| Page 265 |
| Article I |
| WHEN a Surgeon is appointed to one of His Majesty's Ships, he is to repair on board without loss of time, and be constant and diligent in the execution of his duty, strictly complying with his instructions, and observing all orders he shall receive from his Captain or Commanding Officer for His Majesty's service, and never absenting himself from his duty without leave.
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Surgeon when appointed to repair on board without delay. |
| Article II |
| He will be furnished, on application to the Sick and Wounded Board if on a home station, or to their Agent if on a Foreign station, with medicines and necessary utensils agreeably to the rules of the Navy, and he will be required to provide at his own expense such surgical instruments as, the said Board shall judge necessary, a list of which will be put on the back of the warrants given by that Board to every Surgeon and Assistant.
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He will be furnished with medicines, on application to the Sick and Wounded Board at home, or to their Agent abroad.
Surgical instruments to be provided at his own expense. |
| Page 266 |
| Article III |
The Surgeon is, at the end of every twelve months, to write to his Captain, requesting his application to the Commander in Chief or senior Officer present to direct a survey on the medicines, bedding, and other articles placed under his charge, which survey is to be taken by two or more Surgeons of the Fleet, who are to certify and report the quantity and condition of the medicines, utensils, stores and instruments on board; this report the Surgeon is to transmit to the Agent of the Sick and Wounded Board, in. order to his being furnished with such further supply of the different articles as may appear necessary
The Surgeon is not to repeat his demand within the year, unless the Ship shall be ordered on Foreign, or on a detached service; or unless, in case of extraordinary emergency, a particular statement of the circumstances of which is to be submitted to the Board if on a Home Station, or to accompany the demand to the Agent of the Board if on a Foreign Station.
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To apply for a survey on medicines, bedding &c. at the end of every twelve months.
Quantity and condition to be reported to the Agent of the Sick and Wounded Board.
Not to repeat his demand within the year except on particular occasions. |
| Article IV |
| When he shall be informed by his Captain, or Commanding
Officer, that the Ship is destined for Foreign or detached service, he is forthwith to complete his medicines, necessaries, &c. accordingly, in order as much as possible to prevent the necessity of purchasing; but if it should happen from any unforeseen cause, that his supplies shall be expended at a time when he nay not have intercourse with a Naval Hospital, or be enabled to obtain. a supply from another Ship, he. is to represent to the Captain the Necessity of purchasing a supply, and having obtained his order for so doing, he is to make the necessary purchases, observing that the medicines are to be examined by two Surgeons of the Squadron or, if no other Ship be present, by the Physician and Surgeon of a British factory, if there be one, who are to certify that they are of a proper quality before they be allowed to be administered to the sick; but when necessaries or other articles besides medicines are ordered to be purchased, they are to be inspected by the Master and Purser of the Ship, who are to certify to the quality and quantity that were actually received on board; and he is to draw bills for the payment of medicines, necessaries, &c. purchased as aforesaid, on the Commissioners' for sick and Wounded seamen, according-to the form (No. 32) in the Appendix. |
To complete his medicine when Ship is destined for Foreign Service.
How to proceed when a supply shall be necessary.
To draw bills for medicines, necessaries, &c. on the Commissioners for Sick and Wounded Seamen. |
| Page 267 |
| Article V |
| When he shall be appointed to succeed another Surgeon, he is to request the Captain to apply to the Commander in Chief, or senior Officer present, to order two or wore Surgeons of the fleet, to survey the remains of medicines, necessaries, and every other article of Surgeon's stores, which remains are to be delivered over to the charge of the newly appointed Surgeon; one Copy of the report of the survey is to be transmitted to the Commissioners for Sick and Wounded Seamen, and another delivered to the Captain.
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When appointed to succeed another Surgeon, to apply for a survey of the remains of medicines &c. |
| Page 268 |
| Article VI |
| A proportion of necessaries for the use of the sick teeing allowed for each of His Majesty's Ships for the Home and Foreign service, correspondent with the number of the complement as set forth in form (No. 33) in the Appendix, he is to apply for the same to the Agent for the Commissioners of Sick and Wounded Seamen, and when any supplies of necessaries shall be received on board they are to be inspected by him, the Master and Purser, who are to certify whether the quantity and quality agree with the established allowance, and if they do not the defective articles shall be returned, and all deficiencies made good.
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To apply for the necessaries allowed for the use of the Sick.
To be inspected by him, the Master and Purser. |
| Article VII |
| He is to take care that the medicines and necessaries, with which he is supplied, are faithfully administered for the relief of the sick and wounded, and that no part of them be either ''Wasted, or embezzled, or applied to any other purpose than that for which they were furnished, and he is to make affidavit to that effect, as often as he shall peas. his accounts. |
To take care that the medicines and necessaries are faithfully administered ; that no waste or embezzlement is made. |
| Page 269 |
| Article VIII |
| When directed by the Captain to inspect men newly received on board, he is not only very carefully to examine their persons, to discover whether they have any disease, or are is any other respect unfit for the service, but he is also to enquire very particularly in what situations they have been for some time past, that be may be able to judge whether there be any risque of their carrying an infectious disorder into the Ship, that if there be, proper precautions may be taken to prevent it. |
To inspect minutely men newly received into the Ship.
To enquire what situation they have been in. |
| Article IX |
| The Patients are to be removed to the sick berth when the Surgeon shall judge it necessary and he is to request the Captain to allow such a number of the Ship's company as maybe requisite to attend the sick night and day as nurses, and he is to make due representation to the Captain, should he find in any of them negligence, or want of tenderness in the performance of their duty; he is to take particular care that medicines and drink be provided every evening in sufficient quantities, to last until morning; and as drink to the sick, particularly in fevers, is essential to their comfort and recovery, he is to give the most positive directions, that the nurses and attendants offer and gently press it upon the patients every hour, or oftener according to circumstances, although the patients may nut ask for it;. and he ins further to, request the Captain to cause him to be furnished with a proper number of buckets with covers, and any other articles which be may find necessary for the sic berth. |
To remove patients to the sick berth when he judges it necessary.
To be careful that medicines and drink be provided every evening. |
| Page 270 |
| Article X |
| The Sick Berth, and every person appointed to attend on the sick, are to be under his immediate directions. He is to see that the berth be kept as clean as possible and that it be washed with vinegar, whenever he shall think it necessary, and he is to apply to the Captain to give orders for its being fumigated, whenever it may require it.
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The sick berth and persons appointed to attend the sick to be under his directions. |
| Article XI |
| When teen are taken ill of fevers, which he suspects to be infectious, they are to be stripped on their entry into the sick berth and, if practicable, washed with soap and warm water, and to have clean shirts and night-caps on their going to bed, their own bedding and the clothes which they have worn to be immersed in boiling water, and washed before they are returned to the men's chests, and the mattresses, blankets, sheets, &c. of the sick are frequently in suitable weather to be hung up separately on lines for the purpose, that they may be purified by ventilation. |
Men taken ill of fevers suspected to be infectious to be stripped on entry into the sick berth, their clothes to be immersed in boiling water and washed. |
| Article XII |
| When ulcer becomes prevalent among the Ship's company, he is to represent to his captain the propriety of separating and dressing the ulcerated patients at a distance from each other, observing with the strictest attention that all the dressings and foul bandages be immediately thrown into a bucket of boiling water, and that the dressings be afterwards thrown overboard, experience having fully demonstrated that the process of boiling destroys every kind of infection.
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How he is to proceed in cases of ulcer. |
| Page 271 |
| Article XIII |
Hair mattresses, sheets, linen-caps, pillow-cases, and all necessary utensils for patients confined to bed being allowed, together with soap for washing them when dirty, and for cleansing the persons of the sick, he is to give particular directions to the assistants acting under him that the patients be kept in a state of perfect cleanliness.
He is to be particularly attentive to see that the mattresses, sheets, caps, and all the other articles supplied for the use of the sick, are weld taken care of, that no part of them be embezzled or used for any other purpose than that for which they were supplied.
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To give particular directions that the patients be kept in perfect cleanliness.
To be attentive that the mattresses, sheets, &c., are properly taken care of. |
| Article XIV |
| He is to regulate the diet of the sick according to their several symptoms and disorders; this is to consist of a certain proportion of their sea victualling, restricting them in regard to salt provisions, and such other articles as be may judge improper for their complaints, and employing their Oatmeal in making gruel and sowins [see also flummery : made from the husk of the oat], their flour in making soft bread or puddings ; these, together with their molasses or sugar, when allowed ; and raisins, the necessaries in his charge and portable soup, will constitute a wholesome diet for the sick. For such cases, as in his opinion, require wine, at a time when beer or spirits are served, he is to apply to the Captain to direct the Purser to supply in lieu thereof such a quantity of wine as he may judge necessary, not exceeding one pint for each man daily ; and he is to take particular care to note, in his Journal, the cases for which be may have required wine, and to give a receipt to the Purser for the quantity with which he has furnished them. In case any of the articles supplied by the Purser shall be deficient in quantity or improper in quality, he is to represent the same to the Captain for such directions being given as he may judge proper. |
To regulate the diet of the sick according to their several symptoms.
To apply for wine in such cases as may in his opinion require the use of it. |
| Page 272 |
| Article XV |
| When fish are caught for the Ship's company, he is to give the Captain a list of the men who stand most in need of such refreshment, that they may be the first attended to. |
Distribution of fish when caught for the Ship�s company. |
| Article XVI |
No patients are to be sent from the Ship to an Hospital, or or sick quarters more especially in tropical climates, when they can conveniently be cured on board, unless where infection exists.
When fresh provisions cannot be procured for the Ship's company, such of the sick as shall require it may, by the Captain's directions, be victualled by the Agent of any Naval Hospital, the Surgeon making a demand approved by the Captain for the quantity required, according to the form (No. 34) in the Appendix, and giving receipts for the quantity supplied. |
Men not to be sent to an hospital or Sick quarters when they can be cured on board.
Sick requiring fresh provisions may be victualled by the Agent of any Naval Hospital. |
| Page 273 |
| Article XVII |
| He is not to confine his attention alone to the sick berth, and those that may be actually sick: but he is to be attentive to every circumstance that occurs, which may in any degree affect the health of the men, whom he is at all times carefully to observe, and if he discovers the appearance of disease or indisposition in any man he is to examine him though he make no complaint, and finding his suspicion well founded, be is immediately to take such steps as may be necessary for his cure, that by an early attention to every disease, the cure of it in the individual may be more speedy, and the communication of it to others may, if possible, be prevented ; and for the better effecting this purpose, he or one of his assistants is to be present at all Musters.
Upon long cruizes or voyages, when there is not a sufficiency of lemon-juice for the whole number of men on board, he is, in his inspection of the Ship's company from time to time, to co endeavour to ascertain whether any of their have obscure symptoms of sea scurvy, too slight to make it necessary for them to withdraw from duty, and to be put on the sick list, and also to enquire what men have been longest on salt provisions, and making out a list of such men, he is to present it to the Captain, in order that he may give directions for their being supplied in preference with the usual allowance of lemon-juice and sugar, put into the charge of the Purser for that purpose.
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To be attentive to the whole of the Ship�s Company as well as to those who may be actually sick, and to be present at all musters.
What description of men are to be put on the list for lemon-juice and sugar. |
| Page 274 |
| Article XVIII |
| He is to keep every thing necessary for dressing wounded men in such a state of readiness that he may be perfectly prepared, although the Ship should be suddenly brought to action. And whenever the Ship shall be cleared for action, he is with his, assistants and others appointed to attend him to repair to the Cock-pit, or such other place as the Captain shall appoint, where a platform shall be prepared for the reception of the wounded men He is to instruct all those stationed with him, and all others whom the Captain shall appoint, in the use of the tourniquet, many of which when clearing for action shall be distributed to the different quarters, two or three at least being being sent into each top to be applied whenever it may be useful, that the Wounded men may suffer as little as possible from the loss of blood, while they are waiting until he shall be able to attend to them and to dress their wounds. |
To have in constant readiness every thing necessary for dressing wounded men.
To repair the Cockpit when the Ship shall be cleared for action.
To instruct all such as the Captain shall appoint in the use of the Tourniquet, two or three of which are to be sent into each top. |
| Page 275 |
| Article XIX |
| He is to visit the sick and wounded men under his care twice at least every day, or oftener if the state of their health or wounds shall require it, and he is to see that his assistants also visit them and report their condition to him, as often as may be necessary, and that all who are appointed to attend them are at all times as attentive to to them as their situations can possibly require.
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To visit the Sick and Wounded Men twice at least every day and his assistants as often as may be necessary. |
| Article XX |
| If among the sick there be any whose diseases appear to be dangerous or difficult to cure, he is to inform the Captain thereof that application may be made for the assistance of the Physician of the Fleet whose directions, after he shall have seen the patients, the Surgeon is always to follow.
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To report to the Captain dangerous or difficult cases, in order that the Physician of the Fleet may be sent for. |
| Article XXI |
| He is to have a stove with clear-burning cinders in the sick berth, as often as possible, not only for the comfortable warmth of the patients, should the climate and season require it, but to prevent dampness and purify the air.
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To have a Stove with clear burning cinders in the Sick berth. |
| Page 276 |
| Article XXII |
| He is every morning to represent to the Captain the state of all those who are unable to attend their duty, describing their cases in a book, agreeably to Form (No. 55) and submit his opinion on the steps proper to be taken for their comfort and accommodation, and to report particularly any whose distempers may be infectious, in order that they may be sent out of the Ship, or if that cannot be done, that they may be separated from the rest of the sick and the Ship's company, and means taken to prevent the progress of disease.
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To represent to the Captain the state of such as are unable to attend their duty, and to report particularly those whose distempers may be infectious |
| Article XXIII |
When from bad weather the lower deck-ports of Ships of the line cannot be opened, and the leakage from those ports, and the breath and perspiration of the men sleeping below render the space between decks replete with moisture and noxious effluvia, tending to produce disease and generate infection, he is to submit to the Captain the propriety of keeping the Ship as dry and sweet as circumstances will admit, for which purpose he is to recommend that iron pots or hanging stoves with burning cinders be carried between decks, into the well, and every other part of the Ship in which they can be placed with safety, where the air is stagnant and offensive from defect of ventilation.
He is also when infection shall exist, or there shall be cause cause to suspect its existence, with the Captain's permission, to fumigate every part of the Ship, by difusing the vapour of the nitrous acid : with the materials for performing which he will be supplied by the Commissioners for Sick and Wounded Seamen; directions for conducting the process being given in (No. 36) in the Appendix.
During this fumigation the bedding and clothes of the men are to be opened, spread loose and detached, so that they may be completely pervaded by the vapour.
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To submit to the Captain the propriety of carrying iron pots with cinders between decks when the lower deck ports cannot be kept open.
To diffuse the vapour of nitrous acid when infection is supposed to exist.
Bedding and clothing of the men to be opened during fumigation. |
| Page 277 |
| Article XXIV |
Sickness and mortality among seamen in tropical climates, having been observed to be chiefly occasioned by the duties they are required to perform on shore, and Peruvian Bark with wine having been found to be useful as a preventative, he is when his Ship shall be in such climates to request of the Captain a list of the men who are to be sent on shore on wooding or watering duty, and to administer to each man, previous to his leaving the Ship in the morning, a drachm of Bark in half a gill of sound wine, and he is also to give to each man the like quantity of wine after he shall have taken the bark; and alike quantity of bark and wine proportioned in the same manner is to be given to each man in the evening of the same day on his return to the Ship, particularly observing that the bark administered for this purpose is always to be given in substence, and not in tincture. As wine is allowed to Ship's companies on such stations he is to make application to the Captain for some of the best of the wine supplied for the Ship's use, to be reserved for this purpose. If it should happen that any men are to remain on shore all the night, he is to furnish the Officer commanding them with a sufficient quantity of bark and wine, mixed together according to the proportion before-mentioned, for their use.
The Surgeon is to observe attentively the subsequent state of health of the men to whom the bark shall have been thus administered, and to report fully to the Commissioners for Sick and. Wounded seamen his opinion of its effects. |
Peruvian bark and wine and on what occasions to be given.
To report to the Commissioners of the Sick and Wounded the effects of administering Bark and Wine. |
| Page 278 |
| Article XXV |
| It having frequently occurred that the crews of Ships on their passage to England, after having been long in a warm climate, have been destitute of clothes, except such as were adapted to their former station, and that on their arriving in the northern latitudes, particularly in the winter season, great numbers have been seized with rheumatic and pulmonic complaints as well as other dangerous diseases, evidently arising from a deficiency of warm clothing ; he is therefore previous to their sailing to submit this matter to the Captain's consideration, that he may take such steps as be may judge expedient for procuring an adequate stock of suitable clothing.
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To propose to the Captain suitable warm clothing on the return of a ship from a warm climate. |
| Page 279 |
| Article XXVI |
When men having infectious diseases are to be sent to an hospital, the Surgeon is to give as early information as possible of such intention to the Governor or Physician of the hospital, that preparation may be made for their being received without any risk of their communicating the infection to others.
After the sick are landed, he is to represent to the Captain the necessity of the Ship's being thoroughly purified, and of repeated fumigations, also the advantage of fires in the different parts of the Ship, and a proper admission and perflation of the external air, with a view to eradicate the seeds of infection.
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To give notice when men having infectious diseases are to be sent to an Hospital to the Governor or Physician of the Hospital.
To represent to the Captain the necessity of fumigations &c. after the sick are landed. |
| Article XXVII |
| When sick men are sent on shore to an hospital or sick quarters, or on board an Hospital Ship, the Surgeon is to send to the Physician or Surgeon an account in writing, sealed up, of the manner in which they were first seized, of the nature and progress of their disorder, and of the means which have been used for their cure, particularly specifying any reason he may have for suspecting any of their complaints to be feigned.
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To send an account in writing of the cases of Sick Men to the Physician or Surgeon of the Hospital, &c. |
| Page 280 |
| Article XXVIII |
| Whenever there shall be men on board who, from the general state of their health, or the particular nature of their hurts or diseases are no longer fit to serve in His Majesty's Navy, he is to report them to the Captain that they may be surveyed, but he is to be extremely careful not to suffer himself to be deceived by the feigned complaint of artful men, who wish to obtain improperly their discharge from the service.
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To report to the Captain such as from ill health or hurts are no longer fit to serve in the Navy. |
| Article XXIX |
| He is to be provided at all times with a competent number of Smart Tickets, which will be delivered to him on application to the Commissioners for Sick or Wounded Seamen, or to their Agents at the out-ports.
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To provide himself with Smart Tickets. |
| Article XXX |
| He is to give a Smart Ticket to every man who shall be so wounded or hurt in the service as to make it probable that the Chest at Greenwich will grant hum a Pension, or such smart-money as may be worth the time and expense of his going to obtain it. This Ticket in which be is to describe minutely the nature of the wound or hurt is to be made out, before the man leaves the Ship, and not afterwards unless in cases where it shall appear that the wound or hurt has proved of more serious consequence than was at first apprehended, and he is to deliver it to the man himself, if he be be discharged from the Ship, but if he be sent to an hospital, it is to be delivered by the assistant who goes with him to the Surgeon of the Hospital, to be given by him to the man on his discharge therefrom.
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To give a Smart Ticket to every man so wounded or hurt in the Service as to make it probable the Chest at Greenwich will grant him a pension. |
| Page 281 |
| Article XXXI |
| He is to make out every two Months a list according to Form (N�. 37) in the Appendix, of all such Seamen and Marines as may have received wounds or hurts during that time, which may entitle them to relief front the Chest at Greenwich, distinguishing such of them as shall have received Smart Tickets, and such as have not, a copy of which list, signed by himself, he is to deliver to the Captain, to be forwarded with the Muster Books to the Commissioners of the Navy; and he is also to send a general list of all such wounded or hurt Seamen or Marines, specifying such of them as may have received Smart Tickets, as above directed, to the said Commissioners, when he shall leave the Ship, or when he shall apply for his Pay, without which he will not be allowed to receive it.
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To make out every two months a list in the form of (No. 37) of all such seamen and Marines as may have received Wounds and Hurts. |
| Article XXXII |
He is to keep a Journal of his practice, noting the disease and symptoms, with the medicines, daily prescribed, according to the Form delivered to him on his appointment (No. 38) in the Appendix, which Journal is to be sent to the the Commissioners for Sick and Wounded Seamen, with the other papers necessary for passing his Accounts at the expiration of each year, and not oftener, unless in case of his quitting the Ship. He is also to give a general history of the prevailing Complaints in the Ship during the above periods, and if any malignant or infectious diseases shall have existed, to trace them to their source, and to account for their introduction, stating the means used to destroy the infection and prevent its re-appearance. He is also to note therein the particulars of those cases in which he may have demanded wine of the Purser.
If the Crew shall have been healthy, he is also to state in his Journal what has been the general economy of the Ship. |
To keep a Journal of his practice, noting the disease, the symptoms, and the medicines daily prescribed. |
| Page 282 |
| Article XXXIII |
When the Ship shall be in any Port in Great Britain, he is not to fail to transmit regularly to the Commissioners for Sick and Wounded Seamen, a weekly return of the state of the sick, signed by himself, with remarks and observations according to the Form (N�. 39) in the Appendix.
When the Ship shall be Abroad, a like return, containing his observations for two Months, shall be transmitted by him when the Captain sends home his Monthly Books, stating in the remarks the effect of the weather and the climate on the health of the men.
When the Ship has been on a Cruize, one general return is to be made on his arrival at any Port in Great Britain.
In every return the names and qualifications of his assistants are to be inserted.
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To transmit a weekly return to Commissioners of Sick and Wounded when the Ship be in any Port of Great Britain.
A like return every two months when abroad.
A general report on the return of the Ship from a cruise. |
| Page 283 |
| Article XXXIV |
| He is to transmit with his Journal before required, an account according to Form (N�. 40) in the Appendix, of the receipt and expenditure of the medicines, utensils and other articles placed under his charge, to the truth of which he is to make affidavit. On leaving his Ship he is to obtain his successor's receipt for the medicines, necessaries and other articles delivered over into his charge, and in the event of the Ship being paid off be is to return such articles as may remain in his charge to the Agent of the Sick and Wounded Board, taking his receipts for them to accompany his Accounts. |
To transmit with his Journal an account of the receipt and expenditure of Medicines, Utensils, &c.
To obtain his Successor�s receipt for Medicines, &c., delivered to him on leaving his Ship. |
| Article XXXV |
| He having the charge of the lives of so many useful subjects of this kingdom, who from crouded accommodations, the nature of their. diet, the varieties of weather and climate, and various other circumstances, are liable to infectious fevers, as well as to scurvy and chronic complaints, and also to accidents from wounds or hurts, &c. incident to their mode of life: The guarding against and counteracting these evils will depend very materially on his own resources and promptitude in applying the most speedy remedies according to circumstances: and as sickness in the most favorable situations on shore in some degree depresses the spirits, much more must it affect his Patients on board of Ships of War, laboring under so many inconveniences which cannot be remedied ; under those circumstances it becomes his duty to sooth and clear their minds by the most humane attention, to hear with patience all their complaints, and redress whatever they may think grievances by every expression of conciliatory kindness, which will naturally inspire them with confidence, exhilarate their spirits, and add to their hope of recovery, to which it cannot fail to contribute. |
A kind and attentive conduct to be observed towards those under his charge. |
| Page 284 |
| Article XXXVI |
| He is to obey all directions, which he may at any time receive from the Commissioners for Sick and Wounded Seamen, relating to the application of medicines, or the treatment of the sick, and he is to give them all such information as they may require, and in such forms as they shall point out respecting the state of the men under his care, and the means be makes use of to cure them, and he is to communicate to them all observations he may have made which he conceives may be beneficial to the service, and to propose to them all such measures as he may think likely to contribute either to the health of the men immediately under his care, or to the preserving of the health, or promoting the comfort of Seamen in general.
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To obey all directions which he may receive from the Commissioners for Sick and Wounded Seamen. |
| Page 285-6 |
| Article XXXVII |
| It being considered expedient, in consequence of the great advantages mankind have derived from the discovery of the Vaccine Inoculation, that the practice thereof shall be extended through His Majesty's Navy, to effect which he is hereby directed to advise all such Patients as may be put under his care with chronic diseases, or such other as may be in a state of Convalescence, who are known to have hitherto escaped the small Pox, or who are even doubtful of having had that disease, to be inoculated with the Vaccine Virus ; should any person object to such Inoculation, he is, with a view to overcome their prejudices, to represent the advantages and harmless nature of the operation and its subsequent effects, that there, is scarcely ever more than a day's or even an hour's Indisposition, and in the majority of cases there is even no such Indisposition ; that the security against the small Pox is certain provided the Inoculation be instituted, and precautions taken to ensure its success ; that no deformity attends thus Inoculation because there is no Eruption ; that there is no known known subsequent Disease occasioned, and that no Regimen or Medicines are necessary, except living temperately and using the arm Inoculated as little as may be from the eighth to the thirteenth day.
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To recommend the vaccine inoculation. |
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