NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
Duties of the Military Medical Services.
Paras. 117-21.
(ii) When handing over his duties he will ensure that the incom-
ing officer is put in possession of the details of such medical problems
and works in progress as affect the health of the troops in the station
as a whole.
(iii) The senior executive officer R.A.M.C. or I.M.S. at the
headquarters station of a district or independent brigade to
which an A.D.M.S. is appointed will be instructed in the routine
duties of the A.D.M.S., in order that he may be able to carry on these
duties during the absence of the latter from his headquarters.
117. Health officers of Cantonments.—The senior executive medi-
cal officer in military employ in a cantonment is " Health Officer "
of the cantonment, and as such is a member of the Cantonment
Board.
He will exercise a general sanitary supervision over the whole
cantonment, and will submit monthly to the cantonment authority
a report as to the sanitary condition of the cantonment with his re-
commendations in connection therewith. He will perform such duties
in connection with the sanitation of the cantonment as are detailed
in the Cantonment Act of 1924.
118. Assistant Health Officers.—An assistant health officer is a
medical officer appointed by the G.O.C-in-Chief the command as
assistant health officer to the cantonment. The officer so appointed
is usually the officer in medical charge of the cantonment hospital.
He performs such duties in connection with the sanitation of the
cantonment as are, subject to the control of the cantonment authority,
allotted to him by the Health Officer.
119.
Surroundings of cantonments.—The senior executive Officer,
R.A.M.C. or I.M.S., will keep himself acquainted with the condition
of camping grounds and the country generally around the station
and with the health of the inhabitants in and around cantonments.
Duties of Assistant Directors of Hygiene and Pathology.
120. General.—An A.D.H. and P. is appointed to assist and advise
the D.D.M.S. of a command in matters relating to hygiene and
pathology. Under the orders of the D.D.M.S. he will be responsible
for all problems relating to hygiene and pathology. He will keep in
touch with the Director of Hygiene and Pathology at A.H.Q., and
also with the D.A.D.H. and D.A.D.P. of each district in the com-
mand.
NOTE.—When an A.D. of H. and an A.D. of P. are separately posted to a command
the A.D. of P. will be in charge of the command laboratory and will in addition be the
adviser of the D.D.M.S. the command on matters concerning pathology, vide Appendix
XV.
121. Co-operation with civil authorities.—He will keep in touch
with the public health authorities of Local Governments and with
railway medical officers, with a view to taking any measures necessary
for the preservation of the health of the troops.
29
Paras. 122-33.
Duties of the Military Medical Services.
122. Inspections.—He will take steps to keep himself informed
on all matters relating to the health of the troops and military families.
He will make systematic inspections to ascertain the hygienic con-
ditions obtaining in all localities in military occupation and will report
accordingly.
123. Diary.—To ensure continuity of policy and for purposes
of record he will keep a diary in I.A.F.Z-2068 in which all inspec-
tions made and work undertaken during the year will be entered.
124. Inquiries concerning disease.—He will enquire into the origin,
cause and distribution of diseases in the command, and will ascer-
tain the extent to which these diseases are dependent on preventable
causes. He will keep himself acquainted with the medical and sur-
gical work of hospitals and will ensure that the fullest use is made
of the pathology services both in diagnosis and in treatment.
125. Register of infectious diseases.—He will keep a register of
infectious diseases, entering therein particulars of all cases notified.
126. Action on the occurrence of infectious disease.—On the oc-
currence of any serious outbreak of infectious disease, he will without
delay make investigation and, if necessary, visit the locality of the
outbreak, and in conjunction with medical officers and civil autho-
rities concerned, enquire into the causes and circumstances and advise
as to preventive measures.
127. Schemes relating to buildings, water supply, etc.—He will
advise the D.D.M.S and confer with the C.E., on the sanitary details
connected with all schemes relating to buildings, water-supply, drain-
age, sewage disposal, etc., including both new works and alterations;
he will keep himself informed regarding the progress of the work in
its sanitary bearing.
128. Statistics.—He will maintain the health statistics, charts
and records of troops in the command, and will carefully scrutinize
all health returns, medical case sheets, documents and reports sub-
mitted to the D.D.M.S.
129. Military families' welfare.—He will supervise all matters
relating to the welfare of families and the physical condition of school
children. (See A.F. C-319, Schedule of medical inspections.)
130. Instruction in hygiene.—He will ensure that such courses
of instruction of troops in hygiene are carried out as may be necessary,
and will encourage in every way the diffusion of a knowledge of prac-
tical hygiene among officers and men.
131. Inoculations, etc.—He will keep himself informed as to the
preventive inoculation and vaccination state of units and families.
132. Laboratories.—As A.D.P., he will supervise and co-ordinate
the work of all laboratories in the command, carrying out such
inspections as may be considered necessary.
133. Use of sera and vaccines.—He will advise the D.D.M.S. on
all matters relating to the preventive or therapeutic application of
sera and vaccines.
30
Duties of the Military Medical Services.
Paras. 134-37.
134. Annual Report.—He will prepare an annual report giving
a resume of the health statistics for the year, and of the sanitary
and pathological work carried out during the year.
The report will be based on the reports and returns of districts
and independent brigade areas and will be submitted to the D.D.M.S.
for transmission to A.H.Q. It should be despatched so as to reach
A.H.Q. not later than 31st March.
Duties of Deputy Assistant Directors of Hygiene and Deputy Assistant
Directors of Pathology.
135. Duties of D.A.Ds. of H.—A Deputy Assistant Director of
Hygiene will assist and advise the A.D.M.S. to whose headquarters
he is appointed in all matters relating to the prevention of disease
and the preservation of the health of the troops in the district or
independent brigade. He will therefore keep himself informed of
the state of the health of the troops and the sanitary conditions per-
taining in all stations in the district or brigade area.
He will be guided in the performance of his duties by paras. 120
to 134 in so far as applicable.
136. Duties of D.A.Ds. of P.—A Deputy Assistant Director of
Pathology will assist and advise the A.D.M.S. to whose headquarters
he is appointed in all matters relating to pathology, bacteriology
and the laboratory diagnosis of disease.
He will have charge of the district laboratory, will supervise the
technique and laboratory methods employed in brigade laboratories
and the clinical side rooms of, hospitals, and be responsible that the
subordinate staffs of laboratories in the district are trained in modern
laboratory methods.
He will hold annual classes at the district laboratory for the train.
ing of assistant and sub-assistant surgeons in laboratory work in
order that sufficient trained laboratory staffs may be available as
required. Only where exceptional pressure of work is thrown on the
rest of the staff will the D.A.D.P. be called on to assist in carrying
out the executive duties of the hospital at which his laboratory is
located.
He will peruse and sign and bring to notice any points requiring
comment by the A.D.M.S. in medical case sheets, A. F. I.-3056, etc.
Officers in charge of brigade laboratories.
137. Appointment and duties.—Officers in charge of brigade labo-
ratories are nominated by the D.M.S. in India (vide Appendix I).
They will carry out bacteriological work and laboratory test s
requiring special skill or apparatus and will keep in touch with the
D.A.D.Y. of the district in all matters affecting their work and labora-
tories. They will also be available for ordinary hospital duty.
31
Paras. 138-44.
Duties of the Military Medical Services.
Duties of executive officers of the Military Medical Services.
Duties of the officer commanding a military hospital.
138. General duties.—The 0.C. hospital is responsible for all the
duties connected with his unit and for their proper distribution ;
he will exercise a general supervision over all the sick in hospital
and is responsible that the capabilities of the personnel and the re-
sources of the hospital generally are fully and properly applied to
the care and comfort of patients.
He will keep himself informed of the work of officers nominated
by him to medical charge of units and of all matters affecting the
state of health and general sanitary condition of those units whose
sick are admitted to his hospital. Attention is directed to the orders
contained in Regulations for the Army in India, Chapter X, Section 7,
relating to the duties of medical officers.
139. Orga and Equipment.—He will satisfy himself that
the hospital is organised in accordance with the regulations, and
will be responsible for buildings, equipment, stores and supplies.
149. I ispectioi of hospital premises.—(i) He will periodically inspect
the hospital buildings, quarters and enclosures, and he will inform
the M.E. Services of repairs, etc., which require to be carried out.
(ii) He will submit demands for new works required to the O.C.
station, in accordance with paragraph 27, Regulations for the Mili-
tary Engineering Services (1926).
(iii)
He will inspect the vicinity of the hospital periodically and
take steps to ensure its being maintained in a sanitary condition.
141. Equipment, stores and supplies.—He will exercise close super-
vision over all equipment stores and supplies on his charge. He will
satisfy himself, that these are supplied as authorised and .in sufficient
quantities, that they are in good condition, that equipment ledgers
and accounts of expendable stores are correctly maintained in accor-
donee with regulations, and that undue accumulation of stores and
e quipment does not take place.
He or an officer detailed by him will periodically check and in-
spect all equipment and stores. He will satisfy himself that at the
end of each month the balances of rations and expendable articles
in charge of the storekeeper are correct. (See also Section VII.)
142. Books and records.—He will inspect all hospital books and
records to see that they are properly kept and will' satisfy himself
that all reports, returns and vouchers are duly and correctly rendered.
(See also Section VIII.)
143. Books on charge.—He is responsible that the books of regu-
lations, etc., detailed in Appendix XII-B are on charge and that
they are kept up to date and in good condition, vide Regulations for
the Army in India, para. 800-A.
141. Hospital orders.—He will issue such orders as may be neces-
sary for the carrying out of all hospital duties and for the maintenance
of regularity and discipline within the hospital.
3 2
Duties of the Military Medical Service.
Paras. 145-52.
145. X-ray apparatus.—He is responsible that no one, unless duly
qualified or possessing adequate knowledge of radiography, is allowed
to use the X-ray apparatus or to give orders regarding the length
of exposure.
146. Employment of patients.—He is authorised to employ on
light hospital duties, without pay, such patients as he may consider
able to assist the hospital establishment.
147. Regimental nursing orderlies and sick attendants. —(i) Trained
regimental nursing orderlies from British infantry units may be em-
ployed on nursing duties in British Military Hospitals in order to
relieve any shortage of R.A.M.C. other ranks, and also in hospitals
to which no R.A.M.C. other ranks are attached. The number to
be employed will be the minimum consistent with efficiency. These
trained nursing orderlies will be furnished on application to the station
or unit commander.
In addition to the above, soldiers of British infantry units are
attached to B.M.Hs. for training in nursing duties for a period of
six months at the end of which they are examined and those who
qualify are awarded I.A.F. X-1843. The numbers to be trained are
communicated to commands by the Adjutant General in India (vide
para. 441, Regulations for the Army in India).
(ii) A private soldier or follower of an Indian unit may be em-
ployed as a sick attendant on a patient in an Indian military hospital
belonging to the same unit, and who is seriously ill. Such sick atten-
dants will be furnished on the authority of the station or unit com-
mander (vide para. 442, Regulations for the Army in India).
148. Orderly officer. —He will, when necessary, detail an orderly
medical officer.
149. Hours of attendance at hospital.—He will maintain a time
table of the hours of attendance of the hospital staff during the hot
weather and the cold weather. He will cause to be published in
station orders such details of the hours of attendance as may be neces-
sary for the information of units in the station.
150. Conveyance of sick to hospital. —He will arrange when and
where necessary for the conveyance to hospital of the sick of units
requiring admission to or detention in his hospital.
151. Disposal of sick on arrival at hospital. —The 0.C. the hospital
or an officer detailed by him will examine, as soon as possible, all
men sent to hospital and allot them to wards.
He will ensure that each patient is dealt with subsequently in
accordance with regulations and any special orders that may apply
to the case.
He will see all detained patients daily.
152. Discharge of patients from hospital. —The 0.C. hospital will
see all patients for discharge on the day of their discharge from hos-
pital. He will, on the day previous to, or as early as possible on the
day of discharge, notify the names of men for discharge to the Q.C.
unit concerned. Patients will be discharged in the evening.
33
Paras. 153-58.
Duties of the Military Medical Services.
153. Admissions and discharges to be notified to O.C. units.—The-
0.0. hospital will notify Os. C. units concerned on A.F. B-256 or on
A.F. A-27 the dates of admission and discharges of all men of their
units admitted to hospital. (See also para. 206.)
This information should be rendered on the units, A.F. B-256-
(of the day) in those cases in which the sick are seen at the hospital,
or on A.F. A-27 in those cases in which the sick are seen at the M.1.
room at a distance from the hospital. It is left to the 0.C. hospital
to use the method which is best suited to local conditions.
154. Reports of death.—In the case of officers, soldiers and fol-
lowers who die in military hospitals or whose bodies after death are
brought to the hospital mortuary, the death will be reported at once
on A.F. A-27 by the 0.C. hospital to the 0.C. unit concerned and
to the 0.C. station. He will inform the 0.C. unit the hour and date•
after which interment or disposal of the body by other means may
take place. In the case of British troops he will also forward this
information to the chaplain of the denomination to which the de-
ceased belonged. (See also para. 277, Regulations for the Army in:
India, I.A.F. Z-2000 and Appendix XI of these Regulations.)
155. Medical case sheets.—The medical case sheets of all cases•
who die in hospital or which are of special professional interest will'
be forwarded to the A.D.M.S. for information and return.
Before forwarding such documents the 0.C. hospital will satisfy
himself that medical case sheets A.F. 1-1237 give a true'account of
the case and its course and treatment and that they are in original:
and accompanied by clinical charts and laboratory reports (if any)._
He will sign medical case sheets before forwarding them to the A..
D.M.S.
156. Autopsies.—Post mortem examination of fatal cases will be
made for medico legal purposes, or for the elucidation of sonic im-
portant and obscure illness in cases where the relatives or the com-
manding officer do not object.
157. Death certificates.-0s.C., B.M.Hs. and I.M.Hs. will complete•
and forward A.F.B-2090 or I.A.F. A-393 to the O.C. unit concerned
in the case of a death of British or Indian soldier respectively.
The information given in copies of death certificates furnished
to relatives of deceased officers or other ranks will be confined strictly
to an explicit report of the pertinent medical facts ; anything which
may tend to prejudice a decision as to the relation between the cause•
of death and service conditions should be omitted.
158. Seriously and dangerously ill and insane patients.—He will'
at once inform the 0.C. unit concerned by letter or by telegram if
necessary when an officer or soldier (a) becomes seriously or danger-
ously ill, (b) is certified to be insane. In the case of British troops
under category (a) he will also inform the chaplain of the denomina-
tion to which the patient belongs. Any changes in the patient's
condition will also be notified from time to time. The form for
these reports is A F. A.21-A. In the case of R.A.F. personnel the,
34
Duties of the Military Medical Services.
Paras. 159-66.
notification will be sent to the O.C. unit concerned and daily progress
reports will be submitted. (Vide I.A.F. Z-2000 and Appendix XI of
these regulations.)
159. Soldiers admitted for injuries.—The O.C. hospital will ensure
that a report to the O.C. unit concerned is made on A.F. B-117 as
soon as possible after the date on which an officer or soldier has been
placed on the sick list, whether in quarters or in hospital, in conse-
quence of having become maimed, mutilated, or injured (except by
wounds received in action), whether on or off duty, in order that
a court of inquiry may, if necessary, be assembled (vide Regulations
for the Army in India, para. 439).
160. Infectious Disease.—On the occurrence of cases of infectious
disease among the troops whose sick are admitted to his hospital
or their families he will take action as detailed in Section XL
161. Management of cases of mental disability and their disposal.
— " T h e r u l e s g o v e r n i n g t h e m a n a g e m e n t a n d d i s p o s a l o f c a s e s o f m e n t a l
, disease are detailed in Section IX.
162. Daily state of sick (A.F. A-27). —The O.C. a military hospital
will forward A.F.A-27 (Morning state of sick) to the O.C. station
.and the A.D.M.S. concerned daily, bi-weekly or weekly as may be
directed by the A.D.M.S.
The reverse of A.F. A-27 may be used, vide the note thereon, by
the O.C. hospital to communicate to O.C. units the names of men
.admitted, discharged, etc., from the hospital (vide para. 153).
163. Transfer of sick.—If an O.C. hospital wishes to transfer, a
patient to another hospital he will first apply giving a short statement
of the case to his A.D.M.S. for permission to do so.
Before a patient is transferred to another hospital he will ascer-
tain that accommodation is available, and if so, will give not less
than 24 hours' notice of the patient's arrival. The patient's medical
history sheet and his medical case sheet completed to date will accom-
pany him. In the medical history sheet the word " transferred ",
with date, will be inserted in the column for discharge.
164. Sick to be retained until recovered. —When a unit or detach-
ment leaves the station the O.C. hospital will retain such sick belong-
ing to it as are under treatment in the hospital until they are suffi-
ciently recovered to rejoin their unit.
165. Consultation with specialists. —On the occurrence of any
:serious or unusual case of illness or injury the O.C. hospital will, if
he considers it necessary, arrange for a consultation with any spe-
cialist in military employ who is qualified to advise on the case in
accordance with the rules governing the movement of specialists,
contained in Passage Regulations, India.
When applying for the services of a mental specialist the medical
case sheet and A.F. B-183 will be forwarded.
166. Medicines for persons entitled to medical attendance. —He .
' will be responsible that such medicines and surgical materials as are
35
Pans. 167-71.
Duties of the Military Medical Services
.
usually supplied from the public store and are ordered for those
allowed medical attendance in the station are available and supplied
from the dispensary of the hospital. He will also be responsible
that the outdoor prescriptions as copied into I.A.F. Z-2068 agree
with the prescriptions filed by the dispenser. He will arrange for
the dispensing of prescriptions and the issue of medicines, etc., at
fixed hours to suit the convenience of those concerned. In cases
of urgency medicines, etc., will be supplied at any time, in such cases
the prescriptions must be marked "urgent" .by the officer prescrib-
ing the medicines.
167. Patients' diets and extras. —The O.C. hospital will inspect
patients' diet sheets to ascertain that the diets are appropriate and
that unnecessary "extras" are not ordered.
He will take such steps as he considers necessary to check the
issue of and the returns accounting for, diets and extras. (See also
Section VI.)
168. Hours for visitors and passes for patients. —Visitors will be
permitted to see patients in hospital at such hours as may be autho-
rised by the O.C. hospital. A visitor will see the sister or orderly
in charge of the ward before entering the ward.
He may at his discretion grant permission to a. patient to be absent
from hospital
:—
(a) In special cases on account of urgent business.
(b) In exceptional cases where he considers it will benefit the
patient's health.
A patient who is permitted to leave hospital under the above
conditions will not be allowed to enter barracks or places of public
entertainment unless special permission to do so is stated on the
pass. In no case may he visit any premises where the sale of intoxi-
cating liquor is permitted.
In the case of officers allowed "out" for convalescent exercise
the hours of exercise and dates will be published in station orders.
Officers so allowed out will not visit messes, clubs or places of public
entertainment unless specially permitted to do so.
169. Charge of public money. —The O.C. hospital will be person-
ally responsible for the correct expenditure and safe custody of any
public moneys or private funds in his charge and for the maintenance
of accounts in accordance with the Financial Regulations, India.
170. Hospital stoppages. —He will be responsible that accounts
of hospital stoppages are prepared and rendered each month to the
Cs.M.A. concerned. The schedule of hospital stoppages is laid down
in P. and A. Regulations, Part II.
171. Patient's money and valuables.—A soldier who is a patient
in hospital is not allowed to have money or valuables in his posses-
sion without the permission of the O.C. the hospital. Any money
other than that authorised or valuables which may be in his posses-
sion on admission to hospital will be taken over by the O.C. hospital
who will give a receipt for them.
36