surgeons' reports PENNSYLVANIA TWELFTH DISTRICT. 323 



oi)portiinity to breatlio the pure air. The affections of the heart and kidneys are tlie result gen- 

 erally of rheumatic affections. 



TIkmc has been the largest ratio per thousand exempted for hernia, (section 26 of paragraph 

 85, Eevised Kegulatioiis.) This is owing to the laborious habits of the people. Heavy lifting and 

 overexertion Lave produced a large majority of these affections. Second in the list is section 32, 

 [)aragraph 85, which refers to fractures, dislocations, diseases of bones, &c., which are occasioned 

 by the many accidents in the mines. Third in the list is the loss of tieth, section 20, paragraph 85. 

 This is accounted for by the inordinate fear entertained by a large class of people of entering the 

 military service. It is a humiliating fact that there are American citizens who would rather 

 mutilate themselves in such a manner as to render a recovery impossible than to render assistance 

 of any kind to their country. And this section has been a favorite for many such. I believe that 

 ouehalf of those who have been exempted under this section had their teeth extracted for the sole 

 purpose of escaping the draft. In many cases, men have presented themselves for examination, whose 

 gums were yet unhealed. A large proportion of these were young men in the vigt)r of manhood, and 

 many of them the sons of rich men. I mention this to show to what deeds certain political teach- 

 ings will lead men. 



There could be a few changes in paragraph 85 of the Eevised Regulations, which, in my 

 opinion, would be advantageous to all parties concerned. Section 3, which refers to cases of 

 epilepsy, requires the affidavit of a physician in good standing who has attended the man in the 

 disease during or within six months immediately preceding his examination by the board. This is 

 impracticable, as a majority of the confirmed epileptics in this section seldom call for medical aid, 

 and, should a physician be called in the rural districts, the distance is so great that he seldom 

 arrives in time to witness the paroxysm. In most cases of confirmed epilepsy, there is a certain 

 indescribable expression of countenance, which is readily discovered by the surgeon. This, in con- 

 nection with the evidence of good citizens fi'om his immediate neighborhood who have seen him 

 during one or more paroxysms at a recent date, should be sufiBcieut to discharge the man. 



Section 20, relating ro defective teeth, should be stricken from the list of exemptions. Section 

 23 should l)e so moditied as to exempt only c tses of eonfirmed ovaggravated\wgm\iA\ hernia. * * • 



I iiave examiued, ou a few occasions, one hundred and fifty men per day. They were volun- 

 teers, and did not require as much time as drafted men. Men who have always considered them- 

 selves healthy .snddenly discover, after being drafted, that they are afflicted with some fearful 

 malady, and are not satisfied with an examination unless considerable time is spent with them, and 

 all the motions gone through with. To do this, sixty men per day are as many as one man can 

 examine. With volunteers, it is not necessary to consume so much time. The general appearance 

 of the man is sufficient to satisfy the surgeon whether any serious disease of the internal organs 

 exists. If he is well-[)roportioned, witli health written on every feature, it is only necessary to 

 ascertain whether any injuries or local disease exist which would disqualify him for the militiiry 

 service. The surgeon could satisfy himself just as readily in the case of a drafted man, but he 

 would fail to satisfy the man that sufficient attention had been paid him, and I consider it highly 

 proper for the agent of the Government to pay respect to the wishes of the people. A draft is 

 more or less repugnant to all classes, bnt the rough corners can be taken off; and it may be made 

 more palatable to the conscripts if the officers listen patiently to their claims, and succeed in satis- 

 fying them that they have the full benefit of the law. 



The frauds practiced by drafted and enrolled men and by volunteers and substitutes are so 

 numerous that the surgeon soon comes to look upon every man appearing for examination with 

 suspicion. With drafted and enrolled men, hernia has been a favorite claim, and to prove its 

 existence they i)resent themselves with a truss well fitted, and claim to have worn it for years. 

 The closest examination fails to discover the defect, but often develops the fact that the truss has 

 Iteen borrowed for the occasion. Others mutilate themselves by creating ulcers ou the lower 

 extremities, which have the appearance of varicose ulcerations, and it is sometimes difficult in these 

 cases to detect the fraud. Some use irritating ointments on the eyelids to produce the appearance 

 of chronic conjunctivitis, or about the anus to produce prolapsus ani or haemorrhoids. These 

 cases are easily detected. Many present themselves covered with strengthening plasters, claiming 



