surgeons' reports PENNSYLVANIA SEVENTEENTH DISTRICT. 341 



ccptible ninimer iiniwiicd, niid there is no duty of tbe soldier tliat could not be readily perronued 

 by tlieiD. * * # 



In exniuiiKitious of driifted nu'u, with a full day's work ou hand, there is necessarily consid- 

 erable noise made by walliing- through the looiu, jnoniiseuous talking, and by examination of 

 aliens and others who claim exemption Irom causes indei)endent of physical disability. This pro- 

 duces difrtculty in detennining the fitness or unfitness of men when dose discrimination is required 

 to distinguish the normal from the abnormal-sounds of resiiiration, or to anal\zt' the diflerent 

 abnormal sounds of the heart. On these occasions, my nnilorm practice was to hold doubtful cases 

 over until the regular business of the day was disposed of, and then, when the room was completely 

 quiet, I reexamined them. I would here suggest the propriety of ordering the district provost- 

 marshals, shoidd another draft ever be required, to purchase a cheap (luality of carpet or niatt'ng 

 to lay upon the oftice floor, t9 prevent the noise occasioned by tramping about, which is tinavoid- 

 able when a number of men are in the same apartment. The cost would be nothing compared with 

 the great advantage residting from the expenditure. 



The number of men a surgeon can examine per day with accuracy varies much under different 

 circumstances. A surgeon accustomed to the work can examine twice the number per day that 

 one who is not familiar with the routine will, and he will decide too with more accuracy. When 

 there is a run of gooil sound men, whether volunteers, substiuUes, or couscrijjts, examinations can 

 be made with more facility than when the reverse obtains. One who has become familiar with the 

 duties of the office can, without an assistant, examine eighty men per day, and not feel that he is 

 imposed upon. 1 did myself the whole duty required of suigeou of the boar<l until the third draft 

 was ordered, when Dr. Crawford Irvin, of HoUidaysburgh, was a[)poiuted assistant, from whom I 

 derived much valuable aid. 



The frauds resorted to by enrolled and drafted men to escape service are, in onr experience, 

 very uumerous. Every species of falsehood and misrepresentation is indulged iu to feign disease 

 where none exists. Kheumafisin, "weak back," "stitch in the side,'' hiiemorrhoids, lameness from 

 old fractures, old sprains, loss of sight of one or both eyes, disease of the heart, consumption, hai- 

 niorrhage from the lungs, disease of the kidneys, ankylosed joints, and deafness, do not comi)rise 

 even the tithe of diseases feigned by those who wish to escape service. The loss of sight of the right 

 eye is claimed very often without cause. During the first draft, conscripts frequently came with 

 the pupil so dilated that the eye presented the appearance of oiganic change. After exempting 

 several who came first with this disability, I suspected fraud. We arrested two from one sub-dis- 

 trict, and had them properly brought before the board. I re-examined them, found the eyes of 

 both to be sound, and held both to service. They paid comnuitation and were dismissed. Within 

 one year afterward, one of these men enlisted for a, bounty, and entered the service with a pair of 

 sound eyes. I had reason often afterward to suspect tlie application of belladonna to the eye. 

 Under these circumstances, we examined the pockets of the man, and placed him rigidly under 

 guard until the nature of the case was clearly revealed. Irritating substances, such as sand or 

 dirt, are sometimes throvvu into tbe eyes by conscri[>ts for the purpose of producing conjunctivitis 

 preparatory to examination. When a man claims exemption from total loss of sight of right eye, 

 if I can see no evidence of disease, before I decide his case, I close the left eye perfectly, quietly 

 stand a little to one side, and order him, in a peremi)tory manner and sharp tone, to " Look at me;" 

 if the sight is totally gone, the right eye is motionless, but if any sight remains, before he is aware, 

 the eye involuntarily turns with its axis toward uie, which satisfies me that he is attempting decep- 

 tion. I will here state that I have never used the ophthalmoscope to explore the eye. 



Men frequently purge themselves preparatory to examination with aloes and other drastic arti- 

 cles to bring on haemorrhoids. These cases are generally detected by an erythematous discoloration 

 of the skin, radiating from the anus to the distance of one, two, or three inches, connected with 

 alternate contraction and relaxation of the sphincter ani. A great many men, otherwise sound, 

 have had all the teeth extracted from the upper jaw. A considerable j)roportion of tliese, 1 have 

 no doubt, resorted to extraction to avoid service. Some came with gums lacerated and swollen 

 from having had the teeth removed within a few days of examination, while others had their teetli 

 removed perhaps several mouths previous. When we had reason to suspect that drafted meu had 



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