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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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officer or private physician will be made on register cards, Form 52 ;
but this requirement will not be applicable in time of war to troops
or commands in the theater of operations, except camp hospitals (or
field hospitals acting as such), evacuation hospitals, base hospitals
and other immobile sanitary formations on the line of communica-
tions. (See pars. 575 to 582.) These cards collectively constitute
the register of patients, and a case carded on them is said to be on
the register.

(a) The commanding officer will provide the surgeon with any
information the latter may not have which is necessary for preparing
and completing the register.

428. A register card will be made :

(a) For every person admitted to the hospital for treatment.
(&) For every officer and enlisted man with the command, includ-
ing retired officers and soldiers under assignment to active duty,



MEDICAL DEPARTMENT 445

who, though not admitted to the hospital, is excused on account of
sickness or injury from the performance of his military duty, or of
some part of it, such as attendance on certain calls, drills, target
practice, mounted duty, etc.

(c) For every officer and enlisted man with the command who,
though not excused from duty, is prescribed for or treated, or placed
under observation with a view to treatment or, in the case of an
enlisted man, to discharge on account of disability, if his disability is
of such a character as to have a probable bearing on his subsequent
medical history : Provided, That a case once carded for record only
under this provision will not again be carded for record only on the
same register except when necessary to comply with the provisions
of sections (d), (e), (/), and (h) of this paragraph. For example,
every case of venereal disease or insanity, or suspected venereal
disease or insanity, which comes under observation or treatment,
will, unless previously on the register or otherwise required to be
registered, be carded for record only under this provision.

(d) For every officer and enlisted man with the command, not
currently on the register, who is retired or discharged for disability,
or dies.

(e) For every officer ana enlisteu man with the command, not
currently on the register, who is sent to another station or command
for observation or treatment.

(/) For every officer with the command, not currently on the
register, who departs from the command on sick leave.

(#) For every officer and enlisted man whose case is received by
transfer conformably to the provisions of paragraphs 214 to 217.

(h) For every retired officer, retired soldier, former officer, or
former soldier with the command but not in the hospital who dies.

429. Except as required by paragraph 428 a case prescribed for
but not admitted to hospital or excused from duty will not be
registered.

430. Cases under treatment by the dentist will be entered on the
register of sick and wounded only when such entry is required by
the provisions of paragraph 428.

431. When an officer or soldier sick in hospital is retired from
active service, wholly retired from service, dismissed, or discharged,
his case as an officer or soldier will be closed (par. 450) and a new



446 GENERAL MEDICAL ADMINISTRATION

card made for it covering his continuance in hospital under his new
status. .

(a) If an applicant for enlistment sick in hospital is sworn in as a
soldier, his case as a civilian will be closed and a new card made for
his case as a soldier.

(&) Appropriate cross references from the old to the new cards,
and vice versa, will be made in these cases.

432. The register cards will be made day by day as the cases are
taken up. (See pars. 2o8a and 209.) They will be kept in two
files, the current file and the permanent file.

(a) The current file will consist of the register cards of uncom-
pleted cases arranged in dictionary order according to the surnames
of the patients. It constitutes a ready index to all cases currently on
the register. Cards will be transferred from the current file to the
permanent file immediately upon their completion and the prepara-
tion of their report cards.

(&) The permanent file will comprise all the register cards of com-
pleted cases. The cards therein will be filed in the serial order of
their register numbers.

(c) A card index to the register will be kept on Form 520, one
index card for each individual patient whose name appears in the
register. When a register card is started and its number determined
the index will be searched for previous admissions of the patient.
If an index card for the patient is found, the new number will be
entered thereon, and the number of the last previous admission will
be noted on the new register card (par. 443). If no index card for
the patient is found, one will be at once prepared. The index cards
will be filed alphabetically in dictionary order according to the sur-
names of the patients.

433. Cases taken up on register cards should be borne thereon
until finally disposed of. (See par. 450.)

434. The cards will be legibly written in indelible black ink, using
the typewriter when practicable.

(a) Entries must not be crowded. When the space provided on
the front of the card under any heading is not sufficient to complete
an entry thereunder, the record thereof will be continued on the
back of the card, or, if still more space is required, upon an exten-
sion slip. The extension slip must be of the same size as the card,



MEDICAL DEPARTMENT 447

and be pasted to the lower margin o. the bacK of the card, using
about one-half an inch for the seam ; this will place the seam at the
top of the card when the latter is filed. When an entry is continued
its two parts should be connected by cross references, using a small
letter in parenthesis, thus, (a), so that the record can be readily
followed.

435- Tlle senior medical officer is responsible for the correctness
and safe-keeping of the register. He will sign or initial all register
cards completed during the period of his responsibility ; but at gen-
eral hospitals or brigade posts, or when specially authorized by the
Surgeon General, he may designate one or more junior medical
officers to sign or initial them, preferably in each case the officer in
attendance thereon.

(a) When, in the absence of a medical officer, the command is
attended by a civilian physician, he will sign the cards for the cases
completed under his care.

436. Alterations and additions wnen necessary to correct or com-
plete the record may be made in the register cards of uncompleted
cases at the discretion of the senior medical officer of the command
for the time being. A change of diagnosis will be indicated in the
space " complication, seq., etc.," giving the date of the change, and
the original entry under " cause of admission " will not be disturbed.
A change of diagnosis in such cases requires no authentication, as
its date places the responsibility for it. Other changes should be
authenticated by the initials of the officer who makes them. (See
par. 213.)

(a) Alterations and additions to the register cards of completed
cases may be made in like manner by the medical officer who was
responsible for the card at the time it was completed if he is still
the senior medical officer of the command. If he has been super-
seded the card will not be changed, but a successor who concludes,
upon information received, that the card is erroneous in any par-
ticular may file a supplemental card therewith of the same size as the
register card, indicating thereon such conclusion and the information
or reasons upon which it is based. The supplemental card should be
headed " Supplemental card, No. - ," inserting the register num-
ber of the register card, and should be dated and signed by the
officer filing it. A cross reference to the supplemental card indenti-
fying it by its date may appear upon the register card, but it will be



448 GENERAL MEDICAL ADMINISTRATION

a reference only, thus, " See supplemental card dated - ," and
contain none of the matter recorded on the supplement. (See pars.
462, 463, and 464.)

REPORT OF SICK AND WOUNDED

457. The report of sick and wounded comprises, (i) the report
sheet (Form 51), which provides for general information and
numerical tabulations concerning the command and the civilians
therewith; (2) the nominal check list (Forms 510 and 516) for a
chronological list of cases registered; (3) the report cards (Form
52.) for details of the several cases.

458. Subject to exceptions similar to those indicated in paragraph
427, this report is required monthly from every military post and
separate command which is attended by a medical officer or civilian
physician. It will be rendered separately for regular and volunteer
troops, that of regulars to embrace all data pertaining to civilians.
It will be forwarded before the fifth day of the next succeeding
month as follows : From a^general hospital or other independent
post or command direct to the Surgeon General, unless otherwise
ordered by him ; from a transoceanic Army transport to the medical
superintendent of the transport service at the transport's home port,
for transmittal to the Surgeon General ; and from any other organ-
ization or hospital to the department surgeon for like transmittal.

(a) When a hospital is closed or a command is discontinued a
report covering the unreported period of service, giving the begin-
ning and the end thereof, will in like manner be forwarded within
five days thereafter.

(b) If there has been no case on sick report, either remaining
from last report or admitted during the month, Form 51 will never-
theless be forwarded. It will give the name and strength of the
command, etc., with such remarks as may be deemed of interest to
the department surgeon or the Surgeon General.

459. All births and marriages occcuring at the post or with the
command and all deaths among the civilians with the command will
be recorded on the report of sick and wounded under the heading
*' Births, marriages, and deaths."

460. A report card is required for every case registered during the
month, and if the case is not completed until a subsequent month a



449

second report card will be forwarded with the report for the month
during which it is completed. With the report for December, report
cards will be forwarded also for all cases remaining December 31
which were registered previous to December.

(a) A duplicate of the report sheet and of the nominal list will be
retained with the medical records of the post or command. At a
permanent post the duplicate report sheets will be filed in and form
a part of its medical history. (See par. 412.)

(&) The senior medical officer will fill in and sign the certificate at
the foot of the first page of the report sheet. (See par. 400.) The
report cards will be initialed as provided in paragraph 435 for reg-
ister cards. If there is neither medical officer nor civilian physician
with the command when the report is to be made, the officer in
charge of the property of the hospital will make the report over his
own signature and initial the cards.

(c) Alterations should in every instance be authenticated by the
initials of the officer or physician who signs the report and initials
the report cards respectively.



ARTICLE IX SUPPLIES AND MATERIALS GENERAL

PROVISIONS

475. In preparing returns, requisitions, invoices, and receipts per-
taining to medical and hospital supplies, the nomenclature, order
of entry, classification, and weights and measures of the supply
table will be followed. To facilitate the handling of these papers
one line of writing only will be placed in each interlinear space. No
letter of transmittal is required with them.

REQUISITIONS

Post Medical Supplies

477. Annual requisitions for post medical supplies will be pre-
pared on Form 33, for the year commencing January i, unless some
other date is designated by the Surgeon General.

(a) They will be forwarded not less than 20 days before the
beginning of the year, to the department surgeon, in quadruplicate,
29



450 GENERAL MEDICAL ADMINISTRATION

or in the case of general hospitals and independent posts direct to
the Surgeon General in triplicate.

478. Articles of which a definite allowance is given on the supply
table will be required for on the annual requisition except as other-
wise provided in paragraph 486. No remark will be made opposite
the name of any article that a special kind or special make or pattern
is wanted, as the annual requisition is intended to include only such
articles as are kept on hand in supply depots for issue, and not such
as have to be specially purchased; the latter when wanted must be
asked for on special requisition.

(a) Only such quantities will be asked for as probably will be
needed during the year, computed on the basis of original packages.
Fractional parts of a bottle or package will not be asked for. The
quantities asked for, plus the quantities on hand, must not exceed
those specified in the table for the official population most nearly
corresponding to that of the post or command. The quantity of
each article on hand, as verified by a medical officer in accordance
with paragraph 5i2a, will be stated and will be deducted from the
quantity allowed annually "by the supply table (ignoring for the
purpose of this deduction fractional parts of bottles and packages
on hand) to ascertain the balance which may be asked for, if needed.

(&) Before forwarding an annual requisition it will be carefully
examined and compared with the supply table to see that it has
been correctly made out in strict accordance with these regulations
and to avoid the delay that its return for correction will occasion
if they are not complied with.

479. The local prevalence or rarity of certain diseases, as well as
the quantity or number on hand of each article, will be considered
in the preparation and approval of annual requisitions.

480. The smaller posts will not need all the articles included in
the supply table. The surgeon is not expected to require for an
article merely because it is listed. He should call only for what
there is reason to think he will need.

481. The department surgeon to whom an annual requisition is
forwarded will see whether it is prepared in accordance with the
above regulations. If it is, he will approve and forward one copy
direct to the medical supply depot designated for his territory by
the Surgeon General ; if it is not, he will alter it to conform to these



MEDICAL DEPARTMENT 451

regulations, and then forward it to the depot approved as altered.
In either event, he will forward the second copy of the requisition,
with the action taken by him noted thereon, direct to the Surgeon
General. He will retain the third copy in the files of his office and
will return the fourth copy to the surgeon with his modifications,
if any, noted thereon.

482. Special requisitions for post medical supplies are annual,
quarterly, or emergency. They will be made on Form 35, but
separately from those for field medical supplies and those for dental
supplies. The same number of copies will be executed, and they
will be forwarded to the department surgeon or to the Surgeon
General direct, as in the case of annual requisitions from the same
posts or hospitals. (See par. 477a.)

483. Except as otherwise provided in paragraph 486, articles not
on the supply table which will be needed during the year will be
called for on the annual special requisition. It will be forwarded
with the regular annual requisition. The articles will be listed in
alphabetical order, and the necessity for them will be fully explained
in the column of " Remarks." To avoid delay in filling these requisi-
tions a full description of special articles, instruments, and appli-
ances required for will be given in " Remarks," together with a state-
ment of their cost or approximate cost, as ascertained from dealers'
catalogues or other reliable sources of information. When unsual
drugs or chemical reagents are called for similar information as to
their cost will be furnished.

484. Except as otherwise provided in paragraph 486 and in the
footnotes to the supply tables, articles on the supply table of which
no allowance is stated, or which are issued " as required," will be
called for on the quarterly special requisition.

FIELD MEDICAL SUPPLIES

489. Requisitions to replenish field medical supplies or to replace
unserviceable field equipment at permanent posts will be executed
in triplicate, on Form 35, and will be forwarded to the department
surgeon, or, in the case of an independent post or station, direct to
the Surgeon General.

(a) The department surgeon who receives a requisition in tripli-
cate for field medical supplies in conformity with this regulation will



452 GENERAL MEDICAL ADMINISTRATION

promptly forward the same, with his recommendations indorsed
on each copy, to the Surgeon General. In the Philippine and
Hawaiian Departments the department surgeons are authorized to
act upon them as upon requisitions for post supplies. One copy of
the requisition will be returned to the surgeon with modifications,
if any, noted thereon.

490. Requisitions from permanent posts for field medical supplies
should be unnecessary except immediately following active military
operations or as the result of changes in the supply tables.

USE AND CARE OF MEDICAL PROPERTY

514. The stock of alcohol, alcoholic liquors, opium, and the salts,
derivatives, and preparations of opium or coca leaves will be kept
in a locked closet in the storeroom and only issued to the dispensary
in unit containers from time to time as may be necessary, upon the
written order of a medical officer.

(a) In the storeroom, receipts and expenditures of these articles
will be accounted for in the manner prescribed for the dispensary
(par. 240).

515. Field supplies and equipment will not be used as posts, except
when required for purposes of instruction.

516. Field chests and appliances will be frequently inspected and
kept in perfect order for immediate field use.

517. The exchange of medicines with druggists is prohibited.

518. The issue of articles for use in the preparation of cleaning
mixtures, cosmetics, or perfumery, or for use with spirit lamps, etc.,
is prohibited.

519. The responsible officer will cause all instruments in his charge
to be examined by a commissioned medical officer at least once each
month.

520. Steel and plated instruments may be prevented from rusting
by keeping them in a 20 per cent formalin solution saturated with
borax.

523. Blankets not in use should be frequently examined and prop-
erly protected. When stained but otherwise in good condition they
should be continued in service. Hospital bedding will not be used by
members of the Hospital Corps, except when on duty in the wards.

524. When a typewriter is to be transported the ribbon spools



MEDICAL DEPARTMENT 453

should be removed and packed separately, the carriage of the machine
securely tied to the base in such a manner that it can not move in
any direction, and the steel rods or blocks for locking the carriage
placed in position. Medical officers will be held responsible for
damages to typewriters which result from careless packing.

525. Rubber and flexible catheters and bougies will be kept in talc
or glycerin to preserve them.

526. When the canvas in litters becomes soiled it will be removed
from the litters, washed, and replaced. When it becomes torn or
unserviceable new canvas of the proper size should be applied for to
replace it.



PART II THE SANITARY SERVICE IN WAR.

ARTICLE VIII THE SANITARY SERVICE IN WAR GENERAL
CORRESPONDENCE, REPORTS, RETURNS AND RECORDS

Records of Sick and Wounded

567. During and after an engagement diagnosis tags will be
attached to all wounded and dead as soon as practicable. They will
be made out in duplicate.

568. In the case of wounded the primary purpose of the tag is to
advise the medical officers under whose observation the wounded
successively come of the treatment previously given at the several
points of relief on the field or on the way to the rear.

569. The tag will be made out by the first medical officer or
member of the Hospital Corps who treats the man previous to ad-
mission to a hospital on the line of communications. (It is unneces-
sary to tag a patie'nt who is admitted to a hospital on the line of
communications without having been previously tagged.) If the
patient is badly hurt, the identification tag may be utilized to obtain
the necessary information concerning his name, rank, etc. The
original diagnosis tag will be attached to the patient's clothing.

570. The dead found on the field will be tagged in each case by
the Medical Department troops who first reach the body, in order



454 THE SANITARY SERVICE IN WAR

that other medical personnel may not lose time examining it. The
tag will be attached to the clothing of the deceased.

571. The duplicates of the diagnosis tags will be disposed of as
follows :

(a) Those made out by the sanitary personnel of an organization
for the officers and soldiers of their own command will be retained
by the surgeon until disposed of as provided in paragraph 574.

(&) Those made out for officers and soldiers of other commands
will be transmitted as soon as possible after the close of each day of
an engagement to the division surgeon accompanied by the check
list directed to be sent to that officer by paragraph 579.

572. The original tags will be disposed of as follows :

(a) Those of wounded who are returned from aid stations to the
firing line without going farther to the rear will be removed and
retained by the regimental surgeon.

(&) Those of wounded who are returned to their organizations
direct from dressing stations (par. 682) or from the station for
slightly wounded (par. 7140) will be removed upon their reporting
for duty and be turned over to the surgeons of their several organiza-
tions, respectively.

(c) Those of wounded who are admitted to a field hospital and
retained there for definitive treatment will be removed and for-
warded to the division surgeon. If the patients are subsequently
transferred to the line of communications, they will not be retagged,
but will be accompanied by transfer lists in regular form (par. 583).

(d) Those of wounded who are being evacuated from the zone of
the advance will not be disturbed until the patients are admitted to
hospital on the line of communications, when the tags will be re-
moved, stamped with the name of the admitting hospital, and the
date of receipt of the patient, and forwarded immediately to the
division surgeon of the division to which the wounded belong.

(e) Those of wounded who die while in transit from the field to
hospital (the death in each case being noted on the tag as required
by the printed instructions in the tag book), and the tags attached to
the dead found on the field, will be removed when the bodies are
prepared for interment -or equivalent disposal, and will be sent like-
wise to the division surgeon.

573. The division surgeon will cause the tags received by him in



MEDICAL DEPARTMENT 455

compliance with paragraphs 571 and 572 to be distributed without
delay to the senior medical officers of the commands to which the
men tagged belong, so that they may be available in accounting for
officers or soldiers who would otherwise be carried as missing on the
returns of their organizations.

574. Having served their purpose in completing the records of the
organizations, all the tags, both originals and duplicates, will be for-
warded with the next periodical lists of sick and wounded therefrom.

575. The register of patients prescribed by paragraph 427 and
the monthly report of sick and wounded by paragraph 458 are not
required from mobile troops or commands in the theater of opera-
tions. In lieu thereof a record or list of the sick and wounded with
every mobile command in the theater of operations which is accom-
panied by a medical officer, will be kept day by day by such officer on
Form 53, as directed in the following paragraphs and in the in-
structions printed on the form. Field hospitals immobilized and
acting as camp hospitals, evacuation hospitals, base hospitals, supply
depots, contagious disease hospitals, field laboratories, and other
similar sanitary formations will not be regarded as mobile units
within the meaning of this paragraph, but will keep the register of
patients and render monthly reports of sick and wounded in accord-



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 34 of 38)