A COMPLETE HANDBOOK
U. S. ARMY AND NAVY
NATIONAL GUARD AND NAVAL MILITIA
CHARLES FIELD MASON
Colonel Medical Corps, U. S. Army
FOURTH EDITION, REVISED
Approved by the Surgeon-Generals of the Army and Navy
WILLIAM WOOD AND COMPANY
WILLIAM WOOD AND COMPANY
PREFACE TO THE SECOND EDITION
IN presenting the second edition of this handbook the author
desires to say that every page has been carefully examined, corrected,
and brought up to date. Many of the parts have been entirely
rewritten and numerous new and improved illustrations inserted.
The general size, plan, and scope of the work remain, however,
CHARLES FIELD MASON.
WASHINGTON, January 31, 1909.
PREFACE TO THE FOURTH EDITION
IN this edition it has been deemed advisable to omit the part
on drill regulations for sanitary troops, and to considerably expand
those on nursing, and those on pharmacy.
The appearance of a revision of Army Regulations and of the
Manual Medical Department since the last edition of this book
was brought out, has required a complete rewriting of those
parts, while all the chapters have been carefully revised, corrected
and brought up to date.
CHARLES FIELD MASON.
WASHINGTON, December i, 1916.
TABLE OF CONTENTS
SANITARY TROOPS IN POST AND FIELD
CHAPTER I PAGE
THE SANITARY TROOPS IN POST 3
Organization of the sanitary troops; instruction; promotion;
duties ; uniform ; rules for hospital administration.
THE SANITARY SOLDIER IN WAR 12
Administration zones. Objects of Medical Department Administra-
tion. Duties of the Medical Department. Personnel. Titles of Med-
ical officers. Insignia. Status of personnel. Organization in war.
The service of the interior. Mobilization camps. Concentration
camps. Camp hospitals. Hospital trains. Rest stations. Hospital
ships. The theater of operations. The zone of the advance. Camp
infirmaries. The ambulance company. The field hospital. The sta-
tion for slightly wounded. The line of communications. Base hos-
pital. Convalescent camp. Contagious disease hospital. Trains,
boats and ships. Sanitary squads. Rest stations. Base supply depot.
Advance supply depot. Evacuation hospital. Evacuation ambulance
company. Administration. Resume.
ANATOMY AND PHYSIOLOGY
THE SKELETON AND JOINTS 37
Bone. Cartilage. Classification of bones. The vertebral column.
The pelvis. Joints. Lower extremity. Thorax. Upper extremity.
THE MUSCLES, CELLULAR TISSUE, AND THE SKIN 48
Muscles, voluntary and involuntary. Action of muscles; the sterno-
mastoid, biceps, diaphragm. The connective or cellular tissue; fat.
The skin and its appendages. Functions of the skin.
CHAPTER III PAGE
THE NERVOUS SYSTEM AND SPECIAL SENSES 53
The cerebro-spinal system ; brain, spinal cord, and nerves. The sym-
pathetic system ; ganglia and nerves. The special senses ; touch, taste,
smell, hearing, and sight.
THE DIGESTIVE APPARATUS 61
The alimentary principles and their uses ; albuminates, fats, starches
and sugars, minerals. The alimentary canal and digestion.
THE BLOOD AND THE CIRCULATORY SYSTEM .- 69
The lymphatic system and its functions. The blood ; its composition
and uses. The heart, arteries, capillaries, and veins. The circulation
of the blood. The special arteries and their compression points. Spe-
THE RESPIRATORY APPARATUS 81
The larynx and vocal cords. The trachea, bronchi, and air cells.
The lungs and pleura. Respiration. Air. Ventilation. Heat regu-
THE EXCRETORY APPARATUS 85
The skin, lungs, and bowels. The urinary organs ; the kidneys,
ureters, bladder, urethra. The urine. The suprarenal glands.
EMERGENCIES, CONTUSIONS AND WOUNDS
How to act in. emergencies ; removal of clothing. Contusions ;
shock and its treatment; treatment of contusions. Wounds, incised,
lacerated, contused, punctured, poisoned, gunshot. Wound infec-
tion; septicemia and pyemia. Treatment of wounds; first-aid
packets. Wounds of the skull, of the chest, of the abdomen, of the
bladder. Bites of insects, of tarantulas, scorpions, and centipedes ;
bites of snakes of rabid animals. Tetanus ; anthrax. Poisoned
CHAPTER II PAGE
HEMORRHAGES , pg
Capillary bleeding; nose-bleeding, bleeding from a tooth socket.
Venous bleeding. Arterial bleeding, primary, intermediate, and sec-
ondary. Treatment of arterial bleeding; compression with the fing-
ers; with the tourniquet; the Spanish windlass. Bleeding from
special arteries; in the upper extremity, the lower extremity, the
neck, the tongue, the lips, the face, the scalp. Bleeding from the
lungs, the stomach, the bowels.
DISLOCATIONS AND SPRAINS 103
Dislocations, definition of; symptoms, diagnosis from fracture and
sprain; treatment. Special dislocations; shoulder, lower jaw, fingers,
Sprains; definition; symptoms, treatment. Sprained ankle.
FRACTURES . . . 108
Fractures, definition of ; compound, simple, comminuted, compli-
cated, impacted, green-stick; causes of; symptoms. Treatment; of
simple fractures; setting, splinting; of compound fractures. Healing
of fractures. Splints. Special fractures; of the skull, spinal column,
ribs, pelvis, nasal bones, lower jaw, clavicle, arm, forearm, meta-
carpals, fingers, thigh, knee-cap, leg, foot.
FOREIGN BODIES 119
In the eye. In the ear. In the nose ; maggots in the nose. In the
throat. In the air passages. In the stomach and intestines. In the
THE EFFECTS OF HEAT AND THE EFFECTS OF COLD 122
Heat-stroke. Heat exhaustion. Burns and scalds ; burns from cor-
rosive acids and caustic alkalies. General freezing. Frost-bite.
INSENSIBILITY AND FITS 126
Fainting. Concussion and compression of the brain; apoplexy.
Lightning stroke. Electric shock. Acute alcoholism. Epilepsy.
Bright's disease of the kidneys. Opium poisoning.
CHAPTER VIII PAGE
Forms of asphyxia; causes, treatment. Artificial respiration;
Scbaefer's method, Marshall Hall's method. Drowning.
Caustic acids. Caustic alkalies. General management of cases of .
poisoning. Emetics, antidotes, combating the tendency to death.
Special poisons; phenol (carbolic acid), wood-alcohol, food-pois-
oning, ptomaine poisoning, "knock-out drops" (chloral), arsenic,
corrosive sublimate, nitrate of silver, phosphorus, strychnine.
Skin poisons ; poison-ivy, poison oak, poison sumach.
THE WARD 141
Wards in post hospitals ; arrangements, heating, and ventilation.
Field hospital wards. The wardmaster. Night nurse. Ward clean-
WARD MANAGEMENT 147
The new patient. Serving diets. Administering medicines. The
use of the hypodermic. Dying patients. Care of the dead. Autop-
BEDS AND BED-MAKING 152
The hospital bed ; its preparation ; changing bed linen. Changing
the bed. Changing the mattress. Beds for operative cases. Fracture
beds. The bed-rest. Air and water mattresses. Bed sores.
BATHS AND BATHING 157
Purposes for which baths are given. Classification of baths.
Sponge baths. Sedative bath. Hot-water baths. Hot-air and steam
baths. Cold baths. The Brandt System. The cold sponge. Bed
tub-bath. Alcohol bath. Bakes. Electric light bath. The foot bath.
CHAPTER V PAGE
ENEMATA, IRRIGATIONS, DOUCHES, CATHETERIZATION, ETC 163
Enemata, classification of. Laxative enema ; nutrient enema;
medicinal enema. Irrigation.
Urethral injections. Douches; spinal; nasal, eye, ear. Catheteriza-
tion. Irrigation of the bladder. Catheterization of the ureter.
EXTERNAL APPLICATIONS 169
Hot-water bags, bottles, etc. Poultices. Stupes. Cold compresses.
The ice bag. Ice-water coil. Mustard plaster. Liniments. Dry
cups. Biers' cups. Blisters. The Paquelin cautery. Lunar caustic.
Blue stone. Nitric acid.
TEMPERATURE, PULSE, AND RESPIRATION 175
Normal and subnormal temperature. Fever ; classifications of
fevers. The clinical thermometer. Charting temperature. The
pulse; varieties of. Respiration; varieties of. Pulse, respiration, and
SYMPTOMS AND CLINICAL RECORD 179
Symptoms; subjective, objective, feigned; the attitude and ex-
pression ; mental conditions ; the eyes ; the hearing ; the skin ; the
tongue, mouth, and teeth ; cough ; the appetite ; vomiting ; the stools ;
suppression, retention, and incontinence of urine; cough; hiccough;
pain; hallucinations and delirium; sleep. Clinical records; history,
BANDAGING . 185
The triangular bandage and its application to various parts of the
body; the slings. The roller bandage; sizes; method of rolling;
rules for applying; the figure of eight; the spica; the knotted turn;
recurrent of the head; recurrent of a stump; application to various
parts of the body. Flannel and rubber bandages. Fixed bandages;
INFECTION AND DISINFECTION 200
Definition. Disinfectants; dry heat, flowing steam; boiling water,
corrosive sublimate, phenol, cresol, quick-lime, chlorinated lime,
formalin, sulphur. Prevention of spread of infectious diseases. Dis-
infection of sputum, feces, urine, vessels, infected clothing, bedding,
beds, rooms, tentage.
CHAPTER XI PAGE
INSTRUMENTS AND APPLIANCES 208
Description of the ordinary instruments and appliances. Special
appliances and apparatus of the medical department of the army;
compressed air apparatus ; electric batteries ; restraint apparatus ;
steam sterilizing apparatus; aspirating case, emergency case. Diag-
nosis tags. Field equipment; desk; food box; commode chest;
acetylene chest; regimental combat equipment; mess chest.
THE OPERATING-ROOM AND SURGICAL NURSING 242
The bacteria of surgical infection. Toxemia, septicemia, and pyemia.
Preparation of the patient for operation ; after-care ; dressing.
Preparation in the operating-room. The sterilizer. Sterilization of
instruments, trays, dressings, sutures, and ligatures; metal and glass
syringes ; rubber goods, web catheters ; water. Normal saline solution.
Drains. Disinfection of the hands and field of operation. Care of
instruments, etc., after the operation. Operations in the field.
NURSING IN THE INFECTIOUS DISEASES. How INFECTIONS SPREAD. VAC-
CINES AND ANTITOXINS. TYPHOID VACCINATIONS 252
Typhoid fever. Dysentery. Cholera. Malaria. Yellow fever.
Cerebro-spinal meningitis. Gonorrhea. Chancroid. Syphilis. Pul-
monary tuberculosis. Pneumonia. Influenza. Follicular tonsillitis.
Diphtheria. The eruptive fevers. Mumps. Erysipelas. Wound
infections. Plague. Typhus.
MESS MANAGEMENT AND COOKING
MESS MANAGEMENT 259
The mess; sources of supply in post and field. The rations. The
COOKING . . . 2 55
The kitchen. Effect of cooking on foods. Boiling, stewing, soup-
making, roasting, baking, broiling, frying. Bread-making.
CHAPTER III PAGE
Liquid diets. Semisolid or light diets. The hospital stores. The
rations. Approximate measures.
MATERIA MEDICA AND THERAPEUTICS AND PHARMACY
MATERIA MEDICA AND THERAPEUTICS 287
Drugs ; active principles ; classification. Administration of medi-
cines; dosage. Army and Navy supply tables.
Definitions. Pharmaceutical operations. Official and non-official
preparations. Directions for making emulsions, pills, ointments,
powders, and suppositories. Weights and measures. Filling prescrip-
HYGIENE. POST AND CAMP SANITATION
Daily allowance. Surface and ground waters. Purification of
water; the Lyster sterilizing bag; the Darnall siphon-filter; other
processes. Waterborne diseases. Collection of samples.
AIR AND VENTILATION 343
Composition of air; impurities. Floor space and cubic air space.
Ventilation; natural and mechanical. Heating by stoves, furnace,
hot water, steam.
THE DISPOSAL OF WASTES 349
Disposal in posts ; by pits, pans, water carriage. House drainage.
Bacterial methods for purification of sewage. Disposal in the field;
with moving commands; construction of sinks; in fixed camps; gar-
bage; cremations. Sanitation of camps.
CHAPTER IV PAGE
DISEASE PREVENTION 355
Typhoid, malarial, and yellow fevers, and their transmission by
insects. Diarrhea. Dysenteries. Eruptive fevers; vaccination and
SANITATION IN THE FIELD 364
Camp sites. Tents. Water supply. Care of the feet. Charing.
PERSONAL HYGIENE 367
Cleanliness. Dhobie itch. Teeth; hair. Clothing. Venereal dis-
ease. Alcoholism. Food and drink. Exposure to the sun. Chilling
RIDING, PACKING, AND DRIVING
RIDING 37 1
The equipment of the horse. Riding without and with the saddle.
PACK SADDLE AND PACKING 389
The Medical Department pack outfit; to use.
The escort wagon. The army wagon. The ambulance. Harness.
Care of animals, wagons, and harness in the field.
ARMY RECUATIONS 413
Medical Department. Hospital Corps. Garrison Service. Field
Service. General Hospitals. Service of Hospitals. Hospital Build-
ings. Sick Call. Medical Supplies. Artificial Limbs. Manual for
the Medical Department. Field Hospitals and Ambulance Compa-
nies. Hospital Corps Detachments. Analyses of Water. Reports,
Returns, and Records. Hospitals and Medical Attendance. Service
of Hospitals, general. General Hospitals. Supplies and Materials.
The Sanitary Service in War.
CLERICAL WORK PAGE
CLERICAL WORK 459
List of reports rendered daily, trimonthly, monthly, bimonthly,
quarterly, semiannually, annually, occasionally; on breaking up of
hospital; on being relieved of medical property. List of Records.
ANESTHESIA, GENERAL AND LOCAL 467
General anesthesia; preparation for; ether; chloroform. Anes-
thesia in the tropics. Local anesthesia; ethyl chloride; cocaine;
eucaine; Schleich's method. Spinal anesthesia.
ASSISTING AT OPERATIONS. MINOR OPERATIONS 472
Preparation for operation. Handling instruments. Sponging.
Incised wounds ; suturing. Contused and lacerated wounds. Boils.
Carbuncles. Felons. Abscesses. Gum-boils. Ulcers. Piles.
MINOR OPERATIONS, CONTINUED 476
Subcutaneous saline infusions. Rectal continuous saline infusion.
Intra-venous infusions; salvarsan. Antitoxin injections. Acupunc-
ture. Aspiration. Lumbar puncture. Mercury injections for syphilis.
Taking blood specimens. Use of the stomach tube. Forced feeding.
Introduction of metallic catheters and sounds into the bladder.
Hernia and trusses. Toothache and tooth extraction. Electric bat-
ADHESIVE PLASTER, STRAPS AND STRAPPING 485
To retain splints. Extension in fracture of the thigh. Strapping
for fracture of the ribs. Sayre's strapping for fractured clavicle.
Strapping a swollen testicle. To draw wound edges together.
Removal of adhesive plaster.
A COMPLETE HANDBOOK
U. S. ARMY AND NAVY
NATIONAL GUARD AND NAVAL MILITIA
THE SANITARY TROOPS IN POST
THE Medical Department consists of one Surgeon General, chief
of said department, a Medical Corps, a Medical Reserve Corps tem-
porarily, a Dental Corps, a Veterinary Corps, an enlisted force
(Sanitary Troops), the Nurse Corps and contract surgeons.
The enlisted force of the Medical Department consists of the fol-
lowing personnel : Master hospital sergeants, hospital sergeants, ser-
geants (first-class), sergeants, corporals, cooks, horseshoers, sad-
dlers, farriers, mechanics, privates (first-class), and privates. Master
hospital sergeants are appointed by the Secretary of War, but no
person can be appointed master hospital sergeant until he shall have
passed a satisfactory examination under such regulations as the
Secretary of War may prescribe before a board of one or more
medical officers as to his qualifications for the position, including
knowledge of pharmacy, and demonstrated his fitness therefor by
service of not less than twelve months as hospital sergeant or ser-
geant, first class, Medical Department, or as sergeant, first class, in
the Hospital Corps; and no person may 'be designated for such
examination except by written authority of the Surgeon General.
Original enlistments for the Medical Department are made in the
grade of private, and reenlistments and promotions of enlisted men
therein, except as hereinbefore prescribed, and transfers thereto from
the enlisted force of the line or other staff departments and corps
of the Army are governed by such regulations as the Secretary of
War may prescribe. The total number of enlisted men in the Medical
Department should be approximately equal to, but not exceed,
except as hereinafter provided, the equivalent of five per centum
4 SANITARY TROOPS IN POST AND FIELD
*^ ' |
of the total enlisted strength of the Army authorized from time to
time by law but in time of actual or threatened hostilities, the Secre-
tary of \Yar is authorized to enlist or cause to be enlisted in the
Medical Department such additional number of men as the service
may require. The number of enlisted men in each of the several
grades designated below may not exceed, except as hereinafter pro-
vided, the following percentages of the total authorized enlisted
strength of the Medical Department, to wit : Master hospital ser-
geants, one-half of one per centum ; hospital sergeants, one-half of
one per centum ; sergeants, first class, seven per centum ; sergeants,
eleven per centum ; corporals, five per centum ; cooks, six per centum ;
privates, first class, forty-five per centum, and privates, nine per
centum. The number of horseshoers, saddlers, farriers, and me-
chanics may not exceed one to each authorized ambulance company
or like organization.
Enlisted men may be transferred from the line to the medical
department as privates. Married men are not accepted as recruits,
nor transferred from the line for service in the department. Can-
didates for enlistment should apply to a post medical officer or to a
recruiting officer. Applicants who have graduated in pharmacy,
or who have had training as nurses in civil hospitals, should present
certificates of their special qualifications. Slight physical defects
which, under existing orders, would disqualify for the line, do not
disqualify for enlistment in the department, provided they are not
of such a character as would interfere with the full performance
of the duties of a sanitary soldier in garrison or in the field. If a
candidate is accepted he is forwarded to a company or detachment
for instruction in; i. Discipline and the duties of a soldier; 2. Care
of animals and equitation; 3. Bearer drill and field work; 4. Anat-
omy and physiology; 5. First aid and personal and camp hygiene,
including the sterilization of water and disinfection; 6. Nursing;
7. Army Regulations ; 8. Cooking ; 9. Materia medica and pharmacy ;
10. Elementary hygiene; n. Clerical work. All privates are in-
structed in the first six subjects, and those who show special aptitude
take the complete course.
Instruction in the first three subjects is continuous throughout
the year; the other subjects are included in the regular winter course
of instruction covering a period of thirty-four weeks.
Field hospital and ambulance companies maintained in time of
THE SANITARY TROOPS IN POST 5
peace are also utilized so far as practicable in teaching recruits the
work of the sanitary field organizations. The course of study
taught recruits while with these organizations is supplemented by
practical instruction at posts and in the field after their assignment
to other commands.
The course for noncommissioned officers comprises the following
subjects: Sanitary administration, pharmacy, clerical work, minor
surgery, mess management and Army Regulations. Privates, first
class, and privates who are candidates for appointment as noncom-
missioned officers are required to take this course ; and in addition
the regular course prescribed for their grades, or any part of it, if
deemed necessary by the officer in charge of instruction.
Privates, first class, or privates who have shown special proficiency
may be recommended for promotion by the surgeon. To test their
capacity for performing the duties of a noncommissioned officer,
they may be first detailed as lance corporals. Before being appointed
sergeants they must pass an examination as to (i) Physical con-
dition; (2) character and habits, especially as to the use of stimu-
lants and narcotics; (3) discipline and control of men; (4) knowl-
edge of regulations; (5) nursing; (6) dispensary work ; (7) clerical
work; (8) principles of cooking, and mess management; (9) Hos-
pital Corps drill; (10) minor surgery and first aid, including extrac-
tion of teeth. The board will require the candidate to prepare a
full set of papers pertaining to the medical department, and to drill
a detachment sufficiently to demonstrate his thorough knowledge
of the drill regulations.
The written examination will embrace the following subjects :
(i) Arithmetic; (2) materia medica; (3) pharmacy; (4) care of
sick and ward management; (5) minor surgery and first aid; (6)
elementary hygiene. Ten questions will be asked in each subject.
Proficiency in penmanship and orthography will be estimated from
the papers submitted.
Sergeants who have served a year as such, or enlisted men of the
hospital corps who served as hospital stewards of volunteers or acted
in that capacity for more than six months during and since the
Spanish-American war, may be appointed sergeants, first class, upon
the recommendation of the Surgeon General, provided they have
successfully passed a more extensive and detailed examination in
the above subjects than is required for promotion to the grade of
6 SANITARY TROOPS IN POST AND FIELD
sergeant. A reexamination before his first reenlistment may not be
required if his commanding officer and the department surgeon con-
cur in the statement that the candidate has performed his duties
efficiently; but a reexamination is called for before a second re-
enlistment, after which no fuither examination is ordinarily
Army Regulations provide, for at least one noncommissioned
officer and four privates at each permanent military post, with an
additional noncommissioned officer for every additional four
privates; six privates when the garrison is two hundred, and two
privates additional for every additional one hundred of strength.
The uniform for ordinary wear is the same as that of the line
except that the facings are of maroon-colored cloth and that the
caduceus is the emblem of the corps. Privates, first class, are dis-
tinguished from privates by wearing a caduceus upon the sleeves
of the blouse above the elbow. For duty in the wards, kitchen, dis-
pensary, and operating-room a uniform of white cotton duck is
The duties of the sanitary troops in time of peace are chiefly con-
cerned with the care of the sick, sanitation and preparation for war ;
that they are many, varied, and important may be gathered from the
scope of the scheme of instruction detailed in the following pages.
The peace hospitals of the army are of three classes, post hospitals,
department hospitals, and general hospitals; post and general hos-
pitals are distinguished from each other by the fact that the former
usually receive only the sick of the post to which they belong, while
the general hospitals receive the sick from widely separated com-
mands. Some of the general hospitals are of a special nature, such
as that of Fort Bayard for the treatment of tuberculosis, and the
general hospital at Hot Springs, Arkansas, for the treatment of cases
requiring a course of bathing.
Department hospitals correspond in all respects to general hos-
pitals except that they are under the control of the Department