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Section II, Chapter XII

Contents

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SECTION II.

CHAPTER XII.

OVERSEAS HOSPITAL DIVISION.

When the United States entered the World War on April 6, 1917, the field  units of the Medical Department actually organized and operating, apart from the sanitary detachments attached to combatant organizations, comprised  seven field hospital companies and nine ambulance companies.1 There were no base or evacuation hospitals in existence as a part of the Army, nor any of the highly specialized and technical units which the experience of the allied armies  had demonstrated as essential to the proper functioning of the Medical Department in the field.

For several years prior to the onset of the war the American Red Cross had been organizing base hospitals and other medical units which, in time of emergency, would be available for immediate duty with the Medical Department of the Army. This work had been under the supervision of the director of military relief of the Red Cross, and conducted under the provisions of those paragraphs of the Manual for the Medical Department which deal with the subject of "Organized Voluntary Aid."2 There were thus organized 50 base hospitals, 22 hospital units, and 45 ambulance companies.3 These units were in every stage of preparedness; at the date of the declaration of war by the United States some were practically ready for immediate duty, while others were merely skeleton organizations. Some of the physicians attached were members of the Medical Reserve Corps, many were not, while attached attendants and nurses had no connection with the Army.

During the early period of the war while the necessary changes in the administration of the Surgeon General's Office, consequent on the declaration of war, were taking place, the duties of completing the organization and mobilization of the Red Cross units, and the organization of other medical units for service overseas, were assigned to various officers on duty in this office. The need of a definite program for this important work, however, was clearly apparent, and when the Hospital Division of the Office of the Surgeon General was created in July, 1917,4 it was definitely charged "with the task of organizing all overseas units such as base hospitals, evacuation hospitals, ambulance companies, field hospitals, hospital trains, and hospital ships, together with the priority of their shipment, and with the designing, procuring, manning, and controlling of hospital trains, hospital cars, and laboratory cars for domestic use." The Oversets Section of the Hospital Division was organized for the performance of these duties. The activities of the Overseas Section of the Hospital Division increased to such an extent that the Surgeon General decided to establish an independent division in his office for the consideration of such subjects as had hitherto pertained to this section, together with certain other duties which had become closely allied therewith. Accordingly, the Overseas Division was created 5 (see Chart XIII) and to it was assigned the "organization of all


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Chart XIII.—Overseas Hospital Division, Surgeon General’s Office, June, 1918.


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medical units designated for service overseas and with the priority of their shipment; cables; liaison service between the Surgeon General’s Office and the Bureau of Medicine and Surgery of the Navy Department; receiving and distributing confidential information; sanitary personnel for overseas units; female secretaries for overseas units; domestic transportation for sick and wounded." Certain of the duties included in the foregoing as not pertaining to the general functions of this division were later transferred to a more appropriate division, as will be noted.

While, from a military viewpoint, the preservation of the health of the Army is the primary consideration of the Medical Department, the care and succor of the sick and those who have been wounded in battle has always been regarded as a matter of equal importance. There can be no question that, in the public mind, the minor errors of judgment in sanitary measures may never be known, or, if so, may be overlooked, but the slightest failure to render proper care to a wounded or sick soldier is certain to be heralded widely and to cause severe criticism. The care of the sick has always received the closest attention from the Medical Department and every provision for thorough first-aid and hospital treatment has been made. With the sudden expansion of the Army from some 100,000 to over 4,000,000 and with the certainty of a great number of wounded to be cared for, it was urgent that evacuation hospitals, field hospitals, and ambulance companies be provided.

The duties delegated to the Overseas Division were most exacting, on account of the detail work required to assemble the personnel of the separate units. Frequent changes in this personnel were required. The maximum force on duty in the division consisted of 6 officers of the Medical and Sanitary Corps and 13 enlisted men and civilian clerks. The Overseas Division continued to function during the period of active operations. With the signing of the armistice, the necessity for the organization of additional units for service abroad ceased and the division was discontinued on December 1, 1918, by order of the Surgeon General.6

After the armistice was signed, no further combatant organizations were sent overseas, but a number of medical units which had been at the port of embarkation awaiting transportation were directed to proceed, their services being urgently needed for the care of the large number of sick and wounded at that time in the hospitals of the American Expeditionary Forces. Prompt measures were taken, however, for the demobilization of the large number of Medical Department units then in various stages of organization in this country, and the discharge of officers and enlisted men attached to them was expeditiously accomplished according to the directions issued by the War Department.

In order that the necessary hospitalization may be provided for any force on taking the field for active operations, a thorough study must be made of the proportion of casualties to be expected in view of the nature of the warfare anticipated. In addition to this, there must be a thorough understanding of the sanitary conditions of the country in which operations will be carried on. This subject was carefully studied by special officers detailed by the Surgeon General, who were greatly aided by a knowledge of the experience gained by the medical department of the allied armies through several years of actual conflict. The Surgeon General, therefore, upon a consideration of the reports


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submitted by these observers and after receiving estimates from the chief surgeon, American Expeditionary Forces, was able to calculate very definitely the hospitalization required. He recommended that hospital beds sufficient for 15 per cent of the troops serving abroad be provided in the hospitals of the American Expeditionary Forces.7 The War Department approved of this allotment and directed the Surgeon General from time to time to organize the requisite number of units to provide such hospitalization, these medical units to be transported abroad progressively with the troops they were to serve.7

The medical unitsa organized by the Overseas Division embraced the following: 8 Hospital units, base hospitals, evacuation hospitals, evacuation ambulance companies, convalescent camps, convalescent depots, medical supply depots, stationary laboratories, mobile hospitals, mobile surgical units, hospital trains, Army sanitary trains, sanitary squads, division sanitary trains, Army ambulance sections, base veterinary hospitals, Service of Supply veterinary hospitals, corps mobile veterinary hospitals, Army mobile veterinary hospitals, special units, mobile operating unit, central optical unit, Medical Department replacement unit, neurosurgical unit, aviation medical unit, Medical Research Board, aviation ophthalmo-otological unit, anesthetic unit,museum unit, otolaryngological unit, roentgenological unit, neuropsychiatric unit, ophthalmological unit, surgical groups, medical classifying unit, rodentological unit, Medical Department repair-shop unit.

PRIORITY OF SHIPMENT.

The original program for the organization and shipment of troops abroad  provided that the schedule be divided into six phases, certain designated  organizations being allotted to each phase. Included among these were medical units in a definite fixed number, thus providing that the percentage of available hospital beds would remain constantly 15 per cent. No definite period of time was assigned for the transportation of each phase and frequent changes in the original schedule were rendered necessary by the requests from the commanding general, American Expeditionary Force,9 for additional units as required.

During the year 1917 the number of vessels available for the transportation of troops from this country was limited and the total number of men sent abroad consequently small. By expeditiously completing the organization of a number of the Red Cross units previously referred to, the Medical Department was able to transfer to France during the early period of the war a larger proportion of medical units than was necessary for our forces. Certain of these units, therefore, were assigned to duty with the French and English Armies, furnishing them with much-needed medical assistance. The organization of medical units continued, and during the remainder of 1917 and the first months of 1918 medical units were available in sufficient numbers.

In the spring of 1918 repeated requests came to the War Department from the commanding general, American Expeditionary Forces, for a maximum number of combatant troops. During the remainder of the war every effort was expended to that end, with the result that frequently transporta-
_______
   a For organization of dental service, A. E. F., see Surgeon General's Report, 1919, Vol. 11, 1300.


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tion was not available for medical units when they were reported ready for shipment. The sanitary organizations attached to divisions accompanied them when they sailed for overseas, so that the medical organization of the combatant troops was intact, but medical units for the Service of Supply, and consequently the necessary hospital facilities, began to fall short of the authorized allowance." By early summer, when American troops were actively engaged in hostilities on a large scale, the accommodations for care of the sick and wounded had fallen below the desires of the Medical Department. Repeated requests for the transportation of medical units which were available were made to the War Department, but military necessity precluded this authorization. 9

The Medical Department at this time had utilized to the full extent the facilities available for the formation of units. When transportation was finally available, the number of medical units transported left a number of camps available for the organization of other units, but, on account of the time required for their training and the delay in securing the necessary personnel, such units could not be completed in time to continue the medical organization in France at the proper proportion.

At no time during the war was the authorized allowance of enlisted men assigned to this department. At the beginning of the war, the Secretary of War directed that the strength of the Hospital Corps be 10 per cent10 of the combatant troops which they served. The necessity of placing available men in the combatant ranks was considered paramount and, despite repeated requests from the Surgeon General, it was impossible to secure the number of men essential for the formation of the units which this department was endeavoring to organize.11

In the summer of 1918 the original priority schedule was suspended, and the shipment of troops was made according to a new schedule, furnished by cable from the commanding general, American Expeditionary Forces, calling for such organizations as the situation demanded from time to time.12 Urgent requests from the commanding general and the chief surgeon, American Expeditionary Forces, for additional medical units were received and the Surgeon General made strenuous efforts to comply,9 using all men available and combining organizations which had been partially formed in order that complete units might be ready for transportation.

ORGANIZATION OF UNITS.

Shortly after the declaration of war, medical officers’ training camps were established at Camp Greenleaf, Ga., Fort Riley, Kans., and Fort Benjamin Harrison, Ind. The camp at Fort Benjamin Harrison was discontinued in the fall of 1917, the other camps continuing until the cessation of hostilities. At Camp Crane, Allentown, Pa., a camp was established for the formation of the units of the United States Ambulance Service. All these camps were under the direct control of the Surgeon General and were selected as the sites for the organization of such medical units as would be authorized by the War Department for service overseas.13 To these camps were sent as many as possible of the officers and enlisted men entering the Medical Department during the war. They were given an intensive course of instruction in the duties expected of the


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personnel attached to sanitary organizations. At first no special distinction was made between the various medical officers’ training camps with reference to the character of the organization to be formed therein. Later, when only the camps at Camp Greenleaf and Fort Riley were functioning, it was deemed advisable to differentiate between the character of the units to be organized in each. At Fort Riley all units which were to serve with the combatant organizations, such as divisional sanitary trains, regimental (detachments, sanitary squads, and evacuation ambulance companies, were organized, while at Camp Greenleaf such units as pertained particularly to the Services of Supply were mobilized.

The Red Cross base hospitals, previously referred to, were ordered mobilized in their home cities or, as camps became available, in the camps adjacent thereto. The officers of these organizations who were not already members of the Medical Reserve Corps were commissioned therein and all were called to active duty. The nurses were enrolled in the Army Nurse Corps and the male attendants were enlisted in the Regular Army. Certain officers and noncommissioned officers of the regular establishment were assigned to these units in executive capacities and superintended the organization and instruction. Several of the hospitals became promptly available for early transportation overseas and thus relieved the Medical Department for the time being of the necessity for the further organization of base hospitals.

SANITARY TRAINS AND SANITARY DETACHMENTS FOR COMBATANT ORGANIZATIONS.

The Tables of Organization pertaining to the Sanitary formation of a division is as follows:14
                           
PERSONNEL, MEDICAL CORPS.


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The 1st and 2d Divisions (Regular Army) were mobilized in the summer of 1917, the regiments attached thereto being selected from those which had been on duty on the Mexican border and which had their sanitary personnel already attached. The sanitary trains for these divisions were formed from the ambulance companies and field hospitals already organized at the outbreak of the war. The vacancies in the personnel of these organizations were completed by the selection of officers and enlisted men already in the service.

The next activity of the Overseas Division was directed to supplying the sanitary units for the 32 National Army and National Guard divisions, which were organized during the late summer and fall of 1917. The National Guard divisions were formed from the preexisting organizations of State troops.25 Of these, each regiment had a sanitary unit already organized, which, while limited in numbers, had already received a certain amount of instruction and was readily capable of expansion. The vacancies in these units were filled, as far as possible, by enlistments in the National Guard and were finally completed by men reporting from the first-draft calls. In many of the States, field hospitals and ambulance companies were among the units of the National Guard already in existence, certain of which were assigned to each division and used as the foundation from which the sanitary train was evolved. Vacancies in the personnel were filled in the same manner as noted for the regimental units.

Instructions were issued to the commanding officers of the medical officers’ training camps to prepare certain selected officers and enlisted men for duty with the sanitary units of divisions and such as were selected were given special instruction for this duty. To each of the National Army divisions organized in September, 1917, there was sent a skeleton organization.

As rapidly as supplies became available, the sanitary units were equipped and outfitted and their training proceeded under the direction of the division surgeon. All sanitary units and personnel pertaining to the division, being an integral part thereof, were directly under the jurisdiction of the division commander, and proceeded overseas with the division, the office of the Surgeon General being in nowise connected with such movements. Each division, on embarking for service in France, had a complete sanitary personnel which was capable of functioning in a satisfactory manner.

A similar policy was adopted with reference to providing the sanitary units and personnel for divisions later formed. The difficulties which attended the procurement of the enlisted personnel for other medical units was not encountered in the case of divisional sanitary organizations as the division commanders had authority to assign drafted men arriving at their camps to these units as well as to other organizations and it was not necessary to secure from the War Department the special assignment of soldiers to the Medical Department for this purpose.

There were organized at these camps also sanitary squads in the ratio of one to each division, the personnel of which was one officer of the Sanitary Corps and 26 enlisted men of the Medical Department.16


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BASE AND EVACUATION HOSPITALS--PERSONNEL.

The personnel of these organizations comprised: 17

Base hospital, 1,000 beds.--1 colonel, M. C.; 2 lieutenant colonels, M. C.; 2 majors, M. C.; 12 captains, M. C.; 2 captains, D. C.; 3 captains, S. C.; 1 captain, Q. M. C.; 12 first lieutenants, M. C.; 1 master hospital sergeant, M. C.; 1 hospital sergeant, M. C.; 8 sergeants, first class, M. C.; 15 sergeants, M. C.; 5 corporals, M. C.; 12 cooks, M. C.; 158 privates, A. C., 100 female nurses; 2 dietitians; 2 stenographers and typists.

Evacuation hospital.--1 lieutenant colonel, M. C.; 4 majors, M. C.; 12 captains, M. C.; 12 first lieutenants, M. C.; 1 captain or first lieutenant D. C.; 3 captains or first lieutenants, S. C.; 1 captain or first lieutenant, Q. M. C.; 1 master hospital sergeant, M. C.: 2 hospital sergeants, M. C.: 10 sergeants, first class, M. C.; 20 sergeants, Al. C.; 5 corporals, M. C.; 14 cooks, M. C.; 185 privates.

The most important of the units which this division organized for overseas service, and those which required the greatest amount of time and detail, were the base and evacuation hospitals. On such organizations it became incumbent to supply practically all of the permanent hospitalization facilities for the American Expeditionary Forces. The absolute necessity of a sufficient number of these hospitals with a thoroughly efficient staff became early apparent. Every effort was made by the Overseas Division to facilitate the organization of such units and to provide well in advance for a sufficient number in order that a thorough course of training might be given before their transfer to ports of embarkation preparatory to service abroad. Owing to the changes in the priority schedule and the difficulty in securing the assignment of sufficient enlisted personnel to this department, many obstacles were encountered in the attempt to carry out the program adopted. At times it became necessary to hurry the assemblage of authorized personnel, to designate the unit as a base or evacuation hospital, and to report it as ready for shipment, when the state of training was in a lamentable degree of insufficiency.

The tentative program arranged by this division provided for the organization of a certain number of base and evacuation hospitals at the medical officers’ training camps,13 such hospitals to remain at these camps for a period of approximately six weeks for a course of instruction relating strictly to the military side of the unit. After this course it was purposed to send the hospital to one of the cantonments for further instruction,18 with particular emphasis to be laid on the duties of a professional nature which would fall to the lot of the personnel. At these camps the hospital would be attached to the permanent base hospital, the various members of the unit being assigned to duties analogous to those they would perform when the hospital functioned independently. Such a training program was followed by some of the units first organized with thorough success, and such units were all prepared for the performance of the duties pertaining to them by the time they were ordered abroad.

The disarrangement of the priority schedule as at first directed played havoc with the program arranged by this division for the organization of new base and evacuation hospitals. When the hospitals already organized could not be transferred, by reason of lack of transportation, there necessarily followed


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a shortage of places available for the mobilization of new units. This was overcome in part by securing authority from the War Department to designate certain cantonments as places where additional hospital units could be organized.19 There was a constant lack of available enlisted personnel, however, so that many of the units under organization actually had only a small part of such personnel or of the required number of officers. Shortly before the armistice was signed and when the American forces were engaged in their heaviest fighting, urgent demands for additional medical units were received from the commanding general, American Expeditionary Forces. In order to meet these demands, many of the existing units were ordered to be consolidated and, in this way, a number of completed base and evacuation hospitals were rendered immediately available for overseas service.20

Before the World War the bed capacity of a base or evacuation hospital was 500.21 This was increased for both units to 1,000 beds. Their capacity was capable of further expansion, so that frequently these units in active service would care for several thousand patients. In the administrative organization of a base hospital, one medical officer, the three Sanitary Corps officers, and the officer of the Quartermaster Corps were assigned to purely executive duties, a colonel or lieutenant colonel of the Medical Corps being the commanding officer, the three Sanitary Corps officers acting as adjutant, registrar, and mess officer, and the Quartermaster Corps officer as quartermaster. The other medical officers and officers of the Dental Corps were designated to perform the strictly professional medical work of the unit. This service was subdivided as follows:17

Surgical Service:

Medical Service

   1 chief.

   1 chief.

   11 general surgeons.

   3 assistants in general medicine

   1 orthopedic surgeon.

   1 neurologist.

   1 genitourinary surgeon.

Laboratory Service:

   1 brain surgeon.

   1 chief.

   1 otolaryngologist.

   2 assistants.

   1 ophthalmologist.

Dental Service:

   1 oral surgeon.

   2 dentists.

   2 roentgenologists.

 

This assignment to duty furnished a well-balanced professional staff, especially for duty near the zone of active operations, where battle casualties would constitute the greater portion of patients. In case certain hospitals were designated more exclusively for the care of general medical cases, necessary changes in the personnel were made by the chief surgeon, American Expeditionary Forces. The formation of an evacuation hospital was similar to that for a base hospital, the commissioned personnel being one less by one dentist.

In addition to the base hospitals organized for general service, certain units were prepared with a view to assignment to duty for the treatment of special classes of patients. Among these were units for the care of orthopedic, venereal, neuropsychiatric patients, for cases of brain surgery, and for special fracture cases. The hospitals were given the regular serial number of base hospitals, but their personnel comprised only specialists in such diseases and injuries as they would be required to care for.
 
In the organization of these units the Surgeon General first secured authority for the formation of the number desired at a given time and the designation


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of the camp at which each unit was to be mobilized. The commanding officer of the camp was then directed to organize the unit, assigning the enlisted personnel thereto. Upon the arrival of enlisted men at their first camp, classification cards were made for each, showing the special qualification of every man in any line of work, such as mechanic, carpenter, clerk, and hospital attendant. These cards were filed according to the classification of the men. The committee on the classification of personnel of the War Department had arranged complete lists of organizations showing the number of men under each occupational classification who were best fitted for duty therein. In selecting men for these medical units, the commanding officer of the camp, as far as practicable, selected men best qualified according to these lists. In addition, at each of the medical officers’ training camps, as previously noted, there had been established special schools for the training of men in the various duties which would be required in sanitary organizations. These schools included training for cooks and bakers; for X-ray assistants; in orthopedic work, including the manufacture of the various appliances required; and in the clerical work required in the Medical Department. Whenever possible, soldiers who had received instruction in these schools were assigned to the units being organized for the duties in which they had been specially instructed.

The divisions of the Surgeon General's Office in charge of the special branches of medicine and surgery furnished to the Overseas Division the names  of the officers to be assigned to the unit for the special duties previously noted.  Special orders were obtained from the War Department for these officers, who were then reported to the commanding officer of the organization for duty. At times there was a shortage of officers available by the special divisions for such assignments, but on the whole very little delay was encountered. Special attention was paid by this division to the selection of the commanding officer of the unit, only such officers being selected as had records showing special administrative efficiency and ability to command. In the designation of the mess officer every effort was made to secure a man experienced in the methods of procuring, preparing, and serving food, either a former noncommissioned officer who had previously served as a mess sergeant or an officer from civil life who had been manager or steward of a restaurant, club, or hotel. Many excellent officers were obtained for these places and the mess management of these units in general was excellent. The professional qualifications of the medical officers assigned to duty in the various specialties were usually of a high order, such officers having been assigned to their respective specialties after a thorough investigation as to their capabilities. In addition, many of these officers had recently completed a course of instruction in one of the special schools which had been established at Camp Greenleaf and which were equipped in every way to give advanced teaching. The proper quota of nurses was assigned to each base or evacuation hospital organized by the Army Nurse Corps Section of the Surgeon General’s Office. Two female stenographers were assigned to each hospital unit by the Overseas Division.
 
When the hospital unit was completely organized and equipped, it was retained in the camp where organized, or was attached to the base hospital at one of the cantonments until a satisfactory degree of training had been attained, if the movement of troops overseas permitted this delay. If the services of a


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unit were immediately desired overseas and transportation was available, the hospital, as soon as organized, was reported to the Chief of Embarkation Service of the General Staff as available, and orders directing the movement to a port of embarkation were issued. Upon the receipt of such orders the unit passed from under the immediate jurisdiction of the Surgeon General. In some instances, where haste was essential, the entire personnel of officers did not join the unit at the place of mobilization but were ordered directly to the port of embarkation to await its arrival and join it at that point. In a few cases, officers were sent abroad for special study before the hospital was ready to sail, and so reported for duty after its arrival overseas.

When a base or evacuation hospital was organized, the Finance and Supply Division of this office was notified of the fact, together with the approximate date of sailing; that division then arranged for the medical supplies of the unit to be shipped at the same time in order that the entire equipment of the hospital would be available upon its arrival in France. Certain difficulties were encountered in following this program and some of the hospitals arrived abroad without their complete equipment, but were properly outfitted by the medical supply detachment of the American Expeditionary Forces.

In all, 162 base hospitals and 59 evacuation hospitals were organized in this country.22 Of these, 121 base hospitals and 40 evacuation hospitals were actually transported for duty overseas.23 The remainder, which were in various stages of preparedness at the date of the signing of the armistice, were demobilized as rapidly as possible.

OTHER MEDICAL DEPARTMENT UNITS—PERSONNEL.
     
Convalescent camps.—1 major, M. C.; 4 captains, M. C.; 4 first lieutenants; 5 sergeants first class, M. C.; 14 sergeants, M. C.; 5 corporals, M. C.; 16 cooks, M. C.; 50 privates, M. C.; 1 first lieutenant, Q. M. C.

Convalescent depots.—1 major; 4 captains; 4 first lieutenants; 1 sergeant first class; 4 sergeants; 20 privates; 1 captain, Q. M. C.

The duties of the convalescent camps and convalescent depots 24 were implied in their names. They were usually attached to base hospitals, forming departments for the care of convalescent patients. Convalescent depots were also used with the armies in establishing the stations for slightly wounded.

These units were organized at the medical officers’ training camps, the greater number at Camp Greenleaf, and after their organization was completed they were reported to the Chief of Embarkation Service, General Staff, for transportation overseas. The general principles observed in organizing these units followed those outlined for the formation of base hospitals. In all, 14 convalescent camps and one convalescent depot were sent overseas.

Evacuation ambulance company.—1 first lieutenant, 1 sergeant first class, 2 sergeants, 2 cooks, 3 mechanics, 23 wagoners, 6 privates.
 
These units were organized at medical officers' training camps, chiefly at Fort Riley.25 They were transferred directly from these camps to the ports of embarkation for shipment abroad. One hundred and one evacuation ambulance companies were organized in this country, 81 of which were transported for duty overseas.26


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Army ambulance sections.—Before the United States entered the World War a number of volunteer ambulance companies had been organized in France, chiefly from the colleges of this country. After war was declared the War Department authorized the organization of the United States Ambulance Service, 27 to consist of 160 sections, of which 28 were formed from the sections which were already rendering volunteer service with the French Army. The remainder were organized at Camp Crane, Allentown, Pa., this camp having been established especially for this purpose. During the first few months of the war the organization of these sections was directly under the jurisdiction of the commanding officer of the United States Ambulance Service. After the departure of the headquarters of this service for France, the formation of these units was directed by the Overseas Division. As rapidly as units could be organized and transportation became available they were sent to France for service. During 1917 the enlisted personnel of these units was obtained through voluntary enlistments; after enlisting ceased certain numbers of drafted men were sent to Camp Crane for mobilization and assignment to the sections. One hundred and thirty-seven ambulance sections were organized and 120 were sent overseas. The Tables of Organization authorized the following strength, Medical Department, for each unit: 27 1 sergeant first class, 2 sergeants, 1 corporal, 2 cooks, 2 mechanics, 26 privates first class, 11 privates.

Replacement units.—In view of the numerous casualties to be expected  among the personnel of sanitary units attached to combatant troops during active operations, provision had to be made for supplying men to fill the vacancies which would exist among such formations. To accomplish this replacement, units were formed, consisting of 2 officers and 250 men each.28 These units were organized at the various medical training camps and dispatched overseas as promptly as the men could be procured and transportation was available. During the continuance of the war, 56 such units were actually sent to the American Expeditionary Forces.28 There was also a necessity for the transfer of additional officers abroad to replace those who for various reasons had become unavailable for further service. Parties of officers from the medical officers' training camps were constantly being ordered to France for this purpose. The number of officers who were thus transferred, unattached to medical units, is not available, but totals a large number.

Mobile hospitals and mobile surgical units.—The development of modern warfare had necessitated the adoption by the allied armies of new mobile sanitary formations by which facilities for rendering immediate surgical aid and chance of recovery to the seriously wounded could be brought directly to the injured men in place of having to carry the nontransportable wounded for indefinite distances to established hospitals. To meet such conditions, mobile hospitals, which previously had not been a part of our sanitary formation, were authorized.29  Such units were adaptations of the auto-chirs (autonomes) of the French Army.

A mobile hospital consisted of fixed sterilizing, X-ray, and electric lighting plants mounted on two motor trucks. In addition and carried on motor trucks were a light frame operating room, tentage, and sufficient hospital and surgical supplies to fully equip a surgical hospital of 120 beds with modern surgical facilities for the work of six operating teams. Such


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hospitals could function independently when conditions required or could be attached to other advanced sanitary formations to furnish additional surgical assistance. The personnel of such a unit was:

Mobile hospital.29—1 major; 10 captains or first lieutenants; 1 sergeant first class; 17 sergeants; 62 privates first class and privates; 22 female nurses; 1 captain or first lieutenant, S. C.

The mobile surgical unit was another medical formation which was the outcome of the experience gained during the recent war. Frequently, after an extensive battle, the surgical equipment of the sanitary formation in the zone of the army was insufficient to provide operating facilities for the large number of wounded requiring immediate surgical attention. This unit was adopted from the French groupe complementaire, and consisted of portable sterilizing, X-ray, and electric-lighting plant, a light frame operating room and surgical supplies mounted on two motor trucks, or a truck and a trailer. The unit did not provide hospitalization facilities and therefore could not function independently. It supplemented the equipment of the advanced field hospitals and was available for use wherever its services might be most  needed. The personnel of this unit was:

Mobile surgical unit.29—1 captain or first lieutenant, 1 sergeant first class, 3 sergeants, 8 privates first class and privates.

It was not the purpose of this unit to furnish an adequate personnel of officers, the necessary surgical staff being supplied from the permanent personnel of the field hospital with which the unit was serving or by the use of special surgical teams detailed to this duty.

Of these organizations six mobile hospitals and seven mobile surgical units were organized, and six mobile hospitals and four mobile surgical units were sent overseas.29

MEDICAL SUPPLY DEPOTS, STATIONARY LABORATORIES, AND MOBILE LABORATORIES.
 
These units, which were not provided for as sanitary formations prior to the World War, functioned for such duties as are indicated by their titles.

The authorized personnel for each was: 24

Medical supply depot.—Personnel of the Sanitary Corps: 3 captains or first lieutenants, 1 hospital sergeant, 2 sergeants first class, 4 sergeants, 4 corporals, 2 cooks, 10 privates first class, 22 privates; mixed unit, either M. D. or S. C. enlisted personnel.

Stationary laboratory.—Personnel of the Medical Department: 1 major, 5 captains or first lieutenants, 1 sergeant first class, 3 sergeants, 8 privates, first class and privates.

Mobile laboratory.—Personnel of the Medical Department: 1 captain or first lieutenant; 1 sergeant; 3 privates first class and privates; 1 first lieutenant, S. C.

Of these units the following were sent overseas for service: 9 medical supply depots, 5 stationary laboratories, 5 mobile laboratories.

Hospital units.--Prior to the onset of the World War the American Red Cross Society had organized a number of hospital units in various cities throughout the country,3 the personnel of each consisting of 7 officers and 47


357

enlisted men. These units were mobilized during the early period of the war and 18 of them were sent to France, where they were attached to other sanitary organizations, generally to base hospitals. They did not operate independently.

Special units.—The following is a list of special units organized by this division for service with the American Expeditionary Forces: 18 Mobile Operating Unit No. 1; Medical Department Replacement Unit No. 1; Aviation Medical Unit No. 1; Aviation Ophthalmo-Otological Unit No. 1; Museum Unit No. 1; Roentgenological Unit No. 1; Ophthalmological Unit No. 1; Medical Classifying Unit No. 1; Medical Department Repair Shop Unit No. 1; Central Optical Unit No. 1; Neurosurgical Unit No. 1; Medical Research Board No. 1; Anesthetic Unit No. 1; Otolaryngological Unit No. 1; Neurosychiatric Units Nos. 1 and 2; Surgical Groups Nos. 1, 2, 3, 4, 5, 6, 7, 8, and 10; Rodentological Unit No. 1.

These units were organized at the request of the chief surgeon, American Expeditionary Forces, for special duties which could not be performed by the regular sanitary formations. The functions performed by these units are indicated by their names. The personnel was generally few in number and was designated by the professional divisions of this office to which their work pertained. These units were mobilized at different camps, and as promptly as they could be assembled and their equipment provided, were sent overseas.

Veterinary units.—In addition to the medical units noted, the following veterinary units were organized for duty overseas:18 Base veterinary hospitals, S. O. S. veterinary hospitals, corps mobile veterinary hospitals, Army mobile veterinary hospitals.

All these hospitals were organized and their training directed by the Veterinary Division of the Office of the Surgeon General, and when considered ready for overseas duty, were reported to this division, which arranged for their transfer. The subject of the formation of these units is fully treated in the section  devoted to the Veterinary Division.

HOSPITAL SHIPS.

No hospital ships were authorized for the Medical Department of the Army during the World War, the care of the sick and wounded who were returned from France being under the jurisdiction of the Bureau of Medicine and Surgery of the Navy.30 They were returned mainly on transports under jurisdiction of the Navy, which also carried returning troops. The plan of having the Navy in charge of Army patients while on shipboard was not departed from save that after the armistice, when the movement of sick and wounded from overseas was very heavy, Army medical officers on certain occasions accompanied them, their work in cooperation with the naval medical officer in charge being devoted to patients not requiring hospital treatment, the ship’s hospital with the more serious cases being solely under Navy Department jurisdiction. The Navy also carried a limited number of Army patients on Navy hospital ships with a Navy medical staff.

Under date of March 28, 1918, a joint agreement between the Secretary of War and the Secretary of the Navy provided for the return of patients, as follows:


358

[documents]


359

[document]

The policy which the Surgeon General of the Army desired to be adopted with reference to this subject is set forth in the following correspondence:

[document]


360

[documents]


361

[documents]


362

[documents]


363

[documents]


364

[documents]


365

[documents]


366

[documents]


367

[documents]


368

[documents]


369

[documents]


370

[documents]

Following this lengthy correspondence, a further letter from the Adjutant
General was received and answered by first indorsement, both of which follow:

[documents]

The armistice was signed before it had been necessary to bring back to this country a large number of patients from the hospitals of the expeditionary forces. The hospital facilities in France and England being sufficient to care


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for the patients then on hand, no difficulty was experienced in returning the sick and wounded on the regular transports, as they could be distributed over as long a period as was necessary. Had the war continued to render necessary the return of large numbers of patients on transports, it is uncertain whether the policy in force would have succeeded.

LIAISON SERVICE BETWEEN THE SURGEON GENERAL OF THE ARMY AND THE SURGEON GENERAL OF THE NAVY.

The agreement set forth above respecting the return of the sick and wounded  from abroad by which such transfer of patients was under the jurisdiction of the Surgeon General of the Navy rendered necessary considerable communication between the two offices. This liaison service was rendered entirely by the officers of this division. Relations were at all times most harmonious and a marked spirit of cooperation existed.

CABLES.

To this division was intrusted the general charge of the cable service between the office of the Surgeon General and the American Expeditionary Forces. All cables sent from this country to the forces abroad went through the cable branch of the General Staff. This branch received all cables from overseas and distributed them to the departments and bureaus which were concerned with the contents. All such messages for this office were received in the Overseas Division and transmitted to the proper officer for action, careful check being kept that when answer was necessary it would be promptly attended to this duty pertained more practically to the Administrative Division of the Surgeon General's Office, and during the latter part of the war was transferred to that division.

CONFIDENTIAL INFORMATION.

During a portion of the war the Overseas Division was the custodian and branch of transmittal in the Surgeon General's Office of all confidential information received from the War Department. Upon receipt of any confidential communications, copies were made and distributed to the officers concerned. Such documents were at all times kept securely locked in metal filing cases.

PERSONNEL.b
 (April, 1917, to December, 1919.)

Noble, Robert E., Maj. Gen., M. D., chief.
Hart, W. L., Col., M. C., chief.
Morris, S. J., Col., M. C., chief.
Kerns, H. N., Maj., M. C.
Tandrop, O. A., Maj., S. C.
Baldwin, R. E., Capt., M. C.
Wyrick, Guy, Capt., S. C.
Seidler, August, First Lieut., S. C.

______
    b In this list have been included the names of those who at one time or another were assigned to the division during the period April 6,1917, to December 31,1919.
There are two primary groups—the chiefs of the division and the assistants. In each group names have been arranged alphabetically, by grades, irrespective of chronological sequence of service.


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REFERENCES.

(1) Letter fromthe Surgeon General to The Adjutant General, March 3, 1919. Subject: Information Regarding Regular Army Units. On file, Record Room, S. G. O., 322.3 (Ambulance Companies) (A).
(2) Manual for the Medical Department, 1916, corrected to April 15, 1917, 153, 535, 541.
(3) Annual Report of the Surgeon General, United States Army, 1918, 444 et seq.
(4) Ibid., 304.
(5) Office order No. 64, S. G. O., July 10, 1918.
(6) Office order No. 97, S. G. O., November 30, 1918.
(7) Correspondence. On file, Record Room, S. G. O., 177904; and 191421 (Old Files); 632 (Hospitalization Program, A. E. F.) (Y).
(8) Annual Report of the Surgeon General, United States Army, 1919, Vol. 11, l180-1183.
(9) Cables from General Pershing, Nos. 759 and 1037, March 21 and May 2, 1918, respectively. Cablegram File. Memo. from the Surgeon General, United States Army, to the Chief of Staff, April 30, 1918. On file, Record Room, S. G. O., Confidential File.
(10) First indorsement, W. D., A. G. O., to the Surgeon General, United States Army, June 15, 1917. On file, Record Room, S. G. O., 128732 (Old Files).
(11) Memo. from the Surgeon General to the Chief of Staff, April 30, 1918. On file, Record Room, S. G. O., Cablegram File.
(12) Cable No. 751, from General Pershing March 19, 1918. On file, Record Room, S. G. O., Cablegram File. Letter from The Adjutant General of the Army to the Surgeon General, United States Army, August 25, 1918. On file, Record Room, S. G. O., 370.2.
 (13) First indorsement from The Adjutant General of the Army to the Surgeon General, United States Army, May 11, 1917. On file, Record Room, S. G. O., 353. (Medical Officers’ Training Camps).
(14) Tables of Organization No. 28, Series A, Sanitary Train (Infantry Division); and Tables of Organization No. 40, Series A, Medical Department.
(15) Bull., No. 32, W. D., May 24, 1917.
(16) Circular letter, S. G. O., December 6, 1917.
(17) Tables of Organization (Medical Department). On file, Record Room, S. G. O., 320.3-1 (Table Organ.).
(18) Annual Report of the Surgeon General, United States Army, 1919. Vol. II, 1180.
(19) Memo. from the Surgeon General to the Chief of Staff, April 30, 1918. On file, Record Room, S. G. O., Confidential File. Letter from the Surgeon General, United States Army, to The Adjutant General, October 14, 1918. On file, Record Room, S. G. O., 321.6 (Med. Dept.).
(20) Correspondence. On file, Record Room, S. G. O., 322.3 (A. E. F.) (Y).
(21) Manual for the Medical Department, 1916, corrected to April 15, 1917, 227.
(22) l.ists. On file, Record Room, S. G. O., 322.3 (Misc.).
(23) Hospitalization, A. E. F. Chief Surgeon’s Office, Hospitalization Division, 7th edition, November 1, 1918. On file, Record Room, S. G. O., 322.3 Y.
(24) Letter from the Surgeon General to The Adjutant General, December 6, 1917. Subject: Organization Additional Medical Department Formations; second indorsement, from The Adjutant General to the Surgeon General, United States Army, December 28, 1917. Subject: Authorization of Formations. On file, Record Room, S. G. O., 322.3-1.
(25) List containing evacuation ambulance companies. On file, Record Room, S. G. O., 322.3 (Misc.).
(26) Weekly report for November 2:3, 1918, from Overseas Division. On file, Record Room, S. G. O., Weekly Report File.
(27) S. O., 75, W. D., June 23, 1917.
(28) Correspondence. On file, Record Room, S. G. O., Section V. (Replacement Units).
(29) Correspondence. On file, Record Room, S. G. O., 322.3 (Mobile Hospitals) and (Mobile Surgical Units).
(30) Correspondence. On file, Record Room, S. G. O., 541.1.