410 surgeons' reports OHIO ELEVENTH DISTRICT. 



have no well markeil peculiarity of form of disease. Our people have to a considerable extent suf- 

 fered from that complicated disorder known and spoken of in this region as " winter-fever," which 

 is pathologically a pleuropneumonia, with bilious comi)lication, and of low grade of action. This 

 form of disease is more dreaded than perhaps any other prevalent among us. Another fact in this 

 connection of suthcient moment to merit notice is that the proportion of deaths from phthisis pul- 

 monalis is larger in this portion of the State of Ohio than in any other locality with the statistics of 

 ■which I am acquainted. I mention this fact without attempting any explanation of it. 



It will be seen by reference to " Medical Statistics of the Second Draft," that under section 32, 

 of paragraph 85, forty-eight per thousand were exempted, and that under section 23, thirty-two per 

 tliousand were exempted, while under section 9, thirty-two per thousand were exempted. With 

 reference to sections 32 and 23, the first including fractures and diseases of bones and joints, and 

 the second the various forms of hernia, the reasons for the greater percentage of exemptions are 

 obvious, when the occupation of our population is taken into account. They are a laboring people, 

 and liable to injuries in the pursuit of their various avocations, while the same reason holds good 

 in reference to exemptions for hernia, heavy lifting, as is well known, being one of the most prolific 

 causes of that infirmity. With regard to exemptions under section 9 during this draft, I have to say 

 that, including as it does all infirmities otherwise unclassified, I am of opinion that the proportion 

 of exemptions under this section is as small as that of any other district in the United States. 



In reference to other sections of paragraph 85, no very marked disproportion of exemptions 

 obtains under this draft- It will be seen, by reference to ''Medical Statistics of the Third Draft," 

 that ninety-eight per thousand were exempted under section 9 ; seventy per thousand under 

 section 20 ; fifty-nine under section 23 ; and sixty-six per thousand under section 32 ; thus showing 

 a very similar result to that obtained under the second draft, and attributable to the same causes, 

 as a matter of course. An exception occurs with section 20, loss of teeth. I am not prejjared to 

 give a good and satisfactory reason for the great decay of teeth of the present generation ; but it 

 is presumed the proportionate exemptions under this section will be found to be no greater in this 

 district than in other districts of the United States where the laboring population constitute so 

 large a proportion of the entire population, and where the mode of life and habits and style of 

 living are similar. 



In reference to the different sections of paragraph 85, I am of opinion that it is, as a whole, 

 .very wisely and judiciously arranged. While such is my opinion in reference to it as a whole, I 

 nevertheless think that in some of its sections some slight alterations of language might be made 

 with profit. 



Section 3. In this section, I would recommend that the board be peruiitted to take other testi- 

 mony than that of physicians, in extreme cases; amending the section so as to read, "or such 

 other testimony as to the board shall prove conclusively that the epileptic was entirely unfit for 

 military service or the performance of any equally hard labor." 



Section G. I would recommend this section to be so amended as to read, " tuberculosis devel- 

 oped or the diathesis so well marked as to leave no doubt of the man's unfitness for military service 

 or for the performance of any labor equally hard with that of ordinary military service." 



Section 11 1 would recommend to be so amended as to read, "chronic rheumatism, if not mani- 

 fested by positive change of structure, to be proven by such evidence as to the board should be 

 conclusive that the man was totally unfit for the performance of military duties." 



Section 20. As this section now stands, some are exempted for loss of teeth who might do good 

 service as soldiers, and I would recommend that the wording be so altered as to permit the surgeon 

 to receive a recruit with a loss of the front, eye, and first molar teeth, w here the back teeth were 

 good and the man otherwise perfectly sound. 



Section 25. Experience and observation have convinced me that haemorrhoids need not be 

 ulcerated to unfit a man for military service or any other hard labor, and that this section should 

 be so amended as to exempt the drafted man or reject the recruit where the general physical 

 ap|)earance showed that the infirmity had seriously affected the general health. 



Section 35. I am satisfied that surgeons often exempt men for varicose veins who should not 

 have been exempted, and 1 would recommend that those who were able to do ordinary hard labor 

 should not be excused on this score from performance of military duty. 



