held to service; or in other words, the numbers exempted on account of physical and mental infirmities would be somewhat increased.
Having been president of the Board of medical officers which was convened "to prescribe rules for governing boards of enrollment in determining who shall be exempt from draft as physically or mentally unfit for the service," I venture to offer a few remarks explanatory of the action of the Board on two of the points referred to by the committee, not with a view to criticism, but solely that you may more clearly understand the true meaning of the changes proposed.
Paragraph 34 of the official list of disqualifying diseases and infirmities reads: * * * "Varicocele and cirsocele are not in themselves disqualifying." The committee propose to omit the word "cirsocele," so that the sentence would read: "Varicocele is not in itself disqualifying."
Some of the older writers use the word varicocele to designate an enlarged condition of the veins of the scrotum, and apply the term cirsocele to an enlargement of the veins of the spermatic cord; modern authors describe both conditions as varicocele. The use of the word cirsocele by the Board was perhaps superfluous, but it was intended to show positively that the graver condition--that is, enlargement of the veins of the spermatic cord--did not disqualify.
The committee recommend that paragraph 43 be changed so as to read "los of the second and third phalanges of the fingers of the right hand," instead of "first and second," as it now stands. The two expressions are intended to mean the same thing. The Board, after some discussion, used the words "first and second phalanges of the fingers," in deference to popular usage, though, anatomically speaking, the communications on this subject from Prof. S. D. Gross, M. D., and Henry I. Bowdith, M. D., which you have submitted for my perusal, I respectfully offer the following remarks:
Professor Gross comments on "the loss of the nose," "fistula in an," "loss or atrophy of both testicles, or their retention within the inguinal canal," as "disqualifying infirmities." In my opinion the loss of the nose disqualifies, for three reasons: First. It is usually the result of a constitutional vice, scrofulous or syphilitic. Second. On marches over dusty roads, it is, to say the least, a source of very great discomfort. Third. Soldiers have great repugnance to associating and sleeping with one who has this defect.
Paragraph 28 of the official list reads "fistula in an to is not a positive disqualification, but may become so, if extensive or complicated with visceral disease." "Loss or complete atrophy of both testicles" (not their mere absence from the scrotum) is so likely to be followed by loss of manly courage that in my opinion a person with such infirmity should not be placed in a situation where cowardice would be punished by an ignominious death; and, indeed, I doubt whether such infirmity should not be placed in a situation where cowardice would be punished by an ignominious death; and, indeed, I doubt whether such a person is liable to military service under the law which applies only to "able-bodies amble citizens." When the testicles are retained in the groin they become so inflamed, enlarged, and painful on marches or long rides as to unfit for active service.
Doctor Dowditch suggests more definiteness in paragraph 22, and in this I fully agree, and recommend that the application of that paragraph be restricted to those cases where the loss of teeth is so great that if the man were restricted to solid food he would soon become incapacitated for military service.
R. H. COOLIDGE,
Medical Inspector, U. S. Army.