surgeons' reports — NEW YORK TWENTIETH DISTRICT. 271 



The inhabitants of the district are of mixed nationalities ; German, French, Irish, and Welsh 

 coustitute a considerable portion ; but, in reality, in all sections, the Yankee element i)redomiuates, 

 forming the basis or groundwork of society. The people are generally industrious and intelligent, 

 and agriculture forms their leading pursuit. The hilly character of the surface and the kind of 

 soil particularly adapt the greater part of the district to pasturage, and dairying or cheese-making 

 has long been a leading branch of industry. 



From the first draft, there was a large ratio per thousand exempt from military duty on account 

 of physical disability, because of the prevalence of valvular disease of the heart, and hepatization, 

 or carnification, of some portion of the lungs; the former almost invariably traced to previous 

 attacks of rheumatism as its cause, and the latter the result of previous attacks of pneumonia. The 

 reason why these diseases should prevail here to a considerable extent has been hinted at in a for- 

 mer section ; and in the vicinity of Lake Ontario and the Saint Lawrence Eiver, where I think them 

 most prevalent, the cold, damp, sweeping winds, which blow from those large bodies of water, may 

 be added to the causes already stated. 



In regard to the different sections of paragraph 85, Eevised Regulations of the Provost-Marshal- 

 General's Bureau, I would most respectfully suggest that the last clause of section 15, relating to 

 chronicpurulent otorrhcea, in my opinion, ought to be amended so as not to allow exemption under 

 this cause unless the disease involve destruction of the tympanum or necrosis of the bones of the 

 ear, or else so seriously affects the man's ability to perform physical labor as to leave no doubt of 

 his incapacity for military service. Many times, as the result of some one of the exanthematous 

 diseases, the membrane lining the external meatus and tympanum becomes a pus-secretiug sur- 

 face, and continues thus for a term of years without seriously affecting the health of the individual, 

 though he would be entitled to exemption as the section now stands. 



Again, in reference to section 23, " hernia.'' From my experience and observation, I am of the 

 opinion that a man may have a small or medium-sized inguinal or femoral hernia, or an epigastric 

 or hypogastric hernia, that produces so slight an embarrassment to his power to labor, or ability to 

 perform the duties of a soldier, as not to be sufiBcient cause for exemption. In support of this 

 position, I recall to memory some three or four cases that occurred during the examination of men 

 under the first draft, or the draft of the summer of 1863, when I discovered clear, unmistakable 

 hernia — all inguinal, I think — which had not been known to exist by the parties examined prior to 

 my examination, and drafted men are not apt to overlook any defect or ailment that has caused 

 them much trouble. I would suggest, therefore, that small reducible inguinal femoral, epigastric, 

 or hypogastric hernia be excepted from the causes of exemption under this section, unless the man 

 is clearly disabled thereby for the performance of military duty, and this must be established by 

 affidavits to the satisfaction of the surgeon. 



These are the only sections in the paragraph that strike me as needing any amendment. * * 



The number of men that can be physically examined per day with accuracy depends on the 

 number of hours employed. I usually was engaged in examinations during six hours per day, in 

 which time I could examine an average of sixty men. 



The frauds to be guarded against, which are practiced by drafted and enrolled men to escape 

 military service, are in part as follows: A fraudulent plea that the man is permanently physi- 

 cally disabled, from a complication of causes, among which are named dyspepsia, liver-complaint, 

 disease of the kidneys, bronchitis, and consumption of many years' standing, is I think the most 

 common pretense on which a claim for exemption is based. A pretense of hernia, supported by 

 wearing a truss, is quite common. These frauds are generally easily detected : au examination of 

 the hands of the man claiming exemption on so many general causes shows, from the hardened 

 cuticle, that he is a laboring tuan, and his general physical appearance usually negatives all his 

 statements in regard to his disability. The pretense of hernia is generally easily disposed of by 

 inviting the individual whose hernia is not detectible, to take off his truss and walk about for an 

 hour or two, so as to allow the tumor to show itself, and then to come in again. If the case is 

 fraudulent, he will not care to try this experiment, and, if he consents to it, will not return for 

 another examination ; or, to require him to establish his case by affidavits, his own among others, 

 gener.ally betrays the fraud. 



