SUKGEONS' REPORTS IOWA FIRST DISTRICT. 457 



full of offensive and unsightly stumps, if the required number only be left, thoujjh the man is 

 luiable to ma.^^tieate any kind of solid food, he must nevertheless be held to service. To Ije sure, 

 he can go into a hos[)ital as attendant or nurse, and live on soups and soft bread, but it is hardly 

 the design of the e()nscri[)tion-law to draft men for such service. It is conceived that a soldier with 

 a mouth full of defective teeth would be inetiicieut, not merely because of the results of im[)erfect 

 mastication of food, but because bad teeth are an almost infallible token of disordered system. 



The section as first arranged was " loss of sufiQcient number of teeth to prevent proper masti- 

 cation of food and tearing the cartridge ;" and this was explained by the words, (Circular 100:) 

 "This applies to those cases oidy when the loss of teeth is so great that if the man were restricted 

 to solid food he would soon become incapacitated for military service." It is easily understood that 

 abuses might be perpetrated under this rule; and by these abuses the (Tovernment would receive 

 damage; but under the new rule, section 20, the abuse is of the individual, and the regulations 

 should be so made that neither would suffer. Strike out the word " total," and if a case present 

 itself with imperfect incisors and bicuspids, decayed or broken off', it may be decided that there is 

 a loss of these teeth as far as efdcient service is concerned, and that the man should be exempted 

 just as though the teeth had been extracted. 



Section 24. Fistula in ano. — This should be a sufiBcient cause of exemption or discharge without 

 any particular reference to its extent or its complication with visceral disease. It is a most trouble- 

 some and annoying affection, with a tendency to grow worse instead of to improve, and is fre- 

 quently the precursor or the indicator of consumption, or some other fatal maladj'. " Extensive 

 distula" may mean many things. If tliere be a communication with the rectum, and feculent mat- 

 ter escape through the fistula, without regard to the height of the opening above the sphincter, it 

 may be regarded as "extensive." If, however, there be no communication with the rectum, and a 

 l)robe can be passed up one, two, or three inches, if the edges are hardened and the fistula pour- 

 ing out sanious fluid, w ith no disi)ositiou to heal, then again it is " extensive." Almost any fistula 

 in ano is cause enough to discharge a man. It would, I think, be well to strike out all iu section 

 24 after " fistula in ano." 



Piiragrai»h 88. 1 am of opinion that this provision of the regulations, with present instructions, 

 is entirely superfluous. First, it is very clear what particular infirmities disqualify, and if they are 

 not sufliciently apparent to the surgeon of the board, the man must be held to service regardless 

 of the affidavit of any other physician or surgeon ; secondly, no affidavit is of itself sufficient to 

 release the enrolled man from draft, because the surgeon of the board is responsible for the per- 

 sonal inspection of every man drafted or enrolled and claiming exemption; thirdly, it is absurd to 

 consume the time of the board with listening to statements of physicians which cannot be admitted 

 as evidence. If all physicians understood that it was the efect of disease rather than the disease 

 itself that is regarded generally as cause of exem[)tion and discharge, and if they had but partial 

 information as to the orders governing the examination of men, they would be spared a great 

 annoyance by patients; for they could see at once that the mere existence of troublesome symp- 

 toms, whether taking the form of disease or not, was no cause of exemption. To save the prac- 

 titioner and the people, it would be good policy to expunge paragraph 88. » # * 



The number of men that can be physically examined per day with accuracy. — This is a most im- 

 portant subject of inquiry, and the opinions expressed below are given with much diffidence, 

 because the number falls very far below that stated by some men of great experience. Yet they 

 are the result of much carefully-recorded observation, and have not been reached without much 

 reflection. The effieienc^y of an army depends upon the [)hysical fitness of the soldier as much as, 

 and of'en more than, upon the military qualifications and ))olitical ideal of the officer. Soldiers in 

 this war for the Union have redeemed victory from defeat when incomi)etent officers had given up 

 the contest ; and, if history be true, there have been times when the eagle has clutched the rattle- 

 snake of rebellion in his talons, and would have dispatched it in a- trice if the Army that cariied 

 him had not been held back by imbecile commanders. Strong, active, well-muscled, fully-developed 

 men, without disease or injury, are what are demanded to fill up an army. Men enfeebled by intem- 

 perance, boys "scarce half made u))," and fit only for the school-house or the lighter labors of the 

 farm, are splendid material to fill U[) graves and hospitals, or to linger by the roadside. They are 

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