General HINES. It would not be in line of duty. It might not be willful misconduct, but it would not be in line of duty.

Senator CONNALLY. I was just trying to arrive at the boundary line. Senator SHORTRIDGE. Would such a suggested case entitle the man to any relief? Suppose a man over in France did get slightly "overseas" and was injured. Would you regard that resultant injury to him as the result of his misconduct?

General HINES. Not necessarily.

Senator SHORTRIDGE. And exclude him from relief?

General HINES. He would be excluded if it were decided that the disability resulted from misconduct.

Senator SIMMONS. General, of course, the term "in line of duty' is a very broad one.

General HINES. Yes.

Senator SIMMONS. Do you mean to say that if a soldier is accidentally run over by an automobile and injured when he is off duty, we will say, he would not be entitled to compensation?

General HINES. He would be paid; but this was the case of a man who was intoxicated, off on a drunk, and who was hit by an automobile.

Senator SIMMONS. You would not allow it to him just because of his misconduct?

General HINES. It would really be miscounduct; yes, sir. But a man who was injured accidentally, whether he was on pass or on leave, would come in.

Senator CONNALLY. General, do you favor extending the time of the presumptive period at all for these psychiatric cases and tubercular cases? I was not here the other day, and I was sorry I missed your testimony.

General HINES. The bureau has not felt that we should extend the time of those, but we do feel that if you are to equalize, then you should bring certain other chronic disabilities up to 1925. We do not believe that you can justify a further extension of tuberculosis or neuropsychiatric disabilities to 1930, because the best medical advice we can get indicates that even the presumptive period now is way beyond medical judgment. So, the bureau has not felt that until Congress has had an opportunity to study the whole question, that we ought to recommend any extension of the presumptive period.

Senator GEORGE. General, let me ask you one question. Not having had the advantage of your earlier testimony, I take it that you indicated that this first section of this bill relating to lay testimoney or evidence is not wholly objectionable to the bureau if properly circumscribed and restricted.

General HINES. No, sir. We feel that it is not necessary, but we do think it is a more clear definition of the intent of Congress that we should take lay evidence, or medical evidence, than we have ever had before. We have always adhered to considering all evidence, lay or medical, but on a medical question, if we had medical evidence. we would consider the medical evidence as of the greater weight.

Senator GEORGE. You understand this bill, however, to somewhat broaden that.

General HINES. It does.

Senator GEORGE. And that necessarily would liberalize the administration of the act.

General HINES. Yes, sir; it would.

Senator CONNALLY. Is it the purpose to have these other witnesses heard sometime?

The CHAIRMAN. They have all been heard.

General HINES. I have some doctors here, if you wish to ask questions of any of them.

The CHAIRMAN. I do not know of any.

Senator CONNALLY. Did they cover this social matter? Did these doctors cover that?

General HINES. I believe so, at least in part.

Senator CONNALLY. I would like to hear from Doctor McDermott on that, if it will not take up too much time.

The CHAIRMAN. If the doctor wants to talk.

Senator CONNALLY. I do not know whether he wants to or not. General HINES. I will say for the doctor that he is free to state whatever he wants to state on the question, and I will be glad if he can enlighten the committee.

STATEMENT OF DR. BERNARD A. MCDERMOTT, MEDICAL MEMBER OF ADJUDICATION SERVICE, VETERANS' BUREAU

Senator CONNALLY. I do not know that I know enough about this matter to interrogate you, but you heard my questions of the general. I am interested in this particular phase that has to do with the social evil, and what I think is the penalization of a man because he happened to have suffered a disability of that kind. I want to ask you if the effects of that sort of contagion are easily traceable. Is it not a fact that if a man is suffering from a venereal disease, although he has other ailments, if you are not able to differentiate between them, the fact that he has that disease operates usually as an absolute bar to his getting any compensation? You can just take that as a starter, and testify as you please.

Doctor MCDERMOTT. In direct answer to your question, Senator, I will say that it does not act as an absolute bar, but I would have to be frank in saying that with the evidence of any social disease present in a case, it very frequently is a considerable obstacle in determining just how much of his disability may be due to the venereal cause, or to some other nonmanifest or obscure cause, or a manifest and coincident cause.

In connection with the question of these so-called misconduct diseases, I had prepared just a little memorandum, merely from the standpoint of the difficulties that we, as Government physicians are called upon to decide.

A

There is not any question of the prevalence of venereal diseases throughout the length and breadth of the land. There is not any question as to the incidence of the disease in military service. number of causes, of course, are advanced as to why the diseases are so prevalent.

The CHAIRMAN. Doctor, is there a greater percentage in civil life than in Army life?

Doctor MCDERMOTT. According to statistics, Mr. Chairman, I believe it is approximately 10 per cent.

The CHAIRMAN. In the Army?

Doctor MCDERMOTT. No; in civil life.

Senator SHORTRIDGE. Considering the total population?

Doctor MCDERMOTT. The total population. The incidence of venereal diseases during the World War period, taken in the time from April, 1917, to December, 1919, as shown in the medical history of the war from the Surgeon General's office, discloses that approximately something over 357,000 cases were admitted for treatment of actual venereal disease.

Senator CONNALLY. That is all kinds of disease.

Doctor MCDERMOTT. That comprises syphilis, gonorrhea, and chancroid. The incidence of disease was greater within the continental limits of the United States than in the American Expeditionary Forces.

Senator SHORTRIDGE. Measured by percentages.

Doctor MCDERMOTT. Measured by percentages.

Senator SHORTRIDGE. You state that 10 per cent of the total population is suffering from those diseases. What are the percentages of those in the service in continental United States, or abroad?

Doctor MCDERMOTT. Taking the percentage, Senator, of those in the military service, it would be approximately 8 per cent of the entire enlisted and commissioned personnel.

Senator SHORTRIDGE. What was the percentage of the soldiers who went overseas that suffered from those diseases just mentioned— the percentage of the total number who went overseas-if the records disclose it?

Doctor MCDERMOTT. Senator, I have not those figures with me, but I can get them and insert them in the record.

The CHAIRMAN. You know approximately what it is.

Doctor MCDERMOTT. In the total of enlisted and commissioned personnel, it was approximately 8 per cent.

General HINES. About 7 per cent overseas.

Senator SHORTRIDGE. The general suggests about 7 per cent of those who went overseas suffered from those mentioned diseases. Doctor MCDERMOTT. The total of all, overseas and in America? Senator SHORTRIDGE. First give us those overseas.

Doctor MCDERMOTT. I really can not give you the exact figures. of course, in considering the residual disabilities incident to the diseases, we have to consider that a great many of those have cleared up, for the reason that chancroid is a disease that does not usually leave any sequellae.

Senator SHORTRIDGE. You mean aftereffects?

Doctor MCDERMOTT. Aftereffects.

Senator SHORTRIDGE. In our language.

Doctor MCDERMOTT. The great majority of the gonorrheal cases, if they received treatment--and I believe most of them did in servicecleared up, but with the syphilitic cases, in contradistinction to the other two venereal diseases, syphilis being systemic, in that it tends to invade the entire system and not remain localized to the genital regions, that disease of course will not clear up without very active and very intensive treatment. It tends to run a more or less slow and insidious course, and undermine the general health and well being of the individual gradually. History, I think, will show that many cases received partial treatment, treatment which was, for the time

being, sufficient to keep the active devastating effects of the disease in abeyance. Medical history is replete with cases wherein the individual feels that the beneficent effects from a few courses of treatment make him secure, and that he is entirely well, and yet our medical statistics go on to show that after the lapse of 15 or 20 years there is this sudden break in health, and it then is practically in the incurable stage.

The problem, as we see it, is one that we are called upon many times to face, in extending service connection

The CHAIRMAN. Before you leave that, let me ask you a question. Have you kept the statistics showing the percentage of soldiers from each of the States of the Union?

Doctor MCDERMOTT. I do not know, Senator, that that is available, but I imagine that the Surgeon General's office could give us a fair estimate of that. I do not know that they could be given under such captions, but they could be given under the various outfits in which they served.

Doctor COOLEY. The Surgeon General's statistics will show it by States.

The CHAIRMAN. What I would like to know is whether there are such statistics by States.

Doctor MCDERMOTT. I am not sure, Senator.

The CHAIRMAN. I can assure you of one thing, and that is that there never was such a percentage as 8 per cent in the State of Utah, nor 1 per cent.

Senator SHORTRIDGE. I do not know how it would be in Texas, or Georgia, or California, but I think we will measure up just about as good as Utah.

The CHAIRMAN. That is all right. I am only saying that there would not be 1 per cent in the State of Utah, and I say it without a moment's hesitation.

Senator SHORTRIDGE. All sort of inferences could be drawn from your statement, which might be the subject of resentment from other States.

The CHAIRMAN. They can resent it if they want to.

Senator CONNALLY. I make no pretenses about my State. I am sure it did its duty in any part of the military service.

The CHAIRMAN. Proceed, Doctor.

Doctor MCDERMOTT. The purpose of the bill now before the committee is to equalize the benefits to a very large class of really disabled veterans within the financial ability of the Government to do so, by presuming that a large number of diseases are due to service if shown to have existed prior to January 1, 1925, or January 1, 1930. I would like to say here that in speaking of the matters concerning the social diseases, I am simply doing that from the standpoint of a physician in the Government who is frequently called upon by members of the Congress and others interested in their respective constituents, to extend some measure of relief to individuals who are suffering from some phase of these social diseases.

Senator LA FOLLETTE. Doctor, may I ask you a question there? In view of the fact that compensation is finally extended in these syphilitic cases when total disability has been arrived at, what, in your judgment as a physician, and in view of your experience in this work, would you say of the possibility of reaching these cases in time.

to give them some benefit and prevent them from becoming totally disabled if this clause were liberalized in such a way that men could obtain compensation, and therefore feel freer to go into the hospitals

and take an extensive course of treatment?

Doctor MCDERMOTT. That is just what I would like to lead up to, Senator, if I may.

The CHAIRMAN. They can go to a hospital any time they desire. Senator LA FOLLETTE. They can not go in if their families are starving while they are there.

Doctor MCDERMOTT. I would like to say that I am not here as an intercessor for a premium to be placed upon vice, nor as a proponent for Government concurrence in evil acts. I merely wish to call the attention of the committee to a few facts regarding a class of exservice men that is not covered in the proposed bill, and who will continue to present a pathetic appeal to you and to the bureau if nothing is done for them.

If the purpose of the present committee hearing is to end discrimination, and by law and upon legal premises establish justice, then it would seem that there is a large class up to the present time left out and still to be done a legal injustice; namely, the unfortunate veterans suffering from so-called misconduct diseases. These veterans responded with equal alacrity to the mandate of the Congress when the call to arms went forth. From the farm, the shop, the factory, the mill, the office-yea, even from the school, they came forth in the mighty assemblage of the man power of the Nation.

To-day a committee of Congress is in session to consider some measure of relief from a greatful Government for those showing disabilities directly or presumptively residual to war.

There are certain inconsistencies that are presented as arguments to the various appellate agencies of the bureau. They reach the very desk of the director. Members of Congress and influential individuals from all over the States come, and they intercede in behalf of these cases. There is a certain amount of professional confidence that has to be adhered to, in that frequently we can not state just why we can not extend some measure of relief from the generous appropriations that Congress is making for veterans' relief. As has been stated to me on a number of occasions by gentlemen of the Congress, "Well, how can I tell the folks back home that this man has syphilis? I simply can not tell them. What excuse can I give them?" That is one of the difficulties. It is one of the things that we will always have to face.

The other situation is the one that Senator La Follette brings out -a very apparent inconsistency. That is this: After the individual has gotten to the point where he is practically reduced to an inert mass by paralysis, or reduced to an irrational being by paresis, we then make a gesture of humanitarianism, and we take him into the hospital and give him compensation.

Senator CONNALLY. We will not help him while he is alive, but we will bury him.

Doctor MCDERMOTT. The real point that I would argue would be from a humanitarian standpoint. That is, if it were possible to so extend some measure of medical relief to these individuals who are known to have the disease, and to make facilities of treatment available to them without necessitating hospitalization, I should think that