................... .................. ................... ............_..... ................... ~.:.:.:.:.:.:5.:.:.:.:.:.:.:. ................... .................. 4 N&VY DEPARTMENT ~.;.::::::;:::j::::;;:;~::::; ...................

I__ F. W. . -- Farrar. - (MC). U.S.N. -1 .&

VOl. Friday, April 26, 1946 ,No. 9

Hepatitis: Cross Immunity Study ... 12 6 Penicillin: New Mold Strain .......... 13

Early Postoperative Rising ............ .6 Reports on Research Projects ..... .14 Bigeminal Rhythm in Normal Hearts ... 9 Transfer of Typing Laboratories ... 15 Experimental Granulocytopenia ....... .9 Rehabilitation Program of the IJSTJ..16 St. Louis Encephalitis V i r u s .......... 10 Army Industrial College Cbiirse .... 1 7 Penicillin in Neurosyphilis ............ 10 Transfer of Psychologistc; to USN..lt3 Experimental Cyanide Poisoning .... 11 Public Health Foreign Reports ...... 19 Benadryl in Anaphylaxis ............... 11 Medical Dept. Manual Changes ...... 19

Circular Letters:

Maternity Care in Naval Hospitals and Dispensaries.. .... ;. .... Joint1 ,tr ....... .20 Physical Examination of Officers Over 50 Years ' Old .......... .RuMed.. ....... .20 Decreased Potency of Penicillin., ................................... ..BuMed.. ....... .22 Inventory Control P rogram for 1946 (2nd Revision) ............ .UuMcd.. ....... .22 Manual of Medical Department: Advance Changes in ........... .BuMttd., ....... .24 Manual of Medical Department: Advance Changes in .... ;. ..... .BuIvIed ........ ..32 Officers (NC) USNR: Transfer to IJSN .............................. .EuMed ........ :.34 Medical Stores Requisition: Preparation of ....................... .BuNIt?d.. ....... .35 Disestablishment of Naval Medical Activi1.y.. ..................... .SecNav ........ .41 Establishment of USN Medical Center, Giiam.. ................... .SecNav ........ .41 VA Beneficiar ies Hospitalization of Emergent Cases ......... :BuMed.. ....... .44

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Report of Physical Exam f o r Transfer t c j Fleet Reserve ....... BiMed.. ........ 44

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(Not Restricted) Notes on Observations and Studies Made on the Effects of Atomic Bomb

Emlos ions a t Hiroshima and Nagasaki: Captain Shields Warren (MC), USNR, together with other Medical Department personnel under the direction of the Naval Medical Resea rcb Institute, Bethesda, Maryland, working with the Naval Technical Mission to Japaqmade a study of the biological effects of atomic bombs dropped a t Hiroshima and Nagasaki. Captain Warren 's group had the valuable collaboration of the investigators f rom the Manhattan District under Colonel Stafford L. Warren and the Joint U. S, Army Imperial Japanese Govern- ment Atomic Bomb Commission under the direction of Colonel A. W. Oughterson.

These notes constitute the mater ia l that can be released f rom D o c t o r Warren 's repor t and are essentially the same as presented by him a t a meet- ing a t the National Naval Medical Center, Bethesda, Maryland, and before the American Association for Cancer Research a t Atlantic City.

A distinctive feature of the atomic bomb is the large amount of radiant energy which it produces, Although this energy covers a wide range of the electromagnetic spectrum, i t s chief biological effects may be divided into two groups: f i r s t , the effects of heat, producing thermal injuries of the flash-burn type, and thermal injuries resulting f rom induced fires; second, the effects known through experimental studies of the biologic effects of X-rays. This radiant energy w a s produced in an instant.

Combined with and modifying and obscuring the thermal and radiation injur ies are the more usual effects of the conventional types of bombs. Air - blast injury was usually of the secondary type due to flying debris or impact against fixed s t ruc tures , producing f rac tures and ruptures of viscera .

The blast was highly destructive not only to the Japanese type of building which is of fl imsy wood with a heavy tile roof, but to modern s teel factory construction as well . Great numbers of people were pinned beneath the heavy tile roofs of the Japanese houses as they collapsed, and were crushed o r trapped .

The direction of the destructive effect of the blast was centrifugal except at the hypocenter (the projection of the t rue center on the ground) where it w a s essentially vertically downward. Some poles and trees ?emained stand- ing a t the hypocenter because of their smal l c r o s s section presented to the blast force. Those elsewhere were extensively leveled. The importance of streamlining in resistance to blast was well shown by factory smokestacks, the great majority of which withstood the

The thermal effects were striking in of the period during which they occurred.

shock.

their intensity and in the briefness Thus clothes, wisps of hair , o r

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*: (Not Restricted) even an a r m gave protection to the par t of the body it shadowed. The inten- s i ty of the heat and the instantaneous character of the flash are well brought out by photographs which show the profile of blades of g r a s s in relief against the burned background of a board bunker. The instantaneous and intense radiant heat burned the wood before the g r a s s had t ime to wither or' wave.

Many of the flash burns were of second o r third degree, and their t reat- . .. ment s o inadequate that se r ious contractures developed in the survivors. With the sweep of f i r e that fed on the shattered wooden buildings, many

secondary burns, f rom minor to fatal, were received by those trapped in the region a s well as by those attempting salvage o r rescue.

In studying the patients i t became apparent that there could be no clear segregation of the types of injury among them, but that a n individual might well be suffering f rom blast effect, thermal injury and radiation injury simul- taneously. Of the 80,000 people who died at Hiroshima and 45,000 who died a t Nagasaki, it is very difficult to say what proportion was killed by one o r another type of energy. Those persons who died as a result of short-wave radiation o r neutron effects a r e of p r imary interest . Since the biologic responses produced by these different types of energy are essentially s imi la r , they wi l l be considered together.

The character is t ic clinical course of those persons pr imari ly suffering from radiation injury a s a resul t of the atomic bomb explosions may be di- vided into two s tages . The immediate effects were manifested as weakness, malaise , fever and often death, and appeared usually within 48 hours; t h e delaved effects were manifested in a variety of ways.

The disorganization of the Japanese w a s s o great that no adequate ma- terial exists to determine the exact nature of the immediate effects. ' It may be assumed, however, that immediate effects would parallel experimentally induced changes in animals and represent the syndrome of radiation sick- ness car r ied to an extreme degree. It may also be assumed that little mor - phologic evidence other than leukopenia and lo s s of adrenal lipoid would be present.

Material o n t h e d e l a y e d e f f e c t s w a s much better. S t u d y w a s made to d e t e r m i n e t h e presence of a n y possible radiation e f f e c t s in the blood, hemopoietic s t r u c t u r e s , a n d the gonads which a r e known to be particularly irradiation-sensitive and in the hair follicles w h i c h a r e irradiation-sensit ive to a n appreciably l e s se r degree. Many of the patients showed evidences of injury of the irradiation-sickness type. In this group in addition to weakness, anorexia and weight loss , diarrhea was a prominent feature. Because t h e public health facilities of the region w e r e totally L-

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(Not Restricted) disrupted and both bacillary and amebic dysenteries were prevalent, it was extremely difficult to determine t h e cause of this diarrhea.

Excel1en.t cooperaticn was received from the Japanese authorities i r studying survivors . Over 100 were hospitalized by Doctor Warren’s group at the Omura Naval Hosyjital, and about 13,000 were made available for. d casualty survey.

In the cit ies and villages around Nagasaki and Hiroshima it was easy to pic-!< out the vict ims of radiant energy by the character is t ic flash burns and by t 11 e frequent occurrence of epilation which they presented. Scalp hair w a s lost while that of eyebrows, beard, axillae and pubis persisted. In many epilated persons some degree of regeneration of new downy hair was beginning to q- pear four months after the bombing.

The effect on the blood can be readily observed from the clinical mani- fc:-.tation.s as well as from the laboratory findings.

The re were three chief r roups of symptorn complexes resulting from d;Lma!:e to hemopoietic tissue. Although the groups overlapped to some de- greca, l i ~ y were quite distinctive.

‘l’lie first was the leuiiorjenic groug - in which infection, particularly a 1,iidwjg’s type of angina, war, tlie outstanding manifestation. The great Sulk of leu!~:oy:eniz deaths occurred during the f i r s t three weeks following the tx)nibinf:. Judging from the s tudies of Japanese investigators, the leukocytes i I 2 tkt1 c:ir*c,iilating blood were destroyed at the same time that the hemopoietic LI . . ; : . I IP i i v ~ a i : , tlam;q;cd, so I h t wliite blood cell counts as low 2s 200 p e r cubic rriii1 irrieier were found ill the f i r s t f ew days. , .

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ZNot Restricted) ‘l’he third was the anernic [:roup. Those with ser ious bone-marrow dam-

agc’ who weathered the f i r s t few weeks showed later manifestations of anemia with r e d blood cell counts in s o m c instances dropping to one million o r below. Zonie bone marrow:; as shown by sternal biopFy were extremely hyperplastic, while others were aplastic. The hemopoietic t issue attempts to regenerate sometimes to such a degree t a pseudoleukemic pattern appears i n t h e s te rna l marrow biopsy. In rclation to the aplastic: group there w a s one point of interest . Red marrow is rornmonly thought to be active hernopoictic m a r - row in contrast to the yellow fatty marrow. In many of these cases t h e aplastic marrow was r e d , t l u t i t s redness was due only to sinusoidal hypere- mia and there w a s no appreciable formation of blood elements. At t imes the niarrow w a s s o depleted that little but reticulo-endothelial cel ls appeared.

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The gonadal effect w a s much more prominent in the tes t is than in the ovary as would be expected. A1thoup;h a random sample of higli school g i r l s , who previously had been menstruat in[’; regularly, showed suppression of meristruation in a considerable nunibc,r, the probability of psychic shock anrl malnutrition niu:;? be weighed a

R1l-med News Let ter , Vol. 7, No. 3 A (Not Restricted) J

Activation of Ti:,sw L’lernents bv Slow Neutrol; Exoos~re : When tissue is eXIiosetI t o ~ I O w relilronS, reactions take plaL-e betwcen the neiitrons and the nrirlci vf the ~ a r i o u s :

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c Bilmed News Let te r , Vol. 7, No, 9

!Not Restricted) sitting position on the side o i the bed. The advantage of sitting up in this manner w a s that the patient ass is ted in ra is ing himself; he used the f l a n k rriuscles on the side opposite f rom his wound. A s the patient sat on the side of the bed his shoes were put on, and then he stood uy. an a footstool. lVh i 1 e standing on the footstool, he was encouraged L J breathe deeply and to cough severa l t imes af ter deep inspiration. This procedure was less painful than when the patient coughed in bed and was often effective in ra is ing mucous plugs f rom the bronchi. He was then encouraged to walk 8 o r 10 feet before si t t ing in a chair . On the first r is ing the patient remained in the chair about ten minutes, and then returned to bed in the s a m e manner as he rose. He was made to get up f rom bed twice each day. Usually by the third o r foiirth day he needed l i t t le o r no assis tance and could rise at will. The patient was encouraged to move freely about in bed and to breathe deeply several t imes each hour.

The patients who r o s e ear ly were considerably s t ronger and had less pain in their wounds than the others . They were able to c a r e for themselves on about the fourth postoperative day and were ready for discharge consider- ably ea r l i e r than the control group. Although no patients were sent home be- fore the seventh to ninth postoperative day in o rde r to allow time for the possible appearance of wound infection or . disruption, 64 p e r cent of the early- risifig patients were discharged before the .13th postoperative day while only 26 p e r cent of the control group were discharged by this time.

The incidence of wound disruption and wound infection was reduced in t h e ear ly-r is ing group. “Wound disruption” w a s defined as any woiincl in which the fascia w a s shown to ha1.e separated whether o r not the peritoneum remained intact. Among early-rising patients there was 1.1 per cent of wound disruption whereas in the late-rising patients, there was 2.8 pe r cent incidence of wound disruption. The incidence of wound infection among the early-rising pstients was 2.7 pe r cent as compared with 5.7 pe r cent in the patients who r o s e late. Th i s group included all types of infection including stitch abscesses . Al l of the wound infections in both series appeared in patients with potentially con- tam inat ed wounds.

The incidence of pulmonary complications was somewhat lower in the ear ly-r is ing group. The diagnosis of a te lectasis was made on patients on a clinical basis if there was a postoperative rise in temperature associated with rales and a n elevated resp i ra tory rate in the absence of other demonstra- ble cause f o r fever . The diagnosis was a l so made if there was X-ray evi- dence of atelectasis. The incidence in the group rising the f i r s t day was 4.3 Per cent and 6.3 pe r cent in the late-rising group. This reduced incidence of postoperative atelectasis may have been due to increased respiration and

0 more effective coughing, especially when the patient was standing and his diaphragm could descend to lower levels.

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cal wounds was seen in both groups when the cases were divided with respect to the location of the abdominal wound. It was significant that no case of nitelectasis occurred in the patients with low abdominal wounds who rose on the f i r s t day.

The familiar g rea t e r incidence of a te lectasis in upper abdominal verti- r I

Although the incidence of atelectasis in males who remained in bed was iligh, it was unusually low in those who rose on the first d,ty after open t ion . I’he incidence among the females of the two groups was essentially the same. There w a s no significant variation in the incidence of a te lectasis in eilhcr rrroup whether ether o r spinal anesthesia w a s used. The influence of the ;x:c f:iTtor repeated the familiar pattern of increasing incidence of atelectasis :.:rith advancing age in both groups. Sjnce atelectasis most frequently :ippe:irs cliiring the first 48 hours after operation, it is bes t to get the patient ill) froiri bed as soon as possible within that period if r ising is to have a signific.xiL Yffect on preventing atelectasis .

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Pneumonia was such an infreqiient comp?!ii::it ion tliat it did not perrriit ~omp:trative analysis.

ii’zrly rising i s apparently rin! th:) answcr Lo I h:. i)roblerri of postoperative I :r1oii:; thrombosi:;.

‘I’liere may be cer ta in pre2:iutionc which c i r i be cibscrve(1 to rainimize

3 ~ J I - r r ~ ~ ~ s c l e t rauma when patients r i s e f rom bed. ? ’ h e x arp, however, I iliri.lly im;iortant r t ! driy time ic the postoperative period.

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1. Bigeminal rhy!hm due to premsture ventricular contractions may occur in the absence of heart disease and in the absence of digilalis intoxi- cation o r other detectable cause.

2. Bigeminal rhythm occurs commonly in those individuals with i r r e p - la r ly occurring premature ventricular beats, in which cases the coupling of the beats usually occurs only in short intermittent periods. Less cominoi,!;l, it rrtay be constmt and pers i s t for weeks o r months. 'I'h2t the latter may QC- cur in individiAals with normal hear ts i s a fact not cenerally r*ecoer,izcij.

3. Bigeminal rhythm occurs most frequently in feniales and is apparently related in most instances to some emotional disorder. Usually when the errio- tional disturbance is eliminated, the arrhythmia disappears.

4 . The mechanism of prodlietion of the arrhythrriia in otherwise normal individuals is unknown. (Am. J. M. S e . , March '46)

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(Not Restricted) Therapeutic - -- Effect of ---- L. Casei Factor in E:xuerirnental Granulocvtopenia

Produced bv Thiourea and Thyroxin: - A study by Daft et al, of the National Institute of Health, U. S. Public Health Service, Bethesda, Maryland, was summarized by the authors as follows:

Rats given thiourea in a purified diet develop anerrii:t arid, in l e s se r inci- dence, leukopenia. They also IJevelop liemorrhagc and necrosis of the adre- rids. Animals which receive, :oon~:orriitaritly, thyroxin injection:; o r thyroitl powder become granulocytopenic 2nd leukopcni,:, while the iucidence of anemia

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(Not Restricted) and of adrenal hemorrhage and necrosis i s gre;ttly reduced. The granulo- cytopenia and leukopenia of these rat:; may be corrcched by treatment with the L. case i factor. (P roc . SOC. Expcr. D i d . and Med., Feb. '46)

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(Not Restricted) St. Louis Encephalitis V i r u s in the Blood of Exr)erimentallv Inoculated

Fowls and Mammals: F r o m a study of the experimental inoculation of fowls dud mammals with the v i rus of St. Louis encephalitis, Hammon et al. con- clude:

1. Of three species of mammals tested by peripheral inoculation (guinea pig, cat , and horse) none showed viremia under conditions which suggested that any of these species would serve a s a frequent source of mosquito infection.

2. Of the b i rds tested (chicken, duck and dove) all developed viremia and might readily se rve a s natural sources of mosquito infection. Chickens were shown to be very highly susceptible to infection by minute amounts of virus inoculated subcutaneously.

3. Virus has appeared in the blood of chickens within 16 hours a f t e r inocu- lation,and i t has pers is ted until at least the 120th hour. No fowl showed any sign of i l lness as a resul t of the infection. (J. Exper. Med., March '46)

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Trea tment of Neurosmhil is with Penicillin: This is a study based on 197 patients with neuFosyphilis treated with penicillin and followed for more than 120 days.

Definite improvement in spinal fluid occurred in 74 pe r cent, and normal and near-normal spinal fluids were achieved in 36 per cent of the total s e r i e s of neurosyphilitic patients without regard to diagnostic category. Paret ics showed a 62 pe r cent definite improvement but no negative fluids. Normal and near-normal fluids were, however, obtained in 39 per cent of paret ics a n d taboparetics combined, 57 per cent of tabetics, 60 per cent of asymptomatic neurosyphilitics, 45 pe r cent of meningovascular syphilitics and 63 per cent of congenital neurosyphilitics. In the ent i re s e r i e s ; 6 fluids (3.5 per cent) became worse. Over-all clinical improvement of some degree occurred in 65 pe r cent of asymptomatic neurosyphilitics, 24 per cent improved strikingly, 41 pe r cent improved slightly and 9 pe r cent became worse. Thir ty .per cent of paret ics , 31 per cent of tabetics and 1 7 per cent of meningovascular cases improved markedly.

low dosage (1.2 to i e s s than 4.8 million units) and high dosage (4.8 to 10 million units and over) . However, there is a slight trend toward superiority in the

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hi1.ht.r dosage br:tcket. So far there is no conspicuous good effect demonstra- ble f rom m e r e repe!ition of courses , but the prolongation of th2 good effect of o x course is striking. The good effect of penicillin on the spinal fluid i s con- tinlled over weeks and months after administrxtion. The maximum effect is 1iz~i211y secured in the first 120 days; but improvement and final normality rnay follow c v m an unsatisfactory o r atypical ear ly trend. Asymptomatic neurosyphilis most often exhibits the maximum effects in 120 days; pares i s does s o the leas1 often. Relapse may occur in fluids that have become negative, but re lapse to the oricinal formula o r severi ty has not occurred in this series.

A comparison such as this, between results f rom a cooperative clinical group using older methods including chemotherapy and fever therapy, and re- sul ts with penicillin observed by the authors suggests that treatment with peni- cil l in will be found after further experience to equal o r exceed the efficacy of malariotherapy either alone o r following chemotherapy. In asymptomatic neurosyphilis, penicillin ranks far above other methods as a reducer of the spinal fluid to o r towards normal. A single course of not less than 4.8 million units g i v e n regularly throughout the 24 hours of each day for not less than 7.5 days, using penicillin sodium in saline solution intramuscularly, will in the authors ' experience make the best start and usually an adequate total therapy for the majority of ca ses of neurosyphilis. Observation should b e ca r r i ed over at least a year in the absence of convincing evidence of progres- sion before the effects are evaluated and further measures adopted. (OEMcmr- 403, Stokes and Steiger, Univ. of Pa., MS. for publication - CMR Bulletin #75>

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Nit r i te Protection APainst Exgerimental Cyanide Poisoning: It has been I demonstrated that ni t f i tes , with thiosulfate, aff0r.d a definitp protection against

injected cyanide. The mechanism involves the formation bf methemoglobin in the circulaling erythrocytes.

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This work has been extended to hydrocyanic acid in gaseous'form. Dogs, maximally protected, show no obvious symptoms for over a n hour in a n a t - mosphere so concentrated in cydnide that the control (unprotected) animal succumbs within 2 minutes. When protected dogs finally lose consciousness, they recover much more rapidly when rescued than do unprotected animals. The unprotected ones frequently fail to recover . (OEMcmr-51, B a s s a n d Sal ter , Yale Univ. - C M R Bulletin K74)

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L Modification of Anaphylaxis bv Benadryl: A study was urldertakenby Wells et al. t o determine t h e effectiveness of Benadryl (beta dimethylaminoethyl benzhydryl 1 in the prevention of anaphylactic shock in experimental animals.

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(Not Restricted) Irnmunitv ;rid Ctrc);:: - Irnrr/iiriity in I~onioloEous Serum Henatitis and Infcc-

- ’ i o u ~ k b i d e i i i i c ) I€etxi t ii i:,: I n the November issue of the American Jo:ir.nal ( ~ f hlt,clic:tl Scipni-es, N~lefi > , S ~ O K ~ : ; and Gellis made a preliminary report of ~ 1 1 ~ rc::ult:; obtainod in ;In cxperiincrital study in humans of immunity a ri d cross immunity to the infective ,zgents of homologous se rum hepatitis and i r i f c :: L ic 1. ; (ei)l d~ m ic 1 11 ella t i t is.

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Hr~~rioI ogou:; s e rum hepatitis and infectious epidemic hepatitis have :;ecfer;tl character is t ics in common. Both etiological agents p a s s through 1, Lciprial f i l t e rs and are not destroyed-by heat a t 5 6 O C. for 30 minutes. 130th a]:-,, produce sirrii1:tr clinical rrianifestations. However, with infectious I i q d itis the patient’s t einperature is elevated above 100 degrees , t rans- r r L k z i m i s common and the causative agent is found in the feces. Infectious !icdi\;Atilis may be prevented or attenuated by means of human immune se rum, globulin, o r human adult plasma. The presence or absence of c r o s s immunity Lt.lwc-:n infectious 1ii.paI itis and hornologous se rum hepatitis has n o t b e e n ,,:t:Lt)li:;hed. Six hurnari volunteers recovered f rom homologous s e r u m hepa-

4 ii i; : ? i d l a te r failed to develoi tiny a *utc clinical rnaiiifestatioris upon re- jnfJ *~i la! ion with the same c:aiiLrtti~.Jc: I ~ ~ e n t , whereas 8 of 9 volunteer norrrial : f i r i t l ’ 0 1 4 ~ developed hepatitis and j:tiiiidice. The 6 volunteers who had r e - c * w e r t d irorri horriologcus serum hepatitis were next irioculated with material :oritaining the etiological agent of infectious hepatitis, and as a resul t 5 again dc vr>lclped h~pat i t i r , . Coritrols inoculated orally contracted epidemic hepatitis, bii! t ‘i’he i i i ~ - i i t ~ t i o r ~ period of s e rum hepatitis exceeded 60 days, whereas that of inic\>l iou:; hepatitis did not exceed 37 days.

corilrol:; whi :I1 were inoculated parenterally did not develop the disease.

The authors believed that the lack of c r o s s immunity between the two dise:xe:; resulted from differences in the antigenic propert ies of the two

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ctic’loeic agents. (Surg., Gynec and Obst., April ’46 - Shafiroff

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In 1940 the original Brit ish workers were t:ettirig about two units of ;)enicil l in f rom every cubic centimeter of the broth in which the mold js cul- i u red . A f t e r i t was brought to this country, efforts raised [he production figure to xbout fifty units by August 1342. About that t ime a stock laboratory culture known as NRRL-832 was iound which rrl:i.de i t possible to grow the iriol,j i!i l u g e aerated tanks instead of on the surface of shallow flasks. With illat stra-in and with the surface s t r a ins the United State; went into major pro- ( l i iz ! ion in 21 pla!its. Yields slowly increased to about 100 unit s, while m oi-g;triizcd f-ff0l . t to find new s t ra ins w a s begun.

The next s tep w a s the s tudy of a s t ra in of penicillium chrvsogenum on tlic ztem of :1 spoiled melon contributed by a Peoria housewife to the Northern I?r>j-ion:d Research Laboratory. Early tests of this cu l ture which b e c a m e h r i o i v i i xs N R , R l , - l ~ F , l jumped production s t i l l fur ther , and with fiirtlier refine- ~ r , f!t of a n-itlira1 variaiit known as NfZRL-1951-1325, production in one typical i(Jr;l serics increased to an average of 169 units, with a high of 245.

Meanwhile efforts were begun in several laboratories to develop 0 1 k r . variet ies by art if icial means such as X-rays, ultraviolet r a y s o r chemicals.

& A group of promising spore variants actually were di:veloped with X-ray:;. After preliminary testing a dozen o r more hopeful ones we1-e sieved out. Flask

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Meanwhile, two spore:; of X-1612 were picked out at random, and desig- nated P and Q. From these, two lines of progeny were s tar ted and cultured carefully to avoid contamination. The millions of second-generation spores were then exposed to ultraviolet light. The ultraviolet wave length employed was 2650 Angstrom units which is highly effective in producing variants and at the same time highly fungicidal, so that a n hour's exposure of 10 c u b i c centimeter suspensions of each containing f rom 2,000,000 to 4,000,000 spores killed all but a few of the spores .

It was from among some 500 survivors of the two culture series f rom the P and Q, spores that the test cultures were made. Nothing of great im- portance appeared until Q,l76 was reached in the screening test when it was found that the yield from this s t r a in was markedly higher than that f rom the parent s t r a in X-1612 used as control.

Tank-test char t s indicated an average production for Q1'76 of 761 units with a high of 004, compared with the 369 average established by X-1612.

Research continues for a more efficient penicillin-producer despite the possibility tha1 chemical synthesis of penicillin might eliminate dependence on natural production. (Wisconsin Alumni Research Foundation)

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Abstracts of Report:; on Research Projects: (Copies are available upon (Not Restricted)

re quest .I

X-591 Develwment of ;I. Garbage Can Washer and Steril izer for Mess Halls.

Of var ious rnodels tested, a washer which operates f rom h o t water and s team lines proved most efficient. It was demonstrated by the use of this washer in a rriess hall over a period of severa l months that (1) garbage cans could be rapidly and efficiently

odors could be eliminated, and ( 3 ) the number of flies in and around the garbage roorn could be notably decreased.

c'leaned by one mar!, (2) encrustation of grease and most garbage .- u

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. . . - .

Washington National Record Center Office of the Army Surgeon General Record Group 112 Accession #: s%e %.\ Box#: S S File: a . h + w S o n ,w T 4 . d WD- 39%

Eumed News Let ter , Vol. 7, No. 9

(Not Res t r ic led) X-591 (Cont.)

Plans a r c ~ivailLil~le, and the wAsher cou!d be constructed and installed in mess halls by the plumbing shop facil i t ies a t m o s t naval station.;. (MediTal Field Research Lab., Camp Lejeune, N.C.)

B n t a l Anesthesia Induced by Local Refrirreratioa. X- 161

Histologic investigation oi nerves from canine mandibles sub- jected to continuous local refrigeration at Oo to 1' C . for two-hour periods did not disclose evidence of injury to either the inferior alveolar nerves , o r to the nerves of the rriucous membrane and perio-t eurn.

Fifty-two cavities were prepared for filling under local refrig- erat ion a t lo to 2O C. in the teeth of 33 members of the naval ser- vice. In 34 instances, complete anesthesia was obtained; in 13, very mild to moderate pain was experienced; and in five, there was little o r no anesthesia. (N.M.R.I., N.N.M.C., Bethesda 14 , Maryland)

X- 514 Biological Studies of Antimonv Compounds Containing Radioactive Isotopes: Evaluation of the Rhodamine-B Method for the Assav of - Antimonv i i i Biological Samples.

The limitations of the Maren modification of the Webster Rhodamine-B microchemical method for the determination of anti- mony in biological mater ia l have been studied by comparing i t s re- sul ts with radioactivity measurements on mater ia l containing com- pounds of trivalent and pentavalent radioactive antimony.

The microchemical method proved satisfactory for the analysis of urine, plasma, l iver and kidneys having antimony concentrations grea te r than 0.5 microgram p e r gram. However, fur ther modifica- tion is needed before the method can be used for the analysis of red blood ce l l s , whole blood and spleen. (N.M.R.I., N.N.M.C., Bethesda 1 4 , Maryland 1

* * * * * * (Not Restricted)

T rans fe r of -- Enteric Pathorren and Streptococcus Tming Laboratories: --+ During the week of 15 April 1946, the Enteric Pathogen Department and the Streptococcus Typing Department, which since their establishment occupied qua r t e r s in the Naval Medical School, were t ransferred to the Naval Medical Research Institute, PJationa1 Naval Medical Center, Bethesda, Maryland. These two activit ies are now incorporated with the Bacteriology Facility at N.M.R.I. which will operate f o r the present under the Eupervision of Commander L. A. Barnes , H W , USNR.

' -_ 1

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It is c'o~il-~~i~.j)latecl that investigative projects will be initiated concern- in? the \?tiolot,-y - m l zontrol of diarrheal disease in the TJavy and th;lt prob- lcrvls (ior1iisl:terl with str.e;)tococzal iii€ections wi l l be studied.

Because of the requirements for more rigid adherence to r e sea rch f u r r - :ions than has e x i s M in the past , it, has kecorne necessary to discontinue the routine typing of large .lumbers of pathogenic enter ic bacilli and b e t a - hctrlolytic strept ocoi:~:;~I cultures heretofore submitted b y various n a v a 1 lahoratoric,:, within the [Jnitcd States, aboard ships and overseas .

AlthcufTh routine examination and reporting of routine cultures will l~ r"- duced to a rninirnum, it is requested that subcultures of possible new types or unusual s t ra ins of Shigellas, Salmonellas, and beta-hemolytic Streptococci be submitted for further study. Such specimens should be transmitted to the Medical Offirc?r. in Clxnmand, Naval Medical Research Institute, N a t i o n 'z 1 Naval Iv/ledic,il Center', Bethesda 1 4 , Maryland, with pertinent clinical bac-terio- l y i c a l m t l e[)idemiolo[

13f-~~ned News Let te r , Vol. 7, TJo. 3

(Not Restricted) -- IJote: It j:; hoped that wilhin thc: near future arrangeincnts will have been made for the t r i I 1 : ; f c 3 r to the Fltq.hr PJavy of other special is ts and that such arr,ingc- men1 2; will ing.liide more favorctble age requirements , possibly equivalent to tlio.;e of t t i c ) PJiedical Corps .

Helore a cik2firiite commitment can be made, legislation will be required to e:' ibli:.h the SLKI (specialist duty only) designation. T h i s designation wi l l in;luclt;l the special t ies allied to medicine desired by the Medical Corps. (Research L)iv., Ruhted)

* * * * * * (Not fCestricted)

PLtblic Health Foreign .- Reports:

Disease Place -- Date Number 'if Cases

P 1 a. t;u e P-igeria, Oran Feb. 23-Mar. 2, '46 l ftli;il Ir:P;jrpt, Suez F n . 5-12, '46 3 fat ?.l

S rr 1 a. 111) ox Brit ish E. Africa

1 nd c c h i na (Fr e 11 i: h ,

Jan. 10-Feb. '3, '46

Lao:- State Feb. 12-19, '46 ,J (1 f , i t :q I

207 (,$ f a l l 1; ) Dahomey Feb. 11-20, '46 19 1

Morocco (French) Feb. 11 -20, '46 144 ::uci;tn (French) Feb. 11-20, '46 103

'r yp hu s Belgian Congo Feb, 2-9, '46 11:: Fever f;: l

. . . . . . _ . . . . . . . . . . . . . . . . .

Bumed News Let te r , Vol. 7, No. 9

C ir cular Le t te r 46- 56 26 March 1946 (Not Restricted)

To: Al l Ships and Stations.

Subj: Maternitv C a r e in Naval Hospitals and Dispensar ies for Members of the Women’sAeserves of the Naval Reserve , the Marine Corps Re- s e r v e , a x e o a s t G u a r d R e s e r v e , m e m b e r s of the Navy Nurse C o r m and the Nurse Corps , Naval Reserve , Who HaFexeen Dis- charged o r SeDarated From the Service While Pregnant.

---I--- --- -__ .-=-- - -----___- --

---- --- I-p--_ ~ _ _ _ _ _ -----a- ----______- -

I I-- --

Ref:;: (a) SecNav L t r 15 June 1945 (N.D. Bul, Item 45-613. (b) Joint BuPers-BuMed ltr 28 Aug 1945 (N.D. Bul, ltem 45-1032).

1. References (a) and (b) shall apply to all ca ses discharged o r separated f r o m the serv ice under honorable conditions other than because of pregnan:y Ilrovided that the condition of pregnancy can be reasonably determilied by 2 reinitable civilian physician o r naval medical officer as having exisled at t ime of d i x h a r g e . Such certification shall be accepted in lieu of thc le t ter of the Corrimanding Officer required by paragraph 3 of reference (a). --BuPJIed. 120:;:; T. McIntire.

- -BuPers . Louis Denfeld. - -Marcorps . A.A. V;tndwrift.

t * * * * *

c i r (cular ‘Letter 4 G - 6% 1 April 1946 (Not Restricted) To: MedOfConi, NavHosps (Continental).

Subj: Physical Examination of Officers Fifty Years of Age and Over. ----- -- -- Ref: (a) Bu.Pers Circular Letter 293-45, 3 Oct. 1945 (N.D. Bull, Item No.

(b) BuPer s L t r Pers-319- JAW, dtd 28 Mar 1946.

1. (HW) Copy of Ref (b).

45- 1440).

Encl:

1. In accordance with the provisions of reference (b), those officers who were to be examined in accordance with reference (a) and who failed to appear be- f o r e the traveling boards a r e to be examined by boards of medical officers in naval hospitals, convened by the Commandants of Naval Distr ic ts and Naval River Commands within the continental United States. These boards a r e to consist of at least three medical officers and one dental officer. 0

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. Bumed News Letter; Vol. 7, No. 9 1 'i /I (Not Restricted) f

2. The boards of medical officers r e fe r r ed to above a r e to examine such off icers as are r e fe r r ed thereto in accordance with the provisions of para- graph 6 of reference (a). It i s not desired that these boards be convened as statutory board:; nor that their repor t s be submitted formally as required by Naval Courts and Boards as in the case of statutory boards.

3. In the case.; of offil:ers who would otherwise be examined as provided in re ference (a) and who are on the sick list in a naval hospital, i t will be neces- s a r y only that a NAVMED-Y, in duplicate, be forwarded in each case with information to the effect that the officer concerned is on the sick list, and including ai)prok)ri,J,tc entry indicating the reason for hospitalization, t h e probable diagnozis and the prognosis in the case.

--BuMed. Ross 'I'. McIntire.

* *

-- E n c l o s u r e I (Not Restricted)

F r o m : The Chief of Naval Personnel. 28 March 1916 To: Commandants of Naval Distr ic ts and Naval River

Commands within the continental United States.

Sub j:

Ref:

Physical Examination of Officers Fifty Years of Age and Over.

(a) EuPers Circular Let ter 293-45.

1. In accordance with the provisions of reference (a) Naval and Marine c o r p s officer personnel of the regular se rv ices on the active list who will attain the age of fifty (50) during the calendar year 1946, and those officers over fifty (50) yea r s of age, a r e being examined by traveling boards of medical officer:;. In any case where above-mentioned officers fail to appear before either of the traveling boards the Commandants of Naval Distr ic ts and Naval R i v e r Commmds within the Continental United States a;e hereby directed to con- vene boards of medical officers in Naval Hospitals, consisting of at least three medical officers and one dental officer, to examine su'ch officers as soon as practicable in accordance with the provisions of reference (a) and such fur ther instructions as may be issued by the Bureau of Medicine and Surgery.

- -BuPers . T. L. Sprague.

* * * * * *

.

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ter 46-6:j 113 April 1946 (Not Restricted)

1 . c’iirrcint f:linicd :mi experirneritxl studies of the four f ract ions of penicillin, t I i s i r i f > l ; j , V , t:, X ani1 K indicate that fraction K posses ses the least antibiotic

i1:t ivity. ‘I’hi:, woiild d *c*ount for the decreased potency of cer ta in lots of peni- ( s i 1 1 in wlii1.h :Lmtain a:* m u ~ h :is 50 per cent of the “K” with a proportionate 11 ”re i . ,c i r i !he “G” fraction.

:?. T h t ~ fr-iztions of penicillin are identified by their fractionating index only, L. pr’ i(*t i 2 . 1 1 Lhemizal method;: of separation, identification and a s say , are not I : y ~ + . ~ v t i l : l b l e . This accounts for cer ta in gaps in our knowledge of t h i s i r i i i biot i >.

1. ‘[‘he 1 4 m u f i c t u r e r s of penicillin are alreauy undertaking the task of irn- p rov i i~ t ; the potPrlcy of penicillin by increasing the proportion of fraction “G” : l , f I he (2zpen::e r)f f raction “K”. However, there is bound to be a lag before t hi : , irriprqved product beeomer, available for distribution.

! ) . In ordLr rno.:t effectively to utilize the penicillin now in stock and under o r ~ l ~ ~ r , po:;sibly :ontLiinini; ~t high K fract ior , the BLzeau of Medicine and Surgery i.c>comnicnd.; that the do.;ap;e be based on the thcr lpeutic response.

--BuMed. Ross T. McIntire.

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3 . 'The physical inventory will cover all N a v y - ~ v ~ n c ~ l mater ia l except - (a) 1- lant i'iccount Matcr ia l . fb) Mater ia l earmarked and needed f:)r curreii t xhedu led construction. ( c l ) Material earriiarked and needed fo r cu r ren t repa i rs and al terr t t ims.

4 . Enclosure (1) establ ishes til? I hysical inventc~ry s c k d u l e which i s manaatory, so as to secu re uniformity. Should any activity find due to unusual c i r c u r n - stances , that the schedule cannot IX met, ;i repor t sctting forth the c i r 2 u :ri - s t ances will irnmediatcly be r r a d e to Matcrittl Divi:;ion, BuMed, Eri Ioklyn, N . Y . sc that zonsideration can be given to rfiodifyinq sciioduie f o r that activity.

5 . F rocedures outlined in fihclosure (2) shall be ioilclwed, and are suffiziently broad f o r application by addressees .

6 . P r o g r e s s Reports , Enclosure ( 3 ) , will be subrr,itI.d on 31 March, 30 June, 30 September and 31 December of each y e a r . Each repor t will show thc f olluwing data:

(a) Number of i t ems scheduled to be counted in the entire :sic.nllztr y e a r and number of i t ems actiially counted to the date of the 1 eport .

(b) Lercentage of i t ems scheduled to be counted, compared to iiiirri- b e r of i t ems sctually counted.

(e) Estimated, (by reporting periods), the total number of man hL:ur:; scheduled tc be required fo r the ent i re calendar year, and tlic man hours expended to the date of the repor t .

(d) I-ercentage of man hours estimated to be required, c,om~)ared to the man hours expended.

(e) Number of personnel engaged by the categurics: (aa) Officers (bb) Enlisted (cc) C: ivilians.

The € :ogress Reports will be submitted promptly to: I3urcau of Supplic:: a ~ i Accounts (DSI), with copies to Chief of Naval C>perations (01 -412), D i s i r i ut Supply q f f icer and Mater ie l Ilivisioii, RuMed, Broolilyri, l l . Y . ,

'e --BuMed. R o s . ~ T . Mclntirr?.

* Hecausp these ericlosures were forwarded with advance zopie:; to the addressees , they a r e not reprinted here .

Washington National Record Center Oflice of the Army Surgeon General Record Group 112 Accession #: 5$f3 10 qc\ Box#: F;s File: aiL5h-+W500 , bf-, A . d * /uD - 39 8

Burned News Let ter , Vol. 7, No. 9

C ir ci i 1 ar L, e t t e r 4 6 - 6 5 15 April 1946 (Not Restricted) UJotc: T1-c fJr(ler t o make t h i s Burned copy better se rve its

;~ l i~ i lose arid be of greater practical usefulness, the rli-tiiges directed in this c i rcular le t ter are arranged l i e r ~ so that after the lesser corrections have been i r i ; i c I f> , (mnr[;inal, etc., with pen and ink), t h e la rger one:; can be ( t i l t f rom these pages and pasted o r stapled i n the appropriate place in the nianual. --Ed.)

To: Al l Ships arid Stations.

Subj: Manual of the Medical Department, Advance Chanves in.

1. Since the 1945 edition of the Manual of the Medical Department was sent to the pr inter severa l changes have been issued in Circular Le t te rs without reference to the Manual. These changes have been compiled and are given below:

PART I, CHAPTER 2B. PAR UBll.lL Delete, and s u b s t i t u t e t h e following:

AND INACTIVE SIIIFS AND STATIONS -UBll.l - When an a c t i v i t y i s decommissioned o r placed i n i n a c t i v e s t a t u s the medical department corresvonc'ence f i l e s and records (except Property Records) s h a l l be properly arranged, packaged i n num- bered boxes or o t h e r s u i t a b l e con ta ine r s (numbering of boxes t o contain r e f e r - ence t o t o t a l boxes of' shipment, thus : and each box snd container inventor ied. r u p l i c a t e ; one copy t o be placed i n t h e appropr i a t e box or conta iner , one copy t o be submAtted t o t h e appropr i a t e Naval Records Management Center, one copy t o be t r ansmi t t e6 t o the Bureau, and one copy kept aboard t h e s h i p or s t a t i o n . A f t e r records have been packaped and i m e n t o r i e d , a l e t te r of n o t i f i c a t i o n of shipment s h a l l be prepared and s e n t a i r mail t o t h e appropr i a t e Naval Records Management Center. T h i s l e t t e r s h a l l state the approximate cubic footage and t h e gene ra l c h a r a c t e r of the records t o be t r a n s f e r r e d , and s h a l l a l s o have a t t ached cop ie s of t he i n v e n t o r i e s of t h e va r ious r eco rds containers . Carbon co?ies of t h e l e t t e r of n o t i f i c a t i o n and i n v e n t o r i e s s h a l l be sent t o BuMed. The packaged r eco rds may t hen be shipped t o t h e appropr i a t e Naval Records Uanagement Center. Naval Recorda Management Center, 80 Varick Street, New York, N. Y., w i l l serve a c t i v i t i e s i n t h e F i r s t and Third Naval D i s t r i c t s , Naval Records Management Center, Eastern Division, 253 North Broad S t r e e t , P h i l a d e l g h i a , Pa., w i l l serve a c t i v i t i e s i n Naval D i s t r i c t s 4 through 10, i n t h e F i f t e e n t h Naval D i s t r i c t , i n t he Severn and Potomac River Naval Connaands, and in t he European-Africa-Middle East area. Naval 5ecords Management Center, Nestern Divis ion, 417 South Spring S t r e e t , Los hngeles , C a l i f . , w i l l serve a c t i v i t i e s i n Naval D i s t r i c t s 11 t h r o w h 14, i n t h e Seventeenth Naval D i s t r i c t and i n t he A s i a t i c - P a c i f i c area.

TRANSFDi OF MEDICAL DEPARTMENT INACTIVE RECGiiDS AND RECORDS OF DECOWISSIONED

B o x No. 1 of 20, box No. 2 of 20, e tc . ) , Inven to r i e s s h a l l be prepared i n quad-

Washington National Record Center Oilice of the Army Surgeon General Record Group 112 Accession #: 594 10 %q Box#: F;S File: m.h+wsbo ,gc. A . d * fib - 39%

13anled News Letter , Vol. 7 , No. 0 --

(Not Restri2ted) PART I. CHAPTER 3. SUBPAR 1333.7L Delete, Itto t h e supply o f f i c e r of t h e s h i p s o r s t a t i o n s , v i a t h e medical department property o f f i c e r , for disposal" , and s u b s t i t u t e , Itto e i t h e r t h e Naval Medical Supply Depot, Oakland, Calif., o r t h e Naval Medical Supply Depot, Brooklyn, New York, d e F n d i n g upon whether t h e po r t o f e n t r y is on t h e n e s t or east coas t respectively.1t

PXIiT V. CHAPTER I. PAR 5- PACE L87. l i n e 4 the following: Itwhich were formerly h o s ? i t a l shipstt .

I n s e r t between t t t r anspor t t t and f t s h a l l l t

PART V. CHk?TER I. PAR 513. PA= L75, Delete; NAVMED-621, 622, and 623.

PART V. CHAPTER I. I'm 5& PAGE L78. Delete: ACRO FORX B. PMT V. CHAPTER I. ?AR 5127. PACES 193 and L94. Delete e n t i r e paragraph.

PART V. C H A ~ I. PAGE L79. TABLE (ReDorts Added Since 1 November 19L5. Add: MBlD - on Form - I n s e r t t tXf l i n a l l columns except U. PART V. CHA€TER I. PAGE L79. TABLE (Reuorts A dded Sinc e 1 November 1 9 a Add: Other t h a n I n t e r n s - Monthly - B a e d - Monthly - Par 5129(A) - Par 5129(A)- p l ace ttXt1 i n column 6.

PART V , CHAPTER I, PAGE 479. TABLE (ReDorts Added Since 1 November 19L5.1 Add: Monthly - P a r 5129(B) - Par 5129(B) - Place tlX1t i n column 6 ,

NAVMED-D - Transfer of Property Custody - BuMed - as required - PART V I ,

NAVMED-949 - Monthly Report of Medical O f f i c e r s Under I n s t r u c t i o n ,

NAVMED-953 and 953a - Roster Report of t h e Medical Corps - B a e d - FART V. CMmR lr Delete: Par 5l45.

The following d e l e t i o n s and a s d i t i o n s s h a l l be made i n t h e Index t o t h e Manual:

PAGE 507. Dclete l i n e s 53, 54, 55, 56, 57, r i g h t column.

PAGE m. Line 18, change 34l9.3 t o 3419.4, r i g h t column. PAGE 520. Line 114, change 3419.2 t o 3W9.3, r i g h t column.

PAGE 523. Line 11, change 3419.3 t o 3419.4, l e f t column.

PAGE 540. Add, preceding l i n e 63, l e f t column; IIReseme t o Regular Navy, 221Y .

PAGE 55a. Add, preceding l i n e 46, r i g h t column; 'IRostw Report of. - See NAVMED-953 and 953aIt, Add, preceding l i n e 3, r i g h t column; l t I n s t r u c t i o n of Medical O f f i c e r s . NAVMED-949tt. ' PAGE 556. Delete l i n e s 42, 43, 44, r i g h t column.

Washington National Record Center Oflice of the Army Surgeon General Record Group 112 Accession #: 5%f3 \0 q.! Box#: F;s

3 File: c3cc h-tf3f-500 ,w. T4.d * WD - 39%

(Not Restricted) PART 11, CHAPTER 1. SUBPAR 2152.2, 2152.2. of 20 v i t a l s e r v i c e a b l e t e e t h , i nc lud ing f o u r opposed molars, two of which are i n f u n c t i o n a l occlusion on each s i d e of t h e d e n t a l a r ch and f o u r in- c i s o r s which a r e i n func t iona l opposit ion. The s o f t t i s s u e s s h a l l conform t o a high s tandard. The t e e t h m u s t be free of caries and r e s t o r a t i o n s p re sen t must be of a high q u a l i t y , any, must be minor and good f u n c t i o n a l occlusion as w e l l as absence of i n t e r - ference with speech must be demonstrable.

Delete, and subs t i tu te t h e following: A candidate s h a l l no t be accepted un le s s he s h a l l have a minimum

The d e v i a t i o n from normal occlusion, i f

PART 11, CHAPTER 2. PAR 2212. TRANSFER OF RTSERVES TO REGULAR NAVY. - 2213.1. When a Naval o r Marine Corps Reserve o f f i c e r i s given t h e f inal phys ica l examinaticn f o r t r a n s f e r t o t h e r e g u l a r s e r v i c e , a new NAVMED-H-2 s h a l l be prepared and entered i n h i s h e a l t h record. The old NAW-H-2 shall be closed out, a t t ached t o , and forwarded t o t h e Bureau with t h e carbon copy of t h e new NAVMED-H-2. change i n s t a t u e should be noted on h i s h e a l t h record cover and on t h e new NAVMED-H-2, and an e n t r y made on NAVMED-H-8 showing t h e da t e , reason for, and r e s u l t s of t h e phys ica l examination.

Delete, and s u b s t i t u t e t h e f o l l m i n g r

The o f f i c e r ' s

2213.2. When an o f f i c e r o f t h e Nurse Corps Reserve i s appointed i n t h e regular s e r v i c e , t h e o r i g i n a l Health Record s h a l l be continued. H-2 s h a l l be prepare6 and entered i n t h e Health Record. The old NAVMED-H-2 s h a l l be closed and r e t a i n e d i n t h e Health Record f o r comparison and refer- ence. and on t h e abstracts.

A new NAVMED-

Appropriate no ta t ions s h a l l be made on t h e cover, current NkVMED-H-8's,

PART 111. CHAPTER 3& Add: Par 3319.13. ENDORSEEdENT STATEMENT.-A statement s h a l l be included i n t h e endorsement of t h e commanding o f f i c e r , i n d i c a t i n g whether t h e o f f i c e r has been r e t a ined under t reatment a t t h e h o s p i t a l , o r i f discharge6 from t h e s i c k l i s t , t h e nava l d i s t r i c t or l o c a l ac t iv i ty t o which t h e o f f i c e r concerned has been d i r e c t e d t o r e p o r t f o r temporary duty.

PART 111, CHAYTER L. SUBPARS 3,419, 2 and 31- : Delete , and s u b s t i t u t e t h e fol lowing :

3fJ9.2. Remains of Navy, k r i n e Corps, o r Coast G u a r d personnel who d i e on or a f t e r 1 January 1946 i n t h e Tenth, Fourteenth, F i f t e e n t h , and Seven- t e e n t h Naval Dist r ic ts , or on s h i p s which can t r a n s f e r t h e i r dead t o a shore a c t i v i t y i n one of t h e s e d i s t r i c t s , a r e t o be r e tu rned t o t h e United States.

3419.3. I n a l l o t h e r cases, remains of Navy, Marine, or Coast Guard personnel s h a l l be i n t e r r e d l o c a l l y . next of k i n upon r e c e i p t of t h e d i spa tch n o t i f i c a t i o n of dea th addressed t o t h e Sec re t a ry o f t h e Navy. A l l p r a c t i c a b l e measures s h a l l be taken t o pre- serve t h e i d e n t i t y of t h e remains, t h e records, and t h e personal e f f e c t s of t h e deceased, and t o l o c a t e d e f i n i t e l y and record t h e b u r i a l p l ace by proper geographical data , names, landmarks, c h a r t s , etc. t h e i d e n t i t y and l o c a t i o n of t h e deceased s h a l l be prepared and t r ansmi t t ed t o t h e Bureau i n t r i p l i c a t e on ,UVbED-601. paragraph 3W3 .

The Navy Department w i l l n o t i f y t h e

Information r e l a t i v e t o

Reference a l s q should be made t o

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I

Burned N e w s Let te r , Vol. 7 , No. 9

(Not Restricted) PACE 556. Add, preceding l i n e 45, r i g h t column; ItMonthly Report of

Medical O f f i c e r s Under I n s t r u c t i o n , Other t han I n t e r n s , - See NAVMED-949" . - PAGE 562. Add, preceding l i n e 10, l e f t column; "On Trans fe r t o Regular

Navy, 2213.1".

PAGE 564. Add, preceding l i n e l4, r i g h t column; ftNAVMED-D (Transfer of Property Custody), i n Tabulat ion of Report 513". '

PAGE 568, Add, preceding l i n e 47, r i g h t column; nEndorsement i n d i c a t i n g r e t e n t i o n f o r t r ea tmen t o r l o c a t i o n of temporary duty, 3319.13".

PAGE 571, Delete l i n e s 39 t o 5 1 inc lus ive , l e f t column.

Add, following l i n e 18, r i g h t column; nNAVMED-349 (Monthly Report of Medical Off icers Under I n s t r u c t i o n , Other t h a n I n t e r n s ) :

Preparat ion, submission, etc., 5129(A); i n Tabulat ion of Reports, 5131t .

Add, preceding l i n e 19, r i g h t column; t1NAVMED-953 and 953a (Roster Report of t h e Medical Corps) I

Preparat ion, submission, e tc . , 5129(C); i n Tabulat ion of Reports, 513'' .

PACE 572.

PAGE 582.

Delete l i n e a 7, 8 , 9, l e f t column,

Add, preceding line 48, l e f t column; !'Transfer of Custody, Report . & NAVh6ED-Dn.

PAGE 586. Delete last t h r e e l i n e s , l e f t column, and l i n e s 58 and 53, r i g h t column.

PAGE 587. Delete l i n e s 20, 21, 22, r i g h t column.

Add, preceding l i n e 54, l e f t column; IIMedical Officer under i n s t r u c t i o n . NAVMED-949'I . Add, preceding l i n e 53, l e f t column; "Transfer of Property PAGE 588. Custody. & NAVMED-D".

Add, preceding l i n e 2'3, l e f t column; V o s t e r ileport of t h e Medical Corps. See NAWD-953 and 953at1.

PAGE 552. Add, following l i n e 38, r i g h t column; "Roster Report of t h e Medical Corps. &g NAVMED-953 and 953an.

PAGE 592. PAGE 599.

Delete l i n e s 33, 34, 57, 58, 63, 64, 65, l e f t column.

Add, preceding l i n e 6, r i g h t column; "To Regular Navy from Reserve, Health Record e n t r i e s , 2213.1".

%2

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3419.4. When burial ashore cannot be accomplished within reasonable time l i m i t a t i c n s o r is inadvisable , burial a t sea i s 9ermissible. n o t be cremated, except as a san i t axy measure, without p r i o r approval of t h e Bureau.

Remains shall

PART 111. C!IAPl%R 5D. PAFt 35D16, and s u b s t i t u t e t h e following:

Delete ( a ) t o ( i ) a f te r the w o r d " i n f o m t i o n : t l

Duration of period of expoaure. W e t h e r rescued from boat, r a f t , o r water; i f r an , o r boat, an i n ? i c a t i o n of t h e o r i g i n a l number of occupants, and t h e number of survivors . Temperature of water when rescued. Adequacy of food, water, f i r s t - a i d supp l i e s , e t c . Whether su rv ivo r s made use of a n a n anti-exposure s u i t . Immersion, i f any. D i r e c t exposure t o sun. Type of l e s i o n s encountered, t o e e t h e r w i th t reatment , subsequent comolications, and d i s p o s a l , with par t icular reference t o under- water b l a s t i n j u r i e s , dehydration, s t a r v a t i o n , "immersion foo t , " o r eeema of fee t , avi taminosis , fu runcu los i s , and c o n j u n c t i v i t i s , t h e r e s u l t of sunglare or immersion i n o i l y water. Rectal temperature of su rv ivo r a t time of rescue, i f exposed t o cold. Psycholoaical condi t ion of survivor . Brief n a r r a t i v e of experiences, including an est imate by su rv ivo r s of probable con t r ibu t ing causes of c a s u a l t i e s and death. Other r e l e v a n t points . Recommendations of r e p o r t i n g o f f i c e r or corpsmen relat ive t o a c t i o n ind ica t ed t o alleviate s u f f e r i n g and minimize casualties among survivors i n f u t u r e catastrophes.

PART V. CHAPTER 1. Add : P a r 5129(B) . NAVLIED-949 (Monthly Report of Medi- c a l O f f i c e r s Under I n s t r u c t i o n , Other t han I n t e r n s ) . Report of Medical Off icera Under I n s t r u c t i o n , Other t h a n I n t e r n e ) shall be submitted by c o n t i n e n t a l naval h o s p i t a l s , i n d u p l i c a t e , t o t h e Bureau t h c f i f t h of each month. of NAm 949.

NAVWJ-949 (Monthly

No i n s t r u c t i o n s are necessary fo r t h e p repa ra t ion

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(Not Restricted) PART V , CKLP'ER 1. Add: Par 5129(B). NAVMED-953 and NAVMED-953a (Roster Repcrt of t h e Medical Corps). 11i~VvtED-953 and NAVmD-953a (Roster Report of t h e Mec'ical Corps) s h a l l be submitter! i n d u p l i c a t e by a l l c o n t i n e n t a l naval h o s o i t a l s t o t h e Bureau on t h e f irst of each month. s h a l l be submitted v i s a i r mail d i r e c t t o t h e Bureau, a t t e n t i o n Chief of Personnel Division. NA'JMED-953 and 353a s h a l l be , r e p r e d i n accordance with t h e fol lowing i n s t r u c t i o n s .

of Naval Personnel. i s usually on f i l e i n t h e execut ive o f f i c e r ' s o f f i c e .

The completed r e p o r t

a. The allowance ffauthorized' t is t h e al lovance authorized by t h e Bureau These f i g u r e s a r e obtainable from NavPers 350. T h i s form

b. The allowance Iton board" s h a l l be t h e number of medical o f f i c e r s ( inc lude H(S) and H ( h ) o f f i c e r s ) , permanently a t tached t o t h e h o s p i t a l for duty. Medical o f f i c e r s orzered "under in s t ruc t ion ' ' by t h e Bureau of Naval Personnel s h a l l not be reported i n t h i s space.

C. "Off icers Reported or Detached Since Last Reportf1 includes a l l chcinges of s t a t u s of s t a t i o n o r s t , a tu s of all medical o f f i c e r s occurr inq s i n c e l a s t r epor t .

d. 'The term "staff" a p n l i e s only t o medical o f f i c e r personnel who are It does not ap,:ly t o any medical

Temporary p a t i e n t s , temporary a p a r t o f the r e g u l s r h o s i i t a l complement. o f f i c e r temporar i ly a t tached f o r any reason. duty, e tc . , s h a l l be shown on t h e r eve r se of t h e r o s t e r r cpor t under t h e appropr i a t e headings, e.g., flTemporary duty t r , "Fatientsl ' etc, Personnel ordered by t h e Bureau of Naval Personnel from t h e staff t o Wxler Ins t ruc t ion t1 a t t h e same h o s p i t a l s h a l l be shown as tldetachedlt t o f o r i n s t r u c t i o n .

and "reported1'

e. I n making en t r ies i n Columns (A), ( B ) , ( C ) , ( D ) , and ( E ) , (under heading ffReported o r Detached Since Last Reportff ) consu l t foo tno te s a t t h e bottom of t h e f a c e of the r e p o r t form.

f. The r eve r se of t h e report shee t t i t l e d ttRemaining a t End of ?eriod" s h a l l show t h e names of staff personnel by groups according t o rank. Non- staff personnel shall be l i s t e d after staff personnel by classes according t o duty s ta tus , e.g., "Pa t i en t s " , lITemporary Duty", e t c . Group each c l a s s by rank and a r r ange t h e names i n each group a l p h a b e t i c a l l y , surname first . The fol lowing i n s t r u c t i o n s apply t o indiv idual groups and classes:

(1) S t a f f o f f i c e r s (MC, H(S), H ( W ) ) - show duty or d u t i e s ass igned and t h e o r i g i n a l d a t e of r epor t ing .

(2) P a t i e n t s - list those remainlng on board a t t h e end of the perioe r epor t ed , t h i s heading

Do not list staff personnel who are p a t i e n t s under

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Burned News Letter , Vol. 7, No. 9

(Not Restr ic ted) (3) Temporary duty - l i s t an6 give date and s h i p and s t a t i o n from

which repor ted . (4) Under i n s t r u c t i o n - l i s t on ly t hose placed under i n s t r u c t i o n

by orders of t h e Bureau of Naval Personnel, g iv ing cour~e, dates of commencement and completion o f course.

g. s h a l l apply:

For each column on t h e r e v e r s e side of form t h e following i n s t r u c t i o n

Column I - Names grouped by rank and i n a l p h a b e t i c a l o rder , t h e surname first, then t h e C h r i s t i a n name and i n i t i a l s , o r a l l names i n full i n case two or more have t h e same surname.

Column I1 - The rank s h a l l be in6 ica t ed by abbrevia t ions ; i f r e t i r e d , or Naval Reserve c a t i o n e.g. E, H(s), H ( w ~ .

abb rev ia t e as Ret or NR and show classifi-

Column I11 - Orig ina l d a t e of r epor t ing t o h o s p i t a l for duty, show by f i g u r e s , e.g., 7-1-44 for 1 July 1944.

Column N - Beginning of present t o u r of shore duty. Shore duty begins t h e d a t e of detachment from sea d u t y or f o r e i g n shore s t a t i o n , show by f igu res .

Column V - Remarks. In t h i s column, shonr presen t du ty assignment as IrSOQ1), "Ch. of Medll, "Ch, of SurgI1, "On S ick L i s t (with d iagnos is )" , "On Leave (with exp i r a t ion da te ) " , "Awaiting Transfer t o ( t h i s w i l l app ly to a l l Medical Corps Personnel whose orders have been rece ived but who have not been detached as of da t e of repor t" , "Temporary du ty a t -I1, e t c .

Column V I - If s p e c i a l i s t , i n d i c a t e s p e c i a l t y . Wherever t he words Wed ica l o f f i c e r " a r e used it inc ludes H(S) and h.

H('N) c l a s s i f i c a t i o n s .

2. advance changes as of 1 July 1946. succeeding six-aonth per iod o r more o f t e n if necessary.

Page changes will be prepared on t h e above advance changes and subsequent Page changes will be re leased for each

--BuMed. Ross T. McIntire.

* * * * * *

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Washington National Record Center Office of the Army Surgeon General Record Group 112 Accession #: S%e 10 qq Box#: G 5 File: 0.5h-tWson , w. M D - 39

Burned News Let te r , Vol. 7, No. 9

Ci rcu lar Lettey 46-66 15 Apri l 1946 (Not Restr ic ted)

(Note: This Burned News Letter copy of th i s c i r cu la r letter is purposely reproduced he re in a manner that lends itself to removal and insertion by pasting o r stapling in the appropriate section of the Manual. --Ed.)

To: A l l Ships and Stations.

Subj: Advance Change in the Manual of the Medical Department Concerning EmbalminP and Prepara t ion of Remains f o r Return from Overseas .

Refs: (a) BuMed C i r Ltr No . 46-4, 4 Jan 1946. (b) Par. 3420, M.M.D. (z) 1 ar. 3421, M.M.D.

1. The follclwing advance shangc in the revised edition of the Manual of the Medical Department i s published for the information of all concerned and is e f f e T t i ve i m rn e d i a te 1 y :

2. I n paragreph 3,420 add t h e fol lowing subparagraph:

342Q.4 OVERSUS SHIPMENT. A t s t a t i o n s beyond t h e c o n t i n e n t a l limits o r aboard s h i p s in d i s t a n t waters and when t h e body is t o be returned t o a nava l a c t i v i t y i n t h e United S t a t e s , o r w i t h i n t h e Unite? S t a t e s \;;hen t h e body i s t o be shipped t o a nava l a c t i v i t y abroad, a f te r completion of t h e embalming, t h e following a d d i t i o n a l procedures s h a l l be followed i n pre- par ing t h e body for shipment, usinn e i t h e r method A o r method B as may be more p rac t i cab le :

(a ) When t ime permits, t h e body s h a l l l i e f o r s e v e r a l days t o permit drying out, t h e escape of f l u i d s , and discovery of imper fec t ly hardened a reas . Repeated sponging with a l c o h o l w i l l assist dehydration.

(b) Method A . absorbent c o t t o n d r i p p i n g wet with 10 per cen t formalin, and then snugly bandage t h e whole body.

PICKLING. Do not c l o t h e t h e body, but wrap i n

( c ) Method B. SFiikYING. Do not c l o t h e t h e body. Remove any mold a l r e a d y i n evidence with a weak s o l u t i o n of ammonia i n a lcohol . Wipe over s k i n surfaces wi th t h e thymol s o l u t i o n given below. i n s e c t i c i d e sp ray or atomizer, spray s k i n s u r f a c e s with same so lu t ion . (It i s advised t h a t ope ra to r s wear r e s p i r a t o r y masks.) d r y absorbent co t ton , secured by bandages. Nhen placed i n casket ,

Using an

Wrap body i n

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spray wrapped body and a l l ca ske t fabrics. be found s u i t a b l e as a fungicide and f o r p re se rva t ion of skin, while having l i t t l e e f f e c t on appearance and no a c t i o n on f a b r i c or dyes,

The following formula w i l l

c c o r grams

( a ) %rap c l o t h i n g i n an impexvicus, waxed paper, and pack secu re ly on top of casket i n s i d e shipping case,

( e ) If f u n e r a l s e r v i c e s a r e t o be held p r i o r t o shipment, t h e above procec'ures w i l l be c a r r i e d i n t o effect af ter t h e services.

( f ) I f , f o r any reason, t h e remains a r e not t o be handled by a naval a c t i v i t y a t p o r t of a r r i v a l , method B will be followed, except t h a t t h e body s h a l l be f u l l y dressed, and, a5 a final step, t h e spray a p p l i e d t o t h e clothed body i n t h e same manner a3 t o a bandaged body

3. i n s e r t t h e followingt ItEtt t o lmcr ~ ~ 3 8 .

I n pwagraph 3421, a f te r t h e word IIClothingll and before the word IIEach" "Except as d i r e c t e d i n 3420.4,'' changing t h e c a p i t a l

4. t h e i n s t r u c t i o n s contained i n t h e above change i n t h e manual. t h a t t h i s l e t t e r be kept with t h e manual u n t i l p r in t ed change is received.

P a r q r a p h 2 of reference (a) i s hereby cancel led and is superseded by It is d i r e c t e d

--BUM&. Ross T. McIntLre.

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Washington National Record Center Of ice of the Army Surgeon General Record Group 112 Accession #: 553f3 \ Q qc\ Box#: F;S m e : a A 5 h + W S b O ,bf-, A d . /uQ - 3q

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Circular Le t te r 46-67 15 April 1916 (Not Restricted)

T(J: AlNavStas.

Subj: T rans fe r of Officers of the Nurse Corps, U. S. Naval Reserve, to Nurse C u r b s , U . S. Navy during Terminal Leave o r F i r s t Six Mmtlls on Inactive S t a s

-

--

Ref: (a) AlNav 2’71-45, 279-45, 283-45, 104-46.

1 . An officer of tk Nurse Corps, U. S. Naval Reserve, who is in P terminal l..-avc s ta tus o r who has been in an inactive duty s ta tus f o r less than s ix months, may request t ransfer to the Nurse Corps, U. S. Navy.

2 . Qualifications fo r t ransfer are as follows:

(a)- Agi-e - maximum, not over the age to cdmplete 20 yea r s active duty pr ior to 58th birthday including active duty as TJ. S. Naval Reserve.

(b) The educational and professional qualifications of all officers of the Nurse Corps, U. S. Naval Reserve are considsrec adequate to warrant submission of application to Bulv‘Ied fo r review.

3. A1,plicant shall report ta Commandant of neares t Naval Distr ic t o r River ?c;mrnand by le t ter o r in person (not by telephone), stating des i re to t ransfer .

4 . If applicant i s on terminal leave and requests retention on active duty the Commandant shal l cancel remainder of release o rde r s and reassign h e r to duty pending Bureau orders , allowing delay in reporting f o r duty until date of termination of original terminal leave if desired. Application f o r t ransfer in accordance with ALNavs 279-45 and 271-45 shal l be submitted as soon as applicant repor t s f o r duty. If retention on active duty is not requested, pro- cedure shall be s a m e as outlined in Para. 5.

5. Lf aj,plicant i s on inactive duty status the Commandant shall direct he r to the Medical Activity neares t her home authorized to conduct a physical exam- ination f o r officers of the Nurse Corps, in accordance with ALNav 271-45 and submi t tu RuMed h e r properly executed application in accordance with AlNav 27‘3-45. If officer des i r e s recal l to active duty p r io r to the date of he r final appointment in the Nurse Corps, U. S. Navy, the request shal l be submitted to the Bureau of Medicine and Surgery via the Commandant of the District . If

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\i’Jot Restr ic ted) c i rcumstances permit and a Lillet is available, o rde r s wil l be issued f o r h e r to pruceed f r o m h e r home to the new duty station.

6 . T h i s letter does not in any way affect the t ransfer of Reserve Nurses on active duty to the regii1s.r Nurse Corps.

--RuMed. W. J . C . Agnew.

* * * * * *

Circular Le t te r 46-68 1 5 April 1946 (Not Restr ic ted)

To: A l l Ships and Stations.

Subj: - Medical Stcires Requisition, NAVMED 4; Preparat ion and Submission of.

Rei: (a) Art ic les 1164, and 1166, Navy Regulations. (b) BuMed Ci r l t r No. 44-18, 28 Jan 1944. ( z ) BuMed Ci r ltr No. 45-92, 15 Apr 1945. (d) BuMed C i r ltr No. 46-48, 27 F e b 1946 (N. D. Bull, I tem 46-461.

1. Effective i July 1946 reference (c) is suuerseded by this letter.

2 . Effective 1 July 1946, requisitions fo r medical s t o r e s listed in the Catalog of Naval Material , Bureau cjf Medicine and Surgery Section shal l be prepared in quintuplicate on PJavMed-4 (requisition and invoice f o r medical supplies and equipment) in accordance with instructions contained herein and the origi- nal and three ciipips submitted to the neares t medical supply depot o r store- house.

3. A separa te NavMed-4 requisition shal l be prepared fo r the following groups of i tems:

(a) I tems of Supplies (expendable) (b) I tems of Equipment (non-expendable) (c) Biologicals, except Serum Albumin. (d) Prezious metals f o r dental use. (e) Other dental i tems. ( f ) A l l i tems not listed in the Catalog of Naval Material,

(g) i t ems required in emergency o r in advance of routine BuMed Section.

shipments.

4. Medical Supply Uepots are located at Brooklyn, 1, N. Y.; Oakland, California;

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Wasliingtorl National Record Center Of ice of the Army Surge011 General Record Group 112 Accession #: s%f+ ) Q qq B o x # : F;S

Bunled Ncws Let ter Vol. ‘7 No. 9 A (N : ,t Rc. s t I’ i r, t c ( 1 )

J- e a r l Harbor, T . H . ; Guam-Sa’pan. M.I.. and Balboa, C .%. Continental Medir::i! S u ~ y l v Sti>reho .ces are located : t Newbort, R.I., Nc;rfolk, Va.; Charicst ’n, S.C.; Seattle, Vs‘a:;hini;ton; San I- e d m , California and San Diegci, California. An Fxtra- Cmtinental Medical Supply Storehouse is located a t Samar, I- .I.

5. The Responsibility L i s t s f o r medizal mater ia l of IVaval Medical Supply Dekots; Naval Medical Supply Stbrehouses (Cmtiriental); Naval Medical Supply Store- hzuses (Extra-Continental); and Service Fc;rce Floating Storage (Barpcs, AK and AKS) are as fo1l::ws:

(a) Naval Medical Supply Depots - All i t ems cf the Catalog i;f Naval Material, Bureau of Medicine and Surgery Section.

(b) Naval Medical Supply Storehouses (Continental) - I tems listed in the supplement to the Catalog of 1J3val Material, Bureau of Medicine and Surgery Sectian “Itenis Stocked in Continental Naval Medi- ca l Suigly Storehouses. 1 )

(s) N:iv;tl FJIediwl Supply Storehouses (Extra-Contin- mtal) - Item.: listed in the supplement to the Catalog of Nava l Material, Bureau of Medicine and &:iirgery Sec t iw erital Naval Medisal Supply Storehc:uses. C’I 6( I tems Stocked in Extra-Contin-

) >

(d) Service Force Floating Storage (Barges, AK and AKS Ships) - A s determined by the Service F o r c e Commander. L is t of i tems may be obtained f rom such floating facil i t ies.

6 . Tirnely submissivn of requisitibns shall be made in anticipation of needs. Except in emergencies, medizal s to re s shall not be requested by dispatch. No confirniing NavMed-4 i s required when rnedical s t o r e s are requested by dis- patch. Regular replenishment i tems shall be requisitioned quarterly by hospitals and large activities. Biologicals and Gther deteriorable i tems (Drugs, film, batteries, rubber guods, etz .) shall be requisitioned to cover limited require- ments ra ther than to c rea te unnecessarily large reserve stocks.

7 . Requisitions shal l be prepared for medical s to re s in accordance with the f ollvwing instructions. Tlic data required in sub-paragraGhs (a) t o (I), inclusive, sha l l be entered on each sheet of the requisition.

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(Not Restricted) issue” as stated in the catalog (“Each”, “Pair)’, “Dozen”, ‘‘pkg”, ‘‘Bottle” etc .)

(r) MINIMUM STOCK:. ............... Substitute the w o r a s on order , not received”. Enter quantities previously requisitioned but nct yet 6‘

r ec e ived .

the item actually on hand. Material expended f rom the stock ledger, such as par t bottles, et:., in the pharmacy, is not to be included.

required.

(s) ON HAND: ........................... Enter the quantity of

(t) REQUIRED: ......................... Enter the quantity

(u) VALUE: ............................. Leave blank. (v) PAGING: ............................. When the listing of i tems

required exceeds one sheet, each sheet shall be serially numbered near the bottom (Example: 1 of 4, 2 of 4, 3 of 4 e tc . ) Secure in s e t s with paper fastener, a l l originals, all second copies, etc.

and stations shall be signed by the senior medical department representative ( f rom hospitals by the accounting officer) and approved and forwarded by the Commanding Officer. Signatures a r e required only on the original copy of the f i r s t page of the requisition.

(x) COFIES, DESIGNATION OF:. , . The requisitioning ac- tivity shall designate the respective copies as follows:

(w) SIGNATURE:. ...................... Requisitions f rom ships

Ribbon copy: “Original’ ’ Duplicate: “Second’ ’ T r ip 1 icat e : Quadruplicate: ‘ ‘F ourth’ ’ Quintuplicate :

‘ ‘Third ’ ’

“Fifth” (file copy - retain)

REVERSE (NAVMED-4)

(y) SHIPPING INFORMATION:. .... The second copy will (z) EXPLANATION REMARKS: ..... Indicate urgent need

accompany the bill of lading.

and specific delivery dates and places desired. State need for apparent large quantities of supplies o r additional i tems of equipment. Explain need f o r non- listed items and the reason catalog i tems will not suffice. Enter reference to property survey when requesting replacement of equipment.

8. NONLISTED ITEMS: When medical stores (supplies and equipment), not l isted in the Catalog of Naval Material, Bureau of Medicine and Surgery Section, a r e required, a separate NavMed-4 requisition shall be prepared and forwarded

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Washington National Record Center Office of tlie Army Surgeon General Record Group 112 Accession #: s%fi ’ o q.\ Box#: S S File: 0.~5h-tw50n ,w, A . d . uD- 39%

Burned News Letter, Vol. 7, No. 9

(Not Restricted) to the Materiel Division, Bureau of Medicine and Surgery, Sands and F’earl Sts , , Brooklyn 1, N . Y . The same procedure shall be followed in the preparation of NavMed-4 requisitions f o r nonlisted i tems as that outlined in paragraph 7 above, except under “Stock No . number . Example: “NL-3”, “NL-5”, etc. When replacement par t s o r acces- so r i e s fo r X-ray, electrically operated, o r other equipment a r e required, an adequate description of the par t of the equipment item f o r which the par t i s required, o r with which the accessor ies are to be used, must be stated, in- cluding the make, model, s e r i a l number, o r such description as may be avail- able, including electr ic-current data, when indicated, in order to enable t h e Materiel Division to accurately determine the mater ia l required. Requisitions f o r nonlisted books shall s ta te the exact title, author, edition, and publisher’s name. Incomplete description of nonlisted mater ia l necessitates considerable needless correspondence and procurement delays. A s a general rule, in the case of nonlisted material , severa l makes of an i tem a r e available in t h e market, and competitive bidding i s required. Therefore, commercial catalog re ferences must be construed as descriptive but not restrictive, unless sufficient justification is furnished f o r proprietary purchase. Each requisition f o r nonlisted (noncatalog) i tems shall be accompanied by a statement explaining why catalog i tems will not meet the requirements o r answer the purpose. P r e - p a r e six and f o r w a r d five copies of NavMed-4 for NL items.

9. TRANSFER REQUISITIONS:

9 , the appropriate class shall be substituted f o r stock

9.1 For Shore Stations: I tems of medical s to re s deleted f r o m shore stations requisitions with symbol “T” will be backordered by Medical Supply Depots on medical s to re s t ransfer requisition (NavMed 574) and issued when mater ia l becomes available. Naval Medical Supply Storehouses shall cancel out of stock i tems f rGm requisitions and advise requisitioning activities to r e - requi- sition these i tems f rom the nearest Naval Medical Supply Depot in accordance with existing instructions.

T rans fe r requisitions on hand, but not processed, on 30 June of each f iscal year will be automatically cancelled by Naval Medical Supply Depots without reference to requisitioning activities. I tems s o cancelled and s t i l l required shall be re-requisitioned.

9.2 F o r Ships:

(a) Active and Reserve Fleets : Out of stock medical s to re s i tems will not be backordered f rom active and reserve ships replenishment requi- si t ions by Medical Supply Depots and Medical Supply Storehouses. I tems not

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. . . . . . . . . . . . . . , . . . . - , . . .. . .. ,. ' ...

v (Not Restr ic ted) 12. SHORTAGES, LOSS, DAMAGE, ETC. OF MEDICAL STORES: Upon re- ceipt of a shipment, i f any abparent shortage, overdelivery, o r other e r r o r i s found in comparing the invoice o r packing copy of the requisition, a full report thereof shall be made to the issuing depot o r storehouse. If the issuing ac- tivity does not accept responsibility for the discrepancy, the s to re s shall be taken up as invoiced and shortages adjusted on the books of the receiving ac- tivity by expending supplies o r surveying equipment (NR, zh. 45. sec.111). In case of missing narcotics, comply with reference (b). When medical s to re s are lost o r damaged by a Government o r Commercial c a r r i e r , the procedures outlined in Article 1b03 of the BuS&A Manual and Artizle 1840-5 of BuSGA Memoranda, shal l be complied with. When medical s to re s in t ransi t are lost by enemy action the prozedures outlined in Article 1120(4) and 1130(6), BuS&A Manual, shal l be complied with. Receiving activities shall not alter o r change invoice in any manner unless s o authorized by the issuing depot, storehouse o r Materiel Division, Bureau of Medicine and Surgery.

--BuMed. M'. J . C . Agnew.

* * * * * *

Note: See page 44 for Circular Le t te rs 46-69 and 46-'70. -- * * * * * *

(Not Restricted) Disestablishment of Naval Medical Activity. A s published in t h e N a v y

Department Semimonthly Bulletin of 31 March 1946, the following Naval Medi- cal activity was disestablished as of the date shown:

Date of TJame U .S. Naval Hospital

Address Corvallis, Oregon

disestablishment 31 May 1946

f *

(Not Restricted) Establishment of U. S. Naval Medical Center, Guam, Marianas Islands,

and Subsidiary C omljonents.

To: A l l Ships and Stations. Op24B-pd Serial 395F 24

U. S. Naval Medical Center, Guam, Marianas Islands,l5 March 1946 and Subsidiary Components - Establishment of.

Subj:

Ref: (a) SecNav ltr. Op24B-pd, serial 245F24, of 4 Jan. 1946; N. D. Bul. of 15 Jan. 1946, 46-15.

L 1. A U. S. Naval Medical Center is hereby established at Guam, Marianas

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B11112~4 News Let ter , Vol. ‘7, IVo. 9

41‘/‘0-400

Tlli:; 1dedica.l Cciiter conlpristJs the major naval medical and assoc ia l td activi- t ies which are now in operation a t Guam, Marianas Islands, and is under the mili tary cc,nirrian