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Chapter IV

Contents

CHAPTER IV

TRAINING IN DIVISIONAL CAMPS AND IN POSTS

IN DIVISIONAL CAMPS

One of the main purposes of the medical officers’ training camps which were instituted in June, 1917,1 was to provide for the tactical divisions, to be mobilized the following September, as great a number as possible of officers who in the intervening months would be given sufficient instruction in medico-military matters to unable them to take up on a great scale the instruction of divisional Medical Department personnel.

The scheme of training, as noted before, was the outcome of our experiences on the Mexican border, 1916-17, and was promulgated in May, 1917, to the division surgeons of divisions then existent, in order that the work to be done along this line in the medical officers’ training camps might be anticipated somewhat. These instructions were as follows:2

1. These instructions are intended to coordinate the training of officers and enlisted men of the Medical Department with that to he given at the training camps of the Medical Department, of which it is expected that four will shortly be established. In order that such instruction shall be standardized throughout the military service, the general provisions of this letter will he strictly carried out. All details of execution are left to you, and you are held responsible for proper results.
  
2. To this end, you will appoint a specially qualified officer as “training officer,” whose chief functions will be, under you, to take charge of the details of training work and by close supervision see that these are effectively carried out. You will also yourself give much attention to this highly important matter, by supervision, inspection, etc.
You will also make arrangements by which the routine duties of medical officers and men serving with troops shall not unduly interfere with their systematic and progressive instruction and training.
 
3. The course of instruction is intended to be basic. Training will be intensive and pushed as rapidly as possible. The services of thousands of instructed medical officers must he available at an early date. They must be fitted to intelligently undertake field work with independent organizations, under conditions in which many of them will not have either the supervision of trained officers or the aid of well-qualified noncommissioned officers. The training, drilling, etc., of the many thousands of enlisted recruits of the Medical Department will shortly devolve upon them. They must be thoroughly qualified to do it. The military exigency requires that few trained medical officers can be spared for your division. Their places will have to be filled by medical officers of the Officers’ Reserve Corps, most of whom will be absolutely without experience or training. The responsibility for seeing that they get such training in an effective way and in as short a time as possible rests with you. New officers, as they may join you subsequently, will be at once put under training.
  
4. Your staff of instructors will have to be arranged for by you. Individuals who are qualified and those only partly qualified will have to instruct those who are not qualified at all. You will make every effort to assign as instructors in any subject officers who are especially conversant therewith. Where troops are aggregated in considerable numbers, you will organize general classes or schools, with fixed hours for sessions. Where the sanitary personiiel is present in small numbers, its instruction will nevertheless be systematically prosecuted, and its efficiency checked up by frequent inspection by yourself and your assistants. For assistance in map reading, the tactical part of medicomilitary problems and maneuvers, and special lectures, you should secure the services of selected line officers.


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5. Instruction will as far as possible be by recitations in theory, and demonstrations in practice. Student officers should be made to grasp the principles, and then visualize the organizations, apparatus, and methods concerned. To this end, for example, all sanitary appliances and methods likely to be of use in field work will be procured or constructed and kept in operation, and systematized demonstration will be made of their purpose and practical use. Bombproofs will be constructed, protective apparatus against poison gas tested, etc. All official papers required will actually be made out until familiarity therewith and correctness of result is secured. Applied camp sanitation will be taught by sanitary inspections. Drills will be prosecuted until every medical officer can himself handle and instruct therein the enlisted personnel of the Medical Department. Officers and men will be given interchangeable duty, for fixed periods, between the regimental detachments, ambulance companies, and field hospitals to learn their internal administration and their handling on marches and comprehensive field problems.

6. The training course for officers will be divided into three periods: The first, while instructing the officer as such, is intended especially to familiarize him with the duties of the enlisted recruits of the Medical Department which he will shortly be called on to train. The second takes up his training in his own special functions as an officer. The third carries on and completes the course of the second period. As fast as an officer qualifies in a subject, he will be advanced to another. Ordinarily, qualification will be determined by brief oral examination or practical demonstration.
 
7. The following official books will be used in the course of instruction: Army Regulations; Field Service Regulations; Manual for the Medical Department; Tables of Organization; Drill Regulations for Sanitary Troops; Manual for Courts-Martial. You will at once make requisition so that each officer not fully supplied will have a copy. Any other books which may be used will be announced later. You will make requisition for enough wargame maps and sets so that each officer will have access thereto. Procure maps of any maneuver grounds in the vicinity of camps which will be used in your maneuver work and if possible issue a copy to each officer.

8. You will arrange, if possible, to give at least four hours systematized and progressive instruction to medical officers daily, except Saturday afternoon and Sunday. The daily schedules for such instruction you will prepare yourself, bearing in mind the subjects to be covered and the time which it is desired to devote to each subject, as set forth later in this letter. Schedules should be made out for one month at a time, following the plan of dividing the instruction into three periods. Copy of schedule as prepared by you will be furnished to this office without delay. Effort should be made to arrange routine duty so that the entire afternoon can be devoted to instruction, with, if possible, one hour in the morning in addition.

9.The following subjects will be thoroughly taught during the first period: Setting-up exercises (15 minutes daily); drills, 2 hours daily; inspections; equitation; bridling, saddling and care of animals; tent pitching, shelter and pyramidal; personal equipment of sanitary soldier; field and surplus kits; care of equipment; first aid, using soldier’s equipment only; examination of recruits, including papers and finger prints; nature and employment of regimental medical supplies; customs of the service; relation of Medical Department to rest of Army; general organization of the Medical Department for war; general organization of military forces; Manual for the Medical Department; Army Regulations; military hygiene and sanitation; Field Service Regulations; paper work relating to the Medical Department; map reading, use of compass, orientation, etc.

The second period will include: Setting-up drill (15 minutes daily); drills (1 hour daily); inspections, equitation, and care of animals; tent pitching, hospital tentage; elementary position and road sketching the regimental detachment, its use and internal administration; the ambulance company, its equipment, use and internal administration the field hospital, its equipment, use and internal administration; lectures by line officers on the tactical use each of Infantry, Cavalry, Field Artillery, Signal Corps, Engineer Corps, and quartermasters’ supply work in the field; paper work relating to the Medical, Quartermaster, and Ordnance Departments (continued); the Medical Department in campaign; the principles of sanitary tactics; map problems; war games; military hygiene and sanitation (continued); Army Regulations (continued); Manual for the Medical Department (continued).


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The third period will include: Setting-up drill (15 minutes daily); drills (1 hour daily); inspections; handling of rations and mess management; Manual for Courts-Martial; Articles of War; Geneva aud Hague conventions; The Rules of Land Warfare; military surgery; poison gases, their nature, protection against, and treatment of; liquid fire; shell shock; war psychoses and neuroses; malingering; demonstration of trench system, including bombproofs, dugouts, entanglements, abatis, etc.; trench warfare, “trench foot”; cantonment hospitals, their organization and management; sanitary service, lines of communication; hospital ships, ships for patients, hospital trains and trains for patients; base hospitals, their organization and management; contagious disease hospitals, casual camps, convalescent camps, camps for prisoners of war; organization, functions, and limitations of the American Red Cross; civil sanitary function of the Army Medical Department in occupied territory; war games; tactical walks and rides; sanitary inspections; practice march arid bivouac (2 days); practical field maneuvers, including brigade and divisional problems, with not less than two night problems, and using regimental detachments, ambulance companies, field hospitals, stations for slightly wounded, “Dummy” wounded in large numbers will actually be handled. Problems will include the attack, retreat, planned defense, and rencounter, with all arms.

10. Dental surgeons and veterinary surgeons will take the general course for medical officers, with the exception of subjects which pertain more or less exclusively to the work of medical officers as such, and the substitution therefore of subjects directly relating to the dental or veterinary service. Pending instructions from this office, you will arrange tentatively for such special instruction.
  
11. Medical officers who demonstrate exceptional knowledge and ability as a result of this training course will be recommended by you for advancement in rank. A certain number of vacancies in the grade of major and captain are being left unfilled for this purpose. Also officers so excelling, who satisfy the age and other requirements, will he recommended by you to this office for examination with a view to their being commissioned at once as first lieutenants in the Medical Corps of tire Army.

12. If any reserve officer is found unfit for the service by reason of physical, mental, moral, or temperamental reason, you will recommend to this office his separation from the service.

13. You will arrange with military hospitals in the vicinity of troops to furnish facilities for instruction of medical officers in the administration of such hospitals, and in the training of enlisted men as nurses and surgical assistants.

14. Pending further instructions from this office, you will prepare and put into effective operation, without delay, a course of intensive instruction and training for enlisted men of the Medical Department. Schedule of the above will be furnished this office. Eight hours of instruction per day, except Saturday arid Sunday, will be required. Four hours’ instruction will be required on Saturdays. In computing the amount of instruction given, the time actually consumed by enlisted men in the performance of regular duties will be given credit.

15. You will arrange for advanced instruction to he given selected men with a view to their promotion to he noncommissioned officers or assignment as nurses, surgical assistants, dispensary assistants, dental surgeons’ assistants, and clerks. Copy of your plans and schedules will be furnished this office.
 
16. In view of the great need for noncommissioned officers, it is desired to promote selected enlisted men as rapidly as they are found qualified.

17. Selected men to be cooks, horseshoers, farriers, saddlers, mechanics, and chauffeurs should be instructed in such general training institutions for these subjects as are, or may be, available to the enlisted men of the line in your division.

  *  *  *  *  *

Unfortunately, it was impossible to provide accommodations at medical officers’ training camps for all the officers aud enlisted men that would be required for the Medical Department units of the divisions organized in the early fall of 1917; other units had to be provided for besides the divisional units, and these had to be organized simultaneously. Consequently, though


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104 medical officers and 1,455 enlisted men, Medical Department, were required for each of the divisions organized under War Department Tables of Organization, August, 1917, only 60 medical officers and 310 enlisted men, partially trained, could be furnished for each of the National Army divisions so organized.3
  
On October 3, 1917, the following letter of instruction,4 sent to the division surgeon of each division, augmenting instructions previously issued, was intended as an outline for the training of all divisional Medical Department personnel. The course of instruction thus prescribed was to be carried out as rapidly and as completely as local conditions permitted, and was to be concluded only when the Medical Department personnel under instruction demonstrated their qualification before a board of medical officers appointed by the division surgeon.

1. These instructions are intended to coordinate the work of training medical personnel in all divisions so that it may be carried out on common lines. To this end, the general provisions of this letter will be strictly observed. All details of execution are left to you, and you are held responsible for proper results.

2. With the concentration of troops in divisions, each division will, so far as the Medical Department is concerned, constitute a training unit for its sanitary personnel, both commissioned and enlisted.
  
  3. This training will consist of two parts, one in which the medical personnel is trained in their military duties and military environment, the other in which the medical personnel is trained in such professional matters as are created or affected by such military environment. Both are necessary.
  
4. It is realized that with time organization of new troops there must first be a period for organization, equipment, and supply. Under such conditions, with green men, the performance of almost any military duty is new and valuable as a matter of education. For this reason, the scope of instruction may safely be left to detachment and unit commanders for some weeks, subject to the oversight of the division surgeon. But on November 1 the present plan of medical divisional training will be put into operation and continued as long as the division remains in the United States.

5. This Nation is at war, and training must be intensive and arduous so that the sanitary personnel may be fitted for service with the least possible delay. It is a time which calls for every effort and self-sacrifice, and sloth, indifference, and inertia on the part of individuals must not be tolerated. The efficiency of the Medical Department as a whole, as well as in each division, with a personnel composed in large part of those inexperienced in the military service, very clearly depends upon the thoroughness and efficiency with which training is carried out.
  
6. It must be emphasized that the duties of the Medical Department are multifarious, that all are necessary, that any and all individuals may be called upon with little or no notice to perform them, and that training in one line of sanitary duty may give little or no preparation for other lines of work equally important. It is not possible to limit the liability of any individual to one class of duty. Hence each must be prepared to efficiently carry out any of the various duties which he will very likely be called upon to perform from time to time.
  
7. It is obvious that the proper performance of the routine daily duties of the sanitary personnel is of the greatest immediate importance and must be effectively carried out. But it is equally true that some hours daily should be available after this daily routine is accomplished, and this spare time should be effectively used in preparing for future duties and probable contingencies.
  
8. Training will be carried out under direction of the division surgeon, who will prepare a schedule of systematic training in general conformance with this letter of instructions, and submit the same to the division commander, with request that it be issued as a division order. The division surgeon will see that the provisions of such order as may be issued are strictly carried out in both letter and spirit, and that every opportunity for training is taken advantage of by study, drill, arid field exercises.


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9. To assist him in this most important work of preparing his sanitary personnel for war service, the division surgeon will designate a suitable medical officer as “training officer,” and if necessary request his relief from other duties. The duties of the “training officer” will be, under the division surgeon, to classify the personnel, both commissioned and enlisted, into suitable groups for training according to their relative knowledge and experience, arrange for competent instructors, recommend the subjects and hours of instruction for each group, arid, by constant supervision and assistance, verify and promote the efficiency of the training work.
  
10. In each camp there will be found a considerable proportion of officers and men who have had a certain amount of military experience, either at a medical officers’ training camp or through previous service. This personnel should be sought out and their services fully utilized as instructors. The well trained must aid the partly trained, and both must unite to teach what they know to the large group of time wholly uninstructed. They are the instructors upon whom the training officer must rely to carry out the details of his work.

11. Officers and men detailed by you as instructors should be given special authority while serving as such, irrespective of rank.

12. In a general way, the course of instruction should be considered to cover about a three months’ period. Schedules should provide for its completion by January 15 to February 1. Troops going abroad before that time will necessarily discontinue this course of training.

13. Attendance at all training exercises and lyceums is a military duty. No person should be excused from attendance except for official reasons and in emergency. Check lists of attendance will be kept and absentees reported to the proper officer. Excessive routine duty will not be accepted by this office as an excuse for failure to carry out a reasonable amount of training.

14. As far as possible, the training to be given sanitary personnel will be coordinated. For this purpose, there must be systematized rotations of duty. As soon as an officer or enlisted main is able to efficiently perform time task set him, he should be given opportunity to learn something else. The regimental sanitary personnel, after becoming competent to handle regimental work, should be temporarily assigned in detachments to ambulance companies and field hospitals--and vice versa--for mutual familiarity with the duties and methods of these diverse organizations. It is realized that these changes of duty for instruction purposes may be objected to by subordinate commanders as interfering with the highest efficiency of their organizations. Such objections should not be entertained. The efficiency of the medical service of the division as a whole is first to he considered, and until this has been secured to the satisfaction of the division surgeon all regimental detachments and sanitary units of the division should be regarded as training organizations.

15. The subjects in which medical officers must be qualified are as follows:
    Setting up. Medical officers will take this daily with the troops to which they are attached.
Drills; marching, litter, ambulance, other means of transport.
Inspections; personnel and environment.
Equitation; saddling, bridling, care of animals.
Tent pitching.
Personal equipment of the soldiers; its care, field and surplus kits.
First aid; using soldiers’ equipment.
Examination of recruits, with papers and finger prints.
General organization of the military forces of the United States.
General organization of the Medical Department for war.
Relation of the Medical Department to the rest of the Army.
Paper work, relating to the Medical Department.
Paper work, relating to the Quartermaster’s Department.
Paper work, relating to the Ordnance Department.
Customs of the service.
Duties of the soldier.
Army Regulations.


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Manual for the Medical Department.
Field Service Regulations.
Military hygiene, and applied camp sanitation, including sanitary inspections.
Map reading, use of compass, orientation, etc.
Elementary road and position sketching.
The regimental detachment; its use, equipment, and admninistration.
The ambulance company; its use, equipment, and administration.
The field hospital; its use, equipment, and administration.
The Medical Department in campaign.
The principles of sanitary tactics.
The tactical use of Infantry (lecture by line officer).
The tactical use of Field Artillery (lecture by line officer).
The tactical use of Cavalry (lecture by line officer).
The uses of the Engineer and Signal Corps (lecture by officers of service concerned).
The service and mechanism of quartermaster supply in the field (lecture by quartermaster).
Map problems.
War games.
Tactical walks and rides.
Practice marches and bivouacs.
Practical field maneuvers, including brigade and divisional problems, with not less than three night problems utilizing regimental detachments, ambulance companies, and field hospitals in coordination. Problems will include the attack, retreat, planned defense, and rencounter, with all arms. As far as possible, they will be carried out in actual conjunction with problems by line troops.
Handling of ration, food economy, and mess management.
Manual for Courts-Martial and Military Law.
The Articles of War.
The Geneva and Hague conventions.
The Rules of Land Warfare.
Military surgery.
Poison gases, protection against, and their effects.
Liquid fire, trench foot.
Shell shock; war psychoses and neuroses.
Diseases common on the Western Front.
Malingering.
Cantonment, evacuation, base and general hospitals, including their organization, administration, records, management, etc.
Sanitary service of the line of communications.
Contagious disease hospitals, casual camps, convalescent camps, camps for prisoners of war.
Organizations, functions, and limitations of the American Red Cross.
The civil sanitary function of the Army Medical Department in occupied territory.
All medical officers of the division will be required to qualify in the entire course.

16. Much of the instruction should be by recitations and field work. In connection with paper work, all papers required by the medical and other departments will be actually made out until familiarity therewith and the correctness of result is secured.
 
17. To insure due diligence in training work, a board of three senior medical officers should be established in each camp to verify the competency in each subject of officers reported to them as qualified therein. No officer should be excused from training in a subject until the above board has reported him as qualified.

18. The attention of all officers, with the division, should be drawn to the fact that their efficiency and value to the service will largely depend upon the use they make of their opportunities for training.
The second increment of the National Army will come into being about the time the training of your medical officers will be completed. A large number of officers competent to


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perform the more important duties connected with this second draft will be required. This office proposes to call for recommendation as to the medical officers and enlisted men of present divisions who by their zeal, industry, and aptitude have fitted themselves for positions of higher rank amid larger authority with organizations to be created later

19. On the other hand, medical officers who through indifference or inertia fail to qualify themselves properly for their duties, and who do not respond to local disciplinary measures, should be recommended by you to this office for summary separation from the service.

20. It is proposed to check up the efficiency of divisional training by frequent inspections of officers of the Inspector General’s Department and by special inspectors from this office.
  
21. The textbooks authorized and published by the Government are as follows:
Army Regulations.
Manual for the Medical Department.
Drill Regulations for Sanitary Troops.
Field Service Regulations.
Rules of Land Warfare.
Tables of Organization.
Each officer should possess a copy for study and reference. You should make requisition without delay for such number of those as may be required to meet the needs of the commissioned and enlisted personnel of your division.
 
22. The books of reference authorized are as follows:
Military Hygienic, Ashburn.
Sanitation in War, Lelean.
Notes on Sanitation, Vedder.
Gunshot Injuries, LaGarde.
Military Surgery, Penhallow.
Sanitary Tactics, Munson.
Medical Service in Campaign, Straub.
   Also any handbooks published under authority of the Surgeon General.

It is intended that a sufficient number of these should be kept in the base hospital, to meet all needs. They should be kept in the hospital library, and be loaned as required to all medical officers.

Professional magazines issued to such hospitals should be available to all concerned.
 
23. Training will, as far as possible, be made practical. Medical officers and enlisted men of the Medical Department, after learning in theory how a duty should be performed, should be made to actually do it in practice.

24. Divisional sanitary detachments and units must not be allowed to become sedentary. Drills about camp and short marches with return to camp are not sufficient. There must be frequent “hikes” of several days duration, with overnight camps. Nothing prepares for field service like field service.

A minimum of eight hours work a day should be required. There should be not less than four hours work on Saturday. Credit should be allowed for time actually spent in the performance of necessary routine duties. Sunday should be regarded as a day of rest. In addition, not less than three evenings a week should be designated as lyceum nights, when all available medical officers should be required to meet for lectures, conferences, discussions, clinics, war games, etc., on matters pertaining to the medical sciences and military service.

25. Beside the training along medico-military lines already outlined, there must be training along professional lines, especially when these are subject to modification from civilian standards by reason of military necessity and environment. There is opportunity to broaden the outlook and add to the professional efficiency of all. But the professional subjects in which there is an immediate and direct application to the military service are of the first importance.

26. As part of the training course along professional lines, the various specialists attached to the base hospitals, and others sent out by this office, will give outline courses along the lines of their work on which it is important that medical officers in general should be informed. These will take the form of lectures, demonstrations, clinics, presentation of cases, etc. Instructions as to the nature and scope of the formal instruction to be thus given will be sent direct by the several specialists, divisions of this office to the specialists concerned.

27. The subjects of general and orthopedic surgery, general and military medicine, advances in hygiene and sanitation, diseases and injuries of the brain, head, eye, ear, nose,


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and throat, bacteriology and pathology, genitourinary diseases, psychiatry and neurology, Roentgenology, and medical and surgical supplies will be thus covered.

28. The lectures, demonstrations, etc., to be given by specialists in their respective subjects are to be practical. They are not intended to turn the general practitioner class of medical officers into specialists, but to outline to such general practitioners their part in the prevention and cure of important disorders and disabilities through early diagnosis and proper action and the manner in which specialists can be of service to them in the more obscure cases of illness or injury, with some discussion of the specialists’ methods to be employed. They are intended to demonstrate how better professional teamwork may be accomplished.

29. This course of instruction by specialists and lyceums will be arranged by the commanding officer, base hospital, who should confer with the division surgeon’ as to the hours and places most convenient for all concerned.

30. This office proposes to maintain a circuit for certain lectures by authorities in their subjects, to be illustrated by moving pictures and lantern slides. The adjutant of the Army Medical School, Washington, D. C., will handle all details relative to this illustrated lecture circuit. Moving pictures of a nonprofessional nature, but illustrating general military service with troops, will also be sent out for exhibition. The purpose of these pictures is to familiarize medical officers with the conditions and difficulties of the military environment, and of the functions of the other branches of the service with whom they will be associated. The exhibition of such pictures will be credited as part of the lyceum course.

31.You will also prepare a course of training for enlisted men, intended to familiarize them, first, with their present duties, and then systematically give them an insight into the other varieties of service under the Medical Department which they may be at any time called upon to perform.
 
32. You will also establish amid mnaintain a school for candidates for promotion as non-commissioned officers. Details of this course are left to you.

33. Suitable arrangements will be made by you for the effective special instruction of selected men required for dispensary and surgical assistants, ward masters, clerks, cooks, chauffeurs, blacksmiths, farriers, saddlers, and other special duties.

34. Schedules of instruction covering the above subjects will be prepared by your without delay. Copies of such schedules will be furnished this office for its information prior to the beginning of the training course.
  
35. The mounts and animals of the regimental detachments, ambulance companies, and field hospitals should be used in instruct ion of all officers and enlisted men in equitation, driving, and packing.

*  *  *  *   *

The proportion of Medical Department personnel called into the service which could be accomodated at the medical officers’ training camps became smaller as time passed, and the incoming draft increments increased and the number of officers and men ordered directly to divisions, who had never received any military training whatever, continued to increase in the same proportion. During the summer of 1918 it became a matter of great importance that these officers be given intensive training and instruction. Therefore, the Surgeon General sent out another circular letter of instruction, calling attention to the above facts and citing Special Regulations, No.49a, War Department 1917, and previous letters of instruction as a basis upon which intensive instruction was to be placed.5

While the divisions were undergoing organization and training for overseas service in the cantonments in the United States during the early months of our participation in the war, the division surgeon exercised the function of camp surgeon as well as that of division surgeon, and was responsible for the training of all sanitary troops in the camp in accordance with the training plans formulated under the direction of the Surgeon General, except those assigned to the camp base hospitals. It was the intention of the Surgeon General, however, in the issuance of circular letter of instruction on October 3, l9l7, 4


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to all division surgeons, and the circular letter to the commanding officers of all base and general hospitals, on November 1, 1917,6 that the instruction in the cantonments be correlated in such a way that the professional training of all officers in the camps be conducted by the specialists assigned to base hospitals, each one of whom, as a rule, was eminently qualified to give this instruction in his particular branch of medicine, and that the military instruction of all sanitary personnel be given by officers assigned to the field units of the camp. It was also intended that enlisted men from the divisional units be assigned to the base hospitals for training in nursing, ward management, the duties of operating room, orderlies, etc., and in the majority of the camps this was accomplished, especially during the latter part of the war.

When the division surgeon acted also as the camp surgeon, on the departure of the divisions for overseas service, the camps were often left without an organized camp surgeon ‘s office, or without either commissioned or enlisted personnel commensurate with the needs of the camps, and often the division surgeon took away with him all records pertaining to the camp.7 In order to correct this condition and to correlate the activities of the various units, the Surgeon General decided to assign camp surgeons and the necessary sanitary personnel to all camps, to complete the organization of a camp surgeon’s office, and the division surgeons were notified that in case this had not been accomplished they should take steps to select the necessary personnel from the officers and enlisted men who were to remain, to complete such an organization and to instruct them in their duties before the departure of the division, or that in the event the necessary personnel was not available, to make telegraphic request to the Surgeon General for them.7 The following scheme for the organization of Medical Department activities of a large camp, which had been developed at one of our large camps, was thought so well of by the Surgeon General that, on May 27, 1918, it was promulgated by him in memorandum form to all camp surgeons, to be used as a guide in organizing the camp surgeon’s office.8

1. The attached scheme for the organization of Medical Department activities at a large camp is furnished for your information. This plan received the highest commendation from the commanding general of the camp in question and appears to cover in an exceptionally complete manner the various functions of the Medical Department. It is not intended that this plan should necessarily be adopted as a standard, hunt it is desired that you give it careful study with a view to correcting any defects which you may find in your camp organization.

HEADQUARTERS CAMP BLANK,
OFFICE OF THE CAMP SURGEON,
May 10, 1918.

From: The Camp Surgeon.
To:  The Adjutant General of the Army, Washington, D. C. (through the commandant Camp Blank).
Subject: Organization of the medical department of a camp.

1.  The various activities of the Medical Department at a large receiving camp, such as Camp Blank, have been left, as far as the Tables of Organization are concerned, to each camp surgeon to work out as he sees fit.
2.  A camp, such as Blank, is permanent in its character, and it is suggested that a medical officer of at least the rank of colonel be assigned permanently as camp surgeon to coordinate the work of the different divisions and the depot brigade. He should have a permanent staff, both commissioned and enlisted, and the sanitation of the entire camp should be directly under his supervision.
3.  The organization of the medical department of the division is fully covered by the Tables of Organization.
4.  The depot brigade is a permanent organization, and its activities are so varied that it is believed that a complete and coordinated medical organization should be prescribed. This should be permanent, and should be sufficiently elastic to meet the many emergencies which may arise in the brigade.


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5.  As at present organized in this camp, the medical activities consist of seven different services arid embody seven special boards, as follows:
(a) Services:
(1) Examination of recruits.
(2) Remedial defects.
(3)  Venereal.
(4)  Detention camp.
(5)  Quarantine camp.
(6)  Infirmaries.
(7)  Dental.
(b) Special boards:
(1) Tubercular.
(2) Neuropsychiatric.
(3) Eye and ear.
(4) Orthopedic.
(6) Genitourinary.
(7) Psychological.

6. The examination service has assigned to it 9 commissioned officers, and during the periods when men are being received the special boards work in conjunction with this service.

7. The remedial defects service has 5 commissioned officers assigned to it, whose duties are no prescribe drill and exercise to develop defectives, supervise their work, and make recommendations as to the suitable final disposition of these men. The special boards also act as consultants for the various classes of defects conning under their specialties.

8. There are 6 to 8 officers assigned to the detention camp, who act as camp surgeons, complete inoculations and vaccinations, and complete the medical records of the men. While in this camp, an orthopedic survey is made of the men, and corrective drill is instituted where necessary.

9. At the quarantine camp 6 officers are assigned, who act as camp surgeons, treat meningitis carriers, diphtheria carriers, and perform the various duties necessary to the health of the various contacts.

10. The venereal service has three officers assigned to it. This service treats all cases of syphilis and supervises the treatment of all cases of gonorrhea in camp. The service keeps the necessary records. This service is very important, as is evidenced by the fact that from 3 to 5 per cent of all drafted men have venereal disease when received.

11. The infirmary service comprises the battalion medical service, 2 officers being assigned each training battalion (Tables of Organization). This personnel may be cut considerably if this proposed organization is adopted, 3 battalions being served at 1 infirmary and 3 medical officers assigned to each infirmary.

12. The dental service has 11 dental surgeons assigned, with a completely equipped dental infirmary.

13.The various boards examine men when received and act as consultants in their specialties.

14.  It has been found that this organization fulfills all the requirements of the depot brigade and is able to handle the work in an efficient manner. It is therefore recommended that the following Medical Department organizations be prescribed for National Army camps:
1 colonel, camp surgeon.
1 major, assistant to camp surgeon.
1captain, assistant to camp surgeon.
1 major, sanitary inspector.
8 captains or first lieutenants, assistants to sanitary inspector.
1 lieutenant colonel, surgeon, depot brigade.
1captain, assistant to surgeon.
Examination service:
1 major.
8 captains or first lieutenants.
Remediable defects battalion:
1 major.
4 captains or first lieutenants.
Venereal service:
1 major.
2 captains or first lieutenants.
Detention camp service:
1 major.
5 to 7 captains or first lieutenants.
Infirmaries:
1captain or first lieutenant to each
Dental service:
1 major.
10 captains or first lieutenants.


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Special boards:
Tubercular - 
1 major.
4 captains or first lieutenants.
Cardiovascular - 
1 major.
2 captains or first lieutenants.
Neuropsychiatric -
1 major.
4 captains or first lieutenants.
Eye and ear - 
2 captains.
Orthopedic - 
1 major.
2 captains or first lieutenants.
Psychological - 
2 captains or first lieutenants.

15. This organization calls for 73 to 82 medical officers, according to the number of battalions; 11 dental and 2 Sanitary Corps officers.

GENERAL TRAINING FOR MEDICAL OFFICERS

  In general, the principle underlying training of medical officers of tactical divisions was the same for all: (a) Basic military training; (b) special training, so as to permit an officer of the Medical Department to function; (c) training to develop organization efficiency.

The training of officers was made as practical as possible, the intention being to instill discipline, to enhance the ability to command, and to develop qualities of leadership and morale. Medical officers who reported without previous military training were ordered to drill in ranks, under the direction of those who had received basic training in medical training camp, in order that they might learn rapidly and acquire ability to execute drill movements. As soon as they proved themselves, they were given command. The character of the training of officers was varied. Calisthenics, sick call, sanitary inspections, field work, classroom work, and lectures were a part of each day’s schedule.

Division surgeons kept in close contact with the units by frequent conference with all medical officers in order that developing problems might be solved and uniformity in training attained so as to insure proper coordination in the function of regimental detachments with the units of sanitary trains. Officers were given detailed theoretical and practical instruction in the methods of sanitary control, a complete sanitary inspection of every unit area being made each day by the medical officer selected, who made a report and recommendations to the division surgeon. Lectures were conducted 10 hours a week in some divisions (at night) where courses in Army Regulations, organization, tactics, and technique of the Medical Department, administration and sanitary tactics were developed. Papers on medico-military subjects of special importance with relation to war were read, analyzed, and discussed.

Without warning, regimental detachments or units of the sanitary train were called out and required to march with full impedimenta and to establish their stations at points designated on maps by the division surgeon. Drill schedules were outlined by the senior medical officer, and subordinates were made responsible for the execution of them. Medical officers were required to make themselves proficient in all forms of Medical Department drill, and later to operate their detachments on the field under as nearly actual conditions as they would exist in combat. They were instructed in trench warfare, approach of trenches, approved methods of evacuating the wounded in conjunction with ambulance dressing stations and field hospitals. The following is an example of a schedule of instruction for the medical officers of a division:


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Schedule of training for officers, Medical Department


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Schedule of training for officers, Medical Department - Continued.


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Schedule of training for officers, Medical Department - Continued.


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Schedule of training for officers, Medical Department - Continued.


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Schedule of training for officers, Medical Department - Continued.


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Schedule of training for officers, Medical Deparment - Continued.


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Schedule of training for officers, Medical Deparment - Continued.


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Schedule of training for officers, Medical Deparment - Continued.


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Schedule of training for officers, Medical Department - Continued.


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Schedule of  training for officers, Medical Department - Continued.


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SPECIAL TRAINING FOR OFFICERS

  Instruction of medical officers of the divisions in the professional branches was generally received in the regular courses of lectures, clinics, and conferences carried out in the cantonment base hospitals as directed by the Surgeon General for all medical officers of the campus.

IN ORTHOPEDIC SURGERY

Instruction in orthopedic surgery and the care of the feet was carried out in divisions in compliance with directions from the Surgeon General. This instruction was not confined to the personnel of the division while it was in process of organization and training in cantonments, but included the training of all personnel in the camp, including that in base hospitals. The following is an example of a plan for instruction of division personnel by the division orthopedic surgeon, in compliance with War Department General Orders, No. 133, dated October 11, 1917: Medical officers were divided into two or three groups by the division surgeon, each group being given three lectures. As there were between 50 and 75 medical officers in a division, this instruction was readily and quickly accomplished, usually in connection with the division school. It is important to remember in this connection that the orthopedic surgeon was endeavoring to instruct general practitioners, and all material given them was of the simplest, plainest, and most practical character; all technical language and matters were eliminated from the lectures.

IN GAS DEFENSE

  A school of gas defense was established in each divisional camp or cantonment in the United States. The director of this school was a medical officer, who had as assistants one chemist and one noncommissioned officer of the Medical Department. All officers and enlisted men in the divisions and camps were required to take the course of instruction in these schools. 10

On February 27, 1918, gas defense training activities were transferred to the Engineer Corps,11 and in April, 1918, the Adjutant General ordered the relief of all Medical Corps division gas officers and their replacement by Sanitary Corps officers who had been transferred to the Engineer Corps.12

TRAINING FOR ENLISTED PERSONNEL

From the first physical training was given priority on the schedule of instruction of enlisted men, special attention being given to exercises intended to test and develop alertness and attention to orders. Training was made progressive, beginning with physical exercises accompanied by instruction in school of the soldier, military courtesy and bearing, elaborated to the development of the individual’s ability to function in the tactical operation of regimental detachments and units of the sanitary trains.

Independent maneuvers were conducted which developed the operation of all units of the Medical Department serving with the division. Medical detachments were required to participate in regimental parades and all other regimental ceremonies. Reveille and retreat formations were made a part of the daily routine, complete inspections being made as to general appearance, equipment, and soldierly bearing.


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In many of the divisions, at least twice or three times a week, all divisional medical units were trained on a common drill ground. By this action the comparative progress of the units of the divisional sanitary service could be observed, and training could be modified or elaborated so as to assure knowledge of the operation of the combined units of the Medical Department and coordination of action. In addition, detachments accompanied their respective line organizations to the training field, where they carried out the prescribed schedule of instruction, rest periods being given over to instruction in first aid, venereal diseases, and personal hygiene.

When units of the divisions occupied the trenches for special instruction, the medical detachment attached thereto accompanied them, to establish aid stations and conduct training simulating trench warfare conditions.

In general there developed basic and special individual instruction which was elaborated into definitive training in the function of units of the sanitary service with organizations. This scheme as a whole was based on the intensive instruction of the individual followed by the application of the individual knowledge in the development of organization efficiency, so as to evolve thoroughly trained and coordinated sanitary services with divisions.

The following outline 11 and schedule 14 are given as an example of the instruction carried out for the enlisted men by a division during the fall and winter of 1917-18.

OUTLINE OF BASIC INSTRUCTION FOR ENLISTED PERSONNEL AND SUBJECTS COVERED

ANATOMY AND PHYSIOLOGY
 
I.  THE SKELETON AND JOINTS

Give strength and form; protect organs; joints permit motion.
(a) BONE (discuss the subheads briefly):
Composition. - One-third animal (gelatin); two-thirds mineral (lime); animal--toughness and elasticity; mineral--hardness.
Periosteum. - Bone covering; vascular membrane; provides nourishment; when stripped off, bone dies.
Cartilage or gristle. - Elastic substance; ends of long bones; ribs to breast bone.
Classification. - Long; short; flat; irregular, long hones, system of levers, support weight, provide locomotion; short bones, strength and limited motion; flat bones, skull, protection; irregular bones, pelvis.
Vertebral column or spine - Buffers or pads of elastic cartilage; distribute shock; 7 cervical; 12 dorsal; 5 lumbar; 5 sacral; 4 coccyx; bony canal--contains spinal cord.
Pelvis. - Sacrum; coccyx; innominate bones, contents of.
(Four hours.)
   (b) JOINTS (discuss the subheads briefly):
Synovial membrane - Description of.
Ligaments - Description of.
Classification of joints - Ball-and-socket; hinge; sutures.
Dislocation - Slipping away of joint surfaces from each other, so that they may remain out of place.
Hip joint. -
Pelvis; femur.
Knee joint. - Femur; tibia; patella.
Entire bone system. - Tibia; fibula; ankle joint; tarsus; metatarsus; phalanges; ribs, 7 true, 5 false, 2 floating; breast bone or sternum; clavicle; scapula; shoulder joint; humerus; elbow joint; radius; ulna; carpus; metacarpus; phalanges; skull; number and location of permanent teeth.
(Four hours.)


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 II.THE MUSCLES, CELLULAR TISSUE, AND THE SKIN

(a) MUSCLES (discuss the subheads briefly):
  Function. - To contract and thereby move the various parts and tissues of the body. (Reason for splints on fracture.) Differentiate between contraction and retraction.
  Kinds. - Voluntary; involuntary.
  Actions or movements. - Flexion; extension; pronation; supination.
  Rigor mortis. - Change in muscles by which they become rigid.
  (Two hours.)
  (b) CELLULAR TISSUE (discuss the subheads briefly):
  Fat. - Is the padding.
  Structure. - Connective tissue spongy.
  (One hour.)
(c) SKIN. - Tough elastic membrane covering the entire body; sweat glands; sebaceous glands; purpose.
(One hour.)

  III. THE NERVOUS SYSTEM AND SPECIAL SENSES

(a) NERVOUS SYSTEM (discuss the subheads briefly); sympathetic system:
  Parts. - Brain; spinal cord; nerves; also have sympathetic system.
  Brain. - Location; divisions of.
  Spinal cord. - Location; functions.
  Nerves - Sensory; motor.
  Special senses. - Touch; taste; smell; hearing; sight; the organs which accomplish same.
  (Two hours.)

  IV. THE DIGESTIVE APPARATUS
 
(a)  FOODS:
Foods. - Proteids; fats; starches and sugars; minerals.
Proteids. - Muscle builder; blood builder; give force and heat.
Starches and sugars. - Convertible into heat and work; make fat.
Minerals. - Water is a solvent; salts; bone.
(One hour.)
(b) DIGESTIVE APPARATUS:
  Mouth. - Mastication of food; mixing with saliva; no digestion except slight conversion of starch into Sugar; saliva comes from salivary glands; parotid; submaxillary; sublingual; mumps.
  Pharynx and esophagus. - For swallowing and conveying food to stomach.
  Stomach. - Muscular bag; opens into small intestine.
  Small intestine. - Five feet in length.
  Vermiform appendix.
  Rectum.
  Anus.
(Two hours.)
   (c) OMENTUM:
  Umbilicus. - Location of; what for.
Gall bladder. - Location of; what for.
Gall. - What is it?
Sweetbread or pancreas.
Liver. - Function.
Spleen. - Function.
(One hour.)

  V. THE BLOOD AND THE CIRCULATORY SYSTEM

   (a) LYMPHATIC AND BLOOD VESSEL SYSTEM:
Lymph glands. - Inguinal; epitrochlear; post cervical.
Blood and blood vessels. - Functions, receive from lungs and alimentary tract, carry to the body materials for nutrition, temperature and moisture, carry away waste or poisonous matters; appearance and composition, red, bright red in arteries, dark red in veins, cells, liquor sanguinis.
(Three hours.)


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Heart. - Cavities; arteries; capillaries; veins (draw a schematic diagram of blood circulation); aorta; innominate; left common carotid; left subclavian; carotid and right suhclavian; brachial; radial; ulnar; common iliac; internal and external iliac; popliteal; anterior and posterior tibial (illustrate by showing where to make pressure for hemorrhages).
(Three hours.)

VI. THE RESPIRATORYAPPARAflJ5

   RESPIRATORY APPARATUS. - Larynx or Adam’s apple; epiglottis; trachea or windpipe; right and left bronchus; lungs; air cells; respiration; inspiration; expirational necessity of ventilation; sweat or perspiration.
(Two hours.)

  VII. THE EXCRETORY APPARATUS

URINARY APPARATUS. - Kidneys; ureters; bladder; urethra.
(One hour.)

  FIRST AID

 I. EMERGENCIES, CONTUSIONS AND WOUNDS

(a) EMERGENCIES - Bleeding; shock; wounds; fractures.
  (b) CONTUSIONS. -  "Subcutaneous wound”; symptoms; treatment; shock, symptoms and treatment.
  (Eight hours.)
  (c) WOUNDS. - Division of skin and tissue; classes, incised, lacerated, contused, punctured, poisoned, gunshot wounds; granulation; suppuration; inflammation; septic infection; treatment, arrest hemorrhage, relieve shock, prevent infection (first-aid packet); local wounds of skull, chest, abdomen, bladder; poisoned wounds; bites; rabies; tetanus; anthrax; poisoned arrows.
  (Eight hours.)

The close contact of well constructed and protected opposing trenches, the development of the hand grenade, bomb, high-explosive shell, shrapnel, machine gun, and asphyxiating gas have all combined to greatly limit the usefulness of the rifle.

The use of the bayonet in Carrying a position has been a weighty factor during the operations of the present war. The French bayonet, which is triangular on Cross section, needledpointed, fluted, and with one or more cutting edges, is Considerably longer than any of the other bayonets. The English bayonet and that of the continental armies is a knife bayonet, which takes the form of their respective hunting knives.

Rifle
balls. - There are a number of factors which have a bearing upon the character of the wound inflicted by the cylindro-ogival rifle ball, of which the German ball S is a type. If the soft parts only are involved, the wound of entrance and channel are of the same size as tile undeformed bullet. At close range the wound of exit is larger. This is due to the inability of the tissues to spread or separate quickly enough to allow the high-velocity bullet to make a channel without pushing some of the tissue it traverses ahead of it, and only when compact bone is in its path does it cause comminution, and the smaller bony fragments act as secondary missiles.

Grenades. -
They may be thrown by the hand or rifle. The German grenade is composed of a copped rod, to the extremity of which is fixed a Cast-iron cylinder filled with a high explosive and grooved in order to facilitate breaking. It usually fires by percussion. By hand it is used for short distances; with the rifle it has a maximum range of 400 meters. Grenade wounds, besides the usual great destructive effects, are always infected wounds. The “minenwerfer,” or trench mortar, first introduced by the Germans in the early fightilig around Ypres, is another means of hurling a large amount of high explosive into an opposing trench. It throws a shell of about 180 pounds a distance of 350 yards.

The machine
gun. - There is no difference in the actual effect of a ball from these and from the rifle.

Shrapnel. -
Is being used less and less, the high-explosive shell being considered much more effective, both on account of effectively sweeping a larger area and on account of the fact that in the vicinity of the explosion air vibrations alone are sufficient to cause instant


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death. The death from these shells, without any apparent wounds, has remained a mystery. It is probably due to the fact that in the immediate vicinity of the explosions there is a sudden atmospheric depression to the extent of about 350 millimeters of the mercury tube, corresponding to a dynamic pressure of about 10 tons to the square yard. The men exposed to this violent change meet with conditions similar to the men who leave compressed air chambers without taking the proper precautions, the effect being to liberate nitrogen suspended in the blood and to transform it into bubbles of gas. These are transferred by the action of the heart into the capillary vessels, stopping the circulation of the blood in the vital centers and causing instant death. On the other hand, some of the causes of these deaths, without apparent wounds, may be due to the blow the body receives from the primary violent air impact delivered as a blow over one side of the body and especially over the heart, causing reflex actions that register themselves with a fatal effect.

II. HEMORRHAGES

  (a) CAPILLARY HEMORRHAGE. - Treatment; nose bleed.
   (b) VENOUS HEMORRHAGE. - Treatment.
   (c) ARTERIAL HEMORRHAGE. - Character treatment; points of pressure for different arteries; tourniquet; pads; bleeding from lungs, stomach, bowels--symptoms. Treatment--absolute quiet, cold applications.

III. DISLOCATIONS AND SPRAINS

(a) DISLOCATIONS. - Definition “out of joint”; ligaments torn; cause; symptoms— deformity, shortening of limb, lack of movement (unnatural movement in fractures). Treatment—reduction, support. Special dislocations—shoulder, anterior and posterior dislocations of the thigh; symptoms, treatment, Kocher’s method, after-treatment; jaw, symptoms, treatment, after-treatment; finger joints, treatment; patella, symptoms, treatment.
  (Two hours.)
  (b)  SPRAINS - Nature; symptoms; treatment; special sprain--ankle, symptoms, treatment, hot water, cleanse and strap, bandage, shoe, walking, massage.

 IV. FRACTURES

  (a) FRACTURES. - Definition classification--simple compound, comminuted, complicated, green stick; symptoms--loss of power, unnatural movement, crepitus, pain, swelling; treatment--Put parts in place, hold them still with splints; setting; extension and counter-extension; bandages (not too tight), splints; purpose, kinds, extemporized splints; padding; support; “knitting” of bones. Effects of too tight bandaging on splints.
   (Two hours.)
(b) SPECIAL FRACTURES:
Skull. - Cranium, base, special symptoms; special treatment.
Spinal column. - Special symptoms; special treatment.
   Ribs. - Special symptoms; special treatment.
   Pelvis. - Special symptoms; special treatment.
   Nove. - Special symptoms; special treatment.
   Mandible. - Special symptoms; special treatment.
   Clavicle. - Special symptoms, attitude, special treatment, pad in axilla, Sayre’s strapping or Velpeau bandages.
  Humerus. - Special symptoms; special treatment; slings, sling.
  Forearm. - Special symptoms, special treatment, position of arm, splints, radius (Colles’s fracture), symptoms, put in sling, leave for surgeon.
  Metacarpals and flngers. - Splints, bandage.
Femur. - Special symptoms--eversion, shortening, special treatment--setting, extension, counter-extension, splints and padding, method of application, splints tied in 5 places, tie legs together.
Patella. - Special symptoms; special treatment--splints, figure-of-eight bandages.
Leg. - Both bones, special treatment--splints.


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Leg. - Both bones, special treatment--splints, tie legs together; fibula, Pott’s fracture, special treatment--splints (2); tie legs together.
Foot. - Plaster of Paris dressing.
(Eight hours.)

V. FOREIGN BODIES

In the eye. - Eversion of lids, removal of object, use of burned match.
In the ear. - Animal or mineral, water and syringe; vegetable, use wire, keep end of it in sight; wax, use soda solution and syringe, alcohol and boric acid to dehydrate.
In the nose. - Treatment; maggots, treatment--chloroform followed by syringing with warm salt solution.
In the throat. - Use forceps or dry bread or induce vomiting.
In the air passages. - Mention tracheoscopy.
In the stomach. - Mention esophagoscope. Open operation; use of X ray.
In the skin. - Splinters; needles, fishhooks; gunpowder.
(One hour.)

VI. EFFECTS OF HEAT AND COLD
  
(a) HEAT:
Heat stroke. - Cause, contributing factors, symptoms, treatment, effects.
  Heat exhaustion - Symptoms, treatment.
  Burns. - Degrees--first, redness; second, blisters; third, charring; symptoms--shock, chili, pain; dangers from burns of first, second, and third degrees; open treatment, paraffin wax R; treatment of first degree--soda, oil; of second and third degree--protection from air, prevention from infection, relief from shock, care of blisters; general treatment. 
  In the present war, flame projectors are used for throwing burning liquids or gases. The effective range is about 30 meters. The burns caused by this method are of the deep, sloughing variety, exposing tendons and bones, and are treated with wet dressings until healthy granulations appear. These flame projectors are mainly employed in street and house-to-house fighting, although they have been used in the trenches.
  Burns from acids. - Treatment.
  Burns from alkalies. - Treatment.
  Clothing on fire. - Action to be taken.
(Four hours.)
(b) COLD:
   Freezing. - Local effects; general effects; treatment--rubbing with cold cloths in cold room, artificial respiration, warm drinks when the patient can swallow.
    Frostbite. - Nature; symptoms; danger; treatment.
  Chilblain. - Nature, cause; symptoms; treatment; prevention--woolen socks.
   (Four hours.)

 VII. INSENSIBILITY

(a) FAINTING . - Cause--mental; contributing causes--bleeding; exhaustion; symptoms--skin, face, pupils, breathing; treatment--position clothing, stimulants.
  (b) SHOCK. - Cause--physical; symptoms--skin, face, pupils, breathing, pulse, temperature; injuries causing it; treatment--local, stop hemorrhage, general warmth.
(Four hours.)
(c) CONCUSSION OF BRAIN. - Cause; nature; symtoms--mental, pupils, breathing, pulse, treatment--rest, warmth, ammonia.
  (d) COMPRESSION OF BRAIN. - Cause; nature; apoplexy; some paralysis; treatment raise bone, stop bleeding.
  (One hour.)
  (e) LIGHTNING STR0KE. - Effects; treatment--artificial respiration, symptomatic treatment. Electric shock--break the circuit, using dry clothes, stick or rope; treat as for lightning.
  (f) ACUTE ALCOHOLISM. - Symptoms--mental, face, eyes, pupils, temperature, breathing, pulse, no paralysis (distinguish from apoplexy); treatment--induce vomiting, cold to head, warmth to body, warm drinks, sleep. Very important to distinguish from skull fracture.


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(g)EPLEPSY. - Severe type; symptoms--cry, fall without knowing that he is falling, rigidity, convulsions, stupor, sleep, pupils, tongue, bladder, bowels, no paralysis; treatment--protect tongue by twisted handkerchief in mouth; feigned epilepsy; note time of occurrence, tongue not hurt in falling, pupils normal, eyeballs sensitive, soap in mouth, pail of water thrown on patient helps distinguish.
  (One hour.)
  (h) UREMIC COMA. - Distinguish from skull fracture.
  (i) OPIUM P0ISONING. - Symptoms--mental, pupils, breathing, (8-10) pulse; treatment--induce vomiting, permanganate of potassium, coffee, pain, movement to prevent sleep.
  (One-quarter hour.)

VIII. ASPHYXIA

ASPHYXIA. - Definition; modes of occurrence; treatment--removal of the cause, artificial respiration (Shafer’s method) (have the class do it properly). Drowning; treatment--get rid of the water, artificial respiration, restore heat, stimulate circulation, prevent complications. (N0TE.--Only Schafer’s method of artificial respiration correctly done will be used.)
  (One-half hour.)

IX. POISONING

(a) POISONS TAKEN INTERNALLY:
General treatment. - Empty stomach; emetics--warm water, salt, mustard, tickle throat, wash stomach; antidotes given immediately after emetic--general, tea, milk, special, taken up later on; relieve pain--oils, milk, morphine; counteract lethal tendency--shock, stimulants, warmth, rubbing; failing heart--hot coffee, strychnine; failing respiration--coffee, cold douche, artificial respiration; convulsions--chloroform, bromides.
Summary. - If you do not know what poison: (1) If lips and mouth are burned, no emetics, olive oil, rest, morphine, mustard plaster over stomach, counteract symptoms. (2) If lips and mouth are not burned, emetic, three raw eggs, milk or flour and water, hot tea; rest, counteract symptoms. If you know the poison, emetic, appropriate antidote, relieve pain, counteract symptoms. (3) A good antidote, when in doubt, is Haines Universal Antidote, equal parts of heavy calcined magnesium oxide, animal charcoal, tannic acid. Keeps well when dry for a long time.
Classiflcation. - Caustics: Symptoms--primary effects, remote effects; burns on lips, pain, bloody vomit, with shreds of stomach lining; treatment--no emetic, neutralize poison, acids or alkalies, protect mucosa by oils, milk, relieve pain, carbolic acid.
Irritants of alimentary canal: Arsenic, corrosive sublimate, etc. Primary and remote effects.
Neurotoxic, acting primarily on the central nervous system: Opium, strychnine, belladonna, atropine, phosphorus: primary and remote effects.
Asphyxiating gas, chlorine, or bromine gas, compressed to liquid form and liberated from large metal tanks when the wind is blowing toward an opposing trench, has caused very distressing deaths when inhaled in concentrated form. Being heavy gasses, they hug the ground, moving to leeward, and sink into the trenches, there causing a violent irritation of the bronchial tract, with a hypersecretion of a thin water mucus which fills up the air spaces of the lungs and practically causes death from drowning. The protection from this is the prophylaxis in the form of a protector helmet, with a solution of hyposulphite and bicarbonate of sodium. The only form of gas which the present British masks will not protect from is the poisonous carbon-monoxide. This is an active poison, and when it is inhaled it unites with the hemoglobin of the blood.
(Four hours).
  Special poisons. - Carbolic acid; symptoms; treatment--sulphates, albumen, emetics; teach men that one emetic nearly always available when no others are at hand and almost always effective is tepid (not hot or cold) dish water; artificial respiration, warmth, rubbing.
Opium; symptoms; after effects; treatment--emetic, permanganate of potassium, coffee, prevent sleep.
Wood alcohol; symptoms; after effects; treatment--emetics, enema, strychnine, artificial respiration, warmth.


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Ptomaines; nature, symptoms; treatment--emetics, cathartics, relieve pain, stimulants, warmth. Etiology--nearly always bacteriological.
Chloral--“knockout drops”; symptoms; treatment--emetics, strychnine, coffee, rest, prevent sleep.
Arsenic--’”Paris green”; symptoms; treatment--emetics, freshly prepared iron hydrate (tincture of iron and dilute ammonia), morphine, warmth, rubbing, magnesium oxide.
Corrosive sublimate; symptoms; treatment--three raw eggs or milk, emetics later, mnorphine, bland drinks, warmth, rubbing.
Silver nitrate; treatment--salt and water, tickle throat.
Phosphorus (matches); antidote--potassium permanganate solution may be used.
Strychnine; symptoms; treatment--emetics, chloroform or bromides.
(Two hours.)
(b)  EXTERNAL POISONS:
Special poisoning.
Poison ivy. - Three leaflets, hairy stem, white berries; symptoms; treatment--wash with alcohol, later with soda solution.
Poison oak. - Three leaflets notched, downy under surface; symptoms; treatment--wash with alcohol, later with soda solution.
Poison sumach. - White berries (ordinary sumach has red berries); symptoms; treatment--wash with alcohol, later with soda solution.
Snake bite. - Nature of venom, treatment, etc.
(One hour.)

NURSING

I. EXTERNAL POISONS

  (As each is taken up, give examples of where they are used)

(a) HEAT. - (1) Dry heat--means, method of using, precautions. (2) Moist heat-- poultices, methods of making and application; fomentations or stupes, methods of application; sweat tent. Method of testing temperature.
(b) COLD:
Compresses - Method of making and application.
Ice bag - Method of making and application.
Ice water coils. - Method of making and application.
(c) LOTIONS, MEDICATED (two hours).
(d) COUNTERIRRITANTS. - Indications and use:
Rabefacients. - Mustard plaster--method of making and application (no hot water or vinegar); turpentine stupes; iodine; liniments and massage; cupping dry and wet.
Blisters. - Cantharides, collodion, or plaster--method of application, chloroform or ammonia covered; actual cautery use.
Caustics. - Silver nitrate--before using, clean on wet lint. Copper sulphate--for application to eyelids, rub crystal on fine stone to produce fine point. Nitric acid--method of application; used for disinfecting chancroids.
(Two hours.)

II. TEMPERATURE, PULSE, RESPIRATION

(a) TEMPERATURE. - Different at different times; limits.
Normal. - Method of taking--thermometer, self-registering maximum, Fahrenheit scale, method of standardizing; method of use.
Subnormal. - Cause.
Fever. - Danger point; moderate; high; very high; continued; remittent; intermittent. Fever charts.
(One hour.)
(b) PULSE. - Method of feeling; normal pulse--frequency, regularity, fullness, tension, strength, intermittence; effect of--food excitement, etc.; irritable; dicrotic; intermittent (one hour).


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(c) RESPIRATION. - Method of taking without knowledge of patient; normal rate; frequency; regularity; easy or difficult; quiet or noisy; deep or shallow; symmetrical. Slow and shallow in narcotic poisoning, etc. Rapid in pneumonia, peritonitis, etc. Cheyne-Stokes respiration; nature; occurs in heart and kidneys disease. “The lamp tends to flicker when going out.” Stertorous breathing. Dyspnea. Relation of pulse, temperature and respiration (one hour).

III. BANDAGING

(a) TRIANGULAR BANDAGE. - Application.
(b) ROLLER BANDAGES. - Material sizes; preparation.
Rules for use. - (1) Limb in position it is to occupy; (2) begin at extremity of limb; (3) put a layer of cotton between opposed skin surfaces; (4) hold the roller in right hand to hind the left limb, and vice versa; (5) place the outer surface of bandage on inner side of limb and secure by two circular turns; (6) bandage evenly. Do not bandage too tight. (If the blood when pressed out from under nails does not promptly return, the bandage is too tight.)
Circular turns. - Spirals; reverses; figures-of-eight; spica; knotted turn.
Special application of roller bandages. - (1) Recurrent of head or stump; (2) figure-of-eight, of eye or jaw; (3) spiral of chest; (4) Velpeau for fractured clavicle; (5) finger bandages; (6) foot bandages.
(c) TAILED BANDAGES.
(d) T BANDAGES.
(e) STERILE GAUZE BANDAGE.
(f) FLANNEL BANDAGE.
(g) RUBBER BANDAGES. - Care; method of washing; method of application; use as a tourniquet.
(h) PLASTER OF PARIS BANDAGE. - Method of preparing; method of applying (strip of tin); method of removing.
(Two hours.)

HYGIENE

I. INFECTIOUS DISEASES
  (Brief, general discussion of the bacteria. Avoid symptoms of diseases)
  
Typhoid fever. -
Cause; dissemination--infected foods, polluted liquids, fecal matter and urine infection; always present in person of carriers (proportion of 1 to 1,000 in mobilization eainps) contact infection--milk, food, flies (direct carriers and through fecal matter); prophylaxis, immunization; segregation; urine tubs.
Paratyphoid fever. - Take up under same heading as typhoid.
Diarrhea and dysentery. - Fifty-seven thousand two hundred and sixty-five deaths in the Federal armies; simple diarrhea, fermentative or putrefactive; amoebic dysentery; bacillary dysentery.
Cholera. - Method of transmission; prophylaxis (four hours).
T uberculosis. - Everyone infected in childhood; acquired immunity; activity caused by breaking down of resistive power; mode of infection; prophylaxis--fresh air.
Pneumonia. - Avoid vitiated air. Best precaution good ventilation (two hours).
Malaria. - Results only from mosquito-bite method of infection--salivary glands; prophylaxis; destruction of mosquitoes; protection against bites; isolation and protection of malarial patients; medical prophylaxis.
Yellow fever. - Mosquito; prophylaxis.
Dengue. - Break-bone fever; mosquito (two hours).
Typhus fever. - Body louse--in clothing, not on person. Plague; Pulex cheopis - rat flea (two hours).
Spinal meningitis. - Transmission; prophylaxis (two hours).
Smallpox. - Transmission prophylaxis.
Scarlet fever. - Transmission; prophylaxis.
Measles. - Transmission; prophylaxis.
Mumps. - Transmission; prophylaxis (two hours).


331

Tetanus or lockjaw. - Frequency in Europe; injections in first-aid stations of all wounded; transmission; prophylaxis.
  Gas gangrene. - Frequency; cause; prophylaxis (four hours).
  Bubonic plague. - Rat; rat flea.
  Intestinal parasites. - Brief discussion of teniacycle and prophylaxis.
  Skin parasites. - Barbers itch; dhobie itch (two hours).
  Relation of insects to infection. - Flies, fleas, mosquitoes, lice, ticks (two hours).

II.  DISEASES CAUSED BY IMMORAL OR INTEMPERATE HABITS

Venereal diseases. - Gonorrhea; syphilis--stages of, with brief talk of remote effects; chancroid; transmission. Prophylaxis: (1) Moral teaching, the fundamental teaching of all home and school education; (2) sexual intercourse is not necessary to attain the best physical and mental health and that a strong manly character is developed only by self-control and continence. Appreciation of the prevalence and gravity of venereal diseases is essential. One-third of all prostitutes are suffering from some form of them in the infectious stage. Thirty-three per cent of all syphilitics eventually die of tuberculosis, paralysis, or aortic aneurysm. (Explain terms used.) The sinister predilection of tertiary syphilis for the nervous system is well known. Avoid thoughtless exposure; a few days in the hospital will not suffice to cure the disease. Syphilis affects not only the incontinent, but through matrimony many innocent women and children. Speak of the far-reaching effects on female genital organs. (3) All efforts to abolish prostitution have been futile. The strong hand of the military should be exerted to protect camps and garrisoned cities. (4) The life of the soldier in the garrison and camp should be made as attractive as possible. Post exchange with recreation features should be provided. (5) Systematic physical inspection of the men. Men found suffering from some venereal disease should be treated and strictly confined to their post. (6) Men contracting any form of disease after sexual intercourse should report as soon as first symptoms manifest themselves, so that they can be treated before complications arise. (7) Personal prophylaxis is not only advisable but also desirable, inasmuch as the influence of fear is a factor of slight importance in deterring.

Place special stress on (1) moral aspects, (2) continency, (3) venereal prophylaxis, (a) reasons for, (b) how it prevents, (c) time limit for use (six hours).

III. PERSONAL HYGIENE

Bathe and wash the skin. - (1) To promote and stimulate its functions; discuss. (2) To remove dirt and prevent the breeding of germs on its surface. (3) To prevent the fouling of the air by emanations; discuss. (4) For the tonic stimulating effects which cold water produces.
Daily toilet. - Wash face, neck, head, and hands and arms each morning. Do not use soap in the scalp more than twice weekly. Wash hands whenever soiled, before meals. Use neutral soap; explain. The teeth demand special attention. Nostrils. Ears. Hair. Feet, wash daily on the march. Drinking cup, danger of common cup. Baths at least twice weekly. Must wash hands after each visit to the latrine (four hours).

 IV. WATER

Rain, river, lake, and spring. Hard and soft water--what is meant.

  V. WATER PURIFICATION

Heat; chloride of lime; water filtration; calcium (or sodium) hypochlorite (1 hour).

 VI.FIELD COOKING AND BAKING

  The lecture will be illustrated by the preparation of one of several components of the rations on the field range (four hours).

 VII. CLOTHING AND UNIFORM

  Permeability - discuss; hygroscopicity; discuss advantages of wool; heat absorption; colors; head radiation; heat conductivity; evaporation (one hour).


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VIII. EQUIPMENT

 General requirements. - (1) Minimum weight; (2) proper suspension and distribution; (3) facility of putting on and removing; (4) easy segregation and removal of unecessary parts for fighting and marching; (5) simplicity of construction and ease of repair; (6) sanitary construction. Illustrate with soldier in full pack with new equipment (two hours).

 IX. AIR

Composition - oxygen, nitrogen, argon. Oxygen indispensable to the maintenance of life. Nitrogen inert gas.

 X. VENTILATION

  Cause of air contamination; dust; nature of ventilation; natural ventilation--diffusion of gases, action of wind, and thermal circulation; artificial ventilation (very brief); relation of l)ad ventilation in barracks to disease among soldiers (one hour).

 XI. EXCRETA, GARBAGE, AND WASTE

  Latrines. - Construction of; reasons for; types--trenches; latrine box; police and disinfection of each; sites, relation to civil population. Illustrate types of latrine by schematic drawings and construction (three hours).
   Final disposition of feces and garbage. - (l) Discharge into sea, lake, or river; (2) biological treatment; (3) local treatment: (a) Incinerators, types, construction of; reasons for (take this up first); (b) dead animals (two hours).

  XII. SOILS

Ground air
(brief).
Ground moisture (brief).
Ground temperature (brief).
   Influence of vegetation in soil.
Pollution and soil bacteria.
(One hour.)

XIII. CAMPS

Selection of site. - Soil; vegetation; exposures; wood; water; grass; poisonous plants; venomous animals (one hour).
  Tents. - Shelter; wall; pyramidal; hospital; illustrate by pitching or seeing pitched (seven hours).
  Form of camp. - Make schematic drawing on board of camp of unit or detachment (one hour).

XIV. DISINFECTION AND DISINFECTANTS

Air and light.

Heat - Steam; dry.
   Chemical disinfectants . - Gases--chlorin, SO2, formaldehyde, paraform.
   Disinfecting agents in solution or powder. - Bichloride of mercury; mineral acids; formalin; carbolic acid; cresols; chloride of lime; quicklime.
   (Two hours.)

XV. GENERAL SANITARY RULES

(1) Food - sufficient, wholesome, varied, well cooked.
(2) Prohibit sale of food and drinks by hucksters; no food in tents.
  (3) Prevent contamination of water supply.
  (4) Great concentration of troops should be avoided.
  (5) Personal hygiene; cleanliness of body and clothing; fight with empty bowels and bladder.
  (6) Latrines.
  (7) Do not forget the role of flies and mosquitoes in transmission of disease.
  (8) Cleaning, policing, and disinfection of camp grounds.
  (9) Move camp location if practicable.
  (Eight hours.)


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XVI.

  Model sanitary divisional order (see General Order No. 7, headquarters 89th Division, September 11, 1917).

XVII.

Work in orthopedics. -
Care of feet. (One hour once a month under the direction of the orthopedic surgeon; three hours.)


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Schedule of training for enlisted men, Medical Department


335

Schedule of training for enlisted men, Medical Department - Continued.


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Schedule of training for enlisted men, Medical Department - Continued.


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Schedule of training for enlisted men, Medical Department - Continued.


338

Schedule of training for enlisted men, Medical Department - Continued.


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Schedule of training for enlisted men, Medical Department - Continued.


340

Schedule of training for enlisted men, Medical Department - Continued.


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Schedule of training for enlisted men, Medical Department - Continued.


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Schedule of training for enlisted men, Medical Department - Continued.


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TRAINING FOR DENTAL CORPS

The personnel of the Dental Corps received its basic training in conjunction with the personnel of the Medical Department as a whole. The program for the professional training of dental officers in the subjects pertaining to that corps was prepared under the direction of the division surgeon by the supervising dental surgeon of the camp, and he was held responsible for this special training not only of personnel of the division but for all dental officers of the camps.15

TRAINING FOR VETERINARY CORPS

One of the general duties of veterinary officers during the World War was the training of personnel under their command with regard to their professional and military duties and responsibilities.16 Prior to February, 1918, a number of division veterinarians organized schools of instruction for veterinary personnel. In some instances these were included in the general scheme of divisional schools.17 An example of the work given in this period is found in the course of instruction for veterinary officers and enlisted men of the 40th Division, Camp Kearny, Calif. This course covered a period of 6 weeks, with a minimum requirement of 28 hours’ intensive and thorough training. The course in the use of arms was not given because arms were not available.17

OFFICE OF THE DIVISION VETERINARIAN,
40TH DIVISION
Camp Kearny, Calif., January 26, 1918.

  The following schedule of training in the Veterinary Corps of the 40th Division is hereby announced:

  *  *  *  **  * 
This course is to cover a period of six weeks, with the minimum requirement each week of 28 hours intensive and thorough training.

OUTLINE OF INSTRUCTION

STABLE MANAGEMENT

The men are not to be used for stable police or as general grooms. However, proper and thorough grooming is to be taught in detail.
Stable management is to be given in five lectures.
 
   Lecture 1:
(a) Intent of grooming.
(b) Structure and function of the skin.
(c) Grooming utensils, their use and abuse.
(d) Wisps, how to make and use.

Lecture 2:
(a) Sponges, use and abuse.
(b) Use of thorough grooming and massage, in helping to keep sick animals fit.
(c) Routine of grooming--cleaning of various parts, as body, limbs, head, mane, and tail.
(d)Cleaning the hoof.
(e) Cleaning the sheath.
(f)How to deal with wet and muddy horses.


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Lecture 3:
(a) Hygiene of the picket line and stall.
(b) Mucking out.
(c) Bedding down.
(d) Picket-line burning.
(e) Drainage.
(f) Ventilation in detail.

Lecture 4:
(a) Clothing and bandages for warmth and their proper application.
(b) Clipping--when, how, and why done; advantages and disadantages.

Lecture 5:
(a)  Exercise - 
1.Its necessity in order to maintain health.
    2. Bearing on condition, grooming, and cleanliness.
(b) Proper methods for securing animals on the picket line and in the stable.

FEEDS, FEEDING, AND WATERING (TO BE GIVEN IN FIVE LECTURES)

Lecture 1: (a) Anatomy of the digestive organs.

Lecture 2: (a) Physiology of the digestive organs.

Lecture 3:
(a) Teeth, care and importance.
(b) Relation of amount and kind of food for work demanded.
(c) Kinds of forage, amounts usually given, ratios for various classes of animals at rest and at work.
(d) Proper storage of forage.

Lecture 4:
(a) Nosebag feeding; care of nosebag; dangers.
(b) Making bran mashes.
(c) Use of green feed.

Lecture 5:
(a) Care of feed boxes and mangers.
(b) Watering -
1.Kinds of water,
2. Source of dangers.
3. Care of watering troughs.
(c) Salt.

SCHOOL OF THE TROOPER

Will use Cavalry Drill Regulations, both dismounted and mounted drills, giving particular attention to squad drill, omitting rifle and saber drills, but including pistol drill.

HANDLING ANIMALS AND OTHER POINTS (TO BE GIVEN IN FIVE LECTURES)

Lecture 1:
(a) How to trot a led horse properly.
(b) Restraint - 
1. Use of stocks, switches, and blinds.
2. Casting--use and abuse. Casting rope or harness, hobbles, casting for operation, fixation of limbs when cast.
3. Speculum--examining and floating the teeth.

Lecture 2:
  (a) Passing catheter (mare and horse).
(b) Passing stomach tube (orally and by the nares).
(c) Giving inhalations.
    (d) Giving enemata.

Lecture 3:
(a) Balling.
(b) Drenching--bottle and dose syringe; dangers.
(c) Application of tourniquet.
(d) Blistering and fiding.


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Lecture 4:
(a) Preparation of the field of operation.
(b) Poulticing.
(c) Liniments and other external remedies.
(d) Fomentations of the limbs, chest, belly, and precautions to be taken to avoid chills subsequently.

Lecture 5:
(a) Bandaging - 
1. Making and application of all kinds for warmth, exercise, or surgical use.
2. The bandaging of wounds, joints, and swellings; when and how such should be employed or avoided.
3. Pressure bandages, hot and cold bandages, cloths, and rugs.
 
ARMY REGULATIONS
 
1. Should not neglect “honors, courtesies, ceremonies, etc.”
2. This instruction should also include the major amd important regulations applicable.
 
CARE OF THE SICK AND INJURED (TO BE GIVEN IN FIVE LECTURES)
 
Lecture 1:
(a) Teach routine of observation of cases -
1. Respiration - number per minute, quality, significance.
2. Pulse - number per minute, quality.
3. Temperature - normal Thermometry.
4.  Skin, appetite, feces, urine, etc.
(b) Attention to watering and feeding sick animals.
(c) Provision of head rests when necessary.
(d) Ventilation without drafts.
(e) Cleanliness of bedding.

Lecture 2:
(a) Slings - use, how to be applied, cleaning, prevention of slipping.
(b)  Ambulances - moving horses into and out of.
(c) Care of horses down and unable to rise—
1. Frequent turning and how to do it.
2. Care of bedding to prevent bed Sores.
3. Attention to bowels and urine when doivn.
(d) Cast horses, assisting to rise.

Lecture 3:
(a) Control of hemorrhages; tourniquet, ligature, bandaging, packs, enutery, forceps, medicinal, etc.
(b)  Destruction of animals, humanely and quickly.

Lecture 4:
(a) Skin cases - washing, dressing, and clothing.
(b) Dressing of wounds - cleanliness, antisepsis, etc.

Lecture 5:
(a) Lameness - noting alterations of positions.
(b) Colics - 
1. Use of walking exercises, enelnata, and belly fomentations.
2. Value of recording state of pulse and mouth at intervals.
3. Rectal examination - dangers.
4. Routine emergency treatment and after treatment.
5. Prevention.
 
METROLOGY:  MEASURES OF MASS, CAPACITY, LINEAR MEASURE, AND HEAT (TO BE GIVEN IN FIVE LECTURES)
 
Lecture 1:
(a) Metric system -
1. Derivation of units.
2.Tables.


346
 
Lecture 2:
(a) Avoirdupois system.
(b) Apothecaries’ system -
1. Weight.
2. Capacity.

Lecture 3:
(a) Linear systems in common use.
(b) Domestic measures.

Lecture 4:
(a) Review of lectures 1, 2, and 3.
(b) Thermometers
1. Changing between centigrade and Fahrenheit.

Lecture 5:
(a) Transposing between different systems respective of mass, capacity, and linear.
 
MEDICINAL AGENTS (TO BE GIVEN IN FIVE LECTURES)

Lecture 1:
(a) Drugs, use and abuse.
(b) Those in cornlnon use, actions, dosage.

Lecture 2:
(a) Drugs in common use, dosage, continuation of lecture 1.

Lecture 3:
(a) Poisons, dangerous dosage, antidotes.
  
Lecture 4:
(a) Preparations used in emergency treatments. 

Lecture 5:
(a) Administration of medicines.
 
  DISINFECTION (TO BE GIVEN IN TWO LECTURES)

Lecture 1:
(a) Explanation of terms; disinfectant, antiseptic, contagion, infection, absolute cleanliness, fumigation.
(b) Details of disinfection of buildings, yards, cars, and ships.

Lecture 2:
(a) Official disinfectants.
(b) Strengths and how used.
(c) How to make different percentage solutions.
 
FIRST AID TO THE SICK AND INJURED (TO BE GIVEN IN THREE LECTURES)
 
Lecture 1:
(a) Wounds; varieties and emergency treatments.

Lecture 2:
(a) Continuation of lecture 1.

Lecture 3:
(a) Contagious diseases; described, precautions, methods of dealing with outbreaks, with reasons for each.
 
THE FOOT AND SHOEING (TO BE GIVEN IN FIVE LECTURES)
 
Lecture 1:  
(a) Anatomy of the foot (demonstrate).

Lecture 2:
(a) Physiology of the foot.
(b) Pathology of the foot.

Lecture 3:  
(a) Principles of shoeing.

Lecture 4:  
(a) Accidents and minor diseases of the foot and their first-aid treatment.

Lecture 5:  
(a) Examination of the foot.
 
MANAGEMENT OF ANIMALS (TO BE GIVEN IN FOUR LECTURES)
 
Lectures 1 and 2:
(a) On the march and in camp -
1. Feeding and watering.
2. Protection from weather, clothing.
3. Sanitation of lines and camp.
4. Picketing.
5. Marching of such sick or injured animals as is necessitated.


347
 
Lecture 3:
(a) On shipboard - 
1. Preparation and care of animals during voyage.
2. Feeding and watering.
3. Shipboard sanitation.
4. Exercise.
5. Slinging and other modes of embarking and disembarking, how to swim horses.
6. Diseases.

Lecture 4:
(a) In the hospital.
 
PAPER WORK (TO BE GIVEN IN THREE LECTURES)

Lecture 1:
(a) Letter writing (comp. gen. orders).
(b) Requisitions.
(c) Returns.

Lecture 2:
(a) Descriptive lists of animals.
(b) I. and I. report.
(c) Certificates.
(d) Affidavits.

Lecture 3:
(a) Clinic daybook.
(b) Ledger.

NECROPSIES (TO BE GIVEN IN ONE LECTURE)

Lecture 1:
(a) Precautions.
(b) Methods of making post-mortem examinations.

DISPOSAL OF CARCASSES (TO BE GIVEN IN ONE LECTURE)

Lecture 1:
(a)  Cremation - cross trench and other systems.
(b) Burial - dangers of, proper methods.
(c) Food carcasses - meat inspection.

OPERATIONS (TO BE GIVEN IN ONE LECTURE)

Lecture 1:
(a) Assistance at.
(b) Administration of anesthetics.
(c) Aftercare.

VETERINARY EQUIPMENT (TO BE GIVEN IN TWO LECTURES)

Lecture 1:
  (a) Care.
(b) Packing and unpacking.

Lecture 2:
(a) Pack mule transportation (instruction, with demonstrations, in packing veterinary equipment).

ANATOMY (TO BE GIVEN IN SIX LECTURES)

Lectures 1 to 6, inclusive: Elementary structure of the various organs and parts.

PHYSIOLOGY (TO BE GIVEN IN SIX LECTURES)

Lectures I to 6, inclusive: Functions of the various organs and parts.


348

Lectures 1 to 5, inclusive:
(a)  Transmission of disease.
(b) Common parasites.
(c) Life histories.
(d) Recognition.
(e) Prevention.
(f) Economic importance.
(g) Control.

SCHEDULE OF INSTRUCTION

  FIRST WEEK

Monday:
6 to 6.20 a.m...........................................Physical drill.
7.45 to 9.15 a.m......................................Stable management.
9.15 to 11.30 a.m....................................Feeds, feeding, and watering.
1 to 2 p.m................................................School of the trooper.
2 to 3 p.m................................................Articles of War.

Tuesday:   
6 to 6.20 a.m...........................................Physical drill.
7.45 to 9.15 a.m......................................Stable management.
9.15 to 11.30a.m.....................................Feeds, feeding , and watering.
1 to 2 p.m................................................School of the trooper.
2 to 3 p.m................................................Articles of War.

Wednesday:
6 to 6.20 a.m............................................Physical drill.
7.45 to 9.15 a.m.......................................Stable management.
9.15 to 11.30 a.m.....................................Feeds, feeding, and watering.
Half holiday

Thursday:
6 to 6.20 a.m............................................Physical drill.
9.15 to 11.30 a.m.....................................Feeds, feeding, and watering.
1 to 2 p.m.................................................School of the trooper.
2 to 3 p.m.................................................Army Regulations.

Friday:
6 to 6.20 a.m.............................................Physical drill.
7.45 to 9.15 a.m........................................Stable management.
9.15 to 11.30 a.m......................................Feeds, feedings, and watering.
1 to 2 p.m..................................................School of the trooper.
2 to 3 p.m..................................................Army Regulations.

Saturday:
6 to 6.20 a.m..............................................Physical drill.
8.20 a.m.....................................................Inspection.
Half holiday.

SECOND WEEK

Monday:
6 to 6.20 a.m...............................................Physical drill.
7.45 to 9.15 a.m..........................................Handling animals, and their points.
9.15 to 11.30 a.m........................................Care of the sick and injured.
1 to 2 p.m....................................................School of the trooper.
2 to 3 p.m....................................................Army Regulations.

Tuesday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................Handling animals, and their points.
9.15 to 11.30 a.m........................................Care of the sick and injured.
1 to 2 p.m....................................................School of the trooper.
2 to 3 p.m....................................................Army Regulations.  


349

Wednesday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................Handling animals, and their points.
9.15 to 11.30 a.m........................................Care of the sick and injured.   
   Half holiday.

Thursday:
6 to 6.20 a.m................................................Physical exercises.
   7.45 to 9.15 a.m........................................Handling animals, and their points.
9.15  to 11.30 a.m........................................Care of the sick and injured.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Army Regulations.

Friday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................Handling animals, and their plants.
9.15 to 11.30 a.m........................................Care of the sick and injured.
1 to 2 p.m....................................................School of the trooper.
2 to 3 p.m....................................................Army Regulations.

Saturday:
6 to 6.20 a.m................................................Physical exercises.
8.20 a.m.......................................................Inspection.
Half holiday.

THIRD WEEK

Monday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................Metrology.
9.15 to 11.30 a.m.........................................Medicinal agents.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Tent -pitching drills.  

Tuesday:
6 to 6.20 a.m.................................................Physical exercises.
7.45 to 9.15 a.m............................................Metrology.
9.15 to 11.30 a.m..........................................Medicinal agents.
1 to 2 p.m......................................................School of the Trooper.
2 to 3 p.m......................................................Tent-pitching drills.

Wednesday:
6 to 6.20 a.m.................................................Physical exercises.
7.45 to 9.15 a.m............................................Metrology.
9.15 to 11.30 a.m..........................................Medicinal agents.
Half holiday.

Thursday:
6 to 6.20 a.m.................................................Physical exercises.
7.45 to 9.15 a.m............................................Metrology.
9.15 to 11.30 a.m..........................................Medicinal agents.
1 to 2 p.m......................................................School of the trooper.
2 to 3 p.m......................................................Tent sanitation.

Friday:
6 to 6.20 a.m.................................................Physical exercises.
7.45 to 9.15 a.m............................................Metrology.
9.15 to 11.30 a.m..........................................Medicinal agents.
1 to 2 p.m......................................................School of the trooper.
2 to 3 p.m......................................................Personal hygiene.

Saturday:
6 to 6.20 a.m.................................................Physical exercises.
8.20 a.m........................................................Inspection.
Half holiday.


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FOURTH WEEK

Monday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................Disinfection.
9.15 to 11.30 a.m.........................................First aid.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Veterinary Corps, organization and personnel.

Tuesday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................Disinfection.
9.15 to 11.30 a.m.........................................First Aid.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Paper work.

Wednesday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................First aid.
9.15 to 11.30 a.m.........................................The foot and shoeing.
Half holiday.

Thursday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................The foot and shoeing.
9.15 to 11.30 a.m.........................................Management of animals.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Paper work.

Friday:
6 to 6.20 a.m................................................Physical exercises.
7.45 to 9.15 a.m...........................................The foot and shoeing.
9.15 to 11.30 a.m.........................................Management of animals.
1 to 2 p.m.....................................................School of the trooper.
2 to 3 p.m.....................................................Paper work.

Saturday:
6 to 6.20 a.m................................................Physical exercises.
8.20 a.m.......................................................Inspection.
Half holiday.

FIFTH WEEK

Monday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................The foot and shoeing.
9.15 to 11.30 a.m........................................Management of animals.
1 to 2 p.m....................................................School of the trooper.
2 to 3 p.m....................................................Physiology.

Tuesday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................The foot and shoeing.
9.15 to 11.30 a.m........................................Management of animals.
1 to 2 p.m....................................................School of the trooper.
2 to 3 p.m....................................................Physiology.

Wednesday:
6 to 6.20 a.m...............................................Physical exercises.
7.45 to 9.15 a.m..........................................Necropsies.
9.15 to 11.30 a.m........................................Disposal of carcasses.
   Half holiday.

Thursday:
6 to 6.20 a.m..............................................Physical exercises.
7.45 to 9.15 a.m.........................................Operations.
9.15 to 11.30 a.m.......................................Veterinary equipment.
1 to 2 p.m...................................................School of the trooper.   
2 to 3 p.m...................................................Physiology.


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Friday:
6 to 6.20 a.m.............................................Physical exercises.
7.45  to  9.15 a.m......................................Veterinary equipment.
9.15 to 11.30 a.m......................................Anatomy.
1  to 2 p.m.................................................School of the trooper.
2 to 3 p.m..................................................Physiology.

Saturday:

6 to 6.20 a.m.............................................Physical exercises.
8.20 a.m....................................................Inspection.
Half holiday.

SIXTH WEEK

Monday:
6 to 6.20 a.m...........................................Physical exercises.
7.45 to 9.15 a.m......................................Anatomy.
9.15 to 11.30 a.m....................................Parasites.
1 to 2 p.m................................................School of the trooper.
2 to 3 p.m................................................Physiology.

Wednesday:
6 to 6.20 a.m...........................................Physical exercises.
7.45 to 9.15 a.m......................................Anatomy.
9.15 to 11.30 a.m....................................Parasites.
Half holiday.

Thursday:
6 to 6.20 a.m...........................................Physical exercises.
7.45 to 9.15 a.m......................................Anatomy.
9.15 to 11.30 a.m....................................Parasites.
Half holiday.

Friday:
6 to 6.20 a.m............................................Physical exercises.
7.45 to 9.15 a.m.......................................Anatomy.
9.15 to 11.30 a.m.....................................Parasites.
1 to 2 p.m.................................................School of the trooper.
2 to 3 p.m.................................................Practice walk.

Saturday:
6 to 6.20 a.m.............................................Physical exercises.
8.20 a.m....................................................Inspection.
Half holiday.

Under date of January 30, 1918, the following outline of instruction was sent division veterinarians and veterinarians of auxiliary remount depots:16

SCHEDULE OF INSTRUCTIONS FOR OFFICERS OF VETERINARY CORPS ATTACHED TO DIVISIONS OR AUXILIARY REMOUNT DEPOTS

The course will extend over a period of at least 10 weeks, and should cover the following subjects:

ARMY REGULATIONS

Recitations and practical work in Army Regulations, including muster rolls, pay rolls, correspondence as covered by Army Regulations and General Orders (10 hours).
Customs of the service (2 hours).
Manual of Courts-Martial--recitations and lectures (4 hours).


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Veterinary Service regulations--recitations (4 hours).
Organization of veterinary units (4 hours).
Veterinary hygiene and stable management, feeds and feeding, food values, water supply and water, ventilation, building sites for stables and picket lines, routine stable management (20 hours).
Control of communicable diseases (5 hours).
Practical work in proper fitting of equipment of cavalry, artillery, draft and pack animals (10 hours).
Equitation (20 hours).
Drill, setting-up exercises, foot movement, saluting, marching (until proficient).
Training in the use of arms (until proficient).
The instruction will be practical, and paper work will be accomplished in studying subjects requiring same.
Recitations will be the rule in assembled class. Studying will be done outside the class periods.
Six hours weekly will be devoted to recitations and practical work.
Five hours weekly will be devoted to equitation, drill, and training in the use of arms.

By direction of the Surgeon General:
________________________
Lieutenant Colonel, Medical Corps, U. S. Army,
Acting Director, Veterinary Service.

Under date of May 9, 1918, the following letter relative to schools and instruction was sent division veterinarians by the Surgeon General : 17

1. Pursuant to the issue of schedules of instruction for officers and enlisted men of the Veterinary Corps, attached to divisions and auxiliary remount depots, dated January 30, 1918, training schools were organized in each camp and remount depot.
2. Some of these schools developed satisfactory courses, detailed reports of which have been submitted to the Surgeon General. From others no reports have been received except through general veterinary inspectors.
3. As the schedules of instruction referred to in paragraph 1 (this letter) were general in character, obviously great variations in the kind of training given resulted.
4. An attempt is being made to standardize these courses of instruction in order that the training imparted will be uniform throughout the service.
5. It is therefore requested that you forward to the Office of the Surgeon General, veterinary division, a detailed report of the activities of the school or course of instruction under your command since its formation, if you have not already done so.
6. Relevant suggestions and constructive criticism are desired

Up to August, 1918, no data had been received pertaining to instruction of veterinary personnel in 20 divisions. In 2 divisions the instruction given was of an irregular nature, while in 18 divisions the instruction given was thorough, inclusive, and conducted according to approved schedules.

During August and September, 1918, an outline for systematic courses of instruction, as given below, was issued by the Surgeon General to the division veterinarians of 12 divisions (9th to 20th, inclusive) for the training of veterinary officer and enlisted personnel. These courses were conducted to completion in 10 divisions and, due to demobilization and other causes, only partially completed in 2. Later reports show that no instruction was conducted in the 95th and 96th Divisions and that a partially completed course of instruction was accomplished in the 97th Division.17


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WAR DEPARTMENT,
OFFICE OF THE SURGEON GENERAL,
Washington, August 26, 1918.

From: The Surgeon General.
To:  Division veterinarians, 9th to 20th Divisions.
Subject: Instruction.
  
1. It is the desire of this office to establish a uniform course of instructions for the veterinary officers and men in all camps where a division is stationed, and, in order that this may be accomplished, the inclosed schedule of instructions is issued for your guidance and strict compliance.

2. The work pertaining to the treatment of sick animals and necessary sanitation is to be considered paramount and will not be neglected for the course of instruction. It is expected, however, that the necessary veterinary work will be thoroughly done and this instruction carried out at the same time.

3. It is incumbent upon every camp veterinarian to see that the veterinary officers and enlisted men of the division and camp attain a high degree of efficiency, and this can be accomplished by utilizing the formative period of the division in this country for intensive training. It is expected, however, that the course shall be continued in both camp and division after the division leaves. It is contemplated that every officer and man shall become proficient in the subjects outlined, and failure to do so should become the basis of official action. Recommendations for the promotion or elimination of officers and promotion and rejection of enlisted men should be based on progress shown in the course.

4. The instruction should be commenced as soon after the receipt of this letter as practicable. The course is so arranged that officers and enlisted men can start training at almost any time, and the subjects they have missed can be taken up at the end of the course.
5. Instruction. - (a) The camp veterinarian, who is also the division veterinarian, should personally supervise all instruction. The enlisted men should be given instruction as one class and not by individual units. The training of units as such in the necessary performance of their duties will not be neglected.
(b) This instruction will include the veterinary personnel attached to the depot brigades, camp headquarters, and any detached organizations which may be in the camp. The men assigned to the camp meat inspector will be required to take at least the school of the soldier and foot drill. For the enlisted personnel this course of instruction should he commenced when 40 per cent of the men are present.
(c) Whenever lectures are given or it is necessary to utilize a textbook for class rending, a quiz should always follow each lesson. Recitations will be held as outlined in schedule of instructions. It is believed the best results will be secured by invariably requiring men to recite what they have studied. The camp veterinarian will take steps to see that his officers are provided with the necessary textbooks.
(d) Efforts should be made to have the instruction continuous, and it is expected that the schedule will be followed as published. It will be changed only for good and sufficient reasons, and when this is done a full explanation will be submitted.
(e) The schedule is arranged according to weeks, but when exigencies of the service prevent the completion of any week’s work it will be continued the following week and completed before taking up a new subject.
(f) Officers who have satisfactorily completed the training-school course and are found to be fully competent should be utilized as instructors for the enlisted men’s classes. Officers’ and enlisted men’s classes can then be held simultaneously.
(g) A report will be submitted every Sunday direct to thuis office, covering the preceding week, giving the officers and enlisted men present, instruction accomplished, hours used for both officers’ and enlisted men’s classes. Officers and noncommissioned officers will be marked for each day’s work, including examinations, on a scale of 10. An average mark of 7 will be considered as qualifying in a subject.

6. Daily conference. - The camp veterinarian will institute a daily conference, which all the veterinary officers in the camp and the divisional units will be required to attend. Questions pertaining to veterinary matters, unusual medical and surgical cases of importance,


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sanitation in connection with stables, grooming, feeding, forage, etc., veterinary personal equipment, discipline, and regulations are matters to be considered. These conferences aim at closer cooperation in the veterinary service and should tend to increase its efficiency as one large unit instead of separate organizations. It is contemplated that these conferences will continue indefinitely.

7. The receipt of this letter to be acknowledged.

By direction of the Surgeon General:
C. F. MORSE,
Lieutenant Colonel, Medical Corps,
Director Veterinary Corps.

Schedule of instruction for veterinary officers


355

Schedule of instruction for veterinary officers - Continued.


356

Schedule of instruction for veterinary officers - Continued.


357

Schedule of instruction for veterinary officers - Continued.


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Schedule of instruction for veterinary officers - Continued.

HORSESHOER
A suitable man should be selected for horseshoer and arrangements made to have him attend the horseshoeing school at the remount depot.

GAS DEFENSE
Arrangements should be made to have all officers and men thoroughly instructed in this line.

FIRST AID AND PEE5ONAL HYGIENE
Arrangements should be made with the surgeon for necessary instructions in above subjects.

SETTING-UP EXERCISES
Daily, as prescribed by division or camp orders. If not provided for in such orders, the camp veterinarian will prescribe exercises to be taken, and every officer and man in divisional veterinary personnel will be required to take same as daily routine. After this course of instruction is completed, it should be arranged, if practicable, to give the men of the divisional veterinary detachment at least 1 hour of foot drill and 1 hour of equitation a week.

By direction of the Surgeon General:
C. F. MORSE,
Lieutenant Colonel, Medical Corps, Director Veterinary Corps.


359

A separate schedule which was used in connection with this instruction follows :16

MEMORANDUM--CAVALRY FULL PACK EQUIPMENT

Full pack consists of saddle, saddlebags, one United States feed bag, and roll. The roll consists of -
1 shelter half.
1 shelter half pole--on right of roll.
5 shelter half pins--on left of roll.
1 blanket--United States.
1 towel.
1 comb.
1 brush, tooth.
1 brush, hair.
1 cake of soap, toilet.
1 undershirt.
1 underdrawers.
1 pair of socks.

The above toilet articles laid evenly at upper end of roll so it will roll evenly and straight. Roll should not exceed 44 inches in length when rolled. Feed bag: Inner white sack contains three feeds of grain for horse. When strapped to top of roll, the mark “U. S.” should be on the right saddlebags.
Contents of right saddlebag:
2 horseshoes, front and hind.
16 horseshoe nails.1 brush.1 curry comb.
Extra toilet articles.
Left saddlebag:
Soldier’s rations.
Soldier’s mess kit.
Strapped to side of left saddlebag:
Picket pin; picket line, restrapped to cantle.
Canteen strapped to right side of cantle.

IN POSTS

In May, 1917, department surgeons were provided by the Surgeon General with an outline similar to the one intended for divisional personnel quoted above, for a systematized course of instruction, which was to be carried out by medical officers at the military posts and relatively small stations under their jurisdiction.18 Department surgeons were made responsible for the effective carrying out of this course of instruction to the extent practicable under local conditions. From the outline sent to the department surgeons detailed courses of instruction were prepared and sent out to surgeons of stations and posts to be used as a basis for the training of sanitary personnel.

The extent to which this instruction was carried out varied with the local practicability for training and with the individual energy, initiation, and ingenuity of commanding officers, surgeons, and the instructors themselves. In many small stations it was necessarily largely a matter of personal reading, but in some of the larger posts many officers and men were given valuable and effective training. The pressing need for officers for overseas service necessitated the rapid drawing away from posts of the younger, physically fit and alert, medical officers and their replacement by older men, generally over 50 years of age.


360

These older officers were just as patriotic and earnest as the younger officers, but as a class were not as adaptable to the needs of the service as were the men from 30 to 45 years of age. All officers assigned to posts in the early months of the war were generally not supplied with the service manuals and Army Regulations and in many instances there was delay in securing these books for them, thus preventing an early grasping by these officers of the details connected with Medical Department procedure in the Military Establishment. Many of the officers coming from small rural districts were also deplorably deficient in the scientific practice of their profession. 19

These new medical men, derived from civil practice, however, found their places as best they could under Army conditions strange to them, and in the majority of instances soon came to appreciate the advantages to be derived from a practical course of schooling, which was instituted in practically all posts in accordance with the instructions quoted above.20

In connection with the training of enlisted men in the posts, several important problems were to be met. The necessity for department surgeons to supply many hundreds of enlisted men in all grades to units forming inside their departments and elsewhere necessitated the establishment at some of the more important posts of large training detachments for the intensive training of these men. In the Eastern Department, while training progressed in all the posts, the larger schools were established at first at Fort Myer, Va., Forts Hamilton and Jay, N. Y., where experienced medical officers directed the training and later at Fortress Monroe, Va., and Madison Barracks, N.Y.19
Large groups of partially trained recruits were being called for continually by department surgeons to be sent to hospitals forming within the departments. Later in the war the men furnished overseas units were replaced by limited-service men, who were distributed and absorbed by the different post hospitals throughout the departments. Every effort was made to bring these men up to a point of efficiency, but they proved generally unsatisfactory for Medical Department work.19

Before the establishment of the noncommissioned officers’ schools at the larger stations the number of efficient noncommissioned officers became depleted, but the schools gradually decreased and corrected this shortage until, in at least the Eastern Department, there was a slight surplus of noncommissioned officers toward the close of the war.19

The constant changing of personnel, due to the demands of the service, made it impossible for many of the officers who commenced the courses to carry them to completion, but the reports received from stations show that conscientious effort was made in practically all stations and resulted in all cases in much improvement. 19

In May, 1917, a camp intended primarily for the instruction of enlisted men was developed with about 50 medical officers and 2,000 enlisted men of the Medical Department at Fort Ethan Allen, Vt.21 This camp was variously designated as “18th Recruit Company,” “Medical Department Training Company A,” “Medical Department Training Units,” “Medical Department Training Camp.”These recruits, drawn largely from the Medical Department recruiting stations attached to the department surgeon’s office in Boston, and were medical 


361

enlisted Reserve Corps men. They were organized into training companies by local orders. Though eight hours a day were devoted to drills and other instruction, the training was greatly handicapped by a shortage in trained instructors. Partially to overcome this, the most likely men were selected and given special training and made noncommissioned officers and used as instructors.

The training unit was abandoned the latter part of November, 1917, after the transfer of 129 men to Base Hospital No. 66, Tenafly, N. J. As the number remaining in the unit was too small to continue training to advantage, the remaining men were transferred to the permanent detachment of the Medical Department of the post hospital and the surplus noncommissioned officers were transferred elsewhere for duty.21

At Fort Strong a building was rented from the Long Island Hospital, at the nominal sum of $1 per month, for the intensive instruction of selected Medical Department personnel of the coast defenses of Boston. Excellent results were reported by the department surgeon.21 The department surgeon, Central Department, stated in his annual report to the Surgeon General for the calender year 1917, that practical school courses were instituted in accordance with a circular letter from the Surgeon General’s Office, dated May 14, 1917, and was carried through in every detail with great credit to all concerned.22 He stated further:

Considering the frequent changes in both the commissioned and enlisted medical personnel and the fact that this personnel was largely composed of men new to the service, and the vast amount of work thrust upon them, their services were most gratifying to those charged with their training.

As no training school for Medical Reserve Corps officers was located on the Pacific coast, it became necessary immediately after the outbreak of the war for the department surgeon to prescribe a course of instruction, particularly in medical military subjects, in order that newly appointed officers might fit themselves for their new duties. On account of the frequent changes in personnel it was not possible for any appreciable number of officers to complete any prescribed course, nevertheless, considerable progress and benefit was made in this connection. During the calender year 1917, 2,059 enlisted men of the Medical Department were transferred to stations, camps, or regiments outside of the department on telegraphic orders from the War Department.23

The department surgeon in reality ran a correspondence course for Medical Reserve and National Guard medical officers, as it was necessary to return several times in each case, for correction or completion, at least 75 per cent of the reports and returns received in the department surgeon’s office. This was particularly true in regard to the sick and wounded reports and accounts for service or purchases from civilians.

The instruction in this department of so great a number of untrained enlisted personnel was greatly handicapped as was the case in all other departments, by the relatively small number of experienced officers and noncommissioned officers available as instructors. Nevertheless, by persistent effort prescribed courses of instruction were carried out as completely as was practicable, and as soon as they became qualified privates were promoted to noncommissioned grades.


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REFERENCES

(1) First indorsement, A. G. O., to Quartermaster General, May 11, 1917. Subject: Medical training camps. On file, Mail and Record Division, A. G. O., 2,581,692 (Old Files).

(2) Letter from the Surgeon General, U. S. Army, to division surgeons of all organized divisions, Southern Department, May 14, 1917. Subject: Directions as to status and scope of instruction to be given all sanitary personnel. On file, Record Room, S. G. O., 174,912-E (Old Files).

(3) Annual report of the Surgeon General, U. S. Army, 1918, 407.

(4) Letter from the Surgeon General to all division surgeons, October 3, 1917. Subject:Training of sanitary personnel of divisions. Copy on file, Historical Division, S. G. O.

(5) Letter from the Surgeon General to all division and camp surgeons and commanding officers of hospitals, June 13, 1918. Subject: Instruction of new medical officers. On file, Record Room, S. G. O., 353 (M. O. T. C.) C.

(6) Circular letter, Surgeon General’s office, November 1,1917. Subject: Training of sanitary personnel of divisions.

(7) Letter from the Surgeon General of the Army to division surgeons, May 21, 1918. Subject: Organization of camp surgeon’s office. On file, Hisorical Division, S. G. O.

(8) Memorandum from the Surgeon General of the Army to camp surgeons, May 27, 1918.  Subject: Scheme for organization of Medical Department activities. On file, Historical Division, S. G. O.

(9) Schedule of training for officers of the Medical Department, Camp Funston, Kans. Copy on file, Historical Division, S. G. O.

(10) Memorandum for The Adjutant General of the Army, October 3, 1917. Subject: Personnel and material for instructions in gas defense, by Tasker H. Bliss, major general, C. of S. On file, A. G. O., 220.63.

(11) S. O. No. 48, W. D., February 27, 1918.

(12) Memorandum from The Adjutant General of the Army, April , 1918, signed J. J. B. From the office of the Chief of Staff. On file, Chemical War Service.

(13) Outline of instruction for the enlisted personnel of the Medical Department, 89th Division. On file, Record Room, S. G. O., 353 (89th Division) G.

(14) Schedule of instruction for enlisted men of the Medical Department, 89th Division. On file, Record Room, S. G. O., 353 (89th Division) G.

(15) Special report to the Surgeon General. Subject: Training of the personnel of the Dental Corps during the World War. On file, Historical Division, S. G. O.

(16) Special Regulations No. 7, W. D., December 15, 1917.

(17) History of Veterinary Divisional Training (compiled from records and reports). On file, Veterinary Department, S. G. O.

(18) Letter from the Surgeon General of the Army to all department surgeons, May 14, 1917. Subject: Directions as to nature and scope of instruction to be given sanitary personnel at posts. On file, Record Room, S. G. O., 353 (General).

(19) Annual report, department surgeon, Northeastern Department, for the year 1917, February 21, 1918, by Col. P. F. Straub, M. C., U. S. A. On file, Record Room, S. G. O., 319.1 (Northeastern Department) A A.

(20) Annual report, department surgeon, Central Department, for the year 1917, February 14, 1918. On file, Record Room, S. G. O., 319.1 (Annual Report, Central Department) A A.

(21) Correspondence on the subject of training, from the surgeon, Fort Ethan Allen, to the department surgeon, Eastern Department. On file, Record Room, S. G. O., 354.6 (Fort Ethan Allen, Vt.) N.

(22) Annual report of the Surgeon General of the Army, 1918.

(23) Report from Col. L. M. Maus, M. C., U. S. A. (relieved), department surgeon, Western Department, January 31, 1918, to the Surgeon General, U. S. Army, Washington, D. C. Subject: Annual report calendar year 1917. On file, Record Room, S. G. O., 319.1 (Annual Report 1917) A A.