CHAPTER VI

EVACUATION OF THE UNFIT--RELIEVING THE PRESSURE ON THE HOSPITALS AND CONVALESCENT DEPOTS--BACK TO DUTY OR AUSTRALIA--METHODS ADOPTED--TRANSPORT OF INVALIDS BY SEA AND TRAIN.

CHAPTER VI

It became evident, both during the crisis and before the expected attack in August, that Egypt must be cleared of those who were not likely to be fit for service in the immediate future. The necessary effort made to send invalids away for change, and to send the permanently disabled home, involved important questions of policy the determination of which took time. A number of problems at once obtruded themselves. Who was to be permanently invalided, and how was the determination to be reached?

Who was to be sent away temporarily, and for how long was he to go?

Where was he to be sent to? What was to be done with malingerers, of whom there was a small but sufficiently numerous percentage? As regards the first question: is a man, for example, who has lost an eye permanently invalided? Is he fit for base duty in Egypt, or must he be sent home? It is hardly fair to send him to the front and expose him to the risk of total blindness. In this particular case, in view of the possibilities of the development of ophthalmia in Egypt--which, by the way, did not prove nearly as serious as was antic.i.p.ated--it was decided that the man who had lost one eye should be sent home as permanently unfit. Men who had lost a limb were put in the same category. It might be argued that such men were quite fit for clerical work, and that one-eyed men were quite fit for ordinary guard work, for which, indeed, the demand was overwhelming. The view already indicated, however, was taken, and these men were sent to their homes to be discharged. But when these definite and obvious cases were disposed of, there remained some thousands of men whose cases were full of difficulty. In each hospital Boards were accordingly appointed to investigate their cases and to fully answer the questions set out in the following Army Form B 179.

MEDICAL REPORT ON AN INVALID (Taken from Army Form B 179)

8. DISABILITY STATEMENT OF CASE

NOTE.--_The answers to the following questions are to be filled in by the officer in medical charge of the case. In answering them he will carefully discriminate between the man's unsupported statements and evidence recorded in his military and medical doc.u.ments. He will also carefully distinguish cases entirely due to venereal disease._

9. Date of origin of disability.

10. Place of origin of disability.

11. Give concisely the essential facts of the history of the disability, noting entries on the Medical History Sheet bearing on the case.

12. (_a_) Give your opinion as to the causation of the disability.

(_b_) If you consider it to have been caused by active service, climate, or ordinary military service, explain the specific conditions to which you attribute it. (_See_ NOTES _on p._ 71.)

13. What is his present condition?

_Weight should be given in all cases when it is likely to afford evidence of the progress of the disability._

14. If the disability is an injury, was it caused--

(_a_) In action?

(_b_) On field service?

(_c_) On duty?

(_d_) Off duty?

15. Was a Court of Inquiry held on the injury?

If so--(_a_) When?

(_b_) Where?

(_c_) Opinion?

16. Was an operation performed? If so, what?

17. If not, was an operation advised and declined?

18. _In case of loss or decay of teeth._ Is the loss of teeth the result of wounds, injury, or disease, directly[6]

attributable to active service?

19. Do you recommend--

(_a_) Discharge as permanently unfit, or (_b_) Change to England?

-------------------------------- _Officer in medical charge of case._

I have satisfied myself of the general accuracy of this report, and concur therewith, _except_[7]

_Station_---------------- _Officer in charge of Hospital._ _Date_----------------

OPINION OF THE MEDICAL BOARD

NOTES.--(_i_) Clear and decisive answers to the following questions are to be carefully filled in by the

Board, as, in the event of the man being invalided, it is essential that the Commissioners of Chelsea Hospital should be in possession of the most reliable information to ENABLE THEM TO DECIDE UPON THE MAN'S CLAIM TO PENSION.

(ii) Expressions such as "may," "might," "probably," etc., should be avoided.

(iii) The rates of pension vary directly according to whether the disability is attributed to (_a_) active service, (_b_) climate, or (_c_) ordinary military service. It is therefore essential when a.s.signing the cause of the disability to differentiate between them (_see_ Articles 1162 and 1165, Pay Warrant, 1913).

(iv) In answering question 20 the Board should be careful to discriminate between disease resulting from military conditions and disease to which the soldier would have been equally liable in civil life.

(v) A disability is to be regarded as due to climate when it is caused by military service abroad in climates where there is a special liability to contract the disease.

20. (_a_) State whether the disability is the result of (i) active service, (ii) climate, or (iii) ordinary military service.

(_b_) If due to one of these causes, to what specific conditions do the Board attribute it?

21. Has the disability been aggravated by--

(_a_) Intemperance?

(_b_) Misconduct?

22. Is the disability permanent?

23. If not permanent, what is its probable minimum duration?

_To be stated in months._

24. To what extent is his capacity for earning a full livelihood in the general labour market lessened at present?