ON GAS HOSPITAL, JUSTICE HOSPITAL GROUPa
[By Lieut. Col. Harry W. Goodhall, M. C.]
gas hospital, Justice hospital group, was a provisional hospital and
not an organized unit. Its formation
was hastily planned in anticipation of the activities in the St. Mihiel
sector to meet the requirements of an
emergency. The hospital performed an active and useful service from
August 29, 1918, to October 8, 1918, when it
was taken over by Base Hospital No. 87.
August 29, 1918, Lieut. Col. Harry W. Goodhall, M. C., Base Hospital
No. 51, was temporarily relieved
from duty with that organization by verbal orders of Lieut. Col. H. C.
Maddux, commanding officer of the group, to
assume command of the gas hospital. This order was confirmed by
paragraph 1, S. O. No. 11, J. H. G., August 31,
August 30, 1918, First Lieut. George W. Papen, M. C., Base Hospital No.
51, was temporarily relieved
from duty with that organization and reported for duty at the gas
hospital, in compliance with verbal orders
confirmed by paragraph 2, S. O. No. 11, J. H. G., dated September 31,
1918. He was assigned to duty as adjutant,
detachment commander, and mess officer.
August 30, 1918, First Lieut. Russell M. Wilder, M. C., Evacuation
Hospital No. 2, in accordance with
telegraphic orders, commanding general First Army, reported to the
commanding officer of the group and was
assigned to the gas hospital for duty. He was assigned as chief of the
gas service and as supply officer.
three officers were the only permanent officers assigned to the
hospital during its existence, and all
of the administrative work and the burden of the medical work was
carried on by them.
August 30, 1918, 50 enlisted men from the special training battalion
stationed at St. Aignan, then on
duty with Evacuation Hospital No. 3, stationed at Toul, reported at the
gas hospital in compliance with S. O. No. 7,
Hdqrs. J. H. G., dated August 29, 1918.
* * * * * *
August 31, 1918, the following civilian help was engaged:b
* * * * * *
of these women had been employed by the French hospital which occupied
these buildings prior to their
being taken over by the American Army. They worked from 7 a. m. to
11.30 a. m. and from 1 p. in. to 5 p. m. They
had one day per week off and they were paid 6 francs a day. This
arrangement was the same as that under which
they had been employed by the French.
supply the lack of noncommissioned officers, the following Medical
Department men were assigned to
* * * * * *
buildings selected for the gas hospital were those known as the
Lamarche Annex and adjoined Caserne
Lamarche. These buildings were originally constructed for
hospitalization and in times of peace had been used by
the French as the hospital for the entire garrison stationed here. On
this account they were perhaps better arranged
than the buildings that were occupied by the other hospitals in the
were four large ward buildings, constructed of stone and concrete, a
small administration building,
two kitchens, and a large Bessonneau tent.
ward buildings were not entirely fireproof, inasmuch as the floors were
constructed of wood.
were divided into rooms that would accommodate about 15 patients
without crowding, and these
rooms were well ventilated antI very light. The possibilities of
isolation were very good. The corridors and stairways
were spacious. The four buildings would accommodate comfortably 1,000
patients, but owing to the lack of
storerooms and mess accommodations it was only possible to prepare for
a normal capacity of 650 beds.
a Copy on file, Historical
Division, S. G. O. bNames omitted.- Ed.
certain respects the buildings were very poorly arranged for
hospitalization. Running water was to be
found in but one room in each building, and there were no rooms fitted
up as service rooms. There was no
arrangement whereby even a liquid diet could be prepared. There was no
arrangement in the buildings for the
disposal of waste matters.
administration building was sufficient for the purpose and also served
as quarters for the officers. Both kitchens were equipped with French
ranges, which were not suited to our methods of cooking. To add to this
obstacle the grate in one range was broken, and it was not until
September 15 that it was repaired. During the latter
part of September an Army range was installed in one of the kitchens,
which added much to the service rendered,
but even this was not sufficient to meet the demands made upon this
department. The distance between the kitchens
and the wards was a distinct handicap to good service. Liquids
transported in bulk could be kept hot, but special
measures had to be adopted with other foods. There was no means of
keeping food hot once it arrived at the wards
or of heating food in the wards until early in October, 1918.
large Bessonneau tent was in excellent condition and well located for
the purpose for which it was
used, namely, as a triage and reception ward.
was one small laundry operated by hand that could do a limited amount
of small work.
latrines were of the usual French type of can latrine, and these were
emptied by French civilian
water supply was from two sources. A tank situated on the area received
water from the wells located
on the area of Caserne Fabvier, and pipes had been extended from a tank
situated on the area of Caserne Lamarche,
which received water from the Moselle River, passing through a filter.
sewer system consisted of a series of pipe lines and drains which
received, through catch basins, rain
water and liquids from the kitchens, baths, and urinals.
civilian contractors had been employed to carry away garbage, and there
was a good incinerator in
the rear of the area.
has already been stated, this hospital was formed in anticipation of
activities in the St. Mihiel sector, and
as originally planned it was intended to give initial treatment to gas
casualties. Later events showed that this was a
miscalculation, which experience would have recognized immediately,
inasmuch as Toul was about 15 miles from
the nearest point to the front line. As a matter of record only 169
cases out of a total of 1,281 came to the hospital
without first passing through a field hospital where the initial
treatment was given. Furthermore, it was thought that
the gas casualties would be the first to arrive in the group, and the
commanding officer was instructed to have the
hospital clean and with 650 beds set up and ready for patients within
Wilder was assigned to the hospital because he had had long and
intensive experience in the
handling of gas casualties at Baccarat, where Evacuation Hospital No. 2
was located. For this reason the plans as to
the arrangement of the hospital and the selection of the equipment were
left largely in his hands.
48 hours the hospital was clean and the required number of beds set uip
and ready to receive
patients. Within 11 days, the date the first patient was admitted, the
hospital was fairly well equipped and the weak
points of the hospital had been recognized.
arrangement of the hospital was as follows:
Bessonneau tent was used as the triage and as a receiving ward. In one
corner of the tent a room was
screened off for the treatment of cases of phosgene-gas intoxication.
In this way the patient was spared unnecessary
handling, oxygen could be administered promptly, and, if necessary,
phlebotomy done at once. This room was
promptly fitted iup and all the necessary equipment obtained.
B was set aside for these cases as soon as their condition permitted
their being moved. Cases of
severe mustard-gas intoxication were also sent to building B inasmuch
as this was the only building equipped with
bathing facilities. Each of the four large buildings had in one end, on
the lower floor, what was called the
"bathroom," but these rooms were only equipped with small faucets, and
there were no facilities for bathing. In the
building B, however, a French portable bath had been installed in the
bathroom, and this shower would bathe six
persons standing, but only one lying. It was evident that no large
mumber of cases could be handled, and another
portable shower that would bathe eight persons standing was installed
before the first patient was admitted.
Building A was set aside for officers and for
the less severe
cases of mustard-gas intoxication. Building B
was set aside for walking cases in order to facilitate evacuations, and
building C was the overflow ward.
equipment was supposed to be complete and was fairly complete according
to the original French
inventory, but some of the other hospitals on duty in the group had
taken many of the supplies to make up for their
own deficiencies before these buildings had been specified for hospital
were about 700 beds that had been left by the French. These were iron
beds with boards in place of
springs and mattresses made of straw. These mattresses were clean and
had been recently sterilized. There were
sheets and blankets for making up the beds, but not enough sheets for
changes. There were very few towels and
pajamas. There were sufficient cooking utensils and dishes to meet the
emergency, but they were not adapted to our
needs. There were enough bedpans, urinals, etc., to meet the
pharmacy was stocked with a large variety of excellent drugs and
dressings and later, when medical
cases were admitted, as well as gas cases, this proved to be a most
fortunate acquisition. In these early days many
difficulties presented themselves, and some of them were never entirely
was a lack of clerks and stenographers. It was attempted to make up for
this lack by appealing to the
other units on duty in the group, but the men that were sent were
inexperienced, and at no time did the hospital have
a man that could do any of this work satisfactorily. It was necessary
for the officers to do much of the typewriting,
and the record work had to be constantly supervised.
was no office equipment. Everything had to be purchased in the open
market. There were no
typewriters available with the exceptions of two small machines that
officers attached to the hospital had brought
with them. It was not until the middle of September that a standard
machine was obtained, and that was borrowed
from an individual.
forms were difficult to obtain, and inasmuch as it was late in the
month before they were obtainable,
this added much to the necessary typewriting.
enlisted men from the special training battalion were all classified as
class B men, and none of them
was strong and vigorous. Ten of the number were not physically equal to
the demands that were made on the others.
None of them had ever been attached to the Medical Department, and none
of them had any special qualification that
made him useful to the hospital. It was evident from the start that
each man would have to be taught the particular
work he had to perform. The majority of the men did not enter into the
work with enthusiasm, and their discipline
was very poor. They were very much disgruntled, and the idea of working
with the Medical Department was not
pleasing to them.
the first 10 days it required constant watching in order to get the
work performed; it meant constant
disciplinary action to make them realize the task that was before them.
After this time, however, the majority of
them worked faithfully and cheerfully, and it is in a large measure due
to the strained efforts of these men that the
hospital was a success.
enlisted men were assigned to the hospital from another unit in the
group to act as noncommissioned
officers, but these men, for the most part excellent, had not been
trained, and it was hardly to be expected that under
the circumstances another organization would voluntarily give up its
was hoped that these deficiencies would be overcome in a large measure
by the employment of civilian
help, and especially in the kitchen, but it was soon found that the
French cooks were not accustomed to our methods
of cooking, and they were far from being in sympathy with our ideas of
sanitation. It was necessary to let them go
and begin training our own men to cook.
was experienced with all of the civilian help with the exceptions of
the woman in the pharmacy,
the woman in charge of the linen room, and the seamstresses. All these
women proved to be very valuable.
the early days of the group the problem of supplies was a serious one.
There was not enough to go
around, and division on a basis of equality, according to needs, was
attempted, but did not work out very
satisfactorily. Our supply officer had various duties and could give
only a portion of his time to this duty. The other
hospitals had their supply officers, who were constantly on the alert.
This was compensated in a large measure by
the fact that Lieutenant Wilder had seen long service in France and
knew better what was wanted and where to get it
than most of the other supply officers. The spirit of the moment is
well illustrated by the notation that there was a
tendency on the part of some officers to help themselves to whatever
they wanted, regardless of where they saw it.
On one occasion a noncommissioned officer was found removing a valve
from our shower bath, and it was
necessary for the man in charge of the bath to call an officer before
he could be induced to stop. He was found to be
acting under orders from a superior officer.
kitchens were inadequate, even with the repair of the second French
range. Fortunately gas cases are
given nothing but liquid foods in the early days of their treatment, so
that the only ones suffering from the deficiency
were the personnel of the hospital.
the installation of the Army range much better service was rendered,
although another range should
have been set up in order to render the service that should have been
rendered. Effort was made to prepare food,
especially hot, liquid food, in the various buildings, but it was late
in September before small stoves were obtainable
and some time later before oil could be procured.
water supply was very limited and so much so that in running the bath
it was necessary to see that the
bath was used at its full capacity at the hours during which bathing
was permitted. It was planned to be able to give
baths to the cases of mustard-gas intoxication whenever they came in,
and we were able to do this throughout the life
of the hospital. This would not have been so had all the cases required
bathing. This was obviated by the preliminary
treatment given at the field hospitals.
times the water supply was entirely cut off on account of shortage of
water, but by keeping a
reserve in the bathroom it was possible to see that all necessary
treatment was given.
the spirit of the moment was seen when an officer from another unit cut
the tank of the gas hospital
area out of the circuit during pumping hours, hoping to get the extra
amount in his own tank. Fortunately, the water
system was so arranged that any interference with the supply system
made itself evident throughout the group and
the trick was discovered.
of the water was safe for drinking purposes, and it was all boiled or
chlorinated before it was used.
This matter was tinder the constant supervision of one of the officers,
and no case of illness due to the water
occurred at the hospital.
good deal of trouble was experienced in getting the latrines emptied
and the garbage carried away. At
one time the situation was so bad that trenches for disposing waste
matter were dug, but it was never necessary to
use them. Before the rush of work came the contractors were more
regular in their work, but at no time was it
hospital was lighted with electricity and for the most part the service
was good. It was, of course,
necessary to camouflage the entire plant; and although a good deal of
difficulty was experienced in getting the
necessary materials to do this work, it was completed before the
activities began. Here again it was necessary for the
officers to personally put tip the first covers and teach the men in
order that the work could he completed.
September 7, the hospitals were fairly well equipped and supplied; the
men had been assigned to their
various duties and had been started in their training. The entire plant
has been camouflaged and everything was
ready for action.
7 p. m. on this date brilliant flashes of light and sounds of heavy
firing was seen and heard in the
north. The firing continued at intervals all the next day and at 4 p.
m. on September 8, the first patient, Second
Lieut. Paul Odom, Company D, 341st Machine Gun Battalion, arrived and
was diagnosed as phosgene-gas
September 8, 15 nurses were assigned to the hospital for temporary duty
per S. O. 40, Headquarters, J.
H. G. These nurses were attached to Base Hospital No. 45, and while
they were quartered at the gas hospital they
were messed and carried on all reports and returns of their own
* * * * * *
September 11, Capt. Paul Dejains, Evacuation Hospital No. 2, reported
at headquarters, Justice
hospital group, in compliance with telegraphic orders of the commanding
general of the First Army. He was
assigned to duty with the gas hospital.
7. p. m. on the evening of September 11, commanding officers of the
various hospitals were called to
group headquarters and informed that activities were to begin in the
St. Mihiel sector within 24 hours, and we were
given our final instructions as to preparations for the drive. About 12
hours later the activities in the north, which
could be distinctly seen, heard, and felt, indicated that the drive had
begun. The next morning cases began to come
to the group over the road, but only one case was admitted to the gas
hospital on September 12 and only 38 cases on
September 13. All these cases had been sent back from field hospitals.
The early rumors were to the effect that little
or no gas was being used. By this time it was evident that the gas
hospital was destined to act as an evacuation
hospital and there would be comparatively little initial treatment
here. For this reason Captain Dejains returned to
his hospital, Evacuation No. 2, the night of September 12.
Lieut. William J. Kiane, M. C., Evacuation Hospital No. 14, reported
for duty on September 12, 1918,
as per S. O. 45, Hdqrs., Justice hospital group, but was relieved by S.
O. 63, Hdqrs., J. H. G., September 19, 1918. On September 14 General
Gorgas made an official inspection of the hospital. On the afternoon of
cases began to arrive at the hospital in large numbers; and from 12
o'clock noon on the 17th until 12 o'clock noon on
the 18th, 416 cases were admitted and 466 cases were evacuated.
Fortunately, the few cases that had been coming
into the hospital in the five previous days had given the personnel
some experience in the duties that they had to
perform, otherwise the mechanism of the hospital would have broken down
with this large number of cases that had
to be handled by this small number of men. During the evening and also
during a very active period, General Gorgas
made an unofficial visit and watched the operation in the triage with
much interest, after which he made a rather
complete visit of the wards. His interest seemed to be entirely in the
soldier, as he was critical of the attention given
to the men in the triage, making special note as to the methods of
keeping them warm, feeding them, and of the
initial medical treatment that they were receiving. On the morning of
the 18th, it was evident that this small force
could not keep on with the work, and in consequence 40 additional
enlisted men from the same special training
battalion reported for duty on the evening of September 18, 1918.
* * * * * *
the afternoon of September 18, 1918 * * * These officers were ordered
to report for duty to this group
from the schools at Langres. It was not possible to have the advantage
of their undivided service as each had to
spend a part of the time at this headquarters in service at the front.
The uncertainty of their service made it
undesirable to assign adminisrative work to them, but they rendered
most excellent medical service, and arrived
just in time to prevent disaster owing to lack of officers.
was on this same day that the hospital was instructed to admit medical
as well as gas cases. At this time a
severe epidemic of influenza had made its appearance, and owing to the
crowded condition in the other hospitals it
was necessary to admit some of the cases to the gas hospital. This
presented a rather serious problem owing to the
danger to gas cases of secondary infection. All of the respiratory gas
cases were immediately segregated, and in so
far as possible the cases of influenza were isolated.
installation or cubicles was immediately begun and, while materials
were lacking, the work was pushed
as rapidly as possible, cubicled observation wards being established in
each building within 24 hours.
September 20, the number of gas cases admitted began to diminish and
the number of medical cases
to increase. Medical cases were almost entirely respiratory and
enteric. On September 25, Maj. Albert Francine, M.
C., reported for duty as per S. O No. 81, Hdqrs. J. H. G., and was
assigned as assistant chief of the medical service.
On the same date First Lieut. Walter F. Bleifus, M. C., Base Hospital
No. 78, was assigned to duty in compliance
with S. O. No. 88, Hdqrs. J. H. G. On September 30, 1918, First Lieut.
John W. Blake, M. C., Base Hospital No. 55,
was assigned to duty as per S. O. No. 106, Hdqrs. J. H. G. Both of the
last-named officers became ill shortly after
they reported for duty and were not available again for service.
this time a rather severe epidemic of pneumonia, due to the
streptococcus hemolyticus, made its
appearance and assumed severe proportions. The severity of the epidemic
added very much to the work of the very
limited personnel, both officers and men, and repeated attempts to have
more officers, nurses, and men assigned to
the hospital were made but the demand was so great in other units of
the group that none could be spared, and on October 8, 1918, the
patients and property of the hospital were turned over to Base Hospital
No. 87, which had just
arrived in the group.
as the hospital was originally intended for the treatment of gas cases,
the summary will only
touch on that subject. The work done by the hospital is shown by the
this total number of cases, only 169 came directly from the front, and
these found their way by accident
and were not sent back by medical direction. There were but 5 deaths,
all following intoxication with mustard gas. Post-mortem examinations
were made and showed the following condition:
Hels Malgren, 2855737, Company D, 360th Infantry, died September 24,
1918. The autopsy showed
marked burns about the eyes and mouth, burns on the forearms, scrotum,
and buttocks. Beginning at the larynx and
extending down the entire trachea was a thick, frothy, greenish-gray
membrane covering the entire mucous
membrane. This was easily removed. There was marked hyperemia and
edema of the pulmonary tissues.
Scattered throughout both lobes were man dark red, almost black, areas
of consolidation. The bronchi were filled
with a greenish, purulent material extending down to the smallest
bronchioles. Anatomical diagnosis: Gas
intoxication, severe, mustard; bronchopneumonia.
Albade (French), private 151st Regiment 6A, October 2, 1918:
Conjunctivae hyperemic. Around the eyes, over the lips, and around the
nose the skin is ulcerated and covered with a thick red scab. Similar
excoriation on the scab over scrotum. Areas of broncho-pneumonia in
both lungs The bronchi contained pus and
the numerous membrane from the primary bronchi to the smallest
bronchioles were covered with a thick green
membrane. Anatomical diagnosis: Gas intoxication, severe, mustard;
bronchopneumonia. Charles Beneck
(French), private, 151st Infantry, F. A., October 2, 1918: Thick
brownish red scabs around the eyes, lips and nose. External genitals
hyperemic. Areas of
bronchopneumonia in both lungs. The bronchi
contained pus and the mucous membrane from the primary bronchi to
the smallest bronchioles were covered with a thick greenish membrane.
Anatomical diagnosis: Gas intoxication,
severe, mustard; bronchopneumonia.
Fred Hoffman, 93596, Company D, 166th Infantry, October 3, 1918:
Conjunctivae congested. Some
excoriated areas around the eyes, nostrils, and mouth. The larynx and
trachea were covered with a thick yellowish
membrane. Areas of broncho pneumonia in both lungs. Anatomical
diagnosis: Gas intoxication, severe, mustard;
Robert Grundon, 93377, Company D, 166th Infantry, October 8,1918:
Conjunctivae red. The skin
around the eyes, nose, and mouth covered with a thick adherent reddish
scab. Similar scabs around the genitals.
Pharynx and soft palate covered with a thick greenish membrane. A
similar membrane extended from the epiglottis
to the finer bronchi. There was a large amount of bloody froth in the
trachea. Lungs hyperemic. Anatomical
diagnosis: Gas intoxication, severe, mustard.
very interesting facts developed in this very short experience.
Unfortunately there was not time to
take careful notes and collect statistics, but many of the patients
were closely questioned, and the general impression
is probably not very far from correct.
of all, one is impressed by the fact that the large majority of the
cases, fully 75 percent, were not
severely gassed. Of this number 20 percent were probably not gassed at
all. They were rather victims of exhaustion,
shell fume, etc. Fully 25 percent of the cases could have been
returned to duty within 24 hours, and fully 50 per cent
could have been returned to duty within from four to six days. Of the
828 mustard-gas cases the 5 that died were the
only cases that were considered seriously ill. In only about 20 percent
of the mustard cases was the condition severe
enough to confine the patient to bed for more than 48 hours.
division between respiratory cases and contact mustard-gas cases was
about equal. While some of the
skin burns were severe and extensive, in none did it appear that the
healing would be prolonged to any degree. The
eyes were affected in about 40 percent of the cases to a degree to
require treatment, but the rapidity with which they
improved was surprising, and in no case was there real danger to the
about 20 percent of all the cases the diagnoses were by no means
certain. They had been sent back with
a diagnosis of mustard-gas intoxication. On the field card the history
was mustard-gas intoxication, but the signs at
the time of admission were the ones that one might expect of man's
being exhausted. They had been without sleep
and their eyes had been irritated by dust.
the phosgene cases, less than 12 were sick enough to be confined to bed
for more than two days, and in
only one case was it necessary to do a phlebotomy. Of the other cases
of the gas intoxication, none was sick enough
to require any treatment. The cause of the casualty was always
determined in the general way, and it is the opinion
of the officers of the hospital that the great majority of the
casualties was the lack of discipline in the use of the gas
mask and the lack of precaution against gas bombardment. Many of the
men said that they took their masks off, as
they would rather take a chance without it than fight with it on. A
good number had their masks knocked off in one
way or other. Some admitted that their masks were defective and that
they knew it before going into action. One
convoy that was brought in was shelled in the night and caught in the
dugout. No alarm was sounded until it was
too late to protect themselves.
of the more severe contact cases were seen in men who were burned in
helping their comrades out
of danger, or who had taken cover in a shell hole that was
work done at this hospital was in reality work that could have been
handled in any of the units of the
group. Had the cases that were admitted to the hospital been cases
requiring initial treatment, the personnel and the
equipment would not have been sufficient to have rendered proper
service. It is believed, however, that this
particular hospital served a very useful purpose, possibly a service
that none of the others could have rendered, and
that is the isolation and protection of respiratory gas cases from
accidental secondary respiratory infections.