(For official use only)


Third Edition-2000

Corrected upto 30-9-99


It is a privilege to present the third edition of the Indian Railway Medical Manual. The last edition was published in 1981. Since then numerous changes have taken place, fully justifying the publication of an updated edition.

Work on this revised edition began as far back as in 1986 with the commissioning of Dr. A.L. Goswami, Director-General/ RHS (Retd.) for this purpose, for a period of one year and has continued since then in fits and starts. Inadequate documentation and filing system, lack of computerisation and insufficient human resources resulted in piecemeal work. Broken threads of activity had to be picked up-time and again to restore continuity. Innumerable man-hours of labour were spent in retrieving what made sense and in discarding what did not or had already become obsolete, from a large pile of papers, manuscripts and typescripts. Thus it is a matter of considerable personal satisfaction to me that the third edition of Indian Railway Medical Manual is finally seeing the light of day.

This edition is in two volumes and has both English and Hindi versions set on the two sides of each leaf. The entire manuscripts of both versions have been put on computer. An index has been added to facilitate quick reference. Also it has been decided that all future instructions from the Railway Board will be issued, once a month, only in the form of advance correction slips to the manual. These steps are expected to make future updating and revisions much easier.

Genuine efforts have been made to keep this edition free from errors and discrepancies. However, such perfection is impossible to achieve because of the sheer enormity of the task, pressure for time to avoid further delays in publication, various practical constraints and finally the intrinsic fallibility of human nature. I solicit the co-operation of individual readers as well as zonal administrations in bringing errors and omissions to our notice for corrective action.

Many of my eminent predecessors, namely, Dr. M.C. Khorwal, Dr. J.K. Chaudhry, Dr. DC. Joshi, Dr V.D. Mathur and Dr. B.N. Sinha have made useful contributions in compiling this edition. The manual could finally acquire its present, reasonably acceptable shape thanks to the ceaseless efforts of several I.R.M.S. officers notably, Dr. Raghunath Ram, OSD/Medical, Railway Board, Dr. R.K. Mehta, Chief Medical Superintendent, Northern Railway Divisional Hospital, Delhi, Dr. (Mrs.) A. Rawal, DH(FW) and Dr. Amrish Gupta, Joint Director, Industrial Health, Dr. V.R. Vatsal, CMO/Konkan Railway Corporation and Dr. PS. Prasad, Sr. DMO/SER. Dr. Prasad not only compiled a lot of material on his own PC but came forward with his personal collection of valuable documents. It is noteworthy that all these officers voluntarily donated their precious time over and above their normal duties. I take this opportunity to express my sincere appreciation for each one of them as also for Mrs. Bhavani Vatsai who helped in putting substantial portions of the English version on the computer without any financial consideration.

Directorate of Official Language deserve to be thanked for prompt and correct Hindi translations. The contributions made by Dr. Satish C. Agarwal Sr. D.M.O/NER and Dr. S.K. Patodi Dy. C.M.D./WR in the same context deserve mention.

Director General (RHS)



This Manual is meant for the guidance of the staff of all departments dealing with medical and health subjects. It incorporates all the essential provisions in the different codes and Manuals etc.. as also instructions and clarifications issued thereon from time to time, in a self contained and readily understandable form (excluding obsolete references or definitions and special provisions rarely operative in practice). It must, however, be noted that the provisions of this Manual do not supercede the existing rules and orders and in case of conflict the latter should prevail.

The authority on which the different sections Paragraphs of the Manual are based has been identified below each of the Sections/Paragraphs.

This Manual, which shall come into force with immediate effect is intended for uniform adoption on all Indian Railways. The Railways can issue only such routine directives of a local nature as are unavoidable and are not inconsistent with the provisions contained in this Manual. The existing Medical Manuals of Railways shall stand superseded.

For convenience of indexing and of reference. Paragraphs have been numbered according to a four figure "code ' in which the last two figures give the number of the Paragraph and the remaining figure or figures the number of the Chapter. Thus Paragraphs 309 is Paragraph 9 of Chapter III and Paragraph 1207 is Paragraph 7 of Chapter XII.

Corrections to this Manual, when published , will be issued serially numbered.

The Railway Board will be glad to consider any criticism and suggestions from the Railway Administrations.

I take this opportunity to thank Shri A.K.Das Gupta , who has worked patiently and zealously for months preparing this Manual.



Director, Health

Railway Board

New Delhi

Dated the 1st September 1971


1 am glad to bring out this second edition of the Indian Railway Medical Manual. The provisions as contained in the first edition have been corrected based on the orders and instructions issued by the Ministry of Railways up to 15th Jan. 1981. The Railway Board would be obliged to be advised of any omissions or errors that might have crept in . These will be rectified through Correction Slips. It has been planned that Correction Slips will also continue to be published as and when further orders and instructions on the subjects covered by the manual issue.

I acknowledge with thanks the efforts put by Sri A.K Das Gupta to bring out this second edition.

Hindi version of this Manual is being published for the first time. This has been prepared by the Official Language Directorate of the Ministry of Railways with ultimate care and diligence in a simple and intelligible language. I hope, the officers and staff of the Medical Department will also find it helpful in carrying out their official work in Hindi.

Director General
Railway Health Services

New Delhi
Dated the 15th January 1981