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 N. M. 3. 
 
 No. 
 
 1123212 
 
 CIRCULAR 
 
 RELATING TO THE 
 
 PHYSICAL EXAMINATION 
 OF RECRUITS 
 
 FOR ENLISTMENT IN THE 
 
 NAVY AND MARINE CORPS 
 
 (FOR THE USE OF STUDENT OFFICERS) 
 
 
 WASHINGTON 
 
 GOVERNMENT PRINTING OFFICE 
 1916 
 
-, 
 
 N. M. S. 
 
 No. 
 
 1123212 
 
 .CIRCULAR 
 
 RELATING TO THE 
 
 PHYSICAL EXAMINATION 
 OF RECRUITS 
 
 FOR ENLISTMENT IN THE 
 
 NAVY AND MARINE CORPS 
 
 (FOR THE USE OF STUDENT OFFICERS) 
 
 
 WASHINGTON 
 GOVERNMENT PRINTING OFFICE 
 
 1916 
 
V 73 2, 73 
 
BUREAU or MEDICINE AND SURGERY, 
 
 NAVY DEPARTMENT, 
 ^Washington, D. C., July 10, 1916. 
 
 The " Circular relating to the physical examination of recruits 
 for enlistment in the Navy and Marine Corps " is issued for use as a 
 textbook by student officers participating in the naval medical corre- 
 spondence course. 
 
 This circular will supersede the circular entitled "Extracts from 
 regulations and instructions in relation to the physical examination 
 of recruits for enlistment in the Navy and Marine Corps." (N. M. S. 
 No. 112321-1. 1912.) 
 
 W. C. BRAISTED, 
 Surgeon General, U. S. Navy. 
 
 Approved. 
 
 JOSEPHUS DANIELS, Secretary. 
 
 366837 
 
CIRCULAR RELATING TO THE PHYSICAL EXAMINATION OF 
 RECRUITS FOR ENLISTMENT IN THE NAVY AND MARINE 
 CORPS. 
 
 [Extracts from the Manual for the Medical Department of the United States Navy are 
 incorporated in this circular. A few minor changes have been made in the text. The 
 numbers in heavy-face type are those of articles in the manual.] 
 
 CONTENTS. 
 
 Page. 
 Physical examination for enlistment (from chap. 12, Manual for the 
 
 Medical Department) 7 
 
 Supplementary notes on recruiting 21 
 
 Instructions in opening and preparing health records (from chap. 13, 
 
 Manual for the Medical Department) 23 
 
 Identification records and finger prints . 27 
 
 Hints for the inexperienced in naval and marine recruiting, especially 
 
 those examiners without experience at sea 37 
 
 Physical examination of the personnel of the Naval Militia prior to 
 
 being mustered into the service of the United States 48 
 
 5 
 
PHYSICAL EXAMINATION OF RECRUITS FOR ENLIST- 
 MENT IN THE NAVY AND MARINE CORPS. 
 
 \ 
 
 [From chap. 12, Manual for the Medical Department.] 
 
 ENLISTMENTS IN THE NAVY LAWS RELATING TO ENLISTMENT. 
 
 2001. Enlistment of minors, deserters, insane, intoxicated, etc., 
 prohibited. Sees. 1420, 1624 <19) R. S.; acts May 12, 1879, Feb. 23, 
 1881. m 
 
 2002. Term of enlistment. Sec. K73, R. S.; acts Mar. 3, 1899, 
 Aug. 22, 1912. 
 
 2003. Term of enlistment, minors. Sec. 1418, R. S. ; acts May 12, 
 1879, Feb. 23, 1881. 
 
 2004. Consent of parents and guardians required before enlist- 
 ment of minors. Sec. 1419, R. S. ; acts May 12, 1879, Feb. 23, 1881. 
 
 2005. Enlistments in the Marine Corps. Act Mar. 3, 1901. 
 
 2006. Physical examination of men of the Naval Militia upon 
 muster into service of the United States. (Act of Feb. 16, 1914.) 
 
 NAVY REGULATIONS AND NAVAL INSTRUCTIONS RELATING TO PHYSICAL 
 EXAMINATION FOR ENLISTMENT. 
 
 2011. Every person enlisted must pass physical examination pre- 
 scribed in medical instructions. (I 3201-3212) ; R 3523 (1). 
 
 2012. Finger prints to be taken. R 3523 (2). 
 
 2013. Records to be made of persons enlisted with physical dis- 
 ability. R3523 (3). 
 
 2014. Minors under 14 years of age, insane, and intoxicated not to 
 be enlisted. R 3524 (2). 
 
 2015. Reenlistments authorized if physically qualified. R 3526. 
 
 2016. Continuous-service men disqualified. R 3528. 
 
 2017. Entries to be made in service record. R 3541; R 3542 (2). 
 
 2018. Marines enlisted must pass physical examination. R 
 4151 (2). 
 
 2019. Reenlistment of marines with disability. R 4151 (3). 
 
 2020. Disabilities to be entered on enlistment papers. R 4151 (4). 
 
 2021. Persons examined physically to be entered on card (rough 
 formX). 13201. 
 
 2022. Examination to be conducted by medical officer. I 3202. 
 
 2023. Examination to be completed and not terminated upon dis- 
 covery of disqualification. I 3203. 
 
 2024. Medical officer who passes recruit subsequently surveyed to 
 be held responsible. I 3204. 
 
 2025. Inspection and inquiry by medical officer. I 3205. 
 
 2026. Intelligence and detection of mental defects. I 3206. 
 
 2027. Age of applicant to be kept in mind. I 3207. 
 
 7 
 
8 PHYSICAL EXAMINATION OF RECRUITS. 
 
 2028. Entries to be niKeb in service and health records. I 3208. 
 
 2029. Defects waived by department. I 3209. 
 
 2030. Recmils to be reovp mined on receiving ship. R 3511 ; I 3210. 
 
 2031. Recruits to be immediately vaccinated. I 3211 (1). 
 
 2032. No recruit to be transferred until vaccinated. I 3211 (2). 
 
 2033. Typhoid prophylaxis to be administered. I 3212. 
 
 2034. Examination of eyesight of gun pointers. I 2501 (3). 
 
 CIRCULARS RELATING TO ENLISTMENT. 
 
 2041. Circular relating to the enlistment of men for the United 
 States Navy. July 20, 1912. 
 
 2042. Extracts from regulations and instructions in relation to the 
 physical examination of recruits. 
 
 PHYSICAL EXAMINATION OF RECRUITS FOR ENLISTMENT IN THE NAVY 
 
 AND ^ARINE CORPS. 
 
 2051. Whenever any person is examined physically for the Navy 
 or Marine Corps, whether subsequently enlisted or rejected, his name 
 and the particulars shall at once be entered on Form X (rough). 
 This form shall be prepared for each applicant examined, whether 
 accepted or rejected, for original or reenlistment, and will be kept 
 for the purpose of preparing Form X. It shall be retained for ship 
 or station files and shall be filed alphabetically, by calendar years, 
 according to the applicant's surname, in order that information may 
 be furnished the bureau upon request. 
 
 Be careful to strike through with ink the term not applicable to the 
 case. 
 
 Form X shall be prepared from the Form X (rough) kept for the 
 purpose, and will be forwarded from receiving ships, Navy and 
 Marine Corps recruiting stations, and marine recruit depots for the 
 quarters ending March 31, June 30, September 30, and December 31 ; 
 from other ships and naval stations or yards for the year ending 
 December 31, or when a ship is placed out of commission or a recruit- 
 ing or other station closed. 
 
 A copy shall be retained for ship or station files. If there have 
 been " No applicants," the report shall be forwarded and this fact so 
 stated in the blank spaces opposite " Navy " and " Marine Corps." 
 
 Central recruiting stations shall include in their report the sub- 
 stations and traveling parties coming under their jurisdiction. 
 
 Medical officers of ships, naval stations, or yards making exam- 
 inations for ships or stations to which no medical officer is assigned 
 shall include these items in their reports. 
 
 Civilian examiners at substations of the Marine Corps will prepare 
 and forward Form X (rough) to the central stations. 
 
 2052. In case a waiver is requested, the action will be noted on 
 Form X (rough) after the cause of rejection, and approval of waiver 
 shall be entered en this form, and also in the service and health 
 records. (R 3523 (3) ; I 3209.) 
 
 2053. Marine recruit depots shall distinguish between "Accepted 
 applicants" transferred from recruiting stations to the depot and 
 those applying originally at the depot by making the proper entry in 
 the space provided on this form. 
 
PHYSICAL EXAMINATION OF KECEUITS. 9 
 
 2054. Previous Army service shall not be considered a reenlist- 
 ment. Previous Navy or Marine Corps service shall be considered a 
 reenlistment in the Navy, and previous Marine Corps or Naval serv- 
 ice shall be considered a reenlistment in the Marine Corps, so far as 
 it applies for use in the preparation of this form. 
 
 2055. The term of enlistment of all enlisted men of the Navy 
 shall be four years, except minors over 17 and under 18 years of age, 
 who shall be enlisted for the period of minority. Minors under 17 
 can not enlist in the Navy. No enlistment for special service is 
 allowed. 
 
 205(5. No minor under the age of 18 years will be enlisted without 
 the written consent of the parent who is his legal guardian; or, if 
 both parents are dead, of a legally appointed guardian. 
 
 Minors under but claiming to be over 18 years of age are liable, if 
 enlisted, to punishment for fraudulent enlistment under the act of 
 Congress approved March 3, 1893. 
 
 2057. Only such persons shall be enlisted as can reasonably be 
 expected to remain in the service, and when enlisted must serve out 
 the term of their enlistment, and can not be discharged prior to that 
 time, except for cause or as otherwise provided. 
 
 2058. Every person before being enlisted must pass the physical 
 examination prescribed in the medical instructions, and no person 
 shall be enlisted for the naval service unless pronounced fit by the 
 commanding and medical officers. 
 
 2059. No person other than a medical officer shall be permitted to 
 conduct any part of a physical examination, to make any measure- 
 ment, or to make any original entry on any medical record of enlist- 
 ment. 
 
 2060. Every such examination must be completed according to the 
 official forms, and shall in no case be suspended on the recognition 
 of a disqualifying defect. 
 
 2061. Medical officers on recruiting duty shall exercise great care 
 and thoroughness in conducting the physical examination of persons 
 presenting themselves for enlistment. While these instructions are 
 applicable in general to all physical examinations, they are intended 
 to cover more particularly the examinations of applicants presenting 
 themselves for original enlistment. While permitted to use his own 
 discretion as to the routine of procedure, the medical officer shall 
 make inquiry on all points indicated below : After testing the vision, 
 color perception, and hearing, and estimating the general fitness of 
 the applicant, his height, weight, and chest measurements mav be 
 taken and recorded, the clothing having been removed. A general 
 inspection and regional examination is then made, as follows : 
 
 (a) The applicant, entirely nude, is to stand before the examiner, 
 in a bright light, and present successively front, rear, and sides. 
 (Retarded development, deformity or asymmetry of body or limbs, 
 knock-knees, bowlegs, or flat feet, especially in minors ; spinal curva- 
 tures ; feebleness of constitution ; strumous or other cachexia ; emaci- 
 ation, obesity; cutaneous or other external disease; glandular swell- 
 ings or other tumors; nodes; varicosities, cicatrices; indications of 
 medical treatment, leech bites, blister stains, seton or scarification 
 scars ; and evidences of smallpox or successful vaccination, or the ad- 
 ministration of salvarsan. 
 
 51677 16 2 
 
10 PHYSICAL EXAMINATION OF RECRUITS. 
 
 (&) Applicant to present dorsal and palmar surfaces of both 
 hands ; to flex and extend every finger ; to grasp with thumb and fore- 
 finger and with whole hand ; to flex and extend, pronate and supinate 
 wrists and forearms; to perform all the motions of shoulder joints, 
 especially circumduction ; to extend arms at right angles to body, and 
 then bend elbow and touch the shoulders with the fingers ; to elevate 
 extended arms above the head, palm to palm, then dorsum to dorsum ; 
 to evert and invert the feet ; to stand on tiptoe, coming down upon the 
 heels quickly, and then lifting toes from floor; to flex each thigh al- 
 ternately upon the abdomen, and, while standing on one leg, to hop ; 
 to perform all the motions of the hip joint; and to walk backward 
 and forward slowly and at double-quick. 
 
 (c) Note effect of these violent exercises on the heart and lungs; 
 observe movements of chest during prolonged inspiration and ex- 
 piration; examine by percussion and auscultation front and rear. 
 (Incipient tuberculosis, valvular disease.) Care should be taken to 
 differentiate between organic murmurs and the functional varieties. 
 
 (d) With hands on the head and chin up, applicant to cough vio- 
 lently (relaxation of umbilical and inguinal regions; hernia; con- 
 cealed venereal disease, especially beneath prepuce and within 
 urethra ; varicocele ; orchitis and other abnormal conditions of testes) . 
 
 (e) Applicant to bend body forward, with knees stiffened, feet 
 wide apart, hands touching the floor, and nates exposed to strong 
 light (hemorrhoids; prolapsus, fistula?). While the applicant is 
 stooping make firm pressure on the spinous process of each vertebra 
 (noting spinal tenderness). 
 
 (/) Motions of head, neck, and lower jaw. 
 
 (g) Cranium and scalp (malformations, depressions, cicatrices, 
 tinea, vermin, etc.). 
 
 (k) Ears (polypi; otorrhea, perforation, dullness of hearing, and 
 degeneration stigmata). 
 
 (i) Mastoid region for scars or tenderness. 
 
 (j) Eyes (absence of cilia?, tarsal redness, obstructed puncta, 
 cprneal opacities, adhesions of iris, defective vision, abnormal condi- 
 tions of conjunctiva?, trachoma, pterygium). 
 
 (&) Nose (polypi; ozena; chronic nasal catarrh). 
 
 (I) Mouth, teeth, tongue, fauces (hypertrophied tonsils ; syphilitic 
 affections, impediments of speech, lingual scars, cleft palate, and re- 
 pulsive stigmata or scars of the face, grotesque tattooing, or the ex- 
 pression characteristic of adenoids). 
 
 2062. No educational standard has been officially established for 
 recruits presenting themselves for enlistment in the naval service. 
 The regulations require, however, that a candidate shall be able to 
 read and write and that he should possess a reasonably quick and 
 clear understanding. His general intelligence may be estimated by 
 his manner of answering the questions addressed to him in obtaining 
 the data required in the health record, and any impediments of speech 
 noted. 
 
 2063. Section 1420 of the Revised Statutes forbids the enlistment 
 in the naval service of any intoxicated person. The evident intention 
 of the law was not only to prevent the admission into the service of 
 men who at the time of presenting themselves for enlistment were 
 under the influence of alcoholic stimulants or drugs, but of those also 
 who were of intemperate habits, A thorough inquiry should be made 
 
PHYSICAL EXAMINATION OF RECRUITS, 11 
 
 into the history of any applicant in which habits of intemperance 
 are suspected. Long indulgence in habits of intemperance will be 
 indicated by persistent redness of the eyes, tremulousness of the 
 hands, sluggishness of the intellect, satinlike texture of the skin of 
 the body, an eruption upon the face, and purple blotches upon the 
 legs. The morphine habitue is often emaciated, prematurely senile, 
 with foul breath, contracted pupils, peculiar pallor, dry skin, and 
 often showing multiple punctures of the skin from the needle. The 
 habitual user of cocaine may be suspected when the applicant ex- 
 hibits unusual buoyancy and mental overactivity accompanied by 
 irrelevant volubility. Cocaine " snuffers " will usually show a charac- 
 teristic hyperemia of the nasal mucous membrane. Medical officers 
 should endeavor to eliminate the insane, vagrant, and criminal classes 
 by a careful study of the personal characteristics of each applicant. 
 Any doubt as to the mental stability of the applicant should deter- 
 mine a careful investigation directed toward his previous history. 
 
 2064. Certain defects which are frequently found associated with 
 the physical condition in cases of reenlistment or continuous service 
 are not necessarily causes of rejection. If deemed of sufficient im- 
 portance to cause rejection, a waiver of the defects may be recom- 
 mended, provided that such disabilities will not interfere with the 
 performance of duty. Waiver is requested on " Report of Rejection," 
 procurable from Bureau of Navigation (Form No. 54). This report 
 shall be forwarded in all cases of physical rejection of continuous- 
 service men. (R. 3528.) Physical infirmities incident to advanced 
 years and long service should be carefully considered in these exami- 
 nations and especially in the case of reenlistment under continuous 
 service. Slight physical defects in those applicants who have ma- 
 tured are of less importance than when occurring in minors. 
 
 Physical disqualifications of a minor nature of probably temporary 
 duration readily amenable to medical or surgical treatment should 
 not necessarily cause rejection, if the candidate is otherwise qualified 
 and desirable. Application will be made to the bureau for the admis- 
 sion to hospital of such cases as supernumeraries for treatment of 
 such duration as may be desirable, having in view the removal of dis- 
 qualifying defects and the ultimate enlistment of a candidate who is 
 in all "other respects qualified. In stating the cause of rejection in 
 such cases ambiguous terms should be avoided and the degree of 
 visual and auditory defects should be given. (M. and S. No. 123734.) 
 
 2065. The examining surgeon shall consider carefully the physical 
 adaptability of the applicant in relation to the character of the duties 
 which he may be called upon to perform. Moderate height and com- 
 pact build are requisite in the ratings of fireman and coal passer. 
 The duties pertaining to these ratings are extremely arduous, and 
 applicants for such positions and candidates for transfer to these 
 ratings must conform in every particular to the required physical 
 standard. As a general rule minors should not be recommended for 
 the ratings of fireman and coal passer. 
 
 2066. Slight physical defects in applicants who belong to the sea- 
 faring class, or in those who have had experience in military life, 
 have less significance than they might otherwise have in the cases of 
 recruits whose lives have been passed in occupations of a more con- 
 fining and debilitating character. In the latter class of candidates 
 the unusual and peculiar services that would necessarily be exacted 
 
12 PHYSICAL EXAMINATION OF RECRUITS. 
 
 of them might develop any weakness or constitutional physical traits 
 that existed prior to enlistment. 
 
 2067. While it is not expected that candidates for special ratings 
 should possess the physique and endurance of those actively engaged 
 in strictly military duties, the examining surgeon should remember 
 that all candidates examined for the several special ratings are en- 
 listed for the performance of all duties pertaining to the naval service 
 ashore and afloat. 
 
 2068. The examining surgeon should consider carefully the physi- 
 ognomy of the candidate. Where the applicant's face is marked 
 by great deformity, warts, or extensive birthmarks, he shall be con- 
 sidered undesirable for the service and shall be rejected. 
 
 2069. The examining surgeon shall exercise the greatest care in 
 the examination of the candidate's feet. Pronounced flat foot, loss 
 or deformity of the large toe, or of two of the smaller toes on one 
 or both feet, partial ankylosis of the ankles, marked callosities or 
 ingrowing toenails, and any other defects which in the opinion of 
 the examining surgeon may interfere with inarching or prolonged 
 sentry or deck duty shall be considered causes for rejection of the 
 applicant. 
 
 2070. The absence of or the marked deformity of the right index 
 finger or thumb shall cause the rejection of the applicant. The im- 
 portance attached to the absence of or deformity of the left index 
 finger or thumb will depend upon the adaptability of the applicant 
 for his special rating, and provided that he is otherwise physically 
 sound. 
 
 2071. In determining the weight to be attached to slight degrees 
 of varicocele, varicose veins, and hemorrhoids, the examining sur- 
 geon shall carefully consider the age, the general physique, and the 
 rating of the applicant. All candidates with hydrocele shall be re- 
 jected, also all candidates with varicocele when accompanied by 
 atrophy of the testes, pain, or an evident neurotic state. 
 
 2072. Marked enlargement in either testicle or the absence of both 
 testicles shall cause the rejection of the applicant. Applicants 
 whose clothing exhales the odor of urine, or who present any evi- 
 dences of incontinence of urine, shall be rejected. Cases of epispadias 
 and hypospadias shall be rejected. 
 
 2073. Every recruit must have at least 20 sound teeth, and of these 
 not less than 4 opposed incisors and 4 opposed molars ; but, if other- 
 wise qualified and desirable, a waiver may be requested in the case 
 of a candidate not having 4 opposed incisors and 4 opposed molars. 
 
 2074. The examination for visual acuteness is of the utmost im- 
 portance and shall be conducted by the medical officer with the great- 
 est care and patience. An appreciable percentage of men are the 
 subjects of slight visual defects, and in the cases of many of those 
 presenting themselves for reenlistment and enlistment these defects 
 may not be sufficiently serious to disqualify them for the naval 
 service. The ignorance, fear, or stupidity on the part of an applicant 
 undergoing examination should be taken into consideration by the 
 examining surgeon, and unless the examination is conducted with 
 care and deliberation an applicant may be rejected whose vision is 
 really good. Slight errors on the part of the applicant, such as 
 misreading a P or T for an F, provided the majority of the letters 
 
PHYSICAL EXAMINATION OF RECRUITS. 13 
 
 or test characters are read with facility, need not be sufficient cause 
 for rejection. The examination shall be conducted in a large well- 
 lighted apartment, and the test cards shall be placed in a good light. 
 The applicant stands at a distance of 20 feet, one eye being tested 
 at a time, and the other covered by a card. Vision is to be expressed 
 as a fraction, of which the numerator shall be the distance at which 
 Snellen's 20-foot test can be determined and the denominator 20. 
 Normal vision (20/20) for each eye, tested separately, shall be re- 
 quired, but in candidates who are otherwise physically sound a mini- 
 mum visual acuteness of 15/20 shall suffice. The existence of several 
 minor defects, combined with a visual acuteness of 15/20 in each eye, 
 shall cause the rejection of the applicant. 
 
 2075. Color perception is to be carefully determined. The usual 
 examination is by Holmgren's method, which may be briefly de- 
 scribed as follows : The worsteds are placed in a pile in the center of 
 a white surface in good daylight. The green test skein is placed 
 aside upon the white cloth, and the person to be examined is directed 
 to select the various shades of the same color from the pile and place 
 them by the sides of the sample. The color blind will make mistakes 
 in the selection of the shades ; or a hesitating manner with a disposi- 
 tion to take the wrong shades may show a feeble chromatic sense. 
 The purple test skein is then used. If the test with the green skein 
 has shown the person examined to be color blind, and on the second 
 or purple test he selects only the purple skeins, he is incompletely 
 color blind ; but if he places with the purple shades of green or gray, 
 he is completely green blind. The red test skein need not neces- 
 sarily be used, but it may be employed to confirm the diagnosis al- 
 ready made ; for the red blind will select, to match the red skein, 
 shades of green or brown which to the normal sense seem darker 
 than the red, while the green blind will select the shades of green 
 or brown which seem lighter. 
 
 2076. The organs of hearing, both the conducting apparatus 
 (outer and middle ear) and the percipient apparatus (internal ear) 
 must be free from disease. In testing the hearing of the applicant 
 advantage should be taken of the absence of other sounds to make 
 the examination. Medical officers should remember that the appli- 
 cant may be totally deaf in one ear and yet may hear all ordinary 
 conversation perfectly if the sound ear is not completely closed. 
 Deafness may be caused by an accumulation of hardened wax, there- 
 fore an otherwise desirable recruit should have his ears well cleaned 
 before final action is taken in his case. Hearing shall be expressed 
 as a fraction, of which the numerator shall be the distance in inches 
 at which the ticking of an ordinary watch can be heard, and the 
 denominator 40. If the voice is used, hearing shall be expressed 
 as a fraction, of which the numerator shall be the distance in feet at 
 which the voice of the examiner can be heard and the denominator 
 15. The voice is a more reliable method of determining the acute- 
 ness of hearing than the watch test, as it allows for variations in 
 hearing with the modifications produced by changes in pitch and 
 tone. Complete deafness in either ear shall be considered a sufficient 
 cause for rejection. Before completing the examination the medical 
 officer shall satisfy himself of the patency of the eustachian tubes 
 and the integrity of the tympanic membranes. 
 
14 PHYSICAL EXAMINATION OF RECKUITS. 
 
 2078. In every case of rejection, the disability unfitting the appli- 
 cant for service, and in other cases any abnormal condition, former 
 grave illness, or serious injury not inconsistent with present bodily 
 vigor shall be entered on Form X (rough). 
 
 2079. Recruits presenting themselves for enlistment in the naval 
 service shall be rejected by the examining surgeon for any one of 
 the following conditions: 
 
 GENERAL, DISQUALIFICATIONS. 
 
 (a) Mental infirmities. Insanity, idiocy, imbecility, dementia. 
 
 (b) Moral infirmities. Intemperance in the use of stimulants or 
 narcotics, evidence of felony, masturbation, sodomy. 
 
 (c) Diseases of the cerebrospinal system. Epilepsy, chorea, all 
 forms of paralysis, tabes dorsalis, neuralgia, stuttering. 
 
 (d) Constitutional diseases. Feebleness of constitution (poor 
 physique), syphilis. 
 
 SPECIAL DISQUALIFICATIONS. 
 
 (e) The skin. All chronic, contagious, and parasitic diseases of 
 the skin, extensive nevi, deep and adherent cicatrices, chronic ulcers, 
 vermin. 
 
 (/) The head. Abnormally large head ; considerable deformities, 
 the consequence of fracture; serious lesions of the skull, the conse- 
 quence of complicated wounds or the operation of trephining ; caries 
 and exfoliation of the bone, injuries of cranial nerves, tinea capitis, 
 alopecia. 
 
 (g) The spine. Caries, spina bifida, lateral or angular curvatures 
 of the cervical, dorsal, or lumbar regions; lumbar abscess, rickets, 
 fracture and dislocation of the vertebrae, angular curvatures, includ- 
 ing gibbosity of the anterior and posterior parts of the thorax. 
 
 (h) The ears. Deafness of one or both ears, all catarrhal and 
 purulent forms of acute and chronic otitis media, polypi and other 
 growths or diseases of the tympanum, labyrinth, or mastoid cells; 
 perforation of the tympanum ; closure of the auditory canal, partial 
 or complete, except from acute abscess, furuncle, or impacted ceru- 
 men ; malformation or loss of the external ear and all diseases there- 
 of, except those which are slight and nonprogressive. 
 
 (i) The eye. Loss of eye, total loss of sight of either eye, con- 
 junctival affections, including trachoma, entropion ; opacities of the 
 cornea, if covering a part of a moderately dilated pupil ; pterygium, 
 if extensive ; strabismus, hydrophthalmia, exophthalmia, conical cor- 
 nea, cataract, loss of crystalline lens, diseases of the lachrymal appa- 
 ratus, ectropion, ptosis, incessant spasmodic motion of the lids, ad- 
 hesion of the lids, large encysted tumors, abscess of the orbit, mus- 
 cular asthenopia, nystagmus. Any affection of the globe of the eye 
 or its contents ; defective vision, including anomalies of accommoda- 
 tion and refraction ; myopia, hypermetropia, if accompanied by asthe- 
 nopia, astigmatism, amblyopia, glaucoma, diplopia, color blindness. 
 
 (j) The face. Extensive nevi, unsightly hairy spots, extensive 
 cicatrices on the face. 
 
 (k) The mouth and fauces. Harelip, simple, double, or compli- 
 cated ; loss of the whole or a considerable part of either lip ; unsightly 
 
PHYSICAL EXAMINATION OF RECRUITS. 15 
 
 mutilation of the lips from wounds, burns, or disease; loss of the 
 whole or part of either maxilla, ununited fractures, ankylosis, deform- 
 ities of either jaw interfering with mastication or speech, loss of 
 certain teeth, cancerous or erectile tumors, hypertrophy or atrophy 
 of the tongue, mutilation of the tongue, adhesion of the tongue to any 
 parts, preventing its free motion; malignant diseases of the tongue, 
 chronic ulcerations, fissures or perforations of the hard palate, sali- 
 vary or bucconasal and thyroglossal fistulre, hypetrophy of the ton- 
 sils sufficient to interfere with respiration or phonation, pyorrhoea. 
 
 (1) The neck. Goiter, adenitis of the cervical glands, tracheal 
 openings, thyroglossal or cervical fistulse, wry neck, chronic laryn- 
 gitis, or any other disease of the larynx which would produce apho- 
 nia, stricture of the esophagus. 
 
 (m] The chest. Malformation of the chest, or badly united frac- 
 tures of ribs or sternum sufficient to interfere with respiration ; caries 
 or necrosis of ribs, deficient expansive mobility, evident predisposi- 
 tion to tuberculosis, chronic pneumonia, emphysema, chronic pleurisy, 
 pleural effusions, chronic bronchitis, asthma, organic disease of the 
 heart or large arteries, serious protracted functional derangement of 
 the heart. 
 
 (n) The abdomen. All chronic inflammations of the gastroin- 
 testinal tract, including diarrhea and dysentery ; diseases of the liver 
 or spleen, including those caused by malarial poisoning, ascites, 
 obesity, dyspepsia, if confirmed; hemorrhoids, prolapsus ani, fistula 
 in ano, considerable fissures of the anus, hernia in all situations. 
 
 (o) Genito-urinary organs. Any acute affection of the genital 
 organs, including gonorrhea, syphilis, and venereal sores ; loss of the 
 penis, phimosis, if complete, stricture of the uretha, loss of both tes- 
 ticles, undescended testicle or permanent retraction of one or both 
 testicles, chronic disease of the testicle or epididymitis, hydrocele of 
 the tunic and cord unless the hydrocele of the cord is small and in- 
 consequent, atrophy of the testicle, varicocele, malformations of the 
 genitalia, epispadias, hypospadias, but a slight degree of hypospadias 
 not preventing the normal passage of urine may not cause rejection; 
 incontinence or retention of urine, urinary fistula, enlargement of 
 the prostate, calculus, cystitis, and all organic diseases of the kidney. 
 
 (p) Affections common to both the upper and lower extremities. 
 Chronic rheumatism, chronic diseases of joints or movable cartilage, 
 old or irreducible dislocations or false joints, severe sprains, relaxa- 
 tion of the ligaments or capsules of joints, dislocations, fistulse con- 
 nected with joints or any part of bones, effusions into joints,. badly 
 united or nonunited fractures, defective or excessive curvature of the 
 ]ong bones, rickets, caries, necrosis, exostoses, atrophy or paralysis/>f 
 a limb; extensive, deep, or adherent cicatrices, especially of burns, 
 contraction or permanent retraction of a limb or portion thereof, loss 
 of a limb or portion thereof, inequality, deformities. 
 
 (q) The upper extremities. Fracture of the clavicle, fracture of 
 the radius and ulna, webbed fingers, permanent flexion or extension 
 of one or more fingers, as well as irremediable loss of motion of these 
 parts ; mutilation or loss of either thumb, total loss of the index finger 
 of the right hand, loss of the second and third phalanges of all fingers 
 of either hand, total loss of any two fingers of the same hand. 
 
 (r) The lower extremities. Varicose veins, knock-knees, clubfeet, 
 flat feet, webbed toes, the toes double or branching, the great toe 
 
16 
 
 PHYSICAL EXAMINATION OF RECRUITS. 
 
 crossing the other toes, hammertoe, bunions, corns, overriding or 
 superposition of any of the toes to an extreme degree, loss of a great 
 toe, loss of any two toes of the same foot, permanent retraction of the 
 last phalanx of any of the toes, or flexion at a right angle of the first 
 phalanx of a toe upon the second, with ankylosis of the articulation ; 
 ingrowing of the nail of the great toe, bromidrosis. 
 
 2080. (a) Table of physical proportions for height, weight, and 
 chest measurement of adults. 
 
 [Bureau of Navigation Circular relating to the enlistment of men, July 20, 1912.J 
 
 Height. 
 
 Weight. 
 
 Chest 
 (mean 
 circum- 
 ference). 
 
 Inches. 
 
 Pounds. 
 
 Inches. 
 
 64 
 
 128 
 
 33 
 
 65 
 
 130 
 
 33 
 
 66 
 
 132 
 
 33 
 
 67 
 
 134 
 
 34 
 
 68 
 
 141 
 
 84$ 
 
 69 
 
 148 
 
 34} 
 
 70 
 
 155 
 
 351 
 
 71 
 
 162 
 
 36 
 
 72 
 
 169 
 
 361 
 
 73 
 
 176 
 
 36f 
 
 Table of physical proportions for enlistment of Filipinos. 
 
 Age. 
 
 Height. 
 
 Weight. 
 
 Chest 
 measure- 
 ment 
 (mean). 
 
 Expansion. 
 
 18 to 19 
 
 61 
 
 105 
 
 301 
 
 2 
 
 20 to 21 
 
 62 
 
 108 
 
 31 
 
 21 
 
 22 and 
 
 62 
 
 110 
 
 31$ 
 
 2| 
 
 over. 
 
 
 
 
 
 2081. The minimum height for acceptance of a man 21 years old 
 or over is 64 inches barefooted. A variation not exceeding 1 inch is 
 permissible if the applicant is in good health and desirable as a re- 
 cruit. The minimum weight for acceptance of a man 21 years old is 
 128 pounds. A variation of 10 pounds, not to fall below 128 pounds 
 in weight or 2 inches in chest measurement below the standard given 
 in the table is admissible when the applicant for enlistment is active, 
 has firm muscles, and is evidently vigorous and healthy, except for 
 enlistment in the rate of coal passer, for which rate full standard 
 measurements will be required. A chest expansion of less than 2 
 inches in a minor, or of less than 2J inches in an adult, is a sufficient 
 
PHYSICAL EXAMINATION OF RECRUITS. 
 
 17 
 
 cause for rejection of an applicant. The table is given to- show what 
 is regarded as a fair standard of physical proportions and not as an 
 absolute guide to be followed in deciding upon the acceptance of re- 
 cruits. 
 
 2082. A minor enlisting as apprentice seaman must conform to the 
 standards noted in the following table, which is also applicable to 
 apprentice musicians, United States Marine Corps, and to midship- 
 men. (Circular of July 20, 1912.) 
 
 
 Minimum 
 height. 
 
 Minimum 
 weight. 
 
 Chest 
 expansion. 
 
 At 17 years of a^e 
 
 Inches. 
 62 
 
 Pounds. 
 110 
 
 Inches. 
 2 
 
 At 18 years of age 
 
 64 
 
 115 
 
 2 
 
 At 19 years of age 
 
 64 
 
 120 
 
 2 
 
 At 20 years of age 
 
 64 
 
 125 
 
 2 
 
 
 
 
 
 (If the age is 6 months in excess of a full year the requirements are 
 those of the age at the next birthday. ) 
 
 (No underweight or underheight is allowed in minors.) 
 
 2083. Marked disproportion of weight over height is not a cause 
 for rejection unless the applicant is positively obese. 
 
 2084. Any one of the following conditions will be sufficient to 
 cause the rejection of an applicant (Bureau of Navigation Circular, 
 1916) : 
 
 (a) Feeble constitution, general poor physique, or impaired gen- 
 eral health. 
 
 (b) Any disease or deformity, either congenital or acquired, that 
 would impair efficiency, such as: Weak or deranged intellect, cuta- 
 neous disease not of a mild type, parasites of the skin or its append- 
 ages, deformity of the skull, abnormal curvature of the spine, torti- 
 collis, inequality of upper or lower extremities, inefficiency of joints 
 or limbs, deformity of joints or bones (either congenital or the re- 
 sult of disease or injury), evidence of epilepsy or other convulsions, 
 defective vision (minimum 15/20 S. in either eye), disease of the 
 eye, color blindness, impaired hearing or disease of the ear, chronic 
 nasal catarrh, ozena, polypi, great enlargement of the tonsils, impedi- 
 ment of speech, disease of heart or lungs or predisposition to such 
 disease, enlarged abdominal organs or evidence of cirrhosis, tumors, 
 hernia, undescended testicle, large varicocele, sarcocele, hydrocele, 
 stricture, fistula, hemorrhoids, large varicose veins, disease of the 
 genito-urinary organs, chronic ulcers, ingrowing nails, bad corns, 
 large bunions, deformity of toes, loss of many teeth, or teeth gen- 
 erally unsound (teeth properly filled not to be considered unsound). 
 Every recruit must have at least 20 sound teeth. 
 
 (c) Any acute disease. 
 
 2085. (a) Each recruit shall be required to take the oath of alle- 
 giance, and further state that the statement he makes regarding his 
 date of birth and previous naval or other military service is correct, 
 and that he is not subject to fits, has no disease concealed or likely to 
 be inherited, and has no stricture or internal piles. The examining 
 
 51677 16 3 
 
18 PHYSICAL EXAMINATION OF RECRUITS. 
 
 surgeon certifies on the service record as follows: "I certify that I 
 have carefully examined, agreeably to the Regulations of the Navy, 
 the above-named recruit, and find that, in my opinion, he is free 
 from all bodily defects and mental infirmity which would in any way 
 disqualify him from performing the duties of his rating, and that 
 he has stated to me that he has no disease concealed or likely to be 
 inherited." 
 
 (b) (1) On account of insufficient or inaccurate information in 
 reports of rejection as to physical defects of applicants for enlist- 
 ment, the bureau is frequently unable to determine whether such de- 
 fects should be waived, and such reports are often returned for fur- 
 ther information before recommendation can be made. 
 
 (2) When a defect is curable by minor operation, the medical ex- 
 aminer should so state and also whether the applicant agrees to 
 operation if necessary. 
 
 (3) In reporting rejections for any of the following defects the 
 bureau desires that the information as noted below be given : 
 
 (4) Flat foot. Give degree of flatness, stating accurately the dis- 
 tance between the tubercle of the scaphoid and the line from the 
 lower border of the internal malleolus to the low T er tubercle on the 
 head of the first metatarsus. The measurement should be taken 
 standing with the weight of the body on that foot and when the foot 
 is at a right angle to the leg and the second toe is on a line with the 
 crest of the tibia. The size of the shoe should also be given. The 
 width of the ball of the foot should be given and any tendency to 
 talipes valgus noted. 
 
 (5) Bunions, hammertoes, corns, and ingrowing toenails should 
 be described accurately as to location, degree, etc. 
 
 (6) Varicocele. State size and indicate by small, medium, or 
 large. 
 
 (7) Varicose veins. State location, extent, and size and indicate 
 by small, medium or large. 
 
 (8) Hemorrhoids. State character and size and indicate by small, 
 medium, or large. 
 
 (9) Hydrocele. State size and indicate by small, medium, or 
 large. 
 
 (10) Hernia. State location, size, and whether incipient, in- 
 complete, or complete. Relaxed rings only are not cause for rejec- 
 tion unless abdominal walls are weak or there is a decided impulse 
 on coughing. 
 
 (11) Deformities. State location, character, degree, and amount 
 of interference with motion. 
 
 (12) Contractures. State location, degree, and amount of inter- 
 ference with motion. 
 
 (13) Stiff joint. State location, degree of flexion and extension 
 obtainable and the strength of the part. 
 
 (14) Defective hearing. State degree, giving distance by watch, 
 by the whispered and spoken voice, stating whether he can readily 
 hear ordinary conversation. State condition of the external canals 
 and drums. 
 
 (15) Defective vision. State defect accurately, whether due to 
 refractive error or other disease ; when practicable, giving correction 
 by lenses. 
 
PHYSICAL EXAMINATION OF RECRUITS. 19 
 
 (16) Missing or defective teeth. State in detail those missing or 
 unerupted and those defective, using diagram, for that purpose. 
 Also state whether teeth will admit of proper repair. 
 
 (17) Deficient height or weight. Always state age, height, and 
 weight. 
 
 (18) Tachycardia. State cause, character, and duration, giving 
 time during examination for applicant to recover from excitement 
 or overexertion. 
 
 (19) Spinal curvature. State location, character, and degree. 
 
 (20) Atrophy or ^hy per trophy of^ testicle. State degree and cause. 
 
 2086. (a} Recruits shall be vaccinated within 24 hours after their 
 arrival on a receiving ship or at a barracks. In case of failure the 
 operation shall be repeated in eight days. If the second vaccination 
 is not successful it shall be repeated at the first opportunity with a 
 vaccine of assured potency. The only acceptable evidence of suc- 
 cessful vaccination is a pitted scar following vaccination. Results 
 of vaccination shall be recorded on the health record and reported on 
 the quarterly report of sick. 
 
 (b) No recruit in the Navy.or Marine Corps shall be transferred 
 from a training station, receiving ship, barracks, or other rendez- 
 vous until the medical officer is satisfied that the man is protected 
 against smallpox. 
 
 (c) Every enlisted man of the Navy or Marine Corps shall be 
 vaccinated upon reenlisting, or extending enlistment, unless (a) he 
 has two pitted vaccination scars, or (b) shows evidence of a previous 
 attack of smallpox. 
 
 (d) Every officer should be vaccinated upon appointment imme- 
 diately upon reporting at his first station for duty, and the fact en- 
 tered on his health record. Eevaccination should be performed at 
 least once in every seven years thereafter unless he has two pitted 
 vaccination scars, or evidence of a previous attack of smallpox. The 
 responsibility for revaccination shall rest upon the medical officer 
 making the annual physical examination required by I 709 (5). If 
 it is impracticable for this medical officer to perform the vaccination, 
 he shall notify the proper medical officer, through official channels, so 
 that it may be carried out. The medical officer who performs the 
 vaccination shall note the result of the vaccination on the officer's 
 health record. (I 3211.) 
 
 2087. (a) Typhoid prophylactic shall be administered to all per- 
 sons upon their first entry into the Navy or Marine Corps. 
 
 (&) It shall be administered to each enlisted man upon each subse- 
 quent enlistment, or extension of enlistment, who is under 45 years 
 of age, or who has not had a well-defined case of typhoid fever. The 
 medical officer making the physical examination at the time of re- 
 enlistment shall start the administration, if practicable; if not, he 
 shall notify the proper medical officer, through official channels, so 
 that the administration may be completed. 
 
 (c) The administration of typhoid prophylaxis should be repeat- 
 ed after a period of four years for all persons in the Navy or Marine 
 Corps who are under 45 years of age, or who have not had a well- 
 defined case of typhoid fever, and the medical officer making the 
 annual physical examination required by Article I 709 (5) shall be 
 responsible for its administration. If it is impracticable for him to 
 
20 PHYSICAL EXAMINATION OF RECRUITS. 
 
 give the prophylactic, he shall notify the proper medical officer, 
 through official channels, so that it may be given. 
 
 (d) The only acceptable evidence of administration of the proph- 
 ylactic shall be the entry on the health record, signed by the medical 
 officer. (I 3212.) 
 
 2088. Medical officers are required by act of February 16, 1914, to 
 conduct a physical examination of men of the Naval Militia when 
 mustered into service of the United States. (General Order No. 150, 
 June 14, 1915.) 
 
 2089. When available, medical officers will make such examina- 
 tions of members of the Naval Auxiliary Service as are prescribed in 
 the regulations for that service. 
 
SUPPLEMENTARY NOTES ON RECRUITING. 
 
 Whenever health records or reports of medical surveys represent 
 a disability to have existed prior to enlistment, the fact shall be 
 reported to the Bureau of Medicine and Surgery; and the medical 
 officer who passed such recruit shall be held accountable for the 
 improper enlistment. (I 3204.) The examination having been con- 
 cluded, and the candidate found qualified for the service, the medical 
 examiner shall enter his descriptive list upon the blank records 
 furnished by the Bureau of Navigation or the commandant of the 
 Marine Corps, and, having signed it, shall transmit the record to the 
 commanding officer of the ship^ station, rendezvous, or post. Upon 
 the transfer at any time of an enlisted person the medical officer shall 
 make the necessary entries upon the health records. 
 
 Relaxed inguinal rings alone should not be considered a cause for 
 rejection, unless there is plain evidence of weakness of the abdominal 
 walls and a decided impulse on coughing. (Par. 2085, Manual for 
 the Medical Department, 1914.) A condition of patulous rings, how- 
 ever, should be noted by the medical officer, but a request for waiver 
 is not considered necessary. 
 
 In the cases of men suffering from minor disqualifications that 
 can be remedied by operation it is important that the candidate 
 should state his willingness to be operated upon if the condition 
 should later result in a disability, but this should not be interpreted 
 to mean that the applicant should be enlisted with a view that he 
 will be immediately operated upon for the removal of his disqualifi- 
 cation. In the adjudication of pension claims it has been decided 
 that disability due to an operation upon a soldier for the cure of piles 
 by a surgeon under whose charge he was during military service is 
 pensionable, notwithstanding that said piles existed prior to enlist- 
 ment. Similar decisions have been made in the cases of other dis- 
 abilities under like circumstances, where a disqualification at the time 
 of enlistment has resulted in a later disability. 
 
 In making recommendation with regard to defective teeth it is 
 advisable to consider the general nutrition of the applicant, and 
 a waiver should not be requested if the applicant is markedly below 
 the weight requirements. 
 
 External hemorrhoids should always be noted, but where the 
 medical officer considers that they would not result in disability, 
 waiver should be requested. In the past 10 years there have been 
 
 21 
 
22 PHYSICAL EXAMINATION OF RECRUITS. 
 
 only 52 discharges from the service for disability on account of 
 hemorrhoids. 
 
 It is generally believed and has been so expressed in articles written 
 on the subject that the scaphoid tubercle is not normally depressed 
 over one-half inch. The Bureau of Medicine and Surgery has, how- 
 ever, for some time considered waivers of men for enlistment in which 
 the depression has been greater than one-half inch and the medical 
 officer and recruiting officer considered the applicant a proper can- 
 didate for enlistment. It is not considered that the footprint, or 
 the depression of the scaphoid tubercle, are as important in judging 
 the degree of weak foot as the range of motion of the foot, and 
 particularly any limitation of adduction. Statistics show that flat 
 foot is one of the most frequent causes of disability, and in view of 
 the act of March 3, 1885, which provides " That all applicants for 
 pension shall be presumed to have had no disability at the time of 
 enlistment, but such presumption may be rebutted," it is considered 
 advisable, when the depression of the scaphoid tubercle is over one- 
 half inch, that a note be made of this fact and a waiver requested. 
 
 The bureau considers that there are many good reasons why waivers 
 should be requested in the cases of candidates for enlistment who fall 
 below the table of physical proportions, not only on account of the 
 law quoted above, but in order that the recruit depot or training 
 station may know that the applicant's physical qualifications have 
 been fully considered. 
 
 Yaricocele of any size should be noted in the enlistment record. 
 It is not considered advisable, under ordinary circumstances, to recom- 
 mend waiver in cases where the varicocele is larger than the testicle. 
 It has been found at recruit depots and training stations that men 
 with large varicoceles make poor recruits; that after operation con- 
 siderable induration frequently results, and the man has to be ex- 
 cused from drills, etc., for a large part of his time at the recruit 
 depot or training station, often ultimately being discharged for 
 disability. 
 
 Atrophy of one testicle should not be considered a cause for rejec- 
 tion, but should be noted on the enlistment record. 
 
OPENING AND PREPARING HEALTH RECORDS. 
 
 [From chap. 13, Manual for the Medical Department.] 
 NAVY REGULATIONS RELATING TO HEALTH RECORDS. 
 
 2201. Patients transferred to have health records. R 2961 (2) ; 
 R 3585 (l)a. 
 
 2202. Entry to be made in health record of men examined before 
 transfer. R 2961 (3) ; R 3581 (5). 
 
 2203. Date of transfer to other than a naval hospital to be noted 
 in health record. R 2962 (1). 
 
 2204. Health records of patients left in foreign hospitals to be left 
 with consul. R 2962 (2). 
 
 2205. Health record continued by medical officer of any ship ar- 
 riving in port. R 2962 (3). 
 
 2206. Junior medical officer to keep health records. R 2977; I 
 3251. 
 
 2207. Not in line of duty entries, on health record. R 2902 (1-5). 
 
 2208. Disabilities of men enlisted to be entered on health records. 
 (I 3209); R 3523 (3). 
 
 2209. Accidents and injuries occurring in absence of medical offi- 
 cer to be noted on health record. R 4563. 
 
 2210. Disposition of health records of paymaster's clerks upon 
 termination of appointment. R 3318 (7). 
 
 NAVAL INSTRUCTIONS RELATING TO HEALTH RECORDS. 
 
 2211. Custody of officers' health records. I 708 (1). 
 
 2212. Every officer required to notifv medical officer of transfer. 
 I 708 (2). 
 
 2213. Health records to senior officer of board for physical exami- 
 nation. I 708 (3). 
 
 2214. Health records upon completion of examination. I 708 (4). 
 
 2215. Health records where no medical officer. I 708 (5). 
 
 2216. Officer on duty where no medical officer to furnish reports 
 of disability. I 708 (6). 
 
 2217. Periodical physical exercises. I 709. 
 
 2218. Entries in health records indicating use of intoxicants, etc. 
 I 707 (5). 
 
 2219. Health records to be inspected by fleet surgeon. I 1122 (2). 
 
 2220. Health records to be verified. I 2102. 
 
 2221. Health records of patients received for passage. I 2116. 
 
 2222. Medical officers shall keep health records. I 2117 (1). 
 
 2223. Completed records to go to Bureau of Medicine and Sur- 
 gery. I 2117 (2). 
 
 2224. Commanding officer to inspect health records. I 2619 (2). 
 
 2225. Entries upon enlistment and transfer. I 3208 (1-2). 
 
 23 
 
24 PHYSICAL EXAMINATION OF RECRUITS. 
 
 . Record of vaccination to be entered on health record. I 
 3211 (1). 
 
 2227. Administration of typhoid prophylaxis to be entered on 
 health record. I 3212. 
 
 2228. Health records at hospitals to be examined weekly. I 3226. 
 
 2229. Patients upon admission to hospitals to have health records. 
 I 3229. 
 
 2230. Health records to be signed and verified. I 3237. 
 
 2231. Care in keeping health records. I 3252. 
 
 2232. Health records to be opened upon appointment or promo- 
 tion of officer. I 3257. 
 
 2233. Examination of enlisted men for rating of fireman or coal 
 passer to be entered on health records. (Letter Nay. 2158-249, 
 Feb. 24, 1912.) 
 
 2234. Records of physical examinations of officers for periodical 
 physical exercise in January to be made in health records. I 709 
 (5); I 708 (3). 
 
 INSTRUCTIONS TO BE OBSERVED IN OPENING AND PREPARING HEALTH 
 
 RECORDS. 
 
 2241. (a) The whole name (Christian, middle, and surname), to 
 correspond with that on service record and to be legibly written out, 
 without abbreviations, and correctly spelled, preference being given 
 to the original spelling of foreigners' names, the surname to precede 
 and to be distinguished by being underlined. 
 
 (b) As far as possible, on reports and returns, the grades and 
 rates of officers and men should be spelled out in full, but where 
 sufficient space is not provided the abbreviations in par. 2241 (b) of 
 the manual should be used. 
 
 Enter the rating in which actually enlisted. 
 Enter the name of the place where enlisted. 
 
 e) Enter date actually enlisted and strike out the term not to be 
 used as not applying in the case of the man under consideration, 
 following the date of enlistment. 
 
 (/) Enter month, day, and year of birth. 
 
 (g) Specify city, town, or other locality of birth, whatever the 
 nationality. 
 
 (h) Enter (from recruit's statement) all former diseases and 
 injuries. 
 
 (i) Give former occupation or occupations. 
 
 (j) For enlisted persons give the number of continuous-service cer- 
 tificate and years of previous service. 
 
 k) Give name and address of nearest relative or friend. 
 I) Enter religion. 
 
 m) Eyes : Blue, gray, blue-gray, yellow-gray, hazel (light brown) , 
 dark brown, bicolored (as when the pupillary border is of a different 
 color from rest of iris) ; also state when the two eyes are of different 
 colors. 
 
 (n) Hair: Flaxen, sandy (yellowish red), auburn (reddish brown). 
 brown (light, dark, or very dark), black; also whether thin, bald. 
 straight, curly, or woolly. 
 
PHYSICAL EXAMINATION OF RECRUITS. 25 
 
 (o) Complexion is not to be described as simply " light " or " dark," 
 but the character and degree shall be as accurately stated as possible; 
 as complexion, pallid, sallow, fair (only when decidedly clear), 
 ruddy, florid, dark (tawny, sunburnt, or tanned), very dark (swarthy 
 or dusky), mulatto, negro. 
 
 (p) Height to be expressed in inches; the body to be erect, the chin 
 neither elevated nor depressed, the feet and knees touching, legs stiff, 
 and arms hanging perpendicularly. 
 
 (q) Weight, body nude, or allowance made for clothing worn. 
 Accuracy of scales to be ascertained before using. 
 
 (r) Vision to be expressed as a fraction, of which the numerator 
 will be the distance at which Snellen's 20-foot test can be determined, 
 and the denominator 20. 
 
 (s) Hearing is to be expressed as a fraction, of which the numera- 
 tor will be the distance in feet a whispered voice can be heard, and the 
 denominator 15. 
 
 (t) Circumference of thorax to express the mean of the greatest 
 circumference after forced inspiration and of the least after forced 
 expiration, measured by a tapeiine horizontally at the precise level 
 of the nipples ; the difference between the greatest and least circum- 
 ference to be entered as expansion. 
 
 (u) Teeth missing or useless shall be indicated by marking the 
 dental formula as noted. 
 
 (v) Remarks: Note any prominent physical trait not inconsistent 
 with bodily vigor or not in such degree as to constitute cause for 
 rejection leanness or the reverse; hirsuteness; slight asymmetry 
 of body or limbs, knock- knees, bowlegs, or flat feet; peculiarities of 
 teeth and genitalia; slight varicocele, etc. In this connection exam- 
 iners are to remember that imperfections that might pass in a man 
 should reject boys. 
 
 (w) Marks and scars should be indicated as required on the printed 
 outline figure. 
 
 (x] Enter the date and nature of any waiver requested. 
 
 (y} Finally sign the record in the space provided. Corrections 
 made subsequent to enlistment to be entered in red ink and initialed. 
 
 224:2. This record shall be prepared for each officer and enlisted 
 man of the Navy and Marine Corps and for members of the Nurse 
 Corps. 
 
IDENTIFICATION RECORDS AND FINGER PRINTS. 
 
 Identification records, consisting of finger prints and personal 
 descriptions, will not hereafter be forwarded to the Bureau of Navi- 
 gation upon the reenlistment of men if the date of last enlistment 
 was subsequent to January 1, 1907, or upon discharge for undesira- 
 bility, bad conduct, or with dishonorable discharge if enlisted subse- 
 quent to that date. 
 
 The files of finger prints, which were inaugurated January 1, 1907, 
 are now practically complete for the term of enlistment provided by 
 law, and in future it will only be necessary to forward finger prints 
 and personal descriptions in the following cases : 
 
 On first enlistment. 
 
 On reenlistment from the Army or Marine Corps. 
 
 On reenlistment when date of last enlistment was prior to January 
 1, 1907. 
 
 Upon discharge as undesirable or w T ith bad conduct or dishonorable 
 discharge if the enlistment occurred prior to January 1, 1907. 
 
 In future it will only be necessary to forward identification records 
 in the following cases to headquarters, United States Marine Corps ; 
 
 Upon application for first enlistment. 
 
 Upon reenlistment from Army or Navy. 
 
 Upon reenlistment from the Marine Corps when date of last enlist- 
 ment was prior to January 1, 1908. 
 
 Upon discharge as undesirable or with bad conduct or dishonorable 
 discharge if the enlistment occurred prior to January 1, 1908. 
 
 Identification records will not hereafter be forwarded upon the 
 reenlistment of men if the date of last enlistment was subsequent to 
 January 1, 1908. 
 
 OUTLINE FIGURE CARD AND DESCRIPTIVE LIST. 
 
 [From chap. 12, Manual for the Medical Department.].- 
 
 2101. The outline figure on the reverse side of the finger-print 
 record shall be filled out in the case of every recruit that has been 
 found physically qualified and accepted for enlistment and for every 
 sailor or marine who presents himself for reenlistment when date 
 of last enlistment was prior to January 1, 1907. 
 
 2102. Medical officers on recruiting duty shall observe the greatest 
 care in the preparation of these cards and shall exercise every care 
 that the record on each card may be complete. 
 
 27 
 
28 
 
 PHYSICAL EXAMINATION OF RECRUITS. 
 
 2103. The medical officer shall make a careful and systematic 
 examination of the body of the man, front and rear, on each side of 
 the median line, separately, commencing at the scalp and ending at 
 the foot, and the following directions shall be carefully noted : 
 
 (a) Cards showing less than five marks in addition to vaccination 
 scars, tattooing, loss of teeth, and deformities (which should like- 
 wise be noted) can not be relied upon in the effort to discover identity 
 
 or to identify a person in suspected cases. Experience shows that 
 as many as 10 or 15 marks may usually be found. 
 
 (b) If no marks be found upon the recruit, the fact should be 
 stated upon both the front and back of the card. If marks are found 
 upon the front and none upon the rear, or vice versa, the entry " no 
 mark " should be made upon the appropriate side of the card. 
 
 (c) Outline figure cards are to be made out in permanent black 
 ink. Copying ink or indelible pencils should not be used. 
 
PHYSICAL EXAMINATION OF RECRUITS. 29 
 
 (d) Name. Christian and middle name in full and surname in the 
 order to be used. The name should be written very plainly, or pref- 
 erably typewritten or printed in plain gothic letters. 
 
 (e) Rate. The rate in which recruit is enlisted shall always be 
 stated. 
 
 (/) Age. The age at the time the card is prepared is the one that 
 shall be given. 
 
 (g) Height. The height is to be given in inches, and as it is re- 
 lied upon as a base in comparing the cards of recruits with the 
 classified descriptions of the former sailors or marines, and as the 
 measurement may to a considerable degree be affected by efforts at 
 deception on the part of the recruit, great care in ascertaining it is 
 enjoined. 
 
 (h) Hair. The scale of hair colors may be given as follows : Flax 
 color ; light brown ; of red hair, as follows : brick red, sandy red, 
 auburn ( reddish brown) ; dark brown; black; of gray hair, as fol- 
 lows: dark gray, light gray (approaching white), iron gray (mixed). 
 
 (i) Eyes. The eyes should be compared by placing the subject 
 with the face in good light. 'Slide the Standard Eye Chart up or 
 down the left side of the face, close to the left eye. The nearest ap- 
 proach in similarity of color is the number to be given. If the right 
 eye is distinctly different in color, its number also should be given. 
 
 (J) White or colored. Write the word "white" or "colored" to 
 indicate race as the case requires. Do not indicate by crossing out 
 one of the words. 
 
 (/) Date of last prior enlistment in the Navy or Marine Corps. 
 If the recruit has had no prior service in the Navy or Marine Corps, 
 write the word " none." 
 
 (I) Missing teeth. To indicate the missing or useless teeth, mark 
 with an X the letters corresponding to the teeth that are absent or 
 useless. Teeth that are partly decayed should be indicated by draw- 
 ing a diagonal line through the corresponding letters. If none are 
 missing, write the word " no " in front or above the words " missing 
 teeth." This will show that they were not overlooked. 
 
 (m) 'Station and date. Write the name of the station at which the 
 card is made out and the date of its preparation. 
 
 2104. Marks on the outline-figure card should be made at points 
 corresponding to those occupied by the marks on the body of the re- 
 cruit. This may readily be accomplished by drawing imaginary lines 
 on the body of the recruit like the dotted lines on the card and plac- 
 ing the mark in the proper position on the card. As the dotted lines 
 mark the boundaries of regions which are used in the systematic 
 arrangement of the cards for purposes of identification, it is im- 
 portant that each mark on the card should be placed in its proper 
 position. 
 
 (a) A pen picture is desired of all marks, showing their inclina- 
 tion and general shape. In the case of tattoos, this is optional. 
 
 (jb) A straight line should be drawn from each mark to its de- 
 scription on the right or left of the figure. Wlien avoidable, these 
 lines should not cross each other. 
 
 (c) When a description is common to a number of marks, it need 
 not be repeated for each one, but the lines may converge to it, if 
 they can do so without crossing others. 
 
30 PHYSICAL EXAMINATION OF RECRUITS. 
 
 (d) The sizes of all scars, moles, warts, birthmarks, etc., are to be 
 given in inches or fractional parts thereof, except in the case of 
 pinhead moles (abbreviation p. m.). 
 
 (e) Pinhead moles are moles less than one-eighth of an inch in 
 diameter. 
 
 (/) Tattoo marks should invariably be noted and described in de- 
 tail as they appear. In the case of devices composed of two or more 
 figures, the component parts should be named, e. g., "heart, cross, 
 and anchor," not " faith, hope, and charity " ; " clasped hands," not 
 " friendship " ; " eagle, shield, crossed cannon, flags, and arrows," 
 not "American coat of arms." The same applies to all emblems, coats 
 of arms, lodge pins, badges, etc. 
 
 (g) Letters, initials, and words should be printed, by hand, in plain 
 roman capitals or gothic, thus: " J. M. H.," "U. S. V.," "I. X. L.," 
 IN GOD WE TRUST," etc. 
 
 (h) Details of costume, posture, and relationship to other de- 
 vices should be given in the case of tattooed representations of men 
 and women, e. g., " woman clinging to a cross " ; " man and woman 
 embracing, houses, lighthouse, and ship in the background " ; " sailor 
 standing by a tombstone, weeping willow overhead, cap in right 
 hand, words ' in memory of my mother ' on stone." 
 
 (*) The size of tattoos need be given only in the case of dots, 
 blotches, circles, lines, etc. 
 
 (j) It is not necessary to state the color or kind of pigment used in 
 the tattooing. 
 
 (k) Do not crowd the description of tattoos between the right arm 
 of the figure and the edge of the card in front, nor the left arm and 
 edge of the card on the back. 
 
 (I) Indecent or obscene tattooing is cause for rejection, but the 
 applicant should be given an opportunity to alter the design, in 
 which event he may, if otherwise qualified, be accepted. 
 
 (m) Do not write on the figure. The figure is to be used only 
 for the purpose of locating, by pen pictures, the different marks 
 found on the body of the recruit. 
 
 (n) Amputations and losses of parts of fingers and toes should 
 be noted, showing the particular member injured and how much of 
 it is gone. 
 
 2105. The following abbreviations are authorized and will be 
 understood in the sense indicated, viz: Amp., amputation; bl., blue; 
 bmk., birthmark; bro., brown; d., depressed (except when following 
 a dimension; then it stands for diameter); f., flat; fl., fleshy; h., 
 hairy; m., mole; p., pitted; p. m. pinhead mole; r., raised; s., scar 
 or smooth; v., vaccination; var., varicose veins or varicocele; w., 
 wart. 
 
 (a) All combinations of these abbreviations are admissible, e. g., 
 p. s. -| d., pitted scar one-half inch in diameter; s. 1, scar 1 inch long; 
 f. p. s. 1 x -|, an oval, flat, pitted scar, 1 inch long and J inch wide. 
 
 (&) Abbreviations denoting shape are unnecessary, for the letter 
 " d " following a dimension shows that the mark is circular. Two 
 dimensions given indicate that the mark is oval or oblong, and when 
 no letter follows the dimension it is understood that the mark or 
 scar is linear. 
 
PHYSICAL EXAMINATION OF BECKUITS. 31 
 
 (c) When a linear mark or scar is otherwise than straight the 
 length to be given is the shortest distance from one extreme to the 
 other. 
 
 (d) The letters "T. M." should not be used as abbreviations for 
 " Tattoo marks," as they are liable to be taken for tattooed letters on 
 the person. 
 
 FINGER PRINTS. 
 
 The apparatus for taking finger prints consists of a form holder, 
 an ink plate, and a roller for spreading the ink on the plate. 
 
 Keep the roller and ink plate clean and free from dust, grit, or 
 hairs, and the ink tube closed when not in use. When the day's work 
 is finished, clean the ink from the plate and roller by means of a cloth 
 and benzine. When not using the roller, rub it with a little sweet 
 oil or lubricating oil before laying it away, to prevent the composi- 
 tion from becoming too hard. 
 
 Preparatory to taking finger prints squeeze a small quantity of ink 
 from the tube and carefully work it, by use of the roller, into a thin 
 film on the plate, the spreading of which may be facilitated by fre- 
 quently turning over the roller. // too much ink is used, the impres- 
 sion will ~be blurred and consequently unsatisfactory. The thickness 
 of the ink after being spread on the plate should be less than one-half 
 the elevation of the ridges, and this can be tested by taking impres- 
 sions. 
 
 The recruit should wash his hands thoroughly with soap and brush, 
 using, if practicable, running water, especial care then being taken 
 to rinse off all soap or lather with cold water. (Fig. 1.) Failure to 
 do this will cause white blotches to appear in the impressions. Imme- 
 diately before placing the fingers on the inked plate the fingers should 
 be well wiped with a cloth dampened with benzine or ether, which 
 should remove all trace of grease, water, or perspiration. 
 
 Two kinds of impressions are used, " plain " and " rolled." A plain 
 impression is obtained by pressing the bulb of the finger, with the 
 plane of the nail parallel to the plane of the plate, on the inked plate 
 and then on the paper in the same manner. A rolled impression is 
 obtained by placing the side of the finger on the inked plate, with 
 the plane of the nail at right angles to the plane of the plate, and 
 rolling the finger over from one side to the other until the plane of 
 the nail is again at right angles to the plane of the plate, but with the 
 bulb surface of the finger facing in the opposite direction, thus inking 
 the surface of the finger, and then rolling the finger over the paper in 
 the same manner, in this way obtaining a clear impression of the 
 ridges on the surface of the finger. This latter impression should 
 include both the palmar surface and the sides of the finger between 
 the tip and the flexure of the last joint. Always roll the fingers from 
 the awkward position to the natural position. (Figs. 3, 4, and 5.) 
 
32 PHYSICAL EXAMINATION OF RECRUITS. 
 
 It is absolutely necessary that the finger prints shall be clear, that 
 the ridges shall be distinctly outlined, and that the " rolled " impres- 
 sions shall be sufficiently large to include all the points needed for 
 accurate classification, and free from blur. Black impressions are 
 better than light ones if the spaces between the ridges are free from 
 blur. 
 
 When the skin of the fingers is in poor condition, make special 
 effort to get best results. 
 
 Entire palmar surface of first joint should be inked so that whole 
 contour of pattern will be shown when finger is rolled. 
 
 Recruit should first be required to sign his name, and then to 
 roll the impression of the right index finger in the space above his 
 signature. This will eliminate entirely the possibility of the recruit 
 signing other than his own identification record. Have only one 
 recruit at a time present in the room where prints are being made, 
 and complete and file each record before the next man enters or is 
 taken up. In this way no other record than the one in question is 
 available or within reach of the recruit being recorded, therefore 
 he can sign no record but his own. Do not allow records to lie 
 around, but file or otherwise dispose of them at once after completing 
 examination. 
 
 In taking impressions, the operator himself should manipulate the 
 hands of the recruit, who should be directed to relax his fingers and 
 not to attempt to assist by adding to the pressure on the inked plate 
 or on the paper. In order that the ink may be taken up on the 
 finger evenly and in sufficient quantity, an unused part of the plate 
 should be selected each time for inking the finger, and when no 
 unused part of the plate remains the ink should be redistributed 
 with the roller or the plate reinked. See that there are no clots of 
 ink where the fingers are to be rolled on the plate. 
 
 The form holder, which is intended to prevent the form from 
 moving about and blurring the print while impressions are being 
 taken, will be used. The best results will be obtained with a table 
 that places the form holder at about the height of the elbow of the 
 recruit when he is standing with his arms hanging at his sides. To 
 place a form in the holder, press out the plate by means of the levers 
 at the ends, place the form in position under the plate, and push 
 back the levers to their original position. The pressure of the springs 
 on the plate will hold the form firmly in position. 
 
 To record the finger prints on Bureau of Navigation Form No. 2 
 and United States Marine Corps Form N. M. C. 330, place one of 
 the blank forms in the holder (Fig. 2), with the upper heavy black 
 line appearing just above the upper edge of the plate ; then take the 
 rolled impressions, in the order named and in proper spaces on the 
 form, of the thumb, index, middle, ring, and little fingers of the right 
 
FIG. 1. Scrubbing hands preliminary to inking fingers. 
 
^^^^^^^^^^^^^^^^^^^^^^^^I^H 
 
FIG. G. Making plain impression of fingers. 
 
FIG. 7. Making plain impression of thumb. 
 
FIG. 8. Properly made record. 
 
r fi 
 
 *- ' ' ft i\ 
 
 M % !! 
 
 in i; 
 
 FIG. 9. Face of the record. Poor index print. Marks on outline figure 
 give no dimensions. 
 
 L-EFT HAND. 
 
 
 
 
 t 
 
 FIG. 10. Imperfect record. Useless for classification. 
 
FIG. 11. Arch. 
 
 FIG. 12. Tented arch. 
 
 Point of core 
 
 Point 
 X* of core 
 
 ,Delta 
 
 FIG. 13. Radial loop, right hand, or ulnar 
 loop, left hand. 
 
 Delta 
 
 FIG. 14. Ulnar loop, right hand, or radial 
 loop, left hand. 
 
 FIG. 15. Whorl. (2 deltas.) 
 
 FIG. 16. Composite. (2 deltas.) 
 
FIG. 17. Ulnar loop (right hand), showing 65 points of identification. 
 
oo NUT POLO TH,S FORM. 
 
 Classification No. 
 
 RIQHT HAND. 
 
 2. 
 
 L-ETT HAND 
 
 3. 
 
 4. 
 
 AND. RK3HT HAND. 
 
 FIG. 18. 1, Whorl improperly rolled, showing only one delta; 2, same finger properly rolled; 3, loop 
 properly rolled; 4, same finger improperly rolled. 
 
PHYSICAL EXAMINATION OF RECRUITS. 33 
 
 hand, the impressions to be located on the form so that the flexure 
 of the last joint is immediately above the folding line. ' This will 
 leave room for a second print to be taken in the upper part of the 
 space in case the first print is defective. 
 
 After the impressions of the fingers of the right hand have been 
 taken, move the form in the holder until the lower heavy black line 
 appears just above the edge of the plate; then take the rolled im- 
 pressions of the fingers of the left hand in the proper spaces on the 
 form. 
 
 After the rolled impression of each finger of both hands has been 
 obtained, again move up the form in the holder until the plate covers 
 only enough of tha lower edge of the form (not exceeding one-fourth 
 inch) to hold it in place. Then take a plain impression of the four 
 fingers of the right hand at one time, the fingers being held together 
 so as to bring the prints within the allotted space, and a similar plain 
 impression of the fingers of theleft hand. Below the finger impres- 
 sions take a plain impression of each thumb. 
 
 The method of obtaining the plain impressions is to take each of 
 the fingers in turn and place the Imlbs only on the inked plate. When 
 this is done, press the recruit's fingers together, and with his hand 
 limp and flat (not bowed or arched) place it in the space shown on 
 the form and press each finger at the base of the nail, lightly. No 
 attention need be paid to the deltas in the plain simultaneous im- 
 pressions, but the detail must be clearly defined. These impressions 
 are used to determine if the rolled impressions are in their proper 
 sequence. (Figs. 6 and 7.) 
 
 A finger should not be noted missing if any portion of it beyond 
 the flexure of the terminal joint remains. The end of a mutilated 
 finger should, in all cases, be inked and recorded as in the case of a 
 perfect digit. 
 
 Figure 10 shows impressions improperly taken. This record is so 
 blurred that it is impossible to classify the impressions, and conse- 
 quently is of no value. 
 
 No amount of pressure by the operator should be used in making 
 or inking rolled impressions. It is the pressure that causes the ink 
 to more readily run in between the ridges. The finger tips should be 
 allowed to touch the paper only with sufficient pressure to make a 
 record. 
 
 Figure 8 represents the only standard which is satisfactory and it 
 is desired that no record be forwarded which is not up to the 
 standard. 
 
 The utmost care should be taken in recording the impressions of 
 the little fingers. From these fingers a subclassification number is 
 obtained. 
 
34 PHYSICAL EXAMINATION OP RECRUITS. 
 
 When the finger-print side of the form has been completed, the 
 impressions will be inspected to make sure that they are clear and free 
 from blur; that all deltas are shown in the rolled impressions, and 
 that the whole contour of the pattern is shown. The rolled impres- 
 sions will also be compared with the plain impressions for the purpose 
 of ascertaining whether they are recorded in proper sequence. Any 
 defective impressions will then be remedied by taking another print 
 in the upper part of the proper space or by using a new form, if 
 necessary. If the impressions are not recorded in proper sequence, 
 a new form must be used, the old one being destroyed. 
 
 After the finger prints have been taken and examined, the oppo- 
 site side of the form will be filled out and the personal description 
 completed by noting on the outline figures the principal identification 
 marks. 
 
 Before making the entries on the personal description side of the 
 blank, allow the ink on the finger-print side to become sufficiently 
 dry to prevent blurring by rubbing. A few minutes will be sufficient 
 if the form is handled carefully and not rubbed about on the desk 
 while the personal description is being entered. A sheet of blotting 
 paper placed under the form will protect it to some extent. If an 
 impression becomes blurred at any time, a new impression must be 
 taken in the upper part of the proper space, or, if necessary, the 
 imperfect form should be destroyed and a new blank used. 
 
 A delta may be formed by the bifurcation of a single ridge or 
 by the abrupt divergence of two ridges that hitherto had run side 
 by side, thus : 
 
 The core of a loop may consist either of an even or uneven num- 
 ber of ridges not joined together, thus: 
 
 Arches. In arches the ridges run from one side to the other, mak- 
 ing no backward turn. Arches have no deltas. (Fig. 11.) 
 
 Tented arches. In patterns of the arch type the ridges near the 
 middle may have an upward thrust, arranging themselves, as it were, 
 on both sides of a spine or axis, toward which adjoining ridges con- 
 verge. The ridges thus converging give to the pattern the appear- 
 
PHYSICAL EXAMINATION OP RECRUITS. 35 
 
 ance of a tent in outline, hence the name tented arch. Tented arches 
 have no deltas. (Fig. 12.) 
 
 In loops some of the ridges make a backward turn but without 
 twist ; there is one delta. If the downwai d slope of the ridges about 
 the core is from the direction of the little finger toward that of the 
 thumb it is a radial loop. Figure 13 is a radial loop in the right 
 hand. The heavy black line drawn from the delta to the core indi- 
 cates the ridges that are counted in classifying loops. In this im- 
 pression the line cuts or crosses 16 ridges. If the downward slope 
 of the ridges about the core is from the thumb side toward the little 
 finger the loop is ulnar. Figure 14 is an ulnar loop in the right 
 hand or a radial loop in the left hand. In this impression the heavy 
 black line crosses 19 ridges. Be sure that the delta is shown if the 
 impression is a loop. 
 
 Whorls. In whorls some of the ridges make a turn through at 
 least one complete circuit. There are two deltas. Whorls are 
 single cored or double cored. (Fig. 15.) The right and left deltas in 
 this impression are shown by the arrowheads. The deltas in whorls 
 must always be shown, in order that the tracings may be properly 
 made. In whorls the ridge traced starts from the left delta and is 
 traced toward the right delta. When the ridge whose course is 
 traced meets the corresponding right delta ridge the whorl is special- 
 ized as M ; when this ridge goes inside of the right delta with three 
 or more ridges intervening it is specialized as I; when the ridge 
 traced goes outside of the right delta with three or more ridges 
 intervening it is specialized as O. 
 
 Figure 16 is a composite. This pattern is classed as a whorl and 
 has two deltas. The right and left deltas in this impression are 
 shown by the arrowheads. 
 
 Figure 17 shows ridge characteristics used in establishing the 
 identity of a person. Unless an impression is free from blur great 
 difficulty is encountered in picking out the points of comparison 
 between two impressions. Sixty-five points of comparison are shown 
 on this impression which are free from blur and could all be used 
 for purposes of comparison and identification with another print 
 of the same individual. 
 
 Figure 18 (1) shows a whorl improperly rolled, with only one delta 
 showing. It is impossible to make a correct tracing of a pattern 
 rolled in this manner. Figure 18 (2) shows the same impression 
 properly rolled. 
 
 Figure 18 (4) shows a loop improperly rolled, with the delta 
 missing. The space between the delta and point of core in loops 
 must be plainly shown and free from blur. This pattern is of no 
 value and can not be properly classified. Figure 18 (3) shows the 
 same pattern properly rolled. 
 
36 PHYSICAL EXAMINATION OF RECRUITS. 
 
 . Each operator should instruct his relief in the taking of finger 
 prints, so that the Bureau of Navigation and Marine Headquarters 
 will be able to receive good finger-print impressions at all times. 
 
 The skin on the finger tips of the bodies of men which have been 
 recovered from the water will be greatly wrinkled or shriveled, so 
 that without some treatment the making of satisfactory prints may 
 be difficult and even impossible. The way to overcome this is to inject 
 water with a hypodermic syringe beneath the skin of the bulb of 
 the finger. This will smooth out the skin for the impression. 
 
HINTS FOR THE INEXPERIENCED IN NAVAL OR MARINE 
 RECRUITING, ESPECIALLY THOSE EXAMINERS WITH- 
 OUT EXPERIENCE AT SEA. 
 
 [These notes are not to be considered as in any way superseding the Navy Regulations 
 and Naval Instructions, or the instructions in the Manual for the Medical Depart- 
 ment.] 
 
 " The health of a navy is primarily in the hands of the medical 
 officers at the recruiting stations." GATE WOOD. 
 
 The recruiting surgeon stands at the door, and none enters unless 
 pronounced physically fit. 
 
 Your duty is to safeguard the interests of both the service and 
 the candidate. You should be of .an open mind, and not allow either 
 a sudden dislike or sympathy to affect the impartiality of your judg- 
 ment. 
 
 A fixed routine of examination should be early established and 
 rigidly followed, as this prevents confusion, saves time, and is the 
 only way to insure a complete examination. 
 
 A good plan is to have a strong light with a reflector so arranged 
 that it will throw a cone of bright light on the candidate, allowing 
 the examiner to stand in the shadow. 
 
 Common varieties of attempted fraudulent enlistment which the 
 examining surgeon should keep in mind: 
 
 (a) Age falsely sworn with intent to deceive. 
 
 (Z>) Men who have been previously rejected physically by the naval 
 or other military service and who deny the fact, 
 
 (c) Deserters or men with dishonorable or medical discharges who 
 deny the fact. These men usually give an assumed name. 
 
 The recruiting line officer will be vigilant in detecting these frauds, 
 but the medical officer should be on the alert for them also, and he 
 has many opportunities for detection that are not open to the recruit- 
 ing officer. A fraudulent enlistment is almost certain to be followed 
 by detection, and entails a loss of time and money to the Government. 
 Even if undetected, most of this class of recruits will prove worth- 
 less, with the possible exception of the boy who lies about his age in 
 order to pass the minimum legal age limit. And perhaps even in 
 his case his relatives will turn up and demand the annulling of his 
 enlistment. 
 
 A man who has previously had a thorough physical examination 
 will often betray a familiarity with the routine. In inspecting the 
 anal region, if such a candidate be told to present his back to the 
 
 37 
 
38 PHYSICAL EXAMINATION OF RECRUITS. 
 
 examiner and stoop over, he will often pull his buttocks apart with- 
 out further instruction. Then, if asked in a casual voice, " Where 
 were you examined before?" he may be caught off his guard and 
 admit a previous examination. . With his back to you, say in a tone 
 of command, " Turn around." If he does an " about face," the infer- 
 ence is obvious. 
 
 The command to draw back the foreskin will frequently be fol- 
 lowed by milking the urethra by the sophisticated. 
 
 " Head " is a shipboard term for toilet. If a man is asked how 
 long since he was at the head, and he understands it, he has probably 
 been to sea, and in the Navy. Of course, he may have heard it from 
 gome naval relative or friend. 
 
 An explanation of the infallibility of finger-print identification, 
 and a display of careful plotting of marks of identification may be 
 followed by a sudden withdrawal of the candidate. If a candidate 
 requests permission to leave for a moment before being sworn in, 
 don't expect him back. Sometimes at an inland station a man will 
 try to enlist in order to obtain free transportation to the coast. Ex- 
 aminers on Marine Corps recruiting duty should be especially care- 
 ful, as marine recruits are not sworn in until they reach the recruit 
 depot. 
 
 Tattooing. Ninety-five per cent of the men who enlist in the Navy 
 fraudulently by concealing previous military service that is discov- 
 erable are tattooed in a manner characteristic of the naval or mili- 
 tary service. 
 
 This fact has been demonstrated by a close observation of the 
 records for the last five years in the identification office of the Navy. 
 As a result, it has been found that men with certain tattoo marks will 
 almost invariably be identified as having served previous enlistments 
 in some branch of the military service. A list of the tell tale tattoo- 
 ing follows: 
 
 Shoulders tattooed with female heads or figures, birds, animals, 
 grotesque figures, butterflies, and stars. 
 Butterflies on any part of the body. 
 Eagle and globe. 
 
 " C. A. C.," " U. S. N.," " IT. S. A.," and U. S. M. C." 
 " Death before dishonor," " In memory of my mother," " In 
 memory of my father." 
 
 Tombstone and weeping willow. 
 
 Pig tattooed on foot. (In olden times it was believed by 
 sailors that if they had a pig tattooed upon the instep of the left 
 foot it would be impossible to drown.) 
 
 Men who have " Manila, P. I.," or the name of any foreign 
 port tattooed on their person have invariably been found to have 
 had military service. 
 
PHYSICAL EXAMINATION OF RECRUITS. 39 
 
 Sailor's head. 
 
 Eagle and shield. 
 
 Crossed guns. 
 
 Apprentice knot (figure of eight). 
 
 Star or other marks over umbilicus. 
 
 Tattooing on penis. 
 
 Tattooing below waist. 
 
 Obscene tattooing. 
 
 Tattooing on buttocks. 
 
 Designs such as dragons, flowers, butterflies, animals, and 
 Japanese women are used almost exclusively by the tattooer in 
 the Orient. 
 
 Applicants for enlistment who are tattooed in the above-named 
 manner should not be enlisted until finger prints have been for- 
 warded to the Bureau of Navigation to determine whether they have 
 had prior service. Such men will "apply in most cases for enlistment 
 in the ratings of coal passer, fireman, ship's cook, baker, seaman, and 
 ordinary seaman. 
 
 An obviously altered tattoo mark should cause suspicion. The 
 identification experts in the Bureau of Navigation have found that 
 tattoo marks, especially butterflies, on the shoulders are more dis- 
 tinctively naval in origin than any other. Extensive tattooing does 
 not necessarily indicate a naval or even a maritime experience, but 
 even though he be cleared of suspicion as a " repeater," the young 
 idler who has his skin covered with tattooing is often an undesirable 
 frequenter of saloons and dives. 
 
 When the examination is nearly completed and the confidence of 
 the suspected candidate has been won by kindly treatment and 
 friendly conversation, he will be off his guard, and inquiries as to 
 birthplace, age, previous residence, previous illness, family history, 
 etc., may elicit a truthful answer where a false statement was made 
 before. 
 
 Get an actual chest measure, without exaggeration due to muscular 
 action and posture. Check up your tape, measuring rod, and scales 
 frequently. The tape stretches, and sometimes a measuring rod will 
 become bent, and show as much as a half-inch error. 
 
 Do not depend upon milking the urethra. Have the man urinate 
 in your presence. Many are sophisticated enough to urinate just 
 before examination. Examine the underclothing for pus. If the 
 meatus is red keep them in the office long enough to show whether 
 there is suppuration. 
 
 Identification. Be careful to mark the missing teeth correctly. 
 The space left by a tooth extracted during childhood may be entirely 
 obliterated by a lateral movement of neighboring teeth, creating a 
 
40 PHYSICAL EXAMINATION OF RECRUITS. 
 
 gap at another place. Be sure you understand the nomenclature in 
 recording complexion, eyes, and hair. 
 
 Get as many well-defined marks of identification as possible, and 
 plot and record them accurately. Careful search will nearly always 
 reveal at least five marks. Many descriptive lists are worthless as a 
 means of identification. Scars about knees should, of course, be 
 recorded, but they are so common as to be of but little value as 
 identification. The same may be said of vaccination scars. 
 
 Temperature. In cases where the skin feels unduly warm the 
 temperature should, of course, be taken. A fact noted by recruiting 
 surgeons is that applicants very frequently display 'a slight eleva- 
 tion of temperature, as high as 99.0, with no discoverable cause, 
 unless it be due to nervousness or excitement. According to some 
 authorities this may be a normal temperature in some individuals, 
 with a maximum normal diurnal range of 1.8 F. In these cases, if 
 the man is otherwise desirable, he should be allowed to dress and 
 sent to the outer office to talk to the men, or on some trivial errand, 
 so that he regains his composure, and the temperature be taken again 
 after two hours, or on the following day. If the diurnal maximum 
 remains high, be cautious. 
 
 In case of a disability which may be temporary, such as bronchitis, 
 or insufficient weight, encourage the man to return again, and 
 perhaps offer him advice as to how to overcome the defect. It has 
 been found that the bronchitis of cotton-mill workers does not 
 clear up. Many applicants are below w r eight simply because of 
 insufficient nourishment. In many cities the aid of charitable organi- 
 zations may be obtained for these men in the way of obtaining tem- 
 porary employment or food and shelter. 
 
 If you have reason to inquire about possible symptoms, do not 
 say " Do you feel so-and-so ? ", but ask leading questions, as if the 
 possession of such symptoms were a matter of course, as " How many 
 times do you get up at night to urinate? ", " How much weight have 
 you lost ? ", " How much do your ears discharge ? " 
 
 In cases where it is possible to remove disqualifications by surgical 
 means, in many cities arrangements can be made with local hospitals 
 to admit these cases for early operation upon a note or card from the 
 examining surgeon. There may be retired naval medical officers or 
 Medical Reserve Corps officers in the vicinity who practice a specialty 
 or are connected with hospitals who could be of assistance in this 
 respect. In any case, make it clear to the candidate that enlistment 
 can not be guaranteed after the operation. Inform applicant of 
 probable time of convalescence and time before he could be enlisted 
 if operation proves a success. Capable dentists may be found who 
 would do work for a reduced fee to remove disqualifications. A local 
 hospital may be found to make laboratory examinations. 
 
PHYSICAL EXAMINATION OF RECRUITS. 41 
 
 It sometimes happens that an examiner will become impressed by 
 some particular defect, especially if some recruit passed by him was 
 later invalided for that defect, and will get into the habit of being 
 too exacting concerning it. 
 
 Try to get the strong, active men. Many will have no organic 
 defects and may be able to squeeze past the height and weight require- 
 ments, and still not be nearly as desirable physically as another who 
 may be robust and vigorous, but has some minor disqualification, 
 which might be waived by the department. As an instance, relaxed 
 external inguinal rings should not be too severely considered. 
 
 When a report or survey is sent to the recruiting surgeon, he should 
 profit by the knowledge gained, but he should not allow it to make 
 him too timid. It does not necessarily indicate implied inefficiency 
 or carelessness, except, of course, in the case of some such obvious 
 defect as an ankylosed joint or grossly defective vision or hearing. 
 
 If a man gives Arizona, Colorado, or other well-known locality 
 for tuberculous invalids as a previous residence, be especially careful 
 in the chest examination. 
 
 The attitudes of the candidate, and of the same man after he 
 becomes a recruit, may be diametrically opposed. The shiftless, lazy 
 individual while being examined for enlistment will endeavor to 
 conceal the same defect that he may be exaggerating in a short time, 
 after he has become tired of a regulated life and of regular work. 
 The pinch of winter or of hard times will diminish the rheumatic 
 twinges or sharpen the hearing at the recruiting station, but the 
 advent of spring and the lure of the road will have an opposite effect 
 upon the same man after he has become a coal passer. 
 
 Do not forget that your candidate is undergoing an experience 
 probably unique to him, and his embarrassment and desire to appear 
 self-possessed may cause him to appear surly and flippant, when 
 such traits may ordinarily be foreign to his disposition. A candidate 
 treated with kindness and consideration becomes an aid to recruiting, 
 whether accepted or not, and will be the cause of other applications 
 being made, and it takes a great many applications to furnish the 
 needed good material. Be searching in your examination, but patient 
 and considerate. 
 
 The regulations prescribe that a man shall be examined only when 
 clean and sober. If he is drunk, he should not be examined, then or 
 subsequently, as he is undesirable. If his body is unclean, the cir- 
 cumstances should be taken into consideration, as they may be beyond 
 his control. Some of these men come long distances to reach the 
 recruiting station, and many have had to travel without money, 
 riding on freight trains, sleeping in haystacks, and cleanliness may 
 have been impossible, especially in cold weather. Unless a man 
 shows signs of long-continued dirt, and is unashamed of it, he may 
 
42 PHYSICAL EXAMINATION OF RECRUITS. 
 
 not be undesirable. The most unclean man may be desirable, if he 
 voluntarily apologizes and can give an acceptable explanation. 
 
 In many cities inquiry will usually reveal some place to which a 
 man may be sent for a free bath, if there are no bathing facilities in 
 the recruiting office. 
 
 The examination of the skulls of men with long hair should be 
 careful. A most marked asymmetry, or depression, or extensive 
 postoperative scar may be concealed by the hair. 
 
 Real bromidrosis is a sufficient cause for rejection. Aboard ship 
 the men sleep very near each other, head to feet, sometimes in a 
 close atmosphere, and the man with ill-smelling feet w r ill be a general 
 nuisance, and will be made miserable himself by his neighbors' 
 wrath. 
 
 Heart murmurs. If after careful examination you are convinced 
 that a murmur is functional, do not hesitate to recommend a waiver 
 if the candidate is otherwise sound. 
 
 Hearing test. Use whispered voice, with residual air. Use num- 
 bers instead of sentences, as one or two words heard may enable the 
 candidate to guess at the others in a sentence. Many recruiting 
 stations will not afford a room of sufficient size and quietness to make 
 an accurate voice test. In such case, if a room is available where the 
 watch test may be more accurately applied, this should be used, but 
 the change should be indicated on the record. The watch used as 
 the standard at the Naval Academy, at 40 inches, is the Ingersoll- 
 Trenton. 
 
 It is easier to deceive the examiner in the watch test than with the 
 voice. The eyes must be kept carefully covered, and the candidate 
 should not be allowed to cover his own eyes. Of course, the briefest, 
 most indirect glance will suffice to inform the man whether he should 
 hear the watch. The movement of the examiners arm as he raises 
 and lowers the watch may be perceptible to the candidate through 
 friction of clothing, etc., and enable him with luck to make three or 
 four accurate guesses. It is better not to ask " Do you hear it now ?" 
 every time you move the watch, but better have him tell you the 
 instant he hears it or loses it. Do not be too brief, as even random 
 guesses may hit the mark two or three times in succession. 
 
 Some examiners use two watches, one ticking and the other silent. 
 In this case the eyes need not be covered, and the test becomes also 
 one of veracity. 
 
 A man may be confused by the ticking of his own watch. 
 
 If you use the voice test, try your voice on a person with known 
 good hearing, as it may be indistinct. 
 
 Always use a speculum in examing ears. Get a clear view of the 
 eardrum in every case. During the 10-year period 1905-1914 middle- 
 ear disease ranked seventh in frequency as a cause for medical dis- 
 charge. 
 
PHYSICAL EXAMINATION OF RECRUITS. 43 
 
 Vision test. Look out for the peeper. See that the eye not being 
 tested is thoroughly and continuously covered. Do not let the candi- 
 date cover his own eye. Cover the unused eye with something which 
 does not touch the eye, as the pressure of a towel may blur a good 
 vision. Have a card with a slot only large enough to show five or six 
 letters of the test card. Be careful that the margins of the opening 
 do not cast a shadow on the type. To be sure of uniformly good 
 illumination it is best to have a 32-candlepower light, with reflector, 
 above the card. 
 
 The Grow cards are recommended for several reasons: 
 
 These cards all have a uniform type, fulfilling Snellen's principle, 
 while the ordinary commercial Snellen's cards in this country show 
 a wide divergence in size and shape of letters. 
 
 The greater number of letters makes possible many more combina- 
 tions, with less chance of deception. 
 
 The ordinary Snellen card with large letters at the top gives a cue 
 to the candidate who may have memorized that card. 
 
 Be thorough in the examination of the eys. Trachoma is more 
 prevalent in this country than is generally believed, as shown by a 
 survey made by the United States Public Health and Marine-Hospi- 
 tal Service in certain sections of the South. 
 
 Beware the "weak sister" of effeminate mannerisms. He will 
 probably sink under the fire of his shipmates' raillery and sarcasm. 
 The sailor man is unmerciful in his jibes at a man so unfortunate as 
 to possess any marked peculiarities, either of person or manner. For 
 the same reason the candidate with huge, outstanding ears or other 
 very prominent features should cause reflection, unless he possesses 
 the physical size and disposition to enforce respect. 
 
 Drug habitues. Always look for the hyperemia or ulceration 
 of the nasal mucosa due to cocaine or heroin snuffing, and marks of 
 needle punctures in the skin. 
 
 Every recruiting station has a laudable ambition to secure as 
 high a percentage of recruits as possible, but the medical examiner 
 should not allow this desire to interfere with his judgment. 
 
 Extracts from "Weak Foot," by Surg. R. C. Holcomb, United 
 States Navy, reproduced from United States Naval Medical Bulletin : 
 
 Weak foot, commonly called pes planus, flat foot, and splay foot, is a frequent 
 cause for rejection of applicants for enlistment in the Army and Navy. The 
 condition is of sufficient importance for a careful examination into the subject 
 with a view to determining its full significance, not only as a cause for rejec- 
 tion among applicants for enlistment but also as a cause of disability. 
 
 The Navy statistics for weak foot or flat foot as a cause for rejection are not 
 available before 1912. For this year, however, out of a total of 78,180 applicants 
 for enlistment 4,534, or 57.99 per 1,000, were rejected on account of flat foot. In 
 1914 the ratio was 108 per 1,000, and in 1915 it was 79 per 1,000. 
 
44 PHYSICAL EXAMINATION OF KECRUITS. 
 
 Bearing in mind the normal low arch in savage races, the diagnosis of weak 
 foot must be judged not only by the appearance of the foot but largely from 
 its function. The main symptoms as pointed out by Whitman (Orthopedic 
 Surgery) group under the following heads: 
 
 1. Attitude. 
 
 2. Distribution of weight and strain. 
 
 3. Contour. 
 
 4. Height of arch. 
 
 5. Bearing surface. 
 
 6. Range of motion. 
 
 7. Pain. 
 
 Attitude. (a) The heel walk; (&) exaggerated turning out of the foot. 
 These two symptoms are not of necessity early symptoms. The cause of the 
 heel walk with its tendency to take the weight off the arch of the foot is not 
 alone the result of the weakness, but also an effort to ease the arch. The 
 exaggerated turning out of the foot needs little comment. * * * A weak- 
 ness of the structures which tie the arch would result in the sinking of the 
 astragalus and its wedging more deeply between the articular surface of the 
 calcaneum and navicular, thus turning the anterior structure outward. There 
 is also an effort of the individual to ease the inner arch by throwing as much 
 weight as possible on the outer arch of the foot. Have the patient walk and 
 note, if the foot is properly used, whether the great toe points to the median line 
 or turns away. Note where the line of the tibia falls, whether over the second 
 toe or inside the great toe. 
 
 Distribution of weight and strain. (a) Examine shoe. 
 
 (1) Observe signs of bulging inward at the arch (look for the impress of 
 mechanical arches, or the clean area in contrast with the rest of the lining in 
 those who have worn arches). 
 
 (2) Observe wearing away of the inner sole of the shoe. 
 (&) Compare the shoe with the bare foot. 
 
 The wearing of the heel and sole of the shoes, and the misshape, a result of 
 strain on the uppers, are valuable bits of evidence which will show in a good 
 measure the strength or weakness of the foot that has been incased within the 
 shoe. 
 
 Contour. With the applicant standing, observe the feet placed side by side, 
 the two internal malleoli and the metatarso-phalangeal joints touching. In 
 normal feet a slight interval remains between them due to the concavity along 
 the inner border. In weak feet the concavity is replaced by a convexity and 
 an attempt at adduction is accompanied by an inturning of the patellae and 
 crests of the tibia. According to Whitman, "this change of contour is the 
 earliest and sometimes the only evidence of weakness." 
 
 Height of the arch. The height of the arch is measured as the distance from 
 a line drawn between (a) the lower border of the internal malleolus and (ft) 
 the lower tubercle on the head of the first metatarsal (Feiss line) to (c) the 
 tubercle of the scaphoid, which distance should not exceed one-half inch. 
 
 It should be understood that this measurement is relative, and is simply a 
 measurement of proportion in the average foot. A small foot might well have 
 a measurement less than this and still be within normal limits, while a foot 
 larger than the average will give a proportional measurement of much greater 
 than one-half inch. About 5 per cent of the cases examined seem to show a 
 deficiency in this measurement, and this conforms very closely to the Army 
 and Navy average of rejections for flat foot. 
 
 Bearing surface. An imprint taken with the finger-print apparatus will show 
 the shape of the bearing surface of the foot. While this may, when present 
 
PHYSICAL EXAMINATION- OF RECRUITS. 45 
 
 in a normal degree, serve to assist in forming an opinion, on the other hand 
 if the imprint is flat, in the absence of other symptoms it would not be suf- 
 ficient to warrant a diagnosis of weak foot. The fatty pad under the arch 
 which is normally present in the young, the highly developed plantar muscles 
 in the savage tribes, or in those not bred to the shoe, all serve to discount 
 the value of this imprint as an aid to diagnosis. According to Whitman: 
 "Of all the tests, this, so often used to demonstrate the height of the arch and 
 thus confirm a diagnosis of flat foot, is of least importance." 
 
 Range of motion. The range of motion in examining the foot should include 
 flexion, abduction and adduction. 
 
 Under normal circumstances the foot will show a concavity along its inner 
 surface, and a line along the crest of the tibia continued over the foot falls 
 over the second toe. Voluntary dorsal and plantar flexion is accomplished 
 by the movement of the astragalus upon the leg bones between the internal 
 and external malleoli. Dorsal flexion is normally between 10 and 20 less 
 than a right angle between the foot and leg. Plantar flexion is much greater 
 and is between 50 and 60 more than a right angle between the foot and leg. 
 
 During voluntary abduction and adduction the astragalus is practically fixed 
 between the internal and external malteoli, and the foot moves on the astraga- 
 lus. The actual range of adduction, while difficult to measure, is about 30 
 from the line continued from the crest of the tibia; abduction is about 15 
 from this line. 
 
 Voluntary adduction or inversion of the foot, is the most important test 
 of all motions to show the weakness of the foot. Extend the leg; keep the 
 crest of the tibia fixed in the median line, then have the patient turn the foot 
 inward as far as possible without rotating the leg. According to Whitman: 
 "Even mild and early cases of weak foot usually show some limitation of this 
 most important motion, and in many instances it is completely lost, the patient 
 turning the entire limb in the effort to adduct the foot." 
 
 The question naturally presents itself: What degree of weak foot may be 
 accepted for service? It is certain that a large number of cases of weak foot 
 are enlisted without being recognized. I think, as a general rule, any man in 
 whom the scaphoid tubercle is not depressed beyond one-half inch below the 
 Feiss line, and who can adduct the feet each between 25 and 30 from the line 
 continued along the crest of the tibia, may be accepted as attaining a standard. 
 It is well also to observe the contour of the inner border of the foot, the feet 
 being placed side by side, noting any beginning downward and inward displace- 
 ment of the astragalus. 
 
 What degree of flat foot should constitute a disability? I think this must 
 depend largely upon the man's rate. We would naturally expect less disability 
 for this cause in the yeoman than in the marine, whose duty is largely a ques- 
 tion of feet. 
 
 In examining the teeth, look for proper occlusion. Even though 
 few or no teeth are missing, many of them may be useless because of 
 lack of occlusion. In young men with evident general disintegration 
 of the teeth, they may be poor risks even if repaired sufficiently to 
 meet the requirements. Naval dental surgeons are not authorized to 
 do crown or bridge work. 
 
 A row of clothes hooks, a mirror, and a buttonhook are recom- 
 mended. 
 
 It is well not to allow any doubt you may have in your mind about 
 passing a defect to be apparent to the candidate. He may possibly 
 
46 PHYSICAL EXAMINATION OF RECRUITS. 
 
 make capital of it later in an attempt to get a medical discharge for 
 " cause existing prior to enlistment." 
 
 In filling out rejection report, regardless of whether waiver be or 
 be not recommended, be sure to describe every defect even though 
 some may be of such minor importance that if any one existed alone 
 it would not be considered a disqualification. In considering a recom- 
 mendation on these reports it is necessary that the bureau should 
 have a clear, composite picture of the physical, mental, and moral 
 status of the candidate. In forwarding telegraphic requests for 
 waiver of deficient height, weight, or chest measurement, always 
 include all three. 
 
 Have the men at substations forward the addresses of men rejected 
 by them if there is any possibility that they may be accepted by the 
 medical officer. Have the substation men encourage these men to go 
 to the main office for examination, or to present themselves at the 
 substation on the next visit of the medical officer, if such visits are 
 made. Recommend that men before going to duty at a substation be 
 given a thorough course of instruction at the main office. 
 
 Hemorrhoids. In any case of tendency to varix or varicocele be 
 especially careful in looking for internal hemorrhoids. 
 
 FORMS USED BY MEDICAL OFFICERS ON RECRUITING DUTY. 
 
 Form 4: Request for supplies (par. 3933, Manual). 
 
 Form Ca and Ca 1: Survey of property (par. 2961, Manual). 
 
 Form D and Da 1 : Inventory of property (par. 3935, Manual). 
 
 Form F (rough) : Abstract of patients (par. 2357, Manual). 
 
 Form G: Hospital ticket (par. 3937, Manual). 
 
 Form H: Health records (par. 2241, Manual). 
 
 Form H : Descriptive sheets. 
 
 Form L: Request for medical survey (par. 2921, Manual). 
 
 Form M: Report of medical survey (par. 2931, Manual). 
 
 Form N: Report of death (par. 2431, Manual). 
 
 Form O : Request for blank forms. 
 
 Form X and Form X (rough), already described. 
 
 Changes in Hospital Corps (par. 3953, Manual). 
 
 These forms are described in the parts of the Manual to which 
 reference is made. Explanatory notes are also printed on the various 
 forms. 
 
 The original recruiting outfit is as follows : Vision test set, urinary 
 test set, stethoscope, thermometer, otoscope, ophthalmoscope, tape- 
 line, and wooden tongue depressors. 
 
 Additional supplies of these articles are obtained by requisition, 
 Form 4. The stethoscope, otoscope, and ophthalmoscope are not ex- 
 pendable, and must be accounted for, and if lost or damaged must 
 be surveyed. The other articles are expendable. 
 
PHYSICAL EXAMINATION OF RECRUITS. 47 
 
 The medical officer is assisted by an enlisted man of the Hospital 
 Corps, who records the findings dictated by the medical officer. The 
 Hospital Corps man should give the necessary instructions to candi- 
 dates to facilitate smoothness of procedure. He should be on the 
 alert during the presence of the candidate in the office for any inci- 
 dent that may escape the notice of the examiner. He may be allowed 
 to make the finge-print records, after he has demonstrated his 
 competence to do so. The prints should be carefully examined by 
 the medical officer in all cases. He may be given the care of the 
 instruments and apparatus. He may assist in the vision and hearing 
 tests. In case of illness among the personnel of the office, he may 
 act as nurse in so far as it does not interfere with the primary duty 
 of the station to secure recruits. 
 
 The recruiting medical officer has the medical care of the officers 
 and men of the Navy and Marine Corps attached to the station and 
 in that vicinity, unless otherwise .provided. Medicines and necessi- 
 ties, except as above noted, are not furnished by the department, but 
 are procured from local sources on prescription. 
 
 In the event of necessary hospital treatment, the patient shall be 
 sent to a suitable local hospital, as provided in article 4532 (1), 
 Navy Regulations, as follows : 
 
 Officers and enlisted men of the Navy and Marine Corps when on duty at a 
 place where there is no naval hospital, may be sent to other hospitals upon the 
 order of the commander in chief, or the senior officer present, and the expenses 
 of such persons shall be paid from the naval hospital fund, and no other 
 charge shall be made against their accounts than such as are made for persons 
 under treatment at naval hospitals. 
 
 Bills for medical attendance upon enlisted men, for medicines and 
 surgeon's necessaries, and for treatment in hospital shall be properly 
 made out and certified to by the medical officer and submitted 
 promptly to the Bureau of Medicine and Surgery before payment, 
 accompanied by a letter of advice giving the disease or injury on 
 account of which the expenses were incurred. Upon all copies of 
 public bills for such expenses the medical officer will certify that 
 Navy medical supplies were not available, or that the services of a 
 Navy medical officer could not be had, or that treatment in hospital 
 was necessary. (Art. 4534, Navy Regulations. ) 
 
 No expenses for medicines for or medical attendance upon a naval 
 officer will be included in the account current. 
 
PHYSICAL EXAMINATION OF THE PERSONNEL OF THE 
 NAVAL MILITIA PRIOR TO BEING MUSTERED INTO THE 
 SERVICE OF THE UNITED STATES. 
 
 1. All officers and enlisted men must undergo this examination 
 before mustering, regardless of any prior physical examination. 
 
 2. The examination will be conducted by medical officers of the 
 Navy, or by medical officers of the Naval Militia in the service of 
 the United States, who have qualified as such, physically and pro- 
 fessionally, and have been mustered in. 
 
 3. The physical requirements are prescribed in General Order 
 No. 150. 
 
 4. Minor or temporary physical disqualifications may be recom- 
 mended to the Navy Department (Bureau of Navigation or head- 
 quarters, United States Marine Corps, as the case may be) for 
 waiver, using the prescribed form, but a suitable note of such physical 
 disqualifications shall be made a part of the descriptive list of the 
 individual. If a waiver be granted, this shall be recorded in* red 
 ink in the proper place on page 2 of the health record, as follows: 
 "Defective vision waived by Bu. Nav. (or Maj. Gen. Commandant) 
 6-1-16." This shall also be entered in the descriptive list of the 
 service record. 
 
 5. New health records will be opened for all officers and enlisted 
 men. Where Navy health records have been adopted as " State 
 health records," a copy of entries in the vaccination, typhoid pro- 
 phylactic, and dental records, and in the abstract of health record, 
 will be entered in the proper places in the new health record. The 
 State health record will be closed and forwarded to the Division of 
 Naval Militia Affairs. The new health record shall have noted on 
 its face in red ink, "Naval Militia in the service of the United 
 States." 
 
 6. All officers and enlisted men will be vaccinated (cowpox) im- 
 mediately after muster into the service of the United States unless 
 there is a well-marked recent vaccination scar, or two pitted vac- 
 cination scars of older origin, or evidence of a previous attack of 
 smallpox (I 3211). Officers and enlisted men will also be given 
 the typhoid prophylactic, unless the State health records show that 
 they have received it within a period of four years preceding, or 
 that they are over 45 years of age, or have had a previously well- 
 defined, attack of typhoid fever (I 3212). 
 
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