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Chapter I

The Medical Department Of The United States Army in The World War

SECTION I

ORGANIZATION AND ADMINISTRATION OF THE CHIEF SURGEON'S OFFICE


CHAPTER I

GENERAL ORGANIZATION AND DEVELOPMENT

On May 10, 1917, the Surgeon General wrote The Adjutant General of the Army as follows:1

I recommend:

That Col. Alfred E. Bradley, Medical Corps, in addition to his present duties as observer with the English Army, be designated as chief surgeon United States forces in Europe.

That, as chief surgeon of United States forces in Europe, Colonel Bradley be authorized to exercise over the forces under his control the same authority as the Surgeon General holds over the entire MedicalDepartment. Similar authority was granted; on the approval of the Secretary of War February 18, 1899, to the chief surgeon of the Department of the Pacific and Eighth Army Corps (now the Philippine Department).

In conformity with the foregoing request, The Adjutant General wrote to the officer in question, on May 28, as follows:2

The Secretary of War designates you, in addition to your present duties as chief surgeon, United States forces in Europe.

The Secretary authorizes you, as chief surgeon of the United States forces, to exercise over the forces under your control the same authority as the Surgeon General holds over the entire Medical Department.

Meanwhile, on May 26, 1917, this officer had been designated chief surgeon of the American Expeditionary Forces in General Orders, No. 1, of that organization, which was published in Washington, D. C., but neither the foregoing letter nor a copy of the order mentioned was received by him prior to the arrival of headquarters, A. E. F., in London, on June 9, 1917.3

The Medical Department personnel which accompanied the commander in chief consisted of 4 officers, 2 enlisted men, and 4 civilian clerks.4 On arrival in London they were joined by the chief surgeon, who had been serving as military observer with the British, but who, on May 29, had been relieved from that assignment.5 One of his first duties as chief surgeon, A. E. F., was the formulation of instructions for the liaison officer for the Medical Department with the British, who also had been serving as a military observer and who was now charged with supervision of the base hospitals and casual personnel of the American Expeditionary Forces which were under British control.6

On June 13, headquarters, A. E. F., moved to Paris,7 where, by the 17th, it was joined by three other medical officers who had been serving as military observers with the French or British forces.8 When headquarters, A. E. F., established itself in Paris the chief surgeon's office force, now consisting of


40

PLATE 1

BRIG. GEN. ALFRED E. BRADLEY, M. C., CHIEF SURGEON, A. E. F., TO APRIL 30, 1918.


41

PLATE 2

BRIG. GEN. WALTER D. McCAW, M. C., CHIEF SURGEON, A. E. F., OCTOBER 10, 1918, TO JULY 15, 1919.


42

seven medical officers and about twice that number of clerks, was located, with other bureaus, in a small residential building where it occupied three small rooms.9 Almost immediately the chief surgeon and certain members of his staff began tours of inspection in order to determine matters concerning hospitalization at base ports and along the line of communications.10 On July 4, a medical officer was relieved from duty in the chief surgeon's office and assigned as surgeon of base section No. 1 (St. Nazaire), where the first contingent of troops was expected to debark.11

When the staff of the American Expeditionary Forces was organized and its several duties were defined by General Orders, No. 8, Headquarters, A. E. F., July 8, 1917, the functions assigned to the Medical Department were as follows:

Sanitation of camps, quarters, and occupied territory; health of command; care of sick and wounded; collection and evacuation of sick and wounded; medical personnel; medical supplies; veterinary personnel; veterinary supplies; laundries and baths (medical aspect); disinfection of clothing, etc.; supply of personneland material for gas defensive under supervision of director of gas service; technical inspection of medical
organizations and establishments, etc., etc.

Until the administrative structure of the American Expeditionary Forces was radically changed, as noted in the preceding chapter, by General Orders, No. 31, General Headquarters, A. E. F., February 18, 1918, the staff organization in general was comparable to that existing in the War Department. The relationship of the chief surgeon's office to the general staff and to the chiefs of administrative staffs was similar to that existing between the Surgeon General's office, on the one hand, and the General Staff and the several bureaus of the War Department, on the other.a

Until the American Expeditionary Forces was reorganized by the order mentioned the chief surgeon was located at headquarters with the general staff and the chiefs of other administrative staff departments, and he or his assistants, therefore, were enabled to transact business directly with the staff offices concerned.12

As the general staff was charged with approval and coordination of all policies and projects for the American Expeditionary Forces the chief surgeon or his assistants took up directly with appropriate sections of that body all matters pertaining to the medical service which required its authoritization, coordination, or execution.12

The more important policies usually were placed on record and then discussed verbally.12 It was quickly realized that very close cooperation of all elements was necessary at general headquarters and that only through centralized control could prompt results be secured conforming to changing conditions.9 Careful studies were made of future needs and these after being approved by the general staff, were cabled to the United States.9

Communication between the chief surgeon's office and that of the Surgeon General was carried on by letter direct, or, if circumstances required, through official channels, or by cable.13 Communications cabled from one office to the other passed through the respective cable offices in headquarters, A. E. F., and in

    aSuch relationship is described in Volume I of this history.-Ed.


43

the War Department.13 Copies of cables which the chief surgeon's office wished to send were submitted to the adjutant general, A. E. F., if they pertained to administrative matters, or if to other matters, to the Chief of Staff who referred them for examination to the appropriate section of the General Staff.14 A section in the office of the adjutant general edited all cables for clearness, arranged them for logical sequence with previous telegrams, and incorporated them with drafts of other cables on the same subject from other departments into one long message signed, "Pershing."13 The avenues for transaction of business with the medical service of the Allies are discussed in Chapter III.

After the arrival of headquarters of the 1st Division on June 26, 1917, and that of considerable casual personnel, the work of the chief surgeon's office had so multipled that the office space in headquarters, A. E. F., had become overtaxed.9 Therefore, about the middle of July that office, with some other special branches of the headquarters group, moved to more commodious in the Hotel St. Anne, in the street of that name.9

Here some of the more important policies of the Medical Department were developed and adopted and considerable creative and constructive work was accomplished.9 Problems which arose during the earlier stages of the American Expeditionary Forces when headquarters was located at Paris, and later at Chaumont, included determination of general policies, such as location and size of hospitals, percentage of hospital beds to total strength of the American Expeditionary Forces; estimates of quota, distribution and training of personnel; amount and character of Medical Department supplies required; relative priority of Medical Department personnel and supplies in shipments from the United States; the tonnage such supplies would require; character and quantities of supplies that could be procured advantageously overseas; size and location of storage depots; provision of hospital trains; arrangements for care of casualties at the front, for their removal from the lines, distribution and treatment in the rear, and, if need be, sending them home; organization of gas defense; standardization of splints; provision of agencies for transaction with the Allies of business which was of mutual interest, e. g., procurement of sites for hospitals and other installations; procurement of facilities from or through the American Red Cross; control of infectious diseases, especially of venereal diseases; organization of the laboratory system and of the professional services; and many cognate subjects.15 These policies of the Medical Department were determined at conferences attended by the few medical officers available at headquarters, or at more general conferences in which representatives of the Medical Department participated with those of other staff departments of the American Expeditionary Forces or with representatives of the French Army.9

A long step toward decentralization of medical service was taken when a chief surgeon was designated for the line of communications.16 The necessity for such an organization arose when the 1st Division arrived in July, and moved to its training area in the Vosges. The geographical limits of the line of communications extended from the sea to the point where supplies were delivered to the field transportation of the combat forces less such areas as might be excepted. Headquarters of this jurisdiction, while undergoing organization, was located in Paris, whence it moved January 13, 1918, to Tours.9


44

A colonel, Medical Corps, who arrived with a small force on July 18 was assigned as chief surgeon, line of communications,17 and was vested with immediate supervision of Medical Department personnel and transportation, base hospitals, sanitation, and supplies, in its jurisdiction.18 As his office was located in the same building as that occupied by the chief surgeon, A. E. F., numerous conferences occurred between their representatives19 until September 1, when the latter's office moved with headquarters, A. E. F., to Chaumont.4

A medical supply officer for the American Expeditionary Forces arrived on July 20 and proceeded to the base medical supply depot being established at Cosne.17 As additional personnel was now necessary in the office of the chief surgeon, A. E. F., and that of the chief surgeon of the line of communications the adjutants of the six American base hospitals already serving with the British (as mentioned in Chapter I) were relieved from duty therewith and ordered to Paris, where two of them were assigned to the office of the chief surgeon, A. E. F., and four to the office of the surgeon, line of communications.9 Also an American medical officer who had been serving at a French hospital at Ris Orangis and one who had been studying the organization of gas warfare in England were ordered to join the office of the chief surgeon, A. E. F.20

Until the latter part of July, 1917, the chief surgeon's office, A. E. F., had not been divided into sections and none of its personnel had been assigned to particular duties exclusively.19 Nearly all of the work transacted had been of a character which required determination of broad general policies which were part of or conformed to the three important basic projects of the American Expeditionary Forces discussed in the preceding chapter.

As troops began to arrive in increasing numbers, more specific allocation of duties became necessary in the chief surgeon's office, in order that proper action might be taken promptly both on routine reports and on a number of diversified matters.9 For example, base hospitals which were arriving constantly had to be promptly and suitably located, arrangements had to be made with the French for the care or evacuation of American sick until our Medical Department establishments could care for them, the considerable numbers of casual personnel who were arriving had to be suitably classified and assigned, and many questions of policy on a wide range of subjects were now pressing for decision.9

After the arrival of a number of casual medical officers in the latter part of July the chief surgeon's office, A. E. F., was organized on the 28th of that month, as follows:20

(1) An executive officer, who assisted the chief surgeon in supervision and coordination of the sections of his office, represented him when absent at conferences or on tours of inspection, and under the chief surgeon was in general charge of the administration of the medical service, A. E. F.

(2) Hospitalization.-In charge of location, construction, and repair and all other questions relating to hospitals; hospital trains; and the care of sick and wounded.

(3) Sanitation and statistics.-Sanitation of camps, quarters, and occupied territory, laundries, disinfection and disinfestation, collection and evacuation of sick, health of command, reports of sick and wounded, statistics and sanitary reports.

(4) Personnel.-Medical, Medical Reserve, Dental, and Veterinary Corps, enlisted force, schools of instruction, and civilian employees.


45

(5) Supplies.-Hospital equipment, medical, dental, and veterinary supplies, settlement of accounts, ambulances, and all motor transportation.

(6) Records and correspondence.

(7) Chemical Warfare Service.-Defensive gas, gas school, and all professional questions relating to gas.

There was but one officer on duty with each of the sections mentioned above except that the head of the hospitalization section (who was also charged with Franco-American liaison which is discussed in Chapter III) had a commissioned assistant.9 These officers also handled general estimates of personnel and equipment.9 Associated with this headquarters group was another officer who had been designated attending surgeon.9

During the week ending August 4, 1917, a liaison officer was appointed to function between the Medical Department and the coordination section of the general staff, an innovation which it was anticipated would greatly promote transaction of business between the two offices.21

The chief surgeon was also represented by a liaison officer at the headquarters of the American Red Cross and of the Young Men's Christian Association in Paris. He also maintained close contact with the other societies serving the American Expeditionary Forces and availed himself of their cooperation as circumstances indicated.22

So much of the American Red Cross in Europe as was called into the service of the American Expeditionary Forces came under the immediate jurisdiction of the chief surgeon, A. E. F., though in the last analysis that and other like societies serving the American Expeditionary Forces were under the control of the first section of the general staff.21 The activities of the American Red Cross in the military service were quite diversified, but in very general terms they pertained especially to hospitalization and medical supply.

On August 23 a dental officer was assigned to duty in the chief surgeon's office and began, in the personnel division, the organization of the dental service of the American Expeditionary Forces.24

After the chief surgeon's office had been moved from Paris to Chaumont, September 1, 1917, in the zone of the armies, it occupied the upper floors in the west end of the south barracks at that place.19 The floor space allotted here to the chief surgeon's office was many times as great as that which had just been vacated in Paris, for it was appreciated that a large increase in its personnel would soon be necessary.9 The chief surgeon's office when established in Chaumont included 10 commissioned officers of the Medical Department.22 Before leaving Paris, 4 officers were detached to remain in that city, 1 with the water service of the line of communications, 2 as liaison officers with the American Red Cross and the Young Men's Christian Association, respectively, and 1 who served both as the medical member of the general purchasing board, A. E. F., and later as liaison officer with the French Medical Department.22

The Chemical Warfare Service was established as a separate bureau by General Orders, No. 31, G. H. Q., A. E. F., September 3, 1917, and to this a medical officer in close touch with the chief surgeon's office was later assigned.25

On September 13, 1917, the chief surgeon was directed to submit at as early a date as practicable a project for the Medical Department for the next


46

six months covering the proposed location of medical depots, laboratories, hospitals, other establishments, and sanitary units, and his project for supplies and material.26

On October 9, 1917, the chief surgeon submitted the following plan of organization of his office and that of the army surgeon at army headquarters in the field:27

FIG 2.-Wing B of group of three main buildings, general headquarters, A. E. F., in which the office of the chief surgeon, A. E. F., was located prior to its removal to Tours. This wing also was the location, subsequently, of the medical group, G-4, general staff, A. E. F.

Major general

Brigadier general

Colonel

Lieutenant colonel

Major

Captain or lieutenant

Clerks or soldiers

Chief surgeon

1

---

---

---

---

---

---

Assistant to chief surgeon

---

1

---

---

---

---

---

Personnel division

---

---

1

1

3

---

22

Sanitation and statistics

---

1

1

1

---

---

50

Records and correspondence

---

---

---

---

1

---

80

Hospitals, construction and assignment

---

1

2

3

---

---

100

Supplies

---

---

1

---

---

---

3

Total

1

3

5

5

4

---

255

Dental and veterinary service to be represented in this personnel section by an officer of the highest rank in these corps.

FOR ARMY HEADQUARTERS

1 brigadier general.
1 colonel.
1 lieutenant colonel.
1 major.
7 soldiers.


47

In reply to a communication from the adjutant general, the chief surgeon, on November 7, 1917, submitted the following statement of the subdivision of duties in his office, and of the personnel that would be required to staff them, viz, chief surgeon (1 officer), assistant to chief surgeon (1 officer), personnel division (5 officers, including 1 dental and 1 veterinary, and 22 clerks), sanitation and statistics (3 officers and 50 clerks), records and correspondence (1 officer and 80 clerks), hospital construction and administration (6 officers and 100 clerks), supplies (1 officer and 3 clerks).28

On November 13, 1917, a chief nurse of the American Expeditionary Forces was designated and was assigned, with an assistant, to duty in the office of the chief surgeon, line of communications.29 She and her assistant were not incorporated in the office of the chief surgeon, A. E. F., until it moved to Tours. This designation of the chief nurse later was changed to "director of nursing service," but her duties remained unchanged.30

The following data concerning the chief surgeon's office formed a part of the table of organization for headquarters, A. E. F., office of the commander in chief, approved by General Pershing on December 22, 1917:31

Tables of organization, general headquarters, A. E. F.

CHIEF SURGEON'S SECTION

1

2

3

4

5

6

7

Remarks

Unit

Officers

Interpreters

Clerks

Soldiersc

Soldiersa

Total

General officer

1

---

---

---

---

1

(a) Carried in headquarters battalion.
(b) 1 chauffeur, 1 orderly for general officer.
(c) All from Medical Department but attached to headquarters battalion for rations, pay, and clothing.
(d) Clerks
(e) 3 chauffeurs, 5 clerks.
(f) 5 motorcyclists, 5 chauffeurs.
(g) Pistols for 9 chauffeurs, 5 motorcyclists, 15 orderlies.

Colonels

3

---

---

---

---

3

Lieutenant colonels

5

---

---

---

---

5

Majors

9

---

---

---

---

9

Captains or lieutenants

12

---

---

---

---

12

Commissioned interpreters

---

2

---

---

---

2

Total commissioned

30

2

---

---

---

32

Field clerks

---

---

5

---

---

5

M. H. sergeants

---

---

---

5

---

5

Hospital sergeants

---

---

---

5

---

5

Sergeants major or battalion sergeants major

---

---

---

---

d5

5

Sergeants, first class

---

---

---

25

---

25

Sergeants

---

a4

---

52

b2

58

Corporals

---

---

---

20

e8

28

Privates, first class

---

---

---

63

f10

73

Privates

---

---

---

40

h5, 12

52

Total enlisted

---

4

---

210

37

251

Aggregate

30

6

5

210

37

288

Closed cars

1

---

---

---

---

1

Touring cars

3

---

---

---

---

3

Light cars

5

---

---

---

---

5

Motor cycles, with side cars

---

---

---

---

2

2

Motor cycles

---

---

---

---

3

3

Bicycles

---

---

---

---

5

5

Horses, riding

10

---

---

---

5

15

Pistols

---

---

---

---

g29

29

RED CROSS SECTION (SERVICES VOLUNTEERED)

1

2

3

4

Remarks

Unit

Officers

Others

Total

Captain

1

---

1


 
 
 
 
 
 

Total commissioned

1

---

1

Not commissioned

---

1

1

Aggregate

1

1

2

Motor cars

1

---

1



48

With the development of the American Expeditionary Forces, decentralization had been necessary in practically every department. This movement was investigated and the following report on this subject in so far as it pertained to the chief surgeon's office was forwarded to it by the adjutant general, A. E. F., on January 10, 1918:32

Statement of organization and personnel

Division

Officers

Clerks

Soldiers

Chief surgeon

1

---

---

Personnel

a5

---

b10

Hospitalization

5

---

3

Supply

2

---

2

Sanitation and statistics

2

---

10

Records and correspondence

2

4

18

Dispensary

2

---

9

Dental office

2

---

2

21

4

54

aTwo Veterinary Corps (temporary duty).
bSorting mail.

Personnel division.-This division keeps record of all the personnel of the Medical Corps, regular or otherwise, hospital corps sergeants, and nurses, on duty in France. Most of the records concerning personnel are kept on cards; these cards give name of college, date of graduating; whether medicine,dental or veterinary surgery; previous military service and date of appointment and call into active service; and special character of professional work; also specialty and ability to speak or translate French. These cards are made out in cases of all Medical Reserve Corps men. All medical personnel arriving in Franceare now assigned to duty from this office. When the system of automatic replacements is put into effect this work should be decentralized to the line of communication.

Hospitalization.-This division handles all questions relating to the establishing of hospitals in France. The selection of sites are passed upon by the general staff at these headquarters after conference with the French mission. It is not seen how this can be divorced from the office of the chief surgeon. Theactual building and plans, etc., are now decentralized to the line of communications.

Sanitation and statistics.-All reports concerning sanitation, sick and wounded, etc., from the medical sections of all units come to this office. Statistics and reports are made up concerning them; also the weekly report to the commander in chief. If the statistical bureau is established at these and other headquarters, it is believed with representative of the Medical Department serving thereat that most sanitary reports and reports of sick and wounded could come to this bureau.

There is a certain amount of data though which should, in my opinion, come to the chief surgeon, who after all is responsible for the evacuation of sick and wounded and their care, and it is believed that in case of heavy casualties or epidemic the chief surgeon at these headquarters should receive the necessary data in order to enable him to understand the situation. Practically, the evacuation of sick and wounded will be automatic, but in times of emergency, the chief surgeon may have to act and exercise supervision over situations, and he must be kept informed as to the general situation. It is not necessary for him to have allthe information in detail that is required for final reports to Washington. Data required for furnishing reports to the commander in chief should come to the statistical bureau at these headquarters. Others which are only required for the chief surgeon's office in Washington could be sent to the statistical bureau at theheadquarters, line of communications, it is believed.

Records and correspondence.-When the automatic replacement is put into effect much of the records and correspondence work will naturally go from the chief surgeon's office to the depots of the line of communications.

There is a post office here in which is distributed all the mail for the personnel of the Medical Department serving in France. It is recommended that immediate steps be taken to have the mail distributed elsewhere, and that only mail for the personnel on duty in the Medical Department at these headquarters be forwarded here.


49

To this the chief surgeon replied as follows, on January 12:33

1. The receipt is acknowledged of your letter of January 10th (4773-F).

2. Personnel division.-Every effort has been made since arriving in France to keep the amount of work in the personnel division in this office down to the minimum. As the inspector says, there is a card in this office for every member of the Medical Department. It contains only the minimum amount ofinformation. I protest most emphatically against any proposition to remove this information from my office. It is utterly impossible for the chief surgeon of the American Expeditionary Forces to administer his officewithout knowing the personnel he has available. I am not at all concerned in regard to the automaticassignment of personnel arriving in France except in such instances where it is absolutely necessary that it shall be done from these headquarters. I wish to emphasize again that I would consider it the greatest misfortune to bring details into my office which can be handled elsewhere: These details have been given to the line of communications and to the different divisions wherever it was possible to do so. This has been carried to such an extent that personal complaints have actually been made from two of the divisions that they felt very materially the loss of contact with the chief surgeon's office.

3. Hospitalization.-This paragraph hardly calls for remark except that I am not prepared to state now that I agree with the statement of the inspector that the hospital division should rest entirely in this office. This is a question that had been up many times since these headquarters moved to Chaumont. It is being studied now and if improvement on present conditions can be made it will be promptly reported to proper authorities.

4. Sanitation and statistics.-I am perfectly willing to remove from this office as much of this division as is possible, having in mind particularly routine sick and wounded reports, with the understanding that I be furnished with the information necessary to administer the office. Attention is invited to the fact that the chief surgeon can not carry out his functions without knowing the sick rate, the prevalence of epidemicdiseases and the sanitary conditions of the troops.

5. Record and correspondence.-It is hoped that the automatic replacement will relieve this office of a great deal of the record and correspondence, and I will welcome any change in this respect which will not decrease efficiency.

6. Mail.-The distribution of mail which is being done in this office was not of my choice; it was forced upon the Medical Department. The condition which exists in this respect to-day is almost intolerable and I will welcome any proposition which will take this matter out of my office. It appears to me that this is a serious matter in the American Expeditionary Forces. Attention is invited to the great dissatisfaction whichwill be continued throughout the command if the delivery of mail, now so much delayed, is not accomplished with greater expedition.

Until February 14, 1918, there had been no general medical inspectors in the American Expeditionary Forces, but on that date two experienced officers were assigned to this duty. Though these officers functioned in the division of sanitation, chief surgeon's office, their reports considered the entire range of Medical Department responsibilities.34

On February 16, the date General Orders, No. 31, was published, reorganizing the American Expeditionary Forces, the chief surgeon's office included 19 officers, 55 clerks, and 4 orderlies. These were distributed as follows:34 Chief surgeon; personnel section, 2 officers, 11 clerks; dental, 1 officer, 1 clerk; hospitalization, 5 officers, 5 clerks; supplies, 1 officer, 3 clerks; sanitation and statistics, 4 officers, 13 clerks; records and correspondence, 2 officers, 17 clerks, 4 orderlies; veterinary, 2 officers; mail, 4 clerks; property, 1 officer, 1 clerk.

On February 22, the chief surgeon's office reported that in conformity with the order mentioned above, 16 officers, 47 enlisted men, and 4 civilians, would move to Tours.35


50

By General Orders, No. 31, G. H. Q., A. E. F., February 16, 1918, the Medical Department was charged with the following duties: Sanitary inspection; health of command; care of sick and wounded; collection and evacuation of sick and wounded; medical supplies; veterinary supplies; supply of personnel and material for gas defense under supervision of director of gas service; technical inspection of medical organizations and establishments.

In reply to a query from the general staff, A. E. F., concerning the personnel that would be required by the chief surgeon's office36 in the tables of organization for the Services of Supply, the chief surgeon, on March 8, 1918, submitted the following estimate:37

Tables of organization, chief surgeon's office, A. E. F., Services of Supply

Unit

Officers

Interpreters

Clerks

Soldiersc

Soldiers

Total

Remarks

General officer

1

---

---

---

---

1

 

(a) Carried in headquarters battalion.
(b) 1 chauffeur, 1 orderly for general officer.
(c) All from Medical Department, but attached to headquarters battalion for rations, pay, and clothing.
(d) Clerks.
(e) 3 chauffeurs, 5 clerks.
(f) 5 motorcyclists, 5 chauffeurs.
(g) Pistols for 9 chauffeurs, 5 motorcyclists, 15 orderlies.

Colonels and lieutenant colonels

15

---

---

---

---

15

Majors

20

---

---

---

---

20

Captains or lieutenants

15

15

Commissioned interpreters

---

2

---

---

---

2

Total commissioned

51

2

53

Field clerks

---

---

5

---

---

5

Master hospital sergeants

---

---

---

5

---

5

Hospital sergeants

---

---

---

5

---

5

Sergeants major or battalion sergeants major

---

---

---

---

d5

5

Sergeants, first class

---

---

---

25

---

25

Sergeants

---

a4

---

52

b2

58

Corporals

---

---

---

20

e8

28

Privates, first class

---

---

---

63

f10

73

Privates

---

---

---

40

12

52

Total enlisted

---

4

---

210

37

251

Aggregate

51

6

5

210

37

309

Closed cars

1

---

---

---

---

1

Touring cars

3

---

---

---

---

3

Light cars

5

---

---

---

---

5

Motor cycles with side cars

---

---

---

---

2

2

Motor cycles

---

---

---

---

3

3

Bicycles

---

---

---

---

5

5

Horses, riding

10

---

---

---

5

15

Pistols

---

---

---

---

g27

27

In compliance with General Orders, No. 31, G. H. Q., A. E. F., February 16, 1918, the chief surgeon's office arranged for removal of most of its personnel, records, and property, on the night of March 20, to Tours, where it was installed March 21.38 Here it absorbed and superseded the office of the chief surgeon, line of communications. On March 24, the office force of the chief surgeon, A. E. F., included 33 officers and 2 nurses.38

The organization prescribed by the chart approved by the commander in chief on March 6, 1918, was in general that followed in subsequent developments.39 The section charged with combat organization and new equipment was taken over by the representatives whom the chief surgeon left with the general staff at Chaumont, before he moved his office to Tours on March 21.40 The nomenclature of the records division was later changed to administrative division, but its duties were unchanged.41


51

CHART I.-Showing organization of chief surgeon's office, A. E. F., March 6, 1918


52

The chiefs of the 10 technical staff departments of headquarters, A. E. F., who were transferred by General Orders, No. 31, 1918, to Tours, were now under the immediate jurisdiction of commanding general, Services of Supply, in all matters pertaining to procurement, supply, transportation, and construction, but retained their titles and authority as members of the staff of the commander in chief, A. E. F.42 They were directed so to organize their offices that the efficiency of their departments would not be impaired by absences for conferences or other duties assigned them, and though their headquarters were at Tours they were authorized and expected to travel throughout the American Expeditionary Forces to investigate, direct, and supervise the work of all elements of their services, including those with combat units. The chief surgeon thus occupied a dual status, for he was at once the chief surgeon of the American Expeditionary Forces and of the Services of Supply.42

In the Services of Supply the position of the chief surgeon in relation to the general staff of that command, and with the heads of its administrative staff departments, was altogether analogous to that which as chief surgeon, he formerly had held with the corresponding departments of general headquarters, A. E. F., at Chaumont.42 In fact, as stated in the preceding chapter, the chiefs of all administrative staff departments, A. E. F., except the adjutant general, the judge advocate, and inspector general, A. E. F., had also been transferred to Tours where they had the same dual status as had the chief surgeon.42 With the adjutant general, judge advocate, and inspector general of the Services of Supply his relations were the same as with the chiefs of the other staff departments, but the scope of the Medical Department matters upon which they took definitive action pertained to the Services of Supply only.42 Though the chief surgeon was represented on the general staff, A. E. F., at Chaumont, by medical officers assigned to several of its sections, he was not represented on the general staff of the Services of Supply at Tours except for a short period when a medical officer was assigned to its first section.43 Over his subordinates in the several geographical sections (advance, intermediate, and base) into which the Services of Supply was divided, the chief surgeon exercised supervision through the section surgeons who were members of the staffs of the officers commanding those sections.16 His office had direct control, except in a few matters (especially discipline) over certain Medical Department formations which were removed from the jurisdiction of the commanding officer of the section in which they were located; e. g. hospital centers, detached base hospitals, medical supply depots, the central Medical Department laboratory, Dijon, and such hospital trains as were assigned to his office.

The chief surgeon's office, after its location at Tours and its absorption of the office of the surgeon, line of communications, was organized into the following divisions:44 (1) General administration, records and correspondence; (2) hospitalization, evacuation, and hospital administration; (3) sanitation, sanitary inspection, and medical statistics; (4) personnel; (5) medical supplies; (6) finance and accounting.

Under the chief surgeon and his executive officer, the commissioned personnel of the chief surgeon's office was distributed among its several divisions, on March 24, 1918, as follows:38 Sanitation, 7; hospitalization, 6; personnel, 4; supplies, 4; records and correspondence, 4; finance and accounts, 6.


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A chief nurse and assistant chief nurse were at the head of the nursing service in the personnel division, but members of the nursing staff were not yet commissioned.38

The assistant to the chief surgeon examined all papers going to the chief surgeon for his signature and was authorized to sign these in his absence.44 The finance and accounting section was composed of personnel recently arrived, who had been selected from a unit that had been organized in the United States to audit property and money accounts of the Medical Department in France.44

By June 3, 1918, the clerical force in the office of the chief surgeon had grown materially, but was inadequate and on that date he recommended that because of the great number of technical questions reaching his office and the consequent necessity for trained noncommissioned officers, the enlisted personnel on duty therein should be authorized in the following proportions:45 Master hospital sergeants, 2; hospital sergeants, 12; sergeants, first class, 35; sergeants, 60; corporals, 26; privates, first class, 40; privates, 27; total, 202. This number was exceeded by the latter part of July, 1918, for at that time the personnel then on duty in the chief surgeon's office was 43 officers and 220 clerks.46

FIG. 3.-Headquarters, Services of Supply, A. E. F., at Tours, viewed from within. The chief surgeon's office occupied practically the entire first floor of the wing on the right.

A seventh section of the veterinary service, was organized in the chief surgeon's office after the promulgation of General Orders, No. 139, on August 29, 1918.30 Before publication of that order, this activity had been under the control of the remount service of the Quartermaster Department, its chief being


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without administrative authority and having virtually the status of a technical adviser only.30 The general order mentioned, provided that the veterinary service be transferred to the Medical Department and that a new section charged with direction of veterinary affairs be created in the chief surgeon's office of which the chief veterinarian was, therefore, placed in charge.30

After its expansion by the addition of the veterinary division the chief surgeon's office retained the general organization then provided though its personnel steadily increased in number until after the armistice was signed.30

On November 9, 1918, 58 officers were on duty in the chief surgeon's office, distributed as follows:47 Chief surgeon, 1; assistant to chief surgeon, 1; general administration, 1; detachment of enlisted men, Medical Department, 1; records, 1; library, 4; hospitalization, 13 (transportation, 7; sick and wounded, 5); sanitation, 4 (sanitary inspection, 1); personnel, 4 (dental, 5; promotions, 1); supplies, 5; finance and accounts, 4; veterinary, 6.

FIG. 4.-Building in Tours, in which the finance and accounting division of the chief surgeon's office was located

Other personnel who were in charge of specialties in the chief surgeon's office but who were not commissioned included nurses and dietitians. It will be noted that 25 of the 61 officers whose duties were classified above-i. e., more than 40 per cent-were serving in the hospitalization division.47

The personnel serving in the chief surgeon's office or in immediate connection therewith on November 11, the date the armistice was signed, were distributed by rank as follows:48 Officers: Brigadier generals, 2; colonels (one being the chief surgeon, later promoted), 6; lieutenant colonels, 12; majors 6; captains, 9; first lieutenants, 27; second lieutenants, 6. Total, 68.


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CHART II.-Scheme for organization of Medical Department, A. E. F., corrected to November 11, 1918


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Nursing service: Nurses, 2; enlisted men: Master hospital sergeants, 1; hospital sergeants, 21; sergeants, first class, 55; sergeants, 83; corporals, 46; cooks, 3; privates, first class, 26; privates, 43. Total, 278. Civilian employees, 76; grand total, 424.

PERSONNEL

(July 28, 1917, to July 15, 1919)

CHIEF SURGEON, A. E. F.

Brig. Gen. Alfred E. Bradley, M. C., to April 30, 1918.
Maj. Gen. Merritte W. Ireland, M. C., May 1 to October 9, 1918.
Brig. Gen. Walter D. McCaw, M. C., October 10, 1918, to July 15, 1919.

DEPUTY CHIEF SURGEON

Brig. Gen. Jefferson R. Kean, M. C.
Brig. Gen. Francis A. Winter, M. C.

REFERENCES

(1) Letter from the Surgeon General, U. S. Army, to The Adjutant General of the Army, May 10, 1917. Subject: Designation of Col. Alfred E. Bradley, M. C., as chief surgeon, United States forces in Europe. On file, Record Room, S. G. O. (9795).

(2) Letter from The Adjutant General of the Army, to Col. Alfred E. Bradley, M. C., American Embassy, London, May 28, 1917. Subject: Designation as chief surgeon of the United States forces in Europe. On file, Record Room, S. G. O. (9795).

(3) Letter from the chief surgeon, A. E. F., to the Surgeon General, U. S. Army, June 11, 1917. Subject: Status. On file, Record Room, S. G. O. (9795).

(4) Report from the chief surgeon, A. E. F., to the commanding general, A. E. F. (undated). Subject: Outline report of chief surgeon, A. E. F., for use in preparation of the report of the commander in chief. On file, Historical Division, S. G. O.

(5) Letter from The Adjutant General of the Army, to Col. A. E. Bradley, M. C., May 29, 1917. Subject: Assignment. On file, Record Room, S. G. O. 9785 (Old Files).

(6) Memorandum from the chief surgeon, A. E. F., to Maj. W. J. L. Lyster, M. C., American Embassy, London, June 11, 1917. Subject: Administration of American medical personnel serving with British Forces. On file, Record Room, S. G. O., 9795 (Old Files).

(7) Final report of Gen. John J. Pershing, September 1, 1919, 5.

(8) Letter from the chief surgeon, A. E. F., to the commander in chief, A. E. F., June 21, 1917. Subject: Report of personnel of chief surgeon's office. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(9) Wadhams, Sanford H., Col., M. C., and Tuttle, Arnold D., Col., M. C.: Some of the Early Problems of the Medical Department, A. E. F. The Military Surgeon, Washington, D. C., 1919, xlv, No. 6, 636.

(10) Memorandum from the chief surgeon, A. E. F., to the chief of staff, A. E. F., July 14, 1917. Subject: Weekly war diary. Copy on file, Historical Division, S. G. O.

(11) Special Orders, No. 26, Headquarters, A. E. F., July 4, 1917, par. 2.

(12) Report from Col. Sanford H. Wadhams, M. C., the Representative of the chief surgeon, A. E. F. with the General Staff G-4-"B" to the chief of the fourth section, general staff, general headquarters, A. E. F., December 31, 1918. Subject: Activities of the medical group, fourth section, general staff, A. E. F., for the period embracing the beginning and end of America's participation in hostilities. Copy on file, Historical Division, S. G. O.


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(13) Final report from the adjutant general, A. E. F., to the commander in chief, A. E. F., from May 28, 1917, to April 30, 1919. On file, General Headquarters, A. E. F. Records.

(14) General Orders, No. 42, G. H. Q., A. E. F., September 26, 1917.

(15) Memoranda from the chief surgeon, A. E. F., to the chief of staff, A. E. F., from July 14, 1917, to and including December 29, 1917. Subject: Weekly war diaries. On file, Historical Division, S. G. O.

(16) General Orders, No. 20, G. H. Q., A. E. F., August 13, 1917; also memorandum from the chief surgeon, A. E. F., to the chief of staff, A. E. F., July 21, 1917. Subject: Weekly war diary. On file, Historical Division, S. G. O.

(17) War diary, chief surgeon's office, A. E. F., July 21, 1917.

(18) Report of medical activities, line of communications, A. E. F., during the war period (undated), by Brig. Gen. Francis A. Winter, M. C. On file, Historical Division, S. G. O.

(19) Report on medical supply, A. E. F. (not dated), by Maj. A. P. Clark, M. C. On file, Historical Division, S. G. O.

(20) War diary, chief surgeon's office, A. E. F., July 28, 1917.

(21) War diary, chief surgeon's office, A. E. F., August 4, 1917.

(22) War diary, chief surgeon's office, A. E. F., September 2, 1917.

(23) General Orders, No. 8, G. H. Q., A. E. F., July 8, 1917.

(24) War diary, chief surgeon's office, A. E. F., August 26, 1917.

(25) Report from the chief surgeon, A. E. F., to the Surgeon General, U. S. Army, May 1, 1919. Subject: Activities of the chief surgeon's office, A. E. F., to May 1, 1919. On file, Historical Division, S. G. O.

(26) Memorandum from the adjutant general, A. E. F., to the chief surgeon, A. E. F., September 13, 1917. Subject: Project of Medical Department. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(27) Memorandum from the chief surgeon, A. E. F., to the chief of staff, October 9, 1917. Subject: Tables of organization. On file, A. G. O., World War Division, chief surgeon's files (320.2).

(28) Memorandum from the chief surgeon, A. E. F., to the adjutant general, A. E. F., November 7, 1917. Subject: Chart showing subdivisions in his office. On file, A. G. O., World War Division, chief surgeon's files (320.2).

(29) Personnel records. On file, Army Nurse Corps, S. G. O. (Bessie S. Bell).

(30) Report from the chief surgeon, A. E. F., to the commanding general, A. E. F., April 17, 1917. Subject: Activities of the Medical Department, A. E. F., to November 11, 1918. On file, Historical Division, S. G. O.

(31) Tables of organization for general headquarters, A. E. F., in France, approved by Gen. John J. Pershing, December 22, 1917. On file, A. G. O., World War Division, chief surgeon's files (320.2).

(32) Letter from the adjutant general, A. E. F., to the chief surgeon, A. E. F., January 10, 1918. Subject: Report on investigation of methods of decentralization. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(33) Letter from the chief surgeon, A. E. F., to the adjutant general, A. E. F., January 12, 1918. Subject: Report of investigation of methods of decentralization. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(34) List of officers and clerks on duty in the chief surgeon's office, February 16, 1918. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(35) Memorandum from the chief surgeon, A. E. F., to the post quartermaster, February 22, 1918. Subject: Transfer to Tours. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(36) Memorandum from assistant chief of staff, G-3, A. E. F., to the chief surgeon, A. E. F., February 26, 1918. Subject: Tables of organization for the service of the rear. On file, A. G. O., World War Division, chief surgeon's files (320.2).

(37) Letter from the chief surgeon, A. E. F., to the commanding general, S. O. R., A. E. F., March 8, 1918. Subject: Tables of organization. On file, A. G. O., World War Division, chief surgeon's files (320.2).


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(38) War diary, chief surgeon's office, A. E. F., March 24, 1918.

(39) Scheme for organization of the medical department, submitted by the chief surgeon, A. E. F., February 22, 1918, and approved by the commander in chief, A. E. F., March 6, 1918. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(40) Letter from the chief surgeon, A. E. F., to the commander in chief, A. E. F., March 15, 1918. Subject: Organization. On file, A. G. O., World War Division, chief surgeon's files (320.2).

(41) Report on the administrative section of the chief surgeon's office, A. E. F., by Capt. R. A. Dickson, M. A. C. On file, Historical Division,
S. G. O.

(42) General Orders, No. 31, G. H. Q., A. E. F., February 16, 1918.

(43) Report from Col. N. L. McDiarmid, M. C., to the Surgeon General, U. S. A., May 1, 1919. Subject: Activities of the supply division, chief surgeon's office, A. E. F. On file, Historical Division, S. G. O.

(44) Report from the chief surgeon, A. E. F., to the commanding general, A. E. F., July 1, 1918. Subject: The Medical Department in the American Expeditionary Forces to May 31, 1918. On file, Historical Division, S. G. O.

(45) First indorsement from the chief surgeon, A. E. F., to the assistant chief of staff, G-1, A. E. F., June 3, 1918, on memorandum from assistant chief of staff, G-1, A. E. F., to chief surgeon, A. E. F., May 31, 1918. Subject: Table of organization. On file, A. G. O., World War Division, chief surgeon's files (320.1).

(46) Memorandum from the chief surgeon, A. E. F., to assistant chief of staff, G-4, A. E. F., July 4, 1918. Subject: Office personnel and space. On file, A. G. O., World War Division, chief surgeon's files (321.6).

(47) Circular No. 54, chief surgeon's office, A. E. F., November 9, 1918. On file, Historical Division, S. G. O.

(48) Memorandum from the chief surgeon, A. E. F., to assistant chief of staff, G-1, A. E. F., December 2, 1918. Subject: Personnel and transportation. On file, A. G. O., World War Division, chiefsurgeon's files (321.6).

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