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HISTORY OF THE OFFICE OF MEDICAL HISTORY
OTHER BASE HOSPITALS
BASE HOSPITALS, CAMP BEAUREGARD, LA., FORT BLISS, TEX., CAMPS BOWIE, TEX., CODY, N. MEX., CUSTER, MICH., DEVENS, MASS., DIX, N. J., DODGE, IOWA, AND DONIPHAN, OKLA.
BASE HOSPITAL, CAMP BEAUREGARD, ALEXANDRIA, LA.a
The base hospital of Camp Beauregard was located in Rapides Parish, La., 3½ miles north of Alexandria, a town of 20,000 population, on the east side of the Red River. The site was once that of the first University of Louisiana, and later of Camp Stafford, the Louisiana National Guard encampment. The hospital site was at an altitude of 120 feet above sea level, on hills which were wooded with pine and oak.
The soil is somewhat sandy; but forms a great deal of high-flying dust in dry weather and sticky mud after a rain. The climate closely borders that of the Tropics. The weather is warm most of the time, but in the winter months severe cold waves are frequently experienced, with a drop in temperature to about 15° or 20° above zero, followed by a sudden rise. The hospital was not exposed to heavy winds. There were no improved roads in or about the hospital, with the exception of the road leading to Camp Beauregard, about three miles away. The road leading to Alexandria was very bad, at times almost impassable, being of dirt and receiving very little attention. The hospital grounds were well drained, and the sanitary status of the hospital was very good.
The hospital was organized September 1, 1917, with 22 officers and 123 enlisted men. The first patient was admitted on this date. One barrack building was used in the hospital for temporary hospital purposes, and as wards were completed they were taken over and occupied.
The function of the hospital was to treat all cases arising at Camp Beauregard, and medical, surgical, and venereal cases from overseas.
The buildings constituting the hospital were arranged in the following manner: Looking to the east were the receiving ward, the administration building, and the sick officers' pavilion. Directly back of the administration building was the laboratory, and immediately in the rear of the laboratory was the operating pavilion. On the north side of the operating pavilion was a row of wards connected by corridors; and in front, setting well to the northwest of this row of wards, were four wards for contagious diseases. On the south side was arranged a row of wards extending from the front line back to the line of the main kitchen and the patients' mess hall, which was at the back
part of the hospital looking west. This left a large central court between the operating pavilion, the main kitchen, and the patients' mess hall.
The main hospital kitchen and mess hall were located at the rear of the hospital. The enlisted men's kitchen and mess hall were located in a barrack building near the enlisted men's barracks. The sick officers' kitchen and mess hall were located in the building for sick officers.
The officers' quarters and the quarters for the nurses were situated about 200 yards directly in front of the administration building, and across the Jefferson Highway. The quarters for both officers and nurses were enlarged, when the capacity of the hospital was increased.
Three buildings situated alongside the switch, constructed by the railroad to supply them, constituted the storehouses of the hospital.
The water supply was from a deep well near the hospital, and was independent of that of the camp. The water was forced through a filter, into a tank, which stood about 150 feet high, on the central court between the operating pavilion and the patients' mess hall.
The sewage of the hospital was removed by a general sewer, which emptied into the Red River about a mile and a half away. At first latrines were used, then the cesspool, and then toilets, constructed in buildings located between two wards.
The kitchen refuse was disposed of by a contractor, who hauled it each day to a hog pen some distance from the hospital. If the garbage accumulated at any time, it was burned. Manure was sold, given to farmers, or burned.
Shower and tub baths were located in buildings constructed between baths, and were connected with the hospital sewer.
Heating the hospital was effected by means of open stoves, two to four stoves being necessary to obtain a sufficient amount of heat in each ward.
The hospital was successfully and satisfactorily lighted by the electric company that supplied the lights to the city of Alexandria.
The hospital laundry work was done by a laundry in Alexandria. This laundry was too small to handle the enormous amount of work required.
At the beginning the equipment was very meager. There was a great shortage of everything; there was only part of the Wolfe unit for each ward; and the laboratory, the drug room, and the operating room were seriously handicapped in consequence of this shortage. These difficulties were overcome in time, and ultimately the entire hospital equipment was such as to compare favorably with any civil or military hospital.
The post exchange was operated for the benefit of the men, commodities being sold at a very small percentage above cost. The exchange purchased and operated three motor buses to furnish transportation between the hospital and the city of Alexandria. This was done for the convenience of those on duty at the hospital and for visitors to the hospital, there being no other means of transportation. The nominal tariff of 25 cents was charged.
The Young Men's Christian Association building, which was centrally located, was well patronized.
Recreations and amusements were provided by the Young Men's Christian Association directors. These included boxing matches, wrestling matches, and other indoor games, as well as handball games and baseball.
BASE HOSPITAL, FORT BLISS, TEX.a
The base hospital was located within the military reservation of Fort Bliss, about 6 miles northeast of the city of El Paso, Tex., at an elevation of 3,900 feet above sea level. The reservation constituting Fort Bliss is an immense table-land surrounded by mountains at all points of the horizon except at the location of the Pass, from which the city takes its name. East of the hospital, extending for perhaps 30 miles, is a rolling desert covered with mesquite and cactus. The soil consists of a blanket deposit of carbonaceous lime, locally called " caliche," covered by light sand. Severe sand storms are frequent during winter and spring, the three or four rains per year incident to this section making no appreciable difference in the sand. Two hours after a rainfall the ground shows no signs of water excepting in low places where it may have pooled. The climate is semitorrid in character, tempered by the high elevation. Summer makes its appearance suddenly about the first of May, and winter about the middle of November, the seasons being marked by no gradual changes like those of the temperate zones. There is very little snowfall. The nights during winter are very cold and frosty, of a penetrating character peculiar to high altitudes. The summers, while hot, are endurable, the nights being uniformly cool. Were it not for the sand storms, the climate would be ideal. In addition to filling the air with sand, which sifted into all buildings, these winds damaged several of the hospital buildings.
The roads in and around the base hospital grounds were of macadam construction, developed by the Quartermaster Department, and they were adequate for a unit of a provisional character. Fort Bliss, being situated on the outskirts of El Paso, had the use of the city's paved streets, which were mostly constructed of asphalt or concrete. The roads, with the exception of a short section, were uniformly good.
There were no streams in the vicinity of this hospital. The Rio Grande, several miles southwest of the post, is a slow, sluggish river, full of sand bars, the water of which is largely diverted through canals and ditches for irrigation purposes.
On March 15, 1916, by telegraphic order from The Adjutant General, the post hospital at Fort Bliss was designated a base hospital for troops in the Southern Department. By Bulletin 36, Headquarters, Southern Department, dated September 28, 1916, the station was designated Base Hospital No. 2. By General Orders, No. 35, War Department, April 15, 1918, the name was changed to United States Base Hospital, Fort Bliss, Tex.
In view of the fact that this hospital was a development and an extension of the old post hospital, which had been doing more than the work assigned to an ordinary post hospital, the transition period was not marked by any sudden emergencies or needs. The only large building temporarily used for base hospital purposes prior to construction of the hospital proper was a brick barrack building, the lower floor of which was used for offices and the upper floor for convalescent patients. The mess hall of this troop barracks was also used for a short time for Medical Department personnel.
The hospital treated all cases arising at Fort Bliss, and medical, surgical, tuberculosis and venereal cases from overseas.
The construction of 13 wards, each with a capacity of 30 beds, and a mess hall with a seating capacity of about 400, was commenced about the middle of April, 1916, and was rushed to completion in about 30 days. The wards were assigned to various services, and were occupied by patients as rapidly as construction was completed. The mess hall, the last of the buildings to be finished, was opened for use about May 15, 1916. It soon became apparent that the 13 new wards would not provide sufficient facilities for the care of the large number of troops mobilized at El Paso. Additional construction was then provided, including a colony of 14 superior wards, connected by covered walks, a large convalescent officers' ward, a set of nurses' quarters, sufficient to house 40 nurses, a large H-shaped mess hall seating about 600, with attached general and diet kitchens, and an administration building containing a dispensary.
The main hospital building, which constituted the old post hospital, faced west on the main road in Fort Bliss, which ran north and south. The cantonment wards first constructed ran parallel with this road in the rear and to the north of the main building; the wards of later construction were south of the main building, in two rows parallel to the main highway. The nurses' quarters were about 400 yards, in a southerly direction, from the main building, and the administration building was almost opposite the main building on the Fort Bliss Parade.
Enlisted patients and the personnel on duty were provided with a large H-shaped building for mess purposes. Two large dining halls, with a seating capacity of about 300 each, were connected by the kitchens and storerooms. Patients used one of the dining halls and Medical Department personnel the other. Patients in wards were served from the diet kitchens attached to the H-shaped mess hall, and from another unit located in the main brick building. A separate mess for officer patients was maintained, with a kitchen and dining room. Government allowances for rations kept apace with the rising cost of food supplies, and on the whole, this service was very efficient and satisfactory.
Only two sets of quarters were provided at Fort Bliss for the use of officers. The nurses' quarters consisted of several one-story cantonment buildings, divided into small rooms, with one comfortably large assembly parlor, a kitchen, and a small mess hall. No regular quarters for the Medical Department personnel were built, the men occupying such wards as were not needed for patients; or tents, when the capacity of the hospital was required for patients.
No storehouses were included in hospital construction. Rooms in the basement and attic of the old hospital building, and other buildings, were utilized for this purpose.
The water supply was identical with that of Fort Bliss, and was obtained from two artesian wells, 600 feet deep, the pumping capacity of the plant being about 500 gallons per minute. The tank capacity was not sufficient to supply the demand during the heaviest stress period, and the result was an insufficient pressure. At times this deficiency interfered with the service of operating room No. 1, located on the second floor of the main building. The water was of excellent quality and required no treatment for general use.
The sewage of the hospital was carried away in 6-inch pipes which connected with the municipal system of El Paso. These pipes were not quite
adequate to carry away the sewage when the hospital was filled to capacity, but they sufficed for 700 patients. Combination baths and latrines, connected with the sewerage system, were conveniently located to serve each set of about six wards, but they were insanitary and very unsatisfactory. One toilet was installed in the newer wards; but the older wards, used for communicable diseases, still had the old style of closed stools, which, after disinfection, were treated in the usual manner. This condition was undesirable and was remedied in June, 1918.
Kitchen wastes were divided into three classes: The ordinary wet garbage, which was disposed of to civilians, on contract, for hog feeding; bottles and cans, which were turned over to the reclamation section of the Quartermaster Corps; and ordinary dry refuse, which was burned in incinerators. One incinerator, located behind the general mess, was used for all ordinary purposes; another unit, located behind the venereal section, was used for the destruction of dressings, etc., which originated in that department.
The plumbing in the main brick building was connected with the piping system mentioned. Combination bathhouses and latrines were connected with the main sewer through a large cistern, built of concrete, which acted as an equalizer when the sewer main became congested.
The main building was heated by hot-water furnaces, which were very efficient. The cantonment wards, offices, etc., were heated by ordinary soft coal stoves, which were very unsatisfactory.
The electric current was supplied to the hospital by an El Paso company, through the quartermaster. The apparatus proved satisfactory.
The laundry work of the hospital was done on contract with a civilian laundry company in El Paso, and the service was very efficient.
The nucleus of this unit being the old post hospital, its equipment was inherited. By a system of decentralization and amplification, each department was expanded to meet enlarged requirements. The operating room, formerly used by the post hospital for all purposes, was used only for major operations; an operating and dressing room were provided for the venereal section; and a similar unit was provided for acute surgical cases. The eye, ear, nose, and throat department had its own treatment room. The capacity of the hospital was increased from approximately 100 to 800. Three motor ambulances, a motor truck, one escort wagon, a Dodge car, and motorcycles were available.
The post exchange at this hospital was started in the spring of 1916, on credit and without capital. It occupied a superior cantonment building, improved at the expense of the exchange, with modern fixtures, soda fountain, two pool tables, cash register, etc. A Dodge car, purchased with exchange funds, was a source of revenue as well as convenience. On May 31, 1918, the balance sheet showed nearly $3,000 cash on hand. The net value of the exchange was in excess of $7,500. The management was always liberal, and this exchange was one of the conspicuous successes of the station, both financially and from the standpoint of service.
The building used by the Young Men's Christian Association, which was completed during October, 1917, was of excellent construction and design, and had a seating capacity of about 250. The management was in the hands of well-qualified secretaries, who took an altruistic interest in the welfare of the
patients and the Medical Department personnel. Programs were provided for evening entertainments, which included moving pictures three times a week. Helpless patients were visited in their wards.
BASE HOSPITAL, CAMP BOWIE, TEX.a
The base hospital of Camp Bowie was located in Tarrant County, Tex., in the northeastern part of the State, 4½ miles from Fort Worth, a city of 110,000 population. The city of Dallas is east of Fort Worth, 28 miles by interurban railroad and 32 miles by automobile road. The hospital site was at the southwest corner of the camp and embraced 70 acres of slightly and gradually rolling land, which was not wooded but which had flat expanses throughout.
The soil of that locality is of a clay-loam mixture overlying a limestone rock to a depth varying from a few inches to 4 or 5 feet, and there was very little high-flying dust about the hospital in dry weather. Rains, when they occur, are excessive, resulting in considerable extremely sticky mud, which soon disappears. Board and gravel walks, constructed several months after the organization of the hospital, eliminated the carrying of mud into the hospital buildings.
The summers are exceptionally warm, but the humidity is not great; and, despite the heat of the day, the nights are cool as a result of a continuous
breeze, and are conducive to restful sleep. The winters, as a rule, are not severe. The "northers," however, which occur during the fall and winter, bring extreme cold, with very abrupt changes, the temperature sometimes falling 70 or 80 degrees in a day. The gradation of spring into summer and fall into winter is not noticeable. At times the wind is strong, but the location of the hospital was such that the full force of the wind was not received.
Several gravel and asphalt roads of good condition and leading to Fort Worth skirted the hospital.
The hospital was organized on August 21, 1917, as an emergency hospital, and the first patient was admitted on the day following.
Prior to the construction of the hospital proper, several small buildings, similar to the ones subsequently used for the company mess pavilion, were utilized for hospital purposes, and tents were employed for the housing of the hospital corps men. During the construction of the hospital a small wooden building was used as an emergency hospital for construction employees. This contained a dispensary and a dressing station, but no ward.
The buildings of the hospital were systematically arranged over an area of 70 acres. With the exception of six two-story convalescent wards, all buildings were of one-story frame construction, built on concrete footings. The ward buildings were distributed according to a block scheme, there being six blocks. One of these blocks was isolated, and was used for the housing of contagious patients. All other ward buildings were connected by a system of covered corridor runways.
The following scheme was adopted for designating the wards: The four principal rows of wards were designated "A," "B," "C," and "D," from north to south. The six wards in each row were numbered 1, 2, 3, etc., from east to west. The wards in the isolation section were numbered serially, from east to west, E-4 being the neuropsychiatric ward. The F section comprised two-story ward-barrack buildings, situated in two rows of three buildings each. Ten of the wards of the main part of the hospital had porches inclosed by temporary siding, which was removable, and was fitted with windows at appropriate distances. The space thus provided afforded room for about 24 additional beds, should an emergency require additional bed space. This corridor was continuous with the porch at the rear of the ward and had two entrances. The ward known as D-1 was fitted up as an office, with treatment rooms, waiting rooms, etc., for the venereal diseases section of the hospital; and it was here that the orthopedic clinic was held.
The two sets of officers' quarters were at the extreme northeast portion of the hospital, and, like the remainder of the hospital, they were of frame construction. The nurses' quarters were located to the southeast of the hospital grounds and were practically of the same plan and construction as the quarters for officers.
In the early days of the hospital, before the warehouses were completed, supplies for the hospital and for the 36th Division were stored in warehouse No. 10, quartermaster depot. At that time no shelving was supplied, and different articles had to be issued from the boxes in which they were shipped. Five warehouses were completed in October, 1917, measuring 24 by 150 feet, on a portion of the hospital site. Two of these warehouses were shelved, and one was used as a storehouse for medical supplies of the hospital, the other for
medical supplies for the 36th Division. One half of a third warehouse was used to store the surplus stock and unserviceable property of the hospital, the other half was used by the camp medical supply depot. Another warehouse was turned over to the Red Cross, and the remaining one to the quartermaster. Two rooms, 8 by 14 by 11 feet, were built in the opposite ends of each warehouse. In one room of warehouse No. 1 was built a partition with a door and lock and the room, being shelved, served as the narcotic drug and liquor room. Three refrigerators were used in this warehouse for the storing of serums.
When the base hospital was started, and while it was housed in tents, it was equipped with whatsoever could be borrowed from the field hospitals of the 36th Division.
Most of the buildings, which subsequently constituted the base hospital, were received in an unfinished condition on September 24, 1917. At that time the medical supplies on hand were for a 548-bed hospital. The various wards, though unfinished, were equipped with these supplies to meet the demand of a beginning epidemic. There was no heating, water, lighting, or sewerage in connection with any building, and only an absolutely necessary equipment was installed from the Medical Department supplies. From time to time supplies were furnished on the basis of increased capacity, until an equipment was finally received for a hospital of 1,750 capacity. During December, 1917, the wards were ceiled and plumbing was installed in them.
During October, November, and December, 1917, several epidemics occurred, causing approximately 1,800 patients to be continuously in the hospital. This necessitated equipping all buildings with medical supplies, whether they had been finished or unfinished, and included the warehouses, the laundry, and the chapel. It also necessitated the transferring of these various supplies from building to building, and it resulted in an unusual loss of breakable nonexpendable property. Subsequently each ward was equipped according to the Wolfe unit plan.
Two days before the hospital was to be occupied the kitchen and mess hall were destroyed by fire. The kitchen was then installed in what was subsequently used as a bathroom, and the mess hall in a room that later became a medical ward. The kitchen was equipped with two field ranges, on which three meals a day were prepared for about 1,000 persons. Officers, nurses, enlisted men, and patients ate in the improvised mess hall; the patients and enlisted men messing at the same hour, but at separate tables, followed by the officers and nurses. These difficulties were soon overcome, however, and a large mess hall was opened for the convalescent patients in the center of the hospital grounds. Adjacent to this was a special diet kitchen, in charge of a dietitian, where every possible special diet could be prepared. The mess hall, which was one of the brightest spots in the hospital, could comfortably care for about 1,000 patients. The mess for the detachment, Medical Department, was separately located and had its own cooks; likewise, the nurses had a neatly arranged mess of their own. The officers' ward had its separate mess, supervised by a special dietitian; and a large mess hall for convalescent officers was located in the same building in which they were placed.
No laundry was established in the hospital, all laundry work for the institution being handled, at great expense and at much inconvenience, by outside
laundries. From September 1 to December 31, 1917, a total of $5,507.81 was expended on laundry work. Because of the delays in delivery and excessive charges, a six months contract was made with another concern. From January 1 to April 30, 1918, inclusive, the cost was $9,020.18. The stock room for laundry was installed in a central building where the soiled laundry was collected in a separate room and clean laundry was distributed to the wards from another. In this building was installed, for the purpose of sterilizing mattresses, blankets, etc., an American steam sterilizer and an electric sewing machine, a seamstress being hired to repair the torn linen, and garments.
The hospital received its water supply from Lake Worth, about 14 miles distant. The water was conveyed by gravity through 12-inch cast-iron water pipes into the Fort Worth pumping station, whence it passed through a filtration process into a reservoir, where it remained until settled. At the hospital 8 and 6 inch wrought and cast-iron pipe was used, the individual supply for each building having a separate shut-off outside the building and one at the main.
All sewage from the hospital buildings was carried off in 6-inch tile mains, branching into an 8-inch main sewer, which runs through the center of the hospital grounds, into the disposal plant, a modified Imhoff septic tank. After purification the sewage emptied into the west branch of the Trinity River. The ward latrines were situated between the wards, in double wards. Each was equipped with five vitreous china water-closets, one vitreous urinal, and one shower, with hot and cold water supply and a floor drain. All latrines had concrete floors.
Each single ward had a separate lavatory and bath in either the south or the north end of the building. Each was equipped with one white enameled cast-iron bathtub, three white-enameled washbasins with hot and cold water supply, and three water-closets with low flush tanks. The rubbish was burned in a number of incinerators located about the hospital grounds. Prior to the installation of the sewer system, dishwater was evaporated over the incinerators, and the solid residue was then burned. The garbage was collected in large cans each day and sold by the quartermaster to stock raisers. Each ward was heated with two hot-air furnaces. Coal and wood were used as fuel.
The electrical installation of the hospital was laid out excellently, from the converters to the main-line switches. Here there was evidence of contract rush and a disregard of National Code rules; but, in spite of this, the electrical efficiency was brought to the point where trouble calls averaged less than one per diem. A heavy-duty electrical potato peeler, a 3,000-watt electrical dry-bath cabinet, and a 1,200-watt baking apparatus for rheumatic ailments were installed. Many snap switches in the diet kitchen and a complete electrical outfit for the venereal clinic formed part of the electrical equipment. Six two-story ward and barrack buildings were electrically equipped, in which all wires were concealed and the ceiling lights were of the shallow-bowl canopy, pull-chain type. The entire electrical system of the hospital was pronounced over 90 per cent efficient.
The post exchange was organized during the latter part of September, 1917, without capital, with a limited stock, and in temporary quarters. It was soon permanently located at the entrance to the patients' mess building, where it gradually expanded in stock and the scope of its activities. A modern fivechair barber shop, baseball, tennis, and volley ball equipment, hat blocking, clothes pressing, a recreation room with billiard tables, were features of the
exchange. It finally reached a maximum of stock valued at $2,000, and the fixtures were valued at $1,700.
A Young Men's Christian Association was established in December, 1917, across the hall from the post exchange and in the same building. It occupied one room and offered a common reading, writing, and meeting place for patients and Medical Department men. Various kinds of instructive entertainments were given daily. In May, 1918, the association moved into the chapel, where newspapers, books, magazines, games (such as checkers, chess, and dominoes), phonographic music, singers from the city, and other pleasures and comforts were provided.
Because of the crowded condition, in consequence of the epidemics of the winter of 1917-18, Red Cross supplies, which had been kept in a warehouse provided by the Government, had to be removed to and distributed from the basement of the chamber of commerce, Fort Worth. Later, a warehouse, centrally located, was provided and placed in charge of an associate field director. The Red Cross House for Convalescents was dedicated on May 18, 1918.
The field director visited the hospital one to three times daily, and an associate director was stationed at the hospital to notify parents not only of the condition of patients from time to time, but when they were discharged from the hospital.
In addition to the amusements provided by the Young Men's Christian Association and the Red Cross, croquet sets, indoor baseball outfits, magazines, and books were available. The personnel had for their amusement baseball, tennis, handball, and basket ball.
BASE HOSPITAL, CAMP CODY, DEMING, N. MEX.a
The base hospital was situated at the extreme western part of Camp Cody about 3½ miles to the northwest of Deming, N. Mex., a town of approximately 3,000 population. Deming, and the surrounding country for many miles to the east and west, lie in the Mimbres Valley, which at this place is about 30 miles wide and is flanked on either side by mountain ranges, all fully visible from the base hospital. The mountains, with the cloudless skies and wonderful sunsets, furnished a restful and serene outlook for the convalescent patients. The Mimbres Valley, level and unbroken, is practically a desert. To the eye of the casual observer, however, this arid character is partly concealed by the green of the soapweed, the yucca and the cactus. It is traversed from west to east by the Mimbres River, which, in the part of its course adjacent to Camp Cody, is a river in name only, its channel being quite dry except following a cloudburst or the rapid melting of the snows in the mountains. The water in the river, except at flood time, sinks and disappears in the sand at the head of the valley, only to reappear at the surface some miles beyond the Mexican border. This phenomenon is supposed to account for the high level of the underground water in the valley.
The soil is sand, ofttimes mixed with an alluvium, which, under irrigation, is exceedingly fertile.
During the period of high winds (from the latter part of October to May) violent sand and dust storms are common. It is from this characteristic of the
camp that the 34th Division acquired its sobriquet of "The sand storm division." Fortunately, the base hospital suffered less from the sand and dust than other parts of the camp by reason of its location to the windward side. The dust, much of which originated in the camp itself, was carried away from the hospital.
The climate may be considered as agreeable and salubrious. The altitude of Deming is 4,215 feet. This combination of latitude and altitude, together with the cloudless sky in the middle of the day, favors an extreme diurnal range of temperature, which is especially noticeable in the fall and winter. In midsummer, however hot the day, the night is sufficiently cool for refreshing sleep. During the spring and summer seasons violent electrical storms occasionally occur. From September 1, 1917, to September l, 1918, five soldiers were struck by lightning and two of them were killed.
The roads about the hospital and camp were constructed of gravel, which packed almost to the consistency of macadam. The highways of the surrounding country were, for the most part, rather primitive, but by reason of the dry and sandy soil, were rather easily kept in fair condition. The complete absence of waterways, except for the so-called Mimbres River, has already been noted; but irrigation plants, the pumps of which were usually operated by wind, were numerous and made the surrounding tracts present the aspects of an oasis. Except for the absence of running streams, which rendered sewage disposal unusually difficult, the location of the hospital was almost ideal from a sanitary point of view.
The base hospital had its beginning in 1916, growing out of the necessities of a camp occupied by a brigade engaged in the border service incident to the Mexican trouble of that time. With the cooperation of the town of Deming, there was constructed within its limits, on the west, a hospital building consisting of administration offices, an operating room, a patients' kitchen and mess hall and eight wards, all built around a central court. The collection of buildings was partially steam heated, and was electrically lighted. Its normal capacity was 200 patients. This institution performed the functions of a camp hospital throughout the construction period of the camp. On August 25, 1917, the 34th Division, consisting of 22,000 National Guard men from Iowa, Minnesota, Nebraska, and South Dakota, began mobilizing at Camp Cody, and in the course of events, on September 1, 1917, the camp hospital was officially designated as the base hospital. Coincident with the mobilization and establishment of the 34th Division, the construction of a new, more extensive and complete hospital was in progress, but by reason of the remoteness from a large center, and the difficulties encountered in obtaining material and labor, the new hospital was not ready for occupancy until November 4, 1917. Even then the accommodations were far from being complete. The urgent necessities of the medical service, however, permitted no further waiting for a greater degree of completion. Beginning with 45 patients on September 1, by October the service had increased to 130, and to 566 by November 1. The capacity of the original camp hospital (now known as 'old base') was increased by about 140 beds by the use of seven hospital tents. In the meantime, four of the new wards had been casually occupied by convalescent patients and those awaiting discharge for physical disability. Finally, the administrative offices and all of the medical patients were moved to the new quarters, the surgical patients remaining in the "old base."
As finally completed, the new base hospital included 52 buildings. Facing toward the east, on the main north and south road, were three buildings, the receiving office and ward, the administration building, and the officers' ward. Extending to the west from the receiving ward were wards 5, 6, 7, 8, 9, and 10; extending to the west from officers' ward were wards 11, 12, 13, 14, 15 and 16. These two groups of wards, with the main building, surrounded a central court, in which was located in line with the administration building, and extending from it to the west, the X-ray and pathological laboratories, the operating pavilion, the post exchange, and the patients' and enlisted men's kitchen and mess hall. To the rear of each of the two rows of wards mentioned was an additional row of four wards; to the south were wards 1, 2, 3 and 4; and to the north were wards 17, 18, 19 and 20. All these wards and buildings were connected by covered walks, furnishing ready access from one to another. Additional buildings were grouped around this central body of buildings, standing separate and distinct. Across from the main road, and facing the administration buildings were the nurses' quarters; to the southwest was the psychiatric ward; to the west, the isolation wards, the medical property building, the morgue, the guardhouse, the garage, the quartermaster supply building, the enlisted men's barracks; to the north, additional barracks (two story), the Red Cross Hall and Library; and, to the north and facing the main road, the pavilion for head surgery.
At the time the camp hospital was organized as a base hospital, and until the new buildings were completed, the officers were quartered in tents. As the personnel increased, 2 hospital tents were pitched end to end, and occupied by 25 medical officers. The cold nights, the sand, and various other discomforts, rendered the tent quarters decidedly unsatisfactory for men just from civil life, but it was not recorded that anyone suffered from this mode of living. The new quarters were supplied with modern conveniences, one officer to each room. Enlargements of these accommodations were necessary. The nurses' quarters were at first inadequate, but this inadequacy was rectified in time.
The medical stores of the hospital were kept in a frame warehouse, situated at the western edge of the hospital grounds. The office of the base hospital property officer was located at this warehouse. Property was arranged on the shelves according to the Manual for the Medical Department, which calls for the separating of medicines, stationery, miscellaneous, X-ray, laboratory, and additional articles. Surgical instruments, narcotics, poisons, and liquors, were kept under lock at all times. A refrigerator was used to store all biological and perishable articles. A clean and orderly warehouse was maintained.
The family style of service in the officers' mess and nurses' mess was used at the patients' mess-one service to eight patients. The food was properly cooked and the variety was the best possible under the conditions of the market. The mess was supervised by the mess officer and a sergeant first class. A daily inspection of the food served at the three meals was made by the mess officer, who tasted all food served. The kitchen personnel consisted of a sergeant in charge, five cooks, three cooks' helpers, and the "kitchen police." Patients who were able to do so marched to the mess hall from their respective wards, accompanied by an attendant. They entered the hall single file and stood at their places until seated by command. They were required to
remain at the table at least 20 minutes, but they were permitted to remain longer if they desired.
The diet kitchen connected with this mess was in a separate room. The personnel connected with it consisted of 2 dietitians, 2 cooks, and 6 kitchen police. The food going out to the wards was served in tins or containers, each of which had a cover. The containers, filled and ready for transportation to the wards, were placed in large trays containing hot water.
The baking for the different messes was done by two bakers, at night, in the patients' mess.
The family style of service was employed in the detachment mess, as in the other messes, one service to eight men; and this mess was supervised by the mess officer and a sergeant first class, as in the patients' mess. The kitchen personnel consisted of six cooks, two cooks' helpers, and kitchen police. The men marched into the mess hall in single file, standing at their places until seated by command.
In connection with these messes a training department was conducted at the "old base," the mess of which was supervised by the mess officer and furnished with supplies as in the case of the others. The personnel of this kitchen consisted of three cooks and four kitchen police.
The hospital water supply was derived from a deep, drilled well, situated about 500 feet south of the hospital grounds, and equipped with a turbine pump driven by a 50-horsepower electric motor. The capacity of the pump was 200 gallons per minute, filling a tank, located on a 50-foot tower built on high ground, and having a capacity of 200,000 gallons. This tank furnished the necessary pressure and afforded a direct supply of water to the hospital. There was no filter and no sterilization process; the bacteriological analysis of the water showed a very small count. This well was for the hospital use alone, but before it was completed the hospital received its water supply from wells that supplied the remainder of the camp.
The sewer system, which was independent of the camp sewer system, consisted of a 10-inch main, 1 mile in length, running, with a drop of about 12 feet, to the Mimbres River. A large septic tank partially purified the sewage before it entered the river. The hospital buildings were connected with the 10-inch main by 6-inch laterals.
The waste from the kitchen was disposed of by the reclamation service. The trash and other waste was placed in galvanized iron containers and burned at a dump, together with manure from the stable.
Before the sewer system was constructed bathing facilities were furnished by means of shower baths in small buildings adjoining the wards, the waste water running out into ditches. Because of the low temperature in the mornings and late afternoons, and the lack of hot water, bathing was limited to the middle of the day. While somewhat uncomfortable, it was not shown that shower bathing under such circumstances was injurious to health. Subsequently each ward had its own lavatory, with well-equipped tub and shower baths, and the other buildings had ample facilities of this kind.
When the hospital buildings were first occupied the heating facilities were exceedingly primitive. A small sheet-iron stove, officially designated as "wood No. 18," was placed in each end of the ward. Being entirely inadequate, these were soon replaced by large drum stoves (room heaters, No. 18
and No. 20). These added to the difficulty in keeping the wards clean, but they served the purpose of keeping them warm. Steam heat was never installed.
The hospital was electrically lighted from the beginning, being served by the Deming Electric Light Co. The service at first was not very satisfactory, but improved with time.
The laundry work of the hospital was formerly done by outside laundries. In May, 1918, a full steam laundry equipment was donated by a resident of Silver City, N. Mex., for the use of the base hospital for the duration of war. He also gave his services as manager. After July 1, 1918, the laundry washed all the hospital linen and never missed delivering clean linen to each ward daily, except Sundays. In addition, large quantities of work were done for the camp quartermaster and the conservation and reclamation branch of the Quartermaster Corps, at a great saving to them. The clothes of the patients in the hospital were washed every day free of charge. Judging from the prices that would have been charged by an outside firm, the hospital laundry showed a saving of $4,260.44 for the first three months of its operation.
During the period (prior to September 1, 1917) when the hospital was designated a camp hospital, and when it had seven wards, the hospital equipment was in proportion. One end of the ward was partitioned off as a storeroom for both medical and quartermaster property. Practically the only medical stores held in stock were the bedding and patients' clothing, for changes of laundry, and a supply of stationery. The wards were fairly well equipped and the surgical department had just such instruments and appliances as were necessary for handling incoming cases.
Pending the construction of the new base hospital, ward tents were erected, greatly taxing the limited equipment on hand. Some of the necessary drugs and medicines were practically unobtainable. Later, as the new hospital was completed, and the work of moving began, the hospital equipment became altogether inadequate. October, November, and December, 1917, were undoubtedly the hardest in the history of the hospital. Patients not seriously ill brought their own cots and blankets. Drugs and general medical supplies could not be furnished in the large quantities required. Very few modern appliances were in use, and it was necessary to introduce many methods in order to obtain the desired results without the requisite surgical appliances and modern equipment. But with the beginning of the year 1918 conditions began to improve, and ultimately the base hospital at Camp Cody became modern and efficient in its equipment in every department and in all details.
On October 17, 1917, the post exchange was started on credit extended by Deming firms. New features were added from time to time, until the exchange embraced a store department, three barber shops, a tailor shop, pool hall, recreation room, and laundry at the new base hospital, and a general store, pool room, and barber shop at the "old base." In all the departments about 30 men were on duty. An average of 50 cents a day was paid them. The average monthly business of the exchange was about $17,000, with a profit of about $1,700. The exchange was free from debt, but did not declare a dividend, although from time to time a sum was set aside and used for the benefit of the hospital, as allowed by exchange regulations.
The Young Men's Christian Association building was completed and ready for occupancy October 1, 1918. It had an auditorium, 110 by 45 feet, and a social room, 36 by 36 feet. It was painted steel gray and trimmed in light green, the colors offering a striking contrast to the groups of unpainted barracks in the northeast area of the hospital grounds, near which the building was situated. The equipment for the daily entertainment of the men consisted chiefly of checkers and chess boards, pianos, victrolas, and a moving-picture machine. During the emergency of the influenza epidemic the building was turned into a hospital ward, the secretaries giving their assistance in the care of the patients. After the epidemic subsided, weekly programs covering athletics, social, educational, and religious activities were given, which did much toward keeping up the morale of the men. At regular times mass services were conducted by the priest, and Sunday services were conducted by the chaplains in the auditorium.
The American Red Cross building, constructed and furnished at a cost of $25,000, was a pleasing variation to the hospital architecture. It was a two-story structure, built in the form of a cross. The main part of the lower floor was occupied by an auditorium, with a stage, where various entertainments were given for convalescent patients and their friends. Here the patients, the men, and officers might read, write, or play games and feel perfectly at home. The hospital branch of the American Library Association was installed here, and there was a special reading room with professional literature for the medical officers attached to the hospital.
Another valuable feature of the institution, especially appreciated because of the comparative isolation of Deming, was the arrangement for the temporary housing of the relatives of the dangerously sick who came from far away. Twelve rooms were available for this purpose.
The Red Cross built a nurses' house adjacent to their quarters, which could be used for a lounging and rest room or for dancing. A weekly dance given by the nurses served to break the monotony of their routine duties, remote from even a small city. This building, furnished, cost $12,000.
Opposite the administration building the Red Cross built, at a cost of $2,500, a pass and information bureau, in which a part of the administrative work of the hospital was conducted.
All these buildings with their equipment were turned over to the Government and were directly under the control of the commanding officer of the hospital.
In addition to the recreation activities provided by the Red Cross and the Young Men's Christian Association, other sports were fostered and supervised by an athletic officer, appointed for the purpose, who had charge of the athletic training of the men. From time to time boxing and wrestling tournaments were held.
A swimming pool was built by the hospital corps men with the assistance of the Red Cross. The pool, which was of reinforced concrete, was 90 feet long, 40 feet wide, and 9 feet deep at the lower end. A constant change of water took place, and, in addition, the water was disinfected with chloride of lime. All persons were obliged to take a soap and shower bath before entering the pool.
There were five cement and one dirt tennis courts at the hospital, so managed that everyone had opportunity to play.
A baseball and football field was located to the extreme east of the grounds. The boxing and wrestling bouts were held in a regulation 16-foot ring, which was well made and so placed that about a thousand spectators could enjoy the sport.
BASE HOSPITAL, CAMP CUSTER, MICH.a
The base hospital of Camp Custer was favorably located in the county of Kalamazoo, in the State of Michigan, and approximately 7 miles from the civic center of Battle Creek, Mich. The country is rolling, with scattered wooded tracts. The soil is loam and fine gravel and sand, the latter predominating. The site is located on the medial moraine of glacial drift. There is almost no mud, but much wind which stirs up a good deal of the sand, making considerable dust. The winters are quite severe for about three months of each year, the temperature not infrequently dropping as low as 20° below zero. The prevailing winds are from the southwest. Spring often begins early, but the frequent relapses of winter, and often cold, rainy days, with occasional mild days interspersed, necessitate some fire for comfort until June. Throughout the spring and well into summer hot sultry days may alternate with chilly and windy ones. The autumns have many beautiful days, but there may be several weeks of rainy chilly weather. The summer days are warm; the nights are generally cool. The hospital was on a hill directly overlooking Eagle Lake, and was subjected to moderately high winds in winter and spring. The roads were of earth, gravel, and cinders. A concrete road extended from just beyond the hospital receiving ward to the camp.
The hospital was opened for patients on September 5, 1917, a tent being used near the temporary headquarters of the camp. On September 17, two partially completed ward buildings of the new hospital were available; and the base hospital, its detachment, Medical Department, and 24 patients, were moved into these wards. Cases of contagious diseases were temporarily cared for in tents erected contiguous to the ward buildings. As rapidly as new buildings were completed they were occupied, for the patients arrived as fast as adequate space for their reception was obtainable.
The function of this hospital was to treat all cases arising at Camp Custer, and medical, surgical, and venereal cases from overseas. The training of personnel for further duty at home and overseas was a part of the function of the hospital before the armistice.
The hospital wards, 38 in number, conformed to the standard designs for a northern climate. During 1918 the following construction was completed: Additional nurses' quarters and 4 dormitories, 10 two-story ward-barracks, a refrigerating plant, a kitchen and mess hall for the enlisted men; 2 barracks and two additions to the general mess. At the end of the year there were in course of construction an addition to the administration building, the laboratory, the operating pavilion, a garage, nine new wards, a prison ward, and an umbrella corridor connecting the nurses' quarters and the main hospital. A Red Cross house for convalescents and a Young Men's Christian Association but were also added.
Officers, enlisted men, and nurses were quartered in the regulation buildings provided for the purpose. The crowded conditions which obtained in the earlier days were overcome by the construction of additional quarters during 1918.
The storehouses were completed promptly, but great difficulty was encountered because of the lack of shelving at first, and only a minimum amount of shelving was obtained. The storehouses were the last buildings to be equipped with steam heat.
The hospital kitchen was not ready for occupancy at first; consequently, the cooking for both enlisted men and commissioned personnel was done in the open on a field range, underneath a tent fly. Later, the cooking for both classes was done in one kitchen; still later, the portion of the main kitchen designed for a diet kitchen was used in which to cook for the officers' mess; and the detachment mess was separated from the patients' mess. Subsequently, the officers' mess was moved to the officers' quarters.
The following criticisms were made of the construction and equipment of the patients' kitchen: The floor was not impermeable; on the contrary, it was made of green 6-inch lumber which shrank and warped after short use. It was impossible to keep it clean. The wing off the kitchen, shown in the original plans as a bakery, was never built at this hospital, although it was built at other camps and used as a kitchen storeroom. The storage space in the patients' kitchen at this hospital was inadequate from the beginning.
The laundry building was equipped with a drying room, a steam disinfector, and a few laundry baskets. The incomplete equipment of the hospital laundry was met by daily service by the camp laundry. It was necessary, however, to send nurses' uniforms which required ironing to Kalamazoo. A double check was kept on all linen and an inventory taken each week.
The hospital water supply was received from the water system installed in Camp Custer. The water was piped across Kalamazoo River from deep wells in Marshall sandstone. This is a water-bearing stratum 30 or more feet in thickness, situated below a layer of sand and fine gravel varying in thickness from 30 to 50 feet. The average depth of these walls was approximately 110 feet. The water rose in them to within a few feet of the surface, so that electrically driven centrifugal pumps were successfully used. The water was of high quality, but the pipes were fouled during the crossing of the river and the laying of the mains, and liquid chlorine prophylaxis under laboratory control was employed at first.
The sewerage system of the hospital was water borne and passed through sedimentation tanks into the Kalamazoo River, which received also the sewage from Battle Creek, Kalamazoo, and Augusta.
A garbage house 8 by 20 feet, with cement floor and screened windows, was constructed in the rear of the kitchen. To this house garbage was brought from each ward and mess, weighed by an inspector, sorted over, and weights and contents noted. This report was then typewritten and sent to the desk of the mess officer, the dietitian, and the commanding officer. Undue waste from any ward or mess was noted and comment made locally, or at officers' call. By thus fixing individual responsibility the daily waste of edible food was reduced to as low as 0.17 ounce per ration per day. The waste in the detachment mess was as low as 0.06 ounce per person. The garbage, except that from the contagious-disease wards, was hauled away in cans and turned over to a contractor. Sputum cups and articles containing discharges of a similar nature were collected in a pail, lined with newspaper, and burned in the furnace, as
were the infected dressings. Garbage from isolation wards was separated and burned.
Lavatories and baths were connected with the sewer, all fixtures being separately trapped and provided with cast-iron soil piping, which connected with the trunk sewer.
The heating plant consisted of 10 shell boilers 150 horsepower each. The buildings were all steam heated by a one-pipe low-pressure system with no returns. The system was adequate to give ample heat throughout the hospital, with the exception of the new nurses' quarters and the two-story barracks. The inadequacy of the system in this respect was said to be due to the fact that there was no return system. Without exception the original hospital buildings were provided with more radiation than was essential.
The hospital was lighted throughout by electricity, commercially obtained, the system proving satisfactory.
The initial equipment was incomplete as regards instruments, dental apparatus, and ward equipment. Since it was possible to treat patients and administer to their needs by the use of emergency equipment purchased locally, all patients were cared for satisfactorily. Sufficient equipment was eventually obtained.
On September 20, 1917, the base hospital exchange was started on Harmonia Road, in the east end warehouse, with a lot of goods, costing $100. The exchange proper was opened in building 1836 on October 1, 1917. The exchange prospered, the business transacted being satisfactory as to both profits and patronage. It was a distinct asset to the hospital and filled a real want in satisfying the needs of soldiers, patients, and their relatives.
During the early winter of 1917 ward 20 of the base hospital was opened for recreational purposes and was in charge of a private detailed for the purpose. On December 26 a secretary of the Young Men's Christian Association assumed charge. The work was carried on in this ward until January 24, 1918, when it was necessary to move to the base-hospital exchange, on account of the crowded condition of the hospital. Subsequently a new Young Men's Christian Association building was opened. It proved extremely valuable and was much used.
The Red Cross house for convalescents was opened in April, 1918.
Through the cooperation of the Red Cross and Knights of Columbus, Edison and Victor graphaphones were placed in nearly all wards. Sunday afternoon entertainments were given in the wards under the auspices of the Young Men's Christian Association and the Knights of Columbus and by visiting groups of interested entertainers. Afternoon band concerts in the patients' mess hall were frequently given, and the Young Men's Christian Association furnished at least three evening entertainments a week, in addition to their Sunday evening religious concert and service. Quoits, checkers, chess, and other games were distributed; and in favorable seasons the enlisted men played baseball.
An orchestra was organized in the early days of the hospital and proved so successful as to warrant official recognition and encouragement. Assistance was given it from post exchange funds, instruments were purchased, and time off was allowed the members for practice. A band of 26 instruments was developed.
The Daily Bulletin, a single sheet, mimeographed daily paper, was issued, with some intervals, from August 5, 1918. Its object was to keep the patients and the personnel informed as to official news, announcements of the Red Cross, Young Men's Christian Association, and Knights of Columbus, to improve the morale, and to stimulate an esprit de corps.
BASE HOSPITAL, CAMP DEVENS, MASS.a
The hospital was located in Middlesex County, Mass., 14 miles from Fitchburg and 2½ miles from Ayer. The country is rolling, and wooded with second-growth trees, mostly hardwood of small size. The soil, for the most part, is gravelly, but shows the variety common to glacial drift. There was no high-flying dust about the hospital in dry weather, nor sticky, easily carried mud after rains. The climate is characteristic of New England, moderately cold in winter, moderately warm in summer, with frequent changes and considerable sunshine. The hospital site was not exposed to excessive wind. The roads about the base hospital were well kept. The main highways were of the best construction under State control; the county roads were of gravel or dirt.
The Nashua River bordered the hospital grounds on the west, at a distance of a quarter of a mile. This stream was polluted by sewage from towns above. There was some low-lying land on the border of the stream, and there were several small ponds within half a mile of the hospital.
The base hospital was organized the last week in August, 1917, and the first building was occupied August 10, 1917.
The hospital treated all cases arising at Camp Devens, and medical, surgical, and venereal cases from overseas.
A building, located near the center of the cantonment, was maintained by the insurance company as a first-aid station and infirmary for construction employees. It had six beds. Serious cases were sent to Boston.
The buildings constituting the base hospital were distributed in the form of a fan, radiating from the administration building toward the northwest.
There were three rows of medical wards, one row of isolation wards, and a psychiatric group toward the left of the administration building, and three rows of surgical wards to the right, with the administration building, the post exchange, and the main kitchen between the medical and surgical groups. The enlisted men's barracks, the storehouses, garage, shops, and heating plant were to the northwest of the surgical group. Twelve two-story wards were added on the east of the surgical wards. Other construction was added from time to time, in various parts of the hospital.
At the beginning, officers as well as enlisted men, were quartered in buildings which were subsequently used as the men's barracks and the storehouses. The building primarily intended for the officers' quarters was converted into a building for head surgery, necessitating the construction of a new building for officers' quarters. Additional quarters were constructed as the commissioned personnel increased in number. The nurses' quarters were inadequate at first, but additional quarters were provided later. The enlisted men of the detachment were quartered in eight barracks.
The cooking for the patients was done in a central kitchen, which, with an auxiliary diet kitchen, had a capacity for 1,500 or more. An additional dining room was built, so that it would not be necessary, as in the beginning, to have first and second tables. The kitchen, however, was too small, having been designed for a much smaller mess. There was a kitchen and mess for the hospital detachment, Medical Department, in a building adjoining their barracks, which had a capacity of about 200, but at which 300 or 400 were fed under satisfactory conditions.
The nurses maintained a separate kitchen and mess. This also was overcrowded at first because the number of nurses on duty was considerably larger than either the nurses' quarters or the nurses' kitchen and mess were planned to accommodate.
The officers' ward had a separate kitchen and mess, with a capacity considerably larger than the requirements of the sick officers demanded; so, for many months, all officers of the hospital were fed at a mess maintained in the officers' ward. Subsequently a new wing was added to the officers' quarters with a larger kitchen and a seating capacity of 120.
The messes for the patients, the hospital detachment, and the nurses were maintained on the Government ration, but the enlisted men's mess received a liberal addition from the hospital fund and the post exchange, bringing it up nearly to the ration for the patients.
The building intended for the hospital laundry was not used for this purpose because it was not equipped with laundry machinery. All the laundry for the hospital was done outside the camp by firms in cities 30 or 40 miles distant. The laundry was collected in a central building in the camp from which it was distributed. This arrangement was very unsatisfactory.
There were four storehouses, one of which was used for the hospital medical supply, the other three for the camp medical supply. They were buildings similar in dimensions to the wards and barracks, but were arranged with shelves inside and each had a wide platform outside, running the full length, for convenience in loading and unloading.
Shower and tub baths were connected with each ward. There were several shower baths, but no tubs, in each of the enlisted men's latrines. The
water for the shower baths in these latrines was heated during the winter by steam from the heating plant. High-pressure steam was connected later with these lavatories. The officers' quarters were equipped with shower baths and tubs, and the nurses' quarters with tubs but no shower baths.
A central boiler house, located at the lowest part of the hospital area, had a capacity of 14 or more boilers. The steam was conducted by overhead piping, well insulated, to all parts of the hospital, with the exception of the 12 two-story wards, for which a separate heating plant was constructed. The system provided for conveying the steam from the boilers to the radiators, and the water of condensation was allowed to escape through exhaust pipes which emptied upon the surface of the ground, just without the buildings. The heating system worked well and proved entirely adequate even during an unusually severe winter. The consumption of coal was as high as 85 tons a day in winter and about 5 tons a day in summer. The building for surgical operations had an independent heating unit, installed to provide heat for warming the building and for sterilizing materials before the central plant was constructed. It also provided against a possible breakdown in the central heating arrangements. This auxiliary plant proved very satisfactory. Without it the surgical service would have been seriously handicapped during the early months of its existence.
The water supply of the base hospital was identical with that of the camp. It was derived from a group of wells in a favorable location northeast of the camp. Owing to the possibility of surface water finding its way into some of the wells, chlorination was adopted as a precautionary measure.
The hospital had a complete gravity system of sewerage. There were water closets in all the wards, and three latrines adjacent to the men's barracks. Pit latrines were temporarily established at various points on the hospital area for the use of the construction employees and also, in the days before the sewerage system was completed, for the use of the officers and men of the hospital. There was a filtration system near the river for the purification of sewage before its final outlet into the river.
Garbage from the various kitchens and wards was divided into edible and inedible waste, and was weighed so as to keep track of the waste from each ward and kitchen. The garbage was collected daily and transported to a central station where all the garbage of the camp was handled by a contractor. Manure from the stables was hauled away daily and loaded upon a car at the railroad siding.
The hospital was lighted by electricity obtained from the general camp supply, which, in turn, was derived from a hydroelectric station on the Connecticut River, about 75 miles distant. The supply was steady and adequate. The current was 60-cycle, alternating 110-220 volt, to which it was stepped down by means of transformers placed where the high tension lines entered the hospital grounds. Lighting was accomplished by standard watt volt mazda lamps, with a few larger lamps where extra light was required. In the library the recreation rooms and the ophthalmic department, special units of larger power, properly shaded, were installed.
During October, 1918, a building was erected by the American Red Cross Society for the conduct of occupational therapy for convalescent patients. In December the first group of reconstruction aides, 14 in number, arrived. Progress was made in the work, especially among those confined to bed, but lack of teaching personnel hindered the full development of this branch of the work.
In August, 1917, the post exchange was opened. Owing to the large number of workmen who patronized it during the construction period a fund was rapidly accumulated and the exchange placed on a staple basis.
The Young Men's Christian Association was located opposite the enlisted men's barracks, and was connected with the wards by a covered corridor. This building was used by both the enlisted men and the patients. Basketball and other indoor sports were carried on during the winter; an hour, twice a week, being reserved for the officers. Entertainments of some sort, such as moving pictures, addresses, concerts, or dramatic entertainments, were given there nearly every evening. On Sundays religious services were held, by the chaplain or some visiting clergyman, in this building.
The Red Cross building adjoined the part of the hospital where convalescent wards were, and was intended for the use of patients of the hospital. The Red Cross aided the hospital in many ways. A representative called biweekly on the commanding officer to afford financial or other assistance. The patients were visited in the ward and were assisted with their correspondence, the Red Cross representative serving as a medium of communication between patients and their homes.
Baseball and tennis games afforded the principal forms of amusement.
The American Library Association furnished the material and equipment with which to convert the chapel into a library for the use of the enlisted men and the patients. A librarian was placed in charge and 3,000 volumes and a large number of periodicals were filed. The library association also supplied games, puzzles, etc., for the patients.
BASE HOSPITAL, CAMP DIX, N. J.a
Camp Dix, together with the base hospital, which it included, was located at Wrightstown, N. J., 21 miles southeast of Trenton, N. J., and 31 miles northeast of Philadelphia, Pa. The site of the camp is slightly rolling, surrounded by farming country, with some woodland to the east.
The soil is sand, mixed with clay, with strata of loam. There is no highflying dust in dry weather. The soil is white and muddy after about two days of rain, but dries up in three or four days. The mud formed is not sticky.
The climate is moderate. It is warmer in winter than that of either Philadelphia or New York, with less snow and rain than falls in these cities. The summers are pleasant. The prevailing wind during spring and summer is from the west; during the remainder of the year, from the southeast. The hospital was not exposed to high winds.
The roads in the hospital grounds were of concrete; but previous to June, 1918, there were no roads, and great difficulty was experienced during the part of the winter of 1918 in bringing supplies into the hospital, as no motor vehicles could enter the grounds. Roads in the surrounding neighborhood were of dirt, with the exception of one service road to Trenton and one to Philadelphia. All roads were in very bad condition. There were no streams of any size in the immediate neighborhood. The sanitation of Wrightstown, N. J., the
nearest village, was very bad, until the town was closed to soldiers by a camp order, in the spring of 1918. A sewer system was installed subsequently, macadamized roads were laid, and concrete sidewalks built. The condition of the town then became satisfactory.
The medical activities of this camp began with the arrival, on August 27, 1917, of Ambulance Company and Field Hospital No. 22, together with several casual medical officers, all from Fort Oglethorpe, Ga. At the time of their arrival a hospital for the care of sick civilians was in operation in one of the temporary buildings. This hospital continued to care for civilians and later for soldiers until a temporary field hospital was established in another camp building. It functioned as a hospital until October 22, 1917, when the base hospital was opened.
The base hospital plan, as issued by the Surgeon General's Office, was followed exactly: the character of the site permitted this arrangement.
On October 29 the first patients were received, and the patients at the temporary hospital, then numbering 249, were transferred to the base hospital. At that time the north and south wings and central section were still under construction; there was no steam heat; there were no connecting corridors; and all cooking was done in the main mess kitchen and in the kitchen of the officers' ward.
The original plans showed 26 rooms in the officers' quarters. As early as September, 1917, the commanding officer began sending requests for larger officers' quarters. These were persistently refused for several months. Additional quarters were finally authorized, construction was commenced in March, 1918, and the quarters completed the latter part of April. They were not sufficient, however, and a number of officers still had to be quartered in the officers' ward. At times these two buildings were not sufficient to accommodate all officers, and one hospital ward was used for the purpose. The original nurses' quarters were not sufficiently large, and two wards were used until the new nurses' quarters were completed, in May, 1918. The original nurses' quarters were then occupied by the nurses' training school, and the graduate nurses were housed in the five nurses' dormitories erected between March and August, 1918. The original plans showed six barracks. Two additional barracks were built, but one of the original buildings was converted into a mess hall. Each of these barracks held 74 men, but by instructions from the Surgeon General's Office, this capacity was reduced to 60, making a housing capacity of 420 men. The authorized strength of a detachment for this hospital was 650; the barracks, therefore, were entirely inadequate. The surplus men were housed in tents, in warm weather, and in the two-story barracks in cold weather, when these were not required for patients.
The large hospital kitchen was completed October 28, 1917; and from that time until February 15, 1918, all the food for patients, enlisted men, and nurses was prepared here. This mess, which was designed to cook for 1,000, frequently had to serve 2,500, and hardly proved equal to the task. Conditions were improved by adding a large number of steam cookers and roasters. The enlisted men's mess was opened on February 15, 1918, but was large enough to accommodate only the remainder of the detachment continuing to be served in the main hospital mess. An additional mess was authorized in the spring of 1918, but was not completed until August. The arrangement was very poor, as the mess was composed of two buildings connected by a narrow corridor, only one building having a kitchen. The nurses' mess was opened February 1, 1918.
Four storehouses were erected according to the original plans, and they proved sufficiently large for the use of the base hospital alone; but when the division and camp supplies were moved into them they were decidedly crowded. Additional storehouses were constructed later.
In the hospital proper, the two central rows of wards had bath and closets in the wards. The two end rows had bath and closets between wards, making four lavatories for each row of eight wards. The lavatories and baths were
connected with the sewer by ordinary trap. Latrines for enlisted men's barracks were outside of the building.
The hospital was heated by means of stoves until December 12, 1917, when a low-pressure steam heating system was installed. No return system for water of condensation was authorized or installed originally, and this made heating very expensive, as much as 75 tons of coal being used in a day. A return system was finally authorized about the middle of the winter. When it was installed the ground had to be thawed by means of burning fires over it. The expense of installation at this time was at least eightfold what it would have cost when the original plant was installed.
The hospital, like the camp, was lighted by electricity, purchased from the Public Service Corporation of New Jersey.
The hospital water supply, which was identical with that of the camp, was pumped from the south branch of the north fork of Rancocas Creek, 4 miles distant, and was treated by chlorination. The color of the water was very high, and the high carbon dioxid content made it worthless for use in highpressure boilers, as the boilers were eaten out very rapidly and the hot-water supply was continually red with the iron rust. An artesian well was sunk beside the power plant to supply water for the boilers.
The sewerage system was the same as for the rest of the camp, except that on account of a ridge between the hospital and the septic tank, it was necessary to pump the sewage to the tank.
Kitchen waste and garbage were removed by the quartermaster to a central disposal plant.
The laundry work of the hospital was originally done by a private laundry company of Philadelphia; later, it was done in a more satisfactory manner by the quartermaster, in the camp.
In the early days of the organization of the hospital there was no shortage of beds, bedding, or drugs. There was a decided shortage of mess equipment and surgical instruments, however, but they later became adequate and satisfactory.
When the construction of the hospital was begun the contractor was requested to complete the commanding officer's quarters at once, with the exception of the inside finish of the walls and floors. This was done, and the building was used as a post exchange during the construction period. The profit on sales to the workmen employed was sufficient to form a good fund for starting a hospital mess when the hospital was opened. About October 15, 1917, the permanent exchange building was occupied. It proved to be satisfactory, except that it was too small. In emergencies, when necessary articles of equipment and supplies could not be obtained within a reasonable time, they were purchased with exchange funds.
The Young Men's Christian Association building was completed in September, 1918. The construction of this building had been proposed and authorized by the Surgeon General's Office and by the Young Men's Christian Association authorities a year before; but its immediate construction was delayed through the opposition of the Red Cross representatives at the camp, their contention being that the Red Cross should handle all the work. This opposition was
finally overcome, after the work of the Young Men's Christian Association, whose representatives entered the field ahead of the Red Cross, was seriously interfered with for months. Two Young Men's Christian Association representatives were assigned to the hospital and were doing excellent work from the time of its opening. Owing to the strong objection on the part of the local representatives of the Red Cross to having the Young Men's Christian Association encroach upon its field of looking after all that pertained to the patients, a hospital order was issued forbidding all patients to enter the Young Men's Christian Association building. This left the building free for the use of members of the detachment.
There were two Red Cross buildings, a large one for the patients and a small recreation building for the nurses. The work of this organization comprised chiefly the writing of letters for patients, giving entertainments for convalescents, and obtaining minor supplies for the hospital, when they could not be obtained immediately by requisition.
Various games and drills were participated in by convalescent patients. Phonographs and records were placed in wards where it seemed desirable to have them.
BASE HOSPITAL, CAMP DODGE, IOWA.a
Camp Dodge was located on, and extended for about 3 miles along, the western slope of a picturesque ridge, situated just west of the Des Moines River valley. Islands of hard-wood trees, scattered here and there on both the east and west ridges, as well as along the reaches of the near-by Beaver Creek, added to the general picturesque appearance of the location. At the extreme western extremity of the cantonment, the base hospital was constructed. From here to Des Moines was a distance of 20 miles. The composition of the soil at Camp Dodge left much to be desired, considered from the viewpoint of comfort. It is composed of a thick, heavy, black loam, with a substratum of gravel. During wet weather, the lower levels of the area become tenacious in quality, and difficult to negotiate. During dry periods, however, the denuded soil was readily metamorphosed into an impalpable dust, which, whipped by the prevailing strong winds of the valley, became veritable dust storms that occasioned concern.
The hospital was surrounded by well-kept concrete roads; but aside from these cantonment roads, the usual dirt country roads were to be found. South of the hospital, and immediately adjacent to it, was the village of Herrold, the sanitary condition of which was under the control of the division sanitary inspector.
The function of the base hospital was to treat all cases arising in the camp and medical, surgical, and venereal cases from overseas.
When the hospital was organized, August 28, 1917, the division commander (88th Division) gave the use of two of the Government-constructed two-story cantonment barracks. One of these buildings was used for barracks for officers and for the administrative offices of the hospital; the other was used for wards. This ward building was rapidly filled, and a third two-story barracks building was added. Patients were admitted so rapidly at this time that a division of the buildings into special wards became necessary; and within a few days more buildings were added, until 10 two-story barrack buildings were being used exclusively as wards. The officers' quarters were moved out of the barracks, the officers then being quartered in regular officers' quarters. These 11 buildings were used until the latter part of October, 1917.
The cantonment contractor furnished an emergency hospital for the employees. It consisted of a well-equipped hospital tent, under the charge of civilian surgeons. At a later date it was moved into a brick building, and remained under the charge of civilian physicians and surgeons.
On October 28, 1917, the patients were moved from the temporary to the permanent base hospital. At that time 19 wards were completed. Additional wards were equipped and occupied as need arose.
When the base hospital was opened the officers were quartered in three officers' barracks, each building having a capacity of 31 officers. These buildings had independent heating plants and outside latrines. During the winter of 1917, the officers suffered much inconvenience from the cold and from insufficient bathing facilities on account of the inadequacy of these independent heating plants. Later, a new building for officers' quarters was constructed, and opened in January, 1918. These quarters consisted of a main building 160 feet long, and three wings, the outside two of which contained rooms for officers, the central wing containing the assembly hall, dining room, kitchen, and toilets. This building was heated from the central heating plant, was well lighted, and was very comfortable. It contained 48 rooms and accommodated about 100 officers. The care of the building and the administration of the mess were in charge of a house committee, made up of three field officers from the base hospital organization.
The members of the Nurse Corps were quartered in a building of their own, attached to the hospital proper by closed corridors. This building contained bedrooms, a mess hall, and kitchen, and, up to January, 1918, proved ample. As the hospital grew in size, and more nurses became necessary, they were placed in the officers' barracks just vacated. In April, 1918, there was a rapid increase in the number of patients, necessitating a rapid and large increase in the Nurse Corps on duty in the hospital. This, in addition to a fire in the nurses' quarters, made it immediately imperative that new and large quarters be provided. A building was erected, a replica of the new officers' quarters. This was soon filled, and additions were made to it. The original nurses' quarters were rebuilt after the fire, but even this did not provide for the 225 nurses on duty, so that it became necessary to reopen the old officers' barracks.
The enlisted personnel occupied three barracks on the west side of the hospital. As the detachment increased in size it became necessary to house the men in solaria, in vacant wards, in the chapel, and in every available space.
Early in March, 1918, the situation became so acute that five new barracks were erected. These barracks were ready for occupancy on April 5. Added to the original three, they gave adequate accommodations for the 660 enlisted men to which the hospital was entitled.
The kitchen building for the enlisted personnel consisted of a regular standardized structure, 24 feet wide by 156 feet long, with the storerooms at the east end and the kitchen at the other. It was situated as near the center of the hospital as construction permitted, and was connected with the mess hall and wards by closed corridors. The main kitchen equipment consisted of two 12-foot ranges; two steam roasters, with a capacity of 125 pounds of boned meat; two steam vegetable cookers, with a capacity of 4 bushels of prepared vegetables; two 40-gallon steam cookers for soup, etc., two 20-gallon and one 40-gallon steam coffee urns; one vegetable peeler with a capacity of 5 bushels per hour; one electric meat cutter, with a capacity of 150 pounds of boned meat per hour; and the usual auxiliary kitchen outfit for a kitchen preparing meals for about 1,800 patients.
The liquid, and special, therapeutic diets were prepared in the diet kitchen situated just off the main kitchen. This building was 24 by 24 feet.
The general mess hall consisted, for a time, of a single room, 156 by 24 feet, with two rows of combination bench tables running the entire length of the room. Later this mess hall was enlarged by the addition of three wings, 24 by 35 feet, running at right angles to and opening directly into the main hall at each end and in the middle, making a seating capacity of 620.
The kitchen for the commissioned patients, which was well equipped, was attached to the officers' ward. Its administration was entirely separate from that of the general mess, and was operated with its own funds. The mess hall opened directly from the assembly room of the officers' ward and seated approximately 100 persons. The tables were provided by the Medical Department; the table linen was furnished from the officers' hospital fund.
The hospital storehouse consisted of a standardized building, 24 by 150 feet. It had a cement floor throughout its entire length, and was partitioned into five rooms. These rooms were divided into a medical property department and a quartermaster department. It also contained the hospital carpenter shop. It was well lighted and steam heated.
The building originally built as the hospital laundry was wholly inadequate in size and construction for the purposes for which it was intended. It was never equipped, and consequently the hospital had to depend upon the laundries of Des Moines. The laundry was used as a linen room, where soiled linen was taken by the ward men, and exchanged, piece by piece, for clean linen. There was installed in this building a large autoclave for the sterilization of infected linen and for the sterilization of the clothing of patients coming into the hospital with infectious and contagious diseases.
The hospital chapel was ready for use about September 1, 1917. Owing to the great distance of the chapel from the center of activities of the hospital, it was never used for divine services. It served as temporary barracks for enlisted personnel for a number of months.
The hospital water supply was from open and tubular wells, located on the Des Moines River bottoms, situated approximately 1,000 feet west of the
river, and directly east of the cantonment. The water was filtered through a 15-foot bed of sand and gravel, then chlorinated and pumped to a milliongallon concrete reservoir, situated on a high ridge running parallel to the eastern boundary of the cantonment. From this reservoir it was distributed, by gravity, to the whole camp, including the base hospital.
Practically all the toilets of the hospital were placed in the latrines between each two wards. They consisted of flush stools and enameled bowl urinals, with open plumbing, and were modern in all respects. The sewerage system was connected with the general camp system, which discharged, by gravity, into the Des Moines River 3 miles below Camp Dodge and 8 miles above the city of Des Moines.
Kitchen wastes were collected by civilians in Government-owned trucks, under charge of a Quartermaster Corps noncommissioned officer. They were then carried to the railroad and removed from the cantonment by a contractor. Garbage from the infectious disease messes was carried in a like manner to the incinerator, and burned. Manure from the picket lines was conveyed to a dump and burned.
The various wards and buildings of the hospital were heated by a vacuumreturn system from a central heating plant, consisting of fourteen 150-horsepower boilers. The heating of the individual buildings was controlled by automatic gates. The system proved very successful.
The hospital was lighted by electricity throughout. The current was a part of the general camp system, and was obtained from the Des Moines Electric Co.
The first equipment of the hospital consisted of the standard field hospital equipment. Later, Gold Medal cots, with a field mattress, two blankets, and two sheets each, were issued. One pair of pajamas was given to each patient. On September 12, 1917, Medical Department supplies began to be issued, and as these increased the field hospital equipment was gradually removed. The hospital eventually became fully equipped for the care of about 2,000 patients.
When the hospital was first opened the enlisted men and the ambulatory patients patronized a contractor's canteen two blocks from the hospital. This suggested the need of a hospital exchange, and one was established, being opened for business in one of the barracks, September 25, 1917. Trade was good from the start, and rapidly increased. In October larger quarters were obtained, making it possible to carry a larger variety of goods. When the new base hospital was finished the latter part of October, the exchange moved into an independent wing, 24 feet wide by 75 long, in the center of the hospital. A still greater variety of goods was then carried, including various uniform accessories. Three barber chairs were operated. Later, when the hospital had increased to about 1,000 patients, business increased to such a scale that it became necessary to enlarge the exchange. It was then completely renovated, an office was fitted out for the exchange officer, new counters were purchased, a temperance bar was installed, modern office equipment was bought, and a modern sanitary barber shop was installed. Sales increased from about $400 a week to $2,000, and the personnel from 2 to 17. Dividends to the extent of several thousand dollars were paid the hospital fund.
The spirit of the Young Men's Christian Association seemed to be to fill every demand made upon it. Stationery was distributed free in quantity sufficient to write 850 letters per day. Stamps to the value of from $25 to $40 were sold daily, and enough money orders were sold monthly to average more than $12,000. Some months as many as 300 telegrams were sent for patients.
Educational classes were held in all subjects for which there was a demand. Athletic equipment for baseball, indoor baseball, tennis, volley ball, and soccer were furnished. Nearly 200 testaments were given to patients each month, and about 1,000 pieces of religious literature were distributed in the same length of time. The Young Men's Christian Association attendants spoke personally to not less than 1,000 persons in the wards daily, inquiring of them their needs, and supplying for them the obtainable comforts.
Great quantities of supplies and equipment were furnished by the Red Cross, in several emergencies, and every service was rendered by them that would aid as a contributory to the rehabilitation of the patients. For a time the work of the bureau of communications and other activities, operated by the Red Cross, were seriously handicapped for lack of room and other facilities, but these difficulties were overcome with the completion of the Red Cross house. This was connected with the hospital by closed corridors, and served as a place of amusement and diversion for convalescent patients.
The nurses' recreation building, constructed by the Red Cross, with assembly room, library, kitchenette, shower baths, glass-inclosed porch, and other comforts and conveniences, added much to the welfare of the nurses on duty in the hospital.
Numerous forms of carefully planned recreation for patients were available in the hospital. No matter how sick the soldier or what form his malady assumed, amusement was provided for him. Books, scrap books, magazines, in quantities, sent in as gifts, served to interest and amuse the patients. Concerts by the detachment band and the regimental bands were given several times a week. Visiting entertainers also contributed to cheer the patients.
In addition to all this, the Young Men's Christian Association, Knights of Columbus, Red Cross, Lutheran Brotherhood, and B'nai B'rith Club for Jews contributed to their share of entertainment and amusement.
The base hospital was designated a camp hospital on July 5, 1919.
BASE HOSPITAL, CAMP DONIPHAN, PORT SILL, OKLA.a
The military reservation of Fort Sill comprised 67,713 acres. Upon a small portion of it had been constructed, prior to the World War, a permanent post for Field Artillery troops. The garrison buildings included a post hospital commensurate in size to the adequate care of the sick of the command during peace time. As was the case at Fort Riley, an abundance of space was available at Fort Sill, when war was declared, upon which to construct a camp for a division of the National Guard; but there was this difference between the conditions at the two places: the permanent post of Fort Sill was to continue in use, and its buildings were not available for hospital uses; consequently, plans had to be formulated for the provision of a complete temporary base hospital as an integral part of the camp.
Camp Doniphan was situated to the southwest of the "new post" of Fort Sill, 5 miles from Lawton, and about 90 miles from Oklahoma City. To the north of the "new post," which formed the northeast corner of Camp Doniphan, the site for the base hospital was chosen.
The terrain is rolling. To the west of where the hospital was situated there is a series of hills, several hundred feet high and bare of foliage of any kind. On the east and north is a small river bed, which is dry practically throughout the year, though its banks are wooded for several yards on either side, giving the semblance of an oasis in the desertlike region. These trees afforded the hospital a scant but nevertheless appreciable degree of protection against the cold winds of winter. Since the "oasis" was the only shaded spot for miles around, it afforded ample protection from the intensely hot rays of the sun in summer, and its comfort was sought and welcomed.
The soil is loam. The atmosphere is extremely dry throughout the year and is heavily laden with fine dust. It was, consequently, wholly impossible to keep the hospital constantly clean in the sense of the term as usually understood in civil hospitals. During the year 1917-18, there was very little rain, and the dust storms were frequent and trying. It was inevitable that during these high winds particles of prairie dust should penetrate everywhere. The dust problem at the hospital was greatly relieved, though not entirely eliminated, by oiling the dirt roads in the vicinity and around the hospital. Rains, as a rule, are abortive, the parched earth receiving but a drop or two; but when rain in sufficient amount falls, it is taken up by the soil with great difficulty, and in consequence much sticky and tenacious mud results. Numerous puddles also appear and stay until the water has finally evaporated. The summers are intensely hot and long. During the summer the daily temperature ranges from 90 to 130° F. in the sun, more often over 100°, but for the most part the nights are bearable. The winters are short but severe, the changes in temperature being frequently excessive and sudden; and cold, icy, penetrating winds suddenly appear within a moment's notice, laden with dust to spoil a mild and pleasant day. The temperature falls and zero weather and lower is not uncommon. Snow, however, is rare, and when it does fall disappears very
quickly. Aside from the changing spells, the weather continues pleasant into December, and becomes mild in February. The days of the springs and falls are very warm, but the nights are cool and livable.
The hospital roads were made of compressed dirt. They were well kept and were oiled. In the hospital neighborhood the roads were all of dirt, but were smooth. The camp road, 1 mile away, was of gravel construction at first, then of concrete. The road leading to Lawton, the neighboring town, was of dirt construction, bumpy and very uneven; a poor thoroughfare for travel, especially that of an ambulance laden with sick.
Though there were two railroads to Fort Sill-the Chicago, Rock Island & Pacific Railroad, and the St. Louis & San Francisco Railroad-both were branch lines; they were badly ballasted and poorly equipped; and were subjected to frequent and prolonged transportation delays.
The base hospital was organized on September 1, 1917. At this time, however, the wards of the hospital were not ready; so, to care for the sick of the division, it was necessary to employ the facilities and wards of the post hospital, where, for a time, the patients of the post and camp were handled together in the same wards. The commissioned and enlisted personnel of both the base and the post hospitals also united, working side by side, without regard to the origin of the case. This was a very fortunate, even if clumsy, arrangement, for the enlisted personnel of the base hospital were green; and had, for the most part, never seen the inside of a hospital, nor the proper handling of a ward and its patients; whereas the enlisted personnel of the post hospital had at least an average of three months' experience. It can thus be seen how important a factor this combination was in the training of the personnel in the proper performance of their required duties. The property also was in part pooled in the common interest. As the size of the command increased, the facilities of the post hospital became inadequate to meet the needs, and 10 new temporary wards were built around the old hospital to accommodate the excess in the number of the sick. The construction of the base hospital meanwhile was progressing very slowly. Delay upon delay occurred that could be directly attributed to insufficient building supplies. At one time in October construction came to a standstill because of the lack of concrete for the foundations of the buildings. Somewhat later, construction stopped because most of the laborers were removed to complete buildings for the school of fire, the need for which became urgent. And still later, although many of the wards were completed externally, the absence of a sewerage system and a water supply made them totally uninhabitable. Owing to the pressing need of these buildings, temporary cesspools were installed for some of the wards, pending a special appropriation by the War Department for the introduction of a water supply and a sewerage system. It appears that the plans first issued had provisions neither for water and sewage disposal nor for bathing facilities. On November 17, 1917, the buildings were 95 per cent completed, with the exception of a sewerage system. The installation of the sewerage system was begun about December 1, 1917.
In the latter part of October, 1917, the full strength of the division, 27,000 men, had been attained. The number of sick was increasing daily, and the facilities of the old post hospital, including the 10 new wards, were entirely
inadequate to meet the needs. On November 17, there were 40 cases of pneumonia at the hospital, and the cases of meningitis and measles were on the increase. It therefore became urgently necessary to occupy the new base hospital buildings, about a mile away from the post hospital, regardless of the lack of proper sanitation. So, on November 26, the transfer of all the medical cases was begun. As the wards of the base hospital were completed they were at once occupied by patients who had been transferred from the post hospital. This gradual transfer, continuing during the months of December, 1917, and January, 1918, created the complex situation where part of the base hospital patients were at the post hospital and part at the base. Owing to this anomalous situation two officers of the day were required, as well as a constant ambulance service between the new and old hospital, for the admission of surgical cases to the old place and the transfer of patients thence to the new hospital. The operating room, at the base hospital, was one of the last to be completed. The original plans did not provide for the installation of steam heat, or for a proper finish to the walls, to permit their scrubbing and cleansing between operations. Until these improvements were provided most of the major operations were performed in the operating room of the post hospital, which had been constructed and equipped for such work. The very last part of the hospital to move from its temporary ward at the old post was the genitourinary section. This moved into a series of tents within the convalescent camp in March, 1918.
The officers' quarters consisted of a long one-story building the size of a ward, and contained 22 rooms. This was manifestly too small for the personnel and a building, across the way, intended as an officers' ward, was at once converted into officers' quarters. About April 1, 1918, three wings were added to the building originally intended for officers' quarters, which increased the capacity to 62 rooms, and provided a mess hall and assembly room. This addition was altogether sufficient for the purpose. The nurses' quarters consisted of a long one-story building with three wings. The wings at each end contained sleeping rooms, the middle one a mess hall and kitchen. It was totally inadequate for housing all the nurses, and a dozen tents were placed directly behind the home for the additional nurses. Finally, another similar home was completed across the way from the first one. This solved the problem of the nurses' home. The enlisted men were quartered in five one-story barracks similar in size and construction to an ordinary ward. There were separate rooms for the noncommissioned officers.
There were four storehouses, the dimensions of which were about 30 by 120 feet. Two of these were shelved.
Until April, 1918, the laundry was sent to Enid, Okla., 150 miles away. This meant that it took from 10 to 15 days for its return to the hospital. Under such conditions it was inevitable that changes of hospital linen could not be made as frequently as desired unless several times over the supply of linen normally needed for this size hospital could be had in stock. Inasmuch as there was not this supply of linen, some unjust criticism was made against the hospital for conditions of which it was innocent.
The water supply of the hospital, in common with that of Camp Doniphan and the city of Lawton, was obtained from Lawtonka Lake, a body of water
that was situated about 8 miles distant. The source was dependent entirely upon local rainfalls; and since these were infrequent, the amount available, during the years 1917-18, was precariously small. The situation was rendered doubly acute by the accretions to the populations of both Fort Sill and Lawton, and early practices of conservation had to be instituted. These included the prohibition of the watering of lawns, the limitation of the number of baths one might take, and every other known method to cause conservation. In these efforts at conservation the physical characteristics of the water materially assisted: suspended in it were more than appreciable quantities of clay, algae, and protozoa. It frequently required a degree of real fortitude to quaff a glass of water within which there could readily be discerned crustacea darting about in a world of their own. Then, too, there emanated from the water a fishy odor, which, though only objectionable when the water was cold, became positively repulsive when an attempt was made to use it in a hot tub within a small, closed room. Many ineffectual efforts were made to render the water palatable, or even acceptable, by the use of copper sulphate and chlorine; but it was not until after a filtration plant had been installed, during the early part of the year 1919, that it was effected.
It has been related that the installation of a water supply in the hospital was much delayed. In the beginning, though the wards had their full quota of patients, the water necessary for bathing them had, perforce, to be carried in buckets into many of them. It was not until December, 1917, that a cold-water tap had been installed within the wards. But even then running cold water only was available, and to elevate the temperature of it to a point where it could be used for sponge baths it was necessary to heat it in pails placed on the tops of the ward heating stoves. In the isolation wards, this state of affairs existed until so late as January, 1918. The installation of boilers in the wards was begun in January and was completed the end of the following month. It was then only, when hot and cold running water was available in the wards, that conditions began to approximate those which are accepted for granted in civil hospitals.
The necessity for them made it desirable to occupy some of the wards before the sewerage system was installed. Cesspools, therefore, were constructed for the quarters and some of the wards. From these pools the water was removed by water wagons on alternate days. Later, a complete sewerage system was installed which emptied into a large, main sewer that discharged into a small creek at a point over a mile from the hospital grounds. There were two types of wards as regards toilets. In one type a common bathhouse opened off a corridor that connected two wards. This bathhouse contained five toilets and one urinal on one side, five basins, a bath, and a shower on the other side. There were also single wards, such as the isolation ward, in which one of the front rooms was a bathroom, containing a urinal, two toilets, two wash basins, a shower, and bathtub. Unfortunately, the plumbing in the isolation wards was so constructed that only one toilet room was at first installed. To prevent spread of contagion, only one kind of communicable disease could be housed in each building. This, happily, was changed, and the wards later contained three different rooms with toilets. Until the plumbing was all completed the hospital was in a sad plight. Baths were not taken as frequently as was desired; for a
bathtub the officers were obliged to employ a small agate pail into which it was impossible to get even the foot comfortably, and to heat water for bathing purposes on the small heating stoves in each room. In the isolation wards, especially, the lack of plumbing was a hardship, for here the absence of hot running water was tantamount to saying that there was no proper sanitation.
The garbage was sold to a neighboring contractor. It was distributed in different cans according to the nature of the garbage. The contractors then came, removed the cans, and left an equal number of cleaned, dry cans.
The heating of the hospital underwent its own special evolution. No general heating system was installed. Large stoves were used, at first, to warm the wards, three of them being used for each ward. They were not successful, they consumed large quantities of fuel and gave comparatively little heat. The only part of the ward that was warm was that in the immediate vicinity of the stoves; the separate rooms were not warm at all. Finally two large range heaters per ward were substituted for them, and separate stoves were provided for the detached rooms. In this way the wards were kept tolerably warm. Besides a greater distribution of heat the range heaters had another advantage; water could more readily be heated over them, and this facilitated the meager bathing facilities before the boilers were installed.
The hospital was lighted by electricity which was obtained from the neighboring town of Lawton. It was, generally speaking, quite successful. On stormy nights the power was interrupted, but such an occurrence was extremely rare. Although the lighting was the very first utility to be installed, the meningitis ward was, for a considerable period in December, 1917, and January, 1918, without electricity, owing to a faulty construction. This was a great hindrance in the proper treatment of such cases, as many required treatment, night as well as day. Lanterns and candles, although inadequate for this purpose, had to be employed until proper lighting was supplied. The reason why it was not installed as soon as required was that the contractor could not overcome his layman fear of meningitis and for a long time evaded every opportunity to enter the ward. However, it should be said that, in spite of these conditions, proper treatment was never delayed because of such hindrances as poor lights, a fact that was borne out by the low local mortality rate.
There was a paucity of facilities for recreation at the hospital. For the patients, such games as cards, checkers, etc., were furnished by the various welfare organizations. The chapel was refitted by the Young Men's Christian Association and was used by it for a recreation room, in which was installed a phonograph, game tables, facilities for writing, etc.
On July 24, 1918, the War Department authorized the abandonment of the camp.