Medical Department.

ARTICLE XLIV.

MEDICAL DEPARTMENT.

1266. The medical supplies for the army are prescribed in the standard supply tables.

1267. The medical purveyors and the senior medical officer of each hospital, post, or command, will make the necessary requisitions for medical and hospital supplies, in duplicate (Form 1). If the supplies are to be obtained from the principal purveying depôts, the requisitions will be made upon the Surgeon-General on the 31st day of December annually; if from department or field depôts, they will be made upor the medical director at such times and for such periods as he may direct. Good vaccine matter will be kept on hand by timely requisition on the Surgeon-General.

1268. The medical purveyors at the principal depôts will issue medical and hospital supplies only on the order of the Surgeon-General; those at department or field depôts will issue on the order of a medical director. In particular and urgent cases, issues may be made on a special requisition (Form 2), approved by a commanding officer; a like authority will be required in transfers of medical supplies.

1269. When it is necessary to purchase medical supplies, and recourse cannot be had to a medical disbursing officer, they may be procured by the quartermaster on a special requisition (Form 2) and account (Form 3). 1270. When any requisition for medical supplies is not according to the supply table, the reason therefor must be set out.

1271. In every case of special requisition, a duplicate of the requisition shall, at the same time, be transmitted to the Surgeon-General, for his information, giving the name and station of the officer upon whom it is made.

1272. Medical purveyors will make to the Surgeon-General, at the end of each fiscal quarter, returns in duplicate (Form 4) of medical supplies received, issued, and remaining on hand, stating to whom, or from whom, and where and when issued or received; other medical officers in charge of medical supplies make similar returns of them annually, on the 31st December; and all officers, when relieved from the duty to which their returns relate. The returns will show the condition of the stores, and particularly of the instruments, bedding, and furniture. Medical purveyors will furnish abstracts of receipts and issues, with their returns (Form 5), giving the name of the person from whom received and to whom issued.

1273. An officer transferring medical supplies will furnish a certified

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invoice to the officer who is to receive them, and transmit a duplicate of it to the Surgeon-General. The receiving officer will furnish a receipt to the officer making the issue, with a report of the quality and condition of the articles, and transmit a duplicate of the receipt and report to the Surgeon-General. A medical officer who turns over medical supplies to a quartermaster for storage or transportation will forward to the SurgeonGeneral, with the invoice, the quartermaster's receipt for the packages.

1274. Medical officers will take up and account for all medical supplies of the army that come into their possession, and report, when they know it, to whose account they are to be credited.

1275. In all official lists of medical supplies the articles will be entered in the order of the supply table.

1276. Medical disbursing officers will, at the end of each fiscal quarter, render to the Surgeon-General, in duplicate, a quarterly account current of moneys received and expended, with the proper vouchers for the payments, and certificates that the services have been rendered, and the supplies purchased and received for the medical service, and transmit to him an estimate of the funds required for the next quarter.

1277. The senior medical officer of a hospital will distribute the patients, according to convenience and the nature of their complaints, into wards or divisions, under the particular charge of the several assistant surgeons, and will visit them himself each day, as frequently as the state of the sick may require, accompanied by the assistant, steward, and nurse.

1278. His prescriptions of medicine and diet are written down at once in the proper register, with the name of the patient and the number of his bed; the assistants fill up the diet table for the day, and direct the administration of the prescribed medicines. He will detail an assistant surgeon to remain at the hospital day and night, when the state of the sick requires it.

1279. In distributing the duties of his assistants, he will ordinarily require the aid of one in the care and preparation of the hospital reports, registers, and records, the rolls, and descriptive lists; and of another in the charge of the dispensary, instruments, medicines, hospital expenditures, and the preparation of the requisitions and annual returns.

1280. He will enforce the proper hospital regulations to promote health and prevent contagion, by ventilated and not crowded rooms, scrupulous cleanliness, frequent changes of bedding, linen, &c.

1281. He will require the steward to take due care of the hospital stores and supplies; to enter in a book, daily (Form 6), the issues to the ward-masters, cooks, and nurses; to prepare the provision returns, and receive and distribute the rations.

1282. He will require the ward-master to take charge of the effects

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of the patients; to register them in a book (Form 7); to have them numbered and labeled with the patient's name, rank, and company; to receive from the steward the furniture, bedding, cooking-utensils, &c., for use, and keep a record of them (Form 8), and how distributed to the wards and kitchens; and once a week to take an inventory of the articles in use, and report to him any loss or damage to them, and to return to the steward such as are not required for use.

1283. The cooks and nurses are under the orders of the steward; he is responsible for the cleanliness of the wards and kitchens, patients and attendants, and all articles in use. He will ascertain who are present at sunrise, and sunset, and tattoo, and report absentees.

1284. At surgeon's call the sick then in the companies will be conducted to the hospital by the first sergeants, who will each hand to the surgeon, in his company book, a list of all the sick of the company, on which the surgeon shall state who are to remain or go into hospital; who are to return to quarters as sick or convalescent; what duties the convalescents in quarters are capable of; what cases are feigned; and any other information in regard to the sick of the company he may have to communicate to the company cominander.

1285. Soldiers in hospital, patients, or attendants, except stewards, shall be mustered on the rolls of their company, if it be present at the post.

1286. When a soldier in hospital is detached from his company so as not to be mustered with it for pay, his company commander shall certify and send to the hospital his descriptive list, and account of pay and clothing, containing all necessary information relating to his accounts with the United States, on which the surgeon shall enter all payments, stoppages, and issues of clothing to him in hospital. When he leaves the hospital, the medical officer shall certify and remit his descriptive list, showing the state of his accounts. If he is discharged from the service in hospital, the surgeon shall make out his final statements for pay and clothing. If he dies in hospital, the surgeon shall take charge of his effects, and make the reports required in the general regulations concerning soldiers who die absent from their companies.

1287. Patients in hospital are, if possible, to leave their arms and accoutrements with their companies, and in no case to take ammunition into the hospital.

1288. When a patient is transferred from one hospital to another, the medical officer shall send with him an account of his case, and the treat ment.

1289. The regulations for the service of hospitals apply, as far as practicable, to the medical service in the field.

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1290. The senior medical officer of each hospital, post, regiment, or detachment, will keep the following records, and deliver them to his successor: a register of patients (Form 9); a prescription book (Form 10); a diet book (Form 10); a case book; a meteorological register (Form 11); copies of his requisitions, annual returns, and quarterly reports of sick and wounded; and an order and letter book, in which will be transcribed all orders and letters relating to his duties.

1291. He will make up the muster and pay rolls of the medical cadets, hospital steward, female nurses, and matrons, and of all soldiers in hospital, sick or on duty, detached from their companies, on the forms furnished from the Adjutant-General's office, and according to the directions expressed on them.

1292. He will make the rolls of the cooks and nurses for extra-duty pay, which will be paid by the paymaster, in the absence of a medical disbursing officer, as in other cases of expenditures for the medical department (Form 12).

1293. The senior medical officer will select the cooks, nurses, and matrons (and, at posts where there is no hospital steward appointed by the Secretary of War, a soldier to act as steward), with the approval of the commanding officer. Cooks and nurses will be taken from the privates, and will be exempt from other duty, but shall attend the parades for muster and weekly inspections of their companies at the post, unless specially excused by the commanding officer.

1294. Ordinarily, hospital attendants are allowed as follows: to a general hospital, one steward, one nurse as ward-master, one nurse to ten patients, one matron to twenty, and one cook to thirty; to a hospital where the command exceeds five companies, one steward and ward-master, one cook, two matrons, and four nurses; to a post or garrison of one company, one steward and ward-master, one nurse, one cook, and one matron; and for every two companies more, one nurse; at arsenals where the number of enlisted men is not less than fourteen, one matron is allowed. The allowance of hospital attendants for troops in the field will be, for one company, one steward, one nurse, and one cook; for each additional company, one nurse; and for commands of over five companies, one additional cook. 1295. Medical officers, where on duty, will attend the officers and enlisted men, and the servants and laundresses authorized by law; and at stations where other medical attendance cannot be procured, and on marches, the hired men of the army, and the families of officers and soldiers. Medicines will be dispensed to the families of officers and soldiers, and to all persons entitled to medical attendance; hospital stores to enlisted men.

1296. Medical officers, in giving certificates of disability (Form 13), are to take particular care in all cases that have not been under their

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charge; and especially in epilepsy, convulsions, chronic rheumatism, derangement of the urinary organs, ophthalmia, ulcers, or any obscure disease liable to be feigned or purposely produced; and in no case shall such cer tificate be given until after sufficient time and examination to detect any attempt at deception.

1297. In passing a recruit the medical officer is to examine him stripped; to see that he has free use of all his limbs; that his chest is ample; that his hearing, vision, and speech are perfect; that he has no tumors, or ulcerated or extensively cicatrized legs; no rupture or chronic cuta neous affection; that he has not received any contusion, or wound of the head, that may impair his faculties; that he is not a drunkard; is not subject to convulsions; and has no infectious disorder, nor any other that may unfit him for military service.

1298. Medical officers attending recruiting rendezvous will keep a record (Form 14) of all the recruits examined by them. Books for this purpose will be procured by application to the Surgeon-General, to whom they will be returned when filled.

1299. As soon as a recruit joins any regiment or station, he shall be examined by the medical officer, and vaccinated when it is required.

1300. The senior medical officer of each hospital, post, regiment, or detachment, will make monthly to the medical director, and quarterly to the Surgeon-General, a report of sick and wounded, and of deaths, and of certificates for discharge for disability (Form 15), and transmit to him monthly a copy of the meteorological register (Form 11), and a copy of the "statement of the hospital fund" (Form 19).

1301. After surgeon's call, he will make a morning report of the sick to the commanding officer (Form 16).

1302. Every medical officer will report to the Surgeon-General and to the medical director the date when he arrives at a station, or when he leaves it, and his orders in the case, and at the end of each month whenever not at his station, whether on service or on leave of absence, and when on leave of absence his post-office address for the next month.

1303. The medical director will make to the Surgeon-General a monthly return of the medical officers of the command (Form 17), and a consolidated monthly report of the sick and wounded (Form 15) from the several reports made to him.

1304. When it is necessary to employ a private physician as medical officer, the commanding officer may do it by written contract, conditioned as in Form 18, at a stated compensation not to exceed $50 a month when the number of officers and men, with authorized servants and laundresses, is 100 or more; $40 when it is from 50 to 100, and $30 when it is under 50.