when alluding to the ill-ventilated workshops and the 

 crowded residences of the northern wards of Boston. We have many foreigners resident there • in 

 East Boston they are chiefly Irish. The American element prevails at Cambridge and Chelsea, but 

 a very large number of the male inhabitants of both of these places daily come to the city to 

 engage in their various employments, and return to their suburban homes at night. # • * 



Under the various sections of paragraph 85, we have been able to range all the disabilities we 

 have met with. # # # Section 5 should be divided and classified into the various 



heads appropriate for the various diseases. The fact that a certain number are exempted for acute 

 or chronic diseases of the various organs in the three cavities, or of the extremities, may be of 

 value, but of very little scientific importance, compared with what might be obtained by classifi- 

 cation. All these defects in the paragraph would, however, be obviated if accurately prepared 

 tables should, vhen any future draft occurs, be sent out early to the various district surgeons, in 

 accordance with which they should be directed to make up their returns; this plan, thoughtfully 

 jjrepared, should be steadily adhered to during the various drafts. 



With such a plan, and if a corps of able surgeons faithfully performed their task of examina- 

 tion, very curious results might be obtained. Statistics bearing npon the actual state of health in 

 any community are of great value, and by them perhaps some additional knowledge of the causes 

 of disease might be obtained. * * » 



" The number of men that can be physically examined per day with acetiracy.^ 



It is difficult to answer this question accurately. The undressing and examination of any 

 single man would occupy at least 7 or 8 minutes. If examined in squads of three or four at a 

 time, who can, of course, go through the prescribed motions all at the same moment, the time 

 would be somewhat lessened. This lessening of time is not so much as one would suppose, for 

 I am obliged to look at each person and observe how he performs his work, and I must auscult 

 his chest, examine his eyes, teeth, ears, abdomen, &c., &c. Five minutes is, therefore, the least 

 possible amount of time that ought to be given to the thorough examination of each man. Hence 

 we could examine 12 in one hour, or 00 persons between 9 a. m. and 2 p. m. This was the usual 

 time of session of this board. It could not be longer and do all other necessary duties in reference 



