surgeons' reports MARYLAND FIFTH DISTRICT. 357 



another huviiis but tbe two eye-teeth leinaiiiiiiij;-. A strict observauce of section 20, i)aragraph 85, 

 would liiihl these men to military service, though manifestly unserviceable when enlisted. 



Los« of teeth usually indicates ill-health, whether congenital or acquired. Should the health 

 be delicate during dentition, tbe teeth evolved are frail and disposed to decay: or sliotdd any pro- 

 tracted disease impair the digestion or the general health, loss of teeth is often the result. Such 

 cases constitute the majority of those claiming exemption on account of loss of teeth ; but their 

 general i)liysieal condition will become the ground of tbe surgeon's verdict. In other cases, in 

 which the health is not seriously impaired, if it be determined to leave but little to the discretion 

 of the surgeon, it might be ordered that no raan should be exempted Laving six teeth — molars par- 

 ticularly — three above and three below, in coaptation, so as to enable him to triturate bis food in a 

 proper manner. 



Section 23, Hernia. — This section, I would propose, should read as follows : " Hernia. — Irre- 

 ducible hernia, double inguinal, femoral, and ventral hernia shall exempt. Eeducible inguinal 

 hernia and ventral hernia, which can be restrained by a well-fitting and suitable truss, shall not 

 exempt." In tbe concluding portion of section 5 of the i)aragraph already quoted, we are required 

 not to exempt " excei)t where there is no doubt of bis incapacity for military service, and which 

 l)revents his pursuing any equally laborious occupation in civil life." Very many persons with 

 rupture are observed not to be hindered in their occupation, even when of a laborious character. 

 Circus riders and performers, many of whom become rui)tured by the athletic exertions which they 

 are. required to make, nevertheless continue their profession, protected by a well-adjusted truss. 



Tbe number of men that can be physically examined per day with accuracy cannot, I believe, be 

 above sixty. Indeed, without an assistant, fifty would be found enough. Tbe duties of tbe surgeon 

 of the board are multifarious ; physical examinations being but a part of his functions. Questions of 

 age, involving tbe authenticity of family-records, inental disease, and in many cases long medical 

 certificates, consume considerable time. The minute physical examinations, and long and particu- 

 lar descriptive records now required by the department, being of necessity made at the moment, 

 though dictated to a clerk, cause considerable detention. It would manifestly be imi^ossible to 

 comply with tbe order on file requiring the examination of one hundred and twenty per day. 



Frauds to be guarded against. — Since the enactment of the law for the admission of the colored race 

 info military service, the proportionate number endeavoring to obtain exemption by fraud or feigned 

 disease has greatly increased. Uneducated, but of ready cunning, it is of interest to notice their 

 consummate acting, and the ingenuity of their defense when narrowly questioned and particularly 

 examined. 



The white man attempting fraud or feigning disease, when, after examination, taxed with 

 deception, yields the matter at once. The negro persists, and sometimes succeeds in bis imposition. 

 Of all affections, chronic rheumatism is most frequently feigned or exaggerated, especially by 

 the negro. Weakness in the back, tbe alleged result of rheumatism or of injury, or rheumatic pains 

 in the knees or ankles, are the most common localities of complaint. The excellent directions, 

 however, given in this section of iiaragraph 85 for the government of tbe surgeon renders the course 

 to be pursued perfectly clear, so that these cases, though numerous, are easily decided. 



Chronic diseases of the joints, the effects of dislocation or sprains, feigned by both white and 

 colored, are olten claimed as giving a title to exemption, owing to permanent lameness therefrom. 

 A thorough examiniitiou, and watching when not on their guard, generally leads to a correct 

 decision. 



Two cases of pretended hernia, both drafted and both colored, and coming from the same 

 neighborhood, one, no doubt, prompting the other, came before me the day after our examination 

 commenced, when tbe room aiul passage were crowded by persons impatiently waiting their turn. 

 These two bad correctly applied well-worn trusses, and so well did they enact their part that they 

 were exempted. The fraud was soon after discovered by testimony, and they were sent to camp. 

 This led to the adoption of a rule, either to require a sensible proof of the iuiirmity, or the affidavit 

 of a physician in good standing, or other very reliable testimony, never admitting the mere statement 

 of the drafted man. When a truss is well adjusted and carefully confiued to its place, tbe escape of 

 tbe bowels may be very effectually prevented, and a length of time, even twenty-four months, may 

 sometimes elapse without its protrusion. In these cases, tbe patieut may determiuately and perhaps 



