420 surgeons' reports OHIO EIGHTEENTH DISTRICT. 



be held to service who would prove of no service to the Government, but to whom the esiiosiire 

 would cause serious injury, if it did not produce fatal consequences. 



In regard to section 12, there are cases of loss of the sight of the right eye when there is no 

 manifest defect. I have in such cases sent the man to an expert for examination with the ophthal- 

 moscope. 



Section 20. I have always applied this section in a strictly literal manner, and have always ruled 

 that the existence of any teeth forward of the molars was sufiicient ground upon which to hold the 

 man. I do not feelsure that any alteration of the section would be advisable, and still persons have 

 applied to me for exemption in consequence of defective teeth, and have been refused in consequence 

 of their having one or two teeth more than the section prescribes, when the teeth which caused them 

 to be refused exemption were positively worthless. 



There is one point which deserves remarl^, and for which the present is an appropriate place. 

 A man enlists, and on examination is rejected for nearsightedness, for instance, or for loss of teeth; 

 and the same individual is subsequently drafted, and, having no clear cause of exemption, is held 

 to service. To refuse a man who seeks to enlist and to refuse to exempt the same man when 

 drafted is almost necessarily to cause dissatisfaction. Su(!h cases have occurred in my office, and 

 they have been very difticult and embarrassing cases to decide. 1 have no suggestions to make as 

 to the remedy. # * * 



With a competent clerk to record the names, measurements, and descriptions, from Jxfty to nixty 

 men may be physically examined in a day with accuracy. One day, in a severe press of business, 

 I examined ninety-eight men, and on another day eighty men. This is more than I would under- 

 take to do again, and is more than can be done accurately. 



The question of the frauds attempted is undoubtedly most difficult to discuss in a satisfactory 

 manner. The efforts of the recruit are of course to conceal some defect, or to divert attention from 

 some disqualifying disease. An attempt to conceal a partial ankylosis can only be thwarted by a 

 close scrutiny of the motions. Fracture of legs with shortening can be ascertained by measure- 

 ment, and by careful inspection of the man's gait as he is walking, varying the ujanner and rapidity 

 of the walk from time to time. Defective sight can only be detected by putting the man to severe 

 tests, and these must be made to suit the case, and must necessarily be left to the sagacity of the 

 examiner. When the physique of the man is other than good, the pulse should be examined in 

 reference to force and frequency ; the ai)pearance of the tongue and condition of the muscles noted ; 

 and if the tongue were otherwise than clean, if the respiration were of abnormal frequency, or 

 mainly or largely diaphragmatic, and the muscular tissues soft, I would reject. The complaints 

 most frequently set up by enrolled men or drafted men are diseases of lungs, heart, and liver, and 

 rheumatism. Eheumatism, unless attended with visible organic changes, is scarcely a cause of 

 exemption. The measurement of the chest at inspiration and at expiration was intended to be a 

 check against fraudulent claims of diseased lungs; an expansive mobility of two inches or more 

 affording very strong presumption against serious disease. If, however, a drafted man or an 

 enrolled man of shrewdness claims diseased lungs, he will attempt to produce incorrect dimensions 

 of chest by only expanding his chest slightly. In fact, I have found that the chest-measurements of 

 drafted men or enrolled men claiming exemption for disease of lungs are never correct. Occa- 

 sionally, the examiner may succeed in putting the man off his guard, and obtain a more accurate 

 result; but these measurements at best can only be made to approximate to the truth. 



While speaking of chest measurements, I will remark that iu the examination of recruits and 

 substitutes there is a strong liability to error, especially if the recruit is of slender form. In these 

 cases, the measurements at expansion will be incorrect. The enrolled man or drafted man will not 

 allow his chest to expand ; he wishes to a[)pear smaller; the small recruit wishes to appear larger 

 and will not allow his chest to collapse. 



In regard to nationality, I have little to say. I would give the preference to the Scotch, but 

 my estimate would be based on a few examinations. I have one idea to suggest, which ])robably 

 ■ has occurred to the Department. The measurements of recruits of Amvrican birth appear, as corn- 

 oared with those of recruits of other nationalities, relatively somewhat smaller than they should, 

 from the fact that ueaily all the boys who, though claiming to be eighteen years of age, {ire rejected 

 as really under that age, and who also are very generally either under the [)rescribcd size, or only 



