364 surgeons' reports — Kentucky — first district. 



The next iu frequency was to claim the existence of stricture of the urethra ; and when the test 

 was proposed of the introduction of a metallic catheter, it was in most cases waived or declined, uo 

 further effort being made on that point by the party ; the next, a bad form of haemorrhoids, or 

 pretended tistula in ano, which nearly always, on examination, turned out imaginary or feigned. 



In some instances, the existence of stone in the bladder was alleged, but by the proposed im- 

 mediate use of the soiud, the difficulty was quickly disposed of. The frauds that recruits endeav- 

 ored to perpetrate who had had pressuie applied to them to make them unwilling to enlist, or from 

 their own aversion, were the same as those of drafted men. On the other hand, recruits and sub- 

 stitutes, being desirous of enlisting, would, when necessary, resort to the concealment of hernia as 

 far as practicable, and attempt to deceive iu regard to age, both the under and over age, represent- 

 ing themselves withiu the limits of exclusion. The frauds that engaged the legal attention of the 

 board were those attempted by men who, learning that they were enrolled or drafted, would get 

 withiu the rebel lines to be conscripted by them, and those who, on learning the same, would be- 

 come guerrillas lor a while. Both classes, on reporting to the office, would, present the plea that 

 they were rebel deserters. 



The records of the office show that the diseases classed uuder section 5, organic diseases of the 

 internal organs, have disqualified the greatest ratio per thousand from military service. It is known 

 that diseases of internal organs are divided into organic and functional. Many of the latter do 

 not exist to a degree that would disqualify from military service ; but there are others that do, and 

 they were classed with organic diseases of necessity, as there was no other section to receive them 

 so appropriately. # * * 



The people of the United States, possessing as they do a fine physique, active temperament, 

 and great powers of endurance, including their familiarity with fire-arms and horsemanship, may 

 be successfully compared with any nationality, and held as superior to any other in their aptitude 

 for military service. 



Of the physical qualifications of the colored race, judging from what J have seen of them during 

 the exercise of the duties of the office, I would say, as far as i)hysical qualificatious are concerned, 

 their well-developed muscles, particularly of the superior extremities and chest — probably the 

 result of continual physical labor — in connection with their powers of enduring fatigue, heat, and 

 malaria, eutitle them to be estimated as well suited for military service. 



In regard to the operations of the enrollment-law, I can only say, as far as my knowledge 

 extends, it has worked in all its parts harmoniously and well. 



The uplands, so Irequeutly referred to, though producing little or uo malaria, are, nevertheless, 

 not entirely free from it and its- consequent diseases, from the fact that it is carried by the winds 

 over them from the low and overflowed lands. The uplands, therefore, estimated comparatively 

 healthy, are, in common with the two lower tables, subjected to all the causes of disease that have 

 been enumerated in the catalogue, but to a far less extent. The two latter, the flat lands, or glades, 

 and the lowlands, are conspicuous for their dampness and the production of malaria. But of the 

 three tables, in view of pathology, it is iu the first, or that of overflow, which lies within, and helps 

 in part to form, the wide valley of the Ohio and Mississii)pi, that the greatest interest concentrates. 

 Bearing the projjortion of nearly 13 per cent, of surface to the district when compared with the 

 other parts, it may be considered the great laboratory for malarial evolution, and where pernicious 

 fever and others oi' the gravest forms of disease of that class are to be found. 



Here several facts in the province of pathology present themselves that are striking: first, the 

 remarkable sameness that exists in the diseases of the district and valley ; secondly, that they are 

 more frequently functional iu character than organic ; thirdly, that there is much less of diphthe- 

 ria as a form of dlst»ase thau is represented ; a collateral and partially explanatory fact consists in 

 the too frequent habit of taking its existence for granted from expressed or entertained fears of 

 parties, and treatii}g it without examining the fauces, which, when done, 95 per cent, of the cases 

 reveal merely siiii|)le tonsilitis. Another matter, which has engaged my attention oftener practi- 

 cally, and which has excited in me more surprise than any other of a general character, is the nu- 

 merous mistakes that have been and are being made in diagnosis, here and in the West, by taking 

 many of the common diseases of the country, mainly tho.se of malarial origin, for Ujphoidfcrer, and 

 treating them on the expectant plan. For example, numerous cases occur of enlarged liver and 



