Page images
PDF
EPUB

casual irritation or a night's debauch prior to enlistment; such an appearance is easily distinguished, and never ought to be confounded with inflammation. Cloudiness or specks in the cornea have received the several names, nebula, leucoma, and albugo. Nebula is generally understood as a diffused opacity or haziness situated superficially, and might be the result of slight injury or ophthalmia; in healthy subjects absorption commonly takes place. Leucoma is the opacity caused by a cicatrix, the absorption of which is always very doubtful. Albugo is a deposit of lymph in the deep layers of the cornea ; the absorption of this, likewise, must never induce speculation in a recruit. Were any one of these opacities situated in the axis of vision, impairing the sight of even one eye, it is a decisive cause of rejection. If recent, small, and in a healthy young man, probably absorption would occur. Nevertheless, it might not; and were accident or disease hereafter to injure the sight in the sound eye, the discharge of the soldier would most likely be requisite. A soldier having impaired vision of one eye, or having totally lost it, provided the sight is perfect in the other, is by the fifteenth article of the Pensioning Regulations, to be retained in the service; yet a recruit, similarly situated, is obviously ineligible. Affections of the eyes, or serious results of disease, so evident as not to be overlooked, such as staphyloma, onyx, hypopium, injuries to the iris, synechia, &c., need no special remark. The only diseases of the internal structures of the eye liable to be presented, at the same time likely to deceive, may be enumerated as amaurosis and cataract. Amaurosis is an unquestionable disability; yet, I believe, very rarely indeed is this disease presented in a young lad, eligible in other respects, offering himself for a soldier. The size of the pupil, the probable immobility of the iris, and the limited power of vision, would usually excite suspicion, when a more accurate examination would be likely to reveal it.

Cataract, on the contrary, is by no means so rarely met with. Without reference to origin, density, position, or amount, if the least haziness is detectable at the bottom of the eye the individual is unsuited for duties requiring the sense of vision for the destruction of others, for his own preservation, and all the minutiæ incidental to a soldier's occupation. Incipient or slight cataract can be easily overlooked; we have always a very powerful assistant in the actual amount of a man's vision, a test that must be borne in mind as of necessary application in every examination. This, and perception of the opacity of the lens, are the only decisive guides ; as to immobility of the iris, if the disease be incipient, unless accompanied by amaurosis or synechia, motion may be almost as perfect as in a healthy organ. Did the least suspicion exist, the pupil could be quickly dilated with belladonna or atropine, and the examination accurately prosecuted. Most usually a defect in the clearness of the lens, if present, will be detected. If with these aids the imagined change be not rendered evident, and if the accuracy of vision at various distances be perfect, one might reasonably conclude that a cataract did not exist. 7.— Deafness, copious discharge from the ears.”

This prohibition is to be understood in the fullest sense. The examiner is always to be satisfied of the accuracy of hearing in both ears, and the freedom from all mucopurulent or other discharge beyond the ordinary ceruminous secretion, it matters not whether coming from the ossicula or merely from the lining membrane of the auditory canal. Cases might occur in which the use of a speculum would determine a doubt, yet it is in the treatment or invaliding of soldiers that the inestimable value of this aid for rendering apparent morbid changes in the colour or structure of the membrana tympani, or meatus auditorious externus, is so useful.

Any affection of the nose, except polypus, creating a disability, would not be likely to escape observation. Ozena, disease of the bones, or polypus, may be enumerated as those most likely to occur; the two former are easily recognized by the discharge, fetor, and other evidences; the latter, however, might be so situated as not to be observed. I believe polypus ought not to be a questionable disability; there is cften difficulty of cure; they grow repeatedly after extraction, are occasionally distressing, and their number not always determinable. When polypus is suspected, the assistance of a speculum will usually determine the matter at once.

“8.Luss of many teeth, or the teeth generally unsound.

I am aware this is a most disputed point: different medical officers forming their own estimate of the extent intended to be implied. Yet it appears that such variety of opinion is hardly admissible, as by adhering even to the letter of the instruction, considerable latitude is allowed, and were a specification to a very confined limit intended, doubtless such would have been expressed. Having said thus much, it must at the same time be acknowledged, that the objections to unsound teeth are numerous and valid when judiciously applied. Many have stated that the loss of the incisors of either jaw incapacitate a soldier from effectually biting off the ends of cartridges when loading. This is unquestionably the case, as some force is requisite to tear the strong paper of which they are constructed; an act that could not be quickly accomplished if deficiency or decay of the incisors was extensive. A serious objection is likewise constituted in the fact that general unsoundness or loss of many teeth is commonly an indication of a delicate constitution, symptomatic of depraved health, or occasionally of the strumous diathesis; sometimes of the abuse of mercury, or the effect of mineral acids. The teeth are a most important provision in nature for the perfection of digestion; they serve as appreciable distinctions in classifying the animal kingdom; their peculiar shape, arrangement, and density differing, and evidencing not only the nature of the food, but how essential in some is accurate mastication to the accomplishment of digestion. The loss of many molars and bicuspids must tend to the production of dyspepsia, thereby alone injuring the general health or assisting the train of causes producing disease of organs where there pertains any peculiar idiosyncracy of constitution. Decayed teeth often create excessive suffering from head and tooth-ache; abscesses form in the gums, necrosis is sometimes induced, ulcers form on the tongue, and occasionally violent inflammation is produced in this organ and adjacent tissues. Decayed stumps are often most difficult of extraction, and the circumstance of men coming frequently to hospital on account of any of the very painful results of decayed teeth, which may admit of only tardy or temporary relief, should assist in deeming this a decided disability when extensive. Nevertheless, the fact of a recruit being otherwise eligible always deserves consideration, as mitigating the degree of many equivocal objections.

In the case of enlarged tonsils, certain contingencies are to be recollected; the estimation of which will cause this common affection to be regarded in a serious light. The difficulty of reducing the size of these glands when chronically enlarged, at times the impossibility is constantly experienced. An individual so situated is frequently subject to inflam

« PreviousContinue »