surgeons' KEPORTS INDIANA FOUUTII DISTKICT. 427 



skin is uot kept sufficiently clean. To tbis list may be added vices and abuses incident to increas. 

 iug wealth and iiopulatiou, in the absence of the highest moral culture. As necessary even to good 

 health and long lile, we need the practical workings of a pure, soul-liberating, and strengthening 

 (Jhristiauity. Without these we cannot have that which is essential to the individual and body 

 politic, especially to a republic — intelligence and virtue. It will be perceived that the circum- 

 stances and habits of life above stated and yet to be noticed tend more to diseases of au inllain- 

 matory, nervous, and scrofulous character than those which prevailed almost exclusively in the 

 early settlement of the country. 



Many persons emigrating from older States have brought with them, no doubt, the seeds of 

 disease peculiar to their respective habits and localities. Diseases are transplanted by travel and 

 communicated by contact. Though our population is chiefly rural, we have quite a number of 

 cities, towns, and villages. There are seven towns, some of them called cities, ranging from about 

 one to near four thousand inhabitants. They are made up of the usual professions, dealers, and 

 trades of most western towns. Our manufactories are not numerous; one class, however, near the 

 Ohio River, is too numerous, namely, the large m;inufaetories of whisky and beer. 



Tlie i)riucipal railroads iu oiieration passing through this district are the Ohio and Mississippi 

 and the Indianapolis and Cincinnati Railroads. For -^ mixed population, the manners and habits 

 of our towns are not i)eculiar; fashions are infectious and nearly uniform. # # * 



Under the head of permanent physical disability, (Revised Regulations, i)aragraph 85, section (),) 

 there was included a multiplicity of diseases and infirmities thought to be disqualifying. On this 

 account, the ratio per thousand is greatest under that head. The order of the greatest number of 

 exemi)tions under the draft is, first, permanent physical disability ; second, wounds; third, hernia; 

 fourth, organic disease of internal organs ; fifth, tuberculosis ; sixth, fractures, ankylosis, and disease 

 of bones ; seventh, loss of teeth. 



My views ill reference to the different sections of paragraph 85. — There might be added to section 4 

 "decided hy[)ertroi)hy of a limb." To the sixth section there might be added "protracted and 

 aggravated bronchial in itation, affecting the general health ; also, hepatization of any considerable 

 portion of the lung; frequent hiBmoptysis, with evidence of disease; and excessive and confirmed 

 cases of asthma." 



Section 9 should be divided into physical disability and permanent physical disability. There 

 are cases of disability resulting from protracted and recurrent fevers, and other diseases where we 

 cannot say there is serious organic lesion — that disqualify for many mouths. Manifest cases of 

 permanent physical disability in such a division should be striken from the rolls. 



Section 11 might be improved by reading "chronic rheumatism manifested by positive change 

 of structure, wasting of a limb, or pufliness of the joints exempts; well-established cases of rheu- 

 matic diathesis. The person being prostrated when exposed, cases leaving no doubt of unfitness 

 for military service, exemi)t." 



Section 13. Extreme near sightedness certainly does render the man unfit for field-service. 



Section 14. To this might be added polypus entirely obstructing breathing through the nose. 



Section 22. In this, or in a new section, might be included aggravated and well-marked cases 

 of spinal irritation. 



Section 23. In slight cases of inguinal hernia that are congenital, or nearly so, the judgment of 

 examining-surgeons might be left free to determine the fitness or unfitness for ?nilitary service. 



Section 25. There are some extreme cases of external haemorrhoids that certainly do unfit for 

 military service. 



Section 28. It would be well to consider whether well-established cases of renal gravel, of long 

 standing, should not exempt. 



Section 29. "Varicocele isnotof itself disqualifying," but when extreme and complicated with 

 disease of testicle it should be a cause of exemption. Entire want of development of the genital 

 organs, complete or nearly complete absorption of testicles, chronic enlargement of testicles if ex- 

 cessive, with disease of spermatic cord, if in such degree as to disqualify for military service, should 

 be. causes of exem[)tion. 



Section 33. Ankylosis and contraction of left thumb iu direction of palm of haudj ankylosis and 



