NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
196
SANITARY REGULATIONS.
[SECT. X.
154. INSPECTION OF CAMP SITES.—Before selecting any site for an encamp-
ment, the Sanitary Medical Officer, on being directed by the Quarter Master
General to do so, shall accompany him, or such other Officer as the Quarter
Master General may appoint, on his inspection, and the Sanitary Officer shall
give, in writing, his opinion on the salubrity or otherwise of the proposed
position, with any recommendations he may have to make, respecting the
drainage of the site for a camp, the preparation of the ground, the distance of
tents or huts from each other, the number of men to be placed in each tent
or hut ; the state of cleanliness, ventilation, water supply ; the position and
regulation of latrines and slaughtering-places ; cleansing and disposal of
refuse ; burial of the dead and of carcases of animals, &c.
155. SANITARY OFFICER TO SUPERINTEND ARRANGEMENT OF CAMPS, &c.—The
Medical Sanitary Officer shall further superintend the sanitary arrangements
of the camp and of occupied towns. He shall see that the surface and vicinity
of camps and towns are kept clean and free from nuisances—that defects of
the surface-drainage are remedied—that the dead are properly interred, and
the carcases of animals and offal are properly buried, or otherwise disposed of
—that latrines are properly regulated—that the water supply is preserved
in a state of purity.
156. TO RECOMMEND PRECAUTIONS FOR PREVENTING DISEASE.—He shall inform
himself as to the sanitary condition of hospitals, huts, tents, houses, and
other buildings in occupation, and shall recommend, in writing, such precau-
tionary measures for the prevention of disease as he may think fit, whether
as regards cleansing, draining, prevention of overcrowding, ventilating, light-
ing, lime-washing, removal of nuisances, improvement in water supply, and
on all other local matters affecting the health of the troops or the sick.
157. PRINCIPAL MEDICAL OR SANITARY OFFICER TO GIVE ADVICE TO COM-
M A N D E R O F T H E
F O R C E S . — T h e P r i n c i p a l M e d i c a l O f f i c e r , o r S a n i t a r y O f f i c e r ,
as the case may be, of every Army in the field, shall, on being consulted by
the Commander of the Forces, give advice, in writing, on the composition of
rations, clothing, shelter, sanitary arrangements and precautions for prevent-
ing disease, and on all other subjects bearing on the health and physical
efficiency of the troops. Even where such advice is not requested, the
Principal Medical Officer shall, nevertheless, send, in writing, to the Com-
mander of the Forces, the fullest information on all these subjects, with
such recommendations as appear necessary for protecting the health of the
troops.
158. PRINCIPAL MEDICAL OR SANITARY OFFICER TO ISSUE SANITARY INSTRUC-
TIONS .—The Principal Medical Officer or Sanitary Officer of every Army in
the field shall, with the sanction of the Commander of the Forces, imme-
SECT. X.]
SANITARY REGULATIONS.
197
diately on the opening of a campaign, as well as at such other times as may
appear to him to be necessary, issue such instructions regarding sanitary
precautions to be observed for protecting the health of the troops as he may
consider requisite for the guidance of the Medical Officers.
159. PREVENTION OF DISEASE.—The Sanitary Officer shall keep up a con-
tinual daily inspection of the whole camp, and shall especially inform him-
self as to the health of the troops, and of the appearance of any epidemic
disease among them, and he shall immediately, on being informed of the
appearance of any such disease, examine into the cause of the same, whether
such disease proceed from, or is aggravated by, sanitary defects in cleansing,
drainage, nuisances, overcrowding, defective ventilation, bad or deficient
water-supply, dampness, or marshy ground, or from any other local cause, or
from bad or deficient food, intemperance, unwholesome liquors, fruit, defec-
tive clothing or shelter, exposure, fa tigue, or any other cause, and report
immediately to the Commander of the Forces on such causes, and the reme-
dial measures he has to propose for their removal, sending a copy of all such
reports to the Principal Medical Officer of the Army, and he shall report, at
least daily, on the progress or decline of the disease, and on the means
adopted for the removal of its causes, until it is no longer necessary to do so.
160. SANITARY REGULATIONS FOR TROOPS ON MARCH.—When troops are on
the line of march, the Sanitary Officer, the Principal Medical Officer, or any
Medical Officer appointed by him specially for such duty, or the Regimental
Surgeon, as the case may be, shall accompany the Quartermaster-General or
the Officer acting under his orders, and collect as much information as possible
as to the Medical topography of the district, with special reference to places
which ought to be selected or avoided for camping grounds.
161. PRINCIPAL MEDICAL OFFICER TO REPORT TO INSPECTOR-GENERAL.—The
Principal Medical Officer and Sanitary Officer of every Army in the field,
shall send to their departmental superior, at such intervals as may be
determined, full information on all subjects connected with the hygiene of the
Army, together with such recommendations for improving this service as the
Principal Medical Officer or Sanitary Officer may consider requisite.
162. MEDICAL OFFICERS TO REPORT.—All Medical Officers in charge of
General Hospitals, Divisions, and Brigades in the field shall transmit to the
Principal Medical Officer of the Army, for the guidance of the Sanitary
Officer, full information as to the sanitary state of the troops and hospitals,
and on all matters affecting the health and physical efficiency of the men, at
such intervals as the Principal Medical Officer may appoint.
163. SANITARY OFFICERS TO REPORT—Sanitary Officers attached to any
Army in the field, or to any General Hospital, at the base of operations, shall
198
SANITARY REGULATIONS.
[SECT. X.
draw up a weekly Sanitary Report on the state of the Army or Hospital, to
be sent to the Principal Medical Officer of the Army, for the information of
the Commander of the Forces.
164. SANITARY POLICE.—In all occupied towns or villages a Sanitary
Police, properly organized, should be provided to carry out, from day to day,
such precautionary measures as may be pointed out by the Sanitary Officer
who should be instructed to make periodical sanitary inspections and
reports.
165. The Quartermaster or Assistant Quartermaster-General of the Forces
should receive, and take into immediate consideration, all reports and recom-
mendations made to him, in writing, by the Sanitary Officer, respecting the
health and sanitary condition of camps and occupied places, and should give
effect to the same, unless Military exigencies should make it undesirable, in
which case the Quartermaster or Assistant Quartermaster-General, as the case
may be, should state his reasons for non-compliance with the recommenda-
tions of the Sanitary Officer, in writing, and transmit the same to the Com-
mander of the Forces.
166. DUTIES HOW PERFORMED WHEN THERE IS NO SANITARY OFFICER.—
When it has not been considered necessary to appoint a Sanitary Offi-
cer, the Principal Medical Officer, or, in case of single Regiments, the
Regimental Medical Officer, will discharge the duties of Sanitary Officer ; and
Assistant and Deputy Assistant Quartermasters-General of Divisions, and
Brigades, and Quartermasters of Regiments, being responsible for the sanitary
condition of their camps, should comply with the recommendations made
to Commanding Officers by the Principal Medical Officer or Regimental
Medical Officer, as the case may be, on all matters contained in the preceding
instructions.
V.—(a.) Epidemic Cholera.
167. CHOLERA IN CANTONMENTS OR MILITARY STATIONS—Immediate informa-
tion by telegraph, if possible, is to be given by Civil and Military Officers to the
adjacent Military stations, whenever cholera occurs among them, in order
that marching and travelling may be put a stop to, and that other stations
may be put on their guard against it. The telegraph
need. not be used in reporting cases of choleraic diarrhœa.
168. Disinfection.—BARRACKS AND HOSPITALS.—When any case of cholera
occcurs in a Barrack or Hospital, even though it should be considered to be
sporadic only, the room in which the disease has shown itself must at once
be purified. The walls, floors and punkahs should be scraped and lime-
washed; the wood-work should be painted ; furniture, punkah fringes, and
G. 0. C. C., No. Ol
of 1868,
SECT. X.]
SANITARY REGULATIONS.
199
ropes washed, and generally everything possible done for the complete purifi-
cation of every building. Special care should be devoted to cleaning the
latrines. The latrine, urinary, and wash-house used by the man who was
attacked, should be instantly closed, and their use must not be permitted
until they have been completely purified. The work of cleansing these build-
ings must be carried out without the least delay, in the most careful manner
that can be devised. Chloride of Lime, Condy's Fluid, Carbolic acid, or
McDougall's powder should be freely used. All filth and rubbish from the
latrines must be buried at a distance, and all vessels used for their removal
must be carefully cleaned at the place where the refuse is deposited.
169. NATIVE HUTS AND BUILDINGS.—Every Native hut or building in
which a case of the disease occurs, or which there is reason to suspect may
have been contaminated by cholera discharges, shall at once be fumigated
with sulphurous acid (the fumes of burning sulphur), the floor to the depth
of six inches should be dug up, the old earth buried, and fresh earth placed
in it ; the inside of the roof should be washed over with a solution of
McDougall's powder or other disinfectant as above, and the walls smeared
with fresh mud (leeped).
170. PERMANENT FLOORING NOT TO BE DUG UP.—Where the floor is not
earthen, but of brick or other permanent construction, it should not be dug
up, but washed with a disinfectant in the same manner as the ceiling.
G. O. C. C., No. 52
of 1868.
171. EXPENSES OF DISINFECTION.—The cost of purifi-
cation is to be debited to Imperial expenditure.
172. It is not necessary that the whole of the buildings occupied by the
troops should be subjected to the process of disinfection, but only those indi-
vidual huts or barracks which appear likely to retain the germs of the disease.
173. Removal to Cholera Camp. —Whenever cholera occurs in a Can-
tonment, preparations should be made to move any part of the troops into the
selected camps at the shortest notice, and if the disease threaten to manifest
itself in any unusual degree or epidemic form, the body affected should be
immediately moved into camp, and no unfavorable condition of the weather
is to prevent this movement being carried out. The chief Military and
Medical Officers on the spot are to consult as to the course to be taken, and
the result should be communicated by telegraph to Head-quarters. If neces-
sary, two or three camps should be formed, and additional Medical aid
called for.
174. PLANS OF CAMPS.—Plans of selected cholera- camps in the vicinity of
each Military station are always available at the office of the Deputy Quarter-
master-General, or Staff Officer of the Cantonment.
200
SANITARY REGULATIONS.
[SECT. X.
Cir. No. 3,460 of
1866 .
175. FOUR CASES IN ONE WEEK CONSTITUTE EPIDEMIC.—When four cases of
cholera occur within one week, or shorter period, in the
lines of a Regiment or a Barrack, a Jail or Civil Station,
the disease is to be considered as epidemic.
176. SICK TO GO INTO CAMP.—The sick labouring under other diseases than
cholera, unless the hospital be in a detached building, will move with the force,
and share the benefit of removal from the choleraic atmosphere.
177. DISCHARGES TO BE BURIED.—It must be insisted on that all discharges
from the stomach and bowels of cholera patients be instantly removed and buried
in pits.
178. DISINFECTANTS TO BE USED.—Strong deodorants are to be thrown into
the receiving vessels, as well as into the pits, latrines, and privies.
179. MOVEMENT OF CAMP.—Should cholera follow the troops, they will be
removed short distances, at right angles, if possible, to the prevalent wind
and track of the disease, every second or third day, care being taken that
the marches in no way fatigue the men.
180. AMUSEMENT AND OCCUPATION.—The breaking out of cholera in a Regi-
ment or at a station is, on no account, to cause the suspension of the soldier's
daily amusements and occupations, care being taken that the latter in no way
fatigue them; and Commanding Officers will use their utmost exertions to
develope any recreation or employment of which the effect is to keep the men's
minds in their normal state.
181. INDULGENCE IN SPIRITUOUS LIQUORS TO BE AVOIDED.—It often occurs
that soldiers, on a visitation of cholera, indulge in the use of spirituous liquors,
in the belief that they are a preventive against the disease. Commanding
Officers are enjoined to use their utmost endeavours to prevent so baneful a
practice.
182. LOOSENESS OF THE BOWELS TO BE PROMPTLY REPORTED, AND MEDICALLY
TREATED.—The early treatment of premonitory symptoms, of which looseness
of the bowels is a principal one, is most important. Commanding Officers are
requested to give the most precise orders on the subject, and to cause all
men affected by premonitory symptoms to be placed at once under medical
treatment.
183. Return to Cantonment. —BARRACK AND HOSPITAL TO BE PURIFIED.
— T h e t r o o p s a r e n o t t o r e t u r n t o C a n t o n m e n t s u n t i l a l l t r a c e s o f t h e c h o l e r a
shall have disappeared from the neighbourhood, either amongst the European
or Native population. The Barracks and Hospitals will be thoroughly fumi-
gated, the walls white-washed, and the doors and window-frames painted,
before they are re-occupied.
SECT. X.]
SANITARY REGULATIONS.
201
184. PRECAUTIONS.—The men will be supplied with hot tea and coffee
before going out in the morning ; they will invariably wear flannel belts, and
all precautions must be taken to prevent their remaining in wet or damp
clothes.
185. DAILY REPORT OF CASES AND DEATHS.—So long as cholera exists in
Cantonments, or in the adjacent cholera camps among the troops, a daily
report of cases and deaths is to be forwarded to the Quartermaster-General.
Europeans and Natives are to be separately shown., and the names of all
European Officers, attacked or deceased, are to be reported.
186. Purification of tents used as Cholera Hospitals. —Tents occu-
pied as a Cholera Hospital should be disinfected by one
or other of the following gaseous disinfectants, chlorine,
nitrous acid, or sulphurous acid, and subjected to the action of boiling water
or of steam when boiling is not practicable, then pitched and exposed to the
action of the sun and wind until thoroughly dried. The process of disinfec-
tion should be conducted before the return of the Hospital tents to Canton-
ments. If they have been used in Cholera camps, and if they have been used
in Cantonments, it is desirable that they should be taken to some out-of-the-
way, but airy, spot outside Cantonments, to undergo the process of washing
subsequent to fumigation, which should be conducted before the tents are
struck, wherever they may have been standing when in use.
187. As SMALL-Pox HOSPITALS.—During the prevalence of an epidemic
of small-pox, or as long as fresh cases may be expected to occur, the tents
should be disinfected on the spot each time that they are vacated, as directed
above, and afterwards subjected to the action of boiling water, then
pitched and exposed to the action of the sun and wind, and. finally stored
separately until required for the accommodation of small-pox patients. When
they are no longer required for this purpose, they should be destroyed in the
presence of a responsible and trustworthy person.
188. OLD TENTS TO BE USED FOR SMALL-Pox—None but old tents, or those
nearly unserviceable, should be used for the cover of small-pox patients.
189. Of private clothing. —All articles of clothing belonging to persons
affected by contagious diseases, and worn at the time of their admission to
Hospital, shall, if practicable, be cleansed by exposing them to the fumes of
sulphur, ignited over a charcoal fire, after which the articles of clothing are
to be boiled for from half an hour to an hour. They are subsequently to be
exposed. to the air and sun for two or three days, when they should be packed
away for subsequent use.
190. DESTRUCTION OF CLOTHING.—If from the number of sick under
treatment, or any other certified cause, it may not be practicable to clean and
A A
G. O.C. C., No. 162
of 1865.
202
SANITARY REGULATIONS.
[SECT. X.
disinfect the clothing in the manner prescribed, it must be destroyed by fire
in the presence of a Medical Officer.
191. COMPENSATION FOR CLOTHING DESTROYED—Compensation will be
allowed for clothing so destroyed, provided that it be shown that the expen-
diture was unavoidably required for the public safety. The Government
will, however, require in each instance a full explanation of the circumstances
making the destruction of the clothing necessary. But the destruction of
bedding and body-linen is really a question of time, for in any given cases, if
their destruction can be safely deferred till a convenient opportunity offers,
the ground for expediency has ceased to exist, and the destruction of the
poison in the washerman's boiler can be effected without the sacrifice of the
clothes. To destroy accumulations of good but infected bedding and clothing,
when it would be equally easy to boil them as to burn them, would be wanton
waste.
192. HOSPITAL BEDDING AND CLOTHING .—Hospital bedding and clothing,
used by patients affected with cholera and small-pox, are to be purified when-
ever practicable, in the manner laid down in Section II. paragraph 116.
Should, however, the number of patients under treatment render the instant
purification of the clothing impracticable, it must be destroyed by fire in the
presence of a Medical Officer, who will be required to certify to the necessity
of the measure.
193. MATTRESSES.—Coir mattresses should never be used for patients
laboring under contagious maladies. Palliasses stuffed with clean straw are
more easily cleaned, and if they have to be destroyed, they can be re-placed
at a comparatively slight expense.
194. Reports to be made of destruction of clothing. —In carrying
out the foregoing orders, the Quarter Master General's, the Ordnance, and the
Medical Departments, are to act in communication with each other ; and no
destruction of property is ever to take place without a full report of the same
being forwarded from the Officer Commanding the station to the Commander-
in-Chief, in whatever Department the transaction may occur.
195. Disinfectants.—The following instructions for the preparation of
chlorine gas, nitrous acid and sulphurous acid, are appended :
—
196. Gaseous D i s i n f e c t a n t s— C H L O R I N E . — C h l o r i n e g a s m a y b e p r o c u r e d
by mixing three parts (by weight) of binoxide of manganese with one part (by
weight) of common salt. These should be placed in a large open vessel
of glass or earthenware, capable of holding several times the quantity of the
ingredients used, and acted upon by a mixture of two parts (by weight) of
sulphuric acid (commonly known as oil of vitriol) and one part of water ; or,
one part (by weight) of the binoxide of manganese may be mixed with two
SECT. X.]
SANITARY REGULATIONS.
203
parts of hydrochloric acid (commonly called muriatic acid.) The evolution of
chlorine gas soon takes place, and will continue for some days if the opera-
tion be left to the chemical action of the ingredients alone. The application
of a gentle heat, by means of a lamp or charcoal fire placed underneath the
vessel, will facilitate the evolution of the gas, and complete the operation in
a few hours. A vessel containing these ingredients should be placed in every
room required to be disinfected, and the doors and windows must be carefully
closed during the process.
197. NITROUS ACID.—Nitrous acid, in the form of vapour, has, in some
instances, been successfully employed in checking the progress of fevers, and
in disinfecting buildings and the interiors of ships. This acid may be obtained
by pouring half an ounce (by weight) of nitric acid over an equal quantity of
copper turnings, or the powder of starch. These quantities are sufficient to dis-
infect a room of ten feet in each dimension ; and it is advisable, in larger apart-
ments, to multiply the number of vessels rather than introduce larger quan-
tities of the materials into one vessel, as the fumes given off might seriously
affect the operator, who should retire as quickly as possible after the action
has commenced. As in the case of chlorine, the rooms should be kept care-
fully closed for several hours.
198. SULPHUROUS ACID.—Sulphurous acid has also been found useful in
arresting the progress of contagious disorders. This acid is produced in a
gaseous form, when sulphur is burned in the air. It is also procured by heating
sulphuric acid with copper filings, or powdered charcoal. For the purpose of
disinfection, it may be prepared by melting one or two ounces of the flowers of
sulphur or brimstone, in a pipkin or iron pot, and placing the vessel in the
middle of the room to be disinfected. The sulphur should then be set on fire
by means of a lighted match and allowed to burn out. The same precautions
should be observed as in the cases of chlorine and nitrous acid fumes.
(b.) Instructions for Conducting an Enquiry into Cholera
in India.*
199 SPECIAL ENQUIRIES REGARDING THE NATURE AND TREATMENT OF CHOLE-
RA.—The whole subject of epidemic cholera has obtained a new development
from scientific investigations carried out in Europe ; while the great losses,
sustained by troops serving in India, have shown how little has been accom-
plished towards diminishing its fatality. Under these circumstances, it
has been considered desirable that a special enquiry, in conformity with
the following instructions, should be undertaken, with the view of ascertain-
ing whether, with improved methods of research, any further information can
be obtained regarding this disease.
*NOTE.—These instructions were drawn up by Army Sanitary Commission, and
have been modified only so far as to be applicable to the duties of all Executive Medical
Officers in India.