MEDICAL DEPARTMENT OF.THE\ UNITED STATES NAVY GIFT OF MANUAL FOR THE MEDICAL DEPARTMENT OF THE UNITED STATES NAVY PUBLISHED BY THE BUREAU OF MEDICINE AND SURGERY UNDER THE AUTHORITY OF THE SECRETARY OF THE NAVY WASHINGTON GOVERNMENT PRINTING OFFICE 1917 [M. & S. No. 128v)14. Bureau or Medicine and Surgery, Navy Department, Washington, D. C, August 1, 1917. This Manual for the Medical Department of the United States Navy is published for the guidance of the Medical Department. Nothing herein shall be construed as superseding, amendmg, or modi- fying the United States Navy Regulations and Naval Instructions; and this manual shall be subject to amendment by circulars issued by the bureau, and by general orders issued hereafter by the department. W. C. Braisted, Surgeon General^ U. &. Navy. Approved : JosEPHUS Daniels, Secretary of the Navy, 368073 TABLE OF CONTENTS. Page. Chapter 1. Bureau of Medicine and Surgery 7 2. Medical Corps - 11 3. Dental Corps ^^ 4. Hospital Corps ^^ 5. Nurse Corps ^^ 6. Duties of medical officers and dental officers oi 7. Duties of the fleet surgeon and the division surgeon ._ 71 8. Administration and internal organization of naval hospitals. 75 Special hospitals 9. NaA-al hospital ships 1"'' 10. Battle organization of the Medical Department afloat, and expe- ditionary service on shore .- 1"^ 11. Physical examination of candidates for admission, appointment, and promotion ; • ^^^ 12. Physical examination for enlistment, special duties, navy-yard ^ 8er^•ice, and imder compensation act 1^3 13. Health record, nomenclature, Journal of the Medical Depart- ment, and reports of death ; 15"^ 14. Sanitary regulations and reports, and sanitary duties 191 15. Bills of health, quarantine, and disinfection 203 16. Line of duty and origin of disability 213 17. Medical and material surveys and transfers of sick 219 18. Insane of the Navy 227 19. Naval Medical School - . - 231 20. Supplies, services, requisitions, and public bills 235 21. Invoices, property accountability, outfits and supplies, and trans- fers of stores 245 22. Naval hospital fund 249 23. Navy pension fund and general pensions 253 24. Blank forms 261 25. Reports and returns 273 26. Geneva and Hague peace conventions and the American Red Cross . 285 5 M4NUAL FOR THE MEDICAL DEPARTMENT, UNITED STATES NAVY. CHAPTER 1. THE BUREAU OF MEDICINE AND SURGERY. Section 1.— Laws Relating to the Establishment of Bukeaus ; Chiefs of Bureau and Assistant Chiefs of Bureau. 1. Establishment of bureaus. Sec. 419, R. S.^ (R ' 103 (1) ) ; act Aug 22 1912. 2. Custody of books and records of bureaus. Sec. 420, R. S. ; (R lOd (Z)}. 3. Appointment of chiefs of bureaus. . Sec. 421, R. S. 4. Chief of Bureau of Medicine and Surgery. Sec. 426, R. S. 5. Staff officers who have been chiefs of bureau exempt from sea duty except in war. Sec. 1436, R. S. c ..-. r, o . at . q 6. Rank and title of certain chiefs of bureau. Sec. 14*1, R. S. ; act Mar. 6, 1899 7. Rank of chiefs of bureau retired. Sec. 1473, R. S. ; acts Mar. 3, 1899 ; May 13, 1908; June 24, 1910; Aug. 22, 1912. ,^o -.o- t> a 8. Assistant to Bureau of Medicine and Surgery. Sees. Ii8, 13 (O, K. b. Section 2.— Navy Regulations and Naval Instructions Defining the Duties OF the Bureau of Medicine and Surgery. 11. Bureau of Medicine and Surgery. R 133. 12. Duties of Medical Department. R 2901. 13. Autliority of bureau to issue "Manual for the Medical Department. R 901 (1);; R 901 (2) ; R 901 (3). 14 Authority of bureau to publish and distribute " Drill Book for the Hos- pital'Corps." I' 602 (6). Section 3. — Laws Relating to Estimates. 21. Estimates for expenses. Sec. 430, R. S. 22. Manner of communicating estimates. Sees. 3660 to 3671, R. S. ; acts .July 7. 1884, sec. 2 ; and June 22, 1906, sec. 4. 23. Classification in Book of Estimates. Act. Feb. 23, 1881. 24. Requisites for estimates for appropriations for public works. Sec. 3663, 25. Estimates to be submitted to Congress. Sec. 3669, R. S. 26. Department estimates to be furnished before October 15, annually. Sec. 5, act Mar. 3, 1901. 1 R. S. 'ndicates Revised Statutes, edition of 1878 ; R indicates Regulations and I indicates Instructions, both referring to the U. S. Navy Regulations and >.aval Instruc- tions 1913. (Regulations for the Government of the Navy of the Lnited btates, lyirf.) 7 8 MAX UAL FOK THE MKDICAL DEPARTMENT, U. S. NAVY. 27. Secretary of the Treasury to make estimates if none furnislied. Sec. 5, act Mar. o. lOUl. 28. What statements shall accompany estimates. Sec. 3670, R. S. 2?). What additional explanations are required. Sec. 3G64, 11. S. 30. Amount of outstanding appropriations to be designated. Sec. 360.5, U. S. 31. Items of expenditure to be specified in estimates and accounts. Sec. 30G6, R. 3. Section 4. — Instkuctionb Relating to the Preparation of Estimates (blank forms). 41. The Trea.sury Department prepares and distributes among the several executive departments a blank estimate form, covering the estimates of appro- priations for each of the bureaus in the different departments of the Govern- ment for the service of the next fiscal year. 42. A blank estimate form is provided which is filled out by the several bureaus before submitting their annual estimates for the consideration of the heads of their respective departments. 43. Estimates for salaries or compensation are always specified and are never combined with the estimates for general or contingent expenses, nor are con- tingent or general estimates items for salaries or compensation. 44. All estimates for contingent and general expenses pertaining to tlie bureau are included in the naval appropriation bill. Estimates for the salaries of all civil employees in the bureau are included in the legislative, executive, and judicial appropriation bill. 45. Estimates under the two appropriation bills are submitted by the l)ureau on separate estimate sheets. Section 5, — Laws Relating to Appropriations. 51. Appropriations for Navy controlled by Secretary; for each bureau to be kept separately. Sec. 3G76, R. S. 52. Applications of moneys appropriated. Sec. 3678, R. S. 53. No expenditures beyond appropriations. Sec. 3679, R. S., amended by act of February 27, 1906; (I 16). .54. Restrictions on contingent, etc., appropriations. Sec. 3682, R. S. 55. Drafts for War and Navy Departments. See. 3673. R. S. 56. Form of drawing and charging warrants. Sec. 3675, R. S. 57. Special appropriations available for two years. Sec. 3685, R. S. 58. Permanent indefinite appropriations. Sec. 3689, R. S. 59. Expenditure of balances of appropriations. Sec. 3690. R. S. 60. Disposal of balances after two years. Sec. 3691, R. S. 61. Unexpended balances to be covered into the Treasury. Act June 20, 1874 ; June 14, 1878. ^ . . t , o, 62. Auditing accounts by Auditor for the Navy Department. Act July 31, 1894. . ,, , . 63. Method of fixing cost of work uiuier naval appropriation.s. Act March 4, 1911. Section G. — Fixed and Specific Titles of Appropriations. 71. The annual appropriations included in the naval appropriation bill that pertain to the lUireau of Medicine and Surgery are classified under the follow- ing fixed titles: (a) Medical Department. ib) Contingent, Bureau of Medicine and Surgery. (r) Transportation of remains. 72. The detailed objects of exp'cndltures under the fixed titles are to be found In each annual digest of appropriations from which the following is abstracted: Mediial 1 X'liartnient : For surgeons' necessaries for vessels in conunlssion. navv vards, naval stations, Marine Corps, and for the civil establishment at MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 9 the several naval hospitals, navy yards, naval luedical supply depots. Naval Medical School, Washington, and Naval Academy, and toward the accumula- tion of a reserve supply of medical stores. Contingent, Bureau of Medicine and Surgery: For tolls and ferriages; care, transportation, and burial of the dead; purchase of books and stationery, binding of medical records, unbound books, and pamphlets ; hygienic and sani- tary investigation and illustration; sanitary and hygienic instruction; pur- chase and repairs of nonpassenger-carrying vragons, automobile ambulances, and harness ; purchase of and feed for horses and cows ; purchase, maintenance, repair, and operation of two passenger-carrying motor vehicles for naval dis- pensary, Washington, District of Columbia, to be used only for official purposes ; trees, plants, care of grounds, garden tools, and seeds; incidental articles for the Naval Medical School and naval dispensary, Washington; naval medi- cal supply depots, sick quarters at Naval Academy and marine barracks; washing for medical department at Naval Medical School and naval dispensary, Washington; naval medical supply depots, sick quarters at Naval Academy and marine barracks, dispensaries at navy yards and naval stations, and ships ; and for minor repairs on buildings and grounds of the United States Naval Medical School and naval medical supply depots; rent of rooms for naval dispensary, Washington, District of Columbia, for the care, maintenance, and treatment of the insane of the Navy and Marine Corps on the Pacific coast, including supernumeraries held for transfer to St. Elizabeths Hospital for the Insane; for dental outfits and dental material and all other necessary contingent expenses. Transportation of remains: To enable the Secretary of the Navy, in his discretion, to cause to be transferred to their homes the remains of officers and enlisted men of the Navy and Marine Corps, of -members of the Nurse Corps, and of officers and enlisted men of the Naval Militia and National Naval Volunteers and the Naval Reserve Force when on active service with the Navy, who die or are killed in action ashore or afloat, and also to enable the Secretary of the Navy, in his discretion, to cause to be transported to their homes the remains of civilian employees who die outside of the continental limits of the United States: Provided, That no deduction shall hereafter be made from the six months' gratuity pay allowed under the naval act of August twenty-second, nineteen hundred and twelve, on account of expenses for funeral, interment, or for expenses of preparation and transportation of the remains: Provided further. That the sura herein appropriated shall be available for paymeut for transportation of the remains of officers and men who have died while on duty at any time since April twenty-first, eighteen hundred and ninety-eight, and shall be available until June thirtieth, nineteen hundred and eighteen. 73. Special diet as "surgeons' necessaries," is a charge against "Medical Department." Quarantine expenses are not a charge against the appropriations for the Bureau of Medicine and Surgery, but are charged to the appropriation " Pay, miscellaneous," or " Contingent, Marine Corps," as the circumstances require. Care of sick in hospital is a charge against " Naval hospital fund." Transportation of sick and insane patients is a charge against the Bureau of Navigation or the Marine Corps as the case may be. 74. In addition to the fixed titles, the Bureau of Medicine and Surgery, whenever the exigencies of the service require such action, submits through the Bureau of Yards and Docks with its annual estimates specific titles for dis- bursements coming under its cognizance, such as contruction of hospitals, naval medical supply depots, quarters for officers, and all other expenditures for which the fixed titles are not available and which can not be undertaken with- out being authorized by a special enactment. 75. The naval hospital fund is available for the maintenance of the naval hosnitals at the various navy yards and stations and for care and maintenance of patients in other hospitals at home and abroad. (See chapter 22.) CHAPTER 2. THE MEDICAL COlli'S AND THE NAVAL RESERVE FORCE. Section 1. — Laws Relating to the Organization of the Medical Corps. 101. Medical Corps, number of. Sec. 1368, R. S. ; acts Aug. 5, 1882, June 7, 1900. IMar. 3, 1903, Aug. 29, 1916. 102. Rank and title of medical officers. Sec. 1474, R. S. ; acts Mar. 3, 1899, Mar. 3, 1903, Aug. 29, 1916. 103. Retired for age or length of service, rank. Sec. 1481, R. S. ; acts of Mar. 3, 1899, May 13, 1908. 104. When retired for causes incident to service. Sec. 1482, R. S. ; act Mar. 3, 1899. Section 2. — Laws Relating to Appointments. "111. Appointments in, how made. Sec. 1369, R. S. 112. Citizenship. Sec. 1428, R. S. 113. Assistant surgeons, examination, age, etc. Sec. 1370, R. S., amended by act of May 4, 1898. 114. Assistant surgeons from date of original appointment take rank and precedence with lieutenants (junior grade). Act Aug. 29, 1916. 115. Acting assistant surgeons. Sec. 1411, R. S. : act Feb. 15, 1879. 116. Acting assistant surgeons, temporary service. Act May 4, 1898. Section 3. — ^Navy Regulations Relating to Appointments. 121. Examining boards, R 331. 122. Composition of boards. R 332. 123. Appointments subject to examination. R 3301. 124. Candidates for assistant surgeon. R 3305. 125. Forfeiture for nonappearance. R 3319. 126. Penalty for false certificate. R 3320. 127. Acceptance and oath of office. R 3321. 128. Expenses of candidates. R 4540. Section 4. — General Instbuctions Relating to Professional Examinations FOR Appointment as Assistant Surgeon. 131. A candidate for appointment in the Medical Corps of the Navy is first examined for enrollment in the provisional grade of assistant surgeon, rank of lieutenant (junior grade). United States Naval Reserve Force. If found quali- fied, he is subsequently assigned to duty at the Naval Meilical School for a course of instruction and training, during which he receives the pay and allow- ances of an assistant surgeon of the Navy. After completing the course at the Naval Medical School he is given a final examination, and if found qualified is recommended for commission as assistant surgeon in the Medical Corps of the Navy. Legislation establishing the United States Naval Reserve Force contains 11 12 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. In substance matter referable to commissioned grades in the Medical Corps as follows : (c) A member must be a citizen of the United States, except the Naval Auxiliary Reserve. (6) A member obligates himself, and may be ordered to serve in the Navy throughout a war or during the existence of a national emergency declared by the President should either arise during his term of enrollment. (c) A member enrolls or reenrolls for a term of four years. (d) In time of peace, and when no national emergency exists, a member may be discharged upon his own request upon reimbursing the Government for any clothing gratuity that may have been furnished during his current enrollment. (e) A member is required to take the oath of allegiance to the United States. (/) A member is given a provisional grade (assistant surgeon) upon first enrollment in accordance with his qualifications determined by examination. (g) A member after enrolling may, in time of peace, upon his own request, be assigned active duty in the Navy for such periods of instruction and training as may enable him to qualify for and be confirmed in grade. (h) For confirmation in grade a member must serve the minimum amount of active service required (three months) and must qualify by examination under regulations prescribed by the Secretary of the Navy. (t) The minimum active service required for maintaining the efficiency of a member (Naval Coast Defense Reserve) is three months during each term of enrollment. This active service may be in one period or in periods of noi less than three weeks each year. (;■) No person shall be appointed or commissioned an officer in any rank in any class of the United States Naval Reserve Force, or promoted to a higher rank therein, unless he shall have been examined and recommended for such appointment, commission, or promotion by a board of three naval officers not below the rank of lieutenant commander, nor until he shall have been found pliysically qualified by a board of medical officers to perform the duties required in time of war, except that former officers and midshipmen of the Navy who shall have left the service under honorable conditions and who shall have en- rolled in the United States Naval Reserve Force may be appointed in the grade and rank last held by them without examination other than the physical exami- nations herein prescribed. ,, , - (fc) A member receives retainer pay of $12 per annum while enrolled in a provisional grade, provided he makes such reports concerning his movomenta and occupation as may be required by the Secretary of the Navy. After con- firmation in grade his annual retainer pay is two months' base pay of the cor- responding rank in the Naw. Retainer pay is in addition to any pay to which a member may be entitled by reason of active service. Members of the Volun- teer Naval Reserve do not receive any retainer pay. ^, , (I) A member who reenrolls for a term of four years, within four months of expiration of last complete enrollment, and who has performed the minimum amount of active service required during the preceding term of enrollment, for each reonrollment receives an increase of 25 per cent of his base retainer pay. A member wlio completes 20 years of service, and who has performed the mini- mum auK.unt of active service each term of enrollment, on his own application will be retired with rank held, with a cash gratuity equal to the total amount of his retainer pay during his last term of enrollment. (m) A member may accept employment in any branch of the public service exf-ept as an officer or enlisted man in any branch of the military service ot the Uiiited States Naval Reserve Force, shall be made in tli(> Naval Coast l>efense Reserve, class 4. or Volunteer Naval Re.serve for duty in the Naval Coast Defense Reserve, class 4, United States Naval Ri-serve Force. (Members of the Volunteer Naval Reserve receive no retain(!r pay or uniform gratuity in time of i)eace, but when on active duty they receive the service pay of their grade and service.) MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 19 . (b) Citizens of the United States or of its insular possessions of the sea- going profession who shall have heen or may be employed on American vessels of the merchant marine of suitable type for use as naval auxiliaries, and which shuU have been listed as sudi by the Navy Department for use in war, shall be eligible for membership in the Naval Auxiliary Reserve as assistant surgeons, subject to the examinations hereinafter prescribed. Their annual retainer pay after confirmation is one month's base pay of the corresponding rank in the Navy. (c) A candidate for enrollment as above must be between 21 and 44 years of age and a citizen of the United States, except as noted above with reference to the Naval Auxiliary Reserve. He must be a gradimte of a reputable medical school, legally authorized to confer the degree of doctor of medicine. 252. Application for enrollment must be made in the handwriting of the applicant accoi'ding to the following form: (n-.i^Yil ! .1 , (Residence.) grf- , 10— i''STR: I request permission to be examined for enrollment in the provisional grade of assistant surgeon, rank of lieutenant, junior grade, Naval Coast De- fense Reserve, class 4, United States Naval Reserve Force.* I was born at , and was years of age on the day of— -L: — , 191—; graduated from medical school in 19_'_. was licensed to practice medicine in the State of ' 'I am a citizen of the United States, residing in , county of , in the State of I forward herewith letters testifying to my moral character, haliits, citizen- ship, preliminary education, medical education, society membership, license to practice medicine, and professional qualifications. Very respectfully, (Name In full» written legibly.) Chief of the BtrEEAU or Medicine and StiROEUY, • '■'' Navy Department, Washington, D. C. •^53. The above application must be accompanied by the following certificates: '■''{a) Letters or certificates from two or more persons of good repute, testify- ing from personal knowledge to gowl habits and moral character. (/))A certificate or statement from some person of good repute that the applicant is a citizen of the United States. In case the applicant is a natural- ized citizen of the United States his mituralization papers or other satisfactory evidence of citizenship must be submitted. •' '(d)' Certificate of preliminary education. Tlie candidate must submit a cer- tificate of graduation from an accepted high school or an acceptable equivalent. ■■(■^) Certificate of medical education. This certificate should give the name of the school and the date of graduation. , ' Xe-y-A certificate from the president or secretary of a State or local medical society to the effect that the applicant is a member in good standing. vii(/) A certificate of license to practice medicine. .rT^(7) If the candidate has had hospital service or .special educational or pro- fessional advantages, certificates to this effect, signed by the proper authori- ties, should also be forwarded. The applicant will save unnecessary correspondence if he will make sure when submitting bis application that the qualifications enumerated above are clearly and plainly described in his letters or certificates. 1 When directed, the applicant should substitute the words " Volunteer Naval Reserve for duty in the Naval Coast Defense Reserve, <;lass 4, United States Naval Reserve Force, for the words " Naval Coast Defense Reserve, class 4, United States Naval Reserve FurcG ** 20 MANUAL FOR TllE MEWCAL DEPARTMENT, U. S. NAVY. 254. (a) Aftor pnssinp; upon the cnvlcntinls of tho candidate tho P.uroau of Medicine and Sur;,'ery will issue a permit to the candidate, effective for a slated period, to appear before one or m<ssional qualifications, those forwarded with his application being returned to him for this purpose. n; 255. The examination is conducted in the following order : I. Physical. II. I'rofe.ssional. (n) The physical examination is that described in paragraph 130. In the case of candidates for the Naval Reserve Force alone the minimum height retiuirod is 64 inches. (See also paragraph 2107.) (/)) I'rofessional examination. — (a) Letter to the board describing in detail his general and profes.sional education. (b) Examination of diplomas, certificates of State boards, certificates of membership in medical societies, letters, and such other recommendations or certificates bearing upon the professional qualifications of the applicant ;is ho may desire to submit, (c) The candidate will be expected to pass an oral examination as follows: (a) Practice of medicine, to include the etiolog>% pathology, .sympto- mology. diagnosis, prognoses, and treatment of disease. (h) Practice of surgery, to include surgical anatomy, surgical pathology, general, military, and naval surgery. (r) General hygiene, to include personal hygiene, preventable diseases, clothing and equipment, water supply, food, disj^osal of waste, air, ventila- tion, heating, lighting, camp .sanitation, and quarantine. The oral examination will be sulRciently comprehensive to determine whether the candidate is qualified to practice medicine under the usual service conditions. 256. Due credit will be given for knowledge and experience in the case of candidates who have .sju'cialized in certain branches, and the examinati<»n may be modified accordingly. A successful candidate, upon the completion of his examination, will be notified by the president of the board that he has been found qualified. The board will assign an average mark based on a passing mark of 7-") per cent. 257. With the consent of the medical examiners, a candidate may witlidraw at any i)eriod from further examination and may at a future time itrescnt himself for reexamination, provided that such examination is not delaye*! until after tile date that his permit would expire. 25S. i\'o allowance will be made for the expen.ses of persons api)earing for examination. 25J). If the medical examiners find the candidate duly qualified physically and [irofessionally for enrollment In the provisional grade of assistant surgeon, rank of lieutenant, j\inior grade, Naval Coast Defense Reserve, cla.ss 4, United States Naval Reserve Force; or Volunteer Naval Ke.serve for duty in the Naval Coast Defense Ueserve, class 4, United States Naval Iteserve Force; they will immediately forward a r('i)ort and rccomincnd.Mtion to this eflcct direct to the I'.urcau of .Medicinj' and Surgery, together with the certilit ate of the candidate as to his physical (•ondltion, the jiersonal iiisinry and i)liysi<'ai data form, and the letter of the candidate to the medical examiners. A report and recommen- dation will also be made when a candidate is found disqualified. 2(50. After approving the record of examination and the recommendation of the medical examiners in the case of a qualified coudidale, the liureau of Medi- MANUAL FOR THE MEDICAL DEPARTMENT, U* S. NAVY. 21 cine and Surj;t>ry will reconunend to the Bureau of Navlf;:ation the provisiouul enrollnicnt >f Ihc ciiHlidate in flu- United States Naval itescrve Force. ( 261. A inenihor of the United States Naval Reserve Force may transfer to or from the Volunteer Naval Keserve upon approval by the Bureau of Navigation of his request tt» this effect. 2(j2. Confirmation in grade: Assistant sur,u;eon.s provisionally enrolled in the Naval Coast Defense Keserve, class 4, United States Naval Keserve Force; or Volunteer Naval Keserve for duty in the Naval Coast Defense Keserve, Uniteil States Naval Keserve Force, who apply to the Bureau of Navigation via their commanding officer for pern)ission to perform the minimum amount of active service required (at sea) for confirmation in grade, and who after completing the active service recpiired request permission to be examined for confirmation in grade, will be issued a permit to appear for examination at a designat*?d place l)efore a statutory board appointed for this purpose. 263. (o) The physical examination Ls that described in paragraph 255. . (&) Professional examination. — (a) Letter to the board, giving a bi'ief state- ment of the candidate's general and professional education. ]..i ^-.a. ,jij,;jHi;j^ (ft) Examination of active service I'ecord. . iiinth\ii:/.'A .8T!i (c) Knowledge of Navy Kegulations and Instructions, General .Orders; and Manual for the Medical Department, appropriate to grade; medical department duties during emergency drills, such as fire, collision, abandon ship, battle stations, etc. (d) Written examination in (o) anatomy, (ft) physiology, (c) materia niedica and therapeutics, (d) general medicine, (e) general surgery, and (/) obstretrics. Two or more questions are asked in each subject. (e) An oral examination is conducted in each of the above enumerated subjects. (/) The board will give careful consideration to composition and spelling as shown in the written papers submitted by the candidate, and to his service record. (g) Seventy -five per cent is required as a general average. 264. Those assistant surgeons provisionally enrolled in the United States Naval Reserve Force, who have been found duly qualified for confirmation in grade, and who will be within the age limit of 32 years at the end of the Naval Medical School course and on receipt of commission, may apply to the Bureau of Navigation via the Bureau of Medicine and Surgery for permi.ssion to enter the Naval Medical School with a view to further instruction and training, and to subsequent appointment as assistant surgeon. Medical Corps, United States Navy. If authorized to attend the course for this purpose no examination will be required until the course is finished, when the officer will be examined physi- cally and professionally for appointment as assistant surgeon, United States Navy. 265. Medical officers enrolled in the United States Naval Reserve Force shall be appointed in time of peace not to exceed 500 in number. To provide for promotion, medical ofiicers who reenroU within four months after the ter- mination of each enrollment, and who have performed the minimum amount of active service required (at sea), each enrollment, may receive promotion to the rank of lieutenant on third enrollment, and to the rank of lieutenant com- mander on the fifth enrollment, upon performing the minimum amount of active service required (at sea) in the new enrollment, provided they are found quali- fied physically and professionally on examination. 266. The uniform of officers of the Naval Re.serve Force shall be service dress (blue and white), but uniforms will not be required except when such officers are assigned to active duty. Officers on the nonactive list may, however, provide themselves with uniforms and wear same upon appropriate occasions, if they so desire. 267. Assistant surgeons in the Naval Reserve Force who are assigned to duty in attendance upon a course of instruction at the Naval Medical School pre- liminary to final appointment in the regular corps will be required, during the 22 MANUAL FOR THE MEDICAL DEPAKTMENT, U. S. NAVY. period of instruction, to provide themselves only witli IMue service uniforui aud sword. , , . |.,, Section 13.— Information Kegauutng Appointment in the Medicai, CJobps of THE Naval Militia. »71 Naval Militia officers (Medical Cori)S) must be bt^tween the ages of 18 and 4;-) years on first entering the Naval Militia, but they niiiy serve until they are 64 vears of age, if their service in tlie Naval Militia is continuous. 272.' When so authorized by the Navy Department, the examination may be wliolly oral l)Ut sufticiently comprehensive to determine wliether the candidate is competent to practice medicine under the usual service conditions. If Ike oral examination in any subject is unsatisfactory, the applicant may be required to take a written aud a practical examination in this suliject. It is not Uie pur- pose however, to authorize the oral examination e.xcept in instances where the Naval Militia is musteretl for active service, aud the approved professional standard has not been adopted by the State. ,..:,'' *73 Examinations will be held in accordance with the instructions con- tained in General Order No. 153, page 29-31,.aiul Appendices A and 3. .; , , i')'l li;-.i!,M)/ M(U ■ /. bnii ;■• .::!•• ■. -:■ i.t. .- : ■■'■■•.■.'. r.i f.i .' 1.1 Mi/ ■•VIC Milt [ / \ y , 'ij LO •I'.di CHAPTER 3. THE DENTAL CORPS AND THE NAVAL RESERVE FORCE. The Dental Corps. Section 1, — Laws Relating to the Dental CoiiPS. (AcTtA^/o, 2i2,'.lj94^,;,' Acji; Mar. 4, 1913; Act Aug. 29, 1916.) ":".',;,'•;,., V" ^^^ /, . 301. Dental surgeon at Naval Academy: The President is hereby authorized,, by and with the advict and consent of the Senate, to appoint the dentist now at the United States Naval Academy a dental surgeon in the Navy for duty at the United States Naval Academy, to have the corresponding rank, pay, and allow- aucCj as the senior dental surgeon now at the United States Military, Academy : And provided further, That he shall not be eligible for retirement before he has, reached the age of 70 years except for physical disability incurred lin the linp;Of duty. (Act Mar. 4, 1913.) . , 302. Tbe President of the United States is hereby iiuthorized to aijpoint and conunission, by and with the advice and consent of the Senate, dental surgeons in the Navy at the rate of one for each one thousand of the authorized enlisted strength of the Navy and Marine Corps, who shall constitute the Naval Dental Corjis and shall be a part of the IMedical Department of the Navy. 303. (a) Original appointments to the Naval, Dental Corps shall be. proba- tionary for a period of two years and may be revolted at any time during the probationary period by the President. (ft) The I'anli of such officers of the same date of appointment among them- selves at tlie end of said probationary period shall be determined by the recom- mendations of an examining board appointed by the Secretary of the Navy, which board shall conduct a competitive examination, based upon both service record and professional attainments, in accordance with such regulation.s as may be pn^scribed by the Secretary of the Navy, and the rank of sucli ol1ic*ers .so determined sliall be as of date of original apjiointment with reference to other appointments to tlie naval service. 304. All appointees to the grade of dental surgeon shall be citizens of the United States between 24 and 30 years of age, and shall be graduates of stand- ard medical or dental colleges and trained in the several brandies of dentistry:, and who shall, before appointment, have successfully passed moral, physical, and professional examinations before medical and professional examining boards , appointed by the Secretary of the Navy, and have been recommended for appoint- ment by such boards. 305. (a) Dental surgeons shall have the rank, pay, and allowances of lieu- tenants (junior grade) until tliey shall have c< mpleted five years' service. Dental surgeons of more than 5 but less than 20 years' service shall, subject to i such examinations as the Secretary of the Navy may prescribe, have the rank, pay, and allowances of lieutenant. Dental surgeons of more than 20 years' service shall, subject to such examinations as the Secretai-y of the Navy may prescribe, have the rank, pay, and f llowances of lieutenant conunander. 23 24 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. ih) The total number of dt'iital surjieons. with the rank, paj', and allowances of lieutenant connnander shall not at any time <'xeeeental ('ori)s are entitled to ail (he military courtesies and consideration that no with that rank and are accorded to olticers of other branches of the service in a similar j;rade. They wear the same unifonn as other ollicers of the Navy with a desifinating device distinctive of their corps. (See Uniform Regulations, 1913, pars. G (a), 125.) {(I) The tenure of oflient:il (»flic(M- of the ship forms part of the surgeon's division. I 2130 (1). 332. Qualitications for appoiutraent. R 29S8. .. '' 333. Appointment subject to examination. R 2988. ' 334. Pliysical examination by three metlical otticers. R 2989. 335. Professional examination. R 299U. '' 33(J. Duties, sorvicos, and assignments. R 2991. 337. Attfiitioii to patients. R 2992, R 2993. 33S. Records of treatments. R 2994. 33y. Responsibility for dental property. R2995. 340. Reqaisitions and returns. R 2996. ■"■■t'l •• Section 4. — In.structions RB:r.ATiNO to the Professtonat. Examination of Dental Surgeons at Enu of Probationary Period. •: ■ ... ■(' ■■ ■, I'l 346. Professional examination. («) A letter to tije" board giving an account of the candidate's general and professional duties since his admission to the service. Uj) Examination (theoretical) in anatomy (general and dental), physiology (general and dental), histology, physics, chemistry, metallurgy, dental materia nu.'diea and therapeutics, dental ixithology and bacteriology, orthodontia, oral surgery, operative dentistry, prosthetic dentistry, duties of naval dental officers, and Navy Regulations and Instructions. (c) Examination (practical) in iirosthetic dentistry and operative dentistry. (licant according to the following form: (Ilesideuco.) 19_ Siu : I re rrade of dent quest permission to be examined for enrollment in the provisional ^ „^ ..^ntal surgeon, rank of lieutenant, junior gi-ade. Naval Coa.st Defense Reserve' class 4, United States Naval Reserve Force.* I was born at __ — -. and was , years of age on the ___w__ (l-iy of " -— , 191- ; graduated from dental (medi- cid) school' ih 19-^ and atu licensed to practice dentistry in ' the State fam a citizeilof the' United States, residing In ^ — ^—-J^±f county bf , in the State of — . '"' I forward herewith letters testifying to my moral <-haraeter, habits.. citizen- ship, preliminary education, dental education, society membershiit, license to > practice dentistry, and professional qualification.s. "I'l Very resi)ectfully, (Name Tn full writt»sa,l«gii>ly.) Chief of the BukeAu of Medtcinb and Sx'Rgery, .. -iiM Navy Department, Washington, p. G. ' -.vm ,■ , 3r»4. (a) The above apiJlcatiou must be occonipaniod by tlie following" cer- tili<-ates: - , i. v xi«;t..,. Letters or certificates from two or more persons of good rii'pute, testirying from personal knowledge to good Imblts and moral character. A certiticatc or stiiteinent from some person of good repute that the applicant is a citizen of the United States. In case the applicant is a naturallzi^l citizen of the United States his naturalization papm^ orotjier satisfactory evidence Of, citizenship, must be submitted. . .-a^xJ C^rtiticate of preliminary education. The candidate must submit a certificate of graduation from an acceiittnl high scliool or au acceptable equivalent. 'When (llrectpd, the appllcaut slioiilsl .substitute tbe words " VoUint.-er Naval lleserve for duty Iu the Naval Coast l»efeuse Keserve, tlass 4. linlted Stales Nava Ueserve K.rce, for the words •• Naval Coast Defeuse Ueser . e, . lass 4. Tiilled Slates .Naval Ueserve loive. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 29 Certificate of dental education. This certificate should give the name of the school and the date of graduation. , . . . A certificate from the president or secretary of a State or local dental society to the effect that the applicant is a member in good standing. A certificate of license to practice dentistry. If the candidate has had hospital service or special educational or professional advantages, certificates to this effect, signe examiners in the case of a qualified candidate, the Bureau of Medi<'ine and Surgery will recommend to the Kureati of Navigation the provisional enrollment of the candidate in the United States Naval Reserve Force. 3(>0. Upon acce]tling the certificate of enrollment the candidate is reqijirod to take the oath of allegiance, and to certify, on oath, as to his citizen-sldp and age. 361. A member of the United States Naval Reserve Force may transfer to or from the Volunteer Naval Reserve upon approval by the Bureau of Naviga- tion of his request to this effect. 362. Conlirujation in grade : Dental surgeons provisionally enrolled in the Naval Coast Defense Reserve, class 4, United States Naval Reserve Force ; or Vol- UTiteer Naval Reserve for duty in the Naval Coast Defense Reserve, Unitettpr to the board, giving a brief statement of the candidate's gcuieral and professional education. E.xauunation of active service record. . .'•,,,, Knowledge of Navy Regulations and Naval Instructions, Gen6ra,t Orders, aijid Manual for the Medical Department, appropriate to grade; medical department duties during emergency drills, such as fire, collision, abandon ship, battle stations, etc. .. , i.. , ■ r ' Theoretical (writteff 'arid oral) in the following subjects : Aiiatoiby, physio^ ogy, histology, physics, cheriiistry, metallurgy, dental materia rhedica and thfrk- peutics, dental pathology and bacteriology, orthodontia, oral surgery, operative dentistry (theory) and prosthetic dentistry (theory). Practical (clinical) in operative dentistry and prosthetic dentistry. An oral examination is conducted in the following subjects of preliminary education: Arithmetic, grammar, general history, physics, general literature, and Latin. Applicants holding diploma.s or certificates from reputable literary or scientific colleges, normal schools, or high schools may submit stich diplomas or certificates for the consideration of the boin: : ^ . ■ • 421. Duties of Bureau of Medicine and Surgery in connection with the Hospi'tal Corps. R 333. ^ ^ ' , .^ , ■ ■ ♦ f»,„ 422. Not to perform military duties other than those pertaining to the Medical Department. R 1540. . ,. . . , . ^. Toion/ii 423. To constitute a part of surgeon s division on board ship. I 21.>0 (1). 424. Instruction of Hospital Corp.s. R 2901 (1) ; 1 2642 (1-5). 425. Detail and duties on board hospital ships. R 2911. 426. Disciiiline aboard liospital ships. R 2919 (1). 427. Qualifications for enlistment. R 3.'')2."> (1) (12-13). 428 Method of making .service records of the Hosjiital Corps. R 3.)44 (8) e. 42!). i'romotion in Hosi.ital (^oips. R 3317 (1) ; R 3.-r.l (7 8) ; R 35.'i3 (1). 4,10. Di.-iti;f hrij. .fo ...:■ Section 5. — Chief Phabmacist's Mates. ,. ,i s-'l )^'';^51. Enlistment as chief pharmacist's ma,tes. R:3523 (1) ; R 3525 (12-l3l.'ij'.'.'' '452. Permanent appointment. R 35.53. 453. Marines not assigned as chief pharmacist's mates. I 3641. 454. Care of stores R 3402 (1-3). 455. Instruction in first-aid, etc., of Hospital Corps. I 2642. Section 6. — Pharmacist's Mates, First, Second, and Third Class ; Hospital Apprentices, First and Second Class. 461. Rank and precedence. R 1026. 462. Enlistment, requirements and authority for. R 3525 (12). 463. Examination reports and promotions. R 3525 (13) ; R 3.551 (8). 464. Appointment as petty officer. R 3552. 472. Hospital apprentices, second class, may be enlisted without specific authority of department. R 3525 (12). 473. Duties as sick-bay recorder. I 2642 (3). 474. Hospital corpsmen detailed to assist dental surgeons. (M. & S. Letter No. 125300.) Section 7. — General Information Relating to the Hospital Corps. J -481. First enlistments in the Hospital Corps shall be made only in the rating of hospital apprentice, second class, or hospital apprentice, first' class. Appli- cants for enlistment in the rating of hospital apprentice, first class, must obtain from the Bureau of Navigation, Navy Department, permission to be examined for enlistment in this rating. ; Age for enlistment as hospital apprentice, second class, from 18 to 25 years; for hospital apprentice, first class, fi-om 21 to 28 years. Upon enlistment in either of these ratings, men will be transferred to one of the Hospital Corps training schools for instruction. Men who have had previous training in nursing, pharmacy, etc., in civil life may be enlisted in the rating of hospital apprentice, first class, provided they obtain permission to do so from the Bureau of Navigation. 482. A person desiring to enlist as a hospital apprentice, second class, may be examined, and, if qualified, enlisted at any recruiting station or navy yard at which he may apply. 483. Enlisted men of the Navy and Marine Corps are eligible for transfer to the Hospital Corps. Any man desiring transfer to the Hospital Corps should address a request to the commanding officer, who will authorize a board of medical oflicers to conduct the necessary examination. A .successful candidate may bo appointed after his report of examination has had the favorable recom- 98601°— 17 3 . , , 34 J\dA^'UAL FOR THE MEDICAL DEPARTMENT, U. S. KAVY. ineiidation of tlic Tiuroau of Medicine anrl Snrgery approved by the Bureaii of Navijialion. or tho ('(tinniiindant. Alarine Corps, as the case may be. Unlisted men Tt. the Marine Corps desirinp transfer to the Hospital Corps must first rn- qiicst discharjre and ajrree to enlist for a four-year period. Krcept in enun- freiicv a marine is not to be a.ssigned to duty as a chief pharmacist's mate. (I :UJ41 (2).) Men in other l>ranohes or the Marine Corps may chanjre rating only to the ratings of 1i(>v])ital apprentice, second class, or hospital :ii)j)rcntice. first class, proviiled thoy are found qunlifiod by examination as above mentioned. 484. The term of first enlistment in the Hospital Corps shall be for four years. , . • 485. No allowance will be made for trrt^ellng ana other exi>etrsefe attend} iig the examination of applicants. ■ ' 486. Physical and professional examination by one or more medical ofllcers shall be required for enlistment and promotion in each of the several grades and rates. 487. Upon the enlistment, fransf^r, deatli. desertion, change of rating, or discharge of the enlisted force of the Ho.spitid Corps, the medical officer of the ship, hospital, or station will immeditely prepare and for>vard through the con\m:uKlinc ofiicer the prescribed mailing card for the information of the Bureau. This Information is required in order that timely action may be taken to fill any vacancies created. 488. In all cases of transfer to or promotion in the Hospital Corps. Bureau of Navigation, Form No. 1-B shall be forwarded to the Bureau of N^xyigation and Examination Beport, Plospital Corps, and Changes in Hospital Corps, on prescribed forms, to the Bureau of Medicine and Surgery. 489. Members of the Hospital Corps will, in addition to the marks now called for bv the Navy Regulations, have entered on their service records, marks in (1) proficiency in "rating; (2) nursing; (3) first-aid, bandaging, etc. In ad- dition, chief pharmacist's mates an4l pharmacist's mates, first class, will be marked in (4) pharmaceutical ability, and (5) clerical ability. The.se marks will be entered on Bureau Forms Nos. 1 and 1-B under " Professional qualifica- tions " in columns (a), (b), (c), (rf), and (e), respectively; also on continuous- service certificates. 400. Reports of examination: In all cases of examination, either for enlist- ment or promoti(m, or for permanent appointment as chief pharmacist's mate, duplicate reports of examination .shall be made, one copy to be forwarde considered by the Ix.ard and not his aptitude in the present rating. 491. Ktliciency reports: An efficiency report, projierly filled in, shall be for- warded, through the conunanding officer, in every case of transfer, desertion, or di><-hirge of an enlisted n)an of the Hospital (V>rps. (Blank forms of this report are furnished by the Bureau of Medicine and Surgery. 492. In order to avoid confusion the term "nurse" shall be restricted to members of the Nurse ('ori»s (female) and not applietl to members of the Ibispital Corps. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 35 Skction 8. — Chikf Pir\RMAciSTS Axo Pharmacists. 501. Pharniarists sliall, after six years from the date of warrant, he com- missioned chief pharmacists after passing satisfactorily such examinations as the Secretary of the Navy may prescrihe, and shall, wlien so commissioned, have the same rank, pay, and allowances as now or may hereafter he allowed other commissioned warrant officers: rroridcd, That the pharmacists at present in the service who have served or may hereafter serve six or more years in that grade shall he eligible for promotion to the grade of chief pharmacist upon satisfactorily passing the examinations provided for in this act. (A'ct/of Aagl 29. 1016.) '■ "■' !v^';^; 502. The Presidejit may hereaftei-, from time to time, appoint as m';iny pharmacists as may be deemed necessary from the rating of chief pharmaci.st's mate. Chief pharmacist's mates applying for appointment must bo examinefj preliminarily by boards of oflicers to determine their physical and professiortyl fitness to appear for examination. Subsequent to the preliminary examination they shall be required to pass a satisfactory examination before a board t'o de- termine their mental, moral, physical, and profes-sional qualificrations in accord- ance with the provisions of R 3317 (1-2). '/ ' . ^ "' ''^'; ' ',,■;,,, ' ' 503^. A candidate for appointment as pharmacist 'tn«^t''l^e'^'^;^\'1bgTra acting or periuanent appointment as a chief pharmncisf's mate, have served at least three years in the Navy as an enlisted man, at least two years of which service must have been performed on board a cruising vessel, preference being given to men who have been honorably discharged and whose service has been continnous. The average of his marks taken from all his service records must he not less than 85 per cent. No person shall be appointed a pharmacist unles^ his accumulated previous service in the Army, Navy, and IMarine Corps; together with his possible future service prior to attaining the age of 64 yearsi will amount to at least 30 years. (See Changes No. 7, Navy Regulations.) '/ 504. (a) The competitive examination of chief pharmacist's mates for promo- tion to phariuacist shall be conducted by two boards, one to consist of three medical ofric(irs, or, when practicable, two medical officers and a pharmacist, appointed on the station on which the candidate may be serving, another to convene at Washington, D. C. (7)) The local board will examine the candidate physically and in practical work, and al.so conduct the written examination on questions prepared by the Bureau of Medicine and Surgery, but will not assign a mark for the latter. The board at "Washington will mark the written examination and the service record and other records on file in the Bureau of Navigation. The marks of the local board and those of the board at Washington will then be combined to determine the order of merit. (c) The mental and moral examination shall include the previous record of the candidate, his general education, and proof that he is conversant with the clerical duties pertaining to the Medical Department of the Navy as well a^ the management of sick bays and ho.spital wards. His professional examination shall be oral, written, and practical, and shall include pharmacy, materia medica. toxicology, chemistry, minor surgery, hygiene, and the examination of foods. He shall be required to demonstrate, both practically and theoretically, a thorough familiarity with the current jiharmacopoeia. more particularly its pharmacy and materia medica, a knowledge of chemistry sufficient to enable him to make qualitative analyses, uninvolved volumetric quantitative estima- tions (for the latter books are permitted), and urinalyses; a knowledge of minor operations, applications of splints, bandages, etc.; and he shall be re- quired to show that he is well informed regarding the commissary duty at hospitals, and, further, to show his ability in the inspection of foods, such as meats, fi.sh, poultry, etc., and the determining of preservatives and adulterants in milk, butter, jellies, coffee, sugar, and canned vegetables a,nd fruits. 36 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Section 0. — Chief Pharmacist's Mates. 511. (a) Only such men as show particular fitness for the duties of the rating of diiof pharmacist's mate and liave the force of character necessary to control men and to maintain discipline shall be recommended for permanent appointment. A report of insobriety or infraction of discipline shall disqualify any man for examination for at least one year from date of such report. Physical examination is not required. The examination will follow the outline given for the examination for promotion to the rating of chief pharmacists's mate, acting appointment, except tliat more advanced questions shall be given, and include a knowledge of the principal movements of the Hospital Corps Drill Book. (ft) In no case will an acting appointment as chief pharmacist's mate or pharmacist's mate, first class, be issued without the authority of the Bureau of Navigation. Usually an acting appointment as chief pharmacist's mate or pharmacist's mate, first class, is issued only upon the recommendation of a candidate by the Bureau of Medicine and Surgery. (c) Examinations in all cases (for acting or permanent appointment) will bt> practical, oral, and written. r»12. Men must serve in the rating of chief pharmacist's mate, acting apix)int- meut, for at least 12 months before they are eligible for advancement to chief pharmacist's mate, permanent appointment. The examinations. — Candidates for advancement shall be examined in the following subjects: For chief pharmacist's mate (permanent and acting), and pharmacist's mate, first class — (1) Aptitude for the service (shall include gen- eral service record). (2) General education: Arithmetic, spelling, writing (legibility and grammar), geography, and history of the United States. Ho.s- pital training and a knowledge of nursing will be considered to the advantage of the applicant (3) Anatomy and physiology: The skeleton, joints, and muscles, digestive apparatus, blood and circulatory system, respiratory and excretory apparatus, and other organs of the body. (4) Minor surgery and first-aid (including surgical and operating-room technic) : Emergencies of all kinds, con- tusions, wounds, hemorrhages, sprains, dislocations, fractures; the proper con- duct of surgical technic, preparation for operation both as to supplies and appliances, patient, and operator, the proper conduction of minor surgical pro- ct^lures within the duties of a hospital corpsman, attendance upon larger opera- tions in the operating room w'ith Uie surgeon, care of and conduct within the oi)erating room, etc. ; methods of sterilization; removal of foreign bodies in eyes, ears, and air passages ; treatment of effects of excessive heat and cold, bites of poisonous animals, insensibility, fits, a.sphyxia or suffocation ; bandag- ing ; application of splints; and knowledge of the Hospital Corps Drill Book. (5) Nursing and materia medica: Practical and theoretical, including ward management, beds and bed making, baths, treatment other than by mouth, external applications, temperature, pulse, respiration, symptoms and clinical records, names and uses of instruments and appliances, medical and surgical nursing, including preparation of patient for operation. Therapeutic classifica- tion of drugs of the United States Pharmacopoeia, their common, botanical, and oflicial names, parts used, doses and active principles, toxic doses, poisonous syiupliims, and antidotes. (6) Elementary hygiene and sanitation (general and field): Water, air, ventilation, heating and lighting of wards, etc.; dis- posal of wastes; disinfection and disinfectants; sterilization, handling of infectious diseases, and prevention of dlsea.se; practical duty In the field. (7) Diets and messing f(»r the sl<'k ; classes of food, various classes of diet, diet for special diseases, obtaining and preparation of food, jtroper service of diets to patients. (8) Clerical procedures and forms: Knowledge and preparation of bureau forms, tyitevvriting, and ability to fornnilate tM|)les anend on the demands of the service for chief petty officers. A pharmacist's mate, first class, will not be advancetl to the rating of chief petty officer during his first enlistment, but he may be toward the completion of his first eidistment recommended for the rating of chief pharmacist's mate, acting appointment, with a view to his advancement upon reenlistment should he be found qualified by examination and his services be required in that rating, depending upon the needs of the service for chief pharmacist's mates. The examination for these three ratings may be given without the department's further authority, and shall be conducted in accordance with the outline given in paragraph 512, before a board of three medical officers, or two medical officers and a pharmacist, detailed from a station ship, or sliips other than that upon which the candidate is serving, if practicable. 514. The medical officer under whom the candidate is then serving shall submit a statement of his opinion as to the man's qualifications and general fitness for the rating of chief pharmacist's mate, or pharmacist's mate, first class. This statement should be made on the prescribed form, great care being taken to answer questions frankly and to assign marks fair to the man, but with a view to the subsequent service he is to perform. Upon completion of the examination the written proceedings, without corrections or assignment of marks, shall be forwarded to the Bureau of Navigation, the board only to enter marks for practical work and the candidate's aptitude for the higher rating, on the form Examination Report, Hospital Corps. The papers will then be passeil upon by the department, and if the candidate is found qualified instructions will be given for the issue of an appointment, providing his con- duct has been satisfactory in the interim. Section 10. — Pharmacist's Mates, First, Second, and Third Class, and Hos- pital Apprentices, First and Second Class. 520. For advancement to pharmacist's mate, second and third class, and hospital apprentice, first and second class, the medical officer should examine the candidate in accordance with the following outlines : Should the candidate be found qualified for advancement to the rating which he seeks he may be issued an appointment without further authority from the bureau (except in ratings of pharmacist's mate, first class, and cliief pharmacist's mate, acting and permanent). 521. Men must serve in the rating of pharmacist's mate, second class, for at least 12 months before being eligible for advancement to pharmacist's mate, first class, and must pass the examination prescribed in paragraph 512. 522. Men must serve in the rating of pharmacist's mate, third class, for at least 12 months before they are eligible for advancement to the next higher rating. Men must have served in the Hospital Corps for at least 24 mouths continuously before being advanced to the rating of pharmacist's mate, second elas.s. 38 MA>iUAL FOR THE MEDICAL DEPART A1KNT,U. S. NAVY. Applicants for proinotinii to llio nitinfr of pliann.uists mate, sccuiitl class, will he cxaiiiiiicil in llic follou iii}^ .siiltjccls : (1) AptiUiilc for the service (shall inclinle ;,'cn('rMl .service re<'i»r(l). {'2) (Jeiier.il education: Ai'ithnictic, spelliug, \vritin,Lr (legibility ami grauiniar), Kt'oKi'i'pl'.v. and liisLury of the United States. Hospital traininfi antl a knowledj^e of nursing will be considered to the advan- tage of the applicant. (3) Anatomy and jihysiolof^y : The skeleton, joints, and muscles, digestive apparatus, blood and circulatory system, respiratory and excretory apparatus, and other organs of the body. (4) Miuor surgery aud lirst-aid (including surgical and oi^erating-room technic) ; euiergeucies of all kinds, contusions, wounds, heniorrhages, sprains, dislocations, fractures; the proper conduct of surgical tochnic, prepiiration for ()i)eration both as to supplies and appliances, patient and operator, the proper conduction of minor surgical procetlures within the duties of a hospital corpsman, attendance upon larger operations in the opexating room with tlie surgeon, care of and conduct within the operating room, etc. ; methods of sterilization ; renjoval of foreign bodies in eyes, ears, and air passages; treatment of elTects of excessive heat and cold, bites of poisonous animals, insensibility, fits, asphyxia or suffocation ; bandaging; application of splints; and knowledge of the Hospital Corps Drill Book. (5) Nursing ajul materia medica : Practical and theoretical, including ward manage- ment, j)eds and bed making, baths, treatment other than by mouth, external applications, temperature, pulse, respiration, .symptoms and clinical records, names and uses of instruments and appliances, medical and surgical nursing, including preparation of patient for operation; therai)eutic classitication of drugs of the United States I'liarmacopoeia, their connuou, botanical, and ollicial names, parts used, doses and active principles, toxic doses, poisonous symi)toius, and antidote.s. (6) Elementary hygiene and sanitation (general and field) : Water, air, ventilation, heating and lighting of wards, etc.; disposal of wastes; disinfection and disinfectants, sterilization, handling of infectious diseases and prevention of disea.se; practical duty in the field. (7) Diets and messing for the sick: Classes of food, various clas.ses of diet, diet for .special diseases, obtaining and preparation of food, proper service of diets to patients. (8) Clerical procepiies and ap[)liunces of patient and ojH'rator, the proper conduction of minor surgion larger operations in the operating room with the surgeon, care of and conduct williiu the oi>erating room, etc.; methods of sterilization; removal of fc»reign liodies in eyes, ears, and air pas.sages ; treatment <»f eflects of excessive heat aud,(x>m. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 39 bites of poisonous animals, insensibility, fits, asphyxia or suflfocation ; bandag- ing, application of splints, and knowledge of the Hospital Corp Drill Book. (5) Nursing and materia niedica — practical and theoretical, including ward management, beds and beil making, baths, treatment other than by mouth, external applications, temperature, pulse, respiration, symptoms, and clinical records, names and uses of instruments and appliances, medical and surgical nursing, including preparation of patient for operation. Therapeutic classifica- tion of drugs of the United States Pharmacopoeia, their connnon, botanical, and olllcial names, parts used, doses and active principles, toxic doses, poisonous symptoms, and antidotes. (6) Elementary hygiene and sanitation (general and tield) — water, air, ventilation, heating and lighting of wards, etc.; disposal of wastes; disinfection and disinfectants, sterilization, handling of infectious dis- ea.^e and prevention of disease ; practical duty in the field. 524. (a) On first enlistment men will be enlisted in the ratings of hospital apprentice, second class, and hospital apprentice, first class, only. Men already eidisted may change their rating to one of these ratings only. ' Men who have had previous training in nursing, pharmacy, etc., in civil life may be enlisted in the rating of hospital apprentice, first class, provided they obtain permission to do so from the Bureau of Navigation. All men who are enlisted as, or change their rating during the first half of their four-year term of eidistment to, either hospital apprentice, second class, or hospital apprentice, first class, will be transferred to the nearest Hospital Corps training school for instruction immediately upon enlistment or change of rating and without further authority from the Bureau of Navigation. Men who have enlisted in or have been transferred to the rating of hospital apprentice, second class, and have been detailed to one of the Hospital Corps training schools for instruction, must serve in this rating until the course of instruction is completed. Upon completion of the course and graduation from one of these schools, they will be advanced to the rating of hospital apprentice^ first clas.s. ]Men who have changed their rating to that of hospital apprentice, second class, and have not attended a Hospital Corps training school, must serve at least six months in this rating before they are eligible to take the examination for advancement to hospital apprentice, first class. , {b) Applicants for enlistment in or promotion to the rating of hospital ap- prentice, first class, will be examined on the following subjects: (1) Aptitude for the service (shall include general servi^-e record). (2) General education: Arithmetic, spelling, writing (legibility and grammar), geography, and history of the United States. Hospital training and a knowledge of nursing will be considered to the advantage of the applicant. (3) Anatomy and physiology: The skeleton, joints, and muscles, digestive apparatus, blood and circulatory system, i-espiratory and excretory apparatus, and other organs of the body. (4) Minor surgery and first aid (including surgical and operating room techuic) : Emergencies of all kinds, contusions, wounds, hemorrhages, sprains, dislocations, fractures ; the proper conduct of surgicy,l technic, preparation for operation both as to supplies and appliances of patient and operator, the proper conduction of minor surgical procedures within the duties of a Hospital Corps man, attendance upon larger operations in the operating room with the surgeon, care of and conduct within the operating room, etc., methods of .sterilization ; removal of foreign bodies in eyes, ears, and air passages ; treatment of effects of excessive heat and cold, bites of poisonous auinials, insensibility, fits, asphyxia or .suffocation; bandaging, application of splints, and knowledge of the Hospital Corps Drill Book. (c) Applicants for enlistment in or transfer to the rating of hospital ap- pi'entice, second class, will be examined on the following subjects: (1) Apti- tude for the service (shall include generar service record). (2) General edu- cation: Arithmetic, spelling, writing (legibility and grammar), geography, and history of the United States. Hospital training and a knowledge of nursing will be of advantage to. the applicant. *,,_, 40 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NA\^. i25. rantli(l;ites for .•i(lv;iiiceuioiit iiiiist Mttaiu the marks required as fol- lows: For chief plianuacist's inato (permuueiit appointment), 3.5 ; chief phariiia- cist's mate (acting appoiutmeut), 3; pharmacist's mate, first clas-s, 3; all other rate.s, at least 3. While the examinations for chief pharmacist's mate (permanent and actinj.?) and pharmacist's male, llrst class, are similar, a coiiiparatively !j;reater knowi- e.n, . ,/, •"" . ' ' ..iSftei'ibKr l2.^Hosi'iTAii CObpsI' U. S. Naval RE^iEii^T:' Force. 541. Det.'iiled Information as to the obligations, emoluments, and necessary (lualilicalloiKS for enrollment in general will be found in paraj^raph 131 (a-r). Phabmacist. G42. Enrollment of persons (not previously connected with the Regular Navy) us pharmacists, U. S. Naval Reserv^; Force, .shall be made In the Naval C,)oast Defen.sc Ueserve, class 4. 543. A candidate for enrollment as ti pharmacist lii the Naval Reserve Force must enroll in the provisional enlisted rating of chief pharmacist's mate and MANUAL FOB THE MEDICAL DEPARTMENT, U. S. NAVY. 41 must perform at least three months' active duty in this rating. Subsequent thereto, if recommended as a satisfactory candidate for pliarmacist, U. S. Naval Reserve Force, by the medical and conuuandinj;: officers \mder whom duty has been performed, an additional continuous period of at least three months, active duty, for further instruction and training must be served at a naval hospital or on board a hospital ship. 544. Candidates for enrollment must apply to the Chief of the Bureau of Medichie and Surgery for permission to be examined to determine their quali- fications for enrollment in the provisional enlisted rating of chief pharmacist's mate with a view to subsequently qualifying for the grade of pharmacist, U. S. Naval Reserve Force. 545. Application for enrollment must be made in the handwriting of the applicant according to the following form: (Rasidencc.y <>.:ni\: > : __^__^____, 19— SiK : I request permission to be enrolled in the provisional rating of chief pharmacist's mate, in the Naval Coast Defense Reserve, class 4, U. S. Naval Reserve Force, with a view to subsequent examination for advancement to the grade of pharmacist in the U. S. Naval Reserve Force, the examination to be held subsequent to such periods of active service under instruction and train- ing as the Secretary of the Navy may prescribe.* I was born at , and was years of age on the day of , 19 ; and am a citizen of the United States, residing in , county of , , and State of I graduated from the School of Pharmacy and am licensed to practice pharmacy in the State of .. I forward herewith letters testifying to my moral character, habits, citizen- ship, preliminary education, pharmaceutical and chemical education, license to practice pharmacy, experience in hospital organization, management, commis- sary, etc. ..Very respectfully, i; nuii.';! , ■".■ — ^ .^iit^^-d^^ (Name in full,. wvitten legibly.) Chief of the Bubeau of Medicine and Surgery, Navy Department, Washington, D. C. 546. The above application must be accompanied by the following certificates: (a) Letters or certificates from two or more persons of good repute, testi- fying from personal knowledge to good habits and moral character. (b) A certificate or statement from some ijerson in good repute that the applicant is a citizen of the United States. In case applicant is a naturalized citizen of the United States his naturalization papers or other satisfactory evidence of citizenship must be submitted. ■ (c) Certificate of preliminary education. The candidate must submit a certificate of graduation from an accepted high school or an acceptable equiv- alent. (d) Certificate of pharmaceutical education. ThiS'Certiflcate shoukl give the name of the school and the date of graduation, i-. ."i ijoii' ■.aiiiiip iw,,; -..li (e) A certificate of license to practice pharmacy. ' ■'" '•■'■■ ' i' 'a:; (/) Certificates to the effect that the candidate has had experience in hospital organization, management, and commissary and special aiucational or pro- fessional advantages, signed by proper authorities. 547. The applicant will save unnecessary correspondence if he will make sure when submitting him application that the qualifications enumerated above are clearly and plainly described in his letters or certificates. •' . ■ j . ' 'When directed, the applicant should substitute the words '* Volunteer Naval Reserve for duty in the Naval Coast Defense Reserve, class 4, lliiited States Naval Reserve Force" for the words "Naval Coast Defense Reservp, class 4, IJ. tS. Naval Reserve: Force." 42 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 548. After passing u|)i>ii the credoiitijils of tlii> rjimrulate. the Hnrcaii of Medifino and Sur^^ery will issue u permit to the candidate, eflective for a stated period, to apj»ear hefoie one or nioie medical examiners designated by the bureau via tiie commandant or commandinti otficer, for his provisional physical and professioinil examination. The i)ermit will direct the candidate to communicate with the senior medical examiner as to the date and place of examination. An eflort will be made to select the i)hice of examination as near as iM)ssiltle to the place of residence of the candidate. 549. When a candidate i»re.sents himself for examination on the date fixed by tlie senior medical examiner, he nmst bring with him the testimonials as t-»» ciiaracter, habits, citizensliiii, preliminary education, i)harmaceutical educa- tion, license to practice pharmacy, and letters describing professional f|uali- lications and those indicating his experience in ho.spital organization, manage- ment, and coinmissary ; those forwarded with his application being returned for this purpo.se. 550. The examination Is conducted in the following order: 1. Physical. 2. Profes.sional. . • ' (a) The iihysical examination is thorough and the candidate is required to certify that he is free from all nlental, physical, and ' constitutional defects. (See "al.so par. 2107.) Acuteness of vision. 12/20 for each eye unaided by glasses bnt capable of correction by aid of lenses to 20/20, is obligatory. Color perception nmst be normal and the teeth good. If the candidate is found to Tie physically disqualified the exfimrnation Is concluded ; but, in the case of a candidate otherwise desirable, the medical examiners may recommeml that minor discjualitications or departures from standard be waived and i)roceed with the professional exannnation, subject to final approval by the dei)artment. If found to be physically qualified bis examination is continued as follows: , (6) Professi(»nal examination. — (1) Letter to the board dsecribing in detail his general and professional education. ; (2) Examination of diplomas, certificates of State boards. (Certificates and letters and such other recommendations bearing upon the professional quali- fications of the applicant as he may de.sire to subuut. , ,^,, ^.n,: > (3) Written examination as pre.scribed in paragraph 512. (4) Upon completion of the examination the written proceedings, without corrections or assignment of marks, shall be forwarded to the Bureau of Medi- cine and Surgery (Bureau of Navigation), the l>oard only to enter uuirks for I)ractical work and the candidate's aptitude for the rating on the form Examl- nation Ueport, Hospital ('orp.s. The papers will then be passed upon by the bureau, and if tlie candidal e is found qualified the Surgeon (;eneral will reconi- mend to th<' Bureau of Navigation the enrollment of the candidate in the provisional rating of chief pharmacist's mate, United States Naval Reserve Force. ■.'■.( ■ > • :' ' 551. After enrollment In the ivrovlsional enlisted rating of chief phannaclst'a mate Is accomplislii'eriod must be served in the i)rovisional rating of chief pharmacist's mate and may be served in one period or in i)eriods (tf not less than three weeks each year successively. The second jteriiKl must be one of continuous service for three months' active duty at a naval hospital or on board u lios]iital ship. 553. Subscipient to the first period, shouUl the candidate be reconmiended as a satisfactory candidate for pharmacist. UniU'd States Xaval Reserve Force, and ftir further instruction and training by the medical and connn.-inding otfu^TS under whom duty has been performed, he should again ai)ply to the I'.ureau of Medicine ami Suigery for assignment to tluty, the ai)pli<'atiou to accomi)any the MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 43 letter of reconinuMidutioa submittod by the medicul and coinuiandiuj,' ofllfers. Upon receipt of his applieution lie may be given an oj)pui-lunlly to serve aa additional continuous period of at least three months' active duty for further instruction and training- at a naval hosi)ital or on board a hospital ship. At the end of the second period of active duty if he so requests and a vacancy exists the candidate may appear for final examination to determine his quali- ficatious for appointmeut as a pharmacist. United States Naval Reserve Force. 554. Upon receipt of the applicant's request for final examination for ap- pointment and notice from the commanding officer of the hospital that the re-. quired two periods of service under instruction and training have been com-, pleted the candidate will be directed to appear before a board of medical examiners designated by the bur^^u fw" jlais physical.. ancl ^t^of^ssipaafl ,exajBi- nation. , • :.,i ■ ; ■<. . . ..'■ ' ■ ■, ■■■'■■ I )^. i 555. Confirmation in grade: An applicant completing the active service re- quired, who requests permission to be exnmined for appointment as pharma- cist. United States Naval Reserve Force, may be authorized to ajtpear for ex- amination at a designated place before a statutory board apiwiuted for this purpose. (a) The physical examination is that described in paragraph 5;:)0 {a). (?>) Professional examination.— (1) Letter to the board giving a brief state- ment of the candidate's experience while undergoing instruction and training in active service. (2) Examination of active service records. (3) Professional examination as prescribed in paragraph 504 (c). (4) The board will give careful consideration to composition and spelling as shown in the written papers submitted by the candidate and through his service record. (5) Seventy-five per cent is required as a general average. 556. Those "chief pharmacist's mates provisionally enrolled in the United States Naval Reserve Force who have been found duly qualified for appoint- ment as pharmacist, United States Naval Reserve Force, and who will be within the age limit of 35 years at the completion of the examination, will be recommended for appointment as pharmacists, United States Naval Reserve B\)rce, provided they have been found qualified by the examination above. 557. A member of the United States Naval Reserve Force may transfer to or from the Volunteer Naval Reserve upon approval of the Bureau of Naviga- tion of his request to this effect. 558. No allovvance will be made for the expenses of persons appearing for examination. Hospital Apprentice. Fibst and Second Class. 560. A candidate for enrollment as a hospital corpsman is first examined for enrollment in the provisional rating of hospital apprentice, second class, or hospital apprentice, first class, Naval Coast Defense Reserve, class 4, United States Naval Reserve Force. Afterwards, if his enrollment is accomplished, should he so desire, he makes request for active duty for confirmation in rating, and after the completion of a mininnim period of three months' active service he is again examined for confirmation in rating. 561. When first reporting for active service for training during each period of enrollment men are credited with a clothing gratuity of $30. In time of war or national emergency he is credited with $60 less the amount previously credited, if any, during the current enrollment. 562. Men who have. had nursing, first-aid, medical, pharmaceutical, or other allied trainings, such as students at medical, dental, or pharmaceutical colleges, attendants or nurses, druggists' clerks, etc., who are citizens of the United States, between the ags of IS and 28, if found qualified, may be examined for enrollment in the Naval Coast Defen.se Re.serve, class 4, United States Naval Reserve Force, Hospital Corps. 44 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 5G3. The oxjiininnticni coiKlucteil at the enrolling ofTice is simple. It con- siists i)f a physical exaniinatioii, followed by a professional exaiiiination whifh is exa<-tly the same as that ;;iven aitpli'anls for the Kegular Naval Estahlisluiieiit, except that a iHMinit for permission to he exaniini'd for the provisional rate of hospital apprentice, first class, is not required. (See paragraphs 2107 and 524 (ft) and {(■).) 564. A member enrolled who desires active duty for the purpose of instruc- tion and training may make api)lication to his commanding otlictT, the com- mandant of the naval district in which the member has enrolled. The applica- tion may be in person or by letter and should state the length of active duty desired and the approximate dates the member desires to accept service. 605. Confirmation in rating: When the member has served the minimum period of active duty, three months, he may be examined for confirmation in rating. The physical and professional examinations are those prescribed in paragraph 5G3. CHAPTER 5. THE NURSE CORPS. Section 1. — I>aws Relating to the Nurse Corps. 601. Establishment of the Niirse Corps. (Act of May 13, 1908.) "The Nurse Corps (female) of the United States Navy is hereby established, and shall consist of one superintendent, to be appointed by the Secretary of the Navy, who shall be a graduate of a hospital training school having a course of instruction of not less than two years, whose term of office may be terminated at his discretion, and of as many chief nurses, nurses, and reserve nurses as may be needed : Provided, That all nurses in the Nurse Corps shall be appointed or removed by the Surgeon General with the approval of the Secretary of the Navy, and that they shall be graduates of hospital traiiung schools having a course of instruction of not less than two years. The appointment of superin- tendent, chief nurses, nurses, and reserve nurses shall be subject to an examina- tion as to their professional, moral, mental, and physical fitness, and they shall be eligible for duty at naval hospitals and on board of hospital and ambulance ships and for such special duty as may be deemed necessary by the Surgeon General of the Navy. Reserve nurses may be assigned to active duty when the necessities of the service demand, and when on such duty shall receive the pay and allowances of nurses: Provided, That they shall receive no compensation except when on active duty. The superintendent, chief nurses, and nurses shall, respectively, receive the same pay, allowances, emoluments, and privileges as are now or may hereafter be provided by or in pursuance of law for the Nurse Corps (female) of the Array." 602. Ray of the Nurse Corps (Army), Army appropriation act: Extract from the act of March 23. 1910, making appropriation for the support of the Army for the fiscal year ending June 30, 1911, providing for the pay of the Female Nurse Corps of the Army : " * * * and the superintendent and members of the Female Nurse Corps shall hereafter be paLd at the following rates: Superintendent Nurse Corp.s, one thousand eight hundred dollars per annum ; female nurses, fifty dollars per month for the first period of three years' service; fifty-five dollars per month for the second period of three years' service; sixty dollars per month for the third period of three years' service ; and sixty-five dollars per month after nine years' service in said Nurse Corps; and all female nurses shall here^ifter be entitled, in addition to the rates of pay as herein provided, to ten dollans per month when serving beyond the limits of the United States comprising the Union and Territories of the United States contiguous thereto (except Porto Rico and Hawaii), and to cumulative leave of absence with pay at the rate of thirty days for each calendar year of service in said corps ; and when serving as chief nurses their pay may be increased by authority of the Secretary of War, such increase not to exceed thirty dollars per month; and the superin- tendent shall be entitled to the same allowances, when on duty, as a member of the Nurse Corps." 45 46 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Section 2. — Navy Regulations and Xavai, Instructions Relating to the Nurse Corps. 611. Bureau cliiirped with appointment, removal, administration, and in- struction of the Nurse Corps. R 183 (1-2) ; R 2JX)1 (1). 612. Suliject to authority of eonini:m22 (1). 614. Retiuirements for appointment. R 3;>22 (2). (See also circular for the information of persons desiring to enter the Nurse Corps, N. M. S. 1155S3.) 615. Duties of superintendent and detail of nurses. R 3022 (3). 616. Pa.v and allowances. R 3322 (4) : R 4 428. 617. Authorit.v of nurses on duty. R 3322 (5). 618. Commutation of quarters. R 4r»14. 619. Allowance of fuel. R 4515 (7). 620. Plaf-es where eligible for duty. I 3201. 621. Reserve nurses. R 3322 (31. 622. See also Manual for the Medical Department, U. S. Army., 1911. pars. 4S-96- Changes No. .3, April 2(5; l9l2!. Manual for the ^Mcdical.Dopar.tincnt, y..S. Army,' 1911. Army Regulations. 1910. arts. 743-750, 1136', 114S, and 1^1} ^n(^, Army Transport Service Regulations, 190S, arts. 14S-163. 623. Speci.nl nurses not to be eitiploycd. I 3231. (M. & S. letter No. 120r>7«.') " ' " ',' ' 624. Trangl>6rt{ition and travelling allbwances. 1123. ' Section, 3.— Duties of the S^uterintkndbnt of the Nukse Corps. 6.31. The superintendent of the N'urse Corps will he appointed hy the Sec- retary of the Navy upon rofommendation by the Surgeon General, subject to examination as to professional, moral, mental, and physical fitnes-s, and to the re- quirements. of the law regarding hospital training. The appointment may he revoked l>y the Secretary of the Navy upon the recommendation of the Surgeon Ceneral. A request for permission to appear for examination preliminary to appointment will he addre.ssed to the Secretary of the Navy via the Surgerui General. The examinati(m \vi1l be conducted by a hoard of medical ofhcers. Any applicant for the position of superintendent will be required to present herself in Wa,shington, D. C. The requirements for examination are, in general, as hereinafter prescribed fbf the examination of candidates for appointment as nurses. -' ,■ 6.32. The s\iperintendent for the Nurse Corps will have general supervision of the corps under the Bureau of Jledicine and Surgery. By authorized in- spections and from information contained in reports and returns, the superin- tendent will keep hej-.self informed of tlie condition, number, distribution, c«mi- petency, and dates of termination of appointments of the memliers of the corps. She will conduct the correspondence wifh inirses' training schools and nurses' li.ssociations, with the i-"iiif: o Section 5.— Chief^ Nubses. 661. Chief nurses will not be appointed from civil life, but vacancies will be filled by promotion from the grade of nurse. Permanent assignments to duty as chief nurse are made only by the Surgeon General, upon the recommendation of the superintendent. Before final promotion a nurse must have served at least one year in the Nurse Corps and have passed the prescribed examination. 662. The examination of a nurse for promotion will be conducted at the sta- tion, under the direction of the me.i \H' i 'U": • ■■' • '"*''!■ "'^TyCTION 6. — -ASsrONMENTS AND TrANSFEBS. 671. (a) Nurses will be assign^ 'to duty by direction of the Surgeon General, and Ihoy will be rcfpiired to serve at home or abroad. Their services are avail- able for sick, wounded, and disabled officers, enlisted men, and other patients in naval hospitals and for such special duty as may be deemed necessary by the Surgeon General. When traveling under orders by land or sea, they will assist in the care of sick oflicers and enlisted men who may be present on the same conveyance, such services being rendered under the direction of a medical officer, if one is present, and report for such service shall be sent to the Surgeon General by competent authority. (5) The families of officers and enlisted men are not entitled to the services of Navy nurses, and they will not be detailed for such duty except with the prior approval of the Surgeon General. Ati emergency requiring such services in advance of approval should be reported to the Surgeon General, stating all the circumstances. 672. (a) The first six months after appointment shall be regarded as a pro- bationary period to obsetve tlie professional, moral, mental, and physical fitness of the nurse for the naval service in connection with the siiecial instruction, duties, and adaptability to connnunity environment peculiar to the Navy. ,; (h) Three weeks prior to the expiration of the probationary period fh6' bureau will forward the ])rescribed form for a supplementary physical exami- nation to be made and returned to the Surgeon General, obserA-ing the require- ment of confidential coinnuinications. (c) At the same time the chief nurse shall submit a special efiiciency report relative to general fitness and aptitude, considering the professional, moral, and mental qualifications of the nurse, and making such recommendation as may be indicated bv the report. The medi(,-al officer in command will state by indorsement whether or not he concurs in the opinions expressed; and also will niake recommendation as to whether or not he consiplicnti(.n to the Surgeon (general, through official channels, stating the nujuber requinnl and the necessity. A surplus of nurses on the station at any time should be immediately reported to the Sur-' MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 49 geon General and, on a foreign station, to the commandant or commander in chief. 675. Nurses will not be transferred without the authority of the Surgeon General, except at stations beyond the continentiil limits of the United States, where, upon the recommendation of the medical officer, transfers may be directed by the commander in chief. A commander in chief on a foreign station may direct the return of sui'plus nurses to the United States. Nurses so trans- ferred will be directed to report immediately upon arrival in the United States to the medical officer in command of the naval hospital nearest to the port of arrival The nurses will be placed on temporary duty awaiting instructions from the Surgeon General. Such transfer of nurses will be reported at once to the Surgeon General, with a statement of the circumstances. 676. Nurses in complying with orders involving a change of station will be governed bj article 702, Naval Instructions, affecting officers in like circum- 677. A nurse will not leave her station except under orders or when granted leave of absence. Section 7. — Leave of Absence. 681. Members of the Navy Nurse Corps are entitled by law to cumulative leave of absence, with pay, at the rate of 30 days for each calendar year of service in the corps, to be reckoned in each case from the date of her letter of appointment. Extra leave of absence with pay on account of illness can not be granted. Leave credit will not be allowed for periods of absence without 682. (a) Leave may be accumulated at the rate of two and one-half days for each month of completed service, including periods of leave with pay granted under appointment. The accrued amount may be granted whenever the ex- igencies of the service permit. Final leave to the amount accumulated and unusued not to exceed 120 days will be granted prior to honorable discharge. (&) Upon showing good and sufficient reason for such request leave without pay not to exceed one month may be granted when the requirements of the service permit. 683. Leave' accruing but unused under one appointment will not be credited irader a subsequent appointment, but this ruling does not apply to a continua- tion of service beyond the three-year term. 684. (a) Authority to grant leave of absence in excess of 10 days rests only with the Surgeon General, subject to modification in section (d) of this paragraph. (b} Requests for leave of absence or extension thereof shall be submitted by the nurse in writing, using the prescribed form, and shall not be embodied in other requests. Sufficient time shall be allowed for delay and transmission by mail. (c) Nurses absent over leave shall be automatically on status of leave with- out pay and shall be reported to the Surgeon General with such explanation as may be submitted for definite action. (d) In the case of nurses on duty at hospitals or on hospital ships beyond the continental limits of the United States the commanding officer may grant leave of absence as provided in paragraph 681. The original orders granting such leave will be returned to the nurse, and the period of leave and by whom granted shall be reported to the Surgeon General. 685. (a) When accumulated leave of absence with pay is granted to a nurse on service in Alaska or beyond the continental limits of the United States for the purpose of coming to and returning from the United States, such leave shall be calculated between the date she reached or might have reached the United States and the date she left or should have left the United States via the usually traveled routes. If the nurse's return to service abroad is not required, the termination of her leave shall be calculated from the date she 98601°— 17 4 50 MANUAL FOR THE MEDICAL DEPARTMENT, TJ. S. NAVY. arrived or should have arrived in the Unitearation of the reports, returns, .-ind inforniniion slips concendMg the nurses, and she shall be directed to iner must be a citizen of the United States. (b) A member obligates herself to perform and may he ordered to active service in the Navy throughout a war, or during the existence of a national enierg) is not required, the candidate will submit a prescribed essay on nursing subjects designated by the Bureau of Medicine and Surgery. (4) AVheu the written examination {b) and the essay (c) are not required, the Bureau of Medicine and Surgery may direct an oral examination to be conducted by such examiners and at such places as may be detei-mined upon by the bureau. Due credit will be given for knowledge and experience in the case of candi- dates who have specialized in certain branches and who have had exceptional institutional experience, and the examination will be modified accordingly. (ft) Physical ca;amination.—HeiK>Ytfi of physical examination must be made by a medical examiner on blank forms supplied by the bureau for this purpose. The reports are not given to the candidate, but are sent direct to the Bureau of Medicine and Surgery and are regarded as confidential. No allowance will be made for the expenses of persons appearing for exam- ination. Candidates may appear for examination before a medical officer of the Army or Navy. 794. The examination papers and reports are forwarded to the Bureau of Medicine and Surgery, Washington, D. C. for approval. When the candidate is found mentally, morally, professionally, and physically qualified, the Surgeon General, United States Navy, will recommend to the Bureau of Navigation that the candidate be provisionally enrolled as a nurse. Naval Coast Defense Reserve, class 4, United States Naval Reserve Force. 795. Confirmation in graile. — Nurses provisionally enrolled in the Naval Coast Defense Reserve, class 4, who apply to the Bureau of JNledicine and Surgery for permission to perform the minimum amount of active service required for confirmation in grade, and who, after completing the active service required, request permission to be examined for confirmation in grade, will be given an examination in accordance with the following instructions: (rt) Physical examination. — A report of physical examination on the pre- scribed form submitted by the bureau will be required. (&) Professional examination. — (1) Letter from the candidate to the Sur- geon General giving a brief statement of her professional education. (2) Examination of acitve-service record as noted in the filed eiliciency reports. (3) A Avritten or oral examination will be required to determine whether or not the candidate possesses a knowledge of Navy Regulations and the Manual for the Medical Department appropriate to her grade. This examina- tion will be sufficiently comprehensive to determine the candidate's qualifica- tions to perform the duties of a nurse under the usual service conditions. 796. Those nurses provisionally enrolled in the United States Naval Coast Defense Reserve, class 4, who have been found qualified by examinations will be confirmed in grade. CHAPTER 6. THE DUTIES OF MEDICAL OFFICERS (AND DENTAL OFFICERS). Section 1. — Laws Relating to Duties Afloat. 801. Distilled spirits only as medical stores for medical purposes. Sec. 1624, R. S. ; R 13. 802. Commanding officer to consult surgeon regarding health of crew. R 20 (8). 803. Duties of fleet surgeon. Sec. 1374, R. S. 804. Loss of pay of officers and men for absence from duty on account of disease resulting from intemperate use of drugs or alcoholic liquors, or other misconduct. Act April 27, 1914. Act August 29, 1916. Section 2. — Navy Regulations Relating to the Duties of the Medical Officer of a Ship. 811. (a) Organization of the Medical Department. I 2501 (1). ( ft ) General duties and authority of medical officer. R. 2951. 812. Contagious and infectious diseases, prevention, care, and treatment of R 2952. 813. Sanitary condition of ports visited. R 2953. 814. Sanitary suggestions and reports. I 1122 (5) ; R 2954. 815. Precautious against disease among personnel of the ship. R 2955 (1). 816. Malingering. R 2955 (2). 817. Concealed diseases. R 2955 (3). 818. Relief of wounded and instruction in first-aid. R 2956. 819. Killed and wounded, report of. R 2957. 820. Inspection of food for the ship. R 2959. 821. Unofficial certificates of ill health prohibited. R 29.58. 822. Medical survey or transfer to hospital of persons unfit for duty. R 2960. 823. Transfers: (a) Medical officer to accompany serious cases, if practicable. R 2961 (1). (b) Papers accompanying patients. R 2961 (2). (c) Examination of men before transfer. R 2961 (3). 824. Patients transferred to other than naval hospitals, procedure regarding: (a) Medical history continued until ship leaves port. R 2962 (1). (&) Health record transferred to consul upon departure. R 2962 (2). (c) Medical officer of a ship arriving in port to take charge of such patients. R 2962 (3). (d) Hospital expenses. R 2962 (4). (e) Patient so transferred or received shall be reported. R 2962 (5). 825. Certificate (report) of death: (a) Prepared in duplicate and one additional for commander in chief. R 2963 (1). (5) In case of officers, additional copy to Bureau of Navigation. I 5247 (36). (c) Origin of disease or injury causing death to be noted with reasons. (See also Fleet Regulations.) R 2963 (2). 61 62 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 826. Medical storeroom, precautious regarding. R 2964. 827. Custody of spirits, wines, and malt liquors. R 2965. 828. Epidemic or contagious diseases, reports of; and sanitary data from foreign ports. R 2953 ; R 2966. 829. Duty in conuectiou with Indorsement on records of summary courts- martial. R 621 ; R 2967. 830. Absence or disability of medical officer, next in rank to succeed. R 2968. 831. Officer detached during cruise to inspect department with his relief. R 2051. 832. Loss of pay of officers and men for absence from duty on account of disease resulting from intemperate use of drugs or alcoholic liquors or other misconduct. General Orders Nos. 100 and 231. 833. To prepare misconduct reports; see 2820. General Orders, Nos. 100 and 231. Section 3. — Navax Instbuctions Relating to the Duties of the Medicai- Officer of Ship. 841. Duties connected with the fitting out of a ship. I 2101. 842. Examination of crew and verification of records. I 2102. 843. Vaccination. 12103; 13211; 13212. 844. Charge of sick bay and other compartments under Medical Department to be assumed by the medical oflicer. I 2104. 846. Attention paid the .sick by Hospital Corps and when to summon medical officer. I 2105 (1-2). 846. Consultation with other officers regarding professional treatment 1 2106. 847. Daily report of sick. I 2107, 848. Binnacle list. 12108. 849. Instruction in first aid. 1 2109 ; 1 2641. 850. Ini^ection of provisions for crew. 12110; 12618 (2). 861. Preparation of food. 12111. 852. Testing water. I 2112. 853. Inspectio nof fresh provisions and contents of bumboats. 12113 (1-2) ; I 1802 (1) ; I 4482 (1). 854. Inspection of cells and prisoners. 12114. 865. Inspection of living spaces, holds, and storerooms. I 2115 ; I 2702 (2). 866. Patients received for passage. I 2116. 867. Health records. I 2117 (1-2) ; R2994; 1707 (5). 868. Invoices and receipts of medical stores and supplies. I 2118 (1-7) 869. Requisitions for ensuing six months : (o) Receiving ships and ships in reserve. I 2119 (l)c. (ft) Cruising ships. I 2119 (2). (c) Ships on detached service. I 2119 (4). (d) Special requisitions. I 2119 (5). (e) Medical supplies for ships at navy yards. I 4475. 860. Allowances of medical stores and supplies, (a) Based on supply table. I 2120 (1). (6) Purchase to be avoided if possible. I 2120 (2). (c) Stores for sick from other departments. I 2120 (3). (d) Transfer of supplies between departments. I 4422. (e) Supplies or services in emergencies. I 4472 (6). (/) Medical supplies for ships at navy yards. I 4475. (g) Medical supplies purchased to be selected by the head of department I 4480. 861. Laundry and extra provisions. 12121. 862. Surgical instruments and ajipliances replaceable only after survey. I 2122. 868! Loss of medical stores, etc. I 2123. MANUAL FOE THE MEDICAL DEPARTMENT,, U. S. NAVY. 63 864. (1) Medical outfit when going out of commission. 12124 (1), (a) Medicai supplies, etc. I 2124 (l)a. (6) Mirroscopical outfit, etc, (I 2124 (l)b. (c) Journal. I 2124 (l)c. (2) Sliips in reserve. I 2124 (2). 805. Transfer of stores. (a) One medical officer to another. I 2125 (1). (6) Medical officer to his successor. I 2125 (2). (c) Hospital corpsman to his successor. I 2125 (3). 866. Bills of health. I 2126. 867. Sanitary report. I 2127. Also monthly from vessels of a fleet to com- mander in chief giving summary of contagious diseases and sanitary suggestions as required. 868. Duty in battle. 12128. 869. (a) Station and duty at quarters. 12129 (1). (b) Surgeon's division. I 2129 (2). (c) Duties of medical officer as divisional officer. I 2129 (3) ; I 2501 (l)c. 870. Personnel of surgeon's division. (a) Composition and additional attendants. I 2130 (1). ( b ) Under medical officer for issue of money, small stores, and clothing. I 2130 (2). :'• 871. Breaches of discipline. 12131, "' 872. Binnacle list and morning report of sick should correspond. The primary object of the binnacle list is to supply the officer of the deck and other persons concerned with readily obtainable information regarding men excused from duty. The names of men excused after the morning report to the commanding officer has gone in are added to the binnacle list, and If still unfit for duty on the following day should then be regularly admitted to the sick list and entered on morning report to the commanding officer for his information, if necessary, under the caption " for observation," etc. Failure so to do vitiates statistics, leads to omissions from the health record of data that may be of great importance later on, and misrepresents the facts. For example, a ship having a complement of 100 men with 3 men on the sick list reports 3 per cent sick ; a ship with 10 men on the binnacle list only would report per cent sick, with obvious injustice to the former vessel's relative standing. Section 4. — Navy Regulations and Naval Instructions Applying to Juniob Medical Officees. 881. General duty. R 2976. 882. To keep health records. R2977, 883. To consult with the medical officer. R 2978. 884. Permission to leave ship. R 2979. Section 5. — Miscellaneous Duties of the Medical Offices Afloat. 891. Board of inspection and survey for ships. R 157 (1). Note. — The medical officer of the board will carefully inspect the Medical De- partment of the ship in all details. He will also carefully examine the entire ship in regard to its sanitary condition, hygienic regulations, and its efficiency from a professional point of view, noting particularly its ability to cope with a contagious disease or the adequacy of the arrangements for action, (Extract from " Report of Board of Inspection.") 892. Boards of inquest. R 321 (2) R 322 (3). 893. Boards of medical examination. R 3551 (7-8) R3525. 894. Boards of medical survey. R 361-866. 895. Medical certificate on court-martial proceedings. R 2967; R 621 (1). 896. Attention to comfort and welfare of troops embarked, R3847 (2), 64 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 897. Meilical certificate on niembors of general court-martial. R 727 (4). 808. Report on prisons, brigs, and other continement spaces. R 1431 (1). 89J). Medical aid to persons not in the Navy. R 1607. 900. Duty of boards to examine ships empk)ye2r>S. 937. Duties of medical otBcers at naval prisons and prison ships. (See Rules and Regulations for the Government of Naval Prisons, etc., arts. 9, 25, 55-60, and 99.) 93S. Senior medicnl officer at Nav;il Academy to he head of department of uaval hygiene and physiology and act as member of the academic board. fOen. Onier No. 10, Feb. 15, 1909.) 939. The expenditure of medical stores authorized by R 4006 (7) will he limited to such stores as are required to Carry out the treatment prescribed 1 For (Intios at nnvMl hospitals spp rh 8. Rf^rs. (.%) (rt) (7) (H) (0). MANUAL FOE THE MEDICAL DEPARTMENT, TJ. S. NAVY. 65 by the medical officer and will under no circumstalnces be construed to include expenditures for any other purposes. Section 8.^ — Medical Instructions. Physical Examination of Recruits. (See also ch, 11.) 941. Records of examination. I 3201. 942. Only medical officers to conduct examinations. I 3202. 913. Examination must be completed In every case. I 8203. 944. Care to he exercised in examinations. I 3204. 945. Examination of the applicant. I 3205. 946. Intelligence to be estimated from replies to questions. I 3206. 947. Age to he considered in determining standards. I 3207. 948. Entries to be made on service and health records. I 320S (1-2). 949. Procedure when defects are waived by Navy Department. I 3209. 950. Reexamination of recruits sent from a rendezvous. 1 3210. 951. Recruits to be vaccinated. I 3211 (1-2). 952. Typhoid prophylaxis to be administered to all persons. I 3212. Section 9. — General Instructions Relating to the Duties of Medical Officers. 961. Medical officer to keep a journal. I 3251. 962. Health records and all other records, how to be kept. I 3252. 963. Prescription book. I 3253. 964. Statistical report of sick. I 3254. 965. Accountability for property expended. I 3255 (1-4). 967. Health record oi)ened for all persons. I 3257. 968. Bill book. I 3258. 969. Sanitary report from shore stations. I 3259. 970. Employees not to have financial dealings with patients. I 3260. 971. Hospital and ambulance service. I 3261. 973. Biennial examination of pensioners. R. S. 4771. 974. Eyesight examination of candidates for gun pointer. I 2501 (3). Section 10. — Miscellaneous Duties Afloat. 981. (a) He shall see that the personnel of the Medical Department is at all times prepared for emergencies, especially during drills, coaling ship, and other evolutions. Due prominence should be given to the importance of their being immediately available for aseptic work. (&) He shall carry out all the duties required of a divisional officer under Art. I 1822 to I 1827, inclusive. 982. Collision drill: The surgeon's division will make necessary preliminary preparation for saving the sick. 983. Fire drill : The surgeon's division will make preliminary provision for the removal of the sick. Inflammable liquids under the surgeon's charge will be removed to a place of safety, or, if necessary, thrown overboard. I 2707 (5). 984. Fire and rescue party: A medical officer is detailed for duty with the fire and rescue party. He will provide the necessary medical outfit and will ac- company the party whenever it is called away, if the Fleet Regulations so require. 985. Clear ship for action: The surgeon will prepare for action in accord- ance with instructions under " Medical Department in battle," chapter 10. He will inspect the dressing stations: see that the men detailed therefor are present ; that they understand the duties required of them ; that they are ready for duty, and that these stations are properly equipped. He will see that the means for transporting the wounded are provided, and that all arrangements 98601°— 17 5 6G MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. lu'cessar for the (.-are of the wounded are made at this exercise. (See also Pt. in. Ship .md Gun Drills. 1905.) 987. Tlie hospital boat will carry no arras whatever and will fly a Red Cross flag on a .staff in the bow. (Boat Book, 1908, art. 21.) • . '-? Section 11. — Outline of Instuuction in First Aid, j^T^TE. — In connection with all first-aid instruction to officers and enlisted men of the ambuhuue party the medical officer shaU bear in mind the necessity of treatins those sulijects' in simple terms. (I 2641.) (See Handy book for the Hospital Corps, U. S. Navy, 1917.) 1001. The following outline of instruction is designed to insure uniformity. First-aitl in the Navy comprehends the assistance furnished the wounded, ex- hausted, or disabled individual by anyone near-by until lie can be reached by stretcliermen, hospital corpsmen or a medical officer. It is as important t<> know what may not be accomplished by lirst-aid as what may be accomplished. Hemorrhage from large arteries of the thigh, for example, may be controlled by lirst-aid procedures, but this is not possible in hemorrhage from the large arteries of the abdomen. first period. 1002. Contents of the first-aid packet and the shell-wound dressing. (Ex- hibit the first-aid package, and during the course of instruction open it and exhil)it its contents.) Tlie compress is made of cotton gauze which has been boiled in water, or steamed, that is, sterilized long enough to destroy any germs which may have been present. It is then dried at a very high tempera- ture. In the firs't-ald packet the gauze is packed under heavy pressure, so as ti> take up as small a space as possil)le. This packet is designed to cover the wounds made by bullets from small arms. 1003. The shell-vvound dressing is made from the same material, but is ot large size, because a shell wound from shell fragments or shrapnel is usmiUy a large wound. (Exhibit shell-wound dressing and explain its construction .apd application.) • ^ -,r>\ " ' The .shell-wound, or large-wound, dressing consists of a gauze pad lb layers thick and 8* to 9 by 10 inches, held in place by a four-tailed bandage, and is made as follows: From the standard gauze roll of four thicknesses and 8^ to 9 inches wide, cut off a length of 40 inches. Fold the free ends over so that they meet in tlie middle. Now fold a .second time along the line wliere the free ends meet. The length lias thus l)een reducwl to 10 inches and the thickness in- crefised to 10. Tear oft" a piece of unbleached muslin 9^ by 00 inches. Lay the gauze compress in the center of tiie muslin and fasten it there l)y sewing along the sides toward the binders and diagonally from corner to corner. Eadi free end of the unbleached muslin is now torn down the middle to the jiad so as to give a four-tailed bandage. Fold the dressing along tla> center by its sliort dimension so that the gauze is on the inside, the muslin binders on the oulslde. Now fold the upper tails on themselves in layers the width of the exi«used half of the muslin back. Do the same for the lower iniir. (.)nce more iJUe dressing is folded, but now at right angles to previous folds so as to bring the tails or binders in apposition to each other and inside the whole. Cover with a piece of unbleached muslin. 12 by 12 inches, wrapping like an ordinary Iiarcel and securing with a couple of stitches. Mark plainly with indelible pencil, slencil, or rublter staini). Sterilize and dry. Wrapin oiled muslin or jiaixr. Six to 11 dozen of th(;se dressings may h^ wra]iped together in caiivas and kept «t each gun station in a metal box secu!-ed by padlock and key. The container should be fasteniHl to a bulkhead adjacent to but out of the way of the. gun's crew. It will be advisable to have at dressing .sUititms a (certain nunilwr of shell- wound dressings of larger dimensions than those given. Xhese_\yill,UuL be tlis- O — j — II — i(ii>i5»i MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 67, tributed to guns' crows. The dimensions recommended are 10 hy 13 inclies and each pad should be of 32 thiclcnesses of trauze. (Explain the possibility of avulsion of a limb or wide tearing of abdominal wall necessitating a large dressing as temporary cover and why the dressings are aseptic and not anti- septic in view of various uses to which they may be put. Cf. exposed intestines, brain, etc.) The number of the ordinary shell-wound dressings prepared in advance of an engagement should be in the ratio of 40 to each 100 of the crew ; of the extra large size in the ratio of 5 to every 100 men. While there might be no call , for so many shell-wound dressings during an engagement due allowance nnist be made for deterioration and loss after preparation and before battle and for the possibility of wreckage of some portion of supplies during action. Some cases may need reapplication of dressings after the engagement. Undershirts with long sleeves, gloves, and a handkerchief tied around the neck will contribute materially to lessen the danger of surface burns from explosives. 100-t. In applying one of these dressings, after opening the first-aid packet, or the covering of the shell-wound packet, remove the compresses contained in paraffin paper. Unfold each compress, being careful that the surface to be applied to the wound does not come in contact with anything else, and above all is not touched b^' the fingers. 1005. Hemorrhage (bleeding) may be from arteries or veins. Wounds that bleed extensively usually indicate bleeding from the arteries ; the blood spurts in jets or flows very freely. As the blood is pumped from the heart to the dif- ferent parts of the body and is coming from that direction, the means used to stop the bleeding must be applied to the side nearer to the heart. When bleed- ing is very free raise the limb and make pressure over the main artery with the thumb or fingers until a tourniquet can be applied. 1006. A tourniquet is the best means of stopping severe hemorrhage, but should be used only when arteries are severed. The rubber tourniquet is the best. To apply it, grasp a section of the tube (large enough to go round the bleeding part) and stretch it. While stretched, apply it to the part, well above the bleeding point, and wind it oyer and over until only enough is left to secure it. Do not secure it with a square knot; two round turns will hold the tourni- quet in place, and when it becomes necessary to remove the tourniquet, this is easily done. A tourniquet may be made of any strip of cloth (as a handker- chief") tied loosely around the part and leaving enough space to insert a stick or bayonet. Wind it until the bleeding stops, then secure the stick wuth a piece of bandage or cloth. 1007. A tourniquet should not be left on a limb more than two hours, unless the lower part of the limb has been torn away. To allow a tourniquet to remain on the part too long will cause gangrene or mortification, for the reason that it prevents the part from being supplied with blood. Do not use a tourniquet for slight bleeding. This mistake is frequently made. A'enous hemorrhage is sometimes profuse and alarming, but local pressure and eleva- tion will control it, while the tourniquet will often have the opposite effect from that desired. The gauze compress, if applied very firmly, will often stop oozing of blood from wounds not involving arteries, and it is iior as likely to cause gangrene. (Demonstrate the application of the tourniquet by applying it to the arm of one of the class. Require that this be practiced by each member of the class ; have the pulse felt by the index finger to demon- strate that the bleeding would be effectively stopped. Demonstrate the appli- cation of the tourniquet to the upper part of the thigh, the middle of the leg. and the upper arm, explaining tlie anatomy of arterial supply to the regions. Require that this be practiced by each member of the class under instruction, having him first apply digital pressure, then a tourniquet. Explain how wounds of the face and scalp and trunk may be controlled and dressed. Impro- vise a tourniquet from a strip of clothing and a bayonet ; demonstrate its use on the arm, having the pulse felt to indicate its efficacy.) 68 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. SECOND PEinOD. ' 1008. Broken bones. Bones are often broken or shattered by bullets or shell fragments. After bleeding lias been stopped and the dressing applied, the broken bones should be pulled gently until they are in proper position and then placed in some form of splint. Pieces of board (if handy), a nlle. boat stretcher, pillow, or any similar object may be useil. Apply splints improvise 1 from boards to the leg, securing the same by strands of rope or pieces of ■clothing. Importance of securing splints in place by bandages placed well away from site of fracture. Demonstrate extension and counterextension as used for the reduction of fractures. Require the class to practice these maneu- vers. Display diagrams and illustrations, if possible, and practice the same methods as are illustrated. i - < *• ■ I 'I' •' THIRD PERIOD. 1009. "Wounds in general : A bullet or shell fragment may produce a wound of entrance and also a wound of exit, if it pass out, and both wounds should be dressed. Apply a compress to each wound. 1010. Special wounds: Illustrate the application of the compress in the first- aid package to a wound of the forearm. Apply it (a) simply for the purpose of dressing the wound; (h) securely for the purpose of controlling superficial hemorrhage. Require that these procedures be practiced by all the members of the class. Demonstrate the application of the compress to wounds of the scalp, neck, chest, abdomen, Imttock, arm, and forearm, thigh and leg, and the foot, as the instruction progresses. Require that these procedures be practiced by all the members of the class. Scalp wounds: Apply the compress very firmly to the wound. Hemorrhage is arrested by tourniquet or bandage carried horizontally around head just above evebrows and ears and well below the occiput. Neck': The back of the neck should be dressed with a compress and the binder rolled around the neck. Do not bind too firmly, as it would interfere with breathing. AVhen the great vessels in the neck are injured, the bleeding is excessive. Stuff the compress into the wound, using two or three if they are obtainable or combine use of compress with digital pressure. Bind firmly, but be careful that there is no interference with the breathing. Chest : Bullets or shell fragments may remain in the chest cavity or may pass through it. Look for both wounds. Abdomen: Do not give such wounded man anything to drink; the fluid may wash the contents of the intestine into the abdominal cavity. Place the wounded man on his back and keep him as quiet as possible. Apply a compress to each skin wound. If the intestines protrude, replace with a compress and .secure with shell-wound dressing. Buttock: Unless very deep, a compress will answer every purpose. In the case of a very deep wound a tourniquet would not stop the bleeding. FOUKTH PERIOD. 1011. Arm and forearm, thigh and leg: Apply a tourniquet If a spurting vessel is noticed or if the bleeding is very free. If not, apply the compress firmlv to stop the bleeding. Palm: Apply one compress to the wound directly and roll a second into a ball ; then bind firmly. P'oot : The sole should be treated the same as the palm of the hand, with n very firm compress. A single compress firmly applied will stop the bleeding from wounds of other parts of the foot or ankle, unless the main vessel is sev- ered, in which ca.se the tourui(iuet must be applied. MANUAL FOR THE MEDICAL DEPARTTMENT, V. S. NAVY. 69 FIFTH PERIOD. 1012. Restoration of the apjiarently drowned : Demonstrate the various movements used in the resuscitation of the apparently drowned. Require that this be practiced by each member of tlie class. After removing the shirts, lay the man face downward ; stand over him so that he is between your legs ; clasp your hands under the lower part of his abdomen and raise him so as to bring "the water from his lungs. Then place liim on his belly, with his face turned to one side. Kneel beside him and place the palms on the small of his back just below the ribs. Lean forward and gradually bring the weight of the body on the hands, thus forcing air out of the lungs. Avoid roughness. Release pres- sure quickly and return to original position. The first motion should occupy about two or three seconds. Aftei' returning to the original position there should be a wait of about two seconds before re- peating; thus there will be aI)out 12 respirations each minute. Imitation of natural breathing is the object. These efforts should be kept up for at least two hours or until natural breath- ing is restored. (The same method should be employed in resuscitation for elec- tric shock. See " Handy Book for the Hospital Corps, 1917.") If you succeed in starting the breathing, continue helping him until he is breathing regularly. All wet clothing should be removed while attempting to restore him, and his body and limbs should be rubbed upward (in the direction of the heart). The man' should be wrapped in blankets and warmth applied in any shape, as warm bottles, warm bricks, warm sand, or even a hot board that may have been in the sun. Do not give stimulants before the man can swallow. Do not remove him until he is conscious and breathing naturally. Watch for several hours to see that he does not cease breathing. Section 12. — Navy Regulations Relating to the Duties of Dental Officers. 1021. All schools for the education of officers of the Dental Corps to be under the supervision and control of the Bureau of Medicine and Surgery. R 2901 (3) 1022. The authority of the commanding officer of a hospital ship in all mat- ters concerning the discipline and punishment of dental officers. R 2919 (1). 1023. The duties of dental officers assigned to the Medical Department of a ship or station. R 2991. 1024. Care and attention to patients. R 2992. 1025. To keep medical officer informed of condition of patients. R 2993. 1026. To keep a record of all treatments and v/ork performed. R 2994. 1027. Care, preservation, and accountability for property in their charge. R 2995. 102S. Requisitions for and return of dental property. R 2996. 1029. The duties of acting assistant dental surgeons appointed for tem- porary service. R 2997. Section 13. — The Duties of Dental Officers. 1031. Dental officers are by law a part of the Medical Department of the United States Navy, and are required to serve professionally the personnel of the naval service and to perform such other duties as may be prescribed by competent authority. 1032. The regulations provide that the professional services of dental officers shall be available only for officers and men on the active list of the Navy and Marine Corps, and such services are restricted to those measures which will most effectively and economically preserve the teeth of the personnel and insure physical fitness. The department has construed Article R 2991 to apply to and include officers and men of the Naval Auxiliary Service. (Dept. 15G9-355. Nov. 8, 1914; M. and S. 126472.) 70 .-^AXUAL FOR THE MEDICAL DEPARTMENT, U. S. XAVY. 1033. Prosthetic procedures, such as gold, bridge, or crown w(n-k, are not contemplated as a part of the work of a dental officer. 1034. Dental ofticers will keep the medical officer fully informed of the con- dition of all patients, and promptly notify him of any case which may require nie■■■ .j,„;'^,;,.:,Section 3.— The Staff of a^Flag Officer AjfLOAa;jO}^;%^Gf^,|)'t'^f i , ;•,' ,' ■ ,. . ■ ,,.■ .,.-•, •}•■■. ■-»/, <-io,:tn. 1208. Closing of hospitals. Act Mar. 3, 1883. • 1209. Hospitals, buildiniis, and sites to be authorized by Congress. Act IMarch 4, 1913. Section 2.— Navy Regulations Relating to the- Administration of Naval Hospitals. 1211. Removal of sick to hospital may be made whenever recomraendeu. R 4.5.32 (1) ; R 3582 (1). 1212. Tuberculosis cases. R 3.582 (2). 1213. Pay of enlisted men while in hospital. R 4532 (2) ; R 3582 (3-8). 1214. Patients transferred to Naval Hospital, Phihidelphia, to report t(* governor of Naval Home. R 3582 (0). 1215. Transfer papers. R 3585. 1210. Payments to patients in hospital. R3GGD (5). 1217. Officers and men entitled to hospital treatment when no naval hospital. R 4-532 (1). Section 3. — Naval Instructions Relating to the Administration of Naval Hospitals. 1221. Officers transferred to hospitals and when they return to duty to be reported upon. I 956. "' (a) Entitled to remain until cured or surveyed. I 3221 (1). (b) When discharged, if still disabled may go to Naval Home. I 3221 (2). (c) Papers in such cases to go to the Secretary of the Navy. I 3221 (3). 1222. Sick, wounded, or disabled officers entitled to medical attendance. 1 S222. 1223. Responsibility of medical officer in command. 13223. 1224. No changes to be made in buildings, trees, or grounds. 13224. 1225. Inspection of medicines, supplies, etc. I 3225. 1226. Examination of healtli records. I 3226. 1227. Medical officer of the day. (a) Detail. I 3227 (IL (&) Dailv journal. I 3"227 (2). (c) Duties. I 3227 (3). 76 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 1228. Medical oJlkers in charge of wards. 13228. 1229. Patients to be accompanied by liospital tickets and liealUi records I 3229. 1230. Convalescents to be di.scharged when fit for duty. I 3230. 1231. Attendants of hospital alone available for service to patients. I 323L 1232. Diet tables, and variations authorized. 13232. 1233. Special diet list to be revised daily. 13233. 1234-. Forms to be observed upon receipt of patients. 13234. 1235. Patients left in hospital after sailing of ship. I 323-3. 1230. Discharges for disability. (d) Upon approved medical survey. I 3236 (1). (b) Name of ship to be noted in survey. I 3236 (2). 1337. Health records of persons surveyed to be signed and verified. 13237. 1238. Weekly i-eport of sick in triplicate. I 323S. 1239. General regulations for government of hospitals to be submitted to Secretary of the Navy and included in Manual for the Medical Department. De- tailed regulations for internal government of hospitals issued by medical officer in command. I 3239. 1240. Ambulance service for in.jiired civil employees. 13411 (1). 1241. Treatment of civil employees in naval hospital. 13411 (2). 1242. Misconduct report. I 5247 (62). Gen. Ord. No. 100 and 231. Section 4. — General Instbuctions Relating to Naval Hospitals. 1251. Commander in chiefs inspection. 1908. 1252. Fleet surgeon's inspection. 11122 (6). 1253. Hospital to keep ti journal. I 3251. 1254. Hospital records to be kept with neatness and accuracy. I 32.V2. 1255. Issue of medicines, etc., to persons not in Navy to be entered in pre- scription book. I 3253. 1256. List of patients for use in compiling statistical report. 13254. 1257. Property accountability. 13255. 1258. Bill book. I 3258. 1259. Sanitary report from hospitals. I 3259. 12G0. All persons employed in Medical Department prohibited from having financial dealings with patients. 1.3260. 12<)1. Hospital and ambulance service to be performed by Hospital Corps. 1 3261. 1262. Correspondence of naval hospital to be conducted as if a yard depart- ment. I 5340 (9). 1265. A person under treatment for a period of three months shall be sur- veyed in order tliat his further treatment or other disposition may be authorized, and in order that the bureau may have information as to the necessity for such prolonged treatment. 1266. Care should be taken that all convalescents are promptly returned to duty. 1267. No enlisted man under sentence of general court-martial to he sent to Naval Hospital, Fort Lyon, Colo., for treatment. (Department decision, No. 26251-6590, Apr. 14, 1913.) 1268. Otiicers and men of the Naval Militia, though they receive the same Iiay while on naval duty as those in the Kegidar Navy, have no (knluctiou made from their pay for the Naval Hospital Fund (Sec. 4S0S, K. S.), and are ni>r en- titled, under the provisions of law, to treatment and subsistence in naval hos- l)itals, (Sees. 4808, 4812, 4813. H. S., and comptroller's decision of Aug. 25. 1914) except when incorporated with the Navy in time of war. 1276. <3ivil employees: Subsistence while in a naval ho.spital. Notices of admission and discharge, M. & S., Forms "S" and " T," .shall be forwarded by the oflicer in connnand of the naval h(»s;)ital to the paymaster of the yard, who shall receive from the patient tlie 50 cents for each day or part of day in ho.s- MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 77 pital, giving his receipt therefor, and shall deposit same to the credit of the naval hospital fund. ^ , In cases where payment is not made within a reasonable time, or of a refusal to make payment, a sum sufhcient to cover same shall be withheld from any pay due the employees, and a full report of the circumstances shall be made to rhe Bureau of Supplies and Accounts. (Bur. S. & A, Memo., No. 131, Feb. ' 12 t"?. Commanding officers of certain hospitals designated by the Secretary of the Navy are autiiorized by the act of August 29. 1916, to order summary and deck courts-martial and to inflict minor punishments upon all enlisted men attached thereto, whether for duty or as patients, as conferred by law upon the oonnnander of a naval vessel. >: 1278. Medical officers in command of naVal hospitals and hospital ships arp authorized to act as recruiting officers for the Hospital Corps, and for ref- enlisting and extending enlistments of other men in the Navy who may be patients under their command. They are authorized to administer oaths for the purposes of the administration of naval justice and for other purposes; ;o| naval administration. Section 5. — Dutiks of the Medical Officer in Command. ]\joTE. — The following instructions are issued for the guidance of medical officers in command of hospitals (and hospital ships when applicable (R 2919) ) and shall govern in all ordinary circumstances. Any situation requiring a de- parture from these instructions will be made the subject of immediate report to the bureau. 1281. The Navy regulations require that the medical officer; in command of a naval hospital shall be responsible for the care and treatment of the sick, and for the discipline, cleanliness, and economical management of the istitu- tion. The regulations further require that medical officers and all persons em- ployed in the hospital shall perform such duties as shall be assigned them by the medical officer in command, and to this end he is required to exact from subordinates, employees, and patients a proper obedience to his orders and to the laws and regulations of the Navy. (I 3223.) 1282. All general regulations shall be approved by the Secretary of the Navy and included in the Manual for the Medical Department, and all detailed regu- lations relating to the internal government of the hospital of which he is in command shall be submitted to the bureau as soon as issued. (I 3239.) 1283. The regulations require that except in emergency no change shall be made in the hospital buildings, furniture, trees, or grounds, and no bills for purchases and repairs shall be contracted without the permission of the bureau, except in special exigency. (I 3224.) 1284. The medical officer in command is required by the i-egulations to have all medicines, provisions, and medical supplies received at the hospital inspected and their condition reported to him by the officer intrusted with the duty. A record of such inspections shall be entered in the daily journal. (I 3225.) He shall require the executive surgeon to make a daily report on the condition of patients and on other matters of interest pertaining to the hospital. 1285. Once a week, or oftener if he should deem it neces.sary, he shall make a thorough inspection of the hospital buildings and grounds. All matters of interest brought to his attention during his tour of inspection, and requiring subsequent action, shall be noted and recorded in a book kept for this purpose by the executive surgeon. The provisions of Article I 2602 (5-6) shall be ob- served as far as possible in hospitals, and inspections and musters shall not be carried out on Sunday. The medical officer in command shall assign appro- priate punishment for offenses committed, such punishments to be noted against the offenses in the report book and in the journal. 1286. (0) He shall see that the regulations relating to the admission and dis- charge of patients from the hospital and the preparation of all official papers 78 MANUAL FOi; THE MEDICAL DEPARTMENT, U. S. NAVY. are strictly compiled with. He shall inspect aud approve health records and assure himself that they ;iri' properly kept. (b) A per.son under treatment for a period of three months shall be surveyed iu order that his further treatment or other disposition may be authorized, and in order that the bureau may have information as to the necessity for such prolonged treatment. (r) Care should be taken that all convalescents are promptly returned to iluty. 1287. The commanding officer shall keep himself Informed of the iiroI)able necessity for the performance of major surgical operations, and ludess there are urgent reasons to the contrary, no operations of this class shall be performed without his approval. He shall see that the junior medical officers attached to the hospital are afforded ample opportunity for practical surgical work. 1288. lie shall see that the menjhers of the Hospital Corps are thoroughly drilled and instructed in their duties. Whenever a member of the Hospital Corps is transferred to other duty, either ashore or afloat, he shall cause a Hospital Corps efficiency report. Bureau of Medicine and Surgery form, to be filled out and forwarded through official channels to the Bureau of Medicine and Surgery. Whenever changes occur in the Hospital Corps, by transfer, death, discharge, etc., a mailing card shall be forwarded direct to the bureau. 1289. He shall cause the Hospital Corps to be instructed and e.xercised not less than once every week in fire drill, and shall see that every facility is afforded for the protection of the hospital buildings and 'other buildings in the hospital inclosure from lire. 1290. (m) The medical officer in command shall carefully observe the uni- form regulations and require all officers under his conun.iU(l to be in uniform. This requirement shall apply to officers on duty, officers who are patients when practicable, and to members of the Ilosjiital Coips and Nurse Cor])s. (b) He shall .see that Hospital Corp.;nien wear the cap ribbon designating the hospital under his command. 1291. He shall submit to the bureau o-i the 1st of January of each year a sanitary report, with an appendix covering "Public Works." (See par. 2G.'31 (b).) He shall keep him.self informed regarding all changes proposeil or authorized by the bureau in order to present them clearly to the commandant or to tlH> heads of departments concerned. ■ . ,. 1292. The list of headstones for unmarked graves in naval cemeteries shall be subinittetl direct to the l^ircnin annually on .Tuly 1 in duplicate. (I r)24T (8).) 1293. In hos|iitals where there are but two medical officers, the officer iu conunand shall take under his supervision the inventory, the commissary ledger and bill book, the cemetery record, re(iuisitit>ns and bills, and the super- vision of grounds and outbuildings. The junior officer shall kee]t the profes- sional records, supervise the preparation of ll.e required returns, and he respon.sible for the cleanliness and good order of the hospital buildings, and perform such other duties prescribed for an executive surgeon as may be delegated to him by the officer in command. The pharmacist shall act as the relief officer of the .lay for the purpose of preserving di.scipline and for the recharmacist shall act as officer of the day. 1295. The commanding officer shall innuf^diately inform the connnandaut of the station and the department (Bureau of Medicine and Surgery) of any death in the hospital; he shall iu addition inform by telegraph the next of kin, family, or legal representative of the deceased. Section 6, — Dutiks of the ExKctrrivE Surgeon, 1.101. The medicHl officer attached to a usual hospital uext in rank to tlie medical officer in command, uide.ss detailed to perform special duty only, is to be considered the executive surgeon of the hospital, and, under the direction MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 79 of the medical officer in cominand, he shall be responsible for the general nian- asenient of the institution. He shall make himself familiar with all laws, regulations, rules, and instructions relating to the administration and internal government of hospitals, and see that they are complied with. 1302. The executive surgeon shall have such authority under the medical officer in command as may be delegated by the latter. He shall firmly and faithfully execute the orders of the medical officer in command, and shall keep himself informed of his wishes in matters of duty, and carry them out scrupu- lously and energetically. He shall execute all details of organization, police, inspection, and discipline, and shall be responsible to the medical officer in command for the cleanliness, good order, and preservation of buildings and grounds, and do his utmost to render all departments of the hospital efficient. He shall personally supervise all work, repairs, etc., that may be done, and report to the medical officer in command as to their progress. 1303. Except when excused by the medical officer in command, he shall always be on duty when in the hospital, and when on duty shall receive all orders relating to the general duties of the hospital directly from the medical officer in command and transmit them to others as may be necessary, and be responsi- ble for their execution. 1304. He shall, under instructions from the medical officer in command and the (lge. A coniplclo record of all laboratory work will be recorded and reports sent to those desiring the results of examination, on such forms as may be adopted for tliis purpose. It will also be his duty carefully to instruct such subordinates as may be assigned to duty under him in practical laboratory techni(|ue. 1852. ,So far as may be practicable, officers detailed for special duties will not be required to perform other services. 1358. No officer of a naval hospital shall ever be considered as having an alternate "day off duty." The junior officers .shall alternate in dulv as ollieer MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 83 of tlie day only for periods of 24 hours as detailed by the commanding officer, but such relief from duty as- officer of the day shall not in any way relieve them from their professional and other duties at the hospital ; nor shall they fail, upon leaving the hospital, to inform the oiTicer of the day or the relieving officer of any direction of special importance they may have given regarding the patients under their charge or of the condition of any patient who may require special attention during their absence. Section 8. — Duties of the Officer of the Day. 1361. The term of duty of the officer of the day shall consist of 24 hours, from 10 a. m. At this time the officer assigned as officer of the day will relieve his predecessor, receiving from him ail special orders and instructions pertaining to his term of duty that may be necessary. The oflicer of the day's office shall al- ways be open, and except for meals or when called elsewhere by duty the officer of the day shall give his undivided attention to the official business of the hos- pital ; he shall leave the building on duty only, unless excused ))y special permis- sion of the commanding officer ; he shall be in his office until the 9 p. m. reports are made ; and he shall permit no loafing or lounging there by officers, patients, visitors, or others. The officer of the tlay shall occupy quarters in the main build- ing during his terra of duty and shall at all times wear the uniform of the day. In the afternoon he shall make a tour of inspection through the wards, kitchens, mess, and other rooms of the hospital occupied by patients and employees. A simi- lar inspection shall be made at night, at 10 p. m., after the patients are in bed. A list of patients and employees who have received passes shall be furnished the officer of the day as early as practicable every morning, and all patients and others will be required to report their return to him. (I 3227.) He shall sign necessary passes for the removal of personal or otlier property from the hospital. 1362. The officer of the day shall keep a journal in which he shall make a brief record of the following points and events to be noted at the time of occur- rence : The condition of the wards, kitchens, mess, smoking, and other rooms at each inspection ; the condition of the meals served as to quality and quantity ; special trips of the ambulance; the names and diseases of patients admitted, and the places from which they are received; the names, number of days sub- sisted, and the disposition made of patients discharged, and whether the nec- essary papers in each case are correct and complete; the names and condition of patients and employees returning from leave or who have overstayed their leave; the confinement and discharge of offenders and the reasons for punish- ment ; the appointment and discharge of employees ; the reporting and detach- ment of oflicers, or their going upon and returning from leave ; the record of in- spection of all provisions, stores, and medical supplies ; the object and findings of all boards of survey ; and all other matters occurring during the term of duty which it may be desirable to record. Upon completion of his term of duty he shall sign the journal and submit it for the approval of the commanding officer. Entries by any other officer temporarily relieving the regular officer of the day shall be signed by the officer making them. 1363. Health records, the journal, and conduct records shall be carefully supervised by the medical officer of the day. He shall supervise the necessary entries in the ambulance book, the register of patients, and the rough Form F. 1361. The officer of the day, after receiving the final reports at night, shall report the condition of the hospital to the executive surgeon or, in his absence, to the medical officer in command. 1365. The following regulations relating to the admission and discharge of patients shall be strictly followed by the oflicer of the day. (rt) When a hospital ticket is found correct, and the clothing list checked, it shall be filed and retained until final disposition of patient. Upon discharge the patient shall sign tlie receipt of clothing and the receipted ticket shall be placed in the files. 84 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. (h) Eiitor tlio name, etc., (1) in the .i,'eiieral alphal)etical register of patients, which is ilie jHTinjint'iit liospital record, for future reference; and (2) on the card al»stract of ]»atients. (Form F, rouj^li. ) (v) Inspect liealth records (Form H), and file in office. ((f) When a patient is dischai'yed from the hospital tlie fact shall be entered upon the register of patients and also upon the health record, which is to be sijined and approvetl. (r) When an officer patient is admitted or discharged, notice shall be sent to the office for the preparation of leiter to Bureau of Navigation, through com- mandant. (/) In the case of officers or men. when necessary, the misconduct report notice of admission or discharge (I r>247 (61)) shall be made out. 1360. The approved libi-rty lisl will be submitted to him and he shall as far as possible check the same until 10 p. m., after which hour liberty men return- ing will be checked in by the person ilesignated for that pur])ose. Liberty parties will have at a stated hour, an J he shall inspect them and see that the uniform of the day is strictly adhered to. 1367. He shall receive all patients admitted during his tour of duty, and after consultation with the executive surgeon, assign them to .he proper w;u'ds. Each patient received shall have a complete physical examination to determine if any abnormality exists other than that for which admitted. 1368. He shall hold a sick call in the evening at the hour designated by the commaniling officer and after its com])leti< n visit the brigs, if any prisoners are confined, at which time he shall oe accompanied by the master at arms, who will see that any treatment ordered is received. 1369. He shall make himself thoroughly familiar with the details of the fire drill as prescribed in the hospital to which he is attachetl. Section 9. — Duties of the Ph.\kmacist. 1371. The duties of the pharmacist comprise all that relates to the replenish- ment of supplies, the upkeep, expenditure, and survey of property, the com- missary department, and the correspondence and clerical work of the adminis- trative office incident to the above. He also assists in the instruction of mem- bers of the Hospital ('orps. Vov purposes of description these duties may be divided as follows : 1372. Ci.ERirAT. WORK IN THE ADMINISTRATIVE OFFICE: The office Work, when practicable, may be divided into that of personnel and material. The pharma- cist, under suiiervision of tlie executive surgeon, shall have charge of the preparation of requisitions and public bills, the general correspondence, records, files, and returns. All letters and communications received are to be catalogued according to a coTnprehensi\e card-index system, grouped under the several bureaus of the Navy De]>artment and miscellaneous subjects; they are to be cross indexed and filed in ninnbered .jackets. All outgoing letters, indorsements, ration ad- missions and discbarges, and other communications of which a permanent record is desirable, shall be carbon copied when prepared and the copies care- fully ind'^xetl and filed. (1) Division of personnel : This division shall have charge of all files, records, corresprmdencc. and returns relating to the p(M-sonnel. lender this head would come, besides the usual reports and returns (see ch. 24. sec. 4), the following: Admis.sion and discharge of ])atients, rejiorfs on officers admitted and disclmrged, fitness reports, ration notices, entry of patients on rough Form "F," filing of hos- I»itMl ticlcets. misconduct i-cports, cond orders will have another voucher number, thus allowing a quick compilation of the cost of material on one hand and the cost of work performed on the other. At the end of the fiscal year a complete history of expenses incurred by and on account of the hosi)ital will be obtained in one numerical file, and this voucher file, in conjunction with the bill book, will offer ready moans of reference as to any financial transac- tion during the fiscal year involved ; they should be regarded as the permanent record for all financial transactions pertaining to the hospital, and be carefully preserved. 13S8. All expenditures other than those falling under colunm 15 are entered twice on the bill book — first, under the proper appropriation heading, colunms 10 to 14, inclusive ; and, second, the same amount, split up if required, is entered under the respective group, or groups, under the heading "Analysis of expenditures." It is therefore evident that the totals under colunms 10, 11, 12, 13, and 14 should at all times balance those under columns IG to 44, in- clusive. Column 15 shows expenditures made by and on -account of the hospital, but where the expense is chargeable to some appropriation not under the cognizance of the Bureau of Medicine and Surgery. Enter figures under this column in red ink and exclude same from all totals. 1389. Column 8 is to be used for entering the corre.spondence file number whenever the requisition or voucher, or the subject matter thereof, has been given a correspondence number. This colunm is also intended to be used as a means of rapidly segregating and totaling a series of vouchers pertaining to one contract; material purchased in the erection of some particular structure; or in any case where it becomes necessary to secure a total from sevei-ai vouchers which otherwise would not be quickly obtainaI)le. The items may have been purchased at different times, under separate requisitions, or from several firms ; again, it might be desirable to know exactly the amount or cost of some article repeatedly received on stub requisition, e. g., lumber to be used in building. By giving such vouchers, when filed, the .same code letter they can at any time be readily segregated and totaled by running down columu 8 iUKl selecting those bearing a similar letter. Use capital letters of the alpha- bet in this connection. 1390. All stores, except stationery, received from the supply depots on Forms B, B:i. and 4 should be charged under the appropriation "Medical Department, U. S. Navy," column 11. Books and stationery should be charged against the appropriation " Contingent. M. & S." colunm 12. Towels, l)edding, etc., re- ceived from the supply depot under the special annual requisition form, are a charge against the naval hospital fund, column 10. In posting the several classes here referred to under the "Analysis of expenditures " care should be exercised to see that they are entered under the proper heading or headings. Bedding has a distinct column ; so with books and stationery ; all mess gear ; chinaware. etc.. should be entered under "Culinary department." 1391. Since Form Y, for the preparation of which " Medical supplies " columns 19 and 20 were spearated, has been abolished, the following change as shown below has been made in the bill book. The entries under tlie rearranged columns are self-ex;ilanatory. Changes under columns 19 to 23 in bill book: 90 MANUAL FOR THE MEDICAL DEPARTMENT, V. S. NAVY. Hospital supplies. Ambulance service. Medicines, disin- fectants, tab- lets, surgical dressings, dis- pensary and lab- oratory equip- ment, etc. Sargical instrii- Hospital appli- ances, ward and sick room oqiiip- meut, disinfect- ing apparatus, tents, etc. Live stock, wag- ons, ambu- lances, harness, etc. Provender, pasfv line, horseshoe- ing, tires, re- pairs, etc. pliances, X ray. operating, and hydrot hora- peutic room equipment, etc. 19 20 21 22 23 "Hospital supplies," columns 19, 20, and 21, include medicines, ho-spital stores, surgical in.struments and appliances (except artificial limbs), surgical dressings, dispensary furniture and accessories, hospital furniture. (Furni- ture and furni.shings for the hospitals not strictly included under hospital fur niture are entered under column 34; furniture and furnishings for stafC and other quarters under column 17.) 1392. Vaccine, serum, etc., received from the Bureau of Medicine and Surgery are a charge against the appropriation "Medical Department, U. S. Navv," column 11. 139S. Microscopical outfits and any supplies received from the Naval Med- ical School are a charge against the appropriation "Contingent, M. & S.," column 12. 1394. Enter coal and wood used in kitchen imder column 26. 1395. Under "Miscellaneous," column 25, enter ice, artificial limbs, athletic goods, typewriters, subscriptions, cleaning gear, brooms, matches, electric bulbs, maintenance of patients at other hospitals, and such other charges as can not be directly placed against any one department of the hospital. 1396. Vouchers prepared under one contract pertaining to buildings and construction, entered under column 16, should continue to receive the same serial voucher file number as of the fiscal year in which the first voucher was prepared, even though operations are carried beyond the end of the fiscal year. This will confine them, and make the cost appear as a whole under one entry in the " recapitulation " when the work has been completed. 1397. At the completion of each fiscal .vear the totals of the several columns will be computed and entered. The record and transaction for the year will then be recapitulated on a separate page in the bill book, this page to be the final one for the year in question, tlie recapitulation to be made according to: (1) Appropriations; (2) the several departments of the hospital; (3) land, huildlngs, permanent constniction, etc.; (4) civil establishment; (5) hospital maintenance; thus: Recapitnlatinn flftcal year 1915. Appropriation: ) .^ ;( Kavnl hospital fund Medical nopartmont, U. S. N. Contingent. M. & S Brinfjing homo remains, etc.. Specific apjiroprialion Medicnl supplies Ambulance service Power house Culinaiy department lyaitndrV. •i^il fti i;;iiULi Cohimn. ! Amount. Provisions Laundry building. Mortuary Sidcwnlk'j 10 11 12 13 14 10.2^.21 22. 23, 31'. 24,26,37 2';, 38 27,39 28 LanI, htiii lings, permanent construction, etc., column 10(to be shown in detail). Ci * il estal il isl line ri I : Hospital mii'if. 1. incr 3.-41 10 35 $15,000 5,ono 3,5tK) 360 5,000 6,000 1,500 13,000 6,000 l,(it)0 20,000 5,000 2,.*)O0 1,200 8,0«1) 75,000 MANUAL FOB THE MEDICAL DEPARTMENT, U. S. NAVY. 91 Section 12. — Detailed Instructions Relating to the Commissaey Ledger. 1411. The systoui of keepin.^ accounts in the commissary department of the hospitals is essentially one of daily balance of receipts and expenditures, both as to quantities of stores and the cash values thereof, with a summary of the whole at the end of each month. This gives an accurate knowledge of com- missary stores on hand at all times as well as their value, shows the expendi- tures of any item at a glance, and with the ration memoranda affords a ready means of computing the average per diem cost of subsistence. . 1412. Receipts and expenditure voucher contains the transaction of com- missary stores received and expended and the cash value thereof for one day. The entries hereon are taken from dealers' bills and supply officer's invoices and from the rough memoranda of stores issued (on hand) from the storeroom. Stores on delivery should be accompanied by duplicate invoices, and these should be initialed by the officer responsible for the proi>er inspection and weighing of the stores. One invoice is returned to the dealer, the other kept on file in the hospital and used, as before stated, in preparing the daily receipt and expenditure voucher. The completed receipt and expenditure voucher for the day is submitted on the following morning, throufih the executive officer to the commanding officer of the hospital, and upon its return a transcript of the entries thereon is made in the commissary ledger, the quantities received and expended under the respective headings and the cash value of the day's receipts and expenditures in the appropriate columns to the extreme right on the last page for the month concerned. The commissary ledger is a loose-leaf system ledger with two distinct kinds of pages, those containing the " Cash values " columns being supplied in more limited quantity, only one of these pages being used each month, the last for the month concerned. The cash extensions for each day's transactions are here entered. A study of these pages makes- their use plain. It will be noted in the commissary ledger that each item contains sepa- rate columns for the entry of receipts and expenditures — marked " R " and " E," respectively. To distinguish more clearly between the two. receipts are en- tered with black ink, expenditures with red ink. To prepare the commissary ledger for entries write the name of the different articles purchased and on hand under the column " Items." Enter unit and unit price in the two columns below the item name. 1413. On the last day of each month take an inventory and enter the amounts on hand under " Brought forward " for the succeeding month, calcu- lating their value always by the last contract price. Fill in at the end of each month columns on the bottom of the pages. Enter under "Carried over from last month " stores remaining from previous month. The amounts on line •' Received this month," obtained by deducting the " Carried over from last month " column from the totals, has to correspond with the totals of dealers' or supply officer's bills. Under column " Unexpended " will appear the differ- ence between the receipt and expenditure columns, and under column " Inven- tory " the actual amount on hand as found by the inventory. The difference between these two columns gives the "Loss on issue." The money value of the "Loss on issue" column plus "Total expenditures" gives the "Total cost of subsistence. Since provision vouchers are now paid monthly by the ho.s- pitals. the following easy method of proving the correctness of the totals in the " Cash values " column should be employed : To the sum total of vouchers for stores obtained during the month add the value of the stores brought forward from the previous month ; this represents the absolutely correct value of re- ceipts. If the sum so obtained differs from the sura total of the daily receipts, as it is bound to do, due to fractional differences and possible clerical en*ors, write under the total " Corrected totals " and the sum found in that way in red Ink. By deducting the value of stores found on hand by inventory from the above siim the absolutely correct total for expenditures will be found, and the 92 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. same, if differinji from tlie totals obtained from the totals of the daily entries, sliould be entered in the same waj' as " Corrected total." By dividing the corrected total of exiienditures by the total number of rations, obtained from ration memoranda, the "Average cost of subsistence per diem " is obtained. Only provision Koms are to be carried in the commissary ledger. 1415. Tlu' ration return will be lillcd in from day to day according to the changes resulting from admission and discharge of patients, transfer of hos- pital corpsmen, employment and discharge of civilian employee.s, etc. The sura total of colums 1 to 9. inclusive, less .sum total of colunms 10 to 14. inclusive, will give the actual lunuber of rations issued. To tlnd the average cost of sub- sistence for any given time divide the total of expenditures taken fnnn the connnissary ledger by the sum total of rations issued during the corresponding time. 1416. Consideration should he given to the question of reducing the number of open purchase requisitions from hospitals. As the now bill book provides for the necessary classification of purchases into the several hospital depart- ments under "Analysis of Expenditures." no reason remains for limiting requi- sitions in this respect. The only consideration in preparing open-purchase requisitions for the purchase of supplies, etc., is the question of the appropri- ation involved, as it is prescribed (Art. I 4654 (2). N. R. 1913), that: "They must embrace only articles required under one appropriation." 1417. Commanding officers of hospitals will see that persons charged with the duty of preparing requisitions are thoroughly familiar with the section of the instructions, article 4C.j1. et seq., pertaining to the open purchase of supplies. 1418. To assist the purchasing pay officer in preparing proposals to secure bids from several dealers it is well to have the items of a similar nature on a requisition, or those any one dealer would probably bid on follow in sequence on tlie face of the requisition. Section 13. — Instructions Reg.\rding the Preparation of the Statement of Cost of Maintenance. 1421. Under item No. K) enumerate in detail all permanent construction on which work was commenced during the fiscal year, whether completed or not. If work has not been completed insert "Not complete" in place of cost; the date of completion, with cost, to be shown on statement of succeeding year, e. g. : Laundry building, 1911, completed 3-1-1912 ; .$5,000 1422. The total number of .subsistence days (item No. 11) is obtained "l)y combining the 32 monthly totals taken from tlie i-ation .memoranda for tl»c fiscal year concerned. 1423. The average cost per diem of maintenance (item No. 12) will bo deter- mined by which nurses are assigned, arrange their working schedule, and be responsible for the execution of orders. (c) Slie is responsible for the maintenance of order among the nurses and shall correct abuses and prevent violation of discipline, reporting to the execu- tive surgeon any infractions of discipline. In the case of neglect of duty, breach of discipline, or failure to obey orders from proper authority, the chief nurse may temporarily relieve the nurse from duty, and she shall report the case at once to the executive surgeon and medical officer in command. (d) In arranging the detail of nurses for night duty, the chief nurse will be careful to see that this duty is distributed equally among the members of the nursing staff. e) The chief nurse shall be directed to hold a nurses' conference once a week at a stated period approved by the conunanding officer, to be attended by all the nur.ses on duty at the station, for the purposes of instructisn and of dis- cussing such nursing problems as may have arisen. (/) The chief nur.se shall always accompany the conunanding officer during the weekly inspection of the hospital, and she shall make an inspection at least twice a day of those parts of the hospital where nurses are in charge or on duty. 1444. Official reports and requests submitted by nm'ses shall be forwarded through the chief nurse and the executive surgeon for submission to the com- manding officer. General instructions relative to the duties of nurses shall be transmitted through the chief nurse. 1445. (a) The chief nurse shall have charge of the sick records and health records of nur.ses and of records and inventories relating to Government prop- erty in the nurses' quarters, and exercise general supervision over nurses' quarters, linen rooms, and diet kitchens. (ft) It shall be the duty of the chief nurse to keep the official register of nurses, in which she shall enter the name, date of reporting, days sick or on leave, efficiency marks, name and address, or any other facts concerning each nurse that may be important to record, and such register shall be under her charge and available for inspection by the commanding officer or executive surgeon whenever called for. (c) The chief nurse shall also keep a daybook, in which the detail of nurses to duty for the day is entered, the nature of the duty, number of hours on duty, etc., of each nurse. 144G, It shall be the duty of the chief nurse to report immediately to the executive surgeon any sickness requiring the relief of a nurse from duty, unless the illness is of a conlidential nature, in which case she .shall make a confidential report tp the comniaiiding officer. (See chap. 5. sec. 9.) 1447. When required, the chief nurse shall supervise the instruction of Hospital Corpsmen In their nursing duties. 1448. When a chief nurse is granted leave, or is otherwise absent fron\ duty, her duties will be assumed by the senior nurse recommended for promotion, or If none has been so recommended, by the nurse best qualified, having regard to seniority as well as ability. 1449. Nurses will be under the immediate supervision of the chief nurse and directly responsible to her in matters relating to duty, conduct, anrl discipline. 1450. Nurses In charge of wards, openiting rooms. Iin(.^cutively or in such broken periods as will best suit the requirements of the hospital service. 1453. Nurses will not be detailed for general duty in venereal wards, and a nurse will not be required to care for a patient continuously for a longer period than 12 hours at one time, except in special instances. " 1454. No nurse will be required to take night duty for more than a month consecutively, unless in some special exigency of the service, and no nurse will ordinarily be called upon for night duty more frequently than one month out of every three. 1455. In hospitals where there is an active operating service a nurse detailed to an operating room may be exempted from night duty on the recommendation of the chief nurse, if such exemption is approved by the commanding officer. A similar rule may be applied to the nurse assigned as a diet nurse, and to the nurse assigned to duty in charge of the linen room, if considered desirable by the commanding officer. These exemptions from night duty of the operating room, linen room, and diet nurses may be applied only in the larger hospitals. Nurses will not ordinarily serve continuously for a longer period than six months in the operating room, or on other special details. Exceptional cases will be promptly reported to the Surgeon General. 1456. The ward nurse' shall be in full authority as such, and will be held responsible for the keeping of the records, cleanliness, order, and general man- agement of the ward. It shall be part of her duties to instruct Hospital Corps- men in all matters pertaining to the care of the sick, such as the administra- tion of medicines, giving baths, taking of temperatures, pulse, and respiration rates, etc. The nurses will advise the chief nurse concerning the efficiency and progi-ess of the Hospital Corpsmen, and the chief nurse will submit these reports to the executive officer. 1458. A ward nurse shall not be called away from her station and duty except for urgent reasons; nor shall she absent herself from her post of duty without being properly relieved. 1459. The nurse on duty or the chief nurse shall always, unless excused, accompany any officer officially visiting that part of the hospital under her charge. 1460. The ward nurse shall require all patients (not excused by proper authority) to be present at sick call, morning and evening, and will report the names of those absent without leave or over leave to the officer holding the sick call. 1461. Ward nurses are responsible for the condition of bed patients as to cleanliness, clinical data, etc. They shall make careful bedside notes of all cases unless otherwise ordered by the ward officer. 1462. Nurses are responsible for all keys under their charge. When leaving the ward such keys must be transferred to the senior Hospital Corpsman in > The term " ward nurse " Is used throughout In the sense of " nurse in charge of ward." 96 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. the ward, who will be held responsible for them, and maintain discipline during her absence. 1463. (ff) Xursos shall bo responsible for the administration of medicines and shall report any patient who refuses or fails to take his medicine at the appointed time. Nurses shall see that all poisons, narcotics, and liquors are kept under lock and key. (b) Nurses shall be especially careful with regard to poisons, and shall see that the instructions concerning the care of poisons and the use of poison con- tainers are faithfully enforced. 1464. Nurses shall see that money and valuables of patients who so request are transferred to the ward oflicer for safe-keeping. This shall always be done in cases wliere the patient's condition is .such as to render him unfit to safe- guard his posse.ssions. 1465. The ward nurse shall make the detail of duty for Hospital Corps men assigned to the ward, designating to each the duties he shall perform from the time of reporting to tlie time he is relieved. Nurses in charge of property shall report in writing to the executive surgeon breakage of articles on charge and fix the responsibility for such breakage, if possible. 1466. The ward nurse shall be notified when a patient is to be confined in the brig or is to be restricted to the ward or hospital. AVhen a patient is con- fined in the brig or is absent without leave for over 24 hours, she shall have all his clothing and belongings collected, make a list of .same, and turn list and property over to the master at arms. "When a patient leaves the hospital she shall .see that he turns in all ward linen and wearing apparel Issued to him. 1467. The ward nurse will be responsible for the proper keeping of the fol- lowing books and forms or any other.s that may be autliorized from time to time: (a) Property accountability cards: Tliese cards shall be used in making requisitions for unexpendable articles and for turning the .same jn for survey or to store. These are to be signed by the ward oflicer and countersigned by the executive surgeon. (h) Ward property book: Shall contain record of all property on charge and show all changes entailed by receipt of fresh supplies and surveys. The prop- erty book will be verified by a monthly inventory, or oftener if deemed neces- sary. 'I, (c) Admi.ssion reports: Shall show full name, rank or rate, religion, and tliie day and hour of admission of patient ; also the nanie and postal and telegraphic address of the next of kin. {d) Discharge reports: Shall show name, rank or rate, and the day and hour of discharge of patient, and the address to which mail shall be forwardcil. Reports {(■) and ((0 to be sent to the ward officer as soon as practicable. (e) Clinical notes. (/) Daily report of patients: Shall show the number of patients received, discharged, etc., number of vacant beds in ward, and names and rates of pa- tients recommended by the ward officer for discharge or survey. These reports are to be sent to the executive surgeon immediately after sick call. ((/) Liberty list: Shall conlain the names of patients and Hospital Corps- men recommended for lil)erty i)y the ward officer. (/i) Liglit-duty list: Shall be pf)sted daily, showing names of patients de- tailed fur light duty in the ward, with Ihc specific duty each is to vierform. The ward uur.se will also revise daily the list of patients for duty outside the ward. (t) Ward order book: All orders relative to the treatment of patients shall, so far as i)racticable, be legil)ily and explicitly entered in this book and signed by the medical oMieer. 146S. Tile night nur.se shall be informed of all emergencies arising in the wards and is responsible for giving timely information to the offictM* of the day. .Ml onh-rs relative to treatnuiit shall be giviMi to lier and she will be responsible for carrying them out. r.efore going off duty she shall see tliat tli(> morning MAN^UAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. 97 routine is being carried out and leave a written report of any incident worthy of note occurring during the watch. 1469. A nurse shall be detailed for duty in the operating room and will be responsible for its upkeep and cleanliness and for the general surgical technique therein. 1470. Example of a daily ward routine (subject to such modifications as local conditions demand) : 6 a. m. — All Hospital Corpsmeu called by night Hospital Corpsmau. 6.15 a. HI. — Night Ho.spital Corpsman calls all patients permitted to be up and see that all patients get attention as to cleanliness. 7 a. m. — IMuster of Hospital Corps, followed by inspection to see that all Hos- pital Corpsmen are in their wards at work. Breakfast; half hour allowed. 7.30 a. m. — Breakfast for relief Hospital Corpsmen ; half hour allowed. 8 a. m. — Nurses or Hospital Corpsmen take charge of ward. Sweep and polish, and arrange lockers and chairs in an orderly manner for sick call. Take temperatures, serve medicines, etc. Each Hospital Corpsman is given a defi- nite' amount of work and is to be held responsible for that -work. Draw ice allowance. 8.45 a. m. — Ho.spital Corpsmen and patients get into uniform for sick call at 9 a. m. 9 a ni_ — The ward nurse and senior Hospital Corpsman will accompany the medical oiiicer holding sick call, and the nurse will be furnished with a book in v.-hich she shall write all treatment prescribed and which shall be initialed by the ward officer. 9.30 a. m.— Obtain medicine and otlier atlcles ordered; turn in morning report of patients to executive surgeon. The wards liaving been prepared, the heads, bathroom, and washroom, will be in readiness for inspection by the executive surgeon. Send special diet sheet to the commissary department. 10 a. m. — Inspection of the hospital by executive surgeon. Dressings to be done, if any, by nurse or by Hospital Corpsmen under supervision of nurse. 11.30 a. m. — Attend to' ward diets and mess gear. Dinner for relief Hospital Corpsmen. 12 m. — Dinner for Hospital Corpsmen and convalescent patients. 12.50 p. m. — Clean up after dinner. 1 p. m. — Take temperatures, serve out medicines, etc. 2 p. m. — Police wards. 3 p. m. — Sweep or polish floors as required. Draw ice for coolers, ice boxes, etc. 4 p. m. — Police wards. 4.30 p. m. — Attend to ward diets and mess gear. Supper for relief Hospital Corpsmen. 4.45 p. ra. — See that each patient lias had his diet, and clean up ward. 5 p. m. — Supper for Hospital Corpsmen and convalescent patients. G p. m. — Sweep floors, take temperatures, serve out medicines, and have wards in orderly condition for sick call. 7 p. m. — Sick call. 8 p. m. — I'olice wards. 9 p. m. — Report "All patients accounted for," or if there are any .absentees, give their names, rates, etc., to the chief pharmacist's mate on watch. Turn out lights excepting the standing lights. Hospital Corpsmen relievetl by night Hospital Corpsmen. 10 p. m. — ^Turn all orders over to night nurse. Section 16. — Duties of Hospital Cokpsmex. 1471. Hospital Corpsmen when received for duty will be assigned quarters and instructed in the details of their duties. (See Par. 1375.) 1472. Hospital Corpsmen who are in charge of wards will be governed by the rules laid down for nurses in charge of wards. Hospital Corpsmen at- 98601°— 17 7 98 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. taclied to wards will receive their orders from the uurse or Hospital Corpsinan in charge of ward and carry out faithfully such instructions as may be given them. 1473. Hospital Corpsmen when off duty must not loiter about tlie wards. Section 17. — Duties of the Night Hospital Cobpsmajj. 1481. He shall carefully inspect the building at stated hours, render assist- ance to the night nurse as required and carry out such orders as may be given him. He has no authority over tlie night nurse, but is responsible for the maintenance of order and discipline on the part of Hospital Corpsmen, patients, and employees. Section 18. — Example of Routine fok Sick Officeks. (Subject to such modi- fication as local conditions demand.) 1491. (a) Morning sick call will l)e held at 9 a. m. Officers not in bed or excused for cause will be up and dressed. (b) Officer.s must obtain permission before leaving the grounds from the officer of the day and report their return to him until 10 p. m., after which hour they will notify a designated person. (c) Officers will notify the nurse in charge when they expect to be absent fi'om meals. (d) Smoking in bed and in the halls of the hospital is prohibited. (e) Patients will not reprove nurses or hospital corpsmen, but will report promptly any discourtesy or neglect in treatment to the executive surgeon. (/) Only hand baggage and one small trunk will be allowed in a bed room. Other baggage will be put in the trunk room. (g) Officers will not enter the office ot the hospital except for the transaction of official business. (h) Meals will be served at the following hours: Breakfast, 8 a. m. Luncheon, 12 m. Dinner, G p. m. (i) Officers when discharged from hosjutal will leave an address at the offic"o to which mail may be forwarded. Section 19. — Example of Rules for Patients. (Subject to such alterations as local conditions may demand.) 1501. Admission' of patients. At regular trips of the ambulance patients wiil be received by the officer of the day. 1602. The master at arms will, immediately upon arrival of patients, verify their clothing lists from hospital tickets, number their bags and hammocks and transfer them to the bag room, enter names and numbei'S in a book kept for that puipose, and return the hospital tickets to the office for tiling. Patients other than bed patients shall be directed to take a tub bath before entering the ward if tills is deemed necessary, 1503. Rules governing patients in wards. All patients desiring liberty will submit their names to the nurse or pharmacist's mate in charge of w^rd by S.;50 a. UL, who will prepare a liberty list for signature by ward officer at sick call (9 a. m.) when it shall be forwarded to the general office to l)e entered on (he liberty book for tinal approval by the executive surgeon. Requests for extension of leave by telephone will be disregarded excepting In cases of emergency. , „ . x, 1501. Patients will be inspected before leaving hospital to see that they are in correct uniform and upon return will i-eport to the officer of the day until ]0 p. m. and after that to a designated person. The condition of patients return- ing will be noted In the liberty book. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 99 1605. Patients with venereal diseases will not be allowed general libei-ty. ami their names will not be entered on the liberty list. 1506. Patients desiring to remove packages from the hospital reservation will be provided with passes by the officer of the day. 1507. Convalescent patients detailed for work in a ward may be called upon by the nurse or pharmacist's mate in charge for any light duty she or he may order them to perform. Convalescent patients for other than ward duty will receive their orders from the master at arms. 1508. Patients are permitted to smoke only in places designated for that purpose. 1509. Patients are not allowed to play cards or other games in the wards without special permission. 1510. Patients are not allowed to sit on the sides of beds, and those able to be up and about are not allowed to lie on their beds without removing shoes and neatly turning down the spread. 1511. The following articles and no others will be allowed to be kept by patients in their lockors : BLUEJACKETS. Suit of blue or white 1 Suits of underclothing 2 Socks, pair 3 White hat 1 Blue hat 1 Neclverchief 1 Towels 3 Shoes, pair 1 Toilet articles. MARINES. Suit of blue or khaki . 1 Suits of underclothing 2 Socks, pair .3 Shirts ■: ' 2 Blue cap . 1 Towels :-< Shoes, pair , 1 Toilet articles. 1612. Lockers umst be kept in a neat condition and be thoroughly overhauled and washed weekly. 1513. Patients should not talk loudly or make unnecessary noises in any part of the hospital. 1514. Patients are advised to deposit all money and valuables in the hospital safe, receipt being given. 1516. No fruit, candy, eatables, or liquors (alcoholic or other) are to be taken into the ward without permission of the officer of the day. 1516. Patients are to be always in the prescribed uniform. 1517. Patients are not allowed to congregate about the ward desk, nor enter Hospital Corps quarters. 1518. Patients are not allowed to wash clothes In the wards or bathrooms. 1611). Each patient in ward will be supplied with a drinking glass. 1520. Patients will avoid leaving matches, papers, or any rubbish on the floors of the wards or throwing them out of the windows, and any articles of such a character found on the floors or elsewhere shall be removed by the patient whose bed is nearest the place where they are found. 1621. Convalescent patients will be held responsible for the making up of their beds, their neat appearance, and the cleanliness of the immediate neigh- borhood. 1522. When a patient is transferred from one ward to another he shall be accompanied by a slip stating his previous treatment, diet, etc. 1523. Patients will observe strictly these and other rules issued for ttleir guidance by competent authority. 1524. Dischstrge of patients. Wlien a patient is to be discharged from the hospital, he shali remove soiled bed linen, wash and thoroughly clean his bed and locker, carry the mattress to sterilizer room if directed, and return to the nurse or pharmacist's mate in charge all towels, pajamas, slippers, or other hospital property he may have in his possession. lOU MXSVAL FOR TilE MKDIGAL DEPARTMENT, U. S. NAVY. 1525. The niastor at arms will cherk each departiiis; patient's olothin? list, have him si.mi the ro. I'atit'nts discharged from the hospital should leave their futnro address at the general oilice so that mail may be forwarded. 1527. Montldy money lists and small-store requisitions will be prepared after approval by the executive surgeon at designated times. 1528. The names of patients recommended for medical survey will be noted on the mornins report of patients on Mondays, and patients fit for duty will likewise be noted on Tuesdays and Thursdays and will usually be discharged on Wednesdays and Fridays. Section 20. — Instkuctions Hegakding Supernumkr.\ries, Pensioners, etc., in Hospitals. •n 1531. Supernumeraries may be taken to include all per-sons admitted to hos- pital for treatment, except officers and men of the Na^•^' or Marine Corps on the active list. Retired officers and men, officers and men of the Navai Reserve Force and the Naval Auxiliary Service, members of the Nurse Corps, civil employees, officers and enlisted men of the Army, Coast Guard, Coast and Geodetic Survey, and other Federal services, Federal services of friendly powers, and natives treated in the insular dependencies may be considered supernumeraries. 1582. For methods of keeping the medical records of supernumeraries, see pars. 2245, 2247. 221)3, 2365. 1533. («) When ueces.sary in emergency, supernumeraries may be admitted to hospital for treatment subject to the bureau's approval, but ordinarily per- lulssion for the admission of supernumeraries should be obtained in atlvance, except in the case of a retired officer or enlistefl man. Specific authority for the retention in hospital of enlisted men after the expiration of enlistment is unnecessary, but a return should be made to the bureau, through the com- mandant, of all supernumeraries so retained. ( R. 3582 i7) ); (I 5247 (52). » The return referred to in I 5247 (52) shall take the form of a notification to the bureau when enlisted men are retained after expiration of enlistment and the form of a request in all other cases. ib) Article R 36G7 authorizes any person honorably discharged from the naval service to elect a home on board a receiving ship at any time iluring the four months immediately subsequent to his discharge, and each person so electing a homo on board a receiving ship is allowed one ration and is re- force who will be under the pharmacist, when a pharmacist is attached to the hospital) shall be under the direct supervision of the executive surgeon and he shall require the chief engineer, carpenter, painter, and outside foreman to report to him daily at a designated hour to give au account of any work under way and receive orders for work to be done, and also report the absence or tardiness of any employees under them. 154.3. Artisans and laborers employed at naval hospitals, naval meilical supply depots, and the Naval Medical School jare entitled to receive compen- sation under the act of May 30, 1908, for injuries received in the course of their employment. Section 22. — The Dispensary. 1551. The dispensary shall be in charge of a chief pharmacist's mute, who will be held responsible for its cleanliness and general management. One pharmacist's mate, if possible, shall be detailed for instruction in the dispensary, the period of instruction to be the same as that of the operating room pharma- cist's mate. The chief pharmacist's mate in charge of the dispensary shall draw the necessary drugs and supplies from the property pharmacist's mate at designated hours. No prescription shall be tilled or material issued except on an order of a medical officer attached to the hospital. The chief pharma- cist's mate in charge of the dispensary shall issue drugs and fill prescriptions for the wards at a designated hom- and deliver them to wards as soon as possible. Section 23.— The X-ray Room. 1561. The X-ray room sliall be under the direct care and supervision of a medical officer. A chief pharmacist's mate shall be detailed for duty in the X-ray room, and at least one pharmacist's mate shall be kept under instruc- tion there. ' This work may be combined with the duties of the property steward. The Hospital Corpsman under instruction will act as general assist- ant to the property pliarmacist's mate, and will have charge of the hydrotherapy room, and will be carefully instructed in the use of the apparatus under his control. A complete record will be kept of all work done in the X-ray room. Section 24. — The Linen Room. 1571. The linen room shall be under the supervision of the chief nurse, and when practicable a nurse shall be assigned to assist her and have charge. If a nurse is not available, a chief pharmacLst's mate or pharmacist's mate shall be in charge. Linen will be obtained from the property pharmacist's mate when necessary to keep up stock. Each ward Avill have a definite allowance of linen, and this shall be inventoried monthly by the nurse in charge of the ward. Articles for survey will be replaced by use of the property accountability slip. Section 2.5. — The Diet Kitchen. 1581. The diet kitchens shall be under the supervision of the chief nurse, assisted by a nurse detailed for that purpose when practicable. The articles of food required for diet kitchens will be issued from the commissary depart- ment on property accountability slips. .As many dishes of special nature as possible shall be prepared in diet kitchens to relieve the main kitchen of this work. 1-02 MANUAL FO.R TH'E MEDICAL DEPARTMENT^ U. S. NAVY. Section 26. — Thk Akmy and Navy PIospitai., Hoi' Springs, Ark. 1591. Erection of an Army and Navy Hospital at Hot Springs, Ark. Act June 30, 18S2 (Army appi-opriation act). 15*J*2. Composition of board desifrnated to draft rules for its government. Executive order, May 6. 1886. Skution 27. — Navy Regulations and Dei'aktaikntal Cibculars Relating to THE Admission of Patients to the Akmy and Navt Hospital, Hot Spkinos, Abk. •■\' !) 1601. Authority for admission, how obtained. R 4531 (1). .'> 1602. Accommodations, how assl3:ned to the services. R 4531 (2). ■>■• 1603. Rules governing the admission of patients, department circular, Decem- ber 31, 1886 (summarized below) : Section 28. — Information Relating to the Admission of Patients to thb Akmy and Navy Hospital, Hot Springs, Ark. 1611. The hospital is under the direction of the Secretary of War, and is devoted to the treatment of officers and enlisted men of the military and naval services of the United States, officers of the Revenue-Cutter Service, and of the Public Health Service, and honorably discharged soldiers and sailors of the Regular and Volunteer Army and Navy of the United States, for such pur- poses as the waters of the Hot Springs of Arkansas have an established repu- tation in benefiting, except that cases of venereal diseases will not be admitted. 1612. Admission to this hospital is restricted to those of the above-named classes who require medical treatment in the following order of preference: (1) Officers and enlisted men of the Army, Navy, and Marine Corps on the active lists, cadets at the Military Academy, and midshipmen at the Naval Academy; (2) officers and enlisted men of the Army, the Navy, and the Marine Corps on the retired lists; (3) officers of the Coast Guard and the Public Health Service; (4) honorably discharged soldiers and sailors of the Regular and Volunteer Army and Navy of the tTnited States may also be admitted by authority of the Surgeon General when there are vacant beds in the hospital. 1618.' Officers and enlisted men of the Navy and Marine Corps are admitted under regulations prescribed by the Secretary of the Navy. 1614. Honorably discharged soldiers and sailors of the Regulars and Volun- teer Armv and Navy of the United States are admitted upon the approval of the Surgeon General of the Army, from whom blank forms of application can be obtained. These must be properly filled out. giving all necessary informa- rioii in relation to the applicant, and should be certified to by a practicing phy- sician, who will state the nature of the disability and the probable period required for hospital treatment. Patients admitted under this authority may be discharged from the hospital by the commanding officer at any time he may deem proper. Expenses to and from the ho.spital must be defrayed by the appli«ant. 1615. Enlisted men on the active list under treatment or on duty or mem- bers of the Nur.se Corps on duty in the hospital will have the usual allowance of rations commuted at the rate of not le.ss tlian 30 cents per day for enlisted men and 40 cents for inenil»ors of tli(> Nurse Corps. Enlisted men of the .\rniy, Navy, and Marine Corps on the retired list and honorably dischargeil soldiers and sailors of tbe Regular and Volunteer Army and Navy of the United States will pav for subsistence 40 cents per day. 1616. In f.ertit'ying cases for admission to this hospital medical officers and physicians should recommend only those that are serious and obstinate, and In wtiich there is a reasonable prol>ability that the facilities there afforded will ma/^erially aid in the rapidity and permanence of recovery. MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. 103 1617. Relief may reasonably be expected at the Hot Springs in the following conditions: lu the various forms of gout and rheumatism, after the acute or inflammatory stage; neuralgia, especially when depending upon gout, rheuma- tism, metallic, or malarial poisoning ; paralysis not of organic origin ; the earlier stages of locomotor ataxia; chronic Bright's disease (the early stages only), and other diseases of the urinary organs; functional diseases of the liver; gastric dyspepsia not of organic origin; chronic diarrhea, catarrhal affections of the digestive and respiratory tracts; chronic skin diseases, espe- cially the squamous varieties ; and chronic conditions due to malarial infection. 1618. No officer or enlisted man of the Navy or Marine Corps shall be admitted as a patient into the Army and Navy Hospital until he has been con- demned by a board of medical officers and the report of such board has been approved by the department. 1619. If it is not practicable to convene a board of medical officers for this purpose, the certificate of a naval medical officer or that of a civil practitioner should be forwarded to the department, giving a full description of the disa- bility under which the patient is suffering. 1620. Upon approval by the department of the report of medical survey, the Bureau of Medicine and Surgery will forward, through official channels, to the patient an order for his admission into the hospital. 1621. The commanding officer of the Army and Navy Hospital (through the Surgeon General of the Army) is informed of the action taken by the Bureau of Medicine and Surgery. 1622. On admission to the Army and Navy Hospital the patient shall present for the information of the hospital authorities the following papers relating to his case : (a) Order for admission. lb) Copy of report of medical survey (if recommended by medical survey). (c) Health record (if patient is on active list). (d) Copy of hospital ticket (if transferred from a ship, navy yard, or special duty). (e) A statement of patient's condition (if admitted upon the certificate of a civil practitioner). Section 29. — Infoemation Relating to the Admission of Patients to the United States Naval Home. 1631. The regulations for admission to the Naval Home require that a per- son shall have served 20 years in the Navy or Marine Corps and be disabled from earning his living by manual labor. However, it is customary for the Secretary of the Navy to waive the 20-year-service requirement where the applicant for admission to the Naval Home has rendered somewhere near the required number of years service, has a creditable record, and has been dis- charged for disability, or where he has served a number of years, has an exceedingly meritorious record, and is disabled in the line of duty. 1632. Boards of medical survey in the cases of men whom it is contemplated discharging from the service should give the patient when practicable the choice of being discharged from the service or of being transferred to the naval hospital, Philadelphia, Pa., preliminary to his admission to the Naval Home, and it is suggested that such boards enter their recommendations on the sur- vey accordingly. Upon the arrival of the patient at the naval hospital, Phila- delphia, the necessary applications for admission to the Naval Home will be made out for him there. 1633. Inmates of the Naval Home are given a clothing allowance of about $50 a year, li pounds of tobacco a month, and, if not in receipt of a pension, are allowed $3 per month pocket money. Pensioners in the home are allowed to draw their pensions. Each man is quartered in a separate room. Those who are able to work and desire to do so are employed about the buildings and grounds as watchmen, gatekeepers, etc., for which they are paid from $10 to $15 a month. ;.U 'iaa aA ) CHAPTER 9. HOSPITAL SHIPS. Section 1. — Navy Regulations and Instructions Relating to Hospital Ships. 1701. Bureau of Medicine and Surgery to approve the design of liospital ships and liave control of tlieir internal organization and administration. R ]33 (3) ; R 2901 (1) ; R 2911. 1702. Designation, duties, and cognizance of hospital ships. R 2911. 1703. Persons transported restricted. R 2912. 1704. Regulations, instructions, and conventions governing. R 2913. 1705. Assimilated to shore hospitals and manned by merchant crew and Hosiiital Corps. R 2914. 1706. Classed as naval auxiliaries. R 2915. 1707. Characteristic painting required. R 2916. 1708. Neutralization rules. R 2917 (1-3). 1709. Hospital ships subject to inspection by commander in chief. R2918; I 908. 1710. Commanding officer and succession to command. R2919 (1) (2). 1711. Orders to hospital ships. R 2919 (3). 1712. .Junior medical officers. R 2920. 1713. Traffic forbidden. R 2921. 1714. Intoxicating liquor forbidden. R 2922. 1715. Civilian complement, how classified. R 2923. 1716. Authorities and duties, etc., of masters of hospital ships. R2924 (1-16). 1717. Responsibility and duties of first officer. R 292.5. 1718. Responsibility and duties of chief engineer. R2926. Section 2. — Naval Instructions Relating to Hospital Ships. 1721. Arrangement of mes.ses. 14001. 1722. Boat instruction. 14002. 1723. Signals used and instruction in signaling. 14003. 1724. Accounts of officers and men carried on a designated naval vessel. I 4004. 1725. Subsistence and issues. 14005; 14549 (1) ; 14951. 1726. Accounts of master. 14006. 1727. Shipments, appointments, discharges, uniforms, etc., governed by Reg- ulations for Naval Auxiliary Service. I 4007. 1728. Hospital ship regulations to govern civilian crew. 14008. 1729. Obedience to authority enjoined. 14009. 1730. Deportment required to be civil and decorous. 14010, 1731. Uniforms. 14011. 1732. Improper conduct forbidden. I 4012. 105 106 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 1733. Smoking rules and other roKulatioiis. I 4013. 1734. Oflicer and quartermaster always on duty in port. 14014. 1785. Harbor regulations regarding refuse to be observed. I 4015. 1730. Ship's log. I401G. 1737. Duties of the master. I 4017 (1-7). 1738. Duties of the first officer. I 4018 .(1-6). 1730. Duties of the deck officer. 14019. 1740. Duties of the chief engineer. I 4020 (l-ll). 1741. Medical officer in command to make the same reports as are re(iuired from naval hospitals. I 5231, ,■> >Mi'J '^AHJ 1742. Medical officer in command. (a) Relations with master. I 4230. (b) Authority to relieve master of his duty. I 4232 (1). 1743. Responsibility of master. 14231 (1). 1744. Reporting position by radio. General Order No. 130. 1745. Transfer of patients to hospital sliips, see chapter 17, section 9. >i . ' 1740. Transfer of dead to hospital ships, see chapter 20, section 12. /IK CHAPTER 10. ORGANIZATION OF THE MEDICAL DEPARTMENT FOR THE CARE AND DISPOSITION OF THE WOUNDED AFLOAT AND IN EXPEDITIONARY SERVICE ON SHORE. Skction 1. — Navy Regulations and Naval Insteuctions Relating to Peepa- EATION FOB AND THE CONDUCT OF THE MeDICAL DePAKTMENT IN BATTLE AND Subsequent to Battle. ISOl. Medical Department is charged witli making provisiou for cave of wounded in battle. R2901 (1). 1802. Hospital ships to care for and transport the wounded. R 2911. 1803. Medical officer of a ship to malie suggestions regarding care and com- fort of wounded. R 2954. 1804. Medical officer to be in readiness for relief of wounded and instruct ambulance party in fii'st aid. R 2956. 1805. After battle medical officer to make duplicate report of killed and wounded. R2957; R2061 (3). 1806. Chaplain's duty and station in battle. R3102. 1807. Red Cross cooperation in war. R 3861. 1808. Fleet surgeon to make a tabulated report of killed and wounded in action. I 1122 (7). 1800. Executive officer's report after battle. I 1407. 1810. Distribution of first-aid appliances and instruction in first-aid. I 2109. 1811. Medical officer's duty to wounded in battle. 12128. 1812. Station of pay division in battle. 12203 (4). 1813. First-aid instruction to men by divisional officer. 12641. 1814. Instruction to Hospital Corps in first-aid and transportation methods. I 2642. 1815. Reports from officers after battle. I 5327. 1816. Report of casualties in action. (Form K2.) I 5222 (5)r. Section 2. — Detailed Oeganization fob Relief of Wounded Aboard Ship. 1821. The regulations require that the medical officer shall frequently advise the divisional officers in the use of first-aid appliances. These include shell wound dressings, designed to protect wounds caused by shell fragments, and tourniquets for control of hemorrhage. Iii addition, instruction in resusci- tation of the apparently drowned is given. Medical officers should prepare lists of fractures, wounds, burns, scalds, etc., of various parts of the body, and drill Hospital Corps, relief-station crews, and stretcher bearers in these subjects. When a yeoman is detailed to help with the clerical work he should be instructed in spelling the various diagnoses, taught the key letters, and also such blank forms of the Medical Department as may be used, should be fully explained. Where training in the use of rescue breathing apparatus is given, this shall, in all cases, be undertaken in the presence of a medical officer ..U iO ei-li;iiUi;>107 108 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. (Ceneral Order No. 118, Sept. 15, 1914). The divisional officers in turn give instruction to the men under their innnediate command. (I 2109 ; I 2641.) The medical officer also provides for the instruction in first-aid and trauhpoitation methods of the Hospital Corps and stretolu-r men in number equal to about 2 per cent of the coinplement of the ship. (R2956.) Turrets, handling? rooms, gun stations, torpedo, fire, and engine rooms, and fire-control stations and other stations not readily accessible, in which men and officers are stationed in liattle, should be provided with first-aid packap:es, shell-wound dressings, and tourniquets. Dressings for burns and scalds in engine and fire rooms, plainly labeled, should be accessible to the occupants of these stations. (See par. ](>(»8. )- 1S22. (d) Modern naval warfare presupposes a high casualty rate and a rapid accumulation of womuled, but the casualty rate will vary widely on different ships, probably being highest in the leading divisions. Any effective organization of medical personnel to meet the demands of the woun«lod in a naval engagement will usually go beyond the facilities of a single ship and will necessitate the adoption of a "more comprehensive scheme of assistance external to the ship, but every vessel should be self-sustaining so far as practicable, and no effort should be spared to attain this end. When the ship's band is detailetlv returned to their stations. It must be borne in mind that the primary purpose of first-aid Is to keep as many effectives at their stations as possil)ie. A graver class of injuries may require deliberate surgical interven- tion, but extensive procedures on the part of the sidji's force are otily legitimate if evacuation of the wounded for any reason, is dehiyed or rendered inadvisable. The personnel of the Medical Department slionld institute a searcii for the seri- <(usly wounded to afford them relief and to prepare a list of the dead as soon as practicable. To assure the woutuled early and efficient treatment, eff»M«t tlieir rapid removal from the figliting ship, and insvn-e a .-ontinuous record of each case is the object of the organization. 1823. General quarters: When at exercise sinnilating action (In so far as it Is possible to do so), the medical officer will employ this op|-H>rtunity to in- struct the personnel of the dressing stations In their duties, assuring himself that all members of the ambulance party are competent to administer lirst-aid; MANUAL FOR THE MEDICAT DEPARTMENT, V. S. NAVY. 109 tliat they understand their stations and the limits of the ship assigned to tliem, and the usual routes of transpoit to and from the groups of personnel. At drill, the dressing stations will not be equipped in advance of signal " general quarters." 1824. Battle dressing stations: (a) Battle dressing stations should be easy of access and located behind armor. Routes to dressing stations should be indicated by an arrow and a red cross. There should be at least two. one being installed as a main or primary station and one as an accessory or secondary station. The stations should have an abundant supply of drinking water, all connections being installed behind armor. As these connections might nevertheless be interrujited storage tanlcs for drinking water should be provided having a capacity sufficient to furnish in first-class ships 1 gallon of water per man. allowing for 20 per cent of wounded. Dre.ssing stations should also be well ventilated, well lighted, and as cool as the surroundings will permit. It has been estimated that each 3C square feet of area should Ije provided with one cargo light of apiiroximately 200 candlepower (6 lamps). If possible, connections for electric lights should be distributed on two circuits ; lanterns or some other means of lighting should 1)0 available in case the electric lighting circuits suffer interruption. Electric or steam connections should be provided for the water, dressing, and instrument sterilizers. In ships wherein proper connections are provided sterilizers should be removed from the surgical operating room and set up in the main dressing station prior to action. When so installed they should remain during the period of hostilities. If possible, there should be some provision made for the drain- age of this space. In the vicinity of the dressing station or adjoining it there siiould be arranged a berthing space for the wounded sufficient to accommodate about 10 per cent of the complement. This space should be easy of access from the dressing station, and, like the latter, have an abundant air supply. In addition to the usual equipment transferred from the sick bay and operating room and distributed in the dressing stations the following articles should be provided : Electric fans, with proper connections ; half tubs ; water buckets ; swabs and brooms; washing stands; tables for apparatus; shelves; supports or hooks for irrigators, etc.; dressing lockers; bedding for the berthing space for wounded; restoratives, etc. A reserve supply of surgical dressings should be available on this deck in a secondary station, behind armor, and accessible for distribution to the dressing stations, if required. (b) The station of the medical officer of the ship during action will, as a rule, be at the main (operating) dressing station, where he will see that the neces- sary equipment is provided. 1825. Preliminary to battle the personnel should be required to bathe and put on clean underclothing. As part of the preparation for battle it is recommended that socks, drawers, and undershirts be soaked for five minutes overnight in a solution of ammonium phosphate, made by dissolving 1 pound of ammonium phosphate (NH,) J^PO* in 2 quarts of water, which reduces inflammability. When large quantities of thi.s solution are made up and kept for future use and many garments are to be soaked in it, add boric acid, 1 ounce to each 2 quarts, to prevent fermenta- tion. Except in the most risorous weather, the uniform for action should be clean white (washable) clothes. When whites are to be used, they also can be immersed in the ammonium phosphate solution. (See par. 1003.) 182«. IVIeans of identification of the dead, as reipiired by article 17 of the Tenth Hague Convention, should be provided for each officer and man. (See 2097, Identification tag.) (See General Order No. 294.) 1827. The organization of the INIedical Department, showing all dispositions under battle conditions, should be worked out for the ship as soon after going into commission as practicable. Provision should be made for instruction of officers and men in first-aid; for the equipment and organization of battle dressing stations, as described above; and for a definite organization of the personnel of these stations, as well as for their progressive instruction in fir.st- 110 MANUAL FOK THE MEDICAL DEPAKTMENT, U. 8. NAVJi'. aid aud transijortation methods. During action the difliculties of transporta- tion preclude any extensive exercise ol: the functions of the stretcher men. and as their most important duties are to be performed when the action is over, or during interval of action, they will avoid exposing tliemselves unnecessarily. Such emergency work as is feasible will be performed. 182«. Tlie tiMlley and bakery in ships of old type, if intact, after an engage- ment'may be placed at the disposition of the medical officer for preparing addi- tional hot water and dressings and for sterilizing instruments. 1829. Operating room: If not dismantled, the ship's operating room may be made use of after the action to supplement the work of the dressing stations, provided the removal of the gravely wounded direct to hospital ships is not feasible. .,, , . i , , ., ^, u 1830. Transportation of wounded: Apparatus wdl be provided by tiie Medi- cal Department of the ship for transportation of wounded, but complicated appliances liable to disablement will be avoided. Simple measures designeil to facilitate transporting wounded by stretcher directly to the dressing stations by the most convenient hatch, down which they will be lowered or passed by hand to the deck below, or over the side to boats from the hospital ship, are to be preferred to more elaborate means of transport. 1831. A suitable place should be assigned for the di-sposition of the dead. 1832. When the medical transport or hospital ship is at hand, the seriously wounded should be transferred as promptly as is consistent with their welfare. A fighting ship should be cleared of such cases as soon as possible after an action, in order that she may be ready to reengage in battle. On the other hand, patients who will probably soon be fit for duty should be retained on board, aud these may constitute a large proportion of all cases. Skction 3. — ^The Landing Force fob Expeditionaby Sebvicb. (See also, The Landing Force and Small Arm Instructions; Drill Regulation? for the Hospital Corps, U. S. Navy; Uuilorm Regulations, U. S. Navy, 1913; and Sanitary Directions for Landing Parties, ch. 14, sec. 9. See Fleet Regu- ISli. The organization of the Medical Department for duty with the lauding force will depend upon the size and character of the expedition. The landing force may consist of a battalion, regiment, or a brigade. The organization of the battle tleet into four divisions, each of four ships, contemplates the landing force of a division (four or five battalions, including the marine battalion) as a regiment, and the total force of the tleet (four regiments) as a brigade. Two or more companies form a battalion, two or more battalions a regiment, and two or more regiments a brigade. 1842. The brigade surgeon will serve on the staff of the brigade commander. He will be held responsible for the efliciency of his department and from time to time make such suggestions and recommendations to the brigade commander relative to the same as the exigencies of the case may demand. When fur- nished with information regarding the military situation, it shall be his duty to study it and to take the initiative in preparing for and anticipating demands and eniergencies in his department. He shall act upon his own responsibility when necessary to do so. reporting his action to the brigade commander for his approval, lie shall submit plans bel'orehand whenever practicable. He shall keep records and notes of all events and matters of importance in conne<-tion with his duties, and to assist him in this duty he will have detailed as n memi)er of the noncommis-sioued stalf a chief petty officer (chief pharmacists mate) or a pharmacist. The brigade surgeon shall have giMieral direction of all divisions of the sani- tary personnel ; the organ zaiion el" the transiiort column and the reserve n)e sanitary force and to avoid hampering the move- ments of the landing force. In case a base hospital is established on shore it will be under charge of a medical officer detailed for that purpose who will co- operate with the brigade surgeon. The in.1ured will remain in the base hospital until they are fit for duty or able to be sent to a home station. 185(). Distant service: Special provisions nnist be made for transport of the sick and wounded in the case of distant expeditions and long marches. Requi- sitions .should be made upon the regijuental quartermaster (or upon commis- saries in case of battalions acting alone) for necessary tran.sportation of the medifal material and personnel, including the disabled. 1851. As provided under article 4, (Jeneva Convention of 1906, and article 17 of the Tenth Ilsigue Convention of 1907, all personnel .should carry an appro- priate id(>ntification mark or tag. 185'i. I>oose leaves from health records and Form F (cards) will ordinarily he the only material landed with expeditionary forces for keeping medical i-ecords. medical histories being entered thereon and inserted in health record .It a later date or upon return to the ship. 1853. I'^ast pulling boats or steam launches containing the medicMl officers with assistants and pro])er outfits, will be stationed in rear of the main line at the end of the t<>w. They will be desigiuited by the hospital flag placed in the bow of the boat. , , , ; 1854. Parades, reviews, drills: PpSi$ of orflc^t^. (a) IN'gimental staff (including regimental surgeon). In all formations the staff and aids are 3 paces in rear of the regimental commander, the r(»gimental adjutant on the right, the other staff oilicers and aids in order of rank, the senior MANUAL for' THE MEDICAL DEPARTMENT, U. S. NAVY. 113 on the right ; but if only one staff officer is present he takes post 3 paces to the rear and 1 pace to the right of the regimental commander. (b) Battalion staff (including battalion surgeon). The staff officers, except the adjutant, in order of rank, the senior on the right, take post 1 pace apart, 3 paces to the rear of the battalion commander. (c) The staff of the reviewing officer is in single rank, 6 paces in the rear of him, the senior to the right. id) When passing in review the staff of each commander salutes and returns to the carry with him. When landing for parades or reviews ambulance parties will not be massed, but each will follow its own battalion, each stretcher being carried by four stretcher men, the stretchers being horizontal and carried abreast of each other. In all other cases the special detail will be massed by regiments, and for actual service or for drills other than parades there will be one stretcher for each two stretcher men. (Atlantic Fleet Regulations, 1913, pai-. 208 a.) On parades the ambulance party will be landed not simply for parade but to administer first-aid and handle cases of sunstroke or accident. (Atlantic Fleet Regulations, 1913, 208 b.) Section 4. — Outline of the Organization of the Medical Depabtment in THE Field. 1861. The functions of the Medical Department in the field fall under the following headings: (a) Sanitation; (b) professional care and treatment of sick and wounded; (c) providing medical and hospital supplies; (d) collection and evacuation of sick and wounded. 1862. Assistance will usually be rendered to the wounded at the following points: (a) The regimental aid station; (5) the dressing station; (c) the bri- gade hospital; (d) the base hospital (hospital ship or other ship). 1863. At the beginning of an engagement the wounded are cared for by the regimental ambulance party. Those able to walk are taken to sheltered places as soon as possible, out of the way of advancing troops. If the size of the regimental ambulance party permit, the force at each regi- mental aid station (a) may v.'ith propriety be divided or disposed so as to handle the slightly wounded separately. Their presence in considerable num- bers interferes with the treatment of serious cases and they require only an application or readjustment of a first-aid bandage before being ordered back to their post of duty. 1864. Regimental aid stations are established under shelter by the regi- mental surgeons as near the firing line as possible. If the enemy's fire is such that the wounded can not reach the station, advantage is taken of the char- acter of the terrain affording temporary shelter, and the wounded are brought in during lulls in firing or after nightfall. At this station the Hospital Corps- men shah be prepared to apply tourniquets, adjust temporary splints, apply pro- tective dressings, and administer stimulants. They should carry knives or heavy bandage shears for cutting away clothing in addition to the usual equip- ment contained in the Hospital Corps pouch. The wounded who are able to walk will, after the application of a simple protective dressing, be marched to the dressing station or, in the case of trivial wounds, be directed to resume their posts on the firing line. The wounded who are unable to walk will be carried from the aid station to the dressing station (or direct to the field hospital). 1865. The brigade dressing station is the assembling point for the woundetl from the regimental aid stations. It will be located at some point protected from rifle and artillery fire, accessible to the aid stations, and at a point that can be reached by ambulance or other transportation. A water supply and firewood or other fuel are desirable features at this point. 98601°— 17 8 114 MANUAL ror. THE MEDICAL DEPABTMENT^ U. rf. XAVY. The dressing station will be designated by a Red Cross flag' by day and will hoist a white over green light at night. At this station all dressings will he care- fully examined, bnt not renewed unless absolutely necessary. Tourniquets will be removed and bleeding vessels tied, splints readjusted, and the wounded classi- fied and tagged. Examination of wounds .shall be restricted as much as ncs- sible, and the cleaning of the wound and surrounding skin limited to whar is absolutely essential. Water, food, and stimulants will be .served out as re- quired. After inspection, treatment, and classification of the wounded the\ will bo transported to the rear as soon as possible. 1860. The aid and dressing stations are of necessity of a temporary cliur- acter, and should be kept as mobile as the character of the work at hand will permit. 1867. If the landing force is on distant service a field hospital may be neces- sary. This hospital should be located beyond the zone of conflict, usually 3 or 4 niiles in rear of the dre.ssing station. 1868. The brigade hospital receives the wounded from dressing stations and retains them for treatment only so long as may be necessary to arrange for their further transportation to the rear (base hospital). Only urgently necessary operations will be performed at this point, and the brigade hospital should be promptly cleared of all wounded as soon as their condition permits of transportation. The brigade hospital will fly ;i Red Cross flag by day and will hoist a green over a white light at night. i860. The base hospital will be established at the advance naval base. This hospital may not be needed, or needed only as a receiving station, or convales- cent camp or reserve hospital, if a hospital ship is available. ^The flag of the Geneva Convention for us<; at a dressinjr station has the followintr dimensions. White biintinjr, I'S by 16 inches, witli a red cross of bunting 12 inches high and 12 inches wide iv the center, arms of cross to be 4 inches wide. For a brigade hos- pital, 6 by 4 feet, with a red cross of bunting 3 feet high and 3 feet wide in the center, arms of cross to be 12 inches wide. MANUAL F0>: THE MEDICAL DEPARTMENT, U. S. NAVY. 115 Section 5. — DiAGiiA^r. Naval Brigade. ]^J' Regiment. ^."-^ Regiment. 3^^ Regiment. — 1 I ifh 4T Regiment I ine s of assistance for Landing force. A. Regimental aid stations : Here skulkers should be checked and effectives separated from noneffectives. B. Brigade dressing station : Not necessary when a regiment is acting singly. Here cases are assembled from the whole brigade for classification and transport to rear. C. Brigade hospital : Not necessary if operating near base. Located 3 to 4 miles in rear of dressing station, out of range of weapons. D. Base hospital : Not necessary tf a hospital ship is used as base hospital. CHAPTER 11. PHYSICAL EXAMINATION OF CANDIDATES FOR ADMISSION, APPOINT- MENT, OR PROMOTION AS COMMISSIONED AND COMMISSIONED WARRANT OFFICERS OF THE NAVY AND MARINE CORPS. Section 1. — Laws Relating to Physical Examination fob Appointment and Promotion of Officers. 1901. Officers of vessels shall be citizens. Sec. 1428, R. S. 1902. Officers appointed by President, by and with advice and consent of the Senate. Sees. 1369, 1378, 1400, 1402, R. S. 1903. Appointments of assistant surgeons and acting assistant surgeons. (See under "Medical Corps," ch. 2.) 1904. Assistant paymaster. Sec. 1379, R. S. 1905. Chaplain. Sec. 1395, R. S. 1906. Professor of mathematics. Sec. 1400, R. S. ; act January 20, 1881. 1907. Naval constructors. Sec. 1402. R. S. 1908. Marine Corps, appointment. Sec. 1599, R. S. ; acts Augu.st 5, 1882, March 3, 1899, March 3, 1901, March 3, 1903. 1909. Officers not promoted to be retired. Sec. 1447, R. S. 1910. No officer promoted unless physically qualified for all his duties at sea. Sec. 1493, R. S. 1911. Wounds in line of duty do not necessarily disqualify for promotion. Sec. 1494. R. S. 1912. Officer failing physically from disability in line of duty entitled to retire with rank to which his seniority would entitle him to be promoted. Act March 4, 1911. 1913. Physical examination of officers of the Naval Militia upon muster into service of tlie United States. Act of February 16, 1914. Section 2. — Navy Regulations and Naval Instructions Relating to Physical Examination of Officers for Admission and Promotion. 1921. Bureau of Medicine and Surgery to provide for physical examinations. R 133 (1). 1922. Physical examination for Medical Reserve Corps. R 2982. 1923. Physical examination for Dental Corps. R 2989. 1924. Appointment subject to (physical) examination. R 3301 (1). 1925. Physical examination to precede mental and professional and examina- tion to terminate if physically unfit. (R 331 (2).) R 3301 (2). 192(>. Physical qualifications of candidates for assistant paymaster. (R 332 (2).) R 3306 (1). ' 1927. Physical examination for assistant payrilaster. R 3306 (2). 1928. Physical examination for assistant surgeon. R 3305 (1). 1929. Physical examination for acting assistant surgeon. R 3305 (2). 1930. Physical examination for chaplain. R 3307 (2). 1931. Physical examination for assistant civil engineer. R 3309. 1932. Physical exaiuination for machinist. R 3315 (3). 117 118 MANUAL FOE THE MliDICAL DEPARTMENT, U. S. NAVY. 1934. riiysical examination for nurses. 11 3.'>22 (2). • 1935. I'liysical examination for paymaster's clerk, Marine Corps. RH42 '.3>. 1{)3(». riiysical examination required on promotionln Navy. II 3331. 1937. PliVsical examination for promotion in Marine Corps. (I 3662 lo 3671) R 3332 (2). 1938. Health record on pliysical examination. I 708; I 32.57. 1939. An ollicer due for promotion may be examined on a foreign station. R 3333. _fr • ' i l;»i(). IMiysical examination precedes professional. R 331 (2). 1911. Oilicer failin;,' pliysically may be retired in next raiiii. R 331 (3). 191*2. Procedure svlien ollicer is rejected physically for promotion. R 331 (4). 19-13. 'i'\phoid iirophylattic to he administered to all persoas upon their first entry into the naval service. I 3212. 1914. Kxaminins boards for ihe Medical Corps to forward merit roll of candidates for admission or promotion direct to bureau semiannually on Janu- ary 1 and July 1. I 5247 (9). .;; ^.uj.A .1 Section 3. — Instbuctions Relating to Such Examinations. 1951. All candidates for appointment as commissioned oliicers in the Navy or Marine Coriis from civil life and all officers preliminary to promotion must be physically examined by a board of officers, including naval surgeons. Candi- dates for admission to or promotion in the Medical Corps are examined by a board of medical officers. The physical examination will precede the mental and professional. 1952. In comluctirg the physical examination for such appointments the board of medical officers designated for this purpose shall be governed s\ib- .stautially by the instructions contained in the Navy Regulations relating to the physical examination of recruits. (.See ch. 12.) 1953. The board shall exercLse the greatest care in the performance of tliis duty, and in the interest of efficiency a high standard of physical requirements should be maintained. 1954. The examination in each case must be complete lu-r- form efficiently all of their duties at sea. Ttl MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 119 1960. In the Medical Reserve Corps and the Dental Reserve Corps for acti\e service only in time of emergency the physical qualifications for candidates shall conform in general to those for the other corps of the Navy. 1901. Any one of the following conditions will be sufficient to cause the rejection of a candidate for admission : (a) Feeble constitution, poor physique, impaired general health. (b) Any disease or deformity, either congenital or acquired, which would im- pair efficiency, such as weak or deranged intellect, cutaneous disease, parasites of the skin or its appendages, deformity of the skull, abnormal curvature of the spine, torticollis, inefficiency of joints or limbs, deformity of joints or bones, either congenital or the result of disease or injury, epilepsy, or other convul- sions, diseases of the eye, defective vision, color blindness, impaired hearing or disease of the ear, chronic nasal catarrh, ozena, polypi, great enlargement of the tonsils, impediment of speech, disease of heart or lungs, enlarged abdominal organs, evidence of sclerosis, tumors, hernia, undescended testicle, large varico- cele, sarcocele, hydrocele, stricture, fistula, hemorrhoids, varicose veins, disease of the genito-urinary organs, diseased or deformed feet, evidences of intemperance or of the morbid use of drugs loss of many teeth or teeth generally unsound (teeth properly filled are not to be considered unsound). , ,. (c) Anyacutedisea.se. ' - 1962. For any corps the height must not be less than 5 feet 6 inches stripped. Table of physical proportion.^ for height, weight, and, chest mea-rurements. Height. Weight. Chest (mean cir- cumfer- ence). Chest (mean cir- cumfer- ence). Height. Weight. Inches. 66 67 68 69 Pounds. 132 134 141 148 Inches. 33i 34 Mi 345 Inches. 70 71 72 73 Pounds. lO.") 162 169 176 Inches. 35J 3G 36i 36J It is not necessary that the applicant should conform exactly to the figures In the foregoing table, which is given to show what is regarded as a fair standard of physical proportions. A variation not exceeding 15 pounds in weight or 1 inch in the mean chest measurement below the standard given in the table is admissible when the candidate is active, has firm muscles, and is evidently vig- orous and healthy. A chest expansion of less than 2 J inches is a sufficient cause for rejection of the applicant. 1963. Color perception must be normal and acuteness of vision upon a(hnis- sion or appointment must be as follows : For the Medical Corps, Dental Corps, civil engineers, and for chaplains, not less than 12/20 for each eye, xinaided by glasses, and capable of correction by glasses to 20/20. For line officers and the Pay Corps, not less than 15/20 for each eye, unaided by glasses, and capable of correction by glasses to 20/20. For the Marine Corps, 18/20 for each eye, unaided by glasses, and capable of correction by glasses to 20/20. 1964. The hearing of the candidate must be normal (40/40 inches i>y watch and 15/15 feet by voice) for each ear. In the case of promotion of officers the nature of the duties of the candidate should be considered, but, as a rule, less, than 7/15 hearing in either ear is a disqualifying defect. 120 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. • 1066. Canditlates for appointment must he ))etwepn llie following aues: Corps: Years of a^. Acting ensign for engineering duty only ^20 to 26 Flying Corps, acting ensign ^18 to 24 , Flying Corps, student flyer 17t»21 Niivai Reserve Force, assistajit surgeon, for sul)s('iiuent app candidato must ho under ."^2 years of age when he completes the cotirse of Instrnc- ilon at the Naval Medical School, and is further examined to determine fitness for com- misHlon In the Medical Corps. •Trhis limitation as to ape does not apply to chief pay clerks and pay clerks, appointed us Kuch under the provisions of an act of Consress approved March .•?, ini.">. who must be between the ages of 21 and ^5 vears at the time of appointment as assistant paymaster. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 121 (g) Impaired hearing or disease of either ear. The organs of hearing, both the conductive apparatus (outer and middle ear) and the percipient app;fratus (internal ear), must be free from disease. In testing tlie liearing of the can- didate, the voice, the ticliing of a watch, and, if practicable, Politzer's acoume- ter shall be employed. The voice is a more reliable method of determining the acuteness of hearing than the ticking of an ordinary watch, as it allows for variations in hearing, with the modifications produced by changes in pitch and tone. Hearing in each ear must be normally acute to the spoken and whispered voice. In ex- amining the acuteness of the hearing with the voice, one ear of the candidate should be closed while the other ear is being examined, and his eyes should be covered to prevent lip reading. The ticking of an ordinary watch should be heard a distance of 40 inches. (h) Chronic nasal catarrh, ozena, polypi, or great enlargement of the tonsils. (i) Impediment of speech to such an extent as to impair efficiency in the performance of duty. {k) Disease of heart or lungs or decided indications of liability to cardiac or pulmonary affections. (I) Hernia, complete or incomplete, and undescended testis. (w) Varicocele, sarcocele, hydrocele, stricture, fistula, hemorrhoids, or vari- cose veins of lower limbs. (n) Phimosis and diseases of the genito-urinary organs. (o) Ingrowing nails, bunions, cross or hammer toes, flat feet, or other de- formity of feet. (p) Loss of many teeth, or teeth generally unsound. Marked overbite, or lack of occlusion of jaws. There should be at least eight opposing molars, two ou each side in each jaw. All defective teeth should have permanent fillings. Much time can be saved by previous attention to this requirement. 1982. Attention will also be paid to the stature of the candidate, and no one manifestly under size for his age will be received at the academy. The height of candidates for admission shall not be less than 5 feet 2 inches between the ages of 16 and 18 years, and not less than 5 feet 4 inches between the ages of 18 and 20 years ; and the minimum weight at 16 years of age shall be 111 pounds, with an increase of not less than 3 pounds for each addit'onal year, or fraction of a year over one-half. Any marked deviation in the height and weight relative to the age of a candidate will add materially to the considera- tion for rejection. 1983. The decision of the medical board, especially ordered by the depart- ment for the examination oi candidates for entrance to the Naval Academy, upon the physical qualifications for admission, will be final. (Department memo, to Bureau of Medicine and Surgery, May 27, 1904.) 1984. Medical officers are required to examine physically any candidate for the Naval Academy who may appear with a letter from a Member of Congress so requesting. Special attention will be given to the following defects or dis- abilities: Flat feet, defective vision or hearing, heart or lung trouble, and disease of the kidneys. The candidate should be informed of the result of the examination and a copy of the report of examination shall be forwarded to the Member of Congress concerned and a duplicate report to the Bureau of Navigation. Each examination report shall show the name of the Senator or Representative requesting the examination. 1985. Medical examiners should bear in mind that the primary object of this examination is to eliminate those who are obviously disqualified, rather than to give assurance to any candidates that they will subsequently pass the official examination. For example, candidates who appear with rapid heart action, without organic lesion, should be informed that unless such condition is temporary they will probably be rejected. Candidates having varicocele, hemorrhoids, varicose veins, or other minor surgical defects of remediable nature should be informed that they will probabily be rejected unless these defects are corrected by operation. 122 MAKUAl. FOK TMK MKDICAL DEPARTMENT, U. S. NAVY. 1»86 lu every border-line case wherein the exauiiner himself is uncertain as trrthe outcome candidates and Members of Congress should be clearly la- formed thai the case is a doubtful one. (M. & S. No. 124767.) (^avy Deyarf- ment Circular Letter of Oct. 17, 1913.) Section 6.— Instructions Uklating to the Physical Examination of Midshipmen. 1091 In the examination of candidates for admission as midshipmen into the Naval Academy, medical officers shall be governed substantially by the in- structions contained in the Navy regulations relating to the physical examma- °199"^ A'^hi-'h standard of physical excellence is essential in the cases of all canrndates presenting themselves for admission to the Naval Academy, and medical officers should always keep in view the fact that the future Physical efficiency of officers of the Navy will depend largely upon the manner in which this important and exacting duty is performed by the board. 19J)3 A careful urinarv analysis shall bo made in the case of every candidate undergoing examination.* The urine shall be tested qualitftiyely and (if deemed necessary) quantitatively for sugar and albumin. \V here albumin exists in appreciable quantity a microscopic examination shall be made. ' 1997. Typhoid prophylactic shall be administered to all persons upon entry into the service. (I 3212.) . . , «: •„ „.,,. ,...,.l- 1998 No per-son shall be appointwl or commissioned an officer in an> lank in anv class of the Naval Reserve Force, or promoted to a higher rank therein, unless he shall have been examined and recommendetl for such appointment, commission, or promotion by a board of three naval officers not below the rank of lieutenant commander, nor until he shall have been found physically qualified bv a board of medical officers to perform the duties required in time of war. ckcept that former officers and midshipmen of the Navy, who shall have en- rolled in the Naval Reserve Force, may be appointed in the grade and rank held bv them without cxanunation other than the physical examination herein prescribed. (Geu. Urd. No. 237. See also par. 2107.) :am CHAPTER 12. PHYSICAL EXAMINATION FOR ENLISTMENT, SPECIAL DUTIES, NAVY TARE* SERVICE. AND UNDER COMPENSATION ACT. Section 1. — ENLisTjrENTS in the Navt — Laws Relating to Enlistment?."' 2001. Enlistment ot minors, deserters, insane, intoxicated, etc., prohibited. Sees. 1420, 1G24 (19) R. S. ; acts May 12, 1879, Feb. 23, 1881. 2002. Term of enlistment. Sec. 1573, R. S. ; acts Mar. 3, 1899, Aug. 22, 1912. 2003. Term of enlistment, minors. Sec. 1418, R. S. ; acts May 12, 1879, Feb. 23 ISSl. 2004. Consent of parents and guardians required before enlistment of minors. Sec. 1419, R. S.; acts May 12, 1879, Feb. 23, 1881. 2005. Enlistments in the Marine Corps. Act Mar. 3, 1901. 2000. Physical examination oi men of the Naval Militia upon muster into service of the United States. Act of Feb. 16, 1914. Section 2. — Navy Regulations and Naval Instructions Relating to Physi- cal Examination for Enlistment. 2011. Ever\ oerson enlisted must pass physical examination prescribed in medical instructions I 3201-3212; R 3523 (1). 2012. Finger prints to be taken. R 3523 (2). 2013. Records to be made of persons enlisted with physical disability. R 8523 (3). , ,. ^ 2014. Minors under 14 years of age, insane, and intoxicated not to be enlisted. R .3.524 (2). 2015. Reenlistments authorized if physically qualified. R 3526. 2016. Continuous-service men disqualified. R 3528. 2017. Entries to be made in .service record. R 3541; R 3542 (2). 2018. Marines enlisted must pass physical examination. R 41-51 (2). 2019. Reenlistment of marines with disability. R 41.51 (3). 2020. Disabilities to be entered on enlistment papers. R 41.51 (4). 2021. Persons examined physically to be entered on card (rough Form). X). I 3201. 2022. Examination to be conducted by medical ofTicer. I 3202. 2023. Examination to be completed and not terminated upon discovery of disqualification. I 8203. 2024. Medical oflieer who passes recruit subsequently surveyed to be held responsible. I 3204. 2025. Inspection and inquiry by medical officer. I 3205. 2026. Intelligence and detection of mental defects. I 3206. 2027. Age of applicant to be kept in mind. I 3207. 2028. Entries to be made in service and health records. I 3208. 2029. Defects waived by department. I 3209. 2030. Recruits to be reexamined on receiving ship. R 3511 ; I 3210. 123 124 MANUAL FOR THE MEDICAL DEPARTMENT^ U. S. NAVY. 2031. Recruits to be immediately vaccinated. I 3211 (1). 2032. No rocruit to be transferred until vaccinated. I 3211 (2). 2033. Typlioid prophylaxis to be administered. I 3212. 2034. Examination of eyesight of gun pointers. I 2.501 (3). 2035. Naval Reserve Force. R 4053 (b) ; I 5507 (b) ; I 5509; Gen. Ord. Nos. 231 and 237. Section 3. — Cikcular.s Relating to Enlistment. 2041. Circular relating to the physical examination of recruits for enlist- moiil- in the Navy and Marine Corps. (N. M. S. No. 112321-2.) 2042. Circular relating to the physical examination of applicants for enroll- ment in the United States Naval Reserve Force. (N. Nav. 369; N, M. S. 127644.) 2043. Circular relating to the physical examination of women for enroll- ment in the Naval Coast Defense Reserve. (N. Nav. 380. N. M. S. 127644.) Section 4. — Physical Examination of Reckuits fob Enlistment in the Navy AND Marine Corps. 2051. Whenever any person is examined physically for the Navy or Marine Corps, whether subsequently enlisted or rejected, his name and the particulars shall at once be entered on Form X (rough). This form shall be prepared for each applicant examined, whether accepted or rejected, for original entry or re- enlistment, and will be kept for the i)urpose of preparing Form X. It shall be retained for ship or station files and shall be filed alphabetically, by calendar years according to the applicant's surname, in order that information may be furnished the bureau upon request. Be careful to strike through with ink the term not applicable to the case. Form X shall be prepared from the Form X (rough) kept for the pury)ose, and will be forwarded from receiving .ships, Navy and Marine Corps recruiting stations, and marine recruit depots for the quartei*s ending March 31, June 30, September 30, and December 31; from other ships and naval stations or yards for the year ending December 31. or when a ship is placed out of commission or a recruiting or other station closed. A copy shall be retained for ship or station files. If there have been "No applicants" the report shall be forwarded and this fact so stated in the blank spaces opposite " Navy " and " Marine Corps." Central recruiting stations shall include in their report the substations and traveling parties coming under their jurisdiction. Medical officers of ship.s, naval stations, or yards making examinations for ships or stations to which no medical oflicer is assigned shall include these items in their reports. Civilian examiners at .substations of the Marine Corps will prepare and for- ward Form X (rough) to the central stations. 2052. In case a waiver Is requested, the action will be noted after the cause of n-ieition. and approval of waiver shall be entered in the service and health records. (R ;r.23 (.'}); I 3200.) 2053. Marine lecruit depots shall distinguish between "Accepted applicants" transferred from recruiting stations to the depot and those applying originally at tlK' depot by making the proper entry in the space provided on this form. 2054. Previous Army service shall mil be < oiisulered a reeulistniont. Previous Navy or Marine Corps service shall be considered a reenlistment in the Navy, anil previous Marine Corps or naval service shall be considered a reenlistment in the Marine Corps, so far as it ai»i>lies for use in the preparation of this form. 2055. The term of eniislnient of all enlisted men of the Navy shall be four years, except min«»rs over 17 and under ]8 years of age, who sluill be enlisted MANUAL FOR THE MEDICAL DEPARTMENT, "U". S. NAVY, 125 for the period of minority. Minors under 17 can not enlist in the Navy. No enlistment for special service is allowed. 2056. No minor under the age of 18 years will be enlisted without the writ- ten consent of the parent who Is his legal guardian ; or, if both parents are dead, of a legally appointed guardian. Minors under but claiming to be over 18 years of age are liable, if enlisted, to punishment for fraudulent enlistment iinder the act of Congress approved Marches. 1S93. 2057. Only such persons shall be enlisted as can reasonably be expected to remain in the service, and when enlisted must serve out the term of their en- listment, and can not be discharged prior to that time, except for cause or as hereinafter provided. 2058. Every person before being enlisted must pass the physical examination prescribed in the medical instructions, and no person shall be enlisted for the naval service unless pronounced fit by the commanding and medical officers. 2059. No person other than a medical officer shall be permitted to conduct any part of a physical examination, to make any measurement, or to make any original entry on any medical record of enlistment. 2060. Every such examination must be completed according to the official forms and shall in no case be suspended on the recognition of a disqualifying defect. 2061. Medical officers on recruiting duty shall exercise great care and thor- oughness in conducting the physical examination of persons presenting them- selves for enlistme/it While these instructions are applicable in general to all physical examinations, they are intended to cover more particularly the examinations of applicants presenting themselves for original enlistment. While permitted to use his own discretion as to the routine of procedure, the medical officer shall make inquiry on all points indicated below: After testing the vision, color perception, and hearing, and estimating the general fitness of the applicant, his height, weight, and chest measurements may be taken and recorded, the clothing having been removed. A general inspection and regional examination is then made, as follows : (a) The applicant, entirely nude, is to stand before the examiner in a bright light and present successively front, rear, and sides. (Retarded development, deformity or asymmetry of body or limbs, knock-knees, bowlegs, or flat feet, especially in minors : spinal curvatures ; feebleness of constitution ; strumous or other cachexia : emaciation, obesity ; cutaneous or other external disease ; glandular swellings or other tumors ; nodes ; varicosities, cicatrices ; indica- tions of medical treatment, leech bites, blister stains, seton or scarification scars ; and evidences of smallpox or successful vaccination, or the administra- tion of salvarsan.) (b) Applicant to present dorsal and palmar surfaces of both hands; to flex and extend every finger; to grasp with thumb and forefinger and with whole hand; to flex and extend, pronate and supinate wrists and forearms; to per- form all the motions of shoulder joints, especially circumduction ; to extend arms at right angles to body, and then bend elbow and touch the shoulders with the fingers ; to elevate extended arms above the head, palm to palm, then dorsum to dorsum ; to evert and invert the feet ; to stand on tiptoe, coming down upon the heels quickly, and then lifting toes from floor ; to flex each thigh alternately upon the abdomen, and. while standing on one leg, to hop ; to perform all the motions of the hip joint ; and to walk backward and forward slowly and at double-quick. ]■' (c) Note effect of these violent exercises on the heart and lungs; obsM^'^ movements of chest during prolonged inspiration and expiration ; examine by percussion and auscultation front and rear. (Incipient tuberculosis, valvular disease.) Care should be taken to differentiate between organic murmurs and the functional varieties. (d) With hands on the head and chin up, applicant to cough violently (re- laxation of umbilical and Inguinal regions ; hernia ; concealed venereal disease, 126 MANUAL FOB THE MEDICAL DEPARTMENT, U. S. NAVY. especially beii(*iitli prepuce and within un'tlira; varicocele; orchitis and otliei abnormal conditions of testes). , ^ ^ . , 4. (e) Applicant to bend body forward, with knees stiflened, feet wide apart, hands touching the fl(»or, and nates exposed to strong li«lit (hemorrhoids; pro- lapsus, fistula) . While the ap)ilicant is sto(jpinf; make firm pressure on the .spinous process of each vertebra (noting spinal tenderness). (/) Motions of head, neck, and lower jaw. . ^. (g) Cranium and scalp (malformations, depressions, cicatrices, tmea, ver- min, etc.). „ . , V (70 f:ars (polypi; otorrhea, perforation, dullness of neanng, antl degeneia tion stigmata). (i) Mastoid region for scars or tenderness. (/) Eyes (absence of cilia?, tarsal redness, obstructed puntta, corneal opaci- ties, adhesions of iris, defective vision, abnormal conditions of conjunctivae, trachoma, pterygium). , , " . ..(A-.) Nose (i>oly pi; ozena; chronic na.sal catarrh K . (I) Mouth, teetii, tongue, fauces (hyportn\.,liie.i i..n.sUs; syphilitic attectioiis, impediments of speech, lingual scurs, cleft palate, and repulsive stigmata or scars of the face, grotesque tattooing, or the expression characteristic of ade- ""'>()02 No educational standard has been officially established for recruits nre'senting themselves for enlistment in the naval service. The regulations reouiie however, that a candidate shall be able to read and write and that he should posse.ss a reasonably nuick and clear understanding. His general intelli- gence may be estimated by his manner of answering the questions addressed to him in obtaining tl\e data required in the health record, and any impediments •^I)gS Section 1420 of the Revised Statutes forbids the enlistment in the naval service of any intoxicated person. The evident intention of the law was not only to prevent the admission into the service of men who at the tune of presenting them-selves for enlistment were under the influence of alcoholic stimulants or drugs, but of those also who were of intemperate habits. A thorough inquirv should he made into the history of any applicant in which habits of intemperance are suspected. Long indulgence in hahils of uiteniner- ance will be indicated by persistent redness of the eyes, tremulousiu^ss of Uie hands sluggishness of the intellect, satin-like texture of the skin of the body, an eruption upon the face, and purple blotches upon the legs. The mori)hine habitue is often emaciated, prematurely senile, with foul breath, contractetl pupils peculiar pallor, dry skin, and often showing multiple punctures ol the skin from the needle. The habitual user of cocaine niiiy lie suspecteil when the applicant exhibits unusual buoyancy and mental overactivity accompanied by li-relevant volubility. Cocaine " snufCers " will usually show a characteristic hyperemia of the nasal mucous membrane. Medical officers should endeavor to eliminate the insane, vagrant, and criminal classes by a careful study of the per.sonal characteristics of each applicant. .Uiy doubt as to the mental stability of the applicant should determine a careful , investigation directed toward his previous history. . . . , .^i ,, , . 20G4. Certain defects which are frequently tound associated with Uie physi- cal condition in cases of reenlistmeut or continuous service are not mn-essarily caiLses of rejection. If deemed of sufficient jmiiortaiice to cause rejection, a waiver of the defects may be reconunended, provided that such disabilities will not interfere with the performance of duty. Waiver is requested on " Report of rejection," procurable from Bureau of Navigation (Form No. i>4). Physual infirmities incident to advanced years and long service should be carefully con- sidered in the.se examinations, and especially in the case of reenlistmeut under continuous service. Slight pliysical delects in tho.se applicants wiio liave matured are of less importance than when occurring in minors. Physical disqualilications of a minor nature of i»robably temporary duration readily amenable to m^Ulcal or surgical treatment should not ne«essnrily fauf the large toe, or of two of the smaller toes on one or both feet, partial ankylosis of the ankles, marked callosities or ingrowing toenails, and any other dc>fects which in the opinion of the examining surgeon may interfere with marchmg or prolonged sentry or deck duty, shall be considered causes for rejection of the applicant. 2070. The absence of or the marked deformity of the right index finger or thumb shall cause the rejection of the applicant. The importance attached to the absence of or deformity of the left index finger or thurub will depend upon the adaptability of the applicant for his special rating, provide required to take th6 oath of allegliance, and further state that the stalfinent he makes regarding his date of birth and previous naval or other military service is correct, and that he is physically qualified to perform the duties of his prospective rating. Tiio examining sur- geon certifies on the shipping articles ns follows: "I certify tliat I have care- fully examined, agreeably to the Reguhitions of the Navy, the above ii:inioil re cruit, and find that, in my <)i)iiiion, he is free from all bodily defects and men- tal Infirmity which would in any way disiiualify Jiim from performing the duties MANUAL FOR THE MEDICAL DEPARTMENT, U. S, NAVY. 131 of his rating, aud that he has stated to me that he has no disease concealed or likely to be inherited." . . (&) (1) On account of insufficient or inaccurate information in reports of rejection as to physical defects of applicants for enlistment, the bureau is fre- quently unable to determine whether such defects should be waived, and such reports are often returned for further information before recommendation can be made. , ,. , . , , , (2) When a defect is curable by minor operation the medical examiner should so state and also whether the applicant agrees to operation if necessary. (3) In reporting rejections for any of tlie following defects the bureau de- sires that the information as noted below be given : (4) Flat foot.—Give degree of flatness, stating accurately the distance be- tween the tubercle of the scaphoid and the line from the lower border of the internal malleolus to the lower tubercle on tlie head of the first motatarsal. The measurement should be taken standing with the weight of the body on that foot and when the foot is at a right angle to the leg and the second toe js on a line with the crest of the tibia. The size of the shoe should also be given. The width of the ball of the foot should be given and any tendency to talipes valgus noted. ,^ ^ \ (5) Bunions, hammer toes, corns, and ingrowing toe nails should be de- scribed accurately as to location, degree, etc. (6) Varicocele.— State size and indicate by small, medium, or large. (7) Varicose veins. — State location, extent, and size, and indicate by small, medium, or large. (8) HemorrJioids.— State character and size and indicate by small, medium. or large. (9) Hydrocele. — State size and indicate by small, medium, or large. (10) Hernia. — State location, size, and whether incipient, incomplete, or com- plete. Relaxed rings only are not cause for rejection unless abdominal walls are weak or there is a decided impulse on coughing. (11) Deformities. — State location, character, degree, and amount of inter- ference with motion. (12) Contractures.— State location, degree, and amount of interference with motion. . (13) Stiff joint. — State location, degree of flexion and extension obtainable and the strength of the part. (14) Defective hearing.— State degree, giving distance by watch, by the whis- pered and spoken voice, stating whether he can readily hear ordinary conver- sation. State condition of the external canals and drums. (15) Defective vision.— State defect accurately, whether due to refractive error or other disease ; when practicable, giving correction by lenses. (16) Missing or defective tceth.—State in detail those missing or unerupted and those defective, using diagram for that purpose. Also state whether teeth, will admit of proper repair. (17) Deficient height or weight.— Always state age, height, and weight. (18) Tachyca7-dia.— State cause, character, and duration, giving time dur- ing examination for applicant to recover from excitement or overexertion. (19) Spinal curvature. — State location, character, and degi'ee. (20) Atrophy or hypertrophy of testicle.— State degree and cause. 132 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 2082. (a) — Table of physical proportions lor height, weight, and chest meat- urement of adults, [Bureau of Navigation Circular relating to the enlistment of men, July 20, 1912.J Chest Height. Weight. (mean cir- cumfer- ence). Inches. Pouiids. Inches. 64 12S 33 65 130 33 66 132 33J 67 13» 34 68 141 34i 69 148 34} 70 155 35i 71 102 36 72 169 361 73 176 30J (b)— Table of physical proportions for enlistment of Filipinos. Age. IRtoM 20 to 21 22 and over Height. 61 f.2 62J Weight. Chest measure- ment (mean). 105 lOS 110 30t 31' 31J Expansion. 2083. The minimum height for acceptance of a man 21 years old or over is 64 inches barefooted. A variation not exceeding 1 inch is permissible if the ap- plicant is in good health and desirable as a recruit. The minimum weight for acceptance of a man 21 years old is 128 poOnds. A variation of 10 pounds, not to fall below 128 pounds in weight or 2 inches in clicst measurement below the standard given in the table, is admissible when the applicant for enlistment is active, has firm muscles, and is evidently vigorous and healthy, except for en- listment In the rate of fireman third class, for whicli rate full standard meas- urements will be required. A chost expansion of less than 2 inches in a minor, or less than 2^ inches in an adult, is a sufficient cause for rejection of an ap- plicant. The table is given to show what is regarded as a fair standard of physical proportions and not as an absolute guide to be followed in deciding upon the acceptance of recruits. 2084. A minor enlisting as apprentice seaman must conform to the stand- ards noted In the following table, which Is also applicable to apprentice musi- cians. United States Marine Corps, and to midshipmen, (Circular of July 20. 1912.) A I 17 years of age A I 1« years of age At 19 ypiirs of ace At 20 years ol age Minimum height. Inches. Minimum weight. Pound'. 110 115 120 125 Chest ex- pansion. In-.hcs. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 133 (If the age is 6 months in excess of a full year the requirements are those of the age at the next birthday.) (No underweight or underheight is allowed in minors. 2085. Marked disproportion of weight over height is not a cause for rejection unless the applicant is positively obese. 2086. (a) Recruits shall be vaccinated within 24 hours after their arrival on a receiving ship or at a barraclis. In case of failure the operation shall be repeated in eight days. If the second vaccination is not successful it shall be repeated at the first opportunity with a vaccine of assured potency. The only acceptable evidence of successful vaccination is a pitted scar following vaccina- tion. Results of vaccination shall be recorded on the health record and reported on the quarterly report of sick. (&) No recruit in the Navy or Marine Corps shall be transferred from a train- ing station, receiving ship, barracks, or other rendezvous until the medical officer is satisfied that the man is protected against smallpox. (c) Every enlisted man of the Navy or Marine Corps shall be vaccinated upon reenlisting, or extending enlistment, unless (a) he has two pitted vaccination scars, or (b) shows evidence of a previous attack of smallpox. (d) Every officer should be vaccinated upon appointment immediately upon reporting at his first station for duty, and the fact entered on his health record. Itevaccination should be performed at least once in every seven years thereafter unless he has two pitted vaccination scars, or evidence of a previous attack of smallpox. The responsibility for revaccination shall rest upon the medical officer making the annual physical examination required by I 709 (5). If it ia impracticable for this medical officer to perform the vaccination, he shall notify the proper medical officer, through official channels, so that it may be carried out. The medical officer who performs the vaccination shall note the result of the vaccination on the officer's health record. (I 3211.) (e) If possible, all members of the Naval Reserve Force should be vaccinated when enrolled ; if this is not practicable, immediately after reporting for aetiv«^ duty. 2087. (a) Typhoid prophylactic shall be administered to all persons upon their first entry into the Navy or Marine Corps. (b) It shall be administered to each enlisted man upon each subsequent en- listment, or extension of enlistment, who is under 4.5 years of age, or who has not had a well-defined case of typhoid fever. The medical officer making the physical examination at the time of reenlistment shall start the administration, if practicable; if not, he shall notify the proper medical officer, through official channels, so that the administration may be completed. (c) The administration of typhoid prophylaxis should be repeated after a period of four years for all persons in the Navy or Marine Corps who are under 45 years of age, or who have not had a well-defined case of typhoid fever, and the medical officer making the annual physical examination required by Article I 709 (5) shall be responsible for its administration. If it is impracticable for him to give the prophylactic, he shall notify the proper medical officer, through official channels, so that it may be given. {d) The only acceptable evidence of administration of the prophylactic shall be the entry on the health record, signed by the medical officer. (I 3212.) The entry should be In red ink. (e) Typhoid prophylactic should be administered when a newly enrolled memlier of the Naval Reserve Force first reports for active duty. 2088. Medical officers are required by act of February 16, 1914, to conduct a physical examination of men of the Naval Militia when mustered into service of the United States. The physical requirements are those prescribed for the regular service, except that in the case of officers the minimum height is 5 feet 4 inches. Any requirements in addition to these may be made by the States (Gen. Ord. No. 150.) (See par. 2297.) 2089. When available, medical officers will make such examinations of mem- bers of the Naval Auxiliary Service as are prescribed in the regulations for that service. icW MANUAL i'OK THE MEDIOAL DEPARTMENT, U. S. NAVY. Section 5. — Navy Rkgulations ani> Naval Instbitotions Relatino to Identi- fication Records and Finueu PniNTS. 2091. Finger prints sent to Bareau of NavSfrtJtion. R3523 (2). 2092. Reports. I 5221 (18, 20) ; I 5249 (6) ; I 5261 (7). 2093. An identification record, consisting of fiuser prints and personal de- scriptioii, is to be made and forwarded to tlie Bureau of Navigation in the casfe of ever>' man enlisting in tlie Navy, and to tlie Major General Commandant In the case of marines. 2094. Finger prints and identiflcatif»n records are not required upon re- enlistment, or npon discharge for undesirability. 2095. TIic form adopted tor recording the finger prints and personal descrip- tion (Form No. 2. Bureau- of Navigation); (in the case of marines, Form N. M. C. 330), (I 5240 (6) ;■ I 5261 (7)), will carry the finger-priut record on one side and the personal desci'iption on tlie other. In addition, and until furtlier notice, the descriptive list called for on the service record (Form No. 1, Bureau of Navigation) will be filled out as at present. 2096. Instruriions for tlie guidaiice of tiiose concerned in making and for- warding "Identification records": The apparatus for taking finger prints oonsists of a form holder, an ink plate, and a roller for spreading the ink on the plate. Keep the roller and ink plate clean and free from dust, grit, or hairs, and tlie ink tube closed when not In use. When the day's work is finished clean the ink from the plate and roller by means of a clot", and benzine. When not using the roller, rub it with a little sweet oil or lubricating oil before laying it away, to prevent the composition from becoming too hard. Preparatory to taking finger prints squeeze a fimaU quantity of ink from the tube and carefully work it. by use of the roller, into a thin film on the plate, the spreading of wliich may be facilitated by frequently turning over the roller. // too much ink is used, .'fte impression will be blurred and consequently un- satisfactory. Th(; thickness of the ink after being spread on the plate siiouid he less than one-half the elevation of the ridges, and this can be tested by taking impressions. The recruit shoidd wash his liands thoroughly with soap and brush, using, if practicable, running water, esi)ecial care then being taken to rinse off all soap or latlier with cold water. Failure to do this will cause white hlotche.s to appear in the impression.s. Immediately before placin'^ the fingers on the inked plate the fingers .>hould be well wiped with a cloth dampened with benzine or ether, which should remove all trace of grease, water, or perspiration. Two kinds of impressions are used, " plain " and " rolled." A plain Im- pression is obtained by pressing the bulb of the finger. \\ ith the plane of the nail parallel to *he plane of the plate, on the inked plate and then on the paper in the same manner. A rolled impression is obtained by placing the side of ihe finger on the inked plate, with the plane of the nail at right angles to the plane of the plate, and rolling the finger over from one side to the other until the plane of the nail is again at right angles to the plane of the plate, but with the bulb surface of the finger facing in the opposite direction, thu.; inking the surface of the finger, and then rolling the finger over the paper in the same manner, in thi-< way obtaining a clear impression of the ridges on the surface of the linger. TMs latter injpression should include both the palmar surface and the sides of the finger between the ti[» and the tlexure of the last .ioint. Always roll the fingers from the awkward jiosition tc the natural position. (Pigs. 13. 14. 15.) It is absolutely necessary that the finger prints shall be clear, that the ridges shall be distinctly outlined, and that the "rolled" Impres.slons shall be sutli- clently large to include all the points needed for accurate classification, and free fiom blur. Black impressions are better tlian light onas if the spaces between the ridges are fiee from blur. , When the skin of the iiin(iprs is in poor condiiion. make si>e«i(il eflort U* get best results, ~ Fig. hi.— Makiiif; pluiii iiuiirossiuii of lliij;ors. Fig. 17. — -Making plain iniprt'ssiun ol ihuinb. IVIAKTUAL FOR THE MEDICAL DEPAHTMENT, U. S. NAVY. 135 ,,, Entire palmar surface of nvsl joint should be joked Sp.tUat ^hoje coutoy^'iOf pattern will be shown when finger is rolled. / r ; ; ■ r ' Recruit should first be required to sign his name, and then to roll the iiil- pression of the right index finger in the space above his signature. This will eliminate entirely the possibility of the recruit signing other thriu his own Identi- fication record. Have only one recruit at a time present in the room where prints are being made, and complete and file each record before the nest man enters or is taken up. In this way no other record than the one in question is available or within reach of the recruit being recorded, therefore he can sign no record but his own. Do not allow records to lie around, but fi.le or ptherwisfe dispose of them at once after completing examination. , . ' . ., In taking impressions, the operator himself should manipulate the hands of lifie recruit, who should be directed to relax his fingers and not to attempt to assist by adding to the pressure on the inked plate or on the paper. In order that the ink may be taken up on the finger evenly and in sufl^cient quantity, an unused part of the plate should be selected each time for inking the finger, and when no unused part of the plate remains the ink should be redistributed with tlie roller or the plate reinked. See that there are no clots of ink where the fingers are to be rolled on the plate. The form holder, which is intended to prevent the form from moving about and blurring the print while impressions are being taken, will be used. The best results will be obtained with a table that places the form holder at about the height of the elbow of the recruit when he is standing with his arms hang- ing at his sides. To place a form in the holder, pi-ess out the plate by means of the levers at the ends, place the form in position under the plate, and push back the levers to their original position. The pressure of the spring^ on tJiie, pliat^ will hold the form firmly in position. ' J' . ' ■ ' To record the finger prints on Bureau of Navigation Form No. 2 and United States Marine Corps Form N. j\I. C. 330, place one of the blank forms in the holder with the upper heavy black line appearing just above the upper edge of the plate; then take the rolled impressions, in the order named and in proper spaces on the form, of the thumb, index, middle, ring, and little fingers of the i-ight hand, the impressions to be located on the form so that the flexure of the last joint is immediately above the folding line. This will leave 'room for a second print to be taken in the upper part of the space in case the first print is defective. After the impressions of the fingers of the right hand have been taken, move the form in the holder until the lower heavy black line .appears just above the edge of the plate; then take the rolled impressions of the fingers of the left hand in the proper spaces on the form. After the rolled impression of each finger of both hands has been obtained, again move up the form in the holder until the plate covers only enough of the lower edge of the form (not exceeding one-fourth inch) to hold it in place. Then take a plain impression of the four fingers of the right hand at one time, the fingers being held together so as to bring the prints within the allotted space, and a similar plain impression of the fingers of the left hand. Below the finger impressions take a plain impression of each thumb. The method of obtaining the plain impressions is to take each of the fingei's in turn and place the hulhs only on the inked plate. When this is done, press the recruit's fingers together, and with his hand limp and flat (not bowed or arched) place it in the space shqAvn on the form and press each finger lightly at the base of the nail. No attention need be paid to the deltas in the plain simultaneous impressions, but the detail nuist be clearly defined. These im- pressions are used to derermiue if the rolled impressions are in their proper sequence. (Figs. 16 and 17.) A finger should not be noted missing if any portion of it beyohd the flexure of the terminal joint remains. The end of a nnitilated finger should in all cases be inked and recorded as in the case of a perfect digit. "^"'•"1" hk y'/^iil "iJiiii i7iij j»:>iJi*tL 136 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Fi;?ure 1 shows impressions improperly t.'iken. This record is so blurred that it is impossible to classify the impressions, and consequently is of no value. No amount of pressure by the operator should be used in making or inking rolled Impressions. It is the pressure that causes the ink to more readily run in between the ridges. The finger tips should be allowed to touch the paper only with sufficient pressure to make a record. Figure 2 represents the only standard which is satisfactory^ and it is desired that no record be forwarded which is not up to the standard. The utmost care should be taken in recording the impressions of the little fingers. From these fingers a subclassification number is obtained. When the tinger-print side of the form has been completed, the impressions Will be inspected to make sure that they are clear and free from blur ; that all deltas are shown in the rolled impressions, and that the whole contour of the pattern is shown. The rolled impressions will also be compared with the plain impressions for the purpose of ascertaining whether they are recorded in proper sequence. Any defective impressions will then be remedied by taking another print in the upper part of the proper space or by using a new form, if necessary. If the impressions are not recorded in proper sequence, a new form must be used, the oltl one being destroyed. After (he finger prints have been taken and examined, the opposite side of the form will be filled out and the personal description completed by noting on the outline figures the principle identification marks. Before making the entries on the personal description side of the blank, allow the ink on the finger-print side to become sufficiently dry to prevent blurring by rubbing. A few minutes will be sufl!icient if the form is handled carefully and not rubbed about on the desk while the personal description is being en- tered. A sheet of blotting paper placed under the form will protect it to some extent. If an impression becomes blurred at any time, a new impression must be taken in the upper part of the proper space, or, if necessary, the imperfect form should be destroyed and a new blank used. A delta may be formed by the bifurcation of a single ridge or by the abrupt divergence of two ridges that hitherto had run side by side, thus : -\ -^ Fig. Th«' core of a loop may consist of an even or uneven numl)er of ridges, not joined together, thus : Fig. -1. Arches. — In arclies the ridges run from mio side to the other, making no backward turn. An.-hes have no deltas. (Fig. 5.) T(.nted anJicg.—ln patterns of the arch type the ridges near the middle may have an upward thrust, arrunging tlK-nisolves, as it were, on both .sides of a spine or axis, toward wliich iKl.joiiiing ridges converge. Tlie ridges (1ms con- verging give to the ]>att('rn tli<' appearance of a tent in outline, hence the name tented arcli. Tented arches have no deltas. (Fig, G.) Classification Xo. ; rf *^ ■ m <"5 W^ Fig. 1.— Imperfect record. Useless for classification. Fig. 2. — Trojiorly muile rcc-oni. *0>i Fig. 5.— Arch. Fig. 6.— Tented arch. Point of core Fig. 7. -Radial loop, right hand, or ulnar loop, left hand. Fig. 8.— Ulnar loop, right hand, or radial loop, left hand. Fig. 9.— Whorl. (2 deltas.) Fig. 10.— Composite. (2 deltas.) Fig. 11.— L'luar loop (right hand), showing 05 points of ideniification. -jlO this form. Classification A"(j. RIGHT HANO. '3& •'- LEFT H AISJ D. ,, ■;i,„:.t.. 7 1 i.;.-x. ^ M.M!... .. I, ■,.•. h- •! itil.-. •3. 4. LEKT HAMD. RIGHT HANO. Fig 12.— 1 Whorl improperly rolled, showing only one delta: 2, same finger properly rolled; 3, loop ' properly rolled; 4, same finger improperly rolled. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 137 111 loops some of tlie ridges make a backward turn but without twist ; there is one delta. If the downward slope of the ridges about the core is from the direction of the little finger toward that of the thumb it is a radial loop. Figure 7 is a radial loop iu the right hand. Tlie heavy black line drawn from the delta to the core indicates the ridges that are counted in classifying loops. In this impression the line cuts or crosses 16 ridges. If the downward slope of the ridges about the core is from the thumb side toward the little finger the loop is ulnar. Figure 8 is an ulnar loop in the right hand or a radial loop in the left hand. In this impression the heavy black line crosses 19 ridges. Be sure that tlie delta is shown if the impression is a loop. Whorls. — In whorls some of the ridges make a turn through at least one com- plete circuit. There are two deltas. Whorls are single cored or double cored. Fig. 9.) The right and left deltas in this impression are shown by the arrow- heads. The deltas in whorls must always be shown, in order that the tracings may be properly made. In whorls the ridge traced starts from the left delta and is traced toward the right delta. When the ridge whose course is traced meets the cori-esponding right delta ridge the whorl is specialized as M ; when this ridge goes inside of the right delta with three or more ridges intervening it is specialized as I ; when the ridge traced goes outside of the right delta with three or more ridges intervening it is specialized as O. Figure 10 is a composite. This pattern is classed as a whorl and has tvvo deltas. The right and left deltas in this impression are shown by the arrow- heads. Figure 11 shows ridge characteristics used in establishing the identity of a person. Unless an impression is free from blur great difficulty is encountered in picking out the points of comparison between two impressions. Sixty-five points of comparison are shown on this impression which are free from blur and could all be used for purposes of comparison and identification with an- other print of the same individual. Figure 12 (1) shows a whorl improperly rolled, with only one delta showing. It is impossible to make a correct tracing of a pattern rolled in this manner. Figure 12 (2) shows the same impression properly rolled. Figure 12 (4) shows a loop improperly rolled, with the delta missing. The space between the delta and point of core in loops must be plainly shown and free from blur. This pattern is of no value and can not be properly classified. Figure 12 (3) shows the same pattern properly rolled. Each operator should instruct his relief in the taking of finger prints, so that the Bureau of Navigation and Marine Headquarters will be able to receive good finger-print impi-essions at all times. The skin on the finger tips of the bodies of men which have been recovered from the water will be greatly wrinkled or shriveled, so that without some treatment the making of satisfactory prints may be difficult and even impos- sible. The way to overcome this is to inject water with a hypodermic syringe beneath the skin of the bulb of the finger. Tliis will smooth out the skin for the impression. Figures, 5. 6, 7, and 8 represent the standard for impressions of these types. Only impressions of these types which are up to the standard will be accepted. (r) Name of recruit will be entered in full. is) Line "Race" will be filled out "White," "Negro," "Filipino," etc. (t) The complete form must be forwardetl promptly, with the first sheet of Enlistment Record, to the Bureau of Navigation, and must not be folded. Duplicate copy for retention is not required. At time of preparing identification tags for officers make also finger prints for them as described above. Note. — The apparatus for making finger prints is supplied by the Bureau of Navigation, and not by the Bureau of Medicine and Surgery. Platform scales and other paraphernalia required at recruiting offices (except articles on the Medical Supply Table) will not be furnished by the Bureau of Medicine and Surgery. 138 MANUAL FOR THE MEDICAL DKPAJEITMENT, U. S. XAVY. PifKi'AliATrON OK IDENTIFICATION TAGS. (See Qeneral Order 294.) , .r.;iii 2097. The identliicatlon tag for officers and enlisted men of the NaVy fy>ur sists of an oval plate of monel metal 1.25 by 1.50 inches, perforated at one" eud and suspended from the neck by a monel wire incased in a cotton sleeve. The tag has on one side the etched finger print of the right index finger. On the other side are to be etched the individual's initials and surname, the month, day, and year of enlistment (expressed In numerals, e. g., 1-^1916), and the month, day, and year of birth (similarly expressed). This side \vll1 "also bear the letters U. S. N. The etching of the tag shall be done by such member or members of the Hospital Corps as the medical officer may designate. :The following articles are required: [■ 1. The outfit for making a finger print on paper. ,2. A supply of printer's ink thinned to the proper consistency for ea.sy use Svith an ordinary steel pen. (Dilute with gasoline or turpentine.) ' 3. Gilsonite or powdered asphaltum. 4. Nitric acid, 1 part by volume ; water, 2 parts by volume, in glass dish. 5. Alcohol lamp \vith good flame or electric stove. 6. A device for holding the tag without touching the flat surfaces (not sup- plied, but device can be improvised by any carpenter's mate). Tlie steps in the preparation of the etchings are as follows : After collecting the various articles described above, take an ordinary " rolled " ' finger print on paper to show that the finger is clean, not too heavily inked, etc.. and will make a good print, and write down on paper the data for the other side — initiuLs, surname, and dates required. Make a "rolled" finger print (right index finger) on the metal tag in the usual manner. Holding the tag by the edge, turn It over and write on the other side with a clean steel pen (in printer's ink that has been thinned out with turpentine or gasoline) tlie initials and surname, the date of enlistment and of birth (using figures), and the letters U. S. N. on the left end of the oval. While ink Is still frcsli on both surfaces sprinkle them with finely powdered asphaltum. Some of this will mix with the ink and stick to the two surfaces. The rest should be blown off. Now heat the tag slightly above the boiling point of water. Allows the tag to cool. Put It in the nitric acid solution for one hour. Remove, wash in water, and dry. Great care is to be exercised in the preparation of the tags so as to avoid useless expense for tags .spoiled in the process. The following cautions are to be noted: Remove all excess of ink from the finger, leaving a smooth, uni- form coating. Press the finger lightly against the metal tag, avol«ling too great pressure, as this will smear the Impression. If the first impression with Ink is not satisfactory, make it again on a fresh tag Tags that have been soiled with printer's ink can he used again after thorough cleansing with gasoline. The cleansing must be thorouah, as the lea.st trace of ink left on the tag from a previous attempt will spoil (he etciilng. (It is well to put aside the tags on which poor printing lias l>een done and clean them up all at one time for use.) .,.,... In inscribing the name use a blunt pen and diluted printers Ink. Tlte Ink can be thinned with ga.sollne or turpentine. Turpentine 1s preferahle as it does not dry so quickly and the next step must be carried out witli both sides of the tag wet. Have the initials, siirname, and dates writti'U out on paper in advance, so they can be quickly insf-rlbed on the tag without having to delay bv questioning the person for wlioin tlie tag is being prepared. The Ink should be lust thin enough to write wiUi. If it spreads on the iuet;il it is too thin; if too thick it will not flow from the iwint of the pen. *Fln)ser prints nrf " rojlod " and plain: see sec. 2006. MA'NUAi; FOK THE MEDIC A L DEPARTMENT, U. S. NAVY. 139 Be careful not to smudge the finger print while writing name. The next step is the apvilicntion of the gilsonite or asphaltum. This should be line enough to pass througli a sieve having 100 meshes to the square inch. Sprinkle thickly on llie two wet surfaces. Remove what does not mix with and stick to the ink by tapping and blowing. The tag is now held with forceps over a flame or stove until the ink and asphaltum have melted toii:ether, forming sharp, glossy black lines. If not enough heat is applied to completely melt the asphalt the action of the acid will be too powerful. Complete melting of the asphalt is indicated by the lines becoming glossy. If too much heat is applied the lines run to- gether and ai-e obliterated. The etching solution consists of concentrated nitric acid, 1 part by volume; water, 2 parts by volume. The solution may be placed in glass, china, or enameled ironware (if there are no nicks or cracks). A number of tags can be etched at once, but do not pile them one on top of the other. The name side should be up, and the linger-print .side down while in the acid bath. This will favor deeper etching on the name side, which is desirable, as it will then not wear off so rapidly. The etching process or acid bath should be watched and a tag lifted out from time to time to see how lively the action i-;. It can be moderated by adding water. Usually the process of etching requires one hour. The acid solution naturally weakens 'Ailh use and should be renewed from time to time. If the corrosive action is slow in beginning, concentrated muriatic acid (HCi) may be added — 1 part to every 30 of the nitric solution. The data desired are put on thus : (First enlistment.) (Date of birth ) The letters " U. S. N." are at the opjxxsite eKd of the'roval from the perforation for the wire. ! In the case of officers it will be necessary, wlien making the tigs, to.'make also the usual finger prints on jiaper (as required for enlisted men) and to send them to Bureau of Navigation, Washington, D. C, for filing. Enter on the blank the full name of officer, the rante held, and date of ap- pointment. f\' ! '■ . Section 6. — Outline Figure Cakd and DESc|feiPTrvE List. ^ 2101. The outline figure on the reverse side of the finger-print record shall be tilled out in the case of every recruit that has been found physically qualified and accepted for enlistment and for every sailor or marine who presents him- self for reenlistment when date of last enlistment was prior to January 1, 1907. 2102. Medical officei-s on recruiting duty shall observe the greatest care in the preparation of these cards and shall exercise every care that the recoi'd on each card may be complete. 2103. The medical officer shall make a careful and systematic examination of the body of the man, front and rear, on each side of the median line, sepa- rately, commencing at the scalp and ending at the foot, and the following direc- tions shall be carefully noted: ; - •; ■ {a) Cards showing less than five marks in addition to vaccination scat's, tattooing, loss of teeth, and deformities (wliich should likewise be noted), can not be relied upon in the effort to discover identity or to identify a per.son in suspected cases. J]xperience shows that as many as 10 or 1.5 marks may usually be found. 140 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. (b) If no murks l>e foTind upon the recruit the fact should be stated upon both the front and back of the card. If marks are found upon the front and none upon the rear or vice versa, the entry " no mark " should be made ui)on the appropriate side of the card. , , , . , ^, (t) Outline fiiiure cards are to be made out in permanent black ink. Copy- ing ink or indelible pencils should not be used. id) Name— Christian and middle name in full and suruame iu the order to be used. The nanie should be written very plainly, or prefei'ably t^pewritt.-n or printed in plain Kotliic letters. (c) Rate —The rate in wiiich recruit is enlisted shall always be slated (/) Age.— The age at the time the card is prepared is the one that siuiU be given. MANUAL FOB THE MEDICAL DEPARTMENT, U. S. NAVY. 141 (g) Height. — The height is to be given in inches, and as it is relied upon as a base in comparing the cards of recruits with the classified descriptions of the former sailors or marines, and as the measurement may to a considerable degree be affected by efforts at deception on the part of the recruit, great care in ascertaining it is enjoined. (h) Hair. — The scale of hair colors may be given as follovps: Flax color; light brown: of red hair, as follows: brick red, sandy red, auburn (reddish brown) ; dark brown; black ; of gray hair, as follows: dark gray, light gray, (ap-. preaching white), iron gray (mixed). (i) Eyes. — The eyes should be compared by placing the subject with the face in good light. Slide the Standard Eye Chart up or down the left side of the face, close to the left eye. The nearest approach in similarity of color is the number to be given. If the right eye is distinctly different in color, its number also should be given. (;■) White or colored. — Write the word "white" or "colored" to Indicate race as the case requires. Do not indicate by crossing out one of the words. (/c) Date of last prior enlistment in the Navy or Marine Crops. — If the re- cruit has had no prior service in the Navy or Marine Corps, write the word " none." (I) Missing teeth. — To indicate the missing or useless teeth, mark with an X the letters corresponding to the teeth that are absent or useless. Teeth that are partly decayed should be indicated by drawing a diagonal line through the corresponding letters. If none are missing, write the word " no " in front or above the words " missing teeth." This will show that they were not over- looked. (m) Station and date.— Write the name of the station at which the card is made out and the date of its preparation. 2104. Marks on the outline-figure card should be made at points corre- sponding to those occupied by the marks on the body of the recruit. This may readily be accomplished by drawing imaginary lines on the body of the recruit like the dotted lines on the card and placing the mark in the proper position on the card. As the dotted lines mark the boundaries of regions which are used in the systematic arrangement of the cards for purposes of identification, it is important that each mark on the card should be placed in its proper position. (a) A pen picture is desired of all marks, showing their inclination and general shape. In the case of tattoos this is optional. ( ft ) A straight line should be drawn from each mark to its description on the right or left of the figure. When avoidable these lines should not cross each other. (c) When a description is common to a number of marks, it need not be re- peated for each one, but the lines may converge to it, if they can do so without crossing others. (d) The sizes of all scars, moles, warts, birthmarks, etc., are to be given in inches or fractional parts thereof, except in the case of pin-head moles (abbrevi- ation p. m.). (e) Pin-head moles are moles less than one-eighth of an inch in diameter. (/) Tattoo marks should invariably be noted and described in detail as tliey appear. In the case of devices composed of two or more figures, the component parts should be named, e. g., " heart, cross, and anchor," not " faith, hope, and charity " ; " clasped hands," not " friendship " ; " eagle, shield, crossed cannon, flags, and arrows," not "American coat of arms." The same applies to all em- blems, coats of arms, lodge pins, badges, etc. {g) Letters, initials, and words should be printed, by ham in plain romau capitals or gothic, thus : "J. H. M.," " U. S. V.," " I. X. L.," " IN GOD WE TRUST," etc. (h) Details of costume, posture, and relationship to other devices should be given in the case of tattooed representations of men and women, e. g., " woman clinging to a cross " ; "man and woman embracing, houses, lighthouse, and 142 MANIAI. FOR THE MEDICAL I>EP.\BTMENT, U. S. NAVY. sliiij ill rlit backi^iMUud " ; " siiilor standing \>y a toiubstone, weepiuf^ willow overliead, cap in right hand, words " in memory of my mother' on stone." (0 The size of tattoos ueed be given only in the case of dots, blotches, cir- cles, lines, etc. (;■) It is not necessary to state the color or kind of pigment used in the tattooing. (k) Do not crowd the description of tattoos between the right arm of the tigure and the edge of the card in front, nor the left arm and edge of the canl on the back. (I) Indecent or obscene tattooing Is cause for rejection, but the applicant •should be given an opportunity to alter the de.sigu, in whicli event he uiaj , if ■ otherwise qualified, be accepted. (Hi) Do not write on the figure. The figure is to be used for the pur- pose of locating, by pen pictures, the different marks found on the body of the reciniit. (») Amputations and losses of parts of fingers and toes should be noted, showing the particular member injui'ed and how much of it is gone. 2105. The following abbreviations are authorized and will he undersrood In the sense indicated, viz: Amp., amputation; bl., blue; bmk., birthmark; bro., brown ; d., depressed (except when following a dimension ; then it stands for diameter) ; f., flat ; fl., fleshy ; h., hairy ; m., mole ; p., pitted ; p. m., pin-head mole; r., raiseil ; s., scar or smooth; v., vaccination; var., varicose veins or varicocele; w., wart. (a) All combinations of the.se abbreviations are admissible, e. g., p. s. i d., pitted scar one-half inch in diameter; s. 1, scar 1 inch long; f. p. s. 1 x *. an oval, flat, pitted scar, 1 inch long and i inch wide. (&) Abbreviations denoting shape are unnecessary, for the letter "d" fol- lowing a dimension shows that the work is circular. Two dimensions given indicate that the mark is oval or oblong, and when no letter follows the dimen- sion it is understood that the mark or scar is linear. (c) When a linear mark or scar is otherwise than straight the length to be ^giveu is the shortest distance from one extreme to the other. \ (d) The letters " T. M." should not be used as abbreviations for "Tattoo marks," as they are liable to be taken for tattooed letters on the person. Section 6a. — Physical Examination fob United States Naval Resebve Force. 2107. Candidates for enrollment or appointment (or transfer) in the various ela.ssos of the United States Naval Reserve Force are subject to the physical requirements prescribed for the corresponding ranks, grades, and ratings of the Regular Navy. Variations from standard: Variations from the standard prescribe*! are permissible as follows, providetl the examining medical officers are satisfied that the delects are such as will not interfere with the prospective special duties of the candidate as a member of the Naval Reserve Force. Minimum height for officers, 04 inches. Candidates who intend applying for active duty for instruction and training with a view to confirmation in grade, and the further Intention, when authorized, of taking the examination for appointment in the Regular Navy, nuist meet the Navy standard. Fleet Naval Reserve, class 1: The physiciii standard is the same as that for the Regular Navy as applied to officers appearing for promotion and men for reonlistmcnt. , Naval Reserve, class 2: The physical standard Is the same as for class 1. Naval Auxiliary Reserve, class 3: Physical exairiinations in this class will neces.sarlly be governed by the ability of t\w Individual to perform the duties of his po.sltion as a member of the crew of tlie nierchant ship which is listed tc be taken over by the Navy Departnient. Conditions which do not prevent tJbe individual from pursuing his occtipjitlon on the ^lilp, or which do not menace the health of others, nui.\ in i.'cncnil be walvo.1 hy tlio oxaininiiiL; )nodl- MANUAL JFOB THE MEDICAL DEPAETMENT, U. S. NAVY, 143 cal officer. All defects should be carefully noted in the health record and ou the shipping articles, and a waiver form noting the defects should be made out and forwarded to the Bureau of Medicine and Surgery, marked plainly " For file." The examining medical officer should, when necessary, insert the words " except as noted " between the words " free " and " from " in his certifi- cate on the enrollment articles. Naval Coast Defense Reserve, class 4 : All individuals enrolling In this class vdth a view to subsequently taking an examination for appointment in the regular Navy are required to meet the regular Navy standard. All individ- uals enrolling in this class who are capable of performing special useful service in the Navy, and as such are liable for general service, are i*equired to meet the standard prescribed for class 1. Individuals who are enrolled in this class for special or fixed duties on shore will be only required to meet the physical qualifications prescribed for the Naval Auxiliary Reserve, class 3. The same procedure with regard to noting and reporting defects will be carried out as described under class 3. Naval Reserve Flying Corps: The physical standard shall be that prescribed for the Flying Corps of the regular Navy, except that when individuals present evidence of extensive experience in actual flying a waiver may be forwarded. The waiver should indicate the number of flights and the total time recently spent in the air as a pilot. 2108. Female candidates for enrollment in the Naval Coast Defense Reserve are subject to the following physical requirements: Table of physical proportions for height mid iceiyht meanaicment of loomen. Height. Weight. Height. Weight. Inches. Powndg. Inches. Pounds. 60 112 66 IS2 61 114 67 136 62 116 68 i-10 63 119 09 14.' M 123 70 160 65 127 The weight is taken with clothing; the above weights are those after the estimated weight of clothing has been deducted. The minimum height for acceptance is 60 inches. A variation not exceeding 1 inch is permissible if the applicant is in good health and desirable. The minimum weight for acceptance is 112 pounds. A variation of 17 pounds, not to fall below 95 pounds in weight, below the standard given in the table is admissible when the applicant for enrollment is active. A chest expansion of less than 2* inches is a sufficient cause for rejection of an applicant. The table is given to show what is regarded as a fair standard of physical proportions and not as an absolute guide to be followed in deciding upon the acceptance of applicants. Marked disproportion of weight over height is not a cause for rejection unless the applicant is positively obese. Any one of the following conditions will be sufficient to cause the rejection of an applicant : (o) Feeble constitution, general poor physique, or impaired general health. (b) Any disease or deformity, cither congenital or acquired, that would impair efficiency, such as: "Weak or deranged intellect, cutaneous disease not of a mild type, parasites of the skin or its appendages, deformity of the skull, abnormal curvature of the spine, torticollis, inequality of upper or lower ex- tremities, inefficiency of joints or limbs, deformity of joints or bones (either congenital or the result of disease or injury), evidence of epilepsy or other 144 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. convulsions, defective vision (miuiuium 15/20 in either eye), disease of the eye, color blindness, impaired hearing or disease of the ear, chronic nasal catarrh, ozena, polypi, great enlarsement of the tonsils, impediment of speech, disease of heart or lungs or predisposition to such disease, any history of abdominal or pelvic disease or abnormality, loss of many teeth, or teeth gen- erally unsound (teeth properly filled not to be considered unsound). Every applicant must have at least 20 sound teeth, and of these not less than 4 opposed incisors and 4 opposed molars. (c) Any acute disease. Variations from the standard prescribed are permissible, provided the exam- ining medical officers are satisfied that the defects are such as will not interfere with the prospective special duties of the candidate as a member of the Naval Reserve Force. Conditions which do not prevent the individual from pursuing her occupation, or which do not menace the health of others, may in general be waived by the examining medical officer. All defects other than tho.se l>eculiar to the female sex should be carefully noted in the health record and on the enrollment articles, a waiver form noting all defects shoud be made out and forwarded direct to the Bureau of Medicine and Surgery, marked plainly "For file." This will be regarded as confidential. The examining medical officer should, when necessary, insert the words " except as noted " between the words " free " and " from " in his certificate on the enrollment articles. Whenever a naval hospital is within reach, the examination shall be con- ducted at said hospital, where the services of a member of the Nurse Corps (female). United States Navy, w'ill be available. If this is not practicable, the examiner shall use such tact and courtesy as will avoid offending in any way the sensibilities of the applicant. He shall not, however, by such attitude, allow himself to deviate from a proper fulfillment of all the requirements. The applicant should be previously instructed to arrange her clothing in a way that will insure ease, facility, and thoroughness in the examination. A loose gown of light material will not interfere with the examination or the taking of the measurements. Corsets should invariably be removed. Section 7. — Physical Examinations fob Special Duties. 2111. All candidates for the position of gun pointer, who are referred by the commanding officer to the medical officer for examination of eyesight prelimi- nary to training, shall be subject to the following requirements: No applicant shall be recommended as qualified for this rating who can not read with the right eye (or left eye, if used in aiming) at 20 feet the line on Snellen's test card, which is normally .seen at 15 feet (i. e., 20/15 vision). A minimum 20/20 vision should be required with the eye not used in aiming. The test card should be well illuminated, on a level with the candidate's eyes and directly, not obliquely, in front of him. Before each record target practice all qualified and acting gun pointers shall be examined for acuity of vision and the result entered on the gunnery record. A report shall also be submitted to the departmept. (I 2r.01 (3)). 2112. In all cases where men request to be transferred from the seaman branch to the rating of fir?'man. third class, they shall be examined physically by a medical officer, and the result of such examination reported in the recom- mendation of the commanding officer wlioii submitting the request to the bureau. No other written report of such examination need be made other than an entry i>n the man's health record that the examination has been made and (bo man found fit or unfit. (Bureau of Navigation. No. 2158-249. Feb. 24, 1912.) 2113. Aviation duty: All candidates for aviation duty shall be subjected to a rigorous physical examination to determine their fitness for such duty. Physical qualifications shall conform to the standard set In chapter 11, with the additional requirements as follows: MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 145 (a) Normal vision (at least 20/20) in each eye will be required, and no variation below the prescribed minimum standard height or below the mean chest circumference and the prescribed expansion shall be allowed. In all such candidates a normal heart and normal lungs with full and free expansion are of prime importance. Blood pressure will be taken before and after exercise and any marked departure from normal will be cause for rejection. A urinary examination will also be made and disease so disclosed will invariably lead to rejection. (6) In requiring normal acuteness of vision and hearing, medical officers are cautioned to recognize that such acuteness is merely one factor in normal functions of eyes and ears, separately and coordinately. For instance, acci- dent in landing an airplane may be regarded as frequently due to error of judg- ment In regard to distance from earth at the time the machine should be " flattened out." Yet, correct judgment depends upon many factors and even simple acuity of vision can be considered as being of great importance at times in such cases. Furthermore, while judgment may depend essentially upon central conditions, it also has important relation to reflexes from eyes and ears which may dominate those conditions. Therefore, in that direction can frequently be found varying ability of central nervous systems to main- tain coordination and a normal sense of equilibi'ium with reference to acts urgently required. Hence, full functions of eyes and ears are essential for duty in the Flying Corps, but acuity of vision and hearing is only a part of those functions. Nevertheless, good vision is very helpful in selecting a suitable landing field in forced landings and in allowing efficiency without glasses or goggles that can be pushed out of the way when obscured at any time by oil (engine-in-front type) ; while normal hearing has been found to give essential assistance in detecting the first signs of engine defect while in the air or in detecting such defect pi'ior to flight. (c) In considering eyes, all practicable attempts will be carefully made to seek indications of abnormality of function in any direction. In that con- nection reference is made to requirement of even pupils and equal and full re- actions to light and distance, and also to freedom from any appearance of dis- ease in eyes and adnexa. Strabismus or squint in any manifest degree is cause for rejection. Ocular movements, observed while having the eyes follow the finger of the examiner, must show no lack of coordination, and there must be no nystagmus on turning the eyes to right or left 40 degrees or when look- ing to the front. (rf) In relation to ears, the first consideration is acuteness of hearing, which will be determined by the usual methods ; but in the watch test the examiner shall use a watch he has standai'dized. For that purpose he shall satisfy him- self as to the usual average maximum distance the watch is heard by at least five men found to have normal drums and considered from association to have normal hearing. The determination must be made under the conditions to which candidates would be subjected in carrying out the test, and the distance in inches so determined shall be used as the denominator in computing the usual fraction for the record ; but the full distance will be required for accept- ance. The drum and auditory canal of each ear will then be examined with a speculum. Perforation, pus, odor, or any evident condition of disease is cause for rejection. Indication of middle-ear trouble shall be regarded as of special importance, and it should be recognized that such indication is often found in the very diminution of the sense of hearing which is regarded as a cause of rejection. A contributory cause should be sought in examination of nasal septum and for those conditions of the throat and nose suggestive of interference with patulousness of eustachian tubes, such interference not only being in association with middle-ear disturbances, but also preventing the aviator from securing the required balance of air pressure on the ear drums when ascending, or, of special importance, in more or less rapid descents. 98601°— 17 10 146 MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. (c) The practicability, or even advisability, at this time of seeking to make «lefinite inquiry into functions of equilibrium through nystagmus induced by cxcitMtion of vestibular mechanism may be regarded as more or less in question in view of normal differences and also of variations in the personal equations of examiners. Such nystagmus may be produced by rotary, caloric, compres- sion, or galvanic methods. (/) However, in seeking abnormality in function of equilibrium there are certain valuable static and dynamic tests that must be made at each examina- tion. In these tests (he candidate is required, without shoes, and first with eyes open and then closed, to — (1) Stand with knees well back and inner margin of feet touching. (2) Stand on toes from position (1). (3) Stand flat on right foot and rest left foot on right knee or instep. (4) Stand Hat on left foot and rest right foot on left knee or instep. (5) Walk forward with feet flat. (6) Walk to the right in a circle with feet flat. (7) Walk to the left in a circle with feet flat. (8) Walk backward with feet flat. (9) Hop backward on both feet flat. (10) Hop backward on right foot flat. (11) Hop backward on left foot flat. Position (1) should be held for two minutes without abnormal swaying, and position (2) for a minute. Normal attempts at balancing have no significance. Positions (3) and (4) should be held for at least a quarter of a minute. In tests (6) and (7) there should not be expectation of candidate making mathe- matical circle, especially with eyes closed, but only that he will normally tend to follow the general direction of a circle. In making these tests and watching for abnormal deviations, the examiner must recognize that they liave relation not only to peripheral nerve disturbances but also to central conditions, esi)e- (.ially those of luetic origin, and that tlie patella, tendo Achillis, and pupillary reflexes must be considered with them. In the case of the candidate examined for transfer or detail the blood-serum test for specific disease will also be secured, and such test will be secured in other cases when practicable. (g) The static and dynamic tests must also be considered in connection with the prescribed routine examination to determine the free and full movements of joints. In relation to the knee and ankle joints it is evident that their finer movements play a very important part in rudder control, especially in a fast machine requiring qui'clc-acting controls. Difficulty in those joints may also lead to the abnormal position in an airplane that tends to cramping of muscles, (/t) In the consideration of a suitable type of individual the anemic should be discarded, and also the asthmatic, emphysematous, or obese. The desire is for the active with freedom from disease and objectionable tendencies. In that relation the history of the individual may be of great importance and con- sequently must be sought. Is there story of eye trouble, such, for instance, as double vision? Is there history of ear trouble, such as earache, discharge, nolse.s, or mastoiditis? What is the history as to enuresis, asthma, rheinnntism. .seasickness, swing sickness, vertigo, headache, and head injury? Those ques- tions relate to both disease and type and can readily furnish information upon which rejection should be based. A candidate whose history or condition shows lues, or any of the chronic intestinal di.sordcrs tending to dizziness, should be rejected as well as he who is found to have inclination towanl a habit that disturbs mental balance, such as toward alcohol or other drug. (i) In either adult or minor a chest expansion of less than 2A Inches is a sulficient cause for the rejection of the applicant, and there shall be no varia- tion below the pre.sci-ibod chest measurements. In the case of minors no under- weight or undcrheight is allowed, and in regard to adults the weights given for 04 G5, and GG inches will be regarded in each case as a minimum. X«» adult above CG inches will be accepttxl with less weight than 132 pounds, an(' MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 147 iu such a case no variation greater than 7 pounds below the prescribed weight for height will be allowed. But in all cases the applicant must be active, with firm muscles, and evidently vigorous and healthy. Consequently, marked dis- proportion of weight over height will also be a cause for r.ejection when it is an indication of obesity. Special attention will be given to obesity and to any tendency in that direction disclosed by family history or suggested by dispro- portion of weight over height. Examiners will regard obesity or tendency to obesitv as cause for rejection in all cases. 2114. Physical examination of men recommended for trial: Commanding officers recommending a man for trial by general court-martial will direct the senior medical officer on board to make a thorough physical examination of the man so recommended for trial to determine his physical fitness for the service. In case the man so examined shall be found physically unfit for the service, the report shall fully contain the reasons, etc. The report shall be made in deplicate, and will be forwarded to the commander in chief with the other papers in the case. (Atlantic Fleet Regulations, 1913, par. 260 (h).) 2115. Phvsical examination of prisoners prior to transfer to disciplmary ship- In every case before a general court-martial prisoner is trausferretl to a disciplinary ship an examination will be held by a medical officer of the ship to which the prisoner is attached to determine the prisoner's physical fitness for the service, and no prisoner found to be physically unfit will be transferred to a disciplinary ship. A report in duplicate should be submitted. (Department letter No. 26267-81:1, of Jan. 9, 1913.) (Procedure on shore, eee par. 2947.) , . . , ^ - -, ^ 2116 Examination before transfer: Every man about to be transferred from one ship or station to another shall be subjected to a careful phtjsical exami- nation conducted by the medical officer, who shall make the requisite entries on the man's health record. Except in an emergency, no man who is known to have been exposed to any infectious or contagious disease, or who is found to be suffering from such disease or from active venereal infection, which mav be a menace to others, shall be recommended for transfer except for treat- ment in hospital or for passage thereto. When an emergency requires the transfer of men with these diseases, a full report shall be forwarded through official channels to the medical officer of the ship or station to which transfer is made with such recommendation as the medical officer may deem advis- able If any cases of these diseases are found and retained, they shall be promptly admitted for treatment and a report of the fact made to the com- manding officer. (R 3581 (5).) , .^ ^ * x- „ 2117. When practicable, applicants for the rating of mess attendant, natives of Insular or tropiral possessions of the United States, will be examined for the presence of intestinal parasites, and such, if found, will constitute cause for rejection. • Section S.— Naval Instructions Relating to the Navy Yard Service, Physi- cal Examination undee Compensation Act, Etc. 2121. Physical examination of applicants for employment at navy yardS; (civil employees). I 231 (9). , t o--. /oi^ » 2122. Qualifications (physical) of applicants. I2ol(21)(Z. 2123. Causes of rejection. 1251 (23). 2124. Authorization of compensation for injury. 1391. 2125. Medical examination every six months. 1391 (1) e. 212(>. Prevention of injury to eyes. 1392 (1). 2127. Letter of Seci'etary of (Jominerce and Labor relative to importance of physical examination by the medical officer of a navy yard. I 393. 2128. Civil employees at naval hospitals. 1401 (1). 2129. Extension of leave when ill. 1402 (2) (5). 2130. Leave when contagious disease exists in family. 1403 (2) a, b. 2131. Leave on account of sickness and medical certificates. I 404 (2). (Navy Department, circular letter. May 2G. 1917.) 148 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 2132. Tlio.se honorably discharged from Army or Navy for disability in line of duty to be liven preference for appointments. (R. S., sec. 1754.) Section 9.— Detailed Dibections Regarding Navy Yard Service and Duties ON THE Labor Board. 2141. The physical examination of applicants for all positions will be con- ducted wholly with a view to determinins; an applicant's ability to perform the work of the position to which he seeks appointment, and his free(ln v>ew A .ef«t ^e„«ooe.^a^s a_cau^^ Jor rS'™hS°Lcdr"onfot'tSI Sass me™Jned ma/be li.e.y to develop into a SKed S'l'e?r.aili?ra„5°m';;r£ sSinVen.ered above o.be,:. in oases •"^llSll'V Tbffublects and weights of the examlaatioa for positions in groups 11, III. IV, and V (a) shall be: Phvslcal ability, weight 4, and Training and experience, weight 6. %r;nst™Ss'°l^r"ratfn7pVsto\ aW'lW: Applicants for all noneduca- r'S9srVnS^itVo'n^^A^o^xLS''br.T^^^^^^ SSaSsr^rter^ne^tS^^^^ tfclble be execu ed by one of the commission's designated physicians S "iaisr sO T^ ifporthTfoiirrta^ror^Sitfa^d weights : Height. 5feet 5 feet 1 inch 5 feet 2 inches . . 5 feet 3 inches.. 5 feet 4 inches . . 5 feet 5 inches . . 6 feet 6 inches . . 5 feet 7 inches.. 5 feet 8 inches.. 5feet9in:'hes.. 5 feet 10 inches. 5 feet 11 inches. 6feet 6 feet 1 inch — 6 feet 2 inches . . 6 feet 3 inches . . Weight. Pounds, 120 to 144 122 to 147 124 to 151 127 to 154 131 to 158 134 to 163 138 to 168 142 to 174 146 to 179 150 to 185 154 to 191 159 to 198 165 to 204 170 to 208 176 to 215 181 to 224 Per cent. 95 95 95 95 95 95 w^icrht in fractions of an inch, if one-half or over, should be rated at next hiS^nteger; if under one-half, next lower, except to receive the maximum ^^t'^!S^'S<^^eX<^e^^T^ the medical certificate s,/ normal condVtifns; applicants whose measurements are disproportionate, but 150 MANUAL FOK THE MEDICAL DEPAETMENT, U. S. NAVY. who are otherwise normal, are, if over 5 feet 6 inches, to be rated at 95, and if under at 90, except In cases of well-marked obesity, or underweif,'ht. when an additional 5 per cent may be deflucted, making the former rating 90, the latter 85. Tlie maximum rating (9S) should not be given an applicant whose waist measure equals or exceeds tlint of his chest at forced expiration, or whose chest mobility is less than 3 inches. 2154. Deductions will be made for any defect as diminutive physique, spinal curvature, obesity, rupture, defective vision or liearing, organic dise.Tses, de- formity, loss of hand or foot, etc. First, the measurements of the applicant are to be considered and a tentative rating determined from them. Having determined what the normal man of the given ilimenslons would receive as a rating thereon, the further statements of the certificate will be examined and deductions made for abnormalities as found therein. The following list comprises the more common existing disabilities, with their corresponding deductions : Contagious or infectious diseases (including venereal). Reject. Heart disease, except in cases with valvular lesions when the latter are fully comi)ensated, as attested by certificate of two physicians. Reject, Tuberculosis. Reject. Epilepsy. Reject. Insanity. Reject. Blindness. Reject. Loss of both arms or both legs. Reject. Loss of arm and leg. Reject. Locomotor ataxia. Reject. Cancer. Reject. Right's disease. Reject. Diabetes. Reject. Loss of hand or foot. Deduct 35 or more. Hernia (rupture). Deduct from .T) to rejection. PMes, fistula, or fissure. Deduct from 15 to rejection. Arterial sclerosis (hard arteries). Deduct 35. Spinal curvature. Deduct from 15 to 35. Loss of finger or toes. Deduct from 15 to 35. Loss of eye. Deduct 15. Deformities, old fractures, etc. Deduct from 15 to 50. Varicocele. Deduct from 5 to 10. Varicose veins. Deduct from 5 to 35. Minor defects of vision. I>educt from 5 to 10. Skin diseases (noncontagious). Deduct from 5 to 25. Middle ear disease or deafness. Deduct 15. Deficient chest mobility. Dee submitted to United States Employees' Compensation Commission by every employee injured in performance of his duty, or some one on his behalf, within 48 hours after injury. This notice sliall be given by delivering it personally to the officinl superior or by depositing it in the mail properly stamped and addressed to the official superior. (b) C. A. 2 report of injury, to be submitted as soon as possible after injury by the reporting officer. (c) C. A. 4, claim for compensation, to be filed with official superior within GO days after injury causing disability for more (ban three days. This claim must be subscribed and sworn to by applicant and also by the medical officer of the station where the injury was received and by the physician who iittended the claimant. There is, in conclusion, a certificate for signature by the official superior. 217(5. During the semiannual examination of civil employees required \inder the net it shall be the duty of the medical officer to record any disability which might at a subsiniuent flatc l)c allegwl to be the result of accidental injury wliile engaged In Government work. CHAPTER 13. THE HEALTH RECORD, NOMENCLATURE, JOURNAL OF THE MEDICAL DEPARTMENT, AND REPORTS OF DEATH. Section 1. — Navy Regulations Relating to Health Records. 2201. Patients transferred to have health records. R 2961 (2) ; R 3585 (1) a. 2202. Entry to be made in health record of men examined before transfer. R 2961 (3) ; R 3581 (5). 2203. Date of transfer to other than a naval hospital to be noted in health record. R 2962 (1). 2204. Health records of patients left in foreign hospitals to be left with consul. R 2962 (2). 2205. Health record continued by medical officer of any ship arriving in port. R 2962 (3). 2206. Junior medical officer to write up health records. R 2977 ; I 3251. 2207. Not in line of duty entries on health record. R 2902 (1-5). 2208. Disabilities of men enlisted to be entered on health records. (I 3209) ; R 3523 (3). ; 2209. Accidents and injuries occurring in absence of medical officer to be noted on health record. R 4563. Section 2. — Naval Instructions Relating to Health Records. 2211. Custody of officers' health records. 1708 (1). 2212. Every officer required to notify medical officer of transfer. 1708 (2). 2213. Health records to senior officer of board for physical examination. I 708 (3). 2214. Health records upon completion of examination. 1708 (4). 2215. Health records M'here no medical officer. 1708 (5). 2216. Officer on duty where no medical officer to furnish reports of disa- bility. I 70S (6). 2217. Periodical physical exercises. 1709. 2218. Entries in health records indicating use of intoxicants, etc. 1707 (5). 2210. Health records to be inspected by fleet surgeon. 1 1122 (2). 2220. Health records to be verified. 12102. 2221. Health records of patients received for passage. 12116. 2222. Medical officers shall keep health records. 12117 (1). 2223. Completed records to go to Bui'eau of Medicine and Surgery. I 2117 (2) . 2224. Commanding officer to inspect health records. 12619 (2). 2225. Entries upon enlistment and transfer. I 3208 (1-2). 2226. Record of vaccination to be entered on health record. 13211 (1). 2227. Administration of typhoid prophylaxis to be entered on health record. I 3212. 2228. Health records at hospitals to be examined weekly. I 3226. 2229. Patients upon admission to hospitals to have health records. I 3229. 2230. Health records to be signed and verified. 13237. 153 154 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 2231. Care in keeping iiealtli records. I 3252. 2232. Health records to be opened upon appointment or promotion of ofTicer. I 3257. 2233. Examination of enlisted men for rating of fireman to be entered on healtli records. (Letter Nav. 2158-249, Feb. 24, 1912.) 2231. Records of physical examinations of officers for periodical physical exercise in January to be made in healtli records. I 709 (5) ; I 708 (3). 2235. Naval Reserve Force. R 4G53 (b) ; I 5507 (b) ; I 5509; General Orders, Nos. 231 and 237. Section 8. — Instructions to be Observed in Opening and Preparing Health Records, 2241. (c) The whole name (Christian, middle, and .surname) to correspond with that on service record and to be legibly written out. without abbreviations, and correctly spelled, preference being given to the original spelling of foreign- ers' names, the surname to precede and to be distinguished by being underlined. (b) As far as possible, on reports and returns, the grades and rates of officers and men should be spelled out in full, but where sufficient space is not provided the following abbreviations should be used : officers. Admiral Adinr, VAd, or RAd. Captain "(U? S. n')"~-I Capt. Commander Comdr. Lieutenant Commander ■ Lt-C. Lieutenant Lt. Lieutenant (junior grade) Lt-jg. Ensign Ens. Midshipman Mid-1. etc. Medical Director MDir. Medical Inspector ^^^"^P\ ., „.„ Surgeon ■^'^S- ASurg, PAS, or Surg Dental Surgeon DentS. Pay Director PDir. Pav Inspector PInsp. Paymaster APay, PAP, or Pay. Chaplain Sl^^V Professor of Mnthemntics PMath. Naval Constructor ANCon or NCon, Civil Engineer ACEng or CEng. Boatswain CBoat or Boat. Gunner Cl^^"'^ o^' ^un. Machinist C|Mach or Mach. Carpenter CCarp or Carp. Sailmaker GSail or Sail. Pharmacist CPharm or Pliarm. Pav Clerk CPayC or PayC. Brigadier General (U. S. U. C.) BrGM. Colonel (F. S. M. C.) ColM. Lieutenant Colonel (U. S. M. <'.) LtCM. Major (U.S. M.C.) MajM. Captain (U. S. M. C.) CapM. First Liouloiiant (T^. S. M.C.) 1-LtM. Second Lieutenant ( V. S. M. C.) 2-LtM. Quartermaster Clerk (U. S. M. C.) QrCM. Marine Gunner (U. S. M. C.) MarQ. MANUAL FOK THE MEDICAL DEPARTMENT, U. S. NAVY. 155 SEAMAN BRANCH. Mate -^late. Master-at-arms CMntA. MatA-1, etc Boatswain's mate CBM. BM-1, etc. Gunner's mate CGM, GM-1. etc. Turret captain CTC, TC-1, etc. Quartermaster CQr, Qr-1, etc. Coxswain Cox. Seaman gunner SeaG. Seaman Sea-1 or Sea-2. Appentice seamnn AS. ARTIFICER BRANCH. Machinist's mate CMM, MM-1, etc. Electrician CEl, El-1, etc. Carpenter's mate CCM. CM-1, etc. Storelveeper CStkr. Stlfr-1, etc. Printer CPrint or Print-1. Water t7nde7_"_""_V__" CWT or WT. Boilermalier Bmlir. Coppersmitli Csmtii. Sliipfitter Sfit-1 or Sfit-2. Blaclvsraith Blks. Plumber and fitter P & F. Sailmaker's mate SmM. Painter Ptr-1, etc. Oiler <~>iler Fireman F-1, etc. Shipwright Swrt. Sl'hX'IAI, BRANCH. Yeoman CY. Y-1, etc. Pharmacist's mate CPhM, PhM-1, etc Bandmaster Band Commissary steward CCmS, or CmS First musician ^ 1-Mus. Ship's cook SC-1, etc. Baker Bak-1, or Bak-2. Hospital apprentice HA-1 or HA-2. Musician Mus-1, or Mus-2. Bugler Bugler Landsman Lds. MESSMEN BRANCH. Steward to C in C SCinC Cook to C in C CCinC Steward to commandant SConi Cook to commandant CCom Cabin steward CabS Cabin cook CabC Wardroom steward WRS Wardroom cook WRC Steerage steward StS Steerage cook StC Warrant off. steward WOS Warrant off. cook ^— — .__..-_- WOO Mess attendant MsA-1 , etc --i '■.■.7^Mifp;-i -t-^/i'i/r inn lo 9ii;jr;(i r.,r i 156 MANUAL FOE THE MEDICAL DEPABTMENT, U. S. NAVY. MARINE (enlisted). Sergeant (all grades) , Sergt. Corporal Corp. Private Pvt. Apprentice marine ApM. Drummer Drum. Trumpeter : Trump, PRISONERS. Men serving a sentence under a general court-martial (not those awaiting trial) should be noted as GCMP, or for detentioners Det-1, etc., in spaces pro- vided for ratings. (c) p]nter the rating in which actually enlisted. (d) Enter the name of the place where enlisted. (e) Enter date actually enlisted and strike out the term not to be used as not applying in the case of the man under consideration, following the date of enlistment. (/) Enter month, day, and year of birth. (g) Specify city, town, or other locality of birth, whatever the nationality. (h) Enter (from recruits' statement) all former diseases and injuries. (t) Give former occupation or occupations. {}) For enlisted persons give the number of continuous-service certificate, years of previous service. {k) Give name and address of nearest relative or friend. (l) Enter religion. (m) Eyes: Blue, gray, blue-gray, yellow-gray, hazel (light brown), dark brown, bicolored (as when the pupillary border is of a different color from rest of iris) ; also state when the two eyes are of different colors. (n) Hair: Flaxen, sandy (yellowish red), auburn (reddish brown), brown (light, dark, or very dark), black; also whether thin, bald, straight, curly, or woolly. (o) Complexion is not to be described as simply "light " or "dark," but the character and degree shall be as accurately stated as possible; as complexion, pallid, sallow, fair (only when decidedly clear), ruddy, florid, dark (tawny, sun- burnt, or tanned), very dark (.swarthy or dusky), mulatto, negro. (p) Height to be expressed in inches; the body to be erect, the chin neither elevated nor depressed, the feet and knees touching, legs stiff, and arms hanging perpendicularly. (g) Weight, body nude, or allowance made for clothing worn. Accuracy of scales to be ascertained before using. (»•) Vision to be expressed as a fraction, of which the numerator will be (he distance at which Snellen's 20-foot test can be determined, and the denomi- nator 20. («) Hearing is to be expressed as a fraction, of which the numerator will be the distance in feet a whispered voice can be heard, and the denominator 15. (t) Circumference of thorax to express the mean of the greatest circumfer- ence after forced inspiration and of the least after forced expiration, measured by a tapeline horizontally at the precise level of the nipples; the difference between the greatest and least circumference to be entered as expansion. («) Teeth missing or useless .shall be indicated by marking the dental for- mida as noted. (v) Remarks: Note any prominent physical trait not inconsistent with bodily vigor or not in such degree as to constitute cause for rejection — leanne.ss or the reverse; liirsuteriess ; slight asynunetry of body or limbs, knock-knees, bowlegs, or flat feet; peculiarities of teeth and genitalia; slight varicocele, etc. In this connection examiners are to remember that imperfections that might pa.ss in a man should reject boys. (io) Marks and scars should be indicated as required on the priutetl outline figure. (x) Enter the date and luiture of any waiver re) In the event of the condition of the individual being such as to render it imiiracticable.or inadvisable to inform him of such adverse entry, this fact shall lie noted on his health reciu-d, and he shall be so informed so soon as circumslances permit, such action being noted on the record when taken. (C) In the even! of (he death of a iierson in the naval service in which Ihc connnanding officer does not apiirove of llie assigned origin of the l'a[al illness or injury as given in the official report of dealh, it shall be his duty to indorse thereon Ins opinion and (lie reasons llierefor, (he report being (hen forwarded lo the Bureau of Medicine and Surgery for (ile. (7) In the case of an olhcer or enlisled man of the Navy or Marine Corps in iictive sei-vi<'e abseiil fi-om duty oi, account of sickness oi' disease resulling from his own intemperate use of drugs or alcoh.i > ■ .M,T July 20, 1910. Hernia (inguinal) complete, left. Origin in the line of duty. Hernia reduced and retained temporarily by splca bandage. July 25, 1910, To Naval Hospital, Chols(»a, Mass. A. B. Smith, AsHlAtdvf Surgeon, U. S.Jf. Approv(?d. O. D. Jones, Purgeon, V. S. .V. Naval Hospitai., Chki,.sea, Mass. ( July 25, 1910. Hernia (Inguinal), left. Origin not in line of duty,, Article R 2902 complied with. According to patient's accepted statement. Injury existed prior to enlistment. July 28. 1910. Basslnl operation; other anesthesia; no complications. Patient reacted well after operation. August 10, 1910. Convalescent. Au'j:ust 25, 1910. Up and about. September 15. 1910. Cure(L y'(7. E. F. Anukkws, ,/ .{xnisfont Surgeon, U. S. N. Approved. G. H. PiiiiLi's, Medical Dirrrtor, V. S. N., in Vomnuiiui. MANUAL FOB THE MEDICAL DEPARTMENT, U. S. NAVY. 163 2286. No forms, reports, photographs, or folded papers should be attached to or inserted in the health record. In the case of medical survey, a brief entry will be made of the board's findings and recommendations. Entries should be made of all physical examinations, such as are required for change of rating fi'om seaman branch to fireman third class, for aviation duty, for diving, for use of the smoke, helmet, etc. 2287. To prevent breakage, avoid repeatedly opening the metal clips. Slips must not be removed unnecessarily, and when new ones are attached, provide enough for all reasonable requirements. 2289. The health record of an insane patient accompanies the patient and is left in charge of the institution to which he is committed, with a request that a concise history of the case be continued therein. If a medical officer of the Navy is assigned to the institution, it will be his duty to care for such records and continue the case histories of all naval patients. The medical officer of the receiving ship or barracks at Mare Island, Cal., where service records are i'Ctained, has official charge of the health records of insane patients at a State hospital. He should request information regarding the condition of patients from time to time in order to make necessary entries, and upon discharge or transfer close the record and forward it to the bureau. 2290. If for any reason it becomes necessary to forward a health record to the bureau other than for termination of service, it shall be accompanied by a letter stating the reason. 2291. In the cases of stragglers declared deserters subsequently surrendering,, the health record will be returned from the bureau upon request. In the cases of stragglers from other ships or stations, the health record should be requested and, until its receipt, any medical history should be entered on loose leaves for subsequent insertion into the record. 2292. For enlisted men or marines to be embarked on an Army transport, if jiot provided with them, health records should be opened and entries of vaccina- tions made. 2293. Upon the admission of a supernumerary a medical history sheet from a health record shall be opened and kept as prescribed for enlisted men. When discharged, such histories should be forwarded to the bureau, and in case of the death of a supernumerary, a death report shall be forwarded. (See par. 2247.) In cases of rejection of an applicant for enlistment whose admission to hospital for removal or cure of disqualification is recommended, a record shall be kept on medical history leaves and forwarded to the bureau if the candidate is not finally enlisted. If enlisted, such record should be embodied in a health record. 2294. In the case of a man extending his enlistment, his health record shall be continued until the service covering the extension has terminated. Every man extending his enlistment must pass the same physical examination as is required for reenlistment and be vaccinated. (Sec. 2086 (c).) 2295. When men are tran.sferred to the Fleet Naval Reserve (class 1 (c) or (d)) their health records in the regular service shall be closed by noting on the page under " Termination of service " all the entries and stating " By reason' of" transfer to Fleet Naval Reserve, class 1 (c) or (d), as the case may be. The descriptive list and abstract of health record should be copied in a "new health record and the old one then forwarded to the Bureau of Medicine and Surgery and the new one, marked on its face " Fleet Naval Reserve," forwarded, as required, to the commanding officer of the recrniting district concerned. 2296. Upon the granting of a furlough without pay, as authorized by the act of August 29, 1916, note showing action should be made on the sheet used for closing health record and signed by the medical officer. The current health record should then be forwarded to the Bureau of Medicine and Surgery. A copy of the descriptive list (first page of health record) should be made' and, together with the "Abstract of health record," forwarded to the place where the iiervice record Is sent. (Gen. Ord. No. 231.) ■' 164 MANUAL FOR THE MEDICAL DEPAETMENT, U. S. NAVY. 2297. New health records will be opened for all officers and enlisted men. Where Navy health records have been adopted as " State health records," a copy of entVies in the vaccination, typhoid prophylactic, and dental records, and in the ub.stract of health record, will be entered in the proper places in the new health record. The State health record will be closed and forwarded to the Division of Naval Militia Affairs. The new health record shall have noted on its face in red ink, " Naval Militia in the service of the United States." Section 5.— Detailed Directions Regarding the Heat.th Kecords of Officers (Warrant and Commissionioj). 2801. An officer's health record must accompany him throughout his service, its care and disposition being, in general, the same as that prescribed in the case of enli.sted men. 2302. If an officer is on detached duty or waiting orders, his health record will be forwarded to the bureau by the medical officer of the ship or station. All officers are required to notify the medical officer of their detachment, pro- motion, orders before board of medical survey, or board for promotion, retire- ment or examination for special duty (aviator). (Art. I 70S (2).) 2303. (a) When an officer is ordered before a board for promotion or retire- ment his health record shall be forwarded to the president of the board for the findings of the board to be entered therein, to be subsequently sent to the appro- priate medical officer for continuance or final disposition. When examined for promotion, if physically qualified, the board will at once open a new health record. (See par. 22G2') The new health record shall then be forwarded with the old one as noted above. (b) In the case of an officer recommended for appointment from civil life or of a midshipman entering the Naval Academy, the board will proceed with the new health record as provided for in the case of promotion. 2304. Upon termination of service by retirement or otherwise, the health rec-ord is closed and, with abstract appended, should be forwarded at once to the Bureau of Medicine and Surgery. 2305. The medical history is kept in the same manner as that for enliste305 For the titles of all injuries (wounds, etc., and poisons) a key lettei referring' to the cause under which the injury was received is required on all forms In the health record and on forms not specially ruled the key letter is to follow the title, as "Wound, gunshot, neck (K),'' etc. 2326 In the health record the key letter is to follow the title as Wound, -uushot (A) " indicating that it was inflicted with suicidal Intent; the same title with (B) would show that it was homicidal, while, if received in action, the key letter (K) would be used. ; - 2329 The following points are to be observed in assigning a diagnosis . (a) The class and international numbers are given for reference only, not (&) Titles in italics, which are symptoms, are not to be usefl except when the primary disability is not determined. . ,n v, , *^ ^r^ (c) When two or more morbid entities exist, preference shall be given to (I) an infective disease; (II) the graver affection; and (III) a primary disability over a complication. ,,^ , „ • .. ^ i ^ 2331 (o) Certain title.=: followed by the word " unqualified are intended to cover such cases of those disabilities for which no other title is provided and where occurring the word " unqualified " .shall be substituted by the site of the disabilitv or the principaJ organ ailected. as abscess of neck, etc., or for instance epididymitis or orchitis, when due to a gonococcus infection should be returned as Gon. inf. of epididymus and Gon. inf. of testicle. (h) All gonococcal, syphilitic, and chancroidal infections must be recorded under these titles, and titles such as cystitis acute, epididymitis acute, gone- cystitis acute, orchitis acute, urethritis acute, etc., must not be used as primary d'iasnoses when due to venereal infection. 2332. The proper use of the titles " Malingering," No disease, and Diag- nosis undetermined," is as follows : The first is when a patient claims to be ill or'^unduly exaggerates a disability when the medical officer is of the opinion that there is none or only slight actual disability ; " No disease " is to be used for individuals who for any reason have to be carried on the Medical Depart- ment returns as for rations or as " suspects " under observation for infectious diseases do not claim to be sick and are not regarded as such by the medical officer ; and " Diagnosis undetermined " is to be used when there is an evident disability present, the nature of which is, at the time, not evident. 2333. No other titles than those of the following list are to be used in official 2334 Inasmuch as a correct translation of naval vital statistics of injuries into those of the international classification requires an arrangement accord- ing to causes, it is necessary that the returns show the cause as well as the nature of the injury. ...... v • o ^=^11-.,... > ) 2335. The classification of causes desiretl by the bureau is as follo\\ s . A. Suicidal. B. Homicidal. . ^ , ^d 4.- C. Conflagration. Includes all injuries Incident to general conflagi-ation. Burns otherwise received are not classed hereunder. D. Accidental drowning or submersion. _ . . , ,. , 4 , , ,.i • B Traumatism by firearms, accidental. To include all injuries caused by the proiectile, the blast from great guns, or from the piece when fired. F. Traumatism by explosion. To include powder, gas, compre.ssed air, or steam explosions, also the explosion of a gun. ,, ,^^^., G. Traumatism by fall. H. Traumatism by machines. I. Traumatism by other, crushing.. ^_ _. ,_ 168 MANUAL FOR THE MEDICAL DEPARTME^^T, U. S. NAVY. J, Traumatism due to athletic sports. K. Casualty in action against organized enemy. L. Traumatism due to violence other than noted above. 233(5. The above key letters are to be used for example, as follows: Wound, gunshot, of brain (A), showing that it was inflicted with suicidal Intent; (B) tliat it was homicidal, while if received in action the entry appears ^s (K). Accidental drowning or .submersion should appear with the suffix (D), while if due to the destruction of a ship by fire as (C) ; if incident to the explosion of a magazine as (F), unless the same is incident to action, when it should appear as (K), 2353. A diagnosis shall not be altered on the returns after a case has been closed and the patient transferred unless authorized by the bureau. 2354^. Diagnosis undetermined : In order to provide for the admission to the sick list and transfer of patients where, owing to insufficient time or lack of clinical apparatus, it is impracticable for the medical officer to make other than a tentative diagnosis, the use of the designation " Diagnosis undetermined " is made. The object is to prevent the recording of diagnoses which are subsequently proved to be erroneous and which at times operate detrimentally to the future professional prospects of the patient. Under no circumstances shall a case of diagnosis undetermined be disposed of as to duty, died, invalided from service, hospital for the insane, hospital for tuberculosis, or to leave. Place from which transferred : The case shall be originally entered as an ad- mission and when disposed of should appear on Form F (rough) and F as " Diagnosis undetermined " and the other usual entries made. On Form K It shall be listed under " Disabilities " with diseases or injuries, as the case may be. Place to which transferred : When a case with " Diagnosis undetermined " is received from some other place, it shall be taken up as a readraission (R. A.), but leave the diagnosis space open until established, then place it on the records. Cases taken up with " Diagnosis undetermined " and transferred to another place or continued to nest year will, however, have to be reported to the bureau with " Diagnosis undetermined " on the records. 2355. Specialty key letters: The specialization of certain classes of naval work and the peculiar duties surrounding the nature of the work makes it desirable to inaugurate a system of special designations for disea.sos and in- juries, and for this purpo.se the following liey letters shall be used the same as key letters are now used for injuries. R=Aeronautic duty. For diseases or Injuries Incident to actual flying. S=Submarine duty. For diseases or injuries Incident to actual maneuver- ing of or accident to the vessel. 'U=Divers duty. For diseases or injuries Incident to actual diving. When used in connection with injury key letters, first give key letter for Injury and follow by special key letter, e. g., drowning Incident to flying (D-R) ; when In submarine, (D-S) ; or while diving, (D-U). The specialty key letter shall not be used for all persons attached to special duty, but only in cases of actual specialty work — that is, a person attachtni to aeronautic or submarine duty who is di.sabled on ordinary occasions should not have a specialty letter. No otlier than ttiose given shall be used as prefixes for injuries and .«5hall be followed, as requireil, by the site of the principal traumatism or organ Injureil. Under poisons, follow tlie word poison by the name of the sub.stance, and where more than one condition of poisoning is recognizefl state either acute or chronic. 2357. Medical officers on recruiting duty or at places from wlilch the regu- lar I-'orms F and K are n(»t refiuircd. sliall. when cases of Illness or Injury are brought to their attention, prepare and forward the original of Form F (rough) and retain the duplicate. Cards shall be sent to the bureau as soon as the MANUAL FOB THE MEDICAL DEPARTMENT^ TJ. S. NAVY. 169 case is discharged to duty or otherwise disposed of. In the case of treatment of persons on leave from their regular ship or station the medical officer at the place to which the person is attached, as well as the bureau, shall be informed. Section 10. — CJlassification. 2358. The " Navy class number " referred to in the following pages alludes to the classification as follows: I. Diseases of blood. II. Diseases of circulatory system. III. Diseases of digestive system. IV. Diseases of ductless glands and spleen. V. Diseases of ear. VI. Diseases of eye and annexa. VII. Diseases of genito-urinary system (nonvcnoreaI)« VIII. Diseases of infective type (nonvenereal). IX. Diseases of infective type (venereal). X. Diseases of lymphatic system. XI. Diseases of mind. XII. Diseases of motor system. XIII. Diseases of nervous system, XIV. Diseases of respiratory system. XV. Diseases of skin, hair, and nails. XVI. Hernise. XVII. Miscellaneous diseases and conditions. XVIII. Parasites (fungi and certain animal parasites), XIX. Tumors. XX. Injuries. XXI. Poisons. The " international number " refers to the classification of disease?^ and Injuries prepared by the International Commission (Paris, July 1 to 3, 1909). These numbers are given for reference only, not for use. Class I. — Diseases of blood. Anemia, pernicious. Anemia, simple. Anemia, splenic. Hemophilia. Leukemia. Polycythemia, chronic. Purpura. Purpura, hemorrhagic Class II. — Diseases of circulatory system. Aneurism. Aneurism, cirsoid. Aneurism, of heart. Aneurism, varicose. Aneurismal varix. Angina pectoris. Aortitis. Arterial sclerosis, general. Atrophy of heart. Bradycardia. Dilatation, acute cardiac. Dilatation, chronic cardiac. Embolism. Endocarditis, acute. Endocarditis, chronic. Fatty heart. Heart block. Hypertrophy of heart. Mediastino-pericardltls, Myocarditis, acute. Myocarditis, chronic. Palpitation, cardiac. Pericarditis. Pericardium, adherent. Phlebitis. Pneumopericardium. Pyopneuniopericardium. Rupture of heart, spontaneous. Tachycardia. Thrombosis. Valvular disease, chronic cardiac. Varix. 170 MANUAL VOU THE MEDICAL DKPABTMENT, U. S. NAVY, Class III. — Diseases of digestive syetem. Abscess about rectuiu. Abscess of liver. Abscess of omentum. Abscess of pharynx. Abscess of salivary gland. Abscess of tongue. Abscess, subphrenic. Achyila gastrica. Adhesions about gall bladder. Adhesions about stomach. Adhesions of peritoneum. Angina ludovici. Appendicitis, acute. Appendicitis, chronic. Artificial anus. Atony of stomach. Atrophy of liver, acute yellow. Atrophy of pancreas. Atrophy of stomach. .\trophy of tongue. Autointoxication, intestinal. Calculus of pancreas. Cardiospasm. Caries of tooth. Cholangitis, acute. Cholangitis, chronic. Cholecystitis, acute. Cholecystitis, chronic. Cholelithiasis. Chyle cyst of mesentery. Chylous ascites, nonfllarial. Cirrhosis of liver, atrophic. Cirrhosis of liver, hypertrophic. Colitis, acute. Colitis, chronic. Concretions In salivary gland. Concretion in tonsil. Constipation. Deformity of liver, acquired. Deformity of palate, acquired. Deformity of stomach, acquired. Dilatation of esophagus. Dilatation of stomach, acute. Dilatation of stomach, chronic. Displacement of liver. Diverticulitis. Diverticulum of esophagus. Divertl(;nhim of intestines, acquired. Dnodenltis. Elongation of uvula. Enteritis, acute. Enteritis, chronic. Enterocolitis. Enterolith. Esophagitls. Fatty liver. Fermentation, Ka.strlc. Fermentation, Intestinal. Fissure of anus. Fistula, biliary. Fistula, fecal. Fistula in ano. Fistula of (salivary gland or duct). Foreign body in esophagus. Foreign body in intestines. Foreign body in pharnyx. Foreign body in rectum. Foreign body in stomach. . t Functional derangement of Uver. Gaseous tumor of parotid. Gastritis, acute catarrhal. Gastritis, chronic catarrhal. Gastritis, acute phlegmonous. Gastroduodenl tls. Gastroenteritis. Gastroptosis. Gingivitis. Glossitis, acute. Glo.ssitis, chronic. Hematemesis. Hemorrhage, intestinal. Hemorrhoids. Hyperchylia, gastric. Hypertrophy of tonsil. Hyperchlorhydria. Impacted feces. Inflammation of salivary gland. Nervous dyspepsia. Neurosis, intestinal. Neurosis of pharynx. Obstruction, acute intestinal. Obstruction, chronic intestinal. Obstruction of pancreatic duct. . Obstruction of portal vein. Pancreatitis, acute. Pancreatitis, chronic. Peritonitis, acute, general. Peritonitis, acute, local. Peritonitis, chronic, general. Peritonitis, chronic, local. Perihepatitis. Perversion of appetite. Pharyngitis, acute. Pharyngitis, chronic. Pneumophagia. Proctalgia. Proctitis. Prolap.sc of rectum. Pylephlebitis. Pyloric incontinence. Pylorospasm. Pyorrhoea alveolarls. Itl'gurgitation of stomach. Rumination ,, ,, ,, K K .lA •A MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 171 Class 111.— Dimaaes oi digestive system — Conlinued. Rupture of esophagus, spontaneous. Spasm of esophagus. Spasm of rectum. Splanchnoptosis. Sprue. Stenosis of gall duct. Stenosis of pylorus. Stomatitis. Stomatitis, gangrenous. Stricture of esophagus. Stricture of intestine. Stricture of pharynx. Stricture of rectum. Tonsillitis, acute follicular. Tonsillitis, chronic. Torsion of omentum. Ulcer of duodenum. Ulcer of intestines. Ulcer of mouth. Ulcer of rectum. Ulcer of stomach. Ulceromembranous angina. Vomiting, recurrent. Xerostomia. Class IV. — Diseasf^s of iluctless glands and spleen. Abscess of spleen. Acromegaly. Addison's disease. Cretinism. Exophthalmic goitre. Goitre. Hemorrhage into parathyroid gland. Hemorrhage into suprarenal gland. Infarct of spleen. Myxedema. Perisplenitis. Persistent thymus gland. Rupture of spleen, spontaneoiis. Splenitis, acute. Splenitis, chronic interstitial. Splenoptosis. i.jjji, iuodt; ; Thyroiditis, acute, - - - . r Thyroiditis, chronic. Class iV,— Diseases of ear. Ankylosis of ossicles. Caries of ossicle. Cerumen, accumulation of. ^ , ; Deafness. ,1; ."j,' Deformity of external ear, acquired. Eustachian salpingitis, acute. Eustachian salpingitis, chronic. Foreign body in auditory canal. Hematoma of external ear. nontrau- matic. Hemorrhage into labyrinth. Mastoiditis, acute. Mastoiditis, chronic. Myringitis, acute. Myringitis, chronic. Ossification of auricle. Otitis externa. Otitis interna, acute. Otitis interna, chronic. Otitis media, acute. Otitis media, chronic. Perichondritis of auricle. Class VI,— i^,i|Soip^ traumatic. 172 MANUAL FOR THE MEDICAL DEPARTMENT, IT. 8. NAVY. Class VI. — Diseases of eye and adnexa — Continued. Hordeolum. Hyperesthesia of retina. Hyperemia of conjunctiva. Hypernietropia. Hypopyon. Insufticiency of ocular muscle. Iridochoroiditis. Iridocyclitis. Iritis. Keratitis. Keratitis, phlyctenular. Keratoiritis. Leulioma. Myopia. Neuritis, optic. Neuroretinitis. Night blindness. Nystagmus. Opacity of vitreous humor. Ophthalmoplegia. Panophthalmitis. Paralysis of ocular muscle. Presbyopia. Pterygium. Retinitis. Scleritis, Snow blindness. Staphyloma of cornea. Stenosis of nasal duct. Stenosis of punctum lacrlmale. ''• Symblepharon. Synechia. Trachoma. Trichiasis. Ti^^d^. Ulcer of eye and adnexa. '^ Xerosis. -^* Class VII. — Diseases of ffenUo-urinary system (nonvcnercal). Abscess about urethra. Abscess of bladder wall. Abscess of Cowper's glands. Abscess of kidney. Abscess of kidney, perinephvitic Abscess of prostate gland. Abscess of scrotum. Adhesions, preputial. Albuminuria.. Atony of bladder. Atrophy of prostate. Atrophy of testicle. Bacteriuria. Balanoposthitls. Calculus in bladder. Calculus in prostate. Calculus in ureter, impacted. Calculus in urethra, impacted. Chylocele, nonfilarial. Chyluria, nonfilarial. Concretion In seminal vesical. Concretions, preputial. Congestion of kidney. Cystitis, acute. Cystitis, chronic. Cyst of kidney. Deformity of bladder, acquired. Deformity of penis, acquired. Deformity of urethra, acquired. Enlargement of prostate. Epidi,j/. Psychosis, senile. Psychosis, traumatic. Class XU.—Diseases of motor siistem. Amyotonia congenita. Ankylosis of joint. Arthritis, acute. Arthritis, chronic. Arthritis, deformans. Atrophy of (bone or cartilage). Atrophy of muscle. Bursitis, acute. Bursitis, chronic. Calcification of cartilage. Chondritis. Chondromalacia. Contracture of joint. Contracture of (muscle, fascia, tendon, or sheath). Coxa valga. Coxa vara. Cramp of muscle. Curvature of spine. Ganglion. Genu recurvatum. Genu valgum. Genu varum. Hallux valgus. Hallux varus. Hammer toe. Hemorrhage Into joint, nontraumatic. Hernia of (muscle, fascia, tendon, or sheath). Hypertrophy of bone. Leontiasis ossea. Loose body In joint. Loss of substance of (bone or carti- lage). Mallet finger. Meta tarsalgia. Myositis, acute. Myositis, chronic. Myositis, progressive ossifying. Myositis, traumatic ossifying. Myotonia, congenital. Necrosis. Ossification of cartilage, unqualilied. Osteitis deformans. Osteomalacia. Osteomyelitis, acute. Ostoomyelitis, chronic. Paralysis, muscle, Ischemic Periostitis, acute. Periostitis, chronic. Pes cavus. Pes planus. Talipes. Tenosynovitis. Trigger finger. Union of fracture, faulty. joitu etlL'o siniplex. Ingrowing nalU Intertrigo. Keratodermia. Keratosis. Lentigo. Leukodermia. Leukokeratosls. Lichen, planus. Lichen, ruber. Lupus, erythematous. Rlelanodermia. Miliaria. Milium. Molluscum contagiosum. Mycosis fungoides. Nevus. Onychauxis. Onychia. Onychoma. Pemphigus. Pityriasis rosea. Pityriasis simplex. Prurigo. I'ruritus. Psoriasis. Rhinoscleroma. Rosacea. Sclorodermla, .Scl)orrhoa. Sudamina. r\cer of skin. Urticaria. Urticaria pigmentosa. Wart. Xantlinnia. Xerodermia pigmentosa. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Class XVI. — HernioB. Hernia, epigastric Hernia, femoral. Hernia, inguinal. Hernia, internal. Hernia, ischiatic. Hernia, ischiorectaL Hernia, lumbar. Hernia, obturator. Hernia, umbilical. Hernia, ventral. Class XVII. — Miscellaneous diseases and conditions. Acidosis, nondiabetic Adiposis dolorosa. Ainhum. Amputation, stump. Amyloid disease. Anti-inoculation, unqualified. Beriberi. Cicatricial contraction. Cystinuria. Dentition. ^ Diabetes insipidus. Diabetes mellitus. Diagnosis undetermined- Erythromelalgia. Gangrene. Gigantism. Glycosuria. Gout, acute. Gout, chronic. Headache. Hemochromatosis. Hypertrophy of mammary gland. Insomnia. Llpemia. iMalformations, congenital Malingering. Malnutrition. Migraine. Mikulicz's disease. Milk sickness. Nausea marina. No disease. Nostalgia. Obesity. Ochronosis. Osteoarthropathy, hjT)ertrophic. Phantom tumor. Raynaud's disease. Rheumatism, chronic articular. Rheumatism, muscular. Rickets. Scurvy. Senility. Shock. Sinus. Tetany. Vertigo. Class XVIII. — Parasites {fungi and certain animal parasites). Abscess, entamebic, liver. Abscess, entamebic, unqualified. Actinomycosis. Ascarlasis. Aspergillosis. Blastomycosis. Coccidiosis. Cysticercus of brain. Cysticercus of liver. Cysticercus of lung. Cysticercus, unqualified. Dioctophyme renale. Discomycosis. Dracontiasis. Dysentery, balantidic. Dysentery, entamebic. Echinococcus. Erysipeloid, Erythrasma. Favus. 98601°— 17 12 Filariasis. Flagellate diarrhea. Larva migrans. IVIetastrongylus aprL Mucormycosis. Mycetoma. IMyiasis. Oxyuriasis. Paragonimiasis. Parameba hominis. Pediculosis. Piedra. Pinta. Pityriasis versicolor. Sarcopsiliasis. Scabies. Schistosomiasis, intestinal. Schistosomiasis, urinary. Sporotrichosis. Strongyloides, intestinal. 178 MANUAL POK TaV. MEDICAL DEPARTMENT, U. S. NAVY. Class XVin. — Pomsites {fvnfji nml certain animal parasite.^) — Continued. Strongjius, Gibsoni. Teniasis. Thrush. Trichiniasis. Trichophytosis. Adenoma. Angioma. Carcinoma. Chondroma. Cystoma. Endothelioma. Epithelioma. Fibroma. Glioma. Hypernephroma. Lipoma. Lymphangioma. Trychostrongylus insta bills. Trichuriasis. Trlchurls trlchiura. Trypanosomiasis. Uncinariasis. Class XIX. — Tumors. Lymphoma. Mixed benign tumor. Mixed malignant tumor. Myoma. Myxoma. Neuroma. Odontoma. Osteoma. Papilloma. Retention cyst. Sarcoma. Teratoma. Class XX. — Injuries. Abrasion. Air embolism. Avulsion. ■■^^■M^in ^^- Blood donor. Burn. (Castration. Compression. Contusion. Crush. Decapitation. Deprivation of water. Diagnosis undetermined. Dislocation. '■»''^' w*.Di-v5- Drowning. Electric shock. Emphysema. Epilation. Epiphyseal separa<-ion. Exhaustion, heat. Exhaustion, overexertion. Exhaustion, overexposui<'. Foreign body. Fracture, compound. Fracture, simple. Fracture of penis. Frostbite. Heat cramps. Hematocele, tunica vajfinHlTs. Hematoma. Hemorrhage into eyeball. Hemorrhage into joint. Hemorrhage under conjunctiva. Intracranial Injury. Intraspinal injury. Lightning stroke. Multiple injuries, <^xtreme. Powdered glass, Injury from swnlb'W- ing. Rupture (not hernia). Skin donor. Smoke inhalation. Sprain. Starvation. Strain. Strangulation. Strangulation of penis. Submersion. Sunburn. Sunstroke. Synovitis. Thermic fever. .djncl "{o Torsion, spermatio'^Hl. Urethral fever. Wound, gimshot. Wound, incised. Wound, lacerated. Wound, punctured. i^'fS. '»*nf .'f. Class XX I. — y^oisorts. Botulism. Greatoxlsin, Diagnosis undetermined. Insect sting. Lathyrlsni. Poison, anesthesia. I'oison (stnt*' <:ul •stance). MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. 179 2359. Section 11. — Diseases.' Navy class No. Interna- tional No. Abscess aboat rectum Abscess about urethra Abscess, entamebir, liver . . ._. Abscess, entamebic unquali fied Abscess of axilla Abscess of bladder wall Abscess of brain Abscess of Cowper's glands. . . Abscess of eye and adnexa — Abscess of kidney Abscess of kidney, perine- pliritic Abscess of larynx Abscess of liver Abscess of lung Abscess of lymph-node Abscess of nasal septum Abscess of omentum Abscess of pharynx Abscess of prostate gland Abscess of salivary gland. .... Abscess of scrotum Abscess of spleen ; Abscess of tongue Abscess, subphrenic Abscess, unqualified Absence of lens Vchylia gastrica Acidosis, nondiabetle , A.cnft Acromegaly Actinomycosis Addison's disease Adenoids Adenoma Adhesions about gall bladder . Adhesions about stomach Adhesions of epiglottis Adhesions of peritoneum Adhesions, preputial AdijJOsis dolorosa Aerogenes capsulatus Infec- tion AInhum A Ibuminuria Alopecia Alopecia areata A mauTosis A mblyopia Amputation stump Amyloid disease Amyotonia congenita Anemia of brain A neviia, perrudous Antmta, iimple Anemia, splenic Aneurism Aneurism, cirsoid Aneurism of heart Aneurism, varicose Aneurisma! varix Angina ludovici Angina ijeetoris Angiokeratoma Angioma Angiospastic edema. Anidrosis m VII XVIII XA'III X vn xin VII VI vu VIT xrv III XTV X xrv m III VII III VII rv III in VIII VI III XVII XV IV xvin IV xrv XIX ni III XIV III VII XVII VIII XVII ! VII I XV XV I VI ! VI ! XVII j xvn I XII I xni ; 'I I I n II II II n in II XV XIX xin XV Navy class No. Interna- tional Ko. HOB 125 115 107 84 124 60 127 75C 122 122 87 115 98 84 86 117 100 126 99B 127 116 993 118 144 75C 103 55 145C 55 25A 52 86 46 115 117 87 117 127 55 20 149 120 145C 145C 75C 75C 149 55 149 74 54 .■)4 .".4 si .si 79C •SI .S3 100 SO 145C 46 74 145C Ankyloblepharon .'. . .;. Ankylosis of arytenoid carti- lage jVnkylosis of jomt Ankylosis of ossicles Aiiosmia Anthrax Anti-inoculation, unqualif?ed.l Aortitis | A phasia A poplczu '•'• .'.'.".■■ Appendicitis, acute. . . .'. .'.■.■.". - Appendicitis, chronic. .' Arterial sclerosis, cerebral ' Arterial sclerosis, general \ Arthritis, acute .'....' Arthritis, chronic '. . . . I Arthritis, deformans ... Artificial anus Ascariasis ...'■ Aspergillosis Asthma Astigmatism Ataxia, hereditary | Athetosis Atony o) bladder..,, Atony of stomach ; Atrophy of (boneorcartilage). Atrophy of heart Atrophy ofliver, acute yellow . Atrophy of muscle Atrophy of optic nerrt Atrophy of pancreas Atrophy of prostate Atrophy of skin - - . Atrophy of stomach ■.■.... Atrophy of testicle ..•.■.... Atrophy of tongue ..■."..:.. I Autointoxication, intestinal. . I Bacteriuria j Balanoposthit is I Beriberi j Blastomycosis • - - • Blepharitis • - - ■ Bradycardia I Bromidrosis I Bronchiectasis • . I Bronchitis, acute I Bronchitis, chronic Bronchitis, fibrinous Bursitis, acute Bursitis , chronic - - Caisson disease Calcification of cartilage Calculus in bladder Calculus in prostate Calculus in ureter, impacted. Calculus in urethra, impacted Calculus of pancreas Callositas .■.■.... Carbuncle ...V.'.. Carcinoma .",■.■... Cardiospasm .". . . .'- Caries of ossicle '. -- - - Caries of tooth ..■..'. Carrier, comma bacillus...'. . . Carrier, diphtheria bacillus . . Carrier, typhoid bacillus VI XIV xn V XIV vm xvn II XIII xm III HI XIII II xn XII XII III XVIII xvm xrv VI xm xin VII ni xn 11 in xn VI III VII XV m vn in III VII VII xvn xvin VI II XV XIV XIV XIV XIV XII XII xm xn VII VII \n\ Nil III XV VIII XIX m - V m VIII VTII VITT ' lt«ms in Italics are symptoms <)uly. Sec par. 2329 (6;. 75C 87 147 76 86 22 1.89 .\ 81 74 64 108 lOS 81 81 147 1!7 ISA 109 107 2.iB 96 750 63 74 124 103 146 79C HI 149 75C 118 126 145C 103 127 99B llOB 124 127 27 25B 75C 85 145C 9^ 89 90 90 149 149 74 149 123 126 12?. 123 118 145C 143 3»-45 103 76 99A 12a 9b. -f> 180 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Section 11. — Diseases — Continued. Catale] )s y Cataract Cellulitis Cerelirospinal fe". er Ceninien, accuiBulittiou of Chalazion Chancroid Chancroid of lym^-node (thicken pox Chilblain Chloasma Cholanpitis, acute Cholangitis; chronic Cholecystitis, acute Cholecystitis, chronic Cholelithiasis Cholera, asiatic Chondritis Chondroma Chondromalacia Chorea Chores, chronic progressive . . . Choroiditis Chromidrosis Chyle cyst of mesentery Chyloce"lc, nonfllarial Chylolhorax Chylous ascites, nonfilarial..... Chyluria, nonfllarial Cicatricial contraction Cicatrix of slan Cirrhosis of liver, atrophic Cirrhosis of liver, hypertrophic Clavus Coccidiosis f Colitis, acute Colitis, clironic Color Mindness Comedo Concretion in salivary pland . . Concretion in seminal vescicle Concretion in tonsil Concretion, preputial Congestion of kidney Congestion of lung, acute Conjunct i\itis, acute Conjunctivitis, chronic CJonjuncth itis, phlyctenular. . Constipation Constitutional inferiority Constitutional psychopathic state Contracture of joint Contra< ture of (muscle, fascia, tendon, or sheath) Comu Coxa valga Coxa vara Cramp o( liliarv muscle Cramp of muscle Cretinism Curvalure of spine Cyclltis Cysticercus of liraln Cysticercus of liver Cysticer( us of lung Cystii'ercus, imquulified Cystinuria Cystitis, acute (nonvcnereal) . . Cystiliii, chronic (nonvenrreal) Navv class No. xm VI VIII ^'III V VI IX IX VIII XV XV III III in ni HI VIII XII XIX XII XIII XIII VI XV III VII XIV HI vn xvn XV III III XV XVIII III III VI XV III VII III VII VII XIV VI VI VI HI XI XI XII XII XV XII XII VI XII IV XII VI XV in XVIII XVIII XVIII XVII VII VII Interna- tional No. 74 75C 144 61a 7r. 75C 38.\ 38.\ 19 14oC 145C 115 ll.'S 115 115 114 12 149 46 147 72 74 75C 145C 84 S4 84 84 121 145C 145C 113 113 145C 107 105 B lO.'iB 75C 145C 99 B 127 100 127 122 94 75A 75 \ 75 A. HOB 68 68 147 149 145C 147 147 75C 149 74 3CC 75C 107 107 107 107 122 124 124 Cyst of brain Cyst of kidney Cystoma Dacryoadenitis Uacryocystitis. . - Deafnfss Deformity of. bladder, ac- quired Deformity of external ear, ac- quired Deformity of liver, acquired. . Deformity ol nose, acquired. . Deformity of palate, acquired. Deformity of penis, acquired . . Deformity of stomach, ac- quired Deformity of urethra, ac- (luired Dementia, cause unknown Dementia, paralytica Dementia, praecox Dengue Dentition Dermatitis, gangrenosa Dennat it is, unqualified Dermatitis, venenata Detachment of choroid Detachment of retina Deviation of nasal septum Diabetes insipidus Diabetes mellitus Diagnosis, undetermined Dilatation, acute cardiac Dilatation, chronic cardiac Dilatation of esophagus Dilatation of stomach, acute. . Dilatation of stomach, chronic. . Dioctophyme renale , Diphtheria , Discomycosis , Di-splacement of liver , Diverticulitis ; Diverticulum of esophagus. . . Diverticulum of intestines, ac- quired Dracontiiusis Duodenitis Dysentery, bacillary Dysentery, balantidic Dysentery, entamebic Dysenterj, uaclassilied Dysidrosis Dystrophy, progressive mus- cular. . .' Echinococcus Ecthyma Ectropion Eczema Edema of glottis Edema oj luiiy Elejihantiasis, nonfllarial Elongation of uvula Embolism Emphysema, pulmonary Enieplialitis, acute Endocarditis, acute Endocarditis, rhronic Endothelioma EnlargetiiiMit of prostate Enteritis, acute Kavy I Intema- class No. tional No. XIII VII XIX VI VI V VII V III XIV HI VII HI VH XI XI XI VIII XVII XV XV XV VI VI XIV XVII XVII XVII II u III HI HI XVIII VIII XV HI III HI HI HI XVIII III VHI XVIII XVIII ^'HI XV XIII XVIII XV VI XV XIV XIV X HI H xrv XIH II 11 XIX vn HI 74 132 46 75C 75C 76 134 76 115 86 146 127 103 125 68 67 68 19 189A 142 145C 145C 75C 75C 86 55 50 189A 79C 79C 101 103 103 122 9 25B 115 HOB I'Jl HOB 14.10 105 B 14A HB lie 140 145C 03 107 145C 75C M5C 87 •M H5t' 100 82 97 t'>Q 7S 79H 39-43 126 105U MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 181 *■ Section 11. — Diseases — Continued. Navy class No. Enteritis, ohronic Enterocolitis Enterolith Entropion Epidiaymitis, acute (non ve- nereal) Epididymitis, chronic (non- venereal) Epiglottiditis Epilepsy Epilepsy, Jacksonian Epiphora EpUtaxis Epithelioma Erysipelas Erysipeloid Erythema multiforme Erythema nodosum Erythema scarlatiniforme .... Erythema simplex Erythrasma Erythromelalgia Esophagitis Eustachian salpingitis, acute.. Eustachian salpingitLs, chronic Exophthalmic goiter Extravasation of urine Fatty heart Fatly liver Faviis Fermentation, gastric Fermentation, intestinal Fever of unknown cause Fibroma Filariasis Fissure of anus Fissm'e of sViii Fistula, biliary Fistula, fecal Fistula in ano Fistula, intestino-ureteral Fistula, intestino-vesical Fistula of bladder Fistula of kidney Fistula of larchrymal sac Fistula of larynx Fistula of nasal duct Fistula of salivary (gland or duct) Fistula of thoracic duct Fistula of trachea Fistula of ureter Fistula of urethra Fistula, recto-urethral Fistula, thoraco-intestinal . . . Fistula, uretero-vesical Fistula, urethro-vesical Flagellate diarrhea Folliculitis dccalvans Foot-and-mouth disease Foreign body in auditory canal Foreign body in bladder Foreign body in bronchus . . . Foreign body in esophagus . . . Foreign body in frontal sinus. Foreign body in intestines — Foreign body in larynx Foreign body in maxillary sinus Foreign body in nasal passage. Ill III III VI VII VII XIV XIII XIII VI XIV XIX VIII XVIII XV XV XV XV XV III XVII III V V IV VII II III XVIII III III VIII XIX XVIII ni XV III III III VII VII VII VII VI XIV VI III X XIV VII VII VII XIV vn VII XVIII XV VIII V VII xrv III XIV III xrv xrv XIV Interna- tional No. Navy Intema- class No. tional No. 105B 105B HOB 75C 127 127. 87 69 74 75C 85 39-45 18 25B 145C 145C 145C 145" 25B 142 101 76 76 51 125 790 113 25B 103 105B 189A 46 19 llOA 145' 115 llOA llOA 125 125 125 122 75C 87 75C 99B 84 98 125 125 125 93 125 125 105B 145t' 19 76 124 186 101 146 HOB 186 146 186 Foreign body in pharynx Foreign body in rectum Foreign body in stomach Foreign body in trachea Foreign body in ureter Foreign body in urethra Functional derangement of Uver Furunc ulosis Ganglion Gangosa Gangrene Gangrene, infective Gangrene of lung Gaseous tumor of parotid Gastritis, acute catarrhal Gastritis, chronic catarrhal .. Gastritis, acute phlegmonous. Gastroduodenitis Gastroenteritis Gastropt osis Genu recurvatum Genu valgum Genu varum German measles Gigantism Gingivitis Glanders Glaucoma, acute Glaucoma, chronic , Glioma Glossitis, acute Glossitis, chronic Glycosuria Goiter Gonecystitis, acute (nonvene- real) Gonecystitis, chronic (nonve- nereal) Gonococcus toleciion of con- junctiva Gonococcus infection of joints. Gonococcus infection of lymph-node Gonococcus infection of ure- thra -• Gonococcus infection, unqual- ified Gout, acute Gout, chronic Hallux valgus Hallux varus Hammer toe Hay fever ■ Headache • Heart block Hematemesis Hematocele of spermatic cord Hematoma of external ear, nontraumatic Hematoma of spermatic cord, nontraumatic Hematomye'.ia Hematorrhachis Hemataria, renal Hemianopsia Hemiplegia, old Hemochromatosis Hemoglobinuria Hemoglobinuric fever ni III III XIV VII VII III VIII XII VIII XVII VIII XIV III III III III III III III XII xn XII VIII XVII III VIII VI VI XIX m III XVII IV vn VII IX IX IX IX IX XVII xvn XII XII XII XIV XVII II III VII VII XIII XIII VII VI XIII XVII VII VIII 186 HOB 103 186 122 125 115 143 149 19 142 142 95 99B 103 1(B 103 105 B 105B 103 147 147 147 19 55 99A 21 75C 750 46 99B 99B 50 127 38B 38B 38B 38B 38B 48C 48C 149 149 149 98 189A 85 las 127 76 127 63 63 122 75C 60 55 122 19 IS '2 MA^■^rA^. 1*PR THE MEDICAL DEPARrMEiST, U. S. iJAVV. Section 11. — Diseases — Continued. .« Navy class No. Uemoi.tiilia Hemoptt/sif Hemorrhage, epidural JJi iiiorrhaje, imutinal Hemorrhage into ccnbellum.. Hemorrliase into cerebrum . . . Hemorrhage Into joint, non- traumatic Hemorrhage into labyrinth . . . Hemorrhage into medulla. . . . Hemorrhage into parathyroid gland Hemorrhage into pons Hcmon'iagi i(iio relina Hemorrhage into suprarenal gland Hemorrhage, subdural Hemorrhage under conjunctiva, Tumtraumatic Hemorrhoids Hemoihorai Hernia, epigastrif Hernia, femora! '. ". Hernia, inguinal - Hernia, internal Hernia, ischiatlc Hernia, ischiorectal '. -' — Hernia, lumbar Hernia, obturator Hernia of brain Hernia of lung Hernia of (muscle, fascia, ten- don, or sheath) — Hernia, umbilical -■••.-'■• Hernia, ventral Herpes •-■ EUxmigh Histoplasmosis Hodgicin's disease Hordeolum Hydrocele of spermatic cord . . Hydrocele of tunica vagiiui'.is.. Hydrocephalus, acquired Hydronephrosis Hyperestnesia of retina Hyperchylia, gastric Hyperemia of conjunctiva — Hyperidrosis Hypermetropia Hypernephroma Hypertrophy of bone tiypntro^hy of heart Hypertrophy of mammary gland H ypertrophy of tonsU Hypochlorhydria Hypochotidriasis Hypopyon H ysteria Ichthyosis Imbecilitv Impactoa feces Impetigo contagiosa Impetigo herpeliformis Impetigo simplo.x Impotence Incnniinmce of urine Infarct of Widney Infarct of lung Infarct ol spleen. ...,,,,.,... I XIV XIII III XIII XIII xn V xm IV xni VI IV XIII VI ni xrv XVI XVI x\a XVI XVI XVI XVI XVI XIII xrv XII XVI XVI XV xm vui X VI VII VII XIII VII VI in VI XV VI XIX xu n Kvn III III XIII VI XIII XV XI in XV XV XV VIT VII VII XIV .IV Interna- tional No. 55 98 64 HOB G4 H4 147 76 64 85 64 75C 85 64 76C 83 93 109 109 109 109 109 109 109 109 74 149 109 109 145C 74 55 53A 75C 127 127 74 122 75C 103 75C 145C 75C 45E 146 79C 133 100 103 6S 75C 73A i45r 74 lion 1451 145C 145 127 124 m 94 IIU Inflammation of salivary gland Inflammation of spermatic cord Influenza Ingrowing nail Ivto mnia InsufTiciency of ocular muscle. Intertrigo Iridochoroiditit Iridocyclitis Iritis Jaundice, acute infecti% r; (Weil's disease) Kala-azar Keratitis KeratitLs, phlyctenular Keratodermia Koratoiritis Keratosis Lan-a migrans Laryngitis, acute Laryngitis, chroni? Lentigo Leontiasis ossea Leprosy Leukemia Loukodermia Leukokeratosis Leukoma Lichen, planus Lichen, ruber , Lipemia Lipoma Locomotor ataxia Loose bodv in joint Loss of substance of (bone or cartilage) Lupus, erythematosus I Lymphacfenltls, acute I Lymphadenitis, chronic , j LymphangiectasLs Lymphangioma Lymphangitis Lymphoma Malaria Malformations, congenital. . . Malingering Mallet linger Malnutrition Mastoiditis, acute Mastoiditis, chronic Masturbation Measles Mediastino-pericarditis MelannhoMa, involutional Melaiiodermia M^niftre's disease Meningitis, cerebral MenlngilLs, a>rebrospinal.... Meningitis, spinal Motastrongylus apri Metatarsalgia Migraine Mikulicz's disease Miliaria Miliary fever Milium Milk slckn&ss Mixed benign tumor Navy class No. Interna- tional No. m VII VIII XV XVII VI XV VI VI VI VIII VIII VI VI XV VI XV XVIIT XIV xrv XV XII VIII I XV XV VI XV XV xvn XIX XIII XII 99B 127 10 145C 1S9A 75C 145C' 75C 75C 75C 111 54 75C- 75C 145C 75C 145C 145C 145C 146 17 5.3( 145( 145C- 75C 145' 145f 121 4b 62 147 xn 14t. XV 1451 X 84 X 8-1 X 84 XIX 4b X 84 XIX 46 VUI 4 XVII 150 XVII 189B XII 149 XV u 189A V 146 V 146 VII 74 VIII 6 II 77 XI 68 XV 145( XIII 76 XIII 61 XIII 61 XIII 61 XVIII 107 XI I 149 XVII 74 XV 11 g9U XV 145( VIII U XV 145C xvn 19 XJX 46 MANUAL FOR THE MEDICAL DEPARTMENT, U. S, NAVV. 183 Section 11. — Diseases — Continued. Mixed malignant tumor Molluscum contagiosum Mucormycosis Mumps Myasthenia gravis Mycetoma Mycosis f ungoides Myelitis, disseminated Myelitis, transverse Myiasis Myocarditis, acute Myocarditis, chronic. Myoma Myopia Myositis, acute Myositis, chronic Myositis, progressive ossifying Myositis, traumatic ossifying. . Myotonia congenita Myringitis, acute Myrinsitis, chronic Myxedema Myxoma Nausea marina Necrosis Nephralgia Nephritis, acute Nephritis, chronic interstitial. Nephritis, chronic parenchy- matous Nephritis, disseminated, sup- purative Nephrolithiasis Nephroptosis Nervous dyspepsia Neuralgia Neurasthenia Neuritis Neuritis, multiple Neuritis, optic Neuroma Neuroretinitis Neurosis, intestinal Neurosis, occupational Neurosis of bladder Neurosis of la rynx Neurosis of pharynx Neurosis, traumatic Nevus Night blindness No disease Nostalgia Nystagmus Obesity Obstruct ion , acute intestinal . . Obstruction, chronic intestinal Obstruction of pancreatic duct Obstruction oj portal vein Ochronosis Odontoma Onychauxis Onych ia Onychoma Opacity of vitreous humor Ophthalmoplegia Orchitis, acute (nonvenereal). Orchitis.chronic (nonvenereal)j Oriental sore I Ossification of auricle ] Ossification of cartilage, uiv- qualified I Navy class No. XIX XV xvin VIII XIII XVIII XV XIII XIII XVIII II II XIX VI XII XII XII XII XII V V IV XIX XVII XII VII VII vn vn vn VII VII III XIII XIII xm XIII VI XIX VI m xni vn XIV III XIII XV VI XVII XVII VI XVII III III III III XVII XIX XV XV XV VI VI VII VII vm V XII Interna- tional No. 39-45 145C 25B 19 63 25B 25B 63 63 145 ' 78 79,; 40 75-; 149 149 149 149 149 76 76 189 A. 146 122 119 120 120 122 123 122 103 73 B 74 73 B 73 B 76C 46 75C IlOB 74 124 87 100 74 150 75C 189A 68 75C 65 109 109 118 115 55 46 145C 145C 145C 75C 75C 127 127 145C 76 149 Ossification of larynx Ossification of tracheal rtogs.. Osteitis deformans Osteoarthropathy, hypertro- phic Osteoma Osteomalacia Osteomyelitis , acute Osteomyelitis, chjonic Otitis externa Otitis interna, acute ..'.. Otitis interna, chronic Otitis media, acute Otitis media, chronic , Oxyuriasis Ozena Pachymeningitis, cerebral Pachymeningitis, spinal , Palpitation, cardiac Pancreatitis, acute Pancreatitis, chronic Panophthalmitis Papilloma Pappataci fever Paragonimiasis Paralysis, acute ascending Paralysis, agitans Paralysis, Brown-Sequard's.. Paralysis of nerve Paralysis of ocular muscle Paralysis of vocal cords Paralysis, muscle, ischemic. . . Parameba hominis Paramyoclonus multiplex Paranoia Paranoiac state Paraphimosis Paraplegia, ataxic Paratyphoid fever Pediculosis Pellagra Pemphigus Perforated nasal septum Pericarditis Pericardium, adherent Perichondritis of auricle Perichondritis of larynx Perihepatitis Periostitis, acute Periostitis, chronic Perisplenitis Peritonitis, acute, general Peritonitis, acute, local Perilovilis, chronic, general Peritovitis, chronic, local Persistent thymus gland Perversion ol appetite Pes ca vus Pes planus Phantom tumor Pharyngitis, acute Pharyngitis, clironie Phimosis Phlebitis Piedf a Pinta Pityriasis rosea Pityriasis simplex Pityriasis versicolor Plague Pleurisy, acute fibrinous Navy class No. XIV XIV XII xvn XIX XII XII XII v v v V V xvni XIV XIII XIII II III III VI XIX VIII XVIII XIII xin XIII XIII VI XIV XII XVIII xm XI XI VII XIII VIII XVIII VIII XV xrv II II v xrv in XII xn IV in III III III IV III xu XII XVII III III VII II xvin XVIII XV XV XVIII VIII xiv Interna- tional No. 146 36B 46 36A 146 146 76 76 76 76 76 107 86 61 61 85 118 118 75C 46 19 107 63 63 63 66 75C 74 149 107 74 68 68 127 66 1 145(: 26 145C 86 77 77 76 87 115 146 146 116 117 117 117 117 84 103 149 149 189B 100 100 127 83 2aB 253 145C 145C 25B 15 03 184 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Section 11. — Diseases — Continued. Plenrisy, chronie fibrinous Pleurisy, serofibrinous Pleurisy, suppumtive Pleuritic adiiesions Pneumatocele capitis Pneumonia, broncho- Pneumonia, interstitial Pneumonia, lobar Pneumonoconiosis Pneumopericardium Pneumophagia Pnevmothorai Poliomyelitis, acute anterior.. Poliomyelitis,clironic anterior Poliomyelitis, acute bulbar... Polycyihcmin, chronic Polypus, nasal Presbyopia Proctalgia Proctitis Prolapse of rectum Prostatitis,acute(nonven(!real> Prostatitis, chronic (nonvene- real) Prurigo Pruritus Psoriasis Psychasthenia Psychosis, due to organic brain disease Psychosis, epileptic Psychosis (exhaustive, infect- ive, and toxic) Psychosis, hysterical Psychosis, intoxication Psychosis, manic doj>ressive. . Psychosis, polyneuritic Psychosis, senile Psychosis, traumatic Pterygium Purpura Purpura, hemorrhagic Pyelitis Pyelonephritis I*yeleph lebitis Pyloric incontinence Pylorospasm Pyopneiimonericardium Pyopneumntnoraz Pyorrhoea, alveolar Rabies Raynaud's disease Redundant prepuce Redimdant scrotum Regurgitation of stomach Relapsing (over Retention cyst Retinitis Jlheumatic fever, acute liheumatir lever, subacute. . . lUieurnatism, chronic articu- lar Rheumatism, muscular Rhinitis, acute Rhinitis, atroi)hic Rhinitis, hypertrophic Rhinolith Rhinoscleroma Rickets Rocky Nfountain spot ted fever. Rosacea Navy class No. Interna- tional No. XIV gs XIV 93 XIV 93 XIV 93 XIV 145C; XIV 91 XIV 98 XIV 92 XIV 98 II 77 III 103 XIV 93 VIII 63 VIII 63 VIII 63 I 55 XIV 46 VI 75C III 110 A III llOA III HOB VII 126 VII 126 XV 145C XV 145C XV 145C XI 68 XI 74 XI 69 XI 68 XI 73A XI 68 XI 68 XI 68 XI 154A XI 68 VI 75C I 55 I 55 VII 122 VII 122 III 83 III 103 III 103 11 77 XIV 93 111 99A \11I 23 XVII 142 Vll 127 VII 127 III 103 VIII 3B XIX 46 VI 75C Vlll 47 VIII 47 XVII 48B XVII 149 XIV 86 XIV 86 XIV 86 XIV 86 XV 86 XVII 360 VIII 19 XV 145C Rumination Rupture of esophagus, spon- taneous Rupture of heart, spon tancous Rupture of spleen, spontane- ous Sarcoma , Sarcopsiliasis , Scabies Scarlet fever Schistosomiasis, intestinal Schistosomiasis, urinary Scleritis Scleroderma Sclerosis, amyotroi)hic lateral Sclerosis, disseminated Sclerosis, lateral Sclorosisofcorpuscavemosum Scurvy Seborrhea Seminal emisrions Senility , Septicemia Shock , Sinus Sinusitis, ethmoidal , Sinusitis, frontal , Sinusitis, maxillary Sinusitis, sphenoidal , Smallpox , Snov/ blindness , Somnambulism Spasm haliit Spasm nodding , Spasm of esophagus Spasm 0/ rectum , Spasm saltatory; Spermatocele Spermatorrhea Splanchnoptosis Splenitis, acute , Splenitis, chronic interstitial.. Splenoptosis Sporotrichosis Sprue Spur on nasal septum Stammering Staphyloma of cornea Status lymphaticus Stenoxis of brunch us Stenosis of gall-duct Stenosis of lir;ini Stenosis of nasal duct Stenosis ofjninctum lacrimale. Stenosis of pi/loru-s Stenosis of trachea Sterility Stoniat i lis Stomatitis, pangreiious Stricture of rsophagns Stricture of inUsfinf Stricture of pharynx Stricture of rectum Stricture of ureter Stricture of urethra Strongyloides, intestinal Strongylus gibsoni Stuttering Sudamina Suppression of urine Navy class f5o. lU Interna- tional No. 103 III 101 II 79C IV 116 XIX 39-45 XVIII 145C XVIII 145B VIII 7 XVIII 107 XVIII 122 VI 75C XV 145C XIII 63 XIII C3 XIII 63 VII 127 XVII 49 XV 145C VII 127 XVII 154B VIII 20 XVII 189A XVII 145C XIV 146 XIV 146 XIV 146 XIV 146 VIII 5 VI 75C XIII 74 XIII 74 XIII 74 111 101 III HOB XIII 74 VII 127 VII 127 HI HOB IV 116 IV 116 IV 116 XVIII 25B III HOB XIV 86 XUI 74 VI 760 X 84 XIV 98 111 115 XIV 87 VI 750 VI 750 in 103 XIV 08 VII 127 III 99B III 142 III 101 III 109 III 100 Ttl HOB VII 122 vir 123 XVIII 107 XVIII 107 XIU 74 XV 14.50 VII 124 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 185 Section 11. — Diseases — Continued, Symblepharon Synechia Syphilis Syringomyelia Tachycardia Talipes Teriasis Tenosynovitis Teratoma Tetanus Tetany Thrombosis Thrush Thyroiditis, acut« Thyroiditis, chronic Tic, convulsive Tic, coordinated Tic, psychical Tonsilitis, acute follicular TonsUitis, chronic Torsion of omentum Torsion of spermatic cord, nontraumatic Tracheitis Tracheocele Trachoma Trichiasis Trichiniasis Trichophytosis Trichostrbngylus instabilis Trichuriasis Trichuris trichiura Trigger finger Trypanosomiasis Tuberculosis , abdom inal Tuberculosis, acute broncho- pneumonic Tuberculosis, acute general . . . Tuberculosis, acute pneu- monic Tuberculosis, acute pulmon- ary miliary Tuberculosis, chronic pul- monary Tuberculosis of bronchus Tuberculosis of joint Tuberculosis of larynx Tuberculosis of pleura Navy class No. VI VI IX XIII II XII XVIII XII XIX VIII XVII II XVIII IV IV XIII XIII XIII III III in VII XIV xrv VI VI xvin XVIII XVIII XVIII XVIII XII XVIII VIII VIII vni vin vin vra VIIi VIII VIII VIII Interna- tional No. 75C 75C 37 63 85 149 107 149 46 24 74 82 99B 74 74 74 100 100 118 127 75B 75C 107 145A 107 107 107 149 65 31 29 29 Tuberculosis of spinal column Tuberculosis of trachea Tuberculosis unqualified Tuberculous meningitis Typhoid fever Typhus fever Ulcer of bladder Ulcer of bronchus Ulcer of duodenum Ulcer of epidottis Ulcer of eye and adnexa Ulcer of intestines Ulcer of mouth Ulcer of nasal passage. Ulcer of rectum Ulcer of skin Ulcer of stomach Ulcer of trachea Ulceromembranous angina Uncinariasis Undulant fever Union of fracture faulty Ureteral colic Ureteritis Urethritis, acute (nonven- ereal) Urethritis, chronic (noavon- ereal) Urticaria Urt icaria pigmentosa Vaccinia Valvular disease, chronic car- diac Varicocele Varix Veldt sore Verruca peruana Vertigo Vom iting, recurrent Wart ^V'^looping cough Xanthoma Xeroderma pigmentosa Xerosis Xerostomia Yaws Yellow fever Z oster Navy class No. Vin VIII vin VIII VIII VIII VII XIV III XIV VI III III XIV III XV in XIV III XVIII VIII XII vn VII VII VII XV XV VIII II VII II VIII VIII XVII m XV VIII XV XV VI III VIII VIII XIII Interna- tional No. 32 28 34 30 1 2 124 9S 105A 87 75C 105B 99B 86 HOB 145C 102 98 100 108 3A 146 123 122 125 125 146C 145C 19 79A 83 83 145C 55 189A 103 145C 8 14.5C 145C 75C 99B 19 16 145C 2360. Section 12. — Injury (Wounds, etc.). Injury. Abrasion Cstate site) Air embolism (state site) Avulsion (state part) Blood donor Bum (state site) Castration, traumatic Compression (state part). Contusion (state part) . . . Crush (state part) Decapitation Deprivation of water Navy Interna- class No. tional No. XX 186 XX 186 XX 186 .XX 189B XX 167 XX 1S6 XX 186 XX 186 XX 186 XX 186 XX 177B Injury. Diagnosis undetermined Dislocation (state articulation) Drowning (fatal submersion).. Electric shuck, injury from. . . Emphysema,traumatic (state site) Epilation, traumatic (state site) Epiphyseal separation (state bone) Exhaustion from heat Navy class No. XX XX XX XX XX XX XX XX Interna- tional No. 185A 169 B 181 1S6 186 1850 179A 186 MANUAL POB THE MEDICAL DEPARTMENT, U. S. NAVY. Section 12. — Injubt (Wounds, istc.) — Continued. Injwy. Na%'y class No. Exhaustion from overexert !on Exhaustion from overexposure Foreign body, traumatic (state site) Fracture (state bone), com- pound Fracture (state bone), simple Fracture of penis Frostbite (state part) Heat cramps Hematocele, tunica vaginalis, traumatic Hematoma (state site), trau- matic Hemorrhage into eyeball, traumatic Ilemorrhaee Into (state) joint, traumatic Hemorrhage under conjuno- tlva, traumatic Intracranial injury Intraspinal Injury l-ightning strok-e Multiple injuries, extreme Powdered glass. Injury from I swallowing XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX Interna- tional No. 177A 177A 186 1850 185C 186 178 179A 127 186 186 186 186 186 180 186 186 Injury. I Navy class No. Rupture (state organ or part), traumatic (not to be uicd for hemiiB, q. v., under dis- . eases) Skin donor Smoice inhalation ,. . . Sprain (state joint) Starvation Strain (state muscle) , I Strangulation ; Strangulation of penis ' Submersion (nonfatal) Sunburn (state site) Sunstroke Synovitis (state joint), trau- matic Thermic fever Torsion, spermatic cord, trau- matic Urethal fever, traumatic Wound, gunshot (state site).. Wound, incised (state site). . . Wound, lacerated (state site).. Woimd, punctured (state site; XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX XX Interna- tional No. 18«i 189B 16815 ISoll 177Ii 186 186 186 169A 167 179B 186 179A 186 12i-. . 170 171 186 171 23C1. Section 13. — Injury (Poisons). Poison. Botulism Creatoxism Diagnosis undetermined Insect sting..... l^athyrism Navy class No. XXI XXI XXI XXI XXI Interna- tional No. 164 164 165A 69 Poison. Poison (state anaesthetic), ansethesia Poison (state substance and whether acute or chronic). . Navy class No. XXI XXI Interna- tional No. 16.SB .Section 14.- -Instructions Rexating to the Preparation of Statistical Re- poet (Form K). 2871. It shall be prepared and forwarded with Forms F (rough) and F, for a whole or fraction of the quarters ending March 31, June 30, September 30, and December 31 of each year, and when a hospital, ship, or station is placed out of commission. 2372. It shall be typewritten and a copy retained for the transmitting oflice flies. A copy shall be forwarded to the senior fleet or siiuadron surgeon when serving In a fleet or squadron. lUbbDU copy to be forwarded to the bureau. 2373. If there have been " no sick " during the period covered by this report, it shall be so stated In the space under "disabilities." 2876. The report shall include all offlcers and men of the Navy and Marine. Corps, and tho.se of the native and insular forces on the active list; not super- numeraries (retired ofHcers and men, officers and men of the Naval Auxiliary .Service and Nur.so Corps (female), and others). A separate Form K for super- numeraries Is not required. 2377. " Date commlss^loned " shall always be carefully statetl. MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. 187 237S. '■ Date out of commission " will be eatered as occasion requires, other- wise left blank. 2379. ''Average complement " shall be obtained by dividing tlie total number oX daily rations issued and commuted during the quarter or fraction of a quarter embraced in this report by the number of days in the quarter or frac- tion of the quarter, as the case may be, but the average number of officers to whom rations are not allovped must be addeonding to one fifteenth of the weight of the body should be injected into the arterial circuit (allow 493.50 mils to 1 pound) 08 [ Y CHAPTER 14. 'SANITARY REGUTATIONS AND REPORTS AND SANITARY DUTIES. Section 1. — Navt Reqitlations and Naval Instructions Relating to the Sanitabt Duties of the Medical Depabtment. 2501. The Medical Department is charged with inspecting the sanitary con- ditions of the Navy and making recommendations in reference thereto ; advising the department regarding sanitary features of ships, selection of hygienic sites for and hygienic construction of buildings, barracks, and camps ; advising about water supplies and drainage, clothing and food, in so far as these influence health, and safeguarding the personnel by employment of the best methods of hygiene and sanitation afloat and ashore. R 133; R 2901 (1). 2602. The Red Cross to constitute part of sanitary service of uaval forces. R 3861 (1). Section 2. — ^Naval Instructions Relating to the Sanitary Duties of the Commander in Chief. 2511. To regulate sanitary duties in instructions to his command. I 902. 2512. To inspect hospitals and hospital ships within his command. (R 2918) ; I 908. 2513. To report infectious or contagious diseases among ships of fleet. I 916 (3)r. 2514. Yearly report to contain sanitary condition of command, percentage of sick, number of deaths, and number sent to hospital and invalided home. I 916 i4)d. 2516. Precautions on unhealthful statioas. I 952 (1). 2516. Health of ports visited. I 952 (2), 2517. Restriction or deprivation of liberty. I 952 (2)o. 2518. Re.striction of communication. I 9-52 (2)6. 2519. Restriction of supplies. I 952 (2)c. 2520. Modification of routine and drills. I 952 (2)d. 2521. Control of conditions affecting health. I 9.^2 (2)0. 2522. Precautions in Tropics. 1952 (S). 2523. Anchorage in Infected ports. I 952 (4). 2524. Sanitary instructions of department to be observed. I 952 (5). 2526. Precautions to be taken to preserve health of troops embarked. R 1631. Section 3. — ^Navy Regulations and Naval Instructions Relating to the Sanitary Duties of the Commanding Officer. 2631. He shall frequently consult with the medical officer In regard to the sanitary condition of the crew. R 20 (S). 2632. Prison spaces to be reiwrted upon. R 1431. 2533. To use all proper means to preserve health of crew. R 2044. .ii 2534. To observe the instructions contained In I 952 (sanitary duties of commander In chief). R 2112. 2535. Liberty dependent upon local sanitary conditions. R 3670 (2). - 2536. Destruction of olotlilng to prevent spread of disease. I 1351 ; I 4750. 191 192 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. •2537. Survey of insanitary articles. I 4735. 2538. Fires in warm weather to be extinguished as soon as practicable, hav- ing in view comfort of crew. I 2607 (1). 2530. Lights reduced unless required for comfort of crew. I 2007 (3). 2540. Sufficient light to be supplied for reading. I 2607 (8). 2541. Regular boat trips to be made when sanitary conditions permit. I 2608 (1). 2542. Ship to be kept clean, dry, at a comfortable temperature, lighted, ven- tiliited. etc. I 2617 (1). 2543. Exposure of crew to sun, wet, contagion, etc., to be avoided. Com- manding officer to consult medical officeu regarding measures to preserve health of crew; men suffering from disease not to have liberty except upon reconi- mendatioQ of the medical officer; division officers to iuapect clothing of men as to cleanliness; clothing wet with perspiration to be washed and dried before storing; bedding to be aired once a week and mattresses picked over and tickings washed once a year; blankets to be washed as often as necessary. I 2617 (1-6). 2544. Ck)oking and mess utensils to be clean; food wholesome and well cooked, and water approved by medical officer. I 2618 (5). 2545. No harbor water to be used on decks where water-borne diseases are prevalent, or where contaminnted by sewage, animal matter or refuse. I 2621. 2546. Commanding officer to be informed by executive officer relative to physical capacity of crew. I 1402, Section 4. — Navy Regulations and Naval Instructions Relating to the Sanitary Duties of the Fleet Surgeon. 2651. See " Duties of the Fleet and Division Surgeon," chapter 7. 1 1122. Section 5. — Navy Regulations and Naval Instructions Relating to the Sanitary Duties of the Medical Officer of a Ship. 2561. To report infectious and contagious diseases. R2952. 2562. To report on sanitary condition of the port. R 2953. 2563. Sanitary suggestions and recommendations to the commanding officer. R 2954. 2564. To report on diseases among personnel with appropriate recommenda- tions. R 2955. 2565. Inspection of food for sick. R2959. 2566. Sanitary data prescribed in Manual to be obtained .in foreign porta (see infra " Medical Reports of Office of Naval Intelligence "). R 2966 (1). 2567. To report upon epidemics of contagious tlisease in West Indian ports, etc. R 2966 (2). 2568. To Inspect provisions of the crew. I 2110. 2569. To examine cooking and drinking water from shore. I 2112. 2570. To inspect fresh provisions (junior medical officer). (I 2618 (2)) ; I 2113 (1). 2571. Food and drink in bumboats (junior medical officer). (I 2514 (6)) ; I 2113 (2). 2572. The medical officer to Inspect cells and prisoners. (R 14.31); 12114. 2573. To accompany tirst lieutenant on weekly ia.spection. 1211."). 2574. Yearly sanitary report to department (Bureau of Medicine and Surgery). (In duplicate, one copy marked "For the commanilor in chief.") I 2127.' 2575. Hospital Corps to be instructed in personal and ^jliip hygieue. I 2042 (1). 2676. Vaccination of crew upon commission and thereafter. 12103; 13211. 2577. Typhoid prophylactic to be administered to all iHTSons. 18212. 2678. Urgent repairs for sanitary reasons. 14801(1). MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 193 2570. Follow regulations and practice established by "Fleet Regulations" of the force to which ship is assigned. Section 6. — Navy Regulations and Naval Instructions Relating to the Sanitary Duties of Officers in Hospitals (and Hospital Ships). 2681. Medical officer in command of hospital (and hospital ship) responsi- ble for its cleanliness. R 2919 (1). 2582. Inspection of provisions at hospitals (junior medical officer). 13225. 2583. Medical officers in charge of hospital wards held responsible for their neatness and good order. I 3228. 2584. Sanitary report from hospitals to be submitted yearly to department (Bureau of Medicine and Surgery). I 3259. 2585. Harbor regulations to be observed by hospital ships. I 4015. 2586. Master of hospital ship to observe regulations regarding cleanliness of ship and crew. 14017(7). Section 7. — Navy Regulations and Naval Instructions Relating to the Sanitary Duties of a Medical Officer on a Shore Station. 2591. To "supervise hygiene of station and recommend measures to diminish disease; to examine monthly and note in journal the sanitary condition of buildings, etc., and report thereon. R 2901 (2). 2592. Officers and men at navy yards and naval stations to notify medical officer of existence of contagious diseases in their quarters. R 4006 (8). 2503. Sanitary report (yearly) to department (Bureau of Medicine and Surgery). 18239. 2504. Commanding officer of marines to see that sanitary regulations are enforced in barracks. 13578. 2506. Commanding officer of naval prison responsible for sanitation of the prison. (Art. 9, Rules and Regulations, Naval Prisons and Prison Ships.) 2597. Report on operations of the prison to include a separate report from the medical officer. (Arts. 25, 60, Rules and Regulations, Naval Prisons, etc.) Section 8. — Sanitary Directions for the ^Iedical Officer of a Ship. 2601. It is the duty of the medical officer to make recommendations to the commanding officer relating to the sanitary and hygienic condition of the ship and crew. (R 20 (8) ; R 2954; R 2955) ; I 2617 (2). 2602. Strict attention should be paid to ship ventilation and inspections made to see that every care is taken to utilize to the best advantage the methods provided for the proper supply and renewal of the air. I 952 (2)d; I 2617 (1). 2603. Only distilled water should be used for drinking and culinary pur- poses. In ports where cholera, typhoid fever, or dysentery prevail either in a sporadic or in an epidemic form the use of harbor water on any of the decks should not be permitted. This prohibition should also apply where the harbor water is contaminated by sewage, animal matter, or refuse. I 2621. 2604. Careful attention should be given to the food supply, and in localities where night soil is u.sed for fertilizing purposes none of the vegetables ordinarily eaten uncooked should be allowed on board. R 2959 ; I 2110 ; I 2113 ; I 2618 (2). 2605. Clothing adapted to the climate should be worn, witli prompt changes to meet varying changes of the weather. The wearing of white should be con- fined to days when the thermometer is not below SO F. Seventy-five degrees Fahrenheit at 7 a. m. is suggested as the standard for prescribing clothing of white as the uniform of the day. Bathing over the ship's side should not be allowed when the water is below 70 F., nor when the water is contaminated by sewage or refuse, nor until the ship's lieads have been closed for an interval prior to the swimming call. Midday bathing in the Tropics should not be per- 98601°— 17 13 194 MA^'UAL FOR Tlili MEDICAL DEPARTMENT, U. S. NAVY. luilled under uidiuary circuuistauces wheu iirotectiou Irom the direct nijs of I lie sun is impossible. Clothing that has been wet by perspiration should always be dried before being rolled up or stowed away. I li617 (2) (3). 2606. Infected ports should be avoided when practicable. An anchorage in malarial and in infected ports should, whenever practicable, be selected to wind- ward of and at a suitable distance from the jn-obable source of infection. 1952(4). 2607. Upon arrival in unhealthy ports Information regarding the health of the neighborhood shall be immediately obtained, and in the event of the preva- lence of infectious diseases such precautionary ineasures should be adopted as are consistent with the necessities of the ship and the exigencies of the service. (R 2953; I 952 (2).) 2608. Should it be found that the port or neighborhood is unhealthful on account of the prevalence of an infectious or contagious disease, the precau- tionary measures indicated in articles I 952 and I 2617 should be reconniiended. as well :is others deemed advisable. 2609. The crew should b« exposed as little as possible to the rays of the sun. At anchor in the Tropics during the hot season, ship's boats when lowered should keep their awnings spread between the hours of S a. m. sind 4 p. in. regardless of the disposition of the ship's awnings. Ship's awnings should be spread as much as practicable for protection from sun in the day and from dew anf the medical oflScer, be reduced to 7 days, unless violent reaction follows first injection. A speciii) report should be made of illness considered to l)e typhoid, stating whether the diagnosis is confirmed by laboratory flnding.s. the number and dates of antityphoid inoculation, and if not administered the reasons for its omission. (M. & S. No. 124527.) 2613. -Vll ships cruising In the Tropics, and particularly in latitudes where yellow fever and malaria usually prevail, should be provided with an ample snpply of mosquito nets, and under no circumstances sliouUl camping pnrties bo sent from the ship without being furnished with such protection. 2614. Whenever a contngious or infectious disease appears on Ijoard ship every precautionary measure consistent with the exigencies of the service should be adopted to prevent its spread. Official reports shonl«l lie made to c-oni- mnnding officer and through him to conunander in chief. 2615. Whenever cholera, yellow fever, smallpox, or other infectious or. con- tagious disease appears on l>oar<1 ship tlio following measures should he c'arr ried out : ,' («) The prompt removal of the iiatient or patients to .-i hospital wheneveV such removal Is possible. ', (ft) The isolation of those aflfectied. and the segregation under observation 91 the exiMised. The establishment of n cam|i oi\ shore may he advisable, to com- MAisUAL FOR THE MKDKJAL tVEPARJ'MEiN'JV, U. S. NAVY. 195 priise u reoeplioii unit, u camp of observutiou (incubation), a cauip of suspects, hospital, and clean camp. (See Sanitary Directions for Lamliug Parties.) (c) The prompt disinfection and fumigation of the apartments occupied by the patient ; also the disinfection of the bedding, clothing, and any other articles that may be deemed necessjiry or desirable, and the investigation and removal of any local cause. (fZ) When the disease is cholei-a or yellow fever, the ship, if in an un- healthy port, should leave as soon as practicable and measures should be in- stituted for the thorough disinfection of the ship. (See ch. 15, par. 2782.) (e) When malaria, dengue, or yellow fever appears on board shij) the patient or patients shall be thoroughly screened with mosquito netting, and measures taken at once for the extermination of all mosquitoes on board and for prevent- ing their reimportation. In localities where mosquitoes and flies are prevalouf. the thorough screening of all patients with active specific diseases and typhoid fever is advisable. The disinfection of the clothing and bedding of yellow- fever patients and of their apartments is not deemed necessary except for the purpose of destroying mosquitoes. (/) .ill patients with pulmonary tuberculosis and those su.spected of being tuberculous shall be carefully instructed how to dispose of sputum without danger to others. Such cases, until transferred to hospital, should also be re- quired to mess apart from others and to use separate mess gear, which shall be sterilized by boiling after use. 2616. Whenever in the opinion of the medical officer it becomes necessary to disinfect the ship the appropriate measures noted under " Disinfectants,'" chap- ter 15. section 5, should be carried out. (See also par. 2782.) 2617. As a means of preventing the spread of disease on board ships not provided with the sanitary scuttle butt terminals, the scuttle butt cup should be kept submerged in a solution of formaldehyde (1-2500). A metallic bucket, painted white, with a Geneva cross, may be attached to the scuttle butt for this purpose. The medical officer should see that the bucket is kept properly sup- plied with the proper solution, and require that some person be responsible foi- its cleanliness. On board ships provided with the sanitary scuttle butt terminals efficient and frequent measures should be taken to insure an absence of infection in the terminals themselves, such as a daily flaming with blowtorch, etc. 2618. When men are required to work in compartments containing lead- laden dust from chipping red lead some type of respiratory mask should be provided to minimize the danger of lead poisoning, and thorough washing of the hands before eating insisted upon. The chewing of tobacco while working with lead or lead compounds should be prohibited. e deemed advisable for impro\einent : the oi>erating room, whether constructed to meet modern surgical rcquinMiionts; its equipment and fittings; the cniaiition of the floors and walls of all hospUal rooms and wards, and if supi>lied with sanitary furniture; the dietetic appointments of the hospital, the quality of the food supply, the fuel sujjply, laundry and sterilizing apparatus; methods for the transi)ortati(m t»f the sick and injured, the kinds of stretchers used, ambulance service, and the regulations adopted by the hospital for such service; the per.soniiel of the hospital, including the Hospital Corps, nur.ses, watchmen, firemen, cooks, laundresses, attendants, etc. All recommendations relating to increased efficiency in the duties of the Hospital Corps and Nurse Corps; reports upon all oi>erations performed during xW: calendar year, and a general summary dealing with the treatment of disease; facilities afforded by the hospitid for the treatment of all cases of contagious disease; facilities afforded by the hospital for bacteriological and cheudcal work; and facilities for the disposal of the dead. (b) Recommendations regarding new construction or repairs and improve- ments to buildings and grounds should be forwarded as an appendix to the sanitary report, entitled " Public works." Items should be arranged in the order of their relative importance and performance during the current calendar .rear and under the two headings " Necessary "' and " Desirable." with an ap- proximate estimate of the cost of each item of work. It should be borne in mind that work which of itself may be of the greatcsf ultimate importance might be of minor importance for immediate performance and items unauthorized one year may o(;(Upy an entirely different relative posi- tion in work recommended in a subsequent year. In order that these reconmiendations may be before the bureau at the earliest firacticable date this appendix should be submitted separately, if for an\ reason the complete sanitary report shoidd be unavoidably delayed. 2652. The yearly sanitary report from navy yards and naval stations sliall include a general description of the grounds :ind buildings, with such sanitary suggestions and recommendations as may be deemed necessary. Monthlj' sani- tary rer>orts from navy yards and naval stations (including receiving ships) for the information of the Bureau of Medicine aud Surgery shall be forwarded through the commandant in accordance with the provisions of article R 2901 (2). Ships in reserve at a navy yard, in connnission, to which a medical officer is attached or assigned to duty, will not be includerts. The title-page shall read as follows : Sanitary Report of the IT. S. S. for the year 19 — . The second page shall contain a tal)le of contents with Index of pages. Sanitary reports from ships, while embracing matters of general sanitation and professional intoresl, shall give special attention to Information and recom- mendations tending to promote military efficiency through the maintenance of physical Otness in the personnel. (12127.) The personnel. — Complement of ollicers and men ; percentage of sickness and mortality; general health; epidemics; venereal disease; vaccinations. Structural details of ship in their sanitary aspeets. — Number of decks^ and number of men berthed on each deck; cubic air space allowed each man ; venti- lation, amount, means, defects, and remedies; lighting, amount, means, defects, and remedies; heating, amount, moans, defects, and remedies; water, source, composition, supply, aud preservatioji : snnltar.v fittings, water-olo.set8, and urinals; bathing facilities. MANUAL FOR THE MEDICAL DEPABTMENT, TJ. S. NAVY. 199 l^avy ration. — Quality, preparation, and composition ; tlie general massing system; ship's stores ; ice machine and refrigerating rooms ; location of the ship's galley. Clothing. — Adaptability for different climates, its texture and durability; ship's laundry, capacity and efBciency. 'vi Cells lor prisoners. — Number and location ; cubic capacity, ventilation, heat- ing, lighting, and sanitary policing of each cell. (R 1430: R 1431.) Medical and surgical stippUes. — Quality and quantity. Facilities for the treatment of the sick. — Sick bay; location, capacity, number of berths, equipment and fittings, ventilation, lighting, and heating ; dispensary, location, cubic capacity, equipment and fittings, ventilation, heating, and light- ing: medical storeroom, location, capacity, ventilation, lighting, and arrange- ments for storing surgical and medical supplies. Similar information will be furni.shed regarding operating rooms, isolation wards, and venereal treatment and prophylaxis rooms, if the ship is provided with them. Stations in battle. — Battle dressing stations ; arrangements for the care and tran.sportation of the wounded. Hospital Corps. — Hospital Corps drill ; instructions in first aid ; transportation of the wounded ; apparatus employed in handling the wounded. General hygienic considerations, suggestions, and recommendations. 2651. Whenever the opportunity presents itself medical ofiicers shall. If practicable, submit to the Bureau of Medicine and Surgery all information of a sanitary and professional interest pertaining to foreign naval medical estab- lishments. 2655. When cruising on foreign stations or in watei's beyond the continental limits of the United States, medical ofiicers desiring to i-eport in full upon the sanitary condition of the various ports visited by the ship will use the following outline: - (a) Location, populatiou, and climate: (a) Latitude and longitude, general altitude above the sea level; (b) meteorological observations, including direc- tion, velocity of the prevailing winds, records of the relative and absolute humidity, barometric conditions, and temperature records for specified periods of time; (c) drawing or tracing, if practicable, of the port or the city. (b) Medical topography: (a) Character of surrounding country, undulating, hilly, mountainous, or low and marshy ; (b) direction and distance of the near- est hills or mountains; (c) influences of the topographical features in the immediate vicinity upon the health conditions of the port; (d) area of the city or port on mainland: (e) streams of water or canals passing through the city, or port, current, whether rapid, moderate, slow, or sluggish; (f) portions of the city or port subject to overflow ; if so, its bearing on the health of the port ; (g) diseases attributable to the conditions of the soil or geographical formation. (c) Water supply: (a) Source of water supply, stating whether there are any towns, villages, factories, or other sources of contamination located upon the river or stream above the point at which the water is collected ; (b) distance from which the water is brought, in what form of conduit, capacity of pipe, and number of reservoirs; (c) the processes, if any, that are used for filtering or purifying, other than by settling in the reservoirs; (d) the average daily amount of water flowing into the reservoirs and the storage capacity of each reservoir ; (e) the average daily amount for each inhabitant, and the amount of water stored in the reservoirs available in case of fire; (f) the quality of the water. Including its physical, chemical, and bacteriological examination, the facilities possessed by the city or port for conducting such examination; (g) the u.se of cistern, well, or spring water ;. diseases, if any, attributable to such use. (d) Drainage and sewerage: (a) The system of .sewerage; (b) how con- structed, methods adopted for keeping it free from obstruction; (c) proportion of the area of the city or port not sewei-ed ; (d) does the surface drainage pass into thesewers, and if so, is their capacity sufficient in heavy storms; (e) dis- position of the sewage, how collected, how utilized; (f) the .system or method by whicli the sewers are ventilated; (g) the methods of lighting the city or port, whether by gas or electricity. ■ '• .>: i , i 200 MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. (e) Hospitals : (a) The number of hospitals iu the city or port, furnishing, if practicable, a tracing or drawing of each of them; (b) the location of each hospital, nature of soil, direction and character of drainage, shape and area of grounds, number of rooms and beds for pay patients, number of wards and beds for charity patients, number of stories, number and size of wards, floors and cubic space for each bed, accessibility for landing patients transferred from ships, regulations relating to admission of patients from men-of-war; (c) the heating, ventilating, lighting and sanitary arrangements, protection in case of fire, and whether the building is fireproof, operating rooms, X-ray and labora- tory facilities, contagious wards, screening; (d) the date, if practicable, when the hospital was erected, and whether constructed on the pavilion plan; (e) the operating room, paying special attention to its equipment and fittings; (f) quality and quantity of food supply ; (g) transportation of the sick and injured, kinds of stretchers used, whether the hospital is provided with elevators and ambulances, and the regulations relating to ambulance service; (h) manage- ment of the hospital, whether by trustees, municipal boards, religitius orders, or under the control of medical men, method of appointment of the medical and surgical staff, and the manner of appointment and the number of hospital internes; (k) the nursing staff of the hospital, the number employed, and the rules relating to their duty; (1) all practicable data bearing upon the regula- tions pertaining to hospital management, and information dealing with the treatment of disease. (/) Information relating to health laws and regulations. (g) Quarantine: Information relating to national. State, or municipal laws or regulations, furnishing copies, if practicable, of all such laws, ordinances, and regulations. (See 2579.) Section 13. — Sanitary Data Rkqitikeu in Intelligence Report. 2661. Form N. N. I. 77. INTELLIGENCE RErORT. [Forward direct to the Office of Naval Intelligence.] U. S. S- Name of city or town: Date mi<:dioal rki'okt. fThls report should be made by a medical officer.] Population of city or town. Health Conditions. Epidemic diseases : Endemic diseases: Venereal diseases, and also any available information conrprning prevalence and status of prostitution : Mi;i)i( AL TorooKAPiiY. [With reference to Infliionoe upon hcfiMh condttions.] Temperature, average day, ; niglit, ; yearly maxiniuni. ; yearly minimum, Prevailing winds: Prevalence of mosquitoes, flies, otc. : MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 201 Rainfall : Drainage : Sewerage : Height above sea level: Camping sites : Water supply — Quantity : Quality : Method of collection: Method of puritication : Food: Character and sanitary condition of hotels and restaurants, etc.: Availability of surgical and medical supplies : Structures suitable as emergency hospitals: Quarantine regulations: Local laws or regulations regarding disinterment should it be desired to send remains home: Facilities for cremation: 2662. There is published by the Bureau of Medicine and Surgery a Naval Medical Bulletin for the information of the medical officers of the service. Reports of interesting cases, sanitary measures advocated, new devices sug- gested, etc., original articles on topics of general and special professional in- terest are solicited from all medical officers. Contributions should be on one side of the page, typewritten if possible, double spaced, and carefully punctuated and paragraphed to reduce the necessity for emendation by the editor. Special accuracy as to names, editions, etc., should be observed in all references and quotations from other periodicals. It is assumed that original articles con- tributed for the Bulletin have not appeared and are not to appear in other publications except by previous agreement with the editor. T^T in- CHAPTER 15. BII.LS OF HEALTH, QUARANTINE, AND DISINFECTION. Section 1. — Laws Relating to Quarantine and Bills of Health. 2701. The public health. Sees. 4263. 4792-4800, R. S. 2702. Vessels from foreign ports not to enter in violation of this act or State health laws. Act. Feb. 15, 1893. 2703. Permanent appropriation for prevenriuir epidemics, to be expended in di.^cretion of President. Act Mar. 3, 1893. 2704. Bills of liealth to be obtained from consul. Acts Feb. 15, 1893; Aug. 18, 1894. 2705. Quarantine service, punishment, etc., upon quarantine grounds. Act Aug. 1, 1888. 2706. Contagious diseases, to pi-event the spread of. from one State to' :mother. etc. Act Mar. 27, 1890. ■' 2707. Additional quarantine powers and additional duties of the Public' Health Service. Act Mar. 2, 1901, amending act Feb. 15, 1893. 2708. To further protect the public health. Act June 19, 1906. Section 2. — Navt Regxtlations and Naval Instructions Relating to Quaran-^ tine and Bills of Health. / 2711. Commanding officers required to comply strictly with all quarantine regulations. R 3SU1 (1). 2712. To afford every facility to health officers. R 3801 (2). ■; 2713. No communication lo l)e held witli shore until pratique is gi'anted. R. 3801 (3). 2714. Procedure upon arrival in a port with a quarantinable disease. R 3802 (1). .X 2715. To arrange for care of patients ou shore or on board a hulk. R 3802 (2);.i 2716. When at sea with quarantinable disease to hoist and keep flying the quarantine flag. R 3802 (3). 2717. Arriving vessels not to be boarded if suspected subject to quarantine. R 3803 (1). 2718. Communication with vessels at sea, if from a suspected port, to be rejiorted to health officer upon arrival in port. R 3803 (2). 2719. Circumstances that may subject a vessel to quarantine not to be con- cealed. R 3803 (3). 2720. Before proceeding to sea commanding officer shall require the medical officer to procure bill of health when necessary or advisable. I 1312. 2721. Unless otherwi.se directed, the medical officer shall procure a bill of health. I 2126 (1). , . , ; .- . .> 2722. Upon arrival in port medical officer' to receive health officer^, etc^i I 2126 (2). 203 204 MANUAL FOR THE MEDICAL DEPARTMENT U. S. NAVY. Section 3. — Genekai> Infoumation Relating to Quarantine and Qvakantine Regulations. 2731. The Public Health Service recognizes as quarantinable the following diseases : (a) Cholera, period of incubation, 5 days. (b) Yellow fever, period of incubation, a or 6 days. (c) Smallpox, period of incubation, 14 days. (rf) Typhus fever, period of incubation, 12 days. (e) Plague, period of incubation, 7 days. (/) Leprosy: If an alien, not permitted to land. If a citizen, the case Is dealt with according to the State laws of the port of entry. 2732. 146. Vessels of the Navy may be granted the hereinafter-stated ex- emptions from quarantine regulations, but are subject to quarantine inspection upon arrival at a port of the United States. 147. The ceriiticates of the medical officers of the Navy as to the sanitary history and condition of a vessel and its personnel may be accepted for naval vessels by the quarantine officer boarding the vessel in lieu of an actual inspec- tion. 14S. Vessels of the Navy having entered the harbors of infected ports, but having held no communication which is liable to convey infection, may be exempted from the disinfection aud detention impo.sed on merchant vessels from such ports. (Quarantine Laws and Regulations, Treasurv Department, 1910. arts, 146-148.) 2733. On entering port, in addition to the bill of health, the senior medical officer of the ship shall be prepared to furnish the quarantine officer, if required, with a statement relative to the health conditions prevailing on board ship. Certain diseases of a contagious or infectious character, not included among the quarantinable diseases under the quarantine laws and regulations of the Treasury Department, such as the exanthemata, diphtheria, cerelirospinal meningitis, etc., will ordinarily be viewed by local or State authorities as constituting quarantinable diseases and their pre.sence on board should be considered as rendering the vessel subject to quarantine restric- tions. All such diseases should be fully reported to the inspecting health officer. 2734. If, in the opinion of the quarantine officer, a pilot has been exposeil to infection upon boarding a vessel with quarantinable di.sense on board, he may be detained in quarantine a sufficient length of time to cover the period of incubation of the disease in question. (Quarantine Laws and Regulations. 1910.) 2735. .Jurisdiction in matters of sanitation and quarantine in the waters of Colon and Panama is exercised by the United States authorities of the Canal Zone, and in the ca.se of vessels entering the ports of Colon and Panama. In all ports in the Canal Zone original bills of health in duiillcate are required to be obtainefl by masters of vessels clearing from any foreign port or any port In the possessions or other dependeucies of the United States. (Executive Order No. 1761, of Apr. 15, 1913.) Section 4. — Pills of Health. 2741. (a) Naval vessels clearing from one United States port for another United States port do not ordinarily procure a bill of health for presentixtion at the port of arrival. Local or State authorities at the i)ort of arriv.nl niay, however, rensular bills of health is customary or from Unitetl States public health officer if one is stationed there. (e) The following data are usually required when applying for a bill of health : Name of vessel. Tonnage. Number of guns. Name of captain. The number of souls on board. Destination. 2742. Supplemental bills of health (if call is made at some hitermediate port or ports) should be obtained and be properly viseed. "Vessels clearing from a foreign port or from any port in the possessions or other dependencies of tlie United States for any port in the United States, its possessions or other dependencies, and entering or calling at intermediate ports, must procure at all said ports a supplemental bill of health in duplicate signed by the proper officer or officers of the United States, as provided in the law. If a quaran- tinable disease has appeared on board the vessel after leaving the original port of departure, or other circumstances presumably render the vessel infected, the supplemental bill of health should be witheld until such sanitary measures have been taken as are necessary." (Quarantine Laws and Regulations, 1910.) 2743. Bills of health for naval vessels in the fleet may be procured for the fleet as a whole by the fleet surgeon if no diversion of individual ships is con- templated. Bills of health for individual ships should always be procured, how- ever, in the absence of orders to the contrary, in view of the fact that a ship may at any time be detached from the fleet and ordered to operate singly. The medical officer of a ship is not relieved from responsibility for the health of his ship's personnel by the activities of division or fleet surgeon and should personally ascertain and keep his commanding officer informed of the health of every port visited. 2744. Bills of health for naval vessels and indorsement by consular officers are usually extended gratis. Any expense involved in procuring bills of health or in quarantine is a charge against appropriations not under the Bureau of Medicine and Surgery. 2745. In the United States a medical officer procures a bill of healtli by applying in person at the customhouse or collector of the port's office or to the representative of the United States Public Health Service. In foreign ports request for a bill of health should be made at the ofiice of the captain of the port (Bureau du Capitaine du port, Uffizio dell Capitano dell Porto, Capitania del Puerto). 206 MANUAJ. FpK.XHK MEDICAl. DJipAJUMENT, U^ if. N^V^ The medical officer should take with hiiii bills of hciilth from hist porr of departure and be prepared to furnish the details given above (2741f). If epidemic or contagious diseases are present at the time of making the request, a visit should also be made to the consul of the nationality of the next port of call (particularly in the Mediterranean) for his vis^^. Section. — 5. — Disinfection and Distofectants. PHYSICAL disinfectants. 2751. (a) Sunlight.— Birect sunlight will kill pathogenic bacteria after vary- ing times of exposure. For instance, plague bacilli are killed in less than an hour, while tvphoid organisms require six hours' exposure. The violet and ultra- violet rays are the most active, the red and yellow rays boing practically inei-t. \ (b) Burning.— Ot unquestioned efficiency but seldom practiced on account of expense. (c) Boilinff. — Boiling is very efficient, especially In a solution of carbonate of soda,,l per cent strength, for at least one-half hour, preferably one hour. Articles to be disinfected must be wholly immersed and the solution nmst be actually boiling for the required period of dis=infection. Nonspore-bearing bac- teria are killed by short immersion in boiling water at sea level. In elevated regions one should remember that the boiling temperature is lower. ■ id) ,Sffeflw.— Flowing steam (not under pressure) when applied under suit- able conditions is an efficient disinfecting agent. The exposure must be con- tinued 30 minutes after the temperature has reached 100 C. Steam under pressure will sterilize efficiently provided the process is continued 20 minutes after the pressure reaches 15 pounds per square inch. The air must be expelled from the apparatus at the beginning of the process. If impracticable to obtain the designated pressure, a correspondingly longer exposure will accomplish the same result. The best method of applying steam under pressure is to apply it in a special apparatus with vacuum attachment, the object of the vacuimi apparatus being to expel the air and to promote the penetration of the steam. The process is to be continued for 20 minutes after the pressure reaches 10 pounds to the square inch. GASEOUS disinfectants. 2762. (a) Sulphur dtoatd.— This is a weak germicide, but a potent insecti- cide; to be efficient it requires tlie presence of moisture. It is only a surface disinfectant and is lacking in penetrating properties. An atmosphere contain- ing 4.-5 per cent can be obtained by burning 5 poumls of sulphur per 1,000 cubic feet of space. This amount requires the evaporation or volatilization of about 1 pint of water. Under tliese conditions tlie time of exposure sliouM be not less than 24 hours for bacterial infections. A sliorter time will suffice for fumigation necessary to kill mosquitoes ami other vermin. Dry sulphur dioxid produced by burning 2 pounds of sulphur for each 1,000 cubic feet of space will answer for this purpose. An exposure of from fwo to three hours is suffi cient The sulphur may be burned in shallow iron pols (Dutch ovens), con- taining not more than 80 pounds of sulphur to each iwt, and the pots should stand in vessels of water. The sulphur pots sliould be plovatev volume .strength, and where possible thi.s should be generated from a furnace to minimize danger of fire in cargo. 2765. Living compartments, cabins, and forecastles of vessels shall be dis- infected by one or more of the following methods: (a) Sulphur dioxid, the destructive action of the gas on property \hh\\^' borne in mind. I (h) Formaldehyde gas. - (c) Hydrocyanic acid gas. (d) Washing with solution of bichlori. harles, Va ( harlesion, S. (" Tamp.) Hay, Fla Mobile, Ala Oahestou, Te.\ San Francisco, Cal Columbia iUver, Ureg . San Juan, 1*. H ISoston, Mass Providence, U. 1 Cape Fear, iS'. C Savannah, Ga Pensacola, Fla New Orleans, La San Diego, i al Port Townsend, Wash Honolulu, Hawaii 0) (>; (') (2; 46 86o U 8 3fi 63 C9 75 COO 10!) •K) 6 L0(>2 so 6til LOOO ' Hulk in stream. 2 Launch in stream. Ample. CHAPTER 16. LINE OF DUTY AND ORIGIN OF DISABILITY FROM DISEASE OR INJURY. Section 1. — Laws Relating to Line of Duty, etc. (See Also " Navy Tension Fund and General Pensions," Chapter 23.) 2801. Gratuity (death benefit) : (a) Deuth from wounds or disease originating in line of duty. Act of May 13, 1908. (ft) Death from wounds or disease not a result of own misconduct. Act of August 22, 1912. R 4551 (1). 2802. Retirement (officers) : (a) Retiring for incapacity resulting from and incident to service. Sec. 1453, R. S. (b) Retirement for disability not an incident to service. Sec. 1454, R. S. (c) No officer of the Navy shall be placed on the retired list for misconduct: but shall be brought to trial by court-martial for such misconduct. Sec. 1456, R. S. V, 2803. Promotion (officers) : (a) Disability from wounds incurred in line of duty not a bar to promotion if not incapacitated for other duty of the higher grade. Sec. 1495, R. S. (b) Officers failing in physical examination for promotion on account of dis- ability contracted in line of duty. Sec. 1447, R. S. ; act of March 4, 1911. Section 2. — Navy Regulations and Naval Instructions Relating to State- ments AS to Origin of Adverse Nature. 2811. " Not in line of duty " entries. R 2902 (1-5). 2812. Entries in record of an officer indicating use of drugs or intoxicants. I 707 (5). 2813. When records are incomplete the Bureau of Medicine and Surgery is to decide origin. R 4564. 2814. Court of ino.uiry and board of inquest; deaths due to accident. R 322 (3) ; R 323 (2) ; R 401 (2). 2815. Entries ou death certificate as to origin of disability causing death. R 2963 (2). 2816. Report of eyewitnesses to accidents. R 4563. 2817. Reports of death as evidence for claim for pension. R 4562. 2818. "Misconduct" admissions. Gen. Ord. No. 231. Section 3. — Information, Decisions, etc.. Regarding Line of Duty and Origin OF Disability. 2820. Hereafter no officer or enlisted man in the Navy or ISIarine Corps, in active service, who shall be absent from duty on account of sickness ov dis- ease resulting from his own intemperate use of drugs or alcoholic liquors, or other misconduct, shall receive pay for the period of such absence, the time so absent and the cause thereof to be ascertained under such procedure and 213 214 MAM'A). KOi; TPIE MF.DIt.M. DKPARTMENT, U. S. NAVY. rt'-ulations as may bo iirescrila'd by the Secretary of theNavy: Provided, That an enlistment shall not be regarded as eomitlete until the enlisted man shall have made good any time in excess of one day lost on account of sickness or disease resulting from his own intem[)erate ns(! of drugs or alcoholic Jiipiors or other misconduct. Absence from duty of any nihi-er or enlisted man of the Navy, iu active service, on account of disease resulting from his own intemjwrate use of drugs or alcoholic liquors, or other misconduct, is within the purview of the statute quoted above; and any officer or enlisted man who, on or after August 29. 1916, has been absent, or may hereafter be absent, from dutj fr;)iii any suc!\ cause, or causes, is not entitled to pay as distinguished from allowances for the period of such absence. But where the disease, within the purview of the statute quoted above, was contracted prior to August -9, 1910, as a result of which the officer or enlisted man is absent from duty after that date, no deduction of pay will be made. Whene\er an officer or enlisted man of the Navy, in active service, is absent fi'om duty on account of sickness or disea.se. resulting from his own intem- perate use of drugs or alcoholic liquors, or other misconduct, the medical officer having cognizance of the case shall prepare and forward lo the commanding officer an admission " Misconduct report," and ui)on the individual being discharged to duty a discharge " Misconduct report." In the case of officers these reports shall be forwarded in dui)licate, one to the commanding officer, for further reference to the Bureau of Navigation, the other via the com- manding officer to the pay officer carrying the officer's accounts. In the case of enlisted men the reports shall be made in triplicate, if necessary, and forwarded through the commanding officer, one each for the commanding and pay officer carrying the man's accounts, and the third for the officer having custody of the man's service record. In tlie case of erdisttMl men, notation of absence under the purview of this order will be made on the service record on the leaf for recording leaves of absence. The date admitted to the sick list will not be counted as a day of absence; the date discharged from the sick list shall count as a day of absence. When the medical «)lficer having custody of the health record of an officer or enlisted man enters on such record that the sickness or di.sease causing absence from duty is the result of his own intemperate use of drugs or alcohlic llquoi-s, or other misconduct, it shall be the duty of such medical officer to inform the patient when such adverse entry is made, provided the condition of the patient does not make such action inadvisable. He will inform the command- ing officer at the .same time in the manner prescribed above. When the commanding officer and medical officer are in accord the entry shall be final. Should th«' commanding ofli<,*er and the medical olHcer disagree the former will call a board of officers of not less than two members, one of whom shall be a mecli(*iil otlicer, to report upon and make wcomniendations to him in the case. Tlie approval by the commanding officer of the findings of this board shall be final ; but if the commanding officer disapproves the findings of the board the proceedings will be forwarded for the action of the next higher authority. A copy of the final decision In the case will be entered iu the health record. f^ommandlng officers are cautioned not to discharge on account of expiration of enlistment any enlisted man until he has made good the time in excess of one day lost <»n account of sickness or disease resulting from his own intem- perate use of drugs or al<(»liolic li(|Uors or other nii.sconduct. 2H21. Tlic origin of woumls or disease resulting in disability or death in the cases f»f ollicers iiiid enlisted men of the Xavy, whether contracted in liiu> of duty or not in line of duty, the result of own niisc(»nduct, or own vicious habits, is under the law an imi)ortant factor in deciding tlie right of the individual to fXMision, promotion, retirement, or gratuity to beneliciary. As disability oirurring in the .service is usually nuide tlie basis of a claim for iK'Msioii, special care will always be taken to state in health records i lie MANUAL FOK THE MEDICAL DEPARTMENT, U. S. NAVY. 215 iieyree of disability, wound, or disease, the extent to whicli it deprives the patient of the use of any limb or faculty, or affects his health, strength, activity, constitution, or capacity to labor. If such disability was incurred in the line of duty, and the patient declined treatment for the relief of such dis- ability where treatment was directed, that fact will be set forth for the infor- mation of the Bureau of Pensions. In conducting surveys for discharge, it is enjoined upon all officers con- <-erned to observe that there is no conflict between the statements of medical officers as to whether the disability was incurred in line of duty. If any dis- crepancy exists in this particular every possible means will be employed to harmonize the statements before finally forwarding the papers. 2822. The pension laws applying to the Navy, except in the cases of those pensioned under the provisions of sections 47.56 and 4757, R. S. (see Navy Pension Fund), are administered by the Department of the Interior. Commis- sioner of Pensions. 2823. The laws in those cases involving retirement for disability resulting frum an incident of service (sec. 1453, R. S.) : retirement for disability not an incident of service (sec. 1454, R. S.) ; promotion, disability waived, a result of wounds incurred in the line of duty (sec. 1494. R. S.) ; retirement in next higher grade of an officer failing to pass physical examination on account of disability contracted in line of duty (sec. 1447, R. S., act Mar. 4, 1911) ; not to be retired for misconduct (sec. 14.56, R. S., act Aug. 5, 1882) ; gratuity payable upon official notification of death fnsm disease or wounds originating in line of duty (act May 13, 1908) ; and gratuity payable upon official notification of death from wounds or disease not a result of own misconduct (act of Aug. 22, 1912), are administered by the Secretary of the Navy. Cases of officers in- volving discharge from the service, retirement or promotion, are referred to ihe President for final action. 2824. Medical officers are required to enter in the medical records of all enlisted men or officers when admitting them to the sick list, a statement as to origin of the disease or injury, whether in the line of duty or not in line of duty. These records eventually are filed in the Bureau of ^ledicine and Sur gery, where they are cons^ulted to adjudicate claims for pension and gratuity. Where the records are incomplete, the bureaxi decides whether death, injury, or disability occurred in the line of duty. (R. 4-564). If the opinion of the medical officer admitting the patient to the sick list is adverse, and the com- manding officer does not concur, evidence in rebuttal will be entered on the health record and the medical officer will proceed in the manner set forth in R. 2902, copies of the papers being forwarded to the Bureau of Medicine and Surgery for expression of opinion and then to the department for final action. The same method should be followed by boards of medical survey. The •statement of evidence in rebuttal should be incorporated in the record and referred to in the body of the survey. The senior member of a board of examination for promotion or for retire- ment (R. 2902 (2) ) is likewise directed to inform the individual concernetl of the adverse entry in the record. 2825. ^Yhen a medical officer makes au entry in the record of an officer indicating the use by that officer of drugs or intoxicants that would tend to unfit him mentally, morally, or physically for service, he shall proceed as set forth in I 707 (5). 2826. The purpo.se of the entries as to origin of disease or injury in relation to " duty " or " not duty " being for administration of law, it is of the utmost importance that medical officers should with their opinion make a clear state- ment of the evidence upon which the opinion is based. In the case of injury, if the man was not actually engaged in duty at the time, a full statement should be given of all facts upon which the opinion is based. In the case of disease, a professional opinion with due regard to accepted etiology should l)e exjiressed. 216 MANUAL FOR THE MEDICAL DEPARTMENT, V. S. NAVY. 2827. If two causes nre concerned in the origin of a disability, one a pre- dlsposinp; caiise the other an exciting cause, the exciting cause will warrant the weight of favor. 2828. An officer on the retired list, unless the origin of the disease or injury occurred in the lino of duty while on the active list, is not entitled to the bene- fits of line of duty, there being no act or condition of duty involved. 2829. If a patient has two or more diseases or injuries at the time of admis- sion, an opinion as to line of duty shall be separately recorded for each. 2S30. All diseases contracted or injuries received while an officer or en- listed man is on active duty in the naval service of the United States may be a.ssinned to have occurred in line of duty, unless there is evidence, first, thai the disease or injury existed prior to appointment or enlistment ; second, that it was contracted while absent from ship or duty, on leave, over leave, or absent without leave ; third, that it occurred in consequence of willful neglect or as a result of his own misconduct. 2831. When an Individual is disabled while on leave or in confinement the question of line of duty must be determined by the circumstances attending the incurrence of the disability; and the fact of being on leave, and if in confine- ment, whether awaiting trial, or in accordance with sentence, should be stated. In cases of suicide the mental condition should be considered, and if insanity exists an opinion should be expressed as to whether or not the insanity was contracted in the line of duty. The following letter from the Secretary of the Navy to the Bureau of Medi- cine and Surgery. April. 1909, will govern in Navy practice so far as relates to injury to prisoners resulting fnmi obedience to orders: " Referring to your letter of the 3d instant, requesting a decision as to whether or not an injury received by a prisoner while working in the prison or around the yard is to be considered as an injury received in the line of duty, I have to inform you that prisoners are enlisted men in the Navy or Marine Corps, and that work done by them in the j^rison or about the yard is performed in obedience to orders and in execution of military discipline, and that injury to a prisoner resulting from obedience to such orders is regarded by the depart- ment as in line of duty, as it would be in the case of other enlisted men, not prisoners, injured in the execution of orders. The approval of a sentence of court-martial does not impose any forfeiture not expressly stated in the sen- tence, or which may by statute result from a conviction." 2882. Injuries occurring during athletic sports properly indulged in or in cf)nnection with physical exercise or recreation should be weighed with due regard to existing regulations, instructions, and orders. A recent decision reads as follows : " The policy of the department is to foster athletics, and the bureau considers that football and other athletic contests of enlisted men on shore are conducive to their physical development and well-being and better fit them for the performance of their cUitics on board ship, and that injuries received In the.'?e contests may be justly considered in the line of duty." (Horgan case No. 4,^)8-5 of .Tan. 3, 19(tS.) 2H.'J3. In all cases where the opinion not in line of duty is expressed a full statement of facts should be given irrespective of whether evidence In rebuttal is offered at the time or not. In all ca.ses where disability is incurred in the line of duty and the treatment iire.scrilied is declined, that fact will be set forth in the health record or medical survey. 2834. In all cases of death not in the line of duty the medical ofhccr should also state whether in his opinion the death was a result of the individual's own misconduct. 2885. A midshipman (hiring his course at the Naval Academy incurring In- jury or disease is to be giveii "line of duty" or "not line of duty" by the medical oflicer preiiaring the records, in the same maimer and for the same causes that similar entry would be made on reports to the bureau, of conunig- sioned ofhcers and enlisted men of the Navy and Marine Corps (Navv Depart- ment 5252-24, May 2."., 1900). MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 217 2836. The status of midshipmen with relation to the adjudication of a claim foi' pension gratuity is determined by the act of July 16, 1862. (Ch. 183, 12 Stat, 583, sec. 1), which makes nine grades of the active list of line officers of the Navy — rear admiral, first grade; midshipman, ninth grade. (Baker case, 125 U. Sl R.. «46; Cook case, 128 U. S. R., 254.) 2837. When a medical officer makes entry in the health record and is, after due consideration of all ascertainable circumstances, still in doubt as to the origin of the disease, he is justified in saying there is " fair " or " some " evi- dence that it is in line of duty, since a more positive statement would be not only misleadiiig but incorrect. In any such instance, however, he should be particularly careful to enter in the record all the facts upon which his opinion is based in order that they may be available for consideration by a board of survey, by the Bureau of Medicine and Surgery, or the Pension Bureau. If a medical survey is held in such a case the " onus of deciding one way or the other." so far as'concerns the entries on the report, rests entirely with the board. While the facts and opinion expressed in the health record are given due weight, the decision will also be based on a consideration of the patient's statement, the subseouent medical records, if any, and such additional evidence as may be available.' That the board should reach some definite conclusion is important, particularly in case the recommendation is for discharge from the service, and if a unanimous opinion is impracticable, majority and minority reports may be submitted, when the final decision will rest with the bureau and the department. Section 4. — The Practice in Adjudicating Line of Duty in Keference to Claims for Pension and Gratuity. 2841. Congress has enacted laws proffering the Government gratuity to a beneficiary of a deceased officer for services rendered. The spirit inspiring the gratuity includes the intention that the beneficiary shall have all the assistance available fi-om the Government in the discovery and presentation of the basic evidential evidence upon which his claim must be adjudicated. It is not a claim growing out of a contractural right ; the courts have held it to be merely a gratuitv. 7 Letter to Secretary of the Navy from Secretary of the Interior, Jan. 9, 1913.) 2842. A record of evidence as to origin of disability or cause of death is re- quired by section 6 of the act of July 4. 1864. 2843.' When a statute provides pension for disability or death occasioned by wounds or injuries received, casually occurring, or disease contracted in the line of duty, it intends that the performance of duty must have relation of causation or consociation, mediate or immediate, to the wound, the casualty, the injury, or the disease which produces the disability or death. (Digest, Pension Laws and Decisions, etc., 1881.) 2844. In determining the right of favorable opinion, the question is not whether, when the cause of disability or death occurred, the party was on duty or not, in active service, or on furlough, or leave, in arrest or not, but whether in any of the possible conditions of service the cause of disability or death was appurtenant to, dependent upon, or connected with acts within or acts without the line of duty. (Digest, Pension Laws and Decision.s, etc., 1881.) 2845. Upon the question of casualty the opinions of experts are evidence, but they do not constitute either exclusive or conclu.sive proof ; and the question is to be judged on the facts like any other matter of evidence. (Digest, Pen- sion Laws and Decisions, etc., 1881. 2846. Death or injury while on liberty, incurred in the act of attempting to rescue another member of the service, is regarded as line of duty ; such death or injury incurred attempting to save civilians is not in line of duty. 218 MANUAL i;OK THE MEDICAL UKl'AKTMENT, U. S. SAW. Seciion 7. — Weight or Official Recokd-s. 2861. Au official eoiUeun»oraneous record is the best evidence, as to facts tlierein recited, and cfin be successfully rebutted only by direct, positive, and conclusive evidence showing beyond question that there was error or ""stake of fact or fraud in making said record. (7 P. D., 26 ; 2 P. D., 304 ; 4 P. D.. 114 ; 2852."' The pension act of March 3, 1885, provides that applicants for pension shall be presumed to have had no disability at the time of enlistment, and such presumption may be rebutted. A statement In a certificate of discharge that the disabling cause existed prior to enlistment outweighs and rebuts the pre- sumption of prior soundness. (1 P. D., 7; 12 P. D., 264.) CHAPTER 17. MEDIOAI. AND MATERIAL SURVEYS AND TRANSFERS OF THE SICK. Section 1.— Navy Regvi.ations Relating to Mkuicat. Suhveys on Personnel. 3901. By whom requested and ordered. R 361 ; R 2960. 2902. Boards of survey, how constituted. R 362. 2903. Reports of survey. (a) Officers and enlisted men of the Navy. R 363 (1). (6) Officers and enlisted men of the Marine Corps. R 363 (2). 2904. Form and phraseology- of report of survey . R .■'.64 (1). (a) In the case of an officer. R 364 (2). (b) In the case of an enlisted man. R 364 (3). 2905. Cases to be disposed of without delay. (c) Surveys in or near home waters. R 36.5 (1). (b) Surveys outside home waters. R 365 (2). 2906. Surveys in the United States on enlisted men for diseases not in line of duty. R 366. 2907. Transportation of men discharged by medical survey. R 3606 (6). 2908. Character of discharge in medical survey. R 3607 (3). . 2909. Leave and extension of leave on account of sickness requires board of survey. R 3707 (1-4). 2910. .Joint l)oard of survey for pen.sious. R456t. Section 2. — Naval Instructions Ret.ating to Medical Surveys. 2911. Sending home sick condemned by survey. 1954 (2). 2912. Division commander to order and act upon medical surveys. I 1004 (1). 2913. Fleet surgeon to approve medical surveys. 11122 (8). 2914. Officers surveyed in hospital. I 3221 (1-2). 2915. No discharge for disability except by survey. I 3236 (1). 2916. Survevs in hospital shall name ship from whiclx patient A\as ad- mitted. I 3236 (2). ,. y ■ ^ Section 3. — Request foe Medic ae Survey. (Form L.) 2921. A single copy of a request for medical survey shall J)e made uut bj; the medical officer of a ship or station and may embrace any number of cases. ^ 2922. If in the fleet, the request, after approval by the commanding officer will be traiismittermanent " shall be employed. (/) Heconunendation. Under this head shnll be given the contemplateable permanency evident, and as a rule such recommendation shall not be made until the case has been under a period of observation at a naval hospital. Before recommending the invaliding of a continuous-service man from the service the board should care- fully consider the probability of his recovery under extended treatment, espe- cially when the disability is in line of duty. In the case of recruits retention for prolonged treatment when a restoration to duty is unlikely is undesirable. (h) In any case where the reconnuendation involves invaliding from the service for a mental infirmity the board shall state that such a disposition will not constitute a menace to the individual surveyed or to the public safety. When the case is of an infectious nature or of a chronic or disabling nature a statement should also be made that if the case is invalided from the service it Is unlikely ti> constitute an unusual menace to the public health or to become a public charge. (i) The hoard shall be careful to state definitely its opinion as to the origin of the disease or injury, giving all the facts and circumstances connected with the disease or injury, and whether associated with the performance of duty or whether the exposure was incident to any act of the service. In the case of an enlisted man a statement will be made of the board's opinion as to whether the disease or injury is or is not due to the misconduct of the enlistefl man who is the sul)ject of the survey. The statement of the patient in connection with origin of the disease or disability must be weighed by rules governing evidence in general and shall be accepted or rejected. The provisions of article R 2902 (1-4) regarding " not in line of duty " lindiugs shall be carefully complied with by all boards if medical survey, and the facts stated on the report. 2937. When surveys are held upon enlisted men at ho.spitals the board .shall be careful to state on the report the names of the ships from which the men were received. Section 5. — General Information Regarding Surveys on the Personnel. 2941. In all cases of medical survey held on board ship, at navy yards and naval stations the medical officer requesting a survey shall cause a full entry of the report of the board to be entered in the health record. No person shall be surveyed before being fully admitted to the sick list. 2912. In surveys held at hospitals the board shall be careful to specify in the report the name of the vessel from which the patient was received. 2943. Enlisted men condemned by survey on foreign stations who are recom- mended for discharge from the service will be sent to a receiving ship and not to a naval hospital for final action, unless requiring hospital treatment, and such disposition shall be specifically recommended by the board. 2944. The expenses connected with the transportation of sick enlisted men of the Navy and Marine Corps to naval hospitals are a charge against appro- priations under the control of the Bureau of Navigation and the Marine Corps, respectively. 2945. Medical surveys of officers and enlisted men of the Navy, when acted upon by the officer convening the board, are forwarded in duplicate direct to the Bureau of I\Iedicine and Surgery for recommendation by the Surgeon General and transmission to the Bureau of Navigation for final action. One copy of the report is retained for the files of the Bureau of Medicine and Surgery ; the other is forwarded to the Bureau of Navigation. The latter copy is sent bv that bureau to the officer ordering the survey for his information and compli- ance. It is then returned by him to the Bureau of Navigation for its permanent files. At training stations and on receiving ships the cases of recruits who are surveyed by boards of medical survey will be acted upon by the senior officer present. Wlien a board of survey is ordered upon recruits the senior member Avill be preferably an officer of experience, with a full knowledge of service con- ditions. All such surveys with report of action are sent to the Bureau of Medi- cine and Surgery for further transmission to the Bureau of Navigation. 222 MAM UAL FOH THK MEDICAI. DEPARTMENT, U. S. JSIAVY. 2946. Medical surveys upon officers and men of the Murine Corps take tlie same course after action by the officer convening the board, except that " Com- luandant of the IMariue Corps " is substitutwl for " liureau of Navigation" in Ihe preceding paragraph. 2947. Before a general court-marti:il i)risoner is transferred to a disciplinary ship a board of niedi( al survey of three medical officers shall be orderetl to de- termine the prisoner's physical fitness for the service. In any case of physiatmerit of officers and enlisted men of the Army and Navy and civilian officers and crews of naval auxiliaries in hospitals of the Public Ibviltli Service ui>on the written refiuest of their respective connnanding oinc«'rs. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 225 3012. An officer or man actually employed in the naval auxiliary service who is ahsent from his duty for treatment in a hospital, or on board a hospital ship or other naval vessel, shall while so absent from duty receive half pay, excluding the day of admission and including the day of discharge, except where such absence is due to venereal disease of the officer or man, in which case he shall receive no pay while so absent. (Changes in Reg. for N A S 1914, No. 13, par. 95.) 3013. Notations will be made on ration notices whenever officers and men of the naval auxiliary service are admitted to hospital as to whether or not for venereal disease, and. further, should changes be made in diagnosis involving discharges from or admissions as cases of venereal disease, subsequent appro- priate ration notices of discharge or admission will be issued. 98601°— 17 15 CHAPTER 18. THE INSANE OF THE NAVY. Section 1.— Laws Relating to the Establishment and Administration of St. Elizabeths Hospital and Regulations Relating to the Insane. 3101. Insane of the Navy; authority of the Secretary of the Navy, etc. Sec. 1551, R. S. , T c 4000 3102. Estal)Iishment of St. Elizabeths Hospital tor the In.sane. Sec. 48d>>, R. S. 3103. The superintendent. Sec. 4839, R. S. 3104. Boaril of visitors. Sec. 4840, R. S. 3105. President of board of visitors. Sec. 4841, R. S. ;, 3106. Powers and duties of tlie board of visitors. Sec. 4842, R. b. ,„ 3107. Admission of insane persons of the Army, Navy, and ^Marine Corps, etc. Sec. 4843, R. S. ; act Mar. 3, 1875. 3108. Limit to admission. Act June 16, 1880. 3109. Transfer of insane convicts, etc., to St. Elizabeths Hospital. Sec. 48.j_, ' R. S. ; acts Juno 23, 1874, Aug. 7, 1882. ^. .,,.-, . 3110. Admission of insane from National Home for Disabled Volunteers. Act Aug. 7, 1882. . ^ ^, , , . ., 3111. Admission to Hospital for In.sane in the District of Columbia, hecs. 4843-4854, R. S. : acts June 23, 1874, Mar. 3, 1S75, Mar. 3, 1879, Aug. 7, 18S2, Julv 7, 1884, Jan. 31, 1899. , ^, 3112. Enlistment of insane persons prohibited. (Articles lor the Orovorn- nient of the Navy.) R. 19. Section 2.— General Directions Regarding the Insane of the Navy. 3121. The Secretary of the Navy is authorized by law to make suitable provision for the care of the insane of the Navy by plaging them in St. Eliza- beths Hospital in the District of Columbia or in any other institution devoted to the care, maintenance, and support of insane persons. 3122. Under the provisions of the law relating to the care of the insane ot the Navy the following classes of persons are entitled to treatment in St. Elizabeths Hospital. (a) Insane men belonging to the Navy and Marine Corps. (b) Men who while in the service of the United States in the Navy or Marine Corps have been admitted to the hospital and thereafter discharged from the hospital on the supposition that their reason was restored and withiu three years after such discharge have again become insane from causes existing at the' time of such discharge and who have no adequate means of support. (c) Indigent insane persons who have served in the Navy or Marine Corps and have been discharged therefrom on account of disability arising from such insanity. . .., . ^, id) Indigent insane persons who have become insane within three years after their discharge from the Navy or Marine Corps from causes \yhich aros^ during and were produced by said service. (e) Women patients admitted to St. Elizabeths Hospital are limited to those residing in the District of Columbia, who are wives and widOAVs of naval officers and enlisted men. (M. and S. 120642.) 228 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 3123. Indigent or insane persons who liave been discharged from fhe Navy or Marine Corps must show, in order to gain admission or readmission to St. Eii/.ahetlis Hospital, that their disability was incurred in or was connected with their service in the Navy or Marine Corps. 3124. To relieve the Goveninient of the care of niontal defectives whose disabiilty may have had its origin prior to enlistment, medical oflicers on duty where recruits are assembled should carelully observe all recruits for stigmata of degeneration, vicious habits, and mental almormalities. Recruits suspected of mental instal>ility sliould be made the subject of special inquiry, and if the evidence of unfitness for active service al)oard ship is forthcoming, such in- dividuals may be brought to the notice of the commanding oflicer as undesirable and discharged or surveyed and returned, if practicable, to the next of kin or place of enlistnient. (M. and S. Memo. 121591, Dec. 14, 1910.) 3125. Boards of medical survey concerned with recommending the transfer of insane to hospital, should consider the practicability in each individual case of having the patient transferred under the charge of a responsible chief phar- macist's mate, with attendants, if necessary. (M. and S. Memo. 12.5012, June 28, 1912.) 3126. Whenever practicable patients giving evidence of being insane shall be transferred to a naval hospital at which a psychopathic ward has been estab- lished for treatment and observation prior to medical survey and final deter- mination of their mental condition and commitment to a hospital for the insane. 3127. Medical officers having charge of an insane patient prior to recom- mending transfer to a hospital for the insane shall endeavor to obtain an accurate family and personal history of the patient and to secure statements relative to the' case from any institution for the insane of which the patient may have been an inmate. Any such statement should be appended to the report of medical survey. 3128. No officer, .seaman, or marine shall be admitted as a patient into a hospital devoted to the care of the insane of the Navy until he shall have been condemned by a board of naval medical officers and the report of the board has been approved by the department. 3129. Upon the approval by the department of the report of medical survey, the Bureau of Medicine and Surgery will forward through official chaimels to the hospital, station, or ship, or wherever the patient may be, an order for his admission to St. Elizabeths Hospital, and an Interior Department form to be filled out. 3130. Medical officers shall exercise great care in preparing the Interior Department form, giving as full a medical history in each case as possible. 3131. On the 1st of .Tuly of each year the Superintendent of St. Elizabeths Hospital forwards to the Bureau of IMedicine and Surgery a report for the year ended, showing the condition of the insane of the Navy and Marine Corps under treatment, together with the number admitted, discharged, died, and remaining uixler treatment. 3132. Upon the recovery of an officer or enlisted man of the Navy or IVIarine Corps under treatment in a hospital for the insane, the department is notified of the fact by the superintendent in charge of the hospital, and the Bureau of Navigation or Headquarters of the Marine Corps directs his transfer. A medi- cal survey is then ordered to determine the disposition of the patient. Tlie ijureau of Medicine and Surgery is notified of discharges in all su<-h ca.ses. 3133. In tlie transjjortation of the insane, suitable nn'asures shall be taken to insure their proper care and treatment while in transit. 3!34. rpMM tlie .'Mliuission of a patient into St. Elizabeths Hospital the hospital authorities furnish the medical officer detailed for such duty with a receipt for the person and the personal elTtnts of the iiatient. The receipt shall be forwarded withovit delay to the Bureau of Medicine and Surgery for the permanent files of the bureau. 3135. The receli)t l>y the bureau of the certificate relating to the admission of the patient is a necessary i»rellnnnary to the Indorsement by the Surgeon MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 229 General on the orders of the medical officer that his duties, so far as they per- tain to the Bureau of Medicine and Surgery, have been completed. 3136. The superintendent of St. Elizabeths Hospital informs the Bureau of Medicine and Surgery, as soon as practicable after its occurrence, of the death of every officer or enlisted man of the Navy or Marine Corps who dies while under treatment in this institution. The official death report shall be prepared and signed by the medical officer assigned to duty in connection with the patients from the Navy and Marine Corps in St. Elizabeths Hospital. In case no medical officer is so assigned the death report will be prepared in the Bureau of Medicine and Surgery. 3137. For the information of the superintendent of St. Elizabeths Hospital the following records shall accompany each patient upon his admission to the hospital : (a) Order for admission. (b) Copy of medical survey. (c) Copy of hospital ticket, (d) Health record, with a request that a concise record of the case be con- tinued therein, and the record forwarded with the patient In case of transfer, or in case of death, desertion, or termination of service to be forwarded to the Bureau of Medicine and Surgery. (e) Copy of Department of Interior form. (Procurable from bureau.) Section 3. — Laws Relating to the Care of Insane Patients on the Pacific Coast. 3141. Care, maintenance, and treatment of the insane of the Navy and Marine Corps on the Pacific coast. (Annual naval appropriation act.) Section 4. — Instructions Relating to the Admission of Patients to the State Hospitals, California. 3151. A clause in the annual naval appropriation act makes suitable pro- vision for the care, maintenance, and treatment of the insane of the Navy and Marine Corps on the Pacific coast. 3152. Under an annual contract, commencing with each fi.scal year, and entered into between the California State Conmiission of Lunacy and the Secretary of the Navy, the insane of the Navy and Marine Corps on the Pacific coast are sent for treatment to a State hospital for the insane. 3153. On the 1st day of .January and .July of each year the general superin- tendent of State hospitals of California, representing the California State Com- mission of Lunacy, forwards a report to the Bureau of Medicine and Surgery, through the department, showing the condition of all patients of the Navy and Marine Corps under treatment. The report further shows the number of patients admitted, died, discharged, and remaining under treatment. 3154. Under the terras of the contract the expense connected with the care, maintenance, and support of insane patients is $15 a month for each patient, and such expenses are paid out of the appropriation " Contingent, Bureau of Medicine and Surgery." 3155. Outfits of clothing are furnished by the department to all enlisted men under treatment. In the case of enlisted men of the Navy and Marine Corps whose terms of enlistment have expired the hospital authorities are authorized, under the terms of the contract, to provide such patients with suitable clothing at the rate of $2.50 per month. 3156. All expenses connected with the transportation and admission of in- sane patients of the Navy and Marine Corps into a State hospital for the insane, California, are defrayed from appropriations xmder the control of the Bureau of Navigation and the Marine Corps, respectively. All expenses connected with the discharge of enlisted men of the Navy and Marine Corps from siuli a hospital and their transportation to a receiving ship or marine post for discharge from 230 ^rANUAI. FOK THK MKDICAL DEPARTMKXT, U. S. NAVV. tlie naval service or Marine Corps are paid froin ai>pi-opiiations under the con- trol of the Bureau of Navipation and of the Marine Corps, respectively. 3157. The funeral expenses of enlisteH. (Quarterly payments ar«> made by the de|)artment for the care, raaiii- lenaiue. and support of the insane patients of the Navy and Marine Corp< under Treatment in a State liospital, and the vouchers are made payable to the ;reneral superintendent of the State hospitals, California. 3159. The vouciier shall be prepared and shall bear the certificate as to correctness by the medical officer in command of rlie naval hospital. Mare Island. Cal. It is approved by the connuandanl of the navy yard. Mar*- Island, Cal.. ami by the Surgeon General of llie Navy. The I'ay master General of the Nav.\ directs its payment by the Navy pay oltice, San Francisco, Cal. 3100. rpon the admission of a patient into a State hospital the hospital authorities furnish tiie medical officer or attendant accompanying such patient with a receipt for the person and the personal effects of llu^ patient. Sucli receipt shall be forwarded by the medical attendant without delay to the com mandant of the navy yard. Mare Island, for the tiles of his office. 3161. The bureau's permit for the admission of the patient, and the cer- tificate of the hospital authorities that the patient has been admitted into the institution, are a n(K;essary preliminary to the approval and transmission to iJie department by the conunandant of the vouchers for expenses connected with the care and treatment of insane patients of the Navy and Marine Corps in a State ho.spital. 3162. The superintendent of a State hospital informs the commandant of the navy yard. Mare Island, Cal., as soon as practicable after its occurrence of the death of every officer or enlisted man of the Navy or Marine Corps wlu» dies while undergoing treatment in such an institution. Upon receipt of such in- formation the conunandant causes a certificate of death to be prepared by a Jiiedical officer under his command, and such report shall be forwarde be con- tinued therein, and the lecord forwarded with the patient in case of transfer, or in the case of death, desertion, oi- terminaljon of service to be forwarded to the conunandant of the n.avy yard. ^larc? Island, Gal.) (e) The Deparduent of Interior form. 3165. Boards of medical survey reconunenrling the discliiirge o1 harmless in- .^iine able to care for theniselves or be cared for by Irieiuls or th«'ir families, should enter on the report of survey the stntc-ment. "Not a menace to him.self or 1(» the connnnnity." 3166. Thirty day.s' notice of the contemplated discharge of an enlisted man or member of the auxiliary force is re(juirwi to be ghen to the superintendent of St. Elizabeths Hospital and to the SecnMary of tlu> Interior to enable the latter to re(|uest the Attorney General to have the sanity of (he Individual determined, as re(iulred under ilie laws of (he I>is(rl<'( of ('olumbia (M \ s. No. rji.ir.fK) .YVA-/I .a .u .t: CHAPTER 19. THE xVAVAL MEDICAL SCHOOL. ■■ Skction 1. — Rkcutlations Relating to the Naval Medical School. 3201. Order relating to its establishment. General Order No. 89, May 21, 1902. 3202. Order changing name. Department letter No. 19931, May 26, 1905. 3203. Under the supervision and control of the bureau. 112901 (3). 3204. Microscopical outfit and accessories to be forwarded to Naval Medical School when ship goes out of commission. (12124 (1) ?>.), .^ Skction 2. — Insteuctioks Relating to the Naval MEoicAL ScHbOL.' ; '" 3211. The medical officer in command of the Naval Medical School is charged with all duties relating to its administration, and is responsible for its efficiency. 3212. The faculty will consist of the officers ordered to the school as instruc- tors. The medical officer in command shall preside over and conduct all faculty meetings, and the junior member of the faculty shall keep a record of all pro- ceedings. Meetings of the faculty will be held from time to time as may be considered advisable by the medical officer in command and the bureau shall be kept advised of any changes regarded as desirable to improve the efficiency of the school as a whole or in any individual branch. At such meetings de- ficiencies of individual student officers will also be given careful consideration. 3213. Each member of the faculty shall consult with the medical officer in command and shall submit a syllabus of his course when directed, for the offi- cial files of the school. 3214. Upon the completion of the session and at such otiier times as may be considered desirable, examinations will be held. The final examination will be conducted by a board to determine fitness for admission to the Medical Corps. 3215. At the beginning of the school year members of the Naval Reserve Force who may have been selected for that purpose will be ordered to the Naval Medical School for duty and the prescribed course of instruction. 3216. Medical officers who desire to avail themselves of the course of in- struction or of any of its branches may be assigned to the school for such pur- pose upon recommendation by the bureau. 3217. By permission of the bureau medical officers who desire to undertake research work, and who have been detailed for duty in Washington or other place, may, when their services can be spared, avail themselves of the advan- tages of the laboratories for their investigations. . . ,, ,. j 3218. The course of instruction for a session will cover a period' o^rtbt \^^b than five months, and embrace the following : Naval and general hygiehei haivat and operative surgery, tropical medicine, pathology, medical zoology, bacteri- ology, serology, ophthalmology, chemistry, psychiatry, roentgenology, and elec- tro-therapeutics. Hospital Corps drills, duties of the medical officer in Navy Regulations and Naval Instructions and Manual for the Medical Department, and such other subjects, including naval law, epidemiology, quarantine, etc., as may be feasible. In all these courses special attention shall be given to tho^e features pertaining to the practical work of naval medical officers. ' 2.31 '^ 232 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 3219. Student officers shall be required to be present at all the exercises of the school unless excused by the medical officer in command or other com- petent authority. They shall be considered on duty during the hours prescribed for school work, and shall be required to conform in all respects to the United States Navy Kei^ulations and Naval Instructions and such orders as may be issued from time to time for their guidance and the maintenance of discipline. 3220. Applications from medical oHicers of ships and stations for the loan of books, and duplicate copies of current periodicals in the school library, should be addressed to the medical officer in command. It is the intent to have the library of the school utilized by medical officers generally so far as may be practicable, but receipts will be required, and officers securing publications will be held responsible for their prompt return. Section 3. — Instructions Relating to Collecting, Pbesebving, and Fobward- IN6 Specimens to the School. 3221. The laboratories of the Naval Medical School are prepared to make examinations of and furnish reports on pathological, bacteriological, and other specimens. Such specimens and samples should be forwarded direct to the medical officer in command of the school, properly packed, and be accompanied by a report made on a prescribed form issued to medical officers upon appli- cation. 3222. Blood for "Wassermann reaction should be taken from a vein or col- lected in a Wright's tube, and set aside until the clear serum separates from the clot. The serum should then be removed by means of a capillary pipette and forwarded in sealed capillary tubes or small vials. 3223. Samples of which a chemical examination is desired should be ac- companied by an explicit statement as to the kind and extent of examination wanted. Such samples should be adequate in quautitj-. When it is necessary to use preservatives due care must be exercised in their selection that inter- ference with subsequent examination may be avoided. 3224. Pathologic tissue, including gross and microscopic specimens and blood smears, parasitic worms and their ova, mosquitoes, flies, fleas, ticks and other parasitic insects, snakes, poisonous fish, and any other specimens of medical interest, especially in the Tropics, are desired and required for the school col- lection. Specimens of ordinarily little value may be of interest because of the remote or unusual locality in which Ihey were collected. 3225. The simplest method of preserving tissues for microscopic study is to place small pieces, not over h inch (5 mm.) thick, in a 10 i>er cent solution of formalin (4 per cent formakk'hyd) for 10 to 24 hours, then transfer them to 70 per cent alcohol, in which they may be left indefinitely. Feces containing ova may be preserved by mixing with an equal volume of 10 per cent formalin. Worms may be preserved in 10 per cent formalin for from 2 to 24 hours, ac- cording to size, and then transferred to lacto-phenol solution (glycerin 2, water 1. phenol cryst. 1, lactic acid 11 ; nematodes may be placed directly in hot (SO C.) 70 per cent alcohol and allowed to remain indefinitely. 3226. A separate label should be .sent with each specimen, giving full in- formation jiarticuhirly covering the following jioinls: Name, sex, age, and race of patient, with pertinent clinical notes; animal and organ from which parasite was collected; locality in which specimen was collected; locality of probable infection; method of i)reservation. 3227. Double tin mailing cases, with specimen bottles suitable for average siJecimens, have been sent to naval hospitals and certain tropical stations. These and other special bottles and cases will be supplied from the school upon request. 3228. Typhoid bacilli emulsion for Widal test, culture tubes and blcKul stain and other bacteriological siiiiplics listed on the supply tnble as procurable from the school, should be applied for direct by letter or telegram addressetl to the meilical officer In command. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 233 Under section 473, Postal Laws and Regulations, are given restrictions imposed in regard to the transmission through the mail of pathological or dis- eased tissues, blood or syphilitics, tubercular sputum, liquid cultures, etc. Medical officers contemplating the use of the mails for transmission of material that might be forbidden, or for Avhich specific directions are given, should apply for information to the Post Office Department, Washington, D. C. Section 4. — Naval Medical Correspondence Course. 3230. Upon recommendation of the bureau the Navy Department on Jan- uary 24, 1916, authorized the establishment of a correspondence course for medical officers of the Naval Reserve Force. This course is also open to acting assistant surgeons of the Navy and to medical officers of the Naval Militia. Acting assistant surgeons and officers of the Naval Reserve Force on active duty are required to talie the course, unless they have previously completed the regular course of instruction at the Naval Medical School. The course is administered by the Naval Medical School. The object is to promote the efficiency of these officers by systematic instruction in naval forms, customs, regulations, and procedures. >? FAnVi/. .: CHAPTER 20. SUPPLIES AND SERVICES ; REQUISITIONS : PUBLIC BILLS AND VOUCHERS. SiccTioN 1. — IjA\n'.s Relating to the Pkocurement of Supplies, Services, etc. 3301. Regulations of supplies. Sec. 1549, R. S. 3303. Advertisements for proposals. Sec. 37(K), R. S. ; acts June '22. 1874, .Tan. 27, 1894. 3303. Naval supplies, how purchased and issued. Acts Mar. 2, 1891, Mar. 2, 1907. 3304. Supplies to be deemed naval and not bureau supplies. Act June 30, 1890. 3305. Contracts for the naval and military service, liuw controlled. Sec. 3714, R. S. ; act Feb. 27, 1877. 3306. Naval supplies to be furnished by contract. Sec. 3718, R. S. ; act .Tune 30, 1890. 3307. Purchases that may be made witliout advertisinsj. Sec. 3721, R. S. 3308. Contracts to be in writins. Sec. 3744, R. S. 3309. Oath to contract. Sec. 374.5, R. S. 3310. Penalty for omitting returns. Sec. 3741). R. S. 3311. Instructions. Sec. 3747, R S. 3312. Returns office. Sees. .512, 513, .514, 515, R, S. 3313. Original contract to be deposited with Auditor for the Navy Depart- ment. Act July 31, 1894. Section 2. — Navy Regulations and Naval Instructions Relating to These Subjects. 3321. Bureau to require and have custody of all medical supplies. R 133 (4) 3322. Medical outfits for ships. R 4623. 3323. Requisitions and supplies from any other department of the ship. I 4422. 3324. Requisitions for supplies or services on ships at naw vards in emer- gencies. I 4472 (6). 332r>. General instructions as to open-purchase requisitions. I 4654 (1). 3326. Open purcha.se in emergencies. I 4654 (6). 3327. Requisitions for supplies from ships at navy yards. I 4475. 3328. Requisitions foi supplies (b opf'n purchase on shore, how niade, ap- proved, and fulfilled. 1 4657. . " .,,,,, ),,«..■,> • i ■ 3320. Medical supplies, instruments, etc., to be selected by- officers' represent- ing the departments requiring for them. I 4480. 3330. Inspection of supplies purchased. I 3225; I 4678. 3331. Public bills to be prepared without delay. I 4691. 3332. Approval of public bills and preparation of vouchers. I 448^. 3333. Disposition of bills and requisitions. I 4484. 3334. Disposition of medical supplies upon a ship going out of commis- sion. I 2124. 235 236 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Section 3. — Laws and Decisions Rklating to Mf:dicat. Sekvices and Supplies. 3341. Medicines and medical attendance. Sec. 1586, R. S. 3342. Keimburseinent for dental services is authorized after injury incurred in line of duty. (Rulin;,', Comptroller's Ollice, May 23, 1913.) 3343. Officers proceeding under orders entitled to medical attendance. (Rulinii;, Comptroller's Office, Feb. 11, 1902.) Section 4. — Navy Regulations llELAfrNo to Medicines and Medical Attendance. 3351. Expenses? for medical attendance, when allowed. R 4534 (1). 3352. Sickness or injury, to he reported. R 4534 (2). 3353. Claims for expen.ses. R 4534 (3). 3354. Treatmfent by specialist. R 4.534 (4). 3356. Expenses for enlisted men. R 4.534 (5). 335(>. Where there is no Government hospital. R 4534 (6). 3357. Sick officers entitled to attendance within or without a naval hospital. I 3222. Section 5. — General Information Relating to Medicines and Medical Attendance. 3361. All officers of the Navy and Marine Corps on duty are entitled to the professional services of medical officers of the Navy who are detailed for the purpose. When medical officers treat officers who are not regularly under their care, they shall forward medical histories of such cases to the Bureau of Medi- cine and Surgery. I 3222. 3362. Under the laws and regulations, expenses incurred by offifers of the Navy for medicines and medical attendance shall not be allowed unless they were incurred when on duty, and the medicines could not have been obtained from naval medical supplies, or the attendance of a naval officer could not have been had, except as provided in article li 4534 (4). 3363. The regulations require that officers on duty where the services of a naval medical officer are not available shall report their condition to the Sur- ge(m General of the Navy as soon as practicable after the occurrence of their sickness or injury in order that their claims for expenses may receive immediate attention. 3364. All claims for expenses incurred by officers of the Navy for medicines and me38 MANUAL I'OK TllK xMEUlCAL DEPARTMENT, V. S, NAVY. 33i». Requisitions will not call for proprietary articles in any case where it can possilily be avoided, and when callinj? for proprietary articles will be indorsed "The above ar)i. Requisitions afloat in home ports and afloat and asliore abroad will be prepared upon the forms provided by the bureau when it is desired that stores shall be forwarded from a medical supply depot and upon ships' forms when the stores are to be purcliased upon the station. Medical oflicers on shore duty within the United States when submitting requisitions will use Form B and Form 4 for supplies listed in the supply table and for other supplies will use Form 1. 3397. Duplicating proces.ses in the preparation of requisitions aud public bills are commended, as they insure accuracy of copies. Care will be exercised that all copies are entirely legible, and all footings will be make in ink. 3398. Medical officers shall see that all public bills bear the appropriation designated by tlie requisition. 3399. The expense of maintenance of hospitals (including supplies and pro- visions, fuel, medicines, furniture, equipment) and of repairs to buildings, roads, fences, etc., and of repairs of furniture and equipment, is a charge against the naval-hospital fund. The naval-hospital fund is only available for hospital expenses. •• 3400. Other appropriations chargeable with hospital expenses are " Contin- gent, M. and S.," for burial of the dead ; purchase of horses, wagons, trees, seeds, etc. ; " Bringing home remains," for tran.sportation of remains when authorized by the bureau ; " Medical Department," for pay of civil employees on the pay roll ; "Pay of the Navy," for rental of quarters; "Pay, miscellaneous." for tele- grams, telephones," and postage stamps ; " Freight, S. and A.," for expressage and freight. Section 7. — 1'ublic Bills Afloat. 3401. Purchases on board ship are made by the pay officer of the ship, ap- proved by the captain or by the commander in chief. The selection of the articles is made by the medical officer. 3402. Public bills for all supplies and services for the Medical Department on board ships on foreign stations are made out on forms furnisheril and October. (c) For receiving ships and ships in reserve.. on the 1st of May and November. (d) For !boin srtl fit!// l»'jiT.'>r>r: if T MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 247 3o4G. Requisitious for stores and supplies shall be made by the senior medical ofiicer to cover ordinary expenditures ; but if it can be avoided such supplies shall not be procured by purchase. 3547. When any of the supplies and stores on board ship in charge of other officers are deemed necessary for the treatment of the sick, they may be obtained by the senior medical officer upon requisition duly approved by the commanding officer. A receipt for them shall be given. (I 4422.) .4648. Requisitions for medical supplies from ships in commission at navy yards shall be made upon the Bureau of Medicine and Surgery, unless to supply some article for w^hich there is an immediate demand, in which case the pur chase shall be made by the pay officer of the ship upon a requisition approved by the commandant. (I 4472 {());} 4654 (6).) Section 5. — Instructions Relating to the Supply Table, Supplies is-rom Sup- ply Depots, Supply Ships, and the Naval Medical School. 3551. (a) The Supply Table of the Medical Department is intended as a basis for all requisitions from hospitals, shore stations, and ships. (b) The Field Supply Table is intended as a basis for supplying the needs of an expeditionary force. 3552. Medical outfits for ships in commisi^ion on the Atlantic coast shall be furnished from the naval medical supply depot, Brooklyn, N. Y. Medical outfits and supplies for ships in commission on the Pacific coast shall be furnished from the naval medical supply depot, Mare Island, Cal. Medical outfits and supplies for ships on the Asiatic Station shall be furnished, whenever prac- ticable, from the naval medical supply depot, Canacao, P. I. 3553. A supplementary list of articles (not included in the Supply Table) in store at the naval medical supply depots will be furnished upon requisition tfi hospitals, stations, and ships. In making requisitions for supplies from this list medical officers will use special requisition Form Ba. 3554. Medical officers attached to ships fitting out for foreign stations or extended cruises shall submit their requisitions in ample time to have them filled before leaving a navy yard. 3555. Microscopes and microscopical outfits will be supplied upon approved requisition for these items alone, and when received will be carried on the books of the Medical Department, and shall not be transferred except by authority of the bureau. When a ship is placed out of commission the microscopical outfit will be returned to the Naval Medical School, as directed by Naval Instructions, article 2124 (1) &. 3556. The following bacteriological supplies are procurable upon application by letter or telegram to the Naval Medical School, Washington, D. C. : Blood stain (in sealed tubes containing 0.075 gm., and methyl alcohol, 2.o c. c), blood serum albumin, culture tubes blood serum, culture tubes agar-agar, emulsion typhoid bacilli, for Widal test. Section 6. — Txstkuctions Relating to Vaccine Vikus, Typhoid Prophylactic, and Other Sera. 3561. All vaccine virus that may be required is furnished upon request by letter or telegram addressed direct to the bureau, or to the supply depots at Mare Island, Cal., and Canacao, P. I., for the Atlantic. Pacific, and Asiatic St:itions, respectively. 3562. Typhoid prophylactic and other sera that may be required will be furnished upon request by letter or telegram addressed to the bureau. 3563. Receipts are forwarded to all medical officers furnished with vaccine virus, typhoid prophylactic, sera, and antitoxins. They should be signed by the medical officer receiving the articles. The original shall be returned to the bureau for its files, and other copies disposed of as indicated on thp forms. CHAPTER 22. THE NAVAL HOSPITAL TUND. Section 1. — Laws and Regtjlations Relating to its Establishment and Administration. 3601. Power to receive gifts in aid of marine hospitals. Sec. 4801, K. S. 3602. Deduction from pay of officers, seamen, and marines for naval hospital fund. Sec. 4808, R. S. 3603. Appropriation of fines imposed by sentence of courts-martial. Sec. 4809. R. S. 3604. Allowance of rations to naval hospitals. Sec. 4812, R. S. 3605. Allowance from pensions. Sec. 4813, R. S. 3606. Deductions for hospitals from pay of officers and enlisted men of the Marine Corps. Sec. 1614, R. S. 3607. First annual appropriation by Congress for the support of the naval hospital fund. Act May 4, 1878. 3608. Pension of seamen, etc., at naval hospitals. How paid. Act March 3, 1899, amending section 4818, R. S. 3609. Hospital fund. Credit for desertion forfeitures. Naval appropriation act, June 7, 1900. 3610. Superintendence of naval hospitals. Sec. 4807, R. S. 3611. Payments from fines and forfeitures for transportation of discharged prisoners. Act March 3, 1909. 3612. Sites for hospitals and extensions to hospitals to be authorized by Congress. Act March 4, 1913. 3613. Proceeds of sale of hospital property revert to the hospital fund. 3614. Payments from navy-yard employees for subsistence in hospital. Gen- eral Order No. 148, January 10, 1912. Section 2. — Navy Regulations Relating to the Naval Hospital Fund. 3621. Deductions from pay of officers, seamen, and marines for hospital fund. R 4404. 3622. Deduction of value of rations from accounts of persons in hospitals. R4521. 3623. Pensions of pensioners and supernumeraries in hospital. R 4533. 3624. Deduction from pay of nurses for hospital fund. R 4428 (5). 3625. Deduction from pay of officers and men of the Naval Auxiliary Service for hospital fund. (See "Regulations foi the Naval Auxiliary Service.") Section 3. — Information Relating to the Origin and Uses of the Naval Hospital Fund. 3631. On July 16, 1798, Congress enacted a law making suitable provision for the relief of sick and disabled seamen. The law went into effect on September 1, 1798. The first section provided that the master or owner of every ship or vessel of the United States arriving from a foreign port should render to the collector of the port a true account of the number of seamen employetl on board such vessel, and should pay to the said collector at the rate of 20 cents per month for every seaman so employed ; v»'hich sum he was authorized to retain out of the wages of such seamen. 3632. Out of this fund the President of the United States was authorized to provide for the temporary relief and maintenance of sick and disabled seamen 249 250 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVV. in the hospitals or other institutions then existing in tlie several ports of the United States. 3G33. The President was also authorized under the provisions of this act to receive donations of real or personal property in the name of the United States for the erection or support of hospitals for sick and disabled seamen. 3634. Under the same act the President was granted the necessary authority to appoint persons to be called directors of the marine hospitals in the different ports of the United States, who were intrusted with their direction and super- visory control, 3635. The objects and resources of this fund, known as the " Marine hos- pital fund," as provided by the law July 16, 1798, were considerably enlarged by 11)0 act of March 2, 1799, which gave the Secretary of the Navy the necessary uuUiorlty to deduct, after the first day of September, 1799, from the pay of the oflicers, seamen, and marines in the Navy of the United States at the rate of 20 cents per month and to pay the same quarterannually to the Secretary of the Treasury. It was further directed that the money so collected should be applied to the same purposes as the money collected by virtue of the act of July 16, 1798, and that it be expended in like manner under the direction of the President of the United States. 3636. By the passage of this act (Mar. 2, 1799) the officers, seamen, and marines of the Navy of the United States were entitled to receive the same benefits and advantages as were provided by the law of July 16, 1798, for the relief of the sick and disabled seamen of the merchant vessels of the United States. SiisV. On January 16, 1811, the marine hospital fund amounted to .$73,288.38. and of this amount $55,649.29 had been deducted from the pay of the officers, seamen, and marines of the Navy. 3688. Under the provisions of the acts of July 16, 1798, and March 2, 1799. the marine hospital fund was applicable for the relief of merchant seamen and of officers, seamen, and marines of the Navy. 3639. The inconvenience and embarrassments which ai-ose from the treat- ment of patients in the public service controlled by military law in civil hos- pitals, where no such restriction existed, were a source of much concern to tlu> Navy Department, and the attention of Congress was called to the propriety of establishing by law separate institutions for the care and treatment of the sick of the Navy. 3640. To remedy the evils resulting from the joint use of a fund, which up to this period had" been employed for the relief of the sick of the merchant service, as well as those of the Navy and Marine Corps, Congress enacttxl a law approved February 26, 1811, which provided for the establishment of naval hospitals. The act contained a clause which directed that $50,000 be appro- priated out of the unexpended balance of the marine hospital fund, and that this sum be paid to the commissioners of Navy hospitals for the purpose of a naval hospital fund. The naval hospiti^l fund therefore dates its origin from Oio passage of this law, February 26, 1811. The same act contained a further pro vision designating the Secretary of the Navy, the Secretary of the Treasurj-, and the Secretary of War as a board of conmiissioners, to be known as the " commissioners of Navy hospital.s." 3641. In this act (Feb. 2G, 1811), providing for the purchase of suitable sites and the erection thereon of suitable hospital buildings, Congress specified /hat all expenditures for such purposes should be defrayed from the naval hospital futid, 8642. For almost 20 years fi'oni the date of the act establishing naval hos- pitals the commissioners of Navy hospitals, owing to lack of adequate means, wore unable to carry into effect the provisions thereof. 3648. For many years after the e.stablishnient of the naval hospital fund thi> money aecrtiing to "such fund was Illegally expended for other purposes, the gi-eater portion of which was utilized In meeting the expenditures iindor the appropriation " Pny of the Navy." ■•••" ^^^^ i^.-^i iiiiiui4i.:iuj .. i.j MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVV. 251 3(>14. Ill 1S32 the naval liospitfil fuucl w;is in such a condition jis t<> lie avail- able to carry into effect the wise and beneflcent system contemplated by the act of Fehruarj'" 26, 1811, establishing naval liospitals. 3645. For the erection of such hospitals, therefore. Congress by the net of July 10, 1832, appropriated certain specific sums from the naval hospital fund, and directed the Secretary of the Navy to cause to be constructed for the use of the Navy proper hospitals at or near the navy yards of Charlestown, Mass., Brooklyn, N. Y., and Pensacola, Fla. Congress further authorized the erection and completion of the Naval Asylum (Home) at Philadelphia, Pa., the ex- penses for such work being defrayed in part from the naval hospital fund. As the amounts credited to this fund have not always been sufficient at all times for the purposes for which established, Congress has come to the relief of the fund by making specific appropriations for the erection and completion of several hospital establishments which have subsequently been constructed in meeting the requirements and development of the naval service. Section 4. — Continuous Soueces of Revenue to the Naval Hospital Fund. 3651. By the act of Mai-ch 2, 1799, section 1614, Revised Slatutes, the Secre- tary of the Navy was authorized and directed to deduct, after the 1st day of September, 1799", from the pay thereafter to become due, at the rate of 20 cents per month for each officer, seaman, and maiine. Such deductions are made by the pay officers of the Navy and Marine Corps having charge of the pay accounts of the officers, seamen, and marines. The amounts so collected are transmitted quarterly to the Auditor for the Navy Department, and by him placed to the credit of the naval hospital fund. 3652. Section 4812. Revised Statutes, act of February 2fi, 181 1, provides that for every naval officer, seaman, or marine admitted into a naval hospital the institution shall be allowed one i-ation per day during the period that ho remains under treatment in the hospital. The value of such ration is debited again.st " Provisions, Navy." and credited to the " Naval hospital fund." The commutation price of the ration is fixed by section 1585, Revised Statutes, at 30 cents, and commuted rations stopped on account of sick in hospital are credited at the rate of 50 cents per ration to the naval ho.spital fund by au- thority of the naval act of June 30, 1914, (See comptroller's decisions of Aug. 4 and Oct. 28. 1914.) The provision of section 4812, Revised Statiites. is now extended to members of the Nurse Corps and to officers and men of the Naval Auxiliary Service. 3<.53. Section 4813, Revised Statutes, act of February 26, 1811, provides that the pensions of all officei-s, seamen, and marines while undergoing treatment in a naval hospital shall be deducted from the accounts of such pensioners, and shall be paid to the Secretary of the Navy, and credited to the naval hospital fund. The pension agent in whose district such pensions are paid transmits the sum due each oflicer. .seaman, and marine during the time he remains under treatment in the hospital to the pay officers on whose books such accounts are carried, to be by them transmitted to the Auditor for the Navy Department. 3654. Section 4809, Revised Statutes, acts February 26, 1811, and July 10. 1832, provide that all fines imposed on naval officers, seamen, and marines (by sentence of court-martial) shall be paid to the Secretary of the Navy for the ms^intenance of naval hospitals. All credits to the naval hospital fund from this source are adjusted in the oflice of the Auditor for the Navy Department. 3656. The first annual appropriation ($50,000) for the support of the naval hospital fund was provided by Congress under the act approved May 4, 1878. Between that date and 1908 Congress annually appropriated a sum varying in amount. Since the later date no appropriation has been made. 3(i57. The naval appropriation act approved June 7, 1900, provitles that from and after the 1st day of July, 1900, all forfeitures on account of desertion shall he passed to Ihe creilit of the iiaval hospital fund. Such credits are ad- .aollBfiqonqqi! v,o 'Mmtv a aiii>i ^"^ 1^^== 252 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. lusted in the office of the Auditor for the Navy Department. All payments "from navy yard employees for subsistence while in hospital pass to the hospital 3658. The act of March 3, 1909, provided that the receipts from fines and forfeitures imposed by naval courts-martial be made applicable for payment for transportation of discharged prisoners to their homes, the balance not required for such payments to be transferred to the naval hospital fund. 365J). Section 4810, Ilevlsed Statutes, was amended by act of March 4, 1913, to read as follows : " Sec. 4810. The Secretary of the Navy shall procure at suitable places proper sites for naval hospitals, and if the necessary buildings are not procured with the site, shall cause such to be erected, having due regard to economy, and pref- erence to such plans as with the most convenience and least cost will admit of subsequent additions, when the funds permit and circumstances require, and shall provide at one of the establishments a permanent asylum for disabled and decrepit naval officers, seamen, and marines: Provided, That hereafter no sites shall be procured or hospital buildings erected or extensions to existing hospitals made unless hereafter authorized by Congress." (Naval appropriation act, Mar. 4, 1913.) Section 5.— Specific Sources of Revenue to the Naval Hospital Fund. 3661. The first specific appropriation for the naval hospital fund dates from the act of February 26, 1811, providing for the estalilishment of naval hospitals, when Congress appropriated for the purpose $50,000 from the marine hospital 3662. By the act of March 3, 1855, section 6. 10 acres of the land belonging to the naval hospitnl, Chelsea, Mass., were set aside by Congress for the use of the marine hospital of the district of Boston and Charlestown. Several years after the passage of this law Congress, by an act approved June 12, 1858, directed that the value of the land that belonged to the naval hospital at Chelsea, Mass., and that had been ceded to the Treasury Department for the purposes of a marine hospital, should be ascertainecific appropriation, as. for instance, under "Medical Department." tor the pay of civil employees, and under " Contingent " for the purchase of ami feed for horses and cows and the purchase of autom<)t)ile ambulances. Specific jtrovision in an appropriation act eatopR the naval hospital fund for the same purpo.se, so that an ambulance that could be purchased from the fund. If not jirovided In the appropriation, can not be purchased .'^o long as provision is maile by appropriation. CHAPTER 23. THE NAVY PENSION FUND AND GENERAL PENSIONS. Section 1. — Laws Relating to the Navy Pension Fund. 3701. Secretary of the Navy trustee of Navy pension fund. Sec. 4750, R. S. 3702. Penalties, how to be sued for, etc. Sec. 4751, R. S. 3703. Navy pension fund, how to be invested. Sec. 4753, R. S. 3704. Rate of interest on Navy pension fund. Sec. 4754, R. S. 3705. Navy pensions payable from fund. Sec. 4755, R. S. 3706. Half rating of disabled enlisted persons .serving 20 years in Navy or Marine Corps. Sec. 4756, R. S., amended by act of December 23, 1886. 3707. Serving not less than 10 years, may receive what aid. Sec. 4757, R. S., amended by act of December 23, 1886. 3708. Deposit of collections for depredations. Act April 30, 1878. Section 2. — Laws Relating to Pensions and to the Origin of Disability ob Cause of Death, in Relation to Pesions. 3711. Pensions to officers and seamen of the Navy disabled prior to March 4, 1861. Sec. 4728, R. S. 3712. I'ensions to widows and minors of some officers and seamen of the Navy disabled prior to March 4, 1861. Sec. 4729, R. S. 3713. Provisions of former acts extended. Sec. 4712, R. S. 3714. Commencement of anterebellion pensions. Sec. 4713, R. S. 3715. Mexican War veterans. Sec. 4730, R. S. ; restoration of pension in certain cases. Acts June 9, 1880; January 29, 1887; June 6, 1898; April 23, 1900; March 3, 1903; May 11, 1912. 3716. Pensions allowed at age of 62 for service in Civil and Mexican wars. Act of February 6, 1907. Provision extended to certain classes of beneficiaries. Act of March 4, 1907. Section 3. — Laws Relating to Pension fob Disability Contracted in the Line of Duty. 3721. "Who are entitled to pensions. Sec. 4692, R. S. 3722. Beneficiaries under preceding section. Sec. 4693, R. S. 3723. Coast Guard to cooperate with the Navy. Sec. 2757, R. S, 3724. Pensions to officers, etc., Coast Guard. Sec. 4741, R. S. 3725. Pen.«ions for T»hvsical disability of Medical Reserve Corps. Act April 23, 1908; act August 22, 1912. 3726. Organized Militia ; pension for wounds or disabilities received or in- curred in service. Act Jan. 23, 1903. " 3727. United States Auxiliary Naval Force. Act May 26, 1898. 3728. Limitation in cases of disability incurred since July 27, 1868. Sec. 4694, R. S. 3720. Sick leave, sick furlough, veteran furlough, line of duty. Sec 4700, R. S. 3730. Rate of pension for total disability according to rank. Sec. 4695, R. S. 3731. Relative rank in the Navy. Acts March 3, 1877; June 18, 1878. 258 254 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. lllU'Z. Kate of peusion dependent on rank wlien disability origluatetl. Sec. 4096, R. S. 3733. Honorably discharged men serving 90 days during War of the Rebel- lion, disability not results of own vicious habits. Acts June 28. 1906, June 27, 1S90, May 9, 1900, July 1, 1902, May 11, 1912, August 22, 1912. 3734. I{ato of specific disabilities prior to June 4, 1872. Sec. 4697, R. S. 3735. Kate for permanent specific disabilities since June 4, 1872. Sec. 4698, li. S. ; acts June 18, 1874, June 16, 1880, June 17, 1878, March 3, 1879, April 8, 1904, February 12, 1889, February 28, 1877, June 18, 1874, March 3, 1883, March 3, 1885, August 4, 1886, March 2, 1903, August 27, 1888, January 15, 1903, March 4, 1890, July 14, 1892. 3736. Soundness of soldier or sailor at enlistment to be presumed; but may be rebutted. Act of March 3, 1885. 3737. Merchant marine service; persons serving therein liable to draft in time of war and entitled to pensions for wounds received. Act May 28, 1896. Section 4, — Pensions to Widows and Dependent Relatives Based on Sekvice SiNCji Mauch 4, 1861. 3741. Widows and minors, when eutltlai,,, ,Se«s. 4702, 4703, R. S.; acts June 27, 1890, May 9, 1900, April 19, 1908. ,...;. ' 3742. Pensions to dependent relatives., Sec, 470Y, R. S. ; act June 27, 1890. 3743. Date of death fixed in case of officers, etc., lost in wreck of steamer Jeannette. Act January 3, 1887. 3744. One year's pay given to widows, etc., of those lost in wreck of Ashue- lot; to be deducted from any pension allowed. Act January 29, 1887. 3745. Connnencement of pensions arising out of destruction of Maine. Act March 30, 1898. Section 5. — Jnavy Regui^ations Relating to Pensions. 3761. Commanding officer to sign descriptive list on certificates of pension. R 2120. 3752. Pension of pensioner in a naval hospital. R 4533. 3753. Service pension to disabled after 10 years' service. R 4.561 (1). 3754. Pension after 20 years' service. R 4561 (2). 3765. Evidence of claim for pension on official report of death. R 4562. 3 7 66. Accidents in absence of a medical olficer, eyewitnesses to report upou. R 4.563. 3767. If record is incomplete the bureau is to decide line of duty. R 4564. 3768. Medical officers at navy yards to examine applicants for pension under sections 4756 and 4757, Revised Statutes, and give required certificates. I 3461 (3). 3759. Correspondence relating to pensions to be direct with Pension Bureau, r 5309. Skction 6. — General Infobmation Reoardino Pensions and Pension Legislation. 3761. In making entries on medical records great care shall always be taken by medical officers in stating the degree of disability and to describe its extent, nature, and location. Great care sliould also be taken to avoi5. The act for the better government of the Navy, approved April 23, 1800, repealed the act of March 2, 1799, although reenacting many of its features. 'J'he provisions as to the management of the fund were reenacted with a proviso that it might be invested in any manner which a majority of the commissioners might deem most advantageous. The effect of this law repealed the clause in the act of March 2, 1799, directing that the Navy pension fund be invested in 6 per cent interest or other stock, 3700. An act approved March 26, 1804, amended the act of March 2. 1799, and directed that the money accruing from the capture of prizes should be paid to the Treasurer of the United States. The Treasurer was required U) disburse the Navy pension fund on warrants issued by the Secretary of the Navy, countersigned by the accountant of the Navy, who by law was authorized to receive and settle all accounts relating to the Navy pension fund. By the same act the commissioners were authorized and directed to make such regulations as appeared to them expedient for the admission of persons on the roll of the Navy pensioners and for the payment of pensions. .3767. The act of April 16, 1816, provided that the money accruing from the sale of captured prizes should be paid over by the United States District Court to the Treasurer of the United States on account of the Navy pension fund. 3768. The act of March 2, 1831, providing that all forfeitures collected from pe*-sons depredating upon the reserve timberlands should be credited to the Navy pension fund, was repealed by the act of April 30, 1878, which provided that all money derived from this source should be covered into the Treasury of the United States, as is the case with other moneys received from the sale of public lands. 3769. By the act of July 10, 1832, the duties of the commissioners ceased, and the Secretary of the Navy was made the trustee of the pension fund and was intrusted with the payments of all Navy pensions out of it. By the same act Congress directed that the fund be invested in stock of the Bank of the United States. 3770. The act of March 2, 1832, created the office of Commissioner of Pen- sions and provided that Navy pensions should be paid by the Commissioner of Pensions from the Navy pension fund under the direction of the Secretary of the Navy. 3771. By the act of March 3, 1849, the Department of the Interior was created and the Pension Office was transferred to this department from the War Department. The Pension Office was transferred from the Navy Depait- luent to the War Department by the act of March 3, 1835. 3772. The act of July 7, 1862 (sec. 4752, R. S.), for the better government of the Navy, reenacted the former provisions of law relative to the money 256 MANUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. accruing to the United States from the sale of prizes, such money to remain forever a fund for the payment of pensions to officers, seamen, and marines entitled to receive them. S773. The act of July 1, 1864 (sec. 4753, R. S.), directed the Secretary of the Navy, as trustee, to invest the Navy pension fund in repristeifecl securities of the United States, and further directed that the interest payable in coin vpas to be exchanged for legal currency of the United States and to be placed to the credit of the Navy pension fund. 3774. An act approved July 23, 1868 (sec. 4754, R. S.), known as the Butler Act, reduced the rate of interest on the bonds in which the Navy pension fund was invested from 6 per cent in gold to 3 per cent per annum in lawful money. 37 75. The report of the Auditor for the Navy Department for the fiscal year ended June 30, 1905, shows that the money accruing to the Navy pension fund from the sale of prizes captured during the Spanish-American War amounted to $723 770.46. 3776. The pension fund from the sale of prizes amounted on July 23, 1868, to $14,000,000, with an annual Income, derived from the interest at 3 per cent of $420,000. 3777. Since 1870 the amount derived from the interest at 3 per cent on this fund has been inadequate to pay all Navy pensions, and the provision of law which pletlges the public faith to make up the deficiency has been brought into operation by annual appropriations subsequent to the above date. 3778. The average annual expenditure for Navy pensions for the past five years has amounted to about $3,950,000, and the income from the Navy pension fund available for the payment of Navy pensions during the above-mentioned period has been less than 10 per cent of the amount required for that purpose, and it is improbable that the interest on the Navy pension fund will ever again be sufficient to meet such payments. 3779. The naval appropriation act approved March 12, 1870, contained a clause which provided that the present and all future appropriations for the support of the United States Naval Asylum (Home) should be charged to and paid from the income of the Navy pension fund. The amount appropriated by Congress annually for the maintenance of the home is about $75.lHXt. which reduces the interest available from this fund for the annual payment of Navy pensions to less than $400,000. 3780. The interest on the Navy pension fund is paid semiannually and de- posited to the credit of the Secretary of the Navy, as trustee of the Navy pen- sion fund. Congress appropriates annually for pensions, embracing Navy pen- sions, and the Secretary of the Treasury issues appropriation warrants by which the interest on the pension fund is carried : (a) To the Department of the Interior pension ledger; (6) To the amount appropriated by Congress for the maintenance of the Naval Home. 3781. Section 4753 of the Revised Statutes provides that nothing contained therein relative to the investment of the interest on tlie Navy pension fund shall b«' construed to interfere with the payment of Navy pensions imder the supervision of the Secretary of the Interior, as regulated by law. 8782. The Secretary of the Navy does nothing more than to cause the proper entries to be made on the appropriation ledger for the Navy Department, ex- cept to draw for the sum specified by law for the support of the Naval Home. The amount for Navy pensions is drawn by requisition of the Secretary of the 8783. Section 4755 of the Revised Statutes provides that Navy pensions shall be paid from the Navy pension fund, but that no payment shall be made there- from except ui)on appropriations authorized by Congress. 3784 Other charges against the Interest of the Navy pension fund are thos« j.rovided for in the acta approved March 2. 1867, and Deceml)er 2.S. 1880 (sees. 4756 and 4757, R. S.), MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 257 3785. Section 4756 of the Revised Statutes, amended by act of Decenaber 23, 1886. provides that " There shall be paid out of the Navy pension fund to every person who, from age or infirmity, is disabled from sea service, but who has served as an enlisted person or as an appointed petty officer, or botli, in the Navy or Marine Corps for the period of 20 years, and not been discharged for misconduct, in lieu of being provided with a home in the Naval Asylum, Phila- delphia, if he so elects, a sum equal to one-half the pay of his rating at the time he was discharged, to be paid to him quarterly, under the direction of th« Commissioner of Pensions; and applications for such pensions shall be made to the Secretary of the Navy, who, upon being satisfied that the applicant comes within the provisions of this act, shall certify the same to the Commis- sioner of Pensions and such certificate shall be his warrant for making payment as herein authorized." 3786. Section 4757 of the Revised Statutes, amended by act of December 23, 1886, provides that "Every disabled person who has served in the Navy or Marine Corps as an enlisted man or as an appointed petty officer, or both, for a period of not less than 10 years, and not been discharged for misconduct, may apply to the Secretary of the Navy for aid from the surplus income of tht^ Navy pension fund ; and the Secretary of the Navy is authorized to convene a board of not less than three naval officers, one of whom shall be a surgeon, to examine into the condition of the applicant, and to recommend a suitable amouni: for his relief and for a specified time and upon the approval of such recom- mendation by the Secretary of the Navy, and certificate thereof to the Com- missioner of Pensions, the amount shall be paid in the same manner as is pro- vided in the preceding section for the payment to persons disabled by long service in the Navy ; but no allowance so made shall exceed the rate of a pen- sion for full disability corresponding to the grade of the applicant, nor, if in addition to a pension, exceed one-fourth the rate of such pension." 3787. Upon the approval of the recommendation of the board by the Secre- tary of the Navy, he shall certify the same to the Commissioner of Pensions, and such certificate is the commissioner's authority for making payment to the applicant. 3788. Pensions granted under sections 4756 and 4757 of the Revised Statutes are wholly under the control of the Secretary of the Navy, to whom application should be made. 3789. Pensions granted under sections 4756 and 4757 of the Revised Statutes commence from the date of the filing of the application in the Navy Department. 3790. When a sailor or marine is pensioned under the provisions of section 4756 of the Revised Statutes, and where he has also established a claim for pension under the general law for disability contracted in the service and in the line of duty, or under the act of June 27, 1890, a certificate consolidating such pensions is issued, and he is entitled to receive the allowance .uraiited under section 4756, Revised Statutes, in addition to the pension granted him by the Pension Office, either under the general law or under the act of June 27, 1890. 3791. Whenever the Secretary of the Navy certifies to the I'eusion Oliice, under the provisions of section 4757, Revised Statutes, that a person who has served 10 years in the Navy or Marine Corps is entitled to aid from the surplus income of the Navy pension fund, in addition to a pension granted by the Pen- sion Office, either under the general law or under the act of June 27, 1890, a certificate covering both allowances is issued by the Pension Office. 3792. Under the pi'ovisions of sections 4756 and 4757 of tlie Revised Statutes it is not necessary for applicants to prove the fact of the incurrence of disabili- ties in the line of duty. The law requires tliem to show only that their record complies with the provisions contained in these sections us to the length of time they shall have served, and that during their service they have not been dis- charged for misconduct. 3794. The pension agent, at the end of each quarter, forwards to the pay officer of the home a check covering the amount of the stopped pensions. This 98601°— 17 17 258 MANUAL FOR THE AIEmCAl- DiiJ'AHToMENT, U. S. >'AVy. chock is forwarded by the paymaster in Ids next quarterly returns to the Au odicer in connnand upon the pen- sioner's admission to the hospital nnd retiilued in his possession while the poii- MANUAL i<^OR THE MEDICAL DEPARTMENT^ U. S, NAVY. 259 sioner remains iu the hospital, and in case of the pensioner's death in the hos- pital it should be transferred to the Commissioner of Pensions with a statement of (late and cause of death. 3802. Payments will be made by check, drawn upon an Assistant Treasurer of the United States, upon vouchers or certificates of the medical officer in command of the hospital presented to the pension agent on whose roll the peu- sioner's name is inscribed, setting forth the pensioner's name and certificatfr- number, the rate and amount of the pension, and the period or periods covered by the pension during which he was in receipt of the benefits of the hospital, and any intervening period or periods of absence on furlough or otherwise by dates «jf commencement and termination. Checks are umde payable to the medical officer in command and should be indorsed over to the pay officer of the stations. 3808. Cases may be met with in which the pensioner has two certificates representing concurrent allowances of disability pension and money benefit from the Navy pension fund for 20 or 10 years' service under the act of MarcJi 2, 1807 (sees. 4756. 4757, R. S.) Such issues do not differ from single issues in the matter of payment except that two vouchers are required. 3804. The vouchors in each case will bo i>repared and forwarded by the pen- sion agent charged with the payment, under instructions to be given by the {,'oiiiiiiissioiier ot Pensions iipon his receipt on information of the pensioner's admission to the hospital. 3805. Statements of admission and discharge of pensioners made to the Commissioner of Pensions and other communications concerning payment of pensions addressed to the Commissioner of Pensions, should bear the words "Finance Division" in the lower left-hand corner of the envelope, and for convenience in filing, each case should be made the subject of a separate coni- munication with the name and number of the pension certificate in eaeli in- stance, for the purposes of identification. 3806. The Comptroller of the Treasury, May 12, 1913, rendered a decision t" tJie effect that the relief or money benefit authorized under section 4757, Re- vised Statutes, is not a pension, nor is to be considered in lieu of pension, and therefore not subject to the provisions of general pension laws, such as arc contained in section 4813, relating to the pensions of pensioners while in a naval hospital. CHAPTER 24. BLANK FORMS. Section 1. — Navy Regulations and Navax Instbuctions Relating to Blank FOBMS. 3901. Requisitions for medical supplies on prescribed forms. I 2119 (1-5). 3902. Return of property. I 3255. 3903. Transfer of medical stores. I 2118 (4-5). 3904. Medical outfit when going out of commission. I 2124. 3905. Transfer of stores. I 2125, 3906. Respousibility for value of surgical instruments, etc. I 3255 (3). 3907. Weekly report of sick. I 3238. 3908. Daily report of sick. I 2107. 8909. Statistical report of sick. I 3254. 3910. Order of surtey. R 3G1. 3911. Report of survey. R 363. 3912. Report of death. R 2963 (1-2) ; I 5247 (36). 3913. Special diet list. I 3233. 3914. Records of examinations. I 3201. 3915. Misconduct reports, admission and discharge. I 5247 (G2) ; Gen. Ord. 231. Section 2. — Instbuctions Relating to thte Employment of Blan« Fobms. 3921. With the object of securing uniformity and accuracy in the prepara- tion of the reports and returns connected vrith the duties of the MetHeal De- partment, the bureau has established certain blank forms and designated the specific purposes for which such forms shall be used, as follows : 3922. The following table includes a list of the forms issued by the Bureau of Medicine and Surgery : Form B. Requisition and priced invoice. Form B. Dental. Form Ba. Special requisition for articles in stock but not on the supply table. Form 4. Requisition for supplies from supply depot. Form C. Survey of articles (supply depots only), , Form C-1. Survey of articles (supply depots only). Form Ca. Survey of articles (all other places). I Form Ca-1. Survey of articles (all other places). ' Form D. Inventory of property. Form Da. Inventory of property (additional articles) (blank). Form F. Quarterly abstract of patients. Form F. Rough (cards). Form G. Hospital ticket. Form H. Health record : Gray, enlisted men ; green, officers. Dental record for Insertion in Form H. Form I. Weekly report of sick (hospitals and hospital ships), Foi-m K. Statistical report of sick. Form K. Report of dental operations. Form K2. Report of casualties. .^^r^ ,„^,. 261 262 MANUAL FOi; THK MKUICAl. DEFARTMENX, U. S." KAVif, Forin L. Request for medical survey. Form M. Report of medical survey. Form N. Report of death. Form O. Request for blank forms. Form P. Report of operations (yeurly). Form Q. Clinical charts. Form S. Ration notice (admission)..ir^iAHr> Form T. Ration notice (discharge). Form V. Quarterly return of medical stores (supply depots only). Form X. Abstract of enlistments (recruiting stations). Form X. Rough (cards). ,''.u.-i< ; ,: -•>. Bill book (hospitals). Binnacle list. , . ...^ • r , . ,. / . .' l Commissary ledger. Hospital Corps, changes in. (N. M. S. 125682.) Hospital Corps, personal memorandum. Hospital Corps, examination report. Hospital Corps, statement of qualifications prepared when examined. (N. M. S. 42022.) Hospital Corps, subsistence report (No. 88051) (hospitals). Letterheads (hospitals). • Liberty list (ho.spitals). •• Morning report of sick. Pass book (hospitals). ^ Register of dead (hospitals). -'• Register of patients (hospitals). ''■■ •" Special diet (hospitals). •' Telegraph blanks (hospitals). !• Watch details (hospitals). ''• Requisition Form 1. (Original, memorandum.) * ;'. Requisition Form 4. (Original, memorandum.) •'<> Bill Form 5. (Original, memorandum.)* Bill Form 6. (Original, memorandum.)*. ha-hH is at a convenient shipping point or at the navy yard during the repair period or when near a supply depot. I 2119 (2). Timely requisitions for supplies shall be made to cover ordinary expenditures, but they shall not be fll1o4 MANUAL FOR THE MEDICAL DEPABTMENT, U. S. NAVY. (c) The quantities of medicines required shall correspond in amount to the packages mentioned in the supply table. (d) After approval the third will be returned to the ofticer making the requi- sition ; the fourth will be filed at the bureau ; the first and second will be for- warded to the naval medical supply depot filling the requisition and shall accom- pany the stores when shipped. (e) The medical officer of the supply depot filling the requisition shall enter the value of each item in the proper column before forwarding the first and second to the maker of the requisition. (/) Upon receipt of stores, the value shall be entered on the third, and the first and second, properly receipted, shall be forwarded, the former to the medical supply depot furnishing the stores and the latter to the Bureau of Medicine and Surgery. (g) Articles requisitioned for shall be arranged alphabetically and by classes, as indicated in the supply table. (h) Requisitions for articles not on the supply table will be submitted when necessary. They must be made in quadruplicate and accompanied with an explanatory letter stating the necessity for each item required. I 2119 (5). 39S4. I'^orms C and Cn. Surveys on medical property. See ch. 17, sec. 7. 3935. Form D, inventory of property, and Form Da, inventory of property (additional articles) (blank). (a) The attention of medical officers is directed to articles I 2118; I 2124; I 2125 ; and I 3255, Naval Instructions, relating to the preparation of Forms D and Da, "Inventory of proj^rty," and "Inventory of property (itemized ar- ticles)." All accurate inventory down to date of all property belonging to the Medical Department of the Navy shall be kept on file at shore stations and on ships. (b) An annual inventory of the nonexpendable articles on hand shnll be pre- paretl and forwarded to the Bureau of Medicine and Surgery on the 1st day of July of each year. ((') Use typewriter when practicable, enter items on Form Da only; number each sheet and enter name of station or ship thereon ; arrange articles alpha- betically and by classes (a) on ships and shore stations other than hoispltals. to conform with the arrangement of the supply table, and (b) at hospitals, in accordance with departments indicated in the hospital bill hook; each sheet to be lieaded with the name of the hospital department and number of bill-book c3S. Form H. Tleallli reconls . (Sei? ch. 13.) 8989. Form I. Weekly report of sick. (a) Article I 3238. Navid Instructions, specifies when and lu what nmntie the weekly report of sick shall be prepared. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVV. 267 . (6) Form I shall be prepared in triplicate on Monday of each week for tlu' week ending the preceding Saturday, at all naval hospitals and hospital ships. One copy shall be sent to the Bureau of Medicine and Surgery, one to the '. om- raandant of the station or the commander in chief (hospital ships), and one retained for the files of the hospital, as a basis of the report for the following week. The ribbon copy of this report shall be forwarded to the bureau. (c) The report shall l)e signed by the medical officer in command of tne hospital, and shall show the number of patients: (aa) Remaining at last report. (bb) Admitted during the week. (cc) Totals. {dd) Discharged during the week. (ee) Remaining. (j^') Beds for officers— occupied ; vacant; total. (gg) Beds for enlisted men — occupied; vacant ; total. (d) The report shall also contain the following inforniation In the appro- priate columns: „ ^ -rn. .™, ; '1o Column 1. A.. D., C, D. D., H. I., H. T., I. S., L., R., T. ! ■ Column 2. Name (surname and initials only) arranged chronologically by date of admission, officers first and underscored. Column 3. Rank, grade, or rate. Column 4. Disease (diagnosis). Column 5. Where from (ship or station). i- .„.',, > ... Column 6. When admitted; the date shall be expr^fefea-;m-fi§«i^e^^ i- e., for Julv 15 make entry 7-15. ■ ;, ' : ' .' . ; '„ ' .' J/, ;, ,, . . . Column 7. When discharged; the date shftn^-^'fexpi-essefl^^Q'flgHft^,' i'. ft/foi July 15 make entry 7-15. ■•:r ^V ['rll'':!'' ■'X':^;!: vt -.'/r' Column 8. Days in hospitaL ' ' ' ''"^-J' l^ll ,Ly \^- Column 9. Condition; convalescent (C) ; :fav6rablen(FV)'t "S^^i^Wte j(«)J^^^^ ^Sumn 10. Probable date of fitness for duty, i*. ^ foi^ July K make entry 7-15^ (e) The surname of ofticer patients will be underlined with r&d ink, and officers entered first on the report. ' «'j'. ' '' ' •; 3940. Form K. Statistical report. (See ch. 13. ser». S:); " '; 3941. Form K:. Report of casualties. (I 5222 (5)r.) '' '"I, 3942. Form L. Request lor medical survey. (See " Surveys," ch.^l<.) 3943. Form M. Report of medical survey. (See "Surveys," ch. 17.) 3944. Form N. Report (certificate) of death. (See ch. 13, sec. 14.) 3945. Form O. Request for blank forms. - ^vs Form O contains a list of forms employed in thJeMeitJicai' Departrtienk-^ the Navy Whenever blank forms ai-e required, medical officers sTiall submit to the naval medical supply depot, Brooklyn, N. Y., such request on F'orm O, designating the particular forms required by an X sign, and stating the num- ber required. 3946. Form P. Report of surgical operations. (a) One copy shall be submitted to the Bureau of Medicine and Surgery annually, for the year ending December 31, and when a ship, station, yard, or hospital is placed out of commission. , " 1 . ,/■ ^ .!.^,> (b) All operations shall be reported except those'Of a' v^tfy'tfrNial-flatnW. The form shall be kept posted to date that data may be obtained by the bureAti' at any time. The data required in each column will be stated in brief, and each case will be separated from the preceding one by a line. ' (c) When an operation Is performed for a single condition and its iniMWMhirte complication, one operation only shall be recorded, but when several operations have been performed for distinct conditions, each operation must be recorded separately e. g., inguinal hernia, varicocele, and varicose veins of leg all performed 'while under one general anesthetic should appear on Form P as three distinct operations, giving the Information required in e.i<-h column. 268 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. id) Column 1. Give initials and grade or rate of patient. See paragraph 2241 (6), also date of operation, as follows: FUR. Y-1. 7-10. Column 2. Use the terms of the nomenclature and state location when not coverenr]H>se of j)rcparing Form X. li shall be retained for ship or station files and shall be filed alphabetically, by calendar years, a<'c. This is forwarded from liospitals and hospital ships only In case of officers and uwn whose absence from dnty is on ac<;<>unt of disease resulting from their own intemperate use of drugs or alcoholic liquors or other misconduct. It is forwarde<. to the com- manding officer carrying the patlent'g^^ ax^ounts. SicrxJO.N n.— Bureau of Navigation Fobmb Uskd in Hospitau 3981. Report of the fitness of officers. (See ch. 26, sec. 4.) 3982. Blank request for leave of absence. (N. Nav. 21)6a.) 3984. Transfer and discharge slip. (N. Nav. Slip No. 0.) 3985. T.ist of slips, shipping nrtlflcs, and enlistment nx-ords forwarded, etc. (N. Nav. '.>0.) MANUAL rOK THE MEDICAL DEPARTMENT, U. S. NAVY. 271 Section 6. — Bubeau of Supplies and Accounts Fobms Used in Hospital. 3991. Request for books aud blanks. (S. and A. Form No. 173.) 3992. Pay roll. (Form No. 84.) (See sec. 4.) 3993. Stub requisition, (S. and A. Form 129A.) 3994. Request for transfer of labor. (S. and A. Form No. 66.) 3996. Application for leave (civil employees). (S. and A. Form No. 206c (revised).) 3996. Schedule of bills of lading. (S. and A. Form No. 68.) 3997. Bill of lading. (S. and A. Form No. 86.) 3998. Memorandum bill of lading. (S. and A. Form No. 86b.) 3999. Shipping order. (S. and A. Form No. 86d.) Skction 7. — Special Oebtiticates or Forms Sometimes REtiUiKEo in Naval Hospitals. 4001. Medical certificate for St. Eliznbeths Hospital. (Department of In- terior form.) (See ch. 18, sec. 2.) 400'i. Certificates of death for civil authorities, and m some cities the fol- loAN'ing are required : . ,., ^. ^ . , («) Reports of cases of pulmonary and other communicable torms of tuber- culosis, and the recovery, removal, or death of same. ( b ) Report of contagious disease. (c) Report of recovei'y of contagious disease* CHAPTER 25. MEDICAL DEPARTMENT REPORTS AND RETURNS. Section 1. — ^Naval Instructions Relating to Reports and Returns in General. 4101. To be listed in naval instructions. I 5201 (1). 4-102. Periodical returns, how authorized. I 5201 (2). 4103. Reports and returns to be reduced to the requiremeuts of the service. I 35; I 5201 (3). 4104. Recommendations, suggestions, and reports on special subjects not to be held for annual report, but made as the subjects present themselves. I 5202 ( 1 ) . 4105. Annual reports. I 5202 (2). 4106. Duplicates of reports to be so noted. I 5204. 4107. Officers required to submit reports to keep themselves supplied v^^ith necessary blanks. I 5205. 98601°— 17 18 273 274 MANIAI. FOK THE MEDICAL DEPARTMEXi, U. fc-. XAVV. Z o m > a a <^ o £) 03 71 HPTJT^T i;W'C (4 •C.2-2 5^ a i-H Cl rH i-< IM 3.i •_g.'T-.t, ^3 OCZ) 5 ~ c o o*3 .^s a z. -6 w a o cS - / Q SJ P ,a a; ■^S-se^sg^ '8- rJ5 1 s 0) 1.^ T3 >-. £ c o 3 -.-« .S PL, u o o Pi 3 cj pCC r-l S? "73 'O gi fl fl 3 eS C3 "Or-; sc:- Sb 0) O s; 3 S o c ?«) -r-t;.?^ 5 -^.2 3-0-0 go ^^ S § S es w CD w -a p, d 05 ^ a o Ota p CS o o-^ ^ S • cStS o o ^ - a Q S >- n a,^ . o Oi •S-^ o ^3£; l^fe-^.S^^ s-s o PQfQ a 2 [V| 08 X (D £ C § ^ oVj 0) (B O -73 O oo ^' 3 O ►3 P5 5 3 O c fcSn fe fe 'O -a= 03 !E .s— a) P.S3 u ca .2 '■3 o C4 . -S cS e^ fe a a M cr a^ 1 3 e^ OQ 276 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. Q "c^ -« :s. X ^ .g A, ^ .2 o « CM 8-1.2 .a o o 08 -^ •o M ^ ^ ^ o -^ ^ -r o d ^ o « a o a> 1 ■72 "3 P Eh o _ H .S !^ "^ i-i m o bO g i§ > Q>r-I ^ t« t^S a 1 ■'5 >; fcH CD .a o tr l-c 3 «T3 S --•CO g a> '-' .g S be J w a> 002 - o o "o OJ ^ ;3 CO 2 a o ;3 1^ ctn.ScSiiCoo o "^ 3 "^ a 3 c4 o «^ 3 C3 U 03 u o C - o a o 03 4) O a> ; 00 <»_■■'!-)":; S c S3 S 111 0= a> c ?^ S v»- ea t* g,o 3 ^ a d a c c 0^ p,o ^ Q p: ** a ^ p ^ fe '>l V s a 2 bo -5" »2 o o -' 1 "rt c 5 C ■ 04 fe ^ 6 w m T 3 t ?a o a a o o to o P5 a a fe ft, a , . • , s C rt ^ ! a. I-I a o : 2 . (3, c s I HO o a c i| top, _'o :1 s a " a a a o "o ■a C , c c a c »1 2 i 1 c C 5 5 p ^1 3 J Ht7 1 u <5 tr A4 — ) e > c 1 s 3 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 277 ^^^ IM CO (M (M ■*^ ^^ eS ao ^^ hr i© (I » > O p «« b O ■J3 o 278 MA.NUAL FOE THE MEDICAL DEPARTMENT, U. S. NAVY. ^ OS ^ *^ "n ■*•» 3^.a X a- S « U3 I © .a Pi a a o O sfl.S lf.5 "^ •-ss^- •-^fc" c 3 , p't; *j 3 1= a a. 2 ff 2 c a> a =«^ aS* o > o o S-c O c tjoa>'5 •^ rt 3 o H Q >4' JQ CQ S^.i;-J|1'^^ , . o -C< 03 nO. PC »-i <-! w 3 9 O S^?> " O,^ to ^ C«> ^ 5 2 O CI. a* ^ +J *-I g ^'§' •^ ^ St:.' - C5 I-' Si:- o J- PQ t 2-^ a ^ = fea2 c J c5 o j; P. CO «■ I "a « MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVV. l} 79 - ■ r ir C ' ■*:; ?^ (& ,l!H I— ( ,1-1 -m K - ft; : I*' ^ 3 .2r ia -a o Eh 1^ ■1 3 ft"!) <» ^ aj O-.J-i o 5_f U, ^ 3 Oj 73 ■m -- -a (O ■ IK 2 >* .9 f^ 3 c3 CQ « 0^ A C) ^ to - PQ Si- 3 Qj g 00 5 a jg ^ fl o; u a W « 2 4> o » .2 8 3 rt PQ 5§- ■2 3 •- 2 60 2 ? == 3 X a, c S S'^ 'Z ©"fe ft oi -co x r^- q o J s 00 ~ — ' oo ■1-= a ■''^2 - M ft'" * J c3 ■5! S.9 ^ W 280 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 2 o < H a m o W ^ r" S" o? •>«< \a <» 00 OJ M >-• r^ rH l-l r-t rH i-H I-H r-^ rH 25 o^ ^— ^ ^—^ ^■^ ^ ■^■^ § r^ ^ S s t^ s s lO lO to »o w »o lO »o m HH »-H •-H '-' •— ( >-H •^ "^ HH > 2 b>i< .2 i=^s O I& as .a a. P.S1 ••H O :2 8 TSr-t 00 J3 o Is -Oi-^ '3 O 0) 1^ ^ OS 'r- 0) « ^& SCO 19 3 1 S3 O S-^ £ fl S a; d i 3 >;8 S8 a rH ra n pq m m u n Ph ■B d rt CO OJ S Q +i 3 : ^ s ■ >.f i § a .a SS O IB T3 a 8 §-§ '2'-' . 1 -"S. d _j-o I 6 5 o4 oo ?^o9:3ei5a} i-T "3 O , 3'-'.^ C-" • eo o s ^eoCCeo • : ^ ° ■ w O" cy <^ • ; t>S 3 <{S g T o oo 00 6 a .2 • i E 2 "*■ £ mpq. Pci M ;z: "oi s » M "o o o a o o •3 p. 1 < 3 3 5^ T J < \ a. ^ i |8 fa^ P:^ b fe c» E> i< h ■3 a 3 CQ g 1 5 P = 3.b » p. a 2 p. 3 s 2 i = a a o Cm *g3 0) -f} ID P. ■1^ P. ■p- « CO "J a s •2 S*-! o o t P.«D ; S-vi 3 o-S^ 3"'a,§'p, 3sa $ 5 a Is-s- c4 1. P < w 3 TO a c y c /: S :; W MANUAL FOR THE MEDICAL DEPARTMENT, V. S. NAVY. 281 -2S - PQ » ^ fa ll 73 •si ^ u |s.a s p" 1=1 ^'S^ S " '5 2 S >H ° ts "^ ^ o CD d M n O 03 Ph • MO 73 a, .a o .a fl > C O > ■o g a.&,g CQ CO ^ a •sg O in ■II P5 282 MANUAL FOE THE MEDICAL DEP.IRTMENT/ U. S. NAViT. O S CO fl- H o W: t^" s ^.^ S S 2 « ,.-^ ta o o O 11 03— -^ O 0? eS S CO 0} all -1:2 3 OP, -"S = 2 o«« a Q <:, O 3 '■ o r ;o -i. 1^ w MANtjAr: FOR THE MT^DICAL DEPARTMENT, U. S. NAVY. 283 ^ ^ ^ ^ » TJrH 3 O h O tH -n cj 1) -H 'i' r" 2 ^ S 35 i m Ph« . CO oti »^ C J? ..^" r'..-. -r^ ►J ^( CO rt J3 a ^ ■3 g •iH ^ ^ C o u 3 rt 53: CO 2, -.^'13" ^ -^ ! 3 M o 000,2 1^; O--': r- oil' >r8 f • O •a c go m- O O' CO o. S S CI S >-. O -i-i o •S'3'1'3 o o H.2 ^ m^ .21:^ ra a.2 fl o*g o.« cv^ 3 a (u s q O '-' IE « 284 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. S o => „; ii CHAPTER 26. THE GENEVA CONVENTIONS. THE HAGUE PEACE CONFERENCES AND CONVENTIONS AND THE AMERICAN NATIONAL RED CROSS. Section 1. — The Geneva Convention of 1864. 4201. The convention between the United States, Baden, Switzerland, Bel- gium, Denmark, Spain, France, Hesse, Italy, Netherlands, Portugal, Prussia, Wurttemberg, Sweden, Greece, Great Britain, Mecklenburg-Schwerin, Turkey, Bavaria, Austria, Russia, Persia, Roumania, Salvador, Montenegro, Servia, Bolivia, Chile, Argentine Republic, Peru, and Japan; with additional articles: For the amelioration of the wounded in armies in the field ; concluded August 22, 1864 ; acceded to by the President March 1, 1882 ; accession concurred in by the Senate March 16, 1882; proclaimed as to the original convention, but with reserve as to the additional articles, July 26, 1882, commonly known as the Geneva Convention, is as follows: OEIGINAL CONVENTION. 4202. Abticle 1. Ambulances and military hospitals shall be acknowledged to be neuter, and as such shall be protected and respected by belligerents so long as any sick or wounded may be therein. Such neutrality shall cease if the ambulances or hospitals should be held by a military force. 4203. Art. 2. Persons employed in hospitals and ambulances, comprising the staff for superintendence, medical service, administration, transport of wounded, as well as chaplains, shall participate in the benefit of neutrality while so em- ployed and so long as there remain any wounded to bring in or to succor. 4204. Akt. 3. The persons designated in the preceding article may, even after occupation by the enemy, continue to fulfill their duties in the hospitals or am- bulance which they serve, or may withdraw in order to rejoin the corps to which they belong. Under such circumstances, when these persons shall cease from their func- tions, they shall be delivered by the occupying army to the outposts of the enemy. 4205. Aet. 4. As the equipment of military hospitals remains subject to the laws of war, persons attached to such hospitals can not, in withdrawing, carry away any articles but such as are their private property. Under the same circumstances an ambulance shall, on the contrary, retain Its equipment. 4206. Akt. 5. Inhabitants of the country vi'ho may bring help to the wounded shall be respected and shall remain free. The generals of the belligerent pow- ers shall make it their care to inform the inhabitants of the appeal addressed to their humanity and of the neutrality which will be the consequence of it. Any wounded man entertained and taken care of in a house shall be con- sidered as a protection thereto. Any inhabitant who shall have entertained wounded men In his house shall be exempted from the quartering of troops as well as from a part of the contributions of war which may be imposed. 285 286 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 4207. Art. 6. Wounded or sick soldiers shall be entertained and taken eiirL» of. to whatever nation they may belong. Commanders in chief shall have the power to deliver immediately to the out- posts of the enemy soldiers who have been wounded in an engagement, when circumstances permit this to be done, and with the consent of both parties. Those who are recognized, after their wounds are healed, as incapable of serv- ing shall be sent back to their country. The others may also be sent back on condition of not again bearing arms dur- ing the continuance of the war. Evacuations, together with the persons under whose directions they take place, shall be protected by an absolute neutrality. 4208. Art 7. A distinctive and uniform flag shall be adopted for hospitals, •ambulances, and evacuations. It must, on every occasion, be accompaWit'd by the national flag. An arm badge (brassard) shall also be allowed for indi- viduals neutralized, but the delivery thereof shall be left to military anthorify. The flag and the arm badge shall bear a red cross on a white groiind. 4209. Art. 8. The details of execution of the present convention shall bo regulated by the commanders in chief of belligerent armies, according to the instructions of their respective governments and in conformity with the general principles laid down In this convention. Section 2. — The Geneva Convention of 1868. ' additional AKTICLES.* . l. il.Tr;7 ;;;(! '.i>,:VT-t ■:■<<<■■ liUii-jr • ■•■■ ■■" • "'J ' ''iSll? Aii^ci^'l. Tttfe persons designated in article 2 of the convention shail. after the occupation by the enemy, continue to fulfill their duties, aceordinj: to their wants, to the sick and wounded in the ambulance or the hospital which they serve. When they request to withdraw, the commander of the occupying troops shall fix the time of departure, which he shall only be allowed to delay for' a short time in case of military necessity. 4212. Art. 2. Arrangements will have to be made by the belligerent po\v#r.s to insure to the neutralized person, fallen into the hands of the army of tlic; enemv, the entire enjoyment of his salary. ; 4213. Art. 3. Under the conditions provided for in articles 3 and 4 of the convention, the name "ambulance"' applies to field hospitals and other tem- porary establishments, which follow the troops on the field of battle to receive the sick and wounded. , ,,: . ; 4214. Art. 4. In conformity with the spirit of article 4 of the conveutioii. and to the reservations contained In the protocol of 1864, it is explained that for the appointment of the charges relative to the quartering of troops and of the contributions of war account only shall be taken in an equitable manner of the charitable zeal displayed by the inhabitants. 4216. Art. 5. In addition to article 6 of the convention, It Is stipulated thai, 'with the reservation of ofllcers whose detention might be important to the fate of arms and within the limits fixed by the second paragraph of that article, the wounded fallen into the hands of the enemy shall be sent back to their country after they are cured, or sooner If possible, on condition, nevertheless, of not a^in bearing arms during the cphtlnuance of the war. articles conckrnino the marine., ,,. 4216. Art. 6. The boats which, at their own risk attd p'ehl, rfurjpg aWA After an engagement pick up the shipwrecked Or wounded, or which paving packed •The additional articles now are generally accepted and have ncqulrcd tho force and effect of ao iDternatlonal treaty. ..,_.,,. ^ „.. . w »w .. iiThlB JnterpreiBtlon la of HpeclaJ Importune*; In the United States, wnero the term •ambulance" Is geneiaMi- applied to a veUicJe (or ,U»e tr«ijspo nation, oIth« alck and wounded. MANUAL FOR THE MEDICAL DEPARTMENT/ U. S. KAVY. 287 tliem up, convey them on board a neutral or hospital ship, shall enjoy, until the accomplishment of their mission, the character of neutrality, as far as the cir- cumstances of the engagement and the position of the ships engaged will permit. The appreciation of these circumstances is intrusted to the humanity of all the combatants. The wrecked and wounded thus picked up and saved must not serve again during the continuance of the war. 4217. Akt. 7. The religious, medical, and hospital staff of any captured ves- sel are declared neutral, and, on leaving the ship, may remove the articles and surgical instruments which are their private property. 4218. Art. 8. The staff designated in the preceding article must continue to fulfill their functions In the captured ship, assisting in the removal of the wounded made by the victorious party ; they will then be at liberty to return to their country, in conformity vpith the second paragraph of the first additional The stipulations of the second additional article are applicable to the pay and allowance of the staff. 4219. Art. 9. The military hospital ships remain under martial law in all that concerns their stores ; they become the property of the captor, but the latter must not divert them from their special appropriation during the continuance of the war. . , ,, , 4220. Art. 10. Any merchant ship, to whatever nation she may belong, charged exclusively with removal of sick and wounded, is protected by neu- trality ; but the mere fact, noted on the ship's books, of the vessel having been visited by an enemy's cruiser, renders the sick and wounded incapable of serving during the continuance of the war. The cruiser shall even have the right of putting on board an officer in order to accompany the convoy, and thus verify the good faith of the operation. , If the merchant ship also carries a cargo, her neutrality will still protect it. provided that such cargo is not of a nature to be confiscated by the belligerents. The belligerents retain the right to interdict neutralized vessels from all com- munication, and from any course which they may deem prejudicial to the secrecy of their operations. In urgent cases special conventions may be entered into between commanders in chief, in order to neutralize temporarily and in a special manner the vessels intended for the removal of the sick and wounded. 4221. Art. 11. Wounded or sick sailors and soldiers, when embarked, to whatever nation they may belong, shall be protected and taken care of by theii- captors. , . , , . -, ^. ■, r. Their return to their own country is subject to the provisions of article b ^>f the convention, and of the additional article 5. 4222. Art. 12. The distinctive flag to be used with the national flag, in order to indicate any vessel or boat which may claim the benefits of neutrality,, in virtue of the principles of this convention, is a white flag with a red cross. The belligerents may exercise in this respect any mode of verification which they may deem necessary. . , Military hospital ships shall be distinguished by being painted white outside. Avith green strake. , ' ' .. \.v, 4223. Art. 13. The hospital ships, which are equipped at the expense of the aid societies, recognized by the Governments signing this convention, and which are furnished with a commission emanating from the sovereign, who shall have o-iven express authority for their being fitted out, and with a certificate from the proper naval authority that they have been placed under his control during their fitting out and on their final departure, and that they were then appro- priated solely to the purpose of their mission, shall be considered neutral, as well as the whole of their staff. They shall be recognized and protected by the belligerents. ' ."_ ' ^»L-.'- li' *t i.^i' They shall make themselves known by hoisting, togethei* ytth their ■rtational fla<' the white flag with a red cross. The distinctive mark of their staff while performing their duties Shall be an armlet of the same colors. The outer paint- ing of these hospital ships shall be white, with red strake. 288 MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. These ships shall bear aid and assistance to the wounded and wrecked belligerents, without distinction of nationality. They must take care not to Interfere in any way with the movements of the combatants. During and after the battle they must do their duty at their own risk and peril. The belligerents shall have the right of controlling and visiting them. They will be at liberty to refuse their assistance, to order them to depart, and to detain them If the exigencies of the case require such a step. The wounded and wrecked picked up by these ships can not be reclaimed by either of the combatants, and they will be required not to serve during the continuance of the war. 4224. Aet. 14. In naval wars, any strong presumption that either belligerent takes advantage of the benefits of neutrality with any other view than the interest of the sick and wounded gives to the other belligerent, until proof to the contrary, the right of suspending the convention as regards such belligerent. Should this presumption become a certainty, notice may be given to such belligerent that the convention Is suspended with regard to him during the whole continuance of the war. 4225. Art. 15. The present act shall be drawn up In a single original copy, which shall be deposited In the archives of the Swiss Confederation. The additional articles have been acceded to by the United States, and signed on behalf of Great Britain, Austria, Baden, Bavaria, Belgium, Denmark, France, Netherlands, North Germany, Sweden, and Norway, Switzerland, Turkey, and Wurttemberg, but will not acquire full force and effect as an International treaty until the exchange of the ratification thereof between the several contracting States .shall have been effected. Section 3. — The Geneva Con\te:ntion of 1906, fob the Amelioration or thk Condition of the Wounded of the Abmies in the Field. 4231. Signed at Geneva, July 6, 1906. Proclaimed August 3, 1907. Bt the President of the United States of America^ A PROCLAMATION. Whereas a convention between the United States of America and Germany, the Argentine Republic, Austria-Hungary, Belgium, Bulgaria, Chile, China, the Congo Free State. Denmark, Spain, Brazil, Mexico, France, Great Britain, Greece, Guatemala, Honduras, Italy, Japan, Luxemburg, Montenegro, Norway, the Netherlands. Peru, Persia. Portugal. Roumania, Russia. Servia. Slam, Sweden, Switzerland, and Uruguay, for the amelioration of the condition of the wounded of armies In the field, was signed at Geneva July 6, 1906, the original of which convention, being In the French language, Is word for word as follows: [Tranalatlon.] the sick and wounded. Article 1. 4282. Ofllcers, soldiers, and other persons officially attached to armies, who are sick or wounded shall be respected and cared for, without distinction of nationality, by the belligerent In whose power thoy are. A belligerent, however, when couipelletl to leave his wounded in the hands of hit adversary shall leave with them, so far a.s miliUiry condltlon.s permit, a portion of the personnel and materiel of his sanitary service to assist in curing for them. MANUAL FOR THE MEDICAL DEPARTMENT, IT. S. NAVY. 289 Abticuj 2. 4233. Subject to the care that must be taken of them under the preceding article, the siclt and wounded of an army who fall into the power of the other belligerent become prisoners of war, and the general rules of international law in respect to prisoners become applicable to them. The belligerents remain free, however, to mutually agree upon such clauses, by way of exception or favor, in relation to the wounded or sick as they may deem proper. They shall especially have authority to agree: 1. To mutually return the sick and wounded left on the field of battle after an engagement. 2. To send back to their own country the sick and wounded who have re- covered, or who are in a condition to be transported, and whom they do not desire to retain as prisoners. 3. To send the sick and wounded of the enemy to a neutral state, with the consent of the latter and on condition that it shall charge itself with their interment until the close of hostilities. Article 3. 4234. After every engagement the belligerent who remains in possession of the field of battle shall take measures to search for the wounded and to pro- tect the wounded and dead from robbery and ill treatment. He will see that a careful examination is made of the bodies of the dead prior to their interment or incineration. Article 4. „ 423.5. As soon as possible each belligerent shall forward to the authorities of their country or army the marks or military papers of identification found upon the bodies of the dead, together with a list of names of the sick and wounded taken in charge by him. Belligerents will keep each other mutually advised of internments and trans- fers, together with admissions to hospitals and deaths which occur among the sick and wounded in their hands. They will collect all objects of personal use, valuables, letters, etc., which are found upon the field of battle, or have been left by the sick or wounded who have died in sanitary formations or other establishments, for transmission to persons in interest through the authorities of their own country. AjtTICLE 5. 4230. Military authority may make an appeal to the charitable zeal of the Inhabitants to receive and, under its supervision, to care for the sick and wounded of the armies, granting to persons responding to such appeals special protection and certain immunities. sanitary formations and establishments. Article 6. 4237. Mobile sanitary formations (i. e., those which are intended to accom- pany armies in the field) and the fixed establishments belonging to the sanitary service shall be protected and respected by belligerents. Article 7. 4238. The protection due to sanitary formations and establishments ceases If they are used to commit acts injurious to the enemy. 98601'— 17 19 290 MANUAr, FOR THE MKDICAI. DEPARTMEN'JV, U. S. NAVY. Article 8. 4239. A sanitary fonnatioii oi- csiublishmeut shall not be deprived of the protection accorded by article 6 by the fact: (a) Tiiat tije personnel of a forniation or establishment is armed and uses its arms in self-defense or in defense of its sick and wounded. (b) Tliat in tlie absence of arnjetl hospital attendants, the formation is guarded ))y an armed detachment or by sentinels acting under competent orders. (c) That arms or cartridges, taicen from the wounded and not yet turne(l over to the proper authorities, are found in the formation or establishment. PERSONNEL. Article 9. 4240. Tlio personnel cluirged exclusively witli the removal, transportation, nnd treatment of the sick and wounded, as well as with the administration of sanitary formations and establishments, and the chaplains attached to armies, shall be respected and prtjtected under all circumstances. If they fall Into the hands of the enemy thoy shall not be considered as prisoners of war. These provisions apply to the guards of .sanitary fonnations and establish- ments in the case provi(1ed for In section 2 of article 8. 4241. The i)er.sonnel of volunteei* aid societies, duly recognized and auihoi;- i/c(l by their own governments, who are employed In the sanitary formations' and establishments of armies, are jissimilated to the personnel contemplated in the previt! continue in the exerd^*;^; of their fuiicTlons, under the direction of the enemy, after they have fallen lntp'| his power. When their assisluuce is uo longer iiulispen.sable lliey will be .sent back 1o liieir army or country within such period and by such route as may accord with military necessity. They will carry with them such effects, instruments, arms, and liors«»s as are their private property. AmcLE 13. ,^flq 4244. While they remain in his iM)\ver. tlie enemy will secure to the persoimol mentioned in article 9 the same pay uui^ allowances to which i>ersons of (he same grade in his own army are enntlecl. .-, •; .■ '; i':- '<1 .: \i\i\in ni. J II MAJSUAL bOR THE MEDICAL DEPAKTMENT, U. S. NAVY, 291 MATERIEL. Arttcle 34. 4246. If mobile sanitary fermations fall into tlio power of the enemy, thoy Mliall retain their materiel, including the teams, whatever may be the means of transportation and the conducting personnel. Competent military authority, however, shall have tlie right to employ it in caring for the sick and woimded. The restitution of the materiel shall lake place in accordance with the condi- tions prescribed for the sanitary personnel, and, as far as possible, at the same time. AUTICLE 15. 4246. Buildings and materiel jiertaining to fixed establishments shall remain subject to the laws of war, but can not be diverted from their use so long as they are necessary for the siclt and wounded. Commanders of troops engaged in operations, however, may use them, in ease of important military necessity, if before sucli use the sicl? and wounded who are in them have been provide"J The civil personnel and the various means of transportation obtained by requisition, including railway materiel and vessels utilized for convoys, are subject to the general rules of international law. [I' pr^TtNCa?i,V]srfiMBLEii'; Articxe 18. ' 4249. Out of respect to Switzerland the heraldic emblem of the red cross on s white ground, formed by the reversal of tlie F.ederal colors, is continued -as the emblem and distincitire sjgn ,oi th9,.^iuit^ry,,sei;y4cf^j9f a,r^i9^^ . j cij' •}■■■■ n 292 MANUAL FOR THE MEDICAL DEPABTMENT, XT. S. NAVY. Article 19. 4250. This emblem appears on flags and brassards as well as upon all ma- teriel appertaining to the sanitary service, with the permission of the compe- tent military authority. Article 20, 4251. The personnel protected in virtue of the first paragraph of article 9, and articles 10 and 11, will wear attached to the left arm a brassard bearing a red cross on a \\hite ground, which will be issued and stamped by competent military authoi'ity, and accompanied by a certificate of identity in the case of persons attached to the sanitary service of armies who do not have military uniform. Abticle 21. 4252. The distinctive flag of the convention can only be displayed over the' sanitary formations and establishments which the convention provides shall be respected, and Mith the consent of tbe military authorities. It shall be accom- panied by the national flag of the belligerent to whose service the formation or establishment Is attached. Sanitary formations which have fallen into the power of the enemy, however, shall fly no other flag than that of the Red Cross so long as they continue In that situation. Article 22. 4253. The sanitary formations of neutral countries which, under the condi- tions set forth in article 11, have been authorized to render their services, shall fly, with the flag of the convention, the national flag of the belligerent to which they are attached. The provisions of the second paragraph of the preceding article are applicable to them. Article 23. 4264. The emblem of the red cross on a white ground and the words Red Cross or Geneva Cross may only be used, whether in time of peace or war, to protect or designate sanitary formations and establishments, the personnpl «nd raat6riel protected by the convention. APPLICATION AND EXECUTION OF THE CONVENTION. Article 24. 4255. The provisions of the present convention are obligatory only on the contracting powers, in case of war between two or more of tliem. The said provisions shalj cease to be obligatory if one of the belligerent powers should not be signatory to the convention. Artici,e 25. 425(>. It sha'i b(^ the duty of the cDiiiiiianders in chirf of the belligerent armies to provide for the details of execution of the foregoing articles, as well as for unfore.seen cases, in accordance with the Instructions of their respective Governments, and conformably to the general principles of this convention. Aktici.e 2G. 4257. The signatory (lovennncnts shall take the ncve.ssary steps to acquaint their troops, and particularly the protccteeninark, Spain (ad referendum). United States of America. United States of Brazil, France, Greece. Guatemala, Honduras, Italy. Luxem- burg. Montenegro, Nicaragua, Norway, the Netherlands, Peru, Persia. Portugal, Uouinania, Russia. Servla. Slam. Sweden, Switzerland, and Uruguay. The wish was rejected by the following States: Corea, (Jreat Britain, and Japan. In witness whereof the delegates have signed the present protocol. Done at Geneva the 6tli day of July. 19()6, in a single copy which shall b© deposlteo\vers by means of a written notification addressed to the Government of the Nether- lands and communicated by the latter to the other contracting powers. MANUAL FOR THE MEDICAL DEPARTMENT, U. S. NAVY. 297 4296. Art. 6. In the event of one of the high contracting powers denouncing the present convention, such denunciation shall not take effect unti^ one year after the notification made in vpriting to the Government of the Netherlands and immediately communicated by the latter to all the other contracting powers. This denunciation shall only affect the notifying power. 4297. Final act.— At the moment of proceeding to sign the convention havini: for its object the exemption of hospital ships in time of war in the ports of the contracting parties from all dues and taxes imposed on vessels for the benefiv of the State, the plenipotentiaries signing the present act express the wish that, in view of the highly humanitarian mission of these ships, the contracting governments may take the measures necessary in order to exempt these ships within a short time also from the payment of the dues and taxes collected in their ports for the benefit of others than the State, especially those collected for the benefit of municipalities or of private companies or persons. Section 6. — Hagxje Convention of Octobeb 18, 1907, fob the Adaptation of THE PrINCIPI.es OF THE GENEVA CONVENTION OF JUI.Y 6, 1906, TO MABITIME Warfare. 4301. Aeticle 1. Military hospital ships, that is to say, ships con.structed or assigned by States specially and solely with a view to assisting the wounded, sick, and shipwrecked, the names of which have been communicated to the belligerent powers at the commencement or during the course of hostilities, and in any case before they are employed, shaU be respected, and can not be cap- tured while hostilities last. These ships, moreover, are not on the same footing as warships as regards their stay in a neutral port. 4302. Art. 2. Hospital ships, equipped wholly or in part at the expense of private individuals or officially recognized relief societies, shall be likewise re- spected and exempt from capture, if the belligerent power to whom they belong has given them an official commission and has notified their names to the hos- tile power at the commencement of or during hostilities, and in any case before they are employed. These ships must be provided with a certificate from the competent authori- ties declaring that the vessels have been under their control while fitting oul and on final departure. 4303. Art. 3. Hospital ships, equipped wholly or in part at the expense of private individuals or officially recognized societies of neutral countries, shall be respected and exempt from capture, on condition that they are placed under the control of one of the belligerents, with the previous consent of their own Government and with the authorization of the belligerent himself, and that the latter has notified their name to his adversary at the commencement of or during hostilities, and in any case before they are employed. 4304. Art. 4. The ships mentioned in articles 1, 2, and 3 shall afford relief and assistance to the wounded, sick, and shipwrecked of the belligerents with- out distinction of nationality. The Governments undertake not to use these ships for any military purpose. These vessels must in no wise hamper the movements of the combatants. During and after an engagement they will act at their own risk and peril. The belligerents shall have the right to control and search them; they can refuse to help them, order them off, make them take a certain course, and put a commissioner on board ; they can even detain them, if important circum- stances require it. As far as possible, the belligerents shall enter in the log of the hospital ships the orders which they give them. 4306. Art. 5. Military hospital ships shall be distinguished by being painted white outside with a horizontal band of green about a meter and a half in breadth. 296 MANUAL 1<'0K THE MEDICAL DEPARTMENT, U. S. NAVY. The ships Hientiouetl in articles 2 and 3 shall be distinguished by being painted wiiite outside with a horizontal band of red about a meter and a lialf in breadth. The boats of the ships above mentioned, as also small craft which may be used for hospital work, shall be distinguished by similar painting. All hospital ships shall make themselves known by hoisting, with their national flag, the white flag with a red cross provided by the Geneva convention, ami further, if they belong to a neutral State, by flying at the mainmast the national flag of the belligerent under whose control they are placed. Hospital ships which, in the terms of article 4, are detained by the enemy, must haul down the national flag of the belligerent to whom they belong. The ships and boats above mentioned which wish to insure by niglit the free- dom from Interference to which they are entitled must, subject to the assent of the belligerent they are accompanying, take tiie necessary measures to render their special painting sufficiently plain. 4306. Abt. 6. The distinguishing signs referred to in article 5 can only be used, whether in time of peace >r war, for protecting or indicating the ships therein mentioned. 4307. Abt. 7. In the case of a tight on board a warship, tlie sick wards shall l)e respected and spared as far as possible. The said sick wards and the material belonginj: to them remain subject to the laws of war ; they can not. however, be used for any purpose other than that for which they were originally intended, so long as they are required for the sick and wounded. The commander, however, into whose power they have fallen may apply them to other purposes, if tlie military situation requires it, after seeing that the sick and wounded on board are jjroperly provided for. 4308. Art. 8. Hospital ships and sick wards of vessels are no longer entitled to protection if they are employed for the purpose of injuring the enemy. The fact of the staff of the said ships and sick wards being armed for maln- taiiung order and for defending the sick and wounded, and the presence of wireless telegraphy apparatus on board, is not a sutticient reason for with- drawing protection. 4309. Abt. 9. Belligerents may appeal to the charity of the commandeis of neutral merchant ships, yachts, or boats to take on board and tend the sick and wounded. Vessels responding to tliis appeal, and also vessels wliich have of their own accord rescued sick, woundeii. or shipwrecked men, shall enjoy special protec- tion and certain immunities. In no case can they be captured for having such fiersons on board, but, apart from special undertakings that have been made to them, they remain liable to capture for any violations of neutrality they may have conunitted. 4310. Abt. 10. The religious, medical, and hospital staff of any capturetl sliip is Inviolable, and its nuMnl)ers can not be matle prisoners of war. On leaving the sliip they tak»> away with them the objects and surgical instruments which arc their own private property. This staff shall continue to discharge Its duties while necessary, and can afterwards leave, when the commander In chief considers it possible. The belligerents must guarantee to the said staff, when it lias fallen into their hands, the same allowances and pay which are given to the staff of correspond- ing rank in their own navy. 4811. Anr. 11. Sailors and soldiers on board, when sick or wounde■-.,,,. ,'Vi E-llit'i I ^ reported — by executive surgeon .?..-.-. i;iyi I by ward nmse j4gQ to master at arms 1434 Abstract: dental treatment 2270 , enlistments (Form X) 3922, 3(t51, 4121, 4131 • health record — entries on 02.53^ 2261 procedure on promotion 2262 procedm-e on reenlistment 2261 2281 patients, quarterly (Form F). - • .i.ii.i.s,j»sevj.:3a22,3936,412M131 syphilitic treatment '. _ 93,)7 Abuses: executive smgeon to correct .;,.._. ._..,,,,. >io<4OT<;-sK-rf93tfe 1309 jcpression of .■.-.-.-,-.-.-•.-,-.-,-.-.-.-.-.■.-.•.■.-.•.-- -_-..-.-. -.-.-.-.-.-.-.-y 4258, 4259 Academic Board, medical officer member of .... ....._._... .... ._.j.to<5.<»- ssi^iffimiH- 938 Academy, Naval. (See Naval Academy.) Accepted applicants, entry on Form X 20.K Accidental death: board of inqviest ordered 2419 2814 court of mquiry 2426^ 2814 Accidents: ambulance parties prepared for..... ................. .^.j^. .a^pj^.jj.^gj^^. r^^ 1^54 eyewitnesses, report on '... .....\. ,,.,.. Ji8i6,3756 ji ,.in absence of medical officer .- V- ^ -■- . 3756 ; noted on health record j.vii.-. .;■.■■.... 2209 to employee, report of ^ ;f-a-f - 2171 AccountabiUty for property... -.--.-.-.-.•.- ---.-- ................. ,Vk,j.i. .,. ..J -^afU, 3521-3525 ji-dental... ■-■■.■.■.■--.-.--.■.■.■■.■^.-r-^^^^-iiH'^ 1027 5(i«xpended. -.-.■...-...........-.-..-.•.-.•.•.-.-.-.•.-.-.■.-.-.4*>s 965 U hospitals .........^..............^,.,^,......\.. , wi ,..;,,., . .;,.,..-.• . - 1257 J- instructions relating to. . . . .,..,.. . . ....... . . .... ..................................«qjy>sfl:MM-,4wtf>T- • -- 3511 fi cards for -.-.v.V.-.-.v.v.v/////r//.-r.-.-.-^.-.r/.-.-^.:^...r^^.r^^.-r^^^^^^^.,r;r :««?«<■= -»- - ' 3970 ^' ; bstioqai ecf oJ ,:.'.';ii;gQg^ ij jfflo 304 INDEX. Paragraph. Accounting system, hospital 1385-1415 Accounts: . / J ll /I I deceased persons 2406 expenditures to be specified in 31 hospital ship 1 725' master ; .- 1726 on designated vessel ...-/.I.; 1724 men transferred 2989, 3002 Acids: carbolic — crude, as insecticide 2781 disinfection by 27.>5, 2765 care of 903 Act, compensation: instructions relating to ^...,., 2171 , 21 76 payments under ,^,,:^. 2ie*,21C.8 physical examination under , 2121-2132, 21G1-217C Acting appoiatment-s: as hospital apprentice, first class 4G4, 523 as hospital steward 511 expiring in hospital 1263 Acting assistant dental surgeon: age of candidal e for 1965 for temporary service ; 323, 341 promotion of 32o Acting assistant surgeon: appointment of 114, 151, 1903 physical examination for 1929 temporary service 115 Action: adequacy of arrangements for §91 casualty in, key letter for 2335 dut ies of surgeon's division during 985 report of casualties in .• 1816, 3922, 3941, 4111, 4121 Active duty 131 Adenoids, candidate rejected for 1981 Address: fonvarding — noted on discharge report .•.-.-. .'.'?J.'V.'.^ i .'?;'.' 1467 patient to leave 1 ,126 next of kin on admission report H67 Adjutant, post of, in parades, etc 1 854 Administration: '' "n i iio oJ" ' ■'»'■ hospit,!il ship, controlled by Bureau of Medicine and Surgery '. 1701 Nurse Corps .-..•..•.■.■. .•. 611 Admission-s : abbreviation used for 2284 Army and Navy Hospital, Hot Springs, Ark i .'. ;i*.'<.'.".L . .'. .'J.i. ; . . 1601-1622 candidates for — age of ; 1965 merit roll of 1944, 4131 statement under oath 195S employees, to naval hospitals 2174 entered on abstract of health record 2261 foreign hospital, certificate of 905 merit rol I of candidates for 1944, 41:<1 miscondtict report, Marine Corps 1242, 1365, 3915, 3922. 3972, 4131 to Naval Home 1631-1632 officer as patient, to 1)0 reported 4131 INDEX. 305 Admission-s— Continued. Paragraph. ])aticnt — entered in journal .:i>P.lill.-4 i: 1362 regulations relating to ....;.!... 13G5 ration notice (Form S) i^J.ivl'i: .-. .■ 3'>22, 3948,4131 reports kept by ward nurse 1467 supernumeraries, report of 4131 venereal cases, required 2252 Adults, table of measurements for 2082 Advertisements : for proposals 3302, 3372 purchase without 3307 Advisory circular 2252 Affidavit upon death or injury 2164 Age: applicant for enlistment 2027 assistant surgeon 113 candidate for admission — Naval Academy 1974 various corps 1965 entered on descriptive list 132,2103 recruit 947 Aid: first. (S€e "First aid.") medical, to persons not in the Navy ^ ^ 899 societies (see "Red Cross")— n: hospital ships, regulations for ..-......- 4223 regulations concerning 4241-4244 stations- battalion singeon to establish 1844 regimental M^y.'Siyi'. 1862,1864 temporary 1866 to wounded, by inhabitants 4206 Aides, posts of, in parades, etc 1854 Airing of bedding weekly 254^ Alaska, care of insane in 3164 Albumin, urine of candidate examined for 1955, 1993 Alcoholic indulgence 2820 Alcoholic liquors: loss of pay for disability resulting from use of . : 804, 832, 924 not allowed in wards 1515 Alcoholics, not to be enlisted 2063 Alcoholism, rejection for 2113 Allegiance, oath of, applicant takes 2081 Allotments on transfer to hospital 2988 Allowance- s: baggage, expeditionary force :Vk K'.SI'i'. 1847 clothing. Hospital Corps ., 1847 fuel, temperature certificate 920 medical stores 860 Naval Home, inmates of 1633 Nurse Corps- quarters of 751 superintendent of 730, 751 Ambulance: [TOjain*,, book : 4131 806 INDEX. Ambulance— Continued. Paragraph. definition of term l>»tlKL':w J-e. ^. . . . 4213 distinctive flag for • • • - •*208 equipment retained after capture - • ^205 neutrality of -^^^^ ; persons employed in , 42n:i-4205 party- armed against savage enemy "^-5 armed escort for ^^^^ equipment of *®*^ instruction of, in first-aid 1804,1823 not massed in parades ^'^ organization of ■ ^^^ parades, prepared for first-aid 1854 regimental, in engagement -yuiijii. jcJii-i w».si.~;i.-'--1868 weapons not carried by W** personnel, duties continued after capture 4212 service — for civil employees - 1240,2173 I)erformed by Hospital Corps. „...-.^u 402,435,1261 special trips - ^^^ Analysis: --- expenditures in bill book 1^^^ urine required in physical examination 1955, 1993 ^^f^r JJ. .bin Jiiii'J.'.'.vv- 852 Anatomy, instruction in 1^"^ Anchor, removal of mud from 2611 Anchorage in infected ports 2523, 260d Antitoxins, obtained from Bure^iu of Medicine and Surgery 3563 Antityphoid inoculations, intervals between 2612 Apparatus: — electrical, requisitions for .^.. .^^... ..^...^^ 3421 finger-print, supplied by Bureau of Navigation 2096 fire, care of ■ - — - jjji;.';;:tii. *>.,.- -i 1-321 sterili/.ing, care of •>- .^~^^.^^-. •" ^350 Appliances: first-aid— ■ distribution of ;Luui;j. ji.t'ii lsia-1821 instruction in use of -'->^- ^^^ surgical — replaceable only after survey .i:i^..i:^.^.i:i'-A: 2951 » S6'' survey of '^ - Applicant : accepted, entry on Form X 2053 expenses of, no allowance for ■ 258, ai8,357,486 for employment — physical examination of 2121-2123,2141-2156 preference for disability in line of duty .5;'. ;■..-:".'.. • 2132 -,^ preference for honorable discharge .._._.__._.,.__..._.. 2132 ,..,, lor enlistment — adaptability to be considered J'|..j,2066 age of ...:... .. ......... :::::.. ....^...^ . . 2027 examination of "'"* liospital treatment of ^^ for 3)cnsion, examined by medical offlcer.V.vr.V.V. . 3.58 Application: appointment Medical Reserve Corps. . '3- for— leave, civil employee*. ..-.•.-.•.. ...-.-.-.-.-.-r.-.-.-.-.-.-.-.-.-.-.-.-.-.% - '^^ I)enslons ; .:............. ^33 registration by Hed Cross > ^^' INDEX. 307 . . Paragraph. Appomtment-s: acceptance of Vu'u'r'Wi lanl acting assistant surgeon 114-110,151,1903 acting— 464 r,23 hospital apprentice, first class rTi chief pharmacist's mate - - "' 1 ' ■ age of candidates for - - — ; ••;;■,■," ' Vt"" assistant paymaster • - ■ assistant surgeon - ■ • "■'.'.'.'.'.".' ' " ' ".'''" '"• ,Qr i 06^ candidates to have physical examination - ■ . - - -"- ■-•--' - ■ - - - •;.-;;.•;;.■.•.•.:• * " "^^ >' chaplauis , chief of Bureau of Medicineand Svu-gery '{^-giufi'hn chiefsofbureaus •- - ;;;; ;m:3i3; 332-335 Dental Corps ' ^.,^.q Dental Reserve Corps • fleet surgeon hospital ships, regulations for ::::::: '^i'' ' ' ' Jang ^ Marme Corps officers - ----■ - '''■'■■■■■■■-'■■ 'xU\^'m'm--li/2 0*. Medical Reserve Corps. :...;..... -'..;';. o^f ,.„.., 241,2.)l-255 qualifications for • ;.V.V ."■'•'''•*•'■ ^nm (•'' naval constructors ::":::::::' .^-, 273 '• Naval Militia, medical corps of '.■.".VioTr' ' n c\A ''41-647 '• Nurse Corps ■•.■^■(^;■MOVlt.;■^iiiii;Li>■;?-''^ 'J^g^_ggg '■' chief nurse - " -■":'.* superintendent .".■■.■.■.■.■.■.".■.'.■"." ' "."."■'.' '■' n.^a <^' nurse, revocation of ■-- ■' ;^-., ' ■ ' officers, by President, with advice of Senate.-. ■.'. - • ■ - ^ health record to he opened ^"''^' "^ permanent— ,„ ^ 405,523 2,503 1906 hospital apprentice, first class . , ., 442, oOo pharmacist. ^" professor of mathematics — ']l[['llillimill^^~''^' '■ — -' ' subject to examination .........".■. .^^. ^. ^^.^.^^^f^. . ■y^jj' ,-oiffiy^ subject to physical examination ........".■.■...-■.■. :.:■■•-■ .: "'"' ?m surgeon ■ ■ 'wno-m termination of, disposition of health record ^-"'007= Appraisal of articles to be sold • 29oo,2975 Apprentice: 2084 - musician, physical proportions of. .. . .-. :■■".■■.""■■::.■:.";; .'o J ov'c'avisM^""' ' "''' ' ivjoi ' seaman, physical proportions of. .-..•. v.-. -.--•.•-".•...•.... ".■...■. yr-^e',^rf9\ Approprlatiou-s: 1397-1400,3383,3400 charges against .•■;. .. 70 \dnn\dTi contingent. Bureau of Medicine and Surgerj-- ••• /^,i4w,MM ... , • ■ 51-Ca laws relating to ■-■■• 72,3383,3400,3671 Medical Department ••-.■;:.-;.•.• .._-. /seOT 3655 3661 naval hospital fluid .■■■:■;::..... on outstanding, amoimt to be designated ......'. preventing epidemics ■.■■.'."■''- "94 public works, estimates for .■-..■- - . .... - .- - - - - ■ „ f.,, , ■■.'.■.■.■.■.:. /1-75 titles of ■ ;; • ; _2 3433 transportation of remanis ■......-. .^. . j._. - ;^. j. > ; Armed escort for ambulance party - • ■ - ■ - - - ' Arm, flrst-aid care of wounds of - • Arming of ambulance party ■ " ^ Armor, battle dressing stations to be behind.... Arms, use of by sanitary formations 1 -qi ir'>2 Anay and Navy Hospital, Hot Springs, .\rk .:;::.■;:;; ." : : uyi-i'^- qideii m INDEX. ^rmy: Paragraph. Nurse Corps, service in 722 personnel in naval hospital 30ii service, not counted as reenlLstment 205 transport, health records on 2290 Artificial limbs 1395 "Ashuelot," pensions for widows of those lost in 3744 Asphaltum ^. .'. 2097 Assignment: Dental Corps ,. 336 nurses 671-677 Assistant: chief, Bureau Medicine and Surgery 8 civil engineer- age of candidate for 1965 physical examination for 1931 dental surgeon — age of candidate for 1965 promotion to ^ 320 paymaster — age of candidate for 1965 appointment of 1903 physical examination for 1927 physical qualifications for 1926 surgeon — age of 113, 1965 appointment of 1 U, 110, 1903 candidate for 124 examination of 113 Medical Reserve Corps, appointment in Medical Corps 116 physical examination for 1928 professional examination for promotion 191-193 rank of 101 Asylum, Naval, government of 1206 Asymmetry noted on health records 2241 Athletlc-s : goods, entry in bill book 1395 outfits provided for hospitals 1327 relation to line of duty »t..i, 2832 sports , traumatism due to ,,^ 2335 Attendance: medical — officers' families -^V-V-- i 913, 914 ships in reserve 906 Attendants: hospital messes 1318 patients drtailed as :/:.',...'.:.:./. .'.^f^^^^f^f^.^^ 1313 Attention— to patients by dental officer 1024 to sick by Ilfjspital Corps 845 Auction rjfeffccts of deceased .j^j...^.'^,, 2415 Auditor lor Navy Department, contracts niee stated 20(14 Authority: Bureau Medicine and Surgery — to Issue drill regiilatiorei for Hospital Corps 14,438 to iss\io Manual for Metiical Department .,......, 13 civil, deat h reports for 4002 commissary ofl'icer, hospital ship 612, 1022 INDEX, 309 Authority— Continued. Paragraph. e.\ecutive surgeon 1302-1313 master of hospital ship 17X0 medical officer gH nurses on duty gl7 1441 obedience to, required 1729 Autopsy: entered in journal 2318 2443 performance of 2443 Auxiliary-les: naval force, pensions for 3727 naval, hospital ship classed as 1700 officer of, absent 3012 service. (Sec "Service, naval auxiliary.") venereal disease 3013 Average complement, method of computing 2379 Aviation duty, physical examination for 2113 2302 Bacteriological: examination by Naval Medical School 3221 - supplies — from Naval Medical School 3228 requisition for 3.556 Badge: . Nurse CJorps 771 Naval Reserve Force 131 Bag room: . ..n>>iii>'j>i regulations for ....... . .vs. 1433 supervision by master at arms ..'.^..i.... 1431,1502 Baggage: allowance when on expeditionary service 1847 disinfection of 2770 Bakery, Medical Department use after battle. 1828 Band, as ambulance party 1822 Barracks: disciplinary, physical examination prior to transfer to 2115, 2947 marine, sanitary condition of 2594 Base hospital: aid to wounded at 18C2 location of 18G9 Base, sanitary. Red Cross services at 4352 Bath , patient to receive, on admission -. 1502 Bathing: ,, precautions concerning :. . . ; 2605 required before battle 1825 Battalion: ambulance party, organization of .'i............ ^ 1845 organization of :--u.;,.wi -v.xjts-i9uiiii Jsii5o,iMa staff, post of, in parades, etc '.- . . .-. . .- -1854 surgeon — duties of 1844 post of, in parades, etc ,,........,.,...,.„„,^...,,feiL: 1854 Battle: :• care of wounded in , , . , . . ^.. . 1801 , chaplains, duty and station in .^.ta zo. h\av,.iii.iiiMl96 dressing stations 182*, 1827 executive officer's report after , Jiti<; t^P.^ .,;... 1809 fireproof clothing for , ,...,..-... 1825 flrst-aid service during -.-.. 1822 Medical Department, conduct in 1801-18^ 310 IXDEX. Battl«~ConMnu9fl. Paragraph, medical oUicer— auties iu '<16 duty to wuunded l*<11 station during 1S24 pay division, station in .-.J '.'!'.•;'.'. ..- .. .-: : 1812 reports from oflicers after — 1S15 report of killed and wounded aficr ...•.-..■.■.■...-.■.-. 1805 iransportation of wounded durin;; .■.-. . . .-. 1822 uniform for 1*25 Bed-s: convalescent patients to make their own ..•.•.•.■.•.•.'■..•.•. lo2l hospital, assignment to patients ^ .-.-. .•.•...•.■..•.-..■.•.■.•.■.•. : .■; 1320 jiatients not to sit on Al>7.'i'jP.-.'M'.. . . - . ... 1 l.ilO jiatient's, nurse responsible for condition ^. .>•--.-.•.■... Ufil Bedding: .,.ir.,o,^. . aired once a week 2543 appropriation for 1307 for berthing space for wounded 1824 roll, olTicers on expeditionary service 1847 Bellevne Hospital nomenclature ...-.•.... .... 2323 Beneflciary-ies: . .o! .£..,iiia«i>»-j classification of ^''.S'SflfsB gratuity pay to . . .-"il »ftl,2431,3451 pensions when in hospital .• - .^- ......:.' 3656 Berthing space for wounded at battle dressing station 1824 Blchlorid of mercury, disinfection by 3753, 2761, 2762, 276,'i Bidders, acceptable, named on requisitions .-. 3378 BUl-s: '- hook ...-.-.•.¥>.' .0.3«. 93C,S08, 1258, 1319, 4131 instructions concerping 1381-14(M lire, to be posted .•.'.';. '. X'J. 1321 Form 5 -...i.i.iC^fi'Ji'j 3922 FormC 3922 hospital, supervised by executive surgeon .'.'!r.:.;i.M,'.;Wy:.0. 1314 of health ..■.^■^■..^. S»i6 for Canal Zone 2735 instructions relating to 2711-2722. 2741-2744 laws relating to v..... 2701-2708 medical ollicer to secure ..•......;.... 2720.2721 obtained from consul ......;.. 2704 of lading- form for 3997 memorandum - •. ■■■ 3998 schedule of 399<> liublic. (.SVr Public bills.) Blnlodld of mercury, di.siufcolion !>> 2753 Binnacle list ■<4s. 872. 4121 Birth: dale of — entered in he^ilth record ^ ; • • ^■■'- • --*i slated under oath 2081 niiirk, cxten.sivo, rejection for 20(>8 Births at yard or station lo be recorded '''19 Blank-s: rornis. (See Forms). ivqucstfor : ,tn:r:i'-t , '< /. Hospital Corps drill, authority to issue ..,,,..yip, ...,.,*,,,, .1^438 kept by ward nurse , . ,i....ir. f^,. ...^j .,...,.... , ... . ^^ 146S 312 INDEX. Book-s— Continued. Paragrat*. liberty, care of 1311 op^ratinK room 1350 order, kept by ward officer , 1342 pass, supplied by Bureau of Medicine and Surgery 1311 prescription....'. 963,1255,3525 property, kept by ward officer 1342, 1346 request for 3991, 4131 Brassards: description of :..;:. 4251 neutral indi%'iduals to wear 42f>8 stretchermen to wear -' 1^46 Breach of discipline 871 Breakage : reported by property nurse 1^^ responsibility for - 1^^ Brigade; ....,-,.-,.,.... commander, brigade surgeon on staff of. ; -. .'.•.•.'.•.-.•.•j-.-..v.r.-.-.-.-.-.-. .-..-. .•.•.•.-.-.•.•.•.-.-. 1S42 dressing station, location •.•.•.-.i-.-iV.-.vA-.v.-.-.v.-.-.-.y.-.-.v.- .-.•.-.-.•.•.•. 1865 hospital — ....... .-.^ •-- ■■- aid to wounded at . . . .-. •. : 1 ..."■. ....;...... 1S62, 1868 designation of . - - - - -•-' ^^^*^ naval, organization of . . - 1841 surgeon- duties of 1^*2 fleet surgeon detailed as • - H^l Bridge work, not duty of dental officer — — 1033 Brig-s: patient confined in l'**^ report of ^^^ • supervision by master at arms ■ H31 visited by officer of day - - •■• •• 1^'»8 Bringing home remains, charges against appropriation for ..-.•.•.•..•.■.•.':'.' . . . 3400,3439-3443,3455 Brooms: dressing station to have - - 1^24 expenditures for l^f*2 Buckets for dressing stations 1824 Buildings, hospital: authorized by Congress 1209 ' no change to be made in '"■», 12S3 vouchers for ' ''^' weekly inspection of 12s^ Bulletin board, notices on 1329 Bulletin, naval medical, contributions to 2»i(>2 Bulletin, sanitary, issued by fleet surgeon ^ If'S Bumboats, inspection of ^•''3. 2571 Bunions: entered on rejection report 208! rejection for •--•• 1'*1>20T9 Burean-s: V)ooks, custody of .;.\.\.w\:' 2 chiefs of— appointment ^ excmj)l Ion from sea duty ■ ■ ■'' rank and tit le ^^ rank when retired ^ Navy Department, establishment of 1 records, custody of '"••■- 2 Bureau of Construction and Repair, equipment supplied by .• **21 INDEX. 313 Bureau of Medicine and Surgery : Paragraph. administration of tiospital ships controlled by • 1701 appropnations ' ^ ' "^ assistant to chief of ^ authority of, to issue Manual for the Medical Department 13 authority of, to issue drill book, Hospital Corps 14,438 change of diagnosis authorized by 2353 chiefs of, appointment _ '^ decision of line of duty by 2813,3757 design of hospital ships approved by 1701 Carididate-s: admission — age of 1965,1974 statement imder oath 1^^^ expenses ■ ^^^' ^^' ^^^' ^^ gun-pointer, examination 9' ^ merit roll of ^^^ nonappearance ^^ promotions, statement under oath 1958 Candy, not to be taken into wards 1515 Caps, disinfection of 2769 Carbolic acid: crude, as insecticide ■ 2781 disinfection by - -. 2753,2765 Carbon dioxid, destruction of insects by 2781 Cards: Form F (rough) ''■■■'-■'-'-• 3922,3936 Form X (rough) 3922,3951 outline figure, preparation of 2101-2105 permission to play 1509 property accountability •^070 property kept by ward nurse 1^67 Care of: acids 903 inflammable stores 903 insane patients 1316 patients— . dental officer aMi-aiab&.ia.l:. 1024 executive surgeon 1306 property, dental ofTicer 1027 sick, responsibility for 1281 wounded - ■ - 985 Carpenter, hospital, report to executive surgeon 1542 Case-s, surgical, supervision of 1350 Casualty-ies : in action, key letter for 2355 reportof ' 1816,3941 rate in warfare 1^22 Catarrh, chronic nasal, rejection for - 1961, 1981,2079 Causes of injury, classification of 2335 Cavities of teeth, classification of. •os'.iiriiu.w*:'.uj.'. 2271 CeUs: inspection of ^54, 2572 report on condition of 2653 Cemetery-ies: hospital, to be kept in good order 1324 naval, headstones for unmarked graves 1292, 4131 record, supervision of 1319 Cerebrospinal meningitis, quarantine for 2733 314 INDEX. Paragraplir Ceremonies, swords to lie worn at 'j'Ji'fiii'iL^Q ... - J***5 Csrtlflcato-s: ■ admission to hospital (foreign) -,w...-.......< 905 death :.;... I..;... ...*..;.. 825,1141,2815 lor civil authorities '•^'- ••>>-<'^ 4002 FormN .:.:.;v:-. 3M4,4121 discharge from hospital (foreign) ^05 false, penalty for 126 identity, armed escort of ambulance party 1845 medical- civil employees 2131,21o2 court-martial proceedings ^^ St. Elizabeth's Hospital for insane 4^1 member of general court-martial 89( of examining surgeon on service record 2081 t pensions — descriptive list on ^"^1 medical officer to give ^^^ r required, candidates N. R. F 1^2 unofficial, prohibited ^1 Change: diagnosis- abbreviation for "M authorized by bureau 2^^ l^rocedure ^^^ Hospital Corps, report of 3953, 4121, 4131 of Stat ion, nurses f'^*^ rating in Hospital Corps, report of **7 Chaplain-s: ape of candidates for 1^' appointment of 1^^ duty and station in battle 1*^ neutrality of 4203,4240 physical examination of 1^^ services of, at funerals ^■*** at hospitals ^^^ visual acuity required for admission ^^^ Chart: climcal, Form Q 3922.3947,4121,4131 Checkage for naval h-^pital fund . .' .' 731 , 1202, 1268, 3602, 3606, ,3621 , 3624, 3625, 3651 Chemical examination by Naval Medical School - 3223 Chest: conference of nurs«w i. 4^, . -• .J . .>^ i •i'.-i-iU 1443 conference with executive siu-geon • ;.....- — — •' 144.3 daybook kept by ^*^'' duties in hospitals I4»l-l47n INDEX. 315 Chief Nurse-s-Continued. Paragraph.^ efficiency reports prepared by '^-^ inspection of hospitals ■ 1443 instruction of Hospital Corps - - •• - • • 1447 >. instructions transmitted through 1444, 1457 i keeps health records of nurses ■■ '1^ leave of absence 1448 nurses assigned by - - ...-..•.. 144.3 nurses supervised by - • ^440 orders presented to pay officer - • - • .•.•.•;:--'.:•.:■'. i2i pay ■ ■ - ■■ • ■ • ■"-■-'•■'-"■"-■ '-^ records kept by -■ •■ ■-• ^'^^ register of nurses kept by - - ; - — •• -■ - - 1"*^^ • reports forwarded through 1443 sickness of nurses reported 1>y -, 1"*^ supervision of nursing by ..^;V 1443 temporary .-.-.■.-.-.''Pl^. ': 1448 Chief of Bureau of Medicine and Surgery: appointment of • — '^ assistant to • •' ^ Chief of Staff, papers referred to fleet surgeon by ...■.-.-..■...-■ 1139 Chief pharmacist: ' classification of ^"H duties • 443-445 precedence ^ '*" promotion from pharmacist ^"'j ^1 rank of ^^^ Chief Pharmacist's Mate: • ■ -— ■ enlistment of ...-...-.-.-.■.-.•.-.-.-.%-. 451 (See Pharmacist's Mate.) Chiefs of bureaus: appointment of. exemption from sea duty ^ rank and title " retired, rank of ' Chinaware, appropriation for l'^^' Chlorinated lime, disinfection by -'^ Cholera: precautions against 2603,2615 quarantine for ^^ Chorea, rejection for ■ ■ • • 20<^9 Chromatic sense, determination of -^'^ Circulars: relating to enlistment - - 2041,2042 relating to Hospital Corps. . . relating to venereal diseases . of warning 411-413 2252 2252 Citizenship required of all officers - 112, 131 Citizens, officers of vessels to be 1901 Civil authorities, death certificates for '**^-^ Civil employees {See Employees): admission to uaval hospital to hospital, under compensation act affidavits upon death or injury application for leave ■compensation to dependents on death disabilities to be recorded ^^'^ extension of leave for illness — . . - - - - - - - - - - - — - ■ ^129 height and weight, tables of 2174 : 1543 ..:').ii'}if.:''li'^iP?^... 2164 '^y[y^^ 3995 .25iJuJ>K'; 2162 2152 supervision of, at hospitals . transportation of remains. 316 INDEX. CivU Employees {See Employees)— Continued Paxajn»ph. injured — ambulance servMce for ^'^^' ^^ ''^ medical officer to examme "" ' 21 09 injury to eyes leave J,^ for contapious disease in family - 2130 for sickness "^"'^ medical certificate ^'^^ examination "^ ™ , 34(»0 pay of roll of ;-.f2 under compensation act •^^**' -'*^* physical examination 2121-21 70 preference for — disability in line of duty 2132 honorable discharge 2132, 21.50 report of— death from injury 21t>3, 21 ,5 injury to ■ 2171,2175 subsistence in naval hospital 12,6,.W4,3f.57 1542 34c;o treatment in naval hospital • .--.-.-.-.-.-.-.•.....-.-.....-• 1241, 1276 Civil engineers, visual acuity required for admission -.- - • • 19f'3 Civil hospital-s: care of patients expenses of patients ^^ health records of patients medical history of patients - ^24 report of patients " ■ -• *^ transfer to • CiTilian-s: crew, hospital ship — classification of ^_ regulations for ^ ' 2* examiners, Form X (rough) prepared by ■ 2051 medical aid to /^ treatment in naval hospital •'"' ^ Civil Service Commission: Form No. 1042 *'"** Form No. IHOO ;»i*-fn»H*«i' 2152 Classiflcatlon-s: disea.sps " ' Hospital Corps •••-' L:,„ . . '. 2360 injuries international, of diseases and injuries ■^"•^ . „, 23411 poisons ^^ Class number, Navy classification of diseases 2368 Cleaning: detail, master at arms to make - -^ '^^ gear, oxitcnditurcs for - Cleanliness: hospital, responsibility lor.. 12hl, 1343, 1347 , . 2542 «''"' ::"■":;: yss S24 824 M4 Clear ship for action, inodical ofHcer's duties .«4V 1372 Clerical work, hospital: duty of pharmacist "^^ * system of r> • *•''• imyEx. 317 Clerks, paymastei's. (S«e Paymaster's clerks.) Paragraph. Climate, clothing adapted to i'.;' Jfi W.".".*!?.! i?f-.-i 2605 Clinical: - chart, FormQ .......\..»-.-..i.i;..;:: 3922,3947,4121,41,31 notes — form for < ^ < . : s : s : : = : m 3969 made by nurse ........-.•.■..;.; 1407 Clothing : adapted to climate and weather ■. 2605, 2010 allowance for Hospital Corps 1847 when serviag with Marines 1847 allowance for Naval Reserve Force 131 destruction. of, to prevent spread of disease 2536, 2956 disinfection of 1310,2753,2768,2770 division ofTicers inspect 2543 dried before stowing 2543 fireproof for battle 1825 for landing parties 2621 furnished to insane -. 3155 Hospital Corps, inspection of i 1326 Ibt— disposal of 1365 verification of 1502 patient in brig, care of 1486 report on 2653 roll, officers on expeditionary service 1847 washing of, in wards 1518 Coal, entry in bill book 1394 Coaling ship, preparations for emergencies 981 Coast Guard: admitted to Army and Navy Hospital, Hot Springs 1611 cooperate with Navy ' 3723 pensions to officers and men of 3724 Cocain habit, evidences of 2063 Cockroaches, destruction of 2781 Cold, esposure to, to be avoided 2621 Collision drill, surgeon's division duties 982 Colon, quarantine jurisdiction at 2735 Color blindness, rejection of candidates for 1961, 19S1, 2084 Color perception: determination of 2075 standard for 1963 ColuHm, transport, organization of ^ 1842 Comfort: .-.i^'X '.'. j crew, fires for - 25-38 lights for .....::. 2539 troops embarked 896 Commander in chief : hospital ship iaspected by 1709, 2512 material surveys ordered by 2969 naval hospitals inspected by .■ 1251, 2512 reports of contagious or infectious disease 2513 returnable through 1141-1154 submitted to, by fleet surgeon .-.-.•MVA'^l 1140 returns, ship separated from •..•.■.•-•. 1154 sanitary duties of • . . - ..•.'.;. 2511-2525 stafl of - - ". - - - 1111 suggestions from fleet surgeon 113^ -318 INDEX. Commanding officer: ^xn. I'aragraph. complies witli quarantine regulations 2711 healtli records inspected by 2224 hospital ship ~ i 1"10 authority of .:.. 611, 1022 responsibility of 1223 inspects medical joui-nal - ■ - • 2312 opinion as to line of duty i i . . 8442 recommendations to ■ - 2563 sanitary duties of 2531-2546 signs descriptive list on report of death 241*< pension certificate 3751 10 consult medical olBcer '^2 , Command, succession to, on hospital ship 1710 Commissary : hospital steward in charge of ..,,....., 1348 ' pharmacist in charge of -......„...«»»..», ^ 1348, 137), 1373, 1411-1415 , Commissary ledger: forwarded to bureau 4 131 instructions relating to 1411-1418 ration memoranda for 3965 receipt and expenditure voucher for 3966 supervision of 1319 Commission. (Sft Going into commission.) . lo Commission, Civil Service: Form No. 1642 -- .-■ ^'144 Form No. 1800 2152 Commissioned officer, health record lor 2243 Commissioner of Pensions, laws administered by 2822 Communications : Nurse Corps, via official channels. ..,-^i(.H^. 708 restriction of ................,..,,.,,,,,.,.., 2518 Commatatlon : quarters, Nurse Ck)rps — ......... . . ........... ..^.. dl8, 753 ralioas, Nui^e Corps ^t..^.,..^ 741,742 Company, organization of .t,. juj/j; W2 palinnl, in brig ^ 1-W6 si)accs, report of .-.-.• -.•.•.•.•.•.•.•,•.•.•.•.•.•.•.• .•.••.>-.»»..«*.. ''^ Conflagration, injury by 23;i5 INDEX. '^i9 Paragraph. Congress: „i ,,^„uai f„nri .j,-w,a>„v>... 3607,3655,3601 appropriations for uaval hospital iund j.*r.rvw>*, > » estimates submitted to • hospital buildings authorized by ^^ sites authorized by - physical examination requested by Member of ... ; Consent for enlistment of minor "" igsa'wsi "079 Constitutional weakness, rejection for .-.--.•.•.•.■-■.-.•.-.- .-kp- • ' ' - Construction of hospitals: -r- rrrr- • v : 2621 recommendations for • ,.,,^, _ - i.jyo vouchers, filed • • 2704 Consul: bills of health obtained from - ^^ health records transferred to •-■k4 f,-o>-Hf -Mi i>^t3U^ If - - -» Consultation: — ■ • ' ., . .,^., commanding olficer with medical officer ,..........,,,......-.. i-,.—.*v.i. - ,- fleet surgeon with medical officer r r r - - v. , h- regardinghealthofcrew ;:':::::::"8*V888; 1342.1350 regardmg treatment ^^-^ ,......--r . ■ ^^^^ Contagious camps, instractions in hygiene ■ -. t t : - t -.-.:-.- -. Contagious disease-s: abUity to cope with • ,.:.... t^nth^^* s«i care of " " ■-•.-.-•- detail of patient with ^ disinfection of clothing. • ..,,,. -..-....--i.:--,-.H.-rt'iJ-;-.-- ^ disinfection of ship ......,.....,..---.-, --^■f^'r.'-.L. -••-•- - in family, employees leave because of ,. .-.fT^.v . . : ..i . _ in West Indian ports, report of ■■■■■ ............4'.;fo.^M'>;.r-»iV>i^V" ^7 medical officer notified of ..v^^.. ........... ... -^^ men with not to be transferred • "" patients not to beinlandmgforce ..-.-. ;;;:;: :-yi,:;2no7;2608;26i+-2617 precautions regardmg ' oio prevention of .-.--,- wrsm « rejectionfor 4ftkkKrfi^m.^>|i<.^^«^^ s^o '828 4002 report of .._. .^fvKwxx.. ' S'S by commander in chief ,,;►....-£.. ,„.,. .^..., ......,, -...«^^ penalty for omitting rctimis of -.->x-»v. U.t*»* Ja-v.,'* J- .i.vri,ri.-sov. «v«itt status of United States when making - .-.-■, si.iv fv>ii-.j>.?vt..v.:-.;i».-.4ooJ.'.*- - »«» supplies furnished by ;.-;.5:.-.T<.!-i-'ii>-.--i-r»'?'---- ^ to be in writing. ........ -"..•-•• '■--•- ,......,..>.^a>>41"..< 320 INDEX. Paragreph. Contract nnrse , service as i^iit UW'il'A; ..»..„,.. 722 Contractures, entered on rejection report imii,ii:ii.i.ii..nffiti 2085 Convalescent-s: ••'•• ^' ^ ' camp, base hospital acts as i... - - • • 1869 detail lor work ; 1313, 1507 discharged when fit for duty 1230 make own beds 1521 returned to duty promptly 12fiC, 1286, 2948 Conventlon-s (See "Geneva Convention" and "Hague Peace Conference"): governing hospital ships 1704 Convoys of evacuation - -• 4248 Convulsions, rejection of candidate for 19C1, 1981,3079 Cooking: examination of water to l)e used for i 25C9 instruction in 1375 utensils, cleanliness of 2544 disinfection of 2772 Corns: entered on rejection report 2081 rejection for j... 3079 Correspondence : course, Naval Medical School - - - 3320 fleet surgeon 1131 hospital- duty of pharmacist -. 1371, 1372, 1389 hov/ conducted 1262 Nurse Corps— via official channels 708 Cost of maintenance : from hill book .•..v..w.- 1384 statement of 1421-1425,1431 Court-martial: ' fines, for naval hospital fund ^„,,^. ,.^,,,— , 3ti03, 3658 general. (Sfc General court-martial.) indorsement on record of 829 medical certificate on proceedings of 895 summary, at naval hospital 1277 Court of Inquiry: entries on 2S14 on accidents causing death 2426, 2814 Crew: consultation concerning health of 254.5 examination of, going into commission 842 exposure of, to be avoided 2543 fires for comfort of .... ,....vi..»i....j 2538 health of, consultation regarding .1. i :'.j ..•..'. . ^ . . 4';.'.. ; 802 lights for comfort of 2539 merchant, hospital ship manned by 17U5 physical capacity of 254t> preservation of health of 2533 provisions for, insi)CCtion of ''*^> 2568 sanitary condition of "•"' vaooination when going into commission 25. (> Criminal applicants for enlistment, detection of 2063 Crown work, not duty of dontnl officer 1*133 Cruise, medical officer detached during • • • 831 Cruising ships, ro(|ulsltions from • • - 859 Cmsblng, traumatism by ■* 2335 INDEX. 321 -, .. , . Paragraph. Culmary department, entry in bill book , J397 Curtains, disinfection of 27rg Day: book, chief nurse to keep , j.r off duty in hospital , oro officer of. (See Officer of the day.) Dead (.See Deceased; Kemains): burial of, appropriation for 3^0^ ^,^ disposition of 183l'34C"> identification of .'.'.'.'.'.".'.'."'."'.'.'.".'.".'.'.'.'.'"l826, 4235' 2097 transportation of, appropriation for -2 3433 Deafness: ' examination for „.-,,, Mib rejection for ■>• 2070 Dealings with patients, prohibitions regarding. 434 970 1269 Deaths: ' ' accidental — board of inquest ordered ,.ai., 2419 2814 court of inquu-y " ' 2425' 2814 at sea, funeral expenses ' 04.50 certificate^ entry as to line of duty 2315 for civil authorities 40^2 entered in journal '" ™,o ship's log 2412 from injury, report of '2163 2175 violence, procedure ' 242'> in civil hospital „.„^ in foreign country, funeral expenses 345&-3460 in St. Elizabeths Hospital for Insane 2438 3i3f in Hawaii, funeral expenses ' 344, in Hospital Corps, report of 4a., in line of duty ^ " ^ ^ 2846 in Naval Hospital .ga- in State hospitals of California, for insane 2439 3157 3162 medical officer's opinion as to cause of _ _ ' '2422 noted in ship's log „.„, of employee, affidavit upon 2i64 of employee, compensation to dependents 2162 of officer in charge of stores 2953 of retired officers and men 2437 ^^l?°^io^ ^'."'.'.'.'.[\\\'.'.'.'.'.'s25^nil,3912 evidence for claim for pension 2si7 3"5S ^°^™^ 3922, 3941; 412l| 4131 preparation of 2401-2443 to department 241'} to next of kin -^ .'.'.'.'.'.'. '^ m5^2413,Z45S while on — leave of absence „,„. ,., , 2435 ^'^^-^y-; 2846 special duty 2435 waiting orders 243- Deceased (see Dead): accounts of 24or discretion as to disposal of effects 2417 disposal of papers of ' 241/5 effects of— collected and inventoried 2414 sold at auction 241'- 98601°— 17 21 322 INDEX. Paragraph. Deck courts, at Naval Hospitals - - . .i. - ..-—.. . . . j: .... .•.:.. . . .'. 1277 Deck officer, hospital ship, duties of ■-•.•. .v.-.v. .•- . .-A*. i'il'J. -I'. '.'. 1739 Deck, 11S6 of harbor water on 902,2545,2603 Defects, curable 2081 Defects, physical, waiver for 940 entry of 2052, 2081 , 2241 request for 2064 Deformity : entry of, in rejection report 2081 rejection for 19«il, 1981^2079 Dementia paralytica: ' ' . ^'.-^^ method of entering ^59 rejection for - . .^-•v.-.-. ^.•. .-.-. .•.•..-.-.-.•.-.■.•.•.-.•.•.•.•.-. .•.•.■-•. . 2079 Dengue, precautions against - - . - .-...-.....-.. 2615 Dental Corps: age of candidate for 1965 appointment in :U1-313 appointment in, subject to examination ■.■....■.-.•.•....■.■..-.•.■....;: 333 examination of applicants for. ...•.■.•.-.-..•. .-.-..-.■. 313-318 laws relating to ..................^-^^^m^mj. 301,302 Navy Regulations and Instructions regarding 331-340 phj-sical examination for •.■.•.-.•.-.■.-.•.•.-.•.-.-.•. 1923 qualifications for appointment ......-.■.-.■.■.-.-.-.•.-.•.• 315,332 rank and pay of -.. •.. 305 retirement - .....•.■..-.-.•..■.•....■.•.•.•.•.•..-.■.■.•. 307 tenure of office in ^ v. ^.■. •-■.•.. v. ■.•.-.-.■...•.•.•. •..-.:.■.'.. .'.' 305,306 uniform of ....-.^^v.-....^-...-.-.-.. -..-.•.?.' 305,322 visual acuity for admission .■■■■■■ ■■■■■■ ■■■ ■■- -- . - — 1963 Dental officer- s: assignment of <-.-.-.. 33t> at Naval Academy .>■.•.-.■.%-.•.-.•.•..■.. . .■.■..•.-.%. 301 attention to patients ..,,<,...^(-;iii:-. .-. ^^ 337,1024 bridge work not duty of -.^^ .>-.-.-. .-.■.•.•.■- ..-. 10:53 crown work not duty of ^..v.,.^.-... 1033 dutiesof - :{3«, 1021-1038 forms part of surgeon's division 331 for temporary duty 323,341 gold work not duty of 1033 hospital corpsman for duty with 474,1038 information to medical olficer ,,^^v^-^.^-.-.^-.- 1025, 1034 papers required for examination .•-■ -..■.•.^-.-. ■..-.. — 312,313 permit for examination v........ 312 part of medical department '.'... V.. I. . — M23, 1031 patients admitted to sick list - ..>.....-......•.. 1034 probation period .— . ...•.•..•.-.-.•. .■.■...-..•.. 303 property accountability • - 1027 prosthetic procedures 1033 records of work . ■ . 1026, 1^5-1037 requisitions ML's. 1037, 1039. 3'»31, 3932 Reserve, see Naval Reserve Force. responsible for dental property — '39, 1040. 1041 services, persons entitled to 1032 statistical report of work 1''37 to keep records of treatments — 338 towels and aprons for ,,,«.s,^»,.-..v..v;-.,i. . 1042 Dentaloperatlons, report of, Form K, page 8 b.. 3922 INDEX. ;^!2;i Paragraph. Dental record. 103.V10.S7 entered in health record - - - - 2267-22, 1 for insertion in, Form H • — - • "^^^2 Dental report in Form K •-•- - ...-..-.--'-- : -' :■==- i'.- .■.-; .:..-. 2388 Dental Reserve Corps: ' .- age of candidate for _ 1985^ appointment in .• •' — 3ol-3oD authorization of .........^r.==l«.¥PJV..: 303 laws relating to ■.•.•..•.-.-.•-■.•. ...•.-.•.......-.-.-.-.■.-.-.-...■: 303 physical examination for ..■.•.•.■.-.■,-.-.- .....-....-....-.-.-.-.-.- .-.-r. .- 1060 imiform for .'^l-.v. . ..•-.. .... -■- ..•.-.-.•—-.-.-.-.■..■.-.-.•.-.-.•.-.-.-.-.•■•---•- •--■ v . . .- .- .r . . . 358 Dental services, reimbursement for. ..-.-.-.-.-..-.■.-..-..-.-.•.■.•.-.•..-..•..■..-.-.•.-...■.-.•.•.-.-.-.-.-.--•.».- .r**, .-.-.■ .'tV/ '3342 Dental treatment: — '^'"''^' abstract of ^.^.,w^^^. ^^^^.^.^s..... 2270 entered on health record — .^.-..-;;;.-.-.-.i. -...-. 2207 Department of Interior, form for admission 3120,3130,4001 Department of Labor, blank forms h'-A'iV. '.-.'. . 2172, 217.5 Dependents, compensation to, for death. ... .-..-.•.-.-.• - • • 21G2 Deportment to be civil and decorous - . - - ■ . ..■..•...-.-- - - -■ 1"30 Depot-s, medical supply. (Sfc Medical supply depot.) Deratlzation 2763, 2781 Descriptive list: 2077 entries on •.;.-.-,•.-.-.-.■.■.■.-.-.•.•.■.:.•.■.•.■.•-■.■-•.•.■.•.-..•.•..--■. •^^" on pension certificate ■.......■....-.■.-.-..■.•-■. ..■..•-•;•- .-. ^ i I'i - - ■ • - ■ • ■''•'l on report of death - ....^..^^^ivM'ii0.ii^^yiii.^^ .iv .;; . 2418 preparation of - ..^.l«1M01-2105 Deserter-s: •■ abbreviation for -.....^^-.*-.-. 22n4 enlistment of, prohibited - - - - -■- --■•-- • • - .........;;.... ..j. .. . . -• .... 2001 health record of ....:..... .......... v............ ^ ...:•.■.•: 2291 Desertion-s: disposition of forfeitures for •- . -■- - --.-.- - - . .- --V^imQ Jsoiti-i'. 1204 forfeitures credited to naval hospital fund. . . ................ . ....^^.^. .-.-.■. ...-.-.-- 3Wi9. 30.i7 in Hospital Corps, report of - .^.L: .i'; 4S, noted in ship's log ••-- 3'*32 Design of hospital ship approved by Biueau of Medicine and Surgery..-,. ...-•.i;.'.. . . .v. -1701 Detached service: .- 'i..^. health record of ollicer on ■ ^^2 quarters for nui'ses on .•.•.--..- ... . .■.■.•.■.-.•.•^^-^.-.--.•.- ■.~-^- '-^1 Detachment: medical ofQcer during cmise - • - - ^^_^ entered in medical journal ^-^'^2 officer notifies medical officer of 2302 Detail of: hospital apprentice as sick-bay recorder ■I'S Hospital Corps on hospital ships ■_ "•2^ Hospital Corps with dental officer ^"*- 1^38 medical officer of tlie day - ^-^^ nurses --■' • ^!^ officers for special duties • • ^"^-'^ patients for work in hospitals 1-^13, 1507 stretchermen, to be permanent l^'^ Diagnosis: change of — abbreviation for ^^^ authorized bv bureau - '^^^ procedure ^-^ 324 INDEX. Diagnosis— Continued. Paragraph. method of dctenniuing 225S, 2329-2333 secondary 2'253, 2259, 2329-2333 sjTnptom not used as 22-;S "undetermined " use of as diagnosis 2332, 23o4 Died, abbreviation for 22S4 Diet: kitchen — regulations for --•.--.-.-.- 1581 supervision of Uia, 1450 Ust, special 1233,134^,3913,3961 sheet 3971 special '^'*» ^^o, 13*4 from ward-room mess 3422 tables, variations in 1232 Diphtheria, quarantine for 2733 Disability-les: degree of, to be stated 3. 01 discharge for •■ 1236,2^15 due to own misconduct 2254, 2818, 2s20 entered in health record 2208 in line of duty, preference because of 2132 ; retirement for 2^2 , not in line of duty, procedure 2255 of medical officer, next in command succeeds 830 origin of, decisions regiirding 2S21-2837 physical — in line of duty, retirement for 1912 procedure upon fmding .-.-.--.-.-.--.-.-.- 1~3 rank when retired for .k ..:..-■. ^ lf>5 recording of . ^ 2176 report of — in absence of medical officer 2215 termination of --'■■' 21 • 5 sliglit, entered in health record 2250 specific, pension rate for » 3734, 3735 total , rate of pension for ^, . . .ni^^^'^i^: jiB.-ftnj -sb o730 Disabled: men- half rating of 3706 pensions for 3711 officers and men, pensions for widows of 3712 traasfer of, instructions regarding -^ 3O*n-3011 Discharge-s: abbreviation for rr r 22S4 and transfer slip 3984 Ix-forc termination of enlistment 2031 by mediciil survey, truusportation after ■ 2!)07 condition noted in health record 2260, 22S3 convale.sccnts, when fit for duly , 1230 disability 1236 (lisposii ion of healt li records ;.:;;;. 22fi5, 22S1 enlist cd men of Hospital Corps -"J ^80, 431 entered in abstract of health record - • IV.'P.i'. '■ 22<>1 for disability by survey only 2'.>15 honorable, preference 1)ecause of ■ • - • *132, 2150 Hospital Corps men, report of ».J.j...J.. 4S7 (foreign), certificate of - , . . >;ri . ; 905 proper! y to be returned i • ^ . Mjrf*-.-*. • - • 1466 ships, regulations for 1'27 INDEX. Discharge-s— Continued. insane medical survey misconduct report, Marine Corps ■.'■'.'..".'.'.. Nurse Corps • • ,• officer from hospital, to be reported patients- entered in hospital journal regulations relating to ration notice, Form T Discipline : aboard hospital ships breaches of dental officers during absence of -ward nurse l-.ospital, responsibility for. pisease-s: among personnel, report of •••■ classification of concealed, to be reported contagious- ability to cope with camp for candidate rejected for care of clothing to be disinfected detail of pat ients with in family, employees leave lor in West Indian ports, report of medical officer notified of medical officer to report patients not to be in landing force patients not to be transferred precautions regarding •■ prevention of report of report of , by commander in chief treatment of destruction of clothing to prevent. entered in hospital journal epidemic, report of former, entered in health record infectious — care of medical officer to report patients not to be in landing force patients not to be transferred precautions regarding prevention of report by commander in chief treatment of nomenclature of origin of— decisions regarding to be stated precautions against - 325 Paragraph. 3165,3166 " 1236 1242, 1365,3915, 3922, 3972, 4131 691-699,716 "■■"""'. 1221,4131 _.___.. 1362 ' 'la'y} _i}il I3a5 , 1524, 1525 '""... 3922,3949,4131 1467 ..'..... 2115,2947 426 "'. 871 1022 '" 1461 ■■■■""''_. 1281,1285 2564 2358,2359 " 817 891 2615,2621 ""'.'. 1981 812,2782 1316 ' 1313 """_ 2130 2567 ■ '"_'. 2592 2561,2632 1844 2116 916, 2807, 2608, 2614-2617 812 828,4002 ■ 2513 [_.. 812 2536,2956 1362 ■■ 828,1147 2241 =i*'S^:'.V;/i'i'>- 812,2782 ... 2561,2632 18-14 ""'"' ... 2116 '916,^807,2608,2614-2617 812 2513 """..... 812 //__,• 2321-2361 2821-2837 825 815 326 INDEX. Disease-s— Continued. I'araiTJph, iiuaranliuablo — arrival in port with - - - - - 2714 care of patients with ,^i.^,j,,,«j^..--,^.,^-;.. 27l."i llag while at sea --vtr 2716 list of „.....^^;p„,^.... 2731,2733 report of 27;{.'; , ^rejection lor..... IS*"! vmereal. (Sc« Venereal diseases.) Sisiufection: ^ and (iisijifectants ^^::^^/■:r:^••/:r^T•:■■:^::]^^f 2751-2772 done when necessary ^... .......;..- i 2816 of clothing o f patients 1316 plants, list of, United States Public Health Service _- 27R2 Disinterring remains, expenses of ..........._. 3437,34);; Disorder, oxecut i vo surgeon to suppress • - ■ 1309 Dispensary: .,• fiu-nitiure, appropriation for 139S lu>spital, regulations for 1551 Dispensing, instruction in : 137i> Disqualifications, physical examination 2080, 2081 Distant service, transportation of sick and woimded 18o(» Distilled spirits, in medical store.s • 801,827 Divine services a1 hospitals ......._........,... 132S Division: ^ ._ oommauder — ^ io\ f material surveys ordered by 2969 medical svu-veys ordered by -,•; 2912 reports from fleet siu'geon to I'T;! otlicer— first-aid instruction ._...._...._ 1M3, 1821 inspect clothing of crew ._..._. 2543 stafli, dut ies of V. ... ..„\ 1 172 surgeon— duties of 1171-1173 r epor t for - • * 1 ' 1 reports to division commander - • 1173 >urgeon's— atdrilb ..,.,..........^.,.. 9S1-987 at quarters .-.•••.■ •.•.•.•.-••- -.•-.•• •.••.•.•.••.• • • •.••.•• • ^^ dental officer part of ....^, ,...,„,. y., 311 Hospital Corps part of '- ...,,,,,..,<, 423 personnel of :'■<"''■ ^^^ Dizziness, aviator rejected for 2113 Dressing-s: pre})aration of 133" protective, applied in engageiuert l*'**^ shell- wound — contents of 1(X)2, lon:{ instruction in use of •.• — - ^^^^ station - battle 1821,1827 brigade, local Ion of l*i^ desfgnnlionof 1*^ field 1!*62 temporary 1'^ siirgfoni, appropriation for.. . ' 1308 INDEX. 327 ^'^-^^ Paragraph. modification of 2520 posts of oflicers in jgg^ book, Hospital Corps .__ 14 433 surgeon's division, duties in. ^. .^ .....^^. 981-987 Drink, inbumboats, impecfionof ■.-.•.•.•.-...-.-.-,-.-.-.->- ,'.9Uii«uty-les(SfcLineofduty and Not line of duty): .,,,■,,- at sea, special qualifications for 1910 aviation, physical e.xamination for ..., , 2113 military, of Hospital Corps 422 Nurse Corps, where eligible for g2o persons unfit for, transfer of 822 reporting for, entered in journal 13g2 special, officers detailed for 1352 Duty of: battalion surgeons I844 brigade surgeon 1842 chaplains in battle I8O5 chief engineer, hospital ship 1718 1740 chief nurses in hospitals , 1441-1470 chief pharmacists 443-445 deck officer, hospital ship 1739 . Dental Corps , 33g ., , dental officer 1021-1038 division staff 1172 division surgeon. , . U71-1173 executive surgeon, hospital 1301-1334 faculty of Nuv ,\l Medical School ; ., .iii.i.'«-i..'.s.;.ii 3212 3213 •r -first officer of hospital ship • jj.rit,; ij■•• in hospital ■ 1441-1470 superintendent of corps 615, 631-<>33 ward — 145&-1470 officer of the day - .-•-•..•.-... 1361-1369 officers having special duties - . i''-' — : 1341-1358 pharmacist - 443-445,1371-1425 pharmacist's mate of the day 1431-1435 regimental surgeon 1843 surgeon's division during drills 981-987 ward officers 1341-1353 sanitary, of— commander in chief 2511-2525 commanding officer 2531-2546 fleet surgeon 2551 Medical Department • • • 2501 medical officer of hospital - - 2581-2584 medical officer of hospital ship 2581-2586 medical officer of ship 2561-2578 special- death while on 2435 health record of officer on 2302 physical examination for 2111-2116 Dysentery : precautions against - 2603 Ear diseases, rejection for 1961, 1981, 2079, 2081 Eatables, not to be taken into wards ..-.:. I'.... 1 1515 Eating utensils, disinfection of ■....-.-.'J^ 2772 Edacation: of dental officers 1021 standard of, for enlistment 20<3 Effects of: — deceased- collected and inventoried 2414 discretion as to disposal of 2417 sold at auction 2415 disabled persons, care of 2991 Efficiency report- s: Hospital Corps 491, 12S8, 3903, 4121, 4131 Nurse Cori>s 701, 706 special 6T2 Electrical: ujiparatus, rec|ulsltlons for 3421 connections for dressing stations 1S24 EUflblc U«t of laborers 2143 INDEX, 329 Paragraph. 896,2525 Embarkation of troops 2444 Embalming 4249-4254 Emblems for sanitary service Emergency-ies: I46g night nurse informs officer of the day of ^^^ preparation of Medical Department for ■.■.'.;". ■.■.'3326,' 3393, 3394 requisitions, open purchase ^324, 3543 ships at navy yards ' mo services in ggO supplies in Employees. (S«€ Civil employees.) 921,931 compensation for injuries "^ j3g2 entries in journal concerning .''.'!. 1305 executive singeon to supervise 970 financial dealings with patients - injured— 1240 ambulance service for _ g^y at navy yards 13qi report return to officer of day ^276 subsistence in naval hospitals ^241 treatment in naval hospitals Employment: 623 special nurses ' 131 In two branches of service jg45 Enemy, savage, ambulance party armed agamst ^^^ Engagement, reinforcement of stretchermen Engineer. (See Chief engineer.) Engine room: Ig2i first-aid appliances for jg45 force, stretchermen not detailed from Enlisted men: ^ 3706,3707 aid from Navy pension fund 1" -""""'-"'.' 3438,3443 burial expenses of 3602,3606,3625 deductions for naval hospital fund ■ gjg examined before transfer 33.5 expenses lor medical attendance ; "' 3-Qg half rating of when disabled Hospital Corps— 430 discharge of 432 pay of 2903 medical survey on militia— _ 1268 checkage for hospital fund j268 in naval hospital ^^^3^ jggg_ 2006, 2088 physical examination of _ _ 33gg on recruiting duty, medical attendance for .'...".....' 1213 pay in naval hospital 2983 physical examination before transfer retired— 2437 death report of 2246 health records for ' ' 1534 Marine Corps, in hospital Enllstment-s: 3922,3951,4121,4131 abstract of, Form X 2065,2066 adaptability of appUcant for 2027 age of applicant 2063 alcoholics, forbidden 2081 certificate of examining surgeon 380 INDEX. Enlistment-s— Continued. Paragraph. circulars relating to —r- 2041,2042 cont inuous-serv'ice man physically disqualified .' , 201ti criminals, detection of ^ ^ .^. .^.^ f , „ . . .- 2063 defects waived by department .' — ;,-••• 2020,2052 description .,- ■ ■■■:• 2101-210:. descriptive list, entries on 2077 deserters prohibited 2001 disability— , , . . .„ entered on enlistment papers ._. ........'._......_..,.,,.. . 2020 entered on Form X (rough) „.;..r... 207« discharge before termination of 2057 drug habitues forbidden 20(W educational standard for 20f.2 entered — on Form X (rough) 2021, 2051 on health record 2225 expiring in hospitals SOO^ extended— health records r- -Nr ,*- 229^ make physical examination 20«r. Unger prints- instructions concerning 2091-209C, 2097 to be taken ,..,....^ 2012-2097 former illness entered on Form X (rough) > 207S for special service, not allowed 205i> fraudulent, of minor 2056 health record, entries in - 2028, 2077 history of applicants investigated 200a hospital apprentice 472 hospital apprentice, first class 462 Hospital Corps 427, 181-485 report of 487 hospital treatment of applicants for 2064 injuries entered on Form X (rough) .,,...... 207S insane- detection of -.„..t... .k, ,-,, .*-, 206:i prohibited K..,,.,i.....(.y.-. 2001,2014,3112 inspection and inquiry by medical officer 202;'" intelligence and mental defects — 2026 intoxicated, proliibited 2001, 2014, 20.'. papers, dlsabilil y entered on 2020 physical disability, to be recorded .t^ ,^. ,,.„, 201S physical dl.squaliflcations for 1961, 3001, a07» physical cxamlnatii)n for 2011,2088 pliyslral examination required 2011,2018,205s reading and writing required .,..., 206.T record, medical oifirer to luako entries ,,...,,,,, 2050 recruits v;iCClnatod liefore traasler 20'<2 INDEX. 331 Enllstment-s— Continued. ^ _^ ^^Z>^l^-l^nno service record, entries i '^ ■ soundness at time of — ,"""'" '.„ .. 2017,2028,2077,2081 service record, entnes in ■••.■.-.-.■••••■•■ •-■••• ' ' • "i 373fi may be rebutted •. •.-.•.■.-.-.-.-.■.•.-.-.-. -.-••.'^ to be presumed - --•.--v.yfT.»>^^-- special ratings, piiysique for. . . ! — ._i-f,^,^ii.- • statements made under oath -,-.-.- .":.: '2002:2003, 2055 termor • ^^^ must be ser\'ed • •-.-.-•.•.-- ••--;• time and place entered in health record -■■-.. -...- •.•.-.-.-.--.■.-.-.>.. typ'.ioid prophylactic administered :rflt.'!f>iba«> ■-''' ^ ' vaccination to be done immediately . 2064 *' waiver, requested for .,,i,tTi'-i'i»' 'n Enrollments, Naval Reserve Force Epidemic-s: appropriation for preventing___ ..812,828,1147 diseases, report of ■ ' ' entered in journal 2703 1147 2318 * 2567 in West Indian ports, report of -.-.•.■.■.■.•.-.■.•.■-•---■■•-■-■••••-■•••■■•■■•■""■" -•-■-■■•■•-■-■-■-'' " ; " ,,„, ^ , ,.i^.'a.v/--('.-.. 4121,4131 report of. "■"■■■•■•■■■•■■■•■■■•■•■•■•■•■•■:.:;;.: .-....;... 1901, 1981, 2079, 2148 Epilepsy, rejection for ............,..-..-,,.-,.,..- , 2072 2079 Epispadias, rejection for — .-.-.• - -.•. — - , , .l. ^». .^ , ■ Equilibrium, examination of aviators for ■ • • Equipment bulai aftei landing force ambulance party— after capture, retained .,., j„ii.,^>; jR^w,-xi«4w;-i«wi--. *^ ..v.,^i,j.i.l,ii.v.iv-.'i-C. -- «o4d 1824 battle dressing station ...■.■,.■..._._.,..--.- --•.-.--■ .••.-- - ..-...-HHiy-vUssi^-rfq-Vi-i^'*' ■ horse, for mounted ofTicer military hospital subject to laws of war.............. ,.,,.^.si4w- 420o Erection of naval hospitals : • --•>^i'>''rs .- _; Errors in health records ■..,.^v-'.-'';-.s-^> .■■■••-■ ' Escort, armed, for ambulance party — - - - - ,..,,... Establishment of Nurse Corps Estimates: _ accompanied by statements appropriations for public works -. • • ■ 1 • ■ ■ • ^ ^- classification in book of -.-.-•.-".••-. '■•-- ' expenditures to be specified in • •.-.-.-v- ■ expenses ingto ■■": ■" "" " Hof>r«t!ii-v nf Treasnrv ■ " 22 131 41-45 , .. , 21-31 laws relatmg to ■••••. '" " ,- made by Secretary of Treasury - - ■ ■ ■ maimer of communicating — -: of funds from hospitals - •-..-.■•.^- preparation of -. ■ ■ • •. ...--!--- o^ 26 submitted to Congress --.-.--. -.-.st!^.- > Evacuation-s: '■'" ^^48 convoys of ::: ....,.,,,..,-:■■■•■: ^^^ distmctive flag for -,.--^v.--"k:!T ^~^_ neutrality of ••-■■• — • : — •■•■■•- -.-...,-(--- ^ of wounded , landing force ■ , Examlnatlon-s: actmg assistant dental surgeon for promotion admission to Medical Corps ■. ^^3 appointment subject to ^ assistant surgeon ' -^■' ' «• HtH>- • bacteriological, by Naval Medical School '■ ^^^ biennial, of pensioners ^3 chemical, by Niuul Medical School 332 INDEX. Examlnatlon-s— Continued. Paragraph. (lelayetl, rank in case of 161 enlistment Hospital Corps 486, 521 entrance to Dental Corp? 313-318, 321, 333-335 entrance to Dental Reserve Corps 354-356 fireman, entered in health record 2233 for Medical Reserve Corps 241, 243, 254, 255 health records at hospitals 2228 Hospital Corps, enlistment ■ 486, 521 laboratory, reiwrt of 1152 microscopic, of urine of candidates 1955, 1993 Naval Medical School 3214 no allowance for expanses of candidates 258.318,357,485 on foreign stations 1^8, 1939 passed assistant surgeon 162 pathological, hy Naval Medical School 3221 post-mortem, performance of 2443 professional. (iS^e Professional examination.) , , .. promotion - 1**4 Hospital Corps -•'- 486 to chief pharmacist's mate 511-514 to hospital apprentice, first class 521 to pharmacist 502-504 records of • ^^14 reports- hospital apprentice, first class 463 Hospital Corps 4121, 4131 terminates if physically unfit 1^*25 water- entered in journal 2315 from shore 25ti9 Examination-s, medical : iioard of .:::::::.. 893 of employees - • - • - 2165 Examination, mental, preceded by physical examination :;,.".Vi;;-j- ■;■■■• ^^^' ^^ ^^* Examination, physical: ability to perform duty at sea 1959 acting assistant surgeon 1929 all patients entering hospital 1367 applicant— for employment at navy yard 2121-2123, 2141-21.54 pension 37.->S appointment as officer 1951 appointment subject to 1924 assistant civil engineer - 1931 assistant paymaster • • • • 1927 assistant surgeon • 1928 liefore transfer 823, 2116 before transfer, entered in health record :'.'...:. ,. .^ 2202 board of, health record entries • -.r : " " " ^ ' ' ^^'' ^"' Burwau Medicine and Surgery, to provide for • "■ - • r- 1^1 candidates ........ ,..•,..*... 1901-1997 for Naval Academy iJl-'.-'L-'h.. i»7l-19^M«'l-l*», »991-1997 notified of result of '.. 1984 chaplain ■- 1*'0 chest measurements, table of 1902, 2fiS2,2iiS4 compensation act : 2121-2132,2161-2170 conditions causing rejection 1961, 2061, 2079,2154 crew, going into commission ^^2 INDEX. 366 Examination, physical— Continued Paragraph. Dental Corps 1923 Dental Reserve Corps i.^- -- ^-^-> I960 discharge 2265 employees, at naval hospitals 2128 employees, every six months 2125, 2171 employees, importance of 2127 Employees, injured 2172 enlistment 2011, 2088 apprentice seamen 2082 apprentice musicians 2084 birthmarks, rejection for 2068 Bureau Medicine and Surgery, to provide for 1921 care exercised in 2061 circular relating to 2042 chest measurements of adults 2082 chest measurements of Filipinos 2082 chest measurements of minors 2083, 2085 chest measurements, variations from 2081 color perception , 2075 completed in every case , 1 954 conducted by medical ofBcer 2022, 2059 defects curable by operation 2081 defects waived by department 2029, 2052, 2064 disabilities entered on Form X (rough) 2078 disabilities entered in health record 2208 entered on Form X (rough) 2021, 2051 face, deformity of 2068 feet examined carefully 2069 females 2108 fingers examined carefully 2069 fireman, stature of 2065, 2082 Fl ying Corps 2107 former illness entered on Form X (rough) 207S hands examined carefully 2069 health record, disabilities entered in 2208 health record, entries in 2077 health record, procedure with 1938 hearing 2076 height o f adults 2082 height of Filipinos 2082 height of m inors 2084 height, variations from standard 2083, 2085 hemorrhoids, rejection for 2071 . 2079 hospital apprentice , 522 Hospital Corps 486, 521 hydrocele, rejection for 2071,2079 injuries entered on Form X (rough) 2078 inquiry by medical officer 2025 inspection by medical officer 2025 instructions to be followed 1952 intelligence determined 2028 marines required to have 2018 medical officer responsible for recruit surveyed 2024 to conduct 2022,2059 mental defects, detection of 2026 militia 1913, 1966, 2006, 2088 naval auxiliary service v.^isi: 2089 Naval Reserve Force jHOUU-i-'i 2107 334 INDEX. Kraminatlon, physical— Continued. Paragraph. «'- enlistment in — f not determined on finding defect .-.-...-. .-.*.-.-.-.v.-.v.v.v..v.v.....-.v.'M 2023, 2060 ■: nurses 072, 1934 ' physical disability recorded 2013 physical disqualifications, list of 2079, 2080 physiognomy of applicant ,^068 plan of 2061 procedure when rejected 1942 reexamination on receiving ship 203() required ...-...•..-.-.•..•.....•/ 2011,2018,2058 service record, entries in ...•.■.■.■.■..•.•.•.•.•.•.•. V.'l 2077 special ratings, physique for .V. :.:':i^n'.Vil j/.T.'. 2067 1 standard to be high ...-...■.•.. .-.•.•.-.•.■... 1953 .supplementary for nuises 672 teeth required 2073 testicle absent, rejection for ... .• 2072 to be completed 2023, 2060 ' • urinary analysis required 19.55 r varicocele, rejection for 2071 I '' varicose veins, rejection for 2071 i vision examination 2074 J waivers, request for 2029, 2052, 2064 I ' warts, rejection for 2068 »■ weight of adults : 2082 weight of Filipinos 2082 weight of minors 2084 weight, variations from standard 2083,2085 entered in health record 2286 failure to pass 165 for aviation duty ; ;...;....-..; 2113 for gun pointer .- ;.......■ 2111 for fireman, third-class 2112 . Flying Corps ; 2107 I for special duties 2111-2116 f- general court-martial prisoner ; 2114 _ 1 health records, procedure with 2214 i hearing required 1959 i •. height, table of 1962 '■ injured emjjloyees 2172 ■■. machinist .■ 1932 (- medical officer governed by instructions 1991 ,- Medical Reserve Corps 1922 1960 < men, before transfer • 29.83 :. militia 1913,1966,2006,2088 naval auxiliary service 2089 <■ Naval Reserve Force ......•..-.-.■. . . 131 ^ Tiavy-yard service .-.'.".'iVI".. 2121,2176 . nurses 672,1934 "ilicers 90s oilicers, for promotion 1909-1912 paymaster's clerks. Marine Corps 1935 precedes mental and professional 172, 1925, 1940, 1951 l)rcliminary,for Naval Academy .;:..... 4. 1. 1984-1986 promotion in Murine Corps .;.... 1937 promotion in Navy. I 193ft , lecruits 'ra,941-952 ! statement by candidate under oath 1958 hupplementary for nurses ..-.".. T.I .'..'.'.. 673 IISTDEX. 335 ■paragraph , 2115 Examination, physical— Continvied. transfer to disciplinary ship ■ '• - - - • i ■ -----»^ • •' vision— . . 1959 required - ■ ■• ^ggg standard for admission jgg2 weight, table of Examination, professional : ^^ failure to pass -. ...-- ...--.-. -•••■• ■■■.■-■"■.■ V';;;'j9^'i940 1951 preceded by physical examination '[cio',"!'!" "'•':" promotion of — fv.rtf' 191-193 assistant surgeons ".■"'■■■ 201 202 passed assistant surgeons ' ^^^ surgeons 9Q5j Examiners, civiUan, Form X (rough), prepared by Examining board-s: ^22 174 composition of 121 171 convening of jgg3 decision to be final ■" " ' ' ^^ meeting places of ■ • ■ ■ ' ^9^ merit roll forwarded to bureau ' ' ' ■' ^^^ organization of ^^3 j^y- procedure of 2733 Exanthemata, quarantine for Executive oflB.cer: 2548 iuformation as to physical capacity of crew ^^^ report by, after battle Executive surgeon: ^3^2 absentees reported by ■ ' ' ' '■ jg^^ authority of, in hospital --.--- - ■;";X'' 14^5 breakage reported to - • • ^30^ care of patients by ^443 chief nurse to confer with .'--ConsuUation- i:;07, 1342, 1350 J ' ■ by junior medical officer ^^^o detail of convalescents for work ^3^ diet lists submitted to J342 directions of, to be obeyed - j3Qg disorder suppressed by 1:501-1334 duties of " 1333 as officer of the day ...-...--.. - - r - -, ^^^^ junior medical officers assigned by ^^ employees su pervised by • ^g^g ' inspects hospital daily • ' ' ' ' jg^^ junior medical officer to mspect wards with ..--'- liberty- . 1311 book kept by 1344 lists submitted to I-^JH passes Issued by 13Uj permission to leave granted by :.' — ".• report-s- ' 1284 of condition of patient •-' ".■■""'."." 1467 of sick sent to .■:.'-■.. ...... .^--- - - ■ ^^^^ requisitions supervised by ■" • ■ - • ; ' ^^^^ returns supervised by 13jj2 uniform prescribed by jJtii-4297 Exemption of hospital ship, from dues and taxes. .....;.. ■■••-•-• 2217 2234 Exercise, periodical physical, health records ■■""/.■.".■■ ' Expeditionary service: 2264 nealth records -— ---- ^'"•'- ^"^yisil-lSbO landing force for 336 INDEX. Expeditionary force: Paragraph. health records on loose leaves ^852 marines — baggage allowance 1**^ service with - ^847 supplies for 3551 Expendltnre-s : analysis of, in bill book 1397 entered in bill book -.-err 138(,1388 from naval hospital fund, objects of 3671 items of, to be specified 31 medicalstores "^^ property— accountability for : mt^t -,irr ^^ hospitals ■ 1371 public 3521-3525 vouchor, for commissary ledger 3966 Expenses: bringing home remains. , 3400, 3439-3443, 3455 candidates, no allowance for 128, 25S, 318, 357, 485 care of insane 3154 estimates for 21 funeral 2105,3157 laws relating to 3441-3443, 3451-341.0 olTicer 2402 public bill for 2404 report of 2407,4131 interment 2403, 3453 medical ittondance 3351-3357, 33G1-3305 patient in civil hospital 824 quarantine ^3. 2741, 2744 transportation of insane 3156 remains 240^- sick to hospital 2944 traveling, Nurse Corps 'J24, 721 Eiploslon, traumatism by 2335 Exposure of crew, to be avoided 2543, 2009, 2C21 Expressage charged against "Freight, .S. A A." 3400 Extension of enlistment: examinat ion required 2086 health records - 2294 Eye-s: color entered in health record 2241 scaleof 2103 diseases, rejection for 1901, 20?i> injury to * 21t>9 prevention of 2120 sight, examination of gun pointers 974, 2034, 2111 standard for admission 19f'3 witnesses of accidents, report by 2816, 3756 Fabrics, disinfection of ; :- - 2768 Face, deformity of, ri-joction for -- • 20t>S. 2079 Faculty, Naval Medical School, dut ies of - —v. . , 3212, 3213 Fall, traumatism by 2335 Families : oHicor's, medical attention to '''3, 9U services of nurses for ''"1 Fatigue, excessive, to be avoided 2ti2l INDEX. 337 Feces: Paragi-aph. disinfection of 2753 method of preserving 3225 Feet: conditions of, interfering with marching 1844 diseased, candidate rejected for 19^1 examined carefully - 20tj9 fixst-aid care of vcounds of 1011 flat^ candidate rejected for WSl, 2069 degree of, stated on rejection report 2085 entered on health record 2241 examination for 1984, 2061 Felony, evidence of, cause for rejection 2079 Female laborers, rating of 2146 Field: dressing stations 1*^2 hospital, location of 1^67 Medical Department, organization in 1861-1869 officers, baggage allowance for 1847 supply table ^^^ Figure card, preparation of - 2101-2105 Filing requisitions and vouchers 1386 Filipinos, height, weight, and chest measurements table 2082 Filling material, classification of 2271 Financial dealings with patients prohibited 434,970,1260 Fines: appropriation of, for naval hospital fund 1203, 3603, 3654, 3658 transportation of discharged prisoners paid from 3611 Finger-s: deformed, rejection for 2070 prints, apparatus supplied by Bureau of Navigation 2096 for officers 2097 instructions concerning 2091-2097 taken on enlistment 2012 Fire-s: and rescue party 984 apparatus, care of 1321 bill, to be posted 1321 control stations, first-aid appliances for 1821 drUl— at hospitals 1289,1345,1369 on shipboard ^83 for comfort of crew - 2538 Firearms, traumatism by 2335 Fireman: examination for, entered in health record 2233 minors not recommended for 2065 physical requisites for - - - • 2065,2071 Fixeproofing clothing for battle 1825 Firerooms, first-aid appliances for 1821 First-aid: ambulance j)arties prepared for 1854 appliances, distribution of 1810, 1821 instruction 455,818,849,909,1001-1012,1804,1810,1813,1814,1821 service during battle 1822 First officer of hospital ship, duties of 1717, 1738 Fiscal year, hospitals 1397 Fistula, candidate rejected for 1961, 1981,2079 98601°— 17 ^22 338 INDEX. Fitness: Paragraph. for promotion, onus of establishment l*^" reports of 179,3981,4131 Fitting out, duties of medical officer •• 8*1 Flag: distinctive, for hospitals, ambulances and evacuations 4208 hospital, Iwats to carry 1^^ Hospital Corps detachment to have - 1846 national, displayed with Rod Cross flag 1846,4208 quarantine, hoisted while at sea 2716 Red Cross- brigade haspital designated by, daytime, at night lantem 1868 description of 4222, 4249 displayed by sanitary formations 1845 displayed with national flag 1846 dressing stations designated by 1865 hospital boat to carry 987 regulations for use 4252-4254 Fleas, destniction of r 2781 Fleet, organization of ?oi *>jj?fcVA 1841 Fleet staff (See Commander in chief): — regulations 2579 Fleet surgeon: appointment of n^l as brigade surgeon H^l bills of health obtained by !;'.''i- 2743 bulletin to be issued by 1163 consultation with medical oflicer - ;.•..•.,.-..... ,s.i.i. .u 1134 correspondence ^ * 1131 dutiesof 803,1101-1173 embarked on flagship ,.,,.,,,,,,,,, ^.-> ..> i. ., i 11 12 flag officer on special duty ■^^» ;.y, v<{ -H;. ,:j. :i.'. ..; 1121, 1122 Form K forwarded through -••• 2372 health records inspected by 2219 inspection— of medical department 11"'2, 1162 of naval hospital - --••-• ..,,,,.,..,, ,t?. 1136, 1252 sanitary ' H^S inspects ship when ordered 1113 laws relating to «.ij,;i,^<^v,i.;,.> 1101,1102 me 1 138 of death forwarded through - ,>-~'.tio- 2432 of killed and woimded 1137, 1808 returnable through • • • r 1141-1 1 54 sanitary 1138, 2633 submitted to commander in chief .-, » 11*0 requisitions • • • • 1131 returns approved by ■ « • ' — •• • • • • • 1138 sanitary duties of 2561 Fiiggesliona to commander in chief ....,,,,,, .^..Vij.b^woA- 'r < < i..-.- 1135 transfers of patients reported to ,f^,,,,ffj^*«-uoi i 2986 Flies, protection from — 2616,2621 Fluorld of sodium, use as insect icide 2781 Food-8 {See Provisions): cooking of 2544 In biimboals, inspection of ^ • -^ 663,2571 Inspect ion of 820, 860, 853, 2565, '2571 INDEX. 339 Food-s— Continued. Paragraph. precautions when in camp 2621 precautions when night soil is used 2604 preparation of. Sol wholesomeness of 2.544 Foot. (S^eFeet.) Force: auxiliary naval, pensions for 3727 expeditionary, marine, service with 1847 landing — for expeditionary service 1841-1869 Foreign: countries, funeral expenses in 3452 liospitals, certificate concerning , , .„.,,;j, vuiMj^-i-jiv oi/i' : ^05 naval medical establishments, report on .....'................... 2654 ports, report to Office of Naval Intelligence 2566,26.55, 2661 sanitary data from 829,2656 service, pay of nurses on 723 stations, examinations on , 178, 1939 public bills ^[.l....^. 3402 Foreman, hospital, report to executive surgeon 1.542 Forfeitures: desertion, disposition of 1204 • to naval hospital fund 3609,3657,3658 transportation of discharged prisoners *. 3611,3658 Formaldehyd, disinfection by 2752,2765,2768-2770 Formalin: ; disinfection by 2753,276,5 preservation of specimens in 3225 Form-s, Bureau of Medicine and Surgery: blank — list of .......J.-.;— vJ^--;-t:-vv 3922 instructions regarding ?.! 3901-4«02 object of ui;ing 3921 request for 3922,3945,4121,4131 , B, requisition and priced invoice 3375, 3396, 3922, 3931, 4121, 4131 J Ba, special requisition fj,^p.y^^.,-j.j.r.,^jj^tp_..j,^.,..^.y>... .^. 3353,3922,3932 C, survey of material ........"/..' .'..' .' 1...^,. . 2961-2978, 3922, .3934, 4131 ; - Ol, survey of material 2961-2978, 3922* ;. Ca, survey of material 2961-2978, 3922, 3934, 4121, 4131 Ca-1, survey of material 2961-2978, 3922 D, inventory of property 3522, 3922,3935,4121,4131 Da, inventory of property 3922,3935,4121,4131 F, quarterly abstract of patients 3922,3936,4121,4131 key letters required on 3325, 2327, 2337 ; F (rough), cards 3922,3936,4121,4131 , entries by officer of day .'. . -y{- ijr ■ • • ^^'^ expeditionary forces 'y^J^^. ^. 1852 preparation of ,.:,^„^:....:,^^^^^^:^^^y^:^^;,,.„^^, 2367 a, hospital ticket 1 .3922, 3937, 4121, 4131 H, health record 3|922, 3938, 4121, 4131 dental record for insertion in .- 3922, 4131 syphilitic abstract for insertion in 2307 1, weekly report of sick 3922,3939,4131 K, statistical report of sick 3922, 3940, 41^, 4131 preparation of . ....i..... 2371-2391 record of dental treatment ............-.-..■.-.-.- ^.v. 2270 vaccination entered on 2086 Ki, report of killed and woimded in action 810,3922,3941, 4111,4112 '.il't. .... .■ ij'. LiiJi/,.!'- .... J 340 INDEX. Fonn-s, Bureau of Medicine and Surgery— Continued. Paragraph. L, request for iiieJical siu-vey 2921-2925,3922,3942, 4121,4131 M, report of medical survey 2931-2937,3922,394.3,4121,4131 N , report of dcatli 825, 3922, 3944,4121 , 4131 preparation of 2401-2443 0, request for blank forms 3922, 3945, 4121, 4131 P, report of operations 3'.^22, 3940, 4121, 4131 Q. clinical chart 3922, 3947, 4121, 4131 S, ration notice (admission) 3922,3948,4131 T, ration notice (discharge) 3922, 3949, 4131 V, return of medical stores 3922,3950,4131 X, abstract of enlistments 3922, 3951, 4121, 4131 preparation of 2051 preparation of, at marine recruiting depots 2053 X (rough), cards 3922,3951 disabilities entered on 2078 illnesses entered on 2078 injuries entered on 2078 physical examination entered on '. 2021, 2051 Y, abolished — ....... . .• 1, requisition for supplies 339C, 3544, 3922, 4131 4, requisition for supplies 3375, 3396,3544, 3922, 4121, 4131 5, public bill 3922, 4131 6, public bUl 3922,4131 eflacicncy report. Hospital Corps 491 qualifications for promotion, Hospital Corps 3954 Form-s, Bureau of Navigation: 1 , service record 2095 2, finger-print record 2094 used in hospitals 3981-3985 Form-s, Bureau of Supplies and Accounts: 84, pay roll 3962, 3992, 4131 used in hospitals 3991-3999 Form-s, Civil Service Commission ...".. ...■.■.•.■....•.•. 1642, 2144 No. 1800 :'!://{'. I^^?::.::. 2152 Form, Department of Interior, for admission to hospital 3129,3130,4001 Form-s, Department of Labor: C. A-lb 2175 C. A-2b : 2175 C. A-3a 2175 C. A-4 21 72 Form-s, Marine Corps, No. 330 2095 Form-s: '^^' kept by ward nurse .... .'.'...■.■.■.".■.■.■.. 1467 notation on 3'J3i> special, used in hospitals 4001,4(X)2 •ward, kept by ward officers 1342 Fort Lyon, Colo., instead of Las Animas, court-martial prisoners not sent to 1207 Fractures: first-aid care of 1008 of vertel)ro, rejection for 2079 Fraudulent enlistment of minors '......... 2(Vj(i Freight, S. & A.," charges against 3400 Fruit: not to bo taken into ward ... .......^ ......^ 1515 precautions concerning 2621 Fuel allowance: Nurse Corjis 619, 751 temperature certiflcalo 920 INDEX. 341 Paragraph. Fumigation plants, United States Public Health Service list of 2782 Funds, estimate of, from hospitals 4131 Fund, Naval Hospital: appropriation — by Congress for 3607,3655,3661,3662 of fines for 1203 charges agamst 3383, 3399 checkagefor .• 731,1202,1208,3602,3606,3621,3624,3625,3651 credit for desertion forfeitures 3609, 3657 disbursements from 75 entry in bill book 1397 expenditures from 3671 fines appropriated for 3G03, 3054, 3658 forfeitures for desertion 1204 history of 3631-3645 militia not checked for 1268 origin and uses of 3631^3645 payments for subsistence of employees 3614, 3657 pensions paid to 1535,3605,3623,3653,3656 proceeds of sale of hospital property 3613 , , ration allowance to naval hospitals 3604,3622, 3652 sources of revenue to « 3661-3603 Fund, Navy pension: aid for disabled enlisted men 3706, 3707 charges against 3784 collections for depredations 3708 history 3702, 3780 information regarding 3701-3797 interest on 3704, 3780 investment of 3703, 3781 penalties, how sued for 3702 pensions payable from 3704, 3783 Secretary of the Navy, trustee of 3701 Funeral: .Ut)UfgoH - »»»> .on expenses 3157 laws relatmg to 3-131-3444,3451-3460,3461 of officer 2402,2405,3444 public bill for 2402 report of 2407, 4131 services at hospitals 1323 Furlough : sick, pension status when on 3729 veteran, pension status when on , 3729 without pay, disposition of health record on , 2296 Furniture : dispensary, appropriation for 1398 hospital — appropriation for 1398 changes in .,.,. 1283 nurses' quarters, supplied by bureau ....i..., ; . -752 operating room, requisition for :3421 quarters, appropriation for i,^.^-,i,. ..,4,<^.,. , 1398 Fuis, dismfection of .nji..u,.^i.,iHJv.* : 2769 Galley, medical department use after battle ; 1828 Games, playing of, in wards 1509 General court-martials: medical certificate on proceedings of 897 342 INDEX. General court-martiat-s— Coatinued. Paragraph. i>risoners — medical survey of ■. , 2947 not sent 10 Fort Lyon, Colo 1267 physical exaniinut ion of iJlll Oeueral qaarters : inslmct ion of personnel during; 1823 medical oflicers' duties duringi...; .;;......- 1823 station during .1. '..:!;..: ;::::::::.. 869 surgeon's division station during 869 Ce ueva convention : nations participating in : 4201 of iSftS, provisions of .:::.:::::::::::: : . . ..:',■-•--•■ 4211-4225 of 1906, provisions of :::::.-:::::::...*:?.:... ^ . ."1851,4231-1265 ' original, provisions of ;.;.;:;;:::;-.:: -.::ttt::::-. 4202-4209 ratification of .;:;..:-.;;.: ::::::::::?: 4225 :-:iispension because of abuse ...;::;: . . 4224 Genitalia, iieculiarities of, entered in health record.;;:::;;.;;.;.:::: 2241 Genlto-orlnary organs, rejection for disease of — :::;: ::;:;..'. 1981,1981,2079 Gifts in Did of marine hospitals ;;:;;-•;;;.. :.» i^u.vj, . i^. ^^^ accidents noted in " " " ' ' accompany patient on transter ^932 to hospital 2261 admission entered in abstract ^^^^ admissions from 2249 approval of entries — Army transport board for physical examination breakage to be avoided care in keeping change of diagnosis commanding officer to approve completed, sent to bureau compUcations, method of entering ^^^ condition on discharge noted in •■; ' date of transfer entered in "^~''""n" ""■''"-' 2267-2271 dental record ..'..:.; jcl. .. . . . ...... , . i.jaz0.3tiiiu4 .. 2291 deserters • ■ 2203, 2282 destruction of, procedure 2253 2262 2213,.2214, 2251, 2266 .u.;iUi0Wft. 2287 ...-.-..'-2231 „,^ 2284 ^ .iif.A.r.'js.'niS'Jp-T/i.u.- 1286, 1343 2223 , 2258 344 INDEX. Health records— Continued. ParaRrapb. directions resanliiig 2281-2294 disability entered on 2208, 2250 disposition on discharge 2265,2281 enlistment, entries made on 2225 entries 918,2028,2241, 2249, 2254, 2260,2283 indicating use of intoxicants 2218 on admission 2250 on transfer 2992 to be concise 2260 errors in 2307 examination before transfer entered in 2202 for fireman entered 2233 exammed at hospital : 1226, 2228 example of data required 2285 expeditionary force i. , 1S52, 2264 on loose leaves 1852 extension of enlistment 2294 FormH 3922,3938, 4 121, 4 131 forwarded on transfer 2266,2281 to bureau 2266, 22S1-2290 furlough without pay, entries ^ 2296 grades, abbreviations for 2241 injuries noted on 2209 insane patient 22S9 inspected by commanding oflBccr l •. : 2224 fleet surgeon .-, 2219 instructions for opening and preparing .......:... 224 1-2271 junior medical officer to keep KS2, 1313, 2206 key letters required 2325,2326 left with consul 824 line of duty entry on 2254,2256, 2259,228a loss of, procedure 2263, 2282 loose leaves for expeditionary force 2264 medical officer notified of transfer 2212 to keep 2222 medical survey entered in 2286 midshipmen 2306 modiflcat ions of 2249 name to be spelled correctly 2241 Naval Auxiliary Service 2245 nomenclature to be used 2257 no papers to be attached to 2286 notes of trivial affections 2285 not in line of duty entries 2207, 2255 Nurse Corps, custody of 717 nurses- kept by chief nurse 1445 opcmug of 2244 officer — custody of 2211 examination for appointment 2303 examlnat Ion for promotion 2303 examination for retirement 2303,2304 medicallustory 2305 on detached duty 2302 on termination of appointment 2304 on waiting orders 2302 INDEX. 345 Health records-Continued. Paragraph. opened- for all persons on appointment or promotion 2232 patients — admitted to hospitals 2229 in civil hospitals in foreign hospitals. • -. • received for passage 2221 to be accompanied by ■ - -.---.-.•.-.-■-- 1229 transferred, to have -.-.-.-.-.•.-.--.:• 2201 periodical physical exercise '-■ 2217,2234 persons surveyed physical examination- entered in procedm'e of prepared for each person 2242, 2243 procedure on — 824 2204,2205 ■foMMi, *£!■■•?- MO. 2286 1938 ISO promotion ••- ■ ^_ reenlistment - "^ '' promotion, procedure on 2262 rates, abbreviations for ■ ' ■ ■ ^241 retired officers and men 2246 senior medical officer — 094c responsible for .1^10 224Q to approve " sequelae, method of entering 2259 t^ sick leave, forwarded to bureau 2266 . . , 2230 sigmngof State hospitals, CaUfomia ^^°^ sfagglers •-••• 2247 2293 supernumeraries ' supervised by officer of the day "63 symptoms- _ _ notedm not used as diagnosis "^ syphiUtic abstract, inserted when necessary 230? teeth, entries concerning 2271 leeiu.c . . ^^^,_--, 2225,2261,2281,2284 transfers, entries made on ' '„„'„„„ ~^ , .„^ ;„ 2260,2283 treatment noted m ' tvphoid prophvlaxis entered on lyjo, , ££i, , uoo lamination entered on 2086,2226,2253 venereal disease entries ■ ^ 3230 2230 verification of ' vision examinations entered on ;,"""'" Anro ooJi waivers entered on • 00,= ,266 where no medical officer /-/i^/zoo Hearing: defective — entered on rejection report examination for ' ^ ^. . 1901.1981,2079,2148 rejectionfor ' ^^^ entered in health record ■ ; examination of, for aviation requirements on examination for promotion standard— g^ admission and promotion •■• ■ '"TtcJ^Sr^"""' :::::::::::::-i9si:i995,S2?;6 voice and watch test lor ' ' 2081 846 INDEX. Heart: " ' ' Paragraph, disease — examination for 1984 rejection for 1961, 1981, 2079, 2148 Heat, exposure to, to be avoided 2621 Height: disproportionate to weight. ..:.... .... . . .... . .-. . . . ...... ..-...•...'.■. 2083, 2085 employees, table of v 2152 entered on descriptive list ; 2103 health record 2241 rejection report 2081 midshipmen, requirements for 1982, 2084 tables of 1962,2082,2084 for women 2801 variations from standard of 1962, 1982, 20S3, 2085 Hemorrhage: control of lOOi, 1005-1007, 1821 Hemorrhoids: entered on rejection report : 2081 examination of Candida te for ^ 2061 rejection lor 1961,1981,1986,2071,2079,2148 statement concerning ..ivi.-.ii..;...:. 2081 Hernia: ■ ' ' entered on rejection repor( 2081 examination of candidate for 2061 rejection for ..^...-.^-- 1961,1981,2079,2148 History: • ...j)n;> .»).".. K. !«■ medical , applicants for enlistment ....;...;; J .i * .. j '. 2063 expeditionary forces .-. . . 1852, 2261 patients in civil hospitals i 824 naval hospital fund 3631-364,". navy pension fund 3762-3780 Holds: -■•- disinfection of 2761,2762,2764 inspection of 855 Holmgren's method of testing color perception ...-.:. J. . .t 207.'i Home, Naval: ..■..' ,■•■ admission to 1631-1632 allowance of Imnates 1633 govenuncnt of 1206 olficers disabled may go to 1221 patients report to governor of 1211 pensions of persons In 1535, 362ii, 8656, 3752, 3801-3806 survey to 1632 Homicide, injury by 2335 Hookworm, rejection for 1981 Horse-s: charged against contingent, Bureau of Medicine and Surgery 3400 equipment for niount('d oflicor. 1847 Hospital apprentice-s, second class: detail of, to assist dental surgeon 474 duUes of 438, 433 , 473 enlistment of 411-413,423,521 examination for enlistment as 4.U, 483.521 pay of .....ij..t..-..t 403-401' precedence of 401 , 406 rank of -j • ,.... 401,406 INDEX. 347 Paragraph. Hospital apprentice-s, first class : ^-^^ 523 acting appointment of ""■■'■■..'''■ 411-413, 423, -181 enlistment of ■ ' *.'.'.'.'.'.'.".'.'.'-'-- .' ... 463, 520, 524, 525 examination for promotion to - - .-'• .■".■■.'.■■. 403, 406 pay — •• ■ ■"■'". .'..."'".. 401,461 precedence of • • - " " " . 523 promotion of - - - 1591-1622 Hospital, Army and Wavy, Hot Springs. Art - Hospital, base: Ig62 aid to wounded at jg49 command of Ig49 hospital ship used as ; ; ^ggg location of " ' Ig42 organization of • 9g7 Hospital boat, equipment of - Hospital, brigade: ^^^2, 1868 aid to wounded at - ^ggg designation of Hospitals, civil: 824 care of patients in 2436 death in ■ g24 expenses of patients in ".■■■■■■■■".'.""."" .'.'.'.".'. ' - §24 health records of patient sin.... :....-. •--■-■•----■•■•■'""•■■".■■■■"■■.■■. '/VV')"^ g24 mcdicallnstory of patients in...... :.-..■-■-■•' -"--■•' -yi^ ' " g24 reports of patients in ' g24 transfer to Hospital Corps: 402 attached to Medical Department of Kavy ' g^. attention to sick by 39.-,3, 4121, 4131 changes in, report of chief pharmacist. (Stf '-Chief pharmacist.'") 411-413 circulars relating to ■ • .' ' ' ' \\ ^3- classiflcation of •■ '.".' _ j4g5 detailed by ward muse - ■ ■ ■ • • '''..'. 1038 with dental officer • .gp ^g^ discharge of enlisted men of " ' ' ^^ discipline on board hospital ships 14, 438 drill book, issue of ' " 421' 433 duties of bureau in connection wi fi : - .- ' ^ ' ^25 duties on hospital ships '"401 1153,' 1288, 3963, 4121, 4131 efficiency reports of '"I'yi ' 401 483 enlisted men of Navy and Marine Corps eligible for transfer to ".■.■.■.■.■.■.'. 42?' 481 enlistment in 490,4121,4131 examination reports .■ • • ". ' " ^ -^^q- executive surgeon to supervise 434 970 1260 financial dealings with patients prohibited ■:'K'^u ' ' ^^^^^ flag carried by each detachment - • - -.- ■■.■.■.ifyr-u.-' '.■'•' -i^- ■• ''' ^^^^ Handy Book for, method of obtaining ■■■^■^V^^^.l: -lO^ 435 1261 hospital and ambulance service by ,-,r-r,TfT-iTfJ!*" '' ' jyg- ^ospimsm,rn^rn,ea^.y .:.:. ■;;--;455;9io;i288:i3^i:i375:a4i7:i8i4:i82I,^^^ instruction of •■ ■».)>' > isM knives or shears carried by - - - ■ 401-407 laws relating to ^22 military duties performed by • ^ ^^ ^ movements, report of wj rrrtr riiiYu 'r;.' \'i':'i o'rjo.v" " ^^^ "nurse" not used as designation of ■■--■■•ri-MittiTi-''---- ^^ part of enlisted force of Navy - ^^^ surgeon's division -■: :;:;;Vi«,406,432 pay of 348 INDEX. Hospital Corps— Continued. Paragraph. pharioacists. (See Pharmacists.) pouch, chief pharmacist's mate to carry l»4ii, 1S04 precedence of ■*37 promotion in ^"^ quarters, patients not to enter 1517 report of changes in *^7> 12S8 efficiency 491,1288 examination 490,4121,4131 promotion 4S8 subsistence 3954,4131 transfer to •■--•; *^ responsibility for care of stores -.--.-•.--.•. ^^^ service records - - -. '*28, 489 subsistence reports 3964, 4131 term "nurse ' not applied to 492 transfer of enlisted men to ■ 401, 483 transfer of stores ^**^ uniforms to be inspected 1326 Hospital divisions, training of 4353 Hospital expenses 1426 Hospital, field: location of 1^^ organization of •.::"■.;;■. ^^^ Hospital (foreign) : certificate of admission or discharge - 905 patients left in ' • 2204, 2205 H ospital fund. {See Fund . ) Hospital, Government, for the Insane. (See St. Elizabeths.) Hospital, marine, gifts in aid of 3001 Hospital, medical attendance in absence of 3356 Hospitals for insane, State of California: admission to 3160, 3161, 3163 deaths in 2439,3157,3162 health records 2289 insane in 3151-316G laws relating to 3141 papers for admission to 3163 payments to 3158, 3159 report of condition of patients 3153 Hospital-s, military : duties continued after capture 421 1 equipment subject to laws of war 4205 flag to be distinctive 4208 neutrality of 4202 person-s employed in 4203-4205, 4240 Hospital- s, naval: absentees to be reported 1312 accounting s j-stem of 13!>o-1413 acting appointments expiring In 1263 admission of patients, regulations relating to 1365 allotments on tmnsfer to I'TV '^^** allowance of rations to 3('rfH ambulance service, for civil employees , , .., . . ^., 1240 sor\-ice performed by Hospital Corps '. 1261 apprentices not to play with patients 1473 Army personnel in 3011 attendants atone available for service .,.^. 12:U athletic outfits provided .....■.■.........".'... 1327 INDEX. ^^^ Paragraph. Hospitals , naval-Continued. 1431,1433 bag room regulations ■■■ 1320 beds assigned to patients bill^- 1258,1319 book ••• 1381,1385-1410 book, instraction concerning 1314 supervised by executive surgeon .'.......... ^^^^ brigs to be visited 3063 Brooklyn, N.Y., sale of land of 1209 buildings authorized by Congress 1224,1283 ° . iQoq changes in ^•^'^^ bulletin board, notices on 3981-3985 Bureau of Navigation forms used m -• 3991-3999 Bureau of Supplies and Accounts forms used m ••■■■-■ 1319 cemetery record, supervision of 1324 cemetery to be kept in good order - 1224,1283 changes in buildings and grounds 3662 Chelsea, Mass., sale of land of ■••■■ 1441-1470 chief nurse-s, duties of 3011 ^ 1 901 civilians in ^'^°'- cleanliness of, responsibility for 1371 clerical work supervised by pharmacist ■■■■• 1372 system of ' ^"^^ closing of 1316 ciosuigoi commissary department, under pharmacist ■.'.''.'.'.'.'.'.'.'.'. 1319,1411-1418 ledger ^* construction, disbursements for convalescents— 1313,1507 detailed for work 1230 discharged when flt for duty "' 1266,1286 returned to duty promptly correspondence— 1262,1389 how conducted 13( 1 supervised by pharmacist 1353 ^ 1 CC1 day ofl duty ^^^^ diet kitchen, regulations for _ 1233 diet Ust, special, revised daily ■■•• 1232 diet tables, variations in discharge-s- . j236 for disability i''^" on medical survey ; ■ - • ; ■' 1365 discharge of patients, regulations relatmg to - 1281,1285 discipline of, responsibility for ; •• 1316 disinfecting plant, care of ; 1316 disinfection of clothing _ 15^1 dispensarv, regulations tor 1328 divme services to be arranged for 4 1^ dutiesof— *_ chief pharmacist 1471-14-i hospital apprentices 2581-25S4 medical officer ■■■■■■ I'lSl night apprentices "■" ^^'^ pharmacist ■.■'.■■■", ^^^^ economical management, responsibihty for ;■.;".■.■...... ^^^^ emergency requisitions from 350 INDEX. Hospltal-s, naval— Continued. Paragraph. employees- admitted as patients ., 2174 leave of 1541 physical examination of 2128 supervision of , . . ^ 1542 treated in -.■■■trr 1241,1276 Tinder compensations act 15,}3 enlistments expiring in i-? <.r 3001 erection of .^^.^„^-^. VXS, establishment of .' , ^ 1201-1209 estimate of funds ............. 4131 examination of female candidates at 210J! executive surgeon, duties of 1301-1334 expenditures 1387 expenses — appropriations charged against 3400 charged against naval hospital fund 3399 of transportation of sick to 2944, 3010 extensions authorized by Congi-ess 3612,3659 filing requisitions at .^ ,,;^iwi. 1386 financial dealings with patients prohibited jjii,pV-\ . ^>. ... f . , ^ 1260 fire apparatus — care of ...'.'.".'.'..'..'.".'.".'.".'. 1321 bill to be posted '. .'.".". ...V.V.^ ... „-Vu- 1321 drills to be held weekly ...^j^,,^,.^,,.,/.^;:^,:,"..".;/.. 12S9 preparation for ...,,;.,..^.., „.'.,. 1345,1369 funeral services arranged i .'.......'...!. 1323 headstones for immarked graves.. ..V.V.'V.'.V.V.'.'.V. . . .,, YtT^p;^^,,^ .1^ 1292 health records — accompany patient to 2229 examination of 1226, 222,S inspected by commanding officer '..'..'.... 1286 of persons sm'veyed ..'.'.....'. 1237 submitted to commanding officer 1343 to accompany patient ....'....'.'..'.'.'.".'...:.'. .,'„-'v- .li>^-V-- • -j" 1229 chief pharmacist's mate of day, duties of .......'.'..... i. '.. 1131-1435 hospital ticket to accompany patient '.'.\V. 1229 information slip. Nurse Corps 4131 insane patients, care of 1316 inspcction-s — by chief nurse 1443 by commander in chief 1251, 2512 by executive surgeon 1308 by fleet surgeon 1136,1252 by mcdieil officer in command, weekly 12S5 by night apprentice HSl by oflicer of the day 1361 of medicines and supplies 1225, 12Jtl of provisions 2582 recorded in journal 1284, 1362 instruction-s— of Hospital Corps 1371,1375 regarding transfer to ...■.■...■.".■.■.■.■.".■.■.■. 2981-3011 inventory, suiK^rvision of ..".'.."...'. 1319 isolation ward-s, care of 1316 journal to be kept ..".'..■..■..... 1253,1362 junior medical officer, duties of 1341-1353 keyboard and care of keys 1322 INDEX. 351 Hospital-s, naval— Continued. Paragraph. kitchen, care of 1318 kitchen, patients detailed for work in 1313 laboratory, care of .,j,j,tj„„.j, 1317,1351 laboratory work, report of 1351 Las Animas, court-martial prisoners not sent to 12(57 laundry, linen laimdered in 752 laws relating to 1201-1209 liberty- books 1311 list 1344,136s library, care of 1327 linen room, regulations for 1571 list of patients 1256 maintenance of 75 management of 1201-1209 master at arms— j, duties of ,..,,f,wj.j...v> 1431-1435 visits brigs ; '. 1368 meals, inspected on table 1325, 1362 medical officer- accompanies patient to 2981 always present -^ i. 1294 in charge of wards 1228 in command, duties of 1281-1295 in command, responsibility of 1223 of the day, duties of 1227 medical survey — not required for transfer to 2925 of officer in 2913 of patients after three months in 1265, 1286, 2948 medicines— issued to persons not in Navy 1255 to be inspected 1225 mess attendants , 1318 militia, officers and men in 1268 money of patients to be safeguarded ,. 1330 naval auxiliary service, personnel in 3011 night reports 1364 miscellaneous expense requisitions 3382 nurses- duties of ...,.,.,..^ 1441-1470 quarters of 751 officers — discharged to Naval Home 1221 discharge to be reported 1221 entitled to remain in 1221, 1222 having special duties 1341-1353 officer of the day- detail of ..'.'..'.'.".."...".'....'.'.'.'.'.'.'. 1333, 1334, 1353 duties of 1361-1369 operating room, care of ' 1315, 1350 order book kept by ward olTicer 1342 orders to be posted on bulletin board 1329 patients — detailed for work 1313, 1507 fit for duty ...."....."......'...'......... ".....V.'.V/ 1346 left in, on sailing of ship .j, 1236 required to wear uniform .,,>,,^y ..,^i. ;_,„.,.. ^ 1516 852 INDEX. Hospltal-s, naval— Continued. Paragraph. pationts — restricted to - 1'166 surveyed after three months in 1205, 1286, 2948 pay of enlisted men in 1213, 1216 pass book 131 1 passes for men and employees ■ • • 1311 pensions of men in 1207, 3608, 3623, 37.52, 3793, 3801-3806 pensioners in, instructions regarding 1531-1535 permLssion to leave premises 1310 pharmacist— as officer of the day 1294, 1333 duties of 1371-1425 Philadelphia, patients report to governor of Naval Home 1214 physical examination of all patients 1367 prescription book 1255 priced invoice from 3952 probationary service, time spent in 1264 procedure on receipt of patient 1234 property- accountability 1257 accounting 1374 book, kept by ward officer 1342, 1346 responsibility, special wards 1349 psychopathic wards, care of 1316 punishment for offences 1285 purchase of 1205 ration, deduction from pay of persons in - 3622 records kept with neatness and accuracy ..::::::.'\'. . . ; . . ...'.. l.i 1264 recreation time to be provided - — ■• • — ' 1327 Red Cross service at 4352 regulations for government of 1239,1282 reports — and returns from 4131 concerning Hospital Corps 1288 of admission of officer 4131 of condition of patients 1284 of discharge of officer • • 4131 of inspection • - - • 4111 of laboratory work 1351 of officers transferred and discharged 1221 of public works 1 291 of sick, morning 1348 of sick, weekly 1238 of work done 1349 statistical, compiling of 1256 requLsitions — for supplies 1385, 3531, 3541 sujiervLsed by executive surgeon 1314 responsibility- for cleanliness of t 2581 of medical officer In command .'." 1223 returns supervised by executive surgeon 1314 routine — sick officers' 1*^1 wards 1*^0 rules, for patients lSOl-1528 --Wmitary report .'.. 1259. 2584, 2635, 2ti51 ' 'iwvlce performed by HospiUl Corps 402, 435, 1261 IIs^DEX. 853 Hospltal-s, naval— Continued . Paragraph. service to patients by attendants only 1 231 sick call 1348,1368 sick officer's routine 1491 sick removed to, when recommended ; — 1211 sites authorized by Congress ■■ : 1209, 3G12, 3659 ' ■ . special diet list ...;...;;;:;... '3961 (:' revised daily ■-^. .;........•.:. : 1233 ^' special diet sheets inspected ..;...: 1325 V special forms used in .».>. = = » a = i 4001, 4002 >"• special requisitions from - ^ - ;iJP?«>3i> liii 4131 ? statement of cost of maintenanc* ^ 1^21-^1425, 4131 ;; stores, record of -. -- ViiiJJU. > JeJiQ?0/l .,.'.'- ;•. . . S27S,'8ei4^'3657 r. Sunday observance :siiiiirjiLle7iiii^:itiV?P.t!i c ."■'...'.TilCC-. :'iM285 b: superintendence of .." -...-.Iv.^i-'.U j>inJ l|i30li'3010 fi supernumeraries in, instructions regarding Si' jr.fu.'^cri Ji'm. 11531^1535 <; supplies to be inspected .rc/.ijj.." .^1225 surgical operations, necessity for - - - -' i .'. . . 1287 surgical wards, supervision of - :...[;:... 1350 surveys on materials, held when necessary - — 2968 traasfer papers 1215 transfer to --- 822-824,1143,1211-1217,3001-3011 :• treatment of civil employees in - - . . 1241 tuberculosis cases 1212 ,: uniform— of Hospital Corps inspected 1329 prescribed by executive surgeon - . -i^' . - -»w .<. 1304 regulations to be observed :t J-i .iJ.?v 1290 service to be worn : .i. .j. . . . . , 1332 valuables of patients to be safeguarded • -.- . . . ^^ - . 1 1330 visiting hours to be designated - -.^-.-w-.-.-;- - ■ 1331 ; - vouchers • •-- — -.^-...-.- -.-.- 1386 ' wards-s— • ' ■ forms, kept by ward officer 1342 nurse. (See Nurse, ward.) officer, duties of — '* r.^.d-^^-i-hi^'yaTjiiT 1341-1353 special property, responsibility -.-.- -a. > ,vfH-*9w»^ Si -. 1349 surgical, supervision of - •- - • - •- .•••:--■ 1350 X-ray rooms, regulations for 1561 Hospitals, other than United States Naval, patients transferred to 2985, 3003, 4111, 4121, 4131 Hospital, reserve, base hospital acts as 1^69 Hospital, Sanitarium Co., Portland, Oreg 3164 Hospital. (See St. Elizabeths.) Hospital sbip-s: accounts - - - - ■ •--.-.-.•.••<»* r,j - -r • - 1726 of master - -.- - - -.- - -.- ^ •Ki>-i-. 'eitfr 1"26 on designated vessels 1724 adioimstration controlled by bureau 1"01 aid societies, regulations for - - --.-.-.-.-■ ■:; -r.- 1 1 '•--•-•,-•- - ,^223 appointments governed by Regulations for Naval Auxiliary ServiQe..........-.-.-.-.-.-.-.-.-.-.--rh>'^,-.trs^rr;(iil727 assimilated to hospital on shore — .-y:!«?k-ip«w-yJ.'x«;-f-i(C-«s? -cvr-fi.,-^ J705 authority of commanding officer ...-......-.-.-.-.-.-.-.- -.-I^<)jf fw-»<£ffe it\- ■■ 612, 1022 authority of master -.- -'4 Ji-iU-o.^pjy^ iv>iJM;Br.*.-;,^v-yi J716 boat instructions 1-22 capture of — — ■ • •'219 chief engineer- duties of 1718,1740 responsibility of - 1718 98601°— 17 23 354 INDEX. Hospital, sliip-s — Continued. '.^.>.. l '.n-tii. ,<■•» oiAilian complemtnt— Parajniapb. classification of ,.,.,,., 1715 regulations for ,,,.,,.,,.,, - 1728 classed as naval auxiliary ,...,,., 1 < 06 cognizance of '' • -■?--»i •■.- - -< ^ ' f 2 commandini; officer of - l'^" command, succession to... ^''0 conventions governing Mi-v.-j* 1 1^04 deck officer, duties of •• ■ ^ '^9 deportment to be civil and decorous ^- - »: 1730 designation of i. . i ..... . — 1702 , design, approved by bureau. , -. • •'"- -I'i '•*' ■ .>i»ii"-1701 details and duties, Hospital Corps. -i -"-'i-^ olqaa. L.ii.i Ic.-. -J. I'.ir 425 discharges governed by Regulations for Naval Auxiliary. Service o:;-:. 1727 discipline aljoard • -^'■''- '^^ distinguishing marks -,aiiia^ti..i.ii.vJtiLjj.d,..- 4303,4306 _f.c 1702 chief engineer duties of :(.ly.iir.-.: 1718 deck officer '*- ^'^'^ first officer v,tu...aa.^. 1717,1738 master -..,im, 1737, 2586 medical officers.. .:.... •■• -'•■- 2581-2580 exemption from dues and taxes — •-•v— ~ -''^'- '^"^>'J^^- 4291-4297 ^?T'7! ...■.■.".■.■.■.■.■.■.■;.■.■.". 1717-1738 duties of ^ _ responsibility of - •-■■ '_ ' harbor regulations observed by - .x'. .U; 2585 improper conduct forbidden -- - ^'- ''^^>^^'- - ^'^- inspection by commander in chief - I'OO. 2512 instructions— governing • ^'_^ signaling ■ ■ • • • " ■ ■ ; • ^'_^ use of boats • ; ' . ;......:'.'.'.'.,... *:;.l 1.2o issueson 2^^^ journal kept by Junior medical officers of - - ■ • • J'J' liquor, intoxicating, prohibited ' - ■'■.'■."'^•'" " \J^ , , ^ .i..!.::'... 179q log of manned by— • Hospital Corps aiiV-': |J^ merchant crow masler — .-^ ^^'^^'f<>^- :::::::::::':::':;mc,i742 ^"^^°"7°^ ■ : 1716,1737,2.^86 '^"^«^^«V.;;. ••■• 1743 rcspoasimliiy -. ', ' ' 1741 medical officer in command, reports from....... ....,-..■.:'. ^.. i^«» messes, arrangement of .......»-..,.^ v-^-Mi'i.i ^^^^ ^ ' 'obedience to authority required —• — '^ officer on duty in port -• - — '" orders for organUHt ion controlled by bureau ^'"''^^"t^iJ,"/o^ t'ln- pmntingtol>ocl>uractorislic • ...I. 1707,4222, 430o p(irsons traasported by ■^r-r-^-r-T-'-^-. - " ^^^^ position reported by nulio ■ • • ^_^^ (juartcrmaater on duty in porl - - ' ^ Red Oroas organiiation on — IXDEX. 355 Hospital, ship-s— Continued. ■ "^ reports- Paragraph. and rctitms from -'^- - Of inspection of : . ....ftooji ^ aafisci 41U ; regulations- civilian crew governing '•-'. '■ <" refuse ^■-- ....... = >......... = = -. = .- = .> -■ 1728 170 J 1735 reports- " Si ' medical officer in command - •••' "^^ oi swk, weekly ■■ ^ - - ■ • ■- • — ■ • ■ - •-' re-sponsibility — ^ ' for cleanliness of Vl' -of chief engineer ........1....;;..... = — ^■■■' J'i^^sr'- of flrst officer = ..^...........w.."---' Ji-.i.c-m? 2581 1718 services as base hospital . ■U/1-; iV.'i Aiyi:;:';V w :. . . 1849 ..., .....V..... 1727 172S^ . = .. = = ....."'- .1733 lymX^OTl 9v.'. ■:-'■ 1802 .'.QitifwxaPJiV.'J. 1713 shipments governed by Regulations for Naval Auxiliary Service signals used smoking rules • - transportation of wounded by • - '■'- traffic by, forbidden uniforms— governed by Regulations for Naval .\uxiliary Service .......:. iLOi'.^iy.a . * --. 1 ' 2i to be worn "^ .:.....: w.. = = ...-:r':?7?C.>..- 1731 ' C'"' ' " 1802' wounded cared for by ; -; "."'■■/'■■ " ' woimded transported to ; - - - ^ - - - . - - - . • Hospital staff of captured vessel, neutrality of • ^ .........: 4217, 4218, 4278, 4310 Hospitals, State of California, for insane..... -.-.-.-.-.-.- ypJ .- 2289,2439,3152,3156^158,3160-316* Hospital supplies, provision of, in field ..-.-.-.-".-".- .-..-^ ■ ; ' " ' Hospital ticket-s: 0009 accompanies patient to hospital ^°^ ■ disposalof ■ ■--'■ 1365,1002 - FormG - ^ ...3922,3937,4121,4131 to accompany patient .........-.; - ■ = Hospital treatment: of applicants for enlistment ^*^^ 1917 I'^Q'i when no naval hospital - - .....^^^ = . ini,i.o^o Hot Springs, Army and Navy Hospital................ .......iP. nj...to: 1591-1622 Humidity, excessive, exposure to be avoided 2621 Hydrocele: entered on report of rejection...^.... ■ -•--•- ■ f"°* t^jectionfor -- • .......:......:..:.^::^a^-.t-: 1961,1981,2071,2079 =yeie°e= 1375 2575 instruction in ■- ;.....^:^^.^ a^ naval, department of .......:..;.....;•...:.....- 2591 supervision of, at stations - — ;..:..-...-.--..-.---• = Hygienic regtdatlons of ships ■ ■ ■ ^ Hypochlorite of calcium, purification of water by. .... : .; ^ 26-1 Hypospadias, rejection for... ....-........; ; -- ■■■■■■ 20/2,20/9 Ice, entry in bill book -■ ■■■■■^ 1395 appropriation for purchase in hospitals ■■■■■:~V,:"\"r'"';"" ^ Identification: J 1" ^ \' of dead ■■ .........^^^^^■ft^9l^i71 e-tfT^bt'v ' .", -'r''; Illness: coniidential, of nurse ^^'oftq extension of leave for 35B INDEX. lUness— Continued. Paragraph; former, entered on Form X (rough) 207S nurses 7U-717, 1440 Incontinence of urine, rejection for ?072, 2073 Indorsement-s, court-martial records 829 Infected ports: hoaJth of, to be ascertained , , , i-'007 to be avoided 2006 Infections diseases: care of > j, -.-_- t-^ - 812 men with, not to be traasfcrrecl ;»**'■ ,/w- 21W patients not to be in landing force ; - 1844 precautions regarding 0J6,36(Hh2a»>,2»l4-2C17 prevention of , . . , - - . ^ — ,,,,,,.......,,... <«ar,^.i - •. 812 report of ,...,. ,,...,,,,,.,,py>5;K........ 812,828 by commander in chief ..,.....,, .....,,.,..,,,,...,... .if.H'f'ni ■>•*«.* ' — 2513,2501 treatment of , , , ^.»jivsi»»*> T>.x»rijiuM -i*rv*X- -•v>»-.--«ni>bk»i«)>{- «ij(-festFi 812 Infirmity: applicant rejected for ,......,.,. 2079 mental, certified to be free from , i.>{,ffi^>^.V. 2081 Inflammability of clothing reduced -.r. 1S25 Inflammable : liquids during fire drill .^ . . ... ..... .>;.-.•; ..... .^. . . -;. 983 stores, care of ...,...,,,,,,,..,,.,,,,..,,,.;..........;.. 903 Information: bureau division ■ ....... .^-i 4355 slips. Nurse Corps n- -Uw.'^f i •*13l Ingrninal rings, relaxation of, not cause for rejection — .j..f,^i>ia»oii'>:-''-'^--- • affidavit upon , - - ■ • r - -. <8ti> ji!i*H-s» -ift^i- 2104 ambulance service for 1240 at navy yards ^y. „,,,.■ 917 compensation for f r<7- ••r-v .-.»;«». -^,931 report of 2171. Injury: classification of causes of 2335 compensation for, authorization of 2124, 2101 death from, report of ,,..,...,......,... 2103,2176 eyes 210* eyes, prevention of ^f,,. ,:,,.., ..„,,,. 2120 former, entered in health record 2241 key letter for 23iSn23a8 nomenclature of ,..,,........,._.;. 2321-2361 noted on health record ^.^j.^ 2209 officer to report '.'....'...'.'.'. 3352, 3363 origin of— decisions regarding , 2h21-2S37 to be stated ^^^ .,^ „ , v-m.-fr •» 82« serious, entered on Form X (rough) :•••••• -'.,.■- j. 207U Inoculation, protective : entry in Form K 238Q landing; force to have 1S*44 Inquest: board of. (,Sc( lioard.) entered in journal 2318 Inquiry, court of, on accidents causing death 212G Insane. INDEX. 357 Paragraph! 3101-3166 admission to St. Elizabeths Hospital for Insane • 3121-3123, 3137 applicants for enlistment, detection of 2063 pare of 1316,3124-31-31,3133,3154,3164 charge for transportation of '3 clothing for • • ^^55 death of. ■• -MCUi-iwJji; 3136,3157,3162 discharge of - 3W5,3166 enlistment of, prohibited 2001, 2014,3112 expenses of care of -- ^^^^ Government Hospital for. (See Hospital.) .-. health records of 2289 in Alaska - ■ - • ^^''^ medical history to be obtained 3127,3130 menace to community • 3165 on Pacific coast, care of 3141-3166 papers required for admission 3137 payment for care of - 3158, 3159 receipt for persons and effects of ■ — 3134, 3160 recovery of, procedure '■■■"■' 3132 report of condition of 3131, 3153 State hospitals of California, for - - - j - -f-'J 3141, 3166 survey of 3124, 3128, 3129, 3165 transfer of - 3125-3127 transportation of .~-.^-. ... — 3133, 3156 Insanitary articles, survey of .K.xjA.i-. i 'jvj.-:li JA''... A .v...',.. . yrJi??J:. 2537 Insanity, rejection for ^■^..<^^.ii..~ - .■.■.-.■.■..■.■.■.■:: . . . 20/9 Insecticides ■.j'J'Ji^UM :^ii.vDJjV: . . . 2781 Inspection-s : board of, for ships 891 bumboats 2571 camps 2621 colls - 854,2572 clothing by division officer 254$ entered in journal 2318- food for — ships 820 sick : 2565 health records— by oommanding officer 2224 by fleet surgeon - - • - 2219 holds 855 hospital-s — by chief nurse 14^ by commander in chief. ......-.....: — . — 12.51,2512 by executive surgeon 1308 by fleet surgeon • • 1^36, 1252 by night apprentice -'■ 1481 by officer of the day - - 1361 report of 4111 ship, by commander in chief 1709, 2512 ships, report of 4111 weekly ' - - - ^'-85 journal, by commanding officer - - - ; 2312 liberty party - 1504 living spaces 856 358 INDEX. Iaspectio&-s — Continued. Paragraph. meals at hospitals .-. . ..•.-.■.-.•.-.•.■.•.-.•.•.-.-.-.•.■.•.•.•.•..■.■.•.-.•.■.•.•.■.-.-.•.. . 1325, 13fti medical department A'Jv'Jli, Ji^LlA'-J'Jji'iLi'.iJf'Jml'dA-:-.. ':S\: 891 by fleet surgeon -.•.■.-. .■.-.-.-.-.-.■Jt'.aw i.'^^b.^MV.tUl':. 1132, 1162 of ship, report of ..-.......■.-.-.•.-...•.•.-. .-.-.-...•.v.-.-.-.-.-. .-..•.-. . . 4111 medical supplies .... ;....-...-...•.■. .-...•..^,K'iJ'JlU;U.'.; .. ... W4, 1225, 1284 medicines, entered in journal . .. .•.....-.•.•.■.•.•.•.•.■.-.•.•.•.•...•.-.-.•..-....%-.•. .:.•..'. : . . /'' 2313 not to be held oh Sunday .^...^..-.^■. ...... ^^-.^^v^^v^v...-.-...-.-.. v.' ..t.!' 1285 prisoners -...-...,...-...-. — .....^.■.^.......^.■... .\ ::>::. 8»i}iS72 provisions— — ^■- ,.i '■ '■ i i' ■• entered in journal.. ~,..,^^..^..^,^..,..,.. .,-...-...^.... 1362 for crew J-Iulll ."jH »'ii.\ SW, 2.568, 2570 ("L\ in hospitals — > »^^v.»..-i'.; j'j:.^.. — 2582 t ■ : .^juarantine, vessels of Navy subject to , .^. v . . i\i 2732 sanitary— by fleet surgeon 1133 of ships, report of 4111 ship, by fleet surgeon M',\i)eii.st-i<>*r-'^?c>-i«^B«tii*t- - 3511 „,,,..,.,., Ii,^i.V*'!--f^-'^->i- 858 . .1^.^..^.... -.."-\. .....'..'■.. I bf^M.<^. - - 3922, 3931,4121, 4131 ............,;a«4svii*i)-^'-- 1316 for medical outfit going into commission out of commission instructions relating to medical stores priced. Form B • - - Isolation wards, care of Issue : of stores, loss on - . - ..-.-jiwv* leaiv^i. method of •" ■ " ' ' " ' " "■■■'■" on hospital ship • ■ ■ • • ■ " " ' ■"Jeanette," date of death of those lost in wreck of. ........... .......-.....■...--.-.•.•--•.-.•.-.-.-.-:• ......■-,••-■ Joints: ■■ ..-f^jqoH .r^.d v.m. ineflioiency of, rejection for stiff, entry on report of rejection Journal, hospital: absentees noted in — - ■■.-.--.-.-.■.-.-.■.■.-.-.■--.--■ ■ ...^ -■......£ ,■,-■-,..- - -r ----.-; entries in ..,....,.„.„„„..... .-..-^---■■.He'i=i'>i^Hfit-£-.*wi*r>i , .. i. ■ -.; v,-aiii.c«T.^j .{>->. 1284,1362 record of mspections in ..--.-.- ....••.- -.------.-.-.-.-.-.-■•' .-issr c.ii joi -u signed by officer of the day - ---.-. - •- •• •-■.■.•.■--•• -.-.-.-.-.-.-.-.■. - ^ ^_, J^--j^..i>,.,{v . l^OO 1414 3303 1725 3743 ,,M61, 1981,2079 2081 1434 1362 1362 1362 to keep . Journal, Medical Department autopsies entered in changes in personnel entered in . . deaths entered m epidemics entered in examination of water entered in. . forwarded to bureau hospital ship to keep inquests entered in Inspections — by commanding officer entered in of medicines entered in medical officer to keep monthly entries in ■'^•■iH'yAfJfKrrr^-r^ ;864,961,1227 .;.-.-.e-Htxi«s.-+..ln..- 2318,2443 -r^iO^e^i^t,- ... 2318 2318,2434 L.....,.., 2318 :..._„..;jaj^ 2318, 4121, ilM. ' 2316 . . . . : •. . 4^.,,,^.,. . . 2318, 2443 2312 ,,. 231S ^..,,,'...„... 2313 ..".,,.».,.,.... 2318 Nurse Corps changes entered in ■xtrAWfri-AT/i^) ^M officer of the day keeps 2^^^ receipt of stores entered in 360 INDEX. Jdamal, Medical Department— Contiuued. Paragraph. requisitions entered in 2318 retained by ship or station 2318 sanitary— , condition of ship entered in ':.l'.>.iii90:i 2591 reports entered in ■. .,_ 2318 ship to keep 2316,4121 vaccinations entered in ,. 2318 Junior medical officer-s: hospitals— ■, . • , • ' alternate on duty 1353 cleanliness of wards ; 1343, 1347 consultations with executive surgeon 1342, 1350 duties 1341-1353 duties assigned by executive surgeon i3.ll executive surgeon's directions obeyed j 342 executive surgeon tosupenirise I3a5 fire drill 1345 inspection of fresh provisions , 2582 inspection of ward with executive surgeon 1347 ' laboratory, care of 1351 laboratory work, report of 1351 leaving hospital 134«, 1353 liberty list prepared by 1344 officer of the day, detail of .». 133S, 1334, 13S3 operating room 13g^ opportunity for surgical work 1282 order book kept by 1347 patientsfit for duty ,it. 134G patients surveyed . . ^p.tj. ..•.,; i". 1346 property book kept by 1342, 1348 reports of sick ..floioWix'-A'. rM 1348 responsibility of .'..-...■ jj 1347 sick call ] 348 special diets supervised by .1.. 1344 surgical ward supervision ,., .^.. 1350 ward forms kept by 1342 hospital sliip .-.•.•.■.•-■-t.-.w .■.•.-.- ^^v.-. 1712 ship — ■ consultations , 883 duties of 881-884 health records kept by i.. 882, 1343, 2206 inspects bumboats , 2."71 inspects fresh provisions ....■..' 2570 leaving ship SS4 shore stations 919 Kerosene, use of as insecticide .im..i 27S1 Key-s: board, hospital keys hung on 1322 hospital, care of Ii22 kcjit by ward nurse 1402 loiters, use of 2:J25-232R, 233,5-2337, 2385 Kidney disease: examination for 1984 rejection for 2079 Killed, report of sisi, 1 1:57, Ini,'., 1S08,3922, SMI, 4111 ,4121 Kin. (.Hee Next of kin.) INDEX. 361 Kitchen, diet: Paragraaii.: regulations for • wa»,;ii.jX>la «-j1j4;- . . 1481 supervision of , --• • v»& JiiUqroiL ij'1446, 1450 Kitchen, hospital : . . .jioi.ai-;'^. care of --- -. --. •■'-' ^^^^ , inspection of — -— j«a'. iO j. Ai »-•- . . 13G2 patients detailed to work in giJi 1313 Knives, Hospital Corps to carry .,„„„„„-„ — Jiliiz Jla iii; ISM Knock-knees: ::'ix'...1 entered in health record - - ........... ^,, jiood JJfd.ai -i . i. ;;.;.... . 2241 examination for ..- — •tvjl.iiiJJs^im . -■ . 2061,2079 Laboratory: ''■'■' examinations, report of 1162 hospital, care of - ^,. ........ . 1317,1351 technique, instruction in ,iUj^v;ii,iii Jwnji-iu .1851, 1375 work, report of - ------ "■^^'^ ■^^■- -i-i^i-.^iisi. . . 1351 Labor board, duties of ■ .-2141-2154 Labor, request for transfer of ....-.-..- -.-..-. .lit^.-jwiwJj ...3994, 4131 Labor, Department of, blank forms ......,..,..,..,,. 1 . . . . 2172, 2175 Laborers: • i)t' Joooil . eligible list of - ' 2143 rating of oaiiujesy. 2145-2155 Lading. (See Bills of lading.) - "'"' Landing force: boats for 1853 duty of medical officers with 2621 evacuation of wounded .•- - ,..,^1^^. .i.ii.ii... .. 1869 expeditionary service ---- ---- 1841-1869 organization of medical department for ..i- 1841 Las Animas (now "Fort Lyon") hospital, court-martial prisoners not .sent to 1267 Latrines, precautions concerning --„-.,,..,„„ 2621 Laundry: fwi!: hospital, linen laundered in - - — - Ji - .,..:-. -"J -•.■;•- •■ 752 ship's medical department — ■- -'■-■A- ;-----• J* -! ' 861 Laws, military. Red Cross subject to -■.■.;■ 43^ Lead poisoning, prevention of ..- — — .,,.,. j.....^-Jii;., i.... v.. j.Au.L'iv.' 2618 Leather, disinfection of — ,.......,,,„, -j: 2769 Leave, sick: jiqaori biBi board of survey required -.-. 2909 health record forwarded to bureau ....■.^'...■j..h:!....m... .— 2266 pension status when on S.....J... ....;... 3729 Leave of absence. {See Absence, leave of.) Leaving ship, permission required - - - - *^S4 Ledger, commissary. {See Commissary ledger.) Leg, first-aid care of wounds of - - lOH Leprosy, quarantine for -i ■■■■ 2731 Letter of application. Naval Reserve Force : - . - ..,,„,,,„„, ,,,^viiqiv>.-132 Liability, United States not exempt from '- - - .:.-.".fiL*.-!.'<>.f.'^j.'.f.'vf. !\ji . 2167 Liberty: book, hospital to keep 1311 condition when returning from - - - r - - - 1504 dependent on local sanitary conditions — ■ - i :i 2535 inspection before going on .........,,,,, ^ ,,,,.,, , 1504 list, preparation of -.-.-.--.-.-.--.-.-.-.-.-.-.-.-r^.-,,,---- 1314,1366,1467,1503 patients with venereal diseases not allowed on ,.Hv>(,.T-iij'«si-)ii.i4WrfeiHii- 3220 362 INDEX. Ijght-s: Paragraph. allowances of, Nurse Corpb ■ ■. . . .■.-.■.•.•.■. .•.■.-..■.•.•.■.•.■.-.•.-. ::. 751 lurigade hospital designated by . . ... . . . ... .-..•.•.•. .-.■..•.-...•.. . .-. 186)> dressing station •.'.•-'. '. . ':':} 1824, 1865 duty list .....^.^^.......^..^: ::::.. 1467 for comfort of crew ..-..•.•.... 2539 reading ...•.-..•,,-,•.-..-...•..'; 26-10 lighting of ship .......-,.•... ...... . . . ."'.V 2542 limbs : artiflcial, entry in bill book .-. . . .-. .-.-J V. :iV. 'J.V. 1398, 1402 iuetriciency of, rejection for .'. . . . 1961, 2079, 214» lime, disinfection by 275:? linen: nurses' quarters- laundered in hospital laundry 75i; supplied by Bureau of Medicine and Surgery. . . . ..•..-.•.•.-..•.•.•.•.-.-.•.■.•.-.•.■. 752 room — • • ■ • regulation for .■.>.>...-..:.■-»■-•.- 1571 supervision of ....•.•.•...•.■.. 1445, 1450 line of duty. (See Not line of duty): adjudication of 2Stl-28o2 autopsies to determine ■....-. — 244;i bureau to decide XT.-. 2318, 3757 conflict of opinions to be avoided 3761 decisions regarding .-.•. i-.-. ■.-.•. -.i-.v- ••- • 2S21-2837 entries— — ■ • ■ • ^ in health record .-.-.■.y .:■... .-.-.-.•.;..■.■.■.•.>■.-.•.•.-.-. -. -. 2254, 2256, 2824 of adverse nature ..v^^.-.^..-.^ .-.-.. ■..-.-..... 2111-2817 when several diseases exist..... .,...^..,. >-...■.•.>-.. •....-.. 2259 laws relating to i;.''.'?lU.[«i.i.V;iFWiiJ.aAA'. 2< on pension certificate •. . . 3751 headstones for unmarked graves 4131 lilwrty. (See Llljerty list.) ■■• light-duly -..;:•.•..:. 1467 monthly money, preparation of — .:. 1527 patientH 1256 special diet :ftn3,396l slips, shipping articles, and enlistment reoord-s forwarded. . . 8985 litters, one for each 2 stretchermen 1S4<'. living spaces, inspection of 855 Lock, drugs kept imder 1463 INT>EX. 368 Lockers: •' Paragraph. articles to be kept in - - '--' -^.'fA - • 1511 r care of - - ■— - — ■"•■ ^^^^ dressing stations to have - ^.-:d.vil IiAi^i i. 1«24 Locomotor ataxia, method of entering ..Jiilia^^JiJi?. . . 225?t Log, ship's: deaths entered in I.yAClu:-'. 3«2, 2434, 3432 desertions entered in ■-! .iaaUrnQqiiS ,i^i-. 3229 "Maine," pensions from destruction of ■ • ■^7*5 Maintenance: — -•- cost of, from bill book • ■ ■• 1^84 statement of cost of 1421-1425,4131 Malaria: precautions against ■ -■■■ 261.5, 261i> rejection for - i .:.■....-.... 2079 Malarial ports, anchorage in 26(J6 Malingering: to bo reported - - ' ■- ^^^ use of, as diagnosis - • -.-....•.•...•^-^^^.-. .-.-j^.-- 2332 Malt Uquors, custody of Utjcvwf *noma«.'o;ACi..- . 827 Management, economical, of liospirals. re~ponsi'oility for 12^1 Manual for the Medical Department: authority of bureau to issue 1-^ regulations included in 1239,1282 Marching, defects of feet interfering with 2069 Marine-s : barracks, sanitary condition of ...■..'.: 2594 Corps — ■-•^ age of candidates for nftsifHi-:. 1965 charges against aijpropriation "^ deduction from pay for naval hospital fund 3602, 3ti06, 3621, 3651 enlistment in - 2005,2018 Form No. 330 • ■ - -■ • 2095 funeral expenses •-■• ^'^'^ officers, appointment of -...-- .-.-^.- 1908 paymasters' clerks, physical examination for :jij'.';ba'i'.'?0.' 1935 promotion in, physical examination for i . . . .-; - 193- servicein,coiuitsasreenlistmpnt 2054 transfer to hospital - ■ - • - - - - - • - • - 2990 transportation of dead - - - - ■^^'■^> 3^42 visual acuity required. — - - - - — - — • - — ^^^^ expeditionary force — • ..-.-■ baggage allowance -- -.— -— — ......^-...-.•.•.vr; 1847 service with •-•-- — ..^..^.i.^-. .^..- 184/ honorably discharged, preference of .l^)i^P!\: 2150 not assigned as chief pharmacist's mates - — 4.53 physical examination for enlistment. 2018 recruit depots, entry on Form X ■ — 2053 reenlistment of, with physical disability 2010 Marks entered on descriptive list..- 2103,2104 -au22t .' 364 INDEX. Master at arms: Pifa|ir4t)h. brigs visited by ...■.■^^^liJiV'A:: 13(>8 hospital, duties of ....■...-..-...■ 1431-1435,1502 propertj' of absentees cared for by 1466 Master of hospital ship. (Sfe Hospital ship.) ^ Matches, expenditures for : •. 1402 Material, survey on. (See Survey). nJ L -< = i< j^ civil employees .'.;'.;'...; 2131 , 2152 court-martial proceedings , 895 St. Elizabeth's Hospital for Insane ......ji-. 4001 member of general court-martial •. . . j C'.i.\' yii'.'l ^7 Medical Corps: a;;c of candidate for 19(i5 appointment in 111,116, 121-12»,iJ31-152 candidate to have physical examination ; 1951 correspondence school for uuncL 3230 examination for admission to i...';JeJi\4:0£tlC7WI.\.:j.'l\i.V-.Jt':'i'.. 3214 merit roll of candidates for .■.'.";.''.V.^. . . 4131 Naval Militia ■ 271-273 number of lOi organization of 101-104 physical examination of candidates ■.ui-iL-.w 1951 visual acuity for admission ...■. 1963 Medical Department: appropriation 72, 3383, 3400, 3671 bakery used by, after battle 1828 dental officer assigned to 1023, 1031 duties of 12 entry in bill book 1397 field, organization of isi i isf.o galley used by, after battle ...jj.i ;•;■;!. 182S Hospital Corps attached to 402 inspect ion of _. . . . w. . ..... i. . j ....... .V. .. Jj ' 891 by fleet surgeon ■. . . Ill's, 1132, 1162 journal of. {Sre Journal.) landing force organizat ion 1S41 Manual for, authority of bureau to issue 13 organization in field 1861-1869 INDEX. 865 _ ,. J Paragraph. Medical Department — Contmued. 1801-1832 preparation for battle ^gQ^ provision for care of wounded • - ■ • - 4101-4131 reports and returns, instructions regarding ^^^ > i' sanitary duties of '" ^j^^ If'' ships, report of inspection of - ■- , ggg ' United States Navy charges against appropriation.. .• Medical examination (See Examination, physical): ^^^ board of ^. . , §24 Medical history, patient in civil hospital - -- -■-----•-- ------ ^^^ Medical inspectors, professional examination for promotion. . ...•.-.-.•.■.-.•.•.■.•.-.•.•.•--.-.•-•. Medical journal. (See Journal.) Medical oflScer-s: g2Q i' absence of, next in command succeeds .■.".".'"'.".'.".'' 2209 3756 l'<- accidents in absence of • " ' "]^'". ' 2931 i^' ' accompanies patients to hospital - - ...-.--•-■--- ------ ^^^ I'' aid to persons not m Navy - ....•...-. .-■.-- - - - - ^^^ i annual physical examinations - - - - • - ' ^.^^ w applicants for pension exammed by. "," ■:,:■": 2249 '-approves entries m health records ..-.-.-..... ---•- ;■••;• 2591:2597, 2031 ? at stations, duties of if attendance— ^ ...913 914 ■ onfamilies ''"''"[]['''''' __■ -■• 'gll '■"'■■ authority of ■--■ " \' VV' ' \\\\\.' .'.'.' 'lei c &j^]. v.. :*6, 3780, 2721 billsofhealth " " . 848 binnacle list g53 bumboat inspections care of — 903 inflammable stores ^222 poisons ■ gjg y - wounded ■ ' certificate — ...821 of ill health ' 2989 • to accompany accounts ',:"' 8022.=^! 254-? ■■' commanding officer to consult regarding health of crew - 802, 2o31, 254o consultation — g4g §33 regarding treatment ■""■ '^^^^ i/ with fleet surgeon " ' ' ' " ',' " ! ! ^" 812 828 " contagious diseases, report of .."^.. '......:"/... '829 . court-martial records ■.....•--- " ' "^_"^' '^ " " " " " '_][;_ _;^ _ _ §27 custody of liquors V"'l-"' 1025.1834 dental officer to inform of condition of patiems .-.•..y-.^^ . ^^^ detached, inspects department with relief ----- - -- ■- ' ' ^^ disabUity of, next in command succeeds - -- -- ---^^^^Q \ ...'../^.. 2215 disability report in absence of - """"""""^r^"^.^^^— -v. 812,828 diseases, contagious, report of • • ' 'y"' '^"^""7. :r.r. 801-1012,3511-3525 dutiesof 869 as division officer [['^''^.H^ls^tLlLzliii^^. 2581-2584 at hospitals ' " [f^. ^^.,,^, ^..^ 938 at Naval Academy ......^v.---.»-^»->-» ,....t 931-938 at navy yards - ^ "m^Ui'^)../..... .......-.- 937 atprisons - , .,'" 6U,»12, 3591-2597, 2631 at shore stations * .\...._.j^jwi)i'.'V--..... 981-987 during drills • " ; "■'^■^-.^i.C^^.:,. &41 going into commission "'"'i':'W;lil^'Ju."."...! 864 going out of commission - ' ' Mgu/j^... 868,869 in battle '"...' 2581-2586,2632 on hospital ships 366 INDiiX. Medical oWlcer-s— Continued. • f 2141-2154 with landing part y ....,......_.............._._.,....._........ ....... ..->,,. ♦„ 2621 ■ employees, compensation ....._..._.._.... .^..i^ . ,, jj.,,-^^;, ^, 921, 931 epidemic diseiises, report of .......,sr.:u^,■rt«^{e'^«>'M■'^»•?>•'•^♦•■'*-••'•'*i<•.r 812,828 examination — i ; ■ ulfioizvifr injured employees ...............l... 2172,2175 men before transfer ^...j..^^...^.. 828 pensioners .....„^^,jt.rr;*v r--- 973 recruits 94 1-952 fire and rescue party accompanied by 984 flrst-aid instruction ^i,^^j.ji,^ hatsmtaov i-i^)^ 849, 909, 1001-1012 fitting out sl'ip ...........................),, ,j.,_t/^j5.,.^g,,,.... 841 fleet surgeon, duties of .h.>j^»-^ ,>> ni^jj^ftfj-iiSM^fK..- 1101-1173 food , preparation of — ............._.•,,„/-'- tiJ-v»pr-s...-»*«^n»* J. ; 851 health officer received by •.•.•.-.•.-.--tasti-iT,-^! -(f!it/'»4«'ni!*.''1"'''"««'»2722 health record-s -..•-- ....v4;^,iifL.v..- ..»,....;.,. 857 in absence of ^.^.j,,,,,, 2215,2266 kept by 2222 opened by 2243 Hospital Corps to summon — .... ............ . ................ ..^ ,. . . 845 hospital, duties of .........................._....._..„ 2581-2584 hospital ship, duties of — -.-•.• .-.-.-..^-.•.•.-.- .-.......-,-.........{, , 25|8il-2586, 2632 in charge of wards .■.•.•.•.•.•.•.-.•-•.■.-.■.•.•.-.-• 1228 in command of hospital — . .^uoi SOO'. duties of 1281-1295 as recruiting officer --.-.-.-.... ..-.-...-..,...«t>».'V>ft.i-ieiK,-•■., f^-'.-.fTix» 03- i-^Sfft*-;. 2209 infectious diseases, report of 812, 828 inspectionof — injn ■■ bumboats ..j...,. ....... ,^......_. ....... ........ ............. ...«, 853 cells .................................................!.>ji5,^,i:i 854 food ••••.•.•.•...•.-.■...•.•.-.•.-.-.-.-.-.-........,.&'.»., 820 holds — ....................... -•-.-.-.-.- -.-..... ...vv- 855 Uving spaces .^^kk^it*-!.. 855 medical department \.if,4^u 891 prisoners ..„ 854 provisions for crew .....t — 850,853 storerooms , S55 .• . ir I transport for sick «««*„-,,„„, 3007 : <•■' instruction — divLsion oflicers, in first aid .,.,,.,,,,,,/,....... 1821 first aid „.,,,,. „.ra^JwtH8, (449, 909^1001- 1012 Hospital Corps , , . . , , , ,,,,.,,,.,.,,,..., 910 7u journal of Medical Department. (See Journal)., ...,,.,,...,...., 8tt4, 961, 2318 V Jtinior. (.See Junior medical officer.) :. letter lor guidance of ,,,,,,,,,, 2170 inakesinquiry concerning recruit , .,....,.^,,. 2025 maUngering to bo reported by , , , . . . , —jv^PtjoK. *«,■. »-«fc. 816 navy yards, reports by ,,.,,,,,,,»Ui»M 2175 ■idKlaiiqiutl f. . INDEX. 367 Medical officer-s— Continued notified of- Paragrapli. contagious disease at stations ., iV>-i':;'»i^i.~/:v=;^u^.V;i^:.. 2598 detachment, promotion, etc ..i,i.-,...i^^........,.';Vi71.. 2302 transfer of officers 2212 officers entitled to services of 3361 of tlie day, duties of ; vi u i . . .-; 1227 on boards of inquest 2420 opinion as to cause of death required . crpisafiVr.'. . ......... 2422 patients— ?qiii.i in civil hospital „„. ,, - . ^,v ,.....,. ^ .. . ACITi'l" v.-. . 824 received for passage .,,.^^,Ai'Ji<'Ai.F: sse pension certificates given by. .'iVWaUJsJi^J.Uyf/l 375S precautions against disease g^s qualifications for services determined by , .\ . ..; 4347 quarantinable diseases reported by .,..,,...,,,.-.-.•.-,.,.-.- 2733 rank and title of ..-.-,.- .-.w.-.-.-.-.-.-.-.-^. 102 rank when retired J.QOfIp.8 Jeoi^eMj 103 104 recruiting duty ...- = = ..' = ..- = :;:;... 941-952 discretion allowed , ^ . ^ .-.■.■.-fMWj'J-Sri^'i'. 1 2061 recruiting stations J.W??8Jk'i'. 922 recruits inspected by. ..„ ". ...ijiis.-.-iis;; 2025 report-s— ^ XtiV diseases concealed ..,.-.-i4.-..ii.-ijj.-ii.-.-; 817 diseases, contagious ^ ..... ^ . : VL'Jl^. '.: : 812 828 from prisons 2597 from ships, list of .' 4121 killed and wounded , .,.„.•.■.„<.-.-.. 819 prisoners and brigs '29.7*l'.o.Tttii 898 sick, daily ii5^!l'il':;. ti-.IV'l'; 847 use of harbor water ..•.-.•.■.-.-.-.-.-.•.--.-.•.•.•. 902 use of intoxicants or drugs , • ... .-. ..•.■.■.-.-.•.-.-.•.■.-.-.-.-.-.-.-. . . . ; 901 requisitions for supplies .......... ..... . ......•.•....•.•.-.-.-.•.-.-.- .-.•..^.- S59 rescue breathing apparatus v....... ..........•......-.-.-.-.-.-.-.•.■-.-:■.. • 1821 responsibility for— . C" correctness of certificate .-. . . .-. . . . . . 3386 health records 2248 recruits surveyed 2024 sanitary data, foreign ports S28 sanitary reports. (See Reports, sanitary.) ... ship— - care of wounded .V.'. ";'•;!:.. . 1803 1804 duties of 256l'-25'78, 2601-2618 duty to woimded in battle .' ...... 1811 instructs ambulance party in first aid .-. 1804 sick bay in charge of !-i 844 sick, daily report of ".■... 847 spirits, custody of .v.-.'^V .4V' soi 827 station— of at quarters 'jgg- during battle .......■.-.......•..-.■.•.■.....•.....■ 1824 storeroom, care of .-.-.•.-.-....• S25 to accompany serious cases - •.-.■.-..•.. •..-.•.•...■.'; .'i^'.' ,. S23 to keep bill book •..•.-...-...•.•..•.-.■.: :'..'. ...... 936 1381 to conduct physical examination of recruits . . . . .-.v.-.v.-.-.-. 2022 2050 transfer of— insane 3134 3135 stores ...-. . .-. .■.•.-.-.•.xi^?2??VP.". ....'..'...'.. 865^ 3520 vaccination, duties in connection with. . . . . . .-...•..■...•.....-..-.- .il. S43 368 iis^DEx. Medical officer-s— Continuecl. ^"<1- Paragraph, order book signed by X467 routine. 1470 i' water, analysis 852 I approved by .j..ijii>.>.i 2.'>44 - with landing party, duties of ..,^.jii'.-.5l. 2621 Medical outfit: h going out of eommission _^ .; beahii\sxitJi\!d! )i 864 =^'"PS 3322, 3512, 3551 in reserve Ll.j,;Qc;;:/J..... 864 Medical personnel, transportation of isjo Medical report, to Office of Naval Intelligence _.v.i 2568, 2655, 2o61 Medical Reserve Corps: .,, active duty in emergency -.t<.'.:.iiu- 231 f, age of candidate for _.../. 19g5 '. appointments 116,132-146 f, attendance at Naval Medical School ....j;'. 259 ■^^^ ejcamination for •.- B«; 248, 254, 255 J governed by Na\'y Regulations , ;...jn.'i 244 ^ instruction at Nava 1 Medical School , _ 3215 f legLslation relating to '. 231 pension for physical disability 3725 physical examination for 1922 igeo qualifications for appointment in , , 241 •2.')l-255 uniforms required , 245,' 260, 261 Medical school. (S«(? School.) Medical service, neutrality of 4203,4217,4240,4278,4310 Medical staff of captured vessel, neutrality of 4217 4218 Medical store-s. (See Stores, Supplies:) ,, allowance of ., 79Jio..L.ja..ulio..j.. 860 , distilled spirits in ..j jj^.i;.' .,..'.. ^i. 13^.... 801 expenditure of .., .;j gjg 935 inflammable, care of t.,. g(^ invoices of gjtj 'OSS of ■ 863 purchase of ggg receipts for g^g requisitions for j, ^ 359 room, precautioiLs regarding j .ivt ) . . j>j.-hu}91 .-5 828 Medical supplies. (See Supplies.) Medical supply depots: construction of ...........,„„, 7 1 recjuisitions on 3395 surveys at .....i..... 2855,2969,2974 Medical survey. (See Survey.) Medical transport: Ued Cross organization on 4;^! transfer of wounded to j>y2 Medlclne-s: . administration of ^343 1453 j. , allowance of expenses for ■ 3jj4j 3368-8365 ,, inspection of, entered in journal ^ 2313 1^ ls;>ueEX. Minister: Paragraph. piiy for services of """^ services of at hospitals '•'^ Minors: enlistment of— consent required 2004, 2056 fraudulent ■■ ^** prohibited 2001,2014 table of chest measurements lor 2084 table of heights for. 2084 table of weights for 2084 term of 2003,2055 not recommended for flreman 2005 when entitled to pensions ^^^^ Miscellaneous column in bill book l'**J2 Misconduct: „„,„ „^^ admissions -2818,2^20 death due to ..242-5,2801,2834 disability due to ...:.:.; 8W, 832, 924, 2251 discharge of nurse for --■■ ^^''^^'l^ officers not retired for - • - — - 2802 j.^pQ^ 1242. ISfio, 2818, 2820, 3915, 3922, 3972, 4121 Money: deposit of in safe J^ _ lists, monthly, preparation of ^•'2' patients', to be safeguarded 1330,1404 Moral inflrmlty, rejection for. 20*9 Moreue, master at arms to supervise Morning report of patients •-'•''-'•■''f'^ 3967,4121,4131 of sick on ships *'~ Morphln habit, evidences of 2063 ^ 2440 Mortuary reports, preparation of Mosquitoes: „,,., „ , desiruCionof 27o3,2.b protection from 2^.13,2615,262 Mounted officers, hoise equipment for • ^°^' Movements of Hospital Corps, report of •--- ^^^J Mud, remov<>d from anchor and chains -'--'t-L ..j.iytu=.-jia33c. . . l...i.:j.-^ 2611 Musician. (Ste Apprentice musician.) Musters not to be hold on Sunday '■^^ Nails, Ingrowing: entered on report of rejection rejection for Name-s: entered in liealth record ''' recorded in journal Narcotics: intemiKjrance in use of, rejection for ^' kept under lock and key Nasal septum, deviation of Natives of Insular possessions are supernumeraries Naval: Academy— ^ ago of candidate for '"'^'' '^';^ dental surgeon at ^ duties of medical ollicer at • physical examination for adinission 1971-1997 I)relimijuiry physical examination for - ^ 1 1' • 10- 20S1 1981,2079 1981,2079 ... 2247 1984-1980 INDEX. 371 Naval— Continued, Paragraph. Auxiliary Service „ 131, 251 dental services to 1032 health records for 2245 personnel in hospitals. 3011 medical officer to e.xamine 2089 constructors, appointment of 1907 home. (See Home, naval.) hospital. (See Hospital.) fund. (See Fund, naval haspital.) hygiene, department of y38 Militia, Hospital Corps 5.31 transfer to 261 stations, duties of medical officer at 911, 912, 931-9.38 Reserve Force — dental surgeons 301,347-304 Hospital Corpsmen I02 how to enter names on forms 3936 medical officer in 231 age 137 allowances 131, 258 application for entrance • 252-253 certificates required , ..;. ^^v. .,1 253 confirmation in grade .:»: .: .-.rji^ 131, 262-2tJ4 examination of ^ Li.. ; 254 final ;.:.,;. it.^. 142-146 professional j 140 physical 139 where held 133 length of service 131 number of. limited 265 oath of allegiance 131 pay ^i-^l&j.sii. 131 retainer pay ^.s^.ccIj. 131 transfer to Volunteer Reserve 261 uniform _. -. 266 at Naval Medical School 267 nurse 414, 560-565, 790-796 oflicers and men 393tj typhoid prophylaxis 2087 vaccination 2086 volunteer 251 women 2043 Navy: pension fund. (See Fund.) Red Cross cooperation with -.'eJiti^j^i. aj.:\ 4331, 4341-4360 relative rank in the 3731 revenue cutters cooperate with 3723 service in — counts as reenlistment 2054 statement under oath concerning 2081 vessels of, are subject to quarantine inspection 2732 yard-s — duties of medical officers at 911,912,931-938 employee's compensation 9^:1,931,2161-2175 forms used , 2175 employees injured at 917 hospitals at 7,5 medical officer examines for pensions 3758 medical supplies at 918 372 INDEX. Havy— Continued. Paragraph. yard-s— reports and returns from 4131 requisitions — for supplies 3531,3541 from ships at 3324, 3327 service, physical examination for 2121-2176 Nets, mosquito: landing parties to have 2621 use of, in Tropics 2613 Neurotic state, rejection for 2079 Neutral IndiTidoals: continuance of pay after capture 4212 to wear brassard 4208 Neutrality : cessation of 4202 of— ambulances 4202 boats carrying wounded 4216 chaplains 4203, 4240 evacuations 4207 hospital ships ..' 4272-4276, 4301-4304 hospital staff of captiued vessel 4217, 4278 bouse containing wounded 4206 inhabitants aiding wounded 4206 medical staff of captured vessels 4217, 4278 merchants ships carrying wounded 4220,4277,4309 military hospitals 4202 personnel of aid societies 4241 persons employed in hospital 4203-4205, 4240 religious stall of captured vessel 4217, 4278 suspended because of abuses 4224 Neutralization of hospital ship 1708 Nevi, extensive, rejection for 2079 Next of kin: address of, on admission report 1467 deaths reported to 1295, 2413 entered on health record 2241 wishes of 3455 (6) Night: apprentice, duty of 1 481 duty, nurses detailed for 1443, 1454, 1455 reports, hospital .- 1364 soil, precautions where used 2604 "No disease," use of, as diagnosis 2332 Nomenclature, Bellevue Hospital 2323 Nomenclature, Navy: arrangement of 2323 classification of— causes 2335 diseases 2358 uijuncs. 2360 jwisons 2361 key letters 2325-2328,2335-2337 object of 2322 to be used 2257,2321 Notation on forma 3936 INDEX. 373 Notes: Paragraph. bedside, nurse to make 1 461 clinical — form for 3969 nurse to make 1 467 Notice: of waiver of physical disability 2064 ration — admission, Form S - 1276, 3013, 3922, 3948, 4131 discharge, Form T 1276, 3013, 3922, 3948, 4131 Not inline of duty (See Line of duty): entries — on health record 2207,2254,2259 procedure 2355,2811-2817 survey for disease 2906 Number-s : class, of diseases 2358 international, of diseases 2358 loss of, when failing professionally 166 Nurse-s: authority of 1441 breakage reported 1465 chief. {See Chief nurse. ) communication with commanding officer 1451 conference of 1443 deduction from pay for naval hospital fund 3624 diet kitchen, duties of 1450 duty-ies— assigned by chief nurse 1443 continuous, length of 1453 entered in day book 1445 in hospitals 1441-1470 in venereal wards 1453 health record for 1445, 2244 hours of duty 1452 knowledge required of 1442 linen room, duties of 1450, 1455 Naval Reserve, in 790-796 night- duty of 1454,1455 information to officer of day 1468 orders given to 1468 report by 1468 not to be called from station 1458 officer to be accompanied by 1459 operating room, duties of 1450, 1 J55 physical examination for 1934 quarters. Government property in 1445 registers of, kept by chief nurse 1445 reports submitted by 1444 requests, official, submitted by 1444 sickness of 1446 sick records of 1445 supervised by chief nurse 1449 term not applied to Hospital Corps 492 ward- absentees reported by 1460 administration of medicines 1463 bedside notes 1461, 1467 S74 INDEX. Korse-s— Couiinucd. Paragraph, ward— bookskcplby 14C7 breakage reportwl by ...-.;...... i :. :';'. 1400 daily routine - 1470 discipline during absence 1462 duties of • 1450,14-)ft-1470 forms kept by 1467 Hospital Corps men detailed by 1465 hospital property, care of ;...■..... 1460 keys kept by ::.■...:. 1462 liquors, care of 1403 money of patients safeguarded ; 1464 narcotics, care of - . . ; ; 1463 patient confined in brig ; ; ; 1400 patient restricted to ward 1466 poisons, care of ;.;::.: 1463 responsibility for condition of bed patients .V.' .' .;...:.. 1461 valuables of patients safeguarded 1464 Nurse Corps: administration of 611 allowances of - 616,619,624,721-732,751-753,761,762 appointment in - 611, 614, 641-647 revocation of :.:.y.:'.'f: 728 Army, service in - 722 assigiunent of '..".■.'.". :':'.'. .''. 1 .-. .'i.V...: 671-677 authority of : .'..'.'.■...;.'.. 617 badge 771 change of station : • 676 changes in— entered in journal 2317 to be reported 702, 707 chcckage for hospital fund ...:..:..::::. 730 chief nurse. (Se« Chief nurse.) communication by official channels 708 commutation of— quarters ; ,.....:..::...... 618 rations ::::::.;:;::::::.. 741,742 composition of 613 detail of : : 615 discharges of ;.....;..;.....;..........:.;; 691-099, 710 duties of superintendent ;;...;;;:;.;...;..;...;..;:;;... 015 offieiency rcr)0rts ;..:.:.;: ::.;:.....:...:... 072r. 70-1, 4131 eligible list ; - - ..:.:. 647 citablishmcnt of 601 examination, supplementary 6726 executive surgeon to supervise 1305 fuel iillowunce 619 health record, custody of 717 illness of 711,717 illniss of confidential nature :....... ....... ■..':..-• — 706 information slip ...■.•.•.•:..•.•...■.•.•.■...•.•.. 4131 instruction of ......•.•...•..• .■:..■.■.■. ■:...:.'.\-.-:.. 611 laws relating to ...........■...■...•.•..•.•..•.... (V)l,002 leave of absence ;.;... •.•.•.::?'; OSl 689,702 final »^'» longevity pay, calculation of 722 medical atli-ndiinco to .•...•...•..•.. . .'ll-7ir. nionthlv return of .-.. 4131 INDEX. * 375 Nurse Corps-Continued. Paragraph. orders home ...,.izi.\:. 697 pay of 602,616,721-732 places when eligible for duty - 620 probation 672 quarters for 751-753 commutation of 618, 753 rations, commutation of 741, 742 registration required 643 removal of * wts-Mi -iur-- 611 reports concerning •-•- 701-708 requirements for appointment 614 Resei-vc, Naval Force •. 790-796 reserve nurses 621, 781-784 returns of - - - 701-703 revocation of appointment « 672 sale of stores to • 732 services to families - - • • • • - • ■ 671 special nurses, employment of , i.>:>,-. *, . . . , 623 subsistence of -...-.- «»;-,. vf 721, 741-742 superintendent — allowances of 7.30, 751 appointment of 631 duties of 615, 631-633, 2244 pay of ^2 surplus to be reported 674 tour of duty , 673 transfer of ,,^...5^,,>,>,,, ,.,...,,^..,,673-677,728 transportation and travel, expenses 761-762 treatment by specialist — - . ■.-.-.-,-,-.-.-.-.-..■.-.-.-.--.•.•.-.-.-.-.- .•.-?i,H*j-i-k;i-; "^^ uniform ,,......,.,,..,,,.....,,,,..,.,.., 771-774 Kursiug, instruction in ..,,,,,......,,,,,-,...... 1375 Oath: candidate's statement under -.1^5. .,inli0s»i,^"- ■'■ •-■--■ 1958 of allej^iance, recruits to take '- '--,- 2081 of office and acceptance .-.--.-.- > •,tb«»-.-k'i''-- ■ ■ ^ • • ^^" recruit makes statements under .,,.,,...,......,...... .,-.-,;v-r, 2081 to contract required ----- - - - 3309 Obedience to authority required 1729 orders required 1281 Obesity, rejection for • ■ 2061, 2079 Occupation of recruit, entered in health record ....-,,.,,...-,-,-.. 2241 OSenses, punishment for, in hospital ...,,.,,........ 1285 Office of Naval Intelligence, report to ......-.-.,, 2o60, 2655, 2661 Oflacer-s: always on duty in port l''^-* appointed by President with advice of Seiiate 1902 appointment of 1901-1997 assigned to laboratory work 131" baggage allowance, expeditionary force r 184" Coast Guard, pensions to - - - 3724 day off duty •.--.-.-.-.- .-x**- iv''--" - • 1^'^ death, report of ----■ — :-•!:•-:-->'.>!-- 2433 deck. (See Deck officer.) deductions from pay for naval hospital fund 3002, 3G0ti,3Q21, 3625, 3651 dental, forms part of surgeon's division ,,.,..,,., 331 hospital apprentice to assist ,.........,..-:.,- , 474 detached, entered in journal - 1 - 1^62 376 ' INDEX. Offlcer-s— Continued. • '" ' Paragraph. detailed for special duties - -■- - .-.•-•.•.•• . -•- -■'-•-■- - - 1352 disabled— wititled to medical attendance 1222 may go to Naval Home 1221 pensions for 3711 pensions for widows of 3712 discharge from hospital, report of 1221 division, first-aid instruction of 1813, 1821 entitled to remain in hospital 1221, 1222 examination for — appointment, health record of '. 2303 promotion, health record of *. .^.' - —'1 . ; ■: : : : . .■ 2303 retirement, health record of 2303, 2304 field, baggage allowance for 1847 first. {See Firtt officer.) first-aid, instruction to 909 funeral expenses of 2402,2405,3441,3454,3456-3460 health record— ''' '■ accompanies ■-■•-"- -• - -• 2301 custody of 2211 opened on appointment or promotion 2232 in charge of stores, death of 2953 medical. (See Medical olBcer)— attendance to families 913, 914 history sheets of health record of 2305 officer notifies of transfer « 2212 survey on 2903 militia— checkage for hospital fund 1268 in naval hospitals -' 1268 physical e.xamination of 1913, 1966, 2006, 2088 mounted, horse equipment for 1847 notify medical officer of detachment, promotion, etc 2302 of the day- ambulance book, entries in 1363 brigs visited by 1368 detail of 1333,1334,1353 duties of 1227, 1361-1369 fire drill 1369 Form F (rough), entries in 1363 health records supervised by i... ;..... 1363 inspection of hospital jll.'.'Vl..-. if;'.::'.'. 1361 journal kept by 1362 journal supervised by 1363 keeps journal 2314 liberty list ...i^i:i:..j 1366 master at arnw accompanies :..:.'...'...;....'..';...' 1368 meaLs insp«cte,;ii.h,' hook , 1 ,...,.,.,. , 1350 care of 1315, i350, 1450 furniture, requisitions for 3421 technique, iastruction in 1375 use of, after battle 1829 Operation-s: defects remediable by 1985, 208162 report of, Form P , 3922, 3946, 4121, 4131 surgical, necessity for -.-Js.w>j«»f - - 1287 Orders: book kept by — nurse 1467 ward oflBcer 1342 378 INDEX. Order-s— Continued. Paragraph, for— hospital ship I'll medical survey 3'JIO ward management 1457 home, nurses 697 medical attendance for officers proceeding imder 3343 obedience to, required 1281 sheet, standing 396^ shipping 3999 waiting- death while on 2435 health record of officer on i..;;;:;;:^;::'.!.:'.^ 2302 Organization, medical, for battle 1811, 1821-1832 expeditionary force 1841-1853 Origin of disease or injury, statement of 825 Outfits: athletic, provided for hospitals 1327 Hospital Corps, insi)€ction of 1326 medical. (See Medical outfit.) in icroscopical . ( See M icroscop ical . ) Outline figure card, preparation of 2101-2105 Outside foreman, hospital, report to executive surgeon 1542 Overcrowding to be avoided 2021 Ozena, rejection for 1961, 1981, 2079 Pacific coast, care of insane on 3141-316(5 Packages. i)asses to remove from hospital 1506 Packet, first-aid, contents of - .' 1002 Painter, hospital, reports to executive surgeon .......A 1542 Painting of hospital ship, to bo characteristic .': ...'...■....;'. . 1707 Palm, first-aid care of wounds of 1011 Panama, quarantine jurisdiction at 2735 Papers: . . accompanying patient to hospital .....l^.l; 823 of deceased, disposal of 241C Parades: •••• ambulance parties— — not massed in mmitti 1854 prepared for first-aid .^ 1854 posts of officers in ." ■ 18W swords to be worn by surgeons 184,'. Paralysis, rejection for tana.ii 2079, 2148 Parasites: intestmal, in mess attendants 2117 intestinal, rejection for 10^' .skin, rejection for • I;<«il,2(t7'.' Parasyphilitlc disease, method of entry 225(' Parents, coilscuI for enlistment of minors 2004, aO-V. Paresis, method of entering ..:.;;..... i-.^'.v.'.;.'.. 225si Passage, patients received for S56 Pass-es: book, supplied l>y Inu-eau 1'^" issued by executive siugoon of hospital 131 1 signed Ijy officer of t lie day 1361 Passed assistant surgeon: prolcssioniil (^xumination for promotion of ^ . . . .•.-. .i)l, 202 promotion of .■...•;.• 162 Pathological examinations by Naval Medical .School 3221 Pathologloal specimens when forwarded liy mail 3220 INDEX. • 379 Patient-s: ■ ^^""^'^fh:. admission of, regulations relating to ^^60 assignment to wards . ISOf. 27ir. 824 146C 1367 attendants alone available for service to 1231 bed, nvu-se responsible for condition of 1*^1 beds assigned to ^' 20 care and attention to ^'^2^ care of— by executive svugeon in quarantine civil hospital, procediu-e. confinement in brig convalescent, make own beds : l"2i daily routine - ' ' dealings with, prohibitions regarding 434, 970, 1260 dental, admission to sick list ■ ■ ^^^^ detailed for work in hospital - - • - ; 1313, 1507 discharge of, regulations about 1365, lo24, 152;> disinfection of clothing of l^l** entries in jotu^al concerning fit for duty, report of '''^]1*^ 1 990 9901 health records to accompany '^-^' ""^ hospital- apprentice not to play with '^"^ property returned by, on discharge 1^^' ,„„ , .f 1501-1528 rules for .^„, ticket to accompany in hospital— after sailing of ship (foreign) • 2201,2205 three months, to be surveyed 126;., 1286, 2948 insane — .„ , , 1316 care of health record of ^™ list of ■• • ^^ maintenance of "' medical ofllcer to accompany a 1 V money and valuables to be safeguarded 1330, 1*64, 1514 morning report of - - ■ ■ - ', naval, Red Cross and ■ - 36 not in line of duty entry, procedure -2^- not to enter Hospital Corps ' quarters l"''l ' ofB-cer- , 1306 care of of the day to receive m..-:.:--. .. , 1470 routme for . procedure on receipt of, in hospital '^'^^y f ",' quarterly abstract of. Form F 3922,3936,4121.4131 received for passage ' ' health records of recommended for medical survey ..-; — - "^^^ refusal to take medicine ■ - - ■ ;;;...- '' ... 4131 register of entries by officer of the day - • ' ^' report-s— ^^^ condition of , ,„_ J ., ... 146/ daily ......---... ^^^^ m0mmg,0f ....r. :;;::;. return to officer of the day....... -.-- .-.■.■.■.■.....■.■.•.•■.- to governor of Naval Home ■ 380 INDEX. Patient-s— Continned. Paragraph. roq\iired to wear uniform 1516 restricted to ward or hospital Helllon, commencement of 3714 applicants ^^ examined by medical ollioor 3758 arising from destruction of " Maine " 3 < 45 INDEX. 381 Pension-s-Continued. Paragraph, at— age of 62 ^^^^ hospitals, how paid - 3608,3026 auxiliary naval force beneficiaries, classification of ^'^■^ Bureau , information required for 2821 certificate, commanding officer to sign 3751 Coast Guard, officers and men 3/^24 correspondence with Pension Bureau 3759 date of death m " Jeanette " 3743 dependent relatives ^'42 disability bearing on 2250 fund. (See Fund, Navy Pension.) honorably discharged men. War of Rebellion 3733 joint board of survey for -. i ^910 laws administered by Commissioner of Pensions 2822 legislation, information regarding 3761-3797 limitation of 3728 line of duty status 3929 Medical Reserve Corps, for physical disability 3725 men in naval hospitals ^207 merchant marine service 3^37 Mexican War veterans 3715 militia, wounds incurred in service 3^26 minors — of disabled officers and seamen 3712 when entitled to 3741 navy, paid from navy pension fund 3704 officers disabled prior to Mar. 4, 1861 3711 paid— from navy pensionfund 3783 to naval hospital fund ^^^35 pensioner ia Naval Home, or naval hospital 3752, 3793, 3801-3806 persons entitled to - 3/21 rate- according to rank 3731 dependent on rank 3732 for specific disabilities 3734, 3/35 for total disability 3730 reenlistment of pensioner . -. : 3795 relation of ILae of duty to 2841-2852 report of death as evidence for 2409, 2431, 2817, 3755 service, to disabled after 10 years' service 3753 sick — furlough, status when on 3729 leave, statiis when on 3729 status of midshipmen 2836 veteran furlough, status when on 3729 widows — of officers and seamen disabled 3712 of those lost ia wreck of " Ashuelot " 3744 when entitled to 3741 Pensioners: biennial examination of ^^ hospitals, u3structions regarding 1531-1535, 3752, 3793, 3801-3806 Naval Home 1535,1633,3752,3793,3801-3800 Permanent appolntment-s: chief pharmacist's mate ^^2 hospital apprentice, first class ^^> 523 382 INDEX. Permission: Paragrapb. \o leave hospital, by executive surgeou 1310 to leave ship ■.•.•■■.■••.:•.•.:••: ^^ Personal memorandum for surgeon general ..,.>.,., ,^< 4121,4131 Personnel of surgeon's division ■ 870 Petioleum, use of, as insecticide 2781 Petty officers, probationary time in hospital 1264 Pbarmacist-s: acts as oflicer of the day 1294, 1333 appointment of r -yrn-i- fcnr?.')'' • ■ : r — •.'j 401, 442 bill book, instructions oonceming - • - .-•..-, -- -. 1385-1397 classification of - - 441 clerical work supervised by 1371, 1372 commissary department of hospital 1371, 1373 commissary ledger, instructions concerning 1411-1418 correspondence supervised by .- 1371 duties of -• ..■,.:„.... ^j^^,^yi-P c;w.., 443-445,1371-1425 examination for ; 504 instruction of Hospital Corps -. 1371, 1375 meals Inspected by — 1325 precedence of .-.-.- -.- - '• -H-r • vi-h : ---^H-f?-- • • • r • - - -- 441 promotion to chief pharmacist .;.,... 407, 501 property accoimting - - -. v ■■•,■■■ - 1374 ijualifications for 503 rank of 441 statement of cost of maintenance 1421-1425 vacancies filled from chief phiu-macist's mate 502 Pharmacist's mates, chief: appointment- acting -■ ,--•• -T 511,513 permanent oil, 452 enlistment as ■ • • ■ •'■ ■ 451 examination for promotion to 490,512,513,514,3964 instruction of Hospital Corps by - 455 marines not assigned as — ■ 453 of the day, duties of 1431-1435 permanent appointment 452 promotion to pharmacist W7 qualifications for - 511 rank and precedence 401,437 re ;ponsibllity for stores 454 stall potty olficer with brigade surgeon •. 1161 Pharmacist's mates, first class: appointment 464 duties 426 examination ''"'n 'i 520-521 pay ...:...'..,,.^..;. 403,406 promotion ■.'......;. . 512, 513, 521 ,3954 rank ami precedence .^^.^^^^..f, 401,403,461 Pharmacist's mates, second class: ajipointment ; r : 464 duties •- - • • • • • • • • 425 examina t ion ,y.^ , , ,, , |. 522 pay ..:...:...:::..:;;.:: : 403,406 promotion 520, 521 rank and pr^edence '. 401,403,461 Pharmacist's mates, third class: ,iI)pointment 464 .liilir", 426 INDEX. 383 Phaimacist's mates, third class— Continued. Paragraph. examination 523 pay 403,406 promotion 520, 522, 523 rank and precedence 401,403,461 Pharmacy, instraction in j,,^,.„, 1375 Phenol: crade, as insecticide 2781 diiinfection by 2753, 2705 Philadelphia Naval Hospital: patients report to governor of Naval Home 1214 Phimosis, rejection for 1981 Physical: ability, employees, rating of 2145-2155 defects- curable by operation 1985, 2081 entered in report of rejection 2081 found on reenlistment ..'....',.-.'----•-»•>.---' 2004 waiver of ^ ..... . 2029, 2052, 2064 disability- procedure upon linding 173 record made ou enlistment 2013, 2078 disqualifications for enlistment, list of 2079 efficiency, standard to be high , 1992 examination. {See Examination, physical.) exercise- examination for 908 periodical, health records ,.^j_, 2217, 2234 requirements for special ratings 2067 unfitness, professional examination not given when lound — . i925 Physiognomy of applicant for enlistment , 2068 Physiology, department of 938 Pioneers, reinlorcement of stretchermen from ^^.^ 1848 Pillows, disinfection of .-,....:....., j,,.j,.,.i^ 2767 Pilot, detention for quarantinable disease 2734 Place of: birth, entered on health record 2241 enlistment, entered on health record : jft-r -^ 2241 Plague : y, disinfection after 2763, 2781 quarantine for 2731 Plaster of Paris for rat destruction ^i^■,,.,,.^^^y.:^..f..■. 2781 Poisoning, lead, prevention of 2618 Poisons: caro of 1335 classification of 2361 dispensing of 1335 kept under lock and key 1463 Polypi: e.xamination for 2061 rejection for 1961, 1981, 2079 Port-s: arrival in, with quarantinable disease 2714 foreign, report to Oflfice of Naval Intelligence 2566, 2655, 2661 health of 2.516 to be reported 2632, 2655 infected — anchorage in 2523 health of, to be ascertained 2607 to be avoided 2606 384 INDEX. Port-s— Continued. Paragraph. officer always on duty when in 1734 quartermaster always on duty when in 1734 sanitar>- conditions of 813, 828,2562 West Indian, reports of epidemics in 2567 Postage, charged against "Pay, miscellaneous" 3400 Post-mortem examinations, performance of 2443 Posts of officers in parades, drills, etc 1854 Pouch, Hospital Corps, carried by hospital corpsman 1846, 1864 Powder division, Hospital Corps not a part of 423,870 Pratique : no communication with shore until granted 2713 obtaining of 2741 Precedence of: chief pharmacists 441 chief pharmacist's mates 401,437 hospital — apprentice, first and second class 401,461 corps 437 pharmacist 441 pharmacist's mates, first, second, and third class 401,461 Preliminary physical examination for Naval Academy 1984-1986 Preparation of food 851 Prescription book 9<«, 1366,3525 President, officers appointed by 1902 Prints. (See Finger prints.) Prison-s: duties of medical officer at 937 report on 898,2532,2597 sanitation of 2596 ships, duties of medical officers on 937 Prisoner-s: cells for 3653 discharged, transportation of 3611,3658 general court-martial, not sent to Las Animas .I'.'l'. i'.'l 1267 injuries in line of duty 2831 inspection of 854, 2672 medical survey of 2947 . physical examination of 2114 visited by officer of the day 1368 Probationary service 672 Proceedings, court-martial, medical certificate on 895 Professional examination: failure to pass 166 for promotion 164, 172 of assistant surgeon for promotion 191-193 of medical inspector for promotion 221 of passed assistant surgeon for promotion 201-202 of surgeon for promotion 211 Professor of mathematics, appointment of 1906 Promotion: candidates for — merit roll of 1944 statement by 1958 eligibility for .' 177 examinations lor 164, 165, 166 fitness for, onus ol establishment , 178 heal Ih record on .....t!.'....... 180 in Hospital Corps i:.!. ....:...!.: 429,463,486 report of 488 INDEX. 385 Promotion-Continued. "'"'■' ' P'aragraph. laws relating to ^^'Wf^ merit roll of candidates for of assistant surgeon, prolessional examination for 191-193 ^®Tr, . 320,34;^347 dental corps ' disability in line of duty '■ ■ "^^2 examination on foreign stations "^ ^ ,,, , 2232,2202,2303 health record ' ' hearing, requirements hearing, standard of Marine Corps, physical examination for ^^^ Navy, physical examination for notifies medical olficer physical disabiUty in line of duty |^ physical examination required ° physical qualification for duty at sea ^ procedure when rejected physically - ■- J°^ rejected for, to be retired ■ 'Ig" teeth requirements ■ i 959 19^ visual acuity required ; ' wounds in line of duty • of hospital apprentice, first class " of passed assistant surgeon of pharmacist ' " ' ' professional examination of— 191-193 assistant surgeon for " medical inspector for - 201-202 passed assistant surgeon for surgeon for " suspension from . to cliief pharmacist 512-514 to chief pharmacist's mate . to hospital apprentice, first class • '^^ ^^ to pharmacist ' Property. (Se. Stores, Supplies.) 3504,3521-3525 accountability 1467 cards, kept by ward nurse hospitals gg^j instructions relating to . , .. , lo74 accountmg in hospitals book, kept by— -^^ '^"^®-" ' 1342,1346 ward officer breakage of, reported by nurse dental— jq27 '^^'^'^[■y- ;::;:;;;'34o,io28 requisitions for ' responsibility for returns of 965 1027 expended, accountability for expenditure of, in hospital hospital- 3gj3 proceeds of sale of returned on discharge ^qoo ' ^935 Um 4131 inventory of, Forms D and Da 3922,3935,4121,4131 of patient in brig, care of 98601°— 17 ^25 386 INDEX. Property-Continued. Paragraph. private, removal from captured vessel 4217,4310 returns of "^^'^ from slaps 1144,3524 survevs of ^^^^ forms for ■ 3922,3934,4121 in hospitals ■ ^^^^ upkeep of, in hospitals *^^^ Prophylaxis. {See Tj-phoid and venereal . ) Proposals, advertisement for ^302 Proprietary articles to be avoided - • •■ ^379 Prosthetic procedures, not duty of dental ofRcer ..^ 1033 Provisions: extra on open purchase ■ - 861 for crew, inspection of : • - "^^O- ^^> 25''*> 25"0 for hospital, inspection of ■ 1^®*> 2582 inspection of, entered in journal ..,^.,..,. .,r-p- ,(>- '-'- :-T-.r.v :-. ^'^^ Nav^-, appropriation for • ...,i-._.,,.i^..f, „-.- '21 Psychopathic wards, care of ^'^^^ Public bill-s: afloat 3401-3403 approval of ' 3^- disposition of • ^-^ entered in bill book •• — --• 1392.1403 foreign stations • - • - • • • • ^^^ for funeral expenses ■ - -u i^vr -rirr -^ ■'••■• Forms 5 and 5a, 6 and 6a -;.t:- -^j- r-.-i- ^'^^ instructions concemmg - - ■ • - - -. - — -.r ' ■ ■ • oo< i •> i-- medical attendance '■rt-'-:-r.;r- ^^^ ....; .........;.. 3331 3365 prepared without delay, recruiting duty 2707 24 PubUc biU-s: special exigency— to bo avoided "^^^ use of ^^^ Public Health Service: admission to Army and Navy Hospital • • • - -, ^*^^ diseases considered quarantinablc by •-•?-■• ^^^ dismfccting stations of ^^^ ([uarantine duties of PubUc works: estimate for appropriations for - • • • •.■.■.•.>t-*ftr''"*' report of, from hospitals '•^' Punishment: for offenses in hospital 1277, 12«5, 1363 of dental ofTicers .,,.^., 1022 Purchase: of mclical stores .■-••, «)u, joo of naval hospital ••■"*.■,■■.•.■■ of naval supplies "^ without advertising • • ••.•.•.••.•.■.■ ' ■ -.Ui't' *'■ ' ^^ Pyrethrum, disinfection by • - • • • ,T i - -r^ Qualiflcatlons of pharmacists .•••,;.•••? firrr Quallflcation report of hospital corps candidates for promotion 39*4 Quarantinable diseases: arrivalin i>ort will' .••.•.••.•.•■•■••. '„ caro of patients with • • ■ • • • • • • • ' • •• '.* ' ".'Af " '' flag when at sea with ••••• 0-31 ',-3!^ l^-: '• :.::. '^ report of INDEX. 387 Quarantine : Paragraph. boarding of vessels subject to iJll'W}?: 2717 camp 2621 ' duties of Tublic Health Service 2707 expenses ..-. ii." 73,2741,2744 flag, hoisted while at sea 2710 inspection, vessels of Navy subject to - 2732 instructions relating to 2711-2722 jurisdiction at Colon and Panama 2735 laws relating to - 2701-2708 regulations to be observed 2711 Quartering of troops, exemption from 4206 Quarters: for Red Cross peisonnel , 4360 furniture, appropriation for 1397 general. {See General quarters.) hospital- apprentice, assigimient of 14^1 corps, patients not to enter 1517 corps, supervision of 1431 medical officer notified of disease in 2592 nurses 751-753 commutation of 618, 7.53 furniture supplied by bureau 752 Government property in 1445 linen supplied by bureau 752 rent of ■ 721 oflicer-s — disbursement for 74 of the day's 1361 rental of, charge against "Pay of the Navy" 3400 Quartermaster: always on duty in port 1734 regimental, transportation provided by 1850 Rank: examination for, instead of grade -■• 169 of— chiefs of bureaus 6 chiefs of bureaus, retired - 7 chief pharmacists ■, 441 Dental Corps officers 322 hospital apprentice, first and second class 461 medical officer 102 ; when retired 103, 104, 165 ; Medical Reserve Corps officers 231 noted on admission report 1467 officer retired for physical disability 1909, 1941 pharmacist -14) when examination is delayed 161 pension rate according to 37.30, 3732 relative, in the Navy 3731 Rating-s: abbreviations for 2241 change of, in Hospital Corps, report -187 entered on- descriptive list 2103 health record - 2241 noted on admission report 1-167 of applicant for appoint ment as laborer 2145-2154 special, physique of applicant for 2067 388 INDEX. Ration-s: Paragraph. allowance of, to Naval Hospital 3^^^' '^^'^ commutation of, at Army and Navy Hospital ^615 deduction from pay of persons in hospil al for 3622 memoranda for commissary ledger 3965 notice — admission. Form S 1276, 3013, 3*22,3948, 4131 discharge. Form T 1276,3013,3*22,3949,4131 Nurse Corps 741,742,1615 report on -""^^ value of. 3652 Kats, destruction of 2763,2781 Keading, lights supplied for 2540 Readmission, abbreviation used for - - 22»4 Rebellioa, War of, pensions of honorably discharged men ii...-:..i. 3.33 Keceipt-s: and e.xpenditure voucher 3966 for antito.xins, sera, etc 3563 for medical stores 868, 3£01,3513^3515, 3519 instructions regarding 3511 of stores entered in journal 2318 Beceiving ship: domicile between enlistments ^^33 personal memorandum for Surgeon General 4121 reexamination of recruits on 2030 requisitions from ^'' 3^31, 3541 Kecommendations. sanitary, to commanding oflicer 2563 Becord-s: accuracy of -. -"^ burial 4131 cemetery, supervision of ^319 degree of disability to be stated in 3761 denial— in health record 2267-2271 treatments ■. I(r26, 103^1037 enlistment, medical oflicer makes entries on 2059,2077 finger print, instructions concerning 2091-2096 gunnery, vision examination entered on 2111 health. (Sec Health record.) identification, to be prepared 2093-2096 medical*, of expeditionary force 1*^ l''>54 neatness of bureaus, custody of * dental treatment in health record ^^^i 3922 e.xammations _ ^ inspect ion of provisions and supplies ^284 persons dying in naval service 2431 physical disability to be made on enlistment •....».'. 2013 proceedings of board of inquest • • • ■' 2424 treatment, dental olhcer to keep ^ "^^"^ physical txaminatiou, for monthly physical exorcise 2217,2234 86rvicc~~~ entries in 948,2017,2028,2077,2081.2096,2992 of Hospital ( orps *" Vro waivers entered on sick, of nurses, kept by chief nurse ^**^ vorificaiion of, on going into oommLsslou .■.■if4Vi..'j:..i'j......... 842 Recorder, sick-bay, liospil;d apprentice detailed as ;...:..•.: 4'3 INDEl. 389 Paragraph. 3132 Recovery of insane person, procedure ^^27 Recreation time to bo provided Kecniit-s: 933,941-932,2011/2088 examination of 2081 oath of allegiance taken hy ' ' ' " ' g^ reexamination of 2081 statement under oath 2024 surveyed, medical officer responsible for ^^^ 2033 typhoid prophylaxis to 951, 2031, 2032', 2086 vaccination of 1278 Recruiting duty, hospitals 33^5 recruiting duty, medical attendance for men on Recruiting station: 922 duties of medical officer at ! '2051,3922,3951,4121,4131 Form X prepared at ' 2075 Red blindness, detection of Red Cross (see Aid societies): 433I authority for cooperation v/ith Navy 1807 cooperation in war flag— 1868 brigade hospital designated by ^g^^ displayed by sanitary formations ^gg, dressing station designated by gg^ hospital boat to carry _ _ 2502 part of sanitary service of naval forces .'.'.!";... 4341-4360 regulations relating to Reenlistment: 2054 Army service not counted as 2015 authorized if physically qualified - ^oie 2064 continuous-service man , physical disqualifications for ■■•-■•• ^^^^'^ ^^ health records, procedure with ' ' " ' ' ' ggg^ Marine Corps service counted as 2019 Marines with physical disability 2054 Navy service counted as 3795 pensioner, procedure 2064 physical defects found on ' ' ' ' ' 20S7 typhoid prophylactic required 20S6 vaccination required 2064 waiver recommended *■ " 131 132 Reenrollment in Naval Reserve Force Refuse : 2621 disposal of I735 regulations concerning Regimental: 1862,1864 aid stations Ig63 ambulance party in engagement jg^2 commander selects regimental surgeon ^g^^ quartermaster, transportation provided by 1854 stafl, post of, in parades, etc surgeon— 1843 duties of 1854 post of, in parades, etc jg^^ Segiment, naval, organization of Register of: 1445 nurses, chief nurse to keep ; ^j31 patients 1363 entries by officer of day 390 INDEX. Registration: Paragraph. i>y ned Cross, application for • ^^'' of imrses required 643 Regulation-s: for government of hospitals 1239, 1282 harbor, hospital ship I o observe -..,.... 2585 hyf;ionic, sliips ' - 891 qiianintine, to be observed 2711 Reinforcement of stretchermen, during engagement 1848 Rejection: iipplicant— for employment, causes for 2124,2154 for enlistment, causes for l^>i 1,2001,2079 roport— ' instructions concerning .-.-.-.- 2081 waivers requested in 2064 Relatives, dependent, pensions for 3742 Relief of wounded _: 818 Religion, entered on: a'Jtnission report l-***" hc;ilth record 2241 Religious stafl of captured vessel: . i : •• continue duties ^1^ neutrality of 4217,4278,4310 Remains: care in preparation of 3450 diiinlerring, exjwnses of 3437, 3443 expenses of transportation 2405, 3400, 3433-343.5, 3i37,344&-3400 request for shipment of 3455 transportation of, appropriation for 72 Removal of Nurse Corps .^,(.,._.Hf,.-.,iiJr; •'—- '^^^ Rendezvous, reexamination of recruits from — 950 Rent, quarters: charge against " Pay of the Navy ... 3400 Nurse Corps .•••'r-OTm^' ^^^ Repairs, urgent, for sanitary reasons — • • -.r"*-- ^^* Report-s: admission- made by nurse ,■ l**^' of officer as patient 4131 or retention of supernumeraries 4131 aimual *^^^ recommendations on special subjects • 41^4 Wanks necessary for .•.•.•.•.•.: y *^^' brigs : 898 cases of tuberculosis .•-- 4002 casualties In action — .-•'■•::••• ^^l^ changes in nospltal Corps 3053,4121 concealed diseases ^ ^*' concerning nurses <01-70S condition of insane in St. Elizabeths Ilospltal. 3131 conduct 3983 accompanies patient to hospital .••-• 3006 supervised by ofTicor of the day ••.-.If ^"*'''' confliiomcnt spaces 89S contagions diseases ' 828. 2513, 2tl32, 4002 death .• ■ :::....:.....::: S25,ii4i.39i2 evidence for claim for pension . 2M . , 3/ 55 KormN 3923,3944,4121,4131 14G7 4131 INDEX. 391 Report-s-Continued. Paragraph. death — T"''"' ""f. of msaue preparation of 2401-2443 ifental — on Form K ' 2388 operations, Form K ^^22 worlc, statistical - ^"'^ ' disability in absence of medical officer 2215 discharge- made by nurse of officer as patient disease— among personnel ^^^' 2*^2 contagious, on ship 250 epideL.. - 828,1147 infectious, on ship ■"^ in fleet by commander in chief 2513 division surgeon to division commander duplicates to be noted ■ ^ ^ efflciencv, Hospital Corps 491,1153,1288,3903,4121,4131 epidemic 4121,4131 in West Indian ports 2567 examination- hospital apprentice, first class ■**" Hospital corps.... '""'"'^''tZ executive officer's,after battle ;; -179:3981, 131 fitness ' fleetsurgeon, approval of foreign naval medical establishments 2654 from division surgeon - fleet surgeon hospitals, list of hospital ships, list of ' .• ■ medical officer afloat ^2 from medical officer in command of hospital ship i '«l navy yards, list of • stations, list of _ " " ^ funeral expenses 2407, 4131 general sanitary „.• , , , , , . 2032, 2650 health of port ' Hospital Corps, movements of ■ }°t illness considered to be typhoid 2612 infectious or contagious diseases on ship ... , 2171,2175 injury to employee , .. , 4111 hospital ^^ j^ hospital ship ■ medical department of ships hiq',;,, isnR killed and wounded ■ ;;;„"" ^ ;':;!' 1,^ ...... 1805,3922,3941,4111,4121 m battle ' iiro laboratory examinations "I* , . . 816 malmgermg Medical Department, instructions regarding ocq- medical officer of prison ; " ' Wicalsurvev 1142,2903,2931-2937,3910,3922,3943,4121,4131 ^loninHnPt 1242, 1305, 2818, 2820 3915, 3922, 3972, 4121, 4131 misconduct 3967,4121,4131 raommg, of patients 392 INDEX. Report-s— Continued. Paragraph. mortiiarj', preparation of 2440 night, in hospital 13&4 nurse- confidential illness of p. , 70C corp>s, efTjciency <131 illness of 711 ^ ofBcer's— after battle 1S15 discharged from hospital 1221 discharged to Naval Home 1221 required to submit 4107 transferred to hospitals 1221 official, submitted by nurses 1444 operations, Form P 3922, 3946, 4121 , 4131 patients- condition of 1284 daily 1467 in civil hospitals 824 morning 3967, 4i2l, 4131 prisons 898, 2532 public works, from hospital 12D1 quarantinable disease 2733 reduced to requirements of service 4103 rejection- instructions concerning 20S5 waiver requested on 2064 returnable through fleet surgeon 1141-1154 sanitary 814, 867, 1138, 2W1-2655 annual, from hospitals 2635, 2651, 4131 condition of buildings 2591 condition of fleet, by commander in chief 2514 condition of port 2562 entered in journal 2318 fleet surgeon 2633 hospitals ■ - 1259 inspection of ships ..^i,...,,^ .,.,.[,,^..j^.,„..^ 4111 monthly, from stations .., 2631,2652,4131 ships 867,1138,1146,2632,2653,4121 shore stations 969 yearly, from hospitals 2584 yearly, from ships 2574 yearly, from stations ....,..,. 2503, 2634, 2652, 4131 ( sick— , ,( daily 847, 933, 9(>1, 3908 morning 13 18, 4121, 4131 statistical : 1149, 1256, 2371-2391 , 3909, 3922,3940,4121, 4131 weekly 1145. 1238, 3907, 3922,3939, 4131 submitted by fleet surgeon to commander in chief 1140 subsistence of Ilospital Corps ^,..v,.,.... 39f>4,4131 termination of disability 2175 to Office of Naval Intelligence 2;V.i;. 2(;55, 2ail to officer of the day rr: ■* • — ^^^ transfer with venereal di??i?c< ... 2110 use of— harbor water on uci V'02 intoxicants or drugs •.-.••- •-• .•.-.•.•.■.•.•;;: ■.■-.•, ^^ venereal prophylaxis 1150 witnesses of accidents 3816,3756 INDEX. 393 Report-s— Continued. Paragraph, work — done in laboratory 1351 done in special wards 1349 Reporting for duty entered in journal 1362 Request-s: or— blank forms, Form O 3922,3945,4121,4131 books and blanks 3991,4131 leave of absence, blank for 3982 medical survey. Form L 2921-2925,3922,3942,4121,4131 shipment of remains - 3455 transfer of labor 3994,4131 olBcial, submitted by nurses 1444 telephone, for extension of leave 1503 Reqnlsition-s: articles not on supply table 3553 bidders named on 3378 . copies to be filed 3376 cost entered on 3378 disposition of 3333 • emergency i 3393 entered in— bill book 1385 journal 2318 or— bacteriological supplies 3556 dental property and supplies 340, 1028, 1039 medical stores 859,3532,3901 microscopes and microscopical supplies 3555 miscellaneous expenses, hospitals 3382 miscellaneous supplies 3421 , 3422 proprietary articles, to be avoided 3379 transportation of medical supplies 1850 Form— B 3922, 3931, 4121, 4131 Ba 3922, 3932 1 3922, 4131 2 392 4 3933, 4121, 4131 from— fleet siu-geon ; 1132 hospitals 1314, 3531, 3541 receiving ships 3531, 3541 ships 3396, 3531, 3541, 3548, 3554 ships at navy yards 3324, 3327, 3548 stations ...:...,. ..^. 3396,3531,3541 yards ■ ....'J^^^f^.,....., 3531,3541 instructions relating to ,. . ..^.. ,. j.^,. ..^ ..,, -,.' " " ' ' 3541-3548 making of ...,,..^ ....,- 3375-3383 on— , naval medical supply depots 3395, 3411-3414 * . other departments of ship 3323 pay officer 3543 open-purchase - 1416 limited to $500 3373 on ships ■ ; 3325, 3326 on shore ■•;<■<"■)!;"• V ' ^^^^ shipped, summary of - 4131 .'^94 INDEX. Requisltion-s— Continued. Paragraph. small stores, preparation of 1527 special, Form Ba ----.. R59, 3922, 3932, 4131 standard specifications used - - - -r - -.- ■■■■ 3377 .,tx,b .'.-..'.' 338.5,3993,4131 Rescue breathing apparatus 1821 Rescue of civilians 2^*46 Reserve : hospital, base hospital acts as - - - 1869 nurses 601,621,781-784 ships in. (See Ships in reserve.) Reserve. (See Naval Reserve Force.) Responsibility (or: loss of stores ■'■->! Yo' h'' ^^' value of surgical instruments 3906 Kesuscltatlon of apparently drowned 1012, 1821 Retainer pay for Naval Reserve Force 131 Retired : enlisted men. Marine Corps, in hospital 1534 list, rank of— chiefs of bureaus " . medical olHcers : l^i 1^^' oihcers and men- death report of 2437 health records for 2246 Retirement: ' • . j, ' medical officer notified of r 2302 ofTicer- examination for, health record 230:J, 2304 physically disqualified 1^^ rejected for promotion 1909,1912,1941 relation to line of dut y 2802 Returns : fleet surgeon's approval of H-^ hospital, supervised by executive surgeon 1314 medical department, iastructioas regarding 4101-4131 monthly, of nurses '^l-^l of- contract, filed in returas office • 3312 contract, i)enalt y for omitting ::..>;:.;:....;...:... 3310 dental property 3*^ medical stores, Form V 3922,3950,4131 nurses '01-703 property 3902 property from ships 1144,3524 periodical, how authorized *102 reduced to requirements of service 'l^'-' ships separated from commander in chief ' I''*'' revenue cutter service. (Sec Coast Guard.) Revenue Cutter Service. (See Coast O uard. ) RovlowluK officer, post of, in parades, etc ^"^ Reviews: ambiilance i)arlies not massed In l'*54 posts of ofTlcers in ^^^ Rheumatism, rejection for ■^'^ Rictets, rejection for ..■.......;..'.■.... -J"' •' Rlnes, relaxed Inguinal, not cause for rejection '-*''*' Roaches, fle^lructlon of :..:.:. 2781 INDEX. 395 SoU: Paragraph. bedding and clothing, expeditionary force .......: 1847 merit, of candidates forwarded to bureati 1944 pay. {See Pay roll.) Room, operating, care of .-..-,--, 1315, 1350, 14.50 Routine: daily— of ward 1470 sick oflRcers' 1491 modification of 2520 Rubber, disinfection of 2769 Rules for: guidance of attendants 1343 patients in hospital :- 1501-1528 Safe, money and valuables placed in - — - - - ; - - — 1514 Sailors, honorably discharged, preference of 2150 St. Elizabeths Hospital, for insane 3102, 3109, 3111, 3130, admission to 3121-3122,3123,3129,3124,3137 death in 2438,3136 laws relatmg to - 3101-3111 medical certificate for 4001 papers required for admission 3137 Sale of : hospital property, proceeds of 3013 stores to nurses 732 Salutes by staff 1854(d) Salvarsan, evidences of administration of 2061 Sanitarium Co., Portland, Oreg ^ 3164 Sanitary : base. Red Cross service at 4352 condition-s — . boat trips dependent on 2535 liberty dependent on 2535 of ports 813,828,2562 of ships 891 data for report to Office of Naval Intelligence 2566, 2655, 2661 directions for camp 2621 duties of— commander in chief 2511-2525 commanding officer - • ■ ■ ■ 2.531-2546 fleet surgeon 2551 Medical Department 2501 medical officer of hospital '."A-it.i.-in.-.x'.^.i.'i : J^^ *. 2581-2584 medical officer of hospital ship - - - 2581-2586 medical officer of ship 2.561-2578, 2601-2618 formation- display Red Cross flag 1845 neutrality of 4240 protection of 4237-4239 inspection— by fleet surgeon 1133 of ships, report of 4111 personnel directed by brigade surgeon 1842 precautions in unhealthy stations 2515 recommendations to commanding officer 2563 report -s. (See Report, sanitary.) service— emblem-s for 4249-4254 Red Cross a part of 2502 suggestions 814 396 INDEX. Sanitation: Paragraph. field , medical department duties in 1861 instruction in 1375 of marine barracks 2594 of prisoners 2596 Saicocele, rejection for 1961, 1981, 2079 Savage enemy, ambulance party armed against 1845 Scalds, dressings for in battle stations 1821 Scales, not provided. {Sec 2096 note ad finem. ) Scalp wounds, first-aid care of 1010 Scar-s: entered in descriptive list 5103, 2104 examination for 2061 vaccination, character of 2086 Schedule of bills of lading 3996 School-s: for Dental Corps, under control of bureau .'j^.'i'.lVL .•'.'. 1 921 Naval Medical — assignments to 3216, 3217 attendance of Medical Reserve Corps 259-261 bacteriological examinations by 3221 bacteriological supplies from 3228,3556 chemical examinations by 3223 duties of faculty 3212, 3213 duties of medical officer in command 3211 duty status of students 3219 establishment of 3201 examinations -. . . ; 3214 instruction by correspondence 3230 library regulations 3220 mailing cases supplied by 3227 Medical Reserve Corps ordered to 3215 microscopical outfit ;'...':;•.:■.' 3204, 3555 name of 3202 pathological examinations by .-. .-.■.■. 3221 , 3224 specimens collected for .• ■ L'.'.'. . .'I'l'; 3221-3227 subjects taught 3218 super\ision of 3203 Wassermann reactions by 3224 Screening of camps '. 2621 Scuttle butt, care of 2617 Sea duty: candidates to be able to perform 1959 exemption from 5 physical qualifications for 1910 Seamen: deduction from pay for naval hospital fund 3602, 3621 , 3651 disabled- pensions for 371 1 pensions for widows of 371 2 Secretary of: Tronsury, estimates to be made by 27 War, Army and Navy Uospital, Hot Springs, Ark., under direction of . . . 1611 Beedi, charpod against "Contingent, M. & S." 3400 Senate, officers appointed by advice and consent of 1902 Senior medical ofilcer: njiliroves entries in health records 2249 responsible for health records J'.'^ . . .'.'. 224S Sentry duty, defects effect intorforing with .". "..' 2069 INDEX. 397 Paragraph. .„ 1981,2079 S«ptam, nasal, deviation of ■ • ■ • Sera: 1392 appropriation for g-gg obtained from bureau Service-s: ambulance — _ j240 for injured civil employees '^i'^^i'il'^''m^ 1261 performed by Hospital Corps ' ' Army— 2054 not counted as reenlistment 20g5 statement under oath concerning 3371-3378 contracts for IO32 dental, persons entitled to ^ ^328 divine, at hospitals V,nsio?\:^l oS ■ou c 3393, 3394 emergency requisitions for 1841-1869 expeditionary, landing force for 1323 funeral, at hospitals ' " ' ' ggg in emergency 3301-3313 laws relating to procurement of 2054 Marine Corps, coimted as reenlistment merchant marine — 3737 liable to draft .....*., 3737 pensions for 2085 miUtarj', statement under oath concerning Naval Auxiliary— _ 3C,25 deductions for naval hospital fund ' ^245 health records for '"" 2059 medical officer to examine " ' ' ''■ ^^^2 officers and men absent ^^^2 pay when absent 3qj2 pay while sick 3011 persoimel in hospitals ggj2 venereal disease Kavy— ___ 2054 counted as reenlistment • 2085 statement under oath conccrmng 2121-2176 nav>' yard, physical examination for .:.............. 336 of Dental Corps ";,)'-.... 713 of specialist for nurse ". . , ' pension after— 3753 ten years m 3754 twenty years in 12(54 probationary, tune spent in hospital PubUc Health. {See Pubhc Health.) records. {See Records, Service.) 332^ requisitions, smps at navy yards '" 2502 sanitary, Red Cross part of 2^55 special, enlistment for, not allowed ^231 to patients, attendants only available for ^^^ Shears, bandage, Hospital Corps to carry SheU-wound dressings: 1002,1003 contents of I821 instruction in use of Ship-s: atnavyyards— 859,3324,3327,3548 requisitions from ggO suppUes for S91 board for inspection and survey of 398 INDEX. Shlp-s— Continued. Paragraph. cleanliness of j .v. ,-,-. • 2968 medical— ofBcer, duties of 2501-2578,2632 outfit for 3-322, 3552 merchant, neutrality when carrying wounded 4220 on detached service, requisitions from 859 permission to leave ..;.... 884 receiving. (See Receiving ship.) report— from medical officer of 4121 of inspection of Medical Department 4111 of sanitarj' inspection of 4111 requisitions for supplies 3531, 3541, 3548, 3.j54 returns of propKirty from 1144,3.'>24 sailing of, patients left in hospital 1235 sanitary condition of 891 report 1 138, 1 140, 2(32, 2C53 temperature of 2542 ventilation of. .• 2542,2002 Shipments, hospital ship, regulations for 1"27 Shipping articles 2081 Shipping order ^999 Shore: stations — duties of junior medical oihccr 1*19 duties of medical officer 911,931-938 sanitary report : 909 water, examination of ,, 2569 Sick: iKiy- mcdical ollicer in charge of .&..>:<>>.. t>44 recorder, hospital apprentice detailed as 473 call— absentees reported I-IOO hospitals < 1348,136^ care of, In field -.'.<. 1801 charges for tran.sportation of 73 condemned by survey, sending home 2911 cvacuutlou of 1M2, 1849, 1801 INDEX. ^^^ Paragraph. Sick— Continued. 2944,3010 expenses of transportation to hospital 3729 furlough, pension status when on ;•■::■•■":"■ ' ' ' ' * g^ Hospital Corps attention to • ' .............!... 2565 inspection of food for leave— 2909 board of survey required 2266 health record forwarded to bureau ■ : - ■ : 3729 pension status when ou list— 1034 dental patients admitted to ::•--:::••:• 2252 venereal diseases must be admitted to ."'... 1491 oflacers, hospital routine for ^445 records of nurses kept by chief nurse ' ' j^gn removal to hospital when recommended reports of— 817,872,933,904,3908 daily " ' 1348,4121,4131 "l<"™»^g 1149, 1256,3909,3922,3940,4121,4131 :'.,,, ,0 sta-tistical ■••■• 1145,1238,3907,3922,3939,4131 ;' ■ weekly ■■ ■■"■ 1281 responsibility for care and treatment of sent home in— 3007 chartered ship ........ 3008 pubUc vessels if practicable ......--- [..... . 860 stores for .....--.-.. 3001-30II transfer of, instructions regarding ^^^ transportation of, on distant service • - ^^ transports for, to be examined ' " ' ^.^q- wards respected in fight on warship Sickness: 821 certificate of ....-■■- ^^^ of nurse, report of ' " 3352,3368 officers to report 17^ Signals, used on hospital ship ■ ^723 Signaling, instructions in ^g^g Signalmen, reinforcement of stretchermen from 2769 Silks, disinfection of Sites: 2621 for camp, selection of ^^lOii, 3012, 3659 hospital, authorized by Congress Skin diseases: 2061 examination for 1901, 1981, 2079 rejection for ig^il^ 2079 Skull, deformity of, rejection for 3^^ Slip, transfer and discharge Smallpox (see vaccination): ^^^ 2061 examination for evidences of - -.•.-.;■•. ■.-.■.-.-.■.■:■." ■ : : r"'"' '•='■' ] '^'"'" ''*'''■ ^344 landing force protected against -—^--'ii-'!!- ?--■**-■ -■■■■".•'--••• ^g^j precautions against - 2612 protection from, by vaxicination 2731 quarantine for 1 527 Small-store requisitions, preparation of Smoking: ,,,-i. s, ^-^^ in bed, prohibited . . . ^ ^ ! 1508 places designated for ^ ^733 regulation^, hospital ship J3g2 rooms, inspection of 2781 Sodium fluorid, use as insecticide 21.50 Soldiers, honorably discharged, preference of 400 INDEX. Spaces: Paragraph. confinement, report of 898 living, inspections of 855 Special: diet— from wardroonj mess 3422 list 3913, 3961 list, revised daily 1233 sheets, inspection of 1325, 1344 duty- death while on 2435 ofi&cers detailed lor 1352 physical examination for 21I1-211G quarters for nurses on 751 staflofflecton '..' I'l .''.■.".'!'... J 1121,1122 exigency public bill- to be avoided 3393 use of 3394 forms used in hospitals 4001,4002 nurses, employment of 623 ratings, physique of applicants for 2067 service, enlistment for, not allowed 2055 Specialist: t reatment by 3354 treatment of nurse by 713 Specifications, Navy standard to be used 3377 Specimens for Naval Medical School 3221-3227, 3229 Speech, Impediment of, rejection for 19G1, 1981, 2062, 2079 Spine, curvature of: entered on report of rejection 2081 examination lor 2061 rejection for 1961, 1981, 2079 Spirits, distilled: custody of 827 in medical stores 801 Spit kids, dismfection of 2753 Splints, application of 1864 Sputum: disinfection of 2753 disposal of 2615 Staff: of commander in chief 1111 composition of lUl correspondence and requisitions 1131 battalion, post of, in parades, etc 1851 division, duties of 1172 officers, exempt from sea duty 6 petty officer with brigade surgeon 1161 regimental, post of, in parades, etc 1854 reviewing officer, post of, in parades, etc 1854 salutes l)y 1854 Stains, blood, procured from Naval Medical School 3228,3556 Stamps, diargcd against "Pay, miscellaneous" . 3400 Standing-order sheet 3968 Statement: of cost of maintenance, hospital 1421-1425,4131 shall accompany estimates 28 station: aid — battalion sui'geon to establish INDEX. 401 Paragraph. 1844 1866 temporary "- 1824,1827 battle dressing -■- ^^^ brigade dressing, location of ^^^ changes of, nurse ^^^ chaplain's, in battle dressing— ^^g_ designation of „ fi«id :;:: ^^ temporary...... 91 1; 912, 919,931-938 duties of medical officer at "^'""^ ' ' foreign— ^^^ ^g^g examinations ou ' public bills .......-.■- ^^^ journal kept by medical officer— at quarters ----- ---• ■ ^^^ during battle - ■""■■■•"^-^^]^r.::':::^i-2m7 duties of nurse not to be called from - pay divMon in battle .■.".■'igea.lSM regimental aid reports and returns from ■ • • requisitions from ' sanitary report- ^.^ '"°°*"y 2634,2652 yearly supervision of hygiene of . _ surgeon's division at quarters : . . unhealthful , sanitary precautions ou Stationery, appropriation for 2591 S69 2515 1397 1982 2371-2391 Stature, candidates for Naval Academy Statistical report of sick, preparation of ^^^^ Statistics, vital of Navy ;■. ^ Z 2751 ,' 2767,' 2771, 2772 Steam, disinfection by "" ' ' '^^^^ Sterilization of mess gear ' '^ Stsrilizers for dressing stations ^^^ Sterilizing apparatus, care of ■■":■"■" „„, Stigmata of degeneration, examination for ''^ Stimulants: ^ Hospital Corps to admhaister intemperance in use of, rejection for ■ ; ',' _ Stores (see Property; Supplies): ,u.„ !.,.::» 43, accounting of, before discharge - • • - •• • destruction of, necessitates survey ^^^' ^ hospital, record of inflammable, care of -' inspection of, entered in journal ■■■ - loss of, necessitates survey ^^^^' medical. (See Medical stores.) receipt of, entered in journal I^a I-4 responsibility of Hospital Corps for care of ':^, return of, Form V • 392-2, 3950, 4131 SlSf".™. - - - - ^^ ^ - ' ^ - - - • - - ^ ■ ■■ • - • ■ - - ■ • 865,'3502,"36n,'35i6, 3519, 3520, 3903, 3905, 4121, 4131 98601°- 17 20 402 INDEX. storerooms: Paragraph. inspection of 856 medical, precautions regarding -i^inrja w.-it,-«J»i,aAi • • 826 Stoves, allowance of, Nurse Corps vh^ioq ffld) • • 751 Stragglers, health records of 2291 Stretcher, splint, requisitions for ,,,.. 3421 Stretchenuen: brassards worn by ;..•,.;, n.^j,-,. 1846 detail of, to be permaneut 1845 duties during battle 1822 instruction of ....................... 1821 litters for „,,..,,,....,,,,,,.,.., 1846,1854 parade formation u^t^tHia-i-u!' 1854 reinforcement of, during engagement , 1848 Stricture, candidate rejected for ,.......,. „i,.. . . 1901,1981,2079 Stub requisition form 3<)93,41.H1 Stuttering, rejection for l . 2079 Submersion, classification of 2336 Subscriptions, entry in billljook ,..._..... 1402 Subsistence : employees in hospitals 3t)l4, 3657 militia in hospitals ....^.. ,.......,..,._.,......,..,... fus^ilK-iiHO 1268 Nurse Corps ,.. 721, 741 report, Hospital Corps 3964,4131 stores, sale of, to nurses 732 Sugar, urine of candidates test ed for 1955, 1993 Suicide, injuries by 2335 Sulphur dioxld, disinfection by 2752,2761-2768,2781 Summary: court-martial, indorsements on record 829 court-martials, ordered at naval hospitals .---.■■- 1277 of requisitions shipped 4131 Sun, exposure to, to be avoided 254i), 2609, 2621 Sunday, inspections and musters must not 1)e hold on , 1285 Sunlight, disinfection by -.- r .-.-*o .ioj^cm)- 2751 Sunstroke, ambulance parties prepared fijr 1854 Superintendence of naval hospitals 3610 Superintendent of: St. Elizal>elhs Uospilal for insane 3103,3131 Nurse Corps— . allowances of ».,>/;,. ..a n., 730,751 duties of 615 medical treatment of '. 7 1 4 pay of 'iO^ Supernumeraries : applicants for enlistment admitted as 2tK>4 deOniiionof ...,,,.j,....j.jj,,......,,.,',»vi..-*. 4131 Bnppllei. (See I'roperty; .Stores.): lidvcn isemciit for 3302, 3^172 Ijuctoriological — from Naval Medical School r •■ ■ '^'^■^ requlsil ions for 3656 bureau has oustofl v of 3321 UNDEX. 403 Supplies— Continued. Paragraph. contracts for— 3305 how controlled 3:j71-3378 how made 3308 to be in writing 2953 death of officer in charge of - ■ - 3334 disposition when going out of conraiission 3393, 3394 emergency requisition for -^ 3323 from other department of ship 3306 furnished by contract ' " ' ' g60 in emergency 3330 inspection of 3303 issueof 3525 to persons not in Navy ' 1420,3301-3313 laws relating to procurement of medical (see Medical stores)— . nr ■ •»<• > « i: ■ goo allowance of 918 at navy yards ' ' ' 3517 errors in invoices of 864 going out of commission '.■.".'.'.'.';':". 934 1225,1284 inspection of 858 invoices of 3322 outfits for ships ' ' ' ' 186I providing of, in field ■• 858, 3513, 3516 receipts for " ' " ' 3533^ 3541-3-548, 3901 requisitions for ' ' 904^ 93.5^ 3533 select ion of ' ' 3503, 3541 ships in conunission 1850 transportation of i_^' _J^';]'-_'_ _ _•_ 3555 microscopical, requisitions for g^^^ 3^22 miscellaneo\is, requisitions for 33q9 oath to contract required open-purchase requisitions for— .3.305^ 3326 from ships 3328 on shore • 3331-3333 public bills prepared for 3303,3307 pinchase of 33OI regulations concerning 137I replenishment of, in hospitals • ■. ' ' ' 332^ required for by bureau 39:«, 4121, 4131 requisition for, Form 4 ; : 3523 responsibility for loss of • ' ' 2519 restriction of " 3329 selection of 3324,3327 ships at navy yards 86O transfer of, between departments supply depot, medical. (See Medical supply depot.) Supply table: 860 allowances based on 3544 articles not embraced in ' "^ ' ' 3515^ 355^ basis of supplies ;--V-'i"''Vri;'"'''"!'"'"""" 3551-3556 instructiom relating to ■^■' 3542 packages designated hi 2271 Surfaces, teeth, classification of Surgeon-s: 163 appointment of battalion. (See Battalion surgeon. ) brigade. (See Brigade surgeon.) gQ2 commanding officer to consult 404 INDEX. Surgeon-&— C4)iilinued. Paragraph. ilivjsion— dental officer part of 331 duties during drills 981-987 personnel of 870 station at quarters 869 examination, professional, for promotion 211 executive. (See Executive surgeon.) general- death report signed by 2435-2438 personal memorandum for 4121, 4131 to assign nurses 671 , 675 regimental. (See Regimental surgeon.) Surgical: appliances- replaceable only after survey 2951 survey of '*62 cases, supervision of 1350 instruments- appropriations for 139S survey of 862 operations, necessity for 1287 ward, supervision of 1350 work, opportunity of junior medical officers for 12^7 Suivey-s: board of — entered In journal 1362 for ships ^91 material. (See Survey, property.) medical 822 board of 891 discharge upon y-^-- 1236 discharge upon, not in line of duty 2906 entered in health record 2^86 health record signed and verified , -7 -i;: r,- - »>»r 1237 line of duty statement - 2821 medical officer notified of 2302 name of ship to be noted in , 1236 not required for transfer to hospital 2925 officers in hospital 291 1 of general court-martial prisoner 2947 of insane persons 3124,312.% 3128, 3129, 3165 of patient in hospital 3 montlis 126,-., 1286, 294s order for 3910 patient recommended for 1528 regulations relating to r,Mf,t,- •-•'f.tr - 2901-2916 report of .'......'...... 1142,2931-2937, 3911, 3922,3»43, 4121, 1131 request for 2921-2925, 3922, 3942, 4121, 1131 sending home sick condemned by 291! to Naval Home 1632 transportation of men discharged by 2907 "f- Inianilary articles 2537 lostartlcles 3523 surgicallastrumonts •*''^2 properly "'^ boardof «^'7 dental 1"'0 ronnsfbr :=W-^'. '. tl21,H3l hospitals 1'^ inslrucdoas relating to 2951-2956,2961-2978 INDEX. 405, I'iiragraph. 1S24 Swabs, dressiug station to have 2505 Swimming, precautions regarding ■ ■ • • v- ' - • • ^^^ Swords, surgeons to wear at parades, (^ ■ •■ : •■:■.•.•.".".". " ' Symptom-s: 2260,2283" noted in health record 22oS not to be u ;ed as diagnosis 2079 SyphiUs, rejection for 2307 abstract of treatment of Tabes dorsalis: 2259 method of entering 2070 rejection for Table-s: 1232, diet, variations in - 1962,2084,2082 of height, weight, and chest measurements 2152 of height and weight of civil employees supply. (See Supply table.) 2u81 Tachycardia, noted in import of rejection 'J^.^ Tags, identification, personnel to carry •.■.■.■..■ 2097 how prepared ...-..-... ^^^^ TaUpes valgus, noted in report of rejection • • ^^q;. Tattoo marks, entered in descriptive list 4291-4297 Taxes, hospital slup exempt from Technique: 1351,1375 laboratory, instruction in ^375 operating room, instruction in Teeth: 2271 cavities in, classification of 2271 classification of defective— 20S1 entered in rejection report jgg^ to be filled 2073 waiver for 2271 filling material, classification of jgei^i^S 1.2079 loss of, rejection for missing— 2103 entered on descriptive list 2241 entered on health record ^g., 2073 requirements for candidates '2271 surfaces, classification of ^ 3^0^, Telegrams, charged against "Pay. miscellaneous" Telephone-s: 34OO charged against " Pay, miscellaneous" ^g^g request for extension of leave :: '.".■.: ^ 1 ■.■.'■'.' " Temperature: m 920 certificate of ■■■ 2542 of ship 2002,2003,2065 Term of enlistment Testicle : 2072 enlargement of, rejection for ' ' ^(,511981. 2079 undescended, rejection for " ' ^^ Tests of water jOU Thigh, first-aid care of wounds of :: ;.■■:::: ' 2070 Thumb loss of, rejection for : : " ." : : : ' : Ticket, hospital : 1325^ 1502 disposnl of 3922,3937,4121,4131 Form G 2001 2079 Tinea capitis, rejection for ' 3225 Tissues, prpparation for microscopic sl\idy 406 INDKX. Title-s: , , Paragraph. abbreviai ions for 2241 ofcertain chiefs of bureaus 6 of medical officers 102 Toe-s: deformed, rejection for 2079 hammer, rejection for 1981,2009,2079 Toenail, Ingrowing, rejection for 1981,2009,2079 Tongue, mutilation of, n-jection for 2079 Tonsils, enlargement of, rejection for 1961,1981,2079 Torpedo rooms, first-aid appliances for 1821 TorticoUls, rejection for .". .."..:....." 1961, 1981, 2079 Tourniquet, use of lOfH., 1007, 1821, 18M Towels: appropriation for 1397 for dentist's office 1042 Traffic by hospital ship forbidden , ■ 1713 Transfer-s: abbreviation for .■;....■.■...■.■..■.. — ". :.. 22^-' accounts on .".■;.'.■.■.■..■..■.■:..'.■....■.■.■■ 2989 allotments after 298S and disc'.iarge slip 39S-1 date entered in health record ■ 2203 of dead ^..j^_..^....., 174(1 entries in service and health records — ' .....'^y'. 29^*2 examination — before "^^ entered in health record 2202 health record — accompanies patient ..» ....» 2201,2993 entry ...■;;.....:..;....... 222:1, 2261, 2281, 2284 forwarded 2266 of— Hospital Corps, report of 487, 1288 insane - - ■ - • ■ ■ • 3125-3127, 3133, 3135 labor, request for 3994,4131 marines 1 1 ..... ^ 2990 medical stores '.'.'...'.'.'.'. 3903 men with venereal disease 2116 nurses 073-677,728,729 ofTicer, medical officer notified of ^^ 2212 ofhcer to hospital to be reported ......... ^j.^^. ......,,.,,,,........... 1221 officer to naval home A-V- tiI; • (•■.fiVif- ^^* pat ients l)etween wards ■ .' 1522 patients to hospital ships • • 1"45,2926 patients toother than naval hospii 111 -i 4111,4121,413! siclc and disabled, instrucHons repanliu-' .i;.;'.'.;^^... 3001-3011 stores >"'>5, 3')02, 3-511, ;«16, 3519,35520, 5005, 4121, 4131 supplies between departments ^''^O tuberculosis cases 2987 I0 Volunteer Naval ^esc^^'o Force. . 3C1 papers to Ik- transniitled 2984 physical oxaniinatlon before . 21 U>, 2983 recruits vaccinated before 2032 to hospital S22-.S24, 1113, 1211-1217 Civil ^24 corps 401,183, 4SS Inst ructions Rovcming • 2i)8i-30i i other than United States n^val 2985 report ed • tSSn ViKciniition f>fre,. y, , $; . j;f-,.j.t,i.Mfi-'.> ^..-nU ><>•■■ i- 1821 Tympanic membranes, examination of 207C Typewriters, appropriation for at naval hospitals 1395 Typhoid: bacilli, emulsion for Widal test 3228,3556 precautions against 2603,2612 prophylactic — all persons to receive 952, 1943, 1997, 2577, 2612 entered on Form K , 2380 entered on health record .....,, 2227, 2253 instnictions concerning ...a 2087 landing force to receive 1844 method of obtaining 3562 recruits to receive .,,^.^, ,.,.*.,.,.,,.> 2033 protection from flies -■---• •-.-.-;.> r^hIi.-*;, 2615 report of ->,.>!«.> ^^-.■.,.^ 2012 Typhus fever, quarantine for ..^,..j,5-„t..,...4.,« ;..►,, 2731 Ulcers, chronic, rejection for 1981, 2079, 2148 Unclvllzed enemy, ambulance jv.nly armed against 1845 Underclothing:, clean, put on before battle 1825 firpproofing of ." 1825 Underslze, rejection for 1982 Undetermined. (See Diagnosis undetermined.) Unfit for duty, transfer to hospital 822 Uniform: adapted to weather and climate 2605 for— acting assistant surgeon 152 Dent al Corps n,,.,, .rH,«. ,f,ni t 322 Dental Resen-e Corps .j^^.j. ,.^i ^, v ^58 Medical Reser\-e Force .'..",'."-'.•.••. fMr 245,260,261 gratuity for 1825 Nurse Corps .._.._........ . . trii • • 771-774 If (jspital Corps, to be inspected 1320 hospital shij), rogulat ions for 1727, 1731 landing force, to be prescribed 1845 liberty part ies to be inspet led •>,, ^om-, 1504 medical ofTlcers with expeditionary force 1847 Naval Uoserve Force ...w. ..,,,,*,„,/»••. 304 patients always to wear ..„..,,,. 1516 prescrlbe:..,. ..,„.,h, 1955,1998 Urine: ..«»■/ disrofection of 2753 incontiaence of, reject ion for .,.»,. 2079 Utensils, eating and cooking, disinfection of ..,^,,.;^,(. 2772 Vaccination: duties of medical officer in conneotion witli 843 entered in— FormK 2380 health record j^,.,t»*> ,*.«.,*.... . .v. 2226,2253 journal 231S every person to have 2612 examination for 2061 instractions concerning 2086 landing force to have 1844 of— crew on going into commission 257('i recruits 951,2031,2032 recruits to receive- before transfer 2032 immediately v ...-yf-.j... 2031 Vaccines: appropriation for 1399 instructions relating to 3561-3503 Valises, disinfection of -r 2709 Valuables of patients, to be safegniarded 1330, 1464, 1514 Varicocele: entered on— health record 2241 report of rejection 20fel examination for 2061 rejection for 1961, 1981, 1985, 2071, 2079,214* Varicose veins: entered on report of rejection 2081 examination for 2061 rejection for 1961, 1981, 1985, 2071, 2079, 214S Vegetables, precautions when night soil is used 2604 Veins, varicose. {See Varicose venis.^ Venereal: disease — circulars relating to .........._..._._.............. ...r-,.^..^..--- 2252 detail of patient with j,j,.>y^£[y.i„,',.„jj^jj... 1313 entry of sequelae of .^^},,j,.f„5»j,-^j^.^5,. .., 2259 examination for >, 2061 men with, not to be transferred i., , 2116 must be admitted to sick list 2252 not treated at Army and Nav\' Hospital 1611 patients not allowed liberty .^ .., j.^, . .^ ., 1505, 254:; patients not to be in landing force. ......... ..... .;^|i^.,j.;jj,,j^f -^,j,...,g. ,,.;.; .(j,j„. ..p., 1844 patients not to be transferred 5„,^,,f,i^ ,,.-w., . y,,:. -j..^. ^,. .:. . , 2116 rejection for .^.^.^^^lllll^^ll^^l^Ll^' ^^■V....^...„*-w,^^y^,^...:„^'. 2079,2148 See Syphilis abstract i 2307 prophylaxis, report of 11&) wards, nurses not detailed in 1453 Ventilation: ...'.... dressing station to have 1824 ofship 2542,2602 410 INDEX. Paragraph. Verification of records on going into coiniiiisvji.ii .;■.';*.'?.'.". ■?".■!*.: 'J: I .'•. . Tf .■■; l; .V. 848 Vermin : destruction ol 2763 examination of applicant for _ 2061 rejection of applicant for '.'1 2079 Vessels of Navy: officers of, to be citizens 1^1 subject to quarantine inspection 2732 Veteran-s: furlough, pension status when on -...■.:■.■.■.. 3729 of Mexican War, pensions of -.•.•.•.•.-.•..•....i 3715 Violent death, proceduie in case of ; .: ..■.•..■..:..•.:•.;-.:•.!::•.; . 2423 Virus, vaccine. (See Vaccines.) Vision: defective — degree of, to be stated ..rr'*'2064 entered on report of rejection m?Ji Pfl .'T?T?. . 2081 examination for ...;..::::.-.•... 1984 rejection for ::V'lWl,t^«1, 2079, 2148 entered in health record 2241 examination of, for — aviation 2!l3 enlistment ..•.•.■.-:.•..• 2074 gun pointer --.-^ (171. 2n:<4. 2111 requirements, examination for promotion •. 1959 standard for admission to — Naval .Academy •■ 19S^ various corps - ■ 19«S Visiting hours to be designated at hospital 1331 Vital statistics of Navy • 2334 Voice used in test of hearing ...;...... IflftS, 19% Volunteer Army, admission to Ariny and Navy Hospital ..■.■.•.•.•.-.•:.■ 1011 Volunteer Naval Reserve '^^^'- "MC Vouchers: how prepaicd and filed — 13s«"i for commissary stores Hl2 preparat ion of Xi32, 3392 receipt and cxijendituro for commissary ledger 3960 Wagons, charged against "Contingent M. c< S." '. -'^OO Waiting orders: ,24 War: casualty rate in '"22 inerchimt marine service liable to draft •*'^~ Mexican, pensions of veterans of •''l-' Red Cross cooperation in '^' Hebellion, pcii-sions of honorably discharged men ;;;....;. . •'733 staff officers not exempt from sea duty in... •'' Ward-s: (.leunliness and good order of ' "'*' ^**' duties of nurses in charge of .:;.■■..: MSii forms kept by ward officer ■. ..•.......•.■.•.•..•.•••.•.•.•.•.;•.;•.•.■. •.;:.!..■ ■ 1'I2 in,sjHH;tlon of '*''^ I^NDEX. 4 1 1 Ward-s— Continued. Paragraph. isolation, care of 1316 management of U.')tj-1470 medical officer in charge of 1228 nurse. CSee Niu-se, ward.) officer, duties of i:iU-130i order book kept by nurse ■.-.-.-.•Toi-i)Mtcfeft-feHwr- 1"''' patients- assigned to ^y.)r)^.,ytr,.. 13(j7 restricted to _._..j(,.v^^,«,,j,j.yj,;.i^)^. 1466 property book kept by nurse 1467 psychopathic, care of ........................,..,..: i;ilG quiet required in - 1513 routine, daily 1470 special, property responsibility 1349 surgical, supervision of ,-rTRio trnsiwirt-TOP '-^^ transfer of patients between .j,. i.i'^ venereal, nurses not detailed in 1453 washing clothes ui, prohibited .....fr,,^f,.j.,,^jg,^^ma<:'.-ne^^'-'* l''!'^ Wardroom mess, special diet from — 3422 Warrant officer, health record for 2243 Warts, rejection for 20(« Washing: clothes m wards prohibited lol'i stands, dressing stations to have 1824 Wassermann reactions by Naval Medical School 3222 Watch test of hearing itfti, looc, Water: approval by medical oll'icer 2.j )4 drinking, for battle dressing stations .aoiiemt 1824 examination of, entered in journal 2315 harbor, use of, on decks :i>«.>t-.r, ,W2, 2545, 2603 precautions concerning .;.■.;....... 2603 purification of, by calcium hjT)oclilorite ....................,..,,,:.,,. 2621 shore, examination of ...........,.,....,.......,.......;. 25()9 supply for landing parties , — ,-.->■- m< 1 2621 t esting of : , : ......,,,,,,,,,,,,... 852 Weakness, constitutional, rejection for ^, , ,loi jwIj. 1950 Weapons, ambulance party not to cari\ ,.,.,-.... ..„i^ 1845 Weather, clothing adapted to 2605 Weight: disproportionate to height 2t»83,20S'i employees', table of 2152 entered on— health record ,,, ..■.. 2241 report of rejection ....,..,,,,,,,, itui jtvatd i j. . 2081 midshipmen, requirements for :'.^'.-A USSH table of 1962, 20S2, 2084 variation from standard of 1962, 1982, 2083, 2085 Welfare of troops embarked ....,,,,„,., ..,........;, 8% West Indian ports, report of epidemics in 2567 Wet, exposure of crew to, to l)e avoided 2543 Widows: of— disabled officera and men, pensions for • ■n>mi,,w- 3712 those lost in •' Ashuelot," pensions for 3744 when entitled to pension iT\ .• 3741 Whisper test of hearing '. 1996 Wldal test, materia! for - . 3228, 355t; 412 INDEX. Paragraph. Wines, custody of 827 2816 2108 1401 2769 Witnesses of accidents, report of Women, physical examination of Wood, entry in bill book . Woolens, dteinfection of Worli-s: convalescents detailed fw ;:;;:. -.-.v.' 1313,1507 dental- records of ........:.;; 1026, 1035-1037 statistical report of .........: 1 037 laboratory- officer assigned for 1317 report of r.i:>l patients fit for KWC public. (See Public works.) surgical, opportunity of juidor medical officer for 12S7 Worms, method of preservation 3225 Wounded: agreements between belligerents concerning 4233 aid to, by inhabitants -taoe, 1336 assistance to, when rendered 1862 berthing space for 1824 care of 985, 1808 in field 1861-1S69 classification of ::..... 1865 delivery to outposts :.'..' '/. 4207 evacuation of : . . . 1842, 1840, 1861, 1869 first-aid care of . . .'. 1009-1011 hospital ship to care for 1802 In line of duty, effect on promotion 1911 left in hands of adversary 4232 medical officer's duty to :;::•..•.:-.;: 1811 neutrality of house containing 4206 prisoners of war 4233, 4314 protection by captors 4221 , 4234, 4279, 431 1 , 431 7 provisions for care of 1801 relief of 818, 1804, 1821-1832 repatriation of 4207, 4215 report of : 819, 1137, 18ftS, 1808, 3922, 3941, 4111, 4131 slightly .....:.; J... 1865 skull, rejection for 2079 transportation of ...;.:. I'.^l':^.'. t .". .'fl . . 985, 1830, 1832 by hospital sliip .....;. ;....]'.'.*.':1'..;.:^.. . 1802 during lull of battle ..'^.'1 . . : . . . 182J on distant ser\ice 1850 to be neutnil 4203 Wreck of: •■ .Vshuelot," peusious of widows H744 •'Jeanelte,"dateof death of those lost in. .■'.74:( X-ray room, regulation for l.Vil Yard. (6Vt Navy ynrd.) Yellow fever : ...;.., i j : - lUsinfwIiouatier 2763, 27R1 precautions against 2613, 261;'' rpiarantine lor ' 2731 o 3El^^ 14 DAY USE RETURN TO DESK FROM WHICH BORROWED LOAN DEPT. This book is due on the last date stamped below, or on the date to which renewed. Renewed books_axfi_subject to immediate recall. ifW^ O LU P£C13 64-1PI^. LD 21A-607n-4,'64 (E45558l0)476H General Library Uaivenitf of California Berkeley ■ UNIVERSITY OF CALIFORNIA LIBRARY ] > 1 1 1 ; ! 1 J ■; •<