FM 8-40 
WAR DEPARTMENT 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Note.—This is not a revision. This Manual contains only C 1, 12 June 
1942; C 2. 9 July 1942; C 3, 22 December 1942; C 4, 16 March 1943; and C 5, 
30 April 1943, to the 13 August 1940 edition placed at the back following the 
original text, and will not be issued to individuals possessing that edition. FM 8-40 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Prepared under direction of 
The Surgeon General 
NOTE.—This is not a revision. This manual contains only C 1, 12 June 
1942; C 2, 9 July 1942; C 3, 22 December 1942 ; C 4, 16 March 1943; and 
C 5, 30 April 1943, to the 15 August 1940 edition placed at the back following 
the original text, and will not be issued to individuals possessing that edition. 
UNITED STATES 
GOVERNMENT PRINTING OFFICE 
WASHINGTON: 1940 
For sale by the Superintendent of Documents. Washington, D- C. 
Price 25 cents WAR DEPARTMENT, 
PM 8-40, Medical Field Manual, Field Sanitation, is pub- 
lished ‘ the information and guidance of all concerned. 
Washington, August 15, 1940. 
[A. G. 062.11 (6—5—40).] 
By order of the Secretary of War: 
G. C. MARSHALL, 
Chief of Staff. 
Official : 
E. S. ADAMS, 
Major General, 
The Adjutant General. TABLE OF CONTENTS 
Paragraphs Page 
hapter 1. General 1-5 1 
Ihapter 2. Control of Communicable Diseases 
Section I. General 6-15 5 
II. Respiratory diseases 16-17 12 
III. Intestinal diseases 18-22 17 
IV, Insect-borne diseases 23-26 20 
V. Venereal diseases 27-34 22 
3. Water. 
ction I. Responsibility for water supply,. 35-36 25 
II. Water characteristics and re- 
quirements ! 37-39 26 
III. Sources 27 
IV. Purification 43-48 29 
V. Water reconnaissance 49-53 34 
iTR 4. Waste Disposal, 
Section I. General 39 
II. Human wastes 56-69 40 
III. Garbage 70-75 50 
IV. Liquid wastes 76-82 61 
V. Manure 83-91 66 
VI. Rubbish 92-94 70 
•ter 5. Mess Sanitation. 
Section I. Responsibility 95-96 72 
II. Facilities 97-99 73 
III. Cleansing of utensils and disposal 
of wastes 100-101 74 
IV Menus and serving of food 102-105 77 
V. Mess inspection 106-107 79 
S ‘ter 6. Hygenic Control of Food Products 
Animal Origin. 
3Ction I. Meat and meat food products 108-114 84 
II. Sanitary inspections 115-117 86 
III. Poultry and eggs i 118-119 88 
IV, Fish and sea foods 120-121 89 
V. Milk and dairy products 122-126 92 
5R 7. Fly Control. 
ition I. Development and characteristics 
of the fly : 127-128 96 
II. General control measures 129-130 97 
III. Fly traps 131-135 98 
IV. Other special measures 136-140 104 
8. Mosquito Control. 
i I. Development, habits, and char- 
acteristics of the mosquito 141-145 106 
II. Control measures 146-164 111 
Control of Lice. 
i I. General 165-168 121 
II. Methods of disinfestation.; 169-178 123 TABLE OF CONTENTS 
Chapter 10. Rat Control. Paragraphs 
Section I. Importance, classification, and 
habits of the rat 179-181 
II. General control procedure 182-183 
III. Eradication by poisoning 184-187 
IV. Eradication by trapping and fu- 
migating 188-192 
V. Rat surveys 193-196 
Chapter 11. Sanitary Surveys and Sanitary 
Orders. 
Section 1. Sanitary surveys 197-199 
II. Sanitary orders 200-205 
Chapter 12. Field Epidemiology 
Section I. Epidemiological investigation 206-209 
II. Carriers and missed cases 210-211 
Chapter 13. Physical Examinations. 
Section I. Responsibility and standards 212-214 
II. Conduct of examinations and 
inspections 215-21 ‘ 
Chapter 14. Important Factors Relative to 
Personal Hygiene. 
Section I. General 218-2" J 
II. Prevention and treatment of skin 
diseases 220-221 
III. Oral hygiene 222-224 
Chapter 15. Vital Statistics. 
Section I. Statistical rates and strengths 225-227 
II. Methods of computing rates and 
ratios 228-231 FM 8-40 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
CHAPTER I 
GENERAL 
IS 1. Purpose of Military Sanitation.—The application of 
well-established practical measures for the preservation of 
the health and the prevention of disease is essential in order 
that the military personnel may be kept at its maximum 
strength. It is of the greatest importance that all 
officers and enlisted men should be conversant with the 
fundamentals of military sanitation as outlined in this 
manual, and amplified in TM 8-255 (now published as Army 
Medical Bulletin No. 23), and that they cooperate in observ- 
ing and carrying out the measures prescribed in Army Regu- 
lations. The issuance of proper orders and regulations re- 
garding military sanitation will not produce satisfactory 
results unless they are intelligently enforced and implicity 
obeyed by all, from the highest to the lowest grades. 
■ 2. Responsibility for Sanitation.—a. Commanding offi- 
cers.—Commanding officers of all grades are responsible for 
sanitation and for the enforcement of the provisions of sani- 
tary regulations within their organizations and the boundaries 
of areas occupied by them. Commanding officers will take 
such steps as they deem practicable and feasible to correct 
sanitary defects. 
b. Medical Department.—The Medical Department is 
charged with the duty of investigating the sanitary conditions 
of the Army and making recommendations in relation thereto, 
of advising with reference to the location of camps, the quality 
of water supply and purification, efficiency of waste disposal, 
the prevention of disease among military personnel and ani- 
mals, and the execution of all measures for conferring im- 
munity from disease on military personnel and animals. The 
Medical Department is further charged with the responsibility 
1 MEDICAL FIELD MANUAL 
of investigating and making recommendations concerning the 
following: 
(1) Training in matters of personal hygiene and sanita- 
tion. 
(2) The adequacy of the facilities for maintaining sanitary 
conditions. 
(3) Insofar as they have a bearing upon the physical con- 
ditions of troops— 
(a) The equipment of organizations and individuals. 
(b) The character and condition of the buildings or other 
shelters occupied by troops. 
(c) The character and preparation of food. 
(d) The suitability of clothing. 
(e) The presence of rodents, vermin, and disease . u 
insects and the elimination thereof. 
c. Medical officers.—The senior medical officer of a com- 
mand or station is charged, under the commanding officer, 
with the general supervision of the Medical Department of 
the command in the performance of its duties. Medical 
officers, as technical advisers of their commanding officers, 
are responsible for pointing out insanitary conditions 
and making proper recommendations for their correction, 
but the direct responsibility rests with the commanding officer. 
When, however, a commanding officer authorizes a medical 
officer to give orders in his name for the correction of sanitary 
defects, as is advisable under proper limitations, the duties 
and responsibilities of the latter are correspondingly in- 
creased. 
d. Medical inspectors.—The medical inspector is an assist- 
ant to the surgeon and under him is charged especially with 
the supervision of the sanitation of the command to which 
he is assigned and the prevention of communicable diseases 
therein. The veterinarian of a command or station is con- 
sidered as a medical inspector as regards animal sanitation 
and the performance of the prescribed duties in connection 
with meat and dairy hygiene. 
■ 3. Sanitary Supervision.—Supervision of the sanitation of 
a station or command is one of the most important duties 
devolving upon a medical officer. Inspections and reports will 
not be made in a perfunctory manner. (See AR 40-275.) 
2 FIELD SANITATION 
Sanitary defects susceptible of correction by local authority 
will be reported to the responsible officer immediately with 
recommendations for practical remedial measures. Reports 
of inspection are made in accordance with requirements out- 
lined in AR 40-275. 
■ 4. Sanitation Details.—a. General.—The senior medical 
officer of each station or command large enough to warrant 
such action will organize one or more sanitation details from 
officers and enlisted men of the Medical Department. Sani- 
tation details ordinarily function under the direction of the 
medical inspector. 
b. Duties.—The duties of the sanitation details are in 
general— 
(1) To assist the medical inspectors in the performance 
of their duties. 
(2) To make inspections of sanitary appliances and meas- 
ures in use, and to report to the medical inspectors infractions 
of sanitary orders or regulations. 
(3) To inspect and report upon the methods employed in 
the removal and disposal of excreta and refuse, the construc- 
tion of simple sanitary appliances, the adequacy of bathing 
and delousing facilities, water-purification apparatus, and all 
other appliances used in maintaining the health of the 
command. 
(4) To give instruction to troops in technical sanitary mat- 
ters. The duties of sanitation details are distinct from and 
must not be confused with those to be performed by police 
details. 
■ 5. Sanitation in a Theater of Operation.—a. Area sanita- 
tion.—In a theater of operation, when practicable, each army 
and corps area and each section of the communications zone, 
including particularly any rest or training areas containing 
large bodies of troops distributed over considerable territory, 
will be divided and subdivided into a convenient number of 
sanitary areas and subareas, by the designation of definite 
lines of demarcation, for the purpose of systematizing and 
supervising sanitation. One officer of the Medical or Sani- 
tary Corps will have charge, under the medical inspector of 
the military area or sector involved, of each sanitary area so 
designated. A sanitation detail (see par. 4) will be assigned 
3 MEDICAL FIELD MANUAL 
to each such officer. One or more enlisted men of the sani- 
tation detail will be assigned by the officer in charge of the 
sanitary area to the subareas under his jurisdiction. 
(1) The duties in general of such officers in charge of a 
sanitary area are to— 
(a) Instruct enlisted men assigned to his area in the sani- 
tary fundamentals to be put in operation, distribute them in 
small groups to each subarea, and supervise their work. 
(b) Keep himself informed as to all matters of sanitary 
importance in his area and to furnish such information to all 
incoming organizations. 
(c) See that all outgoing organizations leave the territory 
occupied by them in good sanitary condition. 
(d) Make such reports to the medical inspector under 
whom he is serving as may be required. 
(e) Perform such other duties in connection with sanita- 
tion as may be directed or authorized by proper authority. 
(2) The duties, in general, of the enlisted men assigned to 
each subarea are to— 
(a) Keep detail maps of the subarea showing location oi 
water sources, latrines, urinals, stables, dumps, baths, kitchens, 
billets, barracks, and camps. 
(b) Regularly inspect and report upon the condition ol 
sanitary appliances located in the subarea. 
(c) Report to the officer in charge of the sanitary area con- 
cerning sanitary conditions and prevalence of disease in the 
subarea. 
(d) Furnish information as to sanitary conditions and 
location of sanitary appliances to incoming troops. 
(e) Perform such other duties in connection with sanita- 
tion as may be directed or authorized by proper authority. 
b. Disposal of deceased personnel and animals during and 
immediately after a battle.—During or immediately preceding 
or following battle, labor troops or like organizations will be 
assigned to follow in the path of each corps or division in the 
line to make prompt disposal of the bodies of deceased per- 
sonnel and animals under the sanitary supervision of the 
corps (or army) medical inspector. The bodies of deceased 
personnel will be properly buried, and those of animals will be 
either buried or burned as circumstances may indicate. 
4 CHAPTER 2 
CONTROL OF COMMUNICABLE DISEASES 
Section 
I. General 6-15 
II. Respiratory diseases 16-17 
III. Intestinal diseases 18-22 
IV. Insect-borne diseases 23-26 
V. Venereal diseases 27-34 
Paragraphs 
Section I 
■ 6. Classification.—Communicable diseases may be classi- 
fied in a number of ways. From the viewpoint of control they 
are best classified into the following five sroups: 
a. Respiratory diseases. 
b. Intestinal diseases. 
c. Insect-borne diseases. 
d. Venereal diseases. 
e. Miscellaneous. 
GENERAL 
■ 7. Responsibility for Initiation and Enforcement of Pre- 
ventive Measures.—a. Medical Department.—The Medical 
Department is charged with the initiation and supervision of 
measures for the control and prevention of disease in military 
personnel and animals and among inhabitants of occupied 
territories. The functions of officers of the Medical Depart- 
ment are, in the main, of an inspectorial and advisory nature. 
b. Commanding officers.—Commanders of all grades are 
charged with the responsibility of putting into effect sanitary 
orders or regulations. Commanders of all grades will devote 
attention to the enforcement of regulations, especially the 
following: 
(1) Thorough washing of hands after visiting latrines and 
before meals. 
(2) Proper sterilization of dishes and mess kits. 
(3) Vaccination against smallpox, typhoid and para- 
typhoid fevers, tetanus, and other diseases if indicated. 
5 MEDICAL FIELD MANUAL 
(4) Prevention of venereal disease. 
(5) Proper ventilation of barracks or tents. 
(6) Elimination of overcrowding. 
(7) Eradication of mosquitoes. 
(8) Destruction of flies, lice, and other insects. 
(9) Purification of nonpotable water supplies. 
(10) Proper disposal of human excreta and manure. 
(11) Proper disposal of garbage. 
■ 8. Principal Objects.—a. General.—Certain of the meas- 
ures enumerated in this manual relate to the prevention of 
disease in the individual while others deal directly with the 
communicable disease itself and place the responsibility of 
prevention of its spread on specially trained experts. 
b. Objects.—A program of military sanitation has in view 
the accomplishment of the following objects: 
(1) Continuous maintenance in each individual of the high- 
est possible state of health. 
(2) Training of the soldier in such rules of personal con- 
duct as will enable him to avoid the infective agent of com- 
municable diseases. 
(3) Specific immunization of each individual against com- 
municable disease when it is possible of accomplishment. 
(4) Supervision of all known infectious cases with a view 
to preventing the transference of the causative agent to 
others. 
(5) Supervision of the common avenues of transmission 
with a view to freeing them from any living causative agents 
by means of the filtration and chlorination of water, pas- 
teurization of milk, thorough cooking of food, and destruction 
or exclusion of flies. 
■ 9. Definition of Special Terms.—In the application of the 
measures relating to the prevention of the communicable 
disease in man, the following terms are used as defined below: 
a. Contact.—A contact is a person quartered in the same 
tent or occupying a nearby bed in a squad room, or closely 
associated at mess or otherwise, with an individual infected 
with the causative agents of a communicable disease. 
h. Carrier.—The term “carrier,” as used in this manual, is 
applied to an individual who harbors and excretes causative 
6 FIELD SANITATION 
agents of a communicable disease without the usual evidence 
of the disease produced by the agent in question. Carriers 
may be classified as follows: 
(1) True carriers who harbor parasites which are patho- 
genic and virulent. True carriers are subdivided into— 
(a) Incubationary carriers who are temporary carriers in 
the incubation stage of a communicable disease. 
(b) Convalescent carriers who may De temporary or 
chronic. Temporary convalescent carriers are persons who 
are in the convalescent stage of a communicable disease but 
have not as yet eliminated all the causative organisms. 
Chronic convalescent carriers may have apparently recovered 
entirely from the disease, but they presumably still have some 
concealed lesion which permits the parasite to continue its 
growth. The excretion of parasites in such cases is often 
intermittent. 
(c) Contact carriers who may be temporary or chronic. 
Contact carriers are those who acquire parasites from asso- 
ciation with cases or carriers without themselves developing 
the disease. 
(2) Pseudo carriers who harbor organisms morphologically 
and culturally indistinguishable from pathogenic and virulent 
parasites which are, nowever, found on further examination 
to be nonpathogenic and a virulent. During the course of this 
examination these individuals must be regarded as true car- 
riers until nonpathogenicity and avirulence are established. 
c. Suspect.—A suspect is a person exhibiting signs or symp- 
toms which, though not definitely diagnostic in character, 
may indicate some stage of a communicable disease. 
d. Quarantine.—Quarantine is the application of such re- 
strictive measures to the activities ot contacts, carrier sus- 
pects, and cases of communicable disease as may reasonably 
be expected to prevent further spread of the causative 
organisms of these diseases. 
(1) Working quarantine is the segregation of selected car- 
riers or contact groups in such a manner that a given group 
is not brought into contact with another group or with other 
persons, yet the performance of certain duties (such as 
fatigue, drill, or instruction) is not interrupted. 
7 MEDICAL FIELD MANUAL 
(2) Absolute quarantine is the detention of contacts, car- 
riers, suspects, persons ill with communicable disease, or other 
groups of individuals in complete isolation, either individually 
or collectively, as the circumstances may warrant. 
■ 10. Influence of Environment.—The specific part that 
environment plays in the spread of communicable diseases 
depends upon whether or not it permits of the exchange of 
human discharges or whether or not certain insects which are 
known to act as transmitters of disease constitute an integral 
part of environmental conditions. The presence of certain 
insects and overcrowding, combined with faulty discipline 
and limited facilities for bathing the body and washing the 
hands, contribute to the spread of communicable diseases 
whenever certain specific infections are introduced into the 
community. In addition, unfavorable environment will lower 
body resistance and thereby the individual is predisposed to 
contract disease. The rapid mobilization of large numbers of 
recruits and the Bringing together of detachments of men 
from different units for the formation of new organizations 
result in rapid dissemination of nonpathogenic and patho- 
genic micro-organisms carried by individuals. Such condi- 
tions are ideal for the spread of communicable diseases. 
■ 11. Primary Factors in Spread.—a. A communicable dis- 
ease is a process of the interaction of specific microbic para- 
sites and of host. Before such a process can be set up, the 
parasites must be implanted in or carried to the susceptible 
tissues of the susceptible host, and the parasites must be alive 
and endowed with the characters necessary to give rise to 
the disease. The three primary factors in infection are the— 
(1) Seed.—The available reservoir of specific pathogenic 
micro-organisms of adequate infectivity and virulence. 
(2) Sower.—The adequate means of transmitting these 
micro-organisms in adequate numbers to— 
(3) Soil.—The susceptible tissues of the susceptible indi- 
vidual. 
b. When these three primary factors are present and oper- 
ative together, a case of communicable disease will arise. As 
often as this chain of factors is in conjunction so often will 
cases of communicable disease arise, an outbreak, an epidemic, 
8 FIELD SANITATION 
or a pandemic ensuing. The sum total effect of these factors 
giving rise to communicable disease at a given time and place 
may be termed the dispersibility of that disease for that time 
and place. As the disease spreads the number of reservoirs 
will increase and, other things being equal, the cases will 
multiply in geometric progression. The three primary fac- 
tors are, however, mutually dependent, and if one factor is 
totally absent the chain is broken and the number of cases 
will fall. 
■ 12. Establishment of Quarantine.—The establishment of 
quarantine measures at a military station will be made by the 
commanding officer, when necessary, upon recommendation 
of the surgeon. Absolute quarantine of large bodies of troops 
will be instituted only when a disease of a serious nature exists 
in a command or threatens to become widely disseminated 
therein. Ordinary contacts will be held in working quaran- 
tine, and will be subjected to one or more careful physical in- 
spections daily in order that early cases and suspects may 
be detected. In the control of certain communicable diseases 
all quarantine measures may be dispensed with, reliance being 
placed upon careful physical inspections conducted at inter- 
vals to insure detection of cases in their incipiency. The 
special quarantine measures applicable to the various diseases 
will be found in AR 40-210 to AR 40-240, inclusive. 
■ 13. Observation or Detention Camps.—Observation or de- 
tention camps for incoming recruits will be established at sta- 
tions when necessary. Recruits arriving in groups or indi- 
vidually at frequent intervals will be detained in these camps 
for observation during a period of time sufficient to insure 
detection of acute communicable diseases contracted prior to 
arrival, thereby preventing their introduction into the com- 
mand. The status of personnel held under observation will 
ordinarily be that of working quarantine. They will be care- 
fully inspected by a medical officer at least once a day for the 
detection of disease. The minimum period of observation will 
be 2 weeks. In case recruits not known to have been exposed 
recently to a communicable disease of a serious nature are 
joining a command at infrequent intervals and in small num- 
bers, they may be assigned directly to organizations, provided 1 
9 MEDICAL FIELD MANUAL 
that they report to the unit surgeon once a day during a 
period of at least 2 weeks for examination. In large com- 
mands receiving great numbers of recruits, quarantine camps 
may be necessary for the segregation of carriers, certain 
known contacts, and suspected cases of communicable diseases. 
■ 14. Other Means of Preventing Communicable Diseases.— 
a. Control of transmitting agencies.—The control of disease 
through the control of transmitting agencies is accomplished 
by so modifying certain environmental factors as to prevent 
the transmission of the causative agents of disease. This 
method of disease control involves, for example, the purifica- 
tion of water supplies, the control of disease transmitting 
insects, the proper disposal of infected wastes, or the correc- 
tion of housing defects. The methods to be employed to con- 
trol transmitting agencies are discussed in detail in succeed- 
ing chapters, 
b. Immunization.—Immunization is practiced routinely in 
the control of typhoid and paratyphoid fevers, smallpox, and 
tetanus. Where indicated, it may be used in the control of 
diphtheria, cholera, or plague. Artificial immunization does 
not confer permanent, absolute immunity to the extent of 
rendering a group completely nonsusceptible to the disease 
concerned. Thus, while immunization against typhoid fever 
will render the greater proportion of a group immune for 
the time being against a moderate dose of the infection, 
it does not protect all individual members of the group 
against continued massive doses nor does the immunity 
last for an indefinite period of time without further vac- 
cination. Artificial immunization should be employed in 
the control of these diseases in conjunction with and for the 
purpose of augmenting the control of transmitting agencies. 
In the control of smallpox, artificial immunization is the only 
control measure of practical value and must be repeated at 
intervals to maintain a protecting degree of immunity. 
c. Treatment as a preventive measure.—Early or prophy- 
lactic treatment may be employed in the control of certain 
diseases to prevent the development of symptoms. Thus 
malaria may be controlled by prophylactic treatment with 
quinine or atabrine during a period of exposure to the bites 
of infected mosquitoes, or venereal disease can be prevented 
10 FIELD SANITATION 
by the use of chemical prophylaxis immediately after exposure 
to infection. 
d. Discipline and physical training.—(1) Military disci- 
pline insures the cooperation of the individual in the enforce- 
ment of disease prevention and health promotion procedures, 
and is also an important factor in securing uniformity in the 
employment of health measures throughout a command. 
The success of many disease control procedures depends 
wholly or in part on the cooperation of the officers and en- 
listed men, that is, on the discipline of the command. The 
employment of chemical prophylaxis in the control of vene- 
real diseases, the use of mosquito bars to protect the troops 
from the bites of infected mosquitoes, or the maintenance of 
proper air conditions by window ventilation are some of the 
many measures in the enforcement of which discipline plays 
an all important role. 
(2) Military discipline and physical training are in a sense 
synonymous, in that one cannot be attained without the 
other. Aside from any question of specific immunity to dis- 
ease, the trained soldier is more resistant to infection than 
the recruit. To recruits, generally, the military environment 
is strange and at times depressing; they are unaccustomed to 
the physical exertion incident to military training, and they 
react quickly and unfavorably to cold and exposure. The 
trained man does not oecome unduly fatigued by the per- 
formance of military work, and ne is able tc withstand ex- 
posure to cold without excessive loss of body heat. These 
factors, togethei with the general nonspecific resistance to 
infection conferred by continuous close contact with others, 
tend to render the trained soldier less susceptible to disease 
than the raw recruit. 
■ 15. Statistical Charts and Reports.—Surgeons of stations 
and commands are responsible for the collection, tabulation, 
and graphical presentation of information concerning the 
incidence of communicable diseases. Tables and charts 
showing the movement of communicable diseases in com- 
mands will be kept available at all times for inspection by 
commanding officers and inspectors, When rates are in ex- 
cess of the normal average every effort will be made to 
determine and remove the causes. 
11 MEDICAL FIELD MANUAL 
Section II 
RESPIRATORY DISEASES 
■ 16. Classification.—The following diseases are known to 
be or are strongly suspected of being transmitted, in most 
instances, by the discharges from the respiratory tract; 
Measles, mumps, diphtheria, scarlet fever, the common 
respiratory diseases (coryza, acute laryngitis, acute tonsil- 
litis, and acute bronchitis), influenza, the pneumonias, epi- 
demic meningitis (cerebrospinal), pulmonary tuberculosis, 
whooping cough, plague, and poliomyelitis. 
PRINIC1PAL 
TRANSMISSION 
AGENCIES 
CONTROL 
OF TRANSMISSION 
AGENCIES 
PROTECTION 
OF 
SUSCEPTIBLE^ 
CONTACT 
IMMUNIZATION 
ISOLATION or CASTS 
AND CARRIERS 
QUARANTINE OR 
CONTACTS 
WARM CLOTN/NO 
PERSONAL CLEANLINESS 
5Y 
AIR 
VENTILATION OF BARRACKS 
bed smcmmsquad noon 
CUBICLFD BEDS 
PREVENTION OF CROWDING 
' CASE \ 
OR 
.CARRIER-/ 
AIR 
HANDS 
hands: 
INDIVIDUAL PERSONAL 
CLEANLINESS 
FOOD 
FOOD# MESS 
EQUIPMENT 
DISINFECTION OF D/SHES 
AND MESS EQUIPMENT 
SANITATION OF KITCNENS 
CLEANLINESS $ SUPERVISION 
OF FOOD HANDLERS 
AND 
MESS 
EQUIPMENT 
Figure 1.—General factors in the control of respiratory diseases. 
■ 17. Preventive Measures.—a. General.—Commanding offi- 
cers must devote particular attention to the enforcement of 
the following general measures for the control of any one 
of the diseases of this group: 
(1) Allowa?ice of more than the authorized floor space in 
barracks and tents when practicable.—Crowding and the con- 
sequent close contact between infected persons and non- 
immunes are most Important factors in the spread of respira- 
tory diseases. The most dangerous crowding is that which 
12 FIELD SANITATION 
occurs between the sleeping occupants of squad rooms. This 
crowding must be minimized in one or more of the following 
means: 
(a) By utilizing all available space including tentage (if 
weather permits) so that individuals will not be in close con- 
tact. 
(b) By constructing cubicles either with screens, sheets, or 
shelter halves. A cubicle screen should extend to not less 
than 2 feet nor more than 4 feet above the surface of the bed 
at the head of the bed. 
Figure 2.—Method of constructing cubicles in squad rooms by the 
use of shelter tent halves with head and foot arrangement of 
beds 
(c) By proper bed arrangement so that the heads of indi- 
viduals in adjacent beds will be as far apart as possible. This 
may be done by head to foot sleeping and by staggering beds. 
Under average conditions a minimum of 60 square feet of floor 
space should be allotted for each bed exclusive of that occu- 
pied by furniture or fixtures, other than the bed and foot 
locker. Calculation of minimum floor space should not in- 
clude any that extends to a distance of more than 4 feet from 
either end of the bed. In an emergency the minimum floor 
space may be reduced to 50 square feet per bed provided 
555798°—4.°. 2 
13 MEDICAL FIELD MANUAL 
ventilation is adequate. If sides of beds are less than 5 feet 
apart, the beds should be so arranged that the head of each 
bed is opposite the foot of the adjacent bed. 
It is best to limit the number of beds to a room by having 
a number of small rooms, rather than one large one. 
The standard pyramidal tent has a floor space of approxi- 
mately 250 square feet. Under average conditions not more 
than six men should be housed in one tent and in the presence 
of an epidemic of respiratory disease not more than five. 
Figure 3.—Cubicles made by hanging sheets between beds. This 
method is usually preferred in hospital wards. 
(2) Proper ventilation of barracks and tents.—(a) For 
practical purposes the existing air conditions are determined 
by the temperature as shown by a thermometer and the ef- 
fects of the air on the senses. Overheating is normally an 
evidence of poor ventilation. Lack of freshness when a room 
or tent is first entered also indicates improper ventilation. 
(b) Under average conditions, and when there is no con- 
siderable difference between outdoor and indoor temperatures, 
squad rooms which provide 600 to 720 cubic feet of air space 
14 FIELD SANITATION 
per man will require at night from 1,800 to 2,200 cubic feet 
of fresh air per man per hour or three changes per hour. 
During the day a much smaller volume is required since only 
a few men are ordinarily in the room. 
(c) Wind velocities of about 4 feet per second will produce 
definite drafts. 
(d) Window ventilation is the simplest form of ventilation. 
Windows should be opened from the top on the windward side 
and from the bottom on the opposite side. 
(e) It is essential that squad rooms and tents be properly 
ventilated. In ordered to enforce proper ventilation at night, 
especially in cold weather, frequent inspections must be made 
by an officer or noncommissioned officer. 
Figure 4.—Ventilation of squad rooms showing method of arranging 
window openings. A—Inlet. B—Outlet 
(3) Issue of suitable clothing.—Fatigue or chilling will in 
many instances lower the resistance of the individual. Expo- 
sure to inclement weather and exercise resulting in excessive 
fatigue should be avoided. Sufficient bedding to prevent 
chilling of men while asleep must be issued. 
b. Special.—(1) Isolation of cases.—Since the patient with 
the disease is the greatest source of danger to susceptible 
members of the command, it is of vital importance that he 
be removed from contact with other individuals and hospital- 
ized at the earliest possible moment. The fact that many 
15 MEDICAL FIELD MANUAL 
diseases of this group are most infective in the earliest stages 
of illness renders imperative their early recognition and 
immediate hospitalization. 
(2) Physical inspections.—Upon the appearance of the first 
recognized case of any of these diseases (except the common 
respiratory infections), the command or such part thereof as 
the surgeon may recommend (ordinarily contacts) should be 
inspected at least daily and during the presence of an epi- 
demic twice daily until the disease in question is eradicated 
from the command. Special attention must be at all times 
directed to the recognition of cases in the early stages. 
(3) Hospitalization of suspects.—All cases of illness with 
catarrhal symptoms accompanied by a temperature of 100° P. 
or above will be considered as suspects and hospitalized as 
such for observation. The retention and treatment of sick 
men in quarters must not be practiced when epidemics prevail. 
Under these circumstances, unit commanders and noncom- 
missioned officers will send at once to a medical officer any 
soldier who may become ill between the hours of the general 
inspections. 
(4) Control of suspects.—The exanthemata contacts of the 
command should be separated into two groups, one composed 
of susceptible individuals and the other of nonsusceptible per- 
sons. When this separation has been accomplished, control 
measures such as physical examinations, working quarantine, 
or other restrictions will be especially applicable in the 
management of the susceptible groups. 
(5) Immunization.—With the exception of diphtheria and 
scarlet fever, the present status of scientific knowledge con- 
cerning immunity against the diseases of this group does not 
permit of the general application of routine specific methods 
of immunization. 
(6) Measures applicable to special diseases.—For special 
measures applicable to prevention of individual diseases of 
this group see TM 8-255 (now published as Army Medical 
Bulletin, No. 23) and AR 40-220. 
16 FIELD SANITATION 
18-20 
SECTION Hi 
INTESTINAL DISEASES 
■ 18. General.—The intestinal diseases as a group are trans- 
mitted from person to person by food and water, the infective 
agents being disseminated in the excreta of cases or carriers. 
The causal organisms are introduced into water with the 
infected excreta, and into food through the medium of hands 
contaminated with infected material, by water, by contami- 
nated dishes and utensils, by flies, or by direct contact with 
excreta. Occasionally intestinal diseases may be transmitted 
by contact, that is, by the direct transference of infected 
excreta by the hands or by fomites to the mouth without the 
intervention of food or water as an intermediate agency. 
However, under average conditions, such contact is a relatively 
unimportant factor in the transmission of most of the 
intestinal infections among troops. ; 
■ 19. Classification.—The important diseases belonging to . 
this group are— . 
Typhoid fever. 
Paratyphoid fever. 
Common diarrhea. 
Bacillary dysentery. 
Protozoal dysentery. 
Cholera. 
Helminthic infestations. 
Undulant fever. 
Pood infection. 
Botulism. 
H 20. General Importance and Prevalence.—a. Intestinal 
diseases are of great potential importance to a military 
force. However, measures are available by which the inci- 
dence of intestinal diseases can be greatly reduced below that 
which would and does occur in situations where the spread 
of these infections is inadequately controlled. 
h. As sources of infection are constantly present in mili- 
tary organizations, and in the civilian populations with which 
the troops are in contact, any relaxation in measures for the 
control of intestinal infections will almost inevitably be fol- 
lowed by the occurrence among troops of some of these dis- 
eases in epidemic form. The prevalence of intestinal diseases 
and their importance to a military force are, therefore, to a 
very considerable degree dependent on the extent to which 
17 MEDICAL FIELD MANUAL 
suitable control measures are enforced. In this respect, in- 
testinal diseases differ markedly from such respiratory infec- 
tions as influenza or common colds. In many instances, the 
latter cannot be completely controlled by any practical pro- 
cedure, while uncontrollable epidemics of intestinal diseases 
seldom if ever occur in military forces under normal condi- 
tions. 
c. While one attack of certain of the intestinal diseases, 
particularly typhoid, will usually confer permanent immunity, 
troops generally have a high group susceptibility to intestinal 
diseases. 
d. The group of diarrheal diseases which are classified as 
common diarrhea are from a military viewpoint, under ordi- 
nary conditions, the most important of the intestinal dis- 
eases, largely because of their influence on the noneffective 
rate. This group includes those conditions diagnosed as 
enteritis, colitis, or diarrhea, which in many instances are 
probably actually mild dysenteries or food infections. These 
conditions tend to occur as small explosive epidemics and in- 
capacitate a relatively large number of men before control 
measures can be made effective. On the other hand, typhoid 
is of relatively minor importance, but only because it can be 
controlled by available and practical control measures. 
O 21. General Control Measures.—a. The control of intes- 
tinal diseases is based on the control of environmental con- 
ditions with a view to preventing the transmission of the 
causal organisms by water and food. General measures for 
the control of intestinal diseases include water purification, 
food protection and control, waste disposal, and control of 
the housefly. Each of these subjects is considered in detail 
in succeeding chapters. 
b. Group quarantine of contacts is not as a rule effective 
or of value in the control of intestinal diseases. It may, how- 
ever, be employed in the control of cholera. Cases of intes- 
tinal disease may be isolated as individuals or in groups dur- 
ing the infectious stage of the disease. Carriers may be 
quarantined or their activities restricted in order to prevent 
the contamination of food or water or the transmission of 
infection by contact. 
18 FIELD SANITATION 21- 
c. Food handlers are particularly important in the tran 
mission of the etiological agents of many of the intestin 
diseases, in that they have many opportunities to transf 
the infective organisms to the food or eating utensils of oth 
persons. All food handlers should be required to cleanse the 
hands thoroughly before starting work in a kitchen or me 
and after each visit to a latrine. Preferably, they should di 
infect their hands by washing them in a weak solution 
cresol and drying them in the air without wiping. 
d. Prophylactic immunization is employed as a routii 
measure in the control of typhoid fever, and may at tim 
TRANSMISSION 
AGENCIES 
CONTROL Of 
TRANSMISSION AGENCIES 
WATER 
Protection op paw watip or ppopip. 
JlWACrt DISPOSAL 
PURIFICATION Of WATER SUPPLY 
Protection of purified water. 
IMMUNIZATION 
typhoid a paratyphoid rww 
WATER 
FOOD 
Supervision of sanitary conditions under 
WHICH FOOD IS PRODUCED. TRANSPORTED 
AND STORED 
Meat inspection 
Pasteurization of milk 
Elimination of contaminated food 
SUPPLIES or INSPECTION 
Physical examination of food 
HANDLERS TO ELIMINATE CARRIERS 
AND SICK 
CLEANLINESS OF INDIVIDUAL FOOD 
HANDLERS 
Sanitation of kitchens 
CASE 
OR 
CARRIER 
, FOOD 
Protected 
\ troops , 
FLIES 
HANDS 
FLIES 
Control or doiioino places 
Protection op pood prom flips 
Destruction or adult fu.ts 
HANDS 
Individual personal cl£anlincjt 
Figure 5.—General factors in the control of intestinal 
be utilized in the control of other intestinal diseases, par- 
ticularly paratyphoid fever, cholera, and bacillary dysentery. 
See AR 40-225. 
■ 22. Concurrent and Terminal Disinfection.—a. Concur- 
rent disinfection should be practiced in the care of patients 
having an intestinal disease, in order to prevent the trans- 
mission of the causal organisms by contact or through con- 
tamination of food or water which is to be consumed by 
others. It is essential that the feces and urine be thoroughly 
19 MEDICAL FIELD MANUAL 
disinfected and properly disposed of. Any articles which 
might be soiled by excreta should be disinfected or burned. 
b. Intestinal discharges may be disinfected by adding 2 
percent cresol solution or 10 percent formaldehyde and allow- 
ing them to stand for at least 1 hour. The quantity of dis- 
infectant used for this purpose should be equal to at least 
twice the volume of the material to be disinfected. Urine 
may be disinfected by the addition of sufficient cresol to make 
an approximate 2 percent solution. Mercuric chloride in 
amounts sufficient to make a 1: 1,000 solution may also be 
used. 
c. Patients should have separate dishes and eating uten- 
sils which should be disinfected by boiling after use. Any1 
food which has been served to patients but not consumed 
should be destroyed or disposed of in such a manner that it 
will not convey the infection to others. 
d. All sheets, pajamas, towels, or similar articles used by 
the patient should disinfected by boiling or by immersion in 
a 2- or 3-percent cresol solution. 
e. Medical officers, nurses, and attendants should exercise 
care to prevent the transmission of infection by the hands 
or clothing. 
f. Terminal disinfection should consist generally of thor- 
ough cleaning of the room or ward and disinfection of the 
bedding. 
Section IV 
INSECT-BORNE DISEASES 
■ 23. General.—The insect-borne diseases are those trans- 
mitted by biting or bloodsucking insects. In order for these 
liseases to spread, three things are necessary: 
a. Reservoir of infection. 
b. The specific vector. 
c. Susceptible individuals. 
20 FIELD SANITATION 
24-26 
H 24. Classification.—The following insect-borne diseases 
are of particular interest to the Army: 
Disease 
Malaria Anopheles mosquito (a number of 
species). 
Yellow fever Aedes egypti. 
Dengue Aedes egypti and albopictus. 
Tularemia Ply, tick, louse, and flea (also con- 
tact with infected material). 
Rocky Mountain 
spotted fever Tick. 
Relapsing fever Louse and tick. 
Typhus fever, 
epidemic Body louse. 
Typhus fever. 
endemic Flea. 
Trench fever Body louse. 
Plague Rat flea and others. 
Pilariasis Mosquito principally. 
Encephalitis Aedes mosquitoes and possibly 
other insects. 
Principal vector 
H 25. Transmission.—There are two types of insect transmis- 
sion of disease: 
a. Mechanical.—Virus undergoes no change in the insect 
host but is transmitted by a specific insect in the form it is 
taken from the infected person. No period of incubation in 
the insect. 
b. Biological.—Virus or parasite undergoes certain changes 
in the insect host before it becomes infective. This is the 
extrinsic period of incubation as seen in malaria and yellow 
fever. 
■ 26. Objects of Preventive Measures.—The various preven- 
tive measures (chs. 7, 8, 9, and 10) to be employed must be 
directed toward the accomplishment of the following objects: 
a. Protection of— 
(1) Patients and carriers of the causative agents from the 
bites of insects capable of transmitting such agents. 
(2) Healthy persons from the bites of insects infected with 
the causative agents. 
21 MEDICAL FIELD MANUAL 
b. Eradication of— 
(1) Insects capable of transmitting the causative agents. 
(2) Causative agents from the persons of patients and 
carriers. For further details see AR 40-230. 
Section V 
VENEREAL DISEASES 
I 27. Prevalence.—Under average conditions, venereal dis- 
ase is by far the most important cause of noneffectiveness 
mong troops. The prevalence of venereal disease among 
ivilian populations is difficult to determine. Studies have 
aown that from 60 to 75 percent of prostitutes in the United 
tates present demonstrable evidence of venereal disease, 
ctual incidence is probably very much higher. 
■ 28. General Control Measures.—Measures for control fall 
generally into two groups, the first is to attempt prevention 
to exposure, and the second, to prevent the development of the 
disease in the exposed individual. The measures employed 
to control exposure consist of the control of prostitution, edu- 
cational and recreational measures, and regulations. Me- 
chanical and chemical means of prevention play a very im- 
portant part in the control of these diseases should exposure 
take place. The discipline, training, and administration of 
organizations are the basic factors and are more important 
in the control of venereal diseases than in the control of any 
other class of diseases. (See AR 40-235.) 
■ 29. Mechanical Prophylaxis.—a. The condom affords the 
only practicable mechanical protection against venereal in- 
fection. Where properly used, the condom is effective in 
preventing gonorrheal infection and, to a less extent, syphilis, 
chancroid, or lymphogranuloma inguinale. The gonococci 
are infective only in the urethra which is protected by the 
condom, while the infective agents of the other three venereal 
diseases may be inoculated into the skin or tissues of the 
genitals or adjacent body surfaces that are unprotected by the 
condom. 
b. Post exchanges are required to stock condoms, the com- 
position and quality of which will be prescribed by the com- 
manding officer upon the recommendation of the surgeon. 
22 FIELD SANITATION 
(See Cir. Letter 4, Jan. 8, 1940.) Chemical prophylaxis should 
be given even when a condom has been used. 
■ 30. Chemical Prophylaxis.—Chemical prophylaxis consists 
of the application of disinfectants for the purpose of destroy- 
ing the infectious agents of venereal disease immediately after 
exposure and thus preventing invasion of the tissues and the 
consequent development of the disease. Chemical prophylaxis 
may be applied at a prophylactic station or from an indi- 
vidual packet. Application at a prophylactic station is by 
far the better method as it is most effective when properly 
applied. Venereal prophylactic stations are as a rule estab- 
lished wherever troops are assembled. Soldiers should be im- 
pressed with the fact that the sooner after exposure the 
prophylaxis is given the more effective the result. 
■ 31. Operation of Prophylactic Station.—a. The station 
should be in charge of well-trained attendants and should1 
be easily accessible to the troops. At times it may be ad- 
vantageous to establish stations in adjacent civilian com-' 
munities. Frequent inspections should be made by the1 
responsible medical officer. 
b. A high degree of cleanliness and orderliness is essential 
to success in the operation of a prophylactic station. A pro- 
phylactic station should be similar in this respect to an 
operating room in a hospital. 
c. The station should be so arranged that the prophylactic 
treatment can be given in private. All boisterousness, joking, 
or loafing should be strictly prohibited. Otherwise, men who 
should receive the prophylaxis will risk infection rather than 
report at the station. 
■ 32. Method of Applying Venereal Prophylaxis.—The 
minor details of the technique of administering the venerea] 
prophylaxis may vary somewhat but the same basic methods 
are employed throughout the Army. The individual report- 
ing for prophylactic treatment should first be thoroughlj 
examined for venereal disease. He should urinate if possible 
immediately prior to the beginning of the treatment. The 
genitals and the contiguous surfaces of the thighs and abdo- 
men are then thoroughly washed with soap and water. The 
soap is a disinfectant and also serves to remove substance: 
23 MEDICAL FIELD MANUAL 
which would interfere with the action of disinfectants which 
are to be subsequently applied. The same area is then bathed 
and the soap removed with a 1:1,000 solution of mercuric 
chloride. From 4 to 6 cc of a 2 percent solution of protargol 
are then injected into the urethra and retained for 5 minutes. 
Finally, calomel ointment is rubbed thoroughly over all sur- 
faces of the genitals. A paper towel or napkin should be 
used to protect the clothing. All records should be completed 
at the time the prophylaxis is given. 
■ 33. Individual Chemical Prophylaxis.—The individual 
prophylaxis has been found to be of great value if properly 
applied, especially if a prophylactic station cannot be 
reached until a considerable time after exposure or where 
men are going on furlough or pass to places where prophy- 
lactic stations are not available. These packets contain as a 
rule calomel ointment to which 1 to 3 percent of phenol has 
been added. 
■ 34. Treatment as a Control Measure.—The prompt and 
adequate treatment of persons having venereal diseases until 
they are no longer infectious is a most effective method of 
controlling the spread of venereal diseases in the civil popu- 
lation. It is essential that soldiers having venereal disease do 
not serve as sources of infection in civil communities, and, 
consequently, all those who contract a venereal disease should 
be restricted to the station or camp until the infectious stage 
of the disease is past. 
24 CHAPTER 3 
WATER 
Paragraphs 
Section I. Responsibility for water supply 35-36 
II. Water characteristics and requirements 37-39 
III. Sources 40-42 
IV. Purification 43^18 
V. Water reconnaissance 49-53 
Section I 
RESPONSIBILITY FOR WATER SUPPLY 
■ 35. Quartermaster Corps.—The Quartermaster Corps is 
responsible for the construction, maintenance, and operation 
of water-purification plants and distributing systems and for 
the quantity and quality of the water supply at all stations 
and permanent or semipermanent installations in time of 
peace, and in the zone of the interior in war. The Corps of 
Engineers is responsible for all water supplies in the theater 
of operations except, at times, in the case of smaller units 
where it may be impracticable for the engineers to furnish 
water. 
0 36. Sanitary Control by Medical Department.—The Med- 
ical Department is charged with the responsibility for mak- 
ing surveys, inspections, and examinations of water supplies 
and such recommendations as may be necessary to protec 
the health of the troops. The Medical Department coop 
erates with the Quartermaster Corps or the Corps of Engi 
neers, as the case may be, in all phases of water-purificatioi 
work. The scope of the sanitary control exercised by th< 
Medical Department includes the following measures: 
a. Sanitary surveys of the source or sources of propose* 
water supplies, or extensions of existing supplies, for actua 
or potential sources of contamination, and for adequacy o 
supply insofar as quantity will affect the health of the troops 
b. The study of plans for proposed water-purlficatio: 
25 36-39 
MEDICAL FIELD MANUAL 
works and other appliances or installations to be utilized in 
the treatment oi water, with particular reference to sanitary 
features, prior to their final adoption. 
c. Sanitary surveys and inspections ot existing water-sup- 
ply systems, including sources, installations, appliances, the 
distributing system, and procedures utilized in the treatment 
of the water. 
d. The bacteriological and chemical analysis of water as 
delivered to the troops. 
e. The technical supervision of the procurement and purifi- 
cation of the water supply where emergency measures are 
necessary, such as the use of the water sterilizing bag 
(Lyster bag). 
Section II 
WATER CHARACTERISTICS AND REQUIREMENTS 
|B 37. Ttjbidity.-—-Turbidity may be estimated in the field 
(with the United States Geological Survey turbidity rod. In 
laboratories the Hellige turbidimeter is used. Ordinarily, 
these procedures cannot be carried out. so that inspection ot 
the water will have to suffice. Troops will object to drinking 
p. highly turbid water even if they are assured of its freedom 
from pathogenic organisms. A turbidity of 5 parts per mil- 
lion is barely noticeable in an ordinary drinking glass; from 
|I0 to 15 parts per million will render the water objectionable; 
tL00 parts give it a decidedly muddy appearance; while 500 to 
1,000 parts render it practically opaque. 
I 38. Hardness.—The hardness ot water is due to the pres- 
ence of the soluble bicarbonates, sulphates, chlorides, and 
titrates of calcium and magnesium. These chemicals form 
ieposits in boilers and pipes of steam-heating and hot-water 
Diants and appliances, decreasing their efficiency and neces- 
;itating more frequent cleaning. They also form insoluble 
■.alts with soap and impair the value of the water for domestic 
ir laundry purposes, 
I 39. Water Requirements of Troops.—a. During the World 
Var the National Army cantonments consumed 55 gallons of 
vater per capita per day and the tent camps of National 
26 FIELD SANITATION 
39-41 
Guard divisions 30 gallons. These amounts are very greatly 
increased in permanent camps and stations. 
b. Where water must be distributed by trucks or water 
carts, particularly in temporary camps, about 5 gallons per 
man per day are required for drinking, cooking, and washing. 
c. If watering troughs for animals are supplied, about 10 
gallons per animal per day are required. 
d. In bivouac or on the march, troops will require 2 gal- 
lons and animals 10. 
e. In combat, under average conditions, physical efficiency 
can be maintained for a period of not more than 3 days if 
from 3 pints to 2 quarts of water per day are supplied to each 
man. Under like conditions animals require from 3 to 5 
gallons per day. 
Section III 
SOURCES 
B 40. Surface or Ground.—The remote source of all water 
is the rain or snow which falls upon the earth. This water 
occurs in nature as surface water (ponds, lakes, or streams) 
or as ground water (below surface and not in contact with 
atmosphere). Ground water which is obtained from wells or 
springs has been subjected to a certain amount of filtering 
process and may or may not be pure. When obtained from 
beneath the first impervious stratum it is usually pure. 
■ 41. Estimating Stream Flow.—Water for troops in the field 
is usually surface water obtained from streams. As the quan- 
tity of water is important it may be necessary to measure 
stream flow. For a rapid and approximate method the 
velocity-area method is used. A section of the stream is 
selected having a fairly uniform width and depth which are 
determined by measuring. The velocity of the flow through 
the measured section is ascertained by observing the time 
required for the current to carry a surface float from the 
upper to the lower boundary of the section. The mean veloc- 
ity of the stream is about four-fifths of the surface velocity. 
The rate of flow in cubic feet per second would be— 
DXWXL 
V 
27 41-42 
MEDICAL FIELD MANUAL 
SOURCES 
The rate of flow in gallons per second would be the number 
of cubic feet per second multiplied by the number of gallons in 
a cubic foot, which is 7.48. For example, given a section of a 
stream which has an average width of 4 feet, an average depth 
of 6 inches, and is 25 feet long, through which it requires 20 
seconds for the current to carry a surface float. As the mean 
velocity is four-fifths of the surface velocity, 25 seconds would 
be required to empty the 25-foot section, or in other words, 
V in this problem is 25. 
n t 4X0.5X25 
Rate of now= y 
4X0.5X25 
25 
50 
==25 
= 2 cubic feet per second. 
= 2X7.48 or 14.96 gallons per second. 
■ 42. Yield of Wells.—The rate of flow of water into a well, 
or the yield of the well, may be roughly determined by reduc- 
ing the depth of the water a measured distance, noting the 
time required for the water to reach again a given level which 
should be below the original level, and calculating the capac- 
ity in gallons of the space between the two levels. The quan- 
tity of water expressed as cubic feet in any given depth of a 
circular well is determined by multiplying the square of the 
diameter of the well in feet by 0.7854 and multiplying the 
figure thus obtained by the depth of the measured section in 
feet. The content in gallons is determined by multiplying the 
number of cubic feet by 7.48. which is the number of gallons 
in one cubic foot. For example, given a circular well 3 feet 
in diameter in which the normal water level has been reduced 
2 feet by pumping, and assuming that the water rises 1 foot 
28 FIELD SANITATION 
42-44 
in 30 minutes after the pumping has ceased, the yield is 
computed as follows: 
Yield=0.78 54 x 32XlX7.48 
=0.7854X9X1X7.48 
=7.07X1X7.48 
=7.07X7.48 
=51.9 gallons in 30 minutes. 
If the yield is 51.9 gallons in 30 minutes, the yield for 24 hours 
will be 48 times 51.9, or 2,491 gallons. If, under the condi- 
tions of actual use, the pumping rate is greater than during 
the test, the yield will be somewhat more as the water will be 
drawn from a larger area. The depth of the water-bearing 
stratum and the rate, of pumping are factors which must be 
considered in making an accurate estimate of the yield, but 
can be ignored in making practical field tests. 
Section IV 
PURIFICATION 
■ 43. Purification of Temporary Water Supplies.—In sta- 
tions and semipermanent camps, water works may be in- 
stalled similar to those used in towns and municipalities. The 
water supply for moving troops, for temporary camps and 
installations, and for troops in the theater of operations must 
be purified under conditions which do not permit the installa- 
tion of permanent water purification works. The agencies 
employed for this purpose are temporary or improvised facil- 
ities installed by engineer regiments, troops, or units, and the 
water sterilizing bag which is included in the equipment of 
each company or its equivalent. 
■ 44. Engineer Water Supply Equipment.—Engineer regi- 
ments (combat) have certain pumps and canvas tanks which 
may be used for obtaining and storing water. In addition 
they are allowed a mobile water purification unit which is 
mounted on a 21/2-ton truck. The water supply battalion (an 
Army unit) is equipped with 9 mobile water purification units 
and 135 water tank trucks. Engineer battalions (combat) are 
not equipped with water purification apparatus except the 
water-sterilizing bag which is issued to all troops. 
555798°—43 3 
29 45 
MEDICAL FIELD MANUAL 
■ 45. Water-Sterilizing Bag (Lyster Bag).—The water- 
sterilizing bag is made of heavy canvas or rubberized cloth 
and has a capacity of 36 gallons. These bags are issued to all 
organizations at the rate of one for each 100 men or fraction 
thereof. The water-sterilizing bag is used primarily for the 
distribution of water previously disinfected by a water-purifi- 
cation unit or otherwise. Water can be purified in a water- 
sterilizing bag only by chlorination, and owing to the diffi- 
culty of chlorinating small quantities of water having a 
Figure 6.—Water-sterilizing bag suspended from tripod. 
varying organic content, it is used for the disinfection of 
water only when no other facilities for obtaining purified 
water are available. The purification of water in the steri- 
lizing bag is essentially an emergency measure. The proper 
disinfection of water is essential in preventing disease among 
troops operating in the field. Where the water-sterilizing bag 
must be used for this purpose, the chlorination of the water 
should be under the direct supervision of Medical Depart- 
ment personnel. Ordinarily, however, as the disinfection of 
the water is a function of the company concerned, the actual 
work of chlorination is delegated, ultimately, to the personnel 
30 FIELD SANITATION 
45-46 
of the company kitchen. Consequently, the chlorination of 
the water supply for the unit concerned is frequently left to 
the kitchen police who, as a rule, are untrained in the tech- 
nique of water chlorination. As a result, the water may be 
underchlorinated and therefore contaminated, or over- 
chlorinated to a degree which renders it nonpotable. 
■ 46. Technique for Sterilizing Water in Water-Steriliz- 
ing Bag.—The water should be as clear as possible. Clarifica- 
tion may be aided by allowing the water to settle in a barrel 
or galvanized can and then decanting or straining. The steps 
then used are as follows: 
a. Pill the bag to the 36-gallon mark, or if this mark is 
not present, to within 4 inches of the top. 
b. Draw a small quantity of water through one of the 
faucets into a canteen cup. 
c. Break an ampule of the calcium hypochlorite into the 
water in the cup and with a clean stick rub it into a thin 
paste containing no visible lumps. Then add sufficient water 
to fill the cup two-thirds full. 
d. Empty the solution of calcium hypochlorite in the cup 
into the water in the bag and stir thoroughly with a clean 
stick which is long enough to reach the bottom of the bag. 
Then flush out each of the faucets. 
e. After the calcium hypochlorite has been in contact with 
the water in the bag for at least 10 minutes, wash out the 
faucets by allowing a small amount of water to run through 
it onto the ground. Then fill a clean cup about two-thirds 
full of water from one of the faucets. 
/. Add one cc (approximately 15 drops) of the orthotoli- 
dine solution to the water in the cup and allow it to stand 
for about 5 minutes so that the color will develop. Because 
of the reflected light, the color of the water in the cup is 
more intense than it would be if the same water were placed 
in a glass tube. A well-marked yellow color indicates that 
the water contains about the proper amount of residual 
chlorine. An orange color is evidence of overchlorination. 
g. If no residual chlorine is present at the end of the 10- 
minute contact period, the chlorination procedure as outlined 
above is repeated. Where it is suspected that the cal- 
cium hypochlorite is inert, a preliminary test with orthotoli- 
31 46-47 
MEDICAL FIELD MANUAL 
dine should be made immediately after the addition of the 
calcium hypochlorite solution to determine if the water con- 
tains any free chlorine at that time, 
h. As a factor of safety, the water should be allowed to 
stand for 20 minutes after the end of the contact period, or 
for 30 minutes after the addition of the calcium hypochlorite, 
before being used for drinking purposes. 
i. The calcium hypochlorite now furnished is the kind 
known as “Grade A” hypo., and contains about 70 percent 
available chlorine. This is the equivalent of 2.5 parts per 
million free chlorine when added to a bagful of water. The 
organic matter in most water supplies in the field will utilize a 
great deal of this free chlorine so that the residual chlorine 
will be reduced to 0.5 to 2 parts per million. If there is little 
or no organic matter present only a fractional part of the 
tube of hypochlorite should be used. When there is any 
doubt as to the purity of water furnished a unit it should be 
chlorinated. 
■ 47. Other Emergency Measures.—a. If water sterilizing 
bags are not available, the water may be sterilized in the unit 
water cans, clean, galvanized iron cans, pails, or barrels. A 
proportional amount of calcium hypochlorite is used and the 
method of chlorination is the same as with the water steriliz- 
ing bag. 
b. If larger containers are not available, canteens may be 
utilized. One-half gram of grade A calcium hypochlorite is 
dissolved in a canteen of water. This strong solution is then 
used to purify water in other canteens. The cap of a canteen 
is used as a measure and 1 canteen capful of the strong solu- 
tion is added to each canteenful of water to be treated. The 
water should be well shaken and not used until 30 minutes 
after chlorination. 
c. Iodine may be employed as a disinfectant instead of 
chlorine. Ten cc of the tincture of iodine are used to disin- 
fect a water sterilizing bagful of water (36 gallons). Two or 
three drops are used to disinfect a canteenful of water. 
Iodine is expensive and the supply would be limited during 
war. Further, in the treatment of some waters, iodine is 
apparently much less effective than chlorine. The water 
32 FIELD SANITATION 
47-48 
should not be used until 30 minutes after the iodine has been 
added. 
d. If calcium hypochlorite or iodine is not available, water 
may be purified by boiling for 10 minutes. This method 
should not be used, if avoidable, by the individual soldier, but 
the water should be boiled under supervision in comparatively 
large quantities and then distributed to the troops. Water 
may be boiled in galvanized iron cans if they are available. 
Aeration of the water by pouring it through the air from 
one receptacle into another will eliminate the flat taste due 
to boiling. 
H 48. Water Discipline on the March.—a. In marching 1 
mile, a fully equipped soldier generates 90 calories, which will 
require 180 cc of water to dissipate as heat. For 3 miles, or 1 
hour, 540 cc of water are required, which is a little over 1 pint 
(473 cc). For 2 hours the soldier will lose 2 pints or the 
equivalent of 1 canteen of water. There are too many factors 
entering into the water requirements to dogmatize or stand- 
ardize the fluid intake too rigidly. It is safe to assume that 
the soldier starts the march with about 1 pint of extra fluid in 
his stomach. The following diagram shows the ordinary con- 
sumption of water on a day’s march: 
Drinks 
remaining 
half can- 
teenful. 
3 hours. 
Drinks 
remaining 
y2 canteen- 
ful. 
8 hours. 
1 hour. 
6 hours- 
0 hour. 
Start of 
march, 1 
pint in 
stomach. 
2 hours. 
Drinks 
% can- 
teenful. 
4 and 5 
hours. 
Noon rest: 
refill can- 
teen ; leave 
camp with 
1 pint in 
stomach. 
7 hours. 
Drinks 
V2 can- 
teenful. 
9 hours. 
Camp ; 
refill 
canteen. 
b. Water should be chlorinated and canteens filled the 
night before a march is started. Chlorinated water in com- 
pany cans should be available at the noon halt. 
33 49-51 
MEDICAL FIELD MANUAL 
Section V 
WATER RECONNAISSANCE 
■ 49. General.—A source of water supply for moving troops, 
for troops in the theater of operations, or for forces engaged 
in occupational work must frequently be located by reconnais- 
sance. Only in extreme cases where there is a marked short- 
age or an absence of water will the water supply be a govern- 
ing factor in the movement of troops or in the conduct of 
military operations. Ordinarily, the military mission will 
not be influenced by the availability of a water supply, and the 
best source of water from the standpoint of quantity, accessi- 
bility, and purity in the area in which the troops are operating, 
or will operate, must be located by reconnaissance. 
■ 50. Responsibility for Water Reconnaissance.—a. The 
Corps of Engineers is responsible for the procurement and 
purification of water for the major units and installations in 
the theater of operations and is, therefore, responsible for 
water reconnaissance where such action is necessary. 
b. In situations where intestinal disease is, or may become, 
epidemic or where the the protection of the health of the 
troops renders it desirable, the Medical Department assists in 
the conduct of, or makes water reconnaissance, and submits 
recommendations concerning the procurement and purifica- 
tion of water supplies. In the case of small units and instal- 
lations or minor forces operating independently, engineer 
personnel may not be available for this purpose and the re- 
sponsibility for water reconnaissance will devolve upon the 
Medical Department personnel attached to such organiza- 
tions. 
■ 51. Conduct of Water Reconnaissance.—Information as to 
the location and extent of water supply sources in a given 
area may be obtained from geologic or topographic maps, 
from government reports, from the inhabitants, from aerial 
photographs, or by reconnaissance on the ground. The pur- 
pose of a water reconnaissance is to locate a suitable source of 
supply and determine, if indicated, the quantity of water 
available from a given source, the time and labor required to 
34 FIELD SANITATION 
51-52 
develop it, and the quality of the water, insofar as the quality 
will influence the purification measures. In scope, the recon- 
naissance may consist of inspection of an easily accessible and 
satisfactory supply, a more extensive survey to determine 
upon the best of two or more unsatisfactory sources or to 
locate one satisfactory supply, or a study of larger or smaller 
water works systems. 
■ 52. Summary of Points to be Covered and Reported on in 
a Water Reconnaissance.—The following summary Indicates 
the points that should be covered in the average water recon- 
naissance. Not all the points given in the summary are 
applicable in any one situation, while in some instances it 
will be necessary to secure data not mentioned herein. 
a. Location.—Sources and works should be shown on a 
map or the location given by description. 
b. Character of sources.—Well, spring, stream, lake, or 
pond. 
c. Quantity of water available. 
Rate of flow of streams. 
Rate of flow and capacity of wells. 
Rate of flow of spring. 
Dimensions and estimated depth of lake or pond and, 
if indicated, rate of inflow and outflow. 
d. Quality of water. 
Turbidity. 
Color. 
Taste. 
Result of bacteriological examination, if indicated, and 
if it is practicable to secure samples and have them 
analyzed. 
e. Source of bacterial contamination. 
Character of sources. 
Location in relation to water supply. 
Control measures indicated. 
/. Accessibility.—Accessibility of sources of water to troops 
by railroad, highway, improvised roads, trails, or hand carry, 
g. Wells. 
Diameter. 
Depth of well. 
35 52-53 
MEDICAL FIELD MANUAL 
Depth of water. 
Distance from surface of ground to the surface of the 
water. 
Type, condition, and depth of casing or lining. 
Kind of soil. 
Nature of impervious strata if indicated and ascertain- 
able. 
Method of recovering water; i. e., pump, windlass, etc. 
h. Spring. 
Kind of spring. 
Protection provided; i. e., coping, watertight basin, 
ditching, etc. 
i. Streams. 
Mean velocity. 
Mean width. 
Mean and maximum depth. 
Nature of stream bed. 
Height of banks above surface of water. 
j. Existing installations. 
Purification facilities—chlorinating apparatus, filters, 
etc. 
Pumps—number, type, size, speed, and capacity. 
Engines—type, size, speed, and horsepower. 
Electrical equipment. 
Storage facilities—type and capacity. 
Pipe lines—length, size, and material. 
Present condition (description). 
k. Proposed developments. 
Description. 
Material available. 
Material required. 
Time required. 
■ 53. Maps and Conventional Signs for Water Supplies.— 
Wherever practicable, the data obtained by water reconnais- 
sance should be transferred to a map by the use of con- 
ventional signs. A map is one of the best means of recording 
certain parts of such information and transmitting it to 
others. The following conventional signs may be used for 
this purpose: 
36 FIELD SANITATION 
53 
Valves 
Air valves 
Check valves 
Tees (with size) 
Wyes 
Elbows 
Laboratory 
Mobile purification, unit 
PUmp 
Tank and reservoirs (with numbers 
and capacity) 
37 53 
MEDICAL FIELD MANUAL 
Water point 
Water point, animals only (number 
of animals) 
Railway water point 
Railway spill tank 
Water works 
Engineer water supply battalion 
Well 
Spring 
Direction of dip 
Flowing well areas 
Pipe line or aqueduct (diameter 
may be shown) 
Water tank train 
Green 
-.blue 
38 CHAPTER 4 
WASTE DISPOSAL 
Paragraphs 
Section I. General 54-55 
II. Human wastes 56-69 
III. Garbage 70-75 
IV. Liquid wastes 76-82 
V. Manure 83-91 
VI. Rubbish 92-94 
Section I 
GENERAL 
■ 54. Classification of Wastes.—a. Human excreta (feces 
and urine). 
b. Garbage. 
c. Liquid wastes (kitchens, baths, and ablution benches). 
d. Manure. 
■ 55. Responsibility for Disposal.—Unit commanders are 
responsible in their areas for all waste disposal. If the wastes 
from more than one unit are disposed of in some common 
manner, the quartermaster is then responsible for the con- 
struction, operation, and maintenance of all permanent facili- 
ties and installations. This activity, however, is a respon- 
sibility of the Corps of Engineers in the theater of opera- 
tions. The scope of the sanitary control exercised by the 
Medical Department includes the following activities: 
a. The sanitary survey of sites and the study of plans for 
proposed waste-disposal facilities of a permanent nature. 
b. Surveys and inspections of existing permanent waste- 
disposal installations for defects in construction or operation 
which are of sanitary significance. 
c. The formulation of recommendations relative to the in- 
stallation of temporary appliances or the adoption of emer- 
gency measures for the disposal of waste material inimical 
to the health of the troops. 
39 55-59 
MEDICAL FIELD MANUAL 
d. The sanitary supervision and inspection of existing tem- 
porary or emergency facilities for waste disposal. 
e. The laboratory analysis of sewage and sewage effluents. 
Section II 
HUMAN WASTES 
H 56. General.—In many semipermanent camps or canton- 
ments human feces may be disposed of by a water-carriage 
system. Should this system discharge into a municipal sys- 
tem the disposal is simplified. More often, however, a sewage- 
disposal plant has to be constructed. Should this be the case 
the representative of the Medical Department should famil- 
iarize himself with the method of construction and the oper- 
ation of such a plant, even though it be operated by the 
Corps of Engineers or the Quartermaster Corps. 
■ 57. Seating Space.—No matter what type of installation is 
used there should be sufficient latrine seat spaces to accom- 
modate from 5 to 10 percent of the command at one time. In 
temporary latrines this requires 2 lineal feet per space. 
Usually 8 percent of the command are provided for. 
O 58. Disposal on the March.—During brief halts on the 
march the men who desire to relieve themselves should fall 
out, dig a hole with the entrenching tool, piece of stick, or 
some similar material, and after depositing feces should cover 
it well with earth. A trench may be dug for use during a 
halt for a meal. 
■I 59. Disposal in Bivouac.—In camps of short duration (1 to 
5 days) trench latrines are provided. This consists of a 
trench not more than 1 foot wide and from 18 to 24 inches 
deep. Earth from the trench is piled at one end and the 
trenches should be constructed so as to provide 2 feet per man 
for about 8 percent of the command. No seats are provided, 
the man straddles the trench and squats over it. Each man 
covers his deposit with earth from the pile at the end of the 
trench. Toilet paper rolls may be placed on tent pegs near 
trenches if the weather is dry; otherwise, toilet paper should 
be kept dry in a box turned on its side. When the troops 
depart the trench is filled in after spraying contents well with 
40 Figure 7.—Trench latrine. 
41 59-60 
MEDICAL FIELD MANUAL 
crude oil, and if there is a possibility of other troops occupying 
the site it should be marked. 
« 60. Disposal in Camps.—a. General.—Certain kinds of 
latrines have been found to be best suited for use in military 
camps. The pit latrine is the type most commonly used. This 
is an adaptation of the ordinary earthen privy. 
Figure 8.—Flyproofing latrine pit. A—Oil soaked burlap extending 
completely around pit. B—Opening of pit. C—Sidewall of exca- 
vation in which burlap is placed. 
Size of pit: 
Length—8 feet or multiple thereof, as quartermaster 
latrine boxes are constructed 8 feet in length. 
Width—2 feet. 
Depth—4 feet for 2 weeks and add 1 foot for each 
additional week. Usually a maximum of 10 or 12 
feet but governed by character of soil. 
•’igure 9.—Method of flyproofing latrine pit with oiled burlap. 
A—Layer of earth replaced and tamped down over oil-soaked bur- 
lap. B—Oiled burlap exposed before replacement of earth. 
C—Opening of pit. 
b. Flyproofing.—Excavate an area 4 feet wide completely 
urrounding the pit to a depth of 6 inches. Cover this area 
nth burlap soaked in crude oil, the burlap being placed so 
hat it hangs down into the pit to a depth of 18 inches. The 
42 FIELD SANITATION 
60-62 
earth is then replaced over the burlap and tamped down. If 
burlap Is not obtainable the earth from excavated area may 
be mixed with crude oil and tamped back into place 
■ 61. Standard Quartermaster Latrine Box.—This box is 
built as shown in figure 10. When the box is placed over the 
pit: earth should be tamped around the base to prevent the en- 
trance and exit of flies. The box may be made “knockdown” 
Stop block- 
Lid- 
Urine 
deflecting 
strip(metal) 
Pit 
Figure 10.—Latrine box showing different sections. 
in type so that it can be taken apart and packed more easily 
on a truck or wagon. 
■ 62. Urinals.—When the latrine is installed a trough urinal 
should be built near enough to it so that it may be enclosed 
in the same enclosure. Ordinarily this trough may be V- 
shaped (see fig. 12) and lined with tar paper or galvanized 
iron. This trough is then connected with the latrine pit by 
43 Figure 11.—Latrine with screen dropped on one side to show box and urine trough. 
44 FIELD SANITATION 
62-64 
means of ordinary galvanized drain pipe. The trough should 
Slant toward the end in which the drain is located and the 
drain hole should be protected by a wire mesh insert in order 
that it be not blocked by extraneous material thrown Into 
the trough. The trough may be connected to a urine soakage 
pit which is built outside of the enclosure if it is not desired 
to have the urine flow into the latrine pit. 
■ 63. Protection.—Latrine and urine trough should be en- 
closed with a latrine screen made of canvas, or an improvised 
screen should be made of wood, brush, etc. Latrines should, 
wherever possible, be protected from rain by use of tents or 
tent flies. The entire enclosure should be ditched all around 
so that rain and drainage water will be carried away. 
■ 64. Material for One Latrine.—Bill of material for one 
enclosure and one quartermaster box and one trough urinal, 
(Labor—one carpenter, 20 hours.) 
Top of box 
Front of box 
Rear of box 
Ends of box 
Seat covers 
Batten and 
strips (if T & 
G material be 
used batten 
may be omit- 
ted) . 
Frame for box_ | 
Front plank un- 
der box. 
Rear plank un- 
der box. 
End plank 
End plank 
2 pieces 1 inch by 12 inches by 8 feet. 
2 pieces 1 inch by 8 inches by 8 feet. 
2 pieces 1 inch by 10 inches by 8 feet. 
1 piece 1 inch by 8 inches by 8 feet. 
1 piece 1 inch by 12 inches by 7 feet. 
1 piece 1 inch by 2 inches by 7 feet. 
8 pieces 1 inch by 2 inches by 8 feet. 
1 piece 2 inches by 2 inches by 4 feet 
6 inches. 
2 pieces 2 inches by 4 inches by 9 feet- 
1 piece 2 inches by 10 inches by 8 feet. 
1 piece 2 inches by 6 inches by 8 feet. 
1 piece 2 inches by 6 inches by 3 feet. 
1 piece 2 inches by 12 inches by 3 feet 
6 inches. 
555798°—43 4 
45 64-66 
MEDICAL FIELD MANUAL 
End strip 1 piece 1 inch by 6 inches by 2 ieet 
9 inches. 
If wooden enclosure is used: 
Posts 
Boarding (may 
use equivalent 
of other than 
1") 
Battens 
Rails 
Paper 
10 pieces 10 feet. 
48 pieces 1 inch by 12 inches by 6 feet. 
48 pieces 1 inch by 2 inches by 6 feet. 
8 pieces 2 inches by 4 inches by 12 feet. 
2 rolls. 
If roof is used: 
Stringer 
Stringer 
Nails 
Strap hinges 
Flathead screws 
1 piece 2 inches by 4 inches by 14 feet. 
2 pieces 2 inches by 4 inches by 14 feet. 
3 pounds twentypenny. 
8 pounds tenpenny. 
4 pounds eightpenny. 
4 pairs 4 inches. 
4 dozen No. 8. 
For urine trough: 
Ends 
Pipe (approxi- 
mate size). 
Pipe bent (ap- 
proximate 
size). 
I. C. tin 
1 piece 6 inches by 6 inches by 3 feet. 
1 piece 1V4 inches by 1 inch by 1 foot 
4 inches. 
1 piece 1V4 inches by 1 inch by 4 feet. 
1 sheet 20 inches by 28 inches. 
■ 65. Bored Hole Latrine.—This type of latrine has been 
used extensively in the far east. It consists of a round hole 
14 to 18 inches in diameter and 15 to 20 feet deep, made with 
a post hole auger. The box may be a single seat or a concrete 
slab with a hole which may be used by squatting. 
■ 66. Urine Soakage Pit.—a. A hole 4 feet square is dug and 
filled with broken stone 1 to 4 inches in diameter (may sub- 
stitute flattened cans, broken bottles, bricks, etc.). A 
square ventilating shaft 4 to 6 inches in diameter minimizes 
odor production. The shaft should extend from about 1 foot 
above the surface to within 6 inches of the bottom and should 
46 FIELD SANITATION 
66 
Figure 12.—Urinal and urine soakage pit. 
Figure 13.—Urine soakage pit. 
47 66-68 
MEDICAL FIELD MANUAL 
contain a number of holes. The top of the shaft should be 
covered with fine screening to prevent ingress of flies. 
b. The pit may be surmounted by a square trough urinal 
as shown in figure 12, or it may have a V2- to 2-inch pipe 
placed in each corner at an angle of 30° to the vertical plane 
and extending about 1 foot into the pit. A metal or tar- 
paper funnel is placed in each pipe to receive the urine. 
c. In loose soil one soakage pit will dispose of urine from 
100 men for an indefinite period. 
■ 67. Location of Latrines.—Latrines should be at least 100 
yards away from company kitchens and at least 100 feet 
from any well or spring. 
Figure 14.—Scrubbing brush for latrine seats, toilet bowls, and 
urinals. Made by fastening a handle onto one-half of scrubbing 
brush. 
■ 68. Care of Latrines.—Latrines should be policed daily and 
should be lighted at night. If flies are prevalent, baited fly 
traps should be placed about in the enclosure. The pit walls 
and contents should be sprayed daily with either crude oil 
or sodium-arsenite spray (formula par. 140). The outside 
of the box should be scrubbed daily with soap and water and 
the seats twice weekly with 2-percent cresol solution. Urine 
troughs should be scrubbed daily with soap and water. Crude 
oil should not be used in urine trough if trough is lined with 
48 FIELD SANITATION 
68-69 
tar paver or drains into a urine soakage pit. A brush for 
latrine seats and urine troughs may be made by fastening a 
handle to one-half of an ordinary scrubbing brush. 
■ 69. Pail Latrines.—The pail latrine is usually installed 
where buildings without adequate plumbing facilities are used 
as barracks or hospital wards. A standard latrine box may 
be adapted for use as a pail latrine as shown in figure 15. 
When located in a building the latrine should be built in so 
that the pails can be removed from the rear and from the 
outside of the building through openings in the wall. These 
openings should be fitted with hinged doors. The pails 
should be removed at least once daily and replaced by a 
Figure 15.-—Method of adapting standard latrine box for use as 
pail latrine A—Latrine pail. B—Hinged doors C—Self-closing 
lids 
clean pail immediately. The bottom of the pail should con- 
tain about 1 inch of a 2 percent cresol solution. Pails of 
excreta from pail latrines may be removed by hand, cart, 
truck, or wagon and disposed of in one of the following 
ways: 
a. By burial. 
b. By dumping into manhole of community sewer if one 
is available and sewage disposal plant will handle additional 
load. 
c. By incineration. 
d. By placing in flyproof concrete tanks where it under- 
goes decomposition. 
49 70-71 
MEDICAL FIELD MANUAL 
Section III 
GARBAGE 
■ 70. General.—a. Garbage is composed of the solid and 
semisolid wastes produced in the preparation of food. It 
includes waste food, the noneditale portions of foodstuffs, and 
waste materials incident to the preparation of food such as 
tin cans and coffee grounds. It does not include ashes or 
rubbish such as street sweepings, rags, boxes, or paper unless 
the paper is used to wrap the garbage 
b. Amount and character of garbage produced in tempo- 
rary or semipermanent camps are as follows: 
Amount per man per day 0. 5-0. 8 pounds. 
Water content 65-80 percent. 
Amount of dry matter combustible._ 85 percent. 
Amount available for hog feeding 50 percent. 
■ 71. Methods of Garbage Disposal.—a. Burial.—On the 
march or in bivouac, burial of garbage is the method of 
choice. In larger camps, if soil is favorable, garbage may be 
buried in trenches 2 to 3 feet deep; however, it requires about 
2,500 square feet of ground for the burial of the garbage pro- 
duced by 100 troops in one month. When garbage trenches 
are filled to within 1 foot of surface they should be back- 
filled and the earth well tamped down. Garbage pits should 
not be within 100 feet of any source of water used for drink- 
ing or cooking. 
h. Sale or gift.—Arrangements may be made, especially in 
semipermanent camps, to either sell or give the garbage to 
farmers. This is usually done by contract made by the 
quartermaster The contractor should be bonded in order 
that the government may be protected in case of failure. 
All of the safeguards mentioned in paragraph 72 should be 
demanded in order that sanitary defects do not develop. If 
garbage is utilized for animal food the edible portion must 
be separated from the nonedible at the kitchens. The fol- 
lowing are nonedible articles: 
Coffee grounds. 
Tea leaves. 
Eggshells. 
50 FIELD SANITATION 
71 
Banana peels and stalks. 
Pish heads and scales. 
Citron rinds. 
Tin cans, paper, and other rubbish, 
c. Hog feeding.—This is not feasible unless there are at least 
500 troops in a camp for a considerable period of time. Hogs 
consume an average of 15 to 20 pounds of garbage per day. 
As 500 troops produce about 200 pounds of edible garbage per 
day, this will care for 10 to 15 hogs. Hogs should always be 
immunized against hog cholera. 
Figure 16.—U. S. standard incinerator. Stack about 50 feet in 
height. 
d. Reduction.—The cost of a reduction plant, both as to 
construction and operation, renders it impracticable for camp 
or cantonment. 
e. Closed incineration.—Closed incinerators are of two 
types, low temperature (1,400° F.) and high temperature 
(minimum 1,800° P.). The high temperature types cost more 
to install but consume all noxious gases. The U. S. standard 
incinerator is a typical high temperature incinerator (see 
fig. 16). 
f. incinerator.—The semiclosed incinerator is 
more easily built with unskilled labor than the closed type and 
is protected from rain and wind. The incline plane incinera- 
tor is a type which may be considered semiclosed and which 
51 71 
MEDICAL FIELD MANUAL 
will consume the garbage from about 1,000 troops and is easily 
constructed. A trench is dug 11 feet 8 inches long, 2 feet 9 
inches wide, and 1 foot 6 inches deep, as the firebox is below 
Figure 17.—Incline plane incinerator. 
the level of the ground at one end. (See fig. 17.) The rock 
shown in the figure supports a piece of corrugated iron which 
is level for the first 20 inches and then slopes down to the 
Figure 18.—Incline plane incinerator, side view. 
52 FIELD SANITATION 
71 
Figure 19.—Incline plane incinerator, end view. 
53 71 
MEDICAL FIELD MANUAL 
grate. The upper part of the incline plane is roofed over with 
two pieces of oil drum, each consisting of one-third of a drum 
cut longitudinally. The entire outside except the doors is 
covered with a thick layer of wet clay, dried in place with a 
Figure 20.—Multiple shelf incinerator with side cut away to show 
interior construction. 
slow fire. Kitchen wastes are fed through the top door onto 
the corrugated platform and are gradually pushed down the 
plane toward the grate. Being dried out on the way down 
they are easily burned. 
54 FIELD SANITATION 
71 
g. Oven incineration.—(1) If none of the methods of dis- 
posal previously described exist, the garbage produced in a 
camp is disposed of by open incineration. Sometimes one 
incinerator is built for the camp and operated by the quarter- 
master. This type is usually a multiple shelf incinerator (see 
fig. 20) or a rock pile incinerator. The latter type is difficult 
to operate and uses a great deal of fuel so is not constructed 
unless it is impossible to construct other types. 
(2) As a rule company incinerators will be found satisfac- 
tory in most camps where garbage has to be burned in the 
Figure 21.—Barrel and trench incinerator 
camp for relatively short periods. However, this type of in- 
cineration may be carried on over a period of many months. 
(3) The company incinerator of choice is the barrel and 
trench incinerator. This consists of a barrel-like stack which 
is placed over the intersection of cross trenches. The stack 
provides means of preheating and partially drying the gar- 
bage prior to burning. In constructing a barrel and trench 
incinerator there are three parts to consider, the trench, the 
stack, and the supporting material and grate. 
(a) Two trenches 1 foot wide and 10 feet long are so con- 
structed that they cross at right angles at the center of each 
55 71 
MEDICAL FIELD MANUAL 
Figure 22.—Cross trench incinerator. 
Figure 23.—Cross trench incinerator with barrel made of packed 
clay molded over a wooden barrel. 
56 FIELD SANITATION 
71 
trench. Each trench slopes from the surface of the ground 
at each end to a depth of 18 inches at the center at the 
intersection. 
(b) The stack may be made of brick or stone either with or 
without mortar and measures about feet in diameter at 
the bottom and 3 feet at the top (outside measurements). 
The stack may also be made of clay molded over a barrel 
from which both ends have been removed. An oil drum or 
galvanized iron garbage can with ends removed may also 
be utilized. 
(c) The supporting structure may be either wide pieces 
of corrugated iron, sheet iron, or strips of strap iron, iron bars. 
Figure 24.—Cross trench, incinerator made with 50-gallon oil drum. 
The trenches are longer than normal in order to give room for the 
drying pan. 
or rails. The grate irons are made from iron rods or pipe 
and are inserted 3 or 4 inches apart and about 6 inches above 
the ground in all but the metal oil drum and galvanized iron 
can types where they are placed at the bottom of the stack. 
(4) Other types of company incinerators are— 
(a) The rock pit incinerator (fig. 25) which is not economi- 
cal to operate on account of fuel consumption. 
(b) The drying pan incinerator (fig. 26) which may be used 
where it is difficult to dispose otherwise of liquid kitchen 
wastes. 
57 71-73 
MEDICAL FIELD MANUAL 
(5) Operation of open incinerators is an important factor 
in the successful disposal of garbage. Attendants should be 
trained to add garbage slowly so that it will not put out the 
fire, to use care in dumping garbage receptacles so as not to 
break in the top of the stack, and to clean the firebox at 
frequent enough intervals so as not to clog it with ashes. 
■ 72. Garbage Collection.—Garbage should be collected in 
standard galvanized iron cans with tightly fitting lids. The 
cans should be transported by truck or wagon to the point 
of ultimate disposal or to a central transfer station. Garbage 
should not be transferred to a garbage cart or wagon or from 
can to can at the kitchen. 
Figure 25.—Straub rock pit incinerator. 
■ 73. Garbage Stands.—In semipermanent camps, garbage 
stands should be installed adjacent to the kitchens. The best 
garbage stands are built in the form of solid concrete blocks 
with center cores of stone and earth, and with an apron of 
12 to 18 inches of concrete at the base. In height, the stand 
may be from 1 foot to 44 inches. The higher stands will have 
to be supplied with steps but are at the level of truck floors 
so as to facilitate can transfers. If concrete is not available, 
stands may be made of wood, the boards laid crosswise and 
separated at least 1 inch to prevent the retention of organic 
58 FIELD SANITATION 
73 
Figure 26.—Guthrie drying pan incinerator. 
59 73-75 
MEDICAL FIELD MANUAL 
matter. Garbage stands should not be screened or white- 
washed. 
■ 74. Care of Garbage Stands and Cans.—a. In order to min- 
imize the danger of spilling garbage during transportation, 
the cans should not be filled to within more than 4 inches of 
the top. The lids should be kept on at all times except when 
removed to deposit garbage. Care should be exercised that 
no garbage is spilled on the ground, and if solid garbage is 
spilled, it should be immediately collected and placed in a can. 
b. The platform should be scrubbed daily with a stiff scrub- 
bing brush and hot soapy water, and the ground about the 
ASHES 
REFUSE 
AND 
TINCANS 
EDIBLE 
GARBAGE 
EDIBLE 
GARBAGE 
Figure 27.—One method of labeling garbage cans for the collection of 
classified garbage. Concrete garbage stand. 
stand should be sprayed at weekly intervals with crude oil 
and firmly tamped. Intervals between collections should not 
be more than 2 days in the summer and 3 days in the winter. 
Garbage cans should be placed in sufficient numbers on the 
stand so that edible and nonedible garbage, ashes, and refuse 
can be kept separate. Markers may be used as shown in 
figure 27. Garbage cans should not be whitewashed or 
painted. 
■ 75. Transfer Station.—a. In large camps, where other than 
company incineration is used, it is usually necessary to install 
a transfer station. This may be at a central incinerator or at 
60 FIELD SANITATION 
75-76 
a point where the garbage is turned over to a contractor. 
This station should consist of a platform (20 by 100 feet in 
a large camp), at one end of which is a storeroom for paper 
and cans, while at the other end is a room where cans are 
washed. The height of the platform should be about on a 
level with the floor of a truck. A rubbish incinerator is 
usually installed near the platform. 
b. Can-cleaning equipment consists of tanks or vats in 
v/hich to soak cans in cleaning compound, adequate hot- 
water supply, and stiff scrubbing brushes. Equipment shown 
in figure 28 may be installed to straighten cans and lids. 
Figure 28.—Device used for straightening garbage cans and garbage' 
can lids. 
Section IV 
LIQUID WASTES 
■ 76. General.—In camps where sewers are available, liquid 
kitchen wastes may be disposed of by dumping them directly 
into sewer lines. In most camps, however, this is impossible 
and some arrangement must be made to dispose of these 
liquids in the soil. In order to facilitate absorption and to 
prevent clogging of the soil, liquid kitchen wastes should have 
the grease removed before they are discharged into any kind 
of pit or trench. 
555798°—43 -5 
61 77-79 
MEDICAL FIELD MANUAL 
■ 77. In Bivouac.—Kitchen liquids are disposed of in bivouac 
by dumping them into trenches or pits. These pits or 
trenches are filled in when the troops depart. While waste 
water may be disposed of on the surface of the ground, it 
provides a breeding place for flies which may annoy other 
troops who encamp there or persons who live in that vicinity. 
■ 78. Soakage Pits.—The ordinary kitchen soakage pit is 
built the same as the urine soakage pit (par. 66) except that 
it is equipped with a grease trap instead of a urine trough. 
B 79. Grease Traps.—Grease traps are of two general types, 
filter and baffle. 
a. Filter grease trap.—(1) Filter grease traps consist of 
galvanized pails, cans, etc., in the bottom of which a number 
of small holes are punched. The pail or can is placed in the 
center of the pit with the bottom about 2 inches below the 
surface. It is filled two-thirds full with a filtering material 
consisting of hay, grass, straw, or cloth which catches and 
retains a part of the grease and the debris such as bread 
crumbs or vegetable fragments. Where a larger quantity of 
liquid is to be disposed of, a wooden barrel or a metal or 
wooden tub may be substituted for the pail or can. 
(2) The ash barrel grease trap is a very satisfactory trap 
of the filter type. It is made by drilling about 30 holes in the 
bottom of an ordinary barrel. About 8 inches of gravel or 
coarse wood ashes are placed on the bottom and this is covered 
with about 18 inches of finer ashes. The top of the barrel is 
covered with a piece of burlap for a strainer, held in place 
with a barrel hoop. About twice a week the ashes should be 
removed and burned to remove the grease and then buried. 
b. Baffle grease traps.—The baffle or cold water grease trap 
consists of a container which is divided by a hanging baffle 
into an influent and effluent chamber, the former having 
about twice the capacity of the latter. The lower edge of the 
baffle is separated from the bottom of the container by a 
space of about 1 inch. The outlet leads from the effluent 
chamber and is placed from 3 to 6 inches below the upper 
edge of the container. It may consist of a short piece of I- or 
2-inch pipe or a wooden trough. A strainer should be made 
of a perforated pail or box containing hay or straw to remove 
62 FIELD SANITATION 
79 
debris before the liquid passes into the container. When in 
use both chambers are filled at all times with cool water. 
When the warm liquid wastes strike the cool water in the 
influent chamber the grease rises to the surface and is pre- 
BUCKET 
CHOPPED ST PAW- 
DRUM WITH ENDS 
CUT OUT. 
SAND 
MATT I Mi 
OR SACK J 
SAND 
GRAVEL 
BROKEN STONE 
BRICK OR EMPTY 
TINS 
KITCHEN SOAKAGE PIT 
Figure 29.—Pail grease trap. 
vented by the baffle from reaching the outlet to the soakage 
pit. Retained grease should be removed at daily intervals and 
the trap emptied and scrubbed weekly. Sediment removed at 
the time of cleaning should be burned or buried. 
63 79 
MEDICAL FIELD MANUAL 
Figure 30.—Soakage pit and grease traps. Left, cold water grease 
trap; right, ash barrel grease trap. 
Figure 31.—Baffle grease trap. A—Strainer. B—Baffle. C—Outlet. 
D—Outlet pipe. E—Space under baffle leading from the influent 
chamber to the effluent chamber. 
64 FIELD SANITATION 
79-80 
Figure—32.—Baffle grease trap made of a half barrel. A—Influent 
chamber into which the greasy fluid is emptied. B—Baffle. 
O—Effluent chamber. D—Outlet pipe. E—Space under baffle 
leading from the influent chamber to the effluent chamber. 
■ 80. Soakage Trenches.—A soakage trench consists of a 
central pit 2 feet square, 1 foot deep, from each corner of 
which a trench radiates outward for 6 feet. The trenches are 
1 foot wide, 1 foot deep where they leave the pit, sloping to 
a depth of 18 inches at the outer extremity. The central pit 
Figure 33.—Soakage trench. A—Central square area. B—Radiat- 
ing lateral trenches. C—Pail grease trap. 
65 80-84 
MEDICAL FIELD MANUAL 
and the trenches are filled with rocks, broken bricks, or flat- 
tened tin cans. A pail with numerous small holes punched 
in the bottom and containing straw as filtering material is 
placed over the center of the pit as a grease trap. The soak- 
age trench is used when the ground water table is so close to 
the surface that a soakage pit would be flooded, or where the 
condition of the ground makes the construction of a soakage 
pit impractical. 
■ 81. Operation of Soakage Pits and Trenches.—In order 
for a soakage pit to function properly, the permeability of the 
soil must be such that the liquids are drained away so that 
there will be a rest period during which the pit contains little 
or no fluid. At times it may be desirable to have two pits 
using them on alternate days. All debris and as much grease 
as possible should be removed from liquid before it is allowed 
to flow into the pit or trench. If clogging tends to occur a 
week’s rest period each month may correct it. 
M 82. Disposal of Bath and Wash Water.—If sewers are not 
available it may be necessary to dispose of bath and wash 
water in soakage pits or trenches. Water should pass through 
a grease trap before it enters the pit or trench. Where no 
sewered lavatories are available, improvised facilities for 
washing of hands and faces should be provided. Usually, a 
wash bench is installed at one end of each company street 
similar to the one shown in figure 34. 
Section V 
MANURE 
B 83. General.—Manure is of sanitary significance as it pro- 
vides an excellent breeding place for flies. The quantity of 
manure produced varies somewhat with the method of caring 
for the animals. The average where animals are kept on 
picket lines without bedding is 10 pounds per animal per day. 
If bedding is used there will be from 2 to 3 cubic feet of 
material per animal per day to be disposed of. 
■ 84. Collection.—Manure should be collected daily before 
10:00 a. m. If possible. All sweepings from picket lines or 
stables should be included in the collection. The manure 
should be hauled from the picket line or stable to the place 
66 FIELD SANITATION 
84-86 
of disposal in such a manner that none of it will be spilled 
en route. 
■ 85. Disposal by Contract.—The contractor may collect 
the manure at the stables or picket line or it may be trans- 
ferred to him at a transfer point. The contractor should be 
bonded and the terms of his contract prescribed to see that 
the manure is collected and transported in such a manner 
that fly breeding within the military reservation is prevented. 
The place of ultimate disposal should be far enough away that 
flies produced in the manure will not return to the camp or. 
Figure 34.—Wash bench showing center trough draining into a 
soakage pit. 
if disposed of near the camp, measures should be taken by 
the contractor to control fly breeding. Consideration should 
be given to any existing local laws or regulations when the 
contract is made. 
■ 86. Disposal by Composting.—a. Composting or close pack- 
ing of manure in a heap, bin, or other container causes a 
temperature of from 140° to 160c F. in the center of the mass. 
This is caused by fermentation, and as fly larvae are killed at 
115° F. within a few minutes, they are readily destroyed at all 
places except the outside of the heap. 
67 86 
MEDICAL FIELD MANUAL 
b. The following describes a method which will care for the 
accumulated manure from 100 animals for a period of 6 
weeks to 2 months. The area may be enlarged for a greater 
number of animals or for a longer duration. Eight men 
should be able to prepare this area in 4 hours. The method 
consists in the careful preparation of a trenched earthen 
area upon which the manure is placed in a systematic man- 
ner and thereafter properly cared for. 
(1) The compost area should be level or nearly so, 60 feet 
long and 20 feet wide, surrounded by a vertical-walled, flat- 
Figure 35.—Compost pile. 
bottomed trench 12 inches wide and 12 inches deep. Interior 
and exterior to the trench, the vegetation is removed for a 
distance of 2 feet. The ground thus bared is treated with 
oil, preferably road oil, and tamped firmly. A shallow sec- 
ondary trench, V-shaped, 4 inches wide and 2 inches deep, 
should be placed 6 inches interior to the main trench. 
(2) Manure is to be placed on the compost as shown in 
figure 36. Beginning at one corner, say at A, place the first 
day’s manure in a space half the width of the platform ex- 
tending 4 feet lengthwise and piled to a height of 4 or 5 
feet. The manure should be packed tightly as it is placed 
68 FIELD SANITATION 
86-87 
and the sides of the pile kept vertical. The second day’s 
manure should be similarly placed on the adjacent corner B, 
tightly packed against the end of pile one; the third day’s 
manure tightly packed against the first day’s; the fourth 
day’s against the second day’s. On the fifth day the manure 
should be placed on top of the first pile; the sixth day on 
top of the second pile; the seventh against the third; the 
eighth against the fourth. The placing of succeeding days’ 
manure is similar to that of the first 8 days. The upper sur- 
face of the pile should be concave, at least not convex, in 
order to retain rather than shed rain. 
rUNDER CUT 
REMOVE 
Figure 36.—Compost pile. Scheme for placing manure on pile. 
Numbered spaces each represent 1 day’s accumulation of manure. 
■ 87. Care of Compost Pile.—The care of the composted 
manure consists in keeping it sufficiently moist to promote 
active decomposition. The sides of the heap should be sprayed 
daily with either the sodium arsenite fly spray or with a 
mixture of fuel oil, one part kerosene to which 2 percent of 
cresol compound is added. The main trench should contain 
oil which should be of such a consistency as to impede the 
progress of the larvae and also be larvicidal. There should 
be but a small amount of oil on the bottom of the trench 
and the sides should be saturated with oil, A heavy road 
oil is satisfactory for this purpose. The purpose of the sec- 
ondary trench is to entrap the larvae and pupae which are 
always found in large numbers at the edge of the pile. This 
69 87-92 
MEDICAL FIELD MANUAL 
trench should contain road oil. It will also contain the 
larvicide mixture which has dripped down after spraying the 
pile. As a further control measure, the lower edge of the pile 
should be undercut after 3 or 4 days and the manure raked 
out and burned or buried in the top of the pile. A number 
of well cared for fly traps should be kept near the compost 
pile. There is sufficient work about a compost pile of this 
size to keep one man busy most of the time. 
B 88. Compost Bin.—A flyproof concrete or wooden bin may 
be used in which to compost manure. This method is feasible 
only in stations or semipermanent camps. From 0.5 to 1 
cubic foot of space will be required per animal per day. 
B 89. Disposal as Fertilizer.—Only composted manure 
should be used if possible. If fresh manure is used it should 
be spread thin and plowed under as soon as possible. Even 
if fresh manure is plowed under (unless dried), a fly nuisance 
may result as it is almost impossible to obtain it free from 
eggs. 
B 90. Disposal by Drying.—This method is only feasible in 
dry climates. The manure is spread on the ground in a thin 
layer not over 1 or 2 inches thick. The drying area required 
varies from 4 to 12 square feet per animal depending on 
amount of bedding. At least 25 square feet per day is required 
for 100 animals. The drying time required is from 4 to 7 
days, hence from 4 to 7 areas 25 square feet must be selected. 
The ground should be smooth and packed down before each 
application of manure and all lumps and masses broken up. 
Dried manure may be burned or stored. Should it become wet 
again after drying, it may afford a breeding place for flies. 
B 91. Incineration.—Fresh manure may be dumped on the 
ground in long windrows, sprayed with oil, and burned. 
If dried for 3 or 4 days, it may be burned with little or no oil. 
A grid incinerator may be built of rails as shown in figure 37. 
The rails may be placed over a pit rather than on supports 
as shown. 
Section VI 
RUBBISH 
■ 92. General.—Certain items such as tin cans and burned 
bones may be disposed of on dumps. The dump should be 
70 FIELD SANITATION 
92-94 
located where it will produce the least nuisance due to ap- 
pearance or odors. If practicable, a dump site should be 
selected where the dumped material will serve to fill a low 
area. 
■ 93. Construction.—A bank fill dump should always be 
made with a face not less than 8 feet or more than 12 feet 
in height. Where practical, the dump should be built on a 
hillside so that the surface may be made approximately level. 
The face of the dump should be kept as near vertical as pos- 
sible. Backing logs of heavy timbers should be placed along 
the upper edge of the face against which the loaded vehicles 
Figure 37.—Manure incincerator consisting of grid made of railroad 
rails elevated on brick piers. 
may back and dump their loads down the face of the dump. 
Vehicles not equipped for dumping should be driven along- 
side the timbers and unloaded from the side. 
■ 94. Maintenance.—As each load is dumped, the face of 
the dump should be trimmed and all combustible material 
removed and burned in the incinerator. All largo or un- 
sightly articles, or materials which will interfere with plow- 
ing or ditching the surface of the finished dump, should be 
placed on the bottom of the dump, or if necessary broken up. 
As the dump is completed, the top and sides should be cov- 
ered with material which will support vegetation. Earth or 
earth mixed with ashes or manure should be used for this 
purpose. 
71 CHAPTER 5 
MESS SANITATION 
Paragraphs 
Section I. Responsibility 95- 96 
II. Facilities 97- 99 
III. Cleansing of utensils and disposal of wastes 100-101 
TV. Menus and serving of food 102—105 
V. Mess inspection 106-107 
Section I 
RESPONSIBILITY 
■ 95. Administration.—a. An Army mess is administered 
by or under the direct supervision of the commanding officer 
whose unit it serves, and he is responsible to higher authority 
for all matters pertaining to the operation of the mess. The 
commanding officer of a unit may appoint a subordinate 
officer as mess officer. The mess officer functions under the 
direct supervision of the commanding officer, to whom he is 
responsible for the management of the mess. 
b. The mess sergeant, cooks, and at times certain other 
individuals, who are on duty in the mess for continuous 
periods are referred to as permanent food handlers. 
Kitchen police, waiters, and dishwashers are usually detailed 
for daily periods and are referred to as temporary food 
handlers. 
■ 96. Sanitary Control.—The Medical Department is re- 
sponsible for the sanitary inspection of messes and for 
reports and recommendations relative to sanitary defects. 
In scope the sanitary control of a mess includes the following 
factors: 
a. Sanitation of mess buildings. 
b. Inspection of food when received. 
c. Storage of food to prevent deterioration. 
d. Cleanliness of mess utensils and equipment. 
e. Disposal of kitchen wastes. 
/. Methods of formulating menus and character of food 
served. 
72 FIELD SANITATION 
96-98 
g. Methods of serving food. 
h. Physical examination of food handlers. 
i. Training of mess personnel in mess sanitation. 
Section II 
FACILITIES 
■ 97. Mess Buildings.—Where mess buildings are provided 
they should be properly screened during the fly season. 
These buildings should be properly and adequately ventilated 
Figure 38.—Underground ice or cooling box. A—Outer wall 
B—Insulating material. C—Inner wall. 
and lighted. Special attention should be given to floors as 
these, unless made of impervious material, will become grease 
soaked and unsightly. 
■ 98. Inspection of Food When Received.—All food received 
at a mess should be inspected by the mess sergeant, the mess 
73 98-100 
MEDICAL FIELD MANUAL 
officer, or the commanding officer of the organization to which 
the mess belongs. The primary purpose of this inspection 
is to determine if the food in question is of proper quality and 
free from contamination. If evidence of deterioration, spoil- 
age, or contamination is found, the proper Medical Depart- 
ment officer, either the surgeon or the veterinarian, should 
be notified and the suspected articles reserved for his official 
inspection. 
■ 99. Storage Facilities.—Adequate storage should be pro- 
vided for reserve food supplies and these should be protected 
from dust, dirt, and insects. Perishable foods should be kept 
at suitable temperatures to prevent their deterioration. 
a. In the field where commercial refrigerators are not avail- 
able a satisfactory substitute is the underground icebox. 
This is a double-walled box sunk in the ground. The pit 
should be dug several feet deeper than required and filled 
with crushed rock so as to form a soakage pit to take care 
of melted ice. Dimensions of outer box are 5 feet long, 4 feet 
wide, and 4 feet deep; of inner box, 4 feet long, 3 feet wide, 
and 3 feet deep. Earth is packed into the crevices between 
the outer wall of the box and the sides of the pit. A non- 
conductor—hay, straw, or sawdust—is packed between the 
inner and outer walls. Floor is perforated to drain water 
into soakage pit. 
b. Bread should always be kept in screened cabinets. In 
the field a suspended bread container may be made as shown 
in figure 39. 
Section III 
CLEANSING OP UTENSILS AND DISPOSAL OF WASTES 
■ 100. Dishwashing.—a. More attention is now being given 
to the danger of the spread of communicable diseases through 
the media of dishes and kitchen utensils. In order to pre- 
sent danger of infection, dishes and utensils must be treated 
oy heat or chemicals. Immersion in water at a temperature 
af 160° F. for 1 minute will destroy pathogenic organisms, 
[f the temperature is lower the immersion time must be longer, 
mtil at a temperature of 140° to 145° F. the dishes must 
’emain 30 minutes. 
74 FIELD SANITATION 
100 
b. Because of the difficulties encountered in disinfecting 
dishes by heat, certain chemicals have been found satisfactory. 
After dishes have been washed in hot soapy water and rinsed 
in hot clear water they are immersed in a chlorine solution 
containing at least 50 parts per million of free chlorine. 
When the solution is freshly prepared it should contain 200 
parts of chlorine per million. One ounce of grade A hypo- 
chlorite to 25 gallons of water will give this strength solution. 
Figure 39.—Suspended food container. 
c. Dishes and utensils should always be air-dried and dish 
towels should not be used. 
d. Mess kits should have waste food scraped off into suit- 
able container and then be washed in two changes of hot 
soapy water, rinsed in hot clear water, and air-dried. Ordi- 
nary galvanized iron cans over a trench may be used for 
mess kit washing (see fig. 40). In semipermanent camps, in 
order to conserve fuel and save labor, an apparatus similar 
to the one shown in figure 41 may be constructed. A pit is 
dug 11 feet long, 2 feet wide, and 4 feet deep; it is filled to 100 
MEDICAL FIELD MANUAL 
Figure 40.—Fire trench and cans for washing mess kits. 
Figure 41.—Appliance for washing mess kits for use in semiperma- 
nent camps. 
76 FIELD SANITATION 
100-102 
within 1 foot of the surface with stones. Along the two sides 
and one end a wall of stone, brick, or concrete is built, ex- 
tending 2 feet above the ground level and forming a firebox. 
The water containers are made from 50-gallon oil drums, cut 
along the longitudinal axis, 4 inches above the center line. 
Drums with bungs should be used and so cut that the bungs 
will be at the most dependent part of the drum when it is 
placed on the firebox. Pieces of iron pipe of sufficient length 
to extend above the water level are threaded at one end to 
fit the bung hole and drilled at the other end to receive an 
iron rod used to turn them in or out. After the drums are 
placed on the firebox, the space between the drums and walls, 
and between the ends of each drum, is filled with clay, A 
stack is placed at the closed end just beyond the last drum 
and the open space between drum and stack is also filled with 
clay. This device will require a relatively small amount of 
fuel to boil the water, and the draft will be such that it will 
be found desirable to place a damper in, the stack. The men 
can wash their mess kits without being bothered by flame or 
smoke. When washing is completed, the pipes in the bung 
holes are removed and the water escapes into the soakage 
pit. 
■ 101. Disposal of Kitchen Wastes.—See section III, 
chapter 4. 
Section IV 
MENUS AND SERVING OF POOD 
■ 102. Methods of Formulating Menus and Character of 
Food Served.—a. General.—A menu should provide for the 
proper qualities of each food constituent and for articles 
which will be acceptable to the group served by the mess in 
question. In formulating menus, care must be taken to vary 
the kinds of food served and methods of preparing and serving 
the articles of food. Few foods can be prepared and served 
in the same manner day after day without soon becoming 
nonacceptable to the greater proportion of the group served. 
The frequency with which a dish can be repeated without 
becoming nonacceptable varies greatly with the different ai ti- 
des of food and is, to some extent, modified by the character- 
555798°—43 6 
77 102-104 
MEDICAL FIELD MANUAL 
istics of the individuals making up the group served. For 
example, meat and potatoes can be, and are, served day after 
day and, with variation in methods of preparing, do not 
become nonacceptable to the average American soldier. On 
the other hand, troops tire quickly of the same kind of sweet 
pastry or of such vegetables as carrots, cabbage, or beets. 
b. Menu period.—A menu should be formulated for each 
day for a period of days, usually for a period of 5 or 10 days. 
The menu period should be planned for an odd number of 
days, such as five or ten, and not for weekly periods, so that 
the same menu will not be served on corresponding days of 
each week. The most satisfactory menu for the average 
Army mess is a 10-day menu providing for basic dishes to 
which other dishes may be added as opportunity is offered 
to secure desirable articles of food. The acceptability of food 
served by a mess can be enhanced and the nutritional value 
of the ration increased by the addition or substitution of 
special dishes at irregular intervals. This can be accom- 
plished by the mess officer or mess sergeant through the ex- 
ercise of a certain amount of ingenuity and foresight without 
materially increasing the cost of the ration. 
■ 103. Method of Serving Food.—a. Food must be served in 
such a manner that it will not be contaminated during the 
process of serving. The method of serving should enhance 
or at least not lessen the acceptability of the food or its appeal 
to the group appetite, and the food should be so served as to 
reduce wastage to a minimum. 
b. There are two general methods of serving food in a mess, 
the line service or cafeteria method and the table service 
method. In the field, except in semipermanent camps, the 
line service has to be used as there will be no facilities for 
mess hall service. If personnel and equipment are available, 
a well-conducted table service will generally have a more 
favorable effect on the morale and contentment of troops 
than the cafeteria service. 
■ 104. Food Handlers.—a. Every man who is to be assigned 
to duty as a permanent food handler should be reported by 
, his organization commander, or the mess officer, to the 
surgeon of the command for a physical examination. If the 
78 FIELD SANITATION 
104-106 
man is found to be free from communicable disease and is 
not a carrier of communicable disease, the surgeon should 
issue a certificate to this effect to the organization commander 
or mess officer concerned. No one should be assigned to duty 
as a permanent food handler who has not been examined 
by a medical officer and certified to be free from communicable 
disease and not a carrier. Permanent food handlers should be 
re-examined at intervals of not more than 6 months. 
b. Permanent food handlers’ certificates should be kept 
posted, or on file available for inspection, in the place where 
the food handlers concerned are employed. 
c. No one should be considered fit for assignment to duty 
as a food handler who, when physically examined, presents 
evidence of acute or chronic inflammatory conditions of the 
respiratory tract, or any signs or symptoms of venereal dis- 
ease, intestinal disease, or other communicable diseases. 
d. The medical history of the examinee is of paramount 
importance in determining his fitness for duty as a food 
handler. Any history indicating that he may have had 
typhoid fever or bacillary or amebic dysentery should be 
regarded as rendering him unsuited for duty as a food handler. 
e. When deemed desirable by the examining surgeon, the 
feces and urine may be examined bacteriologically to deter- 
mine if the man is a carrier of intestinal disease. 
■ 105. Training of Mess Personnel in Mess Sanitation.— 
The medical officer who inspects the mess should ascertain 
whether or not personnel are familiar with ordinary rules of 
mess sanitation. Instruction of personnel is the responsibility 
of the unit commander. However, he may call upon the 
surgeon for assistance. 
Section V 
MESS INSPECTION 
■ 106. Sanitary Inspection of Messes.—The principal pur- 
pose of a sanitary inspection of a mess is to determine the 
existence and nature of any defects which would result 
in contamination of the food and the transmission of dis- 
ease-producing organisms to the troops, or which would 
impair the nutritive value or lessen the acceptability of the 
food as served to the troops. 
79 107 
MEDICAL FIELD MANUAL 
■ 107. Outline for Sanitary Inspection of Mess.—The 
following outline may be followed in making a complete sani- 
tary inspection of a mess. It is suggested as a guide only: 
a. Attendants: 
Is mess sergeant qualified for position as to— 
Knowledge of food requirements and preparation 
of food? 
Ability to maintain discipline? 
Business ability? 
Are cooks adequately trained? How? 
Have food handlers all had “food handlers’ ” examina- 
tion and been certified as to health condition by the 
surgeon? 
Are food handlers cleanly as to— 
Clothing? 
Hair? 
Hands (inspect fingernails) ? 
Personal habits? Care in washing hands after 
urination and defacation. 
Is there a convenient washroom for food handlers? 
b. Menus: 
Does food served correspond with menu posted? 
Are menus well balanced and amount of food ade- 
quate? 
Check file of menus and mess account balance sheet. 
Note.—Daily food supplied each man should yield at least 3,000 
calories, provide at least 100 grams of protein, and contain adequate 
vitamins. 
c. Food supplies: 
Meat and fish: 
Source. 
Quality. 
Freshness. 
Handling. 
Storage. 
Preparation. 
Milk and dairy products: 
Same consideration as meat. 
Has bacteriological and chemical analysis been 
made? 
Is milk raw or pasteurized? 
80 FIELD SANITATION 
101 
c. Food supplies—Continued. 
Fruit and vegetables; 
Is supply adequate and satisfactory? 
Are men educated to their use? 
Canned foods: 
Is supply satisfactory? 
Bread and bakery products: 
Source. 
Quality. 
Delivery method. 
Storage. 
d. Food storages: 
Refrigerator: 
Is space adequate? 
Condition and sufficiency. 
Cleanliness. 
Disposal of drip water, 
e. Pantries: 
General neatness, cleanliness, and adequacy of storage 
facilities. 
Vegetable storage: 
Have vegetable bins been provided? 
Condition of vegetables in storage. 
Do facilities for storage guard against undue 
wastage by rotting? 
/. Bread boxes: 
Sufficiency, cleanliness, and neatness. 
g. Food preparation and serving: 
Refer to cooks training. 
Is food served in a reasonably attractive manner? 
Could you eat and enjoy the meals served and as 
served to the men in your organizations? If not. 
what corrections are advisable? 
h. Police: 
Dishwashing: 
Does the method meet the requirements ot Army 
Regulations? 
Are trays, dishes, and utensils clean? Look be- 
tween fork tines and around hilt of knife. 
81 107 
MEDICAL FIELD MANUAL 
h. Police—Continued. 
Kitchen utensils: 
Are pots and pans kept grease free? 
Are they properly stored when not in use? 
Are knives and forks clean? Look around han- 
dles and hilts. 
Is there a knife rack and a knife sharpener? 
Are stoves kept clean? 
Is fuel supply adequate? 
Kitchen police: 
Cleanliness of floors, walls, and ceilings. 
Are dirty rags allowed to accumulate on ledges, 
top of bread box. top of refrigerator, etc.? 
Are personal belongings of mess attendants al- 
lowed to accumulate in kitchen? 
i. Waste disposal: 
Is waste handled in a cleanly, satisfactory manner 
inside the kitchens and storerooms? 
Is vegetable preparation and peeling carried out in a 
neat and satisfactory manner? 
Is waste properly sorted and kept in proper recep- 
tacles? 
Ashes. 
Combustible trash and tin cans. 
Edible garbage for piggery. 
Nonedible garbage. 
Are empty cans crushed and perforated before going 
to the trash can? 
Has a trash and garbage stand been provided? Is it 
kept clean? 
Is the surrounding area kept dry and free from soil 
pollution? 
Is waste removed at reasonable intervals? 
Are clean containers provided at reasonable intervals? 
How and by whom are containers washed? 
How are wastes disposed of: 
Ashes to dump? Location of dump? 
Combustible trash burned? Where? 
Garbage incinerated? Or sold? 
82 FIELD SANITATION 
107 
i. Waste disposal—Continued. 
If garbage is sold, are terms of contract being met as 
to— 
Frequency of collection? 
Method of collection? 
Cleanliness of cans? 
j. Insects and rodents: 
Is mess screened adequately? 
Is there a supply of fly swatters or other fly destroyers? 
Are they used? 
Have fly traps been provided and are they kept properly 
baited and set up for use? 
Are roaches and other insects present? If so, what 
method is being used to control them? 
Are rodents troublesome? What steps have been taken 
for their destruction? 
83 CHAPTER 6 
HYGIENIC CONTROL OP FOOD PRODUCTS OF ANIMAL 
ORIGIN 
Section I. Meat and meat food products 108-114 
II. Sanitary inspections 115-117 
III. Poultry and eggs 118-119 
IV. Pish and sea foods 120-121 
V. Milk and daily products 122-126 
Paragraphs 
Section I 
MEAT AND MEAT FOOD PRODUCTS 
■ 108. General.—a. Except in an emergency, food products 
of animal origin such as meat and meat products, poultry and 
eggs, fish and other seafoods, as well as all dairy products, 
usually arrive at the consuming organization after careful and 
thorough inspections by various civil and military inspecting 
agencies that have had as their purpose the protection of the 
health of troops by preventing the introduction of deteriorated 
or contaminated products into organizational messes. 
h. Appropriate Army Regulations place the responsibility 
for the inspection of food products of animal origin on the 
Veterinary Corps of the Medical Department whose purpose 
is to protect the health of the troops by preventing the pur- 
chase or issue of meat and dairy products which, by reason 
of their source, nature, handling, or condition, may be un- 
safe or unsuitable for food purposes. As a sanitary pro- 
cedure, this is a direct extension of the sanitary service 
maintained by the Medical Department which assures a safe 
sanitary product up to the point of issue to troops. 
c. However, when improperly handled and stored, meat and 
meat products are subject to rapid deterioration and during 
the time products remain in the company kitchens, messes, 
or refrigerators, very careful supervision should be exercised 
by medical officers to assure the use of only sanitary products. 
■ 109. Spoilage of Meat.—Meat is considered to be unsound 
which has deteriorated or undergone any undesirable changes. 
8 4 FIELD SANITATION 
109-111 
The meat of a healthy animal is free from bacteria, and 
all bacterial decomposition is due to contamination subse- 
quent to slaughter. It is not practicable, however, to pre- 
vent a certain amount of contamination during the handling 
of meat so that all fresh meat is more or less contaminated 
with bacteria and fungi. Where the meat is properly han- 
dled, the contaminating organisms are nonpathogenic but 
they may cause spoilage of meat. Under insanitary condi- 
tions the meat may be contaminated with pathogenic or- 
ganisms. In meat which has been thoroughly dried and 
properly chilled, the bacteria grow slowly and the bacterial 
penetration is delayed while a moist and improperly chilled 
product is conducive to rapid bacterial growth and penetra- 
tion. Bacteria may penetrate rapidly and deeply into the 
tissues by growth along moist surfaces between muscular tis- 
sues or through open vessels causing areas of decomposition 
in the deep parts of the tissues and around the bones without 
evidence of surface deterioration. 
H 110. Preservation of Meats.—In order to prevent or re- 
tard bacterial invasion resulting in decomposition, products 
must be stored in a temperature which is not conducive to 
bacterial growth or cooked sufficiently to destroy bacteria or 
fungi present. Meat which has been properly handled prior 
to receipt will usually remain free from decomposition for 
from 6 to 10 days if immediately placed in a temperature of 
about 35° F. However, the average ice box or refrigerator 
maintains a temperature of from 45° F. to 55° F. and is not 
satisfactory as storage for more than 72 hours. It is es- 
sential that meat under refrigeration be hung in such a 
manner as to allow free circulation of air around it. Cover- 
ing or wrappings should be removed to hasten chilling 
process. 
■ 111. Small Refrigerators.—A small refrigerator or ice 
box should be desirably located, preferably away from heat of 
stoves or direct rays of the sun. It should be cleaned every 
day and well iced. Doors should be kept closed to conserve 
refrigeration. Meat should not be stored in the ice compart- 
ment and never in contact with ice as the ice may not be 
Clean, also the meat will become wet and this hastens spoil- 
age. Drain pipes should be sanitary and open. Food com- 
85 111-115 
MEDICAL FIELD MANUAL 
partments should not be overcrowded and meats should be 
unwrapped and so placed as not to retard circulation. At 55° 
F. it is possible to keep good, fresh, dry meat for 24 to 36 
hours; at 45° F. three days or more; while above 57° F. the 
refrigerator is inefficient. A good thermometer should be 
used in each refrigerator. 
■ 112. Temporary Camps.—In temporary camps, meat and 
meat and dairy products may be stored for a short time in 
watertight containers and immersed in springs or streams, 
care being taken to prevent contamination. Food may also 
be buried below the surface of the ground in underground 
ice boxes. 
■ 113. Disease Transmission.—Any disease, the causative 
organisms of which can be conveyed by food to a point of 
invasion within the body, may be transmitted by food. The 
diseases most frequently transmitted in this manner are 
those belonging to the intestinal group such as typhoid fever, 
the food infections, dysenteries, and diarrheas, but food may 
also be the transmission agency for other diseases such as 
tuberculosis, scarlet fever, and diphtheria. Diseases due to 
a pre-formed toxin, of which botulism is an example, may 
be caused by food in the sense that the food carries the toxin 
from the point of origin in infected food to the alimentary 
tract of man. 
■ 114. Meat Poisoning, Botulism.—The inspection of meat 
offers but little safeguard against the meat poisoning group 
of bacteria and botulism, or sausage poisoning, for the rea- 
son that the micro-organisms may pervade the meat without 
in the least changing its appearance, color, flavor, or odor. 
Thorough cooking will destroy the infection and eliminate 
the danger of meat poisoning and botulism but the cooking 
must be thorough and it must be remembered that the 
bacillus botulinus grows well in cooked foods. 
Section II 
SANITARY INSPECTIONS 
■ 115. Fresh Meats.—Assuming that all prior inspections 
have shown the product to be acceptable up to the point of 
86 FIELD SANITATION 
115 
issue to the consuming organization, a further and final 
safeguard is essential in order to assure that deterioration 
or contamination has not occurred subsequent to issue and 
prior to consumption. This is accomplished by the sanitary 
inspection of products exercised by the responsible medical 
officer. The sanitary inspection within the company or 
organization mess should include the appearance of a pack- 
age or product as an indication of prior handling, evidence 
of prior official inspection, as well as evidence of contami- 
nation, deterioration, and adulteration. Inspecting officers 
should be familiar with the appearance, color, odor, flavor, 
consistency, and other factors in order to determine accept- 
able sanitary conditions. 
a. Color.—The color of fresh meats depends mainly upon 
kind, age, conditions at slaughter, and part of the carcass 
from which derived. Choice fresh beef should be a bright 
cherry red; veal should be pinkish brown; mutton, a dark 
pink or red; lamb, a light pink, and pork, a light pink. 
b. Odor.—Meat should be free from any abnormal odor. 
Decomposed meat may be detected if it has a strong, sour, 
disagreeable, musty, mouldy, or other off odor. Putrid odors 
are usually due to ammonia or hydrogen sulfide. Rancidity 
of fats may be determined by the odor or flavor. A steel trier 
or knife may be used as an aid in the examination for odors, 
passing the trier into the tissue especially in the vicinity of 
bone and withdrawing for evidence of decomposition. 
c. Consistency.—Sound meat should be reasonably firm to 
the touch and should barely moisten the finger. Meat should 
not be flabby or pit on pressure. If, upon examination, meat 
or meat food products are found to be affected with an un- 
soundness of slight or limited extent, which in the opinion of 
the inspector can be removed by trimming, wiping, or other 
manipulation, this action should be taken followed by rein- 
spection to determine condition of the product. If the 
unsoundness involves any considerable proportion of the car- 
cass or cut and in all doubtful cases, the carcass or cut should 
not be used for food. The removal of surface rancidity or 
sourness may be accomplished by wiping with a dilute vinegar 
or baking soda solution. 
87 116-118 
MEDICAL FIELD MANUAL 
H 116. Cured Meats.—Cured meats showing deep tissue de- 
composition. insect infestation, rancidity, sourness, or exten- 
sive mold or slime should not be used for food. Slight 
degrees of mold or slime may be removed by washing or 
wiping the surface with a dilute vinegar or soda solution. 
8 117. Canned Meat Poods.—Canned meat foods should be 
examined carefully for evidence of defective containers allow- 
ing contamination of the contents or of improperly processed 
contents resulting in spoilage dangerous to health. Defective 
cans are readily detected and are classified as leakers, swellers, 
or springers (AR 40-2200). 
a. Leaker.—A leaker is a can presenting a defect through 
which air may enter or the contents escape. If the defect is 
small, leakage may be indicated only by the removal of the 
vacuum and the disappearance of the concavity in the ends 
or sides of the can. 
b. Sweller.—A sweller is a can which contains gas in suf- 
ficient quantities to produce bulging or distention of the sides 
or ends. The gas is usually due to contamination with gas- 
producing organisms resulting in incomplete sterilization or 
infection subsequent to sterilization. 
c. Springer.-—A springer is a can in which gas within the 
can is sufficient to cause a disappearance of the normal con- 
cavity from one end or side. External pressure on the flat- 
tened or bulging side causes the other end or side to flatten 
the bulge. 
All leakers, swellers, and springers should be rejected for 
food. The presence of bacillus botulinus in canned foods is 
noted by its characteristic foul odor. Such foods should not 
be used for food and should not be tasted. 
Section III 
POULTRY AND EGGS 
■ 118. Poultry.—a. The term “poultry” includes chickens, 
ducks, geese, turkeys, and such other domestic birds as may 
be used for food. Poultry is generally subject to the same 
I kind of contamination as meat products, though the tissues of 
i poultry may afford a more suitable medium for the growth 
of organisms While the diseases common to poultry are not 
88 FIELD SANITATION 
118-120 
readily communicable to man, very careful post mortem 
inspections are necessary in order to prevent the consumption 
of food contaminated with organisms pathogenic for man. 
b. Inspection.—Poultry will usually be received freshly 
killed, chilled, or frozen and should be undrawn, with head 
and feet on unless processed under supervision of Federal 
inspection agencies when they may be accepted fully drawn. 
Evidence of decomposition, slimy or sour carcasses, or any 
other unsoundness render the carcass unfit for food. 
H 119. Eggs.—a. The term “egg” usually includes only 
chicken eggs and while they do not ordinarily serve as a 
transmitting agency for disease-producing organisms, it is 
possible for micro-organisms to pass through the porous 
shell or reach the interior through a break in the shell. 
b. Inspection.—Eggs are inspected for freshness, sound- 
ness, cleanliness of the shell, color, and size. Candling and 
breaking are used to test the freshness or soundness of eggs. 
In candling, the unsoundness is indicated by mixing of the 
white and yolk, adherence of the yolk to the shell, blood 
rings, abnormally colored yolks, movable air cells, discolored 
whites, or foreign bodies. Unsound eggs should not be used 
for food. If, upon breaking, a considerable proportion are 
unsound, the entire lot should be discarded. An efficient 
candling apparatus may be easily constructed by placing a 
lamp or electric light bulb in a can, shoe box, or other 
receptacle through which has been cut a hole about the size 
of the small end of an egg. The egg is placed to this hole 
through which the light shines allowing the inspector to 
determine the internal condition of the eggs. 
Section IV 
FISH AND SEA POODS 
■ 120. Fish.—From the time fish are caught until finally 
consumed they should be handled, transported, and stored 
under proper and sanitary conditions. Otherwise, rapid 
deterioration characterized by putrefactive decomposition 
will occur. The flesh of fish may contain chemical poisons 
which will produce illness in man or it may serve as a trans- 
mitting agency for disease-producing organisms. Most of 
89 120-121 
MEDICAL FIELD MANUAL 
the fish so affected are found in the tropics. The toxic sub- 
stance is usually found in the ovaries and eggs but may also 
be found in the head and liver. Inasmuch as the toxic sub- 
stance is not removed by boiling, the most careful supervision 
must be exercised to assure the removal of these portions of 
the fish. In some localities, various types of fresh water fish 
(pike, perch) may contain the encysted larvae of the fish 
tapeworm which, when ingested in a viable state, develop 
into the adult forms in the intestines. Thorough cooking 
will destroy the larvae. Smoking, drying, salting, or freezing 
will not destroy the larvae. 
a. Inspection.—In the inspection of fresh chilled fish, cer- 
tain characteristic indications of soundness should be sought. 
If a fish is fresh and sound, the following conditions will 
be noted: 
(1) Gills.—Bright red, usually closed, no abnormal odor. 
(2) Eyes.—Prominent appearance, transparent cornea. 
(3) Scales.—Adherent. 
(4) Skin.—Free from malodorous slime, not discolored. 
(5) Flesh.—Firm, only transient indentations by pressure 
with fingers. 
(6) Body.—Stiff, tail rigid. 
(7) Carcass.—Will sink in water. 
The carcass of any fish showing evidence of unsoundness, 
injui'y, or contamination should not be used for food. 
b. Storage of fresh, chilled fish.—Sound, fresh fish which 
have been properly handled and packed in ice may be held 
in storage at a temperature of 32° F. for 10 to 14 days. How- 
ever, strictest care should be exercised to prevent variation 
of temperature. Should fish be defrosted they should be con- 
sumed promptly. Fish should be defrosted gradually in a 
cooler or refrigerator and not exposed to heat or soaking in 
either hot or cold water as this action will lessen the paya- 
bility and food value. 
■ 121. Sea Foods.—a. Fresh.—(1) Many individuals exhibit 
idiosyncrasies to shellfish, such as oysters, clams, crabs, 
shrimp, etc., which are usually manifested by urticaria, 
nausea, and vomiting. These symptoms should not be con- 
fused with those of food poisoning. 
90 FIELD SANITATION 
121 
(2) Inasmuch as oysters thrive best in water, the salinity 
of which is less than sea water, many of the producing areas 
are located where the sea water is diluted with fresh water. 
Some of these areas may be contaminated with the effluents 
of sewage systems. The production and handling of oysters 
are governed by State laws and regulations insofar as factors 
which result in contamination, deterioration, or adulteration 
are concerned and the shipment in interstate commerce is 
prohibited by Federal laws. The use of oysters or other sea 
foods should be confined to products handled under jurisdic- 
tion of State or Federal agencies. 
(3) Inspection.—Oysters may spoil or become stale after 
being shipped or they may become contaminated during 
transportation. Hence, a piece inspection should be made 
for evidence of spoilage, staleness, or adulteration. Oyster? 
whether in the shell or shucked are highly perishable. They 
deteriorate rapidly when improperly handled and present a 
characteristic, disagreeable odor or a gassy or milky appear- 
ance. Oysters may show a green or pink discoloration and 
while there is no evidence that they are detrimental to the 
health of the consumer, they are generally regarded as un- 
desirable for food and should not be used. Ordinarily, only 
canned crabs, clams, shrimps, and lobsters are used in Army 
messes, but should they be furnished fresh, the inspection is, 
in general, the same as for oysters. 
h. Canned.—(1) It is considered that all canned sea foods 
have been prepared under official supervision of civilian or 
military inspection agencies and that the quality of product 
and method of processing is satisfactory. However, deteriora- 
tion of the canned product is subject to spoilage or damage 
and the product should be subject to sanitary inspection 
prior to use. 
(2) Inspection.—The inspection is made by examination of 
the unopened can and the contents of suspected or selected 
cans. If the contents of the can are sound, the ends of round 
cans and the sides of square or flat cans are concave. Should 
the ends or sides become flattened or bulged, it may be due 
to a defect in the can allowing air to enter, or to decom- 
position of the contents with gas formation. Cans present- 
ing defects through which air might enter or contents escape 
91 121-122 
MEDICAL FIELD MANUAL 
or which “bulges” or “swells” as the result of gas formation 
should be rejected for food. Upon inspecting suspected cans, 
care should be taken when opening the can not to damage 
contents. The contents should be carefully examined for 
abnormal odor, appearance, or taste indicative of decomposi- 
tion. The inside surface of the can should be inspected for 
evidence of black discolorations due to chemical reaction. 
Any abnormal odor or appearance should be considered as 
indicative of decomposition and as a cause of condemnation. 
Section V 
MILK AND DAIRY PRODUCTS 
H 122. Dairy Farms.—a. Milk.—Milk is a most important 
agency of transmission for certain pathogenic organisms. It 
is usually served in an uncooked state and, consequently, 
many of the organisms which it may contain will be viable 
when ingested, therefore strict sanitary supervision during all 
stages of production is essential. When possible, the use of 
milk should be confined to establishments operating under 
supervision of the Army veterinary inspection service. A 
dairy farm examination consists of an investigation into the 
sanitation of the dairy farm establishment and all parts, 
equipment, employees’ health and hygiene of dairy animals, 
methods of operation, and products concerned. 
b. Inspection.—Under certain conditions it may be neces- 
sary to investigate the conditions under which milk is pro- 
duced. All bovines on the dairy farm should be free from 
disease as shown by a thorough physical examination con- 
ducted by a qualified veterinarian. The barns should be well 
ventilated, providing at least 3 square feet of window space 
and 500 cubic feet of air space for each animal. Manure 
must be removed and disposed of in such a manner as to 
prevent fly breeding. All milking utensils must be of non- 
absorbent material, in good repair, and properly sterilized. 
Milk must be promptly cooled within 1 hour after milking to 
50° P. and maintained at or below that temperature until 
delivered to the pasteurizing plant (AR 40-2230). All per- 
sonnel concerned with milking or handling of milk should be 
familiar with the necessity of strictest sanitary precautions 
92 FIELD SANITATION 
122-124 
and be required to undergo careful periodical physical exam- 
ination to assure freedom from contagious or communicable 
disease. 
■ 123. Pasteurizing Establishments.—a. General.—Pasteur- 
ization is the heating of all particles of milk or milk products 
to a temperature of not less than 143V2° F. and holding at 
such temperature for not less than 30 minutes in approved 
pasteurization apparatus. The hygienic condition of fresh 
milk depends to a considerable degree upon the conditions 
existing at the source of supply. Insanitary milk due to 
diseased animals or contamination at the source is correctible 
only in part, therefore it is necessary that milk be obtained 
from healthy cows and produced and handled under hygienic 
conditions even when it is pasteurized. 
b. Inspection.—Inspection of pasteurizing plants requires, 
in addition to a thorough knowledge of the pasteurizing 
process, an adequate understanding of the equipment, its 
construction, installation, and operation. Pasteurizing plants 
should have in satisfactory operation vats or holders in which 
the temperature of the milk is raised to at least F. 
and held for 30 minutes, automatic devices for registration 
of the pasteurizing temperature, coolers wherein the milk 
may be rapidly cooled to 45° F. or less after pasteurization, 
automatic bottling and capping machines, automatic bottle 
washers, and facilities for cleansing and sterilizing all parts 
of the pasteurizing equipment with which the milk comes in 
contact. All milk bottles should be sterilized before being 
filled and all pasteurizing equipment sterilized immediately 
before being used. Cleanliness throughout is essential in the 
operation of a milk plant. Pasteurization plants should be 
efficient and meet all sanitary requirements as to construction, 
equipment, personnel, products, and methods of operation. 
An ample supply of safe water and steam for cleansing and 
disinfecting purposes is essential. Doors, windows, and other 
openings should be screened and kept in good repair. 
■ 124. Milk.—a. General.—Milk issued to troops for bev- 
erage and cooking should be grade A pasteurized. When 
this is not obtainable, grade B pasteurized milk may be used. 
The use of bulk milk should be discouraged and the use of 
555798°—43 7 
93 124-125 
MEDICAL FIELD MANUAL 
raw milk should not be countenanced. If grade A or grade 
B pasteurized milk is not available, evaporated milk should 
be used. 
b. Inspection.—Samples for bacteriological and chemical 
analysis should be frequently obtained for laboratory tests. 
These should be packed in ice and promptly transferred to 
the laboratory. If laboratory facilities are not available 
locally, a sample should be furnished corps area laboratory 
for analysis (AR 40-310). Use a sample of 1 quart of milk 
and pour it 25 times between sterile containers. Then add 
1 cc of commercial formalin to the quart of milk and agitate 
thoroughly. Fill sample bottle flush with lower end of stop- 
per and fasten securely. Label specimen, furnishing follow- 
ing information; Station from which sent, date of collection, 
nature of specimen, specific examination required, name of 
establishment from which milk was obtained, and the word 
“formalized.” 
c. Storage.—Milk should be placed in clean refrigerated 
storage at a temperature of 45° F. promptly upon receipt. 
Underground ice or cooling box may be utilized for short 
storage periods. Bottled milk should not be submerged in 
water for cooling because the contraction of the contents 
accompanying the cooling process may create a sufficient 
vacuum within the bottle to suck in water around the edge 
of the cap resulting in possible contamination. 
■ 125. Condensed Milk.—a. General.—Condensed milk is 
primarily fresh milk from which a part of the water has 
been removed and to which sugar may or may not have been 
added. 
b. Storage.—It should be stored at temperatures below 
60" F. and above freezing and the cases should be occa- 
sionally turned in order to offset the tendency of the fat to 
separate and of the milk to solidify. Long storage is unde- 
sirable due to tendency of acid content of milk to react on 
metal of the container producing off flavors, solidification, 
or swells due to hydrogen gas. 
c. Inspection.—Deterioration of condensed milk is evi- 
denced by the formation of gas, the development of abnormal 
tastes or odors, or by discoloration. Cans presenting the 
above conditions should be rejected for food. Certain of the 
94 FIELD SANITATION 
125-126 
constituents of milk may settle out to form precipitates, 
however, this does not necessarily indicate that the milk is 
unsuitable for food. Such supplies should, however, be very 
carefully examined for evidence of other conditions which 
would render the product unfit for food. 
■ 126. Butter.—a. General.—Butter is the fat derived from 
milk or sweet or sour cream, formed into a mass together 
with water and small amounts of other natural constituents 
of milk, such as curd, lactose, and acid. It is essential that 
the production of butter be safeguarded in the same manner 
as the production of milk. 
b. Storage.—Butter exhibits a marked tendency to absorb 
odors and tastes from other substances and for this reason 
should not be stored in the same place or close to odorous 
substances such as fish, cheese, or certain vegetables. If 
butter is to be held for any considerable length of time it 
should be placed in cold storage at a temperature of from 
5 to 10 degrees below zero F. where it may be held for as 
long as 6 months without deterioration. Butter should not 
be held at temperature of from 20° F. to 30° F. for longer 
than 1 month and storage space should be kept dry and 
clean. 
c. Inspection.—Sanitary butter should be clean, sweet, of 
an agreeable aroma, palatable, of fine texture and grain, 
and should not contain adulterations, insects, or foreign 
substances. It is bright in color and of a light straw shade. 
95 CHAPTER 7 
FLY CONTROL 
Section I. Development and characteristics of the fly 127-128 
II. General control measures 129-130 
III. Fly traps 131-135 
IV. Other special measures 136-140 
Paragraphs 
Section I 
DEVELOPMENT AND CHARACTERISTICS OF THE FLY 
■ 127. Development.—The housefly (Musca domestica) de- 
velops by complete metamorphosis as follows: 
a. Egg.—The eggs of the housefly are oval, white, glisten- 
ing bodies about 1 millimeter in length. They are deposited 
in clusters or masses on or in moist organic material. The 
individual fly deposits 100 to 150 eggs at one time and lays 
two to four batches during her lifetime. Under favorable 
circumstances the number of eggs may be increased to over 
2,000. The length of egg stage varies from 8 hours at a tem- 
perature of 85° F.—90° P., about 24 hours when the tempera- 
ture is between 60° F. and 68° F., and in 2 or 3 days at a 
temperature of 40° P. 
b. Larva.—Newly hatched larvae (maggots) are about twice 
the length of the egg. They grow rapidly and feed on organic 
matter. They develop by successive molts reaching maturity 
under average conditions in 4 to 5 days. Cold, lack of food, 
and moisture will prolong the larval stage. Optimum tem- 
perature is about 9(h F. 
c. Pupa.—The pupae are dark in color and about 6 milli- 
meters in length. Pupae are nonmotile and do not feed. 
Under average conditions this stage lasts 3 to 10 days. 
d. Adult.—When the adult fly emerges from the puparium 
it crawls upward through the loose soil, manure, or other 
material to the surface. As soon as the wings harden it is 
ready for flight. The female reaches maturity and oviposi- 
tion begins in 2Vz to 20 days after emergency from puparium. 
96 FIELD SANITATION 
127-130 
The newly hatched fly does not grow after it leaves the 
puparium but emerges full size. 
■ 128. Range of Flight.—The housefly does not migrate 
very far if food and breeding places are accessible. Normally 
this is from 500 to 1,000 yards. They may be carried on ani- 
mals, in vehicles or by wind currents much greater distances. 
Section II 
GENERAL CONTROL MEASURES 
■ 129. Habits Tending Toward Control.—The principal hab- 
its and characteristics of the housefly which are to be con- 
sidered in the formulation and execution of control pro- 
cedures are— 
a. The preference for horse manure as breeding material 
and the tendency to breed freely in horse and other animal 
manure, human excreta, and fermenting vegetable wastes. 
b. The necessity for moisture, warmth, and soluble food for 
the normal development of the larvae. 
c. The susceptibility of the larvae to temperature of 110° 
to 115° F. 
d. The tendency of the mature larvae to migrate from the 
breeding material prior to pupation. 
e. The development of the pupa at or beyond the borders 
of the mass of breeding material. 
/. The ability of the larvae and the adult insect to crawl 
through loose manure or earth. 
g. The attraction of adult flies to food by odor. 
h. The tendency of flies to fly toward light. 
i. The tendency of flies to rest on vertical surfaces or 
hanging objects. 
■ 130. Destruction of Adult Flies.—Adult flies may be 
destroyed by the use of traps, fly paper, poison sprays, and 
swatting. These measures are temporary ones, and the elim- 
ination of breeding places and destruction of immature forms 
of the insect are more important. 
97 131 
MEDICAL FIELD MANUAL 
Section III 
FLY TRAPS 
■ 131. Types of Traps.—a. Fly traps vary in design and size 
but all consist of two main parts, the bait chamber and the 
trap chamber. The bait chamber is the lower and darker part 
of the trap into which the flies are enticed by the odor of the 
bait. The trap chamber is the upper part and is connected 
Figure 42.—Square fly trap with board windshield to protect the 
trap from the wind. 
with the bait chamber by an aperture through which the flies 
crawl toward the light after having fed on the bait. 
(1) The square trap is from 12 to 18 inches square and 18 
to 24 inches in height (see fig. 42). 
(2) The round trap is similar to the square trap except as 
to shape. Nail keg hoops are valuable in the preparation of 
the framework. 
(3) The box trap is made in the same manner as the square 
trap except that the sides are made of boards. The cone and 
lid are made of screening. 
98 FIELD SANITATION 
131 
Pxgure 43.—Round fly trap with conical shaped bait chamber and 
removable top or lid. 
99 131 
MEDICAL FIELD MANUAL 
(4) The triangular trap should not be less than 12 inches 
high and 12 inches long and made as shown in figure 45. 
If traps are less than 12 inches in length the solid ends 
exclude much of the light necessary to attract flies into the 
trap chamber. 
b. Comparative effectiveness of square, round, triangular, 
and box traps.—The square and round traps are more 
effective than the triangular trap, principally because the 
light enters the trap chamber from all sides. They are, 
however, more difficult to construct than the triangular trap. 
Exposure to the weather, and the handling to which fly traps 
Figure 44.—Fly trap constructed of packing box. Corner cut away 
to show method of installing cone. 
are subjected, will cause the square and round traps to warp 
and become unserviceable much sooner than the triangular 
traps. Despite the fact that the triangular trap is some- 
what less effective as a single unit than the square or round 
trap, it will as a rule prove more practical for use in camps 
and large stations than either of the latter because of the 
comparative ease and rapidity with which it can be con- 
structed in large number’s, the availability of material, and 
greater serviceability. The box trap will not catch as many 
flies as the square or round trap, largely because the wooden 
sides exclude the light from the trap chamber. The box 
100 FIELD SANITATION 
131 
Figure 45.—Triangular fly trap with cone shaped bait chamber. 
Single opening at apex of cone leading into trap chamber. The 
small tin disk covers an opening through which flies may be 
removed from the trap chamber. 
101 131-134 
MEDICAL FIELD MANUAL 
trap is, however, more durable than any of the others and 
if packing boxes are available, it can be more quickly and 
cheaply constructed. 
■ 132. Fly Trap Stands.—The efficiency of fly traps is in- 
creased if they are elevated above the ground on stands or 
on boxes, benches or tables. The stand affords a smooth 
base for the trap and a place to alight before entering the 
Figure 46.—Square fly trap with removable top and pyramidal 
bait chamber. 
trap. It also protects the bait from dirt and may be so 
constructed as to protect trap from the wind. 
■ 133. Location.—Fly traps should be placed in or near 
breeding places such as manure piles or latrines, or in the 
vicinity of mess halls, kitchens, or dumps. 
■ 134. Fly Baits.—Baits must have an odor that will attract 
flies but will not constitute a nuisance. The material should 
102 FIELD SANITATION 
134-135 
be cheap and readily obtainable. In general, there are two 
types of bait, putrefactive and fermented: 
a. Putrefactive baits consist of spoiled raw meat or fish. 
Fish heads or canned salmon may be used. 
b. Fermented baits are those which contain alcohol or in 
which alcohol is being formed. Usually, they consist of a 
mixture of cereal, sugar or molasses, yeast and water, which 
is allowed to ferment before or while being used as a bait. 
A formula for a cornmeal bait is as follows: 
(1) Ingredients: 
Cornmeal 8 ounces (by volume). 
Molasses 5 ounces. 
Water 16 ounces. 
Yeast */2 cake. 
(2) Preparation.—Mix the water and the molasses and 
heat to boiling. Pour the molasses and water while boiling 
over the cornmeal, stir, and allow to cool. Add the yeast 
and allow to stand exposed to the air for 3 or 4 days. 
(3) Bran or cornstarch, or bran and cornstarch, may be 
substituted for the cornmeal if the latter is not available. 
Syrup made of water and sugar may be substituted for the 
molasses. 
(4) Other fermented baits may be made as follows: 
(a) Two parts of molasses and one part of vinegar. 
(b) Molasses which has been allowed to stand exposed to 
the air for 3 or 4 days. 
(c) Crushed, overripe bananas in milk. 
id) Brown sugar and sour milk. 
Under comparable conditions various baits may be rated 
as follows: 
Putrefying meat 100 
Fermenting cornmeal 95 
Molasses and vinegar 80 
■ 135. Care.—The following directions should be followed in 
caring for fly traps: 
a. Place bait in wide shallow containers so that volatile 
constituents are readily evaporated and flies have easy access 
to bait. 
b. There should be at least 3 inches between edge of bait 
pan and edge of trap. 
103 135-137 
MEDICAL FIELD MANUAL 
c. Two bait pans should be used in large traps. 
d. Baits should be inspected once daily. 
e. Solid baits such as meat or fish should not be allowed 
to become dry. 
/. Bait pans should be kept filled to desired level and be 
cleaned and refilled when scum forms on surface. 
g. All baits should be kept free from dirt and dust. 
h. Empty traps whenever a sufficient number of flies ac- 
cumulate so as to interfere with light, otherwise empty traps 
at about weekly intervals. 
Section IV 
OTHER SPECIAL MEASURES 
B 136. Fly Wires and Fly Paper.—Paper or wire covered with 
fly mucilage may be used to trap flies indoors. Fly wires 
consist of pieces of wire 18 to 36 inches long, bent at one end 
to form a hook or eye and twisted in a circular manner at 
right angles at the bottom to prevent dripping. Two or 
more wires may be twisted together. Wires are coated with 
mucilage and suspended from the ceiling. They should be 
cleaned and recoated at frequent intervals. Fly mucilage is 
made by beating together one part by weight of castor oil and 
two parts of white rosin. The hot material is stirred while 
being heated until a sticky, homogeneous mass is obtained. 
Care should be taken to avoid boiling. A good grade of white 
rosin should be used as the crude product renders it difficult 
to secure a homogeneous mixture and produces an odor that 
is repellent to houseflies. Variations in atmospheric tem- 
perature and in the grade of oil or rosin used may render it 
necessary to vary the relative proportions of the ingredients 
■ 137. Fly Poisons.—a. The two substances commonly em- 
ployed for fly poisons are formalin and sodium salicylate; 
(1) Formalin poison consists of about 3 teaspoonfuls of 
formalin to a pint of water. It is better to use equal parts 
of water and lime water or water and milk. Formalin solu- 
tions should be freshly made. A small quantity of fermented 
molasses added to formalin bait makes it more attractive. 
104 FIELD SANITATION 
137-140 
(2) Sodium salicylate poison is made from a 1 percent 
solution of the drug with the addition of a small amount of 
brown sugar, 
b. Poison baits should be put out in shallow containers with 
pieces of bread or blotting paper soaked in the poison so as 
to give the flies a place on which to light. 
■ 138. Fly Sprays.—Fly sprays depend largely on extracts 
of pyrethrum flowers. An efficient fly spray can be made by 
soaking crude pyrethrum powder in kerosene, in proportion of 
from V2 to 1 pound of the powder to 1 gallon of kerosene, 
for from 2 to 4 days. The supernatant liquid is then decanted 
or siphoned off and is ready for use as a spray. Its insecti- 
cidal power is appreciably increased by the addition of ap- 
proximately 1 ounce of the oil of pennyroyal or citronella to 
1 gallon of the extract. The efficacy of pyrethrum as an 
insecticide depends upon the pyrethrin content of the par- 
ticular lot of pyrethrum used. Extracts of pyrethrum are 
available on the market in which the pyrethrins extracted 
from 20 pounds or more of the standardized pyrethrum 
flowers are contained in 1 gallon of the extract. A fly spray 
which is approximately equal in toxicity to the kerosene spray 
described above can be made by diluting the concentrated 
extract with 20 volumes of kerosene. A more potent spray 
may be made by using a proportionately greater quantity of 
the extract. 
■ 139. Swatting.—Fly swatting in kitchens and mess halls 
is a valuable control measure and should be used just before 
food is placed on the table. 
■ 140. Sodium Arsenite.—A very good material for spraying 
compost piles, latrines, etc., is made as follows: 
Commercial sodium arsenite 4 pounds. 
Molasses 2 quarts. 
Water 50 gallons. 
105 CHAPTER 8 
MOSQUITO CONTROL 
Paragraphs 
Section I. Development, habits, and characteristics of the 
mosquito 141-146 
II. Control measures 146-164 
Section I 
DEVELOPMENT, HABITS, AND CHARACTERISTICS 
OF THE MOSQUITO 
■ 141. General.—Mosquitoes are known as transmitters of 
malaria, dengue, yellow fever, and filariasis. The most im- 
portant of these from a military viewpoint at the present 
time is malaria. .In order to successfully combat the disease- 
bearing mosquito something must be known of its life habits. 
All species are not vectors, and as various genera and species 
differ as to habits it is important that before starting an 
antimosquito campaign the specific vector or vectors be well 
known. This knowledge will prevent much useless effort. 
■ 142. Life Cycle.—Mosquitoes develop by complete meta- 
morphosis and the life cycle consists of egg, larval, pupal, 
and adult stages. The egg, larval, and pupal stages are 
passed in water while the adult is a free flying insect. 
a. Egg Stage.—Mosquito ova are dark, oval bodies varying 
in size from 0.5 to 2 millimeters in length. They are de- 
posited either singly or in masses on the surface of water or 
near the edge of water collections. 
(1) In a favorable environment, the eggs of Anopheles are 
ieposited singly on the surface of water, usually in batches 
if from 40 to 100 or more. Anopheles ova are 0.5 to 0.8 
nillimeter in length. They are boat-shaped with a mem- 
branous ribbed structure or float on either side. If undis- 
urbed, Anopheles eggs tend to collect together into 
I riangular, star-shaped, or ribbon-like groups or patterns. 
1 (2) The e£gs of Aedes egypti are usually deposited on the 
urface or near the edge of water contained in artificial 
eceptacles located in or near inhabited buildings. Natural 
106 FIELD SANITATION 
142 
collections of water which are near occupied houses may be 
utilized as breeding places. The eggs may be deposited on 
the sides of the container or on the earth above the level 
of the water. They are laid singly, usually in lots of 25 to 
50 or more. Those laid on the surface of the water may 
sink to the bottom without interference with hatching. In 
an unfavorable environment, the eggs of Aedes egypti may 
lie dormant for months without losing their vitality. They 
are resistant to drying and cold and will hatch if placed in 
water after several months storage in dry or cold places. 
(3) The eggs of Culex are deposited in rafts or boat- 
shaped masses, 4 to 8 millimeters in length, consisting of 
100 to 400 eggs cemented together. 
b. Larval stage.—Mosquito larvae are actively motile, cylin- 
drical organisms. They vary in length from 1 millimeter to 
about 10 millimeters, depending on the genus and species 
and the stage of development. They may be gray, green, 
yellowish or reddish brown, dark brown, or black in color. 
(1) The mosquito lava develops by molting, that is, the 
skin splits and a larger and more fully developed form 
emerges. The larva molts four times and at the fourth 
molting passes into the next, or pupal, stage. 
(2) Given a relatively high atmospheric temperature, am- 
ple food supply, and other favorable conditions as to sun and 
shade, the larval period of development may be completed 
in as short a time as 5 days. In a more adverse environment, 
especially if the temperature is low, development is inhibited 
and the larval stage may be prolonged for several weeks. 
Under average conditions in the Tropics, or during the warm 
seasons of the year in the temperate zones, the larval period 
is usually completed in about 10 days. 
(3) The larval phase of development is divided into four 
stages or instars. Under certain conditions, the stage of 
larval development may be an important factor in estimating 
the efficacy of larvicidal control and determining the fre- 
quency with which larvicides should be applied. The first 
stage, or first instar, larva is the form that emerges from 
the egg. It is a minute, nearly transparent body. First stage 
larvae develop rapidly and reach the first molt in about 24 
hours, when they pass into the second stage, or second instar, 
107 142-143 
MEDICAL FIELD MANUAL 
The second stage larvae are darker, larger, and more easily 
detected in the water. In the second stage the specific ana- 
tomical characteristics are more fully developed than in the 
preceding stage. After a period of growth the second stage 
larvae molt and enter the third stage. During the third 
stage, feeding and growth continue until molting occurs, 
when the fourth stage forms emerge. Fourth stage larvae are 
mature and practically full grown. The head is broad and 
prominent. After a period of feeding the fourth stage larva 
becomes quiescent and soon thereafter the skin splits to per- 
mit the pupa to escape. The larvae move tail foremost 
through the water by relatively rapid darting or jerking 
movements. 
c. Pupal stage.—A mosquito pupa is a comma-shaped body 
enclosing the developing adult within a pupal case. The 
head and thorax of the insect form a globular mass called the 
cephalo-thorax, to which is attached the curved flexible 
abdomen. Two paddle-shaped appendages are attached to 
the extremity of the abdomen and two breathing tubes or 
trumpets arise from the dorsum of the cephalo-thorax. The 
pupae obtain air through their breathing trumpets. They 
are actively motile, locomotion being accomplished by flexion 
and extension of the abdomen. They have no mouth parts. 
The pupal stage varies somewhat in length, but usually lasts 
24 to 72 hours. At the end of that period the pupal case splits 
and the full-grown insect gradually emerges. As soon as the 
wing veins and the exoskeleton have hardened in the air the 
mosquito is ready for flight. 
d. Adult stage.—With few exceptions the female mosquito 
Is a bloodsucking insect. It is probable that blood is required 
to stimulate the mating instinct and for the development and 
maturation of the ova. The males have no piercing mouth 
parts and subsist entirely on plant juices and exudates. 
1 143. Longevity.—Under favorable conditions it is probable 
:hat the adult female mosquito may live as long as 3 months. 
They are, however, subject to many dangers from natural 
memies and from adverse climatic and other environmental 
:onditions. Because of these factors the normal life ex- 
pectancy of the mosquito is probably 2 weeks to 1 month and, 
vhen breeding places are controlled, the majority of the adult 
108 FIELD SANITATION 
143-145 
forms present in a locality may be expected to disappear 
within a month. Some may, however, hibernate in heated 
buildings throughout the winter. 
■ 144. Identification.—For detailed instructions relative to, 
specific identification see TM 8-255 (now published as Army 
Medical Bulletin No. 23). 
B 145. Distribution and Breeding Habits.—The following 
table will be of value in antimosquito work. These mosquitoes 
are the important vectors found in the United States and its 
possessions. No Anopheles are found in Hawaii. 
Species 
Remarks 
Anopheles in United States 
Pond breeder, preferring quiet water such as inter- 
mittent pooled streams and small ponds. Does not 
normally breed in streams or acid waters. Most 
common vector into United States. Is found through- 
out southern and southeastern states. Become 
numerous in late spring or early summer. 
Vector in the far west. Occurs from California to 
Alaska. Same breeding habits as A. quadrimacu- 
latus. Partial to small, shallow, sunlit pools or col- 
lections of water containing green algae. 
Breeds in brackish pools and has been found in pools 
containing grass and algae. Rare species. 
Breeds in water in tree holes. Rare species. 
Appears early in the spring in the south, reaching a 
maximum in March or April. Fresh-water variety 
breeds in pools, ponds, fresh water swamps, etc. 
The salt-water variety breeds in the brackish water 
of salt-water swamps and tidal pools. 
California, Arizona, New Mexico, and west Texas. 
Breeds in clear water in pools and springs and along 
the edges of streams, also in ditches and puddles. 
Breeding places not well known. Seems to prefer 
water containing considerable vegetation, especially 
permanent waters. Bare species. 
Anopheles in Panama 
Breeds in fresh or brackish water in pools, ponds, 
swamps, etc. Apparently prefers water exposed tc 
the sun and that contains algae. More prevalent 
during rainy season. 
A. barberi.. .. 
A. crucians. 
A. pseudopunctipennis— 
555798°—48 8 
109 145 
MEDICAL FIELD MANUAL 
Species 
Remarks 
A. tarsmaculatus 
Anopheles in Panama—Continued 
Breeds similar to A. albimanus. 
A. argyritarsus - 
Breeds in small collections of fresh water in seepage 
A. pseudopunctipenms 
pools, small ditches, and hoofprints Also will breed 
in water in artificial containers 
Prevalent in dry season. 
A. punctimaculata 
In Panama breeds in shaded pools and streams. 
4. punctipennis 
Breeds in pools, in springs, and often in small collections 
A. minimus _ 
of rain water. It also breeds in and seems to prefer 
the quiet water along the edges of streams. Appears 
early in the spring and continues breeding until late 
in the fall. 
Anopheles in the Philippine Islands 
Breeds in clear water streams. Is principal vector in 
A. maculatus 
the Philippines. 
Breeds in quiet edges of trickling streams in the open 
A. albimanus 
sunshine. 
Anopheles in Puerto Rico 
More prevalent during rainy season. (See Panama.) 
A. egypti 
Aedes 
Breeds in water in artificial containers in or near human 
A. albopictus 
habitations such as barrels, cisterns, eaves troughs, 
or gutters. A very small amount of water will 
suffice. 
Same as A. egypti Common in the Orient. 
C. fatigans 
Culex 
Will breed in water contained in artificial receptacles 
7. pipiens 
in or near inhabited houses but also prefer water con- 
taining organic material. They will breed freely in 
water contained in catch basins or cesspools and in 
swamps, roadside ditches, and puddles. 
Similar .n habits to C. fatigans 
110 FIELD SANITATION 
146-148 
Section II 
CONTROL MEASURES 
■ 146. Drainage.—Antimosquito drainage to be effective 
must usually be planned and installed for the specific pur- 
pose of eliminating or reducing the extent of mosquito 
breeding waters. Ordinary agricultural or roadside drainage 
not only frequently fails to remove the water in a way that 
will prevent mosquito breeding but, by spreading the water 
and increasing its surface area, may actually cause an 
increase in mosquito breeding. Antimosquito drainage may 
be accomplished by means of surface ditches of either the 
unlined, lined, or rock-filled type, or by subsurface tile drains. 
Careful planning for and supervision of the construction of 
a drainage system will increase its effectiveness and reduce 
the cost of maintenance. Grade lines should be established 
for at least the main ditches or subsurface drains. 
■ 147. Open Ditches.—Open ditches should be so con- 
structed that standing water will be completely removed and 
storm water drained from the face of the ground and from 
the ditches within a short time after a storm. The grade 
and width of the ditches should be such that while all water ' 
will be carried away, the velocity will not be sufficient to 
produce “potholes” by erosion of the bottoms or sides of' 
unlined ditches. A ditch that is too wide or too flat may I 
retain water in small depressions and thus defeat the pur-1 
pose of drainage. Grade lines must be followed during con- 
struction as either low areas will be produced which retain 
water or high sections, which will prevent complete drainage. 
■ 148. Factors in Ditch Construction.—a. Dig only suf- 
ficient ditches to accomplish desired purpose. Too many 
increase cost of construction and maintenance. 
b. Ditches should be constructed with narrow bottoms 
smooth sloping sides, with as few curves as possible, anc 
without sharp turns. Usually, sides of ditches should havt 
a slope of about 45°, in soft mud or sand this slope may b< 
flatter while in rock or clay it may be nearly perpendicular 
c. If ditches are built at an angle to the slope of a hill 
the upper side should be somewhat flatter than the lower 
lessen erosion. 148-150 
MEDICAL FIELD MANUAL 
d. Bottom of all ditches should be U-shaped, not V-shaped. 
e. Main ditch should be constructed first and laterals 
installed only when and where necessary (may have to wait 
until after a storm to locate additional or all lateral ditches). 
f. Lateral or branch ditches should join main ditch at an 
acute angle or gentle curve in order to prevent debris de- 
posit or erosion of opposite bank. 
g. Care should be exercised that dirt thrown out does not 
form banks which prevent drainage by pool formation. 
h. Where ditch goes through a culvert or wherever a pipe 
section is installed, the grade should be increased to prevent 
interference with the flow by deposits of debris. 
i. At the downstream end of a pipe or culvert, the bottom 
of the ditch should be lined with stone or concrete to 
prevent erosion (may screen upper end with iron rod or 
wood grating to prevent entrance of debris or floatage). 
■ 149. Lined Ditches.—In loose soil or in ditches where the 
flow reaches a high velocity it may be advisable to line the 
ditches. Lining also facilitates cleaning. Lining may be of 
concrete or stones set in cement mortar. Continuous concrete 
lining may be constructed by the use of forms. Ditches less 
than 2 feet in width should have about a 2-inch lining rein- 
forced with 2-inch mesh poultry wire. Seepage holes should 
be made in the lining whenever it is probable that water will 
accumulate or flow behind the lining. 
■ 150. Subsurface Drainage.—Tiles or rock-filled ditches 
nay be used for this purpose. The tiling used varies in size 
'rom 3 to 12 inches. The average depth of tiling below the 
lurface is 2 to 4 feet. The so-called “double decker” drain 
las proved of value in draining areas where there is a flow 
if water at all times but where, at certain seasons, the volume 
if water is too great to be carried by the ordinary tile drains, 
[lie double decker drain consists of a ditch, on the bottom 
4 which 6- or 8-inch tile is laid in the usual manner. In- 
tead of completely back-filling the ditch, ordinary sectional, 
oncrete ditch linings (par. 149) are laid on top of or im- 
rediately above the tiling. The dry weather flow is carried 
y the tile line while the wet weather flow is drained away 
irough both the tile line and the superimposed open, con- 
rete-Iined ditch. 
112 FIELD SANITATION 
151-153 
■ 151. Filling.—Depressions and low areas which serve to 
collect and retain water in which mosquitoes breed may, in 
some instances, be permanently eliminated by filling. Fill- 
ing may also be employed to reduce the amount of water 
in areas which are below grade and difficult to drain, and 
may thus facilitate other control measures. Filling may also 
be employed to eradicate accidental collections of water in 
small depressions such as wheel ruts, hoofprints or holes, and 
pits resulting from construction work. Pilling is usually a 
quite satisfactory method of treating low areas or depres- 
sions of varying sizes in which rain water tends to collect, 
but can be seldom utilized successfully to cope with collec- 
tions of seepage water. Filling permanently eradicates the 
breeding places and it has a further advantage over open 
drainage that no maintenance work is ordinarily required. 
At times it will be found that, while the first cost is greater, 
filling is ultimately the cheapest and the most effective 
method of controlling mosquito breeding in a given area. 
■ 152. Stream Training.—In order to prevent pools and quiet 
backwater areas, the bends in the stream may be straightened 
and the marginal depressions removed by filling, draining, or 
regrading. The stream bed may be narrowed or even re-, 
graded in places to increase the velocity. Vegetation and. 
debris in the stream bed, which might retard the flow or. 
shelter the larvae, should be removed. I 
■ 153. Elimination of Artificial Water Containers.—Cer- 
tain species of Anopheles and Culex, but especially Aedes, wil 
breed in artificial containers. All empty tin cans should ta< 
crushed so that they will not hold water before being disposec 
of on dumps or other places in the open. Barrels, buckets, o 
other receptacles in which water stands should, if practicable 
be emptied and dried in the sun at least once each week , 
The water in fire buckets may be treated with a phene 
larvicide. When vessels of water are emptied, care should b 
taken to remove or destroy the eggs and larvae on the side 
and bottom before refilling. Effective control of mosquit 
breeding in artificial collections of water can be maintaine 
only by thorough and repeated inspections. Some person c 
persons should be made responsible by proper authority fc 
113 153-154 
MEDICAL FIELIX MANUAL 
the conduct of such inspections, and the inspections should 
be made routinely at designated intervals. 
■ 154. Oiling.—a. When properly spread over the water, oil 
produces a film which kills mosquito larvae and pupae. The 
lethal effect of oil is probably due to the toxic action of volatile 
gases after inspiration of the oil into the tracheal tubes. Oils 
which have a boiling point between 200° to 500° F. have been 
found to kill larvae and pupae by direct toxic action in about 
30 minutes. 
b. Oil larvicides consist, generally, of crude oil or waste 
motor oil. either of which may be diluted with kerosene. 
Light crude oil which has a specific gravity of from 0.85 to 
0.87 spreads readily and will form a satisfactory film in any 
temperature suitable for mosquito breeding. Kerosene may 
be used to dilute the heavier oils so that they will spread 
to form a film. The proportion of kerosene required varies 
from 20 to 75 percent, depending on the viscosity of the 
crude oil. 
c. Kerosene alone may be used as a larvicide, but it evapo- 
rates rapidly, the film is fragile and easily broken, and it is 
usually too expensive for routine use. 
d. Waste motor oil or other waste oils may be used as a 
base in lieu of the crude oil. Motor oil is relatively nonvolatile 
and is therefore nontoxic. It will kill larvae and pupae only 
Iwhen the film is sufficiently thick and intact to prevent them 
■from reaching the air. As it is difficult to maintain such a 
jfilm, the best results are obtained when the motor oil is mixed 
with and diluted by kerosene in the same manner as crude 
oil. The resulting product is apparently as efficient in the 
destruction of larvae as crude oil and, where the waste oil is 
available, it is considerably cheaper. 
e. The spreading quality of any of the oils is Greatly in- 
creased by the addition of 2 percent of crude castor oil. 
f. Oiling is essentially a temporary measure and must be 
repeated at intervals, the length of which is determined to 
some degree by the weather conditions, the kind of oil used, 
md the character of the water. During summer months oil 
should be applied about once each week. A film of toxic oil 
vhich is irridescent in the sunlight is thick enough to kill 
nosquito larvae. Under the most ideal conditions, in quiet 
114 FIELD SANITATION 
154-155 
waters containing no vegetation or debris, 3 to 5 gallons of a 
light, well-spreading oil will produce a thin but satisfactory 
film over an area of about 1 acre. 
■ 155. Oil Application.—a. General.—Oil may be effectively 
applied to small collections of water by means of an oil- 
soaked broom, an oil mop, or oil-soaked cloths tied to a stick 
or similar contrivances. The ordinary watering pot used for 
watering plants may be used to oil small collections of water, 
or the oil may be poured on the surface of the water. 
b. Sprayers.—The knapsack sprayer consists of an oil con- 
tainer, hand pump, and spray nozzle, and is carried and op- 
erated by one man. The ordinary sprayer has a capacity of 
about 5 gallons and a spraying range of about 25 feet. The 
knapsack sprayer is a practical and economical apparatus for 
applying oil to ditches, small ponds, or other collections of 
water which can be reached by the spray. Larger sprayers 
may be employed to oil extensive areas such as the borders 
of large lakes or, in some instances, large swampy places. 
Such a sprayer usually consists of a barrel or tank container 
and a pump mounted on a vehicle or boat. 
c. Continuous oilers.—Where the oil is dispersed by cur- 
rents, as in streams or ditches, a film can be maintained only 
by the constant application of oil. This type of oiling has 
many disadvantages and is as a rule of three types: 
(1) Drip oilers which consist of a 5-gallon tin or drum 
which is placed on supports over the stream or ditch so that 
the oil will drip on the surface of the water below. It should 
be several feet higher than the stream surface so that the 
oil will spread quickly when the drop strikes the water. The 
rate of flow to furnish a satisfactory film depends on a num- 
ber of factors. Generally, an average flow of from 10 to 20 
drops per minute will suffice for each foot of width of water 
in the stream. 
(2) Submerged oilers are containers having 2 small open- 
ings and so designed that when sunk to the bottom of the 
stream or pond, oil will escape through one opening and be 
replaced by water which enters through the other. They 
have the disadvantage that they are difficult to adjust so that 
the oil will flow properly and the opening is easily clogged. 
115 155-157 
MEDICAL FIELD MANUAL 
(3) Oil may be applied continuously' by means of a 
weighted, submerged bag of oil-soaked sawdust or oil-soaked 
sawdust may be scattered over the surface. 
■ 156. Phenol Larvicide.—a. The Panama larvicide is the 
best example of this type of larvicide. It is made as follows: 
Crude carbolic acid 5 gallons. 
Rosin (finely crushed and sifted) 6 pounds. 
Caustic soda 1 pound. 
Heat carbolic acid in iron container until it is steaming hot, 
the resin is added, and the solution stirred until the resin is 
completely dissolved. The caustic soda is dissolved in a pint 
of water and added and the heating and stirring is continued 
for about 5 minutes. A sample of the mixture is then poured 
into water and if a complete emulsion results, the larvicide 
is ready for use. If the mixture does not emulsify in water, 
or the emulsion is incomplete, the heating and stirring are 
continued until a satisfactory emulsion is obtained. The 
crude carbolic acid should contain not less than 15 percent 
of phenol and have a specific gravity of not more than 0.97. 
b. The Panama larvicide is prepared for use by mixing one 
part of the larvicide with five parts of water. The resulting 
emulsion is applied by spraying, or in the case of small col- 
lections of water, a watering pot may be used or the larvicide 
may be poured into the water. The larvicide should be ap- 
Iplied in such amounts that an emulsion with the treated water 
of from 1 to 1,000 to 1 to 10,000, preferably about 1 to 5,000, 
|Will result. An emulsion of 1 to 5,000 will kill the larvae in 
about 10 minutes. The Panama larvicide can be used wher- 
ever hand oiling is feasible. As it kills the greater proportion 
of the larvae, it need be applied only at such intervals as will 
prevent complete larval development. This interval is usually 
I week but may be as long as 3 weeks. 
■ 157. Paris Green Larvicide.—Commercial paris green con- 
taining not less than 50 percent of arsenious oxide is used, 
'liluted with some inert dust. The diluting dust may be hy- 
Irated lime, road dust, powdered limestone, soapstone, ashes, 
)r stearates of calcium and aluminum. This larvicide is 
•heap, easily transported, and very effective against larvae 
if the anopheles. It is ordinarily diluted with 99 parts of the 
116 FIELD SANITATION 
157-158 
diluting material to one part of paris green. The mixture 
may be prepared in an eccentrically mounted keg as shown in 
figure 47. The larvicide may be applied by means of a hand 
blower of bellows type or by means of a hand-operated duster 
similar to those used in agriculture for dusting fruit trees. 
For large swampy areas with rather open waters the larvicide 
may be applied by means of an airplane. The airplane flies 
low (75 feet from ground) at about 80 miles per hour. It is 
difficult to apply paris green in windy or rainy weather. 
Figure 47.—Equipment for mixing and applying paris green larvicide 
B 158. Destruction by Natural Enemies.—Fish and certaii 
aquatic insects are natural enemies of mosquito larvae. To] 
feeding minnows are most effective for this purpose. Th 
fish should be indigenous to the locality in which they ar 
used. The most efficient minnow for use in the United State 
is the Gambusia affi-nis. This fish is found in all States eas 
of the Rocky Mountains and south of Delaware and Illinoi: 
All vegetation and flotage which might protect larvae shoul 
be removed before the fish are introduced. i 
117 159-161 
MEDICAL FIELD MANUAL 
■ 159. Destruction of Adults.—Adult mosquitoes may be 
destroyed by spraying with pyrethrum spray, by fumigation 
(in buildings), by swatting, and by hand catching. 
■ 160. Screening.—Mosquitoes may be kept out of buildings 
by effective screening. This is difficult in temporary build- 
ings on account of cracks and other openings. While a 
mesh of 16 wires to the inch will exclude Culex and 
Anopheles, it requires 18 wires to the inch to exclude Aedes. 
Copper screening should be used near the sea as the ordinary 
galvanized screening deteriorates very rapidly. 
■ 161. Mosquito Nets.—a. Mosquito netting or bars are 
employed for individual protection against mosquitoes and 
their effectiveness in this respect depends upon the care 
exercised by the individual. They are utilized principally 
where troops are sleeping in tents or in poorly screened 
buildings. The degree of protection which can be attained 
by the use of mosquito bars is largely a question of disci- 
pline. Troops, in general, object to sleeping under mosquito 
bars and will not use them in the proper manner unless 
suitable orders are enforced by unit commanders. Mosquito 
bars should be so adjusted that no part of the netting will 
touch the sleeper and so that the lower edges of the netting 
are tucked in under the bedding completely around the bed. 
[f the netting touches the bare skin of the occupant of the 
'aed, mosquitoes will be able to bite through the spaces 
oetween the threads. If the netting is not tucked in under 
l;he bedding upon which the sleeper is lying, mosquitoes will 
?ain entrance between the bedding and the netting. The 
nosquito net may be made and installed so that the lower 
'dges reach and lie upon the floor. 
1 b. A mosquito bar frame should be provided for beds and 
ots, while in the case of shelter tents the netting should 
ionform to the shape of the interior of the tent and be 
uspended from the tent. 
c. During the day all mosquito bars should be rolled up 
d prevent mosquitoes from hiding within the folds. When 
ut in place at night, the interior of the net should be 
earched for mosquitoes. All nets should be inspected at 
Bgular intervals for tears, holes, and broken threads. 
118 FIELD SANITATION 
161-163 
d. During dusk and the early hours of the night, Anoph- 
eles and Culex bite freely in the open. Men on guard and 
others whose duties require them to remain out of doors in 
localities where infected Anopheles mosquitoes are prevalent 
should be provided with head net and gloves. 
■ 162. Mosquito Repellents.—Various essential oils are at 
times applied to the person as mosquito repellents or deter- 
rents. These are of value for short periods only as they 
soon volatilize. When individuals are obliged to spend time 
in the open exposed to mosquitoes, especially at night, repel- 
lents will be found of value as a small quantity applied to 
the neck and face or to the wrists and hands will last all 
night. It is nonirritating to the skin. This repellent is 
prepared by melting 60 grams of white petrolatum and then 
adding the following: 15 cc citronella oil, 8 cc spirits of 
camphor, and 8 cc oil of cedar wood. Stir well, pour in 
jars, and cool rapidly by placing jar in refrigerator or basin 
of cold water. 
■ 163. Mosquito Surveys.—Mosquito surveys are conducted 
for the purpose of determining the most feasible, and usu- 
ally the quickest and least expensive procedures for con- 
trolling the disease-transmitting species in the area under 
consideration. 
a. Normally, the most important features of a mosquito 
survey are the identification of the species involved, study 
of the relative density and importance of each species, and 
the location of the breeding places of the species, or of each 
species if there is more than one present. It is usually es- 
sential that the species of mosquito concerned be determined 
and this phase of the survey is of special importance i: 
Anopheles are to be controlled when there are two or mon 
species breeding in the vicinity. 
b. In making a mosquito survey and deciding upon th 
control measures to be instituted, consideration must b 
given to the degree of protection required or obtainable am 
the funds and facilities available for mosquito control pur 
poses. In war, it may be that the mission of the troops o 
the exigencies of the military situation will be such tha 
only partial control will be required or obtainable. In con 
119 163-164 
MEDICAL FIELD MANUAL 
centration or rest areas, the lack of time and facilities, or 
even enemy activities, may render it inexpedient to attempt 
to obtain more than partial control of a varying degree. On 
the other hand the conditions at fixed installations during 
peace, or in the zone of the interior or communications zone 
during war, are usually such that the disease-bearing mosqui- 
toes can be adequately controlled. 
■ 164. Method of Conducting Mosquito Survey.—a. Iden- 
tify prevailing species. 
b. Locate all breeding places. 
c. Dispersion of adult mosquitoes. 
d. Nature of terrain. 
e. Climatic conditions. 
/. Facilities for control work. 
g. The disease situation. 
h. The military situation. 
120 CHAPTER 9 
Paragraphs 
Section I. General 165-168 
II. Methods of disinfestation 169-178 
CONTROL OF LICE 
Section I 
GENERAL 
V 165. Diseases Transmitted.—Typhus fever, trench fever, 
and relapsing fever. 
■ 166. Classification of Lice.—The species of lice (pediculus 
humanus) which infest man are P. humanus corporis (body 
louse), P. humanus capitis (head louse), and Phthirius pubis 
(crab louse). 
H 167. Life Cycle.—Lice develop by incomplete meta- 
morphosis. They pass through three stages: the egg, the 
larva, and the adult. 
a. The eggs are deposited on the hairs of the body or head 
or the fibers of clothing. They are ovoid in shape and about 
1 millimeter long. The egg hatches in about 8 days at a 
temperature of 86° to 90° F. At a lower temperature the egg 
stage may be prolonged several weeks. The eggs an 
operculate. 
h. The larva is similar to the adult except that it is mud 
smaller (pin head and white in color). Unless the larva< 
obtain food within 24 hours they will die. The larval forn 
molts three times at about 3-day intervals and emerges 
ually mature. 
c. The adult female starts to lay eggs within a day afte: 
emergence from larval stage. Eggs are laid at a rate of 5 b 
10 per day and under favorable conditions continued for 3' 
days. 
■ 168. Control Measures.—a. In order to be effective, meas 
ures for the control of lice must accomplish complete disin 
festation of both the individual and the unit to which th 
121 168 
MEDICAL FIELD MANUAL 
Figure 48.—Pediculus humanus corporis (body louse). 
122 FIELD SANITATION 
168-169 
infested, man or troops belong. Control measures are di- 
rected toward— 
(1) Disinfestation of the individual. 
(2) Disinfestation of clothing and equipment. 
To be successful, the soldier’s body as well as his equipment 
and clothing must be freed from ova, larvae, and adult lice. 
Bathing and disinfestation of clothing are carried out simul- 
taneously. 
b. Lice and their eggs are killed in 1 minute when subjected 
to dry heat at a temperature of 155° F. or in 5 minutes at 
131° F. Immersion in boiling water for 30 seconds will kill 
Figure 49.—Phthirius pubis (crab louse). 
both adults and eggs. Dry heat will not injure leather, felt, 
or webbing but will harm woolen fabrics. Boiling water will 
cause shrinking of wool but steam causes very little shrinkage. 
Section II 
METHODS OF DISINFESTATION 
■ 169. Bathing.—a. This may be carried on in either a fixec 
installation, a quartermaster bathing and delousing unit, oi 
by means of improvised shower baths. 
123 169 
MEDICAL FIELD MANUAL 
b. An excellent soap to use is made as follows: 
Boil 1 part of ordinary issue soap in 4 parts of water. 
Add 2 parts of kerosene. 
Mix with 4 parts of water. 
c. A simple device for bathing can be made from a water 
sterilizing bag suspended from a scaffold or a tree limb. 
One faucet of the bag is replaced by a rubber tube in the 
end of which is placed a short section of pipe closed at one 
end and perforated at a number of places to act as a shower 
head. 
Figure 50.—Shower bath made from water sterilizing bag. 
d. A perforated kerosene or gasoline can with a perforated 
bottom resting on a platform may be used with one man 
pouring water through while another bathes. 
e. A more elaborate device may be made by means of in- 
serting a small perforated tin can in the bottom of a barrel. 
The water is retained in the barrel by means of a plunger 
which fits into the can. This plunger is controlled by means 
of a lever and handle within reach of the bather. 
f. Bathing with soap and water will not, in many instances, 
destroy all of the eggs attached to the hairs of the body. 
124 FIELD SANITATION 
169 
Where infestation is evidenced either by the presence of 
eggs on the hairs or by indication of louse bites the hair in 
the axillary, pubic, and inguinal regions and, if necessary, 
Figure 51.—Shower bath. 
on the chest should be shaved or clipped. If shaving or 
clipping is not practical, these parts of the body suiface 
should be thoroughly scrubbed with vinegar, kerosene, or 
gasoline. 
555798°—43 9 170-171 
MEDICAL FIELD MANUAL 
■ 170. Disinfestation of Clothing and Equipment.—Outside 
of permanent installations and delousing units the disinfes- 
tation of clothing and equipment is done by means of one 
of the following methods: 
a. Mobile disinfestor. 
b. Serbian barrel type of disinfestor. 
c. Improvised hot air disinfestors. 
d. Hot irons. 
e. Hot water. 
/. Storage. 
g. Chemicals. 
Figure 52.—Portable pressure disinfestor. 
■ 171. Mobile Disinfestors.—These are of the four-wheel 
trailer type and are usually steam pressure disinfestors al- 
though a current steam disinfestor is manufactured (thresh 
type). The pressure type consists of a horizontal steam 
chamber around which there is an outer jacket which is as- 
sembled as a unit with a boiler. After the clothing is placed 
in the disinfestor a vacuum of 10 to 15 inches is created after 
which steam is turned in until a positive pressure of 15 
pounds is attained, this being held for about 20 minutes. At 
126 FIELD SANITATION 
171 
Figure 53.—Disinfestor, Serbian barrel type. 
Figure 54.—Hooks lor suspending material in Serbian barrel. 
127 171-172 
MEDICAL FIELD MANUAL 
the end of this time the steam is released and a vacuum of 
10 to 15 inches is produced in order to dry the clothing. 
This vacuum is held for about 5 minutes. Clothing should 
be placed in loosely in order that the steam may penetrate. 
B 172. Serbian Barrel.—a. Serbian barrel type disinfestors 
consist of barrels or similar containers for the material to be 
Figure 55.—Disinfector, Serbian barrel type, showing water pan and 
the wire netting across lower opening of steamer. 
disinfested, below or in the lower part of which there is a 
receptacle for water and an improvised furnace or firebox. 
The ordinary galvanized iron garbage can is usually the most 
readily available. This can does not need a water receptacle 
beneath it but does require a screen to keep the clothing 
[rom falling down into the water. Water to a depth of about 
128 FIELD SANITATION 
172-174 
6 inches is placed in the bottom of the can and the can 
placed directly over a fire. Hooks on the sides or lid will 
hold the clothing suspended. The can may be heated over 
either a single or cross trench. This type of disinfestor may 
be made from a barrel with tightly fitting lid and water pan 
beneath, or it may be made knockdown type as shown in 
figure 57. 
b. Operation of a Serbian barrel consists in first heating 
the water to the boiling point, after which the clothing or 
equipment is placed loosely in the barrel. The lid is placed 
Figure 56.—Disinfestor, Serbian barrel type. Steam chest so made) 
that it can be disassembled. 
on and disinfestation should continue for 45 minutes after 
steam begins to escape around the edges of the top or bottom 
of the barrel. 
a 173. Improvised Hot Air Disinfestors.—Clothing and 
equipment may be placed in ovens, boxes, or cans; and sub- 
jected to dry heat. Small buildings or dugouta may be 
converted into hot air disinfestors by installing heating ap- 
paratus which will heat the air to 160° F. Clothing should 
be hung loosely and exposed for about 30 minutes. 
■ 174. Hot Irons.—Clothing can be partially deloused and 
the degree of infestation reduced by removing the adult lice 
129 174-177 
MEDICAL FIELD MANUAL 
by hand and then killing the eggs by ironing the cloth, 
especially the seams and folds, with a hot iron. An ordinary 
sadiron, or a piece of iron pipe or scrap iron with a wooden 
handle attached, may be used for this purpose. 
■ 175. Hot Water.—Cotton, linen, or silk clothing may be 
disinfested by immersion in boiling water for 1 minute, or 
in water having a temperature of 135° F. or more for 5 
minutes. In order to disinfect as well as disinfest, the cloth- 
ing should be subjected to a temperature of at least 160° F. 
for 15 to 30 minutes. Woolen clothing can be disinfested by 
this process, but considerable shrinkage will occur. Leather, 
felt, or webbed articles are damaged by exposure to hot 
water. 
■ 176. Storage.—Storage of infested clothing will accom- 
plish disinfestation by depriving the lice of a food supply. 
When denied access to a human host, the adult forms die of 
starvation within a 10-day period and the larval forms will 
survive for only about 24 hours after hatching. However, in 
order to allow sufficient time for all the eggs to hatch, in- 
fested articles should be kept in storage for at least 30 days 
in cold weather and for not less than 3 weeks in warm 
weather. Not infrequently, storage is a very practical method 
of disinfesting clothing and blankets in hospitals or camps, 
provided clean equipment is available for issue and facilities 
for storage can be obtained. The rooms or buildings used 
for storage should be dry. Freshly infested articles should 
not be stored with those which have been in storage for 
some time No article should be removed from a storage 
room until after all articles in that room have been in 
storage at least 30 days. 
■ 177. Chemicals.—a. Chemicals such as acetic acid (vin- 
egar) , kerosene, gasoline, cresol, or naphthaline may be ap- 
plied to the person or clothing of the infested individual. 
Most of these substances will not kill the eggs however. 
1 b. A 5 percent solution of cresol in water is an efficient 
Jdisinfestant for washing articles such as leather shoes and 
belts, felt hats, or web belts which may be damaged by 
'exposure to steam. Clothing and other articles may be 
130 FIELD SANITATION 
177-178 
disinfested by immersion in a 2 percent solution of cresol if 
the temperature is held at 100° F for 30 minutes 
■ 178. Operation of Delousing Plant.—The following gen- 
eral considerations should be observed in the installation of 
a delousing plant; 
a. There must be no mixing of clean and infested men 
or of clean and infested clothing. 
b. The plant should be definitely divided into two parts— 
a clean side and an infested side—which are connected only 
through the shower baths for the men and through the 
disinfestors for the clothing and blankets. 
c. The floor should be made of concrete and provided with 
sufficient slope and drainage outlets to permit rapid and 
adequate cleaning by flushing. 
d. The entire building should be well lighted by natural 
lighting, but special care should be taken that the rooms or 
parts of the building used for the physical inspection or the 
inspection of clothing are adequately lighted. 
e. Separate toilet facilities should be provided for infesteo 
men and for clean men. 
f. Means should be provided for heating the building to a 
suitable temperature. 
g. The minimum divisions of a large delousing plant 
should be— 
(1) A receiving room large enough to care for an excess 
number of men if troops are sent to the plant too rapidly. 
(2) A disrobing room. 
(3) A checking room where shoes, belts, and other articles 
that may not require disinfestation may be checked, together 
with valuables. 
(4) A shower bathroom. 
(5) A disinfestor room. 
(6) A dressing room. 
(7) A barber shop. 
(8) A physical inspection room. 
h. In the case of smaller plants, some of the divisions in 
g above may be combined. 
131 CHAPTER 10 
RAT CONTROL 
Section 1. Importance, classification, and habits of the 
rat 179-181 
II. General control procedures 182-183 
III. Eradication by poisoning 184-187 
IV. Eradication by trapping and fumigating 188-192 
V. Rat surveys 193-196 
Paragraphs 
Section 1 
IMPORTANCE, CLASSIFICATION, AND HABITS OF 
THE RAT 
■ 179. General.—The rat is probably the most expensive 
parasitic animal living at the expense of man. In addition 
to huge economic losses caused by rats these animals are 
causative factors in the spread of several diseases as follows: 
a. Bubonic plague.—Rat acts as reservoir and rat flea 
transmits the disease. 
b. Endemic typhus.—Same manner as plague. 
c. Infectious jaundice.—Rat contaminates food with 
excreta containing leptospira icterohaemorrhagiae. 
d. Rat bite fever.—Spirillum minus transferred to man 
by bite of infected rat. 
e. May harbor intestinal parasites, particularly tapeworms. 
1. May transfer pathogenic organisms from feces to food 
mechanically. 
g. Factors in spread of trichinella spiralis among hogs. 
■ 180. Classification.—The genus rattus includes three 
species of sanitary importance; These are the brown rat, 
R. norvegicus, the black rat. R. rattus, and the roof or Egyp- 
tian rat, R. alexandrinus. 
'■ 181. Habits.—Rats are nocturnal animals but at times 
!come out in the daylight. In order to make an intelligent 
effort toward its destruction some knowledge of the habits 
'of the various species is necessary. 
132 FIELD SANITATION 
181-184 
a. The brown rat keeps mainly to the lower floors and 
basements of buildings, as it lacks climbing ability. It is 
a burrowing animal and will burrow into the hardest soil 
to live and breed. The brown rat has great gnawing ability 
and will eat anything without reference to its degree of 
freshness or decay. 
b. The black rat and the roof rat are both excellent 
climbers and live in hollow walls, garrets, or loose material 
such as boxes, barrels, or rubbish. These rats are cleanly 
in their habits and prefer grain and fresh, clean food. 
c. All rats are great travelers and are found on ships, in 
boxcars, and at times go great distances themselves in search 
of food. 
Section II 
GENERAL CONTROL PROCEDURE 
■ 182. Control Procedures.—Control procedures are either 
suppressive or destructive. Suppressive measures are de- 
signed to prevent rats from reaching a food supply and to 
deny them access to spaces where they can nest and breed. 
Destructive procedures include poisoning, trapping, fumiga- 
tion, and employment of natural enemies. 
■ 183. Ratproofing.—Temporary buildings in camps espe- 
cially if they are to be used as storehouses should either be 
built up off of the ground or ratproofed. Ratproofing con- 
sists in the use of concrete floors and walls of concrete or of 
brick and stone laid in cement mortar, with the occlusion 
of all openings with metal flashings, grating, or screening. 
See TM 8-255 (now published as Army Medical Bulletin 
No. 23) for methods of ratproofing buildings. Should build- 
ings which are not ratproof be used to store food in, the 
food should be elevated or stored in containers which prevent 
rats from gaining access to the food. 
Section III 
ERADICATION BY POISONING 
■ 184. Poisoning.—a. Poisoning is an effective rat control 
measure where there are large numbers of rats but it will 
133 184-186 
MEDICAL FIELD MANUAL 
not kill all of the rats as many will soon learn not to touch 
the bait. The remainder may be killed or trapped. 
h. One of the best poisons is red squill. This may be 
mixed with either canned salmon, ground fresh meat, or 
cooked cornmeal in the proportion of l/% ounce of commer- 
cial red squill to 1 pound of the food base. It is well to 
mix the squill with several different food bases as some rats 
may prefer the meat or fish rather than the cereal, or the 
reverse may be true. Oven-dried rather than sun-dried 
squill should be used as it is much more effective. 
c. Barium carbonate is another very good poison and it 
has similar advantages to squill in that it is relatively non- 
poisonous to children, dogs, and cats. It is mixed the same 
way as squill. 
d. Arsenious oxide, phosphorus, strychnine, and thallium 
are also used but have the disadvantage of being highly 
poisonous to all animals. 
■ 185. Bait Preparation.—The consistency of bait should be 
such that it can be cut or shaped into small balls, cubes, or 
cakes. Balls or cakes should be about Vfc inch in diameter 
and should be well moistened rather than hard or dry. Bait 
should not be handled but mixed with a knife or spoon as 
the human odor may cause the rat to shun the bait. The 
baits are best wrapped in plain squares of paper, the corners 
being brought together and twisted into a torpedo-shaped 
package. The men who wrap the baits should wear rubber 
gloves and when the baits are placed, a pair of forceps 
should be used to handle them. 
■ 186. Bait Distribution.—Baits are best distributed late 
in the afternoon so that they will be fresh when the rats 
start to search for food. The baits should be laid in places 
that are easily accessible to and frequented by rats. Gen- 
erally the best results are obtained when the baits are placed 
along rat runways leading from rat harborages. These run- 
ways usually lie alongside of walls or other similar objects. 
The baits may be placed singly or in groups. Frequently, 
several kinds of bait may be used in one place as, for 
example, a ground meat bait together with a cereal bait. 
Single baits or groups of bait should be placed not more 
134 FIELD SANITATION 
186-189 
than 10 to 20 feet apart along runways or in areas 
frequented by rats in search of food. 
■ 187. Prebaiting.—In order to accustom rats to eating the 
kind of food materials which will be used to carry the poison, 
unpoisoned baits which are exactly like those that are to 
be employed later, except that they contain no poison, may 
be distributed for several days prior to placing the poisoned 
baits. The uneaten baits should be collected daily and re- 
placed with fresh material. When the unpoisoned baits 
are eaten freely by the rats, all those that remain uneaten 
should be collected and a comparatively large number of 
poisoned baits distributed. Frequently, this procedure will 
result in the destruction of a large proportion of the rat 
population. 
Section IV 
■ 188. Trapping.—a. Trapping is an effective rat control 
measure, but requires greater skill and more labor than 
poisoning. A readily accessible food supply decreases the 
efficiency of trapping as a rat control measure. 
ERADICATION BY TRAPPING AND FUMIGATING 
b. Rats soon become suspicious of traps, particularly if 
the traps are unskillfully set, and will then consistently avoid’ 
them. Where many rats are present, a comparatively largeJ 
number of traps should be set at the beginning of the cam-5 
paign in order to destroy as many rats as possible before 
they learn to avoid the traps. 
c. Trapping is a very practicable and efficient procedure 
for the control of rats in large warehouses or storerooms if 
it is persistently and systematically carried out. It also has1 
the advantage that it can be constantly employed to destroy 
new arrivals where the continued exposure of poison would 
be undesirable. 
■ 189. Types of Traps.—There are two general types of 
traps, snap (guilloting or spring) traps and cage traps 
Rats soon become suspicious of cage traps so that the snap 
trap is to be preferred. The trap should be strong anc 
durable and preferably made of steel. 
135 190-192 
MEDICAL FIELD MANUAL 
B 190. Trap Baits.—Baits may be fried bacon, fish, cheese, 
liver, fresh bread or doughnuts, cantaloupes, or tomatoes. 
Pried bacon, cheese, and doughnuts as a rule prove the most 
attractive baits. If trapping is continuous the kind of bait 
should be changed frequently. 
B 191. Trap Setting.—Bait should be large and fastened to 
the trigger securely. It may be tied on with string or thread. 
Traps should be placed in locations normally frequented by 
rats. Where the trap is set along a runway, it should be set 
with trigger end against the wall. The trap may be dis- 
guised by covering it wholly or in part and prebaiting may be 
used at first by not setting spring of trap. The trigger should 
be so set that the slightest movement of the bait will spring 
the trap. All traps should be scalded or flamed at intervals 
to remove the odor derived from the hands. Traps may be 
deodorized by dipping in hot melted paraffin. 
B 192. Fumigation.—a. Hydrocyanic acid gas and sulphur 
dioxide are the gases commonly used for rat destruction. 
The difficulty in using these gases in the field is so great that 
they are of little value. 
b. Rat burrows in dumps, around the exterior of buildings, 
or in other locations may be fumigated and the rats killed 
by carbon monoxide delivered through the exhaust pipe of an 
automobile. Where the burrows are accessible, a flexible 
pipe or a rubber hose is attached to the exhaust pipe and the 
other end is passed into the burrow. The carburetor should 
be adjusted for a rich mixture. In gassing the average bur- 
row, the engine should be allowed to run at moderate speed 
for at least 10 minutes. The burrows and harborages treated 
in this manner should be made as airtight as possible by seal- 
ing the cracks and the openings of connecting burrows with 
earth. 
, c. Carbon disulphide on balls of cotton or waste may be 
■plugged in rat burrows. This is more effective in damp 
weather and when ground is damp. 
136 FIELD SANITATION 
193-195 
Section V 
RAT SURVEYS 
■ 193 General.—Rat surveys are conducted to determine the 
presence of rats infected with plague or to delimit the areas 
harboring infected rats. Surveys may also be made for the 
purpose of estimating the degree of rat infestation in a build- 
ing or area with a view to deciding upon the control meas- 
ures to be employed. 
B 194. Survey to Determine Presence of Plague Infected 
Rats.—a. If a rat survey is made for the purpose of determin- 
ing if plague infected rats are present, the suspected area is 
trapped in order to obtain specimens which will represent a 
cross section of the rat population. The rats thus secured 
are sent at once to a laboratory for examination for evidence 
of plague infection. Usually, trapping should be continued 
until an infected rat is found or, if the area is within a town 
or thickly populated section, until from 30 to 50 rats have 
been examined for every 100 persons living in the area. : 
b. If an infected rat is captured, it is a strong indication’ 
that a number of other plague rats are present in the’ 
locality. The point where the infected rat was captured is 
considered as a center of infection. The trapping activities’ 
are extended to gradually increasing distances from this 
center until infected rats are no longer found and the cir- 
cumference of the infected area is determined. The 
thus mapped out may be subjected to intensive rat eradiJ 
cative measures which progress from the circumference 
inward toward the center. E 
■ 195. Survey To Determine Degree of Rat Infestation.— 
Prior to instituting an antirat campaign in a military statioi, 
or camp, a survey should be made to determine the exten 
of the rat infestation and should include the followin' 
factors; 
a. The location of burrows and harborages. 
b. The kinds of food materials available to rats. 
c. To what extent the food materials that are accessibl 
to rats can be rendered inaccessible. 
d. The kind of control measures that will probably be th 
most successful under local conditions. ., 
137 195-196 
MEDICAL FIELD MANUAL 
As the rat instinctively seeks concealment, the degree to 
which a given building or area is infested must be deter- 
mined by signs of the activities of rats rather than by the 
number that are to be seen. These signs consist of dam- 
aged food, the presence of rat runways as evidenced by 
tracks and marks of dragging tails in the dust, or by greasy 
appearing, discolored marks on woodwork made by the feet 
and tails of the rats, burrows and harborages, freshly gnawed 
wood, or rat excreta. 
■ 196. Organization of Antirat Campaigns.—The results of 
a rat survey of a station or camp will indicate the kinds of 
control measures that should be instituted. These neces- 
sarily will vary according to the conditions but, given aver- 
age conditions with moderate rat infestation, successful con- 
trol can usually be established and maintained by reducing 
the food supply to a minimum and by ratproofing to elimi- 
nate harborages, followed by an intensive poisoning cam- 
paign with persistent and systematic trapping thereafter. 
Slight infestation may be controlled by protection of food 
materials and by poisoning. In any event, a definite and 
predetermined plan of action, trained personnel, and con- 
stant supervision are necessary for success. 
138 CHAPTER 11 
SANITARY SURVEYS AND SANITARY ORDERS 
Paragraphs 
Section I. Sanitary surveys 197-199 
II. Sanitary orders 200-205 
Section I 
SANITARY SURVEYS 
■ 197. General.—A sanitary survey is an analysis of the 
conditions existing in a community which exert a favorable 
or an unfavorable influence on the health of the inhabitants. 
Sanitary surveys vary widely in scope and character and 
may consist of a more or less complete study of all the con- 
ditions within a community which actually or potentially 
affect health. It may, on the other hand, be limited in scope 
and restricted to the consideration of some specific factor. 
■ 198. Form for Sanitary Survey.—The following outline 
is suggested as a guide in the conduct of a military sanitary 
survey but it does not constitute a form which can be ad- 
hered to in all instances: 
a. Military features. 
(1) Military personnel. 
Strength. 
Training and discipline. 
Racial characteristics. 
(2) Mission of the troops. 
Peacetime training. 
Mobilization. 
Wartime training. 
(3) Funds and policies. 
Existing and prospective availability of funds. 
Policies relative to the procurement and expenditure 
of funds. 
139 198 
MEDICAL FIELD MANUAL 
b. Environmental features. 
(1) Topographical and meteorological conditions. 
Nature of terrain. 
Character of topsoil and subsoil. 
Amount of rainfall; mean temperature and humidity 
winds and seasonal variations in climate. 
(2) Recreational facilities. 
Athletics. 
Entertainment and welfare work. 
(3) Water supply. 
Sources. 
Methods of purification. 
Methods of distribution. 
(4) Waste disposal. 
Kinds of wastes. 
Methods of disposal. 
(5) Housing. 
Kinds of shelter used. 
Ventilation, heating, and lighting. 
Bed spacing. 
(6) Food supplies. 
Sources. 
Effectiveness of inspection methods. 
Storage and protection. 
Operation of messes. 
Training and supervision of food handlers. 
Quality of the ration as served. 
Operation of bakeries and post exchanges. 
(7) Insect control. 
Kinds of disease-bearing insects present. 
Control methods employed and their effectiveness. 
(8) Stables. 
General cleanliness. 
Fly control methods used and their effectiveness. 
c. Disease prevalence. 
(1) Morbidity rates. 
Average total sick rate. 
Average admission rates for communicable diseases. 
140 FIELD SANITATION 
198-202 
(2) Communicable diseases. 
Epidemic and endemic prevalence. 
Sources of infection. 
Control measures. 
(3) Hospital facilities. 
Capacity of local hospital installations. 
Facilities for segregation and isolation. 
■ 199. Conduct of a Sanitary Survey.—The first steps in 
the conduct of a sanitary survey consist of a— 
a. Formulation of a more or less complete plan relative to 
the kind of information to be obtained. 
b. Determination of the source of material. 
c. Determination of the methods to be used to collect 
material. 
Section II 
SANITARY ORDERS 
■ 200. General.—A sanitary order is administrative in char-; 
acter, provides for the execution of sanitary procedures ap-i 
plicable to and indicated in the prevailing situation, anc- 
designates those responsible for the enforcement of sucl- 
measures. ) 
■ 201. Responsibility.—Sanitary orders are published b;' 
the command. [ 
■ 202. Preparation.—The surgeon of a command is normally 
responsible for the preparation of a sanitary order. He ma: 
in practice, delegate the actual writing of the order to hi 
medical inspector, but in so doing he does not delegate h 
responsibility for its proper preparation. In the prepare, 
tion of a sanitary order, the surgeon must be conversar, 
with the health situation within the command and with a 
factors which affect or might affect the health of the troop. 
He must give full consideration to the mission of the con 
mand and to the facilities which are available for the a<, 
complishment of sanitary measures. All measures direct* 
by a sanitary order must be of a practical nature. Tlr 
should be necessary to meet the sanitary needs of tl 
command, compatible with the mission of the commar 
555798°—43 10 202-205 
MEDICAL FIELD MANUAL 
and of such character that they can be accomplished with 
the facilities available. 
■ 203. Scope.—The sanitary order contains all of the ad- 
ministrative details necessary to protect the health of the 
troops and applies with equal force to all elements of the 
command. 
■ 204. How Submitted.—The sanitary order as prepared by 
;he surgeon is submitted to the proper military headquarters 
hr approval and publication. In the ordinary small post 
>r camp it is submitted to the commanding officer. In larger 
:amps or in larger tactical commands the order is usually 
ubmitted to G-l of the staff or the adjutant who coordi- 
lates it with other staff sections and then submits it to the 
hief of staff for approval and issue. 
I 205. Form.—a. A sanitary order may be issued in the 
Drm of a general order, as an annex to an administrative 
rder, or as a series of memoranda or instructions. Nor- 
lally, GHQ, army, corps, or communications zone head- 
uarters do not publish sanitary orders as such, but govern 
mitation from an administrative point of view by the 
romulgation of policies pertaining thereto or by instructing 
ibordinate commands relative to action to be taken by 
lem to meet a particular sanitary situation. A sanitary 
•der would normally be published as a general order for 
division or analogous command in a mobilization or con- 
ntration camp or for a summer training camp, 
b. The exact form of the general order will vary with 
e conditions under which the order must be enforced, 
le following may be used as a general guide. 
(Division) 
(Place) 
neral Order 
No. 
(Date) 
pENERAL.—The following provisions for the sanitation of this 
livision are published for the information and guidance of all 
'oncemed; 
[ a. Responsibility of unit commander. 
142 FIELD SANITATION 
205 
b. The division surgeon duties and responsibilities relative 
to sanitation. 
c. The medical inspector (duties and responsibilities. 
d. Water supply. 
e. Food and messes. 
/. Waste disposal. 
g. Quarters (barracks, tents, or billets). 
h. Insect control (where applicable). 
i. Personal hygiene. 
j. Dispensaries (location). 
k. Venereal prophylaxis (location of stations). 
I. Physical inspections. 
m. Special measures for the control of communicable 
diseases. 
2. Civilians.—All civilians and civilian organizations attached to 
the division will comply with this order insofar as it applies 
to them. 
By order of 
Official: 
Distribution. 
c. While Army Regulations fix the responsibilities of all 
concerned with regard to sanitation, the sanitary order as a 
rule again states the responsibility of the unit commanders, 
the surgeon, and the medical inspector. This is done in 
order that the duties of each, and the relations of one to the 
other in the existing situation, may be clearly defined. Un- 
der some circumstances it may be desirable to state in the 
sanitary order the responsibilities of other staff officers such 
as the quartermaster, the engineer officer, or the police 
officer. 
143 CHAPTER 12 
FIELD EPIDEMIOLOGY 
Paragraphs 
Section I. Epidemiological investigation 206-209 
II. Carriers and missed cases 210-211 
Section I 
EPIDEMIOLOGICAL INVESTIGATION 
■ 206. General.—Epidemiology has been defined by the 
American Epidemiological Society as “the science which con- 
cerns itself with the natural history of disease as it is ex- 
pressed in groups of persons related by some common fac- 
tors of age, sex, race, location, or occupation, as distinct 
from the development of disease in individuals.” There are 
several types of epidemiological work, but the medical officer 
is concerned largely with the actual investigation of out- 
breaks of communicable disease in camp or contonment. 
■ 207. Recommendation for.—When communicable dis- 
ease appears among troops an immediate investigation 
should be instituted so that recommendations for control 
measures can be made. In formulating recommendations it 
should be borne in mind that the mission of the troops is 
of paramount importance. The ideal situation, therefore, 
insofar as control measures are concerned, may not be at- 
tained, but an effort should be made to adapt means of 
prevention as far as possible to the existing situation. 
■ 208. Outline for Investigation.—The following outline 
will aid in the investigation of an outbreak of communicable 
disease. In most instances an experienced medical officer 
will make this investigation in whole or in part, as condi- 
tions warrant, without reference to texts or notes. The 
officer who has had little or no epidemiological experience 
will find it useful as a guide. 
a. Make a careful check to see that the disease is the one 
:n question. That is, confirm the diagnosis before any other 
teps are taken. 
144 FIELD SANITATION 
208-209 
b. Is the outbreak above normal expectancy? At certain 
seasons of the year, for instance, there is generally an in- 
crease in respiratory diseases. Compare rates with previous 
week, month, and, if available, same period previous year. 
c. Ascertain from histories of cases if any common foci of 
exposure exist. This is of special importance in intestinal 
diseases where men in different organizations have had a 
common exposure outside of camp. 
d. Isolate patients. Send all patients to hospital and have 
them placed in a separate ward away from others. 
e. Investigate contacts. Include men in same tent and 
squad, also men who have worked with patients. 
f. Investigate food supply and food handlers if disease is 
one thus acquired. 
g. Contacts without symptoms may be placed in working 
quarantine. Period of quarantine to continue for the num- 
ber of days coinciding with the period of incubation of the 
disease. Should new cases appear, continue the period until 
a complete incubation period has passed after the removal 
of the last case. 
h. Have contacts inspected by a medical officer once or twice 
daily. 
i. Instruct unit commanders as to what symptoms to 
watch for and request them to send suspects on sick report 
as soon as discovered. 
j. Prophylactic vaccination if indicated. 
■ 209. Epidemiological Data. — The following tables show 
some of the more important data relative to epidemiology 
and diagnosis of some of the epidemic diseases. 
a. Respiratory group.—This is the so-called droplet group,, 
the diseases being spread usually through the secretions of 
the respiratory tract. . 
145 209 
MEDICAL FIELD MANUAL 
Disease 
Incubation 
period 
Rash 
Remarks 
12-21 days 
2-4 days... 
1-2 days... 
Usually 14-day incubation. 
Usually 14-day incubation. Rash 
appears in crops. 
Cerebrospinal men- 
2-10 days__ 
1-5 days... 
ingitis. 
Rash varies as to type and very 
often none appears. 
7-18 days. 
10-20 days. 
7-20 days.. 
3-4 days... 
None --. 
Usually 14-day incubation. 
Mumps __ _ 
24 hours... 
Early enlargement of posterior 
cervical glands. 
1-8 days-.. 
48 hours... 
Usually 3-5 day incubation. May 
be spread by means of infected 
milk. 
1-4 days... 
7-14 days.. 
None ... . 
Whooping cough 
None 
2-3 days... 
7-14 days- 
1-5 days... 
None - .- 
Septic sore throat 
Not usual. 
Infected milk supply important. 
Encephalitis 
4-21 days.. 
None 
b. Intestinal group.—Diseases of this group are usually 
transmitted through the media of food and water which 
have become infected from the intestinal discharges of 
patients or carriers. 
Disease 
Incubation period 
Remarks 
Milk supply of primary 
importance. 
1-6 days... 
About 14 days 
146 FIELD SANITATION 
209-210 
c. Insect-borne group.—This group is transmitted by blood- 
sucking insects. 
Disease 
Incubation 
period 
Insect vector 
Remarks 
Malaria 
6-30 days.. 
Anopheles mosquito... 
Dengue - 
6-9 days _. 
Aedes egypti and Aedes 
Typhus endemic... 
5-20 days.. 
albopictus. 
Rat flea and rat louse.. 
Rash about fifth day ant 
Typhus epidemic . 
,__do 
Body louse 
tends to disappear be 
fore becoming pete 
chial. 
Rash on fourth or flftl 
14-30 days 
2- . 
3- days.. 
2-6 days.. 
day. 
are also susceptible. 
Yellow fever 
Aedes egypti and many 
to be epidemic. 
Jungle yellow fever o 
Filiariasis . 
Variable. _ 
other species. 
Culex fatigans and 
curs in absence 
aedes. 
Also other mosquitoe 
Rocky Mountain 
3-12 days.. 
Aedes variegatus. 
Tick... 
May produce no clii 
cal symptoms. 
Dermacentor anderso 
spotted fever. 
Tularemia 
1-9 days.. 
Ticks, lice, and chry- 
and Dermacentor va 
abilis, also others. 
Also transmitted by < 
Tick paralysis 
5-14 days.. 
sops discalis. 
Dermacentor andersom 
rect contact with : 
fected animal. 
and certain ixodes. 
Section II 
CARRIERS AND MISSED CASES 
■ 210. Healthy Carriers.—The following diseases are of ii 
portance as they may be transmitted by healthy carriers: 
Typhoid fever. 
Paratyphoid fever. 
Dysentery (bacillary and protozoal). 
Pneumonia. 
Cholera. 
147 210-211 
MEDICAL FIELD MANUAL 
Meningococcic meningitis. 
Diphtheria. 
Scarlet fever. 
■ 211. Missed Cases.—During epidemics there are always 
mild, subclinical, or atypical cases. These cases are prone to 
be missed at the beginning of the epidemic but are recognized 
when the epidemic is established as much greater care is then 
'xercised and everyone is on the alert. 
148 CHAPTER 13 
PHYSICAL EXAMINATIONS 
Paragraphs 
Section I. Responsibility and standards 212-214 
II. Conduct of examinations and inspections 215-2n 
Section I 
RESPONSIBILITY AND STANDARDS 
■ 212. General.—Physical examinations constitute an im- 
portant part of military preventive medicine and are essentia 
in protecting the health of military personnel. Further 
troops cannot be recruited or mobilized for military servic 
without being physically examined, and the performance o 
physical examinations is the first step in the recruitment o 
mobilization of a military force. Usually, it is the principa 
basis upon which men are selected for enlistment in the mill 
tary service. The efficient performance of large numbers q 
physical examinations, from both an administrative and 
professional viewpoint, is a vital feature of mobilization fc 
war. , 
■ 213. Responsibility.—The administrative responsibilif 
for and control of physical examinations rest with the con' 
mander of the command or station concerned. The Medici 
Department is responsible for the performance of physical 
aminations in accordance with administrative orders of con 
petent military authority. 
■ 214. Standards.—Standards of physical qualifications a 
formulated and promulgated by the War Department ai, 
are published in Army Regulations and Mobilization Reg 
lations. 
Section II 
CONDUCT OF EXAMINATIONS AND INSPECTIONS 
■ 215. General.—a. The physical examination, whether p( 
formed for administrative or health conservation purpos 
or both, is an examination of an apparently healthy perse 
149 215-217 
MEDICAL FIELD MANUAL 
It is seldom that the examinee complains of any symptoms 
or conditions indicative of a physical defect or abnormality. 
The methods used, therefore, differ to some extent from 
those employed in determining the cause or nature of an 
existing illness. The examinee may endeavor to conceal 
bhysical defects or he may malinger or endeavor to accen- 
tuate the importance of minor abnormalities. Consequently, 
bhe examiner must be prepared to determine the true phy- 
sical condition of the examinee and detect and properly evalu- 
ite any and all obscure or preclinical abnormalities. 
b. Physical examinations must be thorough if they are to 
>e of any considerable value either for health conservation 
>r for administrative purposes. Usually, if there are a 
lumber of examinees, administrative conditions require that 
he examinations be made as rapidly as may be consistent 
nth thoroughness, but thoroughness should not be sacrificed 
d obtain speed. Where physical examinations are per- 
irmed with such rapidity that the work is slighted, the 
ssults are of but little actual value and the object of the 
lamination is defeated. Such examinations are in reality 
bysical inspections only and should be so regarded. If 
ley are accepted as having the same value as properly 
?rformed physicial examinations, they will tend to cause 
ore harm than good, in that a great many examinees who 
dually have physical defects will be erroneously considered 
; physically fit for military service or will be denied the 
tention necessary to protect their health. 
216. Organization of Examining Units.—The organization 
a physical examining unit depends upon the number of 
m to be examined and the number of examiners available to 
the actual examining. The organization should be such 
'at the work performed at each station is thorough and 
mplete, and a constant, steady flow of examinees is main- 
ned through the various examining stations without con- 
ation or undue delay at any one station. Figures 57 and 
show diagrammatic representations of three types of or- 
lizations for physical examinations. 
217. Physical Inspections.—Army Regulations require 
it all enlisted men be physically inspected once each 
150 FIELD SANITATION 
217 
month. The men to be inspected should be nude. Special 
attention should be given to the detection of signs or symp- 
toms of physical deterioration, such as anemia, under- 
weight, poor posture, etc. Evidence of infectious disease in- 
MEDICAL HISTORY 
DISROlsiNO and 
DRESSING- ROOM 
Figure 57.—Diagrammatic representation of the organization o 
a physical examining board. Nine stations and elevei 
examiners. 
eluding veneral disease should be sought. The teeth and th 
feet should be carefully examined. The general cleanlines 
of the body should also be determined. The medical office 
making the inspection is accompanied by an officer of th 
151 217 
MEDICAL FIELD MANUAL 
company or detachment to which the men belong. Where 
feasible and when required, a monthly physical inspection 
may include a dental survey made by a dental officer. 
Where physical defects are found, appropriate action should 
be taken, for example, treatment or observation in hospital 
or a change of duty. 
FINAL ACTION 
MEDICAL HISTORY 
DISROBING AND 
DRESSING ROOM 
Figure 58.—One method of organizing a physical examining hoard 
which will permit partial examination before the examinees 
disrobe. 
152 CHAPTER 14 
IMPORTANT FACTORS RELATIVE TO 
PERSONAL HYGIENE 
Section I. General 218-219 
II. Prevention and treatment of skin diseases 220-221 
III. Oral hygiene 222-224 
Paragraphs 
Section I 
■ 218. Physical Inspections.—The importance of the 
monthly physical inspection in detecting pathological condi- 
tions cannot be stressed too greatly. It should never be a 
“venereal” inspection but should include, especially, foot 
and skin conditions. 
GENERAL 
■ 219. Care of the Feet.—a. General.—Ordinary care of the 
feet and shoe fitting are covered in FM 21-10. However, 
there are certain pathological conditions of the feet which, 
if not detected early, may lead to invalidism of the individual 
or to wholesale infection of the command. The most 
important of these conditions is ringworm of the feet or “ath- 
lete’s foot.” This is also called dermatomycosis or epidermo- 
phytosis of the extremities as it may affect the hands as well 
as the feet. Dermatomycosis is a subacute or acute inflam-, 
matory condition of the skin occurring most frequently on. 
the feet, especially between and on the plantar surface of 
the toes and on the soles of the feet. It is characterized by, 
various types of lesions, including thickening and scaling of, 
the epidermis, excoriation of inflamed areas, fissures, and, 
vesicles or blebs. Usually, there is more or less intense 
itching. 
(1) Ringworm of the extremities is caused by parasitic 
fungi. It is generally believed that species of Epidermophy- 
ton and Trichophyton gypseum are the most common caus- 
ative agents. The organisms can be destroyed by ordinary 
disinfectants and by boiling water. 
153 219 
MEDICAL FIELD MANUAL 
(2) Ringworm of the extremities is one of the most prev- 
alent of all skin diseases although many cases may pass 
undiagnosed unless their presence is revealed as the result 
of special examinations. The presence of this condition in 
a military organization has an adverse effect on the morale 
of the troops. Relatively severe infections may incapacitate 
for the performance of military duties. 
(3) The causal agents of ringworm of the extremities are 
usually transmitted by indirect contact through the medium 
of inanimate objects. The infection is most commonly 
spread by contact of the bare feet with the floors, mats, 
benches, etc., in the bathrooms of gymnasiums, clubs, and 
swimming pools. Towels, slippers or shoes, or other articles 
worn next to the bare skin are frequently incriminated in 
the transmission of the causative organisms. The primary 
source of the infection is the infected individual. As far 
as is known, the organisms are not derived primarily from 
animals or from the soil. 
(4) One of the means of preventing the spread of ring- 
worm of the extremities is to supply all bathhouses with 
calcium hypochlorite foot baths. Grade A calcium hypo- 
chlorite in the proportion of 1 ounce of the dry chemical per 
gallon of water yields 0.5 percent available chlorine, which 
is the strength recommended. Fresh solutions should be 
prepared daily. Under ordinary circumstances one foot tub 
for bathers to use at the completion of bath will suffice. 
Where fungus infections are present and obstinate in a 
command, two tubs should be furnished, one to use before 
lathing and one after. Foot tubs should be of convenient 
dze and shape and should be deep enough to insure thorough 
vetting of the feet. Foot tubs should be made of concrete 
>r rubber as the calcium hypochlorite acts unfavorably on 
netal and wood. 
(5) Another very important factor in the spread of this 
nfection is the improper drying of the feet, especially be- 
ween the toes. Men should be instructed to sit down and 
arefully dry between each toe before putting on socks and 
hoes. 
b. Control measures.—The spread of the infection among 
roops can be most effectively controlled by the disinfection 
154 FIELD SANITATION 
219-220 
of bathhouse floors and equipment and by the sterilization or 
disinfection of towels, swimming or gymnasium suits, and 
similar articles by which the infection might be transmitted. 
Bathhouse floors and equipment, including mats, benches, 
chairs, etc., should be scrubbed daily with a disinfectant. A 
solution of calcium hypochlorite, soap, and a hot 1 to 10,000 
solution of mercuric chloride, or the various cresol or phenol 
solutions, may be used as disinfectants. Individual slippers of 
rubber or other waterproof materials are useful in preventing 
contact of the bare feet with infected surfaces. All articles 
that can be boiled should be sterilized by boiling. Leather 
and rubber goods can be disinfected with a cresol solution. 
Shoes can also be disinfected by a 1 percent solution of thy- 
mol in gasoline or alcohol. This solution is poured into the 
shoe and allowed to drain away or evaporate. The exchange 
or common use of towels, gymnasium suits, slippers, gloves, 
etc., should either be avoided or they should be disinfected 
after use. 
Section II 
PREVENTION AND TREATMENT OF SKIN DISEASES 
■ 220. Tinea Cruris.—a. This is a skin disease caused b? 
several species of the genus Epidermophyton, the most com- 
mon being E. inguinale. It may also be due to species o’ 
Microsporum. It is most prevalent in the Tropics and 
called “dhobie itch” as it was thought that transmission wa' 
through the medium of clothing infected by native washer 
men (dhobies). f. 
b. Tinea cruris is characterized by reddened, inflamed, an 
swollen areas which begin as rounded, elevated papules an 
extend peripherally, producing a raised festooned bordf1 
covered with scales. The infection is accompanied by intern 
itching and irritation which is most pronounced at nigh 
Secondary bacterial invasion may occur producing boils an 
abscesses. The infection occurs most commonly in tl 
perineal region and the adjacent surfaces of the thighs, ar 
in the axillary region. It may spread to the chest ar 
abdomen and frequently occurs between the toes. 
c. The clinical symptoms may disappear during co 
weather or when the patient goes to a temperate climai 
155 220-221 
MEDICAL FIELD MANUAL 
only to reappear during the next hot season or on return to 
a moist, hot climate. 
d. The causal agent of tinea cruris is transmitted from 
person to person by contact, chiefly by the hands, clothing, 
towels, or bathroom floors. It is also possible that the 
latrine or toilet seat is a factor in the transmission of the 
fungus. 
e. The general preventive measures mentioned under ring- 
worm of the extremities should be followed if tinea cruris 
appears. Every patient should be thoroughly treated, even 
though the infection is slight, in order to eliminate him as 
a source of infection. It may be desirable to hospitalize 
acute cases in order to prevent transmission. Daily bathing 
and the use of a drying powder after the bath serves to 
prevent to some extent the development of the infection. 
The powder which may consist of equal parts of boric acid, 
zinc oxide, and starch should be dusted on the skin of the 
perineum and axillae. 
■ 221. Scabies.—a. Scabies is an acute inflammatory condi- 
;ion of the skin due to the presence in the epidermis of 
Sarcoptes scabiei var. hominis, or itch mite. Simple scabies 
s characterized by the formation of vesicles and papules 
iccompanied by intense itching which is more pronounced 
n the presence of warmth. The lesions are most commonly 
ocated on the lateral surfaces of the fingers, on the wrists, 
luttocks, genitals, especially on the penis, and on the elbows, 
.nees, and ankles. Scabies may be complicated by secondary 
nfection with the production of an ecthymotous impetigo, 
■oils, or dermatitis. 
b. Sarcoptes scabiei var. hoviinis belongs to the order Acar- 
la, which includes the ticks and mites. The female is from 
.3 to 0.4 millimeter and the male about 0.2 millimeter in 
mgth. The impregnated female burrows into the epidermis, 
reating tunnels A to % inch or more in length. The bur- 
:>ws do not penetrate into the tissues below the epidermis, 
he eggs are deposited in the burrow. The eggs hatch in 4 
) 5 days. The larval and nymphal forms pass through four 
ages to become adults in about 2 weeks. The larvae also 
Dre into the skin to find protection and food. The males 
id newly matured females are to be found under the scales FIELD SANITATION 
221 
and crusts on the surface of the skin. The female lives 3 to 
5 weeks and deposits 25 to 50 eggs. It is probable that the 
female dies in the burrow, although she may live a week or 
longer and deposit ova when separated from the body of the 
host. The activity of the mites is governed to a very con- 
siderable extent by the warmth of the skin. Active burrow- 
ing takes place when the skin is warm and ceases when it is 
cold. 
c. The parasite is transferred by direct body contact or 
close indirect contact through the medium of clothes and 
blankets. General control measures consist of first making 
a correct diagnosis and then disinfesting the skin, clothing, 
and blankets of the patient. All troops undergoing treat- 
ment should be segregated in group quarantine. The disin- 
festation of the skin can be accomplished only by treatment 
which will destroy all forms of the parasite. In practice, this 
treatment consists of thorough bathing with hot water and 
soap to remove the crusts and scales, followed by the appli- 
cation of an insecticide. Green soap should be used and the 
entire body should be thoroughly scrubbed 10 to 15 minutes 
with a coarse bath mit. A bath mit made of turkish towel- 
ing or similar cloth may be used, or nail brushes may be em- 
ployed, especially in scrubbing the extremities. The soap 
should then be removed with hot water and the body thor- 
oughly dried. Sulphur ointment (USP) is then applied over 
the entire body from the neck to the tips of the fingers and 
toes, and thoroughly rubbed in. This treatment is repeated 
on the following day and, in the more heavily infested cases 
on the third day. A cleansing bath is then given and the 
patient is regarded as cured if no evidence of the insect car 
be found. Liquor calcis sulphuratae (lime and sulphur lo- 
tion, Vleminck’s solution) may be used in lieu of the sulphui 
ointment. Sulphur ointment containing 10 percent of balsan 
of Peru may be used in the treatment of complicated cases 
The itching may continue for some time after treatment am 
does not necessarily indicate that the treatment has failed t< 
effect a cure. Occasionally the treatment may cause sulphu 
dermatitis. A pyrethrin or rotenone ointment may be usei 
instead of sulphur, especially in the treatment of individual 
subject to sulphur dermatitis. As none of the insecticides wr 
555798°—43 11 221-223 
MEDICAL FIELD MANUAL 
destroy the eggs, it may be necessary to repeat the treatment 
in about a week. The clothing and blankets of men having 
scabies should be disinfested by the methods employed for 
delousing. Care should be taken that all articles of clothing 
including gloves and shoes are disinfested. 
Section III 
ORAL HYGIENE 
H 222. Definition.—As used herein the term “oral hy- 
giene” includes all those measures which the individual may 
practice and apply to himself and which are designed to 
increase or maintain the healthful condition of the oral 
cavity. It does not include those professional measures which 
are rendered by a dental surgeon to a patient for a similar 
purpose. 
■ 223. General Measures.—a. General.—In the Military 
Establishment these measures are largely restricted to the 
proper use of the toothbrush and various cleansing agents. 
Each recruit on enlistment is issued a toothbrush as a part 
if his initial equipment. Thereafter each soldier must pro- 
/ide all toilet articles at his own expense. 
(1) Because these measures are futile unless habitually 
jracticed, it is obvious that the individual will have to be 
rained and disciplined with respect to their performance 
mtil he can be depended upon to practice them thoroughly 
without supervision. The acquisition of habits of oral hygiene 
; a matter of education and training, and the training must 
e based upon proved methods and upon professional advice 
f qualified dental officers. 
(2) The best place for the initiation of training measures 
; at permanent stations, and mobilization, and training 
amps. Correct habits of oral hygiene may be practiced with 
rofit under all conditions, but it is only under conditions 
here training is the primary objective that sufficient super - 
ision may be exercised to assure the development of correct 
abits in an adult who has not previously been trained. 
b. Responsibility of commanding officers and dental of- 
fers.—The dental officer serves too large a command to FIELD SANITATION 
223-224 
exercise the constant supervision that is essential to the 
acquisition of correct habits of oral hygiene. The organiza- 
tion commander is the only person who is in a position to 
inculcate these habits in the members of his command. His 
efforts must be based upon the advice of the specialist, the 
dental officer, whose responsibility is to initiate instruction. 
Even the most ardent efforts will not result in success unless 
they are supplemented by educational measures that will 
make the soldier see the profit and comfort that will follow 
the invariable practice of these habits. This educational 
feature is a most important phase of this matter and the 
one that is of vital concern to the dental officer. 
■ 224. Educational Measures.—Educational measures along 
this line may be roughly divided into efforts directed at 
groups and efforts directed at individuals. In instructing 
either groups or individuals it will be found that it can be 
best accomplished by the following methods: 
a. Exhibits, including actual cases showing the results of 
good or bad hygienic habits, pictures, and demonstrations of 
methods. 
b. Lectures. 
c. Exercises. 
159 CHAPTER 15 
VITAL STATISTICS 
Section I. Statistical rates and strengths 225-227 
II. Methods of computing rates and ratios 228-231 
Paragraphs 
Section I 
STATISTICAL RATES AND STRENGTHS 
■ 225. General.—The Medical Department officer in the field 
has to be familiar with elementary statistical methods as 
there are certain reports which require, not only the report- 
ing of the absolute number of cases, but the rate of occurrence. 
■ 226. Rates.—a. A statistical rate is the number of times 
an event occurs in a definite number of people during a given 
period of time. In order to calculate a rate the following 
must be known: 
(1) Frequencies of the event (cases, deaths, etc.). 
(2) Strength. 
(3) Period of time. 
h. Army vital statistics are figured as rates per 1,000, that 
s, a strength of 1,000 is used as a base. In other places 
10,000 or 100,000 may be used, but it is best to use the same 
igure at all times in order to make rapid and accurate 
■-omparisons. 
c. In addition, Army rates are estimated on an annual 
tasis. That is, a rate of so many cases per 1,000 per annum, 
f in a command of 1,000 men there are 10 cases of measles 
luring any one month and the rate per 1,000 for the year is 
lesired, the 10 would be multiplied by 12. The result in this 
ase would be 120 and as there were 1,000 troops, the rate 
muld be 120 per 1,000 per annum. Here we have assumed 
hat the same number of cases would occur during each of 
be remaining eleven months of the year. In most cases the 
trength is not in even thousands so additional calculations 
re required. 
I 227. Strength.—By strength is meant the number of in- 
ividuals present at a certain time or during a certain period. FIELD SANITATION 
227-228 
To obtain the average strength of a command for a given 
number of days, the strengths for each day are added and 
divided by the number of days in the period, the result being 
the average strength. 
Section II 
METHODS OF COMPUTING RATES AND RATIOS 
■ 228. Formula for Estimating Rates.—The following for-l 
mula will be found valuable in computing rates per 1,000 pen 
annum for any period; : 
Number of events .. One year (expressed in days, 
in the period ’ weeks or months), 
v Number of days, weeks or 
Mean strength X . . . . , 
months m the period 
To illustrate, suppose there were 12 cases of measles in { 
command of 610 in a 5-weeks’ period. What is the rate pe 
1,000 per annum? j 
12X1,000X52 „ 
610X5 204,5 
Here the number of events (cases) is 12 and this is multi 
plied by 1,000 and by 52. The figure 52 represents one yea 
expressed in weeks. This result is divided by the strengt 
multiplied by 5 (the number of weeks in which the 12 cas< 
occurred). J 
Suppose these cases had occurred in one calendar mont 
then 
12X1,000X12 
610X1 ~236-0 
In this case the year is expressed by 12, the number of mont 
in one year, and the strength is multiplied by one, there beb 
one month in the period. 
If these events occurred, in say 18 days, then the formi j 
would be— 
12X1,000X365 _ 
610X18 —398.0 
Most of the morbidity records prepared by camp or stati 
surgeons cover a 4- or a 5-weeks’ period so that the fl 
example shown here would be the one to follow. 
161 P.28-229 
MEDICAL FIELD MANUAL 
For a more extended discussion see FM 8-55 or TM 8-255 
(now published as Army Medical Bulletin No. 23). 
H 229. Noneffective Rate.—The noneffective rate is a daily 
rate and is the number of men sick in hospital or quarters 
per 1,000 strength on the day for which it is calculated. 
The noneffective rate is employed to determine the number 
of troops in a given command that are physically fit for duty 
on a given day, or the average daily noneffectiveness caused 
by a disease during a selected period of time. 
The noneffective rate for a given day may be calculated as 
follows; 
Number of sick X 1,000 
Noneffective rate = -57 rr 
Strength 
The following formula may be used to determine the aver- 
ige daily noneffective rate for a period of more than one 
lay : 
. Sum of number sick daily X 1,000 
Noneffective rate = ■=-—r. —r 
Sum of daily strengths 
The following formula may also be used to determine the 
aily noneffective rate: 
r _ . Total days lost 1,000 
loneffective rate = j— r———r—-,X t—r.— — 
No. ox days in period average daily strength 
Thus, if in a command of 500 troops, 10 men are sick on a 
iven day, the noneffective rate is 20 per 1,000 troops. It is 
ilculated as follows: 
„T • 10 x 1-000 
Nonerfective rate per 1,000=——— 
10,000 
— 500 
= 20 
If four cases of measles occur in a command of 500 troops 
iring one month and these cases are sick for 10, 12, 14 and 
days, respectively, the noneffective rate may be calculated 
follows: 
_ (10+12 + 14 + 14) X 1,000 
Noneffective rate 1,000 = 30X 500~ 
= 50,000 
15,000 
= 3.33 
162 FIELD SANITATION 
229-231 
Or: 
_ _ _ . 50 1,000 
Noneffective rate=^X'-jjQ^- 
= 1.666X^ 
= 1.666X2 
= 3.33 
In 1928 the total United States Army, consisting of 134,380 
troops, lost 73,144 days from duty because of influenza, or, as 
expressed by the noneffective rate, 1.49 men out of every 1,000 
troops were incapacitated for duty each day of the year. 
This is determined by the following calculation: 
73,144 1,000 
Noneffective rate per 1,000=- 355 ~X 330 
1,000 
= 200-39X 
= 200.39X0.00744 
= 1.49 
■ 230. Prophylactic Rate.—In the report of venereal dis- 
eases the prophylactic rate is required. That is, the numbei 
of men per 1,000 strength who have taken venereal prophy- 
laxis during the month. This rate is obtained as follows; 
Number of prophylactics 1,000 
administered Average daily strength 
■ 231. Ratios.—Ratios are used to express relationships be 
tween frequencies of occurrence of related events. Ratio 
are usually expressed in percent (per 100). A case fatalit 
rate is the ratio of deaths from a specific disease to the num 
ber of cases of the disease. If during an epidemic of menin 
gitis there were 120 cases and 30 of them died, the case fa 
tality rate would be 25 calculated as follows: 
. .. 30X100 
Case fatality rate = —— 
= 0.25X100 
= 25 
163 INDEX 
Antirat campaigns, organization of 196 138 
Paragraph 
Page 
Baits, rat: 
Distribution 186 134 
Preparation 185 134 
Trap 190 136 
Bath and wash water disposal 82 66 
Bathing for lice disinfestation •, 169 123 
Bored hole latrine 65 46 
Botulism, meat poisoning 114 86 
Buildings, mess 97 73 
Butter 126 95 
Campaigns, antirat, organization 196 138 
Camps, observation or detention 13 9 
Care: 
Compost piles 87 69 
Feet 219 153 
Garbage stands and cans 74 60 
Latrines 68 48 
Charts and reports, statistical 15 11 
Chemical prophylaxis 30 23 
Individual 33 24 
Classification: 
Diseases: 
Communicable 6 5 
Insect borne 24 21 
Intestinal 19 17 
Respiratory 16 12 
Lice 166 121 
Rats 180 132 
Wastes 54 39 
Collection of garbage 72 58 
Communicable diseases, other means of prevent- 
ing 14 1C 
Compost bin 88 7C 
Concurrent and terminal disinfection 22 1£ 
Condensed milk ; 125 9< 
Conduct of— 
Examinations and inspections, general 215 14S 
Sanitary survey 199 14 i 
Water reconnaissance 51 3‘ 
Control measures 21 11 
Lice 168 12 
Mosquitoes 148-159 111-11; 
Rats 182 13: 
Treatment of venereal diseases as 34 2 
Dairy farms 122 9 
Data, epidemiological 209 14 
Definition of special terms 9 
165 INDEX 
Paragraph 
Page 
Delousing plant, operation 178 131 
Destruction of adult flies 130 97 
Detention or observation camps 13 9 
Development of the housefly 127 96 
Disease: 
Healthy carriers 210 147 
Transmission by food 113 86 
Transmitted by lice 165 121 
Dishwashing 100 74 
Disinfection, concurrent and terminal 22 19 
Disinfestation of clothing and equipment 170 126 
Disinfestors: 
Hot air, improvised 173 129 
Mobile 171 126 
Disposal of— 
Bath and wash water 82 66 
Manure: 
As fertilizer 89 70 
Composting 86 67 
Contract 85 67 
Drying 90 70 
Incineration 91 70 
Wastes: 
Human: 
Bivouac 59 40 
Camps 60 42 
Marches 58 40 
Kitchen 101 77 
Distribution and breeding habits, mosquitoes 145 109 
Dumps, rubbish: 
Construction 93 71 
Maintenance 94 71 
Cggs 119 89 
Engineer water supply equipment 44 29 
Environment, influence of 10 8 
Epidemiological data 209 145 
Epidemiological investigation 206 144 
Outline 208 144 
Recommendation 207 144 
Establishment of quarantine 12 9 
Estimation of stream flow 41 27 
Examinations and inspections, conduct 215 149 
Examining units, organization 216 150 
'eet, care 219 153 
ish 120 89 
'lies 127-130 96-97 
’ly— 
Baits 134 102 
Paper 136 104 
Poisons 137 104 
Sprays 138 105 
Swatting 139 105 
166 INDEX 
Fiy-Continued. Paragraph Paj 
™*0»re 135 1. 
Location 133 H 
Stands 132 H 
Types !31 : 
Wires 13® 11 
Food: 
Disease transmission by 
Handlers *04 
Inspection, on receipt 9° 
Method of serving 103 
Served: 
Character X02 
Methods of formulating menus 102 
Storage facilities 99 
Forms for sanitary survey 19° 1 
Pormula for statistical rate estimation 
Fumigation, rat I92 1 
70 
Garbage 
Cans, care i* 
Collection 72 
Disposal methods 71 
Stands 16 
Care 
Transfer stations 7t> 
General control measures; 
Diseases: 
Intestinal 2i 
Venereal ■--- 28 
General importance and prevalence of intestinal 
diseases 
Grease traps 'a 
Housefly (musca domestica) : 
Destruction of adult 130 
Development 
Habits tending toward control 7*a 
Range of flight 128 
Identification of mosquitoes___ 144 
Individual chemical prophylaxis 
Influence of environment 7a 
Insect-borne diseases 28 
Classification 2* 
Transmission 20 
Inspection: OR 
Food, on receipt 98 
Physical 217, 2*8 150, 
Intestinal diseases 
Classification 
Importance and prevalence 
Kitchen wastes, disposal 1°1 
167 INDEX 
itrine: Paragraph Page 
Bored hole 65 46 
Box, standard Quartermaster 61 43 
Care 68 48 
Location 67 48 
Material for one _ 64 45 
Pail type 69 49 
Seating space 57 40 
irvicides: 
Paris green 157 116 
Phenol 156 116 
00 • 
Classification 166 121 
Control measures 168 121 
Diseases transmitted by 165 121 
Disinfestation: 
Clothing and equipment 170 126 
Methods: 
Bathing 169 123 
Chemical 177 130 
Hot air 173 129 
Hot iron 174 129 
Hot water 175 130 
Storage 176 130 
Life cycle 167 121 
lUid wastes 76, 77 61, 62 
cation of fly traps 133 102 
ster Bag (water-sterilizing bag) 45 30 
;nure 83 66 
1 Collection 84 66 
Compost bin 88 70 
Disposal: 
As fertilizer 89 70 
Composting 86 67 
Contract 85 67 
Drying 90 70 
Incineration 91 70 
ps and conventional signs for water supply 53 36 
rches, water discipline on 48 33 
terial for one latrine 64 45 
;at and meat food products 108 84 
i Preservation 110 85 
Sanitary inspection: 
Canned 117 88 
i Cured 116 88 
Fresh 115 86 
i Spoilage 109 84 
Storage, in temporary camps 112 86 
it poisoning, botulism 114 86 
shanical prophylaxis 29 22 
iical Department, sanitary control of water 
apply 36 25 
aus, method of formulating 102 77 
s: 
Buildings 97 73 
Personnel, training in mess sanitation 105 79 INDEX 
Mess—Continued. Paragraph Pag 
Sanitary control 96 ’j 
Sanitary inspection 106 ' 
Outline .tor 107 f 
Sanitation administration 95 r 
Methods: 
Garbage disposal 71 J 
Food serving 103 ' 
Formulating menus 102 1 
Venereal prophylaxis application 32 
Military sanitation: 
Purpose 1 
Responsibility for 2 
Military sanitation program, principal objects 8 
Milk 124 
Condensed 125 : 
Missed cases 211 1 
Mobile disinfestors 171 1 
Mosquito 141 1 
Control measures: 
Adult destruction 159 
Artificial water container elimination 153 
Destruction by natural enemies 158 * 
Ditches: 
Construction, factors in 148 S 
Lined 149 
Open 147 
Drainage 146 
Filling in low areas 151 v 
Oil application 155 
Oiling J 154 
Phenol larvicide 156 
Stream training 152 
Subsurface drainage 150 
Distribution and breeding habits 145 
Identification 144 
Life cycle 142, 143 106, 
Nets 161 
Repellents 162 
Screening 160 
Surveys 163 
Methods of conducting 164 
Objects of preventive measures 26 
Observation or detention camps 13 | t 
Operation; ? 
Delousing plant 178 
Prophylactic station 31 
Soakage pit and trench 81 
Oral hygiene: ; 
Definition 222 
Educational measures 224 
General measures 223 
Organization of examining units 216 
Outlines for— 
Epidemiological investigation 208 
Sanitary inspections, mess 107 i 
Pail latrines 69 
169 INDEX 
Paragraph. 
Page 
•aris green larvicide 157 116 
"asteurizing establishments 123 93 
nenol larvicide 156 116 
hysical examinations 212 149 
hysical inspections 217, 218 150,153 
Dultry 118 88 
reservation of meats 110 85 
revalence of venereal diseases 27 22 
reventive measures, disease 17 12 
Objects of 26 21 
i Responsibility for initiation and enforce- 
ment 7 5 
■imary factors In spread of disease 11 8 
incipal objects of military sanitation programs. 8 6 
ophylactic— 
Rate 230 163 
Station, operation 31 23 
ophylaxis: 
Application, method 32 23 
Chemical 30 23 
Individual 33 24 
Mechanical 29 22 
rification of temporary water supply 43 29 
rpose of military sanitation 1 1 
establishment 12 9 
artermaster Corps, responsibility for water sup- 
ly 35 25 
t 179 132 
Bait: 
Preparation 185 134 
Distribution 186 134 
Classification 180 132 
' Control procedures 182 133 
Fumigation 192 136 
Habits 181 132 
Poisoning 184 133 
Prebaiting 187 135 
Proofing 183 133 
193 137 
To determine— 
Degree of infestation 195 137 
Presence of plague infected 194 137 
Trapping 188 135 
Praps, types 189 135 
3S 231 163 
igerators, small 111 85 
llents, mosquito 162 119 
,>rts and charts, statistical 15 11 
lirements of troops, water 39 26 
iratory diseases, classification 16 12 
bnsibility for— 
hitiation and enforcement of preventive 
measures 7 5 
’hysical examinations 213 149 INDEX 
Responsibility for—Continued. Paragraph Page 
Sanitation 2 1 
Waste disposal 55 39 
Water reconnaissance 50 34 
Water supply by Quartermaster Corps 35 25 
Rubbish dumps 92 70 
Construction 93 71 
Maintenance 94 71 
Sanitary— 
Control of water supply by Medical Depart- 
ment 36 25 
Details 4 3 
Inspections: 
Meats: 
Cured 116 88 
Fresh 115 
Meat foods, canned 117 88' 
Messes 106 79 
Orders 200 141 
Form 205 142 
Preparation 202 141 
Responsibility 201 141( 
Scope 203 142 
Submission 204 142 
Supervision 3 2 
Survey, coinduct 199 141 
Sanitation, in theater of operation 5 3 
Scabies 221 }« 
Screening, mosquito 160 ill 
Sea foods 121 
Seating spaces, latrine 57 4( 
Serbian barrel 172 12‘ 
Soakage— 
Pits: 
Liquid waste 78 61 
Operation 81 6( 
Urinal : 66 4 
Trench 80, 81 66, 6 
Sodium arsenite 140 10 
Special terms, definitions 9 
Spoilage, meat 109 8 
Spread of disease, primary factors in 11 
Standards for physical qualifications 214 14 
Statistical charts and reports 15 1 
Statistical rates 225, 226 16 ( 
Formula for estimation 228 16 
Noneffective 229 16 
Statistical strengths 225, 227 16 
Storage: 
Facilities, food 99 
Meat and meat food products in temporary 
camps 112 > 
Stream— 
Flow estimation 41 
Training I52 1' 
Summaries, points covered and reported on, water 
reconnaissance — 62 
171 INDEX 
Surveys; Paragraph Page 
Mosquito 163 119 
Methods of conducting 164 120 
Rat 193 137 
To determine— 
Degree of infestation 195 137 
Presence of plague infested 194 137 
Sanitary 197 139 
Form for 198 139 
Tinea Cruris 220 155 
Trap— 
Baits 190 136 
Setting 191 136 
Types 189 135 
Urinals 62 43 
Protection 63 45 
Urine soakagq pits 66 46 
Venereal diseases: 
General control measures 28 22 
Prevalence 27 22 
Treatment of, as a control measure 34 24 
Wastes: 
Classification 54 39 
Disposal: 
Human „ 56 40 
In bivouac 59 40 
In camps 60 42 
On marches 58 40 
Kitchen r 101 77 
Liquid 76 61 
In bivouac 77 62 
Responsibility for 55 39 
Water— 
Discipline, on marches 48 33 
Hardness 38 26 
.Reconnaissance 49 34 
Conduct 51 34 
Responsibility for 50 34 
Summary of points reported on 52 35 
f Requirements, troops 39 26 
Sources, ground or surface 40 27 
Sterilization, other emergency measures used- 47 32 
Supply- 
Equipment, Engineer Corps 44 29 
Maps and conventional signs for 53 36 
1 Quartermaster Corps responsibility for 35 25 
Sanitary control by Medical Department- 36 25 
i Temporary, purification 43 29 
i Turbidity 37 26 
Wash and bath, disposal 82 66 
fater-sterilizing bag (Lyster bag) 45 30 
' Technique for use 46 31 
ells, yield 42 28 FM 8-40 
C 1 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Changes 1 
No. 1 J 
WAR DEPARTMENT, 
FM 8-40, August 15, 1940, is changed as follows: 
Washington. June 12, 1942. 
CHAPTER 16 (added) 
Paragraph; 
Section I. General-.- 232-23* 
II. Control of communicable diseases 235—23- 
III. Feeds and feeding 239—24 
IV. Stable management 243—25* 
V. Statistics and reports - - 251-25 
VETERINARY SANITATION 
Section I 
GENERAL 
■ 232. Responsibility.-—a. The Veterinary Corps is charge 
with advisory and inspectorial duties under two headindgs : 
(1) Preservation of the health and efficiency of militai 
animals. 
(2) Protection of the health of military personnel, and tl 
economic interests of the Government, through the inspecth 
of all food supplies of animal origin to insure that they a 
sound, healthful and fit for human consumption, and that th 
comply with contract specifications. In carrying out the 
functions the veterinarian of a command is considered as 
medical inspector. (See par. 2d.) 
b. This chapter deals only with sanitation pertaining 
military animals. For hygienic control of food products 
animal origin see chapter 6. 
■ 233. Hygiene.—Good veterinary hygiene implies an envin 
ment conducive to animal health. It includes such factors 
adequate nutrition; clean, dry, well-ventilated, and comforta 
stables; proper care of the skin and feet; correct, progress 
exercise, and conditioning; well-fitted equipment; prope 
trained attendants; protection from contact with diseased s 
555798°—43- 12 MEDICAL FIELD MANUAL 
mals; and protection from accidental injury. Its object is to 
maintain a high state of natural resistance to disease and to 
prevent disability. 
■ 234. Military Animals. — The life of a military animal 
parallels rather closely that of a soldier. He is inducted (pur- 
chased) while still young and usually has not been through the 
common diseases of colthood. He comes from various parts of 
the country and immediately finds himself among large groups 
of other animals at a reception center (remount station). He 
is in strange surroundings. His processing involves frequent 
handling, sorting, inspections, inoculations, and movement from 
one place to another. The climate may he radically different 
from that at his home, his food and water are different, he is in 
a greater or less state of excitement. In short he is in an 
environment charged with many predisposing causes of disease, 
md unless correct hygienic measures are maintained disastrous 
-esults will occur. Further, some of these conditions obtain 
hroughout his military career. He differs from the soldier in 
)eing inarticulate and nmst therefore depend on the ability of 
in attendant to detect objective symptoms of abnormality. 
Section II 
I 235. General.—The control of communicable diseases among 
lilitary animals is of the greatest importance. They not only 
onstitute one of the chief causes of disability among such ani- 
mls, but also, in some cases, are directly transmissible to man 
nd tltus create a menace to human health. These diseases are 
iread among animals in exactly the same way as among men. 
riefly this involves the presence of infective organisms in a 
ck animal or contaminated equipment, their transmission by 
irect or indirect contact to a susceptible animal, and their 
irther propagation within the susceptible animal. (See 
n. 11.) 
236. General Measures of Control.—a. Since there are three 
•imary and essential factors concerned in the spread of all 
inmunicable diseases, as indicated in the preceding paragraph, 
rtain general measures of control are applicable regardless 
the specific disease present. The objective is to remove one 
CONTROL OF COMMUNICABLE DISEASES 
174 FIELD SANITATION 
or more of these factors and tltus break the chain of trans- 
mission. Such measures include— 
(1) Frequent inspection to locate the infected animal before 
the disease becomes widespread. 
(2) Isolation of cases and quarantine of the contacts. 
(3) Preventing contact, direct or indirect, paying particular 
attention to indirect contact through the medium of attendants, 
birds, dogs, rodents, insects, equipment, waste material, etc. 
(4) Attacking the infection by thorough cleaning and disin- 
fection of contaminated premises and equipment. 
(5) Raising the natural resistance of the susceptible animal 
by maintaining a high standard of hygiene. 
(6) Being suspicious of all newly arrived animals as they 
may appear healthy but, as incubationary carriers, capable of 
infecting others. Quarantine for at least 21 days. 
(7) Keeping in touch with local livestock sanitary commis- 
sions and similar officials with a view to determining the types 
of disease prevalent among civilian animals. 
(8) Avoiding known centers of infection so far as practicable. 
6. For a definition of various terms used in connection with 
general measures for disease control see paragraph 9. 
■ 237. Specific Control Measures.—a. Specific measures for 
the control and eradication of communicable diseases are used 
whenever the nature of the disease renders such action appli- 
cable and practicable. Specific measures are based on the 
known behavior of the organism causing the disease. In 
military animals these measures include— 
(1) Diagnostic tests made with a view to locating carriers. 
Example: Mallein test for glanders. 
(2) Immunization through the use of agents which produce 
various degrees of artificial immunity. Example: Equine enceph- 
alomyelitis vaccine. 
(3) Eradication of vectors which are known to be spreaders 
of the disease. Example: Vampire bats in the case of rabies. 
(4) Immediate destruction of cases affected with a disease 
in which the treatment is considered uneconomical due to the 
hazards of transmission to other animals. Example: Surra. 
h. In some diseases two or more specific measures of control 
may be applicable, but they should always be supplemented by 
instituting the general measures previously outlined. Constant 
175 MEDICAL FIELD MANUAL 
surveillance is necessary and prompt and energetic action 
should be undertaken with a view to the complete eradication 
of the disease from a command. 
■ 238. Common Communicable Diseases Affecting Military 
Horses and Mules.—a. Influenza and distemper {so-called ship- 
ping diseases).—This group of diseases is widespread and prob- 
ably causes more morbidity among military animals than all 
others combined. It is primarily a disease of colthood and 
may be expected to occur whenever large numbers of young 
unseasoned animals are congregated. Long shipments, fatigue, 
exposure, radical change in climate, and similar environmental 
conditions predispose young animals to the disease. 
(1) General preventive measures.—Close observation to detect 
insipient cases; isolation; quarantine. Maintain a high stand- 
ard of hygiene with special reference to nutrition; keep stables 
well ventilated; avoid fatigue and exposure. Do not ship sick 
animals. 
(2) Specific control measures.—None. 
b. Skin diseases {mange, ringworm).—Ringworm is more or 
less constantly prevalent among remounts, and such animals 
should always be suspected of harboring the causative agent 
with or without visible lesions. Mange is a typical wartime 
disease, wherein the animal is pre-disposed through inadequate 
care of the skin. Both diseases will spread rapidly, usually by 
indirect contact through the medium of horse covers, saddle 
blankets, grooming kits, attendants’ clothing, and similar equip- 
ment. They result in disability through the loss of hair, 
interference with the normal function of the skin, and may be 
complicated by secondary infection. (See ch. 14 for a descrip- 
tion of these diseases affecting man.) 
(1) General preventive measures.—Keep the skin clean by 
thorough daily grooming. Close and frequent inspections for 
visible lesions. Immediate isolation of cases and quarantine 
of contacts. Clean and disinfect horse covers, saddle blankets, 
and grooming kits. Avoid the interchange of equipment from 
one animal to another. 
(2) Specific control measures.—Consider all remounts as 
contacts with ringworm. Clip their bodies, burn the hair, and 
scrub the entire body with lime and sulfur dip at 100° F. 
Repeat in 10 days and give a third application just prior to 
176 FIELD SANITATION 
release from the routine remount quarantine period. Cases of 
ringworm (in isolation) may be successfully hand treated. 
Mange cases require evacuation to a special mange hospital 
equipped with a dipping vat. 
c. Glanders.—A serious, usually chronic, disease primarily 
affecting horses and mules hut also directly transmissible to 
man. Spread by direct or indirect contact with infective dis- 
charges, chiefly from the respiratory tract. Characteristic 
lesions may occur in the mucous membrane of the nostrils or 
in the skin, but the greatest danger results from carriers show- 
ing no visible lesions. Glanders is a very old disease, prevalent 
throughout the entire world, and its incidence in the U. S. Army 
has been comparatively high, up to and including the early 
part of the first World War. 
(1) General preventive measures.—Suspect and quarantine all 
replacements, including stray or captured animals, until proven 
by tests that they are free from this disease. 
(2) Specific control measures.—Glanders is easily and read- 
ily controlled by routine “mallein tests,” immediate destruc- 
tion of positive cases, absolute quarantine of contacts, and 
thorough cleansing and disinfection of contaminated premises 
and equipment. The objective is early diagnosis and complete 
eradication of the disease before it becomes widespread. The 
standard field test is made by the intradermic injection of 
“mallein,” supplemented, in suspicious reactions, by the com- 
plement fixation test. Army animals are required to be given 
the mallein test under the following situations (see AR 
40-2100) : 
(a) At time of purchase. 
(&) Just prior to release from 21-day quarantine period 
which all are required to undergo upon arrival at any station. 
(c) Before issue, shipment, or transfer from one station 
to another, unless tested within the preceding 21 days. 
id) Before embarking on an animal transport, unless tested 
within the preceding 21 days. 
(e) In the case of captured animals. 
if) In the case of contacts with clinical cases or positive 
reactors. 
iff) In the case of suspicious clinical symptoms. 
(h) At least once each year in the case of every anima 
177 MEDICAL FIELD MANUAL 
not previously tested, within 21 days, under one of the fore- 
going situations. This is known as the “annual test,” and, 
so far as practicable should be made between the dates of 
September 15 and October 31. 
(3) Very few and only sporadic cases of glanders have 
occurred in the Army during the past 20 years, due entirely 
to control measures being carried out along the lines outlined 
herein. 
d. Equine encephalomyelitis.—An acute, seasonal disease 
caused by a virus, the behavior of which is as yet not fully under- 
stood. Two forms of virus have been demonstrated and while 
originally considered infective only for horses and mules, 
other animals and man are now known to be susceptible. The 
disease is transmitted by mosquitoes and probably by other bit- 
ing insects. It occurs throughout the United States during the 
summer months. Its incidence and virulence is variable from 
year to year but the mortality is relatively high in all instances. 
It occurs more commonly among range animals than among 
stabled animals. 
(1) General preventive measures— Protection from biting 
insects through mosquito control and by keeping in darkened 
stables when not at work. Close observation for early symp- 
toms of incoordination. Isolate cases for treatment in screened 
stalls. 
(2) Specific control measures.—Active, annual, immuniza- 
tion of all horses and mules with specific vaccine, administered 
shortly before the advent of the “mosquito season.” The pres- 
ent method (1942) in the Army is to use bivalent vaccine admin- 
istered intradermally. This product produces a high degree of 
immunity against both the “Eastern” and “Western” types of the 
disease. 
e. Anthrax.—An acute septicemia, affecting many species of 
the lower animals, particularly cattle, sheep, horses, and mules. 
Also occurs in man hut usually as a local infection of the 
skin. It is transmitted largely through contaminated forage 
due to improper disposal of anthrax cadavers. Anthrax infected 
areas are numerous throughout the southern and northwestern 
States, where, following floods or other conditions favorable for 
the growth of the causative organism, enzootics frequently occur. 
The anthrax bacillus is a spore bearer, and areas once infected 
may remain so indefinitely. Outbreaks have occurred in military 
178 FIELD SANITATION 
animals due to contaminated forage harvested from such areas 
and transported considerable distance. 
(1) General preventive measures.—Keep in touch with the 
local health authorities whenever located near anthrax dis- 
tricts. Determine the source of the forage, especially if 
marching through areas known to be infected. Cases of deatli 
in such localities from causes not clearly diagnosed should 
be quickly cleared up by laboratory examinations, at least 
so far as to determining the presence or absence of anthrax. 
Early diagnosis is particularly important. 
(2) Specific control measures.—Immediate destruction of 
eases with proper disposal of their carcasses. Thorough clean- 
ing and disinfection of the premises. Search should be made; 
for the source of the infection, and if practicable a new supply 
of forage obtained for use during the investigation. Adjacent 
rivers and inundated areas should be suspected. Contacts 
should be placed under absolute quarantine and all animals 
of the command immunized with anthrax bacterin. 
f. Dourine.—A disease of solipeds caused by a blood parasite 
(trypanosome) transmitted by coitus and commonly caller 
“horse syphilis.” It is primarily a disease of breeding ani 
mals and was formerly quite prevalent in the western am 
southwestern States among bands of range-bred horses. I 
has been largely eradicated from the United States except ii 
the southwest. It is of interest to the Army from the view 
point of the remount breeding plan and particularly in Conner 
tion with remount stallions placed with civilian agents. Case 
have been found among young mares and even geldings pui 
chased for regular troop service (nonbreeders). These an 
mals are infected on the range through uncontrolled breedin 
due to late or improper castration of young stallions. 
(1) General preventive measures.—Keep current inform: 
tion from the livestock health authorities in States where tl 
disease is known to exist. Do not permit uncontrolled raiq 
breeding. 
(2) Specific control measures.—The disease can be diagnost 
by complement fixation test. Blood serum should therefore 1 
taken from all breeding mares and stallions at time of pu 
chase, and at intervals thereafter, especially when stallio 
are moved from one agent to another. In case of an outbm 
179 MEDICAL FIELD MANUAL 
reported from a given area, all animals recently purchased 
therein should be tested and further purchasing discontinued 
until the disease is brought under control. Positive cases are 
destroyed. 
g. Rabies.—An acute, fatal disease caused by a specific 
virus, widespread throughout the world among dogs, cats, and 
other carnivorous animals. All species, including man, are 
susceptible to this disease. It is transmitted through the 
saliva by bites from infected animals. Wild animals such as 
foxes, squirrels, wolves, and vampire bats are often an im- 
portant factor in the spread of rabies, but dogs are the most 
commonly implicated due to their large numbers and their 
close association with man. 
(1) General preventive measures.—Proper care and control 
of dogs. Destruction of predatory animals. 
(2) Specific control measures.-—Suspect all dog bites and if 
the offending animal is known, put in quarantine for a period 
)f observation. Do not destroy. If the dog or bitten animal 
lies, send the entire head in an iced container to the nearest 
aboratory for examination. All dogs should be registered and 
mmunized by the annual use of rabies vaccine. Stray and 
iwnerless dogs should be destroyed. 
h. Tetanus.—Tetanus is not a contagious disease but is in- 
luded here because it exists practically everywhere through- 
ut the world, and unless protective measures are instituted it 
lay cause a high death rate following certain types of wounds, 
'etanus is caused by an anaerobic bacillus which readily 
ropagates in deep penetrating wounds. Gunshot wounds, 
owder burns, and penetrating wounds of the horses’ feet and 
•wer legs must be considered as infected with the bacillus of 
itanus and treated accordingly. Mortality from this disease 
very high but prevention is relatively simple. 
(1) General preventive measures.—None other than the usual 
easures to prevent wounds from street nails, kicks, and other 
'cidental injuries. 
(2) Specific control measures.—(a) The two methods avail- 
de are— 
1. Passive immunity through the injection of specific 
antitoxin immediately following injury. 
2. Active immunity through the use of tetanus toxoid. FIELD SANITATION 
(6) The Army is now using the latter method and the toxoid 
treatment is normally given to all animals at a remount station 
during their routine processing. The Horse Record Card will 
show whether or not an animal has had this protection. In 
case of doubt the antitoxin should be used. Fifteen hundred 
units is the average protective dose. 
Section III 
■ 239. Administration.—In mounted units of the Army, ani- 
mals are assigned to a troop, battery, or similar organization 
and administered by the commanding officer. Ordinarily the, 
troop commander will assign a junior officer as the “stable 
officer” and hold him directly responsible for the feeding and 
genera] well being of the animals. 
FEEDS AND FEEDING 
■ 240. Rations.—a. A ration for a horse is the amount 
forage (feed and bedding) authorized for 24 hours. A fee( 
is that part of the ration which is given to the animal foJ 
one meal. Pour basic types of rations are authorized fo 
Army animals (see Alt 30-480). These are the standan 
garrison ration, the variation ration, the field ration, and th 
emergency ration. 
ft. The amounts authorized vary for different species an 
different weights of animals, and certain substitutions an 
conversions of the various components may be made at tl 
discretion of the post commander. In addition to species ar 
weight there are other factors which influence the amount < 
forage required by an individual animal. These include tl 
amount and type of work performed, the state of flesh, tl 
general health, protection from the elements, feeding facilith 
and the temperament of the individual as a so-called “eas 
or “hard” keeper. Since all horses and mules require about t 
same amount of roughage (hay), individual needs are si I 
plied by varying the amount of concentrates (grain). Pi 1 
commanders are responsible that the ration is properly hand! I 
to meet individual needs without waste. The veterinarian I 
responsible for keeping commanding officers advised of methc I 
used and to recommend practicable measures for the correct] I 
of defects. I 
181 c. So far as practicable the variation ration should be used, 
as th'e more components included in a ration the more prob- 
ability of supplying all of the essential elements of nutrition. 
Alfalfa hay is considered particularly desirable. 
■ 241. Procurement, Inspection, Storage. — a. All forage is 
procured by the Quartermaster Corps and issued in kind on 
requisitions approved by the commanding officer. Requisitions 
are normally submitted monthly and, in reasonable amounts, 
may be overdrawn or underdrawn up to June 30, at which 
time a complete balance for the year must be effected. If 
overdrawn the forage must be made up. If underdrawn the 
balance reverts to the quartermaster whether or not it is in his 
warehouse or in the stable. 
h. Forage is purchased on contract, indicating specific 
United States standards and inspected by the veterinarian on 
receipt to insure compliance with specifications. 
c. A 6-week to 3-month1 supply of forage is normally stored 
in the quartermaster warehouse. A 10-day supply is ordinarily 
stored in the troop stables. It is especially important that 
stored forage be protected from waste by rats, mice, birds, 
vermin, careless handling, etc. If stored on the ground floor 
he bottom tier should be raised by planks to permit a free 
‘irculation of air and prevent absorption of moisture. Like- 
vise, aisles should be provided in large warehouses to provide 
'entilation. The forage should be issued in the same order 
s received, as vermin may attack grain held for long periods 
f time, and old hay tends to become harsh and brittle. It is 
esirable to have facilities for cleaning and salvaging spilled 
rain. Torn or ruptured sacks should be repaired to prevent 
urthter loss. In the field the forage must be kept off the 
round by laying down poles, brush, or other dunnage, and 
ivered with paulins to protect it from rain and dew. Forage 
bsorbs moisture readily and unless properly protected it will 
;rment, heat, mold, and cake, not only resulting in a loss of 
le forage itself, but also may be the cause of serious digestive 
sturbances. The proper storage and use of forage with a 
ew to preventing waste is of paramount importance. The 
ithorized allowance is little enough for the animals of an 
’erage active mounted unit. If any appreciable amount is 
asted the result will be undernourished animals, ill-fitted 
MEDICAL E1EED MANUAL 
182 FIELD SANITATION 
for their normal duties. The objective for every pound of 
forage received should be the inside of an animal’s stomach. 
d. By careful handling it is not difficult to save on the grain 
allowance when in garrison. Where such a saving can be 
foreseen, advantage should be taken of the conversion prin- 
ciple wherein the money value of the saved grain may he 
converted to an equal value of hay or bedding, the allowance 
of which is barely sufficient for average needs. This results 
in an incentive for saving and also provides a more adequate 
ration. 
e. Since there is a radical difference in work performed 
throughout the course of a year, it is intended that forage 
accounts with the quartermaster remain open for 12 months, 
and a complete settlement made only on June 30. This pro- 
vides for the necessary flexibility of feeding in accordance 
with the animals’ needs, which could not be done were a more 
frequent settlement required. An active, well-trained, mounted 
unit will just about use up its forage allowance (money value) 
each year, and on June 30 will be approximately even in its 
forage account. A large shortage at this time would indi- 
cate waste. A large overage would indicate undernourished 
animals. 
f. Careful, accurate, daily records of forage must be main- 
tained by each unit, to include amounts received, fed, on hand, 
and the current overages or shortages with the quartermaster. 
These records are comparable to a checking account at a 
hank. Approved requisitions establish1 credit; issue slips are 
similar to checks written, and balances represent cash remain- 
ing in the bank. No logical feeding plan can be instituted 
without such records. 
■ 242. References.—For a more complete and detailed descrip- 
tion of feeding and watering principles see FM 25-5. 
STABLE MANAGEMENT 
Section IV 
■ 243. General.—Stable management refers to the genera 
care given the animal during the time he is in the stable. I 
implies some type of a permanent installation equipped witl 
the necessary facilities for protection from the elements, re 
straint, feeding and watering, rest, comfort, and the genera 
183 MEDICAL FIELD MANUAL 
well-being of military horses and mules. The various duties 
at a stable are performed by a crew of trained specialists in 
charge of a commissioned officer, all of whom are assigned and 
administered by the troop, battery, or similar commander. 
■ 244. Facilities.—The design, type of structure, fittings, etc., 
are relatively as variable in stable construction as they are in 
homes. They may be quite simple or very elaborate. Modern 
facilities are highly desirable, but they do not necessarily in- 
sure good stable management. There are certain minimum 
features, however, which are essential if a structure is to be 
considered a satisfactory place for stabling animals. These 
include a building of sufficient size to house the animals of a 
given unit; location in a well-drained area; containing firm, 
dry standings and aisleways which can be kept clean; sub- 
stantial stalls; stout, tight mangers with removable bottoms 
for easy and thorough cleaning (or other suitable feeding de- 
vices so constructed as to prevent waste of forage) ; adequate 
natural light and ventilation; an abundance of potable water, 
with' sanitary troughs in properly drained locations; storage 
for forage, stable tools, and horse equipment; fire-fighting 
equipment; horseshoeing shop, and quarters for the perma- 
nent stable personnel. 
■ 245. Methods.-—Methods of stable management are of far 
greater importance than facilities. Good methods require a 
conscientious stable crew familiar with the normal habits of 
the horse, interested in horsemanship, and well-trained in the 
various details of operating a stable in accordance with ap- 
proved sanitary principles. For a complete description of 
such principles see FM 25-5. 
■ 246. Stable Peksonnel.—a. The following personnel are 
ordinarily assigned to permanent duty at the stable: 
(1) Stable sergeant.—Under the direction of the stable 
ifficer, the stable sergeant is in charge of the stable, the crew, 
ind equipment at all times and of all horses within the stable. 
He directs the routine daily work around the stable, prepares 
he stable reports, draws and accounts for the forage, maintains 
he proper sanitary standards, observes the feeding and water- 
ng, and is responsible for the safety of the property and the 
general care of the animals in the stable. FIELD SANITATION 
(2) Stable orderly.—The stable orderly is the assistant 
stable sergeant. His chief duty is to feed the animals in 
accordance with the feeding and watering schedule and specific 
directions for individuals. He is familiar with the stable 
routine, assists with the work at hand, and is in charge during 
the absence of the stable sergeant. 
(3) Horseshoers.—Two or more horseshoers are necessary 
to maintain the shoeing, trimming, and care of the horses’ feet. 
The animals to be shod and the type of shoes to be applied are 
usually directed daily by the stable officer. The horseshoers, 
however, are a part of the stable crew, and under the direct 
charge of the stable sergeant. 
(4) Saddler.—The saddler is a skilled leather worker. He 
repairs the saddles, harness, bridles, halters, and similar 
horse equipment as directed by the stable sergeant. 
(5) Wagoner.—The wagoner is in charge of the team and 
wagon used for the daily hauling of manure and waste to 
the place of disposal, drawing forage and stable supplies, and 
for other routine transportation around the stable. 
b. Two or more stable police are detailed to clean the stable 
and perform such other tasks as directed by the stable sergeant. 
Stable police are ordinarily not permanently assigned to the 
stable. 
c. Stable guard during the daytime is a responsibility oi 
the stable crew. The stable sergeant or the orderly should b< 
present both day and night, either in the stable or in then 
adjacent quarters. Active night guard is provided as directee 
by the commanding officer. 
■ 247. Quarters.—Quarters for the stable crew are provider 
usually in a separate building adjacent to the stable. It i 
commonly known as the stable sex-geant’s “shack,” The sam 
standard of cleanliness, neatness, uniformity of beds, locken 
individual equipment, etc., required in the barracks shoul 
also be required in the stable sergeant’s quarters. To perm 
any semblance to a “shack” in these quarters will usual] 
result in similar standards within the stable. 
■ 248. Manure and Waste Disposal.—See section V. 
■ 249. Inspections.—Although the veterinarian is consider* 
a medical inspector he will usually have more success in rai 
ing and maintaining the standards of animal hygiene I 
185 MEDICAL FIELD MANUAL 
approaching the subject as an assistant to those directly 
responsible for such standards, rather than as an inspector 
representing higher authority. Commanding officers of mounted 
units are vitally interested in the condition of their animals 
and are eager for practicable suggestions for improvement. 
By daily contact the veterinarian gains their confidence and 
frequently can have some unsatisfactory condition immediately 
corrected by verbal advice. Nevertheless, he should have at 
least a mental outline of the features to be observed, and for 
formal inspections, in certain cases, it may be desirable to 
make written notes. Following is an outline which can be 
used for either purpose (see FM 25-5 for a definition of terms 
used) : 
a. Storage of hay and grain. Any evidence of waste? Does 
the ration appear adequate and well balanced? 
b. Individual feeding. Are the heel post cards legible and 
understood by the stable orderly? Are the horses in their 
proper stalls? How many bales of hay are fed? Does this 
make the correct allowance for the number of animals in 
the stable? Does the stable sergeant know how much the bales 
of hay weigh or does he guess their weight? Has the capacity 
of the grain measure been determined by actual weighing? 
c. Condition and cleanliness of the mangers and feed boxes? 
Is grain being wasted through the mangers? Do the animals 
have salt? Are they properly tied? 
d. Condition of the water troughs and buckets? Are the 
animals receiving sufficient water? Condition of halters, 
■leanliness and fitting? If the schedule provides for watering 
if ter supper who sees that it is actually done? 
e. Cleanliness and state of repair of the stalls and standings? 
Condition of the entrances and aisleways? Are the floors slip- 
•ery? Is bedding being wasted? 
f. Condition of the saddle and tool rooms? Condition of 
he stable tools? Are the tools in their proper places? 
g. Ventilation of the stable? Cleanliness of the windows 
nd ceilings? General condition of the surroundings, corrals, 
nd picket lines? Condition of the wagon and harness? Is 
lere any method of combating Hies (in summer), birds, and 
idents? 
h. Adequacy of the fire equipment? Do the men know what 
186 FIELD SANITATION 
to do in the case of fire? Any evidence of smoking around the 
stable? Cleanliness and neatness of the quarters for the 
stable crew? Is there any night guard? 
i. Stable records. Is the morning report (board) correct? 
Does the stable sergeant know how much forage he has on 
hand? Is he ahead or behind in his account with the quarter- 
master? Property record? Shoeing record? Sick report? 
Record of animals by Preston brand? 
j. General appearance of the animals as to state of flesh, 
grooming, and clipping? Have they been weighed recently? 
Condition of the feet and backs? Condition of the grooming 
equipment? If horse covers are used are they marked so 
they will not be interchanged? Are the covers clean and in 
good repair? Is the stable crew well informed in the care 
of animals? 
■ 250. Care in the Field/—The principles of care in the field; 
are the same as stable management in garrison. Their appli-t 
cation varies widely, not only from garrison service but also 
in different situations when in the field. Preparation for field 
service should be begun in garrison 3 months or more prior 
to the beginning of field service with a special training and 
conditioning program for men and animals. Young, uncondi 
tioned animals and those in a poor state of flesh usually beconn 
disabled after a few days of hard marching under heavy loads 
Bucks and feet are particularly vulnerable to injury. Unless 
veterinary detachments accompanying a mounted unit in thi 
field are well trained for such service they are likely to beconi' 
a hindrance rather than a help to the command (see FM 25-5) 
Section V 
STATISTICS AND REPORTS 
■ 251. Statistics.—a. With a view to acquainting highe 
authority with the state of health of the animals within , 
command, accurate and current records must be maintained b 
the responsible veterinary officer. In addition to the absolut 
numbers of cases and deaths occurring within a given perioi 
the reports' include certain rates and ratios, which are of pa 
ticular importance in studying the trend of a disease, deal 
rates, noneffective rates, etc. The following rates are requin 
to be maintained in the office of the station veterinarian of a 
187 MEDICAL FIELD MANUAL 
stations with an animal strength of 400 or more, in the offices 
of corps area and department surgeons, and surgeons of 
expeditionary or similar forces. Changes in this requirement 
will be issued from time to time by The Surgeon General. 
(See AR 40-2090.) 
(1) Annual admission rate for all causes. 
(2) Annual admission rate for disease. 
(3) Noneffective rate on the day of the report. 
(4) Annual death rate for all causes. 
(5) Annual admission rates for such communicable diseases 
as may be designated from time to time by The Surgeon 
General or other competent authority. 
b. For the method of computing rates and ratios, see 
chapter 15. 
■ 252. Sanitary Reports.-—Routine sanitary reports, in letter 
!orm, are required quarterly in peacetime (monthly in war- 
ime) from the senior veterinarian of all stations and de- 
ached commands where animals are maintained. The report 
s a resume of the veterinary sanitary conditions existing 
hroughout the command during the period, including those 
onsidered unsatisfactory, together with practicable recom- 
nendations for correcting the latter. For details of the report, 
ncluding subject headings, transmission, etc., see AR 40-2255 
nd 40-2080. 
I 253. Special Reports.—Upon the discovery of an initial case 
f a serious communicable disease among animals (glanders, 
nthrax, equine encephalomyelitis) an immediate report is 
>ade by the responsible veterinary officer through channels to 
igher authority, and to tlje State veterinarian, or similar 
vilian authority in the contiguous area. For a list of these 
diseases, form of initial and subsequent reports, 
nd offices to which reports should be forwarded, see AR 
>-2090. 
[A. G. 062.11 (2-3-42).] (C 1. June 12. 1942.) 
By order of the Secretary of War; 
Official : 
J. A. ULIO, 
Major General, 
The Adjutant General. 
G. C. MARSHALL, 
Chief of Staff. FM 8-40 
C 2 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Changes \ 
No. 2 J 
WAR DEPARTMENT, 
Washington, July 9, 1942. 
FM 8-40, August 15,1940, is changed as follows: 
■ 46. Technique for Sterilizing Water in Water-Sterilizing 
Bag. 
e. After the calcium hypochlorite has been in contact with the 
water in the bag for at least 10 minutes, wash out one of th( 
faucets by allowing a small amount of water to run through i 
onto the ground. Then fill a clean canteen cup to a depth o 
t/2 inch with water from the same faucet. ; 
[A. G. 062.11 (4-27-42).] (C 2, July 9, 1942.) 
By order of the Secretary of War ; 
G. C. MARSHALL, 
Chief of Staff. 
Official 
J. A. ULIO, 
Major General, 
The Adjutant General, 
555798°—43 13 189 FM 8-40 
C 3 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Changes 1 
No. 3 
WAR DEPARTMENT, 
Washington, December 22, 1942. 
FM 8-40, August 15, 1940, is changed as follows: 
■ 4G. Technique for Disinfecting Water in Water Sterilizing 
(Lyster) Bag. 
[A. G. 062.11 (11-28-42).] (C 3, Dec. 22, 1942.) 
■ 46%. (Added.) Technique for Individually Disinfecting 
Water.—a. Water may be purified in the issue canteen by the 
use of individual water purification tablets. Since these tab- 
lets may be supplied in either 4 or 8 milligram size, the number 
of tablets to be added to a canteen full of water varies. Direcj 
tions must be followed as given on the container for thesi 
tablets. Two of the 4 milligram tablets are required per quar 
of clear water, while only one of the 8 milligram tablets i; 
required per quart of clear water. If the water is turbid o 
colored, two of the 8 milligram tablets or four of the 4 milligrar 
tablets will be required to disinfect it. As chemicals alway1 
require time to kill germs, it is imperative that at least 3 
minutes elapse after adding the tablets before drinking tl 
water. 
6. If the individual purification tablets are not availabl 
water may be purified in canteens by using the same powd> 
(calcium hypochlorite) as is used in the Lyster bag. One ai 
pule of grade A calcium hypochlorite is dissolved in a cantej 
of water. This strong solution is then used to purify watl 
in other canteens. The cap of a canteen is used as a measr] 
and one canteen capful of the strong solution is added to eal 
canteen full of water to be treated. The water should be wl 
shaken and should not be used until 30 minutes after chlori!| 
tion. I 
■ 47. (Superseded.) Measures for Disinfecting Water 
Other Containers.—a. If water sterilizing bags are not av 
able, the water may be disinfected in unit water cans or chi 
galvanized iron cans, pails, or barrels. A proportional amo 
191 FM 8-40 
C 3 
MEDICAL FIELD MANUAL 
of calcium hypochlorite is used and the method of chlorination 
is the same as with the water sterilization bag. 
b. Water may be purified in larger containers by using in- 
dividual water purification tablets. (See par. 46%.) Chlorina- 
tion may be done in containers which are larger than the can- 
teen by the addition of the appropriate number of individual 
water purification tablets. The number of tablets required is 
calculated on the size of the container in quarts; thus a 
10-gallon container will require 40 times as many tablets as a 
1-quart canteen. 
■ 47%. (Added.) Test fob Safety.—A rough test for the 
safety of water which has previously been treated for 30 minutes 
)y one of the acceptable chlorination methods is the presence 
>f an odor or taste of chlorine in the water. If chlorine can be 
asted or smelled, this indicates the presence of at least 0.4 
iarts per million of available chlorine and the water is safe, 
n performing this test, precaution must be taken to determine 
tiat the odor or taste comes from the treated water and not 
rom a contaminated container or the hands. 
47%. (Added.) Boiling.—If neither powdered calcium hy- 
x-hlorite nor individual water purification tablets are available, 
ater may be purified by boiling for 1 minute. This method 
tould not be used, if avoidable, by the individual soldier, but 
e water should be boiled under supervision in comparatively 
rge quantities and then distributed to the troops. Water may 
boiled in galvanized iron cans if they are available. Aeration 
the water by pouring it through the air from one receptacle 
:o another will eliminate the flat taste due to boiling. 
[A. G. 062.11 (11-28-42).] (C 3, Dec. 22, 1942.) 
3y obder of the Secretary of War : 
G. C. MARSHALL, 
)fficial : 
Chief of Staff. 
J. A. ULIO, 
Major General, 
The Adjutant General. 
192 FM 8-40 
C 4 
MEDICAL FIELD MANUAL 
FIELD SANITATION 
Changes 
No. 4 
WAR DEPARTMENT, 
Washington, March 16, 1943. 
FM 8-40, August 15, 1940, is changed as follows: 
44. Engineer Water Supply Equipment (Superseded).—a 
Engineer water supply equipment consists of portable and mobib 
sets for pumping, purifying, storing, and distributing water 
The portable set includes a small-capacity portable pump am 
purifying unit carried by all general and most special euginee 
troops. The mobile set includes a larger capacity truck-mounte 
unit which is issued to water supply battalions only. Genera 
engineer troops normally execute all engineer water supply taslJ 
when local sources of water are available and adequate. WatJ 
supply battalions are responsible for purifying and transportirl 
water into those areas where the local supply is not availabi 
or is inadequate. Distillation equipment is used by enginel 
troops in areas where such equipment is required to supply pi 
table water, for example, where the water is brackish or salirl 
&. The portable and mobile water supply sets include equil 
ment to filter and disinfect water. Engineer troops do not hal 
the equipment necessary to run bacteriological tests. II 
[A. G. 062.11 (2-26-43).] (C 4, Mar. 16, 1943.) 
order of the Secretary of War 
G. C. MARSHALL, 
Chief of Siam 
Official 
J. A. ULTO, 
Major General, 
The Adjutant General. 
193 FM 8-40 
C 5 
MEDICAL FIELD MANUAL 
Changes 
No. 5 
FIELD SANITATION 
WAR DEPARTMENT, 
Washington, April 30, 1943. 
FM 8-40, August 15, 1940, is changed as follows 
■ 46. (As changed by C 2 and 3) Technique for Disinfecting! 
Water in Water Sterilizing (Lyster) Bag. I 
e. After the calcium hypochlorite has been in contact with th 
water in the bag for at least 10 minutes, wash out the faucets bj 
allowing a small amount of water to run through it onto ttu 
ground. Determine the presence of free chlorine in the wata 
by one of the following methods: 
(1) Liquid orthotolidine method.—Fill a clean canteen cul 
to a depth of inch of water from the same faucet. Adi 
1 cc of orthotolidine testing solution to the water in the cul 
Wait 5 minutes and note the color produced. Below is I 
guide for reading the color reaction between the free chloriil 
and orthotolidine: I 
(a) No color.—Insufficient chlorination. Add more calciul 
hypochlorite. I 
(b) Canary yellow.—Insufficient chlorination. Add mol 
calcium hypochlorite. I 
(c) Deep yellow.—Satisfactory chlorination. This repiB 
sents about one part per million (ppm) of chlorine. B 
(d) Orange red.—Overchlorinated. Add more water and :■ 
test. I 
(e) Bluish green.— Alkaline or hard water. Add a few mfl 
drops of orthotolidine to get a correct color reading. M 
(2) Orthotolidine tablet method.—Remove the inner vH 
from the testing kit and fill the outer vial with a water samB 
from the same faucet, to the bottom of the colored band, ifl 
inner vial contains orthotolidine testing tablets; drop ll 
■these tablets into the sample and shake until dissolved. nH 
the color produced. B 
195 MEDICAL FIELD MANUAL 
(a) Equal or darker yellow than the colored band.—Satisfac- 
tory chlorination. 
(b) Lighter yellow thdn the colored band.—Insufficient chlo- 
rination. Add more calcium hypochlorite to the water being 
treated; wait 10 minutes and retest. 
(c) Orange color,—Water is overchlorinated. Add more 
water to the water being treated; wait 10 minutes and retest. 
(3) The directions for testing for free chlorine by the 
above methods are outlined on the bottle of liquid orthotoli- 
iine and on the kit containing the orthotolidine testing 
;ablets. 
f. As a factor of safety, the water should be allowed to 
stand for 20 minutes after the end of the contact period, or 
or 30 minutes after the addition of the calcium hypochlorite, 
tefore being used for drinkihg purposes. 
h. Rescinded 
[A. G. 062.11 (4-7-43).] (C 5, Apr. 30, 1943.) 
68. Cake of Latrines.—Latrines should be policed daily and 
lould be lighted at night unless the military situation de- 
ands concealment. If flies are prevalent, baited fly traps 
lould be placed about in the enclosure. The outside of the box 
eluding the seats should be scrubbed daily with soap and 
iter and the seats twice weekly with 2 percent cresol solution, 
xe seats should be dried after each cleaning. Urine troughs 
ould be scrubbed daily with soap and water. A brush for 
rine seats and urine troughs may be made by fastening a 
ndle to one-half of an ordinary scrubbing brush. 
[A. G. 062.11 (4-7-43).] (C 5, Apr. 30, 1943.) 
3y order of the Secretary of War : 
G. C. MARSHALL, 
: 
J. A. ULIO, 
Chief of Staff. 
Major General, 
The Adjutant General. 
196