CHAPTER XXII.

MEDICAL INSTRUCTIONS.

SECTION 1.-PHYSICAL EXAMINATION OF RECRUITS.

991. Whenever any person is examined physically for enlistinent in the Navy or Marine Corps, whether subsequently enlisted or rejected, his name and the particulars constituting his descriptive list shall at once be entered on the list of persons examined (Form X), by the medical officer or the senior member of the board making the examination, who shall then sign his initials on a line with the entry. This record shall be kept at every rendezvous, station, or ship where physical examinations are made, and shall be retained there as the original official record of such examination. (Arts. 1027 and 1028.)

Records of examinations.

992. No person other than a medical officer shall be permitted Only medical officers to conto conduct any part of a physical examination, or to make an duct examinaoriginal entry on any medical record of enlistment. tions. 993. Every such examination must be completed according to. Examinations must be comthe official forms, and shall in no case be suspended on the recognipleted in every tion of a disqualifying defect. 994. Whenever hospital tickets or reports of medical survey Care to be exrepresent a disability to have existed prior to enlistment, the fact ercised in examshall be reported to the Bureau of Medicine and Surgery; and the medical officer who passed such recruit shall be held accountable for the improper enlistment.

995. An applicant for enlistment having been found to be clean and sober, the medical officer shall proceed to make a thorough inspection of his body. While permitted to use his own discretion as to the routine of procedure, he shall make inquiry on all points indicated in Chapters XII and XIII, Instructions for Medical Officers, U. S. Navy, 1909.

996. The intelligence of the applicant will be evident from the character of his replies to inquiries respecting former residence and occupation, family history, etc.

997. The age of the applicant must be constantly kept in view by medical examiners in determining the standard of physical fit

ness.

case.

inations.

Examination

of the body.

Intelligence.

Age.

Entries to be made on enlist

998. (1) The examination having been concluded, and the candidate found qualified for the service, the medical examiner ment records. shall enter his descriptive list upon the blank enlistment records furnished by the Bureau of Navigation or the Commandant of the Marine Corps and, having signed it, shall transmit the record to the commanding officer.

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

When defects

999. In cases where physical disqualifications are waived by the Navy Department, the medical examiners shall fully describe are waived by Navy Depart the same on Form X and other records of enlistment, and at once ment. report the fact to the Bureau of Medicine and Surgery. (Art. 755.)

Reexamination 1000. Recruits enlisted at a rendezvous on shore shall be reof recruits transferred from a examined as soon as they arrive on board a receiving ship, and rendezvous. any defects that may be discovered reported at once to the commanding officer.

Recruits to be vaccinated.

Officers ad

tals.

1001. 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.

SECTION 2.-HOSPITALS.

1002. (1) When officers are admitted into a naval hospital mitted to hospi- they are entitled to remain under treatment and to have all the advantages of such hospital until cured. In the case of chronic disorders which after a sufficient period shall appear to the medical officer in command to be not susceptible of cure, 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 subsequent survey shall recommend a discharge.

Sick and disabled officers en titled to medical attendance.

Responsibility

of medical officers in command.

Mail orderly.

No changes to

(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.

1003. Sick, wounded, or disabled officers are entitled to the benefits of naval medical and surgical attendance, either within or 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 prevent his readmission to the same or to any other hospital.

1004. (1) The medical officer in command of a naval hospital is responsible for the care and treatment of the sick, and for the discipline, cleanliness, and economy of the institution, which it is his duty to keep in an efficient condition. 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 command.

(2) At naval hospitals where it is impracticable for patients and enlisted men on duty to obtain mail except through the mail orderly, the medical officer in command shall appoint some trustworthy person to perform the duty of mail orderly, to whom he shall give authority to receive the mails from the post office and to sign receipts for all registered letters.

1005. Except in cases of emergency, which shall be immedibe made in build- ately reported to the Secretary of the Navy through the Bureau ings or grounds. of Medicine and Surgery, no changes shall be made in the hospital buildings, furniture, trees, or grounds. No bills for purchases and repairs shall be contracted without the permission of the bureau, except in special exigencies.

Inspection of medicines, supplies, etc.

1006. The medical officer in command shall inspect all medicines, provisions, and medical supplies that may be received, or shall cause them to be inspected by a junior medical officer, who

shall report to him their condition. A record of the inspection shall be entered on the daily journal.

Examination

1007. He shall direct the medical officers in charge of wards to present their case papers to him once each week for examina- of case papers. tion, and will assure himself that they are properly kept.

1008. (1) He shall detail a medical officer who, in addition to Medical officer of the day. other professional duties assigned him, shall perform the duty of "officer of the day" for twenty-four hours, beginning at 10 a. m., as prescribed in Chapter VII, Instructions for Medical Officers, U. S. Navy, 1909.

(2) The officer of the day shall keep a journal, which he shall sign at the end of the day's duty, in which he shall make a brief entry of all matters, of which a record is desirable, occurring during such tour.

1009. Medical officers in charge of wards shall be held responsible for the order, neatness, and the good condition of all within them. They shall exercise a personal supervision over the 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.

Daily Journal.

Medical offi

cers in charge of wards.

1010. Patients should be accompanied, upon admission, with Patients should be accompanied hospital tickets (Form G), but they may be admitted without this with hospital paper in cases of emergency, when the medical officer shall report tickets. the fact to the commandant of the station with a statement of the emergency, and cause the necessary hospital ticket to be supplied. 1011. Convalescent patients may be detailed for light service, Convalescents but shall not be retained in the hospital for that purpose after to be discharged when fit for duty. they are fit for duty.

1012. No patient in hospital shall be entitled to any service except that of the regular hospital attendants; nor shall anyone, except medical officers on duty, patients, and employees of the hospital, be subsisted or lodged without permission of the Bureau of Medicine and Surgery.

1013. For patients, diet tables prepared by the Bureau of Medicine and Surgery shall be followed when practicable; but the allowance to attendants' messes may be varied at the discretion of the medical officer in command, provided the value of the ration is not exceeded.

1014. For each ward shall be kept a special diet list, which shall be revised and corrected every morning by the medical officer in charge of the ward.

Attendants.

Diet tables.

Special diet

list.

1015. When a patient is admitted and discharged the pro- Forms to be observed upon recedure noted in Chapter VII, Instructions for Medical Officers, ceipt of a patient. U. S. Navy, 1909, with respect to the preparation of official papers, shall be observed.

1016. When patients are left in hospital after the sailing of Patients left the ship from which they were sent, the medical officer in com- in hospital after sailing of ship. mand shall 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.

1017. (1) No person in hospital shall be discharged from the service for physical disability, except upon the recommendation of a board of medical survey.

Discharges for disability.

Records of cases of persons surveyed.

Weekly report of sick.

Regulations to be submitted.

Medical journal and records.

How kept.

Prescription

book.

Statistical report of sick.

Accountability

pended.

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

1018. A copy of the report of survey, and of any other paper relating to the patient, shall be appended to the case paper, which shall be signed at its conclusion, or on detachment of the officer, by the medical officer in command of the patient's ward. Case papers shall be verified by the signature of the medical officer in command of the hospital.

1019. Each Monday a report of sick (Form I) for the preceding week shall be made in triplicate, one copy being 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.

1020. All regulations for a hospital shall be submitted to the Secretary of the Navy.

SECTION 3.-GENERAL INSTRUCTIONS.

1021. The senior medical officer of every ship, station, or place of duty, except at hospitals where case papers are used, shall keep, or cause to be kept by a medical officer subordinate to him, a journal, which must be a complete and succinct history of the medical affairs coming within his province. Evidence that could have any bearing on a claim for pension must be fully noted therein.

1022. The journal and all other records shall be kept with neatness, accuracy, and uniformity, and in accordance with the directions prescribed in Chapter X, Instructions for Medical Officers, U. S. Navy, 1909.

1023. Issues of medicine or medical stores to persons not in the Navy shall be noted in a prescription book kept for the purpose.

1024. Medical officers shall avoid inaccuracies or deficiencies in the statistical report of sick (Form K) upon which is based the annual statistical report of the Surgeon General. To this end it is directed that a list of patients be kept, in which shall be inscribed the name of every person as soon as he is entered upon the journal. From this list Forms K and F are to be prepared; and if it be accurate, the result will be an exact accordance of these two returns with the journal.

1025. (1) The senior medical officer of each station, hospital, for property ex- and ship shall be held responsible and accountable for all public property under his control belonging to the medical department of the Navy. (Art. 975.)

(2) Medical officers shall forward to the Bureau of Medicine and Surgery, with the return of property (Form D), a concise account of the authority and reasons for expenditure and disposition of all property expended, other than medicines, hospital stores, surgical appliances, and stationery.

(3) They will not be released from responsibility for the value of any surgical instruments or furniture, unless the expenditure shall have been authorized by the bureau or a board of survey.

(4) The property returns from ships in a fleet shall be forwarded through the fleet surgeon, who shall see that expenditures are made with due regard to efficiency and economy, and report to the bureau any instances of wastefulness or unauthorized expenditures.