#•':.' -v ■• '■ .A . "% ;&'*: V. Duties of commissioned officers.....................................--................ 18 General............................................................................ 18 Professional.................................................................-...... 18 Sanitary... Executive VI. Duties of noncommissioned officers and attendants.................................. 20 Vn. Orders, assignments, and travel...................................................... 22 Changes of station, etc................................................-................ 22 VIII. Leaves of absence, sick leave, and waiting orders.................................... 25 Leaves of absence for commissioned officers...................-................. 25 Sick leave.......................................................................... 2' Leaves of absence for noncommissioned officers................................. 28 Leaves of absence for attendants..........................................-...... 29 IX. Uniforms: Supervising Surgeon-General...............................-..................... *> Commissioned officers.............................................-............... Noncommissioned officers......................................-.................. "1 Internes...........................................-................................ ^ Hospital stewards......-.......................................................... ™ Attendants...............................................—........................ j~ Quarantine service..........-....................-................................ X. Discipline............................................................................... Boards of investigation (for commissioned officers)............................. •*> XI. Station management................................................................... XII. Inspections.............................................................. XIII. Relief stations..........-.............................-............................... Definition and classification....................................................... ** XIV. Beneficiaries...................................................................."...... ' XV. Relief................................................................................ 4 Out-patient relief...........................................................-...... Stations of the first class.....................................-.......------- ™ Stations of the second class...................................-----.....---- *• Stations of the third class..............................................-...... f> Stations of the fourth class................................................... 50 I n CONTENTS. Article—Continued. XV. Relief—Continued. Pasre- Hospital relief.....................................-............................--- 50 Stations of the first class.............................- -.......- - -............. 51 Stations of the second class.........................-...............-....... 52 Stations of the third class.......... -...................- -.....- -.............. 53 Stations of the fourth class.................-............-----.............. 54 Transportation of sick seamen................................- -......- - -......... 56 Insane seamen.-...................................-.....................-------- £,,i Deceased seamen.......................................----------................ 57 XVI. Seamen of the Government services and foreign seamen...........---............ 58 United States Navy and Coast Survey................---------................ 58 Foreign seamen..............................................-....... .......-..... 58 Revenue-Cutter Service.......................---------------......... ---- 59 Mississippi River Commission......-.....-...............----......---------- 59 Engineer Corps, United States Army................------.....------....... 59 Life-Saving Service.........................-......-----..........--------..... 60 Light-House Service..................................-----------.............. 60 XVII. Custodians......................................--.......---..................-........ 60 Duties of...-............................................----......-------------- 60 XVIII. Public property...................................-------- --------------......- 64 Unserviceable property..........................---------------.............. 65 XIX. Subsistence and contracts----...............-........-------..........--.......... 66 XX. Requisitions.......-...................---......-........----------------.......... 69 Medical supplies............-....... - -........................................... 69 Stationery, blanks, and books........................-...............--.......... 69 Miscellaneous articles..........-----........-.................................... 69 XXI. Medical and surgical supplies..................-..................................... 70 XXII. Purchases and bills............................................-...................... 71 Emergency purchases.......................................--................... 71 Bills and vouchers........................-........................................ 72 XXIII. Receipts and disbursements....................................------......------- 73 Miscellaneous receipts____....................................------.......— 73 Disbursements......................................------.................--- 74 XXIV. Records, reports, and correspondence..........................................---- 75 Records___....................................-----........----................. 75 Reports..........................................................-------------- 77 Correspondence..................................................-----.......... 78 XXV. Tonnage dues..............................................................____....... 80 XXVI. Hygienic laboratory.................................................................. 80 XXVII. Quarantine............................................. .............................. 81 XXVIII. Revenue-Cutter Service........................'...................................... 8:2 APPENDIX. Instructions relative to physical examinations----............................................ 83 Instructions relative to autopsies............................................................... 84 Diet tables.......................-................................................................ 85 Ordinary diet................................................................................ W Extra diet.......-............................................................................ 87 Milkdiet...................................................................................... 87 Allowance table of uncooked rations for hospital stewards................................ 87 Laws in force relating to the Marine-Hospital Service........................._____......... 88 Calendar of official reports...................................................................... 89 Blanks and books................................................................__.............. 92 Blanks.........................................................................__............. 92 Books......................................................................_________........ 93 Stationery......................................................................................... 94 Treasury Department, Office of the Supervising Surgeon-General, United States Marine-Hospital Service, Washington, D. C, November 29, 1897. The following regulations for the government of the United States Marine- Hospital Service are hereby adopted, and will be enforced on and after December 1, 1897. All regulations and circulars hitherto in operation which are inconsistent or in conflict with these regulations are hereby repealed. One interleaved copy, which shall be designated as " official," will be kept among the record.s ot each station in the custody of the officer in charge, and the neces- sary entries shall be made in it at the proper places whenever any part of these regulations may be altered or amended by the authority of the Department. Walter Wyman, Supervising Surgeon-General, United States Marine-Hospital Service. Approved. L. J. Gage, Secretary of the Treasury. Executive Mansion, November 29, 1897. Approved. William McKinley. PROPERTY OF STATE BOARP 0?=* HEALTH OF R ORIDA ARTICLE I. ORGANIZATION. 1. The corps of the United States Marine-Hospital Service shall Organization consist of the commissioned and noncommissioned officers and the attendants of the Service, namely: Commissioned officers, the Supervising Surgeon-General, surgeons, passed assistant surgeons, and assistant surgeons: noncommissioned officers, acting assistant surgeons, sanitary inspectors, internes, and hospital stewards. The attendants are the pilots, engineers, and miscellaneous employees at relief stations. 2. The Supervising Surgeon-General shall publish on the 1st of Official list of July and the 1st of January of each year an official list of commis- published. sioned and noncommissioned officers arranged in accordance with paragraph 3, and said official list shall be the official register of the Service as to grade and number, except as hereinafter modified. 3. The order of rank and precedence in the Service shall be as follows: Supervising Surgeon-General. Surgeon, according to seniority of commission. Passed assistant surgeon, according to seniority of commission. Assistant surgeon, according to seniority of commission. Acting assistant surgeon, according to seniority of appointment. Hospital interne, according to seniority of appointment.' Senior hospital steward, according to seniority of appointment. Junior hospital steward, according to seniority of appointment. 4. Commissioned officers of the Marine-Hospital Service shall rank relatively with commissioned officers of the Revenue-Cutter Service, as follows: Surgeon with captain; passed assistant surgeon with first lieutenant; assistant surgeon with second lieutenant. When serving on boards with officers of the Revenue-Cutter Service, they shall take precedence according to date of commission in corresponding grades. 5. The official seal of the service shall be circular in form, bear- ing the words "Marine Hospital Service, 1798 U. S., 1871, and stars,'' surrounding a foul anchor and caduceus crossed as shown in the subjoined engraving. Order of rank and precedence. Relative rank with officers of the Revenue- Cutter Service. Official seal to be circular in form. 1 See paragraph 133. 5 6 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. U. s. Stat. L., 6. The Supervising Surgeon-General shall be appointed by the vo_. \ c. , p. pyggj^g^ by an(j with the advice and consent of the Senate. U. S. Stat. L., 7. The salary of the Supervising Surgeon-General of the United 3771; 18, c'130, p' States Marine-Hospital Service shall be paid out of the marine- hospital fund at the rate of four thousand dollars per annum. Sec. 4*02, Rev. 8. The Supervising Surgeon-General shall be selected from among Mar.'M875.Ct ° the surgeons when a vacancy occurs in that office. Supervising 9. The Supervising Surgeon-General is charged by law with the Irll of "the^a-supervision, under the direction of the Secretary of the Treasury, rine-Hospital0f au matters connected with the Marine-Hospital Service, and 29June, 1870,c. with the disbursement of the marine-hospital fund; the conduct of 17(1' S3Mar.487^ the quarantine service, and the publication of the weekly public c.l30,v.l8,p.377. health reports, and other information pertinent thereto. 29 Apr., 1878, c. ^ 66. v. 20, p. 37. 4 Jan., 1889. Orders. 10. All officers and subordinates are subject to the orders of the Supervising Surgeon-General. Ranking med- n. During the temporary absence or sickness of the Supervising duty °as Assist1 Surgeon-General the ranking medical officer on duty as assistant in ant to act in ab- ^ne omce 0f the Supervising Surgeon-General shall perform the ordi- pervising Sur- nary routine duties until the termination of such absence or sick- g6Rev. stat.a 2d ness, except the authorization of expenditures. ed., 1878, sees. 178,179. May designate 12. The Supervising Surgeon-General may designate the assistants sue orders*0 1S on duty in charge of divisions of his office to issue orders pertaining to the routine of their respective divisions in the matter of errors and corrections of accounts, returns, invoicing supplies on approved requisitions, and such communications to officers made "by direc- tion of the Supervising Surgeon-General" shall be obeyed and re- spected accordingly. • 0r(ffr"ht0 V 13' -A-U°rders emanating from said assistants shall be issued " by rection of the direction of the Supervising Surgeon-General" and shall be obeyed lurgeonV-Gen^an<^ resPected accordingly by those concerned. eral." To supervise 14. The Supervising Surgeon-General will exercise constant vigi- ployees. lance over officers and employees of the Service, and will cause prompt and impartial investigation to be made of any reported dereliction of duty. To see that 15. The Supervising Surgeon-General will cause the property re- public property, „ *\.°,° . . , ~ r i j is duly account- turns of commissioned and noncommissioned officers of the Marine- ed for. Hospital Service to be examined, and take care that all public prop- erty for which they are responsible is duly accounted for. To prepare 16. The Supervising Surgeon-General will prepare and revise, and revise reg- ,. .. , » ,, „ . ulations. subject to the approval of the Secretary of the Treasury and the President, all regulations and instructions for the government of the officers and employees of the Marine-Hospital Service. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 7 ARTICLE II. EXAMINATIONS, APPOINTMENTS, AND PROMOTIONS OF COMMISSIONED OFFICERS. 17. Medical officers of the Marine-Hospital Service required by Medical offi- law to be appointed by the President, by and with the advice and byrsthePP?eIi- consent of the Senate, shall be known in these regulations as com- d e n t to be ,^ ■:„„.•„ i cc known as com- missioned officers. missioned offi- cers. 18. Graduates of medicine desirous of undergoing examination Requirements for the position of assistant surgeon in the Marine-Hospital Service piym^for ap- of the United States must make an application, addressed to thepoJ1itmentas Supervising Surgeon-General, in their own handwriting, requesting geon. permission to appear before the board of examiners. Applicants for examination should state their age, date, and place of birth, present legal residence, and whether they are citizens of the United States, and name of medical school and college of which they are graduates, and furnish testimonials from at least two persons as to their professional and moral character. 19. Any applicant for appointment who shall submit false testi- Applicants monials as to his character, or who shall give a false certificate of fatee Testimony age, or make any false statement in his application, or to the board ^ et?.-i *? „be c ■ -i-i-iit t r. t o disqualified for or examiners, shall be disqualified for appointment; or, if appointed appointment. before such false statement is discovered, shall be dismissed from the Service. 20. Xo person will be appointed an assistant surgeon whose age Qualifications is less than 21 or more than 30 years, and, as a preliminary to a m>entaPP°int" recommendation for appointment, the applicant must have been graduated in medicine at some respectable medical college, and must pass a satisfactory physical, academic, and professional exam- ination before a board of- commissioned officers. 21. Commissioned officers will not be appointed to any particular Subject to station, but to the general service. They will be subject to change tk>nnge °f Sta of station, as the exigencies of the Service may require, and shall serve in any part of the United States or wherever assigned to duty. 22. A board of commissioned officers will be convened from time Examination to time by the Supervising Surgeon-General for the purpose of appointment01' examining applicants for appointment. This board shall consist of three or more commissioned officers, of whom the senior shall be chairman and the junior recorder of the board. 23. The board of examiners will make a true report on the merit Board of ex- roll (Form 1936) of the actual and relative standing of applicants pOT^standhig^f and transmit the examination papers, with their recommendation applicants. in each case, to the Secretary of the Treasury through the Supervis- ing Surgeon-General. The maximum mark in any one branch of the examination shall be 100, and no applicant will be recommended for appointment who fails to receive an average grade of 80 in the ratings on the topics named in paragraphs 26 and 28. 8 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Board to con- 24. All academic and professional examinations for appointment tions.8,11 GXami shall be conducted by said board of medical officers, and the order of examinations shall be— 1. Physical. 2. Academic. 3. Professional. 4. Clinical. 5. Personal (including general aptitude and moral fitness). ✓Physical ex 25. The physical examination will be made according to the rulea elsewhere given; the examiners must pay special attention to condi- tions that may impair efficiency or cause early placing on "waiting orders,'" such as hereditary diseases, overstrain of nervous system, impaired vitality from excesses of any kind. Applicants should be required to give an explicit statement of any severe illness or in- jury, and of the cause of death of near relatives, and certify that they believe themselves free from any ailment—mental or physical— or defect which would disqualify them for active service in any climate. Academic ex- 26. The board will examine the applicant orally as to his profi- ciency in general literature, language, history, and geography of the United States in particular, and such branches of general science as they may in their discretion think pertinent. Examinations 27 The written examinations of applicants for appointment will to in wn ing. ^egjn ^th a short autobiography of applicant, in which he will con- cisely state: Whether married or single; the date and place of his birth; the school, institution, or college at which he received his general education; theseveral branches studied, including his knowl- edge of general literature and of the ancient and modern languages; the exact title of the medical school or schools at which he received instruction and the date of his graduation: the name and place of residence of his preceptor and the time when he commenced the study of medicine; also the titles of the text-books studied on chem- istry, anatomy, physiology, histology, materia medica, pharmacy, therapeutics, theory and practice of medicine, principles and prac- tice of surgery, medical jurisprudence, toxicology, obstetrics, hy- giene, biology, pathology, bacteriology, and physics; the opportuni- ties he has had of engaging in the practice of medicine, surgery, and obstetrics or of receiving clinical instruction; and whether he has been a resident physician or interne in a civil or military hospital, and the number of cadavers or parts of cadavers he has dissected while at college or elsewhere. The candidate will append to this statement his name in full, post-office address, and his local address at the date of the examination. Examination 28. The remainder of the written examination of applicants for written ex e r- appointment will consist of questions on (1) anatomy; (2) physi- cises, etc. ology; (3) chemistry; (4) materia medica and therapeutics; (5) prac- tice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene; (9) pathology and bacteriology; (10) reports on selected cases at a hospital. These cases will be selected by the examiners so as to give at least two—one medical and one surgical case—to each applicant. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 9 29. This examination will further consist of such inquiries as General apti- may tend to develop the general aptitude of the person for the spe- cial duties required of a commissioned officer in the service and to show his moral qualifications for the position of trust and responsi- bility which he will assume when appointed. 30. When practicable, applicants for appointment will be required Operative sur- to perform such surgical operations on the cadaver as may be di- rected by the examiners. 31. The passing of an examination will not be considered as giv- Successful ex- . . , . ,. i , t , animation does rag assurance ot appointment; as, in case there should be more sue- not assure ap- cessful candidates than vacancies, the Secretary of the Treasury P°intment- will select for recommendation to the President those of the highest attainments, as shown by their relative standing on the roll reported by the board of examiners. 32. No qualified applicant will be eligible for appointment more Qualified can- than one year. If not appointed within that time he may be reex- for one year! e amined, unless he has passed the limit of age provided in paragraph 20. when, if successful, he will take position with the class last examined. 33. An applicant for appointment failing at one examination may Unsuccessful be allowed a second examination after one year if he has not passed be reexamined. the limit of age as provided in paragraph 20, but he shall not be allowed a third examination. 34. When an applicant for appointment has shown by his papers Applicant may on the four branches—anatomy, physiology, chemistry, and materia without further medica—during the progress of his examination that he is deficient exammation. to such an extent that it would be impossible for him to reach the required general average in all branches, the board of examiners may, in its discretion, reject this applicant without further exami- nation. 35. Before the applicant had demonstrated his inability to pass Applicant may the examination the board in its discretion may accord the appli- examination.0™ cant privilege to withdraw, but in this event the applicant shall not be eligible for another examination for a period of one year. EXAMINATION OF CANDIDATES FOR PROMOTION. 36. A board of commissioned officers will be convened from time Board to ex- to time by the Supervising Surgeon-General for the purpose of dates for pro- examining candidates for promotion. This board shall consist of motlon- three commissioned officers, of whom the senior shall be chairman and the junior recorder of the board. The board will make a true report on the merit roll (Form 1936) of the actual and relative standing of the candidates for promotion and transmit the examina- tion papers with its recommendations to the Secretary of the Treasury, through the Supervising Surgeon-General. 37. Examinations for promotion will be made chiefly in writing, Examinations but may be supplemented, in the discretion of the examiners, by an for Promotl011' oral examination on any subject connected with the official and professional duties of the officer. Candidates for promotion, of whatever rank, must show themselves proficient in all the regula- 10 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. tions governing the Service. The examiners will also examine care- fully the record of the service of the officer as furnished from the Bureau, and shall give due consideration thereto in making their recommondations. No officer will be recommended for promotion who shall be found physically disqualified. Information 38. Previous to the examination of an officer for promotion the ness6ofincandi- Supervising Surgeon-General shall cause to be sent to each officer dates to be fur- un(jer whom the candidate has served a list of interrogatories which examiners. shall be answered by the said officers and returned to the Bureau. These completed papers shall be furnished to the board of officers examining said candidate for promotion. When reports adverse to the character of the candidate are made he shall be furnished a copy of same. Board of ex- 39. Boards of examiners, in making recommendations and in decid- aminers to ob- . ,, ,,. ., -,,..,. 1 -. serve seniority, ing on the relative merit and fitness of several passed assistant or assistant surgeons examined for promotion at any one time, will be governed by seniority, unless there are specific reasons for waiv- ing it. Physical un- 40. When an officer fails to pass the physical examination required soundness of -,„ • 1 -n . , . candidates to be for promotion, the board of examiners shall report in detail the ported? re physical condition of said candidate, and if it shall appear that his condition is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accordance with paragraph 248. If it is the result of disease or disability contracted in the line of duty he shall be recommended for '' waiting orders," or special duty of a light character. Officers on 41 when an officer has been rejected on account of physical dis- waiting orders *" * J or special duty, ability, and is placed on waiting orders or special duty, and it shall physical disabil- subsequently appear, by competent medical evidence, that he has ity, may be or- progressed to recovery, the Supervising Surgeon-General may order board for ex- him to present himself before a board of officers for reexamination, and if found to be physically qualified for promotion the examina- tion provided for his grade shall be continued by said board, and if he passes same he shall be entitled to promotion to the first vacancy occurring in the next grade. Promotion of 42. Assistant surgeons, at the expiration of five years' service, geon. shall be entitled to an examination for promotion to the grade of passed assistant surgeon, as hereinafter specified, and they will be ordered to appear before a board of commissioned officers for this purpose. Failing to pass the first examination, they shall be allowed a second examination, but not until after the expiration of one year, and shall be ordered to appear for said examination as soon after the expiration of the year as practicable. Assistant sur- 43. Assistant surgeons shall, thirty days prior to the expiration feons to apply » ,, . « . , ,... or examination ot their five years service, make application for examination for for promotion. promotion. Requirements 44. An assistant surgeon, in order to be recommended for pro- geon for pro u?otion, must obtain an average mark of 80 per cent, and not less than motion. -q in any 0£ tlae f0nowmg branches: (1) Anatomy; (2) physiology, REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 11 (3) chemistry; (4) materia medica and therapeutics: (5) practice of medicine; (6) practice of surgery; (7) obstetrics and diseases of women; (8) hygiene: (9) pathology and bacteriology. The exami- nation to be written, and he must satisfy the board that he has been diligent in keeping himself informed of the progress and improve- ments in the practice of his profession since his appointment into the Service, and in addition to the above he must pass a physical examination. 45. When an assistant surgeon fails in one examination for pro- A second ex- motion, he shall be allowed a second examination at the expiration fo^-ed.3, lon a of a year, but, again failing, he will not be allowed a third exam- ination, and will be reported to the Secretary of the Treasury as not qualified for promotion. 46. An assistant surgeon reported as above (paragraph 45) sh^a^^an**^?* be requested by the Secretary of the Treasury to tender his resig- geon^ to be re- nation. quested. 47. A vacancy in the grade of surgeon will be filled by promotion pa^ge)massi°s1tant from among the passed assistant surgeons, who shall be eligible to surgeons. promotion to the grade of surgeon in the order of seniority, but such officer will not be promoted until he shall have passed a satisfactory professional examination in writing in the practice of medicine, surgery, hygiene, hospital and quarantine management, and regu- lations of the service, in addition to a physical examination. He shall be required to make an average marking of 80 per cent on the above-mentioned subjects. Passed assistant surgeons who are eligible for promotion to the grade of surgeon shall be ordered to appear before a board of com- missioned officers for that purpose. Failing to pass this first exam- ination, they shall be allowed a second examination after the expiration of one year, and shall be ordered to appear for said examination as soon thereafter as practicable. 48. When a passed assistant surgeon fails in one examination for A second ex- 1 ° . animation al- promotion he shall be allowed a second examination at the expira- lowed. tion of one year, but again failing, he will not be allowed a third examination, and will be reported to the Secretary of the Treasury as not qualified for promotion. When thus reported he shall be placed in the official register of the Service as "not in the line of promotion." 49. When an officer reports himself or is reported unfit to perform Disabled offi- cgi*s to Id© 01*- his official duties by reason of disease, injury, or age, he shall be dered before a ordered by the Supervising Surgeon-General, if, in his opinion, it is ^°^f of exam" necessary, to appear before a board of commissioned officers, who shall thoroughly examine him, and if it shall appear that the dis- ability is the result of irregular or dissipated habits, the case shall be reported as requiring investigation by a board convened in accord- ance with paragraph 248. If it be the result of disability in the line of duty, the board shall recommend him for "waiting orders," or for special duty of a light character. 50. A board convened for the physical examination of an officer Board for of the Service shall consist of two or more commissioned officers, nation to consist of two or more members. 12 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. ARTICLE III. EXAMINATIONS, APPOINTMENTS, AND PROMOTIONS OF NONCOMMISSIONED OFFICERS AND SUBORDI- NATES. ACTING ASSISTANT SURGEONS. Qualifications 51. Candidates for appointment as acting assistant surgeons mentaPP° must be competent physicians and surgeons of good moral and pro- fessional standing, and must be graduates of a reputable medical college. Topassacivil 52. Acting assistant surgeons whose compensation exceeds s300 nation6 exami per annum are required, preliminary to appointment by the Secre- tary of the Treasury, on the recommendation of the Supervising Surgeon-General, to pass a successful examination under the rules prescribed by the United States Civil Service Commission. By whom ap- 53 Acting assistant surgeons, whose compensation is §300 per poin e ' annum or less, will be appointed by the Secretary of the Treasury, upon the recommendation of the Supervising Surgeon-General. INTERNES. By whom ap- 54. Internes will be appointed by the Secretary of the Treasury upon the recommendation of the Supervising Surgeon-General, after passing a satisfactory examination conducted by the com- manding officers of the stations to which they are to be assigned for duty. Mustbegrad- 55. Applicants for the position of interne must be graduates of ielne? in m reputable medical colleges, and must furnish satisfactory certificates relative to their moral character and professional capacity. No applicant will be appointed interne who is married or who is under 21 or over 28 years of age. internes en- 56. Quarters for internes shall be assigned by the commanding ters t0 qUar officer, subject to the approval of the Supervising Surgeon-General. HOSPITAL STEWARDS. By whom ap- 57. Hospital stewards will be appointed by the Secretary of the Treasury upon the recommendation of the Supervising Surgeon- General after passing a successful examination under the rules pre- scribed by the United States Civil Service Commission. Must begrad- 58. Applicants for this position must be graduates of pharmacy, macy. m Phar furmsn certificates of good moral character, and pass a satisfactory physical examination. No applicant will be examined or appointed who is under 21 or over 30 years of age. How graded. 59. Hospital stewards shall be divided into two grades, senior and junior, and original appointments shall be to the grade of junior hospital steward. Promotions. 60. Promotions, according to seniority or merit, will be made, after three years' service, from the junior to the senior grade, after due examination on subjects connected with their official duties. Said examination shall be in writing and the questions shall be pre- pared under the direction of the Supervising Surgeon-General. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 13 Previous to said examination the Supervising Surgeon-General shall cause to be sent to each officer under whom the said steward has served a list of interrogatives which shall be answered by said offi- cers and returned to the Bureau. If their record of efficiency, hon- esty, and sobriety is not good, they will not be promoted. ATTENDANTS. 61. Subordinate employees below the grade of hospital steward To be known in the United States Marine-Hospital Service shall be known and rated as attendants, and will be borne on the roll as such. They shall be required to perform whatever duties may be assigned to them by the commanding officer or the hospital steward acting under his orders. 62. Applicants for the position of attendant will be required to To file appli- file an application on the blank furnished by the Civil Service Com- pointment. mission (which blank may be obtained at any of the marine hos- pitals or quarantine stations), showing age, experience, and other qualifications. Each applicant will also be required to have the medical certificate on the application blank filled out by a medical officer of the Marine^Hospital Service. 63. Applicants for the position of engineer on quarantine duty Qualifications must have a license from the United States local inspector of steam vessels or present other satisfactory evidence of capacity. They must be qualified to take charge of the engines of quarantine boats and naphtha launches, and must also understand the management of stationary engines and boilers. Applicants for the position of engi- neer at a marine hospital must furnish satisfactory evidence that they are competent machinists, be able to make repairs to gas and steam pipes, etc., and must also have some knowledge of electric lighting. Applicants for the position of engineer are required to pass a satisfactory physical examination. 64. Upon receipt of applications by the commanding officer they Names of qual- will be examined, and the names of applicants who may be round to be entered to be qualified as to age, character, experience, and physical condi- o?eligiblef1Ster tion, after an examination by the commanding officer, will be entered upon a register of eligibles (kept at the station), the rela- tive standing of each applicant upon such register being determined after a due consideration of the elements of character, age, expe- rience, and physical condition, as demonstrated in the examination. 65 When a vacancy occurs, selection will be made of one of the Vacancies- ,..., ,, . , , how filled. names of the three applicants standing highest on the register who have applied for employment at the station where the vacancy exists. The commanding officer will forward the name so selected (through the Marine-Hospital Bureau) to the Department for approval. 66. A transcript of the register of eligibles shall be forwardedre^Seifel! (through the Marine-Hospital Bureau) to the Department, and all bles to be for- additions to said register shall be promptly transmitted in the same Department. manner. 67. Commanding officers will report immediately any changes h Changes^f made in the personnel of the attendants, stating in each case the ants to be re- full name and duties of the person employed or whose services have por e' been terminated and the reasons for the change made. 14 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Offer of posi- 68. When a vacancy occurs among attendants at a station the tions to attend officerg on duty at said station shall not offer the position to an attendant then employed at any other station. Only males eli- 69. On account of the character of services required and the fn'ts6 aS attend" regulations in respect to uniforms for attendants, males only shall be eligible for the position of attendant. ARTICLE IV. COMPENSATION AND ALLOWANCES, COMMISSIONED OFFICERS. Compensa- 70. The compensation of commissioned officers, when not pro- tion' vided for by statute, shall be fixed at a uniform annual rate for each rank as follows, viz: Surgeons shall receive $2,500 per annum; passed assistant surgeons shall receive $2,000 per annum, and assist- ant surgeons shall receive $1,600 per annum; and after five years' service an additional compensation of 10 per cent on the annual salary for each five years' service shall be allowed commissioned officers above the rank of assistant surgeon, but the maximum rate w ai t i n g-o r shall in no case exceed 40 per cent. Said officers placed on '• waiting ers pay. orders *' for a period longer than two months shall receive 75 per cent of the pay of their respective ranks while so placed. ACTING ASSISTANT SURGEONS. Compensa- 71. The compensation of acting assistant surgeons shall be fixed by the Secretary of the Treasury at annual rates and according to the extent and importance of the service at their respective stations. INTERNES. Compensa- 72. There is no fixed salary attached to the position of interne, but tlon' quarters (one room), subsistence, and laundering will be allowed. HOSPITAL STEWARDS. Compensa- 73. The compensation of hospital stewards shall be at the follow- tlon' ing annual rates, viz: Senior hospital stewards shall receive $720 per annum; junior hospital stewards shall receive $600 per annum. At the expiration of five years' service they shall receive $792 per annum, and at the expiration of ten years' service they shall receive $864 per annum. Allowances. 74. Hospital stewards, when on duty at United States marine hos- pitals or quarantine stations, shall be entitled to quarters, subsist- ence, fuel, lights, and necessary laundry work, and when on duty at stations where there are no quarters belonging to the Service, they shall be entitled to commutation therefor at the rate of $25 a month. Quarters. 75. Quarters for the hospital stewards on duty at marine hospitals and quarantine stations shall be assigned by the commanding officer, subject to the approval of the Supervising Surgeon-General. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 15 76. Hospital stewards will be allowed medicines and surgical Medicines al appliances in stock at the stations for themselves and families when sick. 77. Hospital stewards, when on duty at United States marine hos- Entitled to pitals and quarantine stations, shall be entitled to subsistence. The ration drawn by the steward may be either cooked or uncooked, as hereinafter provided, and in either case will include only those arti- cles which are embraced in the annual contracts in force at their respective stations, and will be drawn for subsistence only. A cooked ration shall be furnished to unmarried stewards, and it must be served from the hospital kitchen. To provide for stewards with families, an uncooked ration shall be drawn according to pre- scribed schedule adopted as an allowance table for this purpose. See Appendix. 78. A special record will be kept in a subsistence storeroom book . Recor(l of sub- of articles drawn by the steward, in accordance with the ration kept. specified in the appendix. ATTENDANTS. - 79. The compensation of attendants shall be fixed by the Secretary Compensation. of the Treasury on the recommendation of the Supervising Surgeon- General. 80. Attendants when on duty at a marine hospital or quaran- Allowances. tine station shall be entitled to quarters, fuel, light, subsistence, and plain laundry work, and medicines and medical attendance during temporary illness. 81. Quarters for attendants shall be assigned by the commanding Quarters. officer. , 82. Attendants on duty at marine hospitals and quarantine sta- Sick or dis- . , • • 1 ■ !.-■ i n n -i abled attend- tions, who may be taken sick or injured m line of duty, shall be ants to be cared cared for by the Marine-Hospital Service for a period of thirty days. or' If the illness extend beyond this period the case shall be referred to the Bureau for action. 83. In case of the death of an attendant, the Department must ^^fotmld*of be notified at once, and if the deceased person leaves an estate death of an at- rendering the appointment of an administrator necessary, the com- manding officer will forward to the Supervising Surgeon-General a pay roll in favor of the deceased for the amount due including the date of death, duly receipted by the administrator. A certified copy of the letters of administration must be attached to the pay roll. If the deceased leaves no estate, the widow, next of kin, or other heirs or representatives will be required to make an affidavit to that effect on a, form which will be furnished by the Department. If this shall be approved by the proper officers, the amount found due will be forwarded to the commanding officer for delivery to the proper person. OFFICERS. 84. An officer who tenders his resignation while on duty will. Compensation t . , . „ 111 C&SG OI 1 GSlg - receive pay to include the date on which he receives notice ot nation. acceptance, if he continue on duty until that time; or if sooner relieved from duty, to include the date of relief. An officer whose 16 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. resignation takes effect while on leave will be paid to include date of acceptance. When officers 85. Commissioned officers and noncommissioned officers of the to receive pay. Marine,Hospitai Service shall receive compensation only when on duty, sick, under orders, or on authorized leave. Compensation 86. The compensation of commissioned and noncommissioned attenlantl paa°d officers and attendants in the Marine-Hospital Service shall be monthly. pai(j at ^e c\ose 0f each month by check on the assistant treasurer of the United States payable to the officer or attendant, with such exceptions only as are provided for in these regulations. Payrolls: form 87. On the 23d day of each month officers in command will make fofmSSm out pay rolls in duplicate, of the officers and attendants serving 1940c, under them, and forward the same to the Supervising Surgeon- General. This provision does not apply to the stations on the Pacific Coast, where the officers and attendants will be paid by the customs officers on presentation of the pay roll properly signed and certified. Pay rolls to 88. In preparing the pay rolls of the Service, the Government cfaifsariSry table! salary tables furnished by the Treasury Department will be adhered to in all cases where the compensation is at a monthly or yearly rate. Salary to be- 89. The first payment of the salary of an officer or attendant after officfe.0m0ath°£ appointment or promotion will be reckoned from the date of his oath of office, inclusive. Officers or- 90. Officers and subordinates stationed on the Pacific Coast, when Pacifi/coTst1 to leaving that section under permanent orders for duty at a station fUteofh aCment wnere salaries are paid by disbursing officer's check as provided in of salary. paragraph 86, must obtain from the collector of customs of the port where they have been serving a certificate showing to what date they have been paid, and forward same to the Bureau. . Officers or- 91. Upon receipt by an officer or subordinate stationed on the Pacific Coast Pacific Coast of orders transferring him to another station, the col- salary due61 ve lector of customs may pay whatever of his salary is then due and issue to him the certificate prescribed in paragraph 90. Payment of 92. Allotments of pay for the support of the families or other families of offi- relatives of officers of the Marine-Hospital Service may be author- cers- ized on application by the officer, at the discretion of the Depart- ment, for a sum not to exceed in any case 70 per cent of the monthly pay of the officer desiring it and for such time only as he may be stationed apart from his family on public duty. It shall be payable under the same rules which govern the manner of payment to officers. Commutation 93. When a commissioned officer is serving at a station on active duty where there are no quarters belonging to the Service, he shall receive commutation for quarters at the following montly rate, allowed medical officers of the Army of the same relative rank, viz: For surgeons, for four rooms, fuel, and lights, commutation $50 a month; for passed assistant surgeons, for three rooms, fuel, and ' lights, $40 a month, and for assistant surgeons, for two rooms, fuel, and lights, $30 a month. When on duty on board a revenue cutter or quarantine vessel or on waiting orders officers will not be allowed commutation. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 17 94. An officer does not lose his right to quarters at his permanent t J^^ £™y station by a temporary absence on duty. While he continues to temporary ab- hold that right, and exercises it by constructive occupation or usesence on duty' of any kind, he can not legally demand quarters or commutation therefor at any other station. Exceptions to this rule can be made only by the Secretary of the Treasury. 95. The allowance of quarters or commutation therefor, to which Entitled to 1 commutation at an officer is entitled when on duty, may be continued m kind at his station during proper station during leaves of absence authorized by law or regu- oTwhen on tenv lation or when on special temporary duty. An officer under sus- porary duty. pension has the same right to quarters as when on duty status. 96. Quarters at each marine hospital or quarantine station shall Assignment of be assigned by the Supervising Surgeon-General to the commanding officer, and such other apartments as may be available for quarters for additional officers shall be assigned by the commanding officer to junior officers on duty, according to rank and seniority, subject to the approval of the Supervising Surgeon-General. 97. An officer may waive his right to the quarters appertaining Right to quar- to his rank in favor of a junior, such waiver to be approved by the waive™&y commanding officer and reported to the Marine-Hospital Bureau, and to remain in force only during the detail of the officer making the waiver at that station. 98. Commissioned officers when attached to a marine hospital or Commissioned quarantine station shall, when practicable, receive quarters, neces-cejve quarters! sary household furniture for same, fuel, and the necessary privi- furniture, etc. leges of the lighting and water-supply system of the station. 99. Articles of furniture when purchased for and assigned to the Furniture as- specified quarters of a commissioned officer shall not be changed to ned quarters other quarters without special authority from the Bureau. changed.0 be 100. Medicines and surgical appliances in stock at the station Officers al- will be allowed commissioned officers for themselves and their fam- supplies and, in ilies when sick, but they will not be allowed other hospital supplies, s^stenc^sup- When on duty at a United States marine hospital or quarantine plies. station, they may, however, be temporarily furnished subsistence for themselves and their families in special cases when authorized by the Supervising Surgeon-General, but in such event the officer will reimburse the Service the proper cost thereof. 101. The term ''medical supplies" will be understood to include Defining med only articles specified as such on the medical supply table. 102. In the case of the death of an officer payments, when duly Payment of authorized, are only to be made to the legal representative of .such ceased officers6 person, according to the forms of law. No departure from this rule will be sanctioned unless authorized by instructions from the Sec- retary of the Treasury, to whom a report of the case must be made, together with the reasons for dispensing with legal forms. 103 Officers will not be permitted to keep within the hospital Officers not .,#,.,. .,,i ■ • j.- j.i to keep animals grounds any animal tor their own use without permission ot the for private use. Supervising Surgeon-General, nor will they allow any other than authorized animals to be so kept. 8855---2 18 REGULATIONS FOR U. S. MAKINE-HOSPITAL SERVICE. Entitled to 104. Commissioned and noncommissioned officers, when quar- lauSndeeCreianng tered on the vessels of the Service in commission, shall be entitled to when quartered subsistence and laundering. on vessels. Final a c - 105. The final accounts of officers and subordinates of the Marine- ceTsntnot°to0be Hospital Service will not be paid until their property returns shall paid until prop- ^ave -peen examined and found to be correct. erty returns arperiod for 106. In determining the period for which an officer is entitled to is^entMed^to full pay on leave, time within four successive leave years, termi- f ull pay on nating with the one in which absence is taken, will be considered. If the absence does not cover the entire period for which the full pay is allowed, the balance thereof will be placed to the officer's credit as belonging to the last year or years of the four considered, and may be made available for future leave. Must cite on 107. To entitle him to full pay during absence on account of sick- of YautwVty ness an officer must cite on the pay roll the date of the authority granting or ex^ granting or extending his sick leave. During the time necessarily leave.1" ° consumed in making the journey to his post an officer joining from sick leave is entitled to full pay as if on duty. Quarters for 108. Quarters or subsistence will not be furnished in United persons01,1Z6d States marine hospitals to persons who are not employed therein by authority of the Treasury Department, except in extraordinary cases, upon specific authority from the Secretary of the Treasury in each case. ARTICLE V. GENERAL DUTIES OF COMMISSIONED OFFICERS. General du- 109. The duties of commissioned officers of the Service are pro- fessional, sanitary, and executive. Laws, regula- 110. Every commissioned officer of the Marine-Hospital Service eralSorders.gen shall make himself familiar with the laws relating thereto, and with such regulations and general orders for the government of the Service as may from time to time be issued by the Secretary of the Treasury and the Supervising Surgeon-General. PROFESSIONAL DUTIES. Professional 111. The professional duties of commissioned officers are to ex- duties de ne . amjne au applicants for relief, to prescribe for and furnish out- patient or hospital treatment as may be required, and to make physical examinations of the seamen of the several Government services and the merchant marine, under such regulations as shall hereinafter appear. To examine 112. Commissioned officers will, upon the application of the seamen, cadets, TT ..,<-,. , . . . „ , , enlisted men, United States shipping commissioner, or of the master or owner of pbCysicalt0condi- any United States vessel engaged in the foreign, coastwise, or inland tioh. navigation trade, examine as to his physical condition any seaman brought to them for that purpose, and will give a certificate (Form 1928) as to his fitness or unfitness for service. They will physically examine, in accordance with existing regulations governing physical examinations, any foreign seamen sent them for that purpose by / REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 19 the duly authorized agent of a foreign line, or by the consul repre- senting the nation to which the vessel belongs. A fee of $1 will be charged for each examination of a foreign seaman, and fees so received will be deposited with the collector of customs in the same manner as donations to the marine-hospital fund. Officers will also, upon the application of the proper authority, examine cadets, en- listed men, and persons desiring to enlist in the Revenue-Cutter, Life-Saving, Coast-Survey, and Light-House services, or to instruct them in the mode of resuscitating persons apparently drowned. No fee will be charged for this service. They will also examine alien immigrants when detailed for that purpose. 113. Whenever officially requested by the local inspectors of steam To examine vessels or other proper officers, commissioned officers will examine p^t's l?cense°r applicants for pilot"s license as to sense of hearing, color perception, and general visual capacity, and will give a certificate accordingly. 114. No fee will be charged by any officer of the Marine-Hospital No fee to be Service for the medical examination-of seamen of the United States merchant marine or for making a certificate as to their physical condition. 115. A post-mortem examination and report is required in all Reports of :,,_,, , ,, , -, , ., , . , necropsies to be cases possible. The necropsy shall be made and the report signed made. by a commissioned officer or acting assistant surgeon. The com- manding officer will affix his initials and forward the report to the Bureau as soon as completed. 116. All medical officers on duty at a station shall be present at Necropsies. necropsies whenever practicable. SANITARY DUTIES. 117. It shall be the duty of commissioned officers to enforce the To enforce na national quarantine rules and regulations; but no additional com-tine rules3 and pensation shall be allowed said officers by reason of sucli service as Ap?U2^ Vsra*1 s' they may be required to perform except actual and necessary travel- 3; Feb. 15,1893. ing expenses. 118. Commissioned officers shall obey the local health laws in Sanitary du- force at their respective stations when not in conflict with national isVsfs 3; -JoStat! health laws or regulations; execute or aid in executing the re- L-,P-^^r 1792, straints of national quarantine laws, when declared to be in force Aug. l, 1888; act at their respective stations; conduct the national quarantine service, and inspect the various hospitals where seamen are treated, under such regulations as shall hereinafter appear. 119. Commissioned officers will inform themselves fully as to the To comply local health laws and the regulations based thereon in force attheir health laws.0*1 respective stations, and will comply therewith unless in conflict with national laws and regulations. 120. Commissioned officers will report forthwith to the Supervis- To r e p o r t ing Surgeon-General any important event or fact that may come to demies!6 ° their knowledge bearing upon the importation, outbreak, or spread of cholera, yellow fever, small pox, typhus fever, or other epidemic disease at or near their respective stations, and will use the tele- graph for this purpose, if necessary. They will also collect and 20 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. report mortality and morbidity statistics, when so directed by the Supervising Surgeon-General. To vaccinate 121. Upon the outbreak of smallpox at or near a relief station commissioned officers will vaccinate such seamen as may come to the marine-hospital office for the purpose; and officers are authorized at all times to visit vessels to examine and vaccinate crews. Revenue-Cut- 122. Commissioned officers shall, when requested, advise the com- vTceeiu>1Cc;om'- manding officers of the Revenue-Cutter Service relative to sanitary manding offi- measures necessary to be adopted on vessels of that service to preserve C6rs. the health of the crews. EXECUTIVE DUTIES. To keep rec- 123. The executive duties of a commissioned officer are to keep public proper- all records relating to relief at the station, to preserve the public ty, etc. property in his charge, to act as custodian (ex officio) of the build- ings and grounds, and to supervise all subordinate officers and attendants and the administration of the Service at the port. Not to have 124. No commissioned officer of the Marine-Hospital Service shall, tract hospitals, either directly or indirectly, receive pay or emolument or have any pecuniary or material interest in any hospital in which patients of the Marine-Hospital Service are cared for. Official seal. 125. All official certificates issued under these regulations will be stamped with the official seal of the Service. ARTICLE VI. GENERAL DUTIES OF NONCOMMISSIONED OFFICERS AND ATTENDANTS. General du- 126. General duties of acting assistant surgeons are, when placed in charge of stations of the Service, to perform the same general duties (executive, sanitary, and professional), as are required of commissioned officers of the Service in so far as they are applicable to the stations which they command. Shall become 127. Every noncommissioned officer of the Marine-Hospital Serv- th^regulations!ice sha11 make nimself familiar with the regulations governing the Service, and such additions to and modifications of them as may from time to time be issued by the Department, and be governed thereby. tions^of5 ciastai 12B Acting assistant surgeons on duty at stations of the first or or?S ° second class shall perform such duties as may be assigned to them by the commanding officer. Nottohavein- 129. No acting assistant surgeon of the Marine-Hospital Service tract hospitals, shall, either directly or indirectly, receive pay or emolument or have any pecuniary or material interest in any hospital in which patients of the Marine-Hospital Service are cared for. Duties at sta- 130. Acting assistant surgeons on duty at stations of the third class will be required to perform the same official duties as the com- missioned officers, with the exception that they will not issue relief certificates nor hospital permits nor keep the register of permits, REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 21 except when so ordered by the Supervising Surgeon-General, and will not be subject to change of station unless with their consent. 131. Acting assistant surgeons in charge of relief stations will be Responsible held responsible for the proper and economical conduct of the Serv- £or Pr°Perty- ice at said stations and for the care and preservation of all public property in their charge. 132. The duties of an interne are to assist the commanding officer Duties of in- in the professional work of the station and in keeping the clinicalternes- records. 133. Internes are authorized to give orders to hospital stewards Authorized to only in matters pertaining to the professional care and treatmentglve orders' of patients. 134. The general duties of a hospital steward shall be to oversee General duties the duties of the attendants, to report dereliction of duty among ards.Spi ' the attendants to the commanding officer, to issue supplies to the attendants, to supervise the cleaning of the various buildings of the station, and to assist in preserving order in and about the buildings and grounds. He shall exercise the attendants once each week in the fire drill, in accordance with paragraph 507, regulations. 135. The senior or junior hospital steward will make daily inspec- Daily inspec- tion of the wards, kitchen, and quarters of attendants, giving par- ticular attention to cleanliness and proper preparation of food. 136. When there are two stewards on duty at a station the Junior stew- junior is subject to orders from the senior, but such orders shall orderTof senior always be in accordance with the regulations and the rules issued steward. by the commanding officer. 137. The steward shall not send important orders to one attend- Important or- ant through another, but the attendant may be sent for to receive sent one attend - the order, and the steward's duty is not completed until he has seen 0"tbetrhrougl1 an' that the order has been carried out properly. 138. It shall be the duty of the hospital steward to inspect the To make daily meals of attendants and patients daily and see that they are prop- meals6° 10n ° erly cooked and served and that order is maintained. 139. The steward shall instruct each new attendant as to his duties Toinstructat- and read and explain to him the regulations governing attendants. 140. It shall be the duty of hospital stewards to procure the sub- Daily record sistence and other supplies as directed by the commanding officer, stores re*ceived to keep a record, by weight and measure, of all the stores received, and lssued- and also of the stores issued each day to the cook or patients or to stewards, and to compound and dispense such medicines as may be prescribed. 141. The steward must receive all supplies in person. By receiv- To receive ing, is meant weighing or measuring, and, if practicable, at the time son.P 1GS in pei of delivery and in the presence of the person delivering. 142. Hospital stewards shall keep such accounts and records per- To keep ac- taining to the management of the Service as may be directed by the 0rds & reC commanding officer, and, unless otherwise ordered, at the discretion of said officer, shall keep the following accounts and books: Property record. Monthly report of subsistence. 22 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Inventory of patient's effects. Record of subsistence and other supplies. Inventory of medical supplies. Record of liquors consumed. Record of letters and papers sent. Record of letters and papers received. Duties of at- 143. Attendants, after performing their prescribed daily duties, tendants. wi]1 report to the hospital steward for further orders. Not to per- 144. Attendants will not be required or allowed to perform house- form household j u or iauncirv Work for the benefit of a commissioned officer of the work for om- cers. Service or his family. ARTICLE VII. ORDERS, ASSIGNMENTS, AND TRAVEL. CHANGES OF STATION, ETC. Length of 145. Commissioned officers and hospital stewards will not be al- teorns°e &t Sta lowed to remain at any one station for a longer period than four years, unless specially authorized by the Department. Tour of duty 146. The tour of duty of a commissioned officer at a marine bos- on specfal°servr pital and at a station of the second class shall be four years, and at ice. quarantine stations three years, unless in the opinion of the Super- vising Surgeon-General the exigencies of the Service require his earlier detachment. Assignment 147. At each station of the first class a commissioned officer will tfon?CerSt°Sta be assigned to duty as commanding officer; and whenever necessary additional officers will be assigned as assistants, in which event one officer shall be on duty in the out-patient office during business hours. At stations where there are two or more commissioned offi- cers on duty, the officer detailed for duty at the out-patient office shall be a commissioned officer. Transfers of 148. Commissioned and noncommissioned officers and attendants, station. when transferred from one station to another, and when on special duty, will keep the Supervising Surgeon-General informed of their movements. They will report promptly the date of their departure from a station, and the date of their arrival at the point of destina- tion. To comply 149. An order to an officer directing him to proceed to any place, proceed to any hut fixing no date and not expressing haste, shall be obeyed within Place- - four days after its receipt. If the order reads " without delay" he shall'start within two days; if '-immediately," within one day. Preliminary notification of transfers of commanding officers may be given when practicable. Copies of or- 150. A certified copy of all Department and Bureau orders to at station6 B officers shall be made for the files of the station where the officer affected is on duty. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 23 151. When an officer relieves another of the regular command of a station of the first class the following ceremony respecting the formal transfer shall be observed: The senior hospital steward shall muster the attendants at the Ceremonies usual place, as required in paragraph 348, in the uniform prescribed transfer of the for such occasions in the " Uniform regulations; " the commanding c°™mand of a and relieving officers, accompanied by the junior officers, shall then proceed thither and be received with the usual salute. The com- manding officer shall then cause the official orders relieving him from duty to be read by the senior steward on duty; after which the commanding officer shall announce that in accordance with these orders he transfers the command of the station to the officer designated to relieve him. The relieving officer shall then cause the official orders assigning him to duty to be read by the hospital steward: and when so clone the muster shall be dismissed by his order, and an inspection of the hospital be made by the new com- manding officer, as elsewhere prescribed. Immediately preceding the above ceremony the property return shall have been signed, and the outgoing officer shall be entitled to his quarters for the period of twenty-four hours from the signing of said property return. 152. An application for the revocation, modification, or qualifica- . Orders and as tion of orders or assignments to duty will not justify any delay in not be revoked. their execution if the officer ordered be able to travel. Except on the ground of illness or other equally important reason, orders and assignments will not be revoked, modified, or qualified at the sug- gestion or solicitation of the officer affected or made in his behalf by others, and any attempt to alter or evade them, except on the ground before specified, will be regarded as prejudicial to good order and discipline, meriting the disapproval of the Department, and will be noted in the officer's personal record at the Bureau. 153. The receipt by officers of the Marine-Hospital Service of any Acknowledg- official order from the Department will in each case be acknowledged by return mail, but when orders are given by telegraph the acknowl- edgment should also be sent by telegraph. The answer should state specifically the date of intended departure in all cases where the orders involve change of station or temporary detachment from the station. 154. Commissioned officers and noncommissioned officers and Traveling ex- attendants will be entitled to their actual and necessary traveling expenses while traveling under official orders. 155. An officer relieved from duty at a station and granted leave Entitled to of absence before assignment to another, who receives an order of ancesewhen°al! assignment before expiration of leave, is entitled to travel allow- signed to duty ances from the place where he receives the order to his new station, of absence. 156. When the station of an officer is changed while he is on Entitled to leave of absence, he will, on joining his new station, be entitled to pen ses upon traveling expenses from the place of receipt of order to the new tion^while S on station, provided the distance is not greater than that from the old leave of ab- to the new station; but if the distance be greater he will be entitled to traveling expenses for a distance equal to that from the old to the new station only. 24 REGULATIONS FOR V. S. MARINE-HOSPITAL SERVICE. Traveling ex- 157. Officers and attendants will advance their own traveling vancldt0 be ad" expenses, except over land-grant lines of railroad, when transporta- tion orders over such lines will be issued by the Department, Transporta- 158. If the circumstances warrant, transportation orders may be be0fumished. *0 furnished upon application to the Supervising Surgeon-General; but in case of necessity, when the time is insufficient to procure transportation orders, bills for railroad or steamboat fares may be rendered (Form 1988) by the transportation companies fur- nishing same, and certified by the officer receiving the ticket or transportation. Reimburse. • 159 Officers and attendants, upon completing the duty specified ing expenses, in their official orders, will forward to the Supervising Surgeon- General, for reimbursement, an account of traveling expenses, prepared in accordance with the provisions relative thereto. Allowances 160. In accordance with the foregoing provisions, officers travel- expenses, ing upon the official business of this Department will hereafter be allowed " actual traveling expenses" usual and essential to the ordinary comfort of travelers, embraced in the following items of expenditure: Actual fares on steamboats, railroads, and other conveyances, by the shortest practicable route; the hire of special transportation where there are no regular means of conveyance: street-car, omni- bus, or transfer-coach fare to and from depots and hotels, and where there are no such conveyances, moderate and necessary hack hire, and reasonable fees to porters and expressmen; sleeping-car fare for one double berth for each person, or customary stateroom accom- modation on steamboats and other vessels; one seat in parlor car and lodgings and actual board in hotel at a rate not greater than §1 a day; reasonable expense for laundering where the travel continues for a week or more. Hotel bills and receipts will be taken in all cases where it is practicable to obtain them and must accompany accounts as vouchers. No charge will be allowed for hotel bills when the detention is unnecessary for the performance of the duties for which travel is required. traveling1"8 e^ 161- Voucners for actual traveling expenses (Form 1941) shall be penses. rendered. Hotel bills and receipts will be taken in all cases where it is practicable to obtain them, and must accompany bills as sub- vouchers. Accounts shall be itemized as far as possible, and a copy of the order under which the expenses were incurred must accom- pany each account. counts61?? be 162 Each traveling account must be sworn to by the person ren- swornto. dering it as just and true in all respects, and must state that the services specified therein were actually performed, that the expenses charged were actually and necessarily incurred and paid at the dates specified; that the distances as charged were actually and necessa- rily traveled, and that no part of the travel was under a free pass on a railway, steamboat, or other conveyance. mghSur!geeon! 163 The Supervising Surgeon-General must certify that such General to cer- services were performed; that they were necessary and proper, and anre of service, that the prices paid for travel, etc., were just and reasonable. Attendantsal- 164. Attendants, when traveling under official orders, shall be expenses. allowed actual fares on railroads, steamboats, or other conveyances REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 25 by the shortest practicable route, street-car fare to and from depots or hotels, baggage transfer charges, sleeping-car or stateroom accom- modations at night and actual board, at a rate not greater than $3 a day. . 165. Commissioned and noncommissioned officers, when trans-. Allowance for . ., hotel expenses. ferred from one station to another, shall be allowed the actual and necessary cost of board and lodging for three days from the date of arrival at the last station, at a rate not greater than x."> a day. 166. The allowance for baggage and personal effects to officers in , Allowance for D£L£T&r£iSr6. changing stations will be—for surgeons, 2,000 pounds; passed assist- ant surgeons. 1,600 pounds; assistant surgeons 1,200, pounds, and for hospital stewards, 800 pounds. In all cases this allowance shall be for baggage and personal effects actually owned by the officer and sent as freight, and the receipted freight bill will accompany the traveling expense account as a voucher. Bills for express charges shall not be allowed unless previously authorized. 167. Professional and scientific books and instruments the per- Books and in- sonal property of the officer, not exceeding 200 pounds in weight, transported will be transported on change of station, without expense to the py^°ut ex" officer, upon presentation of a receipted freight bill accompanying traveling expense account as a subvoucher. The packages thus transported for which bills are rendered shall be certified under oath by the officer to be of the kind and character above specified. 168. An officer ordered to temporary duty while on leave will be Dutv while on regarded as on duty from the day on which he received the order. When the duty is to be performed at a future date he will be on duty from the day on which he starts to obey the order. The date of the receipt of the order in the first case and the date of departure in the second will be promptly reported to the Supervising Surgeon- General. When relieved from such duty, or on the completion thereof, he reverts to the status of leave, and will be credited with the time on duty under such order. 169. When an officer on leave of absence is ordered to rejoin his , Notentitledto ' travel allow- station he will not be entitled to travel allowances unless the public ances when or- service requires the performance of duty en route, in which case the gfatlon whileon order will specify the duty, the necessity therefor, and the points at leave. which the dutv will begin and end. ARTICLE VIII. LEAVES OF ABSENCE, SICK LEAVE, AND WAITING ORDERS. LEAVES OF ABSEN'CE FOR COMMISSIONED OFFICERS. 170. Commissioned officers of the Marine-Hospital Service onwJler^for duty shall be allowed, in the discretion of the Secretary of the us statutes, Treasury, sixty days' leave of absence without deduction of pay or 239,' actPdf Con- allowance, provided that the same be taken once in two years, and |reejfr ^P™^ provided, further, that the leave of absence may be extended to lsor. three months if taken once only in three years, or four months if taken only once in four years. 26 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Leave year. 171. The leave year is reckoned from June 20 to the following June 19, both inclusive. In computing leave of absence expressed in days during any leave year, every day of such absence will be counted: leave expressed in months will be counted in months. Applications 172. All applications for leaves of absence, or for extensions of the totheasdudpe^visdsame, or for delays, and all correspondence regarding them, shall ing Surgeon-1^ addressed to the Supervising Surgeon-General, and forwarded through the officer in command of the station, who shall note •thereon his approval or disapproval of the application. Granted in 173. Leaves of absence will be granted in terms of months and andmdSayfsm0nthS days, as "one month," "one month and ten days." Leaves for one month, beginning on the first day of a calendar month, will expire with the last day of the month, whatever its number of days. Com- mencing on an intermediate day, the leave will expire the day pre- ceding the same day of the next month. The day of departure, whatever the hour, is counted as a day of duty; the day of return, as a day of absence. Commence- 174. A leave of absence commences on the day following that on ment. which the officer departs from his proper station. The expiration of his leave must find him at his station. May be grant- 175. Leaves of absence may be granted by the Supervising Sirr- ed by the Super- eeon_(}eneral for a period of one month, and when so granted the vising Surgeon-&& „ , , ., ,, ,c j a t *.- General. Secretary of the Treasury shall be promptly notified. Applications for leaves of absence longer than one month will be submitted to the Secretary of the Treasury for action. Length of ab- 176. An application for leave must state the entire length of must be^tatecl absence desired, and if for more than one month, its purpose. Commanding officers, in forwarding the application, will indorse thereon any reasons which exist for granting or refusing the leave. Leave exceed- 177. N0 leave of absence exceeding seven days, except under not granted.ayS extraordinary circumstances, which will be particularly stated, will be granted to any officer until he has served two years. Verbal per- 178. Verbal permits for less than twenty-four hours are not nuts not count- counte(j as leaves of absence, but every other absence of whatever duration, with date of departure and return, will be noted on the medical officer's journal and on the pay rolls of the month cover- ing such absence. Commanding 179. The commanding officer of a station may take leave of ab- seven"davs take sence n°t *° exceed seven days at one time in the same month, reporting the fact to the Supervising Surgeon-General, provided there are two or more commissioned officers on duty at said sta- tion, and further provided that the Surgeon-General be notified by telegraph before leaving station of the date of departure and address during absence. At quarantine 180. Paragraph 179 does not apply to commanding officers of quarantine stations during the active quarantine season. Commanding 181. The commanding officer of a station may grant leaves of granT'se^en aDsence not to excee(l seven days at one time or in the same month, Says, and he may give permission to apply to the Supervising Surgeon- General for extensions of such leaves for a period not to exceed twentv- three da vs. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 27 182. Leaves of absence shall not be granted to an officer during ^ Not granted ° . during epi- epidemics. except in case of urgent necessity. demies. 183. Officers will not leave the United States to go beyond the Not to go be- sea without permission from the Secretary of the Treasury. 184. In d termining the period for which an officer is entitled to Determina- full pay on leave, time within four successive leave years, termi- nating with the one in which absence is taken, will be considered. If the absence does not cover the entire period for which the full pay is allowed, the balance thereof will be placed to the officer's credit as belonging to the last year or years of the four considered, and may be made available for future leave. 185. Officers visiting foreign countries, whether on duty or leave, On foreign will avail themselves of all proper opportunities to obtain informa- tion relating to the operations of the service. They will report the result of their observations to the Supervising Surgeon-General on their return to duty, or sooner if practicable. 186. An officer granted a leave of absence will report to the To report date Supervising Surgeon-General the probable date of his departure and ° epar his new address, and thereafter he will immediately report any change in said address. SICK LEAVE. 187. Application for leaves of absence on account of sickness will AJ)plii:jtionI be made through the same channels as prescribed for ordinary to the Supervis- leaves. and the officer applying will submit to the Surgeon-General Qener^Jrgeon a medical certificate, preferably from a medical officer of the Marine- Hospital Service, if such can be convenientfy obtained, stating explicitly the nature, seat, and degree of the disease or disability, the cause thereof, if known, and the period during which the officer has suffered from it. The medical certificate must state whether the disease or disability can be satisfactorily treated at the place where the officer is stationed, or whether a change of climate or locality within the United States is necessary to afford more rapid or perfect recovery, in which case the special place or region recom- mended will be designated with reasons therefor. The certificate must also state whether the disease or disability requires treatment by a specialist, and if so, the nearest place where it can be obtained; also whetherthe dise use or disability incapacitated the officer from all duty, or whether he can perform special duty, and if so, the kind that he may undertake without endangering his ultimate cure. 188. All absence, with or without leave, will be duly reported to Absence to be the Secretary of the Treasury by the Supervising Surgeon-General. repor e ■ 189. The Supervising Surgeon-General has the same authority to May be grant- grant leaves of absence on account of sickness as to grant ordinary vjslng surgeon! leaves. Permission to leave the port at which the applicant is General. stationed will be given only when the medical certificate shall state explicitly that it is necessary to afford rapid or perfect recovery. 190. On the expiration of a sick leave, if the officer be able to To proceed to travel, he will proceed to his station. If an extension of such leave pfr1atioPn>n Iff be necessary, he will make timely application therefor through the*eave' same channel as in the case of a request for extension of ordinary leave, basing his application upon a medical certificate, as heretofore prescribed. When he cannot procure the certificate of a medical 28 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. officer, he will substitute his own certificate, on honor, as to his con- dition, which will embrace a full statement of his case. While absent from duty he will make report in the same manner as if on ordinary leave. Tobereported 191. An officer who starts to join his station at the expiration of a sick leave will be reported upon the pay rolls of his station as "en route to join station from sick leave of absence," during the time necessarily consumed in making the journey to his station. Should he delay en route, or consume more time in the journey than is necessary, the commanding officer will require him to explain in writing the cause of the delay. This explanation will be forwarded to the Supervising Surgeon-General. Ordinary leave 192. An ordinary leave will not be changed to a sick leave, unless changed to sick the officer desiring it make application therefor to the Supervising leave. Surgeon-General. Said application must be accompanied by a med- ical certificate, given, if possible, by an officer of the Marine-Hospital Service. In all reports concerning absence on account of sickness the officer will state how long he has been absent "sick," and by what authority such leave was granted. To report by 193. Commissioned officers, when on authorized sick leave, shall letter when on rep0Tt by letter their physical condition to the Surpervising Sur- geon-General every fifteen days, with a certificate of the physician in attendance. Not granted 194. Leaves of absence will not be granted on tender of resigna- tion resigna- ^on uniess the resignation be unconditional and immediate, with- out privilege of withdrawal. May be placed 195. Commissioned officers may be placed upon " waiting orders " orders waltmg f°r age °r disabilities incident to their service in cases of infirmity or protracted illness (not due to immoralities or intemperate habits), but before such action is taken the officer who shall apply for this order must be recommended to the Department as entitled to receive it by the Supervising Surgeon-General of the Marine-Hospital Serv- ice upon the recommendation of a board of commissioned officers (his seniors in rank wherever possible), who shall certify to his physical condition in detail, and give the reasons for their action. To report 196. When commissioned officers are placed on " waiting orders"' waft?nIlaoCrede°s! they sha11 rePort bv letter to the Supervising Surgeon-General on the first day of each month, giving their address and a brief state- ment of their physical condition. LEAVES OF ABSENCE FOR NONCOMMISSIONED OFFICERS. Noncommis- 197. Acting assistant surgeons, internes, and hospital stewards fcolea*eIta°sha,U not absent themselves from their respective posts unless tions without granted leave of absence by the Secretary of the Treasury, except as hereinafter provided. Leaves of ab- 198. Leaves of absence shall not exceed thirty days in each fiscal clede30nday°.eX" 3Tear' except in case of sickness, and leaves of absence in excess of thirty days, if granted for other cause, shall be without pay. No application for leave of absence will be considered while the appli- cant is under orders to change stations, except in case of exigencv REGULATIONS FOR II. S. MARINE-HOSPITAL SERVICE. 29 in which case full particulars of the reasons therefor must be given in the application. 199. A^erbal permits for less than twenty-four hours are not Verbalpermits counted as leaves of absence. 200. Applications for leave of absence made by noncommissioned i^p1p]11ultio^s officers shall be addressed to the Supervising Surgeon-General, and dressed to the if made by a junior officer will be forwarded through the officer in |urgeTnSGen? command of the station, who shall note thereon his approval or dis- eral- approval of the application. 201. Leaves of absence for one week or less may be granted to non- How granted. commissioned officers by the Supervising Surgeon-General in his dis- cretion, or by the commanding officer of a station to any subordinate officer, such leaves of absence to be noted on the monthly pay roll. The sum total of such leaves shall not exceed thirty days in any fiscal year. Leaves of absence for internes shall not exceed fourteen days in any fiscal year. LEAVES OF ABSENCE FOR ATTENDANTS. 202. The commanding officer of a station may grant a leave of How granted. absence for one week or less to an attendant, such leave of absence to be noted on the monthly pay roll. The sum total of such leaves shall not exceed seven days in any fiscal year, except in special cases, when the application must be referred to the Department for action. 203. Verbal permits for less than twenty-four hours are not Verbal per- counted as leaves of absence. ARTICLE IX. UNIFORMS. 204. The uniforms prescribed in the official publication entitled Uniforms to "Regulations governing the uniforms of officers and employees of the United States Marine-Hospital Service" shall be worn by all officers and attendants so long as such regulations remain unre- pealed or unaltered by Department authority. Additions and altera- tions which may be officially made from time to time shall be obeyed and respected accordingly. 205. Officers and attendants are required to keep themselves sup- Uniforms ob- plied with all articles of uniform and equipment as prescribed by 1^tovy- the regulations. All uniforms are obligatory unless stated to be optional. 206. Officers and attendants shall wear the prescribed uniform ^ Uniforms, ^of of their respective grades, in accordance with the following regu-grades to be worn. lations: 207. Officers and attendants shall not wear uniform, or any por- wJJJen to be tion thereof (with the exception of the overcoat), when absent from their stations and not on duty. This does not apply to the uniform that may be worn by officers on special occasions. 30 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Civilian dress 208. When in uniform no officer or attendant shall be allowed to not allowed. ... „ . .,. , wear any article of civilian dress. Overcoats to 209. The commanding officer shall prescribe when overcoats shall be worn with uniform, and the occasions for wearing uniform of white material. Negligence to 210. Commanding officers will report to the Department any neg- ligence of junior officers in respect to compliance with the regula- tions governing uniforms, and inspecting officers when visiting stations will include the completeness and condition of the uniforms of all officers and attendants in their report of each station. Newly ap- 211. Medical officers in command shall see that assistant surgeons to^provide uni recently appointed and ordered to report to them for their first duty forms. provide themselves with the proper uniforms within thirty days from date of arrival, and shall report the compliance therewith to the Bureau. Attendants to 212. Commanding officers are required to instruct each attendant relative^0unf when appointed concerning the uniform of his class, and to direct forms. hrm to procure it within thirty days from his appointment. Failure to comply as above will be cause for immediate suspension. Inspection of 213. At least once in each quarter, at the beginning thereof or uniforms. whenever the commanding officer shall so direct, there shall be a special inspection of the uniforms of officers and attendants on duty at a station for the purpose of ascertaining whether the regulations respecting uniforms are obeyed by officers and attendants. When uni- 214. Officers on leave or waiting orders may wear uniform on m a!yS mot aibe occasions of special ceremony, but are prohibited from wearing any worn, part of their uniform except the overcoat while suspended from duty. Uniforms not 215. Officers shall not wear the uniform of their grade when when on duty detailed for duty in the office of the Supervising Surgeon-General at Bureau. except when so ordered by him. Badges may 216. The distinctive badges adopted by military, hereditary, and patriotic societies of men who served in the armies or navies of the United States, or their descendants, during the colonial wars, the war of the Revolution, the war of 1812, the Mexican war, and the war of the rebellion, respectively, may be worn on all occasions of ceremony by commissioned and noncommissioned officers and attend- ants of the Service who are regular members of such organizations and entitled by their rules to wear such decorations. THE SUPERVISING SURGEON-fiENERAL. Full-dress uni- 217. The full-dress uniform for Surgeon-General shall be worn form for Super- ,..„., ° vising Surgeon- on all occasions ot special ceremony. General. Dressuniform 218. The dress uniform for Surgeon-General shall be worn on for Supervising . . ,. Surgeon-Gen- general inspections. eral. Fatigue uni- 219. The fatigue uniform for Surgeon-General shall be worn on vising Surgeon- all informal inspections made by himself. General. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 31 COMMISSIONED (>FFICERS. 220. The full-dress uniform for officers shall be worn at all gen- Full-dressuni- eral inspections made by the Surgeon-General or other inspectors at mi^ioned C°ffi! stations of the first class, at the transfer of hospital and quarantine cers- stations, and on all occasions of special ceremony. 221. The dress uniform for officers shall be worn on all weekly Dress uniform inspections and musters, when serving on all boards, and by officers s°one(i officers?" presenting themselves for examination for promotion, and by officers when reporting for duty at stations of the first class. 222. The fatigue uniform for officers shall be worn by all officers Fatigue uni while on ordinary duty at hospitals, and on ordinary quarantine jnfsTioned Coffi! duty, and when inspecting unserviceable property, and at informal cers. inspections by the Surgeon-General, and at the office where out- patients are treated. 223. The white uniform shall be worn in warm weather as a sub- white uni- stitute for the fatigue uniform, when approved by the commanding orms' officer. The helmet may be worn as a substitute for white cap when necessary, with the approval of the commanding officer. Shoes of white material may be worn with this uniform. 224. The sword belt shall be worn over the full-dress and dress Sword and uniform coats with the lower edge of the belt placed above the two nWw worn.6 L_ lowest buttons in front and the two at the waist behind. The short sling strap shall hang immediately in the rear of left hip and the long sling strap in the center of the back between the buttons. When the sword is hooked up the ring on the front edge of the scab- bard shall be slung so that the hilt shall hang to the rear of the hook with the sword point inclined to the front. When the sword is worn with the overcoat it should hang on the outside, the belt being worn underneath. The long sling shall pass out through the opening between the skirts of the back of the coat and the short sling through the sword slit at the side. When worn with fatigue uniform the belt shall be placed beneath the blouse. 225. Commissioned officers on boarding duty at national quaran- Whenonboard tine stations shall wear the fatigue uniform and sword belt, and, an^ine stations." whenever practicable, the sword, the sword belt to be worn be- neath fatigue coat. 226. Gloves shall always be worn with the sword. White kid Gloves. gloves may be worn on occasions of special ceremony. NONCOMMISSIONED OFFICERS. 227. Acting assistant surgeons on permanent duty at marine Fatigue uni- hospitals and on quarantine duty shall wear the fatigue uniform, ^g^ant as°nmr? When performing the duties of boarding officer they shall wear the geons. sword and belt as prescribed for commissioned officers. 228. A uniform of white material shall be worn by acting assist- White uni- ant surgeons on duty at stations of the first class in warm weather Assistant^sur? as a substitute for the fatigue uniform, when approved by the com- geons. manding officer. 32 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. INTERNES. Fatigue uni- 229. Internes shall wear the fatigue uniform when on hospital forms for in- - ternes. duty. White uni- 230. A uniform of white material (optional) may be worn by ternes. internes in warm weather as a substitute for the fatigue uniform, when approved by the commanding officer. HOSPITAL STEWARDS. Dress uni- 231. The dress uniform shall be worn at inspections, musters, forms for stew- - ,-,,, ., . , -,. -, , ,, -, ards. and on all other special occasions, when so directed by the command- ing officer. Fatigue uni- 232. The fatigue uniform shall be worn on hospital and quaran- worn"1 ~ tine duty and when on duty at the office for the treatment of out- patients. White uni- 233. The white uniform shall be worn in warm weather as a sub- worn, stitute for the fatigue uniform, when approved by the commanding officer. ATTENDANTS. Dress uniform 234. The dress uniform shall be worn on ordinary duty and at for attendants. . ,. inspections. Working suits. 235. Nurses while on duty in wards may wear white linen or duck jackets, to be of uniform pattern at each station. Attendants in kitchen, dining room, and laundry shall wear white linen or cot- ton jackets and aprons, to be of uniform pattern at each station. Attendants detailed as firemen, scrubbers, and gardeners shall wear, when at work, blue jumpers and overalls, for the protection of their clothing. Whitecapmay 236. A white duck cap, without letters, maybe worn in the sum- mer, when ordered by the commanding officer. QUARANTINE SERVICE. Uniforms at 237. Commissioned officers, acting assistant surgeons, hospital tions. stewards and attendants, serving at quarantine stations shall ob- serve the same regulations relating to uniforms as apply to those at hospital stations of the Service. ARTICLE X. DISCIPLINE. Orders of su- 238. Commissioned officers, noncommissioned officers, and at- beobeyed061^ ° tendants of the Marine-Hospital Service are not subject to official orders except those emanating from the President, the Secretary and Assistant Secretaries of the Treasury, the Supervising Surgeon- General, and other superior officers, and they are required to prop- erly observe and promptly obey the lawful orders of their superiors. Obeying 239. If the legality of an order is doubted by the subordinate hp orders under uc protest. must obey the order, but may do so under protest, and if upon con- sideration he deems it of sufficient importance he may submit his REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 33 objection to the same in writing to the Supervising Surgeon-General through the commanding officer. 240. When more than one commissioned officer is assigned to Senior officer duty at a station, the senior officer shall be in command, and shall mand of station. be held accountable to the Department for the proper administra- tion of the Service at such station. 241. The commanding officer at each station shall have authority Commanding over all officers and attendants of that station, and is required to authority over enforce the observance of these regulations and such orders as he subordinates. may deem necessary for the proper management and discipline of the hospital not inconsistent with these regulations and subject to the approval of the Supervising Surgeon-General. 242. An officer can never, while holding a commission, under any Official rela- . , . „, . , , .. , ....... tions can not be circumstances, sever his official relations and responsibilities from severed. the trusts imposed upon him by virtue of said commission. 243. No officer can be permitted to disgrace himself by dissipation Mast not yio- or immoral conduct, or otherwise violate the regulations upon the when off duty. plea that he was "off duty'" or on "waiting orders." 244. Commissioned officers, noncommissioned officers, and sub- Subordinate ordinates are required to treat their official superiors with proper and obedient. respect, and to obey all orders of such superior officers, not in con- flict with the regulations, with promptitude and zeal. 245. When two or more commissioned officers are serving at the Official letters same station, junior officers will forward official communications through senior through the commanding officer, except in his absence, when the omcer- next ranking officer will act in his stead. 246. No person habitually using intoxicating beverages to excess Use of intoxi- shall be appointed to or retained in any office, appointment, or ages1 to exces's. employment in the Marine-Hospital Service. v ^ £ J^ ^ s.'h. ' 247. All officers and subordinates of the Service are prohibited Letters of rec- from giving letters of recommendation in relation to any article of for articles or manufacture or in behalf of any firm or corporation. flrms- BOARDS OF INVESTIGATION. (FOR COMMISSIONED OFFICERS.) 248. A board of investigation shall be ordered only by the Presi- To be ordered dent of the United States or the Secretary of the Treasury, on dLtw? the Sec! recommendation of the Supervising Surgeon-General, and when ^^nr°J tne convened shall, if so required, make, in addition to a report of its findings, recommendations as to punishments. 249. Boards of investigation shall consist wholly of commissioned Of whom corn- officers of the Service, and of not less than three members. If the posef 251. The following are the duties of the recorder: To record the recorder proceedings of the board under its direction, to receive and prop- erly mark all documentary evidence presented to the board, and, in conjunction with the chairman of the board, to authenticate the proceedings by his signature. Testimony. 252. All testimony given before a board of investigation shall be administered delivered under oath or affirmation, and the president of the board Rev°ffltatrSs 183 sna^ have authority to administer an oath to any witness attending to testify or depose in the course of such investigation. Testimony to 253. The testimony given before a board of investigation shall be deroath. delivered under oath or affirmation, and in addition to such oral testimony, documentary evidence may be filed with the board by those in interest. The evidence offered by those making the charges shall first be heard, and this shall be followed by the evidence to be offered by the accused in his defense. The board of investigation shall not take cognizance of collateral matters not involved in the specifications and charges against the accused. ceedfngs °tfoPbe 254, ^he record of tne proceedings shall be signed each day by signed daily. the chairman and recorder. The final report of the board shall be signed by the members concurring, and any member not concurring shall submit and sign a minority report. unfshment °f 255, Tlae followinS are the only punishments that can be recom- mended by the board for infliction upon the accused: 1. Dismissal from the Service. 2. Reduction of rank in his own grade. 3. Retention of his present number on the register for a specified time. 4. Reduction of salary to three-quarters for a period not less than one month nor more than one year. 5. Official reprimand in general orders. 6. Recommendation embodying two or more of the punishments from Nos. 2 to 5, inclusive. charges0Pto be 256 When an accusation is mad© against an officer, either by furnished an ac-report or indorsement upon a communication, or charges are pre- cused officer. ferre(i against him, upon which wholly or in part a board of inves- tigation is convened, a copy of such report, indorsement, or charges shall be furnished to the officer accused. limTred^toT 257 No officer in the Marine-Hospital Service shall be investi- fenses commit- gated or punished for any offense connected with the Service which ted within one -u n L i -i . ^^y^o wmi/u year. snail appear to have been committed more than one year before the issuing of the order for the board of investigation of said offense unless for some manifest reason he shall not have been amenable to investigation within that period. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 35 258. After the record and other documents have been properly Records to be signed they shall be forwarded by the chairman with a letter of the Depart- transmittal to the Secretary of the Treasury (through the Super-ment- vising Surgeon-General), and the board will then adjourn until dissolved by the proper authority. 259. Upon receipt of the report of the board, the Supervising Proceedings Surgeon-General shall review the proceedings and findings and for- ward the same to the Secretary of the Treasury with his recom- mendations. 260. Disrespectful language concerning the President, the Secre- Language dis- tary of the Treasury, the Assistant Secretaries of the Treasury, or the^residentor the Supervising Surgeon-General, and any publication reflecting Treasury offi- cizils or reflec" directly or indirectly upon the Service, or upon an individual officer, tions upon the whether by newspaper, pamphlet, or handbill, will be viewed as ^wt^h^of1- conduct unbecoming an officer and subject the offender to summary fender to disci- discipline. p me' 261. Noncommissioned medical officers are entitled to the same Noncommis- -,,-,. « v,j-i. ■ • j £c sioned medical respect and obedience from subordinates as commissioned officers, officers to be obeyed. 262. No officer or attendant attached to the Marine - Hospital Maltreatment 0 .,i , •,, -. «. ij. i. j of subordinates Service will be permitted to oppress or maltreat any person under or patients not his command, or in the Service, nor to abuse applicants for relief, or permitted. patients under their care. 263. If any person in the Marine-Hospital Service shall consider Acts of op- himself oppressed by his superior officer and fail to obtain redress be reported ^o from said officer, he shall report such fact through the commanding |^.|^P®rvjs^ns officer in writing to the Supervising Surgeon-General. He will be eral. held accountable, however, if his report be found trivial or false. 264. Commanding officers may impose upon subordinates under Grades of their command the following punishments: 1. Upon commissioned officers and noncommissioned officers private reprimand, suspension from duty and privileges pending immediate report of the case to the Supervising Surgeon-General. 2. Upon attendants, suspension from duty, deprivation of liberty to leave the reservation for a specified period, extra duty, and repri- mand at muster. 265. All disciplinary measures imposed by the commanding officer Measu r es ot in accordance with the preceding paragraph (264) shall be entered in entered in jour- the journal of the station, and such entry shall include the date and nal- nature of the offense and the kind and degree of punishment. 266. When the commanding officer of a station is temporarily in absence of absent, the officer next below him in rank shall assume temporary nlxtrankh^gof- command and perform such ordinary duties of his superior officer as ^ceV to assume can not, without injury to the Service, be delayed until his return, and changes or alterations in the routine of the hospital will be avoided. 267. When an officer is detailed to assume temporary charge of Changes in another station during the absence of its regularly assigned com- be made by of- manding officer and custodian, such detail shall not be construed as raryScommand giving the opportunity to make changes in the regular routine of the Service established at that station; but when changes are found to be urgently necessary from conditions of emergency or changed 36 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. circumstances arising during such temporary detail the relieving officer must enter the new official order in the officer's journal, with reasons therefor, over his signature. Status of offi- 268. An officer detailed for duty as described in paragraph 2G7 !ry charge^1"5 will be known officially as " in temporary charge " of that station, and sign himself as "In temporary charge" during such detail. Suspended for 269. The commanding officer will be held responsible for the maintenance of discipline among the attendants at his station and the proper performance of the duties allotted to them; and when any attendant willfully disobeys official orders, is disrespectful, insubordinate, intoxicated, or is otherwise unfitted for the Service, such attendant may be suspended by him and a report of the facts will be made to the Department, through the Supervising Surgeon- General for further action. Personal criti- 270. Officers are strictly forbidden to criticise publicly the pro- fessional competency or impugn the personal character of another officer. i ° Washington 27*- Officers °f the Marine-Hospital Service visiting the District to register at of Columbia, whether on leave of absence or otherwise, are required within twenty-four hours after arrival to register at the office of the Supervising Surgeon-General. Suspension 272. Hospital stewards may be suspended by the commanding officer, or the officer in temporary charge, for dishonesty, incom- petency, insubordination, neglect of duty, or any other sufficient cause; but the charges shall in every case be immediately reported to the Department, through the Supervising Surgeon-General, for further action. investigated0 & 273- If the charges so reported are of sufficient importance, a commissioned officer from another station shall be ordered to inves- tigate the matter and make a full report to the Supervising Surgeon- General, with recommendations. ishment3 of pun" 2 74- Tne investigating officer may recommend either of the follow- ing punishments if the accused is found guilty of the charges, viz: 1. Dismissal from the service. 2. Reduction of salary to three-quarters of pay for a period of not less than one month nor more than six months. 3. Reduction in rank in his own grade. 4. Reprimand in general order. Salute to be 275. Every officer and subordinate on duty at a marine hospital turned.8, * or quarantine station, when meeting or passing his commanding officer, or an officer senior in rank, for the first time each day, shall salute him and the salute shall be returned. The same shall be done in giving and receiving formal orders. Officers not to 276. Commissioned and noncommissioned officers will not pub- tics, ^tc.^with! lisfi or furnish for publication any official reports of current statis- See aaisoh°prarI-tics of the <>Perations of the Service, or concerning the Service, graph 279. without authority from the Supervising Surgeon-General- but this is not to he construed as applicable to purely professional sub- jects based upon original investigations of disease as seen among seamen or others. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 37 277. Commanding officers authorized to grant seven days' leave Leaves of ab- ° ° i ., -i sence not to be of absence to subordinates shall not grant such leave while charges granted while are pending against them, but requests for leave at that time shall ^ej^^6 s are be referred to the Supervising Surgeon-General for action. 278. A junior officer wishing to report the history of any case for ^ Junior officers J & r . .i to obtain con- publication in a medical journal shall obtain the consent of the sent to publish officer in command. cases- 279. No reports or information concerning the Service shall be Information volunteered to the press without the consent of the officer in com-to be given with- mand, to whom also representatives of the press shall be referred °^*e ^o^fmand* when requesting information. ins officer. 280. An order countermanding the written order of a superior. Countermand- mg orders to be officer shall be given in writing. in writing. 281. Complaint against one officer by another may be made, pref- Complaint of ,v i n-iji'- ,one officer erably in writing, but no junior officer has the right to reprimand against another another, and any officer deeming himself badly treated by another may be made- must, nevertheless, pay him official respect. 282. When a junior officer is unable to appear in the regulation Junior officer uniform, or when prevented from observing any settled rule or cus- una^toappear torn, he shall make explanation to the officer in command. in uniform 283. Any correspondence between officers, attendants, and seamen official corre- under treatment, on matters concerning official business, such as transmitted certificates of character, requests for information relative to the through com- , , .,,-,,-, i .i ~» • manding officer. Service at any station, must be transmitted through the officer in command of the station where such attendant or patient may be on duty or under treatment. 284. Officers ordered to duty under other Departments or other x Officers d e _ J . ,, , n , , ,. tailed to other services in the Treasury Department shall report by letter to the Departments to Secretary of such Department or to the chief officer of the particular rePortbyletter- service to which he is detailed. While on such duty he shall obey the orders and directions of the said Secretary or chief officer. 285. When on such duty, officers will beheld directly responsible Officers on de- tothe Supervising Surgeon-General for conformity to the regula-sponsible to the tions of the Marine-Hospital Service, except only in so far as they fu^gYo^-Gen^ may be inconsistent with the special service in which they areeral. engaged. 286. When an officer reports for duty, the commanding officer introduction shall formally introduce him to the officers and attendants at the°f0ant?^erf™r next general muster. duty- 287. If citizens residing in the neighborhood of a hospital reser- Private prac- vation request the professional services of a commissioned officer, it galeJnn!be en is not regarded as inconsistent with the requirements of the regu- lations governing the Marine-Hospital Service for such officer to accept such requests when this does not interfere with the proper performance of his official duties. The establishment of an office outside of the limits of a hospital station or at a station of the sec- ond class, excepting at the residence of the officer, for the purpose of engaging in private practice is prohibited. 38 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. ARTICLE XT. STATION MANAGEMENT. Display of na- 288. The flag of the United States shall be displayed at all sta- iona ensign. ^ons Qf ^e first class from sunrise to sunset, except during stormy weather. On May 30 the flag should be placed at half-staff or half- mast. Flags. 289. Each marine hospital and quarantine station shall be en- titled to two national ensigns, one of the large size (20 feet fly and 10 feet hoist) and one a storm flag (8 feet fly and 5 feet hoist). The former shall be hoisted from a staff erected over or near the execu- tive building of the hospital or quarantine station each day from sunrise to sunset, except during stormy weather. Whenever the weather is too stormy to fly the large national ensign the small storm flag shall be set in its place. Quarantine stations, in addition to the above, shall be entitled to two quarantine flags of special design. Hours for sick 290. The commanding officer shall visit all patients in hospital once each day, and oftener if necessary. The morning sick call shall be made at 9 o'clock each day, and the medicines ordered shall be compounded and delivered to the nurses as soon as practicable after the termination of the visit. The evening sick call shall be made at 6 p. m. daily by an officer of the staff detailed by the officer in command, and he shall be accompanied by the night nurse and by the day nurse in each ward. To report at 291. Officers on duty at first-class stations shall report at the morning sick , „ , n n^ -, - , call. surgeon s office to the commanding officer daily at the morning sick call. Duty at out- 292. When two or more officers are on duty at the same station patient office. .... ^ ..... .-,-,» -, , the junior officer shall be detailed for duty at the out-patient office, which shall be kept open for business during the hours when the custom-house at that port is opened for the transaction of business. Internes shall not be placed in charge of the out-patient office except temporarily in case of emergency. Consent to 293. Junior officers shall not leave the reservation without the tion. consent of the commanding officer; and when desiring to be absent beyond twenty-four hours his address shall be left with the com- manding officer. To report 294. On returning to the reservation after absence, everv officer upon return to,,, ... , . . , J reservation. shall report his arrival in person or by message to the commanding officer. leav^nCreUp-0n 295' The comman(:iing officer, on leaving the reservation, shall tion. notify the officer next in rank. b^eftTithout 296' Stat5ons of the first class shall not be left without the pres- a medical offi- ence of a medical officer, but if exception to this rule is unavoidable cer" special instructions shall be left with the hospital steward. bf \eftTithout 297 Stati°tis of the first class, when but one medical officer and a medical offi- one steward are on duty, shall not be left without the presence of cer or steward. the offlcer Qr ^ h itftl steward> REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 39 298. Junior officers must report to the commanding officer any To report to dereliction of duty on the part of attendants. officer. 299. Junior officers shall not give orders, except of an emergency Not to give character, to hospital attendants other than to the nurses immedi-orders- ately under their charge. 300. When a junior officer wishes to conduct visitors through the Visitors to hospital, or to extend an invitation to any hospital event, the consent of the commanding officer shall first be obtained. 301. The hospital steward's office must not be left without the Hospital stew- presence of a steward or attendant during the day. 302. The steward in charge of the dispensary shall not fill or Prescriptions , , , , ,. . ™ not to be filled. repeat any prescription unless so ordered by a medical officer. 303. Attendants will not leave the hospital reservation without Not to leave permission from the commanding officer or the hospital steward, ou^parmissioii! and before leaving will report their departure to the hospital steward and their return to the hospital steward or night watchman, and the latter shall make record of return in a book kept for the purpose. 304. Attendants must be addressed either by their occupation, as Appellation of ,, , ,, . , attendants. nurse, watchman, etc., or by their last name. 305. Testimonials of character to attendants after leaving the Testimonials. Service are to be given only by the commanding officer. 306. The keys of the station shall be in charge of the hospital Keys of sta- steward under the direction of the commanding officer. Keys must stewardharge °£ never be taken away from the reservation, and when not in use shall be kept in the designated place. 307. Commanding officers of stations of the first class shall, either instruc t i o n s in person or by the detail of some medical officer, give instructions on to attendants nursing to attendants newly employed or detailed for that purpose. 308. On the admission of a patient to hospital, after examination Baths. by the officer on duty and assignment to ward, if not too ill he shall be given a bath and his temperature taken at once; also an evening temperature shall be recorded for the examining officer's informa- tion. 309. Junior officers should invite the attention of the commanding Operationsnot officer to any case especially serious or interesting. No surgical JAj lie Perform- operation, or operation requiring the administration of anaesthetics, shall be performed without the consent of the commanding officer. 310. When a patient is discharged for insubordination, the facts Insubordina- of the case and his physical condition shall be entered in the clinicaltlon of Patlents' record. 311. When a patient is evidently beyond hope of recovery, it is Relatives of the duty of the medical officer in charge of the ward to write, or Patients' cause to be written, for the signature of the commanding officer, a letter, containing a brief statement of his condition, to his nearest relative or friend. 312. Death certificates for local authorities shall bear the initial Death certifi- of the junior officer in charge of the case, but shall be signed by the cate3, commanding officer. 40' REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Informa tion 313. When information is requested by any person regarding the tfenatsdmg Pa" disease for which any patient of the Service has been under treat- ment, such information shall only be furnished at the discretion of the commanding officer. Visiting days. 314. Relatives or friends of patients shall be allowed to visit the hospital wards on Sundays, Tuesdays, and Fridays, from 2 to 5 p. m., and at no other time, except in special cases, at the discretion of the commanding officer. No packages shall be carried to the patients until the contents have been examined and allowed. Must obtain 315, Friends of patients must obtain permission to visit the wards vfsitpaStients. °from a medical officer or steward at each visit. General visitors must be referred to the commanding officer. Prescriptions 316. Officers shall exercise economy in their ward prescriptions. grams. and if possible limit the quantity of a mixture or drug to 100 grams at a time, excepting liniments and lotions. Formulas. 317 n0 formula will be introduced for ward use, or for use in the dispensary, without the sanction of the commanding officer. All formulas must be entered in the formula book kept in the dis- pensary for that purpose. Holidays. 313. The 1st of January, the 22d of February, the 30th of May, the 4th of July, the 25th of December, and such other days as may be so designated by Congress or proclaimed by the President of the United States, shall be considered as holidays in the Marine-Hospital Service, to be observed by suspension of other than necessary labor in the discretion of the commanding officer. State holi- 319. At the discretion of the commanding officer of stations, ys' where State holidays are lawfully established, the same may be observed by him at his station in the same manner as a national holiday. Sunday to be 320. Sunday shall be observed at all stations of the first class and served. on board all vessels of the Service in an orderly manner. All labor or duty shall be reduced to the measure of strict necessity. The religious tendencies of officers and men shall be regarded, and every opportunity consistent with the duties of the station afforded them to attend divine worship. Commanding 321. All articles purchased (except subsistence supplies) and the spect. contents of all packages and boxes received by freight or express. shall be held for the inspection of the commanding officer prior to being issued. Hospital bell. 322 The llospital bell at stations of the first class shall only be rung to indicate the time of day or as a fire alarm. Hospital bell. 323. The hospital bell shall be rung during the twenty-four hours in accordance with the custom on board ship. 324. The hospital bell shall be rung rapidly at short intervals as a fire alarm. Fire alarm. aulaff-mast Set 325' UPon official intelligence of the death of the President of the United States, the Secretary or Assistant Secretary of the Treasury, or the Supervising Surgeon-General, the commanding officer shall REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 41 direct that on the day following and thereafter until the hour of the funeral the national ensign shall be set at half staff or half-mast. The same formality shall be observed at his proper station whenever an officer dies attached thereto. 326. The maintenance of a station fund, known as ."post," " slop " "Slush" fund .. , ■■ .. j. -, . -, .-, ., -. prohibited. or " slush fund, is prohibited. 327. The number of attendants for a hospital having a daily aver- Number of at- age of not less than 20 patients will be 8, to be detailed as follows, viz: One as engineer, 1 as nurse, 1 as night watchman, 1 as night nurse, 1 as ambulance driver, 1 as cook, 1 as launderer, and 1 for general service. 328. Whenever the quota of attendants, as allowed in paragraph Number of at- 327, is found to be insufficient to properly perform the work required be increased. at a given station by reason of conditions peculiar to it, extra attend- ants may be granted if the reasons appear to be sufficient to the Department. 329. Hospital patients at a station of the first class may be required, Patients may as a hygienic measure, to perform such light duties about the hos- §uties.m g pital wards, rooms, or grounds as may be assigned them by the commanding officer of the station. ARTICLE XII. INSPECTIONS. 330. All relief and quarantine stations will be inspected at least . Yearlyinspec- once a year, by commissioned officers detailed for this purpose by the Supervising Surgeon-General. 331. Inspection of stations of the first and second class will be inspections. made wherever practicable by a senior officer; but, as occasionby whom made. may require, any officer regularly detailed by the Supervising Surgeon-General has authority, when so detailed, without respect to seniority, to inspect stations of the first and second class. 332. Inspections will be made under specific orders defining their Inspections, object, which will be shown to commanding officers whose stations are to be inspected; and such commanding officer and others on duty at that station are required to afford every facility and assist- ance to the inspector during his inspection. GENERAL INSPECTIONS. 333. Officers detailed for duty to inspect relief stations of the first Form tobeob class and quarantine stations shall conduct inspections in the uni- fnsplctionofre^ form prescribed (paragraph 220). The commanding officer shall H61 and cuaran- muster the attendants for inspection, and when the inspecting offi- cer is ready to proceed, shall hand to him the current pay roll for the month, who shall then direct a call of said roll for the responses of every attendant, as hereinafter described (paragraph :>>48), veri- fying same to his satisfaction. When the muster is dismissed, the inspecting officer, accompanied by the commanding officer, and the 42 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. junior officers and hospital steward, shall make a systematic inspec- tion of the entire station. Upon completion of the same, the inspect- ing officer shall note in the journal of the station the fact of such inspection, signing such entry with official title. inspections— 334 The methods of procedure during a general inspection shall be under the direction of the inspecting officer, and he shall have authority to require the attendance of all officers and others on duty at the station to furnish information, and to require the pro- duction of all books and other records of the station. Duties of in- 335. Inspecting officers shall inform themselves fully as to the spec ors. conduct of the Service and the observance of the regulations at each port inspected, and shall carefully examine the books, reports, files, correspondence, local hospitals under contract, and the buildings and property for which the commanding officer is responsible. He shall also inspect the uniforms of officers and attendants. Inspectorsnot 336. Inspecting officers will not give orders unless specially author. to give orders. jze(j ^Q ^Q go^ an(j ^hen only for the correction of a violation of a law or regulation involving serious detriment to the Service. Blank forms 337. Reports of inspecting officers will be made upon the blank for inspections. forms furnished by the Department, embodying in the same full and definite information to show the condition of the station inspected. Separate re- 338. In making reports of inspections of the Service at several station °r each stations, a separate report will be made for each station, and shall be prepared and transmitted to the Supervising Surgeon-General as soon as possible after the termination of such inspection. Unfavorable 339. When an unfavorable report is made on any subject by an ommendatiorfs0 inspecting officer, he will, in all cases, make recommendation as to the remedy. Report of vio- 340. Inspecting officers will report at once to the commanding lations of law. 0fgcer any irregularities, violations of law or regulations or orders which they may discover, and which require prompt correction. Full reports of same will be forwarded to the Supervising Surgeon- General in the report of the inspection of the station. Examination 341. The inspecting officer will examine the money account of counts.n6y a°~the commanding officer, comparing the funds kept in the safe with the receipts for patients' moneys and effects (Form 1950), and make report of the correctness of the same upon the inspection blank. Inspection of 342. Officers making general inspections of stations will inspect Property6 ablesuch unserviceable property as may be presented by the officer in command. The prescribed blanks will be used for this purpose. Inspectors to 343. Before leaving a station the inspecting officer will publicly plaints™ com'inform the attendants and patients that opportunity will be given any person to lay before him a well-grounded complaint in the absence of the officers on duty at the station. Inspectors to 344- Inspecting officers will require a performance of the fire drill driu1111"6 fireat eacn station of the first class, under such conditions as w 11 best show the efficiency and promptitude of the force of attendants. \ REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 43 INSPECTIONS BY COMMANDING OFFICERS. 345. Once a week the commanding officers of United States inspection of marine hospitals and quarantine stations shall make a thorough grounds. inspection in detail of all wards, rooms, offices, water-closets, etc., in the buildings and grounds of the station. 346. As the weekly inspection is an important duty devolving OI i^spec^on upon the commanding officer it is not expected that he will delegate not to be dele- its performance to a junior officer, except in cases of urgent neces- sity requiring his absence. 347. The weekly inspection of the stations made by commanding All officers to officers shall be held on Saturday mornings,.and it shall be attended inspections. by such junior officers as may be on duty at the hospital, and, if practicable, by the officer detailed at the out-patient office. Officers will appear in the uniform prescribed by the uniform regulations. 348. At the weekly inspection the attendants shall be mustered Muster at in- J . . spections. in line, the engineer to the left of same, in a convenient portion of the hospital building or inclosure, by the hospital steward, who shall then report to the commanding officer. The latter, with the junior officers on duty, shall then proceed to the appointed place, and the roll shall first be called by the hospital steward, each attendant responding to his name by a military salute to the commanding officer and saying in an audible voice, "Acting cook," "Acting nurse," or whatever the duty each may perform. This shall be fol- lowed by a rehearsal of the stations and duties of attendants at fire drills, eajch attendant stating what is required of him in case of fire, after which any official orders for the day or ensuing week to be observed by them may be read by the hospital steward. Upon com- pletion of the muster, the attendants will be dismissed by an order from the commanding officer to proceed to their several departments to await inspection. 349. The conroletion of the inspection shall be announced to offi-. Completion of ,. „ , , , „ inspection. cers in attendance by the commanding officer, and the same shall be communicated to the attendants through the hospital steward. 350. All work shall be suspended during the progress of an Work to be inspection except duties of an emergency nature, and all patients ing^nspection.r' shall remain in the wards until its completion. 351. The commanding officer shall enter in the journal of the Performance station each week the performance of this inspection, by whom con- be (XreT in ducted, and any special matter relating thereto of an unusual J°unial- character. 352. When the Secretary or Assistant Secretary of the Treasury official visits or the Supervising Surgeon-General officially visits a station of the to Nation- first class, all officers shall assemble, in full dress, at the main entrance of the executive building; the attendants shall be mus- tered in the usual place. He shall be received by the commanding officer, and all present shall salute and remain at "attention " until dismissed by the commanding officer. The same ceremonies shall be observed when he leaves the station. 44 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. ARTICLE XIII. RELIEF STATIONS. Definition. 353. A relief station of the Marine-Hospital Service is a port sit- uated on any navigable water of the United States where an officer of the Marine-Hospital Service is on duty to extend relief to seamen or where an officer of the customs service is specifically authorized to extend said relief. Classes. 354. Relief stations shall be divided into the following classes: Class I. United States marine hospitals. Class II. All other stations under command of a commissioned officer. Class III. All stations under charge of an acting assistant surgeon where there is a contract for the care of sick and disabled seamen. Class IV. All other relief stations not included in the above classes. Provisions for 355. At all relief stations where the number of patients warrants, an officer of the Marine-Hospital Service will be assigned to the command of the station, and, whenever practicable, the patients of the Service will be treated in hospitals maintained exclusively for their benefit. At places where Congress has made no provision for the erection of a marine hospital, buildings or rooms suitable for hospital purposes, or separate wards in State, municipal, or pri- vate hospitals, may be leased or rented, for the exclusive benefit of the patients of the Service, or contracts may be made for the care and treatment of patients with local hospitals, subject to the approval of the Secretary of the Treasury. Supervision 356. The medical and surgical treatment of the patients of the Marine-Hospital Service will be under the supervision of the com- missioned and noncommissioned officers of the Service, at all relief stations where such officers are on duty, and they will be required to take direct professional charge of the patients. Provision for 357. At each relief station of the first and second class, and ditpentaS.11*1 whenever practicable at each relief station of the third class where an acting assistant surgeon of the Marine-Hospital Service is on duty, there shall be a marine-hospital office, where applicants for relief shall be received and examined, and the necessary action taken according to the regulations. Location of 358. The marine-hospital office shall be located at the custom- offices and dis- ,.-,-, . , , ^ pensaries. house whenever practicable, and suitable office room for that pur- pose sha! I. be set apart by the custodian of the custom-house building, subject to the approval of the Secretary of the Treasury. Districts. 359. The relief stations of the Marine-Hospital Service are grouped into eight districts, as follows: The district of the North Atlantic; the district of the Middle At- lantic; the district of the South Atlantic; the district of the Gulf; the district of the Ohio; the district of the Mississippi; the district of the Great Lakes, and the district of the Pacific. t.North Atlan- 360. The district of the North Atlantic embraces the following- named relief stations, viz: Bangor, Me.; Barnstable, Mass.; Bath, Me.; Belfast. Me.; Boston. Mass.; Burlington, Vt.; Castine, Me.; Eastport, Me.; Edgartown. Mass.: Ellsworth, Me.; Gloucester^ Mass.; Machias,Me.; New Bedford, Mass.; Newport, R. I.; Portland REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 45 Me.; Portsmouth, N.H.; Providence, R. I.; Rockland, Me.; Salem, Mass.; Vineyard Haven, Mass.; Waldoboro, Me., and Wiscasset, Me. 361. The district of the Middle Atlantic embraces the following- .Middle Atlan- named relief stations, viz: Albany, N. Y.; Bridgeport, Conn.; Dela- ware Breakwater, Del.; Hartford, Conn.; New Haven, Conn.; New London, Conn.; New York, N. Y.: Perth Amboy, N. J.; Philadel- phia, Pa.; Sag Harbor,N. Y.; Somers Point, N. J., and Wilmington, Del. 362. The district of the South Atlantic embraces the following- .South Atlan- named relief stations, viz: Baltimore, Md.; Beaufort, N. C, Beau- fort, S. C: Brunswick, Ga.; Cambridge, Md.; Charleston, S. C; Darien, Ga.; Edenton, N. C: Elizabeth City, N. C; Fernandina, Fla.; Fredericksburg, Va.: Georgetown, S. C.; Jacksonville, Fla.; Newberne, N. C.; Newport News, Va.: Norfolk, Va.; Richmond, Va.; Savannah, Ga.; Solomons, Md.; Tappahannock, Va.; Wash- ington, D. C, and Wilmington, N. C. 363. The district of the Gulf embraces the following-named relief Ge- stations, viz: Apalachicola, Fla.; Brownsville, Tex.; Cedar Keys, Fla.; Corpus Christi. Tex.; Galveston, Tex.; Key West, Fla.; Mobile, Ala.; New Orleans, La.: Pensacola, Fla.; Port Tampa, Fla.; Rome, Ga., and Shreveport, La. 364. The district of the Ohio embraces the following-named relief °nio. stations, viz: Chattanooga, Tenn.: Cincinnati, Ohio; Evansville, Ind.; Gallipolis, Ohio; Louisville, Ky.; Nashville, Tenn.; Pittsburg, Pa., and Wheeling, W. Va. 365. The district of the Mississippi embraces the following-named Mississippi. relief stations, viz: Bismarck, N. Dak.: Burlington, Iowa; Cairo, 111.: Dubuque, Iowa; La Crosse, Wis.; Little Rock, Ark.; Memphis, Tenn.; Newport, Ark.; St. Louis, Mo.; St. Paul, Minn., and Vicks- burg, Miss. 366. The district of the Great Lakes embraces the following-named Great Lakes. relief stations, viz: Ashland, Wis.; Ashtabula, Ohio; Buffalo, N. Y.; Chicago, HI.; Cleveland, Ohio; Detroit, Mich.; Duluth, Minn.; Erie, Pa.; Escanaba, Mich.; Grand Haven, Mich.; Ludington, Mich.; Manistee, Mich.; Marquette, Mich.; Milwaukee, Wis.; Ogdensburg, N. Y.: Oswego, N. Y.; Port Huron, Mich.; Saginaw, Mich.; San- dusky, Ohio; Sault Ste. Marie, Mich.; Sturgeon Bay, Wis.; Supe- rior, Wis., and Toledo, Ohio. 367. The district of the Pacific embraces the following-named Pacific. relief stations, viz: Astoria, Oreg.; Eureka, Cal.; Juneau, Alaska; Marshfield, Oreg.; Portland, Oreg.; Port Townsend, Wash.; San Diego, Cal.; San Francisco, Cal.; San Pedro, Cal.; Seattle, Wash.; Sitka, Alaska, and Tacoma, Wash. ARTICLE XIV. BENEFICIARIES. 368. The persons entitled to the benefits of the Marine-Hospital ^PersOTHJ_ enti- Service are those employed on board in the care, preservation, or navigation of any registered, enrolled, or licensed vessel of the United States, or in the service on board of those engaged in such tied to relief. 46 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. care, preservation, or navigation. Officers and crews of the Light- House Establishment, officers and crews of the Revenue-Cutter Service, seamen employed on the vessels of the Mississippi River Commission, seamen employed on vessels of the Engineer Corps of the Army, and keepers and crews of the United States Life-Saving Service are entitled to the facilities of the hospitals and relief sta- tions under special rules hereinafter prescribed. Yachtsmen 369. Seamen employed on yachts are entitled to treatment, pro- entitled, vided the said yachts are enrolled, licensed, or registered as vessels of the United States. Exceptions, 370. No person employed in or connected with the navigation, R. s., s. 4804. management, or use of canal boats engaged in the coasting trade shall, by reason thereof, be entitled to any benefit or relief from the marine-hospital fund. Customs offi- 371. In case of doubt as to the fact of registration, enrollment, or ?nforma«onmof license of a vessel, the officer to whom application for relief is made character of shall request information of the collector of customs at the port as vessel. to the character of vessel on which the seaman is employed, and the said collector of customs shall furnish such information, if prac- ticable. Wrecked sea- 372. Seamen taken from wrecked vessels of the United States are men en i entitled to the benefits of the Marine-Hospital Service if sick or dis- abled, and will be furnished care and treatment without reference to the length of time they have been employed. Seamen sent 373. Seamen employed on merchant vessels of the United States cers^entftled" returned to the United States from foreign ports by United States U4l77ReV stat" consular officers, if sick or disabled at the time of their arrival in a port of the United States, shall be entitled to the benefits of the Marine-Hospital Service without reference to length of service. Seamen must 374, j^ sick 0r disabled seaman, in order to obtain the benefits of make applica- ., , _, , tion for relief, the Marine-Hospital Service, must apply m person, or by proxy if too sick or disabled so to do, at the office of the Marine-Hospital Service, to an officer of that Service, or to the proper customs officer acting as the agent of the Marine-Hospital Service at stations where no Marine-Hospital officer is on duty, and must furnish satisfactory evidence that he is entitled to relief under the regulations. Evidence to be 375. Masters certificates and discharges from United States ship- presented by . . ° . £ X. • applicant. ping commissioners, made out and signed in proper form, showing that the applicant for relief has been employed for sixty days of continuous service "in a registered, enrolled, or licensed vessel of the United States," a part of which must have been during the sixty days immediately preceding his application for relief, shall entitle U- 4f;v>Rev- him to treatment. The phrase "sixty days continuous service" shall not be held to exclude seamen whose papers show brief intermis- sion between short services that aggregate the required sixty days. Certifi cates 376. The certificate of the owner or accredited commercial agent agents as evi- of a vessel as to the facts of the employment of any seaman on said dence. vessel may be accepted as evidence in lieu of the master's certificate in cases where the latter is not procurable. Masters must 377. Masters of documented vessels of the United States shall rm furnish, certifi- * \jli cate of service, demand, furnish any seaman who has been employed on such vessel REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 47 a certificate (Form 1914) of the length of time said seaman has been so employed, giving the dates of such employment. This certificate will be filed in the marine-hospital office or office of the customs officer, when application is made for relief, whether the relief is furnished or the claim rejected. 378. In case the master of any vessel shall fail or refuse to fur-. Mastersrefus- nish a master's certificate to any seaman who may have beentif?categlVSe°cs. employed on board said vessel within sixty days, the collector of ^g and 5W0, customs shall cause said master, if he be in port, to appear at the marine-hospital office and produce the ship's books. 379. Any master of a vessel or other person who shall furnish a paise certifi- f alse certificate of service, with intent to procure the admission of a cates- seaman into any marine hospital, shall be immediately reported to the nearest United States attorney for prosecution. 380. When an interval has occurred in the applicant's seafaring . Exceptions. service by reason of the closure of navigation on account of ice or low water, such interval shall not be considered as excluding him from relief unless the sickness or injury for which he applies for relief be the direct result of employment on shore. 381. During the season when navigation is closed at any port by Closure of nav- reason of ice or low water, seamen applying for relief at such portslga lon' shall be entitled to same, provided they present the documentary evidence required in paragraph 375, which must show that the applicants were employed within sixty days immediately preceding the said closure of navigation, and it must be satisfactorily shown that the disease or injury was also acquired during the time of their service. 382. The time during which a seaman has been under treatment Period of in hospital as a patient of the Marine-Hospital Service shall not be t^be^ckoned reckoned as absence from vessel in respect to debarring him from as absence from further relief. 383. Whenever an applicant for relief presents himself at the Affidavits may marine-hospital office or the custom-house without a master's certifi- evid1mce?ted &S cate or shipping commissioner's discharge and it is impracticable to obtain such certificate on account of the absence of the vessel or its master from the port, the affidavit of the applicant as to the facts of his last employment, stating names of vessels and dates of service, may be accepted as evidence in support of his claim for the benefits of the Marine-Hospital Service. 384. When the period of the seaman's service as shown by his Brief service certificate on last vessel is less than 60 days, his affidavit as to pre- °"t ^bar^to vious service may be accepted if supported by satisfactory evidence, relief. 385. In cases of doubt, reasonable effort shall be made to verify Evidence to be the genuineness of masters' certificates and shipping commissioners' ^f doubt"1 CaSe discharges, and of the signatures to the same. Due care shall also be exercised to identify the persons presenting masters' certificates. to protect the fund against imposition. 386. When a reasonable doubt exists whether the applicant is Certain cases entitled to relief under the regulations, the application, accompanied tolu/geon-Gwf- by a statement of the facts, shall be immediately referred to the eral for decision. Supervising Surgeon-General for decision, and when the seaman is in such condition that immediate medical or surgical attendance 48 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. is necessary, he will be placed under treatment pending the decision, and the action in the case taken by the officer shall be reported at the same time. Applications 387. When a seaman applies for relief after an absence of sixty sixty days ab- days or more from his last vessel, and it satisfactorily appears that sence from ves- sucj1 absence was due to sickness or injury acquired in the line of duty, and that it was impracticable for him to apply to the proper officer for treatment, a statement of the facts, together with a copy of the application and other papers in support of same, shall be for- warded to the Supervising Surgeon-General for decision. Seamen to sign 388. Any seaman who is able to write will be expected to sign his name upon the face of the master's certificate issued to him before said certificate is signed by the master of the vessel, and the officer receiving such certificate shall require the applicant to verify the signature in his presence. Cases admit- 389. When patients are admitted for hospital treatment pending cisionetobenum-the decision of the Supervising Surgeon-General, the usual permits bered in order. wij| -^e iSSUed, dated the day on which relief commenced, and num- bered consecutively with current permits, and the date of the author- ization of the Department will be indorsed on the permit if relief is authorized. If relief is not authorized, the applicant shall be dis- charged, and the disapproval indorsed upon the papers. Out-pati e n t s 390. When a seaman who has received continuous treatment at the service certifi- out-patient office for a period of two months applies for further cates- treatment, he must, tot entitle him to treatment, furnish a new cer- tificate of service showing that he is still following his vocation as seaman. Expenses for 391. The expenses of caring for sick and disabled seamen incurred sickness durinsf voyage. during a voyage will not be paid by the Marine-Hospital Service. ^"i11.?11! adi" 392- The expenses for the care and treatment of seamen suffering mitted to local „ . ,. ,.-■-,,•,,, miarantine hos- from contagious diseases entitled to the benefits of the Marine-Hos- plta s' pital Service, who, in accordance with the State or municipal health laws and regulations are taken to quarantine or other hospitals under charge of the local health authorities, will not be paid from the Marine-Hospital fund unless such seamen were admitted at the time by the request of an officer of the Service. Money not to 393. In no case shall money be paid to a seaman or to his family men Tor expln- or friends by the Marine-Hospital Service as reimbursement for ses of sickness, expenses incurred during his sickness or disability. 394. When an applicant's claim for relief is rej or causes for such rejection must be indorsed on tl other papers in each case, which must then be filed and preserved. "i redamen in- 395. Seamen who may be injured during street brawls or while not to receive committing a breach of the peace, and are therefore confined in jail treatment. or ^aken to civil hospitals by the local authorities for such acts, shall not receive treatment at the expense of the Marine-Hospital fund. Seamen taken 396. Seamen taken seriously sick or injured while actually em- titled, ployed on a documented vessel shall be entitled to treatment at relief stations without reference to the length of their service. elaimsforreli f 394' ^hen an applicant's claim for relief is rejected, the cause ' or causes for such rejection must be indorsed on the certificates or REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 49 397. A certificate of discharge may, at the discretion of the officer Certificates of in charge of the case, be given to a hospital patient, but such cer- dlscnarse' tificate when presented at another relief station shall not be taken as sufficient evidence of the applicant's title to marine-hospital re- lief, but may be considered as collateral to other satisfactory data submitted by the seaman. 398. Temporary relief only is contemplated and admission tohos- , °my .tempo- pital is not intended to permit an indefinite residence therein for templatedL C°Q' cause other than actual disease or injury. ARTICLE XV. RELIEF. OUT-PATIENT RELIEF. 399. Sick and disabled seamen entitled under these regulations to Cases to be the benefits of the Marine-Hospital Service whose diseases or inju- patients.aS ries are of such a nature that they can properly be relieved by medi- cines, dressings, or advice, without admission to hospital, shall be treated as out-patients, and furnished medicines, dressings, surgi- cal appliances, or advice, as the case may require. 400. Seamen will not be furnished relief at their own homes, .No relief fur- except by special authority from the Supervising Surgeon-General, ofSpatients0ineS and then only an allowance for medical attendance and medicines will be made at rates fixed by the Treasury Department. STATIONS OF THE FIRST CLASS. 401. The evidence of each out-patient's right to relief will be Records to be recorded in the register of out-patients, over the initials of the officer lief. making the entry, and the certificate and papers in the case filed, STATIONS OF THE SECOND CLASS. 402. The evidence of each out-patient's right to relief will be Records to be recorded in the register of out-patients, over the initials of the officer lief.e ° ou "re' making the entry, and the certificate and papers in the case filed. STATIONS OF THE THIRD CLASS. 403. When out-patient relief of any kind is furnished, its nature Character of (prescriptions, medicines, etc.) will be briefly specified on the relief ported. certificates. 404. When an applicant's claim for relief at the expense of the Relief certifi- Marine-Hospital Service is found to be valid, a relief certificate, on 1915) to be foiv Form 1915, will be made out by the customs officer, or acting assist- ^ajgsUeias soon ant surgeon, if such an officer be in charge of the relief station, set- ting forth specifically the data on which, under these regulations, relief is granted, and this relief certificate, the facts contained therein having been recorded in the proper register of patients, will be forwarded to the Supervising Surgeon-General as soon as issued. 8855---4 50 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. STATIONS OF THE FOURTH CLASS. Character of 405. When out-patient relief of any kind is furnished, its nature ported*0 be re (prescriptions, medicines, etc.) will be briefly specified on the relief certificates. Relief certifi- 406. When an applicant's claim for relief at the expense of the l9l5)eto (be°fo™ Marine-Hospital Service is found to be valid, a relief certificate, on warded as soon Form 1915, will be made out by the customs officer, or acting assist- ant surgeon, if such an officer be in charge of the relief station, setting forth specifically the data on which, under these regula- tions, relief was granted; and this relief certificate, the facts con- tained therein having been recorded in the proper register of patients, will be forwarded to the Supervising Surgeon-General as soon as issued. Provisions for 407. Whenever an application for relief is presented, the proper customs officer at the port (or the acting assistant surgeon, if an officer of that grade is on duty and in charge of the station) is authorized and directed to cause out-patient relief (medicines, etc.) to be furnished in accordance with paragraph 399, or to request authority from the Supervising Surgeon-General to furnish trans- portation to a relief station of the first class. Allowance for 408. One dollar will be allowed physicians (not officers of the examina ions. ]y[arjne-Hospital Service) for the medical examination of each out- patient who is referred by a customs officer for such examination, whether accompanied by a pressription or not, unless otherwise previously directed by the Department (by the terms of speciid agreements or contracts). In cases where an out-patent is relieved more than onca, by direction of the proper customs officer, a written request will be made to the physician to that effect, which written request will be attached to the bill of the physician as a subvoucher. Extra com 409. No separate compensation or allowance will be made for pensation for r . . r hospital treat the medical examination and certificate made by physicians in cases where the applicants examined are placed under hospital treatment or its equivalent at the relief station where the examination is made, except when treated in hospital by another physician. twI°\msTtshain 41°- Out-patient relief will not be furnished except in cases of lowed. emergency, such as acute illness or injury, requiring not more than one or two visits. Unreasonable 411. Unreasonable charges for relief furnished in emergency emerges d 1S3-1- .__ .^ lowed. cases will not be allowed by the Department. Foreign sea- 412. Foreign seamen or employees of the various Government treated* &L DOt services, not beneficiaries, shall not be treated. HOSPITAL RELIEF. Cases for hos- 413. A sick or disabled seaman entitled to the benefits of the pi a rea ment. Marine-Hospital Service shall be admitted to hospital only in cases where the gravity of the disease or injury from which he suffers is such as to require hospital treatment in the opinion of an officer of the Service, or of a reputable physician designated by the Depart- ment to act at a place where no officer is stationed. REGULATIONS FOR U. S. MARIXE-HOSPITAL SERVICE. 51 414. Marine-Hospital officers and customs officers are required to Patients to be discharge patients promptly upon the termination of the necessary charged7 hospital treatment, and without awaiting the expiration of the period authorized in the permit. 415. Officers shall not be required to attend sick or disabled sea- Not required men on board vessels or to visit them in harbor, except at the discre- on Vboard^ea- tion of the officer to whom the application is made. sel& STATIONS OF THE FIRST CLASS. 416. A bed ticket (Form 1917) shall be prepared and delivered to To be valid the applicant for relief in a sealed envelope addressed to the officer issue. or other person authorized to receive the patient. The seaman should at the same time be informed that unless presented on the day it is issued the ticket will be invalid. 417. Bed tickets will be numbered consecutively, in annual series, To be num- t>GrG(3. consGeu." commencing with the unit on the 1st of July of each year. tively. 418. Upon the admission of a patient for treatment, the com- Receipts for manding officer will receive his money and other valuables, and uables of pa- give a receipt therefor (Form 1950). Upon the termination of the*\yQ^s to be treatment of the patient, his money and other effects shall be returned to him, and the receipt taken up and filed. 419. Whenever, in any case, a patient admitted to hospital for a Complication given disease or injury, satisfactorily progresses to convalescence easengma 1S' from such disease or injury, but, before being sufficiently recovered to be discharged, contracts or develops some other disease not prop- erly a sequel or complication of the original affection or injury, a new bed ticket may be issued in such cases by the commanding offi cer without referring the case to the Bureau. In such case, the number of the original bed ticket will be referred to, and the disease or injury for which the patient was first placed under treatment will be stated, together with the result of the treatment for the same. 420. At the end of each month, commanding officers shall report. , Patients un- -.-.; • • <.;■ ,, der treatment by letter, the names and dates of admission of patients who have ninety days. been under treatment ninety days, and will make a recommendation relative to the necessity for further treatment in each case. 421. At the expiration of each fiscal year commanding officers Patients under will make a special report upon cases which have been under treat- year.men °ne ment for a year or more, giving a statement of their condition and prospects for discharge. 422. The officer authorized and directed under these regulations Hospital relief to uG l*6C0rQGQ to furnish relief shall keep a register of all permits issued, for which and reported. purpose a blank book (Form 1945) will be furnished by the Treasury f9^ms 1945 and Department, and a daily report (Form 1942) of all the patients admitted and discharged will be forwarded to the Supervising Surgeon-General on the day following that to which the transactions named in the report refer. 423. Upon the admission of a patient transferred from another Relief certifi- station, as provided by paragraph 457, the commanding officer will dorsed°and for- indorse on thebriefed fold of the duplicate relief certificate the factwarded- and date of such admission and forward the same to the Bureau. 52 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. STATIONS OF THE SECOND CLASS. To be valid 424. A bed ticket (Form 1917) shall be prepared and delivered to iSue.'°r day °f the applicant for relief in a sealed envelope addressed to the officer or other person authorized to receive the patient. The seaman should at the same time be informed that unless presented on the day it is issued the ticket will be invalid. To be num- 425. Bed tickets will be numbered consecutively, in annual tavely. consecu' series, commencing with the unit on the 1st of July of each year. Transfer of 426. Upon admission to a contract hospital of a patient with dis- patients. gage Qr mjury which, in the opinion of the officer of the Service in charge of the case, will require more than twenty days' treatment in hospital, he will at once request authority from the Bureau to transfer such patient to the nearest marine hospital, provided the patient's condition, in the opinion of the officer, is such as to admit of transportation without the services of an attendant. Complication 427. Whenever, in any case, a patient admitted to hospital for ease.rigmal dlS given disease or injury satisfactorily progresses to convalescence from such disease or injury, but before being sufficiently recovered to be discharged contracts or develops some other disease not prop- erly a sequel or complication of the original affection or injury, a new bed ticket may be issued in such cases by the commanding officer without referring the case to the Bureau. In such case the number of the original bed ticket will be referred to, and the dis- ease or injury for which the patient was first placed under treat- ment will be stated, together with the result of the treatment for the same. Patients treat- 428. At the end of each month commanding officers will report, s' by letter, the names and dates of admission of patients who have been too ill to be transferred and who have been under treatment ninety days, and will make a recommendation relative to the neces- sity for further treatment in each case. ,- Hospital re- 429. The officer authorized and directed under these regulations ed and report- to furnish relief shall keep a register of all permits issued, for which andl942mS 1945Purpose a blank book (Form 1945) will be furnished by the Treas- ury Department, and a daily report (Form 1942) of all the patients admitted and discharged will be forwarded to the Supervising Surgeon-General on the day following that to which the transac- tions named in the report refer. Application 430. When a seaman entitled to the benefits of the Service makes office hours. application for admission to hospital after the dispensary is closed for the day, the person in charge of the hospital in which the patients of the Marine-Hospital Service are treated may receive the patient, should the case be urgent, and will then report the fact the follow- ing day and present to the proper officer the master's certificate or other evidence upon which his action was based. In the event of a failure to report on the second day for admission as above the per- mit, should it be proper to issue one, will be dated on the day when such report is made. Whenpermits 431. In no case will a permit be antedated, except as provided dated. 6 & in the foregoing paragraph, and only to cover one working day, exclusive of legal holidays. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 53 STATIONS OF THE THIRD CLASS. 432. Customs officers, or acting assistant surgeons when in Permits for charge of the station by special authority of the Bureau, shall Form 1916. issue hospital permits for the care and treatment of such appli- cants as may be found to be entitled to the benefits of the Service and require hospital treatment. The period for which treatment is authorized by the permit should be based upon the certificate of the acting assistant surgeon or attending physician, as given in the relief certificates, but should in no case exceed twency days. 433. Hospital permits will be numbered consecutively, in annual Permits to be series, commencing with the unit on the 1st of July of each year, secutively 434. Upon admission to a contract hospital of a patient with dis- Transfer of ease or injury which, in the opinion of the officer of the Service or pa physician in charge of the case, will require more than twenty days' treatment in hospital, the collector of customs or other officer issu- ing the permit will at once request authority from the bureau to transfer such patient to the nearest marine hospital, provided the patient's condition, in the opinion of the acting assistant surgeon or physician in charge of the case, is such as to admit of transporta- tion without the services of an attendant. 435. The hospital permit, before being delivered to the applicant Permits valid for relief, must be inclosed in an envelope, sealed, and addressed to fgg,^ on ay ° the person authorized to receive the patient. The seaman should at the same time be informed that unless presented on the day it is issued the permit will be invalid. 436. When a seaman entitled to the benefits of the Service makes Applications application for admission to hospital after the custom house or dis- offlceVours. er pensary is closed for the day, the person in charge of the hospital in which the patients of the Marine-Hospital Service are treated may receive the patient, should the case be urgent, and will then report the fact the following day, and present to the proper officer the master's certificate or other evidences upon which his action was based. In the event of a failure to report on the second day for admission as above, the permit, should it be proper to issue one, will be dated on the day when such report is made. 437. In no case will a permit be antedated except as provided in Whenpermits the foregoing paragraph, and only to cover one working day, exclu- dated. e sive of legal holidays. 438. Continuous relief for periods exceeding twenty days will in Relief not to no case be granted except by special authority from the Bureau. lays6 439 Whenever in any case a patient is unable to bear transporta- Extension of ., ,,-,ii . • --11 -i permits. Form tion to a marine hospital, and hospital treatment is required beyond 1918. the period for which the permit was originally issued, application for an extension (Form 1918) must be made to the Supervising Surgeon-General one week prior to the expiration of the permit. Application will be made by the attending physician and forwarded through the officer issuing the original permit. An application for the extension of a hospital permit must set forth the reasons why it is necessary, the actual condition of the patient at the time, and the additional period, not to exceed twenty days, during which treat- ment will probably be required. 54 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Tobereferred 440. In all cases where relief is extended by spec.al authority to on permits. {^^ ^ Burean the date of the letter authoriziiig the relief must be indorsed upon the permits in each case. Complications 441. Whenever a patient admitted to hospital for a given disease which^dmitted or injury satisfactorily progresses to convalescence from such dis- ease or injury, but before being sufficiently recovered to be dis- charged contracts or develops some other disease not properly a sequel or complication of the original affection or injury, the facts will be immediately reported by the attending officer, through the officer keeping the register of permits, to the Supervising Surgeon- General, and application made by letter for a new permit, a new medical certificate, made out and signed accordingly, to be inclosed with said letter. Should a new permit be issued, the permits will refer to each other by indorsing on the new the date, number, and diagnosis of the old, and vice versa. Permit to be 442. Upon the termination of treatment of a patient, or the issue termination "of °f a new permit, the certificate, on the outer middle fold of the per- treatment, mit which has expired, will be filled out and signed by the attending surgeon, and the permit will be immediately forwarded to the Super- vising Surgeon-General by the officer keeping the register of permits. Diagnosi s t o 443, in an cases where treatment in hospital is required, the diaar- be reported in , . . , , , „ , ,, , , relief cer tifi- nosis, where it is practicable to form one, shall be stated in the relief cate' certificate by the officer or attending physician, and should he deem it necessary the relief certificate may be retained a day or two for that purpose. Exceptions. 444. An approximate or general diagnosis (such as "heart dis- ease," '' renal disease," etc.) in the medical certificate will be accepted as sufficient incases where it is found impracticable to make a spe- cific diagnosis; but in all cases where a specific diagnosis is not given in the medical certificate it must be afterwards supplied by letter as soon as ascertained, and in every case where an error has been made in a diagnosis certified or reported, the error will be immedi- ately corrected by letter. STATIONS OF THE FOURTH CLASS. h Pe ^f1}*8 v°*r 445, Customs officers, or acting assistant surgeons when in charge Form 1916. X ' of the station by special authority of the Bureau, shall issue hospital permits for the care and treatment of such applicants as may be found to be entitled to the benefits of the Service and require hos- pital treatment. The period for which treatment is authorized by the permit should be based upon the certificate of the acting assist- ant surgeon or attending physician, as given in the relief certifi- cates, but should in no case exceed twenty days. to"beamad™eand 446' Whenever a seaman applies for hospital relief, and in the reported by cus opinion of the customs officer it is a case requiring immediate atten- toms officer. tion5 and the papers presented by the applicant show him to be entitled to relief, a competent physician, in the absence of an acting assistant surgeon, shall bewailed to decide whether hospital relief is necessary; and if so advised, and the seaman is not in a condition to be transferred to a marine hospital, the customs officer shall make suitable arrangements for the care and treatment of the patient and report immediately by letter to the Supervising ,Sur REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 55 geon-General, giving rates charged therefor and inclosing the relief certificate. 447. Whenever a seaman entitled to the benefits of the Marine- Arrangements Hospital Service applies for hospital relief at a station where an act- reported by act- ing assistant surgeon is in charge by special authority of the Bureau, ^r|^assistant in whose opinion it is a case requiring hospital treatment, and the seaman is not in a condition to be transferred to a marine hospi- tal, that officer shall make suitable arrangements for the care and treatment of the patient and report immediately by letter to the Supervising Surgeon-General, giving rates charged therefor, and inclosing the relief certificate. 448. The hospital permit, before being delivered to the applicant Permits valid for relief, must be inclosed in an envelope, sealed, and addressed to is°ue.°a &y ° the person authorized to receive the patient. The seaman should at the same time be informed that unless presented on the day it is issued the permit will be invalid. 449. Hospital permits will be numbered consecutively, in annual, To he num- uGl*(JQ C0US6CU ■ series, commencing with the unit on the 1st of July of each year, tively. 450. Continuous relief for periods exceeding twenty days will in Relief not to no case be granted except by special authority from the Bureau. days. 451. Whenever in any case a patient is unable to bear transporta- Extension of , ., -,,-,,, i • • -i i -i permits, Form tion to a marine hospital, and hospital treatment is required beyond 1918. the period for which the permit was originally issued, application for an extension (Form 1918) must be made to the Supervising Surgeon- General one week prior to the expiration of the permit. Application will be made by the attending physician, and forwarded through the officer issuing the original permit. An application for the extension of a hospital permit must set forth the reasons why it is necessary, the actual condition of the patient at that time, and the additional period, not to exceed twenty days, during which treatment will prob- ably be required. 452. In all cases where relief is extended by special authority from Tobereferred the Bureau the date of the letter authorizing the relief must beto on Permits- indorsed upon the permits in each case. 453. Whenever a patient admitted to hospital for given disease ^Xfeast^fOT or injury satisfactorily progresses to convalescence from such disease whichadmitted. or injury, but before being sufficiently recovered to be discharged contracts or develops some other disease not properly a sequel or complication of the original affection or injury, the facts will be immediately reported by the attending physician, through the officer keeping the register of permits, to the Supervising Surgeon-General, and application made by letter for a new permit, a new medical certificate, made out and signed accordingly, to be inclosed with said letter. Should a new permit be issued, the permits will refer to each other by indorsing on the new the date, number, and diag- nosis of the old. and vice versa. 454. Upon the termination of treatment of a patient or the issue ^Permi^to be of a new permit the certificate, on the outer middle fold of the per- termination of mit which has expired, will be filled out and signed by the attending treatment- surgeon, and the permit will be immediately forwarded to the Supervising Surgeon-General by the officer keeping the register of permits. 5G REGULATIONS FOR U: S. MARINE-IK )S1'ITAL SERVICE. Diagnosis to 455. In all cases where treatment in hospital is required the rene^certif? diagnosis shall, where it is practicable to form one. be stated in the cate. relief certificate by the officer or attending physician, and, should he deem it necessary, the relief certificates may be retained a day or two for that purpose. Exceptions. 456. An approximate or general diagnosis (such as "heart dis- ease,''" renal disease.'* etc.) in the medical certificate will be accepted as sufficient in cases where it is fpund impracticable to make a spe- cific diagnosis; but in all cases where a specific diagnosis is not given in the medical certificate it must be afterwards supplied by letter as soon as ascertained, and in every case where an error has been made in a diagnosis certified or reported the error will be immediately corrected by letter. TRANSPORTATION OF SICK SEAMEN. Details of 457. In each case where a sick or disabled seaman is furnished Relief^c e r t i ft- transportation to a marine hospital for treatment, three relief certifi- ntshed^o'n 'de- ca^es> respectively indorsed on the briefed fold " original," " dupli- parture. cate," and "triplicate," shall be made out and signed at the station where transportation is furnished. The original will be mailed to the officer in command of the marine hospital where the patient is to be admitted, the duplicate will be given to the patient in a sealed envelope, with instructions to present it to the commanding officer of the hospital, and the triplicate will be forwarded to the Bureau. Current rates 458. In the absence of specific instructions from the Department as to the transportation routes and the rates to be paid, the current rates charged the public at the time will be allowed for the trans- portation of seamen sent to marine hospitals under the provisions' of paragraph 4.37. Bills for trans- 459. When the transfer of a patient from a contract station to a portation. . . marine hospital has been authorized, bills for railroad or steamboat fare may be rendered (Form 1938) by the transportation companies furnishing same and certified by the officer receiving the tickets or -transportation order. Clinical his- 460. When patients are transferred to a marine hospital for con- to be furnished, tinued treatment, the officer under whose charge the patient has been treated will send to the receiving officer a clinical history of each case and the results of the treatment adopted. cerrtoV1bf °S- 461' 0fficers and otners, when furnishing transportation to sea- formed of prob-men, shall inform the receiving officer, by mail or telegraph, when arrival. * * 6 ° f the patients may be expected to arrive. INSANE SEAMEN. Relief for in- 462. Insane seamen entitled to the benefits of the Marine-Hospital S3iHG S6 ft 111 ft H. o ■ 1 t • -1 Mar. 3, 1875. Service may be admitted to the Government Hospital for the Insane, Washington, D. C, upon the order of the Secretary of the Treasury. deeding CaPPif- 463' 0fficei'8 to whom applications are made in behalf of insane cations. seamen shall exercise special care in these cases to exclude fraudu- lent persons, alien paupers, and others not entitled to relief, as the REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 57 chronic nature of such cases makes them permanent beneficiaries of the Service. 464. When application is made in behalf of a seaman who is suf- Applications .. . „ . ., ,, -, . „ . , to be strictly m- fering from insanity, the usual requirements of service must be vestigated. strictly investigated and the patient's eligibility for treatment fully established by satisfactory evidence before issuing a permit for relief. Pending permanent arrangements, the patient shall be admitted to the hospitals of the Service, if necessary, and the case reported by telegraph or letter to the Supervising Surgeon-General with the recommendations as to transfer to the Government Hospital for the Insane, Washington, D. C, giving the number of attendants absolutely required for conducting him in safety. 465. When insane seamen are transferred the officer charged . History of pa- with the case shall transmit to the Supervising Surgeon-General aforwarded to personal and clinical history of the patient, stating, as far as possi- Bureau- ble, the name, nativity, and age of the patient, the date of com- mencement of insanity, the form of the disease, its cause, as nearly as may be ascertained, its progress, the present condition of the patient, the prognosis of the case, the length of time the patient has been a seaman on American vessels, and the name and post- office address of his nearest known relative. 466. After the authority of the Department has been given for Laws govern- the transfer of insane seamen as patients of the Service to local ment"of insane asylums for the treatment of the insane, officers will carefully to local asylums . . , to be strictly observe the municipal laws governing the commitment of such observed. cases to these institutions, and conform thereto strictly. These patients, except those transferred to the Government Hospital for the Insane shall be carried upon the registers of the station whence they were transferred so long as they remain under treatment, and shall be reported in the regular reports with other cases each month. 467. When application is made in behalf of an insane seaman at Applications a relief station on the Pacific Coast, the officer of the Service or Coast stations. customs officer shall report the facts in the case at once to the Supervising Surgeon-General by telegraph, with recommendations for the transfer of the patient to the nearest local asylum for the care of the insane, giving rates to be charged for maintenance and treatment. DECEASED SEAMEN. 468. On the death of a patient wh.le under the charge of the beR^a*gg|s to Marine-Hospital Service, notice to receive his effects shall be given by letter or otherwise to his nearest known relative, and when said effects are delivered to the latter a receipt shall be taken therefor and filed. 469. The necessary expenses of a plain burial for deceased patients p(^e"al ex" of the Service will be paid, but no part of the expenses of the burial of any deceased seaman will be paid for at the expense of the Marine- Hospital Service unless said seaman was at the time of his death a patient of the Service. When friends or relatives of a deceased seaman claim the body and assume charge of the funeral arrangements, no part of the expenses of the same will be paid by the Marine-Hospital Service. 58 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE ARTICLE XVI. SEAMEN OF THE GOVERNMENT SERVICES AND FOREIGN SEAMEN. UNITED STATES NAVY AND COAST SURVEY. seamerTof varf- 47°- Officers and seamen employed on vessels of the United States ous Govern- Navy and the Coast Survey may be admitted for care and treatment may be ad-as patients of the Marine-Hospital Service only upon the written mitted. request of their respective commanding officers. Every such admis- sion shall be immediately reported to the Supervising Surgeon- General by the officer in charge of the station, on a daily report (Form 1942) or relief certificate (Form 1913), accompanied by a copy of the request upon which such officer or seaman was admitted. They shall be furnished treatment at stations of the first, second, and third class only. The rate of charge to be made for the care and treatment of the said officers and seamen will be fixed by the Department at the beginning of each fiscal year, and will he announced to officers and others in the annual circular entitled "Contracts for care of seamen." The above class of patients are not subject to the. provisions requiring transportation to marine hospitals. FOREIGN SEAMEN. Foreign sea- 471. The accommodations provided for the care and treatment of men may be treated. Sec. 6, the patients of the Marine-Hospital Service are also available to f or- lSStet'L3'^!'0' e^n seamen a^ relief stations of the first, second, and third class upon the application of the consular officer of the nation under whose flag they are sailing; or upon the application of the masters of the vessels upon which said seamen serve, provided satisfactory written security is given for the payment of the expenses of such care and treatment, at rates fixed annually by the Secretary of the Treasury. When treatment is furnished a foreign seaman, the fact will be immediately reported to the Surpervising Surgeon-General, on a daily report (Form 1942) or relief certificate (Form 191.1), accompanied by a copy of the application upon which he was admitted. Bills for care 472. A bill (Form 1926) in duplicate must be rendered by the Formt19f6.ment' officer of the Marine-Hospital Service in command for the care of each foreign seaman or other seaman admitted (not entitled to treatment free), said bill to be rendered upon the termination of treatment in each case. One copy of this bill shall be delivered to the collector of customs, who shall at once collect the amount; the other copy shall be forwarded by the officer rendering the bill to the Supervising Surgeon-General. Monthly ic- 473. Customs officers acting as agents of the Marine-Hospital counts to be o t_ n -n ^ -n , ■-.-. „ , rendered. bervice shall collect all bills for the care and treatment of seamen of the classes enumerated in paragraphs 470 and 471 when rendered by the proper Marine-Hospital officer, and will render monthly accounts for all moneys collected on account of the care and treat- ment of such seamen; said accounts to be accompanied by abstracts giving the name and nationality of the patient, date of admission and date of discharge, period of treatment, and amount collected in each case. REGULATIONS FOR U. S. MARINE-HOSPITAL SERvICE. 59 474. Collectors of customs will notify the commanding officer of Notification of the vessel of the class enumerated in paragraphs 470 and 471, upon amount of blU- whose request the seaman was admitted, of the amount of the bill, and when paid will give a receipt therefor. The money will be deposited as a repayment to the Marine-Hospital fund in the man- ner provided for moneys received for the care of foreign seamen. 475. The rate of charge to be made for the care and treatment of Charges for foreign seamen will be fixed by the Department at the beginning of ment.an rea " each fiscal year, and will be announced to officers and others in the annual circular entitled "Contracts for care of seamen. " Foreign seamen are not subject to the provision of paragraphs 42G and 434 requiring transportation to marine hospitals. THE REVENUE-CUTTER SERVICE. 476. The officers and crews of the Revenue-Cutter Service will Admitted .... ,. , , , without regard receive hospital or out-patient treatment, as hereinafter provided, to length of on certificate signed by the commanding officer or executive officer sein lce' of a revenue cutter, without regard to length of service. The cer- tificate shall contain a description of the applicant for relief. Offi- cers on leave or waiting orders may sign their own certificate. 477. Any such officer or seaman whose condition absolutely re- Admitted to quires treatment in hospital will be admitted to hospitals at sta-1 ana to con- tions of the first class and to all contract hospitals enumerated intract hospitals. the annual circular entitled '•Contracts for care of seamen,"'sub- ject to the provisions of the said circular with regard to the trans- fer of patients from a contract to the nearest marine hospital. No admission to hospital will be granted at any port not mentioned in said circular. At all ports mentioned in the circular, where no specific arrangements for treatment in hospital are made, the regu- lations governing admission at fourth-class (emergency) stations will be enforced. 4 78. Out-patient treatment will be furnished at all stations where Out-p a t i e n t an officer of the Marine-Hospital Service is on duty. At all other Where and how stations out-patient relief will be granted only in case of emergency furnished. and under the provisions of the regulations relative to fourth-class (emergency) stations. No out-patient relief will be granted at any station not mentioned in the annual circular entitled '' Contracts for care of seamen," and in all other respects the regulations of the Marine-Hospital Service must be complied with. THE MISSISSIPPI RIVER COMMISSION. 479. Masters, officers, and crews of vessels in the service of the cr^sc^'sveas"5 Mississippi River Commission shall be entitled to the benefits of the of the Missis- Marine-Hospital Service (except at stations of the fourth class), commi^on™/- under the same regulations as govern the admission of seamen on titled. documented vessels. No charge shall be made for their care and treatment. THE ENGINEER CORPS, UNITED STATES ARMY. 480. Seamen employed on vessels under the charge of the Engi- Seamen em- neer Corps of the United States Army shall be admitted to the bene- sels of the Engi- fits of the Marine-Hospital Service without charge at stations of the geAr entitled. first, second, and third class upon the written request of the com- manding officers of said vessels. 60 REGULATIONS FOR U. S. MAKINE-HOSPITAL SERVICE. THE LIFE-SAVING SERVICE. Employees of 481. Keepers and surfmen of the Life-Saving Service will be Seervicn Marine-Hospital Service upon the application of their respective commanding officers. No charge will be made for care and treat- ment. ARTICLE XVII. CUSTODIANS. DUTIES AS CUSTODIANS Officers to act Dnicers to act as custodians of 488. Commissioned officers or acting assistant surgeons will be anadriquamnPMne aPl)ointed by the Secretary of the Treasury as custodians ex officio stations. of the buildings constituting marine-hospital and quarantine sta- REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 61 tions of which they are in charge, without extra compensation, and they will have control and supervision of the buildings and grounds so intrus' ed to them. 489. The specific duties of officers who are appointed to act as . Duties of cus- custodians of marine hospital and quarantine stations are detailed in an official publication of the Treasury Department entitled "In- structions to custodians of public buildings" (1895), and the rules and regulations therein set forth are to be obeyed by officers and others. 490. Custodians may. when necessary, submit to the Department Acting custo- for approval the nomination of a suitable official for appointment as dlans- acting custodian, to serve during the absence of the custodian by reason of sickness or any other cause; but such person shall not act until his nomination is approved by the Department. 491. Custodians will cause the halls, stairs, vestibules, passage- Custodians to ways, and rooms to be kept clean at all times, and will take such anTlrouild^to measures as may be necessary to prevent nuisances about the build- be kept in order. ing and grounds. The wards must be in good order before 9 o'clock a. m. and the quarters of the hospital attendants before 11 o'clock a. m. of each day. 492. They will not allow any of the rooms in the building to be Rooms to be used for other than official purposes except those assigned as quarters, purposes onlyf1 493. Special attention to economy in the use of gas, electric lights, Economy en- and water is enjoined upon custodians, who will cause attendants of^ight" and and others concerned in their control to promptly extinguish all water- lights not absolutely required for the proper transaction of official business in the executive portions of the buildings under their charge. Water used at meter rates must also be economically employed. 494. Any necessity for repairs or alterations of the building, of Necessity for the approaches to the building, or of the fences inclosing the ^reported.' t0 grounds will be promptly reported by them to the Secretary of the Treasury, through the Supervising Surgeon-General, together with an estimate of the cost of making the same and their recommenda- tion in regard thereto. 495. Expenditures for repairs made without previous authority Unauthorized will not be permitted, and application must be made to the Secre- not permitted6S tary of the Treasury, through the Supervising Surgeon-General, for any improvement or alteration of the building or grounds. 496. Custodians will not incur expenditures for repairs without Emergency the previous written authority of the Department, except in case of ^ifibe allowed. sudden break or defect in plumbing or heating apparatus, or leak in the roof of the building, when they will cause the necessary repairs to be made, and immediately report the same to the Department. 497. When an amount authorized for any specific purpose proves If authorized 6XTJGHQitU.l*6 1 S insufficient, authority must be obtained for any additional expense insufficient. before submitting vouchers for payment. 498. Custodians will prepare and transmit for payment vouchers Vouchers to for all expenditures authorized, charging them to the appropriation 62 REGULATIONS FOR II. S. MARINE-HOSPITAL SERVICE. specified in the letter authorizing the expenditure, which must also be referred to by date. Estimates to 499. Estimates of proposed expenditures should be submitted in dItSanb?tcted ln detail when repairs of the buildings or improvements of the grounds are recommended. Requisitions 500. Custodians will not make requisitions for articles needed in notoftenerthan public buildings under their charge oftener than once a month. Proposals for 501. Proposals for supplying fuel should be made to include all fueL expense incidental to weighing, delivering, and stowing. Certificate of 5Q2 Each voucher for fuel must be accompanied by a certificate inspection ol . , , i j? Ai o • , fuel. of inspection (Form 118) signed by an employee ot the Service who shall have been designated by the custodian to inspect, weigh, and measure all supplies of fuel. Blank forms for such certification will be furnished by the Department. Advertise- 503. Advertisements or public notices, except such as relate to posted on*walls6 public business, must not be posted on the walls or in the corridors of buildings in charge of custodians. Diagrams of 504. Custodians will forward annually, on the 30th of June, to PatiSnaofd same the Supervising Architect, Treasury Department, through the to be forwarded Marine.Hospital Bureau, rough diagrams of the different floors of the buildings under their charge, showing by whom the several rooms are occupied. A duplicate of same shall be sent to the Supervising Surgeon-General for the files of the Bureau. Application 505 Custodians will make application to renew leases of build- renewals, ings at least sixty days before the expiration of existing leases, giv- ing a list of all buildings and rooms rented at their station, the purposes and periods for which they are leased, the annual rent paid, that the premises are suitable for the purpose designed, that the rent charged is as low as suitable premises can be obtained, and that the lessor can give a valid lease. Precautions 506. Custodians of marine hospital and quarantine stations will use every possible precaution to guard against danger of destruc- tion of the buildings and other property by fire. In all buildings where fire hose is not provided, fire buckets are to be kept filled with water, ready for use, and must not be removed from their proper places, or used for any other purpose than extinguishing fire. Weekly fire 507. Attendants will be instructed and drilled once each week by dri11- the hospital steward, under the direction of the officer in command, in the proper use of the fire-extinguishing apparatus. He shall vary the time of holding the drill from week to week, and shall also vary the supposed site of the fire in such manner as will best accustom the attendants to meeting all possible emergencies. Supervision of 508. The fire drill shall be supervised by the commanding officer ire drill. jn persori) 0r by a junior officer detailed by him, and all officers and attendants present for duty shall be required to take part in same. Specific duty 509. Each officer and attendant shall have assigned to him a spe and^ttendant c*nc duty to perform in the execution of the drill, and a placard at fire drill. giving those duties in detail, suitably framed, shall be posted in a conspicuous place in the executive building. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 63 510. In addition, a slip defining their respective duties shall be Slip defining QU.L16S to D8 tur* furnished to each officer and attendant, and kept posted by them in nished. their respective quarters. 511. Officersand attendants shall be required to familiarize them- Familiarity , . . .. . , , , , .. , with duties re- selves with their respective duties, and the attendants shall be quired. required to recite their duties at the regular weekly muster. 512. The character of the station and the number of attendants Determination will necessarily determine the duties to be assigned to each, but the following scheme, designed for a station of eight attendants, is sug- gested as a guide : Fire alarm: Continuous ringing of gong. 513. Alarm: The alarm will be given by the person discovering the fire, and he will then proceed to his proper station. 514. Steward: Will assume direction of the efforts to extinguish the fire, and if in the executive building, will at once remove the records to a place of safety. 515. Engineer: Proceed at once to the hydrant nearest the scene of fire and stand by to turn on water. 516. Driver: (a) If fire is in the stable, remove horse to place of safety, and then return to scene of fire to perform such duties as may be assigned to him. (6) If fire is not in stable, he will assist the yardman in carrying ladder to scene of fire and raising it. 517. Yardman: Assist in carrying ladder to scene of fire and raising it. 518. Messenger: Proceed to scene of fire with ax and fire bucket, and then assist nurse in removing patients to place of safety. 519. Cook: Proceed to scene of fire with ax and fire bucket, and then assist with the hose. 520. Launderer: Proceed to scene of fire and assist with the hose. 521. Nurse: Arrange for removal of patients, get out wheel chairs and stretchers, then stand by for orders. 522. Night watch: By night give alarm and proceed to scene of fire with fire buckets. By day proceed to scene of fire for orders. 523. Persons or corporations demanding payments in advance for Advance pay- • , • * i-i ■ j.-u -n v. ment of bills. gas, water, or other service, or supplies for public the use, will be notified that, under the restrictive provisions of the statutes, no account can be paid except for service, etc., rendered at the date of presentation of such account. 524. The custodian shall take suitable measures to preserve order Trespassing about the buildings and grounds and to prevent trespass, destruc- mjunng"trees tion of trees, fences, or walls inclosing the hospital and quarantine and fences. reservations. He shall report to the United States district attorney Rev. Stat., of the judicial district in which the reservation is situated any seri- cUi5i>, p. 91 vol. 1, Dne reservation is snuaieu any sen- c.i5ii p ous infractions of this provision. 525. Custodians shall not remove trees or shrubbery from the Trees and reservation nor change existing fences without authority from the removed! Department. 596 Yeiretable gardens shall not be maintained at the expense of Gardens not >•» . , . , j, j to be main- the Marine-Hospital fund. tained. 64 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. ARTICLE XVIII. PUBLIC PROPERTY. All property 527. Commissioned officers and acting assistant surgeons shall forbeFaormslS keep a true account of all public property received by them. For 1904. ' this purpose a return shall be rendered by them on the 1st day of July and the 1st day of January, each year. Responsibility 528. The commanding officer is held responsible by the provision officerTfOTcarl of paragraph 123 for all the public property in his charge, and it is of property. expected that he will not allow this responsibility to become a mere routine consideration in the discharge of his duties. This respon- sibility includes the care and conservation of it while intrusted to his control. Actual in- 529. In preparing the semiannual property returns the hospital made68 t0 be steward shall make an examination and count.of the actual articles on hand, and not render a return which is merely a transcript of records. Invoices to be 530. When an officer accountable for public property resigns, cessors. ° SUC" is transferred to another station, or otherwise ceases to have charge of said property, he shall, when so directed by the Supervising Surgeon-General, prepare an invoice (Form 1903 or 1904) thereof to the officer relieving him, and shall remain at station until the transfer invoice is duly verified and receipted by the officer who receives the property. The completed paper shall then be for- warded to the Supervising Surgeon-General by the officer relieved of the custody of the property. The copy retained at the hospital shall be similarly signed. Customs offi- 531. At stations where no officer of the Marine-Hospital Service tudvt0ofaVprop- *s on duty, the proper customs officer will have custody of all prop- erty. erty belonging to the Marine-Hospital Service, and will account for the same to the Treasury Department. Personalprop- 532. Medical officers of the Service who may be charged with the personal custody of certain special property of the Service (micro- scopes, etc.) will render semiannual returns of same in their per- sonal name. Property not 533. No property will be dropped from the property return with- fromreturns, out authority from the Bureau, except such articles as are declared to be expendable by the Bureau. The names of all such articles are to be found in the "Supply table"' in a separate list. Obsolete books. 534. All books, such as L'.sts of Merchant Vessels, city directo- dropped. ries, Nomenclature of Diseases, and other publications, the dates of which render them useless after the year for which thej' are intended, may be dropped from the return. Sale of public 535. Property belonging to the United States Government shall not be disposed of at private sale. When authority has been obtained from the Secretary of the Treasury to dispose of such property, it may be sold at public sale, after due notice by advertise- ment, either by publication in newspapers or by posting written or printed notices in places frequented by the public. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 65 536. In case of loss or destructionof non expendable articles the er^oss of Pr°P_ officer or person responsible for the property shall report to the Super- vising Surgeon-General the facts concerning'the loss or destruction thereof at once, accompanied by his affidavit, sworn to before a notary public or other person qualified to administer oaths. 537. Officers are not expected to account for parts of articles and Material for materials used for the preservation of public buildings and for re- bePaceounted pairs to articles which are already charged to the station, such as for- lumber, paints, gas and electric-light fittings, stove grates and lin- ings, ax handles, drawer pulls, parts of harness, but will render the account of such expenditures under the head of repairs to the several articles. UNSERVICEABLE PROPERTY. 538. The commanding officer of each hospital station shall set Room for un- aside a suitable room for the reception and storing of property property. turned over to the hospital steward as worn out or unfit for use. This room shall be provided with shelving and compartments for the orderly arrangement of such property. 539. Each article of property, when worn out or unfit for use, Arrangement shall be turned in to the hospital steward, who shall affix to same a tag, properly inscribed with date, by whom turned in, where from, cause of unserviceable condition, and date of purchase, except in the case of crockery or glassware, which can not be tagged. 540. Care of such property and the preservation of same pending Care of u n- the action of an inspector is required. Articles which may be property. repaired or which are not entirely worn out must be suitably pro- tected from the effects of atmosphere, vermin, or other deteriorating agencies after deposit in such room. 541. Officers shall forward to the Supervising Surgeon-General Unserviceable on the 1st days of April and October of each year an inventory of reported. all articles of property for which they are responsible, which have been broken, worn out, or otherwise rendered unfit for further use, and all such articles will be retained for inspection. The last report shall include all articles previously reported, which have not been condemned. 542. Articles of hospital bedding and clothing will be made up Arrangement into parcels of ten, properly labeled, and broken crockery and glass- tion. °r ware restored by piece as far as possible and arranged for inspection and count. To facilitate the work of condemnation, all articles are to be so placed in the room that they shall follow in order the sequence of the list as presented to the inspector on Form 1909. 543. All articles when condemned by the inspector shall be sepa- ^^jg11^ rated into two lots for destruction and disposal, viz, articles that tides. can be destroyed by burning and articles that are indestructible by this means. The former class shall be immediately burned on the premises in the presence of the inspector, and the latter class shall be immediately carried off to a public dumping place and there deposited. 8855----5 66 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Use of con- 544. The inspector is authorized to except from the above provi- indeaninVand sion a reasonable quantity of articles (sheets, pillow cases, towels, repair. etc ^ f or use m cieaning work and to permit the retention of por- tions of articles that may be useful in the preservation of others of a similar character or suitable for repair work about the station. Commanding 545. The commanding officer responsible for unserviceable prop- present during erty about to be condemned will accompany the inspector during inspection. such examination and give him all necessary information as to its use and present condition, with the cause thereof. • 0lbiy unt^Tr' 5*6. Public property in use shall not be reported as unserviceable, to be con- nor condemned by the inspector, merely because worn or shabby in appearance, if the same be still serviceable. Authority to 547. No other persons than those designated in paragraph 543, Q1STJOSG of con~ demned- prop-except the Supervising Surg eon-General and the Secretary of the Treasury, shall order the final disposition of condemned property, unless in case of horses, which may be immediately killed to pre- vent contagion or suffering. Recommenda- 548. Articles of property inspected by officers, under instructions property in"-from the Department, will be reported upon fully as to their con- spected. dition, with recommendations for their disposal (Form 1909). Such articles as can be repaired or utilized by the Service will not be Reports of in- recommended to be sold or destroyed. Reports of the inspection of unserviceable property will be forwarded to the Supervising Sur- geon-General in duplicate. Unserviceable 549. Unserviceable property which has once been condemned property to be , ,, , . , ,.,,-,,.. inspected but shall not again be submitted for inspection except m case of the dis- 0Ilce' approval of the inspector's report, when in such case the last inven- tory must contain a note of that fact. urchase8 To n° 550' Pu1alic property which has been condemned and is offered for demned prop- sale by authority of the Department, shall not be purchased by the officer who was responsible therefor at the time of condemnation, nor by an officer who bore any part in such condemnation. ARTICLE XIX. SUBSISTENCE AND CONTRACTS. Subsistence, 551. Articles of subsistence, fuel, ice, groceries, laundry supplies, plies? forage^and forage not furnished from the Bureau shall be obtained for the United States marine hospital and quarantine stations, whenever practicable, by contract, after advertisement; said contract to be executed by the commanding officer in behalf of the United States. sub^Lrten101" 552' °n tlie lst day of May of each year the commanding officer Form 1910. ' of each United States marine hospital and quarantine station shall forward to the Supervising Surgeon-General an estimate in dupli- cate of the quantities of subsistence and other supplies required for consumption during the ensuing fiscal year. anobwlde sta6 553- The ordinary articles and quantities of subsistence supplies tions. ' for 10,000 full rations shall not exceed 8,000 pounds of meat fresh and salt; 2,000 pounds of fish, fresh and salt; 10,000 pounds of veg- REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 67 etables; 10,000 pounds of breadstuffs and other prepared farinaceous food; 100 pounds of tea; 300 pounds of coffee; 1,500 pounds of sugar; 25 gallons of molasses or sirup; 800 gallons of milk; 1,000 pounds of butter; 300 dozens of eggs;- 300 pounds of lard; 1,500 pounds of fresh and dry fruit; 500 pounds of salt; 25 pounds of pepper; 25 gallons of vinegar: 25 gallons of pickles. 554. Upon the approval of the estimate for annual supplies, Schedules to advertisements for proposals shall be published in accordance with dealers.116 the directions of the Bureau, and schedules shall be furnished deal- ers in the articles enumerated, for the purpose of obtaining their proposals. 555. In making schedules of articles on which proposals to fur- Schedules to nish the supplies may be based, each article shall be fully specified, cific, FormSl9lL describing, so far as possble, its kind, brand, and quantity. The exact weight or volume shall be given, in order that there may be no doubt as to what the bidder will be required to furnish, if his proposals are accepted. 556. Should there be reason to suspect collusion among dealers to Collusion obtain more than a fair market price for articles required to be pur-among chased, or should the prices be exorbitant, the proposals will be rejected and authority will be given to advertise for new proposals and other dealers invited to compete. If necessary, authority will be given to purchase in open market or elsewhere at current trade prices. 557. Advertisements shall be inserted in such newspapers as the No advertise- „ ,. _, _. . . . ... „ - ,. . ment without Secretary of the Treasury may direct, and no bill for advertising authority. Rev. will be paid, unless there be presented with the bill, the original, or f t||&1.87i5 July! a copy of such written authority. 18T0, c,,292, s. 2, v. *J 16, p. 308. 558. Dealers shall be instructed that the proposals must be signed foindeaters!°nS in duplicate with the firm signature and be delivered in duplicate in a sealed envelope marked "Proposals for hospital supplies," addressed to the commanding officer of the station. 559. Proposals from at least three dealers in the respective arti- Three bids re- cles will be required, if obtainable, for each class of supplies. class. 560. Commanding officers of marine hospital and quarantine sta- Bids from re- • n j.i i J3 x sponsible ctejii" tions shall make reasonable effort to induce the largest and most ers desired. responsible dealers at the station to submit proposals to furnish sub- sistence and other supplies. 561. The commanding officer shall make separate schedules in I^P^1"^ \l accordance with the approved estimate for each of the different made. classes of articles, namely, for meats, vegetables, breadstuff's, gro- ceries, fuel, forage, and ice. These schedules shall be furnished in duplicate to all persons who may call for them for the purpose of submitting bids, but bidders must be actual dealers in the articles they propose to furnish. 562. If more advantageous to the Service at particular ports to Changes in separate certain articles from any of the groups referred to, in order be made. to obtain separate proposals from dealers therein, the schedule shall be made out accordingly or they may be grouped together to secure combined proposals in the discretion of the commanding officer. 68 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Samples to be 563. Samples shall be required to be submitted to the command- submitted. ing officer by tne several bidders, as far as practicable, and the quality of the samples submitted, as well as the prioes, will govern the recommendations of the commanding officer as to the accept- ance of any bid. Opening of 564. The proposals received shall be opened at the time specified in the advertisement by the commanding officer of the marine hos- pital or quarantine station, in the presence of such bidders as may present themselves. Comparative 565. A comparative schedule of all the proposals received shall be schedule to be , ,x , ... , ,, « . . n ^ made. prepared and transmitted to the Supervising Surgeon-General, together with the proposals in duplicate, accompanied by a letter of transmittal giving the recommendation of the commanding officer as to the relative merits of each proposal. Contracts, 566. Upon receipt of instructions from the Bureau as to the pro- Form 1912 posals accepted, commanding officers of United States marine hos- pital and quarantine stations will enter into contract with the bid- ders whose proposals have been accepted; the contracts shall be made out in quadruplicate upon the blank form furnished by the Depart- ment for that purpose, and when completed shall be transmitted to the Supervising Surgeon-General. Period of con- 557. Contracts for subsistence and other hospital supplies will be made for one year, commencing on the 1 st day of July of each year, and ending on the 30th of June following. • Legal require- 568. The contract shall be signed in the firm name, without seals, ments of sign- ° ' ' ing. but the bond accompanying the contract must be signed by the individual members of the firm and their sureties, and each signa- ture to the bond must have a seal attached. When a person signs a contract for a company, a power of attorney or other written evidence that he is authorized to act for the company must be attached to the contract. H°>Ir*Jadeand 569' ASreements and contracts made on account of the Marine- Hospital Service, required to be made in legal form with bonds and sureties, shall be certified by the proper customs officers, respectively, as to the sufficiency of the sureties given. Officers may 570. Officers on duty in United States marine hospital and quar- nave benefit of ,. ... . ... ., . ., „ , * j- . contracts. antme stations shall have the privilege of purchasing regular subsist- ence supplies at the contract rates from contractors furnishing said stations, and a clause to that effect may be included in each con- tract; but such officers shall not be allowed to include in the contract articles not included in the estimate. DejSKSt r°ef 571, Contracts or agreements made or entered into by officers of quired. the Marine-Hospital Service for work, labor, or material, or supplies of any kind will not be binding until they shall have been approved by the Department or written authority obtained to enter into such contract or agreement. supp^s"011 °f 572* Articles and supplies purchased for the Service, before being accepted by the person authorized to receive them, must be care- fully inspected, and shall be rejected unless of good quality, corre- sponding to the specifications in the bid, and in every respect satis- factory. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 69 573. Commanding officers of United States marine hospital and To inspect quarantine stations shall, from time to time, inspect the quality of supphes- the hospital supplies furnished under contract, and shall reject such as are of inferior quality. ARTICLE XX. REQUISITIONS. MEDICAL SUPPLIES. 574. Commanding officers shall as far as practicable anticipate Requisitions, the needs of the Service at their respective stations by making requi-Form 1905' sition for such articles of hospital equipment, bedding, clothing, and medical supplies, or other property, as may be necessary. 575. Requisitions for medical and surgical supplies will be made . Time of mak- semiannually, on the 1st days of April and October of each year, anding' shall be forwarded to the Supervising Surgeon-General. 576. The standard as to articles and quantities allowed testations Official Sup- shall be the " Official Supply Table Of the Marine-Hospital Service." ply Table' 577. Medical officers will see that the semiannual requisitions do Requisitions not call for any article not in the Supply Table, nor for quantities artMe^in^the in excess of those therein allowed. They will forward one copy to Suppiy Table. the Supervising Surgeon-General and will retain one in their office. 578. In order to permit the* indulgence of individual preferences, Medical sup- and to provide for the exigencies of climate, season, epidemic diseases, p ies' etc., additional medicines may be requested by officers, who will state the reasons for adding unusual articles and amounts. 579. When supplies require to be replenished at any time be- intermediate tween the dates for making the regular requisitions, special requisi- re(imsitlons- tions may be forwarded to the Supervising Surgeon-General, stating the articles and the quantities required up to the time of the next semiannual issue of supplies, and the reason which necessitates the request. « 580. Requisitions for liquors and vials will be made on the 1st Liquors and of October of each year for a supply of twelve months. V1 STATIONERY, BLANKS, AND BOOKS. 5.81. Requisitions will be made semiannually, on the 30th of June Stationery, and 31st of December of each year, by officers for stationery, andj^y^pQ^g on the 1st of April and the 1st of October of each year for blanks1906 and 1907. and books. 582. Requisitions for stationery must be accompanied by samples Sample envel- of printed envelopes desired. opes' 583. In preparing requisitions for stationery a full year's supply ink and muci- of ink and mucilage shall be included on the requisitions forwardedlage- June 30 of each year. MISCELLANEOUS ARTICLES. 584. In special requisitions each item must be fully described, Special requi- and the kind, quantity or number, and estimated price of each article must be given in appropriate columns, and a total made. 70 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Special requi- 585. The several columns in special requisitions shall be filled lm0*' F°rmout in respect to each item listed. The estimated price shall be given in all cases where practicable to obtain it from dealers, and the appropriation from which payable shall be indicated in the column designed for that purpose. In the case of new or unusual items involving considerable cost it will not be sufficient to report none on hand, but an explanatory letter must accompany such requisi- tions, referring in detail to those particular articles and presenting statements in support of same. Supplies must 586. Requisitions for articles of hospital equipment, such as lated V^yo-od utensils, implements, etc., must not be made in anticipation of needs needs. beyond the fiscal year, nor with a view to accumulate a surplus stock in excess of probable loss by breakage or wear. Letters of 587. Special requisitions, estimates, proposals, and bills must always be accompanied by letters, giving briefly such information as may be necessary for proper action. Repairs to 588. The subject of repairs to property of the Service shall form proper y. ^e ^agja Qf separate communications, and in all cases must be accompanied by estimates of the probable cost of same. Shipments by 589. When stationery, books, and blanks, or other supplies are freight3 S forwarded by express the charges thereon are invariably prepaid by the Department or Bureau, but on all shipments by freight the charges are to be paid by the officer receiving the goods, who shall forward vouchers for the amount advanced by him, attaching the freight bills as subvouchers. The drayage or other charges attend- ing the transfer of goods from the depot or wharf at the point of destination shall be paid by the officer receiving the shipment, and will be refunded upon receipt of bills accompanied by subvouchers covering the full amount charged. ARTICLE XXI. MEDICAL AND SURGICAL SUPPLIES. Supply Table 590. The Supply Table, issued by the Bureau, enumerates the medical supplies issued to the United States Marine-Hospital Serv- ice and the quantities and sizes of original packages. hesnissuedSUP" 591' It *S the Policy of the Bureau to supply from time to time new remedies of determined therapeutic value; but newly intro- duced remedies desired only for experiment and such as offer no manifest advantage over those already issued will not be supplied. It is believed that all necessary articles are included, and that the quantities allowed will be found sufficient under ordinary circum- stances. ratk)nCsialnotePah 592< Recmisitions for particular preparations, simply because lowed. they are agreeable to the taste or to save trouble in compounding, will not be approved; nor will preparations of a drug be furnished when one or more practically equivalent ones are on the list. pheesfetCotSb^SUr?: 593 Medical oncers shall report to the Supervising Surgeon- ported. General all defects observed in the quantity, quality, or packing of REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 71 medical supplies. They are requested to freely communicate with the Supervising Surgeon-General as to any suggestions tending to the improvement of medical supplies, appliances, etc., and to make reports as to new designs of apparatus, etc. 594. Surgical appliances, such as trusses, elastic stockings, artifi- Appliancesand cial limbs or eyes, glasses, and orthopaedic apparatus, must not be tu^no^to^be purchased for patients of the Service without special authority from purchased. the Bureau. 595. Commissioned officers desirous of making investigations. Microscopes may apply to the Supervising Surgeon-General for a microscope sona! account?1"" and attachments, which, when furnished, will be under their per- sonal charge, and they shall be responsible for its care and preser- vation and shall take same with them when changing station for permanent duty. While it is in their charge they will be required to make a semiannual property return of the said microscope and accessories on Form 1903. 596. Medical officers desiring to issue surgical appliances to out- Appliances for going patients, such as crutches and rubber bandages, must obtain Patients- authority from the Bureau to issue them. Patients needing other special appliances may be supplied upon authority from the Bu- reau after a full statement of the case is submitted for considera- tion; but officers are not authorized to purchase such articles under the exigency clause. 597. The exchange of medicines or supplies with druggists or Exchange of merchants is prohibited. SoiS68 P r °' 598. Elastic stockings will be furnished only to patients in hos- Elastic stock- pital at the date of requisition. Said articles will not be furnishedings to out-patients unless under exceptional circumstances, which should be fully stated in a letter of transmittal. ARTICLE XXII. PURCHASES AND BILLS. EMERGENCY PURCHASES. 599 The necessity for economy in the expenditure of the fund Economy in for the support of the Service, and the appropriations for fuel, lights, be observed S t0 water, and miscellaneous items, and furniture and repairs of furni- ture (the two latter being limited allotments for the use of this Service), must be observed. It is not possible to define absolutely an emergency purchase, but in general it may be stated that it covers only such items as medicines and surgical supplies (listed on the Sup- ply Table) which have become unexpectedly exhausted; the break- age of articles in daily use and absolutely necessary for the proper administration of the hospital, such as surgical instruments, wagons, harnesses, horseshoeing, cooking stoves, and important utensils used in the hospital kitchen, and which must be replaced or repaired im- mediately, and these will be held to be examples of an emergency recognized by the Bureau in its approval of bills forwarded under this clause. Officers shall not contract bills under this exigency 72 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. clause for articles or services other than those already defined, unless it is clearly established that injury to the public interests, or dam- age to public property would result by such delay as would have been necessary to procure the authority of the Bureau for the pro- posed expenditure. Proposals 600. Proposals from at least two responsible dealers, each stating ny1 certain^pe- the price at which he proposes to furnish the articles or make the cial re qui si- repairs, will be required to accompany all special requisitions for purchases or repairs, and no expenditure of this character will be incurred by commanding officers or acting assistant surgeons of the Marine-Hospital Service without specific authority from the Depart- ment, except in cases of emergency. These proposals must be trans- mitted with recommendations of the officer as to the acceptance or rejection of such proposals. Emergency 601. For such absolutely necessary purchases, including articles of Stat., s.S3709.6V subsistence not provided for by contract and repairs as require im- mediate attention and involve but small amounts, bids will not be required; but it must be satisfactorily shown that the expenditure was immediately necessary, and that the necessity therefor could not have been foreseen by ordinary care, and the exigency must be certified on the face of the voucher. Subsistence 602. Extra purchases of subsistence supplies (i.e., of articles not side of con-in the contract) are to be made by the steward on the order of the tracts. commanding officer of the station. If in the latter's absence an emergency purchase must be ordered by the officer in temporary charge, it should be reported at the first opportunity to the com- manding officer. Verbal orders 603. There shall be no verbal orders given to contractors or deal- ers. Orders shall be in a printed form or in writing, and dealers should be informed that no attendant is authorized to make pur- chases without a properly signed order. nottoi0urchaleS 604 ^° Purcnase wil1 be made by a junior medical officer, except when unavoidable, and in the absence of the commanding officer. Public pron- 605. No article of furniture or any material belonging to the given11 as pay6 Government can be given or allowed in part payment for any sup- ment for sup- plies or work. plies. BILLS AND VOUCHERS. bmeForms1]9^3f 606' A11 bills on account of the Marine-Hospital Service must be 1937,1938. " ' rendered in duplicate on the proper blanks. They must be item- ized, and in cases where services or articles are furnished seamen the names of the latter must be given and the items specified. b Authority to 607. Upon bills incurred under special authority from the Depart- ment, the particular authority for the expenditure will be referred to, and the dates of the Department letters or circulars authorizing them must be given. rendered.*0 be 608 As far as Practicable, every bill incurred on account of the Marine-Hospital Service will be obtained and promptly forwarded at the close of each month to the Supervising Surgeon-General. of^oucher^for 609, Vouchers presented for payment must be in duplicate, prop- payment, erly certified, and receipted in black ink, and indorsed and made in * * REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 73 the name of the party, parties, firm, or corporation furnishing sup- plies or rendering service, and care should be taken that the signa- ture to receipt conforms to the caption of the voucher. 610. Bills so forwarded will be accompanied by a letter giving Letters of the names of payees, the kind of articles purchased, and the amounts in each case, stating the necessity for the purchases made, etc., unless previously authorized. 611. Bills for articles embraced in any special requisition Items to be approved by the Department must contain no other items. 612. The monthly bills for the care and treatment of the patients Bills for main- of the Marine-Hospital Service (Form 1923) will be compared with 1923. the register of permits by the officer issuing hospital permits at each station, who will also muster the patients in hospital on the last day of each month, and certify the bills accordingly; and said bills will hi no case be paid until they shall have been so compared, found correct and certified. 613. The necessary medicines furnished patients of the Marine- Bills for med- Hospital Service by apothecaries, upon the prescriptions of physi- ' cians authorized to prescribe for such patients, will be paid for at the lowest current and just prices charged the public at the time and place, bills to be rendered in due form by the apothecary and certified by the physician and customs officer. 614. Bills for medicines dispensed to sick and disabled seamen, Names of sea- upon the prescriptions of medical officers or attending physicians, Chills for^pre3 should state the names of seamen prescribed for. scriptions. 615. Bills for repayment of amounts advanced for official tele- Telegraph graphing shall be rendered at the rates established by the Post- master-General, and accompanied by copies of the telegrams charged for, and receipts from the agents of the company per- forming the service. 616. When an amount approved for any specific purpose or pur- Au^a^it;J f*° chase proves insufficient, authority must be obtained for any addi- additional ex- tional expenditure before submitting vouchers for payment. penditure. 617. Subvouchers shall be securely attached to bills by fastening Subvouchers. across the top with mucilage. ARTICLE XXIII. RECEIPTS AND DISBURSEMENTS. MISCELLANEOUS RECEIPTS. 618. Receipts accruing from the unclaimed moneys and effects ^How^de^os- of American seamen dying on shipboard outside the limits of the stat., s. 4538. United States, when deposited under the act of June 7, 1872, shall be credited to the appropriation for the Marine-Hospital Service. 619. Receipts accruing from the proceeds of sale of condemned Proceeds of and surplus property belonging to the Marine-Hospital Service shall sales. be deposited as " miscellaneous receipts." 74 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Repayments 620. Receipts from the collection of bills for the care of foreign men, Form 1926. seamen, receipts from the sale or lease of marine-hospital property, and other miscellaneous receipts appropriated for the use of the Marine-Hospital Service are not available for disbursements, and customs officers will accordingly render separate accounts each month for such receipts, accompanied by itemized abstracts. Unclaimed 621. Unclaimed money and valuable effects of deceased patients money and ef- „ ,, ,, __ ., , z. . , •,.„,,. , ,, fects of deceased of the Marme-Hospital Service at each relief station shall, at the seamen. close of each quarter, be delivered by the medical officer or acting assistant surgeon of the Service to the proper customs officer. Method of dis- 622. Tht customs officer will sign triplicate receipts for such erty of deceased moneys and effects deposited by officers of the Marine-Hospital Serv- seamen. .^ an(j wjvi forwar(i the original to the Department; the duplicate and triplicate will be forwarded to the commanding officer, who will transmit the duplicate to the Bureau and retain the triplicate as his personal voucher. In forwarding the duplicate, the medical officer will accompany it with a letter of transmittal, giving a descriptive list of the deceased and the name of the vessel on which he last sailed. Customs officers will deposit moneys so received to the credit of the Secretary of the Treasury, special deposit account No. 3. property to be 623- The valuame effects of deceased seamen, deposited with the sold after one customs officer as provided in paragraph 621, and which shall remain unclaimed for a period of one year, shall be sold at public auction by the customs officer when authority has been obtained from the Secretary of the Treasury, and the receipts accruing from such sale shall be deposited by the customs officer as provided in paragraph 622. unclafmedmon- 624- SeParate accounts will be rendered covering receipts from eys and effects, unclaimed moneys and effects of seamen who die in hospital under the charge of the Marine-Hospital Service, which accounts must include no other items. property of Jde£ 625, If the moneys and valuable effects of deceased patients re- ceased patients, maining in the custody of an officer of the Marine-Hospital Service are not called for within three months, after due notice as above, they will be disposed of as provided in paragraphs 468 and 621 of these regulations. po^tofproje/ty 626 At third and fourth class stations> the customs .officer (or of deceased pa- acting assistant surgeon, if in charge of the station) shall, at the end of each quarter, report to the Department the name and description of any and all patients of the Marine-Hospital Service who may have died during that period, leaving either money or valuables, or both, in their custody, which may remain unclaimed after three months. DISBURSEMENTS. ceSSSttasdfe- 627 Bonded customs officers are required, when so directed by bursing agents the Secretary of the Treasury, to act as disbursing agents of the at certain ports. Marine-Hospital Service, and shall pay, out of the funds remitted by the Treasury Department for that purpose, bills on account of said Service previously authorized by the Department; but the prin- cipal disbursements will be made by the disbursing clerks of the Treasury Department. 4 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 75 Marine-Hospital Service shall promptly liquidate all authorized ment. Cat. No. bills, and at the close of each month an account current of disburse-113 ments will be prepared and forwarded, showing the amounts dis- bursed during the month, said account to be accompanied by the proper abstract and vouchers. 629. Accounts current of disbursements on account of the Marine- How trans- Hospital Service, with accompanying vouchers, may be forwarded mi e ' without letters of transmittal, unless remarks or explanations con- cerning them are necessary. ARTICLE XXIV. RECORDS, REPORTS, AND CORRESPONDENCE. RECORDS. 630. The following-named official records shall be kept at stations Stations of of the first class, viz: A register of out-patients (Form 1944); a reg-class L ister of hospital permits (Form 1945); a register of hospital patients (Form 1946); a record of moneys and valuables of hospital patients (Form 1950); a journal (Form 1955); a record of medical inspection of seamen (Form 1956); a record of letters and papers received (Form 1957); a record of letters and papers sent (Form 1958); an inventory of patient's effects (Form 1949); a record of subsistence and other supplies (Form 1951); a record of liquors consumed (Form 1952); and a record of public property (Form 1959). 631. The following-named official records shall be kept at stations Stations of of the second class, viz: A register of out-patients (Form 1944); a register of hospital permits (Form 1945): a register of hospital patients (Form 1946); a journal (Form 1955); a record of medical inspection of seamen (Form 1956); a record of letters and papers received (Form 1957); a record of letters and papers sent (Form 1958); and a record of public property (Form 1960). 632. The following-named official records shall be keptat stations Stations of of the third class, viz: A register of out-patients (Form 1944), a register of permits (Form 1945), a record of public property (Form 1960) to be kept by the officer who issues relief papers, a register of hospital patients (Form 1946), a record of letters and papers received (Form 1957), a record of letters and papers sent (Form 1958), and a record of medical inspection of seamen (Form 1956) to be kept by the acting assistant surgeon. 633. The following named official records shall be kept atstations Stations of of the fourth class, viz: A register of out-patients (Form 1944), acass4 register of permits (Form 1945), a record of public property (Form 1960) to be kept by the officer who issues relief papers, and, if an acting assistant surgeon is on duty, a record of medical inspection of seamen (Form 1953) to be kept by that officer. 634 The register of out-patients shall contain the number (com- Register of out- patients Form mencing with No. 1 on the 1st day of July of each year), name, age, 1944. and nativity of each patient; the name of the vessel on which he last served, and the period of his last service; the patient's statement as 76 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. to any previous relief from the Marine-Hospital Service, and when, where, and for what disease such relief was obtained; present dis- ease or injury; dates on which outdoor relief was furnished and the kind of relief furnished. Only one entry of each patient shall be made during any current month when relieved for the same dis- ease or injury, but when relief is furnished several times during the month for the same disease or injury the date and the kind of relief will be entered each time in the same place. A seaman who has received office relief for one disease or injury and applies again in the same month for relief on account of another disease or injury will be reentered as a new case, if again relieved as an out-patient. An out-patient relieved two or more successive months for the same disease will be reentered on the register each month as remaining from the previous month. Register of 635. The register of hospital permits to be kept in the marine-hos- mitsPForml945 P^al office shall contain the number and date of the permit or bed ticket; the name, age, and nativity of the patient; the name of the vessel on which he last served; the total period of his last service; the number of years he has been a seaman on United States vessels; the disease or injury for the treatment of which the permit is issued; the date of termination of treatment, and any necessary remarks. Register of 636. The register of hospital patients to be kept at first, second, tients, Form and third class stations shall contain the number of the permit or 1946- bed ticket; the name, age, and nativity of the patient; the date of admission; the disease or injury; subsequent complications, if any; date of letter authorizing extension of original permit; date of ter- mination of treatment; condition of patient on termination of treat- ment; total duration of treatment in hospital under the permit, and any necessary remarks. This register is to be kept by months, and patients remaining at the close of each shall be carried forward on the first day of the following month in the order of priority of admission. At second and third class stations this book shall be kept at the hospitals where patients are treated. Journal of sta- 637. In the journal shall be recorded the dates of changes of I955.ns' Form officers or attendants, repairs or alterations of buildings, general condition of the station for each week as shown by the weekly inspection, the breaking out of an epidemic, and any other events of interest and importance to the Service at the port. Inspections made by officers charged with that duty shall be noted and signed by them in the journal of the station. Record of 638. A record of all medical inspections of seamen shall be kept t?onsof seamen, at stations of the first, second, and third class, giving name, age, Form 1956. and nativity of the persons examined, number of years a seaman on United States vessels, vessel on which applicants intended to sail, or if a candidate for keeper or surfman of the Life-Saving Service, the name of station where he is to be employed shall be entered, at whose request the person was examined, whether passed or rejected, and remarks on the case. This book shall also be kept by the act- ing assistant surgeon specially appointed for the examination of surfmen. When officers are detailed to conduct physical examinations at points remote from their station, the records of such work shall REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 77 be entered upon the book (Form 1953) of the station to which they are attached, with appropriate references to the special character of such examinations. REPORTS. 639. At the close of each month commissioned and noncommis- Monthly re- sioned officers shall make reports (Form 1919) of the current trans-f^fg^ orms actions of the Service and reports of relief furnished seamen (Form 1925), under paragraph 471 of these regulations. 640. At the close of each month commissioned and noncommis- Forms 1902, sioned officers and other physicians having charge of the profes-1921'1923- sional treatment of patients of the Service will make reports (Form 1921) of all cases of disease and injury treated by them in hospital, and (Form 1920) of all cases of disease and injury treated in the out-patient department. They will also make, on the 30th of June of each year, reports (Form 1922) of the surgical operations per- formed by them upon patients of the Marine-Hospital Service. 641. In preparing the medical and surgical reports and all medi- Nomenclature cal certificates the official "Nomenclature of diseases" adopted for0 lseaseSi the Marine-Hospital Service shall be observed and the English names of diseases, and injuries shall be used in the order given in said nomenclature. 642. At the close of each quarter a transcript of the record of Reports of medical inspection of seamen shall be made and forwarded to the™®^* p^ Bureau. 1929- 643. A separate report will be made of each necropsy, to be writ- Reports of ne- ten on legal-cap paper, on every other line and one side only of the crops sheet, and otherwise prepared with care for publication. Each report shall include the diagnosis, initials, age, nationality, date of admis- sion (with name of station), and date of death of the seaman. Each report will be accompanied by a complete clinical history and for- warded to the Bureau as soon as completed. (See instructions in Appendix.) 644. At the close of each fiscal year commanding officers of sta- Yearly report _ . _ oi repairs 1213(0.6. tions of the first class shall prepare and forward to the bureau a detailed statement of the repairs and improvements which have been made at their stations during the preceding year. 645. At the close of each fiscal year commanding officers of sta- Estimates for tions of the first class and quarantine stations shall prepare and forward to the bureau a detailed estimate of the amount required for their several stations for ordinary repairs, payable from the appropriation "Repairs and preservation of public buildings;" also a separate detailed estimate of the amount required for new con- struction and extraordinary renovation of buildings, requiring special appropriations by the Congress. Such reports are to be made for the fiscal year following the one in which the report is made. 646. Commissioned officers detailed for the inspection of immi- Reports of in- grants shall make a monthly report to the bureau containing the migrants. number of immigrants examined, number rejected, and causes of rejection, and at the end of each fiscal year a resume of this work shall be sent to the bureau. 78 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. tions. Official forms 647. All returns, vouchers, reports, and other official papers re- to be used. quired under these regulations must be made out in conformity therewith upon the blank forms furnished by the Department for that purpose. ' No transac- 648. Whenever at any time there are no transactions to be stated in any report, account, or other return required by these regula- tions to be periodically rendered, the words "No transactions" will be written across the face of the blank form in each case, which will then be dated, signed, briefed, and forwarded. Letters of 649. Regular reports rendered under these regulations and other transmittal, paperS) which are in themselves communications, require no letters of transmittal, unless they require special explanation or additional information. Orders con- 650. A copy of every order convening boards or detailing officers vening boards. wm be incorp0ratecl in the reports submitted in accordance with such orders. Copies of re- 651. Copies of all official reports shall be retained and placed on ports to be filed. fiJe &t the gevera] stations of the service. List of attend- 652. Commanding officers shall transmit to the Bureau, on the mYttetdbetranS'S,lstof December and the 30th of June of each year, a list of the hospital attendants on duty at their stations with a detailed state- ment of the duties of each, and their compensation. CORRESPONDENCE. Official com- 653. All official communications on whatever subject to the mumcations. Depart.ment sha11 be addressed to the Supervising Surgeon-General, or through the Marine-Hospital Bureau. The envelope will be addressed to the Bureau. Free trans- 654. Official communications, packages, or other mail matter relating exclusively to the public business will be transmitted through the mails free of postage. Official signa- 655. Official papers, reports, and letters of commissioned officers dresses. and acting assistant surgeons will be in due official form, and signed over the official designation or title of the writer, and each letter will, as far as practicable, cover but one subject. Personal matters will not be included in official communications. All letters to the Secretary of the Treasury on matters pertaining to the Marine- Hospital Service shall be addressed '' To the Honorable the Secre- tary of the Treasury, Washington, D. C." All letters to the Bureau shall be addressed "To the Supervising Surgeon-General, U. S. Marine-Hospital Service," and letters shall conclude with the words ''Respectfully yours," followed by the signature and title of writer, the latter to be unabbreviated. Letters comprising more than one sheet must be paged. Indorsements 656. When communications are referred, the reference shall be made on the first fold. Indorsements shall be placed in regular sequence or chronological order. A reference shall follow the mat- ter immediately preceding it, but if it is necessary to carry it to the next side of the fold, the word " over " must be placed at the bottom of the last. No paper shall be attached in any way for additional indorsement or reference until the u-hole back of the letter sheet is covered, and then, if necessary, a sheet 3^ by 8 inches, with a flap REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 79 for attachment, may be fastened in such manner as not to cover a previous indorsement, reference, or date. 657. In referring to a Department or Bureau circular relating to .Department the Marine-Hospital Service, officers of the Service and customs offi- cers will give its date and number in the annual series of the Marine- Hospital Service. 658. In replying to an official letter from the Department, the Replies to De- date of said letter, its subject-matter, and the initials on the upper ters. left-hand corner shall be referred to. 65 9. Communications on letter paper shall be folded in three folds, Official com- and those on foolscap paper in four folds, and briefed by the writer mulas. or sender on the first or upper fold, as follows: I. The place where the communication was written and the date. II. The name and official designation, if any, of the writer, III. A brief of the subject-matter, embracing everything of importance, particularly the names of persons mentioned. At the top of the fold a space of an inch shall be left blank and the number of inclosures shall be noted at the bottom. In stating the number of inclosures, the communication itself must not be counted as an inclosure. 660. All communications from subordinate officers and attend- Official com- munications to ants to the Department must be forwarded through the commanding be for warded officer. All acting assistant surgeons on duty at stations where the mandfng officer. collector of customs issues hospital permits and certifies to accounts shall send all official communications through that officer. 661. Letterpress copies shall be taken of all official letters writ- ^fnettersf °ffl ten by officers. 662. Reports of boards of medical officers of the Service, con- b^aerpd°srtto ll vened for whatever purpose, shall be transmitted to or through the transmitted to Supervising Surgeon-General, as the case maybe. When boards ^up^rTisinl forward their reports they shall inclose a copy of the order conven- Surg eon-Gen- ing such board. 663. The standard authorities on spelling shall be in the order ^^oHties named: Webster's Dictionary, the Decisions of the United States Board on Geographic Names, and the United States Postal Guide. 664. In using the telegraph for official purposes, the circulars q Telegraph^for issued from time to time on the subject by the Department shall be poses. observed. 665. Whenever it shall be necessary for officers to make use of Telegraphing. the telegraph in sending messages to the Department, due care will be taken to make the same as brief as is consistent with clearness. Initials of names will be omitted in the address and signature. 666. Telegrams making application for leave of absence or exten- le™|goT^b- sion of leave or of inquiry whether leave has been granted, and sence. the replies made thereto by telegraph, will not be sent or paid for as " official business." 667. All records, documents, correspondence, etc., received and Preservation deposited in the files of the station shall be carefully preserved, and stat.s.,540'3,5408; no book of record, paper, or document of any kind shall be removed acts 26Feb.,i853, therefrom or destroyed, under the penalties prescribed by law in p. no. such cases. 80 REGULATIONS FOR U. S. MARINE-HOsPITAL SERVICE. ink. 668. All official records and communications to the Department must be written in black ink or such permanent ink as is used for typewriting machines, except that red ink may be used for ruling on books, bills, and schedules, and in annotation of correspondence. Abbreviations. 669 Abbreviations of words must be avoided in all official letters and papers. Metric sys- 670. Officers shall, for all official, medical, and pharmacal pur- poses, make use of the metric system of weights and measures. In expressing quantities by weight the terms "gram" and " centi- gram," and in expressing quantities by measure the term "cubic centimeter," only shall be employed. Centigrade 671. In recording thermometric observations, officers shall make scale. ° use of and refer to the centigrade scale. Official files 672. There shall be three official files for letters received at all for letters. . stations—one for Department letters, one for Bureau letters, and one for miscellaneous communications—and letters or papers re- ceived from these three sources shall be filed in chronological order. Circular let- 673. A separate file for circular letters issued by the Department or Bureau shall be kept at each station, and they shall be filed in chronological order. ARTICLE XXV. TONNAGE DUES. Maintenance 674. The expense of maintaining the United States Marine- Hospital aServ- Hospital Service shall be borne by the United States, out of the lce- receipts from duties on tonnage provided for by law. Commissioner 675. The Commissioner of Navigation shall forward at the close reprrrcollec0 of eacn month, for the information of the Marine-Hospital Bureau, tions of tonnage a summary statement of the aggregate collections of tonnage tax at the various ports during the month. ARTICLE XXVI. HYGIENIC LABORATORY. Hyg\mScnLabo£ 676- The HyS1*31"0 Laboratory shall be under the command of a ratory. commissioned officer of the Service, whose title shall be ex officio Director of the Hygienic Laboratory, but he shall not receive extra compensation therefor. ciaLslti0n °f 677' The Hygienic Laboratory shall be deemed a station of the first class and all regulations applying to the management of such stations, in so far as they are applicable, shall be observed in the management of the laboratory. Management. 678. The Director of the Hygienic Laboratory shall exercise the same authority in its management as officers in command of sta- tions, and shall report direct to the Supervising Surgeon-General. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 81 679. All purchases shall be made upon requisition, duly approved Purchases and according to the provisions of paragraphs 600 and 601, and equip- ments for the laboratory shall be purchased through the purveying division, except daily supplies bought under contract. 680. It shall be the duty of the Director of the Hygienic Labora- Duties of di- tory to perform such duties, general and specific, as relate to the investigation of the causation and prevention of disease and col- lateral subjects, under the direction of the Supervising Surgeon- General. 681. It shall be the duty of the Director of the laboratory to recom- Duties of di- mend, from time to time, special researches in the causation and prevention of disease and collateral subjects relating thereto. 682. Special investigations, examinations, or analyses not con- investigations nected with the routine work of the laboratory shall not be under- taken by the Director except with the approval of the Supervising Surgeon-General. 683. Officers and attendants detailed for service in the Hygienic Uniform. Laboratory are not required to wear uniforms while on such duty. 684. Officers detailed for service in the Hygienic Laboratory shall j^^nts*01" S 'aS be assistants to the Director, and shall perform such duties in con- nection therewith as may be assigned them by the Director. 685. The hours of duty for officers serving at the Hygienic Lab- Hours of duty oratory shall be those of the Treasury Department in Washington, but this provision shall not apply to the continuance of work or investigations deemed necessary by the Director beyond such hours. 686. Commissioned officers of the Service may, from time to time, Officers de- . , . ,. , , n tailed to labora- be ordered to the laboratory for special instructions, and during such tory. time, when serving in the laboratory, they shall be under the direc- tion of the Director, irrespective of rank, in the pursuance of such studies Officers thus detailed, while serving in the laboratory, shall be considered as on special temporary duty, and in addition to allowances specified in paragraph 9.1 shall be allowed actual expenses not to exceed 810 a month. 687. At the close of each month the Director of the laboratory Monthly re- shall make a report to the Supervising Surgeon-General, giving aports- resume of work performed, results obtained, and work in progress. 688. The Director of the laboratory shall make a report annually Annual re- to the Supervising Surgeon-General concerning the operations ofpor s' the laboratory, giving in detail the character of work performed, with results obtained. ARTICLE XXVII. QUARANTINE. 689. Quarantine stations shall be governed by the general regu- Regulations n ?■ -i i mi -c j j.- 4! governing quar- lations of the Service, so far as applicable. The specific duties ot antme stations. officers at quarantine and inspection stations under the control of the United States Marine-Hospital Service shall be according to the requirements embodied in the official Quarantine Regulations issued by the Secretary of the Treasury. 8855----6 82 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. ARTICLE XXVIII. REVENUE-CUTTER SERVICE. Rank of medi- 690. When serving on board vessels of the Revenue-Cutter Serv- rn"g°onCrerveSnuI-ice, commissioned officers of the Marine-Hospital Service shall cutter vessels. rank relatively with commissioned officers of the Revenue-Cutter Service, as follows, viz: Surgeon shall rank, in matters of official etiquette, with and next after the commanding officer: passed assistant surgeon with and next after the executive officer; assist- ant surgeon with and next after second lieutenant. Quarters will be assigned a medical officer so serving in the ward room on the port side, in accordance with his relative rank. Uniforms. 691. A commissioned officer serving on board a revenue cutter shall wear the uniforms of his grade as prescribed by the command- ing officer. Reports of 692. Whenever he deems it necessary, it shall be his duty to make tfonofrship? *° *ne commanding officer written suggestions or reports concern- ing the sanitary condition of the ship or its personnel, and suggest remedies. Reports of 693. He shall keep himself informed of the health of the port in eases. which the ship may be, and immediately report to the commanding officer the presence or appearance of any contagious diseases or epi- demic which may come to his knowledge. Morning sick 694. He shall submit to the commanding officer, through the executive, a daily morning report in writing of the sick on board, their condition, etc. Analysis of 695. Whenever a supply of water is obtained from shore, he shall make an analysis of same, as far as possible, and report to the com- manding officer in writing upon its purity. In charge of 696. He shall have charge of the medical storeroom, medicines, room, etc. surgical instruments, and sick bay, and see that they are prepared for inspection at the same time as the other parts of the ship. tion ofrmedicai 697- When fitting out> the medical officer shall examine the med- supplies, etc. ical and surgical supplies and equipments and the sick bay and report to the commanding officer upon the condition of same. felslonal wo?k°" 698 He sha11 keep a record of professional work done by him during the cruise, and at its termination make a report to the Super- vising Surgeon-General of the number of physical examinations and the cases treated, together with any other items of professional interest observed by him during the voyage. APPENDIX. INSTRUCTIONS RELATIVE TO PHYSICAL EXAMINATIONS. I. Officers of the Marine-Hospital Service detailed to conduct physical examina- tions will be guided by the following general directions: II. The candidate should be asked his name, age, nativity, and occupation, and questioned in regard to his general health and that of his family, whether any hereditary taints exist, and if he has ever suffered from any disease or accident, thus endeavoring to obtain all the information possible concerning him, his con- versation at the same time enabling the surgeon to judge of his mental qualifica- tions. III. The applicant will be required to divest himself of all his clothing in the presence of the examining surgeon, so that any defect, as a stiff joint, etc., which the applicant would wish to conceal may be detected. IV. Having divested himself of his clothing, he will then be placed under the sliding bar of a measuring rod and directed to stand erect while his height will be accurately measured. The height measure will be taken while the toes are raised, the candidate resting his feet squarely on the heel and ball of each foot. V. A tape measure will be passed around the chest over the inferior angles of the scapulae and directly over the nipples, and an accurate measurement taken both at forced inspiration and expiration. The tape will be passed around the chest while both arms are extended at a right angle from the sides, and the arms will then be dropped to the side while the measurements are taken. VI. After this the color of the eyes and hair and complexion should be noted and a general inspection of the whole body made, notice being taken of the mus- cular development and general appearance; and at the same time tumors, ulcers, varicose veins, chronic swellings of the extremities, or any visible defect that would disqualify him for service should be carefully sought for. VII. The head will then be examined for any depressions or irregularities that may exist, and the eyes, eyelids, nose, ears, teeth, palate, and fauces attentively noticed. VIII. The chest will then be inspected, and the respiration, action of the heart, and condition of the lungs ascertained by auscultation and percussion. IX. He will next be directed to stand erect, place his heels together, and raise his hands vertically above his head, the backs together, in which position he will be required to cough and make other expulsive movements, while the abdomen, the inguinal rings, and the scrotum are being examined for hernia. X. The penis will then be examined for epispadia, hypospadia, and venereal dis- ease; the groin for glandular enlargements; and testicles for atrophy, induration, and other diseases. XL He will then be required to bend forward, the fingers touching the floor, the legs straight, and the feet widely separated, in which position the fissure between the nates will be inspected for hemorrhoids, fistula, prolapsus, or other disease of the anus, and firm pressure will be made along the whole length of the spine, at short intervals, to discover if any tenderness indicative of disease exists. 83 84 REGULATIONS FOR 1T. S. MARINE-HOSPITAL SERVICE. XII. Next he will be required to extend his arms laterally at right angles to the body, and then bring them together on as nearly the same level as possible both in front and behind: to pronate and supinate them rapidly; to strike out from the shoulder; to flex the arm upon the shoulder and the forearm upon the arm, and to open and close the fingers rapidly. XIII. He will then be required to walk rapidly and to run around the room several times; to hop, first on one foot and then on the other; with his heels together, to raise himself "upon his toes; to flex and extend the thigh, leg, and foot; to kick, first with one foot and then with the other, and to make several leaps in the air. While thus excited he will again be examined for lung and heart diseases, also for hernia. An examination of the urine shall be made in every case. XIV. In making the examination of the inguinal rings the surgeon will use the index finger of the hand corresponding to the side examined, thus: for the right ring the right index finger, and vice versa. XV. The eyesight will be tested by the test types furnished by the Bureau, and the Holmgren worsted test will be employed in testing for color sense. The test must be made for each eye separately. XVJ. The hearing will also be tested by modulating the tones of the voice in conversation with the applicant, and by covering one ear while endeavoring to dis- cover defects which may exist in the other. XVII. The result of the examination will then be recorded, and, in case of rejec- tion, the disqualification on account of which he was found unfit for service will be written in full in the book prepared for that purpose. XVIII. Applicants for enlistment in the Revenue-Cutter Service, and for the position of surfman and keeper in the Life-Saving Service, will be rejected for any defect of sufficient importance to warrant notice on the examination paper. XIX. In physical examinations of officers, as preliminary to promotion, and of enlisted men, as preliminary to reenlistment, the clothing may or may not be removed, at the discretion of the examining officer. XX. Any one of the following defects will be sufficient cause for rejection, viz: Decided cachexia, strumous diathesis, or apparent predisposition to any constitu- tional disease: permanent defects of either of the extremities or articulations, unnatural excurvature or incurvature of the spine, impaired vision (not including errors of refraction corrected by glasses), color-blindness, chronic disease of the visual organs, epilepsy, insanity, chronic disease of the ears, deafness, chronic nasal catarrh, polypi, chronic ulcers or cicatrices of old ulcers likely to break out afresh, chronic cardiac affections, insufficient chest expansion, hernia, sarcocele, hydro- cele, varicocele (unless slight), stricture of the urethra or rectum, fistula in ano, hemorrhoids, varicose veins of lower limbs (unless slight), stature less than 5 feet. XXI. In addition to the above, the existence of any disease, physical deformity, or abnormal condition of such character as to incapacitate the candidate for the performance of his duties will be cause for rejection. XXII. In case the disease or disability for which an applicant was rejected is temporary in its character, the rejection at such examination shall not debar him from subsequent examination, in case he claims that the disease for which he was rejected has disappeared. Instructions Relative to Necropsies. Examinations shall be made in accordance with methods* prescribed in Vir- chow's Post-Mortem Examinations, and shall include the following: (a) The calvarium is to be removed, and the condition of the skull cap, the brain case, the sinuses and vessels, and the brain and its membranes noted. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 85 (b) In the thorax the examination will include the anterior mediastinum, the heart and pericardium, the lungs and pleura?, the great vessels and nerve trunks, and diaphragm. (e) In the abdomen the examination will include the omentum, spleen, kidneys, and suprarenal capsules, urinary bladder, organs of generation (prostate, seminal vesicles, testicles, penis, and urethra), rectum, duodenum, stomach, gall ducts, liver, pancreas, solar plexus, mesentery, small intestines, large intestines, and the great vessels. (d) In cases involving disease of or injury to the spinal cord, the examination will include the cord and its membranes. (e) Microscopical examinations shall be made of pathological processes and suspected organs. When it is not practicable to make these examinations at the station, specimens should be sent to the Bureau. For this purpose nervous tissue should be placed in Miller"s fluid, lung tissue in a solution of ."> per cent formal- dehyde, and other organs in alcohol, 50 per cent. The specimens should be from 1 to 2 cubic meters, square, and carefully labeled. Diet Tables. The following diet table will be observed m all United States marine hospitals, with such modifications only as climate and season may render necessary: ORDINARY DIET. «l Monday. Coffee...........pt. 1 Bread__________oz. (i Butter_________oz. .! Meat hash, with vegetables__oz. ti Stewed fruit* ..oz. 3 Tuesday. .pt. 1 Coffee.... Bread_____ Butter __....._:_oz. 1 Corned-beef hash, with potatoes .oz. (i Wednesday. Coffee........ Bread______ Butter -_..... Fish hash, vegetables. ...pt. 1 ..oz. 4 ..OZ. .! with ..oz. 0 Thursday. Coffee...... Bread ____ Butter_________oz. vj- Meat stew......oz. 6 ..pt. 1 . .oz. (i Friday. Coffee..........pt. 1 Bread________oz. ti Butter_______oz. $ Fish hash, with vegetables...oz. (J Saturday. Coffee . Bread . Butter Mutton ■ .pt. 1 ____oz. hops .oz. ti Vegetablosoup.pt. 1 Beef, boiled____oz. ti Potatoes........oz. 8 Pudding, with sauce_______oz. 4 Bread...........oz. 4 Tea.............pt. 1 Bread...........oz. 6 Butter..........oz. .!■ Fruit sauce.....oz. fi Beef soup.......pt. 1 Beef, boiled____oz. 0 Fish, fresh......oz. (i Vegetables____oz. 8 Bread....._____oz. 4 Fruit______.....oz. 4 Tea.............pt. 1 Bread...........oz. (5 Butter________oz. | Fruit, stewed *.oz. 4 Mutton broth ..pt. 1 Mutton,boiled..oz. ti Potatoes ______oz. 8 Rice pudding, with sauce..........oz. 4 Bread......____oz. 4 Tea.............pt. 1 Bread...........oz. (i Butter..........oz. i Cooked fruit ...oz. 4 Soup,bullion ...pt. 1 Beef,roast......oz. ti Potatoes........oz. 8 Bread____......oz. 4 Fruit............oz. 4 Tea.............pt. 1 Bread...........oz. 4 Butter..........oz. .', Fruit pudding..oz. 4 Vegetable soup .pt. 1 Meat stew......oz. 8 Fish ............oz. (i Bread.........._oz. 4 Vegetables.....oz. 8 Fruit...........oz. 4 Tea............pt. 1 Bread..........oz. 4 Butter........_oz. f- Cold meat.....oz. 4 Fried potatoes.oz. ii Barley soup .. .pt. 1 Mutton,boiled.oz. 8 Bread..______oz. 4 Vegetables___oz. 1(1 Tea............pt. 1 Bread..........oz. 4 Butter_______oz. j Rice, with sauce or sirup.........oz. 4 ♦Fresh fruit may be substituted in season. Norn.- - The tea and coffee prepared with milk and sugar The quantities of the articles of diet indicate them as the they are prepared ready to serve Sunday. Chocolate.......pt. 1 Bread___.......oz. ti Butter..........oz. J Meat stew......oz. 4 Fruit sauce.....oz. 3 Soup............ .pt. 1 Beef, roast -.....oz. ti Potatoes______OZ. 8 Other vegetables oz. 4 Rice or tapioca pudding......oz. 4 Tea............pt. Bread.........oz. Butter____...oz. Mush and milk - oz. construction of hospital dietaries. In making any change from the above, the substituted articles should be in such quantities and of such kinds as to furnish constituents equivalent to those of the articles replaced. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 87 Extra Diet. For breakfast: Mutton chop or beefsteak.._.................................... ounces.. 6 Eggs..........................................................number.. 2 Dinner: Chicken or game_____..........................„..............ounces.. 6 Ale or wine_______..................................................._. — Supper: Dry or dip toast---..............................................ounces.. 4 Milk Diet. Breakfast: Hominy or corn-meal mush..............................___.....ounces.. 14 Milk---.......................T..........................______do.... 16 Dinner: Rice or tapioca (cooked).___....................___________.....do___ 12 Milk_______......................_________________________do.... 16 Sirup__________.....................______________________do... 1 Bread__________...............___________....................do__ 4 Butter ._....._______..........____.............................do... -£ Supper: Cracked wheat or oaten grits (when cooked).........._•.......____do___ 14 Toasted bread......_____.....______............____________do___12 Milk......._______._______.....______.............________do.... 16 Allowance Table of Uncooked Rations for Hospital Stewards. Articles. Unit of daily ration. Meat or fish, fresh or salt... Bread or crackers........... Or. in lieu thereof, flour Vegetables.................. Milk.......................... Eggs......................... Butter....................... Oatmeal____......----..... Rice, hominy, or tapioca--- Coffee or chocolate.......... Tea...................-...... Sugar....................— Molasses or sirup............ Vinegar...................... Pickles....................... Cheese.......-----.......... Spices......................... Salt...........______....... Lard.....................--- Fruit, fresh or dried........ lj- pounds. 1 pound. 2 pounds. 3 pounds. 1 quart. I dozen. 6 ounces. 2 ounces. 3 ounces. H ounces. | ounce. (i ounces. 4 ounces. 4 ounces. 1- pint. 4 ounces. i ounce. 4 ounces. 8 ounces. 8 ounces. Ice in sufficient quantities for the preservation of ration in a small refrigerator will be allowed. Baking powders, yeast cakes, and flavoring extracts in sufficient quantities for cooking the above-mentioned articles will be allowed. 88 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. The following are the laws in force relating to the Marine-Hospital Servict Title. DEPARTMENT OF THE TREASURY. OFFICE OF THE SUPERVISING Sl'RGBOS-GEXEUAL. MARINE- HOSPITAL SERVICE. 1802. Act amendatory of the act for the relief of sick and dis- abled seamen provided: " That the monies heretofore collected in pursuance of the several acts ' for the re- lief of sick and disabled seamen,' and at present un- expended, together with the monies hereafter to be collected by authority of the before-mentioned acts, shall constitute a general fund, which the President of the United States shall use and employ, as circum- stances shall require, for the benefit and convenience of sick and disabled American seamen "_____...... 1875. The salary of the " Supervising Surgeon-General of the Marine-Hospital Service," which officer it was re- quired shall be appointed by the President, by and with the advice and consent of the Senate, to be paid out of the Marine-Hospital fund, was fixed at the annual rate of S4.000.................................... 1875. The Secretary of the Treasury authorized to rent or lease such Marine-Hospital buildings and the lands appertaining thereto as lie may deem advisable in the interest of the Marine-Hospital Service, and the proceeds of such rents or leases appropriated for the said service. The sick and disabled seamen of for- eign vessels and of vessels not subject to hospital dues may be cared for by the Marine-Hospital Service at such rates and under such regulations as the Secre- tary of the Treasury may prescribe................... 1SS4. All acts providing for the assessment and collection of a hospital tax for seamen repealed, and the expense of maintaining the Marine-Hospital Service to be hereafter borne by the United States out of the re- ceipts for duties on tonnage provided for by the act of June 20. 1884.......................................... 1886. Act providing for suspension of duties on vessels of foreign ports having reciprocal regulations____..... 1888. Act to perfect the quarantine service of the United States................................................... 1889. Act to regulate appointments in the Marine-Hospital Service of the United States........................... 1*90. Act to prevent the introduction of contagious diseases from one State to another.............................. 1893. Act granting additional quarantine powers and impos- ing additional duties upon the Marine Hospital Service____................. Is93. Act providing for examination of alien immigrants by officers Marine-Hospital Service...................... 1894. An act to extend the benefits of the Marine-Hospital Service to the keepers and crews of the Life-Saving Service......_...............___........................ 1895. Act providing for deductions from gross tonnage of vessels on account of compartments occupied by crew of vessels___.......................________..... is!)7. An act granting cumulative leave to commissioned officers....._............ Refeivm-'s to Statutes at Large, Revised Statutes, or Supplement. Vol. Date. |R.S..or Sup. 1803, May 3 lsrr>, Mar. 3 1875, Mar. 3 1884, June 20 1886, June 19 1888, Aug. 1 1889. Jan. 4 1890, Mar. 27 { 1893, Feb. 15 1893, Mar. 3 18 18 Sup. ( 18 \ Sup. f 23 \ Sup. 24 { Sup' { Sup.' Page. Sec- tion. 2(i Sup. 1894, Aug. 4 1895, Mar. 2 1897. Feb. 19 1-7 377 1 480 7 '3.95 485 4,6 94,95 ! 443 82 355 ti(K) 15 12 1-3 1,2 1-3 1-9 229 I 213 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVIGE. 89 CALENDAR OF OFFICIAL REPORTS TO BE MADE DURING THE FISCAL YEAR BY THE MEDICAL OFFICERS OF THE UNITED STATES MARINE-HOSPITAL SERVICE. JULY. Property return (Form 1903 or 1904). Requisition for stationery, including ink and mucilage (Form 1907). Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Report of surgical operations (Form 1922). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Transcript of record of medical inspection of seamen (Form 1929). Bills for subsistence and miscellaneous#supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). Letter reporting patients under treatment one year (paragraph 421). Letter reporting names, etc., of deceased patients leaving unclaimed valuables (paragraph 626). Report of repairs made (paragraph 644). Detailed estimate of amounts required for ordinary repairs (paragraph 645). Detailed estimate of amounts necessary for new construction, etc., requiring special appropriations by the Congress (paragraph 645). List of attendants on duty June 30 (paragraph 652). Diagram of building with assignment of rooms (custodians) (paragraph 504). AUGUST. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). SEPTEMBER. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). 90 REGULATIONS FOR U. S. MAlilXE-HOSPITAL SKRVICE. OCTOBER. Requisition for medical supplies (Form 1905). Requisition for blanks and books (Form 1906). Inventory of unserviceable property (Form 1909). Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Transcript of record of medical inspection of seamen (Form 1929). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). Letter reporting names, etc., of deceased patients leaving unclaimed valuables (paragraph 626). • NOVEMBER. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls(Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). DECEMBER. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report ot out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety da%ys (paragraphs 420 and 428). JANUARY. Property return (Form 1908 or 1904). Requisition for stationery (Form 1907.) Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925) Transcript of record of medical inspection of seamen (Form 1929). REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. 91 Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). Letter reporting names, etc., of deceased patients leaving unclaimed valuables (paragraph 626). FEBRUARY. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). MARCH. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). APRIL. Requisition for medical supplies (Form 1905). Requisition for blanks and books (Form 1906). Inventory of unserviceable property (Form 1909). Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925)., Transcript of record of medical inspection of seamen (Form 1929). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). Letter reporting names, etc., of deceased patients leaving unclaimed valuables (paragraph 626). MAY. Estimate of subsistence supplies (Form 1910). Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). 92 Kl.GULATIONS FOR U. S. MARINE-HoSPITAL SERVICE. Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 19231. Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). JUNE. Report of subsistence and other supplies (Form 1913). Medical officer's report of relief (Form 1919). Medical and surgical report of out-patients (Form 1920). Medical and surgical report of hospital patients (Form 1921). Bills for care of seamen (Form 1923). Report of relief furnished foreign seamen (Form 1925). Bills for subsistence and miscellaneous supplies (Form 1937 or 1938). Pay rolls (Form 1939 or 1940). Report of examination of immigrants (paragraph 646). Letter reporting patients under treatment ninety days (paragraphs 420 and 428). BLANKS AND BOOKS. BLANKS. Form No. 1901 Oath of office. 1903 Property return (United States marine hospitals). 1904 Property return (for officers not in charge United States marine hospitals). 1905 Requisition for medical supplies. 1906 Requisition for blanks and blank books. 1907 Requisition for stationery. 1908 Special requisition (miscellaneous). 1909 Report of inspection of property. 1910 Annual estimate of subsistence and other supplies. 1911 Schedule of and proposal to furnish subsistence and other supplies. 1911a Proposal to furnish supplies. 1912 Contract to furnish subsistence and other supplies. 1913 Monthly report of subsistence and other supplies. 1914 Master's certificate of seaman's service. 1915 Relief certificate. 1916 Hospital permit. 1916i Certificate of discharge. 1917 Bed ticket. 1917* Daily diet list. 1918 Application for extension of permit. 1919 Medical officer's monthly report of relief. 1920 Medical and surgical report of out-patients. 1921 Medical and surgical report of hospital patients. 1922 Annual report of surgical operations. 1922* Necropsy notes. 1923 Bill for the care of seamen. 1925 "Report of relief furnished foreign seamen. 1926 Bill for care of foreign seamen. 1926A Bill for care of foreign seamen (out-patients). 1927 Proposal to furnish care and treatment to sick seamen. REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Form No. 1927a Proposal to furnish care and treatment to sick seamen suffering fr tagious diseases. 1927b Proposal for burial of deceased seamen. 1928 Certificate of medical inspection of seamen. 1929 Transcript of record of medical inspections of seamen. 1930 Weekly report of vessels at quarantine stations. 1931 Weekly abstract of bills of health. 1932 Discharge from quarantine. 1933 Weekly report of sanitary inspection of persons and things. 1934a Domestic sanitary report. 1934b Consular sanitary report to Secretary of Treasury. 1935a Clinical chart (75 in a pad, A. B, C. D method). 1935b Temperature chart (A, B, C, D method). 1935c Binding cover (A. B, C, D method). 1935d Examination of urine (A, B,C,D method). 1936 Roll of candidates. 1937 Bill. 1938 Bill. 1939 Pay roll. 1940a Pay roll, acting assistant surgeons, stewards, and attendants. 1940b Pay roll for commissioned medical officers only. 1941 Voucher for traveling expenses. 1942 Daily report of seamen admitted and discharged. 1943 Letter transmitting check. 1943^ Gate pass. 1943 q Laundry list. 1943| Purchase order. 15 Bill (Supervising Architect's office). 116 Bill (furniture and repairs of furniture). 117 Bill (fuel, lights, and water). 118 Certificate (inspection of fuel). 100 Report of inspection of stations of class 1. 100a Report of inspection of stations of class 2. 100b Report of inspection of stations of class 3. 100c Report of inspection of stations of class 4. lOOd Report of inspection of United States quarantine stations. lOOe Report of inspection of State and local quarantine stations. BOOKS. 1944 Register of out-patients. 1945 Register of permits. 1946 Register of hospital patients. 1949 Inventory of patients' effects. 1950 Record of and receipt of moneys and valuables of patients. 1951 Record of subsistence and other supplies received and issued. 1952 Quarantine declarations. 1954 Record of liquors consumed. 1955 Station journal. 1956 Record of medical inspections of seamen. 1957 Record of letters and papers received. 1958 Record of letters and papers sent. 1959 Property record (United States marine hospitals). 94 REGULATIONS FOR U. S. MARINE-HOSPITAL SERVICE. Form No. 1960 1962 1963 1964 Property record (for officers not in charge of United States marine hospitals). Blank book, plain. Blank book. Blank book. STATIONERY. Arm rests. Bond seals. Copying books. Copying bowls. Copying brushes. Copying presses. Desk baskets. Envelopes. Erasers, rubber. Erasers, steel. Files, adhesive. Files, bill, upright. Ink. Inkstands. Ivory folders. Letter clips (board). Letter clips (small). Memorandum blocks. Mucilage. Oiled sheets. Paper, bill. Paper, blotting. Paper, cap. Paper, copying. Paper, legal cap. Paper, letter. Paper, manila. Paper, note. Paper fasteners. Paper weights. Pencils. Penholders. Penracks. Pens. Pincushions. Pins. Red tape. Rubber bands. Ruling pens. Scissors. Sealing wax. Shears. Sponge. Sponge cups. Twine. Typewriter ribbons. I X D E X . [Note.- -The flgu -es refer to paragraphs, except the Appendix, where page is meant.] A. Paragraph. Abbreviations of words must be avoided.......................................... (jtig Absence or sickness of Supervising Surgeon-General, ranking medical officer to serve____ 11 with or without leave to be reported____.................................... ls,s of senior officer, next ranking officer to assume command......................... 266 leaves of, when not to be granted.....................................____ 277 telegrams for, will not be sent or paid for as '' official business "_________ 666 from reservation, officers returning to. will report to commanding officer......... 294 Academic examination of applicants for appointment....._........................ 26 Accounts will not be paid until property returns have been found correct.................. 105 and books, list of, to be kept by steward..................................... 142 traveling, to be sworn to.........___............................._........_..... \§% for moneys collected for care of foreign seamen, etc................................ 473 current of disbursements......_............................. .................... 628 current of disbursements may be forwarded without letter of transmittal...... 629 of unclaimed moneys and effects of seamen......................................... 624 Acknowledgment of orders_____.........................._................................... 153 Acting assistant surgeons, qualifications for appointment..................._.......________ 51 to pass a civil-service examination........................._...... 52 by whom appointed................................................ 53 compensation of............................................______ 71 general duties of........................................_________ 126 duties of, at stations, first and second class..............______ 128 not to have interest in contract hospitals........................ 129 at stations of third class, duties of................_____......... 130 responsible for property..........................._____________ 131 not to leave stations without authority.............__________ 197 uniform for......._____.............................__________ 227,228 Advance of traveling expenses by officers and attendants..........._____......._________ 157 payment of bills can not be made.........................._______....._............ 523 Advertisement to be made in newspapers for subsistence -..................___....._____ 557 Advertisements not to be posted on walls of buildings.............___.....__________..... 503 bills for, how paid...............________.......____........_________..... 557 Affidavits may be accepted as evidence.......................................................... 383 Age limit for appointment: assistant surgeons. 21 to 30...................................................._............. 20 hospital stewards, 21 to 30...........................................................______ 58 internes, 21 to 28......-................................................................_____ 55 Agreements or contracts, approval by Department required..........................____ 571 Allotments to families of officers...........................................................____ 92 Allowance for commissioned officers at marine hospitals or quarantine stations............ 98 Allowances for hotel expenses----............................................................. 165 baggage.......................................__................._......._....._ 166- of hospital stewards...................................................._.......__. 74 attendants entitled to..................................................._ _.....___ so travel, officer entitled to, when assigned to duty while on leave............___ 155 for " actual traveling expenses "...............................................___ 160 travel while on leave..............................._...........___..............___ 169 Analyses, special examinations, etc.......................................................____ 082 of water, medical officer to make and report of its purity......................... 695 Antedate of permit.......................-.................................................... 431,437 Apothecaries, bills of, for medicines furnished, how paid..................................... 613 95 9G INDEX. Paragraph. Appliances, surgical, and special apparatus not to be purchased without authority------- ->9I for patients.............---......................................------........ '' Applicants for appointment, examination of.................................................. "~ examination of, for appointment...................- - -..............----......... *u academic examination of, for appointment.........................----- --- ^ for appointment, professional examination of...................--------...... ~' required to perform surgical operations on cadaver............. - -............. 30 may withdraw..................................................-.......-......... '''' unsuccessful, may be reexamined after one year................................. ;S:> when they may be rejected without further examination-------............... 34 for appointment as attendant—blanks furnished by Civil Service Commission. 02 Applications for leaves of absence.........................-.................................... l'~ shall be addressed to Supervising Surgeon-General..... 200 relief after sixty days' absence from vessel....................-............ 387 office hours_____............-............... ......-...........430,436 sick leave to be addressed to Supervising Surgeon-General................ 187 Appointment of Supervising Surgeon-General.............................--................. 6 in service, successful examination does not assure...................--------- 31 aptitude to be considered..............................................--------- 39 as assistant surgeon, requirements for..........................--........---- 18 of commissioned officers...................................-.....---------.....- 1' Arrangement for inspection of unserviceable property---...................---.....- -..... 539 Assignment of officers to stations............................---.......-................-....... W7 quarters........................................................-......-......... 96 Assignments and orders will not be revoked...................................-.....-------- h>2 Assistant surgeon, requirements for appointment as...............................------ 18 qualifications for appointment as......................-.............----- 2d may be examined for promotion after five years' service................ 42 to apply for examination for promotion.............-.................... 43 requirements of, for promotion........................................... 44 a second examination allowed, but not a third.....................-..... 45 resignation to be requested when he fails at second examination....... 46 Assistants may issue orders..................................................-.........-........ 13 Attendants, subordinate employees below grade of hospital steward shall be known as attendants........-.....................-......................................... 61 to file application for appointments...................-......-..............-..... 62 qualifications of engineers......................................................... 63 names of qualified applicants to be entered upon a register of eligibles........ 64 vacancies, how filled.................................................-.........--- 65 transcript of register of eligibles to be forwarded to Department.............. 66 changes of, to be reported............................---......................... 67 offer of positions to.........................................................---- 68 only males eligible as................................................-......----- 69 changes in personnel to be reported immediately...........----........._____ 67 males only eligible............................................................____ 69 compensation of...............................................................___ 79 allowances for.........._______..............................---........._...... 80 quarters shall be assigned..............................________................. 81 sick or disabled, to be cared for___..............____________________........ 82 Department to be notified of death of........___......________........_____ 83 paid monthly, by check.......................................................___ 86 hospital steward to instruct as to his duties___................................. 139 allowed traveling expenses....................................................... 164 maybe granted seven days' leave................................................. 202 verbal permits for less than twenty-four hours are not counted as leaves of absence..............................,............................................ 203 • how punished when disrespectful, insubordinate, or intoxicated .............. 269 dereliction of duty by, junior officer to report.................................. 298 will not leave grounds without permission................................_____ 303 appellation of...................................................................... 304 testimonials of character to be given only by commanding officer............. 305 instructions to be given newly employed, on nursing......._......._....._____ 307 number allowed for a hospital............................................______ 327 number may be increased................................................_______ 327 list of, to be transmitted, etc____.........................................____ 652 Authority to be cited upon bills......___..............................._____.....____..... 607 Authorities on spelling..............................................................____...... 663 INDEX. 97 B. Paragraph. Badges may be worn.................................................______ 216 Baggage, allowance for........................__.............________________.......... 166 Baths......-.......................................--.....--......---------......... ...... 308 Bed tickets, valid only for day of issue................... ___.................... 416 424 to be numbered consecutively...................________________ 417 425 Bell at hospital_____...............___........__________ : j'"-:}^! Beneficiaries____.................._____.................. 368-398 Persons entitled to relief............................... ........... 36g Yachtsmen entitled............................_...... ......... 369 Exceptions, persons employed on canal boats...................______________ 370 Customs officer to furnish information as to character of vessel, etc_________.....____ 371 Wrecked seamen entitled............................ .............. 372 Seamen sent by consular officers entitled............._.................... 373 Seamen must make application for relief........______.....__......... 374 Evidence to be presented by seamen to obtain relief.............................._______ 375 Certificates from owners or agents as evidence____......___......____________________ 376 Masters shall furnish seaman a certificate of service____......________..............___ 377 Masters refusing to give certificate............_............................______________ 378 False certificates___..................._..............___............. 37g Closure of navigation..............________..........___.............._._....... 381 Exceptions— Closure of navigation...................................._.................____ 381 Brief service on last vessel not a bar................................................ 384 Foreign seamen or employees of Government services, not beneficiaries, shall not be treated..............................................................._............... 412 Period of treatment not to be reckoned as absence from vessel..................._______ 382 Affidavits may be accepted as evidence..................................................... 383 Brief service on last vessel not a bar to relief.............................................. 384 Evidence to be verified in case of doubt.............................______................ 385 Certain cases to be submitted to Supervising Surgeon-General.............____________ 386 Money not to be paid to seamen for expenses of sickness......................_____...... 393 Rejected claims for relief.._................................................................. 394 Seamen injured in brawls not to receive treatment......................___________..... 395 Seamen taken ill on vessel entitled.................. .....................____............ 396 Certificates of discharge........................ ..........................-----............ 397 Temporary relief only contemplated.........................................-------..... 398 Applications for relief after sixty days' absence from vessel.............................. 387 Seamen to sign certificates......................----..................................---- 388 Cases admitted pending decision to be numbered in order................................ 389 Out-patients to furnish new service certificates........................................— 390 Expenses for sickness during voyage will not be paid..*................................... 391 Expenses for care of seamen at local quarantine hospitals................................ 392 Seamen taken to local quarantine hospitals, expenses can not be paid................... 392 Bids, three required in each class of supplies.................................................. 559 from responsible dealers desired....................-----................................ 560 Bills for transportation of sick seamen---....................------..........------......... 459 payment of, in advance can not be made.................................................. 523 for advertising, how paid............................-----------........................ 557 and purchases......................................--------............-............... 599-617 vouchers...................................-.........-.......-..................---606-617 must be rendered in duplicate, etc---..............................—.................. 606 authority to be cited.............................................-----------------..... 607 to be rendered at close of each month................................-----------....... 608 items in, to be classified........................................................-........... 611 for maintenance..................--...............................-.......- --.....-........ 612 medicines furnished by apothecaries............................---------.....---- 613 prescriptions, names of seamen should be given on................____............ 614 repayment for official telegraphing........................_............—.......... 615 Blank forms for inspectors.............-........................................................ 337 Blanks and books, requisitions for, will be made semiannually............................... 581 Boards of investigation.........................................................-..............248-259 Ordered only by the President or Secretary of the Treasury.............___....._____ 248 Of whom composed.......................................................................... 249 Duties of chairman............................—.............................-............ 250 recorder......-..............-..................................................... 251 8855----7 98 INDEX. Boards of investigation—Continued. Paragraph. Testimony and oaths..........................___. .......________..................... "'■'"' Testimony to be administered under oath.......................... --- ............. 25:i Record of proceedings to be signed daily...................------------................ 251 Grades of punishment..............................................---.......--- -..... 255 Copy of charges to be furnished accused officer.............-----........................ 256 Investigations limited to offenses committed within one year--------------....... 257 Records to be forwarded to Department.......................----................... 25s Proceedings to be reviewed................................................................. 259 Boards, reports of, to be transmitted to or through the Supervising Surgeon-General...... 662 orders convening....................................._______.......................... 650 Board of commissioned officers to be convened for examination of applicants for appoint- ment.................................................................................. 22 examiners to report standing of applicants___.................................___ 2:) to conduct all examinations for appointment.............____........................ 24 of examiners for promotion..................................___................._____ 39 observe seniority, unless there are specific reasons for waiving it.___ 3!) disabled officers to be ordered before.................................... 49 physical examination of officers by commissioned officers........____ 50 Books and accounts, list of, to be kept by hospital steward......................._____..... 142 instruments transported without expense to officer........................ ...... 167 obsolete, may be dropped from the return.........................................___ 531 Boxes and packages shall be held for inspection................__________.................. 321 Buildings and grounds to be kept in order.............................._____........._____ 491 Brawls, seamen injured in, not to receive treatment.......___....._______........_______ 395 C . Canal boats,persons employed on, not entitled to relief.....................___........____ 370 Candidates eligible for one year only......................................_____.............. 32 Candidates for promotion, examination of...................................___......______ 36 Will be made chiefly in writing.......................___________________............. 37 Candidates must be physically qualified...........................................____........ 37 Care of unserviceable property..............._.....................______................___ 540 Cases for hospital treatment..........................................___...................... 413 Centigrade scale, officers shall make use of, etc......................_......................... 671 Ceremonies attending transfer of command of station........................................ 151 Certificate of payment of salary to be forwarded by officers leaving Pacific Coast.......... 911 to be furnished by collector of customs to officers leaving Pacific Coast......... 90 of service, master shall furnish........................................._......... . 377 discharge........................................_.................._............. 397 Certificates of death.............____,...........................................______ 312 service may be accepted as evidence................................._......... 376 relief, forwarded soon as issued.................._..................____....... 404 Change of station, commissioned officers subject to......................................... 21 Changes in personnel of attendants to be reported immediately.......................... 67 routine not to be made by officers in temporary command....................... 267 Charges for care and treatment of foreign seamen..........................._ _............... 475 Civil-service examination, acting assistant surgeons must pass.............................. 51 hospital stewards must pass...............____............. 57 Civilian dress not allowed............................................................... 208 Circular letters, separate file to be kept at each station...................................... 673 Circulars, department or bureau relating to Marine-Hospital Service........................ 657 Clinical history of each case furnished transportation_____....._...................... 46u Coast Survey, commissioned officers to examine persons desiring to enlist........... 112 seamen of, entitled to treatment......__................................ 47(1 Collector of customs to furnish certificate to officers leaving Pacific Coast.................. 90 may pay salary and issue certificate prescribed in paragraph 9i 1...... 91 Collector of customs will notify commanding officer of amount of bill.................. 474 Collusion among dealers................._................................____ 550 Commanding officer may take seven days' leave.................. 179 grant seven days' leave......................... ......... 181 leaving reservation shall notify officer next in rank............. 295 to inspect contents of packages and boxes received................. 321 shall enter in j ournal performance of weekly inspection............ 351 to accompany inspector during inspection of property................. 545 responsible for care of property................................. cog INDEX. 99 Paragraph. Commanding officers of marine hospitals to make weekly inspections___________......... 345 officer shall forward yearly report of repairs____........_....._.....________ 644 to forward estimate for repairs..........._.....................________ 045 shall make requisition for supplies.............................________ 574 Commissioned and noncommissioned officers, when entitled to subsistence and laundering.. 104 allowed hotel expenses........................ 165 officer shall make himself familiar with laws relating to service, etc______ 110 tour of duty, four years................................._...... 148 at quarantine station, three years______................_....... 146 officers, examinations of...................................._....._____ 17 appointments of.............._____................____............... 17 promotions of................................................ 17 to serve in any part of the United States............._............... 21 appointed to the general service...................................... 21 board of, to be convened for examination of applicants for appoint- ment...................__............................................. 22 compensation of........._........................_..................... 70 waiting orders..........._......................._.............._....... 70 commutation of quarters for........................_.......___...... 90 duties of, are professional, sanitary, and executive......._________ 109 executive duties of...................__......................___123,124,125 and hospital stewards, length of service.........._................... 145 and noncommissioned officers and attendants entitled to actual traveling expenses.......________............._.................... 154 executive duties of: To keep records and preserve public property.......___...... 123 Not to have interest in contract hospitals..........___.......... 124 Official communications to be stamped with official seal______ 125 leaves of absence for, cumulative............................_ _....... 170 when to report physical condition by letter.......................... 193 placed on "waiting orders"..........._______................ 195 placed on '' waiting orders'' shall report by letter, etc____......... 196 of Marine-Hospital Service to rank relatively with commissioned officers of Revenue-Cutter Service.....................__.......... 4 furnished with a microscope on their personal account............. 595 professional duties of.................................................. Ill to examine applicants for relief...................................... Ill prescribe for and furnish out-patients hospital treatment........ Ill make physical examinations of seamen of several Government services and merchant marine.................................... Ill examine physically seamen engaged in foreign, coastwise, or inland navigation trade.................................. 112 foreign seamen............................................ 112 cadets, enlisted men, and persons desiring to enlist in , Revenue-Cutter, Life-Saving, Coast Survey, and Light-House Services...............-.................. 112 alien immigrants...................-..................... 112 applicants for pilot's license............................. 113 no fee for examination of seamen..................................... 114 reports of necropsies to be made...................................... 115 medical officers shall be present at necropsies....................... 116 Commencement of leave of absence----..................................-----..............- 174 Commissioner of Navigation to report, monthly, statement of collections of tonnage tax.. 675 Communications, official, instructions concerning........................................---- 659 to be forwarded through commanding officer, etc............— 660 Commutation of quarters, when not allowed officers............................................ 93 for commissioned officers............................................ 93 officer entitled to, during leave of absence and when on special temporary duty.............................-.........-.................................... 95 Compensation of commissioned officers-------............................................... 70 acting assistant surgeons.................................................... 71 internes.....-................................------.................------ 72 hospital stewards..................................................____..... 73 allowances................................................ 74 quarters............__________........................... 75 attendants........................................------ ----.............. 79 100 INDEX. Paragraph. Compensation in ease of resignation of officer while on duty.................................. *** for officers, only when on duty, sick, under orders, or on authorized leave. 85 of officers and attendants paid monthly by check.......................... S|> Complaint of one officer against another may be made...............................------- ~81 Complaints, inspectors to receive---..................-.........'- - -...............-............ 343 Completion of weekly inspection...............................................................- 349 Complication of original disease...................................................... 419,427,441.453 Condemned articles, disposition of................................--.....--- -.................. 543 use of, in cleaning and repair......................-----................ 544 property, authority to dispose of..............................-...............--- 547 officers not to purchase.___.....--------............................ 550 Contagious diseases, presence of, to be reported to commanding officer..................— 693 Contract hospitals, acting assistant surgeons not to have interest in......................... 129 Contracts and subsistence____..........................................................---- 551-573 for care of seamen, circular..................................................--...... 475 when completed, to be forwarded.................................................. 566 period of......................................- -...............................----- 507 legal requirements of signing....................................................... 568 and agreements, how made and certified........................................... 569 officers may have benefits of........................................................ 570 or agreements, approval by Department required................................ 571 Copies of official reports to be filed at stations................................................. 651 departmental and bureau orders to officers shall be made for files of station..... 150 Correspondence................................................................................ 653-673 records, reports.............................................................. 630-673 official, to be transmitted through commanding officer...................... 283 official communications, how they should be addressed---................. 653 date and number in the annual series of the Marine-Hospital Service to be given.......................................................................... 657 official communication formulas......................-....................... 659 abbreviations must be avoided................................................ 669 Corps of Service to consist of................................................................... I Countermanding written order of a superior shall be given in writing...................... 280 Current rates will be allowed for transportation of sick seamen............................. 458 Cumulative leave for commissioned officers................................................... 170 Customs officer to furnish information as to character of vessel............................. 371 to have charge of public property where no officer of Service is on duty... 531 will render separate accounts, etc............................................. 620 to act as disbursing agents.................................................... 627 Custodians: Duties as................................................................................... 488-526 Officers to act as custodians of marine-hospital and quarantine stations................. 488 Duties of................................................................................____ 4S9 Acting, to serve during absence or sickness of custodian................................. 490 To cause buildings and grounds to be kept in order.......................................j 491 Rooms to be used for official purposes only................................................ 492 Economy enjoined in use of lights and water.............................................. 493 Necessity for repairs, etc., to be reported.................................................. 494 Unauthorized expenditures not permitted................................................ 495 Emergency expenditures will be allowed.................................................. 496 If authorized expenditure is insufficient................................................... 497 Vouchers to be transmitted................................................................. 498 Estimates to be submitted in detail......................................................... 499 Requisitions not to be made of tener than once a month.................................. 500 Proposals for fuel............................................................................ 501 Certificate of inspection of fuel____........................................................ 502 Advertisements not to be posted on walls____............................................ 503 D iagrams of rooms, showing by whom the several rooms are occupied.................. 504 Application for leases and renewals........................................................ 505 Precautions against fire..................................................................... 506 Weekly fire drill............................................................................. 507 Supervision of fire drill..................................................................... 508 Specific duty of each officer and attendant at fire drill____.............................. 509 Slip denning their duties shall be furnished each officer and attendant.................. 510 Officers and attendants required to familiarize themselves with their repecti ve duties.. 511 Determination of duties to be assigned to each............................................ 512 • • INDEX. 101 Cv.stodians—Continued. Paragraph. Fire alarm..........................-........................................................ 513 Steward, duty of...............-............---............................................. 514 Engineer, duty of........................................................................... 515 Driver, duty of......................---------............................................. 516 Yardman, duty of.................................................................____..... 517 Messenger, duty of.......................................................................... 518 Cook, duty of..............................................._____...............____...... 519 Launderer, duty of.......................................................................... 520 Nurse, duty of............................................................................... 521 Night watch, duty of........____.....................................____......_ _____ 522 Advance payment of bills can not be made..........................____...........____ 523 Measures to be taken to prevent trespass or injuring trees, etc.......................... 524 Trees and fences not to be removed..................... .......................________ 525 Gardens not to be maintained at expense of marine-hospital fund...................___ 526 I). Date of letter authorizing relief must be indorsed on permits................................ 440 Dealers, collusion among..............................................................________ 556 instructions for......................................................................... 558 verbal orders to, prohibited___........................................................ 603 Death of an attendant to be reported to Department......................................... 83 certificates...........................................................-............._____ 312 Deceased officers, salaries of, payment to be made to legal representative................... 102 American seamen, dying on shipboard, unclaimed moneys of, how deposited...... 618 seamen, relatives to be notified...................................................... 468 burial expenses.............................................................. 469 unclaimed money and effects of, shall be delivered to proper customs officer..............................................................-......- - 621 method of disposing of property of......................................... 622 unclaimed property of, to be sold after one year............----........ 623 patients, disposal of property of-----...........-............-...................... 625 quarterly report of property of, shall be reported to Department-...... 626 Defects in medical and surgical supplies shall be reported..................................... 593 Definition of a relief station........-.....................................-..................... 353 Department and Bureau orders to officers, certified copies shall be made for files of station. 150 or Bureau, circulars relating to Marine-Hospital Service...................... 657 letters, replies to, instructions concerning-----............................— 658 Departure, officer to report date of and histnew address.............................------- 186 Dereliction of duty, investigation to be made of---................-.................-....... 14 Detailed duty, officers shall report by letter to the Secretary of such Department......... 284 officers on, responsible to Supervising Surgeon-General..................... 285 Diagnosis, to be reported in relief certificate..................-............—........... - 443.455 Exceptions........................................................................---..... 444,4:>6 Diagrams of rooms, etc........-...........................................................-..... 504 Director of the Hygienic Laboratory shall exercise same authority in management as officers in command of stations...........------ (78 duties of............................................. W0,081 to make monthly report----........................ 687 shall make an annual report to the Supervising Surgeon-General................................... 688 Disabled officers be ordered before aboard of examiners.............................-.....+-- 49 or sick attendants to be cared for.................--................................. 82 Disbursing agents, Marine-Hospital Service: Customs officers to act as, at certain ports..............-................................. 627 Will liquidate authorized bills, etc............-..........---.............-------......... 628 Disbursements, accounts current of............-.....................-------------.......... 638 May be forwarded without letter of transmittal.............................- -.......... 629 Discharge, certificates of..............................................-............... -........ 397 of patients promptly, concerning........................................—...... 414 Discipline.....................................................--........----.................. 238-287 Orders of superiors to be obeyed....................... .....-.....-..........-.............. 338 Obeying orders under protest..........................................—......—....... 339 Senior officer to have command of station.......................................--........ 240 Commanding officer to have authority over subordinates-----..............-----...... 241 Official relations can not be severed....................................------.........--- 242 Violation of regulations when "off duty" or on "waiting orders"....................... 243 102 INDEX. Discipline—Continued. Paragraph. l" Off duty," officers must not violate regulations when.........................----..... 243 "Waiting orders," officers must not violate regulations when on.....................- - - 243 Subordinates to be respectful.....................................................-........ 244 Official letters to be sent through senior officer........................--------- ....... 245 Commanding officer responsible for----....................................-------...... 269 Disease of patient, information relative to..............---------...........------........ 313 Dispensaries, provision for marine-hospital.....---................--------------.......... 357 Dispensaries and offices, location of.........................................-------.......... 358 Disposal of property of deceased patients......................________.....____........... 62.5 Disposition of condemned articles.............................................................. 543 Disrespectful language subjects offender to discipline........................................ 260 Districts of relief............................................................................a59-367 North Atlantic, with list of stations where relief is furnished............................ 360 Middle Atlantic, with list of stations where relief is furnished........................... 361 South Atlantic, with list of stations where relief is furnished.........________......... 362 District of the Gulf, with list of stations where relief is furnished........................... 363 Ohio, with list of stations where relief is furnished.......................... 364 Mississippi, with list of stations where relief is furnished.................... 365 Great Lakes, with list of stations where relief is furnished.................. 365 Pacific, with list of stations where relief is furnished........................ 367 Duties of Supervising Surgeon-General........................................................ 9 commissioned officers are professional, sanitary, and executive.........__......___ 109 Duties, professional, of commissioned officers.......................................___.....111-116 To examine applicants for relief............................................................ Ill To prescribe for and furnish out-patients hospital treatment............................ Ill To make physical examinations of seamen of several Government services and mer- chant marine............................................................................. Ill To examine physically seamen engaged in foreign, coastwise, or inland navigation trade......................................................................... 112 foreign seamen............................................................... 112 cadets, enlisted men, and persons desiring to enlist in Revenue Cutter, Life Saving, Coast Survey, and Light-House services..................... 112 alien immigrants......................................................_....... 112 applicants for pilot's license................................_................. 113 No fee for examination of seamen........................._________...................._ 114 Reports of necropsies to be made............._______.........._............______...... 115 Medical officers shall be present at necropsies...................._____................... 116 Duties, sanitary, of commissioned officers...................._________......____......... 117-122 To enforce national quarantine rules and regulations...................______.......... 117 Sanitary duties defined...................................._................................. 118 To comply with local health laws.............................................___.....____ 119 To report presence of epidemics, etc.............._........................................ 120 To vaccinate seamen.............................._.......___.........................___ 121 To advise officers of the Revenue-Cutter Service........................._........______ 122 Duties, executive, of commissioned officers........................................________ 123-125 To keep records and preserve public property.........._.......................________ 123 Not to have interest in contract hospitals........................................._______ 124 Official communications to be stamped with official seal.........._............. _.....___ 125 Duties of inspectors..................................................._......................... 335 custodians.............................................................._...........488-526 general, of acting assistant surgeons..................................____..........._ 126 of acting assistant surgeons at stations, class one and two....._...................... 128 acting assistant surgeons at stations of third class................................. 130 general, of hospital stewards..........................................................134-142 of interne................................................................................. 132 Duty, dereliction of........................................................._________......___ 14 officers to receive compensation only when on.............................._.......... 85 temporary, while on leave............................................................... 168 K. Economy enjoined in use of lights and water................................................... 493 in expenditures to be observed...................................................... 599 Elastic stockings................................................................................. 598 Eligibles, names of qualified applicants for position of engineer to be entered upon a reg- ister ............................................................................................ 64 , INDEX. 103 Paragraph. Employees and officers, Supervising Surgeon-General will prepare and revise regulations for government of................................................................_ ig subordinate, below grade of hospital steward shall be known as attendants___ 61 of Government services, not beneficiaries, shall not be treated.................. 412 Emergency cases, unreasonable charges in, will not be allowed............................... 411 expenditures by custodians will be allowed.................................. 496 purchases...............................................................'.!!." ."."."."589,601 Engineer Corps of the Army, seamen employed on vessels of, entitled to relief............. 368 United States Army, seamen employed on vessels of, entitled to treatment, except at stations of fourth class............................................ 480 Engineers, qualifications of.............................................. 63 Envelopes, printed, samples to accompany requisitions.................................. 582 I Epidemics, presence of, commissioned officers to report forthwith.................... 120 ieaves of absence not granted during.................................... 182 Equipment and purchases for hygienic laboratory.................................... 679 Estimates to be submitted in detail by custodians___............_.....__................ 499 for subsistence to be forwarded......................................... 552 repairs at stations to be forwarded.........._____......_....... ............. 645 Examinations of commissioned officers...........______.___................ 17 applicants for appointment______......................_ _.................... 23 Examinations by board, order of— Physical____.......____........_....._.........._.......................... 24 Academic........_......._.................__.......__....... ....._........... 24 Professional......................._........_......................................... 24 Clinical............__.........................___........_............................. 24 Personal____............................................._..................... 24 Examinations for appointment, how made........................................___........ 27,28 general aptitude to be considered...................______ 29 Examination, successful, does not insure appointment-....................................... 31 withdrawal of applicant from.....................___........................... 35 of candidates for promotion.'........................_...................._...... 36 made chiefly in writing.......................................................... 37 must be physically qualified......................................._.......____ 37 for promotion of assistant surgeons—second allowed, but not a third___..... 45 Examiners, board of, to report standing of applicants...................________........... 23 for promotion observe seniority unless there are specific reasons for waivingit.........................................................___ 39 Exceptions. (Relief)............................................................................ 380 Closure of navigation....................................................................... 381 Brief service on last vessel not a bar......................................................._ 384 Foreign seamen, or employees of Government services, not beneficiaries, shall not be treated..................................................................................... 413 Exchange of medicines, etc., prohibited........................................................ 597 Executive duties of commissioned officers.................................................... 123-125 To keep records and preserve public property-----....................................... 123 Not to have interest in contract hospitals.............................---................. 124 All official certificates to be stamped with official seal.......---------................... 125 Executive duties of commissioned officers........................-----................. 123,124,125 Expenditures, additional, authority must be obtained for.................................... 616 unauthorized, not permitted.........................--------.....----...... 495 if insufficient authority may be obtained............-----------------..... 497 vouchers to be transmitted.................................................... 498 Expenses for sickness during voyage will not be paid.................------------------- 391 Express, shipments by, are prepaid by Department or bureau............................... 589 Extension of permits..........................................................--......-.......439,451 F. False certificates.....................................-.........................-------.......... 379 testimonials submitted disqualifies applicant for appointment............ ........... 19 Families of officers, allotment to..................,............................................. 92 Fee of *1 for examination of foreign seamen.............................._.......------..... 112 not to be charged for examination of seamen or for certificate as to physical condition. 114 Files, official, for letters at stations, instructions concerning................................. 672 for circular letters, to be kept separate from letter files______............... 673 Final accounts of officers will be paid when property returns are correct____.............. 105 104 INDEX. Paragraph. Fire, precautions against, by custodians........................................................ 506 alarm at hospitals....................---------........................................... 324 drill, inspectors to require................................................................ 344 weekly...........................................................................— 507 supervision of, by commanding officer or junior officer, etc...................... 508 specific duty of each officer and attendant at...................................... 50!) First-class stations shall not be left without the presence of a medical officer............... 296 with one officer on duty, shall not be left without the presence of the officer or steward......................................................... 297 Fitness of candidates for promotion............................................................ 38 Flag shall be displayed from sunrise to sunset at first-class stations.......................... 288 to be set at half-mast on certain occasions............................................___ 325 Flags, marine hospitals and quarantine stations entitled to two national ensigns............ 289 Foreign, leave........................-.......................................................___ 185 seamen, a fee of SI will be charged___................................................ 112 commissioned officers to examine............................................ 112 etc., not beneficiaries, shall not be treated......................_............ 412 may be treated..........................................................____ 471 bills for care and treatment of...................................-............ 472 monthly accounts to be rendered............................................ 473 charges for care and treatment of................................___........ 475 receipts from collection of bills for care of, etc.............................. 62o etc., repayments for............................................___........... 620 Form to be observed during inspections....................................................... 333 Forms, blank, for inspectors........................................................---........ 337 to be used............._................ ................................................. 647 Formulas...........................................-............................................. 317 official communications.............................................................. 659 Free transmission of official communications, etc...................................________ 654 Freight, shipments by, are paid by officer receiving the goods...........................___ 589 Friends of patients must obtain permission to visit wards.................................... 315 Fuel, etc., for officers at a marine hospital or quarantine station............................. 98 Fuel, proposals for............................................................................... 501 inspection of................................................................................ 502 Furniture, etc., for officers at a marine hospital or quarantine station....................... 98 Furniture assigned to specified quarters not to be changed............... _................... 99 Full pay on leave, period for which officer is entitled to............................-......... 106 G. Gardens, vegetable, not to be maintained at expense of marine-hospital fund.............. 526 General orders and regulations relating to service, every commissioned officer shall make himself familiar with................................................................ 110 duties of commissioned officers............._.......................................... 109 Government salary tables to be adhered to.................................................... 88 services, officers and seamen of, may be treated................................ 470 bills for care and treatment.................. 472 Grades of punishment.................._........................................................ 264 Great Lakes district, stations of............................................................ 366 Gulf district, stations of................................_............................ 363 II. Health laws, local, commissioned officers to comply with................................ 119 Holidays, national........................................................... gig State.......................................___.............____ 319 Hospital bell. _........................................_ _........... 322-334 patients may perform light duties.............._.........._........... 329 register of........................_.............. ........... 636 permits, register of...................................__.......... 6,35 relief to be recorded and reported............................... 422 429 permits for..........................................__..............._______ 432,445 arrangements to be made and reported by customs officer.............____ 446 Hospital stewards......................................................._....... .""-60 Appointed by Secretary of Treasury........................................_____ 5- Age limit, 21 to 30.................................................._..... ....... ^ Must be graduates of pharmacy.............____.........._____..................... ^ INDEX. 105 Hospital stewards—Continued. Paragraph. Graded as senior and junior................_______......._________................. 59 Promotion after three years' service................_____ _____________________ 60 Compensation*................................__________________ 7:5 Medicines will be allowed.....................________............._____...... 76 Entitled to subsistence (see Appendix)................................... 77 Inspection daily to be made by..............___......_..................... I35 Junior subject to orders of senior steward......................... 136 Important orders not to be sent one attendant through another............. 137 To make daily inspection of meals..................................... 138 Shall instruct attendants................................................ 139 Shall record daily stores received and issued.......................... 140 Must receive supplies in person........................___........ 141 Not to leave stations without authority..............._......._......... 197 Maybe suspended for cause......................_....._.................. 272 Suspension of, for dishonesty, etc....................__........_..... 272 Charges against, to be investigated..................._ _................ ......... 273 Grades of........................................... ........._......____ 274 Office not to be left without presence of, or attendant.................................... 301 Not to fill prescriptions unless ordered by a medical officer.................._ _.......... 302 To have charge of keys_______...................................................... 306 Shall make actual invoice of articles on hand in preparing semiannual property return. 529 Shall keep accounts and records...................._....................................... 142 At discretion of commanding officer shall keep certain books....... .................... 142 Length of service at stations..........................___........................._______ 145 Hospital treatment, cases for.........................................___.......____........_. 413 supplies must not be accumulated beyond actual needs..................________ 586 Hotel expenses, allowance for....................................................___.....____ 165 Hours for sick call..................................................____............____....... 290 of duty in hygienic laboratory..................._...................................... 685 Hygienic laboratory................................................................________ 676-688 Shall be under command of a commissioned officer..............................._______ 676 Title of officer in command shall be ex officio director of the hygienic laboratory_____ 676 Shall be deemed a station of the first class......____.............._ _................____ 677 Director of the, shall exercise same authority in management as officers in command of stations........................................................................-------- 678 Purchases and equipment for......................_.........-..........................--- 679 Director of the, duties of..................................................................680,681 Analyses, special examinations, etc......................................................... 682 Uniforms, officers and attendants detailed in laboratory not required to wear.......... 683 Officers detailed in, shall be assistants to director......................................... 684 Hours of duty in............................................................................. 685 Officers detailed to, considered as on special duty-----.................................. 686 Director shall make a report each month................................................... 687 Director shall make an annual report...................................................... 688 I. Immigrants, reports of inspection of.........................-----..........-----........... 646 Indorsements and references...........................................-------------------- 656 Information for press not to be given...............................................----....... 279 regarding disease of patients..................................-................... 313 Ink and mucilage, one year's supply should be included in requisitions...................... 583 Ink, kind to be used..............................................................-............... 668 Insane seamen...........-................................................-------........... - 462-467 Inspecting officers will report violations of law or regulations................................ 340 examine money account of commanding officer............-------- 341 Inspection of meals to be made by steward..................................................... 138 supplies...............................................----......------...... ">72,573 Inspections, yearly...............................................................------------ 330 Inspections: By whom made........................................................................ ...... 331 How made...........................................................................------ 332 General...............................................-.................................■--- :*'#-344 Form to be observed...................................................... .....----........ 333 Method of.......................................................-........................... 334 Blank forms for.......-...............................................................-...... 337 Reports shall be made separate............................................................. 338 106 INDEX. Inspections—Continued. Paragraph. Form to be observed during inspection of relief and quarantine stations............ - - 33? Methods of.................-............-.............----....................;- ...... *^ Duties of inspectors......................-.........-------------................. ..... *l> Inspectors not to give orders......------................-.....................- ......--- 336 Blank forms for inspectors........................................---......----.......... 33 < Inspection reports shall be made separate..................- -...........- - -............--- 338 If unfavorable report, recommendation should be maue as to remedy---............... 339 Inspecting officers will report violations of law or regulations —........................ 340 Inspecting officer will examine money account of commanding officer................... 341 Officers making general inspections of stations will inspect unserviceable property--- 342 Inspectors to receive complaints.........................-.....-..........................-- 343 Inspectors to require afire drill.....................----.............................--- 344 Weekly inspections of buildings and grounds by commanding officer.................... 345 Weekly inspections of marine hospitals and quarantine stations not to be delegated... 346 Officers to attend the weekly inspections----............................................. 347 Muster at weekly inspections............................................................... 348 Completion of weekly inspection........................................................... 349 Work to be suspended during progress of an inspection.............................--- 350 Commanding officer to enter in journal performance of weekly inspection.......----- 351 Official visits to station.......................-..............................................- 352 Inspectors not to give orders ........................................................-.......... 336 blank forms for......................-.........-................................---- 337 to receive complaints................................................-..........--- 343 require a fire drill............................................................--- 344 tructions and regulations for government of officers and employees, Supervising Sur- geon-General will prepare and revise......................................— 16 to be given to attendants on nursing........................................---- 307 Instruments and books transported without expense to officer ----........................ 107 Insubordination of patients....................................-----......................-- -- 310 patients discharged for...................................................... 310 Intermediate requisitions for medical supplies may be forwarded..............------- ... 579 Internes...................................................................-......----.....----54-56 to be appointed by Secretary of the Treasury....................................... 54 pass satisfactory examination.............................--------------........ 54 be graduates of reputable medical colleges................-------------........ 55 furnish certificates of moral character..........................._________...... 55 compensation of----...........................-----------.......................... 72 duties of......................................._______......___________............ 132 authorized to give orders...............................___________________....... 133 not to leave stations without authority.............___......___________________ 197 leave not to exceed fourteen days...........______..................______________ 201 uniform of...........................................................__________...... 229 shall not be placed in charge of out-patient office.................................... 292 Intoxicating beverages, excessive use of...................................._____.....______ 246 Introduction of an officer when he reports for duty...................................______ 286 Inventory of unserviceable property to be forwarded..................____......________ 541 Investigation, boards of (248-259). How board shall be ordered...................................__.........___............. 248 Of whom composed........................................__________ _________....... 249 Duties of chairman...........................................________..........____..... 250 recorder............................___........____________________________ 251 Testimony and oaths.................................________________________________ 252 to te administered under oath............____................_____________ 253 Record of proceedings to be signed daily....................._............._ _......._..... 254 Grades of punishment.......................................................... ____...... 255 Copy of charges to be furnished the accused officer____.................._____________ 256 Investigations limited to offenses committed within one year........................... 257 Records to be forwarded to Department................................................... 258 Proceedings to be reviewed.........................................................._...... 259 Invoices of property to be made to successors____........................................... 530 J. Journal of stations............................................................................... 637 Junior officer to explain when unable to appear in uniform..............____...... 282 obtain consent to publish cases.........................._ _..........._ _..... 278 shall be detailed at out-patient office____..................................... 292 INDEX. 107 Paragraph. Junior officers shall not leave reservation without consent of commanding officer_______ 293 not to give orders except of an emergency character................________ 299 to obtain consent to conduct visitors through hospital........................ 300 to invite attention to serious or interesting cases............................. 309 not to purchase.......................__.......................__................ 604 to report dereliction of duty by attendants......................___________ 298 K. Keepers and surfmen of Life-Saving Service admitted to hospital or as out-patients when stations are open......_..................................._.................._____............ 484 Keys of station shall be in charge of steward................................................... 306 L. Laundering and subsistence, when officers are entitled to.................................... 104 Laws in force relating to Marine-Hospital Service. Appendix............................... 88 relating to service, every commissioned officer shall make himself familiar with___ 110 Leases and renewals, application for, by custodians........................................... 505 Leave, officers to receive compensation when on authorized..........._......_____________ 85 officer entitled to commutation when on special temporary duty..........________ 95 period for which an officer is entitled to full pay...................................... 106 sick, officer must cite on pay roll date of authority...............................___ 107 officers entitled to travel allowances when assigned to duty while on................ 155 officer entitled to traveling expenses upon change of station while on........._____ 156 temporary duty while on...............________....................____.............. 168 officer not entitled to travel allowances when ordered to rejoin station while on___ 169 for commissioned officers, cumulative........___................_ _............_..___ 170 year, reckoning of..............................______........_______........_______ 171 applications for..........................................._____........................ 172 granted in terms of months and days..............._____........................___ 173 commencement of..........................._...................________________..... 174 for one month, granted by Supervising Surgeon-General................__________ 175 length of absence desired must be stated....................................___...... 176 exceeding seven days not granted until officer has served two years.............___ 177 verbal permits for less than twenty-four hours not counted................—...... 178 commanding officer may take seven days..........................................---- 179 grant seven days.......---:................................ 181 not granted during epidemics..............---......--------.............-------- 182 officers not to go beyond sea____.............. - -.....-------------------------- 183 determination of period of____...............-......................-...........-..... 184 foreign ._.................................---........---------.......-.......---...... 185 officer to report date of departure and his new address----......................--- 186 sick, applications for, to be addressed to Supervising Surgeon-General............. 187 with or without permission to be reported............................................ 188 may be grantedjby Supervising Surgeon-General...................................... 189 to proceed to station on expiration of sick leave....................................... 190 officer on way to rejoin station after sick leave, how to be reported on pay roll---- 191 ordinary, not to be changed to sick leave................................-............. 192 not granted on tender of resignation, etc....................-----................... 194 Leaves of absence for noncommissioned officers...............................-----------197-201 Not to exceed thirty days in each fiscal year, etc.......................................... 198 Verbal permits for less than twenty-four hours not counted............................. 199 Leaves of absence, applications for, shall be addressed to Supervising Surgeon-General--- 200 for one week or less, how granted......................................... 201 for internes not to exceed fourteen days.................................. 201 for attendants, commanding officer may grant one week's leave........ 202 when not to be granted..................................................... 277 telegrams for, will not be sent or paid for as '' official business "........ 666 Length of service atstations.................................................................... 145 Letterpress copies to be taken of all letters...........................................------- 661 Letters to be sent through senior officer.......................................----........... 245 recommending articles prohibited............................................_______ 247 of transmittal.................-.......-.........................................-....... 649 must be sent with special requisitions, etc............_____......... 587 will accompany bills.................._................................. 610 at stations, instructions concerning files for---...................................... 672 K 8 INDEX. Paragraph. Life-Saving Service.........................................................................--- 481-486 keepers and crews, where treated........._____.......... --.....----- 4s 1 an applicant must furnish certificate of service......................... 482 what the certificate must show........................................... 483 keepers and surfmen admitted during period stations are open........ 484 admitted during period stations are closed----- 485 only temporary treatment furnished................................--- 486 officers to examine persons desiring to enlist in......................... 112 keepers and crews of, entitled to relief................................... 368 Light-House Service, commissioned officers to examine persons desiring to enlist in....... 112 officers and crews of, entitled to relief.................................. 368 officers and crews of, entitled to relief without charge................. 487 Lighting and water supply system for officers at a marine hospital or quarantine station.. 98 Liquors and vials, requisitions for, when made........................ ....................... 580 List of officers to be published___............................................................... 2 attendants to be transmitted, etc....................................................... 652 Local health laws, commissioned officers to comply with..................................... 119 quarantine hospitals, seamen taken to, expenses can not be paid...................... 392 Location of offices and dispensaries____.....----........... ................................. 358 >r. Maintenance, bills for.............. ...........---............................................. 612 Males only eligible for position of attendant.........................................._....... 69 Maltreatment of subordinates or patients not permitted..................................... 262 Marine hospitals, quarters or subsistence not furnished to persons not employed therein.. 108 and quarantine stations to be inspected once a week by commanding officers...................................................................... :S45 Masters shall furnish seamen certificate of service............................................ 377 refusing to give certificate........................................___...........___ 378 Meals of attendants and patients, steward to make daily inspection of.................____ 138 Measures of discipline to be entered in journal.............................._................. 265 Medical inspection of seamen, transcript of record of to be made............................ 642 record of.................................................................... 638 officer detailed on revenue cutter shall examine medical supplies, etc., when fit- ting out....................................................................... 697 detailed on revenue cutter shall keep a record of professional work........ 698 supplies and in special cases subsistence supplies allowed officers.................. 100 includes onhy articles specified as such on the medical supply table...... 101 requisitions for, time of making............................................. 575 to be limited................_................................................. 577 to provide for exigencies, climate, etc..................................___ 578 special requisitions may be made for..............._................_______ 579 Medical and surgical supplies......................................................_________ 590-598 Supply table, medical............................................................_________ 590 Kind issued.................................................................................. 591 Medicines, special preparations not allowed............................................... 592 Defects in, shall be reported____..............................................__________ 593 Surgical appliances, etc., not to be purchased without authority............_............ 594 Officers furnished with a microscope on their personal account.......................... 595 Appliances for patients..................................................._.......... ....... 596 Exchange of medicines, etc., prohibited..............................__.......__________ 597 Elastic stockings............................................................. .......... 59^ Medical officer, revenue cutter, shall have charge of medical stores, etc..................... 696 Medicines will be allowed hospital stewards............................._................. 71; special preparations not allowed___.................______..................____ 590 exchange of, prohibited........................................................ 597 furnished by apothecaries, how paid............................................... 613 Methods of inspections...................._.................._....................... 334 Metric system, instructions concerning.................................................. 670 Microscope, commissioned officers furnished with a, on their personal account............. 595 Middle Atlantic district, stations of................................................. 36i Miscellaneous articles, requisitions for.....___...................................... 584-589 •Miscellaneous receipts." proceedsof sale of condemned and surplus property deposited as. 619 Mississippi district, stations of................................................. ..... i%- Mississippi River Commission, seamen employed on vessels of, entitled to relief........ 368 officers and crews of vessels in service of. entitled to treat- ment, except at stations of fourth class................... 479 *% INDEX. 109 Paragraph. Money account of commanding officer to be examined by inspector......................--- 341 not to be paid to seamen for expenses of sickness...............................----- 393 of patients, receipts to he given.................._____....................-........... 418 Morning sick report to be submitted to commanding officer____.........___..... ......... 694 Muster at weekly inspections.................................____........................— 347 N. National ensign should be displayed at stations of first class from sunrise to sunset........ 288 holidays................................................................................ 318 Navy, United States seamen of, entitled to treatment..................................---- 470 Necropsies to be made.......................................................___............... 115 officers to be present at, whenever practicable................................... 116 reports of.........................................................._________...... 643 Ninety days, patients under treatment....._________..................______.............. 420 patients treated...........................................________........___420,428 Noncommissioned officers, when entitled to subsistence and laundering.................... 104 general duties of.................................................. 126 shall familiarize themselves with regulations.................... 127 and commissioned officers and attendants entitled to actual traveling expenses............................................... 154 not to leave stations without authority.....___............---- 197 uniform for....................................................--- 227 fatigue uniform for acting assistant surgeons.................... 227 white uniform..................----............................... 228 to be obeyed......................-----........................... 261 "Nomenclature of diseases" shall be observed in preparing medical and surgical reports. 641 "No transactions " to be written across the face of the blank in certain cases........----- 648 North Atlantic district, stations of..................................----------------....... 360 Number of attendants allowed for a hospital___.............----......—...........---- 327 may be increased..........-----...............................------ 328 O. Oath of office, salary to begin from date of.........................--------..........------ 89 testimony to be delivered under...................-----..........................---- 253 Office hours, application for relief after.................................................----- 430 of hospital steward not to be left without presence of steward or attendant_______ 301 Officer rejected for physical disability may be ordered before board for reexamination for promotion................-...............................---........................... 41 tendering resignation while on duty, compensation of................................ 84 does not lose right to quarters by temporary absence on duty....................--- 94 entitled to compensation at station during leave of absence or special temporary duty................................................................................---- 95 may waive right to quarters............................................................ 97 must cite on pay roll date of authority granting or extending sick leave............ 107 entitled to travel allowances when assigned to duty while on leave ..........._..... 155 entitled to traveling expenses upon change of station while on leave of absence___ 156 to serve two years before more than seven days' leave will be granted.............. 177 to proceed to station on expiration of sick leave................................____ 190 "in temporary charge," status of............................... -----................ 268 complaint of one against another may be made...............-----.................. 281 introduction of, when he reports for duty...................----..................... 286 receiving seamen transported from another station to be informed of probable date of arrival.......................................... ..........-...........- - -........- - - 461 to prepare invoice to his successor...............-..................-............----- 530 detailed, shall make report of contagious diseases, etc................................. 693 Officers, list of, to be published......-...........---------------.....-...................... 2 rank and precedence of...............................................-----........... 3 examinations of.................................. -............----......---........ 17 appointments of...............---..................---------...........-.....----- 17 promotions of...............................----------.........— - -......---- - - 17 appointed to the general service...................................................... 21 disabled, to be ordered before a board of examiners...........................____ 49 compensation only when on duty, sick, under orders, or on authorized leave____ 85 leaving Pacific Coast may receive salary then due —............................... 91 families of, payment of allotments to................................................. 92 allowance at marine hospitals or quarantine stations................................ 98 110 INDEX. Paragraph. Officers allowed medical supplies and. in special cases, subsistence supplies................ H»: deceased, salaries of, payment to he made to legal representative-------.......... l<>2 not to keep animals on hospital grounds for private use..........................--- 103 are entitled to full pay on leave.............................-...................----- 196 to examine cadets and enlisted men, and persons desirina; to enlist in the Revenue- Cutter, Coast Survey, and Light-House services—................. ........----- 112 assignment of, to stations_______......................... ......-.............------ 14i not to go beyond sea, etc.....................................-...................----- 1 s3 newly appointed, to provide themselves with uniforms......-------- ----- - . 211 in temporary command not to make changes in routine---.....--------.......... 267 forbidden to criticise publicly another officer.................... .................... 27i I visiting Washington to register at Bureau............................................ 271 not to publish statistics without authority............................................ 276 detailed to other departments to report by letter to the Secretary of such Depart- ment..................................-.............----................-........... 284 on detailed duty responsible to Supervising Surge(m-General....................... 285 may engage in private practice....................................................... 287 to report at surgeon's office at morning sick call----.........................--- 291 returning to reservation after absence shall report to commanding officer......... 294 making general inspections will inspect unserviceable property.................... 34:.' to attend weekly inspections............................---------.................... 347 not required to visit seamen on board vessels......................................... 415 of Service will render semiannual returns of special property..................--- 532 not to purchase condemned property..........---.................................... 550 may have benefit of contracts..............................................---........ 570 shall make monthly reports of current transactions................................. 639 and other physicians to make of diseases and injuries and of surgical operations.. 640 detailed in the hygienic laboratory shall be assistants to director................... 684 to laboratory shall be considered as on special duty........................ 686 and attendants paid monthly by check................................................. 86 to keep Supervising Surgeon-General informed of their movements 148 in hygienic laboratory not required to wear uniforms.............. 683 and employees, Supervising Surgeon-General will prepare and revise regulations for government of.................................................................... 16 and subordinates subject to orders of Supervising Surgeon-General................ 10 ordered from Pacific Coast to furnish certificate of payment of salary.............................................................. 90 noncommissioned, to be obeyed...... ................................................. 261 Offices and dispensaries, location of____________...........................................___ 358 Official list of officers to be published......______........................ _..................... 2 seal to be circular in form.......................................____.'................. 5 letters to be sent through senior officer.........................................____ _ 245 correspondence to be transmitted through commanding officer........____........ 283 visits to station.......................___...........................__________________ 352 supply table of the Marine-Hospital Service......................._________.......... 576 forms to be used........................................._.......________________...... 647 reports, copies of, to be filed at stations................................................ 651 communication formulas___...................................____.....___......___ 659 communications, how they should be addressed.......___..............___.......... 653 free.......................................................___________ 654 to be forwarded through commanding officer, etc_______________ 660 papers, reports, and letters, how they should be addressed........................... 655 files for letters at stations, instructions concerning..........______ ..........._____ 67:j Ohio district, stations of........_____.................................._....._..... __.......... 364 One year, patients under treatment..............._............................._...... _..... 421 Operations not to be performed by junior officers.........___...................____........ 309 Oppression, acts of, maybe reported to Surgeon-General................__________________ 263 Order of rank and procedure....................................................._........... 3 countermanding written orde r of a superior shall be given in writing................ 280 Orders, assignment and travel............................................................... 145-169 may be issued by assistants_____...................................................... 12 to proceed to any place, but fixing no date, shall be obeyed within four days....... 149 " without delay," to start within two days.............._..............____....... 141.1 "immediately," to start within one day............................... ......._....... 149 and assignments will not be revoked_____............................. .....______ 150 Department and Bureau, to officers, copies shall be made for tiles of station..... 150 INDEX. Ill Paragraph. Or ders, acknowledgment of....................................................- -......_______ 153 for transportation to be furnished___..............................-------------- 158 junior officers not to give, except of an emergency character........................ 299 not to be given by inspectors__________..............._....................---...... 336 convening boards___.■......_____________................................. ________ 6511 Ordinary leave not to be changed to sick leave___............................................. 192 Organization -.....................................................______......._____________ 1 Out-patient office, junior officer shall be detailed at........................................... 292 internes shall not be placed in charge of.............................____ 292 treatment for Revenue-Cutter Service, where and how furnished............. 478 Out-patients to furnish new service certificates............................................... 390 register of................................_____.................................. 634 Overcoats, when worn with uniform, etc......___............................................ 209 P. Pacific Coast, officers and subordinates ordered from, to furnish certificate of payment of salary____..............................................----.......— 90 ordered from, may receive salary----------------...........----- 91 district, stations of..................................._____....................._____ 367 Packages and boxes shall be held for inspection of commanding officer.................____ 321 Passed assistant surgeons, promotion of........................................_____.......... 47 allowed a second examination.......___.......................... 47 if failing at third examination will not be in line of promotion.. 48 Patients treated ninety days..............-................................................... 420,428 under treatment one year...........................................____........____ 421 or subordinates, maltreatment of, not permitted......______.................___ 262 discharged for insubordination.......____.........._________..................... 310 friends of, must obtain permission to visit wards______.....___..............___ 315 may perform light duties at hospitals_________......................._______..... 329 transfer of..........................................................______________ 426.434 to be promptly discharged................--------......._____ _______________ 414 transferred from another station--------------......----------.........______ 423 appliances for............................--------...................._____________ 596 Payment of allotments to families of officers.................................................. 92 salaries of deceased officers........................................ ___......... 102 Pay rolls to be forwarded on 23d of each month___.........................___.......____ 87 conform to official salary tables..........................__________.....______ 88 Period for which an officer is entitled to full pay on leave.............________............. 106 of leave, determination of.............____........................_______............. 184 Permits, when they may be antedated............................—................._____431,437 for hospital relief..............-----.........-.................... - -.........- -..... 432 valid only on day of issue..........................................-------.______ 435,448 extension of......................................................... .................. 439 date of letter authorizing relief must be indorsed on............_____________..... 440 will be numbered consecutively................................................____433,449 to be forwarded on termination of treatment..............---.....____________ 442.454 Personal criticism of one officer by another forbidden..............-----......___________ 27o Personnel, change in attendants to be reported immediately.............--------.......... 67 Physical examination of applicants for appointment.......................------......___ 25 qualifications necessary for promotion...................--------.....__________ 37 unsoundness of candidates to be reported (see par. 248)......._____.....____...... 40 examination of officers to consist of two commissioned officers_________________ 50 Pilot's license, commissioned officers to examine applicants for.............______________ 113 "Post," "slop" and "slush" fund prohibited.................................................. 326 Precedence and rank of officers................................................................. 3 Preparation of vouchers for payment.............................................._........... 609 Prescriptions not to be filled by hospital steward unless ordered by a medical officer...... 302 limited to 100 grains............................................................. 316 bills for. names of seamen to be given on......._........_________.......___ 614 Private practice may be engaged in by officers................................_ _.............. 287 Preservation of records at stations........------......................................_____ 667 Press, information for, not to be given...........----.......----------......___________ 279 Professional duties of commissioned officers...............................---------....... 111-116 To examine applicants for relief....................................................______ HI To prescribe for and furnish out-patients hospital treatment.................. ......... HI 112 INDEX. Professional duties of commissioned officers—Continued. Paragraph. To make physical examinations of seamen of theseveral Government services and mer- chant marine_____......................................-................................. 111 To examine physically seamen engaged in foreign, coastwise, or inland navigation trade. 112 To examine foreign seamen................................................................. 112 To examine cadets, enlisted men and persons desiring to enlist in Revenue-Cutter, Life Saving, Coast-Survey, and Light-House services........................................ 112 To examine alien immigrants.................................-------..................... 112 To examine applicants for pilot's license.................------...........----......... 113 No fee for examination of seamen.......................__________.....----............ 114 Reports of necropsies to be made.........................._______............--------- 115 Medical officers shall be present at necropsies......_____.............________ _____ 110 Professional examination of applicants for appointment.................____________..... 27 Promotion of commissioned officers........___.......................................__ ___ 17 examination of candidates for...................................................... 36 will be made chiefly in writing...................................... 37 must be physically qualified.................................. ...... 37 fitness of candidates to be furnished to board of examiners_________.......... 138 physical unsoundness of candidates to be specially reported.---............... 40 of assistant surgeon................................................................. 42 reexamination of officer for....................................................___ 41 failing to pass a first examination, shall be allowed a second, after one year___ 42 of passed assistant surgeons........................................................ 47 passed assistant surgeons not in line of, if failing at third examination.....___ 48 for hospital stewards after three years.......................-----............. 60 Property, acting assistant surgeons responsible for....................-------.............. 131 when may be dropped from property return...................................... 533 loss of____............................................................................ 536 inspected, recommendation concerning, to be reported upon fully................ 548 repairs to should form basis of separate communication............................ 588 public, not to be given as payment for supplies..................................... 605 of deceased patients, disposal of......................................___........... 625 quarterly report of, shall be reported to Department...... 626 Property returns..................____......................................................... 15 when found correct final accounts will be paid............................. 105 to be rendered by commissioned officers and acting assistant surgeons... 527 invoices to be made semiannually............................................ 529 semiannual, to be made by commissioned officers for microscopes........ 595 •' Proposals for hospital supplies " to be marked on envelope by dealer...................... 558 for subsistence, opening of......................................................... 564 must accompany special requisitions.............................................. 600 Provision for marine-hospital dispensaries....................................._............... 357 Provisions for relief............................................................................. 355 Public property: All property to be accounted for..........................................................._ 527 Responsibility of commanding officers for care of......................................... 528 Actual invoices to be made..............................................................___ 529 Invoices shall be prepared and transfer invoice verified.................................. 530 Customs officers to have charge of, where no officer of the Marine-Hospital Service is on duty..................................................................................... 531 Sale of........................................................................................ 535 \Shall not be disposed of at private sale..................................................... 535 Loss of'........................................................................................ 536 Material for supplies need not be accounted for........................................... 537 Publications of official reports, statistics, etc., without authority, forbidden................ 276 in medical journals restricted................................................... 278 Punishment, grades of.............................................._............._...... 264 Purchases and bills........................................_............_............ 599-617 Emergency................................................................................. 599,601 Economy in expenditures to be observed in......................_................_____ 599 Proposals must accompany special requisitions................................. ...... 600 Extra, of subsistence supplies, how made................................... 602 Subsistence outside of contracts, how made..................._........ 602 Verbal orders to dealers prohibited.........................._.........___.............. 603 Orders for. shall be in printed form or in writing...................._.................. 603 Junior officers not to purchase............................................................ (;,^ Puplic property not to be given as payment for supplies............................. 61 r INDEX. 113 Purchases and bills-Continued. Paragraph. Bills and vouchers......................................................................... 606-617 Must be rendered in duplicate, etc................___..................................... 606 Authority to be cited___:................................................................... 607 To be rendered at close of each month................................................--- 608 Preparation of, for payment.......... _................................................---- 609 Letters of transmittal will accompany bills.......................................---..... 610 Items to be classified............................................____.....................- 611 For maintenance............................................._.............................. 612 For medicines furnished by apothecaries, how paid..............................------- 613 Names of seamen to be given on bills for prescriptions................................... 614 Telegraph................................................................_................... 615 For repayment for official telegraphing.................................................... 615 Authority must be obtained for additional expenditure before submitting.............. 616 Subvouchers shall be securely attached to bills.........................................--- 617 Purchases or repairs, proposals must accompany special requisitions for.................... 600 extra, of subsistence supplies, how made.........____............................ 602 and equipment for hygienic laboratory.....................................----- 679 Q. Qualified candidates eligible for one year only................................................ 32 Qualifications for appointment as assistant surgeon........................................... 20 Quarantine stations, annulling paragraph 179 at............................................... 180 form to be observed during inspection of............................... 333 and marine hospitals tp be inspected once a week by commanding officers..............................-.................................... 345 governed by general regulations____....................__............ 689 and inspection stations, specific duties of officers at............................. 689 vessels, commutation of quarters not allowed officers when on board of....... 93 Quarterly report of property of deceased patients shall be reported to Department....... 626 Quarters, internes entitled to................................................................._. 56 for hospital stewards................................................................_ 75 commutation of, for commissioned officers....................................____ 93 for attendants........................................................................ 81 commutation of, when not allowed officers....................................____ 93 right to, not lost by officer when absent on temporary duty....................... 94 assignment of......................................................................... 96 right to, may be waived by officer.................................................. 97 etc., for officers at a marine hospital or quarantine station....................___ 98 or subsistence not furnished in marine hospitals persons not employed therein.. 108 B. Ranking officer to sign in absence of Supervising Surgeon-General...................._..... 11 Rank of officers serving on revenue cutters.................................................... 690 and precedence of officers................................................................ 3 relative, with officers of Revenue-Cutter Service..................................____ 4 Receipts accruing from unclaimed moneys, etc., how deposited.............................. 618 for money and valuables of patients to be given..................................... 418 from sale of condemned property shall be deposited as " miscellaneous receipts ". 619 collection of bills for care of foreign seamen, etc.............................. 620 Receipts and disbursements..................................................................618-629 Accruing from unclaimed moneys, how deposited................._................_____ 618 Repayments for foreign seamen.................................. _........................ 620 From collection of bills for care of foreign seamen, etc.............._________......... 620 Customs officers will render separate accounts............................................ 620 Unclaimed money and effects of deceased patients shall be delivered to proper cus- toms officer.............................-.................................................. 621 Deceased seamen, method of disposing of property of............____................... 622 Unclaimed property of deceased seamen to be sold after one year_______.............. 623 Accounts of unclaimed moneys and effects of seamen............___.........____....... 624 Unclaimed moneys and effects of seamen, how to render accounts................_____ 624 Disposal of property of deceased patients..........................................._____ 625 Quarterly report of property of deceased patients shall be reported to Department... 626 Customs officers to act as disbursing agents, etc.....................___................ .. 627 Disbursing agents of Marine-Hospital Service will liquidate authorized bills, etc.....-. 628 Accounts current of disbursements may be forwarded without letter of transmittal.. 629 Recommendations of articles forbidden ............................................. 247 8855---8 114 INDEX. Paragraph. Records, preservation of, at stations........................................................... 607 reports, and correspondence ----------......................................630-673 to be kept at stations of first class---------.....-------- ...................... 630 Records and reports: Correspondence..................................... --------...... -------- .....'--- 630-073 Records to be kept at stations of first class.......--------...... ............... 630 Records to be kept at stations of second class.....................—............. ...... 031 Records to be kept at stations of third class....................-------....... — 032 Records to be kept at stations of fourth class..........----............----------..... 633 Register of out-patients................................. ..........-.....-----.....----- 634 Register of hospital permits.....................................-----..... ----- 035 Register of hospital patients.................................--......-........... 030 Journal of stations.............................---...........-..............-........-...... 637 Record of medical inspections of seamen................................-........■ ........ 038 Record of medical inspections of seamen................................... ...........--...... 638 service of officer to be considered in examination for promotion................. 37 subsistence to be kept of articles drawn by steward----...........-----....... 78 second class............................................----- 631 third class___........................-....................- 032 fourth class.............................-........ ...... 635 Reexamination of unsuccessful applicants after one year..............................---- 33 officer for promotion.........................................------ ---- 41 References and indorsements........................................................-.......... 659 Register of eligibles, transcript of. to be forwarded to Department....................-..... 66 out-patients..................................................-.............------- 634 hospital permits..................................-------................---..... 635 hospital patients............................................................------ 636 Regulations for government of officers and employees to be prepared and revised by Super- vising Surgeon-General.......................................................... 16 and general orders relating to Service every commissioned officer shall make himself familiar with............................................................ 110 noncommissioned officers shall familiarize themselves with.................... 127 Reimbursed, service to be, for subsistence furnished officers and their families---------- 100 Reimbursement of traveling expenses......................................................... 159 Rejected claims for relief........................■..........................................---- 394 Relative rank with officers of Revenue-Cutter Service...................................---- 4 Relatives of patients to be notified when patient is beyond recovery........................ 311 Belief, provisions for............................................................................ 355 supervision of........____..............___................_____..................___ 356 stations grouped into eight districts................................................. . 359-367 seamen must make application for...................................................... 374 evidence to be presented by seaman................................................___ 375 certificates of service may be accepted as evidence.................................. 376 masters shall furnish seamen a certificate of service.................................. 377 exceptions............................................................................... 380 closure of navigation...................................._.................. 381 brief service on last vessel not a bar..................... .............. 384 foreign seamen, or employees of Government services, not beneficiaries, shall not be treated...................................................___ 412 application for, after sixty days' absence from vessel................................. 387 cases admitted pending decision to be numbered in order............................ 388 brief service on last vessel not a bar to.........................................._____ 384 evidence to be verified in case of doubt................................................. 385 certain cases to be submitted to Supervising Surgeon-General....................... 386 rejected claims for....................................................................... 394 temporary, ODly contemplated.......................................................... 398 certificates forwarded soon as issued................................................... 404 hospital, to be recorded and reported..............................................._ 422,429 application for, after office hours....................................................... 430 not to exceed twenty days at third and fourth class stations....................... 438,450 date of letter authorizing must be indorsed on permits............................... 440 certificates to be furnished sick seamen when given transportation.................. 457 the Engineer Corps, United States Army, seamen employed on vessels of, entitled to treatment, except at stations of fourth class...................................... 480 station, definition of.............................................................. ...... 353 stations, form to be observed during inspection of.................................... 33' Relief...----............------..............-----......................................... 399-486 Out patients, cases to be treated as......................................................... 399 INDEX. 115 Relief—Continued. Paragraph. No relief furnished at houses of patients..........................-....................... 400 Records to be made of out-relief stations, first class..........................- -........... 401 Records to be made of out-relief stations, second class...............-----.............. 402 Character of relief to be reported at stations of third class............- - -......—...... 403 Character of relief to be reported at stations of fourth class...............------------ 405 Relief certificates to be forwarded soon as issued................------------------- 404.406 Provisions for........................................_.......................------------- 407 Allowance for examinations................................................................ 408 Extra compensation for hospital treatment..................____........-------......- - - 409 Not more than two visits will be allowed to out-patients____............................ 410 Unreasonable charges will not be allowed...................._____.................---- 411 Foreign seamen, or employees of Government services not beneficiaries, shall not be treated..................................................................................... 412 Cases for hospital treatment...............____............................................ 413 Patients to be promptly discharged..........................._____....................... 414 Officers not required to visit seamen on board vessels.................................... 415 Stations of the first class.................................................................. 416-423 Bed tickets valid only for day of issue................................................... 416,424 Bed tickets to be numbered consecutively............................................... 417,425 Receipts for money and valuables of patients to be given............................---- 418 Complication of original disease.................................................. 419,427.441,453 Patients under treatment ninety days..................................................... 420 Patients under treatment one year......................................................... 421 Hospital relief to be recorded and reported-............................................... 422 Relief certificate to be indorsed and forwarded............................................ 423 Stations of the second class..............................__________________............ 424-431 Transfer of patients..........................................._________________________ 426 Patients treated ninety days....................___............______________________ 420,428 Hospital relief to be recorded and reported...................------------------------ 429 Application for relief after office hours...................._________________________ 430,436 When permits may be antedated_____....................__________________________ 431,437 Stations of the third class___................___.................................._......432-444 Permits for hospital relief____.........................................___................ 432 Permits to be numbered consecutively..................................________________ 433 Transfer of patients.............................................................__________ 434 Permits valid only on day of issue.....................___.........................______ 435 Not to exceed twenty days........................._____.................._.........___438,450 Extension of permits..............................................................._______ 439 Date of letter authorizing relief must be indorsed on permits....................______ 440 Permit to be forwarded on termination of treatment........................___________ 442 Diagnosis to be reported in relief certificate................._____............_____....... 443 Exceptions....................---........................____..............______..... 444 Stations of the fourth class......................................................._........ 445-456 Hospital, permits for..............______.........................................._______ 445 arrangements to be made and reported by customs officer__________________ 446 acting assistant surgeon.......... 447 Permits valid only on day of issue........_____...........................______________ 448 will be numbered consecutively______________________................______ 449 Relief not to exceed twenty days........................................................... 450 Extension of permits....................................___............_......__________ 451 Date of letter authorizing relief must be referred to on permits.......___.............. 452 Complications of disease for which admitted................................... _.......... 453 Permit to be forwarded on termination of treatment.....__...... _____.......______ 454 Diagnosis to be reported in relief certificate...................................._.....____ 455 Exceptions................................-----.......................................... 456 Transportation of sick seamen............................_________......___________ 457-461 Details of transportation............................______.................._......_____ 457 Relief certificate to be furnished on departure___................___............_. _____ 457 Current rates to be allowed....................______........................._.........___ 458 Bills for transportation....................................................... ........_____ 459 Clinical history of each case to be furnished.........................................______ 460 Receiving officer to be informed of probable date of arrival.............................. 4m Insane seamen........................................................__________ _____ 462-467 Maybe admitted upon order of Secretary of Treasury................._......._________ 462 Officers shall exorcise special care in deciding complications_______________________ 463 Complications to be strictly investigated............................................... 464 116 INDEX. Relief—Continued. Paragraph. History of patient to be forwarded to Bureau......................................... 465 Laws governing commitment of insane seamen to local asylums to be observed........ 466 Applications from Pacific Coast to be reported by telegraph..........................- - - 46? Deceased seamen's relatives to be notified.......................... ...............-.....- 468 burial expenses....................-----......-------......-.......--- 569 Navy, United States, seamen of, entitled to treatment.................-.......---------- 47n Coast Survey, United States, seamen of, entitled to treatment........................- - - 470 Foreign seamen entitled to treatment................................................ ..... 471 Bills for care and treatment................................................................ 472 Officers shall collect all bills for care of seamen of Government services, etc............ 473 Bills for care and treatment of foreign seamen, etc.......................-............. - 472 Monthly accounts to be rendered............................-.......-....................... 473 Notification of amount of bill---............................-...........-................. 474 Charges for care and treatment of foreign seamen........................................ 475 Revenue-Cutter Service................................................................... 476-478 Officers and crews of, to receive hospital or out-patient treatment................... 476 Officers or seamen to be admitted to station of first class and contract hospitals........ 477 Out-patient treatment, where and how furnished......................................... 478 The Mississippi River Commission, officers and crews of vessels of, entitled to relief except at stations of fourth class ........................................................ 479 Life-Saving Service............................................................-........... 482-486 An applicant must furnish certificate of service................................-----..... 482 Requirements of certificate....................-...........-................................ 483 Sick or injured keepers and surfmen admitted to hospital or as out-patients when sta- tions are open............".................................................................. 484 Sick or injured keepers and surfmen admitted to hospital or as out-patients when sta- tions are closed............................................................................ 485 Keepers and surfmen admitted to hospital or as out-patients when stations are closed. 485 Temporary treatment only furnished in marine hospitals............................... 486 Light-House Service, officers and crews of, entitled to relief, without charge.......... 487 Repairs, etc., to be reported.......................................................--........... 494 material for, need not be accounted for.............................................. 537 to property shall form basis of separate communications........................... 588 or purchases, proposals must accompany special requisitions for.................. 600 and improvements, commanding officers to make detailed statement of........... 644 preservation of public buildings................................................. 645 commanding officers to forward estimate for........................................ 645 Repayments to the Marine-Hospital fund____................................................. 474 for foreign seamen, etc........................................................--- 620 Replies to Department letters, instructions concerning....................................... 658 Report of inspection. If unfavorable, recommendation will be made........................ 339 Reports: Monthly, to be made by officers............................................................. 639 Monthly, to be made by officers and other physicians of diseases and injuries, etc...... 640 •' Nomenclature of diseases'' shall be observed in preparing medical and surgical reports. 641 Medical inspection of seamen, transcript of record of, to be made........................ 642 Reports of necropsies........................................................___............ 643 Commanding officers to forward yearly report of repairs................................. 644 Estimates for repairs at stations to be forwarded......................................... 645 Reports of inspection of immigrants....................................................... 646 Official forms to be used..................................................................... 647 "No transactions" to be written across face of blank in certain cases................... 648 Letters of transmittal-...................................................................... 649 Orders convening boards...............................____................................ 65< i Copies of official reports to be filed at stations........____................................. 651 List of attendants to be transmitted, etc.........................................._........ 652 Official communications, how they should be addressed.................................. 653 Official communications free of..................................._................________ 654 Official signatures and addresses........................................................... 655 References and indorsements............................................................... 656 Circulars, Department or Bureau, relating to Marine-Hospital Service.................. 657 Date and number in the annual series of the Marine-Hospital Service to be given...... 657 Instructions concerning replies to Department letters.................................... 658 Official communication formulas..-........................................................ 659 Official communications to be forwarded through commanding officer.................. 660 Letter-press copies to be taken of all official letters___................................... 661 Reports of boards to be transmitted to or through the Supervising Surgeon-General.. 662 INDEX. 117 Reports—Continued. Paragraph. Authorities on spelling...................................................................... 663 Telegraph for official purposes. Department circulars to be observed................... 664 Telegraphing, instructions concerning____................................................ 665 Telegrams for leave of absence, etc., will not be sent or paid for as "official business". 666 Preservation of records at stations.....................................................— 667 Ink, kind of, to be used.............................____..........................---....... 668 Abbreviations of words must be avoided............___............................... 669 Metric system, instructions concerning..........................—......----......— 670 Centigrade scale, officers shall make use of....................__________............... 671 Files for letters at stations, instructions concerning..................................--- 672 Circular letters, a separate file to be kept at each station................................ 673 Reports......................................................................................... 639-652 monthly, to be made by officers....................................................... 639 of inspection of unserviceable property will be forwarded in duplicate............. 548 necropsies.............___.........._............... ................................ 643 inspection of immigrants..........................................,.................. 646 boards to be transmitted to or through the Supervising Surgeon-General....... 662 sanitary condition of ship by officer detailed on same............................. 692 Reservation, j unior officers shall not leave, without consent of commanding officer______ 293 commanding officer leaving, shall notify officer next in rank.................. 295 Resignation, leaves not granted when tendered............................................... 194 of officer while on duty........................................................... 84 of assistant surgeon to be requested when failing at second examination..... 46 Requirements for appointment as assistant surgeon.......................................... 18 Requisitions......................................______..................................___574-580 for supplies, commanding officers shall make.................................... 574 time of making..................................................................... 575 for medical supplies to be limited........................................______ 577 liquors and vials, when made................................................. 580 stationery will be made semiannually....................................... 581 blanks and books will be made semiannually.........................____ 581 stationery, samples of printed envelopes to be inclosed................___ 582 ink and mucilage should include a year's supply...................______ 583 special, each article must be fully described.................................... 584 requirements of, defined................................................. 585 for articles of hospital equipment must not be made in anticipation of needs beyond fiscal year.................................................. 586 needed not to be made oftener than once a month................ 500 Revenue-Cutter Service: Relative rank of officers of Marine-Hospital Service with officers of........_............ 5 Commissioned officers to examine persons desiring to enlist..........____............... 112 Officers and crews of, entitled to relief..................................................... 368 Officers and crews of, to receive treatment................................................ 476 Officers or seamen to be admitted to stations of first class, and to contract hospitals___ 477 "Out-patient" treatment, when and how furnished.............................._....... 478 Rank of officers serving on cutters.....................................................___ 690 Uniforms, officers serving on cutters..................................................___ 691 Report, sanitary condition of ship by officer detailed on same....................._____ 692 Officer detailed shall make report of contagious diseases, etc............................. 693 Morning sick report to be submitted to commanding officer............................. 694 Analyses of water, medical officer to make, and report of its purity...................... 695 Medical officer detailed on cutter shall have charge of medical stores, etc..........____ 696 Medical officer shall examine medical supplies.................____....................... 697 Medical officer detailed on, shall keep a record of professional work...................... 698 Revenue cutters, commutation of quarters not allowed officers when on duty on board of. 93 Rooms to be used for official purposes only........-.-........................................... 492 Routine, changes in, not to be made by officers in temporary command..................... 267 s. Salaries of deceased officers—payment to be made to legal representative.................. 102 Salary of Supervising Surgeon-General........................................................ 7 tables, Government, to be adhered to.............................................____ 88 to begin from date of oath of office..............____....................... 89 Salute to be given___.....................................______................ ........... 275 Samples of subsistence to be submitted................._____.................. 563 118 INDEX. Paragraph Sanitary duties of commissioned officers.................................._______.......... 117-122 To enforce national quarantine rules and regulations................... ___............ 117 Sanitary duties defined.................................................................... lis To comply with local health laws........................................___ .. . IP To report presence of epidemics, etc..................................._________________ l.'i i To vaccinate seamen..............................—............................____..... 121 To advise officers of the Revenue-Cutter Service....................................____ 1 •.'•.' Sanitary duties of commissioned officers defined.............................................. lis condition of ship, reports to be made of............................................ 692 Schedules to be furnished dealers........................................................____ 554 separate, for each of the different classes of articles to be made____............. 561 changes in, may be made............................................................ 562 Seal, official, to be circular in form............................................................. 5 Seamen on board vessels, officers not required to visit........................................ 415 insane................................................................................. 462-4!i7 wrecked, entitled to relief............................................................. 372 sent by consular officers entitled to relief............................................ 373 must make application for relief..............................................._____ 374 evidence to be presented by...................................___.......___......... 375 to sign certificates................................................ .........____....... ;{s8 injured in brawls not to receive treatment........................................... 395 taken ill on vessels entitled to relief..............................____................ 396 names of, should be given on bills for prescriptions.................................. 614 record of medical inspections of....................................................... 638 medical inspection, transcript of record of, to be made.............................. 642 Sea, officers not to go beyond........................___................... ___................ ]s:{ Second examination allowed assistant surgeons for promotion, but not a third............. 45 Senior and junior, hospital stewards graded as................................................ 59 officer absent, next ranking officer to assume duties............................_____ 266 Seniority, board of examiners to observe,unless there are specific reasons for waiving it.. 39 Separate report will be made for each station.................................................. 338 Service, corps to consist of......................................_......___........___..... ... l Shipments by express prepaid by Department or Bureau.................................... 589 freight to be paid by officer receiving the goods....._____................... 589 Sick or disabled attendants to be cared for................................__________....... 82 officers to receive compensation when................................................... K5 call, hours for..............................._.................._.........._................. 290 morning,officers to report at surgeon's office........................................ 291 leave, officer must cite on pay roll date of authority................................____ K17 maybe granted by Supervising Surgeon-General____..........................._ 189 authorized, commissioned officers to report by letter physical condition........ 193 applications for. to be addressed to Supervising Surgeon-General...........___ ls7 medical certificate must be furnished............_......._........................ Is7 officer to proceed to station on expiration of sick leave............._............. 190 when officer shall be reported on pay roll as " en route to rejoin station "...... 191 report, morning, to be submitted to commanding officer of cutter..................... 694 Sickness or absence of Supervising Surgeon-General, ranking medical officer to serve..... 11 "Slush fund" and "post" or "slop" fund prohibited......................................... 326 South Atlantic district, stations of................._............................ 3H2 Special requisitions for medical supplies may be forwarded................_......_________ 579 each article must be fully described.............._______.........____ 584 requirements of, defined................____....._..................... 5s,-> estimates, etc., must always be accompanied by letters of transmittal.. 5*7 proposals must accompany same......................................... 6i«) investigations, examinations, etc..................................... 682 duty, officers detailed to laboratory shall be considered as on..........._.......____ <;s6 Spelling, authorities on...................._.................. 663 State holidays....................................... 319 Stationery, blanks, and books...................... 581-583 requisitions for, will be made semiannually..........................._........... 581 samples of printed envelopes to be inclosed..................... 582 Station, change of, commissioned officers subject to.......... ............ 21 Stations, assignment of officers to............................ 147 of first class shall not be left without the presence of a medical officer, etc........ 296 INDEX. 119 Paragraph. Stations, of first class with one officer on duty shall not be left without the presence of the officer or steward....................................-................. 39. records to be kept at...................................................- 630 second class, records to be kept at______.........., —............................ 631 third class, records to be kept at-------..................................------ 032 fourth class, records to be kept at_________..................................... 633 third class...........................................................-.............403,404 fourth class.........................................................-.............. 405-412 journal kept at.....____.............................................................. 637 Steward to keep record of articles drawn by him............................................. 78 Stockings, elastic____........................................................................... 598 Subordinate employees below grade of hospital steward shall be known as attendants..... 61 Subordinates and officers subject to orders of Supervising Surgeon-General................ 10 or patients, maltreatment of, not permitted_____............................. 262 Subsistence and contracts..................................................................... 551-573 laundry supplies, forage, etc., not furnished by Bureau, how obtained......... 551 estimates for, to be forwarded...................................................... 552 Subsistence and contracts: Articles and quantities of allowed stations................................................ 553 Schedules to be furnished dealers................______.................................. 554 Schedules to be made specific......................................................<......... 555 Collusion among dealers.................................................................... 556 Dealers, collusion among.................................................................... 556 Advertisement to be made in newspapers.................................................. 557 Bills for advertising, how paid................................................._............ 557 Advertisements, bills for, how paid........................................................ 557 Instructions for dealers................._...................................._............... 558 '' Proposals for hospital supplies " to be marked on envelope by dealer.................. 558 Bids, three required in each class of supplies.............................................. 559 Bids from responsible dealers desired...................................................... 560 Schedules, separate, for each of the different classes of articles to be made............. 561 Schedules, changes in, may be made...................................................___ 562 Samples to be submitted............................................................._....... 563 Proposals, opening of............................________....................._............ 564 Comparative schedule of proposals to be forwarded...................................... 565 Contracts when completed to be forwarded...........................................___ 566 Contracts, period of......................................................._______________ 567 Contract, legal requirements of signing......................___............___________ 568 Contracts and agreements, now made and certified...................________________ 569 Contracts, officers may have benefit of.......................................__________ 570 Contracts or agreements, approval by Department required................._________ 571 Inspection of supplies.....................___..................................___...... 572,573 Commanding officers to inspect supplies.............................................____ 573 Subsistence, record of, to be kept of articles drawn by steward......._______........_..... 78 will be allowed hospital stewards........................_....................... 77 when allowed officers and their families.......................................... 100 and laundering, when officers are entitled............................. ......... 104 or quarters not furnished in marine hospitals to persons who are not employed therein......................................._................................... 108 purchases outside of contracts, how made..............._____........... 602 Subvouchers shall be securely attached to bills.............................................. 617 Successful examination does not assure appointment................................ 31 Sunday to be properly observed............................................... ..... 320 Supervision of relief................... ........................................... 356 Supplies, inspection'Of................................................................. 572 573 Supply table, official, of the Marine-Hospital Service................................ 576 medical...................................................................... 590 Supervising Surgeon-General: Appointed by President............................................................ 6 Salary of................................................................. r- Selected from among surgeons when a vacancy occurs.......................... 8 Duties of................................... ............................. n Officers and subordinates subject to the orders of____........................ 10 Ranking medical officer to perform duties during absence or sickness of........... 11 12o INDEX. Supervising Surgeon-General—Continued. Paragrap . May designate assistants in his office to issue orders pertaining to routine work....... J- Orders of assistants to be issued "by direction of"....................................... ' To supervise officers and employees........................................-............-- To see that public property is accounted for.............................................. To prepare and revise regulations.............................................-........... To certify to services and that prices paid for travel were j ust, etc....................... 163 May grant leave for one month.........................................................--- !'•' Surgical appliances and special apparatus not to be purchased without authority.......... 594 T. Telegrams for leave of absence, etc., will not be sent or paid for as "official business"--- 666 Telegraph vouchers.....................................—..................................... 61o for official purposes, Department circulars to be observed...................---- 664 Telegraphing, instructions concerning....................................................---- 665 Temporary duty while on leave..................-.............---................-........... 168 relief only contemplated........................................................... 398 treatment only furnished in marine hospitals.................................... 486 command, officers in, not to make changes in routine............................ 267 charge of station, officer in, status of.............................................. 208 relief only contemplated........................................................... 398 Testimonials, false, disqualify applicant for appointment.....................---............ 19 Tonnage dues, maintenance of service borne by, receipts from............................... 674 tax, Commissioner of Navigation to forward monthly aggregate collections of... 075 Tour of duty of commissioned officer at marine hospitals and stations of second class four years................................................ 146 quarantine station three years...................... 146 Treatment, period of, not to be reckoned as absence from vessel............................... 382 Transmittal, letters of, will accompany bills................................................... 610 letters of........................................................................... 649 Transfers of station, officers and attendants to keep Supervising Surgeon-General informed of their movements............................................................................ 148 To report promptly date of departure and date of arrival................................ 148 Transfer of the command of a station, ceremonies attending the............................. 151 patient from another station....................................................... 423 patients................................................................----...... 426.434 Transportation orders to be furnished..................................................----- 158 of books and instruments without expense to officer...........___......... 167 sick seamen; details of..................................................... 457 bills for....................................................... 459 Traveling accounts to be sworn to...........................................................___ 162 expenses allowed............................................_____................... 154 officer entitled to, upon change of station, while on leave of absence... 156 to be advanced by officers and attendants.............................._. 157 reimbursement of......................................................... 159 allowances for........................................,.................... 160 actual...................................................................... 160 vouchers for............................................................... 161 allowed attendants......................................................... 164 Traveling-expense account, Supervising Surgeon-General to certify to prices paid, serv- ices performed. etc............................................................................. 163 Travel allowances, officer entitled to, when assigned to duty while on leave................ 155 while on leave.............................................................. 169 Trespassing on grounds to be reported to United States district attorney____............. 524 Twenty days' relief at third and fourth class stations....................................... 438 450 U. Unclaimed moneys, etc., receipts accruing from, how deposited............................. 618 and effects of deceased patients shall be delivered to proper customs officer. 621 property of deceased seamen to be sold after one year.......................... 62^ money and effects of seamen, how to render accounts......................... f..>. Uniform, any article of civilian dress not allowed to be worn by an officer when in...... oau when overcoats shall be worn..................................................... 2f)„ negligence concerning, to be reported............................................. om INDEX. 121 Paragraph. Uniforms....................................................................................... 204-237 to be worn............................................................................. ~"_ obligatory............................................................................. 30;> of respective grades to be worn...................................................... 306 when to be worn...................................................................... 307 newly appointed officers to provide.................................................. 311 commanding officer required to instruct each attendant concerning.............. 212 to be procured within thirty days from appointment........................-..... 312 inspection of....................................___........................--------- 213 when they may and may not be worn................................................ 213 when may be worn....................................................................' 214 not to be worn when on duty at Bureau............................................. 215 badges may be worn.................................................... ............. 216 Uniform for Supervising Surgeon-General: Full dress..................................................................._____.......... 217 Dress......................................................................................... 218 Fatigue....................................................................................... 219 Uniform for commissioned officers........................................................... 220-226 Full dress.................................................................................... 220 Dress.........................................................................________...... 221 Fatigue...................................................................._______________ 222 White...................................................................................____ 223 Sword and belt, how worn............................................___________........ 224 When on duty at quarantine stations....................................................... 225 Gloves always worn with sword....................................____________------ 226 Uniform for noncommissioned officers............................................_________ 227-237 fatigue, for acting assistant surgeon............................----------------- 227 white, for acting assistant surgeon...............................................— 228 fatigue, for internes............_______.............................................. 229 white material for internes................................................________ 230 junior officer to explain when unable to appear in.................................. 282 dress for hospital stewards........................................................... 231 fatigue for hospital stewards......................................................... 232 white for hospital stewards...................................................______ 233 dress for attendants.................................................................. 234 working suits'for attendants.....................................___................ 235 white cap for attendants.............................................................. 236 regulations to be observed at quarantine stations................................... 237 Uniforms, officers and attendants detailed in hygienic laboratory not required to wear ... 683 Unserviceable property......................................._____....................____538-550 Room for.............................................................................______ 538 Arrangement for inspection of.................................____............._........ 539,542 Care of......................................................._____.................._........ 540 Inventory of. to be forwarded..................................................._________ 541 Disposition of condemned articles..........._..........._.................................. 543 To be inspected but once..................................................._........_....... 549 Officers not to purchase..................................................................... 550 Will be inspected by officers making general inspections.............................___ 342 Unsuccessful applicants may be reexamined after one year.................................. 33 V. Vacancies, selection to be made of one of three applicants standing highest................. 65 commanding officer will forward name selected to Department for approval... 65 in position of attendants, how filled................................................ 65 at stations among attendants....................................................... 68 officer shall not offer position to an attendant employed at any other station... 68 Verbal permits for leave for less than twenty-four hours not counted...................... 178 orders to dealers prohibited............................................................ 603 Vessels, seamen on board of, officers not required to visit.................................... 415 Violations of law or regulations to be reported................................................ 344) Visiting days........................................................._........................ 3H Visits, official, to station.................................................................... 352 Vouchers for traveling expenses...........................r..................... 16i preparation of, for payment.................................................... 609 Voyage, expenses for sickness during, will not be paid............ 391 8855---9 122 INDEX. w. Paragraph. "Waiting orders" on account of dissipated habits............................................ 40 on account of physical disability.........................-................. 41 referring to disabled officers............................................... 49 pay for commissioned officers......................................... ... «n commutation of quarters not allowed officers when on.............___ 93 commissioned officers may be placed on................................... 195 commissioned officers shall report by letter, etc......................... 196 Washington, officers visiting, to register at Bureau........................................... 271 Water-supply system and lighting for officers at a marine hospital or quarantine station.. 98 medical officer to make analyses of..................................................... 695 Weekly inspections of buildings and grounds by commanding officer........................ 345 not to be delegated to a junior officer................._ _................ 346 officers to attend .......................................................... 347 muster at.................................................................. 348 completion of.............................................................. 349 work to be discontinued during.......................................... 350 commanding officer to enter in journal completion of.................. 351 Withrawal of applicant from examination..................................................... 35 Wrecked seamen entitled to relief............____............................................. 372 Y. Yachtsmen entitled to relief...............................................; —................ 369 Yearly inspections............................................................................... 330 report of repairs to be made............................................................ 644 / / INDEX OF APPENDIX. A. Page. Appendix........................................................................................ 83-94 Allowance table for hospital stewards......................................................... 87 B. Blanks, list of................................................................................... 92,93 Books............................................................................................ 93 C. Calendar of reports to be made by medical officers............................-............... 89-92 D. Diet tables: Ordinary___................................................................................. 86 Extra..............._____.................................................................... 87 E. Examinations, physical, instructions relative to............................................... 83,84 Extra diet (table)................................................................................ 87 H. Hospital stewards, allowance, table of rations for............................................. 87 I. Instructions relative to physical examinations................................................ 83 necropsies................. ...................................._...... 84 L. Laws in force relating to the Marine-Hospital Service......................................... 88 M. Marine-Hospital Service, laws in force relating to............................................. 88 Medical officers, calendar of reports to be made by........................................... 89-92 N. Necropsies, instructions relative to............................................................. 84,85 O. Ordinary diet (table)............................................................................ 86 P. Physical examinations, instructions relative to...........................-----------....... 83,84 R. Rations for hospital stewards, table of...................................._________________ 87 Reports to be made by medical officers, calendar of..............................__________ S9-93 S. Stationery, list of................................................................................ 94 T. Table diet, allowance for hospital stewards: , Ordinary..................................................................................... 86 Extra.....................................___............................................... 87 123 ( y NLfl 05131525 7 NATONAL LIBRARY Of MEDICINE m mm mmrm V;," '.•■-' ■ ' >. ■•• •',■•.:■.' ,v'1 ''•■^V.':\^ fHI iHi 11111 I WOBsBBsm ^