,456 surgeons' reports — iowa — first district. 



the release of hundreds of men. But a case of tubercles not yet developed presents itself; there is 

 dullness on percussion over the upper portions of the lung, and other physical signs of disease; 

 there are emaciation, llabbiuess of muscle, quickness of respiration, fatigue upon slight exertion, 

 flushed cheeks, brilliant eyes, tumultuous action of the heart, &c., yet there is no consumption. In 

 such case the man can be readily discharged under section 5, because he has "organic disease of the 

 lungs, which has impaired his general health." Likewise, ho could be discharged under section 9, 

 because he has "permanent physical disability,'" and the regulations demand that it should be 

 stated in the column of remarks that the man had tubercles not developed. There may be enlarge- 

 ment of the liver or spleen, or obstruction of the viscera causing dropsy, anteinia, or other cachectic 

 condition of system ; it can be placed as readily under section 9 as section 5. For the sake, then, of 

 convenience and dispatch in enumerating causes of discharge and in making up medical reports, it 

 were well if section 5 were expunged, and the entire enumeration and description of diseases trans- 

 ferred to section 9. 



Section 7. Cancer. — This disease should bea positive disqualification for military service. There 

 is no absolutely infallible proof that any given tumor is cancerous, except the character of the cau- 

 cercells as developed by the microscope. Hundreds of cases are called cancer and cured as such, 

 when it is notorious to the profession that no case of genuine cancer existed. It is one of the 

 opprohria medicorum, and it is probable that, like epilepsy, it will so continue. Several enrolled 

 men claimed exemption on account of cancer, and their claims, in some instances, were supported 

 by the affidavit of physicians; not one of these claims was sustained. Every tumor, swelling, or 

 induration about the body that is obstinate in resolving is immcduitely called cancer. Some igno- 

 rant and too olten dishonest cnarlatan applies his caustics, his arsenic, calomel, and antimony, and 

 "eats out" a simple, harmless, non-malignant tumor, pockets an enormous fee, and receives immense 

 credit for bis medical skill. If these things be true, especially if the existence of cancer cannot be 

 adequately determined except by microscopic examination, it would be manifestly proper to qualify 

 it as other disabilities are qualified in paragraph S5. If a case of cancer had reached the ulcerative 

 stage, had produced in the patient its peculiar cadaveric hue, or had broken up his constitution, 

 then only should he be discharged and sent home to die. 



Section 9. Permanent physical disability, dc. — There is here, perhaps, more left to the discretion 

 of the surgeon than in any other paragraph of the regulations; yet, when complied with, the fa(;t 

 that he must specifically name the disease or infiraiity which is the fons et ori'j:) of the permanent 

 physical disability, circumscribes the scope of his judgment. This rule, as already observed, 

 makes section 5 a useless and troublesome appendage. It has been observed that section 9 

 was intended for cases where the jiatieut knew nothing and the surgeon knew less; that is, there 

 are sick and debilitated people who have baffled the skill of the physician both as to a diagnosis 

 and a cure. That some disease is present and preying upon the system is evident; but to declare 

 its seat, define its exact character, or give it a name and [>lace in any system of nosology is not an 

 easy matter. In the early stages of examinations of drafted men, some cases — a very lew of them — 

 were "made up" under section 9. Thus, a drafted man had very defective teeth, but not quite 

 bad enough to exempt under section 20; had old h.neraorrhoids, not quite enough to exempt under 

 section 25; had corns or bunious, not quite enough to exeaipt under section 34 : besides, was stoop- 

 shouldered, prematurely old, &c. Taking all these parts together, a magnanimous whole was 

 formed, and the party discharged under section 9. Of course, this i)ractice was abandoned as soon 

 as it was ai)preciated that the Department required a strict observance not only of the spirit but 

 of the nomenclature of the regulations. 



Section 11. Claims of exemption on account of chronic rheumatism were more frequent than 

 for all other diseases. Not one of them was sustained under the stringent regulations of this sec- 

 tion ; and yet there are cases of this malady which do not present any positive change of structure, 

 though the subjects of it are evidently unfit for military service. The disease is so easily simulated, 

 however, that there can be no harm in having a rule of very great severity. 



Section 20. Total loss of all the front teeth, tf-c— It is suggested that the word "total" be 

 stricken out, or that the section be so modified as to leave something in this regard to the di.scre- 

 tion of the s.irgeon. If but one front tooth, oik^ eye tooth, and one of the first molars be present, 

 then the man must be held to service. If all tlie teeth are decayed and decaying, and the mouth 



