VG 123 A3 1881 INSTRUCTIONS ' . . '-' FOR ■ MEDIOAI^FFICEES OF TH&- - ' : UNITED STATES NAVt. 1881/ VG \88\ f otoH Ittnirasitg Iptatg THE GIFT OF .ILL., /bu^at.'. ..n s --.w.Ch^uAvuAAXft» J . Mtsms* i^s-h^ Cornell University Library VG123 .A3 1881 Instructions for medical officers of the 3 1924 030 897 213 oiin Cornell University Library The original of this book is in the Cornell University Library. There are no known copyright restrictions in the United States on the use of the text. http://www.archive.org/details/cu31924030897213 <6^\f4(*[ INSTRUCTIONS MEDICAL OEFIOEES OF THE UNITED STATES NAVY. PUBLISHED BY ORDER OP THE NAVY DEPARTMENT. WASHINGTON: GOVERNMENT PRINTING OFFICE. 1881. 9 r A. 1X54^ Section 4 of Act to Re-organize the Navy Department of the United States. And be it further enacted, That the Secretary of the Navy shall assign and distribute among the said Bureaus such of the duties of the Navy Department as he shall judge to be expedient and proper ; and all the duties of the said Bureaus shall be performed under the authority of the Secretary of the Navy, and their orders shall be considered as emanating from him, and shall have full force and effect as such. Approved, July 5, 1862. Navy Department, Washington, April 15, 1881. The following "Instructions" are approved and will be enforced. WILLIAM H. HUNT, Secretary of Navy. INSTRUCTIONS FOE MEDICAL OFFICERS OF THE UNITED STATES NAVY. ARTICLE I. GENERAL DUTIES. 1. Medical officers are required to be familiar with the laws and regula- tions relating to their duties. 2. The senior medical officer of every ship or station (except at hospitals where Case-papers are used) shall keep, or cause to be kept by a medi- cal officer subordinate to him, a Medical Journal, which must be a com- plete and succinct history of the medical affairs coming within his province. In this and all other records, especial regard is to be paid to neatness, accuracy, and uniformity. While it is impossible to give directions so minute as to cover every detail, and much must be left to an intelligent discretion, the principal points to be observed in keeping this Journal are the following : The origin, history, and treatment of every case of disease or injury of sufficient gravity to require a relief from duty are to be recorded in the Journal. Upon admission, the patient's name is to be written in full, followed by his grade or rate (which must accord with those contained in the muster-roll), his age, nativity, color, place and date of enlistment, and disease according to the nomenclature. The origin is then to be stated, with an expression of opinion as to its. connection with duty, and the facts upon which this opinion is based. When the testimony of the patient is important as bearing upon this point, it is to be recorded and definitely accepted or rejected ; in the latter case, with the reasons for rejection. The clinical history of the pase should follow, its essential points be- ing given carefully and as concisely as is compatible with clearness. The treatment is then to be briefly noted. 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. 6 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Should a change of diagnosis become necessary, the case must be closed by the discharge of the patient, and reopened by his admission with the amended diagnosis ; except in cases of intercurrent affections depending upon the original cause of disease, when the record may be continued. It is suggested that in doubtful cases a blank space for the disease may be left until a positive opinion can be formed. A patient readmitted with a disease for which he has previously been treated and discharged shall be regarded as a new case. Records of the temperature, pulse, respiration, and excreta of im- portant cases shall be kept and appended to the Journal or Case-paper. In case of death, post-mortem examinations should be made when practicable, and the results fully recorded. After the completion of the daily record connected with the sick, men- tion shall be made of all other matters relating to the duties of the medi- cal officer, such as sanitary inspections, recommendations made to the commanding officer, vaccinations, etc. The record of each day shall include all admissions, discharges, deaths, and other occurrences up to midnight of that day. In all cases where a patient is admitted and discharged upon the same day, he shall be noted as having been upon the sick list one day. The senior medical officer of the ship or station is alone responsible for the accuracy of the Journal and Case-paper, and they shall be signed by him, although he may delegate the duty of their preparation to one of his subordinates. When a patient is treated whose sickness is of so trivial a character that a relief from duty is not necessary, his name, with the prescription ordered, shall be appended to the record of the day, and all expenditures of liquors shall be recorded in the same manner. Issues of medicines or medical stores to others than those in the ISavy shall be noted in a prescription book kept for the purpose. At the end of the quarter a copy of the Report of Sick, Form X, shall be affixed to the Journal. Upon the completion of the Journal it shall be sent to the Bureau by the first convenient and safe opportunity to be filed. 3. A Morning Report of Sick, containing the names of all the sick, shall be made daily to the commanding officer, and on shipboard a duplicate list placed in the Binnacle for the use of the officer of the deck. Cases excused from duty during the day, after the morning lists have been made, shall be placed on the Binnacle List until the following morning, when, if continued, the patient is to be regularly admitted to the sick list on the Journal and records. 4. On the 1st day of January, April, July, and October, a Quarterly Ab- stract of Patients, Form F, shall be made for the preceding quarter or period, which shall accord with and accompany the Report of Sick, and INSTRUCTIONS FOK MEDICAL OFFICERS OP U. S. NAVY. 7 shall contain the name, rate, disease, origin, disposition, etc., of every case regularly admitted on the Journal, of which it is an index. The names shall be arranged alphabetically, each letter immediately follow- ing the preceding one, as many sheets only being used as will contain all the entries. Under the head " Origin" shall be written "duty" or " not duty," as expressive of the opinion of the medical officer with re- gard to the connection of the disease or injury with the line of duty; and under the head of "Bemarks" a statement of the facts upon which this opinion is grounded. The signature of the medical officer in charge shall be affixed to the Abstract as an attest of its correspondence with the Journal. In transmitting this Abstract to the Bureau it should be sent in a rolled form, to avoid folding and breaking. 5. The Report of Sick, Form Z, shall be made on the 1st day of January, April, July, and October, and sent with the Quarterly Abstract* with which it must agree, direct to the Bureau. On board of cruising vessels a duplicate is to be forwarded to the Surgeon of the Fleet. The annual statistical report of the Surgeon-General is based upon the report of sick, and inaccuracies or deficiencies in this will conse- quently prejudice the correctness and value of the former. Medical officers will therefore see the necessity for care and exactness in its prep- aration. To this end it is directed that a List of Patients be kept, in which shall be inscribed the name of every man as soon as he is entered upon the Journal. Prom 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. 6. The following returns shall accompany Form K to the Bureau : 1. Abstract of Patients. 2. Triplicate receipt for articles obtained from the Laboratory, or from any person in charge of stores. 3. A triplicate of all bills paid. 4. Unpaid bills in triplicate for approval. 5. Eequisition in triplicate for stores. 6. Meteorological observations. 7. Special reports of interesting cases or operations which have oc- curred under the notice of the medical officer, accounts of epidemics, reports of sanitary observations, or of other matters of importance. • 7. During the prevalence of epidemic or contagious diseases on foreign stations, especially in ports of the Gulf of Mexico, the West Indies, and t he South Atlantic Station, medical officers shall forward to the Bureau, in accordance with the circular of the Secretary of the Navy of August 8 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 18, 1879, all reliable information relating thereto which they may be able to procure, consulting for this purpose the consular and health offi- cers of the ports affected. 8. At the close of each year, and at the end of the cruise, a Sanitary Eeport shall be made to the Bureau under the following heads : (a) General hygiene, which shall include a report of the sanitary con- dition of the ship or station, accounts of epidemics or important cases of disease which have not previously been reported, together with such information or suggestions as may tend to the prevention of disease, or have an influence in the preservation of the health of the personnel of the ship or station. (&) Topography; to embrace a description of the ports visited during the year, with such information as may be attainable. 1. General physical characteristics, relating to situation, soil, drain- age, streets, and buildings, etc. 2. Population — number and character of, customs, and habits of the people. 3. Climatology. 4. Food supply. 5. Water supply. 6. Prevailing diseases and statistics of diseases and mortality. 7. Establishments for the care of the sick. 8. Education, general and professional. 9. General remarks, including such recommendations or cautions as may be of service to other vessels visiting the port. 9. On the 1st of July the medical officer in charge at all stations, hos- pitals, and receiving ships shall send to the Bureau an accurate Inven- tory, Form D, of all property belonging to the Medical Department in his charge, which shall show the quantity of each article on hand at the last return, the subsequent additions, the amount of expenditures, and the quantity on hand at the date of the iuventory. In cruising vessels this return shall be made at the end of the cruise, the first column, in such cases, to be filled in with the outfit. 10. When a transfer of property is made the officer receiving it shall give a Receipt in triplicate, on Porm D, for all property transferred, the last column alone being filled, one copy of which shall be retained by him- self, one given to the officer from whom the property is received, and the third sent to the Bureau. These receipts shall include the official records of the ship or station. INSTRUCTIONS FOE MEDICAL OFFICERS OF IT. S. NAVY. 9 11. A patient transferred from the charge of one medical officer to that of another must be accompanied by a Hospital Ticket, Form G, containing the statement of his case as recorded in the journal, which shall also be recorded in the Journal of the officer to whose care he is transferred, or affixed to the case papers. When practicable a patient transferred to a hospital shall be accom- panied by a medical officer. 13. Certificates of Death in duplicate are to be sent promptly to the Bureau, or, in squadron, to the Sturgeon of the Fleet, to be forwarded. 13. In the preparation of the Meteorological Returns, which shall be sent in quarterly, care is necessary — 1. That correct readings are taken of wet and dry bulb thermometers. 2. That water is always supplied to the wet-bulb thermometer, and that, the cotton siphon is frequently renewed. 3. That the monthly average number of ship's company is given. 4. It should be noted in " Eemarks" when sick are sent to hospital. 5. When steam is used for warming the. ship a note to that effect should be made. 6. Any peculiar conditions, local or general, tending to modify the state of the atmosphere should be stated, the object of these reports being to establish the relation, if any, between the atmospheric and sanitary condition of ships. 14. A yearly Return of Books shall be made on the 1st of January from every station supplied with a library, giving the author's name (alpha- betically), title of book, and number of volumes. On the first day of each subsequent quarter of the year, this return shall be compared with the books on hand, and a supplementary report made of the additions and losses (if any) which have occurred during the quarter. 15. Hereafter, on the request of medical officers, microscopes (for the care and safety of which they will be held strictly responsible), will be fur nished by the Bureau. Officers to whom these instruments are issued will be required to make a quarterly report of their condition, and a brief statement of the work done in any field of microscopical investigation. Monographs upon special subjects for publication, mounted specimens, 10 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. camera drawings, or interesting material for laboratory investigation are solicited by the Bureau, and will be duly credited. Cryptogamic structures, the minute forms of animal life, the micro- scopical characters of medicinal plants, and animal histology, normal and pathological, are suggested as instances of the many subjects within reach of medical officers, and in these departments much interesting and useful work can,be done. AETICLE n. SUPPLIES. « 1. The metric system of weights and measures shall hereafter be employed in the Medical Department of the Navy. 2. "When a ship is fitted for sea her medical officer will receive from the Director of the Laboratory her outfit, together with Receipts in triplicate, one of which is to be priced. These shall be signed by him, and the original sent to the Laboratory, the duplicate, to the Bureau, while the priced triplicate will be retained for use in making the final Inventory. 3. Requisitions, Form B, in triplicate, shall be made quarterly for such stores as may be needed for the ensuing three months. In preparing them articles for special use shall be fully described, and the quantities of medicines asked for shall correspond to the packages mentioned in the Supply Table. 4. The allowances in the Supply Table are intended, in the outfit of a ship, as the basis of supplies for the cruise. Needful additions may be made from time to time by requisitions, but it is not necessary nor expected that subsequent demands shall bring the amount of stores on hand fully up to that given in the Supply Table. Special Requisitions may be made for articles not on the Supply Table which are considered indispensable, or for supplies needed before the end of the quarter. 5. Purchases of stores are not authorized except in cases of urgent ne- cessity. Timely requisitions can be made to cover the ordinary de- mands. INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 11 6. On foreign stations, requisitions for supplies shall be made on the Surgeon of the Fleet. When, however, a ship is separated from the flag-ship, her medical officer may, in case of need, make purchases upon requisitions approved by the commanding officer. Upon rejoining the flag-ship, the necessity for this action must be explained for the appro- val of the Surgeon of the Fleet and the Commander-in-chief. 7. Medical officers may obtain from pay officers or officers in charge of stores, such articles as are needed by the Medical Department, giving receipts in proper form. Current accounts are not authorized, except for washing, and provisions and groceries for the sick. 8. ~So issue of instruments or surgical appliances shall be made to replace old ones, without the previous Survey and condemnation of those already on hand, and all articles of this character shall be returned .to the Labo- ratory when condemned. 9. When a vessel is put out of commission on the Atlantic Coast, her surgical instruments and Medical Stores of every kind, carefully packed and accompanied by an accurate inventory in triplicate, made out in the order of the Supply Table, stating the quantity and condition of the ar- ticles and signed by the senior medical officer of the vessel, shall be transferred to the medical officer of the yard, who shall forward them by the first public conveyance to the Laboratory. All stores and in- struments returned to the Laboratory shall be surveyed, and such as are fit for issue turned into the general stock of the Laboratory. On the Pacific Coast the stores, etc., shall be transferred to the medical officer of the Mare Island navy-yard, who shall receive them and cause a survey to be held as at the Laboratory. AETICLE III. HOSPITALS. 1. The medical officer in charge 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 always in an efficient condition, and to this end he shall exact from his subordinates, employes and patients, a proper obedience to his orders and the laws and regulations of the Navy. 12 INSTKUCTIONS FOE MEDICAL OFFICERS OF U. 8. NAVY. No changes, except in cases of emergency, shall be made in the hos- pital buildings, furniture, and grounds, such as destroying or removing trees, or disturbing the soil around them ; and no bills for purchases or repairs shall be contracted without the permission of the Bureau. 3. The surgeon in charge shall cause to be inspected by a subordinate medical officer all medicines, provisions, bedding, furniture, etc., which may be received, who shall report to him such deficiencies in quantity or quality as may be found. 4. OFFICER OF THE DAY. The officer in charge of the hospital shall detail a medical officer who, in addition to such professional duties as may be assigned him, shall perform the duty of "officer of the day "for twenty-four hours, com- mencing at 10 a. m. ; and who, except when visiting a patient, making an inspection, or at meals, shall be in attendance in a room designated for the purpose. The officer of the day shall make a tour of inspection through the wards, kitchens, mess and other rooms occupied by patients and employes, upon going on duty at 10 a. m., during the afternoon at a different hour daily, and finally at night after the patients are in bed. A list of patients and employes who have received passes shall be furnished him as early as practicable every morning, and all patients and others will be required to report their return to him. A Journal shall be kept by him which he shall 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 which 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 transferred ; the names, number of days subsisted, and disposition of patients discharged, and whether the proper papers in each case are incorrect or incomplete ; the names and condition of patients and employes who have returned intoxicated or overstaid their leaves ; the confinement and discharge of offenders, and cause of pun- ishment; the appointment and discharge of employes; the attachment and detachment of officers, or their going upon and returning from leave; and finally such other matters happening during his term of duty as it may be desirable to record. 5. Medical officers and all persons employed in the hospital establish- ment shall perform such duties as may be assigned to them by the offi- cer in charge. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. IB 6. Medical officers in charge of wards shall be held responsible for their order and neatness, and for 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, dressings, regimen, etc., are accurately and promptly carried out. 7. Patients should be accompanied, upon'admission, with Hospital Tickets, Form G, but in cases of emergency they may be admitted without this paper, when the medical officer shall report the fact to the commandant of the station with a statement of the emergency, and cause the neces- sary hospital ticket to be supplied. 8. Convalescent patients may be detailed for light service, but shall not be retained in the hospital for that purpose after they are fit for duty. 9. No patient in hospital shall be entitled to any service except that of the regular hospital attendants, nor shall any one except patients and employes of the hospital be subsisted or lodged without permission of the Bureau. IO. FULL DIET. In hospitals, the following Diet Tables will be closely followed for pa- tients; but the allowances to attendants' messes may be varied at the discretion of the medical officer in charge, provided the value of the ra- tion be not exceeded : Breakfast. Supper. Bnnday • Monday . ..■ Tuesday . Coffee (oz„ I) pt. Bread oz. Butter oz. Stewed mutton oz Sugar oz. Milk oz. Coffee (oz., 1) .. pt. Bread oz. Butter oz Beet hash oz Sugar oz. Milk oz. Coffee (oz., 1) pt. Bread; oz. Butter oz Mutton hash oz Sugar oz. Milk oz. Roast beef oz. Bread oz. Potatoes oz Other vegetables oz . Pickles oz. Mutton.. oz. Bread oz. Potatoes oz. Other vegetables oz Pickles oz. Boiled beef oz Bread oz. Potatoes oz Other vegetables oz Pickles ...oz. Tea (oz., i) pt. Bread oz. Batter oz. Sugar oz. Milk oz. Tea (oz.,i) pt. Bread... oz. Butter oz. Sugar oz. Milk .' oz. Tea (oz.,4) pt. Bread oz. Butter oz. Sugar...'. oz. Milk oz. 14 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. "Wednesday ■ Thnrsday..< Friday. Saturday .. Breakfast. Coffee (oz., 1) pt Bread oz. Butter oz. Beef hash. oz. Sugar oz Milk oz. Coffee (oz.,1) pt Bread oz. Butter oz Fork and beans . . . . pt . (warmed). Sugar oz Milk oz. Coffee (oz.,1) pt Bread oz Butter oz . Fish, chowder oz. Sugar oz. Milk. ...oz. Coffee (oz.,1) pt. Bread oz. Butter oz. Beef hash oz Sugar oz Milk oz Dinner. Beef soup pt. Pork oz. Beans oz Bread oz . Potatoes oz Pickles oz Roast beef oz Bread oz. Potatoes oz . Other vegetables oz . Pickles .oz Fish _ oz. Bread oz Potatoes oz. Other vegetables oz . Pickles > oz . Bean soup pt. Stewed mutton oz. Bread oz. Potatoes oz. Other vegetables oz . Pickles oz- Supper. Tea (oz.,J) pt. Bread. oz Butter oz. Sugar oz Milk oz. Tea(oz.,3j) pt Bread. oz . Butter oz. Sugar oz. Milk oz Tea(oz.,i) pt. Bread oz Butter oz Sugar oz. Milk oz Tea (oz.,4) pt. Bread oz . Butter oz. Sugar oz. Milk ob. n. A Special Diet Book, Form P, shall be kept for each ward which shall be revised and corrected every morning by the medical officer in charge of the ward. 13. ADMISSION OP PATIENTS. The officer of the day shall examine the hospital ticket accompanying the patient, and if correct it shall be indorsed and attached to the Case- paper, which shall immediately be opened. If the hospital ticket is found to be defective it shall at once be returned to the medical officer by whom it is signed. The name, etc., of the patient is then to be entered in the General Register of Patients, Form E, which shall be kept at hospitals for future reference and for convenience in preparing the Quarterly Abstract of Patients. If the patient be a marine from barracks the Ration Notice as pre- scribed by the Bureau of Provisions and Clothing shall be sent to the commanding marine officer; in any other case to the pay officer in charge of his accounts. 13. DISCHARGE OF PATIENTS. No person shall be discharged from the service for physical disability without having been previously surveyed by a board of medical officers. 14. A copy of the Report of Survey and of any other papers relating to the patient shall be appended to the Case-paper. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 15 15. When a patient is discharged from hospital the fact shall be entered upon the Register of Patients, and also upon the Case-paper, which is then to be filed with the hospital ticket attached. The discharge shall be reported to the commandant of the station and also to the command- ing officer of the ship or barracks to which the patient is returned; and the paymaster shall be notified in order that rations may again be issued. 16. On every Monday, a Report of Sick, Form I, for the preceding week, shall be made in duplicate, one copy of which shall be sent to the comman- dant of the station, and the other to the Bureau. AETICLE IV. SURGEON OF THE FLEET. 1. The Surgeon of the Fleet shall exercise supervision over all medical officers serving in squadron with him, visiting from time to time their ships to inquire into the sanitary condition of the ship's company and the care of the sick. He shall, under the orders of the commander-in- chief, inspect c?refully the Medical Journals and other records, instru- ments, dispensaries, and store-rooms, and report their condition. 2. He shall suggest to the commander-in-chief or senior officer measures which he may consider necessary for the preservation of health in the fleet, or to arrest the progress of disease, and for the promotion of the comfort of the sick or wounded in the fleet. 3. The Statutory Law directs him to " examine and approve all requisi- tions for medical and hospital stores for the squadron or fleet, and inspect their quality. He shall, in difficult cases, consult with the surgeons of the ships, and he shall make and transmit to the Navy De- partment records of the character and treatment of diseases in the squadron or fleet." ' 4. He shall specify, when required by the commander-in-chief, those ves- sels which may appear, from the state of health of their crews, least fit for active service or most in want of refreshment. 16 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 5. He shall, after an engagement, require a Report of Killed and Wounded from the surgeons of all the vessels, which he shall embody in a general report, to be forwarded to the commander-in-chief. 6. He shall approve and forward to the Bureau all reports of survey and certificates of death, and make, from the duplicate quarterly reports of sick sent to him, an Aggregate Report for the Bureau, which shall be accompanied by the record referred to in Paragraph 3 of this section, and a General Sanitary Report of the station. 7. He shall cause to be circulated the books and periodicals sent to him for distribution, in such manner as may seem best calculated to secure the object of the Bureau, which is to place within the reach of all the medical officers of the squadron, the latest progress in medical science. AETICLE V. SEA- GOING SHIPS. The senior medical officer ordered to a vessel fitting out shall examine the dispensary, medical store-rooms and sick bay, to see that every proper preparation is made for the reception of the stores and medicines, and for the care of the sick and wounded. Defective arrangements shall be immediately reported to the commanding officer. 2. As soon as the crew has been received on board he shall inspect the men, and request a medical survey upon all who appear to be disqualified for service. He shall also make a list of all who may seem to require vaccination, and the operation shall be done as soon as possible, and repeated in case of failure, until there is a reasonable assurance that the person is protected. 3. He shall, at all times, have in readiness everything necessary for the relief of the wounded, and on the probability of an engagement he shall distribute a sufficient number of tourniquets, in the use of which the persons to have them in charge shall be instructed. After battle he shall make out in duplicate a careful report of killed and wounded, one copy of which he shall send to the commanding officer, and the other to the Surgeon of the Fleet. INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVT. 17 4. "Whenever any person on board shall receive a wound or injury which may entitle him to a pension, he shall report the same to the command- ing officer in writing before the person is removed or discharged. Med. ical officers are forbidden to give unofficial certificates of the health or of inability to perform duty. He shall, when directed by the commanding officer, cause-to be exam- ined the boats attending the ship for the sale of articles of food, to ascertain whether they contain anything which may be prejudicial to health. He shall also, wheu required, inspect the provisions of the crew, and test the water ip be received on board, reporting to the commanding officer any unsoundness or impurities which may be found. 6. He shall make known to the commanding officer everything conducive to or militating against the general health of and comfort of the ship's company. 7. He shall forward to the Bureau at the expiration of the cruise the returns which are due at the end of the quarter, the Medical Journals remaining on board, all periodicals and books which have been furnished to him, and the final Return of Property, Form D. ARTICLE VI. RECRUITING. 1. Medical officers shall exercise great care in the performance of this duty; and hereafter, when reports of Medical Survey or Hospital Tickets represent a disability to have existed prior to enlistment, the fact shall be reported to the Bureau, which will hold the medical examiner who passed the recruit accountable for the improper enlistment. 3. The applicant for enlistment having been found to be clean aud sober, the medical examiner shall proceed to make a thorough inspection of his body. While permitted to exercise his own discretion as to the routine of procedure, he shall make inquiry on all the points indicated below : General Surface.— The applicant, being entirely nude, is to stand erect before the examiner, in a bright light, and present successively front, 2 INS 18 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. 8. NAVY. rear, and sides. [Retarded development, deformity or asymmetry of body or limbs; knock-knees, bow-legs, or splay feet, especially in minors; spinal curvatures; feebleness of constitution; strumous or other cachexia; emacia- tion; obesity; cutaneous or other external disease; glandular swellings or other tumors; nodes; varicosities; cicatrices; indications of medical treat- ment; leech-bites, blister stains, seton or scarification scars; and evidences of small-pox or successful vaccination.] Extremities and Articulations. — Applicant to present dorsal and palmar surfaces of both hands; to flex and extend every finger; to grasp with thumb and forefinger, and with whole hand ; to flex and extend, pronate and supinate wrists and forearms ; to perform all the motions of shoulder- joints, especially circumduction; to extend arms at right angles to body, and then bend elbow and touch the shoulders with the fingers; to elevate extended arms above the head, palm to palm, then^orsum to dorsum; to evert and invert feet; to stand on tip-toe, coming down upon the heels quickly, and then lifting toes from floor ; to flex each thigh alternately upon the abdomen, and, while standing on one leg, to hop with each foot ; to perform all the motions of the hip-joint ; and to walk backward and forward slowly and at double-quick. Thorax. — Note effects of these violent exercises on heart and lungs ; observe movements of chest during prolonged inspiration and expira- tion; examine by percussion and auscultation front and rear. (Incipient pulmonary phthisis, valvular disease.) , Abdomen, Groins, and Genitals. — With hands on the head and chin up, applicant to cough violently (relaxation of umbilical and inguinal regions; hernia; concealed venereal disease, especially beneath prepuce and within ori- ficium urethra;; varicocele; orchitis and other abnormal condition of testes). Spine and Perineum. — Applicant to bend body forward, with knees stiff- ened, feet wide apart, hands touching the floor, and nates exposed to strong light (hemorrhoids; prolapsus; fistulas). While the applicant is stooping make firm pressure on each spinous process of the vertebrae, (noting spinal tenderness). Head, Face, and Neck. 1. Motions of head, neck, and lower jaw. 2. Cranium (malformations, depressions, cicatrices, tinea, etc.). 3. Bars (polypi, otorrhcea, perforation, dullness of hearing). 4. Eyes (absence of cilice; tarsal redness; obstructed puncta; corneal opa- cities; adhesions of iris; defective vision; color-blindness; abnormal condi- tions of conjunctiva;; etc.). 5. Nose (polypi; ozcena; chronic nasal catarrh). ' 6. Mouth, teeth, tongue, fauces (hypertrophied tonsils; syphilitic affec- tions; impediments of speech). The Intelligence of the applicant will be evident from the character of his replies to inquiries respecting former residence and occupation, family history, etc. The Age of the applicant must be constantly kept in view by medical examiners ,in determining the standard of physical fitness. INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 19 3. The following instructions shall be strictly followed in preparing the List of Persons Examined, Form X. Names — The whole name (christian, middle, and surnames) to be legi- bly written out, without abbreviation, and correctly spelled, preference being given to the original spelling of foreigners' names ; the surname to precede and to be distinguished by being underlined. Date of Birth. — Year, month, and day to be ascertained whenever pos- sible. Place of Birth. — Specify city, town, or other locality of whatever na- tionality. Complexion, Hair, and Eyes are not to be described as simply "light" or " dark," but the character and degree of color are to be as accurately stated as possible ; as, Complexion— pallid; sallow; fair (only when de- cidedly clear) ; ruddy; florid; dark (tawny, sunburnt, or tanned) ; very dark (swarthy, dusky); mulatto; negro, &c. Hair. — Flaxen; sandy (yellowish-red); auburn (reddish-brown); brown (light, dark, or very dark) ; black; also whether thin, bald, curly, straight, wool, &c. Eyes. — Blue; gray; blue gray; yellow-gray; 'hazel (light brown); brown; dark brown; bicolored (as when the pupillary border is of a different color from rest of iris) ; also state when the two eyes are of different colors. Other Personal Characteristics. — Any prominent physical trait not incon- sistent with- bodily vigor, or not in such degree as to constitute cause for rejection — leanness, or the reverse; hirsuteness; slight asymmetry of body or limbs, knock-knees, bow-legs, or splay feet; peculiarities of teeth and genitalia; slight variocele or cirsocele, &c. In this connection medical examiners, are to remember that trivial imperfections that might pass in men should reject boys. Former Residence. — Whether in city, town, or country, and in healthy or unhealthy localities. Former Occupation. — Whether at school or at work — arduous or light — indoor or out. Family History.— Any fact suggesting predisposition or tendency to, or exemption from morbid action {longevity, decease, insanity, or sickness of parents or near relatives). Age To-be expressed in years and months; and the month to be always the month concluded and not the month current. Weight. — Accuracy of scales to be ascertained before using; body nude. Height. — To be expressed in inches ; the body to be erect, the chin neither elevated nor depressed, the feet and knees touching, legs stiff, and arms hanging perpendicularly. The vertex bar must be at right angle to the upright, which must be plumb. The perineal height must be measured as close to the extremity of the spinal column as possible, the nates being separated when necessary. 20 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVf. Thorax. — Circumference to express the mean of the greatest after forced inspiration and of the least after forced expiration, measured by a tape- line horizontally at the. precise level of the nipples ; the difference be- tween the greatest and least circumferences being entered as Expansion. Spirometer. — Applicant to be carefully instructed, and several trials to be made before measure is recorded. (When no instrument is furnished this column is to be left blank.) Vision. — To be expressed as a fraction, of which the numerator will be the distance at which Snellen's twenty-foot test can be determined, and the denominator 20. Color-perception. — To be always carefully determined, as directed in the Bureau's circular of March 20, 1880, and the results of the exam- inations to be reported quarterly, according to the form prescribed. Health, Sickness, etc. — 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 incon- sistent with present bodily vigor. In re-examination of minors and con- tinuous-service men, here enter statementof health since previous examina- tion, and affix signature of the medical officer -making the re-examination- Puberty. — In the case of minors, the facts always to be noted whether there are " no signs of," " incipient," " advanced," " established," etc. 4. No apothecary, nurse, or other person than a medical officer shall be permitted to conduct any part of a physical examination, nor to make any measurement or original entry on any paper or record of enlistment. A Record of Physical Condition of all minors in the Navy, including cadets and apprentices, shall be kept according to the form prescribed [Descriptive List], examinations for the purpose being made at intervals of twelve months, by a medical officer who shall affix his name to each examination. In the case of cadets, this record shall be preserved at the Naval Academy. The Physical Record of apprentices and other enlisted minors will be printed on parchment-paper similar to and of the size of Continuous-Service Certificates, and shall constitute the Descrip- tive List of said minors and accompany them throughout their career in the service. A similar record of the successive examinations prior to re-enlistment of continuous-service men shall be attached to the Continuous-Service Certificate and form an indispensable part of it. In the case of adults the column "Puberty" shall be omitted, and annual examinations will not be required. When minors remain in the Navy as continuous-service men their record prior to their maturity shall also be included with that subse- quent. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 21 6. Whenever any person is examined for enlistment or appointment in the Navy or Marine Corps, whether for general or special service, and whether subsequently enlisted or rejected, his name and other particu- lars constituting the Descriptive List shall at once be entered upon the list of Persons Examined, Form X, by the medical officer or senior mem- ber of the board making the examination, who shall then sign his name on a line with the entry. This record (Form X) shall be kept at all regular rendezvous, stations, or vessels where physical examinations are made, and retained there as the original official record of such examinations. On the first day of each quarter, the senior medical officer of all reg- ular stations where such examinations are conducted, shall forward to this Bureau an abstract of enlistments and a like abstract of rejections, (Form X being used in both cases), to be compiled from the original record referred to above. In both of these returns the names shall be arranged in alphabetical order, the surnames first, and in the abstract of rejections, the cause of rejection shall be fully stated. From all other places and vessels these abstracts shall be forwarded annually, on the 1st day of January, or on the closing of the station, or when the vessel goes out of commission. These abstracts should be sent to the Bureau in a rolled form, to avoid breaking by folding. 7. A similar List of Persons Examined, embracing the particulars on Form X, shall be kept by all boards of medical examiners and by all medical officers charged with the physical examination of candidates for appointment as officers in the Navy, and of officers for promotion, returns of which shall be made to the Bureau as directed in the preced- ing paragraph. 8. In cases of rejection for disabilities which are permanent and charac- teristic, medical examiners will not be required to complete all the entries in Form X as to chest measure, vision, &c, but simply to record the name, nativity, age, height, color of hair, eyes, and complexion, which, with the permanent disability, may be sufficient to identify the individual. 9. The examination having been concluded, and the candidate found qualified for the service, the medical examiner shall, upon a blank fur- nished by the Bureau of Equipment and Recruiting, or Commandant of the Marine Corps, make, sign, and transmit to the commanding officer of the rendezvous, post, station, or vessel, a Descriptive List which shall correspond in its entries with Form X. This Descriptive • List is to remain with the commanding officer for the preparation of the one which is to accompany the recruit when sent away. 22 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 10. Whenever recruits are transferred from the place of enlistment to any other vessel, station, or post, and at every subsequent transfer) they shall be accompanied by a Descriptive List, which shall be identical with that remaining in the possession of the commanding officer. After its signature by the commanding officer, the senior medical officer, assuring himself of its accuracy by comparing it with the original Descriptive List, shall note in the last column the state of health of the person up to the date of transfer, and it shall then be signed by him. Upon the discharge of an enlisted or appointed man, the Descriptive List shall be written or printed on the discharge, and the senior med- ical officer shall affix his signature to it, after verifying it by a compar- ison with the original or transfer descriptive list, and noting in the proper column the state of health of the man during the cruise. In the case of continuous-service men and minors, no other Descrip- tive List is necessary than that included in the Record of Physical Con- dition. New physical examinations are not contemplated at each transfer, but a rigid adherence to the spelling of the name and other facts oh the Descriptive List as prepared by the medical examiner shall be exacted, unless manifest errors are discovered, when these shall be reported to the Bureau and the necessary corrections made. 11. In cases where infirmities not amounting to disqualification for special ratings are waived by the Navy Department, the medical examiner shall fully describe the same on Form X and other records of enlist- ment, and at once report the fact to the Bureau of Medicine and Sur- gery, that no claim for pension may be based upon them. 19. Eecruits enlisted at rendezvous on shore shall be re-examined as soon as they arrive on board the receiving-ship, and any defects which may be discovered reported at once to the commanding officer. 13. Eecruits shall be immediately vaccinated, and in cases of failure the operation should be repeated until the medical officer is convinced that the individual is protected. Results of Vaccination shall always be re* ported on Form K. AETICLE VII. SURVEYS. 1. Whenever any person in the Navy becomes, in the opinion of the sen- ior medical officer, unfit for further fluty upon the station to which he INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 23 is attached, or for the service, the latter shall report the fact to the commanding officer with a Request for a medical survey, Form I. Reports of Medical Survey shall be made in duplicate, and duly for- warded to the Bureau of Medicine and Surgery through the usual chan- nel; except in cases of marines, when they shall be in triplicate, the third copy to be given to the commanding marine officer, to be forwarded to the Commandant of Marines. In all cases of Medical Survey, a copy of the Report shall be given to the medical officer making the request, which is to be attached to the Journal or Case-paper. Reports of Sur- vey shall be made according to the prescribed form, an opinion as to the origin being definitely given, and a statement of the facts connected therewith. When no unfitness is found, it is sufficient to state this fact; ; when it exists, and is regarded as being temporary, the phrase "unfit for duty" should be used, and when permanent, that of "unfit for serv- ice" employed. The common name of the disease is to be given. Under the head "Recommendation" is to be given the contemplated disposition of the patient. In the case of officers, this may be detach- ment, either with sick leave or for hospital treatment ; or if the unfit. ness is judged to be temporary, he may be detailed for hospital treat- ment with the view of being returned to his station. Enlisted men should be sent to hospital for treatment, or recommended for discharge. 3. Surveys of Property will be ordered by the Bureau within the United States, and the Commander-in-chief abroad, upon such articles as may be considered unfit for further use, and it shall be the duty of the Board to decide upon this point, and also, in case the article is condemned, as to its disposition. In the case of surgical instruments and appliances which have become unfit for further use, a Survey shall be held before the issue of others. ARTICLE VIII. APOTHECARIES, ETC. Apothecaries and bay-men or nurses will be selected by the senior medical officer with the approval of the commander of the vessel or sta- tion, and enlisted as provided by regulation. They, and all other per. sons employed in the Medical Department of the Navy, are prohibited from accepting donations or bequests from patients or contractors, or from the friends of either, and from acting as administrator or executor, or receiving on deposit any article of value from any patient. PHILIP S. WALES, Surgeon- General . 24 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Form A. — Medical outfit. [Triplicate.] Medical outfit of U. S. S. - at , 18—. [Signature of Medical Officer. 1 Articles. [Names in order of Supply table.] Articles. 0? Received from ■ all the articles to which quantities are affixed ; the whole being of good quality and properly packed, unless otherwise noted with red ink. [Signature of Medical Officer.] U. S. S. , At , 18—. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 25 Form B. — Requisition. [Triplicate.] U.S. 18-. Sir : The following articles are required in the Medical Department of this Respectfully, [Signature of Medical Officer.] To Artioles. | Articles. Approved : 8 =8.9 op U.S. -,18- Reoeived from ■ ■ the above articles, excepting those marked P, of good quality. [Signature of Medical Officer.l 26 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Form C — Bill. [Triplicate.] ,18—. U. S. Navy Department, Bureau op Medicine and Surgery, Per [Hospital, Navy Yard, or Ship.] To , Dr. Date. Articles. Amount of items. Dolls. Cts Aggregate amount. Dolls. Cts. The above account is correct. Approved , 18—, for — dollars - [Signature of Medical Officer. J cents, and ordered to be paid by Received, • dollars and — -, 18—, of ■ cents, in full of the above bill. [Signature of Commanding Officer or Surgeon-General.] -, [Pay-Officer U. S. Navy,] the sum of INSTRUCTIONS FOE MEDICAL OFFICERS OF IT. S. NAVY. 27 Form D.— Inventory of Property. In the Medical Department of U. S. , for the 18 — , and ending , 18- , commencing ■ [Signature of Medical Officer.] [Articles. Articles. rwhen transfers of property are made, the column "on hand" to be filled up, and the receipt ap- 28 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Form E.-Ormial Register of Patienta. Name. I ■■3 ■a Bernards. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 29 m 2 s 3 9 « ■a o O 3 la 4= M O -J -J CD 1 1 5 1 1 .S £gS a «^ t- s is-g •1 .9 ^ | Is | 1 3 , | i s | S ® SB'S S CO g-C X P w W -gag 3 a | & iMIs a g ST* 1 1 p» i> >> a +- -** ■« ■a •B B a ^ *Q T3 tA * >S >1 t*. -*3 -+i +J -•* ■+= 12 -fi 12 O a O O a o: d d s p fe fc P & R P P *oo >i o & rcj : fd- ■a S 1 ^ ■ ,■ e j fe* " 5 ft 1 p a "S .9 d .9 C9 rtf » T3 fl « 5 ^ 5 .9 • 2 1 o a a o o o o o h R W tn H H O H O \ra).msilll 8iqt rn in c* o ■* »n oo w rH T Snunp 3[0ie e*B(i iH « « CO o 00 (N ^H 54 •oSacqosip jo oi«(X £ 3 ^ o & a a **£ ft £ X 4 •4 I 1 H ail* Ills u •S. -c o ® •3 5 .5 o s ts a -3 CD (S 8 03 M .2 5 ■S -3 i * 1 S 3 3 fc -t 3 ^ o ^ a fl 5 K « a o a £> 3 i. o ^q t. © & £ s H a* > Trs. Mos. Lbs. In. In. In. In. Qttb. in. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 31 JList of Clothing, etc. 0) O m a .fl - M o o a 1 i ■a i 1 CO to s i s a s a h R .a m §i 3-S INSTRUCTIONS FOE MEDICAL OFFICERS OF XT. S. NAVY. 35 TRANSFERRED AND DEAD. Name. Grade. T>i tp nf Disease or injury. aciatli Where transferred. AGES. 16 to 26. 25 to 3B. 35 to 45. 45 to 55. Over 55. Grades. i Q ■a 8 6 1 oa 1 O o 1 T3 a si d 1 o A d o d 1 ■d o £> a o d ■a a a ■a a d t5 1 o § 1 •a 2 1 IS d i I REPORT OP VACCINATION. Presenting good cicatrices. No evidence of previous vacci- nation. Evidence of former attack of small-pox. Successful. Unsuccessful. Successful. Unsuccessful. Successful. Unsuccessful. Ports visited. Days at sea. 36 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Form I> — Request for Medical Survey. u. s. , -, 18—. To Commanding U. S. . Sir : I have to recommend medical survey of— Name. Grade. Disease. &c [This application and order are to be renderedin manuscript, and may include any number of names.] Respectfully, To [Signature of Medical Officer.] U. S. . , 18-. Gentlemen : You will hold survey as recommended above, and make separate reports, in duplicate, of each case, in strict accordance with prescribed form ; and you will particularly state all facts you may be able to elicit in regard to origin of disability, even when you do not find it to be in line of duty. Respectfully, Commanding V. S. INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 37 Form M — Report of Medical Surviy, [In duplicate.] U. S. To , Sir : In obedience to your order of , we have held a careful' survey on [give name and grade in full], attached to the U. S. , native of . aged — '■ , enlisted at — — , on the , and heg leave to report as follows : 1. Present condition : ("TJnfrt for duty" means present unfitness ; "Unfit for service," permanent unfitness. There may be Hypochondriasis or Malingering to be noted under this head.) 2. Disease: (By name in common use, if any ; also location and character.) 3. Probable future duration : (Approximate, if possible.) 4. Recommendation : (Officers may be "detached" or only "detailed" for Sick-leave. See Circular June 25, 1£62. This distinction is important to personal interests. Half-pensions, as being one-half disabled from obtaining subsistence by bodily labor.) 5. Origin: (State all facts, negative or positive, whether found to be in line of duty or found not to be in line of duty. When the patient's own statement is all that can be got, accept or reject it in terms. When "present condition" indicates no disease, the report need not proceed further. Respectfully, Kotes. — 1. The Report will not embrace more than one case. 2. Insert first name in full. 3. Location and character of injury to be state 4. State all the facts. 38 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Form Pi, — Certificate of death. [Ill duplicate.] I hereby certify that , who was a in the United States Navy, while attached to the (a) , , and holding the rank above mentioned, departed this life (i) , on the day of , in the year 18 — , and that he died of (c) , as set forth in the record of his case, as follows :* [Signature of Medical Officer.] The above-named , deceased, was born at , in the State of about years of age ; feet inches high ; complexion ; eyes; hair; and entered the United States naval service at , on the day of — '-. , in the year 18 — . [Signature of Commanding Officer.] (a) If at a navy-yard, ship, or hospital, insert name and place. ' (b) The same. a +» * Is 1*1 £S£?g £gg*S £ £ ° a " • -SS.a' 11 5 §i i - o 5«s | 'S93 5 ««H O.H i?«H goe.H^o * 3 • 5 -43 d a a g* o a o i •a © ■s "3 >> Q ID (A a p PS si & a I 1 © V I a ^3 a 3 cp i 2 3 4 5 6 7 8 9 '10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 Observations for carbonic acid should be made at least once a week, and the air of the berth-deck at night ot early in the morning should be selected. The results will not be entered unless the observer is certain of their accuracy. J The time and circumstances of observations for carbonic acid and the wetting of the decks from any cause will be entered in column of remarks. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 43 spheric Observations. for the month of , IS — . Berth-deck. Average number of ship's company. 10 a. m. 4 p. m. 10 p. m. No. — . i? 3 s .a « a S 3 2 a 1 *3 -a Is a 3 3 1 1 > eS M a u 1 Carbonic acid corrected for temperatare and pressure per 1,000 vol- umes. •6 M . .11 •■J I Remarks. • • Same instruments to be used in all hygrometric observations. Surgeon, V. 8. N. 44 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Instructions for Atmospheric Observations! For ascertaining the amount of carbonic acid in the air the following apparatus is supplied : Two glass jars, cubic capacity marked in cubic centimeters. India-rubber stoppers, and sheet India rubber to tie over neck of jars. Glass measure graduated to 60 c. c. One Mohr's burette, 60 c. c. graduated into tenths. Glass rods. Glass bottle of one liter capacity. Bottle containing papers of crystallized oxalic acid of 2.25 grams each. Bottle containing litmus or turmeric paper. A small bellows, or, in its absence, a Davidson's syringe may be used. Lime-water and distilled water. Directions : Pettenkofer's method is to be followed. For those not familiar with it the following process, extracted from Wilson's Hand-Book of Hygiene, is recom- mended : The analysis depends on the relative alkalinity of lime-water before and after it has absorbed the carbonic acid in the sample of air examined. 2.25 grams of crys- tallized oxalic acid are dissolved in 1 liter of distilled water ; 1 c. c. of this solution exactly neutralizes 1 milligram of lime, and hence the amount of lime in a given quantity of lime-water can be determined by adding the solution of oxalic acid until the point of neutralization is reached. The amount of oxalic acid required for neu- tralization expresses the alkalinity of the lime-water. If the alkalinity of the lime- water be known before and after it has absorbed the carbonic acid in the air contained in the glass jar, the difference will give the amount of lime in milligrams which has united with the carbonic acid, and the amount of the latter is obtained by calculating according to the atomic weights. The jar should be perfectly clean and dry. The air to be examined is forced into the jar by a pair of bellows, or a bellows-pump may be used. In either case the nozzle should reach the bottom of the jar. After the jar has been filled, 60 c. u. of lime-water are introduced, the mouth of the jar closed by the stopper, and the stopper secured by a tightly-fitting India-rubber cap. The jar is then well shaken so that the lime-water is made to thoroughly wash the contained air, and afterward is left to stand at least eight hours and not more than twenty- four ; 60 c. c. are introduced in order that 30 may be taken out for analysis. Thirty cubic centimeters of lime-water are poured into the graduated glass and its alkalinity determined by the test solution. Then 30 c. c. are taken from the jar and the alkalinity also determined. The difference is doubled to account for the 30 c. c. left in the jar, and the product gives the amount of lime which has combined with the carbonic acid. The amount of the latter is obtained by converting weight into Volume according to the atomic weights, and in one sum by the factor .39748+. The following rule will simplify the calculation : Multiply the difference between the alkalinity of the lime-water before and after it has been placed in the jar by 795 and divide this sum by the number of cubic centimeters in the jar, minus 60. The result will be the ratio of carbonic acid per 1,000 volumes. A correction mu9t be made for temperature as it is above or below the standard of 62° Fahrenheit. As the coefficient of expansion of air is ,0020361 for every degree of Fahrenheit, the rule for correction may be stated with sufficient accuracy thus : For every 5° Fahrenheit above 62° add 1 per cent, to the amount of carbonic acid calcu- lated as above, and deduct the same percentage for every 5° below 62°. The formula for the correction for pressure is as follows : 30 : observed height of bar : : capacity : *. The result expressed by z is substitute! for the actual capacity of the jar in the cal- culation for carbonic acid. INSTRUCTIONS FOR MEDICAL OFFICERS OP U. S NAV5T. 45 Relative humidity table. Table of the relative humidity given by the difference between the dry and wet bulb. Temperature of the dry bulb. Difference between the dry and wet bulb. 13 3 4 5 7 8 13 14 Eelative humidity ; saturation = 100. 90. 89. 88. 87. 86. 85. 84. 83 82 81 80. 79. 78 77 76. 75 74 7J 72 71 70 fi9 68 67 66 65 64 63 62 Zinci sulphas, 25-gram bottles gm. Zingiberis ext. fluid, 200-gram bottles gm HOSPITAL STOKES. Arrow-root, 500-gram tins. gm. Barley, 500-gram tins gm. Brandy, 500-cc. bottles It. Corn-starch, 500-gram tins gm. 200 200 500 400 50 100 1 500 500 500 200 1 1 200 25 200 25 100 200 200 200 200 200 200 25 1,000 800 100 25 100 300 3 100 100 100 1,000 1,000 1,000 200 1 2 500 200 1,000 5 500 2,000 1 50 ' 25 25 25 50 200 500 500 4 1.000 25 100 200 400 200 200 400 200 25 2,000 1,000 100 25 150 600 6 100 100 100 2,000 2,000 2,000 200 200 4 1,000 400 2,000 5 500 5,000 1 50 25 200 25 25 75 400 500 1,000 6 2,000 25 200 400 400 400 400 600 400 50 3,000 2,000 200 50 200 900 12 200 200 200 3,000 3,000 3,000 400 400 2 6 1,500 800 3,000 5 1,000 8,000 2 100 25 400 25 50 100 800 1,000 1,500 12 2,000 54 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Supply table— sContinued. Articles. Hospital stokes— Continued. Extract of beef, 100-gram jars... gm Extract of malt, 500-gram bottles gm Milk, 500-gram cans gm Uutmegs gm Sugar, white, 2 kilo, cans Kg Tapioca, 500-gram tins gm. Tea, black, 500-gram tins gm. ■Whisky, 500-cc. bottles .". It "Wine, port, 500-cc. bottles It "Wine, sherry, 500-cc. bottles It SURGICAL INSTRUMENTS. Aspirator ..no. Atomizer, steam no. Bougies, gum no. Bougies, o. p no. Catheters, gum no. Catheters, o. p no. Catheters, silver no. Case, antopsic no. Case, dental, No. 1 no. Case, eye and ear - no. Case, expeditionary and boat no. Case, general operating no. Case, general operating, small no Case, pocket no Case, urinary no Cupping-glasses no Galvanic battery „ no Lancets, thumb no Laryngoscope no. Microscope, (special requisition) no Ophthalmoscope no Bazor no Razor-strop no Scarificator no. Speculum, anal no. Speculum, aural set. Stethoscope, double no. Stomach-pump no. Syringes, enema no. Syringes, hypodermic no. Syringes, p., glass no. Syringes, p., rubber no. Syringes, self-injecting no. Thermometers, clinical sets. Tourniquets, field no. Tourniquets, screw no. Urinometer no. 500 1,000 3,000 2,000 25 a 500 500 6 3 3 2,000 5,000 3,000 25 2 500 500 12 4 4 a o o 2 3,000 6,000 4,000 25 4 500 1,000 15 6 4,000 8,000 6,000 25 6 1,000 1,000 18 9 10 1 18 1 2 1 1 1 1 2 4 12 4 2 30 16 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Supply table — Continued. 55 Articles. S SURGICAL APPLIANCES. Bandages, Esmarch's - 4 . Bandage roller Bandages, suspensory Binders' boards Buckskins ■no Cotton batting, i-kilo. packages. Flannel G vpsuni, calcined, 2-kilo. tins. . . Ligature, silk Ligature, wire, 1-meter rolls Lint, patent, i-kilo. rolls Muslin Muslin, oiled, 1-meter rolls Needles, thimble, and thread Pencils, hair Pins Plaster, adhesive, 5-meter rolls Plaster, isinglass, 1-meter rolls. . Silk, gray Splints Sponge, bath Sponge, surgical Tape Tape-line Trusses, single Trusses, double Wax, yellow no. no. no. no. Kg. -meters. Kg. gm. m. tg- .meters. m. sets. no. gm. m. m. m. sets. gm. gm. .pieces. no. no . no. gm DISPENSARY FURNITURE. Apparatus-stand Apparatus, atmospheric Boat medicine-chest Bottle-clasps Bottles, tinoture, 500-oc Bottles, tinoture, 250-cc Bottles, tincture, 125-cc Bottles, tincture, 50-cc Bottles, tincture, 25-cc Bottles, salt-mouth, 500-gm . Bottles, salt-mouth, 250-gm . Bottles, salt-mouth, 125-gm . Bottles, salt-mouth, SO-gm... Bottles, salt-mouth, 25-gm... Bottles, salt-mouth, 15-gni... Corks, bottle Corks, vial Cork-extractors Cork-screw Funnels, glass .no. .no. .no. .no. ..no. .no. .no. .no. .no. ..no. ..no. no. 50 no. no. 1 no 40 3 1 6 100 5 2 i 1 100 100 2 1 2 1 100 50 100 1 1 1 4 1 6 150 5 3 i 1 100 100 1 100 50 150 1 1 1 4 16 2 4 120 5 1 12 200 10 4 1 1 200 200 4 1 4 75 300 1 1 56 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Supply table— Continued. Articles. jDispenbaby furniture— Continued. Funnels, gutta-percha - G alii cups Grater, nutmeg Lamp, nursery Litmus paper, red Litmus paper, blue Measures, tin, 500-cc Measures, tin, 250- cc Measures, glass, 250-cc Measures, glass, 125-cc Measures, glass, 50-cc Measures, glass, 25-cc Measures, glass, 5-cc . - Medicine chest Mortar and pestle, glass Mortar and pestle, wedgewood Percolator Pill boxes, paper Pill boxes, wood i , Pill tile Psychromet'er Scales, apothecary's Scales, apothecary's, small Scale-case Scissors Sheepskins Spatulas, 15 c. m Spatulas, 12J cm Spatulas, 10 cm Spatulas, 7* cm Spirit-lamp Test case Test tubes ■ Tnbing,glase Twine , Vials, assorted.'. "Weights, apothecary's HOSPITAL FURNITURE. Ambulance cot Basin and pitcher, delf Easins and pitchers, metal Basins, tin, dressing Bed pans.... Bowls, pint Brush, dust Buckets, tin Buckets, wood Candlesticks ..no ..no ..no. ..no .bot .bot ..no. .no .no ..no. .no. .no. .no. ..no. .no. .no. .no. .no. .no. .no. .pairs. no. no no. ....no. no. no. no. no. ...gin. ...gm. no. ..sets. .no .no ..no. -no. .no. .no. 15 5 135 185 50 1 5 250 250 60 1 1 1 o 3 1 3 1 1 1 2 1 3 1 150 25 1 1 1 1 1 1 10 375 375 70 1 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 57 Supply table — Continued. Articles. Hospital furniture— Continued. Chairs no. Close stool, large no. Close stool, small no. Caps and saucers no. Feeding cups no. Filter, water no Knives and forks no. Ladle no. Lamps, hanging no Lantern, hand no Mugs no Pans no. Saucepans no. Shovel, dust no. Spit-cups no Spoons, medicine no. Spoons, table no. Spoons, tea no. Table, writing and operating no Table, writing no Tea-pot no. Tub, foot no. Tumblers no Urinals, glass no. "Wine-glasses no. Bed spreads no Blankets no Mattresses, hair no Mattress covers no Pillows no Pillow covers no Pillowcases no Pillowcases, gnm no. Sheets, cotton no. Sheets, gum - no. Towels no BOOKS. Dispensatory no. Parke's Hygiene no Formulary no. STATIONERY. Blank books, foolscap, 4-quire no. Blank books, foolscap, 2 quire no. Blank books, small quarto no Envelopes, official no. Envelopes, small - no. 1 1 25 25 a. 8 G 6 6 % 6 12 2 24 2 18 2 a 3 100 10. 58 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Supply table — Continued. Articles. Stationery— Continued. Erasure knife no. India robber pieces. Ink, black bot. Ink, red u .--bot. Inkstands no. Lead pencils no. Medical Journals no. Mucilage bot. Taper, blotting r qrs. Paper, envelope qrs. Paper, filtering qrs. Paper, foolscap qrs. Paper, official qrs. Paper, letter qrs. Paper, ruled, note qrs. Paper, wrapping, blue qrs. Paper, ■wrapping, white qrs. Penholders no. Penknives no. Pens, steel box. Portfolios no. Quills no. Rulers no. 1 1 3 1 2 10 4 1 1 5 S .10 10 10 10 20 10 10 1 1 1 25 1 SUPPLEMENTARY SUPPLY TABLE. SPECIAL REQUISITION. PILLS. Pil. acid, arsen., 0.001 gm. Pit acid, tannic, 0.3 gm. Pil. aconitise, 0.001 gm. • Pil. aloin, 0.03 gm. Pil. amnion, bromid., 0.3 gm. Pil. amnion, muriat., 0.2 gm. Pil. ammon. muriat. co. Pil. ammon. valerianat, 0.1 gm. Pil. assafoetidsB co., 0.2 gm. Pil. belladonna ext., 0.02 gm. Pil. bismuth, subnit., 0.2 gm. Pil. caffein cit., 0.06 gm. Pil. calcii sulphis., 0.03' gm. Pil. calcii lactophos, 0.3 gm. pil. oampb. monobrom., 0.2 gm. Pil. camph. et hyosoiam., 0.2 gm. Pil. oath. comp. (imp.) 0.1 gm. Pil. cerii. oxalat., 0.2 gm. Pil. cannabis ext., 0.03 gm. Pil. codeise, 0.01 gm. Pil. digitalin, 0.001 gm. Pil. guaranse ext., 0.2 gm. Pil. hyosciam. ext., 0.06 gm. Pil. ferri et quin. cit., 0.02 gm. Pil. ferri iodid., 0.05 gm. Pil. ferri lactat., 0.5 gm. Pil. ferri phos. quin. et strycb., 0.1 gm. Pil. ferri protocarb. (Vallet), 0.2 gm. Pil. ferri redact. (Quevenne), 0.2 gm. Pil. hydrarg., 0.1 gm. Pil. hydrarg. chlor. mit., 0.03 gm. Pil. hydrarg. biniodid., 0.002 gm. Pil. ipecac comp., 0.3 gm. Pil. pepsin et bismuth, 0.4 gm. Pil. potass, chlorat., 0.3 gm. Pil. podophyllin, 0.02 gm. Pil. quin. sulph., 0.1 gm. INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 59 Pil. salicin, 0.1 gm. Pil. sodii salicylat, 0.2 gin. Pil. zinoi phosphid., 0.03 gm. Pil. zinci valerianat, 0.06 gm. FLUID EXTRACTS. Ext. brayerae fluid, 100 gm. bot. Ext. buchu co. fluid, 100 gm. bot. Ext. cypripedii fluid, 50 gm. bot. Ext. euonimi fluid, 100 gm. bot. Ext. gelsemii fluid, 50 gm. bot. Ext. grindeliae rob. fluid, 100 gm. bot. Ext. grindelise squarros, fluid, 100 gm. bot. Ext. glycyrrhiz. co. fluid, 100 gm. bot. Ext. hammamelis fluid, 100 gm. bot. Ext. Hydrastis fluid, 100 gm. bot. Ext. krameriae fluid, 100 gm. bot. Ext. malloti fluid, 100 gm. bot. Ext. opii deodorat. fluid, 50 gm. bot. Ext. pulsatillse fluid, 50 gm. bot. Ext. rubi villos. fluid, 100 gm. ,bot„ Ext. santali fluid, 200 gra. bot. Ext. serpentariae fluid, 100 gm. bot. Ext. stiUiDgioe fluid, 100 gm. bot. Ext. taraxaci fluid, 100 gm. bot. Ext. tritici repent, fluid, 100 gm. bot. POSOLOGICAL TABLE. Acidum aceticum dil., 4. to 8. cc. Acidum carbolic cryst., 0.05 to 0.2 gm. Acidum citricnm,0.50 to 2. gm. Acidum muriaticum dil., 0.50 to 2.00 cc. Acidum nitricum dil., 0.50 to 2.00 cc. Acidum phosphor, dil., 0.50 to 4.00 cc. Acidum salicylicum, 0.30 to 1.00 gm. Acidum sulphuricum dil., 0.20 to 2.00 cc. Acidum sulphur, aromat., 0.20 to 2.00 cc. Acidum tannicum, 0.10 to 0.60 gm. Acidum tartaricum, 0.50 to 2,00 gm. Aconiti radicis ext. fluid, 0.30 to 1.00 cc. ^Etheris spiritus comp., 2.00 to 4.00 cc. jEtheris spiritus nitros, 2.00 to 8.00 cc. Alumen, 0.50 to 1.00 gm. Ammonia aqua, 0.50 to 1.20 cc. Ammonii carbonas, 0.15 to 0.60 gm. Ammonii chloridum, 0.50 to 2.00 gm. Ammonite spirit, arom., 1.00 to 4.00 cc. Antimonii et potass, tart., 0.004 to 0.10 gm. Argenti nitras, .01 to 0.20 gm. Atropiae sulphas, 0.0006 to 0.005 gm. Belladon. ext. ale, 0.015 to 0.06 gm. Bismuthi subcarb., 0.30 to 1.00. Buchu ext. fluid, 1.00 to 2.00 cc. Camphora., 0.10 to 0.60 gm. Cannabis indie, ext. ale, 0.015 to 0.06 gm. Cantharidis tinct., 0.30 to 1.30 cc. Capsici ext. fluid, 0.50 to 2.00 cc. ■Chloral hydras, 0.30 to 1.20 gm. Chloroformum purificat, 0.05 to 0.30 cc. ■Cinchoniae ext. fluid comp,, 0.50 to 2.00 cc. Colchici sem. ext. fluid, 0.10 to 0.50 cc. Colocynth. ext. comp., 0.10 to 0.35 gm. Copaiba, 1.00 to 4.00 cc. •Creta praeparata, 0.50 to 2.00 cc. Cubebse oleo-resina, 0.30 to 2.00 gm. Cupri sulphas, 0.03 to 0.60 gm. Digitalis tinctura, 0.50 to 2.00 cc. Ergotae ext. fluid, 1.00 to 2.00 cc. Ferri chloridi tinctura, 0.50 to .2.00 cc. Ferri et potass, tart., 0.50 to 2.00 cc. Filicis oleo-resina, 1.00 to 2.00 gm. Gentianae ext. fluid comp., 0.50 to 3.00 cc. Glycerina, 0.50 to 4.00 cc. Hydrarg. chlor. corros., 0.004 to 0.01 gm. Hydrarg. chlor. mite., 0.03 to 0.50 gm. Hydrarg. iodid. viride., 0.08 to 0.10 gm. Hydrarg. pilul., 0.20 to 0.60 gm. Hyoscyami ext. ale, 0.20 to 0.50 gm. Iodiuium, 0.015 to 0.03 gm. Ipecacuanha ext. fluid, 1.00 to 2.00 cc. Ipecacuanha} pulvis, 0.03 to 2.00 gm. i Ipecacuanha) pulvis comp., 0.30 to 0.60 gm. Jaborandi ext. fluid., 4.00 to 15.00 cc. Lithii carb., 0.20 to 0.40 gm. Magnesia, 0.50 to 1.20 gm. Magnesii carb., 0.5 to 0.2 gm. Magnesii sulph., 8.00 to 25.00 gm. Morphias sulphas, 0.008 to 0.03 gm. Morrhuae oleum, 4.00 to 15.00 cc. Nucis vomicae ext., 0.02 to 0.06 gm. Olivae oleum, 15.00 to 30.00 cc. Opii pulvis, 0.03 to 0.10 gm. Opii tinctura, 0.50 to 2.00 cc. Opii tinctura camph., 1.00 to 4.00 cc. Pepsina, 0.10 to 0.50 cc. Pilul. aloin comp., 0.20 to 0.60 cc. Pilul. cathart. comp., 0.30 to 0.60 gm. Pil. phosphor, 0.002 to 0.005 gm. Plumbi acetas, 0.10 to 0.50 gm. Podophylli resina, 0.50 to 1.30 gm. Potass, arsenit. liq., 0.10 to 0.50 cc. Potass, acetas, 0.50 to 1.30 gm. Potass, bicarb., 0.50 to 1.30 gm. Potass, bitart., 2.00 to 15.00 gm. Pota9s. chloras., 0.50 to 1.30 gm. Potass, et sod. tart., 10.00 to 30.00 gm. Potass, nitras, 0.30 to 1.30 gm. | Potass, permanganas, 0.008 to 0.03 gm. 60 INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. Potass, bromidum, 1.00 to 4.00 gin. Potass, cyan idnm, 0.005 to 0.008 gm. Potass, iodidum., 0.10 to 0.60 gm. Quinine sulphas, 0.05 to 0.30 gm. Ricini oleum, 4.00 to 30.00 co. Rhei ext. fluid, 0.50 to 2.00 co. Rhei pulvis, 0.05 to 2.00 gm. Santoninum, 0.10 to 0.40 gm. Scillte syrupus, 2.00 to 4.00 cc. Senegas ext. fluid, 0.05 to 0.30 co. Sennae ext. fluid comp., 4.00 to 15 00 cc. Sodii bicarbonas, 0.50 to 2.00 gm. Sodii boras, 0.50 to 2.00 gm. Strychnia, 0.001 to 0.005 gm. Sulphur, 2.00 to 15.00 gm. Terebinth, oleum, 0.50 to 2.00 cc. Tiglii oleum, 0.02 to 0.06 cc. Valerianae ext. fluid, 2.00 to 4.00 cc. Verat. virid. ext. fluid, 0.10 to 0.30 cc. Zinci carb. praecip., 0.10 to 0.60 cc. Zinci sulphas, 0.05 to 2.00 cc. Zingiberis ext. fluid, 0.50 to 1.30 cc. Brayeras ext. fluid, 8.00 to 15.00 cc. Buchu ext. fluid comp., 4.00 to 8.00 cc. Cypripedii ext. fluid, 1.00 to 4.00 cc. Euonimi ext. fluid, 2.00 to 4.00 cc. Gelsemii ext. fluid, 0.10 to.0.30 cc. Grindeliae rob. ext. fluid, 2.00 to 4.00 cc. Grindeliaj squarros ext. fluid, 2.00 to 4.00 cc. Glycyrrhizae ext. fluid, 4.00 to 8.00 cc. Hammamelis ext. fluid, 4.00 to 8.00 cc. Hydrastis ext. fluid, 0.50 to 3 00 cc. Krameriae ext. fluid, 2.00 to 4.00 cc. Malloti ext. fluid, 8.00 to 15.00 cc. Opii deodorat. ext. fluid, 0.50 to 3.00 cc. Pulsatilla ext. fluid, 0.10 to 0.30 cc. Rubi villos. ext. fluid, 4.00 to 8.00 cc. Santali ext. fluid, 4.00 to 8.00 cc. Serpentariae ext. fluid, 2.00 to 4.00 cc. Stillingiae ext. fluid, 4.00 to 8.00 cc. Taraxaci ext. fluid, 0.50 to 2.00 cc. Tritici rep. ext. fluid, 8.00 to 15.00 cc. The unit of the Metric System of Weights and Measures is the Meter, or the ten-millionth ^part of the distance from the equator to the north pole measured on an arc of the me- ridian ; and all other measures of length, surface, capacity, and weight are designated by decimal multiples and subdivisions of this unit, and of the Gram, which is the weight of one cubic centimeter of distilled water at its maximum density under the pressure of one atmosphere. The terms in most common use, besides the Meter for linear measure, will be the Kilogram, or simply Kilo, and its equivalent, the Liter, for heavy solids and liquids and the Gram and its equivalent, the Cubic Centimeter, CC, for smaller quantities. The Meter is about equal to 3 ft. 3f in., or 1.' yard. The Liter is about equal to 33f oz, or 1.' quart. The Half-Jiilo is about equal to 17J oz, or 1.' pound. The Cubic Centimeter,' CC, is about equal to 16£ ttj . The Gram is about equal to 154 grains. The Foot is about equal to 32 centimeters. The Ounce and f . \ are about equal to 32 grams, or 32 cc. The Drachm and f. 3 are about equal to 4 grams, or 4 cc. The Grain and 1$ are about equal to ^ gram or jV cc. Hence, to convert English denominations into Grams and Cubic Centimeters- Divide the number of grains by 15 ; or Multiply the number of drachms by 4 ; or Multiply the number of ounces by 32. In writing prescriptions Arabic numerals should be used and precede the abbrevia- tions Gm. and CC, care being also taken to place the decimal points of the several lines under each other, or to indicate their place by a perpendicular line, the fractional INSTRUCTIONS FOE MEDICAL OFFICERS OF- U. S. NAVY. 61 subdivisions of the gram or cubic centimeter being on the right and the whole numbers on the left of this line ; thus : R. — Potassii cyanid Opii tinct. camph 16 Prun. virg. ext. fl 32 Tolutani syrup 32 Acacia 1 syrup 48 M. R — Hydrarg. chl. mit Pepsinaj sacchar 10 Magnesise 5 M. In chart. X divid. In ordering doses, in the absence of graduated measures — An ordinary teaspoon may be considered as equivalent to 5 cc. An ordinary dessertspoon 10 cc. An ordinary tablespoon , 20 cc. An ordinary wineglass 50 cc. An ordinary tumbler 250 cc. 05 00 gm. cc. 00 cc. 00 cc. 00 cc. 1 00 gm. gm. 00 gm. The following tables represent in detail the several denominations of the Metric System, with their equivalents in English weights and meas- ures, as legalized by act of Congress. Measures of length. Denominations. Abbreviations. Values. Equivalents. Hm 328. 08964 feet. 32.8089 feet. 3.28U8 feet. 3.9371 inches. 0.3937 inch. 0. 03937 inch. Measures of surface. Denominations. Abbreviations. Values. Equivalents. 1 Ha 1 sq. hectometer = 10,000 sq. meters. 1 sq. dekameter = 100 sq. meters. 119. 603 sq. yards. 10. 7643 sq. feet. Weigh ts. Denominations. Abbrevi- i ations. Metric ton. Quintal Myria-gram Kilo-gram . . Hecto-gram Deka-gram G ram Deci-gram .. Centi-gram . Milli-gram . MT Q-- Mg P Dg. ag- es- mg. 1, 000, ooo. 100, 000. 10, 000. 1, 000. 100. 10. 1. .1 .01 grams, grams, grams . grams, grams, grams, gram . . gram . . gram. . 001 gram. Equivalent avoir- dupois. 0.9844 ton 220.46 pounds.. 22. 0462 pounds . 2. 2046 pounds. . 3.5274 ounces .. 0. S643 drachm . 0. 0564 drachm . Equivalent apoth- ecary's. 267. 92273 pounds. 26. 79227 pounds. 2. 67923 pounds. 3. 21507 ounces: 2. 472 drachms. 15. 43235 grains. 1. 5432 grains. 0.1543 grain. 0.0154 grain. 62 INSTRUCTIONS FOK MEDICAL OFFICERS OF U. S. NAVY. Measures of capacity. Denominations. Abbrevi- ations. "Values. Equivalent dry measure. Equivalent wine measure. Kilo-liter or Ster. Hectoliter Deka-liter KlorSt. HI. , „ Dl 1 dl cl ml orcc. 1 cu. meter = 1,000 cu. dm. . - 100 cu. dm... 10 cu. dm . . . 1,000 cc. = leu. dm... 35. 3165 cu. feet . . . 2. 6374 bushels . . . 1. 1349 pecks 0. 908 quart 6. 1032 cu. inches . 0. 6102 ou. inches . 0. 061 cu. inches ■ 364. 17 gallons. 36. 417 gallons. 3. 647 gallons. 1. 054 quarts. 0. 845 Bill. Milliliter .. Metric equivalents of English weights and measures. Measures. Gallon. Quart. Pint. Ounoe. Drachm. Minim. Liters. 3.785 4.403 4.543 4.617 Liters. 0. 9465 1. 10135 1. 13586 1. 15438 CC. 473.25 550. 67 567. 93 577. 19 CC. 29. 57812 CO. 3. 6927 CO. 0.6162 Dry ! Measures. Pound. Ounce, Drachm. Grain. Grains. 453. 59 373. 24 Grams. 26. 34959 31. 10349 Orams. 1. 77185 3. 88794 Oram. CONTENTS OF INSTRUMENT CASES. General Operating Case. 1 large saw. 1 butcher's saw with extra blade. 1 metacarpal saw with movable back. 1 chain saw. 1 Hey's saw. 2 trephines (1 small, 1 large). 1 elevator. 3 bone-cutting forceps. 3 bone-holding forceps. 3 gouges. 4 bone-drills (with one handle). 1 straight knife, 9^-inch cutting-edge. 1 straight knife, 7-inch cutting-edge. 1 catling, 8-inch. 1 catling, 6|-inch. 1 cartilage-knife. 7 scalpels (3 dissecting, 4 large). 2 tenacula. 3 artery-forceps (1 Liston's b. d., 1 slide- catch, 1 disaeeting). 1 dressing-forceps. 3 probes (1 Nelaton's bullet-probe and 2 silver). 2 directors. 1 probang. 1 bristle probang. 1 oesophageal forceps (Bond's). 6 pair serre-fines. 1 straight trocar and canula. 1 curved trocar and canula. 2 tracheotomy-tubes (1 large, 1 medium). 1 tongue-depressor. 12 yards suture-wire (9 yards silver, 3 yards lead. 2 metal retractors. 12 surgeon's needles (6 sharp and 6 curved.) 6 wire-suture needles and 3 Emmett's. 1 needle-carrier and cuttiDg-pliers. 2 dozen suture-pins. i ounce ligature-silk. 1 Sim's torsion-forceps. 1 screw tourniquet. 1 straight probe-pointed bistoury. 1 straight sharp-pointed bistoury. 1 curved probe-pointed bistoury. 1 curved sharp-pointed bistoury. 1 curved hern,ia-knife. 1 lithotomy-scalpel (sharp-pointed). 1 lithotomy-bistoury (probe-pointed). 1 aneurism-needle ( with set of movable points, Mott's). 2 pair scissors (1 straight, 1 curved on edge). 1 bullet-forceps (Gross'). INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. 63 Expeditionary and Boat Case. 1 straight knife, 10 inches. 1 catling, 9 inches. 1 straight knife, 8 inches. 1 scalpel, 3 inches. 1 bistoury, 3 inches. 1 tenaculum. 1 artery-needle. 2 artery-forceps (1 Liston's, 1 slide- catch). Pocket Case. 1 straight finger-knife. 1 double-edged scalpel. 1 curved bistoury, sharp-pointed. 1 catheter (Parker's). 1 tenaculum, with 3 movable points (ar- tery-needle, etc., Mott's). 1 lancet, thumb in one end, vaccinator in the other. 1 curved bistoury, probe-pointed. 1 exploring trocar. 1 tenotone. 1 pair scissors, straight. 1 pair scissors, curved or flat. 1 dressing-forceps. 1 artery-forceps (Amussat's, arranged to carry needle). JEye and Ear Case. 1 amputating-saw. 1 metacarpal saw. 1 bone-cutting forceps (Liston's). 1 bullet-foroeps (Tiemann & Co.). 1 tourniquet, screw. 1 dozen needles. 3 skeins silk. 1 artery-forceps (Liston's bull-dog, fenes- trated). 1 lancet, abscess. 2 probes, silver. 1 probe with porte-meche and porcelain button. 1 director, silver curved spatula-handle. 1 double canula. 25 silvered entomological pins. 6 suture- needles, 3 straight, 3 grooved for wire. 6 acupuncture needles. Silver and lead wire. 1 Anel's (silver) syringe and probe. 1 set Bowman's probes, Nos. 1 to 8. 1 cilia-forceps. 1 iris-forceps. 2 Von Grsefe's knives. 1 Weber's canaliculus knife. 1 pair scissors, Noyes'Jiris. 1 Critchett's spoon. 1 strabismus-hook. 1 NoyeB' eye-speculum. 1 hydrocele-syringe, with stop-cock and ear-piece. ' 1 set specula (Toynbee's). 1 curette, Gross'. 1 eustachian catheter 1 Politzer's bag. 1 Toynbee's forceps. Urinary Case. 1 set (Van Buren's) bougies, nickel-plated, Nob. 6, 9, 12, 15, 18. 1 straight sound. 1 grooved staff, medium (Little's). 3 catheters, silver, Nos. 3, 6, 9. 1 prostatic catheter (Van Buren's). 1 prostatic catheter (Squire's). 1 lithotomy-forceps. 12 whalebone bougies. 3 b. a. bougies, Nos. 1 to 6, inclusive, dou- ble. Dental Case No. 1. 1 upper-bicusped forceps. 1 lower-incisor forceps. 1 right upper-molar forceps. 1 left upper-molar forceps. 1 lower-molar forceps for both sides. 1 upper-incisor forceps. l 1 lower-incisor forceps. 1 universal forceps. 1 lower-molar forceps. 1 wisdom-tooth forceps (bayonet). 1 front-root forceps. 1 back-root forceps (bayonet). 2 elevators. 1 gum lancet. Dental Case No. 2. 1 root-forceps. 1 elevator. 1 gum-lancet. -64 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Autopsic Case. 1 aneurism needle, large. 1 blow-pipe. 1 brain-knife, double edged. 1 cartilage-knife. 1 set chain-hooks. 1 gouge and 1 chisel. 1 costatome. 1 director. 1 enterotome. 1 Billings' dissecting forceps. 1 hammer, 3 large needles. 1 saw. 4 scalpels, assorted sizes. 1 pair scissors. 1 tenaculum. Laryngoscope Case. 1 3J-inch mirror with head band. 2 laryngeal mirrors, Nos. 3 and 5. 1 pair Shimrock's laryngeal forceps. Aspirator. 1 pump and tubing. 3 trocars and needles, nickel-plated. 1 32-ounce bottle, graduated. General Operating Case (Wood's) >o. 2. 1 pair silver probes. •2 steel sounds. 1 long amputating knife. 1 circular knife. I catling. 1 trepanning scalpel with raspatory. 1 spiral tourniquet. 12 needles, silk, wax, plastic pins. 1 trepanning brush. 1 metacarpal saw. 1 Tiemann &, Co.'s bullet forceps. 1 pair straight dressing scissors. 1 pair curved eye scissors. 1 Hey's saw. 1 silver-plated catheter. 1 gum-elastic catheter. 2 gum-elastic bougies. 1 capital saw. 1 pair Liston's bone-forceps. 1 trephine and handle, Gait's. 1 pair spring-catch artery forceps, plain. 1 trepanning elevator. 1 director, steel. 1 Beer's cataract knife. 1 curved sharp-pointed bistoury. 1 curved probe-pointed bistoury. 2 scalpels. 1 plain aneurism-needle. 1 tenaculum. 1 strabismus blunt hook. 1 straight eye-needle. 1 curved eye-needle. 1 curved eye-forceps, strabismus. Set of Splints. 1 double inclined plane. 1 long splint, for fractures of the lower extremities, with a belt and perineal pad and strap. 1 short curved splint, for the inside of the thigh. 2 carved splints for general use. (All these have pads fitted and tied to them.) 1 set of leathered wooden splints. 2 sheets of cotton wadding. 1 package of tow. The double inclined plane has the lower part ao arranged as to be easily detached and nsed sepa- rately as a fracture-box when required ; it has also large buttons on the bottom, which, when turned crosswise, make the apparatus rest more firmly on the mattress. The long splint, for the lower extremities, is adapted for the use of an adhesive-plaster extend- ing-band. A strip of adhesive plaster, about two inches wide, is to be applied to the limb in the di. rection of its axis from the seat of fracture, down one side and up the other, leaving a loop or stirrup under the sole of the foot. The whole is then en- veloped with a roller bandage, applied with a mod- erate degree of firmness. A thin piece of board, about two inches square, is made to adhere to the inside of the loop or stirrup at the sole of the foot, and around this, and over the hook of the splint, a piece of tape is passed, by which to make extension. A pocket is made in the belt to receive the upper end of the splint, and the buckles on the outside of the pocket receive the ends of the perineal straps for counter extension. To adapt the splint to opposite sides, it is only necessary to take out the hook and adjust it so that the opening may look upward. INSTRUCTIONS FOE MEDICAL OFFICERS OF U. S. NAVY. 6& Contents of Box for Examination of Air. 2 glass bottles with India-rubberstoppers. 1 Mohr's bruette, 50 oc, complete. 1 glass graduate, 60 cc. 1 glass bottle, 1,000 cc. capacity. 1 glass bottle for lime-water. Glass rods, q. s. Sheet rubber, q. s. Litmus or turmeric paper, q. s. Oxalic acid, crystallized, in small glass bottles, each containing 2.25 grams of. acid. Test Case. Red and blue litmus paper. Forceps. Urinometer. 4 porcelain capsules and covers. 2 separating glasses. 4 test tubes. 3 glass tubes. 3 glass rods. 3 watch-glasses. 1 gas-tube, 25 cc. 1 graduated tube, with f oot,. 25 cc. 9 glass funnels. 2 small beakers. 1 pipette, 5 cc. graduated in 1-10. 2 sheets Swedish filtering paper, "J. H. Munktell." 1 mahogany case. 5 INS* 1 set centesimal weights. 1 ounce acetic acid, c. p. 1 ounce hydrochloric acid, c. p. 1 ounce nitric acid, c. p. 1 ounce sulphuric acid, c. p. Potassium hydrate. Barium chloride. Sodium acetate. Ammonium oxalate. Uranium nitrate. Potassium chromate. # Sodium carbonate, free from chlorides. Wire gauze, 5 by 5. Calcium carbonate, pure. " Memoranda to accompany the Naval Test Case." 66 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. Supply-Table for Medical Outfit for the Boat of the Medical Officer. (To be put up at the Laboratory and supplied as part of the outfit of the vessel.) Articles. Quantities. Uses. Whiskey Extract of beef Laudanum i Chloroform '. , Diarrhoea mixture Lime-water and linseed oil, equal parts. Sulphate of zinc Ipecacuanha, fluid ext Liq. ferri subsulph Adhesive plaster Isinglass plaster Lint Muslin Bandages, assorted Tourniquets, field Ligatures, silk Needles, threaded Fins Scissors Soap Sponges Towels Tumbler "Wine-glass - Measure-glass, 50 cc Teaspoon Tablespoon 2 bottles— 200 cc. ljar 1 bottle— 100 gm. 1 bottle— 200 gm. 1 bottle— 100 gm. 500 cc 4 powders-0.3 gm 1 bottle— 50 gm.. 1 bottle — 25 gm.. 2 meters 1 meter 500 gm 2 meters 10 10 10. .1 5 25 gm 1 pair 50 gm 3 3 f Stimulants for exhausted and wounded 5 men. ? To relieve pain. To check diarrhcea. For burns and scalds. , Emetics in cases of poisoning. For arresting hemorrhage and dressing wounds. For administering medicines. J^Every article to be labeled with its use, and each medicine to be distinctly marked, with directions for administration and quantity of dose. STATISTICAL NOMENCLATURE DISEASES, ETC. 67 STATISTICAL NOMENCLATURE OF DISEASES, ETC. A.— General Diseases. I. — Zymotic Diseases. Catarrhus epidemicua. Febris flava. Pysemia. Cholera epidemica. Febris intermittens. Roseola. Denguis. Febris reoidiva. Scarlatina. Diphtheria. Febris remittens. Vaccina. Erysipelas. Febris typhus. Varicella. Febricula. Morbilli. Variola. Febris cerebro-spinalis. Parotitis. Varioloides. Febris continua simplex. Pertussis. Febris enterioa. Phagedena putris. II. — Constitutional Diseases Adynamia. Hydrops. Scrofula. Aruuinia. Hypertrophia. Senectus. Atrophia. Lumbago. Svphilis primitiva. Carcinoma. Podagra. Syphilis conseoutiva. Degeneratio. Rheumatismus acntus. Torticollis. Diabetes. Rheumatismus chronicus. Tuberculosis. Gangraena senilis. Scorbutus. B.— Local Diseases. I. — Diseases of the Nervous System. Apoplexia. Iusolatio. Neuralgia. Cephalalgia. Irritatio spinalis. Nostalgia. Cerebritis. Insomnia. Paralysis. Chorea. Mania. Pleurodynia. Convulsio. Melancholia. Tetanus. Dementia. Meningitis. Vertigo. Epilepsia. Myelitis. Hysteria. Nausea marina, II. — Diseases of the Eye. • Amaurosis. Hemeralopia. Ophthalmia gonorrhoea. Asthenopia. Hordeolum. Ophthalmia tarsi. Cataracta. t Iritis. Pterygium. Conjunctivitis. Keratitis. Retinitis. Ectropium. Nyctalopia. ; Sclerotitis. Fistula lachrymalis. Ophthalmia. Ulcus corneal. III. — Diseases of the Ear. Otalgia. Otorrhcea. Surditas. Otitis. IV. — Diseases of the Teeth. Odontalgia. Paruiis. 69 70 INSTRUCTIONS FOR MEDICAL OFFICERS OF U. S. NAVY. V. — Diseases of the Circulatory System. Aneurysma. Angina pectoris. Dilatatio cordis. Endocarditis. Apnoea. Asthma. Bronchitis acuta. Bronchitis chronica. Catarrhus. Emphysema. Ascites. Cholera morbus. Cirrhosis hepatis. Colica. Congestio hepatis. Constipatio. Diarrhoea acuta. Diarrhosa chronica. Dysenteria acuta. Dysenteria chronica. Hydrops pericardii. Hypertrophia cordis. Morbi valvularum cordis. Palpitatio. Pericarditis. Phlebitis. Syncope. Varix. VI. — Diseases of the Sespiratory System. Epistaxis. . Hsemoptysis. Hydrothorax. Laryngitis. Phthisis pneumonica acuta. Phthisis pneumonica chron- ica. Pleuritis. Pneumonia. Pneumo-thorax. VII. — Diseases of the Digestive System. Dyspepsia. Enteritis. Fistula in ano. Gastritis. Gastrodynia. Hsematemesis. Hsemorrhois. Hepatitis acuta. Hepatitis chronica. Hernia. Icterus. Peritonitis. Pharyngitis. Proctitis. Prolapsus ani. Rhagades ani. Splenitis. Stomatitis. Tonsillitis. Vermes. Albuminuria. Balanitis. Calculus. Chancroides. Cystitis. Dysuria. Enuresis. VIII. — Diseases of the Genito-urinary System. Fistula vesicae. Gonorrhoea. Ha- in atari a. Hydrocele. Ischuria. Nephritis. Orchitis. Paraphymosis. Phymosis. Prostatitis. Spermatorrhoea. Urethrse strictura.. Varicocele. IX. — Diseases of the Locomotive System. Arthritis. Ankylosis. Caries. Abscessus. Acne. Adenitis. Anthrax. Ecthyma. Eczema. Erythema. Furunculus. Herpes. Adenitis. Coxalgia. Hydrops articulorum. Necrosis. Ostitis. Periostitis. Synovitis. X. — Diseases of the Integumentary System. Impetigo. Lepra. Lichen. Onychia. Paronychia. Pemphigus. Pernio. Porrigo. Prurigo. Psorasis. Rupia. Scabies. Tinea. Unguis involutis. Ulcus. Urticaria. XI. — Diseases of the Absorbent System. Lymphangitis. INSTRUCT] :ON8 FOR MEDICAL OFFICERS OF U. S. NAVY. XII. — Non-malignant Tumors and Cysts. Adenoma. Enchondroma. Osteoma. Angeioma. Fibroma. Polypus. •Condyloma. Lipoma. Sarcoma. Cystis. Neuroma. C. — Poisons. Alcoholismus. Delirium tremens. Vulnus venenatum. Colica pictonum. Ebriositas. D.— Violent Diseases axd Deaths. Abrasio. Fraotura. Vulnus contusum. Ambustio. Homicidium. Vulnus incisum. ■Conoussio cerebri. Luxatio. Vulnus laceratum. Congelatio. Stremma. Vulnus punctum. Contnsio. Submersio. Vulnus sclopetarium. Explosio. Suicidium. 71 i ■ ' ' ■ . . .■ mi ■.'■■■' .'.':":•: '.,■.■•'•'•• :■