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raise himself upon his toes, then flex and extend the thigh, leg, and ankle, kick first with one foot and then the other, and make several leaps in the air. While thus excited, he was again examined for chest diseases and also for hernia.
The eyesight was next tested by placing him at one end of the room, while the surgeon stood at the other, and asking him the number or color of objects displayed to each eye separately. The hearing was also tested at the same time by modulating the tones of the voice while conversing with him, and covering one ear while endeavoring to discover any defects that might exist in the other.
The remaining portion of the record was then made out, result of examination recorded, and, in case of rejection, the disease or infirmity for which he was found unfit for military service written out in full.
In case of recruits and substitutes, when accepted, some mark or scar which was on their body was recorded for the purpose of future identification.
The number of men that can be examined per day with accuracy depends not only upon the character of the men examined, but whether or not they are drafted men, as much more time must be devoted to them in answering all their questions and listening to and deciding upon their claims for exemption than in the examination of recruits or substitutes. Forty, however, is fair average, of all classes, of the number of men that can be examined per day with accuracy.
Various modes were adopted for the detection of frauds practiced by recruits and substitutes to enter, and by drafted and enrolled men to escape, the service.
The volunteer and the drafted man are governed by very different motives in presenting themselves for examination; for, while the former tries to conceal every physical defect, the latter is equally anxious to magnify every slight ailment. If the volunteer resorts to false teeth, hair-dye, and falsehoods to conceal his age, bandages for varicose veins, and the application of ice for hernia, the drafted man also feigns deafness, blindness, liver and kidrey complaints, or any other disease that will avail him in his extremity.
When deafness is feigned, the following method was found useful for detecting it: the man was seated directly in front of the surgeon and close to him; a watch was then placed against one of his ears, and he was asked, in a loud tone, “if be could hear it;" to which he usually answered in the affirmative. The watch was then withdrawn a few inches, and the question repeated in a low tone several times, gradually withdrawing the watch and sinking the voice until it was scarcely more than a whisper; while his attention was fixed upon the watch he did not notice how far the surgeon had moved from him, or in what tone he was speaking.
The would-be-blind man was detected by telling him that he must accompany the surgeon to a place prepared to test the eyesight; and, taking him up and down stairs, over logs, boxes, and impediments of all kinds, and if he avoided all these his blindness was not considered sufficient to unfit him for the military service.
Cardiac disease is often feigned, and men frequently present themselves for examination after having undergone violent physical exercise; in such cases they should be allowed to wait and sit quietly for at least half an hour, and then, by careful examination, the attempted fraud can usually be detected at once.
The frauds against which the examining surgeon has to guard, it will be seen, are as various as the characters of the men examined, and no rules can be given to govern in such cases; but, to guard successfully against these frauds, aside from professional skill, he should be conversant with the frailties and idiosyncracies of human nature, and be able to turn his knowledge to account, for he
SURGEONS OF BOARDS OF ENROLMENT, WITH RECOMMENDATIONS AS TO THEIR
FUTURE APPOINTMENT AND STATUS.
Medical, like all other talent, should not be expected without proper compensation; and, although this bureau obtained it, it is nevertheless true that the great majority of the late surgeons of boards continued in the position from a patriotic desire to serve their country, or a personal feeling of pride, (that, having commenced, they would continue to end,) fearing, perhaps, that in the case of resignation their enemies would ascribe it to the fact that they were obliged to do so for faults committed in the performance of their duties.
Many surgeons of boards received the appointment unsought, having been recommended by their respective members of Congress on account of their high standing in community. They were men of ability and honesty, and, indeed, in their recommendations of physicians for the position of surgeons of boards of enrolment, inembers of Congress seem to have selected, as a rule, only those who, on account of attainments, experience, and honesty, they considered best fitted for the position.
The position of the surgeon on boards of enrolment has been one of much responsibility.
Maligned by those whom he failed to consider entitled to exemption, and accused of exempting those not disabled, he has been placed between two dilem
If he exempted too great a proportion he was liable to censure from his official superiors. "If the number of exempted men was small, the community accused him of forcing cripples and men at the point of death into the army. Should he reject a large per cent. of substitutes or recruits, the district, being anxious to fill the quota and thus escape the draft, accused him of being hypercritical in his examinations, and said that he rejected able-bodied men.
On the other hand, he was liable, not only to official censure in case he accepted disabled substitutes and recruits, but his pay was liable to be stopped, and all expenses attending the enlistment of the disabled man deducted therefrom.
His position being then one by no means enviable, it is a matter of no little surprise that the services of medical gentlemen of such ability in their profession were secured or retained.
I would recommend, instead of the present method of appointing surgeons of boards of enrolment, that they be supplied by detail of those medical officers in the service who, by experience and talent, are evidently fitted for the position. I would also suggest that they have, while serving on boards of enrolment, the rank, pay, and emoluments of surgeons in the army.
Should this be found impracticable, I would recommend that surgeons of boards of enrolment be appointed and cominissioned as such only after due and careful examination as to their ability to perform the duties pertaining to the position, and that they have the rank, pay, and emoluments of surgeons in the army.
It is also important that they be stationed in other States and districts than those in which they reside, and that their stations be changed at least once in six months, or after the completion of each draft.
This would obviate the great difficulty with which surgeons of boards of enrolment have had to contend, viz: the pressure of sectional feelings, and their being stationed where a proper discharge of duties would not interfere with their future professional prospects or their individual feelings.
There also should be detailed upon the staff of each acting assistant provost marshal general a commissioned medical officer of experience and ability, to act as medical inspector, and, under the direction of such acting assistant provost marshal general, to have supervision of all medical matters pertaining to boards of enrolment in the State or division to which he may be assigned.
Such medical officer should examine and forward all medical reports of surgeons of boards, and report at least monthly the result of his labors. He should be guided in his decisions by the regulations of this bureau, and by such other instructions as might be sent him by order of the Provost Marshal Ġeneral.
The detail of such an officer would obviate many of the difficulties which have been encountered in the past experience of this bureau.
MEDICAL BOARDS OF RE-EXAMINATION AND RENDEZVOUS CAMPS. I am convinced that no little injustice has been done surgeons of boards of enrolment by medical boards of re-examination at rendezvous camps. Surgeons of boards of enrolment, for instance, decided not to exempt drafted men with whom they were personally acquainted, and knew that there existed no physical or mental disability sufficient to entitle them to exemption. Yet, upon the arrival of these men at rendezvous camps, their representations of physical unfitness appeared so well founded that the boards of re-examination, although perfect strangers to the applicants, have recommended the men for discharge and reported the surgeon of the board as negligent in the discharge of his duty.
This has also been the case with recruits and substitutes who received large bounties, and on their arrival at rendezvous camps feigned or produced such disabilities as to secure their discharge.
This has been a subject of much complaint from surgeons of boards who have produced evidence in particular cases of this kind to prove their complaints wellgrounded. Circular No. 15, Adjutant General's office, 1865, corrects this difficulty, but, unfortunately, it was issued but a few days before all drafting and recruiting were stopped.
It will, however, be a matter of great importance to the interest of the service, should any future recruitment of the army become necessary by draft or through boards of enrolment, that the requirements of this circular be strictly observed and carried into effect, viz :
Circular No. 15.
WAR DEPARTMENT, ADJUTANT General's Office,
Washington, April 7, 1865. I. With a view to fix the responsibility of receiving into service recruits, substitutes, drafted men, &c., who at the time of entry into service are incapable of performing the duties of a soldier, on the proper mustering and recruiting officers and examining surgeons, and to prevent the improper discharge of persons on the ground of disability contracted before entry into service, the Secretary of War directs that all enlisted men who appear to be fit subjects for discharge, on account of disability cxisting at the time of entry into service, be not discharged until they shall have been sent to such United States general hospitals as the Surgeon General may designate for the reception of this class of patients, where, after thorough treatment and observation, they will be disposed of on the recommendation of boards to be designated by the Surgeon General for that purpose.
II. The Secretary of War also directs that the chief medical officer, under the Provost Marshal General, shall have an opportunity to make such observation and examination of this class of patients, together with the surgeons who examined them on their entry into service, as may be necessary to inculpate or exculpate the mustering and recruiting officers and examining surgeons.
E. D. TOWNSEND,
Assistant Adjutant General. Official :
IMPORTANCE AND EXTENT OF RECORDS ON FILE IN THIS BRANCH.
The final reports of surgeons of boards of enrolment give the medical results of the examination of 605,045 drafted men who were examined during the progress of the several drafts, exhibiting the distinct diseases for which those men were found unfit for military service.
A grand total of the drafted men examined and exempted is as follows: Drafted men examined......
605, 045 Drafted men exempted for physical or mental disability
155, 730 Ratio exempted per 1,000 examined...
257.38 There are also, in addition to the above records on file in this branch of your bureau, monthly medical reports, giving the minute medical examination, including name, age, nativity, occupation, height, chest measurement at inspiration and expiration, complexion, color of eyes and hair, white or colored, married or single, physique, and result of examination of 508,735 recruits, substitutes, drafted, and enrolled men, and the reports of boards of examination, showing the disabilities for which enlisted men were recommended for transfer to the Veteran Reserve Corps.
In addition to the statistical records already enumerated, able and valuable reports have been received from surgeons of boards of enrolment, giving, as the result of their experience, information upon the following subjects :
1st. Experience in the examination of men for military service, and number examined.
2d. General geographical description of congressional district, with prevalent diseases and causes conducive thereto; character of its inhabitants, their modes of life and occupations.
3d. Reasons why any particular diseases or disabilities have disqualified a. greater ratio per thousand from military service.
4th. Views in reference to the list of disqualifying diseases and disabilities, as given in the Revised Regulations, Provost Marshal General's bureau, and what changes recommended.
5th. Statement in minute detail of method of examining men for military service.
6th. The number of men that can be physically examined per day with accuracy.
7th. Frauds most to be guarded against, which are practiced by drafted and enrolled men to escape, and by substitutes and recruits to enter the service, and other obstacles contended with in the discharge of duties, with suggestions as to the best method of avoiding or overcoming these difficulties in future.
Sth. What nationality presents the greatest physical aptitude for military service.
9th. Experience as to the physical qualifications of the colored race for military service.
ioth. Views as to the operation of the enrolment law as it now exists, with recommendations and suggestions thereto.
These reports cover two thousand pages in manuscript, and have evidently been carefully prepared, and the important information and useful suggestions. contained therein are of great interest and value, not only to the medical profession of our own, but to that of other nations.
From all this data much important medico-scientific information can be de duced, not only in reference to the natives of this country, but of many others.
More than fifty different nativities are included among these records of the examination of men for the army.
Of the most important questions which can be discussed, I would mention the following:
1st. The physical condition of each State or congressional district of the United States.
2d. The prevalence of certain diseases and causes conducive thereto in any section of the United States.
3d. Influence of geographical situation on disease, as climate, hydrological condition, geological formation.
4th. Influence of occupation on disease.
9th. What nationality presents the greatest physical aptitude for military service.
10th. Physical qualifications of the colored race for military service.
11th. Frauds practiced by drafted and enrolled men to escape, and by recruits and substitutes to enter military service, and the best method of detecting, avoiding, or overcoming these difficulties in future.
12th. Height of the inhabitants of each congressional district in the United States ; the average height in each State and in the United States; also the same information in regard to each of the different nativities.
13th. The chest measurement of the inhabitants of each congressional district in the United States; the average in each State and in the United States ; also the same information in reference to each of the different nativities.
14th. Comparison between mental and physical diseases.
It will be observed that the tables presented with this report relate only to the prevalence of certain diseases in each congressional district of the United States, in each State, and in the United States; the number of drafted men, recruits and substitutes examined, and number exempted, together with ratio exempted per thousand examined; the more minute discussion of the subject being impossible for want of time.
Of the importance of the information to be derived from the records on file in this branch of your bureau, I need not speak in extenso.
The medical records of foreign countries relate only to the natives of those particular countries, and do not equal in extent or minuteness those on file in this branch.
The medical reports of recruiting the armies of Great Britain treat almost exclusively of Englishmen, Irishmen, and Scotchmen, from whom those armies are recruited.
Reports of conscription in France and Belgium relate to the natives of those countries alone.
Our own country containing numerous representatives of all other nations, presents the rare opportunity of comparing the physical condition and aptitude for military service of nearly every nation in the world, for, among the recruits and substitutes nearly all nations were represented.
The medico-military history of this country may properly be divided into three divisions :
1st. The physical aptitude of the entire nation for military service, and the character and degree of frequency of disqualifying diseases among its inhabitants of military ages.
2d. The disqualifying causes which render unfit for military service that comparatively small portion of the nation who have entered the army.
3d. The records of that still smaller portion who, having been disabled in