NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
SECT. XV.]
INVALIDING.
45
circumstances under which the accident occurred, and whether on or off duty,
should be stated.
VII. Gunshot or other wounds, or injuries which the soldier may at any
time have received in action, or under circumstances contingent upon service
before the enemy or otherwise, or by accident, or by his own fault, should be
described, with a view to adjustment of the claim they give, and to proper
arrangement of the case in the prescribed classification. If the wound or
injury be of distant date, the extent of inconvenience or discomfort continuing
therefrom should be stated.
VIII. Any physical defects and results of previous injuries and diseases,
though not immediately connected with the disability for which the soldier is
i n v a l i d e d , s h o u l d b e n o t i c e d , a n d s u c h i n f o r m a t i o n g i v e n a s m a y t e n d t o
elucidate any claim that may be founded on them.
IX. Full particulars of the medical treatment of the case up to date of
invaliding .
14. In cases where soldiers on foreign stations are invalided as totally
unfit for further service, and may be permitted to remain abroad, the prescribed
documents are to be forwarded in the same manner as if those invalids were
on their way home.
15.
CASES OF MENTAL DERANGEMENT.—In cases of men invalided, and sent
to the Invalid Depot, on account of mental disabilities, the medical history
should furnish the following details :—
1st.—Name. Regiment. Regimental No.
2nd.—Age. Length and places of service.
3rd.—Place of birth. Names and residences of nearest surviving relatives.
4th.—Social state, married or single.
5 th.—Temperament
6th.—Character, especial regard being paid as to whether temperate
or otherwise.
7th.—Form of mental disorder.
8th.—Whether a first attack.
9th.—Duration of present attack.
10th.—Whether the attack was sudden or insidious? If the latter,
mention any peculiarity of behaviour or change in habits which
preceded it.
11th.—Whether insanity was preceded or accompanied by any particular
illness, as fever, rheumatism, syphilis, &c. ? Whether mercury to
a large extent has been used for the treatment of any one of them.
12th.—What are its supposed causes (moral or physical) ? Whether
the patient has suffered from sun-stroke, concussion, or injury of
the head ?
46
[SECT. XV.
INVALIDING.
13th.—Whether any hereditary predisposition exists ?
14th.—What are the particular ideas or actions which have induced the
belief of insanity ?
15th.—Whether the disease is complicated with epilepsy or paralysis,
with homicidal or suicidal impulses ? If suicidal tendency exists,
mention the way in which self-destruction has been attempted.
16th. — W hether the patient is noisy, dangerous, or mischievous, or given
to steal ? Whether his habits are cleanly or dirty ?
17th.—What treatment has been adopted since invasion of the disease.
16.
DEFINITIONS OF MENTAL DISEASE.—To obviate amongst medical
officers the confusion so common in the use of terms designating the various
forms of mental unsoundness, it is requested that cases may be named in
accordance with the terms and definitions as follow :—
Amentia
...
Congenital imbecility, including the various grades of
weak intellect, rendering a man incapable of fulfilling his
military duties.
Mania Acuta
„
Chron.
Interm.
General insanity, characterized by incoherence and
excitement of mental faculties, frequently leading to acts
of violence and mischief, and attended with illusions or
hallucinations of one or more of the senses.
Dementia ...
The more or less general impairment or obliteration of
the mental faculties in a mind originally possessing average
power. The more advanced stage of this form of insanity
constitutes fatuity.
Monomania ...
Insanity
on one particular point, mind otherwise
healthy.
Melancholia ...
Morbid depression of feelings or affections, with or
without real moral causes.
Mania with Epilepsy.
„ with Paralysis.
Dementia with Epilepsy.
, , w i t h
P a r a l y s i s .
17.
INSANE SOLDIERS.—Much inconvenience having resulted from the
present mode of dealing with insane soldiers, the following regulations are
for the future to be strictly complied with :
—
(a.) An insane soldier, should, under ordinary circumstances, be
attended by the medical officer of the Corps to which he belongs, for one
month at least, as the tatter, from knowing the probable origin and causes of
the attack, is considered the most competent to treat the disease in its earlier
stage.
SECT. XV.]
INVALIDING.
47
(b.) If after such period of treatment the patient should not recover, or,
if in consequence of exceptional circumstances which do not admit of delay,
it be desirable to remove him, application should be made by the medical
officer in charge to the Inspector General for permission to transfer the
insane soldier to an establishment in which lunatic wards exist.
(c.) Such applications should be accompanied by an abstract of the
case, drawn up in accordance with the instructions laid down in para. 15
together with a copy of the Soldiers' Medical History Sheet, and a state-
ment of the reasons which induce the medical officer in charge of the
case, to believe, that if discharged, he will not be able to re-enter the
service.
(d.) On receipt of the documents by the principal medical officer, the
necessary instructions will be issued for the disposal of the case.
Indian Troops.
18. INVALIDING BOARD.—Annual Invaliding Committees are to be com-
posed exclusively of medical officers, five when available,
but not less than two. When the latter number cannot
be conveniently assembled, and the men to be examined are unable to pro-
ceed to another station for that purpose, a report of the circumstance is to be
made to head quarters of the army, when special instructions will be issued.
19. The Deputy Inspector General will be nominated as President of
Committees, assembled at the station at which he resides, and elsewhere the
senior medical officer, who may be available.
20. Committees are required to decide, in each case, as to the fitness or
unfitness of the individual for further service.
21. Men considered unfit for further service with their corps or depart-
ment are, in the first instance, to be selected by the Commanding Officer or
head of department, and the medical officer in charge. Men selected by the
Commanding Officer as unfit for further service, are to be included in the
Medical Return, and the medical officer will state his opinion upon them,
although they may not have been recently under treatment, and may not be
considered by him unfit for further service.
22. RETURN OF MEN PROPOSED TO BE INVALIDED.— The Medical Return
will embrace the following particulars :—
First—The disease or other cause of unfitness for the service.
Second—How such disease or other cause of unfitness was contracted,
viz., whether on "Actual Service in India" "on Foreign Service," or during
" General Service," or as the case may be.
Third —Whether it is, or is not the result of his own imprudence.
G. O. C. C., No. 65
of 1st Nov. 1845.
48
INVALIDING.
[ SECT. XV.
Fourth— Summary and period of previous treatment.
Fifth—Opinion—in one of the terms laid down in para. 26, or as the
case may be—and, for men unfit for any further service, from wounds or
disease contracted in China, " Disabled in China."
23.
MODE OF CONTRACTING DISEASE TO BE PARTICULARISED.—Disease or
other cause of unfitness may be contracted on " Actual," " Foreign," or
" General" Service, without being in any degree attributable to the nature
of the service or insalubrity of the climate. For example—a man on " Foreign
Service" may fall accidentally, or from carelessness, or from intoxication,
and break a limb ; yet the injury could in no measure be attributable to the
nature of the service or to the climate. Leprosy and other diseases may break
out on " Foreign Service," or, having previously existed to some extent,
may increase to such a degree as to render the individual unfit for further
service, still the unfitness may not be attributable to the nature of the
service or climate. It is therefore absolutely necessary that medical officers,
when they are satisfied that the unfitness, although contracted on any parti-
cular service, is not attributable to the service itself, should so record their
opinion in the Medical Return.
24. Unfitness must never be stated as having been caused by a com-
bination of any two or more of the three descriptions of service. If it cannot
be attributed solely to either "Actual Service in India" or " Foreign Service,"
it must be declared as having been caused by " General Service."
25, In the event of sick soldiers being received by transfer without
statements of their cases, which would enable the medical officer receiving
them to furnish the required Medical Return, an immediate report of the
circumstance must be made to the Administrator Medical Officer of the circle,
for the information of the Inspector General, who will take the necessary
steps for having the deficient information supplied.
26. The " opinion" of the Medical Board upon each case is to be
entered in the following terms :—
1st.—" Unfit for any further service."
2 nd.—" Unfit for Field, but fit for Garrison duty."
3rd.—" Fit for further duty."
4th.—" Recommended for further treatment" or " for further obser-
vation."
5th.—" Recommended to have leave to (here enter place and period) for
the benefit of health."
6th.—" Recommended to be sent to the Eye-Infirmary (or elsewhere").
7th.—Or as the case may be.
SECT. XV.]
INVALIDING.
49
27.
WOUNDED MEN.—In the case of men disabled by wounds received in
action, the Board will record in their Proceedings, in the column " Remarks
of the Medical Committee" whether or not, the injury sustained by each is
equivalent to the loss of a limb,* or whether amputation has taken place in
consequence of such wound.
28. In the cases of Natives enlisted on or after the 16th of August 1842,
disabled by wounds received in action, it should be stated in the column
" Opinion of the Medical Committee," after the words " unfit for any further
service." " Entitled to the 1st (or 2nd, 3rd or 4th) degree of the scale of
Wound Pension," viz. :—
1st Degree.
2nd Degree.
3rd Degree.
4th Degree.
Men losing two limbs
or both eyes, or being
so severely wounded
as to be totally incapa-
ble of earning a liveli-
hood, and to require
the assistance and care
of some other person.
Men rendered in-
capable of earning a
livelihood, but not
requiring the care
of another person.
Men able to contri-
bute in a small de-
gree towards a liveli-
h o o d .
Men able to contri-
bute materially to-
wards a livelihood,
although unfit for the
ordinary duties of the
service.
29.
WOUND PENSION.—The Wound Pension for Natives enlisted on or
after 16th August 1842, will be fixed according to the rates in the foregoing
scale, and the Committee will grant the lowest or highest, or any intermediate
rate, according to the degree of the injury received, the length of the soldiers'
previous service, his character, or any peculiar circumstances attending his
conduct at the time the wound was received.
30. In cases of men rendered unfit for any further service by wounds
or disease contracted in China, Medical Committees will record in their Pro-
ceedings, in the column " Opinion of the Medical Committee" after other
entries, the words "Disabled in China."
31. In cases of Natives rendered unfit for further service from injuries
received whilst in the execution of their duty, Medical Committees will enter
* The term " Limb " is to be considered " applicable to an arm, a leg, a hand, a
foot, or an eye, and such wounds as deprive a soldier bona fide of the use of either,
shall entitle him to the pension of full pay. Fingers or toes may be separated from the
body without depriving the wounded man of the use of his hand or foot,—while in other
cases dislocation of a joint, separation of the tendons, or stiffness produced by the effects
of wounds, may entirely disable the limb from any useful effort. Of the nature of such
wounds, and the extent of debility they produce, the best judgment may be formed by
inspection, and from the opinion of medical officers. The case can seldom be doubtful,
but where doubt exists, the bias should be towards the favourable determination."
VOL. II.
INVALIDING.
[ SECT. XV.
in their Proceedings in the column " Remarks of the Medical Committee"
whether the injury is, or is not of such a nature as to incapacitate the
individual from earning a livelihood.
32.
APPEALS AGAINST DECISION OF MEDICAL BOARDS.—A Return of all
men whom the Board have not passed as " unfit" is to be prepared by them,
and forwarded along with the other papers. This document will then be
transmitted to the Officer Commanding the Regiment or Head of Department
to which the men belong ; and, should he in any case appeal from the decision
of the Medical Committee, he will do so immediately, and forward Proceedings
for the men in whose cases he appeals, accompanied by the Return, when the
Officer Commanding the Division or Force will order the assembly of a
Committee of three Field or Senior Officers, to whom all such cases will be
referred for final decision.
33. it will be the duty of the Committee of Appeal carefully to investi-
gate the grounds upon which the men are considered unfit for further duty;
and to record their opinion, with the ground. thereof, in the column appro-
priated for that purpose. These Proceedings, accompanied by the Return, are
to be forwarded through the regular channel to the Officer Commanding the
Division or Force for transmission to the Adjutant General, and submission
to the Commander-in-Chief.
34. The Proceedings of Committees of Appeal must be forwarded to
Army Head Quarters, simultaneously with the original Proceedings of the
Medical Committee upon the persons in question. The original Proceedings
being detained until it has been ascertained from the Officer Commanding
or Head of Department, who must report immediately, whether he desires to
appeal or not.
35.
SPECIAL COMMITTEES.—Officers Commanding Divisions, Forces, and
Stations, are empowered to assemble Special Committees, for the examination
of men who may from time to time be considered unfit for further service,
without previous reference to Head Quarters. Special Committees are
intended for the disposal only of individuals who, during the interval between
the assembling of the " General" Committees, may become totally unfit for
the performance of their duty.
36.
MEN RETURNED FROM FOREIGN SERVICE.—It is to be considered,
however, a general rule, that men returned from foreign service, and apparently
unfit for further duty, are not to be brought before Committees until they shall
have been at least six months returned, and in the case of Natives have also
had leave to their villages, if able to proceed thither for the benefit of their
health.
SECT. XV. ]
INVALIDING.
51
Native Troops.
37. Discharge of short service men.— (a.) Soldiers of short service,
recommended for discharge on account of physical unfitness, are to be brought
before the Annual Invaliding Committee, their names being entered in rolls
distinct from those of men recommended for transfer to the pension establish-
ment. If a soldier becomes altogether unfit for military duty, subsequently to
the assembling of the Annual Invaliding Committee, he is to be brought
before a Special Medical Committee, convened for that purpose by order of
the General Officer Commanding the division or district.
(b.) At a station where a Committee of medical officers cannot conveniently
be assembled, the Commandant of a Corps is empowered to dispose summarily
of the cases of men pronounced physically unfit for the service by the Regimental
Surgeon. But before directing the discharge of such men, the Commandant
will obtain the written opinion of the medical officer of the regiment, that the
soldier concerned is physically unfit for his duty, and is not likely to become
fit, from treatment in hospital, from change of air, or from sick leave to his
home ; and that he is not a malingerer, or suspected of being so.
(c.) Soldiers who become incapacitated for duty in the fifteenth year of
their service, are not to be discharged with gratuity, without the special sanction
of the Commander-in-Chief, but they should generally be brought before the
next Annual Invaliding Committee.
SECTION XVI.
SPECIAL HOSPITALS.
I . — G e n e r a l H o s p i t a l , M a d r a s .
II.—Eye Infirmary.
,,
I I I . — L y i n g - i n - H o s p i t a l . , ,
IV.—Fort and Port Surgeon's Department.
1.—General Hospital, Madras.
1. MEDICAL STAFF.—Three medical officers are appointed to the General
Hospital a Physician, a Surgeon, and a Resident Medical Officer. The senior
Medical Officer has general charge of the hospital establishment. The medical
and surgical wards are under the charge of the Physician and Surgeon
respectively. The Ophthalmic wards are under the control of the Govern-
ment Oculist, and Superintendent of the Eye-Infirmary. The Resident
Assistant Surgeon has special charge of the out-patient department. These
officers hold ex-officio appointments in the Medical College, viz. the Physician
is Principal of the College and Professor of medicine and Clinical medicine,
the Surgeon is Professor of Surgery and Clinical Surgery, and the Resident
Assistant Surgeon is Professor of Pathology. The General Hospital being
the great field of clinical training, its arrangements are made to harmonize
with the requirements of the Medical College.
2. PATIENTS.—The Madras General Hospital is designed to afford aid
to the following classes of patients.
(a.) MILITARY DETAILS.—Native military patients arriving from foreign
service, if too ill to proceed to the Native Infantry Depôt, Palaveram, are
received into the General Hospital. Warrant and Non-Commissioned Officers
of the Ordnance, Commissariat and Public Works Department, Artificers of
SECT. XVI.]
SPECIAL HOSPITALS.
53
the Gun Carriage Factory, and pensioned Military servants are also received.
As a rule, the General Hospital is intended for the accommodation of persons
in the service of the Government, and their families, as well as of the civil
population. At present no females are admitted as patients. The expendi-
ture on account of the General Hospital is debited to the Civil Department.
(b.) SAILORS.—Seamen of merchant ships are received into the General
Hospital, on a requisition signed by the Master Attendant. The ships' agents
are required to be answerable for all expenses incurred in the dieting of such
patients. Seamen of Her Majesty's Navy, or Indian Transport Service, may
be admitted to the General Hospital.
(c.) OFFICERS, NAVAL AND MILITARY.—Superior accommodation is provided
at a fixed cost, for the use of military or naval officers, or commanders and
officers of the merchant navy, who may request or require admission to
Hospital.
(d.) Europeans not belonging to the public service, if in poor circumstances,
are received into the General Hospital, and while there, are clothed and dieted
at the expense of Government.
(e.) Sick poor, of all races and castes, are admitted gratuitously, if their
cases demand hospital treatment, no certificate or letter of recommendation
being required of them.
(f.) There being at present no accommodation for women and children
in the General Hospital, they are, as a temporary arrangement, received and
treated in the Women's Hospital, Vepery, under the care of the Medical
Officer of the 2nd District. Those who can afford it are charged the usual
sum for dieting expenses, while the poor are dieted and clothed at the cost
of Government.
3. VISITS OF ADMINISTRATIVE OFFICER.—The Deputy Inspector General of
Hospitals, of the Circle (Indian Department), shall visit the General Hospital
at least once a week, and transmit to the Staff Officer and Superintendent of
Details, Fort St. George, a return of the military patients under treatment,
with the dates of their admission into hospital.
4. MILITARY DETAILS.—Whenever any non-commissioned officer or
soldier dies in the General Hospital, the senior Medical Officer will, as soon
as the event is made known to him, report the circumstance to the Staff
Officer and Superintendent of Details, Fort St. George.
5. The senior medical officer of the hospital will forward to the Superin-
tendent of Details, on the first day of every month, a return of military sick,
specifying the name, date of admission, and discharge of every individual in
the following form :—
54
[SECT. XVI.
SPECIAL HOSPITALS.
MADRAS,
GENERAL HOSPITAL,
18 .
Physician, General Hospital.
FORM A.
Return of Military Men belonging to other Stations in the General Hospital of
Fort Saint George.
Corps. No. Rank.
Names.
Diseases.
Date of
Admission.
Whether likely
to recover, and when.
6.
MILITARY DETAILS TO RECEIVE NO PAY IN HOSPITAL.—The sick in the
hospital, being furnished with suitable provisions, and provided with every-
thing necessary for their support, are not to receive their arrears of pay until
discharged, unless circumstances should render it necessary for the surgeon
to apply for such arrears.
7. The daily report shall be sent to the Brigade Major direct.
FORM B.
The Brigade Major's Daily Report of Sick in the General Hospital of Fort Saint
George. on the
187.
Corps.
N u m b e r o f p a t i e n t s r e m a i n d e d .
A d m i t t e d .
D i s c h a r g e d .
D i e d .
R e m a i n i n g .
Remarks.
Ordnance Artificer Company.
Ordnance
European ...
Department. Natives ...
Volunteer Band ...
. . .
Garrison Band
...
. . .
Medical Department
. . .
Artillery Veteran Company..
Pensioners
...
. . .
Civil Europeans ...
. . .
Police
European ...
Natives . . .
. . .
Native Details
...
. . .
Civil Natives
...
. . .
Total...
C l o s e d a t A . M .
General Hospital,
SECT. XVI.]
SPECIAL HOSPITALS.
55
8. DISCHARGE CERTIFICATE.—Men when discharged from the hospital, will
if required, be furnished with a certificate to that effect, in the following form :—
FORM C.
Discharge Certificate.
who was admitted on the
will be discharged this day at
Madras,
General Hospital,
Surgeon Major,
18 . Physician, General Hospital.
9 . F U N E R A L E X P E N S E S O F P A U P E R S D Y I N G I N H O S P I T A L . — T h e f u n e r a l
expenses of European, or East Indian men not belonging to any regiment,
are to be borne by their relations, if they have any ; but, should they have
neither friends nor relations, the amount is to be charged to the Government.
A sum of Rupees 8-8-0 is allowed for a European, and Rupees 2 for a native
funeral.
1 0 . C H A P L A I N S V I S I T S . — T h e S e n i o r M e d i c a l O f f i c e r i s r e s p o n s i b l e t h a t
divine service is performed at least once a week in the hospital, that convales
- c e n t p a t i e n t s a r e d u l y i n f o r m e d o f t h e p l a c e a n d t i m e , a n d t h a t t h e s i c k a r e
regularly visited by the chaplain in charge.
1 1 . T h e S e n i o r M e d i c a l O f f i c e r i s a l s o h e l d r e s p o n s i b l e t h a t n o c a t t l e ,
dogs, or poultry of any description, are kept within the precincts of the hospital.
12. A port i on of t he General Hospi t al bui l di ng i s al l ot t ed f or t he t reat
- m e n t o f t h e s i c k o f t h e B r i t i s h r e g i m e n t d o i n g d u t y i n t h e f o r t , a n d
European details from the interior, and is exclusively under the care of the
Surgeon of the regiment.
1
1 3
1 3 .
R e s i d e n t M e d i c a l O f f i c e r .—
T h e d u t i e s o f t h e R e s i d e n t A s s i s t a n t
Surgeon resemble those of a House Surgeon in a public hospital in England.
He is held responsible that the regulations of the Hospital are obeyed and
that all irregularities are at once brought to the notice of the Senior Medical
Officer. The Necroscopical and out-patient departments are placed under
his charge, he is also entrusted with the care of the Nominal Register and
with the oversight of the preparation of the Monthly Returns ; the immediate
control of the Hospital servants is vested in him, and he is required to
inspect the rations daily, and the cooked diets, when issued twice weekly.
In matters of detail he will carry out the instructions of the Senior Medical