NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Duties of the Military Medical Services.
Paras. 172-78.
172. Cash payments to soldiers in hospitals. —Soldiers whilst in
hospital may receive cash payments at the discretion of the O.C.
hospital who will bring their requirements to the notice of their C.O.
Where the hospital is located in the vicinity of the patient's unit or
detachment, an officer will visit the hospital weekly and make the
necessary payments. In other cases the procedure will be as autho-
rised in Financial Regulations, India, Part II, paragraph 87 for the
remittance of public money by military units and formations. Cash
payments will be limited to a maximum of Rs. 5 per week.
173. Transfers on relief of personnel. —The O.C. hospital will
attend or depute an officer to attend on such occasions to scrutinise
the transfer of any stores and equipment.
He will complete and dispose of the various transfer documents
and records of members of the I.M.D. or I.H.C. when transferred
from his unit. (See I.A.F.Z-2039.)
1 7 4 . P a y o f h o s p i t a l s t a f f .—
H e w i l l b e r e s p o n s i b l e f o r t h e c o r r e c t
distribution of the pay of the personnel under his command. Pay-
ments will invariably be made by an officer.
1 7 5 . D u t i e s i n c o n n e c t i o n w i t h t h e I . H . C . c l o t h i n g a n d e q u i p m e n t .—
He is responsible that personnel of the I.H.C. attached to the hospital
for duty are in possession of the complete authorised equipment
and that this equipment is regularly inspected.
1 7 6 . C h a r g e o f c o m m a n d .—
W h e n a b o u t t o h a n d o v e r c o m m a n d
of the hospital he will make arrangement to transfer his duties in
connection with the buildings, equipment, supplies, and stores and
the cash and accounts of public and private funds in his charge to
his successor.
The regulations regarding the transfer of stores, etc., are laid
down in E. R. (India), Part I. In addition to the procedure therein
described a letter will be sent to the A.D.M.S. concerned to report
handing and taking over.
Duties of second in command of an Indian military hospital.
1 7 7 . T h e s e c o n d i n c o m m a n d o f a n I . M . H .—
H e w i l l p e r f o r m s u c h
administrative duties as may be delegated to him by the O.C. hospital
in addition to his duties in medical charge of wards. He will keep
himself conversant with the general organization and routine work
of the hospital in order that he may be able to carry on the duties
of O.C. during the latter's absence.
Duties of officers doing duty in military hospitals.
1 7 8 . G e n e r a l d u t i e s .
— O f f
i c e r s d o i n g d u t y a r e r e s p o n s i b l e t o t h e
O . C . t h a t t h e d u t i e s a s s i g n e d t o t h e m a r e d u l y a n d c o n s c i e n t i o u s l y
carried out, and that order, cleanliness, comfort and regularity pre-
vail in the various parts of the hospital under their charge.
They will report to the O.C. hospital any breach of discipline,
irregularity or neglect of duty on the part of any of the hospital per-
sonnel or patients.
37
Paras. 179-84.
Duties of the Military Medical Services.
179. Responsibilities for ward management.—They will visit their
patients in the morning at such time as may be fixed by the O.C.
hospital and again in the evening. At such other times as may be
necessary they will visit all patients who are seriously or dangerously
ill. In addition to discharging their professional duties, they are
responsible that the rules for the management of wards contained
in these regulations and in hospital orders are complied with.
They will be responsible that the personnel detailed for duty in
the wards or departments of the hospital in their charge perform their
duties efficiently.
180. Personal responsibility. —They will at once draw the atten-
tion of the O.C. hospital to patients seriously or dangerously ill and
will in all matters of professional difficulty seek his advice. This
will not however relieve them from personal responsibility for the
droper treatment of patients under their care.
181. Diagnosis.—As soon as possible after the admission of a
patient, the officer in medical charge of the case will make a diagnosis
in accordance with the nomenclature of diseases ; he will, when neces-
sary, alter the diagnosis, notifying the O.C. of any such change.
In diagnosing cases officers will make full use of the hospital cli-
nical side rooms and of district and brigade laboratories in accord-
ance with these regulations and of instructions and circulars from
time to time issued.
182. Examination of pathological specimens. —Simple routine
examinations of blood films, blood counts, sputum, faeces for ova,
etc., urines, etc., will be carried out in the clinical side rooms of the
hospital by the officer in charge of the case. The results of such
examinations will be entered on the patient's documents, and in a
register kept for this purpose in the clinical side rooms.
When a medical officer sends specimens for examination to the
district or brigade laboratory he will make out I.A.F. M-1265-D.
in duplicate and forward both copies along with the specimen to the
pathologist, who will complete the forms, retaining one and return-
ing the other to the hospital where it will be placed with the patient's
clinical records.
183. Venereal disease.—Every British patient suffering from sy-
philis or gonorrhœa will on admission to hospital be given a card
(A.F. I-1242 or 1243) containing instructions regarding his disease.
On his discharge or transfer to another hospital the card will be des-
troyed.
Instructions regarding the record and surveillance of cases of
V.D. are given in Appendix X.
184. Other special diseases. —Cases of other special diseases, e.g.,
malaria, dysentery, enteric, will be dealt with in accordance with
orders and memoranda issued from time to time. For instructions
regarding infectious disease (see Section XI).
38
Duties of the Military Medical Services.
Paras. 185-94.
185 Injuries.—In all cases admitted for injuries they will, with
-out delay, make out A.F. B-117. (See para. 439, Regulations for the
Army in India.)
186. (a) Hospital Record Cards.—They will be responsible that
A.F. I-1220 is made out for each case on admission and is completed
on the patient's discharge. (See para. 39 7 ).
(b) Medical Case Sheets. —They will carefully record on A.F.I.-
1237 all cases of professional interest or of serious illness and every
case concerning which reference is likely to arise. (See para. 398.)
187. Entries in medical history sheets. —They will obtain the
medical history sheets of all patients admitted to their care and on
discharge of the case will enter therein particulars relating to that
admission.
188. Temporary medical history sheets. —In cases where the ori-
ginal medical history sheet is not available they will complete as
far as possible a temporary medical history sheet and enter therein
the particulars of the case as detailed above.
All entries on temporary medical history sheets will be trans
-ferred to the original medical history sheet by the medical officer
having custody of the latter. All such entries will be signed and
dated by the officer making them, and the temporary sheets will then
be destroyed.
189. Training.—They will take every opportunity of giving ins
- t r u c t i o n s t o j u n i o r m e m b e r s o f t h e I . M . D . a n d t o N . C . O s . a n d m e n
of the R.A.M.C. and I.H.C. doing duty in their wards.
190. Equipment, etc.—They will see that the medical, surgical,
barrack and ordnance equipment on charge in their wards is complete
and in good order and that the clothing and bedding supplied to
patients are sufficient and suitable.
191. Investigation of damages or deficiencies. —They will inves
- t i g a t e w i t h o u t d e l a y a n y d a m a g e t o o r d e f i c i e n c i e s i n t h e e q u i p m e n t ,
clothing or bedding on charge in their wards. They will report to
the O.C. hospital in writing the circumstances in which the damage
or deficiency arose, showing whether by accident, neglect or fair
wear and tear and will state their opinion as to whether the charge
should fall upon the individual (and if so on whom) or upon the State.
192. Insurance certificates. —They will when required furnish
officers or soldiers insured against accident or disease, with certifi-
cates as to the nature and duration of the disabilities for which they
are or have been under treatment.
193. Patients' diets. —Diets and extras for patients will be ordered
on each patient's diet sheet I.A.F. M-1204 by the medical officer
in charge of the case. (See also Section VI.)
194. Inspection of Diets.—They will frequently inspect articles
of diets and extras supplied to patients in their wards to ascertain
that they are properly cooked and served ; they will in all important
cases give precise instructions as to the hours food and stimulants
are to be administered.
They will report to the O.C. any defects in cooking, quantity or
quality of diets and extras.
195. Prescriptions. —They will write all prescriptions in a clear
and legible manner and will date and sign them and specify the name
and rank of the person for whom the prescription is given. In the
case of a person who is not a member of H.M. Forces the full name
and address will be entered. They will append specific instructions
in English as to the administration of the medicine ordered (see
also para. 166).
Prescriptions for medicines ordered for patients in hospital will
be written in the ward prescription book maintained for that pur
-pose.
196. Discharge of patients from hospital.—When they consider
that a patient is fit for discharge to duty or for outdoor treatment
in barracks they will bring him before the O.C. hospital who will
initial the diet sheet if he concurs.
Duties of the orderly officer.
197. Period and place of duty,—The periods of duty and the periods
of absence from the hospital will be fixed by the O.C. hospital. In
all cases the arrangements will be such as to ensure that a medical
officer can be obtained, if required either within or without the hos
-pital, with the minimum delay.
198. Inspection of stores and diets. —He will inspect the articles
of diets and extras supplied to the hospital and satisfy himself that
they are of good quality. He will visit the kitchens and see that
they are clean and that the cooking utensils are properly cleaned
and stored.
199. Visiting wards and complaints. —He will visit the wards at
intervals after hospital hours to ascertain that order and regularity
are maintained and will investigate reports and complaints. He
will visit all parts of the hospital and report to the O.C. any irregu
-larities or insanitary conditions observed.
200. Duties to sick.—He will perform all necessary and urgent
duties towards the sick in hospital during the absence of the medi
-cal officers in charge of the cases and will deal with fresh cases of
injury or sickness as they arise.
201. Death in hospital.— O n r e c e i p t o f
a r e p o r t
o f a d e a t h h e w i l l
satisfy himself of the correctness of the report before giving instruc
-tions for the removal of the body to the mortuary.
202. Local duties.—He will perform such other duties as may
be assigned to him, including the medical examination of casual re-
eruits and of soldiers in arrest and under sentence.
203. Reports.—He will, when relieved, report in writing that he
has performed the above duties and will record any unusual circum-
stances which have arisen during his tour of duty
40
Duties of the Military Medical Services.
Paras. 204-08.
Duties of officers in medical charge of troops.
204. Appointment.—An officer will be nominated for the medical
205.
and sanitary duties outside hospitals connected with each unit (vide
Appendix I).
Officers appointed to medical charge of training battalions espe
-cially should be changed as seldom as possible.
206. Medical duties.—The officer in medical charge of a unit will
207.
be in medical charge of all personnel of that unit, and their families
who are allowed medical attendance at public expense unless another
medical officer is especially appointed for this purpose.
He is the adviser of the O.C. unit on all sanitary and medical
matters pertaining to the health of the unit, and as such will main
-tain close liaison with the officer commanding. He will make such
recommendations, verbally or in writing, as he may consider neces
-sary for the maintenance of the health of the troops.
206. Sick report.—The name of every soldier reporting sick will
be entered in the sick report (A.F. B-256) which will be prepared
in duplicate by the soldier's unit. This report will be dealt with in
accordance with the instructions noted thereon.
207. Examination of sick.—The officer in medical charge will
conduct the morning sick parade at the unit's medical inspection
room at such an hour as will permit sick requiring admission to hos
-pital to reach hospital at a reasonable time during hospital hours.
He will enter on A.F. B-256 a diagnosis of each case reporting
sick, and the disposal of the case in the column of remarks in the
following terms :—
1. "Medicine duty " —viz. treatment and return to duty.
2. " Attend A," "B".and " C."— viz., attendance for treatment
at the Medical Inspection room with such duties as may
be recommended.
3. " Detained "—viz., detained in hospital up to 48 hours and
subsisted in hospital on extras during the period of de
- t e n t i o n .
4. " Hospital "—viz., admitted to hospital, subsisted on extras
for the day of admission and placed on hospital diet for
the following day.
5. " Duty " —viz., reported sick unnecessarily.
NOTE.—" Attend A " means attend for treatment as ordered and to perform ordi
-nary regimental duties.
"Attend B" means attend for treatment as ordered and to perform light duties
only.
" Attend C " means attend for treatment and to be excused all duties.
208, Officers on sick list.—He will report immediately to the
officer's O.C. as well as to the O.C. hospital when an officer is placed
on the sick list, and when an officer sick in quarters is removed from
the sick list.
41
Paras. 209-13.
Duties of the Military Medical Services.
209. Transfer of sick to hospital.—He will arrange in communi
–
cation with the O.C. hospital for the transfer of such sick to hospital
as require admission or detention, that is, those whom he considers.
unfit for duty and unsuitable for treatment in barracks.
210. Details to be furnished to O.C.—He will furnish the O.C.
hospital with all information required for the correct compilation
of the monthly statistics, and will report to him all matters of medical
and sanitary interest pertaining to the troops and families under
his care. (See also Appendix XI, Reports and Returns.)
211. Medical history sheets.—He will be responsible that parti
–
culars regarding preventive inoculations and vaccinations, etc., are
entered in the medical history sheets of troops in his medical charge.
Entries in medical history sheets will be made as follows :
—
(a) By medical officers—particulars on enlistment; all admis-
sions to and discharges from hospital, and the sick list
in the case of warrant officers treated in quarters; parti-
culars regarding vaccination and re-vaccination; pro-
phylactic inoculation; medical boards; issue of and repairs
to surgical appliances, etc., fitness for active or foreign
service.
(b) By dental officers—all entries regarding dental matters.
(c) By Os.C. unit—vide King's Regulations and Regulations for
the Army in India.
212. Medical equipment of inspection rooms.—He will indent on
the O.C. military hospital concerned for the issue on loan of the neces-
sary medical equipment for the medical inspection room, for such
supplies of medicines and surgical materials as are required and for
the necessary stationery. These articles will be kept in the medical
inspection room.
213. Medical inspection of troops.—(i) He will carry out the re
-
quired medical examination when troops are ordered on active service
or overseas and when drafts or individuals are detailed for duty at
another station. He will inspect men joining the unit on the morn
-
ing after joining, whether from abroad, from another unit, as recruits,
or on return from leave or furlough.
(ii) He will inspect the troops and followers in his charge monthly,
or more frequently if necessary to satisfy himself as to their personal
hygiene. Whenever special examinations of soldiers are made, each
individual soldier will be examined by the medical officer in private,
and in the presence of a third person, who should be an N.C.O.
(iii) He will examine soldiers desirous of an extension of service
or re-engagement and when doing so will inspect their medical history
sheets and will not reject men for minor defects or trivial ailments
which are not likely to interfere with the efficient performance of
their duties, but will note such facts on I.A.F. M-1239. In cases
of fitness this certificate will be considered final but the cases of men
considered unfit will be decided by a medical board.
42
Duties of the Military Medical Services.
Parkas. 214-18.
(iv) He will examine men for transfer to the Reserve.
(a) British troops.—A soldier found medically unfit for service
in the army reserve will be brought forward for discharge
as an invalid. A ruptured soldier who has previously
performed his duties without serious inconvenience will
not be invalided for this cause alone, but will be
classi-
fled on A.F. B-268 as fit for base or garrison service only.
(b) Indian troops.—The medical examination for the reserve
w i l l
(c)
be limited to ascertaining their fitness for further
duty according to the average of their class and length
of service; they will not be rejected on account of minor
disabilities.
214. Physical state of unit.—He will keep himself accurately
informed as to the fitness for service of the unit of which he is in
medical charge, and will submit a report quarterly on Form D.M.S.-40
to the O.C. hospital.
215. Physical training.—He will keep himself informed on all
matters concerning the physical training of the troops and will give
his advice on such subjects, especially with regard to recruits. He
will keep a record of those men whose training has been modified
and of their subsequent progress.
216. Inspection of children and schools.—He will, unless there
is an officer specially detailed for the charge of families, frequently
visit the schools at times when the children are present, in order to
ascertain that their studies are pursued under hygienic conditions.
He will note in his sanitary diary any conditions likely to affect the
health of the children, and will make such representations as cir--
cumstances demand (see A.F. C-319, Schedule of medical inspection).
He will be responsible for the periodical medical examination of all
school children in March and September each year.
In Indian units he will keep himself informed as to the health
of the families of troops and followers living in the lines.
217. Lectures by medical officers and training in first aid and sani-
tation.—He will deliver lectures to officers and men on the use of
the first field dressing, on sanitation and on venereal disease (see
Appendix VI).
He will carry out the training in first aid, sanitation and stretcher
drill and the use of the first field dressing in accordance with Regula
- t i o n s f o r t h e A r m y i n I n d i a , p a r a g r a p h s 3 1 8 - 3 2 0 - B .
The training in stretcher drill and first aid and sanitation will
be conducted on the lines laid down in R.A.M.C. Training, 1925.
218. Inspection of barracks.—He will inspect every portion of
the barracks, including the married quarters, and followers' quarters
:at least once a month. At such inspections he should be accompanied
by an officer of the unit and the N.C.O. of the regimental sanitary
detachment of the unit in occupation of the barracks. The
N . C . O . w i l l m a k e n o t e s o f a l l t h e d e f e c t s o b s e r v e d . T h e o f f i c e r i n m e d i c a l
43
Paras. 219-23.
Duties off the Military Medical Services.
charge will report verbally to the O.C. the unit concerned any defects,
noticed, and will make necessary recommendations for remedying
them. The hygienic defects found and the recommendations made to
the O.C. will also be recorded in a sanitary diary (A.B.-39), which
will be submitted to the O.C. hospital and passed to the O.C. unit
concerned who after recording in it the action taken will return it to
the officer in medical charge.
N.B.—The pages of the sanitary diary should be ruled in 3 columns to show (1)
medical officer's remarks, (2) commanding officer's remarks, (3) action taken. It is
essential that the action taken should be recorded.
219. Ventilation, lighting, limewashing, etc.—He will satisfy him-
self that every barrack, guardroom, and detention room is suitably
lighted and provided with sufficient means of ventilation ; that the
beds and bedding are freely exposed to the air ; that the married
soldiers' quarters, regimental institutes, kitchens, wash-houses, lava-
tories, urinals and latrines are suitably ventilated and lighted ; and
that the walls and ceilings of barracks and quarters are clean and
in a satisfactory condition.
220. Spacing of beds.—He will satisfy himself that there is no
overcrowding and that wherever possible the beds are not closer
together than 6 ft. centre to centre or as may be authorised from
time to time.
221. Food and cooking.—He will ascertain that articles of food
and drink supplied to the troops are of good quality, and that the
amount, cooking, variety, preparation and storage of food are satis-
factory. He will see that overcooking is not practised so as to des
troy the vitamins. He will satisfy himself that no typhoid or dysen-
tery carriers are employed in the preparation or handling of food-
stuffs. He will keep himself informed of orders and instructions
governing the issue of extra articles of food and drink that may from
time to time be published.
222. Cleaning of drinking and other utensils.—He will frequently
inspect the method of sterilization of drinking vessels in all canteens,
institutes, etc., and satisfy himself that adequate means are main.
gained in constant use to ensure that all cups, mugs, tumblers, spoons,.
forks, etc., are sterilised in boiling water immediately after use by
each individual.
NOTE.—The following instructions as regards the sterilization of drinking vessels
used by troops, whether in cantonment or camp, in order to prevent the spread of
infectious diseases, will be observed :—
(i) every drinking vessel should, immediately after use, be well washed in hot water
and dipped in boiling water in such a manner that the upper two inches are
immersed ;
(ii) for this purpose arrangements should be made for the provision, in the most
economical manner according to local conditions, of the necessary means
of maintaining supplies of boiling water.
223. Water supply.—He will satisfy himself that the amount,
quality and arrangements for distribution of drinking water are satis-
factory.
44