surgeons' reports — KENTUCKY SIXTH DISTRICT. 375 



those exempted for lieruia are foreigners, principally Germans, among whom this disability is very 

 common. They have been already rejected under the conscriptions in Europe, and have brought 

 the disability with them when they emigrated to this country. Amoug onr own people, farmers 

 are oftener the subjects of hernia than any other class; no doubt because their calling subjects 

 them to nuich heavy lifting and hard straining. 



Fractures and wounds are accidental occurreuces; but the uegro is comparatively free from 

 the former, which would seem to indicate that there is some peculiarity in the bones of the white 

 race predisposing them to fractures. 



The number of disabilities coming under the head of organic disease of internal organs is prin- 

 cipally made up of chronic pleurisy, chronic pneumonia, bronchitis, asthma, liver-complaints, kid- 

 ney-affections, chronic disease of the bowels, and the various forms of organic disease of the heart. 

 This last disease, as already uoticed, is traceable in a large number of instances to rheumatism; in 

 other cases, to occupation. It is not uncommon among sbip-calkers, blacksmiths, rowers, rail- 

 splitters, wood-choppers, men who drill and blast rock, who shovel, grade, and pave streets, or who 

 load and unload vessels. 



Tuberculosis is nearly always hereditary. Most of the cases that have come under my official 

 uotice could be traced to this cause. 



The loss of teeth is made common by the universal habit of eating biscuit lightened with soda 

 or bitartrate of potassa, and neglecting to clean them with a brush after meals. But the element of 

 race also seems to have something to do with their premature decay aud loss; for we find them 

 comparatively good in the German, good in the Irish, aud perfect Iti the uegro. Scrofula is another 

 cause of their loss, especially amoug Americans and Germans. They are commonly decayed, aud 

 often entirely gone, in curvature of the spine and in scrofulous disease of the joints or l)ones. 

 The negro preserves his teeth, though he never cleans them, and is frequently scrofulous. 



Varicose veins depend upon a peculiar constitutional organization of the vascular system, 

 especially the venous, which might be calleil the varicose diathesis ; for hajmorrhoids and varicocele, 

 forms of the same disease, often exist when there is ujarked varix. * # * 



Sections 1 and 2 of paragraph 85 are right as a matter of necessity. Section 3 requires a modifi- 

 cation. In some of the clearest cases of epilcpsii that ever came under my notice exemption was impos- 

 sible because " the fact" that " must be established by the duly-attested affidavit of a physician in 

 good standing, who had attended him in the disease icitliin the six months immediately preceding his 

 examination by the board," eunld not he so established. There are epileptics living all over the country 

 who have been afflicted with the disease for ten and fifteen years, but who have long since ceased 

 to send for a physician when an attack comes on, because, regarding themselves as incurable, they 

 believe that he can do them no good, aud that his presence would oitly be a useless expense ; all 

 their families, all their neighbors, everybody that knows them, physicians included, will make affi- 

 davits as to the jwsj^^fe and constant existence of the ciiileptiG condition of the unfortunate men; 

 but all this will not exempt them, because no physician can swear that he has " attended them in the 

 disease" within the "last six months preceding their examination by the board." All such men 

 are utterly worthless. What is to be done? for, as the case now stands, exemptiou is impossible. 

 The re(iuirement about the physician aud the last sis months should be altered, or made to conform 

 to that whicii in praefieable in such cases. 



Section 4. No remarks. Section 5. Valvular disease of the heart and hypcrtropht/ may, und in a 

 majority of instances do, exist without " seriously impairing the [leneral health," indeed without 

 impairing it at all; yet men so aifiicted can do little or nothing. The least excitement, any consid- 

 erable exertion or exercise, brings on horrible dyspnoea and lays them up. The existence of the 

 disease iajter .se disabling, utterly so, whatever may be the condition of the general health. Yet I 

 have always acted upon the section as it now stands. 



Section G. Developed tuberculosis. — This needs a clear, preci.se, ;uid unequivocal definition. 

 When crude tubercles exist, however small in size or few in number, whether in one or both lungs, 

 there is to all intents and purposes "developed tuberculosis;" yet in such a case, and it is no un- 

 common one, there is no emaciation or other signs of failing g'eneral health, but, on the contrary, 

 the man looks tolerably well and appears hearty, labors fiurly at his trade or on his farm, can 

 endure considerable exertion, and will not in all probability die for years. Should such a man be 



