356 surgeons' reports MARVLANU FIFTH DISTRICT. 



beiug iiinugnrated, will this people successfully compete with the foreigner or the iikiii of the North 

 coining into the district seeking employment "I I imiigine not. 



The diseases of this section are almost exclusively miasmatic, prevailing generally in the form 

 of chronic intermittent neuralgia, diarrhcea, general debility, antemia, and the various visceral conges- 



(i^ons rarely prevailing epidemically — in the form of congestive or malignant fever. The last 



serious visitation of epidemic fever was, I believe, in 1847. 



This wide-si)read malarial influence, pervading, as it does, not only the whole of this section of 

 our district, but, perhaps, nine-tenths of our southern country, though undoubtedly inimical to 

 health, can be, in a great measure, restrained by a judicious attention to the rules of health ; that 

 the influence of this poison can be resisted in great measure by persons of good constitution 

 continually residing in the district, we have ample and constant proofs. When the laws of 

 hygiene are generally understood and respected, I do not doubt the comparative healthfulness of 

 this district. Then will it become a choice spot of our country, not excelled in climate. It is situ- 

 ated in a latitude adapted to the productions of both North and South, its waters teeming with 

 delicious food, and the laud only awaiting an intelligent husbandry to produce iu abundance the 

 choicest fruits and vegetables. 



Particular diseases or disabilities have disqualified a greater ratio per thousand from military 

 .service in this district, perhaps, than throughout our country, a condition which it will be readily 

 perceived has grown out of our late civil war. At the commencement of the rebellion many white 

 persons — young men particularly— left the district and joined the rebel army. Every part of our 

 State furnished its renegades ; but much larger numbers in proportion left the lower district as com- 

 pared with the rest of the State. So general, indeed, was the exodus that it was remarked that but 

 "few young men of respectability remained at home." Some of these young men have perished on 

 thebattle-field, many from the fatigues and privations incident to military life ; few, comi)aratively, 

 have sought their former homes, so deficient were they, from wrong nurture and education, in the 

 powers of endurance. 



Our examinations, held at Benedict, Charles County, for the convenience of the drafted men of 

 the lower district, resulted, after a careful physical examination, iu the ratio of six hundred and 

 thirty rejected per thousand, (the colored men drafted being exempted iu a ratio very little in 

 excess of the usual proportions, and this subsequent to General Birney's enlistments;) this large 

 proportion being due to the number necessarily exemi)ted under seciion 5, organic diseases of 

 internal organs; section 6, developed tuberculosis, (phthisis ;) and section 9, permanent physical 

 disability. 



1 have carefully examined the different sections of this paragraph, (85,) and find them so judi- 

 cious in general as to leave little room for suggested improvement. I would, however, venture to 

 propose as follows: "Developed tuberculosis," now numbered 6, might immediately succeed No. 4, 

 (paralysis,) and be entitled " Developed tuberculosis or phthisis.''^ It should be confirmed by 

 auscultation, and attended either by baBmoptysis or other pathognomonic signs of phthisis in 

 progress. Succeeding No. 5 as above, 1 would introduce " No. 6," " Diseases of the heart and 

 appendages such as would manifestly unfit for military service." No. 7 might then read, " Organic 

 diseases of internal organs" (except such as were embraced by Nos. 5 and 6) " which have so 

 seriously impaired the general health as to leave no doubt of unfitness for military service, and 

 which prevent the pursuit of any equally laborious occupation in civil life." Cancer and aneurism 

 would then be numbered 8, &c., &c. 



I suggest the above changes for the purpose of separating the very interesting diseases of the 

 thorax from those of the abdomen, so as to give a greater degree of precision to our statistical 

 tables of disease; and this would be obtained by requiring from the exaniiiiiiig-surgeon a greater 

 degree of exactness in his diagnosis. 



Section No. 20, "ioss of teethP — This section has already been modified, perhaps twice; 

 exemption depending at one time ou the inability to tear the cartridge, at another on inability to 

 chew the ration, and the surgeon is at present ordered not to exempt the drafted man who has not 

 lost " the front teeth, the eye-teeth, and the first molars of either jaw." The above modifications 

 are indicative of the difficulty of framing any precise rule iu tlie premises. A drafted man has 

 claimed exemption having but two teeth in the upper jaw, and these two were front incisors j 



