NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Correspondence.
Paras. 397-98.
N. B.—Those reporting for medical inspection, inoculations, etc.,
and those marked " M and D " will not be recorded in the A. and D.
Book.
(d) Patients transferred from barrack treatment to hospital.— When a
patient under treatment in barracks requires admission to hospital, the
words " transferred to hospital," with date, will be entered in the
" Observations " column in the A. and D. Book for barrack treatment.
The case will be entered as an admission in the hospital A. and D. Book
in the ordinary way.
397. Hospital record cards.—( a) A. F. I-1220 will be made out
for each case admitted or transferred to hospital, including admission
to a civil hospital. A card will also be made out for each death occurr-
ing out of hospital. Cards will not be required for cases treated in
barracks or in quarters or in non-dieted hospitals.
(b) Immediately after the disposal of the patient to whom the
A. F. I-1220 refers, whether by discharge, transfer, invaliding or death,
the card which should not be folded, will be forwarded to :—
The Director of Medical Services in India, Army Headquarters, Simla.
Before despatch the 0. C. hospital will satisfy himself that the card
has been correctly completed.
(c) Cards to be confidential.— The cards are confidential documents
and will not be given, nor will their contents be divulged, to patients,
nor will they be kept where patients may have access to them.
(d) Errors in diagnosis.—When a diagnosis is found to be erroneous,
the original entry will be crossed out in such a way as to remain legible,
and the new diagnosis will be entered above it.
(e) Sequence in serial numbers.— If, owing to an error of entry, the
series of entries in the admission and discharge book is broken, a blank
card, bearing the appropriate serial number with the word " cancelled "
written across it, will be forwarded to the D. M. S.
(f) Suicides.—In a case of suicide the word " Suicide " will be
written against the cause of death, and the supposed motive will be
given. The result of any enquiry held will also be given. When no
enquiry is held, the fact should be stated.
NOTE.—The Hospital Record Card System of recording cases is at present in force for
British military hospitals and British sections of Indian and combined military hospitals
only.
(g) Patients remaining in hospital on 31st December.— On 1st Janu-
ary each year, a new card with a fresh serial number will be made out
for each patient who remained in hospital on the previous day, the word
" Remained " being written on the top of the new card. The old cards
of these patients will then be forwarded to the D. M. S., the word,
" Remaining " being written on the card.
398. Medical case sheets.—Officers will carefully record on A. F.
I - 1 2 3 7 a l l c a s e s o f p r o f e s s i o n a l i n t e r e s t o r o f s e r i o u s i l l n e s s a n d e v e r y
case concerning which reference is likely to arise. A note will be made
on A. F. I-1220 whenever A. F. I-1237 has been made out. The case
99
Paras. 399-400.
Correspondence.
sheets of patients under treatment will be kept in portfolios provided
for this purpose and will not be allowed to fall into the hands of patients.
The first and last entries will be signed and transfers from one medical
officer to another attested by their signatures.
The etiology, present condition, changes in symptoms, diagnosis,
treatment, etc., will be clearly and concisely recorded and in fatal cases
the result of the post-mortem examination if held. The diagonsis will
be in accordance with the Nomenclature of Diseases. Medical case
sheets together with other clinical documents, on discharge of the
case from hospital will be filed and retained in the hospital. Those of
fatal cases and of special professional interest will be signed by the
O. C. hospital and forwarded in original, with laboratory and other
relevant reports, to the A. D. M. S. for perusal before being filed in
the hospital.
Medical case sheets of fatal cases of cholera, dysentery, enterica,
malaria, syphilis, heatstroke or any uncommon disease will be forwarded
to the D. M. S. in India through the usual channels.
399. Surgical operation book.—Os. C. hospitals will satisfy them-
selves from time to time that clear and concise records of all opera
tions are entered in A. B. 485.
400. Monthly returns.—(a) A monthly return on A. F. A-31
of officers, members of the M. N. S., warrant officers, N. C. Os. and men
of the Regular Forces (including Auxiliary Force, Territorial Force and
Reservists when embodied) and of the families of British officers and
British other ranks admitted to hospital will be rendered direct to the
D. M. S. by the O. C. of every military hospital, copies of this return
will be sent direct to the A. D. M. S. and D. D. M. S.
Each return will contain the details for the calendar month. Errors
will be notified at once direct to the D. M. S., D. D. M. S. and A. D. M. S.
(b) Returns to be rendered .—Separate returns on A. F. A-31 will be
rendered as follows :—
(i) One for troops who submit A. F. A-20 and whose strength is
shown in Table III of the A. F. A-31 for the station.
(ii) One for cases admitted from troops whose strength is not
shown on the return. A nil return is not required, but a
note should be made in the column of remarks of the A. F. A--
31 for troops on the strength of the station that there are no
cases coming under this category. In order to obviate the
necessity for rendering this A. F. A-31 the D. D. M. S. will,
when possible, arrange for strength returns to be sent to the
hospital actually receiving the sick.
(iii) Auxiliary Force, Territorial Force and Reservists undergoing
training.
(iv) Overseas cases.
NOTE 1.—M.N.S.—The names of nurses and the diseases for which they are admitted
will be entered on a slip attached to A.F.A-31.
100
Correspondence.
Paras. 401-04.
NOTE 2 .—Indian soldiers invalided by medical boards and retained in hospital after the
date of their discharge from the service.—A separate A.F.A-31 is not required, but a note
should be made on the form showing (1) how many Indian soldiers were discharged from the
service as invalids and (2) how many discharged invalids are retained in hospital. Statis-
tics regarding such retained invalids should not be entered in the body of the form.
(c) Compilation of A. F. A-31.— No additions or alterations will be
made to the printed list of diseases without special instructions from
A. H. Q.
All cases when first received in hospital (including those from
camps, manœuvres and the line of march) will be returned as admissions.
Sick transferred from other hospitals or from boardship will be re-
turned as transfers.
401. Cases sent to convalescent Depôts.—British troops sent
from a hospital to an enteric or other convalescent depôt will be shown
in Table I of A. F. A-31 in the column " Discharged " and not in the
column " Transferred to other hospitals."
402. Returns of sick in camps, Manœuvers and on the line of
march.—(a) Where the strengths of the troops are shown on the
A. F. A-31 of a hospital, all sick in such camps, etc., will be included in
the A. Fs. A-31 or A-31-A of the hospital receiving such sick.
(b) Where the strengths of the troops concerned are not shown on the
A. F. A-31 of any hospital a return of sick will be rendered on I. A. F.
M-1235 (Return of sick of troops whose strength is not shown on the
A. F. A-31 of any hospital).
403. Returns of Patients in Civil Hospitals.—A patient sent to
a civil hospital for treatment will be accounted for on A. F. A-31 or
I. A. F. M-1230( a), rendered as though the patient was in the military
hospital rendering those returns. In the space for remarks on the back
of the return a note will be made stating the name of the civil hospital
to which the patient was sent, the date of admission thereto, the nature
of the disease or injury and the date of return to the military hospital
or disposal otherwise. In the case of British patients A. F. 1-1220 will
also be completed and an entry made showing the civil hospital in which
the patient was treated.
404. Returns of Barrack Treatment.—A. F. A-31-A.—A separate
return on A. F. A-31-A will be rendered for each of the following groups
when treated in non-dieted hospitals, barracks or quarters :
—
(i) Troops who submit A. F. A-20 and whose strength is shown in
Table III of the A. F. A-31 for the station.
(ii) Auxiliary Force, Territorial Force and Reservists when under-
going training.
NOTE.—In the case of troops whose strength is not shown in Table III of the A.F.A-31
of any hospital, the barrack sick will be shown on I.A.F. M-1235 (see para. 402(b).)
When the medical officer orders " medicine and duty," or " excused
duty," for the day only on which the patient first reports sick, the
patient's name will not be entered in the barrack admission and dis
charge book nor included in the numbers shown on A. F. A-31-A.
101
P aras. 405-09.
Correspondence.
A. F.-A-31-A will be forwarded with A. F. A-31 direct to the D. M. S.
by the O.C. of every military hospital. Copies will be sent direct to the
A. D. M. S. and D. D. M. S. with A. F. A-31. Nil returns are not
required but a slip stating that no sick were treated in barracks will be
attached to A. F. A-31.
405. Returns of sick on Boardship.—These will be rendered on
A. F. B-182.
406. Monthly and Annual Return of followers.—A monthly and
an annual return of followers admitted to hospital will be rendered on
I. A. F. M-1230 (a).
407. Annual Returns.—A. F. A-32 will be rendered for Indian
troops only in accordance with the instructions on the form. Separate
returns will be rendered for the following classes :—
(i) Troops who submit A. F. A-20 and whose strength has been
shown in Table III of the A. Fs. A-31 submitted for the
station in accordance with para. 400 (b) (i).
(ii) Overseas cases.
NOTE.—The statistics of the sick of troops whose strength has not been shown on the
A.Fs.A-31 rendered for the station will be compiled in the office of the D.M.S. from the
A.Fs.A-31 submitted in accordance with para. 400 (b) (ii).
408. Annual Report of Medical Transactions.—The annual report
of medical transactions and prevailing diseases, to which will be
attached the medical case sheets of all fatal cases for the year under
review, will be submitted by the O.C. military hospital to the A. D. M. S.
district or independent brigade by 15th January each year. A. Ds.
M. S. will forward these reports to D. Ds. M. S. accompanied by a brief
general report on the equipment, accommodation, organisation and
general working of the hospitals.
The D. D. M. S. will forward the transactions and reports to the
D. M. S. as soon as possible after perusal.
409. Venereal case cards, reports and returns.—Venereal reports
and returns will be rendered, and venereal case cards dealt with in
accordance with the instructions laid down in Appendix X.
102
Medical boards.
Paras. 410-12.
SECTION IX.—MEDICAL BOARDS AND INVALIDING,
CASES OF MENTAL DISABILITY AND THEIR DIS-
POSAL.
GENERA
L .
410. Convening and composition of medical boards.—Medical
boards will be assembled under the orders of the district or inde-
pendent brigade area commander whenever necessary, and will
ordinarily be composed of a president and two members, but, if this
number is not available, a board may consist of two medical officers
only.
If it can be avoided the medical officer in charge of a case should
not be a member of the board which considers it, and in no instance
may he act as president of the board.
411. President of Medical Boards.—( a) British officers and British
other ranks.— (i) The A. D. M. S. district or independent brigade area
will be the president of all medical boards held on British officers of the
British or Indian services and on British other ranks who are boarded—
(a) with a view to recommending them for leave out of India
on medical grounds or for invaliding as unfit for further
service or change to England.
(b) for pension in respect of disabilities attributable to war or
to ordinary military service.
Should exceptional circumstances prevent the A. D. M. S. presid-
ing at such boards, the O. C., B. M. H. in the station will be president.
(ii) The O. C., B. M. H. in the station will be the president of
medical boards held on British officers and British other ranks in
circumstances other than the above.
(b) Indian officers, Indian other ranks, followers, etc.— The O. C.,
I. M. H. will ordinarily be the president of medical boards held on
these personnel.
412. Cases dealt with by medical boards.—The following classes
of personnel of the Army in India will be dealt with by medical boards
in the circumstances and in accordance with the instructions on the
forms and in the regulations noted below—
(a) (i) Officers of the British and Indian service, soldiers on the
I. U. L., Lady nurses, school-masters and school-mistres-
ses, families of officers of the Indian service, of soldiers
on the I. U. L., of school-masters and school-mistresses,
recommended leave, furlough or change of climate on
medical certificate—See I. A. F. M-1243, P. and A.
Regs. and Regulations for the Army in India.
(ii) Families of officers and of other ranks of the British service
recommended for change of climate on medical certi-
ficate—See A. F. A-2.
103
Paras. 413-15.
Medical boards.
(b) Warrant and N. C. Os. and men of British corps, proposed
for change of climate, or invaliding, see A. F. B-179
(modified for India), A. F. B-3977, and Regs.for the Army
in India.
(c) British cases of mental disease including women and children
—see paras. 452-457 et seq.
(d) British officers and Lady nurses claiming wound, injury or
disability pensions or gratuities—see A. F. A-45,
A. F. A-45-A, M. P. O. Form 45 F. A., Royal Warrant
for Pay, etc. and Pension Regulations, India.
(e) Individuals applying for furlough or leave (under the 1866
or 1875 rules) on account of disability which originated
on field service—see I. A. F. M-1243.
(f) Members of the I. M. D. proposed for invaliding—see I. A.
F. A-311 and Pension Regulations, India.
(g) Indian officers, soldiers, and followers considered unfit for
further service, or claiming wound, pensions or gratuities
—see I. A. Fs. Y-1948 and M-1265, Pension Regula
tions, India.
(h) Unattested followers, and persons serving under the C. S.
Regulations (under 60 years of age), proposed for invalid-
ing or claiming pension—see I. A. F. M-1239, I. A. F. (Medi-
cal) 8 and C. S. Regulations.
(i) Indian cases of mental disease—see para. 458.
413. Necessity for care and accuracy.—When answering the ques
tions of the various Army Forms and India Army Forms members
of medical boards must bear in mind that the disposal of the invalid,
and the determination of the individual's eligibility for a disability
pension or gratuity, is mainly decided on the facts brought to the
notice of and opinions expressed by the board. Hence it is of para-
mount importance that the proceedings should show on what facts
the boards, have based their opinions, or their reasons for arriving
at a conclusion.
414.
Definition of term " attributable to military service ".— (a)
A wound or injury will be regarded as attributable to military service
only when it is incurred during the actual performance of military
duty and arises directly out of such performance. In this connection
see Regulations for the Army in India para. 299.
( b) A disability, other than a wound or injury, will be regarded
as attributable to military service only when it arises directly out
of circumstances necessarily incidental to military service. It will
not be so regarded if, although contracted during the period of such
service, it is due to the ordinary risks to which the individual would
have been exposed in his normal indoor or outdoor civil life.
415. Proceedings confidential.— Proceedings of a medical board
will be treated as confidential except as noted below
:—
(i) In the case of an officer who is found fit to return to duty,
the president of the medical board will so inform the officer
and will instruct him to report himself for duty forthwith.
104
Medical boards.
Paras. 416-20.
(ii) In the case of an officer who is found temporarily unfit, the
president will inform the officer of the board's opinion as
to the period of unfitness.
(iii) In the case of an officer who is found permanently unfit,
the president will inform the officer of the opinion of the
board, making it clear to him that the information should
not be acted upon until it is confirmed by the War Office,
India Office or Army Headquarters.
416. Dates of boards on British officers, British other ranks, and
the families of these and on members of Q. A. I. M. N. S. and Q. A. M.
N. S. I.—Emergency medical boards may be held as required.
Regular medical boards for the invaliding season will be held in
accordance with the instructions on " Trooping " issued in I. A. Os.
417. Disposal of Documents—General.—(a) British personnel.
—
The Medical Board proceedings of all persons recommended for sick
leave to England, or for invaliding ex -India will be disposed of in
accordance with instructions on " Trooping " issued from time to
time in I. A. Os. Invaliding documents should reach the D. M. S.
in India not later than three weeks after the date on which the Board
is held, or earlier if possible. Where this is for any reason impracti-
cable, an explanation of the delay should be given.
The proceedings of medical boards held in other circumstances,
e.g., sick leave in India will, after approval by D. Ds. M. S. or in the
case of Burma District by the A. D. M. S. be disposed of in accordance
with the instructions on the forms or in regulations, applicable to each
case (vide para. 412).
Should the approving authority not concur in the finding of a
medical board he may direct that—
(1) a fresh board be held, or
(2) the case be retained in hospital for further treatment, or
(3) the case be disposed of otherwise as he may consider suit
able in the circumstances.
(b) I . M. N. S. and mat r ons f ami l y hospi t al s. —M e d i c a l
b o a r d s h e l d
on members of these services will be approved by the A. Ds. M. S.
(see also paras. 428 and 429).
( c) Indian personnel.— The medical board proceedings will, after
approval by A. Ds. M. S., be disposed of as directed on I. A. F. Y-1948.
418. Despatch of invalids and insanes to the U. K.—Arrangements
will be made by the Os. C. hospitals for the despatch of invalids to the
U. K. in accordance with the instructions on trooping issued from
time to time in I. A. Os.
419. R. A. F. medical boards.—Instructions regarding the medical
boards and invaliding of R. A. F. personnel are given in Section XIII.
British officers.
420. Statement of case.—On the occasion of an officer's first
appearance before a medical board, the circumstances under which
105
Paras. 421-28.
Medical boards.
the disability was contracted will be fully detailed and a statement
of the case by his medical attendant will be attached to the proceed-
ings of the board.
421. Proceedings of previous medical boards.—When an officer is
ordered to appear before a medical board the A. D. M. S. will arrange
that, if possible, copies of the proceedings of any previous medical
boards on the officer are available for the information of the board.
422. Opinion of subsequent medical boards.—Medical boards,
when recording their opinions as to causation, degree of disability
and fitness for general service, will be careful not to allow their deci-
sions to be influenced unduly by the proceedings of the previous
medical boards. In the event of their disagreeing with the opinions
expressed by previous boards, they will state the grounds on which
they base their disagreement.
423. Delayed recovery through inadequate treatment.—Medical
boards on sick officers will enquire into the treatment of the case,
and will report if they consider an officer's recovery is being delayed
through inadequate treatment or neglect of proper precautions.
424. Invaliding and leave ex-India on m. c.—When recommend-
ing British officers of the British or Indian Service for invaliding or
leave on m. c. ex -India medical boards will be guided by the rules
in Regulations for the Army in India, para. 881.
425. An officer unfit to manage his own affairs.—When an officer
suffering from mental disease or extreme illness, is not fit to manage
his own affairs and is sent to the U. K. on leave on m. c., it will be
the duty of his immediate superior to see that the necessary documents
(see I. A. F. Z-2053) are made over to the sick officer's attendant, and
that the date of his departure is telegraphed to the staff officer who is
charged with making arrangements for his passage.
426. Annual confidential reports on officers.—Officers who are
reported to be unfit for general service when examined in connection
with their annual confidential reports, will be brought before a medi-
cal board unless the disability is of a temporary nature. A copy of
the proceedings of the medical board as well as the medical officer's
certificate will be attached to the annual confidential report.
Military Nursing Services.
427. Q. A. I. M. N. S. and Q. A. M. N. S. I—The instructions regard-
ing the invaliding of British officers apply also to members of the
Q. A. I. M. N. S. and Q. A. M. N. S. I.
428. The I. M. N. S.—If a member of the I. M. N. S. is considered
unlikely to become fit for full duty, on the expiration of the leave on
m. c. admissible under para. 51-A, the medical board proceedings re-
lating to the case will be forwarded to the D. M. S. in India, who will,
if he concurs, give the lady nurse two months notice of termination
of her service. Such notice will run concurrently with the leave
granted to her.
106