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.

698/978 page 572

$Bed covers. Bla.ukets. Bed sheets. Caps and shirts. Xiiien trow- Mcrs & socks- Table-eloths :iri(l napkins. Aprons. Spittinj;- tlotlia.cloths and towels. Washing cloths. Patients. Clothes. Damaging or neglect- ing clothes. Personal cleanliness. between the two mattresses a piece of oiled canvas whenever those are so abundant that they might pass through such additional mattress. The oiled canvas should not be put immediately nnder the invalid because it would pre.serve a large quantity of unwholesome fluid under him which would produce irritation in the skin, &c. &c. Such patients ought to be removed from the central parts of the ward to one of the most remote ends. The bed covei's having the greatest .share in the general appearance of the wards deserve most par- ticular attention. Their cleanliness must be perfect. They should be always carefully tucked in to avoid their touching the floor and getting sullied ; must be beaten once every month, choosing the time Avhen favourable, and finally they must be kept clean from every stain of brotli or wine or any other sul)stance, either greasy or coloured. Should blood or any other colouring thing be dropped or upset upon them, the stained spot must be immediately washed Avith alkaline Avater, if it is so limited as not to give inconvenience to the invalid. If the stain is much extended they must be changed. The alkaline water may be made with wood or char- coal ashes, or with soda or potash. The quantity of ashes employed should be just sufficient to render the water soft to the touch, but not too much, for it would become caustic and corrosive. Blankets being double in Avinter and generjiliy the under blanket smaller and coarser than the upper one, it will be observed not to put one in the place of the other. No time can be fixed for changing them, but always when they are dirty or in case of demise. In this last case not only the blankets but all the bed furniture shall be removed, the straAv bed emptied, the mattress undone, Avashed, and beaten ; the straAV bed and mattress cases as Avell as the cloak and troAvsers are to be Avashed also. The bed sheets according to the regulations are to be changed every fortnight, as in ordinary circum- stances they can be kept clean for that period of time, saA'e in the case of being accidentally stained or soaked Avitli perspiration or other substance. In that event they shall be changed when necessary. Excepting for the above-mentioned extraordinary causes the caps and shirts are to be changed every five days. In case of the probable discharge of a patient, upon the indication of the medical officer the change of the bed sheets can be delayed from one to three days. Linen trowsers must be changed every fortnight, socks every five days. T.nble-cloths and napkins every five days. Officers' aprons at their request. Linen spittoons CA^ery day, cloths and toAvels every day. Each infirmier must have two aprons, putting on the clean one for the distributions. He puts on for common Avork the one that he used the day liefore for the distributions, and he changes the other one every day. The linen and AvooUen Avashing cloths are changed only Avhen they are quite Avorn out ; infirmiers a sufficient quantity of them at their disjiosal, Avhich they Avash after using, and are sent to the laundry only Avhen soaked Avith greasy matters. It remains noAV to speak of the cleanliness of the patients themselves. The infirmiers must paj' great attention that all the Avard clothes of the invalids, from the cap to the socks and slippers, are all perfectly clean and sound, that is without stains or holes, and not ripjied open or buttonless. Should their clothes Avant repairing the infirmiers must report it to the infirmiers majors, Avho Avill have them done immediately. They will also report to the infirmier major any invalid damaging or neglecting Avilfully his clothes. They must give also great attention to the per- sonal cleanliness of the iuAalids, keeping ahvays ready for them hot and tepid Avater to Avash their feet and hands, see that their nails are properly clipped. Ext Av^or clea their hair regularly cut, and their beards shaved twice a week by the barber attached to the hospital as already prescribed in the Chapter 5, Instructions to Infirmiers Majors. They must help those that are unable to help them- selves. Finally, they must Avatch that no invalid leaves his Drd bed unless completely dressed in his full hospital suit, and if any of them refuses to conform to this rule the infirmier must report him immediately to the infirmier major. Chapter 12th. External cleaning. Besides the directions given in chapter 5th of instructions for infirmiers majors Avith regard to the cleaning of the courtyards, staircases, and lobbies, to prevent the dirt from being introduced into the Avards, the following are to be added on the same subject, viz. :— In Avinter all the gutters and streams must be fre- Gut quently SAvept, to prevent the Avater in them freezing strei and stopping the jiassage of the Avater, &c. The ice, Avhen formed, must be broken and heaped Ice- up on one side. ing. On the snoAV falling, it must be SAvept and heaped Sno' u]) on one side, slanting, and if possible remove it out of doors. Sand, ashes, or saAvdust must be spread on the passages Avhenever it freezes, or the paving is slippery. As soon as it thaAvs, the ice must be broken and the circulation of the water re-established, the paving Avashed, and all dirt removed, causing also all to abstain from Avalking on the loose ground or sand, until it is completely thaAved. In rainy Aveather, besides the precautions to be taken to prevent the introduction of mud and wet into the Avards, infirmiers must sweep away the fallen leaves to facilitate tlie floAving of the Avater, and SAveep away the Avater from the open spaces to make them quite clean. In dry Aveather all the fallen leaves must be SAvept aAvay, the stones raked away from tlie spots cultivated, and all the stones found loose collected in a heap. Any linen or lint that may be found by the Linei infirmiers at any time nuist be picked up and put into lint, the depot basket. An infirmier leaving on his passage a loose stone or piece of linen or lint without picking them up, is guilty of neglecting his duty, and marked doAvn as such. The good keeping and cleanliness extends also to Exi the external walls. The infirmiers must keep them -walls, clean, and must alloAV no one to dirty or deface them in l^a™ au}^ way, and Avill e([ually Avatch that no dirtying or damage is caused to be done, or done by any one, either |,g to the walls, the doors, the AvindoAvs, or the plantations; report and, finally, it is j^art of their duty to report to the infirmier major or ojficier dadministration any damage that they may see in any part of the establishment, in order tliat tliey may at once provide for its being repaired, according to the circumstances. Tha Rain leavf the Avards, consist in keeping the fires according to the orders they recei\-e, either for their kindling, their duration, or the manner of regulating them. There are as nuiny ways of making and regulating the fire, as there are forms of stoves, and kinds of fuel. There fire tAvo principal kinds of stoves, one Avith grates, fitted for coals, the others Avithout grates, fit for Avood fires. The first thing before lighting the coal stoves is to Coal- clear the stove of all the ashes, then a fcAV sticks stoves, cut small and Avell dry are jilaced on the bars and grate so that the air can Avell circulate between them, then some small bits of dry coals are placed 1' Chapter 13. Heating of the Wards. The duties of the infirmiers al^out tlie heatins: of Fires, i$