44fJ SURGEONS' REPORTS ILLINOIS SEVENTH DISTRICT. 



reliable evidence might be introduced, such as, for instance, the afiQdavit of a pLysieiaii or other 

 credible person, as recoiumeuded in the case of epilepsy. 



I beg leave also to make a few suggestions as to chronic rheumatism. The Revised Itegula- 

 tions as they now stand direct exem])tion or rtjection for chronic rhenniatisui, bnt not "unless it 

 is manifested by positive change of structure, wasting of the affected limb, or pufduess, or distor- 

 tion of the joints." Now the ])racticiug physician is constantly called upon foi advice and treat 

 menl, in souje of the hybrid or more common chronic forms of the disease, where it is not niani 

 lested by any such alteration in the jiarts as named, and yet the man may be entirely disiiualified 

 for military service, or for most kinds of manual labor. Every practicing physician must frequently 

 have met with such cases; at least they are not tincomnion in tliis district. I think the regula 

 tions should be so amended as to permit exemption for such cases, when considered by the surgeon 

 and board of enrollment to disqualify for military service, the testimony of a physician or other credi- 

 ble evidence being presented, showing that the subject has been disqualified for the performance of 

 manual labor, and that the disease has been of long standing. I know that great care and caution 

 arc necessary in exempting drafted men for this form of disease, as they are more likely to feign it 

 than almost any other, from the fact that they think it more difficult for the surgeon to detect 

 the attempted imposition. 



* lam requested to mention the "frauds most to be guarded against which are practiced by 

 drafted and enrolled men to escape, aud substitutes and recruits to enter the service, and any 

 other obstacles I have had to contend with in the discharge of my duties, and to make any sug- 

 gestions as to the best method of avoiding or overcoming these difhculties in future." 



The greatest ditticulties are i)resented in the examination of drafted and enrolled men. for it is 

 rare, and is indeed the excei)tiou instead of the rule, for them when under examination to admit 

 themselves to be in good health ; such cases, however, do occasionally occur. It matters u.t 

 wliat may be the size of the room in which the examinations are conducted ; for when an attempt 

 is maile to walk or move the men around rapidly they generally pretend to be as stiff as a foundered 

 liorsc. We feel as if we were among the lame, blind, dumb, and halt. On listening to their com- 

 l)laiuts, could we believe them, we should imagine there was much more need of a physician or 

 surgeon to heal them of their infirmities than to examine them as recruits for the Army. One 

 experiences great sympathy for the poor fellows at such times. If one excuse fail, they resort to 

 another for exemption. But I may have spoken rather too unfavorably as to their honesty. I 

 must admit that quite a respectable number of the drafted men boast of fine health and disdain 

 feigning any disability for exemption. Many complain of disease of the chest, and pretend to 

 believe themselves consumptive. J)iseases of the liver and heart are quite common among them. 

 But all attempts at fraud in claiming to be afflicted by these diseases can generally be detected by 

 the surgeon (hiring a critical examination. 



With substitutes and recruits the case is quite different. They are anxious to enlist for the 

 bounty offered ; they are consequently very sui>ple aud active, and have no consumption or disease 

 of internal organs unless the surgeon can discover the same, which he may occasionally do on a close 

 gxaminatiou. 



Internal Imjmorrhoids are often alleged by drafted and enrolled men. The surgeon should 

 keep on hand a dilating metallic rectum-speculum, aud when this disease is claimed for exemptijn, 

 should exhibit and explain its use to the man, and propose an examination, assuring him that he 

 can by its use ascertain the existence of any disease. If he be a drafted or enrolled man, and 

 -object to the examination, it may be fairly assumed that he is attempting imposition, and should 

 at once be examined, or, if he still objects, it may be taken for granted that nothing is the matter; 

 for if diseased he will readily submit to an examination. It is otherwise in the case of substitutes 

 and recruits, for, if not diseased, they will not be likely to object. 



Partial deafness is not unfrequently claimed for exemption. I know uo lietter way of detect- 

 ing this character of im[)osition than by drawing the man into conversation, and, by frequently 

 changing the .subject, surpii.se him into an admission of the attempt to irai)ose upon the surgeon. 

 We detected several in this way. 



Total loss of sight of right eye, also, is not unfrequently feigned. We had several enrolled 

 men to make this plea, one of whom was a doctor. If neither of the (Tuter structures of the 



