surgeons' reports PENNSYLVANIA TENTH DISTRICT. 315 



as the coal is found in layers which have tilted np at the sides by the forces beneath the surface 

 unti] they often stand almost perpendicuhirly, it will be easily understood that the process of coal mining 

 here must be peculiarly dangerous, from the liability of fre(|nent falls of the superineiiiidieiit eaith 

 and coal. In addition to this, the vitiation of atmosjiheric air in the mines fnim the respiration of 

 the workmen, the combustion of lamps, explosions of powder, the spontaneous decomposition of 

 minerals, (as the change of suli)lHiret of iron into snlithate,) the decay of the timbers wliic^h prop the 

 sides or roof, and the diseugagenient of noxious gases which accumulate in the workings, render 

 the business a very hazardous one. 



The last item alluded to is the frequent cause of surgical accidents. I allude to the ex|)losion 

 or buining of carbureted hydrogen-gas, called also fire-damp or inflammable air. This gas has a 

 specific gravity of about 0.558, and, being readily ignited, burns with a pale flame, though with a 

 more intense light than hydrogen. Mixed with atmospheric air, even in the proportion of one- 

 twelfth the part of air, it becomes highly explosive, so that the slightest inadvertency in using the 

 miner's lamp may result in wide-s[)read destruction, both from the direct influence of the fire and 

 liom the crash of falling timbers, wagons, coal, and earth. After the explosion of this gas, also, a 

 mixture of carbouic-acid gas and nitrogen remains behind, making it dangerous to enter the mine 

 for some time. Occasionally inexperienced persons thus perish by suffocation. 



Besides these causes of injury, our country is covered with a net-work of railroads for the 

 transportation of coal, so that we have here probttbly the best school for practical surgery to be 

 found in the United States. 



From the above account, it will be seen that many causes exist to produce peculiar diseases 

 and disabilities, disqualifying a greater ratio per thousand from military service than in most dis- 

 tricts out of the mining-region. , 



A brief classification may not be inappropriate : 1. Burns, either from fire damp or explosions 

 of powder, resulting in deformities, loss of sight, &c. ; 2. Injuries requiring amputation ; 3. Other 

 injuries arisir.g from accidents in the mines and railroads, resulting in deformities, injuries of 

 the eyes, &c. 



Peculiar diseases are caused by working in bad air, producing a depravation of the blood, 

 causing debility of the whole nervous system, and thereby disordering the functions of respiration, 

 circulation, nutrition, &c. Persons suffering under these affections experience a great variety of 

 nervous sensations — ])alpitation, dyspnoea, neuialgic pain, horripilation, formication, loss of all 

 energy, and a habit of dwelling ui)on their moibid sensations; there is a dull leaden or bluish- 

 white color of the face, which marks the toxtemic condition of the blood. Persons thus affected 

 go about, sometimes work irregularly, luit are for the uiost part useless to their families and a 

 burden to themselves. This class, having no organic lesion, must be exempt under section 9 of 

 paragraph 85, as they are totally unfit for military duty. 



The list of disabilities comj^rised in paragraph 85, lievised Eegulatious, for the government of 

 the examining-surgeon, is, in my opinion, as nearly perfect as the nature of the subject will admit, 

 with the exception of section 20. 



There are many cases of defective teeth, in which the individual is unable properly to masticate 

 his food, aud yet has not lost all the " front, eye, and first molars," even of one jaw. I think some 

 latitude should be allowed the examining-surgeon, and that he should not be required to send a 

 man into military service unless he is fit and able to render the Governmeut the service required. 



We are told, in paragrapli 91, that examining-surgeons will bear in mind that the object of the 

 Government is to secure the services of men who are effective, able-bodied, sober, aud free from 

 disqualifying diseases; and yet we aie bound by a set of arbitrary rules, in which very little dis- 

 cretion is allowed. The man must come under some one of the rules there laid down, or we are not 

 permitted to exempt him, although we maybe satisfied that he will never make a good soldier. 

 I know the difficulties which surround the subject, and 1 would not recommend any other alteration, 

 unless Government could secure always perfectly reliable examining-surgeons. 



The number of men that can be physically examined per day with accuracy depends a good 

 deal on the class of persons to be examined. In one case, the whole examiuation may not require 

 more thau five minutes, while another will occupy fifteen. In one, it will take two minutes to strip, 

 in another five or ten ; but, as a general thing, I think an examining-surgeon ought not to be required 



