NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
174
Table showing the rules under which leave is granted and the sanctioning authorities for leave for various classes.
Application from.
Leave rules.
Authority for sanctioning
leave ex-India.
Authority for sanctioning
leave in India.
Authority for sanctioning
privilege leave (or full
pay leave for Sub-Assistant
Surgeons) in or ex-India.
R. A. M. C. Officers and A. D.
Corps officers.
As for British service
District or Independent
Brigade Commander with
concurrence of A. G. in
India.
District or Independent
Brigade Commander with
concurrence of A. G. in
India.
District or Independent
Brigade Commander (in
the case of privilege leave
ex-India Except Ceylon
with concurrence of A. G.
in India.)
Q. A. I. M. N. S. .
.
.
Ditto.
.
Ditto.
.
Ditto.
.
Ditto.
I. M. S. Officers
.
.
.
Indian Army .
.
.
District or Independent
Brigade Commander with
concurrence of A. G. in
India and with concur-
rence of D. G., I . M. S. in
the case of study leave.
Ditto.
•
District or Independent
Brigade Commander (in
the case of privilege leave
ex-India with concurrence
of A. G. in India.)
I. M. S. Officers of the Medical
Store Department.
Privilege leave under civil
leave rules, other leave
under either civil leave
rules or Indian army
rules.
D. G., I. M. S.
.
.
D. G., I. M. S.
.
D. G., I. M. S.
I. M. D. Assistant-Surgeons . As for officers and warrant
officers of departments
(I. U. L.).
District or Independent
Brigade Commander with
the concurrence of A. G.
in India and in the case
of study leave with the
concurrence' of D. G., I.
M. S.
District , or Independent
Brigade Commander.
District or Independent
Brigade Commander.
M. D. Sub-Assistant-Surgeons Special .
.
.
.
District or Independent
Brigade Commander with
the concurrence of the
Government of India.
Ditto.
District or Independent
Brigade Commander (in
the case of full pay leave
ex-India) with the con-
currence of Government of
India.
Appx. V.
L e a v e , a p p l i c a t i o n s , e t c .
175
L e a v e a p p l i c a t i o n , e t c .
Appx. V.
I. M. N. S.
Para. 51-A of these Regs.
....
District or Independent
. Brigade Commander.
District or Independent
Brigade Commander.
Matrons family hospitals
Para. 53 of these Regs.
....
A. D. M. S.
....
I. H. C. except General Section As for I. O. Rs.
....
O. C. Company.
....
I. H. C. General Section.
As for regimental follower
....
Di t t o.
....
Q. A. M. N. S. I.
Variety of leave.
Para. 6, Appendix
II of this volume.
Para. 7, Appendix
II of this volume.
Para. 8, Appendix
II of this volume.
Privilege leave ex-
India.
Privilege leave in
India.
Sanctioning authority
A. G. in India
District or Ind. Bde.
Commander.
A. G. in India
A. G. in India
District or Ind.Bde,
Commander.
NOTE.—Leave in India includes leave to Ceylon, Burma or Kashmir.
Appx. VI.
First field dressings and hygiene.
APPENDIX VI.
SYNOPSIS OF LECTURES ON THE FIRST FIELD DRESS-
ING AND ON HYGIENE FOR THE GUIDANCE OF
OFFICERS IN MEDICAL CHARGE OF EFFECTIVE
TROOPS.
LECTURE I.
First Aid.
1. First Field Dressing.—Method of carrying ; its value in protect-
ing the wound from germs and in helping to arrest bleeding.
Mode of packing to prevent entrance of air, dust and dirt ; the
dressing, when opened, not to be allowed to touch the ground or
be put in a soiled place.
Mode of application of dressing to one or two wounds. Prac-
tical illustrations of application.
Dressing not to be applied until after arterial haemorrhage ha
s been stopped.
Bandage to be firmly but not too tightly applied, as evidenced.
by the finger when inserted under edge.
Wound if possible not to be touched, as thereby the risk of infecting
it is incurred.
Infection of wounds ; general remarks on the universal presence
of germs in the air, in dust, hands, clothes, etc., and the advantages
of surgical cleanliness.
2. First aid in. Drowning.—Commence treatment at once. Empty
mouth of weeds, straw, etc., pull out tongue (with cloth) to open
windpipe. Artificial respirations 18 times a minute, and continue,
in spite of its apparent uselessness, for half an hour ; apply warmth
and friction.
LECTURE II.
Hygiene, or the Maintenance of Health.
1. General.—Fighting efficiency of an army dependent on health
loss of man-power from disease ; the influence of disease on campaigns
in the past ; hygiene a valuable means of keeping up man-power and
thus providing re-inforcements. Vital importance of wide-spread
knowledge of principles of disease prevention.
2. The human material of the army .—Only perfectly fit men re-
cruited, otherwise stress of war would lead to breakdown. Men
of certain standards necessary to carry out marches with full equip-
ment. Importance of physical training of the recruits.
176
First field dressings and hygiene.
Appx. VI
3. Environment of the soldier in peace .—Best conditions for main-
taining good health required. Barracks sited and built to give good
light, sufficient space, free ventilation, and a good system of drains
to carry away waste matters. Institutes and married quarters neces-
sary to provide for comfort and home life.
4. Environment on service.—Absence of amenities and exposure
to climatic changes. Risk of heat-stroke ; importance of texture,
quantity, and disposal of clothing and equipment. The march—
proper regulation of speed, halts, and spacing in the ranks ; water.
supply and food on the march ; care of the feet. Conditions arising
from cold—trench foot and frost bite. The ration on service—ade-
quacy, to provide for energy expended, and care as to quality of
supplies ; vitamins essential ; variety in cooking ; service—hot-boxes
etc.
5. The dangers of parasites .—What parasites are—organisms
living at expense of man's body. Variety—germs, worms, insects,.
etc. Importance of individual effort in preventing infection by any
of those parasites, and consequent disability—“The preservation of
health and the prevention of disease
incumbent on
every officer and soldier.” (F. S. Regulations, Vol. II, Sec. 51.)
How this is achieved—(a) The use of vaccines (inoculation) to.
increase man's resisting power to invasion by germs ; ( b) Cleanliness
of the teeth, body, clothing and surroundings of every individual ;.
(c) Immediate isolation of infected individuals in hospital, and dis-
infection of their quarters.
LECTURE III.
The Prevention of Disease.
1.Introduction .—Explanation of importance of knowing how
and by what routes parasites get into man's body ; this suggests
most suitable means of prevention. Most diseases fall into one of
four main groups. Need to consider risk of outbreaks at any time
owing to possible presence of “carriers.”
2. Diseases spread by contact or overcrowding in dugouts, etc . —
Scabies, infestation by lice, venereal disease ; great wastage from
these in war. Prevention largely dependent on spacing out and
personal cleanliness. Bathing parades, changes and laundering
of clothes and blankets. Mass disinfection in war, by steam, hot-
air, etc.
3. Diseases spread by droplets in coughing, etc.—The catarrhal
and respiratory infections—outbreaks of influenza, of cerebrospinal.
fever, etc. Vital importance of spacing out and increasing head to
head distance (difficulties on shipboard) ; and essential importance of
free ventilation to carry off contaminated air. Washing and sterili-
zation of cups, etc., in messes and canteens.
4. The excremental group of infections : Cholera, Typhoid, Dysentery,
Worm infections, etc .—Success of sanitary measures in controlling for
177
.Appx. VI.
First field dressings and hygiene.
the first time these "killers" in the Great War. (Contrast with
typhoid in South Africa). Routes of spread either ( a) viâ faulty
latrines to water sources, or ( b) vià flies from badly proofed latrines
to foodstuffs, or (c) carriers handling foodstuffs or beverages.
Prevention therefore dependent on attention to ( a) latrines—
siting and proofing from flies ; ( b) sterilization of water by filtration
and use of bleaching powder ; ( c) protection of foodstuffs ; (d) anti-
fly measures—disposal of refuse and manure so as to minimise further
breeding, and use of traps, poisons, etc., to destroy adults ; ( e) care
in selecting personnel for food and water duties.
5. Blood infections, transmitted by biting insects—relation of
insects and empire. Mosquitoes—malaria, the great cause of physical
inefficiency in India, yellow fever, dengue, (Greece, Panama). Lice
—Typhus, relapsing and trench fevers (Servia, Poland, the War in
France, etc.). Biting Flies—sleeping sickness, etc., (“Darkest Africa”).
Fleas—plague (India, Defoe, etc.). Sand flies, ticks; bugs, etc. Pre-
vention dependent on eliminating the insect intermediary, e.g., mos-
quitoes—nets to protect individuals at night ; special clothes, head
nets, gauntlets, etc., for men on duty ; attention to human reservoirs
of the disease ; campaigns against breeding waters—drainage, oiling,
etc.; destruction of adult mosquitoes in houses by trapping, swatting,
fumigation, etc. Other insects in comparable fashion.
6.Conclusion.—Every individual to realise he can help by intelligent
co-operation, and following out instructions laid down for his own
ultimate benefit. Sickness still high in war even though fatal diseases
now controlled. Remains to give more attention to minor conditions
and so maintain maximum number of fit men to achieve victory.
LECTURE IV.
Venereal Diseases.
Venereal Disease.—The serious nature of venereal diseases espe-
cially syphilis and gonorrhoea ; danger to individual, to nation and
to future offspring ; as a cause of inefficiency ; relationship between
drinking and venereal incidence. Necessity for efficiency in army.
Short description of the venereal diseases, emphasising effects
on wife and offspring.
Prevention—continence only certain one ; value and use of pre-
ventive packets, Prophylactic Treatment Rooms, and abortive treat,
ment, necessity for reporting sick at once and regular attendance.
Esprit de corps, its value :value of games, competitions and plenty
.of work.
178
Lectures on nursing for I.H.C.
Appx.VII.
APPENDIX VII.
SYLLABUS. OF LECTURES FOR THE INDIAN HOSPITAL.
CORPS (NURSING SECTION) .
1. Moral qualifications required in a nursing orderly, obedience,
sobriety, truthfulness, patience, etc.
Cleanliness and ventilation of wards and annexes, floors, lockers,.
beds, cupboards, etc.
2. Bedmaking, how to make a bed to receive a patient on admis-
sion, undressing, bathing, and care of helpless patients.
3. Bedmaking continued, changing of sheets, use of drawsheet,.
macintosh, air pillows, airbeds, etc., making of special beds, fracture,
operation, etc.
4. Moving and lifting of helpless patients, care of back, prevention.
of bedsores, cleaning mouths, etc.
5. Observation of sick, what to observe and report, such as rashes,.
spots, pain, vomiting, haemorrhage, etc.
Observation of stools and urine.
6. Use of thermometer and of measure glass, taking of pulse and
respiration, administration of feeds, care and cleanliness of utensils,.
ice box and food receptacles.
7. Baths, hot and cold sponging, cold packs, ice bags, medicated
baths, bath temperatures, etc.
8. Enemata. Simple, glycerine, oil, turpentine, starch and opium,.
nutrient, etc., use of various syringes, method of administration.
9. Disinfectants and their uses.—Disinfection of hands, crockery
linen, excreta, spittoons, etc.
10.Administration of medicines by mouth, inhalations ; inunc-
tions, etc.
11 & 12. Nursing of special diseases, enteric, dysentery, cholera,
diphtheria, heart cases, pneumonia, bronchitis, etc., use of bronchitis
kettle, making of poultices, etc.
13.Surgical nursing. Different kinds of fractures, and nursing of
same, application of fomentations, dressings, etc.
14.Bandaging, use of cradles, extension, sand bags, etc.
15.Preparation of patient for operation, instruments in common
use.
16.Nursing of abdominal cases after operation.
17.Antiseptic and aseptic treatments, sterilizing of instruments,
lotions in common use.
18.Practical demonstrations in invalid cookery, whey, junket
peptonised milk, Benger's food, bread and milk, arrowroot, albumen
water, egg flips, mutton broth, chicken tea, etc.
NOTE.—Practical demonstrations in bandaging should be given at each surgicallecture.
179
Appx. VIII.
Training wives of B.O.Rs. as nurses, etc.
APPENDIX VIII.
TRAINING OF SICK NURSES AND MIDWIVES .
A limited number of wives and widows of warrant officers and
soldiers (departmental, regimental and pensioned) may be sent to
the civil hospitals at Calcutta, Madras, Bombay, or Poona for train-
ing as sick nurses and midwives. The names of candidates, who
fulfil and agree to the conditions noted on the attached form, will
be submitted on a manuscript copy of it by the O. C. corps or local
head of department to the district or independent brigade commander
for his orders and disposal.
Applications of approved candidates will be disposed of as follows :
—
From Peshawar, Rawalpindi, Kohat, Lahore, Meerut, Lucknow
and Presidency and Assam districts, to the Principal,
Medical College, Calcutta.
From Baluchistan, Mhow and Bombay districts and Sind and
Poona independent brigade areas to the Senior Medical
Officer, J. J. Hospital, Bombay, or Superintendent, Medical
School, Poona.
From Madras and Burma districts to the Principal, Medical
College, Madras.
NOTE. —Candidates desirous of being sent to a particular institution instead of to the
one allotted to the district may be allowed to do so, provided they defray any extra
expense involved.
Roll of a candidate for training as pupil nurse or midwife .
wife
Name
of
widow (Rank, name and corps or department).
Age
(Must be under 35 years)
Character
General intelligence
Can she read and write sufficiently
well to carry out written instruc-
tions, and to take notes-?
When is she likely to leave the district ?
Physical fitness for the course.
(Must not be pregnant.)
M.O.
180
Training wives of B.O.Rs. as nurses, etc.
.Appx. VIII.
The candidate (and her husband) understand and consent to, the
following conditions :
—
(a) That in order to obtain a certificate of proficiency she will
have to undergo training for about one year, and that
her husband and children cannot accompany her.
( b ) S h e m u s t p r o v i d e h e r o w n s h e e t s , p i l l o w s , p i l l o w c a s e s , t o w e l s ,
blankets and wearing apparel which must include the
following :
—
White drill skirts two inches off the ground.
White shirt blouses, made plain with detachable collars,
Aprons with bibs and straps and pockets.
Plain stand-up collar.
Black stockings.
Black shoes.
Scarlet waist belt.
(c) She must conform to the rules and discipline of the training
institution.
:(d)In the event of her resigning before obtaining a certificate
the amount paid by government on her account will be
refunded.
:(e)Her services may be dispensed with (without penalty) for
inaptitude for work or for misconduct.
(O.C. or local head of Department.)
Station
Date
Signature of candidate.
181
Appx. IX. Disposal of cases of V.D. amongst time expired
British Troops.
APPENDIX IX.
DISPOSAL OF CASES OF VENEREAL DISEASE AMONGST
TIME EXPIRED BRITISH ,TROOPS.
Soldiers suffering from venereal disease when due for discharge
from the service or transfer to the Army Reserve will be evacuated to
England ; they will not be retained in India. Officers Commanding
units are responsible that the names of all such soldiers in their units
are communicated to the Officer Commanding British Military Hospital
concerned as early as possible and periodically throughout the trooping
season.
The procedure detailed in this Appendix will also apply to soldiers
who, although suffering from venereal disease, are sent to the U.K.
for any reason other than discharge from the service or transfer to the
Army Reserve.
2. For the purpose of embarkation such cases are sub-divided into
two categories, viz.,
I. Active, i.e., patients in hospital.
II. Non-active, i.e.
(a)Men attending hospital.
(b)Those men still on the syphilis register.
(c)Those under observation.
I. Active.—In order to ensure the protection of other troops and the
proper supervision and treatment of the cases themselves, men coming
under category I will be sent home as “ sick transfers.”
On receipt of information that any man coming under category I
has been included in the unit bulk allotment for any particular transport,.
the Officer Commanding British Military Hospital will at once inform
the D.M.S. in India by telegram, repeating to Q.M.G., full particulars
of the man's number, rank, name, unit, transport by which sailing and
date due for discharge or transfer to Army Reserve, notifying that
hospital accommodation will be required for him en route to and on
board ship.
Army Headquarters will then make the necessary adjustment of
hospital accommodation on that vessel or if time permits transfer the
man to a later sailing if more desirable and will re-allot the vacancy
caused in troopdeck bulk allotment. These cases will be transferred to
the port in the same manner as Class A invalids and should if possible
embark on the day prior to sailing. If sent by troop special they will
travel in hospital accommodation.
11. Non-active.—Men coming under category II will proceed to the
U.K. with their drafts and no special arrangements will be
made for their segregation either en route to, or on board ship. Such
182
Disposal of cases of V.D. amongst time expired Appx. IX.
British troops.
cases being non-infective do not come under the provisions of para. 179,
Voyage Regulations.
3. Os.C. B.M.Hs. will ensure
—
(i)that the men in category I who are being evacuated as “ sick
transfers ” are accompanied to the port of embarkation by
an attendant.
(ii)that in all cases adequate medical supervision and sufficient
dressings are provided for the train journey to the port of
embarkation.
(iii)that if, owing to any circumstances, the patient should be un-
fit to travel, the D.M.S. in India is immediately informed
by telegram, the telegram being repeated to the Q.M.G.
in India, and to the Embarkation Commandant concerned.
4. Documents.—Category I—Active—Nominal rolls will be prepared
b y t h e O . C . B . M. H . i n t r i p l i c a t e f o r a l l c a s e s a n d w i l l b e d i s p o s e d o f a s
follows :—
(1)One copy will be forwarded to the D.A.D.M.S. (D. & E.) so as
to reach him seven clear days before the date of embarkation.
This copy is for the information of the S.M.O. Hired Trans-
port.
(2)One copy will be given to the Officer Commanding invaliding
escort.
(3)The third copy will be retained as a hospital record.
The medical and regimental documents of these active cases will be
disposed of in the same way as those of invalids (as laid down in India
Army Orders).
Category II non-active—Nominal rolls will be prepared and
disposed of in the same manner as those of men coming under category
I, except that in this case a copy of the nominal roll will be given to the
Draft Conducting Officer instead of to the Officer Commanding invalid-
ing escort.
I.A.F. M-1263 or M-1264 will accompany such cases and will be hand-
ed over by the Draft Conducting Officer to the D.A.D.M.S. (D. & E.)
who will pass them to the S.M.O. of the Hired Transport. Other medi-
cal documents will be sent to the unit (the O.C. unit must call for them
if necessary) before the man is despatched.
5. Duplicate Case Cards (I.A.F. M-1263) of all cases of syphilis
will be completed and forwarded to the D.M.S. in India.
6. The object of the above procedure is to ensure that every man
transferred to the United Kingdom for service reasons ( i.e., other than
invaliding) who is suffering from V.D. shall be kept under continuous
medical observation (and treatment when necessary), and that all such
men shall come under the notice of the authorities in the U. K. who are
concerned with carrying out discharges and transfers to the Army
Reserve.
This will enable arrangements to be made for continuous treatment
after discharge or transfer to the Reserve, in accordance with Regula-
tions for the Medical Services of the Army, para. 464, and will prevent
infected men being passed unobserved into civil
183
G 2
Appx. X.
A P P . X .
V . D . r e p o r t s a n d r e t u r n s .
APPENDIX X.
V A N E R E A L D I S E A S E .
DIAGNOSIS ; LEPORIS AND RETURNS ; DISPOSAL OF VENE-
REAL CASE CARDS.
1. Diagnosis.
In every case of venereal sore the exudate will be examined for
spironema pallidum before any local antiseptic treatment is applied,
and at the same time a specimen of the blood will be taken for a Wasser-
mann test. If the first examination of the exudate is negative, further
examinations will be made on the following two days, the sore in the
meantime being dressed with saline solution only.
Before a negative diagnosis of syphilis is made, all the following
conditions must be satisfied :
—
1. Three months must have elapsed from the date of appearance of
the sore.
2. Scrapings for spironema pallidum must have been negative on at
least three different dates.
3. No clinical signs of syphilis must have been noted.
4. The Wassermann tests must have been consistently negative
during the 3 months period.
Where there is any definite suspicion of the case being syphilitic,
the Wassermann test will be performed at weekly intervals ; where
there is no definite suspicion of syphilis, the Wassermann tests will be
carried out at monthly intervals. It must be clearly understood that
the Wassermann reaction is generally negative during the first, three,
four, or even six weeks after infection.
2. Reports and Returns.
The A.D.M.S. will compile a consolidated monthly statement showing
admissions for V.D. by units (British and Indian) in his district or
brigade area. This information will be extracted from Table VII
of A.F. A.-31. A copy of the statement will be forwarded to the Der-
matological Specialist of the district who will return it to the A.D.M.S.
with his remarks or recommendations and report of any action taken.
Quarterly Venereal Disease Report.—This report will be compiled in
triplicate by the A.D.M.S. District or Independent Brigade Area from
Table VII of A.F. A-31. The remarks of the District or Independent
Brigade Area Commander having been obtained, two copies will be
forwarded by the 15th of the month following the period under review
to the D.D.M.S. Command. The latter having obtained the remarks
of the G.O. C.-in-C. Command will forward one copy to the D.M.S. in
India.
184