SUKGEONS' KEPORTS PENNSYLVANIA THIRTEENTH DISTRICT. 329 



seldom called in on aecount oi earache, and the disease runs its course to suppuration unchecked; 

 attack follows attack until the hearing is seriously imi^aired. 



The ratio of chroin'e ulcers and varicose veins is niucii higher in the foreign-liorii population, 

 especially among tlie Irish, than in Americans. The cause of the huge ratio in the former may be 

 ascribed to neglect and the b.id liabit of l)od.\ induced by alcoholic; stimulants. 



Scroiuladoes not exhibit itself ofti'u as a cause of exemption, (uidess tidierculosis be consid- 

 ered as sciofula,) and in this region is generally of hereditary origin. Tiie people of the district 

 live too much in the open air and use too much wiiolesonjc food to Tunirish scrofula into existence 

 Of secondary syjihilis, the ratio is very low. 



LoHn of ticlli. — The high ratio of exemptions for this cause is in a great measure"owing to the 

 eflect of vicioris cookery, anfl pcriiajis to the general weakening of the constitution from too long- 

 continued labor; more food is taken into the stonnich than it can digest, and it is taken in a lialf- 

 masticateil form, hence disindcr of the stomach follows, and the organ fails to perform its function 

 in a thorough manner. I noted, in my last statistical report of the third draft, the relative ratio of 

 the loss of teeth in drafted and enrolled men ; there were for both upper and lower, thirty seven ; 

 for upper, one hundred and ninety-four; for lower, nine. Perhaps this may be attributed to the 

 fact that the lower teeth are more shielded from vicissitudes of temperature from their ]>osition 

 between the tongue and cheeks, and from the manner in which the air is inhaled through the open 

 mouth ; as an ultimate cause, the lower teeth are more necessary as a sheath for the tongue in 

 old age. 



InvcUrate and extensive diseaxc of the ,sMn. — The latio under this section is really very low, 

 althongh swelled to sixteen per thousand by a number of cases of disease of the skin of the 

 s(!rotum, pubcs, thighs, &t:, forming three-fourths of all exenipted. These cases were from impure 

 coition, but could not jjroperly be exemi)ted under section 10, syphilis. The disease is primary, 

 although it had existed from one to four years ; all the men had been engaged in boating, and bad 

 contracted the disease along the line of the canal. 



raragiajih 85, Revised Eegulations, is a code of instructions to the examining-surgeons of 

 boards of enrollment, so judiciously* prepared, that 1 approach the subject of suggesting amendments 

 with diftidence. If strictly caiTied out, the effect of the code is to ]irevent all able, drafted men from 

 escaping service on account cf pretended disability. In reviewing the sections of paragraph 85 in 

 their numerical oider, the first section 1 would mention for revision is_ section 3, epilepsy. The 

 evidence of its existence must in most cases be obtained from some one else than the man, ami a 

 door is thus opened for fraud. If " the testimony of a physician in good standing, who has attended 

 him in the disease within the six months immediately preceding his examination," be interpreted 

 to mean in ihefit, few ei)ileptics in the rural districts can furnish snch testimony, as physicians 

 seldom arrive in time to see him during the attack. Further, epileptics do not long continue under 

 medical treatme?it without a reliance on the promise of a cure, a promise no candid physician will 

 give. If a physician in good standing certifies under oath that he has attended the man for 

 ejiilepsy within two or three yearx before the examination, and other reliable testimony of the con- 

 tinued recurrence of the fits is produced, the decision miyht be left to the discretion of the lioard 

 of enrollment. Two cases have occurred in the presence of the surgeon of men waiting for exam- 

 ination having eiiileptic fits: one was a diafted man, who lived remote from a physician and could 

 not have produced the requisite testimony, yet ihe man was actually becoming imbecile; the 

 second case was that of a recruit, who, when examined, had asserted that he was not subject to 

 fits, yet he had a fit while clothing himself The former was exempted and the latter rejected. 



The ratio of exemjition for permanent physical disability is very high, comprising, as it does, 

 men disabled fron) various causes. Physical disabilit,'^ may exist to such ,a degree as to leave no 

 doubt of the man's incapacity for military service, and yet not he permanent ; a year or two may 

 change his condition. Although oi)ening a door for liaud, may it not be advisable that another 

 clause be added ? 



So severe a drain on the able men of the country for military service will probably never be 

 made again. If as many men should be again required, the time will be alter the population"of 

 the country shall have increased, and the men need not be culled so closely. I recommend that in 

 future drafts more should be left to the discretion au<l jinlgment of the exaniining-surgeou. 

 42 



