\v-y>, INSTRUCTIONS FOR MEDICAL INSPECTORS OF THE UXITED STATES ARMY. The .Medical Inspector is required to see that all regulations tor protecting the health of troops in barracks, camps, and transports, for securing the sanitary con- dition of hospitals, and for the careful treatment of and attendance on the sick and wounded, are duly observed. He is to satisfy himself as to the quantity and quality of medical and hospital supplies, and as to the condition of the surgical instruments and appliances. lie is to examine the medical, sanitary, statistical, property, and military records, and accounts of hospitals and regiments, to see whether they have been properly kept, and that the reports and returns required by Regulations have been regularly forwarded to the Surgeon General. He is to ascertain from these records the amount of disea>e and mortality among the troops, especially from pulmonary diseases and from disease of the zymotic class. He is to inquire into the causes of such diseases, and into the steps which may have been taken for their prevention or mitigation. He is to advise with medical officers on any measures for the mitigation or prevention of disease that may be required ; and he is to recommend, verbally or in writing, any additional precautions that he may consider requisite. INSPECTION" OF QUARTERS AND BARRACKS. The Medical Inspector is to examine into the sanitary condition of quarters. barracks, guard rooms, prison cells, and of all buildings and rooms used and occu- pied by troops ; and particularly as to their cleanliness within and without, their ventilation, warming, and lighting. He is to ascertain whether the number of men accommodated in any barrack. or guard room is greater than is compatible with the preservation of health. 2 ., He is to satisfy himself that the drainage, latrines, urinals, &c, &c,arc in a good sanitary condition. That the rations are good and of proper quantity ; that the kitchen utensils arc sufficient and in good order ; that the cooking is well done and the diet sufficiently varied ; and that the meals are regularly and properly served. That the lavatories and baths are ample for the number of men, arid that the baths are sufficiently used. That the games and gymnastic exercises are so conducted as to contribute to the health of the troops and to prevent injury. That the supply of water is abundant and good ; that the wells are properly covered, and that there is no soakage from cesspools, drains, &c, into them. He is to . examine into any sources of any local malaria in the vicinity of the garrison, station, barrack, camp, or hospital, with a view to recommending suitable precautionary measures in regard to them. INSPECTION OF HOSPITALS. The Medical Inspector is to satisfy himself that the drainage, ventilation, clean- liness, water supply, water closets, latrines, urinals, and sinks of every hospital are in good condition, and that the means of warming and lighting the hospitals are sufficient. That the excreta of the sick are promptly removed from the wards. That the sick have suitable means of cleanliness, and that the baths and lava- tories are sufficient and in good condition. That the vicinity of the hospital is in a good sanitary condition. He will also satisfy hirnself as to the cleanliness and sufficiency of the bedding, linen, ward furniture, and utensils. As to the sufficiency of the kitchen arrangements and utensils. As to the quality, variety, and cooking of the diets. That the diet tables are in accordance with Regulations, and properly hung up in the wards. That the medical attendance and nursing of the sick are sufficient. He should ascertain whether there has been any unusual amount of disease or mortality originating within the hospital. Whether erysipelas, hospital gangrene, fever, dysentery, cholera, or any other epidemic disease, has shown ifsclf among the sick or attendants ; whether wounds heal easily, and cases of disease recover rapidly. He should endeavor to trace to its cause any epidemic that may exist, and, in consultation with the medical officer in charge, decide upon the means of preventing or mitigating such disease. He shall satisfy himself as to the state of the surgery, the quality and supply of medicines and medical comforts, and the means of preparing and dispensing medi- cines. 3 As to the condition and sufficiency of the surgical equipments and instruments. As to the state of the hospital stores. As to the state of repair of the hospital. As to the state of discipline of the hospital, and whether due order and quiet are observed, and the orders of the medical officer properly attended to.. He should listen to all complaints or disputes in the Medical Department, and endeavor to arrange them so that the service may not suffer. He is to inspect the operating rooms, dead rooms, and post-mortem rooms, to Bee that they are suitably provided with tables and other appliances, and are clean, well supplied with water, well ventilated, and warmed, if necessary. He is to inquire as to the arrangements for the burial of the dead, whether they are sufficient to prevent injury to health, and whether they are properly attended to. INSPECTION OF CAMPS AND FIELD HOSPITALS. In the inspection of camps and field hospitals, the Medical Inspector will note the situation of the same relative to supplies of water and fuel. He will observe the character of the soil, whether it is tenacious and clayey, or open and of easy drainage. Whether the surrounding country is mountainous and hilly, and the immediate locality with a good surface drainage, or level and difficult to be relieved from the natural fall of water, either in snow or rain. He will note the prevailing winds, and also local currents caused by neighbor- ing hills and mountains. He will also observe whether the vicinage is subject to malaria from marshes and rivers, or to any other local cause of disease. lie will observe the police of the camps and hospitals. Whether the tents are too crowded, and whether they are sufficiently ventilated. Whether they are struck and pitched upon new ground as often as is necessary to health. Whether the tents are of good quality and good kind, and sufficient in number to protect the men. Whether there is sufficient attention to the construction of sinks and cesspools, and to the proper filling and care of the same, and to the removal of offal and rub- bish from the limits of the camp, &c, &c. Whether the camping ground has been occupied before, and if so, how recently. He will also examine into the cooking arrangements lor both regiments and hospitals. Whether the officers arc diligent in inspecting the food cooked for the men, to see that it is well and sufficiently done. 4 Whether any effort is made on the part of officers to provide portable ovens, for the purpose of giving fresh bread to the soldiers. Whether they make as adequate provision for a supply of fresh, vegetables as circumstances will admit. Whether the men are dirty and slovenly in their dress and person, and whether the officers are diligent in enforcing the discipline necessary to obviate such evils. He will observe the state of the clothing of the men. He will ascertain the number of hospital tents to each regiment; the state of transportation for sick and wounded men, and for the medical and hospital supplies ; and whether the accommodations are sufficient for the wants of the sick, in the peculiar circumstances then and there existing. He will inquire if the regimental medical officers are present witli their corps, and if not, the cause of absence. To prevent loss of time, the inspecting officer should at once give any advice, in writing, that may appear requisite, on any matter included under these instructions, to the commanding officer and medical officer of the regiment or corps, sending a copy thereof to the Medical Director ; and as soon as his inspection is completed, he should report in detail to the Surgeon General, stating fully all defects in the medical, sanitary, and statistical departments of the service, the recommendation he lias made, with the result of the same, with any suggestions for improvement that may occur to him. INSPECTION OF TRANSPORTS, In the inspection of a transport, the Medical Inspector will ascertain whether the tonnage, height between decks, superficial area, cubic space, and means of ven- tilalion, are adequate for the number of troops or sick to be embarked. That the ship is clean, the bilge sweet; that the water closets are sale, ample. and in good order : and that means prescribed in General Regulations for fumigating the vessel are at hand. That the passage ways leading from the upper deck to that occupied by the troops are protected by temporary houses, p'-operly constructed and secured : and that the stairs or ladders are furnished with a hand-rail of wood or rope. That the bunks are properly constructed and are sufficient in number : and. when sick are to be transported, that they are supplied with the necessary bedding and furniture. That the cooking apparatus and utensils are sufficient in all respects, and the stores and water supply of good quality and abundant. That a suitable place is reserved for a hospital and properly furnished, and that the medical and hospital supplies are in due pri. portiou. Fhould the Medical Inspector find any defects in the above particulars, he will 5 immediately report the same, in writing, to the Military Commander charged with the embarkation of the troops, together with any recommendation he may deem necessary to remedy the said defects : and will also transmit a copy of his report, together with the results, to the Surgeon General. Upon the arrival of troops or sick at any port of disembarkation, the Medical Inspector detailed for the duty will immediately visit and examine the vessel and the state of health of the men on board. He will ascertain what casualties have oci Hired during the passage, and the number of deaths. Whether suitable provision had been made for the health and comfort of the troops, and whether the vessel was kept in good sanitary condition during the voyage. Whether any defects in the sanitary outfit were discovered during the voyage. The Medical Inspectors will report the results of such inspections direct to the Surgeon General. Medical Inspectors are authorized and empowered to discharge from the service of the United States any soldier or enlisted man, in the permanent hospitals, laboring under any physical disability which makes it disadvantageous to the service that he be retained therein. The certificate of discharge shall show that it is granted upon personal inspection of the soldier, and with the soldier's consent; and shall specially docribe the nature, origin and degree of his disability. All such discharges are to be reported to the Adjutant General aud Surgeon General. Medical Inspectors are also charged with the duty of designating to the surgeons in charge of military general hospitals and camps, all soldiers who may be* in their opinion, fit subjects for discharge on surgeon's certificate of disability, or suffi- ciently recovered to be fit for duty, In all such eases, they will direct the surgeon to discharge from service or return to duty, as the case may be, all soldiers so designated by them. [Signed] W. A. HAMMOND, Surgeon General Otkh'ial: Jos. R. Smith, Surgeon JJ. S. Arfiiy. * ^