PERSONAL EQUIPMENT OF MEDICAL OFFICERS ON ACTIVE SERVICE. By C. SlBTHOUPE, Surgeon, I. M. D., Madras. The following notes were drawn up by me on returning from Afghanistan last year, and as they are the result of some study of what has been written on the subject, of some practice in travelling, and of experience gained during my time up there, I think they may be of interest to other medical officers, especially to those who have not had the same opportunities, and are likely to be ordered on service at short notice. The great comfort of travelling with a light kit has only to be tried to be appreciated, and, considering the slight difficulty in the present day of getting what one requires by post, the necessity of carrying a large kit no longer exists, even if the supply of transport allowed of it. On the Cabul Scale each officer was allowed?
The
Camp Equipage
...
Kit
...
Cooking utensils
...
Mess Stores
...
eighty-pound
tent made in
Eighty pounds. Eighty pounds. Ten pounds. Forty pounds. the Bangalore Jail and
those made in the Jubbulpore School of Industry, or in the Elgin Mills, Cawnpore, were all equally good, but with them a separate tent for servants could not be carried, full weight. Officers travelling alone as they were were allowed thirty-six pounds extra for a mess tent : this weight might have been utilized by them for a tent for servants. It is a good plan to have three or four pockets made inside the tent, they are so useful for keeping papers, &c., in. The following is a list of my kit made up to suit the eighty-pound scale : In a soldier's kit bag was packedTwo suits of warm under-clothing. Six silk pocket handkerchiefs. Six pairs of warm woollen socks. ?
One pair of slippers. One suit of uniform, blue patrol and trousers. One suit khaki uniform. One case holding knife, fork, spoon and drink-
ing cup.
THE INDIAN MEDICAL GAZETTE.
152
Tabular Statement
Mode of
Treatment.
Form
Etiology.
of Abscess. bp
(a.) Valvular incision
1880.
of Cases.
Result.
Remarks.
?g S ?g
Days.
Years.
Lumbar
[Juse 1,
22
Injury
10
Recovery
40
Strain
63
Recovery
40
Death
Sequel of fever
Iliac
29
Iliac
23
Parturition
20
Gluteal
11
Coxalgia
42
Gluteal
SO
Coxalgia
Iliac
27
Strain
Gluteal
41
Cold
Ischio-rectal
21
Lumbar
18
Valvular incisions twice made, pus re-accumulated drainage had to be used.
free openings with
Fever of an asthenic type ensued, the pus became foetid, and the patient died from septicemic compli^ cations.
b.) Lister's antiseptic method
(.c). Aspirator
Abdomino-parietal Ilio-lumbar
40
Perityphlitis
Iliac
27
Strain
Abdomino-parietal
21
Iliac
19
Psoas
6
14
Recovery
Sequel
Sequel
Recovery
of fever
Recovery
Death
Recovery
of fever
Recovery
Injury
A scrofulous subject, worn out, and in an advanced stage of coxalgia, abscess in the buttock was opened, but followed shortly after by similar swelling in iliac fossa. Death from exhaustion. Autopsy revealed necrotic openings in acetabulum through which pus had escaped into the sub-peritoneal cavity.
In none of these did pus re-accumulate, nor did Vthe serous discharge which oozed from the openings I during the process of cure, show a tendency to
j putrefy.
J
Abscess involved both tho psoas and iliaeus of the affected side; was opened below Poupart's ligament. Coecal fistula was diagnosed, and autopsy confirmed this opinion.
Tapped
Recovery
Gluteal
30
Sequel of fever
Recovery
Lumbar
50
of fever
Recovery
Double Psoas
11
Spinal disease
Double Psoas
28
Double Coxalgia
twice.
?
once.
,,
5 times.
Recovery
Strain
Sequel
Abscess was the result of caries of the head of the femur ; the diseased portion of the bone was excised by Dr. Gayer, and the antiseptic method continued throughout with success.
Recovery Recovery
Injury
25
Recovery
Death
of fever
Sequel
Recovery
No evidence of no pus formed.
spinal disease ; after two tappings
Tapped once. A large abscess in which aspirator was used four times. Pus re-formed rapidly and free opening was resorted to.
fdj. Free opening
Death
180
Crippled
From
exhaustion.
A soldier who had double
hip-joint disease, abpointed simultaneously on either side below Poupart's ligament; both were freely incised?discharge was constant, exhaustion very marked and the patient was sent to England as an invalid. Drainscesses
age tubes Iliac Gluteal
Parturition Fall
were
used.
Recovery
No
Recovery
Drainage used.
drainage.
Ischio-rectal
Blow in abdomen
Abdomino-parietal
Biliary Calculi causing oVstruction and irritation
Recovery
Tapped 3 times and afterwards freely opened; drainage employed, counter-openings were necessary ?recovery with the formation of fistulae.
Pelvic (true)
Sequel of fever
Recovery
Opened at most fluctuating point in back of thigh ; drainage used.
Death
Autopsy showed necrotic opening in acetabulum and passage of pus into pelvis.
Gluteal
Coxalgia
Recovery
No
drainage.
J. R.
WALLACE, P. H? A., Bengal Ser
June 1,
1880.] One
PERSONAL EQUIPMENT OF MEDICAL OFFICERS.?BY C. SIBTHORPE. 153
case
of needles and
thread,
spare buttons,
be tied cover.
on
One forage cap. A money
bag.
A
pocket filter. Spnre eye-glass and cord. A copy of Shakespear. in a large waterproof sheet and strapped A cork mattress. Two warm Austrian a
blankets,
one
were?
made like
bag.
Two flannel shirts One pair of strong walking boots. One pair of gaiters. One boot brush and tin of blacking. Carried on person? Helmet and khaki cover. Khaki patrol jacket over serge blue one, with a first dressing sewn inside. Riding breeches?cords the best. Riding boots, or, still better, walking boots and
gaiters.
Spurs?gloves.
Sword and Sir S. Browne's belt with revolver and spare cartridges one that takes the Government cartridges should be chosen. Note book to go in pocket. Pouch belt covered with khaki, the new one of the A. M. D. is the best one, it should be worn when at all likely " tables" or diagnosing cards. to be of use. A few spare Hunting watch, compass, large penknife with corkscrew, &c., silk pocket handkerchief, flannel shirt and undershirt, drawers, braces, and socks, water bottle and havreAll buttons should be in duplicate on trousers and sac. strongly sewn. It is a good plan to have the pockets of both coats and trousers made of chamois leather. The horse should carry? A regulation saddle and bridle, a set of extra shoes and nails in the regulation-shaped leather pocket hung to a ?
shaped ring
; a
pair
of binoculars
hung
to
another D.
bags
and
a
their own over the saddle bags instead of The saddle bags made to fit on behind the saddle by Owen of Bangalore were very useful, and on these was strapped a valise similar to those in use with the cavalry. In it was packed one pair of drawers, one pair of socks, one towel, one flannel shirt, a holdall containing brushes, comb, sponge, nail and tooth brush,
Two pounds of soap.
One flannel night cap. One flannel sleeping suit. One pair of long woollen socks, admirable cold nights. One one-pound tin of chipping. One cholera belt.
D.
should hold two Esmarch's triangular little lint, brandy flask, tobacco and pipe, matches, a hypodermic syringe and a small bottle of solution of morphia in a tin case, a pocket aneroid and a pair of sun glasses. The great coat with its cape and a light waterproof coat rolled as close as possible should
Three pounds of candles. Two pounds of tobacco. One spare pipe. Twelve boxes of matches and one tin cover. One map of the country. One writing portfolio with paper and ink. One journal book. Porter's Surgeon's Pocket book ; Esmarch's is perhaps better. Six spare boot laces.
Packed
The saddle
bandages
&c. One candle lamp. One pair of braces. One canvas basin. Four rough towels.
clothes brush, soap, pins, a light suit of khaki uniform, and a spare pair of boots. A medical officer can afford to load his horse like this on occasion as he will probably for his own sake do a good deal of a march on his own feet and rarely requires to put his horse out of a walk. For the horse was carried a stable bucket, a warm blanket, two heel ropes, two brushes, one curry comb, one gram bag, and two iron pickets. For cooking utensils nothing is better for an officer travelling alone than a small Warren's cooking pot if he learns how to use it. The cover of this should be made to act as a frying pan, and should be supplied with a moveable handle. In it might be packed a small a
kettle, two iron enamelled plates, a teacup and saucer of the same material, a set of good muffineers for pepper, salt and mustard. All should be made to pack up together in a strong canvas 01* leather water bucket. The following articles should be carried whenever the transport will allow of it. A good strong camp chair, a small camp table, and a camp cot, the latter is nearly a necessity in India, the Cashmere pattern is one of the best. A kerosine lantern similar but smaller than those made by Messrs. P. Orr & Sons of Madras, called their P. W. D. camp lantern, is extremely useful, and keeps the tent warm on cold nights. They made me a capital one, about half the weight and size of their ordinary one. A large brass cheelumchee for a bath is also a great comfort; when it is not possible to have this, the old camp plan of digging a hole in the ground and placing the waterproof sheet in it does very well. The horse-keeper, if trustworthy, can always carry a gun
and some cartridges. All servants should be well and warmly clothed, they should not be allowed to carry anything but a single change of their light native clothes, blankets and cooking utensils. They ought to be supplied with waterbottles and liavresacs. The value of good servants is perhaps more thoroughly appreciated in camp than anywhere else, and a little thought for their comfort will render them contented and amply repay the master.
Stores, when an officer is isolated the best carry, if he has to live on the Commissariat rations and rum allowed by Government, would be some tins of soup and of Liebig's extract of beef, some small tins of prepared Australian beef, some tins of condensed As to Mess
he
can
milk, up the
some
cocoa
forty pounds
and
milk,
allowed.
biscuits and bacon to make
154
THE INDIAN MEDICAL GAZETTE.
It is
important to remember to leave one's measuregood tailor and a good boot-maker. I liave known this forgotten before now, and an officer has to depend on England for his supplies.
ments with a
General Hospital ; 12th February 1880.
Madras,
) )
[June 1,
1880.
The
Camp Equipage
...
Kit
...
Cooking utensils
...
Mess Stores
...
eighty-pound
tent made in
Eighty pounds. Eighty pounds. Ten pounds. Forty pounds. the Bangalore Jail and
those made in the Jubbulpore School of Industry, or in the Elgin Mills, Cawnpore, were all equally good, but with them a separate tent for servants could not be carried, full weight. Officers travelling alone as they were were allowed thirty-six pounds extra for a mess tent : this weight might have been utilized by them for a tent for servants. It is a good plan to have three or four pockets made inside the tent, they are so useful for keeping papers, &c., in. The following is a list of my kit made up to suit the eighty-pound scale : In a soldier's kit bag was packedTwo suits of warm under-clothing. Six silk pocket handkerchiefs. Six pairs of warm woollen socks. ?
One pair of slippers. One suit of uniform, blue patrol and trousers. One suit khaki uniform. One case holding knife, fork, spoon and drink-
ing cup.
THE INDIAN MEDICAL GAZETTE.
152
Tabular Statement
Mode of
Treatment.
Form
Etiology.
of Abscess. bp
(a.) Valvular incision
1880.
of Cases.
Result.
Remarks.
?g S ?g
Days.
Years.
Lumbar
[Juse 1,
22
Injury
10
Recovery
40
Strain
63
Recovery
40
Death
Sequel of fever
Iliac
29
Iliac
23
Parturition
20
Gluteal
11
Coxalgia
42
Gluteal
SO
Coxalgia
Iliac
27
Strain
Gluteal
41
Cold
Ischio-rectal
21
Lumbar
18
Valvular incisions twice made, pus re-accumulated drainage had to be used.
free openings with
Fever of an asthenic type ensued, the pus became foetid, and the patient died from septicemic compli^ cations.
b.) Lister's antiseptic method
(.c). Aspirator
Abdomino-parietal Ilio-lumbar
40
Perityphlitis
Iliac
27
Strain
Abdomino-parietal
21
Iliac
19
Psoas
6
14
Recovery
Sequel
Sequel
Recovery
of fever
Recovery
Death
Recovery
of fever
Recovery
Injury
A scrofulous subject, worn out, and in an advanced stage of coxalgia, abscess in the buttock was opened, but followed shortly after by similar swelling in iliac fossa. Death from exhaustion. Autopsy revealed necrotic openings in acetabulum through which pus had escaped into the sub-peritoneal cavity.
In none of these did pus re-accumulate, nor did Vthe serous discharge which oozed from the openings I during the process of cure, show a tendency to
j putrefy.
J
Abscess involved both tho psoas and iliaeus of the affected side; was opened below Poupart's ligament. Coecal fistula was diagnosed, and autopsy confirmed this opinion.
Tapped
Recovery
Gluteal
30
Sequel of fever
Recovery
Lumbar
50
of fever
Recovery
Double Psoas
11
Spinal disease
Double Psoas
28
Double Coxalgia
twice.
?
once.
,,
5 times.
Recovery
Strain
Sequel
Abscess was the result of caries of the head of the femur ; the diseased portion of the bone was excised by Dr. Gayer, and the antiseptic method continued throughout with success.
Recovery Recovery
Injury
25
Recovery
Death
of fever
Sequel
Recovery
No evidence of no pus formed.
spinal disease ; after two tappings
Tapped once. A large abscess in which aspirator was used four times. Pus re-formed rapidly and free opening was resorted to.
fdj. Free opening
Death
180
Crippled
From
exhaustion.
A soldier who had double
hip-joint disease, abpointed simultaneously on either side below Poupart's ligament; both were freely incised?discharge was constant, exhaustion very marked and the patient was sent to England as an invalid. Drainscesses
age tubes Iliac Gluteal
Parturition Fall
were
used.
Recovery
No
Recovery
Drainage used.
drainage.
Ischio-rectal
Blow in abdomen
Abdomino-parietal
Biliary Calculi causing oVstruction and irritation
Recovery
Tapped 3 times and afterwards freely opened; drainage employed, counter-openings were necessary ?recovery with the formation of fistulae.
Pelvic (true)
Sequel of fever
Recovery
Opened at most fluctuating point in back of thigh ; drainage used.
Death
Autopsy showed necrotic opening in acetabulum and passage of pus into pelvis.
Gluteal
Coxalgia
Recovery
No
drainage.
J. R.
WALLACE, P. H? A., Bengal Ser
June 1,
1880.] One
PERSONAL EQUIPMENT OF MEDICAL OFFICERS.?BY C. SIBTHORPE. 153
case
of needles and
thread,
spare buttons,
be tied cover.
on
One forage cap. A money
bag.
A
pocket filter. Spnre eye-glass and cord. A copy of Shakespear. in a large waterproof sheet and strapped A cork mattress. Two warm Austrian a
blankets,
one
were?
made like
bag.
Two flannel shirts One pair of strong walking boots. One pair of gaiters. One boot brush and tin of blacking. Carried on person? Helmet and khaki cover. Khaki patrol jacket over serge blue one, with a first dressing sewn inside. Riding breeches?cords the best. Riding boots, or, still better, walking boots and
gaiters.
Spurs?gloves.
Sword and Sir S. Browne's belt with revolver and spare cartridges one that takes the Government cartridges should be chosen. Note book to go in pocket. Pouch belt covered with khaki, the new one of the A. M. D. is the best one, it should be worn when at all likely " tables" or diagnosing cards. to be of use. A few spare Hunting watch, compass, large penknife with corkscrew, &c., silk pocket handkerchief, flannel shirt and undershirt, drawers, braces, and socks, water bottle and havreAll buttons should be in duplicate on trousers and sac. strongly sewn. It is a good plan to have the pockets of both coats and trousers made of chamois leather. The horse should carry? A regulation saddle and bridle, a set of extra shoes and nails in the regulation-shaped leather pocket hung to a ?
shaped ring
; a
pair
of binoculars
hung
to
another D.
bags
and
a
their own over the saddle bags instead of The saddle bags made to fit on behind the saddle by Owen of Bangalore were very useful, and on these was strapped a valise similar to those in use with the cavalry. In it was packed one pair of drawers, one pair of socks, one towel, one flannel shirt, a holdall containing brushes, comb, sponge, nail and tooth brush,
Two pounds of soap.
One flannel night cap. One flannel sleeping suit. One pair of long woollen socks, admirable cold nights. One one-pound tin of chipping. One cholera belt.
D.
should hold two Esmarch's triangular little lint, brandy flask, tobacco and pipe, matches, a hypodermic syringe and a small bottle of solution of morphia in a tin case, a pocket aneroid and a pair of sun glasses. The great coat with its cape and a light waterproof coat rolled as close as possible should
Three pounds of candles. Two pounds of tobacco. One spare pipe. Twelve boxes of matches and one tin cover. One map of the country. One writing portfolio with paper and ink. One journal book. Porter's Surgeon's Pocket book ; Esmarch's is perhaps better. Six spare boot laces.
Packed
The saddle
bandages
&c. One candle lamp. One pair of braces. One canvas basin. Four rough towels.
clothes brush, soap, pins, a light suit of khaki uniform, and a spare pair of boots. A medical officer can afford to load his horse like this on occasion as he will probably for his own sake do a good deal of a march on his own feet and rarely requires to put his horse out of a walk. For the horse was carried a stable bucket, a warm blanket, two heel ropes, two brushes, one curry comb, one gram bag, and two iron pickets. For cooking utensils nothing is better for an officer travelling alone than a small Warren's cooking pot if he learns how to use it. The cover of this should be made to act as a frying pan, and should be supplied with a moveable handle. In it might be packed a small a
kettle, two iron enamelled plates, a teacup and saucer of the same material, a set of good muffineers for pepper, salt and mustard. All should be made to pack up together in a strong canvas 01* leather water bucket. The following articles should be carried whenever the transport will allow of it. A good strong camp chair, a small camp table, and a camp cot, the latter is nearly a necessity in India, the Cashmere pattern is one of the best. A kerosine lantern similar but smaller than those made by Messrs. P. Orr & Sons of Madras, called their P. W. D. camp lantern, is extremely useful, and keeps the tent warm on cold nights. They made me a capital one, about half the weight and size of their ordinary one. A large brass cheelumchee for a bath is also a great comfort; when it is not possible to have this, the old camp plan of digging a hole in the ground and placing the waterproof sheet in it does very well. The horse-keeper, if trustworthy, can always carry a gun
and some cartridges. All servants should be well and warmly clothed, they should not be allowed to carry anything but a single change of their light native clothes, blankets and cooking utensils. They ought to be supplied with waterbottles and liavresacs. The value of good servants is perhaps more thoroughly appreciated in camp than anywhere else, and a little thought for their comfort will render them contented and amply repay the master.
Stores, when an officer is isolated the best carry, if he has to live on the Commissariat rations and rum allowed by Government, would be some tins of soup and of Liebig's extract of beef, some small tins of prepared Australian beef, some tins of condensed As to Mess
he
can
milk, up the
some
cocoa
forty pounds
and
milk,
allowed.
biscuits and bacon to make
154
THE INDIAN MEDICAL GAZETTE.
It is
important to remember to leave one's measuregood tailor and a good boot-maker. I liave known this forgotten before now, and an officer has to depend on England for his supplies.
ments with a
General Hospital ; 12th February 1880.
Madras,
) )
[June 1,
1880.
