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Section I

Contents

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SECTION I.

RELATIONSHIPS OF THE MEDICAL DEPARTMENT WITHIN THE MILITARY ESTABLISHMENT.

In order to appreciate fully the manner of execution of the enormous task which devolved upon the Medical Department of the Army in the exercise of its functions during the World War, it is essential that one have a comprehensive conception of the military establishment, of which the Medical Department forms an integral part.

MILITARY ESTABLISHMENT.

The complex military machinery, broadly known as the Army of the United States, had the following constitution on April 6, 1917, when war was declared against Germany: 1

I . The Regular Army.--(1) Troops (Infantry, Cavalry, Coast Artillery, etc.); (2) General Staff Corps; (3) Adjutant General's Department; (4) Inspector General's Department; (5) Judge Advocate General's Department; (6) Quartermaster Corps; (7) Medical Department; (8) Corps of Engineers; (9) Ordnance Department; (10) Signal Corps; (11) Bureau of Insular Affairs; (12) Militia Bureau; (13) Various groups representing detached officers, non-commissioned officers, chaplains, those on the retired list, etc.; (14) Regular Army Reserve.

II. The Officers' Reserve Corps.

III. The Enlisted Reserve Corps.

IV. The Organized Militia (while in the service of the United States) (1) National Guard; (2) National Guard Reserve.

The functioning of the Regular Army at peace was effected by distributing its component forces among the territorial departments under the command of department commanders, each of whom was charged, under the direction of the War Department, with the duty of preparing for war all the troops and all the military resources of his department, and with the administration of all military affairs of his department, except as otherwise prescribed by Army Regulations or existing orders. 2

Troops were not ordinarily grouped at large garrisons, but, with the idea of insuring complete continuity of function in peace and war, tactical divisions existed. Army Regulations provided that these tactical divisions, or portions of them, would be annually concentrated under the department commanders. The main purpose of these concentrations was that division commanders might secure for themselves and their division staffs as much practice as possible in the actual handling and supply of troops in the field. 2

During the war period the following additional War Department bureaus were created, or were made independent of parent bureaus of which they formerly formed a part: Construction Division,3 Air Service,4 Chemical Warfare Service.: Motor Transport Corps,6 Tank Corps,7 and the Finance Service. 8


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GENERAL STAFF CORPS.

The General Staff Corps consisted of the Chief of Staff, the Assistant to the Chief of Staff, and other officers detailed to the General Staff Corps from various branches of the Army, not over half of whom could be stationed in or near the District of Columbia. This corps, under the Chief of Staff, was charged with the duty of investigating and reporting upon all questions affecting the efficiency of the Army and its state of preparation for military operations, the preparation of plans for the national defense and other details which would enhance the possibilities of the Nation successfully surviving conflict at home or abroad.9 The command of the Army rested with the constitutional Commander in Chief, the President, whose command was exercised through the Secretary of War and the Chief of Staff. 10 The Chief of Staff reported to the Secretary of War, acted as his adviser, received from him directions and orders given in behalf of the President, and gave effect thereto. General Staff officers serving with troops were assigned to the general staff of a command in such numbers and grades as were recommended by the Chief of Staff. The senior General Staff officer on duty with the command was the chief of staff of the command unless otherwise directed by the War Department. 11

The duties of the General Staff Corps were confined to supervising, coordinating, and informing powers connected with the operation of the Army as a whole. 12

During the early months of preparation for war Congress passed enactments which gave the Chief of Staff of the Army rank and precedence over all other officers of the Army, 13 and removed the restriction on the proportionate number of the General Staff Corps in or near the District of Columbia.

To enable the Chief of Staff to exercise effectively his supervisory and coordinating powers in respect to overseas movements, there was created in his office, for the period of the war, a section to take charge of the embarkation of troops and supplies for trans-Atlantic transportation, and to exercise, under the Secretary of War, the direct control incident to this service." This section was later transferred to the newly created section of the General Staff, the Storage and Traffic Service," which functioned to provide for coordination of movement of troops and shipments of munitions and supplies of every kind during manufacture and after final assembling; necessary storage facilities on these aboard and at interior points; the movement of raw materials and finished supplies from points of origin to each and every destination, including ports of embarkation; the supervision of ports of embarkation; the control of the employment of Army transports engaged in the trans-Atlantic service, as well as supplementary commercial ships; and arrangements for convoy service with the Navy. Chiefs of bureaus were directed to keep the Director of the Storage and Traffic Service fully informed on the condition of supplies in their several services by direct correspondence.

As a further developmental measure in the prosecution of the war, an additional section, the Purchasing Service of the General Staff, was created in January, 1918, which was charged with the acquisition, by purchase, of all supplies and munitions required for the use of the Army. 16

These newer sections, instituted for the emergency, were incorporated in the reorganized General Staff, effected on February 9, 1918, the plan of which


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provided for five main divisions, 17 each under an officer who was given full power to act for the Secretary of War and the Chief of Staff upon all matters charged to his division. The divisions were: Executive, War Plans, Purchase and Supply, Storage and Traffic, and Army Operations.

To coordinate the activities of all the divisions of the General Staff and the several bureaus, corps, and other agencies of the War Department, to prevent duplication of work and to eliminate all unnecessary machinery or organization, the Coordination Section of the General Staff was created in the office of the executive Assistant of the Chief of Staff.18

A rearrangement of the separate divisions of the General Staff was subsequently effected, providing for the following divisions: Military Intelligence, War Plans, Army Operations, Purchase, Storage and Traffic. 19 The executive Assistant to the Chief of Staff was placed in charge of the office of the Chief of Staff, and had cognizance and control of the organization, administration, and methods of all the divisions of the General Staff and several bureaus, corps, and other agencies of the War Department for coordination, prevention of duplication of work, securing harmonious action, and the elimination of unnecessary machinery of organization. The delegated administrative powers of these various divisions of the General Staff, in so far as they directly concerned the Medical Department, were as follows : 19

WAR PLANS DIVISION.

Plans for the organization of all branches of the Army and the preparation of Tables of Organization; proposed legislation and the preparation of regulations and rules for the Military Establishment; training; inspection to insure efficiency and thoroughness in training and instruction.

ARMY OPERATIONS DIVISION.

Reconstruction and mobilization, including the assignment and distribution of the draft; the personnel of troops, their movement and disposition; the determination of overseas priority; appointment, promotion, and assignment of the commissioned personnel of all branches of the Army; camp sites, cantonments, Army posts, hospitals, construction, plans, and projects for all branches of the Army except for harbor terminal facilities; the determination and distribution of all types and quantities of equipment and supplies of all branches of the Army, together with regulations concerning them; and the design, production, procurement, reception, storage, maintenance, and replacement of all motor vehicles.

PURCHASE, STORAGE, AND TRAFFIC DIVISION.

The supervision and direction of all requirements and the procurement and production activities, including real estate, of the several bureaus, corps, and other agencies of the War Department; the coordination and correlation of the requirements of the procurements and production activities of the several bureaus: representation of the Army in all arrangements for coordinating requirements, procurement, and production activities in the several bureaus with other agencies of the Government and with the Allies; the determination


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of purchasing and manufacturing priorities; the supervision and coordination of all fiscal accounting systems and appropriations, estimates, and requirements and other financial matters relating to the purchase of all supplies; the storing of all property; all that pertained to transportation, inland and coast-wise, of troops and property; the transportation of troops and supplies overseas; embarkation and overseas service relating to the Army program, including the employment of all Army transports; supplemental commercial shipping, including arrangements with the Navy Department for convoy service; providing ports of embarkation, expeditionary ports and concentration camps in connection therewith; courier service between the War Department and General Headquarters, American Expeditionary Force.

BUREAUS OF THE WAR DEPARTMENT.

The War Department is the administrative branch of the Military Establishment, which is presided over by the Secretary of War, and which embraces, in addition to the General Staff Corps, the various bureaus whose chiefs normally supervise and control the departments they represents The bureau chiefs are stationed in Washington and are the advisers of the Secretary of War and the Chief of Staff on all matters connected with the operations of their respective departments or corps throughout the entire Military Establishment. They are kept sufficiently informed of the plans for the field forces to enable them intelligently to recommend adequate steps to insure the success-ful execution of these plans, in so far as their respective branches of the service are concerned. Normally, also, they control directly and are responsible for the efficient operation of the general depots of supply, general hospitals, arsenals, and other activities for which they are responsible. They are charged with the accumulation of the necessary supplies and with forwarding the same, in accordance with Army Regulations, to the point where they come under the control of the department commander a the commander of the field forces, concentration camps, etc. They formulate estimates for the necessary appropriations to effectually carry on the operations of their respective departments.

The bureaus of the War Department whose activities materially concern those of the Medical Department and its chief, the Surgeon General, and which, therefore, need be considered here for purposes of orientation, are: The Adjutant General's Department, Inspector General's Department, Judge Advocate General's Department, the Quartermaster Corps, the Corps of Engineers, the Ordnance Department, and the Signal Corps. The chiefs of these bureaus, as has been stated above, act as technical advisers to the Secretary of War and the Chief of Staff, and are concerned, therefore, in the administration of the Army. The relationship of the Medical Department to the Commander in Chief of the Army, to the Secretary of War, to the General Staff, to the other bureaus of the War Department, and to the activities of the Army without the War Department, just before the declaration of war and at the height of the war activities, is depicted in Plates I, II, and III.

a September 1, 1920, the territorial departments embracing the continental area of the United States were superseded by corps areas. (General Orders, No. 50, W. Di., August 20, 1920.)


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PLATE I.  RELATIONSHIPS OF THE MEDICAL DEPARTMENT, PRIOR TO THE WORLD WAR


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PLATE II.  RELATIONSHIPS OF THE MEDICAL DEPARTMENT, PERIOD OF THE WORLD WAR


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PLATE III.  RELATIONSHIPS OF MEDICAL DEPARTMENT SOURCES AND DISTRIBUTION OF PERSONNEL, MATERIALS AND SUPPLIES -- FUNCTIONS, PERIOD OF THE WORLD WAR


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During the war the functioning of the War Department bureaus was gradually restricted by administrative activities assumed by the General Staff in order that the Army program for prosecuting our part of the war could be speedily and efficiently effected. How many of these administrative activities were taken over by the General Staff has been set forth in the preceding pages descriptive of the General Staff organization.

The normal functions of the War Department bureaus with which the Medical Department had close interrelations are outlined below, together with the modifications superimposed by war's necessities.

THE ADJUTANT GENERAL'S DEPARTMENT.

This bureau, known within the War Department as The Adjutant General's Office, or the “A. G. O.," is the department of records, orders, and correspondence of the Army and the militia. 21 Under the direction of the Secretary of War, and subject to the supervision of the Chief of Staff, in all matters pertaining to the command, discipline, or administration of the existing Military Establishment, The Adjutant General is charged with the following duties which have pertinence to the Medical Department: Recording, authenticating, and communicating to troops and individuals in the military service, all orders, instructions, and regulations issued by the Secretary of War through the Chief of Staff; preparing and distributing commissions; compiling and issuing the Official Army Register and the Army List and Directory; consolidating the general returns of the Army, arranging and preserving the reports of officers detailed to visit encampments of militia, of preparing the annual returns of the militia required by law to be submitted to Congress; managing the recruiting service; recording and issuing orders from the War Department. Under the Secretary of War, The Adjutant General is vested by law with charge of the historical records and business of the permanent Military Establishment, including all pensions, pay, bounty, and other business pertaining to or based upon the military or medical histories of former officers or enlisted men.

The archives of The Adjutant General's Office include all military records of the Revolutionary War; the records of all organizations, officers, and enlisted men who have been in the military service of the United States since the Revolutionary War; the records of the movements and operations of troops; the medical and hospital records of the Army; all reports of physical examination of recruits and all identification cards.

During the World War there were certain changes in the functions of The Adjutant General's Office. The Army Operations Division of the General Staff was given control of the recruitment and the mobilization of the Army, including the assignment and distribution of the draft; the personnel of troops; the movement and disposition of troops; the appointment, promotion, transfer, and assignment of the commissioned personnel of all branches of the Army. "A Commissioned Personnel Branch, Operations Division, General Staff, was also created, which was a consolidation of the Commissioned Personnel Section, General Staff, and the committee on classification of personnel of The Adjutant General's Office.23 All staff corps and departments submitted requisitions to


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the Operations Division, General Staff, for the number and kind of officers needed for any particular organization or duty.

As previously stated, all official documents referred to or from the War Department, normally passed through the War Department office of record, The Adjutant General's Office, but during the war this requirement was modified, to economize in time, and the chiefs of the several bureaus, corps, and other agencies of the War Department were authorized to communicate directly with the directors of the several divisions of the General Staff or chiefs of branches of those divisions on matters over which the latter had control. 24

THE INSPECTOR GENERAL'S DEPARTMENT.

Every branch of military affairs, except when specially limited by regulations or orders, comes within the sphere of inquiry of the Inspector General's Department. 25 Inspector generals and acting inspector generals exercise a comprehensive and general observation within the command to which they maybe respectively assigned over all that pertains to the efficiency of the Army, the condition and state of supplies of all kinds, of arms and equipments, of the expenditure of public property and moneys, and the condition of accounts of all disbursing officers of every branch of the service, of the conduct, discipline and efficiency of officers and troops, and report with strict impartiality in regard to all irregularities that may be discovered. From time to time they make such suggestions as may appear to them practicable for the correction of any defect that may come under their observation. Inspector generals or acting inspector generals assigned to a military command are under the immediate direction of its commanding general; when not so assigned, they are under the orders of the War Department. They make the garrison and such special inspections as the commanding general may direct within the limits of his command. The chief of this bureau, in addition to administering his department, makes inspections, from time to time, of the different activities of the military establishment.

During the war, tactical inspections were made from time to time by members of the Training and Instruction Branch of the General Staff as the Chief of Staff directed. 26 These inspections were made with a view of securing uniformity in instruction and adherence to proper training methods and to insure progress in the training of divisions. In addition, the chiefs of the War Department bureaus were authorized to direct inspections of the troops of their branches.26

JUDGE ADVOCATE GENERAL'S DEPARTMENT.

The Judge Advocate General is the custodian of the records of all general courts-martial, courts of inquiry, and military commissions, and of all papers relating to the title of lands under the control of the War Department, except the Washington Aqueduct and the public buildings and grounds in the District of Columbia. 27 The officers of this department render opinions upon legal questions when called upon by proper authority. Reports rendered by the Judge Advocate General of the Army upon cases received by him, which require the action of the President, are transmitted to The Adjutant General of the Army for record and for the consideration of the Secretary of War and the President. After final action by superior authority in such cases, all the papers are


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returned to The Adjutant General of the Army, who, before publishing the action taken, refers the papers to the Judge Advocate General for further scrutiny.

THE QUARTERMASTER CORPS.

Prior to the war the Quartermaster Corps was charged with the duty of providing means of transportation of every character except motorized ambulances (for the Medical Department), either under contract or in kind, which was needed in the movement of troops and material of war. 28 It furnished all public animals employed in the service of the Army, the forage consumed by them, wagons and all articles necessary for their use, and the horse equipment for the Quartermaster Corps. It furnished clothing, camp and garrison equipage, barracks, storehouses and other buildings; constructed and repaired roads,railways, bridges; built and chartered ships, boats, docks, and wharves needed for military purposes; supplied subsistence for enlisted men and others entitled thereto; supplied articles for authorized sales and issues; furnished lists of articles authorized to be kept for sale; gave instructions for procuring, distributing, issuing, selling, and accounting for all quartermaster and subsistence supplies; had charge of the supply and distribution of an accounting for funds for the payment of the Army and such other financial duties as were especially assigned to it; and attended to all matters connected with military operations which were not expressly assigned to some other bureau of the War Department. It transported to the place of issue and provided storehouses and other means of protection for the preservation of stores supplied for the Army by other departments.

In order to carry to prompt completion the vast building program incidental to the housing of the armies to be mobilized, it became necessary in May, 1917, to organize a special division of the Quartermaster General's Office, to which was given the name of Cantonment Division, and to which was assigned the work of construction of cantonments and camps. 29 A large number of additional projects caused the creation, on March 13, 1918, of the Construction Division of the Army, which absorbed the Cantonment Division and was separated from the office of the Quartermaster General.

On April 18, 1918, a Motor Transport Service 30 was organized as part of the Quartermaster Corps. An assistant to the Quartermaster General was detailed to duty as chief of this service. This officer, under the direction of the Quartermaster General, had technical supervision of the Motor Transport Service, the functions of which were the supervision of the purchase and procurement of all motor-propelled vehicles except tanks, "caterpillars," and other artillery tractors; the maintenance and repair of motor vehicles of standard types; the technical supervision of all motor vehicles; the maintenance and operation of all motor repair shops and garages; and the maintenance of reserve vehicles. The Motor Transport Service was separated from the control of the Quartermaster General and became the Motor Transport Corps, 6 whose functions were somewhat similar to but broader than those of the Motor Transport Service. All existing contracts for motor vehicles, motor-vehicle equipment and supplies, maintaining, operating and repairing, purchases, and disbursements were all taken over by the chief of the Motor Transport Corps,


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which in effect removed from the Medical Department direct control of motor ambulances. On May 15, 1918, the Water Transport Branch of the Quartermaster General's Office was placed under control of the Embarkation Division of the Purchase, Storage, and Traffic Division, General Staff::31 and on June 6, 1919,the Finance Service was established under the Director of Finance. 8

CORPS OF ENGINEERS.

The duties of the Corps of Engineers 32 comprise reconnoitering and surveying for military purposes, including the laying out of camps: the preparation of military maps of the United States and its possessions, including cooperation with other Government or private mapping agencies, and in field operations, of maps of the theater of operations; selection of sites and formation of plans and estimates for military defenses; construction and repair of fortifi-cations and their accessories; the supervision of the location of all buildings in or within 1 mile of any fortification; the installation of electric power plants and electric power cable connected with seacoast batteries, and furnishing the necessary electrical supplies connected therewith; planning and superintending defensive or offensive works of troops in the field; examination of routes of communication for supplies and for military movements; construction and repair of military roads, railroads, and bridges; military demolitions; execution of river and harbor improvements assigned to it; and such other duties as the President or Congress may order. It collects, arranges, and preserves all correspondence, reports, memoirs, estimates, plans, drawings, such deeds and titles as relate to the Washington Aqueduct and public buildings and grounds in the District of Columbia, and models which concern or relate in anywise to the several duties enumerated. In time of actual or threatened hostilities within the theater of operations it has charge of the location, design, and construction of wharves, piers, landings, storehouses, hospitals, and other structures of general interest; and of the construction, maintenance, and repair of roads, ferries, bridges, and incidental structures; and of the construction, maintenance, and operation of railroads under military control, including the construction and operation of armored trains. The Chief of Engineers, under the direction of the War Department, is charged with the command of the Corps of Engineers, excepting such portions as are specifically detached by order of the War Department, and with the management of the Engineer Department, including the regulation of the duties of all officers, agents, and others who may be employed under his direction.

ORDNANCE DEPARTMENT.

The Ordnance Department 33 is charged with the duty of procuring, by purchase or manufacture, and distributing the necessary ordnance and ordnance stores for the Army and the Organized Militia, and establishes and maintains arsenals and depots for their manufacture and safe-keeping. All officers or other persons in the Military Establishment to whom ordnance and ordnance supplies or funds are intrusted are required to make accounts and returns thereof to the Chief of Ordnance at the times and in the manner prescribed. Ordnance and ordnance stores include cannon and artillery vehicles and equip-


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ments; apparatus and machines for the service and maneuver of artillery; small arms, ammunition, and accouterments; horse equipments and harness for the field artillery, and horse equipments for cavalry and for all mounted men except those in the Quartermaster Corps; tools, machinery, and materials for the ordnance service; and all property of whatever nature supplied to the Military Establishment by the Ordnance Department.

The articles supplied by the Ordnance Department for use of the Medical Department during the war were comparatively few in number. They comprised horse equipment, guidons and standard carriers, small arms, and certain articles of individual equipment, such as belt, canteen, mess kit, hand ax, spurs, and spur straps. 34

SIGNAL CORPS. 35

The Signal Corps, under the direction of the Secretary of War, has charge of all military signal duties and of books, papers, and devices connected therewith, including telegraph and telephone apparatus and the necessary meteorological instruments for use on target ranges and for other military uses; of the construction, repair, and operation of military telegraph lines and the duty of transmitting messages for the Army, by telegraph or otherwise, and of all other duties usually pertaining to military signaling and the operations of such corps as shall be confined to strictly military matters; of the direction of the Signal Corps of the Army and the control of the officers, enlisted men, and employees attached thereto; of the supply, installation, repair, and operation of military cables, telegraph and telephone lines, and radio apparatus and stations, except such as come under the jurisdiction of the Corps of Engineers or the Coast Artillery Corps (par. 15054, A. R., p. 303); of the supply, repair, and operation of field telegraph trains and balloon trains; of the preparation and revision of the War Department Telegraph Code; of the supervision of such instruction in military signaling, telephony, and telegraphy as may be pre-scribed in orders from the War Department, except such as is used by the Coast Artillery in fire control and fire direction and service of submarine mines; of the procurement, preservation, and distribution of the necessary supplies for the Signal Corps, and of the procurement and issue of Signal equipment required in coast defense.

The Aviation Section of the Signal Corps, created a separate section by act of Congress, June 3, 1916, 33 was materially enlarged by the act of Congress, July 24, 1917,37 in the provision of which authorization was given for, among other activities, the necessary construction, maintenance, and repair of hospitals at aviations stations.

By an Executive order, issued by the President on May 20, 1918, 4 the Aviation Section was removed from control of the Chief Signal Officer and placed under the Director of Military Aeronautics, afterwards designated Chief of Air Service. 38

THE MEDICAL DEPARTMENT.

The Medical Department is charged with the duty of investigating the sanitary condition of the Army and making recommendations in reference thereto; advising with reference to the location of permanent camps and posts; adopting systems of water supply and purification, and the disposal of waste; caring


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for the sick and wounded; making physical examination of officers and enlisted men; managing and controlling the enlisted force of the Medical Department and of the Army Nurse Corps; and furnishing all medical and hospital supplies. 39 It is further charged with protecting the health and preserving the efficiency of the animals of the Army. 40 The increased activities of the Medical Department during the war period necessitated a marked expansion of the office of the Surgeon General, among the many functions of which may be emphasized those which dealt with per-sonnel, technical supplies, sanitation, professional care and treatment of the personnel of the Army, the professional care and treatment of the animals of the Army, and the coincident administrative duties in connection with these functions. By referring to Plates I and II, the extent of the expansion of the Surgeon General's Office may be readily appreciated. The details incident to this expansion are described in separate chapters on the newly created and augmented divisions; therefore, in the present connection, only the functioning of the latter in relationship to the War Department as a whole will be given in general terms.

The military personnel of the Medical Department includes officers, female nurses, and enlisted men. During the war it was the function of the Personnel Division of the Surgeon General's Office to provide and to adequately distribute to the various activities of the Army suitable Medical Department personnel to carry on their prescribed duties. The authority for orders issued in connection with the assignment of personnel, emanating from the War Department, is the Secretary of War, through the instrumentality of The Adjutant General of the Army. It was assumed that a chief of a bureau ordinarily has the greater cognizance of the necessities for supply and distribution of personnel, and the War Department orders on the movements of Medical Department personnel are based on recommendations made by the Surgeon General. In actual practice, to promote expedition during the war, these recommendations were assumed in the formal preparation of routine personnel orders in the Personnel Division, Surgeon General's Office, which were sent to The Adjutant General's Office for the signature of an adjutant general on duty therein, thus officially promulgating the orders. Any orders affecting commissioned personnel not of a routine nature went to the Commissioned Personnel Branch, Operations Division, General Staff. 41

In the professional care and treatment of the sick and wounded a pre-requisite was suitable housing facilities or hospitals. The ultimate responsibility for the suitability of the war hospitals rested on the Medical Department; their actual provision, however, was a function of the Quartermaster Department during the earliest months of the war, 42 and subsequently of the Con-struction Division, a fragmented portion of the Quartermaster General's Office. 3

Funds for the construction of hospitals were secured from Congress, 43 on estimates prepared by the Surgeon General's Office, but the funds were appropriated to the bureau charged with the construction, for expenditure on hospital construction. Liaison between the bureaus effected construction in accordance with basic plans devised by the Medical Department.

As an outcome of the necessity for close cooperation between the Surgeon General's Office and the Construction Division of the War Department, a hos-


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pital section was established in the Construction Division October 16, 1917, 44 and in June, 1918, the section of the Surgeon General's Office concerned with planning hospitals was physically placed in the Construction Division.

The necessity for hospital construction having been determined in the Surgeon General's Office, and the required plans completed in the Construction Division, the project had to be cleared by the War Industries Board, 45 through the Director, Purchase, Storage and Traffic Division, General Staff, who coordinated requirements and production activities in the several bureaus with other agencies of the Government; and had to be authorized by the director, Opera-tions Division, General Staff, who finally determined the necessity for construction. 40

In the establishment of hospitals in existing buildings, leases, nominal or otherwise, had to be executed prior to any essential reconstruction, remodeling, or added construction. At first, leases were effected by the Quartermaster General, on request of the Surgeon General, and after approval by the Secretary of War; 47 but, in August, 1918, a real estate unit was organized in the Purchase, Storage and Traffic Division of the General Staff, and the General Staff took over the functions connected with conducting investigations, authorizing expenditures, and executing leases. 48

As a further time saving expedient, hospital boards were formed, each consisting of a representative from the Real Estate Section of the Purchase, Storage and Traffic Division of the General Staff, the Construction Division, and the Surgeon General's Office. 49 The duties of these boards were to investigate likely properties in the large cities. They were authorized to close leases, where rentals would not exceed $250 per bed per year, after clearance by the regional adviser of the War Industries Board.

As these boards completed their share in the prosecution of a project, other groups of officers, consisting of one versed in Medical Department requirements, from the Surgeon General's Office, and an assistant from the Hospital Section of the Construction Division, proceeded to the site and collaborate with the local constructing quartermaster in completing the plans for construction work. 49

Medical Department supplies, when we entered the war, consisted of medicines, blank forms, surgical dressings, surgical instruments, ward equipment, gas masks, motor ambulances, X-ray machines and supplies, vaccines, and biologicals. The Surgeon General was charged with the procurement of these supplies for which special congressional appropriations were made for the Medical Department. 50

Central administration functioned in the Supply Division of the Surgeon General's Office, into which was later incorporated the section of the office handling the administrative audit of vouchers and property returns, the whole becoming the Division of Finance and Supply, which was charged with all matters pertaining to the procurement and issue of Medical Department supplies and the administrative audit of all vouchers in payment for them, as well as for services rendered the Medical Department. 51

In July, 1918, the Gas Defense Service of the Medical Department was transferred to the Chemical Warfare Service, created during the previous month; 5 and in August activities connected with the procurement, assembly,


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issue, and maintenance of motor ambulances and motor vehicles were transferred to the Motor Transport Corps. 6

On November 15, 1918, the procurement activities of the Medical Depart-ment were transferred to the Director of Purchase, Storage, and Traffic Division of the General Staff; the distribution of supplies and depot activities to the Director of Storage; the finance and accounting activities to the Director of Finance; and the requirements activities to the Director of Purchase and Storage. 52 The Director, Purchase, Storage, and Traffic, approved the retention, by the Medical Department, of activities pertaining to the procurement and distribution of artificial limbs, orthopedic and prosthetic appliances; biologicals, arsphenamine, and other arsenicals; books, journals, and reprints; printing and binding; and the administrative examination of certain vouchers, civilian medical attendance, medicines, and laundry. 53 From November 16, 1918, the Medical Department functioned only in an advisory capacity in so far as its supplies other than those reserved to it were concerned.

The administrative functions of the Surgeon General's Office, pertaining to the operation of Medical Department personnel, in the care and treatment of the sick and wounded and the prevention of disease, bore no direct relationship with other bureaus of the War Department. They are described at length in the separate chapters on the administrative divisions of the Surgeon General's Office.

DEPARTMENT COMMANDERS.

The territorial distribution of the forces of the Army created the necessity for a more or less decentralization of military control. Before the World War this control was vested in department commanders. The organization of a department headquarters was as a wheel within a wheel and reflected on a smaller scale the provisions for administrative control obtaining at the War Department.

The peace-time organization of a territorial department commander's staff consisted of his authorized personal aides, an officer in charge of militia affairs, and one officer from each of the following corps and departments: 54 General Staff Corps, Adjutant General's Department, Inspector General's Department, Judge Advocate General's Department, Quartermaster Corps, Medical Department, Corps of Engineers, Air Service, Ordnance Department, and Signal Corps, and such additional staff officers as were assigned by the War Department, including a medical officer, who acted as sanitary inspector of the department. This staff was originally organized into two sections as follows: The territorial department staff, consisting of six officers whose functions pertained to the department as a territorial command; the division staff, consisting of six officers whose functions pertained to the division as a tactical unit to accompany the division wherever it might go.

When the new Army was organized into tactical divisions, all that pertained to their administration, instruction, training, and discipline was exempted from the control of department commanders; 55 and subsequently this exemption referred to all troops attached to the tactical divisions. 56


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Departments were maintained throughout the war, their organization and operation being very similar to those of peace times. All the new war organizations were placed directly under the War Department. Practically all Regular Army organizations when the war started were under department commanders, and they continued so until ordered elsewhere. So they were very largely expanded to war strength and equipped while still under the jurisdiction of a department commander.

REFERENCES.

(1) Bull., No. 16, W. D., June 22, 1916.

(2) A. R., 193, 1913.

(3) Annual Report of the Chief of the Construction Division. W. D., 1918. 31-32.

(4) G. O., No. 51, W. D., May 24, 1918.

(5) G. O.. No. 62. W. D., June 28. 1918.

(6) G. O.. No. 75, W. D., August 15, 1918.

(7) Letter from The Adjutant General of the Army to the Director of Tank Service. March 6. 1918. Subject: Creation of a Tank Service. On file, Mail and Record Division, A. G. O., 322.06  E. E. (Miscl). Letter from The Adjutant General of the Army to the Director of Tank Service, March 22, 1918. Subject: Creation of Tank Corps. On file, Record Room, S. G. O., 321.17-1.
(8) G. O., No. 72, W. D., June 5, 1919.

(9) A. R., 754, 1913.

(10) A. R., 761. 1913.

(11) A. R., 770 and 771, 1913.

(12) Bull.. No. 16. W. D.. June 22. 1916, 4.

(13) Bull., No. 30. W. D., May 22. 1917, 9.

(14) G. O., No. 102, W. D., August 4, 1917.

(15) G. O.. No. 167, W. D., December 28, 1917.

(16) G. O.. No. 5, W. D., January 11, 1918.

(17) G. O., No. 14, W. D., February 9, 1918.

(18) G. O., No. 36, W. D., April 16, 1918.

(19) G. O., No. 80, W. D., August 26, 1918.

(20) Bull., No. 16, W. D., June 22, 1916, 6 et seq.

(21) A. R., 774, 1913.

(22) G. O., No. 80, W. D., August 26, 1918, par. 5.

(23) G. O., No. 86, W. D., September 18, 1918.

(24) G. O., No. 80, W. D., August 26, 1918, par. 6, c.

(25) A. R., Article LXVIII, 1913.

(26) G. O., No. 74, W. D., August 14, 1918.

(27) A. R., Article LXVIII, 1913.

(28) A. R., Article LXXIII, 1913.

(29) Annual Report, Chief of Construction Division, W. D.. 1918, 4.

(30) G. O.. No. 38, W. D., April 18, 1918.

(31) G. O., No. 52, W. D., May 25, 1918.

(32) A. R., Article LXXV, 1913.

(33) A. R., Article LXXVI, 1913.

(34) Manual for the Medical Department, 1916, 865, 879, 943.

(35) A. R., Article LXXVII, 1913.

(36) Bull.. No. 16, W. D., June 22, 1916, 15.

(37) Bull., No. 46, W. D., August 15, 1917.

(38) G. O., No. 51, W. D., May 24, 1918. A. R., Article L.XXXI (C. A. R., No. 73, June 10, 1918).

(39) A. R., Article LXXIV, 1913.

(40) S. R., No. 70. W. D.

(41) G. O.. No. 80. W. D., August 26, 1918. G. O., No. 86, W. D., September 18. 1918.

(42) A. R., 1000. 1464-1470, 1913.


122

(43) Bull., No. 30. W. D., May 9, 1917, 24.

(44) Memo from officer in charge, cantonment division, to all divisions, Construction Division, October 16, 1917. Subject: Hospital Section. On file. Mail and Record Room, Constrution Service, Quartermaster Corps, 652-B General.
(45) Verbatim excerpt from minutes of meeting of Council of National Defense. held July 28, 1917. On file, Finance and Supply File, S. G. O., 533/1 (Misc.).

(46) G. O., No. 80, W. D., August 26, 1918, par. 5, c.

(47) A. R., 1000, 1913.

(48) G. O., No. 80, W. D.. August 26, 1918, par. 6, a.

(49) Memo. for director of operations from Acting Surgeon General, September 16. 1918. Subject: Hospital Boards. On file, Record Room, S. G. O., 334.7-1 (General).
(50) Article on "Preparedness of the Medical Department for War," delivered at the War College, November 16. 1916. On file, Finance and Supply Division, S. G. O., 12709 E (Old Files).
(51) Orders, Surgeon General's Office, September 20, 1917. On file, Record Room, S. G. O., Finance and Supply Division, 50882-C (Old Files).
(52) Supply Circular No. 102, Purchase, Storage and Traffic Division, General Staff, October 24, 1918.
(53) Letter from Assistant to Director, Purchase, Storage, and Traffic Division, General Staff, to the Surgeon General, November 9, 1918. Subject: Supply Circular No. 102. On file, Record Room, S. G. O., 024 (Finance and Supply Division).
(54) A. R., 197-199. 1913. (C. No. 73, June 10, 1918).

(55) G. O., No. 96, W. D., July 20, 1917.

(56) G. O., No. 137, W. D., October 30, 1917.