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Foreword

Table of Contents

Foreword

For the Army, U.S. involvement in the Vietnam war occurred at a time when the Medical Department was best prepared to accept the challenge of increasing numbers of patients with complex medical diseases. The physician draft had infused the Medical Corps with young, eager, and talented physicians; Army medical education programs had generated mature staff officers, capable of knowledgeable decisions on the wards, in the clinics, and in management and command positions. Year after year throughout the conflict, a steady stream of these physicians moved back and forth across the Pacific. As I see it, the demands on these medical officers in Vietnam were different and more difficult than those required during the prolonged but continuous service experienced in World War II, or by the involvement in the Korean war. A continuity of medical care had to be maintained despite the yearly turnover of the medical staffs. Effective care depended upon the perpetuation of knowledge gained each year. The USARV Medical Bulletin, the consultant system utilizing conferences and reports, the ultimate standardization of therapy for such diseases as malaria and hepatitis all provided some basis for maintaining a continuing proficiency in the delivery of health care.

Internal Medicine in Vietnam, Volume II, chronicles the efforts of the Army Medical Department in the management of those diseases encountered by troops obliged to fight in a tropical environment. There was a determined effort to meet the challenge of this new environment and the large numbers of patients with febrile illness or other infrequently encountered diseases, some of which were previously chronicled only in the aging textbooks of a past era. The amalgamated efforts of the Regular Army staff and the drafted physician and the constant contributions of Army research activities achieved a remarkable success which was translated into a decrease of mortality and morbidity in the U.S. soldier stationed in Vietnam. For the maneuver battalions, it meant a reduction in combat man-days lost, unparalleled in previous conflicts. The achievements in medical care, especially the enhanced knowledge of tropical diseases presented in this comprehensive review, will provide the historical perspective so necessary to an appreciation of the requirements for a strong medical department capable of response on a worldwide basis when the health and welfare of the U.S. soldier are threatened.

I believe the reader will find these chapters replete with the essentials of a military medical history with emphasis on the intimate association of war and medicine. The text provides a lasting contribution to global health care in any tropical setting and serves as a sourcebook for medical and military planners who wish to broaden their experience by study of these lessons of history. In addition, it provides insight into the medical care required to maintain the health of the Army while fighting abroad.

The volume represents a consolidation of a remarkable amount of information garnered from the yearly experience of thousands of medical officers who served during the Vietnam era. As one of those participants, I can appreciate the magnitude of the effort required to produce it and its value as a contribution to the medical literature.

CHARLES C. PIXLEY, M.D.,
Lieutenant General

The Surgeon General