CHAPTER VI
Special Statistical Studies In World War I
A short time after Love assumed charge of the work in the Medical Records Section, Col. Frank R. Wigmore, Northwestern University Law Department, attached to the Office of the Provost Marshal General, visited Love`s office with a request that a consolidated table suitable for publication be made from tables that had been received in the Office of the Provost Marshal General. These tables showed the physical condition of the men in the several mobilization and training camps. After this was accomplished, Colonel Wigmore returned to the office with a letter signed by the Provost Marshal General, requesting that the Surgeon General add his signature. The letter was addressed to The Adjutant General and was a request for a statistical analysis to be made of the reports of the physical examinations of the Selective Service registrants submitted by the local boards and the camp examining boards. Love explained to Colonel Wigmore that, in his opinion, the work could be done to better advantage in the Surgeon General`s Office where medical supervision and sufficient personnel engaged in similar work were available. Colonel Wigmore readily agreed to the suggested change, and The Adjutant General consented to make the necessary records available to the Surgeon General for the purposes stated.
It should be pointed out that the Office of the Provost Marshal General was responsible for the direction of the operation of the Selective Service System, specifically establishing the number of men to be submitted for induction from the various sections of the country. This office therefore received reports relating to registrants classified according to the results of the physical examinations held in the local boards and the camp examining boards.
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Both the Provost Marshal General and the Surgeon General recognized that the analysis of these data offered an unusual opportunity to obtain valuable information from a general survey of the population in this country. The study had important military bearing, since it indicated the proportion of men available for the different types of military service. It was important from the standpoint of the social and industrial life, since it would give some insight into the availability of the American population for the various occupations which the social organization required. It had social medical bearing, since it indicated the physical and mental status of the population in various sections of the country under the different sanitary conditions that prevailed and with the varying opportunities for medical and surgical treatment. In connection with this aspect of its importance, it indicated the size and the nature of the task for those who would seek to improve, by better conditions as well as by better care and surgical treatment, the physical and mental status of the population. Finally, it had biological and eugenic significance insofar as it might reveal the inherent failure of man to make a complete adaptation to the rapidly advancing requirements of a highly artificial civilization, and insofar as it might throw light on the constitutional limitations of the various races comprising the population to meet the conditions imposed by that civilization.
Since physical condition depends to some extent on economic, social, environmental, racial, and industrial factors, it seemed essential, in order to obtain a true picture of the physical condition of the population of any section or group of sections, that those examined be truly representative of all classes. These conditions were fulfilled by the draft, since the men were not drawn from any particular economic class or any one section or group of sections. The Provost Marshal was no respecter of persons or sections, and his long arm reached out and drew them in from the densely populated urban districts and from the sparsely settled mountain sections, from congested factory and isolated farm areas, from clerical positions and from occupations as laborers, from the most sumptuous homes of the rich and the most squalid hovels of the poor-in fact, from every economic and social class. Men were called without distinction as to race or color except insofar as military necessity dictated, and the number drafted from each section
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of the country was sufficiently large to furnish a representative cross section and, therefore, significant findings.
On 6 April 1917, Congress declared war against Germany, and on 17 May the Selective Service Act became law. In accordance with the provisions of this act, 9,929,751 males between ages of 21 and 30 were registered between 5 July 1917 and 11 September 1918. In addition to this number, between the dates of the first registration on 5 July 1917 and 24 August 1918, 912,564 young men who had in the meantime reached the age of 21 registered. Also, on 12 September 1918, 13,395,706 men between the ages of 18 and 20 and 31 and 45 were registered. The Armistice occurred before any of these latter groups reported to camps. The total number, however, of the three registrations for the United States, without the territories, amounted to 23,908,576.
Of the approximately 10 million males registering on 5 July 1917, 2,510,706 were measured and physically examined by local boards prior to 15 December 1917; 516,212 of these were entrained for camps. After 15 December 1917, all registrants who had not entrained for camps were reclassified upon economic grounds. This resulted in 3,247,888 men being placed in class I, as available for military service. It is evident that this number included many of the men examined before 15 December, who had not already entrained for camp.
The records of the physical examinations of all Selective Service registrants who had entrained prior to 15 December 1917, as well as those who were sent to mobilization camps subsequent to that date were forwarded to the Office of the Adjutant General of the Army. As stated previously, The Adjutant General kindly permitted these reports to be taken from his office to the Medical Records Section of the Surgeon General`s Office for the purpose indicated. The chief clerk of the Adjutant General`s Office, Mr. Thomas A. O`Brien, materially assisted by his cooperation and suggestions in arranging the details. Mr. John N. Manning, principal clerk of the Medical Records Section of the Adjutant General`s Office, also assisted materially in obtaining and handling the records. The records, which were folded in three parts and filed in vertical filing boxes, were brought from the Office of the Adjutant General to the Surgeon General`s Office in large packing boxes,
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about 30 or 40 filing boxes of records being contained in each packing box.
Advantage was taken of a lull in receipt of the sick and wounded records and in the alphabetical arrangements of them to make statistical cards from the physical examination records received from the Office of the Adjutant General. Approximately 2 million records of the men who were sent to camp were used in assembling the statistical material.
In addition to that number, the records of the 549,099 men who had been found physically unfit by the local boards were sent direct from the local boards to the Surgeon General`s Office as directed by the Office of the Provost Marshal General to the local boards. Col. Frank H. Wigmore, Col. James Easby?Smith, executive officer of the Provost Marshal General`s Office, and Col. (later Brig. Gen.) Frank R. Keefer, the medical officer on duty with the Office of the Provost Marshall General, all gave assistance and enthusiastic support.
Although Maj. Charles B. Davenport, coworker and co?author of the reports named below, made a real contribution to the preparation of the 1918 Surgeon General`s report, as well as in the general work of the office, he was particularly concerned with the analysis of the statistics of the Selective Service examination data. He became associated with the Medical Records Section in April 1918, in a civilian capacity, and served in that capacity until he was commissioned a major in the Sanitary Corps in July of that year. He was discharged at his own request to return to his duties with the Carnegie Institute in Washington in January 1919 but continued to serve in a civilian capacity 3 days a week until about 1 June 1919. On 7 July following, he came back into the office to supervise the taking of uniform measurements and the preparation of the tables from the data obtained.
Major Davenport was a statistician and scientist of national as well as international reputation. In addition to his association with the Carnegie Institute of Washington as director of the Biological Research Laboratory and summer school at Cold Spring Harbor, N. Y., he was also in charge of the Harriman Eugenics Laboratory located there. No one could have worked harder and more unselfishly for the advancement of the work of the entire Medical Records Section than did Major Davenport. He was untiring, enthusiastic, and unselfish in his
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efforts. Gifted with a quick incisive mind, he worked rapidly and effectively and was of tremendous value in the work done in the Section.
Analysis of data.-The results of the statistical analysis of the data obtained from the reports of the physical examinations were published as follows:
1. The Physical Examination of the First Million Draft Recruits. Washington: Government Printing Office, 1919.
2. Defects Found in Drafted Men. Washington: Government Printing Office, 1920. This publication contained the results of the statistical analysis of both the approximately 2 million Selective Service registrants who were sent to military camps and the 549,099 who were rejected as physically unfit by the local boards.
3. Army Anthropometry in the Medical Department of the United States Army in the World War. Statistics. Washington: Government Printing Office, 1921, vol. XV, pt. I. The data of the physical examination studies were combined with the anthropometric data and analyzed. General distribution tables by States and by racial groups were prepared for the stature, weight, and chest measurement (expiration) for the first million Selective Service registrants who were sent to the mobilization camps. In addition, special tables were prepared for men who were found suffering from various diseases or conditions, such as tuberculosis, pulmonary valvular diseases of the heart, myopia, and flat feet, in both the first million men and the second million who were sent to training camps.
In the three publications, the data were analyzed not only by States but also by urban and rural, industrial, and racial groupings. For the groupings other than States, an elaborate table, using data from the 1910 census reports, was prepared by 2d Lt. Louis R. Sullivan. The United States was divided into 156 sections by density of population, occupation, and racial grouping totaling 22 groups. The racial groups included 10 percent or more of the race in question. Thus; it was possible to study the effects of special groupings upon the incidence of diseases and defects as well as upon anthropometric measurements.
Obviously, a great change in the character of the population in several areas in this country has occurred in the 41 years that have elapsed between the close of World War I and the
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present time. Although many of the findings of the 1917-18 physical examination of Selective Service registrants are not applicable today, it is possible that the findings may be of some interest and value in drawing comparisons between conditions of the population in this country now and at that time.
The results of the studies may be summarized as follows: Of the class 1 men between the ages of 21 and 30 who were found available for military service on economic grounds, 46.8 percent had a significant military defect and 21.2 percent were rejected, either by the local or camp boards, as physically or mentally unfit for all forms of military service. In addition to this latter number, 8 percent were classified by the local boards as available only for limited service; that is, for clerical or other duties in the noncombatant branches of the Army, usually in the United States. Twenty-nine percent were then unfit for active military duty with the fighting units overseas. One-half of the limited-service men were called.
It is self-evident that the number of men who were found to be unfit for military service or were held for limited service only depended to a considerable extent upon the physical examination standards that were in force at that time. An attempt was made in the physical examination of the first million draft recruits to review and to evaluate the physical standards which were changed from time to time as experience and necessity indicated.
Some of the defects mentioned were of greater importance from a military standpoint than from the ordinary demands of civil life. Practically all of them, however, are of some importance to those who expect to engage in strenuous or arduous physical exercise or labor. For example, a man with a pronounced degree of flat feet, even though able to carry on and maintain himself and family in civil life is surely inconvenienced, if not actually handicapped, by such a defect.
In considering the characteristic defects of racial, ethnic, and national groups, it will be recalled that the groups were influenced only by 10 percent or more of the races studied. Bearing this condition in mind, the effect of racial descent on the percentage of defective men in the population showed that, of the races, the Negro group was characterized by an abnormally high amount of venereal disease and its sequelae, such as valvular heart disease, arthritis, and ankylosis; by hemorrhoids; ;
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by poor emotional control, including tachycardia, hysteria, and psychasthenia; by relatively little otitis media, deafness, and defect of vision (though by much blindness in one eye); by little diabetes, spinal curvature, cryptorchidism, and flat feet; and by many bullet and other wounds. The Scandinavian group was characterized by a slight amount of venereal disease, by relative freedom from halux valgus, but by flat feet and a tendency to hernia. The German group was characterized by neurasthenia, psychoneurosis, and various psychoses, but by relatively little mental deficiency, and by an excess of myopia and curvature of the spine. The French-Canadian group showed an extraordinary excess of defects in various important respects, such as tuberculosis, spinal curvature, deaf-mutism, mental deficiency and psychosis, refractive errors, otitis media, defective hearing, asthma, bad teeth, hernia, deficient size of chest and of height, and underweight. The sections of which the French-Canadians formed a predominant factor were among the poorest from a military standpoint. The group occupied by a relatively large percentage of Indians and Mexicans was characterized by a large amount of tuberculosis, venereal disease, ankylosis, cleft palate, and harelip. There was an indeterminate amount of hernia and a low rate of valvular heart disease and deformities of the hand. The mountain white constituted a subrace of the whites occupying the southern Allegheny Mountains. They were characterized by an exceptionally high proportion of mental defects and mental disease, varicose veins, numerous deformities of the extremities, and underweight.
With the variation among population groups, the relative number of defective men in different States varied from 64 percent in Rhode Island to 35 percent in Kansas. The number of Selective Service registrants who were found to be physically unfit for all forms of military service varied from 42 percent in Rhode Island to 13 percent in Wyoming. It is evident that there is nothing in the climate of Rhode Island which would produce such an excess of defective men. The apparent explanation is that, being a highly industrialized State, it may have drawn to its borders a type of immigrant many of whom were defective.
In the brief comparison of the difference between the so-called rural and urban areas, the following may be of interest:
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The rural areas were characterized by an excess of defects, the results of chronic infections and those due to the absence of or the poor quality of medical and surgical treatment. Defects noted included trachoma, pyorrhea, traumatic defects of the extremities, hemorrhoids, blindness in one eye, hernia, and deafness. In addition, defects of congenital origin (the results of too frequent intermarriage and consanguineous matings in remote rural districts) such as mental deficiency, epilepsy, defective speech and hearing, chorea, and hysteria were prevalent, and there was an excess of certain diseases, especially gonorrhea, the result of the inclusion of a large percentage of the Negro population from many rural districts in the Southern States.
The urban population, on the other hand, was marked by an excess of certain conditions, the result of chronic infections of the ear, nose, and throat due, in part, to environment, such as, otitis media, sinusitis, defective hearing, and hypertrophied tonsils; by other conditions the result of the inclusion of a large percentage of foreign population from southern Europe and French-Canadians such as underweight, underheight, obesity, defective and deficient teeth, errors of refraction and strabismus; by certain nervous and mental disorders, such as neurasthenia, neurocirculatory asthenia, constitutional psychopathic states, dementia praecox, psychasthenia, and psychoneurosis; by foot conditions resulting from improperly designed and fitted footwear, such as pes planus, hallux valgus, hammertoe, metatarsalgia; and by other conditions resulting from varying and undetermined factors, such as syphilis with paresis and tabes dorsalis, valvular heart disease, chronic hypertrophy and dilatation, functional cardiac disorder, drug addiction, alcoholism, and exophthalmic goiter.
Anthropometric Studies
In addition to the studies described, an opportunity became available to make an anthropometric study based on measurements of men in the Army. As has been mentioned (p. 14), an excellent study of anthropometric measures of the Civil War draft recruits, draft substitutes, and late volunteers was prepared after the close of the Civil War by Col. Jedediah H. Baxter, MC, chief medical officer in the Office of the Provost
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Marshal General, and was published in a two-volume work in 1875 under the title `Statistics, Medical and Anthropological.` In addition, Dr. B. A. Gould, of the U. S. Sanitary Commission, published a valuable study of the important anthropometric measurements of the 20,000 Civil War volunteers and draftees at demobilization in 1865 which was highly regarded by anthropologists, both in this country and abroad.
In the summer of 1917, the National Academy of Sciences made an effort to secure authorization for special measurements of soldiers so that a study, similar to that made by Dr. Gould, could be published from the World War I material. However, during the stress of the preparation for war and during the war itself, authorization was not deemed advisable by the military authorities. On 9 June 1919, however, The Adjutant General issued instructions that 100,000 men be measured at demobilization to secure data for the fashioning of uniforms. These data formed the basis for an anthropological study of the type desired. It should be stated that Dr. Charles D. Wolcott, secretary of the Smithsonian Institution, Dr. William H. Welch, of the Johns Hopkins University Medical School, Brig. Gen. Edward L. Munson, of the Morale Branch of the General Staff, and Col. A. J. Daugherty, of the Equipment Branch of the General Staff, were all helpful in securing the authorization for this study from the Secretary of War. As has been mentioned, Dr. Davenport was recalled to the Office of the Surgeon General on 7 July 1919, to assist in carrying out the study.
The professional anthropologists throughout the country responded generously to the request by the Surgeon General for assistance in securing the necessary measurements at the various mobilization camps. Sixteen demobilization camps were selected for the study in order to secure a representative cross section of men throughout the various areas of the United States. The necessary equipment was secured, and 20 outstanding anthropologists from universities and scientific laboratories were selected to supervise the taking of the measurements. Daily reports were submitted to the Surgeon General of the number of measurements taken. The total number of men so measured was 100,000. All the linear and circular measurements considered of general interest to anthropologists were taken.
Statistical cards were made for these 100,000 men, and from
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them distribution tables were prepared showing the relationship and interrelationship between the constants of the various measurements not only by general groups but also by racial groups. In addition to these general distribution correlation tables, a large number of tables were prepared for breeches and blouses groups. It was hoped that these special measurements would be of assistance to the Quartermaster General in designing the uniforms for enlisted men. These tables and those from the mobilization data were all published in the anthropological volume referred to earlier (p. 75). Some brief discussion of the findings may be of interest.
Stature-The mean or average stature of the first million draft recruits between the ages of 21 and 30, including both white and colored, was 67.49 inches. The mean stature of the 100,000 men measured at demobilization was 67.72 inches. This slight gain was due, in part, to the fact that, first, the men were older; second, they were more erect; third, some of the shorter divisions were not included in the 100,000; and fourth, some short men were rejected when they were examined for mobilization. Comparing the average stature of recruits in World War I with those of the Civil War, after combining the figures of Colonel Baxter and Mr. Gould and with due allowance being made for the number recorded in each case, it was found to be practically the same-67.50 inches in the Civil War and 67.49 inches in World War I.
The heights of men of military age apparently had changed little in the United States in the 50 years from the Civil War through World War I. This conclusion might be considered hasty, for the men of 1917-18 were taken from all parts of the United States while those for the 1864-65 group excluded largely the Southern States. Since some of the men from the latter States are exceptionally tall, their inclusion tends to raise the mean stature. It has been suggested that since this country had received a very large number of immigrants of prevailing lower stature from southern Europe during these 50 years, the average stature of the population of the country should have shown a decrease. Such, however, was difficult to demonstrate mathematically, since the methods used in recruiting the two armies differed so materially. Indeed, the question of whether the physique of young men in the United States had changed in the 50 years before 1917, unless qualified, had little meaning.
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If the racial constitution of the population remained constant, that is, had there been no heavy immigration, then the question would have had more meaning. In view of the tremendous immigration, however, amounting in some years to nearly 1 million persons, the physical change in the racial constitution of the stock was so great as to mask entirely any slight alterations that may have occurred in the population stock of 50 years before through other improvements or deterioration of environmental economic conditions.
It was found that men differed much in stature by States. The Texans were tallest, having an average stature nearly 1 inch above the national average. The mean of the men from the Southern States was taller than the average, while men from Connecticut, Pennsylvania, New York, Massachusetts, and New Jersey had an average short stature, probably due to the introduction of a large number of immigrants of short stature, Among men from the North Central States, including those from Kansas, Idaho, Oregon, Nebraska, South Dakota, Iowa, and Minnesota, the average stature was high. This again probably was influenced by the Scandinavian and German immigration into those areas. At demobilization, the greatest increase in average stature was found in men from the Southern States, who had apparently greater room for improvement, at least in absolute measurements.
The average stature of the men from different sections revealed points of even greater interest. At the head of the list stood men from the mountain sections of North Carolina, with a mean stature of 68.67 inches, nearly 1.2 inches above the national average. It must be recalled that some of the inhabitants of that section were the descendents of the early Scotch settlers in Cape Fear River Basin, The next tallest men were found in the Ozark Mountains regions, mean stature being 68.64 inches. This was followed by men from the Texas section, averaging about 68.47 inches. Leading in the northern section were men from northern Minnesota, with the so-called big Swedes. Other sections with men of tall stature were Mississippi, the mountain sections of Tennessee and Kentucky, other parts of North Carolina, western Kansas, Oklahoma, Arkansas, California, and Nebraska. At the other extreme were men from Rhode Island, New York City, the mining area of eastern Pennsylvania, Philadelphia, the manufacturing towns of northeast Massachusetts,
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eastern New Jersey, and all parts of Connecticut. It cannot be said that the inhabitants of these mining and manufacturing sections were small because of the injurious somatic effects of the mining and manufacturing occupations, for the miners of Idaho stood far above the average of the country and the inhabitants of the flour-mill `Twin Cities of Minnesota` averaged 0.3 inch above the mean of the country. On the other hand, an agricultural section of eastern Pennsylvania had a population 0.7 inches below the mean of the country. It was obviously the inclusion of short or tall races that was the important factor.
Weight.-The mean weight of the first million recruits was 141.54 pounds, which was slightly higher than the mean weight of 136.0 pounds of a few thousand white American recruits measured at the time of the Civil War (p. 14). At demobilization, the troops weighed on an average 3 pounds more than did the recruits; namely, 144.89 pounds. A similar increase was noted in the veterans over the recruits in the Civil War. In World War I, the men from the Southern States showed an increase above the average of the entire country.
Further noted at demobilization, in 1919, was a reduced variability in weight. The soldier had increased 2 percent in weight and diminished 2 percent in variability. It might be said that the fine physical conditions of Army life had tended to raise the weight to a uniform level.
The greatest weight was found in men from the extreme North, with men from the Territory of Alaska and from the following States leading the list: South Dakota, North Dakota, Minnesota, Oregon, Montana, Washington, Nevada and Idaho. The men from these States were not the tallest but the stockiest, probably due not only to racial characteristics but also to climatic conditions. Recruits from the French-Canadian sections had the least weight. Men from the eastern manufacturing groups came next; largely because they contained so many small men. Condition in life could not be given as the principal cause of the low weight, as indicated by the fact that recruits from commuter, that is, suburban groups, also showed a low average weight, Of the Europeans, at demobilization, the Germans showed the greatest average weight, south Italians and Hebrews the least; the Scotch were the most variable in weight, and the Poles the least. The Negro troops were slightly
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heavier and showed a greater variability in weight than the white troops, with the Japanese weighing the least of all. In the southern sections, where a large proportion of the men were colored, relatively less obesity was noted than in those sections where only a small proportion were colored.
Chest measurement.-The chest circumference of the deflated chest of the first million draft recruits was 33.22 inches. There was evidence that the mean chest girth of the veterans increased about 1 inch during their military service. A similar increase was noted in the Civil War. Recruits from the Northwestern States showed the greatest chest circumference, while those from the Southern States, Rhode Island, and the District of Columbia showed the least. In relative, not average, chest circumference, men from Connecticut stood first, partly because of the racial composition of her population. Indeed, all States whose male population was representative of the stocky Mediterranean races ranked high in this regard. The tall Southerners ranked very low in a series of relative chest girths. Of the group, the largest mean (not relative) chest circumference was found in such States with 10 percent or more of Finns, agricultural
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Russians, French-Canadians, German-Austrians, and Scandinavians. Scotch sections in Southern white groups showed the smallest relative chest girth. Chest girth of the Negro troops was relatively somewhat less than that of the white.
Figure 20 shows the comparative measurement of the 93,185 white and 6,264 Negro troops included in the special demobilization groups. In general, it is apparent that the main differences of shape between Negro and white groups are that the former have relatively larger appendages; shorter trunk, head, and neck; broader shoulders; narrower pelvis; and greater girth of neck, length of thigh and calf, than the latter.
Measurements of defective groups.-An attempt was made to determine the stature, weight, and chest measurements of the men included in the first and second million draft recruits who had a recorded defect or disease. It was hoped that in this way some data might be obtained that would be useful in the future determination of the relative value of height and weight standards. Among this group of men, the following diseases showed men relatively above the average in stature but with less average weight for their height: Pulmonary tuberculosis, valvular heart diseases in young men, mitral stenosis, tachycardia, cardiac hypertrophy, varicocele, exophthalmic goiter, and hemorrhoids; while other diseases showed men below the average in height and also below the average in weight; namely, defective and deficient teeth, asthma, hyperopia, myopia, astigmatism, and defective physical developments.
