organizations or stations and under the control of the Medical De-
partment action will be taken by the proper medical officers as
follows: If a soldier is discovered to be a deserter from the Navy
or Marine Corps, paragraph 133 will be complied with; if a soldier
is discharged, final statements will be furnished him; if a soldier
dies, paragraph 162 will be complied with.
1452. Sick or wounded soldiers, discharged while in hospital, will
be entitled to medical treatment in hospital, and to the usual ration
during disability, or for the period considered proper for them to
remain under treatment, but a discharged soldier who has left the
hospital will not be readmitted except upon the written order of
the commanding officer.
MEDICAL DEPARTMENT 423
1453- Recently discharged soldiers, needing hospital treatment,
who arrive in New York City, San Francisco, or other port on
Government transports, may be sent to one of the military hospitals
in the vicinity, and rations in kind drawn for them while undergoing
1454. Tents, clothing, hospital furniture, and other stores used
in the treatment of contagious diseases, will be disinfected or burned
upon the recommendation and under the supervision of a medical
1455. The Secretary of War may, on the recommendation of the
Surgeon General, order gratuitous issues of clothing to soldiers who
have had contagious diseases, and to hospital attendants who have
nursed them, to replace articles destroyed by order of the proper
medical officer to prevent contagion.
1457. Civilian employees at military posts, including employees of
post exchanges, may be furnished the medical supplies prescribed for
them by a medical officer under, such regulations as the Surgeon
General may establish in accordance with law.
1458. A civilian employee on duty at a station where other than
army medical attendance cannot be procured is entitled, when
necessary, to admission to hospital.
1462. The surgeon of a post or command, or the commanding offi-
cer of a general hospital or other sanitary formation, will keep,
account for, and expend the hospital fund, according to the instruc-
tions of the Surgeon General, exclusively for the benefit of the sick
in hospital and of the enlisted men of the Hospital Corps and mem-
bers of the Nurse Corps on duty therein.
1466. When alterations of or additions to hospitals are necessary
the surgeon of the post, after obtaining from the quartermaster an
estimate of cost, will transmit plans and specifications, with proposed
modifications, through military channels, to the Secretary of War.
Similar action will be taken upon quarters for sergeants first class.
1468. Estimates for new construction, betterments, and repairs
in connection with hospitals, Hospital Corps sergeants' quarters,
and other buildings, structures, and systems payable from the appro-
priation for " Construction and repair of hospitals " or " Hospital
stewards' quarters " will be prepared separately, but in the same
424 ARMY REGULATIONS
manner and forwarded at the same time as the estimates pertaining
to other appropriations of the Quartermaster's Corps.
These estimates will be prepared by the quartermaster, to whom
the surgeon will furnish in writing a statement showing the items
When the work has been completed the surgeon will report to
the Surgeon General whether or not it was performed according
to the estimate and will furnish to him a statement showing the
material and balance of allotment remaining. Approved plans or
estimates for construction or repair will be altered only by authority
of the Secretary of War.
1471. At sick call the enlisted men of each company who require
medical attention will be conducted to the hospital or infirmary by a
noncommissioned officer, who will give to the attending medical
officer the company sick-report book containing the names of the
sick. The medical officer, after examination, will indicate in the
book, opposite their names, the men who are to be admitted to hos-
pital and those to be returned to quarters, what duties the latter can
perform, with any other information in regard to the sick which he
may have to communicate to the company commander. The senior
medical officer of the command will make a daily report of the sick
and wounded to the commanding officer.
1473. Medical officers and contract surgeons on duty will attend
officers, enlisted men, contract surgeons, contract dental surgeons,
members of the Nurse Corps (female), prisoners of war and other
persons in military custody or confinement, and applicants for en-
listment while held under observation; also, when practicable, the
families of officers and enlisted men ; and at stations, or in the field,
where other medical attendance can not be procured, civilian em-
ployees. Medicines will be dispensed to all persons entitled to
medical attendance, and hospital stores to enlisted men and hospital
matrons, also to officers at posts or stations where they cannot be
procured by purchase.
1474. Medical officers and contract surgeons at their stations will
furnish medical attendance to officers and enlisted men on the
retired list, but they will not be required to leave their stations for
that purpose. Medicines, dressings, etc., will be supplied to retired
officers and enlisted men from army dispensaries on medical officers'
1487. The routine issue of disinfectants is prohibited.
1488. Damaged or unserviceable medicines, medical books, sur-
gical or scientific instruments and appliances, pertaining to the
Medical Department, will not be presented to an inspector for con-
demnation until authority for so doing has been obtained from the
department surgeon, or, if with a mobilized division, from the
1490. Every officer, enlisted man, or employee of the military
forces of the United States who, in the line of duty, or through dis-
ease contracted in service, shall have lost a limb, or the use of a
limb, will receive once every three years an artificial limb or appli-
ance, or commutation therefor, if he shall so elect, under such
regulations as the Surgeon General of the army shall prescribe. The
money value allowed as commutation is, for a leg, $75 ; for an arm,
foot, and apparatus for resection, $50.
1491. Necessary transportation, including sleeping-car accommo-
dations, required for travel to place where artificial limbs may be
fitted, will be furnished by the Quartermaster's Department, the
cost to be refunded from any money appropriated for the purchase
of artificial limbs.
426 GENERAL MEDICAL ADMINISTRATION
MANUAL FOR THE MEDICAL DEPARTMENT
PART I GENERAL MEDICAL ADMINISTRATION
ARTICLE II EDUCATION AND TRAINING
Field Hospitals and Ambulance Companies
157. A limited number of field hospitals and ambulance com-
panies are maintained in time of peace to provide trained organiza-
tions for duty with the troops when they are on field service and to
afford a means for training officers and men of the sanitary service
in the work of the sanitary field organizations. So far as practi-
cable men trained in these organizations should constitute that por-
tion of the Hospital Corps personnel at posts which is assigned to
units of the divisional sanitary train on mobilization. (See Army
Regulations: Hospital Corps.)
In the training of these organizations special attention should be
given to those elements of field work for instruction in which only
limited facilities are afforded at posts, such as the practical use of
the articles of field equipment, lines of aid, equitation, care of
animals, and use of the pack saddle.
158. The personnel of these organizations in time of peace com-
prise two classes: (i) A permanent cadre, consisting of such num-
ber of noncommissioned officers and men as are deemed necessary
to'maintain continuity of policy and method in instruction ; (2) tem-
porary personnel attached to these organizations for purposes of
(a) Details of organization of field hospitals and ambulance com-
panies are given in Tables of Organization.
163. Records of class work will be kept for each individual in each
subject of the course, preferably upon loose sheets appropriately
ruled or in a blank book adapted to the purpose.
(a) The relative standings of men pursuing the same courses, as
determined by their average monthly standings, will be published
monthly to their respective classes.
164. Privates first class and privates who obtain a final mark of
70 per cent in each subject of the course, will be given certificates of
proficiency on Form 60.
(a) Any man who, after two months' instruction, shows such
MEDICAL DEPARTMENT 427
mental incapacity and inaptitude as to render his further attendance
on this course of instruction useless, will be reported to the Surgeon
General for his action.
(&) Men who fail to attain proficiency in any subject may, in the
discretion of the officer in charge of instruction, be required to go
over the subject again.
165. Enlisted men of the permanent personnel who shall have
taken the prescribed course and obtained certificates of proficiency
will not ordinarily be required to take the course again ; but should
it subsequently appear probable that any such enlisted man, having
a certificate of proficiency, is nevertheless not proficient in one or
more of the subjects, he may be required to take the course therein
once more. If upon the second course the soldier does not show
proficiency, his former certificate will be canceled by writing across
its face the words : " Canceled for failure to qualify in
(naming the subject or subjects) on second course, to ,
19 ." This notation will be signed by the officer in charge of
instruction. Failure to qualify on such second course will be
reported at once to the Surgeon General with a view to securing the
soldier's transfer to post duty, it being the aim of the department to
retain in the permanent personnel only such qualified men as will
be a constant example of efficiency to the men of the temporary
personnel attached for instruction. Should, however, the soldier
taking such second course in whole or in part be again found pro-
ficient a new certificate of proficiency will not be given him, but a
notation of the facts will be made in his descriptive list. A third
course will be required in no case. Lack of efficiency in practical
work after a second course will indicate the necessity of other
measures of discipline.
DISCIPLINE AND DUTIES OF THE SOLDIER
168. Instruction in discipline including character, conduct, mili-
tary bearing, obedience, and general efficiency is to be taken up at
once when the recruit joins the detachment, and never ceases, being
given by commissioned and noncommissioned officers in connection
with the soldier's daily round of duties and continued as long as he
remains in the service.
169. Instruction in the duties of the soldier will cover the Articles
of War, the soldier's handbook, the orders and regulations in regard
to saluting, the granting of indulgences, arrest and confinement, the
428 GENERAL MEDICAL ADMINISTRATION
wearing of uniforms, etc. Besides the few hours of formal teaching
provided for in the first regular winter course in garrison every
opportunity should be taken at all times to impart information in
these various subjects.
BEARER DRILL AND FIELD WORK
170. Instruction in drill and field work will be given throughout
the year for one hour a week. All members of the detachment will
attend it unless excused by the surgeon for some special reason.
(a) This instruction includes all the subjects in Part I of the Drill
Regulations and Service Manual for Sanitary Troops and all the
usual employments of field work, especially
Uses of the first-aid packet.
Uses of other articles of the individual equipment of the Hospital
First-aid treatment of fractures in all regions of the body.
The methods of transporting wounded in peace and in war.
Organization of the ambulance company. Work of the ambulance
company during an action. Establishment of aid and dressing sta-
tions. Collection, care, and transportation of the wounded from
the firing line to the field hospital, with the tagging of patients and
the treating of them as indicated, using first-aid equipment and
Use and care of articles of field hospital equipment.
Pitching and striking tentage and packing field equipment.
171. Full advantage should be taken of the summer marching and
encampment of troops to impart the above instruction.
(a) Occasionally, throughout the year, all available men should
be taken out for marches with and without the litter.
CARE OF ANIMALS AND EQUITATION
172. Men of the Hospital Corps will be instructed in the care of
animals and in equitation as prescribed in Army Regulations and in
WINTER COURSES OF INSTRUCTION IN GARRISON
173. The regular winter courses of instruction in garrison com-
prise a period of 34 weeks from November i to June 30. Acting
cooks will be required to attend those in cooking only. All the other
MEDICAL DEPARTMENT 429
men of the detachment will take the prescribed courses, except
" qualified " men, men excused by the Surgeon General from further
instruction under the provisions of paragraph 1780, and the abso-
lutely necessary attendants in the hospital, such attendants being
detailed as far as practicable from the " qualified " men and those
excused by the Surgeon General. Night nurses, when on duty all
night as such, will be considered " necessary attendants " within the
meaning of this paragraph.
174. The winter courses are as follows :
Course No. i. For privates first class and privates. Subjects:
Duties of the soldier, hours 8; anatomy and physiology, hours 16;
first aid, hours 20 ; nursing, hours 36 ; total, hours 80.
Course No. 2. For selected privates first class and privates.
Subjects: Cooking and diet cooking, hours 12; materia medica and
pharmacy, hours 24; elementary hygiene, hours 8; clerical work,
hours 12 ; total, hours 56.
(a) The following textbooks will be used for study and refer-
ence: Mason's Handbook for the Hospital Corps; Drill Regula-
tions and Service Manual for Sanitary Troops; Manual for the
Medical Department; Army Regulations.
175. Practical performance of the work they are being instructed
in should be required of soldiers pursuing the winter courses. While
theoretical teaching by lectures, demonstrations, and recitations from
textbooks has its place, it should be regarded as a secondary one.
176. The sequence of the subjects will be determined by the de-
partment surgeon, who will consider the climatic and other condi-
tions in his department in arranging the year's instruction.
177. Each subject will be finished before taking up another, and
upon its conclusion an oral examination therein will be held by the
instructor, under the direction of the surgeon.
178. Records of class work in the winter courses will be kept in
a blank book adapted to the purpose. Every soldier taking the
courses will be marked in each subject thereof daily.
(a) Men who obtain a final mark of 70 per cent in any subject
will be classed as "qualified" in that subject. Men who fail to
obtain 70 per cent will be required to take the course the following
year. If they again fail, their names will be reported to the Surgeon
General, who may in his discretion excuse them from subsequent
430 GENERAL MEDICAL ADMINISTRATION
(&) Men who obtain a final mark of 70 per cent in each subject
of one or more of the winter courses will be given certificates of
proficiency therein on Form 6oa.
179. Men who have previously qualified will be examined at the
beginning of the winter courses to ascertain whether they continue
qualified. If a soldier is found still proficient on such examination,
that fact will be noted in his descriptive list and he will be excused
from instruction in that subject; but a new certificate of proficiency
will not be given to him. If, however, he is found deficient in any
subject or subjects he will be required to take the ensuing course of
garrison instruction therein. .
180. The aggregate number of hours of instruction in bearer drill
and field work, in care of animals and equitation, and in the regular
garrison courses given during the period of a return of the Hospital
Corps, Form 47, to each soldier carried thereon, will be noted in the
appropriate column opposite his name on the return.
INSTRUCTION IN THE FIELD
181. In the field special attention should be given to field work, to
include the care of animals, equitation, use of field appliances, camp
sanitation, establishment of lines of aid in battle, etc. In the field
no limit is to be placed on the amount of time to be devoted to this
ARTICLE IV HOSPITALS AND MEDICAL ATTENDANCE
210. Patients will not be transferred from one ward to another
without the authority of the commanding officer of the hospital.
The transfer of a case from one ward to another will be reported to
the office with the next ward morning report of the ward from which
the case is transferred. All that is necessary is to report the patient's
name, rank, company, and regiment or corps, and state the fact that
he has gone from one ward to the other, designating them. No
special form is provided. A memorandum will suffice, or a register
card, Form 52, may be used. Upon the receipt at the office of the
notice of transfer a memorandum thereof will be made on the back
of the register card, which will thus always show what ward the
patient is in.
211. To facilitate and assure the prompt and proper distribution
MEDICAL DEPARTMENT 431
of patients, each ward surgeon will every morning, immediately
after his morning round of the ward, forward to the office a morn-
report of the ward on Form 72, which will be accompanied by
diagnosis slips for new admissions, by all change of diagnosis cards,
by the clinical records of all cases completed in the ward or which
depart from the ward otherwise than by transfer to another ward,
and by the notices of cases transferred to other wards since the
preceding report. The ward morning reports, being of no perma-
nent value, may be destroyed after they have served their purpose.
EFFECTS OF PATIENTS
221. The commanding officer of the hospital is responsible that
due care is observed in safeguarding the money, valuables, clothing,
and other effects of patients admitted to hospital. Money or other
valuables will be" receipted for by the commanding officer or by an
officer designated by him, and, when practicable, deposited in the
hospital safe or in a bank. Enlisted men are forbidden to retain
money or other valuables received from patients for safe-keeping.
(a) In the presence of the patient, or of another enlisted man in
case the patient is unconscious or insane, his clothing and other
effects will be tagged (Form 76) for identification and listed- in
duplicate on the patient's property card (Form 75). This list with
the effects will then be sent to the individual in charge of the store-
room for patient's effects. He will retain the original list and turn
the duplicate in to the record office, or give it to the patient as the
regulations of the hospital may provide. In the smaller hospitals
the duty of caring for patients' effects as outlined above will devolve
upon the wardmaster ; in general or other large hospitals it will be
performed as directed in paragraph 303.
222. The soiled clothing of patients will be washed, before it is
put away, as a part of the hospital laundry (par. 267). When there
is reason to suspect that the clothing is infected such measures of
disinfection as may be necessary to protect the command will be
taken and accounts for the expenses incident thereto will be for-
warded on Form 330, W. D., for settlement, with an explanation of
223. Wh*en the patient goes to duty, is furloughed, or is discharged
from the service, the surgeon will restore his effects and take his
432 GENERAL MEDICAL ADMINISTRATION
224. When the patient is transferred from a hospital his effects
will, if he is able to take care of them, be restored to him. When
he is unable to take care of them, they will be intrusted to the rank-
ing officer or soldier in whose charge the patient is put. A list
of the effects will be furnished to such ranking officer or soldier,
who will give his receipt therefor to the transferring officer. On
arrival at destination said custodian of the effects in transit will
turn them over, with the list, to the commanding officer of the
receiving hospital, and take his receipt therefor.
225. In the event of the death or desertion of enlisted or commis-
sioned patients or of military prisoners in hospital, their effects
will be disposed of in accordance with the provisions of Army
226. The effects of deceased civilian patients, if claimed within a
reasonable time, will be delivered to their legal representatives. If
not claimed within a reasonable time, they will be sold by the hospital
council and the proceeds taken up and accounted for with the hos-
pital fund. Should claim thereafter be made within three years for
the proceeds, the same may on the authority of the Surgeon General
be paid over to the legal representatives of the deceased. A similar
procedure will be followed in the case of effects abandoned by
civilian patients upon their departure from the hospital. Watches,
trinkets, personal papers, and keepsakes of civilians will not be
disposed of as long as there is a fair prospect of rinding their right-
PUBLIC PROPERTY IN THE POSSESSION OF PATIENTS
227. Public property brought into the hospital by the patient will
also be listed in duplicate on his property card, Form 75. If his
disability is so slight as to require treatment for a few days only,
the property will be kept intact, tagged, and restored to him upon
his return to duty, taking his receipt therefor; otherwise, it will,
if practicable, be turned over at once to his commanding officer,
whose receipt should be obtained. If such transfer is not practicable,
the following action will be had : ( i ) The medical officer will take
up on his return the medical property in the soldier's possession and
forward his receipt therefor to the accountable officer ; (2) if the
medical officer is accountable for quartermaster or ordnance prop-
erty, he will take up on his quartermaster or ordnance papers all
MEDICAL DEPARTMENT 433
property belonging to those departments brought in by the patient ;
otherwise he will transfer such property to the nearest representa-
tives of those departments, whose receipts therefor should be ob-
tained; (3) the patient's commanding officer will be immediately
notified by mail of the action taken under (i) and (2). (See also
pars. 640 and 649.)
228. Hospital clothing will be worn by patients only during their
stay in hospital. Each article will be marked as hospital property.
When very sick soldiers are transferred from one hospital to another
the hospital clothing necessary for their comfort may be sent with
them, properly invoiced, and accompanied by a check list, giving the
names of the men in whose possession it is. Under the provisions of
this paragraph, crutches and similar articles may, if necessary, be
similarly transferred with the patient from one post or hospital to
another. (See pars. 496 et seq.)
229. Upon the discharge from service of men permanently dis-
abled, they may retain the surgical appliances then in their use which
are necessary for their comfort and safety, and the accountable
officer will drop the same from his next return of medical property,
submitting a certificate explaining the circumstances as a voucher
for so doing.
DESTRUCTION OF INFECTED PROPERTY
230. Infected clothing and other articles which can be immersed
in boiling water, or otherwise disinfected, without material injury,
should be disinfected and not burned. Articles destroyed to prevent
contagion must be accounted for by the affidavit of the officer
responsible, setting forth fully the circumstances necessitating such
destruction. (See par. 502.)
231. The food supplies for the hospital personnel and patients
consist of rations issued by the Quartermaster Corps, of articles pur-
chased with or derived from the hospital fund (see pars. 248 to