NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
SECT. XX.]
REPORTS AND RETURNS. 1 0 7
(f.) CHOLERA REGISTER.—Cholera Register (in the form laid down by
the Army Sanitary Commission.)
(g.) LETTER BOOK.—A Letter Book, in which all official lett ers, written
by the Medical Officer in charge, and all representations or re commendations,
respecting the sanitary state of the troops, which he has considered it
necessary to make in writing to the Commanding Officer, with the replies,
are to be entered for the inspection of the Military Inspecting General, or
any Inspecting Medical Officer.
(h.) A DIARY, OR HISTORICAL REGISTER.—A diary, or historical register,
in which the Medical Officer is to enter all medical occurrences, and the
notes of his sanitary inspections and inquiries, with copies of his reports.
(i.)
RETURN BOOK.—Miscellaneous Return Book.
(j.) VACCINATION REGISTER.—A Register Book, for cases of vaccination
and small-pox.
(k.) Prescription Book.
(l. ) REGISTER OF RECRUITS.—A Register of Recruits.
2. GENERAL HOSPITAL BOOKS.—In every General or Depot Hospital the
following books shall be kept :—
(a.) ADMMISSION AND DISCHARGE BOOK.—An Admission and Discharge
Book, Form K., which is to be kept in the same manner as the Regimental
Admission and Discharge Book.
(b.) MEDICAL CASE BOOK.—A Medical Case Book, containing the details
of every acute and important case admitted into hospital in Form L.
(c.) WARD BOOK.—A Ward Book.
(d.) LETTER BOOK.—A Letter Book.
(e.) NECROLOGICAL REGISTER
.—A Necrological Register.
(f.) CHOLERA REGISTER
.—A Cholera Register.
3. Registration of Diseases and Causes of Death. —The "Nomen
-clature of Diseases," as published by the authority of the Royal College of
Physicians of London, is to be strictly adhered to in all Military and Civil
Medical Returns.
4. The objects in view in adopting a more comprehensive nomenclature
are the "fixing definitely for all places, the things about which medical
observation is exercised, and of forming a steady basis upon which medical
experience may be safely built,"
5. Another main use of statistical registration of disease on a wide
scale is that it must tend to throw light upon the causes of disease, many of
which causes, when duly recognized, may be capable of prevention, removal, or
diminution.
108
REPORTS AND RETURNS.
[SECT. XX.
6. In the revised nomenclature, there is little deviation as regards
the English names of diseases, from the terms employed by the Registrar-
General of England, in the returns compiled by him for the past thirty years.
As regards classification of diseases, however, the new system is based " on
anatomical considerations" alone, and in this respect differs considerably from
the system of classification hitherto followed in Army and other official returns.
7. In all statistical returns the English names of diseases must be given.
A reference to the original volume of " Nomenclature of Diseases " (copy of
which is attached to every medical charge), will show the Latin, French,
German, and Italian equivalents, of the English definitions, but it is not
intended that any of these shall be introduced in official documents when a
descriptive term can be given in English.
8. A good classification aids and simplifies the registration of diseases ;
helps towards a more easy comparison and knowledge of them, and towards
the storing of experience respecting them, and facilitates the discovery of
general principles, from the collected, grouped, and compared phenomena.
9. Many modes of classification might be adopted, such as according to
symptoms, the intimate nature of diseases, the tissues or systems affected, or
to the parts of the body as they lie anatomically, but the anatomical system of
classification has been considered, in the present stage of medical science, to
be the simplest and most complete.
10. In subservience to this anatomical distribution, diseases may also be
grouped as being General or Local.
11. General diseases are such as affect the whole frame rather than
any special part of it. Local diseases are such as occupy special parts of the
body.
12. General diseases are classified in two Sub-divisions, A. and B.
Sub-division A. comprehends those disorders which appear to involve a
morbid condition of the blood, and which present for the most part, but not
all of them, the following characters :
—
(a). They run a definite course.
(b). Are attended with fever.
(c). Sometimes, with eruptions on the skin.
(d). Are more or less readily communicable from person to person.
(e). Possess the singular and important property of generally protect-
ing those who suffer them from a second attack.
( f. ) Apt to occur epidemically.
Sub-division B. comprises, for the most part, disorders which are apt to
invade different parts of the same body, simultaneously, or in successions These
SECT. XX.]
REPORTS AND RETURNS.
109
are sometimes spoken of as constitutional diseases, and they often manifest a
tendency to transmission by inheritance.
13. In the arrangement of local diseases, the list at page 29 of the
" Nomenclature" should be carefully consulted.
14. Diseases are not to be returned under such general names, as
" Dropsy," " Convulsions," "Palsy," &c., if the morbid conditions upon which
they depend are known. If the cause has been ascertained, the case should
be registered under the head of the primary disease.
15. The following headings will show the main features of the "nomen
-clature of diseases" now adopted. The work being supplied to every
independent medical charge, it is expected that Medical Officers and subordi
-nates will make themselves familiar with the definitions of disease and
system of classification employed :—
I. General diseases.
SUB-DIVISION A.
SUB-DIVISION B.
II. Local diseases.
1 . N E R V O U S S Y S T E M .
Diseases of Brain and Membranes.
of Spinal cord and Membranes.
of Nerves.
Functional diseases of the Nervous system.
Disorders of the Intellect.
2. DISEASES OF THE EYE.
of Conjunctiva.
of Cornea.
of Sclerotic.
of Iris.
of Choroid and Retina.
of Vitreous body.
of Lens and its capsule.
General affections of the eye.
Defects of sight.
Diseases of the Lachrymal Apparatus.
Eyelids.
Within Orbit.
3 DISEASES OF THE EAR.
of Auricle.
of External meatus.
of Membrana Tympani.
110
REPORTS AND RETURNS.
[SECT. XX.
of Eustachian Tube.
of Tympanum.
of Internal Ear .
4. DISEASES OF THE NOSE.
5. DISEASES OF THE CIRCULATORY SYSTEM.
of Heart and its Membranes.
of Pericardium.
of Endocardium.
of Muscular structure of heart.
of Blood vessels.
of Arteries.
of Veins.
6. DISEASES OF ABSORBENT SYSTEM.
7. DISEASES OF DUCTLESS GLANDS.
of Thyroid Gland.
of Thymus Gland.
of Supra-renal Capsules.
8. DISEASES OF RESPIRATORY SYSTEM.
of Nostrils.
of Larynx.
of Trachea and Bronchi.
of Lung.
of Pleura.
of Mediastinum.
of Bronchial Glands.
9. DISEASES OF DIGESTIVE SYSTEM.
of Lips.
of Mouth.
of Jaws, including antrum.
of Teeth, Gums, and Alveoli.
of Tongue.
of Fauces and Palate.
of Pharynx.
of Salivary Glands.
of Œsophagus.
of Stomach.
of Intestines.
of Rectum and Anus.
of Liver.
o f H e p a t i c d u c t s a n d G a l l B l a d d e r .
SECT. XX.]
REPORTS AND RETURNS.
111
of Pancreas.
of Spleen.
of Peritoneum.
of Mesenteric Glands.
10. DISEASES OF URINARY SYSTEM.
of Kidney.
of Bladder.
of Prostrate.
of Male Urethra.
11. DISEASE OF GENERATIVE SYSTEM.
Diseases of Male organs of Generation.
of Penis.
of Scrotum.
of Cord.
of Tunica Vaginalis.
of Testicle.
Diseases of female organs of Generation unimpregnated.
of Ovary.
of Fallopian tube.
of Broad ligament.
of Uterus, including the cervix.
of Vagina.
of Vulva.
Functional diseases.
Diseases of Female Breast.
of Male Mammilla.
12. DISEASES OF ORGANS OF LOCOMOTION.
of Bones.
of Joints.
of Spine.
of Muscular system.
13. DISEASES OF CELLULAR TISSUE.
14. DISEASES OF CUTANEOUS SYSTEM.
III. Conditions not necessarily associated with General or
Local diseases.
IV. Poisons.
Metals and their Salts.
Caustic Alkalies.
Metalloids.
Acids.
Vegetable poisons.
112
REPORTS AND RETURNS.
[SECT. XX.
Animal poisons.
Gaseous poisons.
Mechanical Irritants.
Poisoned wounds.
V. Injuries.
General.
Local.
VI. Surgical operations.
APPENDIX.
Human Parasites.
Congenital Malformations.
16. Statistical and Sanitary Returns. —The following Statistical
Returns and Reports shall be made up from the Regimental Hospital Books,
by the Surgeon or Medical Officer in charge, and transmitted to the Inspector
General, in the manner hereinafter mentioned :
(a.) WEEKLY RETURN OP SICK.—A Weekly Regimental Return of Sick,
(Form No. 21) is to be filled up and sent at the end of every week by every
Surgeon or Medical Officer in charge to the Deputy Inspector General of
the Circle. A duplicate of the Weekly Return is to be forwarded dire
c
t to the Inspector General, and a triplicate return to the Sanitary Com-
missioner for Madras. To the Weekly Return may be appended any
medical, sanitary, or statistical notes which the Medical Officer may think
it necessary to add respecting the health of the troops. But any unusual
amount or kind of sickness or mortality in the Regiment, with its causes
or predisposing conditions or circumstances, the recommendations made
by the Medical Officer to the Commanding Officer respecting it, and the
results of these recommendations, must always be carefully noted.
(b.) MONTHLY SANITARY REPORT.—On all stations every Medical Officer
holding a separate charge shall transmit to the Principal Medical Officer of
the station together with the last Weekly Medical Return of each month, a
report on the health of the troops, and on the sanitary condition of the
barracks, quarters, hospitals, and vicinity of the station for the preceding
month, and on the rations, drinks, clothing, duties, &c., of the troops, and the
effects of these on their health ; the report (see form No. 22 in Appendix) to be
sufficiently detailed to enable the Administrative Medical Officer and the
Inspector General to ascertain that every necessary precaution for protecting
the health of the troops has been in use. In the first two monthly Sanitary
Reports for each quarter, Medical Officers are not required to repeat details
as to plans of barracks and hospitals, means of ventilation, of drainage, com-
position of rations, &c., provided there has been no change in any of them.
SECT . XX.]
REPORTS AN
D RETURNS.
113
during the month to Which the report refers. " No change" is considered a
sufficient entry under such circumstances.
But all changes are required to be noticed as they occur. The condition
of barracks, latrines, ablution-rooms and cook-houses, as to cleanliness or
otherwise, and the state of the drains are always required to be stated, and
the quality of the rations and canteen drinks must always be mentioned. In
the report for the third month of each quarter full particulars must be given
under each head. Monthly Sanitary Reports must be countersigned by
Commanding Officers of Corps previous to despatch. For native troops the
sanitary report is required to be rendered only at the end of every quarter
instead of monthly.
(c.) ANNUAL SANITARY REPORT.—An Annual Sanitary and Statistical
Report on the printed W. O. Form No. 517, and made up to December 31st of
each year, shall be drawn up by every Surgeon or Medical Officer in charge
of any Regiment or Detachment, and transmitted through the local adminis-
trative officer to the Inspector General on or before January 31st following.
17. DEPOT STATISTICAL AND SANITARY REPORTS.—Weekly, monthly and
Annual Medical Returns with appended Sanitary Notes, Memoranda, and Re-
ports in the same form as the Regimental Returns and Reports, shall be drawn
up by the Staff Surgeon or Medical Officer in charge of every Depôt Hospital,
and transmitted in the same manner to the Inspector General.
18. GENERAL HOSPITAL WEEKLY STATE.—A weekly Hospital State shall
be made up by the Registrar of every General Hospital, in Form No. 21 with
the names of the Regiments to which the case belong, and transmitted week
by week to the Inspector General through the Principal Medical Officer of
the hospital.
19. QUARTERLY STATISTICAL RETURN.—The Administrative Medical
Officer of a Circle shall make up and transmit to the Inspector General a
quarterly statistical return of the diseases and mortality within his district,
compiled from the Weekly returns received by him from Medical Officers.
20. ANNUAL REPORT.—The Administrative Medical Officer shall
transmit to the Inspector General an annual report of the diseases within his
districts, compiled from the Regimental Reports and States, and also a detailed
sanitary report for the year.
21. REPORT OF EPIDEMIC DISEASE IN A G
ARRI S
ON.—When epidemic disease
prevails among any population, in the neighbourhood of which any Regiment
or Detachment is stationed, or among the civil population of any garrison,
station, or camp, sanitary reports or memoranda shall, in every such case, be
sent by the Medical Officer in charge, week by week, to the Inspector General
through the Administrative Medical Officer, together with the Weekly
VOL. II.
P
114
REPORTS AND RETURNS.
[SECT. XX.
Statistical Report. Daily reports of admissions and deaths from malignant
cholera are to be sent, so long as the disease continues epidemic.
22. EPIDEMIC DISEASES AMONG TROOPS.—If any epidemic disease attacks
the troops in any Regiment or Detachment, the occurrence must be forthwith
notified by the Medical Officer in charge to the Administrative Medical Officer,
and a report on the progress of the disease and the sanitary state of the
troops must be sent to the Inspector General through the Administrative
Medical Officer, day by day, as far as it may be practicable to do so, till
the disease has disappeared.
23. ( a. ) REPORTS TO INCLUDE, STRENGTH, SERVICE, AND AGES OF TROOPS
.
—Every Weekly Regimental Return must contain the strength of Officers,
Non-Commissioned Officers, and men, the numbers to be obtained by the
Surgeon from the Orderly-room.
(b.) Every Quarterly and Annual Report must contain the average
strength for the period, to be obtained in the same manner.
(c.) In addition to the average strength, the Annual Return must
contain the ages and periods of service of the men arranged in quinquennial
periods, and the numbers of men of each rank in the several classes.
24. DIARY AND MARCHING REPORT.—A diary shall be kept by every
Medical Officer in charge of a Regiment or Detachment of troops, when
marching, and in which diary shall be noted the principal subjects of interest
bearing on the health of the troops. At the termination of the march, a
report (Form No. 23) of the occurrences on the march is to be rendered to the
Administrative Medical Officer of the Circle, for submission to the Inspector
General.
25. MEDICAL STATISTICS OF AN ARMY IN THE FIELD—When an Army is
in the field a Daily Medical Return of Diseases is to be made up by the
Regimental Surgeon or Medical Officer in charge (Form No. 21) and trans-
mitted to the Principal Medical Officer, to be used for his report to the Com
-manding Officer of the Forces.
26. RETURN OF WOUNDS.—A classified Return of Wounds and Injuries,
received in each action (Form No. 24) is to be sent, as soon as possible, by
the Surgeon or Medical Officer in charge to the Principal Medical Officer.
27. WOUNDS, &C., IN HOSPITAL.—A classified Return of Wounds and
Injuries of every kind, received in action and admitted into hospital (Form
No. 25) is to be made up and transmitted by the Regimental Surgeon or
Medical Officer in charge to the Principal Medical Officer at the conclusion
of each week.
28. CLASSIFIED RETURN OF OPERATIONS.—All Surgical Operations per-
formed throughout the service are to be entered in the Classified Return of
SECT. XX.]
REPORTS AND RETURNS.
115
Operations, (Form No. 26) and the form filled up is to be sent by the Surgeon
with his Annual Report.
29. ADMISSION AND DISCHARGE BOOK AND MEDICAL CASE BOOK FOR
OFFICERS.—An Admission and Discharge Book, similar to Forms No. 27 and
No. 28 should be kept for officers, and in them will be entered the Admis
-sions and Discharges, Invaliding and Deaths from disease, from wounds, in
hospital, and. from deaths in the field, of all Commissioned Officers. Tabular
extracts from this book must be transmitted by the Surgeon or Medical
Officer in charge, with his Annual Report. The details of important cases
will be entered in a Medical Case Book for officers, similar to Form No. 29.
30. DETAILED MEDICAL REPORTS OF FATAL CASES.—Detailed Medical
Reports of fatal cases are invariably to be transmitted to the Inspector
General under the following circumstances :
—
(a.) All deaths of officers.
(b.) When a soldier dies, on or immediately after his transfer either
from one hospital to another or from a Foreign station to England, as in the
case of invalids, and vice versâ.
(c.) When such report is specially required by the Inspector General,
or by the Administrative Medical Officer of the station.
(d.) When necessary to illustrate a morbid preparation.
(e.) When, from the peculiarity and rare occurrence of the case, such
report may appear to the attending Medical Officer to be interesting and
valuable.
31. Business Return.—The undermentioned Return is to be ren
-dered by the Inspector General, British Medical Service, as soon as possible,
after December 31 in each year, viz. :
—
A monthly Staff Return (pages 195-8, Army Medical Regulations),
showing also the names and duties of the Regimental Medical Officers in the
command (Form No. 30.)
32. Instruction to Medical Officers in making up Annual
Medical Reports.—Annual Reports should give the fullest information on
all subjects connected with the health of the troops, and the nature, treatment,
and prevention of disease, so that the Inspector General may be in possession
of every fact and circumstance regarding these subjects which it is necessary
for him to know.
33. At stations where meteorological instruments, forms, and tables are
supplied for the purpose, the Medical Officer in charge will cause observations
to be made, and registered with accuracy, which observations will be available
for other medical officers, in the preparation of their annual reports.
34. The Medical Officer of a Corps will transmit annually meteorological
tables, according to the printed forms and instructions, stating his opinion
REPORTS AND RETURNS.
[SECT.
XX.
as to the influence of the climate on particular constitutions and temperaments,
and on the progress and termination of diseases.
35. He should describe, generally,—
(a.) The geological formation;
(b.) The physical geography and medical topography of the surrounding
country;
(c.) Its features, mountains, valleys, rivers, lakes, marshes, vegetation,
natural history, the diseases, particularly those of the zymotic class prevalent
among its population;
(d.) Also its vegetable and animal products, their nature and amount,
and their adaptation for furnishing supplies for troops; the sources, quality,
and quantity of the water-supply, and whether it is wholesome, and what
means of purification are in use, if such be necessary.
36. At all stations he should describe the buildings in use for barracks or
hospitals, guard-rooms, and cells, as regards their position, exposure, elevation
above the sea level, or above neighbouring low ground, or lake, or river
banks; their distance from sea, lakes, or rivers; the number of men they
are capable of containing according to regulation, and the numbers in them;
their structure, drainage, means and sufficiency or otherwise of means for
ventilation; materials of which they are built; the number, length, breadth,
and height of rooms and wards; the number and position of windows and
doors; the average monthly cubic space each man has had in barracks,
guard-rooms, cells, and hospitals; state of cleanliness within and without
the buildings; and whether the walls are sufficiently limewashed;
37. Means of lighting and warming; nature and amount of fuel;
38. Baths and lavatories, their condition, and if sufficient for cleanliness
for troops and sick; whether there are bathing parades, and how often a week;
39. Kitchen and cooking utensils for barracks and hospitals, whether
sufficient for a variety of cooking;
40. The amount and sufficiency of barrack accommodation for married
soldiers, and the state of their quarters;
41. The sanitary state of latrines and urinals, whether they are flushed or
emptied by hand, and at what interval of time, also of water-closets, ash-pits,
stables, &c.;
(a.) The nature and composition of rations, whether sufficient and
sufficiently varied, and what facilities are afforded by the station for varying
them; what fresh or preserved vegetables are used, and their average daily
amount; whether ration includes tea, coffee, or cocoa;
(b.) The nature and qualities of fruits and vegetable obtainable and
in use, and their effects on health;
SECT. XX.]
REPO R
TS AND RETURNS.
117
(c.) Whether rations and diets are properly cooked by roasting, boiling,
baking, &c.;
(d.) The quality of bread or of biscuit, and the amount of either in the
ration;
(e.) The spirits, beer, or other liquors used by the troops, their quality
and effect on health;
42. Similar information as to hospital diets, and a statement of any
changes made in them on account of the character or kind of supplies available;
43. Whether the clothing of the troops is sufficient and adapted for the
climate, and if not, to state what improvements might be made;
44. The nature of the bedding, and whether sufficient;
45. The nature and amount of duty or labour performed by troops, and
their influence on health; drills how often, and at what hours they take
place; length of marches, and at what hours;
46. The proportion of nights in bed to those on duty;
47. Gymnastics, amusements, and recreations in use, and if conducive
to health;
48. State of canteens, size and state of ventilation of rooms, and quality
of provisions and liquors sold in them; whether the canteens are under proper
regulations; whether disease is traceable to articles sold in them;
49. Amount of intemperance and of crime and disease directly or
indirectly traceable to its effects; also the means in use for repressing
intemperance.
50. State of vaccination in the Corps, and the extent to which it is a
preservative against small-pox; whether re-vaccination has been carried out,
and the results.
51. The Annual Report must contain a carefully filled-up table of diseases
and mortality classified according to the Statistical Nomenclature now in use.
The Annual Return of sick and wounded, (W. O. Form No. 298) must also
be filled up and transmitted along with the Annual Report.
Also a general summary during the year, showing :
(a.) The average strength of the Regiment throughout the year, distin
-guishing and showing any change in its composition; also the stations and
strength of each detachment.
(b.) The causes of mortality arranged under the orders of each class, and
the total deaths to strength for the year, calculated at the rate per 1,000 per
annum.