Nov.
TIIE DEFECTS OF FIELD HOSPITALS.
1898.]
419
the sepoy has to do, the services of these could only be obtained by offering very liberal terms in pay, and rations no whit inferior to those given to the sepoy. It is also suggested
thing
men
THE
Jndian Dflcdiqal (f> a 2 c 11 e. NOVEMBER, 1898.
and September issues called attention to various defects in the our
working
July
of
experiences
we
have
practical
Field Hospital s3rstem. The gained in Tirah are still fresh in our
men's minds, and it appears to us advisable to once more a few of the comments and
recall
recommendations which have been made regarding the working of Native Field Hospitals. We understand that the chief anxiety of any medical
proceeding on service with a Field Hospital transport, and, from the instances there narrated, appears to be good cause for this anxiety. Strong expressions of opinion have been made that ponies are unsuitable as hospital baggage animals, and should not be employed for this purpose. They are said to be too weak to officer
is his
the loads even for a few marches, and to rapidly deteriorate in condition, under exposure carry
and
privation.
A
strong preference
of
opinion
exists for mules,?first class mules if possible? but at any rate mules, as a means of transport
hills; we sincerel}' hope that medical officers may get them in future. The ambulance carts are said to be heavy and cumbersome, and tiie use of hand ambulances, where roads exist, is advocated. Various patterns are suggested ; amongst others we note a strong advocacy for the excellent hand ambulances used by the Bombay Plague Committee. In these the patient in the
reclines on a detachable stretcher, from which he need not be moved so long as the journey by road continues, the stretcher being unhooked, and
carried with the patient into the hospitals the lines of communication. It is stated, and the statement agrees with our own experience, that it is useless to suggest anything to replace the dhooly, until the authorities have decided on
to
replace the dhooly bearer. We learn, and we quite credit the fact, that there are in various parts of India coolies accustomed to carry heavy burdens to whom the carriage of sick or wounded sepoys even in hilly tracts would present no insuperable difficulties; but it is pointed can
out that
as
cover
of the
dhooli/
and
tents should
hospital equipment including changed to khaki. It would appear that not infrequently the Commissariat Sergeant attached to the hospital does not possess that knowledge be
THE DEFECTS OF FIELD HOSPITALS. In
that the colour of the of the
the work is far harder than auy-
of
transport duties, and of the To remedy this
is desirable.
vernacular which in some measure
it is advocated that he should be
supplied
with
small book containing a few simple rules about the grooming, watering, and feeding of the
a
various animals used in ambulance transport, the scale of forage allowed each animal, the
transport equipment which should accompany each animal and the number of attendants sanctioned to look after them. The book should also contain
a
"
Ready
Reckoner for
wages,"
such
as can be found in any Indian diary, to enable him to quickly calculate broken periods
in
out
making
acquittance rolls,
etc., and also
"Ready Reckoner" for rations and
forage
a
to
enable him, without unnecessary trouble, to check the forage drawn by the transport agent from the Commissariat. Above all it should contain a simple glossary in Urdu and English of every detail of gear and equipment in use, and of the names of the various
grains and forage issued as rations. We note suggestions to reduce by half the amount of medical comforts carried
in
the boxes, stock
being replenished from the Commissariat as required; to discard the disinfectants carbolic powder
sulphur as being too bulky and too quantity to be of any practical value.
and
small in If considered necessary, these articles should be kept by the Commissariat. It is alleged that the lanterns for the tents are cumbersome, heavy,
and
moreover useless, as the country cotton used will not absorb the common oil supplied. Their abolition and replacement by hurricane lanterns is suggested. Lord's lamp is said to be an ex-
cellent one; fault is, however, found with its weight, and with the circumstance that the handle instead of being rivetted on to the body is soldered on to the top of the lamp, the conse-
quence of which is that the handle occasionally off. Although considerable improvement has taken place in recent years in the medical equipment, we do not gather that our correcomes
spondents
arc
satisfied, and the opinion
is
cx-
'420
THE INDIAN MEDICAL GAZETTE.
pressed
that scales and
weights
are
out of
place
[Nov. of Tome's
light pattern
extra
1898.
tooth-forceps
on active service, and that, wherever possible, all would do admirably. The operating tables are and shaky, and the iron catches drugs should be supplied as compressed tabloids said to be weak or soloids, etc. something stronger We should certainly like to see apt to become unfixed ; is asked for. It is pointed out that and a simpler hand free given to some firm like Messrs. and the dislocation appaclavicle the apparatus Burroughs, Wellcome & Co., who have done so be should done with ratus much for travellers, to pullies away with, equip one section with and the latter the-former being unnecessary drugs as an experimental measure. The troops> as a curiosity. Duncan's elsewhere but more especially the followers, seem to have only kept in Disease of Prevention Tropical Campaigns suffered from chapped hands and cracked feet in lieu of Porter's "Surgeon's Pocketoo due to the cold and exposure. It is suggested is suggested that the Commissariat should be directed to book" as being more useful in this country. British offikeep a small stock of glycerine for issue when It is remarked that as .occasionally cers and privates have to be treated in Native required, the quantity necessary being too bulky a small portable commode? Field Hospitals of to be carried in the boxes. Instead glycerine, be substituted in Alipur camp pattern?might be added to each boracic acid "
"
powdered might operations on the eastern Frontier, as in that region troublesome sores form between the toes owing to the moisture, excessive perspiration, etc., and these sores can be cured by freely dusting the feet and socks with boracic acid powder or naphthalin. It is suggested that all instruments should be aseptic, i.e., solid forged without bone or ebony handles, to facilitate their sterilization by boiling, and that metal cases should take the place of leather pocket cases. Other suggestions are?(1) that nail brushes should be provided both for cleansing the part to be operated on, also the hands of the operator, instruments, etc.; (2) that a square tray of enamelled iron or papier machd lbr carbolizing instruments at the time of performing major operations should be added to the equipment; (3) that the metal dressing
basins should be of enamelled irou as they could then be used when dressing foul wounds without causing precipitation of the sublimate in the
section.
The number of
correspondence
returns
and amount of
unfavourable
excite
It is shown that the
use
comment.
of the memorandum
Book?Form 23?the most useful article in the stationery box, is strictly limited, as it is not to be used in correspondence with officers commanding or with senior medical officers. Why its
should he thus
unnecessarily curtailed cannot tell. It is suggested that the medical history sheets of all sepoys should be kept use
we
the regimental depot when the necessary entries could be filled in from the medical certificates, and from whence they could be obtainat
ed in the event of At
casualty taking place.
a
said to get torn and occaare passed on with the When missing, much base.
present they sionally lost as they sick
art
towards
fruitless
the
correspondence
as
to their
whereabouts
with various medical officers, officers commanding the head-quarters of the regiment takes
places
field,
and the officer
stock of corrosive sublimate soloids, various sizes, should be supplied for use when a bearer company is sent out. Time would be saved and the use of
in the
glasses avoided; (5) it should be stated that the antiseptic solution is free from
vided with a ration certificate, a small printed certificate form is required, thus saving time and
antiseptic solution; (4)
that
a
measure
and is suitable for internal medication if required. Diluted it is said to be an excellent remedy in certain cases of diarrhoea, etc.; (6) complaint is made that the
impurities,
dysentery,
of
tooth-forceps will extract universal pattern nothing-, and recommendations are made that should be replaced by others of a more they
suitable kind.
A small
would suffice:
lowing forcops, ditto
molars, and one pair each for stump, with an elevator. The
lower
upper and lower
case containing the folRight and left upper molar
commanding
the
depot. Since every sepoy or follower 011 transfer or discharge from a Field Hospital must be pro-
labour in writing out manuscript certificates, as is now the custom. Difficulty would appear to be experienced in getting returns from the staff officers concerned *of the various regiments at the post
brigade,
and
as
these
figures
strength of or forming
the the
necessary to sick the the weekly rate, prepare suggestion is offered that the work might be facilitated if printed Klips with spaces for the name of the various corps, their strength, etc, were available. These
slips could
be
easily
are
filled in
by
the staff
Nov.
ROLE OF THE HOUSE-FLY IN THE PROPAGATION OF DISEASE.
1898.]
returned, and would facilitate his he is without clerical assistance. Suris expressed, in which we share, at returns
officer and work
prise
as
being sent back for fling errors as 1896
the
correction of such tri-
for 1897, or for the omission of the medical officer's signature to some table, although the return may have been correctly signed on more than one page. It is
pointed
that if the insistance
out
the
on
re-
submission of the return, duly corrected, is intended as a disciplinary measure, it frequently
fails
in its object, owing to the offending medical officer having been transferred in the interval. We should have thought that it would have been held
to
to
be the
duty,
in order
facilitate the despatch of business, of the first
who detected medical officer or subordinate them to correct such obvious and trifling mistakes, and only to refer the matter when the correctness of the return is in question. Such then are some of the defects in our Field Hospitals brought to light during the Tirah
Campaign,
Some of them
serious, but all
we
are,
are
slight,
others
believe, remediable. It is
to be hoped that as the result of the labours of the Committee recently sitting at Simla to enquire into the working of Field Hospitals these defects will be removed, and that the next time our medical officers take the field it will be with
suitably equipped hospitals and with thoroughly re-organised transport. It is greatly to their credit that they dealt so successfully with such defects as existed, and the British and more
more
had occasion to
grateful to,
medical officers
Indian Armies have be
proud of,
and
once
of the sick and wounded
for their excellent
care
under very
conditions.
trying
421
TIIE DEFECTS OF FIELD HOSPITALS.
1898.]
419
the sepoy has to do, the services of these could only be obtained by offering very liberal terms in pay, and rations no whit inferior to those given to the sepoy. It is also suggested
thing
men
THE
Jndian Dflcdiqal (f> a 2 c 11 e. NOVEMBER, 1898.
and September issues called attention to various defects in the our
working
July
of
experiences
we
have
practical
Field Hospital s3rstem. The gained in Tirah are still fresh in our
men's minds, and it appears to us advisable to once more a few of the comments and
recall
recommendations which have been made regarding the working of Native Field Hospitals. We understand that the chief anxiety of any medical
proceeding on service with a Field Hospital transport, and, from the instances there narrated, appears to be good cause for this anxiety. Strong expressions of opinion have been made that ponies are unsuitable as hospital baggage animals, and should not be employed for this purpose. They are said to be too weak to officer
is his
the loads even for a few marches, and to rapidly deteriorate in condition, under exposure carry
and
privation.
A
strong preference
of
opinion
exists for mules,?first class mules if possible? but at any rate mules, as a means of transport
hills; we sincerel}' hope that medical officers may get them in future. The ambulance carts are said to be heavy and cumbersome, and tiie use of hand ambulances, where roads exist, is advocated. Various patterns are suggested ; amongst others we note a strong advocacy for the excellent hand ambulances used by the Bombay Plague Committee. In these the patient in the
reclines on a detachable stretcher, from which he need not be moved so long as the journey by road continues, the stretcher being unhooked, and
carried with the patient into the hospitals the lines of communication. It is stated, and the statement agrees with our own experience, that it is useless to suggest anything to replace the dhooly, until the authorities have decided on
to
replace the dhooly bearer. We learn, and we quite credit the fact, that there are in various parts of India coolies accustomed to carry heavy burdens to whom the carriage of sick or wounded sepoys even in hilly tracts would present no insuperable difficulties; but it is pointed can
out that
as
cover
of the
dhooli/
and
tents should
hospital equipment including changed to khaki. It would appear that not infrequently the Commissariat Sergeant attached to the hospital does not possess that knowledge be
THE DEFECTS OF FIELD HOSPITALS. In
that the colour of the of the
the work is far harder than auy-
of
transport duties, and of the To remedy this
is desirable.
vernacular which in some measure
it is advocated that he should be
supplied
with
small book containing a few simple rules about the grooming, watering, and feeding of the
a
various animals used in ambulance transport, the scale of forage allowed each animal, the
transport equipment which should accompany each animal and the number of attendants sanctioned to look after them. The book should also contain
a
"
Ready
Reckoner for
wages,"
such
as can be found in any Indian diary, to enable him to quickly calculate broken periods
in
out
making
acquittance rolls,
etc., and also
"Ready Reckoner" for rations and
forage
a
to
enable him, without unnecessary trouble, to check the forage drawn by the transport agent from the Commissariat. Above all it should contain a simple glossary in Urdu and English of every detail of gear and equipment in use, and of the names of the various
grains and forage issued as rations. We note suggestions to reduce by half the amount of medical comforts carried
in
the boxes, stock
being replenished from the Commissariat as required; to discard the disinfectants carbolic powder
sulphur as being too bulky and too quantity to be of any practical value.
and
small in If considered necessary, these articles should be kept by the Commissariat. It is alleged that the lanterns for the tents are cumbersome, heavy,
and
moreover useless, as the country cotton used will not absorb the common oil supplied. Their abolition and replacement by hurricane lanterns is suggested. Lord's lamp is said to be an ex-
cellent one; fault is, however, found with its weight, and with the circumstance that the handle instead of being rivetted on to the body is soldered on to the top of the lamp, the conse-
quence of which is that the handle occasionally off. Although considerable improvement has taken place in recent years in the medical equipment, we do not gather that our correcomes
spondents
arc
satisfied, and the opinion
is
cx-
'420
THE INDIAN MEDICAL GAZETTE.
pressed
that scales and
weights
are
out of
place
[Nov. of Tome's
light pattern
extra
1898.
tooth-forceps
on active service, and that, wherever possible, all would do admirably. The operating tables are and shaky, and the iron catches drugs should be supplied as compressed tabloids said to be weak or soloids, etc. something stronger We should certainly like to see apt to become unfixed ; is asked for. It is pointed out that and a simpler hand free given to some firm like Messrs. and the dislocation appaclavicle the apparatus Burroughs, Wellcome & Co., who have done so be should done with ratus much for travellers, to pullies away with, equip one section with and the latter the-former being unnecessary drugs as an experimental measure. The troops> as a curiosity. Duncan's elsewhere but more especially the followers, seem to have only kept in Disease of Prevention Tropical Campaigns suffered from chapped hands and cracked feet in lieu of Porter's "Surgeon's Pocketoo due to the cold and exposure. It is suggested is suggested that the Commissariat should be directed to book" as being more useful in this country. British offikeep a small stock of glycerine for issue when It is remarked that as .occasionally cers and privates have to be treated in Native required, the quantity necessary being too bulky a small portable commode? Field Hospitals of to be carried in the boxes. Instead glycerine, be substituted in Alipur camp pattern?might be added to each boracic acid "
"
powdered might operations on the eastern Frontier, as in that region troublesome sores form between the toes owing to the moisture, excessive perspiration, etc., and these sores can be cured by freely dusting the feet and socks with boracic acid powder or naphthalin. It is suggested that all instruments should be aseptic, i.e., solid forged without bone or ebony handles, to facilitate their sterilization by boiling, and that metal cases should take the place of leather pocket cases. Other suggestions are?(1) that nail brushes should be provided both for cleansing the part to be operated on, also the hands of the operator, instruments, etc.; (2) that a square tray of enamelled iron or papier machd lbr carbolizing instruments at the time of performing major operations should be added to the equipment; (3) that the metal dressing
basins should be of enamelled irou as they could then be used when dressing foul wounds without causing precipitation of the sublimate in the
section.
The number of
correspondence
returns
and amount of
unfavourable
excite
It is shown that the
use
comment.
of the memorandum
Book?Form 23?the most useful article in the stationery box, is strictly limited, as it is not to be used in correspondence with officers commanding or with senior medical officers. Why its
should he thus
unnecessarily curtailed cannot tell. It is suggested that the medical history sheets of all sepoys should be kept use
we
the regimental depot when the necessary entries could be filled in from the medical certificates, and from whence they could be obtainat
ed in the event of At
casualty taking place.
a
said to get torn and occaare passed on with the When missing, much base.
present they sionally lost as they sick
art
towards
fruitless
the
correspondence
as
to their
whereabouts
with various medical officers, officers commanding the head-quarters of the regiment takes
places
field,
and the officer
stock of corrosive sublimate soloids, various sizes, should be supplied for use when a bearer company is sent out. Time would be saved and the use of
in the
glasses avoided; (5) it should be stated that the antiseptic solution is free from
vided with a ration certificate, a small printed certificate form is required, thus saving time and
antiseptic solution; (4)
that
a
measure
and is suitable for internal medication if required. Diluted it is said to be an excellent remedy in certain cases of diarrhoea, etc.; (6) complaint is made that the
impurities,
dysentery,
of
tooth-forceps will extract universal pattern nothing-, and recommendations are made that should be replaced by others of a more they
suitable kind.
A small
would suffice:
lowing forcops, ditto
molars, and one pair each for stump, with an elevator. The
lower
upper and lower
case containing the folRight and left upper molar
commanding
the
depot. Since every sepoy or follower 011 transfer or discharge from a Field Hospital must be pro-
labour in writing out manuscript certificates, as is now the custom. Difficulty would appear to be experienced in getting returns from the staff officers concerned *of the various regiments at the post
brigade,
and
as
these
figures
strength of or forming
the the
necessary to sick the the weekly rate, prepare suggestion is offered that the work might be facilitated if printed Klips with spaces for the name of the various corps, their strength, etc, were available. These
slips could
be
easily
are
filled in
by
the staff
Nov.
ROLE OF THE HOUSE-FLY IN THE PROPAGATION OF DISEASE.
1898.]
returned, and would facilitate his he is without clerical assistance. Suris expressed, in which we share, at returns
officer and work
prise
as
being sent back for fling errors as 1896
the
correction of such tri-
for 1897, or for the omission of the medical officer's signature to some table, although the return may have been correctly signed on more than one page. It is
pointed
that if the insistance
out
the
on
re-
submission of the return, duly corrected, is intended as a disciplinary measure, it frequently
fails
in its object, owing to the offending medical officer having been transferred in the interval. We should have thought that it would have been held
to
to
be the
duty,
in order
facilitate the despatch of business, of the first
who detected medical officer or subordinate them to correct such obvious and trifling mistakes, and only to refer the matter when the correctness of the return is in question. Such then are some of the defects in our Field Hospitals brought to light during the Tirah
Campaign,
Some of them
serious, but all
we
are,
are
slight,
others
believe, remediable. It is
to be hoped that as the result of the labours of the Committee recently sitting at Simla to enquire into the working of Field Hospitals these defects will be removed, and that the next time our medical officers take the field it will be with
suitably equipped hospitals and with thoroughly re-organised transport. It is greatly to their credit that they dealt so successfully with such defects as existed, and the British and more
more
had occasion to
grateful to,
medical officers
Indian Armies have be
proud of,
and
once
of the sick and wounded
for their excellent
care
under very
conditions.
trying
421
