Chapter X: Letter I: received from the Gentleman whose Care I left him (4)

9. That for the better executing these Regulations, orderly Serjeants or Corporals be appointed for the Care of the Men; who shall mount a Guard of six or more of such of the Patients of the said Hospital as are fit for this Duty--That the Serjeants are to call a Roll of all the Patients regularly three Times a Day, before Breakfast, Dinner, and Supper; to see that the Men behave themselves soberly and decently; and that they keep themselves clean, and commit no Riots; and to confine in the Guard such as commit Riots and other Irregularities, or whom they find drunk, or who stay out all Night; and to report the same to the Officer on Duty.

10. That an Officer on convalescent Duty do visit the said Hospital daily at the Times of Roll-calling, to see that every Thing be carried on properly; and to receive the Reports from the Serjeants, and give what Orders he may think proper for the better regulating the said Hospital.

11. That if at any Time it should happen that there are more Convalescents than the Hospital can hold conveniently, a Review be made of all the Patients, and the strongest and most healthy be sent to Billet.

12. That a Review be always made, when any Party is going to join the Army, to pick out the Men who are fit to join their Regiments.

The Physical Officers employed in the Military Hospitals, are Physicians, Surgeons, and Apothecaries.

No Person ought to be appointed a Physician to the Army, or Military Hospitals, without previously undergoing the same Examination at the College of Physicians, as those do who enter Fellows and Licentiates of the College, that none but proper Persons may be employed. On such Examinations the Physician General to the Army ought to be allowed to sit as one of the Censors of the College.

The Surgeons are all obliged to pass an Examination at Surgeons Hall before they are appointed, and the Apothecaries ought in like Manner to pass an Examination at Apothecaries Hall.

The Mates employed in the Service ought, previous to their Appointment, to be examined both in Surgery and Pharmacy, as the Service commonly requires their acting in both Branches.

The Direction of all Military Hospitals ought always to be committed to the Physicians, who have the immediate Care of Hospitals.

When an Army is acting on a Continent, and there is a Number of Hospitals in different Places, the Physician who attends the Commander in Chief ought to be made Physician General and Director of the Hospitals, with proper Appointments; and all Orders from Head Quarters ought to go immediately thro' this Channel.

Every other Physician at the different Hospitals ought to direct every Thing about the Hospital which he attends, and his Orders ought to be punctually obeyed; and he ought to keep up a constant Correspondence with the Physician General; acquainting him from Time to Time with the State of the Hospital, and what is wanted for it; and he ought punctually to obey whatever Orders he receives from the Physician General.

If there be separate Hospitals for the Surgery Patients, the eldest Surgeon ought to direct every Thing in the Hospital he attends; and when any Thing is wanted for his Hospital, to report the same to the Physician General.

The directing and purveying Branches ought never to be entrusted to the same Person, as the Temptation of accumulating Wealth has at all Times, and in all Services, given Rise to the grossest Abuses, which have been a great Detriment to the Service, as well as to the poor wounded and sick Soldiers, and has occasioned the Loss of many Lives. And therefore neither the Physician General, nor any of the Physicians or Surgeons of the Army, or any other Person concerned in the Direction of the Military Hospitals, ought ever to act as Purveyor or Commissary; nor ought they ever to have any Thing to do with the Accounts, Contracts, or any other Money Affairs relating to the Hospital; and if ever they be found to intermeddle in these Affairs, they ought to be immediately dismissed the Service.

The purveying or commissariate Branch ought to be entirely distinct from the physical. The Purveyors or Commissaries ought punctually to obey whatever Orders they receive from the Physicians or Surgeons; to provide every Thing for the Hospital; to keep regular Accounts of all the Men who come into, or go out of the Hospitals; and from Time to Time to make Returns to Head Quarters of all the Men in Hospitals; and their Accounts ought to be controuled by such Persons as the Government may think proper.

Every Physician and Surgeon of a Military Hospital ought to visit the Sick at regular stated Hours, and the Mates to attend and go round with them, and receive and execute their Orders.

Every Mate ought to have a certain Number of Patients allotted him, for whom he is to make up all Medicines, dress all Sores, and execute whatever Orders he receives from the Physician, Surgeon, or Apothecary. That the Mates may know and execute their Duty, proper Orders in Writing should be hung up in the Apothecaries Shop for that Purpose. The following are those which I gave out at all the Hospitals I attended in _Germany_.

_Orders for the Mates._

1. That all the Gentlemen do attend at the Apothecaries Shop every Morning at eight o'Clock, to assist in making up the common Medicines of the Day, and afterwards to go round the Hospitals with the Physicians and Surgeons.

2. That every Mate have a Book for writing the Prescriptions of the Physicians in, which is to be kept in the following Order.--First, to mark the Patient's Name and Regiment; then the Day of his Entry into the Hospital and his Disorder; then the Prescriptions of the Physician; and after all the Day of his Discharge, or of his Death. _Ex. gr._

_John Clarke_, 20th Regiment. _Jan._ 1. Fever.

_Jan._ 1. V. S. unc. x.--H. salin. cum pulv. contrayerv.
4r. die.--2. Emplast. vesicat. dorso, &c.

Discharged or dead _Jan._ 28.

3. That every Mate make up himself the Physician's Prescriptions for his own Patients, and afterwards go round and administer them, or give them to his Patients with proper Directions; that he bleed his own Patients, and dress any slight Sores they may have, which do not require their being sent to the Surgery Hospital.

4. That every Mate go round amongst his Patients in the Evening, to see that every Thing is well conducted, and to report to the Physician or Apothecary if any Thing extraordinary happens.

5. That two of the Mates attend all Day at the Apothecary's Shop to receive any Sick that may arrive, and to place them properly; to make up what Medicines they may immediately want; to order each of them a Mess of Water Gruel; and if any Thing extraordinary occurs, to send an orderly Man to acquaint the Physician or Apothecary with the same. The orderly Mates to make up likewise for Officers, or others, all Prescriptions sent to the Apothecary's Shop through the Day.

A Joint of Meat, roasted or boiled, for Dinner, and a Bottle of Wine, was allowed to the orderly Mates, by Lord _Granby_'s Order, that they might not absent themselves from their Duty.--Where there was Conveniency for it, a Mate lodged in the Hospital.

The Apothecary ought to take Care of the Medicines; to go round the Hospitals in the Morning before the Time of the Physician's visiting; to see that the Wards are in proper Order; that the Nurses and other Servants have done their Duty; to examine into the State of the Sick, and to see that the Provisions are good; and make a faithful Report of all these Things to the Physician when he arrives.--To take Care that the Mates prepare in the Morning the Medicines that are commonly wanted for the Day; and that they afterwards make up faithfully the Prescriptions of the Physician; to go round the Hospital again in the Evening, to see that the Sick have got their Medicines regularly; and to make the same Enquiries as in the Morning.

The Apothecary should always be lodged near the Hospital, to assist in Case of any Accidents happening, or of Sick arriving at the Hospital.

When there are any strong infectious Disorders in Military Hospitals, the physical Gentlemen may use the following Precautions to guard themselves against Infection.

1. Never to visit the Sick with an empty Stomach; but to eat Breakfast before they go into the Hospital.

2. To have a Suit of Cloaths reserved for visiting the Hospital, and a waxed Linen Coat to wear above them in going round the Wards; and as soon as they have come out of the Hospital, to wash and change their Linen and Cloaths.

3. Before they go into the Wards, to order that they be well cleaned out, and sprinkled with Vinegar, and afterwards fumigated, and aired by opening the Windows, or by Working the Ventilators.

4. If the Infection be very strong, to take a Glass of the spirituous Tincture of the Bark just before they go into the Hospital.

5. To put small Rolls of Lint, dipped in camphorated Spirits, up the Nostrils, and to direct a Vessel, with warm camphorated Vinegar, to be carried round, and held near the Patients they are examining.

6. In examining Patients affected with the Petechial Fever, or any other malignant Distempers, to stand at some little Distance, and ask what Questions they may think proper; and when they come near, to feel the Pulse, and examine the Skin, not to inspire while their Head is near the Patient's Body; but after being fully satisfied in these Points, to retire a little, and ask what other Questions may be necessary.

It would be right to establish some military Rank for every commissioned Officer of the Hospital on Service, and to settle the same Subordination in the physical as in the military Department. By these Means, the Service would be carried on with greater Order, and more Advantage to the Sick.

And it would be right, in Times of War, to add a Clause in the Mutiny Bill to allow any military Officer on convalescent Duty to call in the commissioned physical Officers to assist in making up a Court-Martial, when there are not a sufficient Number of military Officers in a Place, to try convalescent Soldiers guilty of Crimes. For in Times of Service, very often a sufficient Number of military Officers cannot be spared to be on Duty at the different Military Hospitals; and at all such Places the Convalescents are generally very disorderly, when they know that there is not a sufficient Number of Officers to form a Court-Martial for punishing them. Where-ever there are a sufficient Number of military Officers, no physical Officer ought ever to be called upon as a Member of a Court-Martial.

Men, in Time of Service, are often apt to saunter in and about Hospitals, and there learn all Manner of Debaucheries, and lose all Sense of Discipline; and therefore, to keep up Order and Decorum, there ought to be, at every Fixed and every large Military Hospital, a military Inspector or Commander, an Officer of known Activity and Probity; and a Number of Officers on convalescent Duty sufficient to form a Court-Martial whenever required.

The Duty of the Military Inspector, or Commander, should be, to take Care of all Convalescents on Billet; to see that the Officers under him do their Duty, and maintain the same Regularity and Discipline among the Men belonging to their respective Corps, as if they were with their Regiments; and that the Men attend the Parade and Roll-calling; and that they always appear neat and clean.

He ought, from Time to Time, to visit the Hospitals; to see if they are kept clean; to enquire if the Men behave well, if the Diet is good, and the Officers, Nurses, and Servants, do their Duty; and if he finds any Thing amiss, to report the same to the Physicians and Surgeons of the Hospital, or to the Purveyor or Commissary, or others, under whose Department it may be, that the same may be immediately rectified; and if he finds that the superior Officers of the Hospital overlook such Abuses, notwithstanding his Representations, to report the same immediately to the Head Quarters.

He ought to order one of the Officers on convalescent Duty to visit the Hospitals daily, to make the Enquiries above-mentioned, and to give him a Report of the same in Writing.

The Purveyor or Commissary ought to make a Return to him twice or thrice a Week of every Man admitted into, or discharged from, the Hospitals, or who dies in them; marking in the Return the Name of every Man, and the Company and Regiment he belongs to; that he may report the same to the Officers of the different Brigades or Regiments.

The Military Inspector ought to have the Power of providing Billets for all Officers and Soldiers about Hospitals; and the Names of all Men to be discharged from Hospitals should be sent to him the Day before they are discharged, that he may provide Billets for them; and next Day the Men ought to march from the Hospitals to the Parade, to receive their Billets, and the Orders of the Military Inspector, and of the Officers of the Corps they belong to.

The Military Inspector ought to see that the Arms of the sick Men, and the Arms and Cloaths of those who die and are lodged in the Magazines, be properly taken Care of; and that the Stores of the different Regiments be properly looked after.

As the Service often makes it necessary at Military Hospitals, where the Number of Sick is great, to employ the convalescent Soldiers[163] as orderly Men and Servants about Hospitals, all Men thus employed ought to have a special Leave from the Military Inspector for so doing; and no Man should be employed in any Capacity as a Servant about an Hospital, who at that Time is on the Books as a Patient. And all Men employed about the Hospital ought to be reviewed once a Week by the Military Inspector, and likewise whenever a Party of Convalescents is going to join the Army, or their Regiments; that no Man may be allowed to remain with the Hospital, after he is fit to do Duty in his Regiment.

[163] In the _French_ Hospitals there are always a Number of
Men who attend their Sick who belong to the Hospital, so that
they have no Occasion to employ their Convalescents, as we
are often obliged to do, where the Sick are attended by
Nurses, who are commonly Soldiers Wives, and not so capable
of doing such laborious Work as the Men.

When the Military Inspector is absent, the eldest Officer on convalescent Duty ought to act in his Place.

Every Officer sent on convalescent Duty ought, as soon as he arrives at the Place where the Hospital is, to wait on the Commandant, or Military Inspector; to acquaint him of his Arrival, and to receive his Commands. He ought then to go to the Purveyor or Commissary's Office, to get a List of all the Soldiers who are in or about the Hospital, and belong to the Regiment or Brigade he is employed for, wherein those on Billet are distinguished from those in Hospitals. The next Day he ought to parade all those marked on Billet, to see if the Number of Men agrees with the List given him, and to examine in what State each Man is, and how he is employed; and then he ought to go round the Hospitals, attended by an orderly Serjeant, to see all the Men in the Hospitals, and to know if the List given him at the Purveyor's Office was right; and afterwards he ought to send every Day a Serjeant or Corporal to see the Men in Hospitals, and to report to him when any Men are discharged or die.--And he ought to procure from the Military Inspector a Return of all the Men of his Corps, who are either admitted into, or discharged from Hospitals, on the Days when such Returns are made. He ought to make all his Men on Billet appear regularly on the Parade at Roll-calling, and to oblige them to keep themselves clean and their Arms in good Order, and to endeavour to preserve the same Regularity and Discipline as when they are with their Regiments. And whenever a Party is to be sent to join their Regiments, he ought to have all his Men particularly examined; and those Men who are found to be perfectly recovered, should be sent to their Regiments.

If every Officer on convalescent Duty conform to these Directions, no Man can ever be detained without his Knowledge in or about Hospitals, as he must always know where every Man is, in what State of Health, and how he is employed; and may at any Time be able to make a Return to the Brigade or Regiment for which he is employed, of every Man who is admitted, discharged, or dies in the Hospital.

FINIS.