The consolidated returns of this office show for the Army a year of exceptional freedom from disease, although it has been one of unusual activity and hardship for troops stationed on the Southwest frontier. The actual number of admissions to sick report was 3,839 less than for the preceding year, while the ratio of cases to mean strength of command was considerably lower, being as 1,367 per thousand is to 1,532 per thousand. Compared with the average rate for ten years preceding, the admissions were about one-fifth less. The number of cases receiving hospital treatment was 13,650, or 563.5 per thousand of strength. The hospital admissions comprise the more serious cases, and they are the only ones that can be used in making comparisons with the sick rates of the Navy, or with those of the British army. Reports of the former show for the year 1884 an admissiou rate of 967 per thousand of the force afloat; and of the latter, for troops serving in the United Kingdom (1870-'79), 809 per thousand of strength. It is a matter of congratulation that not only the admission rate for the troops, but also the death-rate, has fallen to a lower point than at any time within the history of the Medical Department. Comparisons with the ratios of admissions and deaths for all the years of peace since 1839 will show a progressive and apparently permanent improvement in health. • The years of the war with Mexico and the civil war are omitted. An epidemic of small-pox during this year furnished 877 deaths. An epidemic of cholera and yellow fever furnished 681 deaths. Losses to the Army from discharges for physical disability have also decidedly decreased, though not to the extent shown by the death-rate. * SURGICAL REPORT FOR THE YEAR. Upon consolidated reports of the Medical Department received at this office during the year, there were returned 6,016 cases of injuries, of which 3,393 were cases of contusions and sprains, that, while contribut ing materially to the non-effectiveness of the troops, were not of a seri ous nature. The rate of occurrence for injuries was 247 per thousand of strength, against 273 per thousand for the previous year. Deaths from wounds or other violent causes numbered 72, being in the proportion of 2.95 per 1,000 of strength to 3.45 per 1,000 for the previous year. The number of discharges on certificates of disability for this cause was 69. Appendix B will show, in tabular form, the specific nature of the various causes of death from injuries, with ratios for white and colored troops separately. The years 1883 and 1884 were without casualties from actual warfare. Early in the spring of 1885, however, an outbreak occurred among the Chiracahua Apaches, which was followed by several engagements, in which our troops (chiefly Indian scouts) suffered some losses. At Devil's Creek, New Mexico, May 22, Troops A and K of the Fourth Cavalry, and Indian scouts, under Capt. A. Smith, Fourth Cavalry, engaged the band mentioned, with the loss of 1 enlisted man and 1 scout wounded. The casualties among the hostiles, if any occurred, could not be ascertained. The wounded were transferred to Fort Bayard, N. Mex., and placed under the care of Surg. V. B. Hubbard, U. S. Army. Near Oporto, Mexico, whither the hostiles had been followed by Capt. E. Crawford, of the Third Cavalry, and his command of Indian scouts, an affair occurred on the 23d of June, in which 1 scout was wounded, 1 hostile killed and 3 wounded. Asst. Surg. P. R. Egan, U. S. Army, was in attendance and cared for the wounded. August 7, in the Sierra Madre Mountains, Mexico, Lieut. M. W. Day, Ninth Cavalry, commanding Indian scouts, met the hostiles, with a result of 5 killed, 3 wounded, and 15 captured on their side, our troops sustaining no casualties. Asst. Surg. H. P. Birmingham, U. S. Army, was with the command and furnished the report. September 22, in the Torres Mountains, Mexico, Capt. W. Davis, Fourth Cavalry, commanding Indian scouts, had an engagement with the hostiles, in which he lost 1 scout killed and 1 wounded, the hostiles leaving on the field 1 killed and several wounded. Asst. Surg. H. P. Birmingham, U. S. Army, was with the command and reported the cas ualties. November 7, near Beyer's Springs, N. Mex., a patrol guard of the Sixth Cavalry was ambushed by hostile Apaches. One Indian scout was killed and 1 enlisted man wounded. December 8 and 9, at Clear Creek, New Mexico, a detachment of Troop C, Eighth Cavalry, Lieut. S. W. Fountain, Eighth Cavalry, com manding, attacked the hostile Apaches, killing 2 and wounding several; no casualties occurred among the troops. Asst. Surg. T. J. C. Maddox, U. S. Army, was with the command and furnished the report. December 19, at Little Dry Creek, New Mexico, the same command was ambushed by the hostiles. In this affair 1 officer and 4 enlisted men were killed, and 1 officer and 2 enlisted men wounded, Assistant Surgeon Maddox losing his life. This engagement closed the melancholy list and completed a total of 7 killed and 8 wounded. In addition to the casualties of battle, the rifle-range furnished its quota of gunshot wounds, 3 of which were instantly fatal; besides, 3 men being lost to the service by discharge for disability from this cause. The remaining 12 were returned to duty cured. Of the instantly fatal cases for the year 1 was a shot wound in the head, 1 of the face, and 1 of the abdomen. The location of injury in 15 cases where recovery took place was as follows: Scalp, 3; face, 2; neck, 1; chest, 1; femur, fracture, 1; finger, fracture, 1; arm, flesh, 3; leg, flesh, 3. In the preparation of ammunition for use in rifle practice there occurred 19 cases of injury from explosion of cartridges. All were fol lowed by recovery and return to duty. Location of injury: face, flesh wound in, 4; neck, in, 2; fingers, fractured, 3; arms, flesh wounds, 8; legs, flesh, 2. In addition to the casualties of battle and the rifle-range, there were other cases of death from shot wounds, the result of homicide, suicide. and accident, which are shown in the following table: There were reported 37 operations consequent on shot injuriesTwenty-eight of these were amputations; 1 a simple incision, 1 extrac. tion of bone, 6 for extraction of the missile, and 1 operation for a return of protruding intestines after a perforating gunshot wound of the abdominal walls. In this case death from shock and peritonitis took place within twenty-four hours. There were 95 shot injuries treated conservatively, and in 8 cases death resulted. In addition to the foregoing, there were reported 147 operations for diseases or injuries other than shot wounds, 4 deaths resulting. Three were resections of bone, 5 ligations of arteries, and the others miscellaneous operations, as shown in the table. Anesthetics were employed in 138 operations. General anesthesia was produced by the use of sulphuric ether in 95 cases; by a mixture of chloroform and ether in 24 cases; by chloroform alone in 4; as a local anesthetic, the ether spray was used in 6 cases; the hydrochlorate of cocaine in 10 cases. In 28 operations the reporters failed to state whether anæsthetics were used, and in 18 none was employed. No fatal results following the administration of these drugs have been returned. Threatening symptoms occurred in 3 cases where ether was used, and in 1 operation under chloroform. In 1 case, where a mixture of chloroform and ether was employed, there was great difficulty in the production of anaesthesia, and its use followed by cessation of respira tion, prostration and vomiting. Cocaine was satisfactorily used in 2 operations upon the eye, in 2 single incisions, 1 extirpation of the toe-nail, 1 operation for hemorrhoids, 1 circumcision, 2 operations for urethral stricture, and one for varicocele. The use of Esmarch's elastic bandage for the control of hemorrhage during surgical operations was reported in 18 cases, as follows: In 2 of these cases there was a troublesome capillary hemorrhage following the removal of the constricting bandage. Asst. Surg. C. N. B. Macauley, U. S. Army, reported a case of intermediary amputation of the fore-arm, following shot fracture, where severe oozing continued five hours after operation; it was checked by the free use of liquor ferri subsulphatis. Asst. Surg. H. G. Burton, U. S. Army, also reports in a primary amputation of the ankle joint for shot fracture that there was profuse capillary hemorrhage after the removal of the tourniquet, which was with difficulty controlled; this oozing continued through the night. Antiseptics.-Antiseptics were employed during surgical operations as follows: Solutions of the mercuric bichloride in 32 cases, carbolic acid in 26, salicylic acid in 2. In 108 cases no antiseptics were used, and in the remaining 16 no information is given as to what substance was employed. For surgical dressings after operations, solutions of carbolic acid were used in 46 cases, the mercuric bichloride in 26, iodoform in 28, chlorinated soda in 2. In 73 cases antiseptics were used, and in 9 no information was furnished. Complications.-As complications to shot wounds, there was reported 1 case of chronic tetanus following a wound of the upper extremity, 1 case of acute mania, with amputation of the thigh for shot fracture, 2 cases of partial paralysis following flesh wound of the chest, the loss of sight in one eye from a shot wound of the face. No cases of erysipelas or pyæmia were reported. Vaccinations.-The following tables, compiled from the monthly consolidated reports of the Medical Department of the Army, show the number of troops vaccinated and revaccinated during the year, with ratios per 100 of successes and failures. The tables also show comparative results following the use of bovine and humanized virus. Out of 8,845 vaccinations, there were reported 389 cases in which the conditions produced were of sufficient gravity to cause admission to sick report. No deaths were reported from this cause. The character of the lesions, in most cases, were normal, although in a few instances, where the bovine virus had been used, the occurrence of great prostration, high fever, diffuse cellulitis, swelling of axillary lymphatics, and erysipelas were reported. Recruiting. There were received during the year very complete monthly reports of the examinations of recruits for the Army from 129 military stations and 25 recruiting rendezvous and depots. These reports show that there were inspected by medical officers 16,805 applicants for enlistment. Out of the whole number examined, there were accepted into service 7,244 men and rejected on primary inspection 9,561, or about 57 per cent. of all presenting; of all recruits accepted on primary examination, there were rejected on re-examination at depots 56, or eight-tenths of 1 per cent. For lack of sufficient clerical force, it has been impossible to arrange all the statistical data given upon these reports, but such geueral facts as relate to the various causes of rejections are herewith submitted. By far the most frequent causes of non-acceptance were imperfect mental and physical development and general unfitness. For these reasons, there were rejected 1,996 applicants, or about 12 per cent. of all persons presenting. What these terms really imply is best set forth by Surgeon Greenleaf, U. S. Army, in his Epitome of Tripler's Manual of the Examination of Recruits, 1883: We frequently see men whose constitutions may or may not have been originally feeble, but who, from unfavorable hygienic circumstances, have aggravated or acquired this feebleness, debility, or general unfitness. There is partial or general emaciation, mental sluggishness, a listless air, a torpor of all the faculties, absence of activity, indifference to all their surroundings. Too lazy or too feeble to work, they seek the service as an asylum only, without the least notion of ever performing their duties. Such men are cases for absolute rejection. Diseases and injuries of the locomotor system, such as curvature of the spine, deformities of the legs and of the feet and toes, diseases and injuries of the joints, &c., furnished 1,190 rejections, or 7 per cent. of all persons examined. Disease of the organs of circulation furnished 858 rejections, or about 5 per cent.; 9 of these cases were discovered on secondary inspections at recruiting depots. For diseases of the heart and valves there were 237 rejections, and for varicose veins 621. Diseases of the digestive system contributed 831 rejections, or about 5 per cent., hemorrhoids, the loss of teeth, and hernia being the most frequent causes. On account of visual defects there were 604 rejections, or about 4 per cent. Under the head of impaired vision alone, there were 485 rejections. Seventy-two men were definitely recorded as myopic, and 5 as astigmatic. One case of color-blindness was discovered. There were only 22 rejections for defective vision among colored applicants, the ratio being about one-half less than for the white. Diseases of the urinary and reproductive organs furnished 691 cases; over 500 of these were for varicocele. The rate among white recruits was considerably higher than among colored, standing as 6 to 4 per 100. There were 429 syphilitics detected, and 98 persons having other venereal diseases. Relatively the colored applicants furnished the greater number. For intemperance there were 376 rejections, the rate among white applicants being very nearly four times greater than among the colored. A detailed exhibit of all causes of rejection during the year will be found attached to this report, Appendix D. WORK PERFORMED IN THE RECORD AND PENSION DIVISION DURING THE FISCAL YEAR ENDING JUNE 30, 1886. The total number of official calls upon the Record and Pension Divis ion during the year for information as to the cause of death in cases of deceased soldiers, and for the hospital record of invalids, was 53,352, |