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Chapter 4

The United States Army Medical Service Corps

BETWEEN THE WORLD WARS

The Armistice that ended World War I also eclipsed the Medical Department's ability to commission officers for administrative and scientific specialties. The wartime expedients of the U.S. Army Ambulance Service (USAAS) and the Sanitary Corps began to disappear as the United States rapidly demobilized. All USAAS officers had to leave active duty, and their numbers dropped from a peak of 209 officers in November 1918 to 3 in July 1920. A few Sanitary Corps officers could be retained on active duty upon the specific request of the surgeon general. Nevertheless, the corps went from 2,919 officers to 219 in the same period, and Col. William Wrightson, SnC, who had served as its de facto chief, returned to civilian life. Medical Department reductions were part of the overall military drawdown as the Army's strength dropped from 3,685,458 in November 1918 to 131,959 in 1923. The Medical Department shrank from a peak wartime strength of 353,572 to a low point of 11,535 in 1939, and the Surgeon General's Office went from a staff numbering over 2,100 to a mere 177 in 1934.1

Meanwhile the economic, cultural, social, and political upheavals caused by World War I set the stage for World War II. The United States, after the flush of victory in Europe, withdrew into isolationism and stumbled into its worst economic depression.2 The times were bad, and in 1932 the American people turned Herbert Hoover out of office. They elected Franklin Roosevelt, who ushered in the New Deal and went on to an unprecedented four terms as president. Yet, despite FDR's activism, the Great Depression refused to release its grip on the American economy until after the United States entered World War II.

Meanwhile, the Army endured a time of genteel poverty. George Marshall reverted in 1920 from his wartime rank of colonel (and a recommendation for promotion to brigadier general) to his permanent grade of major. Dwight Eisenhower and George Patton also reverted to major from colonel in 1920. (Patton would spend fourteen years as a major, Eisenhower sixteen.) In 1935 Marshall wrote that he was "fast getting too old to have any future of importance in the Army."3

However, the officers destined for greatness in World War II benefited from Army schools that provided a progressive series of courses unlike anything that had existed before. The branch schools taught Army management and tactics to company grade officers in advanced courses. The Command and General Staff College at Fort Leavenworth, Kansas, guided field grade officers through the complex problems of maneuvering and sustaining large formations. Officers at the Army Industrial College in Washington, D.C., explored the strategic impact of

Parade ground at Carlisle Barracks, 1925


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Basic course students, Medical Field Service School, 1925

logistics, and the Army's premier school, the Army War College-also in Washington-instructed senior officers in strategic planning. Eisenhower was first in his Leavenworth class. George Patton, a Leavenworth honor graduate, was first in his War College class.4

In 1920 the Medical Department established the Medical Field Service School at Carlisle Barracks, Pennsylvania, to teach department officers "the military side of their work."5 The school conducted a four-month officer basic course, a two-week officer advanced course, and a six-week field officer course for National Guard and reserve officers. By the early 1930s the basic course had lengthened to a five-month program conducted eight hours a day on Monday through Friday plus classes on Saturday morning. Instruction covered tactics, military organization, military law, logistics, leadership, administration, map reading, and field medical service, the last featuring two weeks of field exercises. The officer advanced course had expanded to a two-month program. The Medical Field Service School established a fine reputation, and a report of an inspector from the Army Inspector General's Office declared that "someone besides the Medical Department ought to know how good it is."6

The Army experimented with new technology during the interwar period, and the Medical Department was affected by those developments. As the department had accommodated motorized vehicles, it now took some tentative steps at adapting its doctrine to the airplane. It took delivery of two airplane ambulances in 1926, stationing one plane at Kelly Field, San Antonio, Texas, and the other in the Canal Zone, Republic of Panama. The marines tested a Pitcairn XOP-1 autogyro in the evacuation of casualties in Nicaragua, and the Medical Department


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Cox-Klemin airplane ambulance at Kelly Field, Texas, 1926

tested this forerunner of the helicopter at the Medical Field Service School in 1936. Both tests showed that it was underpowered for use as a forward evacuation vehicle. Overall, there was little progress in the development of air ambulance technology and doctrine. Although many predicted that aviation would revolutionize field medical support, there remained considerable inertia as well as skepticism about its safety, medical efficacy, and military usefulness.7

Formation of the Medical Administrative Corps

The Medical Department's experience in World War I had demonstrated the importance of medical administrative and scientific specialty officers as members of the military medical team. Losing that capability after the war, the department searched for a solution. The establishment of a Sanitary Section of the Quartermaster Reserve was a partial remedy, and by 1920 413 Sanitary Corps officers had accepted appointments and transferred to the Quartermaster Corps. Col. Michael Blew, SnC, a sanitary engineer, was one of the officers who resigned his Sanitary Corps commission after the war and received a reserve commission in the Quartermaster Corps Sanitary Section.8

However, opportunity for commissioning in the reserves did nothing to alleviate the Medical Department's staffing problems for the Regular Army and provided only a tenuous source of officers. The absence of Regular Army officers in the specialties that had been provided by the USAAS and the Sanitary Corps again compelled the department to place physicians-as well as some dentists and veterinarians-in administrative positions as medical supply officers, adjutants,


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General Ireland

registrars, and commanders of field units and in charge of ambulances and transportation. The department estimated that about 20 percent of its uniformed physicians were engaged in nonclinical duties during this period. Maj. Gen. George E. Armstrong, who would serve as surgeon general during the Korean War era, said that when he entered active duty in the 1920s Army pay for physicians was equivalent to the incomes of their civilian peers, but the administrative jobs given to them made Army medicine unattractive. "We didn't go seven or eight years to medical school to become administrators; we wanted to take care of sick people."9

Brig. Gen. Harold W. Glattly, MC, later chief of personnel in the Surgeon General's Office, recalled the interwar period as a time of promotion "by senility" in the Medical Department.10 The department was held in high esteem by neither the civilian medical establishment nor the Army, and it experienced difficulty in recruiting qualified applicants. In 1927 only thirty-five physicians took the entrance examination for the Medical Corps, and only sixteen of those qualified. Not until the Great Depression did the number of applicants in a single year exceed 100.11

Such problems prompted Maj. Gen. Merritte W. Ireland, General Gorgas' successor as surgeon general from 1918 to 1931, to recommend formation of a Regular Army "Medical Service Corps." Ireland, in testimony on 4 September 1919 before the Senate Subcommittee on Military Affairs, proposed a corps of officers in grades from lieutenant to major who would perform the administrative specialties the department needed. It would provide commissioning opportunities for enlisted soldiers who had a minimum of five years' service, including at least three years as a noncommissioned officer.12

General Ireland was willing to give up authorizations for Medical Corps officers in order to establish a Medical Service Corps because he wanted to forestall any revival of the Civil War practice of detailing line officers for duty with the Medical Department. "The line officer you want for that kind of work is not at all willing to accept it. He wants to be with his organization in time of war."13 He argued that a Medical Service Corps would not only resolve that problem but would serve as an encouragement to enlisted members of the Hospital Corps, who would then have an opportunity to earn a commission in the Medical Department. It would also improve the utilization of pharmacists, since the new corps could include a limited number of pharamacists commissioned for duties in medical supply.


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TABLE 2-STRENGTH OF THE SANITARY RESERVE CORPS, 1921-1941

Date
(as of 30 June)

COL

LTC

MAJ

CPT

1LT

2LT

Total

1921

1

5

30

71

74

64

245

1926

4

41

101

144

110

97

497

1931

3

27

101

108

108

118

465

1936

2

17

72

71

67

166

395

1941

2

22

51

99

283

2

45

Source: Annual Reports of The Surgeon General, 1921-1941.

TABLE 3-STRENGTH OF THE MEDICAL ADMINISTRATIVE OFFICERS' RESERVE CORPS, 1921-1941

Date
(as of 30 June)

CPT

1LT

2LT

Total

1921

134

147

185

466

1926

304

431

760

1,495

1931

406

489

1,183

2,078

1936

261

416

889

1,566

1941

236

386

426

1,048

Source: Annual Reports of The Surgeon General, 1921-1941.

Congress acted upon Ireland's proposal in the Army Reorganization Act of 4 June 1920. The new law, codifying a U.S. defense policy of a small regular force backed up by a large, trained reserve, defined three components: a Regular Army composed of officers and enlisted personnel on continuous active duty; a National Guard; and an Organized Reserve. It established a Regular Army Medical Administrative Corps (MAC) as a permanent part of the Medical Department. The reserves included a Medical Administrative Officers' Reserve Corps and a Sanitary Officers' Reserve Corps. Congress used the title Medical Administrative Corps rather than General Ireland's proposed Medical Service Corps in order to distinguish the new corps as an organization designated for administrative specialty officers, in contrast to the Sanitary Corps, which was set aside for scientific specialty officers. There was no restriction on grades in the Sanitary Corps, but officers appointed in the Medical Administrative Corps were limited to the grade of captain.


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The law set an initial authorization for 140 Medical Administrative Corps officers in grades from second lieutenant to captain and provided for the appointment of enlisted soldiers with two or more years of active service. Examinations for appointment included tests in basic educational skills as well as written, oral, and practical tests in administrative regulations, office organization and administration, mess management, property management, military law, and drill and ceremonies. There was a good response to the opportunity for a commission in the Medical Department, and thirty-nine officers were appointed by the end of September 1920. Their principal duty assignments were adjutant, personnel adjutant, mess officer, supply officer, and office executive. By December 141 officers were on active duty, one more than the 140 authorized. All charter members of the Medical Administrative Corps were given a 1 July 1920 date of rank (see Appendix B).14

Officers with wartime service in the scientific specialties were generally appointed in the Sanitary Officer's Reserve Corps. Colonel Wrightson received such an appointment, as did 245 other World War I Sanitary Corps officers. Officers who had served in administrative specialties during the war were appointed in the Medical Administrative Corps Reserve. Some noncommissioned officers who were unable to obtain appointments in the Regular Army MAC were appointed in the MAC Reserve, which also provided for direct appointments from civilian life. By 1928 there were 1,887 officers in the MAC Reserve and 499 officers in the Sanitary Corps Reserve. A few officers were appointed in the National Guard. In 1937 the National Guard had 1 Sanitary Corps and 136 Medical Administrative Corps officers.15

The new corps had a rocky road to travel. The initial authorization of 140 officers-a figure based on a ratio of 1:2,000 enlisted soldiers in the active Army-was reduced in subsequent congressional action, dropping to 72 in June 1922. At that point, sixty-six MAC officers were surplus, a state of affairs not improved by the Pay Readjustment Act of 10 June 1922, which limited their income by preventing them from counting enlisted service for pay and allowances. General Ireland called that "unjust and discriminatory,"16 and the pay restrictions were lifted in 1928.The cap on promotions remained, even though Ireland sought legislation to establish promotion opportunity for MAC officers through the grade of colonel.17

Lack of a permanent corps for both administrative and scientific specialty officers soon produced problems to plague the department. In 1920 General Ireland began lobbying for establishment of a medical auxiliary corps that would merge the wartime MAC and Sanitary Corps into a permanent part of the Medical Department.18 Ireland continued his efforts throughout his long tenure as surgeon general. In April 1929 Congressman Jonathan M. Wainwright introduced legislation to replace the Medical Administrative Corps with a medical auxiliary corps of 120 officers and the enlisted personnel of the department's     Hospital Corps.19 Wainwright's proposal did not pass.

There was a trickle of appointments in the Medical Administrative Corps in the 1930s as vacancies occurred. For example, examinations conducted in the spring of 1934 resulted in nine appointments; examinations were held that fall for another ten. A disappointment for veteran officers came in 1935. Legislation was


97

enacted that provided a special retirement option to encourage officers in the World War I "hump" to retire, speeding up promotions for those who remained on active duty. Officers who met certain criteria were eligible to retire in the grade of major with a special pay multiplier. The problem was that all but six MAC officers in that category exceeded the maximum number of years of service (thirty) allowed by the law. If they retired, they would receive less retired pay than those officers who retired with less than twenty-nine years of service. The surgeon general, believing that this discrimination was not the intent of Congress, requested remedial legislation, but no action was taken.20

That was the background for the most dramatic of the setbacks for the Medical Administrative Corps, which came when Congress in 1936 reduced the corps to sixteen officers, a number that held until the eve of World War II. Officers already on active duty were "grandfathered," but the law restricted future appointments in the Regular Army Medical Administrative Corps to graduates of four-year schools of pharmacy.21

General Ireland, called "one of the greatest champions the Medical Administrative Corps ever had,"22 had been succeeded by Maj. Gen. Robert U. Patterson (1931-1935), who was followed by Maj. Gen. Charles R. Reynolds (1935-1939). General Reynolds, disenchanted with the corps, supported the cut­back. He said that recent appointees had been "inadequate substitutes" for physicians due to their lack of technical qualifications and limited military experience. Reynolds said the department had found it necessary to extensively train the new generation of MAC officers so that they could perform adequately. In short, he believed that a Medical Administrative Corps of sixteen pharmacists was plenty for the active Army. He also believed it would satisfy the desires of pharmacists, who for fifteen years had been clamoring for commissioned status. Finally, he believed it would end appointments of enlisted personnel as MAC officers, a practice he viewed with disfavor.23

Reynolds was reacting to an unevenness of quality in the MAC. Many of the officers who had originally been appointed in the corps had extensive military service, some dating from the Spanish-American War. As those older officers retired in the 1920s and 1930s, the replacement stream of new officers was drawn from a pool of personnel with much less experience, but who met the minimum requirement of two or more years of enlisted service. Some were commissioned as the result of efforts by senior Medical Corps patrons doing favors for their enlisted "dog robbers." Others, "commissioned corporals," were discredited by graft, pilferage, indebtedness, marital problems, or immorality. A few problem officers cast a bad light on the corps and blinded some of the department's leaders-General Reynolds for one-to the benefit of a corps of administrative specialty officers.

Indeed, given the limits of opportunity, the Medical Department was fortunate to attract and retain superior Medical Administrative Corps officers. Col. Frederick H. Gibbs, MSC, who served during this period, pointed out that while the majority were able, some were not up to the challenges of service as an officer, a problem at least partly a creation of the department's, since it had control over the selections for appointments in the corps. Colonel Gibbs believed that MAC officers of the interwar period had to be viewed within the context of their


98

times. They had limited opportunities for development, and the officers generally progressed to the extent of their own initiative for improvement, but without the benefit of personnel management planning by the department. Not surprisingly, MAC officer professional development was uneven.24

What General Reynolds said publicly he argued for more forcefully in private, to the extent of calling for the abolition of the Medical Administrative Corps. He said that in its time the MAC had been a worthwhile organization that had provided commissions for senior NCOs who had held wartime commissions in the Sanitary Corps. But that time had passed. Those old-timers were on the way out and their replacements did not have the education, experience, or potential to be officers. It would be best, he argued, to discontinue the corps. Only external pressure to create a separate pharmacy corps kept him from succeeding completely.25

Proposals for a Pharmacy Corps

There were proposals to establish additional Medical Department commissioned corps. One of the more unusual was an undertaking in 1935 by Congressman Frank Dorsey to establish an embalmers corps. Commissioning in that corps would have required a diploma from a recognized embalming school, three years' experience, and a qualifying examination. Successful candidates would be appointed as embalmers and assistant embalmers in the grade of first and second lieutenant, respectively, and would have an opportunity for promotion through the grade of major. The Medical Department opposed the proposal, citing insufficient workload. For example, in 1933 there were 574 Army deaths at 126 different locations, a figure that did not support the proposed solution.26 The proposal failed to gain War Department or congressional support.

The most significant proposal was a move to create a separate pharmacy corps, or at least to recognize pharmacists as commissioned officers. The initiative took on a life of its own during the 1920s and 1930s and embroiled three surgeons general. It exemplified the evolutionary process of twentieth-century American medicine in which emerging health care specialties were striving for recognition. When the pharmacy profession encountered institutional discrimination in the Medical Department, it turned to avenues outside the Army for help. Those avenues were open through a political influence unlike other specialties. Pharmacists, respected and trusted professionals, provided a gathering place for townspeople and neighbors to exchange news and gossip in thousands of corner drug stores all over the country. Not infrequently citizens also turned to them for assessments of the quality of local physicians. Smart politicians stayed tuned in to the pharmacists in their area, some of whom ran for office themselves.

In 1918 Caswell A. Mayo, editor of the American Druggist, had recommended the formation of a pharmacy corps along the lines of the French Army and the armies of other major powers, which commissioned pharmacists for a variety of administrative and scientific duties The French pharmacy corps, headed by a brigadier general, offered opportunities for its officers at all levels of the French military from the War Ministry on down in staff work, the management of manufacturing and warehouse operations, and scientific duties in clinical, toxicology,


99

research, and quality control laboratories. The pharmacy corps of Germany, Japan, and Spain were headed by colonels; those of Italy, Belgium, Holland, and Austria by lieutenant colonels; and majors headed the corps of Switzerland, Norway, Sweden, and Australia. Caswell had cited the department's success in the war with advisory committees composed of medical supply and equipment executives. Some were pharmacists, and their expertise had greatly assisted the mobilization. He found it inconceivable that there was no means to commission such talented leaders in the Medical Department. "We ask you to let pharmacists take the place of the physician doing non-medical work."27

Protestations by organized pharmacy at the end of the war had been overshadowed by the formation of the Medical Administrative Corps, but the issue remained alive as time passed, and pharmacists were still unable to obtain commissions. The American Pharmaceutical Association (APA) took up the issue and passed a resolution in 1928 supporting legislation to create a pharmacy corps. In October of that year, A. L. I. Winne, the APA chairman, wrote General Ireland asking for a meeting to discuss their proposal. His letter set off correspondence that would continue in a contentious spirit for over a decade. Even the details for setting an initial meeting became fractious.28

Ireland responded that he did not support creation of a pharmacy corps, just as he did not support establishing separate corps for psychology, nutrition, or other specialties. The surgeon general reminded Dr. Winne of a gentleman's agreement between Lt. Col. Carl R. Darnall, MC, his representative, and Dr. E. Fullerton Cook of the APA at the time the Medical Administrative Corps was formed. The Medical Department had agreed to provide commissioning opportunity for graduate pharmacists in the Regular Army MAC, which would be further supplemented in wartime by appointments in the Sanitary Corps Reserve. For its part, the APA had agreed to cease lobbying for a pharmacy corps. "Now with this perfectly frank statement on my part, I see no reason to put your committee to the trouble of visiting Washington for an interview." Of course, Ireland's office "was always open for visits by any gentleman who wants to see me." He added that he would be in his office during the period suggested by Winne.29

Winne was insulted by the surgeon general's putting off his committee. In the ensuing exchange of letters, Ireland denied that he had refused, but Winne insisted he had.30 He was certain that no "self-respecting committee would intrude themselves upon your presence on the strength of your statement that your office is open, and they may come in if they want to."31 There is no record that such a meeting occurred that year, and the controversy continued to simmer. General Ireland's continuing effort to get a medical auxiliary corps for all administrative and scientific specialties-including commissioned pharmacists-did not satisfy those who continued to seek a separate corps for pharmacists.32

The dispute went public in 1928 when Murray Breese, editor of the American Druggist, bitterly complained that restricting pharmacists to enlisted status ranked them no higher than cooks. For two decades pharmacists had been "shuttlecock to the Medical Corps' battledore," and the recognition accorded them in the Revolution and the Civil War had been lost. Patriotic labors of pharmacists had been met with "sweet words to the face and kicks


100

from the rear." Breese feared that General Ireland's medical auxiliary corps would result in a token number of commissions for pharmacists so that the department could argue that it had adequately provided for the specialty. He urged his readers to fight for their own corps, and he called on every pharmacist to join the fray.33

In January 1930 Senator Royal Copeland countered the proposal for a medical auxiliary corps with legislation for a pharmacy corps. This prompted Ireland to write a lengthy letter to the American Pharmaceutical Association expressing his support of the Wainwright Bill and his opposition to Copeland's. In private he was convinced that his proposal for a medical auxiliary corps would deflect the APA lobbying for a separate corps.34 In fact, it did please the moderate wing of the APA, as reflected when E. Fullerton Cook, Ph.D., head of a special committee of the APA, wrote Ireland to express his hope that the surgeon general would have the full support of the pharmacy profession for the Wainwright Bill. Ireland, encouraged by this, told Congressman Wainwright that he opposed the establishment of a pharmacy corps but was attempting to reach agreement with American Pharmaceutical Association representatives.35

Neither legislative proposal passed, but the issue of commissioning pharmacists did not die. In 1932 the surgeon general, General Patterson, wrote the APA that there were thirty graduate or registered pharmacists on active duty as enlisted pharmacists in Medical Department facilities. His office had canvassed Army hospital commanders and determined that there was a requirement for ten more, but no requirement for commissioned officers. Consequently he had closed the door on any support for commissioning, a position he reiterated in 1934. However, the APA persisted, and in 1935 its president wrote Patterson that there continued to be considerable support for a separate pharmacy corps. Patterson would not hear it. He did not support efforts that would create an "unwieldy and illogical organization."36

The legislative drumbeat continued. General Patterson supported a proposal to establish a medical auxiliary corps that was introduced by Congressman Jed Johnson in 1935, but he opposed another that would increase the Medical Administrative Corps by forty spaces for commissioned pharmacists. He again called for the establishment of a medical auxiliary corps. Another House legislative proposal called for appointment of pharmacists in the Medical Corps.37

In May 1935, his final month as surgeon general, Patterson wrote of his exasperation with the whole business. He complained that a great deal of the agitation by organized pharmacy was "based upon the desires of certain men in the enlisted ranks of the Army who were trying to force themselves into a better status in the Medical Department without having the necessary educational qualifications." Patterson declared that in many hospitals "there wouldn't be one full hour's work a day" for a pharmacist. The truth was that he believed there was a requirement for no more than fifteen or seventeen pharmacists in the entire Medical Department.38

General Reynolds became entangled in this issue shortly after succeeding Patterson as surgeon general. Reynolds supported his predecessor's proposal for a


101

medical auxiliary corps and opposed the formation of a pharmacy corps. However, he soon learned that organized pharmacy had not abandoned hope for a separate corps. In January 1936 Dr. H. Evert Kendig, head of an APA committee formed to promote a pharmacy corps, wrote to Reynolds asking for his help in commissioning pharmacists. Kending said he was under considerable pressure to support a separate corps and was being rapidly forced into a nonnegotiable position by members of his profession.39

General Reynolds, changing the department's tune, came out in favor of commissioning pharmacists, pointing to recent increases in the Army's enlisted strength, which had created new patient care workload requirements for the Medical Department. A study conducted by the Surgeon General's Office identified requirements for twenty-one commissioned pharmacists. Seven were at general hospitals, eight at station hospitals, one at a general dispensary in Washington, D.C., four in depots, and one in the Surgeon General's Office. Commissioning pharmacists in the MAC would be an obvious solution, but the problem was that the two-year enlisted service requirement precluded commissioning officers from outside the enlisted ranks.40

In March 1936 Senator Norm Sheppard of the Senate Committee on Military Affairs sent Reynolds a copy of a bill he had introduced to restrict Medical Administrative Corps appointments to pharmacists. The surgeon general was not in a receptive mood since he was now pushing for abolition of the Medical Administrative Corps. His previous spirit of accommodation had vanished, and he opposed commissioning pharmacists. He believed the Army's pharmacy requirements were adequately met by the nearly forty graduate pharmacists who were serving as enlisted technicians under the direct control of physicians. Wartime needs would be handled by appointing pharmacists in the Officer Reserve Corps. In short, pharmacists were just one of a number of groups-osteopaths, chiropractors, chiropodists, and embalmers were others-"definitely not essential to the medical service of the Army."41

That was not the end of it, for General Reynolds would soon reverse himself again when he saw a way to, in effect, eliminate the Medical Administrative Corps by restricting it to pharmacists. Testifying in hearings on Sheppard's bill on 26 May 1936, Reynolds supported the appointment of sixteen pharmacists in the Medical Administrative Corps. He stated that these officers could serve in a variety of positions useful to the Medical Department, including procurement of medical materiel and training enlisted pharmacy technicians.42

The effort to commission pharmacists at last succeeded when, on 24 June 1936, Congress required the Army to appoint graduates of recognized four-year pharmacy programs as officers in the Medical Administrative Corps. The Medical Department conducted examinations and commissioned two of eighty-five applicants: 2d Lt. Glenn K. Smith, MAC, and 2d Lt. Howard B. Nelson, MAC. By 1939 there were eleven graduate pharmacists in the MAC, and examinations were conducted that November to fill five vacancies. General Reynolds' move to eliminate the Medical Administrative Corps turned another corner on 3 April 1939, when Congress limited the Regular Army Medical Administrative Corps to sixteen pharmacists, thereby restricting future appointments to pharmacists. There


102

were just sixty-eight Regular Army MAC officers on active duty when the United States entered World War II.43

In the end, resolution of the issue was a compromise. Pharmacists had gained the opportunity to serve as commissioned officers in the Medical Department. The department had acquiesced to that ambition but had prevented the establishment of yet another separate corps by restricting new appointments in the Regular Army MAC to pharmacists. Unfortunately, the department had achieved a Pyrrhic victory, because it had lost from the Regular Army the range of administrative specialties the Sanitary Corps had provided it in World War I. Those officers were vital for wartime readiness, and the loss of that capability would hamper the department's performance in the early years of World War II. It was a loss that could have been devastating if the nation had not enjoyed the luxury of a long period to mobilize.

Administrative Specialty Officers

Medical Administrative Corps officers were scattered throughout the Army, but their small numbers did not preclude their use in emergency situations. A relief expedition sent to Japan after an earthquake in 1923 included two MAC officers who assisted in establishing a 1,000-bed base hospital and a field hospital in Tokyo. Some MAC officers filled administrative positions in the Medical Division of the Air Corps, the forerunner of the U.S. Air Force Medical Service and a component of the Medical Department that operated semiautonomously.44

A large post would have only two or three MAC officers. In 1925 2d Lt. Robert L. Black, MAC, who as a colonel would become the second chief of the Medical Service Corps, enlisted, and in 1928 he successfully competed for one of four Medical Administrative Corps vacancies. Commissioned that December, he reported to Fitzsimons General Hospital, Denver, Colorado, where he joined the hospital's adjutant and the officers club manager as one of three MAC officers on the post, each of whom assumed a number of additional responsibilities. Black was assigned as the medical supply officer, but one of his extra duties was management of a pig farm, which the hospital maintained to handle the disposal of edible garbage. When Black moved the following year to the hospital at Schofield Barracks, Hawaii, he was the sole Medical Administrative Corps officer. There he served as medical supply officer, adjutant, mess officer, registrar, troop commander, recreation officer, and summary courts-martial officer.45

Duty conditions were not necessarily unpleasant. After Hawaii, Black reported to Fort Benning, Georgia, where he was one of two MACs. There, as in Hawaii, the duty day ended at 1300, a situation that made it possible for the Black family to take up golf and horseback riding. Yet, however pleasant the working conditions might have been, they did not fully compensate for the shortcomings of military service in the interwar period. Black was promoted to first lieutenant in 1931, but a cut in military spending meant that promotions would result in no increase in pay, and he continued on the salary of a second lieutenant. Injury was added to insult when Congress imposed a 15 percent pay cut.46


103

A few officers attended the basic officers course at the Medical Field Service School, Carlisle Barracks, Pennsylvania. There 1st Lt. Glenn K. Smith was the only Medical Administrative Corps officer among fifty-eight graduates in the audience when Army Chief of Staff Maj. Gen. Malin Craig addressed the class in June 1938. Attendance at the advanced course was practically unknown for MAC officers, and none attended the Army Command and General Staff College at Leavenworth or the Army War College. Two attended the Army Industrial College during the interwar period.47

Reserve officers were supposed to receive two weeks of training each year, but that was not always the case.48 Despite the fact that reserve training was erratic, some Medical Department reservists were able to attend two-week summer camps throughout the country; 223 Medical Administrative Corps and 51 Sanitary Corps reserve officers attended those camps in 1931, a representative year. Other reserve MAC and Sanitary Corps officers served as instructors with Medical Department Reserve Officer Training Corps (ROTC) summer camps for medical, dental, and veterinary students at Carlisle Barracks, Pennsylvania; Fort Snelling, Minnesota; Fort Lewis, Washington; Fort Sam Houston, Texas; and Fort Oglethorpe, Georgia.49

The Medical Department benefited from the service of MAC officers who stuck it out during the interwar period. One was Lt. Col. Thomas M. England, MAC, an officer whose services received special recognition when England General Hospital, a 3,650-bed hospital in Atlantic City, New Jersey, was named after him during World War II. England had enlisted in the Army in 1899 and served in the occupation of Cuba. While there, he volunteered for Walter Reed's yellow fever experiments, whose protocol required him to sleep twenty nights in a bed formerly occupied by a yellow fever patient, in the clothing worn by a victim of the disease, and with his head lying "on a towel stained with the blood of a case of yellow-fever." In 1931 England was awarded the Yellow Fever Medal for this act of courage, a congressional award consisting of a gold medal, annual listing in the Army's Roll of Honor, and payment of $250 per month for life.

England was a master hospital sergeant when commissioned in the Sanitary Corps in 1918. He had served as a medical supply officer in the United States and France during World War I and in Washington, D.C., after the war. He was in the original group of officers appointed in the Medical Administrative Corps. England retired in October 1940 upon reaching the statutory age limit of sixty-four. He was recalled to active duty a week later, promoted to major when the Medical Administrative Corps grade limitation of captain was lifted, and later promoted to lieutenant colonel. He died on active duty in 1943 while serving as the Executive Officer and Chief, Medical Branch Office, Headquarters, Fifth Service Command, Fort Hayes, Ohio. He was sixty-seven years old and in his forty-fifth year of active federal service at the time of his death.50

Another early Medical Administrative Corps officer was Capt. Robert A. Dickson, the Sanitary Corps officer awarded the Distinguished Service Medal for his service in France in World War I. Appointed as a captain in the Medical Administrative Corps at age forty-five, he performed in a variety of assignments


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Army Industrial College Class of 1929-30. Captain England is fourth from left and Captain Dickson is sixth from right in the second row

in the 1920s and 1930s, including adjutant, enlisted detachment commander, and post exchange officer. He retired as a captain in 1934. Dickson and England were the only MAC officers to attend the Army Industrial College during this period. Capt. Oscar Burkard, the Sanitary Corps holder of the Medal of Honor, was also one of the first Medical Administrative Corps officers. Burkard served at various posts in the 1920s and retired as a captain in 1930.51

Some MAC officers would later be leaders in the Medical Service Corps and retire as MSC colonels. One was Joseph Carmack, who enlisted in 1924. In 1930 he was commissioned as one of three successful candidates out of 300 applicants. Another was Harry Nelson, who enlisted in 1932 and later applied for an MAC commission. He passed the appointment examination in Omaha, Nebraska, in October 1934, but a shortage of vacancies delayed his appointment until August 1935. In December 1935 he reported to the basic officers course at Carlisle Barracks, which was followed by assignment to the 11th Medical Regiment, Schofield Barracks, Hawaii. There he served with the ambulance company, as commander of the headquarters and service company, and later as hospital medical supply officer. In 1935 he was assigned to Fort Jay, New York, where he was promoted to first lieutenant after five years in grade as second lieutenant, a wait that was normal for that period. At Fort Jay he was the only Medical Administrative Corps officer assigned to the hospital. He was promoted to captain in 1940 but, due to congressional funding limits for the military, continued at the salary of his previous grade.52

Col. Louis "Bill" Williams, MSC, enlisted in 1923 and was commissioned in the Medical Administrative Corps in 1931. "General MacArthur was on one end of the promotion list and I was on the other." He concentrated in medical logistics, a specialty that particularly appealed to him because, unlike people, supplies did not talk back. Officers were identified only by their branch, for this was before the Army established military occupational specialties (MOSs) for officers, and Williams handled the various duties common for MAC officers. "You did not tell the old man that was not your MOS, you just did the job," he later recalled. Army life appealed to him. "I came out of a tobacco patch in Tennessee, so every day in the Army was like Sunday on the farm."53


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Medical Logistics

Medical logistics began to expand greatly as American medicine underwent a technological revolution. The Army supply table listed 74 drugs and 18 surgical instruments in 1918; by 1927 the table listed 4,300 items in these categories. Medical Administrative Corps officers handled the overseas responsibilities for medical logistics. One was Capt. W. Harvey Kernan, MAC, who from 1925 to 1928 served as the medical supply officer in Panama where he was instrumental in organizing the medical supply depot on the Atlantic side of the Panama Canal Zone. The depot was named in his honor in 1967. In 1935 MAC Capts. John D. Foley, Richard E. Humes, and Edward D. Sykes were in charge of medical supply operations in Panama, Hawaii, and the Philippines, respectively.54

The minuscule size of the Medical Administrative Corps limited the use of MAC officers, and it again fell to physicians in the active Army to assume duties as medical supply officers. In 1934 the medical supply officers of the New York, Eighth Corps Area, San Francisco, and Chicago quartermaster depots and the commander of the St. Louis Medical Depot were all physicians. Colonel Black was assigned in 1937 to Fort Sam Houston, San Antonio, Texas, as the medical supply officer, replacing a Medical Corps officer who believed that "no lay person could ever successfully hold such a position."55 At least some efforts were made during the interwar years to plan for mobilization. In 1924 sixty-two medical supply industry executives were commissioned in the Sanitary Corps Reserve for that purpose.

That the Medical Department retained its medical supply function at all was in itself an accomplishment. Maj. Gen. George W. Goethals, who had directed the completion of the Panama Canal-and had been General Gorgas' nemesis-was recalled to active duty in World War I as the Army's director of purchase, storage, and traffic.56 At the end of the war Goethals succeeded in transferring the medical supply functions of the surgeon general to his office where it remained for about two years, shifting back only after Goethals retired. The surgeon general reported that the experiment was a failure, having "demonstrated that a single supply system is too complicated for general use in providing supply for the Army."57

Goethals saw it differently. Called to testify in the congressional hearings for the 1920 Army Reorganization Act, he argued for creation of a department of supply for the Army that would handle all Army standard supply and transportation functions, including medical items. He once again clashed with the surgeon general. He recalled his experience during the war:

They stated I could not buy medicines. Well, the doctors can not buy medicines, either. They get chemists in to do their purchasing, and I could get chemists in to do the purchasing, and those chemists could buy other chemical goods that are required by the other bureaus. . . . [Army physicians] could then look after the sick. That is their proper function.58

Goethal's proposal was not adopted, and the Medical Department retained its medical logistics responsibilities.

Training was principally a matter of detailing junior officers to medical supply depots for on-the-job experience. Some Medical Administrative Corps, Medical Corps, and Veterinary Corps officers attended a two-year Medical


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Supply Training School established in 1922 at the New York General Depot, which had the largest medical section of all the depots. The school also offered an advanced medical supply training program designed to prepare Army physicians for the highest positions in medical supply. This program consisted of a series of rotations beginning with twenty-one months at the New York Depot, followed by twelve months' experience in the Surgeon General's Office and the ten-month course of the Army Industrial College. Colonel Black applied for the advanced program, but the Surgeon General's Office "quite definitely closed the door for other than Medical Corps pupils."59

There were attempts to increase the training of reserve medical logisticians as war threatened in Europe. The most advanced program was at the New York Depot, where in the late 1930s the department could rely upon about 125 reserve medical supply officers in the New York City area. Many of the reserve officers worked in areas allied to their Medical Department specialties as hospital purchasing agents, drug company executives, chemists, and plant managers. The department's training program consisted of lectures, demonstrations, and exhibits. Fifty-four officers attended the 1938 session.60

The military buildup in the years just before the United States entered World War II created additional requirements for medical logistics officers. Accordingly, the Medical Department requested authority in 1940 to commission lieutenants in the Sanitary Corps Reserve to serve as purchasing agents, and it regularly brought the shortage of medical supply officers to the attention of the assistant secretary of war. Those shortages and others caused the War Department to bring additional reserve and National Guard MAC and Sanitary Corps officers on active duty in the year prior to America's entrance into the war. There were twelve MAC and Sanitary Corps Reserve officers on active duty in June 1940. A year later there were 1,233.61

There was a lighter side to the medical supply business. In Hawaii, Colonel Black managed the medical war reserve stock of supplies and equipment, mostly World War I surplus. This included 55-gallon drums of alcohol, which the depot repackaged into 5-gallon containers for issue to medical units. The drums had originally been filled in a cold climate, and when opened in Hawaii would erupt in a fountain of spray. Black devised a way to capture the surplus, which when mixed in charcoal barrels made a satisfactory gin. He never lacked for associates willing to help in his "surplus disposal activities."62

A medical supply officer for Schofield Barracks, 1st Lt. Joseph E. McKnight, MAC, demonstrated innovation of a different sort when asked to repair a hopelessly overloaded air compressor for the dental clinic. McKnight rounded up an old Kelvinator compressor, a one-half-horsepower electric motor from a dishwasher, an automatic switch, and a forty-gallon tank. He talked the post electrician into assembling that collection of parts into a suitable replacement compressor, which ended complaints about compressed air.63

Hospital Administration

Health care had become a billion-dollar business in the United States. American hospitals were on their way to being important institutions, although


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the Great Depression whittled their number from 6,852 in 1928 to 6,166 in 1938.64 Their buildings became more imposing structures as Elisha Otis' successful development of the elevator enabled vertical rather than pavilion-style construction. Pressure from external influences, such as the American College of Surgeons (ACS), pushed hospitals into management improvements. The ACS conducted more than forty thousand surveys of American hospitals from 1918 to 1936. It approved 76 percent of the 3,564 hospitals it surveyed in 1939-over 93 percent of the large hospitals passed-a great improvement since its first surveys in 1918.65 The number of American medical schools dropped to ninety-six in 1915 and to seventy-six in 1930 as the institutional revolution of American medical schools from 1885 to 1925 was completed, and medical schools assumed the corporate form they would retain for the rest of the century. That development had given rise to the modern teaching hospital, another pressure for professional hospital administration.66

Army hospitals also became considerable enterprises demanding professional management. The Medical Department operated seven general hospitals and eight smaller station hospitals in the United States and the Philippines, the largest of which in 1936 were two 1,200-bed hospitals, the Walter Reed General Hospital in Washington, D.C., and the Fitzsimons General Hospital in Denver, Colorado. In 1925 all government hospitals submitted to the survey program of the ACS, and all passed.67 Yet, while the civilian practice of hospital administration was maturing into a clearly defined profession, change occurred slowly in the Army. A shortage of military physicians in the expanding prewar Army became acute during the winter of 1940-41, and some MAC officers replaced physicians in administrative specialty positions to help alleviate the staffing problems. But substitution of that sort did not materially progress during the interwar years. It would take World War II to spur the growth of professionalism in Army hospital administration.68

While evolving, hospital administration did not yet possess the attractiveness as a profession that it would later have. It was still "generally viewed as an inferior calling, offering a berth rather than an opportunity."69 Educational levels reflected that perception: of 2,196 administrators responding to a survey in 1935, 12 percent had no education beyond high school. While 67 percent of the men had university degrees, that figure was misleading because two-thirds of all administrators were women, and only 8 percent of the women had college degrees. Furthermore, half of all male respondents were physicians whose training was not related to management.70

The American College of Hospital Administrators (ACHA) was an important factor in the development of the profession both in civilian life and in the Army. Formed in 1933 to enhance the professional growth and development of its members, it both influenced and was influenced by Medical Administrative Corps and, later, Medical Service Corps officers. University training in hospital administration began, and in 1934 Michael M. Davis at the University of Chicago started the first successful graduate program. However, the Medical Department offered its officers no programs to improve their skills in hospital administration during the interwar period.71


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Professor Gibbs

Frederick H. Gibbs was a pioneer in hospital administration whose career exemplified the noncommissioned officers who developed expertise in various administrative specialties and went on to obtain appointments in the Medical Administrative Corps. Gibbs enlisted in 1925 and his Medical Department assignments led to commissioning in 1941 and to various hospital administration assignments, including duty during World War II as the 4th Service Command Hospital. During the war Gibbs served as chief of the Surgeon General's Management Improvement Branch and as the second director of the Army-Baylor Program in Hospital Administration. In 1956 Colonel Gibbs became director of the Interagency Institute for Federal Health Care Executives. He founded the graduate program in Health Services

Administration of the George Washington University after his retirement from the Army.72

Scientific Specialty Officers

The absence of a Sanitary Corps in the Regular Army prevented the flowering of the scientific specialties provided by that corps in World War I. A small number of Sanitary Corps officers maintained an Army affiliation during the interwar years through the reserve or National Guard. The importance of that corps as a Medical Department wartime asset was recognized in the Medical Department's Handbook for the Medical Soldier:

It is composed of officers qualified as sanitary engineers, hospital architects, public health licentiates who are not graduates in medicine, experts on food and nutrition, psychologists, chemists, laboratory and x-ray experts, and business and technical men engaged in the production of supplies and appliances used by the Medical Department.73

Annual training of Sanitary Corps Reserve officers began with four officers attending summer training in 1923 and 1924. A two-week course for Medical Department officers began in 1925 at the Medical Field Service School, Carlisle Barracks, that was attended by twenty-five Sanitary Corps and twenty-six Medical Administrative Corps Reserve officers the first year. During the 1927 session Lt. Col. William A. Hardenbergh, SnC, recognized a need for training physicians and Sanitary Corps officers in the distinctive requirements of military preventive medicine; he led the other sixteen Sanitary Corps officers attending


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summer camp in developing a military sanitation course that was conducted each summer from 1928 to 1940 for both Medical Corps and Sanitary Corps officers. The course included instruction in epidemiology, sanitary engineering, and preventive medicine administration. The reserve officers also used the time at summer camp to develop wartime preventive medicine doctrine and plans for the utilization of scientific specialty officers, principally sanitary engineers. That effort included plans drawn up in 1935 by Lt. Col. Paul E. Howell, SnC, and Maj. Rudolph J. Anderson, SnC, for the use of nutrition officers. The efforts of these officers during the interwar years helped to offset the absence of their expertise on active duty and ensured that the Army had a nucleus of preventive medicine specialists and doctrine to draw from when the United States entered World War II. A small reserve corps devoted to preventive medicine purposes provided the department and the nation with a capability that had not existed in previous interwar periods.74

Sanitary Engineering

Sanitary engineers were prominent in the Medical Department's planning efforts. Led by Colonel Hardenbergh, a prominent sanitary engineer who published standard texts on water purification and sewage treatment during this period, they maintained their currency with military medicine and with each other through correspondence courses, meetings of local reserve groups, and annual training. Hardenbergh, Lt. Col. Michael Blew, SnC, and others directed the two-week training sessions at Carlisle.75

The wartime doctrine, as they developed it under Hardenbergh's leadership in 1934, called for sanitary engineers to gather preventive medicine data and to supervise sanitation efforts within each corps area during the mobilization period. They envisioned that sanitation for a field army would be the responsibility of Sanitary Corps public health specialists assigned to the army surgeon who would have a sanitary battalion to execute the preventive medicine efforts throughout the field army area of operations. Hardenbergh and other planners believed that the structure they proposed would both improve the Army's sanitation efforts and provide increased opportunity for field grade promotions for Sanitary Corps officers.76

Their planning, which was based on the concept of a small reserve Sanitary Corps without any Regular Army counterpart, gave pause to some outside observers. The editor of the American Journal of Public Health argued that only 100 of the 400 Sanitary Corps Reserve officers were "qualified sanitarians." That number would be insufficient for the public health capability to support the Army's planning for the mobilization of over 1.5 million soldiers in four months. Their plans were not the precise blueprint; a sanitary battalion would not come to pass, for example. Yet the effort had catalyzed organizations representing the interests of sanitary engineers into a posture of careful oversight that would intensify after World War II.77

Perhaps most important, the department had an enthusiastic nucleus of officers who were devoted to the objectives of preventive medicine. Their training ended each summer with a meeting of the Loyal Order of the Boar, a fraternal group


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Colonel Hardenbergh
(Photo taken in 1941.)

formed at Carlisle in 1928. Membership was by invitation for a select group of Sanitary Corps and Medical Corps officers who were "interested primarily in sanitation and the promotion of good fellowship between officers of the Regular and Reserve components of the Army." Its mottos were Fratres Suilis and "In Union There Is Strength." Its logo was two hogs pointing in opposite directions with their tails entwined. Meetings followed an agenda of "banquet, Boar business, and the initiation of the shoats into the Order." Officers included a president, vice president, secretary-treasurer, and "The Boar." The Loyal Order of the Boar continued to generate a fraternal spirit among officers affiliated with the preventive medicine mission during the interwar period as well as after World War II.78

Chiropody and Optometry

No state regulated chiropody prior to 1895, and barbers, masseurs, shoemakers, and shoe clerks cut corns as a sideline along with itinerant corn-cutters. By the early 1930s chiropody had come to include the treatment of a variety of foot conditions such as bunions, abnormal nails, and defective arches. It was becoming established as a distinct health care specialty, partly "because chiropodists are able to supply service at a price which physicians cannot and will not meet."79 H.R. 3738, introduced in 1941, proposed establishment of an Army chiropody corps of the same number of officers as the Dental Corps. Candidates would have to be graduates of established colleges of chiropody and pass a Medical Department examination in the specialty. This legislation, as in the case of the embalmers corps, failed to gain congressional support and died.80

By 1932 there were 20,000 optometrists practicing in the United States, and the profession was exhibiting a widening scope of practice based on a broader range of diagnostic procedures. Their bread-and-butter procedure of refraction was becoming viewed as a technical application for which the ophthalmologist was overtrained. When a physician performed that procedure "his general medical knowledge lies idle and constitutes an unused overhead for which patients must pay." However, the absence of military optometrists required Army physicians to perform the examinations.81

The program of free issue of spectacles to enlisted personnel begun in 1918 was extended to officers in 1920 and then dropped in 1922. While Army physicians could prescribe spectacles, the government would not as a rule supply them free of charge. The Medical Department got back in the business-although not


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for soldiers-in the 1930s when it was tasked with providing medical support to the Civilian Conservation Corps (CCC), one of FDR's New Deal programs. The Army charged the CCC enrollees an average of $2.60 for a pair of eyeglasses. This was during a time when spectacle prices generally ranged between $5 and $10, although some larger drug chains would sell them for as low as $3-$5.82

Summary

The Army needed commissioned officers in a variety of administrative and scientific specialties to form the team necessary for a modern military medical support system. As a result, the Medical Department struggled to retain in peacetime the capabilities that had been created during war, and Surgeon Generals Ireland and Patterson fought to establish a full-time corps, which they called the Medical Auxiliary Corps. But their dream was not to become reality during the interwar period. The formation of the Medical Administrative Corps in the Regular Army and reserve components and the retention of the Sanitary Corps in the reserve components was as far as Congress was prepared to go.

The need for officers in administrative specialties was met only marginally, and the department again resorted to using clinicians-principally physicians and dentists-to fill administrative positions. The need to return such specialists to clinical practice (and to enable them to retain their professional skills), the increasing sophistication of health care institutions, and the advances in administrative specialties were building a demand not met by the Medical Department's structure. The professionalization of hospital administration in the civilian sector-as exemplified in the formation of the American College of Hospital Administrators-represented advances in the civilian health care industry not matched by the Army. The move to provide additional reserve component officers qualified in medical supply was an encouraging development, but not enough for a department charged with preparing an industrial capability to support a world power.

The growth of scientific medicine was producing emerging specialties that sought professional recognition by the Army. Chiropody knocked on the door with a proposal for a separate corps, and the Army's tentative steps in establishing an optical program for soldiers was a glimpse at the future of optometry. Sanitary engineers established a position of prominence, to the credit of Col. William Hardenbergh and his fellow reserve officers. Their work in developing a sanitary engineering doctrine for wartime preventive medicine exhibited the progressive thinking necessary for a modern army.

Pharmacy's lobbying for a place in the commissioned officer ranks was one of the larger stories, both as an example of an emerging scientific specialty and as a demonstration of the effect of external influences upon the Medical Department. The pharmacy struggle entangled three surgeons general in a protracted debate with representatives of a politically influential specialty's professional guilds and trade press. It resulted in the addition of a needed commissioned specialty, but only at the cost of losing others.

Opportunities for career advancement remained small. The Army offered Regular Army careers for a small number of officers commissioned in adminis-


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trative and scientific specialties, the latter restricted to pharmacy. For those few officers, their opportunity in the Army beyond commissioning was circumscribed by limited chances for training, positions, promotions, and sometimes pay. Those constraints made it difficult to build professionalism in the Medical Administrative Corps. Another small group had an opportunity for Army affiliation on a part-time basis through the reserve and National Guard, but the active and reserve components together did not provide the numbers or expertise for the department to assume global responsibilities.

Nevertheless, a small group of Medical Administrative Corps officers kept the flame alive in the Regular Army during the interwar period. They formed a slender thread of continuity between the world wars. Years later, Col. Othmar Goriup, the first chief of the Medical Service Corps, saluted the officers who stuck it out, "little, old, gray-haired people who were still captains." He hoped that young officers just entering active duty would be told about "the real black days" when opportunity was so limited. "If it hadn't been for these people, God knows we probably wouldn't have . . . the Corps that we have today."83


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Notes

1Demobilization: See Marvin A. Kreidberg and Merton G. Henry, History of Military Mobilization in the United States Army, 1775-1945 (Washington, D.C.: Government Printing Office, 1955), pp. 374, 379. Numbers: SG Report, 1919, 2: 1112; SG Report, 1920, p. 284; Lynch, The Surgeon General's Office, p. 138. Reductions: John H. McMinn and Max Levin, Personnel in World War II, vol. 14 of Medical Department, United States Army in World War II, ed. John B. Coates, Jr. (Washington, D.C.: Office of the Surgeon General, Department of the Army, 1963), pp. 23, 113; Medical Bulletin (April 1938): 1. SGO cut: Medical Bulletin (October 1934): 4. USAAS and SnC: SG Report, 1919, 2: 1118. Wrightson: Biographical summary, U.S. Army Center of Military History, in MSC-USACMH.

2Great Depression: John J. Ward, who would eventually retire as an MSC colonel, entered college in 1929, the year of the stock market crash. He worked in a steel mill for 17¢ an hour in order to pay $5 a week for room and board. Stack Arms, newsletter of the Willow Grove Chapter of the Retired Officers Association, Incl to Ltr, Col John J. Ward, USA, Ret., to Col Walter F. Johnson III, MSC, 18 Mar 85, in MSC history files, DASG-MS.

3Interwar period: Biographical information based on lectures and typed summaries by D. Clayton James, Ph.D., Morrison Professor of History, U.S. Army Command and General Staff College, Fort Leavenworth, Kans., 2 Apr-2 Jun 81, author's notes. See also Thomas W. Collier, "The Army and the Great Depression," Parameters 18 (September 1988): 105; Peter Lyon, Eisenhower: Portrait of the Hero (Boston: Little, Brown, and Company, 1974), p. 53. Quoted words: Forrest C. Pogue, George C. Marshall: Education of a General, 1880-1939, vol. 1 of 3 (New York: Viking, 1963), p. 297. Marshall was a lieutenant for fourteen years after his graduation from Virginia Military Institute in 1901.

4Schools: See also Weigley, History of the United States Army, pp. 477-78. They also wrote. In 1920 Eisenhower and Patton published articles in the Infantry Journal promoting the tank, an action that got Eisenhower in hot water with the chief of infantry. See George S. Patton, "Tanks in Future Wars," Infantry Journal 13 (May 1920): 958-62; Dwight D. Eisenhower, "A Tank Discussion," Infantry Journal 13 (November 1920): 453-58; Eisenhower, At Ease: Stories I Tell to Friends (New York: Doubleday, 1967), p. 173.

5Quoted words: SG Report, 1922, p. 242.

6Medical Field Service School (MFSS): SG Report, 1922, pp. 243-44; Interv, Col Henry J. Nelson, MSC, Ret., with Col Harral A. Bigham, MSC, Denver, Colo., 2 Jan 85, DASG-MS. Quoted words: Maj C. H. Rice, Inspector General Department (IGD), War Department Inspector General (WDIG), in Rpt, sub: Inspection and Survey of Carlisle Barracks, Pennsylvania, June 3-7, 1929, 22 Jun 29, RG 159, E11, Box 185, NARA-WNRC.

7Air ambulances: SG Report, 1926, p. 304, and 1930, p. 395; Medical Bulletin 26 (September 1931): 122-31; Richard Tierney and Fred Montgomery, The Army Aviation Story (Northport, Ala.:

Colonial Press, 1963), p. 204; David M. Lam, "From Balloon to Black Hawk: The Origins," pp. 46-48. The Panama plane flew five missions evacuating seven patients before it was destroyed in a crash. Each mission averaged five hours, a savings of twenty-four hours. The Kelly Field plane received national attention when it evacuated casualties from a tornado in Rocksprings, Texas, in 1927; in 1930 it evacuated thirty-four patients.

8Colonel Blew: THU, OTSG, Minutes of the First Meeting of the Advisory Editorial Board for the History of the U.S. Army Medical Service Corps, held at Forest Glen, Maryland, 13 November 1958, MSC-USACMH, cited hereafter as 1958 MSC History Project. Appointments: SG Report, 1920, p. 293. SnC Reserve: Speech, Lt Col. Joseph J. Gilbert, SnC, at Sanitary Corps, U.S. Army, Conference of Sanitary Corps Officers, Headquarters (HQ), 2d Service Command, 24 Nov 44, MSC-USACMH.

920 percent: Medical Bulletin (February 1922): 45. Quoted words: Interv, Maj Gen George E. Armstrong, MC, Ret., with Col. Joseph Israeloff, MSC, THU, OTSG, 12 Mar 76, interv files, USACMH.

10Quoted words: Interv, Brig Gen Harold W. Glattly, MC, Ret., with Samuel Milner, CMH, 22 Oct 63, USACMH.


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11Problems: James A. Tobey, The Medical Department of the Army, Institute for Government Research Monograph no. 45 (Baltimore: Johns Hopkins, 1927), pp. 68, 84-92, hereafter cited as

Tobey, The Medical Department, Maj Gen Norman T. Kirk to Brig Gen Elliot G. Cutler, Harvard University Medical School, sub: The Procurement of Medical Officers for the Post War Army, 1 Jul

46, MSC-USACMH. "They were looked down upon by the line, and had little to do with civilian medicine, who didn't think much of them either" (Interv, Col Frederick H. Gibbs, MSC, Ret., with

Samuel Milner, CMH, 18 Mar 64, USACMH).

12MSC proposal: U.S. Congress, Senate, Hearings on S. 2715, A Bill To Increase the Efficiency of the United States Army, and for Other Purposes, 66th Cong., 1st sess., 1919, p. 612. In fact a "Medical Service Corps" already existed. The Council of National Defense, in an action on 31 January 1918 that was approved by President Wilson on 12 August, formed a "Volunteer Medical Service Corps" for the purpose of enrolling all physicians who were not eligible for reasons such as age, physical disability, etc., for service in the Medical Reserve Corps of the Army or Navy. This was a creature of the moment when there was patriotic fervor to "go over there," and the catalyst for the group ended with the armistice. Franklin Martin, "Volunteer Medical Service Corps," New York Medical Journal 108 (1918): 291-93.

13Quoted words: Ibid.

14MAC formation: 41 Stat. 767, 4 June 1920; Memo, Capt E. R. Taylor, Judge Advocate General Corps (JAGC), for Col Kintz, sub: Brief Summary of Medical Administrative Corps Legislation, 12 Feb 46, MSC-USACMH; Fact Sheet, OTSG, sub: Army Medical Service Corps, 1957, DASG-MS. Appointments: SG Report, 1921, p. 109. Positions: Charles V. Lewis, "Medical Administrative Corps," Military Surgeon 80 (April 1937): 304-05.

15Reserves: SG Report, 1921, pp. 117-18; Medical Bulletin (1 January 1931); War Department, Annual Report of the Chief of the National Guard Bureau, 1937; Crossland and Currie, Twice the Citizen, p. 37.

16Quoted words: SC Report, 1926, p. 222.

17Reductions: 42 Stat. 721, 30 June 1922. Ceiling on pay: 42 Stat. 625, 10 June 1922. MAC positions: SGO Cir Ltr 2, 10 Jan 23, MSC-USACMH. TSG proposal: Memo, Brig Gen F. R. Koefer, Asst Surg Gen, for Cob David L. Stone, General Staff (GS), Office of the Chief of Staff, Army (OCSA), sub: Letter of Captain C. R. Dabbs re Discrimination Against M.A.C., 6 Apr 27, MSC-USACMH. Pay restriction lifted: 45 Stat. 788, 28 May 1928.

181924 efforts: Maj Gen Merritte W. Ireland, TSG, to A. L. I. Winne, Chairman (Chm), American Pharmaceutical Association (APA), 9 Nov 28, MSC-USACMH.

19Wainwright bill: U.S. Congress, House, H.R. 1248, 71st Cong., 1st sess., 18 April 1929.

201934 accessions: Medical Bulletin (October 1934): 17-18. Promotion "hump": 49 Stat. 505, 31 Jul 35; Medical Bulletin (October 1935): 70; Memo, Henry N. Fuller, sub: Notes Relative to the Medical Administrative Corps, 4 May 37, MSC-USACMH.

21MAC reduced: 49 Stat. 36, 24 June 1936.

22Quoted words: Speech, Maj Gen James P. Cooney, Dep Surg Gen, sub: Some Notes on the Historical Development of the Medical Service Corps, at monthly MSC meeting, Forest Glen annex, Walter Reed General Hospital, 25 Oct 56, box 2/18, MSC-USACMH. "Ireland did everything possible to dissolve the inequities under which the Corps labored at the time."

23Reynolds views: Charles R. Reynolds, "Legislation Affecting the Medical Department," Medical Bulletin (July 1936): 7, 9.

24Problems: Interv, Col Louis F. Williams, MSC, Ret., with Lt Col Richard V. N. Ginn, MSC, Clearwater, Fla., 15 Nov 84, DASG-MS; Interv, Col. Frederick H. Gibbs, with Milner, CMH, 24 Oct 63, MSC-USACMH. Colonel Williams served on the court-martial of one of the MAC officers convicted of wrongdoing during this period.

25Reynolds views: Memo, Reynolds, sub: Commissioning of Pharmacists in the Army, 4 Apr 36, MSC-USACMH.

26Embalmers corps: U.S. Congress, House, H.R. 8282, A Bill Amending the Act of June 3, 1916, entitled "The National Defense Act," 74th Cong., 1st sess., 31 May 1935; Medical Bulletin (July 1935): 14.

27Pharmacy Corps: Caswell A. Mayo, "Why the Pharmaceutical Corps Should Be Established," American Druggist 66 (April 1918): 25-27.


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28Winne letter: A. L. I. Winne, Chm, APA, to Maj Gen Merritte W. Ireland, TSG, 15 Oct 28, MSC-USACMH.

29Ireland: Ireland to Winne, 10 Oct 28, MSC-USACMH.

30Exchange of letters: Winne to Ireland, 22 Oct 28; Ireland to Winne, 24 Oct 28, both MSC­USACMH.

31Quoted words: Winne to Ireland, 25 Oct 85, MSC-USACMH.

32Controversy continues: Winne to Ireland, 1 Nov 28; Ireland to Winne, 9 Nov 28, both MSC­USACMH.

33Quoted words: Murray Breese, "Will Pharmacy Again Be a Joke in the Next War," American Druggist (October 1928): 18-19, 70, 72.

34Copeband bill: U.S. Congress, Senate, S. 3211, A Bill To Amend the National Defense Act by Providing/or a Pharmacy Corps in the Medical Department, 71st Cong., 2d sess., 6 January 1930. 21-page letter: Ireland to Special Conference of the APA Committee, 15 Nov 30; Lt Col G. L. McKinney, MC, Planning and Training Div, SGO, to Lt Col. A. D. Tuttle, MC, Spec Asst to TSG, 1 Dec 30, MSC-USACMH.

35APA delighted: E. Fullerton Cook, P.D., Philadelphia College of Pharmacy and Science, to Ireland, 24 Nov 30, MSC-USACMH. Opposition: Ireland to Rep Jonathan M. Wainwright, 3 Dec 30, MSC-USACMH.

36Pharmacy survey: Memo, Col. S. J. Morris, MC, Spec Asst to TSG, for TSG, 10 May 32. No need for change: Maj Gen Robert U. Patterson, TSG, to E. F. Kelly, Secretary (Secy), APA, 20 Jun 32. TSG position not changed: Lt Col. Robert C. McDonald, MC, Executive Officer (XO), SGO, to E. F. Kelly, 11 Apr 34. APA president under pressure: Robert P. Fischelis, Pres, APA, to Patterson, 7 Mar 35. Quoted words: Patterson to Fischelis, 11 Mar 35, all in MSC-USACMH.

37Medical Auxiliary Corps: U.S. Congress, House, H.R. 5594, 74th Cong., 1st sess., 12 February 1935; Medical Bulletin (April 1935): 24. Johnson bill: Rep Jed Johnson to Patterson, 8 Apr 35;

Patterson to Johnson, 15 Apr 35, MSC-USACMH; U.S. Congress, House, H.R. 7485,74th Cong., 1st sess., 12 April 1935; Medical Bulletin (July 1935): 14-15. Pharmacists in the MC: U.S. Congress,

House, H.R. 7455, 74th Cong., 1st sess., 11 April 1935.

38Exasperation: Patterson to Fischelis, 2 May 35. Medical Auxiliary Corps: Patterson to ACS, G-1, sub: Pharmacy Bill (HR 7485), 6 May 35, both in MSC-USACMH.

39Reynold's opposition: Maj Gen Charles R. Reynolds, TSG, to Johnson, 12 Jul 35, MSC­USACMH. APA: H. Evert Kending, Chm, Committee on Pharmacy Corps in the U.S. Army, to Reynolds, 16 Jan 36, MSC-USACMH.

40Response: Reynolds to Kending, 22 Jan 36, MSC-USACMH. Requirements: Memo, Maj J. A. Rogers, MC, for TSG, 25 Jan 36, MSC-USACMH.

41Sheppard bill: U.S. Congress, Senate, S. 4390, 74th Cong., 2d sess., 30 March 1936; and Sen Norm Sheppard to Reynolds, 31 Mar 36, MSC-USACMH. Quoted words: Memo, Reynolds, 4 Apr 36, MSC-USACMH.

42Reynold's testimony: U.S. Congress, House, Military Affairs Committee, Hearings, 26 May 1926.

43Commissions: 49 Stat. 1907, 24 June 1936. Examinations: Medical Bulletin (April 1937): 30; SG Report, 1939, p. 171. Candidates were required to be male U.S. citizens, between the ages of twenty-one and thirty-two, possessing a BS in pharmacy from an acceptable four-year college. The examination process included a physical examination, an assessment of the candidate's adaptability for military service, and a written test in the practice of pharmacy, pharmaceutical chemistry, pharmacognosy, pharmacology, bacteriology, and hygiene and sanitation. Medical Bulletin (October 1938): 113-14. 16 officers: 53 Stat. 555, 3 April 1939. 68 officers: McMinn and Levin, Personnel in World War II, p. 113.

44Japan: SG Report, 1924, p. 300. Aviation: See SG Report, 1930, p. 394.

45Lieutenant Black: Transcript, Lt Col. Richard V. N. Ginn, MSC, Asst to Chief, MSC, sub: Panel Discussion with Former Chiefs of the Medical Service Corps, Washington, D.C., 6 May 83,

DASG-MS; Interv, Col Robert L. Black, USA, Ret., with Lt Col Michael C. Baker, MSC, Palm Springs, Calif., 7 Mar 84, Project 84-16, Senior Officers Oral History Program, U.S. Army Military

History Institute (USAMHI) and the U.S. Army War College, Carlisle Barracks, Pa., USAMHI, hereafter cited as Black, Baker Interv. Schofield: Black to Ginn, 24 Dec 84, DASG-MS.


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46Fort Benning: MSC Panel, 6 May 83; Isadore S. Falk, Organized Medical Service at Fort Benning (Chicago: University of Chicago, 1937), p. 3. Pay cut: Black, Baker Interv.

47Training: Memo, Col. Charles R. Reynolds, MC, CDT, MFSS, sub: The Medical Field Service School, 9 Nov 29, in Stimson Library, Academy of Health Sciences, Fort Sam Houston, Tex.; SG Report, 1931, p. 346. Also see Black, Baker Interv. In other examples: no MACs attended any course in 1926; six attended the basic course in 1935 and one attended in 1940, but no other courses either year. SG Report, 1926, p. 328; 1927, p. 332; 1935, p. 143; 1940, p. 180. In 1929 a report of the Army inspector general singled out Capt. Samuel W. Pennington, MAC, for special praise for his food service operation at Carlisle. Rpt, WD IG, sub: Inspection and Survey of Carlisle Barracks, Pennsylvania, Made June 3-7, 1929, by Maj. C. H. Rice, IGD, 22 Jun 29, RG 159, E11, Box 185, NARA-NA. The first advanced course was conducted 11 February to 15 December 1926 for five MC officers. The course was divided into three sections: mobilization, industrial procurement, and medical planning. SG Report, 1927, p. 332. Lieutenant Smith: Medical Bulletin (July 1938): 96.

48Reserves: Crossland and Currie, Twice the Citizen, p. 40.

49Reserve training: SG Report, 1931, p. 344.

50Colonel England: "Captain Thomas M. England," Military Surgeon 87 (October 1940): 384-85; Biographical summary, THU, OTSG, undated, MSC-USACMH; WDGO 57, 21 Sep 43, PL; Clarence M. Smith, The Medical Department: Hospitalization and Evacuation, Zone of the Interior, in the series United States Army in World War II (Washington, D.C.: Office of the Chief of Military History, Department of the Army, 1956), p. 306, hereafter cited as Smith, Hospitalization and Evacuation. Used as an amputation center, its closure in 1946 became a cause celebre as amputees staged protests in Atlantic City. MS, Tracy S. Voorhees, "A Lawyer Among the Doctors," USACMH, p. 218.

51Dickson and Burkard: Biographical data cards, THU, OTSG, USACMH.

52Carmack: Interv, Col. Joseph Carmack, MSC, Ret., with Israeboff, 25 Jan 67, USACMH. Nelson: Nelson, Bigham Interv, DASG-MS.

53Williams: Williams to Col R. L. Parker, MSC, 13 Jun 60; Williams to Ginn, 7 Nov 84; Williams, Ginn Interv, DASG-MS.

54Increase: M. A. Reasoner, "The Development of the Medical Supply Service," Military Surgeon 63 (July 1928): 2. Overseas: Medical Bulletin (October 1935): 18-19. Kernan: "Medical Supply

Renamed After Pioneer Corpsman," Southern Command News, 10 November 1967; "Medical Officer's Widow Unveils Memorial Plaque," Southern Command News, 12 November 1967, DASG­MS. His son, Col. William F. Kernan, USARSO Dep Cdr, assisted Mrs. Kernan in the ceremony. Appointments in reserves: SG Report, 1924, p. 227.

55Shortage: Medical Bulletin (15 October 1922): 177. Black: Black to Col R. L. Parker, MSC, 17 May 60, MSC-USACMH.

56Feud: See Gorgas and Hendrick, William Crawford Gorgas, pp. 222-33; McCullough, The Path Between the Seas, pp. 572-73; Harrison, Mosquitoes, Malaria and Man, p. 166; Joseph Baldwin

Bishop and Farnham Bishop, Goethals, Genius of the Panama Canal (New York: Harper and Brothers, 1930), pp. 171-75.

57Transfer: Wolfe, Finance and Supply, pp. 75-81; WD Cir 102, 24 Oct 18, PL. Quoted words: Wolfe, Finance and Supply, p. 81.

58Clash: Bishop and Bishop, Goethals, Genius of the Panama Canal, p. 378. Quoted words: U.S. Congress, Senate, Hearings on S. 2715, 66th Cong., 1st sess., 29 September 1919, pp. 1031-32.

59Supply training: Wolfe, Finance and Supply, p. 663. MC emphasis: Medical Bulletin (April 1938): 34. General depot program: Medical Bulletin (October 1922): 179; Robert J. Parks, Medical

Training in World War II (Washington, D.C.: Office of the Surgeon General, Department of the Army, 1974), in the series Medical Department in World War II, p. 48. Black: Black to Parker, 17 May 60, MSC-USACMH.

60Reserve supply training: Medical Bulletin (July 1938): 99-100.

61SnC Reserve: OTSG, Supply Service Notes, Sep-Dec 44, MSC-USACMH. Asst Secy: Lt Col. Charles F. Shook, MC, Finance and Supply Div, SGO, to Maj Paul I. Robinson, MC, sub:

Assistant Secretary of War's Weekly Report, 10 Sep 40, MSC-USACMH. Increase: McMinn and Levin, Personnel in World War II, p. 113.


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62Quoted words: Black, Baker Interv.

63McKnight: Medical Bulletin (January 1936): 77-78.

64Hospitals: Neuhauser, Coming of Age, pp. 41-42; Siegfried Giedeon, Space, Time and Architecture (Cambridge: Harvard, 1956), pp. 206-09.

65ACS: American College of Surgeons, Manual Hospital Standardization (Chicago: ACS, 1937), p. 7. The ACS classified hospitals of 100 beds or more as large hospitals.

66Medical schools: U.S. Department of Labor, Postwar Outlook for Physicians, Bulletin 863 (Washington, D.C.: U.S. Bureau of Labor Statistics, 12 February 1946), p. 3. Teaching hospitals:

Ludmerer, Learning To Heal, pp. 219-33, 257. The dates are Ludmerer's.

67Army hospitals: Memo, Maj John A. Rogers, MC, for TSG, 25 Jan 36, MSC-USACMH; Tobey, The Medical Department, p. 103.

68Substitution: Smith, Hospitalization and Evacuation, pp. 30-31.

69Quoted words: Neuhauser, Coming of Age, p. 57.

701935 survey: Ibid., p. 58.

71ACHA: American College of Hospital Administrators, ACHA News 15 (January 1957); Neuhauser, Coming of Age, p. 15. Reports: James A. Tobey, "The Mission of the Sanitary Corps

(Sanitation Section) in War Time," Military Surgeon 76 (April 1935): 73. First program: Michael M. Davis, Hospital Administration: A Career (New York: Rockefeller Foundation, 1927), pp. 58-88;

Neuhauser, Coming of Age, pp. 92-93.

72Gibbs: Interv, Col Frederick H. Gibbs, MSC, Ret., with Ginn, St. Petersburg, Fla., 15 Nov 84, DASG-MS.

73Quoted words: Arnold D. Tuttle, Handbook for the Medical Soldier (New York: William Wood, 1927), p. 39.

74Training: Cols William A. Hardenbergh, Michael J. Blew, and Raymond J. Karpen, draft chapter, sub: The Sanitary Corps, undated, folder 83, box 6/18; Rpt, Lt Col Paul E. Howe, SnC, and Maj Rudolph J. Anderson, SnC, sub: Proposal for the Use of Officers of the Sanitary Corps Trained in Food and Nutrition, MFSS, 1935, folder 109, box 8/18, both in MSC-USACMH. The 1925 course also included 252 Medical Corps (MC), 24 Dental Corps (DC), and 7 Veterinary Corps (VC) officers. The Military Sanitation Course was not held in 1933 because the Reserve Army instructors were on Civilian Conservation Corps duty.

75Sanitary engineers: Speech, Lt Col. Joseph J. Gilbert, MSC, sub: The Sanitary Corps-U.S. Army, presented at the meeting of the Association of Military Surgeons, Sanitary Engineering panel,

2 Nov 44; Col. Stanley J. Weidenkopf, draft chapter, sub: Sanitary Engineering, in THU, MSC history project, 1965, pp. 14-15, all in MSC-USACMH. Hardenbergh: William A. Hardenbergh (Lt.

Col., SnCR), Sewerage and Sewage Treatment (Scranton, Pa.: International Textbook Company, 1936); Hardenbergh, Operation of Sewage-Treatment Plants (Scranton: International Textbook Company, 1939); Hardenbergh, Purification of Water (Scranton: International Textbook Company, 1938).

76Sanitation plan: Tobey, "The Mission of the Sanitary Corps," pp. 180-81.

771938 editorial: Cited in Military Surgeon 83 (November 1938): 459-60.

78The Boar: Maj Gen Paul H. Streit, MC, to Lt Col. Elwood Camp, MSC, 8 Jul 50; Col Raymond J. Karpen, MSC, Ret., to Lt Col. Joseph Israeloff, MSC, sub: Observations on the Formative Period of the Medical Service Corps, 14 Apr 76, both in DASG-MS.

79Chiropody: Louis S. Reed, Midwives, Chiropodists and Optometrists: Their Place in Medical Care, pamphlet no. 15 (Washington, D.C.: Committee on the Costs of Medical Care, March 1932), pp. 6-8.

80Chiropody corps: U.S. Congress, House, H.R. 3738, A Bill To Establish a Chiropody (Podiatry) Corps in the Medical Corps of the United States Army, 77th Cong., 1st sess., 3 March 1941.

81Optometry: Reed, Midwives, Chiropodists and Optometrists, pp. 3-9.

 82Optical program: TSG Cir Ltr 99, 25 Aug 20, RG 112, Accession 69A-127, Box 10/32; TSG Cir Ltr 20,4 Apr 22, RG 112, 69A-127, Box 10/32; Memos, Jones for the Executive Officer, SGO,

1 Aug 34 and 12 Aug 37, RG 112, 44A-0041, Box 1/1; TAG to CG, 1st Army Corps Area, 5 Jun 41, and TSG to TAG, 5 Jun 41, RG 112, 69A-127, Box 10/32, all in NARA-WNRC; WDGO 14,

31 Mar 22, PL. Prices: Advertising, Optometric Weekly, 23 November 1933 and 15 February 1934, and Ltr to the editor, J. H. Lepper, 14 December 1933, p. 1208; Editorials, Journal of the American

Optometric Association, November 1931, p. 30, and November 1939, pp. 14, 15.

83Quoted words: THU, 1958 MSC History, p. R-2 (1-2).