318 surgeons' EEPORTS^PENNSYLVANIA ELEVENTH DISTRICT. 



I am asked my A-iews with reference to the differeut sections of paragraph 85, Revised Regnhv 

 tions ProvostiMarshalGeneral's Bureau, and what changes I wouhl recommend. I would prefer to 

 have these points discussed by some one more competent and experienced. It is a delicate matter 

 to criticise the work of men whose ability far exceeds that of the critic, and 1 should be pleased to 

 keep silent on this sulyect were it not contrary to my instructions. 



As a whole, the ditferent causes for exemption, as laid down in paragraph 85, are just and 

 equitable. But, as I am allowed the privilege, I would respectfully suggest the propriety of a modi- 

 fication in the requirements to establish the existence of the disqualification mentioned in the third 

 section of said i)iiragraph. Epilepsy, or the tact of its existence, is to be established "by the duly- 

 attested affidavit of a physician in good standing who has attended" the applicant for exeraptiou 

 " in the disease within the six months immediately preceding his examination by the board." In 

 the rural districts, and especially in the sparsely-inhabited regions of the mountainous sections of 

 such countries as those composing our enrollment-district, where the allotted field of labor of a 

 physician generally has an extent of territory ranging from ten to twenty miles in length and as 

 many in breadth, where some families have Irom five to ten miles of the most execrable roads to 

 traverse in order to reach a physician, it is almost impossible to procure the evidence required by 

 this section. Numerous cases coming under my personal observation in my practice have con- 

 vinced me of the difficulties connected with the fulflllinent of these requirements. Very frequently 

 liave I been called u]>on to administer relief to an unfortunate patient sufi'ering with a fit of epilepsy, 

 only a few miles from my residence, in a neighborhood more thickly inhabited than the generality 

 of the district, and before I could reach the tield of operations my patient had struggled through 

 his fit ; and the fact that he was completely exhausted and unnerved would not authorize me to 

 sicear that he had undergone a fit of epilepsy, though the symptoms still ap[)arent might lead me 

 to helieve such to have been the case. But in many of the more thinly-settled localities, among the 

 mountains of the northern part of this district, the sufferer can completely recover from a severe fit 

 of this nature before the physician can reach the abode of his patient. This is such a usual occur- 

 rence that in eight cases out of ten the family in which such visitations occur frequently, becoming 

 familiar with the disease and the remedies usually applied, scarcely think of sending for a physi- 

 cian, knowing that the victim will recover or die before medical assistance can possibly arrive. 

 Hence the great difficulty in establishing the fact of the existence of this disability by the testi- 

 mony of an attending physician in numerous cases. The only testimony which can be procured 

 in many instances is that of the members of the same family, or those of their neighbors who may 

 be called upon or be accidentally present on such occasions. » * » 



The prescribed method of examining men if carefully followed will enable a surgeon to examine 

 not more than seventy-five men a day, if he should work as we did in this office, namely, from seven 

 o'clock in the morning until night, and supposing him to meet with no difficult subjects to occupy 

 his time beyond the average period necessary for the examination of ordinary cases. 



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

 volunteers and substitutes, are many, and as varions in their forms as they are numerous. To 

 describe all of these in detail would alone make an extensive history. I will therefore mention but 

 a few of the most common tricks practiced by a certain class of persons, who, during the rebellion, 

 made this species of fraud and subterfuge a profession. * * * I remember one case 



in which I was deceived by a person who was afflicted with that disgusting disease otorrhoea. 

 This man presented himself before the board for examination, and I soon detected the existence of 

 thedisease, and at once rejected him. He left the office, and, at the suggestion of his associates, he 

 trimmed his hair and beard, thoroughly cleansed his ear, donned another dress, and, with the aid of 

 perfumeries, &c., completely changed his appearance, as well as disguised the peculiar scent which 

 usually accompanies this disease. Watching an opportunity, he managed, disguised and purified 

 as he was, to present himself before the board the second time, among a large number who were 

 pressing into the room, during a very busy season, and I accepted him. Persons with venereal 

 disease, unless very carefully examined, will at times, in certain stages of the dise§se, succeed in 

 disguising it liy a discharge of urine and the use of injections previous to examination. I have 

 detected numerous cases of the kind. 



Another dangerous practice resorted to is this: A certain person, whom for convenience we 



