Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty.

Great Britain. Royal Commission Appointed to Inquire into the Sanitary Condition of the Army.

Date:: 1858

Credit: Report of the Commissioners appointed to inquire into the regulations affecting the sanitary condition of the army, the organization of military hospitals, and the treatment of the sick and wounded ; with evidence and appendix. Presented to both Houses of Parliament by Command of Her Majesty. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

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$Some cautions are nevertheless necessary to be given regarding its use. 1st. It must be kept always very clean inside and out. 2nd. It must be seen that the hemp round the piston is in good state and fills well up all the cir- cumference of the body of the pipe. 3rd. It must be ascertained that it works easily, and if it is found too hard the hemp must be greased with a little butter or fat. 4th. Then the syringe is filled up and the small pipe is also greased. 5th. The whole must then be tried that no air is left in it by raising the small pipe upwards and push- ing the piston till all bubbles are expelled and the water comes out. 6th. It is then ready for use, and when introduced the patient must be cautioned not to keep his breath, which would jorevent the liquid from penetrating into he intestines. 7th. The water is discharged from tlie syringe, pushing the handle of the piston inwai'd with a gentle semicircular motion of the right hand from left to right and from right to left, holding the pipe firm with the left hand. The use of the pump syringe is so simple that it needs no further directions to be given. Chapter 11th. Cleanliness of the Wards. The cleanliness of the Avards must comprise the walls, the ceiling, the floor, doors, and Avindows, the beds, and all the rest of the furniture. The ceilings and the walls must be frequently brushed from the dust, and the latter should not be suffered to be dirtied or defaced by marks with colours, or spitting, or scratches, nor sullied when the floor is brushed or washed. For the keeping of the floors in a state of cleanliness we shall add to what was already said at Chapter 5 of the instructions to the infirrniers, that both the invalids and the infirmiers must help each other in this respect for the mutual welfare. The invalids will be furnished with bed spittoons, large wooden spittoons, with sawdust near the stoves or tables, and spitting cloths for those who are unable to use their bed spittoon. They will be brought to under- stand that if all should spit or mess on tlie floor it would create a great filth, that besides the discomfort and unwholesome effects it would produce, it would also give so much occupation to the infirmiers in cleansing that they could not be able to give the attention due to their comfort. The infirmiers must for their own interest endeavour to persuade the invalids not to throw anything on the floor, but to throw their slops into their pots, which will save them much labour in Avashing. By these precautions the Avashing of the floors Avill be seldom required, and the regular sweeping Avill suffice. Sweeping the floors should be done at least six times every day, that is, b(?fore the visit, after the dressing, after the distribution of the morning, after the Avorks of cleaning, after noon, after tlie dressing, and after the distribution of the evening. But besides this, sweeping must be done immediately whenever any filth is found. The sweeping is to be done thoroughly, that is, under the beds, the tables, along the walls, in every corner. To avoid raising the dust, instead of pushing it for\A-ard the infirniier must draw it toAvards himself, and proceed on so gradually Avithout leaving anything behind. Sprinkling Avater before sweeping should be avoided, and only done in case of great pressure, for when the water is sprinkled it is very apt to stick together Avith the dust on the floor. When the washing is -indispensable it must be done with brushes and not Avith brooms, nor throwing Avater abundantly, but Avith all the precautions already de- scribed at Chapter 5t]i, Instructions to the Ivfirmiers. The washing is done differently in the Avards that are not occupied from that done in those wliere are the invalids. In the empty Avards, after having opened all tlie windows, one range of the beds is advanced in the space between the tAvo ranges, the space Avhich they occupied is then scrubbed with a brush by an i?fir- mier, and wiped dry by another Avith a sponge or a cloth as he advances. If the floor is too greasy hot water should be used, and some ashes or soda or potash added. When a portion is washed and dried the beds are replaced, and when one row^ is done on one side, the other is to be done in the same way, and finally the central spaces. In the wards occupied by patients the wasliing is done in the same way, except that instead of moving the beds to the middle space, the infirmiers wash under and between the beds, and the windows are not open, but only those that cannot injure the patients with their draft of air. The precautions to be used to prevent the floor of the wards being sullied Avith the mud or dirt brought in from the exterior, or Avith liquids carried about in pails or other vases, were described at length in the oth chapter of the Instruc- tions to infirmiers majors. The Avooden part of the Avindows is washed Avith Windows, a sponge or a piece of wet cloth. The glass panes are Avashed in the same way, or Glass if necessary Avith whiting diluted with water to the panes, consistence of a thin pap. This is spread over the panes with a piece of cloth, or hemp, or avooI, and Avhen it is diy it is rubbed off till the glass is per- fectly cleaned. The doors also must be Avashed frequently. Besides Doors, the cleaning of the doors and Avindows, their opening and shutting easily and without noise must be attended to. This is obtained by putting some drops of oil at the hinges, locks and bolts, &c. &c. The couches also require special cleaning ope- Couches, rations. The bedsteads must not have stains of blood Bedsteads, or any other kind, and if any be on them they must at once be washed and Aviped dry, and all the different parts of the bed and jiarticularly the board at the head and feet are to be kept ahvays free from dust or Avet. The bed-boards must be wiped and dried after each Bed- sweeping, and above all after the visits and before boards, and after each distribution. The night-tables as Avell as all the other bed-boards Kiht- must be also Avashed and Aviped dry frequently. tables. The mugs, basins, and plates shall l)e Avashed after Vases, each distribution, and also each jitisan pot before every new distribution of them. When some sediment is sticking at the Ijottom or sides of a vase it Avill l)e found useful to rub Avell the angles Avith a bit of stick covered Avith some linen. The folloAving rules are given for the maintenance Bed furni- and cleanliness of the bed furnitures. tures. It is necessary to see that the (paillasses) straAV- Paillasses beds are well closed that there are no holes through or straw Avhich the straAV may escape, that the straw is not too ^^'l*- broken. No fixed time is given for the change of the straAV, it must Ijc done as soon as it is so broken as to have no elasticity. Mattresses under ordinary circumstances should be Mattresses, beaten every six months, but they must be changed Avlien they are Avet, stained Avith blood, or sunk down under the patients. If they are merely Avet from having upset accident- ally some Avater or other not impure liquid, they may be used again Avhen dried Avithout having them washed first ; but if they were wet with blood, excremental matters, or perspiration, they must be put away for Avasliing. • To preserve the mattresses from deterioration, a Oat-chafF certain number of thick mattresses stuffed Avith oat- mattresses chaff must be kept in readiness to put them on the oiled top of the Avool mattress under the patients, when '^^I'lvas. these are unable to con'vol their excretions, putting 4 C 4$