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Charles Field Mason.

A complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia online

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262), and of products of the hospital garden.

235. Each ward surgeon will, every morning, immediately after

the first round of his ward, fill out a diet card, Form 73, covering the

diet requirements of his patients for the ensuing 24 hours. Bills of

fare for regular, light, and liquid diets should be made OUt and

28



434 GENERAL MEDICAL ADMINISTRATION

posted in the wards and kitchens. Additional articles not included
in these diets are to be ordered for special cases only.

(a) The diet cards from the wards will be sent promptly to the
hospital office, where the necessary card or cards will be made out
covering the meals of the hospital personnel. All the cards will
thereupon be turned over to the noncommissioned officer in charge
of the mess in season for his action toward the preparation of the
day's dinner. Additional cards for newly admitted patients or newly
arrived personnel will be made out promptly when necessary and
sent to the noncommissioned officer in charge of the mess without
delay. The diet cards may be destroyed after they have served their
purpose; usually they will have no value beyond the day of their
date and the following day.

236. Each hospital mess will be placed under the immediate charge
of a competent noncommissioned officer.

(a) It will be his duty to receive and care for all articles of food
for the mess, and he will be held responsible for their proper dis-
position. He should be provided with suitable apparatus for pre-
serving perishable foods and a suitable storeroom for the balance,
and should secure them by proper locks. He will issue daily from
the stores to the kitchen the articles required by the diet cards and
will see that the food is cooked as indicated thereon. He will keep
such record of his receipts and issues as the surgeon may prescribe
according to the needs of the particular hospital, no special form
therefor being provided. He will be responsible for the condition
and cleanliness of the kitchen and cooking utensils, and the kitchen
force will respect his orders accordingly. He will be responsible
also for the cleanliness and discipline of the messroom, the service
of the meals therein, and the distribution of food to wardmasters
for patients unable to leave the wards ; and for the cleanliness of
the napery and table utensils used in serving the food. He will see
that table clothing and utensils used for patients suffering from
infectious diseases are properly disinfected before being returned to
the storerooms for further use. He will be provided with a suffi-
cient number of assistants to assure the prompt and efficient per-
formance of these duties.

237. A mess account on Form 74 will be kept by the noncom-
missioned officer in charge. It should be filed at the end of every
month with the retained hospital fund papers for that month. In-



MEDICAL DEPARTMENT 435

ordinate gains in the plus column would indicate undue economy in
the diet, while, on the other hand, continual losses in the minus
column would signify mismanagement of the hospital fund or im-
proper care of the food supplies. The commanding officer of the
hospital should inspect this record at frequent intervals, with a view
to keeping constantly informed in this respect.

(a) When there is more than one mess, a consolidated mess
account on the same form for the entire hospital should be kept in
the office, the noncommissioned officers in charge of the several
messes being required to report daily the data therefor.

238. For methods of preparing food for both sick and well, refer-
ence should be had to the authorized Handbook for the Hospital
Corps and the Manual for Army Cooks.

DISPENSARY MANAGEMENT

240. All prescriptions will be written in the metric system. They
will be placed on file in three separate files, as follows: (i) Pre-
scriptions for alcohol or alcoholic liquors and for medicines con-
taining opium or any of the salts, derivatives, or preparations of
opium or coca leaves. (2) Prescriptions for civilians which do not
include articles of the preceding class. (3) All other prescriptions.
Prescription files will be subject to inspection by inspectors and post
commanders at all times.

(a) In connection with file (i) a record will be kept of the dis-
pensary receipts and expenditures of each article specified therein.
Unless otherwise authorized by the Surgeon General, this record
will be made on blanks of Form i;a, adapted as may be necessary
to the purpose. A separate slip will be kept for each form in which
the liquor or drug is supplied, as " Morphinae sulphas, powder," and
" Morphinae sulphas, lomgm. hypo, tablets." The date of receipt
thereof from the storeroom will be noted in the left-hand column
and the amount, in the proper metric unit, in the debit column.
The expenditures will be noted by entering the prescription number
in the left-hand column and the amount expended in compounding
the prescription in the credit column. At least once a month the
slips will be balanced and the quantities remaining on hand will be
verified by a medical officer and the facts noted over his signature. ^

241. Active poisons, alcohol, alcoholic liquors, and all
forming drugs will be kept under lock and key in a separate closet.



436 GENERAL MEDICAL ADMINISTRATION

242. Civilian employees of the Army stationed at military posts
may purchase medical supplies when prescribed by a medical officer.

(a) Medicine charges for employees not in hospital will be as
follows: In ordinary cases, 25 cents for each prescription; in the
case of rare and expensive medicines, dressings, appliances, etc., at
such increased rate, to be determined by the surgeon, as will reim-
burse the United States their cost.

(&) Medicine charges for civilian employees in hospital are fixed
at 25 cents a day in Army Regulations.

HOSPITAL FUND

248. The hospital fund is derived

(1) From commutation of rations of patients and members of the
Nurse Corps.

(2) From savings on rations of the Hospital Corps.

(3) From dividends from post exchange.

(4) From dividends from post garden.

(5) From money received for the subsistence of officers and civil-
ians treated in hospital.

(6) From sales of property purchased with hospital fund (par.
259), or products pertaining to the hospital fund (vegetables from
hospital garden, etc.).

249. In addition to the post exchange dividends due the hospital
detachment, the exchange council, with the approval of the com-
manding officer, shall determine the amount, if any, to be turned
over to the surgeon for the sick in hospital. (See Appendix: Post
Exchange Regulations. )

251. The hospital fund is regarded as a company fund, and is
applicable generally to similar purposes, in the interest of enlisted
men of the Hospital Corps, and of the sick under treatment and
members of the Nurse Corps on duty in military hospitals.

254. The officer commanding the hospital will see that due economy
in expending the fund is observed, and that expenditures are not
made for improper purposes. Receipts will be taken for all pay-
ments.

255. Gratuities to hospital cooks and assistant cooks may be au-
thorized by department surgeons or the Surgeon General when the
amount of the hospital fund on hand justifies such expenditure.

(a) A gratuity of not exceeding $10 a month may be paid from



MEDICAL DEPARTMENT 437

the hospital fund to the hospital gardener, when authorized by the
department surgeon or the Surgeon General.

(b) Vouchers for gratuities will cite upon their face the date and
source of the authority for paying them.

ICE FOR HOSPITALS

263. The chief use of ice in hospitals is as an article of food or for
the preservation of food. For such use it should be obtained from
the Quartermaster Corps, from the ice plant, if one is available, as
provided in existing orders (see Appendix: Ice}, or as an issue
under Army Regulations, when authorized; or by purchase from
the hospital fund.

264. Ice required for medical administration proper, such as for
ice baths of the sick, for medical photographic work, etc., should be
procured from the Quartermaster Corps ice machine, if one is avail-
able, or be obtained by purchase at the cost of the medical and hos-
pital appropriation. Routine purchases of ice for medical purposes
will not be made without the previous authority of the Surgeon
General, or, in the Philippine Department, of the department sur-
geon. Accounts for emergency purchases will invariably be accom-
panied by a separate statement of their necessity. Accounts for
ice for medical work will be stated on Form 330 or Form 3300,
W. D., will show in the officer's certificate (taking care not to
encroach upon the approval space to the right of the $ sign) or on
the blank fold on the back of the form, specifically what the ice was
for as, e. g., for use in the treatment of sick in hospital, for use
in developing photographic negatives for identification work, etc.
and will be forwarded, with one invoice of articles purchased, Form
12, to the department surgeon, or if from a command under the
immediate supervision of the War Department, to the Surgeon
General, unless otherwise directed by him.

HOSPITAL MATRON

265. Authority for the employment of hospital matrons is given
by section 1239, Revised Statutes. Their compensation of $10 a
month and a ration in kind or by commutation is established by
sections 1277 and 1295.

266. It is the duty of the hospital matron to mend and keep in



438 GENERAL MEDICAL ADMINISTRATION

repair the table, hand, and operating linen, the bedding and the
hospital clothing belonging to the Medical Department, including the
linen of the dentist's office, and to do the hospital laundry, or so
much thereof as possible up to a minimum of 500 pieces a month,
from time to time, as the same may be required by the surgeon.

(a) In the case of matrons on duty at the larger posts and at
general hospitals the Surgeon General may modify or waive so much
of this provision as requires the laundering of a minimum of 500
pieces of hospital linen a month in addition to all the mending.

267. The hospital laundry comprises: First, the linen, clothing,
and bedding belonging to the Medical Department, as above enu-
merated; second, the washable clothing of patients admitted to hos-
pital, which requires cleansing before it can be put away (par. 222) ;
third, the white coats and trousers of the enlisted attendants (par.
470) ; fourth, the uniforms (par. 93) of the Nurse Corps soiled
while on public duty.

(a) Soiled blankets, spreads, and other heavy pieces should not
be allowed to accumulate, but should be washed a few at a time as
they become soiled, so as to equalize the matron's work.

268. The compensation of the matron being fixed by law, no extra
compensation for performing any of the duties incident to her em-
ployment can be allowed, nor can other persons be employed at the
expense of the United States to do her work or any part of it.

(a) Matrons are forbidden to farm out their work to other
persons.

(&) Matrons are not entitled to leaves of absence or to pay and
rations while absent or while unable to perform their duty.

(c~) Matrons who are unable or unwilling to meet these require-
ments should be discharged.

269. When the number of pieces to be laundered is more than the
matron can do (having in mind the minimum of 500 pieces a month
above required) the excess may be put out under the provisions of
paragraphs 270 to 278. When it would be an economy and advan-
tage to put the entire laundry out instead of the excess only, the
facts should be reported to the department surgeon for his informa-
tion with a view to obtaining the necessary instructions and au-
thority for further action. For the purpose of this report the
matron's total compensation, including pay and allowances, is re-



MEDICAL DEPARTMENT 439

garded as equivalent to $18 a month, of which $3 may be taken as
for the mending, and the balance, $15, for the laundering.

LAUNDRY WORK NOT DONE BY MATRONS

270. The excess laundry at hospitals where there are matrons and
the entire laundry at other hospitals (except those with laundry
plants or otherwise provided for under special instructions from the
Surgeon General) may be put out to private laundries. When com-
petition is not had the responsible officer will ascertain the lowest
prices current in the vicinity for good hand or machine work and
govern his action accordingly.

271. Individual laundrymen and laundresses may be employed
under this authority without advertising for proposals, provided
they do the work in person, the same being regarded as personal
services within the meaning of section 3709, Revised Statutes. The
vouchers will bear a notation showing that the work was done by
the creditor in person.

278. Vouchers for laundry at a hospital where there is no matron
will contain in the officer's certificate the notation " No matron at
post."

(a) Vouchers for excess laundry at a hospital where there is a
matron will be accompanied by a statement showing the matron's
name, the kind and number of pieces laundered by her and put to
hire, respectively, during the period covered, and by a certificate
that she was unable to do any of the laundry put out. These will
be separate from the vouchers, which should contain no reference
thereto.

GENERAL HOSPITALS

Officer of the Day

297. The officer of the day will be assigned to duty for a tour of
24 hours, during which he will always be accessible for cases of
emergency and to meet the requirements of the duties hereinafter
stated. He will be notified by the adjutant of his selection for duty
on the day preceding that on which his tour begins. He may be
required to perform his regular duties when they will not conflict
with the performance of his duties as officer of the day.



440 GENERAL MEDICAL ADMINISTRATION

298. Three noncommissioned officers will ordinarily be detailed
permanently as assistants to the officer of the day, and there will
be at all times one noncommissioned officer and one private on duty
in his office. The noncommissioned officers will report to the officer
of the day at the beginning of their respective tours of duty and
will in no case leave the office until the arrival of their relief.

299. At an hour to be designated in hospital orders the old and
the new officers of the day will report to the commanding officer,
the old officer of the day to render his report, the new officer of
the day to receive such instructions as the commanding officer may
wish to give. At the expiration of his tour of duty the officer of
the day will report in writing to the commanding officer the hours
at which the prescribed inspections were made; any breaches of
discipline, infraction of the hospital rules, neglects or disorders that
may have occurred during his tour of duty; and any other occur-
rences which should properly be brought to the attention of the
commanding officer.

300. The officer of the day will make a general inspection of the
hospital at such hours as the commanding officer may direct. Dur-
ing this inspection he will note any disorder or neglect and, if prac-
ticable, will immediately correct the same. He will satisfy himself
that the watchmen or guards are familiar with their duties and are
performing them satisfactorily. During his tour of duty he will
inspect at least one of the meals served in each hospital mess. He
will receive the reports of the roll calls required by orders. On the
outbreak of fire he will assume charge until the arrival of the fire
marshal or of the senior officer present at the hospital. In the
absence of the ward surgeon he will examine the body of any patient
who may die during his tour of duty and order its removal to the
morgue, notifying the adjutant of his action.

301. The officer of the day will examine and admit all incoming
patients. If the officer of the day is temporarily unavailable, the
noncommissioned officer on duty in the receiving office will notify
the adjutant of the arrival of patients, and the adjutant will act
in his stead or designate another officer to act temporarily as sub-
stitute for the officer of the day until he is again available. In no
case will a patient be admitted and assigned to a ward until he has
been seen and examined by the officer of the day or some regularly
designated substitute.



MEDICAL DEPARTMENT 441

(a) If there is any doubt as to the ward to which he should be
assigned the patient will be held in the receiving ward for disposi-
tion by the chief of the medical service. The officer of the day will
receive money and valuables from patients on admission and will
turn them over to the registrar for safe keeping. An attendant from
the receiving office will conduct incoming patients to the wards to
which they have been assigned, care for their baggage and equip-
ment, and turn over to the wardmaster the patient's admission slip.
(See par. 209.)

302. The noncommissioned officers on duty with the officer of the
day will keep a card index of patients in hospital and will enter
gains and losses on the morning report of sick. (Form 71.)

303. Upon the admission of a patient to hospital the noncommis-
sioned officer will secure his effects, other than money and valuables,
list them in duplicate on the patient's property card (Form 75),
tag them for identification (Form 76), and turn them over to the
noncommissioned officer in charge of the store room for patients'
effects. The latter will sign both lists, retain one of them and
return the other, which will be filed in the registrar's office. Upon
the departure of a patient from hospital the wardmaster will notify
the noncommissioned officer on duty, who will obtain the list of the
patient's effects from the registrar's office, and upon their delivery to
the patient obtain his receipt, which will be returned to the registrar's
office for file. (See par. 221.)

304. All public property left by patients at the hospital will be
turned over to the quartermaster, who will dispose of it as indicated
in paragraph 227.

305. In time of peace the noncommissioned officer on duty will
have charge of the Hospital Corps men on duty as watchmen. He
will satisfy himself that they have been properly instructed and
understand their orders. He will maintain quiet and order in the
hospital and will notify the officer of the day of any unusual
occurrence.

306. In time of peace the hospital will be guarded by Hospital
Corps men detailed as watchmen under the officer of the day and
his noncommissioned assistants. In time of war the necessary
guard will ordinarily be performed by a permanent detail of sani-
tary troops, and for this purpose the Hospital Corps personnel will
be increased.



442 GENERAL MEDICAL ADMINISTRATION

(a) When this detail from the sanitary troops is not available the
necessary guard may be obtained on request from the department
commander. When the commander of such a guard is a commis-
sioned officer he will confer with the commanding officer of the
hospital as to the character of the guard duty desired by the latter,
but will exercise no control over the sanitary formation. If such
a guard is not accompanied by a commissioned officer it will be
reported by the noncommissioner officer in charge to the command-
ing officer of the hospital and will be placed under the immediate
command of the officer of the day.



ARTICLE V DEPARTMENT LABORATORIES

Water

357. The specimens should, when practicable, be collected by a
medical officer. If the water to be examined is delivered through
pipes or is pumped from a well or cistern, the local supply pipe and
all pump connections should be emptied by allowing the water to
run for 15 minutes before taking the samples.

358. Bacteriological examinations. Samples of water for bac-
teriological examination should be collected in bottles furnished for
the purpose. Each bottle is sterilized before leaving the laboratory,
and the glass stopper is protected by a piece of heavy sterilized mus-
lin securely wired to the neck of the bottle. The stopper should not
be removed until immediately before the bottle is filled.

(a) In taking specimens from a faucet or pump (after emptying
the supply pipes and connections conformably to par. 357) a small,
gentle stream should be allowed to flow, the stopper taken out, the
bottle grasped near the bottom, held in an upright position, and the
stream permitted to flow into the bottle until it is filled to the
shoulder. The stopper should then be replaced; both it and the
cloth should be secured by carrying the wire several times around
the neck of the bottle and twisting the ends tight. The stopper must
be handled only by the square cloth-covered top. The lip of the
bottle must not be brought in contact with the faucet or spout, nor
should the neck of the bottle or naked part of the stopper be per-
mitted to come in contact with any object during the manipulation.



MEDICAL DEPARTMENT 443

The projecting flange is designed to protect the plug of the stopper,
which it will do if the stopper, after withdrawal, is held by the top
in a vertical position. The stopper should not be laid down and the
cloth should not be handled by the ringers except in the act of secur-
ing the wire about it. When well water is to be examined the
bottle should be filled directly from the bucket constantly in use for
drawing the water, and from no other vessel.

(&) On account of the labor involved and the possibility of error,
bacteriological examinations of water collected in any other than the
prescribed receptacles will not be made.

(c) Each package should be plainly marked to show the source
from which the sample is taken and the date of collection.

(d) The case should be marked, " Water for bacteriological ex-
amination," and it should be forwarded by mail at the earliest
moment. (See par. 3550.)

359. Chemical examinations. The quantity of water forwarded
for chemical examination should be not less than 3 liters. The
receptacles for transporting it should be chemically clean, and all
vessels used in its collection should be as clean as it is possible to
make them.

(a) Glass-stoppered bottles of suitable size are best adapted for
the preservation of a sample of water in its original condition. In
pouring the water into bottles it should not come into contact with
the hands of the operator or with anything not essential to the
operation. Bottles should be filled to within an inch of the stop-
pers; the stoppers should be carefully rinsed and inserted and
secured with a canvas cover tied tightly around the neck of the
bottle. Sealing wax or similar material should not be used to secure
the stoppers.

(&) If no proper receptacles are available at the post or camp suit-
able bottles may be obtained upon application to the officer to whom
the specimens are to be sent for analysis. Bottles so obtained should
when filled be repacked in the box in which they came, reversing the
cover, which should have the laboratory address thereon. The
package should be tagged or labeled to show the place and date of
collection.

(c) Water for chemical analysis should be shipped, immediately
after its collection, by express. A Medical Department bill of lad-



444 GENERAL MEDICAL ADMINISTRATION

ing will be made for each such shipment and the carrier's signature
taken thereto upon turning over the package for transportation.

Until a special form shall have been provided therefor Form 153,
Q. M. C, may be adapted to the purpose by altering the symbol
" W. Q." in the upper right-hand corner to read " W. Medical,"
followed by the number of the bill. The consignor should in every
case fill out the instructions for billing at the foot of the bill of
lading, specifying therein that the freight charges are to be vouched
to the Surgeon General, Washington, D. C., and should immediately
mail the bill to the consignee, who will upon receipt of the articles
accomplish the bill and surrender it to the carrier. The consignor
should at the time of shipment furnish the carrier with a shipping
order (Form 156, Q. M. C.), and mail a memorandum of the bill of
lading (Form 154, Q. M. C.) to the Surgeon General, with infor-
mation as to the purpose of the shipment unless the same is clearly
revealed by entries on the bill.



ARTICLE VIII RECORDS, REPORTS AND RETURNS REGIS-
TER AND REPORT OP SICK AND WOUNDED

The Register

427. A full record of the sick and wounded of every military post
or station and separate command which is attended by a medical



Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 33 of 38)