A preliminary medical examination of all but one of the men in Squad A was made by Dr. Walter H. Chapin, of Springfield, in October, 1917. The results of these examinations are given in the personal histories (see pp. 47 to 53). In addition, arrangements were made with Dr. H. W. Goodall, of Boston, to give the men a complete clinical examination every time they came to Boston for the biweekly experiments in the group respiration chamber. In these examinations of Dr. Goodall particular attention was given to blood pressure. The results of these determinations will be considered in another section. (See p. 370.) Dr. Goodall went over each man with characteristic care, which is particularly exemplified by his method in examining the subject of the long fast in the Nutrition Laboratory.1 The members of Squad A were first seen by Dr. Goodall on October 13, 1917. His report, aside from blood-pressure observations, for each subject follows:

Details Of Clinical Examination

Bro

October 13, 1917, entirely negative, with exception of slightly enlarged tonsils and very small cervical glands. During the period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, or lungs, percussion outline of heart, or size of liver. Nothing remarkable noted in physical condition of abdominal organs. On February 2, 1918, right kidney felt for first time.

Can

October 13, 1917, negative, with exception of slightly enlarged tonsils. Slight changes noted in percussion outline of heart area as follows: October 13, left border of cardiac dulness 11 cm. from median line, right, 2.5 cm.; October 27, left border, 11 cm., right border, 2 cm.; November 10, left border, 10 cm., right border 2 cm.; same on all following examinations. No change noted in abdominal organs except that on November 10, right kidney palpable for first time; felt at each subsequent examination.

Fre

October 13, 1917, negative, except for very small cervical glands. Heart: Left border cardiac dulness 6.5 cm. from median line, right border, 1.5 cm. Seen only once.

Gar

October 13, 1917, entirely negative, with exception of slightly enlarged tonsils. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, or lungs. Slight changes noted in percussion outline of heart as follows: October 13, left border of cardiac dulness 10 cm., right border 3 cm. from median line; October 27, left border 10 cm., right border 2 cm.; in all subsequent examinations left border, 9 cm., right border, 2 cm. No change noted in abdominal organs, except that on November 10 right kidney was just palpable and at all subsequent examinations.

Gul

October 13, 1917, entifely negative, except for slightly enlarged tonsils and small cervical glands. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. No change noted in percussion outline of heart or abdominal organs. Kidney not felt at any examination.

Man

October 13, 1917, entirely negative, with exception of slightly enlarged tonsils and small axillary glands. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. A slight change noted in percussion outline of heart: October 13, 1917, left border of cardiac dulness 11 cm. and right border 1.5 cm. from median line; October 27, left border 10.5 cm., right border 2 cm.; November 10, left border 9 cm., right border 2 cm., and the same in subsequent examinations. October 13 and 27, edge of liver felt indistinctly; not felt at any subsequent examination. Right kidney just palpable throughout entire period; otherwise no change in abdominal organs noted.

1 Benedict, Carnegie Inst. Wash. Pub. No. 203, 1915, p. 53.

Moy

October 13, 1917, entirely negative, except that cervical and axillary glands small. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. No change noted in percussion outline of heart or in abdominal organs. Right kidney just palpable on February 2.

Pea

October 13, 1917, entirely negative, except for slightly enlarged tonsils. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. No change in percussion outline of heart or in abdominal organs, except that the liver was just felt with deep inspiration on January 12; subsequent to that date it could not be palpated. Right kidney was palpable for first time on November 10 and in all subsequent examinations.

Pec

October 13, 1917, entirely negative, except that axillary and epitroch-lear glands were small and there was a slight thickening of radial arteries. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. No change in percussion outline of heart or in abdominal organs. Kidney not felt.

Spe

October 13, 1917, entirely negative, except that the tonsils were slightly enlarged and cervical and axillary glands were small. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. Heart: Left border of cardiac dulness October 13, 10 cm. from median fine, right border 1.5 cm.; October 27, left border 9.5 cm., right border 2 cm.; November 10, left border 8 cm., right border 2 cm., and the same on all following examinations; last examination, December 8. No change noted in abdominal organs. Kidney not palpable.

Tom

October 13, 1917, entirely negative, except for slightly enlarged tonsils; pharynx reddened and axillary glands small. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs; no change in percussion outline of heart or abdominal organs. Kidney not palpable.

Yea

October 13, 1917, entirely negative, except for small cervical glands. During period of observation no change noted in general appearance, skin, mouth, and contained organs, glands, reflexes, chest, and lungs; no change in percussion outline of heart or abdominal organs except that right kidney was just palpable on February 2.

Kon

October 27, 1917, entirely negative, except for slightly enlarged tonsils. During period of observation no change noted in general appearance, skin, mouth and contained organs, glands, reflexes, chest, and lungs. A faint systolic murmur over the base of the heart heard throughout. Left border of cardiac dulness October 27, 10 cm. from median line, right border 2.5 cm.; November 10 and 24, December 8 and 22, left border 10 cm., right border 2 cm.; January 12, left border 10 cm., right border 1.5 cm.; January 26 and February 2, left border 9 cm., right border 2 cm. No change noted in abdominal organs except that right kidney was palpable after January 12.

The general physical examination of all the men in Squad B was negative. Examinations were made on January 5, 13, 19, and 27, 1918, when all the men were seen. No changes were noted in the percussion of the heart area.

General Observations

In view of his extensive experience as a clinician and his practice in medical examinations, Dr. H. W. Goodall's observations and comments on these men as the research continued are significant. These are given in a letter written a few weeks after the close of the research, and reproduced here. In partial explanation of this letter it should be stated that Dr. Goodall said to one of us that he considered these men were in no condition to endure severe muscular exercise as, for example, trench fighting. It was in response to our request for an elaboration of this statement that he made the following comments:

"According to my notes the attention of the men was considerably fixed upon their low diet on the 10th of November. There was no evidence of any particular physical weakness at that time. On the 24th of November it seemed to me that they moved around with considerably less energy, and on the 8th of December they all complained of not feeling specially well. There was a distinct sense of fatigue on muscular exertion, they found it difficult to study, they were thinking of food all the time. After the Christmas holidays, however, they complained very little, and seemed much stronger and better. It was on the 8th of December that I told you I did not believe these men would be fit to do work in the trenches".