Examination Instructions and Requirements for candidates for appointment as Cadet, United States Coast Guard » » » » » » AUG UST 1 962 CG-147-1 § 40.7, Physical requirements (a) All candidates for the Coast Guard Academy must meet the physical stand- ards established in this section and in § 40.8 under the heading Physical Standards and Disqualifications. (b) The physical standards outlined in the succeeding paragraphs in this section and in § 40.8, although not all inclusive, cover general physical re- quirements which are necessary for an effective career in the Coast Guard. Conditions which are noted as disquali- fying and make the applicant unaccept- able fall in categories which may en- danger the health of other personnel, require repeated admission to the sick list, cause prolonged hospitalization and early retirement for physical disability, or preclude an active general service career. (c) Two physical examinations are required: (1) formal physical examination be- fore appointment is tendered; (2) physical re-examination at the time of reporting to the Academy. (d) Applicants are encouraged to ob- tain a preliminary physical examina- tion from a private physician prior to submission of application for cadetship. A preliminary physical examination serves to rule out, at this stage of the potential cadet's processing, those appli- cants who obviously will not meet the required physical standards for appoint- ment. The private physician should be requested to review the physical require- ments set forth in § 40.8 and upon com- pletion of his examination advise the candidate whether or not in his opinion the candidate meets the physical re- quirements for appointment. Inaccuracy in ascertaining defects and determining the physical status of the candidate at the time of his preliminary physical results in unnecessary work for the Coast Guard and disappointment to the candidate when defects are found later at the time of the formal physical exam- ination. (e) Candidates and their parents and sponsors are urged to refrain from re- questing waivers for medical defects. The Coast Guard bases its decision to disqualify a young man on medical facts revealed in a thorough medical examina- tion. Candidates unable to satisfy the minimum requirements are not suited for commissions in the Regular Coast Guard, and consequently are not eligible for training at the Coast Guard Acad- emy. A request for waiver for a medical defect invariably results in disappoint- ment to all concerned. (/) Prior to formal physical exami- nation, all applicants are required to execute Standard Form 89, Report of Medical History, furnishing a true ac- count of all injuries, illnesses, operations and treatments since birth and present same to the examining medical officer. False statements or willful omissions in executing Standard Form 89 may result in the separation of the candidate from the service on arrival at the Academy or later in his service career. (g) Formal physical examinations prior to acceptance of candidates must be performed by a U.S. Public Health Service, Navy, Army, Air Fozce or Vet- erans' Administration medical officer. All candidates are instructed where to report for such examinations. The re- sults of this formal physical examina- tion must be reported on Standard Form 88, Report of Medical Examination. (h) The medical officer, prior to the physical examination, will review the data furnished by the candidate on Standard Form 89 as to completeness of the medical history submitted and will then complete item 40, Standard Form 89, and sign same. § 40.8. Physical standards of height and weight table ratio. The and disqualifications following Table 40.8 (al) and Table 40.8 (a2) are for growing youths and (a) Physical proportions. — The are for the guidance of medical officers applicant's weight should be well dis- in connection with the other data ob- tributed and in proportion to age, tained at the examination, a considera- height, and skeletal structure. Medical tion of all of which will determine the examiners will recommend rejection of candidate's physical eligibility. The individuals who show poor physical de- applicant's height should be measured velopment, who appear to be undesirable in inches to the nearest V2 inch without candidates because of excess fat, or show shoes, and weight measured to the near- a definite tendency to obesity regardless est pound without clothes. Table 40.8 (al) Height (inches). 64 65 66 67 68 69 70 71 72 73 74 75 76 77 78 Weight (pounds) : Minimum 112 116 120 124 128 132 136 140 144 148 152 156 160 164 168 Maximum 160 165 170 175 181 186 192 197 203 209 214 219 225 230 235 Table 40.8 (a2) (7) Hernia of the brain. Inches (8) Unsightly deformities, such as Minimum height 64 ^ ar § e birthmarks, large hairy moles, ex- Maximum height 78 tensive cicatrices, mutilations due to in- Minimum chest expansion 2 j ur j es or surgical operations, tumors, (b) The head, scalp, face and ulcerations, fistulae, atrophy of a part neck. — The following conditions are of the face, or lack of symmetrical de- causes for rejection: velopment. (1) Tinea in any form. (9) Persistent neuralgia, tic doulou- (2) All benign tumors which are of reux, or paralysis of central nervous sufficient size to interfere with the wear- origin. ing of military headgear, or subject to ( 10) Ununited fractures of the maxil- chronic irritation. lary bones, deformities of either max- (3) Imperfect ossification of the era- illary bone interfering with mastication nial bones or persistence of the anterior or speech, extensive exostosis, necrosis, fontanelle. or osseous cysts. (4) Extensive cicatrices, especially (11) Chronic arthritis of the tem- such adherent scars as show a tendency poromandibular articulation, badly re- to break down and ulcerate. duced or recurrent dislocations of this (5) Depressed fractures or other de- joint, or ankylosis, complete or partial, pressions, or loss of bony substance of ( 12) Malignancy or substantiated his- the skull, unless the examiner is certain tory thereof, unless successfully removed the defect is slight and will cause no 5 or more years previously. future trouble. (13) Cervical adenitis of other than (6) Deformities of the skull resulting benign origin, including cancer, Hodg- in any unusual physical appearance or kin's disease, leukemia, tuberculosis, of any degree associated with evidence syphilis, etc. of disease of the brain, spinal cord, or (14) Adherent or disfiguring scars peripheral nerves. from disease, injuries or burns. 2 (15) Thyroid adenoma; exophthalmic goiter or thyroid enlargement interfer- ing with breathing or with the wearing of clothing; exophthalmic goiter or thy- roid enlargement from any cause asso- ciated with toxic symptoms or which is disfiguring. (16) Torticollis. (17) Tracheal openings, thyroglossal or cervical fistulae. (18) Restricted motility sufficient to limit the normal range of motion. (19) Cervical rib when symptomatic; scalenus anticus syndrome. (c) The nose and sinuses. — The following conditions are causes for re- jection: (1) Loss of the nose, malformation, or deformities thereof that interfere with speech or breathing, or extensive ulcera- tions. (2) Perforated nasal septum if con- sidered causative of symptoms or local pathology, or likely to do so. (3) Nasal obstruction due to septal deviation, hypertrophic rhinitis, or other causes, and particularly if suffi- cient to produce mouth breathing. (4) Hay fever if more than mild or if likely to cause more than minimal loss of time from duty or if associated with nasal polyp9 or hyperplastic sinusitis. (5) Atrophic rhinitis. (6) Chronic sinusitis, if more than mild, and if not amenable to therapy. (d) The mouth and throat. — The following conditions are causes for rejec- tion: (1) Harelip, unless adequately re- paired, loss of the whole or a large part of either lip, unsightly mutilation of the lips from wounds, burns, or disease. (2) Malformation, partial loss, atro- phy, or hypertrophy of the tongue, split or bifid tongue, or adhesions of the tongue to the sides of the mouth, pro- vided these conditions interfere with mastication, speech, or swallowing, or appear to be progressive. (3) Malignant tumors of the tongue, or benign tumors that interfere with its function. (4) Marked stomatitis, or ulcerations, or severe leukoplakia. (5) Ranula if at all extensive, or sali- vary fistula. (6) Perforation or extensive loss of substance or ulceration of the hard or soft palate, extensive adhesions of the soft palate to the pharynx, or paralysis of the soft palate. (7) Malformations or deformities of the pharynx of sufficient degree to inter- fere with function. (8) Postnasal adenoids interfering with respiration or associated with mid- dle-ear disease. (9) Marked enlargement of the ton- sils or markedly diseased tonsils. (10) Laryngitis if not amenable to therapy or recurrent. (11) Paralysis of the vocal cords, or aphonia. (e) The ears and hearing. — The following conditions are causes for re- jection : (1) The total loss of an external ear, marked hypertrophy or atrophy, or dis- figuring deformity of the organ. (2) Atresia of the external auditory canal, or tumors of this part. (3) Acute or chronic suppurative otitis media, or chronic catarrhal otitis media. (4) Mastoiditis, acute or chronic. (5) Existing perforation of either membrana tympani. (6) Deafness of one or both ears. (7) Any diminution of auditory acuity in either ear, below 15/15 by whispered voice. If any question of diminuted auditory acuity arises on whispered voice test an audiometric determination should be made. Loss of hearing as determined by the audiom- eter must not be greater than 15 decibels in any of the frequencies 500, 1000, 2000 nor greater than 45 decibels in either of the frequencies 4000 or 5000. If hearing loss ascertained is not con- sidered completely stabilized, candi- date should be rejected. (8) Any acute or chronic disease of the external, middle, or internal ear. (f) Eyes and vision. (1) For appointment as a cadet in the Coast Guard a minimum uncor- rected visual acuity of 20/30 each eye is acceptable provided that vision is cor- rectible to 20/20 each eye and that re- fraction by an ophthalmologist reports eye grounds free from disease with no indication of an accelerated progression toward further decreased visual acuity. Refraction is not required where the vision in each eye is 20/20 uncorrected, unless medically indicated. (2) Disease of the eye grounds shall be cause for rejection. (3) Contraction of visual field. (4) Both eyes must be free from any disfiguring or incapacitating abnormal- ity and from acute or chronic disease. (5) Any cadet in the United States Coast Guard Academy whose vision has dropped below 20/40, correctible to 20/20 in each eye, for any significant period of time shall be reported upon by a Board of Medical Survey. (6) The requirement as given above is considered necessary in order to grad- uate cadets with vision sufficiently serv- iceable to enable them to carry out their duties at sea. During late adolescence it is quite common for developmental myopia to become manifest to such an extent that the resulting myopic visual defect is sufficient to disqualify the cadet. It is therefore imperative that a careful examination for visual acuity be performed. (7) The following conditions are causes for rejection: (i) Trachoma. (ii) Chronic conjunctivitis, or xe- rophthalmia. (iii) Pterygium encroaching upon the cornea. (iv) Complete or extensive destruc- tion of the eyelid, disfiguring cicatrices, adhesions of the lids to each other or to the eyeball. (v) Inversion or eversion of the eye- lids, or lagophthalmus. (vi) Trichiasis, ptosis, blepharo- spasm, or chronic blepharitis. (vii) Epiphora, corneal dystrophy, chronic dacryocystitis, or lachrymal fistula. (viii) Chronic keratitis, ulcers of the cornea, staphyloma, or corneal opacities encroaching on the pupillary area and reducing the acuity of vision below the standard and any corneal distrophy. (ix) Irregularities in the form of the iris, or anterior or posterior synechiae sufficient to reduce the visual acuity be- low the standard. (x) Opacities of the lens or its cap- sule sufficient to reduce the acuity of vision below the standard, or progressive cataract of any degree. (xi) Extensive coloboma of the cho- roid of iris, absence of pigment (al- bino), glaucoma, iritis, or history of recurrent iritis, extensive or progressive choroiditis of any degree. (xii) any retinopathy or detachment of the retina, neuroretinitis, optic neu- ritis, choreoretinopathy, or atrophy of the optic nerve. (xiii) Loss or disorganization of either eye, or pronounced exophthalmos. (xiv) Pronounced nystagmus, strabis- mus, or lack of continuous and complete third degree binocular fusion. (xv) Diplopia, or night blindness. 4 (xvi) Abnormal condition of the eye due to disease of the brain. (xvii) Malignant tumors of the lids or eyeballs. (xviii) Asthenopia. (xix) Any organic disease of either eye. (xx) Ocular foreign bodies. (8) Color perception : (i) Color blindness, complete or partial, is cause for rejection. Color perception will be tested by the color plate test as set forth in the American Optical Test Book, 1940 Edition, or the Farnsworth Lantern test. Candidates who fail to pass the American Optical Company p9eudo-isochromatic plate test shall be considered qualified if they pass the Farnsworth Lantern test. The re- sults obtained with the Farnsworth Lantern test shall be considered final in the resolution of all cases of question- able color perception. (ii) Detailed instruction for the ad- ministration of the Farnsworth Lantern test, as well a9 the criteria for passing the test, are engraved on a metal plate which is permanently attached to the instrument and shall be followed with- out exception. The results of the test shall be recorded in item 64, Report of Medical Examination as "Passed Fa- Lant" or "Failed FaLant." (iii) Candidates who failed the Amer- ican Optical Company pseudo-isochro- matic plate test at places where the Farnsworth Lantern test is not available may be given a reexamination on the Farnsworth Lantern test at places where same is available. The cost of travel to and from the place of reexamination and subsistence must be borne by the applicant (iv) The standard requirement for color perception will be ability to pass the abbreviated test with not more than three errors. (g) Lungs and chest. — The fol- lowing conditions are causes for rejec- tion: (1) A chest expansion of less than 2 inches. (2) Congenital malformations or ac- quired deformities which result in re- ducing the chest capacity and diminish- ing the respiratory function to such a degree as to interfere with vigorous physical exertion or to produce disfigure- ment when the applicant is dressed. (3) Pronounced contractions or markedly limited mobility of the chest wall following pleurisy or empyema. (4) Deformities of the scapulae suffi- cient to interfere with the carrying of equipment. (5) Absence or faulty development of the clavicle. (6) Old fracture of the clavicle where there is much deformity or interference with the carrying of equipment; un- united fractures, or partial or complete dislocation of either end of the clavicle. (7) Suppurative periostitis or caries or necrosis of the ribs, the sternum, the clavicles or the scapulae. (8) Old fractures of the ribs with faulty union, if interfering with func- tion. (9) Malignant tumors of the breast or chest walls or substantiated history of same, unless successfully treated 5 or more years previously in the absence of disqualifying residuals. (10) Benign tumors or cysts of the breast or chest wall which are so large as to interfere with the wearing of a uniform or equipment. (11) Unhealed sinuses of the chest wall. (12) Scars of old operations for em- pyema unless the examiner is assured that the respiratory function is entirely normal. (13) Active tuberculosis of any degree or extent. (14) A history of tuberculosis clini- cally active within the preceding 5 years. (15) A substantiated history of, or X-ray findings of, tuberculosis of more than minimal extent, at any time. (16) Pleurisy with effusion of unde- termined origin or history thereof. (17) Recurrent spontaneous pneumo- thorax within the preceding 3 years. (18) Pneumoconiosis, extensive pul- monary fibrosis or pulmonary emphy- sema. (19) Acute or chronic pleurisy or empyema. (20) Pneumothorax, hydrothorax, or hemothorax. (21) Tumors of the lung, pleura or mediastinum. (22) Chronic bronchitis if more than mild or if mild and does not respond to therapy. (23) Bronchiectasis. (24) Asthma or a history of asthma (except a history of childhood asthma with a trustworthy history of freedom from symptoms since the twelfth birth- day) is a cause for rejection. (25) Abscess of the lung. (26) Pulmonary infiltration of unde- termined origin. (27) Cystic disease of the lung. (28) Actinomycosis, nacardiosis, blas- tomycosis, coccidioidomycosis, asper- gillosis or histoplasmosis if there is reason to suspect recent activity of the disease process. (29) Sarcoidosis. (30) Hydatid or echinococcus cysts of the lung. (31) Foreign body in the lung or mediastinum causing symptoms, or ac- tive inflammatory reaction. (32) History of pneumonectomy or lobectomy. (33) Disqualifying defects demonstra- ble by a roentgenographic examination of the chest, such as: (i) Evidence of reinfection (adult) type tuberculosis, active or inactive, other than slight thickening of the apical pleura or thin solitary fibroid strands. (ii) Evidence of active primary (child- hood) type tuberculosis. (iii) Extensive calcification of the pleura, lung parenchyma or hilum, if of questionable stability or of such size and extent as to interfere with pulmonary function. (iv) Evidence of fibrous or serofibrin- ous pleuritis, except moderate diaphrag- matic adhesions with or without blunting or obliteration of the costophrenic sinus. (h) Heart and vascular system. — The following conditions are causes for rejection: (1) All diastolic murmurs. (2) Apical systolic murmurs, when persistent in both the recumbent and upright positions, when moderate in intensity, when transmitted to the axilla, and when not abolished nor signifi- cantly diminished in intensity by forced breathing. (3) Harsh systolic murmurs, heard at aortic area, even of less than moderate intensity with diminished or absent second sound. (4) All organic valvular diseases of the heart, congenital heart disease, or pathological murmurs. (5) Hypertrophy or dilation of the heart. (6) History of angina pectoris, coro- nary occlusion, or coronary arterioscle- rosis. (7) A pulse of 100 or over, or of 50 or under if felt to be a manifestation of organic heart disease. (8) Persistent marked cardiac ar- rhythmia or irregularity, unless due to sinus arrhythmia or an authenticated history of paroxysmal tachycardia, or auricular fibrillation or flutter. (9) Arteriosclerosis. (10) Arterial hypertension, essential hypertension (hypertensive vascular disease). The diagnosis of essential hypertension, especially in the earlier phases when blood pressure is still vari- able, requires judgment tempered by experience and with evaluation of any family history of hypertension, the vas- cular reaction to special tests, and re- peated blood pressure and pulse rate determinations. In general, a persistent systolic blood pressure above 140, or a persistent diastolic blood pressure above 90, is cause for rejection, particularly if associated with a labile pulse rate or evidence of vasomotor lability, or with positive family history of hypertensive vascular disease (sitting blood pressure values). The objective is to disqualify those applicants who are most likely to develop severe and incapacitating hyper- tension within a relatively short time. Generally, youthful applicants with a healthy vascular system are to be con- sidered qualified even though blood pressure values sometimes exceed the standard. (11) Aneurysm of any variety in any situation. (12) Intermittent claudication. (13) Peripheral vascular disease in- cluding Raynaud's disease, Buerger's disease (thromboangiitis obliterans), erythromelalgia, arterioscelerotic and diabetic vascular disease. Special test will be employed in doubtful cases. (14) Thrombophlebitis of one or more extremities, if there is a persistence of the thrombus or any evidence of obstruc- tion to circulation in the involved vein or veins. (15) An authenticated history of rheumatic fever or chorea within the past 5 years, or a history of more than one attack of rheumatic fever. (16) Arterial hypotension if it is causing, or has caused, symptoms. (17) Varicose veins if large, or if associated with edema or with skin ulceration. (i) Abdomen and viscera, anus and rectum. — The following conditions are causes for rejection: (1) Wounds, injuries, cicatrices, or muscular ruptures of the abdominal wall sufficient to interfere with function. (2) Fistulae or sinuses from visceral or other lesions or following operation. (3) Hernia of any variety. (4) Large tumors of the abdominal wall. (5) Scar pain, if severe or causing persistent or recurring complaints. (6) Chronic diseases of the stomach or intestine or a history thereof, includ- ing such diseases as peptic ulcer, re- gional ileitis, ulcerative colitis and diverticulitis. (7) Gastric resection, resection of peptic ulcers, gastroenterostomy, or bowel resection. (8) Chronic appendicitis (so-called). (9) Ptosis of the stomach or intes- tines. (10) Acute or chronic disease of the liver, gall bladder, pancreas, or spleen. (11) Chronic peritonitis or peritoneal adhesions. (12) Chronic enlargement of the liver. (13) Chronic enlargement of the spleen. (14) Jaundice or substantiated his- tory of recurrent jaundice. (15) Splenectomy for any cause other than trauma, or congenital spherocy- tosis. (16) Proctitis, stricture or prolapse of the rectum. (17) Fissure of the anus or pruritus ani if severe or recurrent. 636863°- -62- (18) Fistula in ano or ischiorectal abscess. (19) External hemorrhoids sufficient in size to produce marked symptoms; internal hemorrhoids, if large or ac- companied by hemorrhage, or protrud- ing intermittently or constantly. (20) Incontinence of feces. (21) Amoebiasis; uncinariasis. (j) Endocrine system and metab- olism. — The following conditions are causes for rejection: (1) Toxic goiter and thyroid adenoma. (2) Cretinism; hypothyroidism; myx- edema, spontaneous or post-operative (with clinical manifestations and diag- nosis not based solely on low basal metabolic rate). (3) Gigantism or acromegaly; diabe- tes insipidus, Simmonds* disease; Cushing's syndrome, other diseases be- cause of a disorder of the pituitary gland. (4) Frohlich's syndrome. (5) Hyperparathyroidism and hypo- parathyroidism when the diagnosis is supported by adequate laboratory studies. (6) Addison's disease. (7) Glycosuria if persisting; diabetes mellitus; if sugar is found in the urine. further specimens voided in the presence of the physician or authorized assistant, should be examined. In doubtful cases the fasting blood sugar and glucose tolerance tests should be obtained. In the presence of diabetes mellitus in a parent, sibling, or grandparent, a stand- ard glucose tolerance test is required. (8) Nutritional deficiency diseases (including sprue, beriberi, pellagra and scurvy) which are severe or not readily remediable or in which permanent pathological changes have been estab- lished. (9) Gout. (10) Hyperinsulinism when estab- lished by adequate investigation. (k) Genito-urinary system (1) All candidates for the Coast Guard Academy shall receive a sero- logic test for syphilis and a urinalysis. These tests shall be conducted at the time of the formal physical examina- tion. (i) When albumin, casts, hemoglobin, or red blood cells are found in the urine, the applicant shall not be accepted un- less further study proves such findings to be of no significance. Such further study, if desired, should include daily complete examinations of the urine for at least 3 days and such other tests as are necessary, unless the presence of albumin and casts is associated with enlargement of the heart, high blood pressure, or other evidence of cardiovas- cular disease of such degree that a diagnosis of renal disease may be made immediately. When albumin or casts are constantly or intermittently pres- ent, the underlying pathological condi- tion should, if possible, be determined and stated as the cause for rejection; but if albuminuria or casts are present daily during a period of 3 days, it should be regarded as reason for rejec- tion, even if the origin cannot be deter- mined. (ii) When the specific gravity of the specimen first examined is under 1.010, further observation of the applicant and repeated complete urinary examinations are indicated. (iii) A negative serological test will be accepted as satisfactory evidence of freedom from syphilis in the absence of a history of previous treatment for, or clinical signs of syphilis. When the serological test for syphilis is positive, the possibility of a false positive test should be considered. In view of the possibility of error in such a test the candidate will be given the opportunity of a reexamination. A repeated posi- tive serological test, in the absence of a history of syphilis, will be cause for rejection. (2) The following conditions are causes for rejection: (i) Acute or chronic nephritis, dia- betes, mellitus or insipidus, or glyco- suria if accompanied by abnormal response to blood sugar tests. (ii) Blood, pus, or albumin in the urine, if persistent. (iii) Floating kidney, hydronephrosis, pyelonephrosis, pyelitis, tumor of the kidney, renal calculi, or absence of one kidney, horseshoe kidney, or double ureter. (iv) Acute or chronic cystitis. (v) Vesical calculi, tumors of the bladder, incontinence of urine, enuresis, or retention of urine. (vi) Hypertrophy, abcess, or chronic infection of the prostate gland. (vii) Urethral stricture or urinary fistula. (viii) Epispadias or hypospadias, ex- cept for minor displacements of the urethral orifice with no impairment in function of micturition, and no symp- toms of irritation. (ix) Phimosis when prepuce is adher- ent in whole or in part to the glans. (x) Hermaphroditism. (xi) Amputation of the penis. (xii) Varicocele, if large and painful, or hydrocele. (xiii) Atrophy of both testicles or loss of both. (xiv) Undescended testicle (accept- able if unilateral, abdominal and unas- sociated with hernia), infantile genital organs. (xv) Chronic orchitis or epididymitis. (xvi) A persistently positive serologic test for syphilis. (xvii) Syphilis in any stage, or a clearly defined history thereof. (xviii) Any active venereal infection, acute or chronic, or any active infec- tious process resulting therefrom. (xix) Reiter's disease. (I) The extremities. — The follow- ing conditions are causes for rejection: (1) All anomalies in the number, the form, the proportion, and the move- ments of the extremities which produce noticeable deformity or interfere with function. (2) Atrophy of the muscles of any part, if progressive or if sufficient to in- terfere with function. (3) Benign tumors if sufficiently large to interfere with function. (4) Ununited fracture, fractures with shortening or callus formation sufficient to interfere with function, old disloca- tions unreduced or partially reduced, complete or partial ankylosis of a joint, or relaxed articular ligaments permit- ting of frequent voluntary or involuntary displacement. (5) Reduced dislocation or united fractures with incomplete restoration of function ; substantiated history of recur- rent dislocations of major joints. (6) Amputation of any portion of a limb (except fingers or toes if there is no interference with military activities) , or resection of a joint. (7) Excessive curvature of a long bone or extensive, deep, or adherent scars interfering with motion. (8) Severe sprains. (9) Disease of the bones or joints; active osteomyelitis ; history of an attack of hematogenous osteomyelitis; recur- rent attacks of osteomyelitis; seques- trum demonstrable on X-ray; or a sub- stantiated history of a single attack of osteomyelitis, except when treated suc- cessfully 3 or more years previously without subsequent recurrent or dis- qualifying sequelae. (10) Chronic synovitis; torn carti- lage; osteochonditis dessicans; or other internal derangement in a joint (partic- ularly of knee joint with history of disability) . (11) Varicose veins in an extremity when they cover a large area; are markedly tortuous or much dilated, or are associated with edema, or are ac- companied by subjective symptoms. (12) Varices of any kind situated in the leg below the knee, if associated with varicose ulcers or scars from old ulcera- tions; chronic edema of a limb. (13) Chronic or obstinate neuralgias, particularly sciatic neuritis. (14) Adherent or united finger (web fingers) . (15) Deviation of the normal axis of the forearm to such a degree as to inter- fere with the proper execution of the manual of arms. (16) (i) Permanent flexion or exten- sion of one or more fingers, as well as irremediable loss of motion of these parts, if sufficient to interfere with proper execution of duties. (ii) Entire loss of any finger. (iii) Mutilation of either thumb to such an extent as to produce material loss of apposition or strength of the member. (iv) Loss of more than one phalanx of the right index finger. (v) Loss of the terminal and middle phalanges of any two fingers on the same hand. (17) Perceptible lameness or limping. (18) Knock-knee, when the gait is clumsy or ungainly, or when subjective symptoms of weakness are present; bow-legs if so marked as to produce noticeable deformity when the applicant is dressed. (19) (i) Clubfoot unless the defect is so slight as to produce no symptoms. (ii) Pes cavus if extreme and causing symptoms. (iii) Flatfoot when accompanied with symptoms of weak foot or when the foot is weak on test. Pronounced cases of flatfoot attended with decided eversion of the foot and marked bulging of the inner border, due to inward rotation of the astragalus, are disqualifying, re- gardless of the presence or absence of subjective symptoms. (20) Loss of either great toe or loss of any two toes on the same foot. *(21) Overriding or super position of any of the toes to such a degree as will produce pain. (22) Ingrowing toenails when marked or painful. (23) (i) Hallux valgas, particularly congenital type or when accompanied by bunion. (ii) Bunions sufficiently pronounced to interfere with function. (iii) Hammertoes when existing to such a degree as to interfere with func- tion when wearing shoes. (iv) Corns or calluses on the sole of the foot when they are tender or painful. (24) (i) Hyperidrosis or bromidrosis when present to a marked degree. (ii) Habitually sodden feet with blis- tered skin. (iii) Unusually large or deformed feet for which proper shoes cannot be read- ily obtained. (25 Severe fungoid infection of nail- beds. (26) Surgical procedures involving major joints unless at least a six-month period since operation, has elapsed and full function has been restored. (m) The spine and other mus- culoskeletal. — The following condi- tions are causes for rejection: 10 (1) Lateral deviation of the spine from the normal midline of such degree that it impairs normal function or is likely to do so. (2) Curvature of the spine of such degree that function is interfered with or is likely to be interfered with, or in which there is noticeable deformity when the applicant is dressed (scoliosis, kyphosis, or lordosis). (3) Fracture or dislocation of the vertebrae. (4) Vertebral caries (Pott's disease). (5) Abscess of the spinal column or its vicinity; acute or chronic osteomyeli- tis. (6) Osteo-arthritis of the spinal col- umn, partial or complete. (7) Coeeydynia; spina bifida mani- festa; spondylolisthesis; cervical rib. (8) Active arthritic processes from any cause. (9) Herniation of intervertebral disc (nucleus pulposus) or history of opera- tion for this condition. (10) Malformation and deformities of the pelvis sufficient to interfere with function. (11) Disease of the sacroiliac and lumbo-sacral joints which is chronic in nature, associated with pain referred to legs, muscular spasm, postural deform- ities, and/or limitation of motion in the region of the lumbar spine. (12) History of chronic or recurrent low back pain. (n) Skin, — The following condi- tions are causes for rejection: (1) Eczema of long standing or which is resistant to treatment ; allergic derma- tosis, if severe. (2) Chronic impetigo; sycosis; car- buncle; acne upon face or neck which is so pronounced as to be definitely unsightly. (3) Actinomycosis; dermatitis herpet- iformis; mycosis fungoides. (4) Extensive psoriasis, ichthyosis; chronic lichen planus. (5) Elephantiasis. (6) Scabies; pediculosis (if indica- tive of unhygienic habits) . (7) Ulcerations of the skin not ame- nable to treatment, or those of long standing or of considerable extent, or of syphilitic or malignant origin. (8) Extensive, deep, or adherent scars that interfere with muscular movements, or that show a tendency to break down and ulcerate. (9) Naevi and other erectile tumors if extensive, disfiguring or exposed to constant pressure. (10) Obscene, offensive, or indecent tattooing. (11) Pilonidal cyst or sinus if evi- denced by presence of readily palpable tumor mass or if there is a history of inflammation or of purulent discharge. (12) Lupus vulgaris; other tubercu- lous skin lesions. (13) Lupus erythematosus, discoid or generalized ; scleroderma. (14) Epidermolysis bullosa; pemphi- gus. (15) Plantar warts on weight-bearing areas. (16) Cysts and benign tumors of such a size and/or location as to interfere with the normal wearing of military equipment. (17) Any other chronic skin disease of a degree which renders the individual unfit for military duty or so disfiguring as to render it difficult for the individual to adjust to the ordinary social relation- ships. (0) The nervous system. — The following conditions are causes for re- jection : (1) Neurosyphilis of any form (gen- eral paresis, tabes dorsalis, meningovas- cular syphilis). 11 (2) Degenerative disorders (multiple sclerosis, encephalomyelitis, cerebellar and Friedreich's ataxia, athetoses, Hunt- ington's chorea, muscular atrophies and dystrophies of any type, cerebral arterio- sclerosis) . (3) Residuals of infection (moderate and severe residuals of poliomyelitis, meningitis and abscesses, paralysis agi- tans, postencephalitis syndromes, Syden- ham's chorea). (4) Peripheral nerve disorder (chron- ic or recurrent neuritis or neuralgia of an intensity which is periodically inca- pacitating, multiple neuritis, neurofi- bromatosis). (5) Residuals of trauma (residuals of concussion or severe cerebral trauma, post-traumatic cerebral syndrome, in- capacitating severe injuries to peripheral nerves) . (6) Paroxysmal convulsive disorders and disturbances of consciousness (grand mal, petit mal, and psychomotor attacks, syncope narcolepsy, migraine). (7) Miscellaneous disorders (tics, spasmodic torticollis, spasms, brain and spinal cord tumors, whether operated upon or not, cerebrovascular disease, congenital malformations, including spina bifida if associated with neurolog- ical manifestations and meningocele even if uncomplicated, Meniere's dis- ease). (p) Psychiatric and personality deviations. — The following conditions are causes for rejection: (1) Psychotic disorders or a substan- tiated history of psychotic episode. (2) Psychoneurotic reactions which have been incapacitating. (3) Character and behavior disorders which have prevented a good adjust- ment with particular reference to anti- social tendencies, sexual deviation, chronic alcoholism or drug addiction. (4) Immaturity reactions. (5) Disorders of intelligence. (q) Teeth. (1) All candidates shall be given a type 2 dental examination (mouth mir- ror and explorer examination; adequate natural or artificial light ; posterior bite- wing roentgenograms, when indicated) 1 by a dental officer at the time of physical reexamination and, if practicable, at for- mal physical examination, report of which shall be recorded under item 44, Standard Form 88, Report of Medical Examination. (2) Candidates must have a minimum of 20 serviceable permanent, natural teeth, of which at least 10 must be in each arch. When third molar teeth have not erupted and are shown by X-ray examination to be present and in normal position for eruption, they may be counted as serviceable teeth in the event candidates do not otherwise meet the minimum requirement of 20 teeth. (3) Definitions: (i) Serviceable teeth are permanent, natural teeth which meet all of the fol- lowing conditions: (a) Adequately supported by healthy tissue. (b) In satisfactory occlusion with op- posing natural or artificial teeth. (c) Of sufficient size (crown and/or roots) and without faulty calcification (severe dysplasia). (d) If carious, capable of being sat- isfactorily restored. (e) If filled or crowned, the tooth and restoration are in satisfactory condition. (/) If nonvital, treated with satis- factory pulp canal fillings. (ii) A nonserviceable tooth is one that fails to meet any of the above conditions. 1 These X-rays are only needed when, un- crupted third molars must be counted as serviceable permanent teeth to meet require- ments of subparagraph (2) of this paragraph. 12 (iii) Satisfactory masticatory function exists when a minimum of 3 masticating teeth (bicuspids and/or molars, natural or artificial) are in functional bilateral occlusion. (4) Prior to the candidates' reporting to the Academy, missing teeth that cause unsatisfactory incisal and/or mas- ticatory function or that result in un- sightly spaces must be replaced by well- designed, functional, partial dentures or fixed bridges, and all carious teeth except those with incipient carious lesions must be satisfactorily restored. (5) The following conditions are causes for rejection: (i) Loss of teeth in excess of the num- ber specified in subparagraph (2) of this paragraph. (ii) Nonconformance with subpara- graph (4) of this paragraph. . (iii) Malocclusion that interferes with satisfactory incisal and/or mastica- tory function or proper phonation. (iv) Unsightly dento-facial deform- ity. (v) Chronic subluxation of the man- dible associated with pain and not amenable to treatment. (vi) Advanced and extensive peridon- toclasia. (vii) Syphilitic lesions, malignant tu- mors. (viii) Benign tumors or cysts, which require treatment or may require treat- ment in the foreseeable future. . (ix) Perforations from the oral cavity into the nasal cavity or maxillary sinus. (r) Miscellaneous conditions. (1) The following miscellaneous con- ditions are causes for rejection: (i) Any deformity which is repulsive or which prevents the proper functioning of any part to a degree interfering with military efficiency. (ii) Stuttering or other impediment of speech. (iii) Deficient muscular development or deficient nutrition. (iv) Evidences of physical character- istics of congenital asthenia, such as slender bones, a weak ill-developed thorax, nephroptosis, gastroptosis, con- stipation, and "drop" heart, with its peculiar attenuation and weak and easily fatigued musculature. (v) All acute communicable diseases. (vi) All diseases and conditions which are not easily remediable or that tend physically to incapacitate the individual such as: chronic malaria or malarial cachexia; tuberculosis; leprosy, acti- nomycosis; rheumatoid arthritis; osteo- myelitis; malignant disease of any kind in any location or substantiated history of same unless successfully treated 5 or more years previously; hemophilia; pur- pura, leukemia of all types; pernicious anemia; sickle cell anemia; trypano- somiasis; filariasis which has produced permanent disability or deformity, his- tory of any acute attack of filariasis within 6 months of date of examination, or the finding of micro-filaria in the blood stream, chronic metallic poison- ing, allergic manifestations such as hay fever, if more than mild or if likely to cause more than minimal loss of time from duty or if associated with nasal polyps or hyperplastic sinusitis; allergic conjunctivitis, allergic dermatoses, or allergic rhinitis particularly if there is associated hyperplastic sinusitis or nasal polyps, or a history thereof, when in the opinion of the examiner, the condition is likely to frequently recur, or to cause more than minimal loss of time from duty or otherwise is of present or future clinical significance. (2) Conditions not enumerated or combinations of conditions which, in the opinion of the medical examiner, 13 will not permit a full productive military examiner considers all defects in final career, should be recorded in detail determination as to qualification of can- with appropriate recommendations. didate, the Commandant's acceptance or (3) If all defects present are recorded rejection of candidates will be simpli- on Standard Form 88 and the medical fied. UNIVERSITY OF FLORIDA 3 1262 08859 7637 fill 537 14 U.S. GOVERNMENT PRINTING 0FFICE:«96l