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1137. Th sible for the cleanliness, a keep always from subord his orders and officers and a

nese, etc.

duties as may

Entries to be

brown which to the normal sense seem darker than the red, while
the green-blind will select the shades of green or brown which seem

lighter.
Health, sick (n) Enter in last column, in every case of rejection, the disability

unfitting the applicant for service, and in other cases any abnormal
condition, former grave illness, or serious injury not inconsistent
with present bodily vigor. In reexamination of minors and continu-
ous-service men, here enter statement of health since previous ex-
amination, and affix signature of the medical officer making the
reexamination.

1131. (1) The examination having been concluded, and the can. made ron enlist- didate found qualified for the service, the medical examiner shall

enter his descriptive list upon the blank enlistment records fur-
nished by the Bureau of Navigation or the Commandant of the
Marine Corps, and, having signed it, shall transmit the record to the
commanding officer of the ship, station, rendezvous, or post.

(2) Upon the transfer at any time of an enlisted person, the med-
ical officer shall make the necessary entries upon the enlistment
records.

1132. In cases where physical disqualifications are waived by are waived by the Navy_Department, the medical examiner shall fully describe the Navy Depart

same on Form X and other records of enlistment, and at once report
the fact to the Bureau of Medicine and Surgery. (Art. 831.)

1133. Recruits enlisted at a rendezvous on shore shall be reexof recruits trans- amined as soon as they arrive on board a receiving ship, and any

defects that may be discovered reported at once to the commanding
officer.

1134. Recruits shall be immediately vaccinated, and in cases of
failure the operation shall be repeated until the medical officer is
convinced that the person is protected. Results of vaccination shall
be reported on the quarterly report of sick.

1138. Exc reported to t2 be made in th destroying or and no bills f the permissio

1139. The provisions, ar cause them to report to him entered on the

1140. He present their

When defects

ment.

Reexamination

ferred from a rendezvous.

Recruits to be vaccinated.

SECTION 2.-HOSPITALS.

and will assur

1141. (1) E such other pro the duty of at 10 a. m.

(2) The offic make a tour other rooms o tion shall be 1 and another a

(3) A list of be furnished morning, and return to him

1142. The sign at the en make a brief : the time of oc smoking, and meals served patients admit names, numbi

Officers ad

tals.

1135. (1) When officers are admitted into a naval hospital they mitted to hospi- are entitled to remain under treatment and to have all the advan

tages of such hospital until cured, unless in the case of chronic dis-
orders which, after a sufficient period, shall appear to the medical
officer in charge to be not susceptible of cure. Of such cases he
shall make a report to the commandant of the station and request
a medical survey thereon. If a survey recommends a continuance
of treatment the officer or officers surveyed may remain until a sub-
sequent survey shall recommend a discharge.

(2) When a medical survey, duly approved, shall recommend an
officer's discharge from hospital, it shall be at the option of such
officer, if disabled or decrepit, to be transferred to the Naval Home.

(3) A copy of all the papers in such cases shall be forwarded by the commandant to the Secretary of the Navy.

1136. Sick, wounded, or disabled officers are entitled to the bled officers enti- benefits of naval medical and surgical attendance, either within or tlednoton medical without a naval hospital, so long as they remain sick, wounded, or

disabled. The fact that an officer has been treated within a naval
hospital for four months, or for a longer period, shall not be consid-
ered as a bar to his readmission to the same, or to any other
hospital.

Sick and disa

discharged, a1 rect and com ployes who hi confinement a the appointm tachment of the record of all boards of term of duty

1143. Mei ble for their within them.

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Examination

Medical officer

1137. The medical officer in charge of a naval hospital is respon Responsibility sible for the care and treatment of the sick, and for the discipline, of medical officleanliness, and economy of the institution, which it is his duty to keep always in an efficient condition; and to this end he shall exact from subordinates, employees, and patients a proper obedience to his orders and to the laws and regulations of the Navy. Medical officers and all persons employed in the hospital shall perform such duties as may be assigned to them by the medical officer in charge.

1138. Except in cases of emergency, which shall be immediately No changes to reported to the Bureau of Medicine and Surgery, no changes shall be made in build

ings or grounds. be made in the hospital buildings, furniture, and grounds, such as destroying or removing trees, or disturbing the soil around them; and no bills for purchases and repairs shall be contracted without the permission of the Bureau.

1139. The medical officer in charge shall inspect all medicines, Inspection of provisions, and medical supplies that may be received, or shall medicines, supcause them to be inspected by a junior medical officer, who shall plies, etc. report to him their condition. A record of the inspection shall be entered on the daily journal.

1140. He shall direct the medical officers in charge of wards to present their case papers to him once each week for examination, of case papers. and will assure himself that they are accurately and carefully kept.

1141. (1) He shall detail a medical officer who, in addition to such other professional duties as may be assigned him, shall perform of the day. the duty of “officer of the day” for twenty-four hours, commencing at 10 a. m.

(2) The officer of the day, upon going on duty at 10 a. m., shall make a tour of inspection through the wards, kitchens, mess, and other rooms occupied by patients and employees. A similar inspection shall be made during the afternoon, at a different hour daily; and another at night, after the patients are in bed.

(3) 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.

1142. The officer of the day shall keep a journal, which he shall Daily journal. sign at the end of his term of duty at 10 a. m., in which he shall make a brief record of the following points, that are to be noted at the time of occurrence: 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: the names and diseases of patients admitted, and the places from which they are received; the names, number of days subsisted, and disposition made of patients discharged, and whether the necessary papers in each case are correct and complete; the names and condition of patients and employes who have returned, or who have overstayed their leave; the confinement and discharge of offenders, and cause of punishment; the appointment and discharge of employees; the reporting and detachment of officers, or their going upon and returning from leave; the record of inspection of all articles; the object and findings of all boards of survey; and all other matters occurring during his term of duty which it may be desirable to record.

1143. Medical officers in charge of wards shall be held responsible for their order and neatness, and for the good condition of all cers in charge of within them. They shall exercise a personal supervision over the

Medical offi

wards.

Patients should

Forms to be ob

comfort and welfare of the sick, visiting them at least twice daily, and oftener in severe cases; and they shall assure themselves that their directions as to medicines, dressing, regimen, etc., are accurately and promptly carried out.

1144. Patients should be accompanied, upon admission, with be accompanied hospital tickets (Form G), but they may be admitted without this with hospital tickets. paper in cases of emergency, when the medical officer shall report

the fact to the commandant of the station with a statement of the

emergency, and cause the necessary hospital ticket to be supplied. Convalescents 1145. Convalescent patients may be detailed for light service, to be discharged but shall in no case be retained in the hospital for that purpose after when fit for duty.

they are fit for duty. Attendants. 1146. No patient in hospital shall be entitled to any service ex

cept that of the regular hospital attendants; nor shall any one,
except medical officers on duty, patients, and employees of the hos-
pital, be subsisted or lodged without permission of the Bureau of

Medicine and Surgery.
Diet tables. 1147. For patients, diet tables prepared by the Bureau of Medi-

cine and Surgery will be followed when practicable; but the allow-
ance to attendants' messes may be varied at the discretion of the
medical officer in charge, provided the value of the ration be not

exceeded. Special diet 1148. For each ward shall be kept a special diet list (Form P), list.

which shall be revised and corrected every morning by the medical officer in charge of the ward.

1149. When a patient is admitted, the following forms shall be served upon re- observed: ceipt of a patient.

(a) When the hospital ticket is found correct, indorse and file it, with accompanying papers relating to the case. If defective, return it to the medical officer who signed it, through the usual channels, if he is at hand; otherwise, through the Bureau.

(b) Enter the name, etc. (1), in the general alphabetical register of patients (Form E), which is the permanent hospital record, for future reference; and (2), in the abstract of patients (Form F). (c) Open case paper (Form H).

(d) If the patient is an enlisted person from the receiving or other ship, or from neighboring marine barracks, send ration notice, through the commandant, to the commanding officer of the ship or barracks.

1150. When patients are left in hospital after the sailing of the hospital after ship from which they were sent, the medical officer in charge shall sailing of ship.

report to the commandant of the station as soon as they are in a position to justify their removal, making a particular statement of

the facts and circumstances connected with each case. Discharges for 1151. (1) No person in hospital shall be discharged from the disability. service for physical disability, except upon the recommendation of

a board of medical survey.

(2) In reports of survey the name of the ship from which the person was received shall always be noted.

1152. A copy of the report of survey, and of any other paper cases of persons relating to the patient, shall be appended to the case paper, which surveyed.

shall be signed at its conclusion, or on detachment of the officer, by the medical officer in charge of the patient's ward. Case papers shall be verified by the signature of the medical officer in charge of the hospital.

Patients left in

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Records of

of

1153. (1) When a patient is discharged from the hospital, the Discharge fact shall be entered upon the register of patients and also upon the patients from

hospital. case paper. The latter is then to be filed, with the hospital ticket attached.

(2) A ration notice shall be forwarded, as directed, upon the entry of a patient. (Art. 1149.)

1154. On every Monday, a report of sick (Form I) for the pre- Weekly report ceding week shall be made in triplicate; one copy of which shall be of sick. sent to the commandant of the station, one to the Bureau of Medicine and Surgery, and the other retained for the files of the hospital as a basis for the report of the following week.

1155. All regulations for a hospital shall be submitted to the Regulations to Secretary of the Navy.

Secretary.

be submitted to

SECTION 3.-GENERAL INSTRUCTIONS.

Instructions

on the

1156. (1) The senior medical officer of every ship, station, or Medical jourplace of duty, except at hospitals where case papers are used, shall nal. keep, or cause to be kept by a medical officer subordinate to him, a medical journal, which must be a complete and succinct history of the medical affairs coming within his province. In this, and in all other records, especial regard must be paid to neatness, accuracy, and uniformity.

(2) While it is impossible to give directions so minute as to cover every detail, and much must be left to an intelligent discretion, the for keeping jour

. principal points in keeping this journal are the following:

(a) Patient's name in full, also his grade or rate; both from the muster roll.

(b) Age, years.
(c) Native of
(d) Color,
(e) Enlisted at

day of

19(f) Disease; with explanatory remarks, if necessary.

(g) Time and place of occurrence, or dates between which there was exposure to morbific cause.

(h) Whether considered to be in line of duty or not in line of duty; state all facts that can be elicited, distinguishing between the testimony of the patient himself and that of any other witness, and in express terms accepting or rejecting that of the patient and giving reasons for so doing.

(i) Medical officers will observe conciseness in clinical reporting. Common symptoms of ephemeral diseases need not be noted; the simple nosological title will suffice in such cases, as “ diarrhea ecuta,” “constipatio,” “ catarrhus,” with statement of origin.

(j) The medical journal must be indexed daily.

(k) Any evidence that could have any bearing on a claim for pension must be fully noted.

(3) The journal will be indexed in the following manner: (a) Henry Ashton first appears at page 1, where the description for indexing. of him is complete; he reappears at page 34, where reference is made to page 1; again at page 67, and new reference. (See page 1.) Ashton (Henry), 1, 34, 67, 89, 121, 156_Brown (John), 2, 31, 42, 51.

B in Index.
Buuce (Philip), 4, 75, 108_
Cullen (William), 4, 19, 63
Davis, (Henry), 3.--

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Instructions

A in Index.

Bin Index.
Cin Index.
Din Index.

of

Order names.

admitted.

(6) When the first line allotted to any name is filled, take up that name again on the next blank line below-e.g., Ashton (Henry), 190, 234.

(c) The journal may thus be traced for a full history of each case:
A in the margin means admitted.
R A in the margin neans readmitted.
D in the margin means discharged to duty.
Dsd in margin means deserted.
D D in margin means died.
H in margin means invalided to hospital.
H I in margin means invalided to Government Hospital for Insane.
I S in margin means invalided from service.
L in margin means invalided on leave.

(4) On each successive day the names of the patients shall be recorded in the order of admission, with mention of the changes in

the condition and treatment until the final disposition of the case. Change of di (5) Should a change of diagnosis become necessary, the case must agnosis.

be closed by the discharge of the patient, and reopened by his admission with the new diagnosis, except in cases of intercurrent affections depending upon the original cause of disease, when the record may be continued. This rule applies alike to case papers

and journals. A patient re (6) Original admissions for any one disease shall be considered as

admission, and indicated in the margin of the medical journal by the letter A. A subsequent entry on the journal for the continuance of the same disease shall be designated a readmission, and indicated in the margin of the medical journal by the letters R A. Forms F, F? and K shall correspond with the journal as to admissions and

readmissions. Temperature, (7) Records of the temperature, pulse, respiration, and excreta pulse, etc.

of important cases shall be kept (form Q) and appended to the journal or case papers.

(8) In case of death, post-mortem examinations should be made, when practicable, and the results fully recorded in the journal or on case paper.

(9) After the completion of the daily record connected with the general duties.

sick, mention shall be made of all matters relating to the duties of the medical officer, such as sanitary inspections, recommendations

made to the captain, and vaccinations. Record of each (10) The record of each day shall include all admissions, disday.

charges, deaths, and other occurrences up to midnight of that day. One-day pa

(11) When a case is admitted and discharged on the same day

shall count as one sick day, provided the discharge be to duty or on account of death, but when the discharge is a transfer to hospi. tal, or in any way involves admission on another journal, it shall

not be counted. Responsibility (12) The senior medical officer of the ship or station is responsible for accuracy of for the accuracy of the journal and case paper, which must always

be written by a medical officer. Signatures to (13) Whenever a medical journal is kept, the medical officer who

holds sick call shall make the entries in the journal over his own signature. The journal shall be inspected daily by the senior medical officer, who shall attach his signature to indicate the correctness of the record, and shall make any additional entries he may deem proper

(14) When a patient is treated whose sickness is of so trivial a trivial character. character that a relief from duty is not necessary, his name shall be

of

In case death.

Mention of

tients,

entries.

Sickness of a

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