LVI 
INTRODUCTORY. 
Porrigo; sycosis; the syphilides. 
Alopaecia, if total. 
Naevi; large, livid, hairy, and unsightly spots on the face 
When the imperious need of obtaining men to fill up the dwindling regiments of 
the national forces resulted in the passage of the enrollment-law, a concise code of 
instructions to medical officers, for their guidance in examining recruits, formed a 
part of the official regulations issued by the Provost-Marshal-General for the govern- 
ance of the conscription. Although the more copious rules just given form the present 
official standard, the instructions to enrolling surgeons are well worthy of preservation 
for their own merit and for their pertinence to the history of the draft. In the 
supplementary part of this volume will be found the expressed opinions of a large 
number of the surgeons entrusted with the onerous duty of examining men drafted 
or offered for service, as to the sufficiency and equitable adaptedness of this code for 
the purpose intended. It met, for the most part, with their emphatic approval, the 
alterations recommended being chiefly technical or comparatively unimportant. 
INSTRUCTIONS FOR THE PHYSICAL EXAMINATION OF DRAFTED MEN AND SUBSTITUTES, 
AND GENERAL REGULATIONS CONCERNING.1 
The duty of inspecting men and of determining whether they are fit or unfit for 
the military service of the country requires the utmost impartiality, skill, and circum- 
spection on the part of the examining surgeon and board of enrollment; for upon the 
manner in which this duty is performed will depend, in a very great degree, the 
efficiency of the Army. 
In the examination, the examining surgeons will bear in mind that the object of 
the Government is to secure the services of men who are effective, able-bodied, sober, 
and free from disqualifying diseases. 
The .examining surgeons will also remember that the object of the drafted men, 
in claiming exemption, may be to escape from service by pretended, simulated, or 
factitious diseases, or by exaggerating or aggravating those that really exist, and that 
the design of substitutes frequently is to conceal disqualifying infirmities. % 
The examination by the examining surgeon is to be conducted in the day-time, 
in the presence of the board of enrollment only, and in a room well lighted and 
sufficiently large for the drafted man to walk about and exercise his limbs, which he 
must be required to do briskly. 
The man is to be examined stripped. 
The surgeon will habitually conduct his examination of a man in the following 
order, to ascertain: 
1. Whether his limbs are well formed and sufficiently muscular; whether they 
are ulcerated or extensively cicatrized; whether he has free motion of all his joints; 
and whether there are any varicose veins, tumors, wounds, fractures, dislocations, or 
sprains that would impede his marching, or prevent continuous muscular exertion. 
2. Whether the thumbs and fingers are complete in number, are well formed, 
and their motion unimpaired. 
1 Revised regulations for the gorerninent of the Bureau of the Provost-Marshal-General. Washington, April 1, 18G4. INTRODUCTORY. 
LVU 
3. Whether the feet are sufficiently arched to prevent the tuberosity of the 
scaphoid bone from touching the ground; whether the toes are complete in number, 
do not overlap, are not joined together; and whether the great toes are free from 
bunions. 
4. Whether he has any inveterate and extensive disease of the skin. 
5. Whether he is sufficiently intelligentis not subject to convulsions; and whether 
he has received any contusion or wound of the head that may impair his faculties. 
6. Whether his hearing, vision, and speech are good, and whether the eye and its 
appendages are free from disqualifying diseases. 
7. Whether he has a sufficient number of teeth in good condition to masticate his 
food properly, and to tear his cartridge quickly and with ease. The cartridge is 
torn with the incisor, canine, or bicuspid teeth. 
8. Whether his chest is ample and well formed, in due proportion to his height, 
and with power of full expansion. 
9. Whethe? there is any structural or serious functional disease of the heart. 
10. Whether the abdomen is well formed and not too protuberant; whether 
either the liver or spleen is considerably enlarged; and whether the rectum and anus 
are free from disqualifying diseases. 
11. Whether the spermatic cords and testes are free from diseases which would 
impair his efficiency; whether the testes are within the scrotum; and whether he has 
any rupture. 
12. Whether there is any organic disease of the kidney or bladder, or permanent 
stricture of the urethra. 
13. Whether his physical development is good, and constitution neither naturally 
feeble nor impaired by disease, habitual intemperance, or solitary vice ; whether 
he is free from phthisis, scrofula, and constitutional syphilis ; and whether he is epilep- 
tic, imbecile, or insane. 
Many of the physical defects above mentioned are insufficient to disqualify for 
military service. In determining whether the man is fit or unfit for service, the board 
must be governed by the list of diseases and infirmities enumerated in paragraph 85. 
Paragraph 85. 
The following diseases and infirmities are those which disqualify for military 
service, and for which only drafted men are to be "rejected as physically or mentally 
unfit for the service," viz : 
1. Manifest mental imbecility. 
2. Insanity. This includes well-established recent insanity, with liability to a 
recurrence. 
3. Epilepsy. For this disability the statement of the drafted man is insufficient, and 
the fact must be established by the duly-attested affidavit of a physician in 
good standing, who has attended him in the disease within the six months 
immediately preceding his examination by the board, and, in addition thereto, 
by such other evidence as the board may require. LV111 
INTRODUCTORY. 
4. Paralysis, general or of one limb, or chorea; their existence to be adequately 
determined. Decided atrophy of a limb. 
5. Organic diseases of internal organs, which have so seriously impaired his general 
health as to leave no doubt of his incapacity for military service, and which 
prevents his pursuing any equally laborious occupation in civil life. 
6. Developed tuberculosis. 
7. Cancer; aneurism of the large arteries. 
8. Inveterate and extensive disease of the skin, such as will necessarily impair his 
efficiency as a soldier. 
9. Permanent physical disability of such degree as to leave no doubt of the man's 
unfitness for military service. 
10. Scrofula, or secondary syphilis, which has so seriously impaired his general health 
as to leave no doubt of the man's incapacity for military service. 
11. Chronic rheumatism, unless manifested by positive change of structure, wasting of 
the affected limb, or puffiness or distortion of the joints, does not exempt. 
Impaired motion of joints and contraction of the limbs, alleged to arise from 
rheumatism, and in which the nutrition of the limb is not manifestly im- 
paired, are to be proved by examination while in a state of anaesthesia, induced 
by aether only. 
12. Total loss of sight of right eye; cataract of right eye; loss of crystalline lens of 
right eye. 
13. Partial loss of sight of both eyes, vision being so greatly impaired as to leave no 
doubt of the man's inability to perform military duty. Serious permanent 
diseases of the eye or eye-lids so manifestly affecting the use of the eyes as 
to leave no doubt of the man's incapacity for military service. Nearsighted- 
ness does not exempt. 
14. Total loss of nose; deformity of nose so great as seriously to obstruct respiration; 
ozaena, dependent on caries in progress. 
15. Decided deafness. This disability must not be admitted on the mere statement of 
the drafted man, but must be proved by the existence of positive disease or 
by other satisfactory evidence, and it must be so decided as to leave no 
doubt of the man's unfitness for military service. Chronic purulent otorrhoea. 
16. Incurable diseases or deformities of either jaw, such as will necessarily greatly 
impede mastication or speech. Ankylosis of the lower jaw ; caries of the 
bones of the fa«e, if in progress; cleft palate, (bony;) extensive loss of sub- 
stance of the cheeks, or salivary fistula. 
17. Dumbness; permanent loss of voice; not to be admitted without clear and satis- 
factory proof. 
18. Total loss of tongue; hypertrophy, atrophy, mutilation, or obstinate chronic ulcera- 
tion of the tongue, if sufficient in degree to interfere seriously with the use 
of the organ. 
19. Stammering, if excessive and confirmed; to be established by satisfactory evidence 
under oath. 
20. Total loss of all the front teeth, the eye-teeth, and first molars, even if only of 
one jaw. INTRODUCTORY. 
LIX 
21. Tumors, or wounds of the neck, impeding respiration or deglutition ; fistula of 
larynx or trachea ; torticollis, if of long standing and well marked. 
22. Excessive deformity of the chest, or excessive curvature of the spine, sufficient to 
prevent the carrying of arms and military equipments; caries of the spine, 
ribs, or sternum, attended with ulceration. 
23. Hernia. 
24. Artificial anus; stricture of the rectum; prolapsus ani. Fistula in ano, if exten- 
sive or complicated with visceral disease. 
25. Old and ulcerated internal haemorrhoids, if in degree sufficient to leave no doubt 
of the man's unfitness for military service. External haemorrhoids are no 
cause for exemption. 
26. Total loss or nearly total loss of penis; epispadia or hypospadia at the middle or 
near the root of the penis. 
27. Incurable permanent organic stricture of the urethra, in which the urine is passed 
drop by drop, or which is complicated by disease of the bladder; urinary 
fistula. Recent or spasmodic stricture of the urethra does not exempt. 
28. Incontinence of urine is not, of itself, a cause for exemption. Stone in the bladder, 
ascertained by the introduction of the metallic catheter, is a positive disquali- 
fication. 
29. Confirmed or malignant sarcocele; hydrocele, if complicated with organic disease 
of the testicle. Varicocele is not, in itself, disqualifying. 
30. Loss of a hand or foot. 
31. Wounds which would manifestly incapacitate the man for military service; mus- 
cular or cutaneous contractions from wounds, burns, or tumors, which 
would prevent marching, or otherwise manifestly incapacitate the man for 
military service. 
32. Fractures, irreducible dislocations or ankylosis of the large joints, or chronic 
diseases of the joints or bones, that would prevent marching, or otherwise 
unfit the man for military service. 
33. Total loss of right thumb ; loss of ungual phalanx of right thumb ; total loss of 
any two fingers of same hand ; loss of the first and second phalanges of the 
fingers of right hand. Permanent extension or permanent contraction of 
two fingers of right hand; all the fingers adherent or united. 
34. Club-feet; total loss of a great toe. Other permanent defects or deformities of 
the feet, such as will necessarily prevent marching. 
35. Varicose veins of inferior extremities, if large and numerous, and accompanied 
with chronic swellings or ulcerations. 
36. Chronic ulcers; extensive, deep, and adherent cicatrices of lower extremities. 
No limits of stature are established for drafted men, beyond which they shall be 
exempted from military service. The matter of stature should be considered by the 
board only in the general examination as to the physical fitness of the man for military 
service. • 
The regulations issued by the principal governments of Europe, and those in force 
in our own country, touching the physical qualifications of the recruit, are much alike