able element of those who served in the Army or Navy during the late war, has demanded the appointment of examining surgeons to meet the want thus created. In their appointment it has been the object to locate them so as to best serve the convenience of pensioners and claimants, and yet not to make any appointment in excess of the actual demand, it having been the constant experience of this office that such excess entails vexation and mischief, and not unfrequently attempts at fraud.
As hitherto in the conduct of the office, no effort has been spared to instruct the surgeons as to what is desired of them, and to incite them to increased care in conducting the examinations and in the construe tion of the certificates of examination.
There is every reason to believe that this has been attended by good results, since, while two years ago about 40 per cent. of the certificates were returned to the surgeons for correction or for greater detail, there are now not more than 5 per cent. returned to them, and these to such surgeons as, newly appointed, are not yet familiar with the requirements. This improvement in the character of the certificates of examination has resulted, it is firmly believed, in a degree of intelligence and accuracy in the adjudication of invalid claims not before attained.
As said in my report of 1872, the certificates of examination constitute a very important part of every invalid claim, and practically amount to vouchers for the disbursement of the pension appropriation, and I take pleasure in saying that at no time in the history of the office has the examination of invalid claimants been so thorough, nor the certificates thereof so accurate in the "particular description," as within the past year.
The act of Congress of March 3, 1873, codifying the laws in existence, as recommended in the last report, provided by its 38th section for the appointment of a "duly qualified surgeon as medical referee," and for the appointment of such other duly "qualified surgeons (not exceeding four) as the exigencies of the service may require," as aids to the medical referee. Immediately upon the passage of the act, Dr. T. B. Hood, who had been chief of the medical division, was appointed medical referee, and, after an examination in compliance with the civil service regulations of such character as to insure qualifications of a high grade, Drs. J. B. G. Baxter, N. F. Graham, William Grinsted, and W. L. Worcester, were appointed as his aids.
The records of this office contain matter relating to injuries and diseases, particularly those forms incident to military service, which, properly classified and tabulated, would be not only of professional and general interest, but of great practical value, as affording, in case of need, basis for intelligent calculation and legislation. From these facts, tabulated, could be studied many questions touching the rarer forms of gunshot wounds, and the relation of some of the commoner forms of a disease—consumption, for instance—to military service. Many other questions, such as the influence of war in unfitting any given mass of people of a country for manual labor, might be studied from them also— questions which, in their social bearing, are daily becoming more and more important, and of greater and greater interest to the scientist and statesman.
It was hoped to be able to present herewith a table bearing upon the average life of the invalid pensioner of the United States, but so extremely difficult was it found to collate the data that it was necessarily abandoned. There is presented, however, a short table exhibiting the average life, after being pensioned, of 684 invalid pensioners of the
