NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Paras. 542-44.
Infectious Diseases.
In cases where complete disinfection is called for it may be neces-
sary, subsequent to the disinfection, to have the walls scraped, white-
washed, distempered or repapered.
542. Disinfection of clothing, bedding, etc. —(a) All articles not
likely to be damaged in the process will be disinfected in a steam
disinfector. Before removal for disinfection they will be packed in
sacks or sheets soaked in 2½ per cent. cresol solution.
(b) As the process of steam disinfection varies in detail according
to the type of machine in use, it is necessary, in order to ensure
thorough disinfection, that the man operating the disinfector should
be trained in the duties and the medical officer responsible should
satisfy himself that the instructions issued with the type of machine in
use are strictly observed.
(c) Articles likely to be damaged by steam disinfection (e.g., leather
goods, books, furs, rubber material, clothing with leather strappings,
etc.) will be thoroughly sprayed with formaldehyde solution and
exposed to the air to dry. If they are in a room which is to undergo
complete disinfection the spraying will be carried out within the
room.
(d) As toys and pencils are particularly liable to become infected,
great care should be taken to ensure their efficient disinfection by
one or other of the processes described. Toys, books, papers and other
articles of little value, which cannot be effectively rendered free from
infection, may be burnt, subject to the provision of paragraph 552.
(e) In stations or other localities where steam disinfection is not
available for articles normally dealt with under paragraph 542 ( a ),
sheets and other articles of cotton or linen also blankets and woollen
articles will be soaked in 2½ per cent. cresol solution for half-an-hour,
then washed or sent to the laundry. Other articles of clothing or
textile which might be spoilt by cresol will be thoroughly sprayed with
formaldehyde solution and exposed to the air and sun to dry.
In the case of the diseases mentioned in Group I of paragraph 554
mattresses will be soaked for one hour in 2½ per cent. cresol solution.
543. Clothing, equipment and bedding returned to store. —If the
clothing, equipment or bedding of a man suffering from a communi-
cable disease, or who after admission to hospital develops such disease,
should have been returned to a unit or other store without the neces-
sary disinfection having been carried out, care will be taken that all
such articles are recovered from store and suitably disinfected, and
that any other articles or any portion of the store which may have
been in contact with such infected articles are also suitably disin-
fected.
544. Special disinfections. —In certain diseases it may be neces-
sary to disinfect latrine seats and pans, or articles of crockery or cutlery
in the mess room or institutes : in such cases the latrine seats and
pans will be scrubbed with 2½ per cent. cresol solution, followed by
soap and water. Cutlery and crockery will be steeped for half-an-hour
in 2½ per cent. cresol solution and subsequently washed in hot water
containing washing soda.
132
Infectious Diseases.
Paras. 545-48.
545. Hospital bedding, etc.—The measures of disinfection laid down
in paragraph 542 will also be adopted in connection with the bedding,.
clothing, etc., used by patients in hospital suffering from infectious-
diseases and all soiled bedding and clothing, etc., which have been in
intimate contact with infectious patients will be immediately steeped
in 2½ per cent. cresol solution for at least half-an-hour before being
removed from the ward. Articles which cannot be steeped should be
sprayed with formalin.
When hospital bedding and clothing, or textile stores of any des-
cription, which have been used by patients suffering from infectious
diseases, are returned direct to an ordnance depot or to a unit, a
certificate from the 0. C. hospital concerned will accompany the
bedding, clothing and textile stores so returned, stating that they
have been efficiently disinfected.
546. Venereal and infectious patients.—A supply of sheets, pillow-
slips, shirts, drawers, handkerchiefs and towels, distinctively marked
with the letter " V " will, when necessary, be set apart in hospitals
for the use of patients suffering from venereal diseases, and a supply.
of bedding and clothing distinctively marked with an " I " for the use.
of patients suffering from infectious diseases. When no steam dis-
infector is available, the articles marked " V " will invariably be
steeped in 2½ per cent. cresol solution for at least half-an-hour, and
subsequently rinsed thoroughly in clean water before being sent to,
the laundry or contractor for washing. The articles marked " I "
will be dealt with as laid down in paragraph 542. All feeding utensils
intended for use by syphilitic patients should be marked with a " V "
and kept solely for their use.
547. Utensils in typhoid and paratyphoid fevers.—All utensils-
(e.g., feeding cups, bedpans, urinals, etc.) intended to be used by en-
teric patients, must be marked " E ". The contents of the bedpans
and urinals will be mixed intimately with an equal quantity of 2½
per cent. cresol solution and allowed to stand for half-an-hour before
being disposed of. The bedpans and urinals must invariably be dis-
-infected by washing with 2½ per cent. cresol solution.
548. Disinfestation.—To ensure efficient disinfestation the entire-
room or quarters and their contents and the occupants and their
clothin must be dealt with simultaneously. In dealing with bugs
it may be necessary to deal with the whole building.
(a) THE ROOM.
Dugs may be got rid of in a room by formaldehyde gas generated
by the action of formalin on bleaching powder.
The room is sealed up and the fires lighted to obtain a tempera-
ture of at least 70° F., water is sprayed upon the floor and other sur-
faces to raise the relative humidity to about 70 per cent. Efficient
diffusion of the 'gas is ensured by placing the bucket in which it is
generated at a distance of not more than 6 feet from the ceiling. For-
malin (40 per cent. formaldehyde) is placed in an ordinary galvanized'
iron pail and chloride of lime wrapped in thin paper is added. When
all is ready the paper is rapidly pierced. Two pints of formalin and
Paras. 548–50.
Infectious Diseases.
two pounds of chloride of lime are required for every 1,000 cubio
feet. Not more than these amounts should be used in any one bucket.
The operator on piercing the paper withdraws and seals the door of
the room which is left sealed for 24 hours. At the end of this period
the operator wearing a mask opens the doors and windows and lights
the fires and the room is ready for occupation in a few hours.
Lice seldom leave their host and his clothing, but in order to ensure
destruction of any that may fall off on to the floor, skirting board,
bedstead, equipment, shelf or locker such places will be washed with
an emulsion of cresol and soft soap.
Fleas will be got rid of by washing the entire floor, skirting boards,
bedsteads and equipment shelves or boxes with the cresol and soft
soap emulsion described above or with a paraffin and soft soap emul-
sion. The disinfestation for fleas will seldom be required except
in cases of plague when the rat problem must never be overlooked.
( b) BEDDING, CLOTHING AND TEXTILES, ETC.
These will be dealt with as described in paragraph 542, the proce-
dure being particularly necessary in the case of lice or flea borne
infection where it is essential in addition to disinfestation to ensure
destruction of the virus.
When disinfestation only is required ( e. g., in the absence of disease),
disinfestation by hot air may be employed. (See paragraph 232,
Army Manual of Sanitation, 1926).
(c) THE OCCUPANTS.
The occupants will receive hot baths, when necessary hairy parts
will be shaved, and before putting on clean clothing all individuals
will be inspected.
549. Disinfection and disinfestation on board ship. —Disinfection
will be carried out on the same lines as on shore.
(a) Cabins, small apartments and troop decks as indicated in
paragraphs 537 to 541.
( b ) B e d d i n g , c l o t h i n g , e t c . , a s i n d i c a t e d i n p a r a g r a p h s 5 4 2 a n d
554. Apparatus for steam disinfection is available on
all transports and troop-ships.
(c) Holds and Bilges. Disinfection is carried out by the Admi-
ralty.
( d ) D r i n k i n g w a t e r t a n k s . I f c o n s i d e r e d n e c e s s a r y t h e c o n t e n t s
should be chlorinated, one part for each million of free
chlorine (verified by use of a water test case) being
allowed to act for at least half-an-hour.
( e ) D i s i n f e s t a t i o n w i l l b e c a r r i e d o u t a s i n d i c a t e d i n p a r a g r a p h
548. For the complete disinfestation of a ship So2 or
HCN gas are most effective.
550. Disinfection of vehicles. —Any ambulance car or wagon or
other vehicle which has been used for the carriage of a case of infec-
tious disease or of an infected person or of infectious or infested articles
will be disinfected by spraying with formalin solution or by swabbing
134
nfectious Diseases.
Pares. 551–54.
the whole interior with 2 per cent. cresol solution before being used
again ; all articles accompanying the patient will also be suitably-
disinfected ; this will be carried out by the medical authorities.
551. Disinfection of drains, gullies, etc.—Complete disinfection
of drains, gullies, taps, latrines, urinals, refuse receptacles, etc., in
barracks or in camp is practically impossible. While disinfectants-
used in such places may act as deodorants, the mere fact that such
places need deodorization indicates faulty conditions. This should
be looked into and corrected, but disinfectants will not be used.
552. Destruction of Infected articles. —The destruction of any
article instead of its disinfection is rarely justified. When, on grounds
of health, the destruction of any article of public 'or private property
is deemed absolutely necessary, the medical officer concerned will
report accordingly in order to obtain authority for carrying out the
destruction ; but in cases where delay would involve risk or danger
to the troops he must act on his own responsibility, and be prepared
to justify his action when making application for covering authority.
553. Cleansing of Army Schools.—Army schools will be cleaned
during the Christmas and Summer vacations in the following manner:—
(a) All dados, desks, seats, floors, and other woodwork will be
cleansed thoroughly with 2½ per cent. cresol solution.
(b) The windows will be left open, if practicable, throughout
the whole vacation.
( c ) A n n u a l l y ,
u n d e r t h e d i r e c t i o n o f t h e M . E . S . t h e w a l l s o f
W. C.'s, urinals and other walls previously limewhited
will be thoroughly scraped, brushed and re-limewhited.
( d ) E v e r y f i v e y e a r s
the walls of the school-rooms will be re-dis-
tempered, ceilings re-whitened, and painted work repainted
as may be deemed necessary by the M. E. S.
554. Methods to be employed in different diseases. —As soon as
possible after the removal of any case of communicable disease, dis-
infection or disinfestation or both as described in paragraphs 533–-
552 will be carried out when applicable and as indicated hereunder.
GROUP I.
A. Cholera . . . . . . .
Complete disinfection.
Puerperal septicæmia.
.
.
.
.
B. Dysentery (including clinical dysentery)
.
Local disinfection but excluding
the adjacent beds and bedding,
and including latrine pans and
seats.
Enteric group .
.
.
.
.
.
Infective enteritis
.
.
.
.
.
Paratyphoid fevers .
. . . .
Typhoid fever .
.
.
.
.
.
Mediterranean or undulant fever
. .
C. Venereal diseases
.
.
.
.
Disinfection of bedding, under-
clothing, towel and handker-
chiefs only, except in cases of
secondary syphilis, when eating-
and drinking utensils should be
dealt with.
135
Para. 554.
Infectious Diseases.
GROUP II.
A. Plague (pneumonic) . . . . . Complete disinfection.
Tubercle of the lung
. . . .
B. Cerebro-spinal, fever
. . . .
Local disinfection, and In addition
eating and drinking utensils, if
accessible, and toys and pencils
in the case of children will be
dealt w i t h .
Diphtheria . . .
Encephalitis lethargica
Influenza
. . . . .
Measles . . . . . .
Mumps . . . . . . .
Pneumonia (lobar and lobular) . .
Polio-myelitis . . . . .
Rubella . . . . . . .
Scarlet fever . . 4
Whooping cough . .
.
GROUP III.
A. Small-pox
. . . . . . Complete disinfection.
B. Anthrax (cutaneous)
.
Local disinfection.
*Chicken pox
. . . . .
Erysipelas
. . . . . .
Ophthalmia neonatorum . . .
Pink eye . . . . . .
GROUP IV.
Plague (bubonic) . . .
.
Disinfestation as defined in par a -
graph 548.
Relapsing fever
. .
.
Trench fever . . . . . .
Typhus fever . . . . . .
GROUP V.
Communicable skin diseases . . . Local disinfection, but excluding
the adjacent beds and their bed-
ding.
* During an epidemic of small-pox complete disinfection.
136
Troops Moving.
Paras. 555-61.
SECTION XII.—MEDICAL DUTIES IN CONNECTION WITH
THE MOVEMENT OF TROOPS.
GENERAL.
555. Administration. —Under the orders of the G. O. C. district
or independent brigade, the A. D. M. S. will issue such orders or
take such steps as may be necessary to ensure adequate medical arrange-
ments being made for troops moving from or within his area.
556. Medical arrangements.—Medical personnel and equipment
will be detailed from B.M.Hs. and I.M.Hs. as noted in the subsequent
paragraphs.
An adequate supply of " preventive packets " for protection
against V. D. will be included in the medical equipment with troops
moving by road, river and rail.
Written orders and instructions will be given to officers, or mem
-
bers of the I.M.D., detailed in medical charge of troops or to other
medical personnel accompanying troops by the officer who details
them for this duty as to :
—
(a) the disposal of sick on the march or journey,
(b) care and disposal of medical equipment,
(c) handing over medical charge of the troops and the return of
medical personnel to their original stations.
557. Responsibility for medical equipment. —The officer or member
of the I.M.D. detailed in medical charge of troops is responsible for
the medical equipment issued for the march or journey. He will
check the equipment on taking it over and again on handing it over.
Troops moving by road.
558. Medical arrangements. —All men unfit to march will be de-
tained in or admitted to hospital until fit to rejoin their corps. The
hospital arrangements and the medical equipment required for de-
tachments moving are laid down in para. 323.
559. Disposal of sick.—During the journey sick will be admitted
to military hospitals on the line of march as may be necessary, or
will be disposed of in accordance with any special instructions issued.
Officers in medical charge of units or detachments will report the
numbers of sick requiring admission to hospital to the O. C., B. M. H.,
or I. M. H. of stations through whom they pass.
560. Returns.—Returns of sick on the line of march will be render-
ed in accordance with para. 400.
Troops moving by rail.
561. Hospital arrangements.—The hospital arrangements are
laid down in para. 323.
137
aras. 562-68.
Troops Moving.
562. Medical personnel.—The scale at which medical personnel
will accompany troops moving by rail is laid down in Regs. for the
Army in India, para. 631.
5 6 3 . D u t i e s .
— T h e o f f i c e r o r t h e m e m b e r o f t h e I . M . D . , i n
medical charge of troops travelling by train, is responsible not only
for the care of any sick in his charge but also for bringing to the notice
of the O. C. train any defects likely to lead to the production of disease
and suggestions for remedying them.
Before the troops entrain he will inspect the accommodation
provided and will bring to the notice of the O. C. train any cases of
overcrowding and any defect in the kitchen cars, carriages and latrines.
He will ensure that the supply of drinking water is adequate and
chlorinated ( vide Regs. for the Army in India, para. 634).
In the case of serious illness he will telegraph to the nearest mili-
tary hospital (or in cases of immediate urgency to the nearest civil
hospital) for transport to meet the train. The nature of the illness
and probable time of arrival must be mentioned.
He will forward to the A. D. M. S. of the district or independent
brigade area in which the troops arrive a report of any medical of
sanitary defects or any special points he wishes to bring to notice.
He will satisfy himself that the supply of drugs, dressings and
medical comforts is sufficient for the journey.
564. Returns. —Returns of sick moving by train will, when re-
quired, be rendered as for troops on the line of march.
Troops moving by river.
565. The above instructions apply to troops moving by river.
Troops moving by sea.
566. General.—Special arrangements in connection with troops,
moving by sea, are contained in Regs. for the Sea Transport Service
and I. A. Os. on trooping published from time to time. See also paras.
115 and 323.
Annual relief of British troops.
567. British troops arriving in India from the U. K.—The medical
duties in connection with the transport of troops from the U. K. to
India are laid down in Regs., M. S. A. The statistical returns to be
rendered, inspections to be carried out, and information required
regarding sick, etc., are detailed in K. R., paras. 1145, 1159 and
1186.
568. British troops proceeding to the U. K. —The medical duties
in connection with the transport of troops and invalids to the U. K.
are published in India Army Orders from time to time.
138
Troops Moving.
Paras. 569-71.
Troops moving by sea other than to and from the U. K.
569. Administration.—The general medical administration and
arrangements in connection with hospital ships, ambulance transports
and transports will be carried out by D. A. Ds. M. S. or by E. M. Os.
attached to embarkation staffs acting under the orders of the D. M. S.
in India.
570. Officer in medical charge.—The officer in medical charge of
troops will be guided by the instructions governing the duties of Os.C.
hospitals and officers in medical charge of troops so far as these are
applicable (vide Section II of these Regulations). Attention is also
directed to the instructions contained in Regs. for the Medical Services
of the Army, para. 568, et seq. , where applicable, and in Regulations
for the Army in India and King's Regulations.
571. Returns to be rendered.—Statistics will be rendered on A. F. B.-
182 (modified for India).
In the case of British troops, Hospital Record Cards (A. F. I-1220)
will be made out for all cases admitted to hospital or dying on board
ship and will be forwarded to the D. M. S. in India on completion of
voyage.
139
Paras. 572-76.
R. A. F.
SECTION XIII.—THE ROYAL AIR FORCE IN INDIA.
THE RELATION OF THE MEDICAL BRANCH OF THE ROYAL AIR
FORCE TO THE MEDICAL SERVICES OF THE ARMY IN INDIA.
572. General.—Officers of the R. A. F. Medical Branch are entire
-
ly at the disposal of R. A. F. authority for all purposes of discipline,
posting and allocation of duties.
573. Duties.—Subject to the foregoing stipulation a R. A. F.
medical officer may do duty in the local military hospital under ar-
rangement with the officer commanding the hospital, or may be
detailed for such other duties as may be requested by the A. D. M. S.
of the district, provided that there is no interference with the efficient
discharge of his duties to the R. A. F., and subject to the consent
of the officer commanding the R. A. F. unit concerned.
He may be detailed by his commanding officer, at the request
of the O. C. a military hospital, to act as orderly medical officer of
the hospital, in which case a notification of the dates on which he
will be so employed will be published in station orders.
574. Leave.—When a R. A. F. medical officer applies for leave
and a R. A. M. C. or I. M. S. officer is required to perform his duties
in his absence, applications for his relief will be made as follows
in the case of
—
(i) casual leave, the O. C., R. A. F. unit concerned will apply
to the O. C. station for a relief, or for arrangements to
be made to permit of the medical duties being carried out
during the proposed absence ;
(ii) privilege leave or leave on private affairs, the O. C., R. A .F.
unit concerned will apply to the Headquarters district
for a relief, or for arrangements to be made to permit
of the medical duties being carried out during the pro
-
posed absence.
575. R. A. M. C. or I. M. S. officers in medical charge of R. A. F.
units will be guided by R. A. F. Instructions and Orders (India) in
carrying out their duties.
576. Sanitation.—The O. C., B. M. H. of the station will advise-
the O. C. a R. A. F. unit in that station regarding all matters of sanita-
tion and the prevention and limitation of disease affecting the station.
When he considers that any matter, in the area for which the officer
commanding R. A. F. is responsible, should be brought to the notice
of higher authority, he will forward a report embodying his recommend-
ations to the O. C. station with copies to the A. D. M. S. district and
the P. M. O., R A. F. (India). Instructions as to any action to be
taken upon such recommendations will be issued by Headquarters,
R. A. F. (India).
140
R. A. F.
Paras. 577-79.
577. Admission to hospital.—Officers and airmen of the R. A. F.
requiring admission to hospital will be admitted to British military
hospitals under the same rules as British officers and men of the Army
in India (see para. 271).
The families of officers and airmen of the R. A. F. will be admitted
to military family hospitals under the same conditions as families of
British officers and other ranks of the Army in India (see para. 271).
Indian personnel and public followers of the R. A. F. requiring
admission to hospital will be admitted to I. M. Hs. under the same
conditions as Indian troops and followers of the Army in India (see
para. 271.
Instructions for the preparation of Royal Air Force medical statistical
returns.
578. The following forms in use in the Royal Air Force require
to be prepared and rendered as shewn when Royal Air Force officers
and airmen are treated in hospital :—
Form 38 ..
.
.
Weekly sick report.
Form 39 (Army Form I-
1220) and Form 41
. Record of individual sickness.
Form 48 ..
.
.
Medical History Envelope.
579. Form 38.—Consists of a flimsy and stouter sheet, the whole
being bound in book form and providing a weekly list of cases admit-
ted to hospital.
(i) Form 38, Sections I and IV, will be completed for each week-
ly period Sunday to Saturday, by all military hospitals receiving sick
from Royal Air Force units.
Section 1.—(a) Full particulars of all fresh cases, officers and
airmen, admitted during the week to hospital are to be entered in
this section as received, with the exception of cases of 48 hours dura-
tion or less which are discharged to some form of duty within that
time ; but cases transferred from hospital to another hospital will
be shown in this section irrespective of the duration of their stay .
In the case of officers or airmen originally " detained" only, who
are subsequently admitted to hospital, the date on which they were
detained will be given as the date of admission. Cases under treat-
ment but still doing some form of duty will not be included. Each
case on the form is to receive a serial number, the 1st case on 1st
January being numbered 1 and the series continued up to 31st De-
cember. The " how disposed of" column of the flimsy will be filled
up at the end of the week as follows :
—
For cases returned to duty the words "duty" or "light duty"
will be entered. For cases discharged to unit, who are
unfit to resume duty, the words " excused duty " will be
inserted.
For cases admitted during the week and still remaining, the word
" remaining " will be inserted.
141