NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
SECT. XIV.]
MEDICAL BOARDS AND CERTIFICATES.
25.
33. ILLNESS CONTRACTED ON FIELD SERVICE.—Officers who in consequence
of wounds received in action, or illness contracted by
Service in the Field, are permitted the privilege of
reckoning the periods spent on sick leave as service for retirement on full
pay, under the following conditions : —
(a) A specific report is to be made on each case by the Standing
Medical Committee of the Presidency, showing the
nature of the illness and the grounds on which it is
considered that the illness Was contracted by Service in the Field
.
(b.) Every claim of this nature after being reported on by the Standing
Medical Committee must be accompanied by the opinion thereon of the
Government, and Commander-in-Chief.
(c.) All such grants of leave shall be for periods not exceeding eighteen
months, to be extended if necessary.
34.
MEDICAL BOARD AT THE INDIA OFFICE.—All Military and Civil officers
of the Indian Establishment who may require an extension of leave in Europe
on Medical Certificate, shall appear before a Medical Board at the India Office,
in London.
35. The home Medical Board is composed of a President (the Examining
Physician to the Secretary of State for India), a member of the Indian
Medical Department on leave, and a member of the British Medical Service,
nominated by the Horse Guards.
36. All officers of the Indian Army, Staff Corps, and Medical Department
on leave in Europe, and desirous of appearing before the
Board for the purpose of extending or cancelling their
leave or of returning to duty in India, shall apply for permission to do so, to
the Military Department of the India Office.
37.
Officers on Medical Certificate in India.—Officers who may
obtain leave of absence in India on medical certificate, are required to conform
to its terms. They are not to proceed to any other station than that which may
have been named for them, without a further certificate from the Medical
officer under whose charge they may be, and which must, if possible, be con-
firmed by a Board of Medical Officers. Officers will not leave any station
which may have been designated for them, for the purpose of returning to
their duty, until such period short of the expiration of their leave as will
allow them time to join at the prescribed rate, and then only upon being
reported by their immediate medical attendant as fit to join. Should such
medical attendant consider an officer unable to join, he will immediately
furnish the prescribed medical certificate, recommending the necessary exten-
sion, which will be disposed of in the same manner as all other certificates for
extension of leave.
G. O. G., No 290
15th Sept. 1857.
G. O. C. C., No. 32
21st March 1859.
G. O. G., No. 43 of
1865.
VOL. II.
26
MEDICAL BOARDS AND CERTIFICATES.
[SECT. XIV.
38. CONVALESCENT OFFICERS.—Convalescent officers may be permitted to
enter into society upon a certificate from their medical attendant, recommend-
ing amusement and recreation. The medical certificate recommending the
indulgence is invariably to be submitted to the Officer Commanding the
division (if the Head Quarters of the division be at the station) and to the
Officer Commanding the station. The senior officer, on any abuse of the privilege
being brought to his notice, is requested immediately to cancel the indulgence,
and report the circumstance for the information of the Commander-in-Chief.
When convalescent officers may be absent from their regiments at the
Presidency, the required certificate must be forwarded to the Adjutant General
of the Army.
3 9 . O F F I C E R S
NOT TO BE SENT FROM CORPS, FOR TRIFLING AILMENTS.—Sick
officers should not be removed from their regiments and stations to the sea
coast, or to the Presidency on trivial cases, which, with proper care and atten
- t i o n , m i g h t b e e f f i c a c i o u s l y t r e a t e d w i t h o u t i n c o n v e n i e n c e t o t h e i n d i v i d u a l
and the service. It is difficult to prescribe any defined rules for such cases ;
but Regimental Surgeons, as well as the Boards of Medical Officers, who confirm
sick certificates, will hold in mind that such removal should obtain their
recommendation only when the patient may require change of climate, or the
sea air, or when medical consultation, or further medical advice or treatment,
is important to the case.
40. Transfer of Medical charge of sick Officers. —(a. ) In all cases
in which a transfer of the medical charge of a sick officer may take place, a
detailed statement shall be furnished by the Medical officer who conducted
the first part of the treatment, for the information of the succeeding Medical
attendant.
(b.) On occasions where it is not known what Medical officer is next to
have charge, this statement is to be enclosed in a sealed cover, and given to
the patient himself, for delivery to the Medical officer by whom he may next
be attended.
(c.) When a sick officer arrives at any station, he is to deliver the
statement of his case, if furnished with it as above directed, to the medical
officer, under whose care he is to be, at the first visit he receives from him ;
and the Deputy Inspector General, if present at the station, is expected to
take an early opportunity of visiting the patient, and of affording his profes-
sional advice to the medical practitioner who attends him.
(d.) Each succeeding medical officer is to add his own statement of the
case to that of his predecessors, which is to be enclosed in like manner for
the information of the Medical officer on whom the charge may next devolve ;
SECT. XIV.]
MEDICAL BOARDS AND CERTIFICATES.
27
so that a connected view may be given of the history and progress of the case,
from its commencement to the time of each transfer.
(e .) In the event of any Medical officer being required to attend a sick
officer without being furnished with the information herein required, an
immediate report must be made of the circumstance to the Administrative
Medical Officer of the Circle.
41. MEDICAL CASES AND CERTIFICATES TO BE MADE OUT IN DUPLICATE.—
The statements of cases, and medical certificates, must always be made out
in duplicate, One copy for the patient to carry with him, the other for
record in the office of the Inspector General, Medical Department.
42. DISPOSAL OF DUPLICATE COPY OF CASE.—The duplicate copies of the
statements of the cases of all officers, both Civil and Military, must be forwarded
to the Inspector General through the Administrative Medical Officer of
the Circle by the same post, or on the same date as that on which the
sick certificate and sealed statement of case is sent to the patient, to
enable the Inspector General to judge of the circumstances under which the
certificate has been granted, and to furnish any information he may deem
necessary in particular cases, to the Commander-in-Chief or Government
before certificates are acted upon. In all instances which it may not be
practicable to transmit the case and certificate at once, Deputy Inspectors
General will communicate to the Inspector General without delay, the name
of the disease, its duration, and the circumstances which have rendered it
necessary to grant a certificate.
Cir. No. 3,517 of
24th Sept. 1869.
43. OFFICERS PROCEEDING VIA BOMBAY, TO HAVE CASES MADE OUT IN TRIPLI-
CATE.—(a. ) Medical officers will furnish every Military officer sent on sick
leave to Bombay, preparatory to proceeding to Europe,
with two copies of his medical case (both of which should
be taken by himself, and not sent by post, as they are liable to miscarry) ; one
for the officer himself to be taken to Europe, and the other for the Standing
Medical Committee and eventual record in the Office of the Inspector General
Indian Medical Department, Bombay. The third copy is to be forwarded
in the usual way for record in the office of the Inspector General, Madras.
(b. ) In the case of Civil Servants or members of the Uncovenanted.
Civil Service, an additional third copy of the medical case is to be furnished,
for submission to the Government of Bombay.
44. CASES OF BRITISH OFFICERS.—Medical officers of the Indian Medical
Department will furnish copies of all cases of sick officers of the British
Army, who have undergone treatment by them, to the Inspector General,
British Medical Service.
28
MEDICAL BOARDS AND CERTIFICATES.
[SECT. XIV.
Cir. No. 2,402 of
4th July 1867.
45. INSANE OFFICERS.—When insane officers are recommended for leave
to Europe, the medical case must be forwarded in
duplicate, with a letter pointing out that the officer
is suffering under mental derangement. The medical history of such patients
must be sent by the Government to the Secretary of State for India, by the
first steamer after the embarkation.
46. SICK OFFICERS ARRIVING AT MADRAS.—(a. ) When officers (British
or Indian) arrive at the Presidency from the interior on medical certificate,
they shall report themselves to the medical officer of the district in which they
reside, in order that their names may be entered in the return of sick officers,
prepared for the information of the Commander-in-Chief.
(b. ) When the sick officer places himself under the charge of any other
medical officer than the District Surgeon, such medical officer is particularly
required to send a weekly memorandum of the state of the patient's health to
the Surgeon of the district in which the patient resides, in order that he may
be included in his weekly and monthly returns. He is also to notify when the
patient is struck off the sick report, or transferred to the care of another
medical officer, as inconvenience has been experienced from sick officers
changing their place of residence, removing into another district, and even
quitting the Presidency without giving any intimation thereof to their medical
attendant, to whom sick officers are strictly enjoined to be most particular in
reporting all such movements.
G. O. G., No. 387 of
3rd Nov. 1863.
4 7 .
M e d i c a l C e r t i f i c a t e s .
— A l l
sick certificates must distinctly specify
the period for which the Surgeon is of opinion that the
officer's state of health requires that leave of absence
should be granted to him. Leave on medical certificate in India is limited
to one year, subject to extension on fresh medical report.
4 8 . S T A T I O N T O B E N A M E D I N C E R T I F I C A T E . — M e d i c a lofficers, when grant-
ing a sick certificate to an officer to proceed to the " sea coast" or " Eastern
coast," will specify the station, and confine themselves strictly to those places
where medical aid is available.
4 9 . N E I L G H E R R Y S A N I T A R I A . — W i t hr
e g a r d t o
O f f i c e r s
proceeding on
Medical certificate to the Neilgherry Hills, attention must be given to the
following remarks as to the diseases for which that climate has been found
suitable.
i. Convalescents from fever, dysentery, and acute hepatitis, who are
quite free from structural disease, but so debilitated as to render it
improbable that they would recover perfectly under ordinary circum-
stances in India.
SECT. XIV.]
MEDICAL BOARDS AND CERTIFICATES.
29
i i . P e r s o n s d e b i l i t a t e d f r o m p r o t r a c t e d r e s i d e n c e i n I n d i a , u n a f f e c t e d
with any marked disease, or persons suffering from dyspepsia,
irregular action of the bowels, or symptoms of functional derange-
ment of some of the viscera, and
iii. Young men of weakly constitutions, having no actual disease, but
from debility and exhaustion unfit for military duty.
50. In cases of the above description, residence on the Hills is often
found peculiarly beneficial ; to many such, however, the climate of Coonoor, on
account of its mildness is, especially for the first six or eight weeks, best
suited.
51. To persons who have been long subject to returns of intermittent,
or who have repeatedly suffered from attacks of remittent fever, and to those
who have experienced repeated attacks of acute hepatitis, or have long
suffered from chronic hepatic or dysenteric affections, or those who labour
under rheumatism, syphilitic or pseudo-syphilitic affections, the climate of the
Hills has been found to be, generally, speaking, injurious, and as a rule they
must be debarred from proceeding to a hill climate ; in such cases, a long sea
voyage, or a return to Europe should be had recourse to.
52. The season of the year, and station on the Neilgherries, to which
patients are recommended to proceed, should be carefully considered ; and the
precautions, in regard to clothing and exposure, necessary for obviating the
bad effects which might arise from sudden reduction of temperature on
ascending the Hills, should be carefully explained to the patient. Patients
who are much enfeebled, and consequently most liable to suffer from such a
transition, may with advantage, in the first place, proceed to the lower, and
more temperate stations of Coonoor, Wellington and Kotagherry, especially
during the monsoon months of June, July, and August.
Cir. No. 2,108 of
1867.
5 3 . F O R M S O F M E D I C A LCERTIFICATES.—Medical Certificates of the
subjoined forms are to be strictly adhered to for all
Commissioned and Warrant Officers of the Indian Army
and Staff Corps, whether they may be occupied in Civil or Military employ.
FORM No. 1.
Within the Presidency.
I do hereby certify that A. B. is in a bad state of health, and that I think
it necessary he should proceed to ———— , and that he should be permitted to be
absent from his duty until————.
Station.
C. D.
Date.
Surgeon, &c.
30
MEDICAL BOARDS AND CERTIFICATES.
[SECT. XIV.
No. 2.
In extension.
I do hereby certify that A. B. has not sufficiently recovered his health to
enable him to return to his duty ; and I am of opinion that he should receive
further permission, to be absent thereform until the—————
Station.
C. D.
Date.
Surgeon,&c.
No. 3.
Preparatory to application for leave to Europe, &c.
I do hereby certify that A. B. is in a bad state of health, and that it is
necessary, in my opinion, he should proceed to the (here insert the station whether
the Presidency or other, to which recommended to proceed) for the purpose of
obtaining a final medical certificate, to enable him to proceed to Europe (or to
sea, to the Cape of Good Hope, or to other places eastward of the Cape) for the
space of—————
Station.
C. D.
Date.
Surgeon, &c.
No. 4.
I do hereby certify that A. B. is in a bad state of health, and that I think
a return (or an immediate return) to Europe necessary for his recovery, and that
he should be allowed to embark from (here enter Eastern or Western Coast, or
particular port or other Presidency, as the case may be).
Station.
C. D.
Date.
Surgeon, &c.
54. Applications for leave on Medical Certificate.—(a. ) All appli-
cations for original leave for officers on medical certificate , accompanied by the
Proceedings of a Medical Board (when such has been held), and the medical
certificate, are to be forwarded through the prescribed channels to Government,
or to the Adjutant General of the Army.
( b. ) EXTENSION OF LEAVE OR CHANGE OF LOCALITY.—Applications for exten-
sion of leave on sick certificate or change of locality, accompanied by the medical
certificate, are in the first instance to be submitted in the manner prescribed by
the regulations of the service, by the officer himself to the Officer Command-
ing the station at which the medical certificate may have been obtained.
The Commanding Officer, if at a station where a Medical Board cannot be
formed, will forward the application through the prescribed channel to Gov-
ernment or to Army Head Quarters ; but when there are sufficient medical
officers, he will assemble a Board ; and if the certificate be confirmed,
forward the application, certificate, and Board's Proceedings as above directed.
SECT. XIV.]
MEDICAL BOARDS AND CERTIFICATES.
31
(c.) No other application for leave is to be made by the officer himself
but he will forward to his regiment or department, for information, a dupli-
cate of the medical certificate, with confirmation of Medical Board recorded
thereon, when one has been convened, which the Officer Commanding the
station will cause to be delivered to him.
(d.) Upon the approval by a Medical Board of a certificate recom-
mending extension of leave or change of locality, or at stations where there
may be only one medical officer, upon an urgent certificate to that effect,
which is also to accompany the application, the patient may be allowed by
the Officer Commanding the station, to act accordingly in anticipation of leave
from Army Head Quarters.
(e.) Medical Boards or officers are to grant the certificates, required by
the foregoing regulations, to officers to proceed to the Presidency or elsewhere,
as they may consider most conducive to the health of the patient.
5 5 . A P P L I C A T I O N S F O R E X T E N S I O N O F L E A V E . — I nparticular cases where
circumstances prevent the possibility of applications for extended leave of
absence on sick certificate being received at head quarters, through the regular
channel, in sufficient time for the decision of the Commander-in-Chief being
notified, previous to the expiration of the leave originally granted, officers
are permitted to forward duplicates direct to the Adjutant General of the
Army.
56. SEALED STATEMENT OF CASE TO BE GIVEN TO PATIENTS.—Previous to
departure from a station, each sick officer is to be furnished with a sealed
medical statement of his case, to be produced to the Board before which he
appears, which case, after examination, will be returned to him sealed by
the Board, for the purpose of being delivered to the medical officer by
whom he may next be attended.
57. In cases in which an officer's sick certificate may not be confirmed
by a Board at a station on his route, he is to be allowed to remain there,
pending the orders of Government or the Commander-in-Chief upon the
Board's Proceedings.
58. When an extension of leave or change of locality may be considered
advisable for officers on medical certificate, the recommendation of their medical
attendant to that effect is to be submitted to the Board of Medical Officers at
the station.
59. OFFICERS AT PRESIDENCY TO REPORT TO DISTRICT MEDICAL OFFICER.—
On the arrival of an officer at the Presidency on sick certificate, he is to
report himself to the medical officer of the district in which he resides. At
any out-station, to the senior Staff or Garrison Surgeon. These reports
32
MEDICAL BOARDS AND CERTIFICATES.
[SECT. XIV,
are not of course intended to supercede others required to be made to the
several authorities by the regulations of the service.
60. Whenever a sick officer residing at Madras, may change his place
of residence, or remove into another district, he shall make an immediate
report of the circumstances to the medical officers of both districts.
61. PRESIDENCY STANDING COMMITTEE.—The Presidency Board will meet
at the President's quarters once a week, at a fixed hour, but when extra
meetings are required, the President will arrange for their being held. Sick
officers unable to attend at the place appointed, will be examined at their
own quarters.
60. Medical Certificates to Officers in Civil Department. —When
an application for leave of absence is made on the ground of ill-health, it must
be accompanied by a certificate, and a statement of the case, from the medical
officer by whom the applicant has been attended, distinctly stating from
personal observation, the nature of the disease, the symptoms by which it is
manifested, the period during which it has existed, as far as the knowledge of
the medical officer extends, and the necessity for temporary absence in India,
Europe, or elsewhere, and in the case of the applicant visiting the Presidency
preparatory to obtaining leave, the certificate must be countersigned by the
Inspector General, Indian Medical Department, on his being satisfied, on a
perusal of the medical attendants' statement of the case, that the leave applied
for is necessary towards his recovery. Should the applicant's medical
attendant be of opinion that he ought to proceed to a sanitarium or other
place without visiting the Presidency, the certificate must, in the first instance,
be countersigned by the Deputy Inspector General, Indian Medical Depart-
ment, of the division in which the applicant may be located, and afterwards
submitted, with the statement of the case, for the consideration and counter-
signature of the Inspector General.
63.
Covenanted Civil Servants. —The certificate shall be given in the
following form :—
No. 5.
Cir. No. 4,025 of
1865.
I., A. B., Surgeon at or of ———— do hereby certify on honour,
that D. F., of the
service, is in a bad state of health,
and I sincerely declare that, according to the best of my
judgment, a change of air is essentially necessary to his recovery, and do therefore
recommend that he may be permitted to proceed to sea (or to such place as the
Surgeon may think proper, expressing it in the certificate).
SECT. XIV.]
MEDICAL BOARDS AND CERTIFICATES.
33
The following form shall be observed by the Inspector General or the
Deputy Inspector General, in countersigning the Surgeon's certificate.*
I
do hereby certify, that according to the best of my professional judgment,
after careful personal examination of his case, I consider the state of health of
D. F. to be such as to render, leave of absence for a period of
————
absolutely necessary (or highly desirable) for his recovery.
64. EXTENSION OF LEAVE IN INDIA.—An application for extension of leave
must, if the applicant be in India, be accompanied by a certificate to a like
effect from the medical officer by whom the applicant is attended, together
with a statement showing sufficient reason for the extension solicited, and
such certificate must be countersigned by the Inspector General or by the
Deputy Inspector General of the division in which the applicant may be
located, as the case may be, on perusal of the statement. In like manner, if
the applicant shall have proceeded beyond the territories under the Govern-
ment of India, he must furnish a certificate and statement, to the required
effect, from a surgeon or physician at the place of his temporary residence by
whom he has been attended ; such attendance, and the period of it to be
stated.
G. 0. G., No. 32 of
1865.
6 5 . E X T E N S I O N O F L E A V E I N E U R O P E . — I fthe applicant, for an extension
of leave on medical certificate, be residing within 20 miles
of London, he must produce a certificate from the Medi-
cal Board attached to the India Office, showing the necessity for such exten-
sion. If residing beyond that distance from London, certificates in the second
of the above forms must be produced from two Medical Practitioners.
Cir. No. 187 of 18th
Jan. 1867.
66. CERTIFICATE TO BE IN FORM.—Deputy Inspectors General are strictly
enjoined not to pass any certificate for officers in the Civil
Department, unless drawn up conformably to regulations
and whenever they may be unable to examine the candidate personally, an
explanation of the circumstance must be forwarded to the Inspector
General.
Cir. No. 2428 of 7th
June 1866.
6 7 .
O f f i c e r s o f t h e D . P . W .
—Whenever Executive Officers and
subordinates of the Public Works Department are dis-
abled for duty, by either slight or severe sickness, the
medical officer is at once to put them on the sick report, granting a certificate
of leave in Form No. 6 or 7 as the officer may belong to the Civil or Military
Department ; and at the end of that term, if necessary, an extension of leave
* The Inspector General or Deputy Inspector General, before countersiging a certi-
ficate as above mentioned, must either personally examine the applicant, or state some
sufficient reason why he has been unable to do. When any of the required particulars
are neglected leave will be refused.
VOL. II.
E