During the Civil War, desperation to avoid military service drove some draftees to extreme lengths. One example was the self-extraction of teeth- men would literally pull out their own healthy front teeth (or hire willing dentists to do so) in hopes of failing the army’s dental requirements.[1] This form of draft evasion reflected a broader pattern of men injuring themselves or feigning illness to secure medical disqualifications. These acts not only carried risks of infection, hemorrhage, and long-term disability but also forced military authorities to adapt. Army surgeons grew wise to these ploys, tightening examination standards and even pursuing those seeking evasion. This essay examines the topic of medically-motivated draft dodging in the Civil War, beginning with the case of pulled teeth and expanding to the wider context of self-harm and feigned illness as means to avoid service.
Both the Union and Confederacy relied on the draft as the war progressed. From the start, medical standards determined eligibility. Among the most famous requirements was possession of enough teeth to bite open powder cartridges for rifles. Union regulations stated that loss of incisors and canines from both jaws disqualified a recruit, since he needed “a sufficient number of teeth in good condition…to tear his cartridge quickly and with ease.” The ability to chew hard crackers and salt pork for nutrition was equally important, as was dental health as a marker of overall fitness.[2]
During the Union draft of 1863, over 5,200 men, about 2.4 percent of those examined, were exempted for dental reasons. Examiners even had an abbreviation for men rejected due to teeth: “4-F,” initially shorthand for lack of four front teeth. At first, losing teeth for any reason could bar a man from service, but standards tightened as reports emerged of deliberate extractions. Surgeon Robert Bartholow’s 1864 manual clarified that missing incisors were not grounds for exemption unless loss was clearly due to disease.[3] As opposed to the Union, Confederate practice was more lenient. Regulations said little about teeth, and as personnel shortages grew worse, even men with grave disabilities were kept in the ranks. One particular Confederate soldier had lost most of his teeth and many parts of his jawbone from mercury treatment. He would have been discharged by Union examiners because he was unable to chew solid food, yet he remained in service until his death in 1864.[4]
Missing teeth were only one part of a wider trend. Once the draft began, many men plotted how to fail the physical. Surgeons noted a surge of “accidents” such as missing fingers and inflamed eyes. Some draftees limped on an old injury, inflated heart rates by running before an exam, or tied ropes to swell veins and mimic circulatory disease. It was common to feign deafness and blindness- doctors devised tests such as speaking softly or tricking eye movements to catch fraud. Some draftees rubbed cayenne or lye into skin or eyes to create rashes and swelling. One Minnesota draftee soaked his feet in lye for ten days to secure exemption, only to be arrested when his feet “miraculously healed.” Lastly, and probably most notably, others cut off trigger fingers or toes.[5] Newspapers often reported on such acts, condemning the men as cowards.[6]
W. E. S. Trowbridge, Candidates from the Exempt Brigade
Union officials quickly caught on. After the Enrollment Act of 1863, local draft boards with examining surgeons began sharing ways to spot men faking illness or injury. They devised trick tests and looked for fresh injuries. They would test claimed deafness or blindness by observing involuntary reactions, and would note when a supposedly injured man forgot to limp under distraction.[7] Exemptions for unhealed gums started to be denied. Bartholow emphasized in his manual that sudden loss of healthy teeth did not qualify.[8] Some officers even suggested drafting tooth-pullers anyway to become the laughing stock of soldiers.[9] Follow-up exams further exposed fraud. In the North, men who had been excused were sometimes called back weeks later, and if their problems had disappeared, they were arrested. These jailed offenders were often used as publicized cases to deter others.[10]
Deliberate self-injury to evade the draft caused outrage. Newspapers blasted “coward hordes” who cut off extremities or fled abroad. The Chattanooga Daily Gazette in 1864 mocked men who paid surgeons to remove teeth, suggesting they be drafted anyway to face ridicule.[11] The Cleveland Herald in 1862 condemned a man who chopped off his toes, arguing he had forfeited manhood and should be cast from society.[12] These reactions show how closely patriotism, masculinity, and military service were tied together during the Civil War era. To many, self-mutilation looked like cowardice and selfishness, but the reality was likely a little more complicated. Many soldiers were poor and fearful of death in a war that had already killed thousands. Drafted into a war against their will, these men could have reached a breaking point where the certainty of personal injury seemed preferable to the roulette of combat.
Men pulling their own teeth to escape Civil War service illustrates the tension between self-preservation and duty. From tooth extractions to faked illnesses and mutilations, draft dodgers forced examiners into a back-and-forth contest of deception and detection. Ultimately, few succeeded in escaping service this way, but the symbolism remained important. To their contemporaries, the man who maimed himself to dodge combat was a coward. For historians, these acts reveal the psychological toll of the draft and the extraordinary lengths men would go to avoid war. They remind us that alongside tales of heroism, the Civil War also produced scars of desperation- sometimes self-inflicted.
Bibliography
Chattanooga Daily Gazette (Chattanooga, TN). “Self-Mutilation to Escape the Draft.” August 9, 1864. Quoted in Aileen E. McTiernan, “Suicide and Self-Mutilation.” Gale Library of Daily Life: Slavery in America. Gale, 2008.
Daily Cleveland Herald (Cleveland, OH). “Self-Mutilation.” October 10, 1862. Quoted in Aileen E. McTiernan, “Suicide and Self-Mutilation.” Gale Library of Daily Life: Slavery in America. Gale, 2008.
Dalton, Kyle. “The Myth of Two Teeth.” The Medical Record. National Museum of Civil War Medicine. March 7, 2022. Accessed September 18, 2025. https://www.civilwarmed.org/two-teeth/
Marzoli, Nathan. “Fraud and Deception: Challenges for Enrollment Board Surgeons, 1863–1865.” The Medical Record. National Museum of Civil War Medicine. November 30, 2018. https://www.civilwarmed.org/enrollment-board-surgeons/
Riaud, Xavier. “A Dentist from the North Removed a Tooth in a Southman’s Mouth (American Civil War 1861–1865).” Journal of Otolaryngology – ENT Research 10, no. 6 (2018): 344.
Trowbridge, W. E. S. Candidates from the Exempt Brigade. Lithograph on wove paper, 1862. Library of Congress Prints and Photographs Division, Washington, D.C. https://www.loc.gov/pictures/item/2008661641/
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