SUEGEONS' REPORTS — NEW YORK — EIGHTH DISTRICT. 249 



form of tubercnlosis, aud as section 10 embraces scrofula, I suggest tbe additiou of tbc words " of 

 the luugs." Section 5, however, covers the grouud. 



Section 8. " What skiu-disease, and what amount of it, necessarily totally incapacitates from 

 service?" Very few, I suspect. Eczema might, if severe and extensive; itch would; lepra and 

 psoriasis would not. Would not the wording of section 10, thus, " Scrofulous or secondary sypliilitic 

 cachexia, which," &c., be better? At present, it is difUcult to say what amount of scrofula or 

 secondary syphilis suffices to exempt or reject ; but scrofulous or syphilitic cachexia is apparent, 

 even to a bystander. 



Section 11. Lumbago, which I shall call here neuralgic (muscular) rheumatism, is by the people 

 invariably considered as disease of the kidney. There is such a thing as chronic sciatic lumbago 

 embitteriTig life. 1 suggest that the section read, " Neuralgia, not organic or excessive; chronic 

 rheumatism," &c. 



Section 20. I would read, "Total loss, for all useful purposes of mastication, of all, or of eight 

 consecutive, front teeth in either jaw." * « # 



Section 22. Caries of the S2)iuc, if marked, is always of scrofulous origin, causes deformity, and 

 may be progressing. It must, anyhow, produce disability; and I suggest that the words "attended 

 with ulceration" be omitted. This disease, as well as fistula in ano, seems to me to demand exemp- 

 tion without qualification ; so, also, do some cases of real external hmnorrhoids, the distress and 

 disability from which often equal or excel those from strictly internal ones, as I know from my own 

 observation in several cases. Many cases of apparent external haemorrhoids are returnable by 

 pressure within the sphincter, and mistakes may thus arise. 



Section 27. Permanent organic stricture, admitting the passage of only a small bougie, and 

 not necessarily incurable, would, it seems to me, justify exemption. The condition specified in 

 section 27 is scarcely compatible with existence, and of rare occurrence. 



Section 32. For "iirevent" say "impede." 



Section 33. I should read, " Permanent contraction or extension of all or any two fingers of 

 either handP "What can a man do as a soldier if two of the fingers of his left hand arc" disabled? 



Section 35. Varicose 'veins, if large and numerous, and accomiyanied icith chronic dwellings or 

 M/cerrt^<07i of the legs, are so rare that I should read "or accompanied" for "and accompanied;" 

 otherwise, very few would be exempted under the section. By no other cause are so many good 

 men really disqualified from service as by this. Moderate varicosity need not exempt from the 

 duties of the reserved corj^s; and a recruit in whom the varicosity is simple, even if it be numerous 

 and large, but unattended with erythema, ulcerations, or cicatrices of ulceration, and who denies 

 suft'ering any iucouvenience, ought, in my opinion, to be accepted, and not allowed afterward to 

 shirk from his duty. Hundreds of men perform the daily laborious duties of life with varicose veins, 

 and suffer from them little or no inconvenience. It is only the enrolled man, desirous of avoiding 

 the draft, too unpatriotic to serve in person and too parsimonious to procure a substitute, that com- 

 plains of them. I would be glad to have this subject reconsidered and the law defined. 



I conclude my remarks on the sections of paragraph S5 by saying that I think excessive obesity, 

 or a weight of over 200 pounds, is a sufficient cause for exemption ; -also, that no lad should be held 

 or enlisted (and juany are presented as recruits) unless he be over 18 years of age, weighing over 

 110 pounds, measuring at least 30 inciies in circumference of chest, standing at least 5 feet 3 

 iuclies, of good muscular development, and exhibiting manifest signs ofimhcrty. Many such prove 

 to be efficient soldiers ; more so than even larger adults. I do not, therefoi'e, coincide in the eighty- 

 sixth section of i)aragraph 85. * * * 



As regards re-examination at rendezvous-camp, I beg to say that I think it would be more just 

 toward the surgeon who enlists the men, and facilitate his exculpation when complaint is made, if 

 he were to be informed ivhat was the supposed disqualification which, in the letter from Washing- 

 ton, it is assumed that he has overlooked for want of sutiicient care. At the same time, in the 

 hurry of business, such inadvertence is very likely to occur, and should, I think, be leniently dealt 

 with, unless often repeated. * * * 



I would advise that the filling up of a ^'■Formfor examining recruits," for each man enlisted, be 

 made obligatory on the surgeons, and kept on file in the office. No better guide to, or record of, 

 accuracy could be desired. * » * 



