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Chapter VIII

Contents

CHAPTER VIII

THE DIVISION OF SANITATION AND INSPECTIONa

ORGANIZATION

The division of sanitation, chief surgeon's office, A. E. F., eventually became, in very large degree, an office of preventive medicine wherein all activities relating to that subject were centralized.1 However, this centralization was not complete until December 26, 1918, when there was transferred to the sanitation division the subsection of venereal diseases, which in the division of urology had theretofore pertained, with the other professional services, to the division of hospitalization.2

CHART III.-Scheme for organization of division of sanitation and inspection, chief surgeon's office, A. E. F.

When the chief surgeon's office, A. E. F., was organized, July 28, 1917, the prescribed activities of the division of sanitation were as follows:3 In charge of sanitation of camps and quarters, laundries, disinfection and delousing, health of command, report of sick and wounded, statistics and sanitary reports. Subsequently these activities were somewhat modified, several of them being transferred from the Medical Department to other departments of the American Expeditionary Forces. Thus, General Orders, No. 31, G. H. Q., A. E. F., January 21, 1918, directed the provision and operation of laundries be vested in the Quartermaster Corps, and that portable shower baths, taken by organizations into the zone of the advance, be installed when necessary by the engineers. General Orders, No. 60, G. H. Q., A. E. F., April 20, 1918, provided that the personnel of portable disinfestors be furnished by the engineers, and that of portable laundries and bathing units by the Quartermaster Corps. Concurrently with this transfer of some of its responsibilities, the sanitation division assumed others which had not pertained to it originally.2 By General Orders, No. 29, G. H. Q., A. E. F., February 14, 1918, general sanitary inspectors were provided for, and though these officers reported on a wide range of subjects, in addition to sanitation, they were essentially a part of the division of sanitation.

aConsult also Sec. II, Vol. VI, of this history, wherein a fuller consideration is given the activities of this division.


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On March 6, 1918, the chief surgeon prescribed that the division of sanitation be organized into the following sections:2 (1) Sick and wounded records; (2) laboratories and infectious diseases; (3) inspection; (4) epidemiology. Though the last-mentioned section was established while the chief surgeon's office was yet at Chaumont-that is, during the early part of March-this outlined organization was not effected immediately.2 On March 31, the division of sanitation was redesignated the division of sanitation, sanitary inspection, and sanitary statistics, with duties more clearly defined and established than they had been during the formative stage of its activities.4 On May 5, 1918, the laboratory service was separated from the other professional services5 with which it formerly had been operating under the division of hospitalization, to become a part of the division of sanitation, though formal orders concerning this transfer, and the reorganization of the section of laboratories and infectious diseases as a part of the division of sanitation, were not published until July 20, 1918.6

The organization outlined above was retained until December 26, 1918, when, as previously stated, the division of urology was transferred to the division of sanitation from that of the professional services.2

ADMINISTRATIVE FUNCTIONS

In view of the organization described above, the administrative functions which were included within the jurisdiction of the division of sanitation and inspection may be classified as follows:2

(a) The receipt, record, and analysis of reports of disease and injury.

(b) The receipt and review of monthly and special sanitary reports.

(c) The selection, supply, and direction of laboratory services for the prevention, diagnosis, and treatment of disease, for the protection of water and food supplies, and for research by experimental laboratory methods in all matters pertaining to personal hygiene, physiology, the science of nutrition, pathology, and bacteriology, as they bore upon the problems of the armies.

(d) Inspection of areas and premises occupied by the troops together with such examination of men, singly, or in groups, as was required in tracing the origin, distribution, and spread of causes of noneffectiveness, whether due to communicable disease or to other cause.

(e) Correlation of the reports of disease with the reports of sanitary conditions, troop movements, weather conditions, military operations, or other essential factors, to the end that epidemics might be brought to an end promptly and their recurrence prevented.

(f) Collection of data for statistical purposes to serve as a basis for the direction of sanitary policies during the present emergency, and for the service of students and administrators in the future.

(g) The selection, training, and appointment of qualified officers and enlisted men to serve the functions above described.

(h) Collection and publication of information dealing with preventive medicine.

(i) Maintenance of liaison with other divisions of the Medical Department.

(j) Maintenance of liaison with the medical services, both civilian and military, of our Allies, and with conditions of disease among our enemies, which might affect the health of our troops.

OFFICE CONTROL

Communications between the division of sanitation and inspection and other divisions of the Medical Department passed through the office of the chief of the division. All but routine reports were submitted direct to the chief of the division.2


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By central control of correspondence and of reports concerning personnel and supplies, at the offices of the chief of the division, and of the director of laboratories, provision was made and responsibility placed, for all actions taken.2

MEETINGS AND LIAISON

Meetings of the heads of the subdivisions at the office of the sanitation division, at Tours, or at the central Medical Department laboratory, at Dijon, provided frequent opportunity for the discussions of new problems and agreement upon policies affecting the division of sanitation.2 Through the deputy of the chief surgeon, at General Headquarters, the chief of the division of sanitation was kept constantly informed of the changing problems of the general staff.2 Through the surgeons of armies, or of the administrative sections of the Services of Supply, he was kept in touch with the needs of combat troops and of organizations in the Services of Supply, from the moment of their arrival at the ports of debarkation, to arrival at their station in the Services of Supply, or at the front.2 Officers,-e. g., sanitary inspectors and laboratory experts-charged with duties pertaining to the sanitary services, were assigned to the larger organizations of combat troops, to sections of the Services of Supply, to hospital centers, training areas, and other large commands.7 When the size of an organization did not justify the assignment of an officer to such service exclusively, one was charged with sanitary services of the command in addition to his other duties.7 Officers charged with sanitary duties thus served all commands from the largest to the smallest, and through these agencies, by successive echelons of responsibility, the sanitation division exercised appropriate supervision in its specialty over all elements of the American Expeditionary Forces.7

Close contact existed between the divisions of sanitation and hospitalization, particularly in matters pertaining to infectious diseases.7 These included the venereal diseases, after the subsection charged with that specialty was transferred to the division of sanitation as described above. The laboratory division was in especially close liaison with the professional services.7

The location of the headquarters of the division of laboratories and infectious diseases at Dijon, while the office of the chief surgeon was located at Chaumont, and then at Tours, caused at times, especially after the chief surgeon's office moved to Tours, delay and inconvenience to the office of sick and wounded and that of epidemiology, but difficulties in communication were reduced to a minimum by the almost daily telephonic and telegraphic communication, exchange of reports, and the frequent conferences held by the heads of the subdivision.2

The sanitation division also maintained close contact, in matters pertaining to bathing and disinfestation, with the Quartermaster Department,2 and through its laboratory division with the laboratories of the Chemical Warfare Service.8

The division also maintained contact with the French civil and military services, in matters pertaining to sanitation and epidemiology, through the medical officers of the French military missions at general headquarters and at headquarters, Services of Supply, and through the French medical officers in each of the French regions in which American troops were stationed, or through which they passed.9


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PERSONNEL a

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

Brig. Gen. Walter D. McCaw, M. C., chief.
Col. Percy M. Ashburn, M. C., chief.
Col. Daniel W. Harmon, M. C., chief.
Col. Henry A. Shaw, M. C., chief.
        Col. Haven Emerson, M. C.
        Col. Henry C. Fisher, M. C.
        Col. Daniel W. Harmon, M. C.
        Col. Paul C. Hutton, M. C.
        Col. Howard H. Johnson, M. C.
        Col. James C. Magee, M. C.
        Col. Robert U. Patterson, M. C.
        Col. George Walker, M. C.
        Col. Linsley R. Williams, M. C.
        Maj. George Blackburne, M. C.
        Maj. Robert H. Delafield, San. Corps.
        Maj. John S. C. Fielden, jr., M. C.
        Maj. Bascom Johnson, San. Corps.
        Maj. Frank A. Ross, San. Corps.
        Capt. George J. Anderson, San. Corps.
        Capt. T. L. Harrington, M. C.
        First Lieut. Howard H. Antles, San. Corps.
        First Lieut. Arthur B. Crean, San. Corps.
        First Lieut. Arthur E. Nelson, San. Corps.
        First Lieut. Dennison Walcott, San. Corps.

REFERENCES

(1) Report from Lieut. Col. J. F. Siler, M. C., director of laboratories and infectious diseases, A. E. F., to the chief surgeon,  A. E. F. (undated). Subject: Activities of the division of laboratories and infectious diseases, from August, 1917, to July, 1919. On file, Historical Division, S. G. O.

(2) Report of the division of sanitation and inspection, Medical Department, A. E. F., May 31, 1919, by Col. Haven Emerson, M. C. On file, Historical Division, S. G. O.

(3) Report from the chief surgeon, A. E. F., to the commanding general, Headquarters, A. E. F., April 17, 1919. Subject: The Medical Department, A. E. F., to November 11, 1918. On file, Historical Division, S. G. O.

(4) Memorandum from the chief surgeon, A. E. F., to the chief of staff, A. E. F., April 1, 1918. Subject: War diary for week ending March 31, 1918. On file, Historical Division, S. G. O.

(5) Circular No. 25, chief surgeon's office, A. E. F., May 5, 1918. On file, Historical Division, S. G. O.

(6) Circular No. 40, chief surgeon's office, A. E. F., July 20, 1918. On file, Historical Division, S. G. O.

(7) Report on "Sanitary reports, monthly and special," October 7, 1921, by Col. Haven Emerson, M. C. On file, Historical Division, S. G. O.

(8) 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.

(9) Letter from the chief surgeon, A. E. F., to Sous-Secretaire d'Etat du Service de Sante, section Franco-Americaine French mission, G. H. Q.,
A. E. F., March 8, 1919. Subject: Epidemic diseases in the A. E. F. On file, A. G. O., World War Division, chief surgeon's files, 710.

aIn this list have been included the names of those who at one time or another were assigned to the division during the period July 28, 1917, to July 15, 1919.
There are two primary groups-the heads of the division or the section and the assistants. In each group names have been arranged alphabetically, by grades, irrespective of chronological sequence of service.

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