INSTRUCTIONS RELATIVE TO THE PHYSICAL EXAMINATION OF APPLICANTS FOR ADMISSION TO AND PROMOTION IN THE REVENUE-MARINE SERVICE. AND FOR ENLISTED MEN OF SAID SERVICE. INSTRUCTIONS RELATIVE TO THE PHYSICAL EXAMINATION OF APPLICANTS FOR ADMISSION TO AND PROMOTION IN THE REVENUE-MARINE SERVICE. AND FOR ENLISTED MEN OF SAII) SERVICE. Treasury Department, ) Document 82. Secretary—It. M. ] INSTRUCTIONS. Treasury Department, Revenue Marine, Washington, I). C., December 17, 1880. Upon the recommendation of the Surgeon-General of the Marine- Hospital Service, the following regulations governing physical exami- nations are adopted: I. Medical officers of the Marine-Hospital Service, detailed to conduct the physical examination required by paragraph 3 of the regulations governing the admission of candidates to the grade of cadet in the Revenue-Marine Service, will be guided by the following general direc- tions, which will also apply to the examination of applicants for exami- nation for admission to the Engineer Corps of said Service and of sea- men as preliminary to enlistment: II. Any one of the following defects will be sufficient cause for rejec- tion, viz: Decided cachexia; strumous diathesis, or apparent predis- position to any constitutional disease; permanent defects of either of the extremities or articulations, causing inefficiency ; unnatural ex- curvature or incurvature of the spine; impaired vision; color-blindness; myopia; chronic disease of the visual organs; epilepsy; insanity; apparent tendency to convulsions; chronic disease of the ears; deaf- ness; chronic nasal catarrh; polypi; chronic tonsilar enlargement; chronic ulcers, or cicatrices of old ulcers likely to break out afresh ; chronic cardiac affections; insufficient chest expansion; hernia; sar- cocele; hydrocele; varicocele, unless slight; stricture of the urethra or rectum; fistula; hemorrhoids; varicose veins of lower limbs, unless slight; stature less than five feet. III. Besides the above, the existence of any disease, physical de- formity, or abnormal condition of such character as to incapacitate the candidate for the performance of his duties, will be cause for rejection. IY. In making the examinations, medical officers will be guided by the following special directions, which are slightly modified from those in force in the United States Army: 1. In physical examinations of officers, as preliminary to promotion, and of enlisted men as preliminary to re-enlistment, the clothing may or may not be removed at the discretion of the examining-surgeon. 2. In case the disease or disability for which an applicant was rejected is temporary in its character, the rejection at such examination shall not debar him from subsequent examination, in case he claims that the disease for which he was rejected has disappeared. 3. The applicant will be required to divest himself of all his clothing, in the presence of the examining-surgeon, so that any defect, as a stiff joint, &c., which the applicant would wish to conceal, may be detected, especially as he will be thrown off his guard, not supposing the exami- nation had commenced. Having divested himself of his clothing, the candidate should be asked his name, age, nativity, and occupation, and questioned in regard to his general health and that of his family, whether any hereditary taints exist, and if he has ever suffered from any disease or accident; thus endeavoring to obtain all the information possible concerning him; his conversation at the same time enabling the surgeon to judge of his mental qualifications. He will then be placed under the sliding-bar of a stationary measuring-rod, directed to stand erect while his height will be accurately measured, together with the body length. The height measure will be taken while the toes are raised, the candidate resting the foot squarely upon the heel and ball of the foot. A tape measure will be passed around the chest over the inferior angles of the scapula, and directly over the nipples, and an accurate measurement taken both at inspiration and expiration. After this, the color of the eyes and hair and the complexion should be noted, and a general inspection of the whole body made, notice being taken of the muscular development and general appearance; and at the same time tumors, ulcers, varicose veins, chronic swellings of the extremities, or any visible defect that would disqualify him for service should be carefully sought for. The head will then be examined for any depres- sions or irregularities that may exist, and the eyes, eyelids, nose, ears, teeth, palate, and fauces attentively noticed. The chest will then be inspected, and the respiration, action of the heart, and condition of the lungs, ascertained by auscultation and percussion. He will next be directed to stand erect, place his heels together, and raise his hands vertically above his head, the backs together, in which position he will be required to cough and make other expulsive movements, while the abdomen, the inguinal rings, and the scrotum are being examined for hernia. The penis will then be examined for epispadia, hypospadia, and venereal disease; the groin for glandular enlargements; and testi- cles for atrophy, induration, and other diseases. He will then be re- 5 quired to bend forward, the fingers touching the floor, the legs straight, and the feet widely separated, in which position the fissure between the nates will be inspected for haemorrhoids, fistula, prolapsus, or other disease of the anus, and firm pressure will be made along the whole length of the spine, at short intervals, to discover if any tenderness indicative of disease exists. Next he will be required to extend his arms laterally, at right angles to the body, and then bring them together on as nearly the same level as possible both in front and behind; to pronate and supinate them rapidly; to strike out from the shoulder; to flex the arm upon the shoulder, and the forearm upon the arm; and to open and close the fingers rapidly. He will then be required to walk rapidly and to run around the room several times ; to hop, first on one foot and then on the other; with his heels together, to raise himself upon his toes; to flex and extend the thigh, leg, and foot; to kick first with one foot and then with the other, and to make several leaps in the air. While thus excited he will again be examined for lung and heart diseases, also for hernia. In making the examination of the inguinal rings the surgeon will use the index finger of the hand corresponding to the side examined, thus: for the right ring, the right index finger, and vice versa. The eyesight will be tested by the test types furnished by the Department, and the Holmgren worsted test will be employed in testing for color-blindness. The test must be made for each eye separately. The hearing will also be tested by modulating the tones of the voice in conversation with the applicant, and by covering one ear while endeavoring to discover defects of the other. The result of the examination will then be recorded, and, in case of rejection, the disease or infirmity on account of which he was found unfit for service will be written in full in the book prepared for that purpose. JOHN SHERMAN, Secretary.