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Chapter 22

Chapter 22

Dehydration Survey in the Combat Soldier

A Study in the Korean Theater

Captain John M. Howard, MC, USAR
Captain John H. Davis, MC, USAR

The long supply lines and the mobility of the front inevitably raised difficulties to furnishing the front line soldier an adequate supply of purified water. For this reason, it was deemed advisable to gather objective evidence in order to assay the problem in Korea.

This study was carried out on the Eastern Front during the period January through July 1952. During this period the main line of resistance was stable. Supply lines were good. However, the terrain was extremely mountainous and the front lines were inevitably strung out across the top of mountain chains. Water was brought nearby in trucks but had to be carried to the top of the mountains on the backs of soldiers and laborers. Carrying the water up the mountain trail was comparable to carrying it up a flight of stairs, the equivalent of a 10- to 50-story building. A water point was thus established on top of each ridge. No reserve was maintained at this point, however, so that availability of water might vary from time to time. No severe shortage was ever reported. In spot checks, men in the front lines were systematically (daily) asked two questions: first, are the men thirsty, and second, is the water supply adequate or inadequate? Their answers had little correlation with objective evidence as illustrated by several typical observations (Table 1).

Dehydration Survey in Combat Soldier

Objective evidence was therefore sought by selecting volunteers in the front line and measuring their daily urinary output and its specific gravity. The most mountainous terrain was selected for these observations. The findings are summarized in Tables 2, 3, 4, and 5. Because of the danger inherent in the study, further observations did not seem warranted until a time when the tactical conditions might change.

Analysis of the data indicates that the lowest average urine volume occurred in January (992 ml. for 21 man days). This is entirely reasonable for the temperature was below zero (Fahrenheit) at this time. In March the average 24-hour volume was 1,344 ml. for 92 man days. In May the average volume was 1,246 ml. for 137 man days. In June and July the average volume was 1,168 ml. for 15 man days.


277

Table 1. Water Supply and Urinary Output

Subject

Day

Question: Is the Water Supply Adequate?

Are the Men Thirsty?

24-Hour Urinary Volume (ml.)

24-Hour Urinary Specific Gravity

Master Sergeant

1

Inadequate

Yes

2,600

1.009

2

Inadequate

Yes

2,050

1.010

3

Inadequate

Yes

2,100

1.015

4

Adequate

No

3,200

1.010

Second Lieutenant

1

Inadequate

Yes

1,450

1.020

2

Adequate

No

1,400

1.025

3

Adequate

No

1,000

1.030

Private

1

Inadequate

Yes

1,200

1.025

2

Adequate

No

600

1.030

3

Inadequate

Yes

2,200

1.012

First Lieutenant

1

Inadequate

Yes

1,275

1.020

2

Adequate

No

1,200

1.020

3

Inadequate

Yes

1,250

1.025

4

Adequate

No

1,200

1.020

Table 2. Urinary Volume (Milliliters Per 24 Hours)

Date

Soldier

1

2

3

4

5

6

7

8

9

10

Average

1952

 

 

 

 

 

 

 

 

 

 

 

29 Jan.

1,850

750

450

1,150

650

1,150

1,000

650

500

1,200

935

30 Jan.

850

1,200

 

1,250

 

1,000

850

1,200

850

 

1,029

31 Jan.

450

1,100

 

1,500

 

1,250

 

 

 

 

1,075

Average

1,050

1,017

 

1,300

 

1,133

925

925

675

 

 

Average urinary volume
992 cc. 21 man days

Although there were a few instances in which the urine volume was rather low, the average for all the men on any day appeared adequate so that the supply for the area appears to have been satisfactory.

The over-all average for the 265 man days was 1,252 ml. of urine per day with a specific gravity of 1.022 (Table 6).

Finally, to note the effect of time lag after wounding, the specific gravity of the urine was measured on 25 casualties during the winter (1.025) and compared with that of 25 casualties during the summer (1.026). These measurements were made at the time the casualties arrived at the Mobile Army Surgical Hospital approximately 3.5 hours after wounding. No conclusion is justified beyond the observation that no significant difference existed.


278

Table 3. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)


279

Table 4. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)


280

Table 5. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)


281

Table 6. Dehydration Survey in the Combat Soldiers

Date

Man Days

Average Urinary Volume (ml. per 24 Hours)

Average Specific Gravity

January 1952

21

993

 

March 1952

92

1,344

1.021

May 1952

137

1,246

1.023

July 1952

15

1,168

1.020

265 total 1,252 average

Clinically dehydration was not noted. Thirst is an immediate result of severe injury and does not necessarily signify dehydration immediately after injury.

Summary

During the period January-July 1952, studies of the daily urinary output of soldiers on the front lines of the Eastern Front in Korea demonstrated no evidence of dehydration.


282

Appendix

Daily Temperature Record

(Fahrenheit)

Combat Area-Eastern Korea

1952

Temperature

Date

1200 Hours

2400 Hours

Date

1200 Hours

2400 Hours

Dry

Wet

Dry

Wet

Dry

Wet

Dry

Wet

April 3

58

50

40

38

May 1

84

70

56

50

4

58

49

42

40

2

78

63

56

52

5

71

55

48

46

3

77

65

62

57

6

70

50

41

41

4

66

59

53

50

7

55

50

46

44

5

71

57

51

46

8

72

59

52

47

6

75

58

61

52

9

74

68

51

48

7

72

62

60

52

10

50

47

52

49

8

70

57

54

45

11

62

52

54

49

9

74

60

58

48

12

57

50

50

49

10

73

60

57

50

13

46

42

36

36

11

       

14

51

45

43

42

12

79

61

55

49

15

43

41

38

36

13

80

65

60

52

16

52

47

59

51

14

83

66

63

56

17

54

51

42

38

15

74

60

60

53

18

53

46

46

42

16

84

65

66

59

19

34

32

38

35

17

80

64

68

60

20

49

43

42

39

18

83

67

65

53

21

55

52

35

33

19

71

59

62

55

22

56

48

40

37

20

78

63

60

55

23

57

46

40

38

21

82

65

60

54

24

62

50

46

43

22

87

66

63

52

25

64

54

44

43

23

74

59

52

50

26

56

48

43

41

24

71

53

54

48

27

63

52

49

44

25

77

63

57

52

28

55

52

53

50

26

73

59

64

56

29

68

52

48

45

27

80

67

63

58

30

73

63

54

50

28

80

71

63

58

         

29

81

70

59

56

         

30

55

51

57

51

         

31

74

64

58

53


283

Temperature

Date

Maximal

Minimal

Date

Maximal

Minimal

Dry

Dry

Dry

Wet

Dry

Wet

June 1

79

54

July 1

90

77

72

71

2

77

52

2

80

73

67

66

3

63

56

3

78

69

63

61

4

73

53

4

83

71

62

60

5

78

53

5

81

70

58

57

6

83

53

6

81

70

64

63

7

87

52

7

83

73

64

63

8

71

56

8

80

69

63

62

9

82

55

9

76

68

63

62

10

68

56

10

80

69

65

63

11

73

56

11

82

72

63

62

12

81

55

12

90

78

62

60

13

83

60

13

87

73

64

62

14

89

67

14

79

69

60

57

15

92

57

15

75

69

66

64

16

87

63

16

88

76

68

65

17

79

62

17

80

74

73

70

18

84

63

18

88

76

72

70

19

87

64

19

75

72

72

68

20

85

58

20

84

75

70

68

21

88

57

21

83

73

68

67

22

92

58

22

90

75

67

66

23

91

61

23

88

75

67

66

24

96

60

24

88

75

69

68

25

98

65

25

80

72

69

67

26

98

64

26

74

72

66

66

27

93

63

27

70

69

66

66

28

90

67

28

71

69

64

64

29

76

69

29

70

70

66

66

30

78

68

30

75

74

66

66

     

31

77

74

69

68


284

Temperature

Date

Maximal

Minimal

Date

Maximal

Minimal

Dry

Dry

Dry

Wet

Dry

Wet

August 1

88

74

September 1

74

67

58

58

2

76

65

2

74

67

57

57

3

87

68

3

62

62

59

59

4

88

65

4

70

65

59

59

5

90

64

5

75

66

59

59

6

91

65

6

78

70

59

59

7

92

67

7

71

68

59

59

8

87

68

8

77

68

56

56

9

90

67

9

79

68

58

58

10

91

68

10

78

69

58

58

11

92

70

11

74

67

62

62

12

94

70

12

71

66

58

57

13

88

72

13

62

60

56

56

14

94

74

14

66

 

57

 

15

90

70

15

71

67

54

54

16

91

70

16

68

61

52

52

17

90

69

17

68

58

48

46

18

80

69

18

69

61

43

42

19

79

69

19

71

62

53

52

20

86

64

20

65

58

49

48

21

87

69

21

69

58

46

46

22

85

53

22

65

60

44

43

23

74

66

23

76

 

58

 

24

75

70

24

59

58

56

55

25

74

68

25

58

58

47

47

26

71

68

26

61

58

41

41

27

85

64

27

63

55

38

37

28

70

65

28

60

55

46

45

29

76

62

29

59

57

40

39

30

82

63

30

64

56

39

38

31

75

68

         

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