8UKGEON.S' KEPOKTS ILLINOI.S SKVENTU l^ISTKICT. 447 



eye, nor the iris, nor the crystalline lens be diseased, the man may still have lost his sight by 

 amaurosis. I think the surgeon should be prepared with an ophthalraoscojie, and when the claim 

 to loss of sight is urged, and no external evidence of it exists, he should show the instrument 

 to the man and exjdain the manner of using it, assuring him he can detect the ditticulty if any exists. 

 If he is feigning blindness, he will not be apt to .-^how a disposition to give him the trouble to 

 make the experiment, as was the case with the doctor above named. Nothing could be seen iu the 

 eye in liis case to justify the belief that he was blind, ami lie was not therefore exempted when he 

 came before the board for examination, i afterward saw him and told him I might have done him 

 injustice; that 1 had since procured au ophthalmoscope, and if he would call at my room I would 

 examine his eye with it, and that I should thus be able to ascertain its true condition, and that he 

 could yet be exempted if the eye was found to be blind. He promised to do .so ; but that was the 

 last I saw of him. I afterward inquired of his neighbors about his being blind in one eye, l)ut no 

 one had ever heard of it before. This instrument may assist the surgeou very much in deciding 

 with regard to blindness from amaurosis, if he has practiced its use. 



There were a number of instances in which drafted men and enrolled men came before the 

 board tor examination, wearing trus.ses and claiming that they had hernia. When imposition was 

 being attempted iu these cases, the skin was more irritated and red iioui the i)ressure and friction 

 of the ball or pad than iu cases of true hernia, where it has become accustomed to the use of the 

 truss. The abdominal ring should be examined and compared with the other side, to ascertain 

 whether it is larger than it should be where hernia does not exist. It would be well to have the 

 man to strain the abdominal muscles, and also to jump and lift, for the purpo.se of discovering the 

 disability. If these measures fail to i)roduce any manifestations thereof, it is presumable that none 

 exists in his case. Of course, it will be quite as necessary to use these tests with substitutes and 

 recruits, as they are equally anxious to conceal the same for the purpose of .securing the bounty; 

 but when iu the service, and the bounty secured, they Irequently obtain a di.scliarge for this cause. 

 I may flatter myself that we were quite successful iu detecting diseases fraudulently attempted to 

 be concealed by substitutes and recruits, as we rejected many who attempted such. There is no 

 danger of drafted men ever concealing a disease for which they may afterward be discharged ; 

 they, of course, conceal nothing. 



But the most perplexing diseases Ibr the surgeon are, probably, the hybrid forms of chronic rheu- 

 matism, some of it.s more regular chronic forms, and the large class of neuralgic diseases. I speak 

 thus from the fact that these diseases are often met with iu some form or other of so aggravated a 

 character as to entirely disqualify a man for military service, although the health in other res[)ects 

 may appear fair. It may take the form of a long-standing rheumatic back, pain in tlie hip, chest, 

 or in various parts of the body. Sometimes it is found over the region of the heart, and >et the 

 disease is not manifested by any apparent alteration of structure, such as wasting or pufhuess. It 

 might often be concealed by a substitute or reciirit without the surgeon's being able to detect it. 

 A drafted man will claim exemption for it, and from the difliculty that the surgeou will labor 

 under iu deciding whether the man is telling the truth, he may receive him into the service, though 

 he may prove to be of no use whatever. I know of no better way of arriving at the truth in these 

 cases than to have the man who claims exemption for such diseases procure the affidavit of his 

 family-physician, and other evidence of reliable persons acquainted with him. I think the regula- 

 tions should be so amended as to allow this. 



A man claiming exemption for asthma, as it is not likely that he would go before the board 

 for examination during a paroxysm, should be required to procure such evidence as is above sug- 

 gested for chronic rheumatic diseases. 



A number of drafted and enrolled men claim to havedi.sea.se of the kidneys and urinary organs, 

 disqualifying them for military service. For di.sea.ses of this kind, the surgeou can generally have 

 no other evidence than the man's own statement, unless he is permitted to introduce the evidence 

 of his physician and other acquaintances, or unless the surgeou could have the opportunity of 

 examining his urine with chemical tests and the micioscope. With this kind of evidence, the sur- 

 geon might often be able to decide the nature of the case with approximating accuracy. In the 

 case of enrolled men, he would have the opportunity of making investigations in this manner; but, 

 in the case of drafted men, who are of more importance, it is more difficult for the surgeou to do 



