|OFFICE OF MEDICAL HISTORY AMEDD REGIMENT AMEDD MUSEUM|
HISTORY OF THE OFFICE OF MEDICAL HISTORY
THE AISNE-MARNE OPERATION; JULY 18 TO AUGUST 6, 1918. DIVISIONS PARTICIPATING WITH THE FRENCH:a b 1ST, 2D, 3D, 4TH (JULY 18-22 AND JULY 28); 32D (JULY 30 TO AUGUST 2); FIRST CORPS, 26TH, 42D, AND, FROM AUGUST 3, 4TH; THIRD CORPS (FROM AUGUST 3), 3D, 32D, AND 28TH
The following extracts are quoted from the Final Report of General Pershing:1 2
The Marne salient was inherently weak and offered an opportunity for a counteroffensive that was obvious. If successful, such an operation would afford immediate relief to the allied defense, would remove the threat against Paris, and free the Paris-Nancy Railroad. But, more important than all else, it would restore the morale of the Allies and remove the profound depression and fear then existing. Up to this time our units had been put in here and there at critical points as emergency troops to stop the terrific German advance. In every trial, whether on the defensive or offensive, they had proved themselves equal to any troops in Europe. As early as June 23 and again on July 10, at Bombon, I had very strongly urged that our best divisions be concentrated under American command, if possible, for use as a striking force against the Marne salient. Although the prevailing view among the Allies was that American units were suitable only for the defensive, and that at all events they could be used to better advantage under allied command, the suggestion was accepted in principle, and my estimate of their offensive fighting qualities was soon put to the test.
* * * * * * *
The selection by the Germans of the Champagne sector and the eastern and southern faces of the Marne pocket on which to make their offensive was fortunate for the Allies, as it favored the launching of the counterattack already planned. There were now over 1,200,000 American troops in France, which provided a considerable force of reserves. Every American division with any sort of training was made available for use in a counteroffensive.
General Pétains initial plan for the counterattack involved the entire western face of the Marne salient. The First and Second American Divisions, with the First French Moroccan Division between them, were employed as the spearhead of the main attack, driving directly eastward, through the most sensitive portion of the German lines, to the heights south of Soissons. The advance began on July 18, without the usual brief warning of a preliminary bombardment, and these three divisions at a single bound broke through the enemys infantry defenses and overran his artillery, cutting or interrupting the German communications leading into the salient. A general withdrawal from the Marne was immediately begun by the enemy, who still fought stubbornly to prevent disaster.
The First Division, throughout 4 days of constant fighting, advanced 11 kilometers (6.8 miles), capturing Berzy-le-Sec and the heights above Soissons and taking some 3,500 prisoners and 68 field guns from the 7 German divisions employed against it. It was relieved by a British division. The Second Division advanced 8 kilometers in the first 26 hours, and by the end of the second day was facing Tigny, having captured 3,000 prisoners
and 66 field guns. It was relieved the night of the 19th by a French division. The result of this counteroffensive was of decisive importance. Due to the magnificent dash and power displayed on the field of Soissons by our First and Second Divisions, the tide of war was definitely turned in favor of the Allies.
Other American divisions participated in the Marne counteroffensive. A little to the south of the Second Division, the Fourth was in line with the French and was engaged until July 22. The First American Corps, Maj. Gen. Hunter Liggett commanding, with the Twenty-sixth Division and a French division, acted as a pivot of the movement toward Soissons, capturing Torcy on the 18th and reaching the ChateauThierrySoissons road on the 21st. At the same time the Third Division crossed the Marne and took the heights of Mont St. Pere and the villages of Charteves and Jaulgonne.
In the First Corps the Forty-second Division relieved the Twenty-sixth on July 25 and on the 26th extended its front, relieving the French divisions. From this time until August 2 it fought its way through the Forest de Fere and across the Ourcq, advancing toward the Vesle until relieved by the Fourth Division on August 3. Early in this period elements of the Twenty-eighth Division participated in the advance.
Farther to the east the Third Division forced the enemy back to Roncheres Wood, where it was relieved on July 30 by the Thirty-second Division from the Vosges front. The Thirty-second, after relieving the Third and some elements of the Twenty-eighth on the line of the Ourcq River, advanced abreast of the Forty-second toward the Vesle. On August 3 it passed under control of our Third Corps, Maj. Gen. Robert L. Bullard commanding, which made its first appearance in battle at this time, while the Fourth Division took up the task of the Forty-second Division and advanced with the Thirty-second to the Vesle River, where, on August 6, the operation for the reduction of the Marne salient terminated.
In the hard fighting from July 18 to August 6 the Germans were not only halted in their advance but were driven back from the Marne to the Vesle and committed wholly to the defensive. The force of American arms had been brought to bear in time to enable the last offensive of the enemy to be crushed.2
* * * * * * *
DIVISIONS PARTICIPATING WITH THE FRENCH
THE 1ST DIVISION
On July 15, 1918, orders were received from the French Tenth Army, placing the 1st Division under the French Twentieth Army Corps, and the same date orders from the latter corps directed the movement of that division in the direction of the sector held by the French Twentieth Corps, southwest of Soissons. This movement began during the night of July 15-16, the numerous elements of the division being carried in trucks. On July 16, the division, P. C., was established at Mortefontaine. During the night of July 17-18 the division marched to its position, on the extreme left of the Twentieth Corps southwest of Soissons.3
For four days the division advanced against determined resistance, finally crossing the SoissonsChateauThierry road and bringing Soissons itself under American guns. The division advanced 11 km. (6.8 miles), captured 3,500 prisoners, 68 guns, and quantities of other materials.4
The following extracts from the divisional report of operations describe its activities here in greater detail:3
July 17 orders were received from the 20th C. A. that the 10th Army French would make an offensive to break the enemy's front between the Aisne and the Ourcq and would
push in the direction of Fere-en-Tardenois. * * * The attack was ordered for 4.45 a. m. July 18. It was not to be preceded by artillery fire, but the advance was to be covered by a rolling barrage. * * *
All troops were in place in sufficient time to begin the attack at 4.35 a. m. At 5.30 a. m. the 1st objective had been attained by all troops, with comparatively few losses, and there was little resistance encountered-mostly on the right. At 7.15 a. m. the right of the attack had reached the 2d objective. The left of the division was on the west side of the Missy ravine. Shortly afterwards the 2d objective was reached by all troops. The 2d Brigade had heavy fighting in the Missy ravine. After the halt at the 2d objective, the 2d Brigade was unable to continue the advance to the 3d objective on this day.
The 1st Brigade advanced to the 3d objective and pushed patrols out in front of the objective. * * * At the end of the day the situation was: 2d Brigade on 2d objective * * *, 1st Brigade on 3d objective, with left flank extended to establish liaison with the 2d Brigade. * * *
On the night of July 18-19 orders were received from the 20th C. A. that the 10th Army would continue the attack at 4 a. m. July 19th. * * *
In conformity with these orders the division attacked at 4 a. m. * * * In liaison with the Moroccan Division, the 1st Brigade was able to advance and to occupy a line extending from the head of the Chazelle ravine to its junction with the 2d Brigade, on the SoissonsParis road. The 2d Brigade continued to suffer heavily from machine-gun fire and was unable to advance beyond the Soissons-Paris road at this time. * * * At 5.30 p.m.,in liaison with the 153d D. I. on the left, the division again attacked. * * * This operation was successful, although many casualties were suffered from machine-gun fire from strong points to the north. At night the front of the division was marked by Ferme de Mt. de Courmellesedge of Ploisy ravineChazelle. The casualties suffered in this days operation were heavy; probably 3,000 for this day and 4,500 for the two days. * * * On July 20th orders were received from the 20th C. A. that on account of the difficulties the 153d D. I. had encountered in its progress the 1st Division would be charged with the taking of Berzy-le-Sec, formerly in the zone of the 153d D. I., and that the zone of action of the 1st Division would extend to the north of the village. In compliance with the above orders the division attacked at 2 p. m. for the purpose of taking Berzy-le-Sec and heights to the north and straightening the front of the division on the general line Berzy-le-SecBuzancy. * * *The 2d Brigade suffered very heavily from machine-gun nest to north, which had not yet been taken and was not able at this time to take Berzy-le-Sec. The 1st Brigade, in liaison with the Moroccan Division, crossed the railroad and advanced to the vicinity Bois Gerard, Visigneux, and Aconin farm, retiring its left flank to connect with the 2d Brigade. The situation at nightfall was: 28th Infantry on plateau in front of Berzy-le-Sec; 26th Infantry dug in along road between Berzy-le-Sec and Chazelle; 1st Brigade in liaison with the 2d Brigade, and with Moroccan Division at Visigneux. Casualties continued heavy; approximately 1,000 for the day. * * *
During the night of July 20-21 orders were received from the 20th D. I. that the corps would attack on the morning of July 21 at 4; * * *.The first objective was given as Berzy-le-Sec (inclusive) the heights north and east of Buzancy-Buzancy (exclusive).
In conformity with these orders the division attacked at 4 a. m.,July 21. * * * The 1st Brigade was sent forward * * * at 8.30 a. m. * * * the 2d Brigade advanced * * * and at 9.15 took Berzy-le-Sec. * * *
The line at nightfall was the heights north of Berzy-le-Sec, the Chateau-ThierrySoissons road, south of the Sucrerie, and the heights north of Visigneux. Casualties continued heavy. ***
On July 22 the 26th Infantry occupied the Sucrerie. * * * Casualties were lighter. * * * Orders were received for the relief of the division by the 15th Scottish Division, beginning the night of July 22-23 * * * and ending July 23-24. * * *
In accordance with the above orders all elements of the division except the Field Artillery brigade, the ammunition trains and the sanitary units were relieved and withdrawn from the sector on the night of July 22-23.3
MEDICAL DEPARTMENT ACTIVITIES
The division surgeons office was located at Pierrefonds-les-Bains before the attack and was then moved to Mortefontaine and finally to Cuvres-et-Valsery.5
Regimental aid stations with troops were located as follows:5
16th Infantry: Cutry, Missy-aux-Bois.
During the entire advance battalion aid stations were located in shell holes, old gun emplacements, in caves or cellars, and behind hills, within
their shelter. These stations were very mobile, being almost constantly on the move, and keeping in as close touch as possible with the troops they served.5
The medical personnel of the regiments served with their organizations, regimental surgeons establishing their stations in the vicinity of regimental headquarters; while battalion surgeons, with their enlisted personnel, accompanied their units and established aid stations and collecting points as close to the fighting line as the terrain would permit.6 At first there was ashortage of medical supplies at the front, as they were not being brought forward rapidly enough, and in an effort to meet deficiencies German material of this character was hunted for on the field.
For the first two days, supplies were carried in Hospital Corps pouches and in sacks, or "feed bags," as they were called by the enlisted men.6Not only was there a shortage in dressings, splints, and bandages, but the number of litters available was very limited.6 After the second day ambulances carried to the collecting points for wounded, litters and other supplies that had been brought up by truck from Paris.6 Regimental medical personnel was taxed to its limit to keep the advancing line cleared of the wounded.
Litter bearers worked constantly in the open, under machine-gun and shell fire, and a number of them were killed or wounded.7 Every medical organization at the front impressed German prisoners into service as litter bearers; by this means it was possible to keep more ofthe enlisted men of the Medical Department with the combatant line. There they rendered prompt first-aid service. The number of such men assigned to regiments was inadequate, and, contrary to Field Service Regulations, men of the line in a number of instances carried their wounded comrades toward the rear.7
First-aid dressings and bandages and, when advisable, splints were applied at the first point behind the firing line offering comparative protection from fire. As long as a supply was available, strychnine or morphine was administered hypodermically, by means of the Greeley unit tubes, whenever such medication was indicated. Antitetanic serum was not administered until the wounded reached a dressing station or a field hospital. From the first point where they were given attention the wounded unable to walk were carried by litters to the farthest forward location reached by ambulances. In many cases no issue litters were available and improvisations of all kinds were utilized, the most popular of these being made of blouses or ponchos with rifles for side bars. The wounded often had to be kept in the protecting shell holes until after nightfall, on account of the impossibility of transporting them with safety across the shell and bullet swept stretches intervening between them and sheltered points farther toward the rear.7 No hot drinks or food were available until the wounded reached the dressing stations, and many men arrived at these points in much worse condition than would have been the case otherwise. During the advance the troops lived on the two days reserve ration which they had with them when the attack began. As it was impossible for rolling kitchens or water carts to get close enough to the line to supply the troops, the dressing stations had to care for wounded who not only had been exhausted by severe fighting in rain and mud but whose physical resistance had been further lowered by lack of sufficient nourishment.8
During the march toward Soissons the sanitary train had been removed from the control of the division surgeon, and for some time he was unable to locate it.9 Apparently, from some oversight, he had not been consulted regarding the location of Medical Department formations, his first information concerning lines of evacuation and the location of dressing stations coming from G-l of the French Twentieth Corps.10 This was verified as soon as communication could be established with G-1 of the 1st Division.10 The only dressing stationestablished at first was located at Haute-Fontaine, about 9 km. (5.5 miles) in rear of the line of departure, in a barn used also by the French.10 Nearer the front were stationed a medical officer, a few enlisted men, and a few trucks, but the rapidity of the movement and the promptitude of the attack were such that there had been no time to designate evacuation routes, to post
men, to direct the slightly wounded, or to perform similar duties.10 Within a few hours after the attack the above-mentioned station was moved to Cuvres and another was established at Cutry.10
Ambulance Company No. 2 operated a dressing station at Cutry July 18-19 and there cared for 1,653 patients. On the morning of July 19 the station moved to Dommiers where, in a ruined building, it dressed and evacuated 1,900 patients during the ensuing 36 hours. On July 20 the station again moved forward, this time to Chaudun, about 2 km. (1.2 miles) behind the line, where it remained until July 23, when it was relieved by a medical unit of the 15th Scottish Division. Our station at this point cared for some 1,200 wounded.11
Ambulance Company No. 3 opened a dressing station at 6 a. m. on July 17 in a large cave near Cuvres and sent 40 men to serve the Infantry as litter bearers, employing its vehicles to evacuate from the advance dressing stations to Field Hospital No. 3, at Mortefontaine, and to Field Hospitals No. 2 and No. 12 at Pierrefonds-les-Bains. The company operated here until July 24, passing 500 patients through its stations and evacuating a much greater number.12
Ambulance Company No. 12 established a dressing station July 18 at Cuvres, but was moved daily as the front advanced, until, when the division was relieved, it was operating in a cave at Missy-aux-Bois. Fourteen hundred and seventy-seven patients passed through the stations of this company.13
Ambulance Company No. 13 operated a dressing station at Haute-Fontaine July 18, but the next day moved to Cuvres, where it operated until July 23. It furnished litter bearers to the 16th and 18th Infantry. While in this sector the company evacuated some 2,000 patients.14
United States Army Ambulance Section No. 649 supplemented the division ambulance companies, transported the wounded from the various collecting points and dressing stations to the field hospitals, but the number of wounded was so great that despite its assistance ambulances available were insufficient to evacuate the wounded expeditiously. The local representative of the American Red Cross obtained from Paris 40 additional ambulances,15 which joined on the morning of July 19 and began operations at once. Trucks of the divisional sanitary train, supply train, Red Cross, Salvation Army, and Young Mens Christian Association were also employed to remove the wounded, but though each could carry eight recumbent cases at a time they were too unwieldy and too hard riding to lend themselves satisfactorily to this purpose.9 The animal-drawn ambulances with the division proved unsuitable and were not used; the personnel of the company served as litter bearers.16
At the beginning of this operation 96 men of the sanitary train had been sent to reinforce the Medical Department detachments of the regiments, but the brigade commanders to whom they were reported assigned them, apparently because of immediate needs, in such a manner that some regiments received none, thus necessitating the use of some line troops in those regi-
ments in order to remove the wounded.16 Casualties among medical officers were so great that it was necessary to call in and assign to regiments all the medical officers on duty with certain noncombatant elements, e. g., the ammunition and supply trains.16
Even after they had been placed in ambulances the wounded were not out of danger from shells or gas, for the roads were shelled and bombed frequently.8 The enemy was thoroughly acquainted with the terrain and its places of possible shelter. "Whether by accident or design, approaches to dressing stations and field hospitals seemed to be the favorite targets. In the spacious caves used as dressing stations (that near Cuvres could shelter 500 men) the wounded were protected from battle and from weather, and all sounds of battle were excluded. Though patients remained here but a short time, the relaxation they enjoyed for the first time in many days, in quietude, aided greatly in preparing them for the trip to the field hospitals."8
Field Hospital No. 12 arrived at Pierrefonds-les-Bains at 6 p. m. on July 17, established itself in an old hotel, and began caring for surgical cases.17 The location was poor in the extreme, but it was the only place available, as all of the good locations had been occupied by the French.9 During the first few days of combat this hospital expanded enormously to include all the neighboring buildings and streets and was augmented by personnel from Field Hospital No. 2, by several surgical teams sent up from the rear, and by X-ray equipment from Mobile Surgical Unit No. 2.17 The first casualties at this hospital were admitted at about 7 a. m. on July 18, and thereafter it continued to give emergency surgical aid until after the relief of the division, including among its patients some from the Scottish division which relieved our 1st Division.17 It cared here for 3,385 patients, evacuating to Crepy-en-Valois, whence patients were to be moved by hospital trains.18
Field Hospital No. 3 proceeded to Mortefontaine at about 11 a. m. on July 18, establishing the next day in tentage a triage hospital, which functioned as such throughout the remainder of the operation.17 It received and evacuated approximately 5,000 patients,19 including 3,417 slightly wounded.20 The division surgeon made request of G-1 that Field Hospital No. 3 be ordered to Cuvres-et-Valsery, but this was disapproved on the ground that the site was too far forward and would be in danger of shell fire. This site was then used for four days as a collecting point.10 A calculation made after the engagement showed that had the hospital been located there some 6,400 km. (4,000 miles) of ambulance travel over crowded roads would have been saved at a time when ambulances were in great demand.10 The event showed that the danger from shell fire had been overestimated.
Field Hospital No. 13 was established in tentage on July 18 at Sery-Magneval, where it operated as an improvised evacuation hospital, there being no evacuation hospital at first in rear of the division. It remained in this location throughout the operation, relaying patients to French hospitals at
Senlis and Chantilly and to hospital trains at Crepy-en-Valois, until this service was taken over by Evacuation Hospital No. 5 on July 20.17 It received, among others, 2,987 slightly wounded patients.20
Field Hospital No. 2 did not function as a unit. Part of the personnel supplemented Field Hospital No. 12 at Pierrefonds-les-Bains. The remainder of this hospital was inactive, with skeletonized personnel at Trumilly.17
The field hospitals not only admitted the wounded of the 1st Division but also some patients from the 2d Division, as well as others from French, British, and Moroccan divisions and some disabled German prisoners. Throughout the operation the field hospitals supplied hot food and hot coffee day and night to men who had become separated from their commands, including some who through ignorance of troop movements had remained after the division had withdrawn, as well as to many military wayfarers.21
Evacuation was operated under very serious handicaps, viz, large numbers of wounded; roads enormously congested, frequently blocked completely for hours by the great amount of forward-moving traffic, especially of ammunition and artillery; very long evacuation routes, for the divisional evacuation service extended from the battle front to Senlis and Chantilly, 55 km. (34 miles) to the rear.22 Three wounded transport circuits were established: (1) Front, (2) rear, and (3) evacuation.22 The front circuit of all the Ford and many of the G. M. C. ambulances, regulated from the dressing stations, extended as far forward as traffic, terrain, and combat conditions permitted and evacuated to the dressing stations and to the triage at Mortefontaine.22 Great difficulty was experienced in making this circuit adequate and in getting ambulances to battalion aid stations, on account of the congestion of forward roads. All available ambulances, including those of United States Army Ambulance Section No. 649, were placed on this circuit to clear the field of wounded.22 Dressing stations were very active in making emergency dressings and in relaying patients to the rear.22
At Mortefontaine patients were triaged, given emergency treatment, and evacuated to the rear circuit. Seriously wounded were sent to Field Hospital No. 12 at Pierrefonds-les-Bains by G. M. C. ambulances, and all others to Field Hospital No. 13 at Sery-Magneval by trucks.22 Very few ambulances could be spared for this rear circuit. Animal-drawn ambulances, useless in front circuit, were used in the rear circuit to help evacuate patients from Mortefontaine.22
At Pierrefonds-les-Bains several surgical teams operated, providing emergency aid to the seriously wounded. From there all who could be moved and for whom transportation could be found were evacuated to Sery-Magneval, where they were received at first by Field Hospital No. 13 and later by Evacuation Hospital No. 5.22
From Sery-Magneval an evacuation circuit became necessary. This was made up chiefly of field hospital trucks. Patients were sent to the French evacuation hospitals at Senlis and Chantilly, which also soon became over-
crowded.22 About July 20 patients began to be sent from Sery-Magneval to Crepy-en-Valois, whence they were moved by hospital train. On July 19 several sections of Red Cross ambulances (Fords) were attached to the ambulance section at Mortefontaine, whose headquarters were located with Field Hospital No. 3 and were used on both front and rear circuits, releasing some heavy ambulances from the rear and evacuation circuits.22
Evacuation in the early part of this operation was exceedingly difficult and beset with hardships. There was no American evacuation service in operation behind the division to relieve divisional units of patients and to permit the divisional medical service to confine its activities to the divisional area, which by itself was an enormous responsibility. For this reason all field hospitals rapidly became overcrowded, with no means or place for their evacuation. The French hospitals at Senlis and Chantilly had been designated by the French high command as evacuation points for the 1st Division, but these were very far in the rear and soon were unable to receive more patients.23
Before the engagement the French had assured the division surgeon, 1st Division, that they would evacuate the field hospitals, and that American divisions would be expected to do only what is prescribed for divisional service by our regulations, viz, work within the division, but as the wounded accumulated it became evident that our field hospitals could not be cleared under this arrangement.24
The 1st Division therefore moved many patients to Senlis, a distance of 90 km. (55.8 miles), and cared for the remainder to the extent of its limited resources, until the French brought up hospital trains and moved patients to Paris.24
On July 20 the division surgeon was informed by the French corps surgeon that he was to evacuate all his wounded to Crepy-en-Valois, where there would be ample hospital train service to care for them.15 This was done, but several days later it was learned that hospital trains had not arrived there and that the wounded had received little attention.15 As soon as American headquarters had located the division, several operating teams arrived and rendered great service. Many patients had been at the field hospitals two days and were urgently in need of surgical attention.15
So far as the division surgeon could ascertain no wounded remained upon the field or in the dressing stations more than six or eight hours. When the division was relieved there were no wounded on the field or in the dressing stations, for evacuation from the front had been carried on with vigor, but in field hospitals patients were compelled to remain 48 hours, as for a time there was no adequate means of evacuating these units.25 Evacuation Hospital No. 5, which began to function at Sery-Magneval on July 20, relieved this situation, as described later.
This engagement brought out the fact that a division conducting active field operations required very considerable quantities of medical supplies, much greater indeed than had been anticipated.
As the 1st Division had been engaged in trench warfare and in consequence had abandoned its standard field medical equipment or had replaced it with that suitable for use in the trenches, it proved to be inadequately equipped for this operation. It went into action with about 600 litters and the usual number of blankets, but in five or six hours the supply was exhausted.24 Taking several trucks, the medical supply officer hurriedly visited Senlis, Neuilly, and Paris, and in three days obtained and delivered at least 3,000 litters and as many blankets, but even these proved insufficient, for as evacuation from the field hospitals was retarded and they were overcrowded they were obliged to use litters as beds.24 Because of the military situation no telegrams designating location were permitted, and as the medical representative of the American general staff, who was charged with supervision of the medical service of the divisions in the Marne area and with supply and evacuation in rear of them, had not been informed (in the interests of military service) of the location to which the 1st and 2d Divisions had so suddenly been moved, his services in both these capacities were for a time unavailable. Consequently wounded accumulated in the field hospitals and required more matériel for their service than they otherwise would have needed. The local representative of the Red Cross went to Paris as soon as the need of supplies became evident, and on the night of July 18 returned with several truck loads of matériel, including much-needed dressings.24 He also notified the officers of the Paris group of the divisions location, thus permitting them to effect evacuation and to supplement its Medical Department personnel.15
The division medical supply unit was located at Pierrefonds-les-Bains, with an advance unit at Mortefontaine.23
When the 1st Division was relieved its medical personnel had been working continuously for five days, but when it was learned that the Scottish division effecting its relief had but eight ambulances the 1st Division ambulance companies all volunteered to remain and assist in evacuation of its wounded.25 The divisional artillery also remained to assist in the Scottish divisions attack. The helpful service of the Medical Department was acknowledged by the commander of the latter division, who wrote in part as follows:25"Without the help of Colonel Mabee and his establishment of ambulance cars I have no hesitation in saying that at least 400 of our wounded would still be on our hands in this area."
THE 2D DIVISION
The 2d Division, with the American 1st and the Moroccan 1st Divisions, made the main attack from the west, south of Soissons. As was the case with the other divisions in this operation, there was no artillery preparation, this being a surprise attack.26 The division advanced 8 km. (4.9 miles) in 26 hours, captured the powerfully organized positions of Beaurepaire Ferme, Vauxcastille, and Vierzy, and by the close of the second day was facing Tigny. On the night of July 19-20 the division, less its artillery, was relieved by the French and withdrew to an assembly area near Pierrefonds.
The divisional artillery supported the French until July 25, when it also was relieved.26
The following extracts from the report of operations of the 2d Division describe its activities in this offensive in greater detail as follows:27
On the morning of the 17th of July the troops debussed in the vicinity of Pierrefonds, Retheuil, and Taillefontaine. Division headquarters was established at Carrefour de Nemours (2½ miles north of Villers-Cotterets). It then became known that the 2d Division was to participate in a surprise attack. * * * In the attack, the 1st Division (French) Moroccan was placed between the 1st and 2d United States Divisions. * * * The three objectives for the division were generally marked by a north-and-south line through Beaurepaire Ferme, the ravine east of Vauxcastille, and the eastern edge of Vierzy. * * *
The attack was made by the following troops in line from right to left: 23d Infantry, 9th Infantry, 5th Marines. The 6th Marines were corps reserve. The direction of the attack to the first objective was generally northeast. Then its course turned to the southeast. * * *
The surprise was a complete success and by 1 p. m. most of the third objective had been taken. The town of Vierzy was not taken until later in the day. Another attack late in the evening carried forward the line to a point about 1 km. east of Vierzy.
Early on the morning of the 19th the 6th Marines passed through the front east of Vierzy and occupied the line running just west of Villemontroire and Tigny. The regiment had been in reserve until now, its advance from Beaurepaire Ferme to the "jumping off" line east of Vierzy was under hostile shell fire. * * * Many casualties were suffered before the front lines were reached. * * * This attack caused 40 per cent of losses.
The division was relieved from the front lines on the night of July 19-20 and then moved back to the forest, where they had jumped off on the 18th; thence was marched back to a new area for billeting.
MEDICAL DEPARTMENT ACTIVITIES
During the night of July 17-18 battalion aid stations were set up very near the enemys trenches, in one case within 50 yards. Regimental aid stations were slightly farther back, some at Maison Neuve and others in the forest.28 Locations were the most suitable that could be found near positions assigned the troops at the line of departure, but reconnaissance was imperfect because of darkness, rain, mud, and road congestion.29 The attack advanced so rapidly that thereafter no battalion aid station, definitely organized as such, could be established, but collecting points for the wounded were designated at the various crossroads, in buildings, and at other points which afforded some shelter.29 These, in the order of advance, were at Maison Neuve, Verte Feuille Ferme, Beaurepaire Ferme, Vauxcastille, and, finally, in the late afternoon, Vierzy, which, on the 19th, became a concentration point for the battalion and regimental aid stations of practically all the division except the Artillery.29 Some battalion aid stations were also farther forward in the field wherever there was any protection.29 At this time the Artillery had aid stations in Vauxcastille and along the railroad between Longpont and Vierzy.29 The latter town was badly shelled a great deal of the time, but numerous large caves and the stone quarries there gave absolute protection. On July 19 many
gas shells were poured into the town, which, because of encircling hills, became a veritable gas pocket, thus hampering greatly the work of the medical personnel.28
Field Hospital No. 15, a detachment from Ambulance Company No. 1 of 1 officer, 36 litter bearers, and 4 ambulances had accompanied the Artillery brigade, which began its movement into the sector on the night of July 14-15.29 One-half the personnel of Field Hospital No. 16 remained at Jouarre, where it cared for the divisional sick in a convent previously used by the French as a military hospital. The remainder of the sanitary train started on the evening of July 16 for an all-night ride to Bonneuil-en-Valois, Oise, arriving on the morning of the l7th.30
The transportation section of the 16th Ambulance Company (animal drawn) arrived in the area on July 17, except the dismounted members of the company, who, overlooked in the distribution of trucks, proceeded by rail and rejoined the other sections on the 19th at a point in the forest one-half kilometer (0.31 mile) west of Haramont.29
Contact with the French corps surgeon could not be made until night of July 17, and the only instructions then given by him to the division surgeon were that a field hospital be established as a triage at Taillefontaine and that one be located at Sery-Magneval to reinforce the French hospital there. Owing to traffic congestion these instructions could not be carried out until the next morning.29 At 9 p. m., July 17, orders were received for the location of ambulances and dressing stations, but on account of the great amount of traffic the detachments concerned were unable to reach their destinations until the following morning.29
Ambulance Company No. 1 sent 3 ambulances to the 23d Infantry, 3 to the 9th Infantry, 1 to the 5th Marines, and 7 to Field Hospital No. 23 at Haramont. Because of road conditions, the ambulance ordered to serve the marines did not reach its destination until noon of the following day, though the distance traveled was only 20 km. (12.4 miles).29
Ambulance Company No. 15, with personnel and equipment for two dressing stations, was ordered to establish them on the Montgobert-Longpont road, north and south, respectively, of the main road between Soissons and Villers-Cotterets. Though the distance to be traveled was but 18 km. (11.1 miles) the unit did not reach its destination until 7 a. m. on July 18. As wounded came through these points, the company established a dressing station at Maison Neuve, the crossroads of the highways mentioned, where wounded were beginning to collect and where Infantry regimental surgeons were gathered. This became the main dressing station. At 3 p. m., on July 19, Ambulance Company No. 15 established an advance station at Verte Feuille Ferme, but this was soon closed and the detachment returned that night.29 On the following day the unit moved to Vivieres.31
Ambulance Company No. 16 established a station at its assembly point one-half km. (0.31 mile) west of Haramont, but only 75 wounded were received.29
Ambulance Company No. 23 sent three ambulances to Field Hospital No. 23, at Haramont.29
At 4 a. m. on July 18 all available ambulances and litter bearers were sent forward, but as the former were soon blocked on the congested roads the latter proceeded on foot. On the same date all the ambulance companies (with the exception of the 15th) moved their headquarters to Taillefontaine, where they remained until withdrawn from the sector.29
Evacuation was very difficult, for the sanitary train arrived in the area with depleted transportation. Only 32 serviceable G. M. C. ambulances and 21 trucks were available in the train at this time, and these were not supplemented by any United States Army ambulance sections. During the 18th the greater part of the evacuations were made by ambulances, sanitary-train trucks, and returning ammunition trucks. On the following day all these, and supply-train trucks as well, were used for evacuating the wounded. On the latter date French troops relieving the division provided five Ford ambulances, but only one trip was made with these.29
Two other circumstances conspired to aggravate evacuation difficulties, viz, road conditions and the necessity for evacuating field hospitals by divisional transport. The SoissonsVillersCotterets roada very narrow, paved highway, with borders of soft mudwas noted on commercial road maps as "impracticable for autos." Innumerable trucks "skidded" into the ditches and had to be pulled out by tanks. Traffic moved either at snails pace or was stopped completely, until, on the 19th, military police were charged with its control. After that date blocking of the road was practically eliminated.28
As provision for the prompt removal of the wounded from field hospitals by other than divisional transport did not meet requirements, divisional transportation had to be used to clear these hospitals to the rear. This situation required that trips from 20 to 34 km. (12.4-21.1 miles) in length be made, until, on July 20, Evacuation Hospital No. 5 was established at Sery-Magneval. Despite all difficulties, battalion aid stations had all been cleared at 2 a. m. on July 20.29
On July 22 the division having been withdrawn, a detachment from Ambulance Company No. 23 was assigned to the 2d Artillery Brigade, which was to remain in line. This detachment consisted of three officers, a dressing-station party, and four ambulances. An ambulance dressing station was established at Verte Feuille Ferme and operated there until July 25, when it was withdrawn with the Artillery. During these three days it cared for many wounded men, mostly from the Scottish and British troops sent into line to relieve the 1st Division.29
Field Hospital No. 1 had been ordered to Haramont, but after finding, on the 18th, a suitable location and beginning to open up, it was ordered to Sery-
Magneval, where it arrived at 2.30 p. m.and immediately set up tentage. It functioned as an evacuation hospital for the division and operated on nontransportable cases, but was unable to care for all of these, its overflow being received by French hospitals at this place and at Crepy-en-Valois. When the hospital left this location on July 24 it had cared for 200 gassed patients, 1,034 wounded, 45 psychoneurotic cases, and 81 injured, a total of 1,360.29
Field Hospital No. 23 reached Haramont at 7 a. m. on the 18th, having been delayed all night on the road, though it had had a march of only 5 km. (3.1 miles). Here it operated a sorting station until noon of the same date, then moving to Taillefontaine, where it reestablished its triage and cared for patients until they could be removed. Facilities were limited; one small building was used for dressing purposes and another for gassed cases. After being treated, patients were cared for in tents or on litters in the open. Assisted by personnel from Field Hospital No. 16, the unit here cared for 75 gassed cases, 966 wounded, 13 psychoneurotics, 12 injured, and 180 sick, a total of 1,246 patients. When the division moved to this sector the other half of Field Hospital No. 16 had been left, as noted above, at Jouarre to care for divisional sick left behind in the sector formerly occupied.29
Field Hospital No. 15, which had arrived in this area on July 16 with the Artillery, moved to a point in Bois de Brassois, near the crossroads 1½ km. (0.93 mile) north of Eméville, where, until, July 24, it operated a sorting station. It treated 607 patients, including 48 gassed, 369 wounded, 7 psychoneuroses, 31 injured, and 152 sick.29
On July 20 all forward field hospitals were cleared and all ambulances and Sanitary Train trucks sent to Sery-Magneval, where Field Hospital No. 1 was cleared as rapidly as hospital trains could evacuate it. Here Evacuation Hospital No. 5 also was cleared by ambulances and trucks of the division during the following two days, as was also the 1st Division field hospital operating at the same place. Ambulances of the 2d Division likewise assisted in evacuating great numbers of French wounded from the French hospital there.29
As noted elsewhere, the Medical Department representative of the general staff who was charged with evacuations from the divisions in the Marne areas had received no information of the intended attack toward Soissons and for military reasons the division surgeon was not permitted (until after the attack developed) to telegraph him concerning the need for an evacuation hospital and for operating teams.29 The division surgeon had been assured by the French that they would evacuate American wounded from the division and provide evacuation hospital facilities for them. This service included the evacuation hospitals at Pierrefonds-les-Bains, Sery-Magneval and Crepy-en-Valois, but during the first days these hospitals were filled to overflowing and so were unable to admit more patients. French evacuation hospitals were located also at the following points: Senlis, for all classes of cases; Chantilly, for slightly wounded; Ognon, for fracture cases.29 Some patients were admitted to these hospitals but soon, because of the needs of their own wounded, further admissions were refused, and this difficult extra trip of from 22 to 34 km. (13.6-21 miles) from Field Hospital No. 1the
evacuation hospital of the 2d Divisionand return was made to no purpose. Owing to the fact that preference on the railroads was given to ammunition and supplies, the arrival of French hospital trains was delayed many hours. Shelter being insufficient, many wounded men, mostly belonging to the 1st and 2d Divisions, were left for hours in the railroad yards at Crepy-en-Valois, where they had been sent from overfilled French hospitals. Upon arrival of Evacuation Hospital No. 5, on July 20, the situation was immediately relieved.29
MEDICAL SUPPLY UNIT
The divisional medical supply unit remained at La Ferte-sous-Jouarre, but during the night of July 17 sent up two sanitary-train trucks with litters, blankets, gauze, cotton, bandages, etc., which had been previously loaded and were awaiting orders. On July 19, the division surgeon asked for 500 litters, 500 blankets, Thomas splints, etc. The message was telegraphed to the medical supply depot at Lieusaint, and supplies were delivered at La Ferte-sous-Jouarre at 3 a. m. on the 20th.29 They were forwarded at once and reached Taillefontaine at 11 a. m. on the same day. Though too late to be of service to the 2d Division, they were of great value to the 1st Division, to which they were delivered.29
MEDICAL DEPARTMENT SERVICE IN REAR OF THE DIVISIONS
One or more representatives of the medical group attached to the fourth section of the general staff, G. H. Q., A. E. F., was constantly in the field during the more important operations on the Marne, submitting recommendations for coordination by the general staff, and at times actively directing the operations of the medical service at the front. The Medical Department representative of the general staff previously sent to the Chateau-Thierry front acted as and was later assigned as chief surgeon of the "Paris group." The chief surgeon of the Paris group was in general charge of Medical Department activities in this area.32
Such great secrecy had been maintained concerning the offensive toward Soissons that no information regarding it had been given the acting assistant chief of staff, G-4, of the Paris group, under whom functioned the medical service charged with evacuation of the disabled from the divisions, medical supply, assignment of evacuation hospitals, and operating teams and related duties.32 In point of fact, since American troops were operating in this offensive as a part of a French corps, were under its tactical command, and the latter had assumed responsibility for the removal of wounded, this group was supposed to have no official duty in the matter.33 Nevertheless the Medical Department felt that an obligation existed and feared that hospitalization which the French could provide would be inadequate. Such, in fact, proved to be the case, and as soon as the divisions location was ascertained, relief was expedited. Concerning this episode the medical group operating under G-4, G. H. Q., reported as follows:34
Divisions were hurriedly withdrawn from one part of the line and thrown into another alongside the French without advance notice to the medical representatives in the
field and at times evidently without due notice being furnished the tactical headquarters of the Paris group, then established at La Ferte-sous-Jouarre, under which title all American divisions operating in that region functioned. This condition of affairs created a situation on the Soissons front that evoked considerable unjustifiable criticism of the Medical Department. The 1st and 2d Divisions were thrown into battle there without advising the American headquarters, and as we had no hospitalization established in that sector the heavy casualties sustained were not promptly or well cared for. As it developed, moreover, the French were no better prepared to meet the hospitalization obligations that this new situation imposed upon them. This incident was regrettable in that we had, packed and available for quick transportation, a mobile and an evacuation hospital to meet an emergency of this nature. Had we been given notice of this impending tactical change we could have established hospitalization of our own behind the troops engaged on the Soissons front. The French Medical Department was greatly embarrassed by the large number of wounded that flowed into their organizations from our two divisions engaged there, and while the responsibility for the care of our sick and wounded devolved upon them, events showed that they were woefully unprepared to receive them. The evacuation of our own men from that sector was eventually carried out under direction of our G-4 representative, on our own trains hurriedly sent up on his call.
In all fairness it should be added that the great loss of beds in evacuation hospitalssome 40,000 or 45,00035which the French had recently suffered during the German advance in this area, prevented their giving the assistance promised. Also, their tactical officers maintained that the movement of an evacuation hospital and other medical formations to a prescribed destination would have jeopardized the success of a very important military operation.36
The following description of the efforts of the chief surgeon, Paris group, to meet this emergency is abstracted from his report. His representative had left headquarters on the afternoon of the 17th of July, instructed to select sites for evacuation hospitals to serve the 1st and 2d Divisions in the Dammartin area, where it was understood that they were to be located.37 The regulating officer at Le Bourget informed the chief surgeon by telephone that these divisions had been removed from Dammartin on the preceding night and placed in the line south of Soissons for an offensive which had occurred on the morning of the 18th. He stated that losses had been heavy but could give no figures. The chief surgeon, Paris group, then requested a medical officer from General Headquarters, who was inspecting the area informally, not to return to General Headquarters until early the next morning, it being probable that he would wish the latter to go to Soissons to take charge of the situation there. Early on the morning of the 19th, it being impossible for the chief surgeon to leave, he assumed authority to direct this officer to proceed with all haste to the vicinity of Soissons, take such steps as might be necessary to meet the needs there existing, and to acquaint him, the chief surgeon, by telephone, telegram, or special delivery, with the situation. The officer so assigned left at once.38 The chief surgeon then called up the regulating officer at Le Bourget and asked him to inquire of the French railroad authorities as to the nearest point to Soissons where a hospital train could be "spotted."39 About noon of that day the latter reported that hospital trains could go no nearer Soissons than Crepy-en-Valois, and a little
later that day the assistant to the chief surgeon above mentioned reported that he had covered the ground on the west flank, that Crepy-en-Valois was the best location for an evacuation hospital, and that the French were caring for American wounded at Senlis, Chantilly, and Ognon.39 Accordingly, Evacuation Hospital No. 5 was routed through to Crepy-en-Valois and its early delivery urged.39 The American Red Cross, learning of this offensive, had hurriedly sent officers, nurses, and enlisted men from Paris and from American Red Cross Hospital No. 104 at Beauvais to the ambulance St. Paul which it was conducting at Chantilly where it established an evacuation hospital. It also rushed supplies here for a 300-bed hospital which was soon expanded to 400 beds.40
About 1 oclock on the morning of July 20, the representative whom the chief surgeon had sent to reconnoiter the situation in the vicinity of Soissons returned and reported a deplorable state of affairs. He estimated casualties at 10,000, but gave these figures with uncertainty. The French were transporting the wounded to Senlis and Chantilly, and a few were drifting into Juilly. Reliance had been placed entirely upon hospitals already established; and though roads were poor and terrain rough and difficult, no hospitalization had been provided by the French at any convenient point. This officer reported evacuation service as most unsatisfactory, many wounded yet remaining at the front. Shortage of transportation, difficult terrain and lack of roads all contributed to the existing chaos. He had not seen the hospitals at Senlis and Chantilly, but had heard that they were overcrowded and utterly unable to meet the situation.39 He was directed to return at once and establish Evacuation Hospital No. 5 at Crepy-en-Valois (the regulating officer having reported to the chief surgeon that it would arrive during the night), and was authorized to take such action as he might deem necessary. He was to order hospital trains direct from the regulating officer, and, for the time being, to send all preoperative cases to Paris for operation. He returned immediately to carry out these instructions.41
Without delay the chief surgeon, Paris group, telephoned the regulating officer requesting him to send two trains to Crepy-en-Valois with all possible speed and to be prepared to send additional trains when called for. About 6 a. m. six surgical teams which arrived by automobile from the vicinity of Chaumont were sent forward in the same car to Crepy-en-Valois, and, upon arrival there, were directed to report to the chief surgeons representative. The personnel of Field Hospital No. 120, which had arrived in compliance with the chief surgeons request, were sent immediately to the same destination.41 One United States Army ambulance section, also ordered to Crepy-en-Valois under the same instructions, promptly left the area but was intercepted by the French and not allowed to proceed. It was some 24 hours later before the chief surgeon learned that this ambulance section had not reported at Crepy-en-Valois, and upon being informed of its hold-up he registered an official complaint through the French liaison officer on duty with headquarters, Paris group. Evacuation Hospital No. 5 reached Crepy-en-Valois at 10 a. m.on July 20, then moving to Sery-Magneval, about 5
km. (3.1 miles) distant.41 The site proved to be a vacant field of 10 or 15 acres, adjacent to a French mobile hospital.42 Field Hospital No. 13, 1st Division, was also in operation near the same place. The site was poor and surroundings very insanitary.42
After some delay in obtaining truck transportation to carry the equipment of Evacuation Hospital No. 5 (some of this transportation was loaned by the French) the first of its property arrived at the camp site at 3 p. m. During the afternoon the work of establishing the hospital went on actively. In the midst of tent pitching the surgeon of the Third Corps came to the camp and importuned the commanding officer to detail 10 officers and 30 enlisted men to care for some three or four hundred wounded who were reported to be lying uncared for on the other side of the railway track. Four officers and ten men were detailed for this duty, with orders to remain with these wounded until they had been properly cared for.42
By 9 p. m. of July 20 the hospital was functioning, its surgical staff was at work, and the portable electric-light plant working satisfactorily. This light plant, with the X-ray apparatus, proved of inestimable value. Hardly had the work begun when appeal was made for shelter for 200 wounded men then at the railhead. These woundedactually about 400were waiting for a hospital train which failed to arrive. All night wounded men were coming in, and the surgical staff worked without a pause until noon of the next day, when a number of operating teams began to arrive.42 During the night 477 wounded were formally received, cared for, and sheltered. They were evacuated the next morning. Admissions were reported as follows: Gassed patients, 253; medical, 302; surgical, 2,071; total, 2,626. The chief surgeon, First Army, reported that though the hospital arrived too late to be of much service to our troops, "it was a veritable godsend to British and Scottish divisions which came in to relieve the American troops in such haste that their sanitary trains were left far behind."42 On August 1 the hospital left by truck train for La Ferte Milon, Aisne.42
The Soissons experience led to the following letter from the chief surgeon of the Paris group to the assistant chief of staff, Paris group:43
From: Chief surgeon, Paris group.
1. It is known to you that the 1st and 2d Divisions were withdrawn from the front lines and placed in rest near Dammartin. After entering the rest area they were suddenly moved northward by the French to the vicinity of Soissons, and without warning to this office quickly thrust into a line back of which we had no hospitalization. Under such circumstances the French, of course, always hospitalize and care for our wounded, but events have proved that they were, in this case, unprepared to do this, and as a result there has been much suffering and probably deaths. Such hospitalization as the French had at their disposal has been as open to the Americans as to the French themselves, but the amount in the Soissons vicinity was utterly inadequate to meet the needs, and we had no opportunity to better the situation.
2. This office was in a position to supply hospitalization, and had it been notified of thecontemplated movement northward much suffering that has occurred might easily have been prevented. In view of this incident, this office wishes to recommend that the chief surgeon of the Paris group be kept informed of contemplated troop activities, which step it is thought will prevent repetitions of this unfortunate occurrence.
As a result of this letter and the experience of the 32d Division at Juvigny, the commander in chief, on August 31, addressed the following note to the French Mission:44
From: C. in C.
I. Every effort is now being made by the A. E. F. to so organize and distribute its Medical Department personnel and equipment as to assure that adequate hospitalization and evacuation facilities will be provided for the sick and wounded, wherever and irrespective of the conditions under which they may be called upon to serve.
II. In the past the French have kindly shared with us all their resources, even when the aid extended has resulted in some embarrassment to their own service. We feel deeply grateful for the assistance so rendered. However, owing to the difference in language and the consequent difficulties encountered by our soldiers in making their wants known when hospitalized in French formations, it becomes desirable and necessary that as far as possible we provide them the necessary hospital accommodations in our own units.
III. Therefore, in view of existing agreements and customs which are more or less in conflict with the propositions below set forth, it is requested that this matter be given favorable consideration by the French, to the end that whenever American divisions are detached for combat purposes with the French Army the following principles shall be mutually recognized:
1. That the American Medical Department is authorized to establish its own hospitalization behind any of the divisions serving with the French and direct or assist in, according to circumstances, the evacuation of A. E. F. wounded.
2. That the French, in devising their tactical plans for a battle in which they expect to utilize the services of American divisions, designate and communicate to proper American officials, for the information of the American Medical Department, suitable sites for at least two American evacuation hospitals for each American division operating with the French.
3. That the French arrange details necessary to permit access of American hospital trains to any American evacuation hospitals so established.
4. That the French furnish timely information to the immediate headquarters of the American army, corps, or "group" from which a division or divisions are detached for service with the French, as to the contemplated use and movements of these divisions while they remain under French control, in order that the A. E. F. Medical Department may make preparations necessary for the hospitalization and evacuation of American wounded, and in case the A. E. F. is not in a position to provide the necessary facilities to furnish proper notification to that effect to the French.
IV. In connection with Section III, paragraph 4, above, the recent activities of the 32d American Divisioncare cited as an example of the necessity for this information. This division, forming part of the Third American Corps, was suddenly detached from the Vesle sector and assigned to the Tenth French Army for combat purposes on the Soissons sector. The chief surgeon (American) of the "Paris group," with headquarters at La Ferte-sous-Jouarre, who is directly charged with the provision of proper hospitalization
and evacuation for A. E. F. troops in that region, had no information as to the movements of this division upon which he could act intelligently in the matter of locating sanitary units for their care. Immediately upon the departure of the division he ordered a mobile (tent) evacuation hospital to pack, proceed, and reestablish somewhere in the rear of the line this division might occupy. In the absence of authoritative information the location selected was a mere matter of guesswork on his part. However, as events have proven, his selection, due to good fortune more than anything else, resulted happily. It appears that there are times when even the French medical service is not informed as to the advent, for combat purposes, of American divisions in their midst, and consequently has not been in a position to meet the additional hospitalization and evacuation problem thrust upon them by tactical commanders.
GEO. VAN HORN MOSELEY,
The French acceded to these requests and complied with them after the attack of the 32d Division against Juvigny. From this time the care and evacuation of our wounded in rear of the divisions moved very smoothly, though our Medical Department continued to be greatly embarrassed by the great shortage of personnel and of evacuation hospitals. In this connection it should be noted that though the American Expeditionary Forces shortly thereafter were largely concentrated in our own sector, a numberof our divisions continued to operate exclusively with our Allies.
On July 22 the chief surgeon, district of Paris, reported that his hospitals in Paris were full and that he was unable to obtain trains for their evacuation. At the same time the regulating officer at Le Bourget reported that he had heard from Crepy-en-Valois that there were 1,000 patients there to be evacuated and cared for.45 Though trains were very scarce, it appeared that the situation could be met within 48 hours. Hospital trains again being made available on the 24th, Crepy-en-Valois was entirely cleared except for a few nontransportable cases. Many American wounded had been evacuated on truck trains, but the French hospitals at Senlis, Chantilly, and Ognon were still filled to overflowing with our wounded.46
On July 29 figures were received from the railway transport office which showed that 10,578 patients from the 1st and 2d Divisions had been moved by train principally from Crepy-en-Valois and Senlis, together with some 200 wounded prisoners.47 These figures did not take cognizance of nontransportable cases still in French hospitals.47 Of the number mentioned, 3,393 had been evacuated in American trains and 6,792 in French trains.46
The Medical Department of the Third Corps was in a peculiar situation in this operation as that corps at the time did not have tactical command. The corps headquarters staff had officially the status of "observers,"48 but concerning its activities here the corps surgeon wrote as follows:49
Although the official entry of the 3d Army Corps into battle is given in the reports as August 3, 1918, the days immediately following July 18 were among the most stirring in the career of the organization. Whether the staff officers of the 3d Corps were observers or administrators or tactical advisers has never been quite clear, but certainly the part they played was active.* * *
Efforts made by the corps surgeon to ameliorate the situation in rear of the 1st and 2d Divisions will now be described.
While the 1st and 2d Divisions were at this time under administrative control of the American Third Corps, though under tactical command of the French, the corps surgeon endeavored to learn from the officer in charge of G-1 of the corps what was the general scheme of evacuation, believing, because of his experience with the dissimilar American and French systems, that he could promote their coordination. He was informed, however, that the scheme of evacuation was a military secret which G-1 would not divulge.50 The corps surgeon then visited a number of points in the evacuation area of the 1st Division, and on July 19, learning that additional personnel was badly needed by the divisional hospital at Pierrefonds-les-Bains, succeeded in having members of the corps headquarters troops sent to its relief.51 Two hours later he reported this congestion of field hospital to G-1 of the corps and recommended that the Paris group be advised of the situation and that ambulances and personnel be requested. He then visited corps headquarters and reported to the chief of staff the situation concerning the wounded. The officer commanding the United States Army Ambulance Service arrived in response to a message sent him and provided additional ambulances.52 Operating teams, also, were arriving. On July 20, the corps surgeon visited the surgeon of the French Tenth Army and was told that representatives of the French Corps had conferred with the surgeons of both the 1st and the 2d Divisions and had described the French system of evacuation.52 It was understood in his office that the surgeon from the 1st Division had undertaken to evacuate back of Pierrefonds-les-Bains to Sery-Magneval, but from Sery-Magneval it was acknowledged that the French plan was to evacuate to Senlis; by ambulance for the seriously wounded, by trucks for the slightly wounded, and by trains from Crepy-en-Valois.52 The surgeon of the French group of hospitals from Crepy-en-Valois received orders for French personnel to attend to the entrainment at Crepy-en-Valois.52 The French medical officer in the office of the medical representative of the general staff was of the opinion that neither side was familiar with the system of the other and that American division surgeons had arrived too late for effective work;52that the French system of classification was not followed, that no one had asked the French for help on July 18 and 19, and that if his help had been asked for it could have been furnished.52
At Crepy-en-Valois, where the surgeon of the Third Corps had been told that there was French personnel to attend to entrainment, he found about 250 wounded American soldiers on litters, exposed to wind and dust, and without personnel except one medical officer, some line officers, and other volunteers in attendanceall Americans, who were doing what they could. Conditions were pathetic.53 As already mentioned, he arranged with the commanding officer of Evacuation Hospital No. 5, just arrived at Sery-Magneval but not yet ready to receive patients, to send assistance to the wounded at Crepy-en-Valois railroad station. All these facts were reported to the commanding officer of the Third Corps as soon as possible on July 20, and
the fact emphasized that conditions at Crepy-en-Valois would continue and would tend to become worse as the congestion of wounded increased. The corps commander directed the corps surgeon to proceed to the lines and find medical personnel to cover the emergency at Crepy-en-Valois.53 Medical officers of the 9th Infantry were the first to be found, and several of them were sent by ambulance to Crepy-en-Valois to assist in relieving the situation.53 Through the work of the officer representing the chief surgeon, G-4, Paris group, which supervised the supply and evacuation of American troops engaged in the Marne salient, the timely arrival of hospital trains and an ambulance company with personnel sufficient to man the entrainment station at Crepy-en-Valois and the establishment at Sery-Magneval of Evacuation Hospital No. 5, the difficult situation was overcome by the afternoon of July 21.
The chief surgeon, Third Corps, reached the conclusion that when American troops were here put into action with the French all departments of importance, except the medical, were in contact, through officers skilled in such work, with the corresponding departments of the French Army.54 The French took pains to inform the American division surgeons of their plans, but did so in a general way and did not associate medical with specific military plans. These latter were kept secret. On the other hand, American division surgeons failed to bring to the attention of the French the urgency of their situation.54 Several officers, including the representative of the medical group of the general staff, the corps surgeon, and the division surgeon, worked along independent lines, not so coherently as would have been possible with better organization and information; but by their several efforts a great catastrophe was narrowly averted.54
THE 4TH DIVISION
Activities of the 4th Division in the reduction of the Marne salient and immediately thereafter in its operations along the Vesle may be divided into two phases, the first from July 18 to July 22, and the second from August 3 to August 12. Yet between these dates certain units of the division also came into action for short periods.55
During the former of these two phases (which is that described at this point), the division continued to be brigaded with the Second and Seventh Corps of the French Sixth Army, a little to the south of the 2d American Division. Its 7th Brigade served with the French Second Corps, the rest of the division serving with the French Seventh Corps, chiefly in support, though some elements saw front-line service.55 None of these larger than a regiment operated as a tactical unit during the period of the division's service in the French Sixth Army, and as a rule battalions went into action with French regiments.55 Three Infantry regiments were in the front line when the allied counteroffensive began on July 18, while the fourth (the 47th Infantry) was in immediate reserve with the 11th Machine Gun Battalion and two companies of the 4th Engineers, defending a position from Varinfroy to Riviere.55
From left to right the French Sixth Army consisted of the French Second and Seventh Corps, the American First Corps, and the French Thirty-eighth Corps.56 On July 17 the Second Corps front extended to a point south of Dammard and that of the Seventh Corps from this point to southeast of Hautevesnes.55
* * * In the sector of the Second Corps the 39th Infantry was placed under orders of the 33d Division (French), and on the afternoon of July 16, 1918, received orders to relieve French troops then in line. This relief was nearing completion on the night of July 17-18, when orders were received to attack at 8 a. m. July 18. The attack was made in accordance with plans, and all objectives were taken by 3 p.m.,after which the regiment took Norroy, which, according to plans, was to have been taken by the French. At 4 a. m. July 19 the regiment again advanced, taking its three successive objectives as ordered. At about 5 a. m. July 19 the regiment received orders to withdraw from the line, upon its relief by French troops, which was done during the night of July 19-20. * * *
* * * In the sector of the French Seventh Corps the 58th and 59th Infantry and 12th Machine Gun Battalion were attached to various elements of the 164th French Division.
The 58th Infantry was placed with the attacking troops. Two battalions of the 59th were placed as safety garrison of the position of resistance and one battalion in reserve for the army corps at Marmon-la-Poterie. These reserve battalions were sent forward on July 19. On July 18, at 4.35 a. m., without artillery preparation, the French and American troops advanced to the attack after a fire of smoke shells. Hautevesnes was taken at 5 a. m., Courchamps about 11 a. m. The American troops * * *took the village of Chevillon, then advanced very rapidly to the Sept-Bois (southeast of Montmenjou), and passed through it. * * * The French and American units acting in conjunction took Priez and La Grenouillere Farm on July 19. * * * On the 20th Sommelans was taken, but Petret Farm on the south was not taken until July 21. Bois de Bonnes was entered on this date. On the 22d Bois de Bonnes was taken and Bois de Chatelet entered. On the nights of July 22-23 and 23-24 the elements of the 4th Division were relieved from the line. * * *
On July 28 the 4th Division came under control of the First Corps and assembled the next day in Bois de Chatelet.55
MEDICAL DEPARTMENT ACTIVITIES
When the 4th Division entered on the first phase of its activities in the Aisne-Marne operation, the following plan was adopted for regimental aid: Two privates of the Medical Department and 8 bearers from the line were assigned to each line company. One officer, 1 sergeant, and 3 privates of the Medical Department, with 14 bandsmen as litter bearers, were assigned to each battalion in the front line; 1 officer, 1 sergeant, and 2 privates to each regimental aid station; the surgeon and 1 private to regimental headquarters. A relay bearer section was formed when the distance from the front line to the battalion aid station was more than 800 yards.57
Evacuation of regimental and battalion stations was to be made by ambulances when possible. In spite of the assignment of additional personnel from the line, it was soon learned that the medical personnel,though thus reinforced, was insufficient for prompt portage of the wounded. The division surgeon was constantly receiving requests for more litter bearers.
and details of 30 to 40 men were made from ambulance companies to aid the regimental service.57Early in the first engagements it was demonstrated that only vigorous and courageous men should be assigned to the medical detachment of a regiment. Men reporting for duty at the front, brought up hurriedly at night, knowing nothing of the terrain, having had no experience with explosives, and without regimental esprit, might easily become lost or panic-stricken when sent out into strange territory to collect wounded men. It was recognized that only men of the highest type obtainable, after intensive training, could do this work satisfactorily.57
During the first few days of battle a considerable number of men of the 4th Division returned to the rear, assembled around the kitchens or wandered about, claiming to have been gassed, lost, or thrown down by shell concussion and left behind. The number of men claiming to have been gassed was large. Medical officers of the division, having theoretical but not practical knowledge of the effects of toxic gases, gave these men the benefit of the doubt and evacuated them to the rear. Later, this mistake was corrected.57
As American troops in the line were here interspersed with the French, it was decided to combine the evacuation service with that of the nearest French divisions and thus avoid duplication of effort. In conformity with an agreement between the Médecine Divisionnaire of the French 33d and 164th Divisions and the surgeon of the American 4th Division, our Field Hospital No. 19 was attached to the French triage at Mary-sur-Marne, functioning as a triage for troops of the 8th Brigade.58 Ambulances having been furnished the ambulance section of the sanitary train, 8 G. M. C. ambulances and United States Army Ambulance Section No. 584, with 26 Ford ambulances, 5 medical officers, and 40 litter bearers reported to the French 164th Division at Vendrest for work with the evacuation service.58
In the 7th Brigade area, during this period of service with the French 33d Division, Field Hospital No. 33 and Ambulance Company No. 33 were attached to the French triage and hospital for nontransportable wounded at Acy-en-Multien.58
Special surgical operating teams with equipment and personnel were hurriedly sent by the American First Corps to the hospitals at Gue-a-Tresmes and Acy-en-Multien. All gassed patients were evacuated and treated at the hospital at Mary-sur-Marne. Evacuations were made to Juilly and Montanglaust, and later to Meaux.58
THE FIRST CORPS
At the beginning of the Aisne-Marne operation the First Corps consisted of the French l67th and the American 26th Divisions.56 In the operation of July 18 its first objective was the line of woods southeast of HautevesnesTorcyBelleau.59 The initial attack resulted in the capture of Torcy, Belleau, and Givry on that date.60 Next day the advance was delayed by the network of machine-gun nests on Hill 193, south of Monthiers.61 On July 20 the objective assigned to the corps by the French Sixth Army
embraced the entire corps sector. In pursuance of the plan to straighten out the pocket formed between Chateau-Thierry and Soissons, the French 167th Division advanced this day farther than did the American 26th Division. For the moment the operation pivoted on the wooded crest of Hill 204, which hitherto had resisted all attacks and had dominated Chateau-Thierry and the line of the Marne. By evening of the 20th the pocket had been straightened out and the French Tenth and Sixth Armies had advanced their lines to the outskirts of Le Plessier-Huleu and Oulchy-la-Ville. Latilly, Bonnes, and Monthiers had fallen.61
From this point the axis of the corps, which hitherto had been nearly due east, swung to the northeast in a gradual parabola, and after crossing the Ourcq River ran in an almost northerly direction to the Vesle. It was incumbent on the First Corps and the French Thirty-eighth Corps on its right to make the greatest daily advance in conformity with elements on the left.61 On July 21 the corps made a maximum advance of 7 km. (4.3 miles), but for two days it was held up on the ridges to the northwest and south of Epieds, where the line stood on the 23d.61 On July 24 there was another advance of 5 km. (3.1 miles), when the corps was halted again south of Beuvardes. During the next three days an average advance of 1 km. (0.6 mile) per day was made.61
Meanwhile, on July 26, the French Seventh Corps on the left was withdrawn, as the wedges driven into the salient gradually closed in and the frontage diminished. Another result of this reduction of units and of the movement pivoted on the left was displacement of the limits of the corps sector to the west.61 On July 25 the 26th Division, which had been in line since July 10, was relievedexcept its field artillery and engineersby the 42d Division. The 101st Engineers and the Artillery brigade remained in line until August 3 and 4, respectively.62 On July 26 the 42d Division relieved the French 167th Division also. From that time until the Vesle was reached the First Corps had but one division in the line.61
On July 28 a maximum advance of almost 5 km. (3.1 miles) was made, the 42d Division crossing the Ourcq the following day, on a 3-km. (1.8 mile) front and capturing Meurcy Ferme and Sergy.61 On July 28 the French Tenth Army had captured all the crests to the west of the Crise. Hartennes-et-Taux and Grand Rozoy had been liberated, so that the Chateau-ThierrySoissons road was inside allied lines to within less than 4 km. (2.4 miles) of Soissons.63 The entire line of the Marne had been cleared. As was learned later from German prisoners, it was here that the German command decided to make a last stand while it withdrew its divisions and supplies beyond the Vesle.63 Therefore along the Ourcq occurred the most stubborn fighting on the corps front during the entire operation.63 On the yellow wheatfields sloping gradually eastward from Meurcy Ferme; on the heights of Hill 184, and along the little mud road rising steeply from Sergy to the Peuplier disk on the crest, remained innumerable evidences of the stubbornness of the fighting.63 "Bodies of our men often lay in rows not 20 yards from the German fox holes; the opposing lines were often within a stones throw of
each other, and the bodies of German and American dead in the same machine-gun nests were a further testimony of the mutual stubbornness of the conflicts."63
From July 28 to August 2 the First Corps was held again north of the Ourcq. During this period, however, its line formed a flattened salient, and it was natural, therefore, for the corps to hold its position until the corps on the left and that on the right had advanced their lines in conformity with its front.63
By August 1, when this rectification had been made, the German command apparently had decided to fall back immediately to the Vesle. On August 2, the corps advanced 3 km. (1.8 miles). Next day the 4th Division relieved the 42d and pushed forward almost without opposition through Bois de Dole to the Vesle, where it took over the sector of the French Second Corps, which included the French 62d Division.63 On the 6th a crossing was effected and the outskirts of Bazoches reached.63 The engagement along the Vesle was sustained and severe, so that casualties suffered by the 4th Division were numerous. On August 12 the 77th Division relieved the 4th, and on the 13th the First Army Corps was withdrawn and sent back to La Ferte-sous-Jouarre.63
MEDICAL DEPARTMENT ACTIVITIES
Though the 26th Division, the first division of the first corps to be engaged, had many casualties during the early part of this operation, and evacuation service was arduous, roads were excellent, hauls were comparatively short at first, and there were no very severe difficulties in the corps evacuation service.64 By 10.40 p. m. of July 18 the enemy had been driven to the line Noroy, east of Courchamps, east of Licy-Clignon, Torcy, Belleau, Bouresches.64 Evacuations had been made in accordance with recommendations formulated by the corps surgeon and published in Secret Orders, No. 6, July 9, 1918, concerning evacuation of sick and wounded. This order is quoted in Chapter XI.
In this connection, and in connection with the history of the First Corps, it should be explained that as the war progressed the corps surgeons immediate responsibilities for the evacuation of sick and wounded became somewhat less than the foregoing order quoted in the chapter on the Champagne-Marne operation indicates that they were at that time. This was especially true with reference to the location of division field hospitals, which, except for the initial location, were later placed by the division surgeon after consultation with the corps surgeon. In preparation for an attack the initial location was generally selected by the corps surgeon, as he had knowledge of road conditions and supply points which the division surgeon usually did not possess. Later also the corps surgeon, through the commanding officers, corps sanitary train, took over evacuation from field hospitals to evacuation hospitals and relieved the division surgeon of all responsibility back of the field hospitals. This could not be done in these earlier engagements because of lack of transportation belonging to the corps. The corps surgeon then had only sufficient transportation for his own office purposes and had no sanitary train.65
As it was evident that the sanitary personnel of a division was inadequate to care for the casualties of active operations, the foregoing order contemplated that additional personnel be obtained by division surgeons through the corps surgeon from Medical Department personnel in reserve. The expedient was unsatisfactory, for such men needed all the rest they could obtain, but the order mentioned above was secured in default of better measures, with a view to meeting what appeared to be an impending shortage. In point of fact it did not prove necessary to call on the sanitary troops of other divisions, in reserve during this operation, and adequate assistance in removing wounded from the field was soon made available in a more satisfactory manner by temporary assignment to this duty of selected men from each line company.65 The corps order directing this practice was published July 30.66
As the situation changed, the provisions concerning evacuation prescribed by Order No. 6, published July 9, were modified from time to time. On July 18 the following was issued:67
(a) After the advance has passed the road EtrepillyGrande Picardie FermeLes Rochets FermeVaux, an advance dressing station will be established by the Sanitary Train, 26th Division, at Bouresches.
Evacuation route: Bouresches Lucy-le-Bocage Montgivrault Petit-Paris roadVentelet FermeBezu-le-Guery.
From latter point as per par. 1 (f), Part II, Order No. 6, First Army Corps, July 9, 1918.
(b) For 167th Division (French) after the advance passes the road as above, a triage will be established at Marigny-en-Orxois.
Evacuation will be by Cocherel and the axial road of the division.
On July 19 and 20 there was no change in the plan of evacuation. By 10.40 p. m. on July 21 the French Sixth Army had passed the Chateau-ThierrySoissons road between the Ourcq and Clignon and had reached the road BezuEpiedsCharteves.68
Field Order No. 19, July 21, published the following concerning evacuation of sick and wounded:69
No change except as follows:
(a) When the 26th Division (U. S.) has advanced beyond Trugny it will establish a triage at Bouresches. An advance dressing station will also be established at La Sacerie at this time.
Evacuation route: Road La Sacerie south to Point 190, thence northwest via Gde Picardie Farm to Point 225, thence via La Gonetrie Fme to Bouresches. From this point as prescribed in previous orders.
(b) The 167th D. I. (French) will continue to maintain a triage at Marigny-en-Orxois. The chateau at this station will be left vacant for the post of command of the Sixth Army.
Evacuation route: Road Marigny-en-Orxois to Paris road, thence via La Ferte.
Field Order No. 21, dated July 23, made the following change in plan of evacuation:70
(b) The 167th D. I. (French) has moved its triage from Marigny-en-Orxois to Belleau and will establish at Cocherel a station for nontransportable wounded.
Evacuation route: From Belleauthe axial route of the division.
From Cocherel road CocherelPorte Ferree to main Paris road; thence on the axial road of the division.
The line of evacuation was becoming long. This condition, which continued to grow worse during the operation, later caused great difficulty. It was due to the inability of headquarters of the Paris group to bring evacuation hospitals nearer to the front. That organization fully realized the situation and used every effort to meet it, but before relief could be effected the lines had advanced so far that ambulances were covering as much as 112 km. (70 miles) on a round trip.71 Another unfortunate result was that cases were operated at the hospital for nontransportable wounded which would have been sent for operation to the rear had evacuation hospitals been within reach. The only mobile surgical hospital available at this time was No. 1, and this was placed at Montanglaust with Evacuation Hospital No. 7.71
Relief of the 26th Division by the 42d was promptly accomplished, the mission of American troops remaining unchanged.72
Field Order No. 24, July 25, 3 p. m., contained the following pertaining to the plan of evacuation:73
As previously prescribed for the 167th (French) Division and the 26th (U. S.) Divisions:
The 42d Division (U. S.) will establish an advance dressing station and a sorting station at points now existing for the 26th Division.
The 56th Brigade, 28th Division, will evacuate through the sanitary units of the 26th Division.
As the advance progresses, new advance dressing stations and sorting stations will be established under the direction of the corps surgeon.
The entire front of the First Corps was now held by the 42d Division, which met stiff resistance at first, especially at the crossing of the Ourcq, and suffered many casualties. The 26th Division fell back to the vicinity of Etrepilly for rest and re-forming. The 167th (French) Division passed to the army reserve. The 42d was ordered vigorously to pursue the attack, which, on account of the narrowness of the sector, was often made on a battalion or company front.74
Part II of Field Order No. 25, July 26, 1 p. m.,prescribed the following changes in the evacuation service:75
167th Division (French). Upon relief of this division it will withdraw its triage at Belleau.
42d Division (U. S.). Has established an advance dressing station at Trugny and a sorting station at Farsoy Fme near Point 190 on the Chateau-Thierry road and is establishing a station for nontransportable wounded at Villiers-sur-Marne.
26th Division (U. S.). Upon relief of this division it will withdraw its advance dressing station and its sorting station. * * *
56th Brigade, 28th Division (U. S.). Will evacuate through the evacuation system of the 42d Division (U. S.).
There was no important change at this time in the general plan. Evacuation hospitals had not yet been brought forward, and the strain on transportation imposed by the necessarily long hauls was terrific. The 42d Division now established a hospital at Villiers-sur-Marne for nontransportable wounded, but this relieved the situation to only a limited extent.74
July 27 the advance continued, the First Corps attacking in the direction of Sergy and Villers-sur-Fere.76
Field Order No. 27, dated July 28, announced that the enemy had evacuated Fresnes and Courmont, and it was thought that he had taken up a position to the north of the Ourcq. The 42d Division was ordered to attack.77 A memorandum from corps headquarters, dated July 28, 1 p. m., directed the 42d Division to establish an advance dressing station at Beuvardes.
Field Order No. 30, July 29, 1918, at 23 hours, directed the following changes in the evacuation service:78
4th Division (U. S.). Station for slightly sick, skin and venereal diseases, to a field hospital established at Bussiares. Only cases will be sent to this hospital as will be ready for duty in four days. All other sick and wounded will be sent to Evacuation Hospital No. 7 at Montanglaust, near Coulommiers.
Evacuation route: By the main SoissonsChateau-ThierryParis road to La Ferte-sous-Jouarre. Thence direct on the main road to Coulommiers.
42d Division (U. S.). Advance dressing station at Beuvardes. All sick and wounded of whatever character, except nontransportable wounded, to Evacuation Hospital No. 7, at Montanglaust, near Coulommiers. Seriously wounded (nontransportable) to Chateau-Thierry.
Evacuation route as previously prescribed.
Corps and Army troops and attached French troops will be evacuated as prescribed for the division to which attached or the division nearest to which they are functioning.
* * * * * * *
From this order it will be noted that the wounded were still to be sent to Evacuation Hospital No. 7, at Montanglaust. This was one of the worst periods in the evacuation service of the First Corps in this area. Hauls were almost more than could be accomplished, with all the assistance that could be given by United States Army Ambulance Service sections, corps ambulances, and ambulances from the sanitary trains of divisions not then in the line.79 The 32d and 3d Divisions aided materially by the use of their ambulances during this period. The 42d Division now established a hospital for nontransportable wounded in Chateau-Thierry which helped considerably.79 Both this hospital and the one at Villiers-sur-Marne were required to operate on toomany patients, but, owing to the length of the haul to evacuation hospitals, this was unavoidable.79 By July 30, the 42d Division had suffered 2,454 casualties, which fact gives some idea of the amount of evacuation carried out over these tremendous hauls. Roads were also badly congested, thus aggravating the difficulty of transportation. Though always given right of way and aided in every possible manner, ambulances often were detained unavoidably en route, but not to so great degree as later in the Meuse-Argonne operation.79
Field Order No. 32, dated July 31, 1918, contained the following concerning the evacuation service:80
No change in plan of evacuation of sick and wounded except as follows:
(a) Evacuation of seriously wounded (nontransportable cases only):
4th Division: To Evacuation Hospital No. 3 at La Ferte-Milon.
Evacuation route: BeauvardesBeauvardelleBrecyBezu-St. GermainAutrecourt; thence north on Chateau-ThierrySoissons road; thence northwest on the main highway via GrisollesLatillyNeuilly-St. Front; thence west to La Ferte-Milon.
26th Division: To Evacuation Hospital No. 7, at Montanglaust, near Coulommiers.
Evacuation route: As prescribed previously.
4th Division: To Evacuation Hospital No. 5, at Etampes, just south of Chateau-Thierry.
Evacuation route: As prescribed previously.
Corps troops: To Evacuation Hospital No. 7, at Montanglaust, near Coulommiers.
Evacuation route: As prescribed previously.
(b) Slightly wounded of the 42d Division will be sent to Evacuation Hospital No. 4 at Chateau Perreuse, just west of Jouarre (which is on the main La Ferte-sous-JouarreCoulommiers road). Any overflow will go to Evacuation Hospital No. 7, at Montanglaust, near Coulommiers.
(c) All other sick and slightly wounded of the other divisions and corps troops will be sent to Evacuation Hospital No. 7 at Montanglaust, near Coulommiers.80
The location of Evacuation Hospital No. 3, at La Ferte-Milon, on July 29, for nontransportable wounded only, was of some help, but as the hospital was well off the left flank it did not relieve matters materially in this corps, and it was too far away for the more serious nontransportable cases.81
Evacuation Hospital No. 4 had also been established, on July 22, at Chateau Perreuse; but as this was south of La Ferte-sous-Jouarre, neither was it of much benefit.81
On August 2-3 the 4th Division relieved the 42d, the latter becoming corps reserve.82
Field Order No. 34, dated August 1, 1918, prescribed the following changes in evacuation methods:83
(a) 4th and 42d Divisions:
Evacuation of seriously wounded (nontransportable cases only). Extreme cases only to the field hospital of the 42d Division, located at Bezu-St. Germain.
Other seriously wounded cases to Evacuation Hospital No. 6, at Etampes, just south of Chateau-Thierry. Overflow to Evacuation Hospital No. 3, at La Ferte-Milon.
Slightly wounded and other cases to Evacuation Hospital No. 4, at Chateau Perreuse. Overflow to Evacuation Hospital No. 7, at Montanglaust, near Coulommiers.
Evacuation routes: As prescribed previously.
(b) 26th Division and corps troops: As prescribed previously.
Field Order No. 36, August 3, announced that the enemy was retiring across the Vesle and that troops on the left had already reached that river, with troops on the right in close pursuit. Orders were issued to establish bridgeheads across the Vesle.84 The Chateau-Thierry salient had been completely eliminated.
On August 6, field hospitals of the 4th Division, then in the line, were grouped at Chateau de la Foret, as described in the history of the 4th Division. Evacuations were now effected from the division by the corps sanitary train, this method proving so satisfactory that when, on August 12, the 77th Division relieved the 4th it carried on the same arrangements. Activities then were lessened somewhat, and evacuation, conducted under the same plans as those mentioned for the 4th Division, presented no great difficulties.85
The First Corps was withdrawn from the line on August 12 and its headquarters returned to La Ferte-sous-Jouarre, where it remained until
August 18.85 The American Third Corps then took over the First Corps sector, under control of the French.86
Several developments in the Marne area were of especial interest to the Medical Department in connection with service of the First Corps and its component divisions:
(1) Inadequacy of ambulance transportation.-Whilesufficient for trench warfare, the number of ambulances in the division sanitary train proved entirely inadequate to care for casualties arising in active, open warfare. For slightly wounded and slightly gassed cases it was necessary to use all the trucks that could be procured. In addition, all the United States Army Ambulance Service sections that could be obtained, plus ambulances of the corps sanitary train, were required, working to full capacity, to meet the need when casualties were heavy. Except for following troops on the march, animal-drawn ambulances proved of little value.85
(2) Long hauls.-The long hauls impaired transportation greatly. For a considerable period, evacuation hospitals could not be brought forward within a reasonable distance from the front, and there were times when the round trip of an ambulance covered 96-112 km. (60 to 70 miles). This was a feature of open warfare which could be met only by the establishment of additional evacuation hospitals to receive patients from divisional units.85
(3) Road congestion.-Greatroad congestion prevailed. In the First Corps, in spite of the fact that ambulances always had the right of way, delays were frequent and distressing. Yet in the Aisne-Marne operation, where but one American division was in the line at one time, the problem was not nearly so difficult as it proved later in the Argonne.85
(4) Inadequacy of sanitary personnel.-Thesanitary personnel attached to regiments and other units proved very inadequate during periods of activity. This difficulty, as previously noted, was overcome in the First Corps by an order detailing men from the line companies to serve as litter bearers. This, the necessary and only possible solution during the war, was but a makeshift measure. The use of bandsmen as litter bearers proved inadvisable; even when they were employed their assistance amounted to relatively little in great emergencies. Furthermore, music was of such value in maintaining the morale of troops that it was believed skilled musicians should not be subjected to the dangers attendant upon litter bearing.87
(5) Position of division surgeon during battle.-Inonly one division in the First Corps during the activities in the Marne area was the division surgeon located at the divisional post of command, and this only for a brief period. Normally he was with the field hospital section of the sanitary train, detailing to the division command post a subordinate officer who kept him advised concerning tactical changes. When at the former, the division surgeon was in touch with all elements of the medical service and, in the opinion of the corps surgeon, could direct evacuations infinitely better than if relatively isolated, well forward, with the division commander.87
(6) Burial of the dead.-This painful duty became a most serious sanitary problem and one intimately connected with the question of morale. It was decided that divisions should not be called upon to perform this work, on the ground that, though prompt burial of the dead was essential, during combat their line troops could not be spared from the front for this purpose; and after combat such troops would be mentally and physically exhausted. Moreover, the effect of this kind of service was found to have a most injurious effect upon the morale of combatant troops; on the other hand, if, when returning from the battlefield, they saw no evidences of the recent engagement they were not so depressed as otherwise they would have been. Prompt clearing of the battlefield by removing and caring for all the wounded and decently burying all dead had a powerful effect on maintaining the esprit of troops.88
As the corps advanced over this front many dead bodies of men and animals were found scattered over the terrain, numbers of them having lain there apparently for 10 days or longer. This was especially remarked around Fere-en-Tardenois, where many French and German dead lay just outside the town. The stench from these bodies was intolerable. Dead horses lay at short intervals along the way, many having died from exhaustion. The weather was hot and the bodies of both men and animals had become black, swollen, disorganized masses of organic matter, alive with maggots. Flies bred in millions and soon became an intolerable nuisance as well as a more or less serious menace to health. Other insanitary conditions existed, and there was much reason to apprehend an outbreak of intestinal diseases.89
The corps surgeon prepared a request, which was forwarded approved by the corps commander, that a labor organization of 500 men be assigned to the corps for the sole purpose of burying the dead. They were to work with the Graves Registration Service, so that proper identification of the dead and the care of their effects might be assured. This request was returned from General Headquarters disapproved. The corps surgeon then recommended that Pioneer Infantry be allotted for this purpose. This recommendation was approved and thereafter applied in the First Corps, with striking improvement in its battlefield sanitation. Fields were promptly cleared of the dead, and the bad conditions about Chateau-Thierry never occurred again.90 The men assigned to this work did faithful service, often so close to the front that several of them were killed on one occasion. Their work was arduous. In this connection it should be explained that incineration was impossible, both on account of lack of fuel and from the danger of attracting enemy fire by smoke by day or flame by night.91
At first these Pioneer Infantry troops were detailed to work under the division quartermaster, but this was soon found to be an unsatisfactory arrangement, as the quartermaster was generally near the railhead and preoccupied with other duties. The corps surgeon then recommended that these troops be placed under the division sanitary inspector for the sole duty
of burying dead men and dead animals. This plan was approved and was ordered in paragraph 11, annex 9, "Plan of communications, supplies, and evacuation," of Field Order No. 57, First Army Corps, September 22, 1918, as follows:92
(a) Every effort will be made to promptly and properly bury the dead and to secure proper identification.
(b) Dead animals will be promptly buried.
(c) To bury the dead and to promptly dispose of dead animals each front-line division has been furnished with one company of Pioneer Infantry. These companies will be dispatched so as to arrive not later than noon of D-l.
These troops will be reported to and will work under direction of the divisional sanitary inspector.
(7) Mobile surgical hospitals.-These,in the opinion of the surgeon of this corps, should be readily movable and should be placed under the corps surgeon's immediate control.93 Two of these, he concluded, were adequate for a corps under usual circumstances.
(8) Standard plan for evacuation.-The need for a plan of evacuation applicable to all divisions in the American Expeditionary Forces, the proper carrying out of which could be made feasible by early information concerning the military situation, had already been recognized. This war of movement had shown that this plan should be elastic, yet comprehensive enough to cover all probable conditions.93
(9) Hospital Corps belt.-Inthe opinion of the corps surgeon this belt proved almost useless. The 42d Division substituted for it pouches similar to the old Hospital Corps pouch. These, obtained through the Red Cross, proved very satisfactory. An effort was made to procure them for every division in the First Corps, but this did not prove practical and, in any event, the changes of divisions in the corps were so frequent that it would have been difficult to supply all the divisions in the short time available.93
Upon their return from the front line and into the army reserve it wasimmediately evident that the troops were utterly exhausted, both mentally and physically. While camps were established in shelter tents in the woods, the simplest camp sanitary precautions sometimes were disregarded. Thus in some instances no latrines were provided, or, if dug, were left uncovered and uncared for. The result was the breeding of more flies. Some of the troops too were disposed to drink water from any supply available, such as in shell holes or from other questionable sources. In one battalion which had lost every officer as a battle casualty there was notable sanitary disorganization, and similar conditions existed in other organizations. It is true the camps were regarded as temporary, but actually they remained established longer than had been anticipated and soon were very insanitary.89 With indifferent food, bad water (many Lyster bags had been lost in the advance), myriads of flies, and lowered physical and mental vitality, many cases of intestinal disease developed. A sanitary inspector from the central laboratory reported true Shiga, Flexner, and paratyphoid bacilli, as well as certain aberrant types. Fortunately, the infection was mild, for there was no mor-
tality and patients were sick for a few days only; on the other hand, cases were very numerous, and there was reason to fear that a serious epidemic might supervene. Previous antityphoid and antiparatyphoid inoculations apparently saved the troops from what would have been a severe epidemic of these diseases, but their administration does not explain the escape of the corps from a serious outbreak of dysentery. Conditions called for vigorous action, and effective sanitary measures based on accepted methods were soon ordered and enforced.90
THE 26TH DIVISION
The 26th Division had relieved the 2d Division July 10 and held 5 km. (3.1 miles) of front between Belleau and Vaux.59
The 52d Brigade, on the left, attacked at 4.35 a. m. July 18, with three battalions in line. Objectives were the railway from Givry to Bouresches, Belleau, and Givry, and the town of Torcy. This was taken by 5.40 a. m., Belleau and Givry by 8.30 a. m.,and the railroad at about the same time. The line was consolidated and held.94
On the 19th the 26th Division, awaiting the division on its left (French 167), which was delayed, remained in place and so continued until 3 p. m. on the 20th of July. An attack was then made along the entire front, in conjunction with the French 39th and 167th Divisions. The first objective was gained, and the line was as follows: GivryWoods one-half kilometer north of les Brusses FermeLes Brusses FermeHill 190La Gonetrie FermeHill 201.94
At 4 a. m. on July 21 the advance was resumed, the two brigades moving abreast. The enemy fell back and was pursued closely until troops reached the vicinity of Epieds and Trugny. In the woods near the latter place he had strong defenses.94
At 6 oclock on the morning of July 22 the advance was resumed, and in spite of severe enemy fire, Epieds and Trugny were taken, but later the troops were withdrawn because of heavy artillery fire.94 At 3 p. m. on the same date another attack was launched by a battalion of the 103d Infantry and a battalion of the 102d Infantry, but the advance was slight. The 101st Infantry was then directed to break through on the division front on a line east of Trugny. This attack, made next day, gained some ground.94 During the night of July 23-24 the 56th Brigade (28th Division) relieved the 52d Brigade.94
On the 24th, after some delay, another advance was made, and occupied a line in the Foret de Fere west of the Fere-en-TardenoisJaulgonne road.94 During the night of July 24-25, the 42d Division passed through and relieved the 26th, the latter remaining in reserve near La Ferte.94
MEDICAL DEPARTMENT ACTIVITIES
In the lines, men sheltered themselves as best they could in individual excavations, and in farm houses, villages, and behind the banks of watercourses. As villages were often shelled, the heavily built cellars of farm-
houses proved the best sites for aid stations. When these were not available, the stone culverts of dry watercourses, or shallow excavations, usually covered with logs, were utilized. The prescribed aid station equipment and other supplies were replenished by bearers and ambulances.95
Dressing stations were established at La Voie du Chatel (Ambulance Company No. 104) on the north and at Villiers-sur-Marne (Ambulance Company No. 103) on the south, with ambulance heads as far forward as cover permitted.95 The natural drift of wounded men made the former station very active, the latter only slightly so.95
About midway between, at Bezu-le-Guery, and just beyond the usual range of enemy shells, a triage and gas station were operated by Field Hospital No. 102. Ambulance Companies No. 101 and No. 102 were also located here.95 Well to the rear, but not beyond extreme artillery range, at Luzancy, Field Hospitals No. 101 and No. 104 were established in a large schoolhouse, where they operated, together, a hospital for the slightly wounded, gassed, and sick.95 At La Ferte-sous-Jouarre, several miles in the rear, Field Hospital No. 103, reinforced by 6 operating teams and 35 nurses, operated a hospital for severely wounded, in a large convent converted into a well-equipped surgical hospital.95
United States Army Ambulance Section No. 502 evacuated from the ambulance heads to dressing stations, and divisional ambulances from the dressing stations to the triage and field hospitals.95 Trucks of the sanitary train and such ambulances as could be spared evacuated patients from the field hospitals to Evacuation Hospital No. 7, at Montanglaust, near Coulommiers. (More than 2,000 patients had been evacuated by the sanitary units in the two weeks prior toJuly 18.)96
During the evening of July 17, in rain and inky darkness, Ambulance Company No. 102 moved up to reinforce Ambulance Company No. 104, at La Voie du Chatel, whence litter bearer sections were sent to reinforce the regimental bearers, in anticipation of the coming offensive.96 At 4.35 a. m. July 18, the artillery opened fire, and the infantry attack began at 6 a. m. Thereafter for days the entire medical personnel worked continuously, resting only when an occasional lull permitted. The wounded accumulated in some numbers at all stations, but only for short periods. During the first day of the offensive 1,280 cases passed through the dressing station at La Voie du Chatel, and 1,648 through the triage at Bezu-le-Guery.96
By July 20, the Infantry had reached a line from Monthiers to Vaux. Following this Infantry advance a dressing station was established on the same day at Bouresches.96 As the division still pressed forward, a station was opened farther in advance, at Farsoy Ferme, near the Chateau-ThierrySoissons road, and still later another station was established at Trugny. This was in a farmhouse in front of a wheat field, still bestrewn with the bodies of American and German dead.96 All the ambulance companies participated in operating these dressing stations, advancing by the "leapfrog" method;
i. e., one company from the rear passed the one in operation and began work farther forward, the station left in the rear now closing and going into reserve, to be advanced again when needed.96 This method worked so well in this offensive that, modified as circumstances required, it was used by the 26th Division throughout the war.96
The sanitary train of the 26th Division was equipped with the following transportation for evacuation of the wounded:97
Even with this large transport, the wounded accumulated at Bezu-le-Guery and Luzancy faster than they could be removed, for vehicles were obliged to carry the wounded from the hands of litter bearers at the front, through dressing stations, triage, taking the overflow at Luzancy, to the nearest evacuation hospitalNo. 7, at Montanglaust, near Coulommiersa distance all told of 60 or more kilometers (37.2 miles). This rear service was, of course, one which our regulations for the operation of the medical department of a division had never contemplated. Fifty to sixty hours continuous duty was not unusual for ambulance drivers, no vehicle standing still longer than was necessary to load, unload, grease, gas, water, and repair. At no time was there any avoidable delay in the evacuation of casualties. Roads were often crowded and occasionally were blocked by impassable shell fire, but even then they were soon opened.97
The 12 animal-drawn ambulances of Ambulance Company No. 101 were posted with the Field Artillery, which, due to its location farther to the rear, was more readily served by animal-drawn vehicles.98 These vehicles were assigned to like duty throughout subsequent operations. They could sometimes get over ground impassable to motors.98
During this operation, liaison between the ambulance heads ("cab stands") and battalion aid stations was defective. Normally, this would have been effected by the litter-bearer sections of ambulance companies operating the dressing stations, but in this operation the litter-bearer sections of the ambulance companies were distributed for duty with regiments, where they either collected wounded or assisted at battalion aid stations.98 Ambulance drivers found difficulty in locating the rapidly moving battalions.98
Realizing the total inadequacy of litter bearers at the disposal of regimental and battalion surgeons, and the consequent necessity of depleting ambulance companies by reinforcing battalion bearers with ambulance company
litter bearers, the commanding officer of the sanitary train on July 3 strongly recommended and urged the immediate assignment of line company bearers at the rate of 12 to each line company or corresponding unit. This request was complied with on July 28, by which time the necessity for the measure in question had been demonstrated to the satisfaction of all concerned.99
Inaccordance with the division surgeons request, this order specified that company commanders were to select for litter-bearer service only men of the strongest physique, best intelligence, and courage. No weaklings, mental or physical, were to be included.99
Medical supplies were brought up by ambulances in compliance with requests sent back by them. Information concerning conditions at the front which orderlies of these ambulances brought back was of inestimable value to the officers and formations toward the rear.96 Prompt bihourly reports of casualties from the triage kept both division surgeon and division commander informed of battle conditions. They indicated the places where greatest resistance was occurring.96
An effective method for bath treatment of gas casualties was developed at the triage, although equipment and water were scarce. Under convenient shelter, rows of inclined planes were constructed by placing litters on wooden trestles of unequal height. These litters were covered with rubber blankets and drained into buckets at their lower ends. Above, suspended from wires, were douches for the eyes, nose, and ears. Watering pots containing strong soap solution were utilized for the face. Attendants were protected by gas-proof clothing and gloves. The Red Cross assisted in promoting the comfort of patients.100
When the sector was taken over many unburied bodies of both men and animals were found, and during the first days occupancy 50 of these were buried in one wood alone.96 Numerous casualties occurred among burial parties.96 Many of the bodies had been but slightly covered with earth in the shallow holes that had been dug for shelter, and frequently an extremity protruded.96 As the troops in exposed positions kept close in their shelters the soil in and near these became polluted. Enemy locations were subsequently found to be nearly as bad.100 Latrines often contained moving masses of maggots, and flies appeared in enormous numbers. Food, when obtained, was often sour from long carriage.100 Practically 100 per cent of the command was attacked by diarrhea. The disease was so mild, however, that not more than 2 per cent of those affected had fever or required hospitalization. The French civilian population suffered more severely than did the troops.100 With improved sanitation, this epidemic, attributed to bacteria conveyed by flies, disappeared.
On being relieved the division spent two weeks in reserve and then moved to the twelfth rest area, in the vicinity of Chatillon-sur-Seine.100
THE 42d DIVISION
On July 25 the 42d Division relieved the 26th in the Epieds area, and next day the French 164th and 167th Divisions.101
On July 26 the 84th Brigade attacked in the direction of La Croix Rouge Ferme and captured the buildings, with heavy losses.102
On July 28, in spite of strong resistance, both brigades crossed the river, captured Sergy, and established themselves on the northern banks of the stream. The enemy launched a heavy counterattack and recaptured Sergy, but was again driven out.102
On the morning of July 29, Sergy was definitely occupied. In the afternoon, despite stubborn resistance, the 83d Brigade took Seringes, and at 8 that night the division held the line SeringesMeurcy FermeSergy Hill 212.
On July 30 the division again attacked. The 83d Brigade advanced to the southwest edge of Foret de Nesles, the 84th Brigade to 1 km. north of Sergy.102
On July 31 the 84th Brigade atacked on the right, without success.
On August 1 the 84th again attacked, but was unable to advance on account of its exposed right flank. On August 2 the advance continued. The enemy was withdrawing and pursuit was active, reaching a line south of Mareuil-en-DoleChery-Chartreuve, an advance of 15 km. (9 miles).71 On the night of August 2-3 the division was relieved by the 4th.72
MEDICAL DEPARTMENT ACTIVITIES
As before, 1 enlisted man of the Medical Department to render first aid, and 12 litter bearers from the line were assigned to each company or battery, the remainder of the Medical Department detachment on duty with a battalion being held at its aid station.103 Whenever possible such stations were located at command posts, often in the same building with them. Shelter was of a superficial nature, detachments often caring for the wounded under direct enemy observation and shell fire.103
Because of road congestion, the large number of casualties, and the long distance to evacuation hospitals, the removal of patients to them was retarded, with the result that the wounded accumulated at all sections.103 At the aid stations the walking wounded were tagged and started, unaccompanied, to the dressing stations, only litter cases being held for ambulances. Trucks, escort wagons, and United States Army Ambulance sections gave material aid in relieving these stations near the lines. Doubtful cases attributed to gassing were held until definite diagnosis could be made, thus preventing some unnecessary evacuation.103
As the battalions advanced, aid station detachments left one or two Medical Department men at the old station until patients were removed, while the remainder of the personnel advanced to establish the new station.104 Men (Medical Department) on duty with front-line companies were relieved at intervals by other men from the aid station personnel, and in a similar manner medical officers were sent forward from the ambulance companies to relieve exhausted battalion surgeons.104
At 10 a. m. on July 25 a dressing station was opened at Epieds, when a few patients came in at once, but it was not until after nightfall that they arrived in considerable numbers. As Epieds was on the axial road of the division and was well situated for the collection of the wounded from the whole front, the only dressing station operated by the 42d for several days was that located here. This station also functioned as triagethe first attempted by this division.105
Whenever it was practicable to do so the personnel of this station was changed every 12 hours, but during very active periods this was impossible, though all four ambulance companies cooperated in its service.106 Owing to the remoteness of the supply dumps, the large number of wounded, and the failure of some hospitals to exchange equipment, there was a shortage of litters and blankets.106
The most noticeable defect in the evacuation service was inadequacy of contact between aid stations and dressing stations. Officers were ordered forward to connect with the regiments and battalions, but the policy of having one ambulance officer on duty with each regiment had not yet been adopted.107 Ambulances ran continuously for 8 days and evacuated all wounded as soon as located. During the 14 days from July 25 to August 7, the 11 vehicles of one ambulance company transported 2,527 persons (including some litter bearers going forward) and traveled a total of 15,546 miles.107 This activity was typical of all. Each company employed its drivers under a system of shifts providing 16 hours on duty and 8 hours off.107
United States Army Ambulance Service Section No. 502 was assigned to the division, but many of its cars were in poor condition, thus restricting the value of its service.107 An evacuation ambulance company was ordered to the service of the division, but was two days late in arriving and was then assigned to work in rear of the field hospitals. Trips in this circuit varied in length from 33 to 140 km. (20.4-86.9 miles).91 The divisional ambulance service was thus thrown largely on its own resources for intradivisional work, which required the evacuation of a total of 5,596 patients.108
Toward the end of the first day patients accumulated in such numbers at the front that evacuations by ambulance from Epieds were stopped, and by midnight approximately 400 patients were in and around the station at that place.108 At this time every motor ambulance was working in advance of Epieds behind the front. Many of the wounded were in a serious condition, but it was decided that clearing the aid stationsin many cases badly overcrowded and subject to shell firewas of first importance.108 For the service in rear of this station ration trucks were employed and sitting cases transported to Chateau-Thierry.108 A station for the slightly wounded was opened at Bezuet, where ambulance company reserves were stationed. To this point patients were transported from Epieds by the animal-drawn ambulance company hitherto held in reserve. As soon as congestion at the front was relieved, division ambulances again evacuated to the rear.108
On July 28, as a result of the attack against Sergy, there was another great influx of wounded. In this emergency the light trucks of the 149th Machine Gun Battalion rendered valuable service by evacuating many wounded from Sergy to Epieds.108 On the same day, the line being advanced, a relay dressing station was established at Beuvardes. As a collecting point this station was poorly located, for it lay between an ammunition dump and a signal station, both under constant shell fire.108 After 36 hours it was withdrawn; it had then become apparent that it was of no particular value.108
Following the capture of Sergy, Seringes, Nesles and Fere-en-Tardenois, the line moved forward rapidly, clearing the NeslesFere-en-Tardenois road.109 The battalion aid station cleared or gained this road, which then became the logical evacuation route leading to Fere-en-Tardenois. A dressing station was opened at Villers-sur-Fere, where it operated until August 3.109
During this engagement every available litter bearer from ambulance companies had been sent forward to aid the sorely pressed regimental bearers, overwhelmed by the number of patients and the long carries. Six officers belonging to ambulance companies also were ordered forward to assist battalion surgeons.109
When the division was relieved, on August 3, the field had been cleared; 4,408 patients had been evacuated in eight days. Two ambulances were then assigned to each Infantry regiment to care for the sick, who now began to appear in considerable numbers. Twelve ambulances were assigned to the 4th Division for temporary duty, when this division relieved the 42d. The remaining ambulances were kept busy for another five days evacuating patients from field hospitals to mobile and evacuation hospitals or to hospital trains.109
The field hospital section of the 42d Division arrived at Luzancy on July 23.110 From this point Field Hospital No. 165 moved to Villiers-sur-Marne on the 27th, and thence on the day following to Chateau-Thierry, where it opened in a park near the Jean Mace School and received gassed patients. On July 29 it turned over its apparatus and standing tentage to Field Hospital No. 126 of the 32d Division, and advanced to Epieds to relieve the crowded dressing station there to perform triage duty and to care for slightly wounded patients. The next day, as the line was advancing rapidly, it moved to Bezu-St. Germain and began operating at once.110
Field Hospital No. 168 moved on July 27 to Chateau-Thierry, there taking over a site in an old convent building shortly before utilized by the Germans as a hospital and capable of accommodating 500 patients. Within 4 hours the building had been cleaned and equipped, 350 patients had been admitted, and five operating teams were at work. Within 12 hours the hospital was crowded to the limit of its capacity. A mobile hospital ordered to serve the division had been held at Coulommiers and, as a result of this the divisional hospitals, especially Field Hospital No. 166, in addition to their normal duties, had to perform for a few days those usually discharged by mobile or evacuation hospitals. As they filled rapidly when evacuation
was obstructed, Field Hospital No. 166 here performed more surgical operations than are usual for a divisional hospital.110
Field Hospital No. 167 moved on July 26 to Bezu-le-Guery to relieve a field hospital of the 28th Division operating there;110 thence, on July 28, to Chateau-Thierry and, on the 31st, to Bezu-St. Germain, where it received gas cases. This unit had been designated for gas service before the engagement and was especially organized and equipped for that purpose; but as a result of its activities at this time its arrangements were further developed into what proved to be their final character.111
Field Hospital No. 168 moved on July 27 to Villiers-sur-Marne.110 After July 30, with two field hospitals at Bezu-St. Germain, one at Chateau-Thierry, and one at Villiers-sur-Marne, the ground was well covered, and there were no further changes in the location of these units until August 12, when the division moved out of the sector. The large number of casualties, with frequent moves necessitated by the rapid advance of the line, had required incessant labor and had demonstrated the fact that in open warfare extreme mobility was a most essential attribute for divisional hospital units.111
The problem of evacuation in this sector was replete with difficulties, and there were in consequence temporary accumulations of patients at the various stations.106 One of these difficulties was due to the large number of wounded. A second difficulty was the relative inaccessibility, at first, of field hospitals, and a third was the distance to evacuation hospitals in rear of the division.106 On the night of July 27, when delayed information was received that the division was about to attack, two field hospitals had been ordered to Villiers-sur-Marne to take over hospitals there, one had moved for the same purpose to Bezu-le-Guery, and only one was in a position to move forward.110 When, a little later, two of the field hospitals were in Chateau-Thierry, these quickly became overcrowded, and it was necessary to evacuate to Villiers-sur-Marne and to Neuilly on the outskirts of Paris,108 rear evacuations varying in length from 33 to 140 km. (20.4-86.9 miles).107This delay in the forward movement of the field hospitals was due in part to the fact that evacuation units in rear of them had been delayed in clearing patients and moving up, that an inadequate number of evacuation hospitals was available, and because the field hospitals of the division had taken over patients from the division preceding them in the sector. However, by means of ambulances, trucks, barges, and later of trains with favorably located evacuation hospitals, the situation was rapidly ameliorated.111
Certain conclusions reached by the division surgeon as a result of this operation were the following: (1) The triage or sorting station is indispensable and should be able to give extensive care to nontransportable patients; (2) a designated ambulance officer should be assigned to each regiment for liaison purposes and should at all times be on duty with it; (3) the divisional ambulances, if unaded by evacuation ambulance companies, are hopelessly inadequate to meet the needs incident to a severe engagement in open warfare.109
THE 4TH DIVISION, JULY 28 TO AUGUST 12
The 4th Division, withdrawn from the French Sixth Army, came under control of the American First Corps on July 28 and assembled next day in Bois du Chatelet preparatory to entering upon the second phase of its activities in this area.56
Two battalions of the 47th Infantry, placed at the disposal of the 42d Division, participated in the operation of July 30, crossed the Ourcq, and attacked Sergy, with losses amounting to about 50 per cent of their strength. The 39th Infantry, which relieved them on July 31, operated with the 42d Division until August 2.56
During the night of August 1-2, the 4th Division moved to Foret de Fere and on the 2d made reconnaissance with a view to taking over the line held by the 42d Division.56 On August 3 the 4th Division, as a division, took over a sector for the first time, its line running east and west through Foret de Nesles; the 7th Brigade on the left near Seringes and the 8th Brigade on the right near Nesles. During the night of August 3-4 and the following day the division advanced to the south bank of the Vesle, where it was held by intense enemy fire.56 The Germans had begun to retreat and to withdraw to the line of the Vesle River, leaving rear guards, composed chiefly of well-concealed and efficiently manned machine guns, to prevent a too-rapid advance of allied troops. At the Vesle they had taken position in strongly entrenched lines, at St. Thibaut on the left bank, and at Bazoches on the right bank of the river. Upon the high bluffs on either side of the Vesle machine guns were placed advantageously for command of both towns, and from his vantage points the enemy had direct observation of the river and of the movement of allied forces.57
In the face of strong opposition, one regiment of each brigade was pushed forward to the river, where, during the ensuing night, they were subjected to heavy gas attacks.56 While American Artillery carried on interdiction and harassing fire in towns and crossroads north of the Vesle, the enemy retaliated with many high-explosive shells.56 On the night of August 4-5 small detachments crossed the river, but progress was slow and difficult, the enemy offering strong resistance to all such attempts.56 During the night of August 5-6 troops that had crossed were withdrawn to await artillery preparation.56 On August 6 the Infantry, preceded by a barrage, advanced at 4.30 p. m.; the 58th Infantry, on the right, crossed the Vesle and reached the SoissonsReims road, later repulsing counterattacks. On the left the 39th came under intense fire and was unable to cross, but next morning two of its companies succeeded in doing so.56 During the day and night of the 7th, 8th, and 9th troops were heavily engaged in both offensive and defensive operations. They entered Bazoches, but were repulsed by airplane bombs and artillery and machine-gun fire.56 On the 10th, in the sector of the right brigade, the line of the railroad north of the Vesle was held and patrols of the 59th Infantry were pushed to the front.56 Except its Artillery brigade, which remained in action until August 17, the division was relieved by the 77th on the night of August 11-12.
In this operation the 4th had advanced the line to a depth of 9½ km. (5.8 miles).56
MEDICAL DEPARTMENT ACTIVITIES
In this, the second phase of the 4th Divisions activities, regimental surgeons, in general, were allowed to exercise their own initiative in locating their aid stations and in the distribution of their personnel. It had been found, as previously explained, that in any severe action this personnel, even when supplemented by details from the ambulance companies, was totally inadequate in numbers to clear the field of a regiments casualties. In order to meet to a degree this emergency, the details from ambulance companies to regiments were made so large that the companies were reduced below the strength absolutely necessary for the prosecution of their work, and the consequence was a destruction of the efficiency of these commands, which had been especially trained for their peculiar duties. It was demonstrated, furthermore, that the ambulance men brought hurriedly to a new field of action could not work to their fullest efficiency when suddenly confronted by the unfamiliar conditions thus encountered.112
Bandsmen divided between the three battalions were distributed as litter bearers at whatever points their services were required. Frequently it was found necessary to establish relay stations between front-line aid posts and the battalion aid stations. It became evident that the regimental aid station could be replaced with advantage by the dressing station of an ambulance company, thus releasing the regimental surgeon and his personnel for more valuable supervisory and administrative work and facilitating liaison. Prior to this time the system in general use had been to have two enlisted men of the Medical Department with each line company and six men at each battalion aid station. Usually one medical officer was on duty at this station, while the other accompanied the advancing troops.112
In the early days of this offensive it was necessary to remove by litter all patients requiring litter transportation from the aid station to some point a kilometer (0.6 mile) or more to the rear which could be reached by ambulances.112 As soon, however, as ambulances could evacuate directly from aid stations congestion of the wounded at these points was overcome. Aid stations were established in banks of earth, in abandoned cellars, or in dugouts, for there was no time to construct more elaborate shelter. These stations were small, poorly lighted, and with but little ventilation. The personnel on duty in them was continually exposed to gas brought in on the clothing of gassed patients, and their diminished numbers were reduced further by casualties occasioned thereby.112
Rapid advance made difficult the efficient care and evacuation of the disabled from aid stations, though ambulance companies were brought up to keep in touch with the advancing lines.113 On July 24 headquarters of the sanitary train and Field Hospital No. 19 advanced to Crouy-sur-Ourcq, where a hospital was established in conjunction with a French triage already in
operation for the reception of the wounded.113 The other field hospitals remained at their former stations. On July 29, when the 4th Division was in the Foret de Fereand Bois du Chatelet, Ambulance Company No. 19 advanced to Epieds and established a forward dressing station in connection with the triage of the 42d Division already in operation; this had been caring in part for wounded of the 4th Division.113 The numerous casualties which occurred among certain troops of the 4th Division when they were assigned temporarily to the 42d (July 30 to August 2) were cared for in the field hospitals of the latter division.113 Ambulance Company No. 19 also functioned as a triage and to August 3 evacuated about 540 patients.83 Sanitary train headquarters then advanced to Epieds and Field Hospitals No. 19, No. 21, and No. 33 were ordered to Epaux-Bezu for station.113 Field Hospitals No. 19 and No. 33 opened for the reception of seriously wounded and sick and No. 21 was held in reserve. Simultaneously Field Hospital No. 28 was advanced to Bezu-St. Germain to receive gassed patients.113
The remainder of the ambulance section advanced on August 1 to Epieds. Two days later, the line having advanced rapidly again, the entire ambulance section was moved to Villers-sur-Fere, where a dressing station which functioned also as a triage was established. Because of continuous rains, bad road conditions, and deplorable lack of motor transportation, evacuations both from front and rear became impeded at this time. Ambulances were forced to evacuate all case as far to the rear as Chateau-Thierry, La Ferte-sous-Jouarre, and Coulommiers, 30 to 50 km. (18.6-31 miles) to the south.113
On August 4 the entire ambulance section was advanced to Mareuil-en-Dole, where an advance dressing station was established. As the line became somewhat stationary along the Vesle casualties increased rapidly in number and severity, and to meet this condition the dressing station was expanded until it became a triage.113 Specially constructed shock rooms and a station for slightly wounded were added, and under the division medical gas officer a ward was equipped for the initial treatment of gassed patients. Here, also, the division psychiatrist maintained a ward for examination and treatment of war neuroses.113 In so far as was possible, collection, sorting, and evacuation of all cases directly to the proper hospitals were effected at this station. Continued rains made roads deep and heavy, thus causing delay and increasing the shock from which wounded were already suffering through exposure to cold and wet on the field. Except for intermittent shelling of surrounding roads, there was no firing or bombing of the village where this triage was established, but on account of the character of the terrain in the battle area and its exposure to incessant enemy fire many of the wounded remained on the field until darkness fell, in shell holes or under other slight cover.113
On August 6, 1918, all of the field hospital section advanced to Chateau de la Foret, just south of Fere-en-Tardenois, where it was well concealed in a wood of the same name. The chateau was in good repair and served admirably as a hospital for nontransportable wounded, and there Field Hospital No. 19 opened for the reception of cases of this character.113 Ward tents were erected
in the grounds around the château, with Field Hospital No. 21 for neurologic cases, No. 28 for gassed cases, and No. 33 for the sick.113 The triage was transferred from the dressing station to the site of these field hospitals. Three additional surgical teams, two shock teams, and seven nurses were furnished by the corps.113 A portable X-ray plant was established. A very complete hospitalization center for the reception of sick and wounded was thus created. It was located on the main axial road, was accessible and within easy hauling distance from the front, was concealed from aerial observation, and completely free from danger, thus allowing its personnel to operate and work without nervous strain other than that incident to fatigue.113 In accordance with orders, only truly nontransportables were operated upon here, viz, cases of hemorrhage, abdominal wounds, aspirating chest wounds, and severe compound fractures of the long bones.113 Here, too, was learned the economic lesson of holding all psychopathic cases instead of evacuating them to the rear. With complete rest in bed in a quiet area, sufficient food, and no treatment other than suggestive therapeutics, from 25 to 40 per cent of all cases of this character were returned to their organizations in from three to five days, well rested and restored.112
Patients were evacuated from this point by sections of the United States Army Ambulance Service and by the sanitary train of the First
Corps, which was now functioning. This train had joined the corps on August 9. The corps surgeon in his report emphasized the advantages consequent on the grouping of field hospitals, when tactically possible, through the saving thereby effected in personnel and transportation.112
The Medical Department of the 4th Division, which functioned for the first time as a unit in the operations toward the Vesle, learned from its new experiences the necessity for the following provisions: A selected, trained personnel of not less than 100 men with each regiment; discontinuance of the regimental aid station and its replacement by the dressing station of an ambulance company; relief of the regimental surgeon from all responsibility for evacuation to the rear of his battalion aid stations; increased motor transport for ambulance companies; treatment of all cases of shock by specially trained personnel before evacuation; facilities for giving, as promptly as possible, rest, heat, and morphine, as required, in the treatment of shock, hemorrhage, and depressed vitality due to exposure; facilities for the early treatment of gassed patients by undressing and bathing them at the battalion aid station if possible, or, if this were not practicable, at the dressing station; and advancement of the field hospital sections as far forward as possible, even to a point of some danger, in order to give the wounded the earliest possible rest and care.112
During the period from August 1 to 12 an epidemic of gastroenteritis occurred in which practically 80 per cent of the division was affected. This epidemic was fully described by a research committee appointed by General Headquarters and was found to be due entirely to lack of sanitary facilities.112
After 27 days had been spent in fighting and marching, the 4th Division moved to the Rimaucourt area for a period of rest, reorganization, and training.112
THE THIRD CORPS
The formation of the Third Army Corps was announced in General Orders, No. 102, General Headquarters, A. E. F., June 25, 1918.
The corps headquarters moved to Meux on July 12 and assumed administrative control over the 1st and 2d Divisions operating under the French Tenth Army. On July 15 the corps headquarters moved to Chateau Chanoye, and on the following day the advanced echelon moved to Taillefontaine.114 The corps surgeons office remained with the 2d echelon at Chateau Chanoye.115
After the attack against Soissons, headquarters of the Third Corps was moved, on July 24, to Mortefontaine with the 1st and 2d Divisions, remaining there in rest until July 30, when it returned to the front. The 1st echelon remained at Mont St. Pere from August 1 to 5, with the 2d echelon installed in the little village of Gland.116 The 3d, 28th, and 32d Divisions were assigned to the Third Corps at this time, the corps commander taking over technical command from the French Third Corps on August 5, when the corps entered fully organized into the battle line and for the first time exercised tactical control of its front.117 The western limit of the corpss sector was: Villers-en-Prayeres (exclusive)Barbonval (exclusive)Blanzy-les-Fismes (inclusive)Perles (exclusive)Mont St. Martin (inclusive)Chery-Chartreuve (ex-
clusive)Ferme de Camp (exclusive)Sergy (exclusive)Fresnes (inclusive)La Croix Rouge FermeMaison BoutachsBraslesChateau-Thierry (north bank exclusive)Marne River from Chateau-Thierry to Azy. Eastern limit was: Concevreux (inclusive)Roman (exclusive)Huit-Voisins (exclusive)Ormont Ferme (exclusive)Courville (inclusive)Arcis-le-Ponsart (inclusive)eastern edge de Bois DormontBois de LanauxVillers-Agron-Aiguizy (inclusive)La Temple Ferme (inclusive)Passy (inclusive)Verneuil (inclusive). Dividing line between sectors of 32d Division (United States) and 4th Division (French): Maizy (to 4th Division)Glennes (to 32d Division)Baslieux-les-Fismes (to 4th Division)St. Gilles (to 4th Division)Longeville Ferme (to 32d Division)Cohan (to 32d Division)Coulonges (to 32d Division)Roncheres (to 32d Division)Barzy-sur-Marne (to 4th Division).117 The 3d and 28th Divisions were in rest billets in the rear.
A part of the French 4th Division, which had been occupying the right half of the sector, was relieved by the 6th Brigade of the 3d Division on August 6. On the following day the remainder of the French 4th Division was relieved by the French 164th Division. The latter was relieved from the Third Army Corps on August 13.118On August 6 the 4th Division, as a part of the First Corps, and the 32d Division reached a line which was approximately that of the Vesle.118
MEDICAL DEPARTMENT ACTIVITIES
On August 1 the corps surgeon established his office at Gland.119 As long as the French division above mentioned remained in this sector, a matter of only two days, its evacuation and hospitalization plans were uninterrupted. Three field hospitals of the 32d Division were at Chateau-Thierry, and one, Field Hospital No. 128, was farther to the rear, receiving the sick at Azy. On August 2, Field Hospital No. 125 was advanced to Jaulgonne to act as a triage. Before this unit was installed there evacuation had been made to Juoy-sur-Morin and Coulommiers through a triage established by the 42d Division at Chateau-Thierry. Two of the field hospitals of the 3d Division were at Chierry, one farther to the rear and one at Mezy. Those of the 28th were at Brasles, or coming up from the rear. Evacuation hospitals had not then been placed at forward positions, and for a day or so field hospitals left behind by divisions withdrawing from the neighborhood of Chateau-Thierry received some gassed and some wounded. Although the army hospitals soon made evacuations to distant points unnecessary, for a short time it was necessary to make these as far back as Coulommiers. Hospital trains coming into Chateau-Thierry cleared the congestion in that town, and by August 4 both evacuation and hospitalization facilities were ample.119
The Paris group headquarters was in control of the sector until August 10, when organization of the First Army was officially accomplished and command of the Third Corps turned over to it. American Red Cross Hospital No. 111 arrived and was established in Chateau-Thierry August 10. Evacua-
tion Hospital No. 6 and Mobile Hospital No. 1 were established at Chierry on July 29. Evacuation Hospital No. 5 arrived at Chierry on August 2 and Evacuation Hospital No. 3 at Crezancy on August 5.119 As soon as the position of the battle line permitted, American Red Cross Hospital No. 110, Evacuation Hospital No. 4, and Mobile Hospital No. 2 were placed in well-chosen sites at Coincy, but this last addition to the evacuation service did not become effective until August 9.120
The corps had no sanitary train until the latter part of August, when Field Hospital No. 332 and Ambulance Company No. 332 arrived at Gland to form the nucleus of such an organization. Being newly organized, they could do little more at that time than serve corps troops. All other evacuation service for the sector was performed by divisions direct to evacuation hospitals or by ambulance companies under the supervision and assignment of the Medical Department representative of the general staff with headquarters of the Paris group. Habitually these units were attached to the different evacuation hospitals as occasion required. During part of the time evacuation was effected to a certain extent by canal boats and barges, which also operated under the supervision of the above Medical Department representative. During the first few days most of the wounded in the corps came from the 32d Division, the only part of the 3d Division then in line being the Artillery. By August 2, Field Hospital No. 125, of the 32d Division, was established at Jaulgonne to function as a triage and to receive nontransportable wounded. By August 4, a field hospital (No. 127) was placed at Reddy Ferme and Evacuation Hospitals No. 5 and No. 6 established at Chierry and Etampes.120
THE 3D DIVISION
From July 16 to 19 the 3d Division remained in its sector on the Marne, with the right flank regiment facing to the east as a measure of protection against the German line which had crossed the river. On the morning of July 20, three French divisions attacked this line, only to find that the enemy had retired to the north side of the Marne during the preceding night. On the same day orders were received to assume the offensive and cross the river. Material was prepared and bridges built during the night of July 20-21. A part of the Infantry had managed to cross the river in boats. By the 22d, the 3d Division was well across and had its leading elements above the towns of Jaulgonne, Charteves, and Mont St. Pere.121
From the 22d to the evening of the 25th very bitter fighting took place on all the wooded slopes leading up to the town of Le Charmel. By evening of that date American troops had fought their way, little by little, into the town, and on the following morning were in possession of the first crest, parallel to the river and approximately 3 km. (1.8 miles) north of it. The Ourcq was reached on July 26, and from that time until morning of July 30 the 3d Division, together with French units on its left, slowly advanced.121
The 3d Division was relieved by the 32d on July 30 and assembled south of Chateau-Thierry. On August 2, the 6th Brigade was dispatched to sup-
port the French Third Army Corps operating toward the Vesle. It was relieved from this duty on August 10 and rejoined the division, which had gone into the rest area near Gondrecourt.122
MEDICAL DEPARTMENT ACTIVITIES
On July 22, the division surgeons office moved from Viels Maisons, Seine-et-Marne, to Chateau la Dultre, remaining at the latter place until August 16. During the period which intervened the division surgeon was occupied chiefly in locating and inspecting hospitals, supervising the evacuation of the wounded, and inspecting the regimental medical service.123 Sixteen men of the line had been selected from each battalion and trained in first aid and in litter bearing.124 The division surgeons other duties were those incident to replacement of casualties in the Medical Department, replacement of officers and men at the front who would have become incapacitated from exhaustion had they not been relieved from duty there, and provision of supplies.123 Service of the medical supply unit, supplemented by the Red Cross representative, was such that medical matériel was ample throughout this operation. The supply officer collected property abandoned by formations as they moved forward, and one of the duties of the sanitary inspector was to determine whether medical units were fully equipped. Sanitation of the command was exceedingly poor, but this was cared for as far as the existing tactical situation permitted.124
Headquarters of the ambulance section of the sanitary train was located at Verdelot from July 15 to 24, then moving to Crezancy, where it remained until August 14. It then moved to Bonnet.125
On July 22, the division having crossed the Marne, Ambulance Company No. 5 advanced its dressing station from Essises to Blesmes, where it opened in a château. In the interval from July 15 to 22 this company evacuated approximately 2,700 patients, of which number more than half were recumbent cases. Over 2,000 of these patients were redressed or received antitetanic serum or other treatment at the main dressing station at Essises. On July 23 this company established an advance dressing and ambulance station at Jaulgonne, with 2 officers, 1 noncommissioned officer, and 10 enlisted men. It posted two ambulances at Le Charmel, one at a point 0.8 km. (one-half mile) northeast of Le Charmel, at the regimental aid station of the 76th Field Artillery, and one with the 4th Infantry post control at Villardelle Ferme.125
Wounded were evacuated through the station at Blesmes to Field Hospital No. 27, at Verdelot, until July 28, on which date that unit moved to Chateau-Thierry. On August 2 the advance dressing station at Jaulgonne was withdrawn and on the following day a medical officer, with two ambulances of Ambulance Company No. 5, was detailed to make, each morning at 8 oclock, the rounds of the 7th Infantry at Viffort; the 1st Battalion, 4th Infantry,
and 8th Machine Gun Battalion, at Montharmeaux; 2d Battalion, 4th Infantry, at Auclaine; 3d Battalion, same regiment, at Montlevon; 2d Battalion, 76th Field Artillery, at La Grande Bordeaux Ferme; 18th Field Artillery, at Nesles; 10th Field Artillery, at Les Evaux; 2d Battalion, 10th Field Artillery, near Chateau-Thierry station; and of 1st Battalion, 10th Field Artillery, at Mont de Blesmes.125 At 4 p. m.every day two ambulances without an officer again covered this route. The service of these "sick call" ambulances was discontinued on August 7, and the 5th Company began to evacuate patients from Field Hospital No. 7 at Cohan to Evacuation Hospitals No. 3, No. 5, and No. 6. For three days a detail from this company assigned to Field Hospital No. 7 assisted it in this evacuation, but was withdrawn when that hospital moved, on August 11.126 From July 22 to August 11 Ambulance Company No. 5 evacuated 1,860 patients and the medical department personnel suffered the following casualties: Killed, 2; wounded, 7 (of whom 2 died); gassed, 4. From August 12 to 15 the company remained at Blesmes awaiting orders, moving on the 16th toward Bonnet near Gondrecourt.126
Ambulance Company No. 7 had established its main dressing station at Pertibout on July 15, but when the 3d Division assumed the offensive it moved on the 22d to Courboin and to Crezancy on the 24th. On July 31 and August 1 its dressing station was located at Jaulgonne; on August 3 at Roncheres. The next day the station here was closed and the company moved to Cohan, where, on August 5, it reestablished its dressing station. This was again moved, the same day to Dravegny and the next day to Arcis-le-Ponsart.126 From time to time throughout this period the company furnished litter bearers to regiments. In the interval from July 15 to August 8 Ambulance Company No. 7 evacuated 3,627 patients and experienced 1 fatality and 15 other casualties among its personnel.126 On August 11 the company closed its dressing station, and then moved to a rest area with the remainder of the division.127
Ambulance Company No. 26, stationed at Verdelot from July 15 to August 1, left that location on the latter date and moved to Courboin, where on August 7 it established a dressing station.126 It remained there until it left the sector on August 16, meantime keeping one ambulance in the routine service of the 4th Infantry and another for the 7th. During this period five of its men were wounded in an air raid.128
Ambulance Company No. 27 was stationed at La Ferotterie from July 15 to 20, all of its available ambulances evacuating from Field Hospital No. 27, at Verdelot, to Field Hospital No. 26, at Coulommiers, and to Army Red Cross Hospital No. 107, at Jouy-sur-Morin. From July 21 to 29 it was at Verdelot, its ambulances operating as before; and from the latter date until August 16 it was at Chierry, its ambulances evacuating from neighboring points into Field Hospital No. 27 and also from that unit into others farther to the rear.128 United States Army Ambulance Section No. 524 was employed to evacuate the wounded from dressing stations to field hospitals and proved an important supplement to divisional resources.127
Headquarters of the field hospital section was located at Verdelot from July 15 to 30, and thereafter at Crezancy, remaining in this location until August 16.125
Field Hospital No. 5, at Ville Chamblon, received gassed cases of the 3d Division, but only a few of these cases were severely affected. Most of those first received were suffering from intoxication by gases which induced sneezing or vomiting; later casualties were attributed to phosgene and, when the enemy began his retirement, to mustard gas. On July 31 the hospital was bombed by a low-flying airplane, 6 men being hit, 4 of whom were killed. This unit was located at Mezy on August 1, but because of air raids itmoved to a position on the St. Eugene-Crezancy road, 1½ km. from Crezancy, remaining in this location until August l6.129
On July 21, Field Hospital No. 7, which had been stationed at Chateau Villiers, near St. Barthelemy, was moved to Ville Chamblon, and on July 27 to Courboin, where it remained until August 5, receiving gassed patients at both these locations. It then moved to Cohan, where it operated a field hospital until August 11, when it returned to Courboin. On August 16 the unit began its movement toward the Gondrecourt rest area.130
Field Hospital No. 26, at Coulommiers July 15 to 25, acting as divisional evacuation hospital, admitted 1,157 patients.131 It then moved to Verdelot, where it received 300 neurotic, sick, and venereal patients. From August 1 to 13 it was established at Chierry, in connection with Field Hospital No. 27, admitting 569 patients of the same class as those it had received at Verdelot;129 but at Chierry, because of an epidemic of dysentery, 350 cases received were medical. On August 13 this unit turned over its patients to Evacuation Hospital No. 5, located in the same town, and began preparations for a move to the rest area.131
Field Hospital No. 27 operated at Verdelot until July 28, receiving patients from the 3d and other divisions. Of the 4,512 cases admitted between July 15 and 28, about 75 per cent came from the 3d, the remainder from the 26th Division.129 Cases received included nontransportables, slightly wounded, scabies, genitourinary, war neuroses, sick (other than contagious), and some gassed patients. This unit also served as the triage hospital, recording all admissions and evacuations. From July 28 until August 16, Field Hospital No. 27 was located at Chierry, operating there most of the time as a triage and as a camp hospital.129 During this period it received 645 patients, including nontransportables, slightly wounded, and miscellaneous medical cases, especially those suffering from an acute enterocolitis of infectious origin. This unit temporarily assimilated Field Hospital No. 26, including its personnel and equipment.132
The principal evacuation point for all the field hospitals of the 3d Division, was Chateau Montanglaust, near Coulommiers, where Evacuation Hospital No. 7 and Mobile Hospital No. 1 had been established on June 12. Army Red Cross Hospital No. 107 was stationed at Jouy-sur-Morin near La Ferte-
Gaucher from June 15 to August 11, when much of its personnel and material were transferred to the newly organized American Red Cross Hospital No. 111 at Chateau-Thierry. The first mentioned of these places was 20 km. (12.4 miles to the southwest of Ville Chamblon and some 30 km. (18.6 miles) or more from the line of the Marne.
On August 16 the sanitary train proceeded to Bonnet, near Gondrecourt, for rest and training.133
THE 32D DIVISION
The 32d assembled near Soissons on July 26 as a reserve of the French Tenth Army, but immediately moved to the vicinity of Chateau-Thierry, where it entered the French Thirty-Eighth Corps of the Sixth Army.134 On July 29-30, it relieved the 3d Division in the vicinity of Roncheres on the Ourcq, and on August 4 passed under control of the American Third Army Corps.134 The commanding general of the 32d Division assumed control of the front, in the sector occupied by his division, at 11 a. m. on July 30; at 2.30 p. m. of the same day an attack was launched which took Bois de Grimpettes and the edge of Bois de Cierges. The 28th Division on the left advanced to the edge of Cierges. On the night of July 30-31 the 28th Division, on the Ourcq, was relieved by the 63d Brigade of the 32d, thus extending the front of the 32d Division to the left toward Sergy. On July 31 the village of Cierges was captured. Strong resistance at Reddy and Bellevue Fermes stopped the advance, but the enemy was forced to abandon the latter position next day, when American troops gained Bois de la Planchette and Hill 230. The German forces now withdrew rapidly, and on August 3 the 32d Division reached the hills overlooking the valley of the Vesle.134 The following description of the offensive from this point is taken from the report of the division commander:135
About midnight of August 3 an order was received from the corps commander to press forward with all possible haste to the Vesle River and to provide means, if possible, for crossing the river * * *. The order contemplated the capture of Fismes with the right column and the railroad yards and large ammunition dumps in left of sector by the left column. When the columns moved forward they met with stubborn resistance and failed to reach the river. * * *
The two columns again pushed forward at night. The left column, upon reaching the river, succeeded in getting two small patrols across, but they could not maintain themselves there and were driven back. The right column attempted to enter Fismes, but met with a determined resistance by a considerable force. They held to a position south of the village; but the next day, after artillery preparation, Fismes was taken by assault and held by our troops. During these operations along the south bank of the river, covering a period of three days, fighting was severe and very difficult. * * *
The casualties sustained by my Infantry in these two days according to the best information (August 10) available approximated 2,000 in killed and wounded, and, upon inquiry by the corps commander (Third United States Corps), I gave it as my opinion that my troops were too much exhausted and too depleted to make further attempt for an immediate crossing. He thereupon gave the order for the relief of my division by the 28th United States Division during the night of August 6-7, which was accomplished in accordance with the order.
MEDICAL DEPARTMENT ACTIVITIES
Litter bearers serving with the regiments were reinforced by details from the line and from ambulance companies and by bandsmen. Awaiting developments of the attack, eight motor ambulances were assigned to each infantry brigade and four horse-drawn ambulances to the artillery. When the attack commenced, dressing stations were established as far forward as possible and ambulance heads pushed out in front of them as circumstances indicated. Aid and dressing stations were advanced as required by troop movements. This offensive demonstrated the need of better contact between battalion aid stations and the ambulance companies and also that the Medical Department be furnished good maps, with prompt information concerning troop movements.136
Regimental and battalion aid stations were located near their respective control posts, in cellars, dugouts, or behind protecting embankments. In some instances regimental aid stations were operated in the immediate vicinity of advanced dressing stations established by ambulance companies. Medical Department personnel as reinforced by bandsmen and details from ambulance company litter bearers was adequate except in a few emergencies.137
From advance stations to the field hospitals Medical Department transportation proved adequate, except that on a few occasions between the dressing stations and the field hospitals trucks of the supply train were utilized, as well as somebelonging to the sanitary train. On July 28 and 29 the sanitary train furnished 19 ambulances for the service of other divisions. None of its motor ambulances was out of service during this time except occasionally for very brief periods while undergoing necessary repairs.136
This movement to the Ourcq was so rapid that the division was in action before its rear medical formations had established themselves and had begun to operate, for which reasons during its early activities it was assisted by medical department units of the 42d Division previously in action here.
As evacuation from the front was toward Chateau-Thierry, the triage for the 32d Division was at first operated by Field Hospital No. 166 of the 42d Division, which was not in a position to leave the sector when the 32d arrived, some of the wounded of the 42d being still in its wards.136 Field Hospital No. 125, at first in reserve near Chateau-Thierry, had been established and was in operation on the night of July 31, when its immediate vicinity was bombed and it was sprayed by machine-gun bullets from an airplane.138 On August 2 it was established at Jaulgonne, where it operated the triage and received nontransportable wounded. Its patients were received from 5 to 24 hours after they had been hit. In only a few cases was the administration of antitetanic serum indicated here, because of its omission further forward, but, generally speaking, readjustment of splints and dressings of the slightly wounded was necessary. Patients suffering from fractures, large shell wounds, or wounds of the chest or abdomen suffered greatly from shock, and
despite liberal use of blankets their vitality became much lowered during transit from the dressing stations to this hospital. During this operation this unit admitted 312 slightly wounded patients, 181 seriously wounded, 140 slightly gassed, 32 severely gassed, and 7 sick. At Jaulgonne it buried 36 dead and returned 31 casualties to the division.138
Field Hospital No. 126 opened under tentage on July 28 in Chateau-Thierry, functioning as an overflow ward for Field Hospital No. 165 of the 42d Division, located near the Jean Mace School. Next day it took over the equipment and standing tentage of that unit and operated until August 7, receiving gassed, exhausted, and psychoneurotic cases.139 Its bed space, originally 200, was later expanded to 300 by taking over empty wards in the Jean Mace School.140 In addition to the overflow mentioned, of the 42d Division, it received 757 patients from the 32d Division, classified as follows: Slightly gassed, 27; moderately gassed, 369; seriously gassed, 101; psychoneurotic, 90; wounded, 77; sick, 57; exhausted, 20; injured, 16.139 About 10 per cent of these cases were transferred to Field Hospital No. 128 to be returned shortly to the ranks. All gassed cases were bathed, but on account of shortage of water and the exhaustion of bathing squads, this practice was later modified, and only selected cases were bathed and given special treatment of mouth and eyes.140 Cases were kept from 2 to 24 hours, an average of 10 hours, the period of detention being determined by evacuation facilities. As evacuation hospitals were well to the rear, trucks were used as conveyances to them, supplemented on the last day of activity in this sector by an evacuation ambulance company.140 The unit moved later to Reddy Ferme.
Field Hospital No. 127 reached Chateau-Thierry on July 28, and until August 1 operated in conjunction with Field Hospital No. 166 of the 42d Division in the Jean Mace School, but by noon of the latter date it began to receive patients from the 32d Division.141 The unit here had a bed capacity of about 500 and an operating capacity of 80.142 Prior to August 3 it received 113 wounded patients and operated upon 2l.141 On August 4 the hospital moved to Reddy Ferme, where it functioned as a triage and received non-transportable and gassed cases.136
Field Hospital No. 128 moved to Azy, opening there on July 31 and receiving 409 sick, 43 gassed, 45 psychoneurotic, 50 injured, and 17 wounded patients. On August 14 it moved to Barzy-sur-Marne.143
At the close of this offensive Field Hospital No. 125 was in reserve at Jaulgonne, Field Hospitals No. 126 and No. 127 at Reddy Ferme, and No. 128 at Barzy.144
The position of these hospitals at the beginning of this operation approximated what was called in this division the "diamond formation," which it employed whenever practicable. According to this plan one hospital, advanced as far forward as possible, acted as a triage and cared for nontransportable wounded. Two other hospitals, farther to the rear, cared for gassed and slighter surgical cases, respectively, while the fourth, yet farther to the rear, took over such cases as would be fit for return to duty in a few days.145
Based on its experience in this campaign, the division developed what was practically a separate triage unit, composed of officers and enlisted men selected from all the field hospitals. This group was engaged solely in the examination, sorting, and registration of patients.145 Every six hours it sent by courier to the division surgeon a report of its activities, thus enabling him to give the division commander a daily statement of casualties, showing the number of wounded admitted, the organizations to which they belonged, and the missiles causing the wounds. This report was thus of some value to the division commander in determining the tactical situation. As the triage operated continuously, the group conducting it was divided into two shifts.144
Almost all the wounded of the 32d Division passed through its own field hospitals, though a few were cared for in the hospitals of other divisions. Hospitals of the 32d treated approximately 40 per cent of casualties admitted and operated upon 358 patients. They evacuated 60 per cent of those received direct to evacuation hospitals or to hospital trains.136
At the commencement of this offensive evacuations from the 32d Division were through the triage operated by Field Hospital No. 166 of the 42d Division at Chateau-Thierry and hospitals of the 32d established in the same place. From Chateau-Thierry patients were sent to Army Red Cross Hospital No. 107 at Jouy-sur-Morin and to Evacuation Hospital No. 7 and Mobile Hospital No. 1 at Coulommiers.136 From July 28 to August 2, when patients were being sent to Coulommiers, the haul was so long that evacuation was unsatisfactory. After Field Hospital No. 125 was established at Jaulgonne, to serve as a divisional triage and receive nontransportable wounded, evacuations to Coulommiers continued, though some patients were sent by train direct from Chateau-Thierry. After August 4, evacuations were made to Evacuation Hospitals No. 5 and No. 6 which had been established at Etampes and Chierry, about 2 km. (1.2 miles) distant from Chateau-Thierry. Thereafter, with two evacuation hospitals close at hand, with hospital trains in service and barges on the Marne available as required, evacuation facilities were ample.136
Methods for using motor trucks of the field hospital train for evacuation purposes were considerably developed in this campaign. Trucks were arranged to carry 12 recumbent patients, 6 longitudinally on the floor and 6 transversely on litters which were lashed by litter slings to the hooks on the side boards of the truck which normally engaged the fastenings of its canvas cover.145 Provisions were made also by which a truck could carry 24 sitting patients. Thus equipped, these vehicles were reasonably comfortable on fair roads and their use prevented the congestion that otherwise would have occurred. They were used especially between the field and evacuation hospitals, thus relieving the ambulances in this circuit of all but the graver cases.145
Because of the tactical situation, sanitary conditions throughout this operation were very unsatisfactory. Every shell hole was polluted, bodies lay undiscovered and unburied for days, and flies were incredibly numerous. Not a mouthful of food escaped their visits. To these insects were attributed enteric diseases which attacked almost all of the division at this time.144
THE 28TH DIVISION
The 28th Division, which had been operating in support of the French and furnishing a number of small elements for front-line service, entered the advance line as a unit on the night of July 27-28, the 55th Brigade relieving the French 39th Division and the 56th Brigade was in reserve in the Bois Vente Jean Guillaume. Bridges were constructed across the Ourcq by the engineer troops, and the 55th Brigade advanced in the face of sustained and severe machine-gun and artillery fire. On July 30, with the 32d Division, it attacked through Grimpettes Wood and reached Cierges, but on account of gas the town was not occupied and the line was established on the high ground just south of the town. The 28th Division was relieved on the night of July 30-31 by the 32d.146
MEDICAL DEPARTMENT ACTIVITIES
Headquarters of the ambulance company section moved from Le Rousset to Chateau-Thierry on July 24, and thence on August 11 to Cohan. With it moved the motor repair park and an ambulance subsection of the medical supply unit maintained to expedite supply of the dressing stations.147
Ambulance Company No. 109 moved, on July 26, from Le Rousset to Chateau-Thierry, where it remained until August 13. From that point its personnel was sent out as litter squads to a number of advance pointsLe Charmel, Fresnes, Courmont, Cierges, and Roncheresto aid infantry units. From July 29 to 31 it maintained a dressing station at Mont St. Pere.148
Before the allied counteroffensive began, Ambulance Company No. 110 had moved with the 55th Brigade of the 28th Division to Charly, but on July 27 returned to Artonges, where it had operated during the German offensive. On the same day it opened at Mont St. Pere a dressing station which it operated until July 29.149 From that date this company was occupied exclusively in evacuating the wounded to a dressing station at Le Charmel operated by Ambulance Company No. 111, thus relieving a United States Army Ambulance section which had previously performed the evacuation in question. While at work in this area ambulances made frequent trips to the Ourcq, 6 of these vehicles evacuating 620 patients in 12 hours. On August 3 the company moved from Le Charmel and established, on the 9th, a dressing station at Chery-Chartreuve which it operated until August 13.150
Ambulance Company No. 111 moved on July 22 to Chateau-Thierry, where it opened a dressing station, a detachment from the company setting up another station at Charly. On July 24 the company moved to Bezu-St. Germain, where it maintained, until July 28, a dressing station which cared for wounded from the 26th, 28th, and 42d Divisions; from this point the company moved to Le Charmel, where it operated a dressing station until August 3. During the period from July 29 to 31, inclusive, this station cared for 2,481 patients.151 On August 3 it was moved to Dravegny, where it remained until the 13th, serving the 32d and 28th Divisions, and the artillery
stationed between Dravegny and St. Gilles. An advance dressing station established at the latter place on August 8 had to be abandoned next day because of shell fire, but ambulances continued to evacuate from that point. This station was reestablished on August 12, although it continued to be harassed by artillery fire. The remainder of the company, which moved to Courville on the 12th, had similar harassment from enemy fire.152
Ambulance Company No. 112 was ordered, on July 21, to Chateau-Thierry, where it opened a dressing station and for the first 24 hours performed what was virtually the work of a battalion aid station, having preceded the infantry of the division. Patients began to arrive before the station wasfully established, and many were brought in from different parts of the town. Shelling and gas attacks continued heavy and interfered considerably with its work.153 The station was well located, however, and cared for disabled of the 1st, 3d, 26th, 28th, and 32d Divisions, as well as for numerous French wounded. Meantime litter details operated with the 112th Infantry in the field. Ambulances cleared the triageField Hospital No. 112established here on July 25, which cared for wounded of the troops mentioned above, and also for those of the 42d Division.154 On August 12 the company moved to Cohan and remained there until the 20th. Evacuation from the triage was taken over partly by its ambulances, and a dressing station was operated at Mont St. Martin.154
Field Hospital No. 109 was moved from Marlande to La Ferotterie on July 17 and prepared to receive wounded in a deserted school building and in tentage erected for the purpose;155 but as no patients arrived, it moved
on July 21 to Rieux, in the vicinity of Montmirail, where it opened again in Chateau Lamartine and its adjoining grounds. It was joined here by operating teams.156 Four days later the unit moved to Charly, receiving there its first patients, 10 in number. It was as yet operating in reserve. On July 30 it moved toward Le Charmel, but as that point was undergoing heavy bombardment it did not enter the town until next day.157 It operated here as a triage until August 7; then, as its distance behind the front was increasing, it moved to Cohan, where for a month it operated a triage in the church building, which proved well adapted to the purpose.158
On July 16, Field Hospital No. 110 received orders to move to Fontaine Tige, where Field Hospital No. 111 had already opened. On and after July 22, it sent 3 officers and 59 men to assist Field Hospital No. 112 at Chateau-Thierry. The remainder of the unit moved to Chateau-Thierry on August 2 and on the 4th to Courmont, caring at the latter place for gassed and psychiatric cases.159
Field Hospital No. 111 was established on July 12 at Fontaine Tige, there equipping a vacant house and pitching tentage for the treatment of shock and surgical cases.160 The first patients arrived July 16, and the hospital continued to function actively until August 8. On the latter date it was moved to Jaulgonne, but not finding a suitable location for a hospital, proceeded next day to Courmont, nearing the advancing division. At Courmont it set up 15 tents and began to receive patients at once.161
Field Hospital No. 112 opened on July 16 on the grounds of a château near Artonges, camouflaged its tents, and improvised baths.162 At this point it received only 59 gassed patients, evacuating these to Fontaine Tige.163 On the 24th it moved to Chateau-Thierry and occupied the partly ruined buildings of the Hotel Dieu.164 While there its personnel was supplemented by details from outside sources; i. e., medical officers, surgical, shock and X-ray teams, and 32 nurses. It received slightly and seriously wounded patients.165 On August 9 the unit was relieved by Red Cross Hospital No. 111 and moved to Cohan.166 There it expanded rapidly, developing from a triage into a hospital of more than 300-bed capacity. Evacuation was effected by ambulances, trucks, trains, and barges to Coulommiers, Coincy, Jouy, Cocherel, and Paris. The functions of Field Hospital No. 112 at this point were those of triage, and of a surgical and an evacuation hospital.167
MEDICAL DEPARTMENT SERVICE IN REAR OF THE DIVISIONS
At suitable points in the foregoing text allusions have been made to the arrangements for care of the disabled in rear of the divisions, but in order that a more comprehensive idea of such service in the Marne area may be gained by the student, what follows has been abstracted from the report of the chief surgeon of the troops operating there, the Paris group. So much of his report as pertains to provisions made in the operation against Soissons has, however, already been given almost entirely in connection with the histories of the 1st and 2d Divisions there engaged, and this need not be repeated here.
During the Soissons operation, evacuation hospitals in the vicinity of Chateau-Thierry and in rear of it retained their former locations. Although the railhead at Crepy-en-Valois was given priority rights in obtaining hospital trains, enough were available for the hospitals at other points to insure a reasonable number of vacant beds to meet sudden emergencies.168On the morning of July 20 all wounded were cleared from the field hospitals in preparation for the offensive which was slated for 3 p. m. on that date, yet by 2 p. m. of the following day Evacuation Hospital No. 7, at Chateau Montanglaust, was nearly full.169 Information was received that the 42d Division had arrived and that the 32d would enter the area at an early date, but attempts to ascertain their probable destination with a view to locating evacuation hospitals to the best advantage were unsuccessful. Nevertheless, arrangements were made to have an evacuation hospital established at Meaux and another at Chateau Perreuse, near La Ferte-sous-Jouarre.169 Medical units were assigned as follows: Evacuation Hospital No. 4, which reached its destination on July 22, to Chateau Perreuse; Evacuation Hospital No. 6 to Meaux, where it arrived July 20; and Mobile Hospital No. 2 to Chateau La Trousse, near Lizy-sur-Ourcq, where it arrived July 23.169
On the 22d, the chief surgeon, district of Paris, reported that the hospitals in Paris were full and that he was unable to secure trains to evacuate them.169 The situation was further complicated by the fact that there were still 1,000 patients awaiting evacuation at Crepy-en-Valois and the evacuation hospitals at Montanglaust and Jouy-sur-Morin were running to capacity; but with 800 vacant beds at Juilly, despite the long haul to that point it appeared that the situation could be met, especially in view of the arrival of the hospitals mentioned above.170 Evacuation Hospital No. 6 was ready to receive patients on the 22d and promptly admitted a large convoy direct from the front. During the following night another convoy was sent to Evacuation Hospital No. 4, for the 26th Division had suffered many casualties, and its wounded were coming to the rear in trucks as well as in ambulances. As our divisions were advancing, forward areas in their vicinity were inspected for hospital sites nearer the front, and barge evacuation on the Marne received consideration for the first time. By July 24 hospital trains were again available.170
From July 16 to 24, Evacuation Hospital No. 7 evacuated by train 8,689 patients, several hundred of whom had come from the Red Cross hospital at Jouy-sur-Morin.171 From July 17 to 24, Evacuation Hospital No. 8, at Juilly, sent out 1,199 patients and the hospital at Jouy-sur-Morin about 1,000.171 Total evacuations, wounded and gassed patients, to date were about 20,000. Selection of advanced sites for hospitals was delayed despite increasing needs that these units be moved forward, because of limitations imposed on railway service to several points which otherwise would have been satisfactory. Evacuation Hospital No. 6 was ordered to prepare for a quick movement.171
On July 26, the stream of wounded which had been flowing since early morning of July 15 showed no signs of diminution.171 On July 27 the Paris group was replaced by the First Army. On July 28, Evacuation Hospital
No. 6 was ordered to the vicinity of Chateau-Thierry, Mobile Hospital No. 1, which arrived there July 29, was ordered to discharge with Evacuation Hospital No. 6 the same consolidated service that it had previously performed with Evacuation Hospital No. 7.172 On the following day United States Army Ambulance Section No. 578, assigned to the 28th Division, was withdrawn and attached to Evacuation Hospital No. 6.173
On July 29, most of the wounded came from the 42d Division, but a number were also received from other organizations. Arrangements were made with hospitals in Paris to receive one trainload of patients, and preparation was begun for the prompt docking of hospital barges in that city.173
By July 30, Evacuation Hospital No. 7 had evacuated 15,871 patients, including some sent by ambulance from Jouy-sur-Morin. Juilly had evacuated 1,499 patients and Jouy-sur-Morin 924 by train. The total for the area to date was 28,882, exclusive of those from the 2d Division when first struck by the German advance early in June.173
Evacuation Hospital No. 6 and Mobile Hospital No. 1, which had arrived at Chierry, near Chateau-Thierry, on July 29, were established by the 31st, but only the seriously wounded were to be received in them. Slightly and moderately wounded patients were to be sent to evacuation hospitals farther to the rear.174
Evacuation Hospital No. 3 was ordered to go with all speed to La Ferte-Milon, where it arrived on July 29. The litter-bearer service at Evacuation Hospital No. 7 had again become a source of grave concern. The Artillery of the First Corps, in reserve, had furnished that unit on July 22 with 100 men who served as litter bearers for three days, relieving the personnel of the hospital, who were utterly exhausted, to that extent. A few days later Ambulance Company No. 120 had arrived, but now both its bearers and those with Evacuation Hospital No. 7 were greatly fatigued. The rest of the hospital personnel likewise was showing the severe strain they had undergone. None of them had had time to sleep for three weeks except occasionally during the late hours of the early morning, and even this had been interrupted by frequent demands.174
At about this date 4 ambulance companies with 12 G. M. C. cars each arrived. This relieved the situation, for until these ambulances reported trainshad had to be spotted at a given place at a given hour, in order that ambulances might be there ready to load them. Thus if trains arrived at Jouy-sur-Morin and Coulommiers the same morning, the number of ambulances was so small that the trains could not be loaded simultaneously. It was necessary to load at one point, then to make due allowance of time for ambulances to reach the other point before spotting a train there.175
On August 1, Evacuation Hospital No. 5 was ordered from Crepy-en-Valois to Chateau-Thierry, where it arrived on August 2. On the same date territory in advance of that point was inspected with a view to selecting advance sites for evacuation hospitals, and one at Coincy was selected.
Recommendations were made that labor troops follow combatants and care for sanitation of the rear.
A floating dock, at Azy, near Chateau-Thierry, was now completed, and the first wounded to be sent by steam barge to Paris left there on August 2.176 This convoy, made up of seriously wounded, included fracture cases and many patients who would have been nontransportable except by boat. The capacity of these barges varied, the largest carrying 84 patients. They were reported by the patients as being very comfortable, as the engines, being small and located well astern, caused little vibration. Bunks were placed in the hold, and the general appearance of the interior was similar to that of an ordinary hospital ward except that it was broader and the bunks cruder.176 Personnel assigned to each barge consisted of 1 medical officer, 6 enlisted men of the Medical Department, 4 Red Cross workers, and a variable number of French litter bearers. The time required for a trip averaged 14 hours to Paris and 18 hours for the return.177
Evacuation Hospital No. 5, after opening at Chatean-Thierry on August 2, received seriously wounded from one corps, while those from the other corps engaged were sent to Evacuation Hospital No. 6 and Mobile Hospital No. 1, at Chierry. Their work was coordinated and their evacuation effected by a representative from the army surgeons office. Slightly wounded patients were sent to the hospitals at Chateau Perreuse, near La Ferte-sous-Jouarre, Montanglaust, and Jouy-sur-Morin. At this time a survey was made with a view to establishing at Chateau-Thierry the medical supply depot heretofore operating at Lieusaint, 50 km. (31 miles) to the rear.177 This depot had been able to meet most demands promptly, the most serious shortages having been in instruments and tentage. Blankets, litters, antitetanic serum, pajamas, cots, and other essentials for front-line service had always been in stock. On several occasions the supply of splints had been well-nigh exhausted, and it was only by extra efforts that they were procured in time to meet all needs.178 Requisitions from division surgeons had come direct to the property desk in the office of the liaison officer for the Medical Department (chief surgeon, Paris group), later to that in the army surgeons office, where they were approved, to be forwarded twice daily to the depot which delivered supplies at the front by truck.178
Evacuation Hospital No. 3 moved on August 3 to Crezancy, a small village about 8 km. (4.9 miles) east of Chateau-Thierry, and tentative arrangements were made to move Red Cross Hospital No. 107 from Jouy-sur-Morin to Chateau-Thierry.178 The hospitals at Montanglaust filled during the night of August 4-5, but were cleared promptly by trains.179 Inspection for a suitable location for an evacuation hospital near Fere-en-Tardenois was made at this time. By August 6, some slightly wounded patients were being received by Evacuation Hospitals No. 5 and No. 6 and Mobile Hospital No. 1, but the majority of such patients continued to be sent as before.179 Arrangements were now made for the immediate movement of Red Cross Hospital No. 110 from Chantilly to Coincy, to which point Evacuation Hospital No. 4 was also ordered from Chateau Perreuse. The latter arrived at Coincy on
August 6.180Evacuation Hospital No. 3, established at La Ferte Milon on July 30, had moved, on August 5, to the vicinity of Chateau-Thierry, when fighting in that neighborhood assumed such unusual proportions. Devastation north of the Marne left little option in the choice of sites nearer the front, and the selection of Crezancy had been made only after some hesitancy.181 This location was so far forward there was danger that it would be bombed or bombarded, but the only alternative at this time was the grouping of all the forward evacuation hospitals at Chateau-Thierrya disposition which appeared inadvisable.
On August 11, orders were received that the First Army move to the vicinity of Neufchateau. A report was received that the Paris group would be revived. This proved true, and upon departure of Colonel Stark to his new station Colonel Hutton resumed his former duties as chief surgeon of troops in the Marne area (Paris group).182 The personnel of Ambulance Company No. 120, which up to this time had been assisting Evacuation Hospital No. 7, was now sent to assist Red Cross Hospital No. 110 at Coincy, and much of the personnel and equipment of Red Cross Hospital No. 107 was moved from Jouy-sur-Morin to American Red Cross Hospital No. 111, newly established at the Hotel Dieu at Chateau-Thierry.182 Though this building had been greatly damaged by artillery fire, it lent itself well to hospital purposes and, by erecting tents in the neighboring grounds, the unit soon had about 600 beds set up. The site was a good one, being near the river and also near a railway spur.182
On August 12 Evacuation Hospitals No. 6, No. 7, and No. 8 and Mobile Hospital No. 1 were ordered to move with the First Army to the vicinity of Neufchateau, but the other evacuation units were to remain in the Marne area.182 Information was received that the First Corps would move with the First Army, but that the Third Corps would remain in line along the Vesle, where it would pertain to the Paris group. As no further movement of our troops was contemplated at this moment, the medical units transferred, and probably others, could well be spared. By this time Evacuation Hospital No. 4 and Red Cross Hospital No. 110 were functioning at Coincy.183
Evacuation by steam barges was on a fairly systematic basis by August 14. Ambulance Company No. 41, which had joined recently, had been directed to establish a camp at Azy, where it received patients preparatory to their removal by boat. This camp was furnished with matériel sufficient to equip a relay station of some 150 beds. Patients usually were received here in the afternoon, placed on board a barge the next morning, and arrived in Paris on the same day. Personnel of Evacuation Hospital No. 6, which heretofore had cared for patients here, now rejoined their own organization. An annoying but unavoidable feature of this barge service was the irregularity of its schedule, due to the fact that these vessels required frequent repairs. Nevertheless they proved of material assistance both by the relief which they afforded the congested railroads and by the greater comfort which they provided for the seriously wounded during transport.183
A report rendered by Evacuation Hospital No. 7 before it left this area showed that it had evacuated 27,055 patients from July 17 to August 8.184Some of them had been treated in the hospitals at Jouy-sur-Morin and at Chateau Perreuse and were merely transferred to Evacuation Hospital No. 7 for evacuation.181 Mobile Hospital No. 1 had supplemented the latter unit during most of its service here; but nevertheless the amount of work accomplished, taking this into account, was considered remarkable, especially in view of the fact that neither organization had had prior service in campaign.184
The medical supply depot at Chateau-Thierry supplied troops at the front for some days prior to August 16, replenishing its stock from the depot at Lieusaint, which was still in operation. This provision of a forward depot not only effected a considerable saving in transportation but it also accelerated delivery at the front. Divisions in need of supplies either sent for them by their own transport, or the articles requisitioned were sent up by truck from the depot.184
Red Cross Hospitals No. 110 and No. 111 were staffed by army personnel, but their supplies, except rations, usually were obtained from the Red Cross, though it was understood that the resources of the army medical depots were at their disposal.184 Attempts made by the Red Cross to furnish its hospital at Jouy-sur-Morin with rations had demonstrated the difficulties incident to that method of supplying food, and Red Cross units now drew rations as did other army hospitals. These were supplemented by donations from the Red Cross.185
Reports now compiled (August 18) showing the length of time lapsing from receipt of wound to time of operation (bearing no reference to the hour of arrival at the evacuation hospital) showed that at Evacuation Hospital No. 7 the average was slightly less than 12 hours. Occasionally the wounded had reached the hospital in four hours, but pressure of work was such that with the operating teams actually available they could not always be operated immediately. Not infrequently the wounded had been lying in shell holes for a day or sometimes two days before they were recovered, which fact raised the average length of time lapsing prior to operation. The average interval prior to operation, at Chateau-Thierry, during the rush period was at first 10 hours, later 8, and at Coincy it was from 6 to 7 hours. Generally speaking, surgery was well done, with a minimum of delay, and results obtained compared favorably with those of any of our Allies.186
Reserve personnel and hospitals were withdrawn from wherever they could be spared and sent to the Marne area for duty.187
At the height of our activities there, the hospitalization provided for our forces was 6 evacuation hospitals, 2 American Red Cross hospitals, and 2 mobile hospitals, with a total bed capacity of approximately 7,000.187 Their various locations have already been given. While relatively few in number, they were brought up as rapidly as possible. The greatest difficulties encountered in this and other respects were due to lack of transportation.
One evacuation hospital, urgently needed, through lack of motor transport had to be ordered up by rail. It was four days en route from Bazoilles-
sur-Meuse to Coulommiers. Personnel in the region of Langres, also urgently needed, could not be provided with transportation until the French were appealed to and furnished motor camions for the movement.187
The ambulance shortage was so acute that trucks had to be utilized in transporting the wounded. By working the personnel night and day, often without adequate rest, and operating hospital trains and ambulance evacuations to maximum possibilities, it was barely possible to meet requirements.188
Evacuations, at first regulated from the station at Creil and then transferred to the more centralized station at Le Bourget, were largely carried on through the operation of American hospital trains garaged at Pantin, Paris. Frequently trains had to be borrowed from the French, but during the height of activities there were 16 American Expeditionary Forces trains in operation there.187
In marked contrast to the chaotic conditions that existed in rear of the Soissons front because of the fact that the Medical Department had been given no information concerning the offensive there were the smoothness and precision with which the evacuation in rear of the divisions on the Chateau-Thierry front were conducted and operations on thousands of American wounded performed. For example, on the ninth day of the offensive and counteroffensive, operations and evacuations had been carried through with a regularity that still left 3,800 vacant beds in the evacuation hospital chain there. American forces were operating there with the French Sixth Army and were given unrestricted opportunity to conduct their own hospitalization and evacuation. The work carried on there under most trying circumstances challenged any criticism.188
Reports received August 18 concerning the etiology of the epidemic of enteritis which had affected the troops since the early part of the month indicated that the disease was of bacillary origin. Responsibility was not attached to any one organism, though both Shiga and Flexner types were isolated.185 The epidemic did not begin until our troops had started their advance. This was attended by the death of thousands of animals, whose carcasses, being unburied, had afforded opportunity for great multiplication of flies. There were few facilities for the protection of food from them, and it was believed that the epidemic was largely attributable to the agency of these insects.182 The fact that bread received at this time was moldy was also considered to be a possible contributory cause.185
Portable apparatus to free men from lice were brought up back of the lines, but these were inadequate in number. Two for a division were authorized, but this quota, even when supplied, did not meet all requirements. In the absence of other delousing appliances, division surgeons improvised such apparatus as their facilities permitted.183
MEDICAL SERVICE OF THE FRENCH SIXTH ARMY189
A large proportion of the American troops in the Marne area operated under the control of the French Sixth Army, which occupied the region, including Chateau-Thierry. The chief surgeon of this army did not attempt to
control the American evacuation service; on the other hand, he assisted in every way possible its operation and individual development. Data furnished by him are inserted here in order to afford some basis of comparison of the methods of the French and American medical services which were closely associated in this area, and to give the total casualties of their army, to which several American divisions then belonged. The difficulties under which the French medical service was laboring at this time are evidenced by the large percentage of wounded which their army was obliged to evacuate unoperated.
On July 15 the front of the French Sixth Army from south of Faverolles to the west of Dormans, passing by Troesnes, Chezy-en-Orxois, Bussiares, Belleau, Bouresches, Vaux, and the course of the Marne, was held by the French Second and Seventh Corps, and the American First Army Corps with the French Thirty-eight Corps echeloned from north to south and to the east. The military operations of the French Sixth Army following July 14, were divided by the French into three phases: (1) The German offensive of July 15-17, in the course of which only the right wing of the Sixth Army was engaged. (2) The attack of the 18th and 19th by the left wing of the Sixth Army. (3) The general attack, beginning July 19, by four corps from left to rightthe Second and Seventh (French), First (American), and Thirty-eighth Corps (French). This, after the 27th, was continued by but three corps, the Seventh (French) having been withdrawn.
The French medical service was disposed on July 15 as follows: On the line of the corps(1) One field hospital per division (assembly, urgent aid, washing of burned cases, and detention of suitable cases). (2) A group of surgical hospitals, by corps. (3) A center for convalescents and slightly gassed cases, by Army Corps.
On the line of the army: Evacuation hospitals of the first line at Meaux and Coulommiers, of the second line at Montevrain, with sections at Lagny and Ferrieres, medical centers at Meaux and Mauperthuis, and a convalescent center at La Houssaye (slightly sick, gas burned, and footsore).
All these formations taken together afforded 5,250 beds, of which 1,500 were primarily for surgical cases, 850 for medical, and 1,000 for convalescents.
Surgical facilities in both the corps and the army included (exclusive of those serving the Americans) 27 class A equipments, 14 class B equipments, certain emergency provisions for the changing of dressings, and 24 radiologic establishments.
The vehicles of the medical service in addition to those of divisions comprised 4 sanitary service sections (20 ambulances each) and 16 auto cars. In the course of the operations they were reinforced successively by 6 Army Ambulance sections (of which 1 was assigned to each of the 3 French corps and 3 to the American troops) and by 36 trucks (12 per French corps).
An evacuation service by water eventually was organized, with 2 freight barges, each carrying 40 sitting and 40 recumbent, and 3 Parisian steamships, each carrying 200 seated. On the 23rd of July to these were added a pinnace equipped with 94 litters; on the 25th another vessel.
During the first phase of these engagements there was no change in the location of French medical formations, though the enemy reached the imme-
diate vicinity of the triage of the 125th Division at Moulin Ragronet. In the second phase the divisional medical units in the Second and Seventh Corps were advanced, and in the third phase this progression was continued, while all the surgical groups of the several corps were advanced also. Thus the surgical hospitals of the Second Corps were moved from dAcy-en-Multien to Marolles (July 21) where one hospital for nontransportables remained, the other units of this group moving to Grisolles on the same date. Simultaneously the surgical hospitals of the Seventh Corps moved from Gue a Tresmes to Crouy-sur-Ourcq. In the First Corps an American hospital replaced at Perreuse the surgical hospital of the 167th Infantry. On the right the surgical center of the French Thirty-eighth Corps moved July 23 from La Ferte-Gaucher to Charly, and the triage hospital at Verdelet moved July 28 to Chateau-Thierry.
Despite the elongation of the lines of evacuation, it was impracticable to move the two large evacuation centers at Meaux and Coulommiers, which, especially the one at Meaux, were laboring to full capacity, and even momentary cessation of the work of either would have greatly jeopardized the care of the wounded. The evacuation hospital at Montevrain was held ready to move forward, and on the 24th was sent to Charly, whence it transferred patients by barges to Meaux. On July 30 it moved to Chateau-Thierry, where it was held on the alert in reserve.
Relay units were established in the larger evacuation routes at Gue a Tresmes on the road to Villers-Cotterets and at Jouarre on the route to Chateau-Thierry. These relays utilized an army hospital, or were affiliated with a group of corps hospitals, their mission being to liberate the vehicles of the corps, to afford rest and nourishment to the passing casualties, and to stop and accommodate nontransportable patients.
On July 31 the army front extended from near Saponay to Seringes and Nesles, to descend toward Cierges and Roncheres. From left to right it was held by the French Second, American First, and French Thirty-eighth Corps. Surgical formations for these corps functioned respectively at Grisolles, Bezu, and Chateau-Thierry. Wounded reached the French evacuation hospital at Meaux by ambulances, relaying from Marolles, and by barges from Charly. After August 10 they arrived at Meaux by train from Chateau-Thierry. The most gravely wounded from Chateau-Thierry were operated here or sent to Marly. American troops were served by the American evacuation formations at Montanglaust and Jouy-sur-Morin. On the 30th the hospital of Meaux moved to Chateau-Thierry (Chierry).
As the hospital at Meaux had but a limited number of surgical equipments, it was impossible to operate all the wounded reaching this point. Therefore a very thorough surgical triage was organized under the consulting surgeon. Wounds of all recumbent and of doubtful sitting cases were inspected and 6 dressing tables were constantly operated by 12 alternating teams. After several days the need for medical officers was so great that the application of dressings, under direction of the consulting surgeon, was entrusted to two volunteer American women doctors and to especially qualified nurses.
A similar triage was conducted at Coulommiers on the 15th, 16th, and 17th of July. Almost all operations, both at this point and at Meaux, were performed on nontransportable patients. With the resources available this was the only solution of the problema minute triage of patients, operation on the nontransportables such as required immediate care and of such others as was possible, and the evacuation, nonoperated, of all others after rendering them such other surgical services as was indicated and possible.
Total French losses during the period from the 15th to the 31st of July were as follows: Wounded 14,055 (of whom 7,202 were operated in the army area and 6,853 evacuated not operated); gassed and burned, 2,081; sick, 2,554; total, 18,690. Of this number, 14,549 were evacuated by July 31; 2,145 remained in army hospitals, 285 in corps formations, and 1,710 in the camps for slight disabilities (centers de recuperables).
Total American patients during the same period evacuated by American formations were: Evacuation hospitals at Chateau-Montanglaust and Jouy-sur-Morin, 21,175; by hospital at Juilly, 1,199; total 22,374.
During August, losses were as follows in the French Sixth Army: French, wounded, 1,607; gassed, 1,102. American, wounded, 2,235; gassed, 335.
All French casualties evacuated by water went from Meaux to Charenton. These numbered 4,047, of whom 3,899 were not operated. Train transportations of French casualties numbered 10,502, of whom 7,438 were wounded (including 2,050 not operated), 1,621 sick, 1,443 gassed and burned. These were moved by 44 trains. Movement by water, though slow (8 km. per hour) was very comfortable. Sometimes hospital trains were greatly delayed, and occasionally they arrived at evacuation hospitals as much as nine hours late.
Causes and distribution of wounds in cases examined in the hospitals of the Sixth Army from the 15th to the 30th of July were as follows:
(1) Final Report of Gen. John J. Pershing, September 1, 1919, 34.
(2) Ibid., 36.
(3) Special report, Field Orders and Instructions, "Operations of the 1st Division, July 18-24, 1918, South of Soissons." On file, Historical Section, the Army War College.
(4) Outlines of Histories of Divisions, U. S. Army, 1917-1919, prepared in the Historical Section, the Army War College. On file, Historical Section, the Army War College.
(5) Report of Medical Department activities, 1st Division, A. E. F., by Lieut. Col. Wilbur M. Phelps, M. C., sanitary inspector, 1st Division, undated, Part II, 21. On file, Historical Division, S. G. O.
(6) Ibid., 25.
(7) Ibid., 26.
(8) Ibid., 27.
(9) Report of Medical Department activities, 1st Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 23. On file, Historical Division, S. G. O.
(10) Ibid., 24.
(11) Report of Medical Department activities, Ambulance Company No. 2, 1st Division, prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(12) Report of Medical Department activities, Ambulance Company No. 3, 1st Division, A. E. F., prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(13) Report of Medical Department activities, Ambulance Company No. 12, 1st Division, prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(14) Report of Medical Department activities, Ambulance Company No. 13, 1st Division, prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(15) Report of Medical Department activities, 1st Division, prepared under the direction of the division surgeon, undated, Part I, 26. On file, Historical Division, S. G. O.
(16) Ibid., Part I, 28.
(17) Ibid., Part I, 53.
(18) Report of Medical Department activities, Field Hospital No. 12, 1st Division, A. E. F., prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(19) Report of Medical Department activities, Field Hospital No. 3, 1st Division, A. E. F., prepared under the direction of the commanding officer, undated. On file, Historical Division, S. G. O.
(20) Report of Medical Department activities, 1st Division, prepared under the direction of the division surgeon, undated, Part III, 8. On file, Historical Division, S. G. O.
(21) Ibid., Part III, 10.
(22) Report of Medical Department activities, 1st Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 54. On file, Historical Division, S. G. O.
(23) Ibid., Part I, 55.
(24) Ibid., Part I, 25.
(25) Ibid., Part I, 27.
(26) Outlines of Histories of Divisions, U. S. Army, 1917-1919, prepared in the Historical Section, the Army War College. On file, Historical Section, the Army War College.
(27) Report of operations, 2d Division, in the attack of the Twentieth Army Corps, French Fourth Army, near Soissons, July 17-21, 1918, by Maj. Gen. John A. Lejeune, U. S. M. C. On file, Historical Section, the Army War College.
(28) Report of Medical Department activities, 2d Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 30. On file, Historical Division, S. G. O.
(29) Report of operations, Medical Department, 2d Division, A. E. F., July 18-24, 1918, from the division surgeon to the commanding general, 2d Division, February 5, 1919. On file, Historical Division, S. G. O.
(30) Report of Medical Department activities, 2d Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 28. On file, Historical Division, S. G. O.
(31) Ibid., Part I, 29.
(32) Report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F., by Col. S. H. Wadhams, M. C., chief of section, December 31, 1918, 55. On file, Historical Division, S. G. O.
(33) Exhibit "M" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.: Memorandum from Lieut. A. D. Tuttle, M. C., representative of chief surgeon G-4, to the assistant chief of staff, G-4, G. H. Q., July 25, 1918. On file, Historical Division, S. G. O.
(34) Report on activities of G-4-B, medical group; fourth section, general staff, G. H. Q., A. E. F., by Col. S. H. Wadhams, M. C., chief of section, December 31, 1918, 53. On file, Historical Division, S. G. O.
(35) Ibid., 38.
(36) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.; Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, undated, 34. On file, Historical Division, S. G. O.
(37) Ibid., 30.
(38) Ibid., 31.
(39) Ibid., 32.
(40) Military History of the American Red Cross in France, by Lieut. Col. C. C. Burlingame, M. C. (director, medical and surgical department, Red Cross), undated, 85. On file, Historical Division, S. G. O.
(41) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.; Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, M. C., undated, 33. On file, Historical Division, S. G. O.
(42) Report of Medical Department activities of Evacuation Hospital No. 5, A. E. F., by Lieut. Col. E. F. Geddings, M. C., commanding officer, undated. On file, Historical Division, S. G. O.
(43) Exhibit "M" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F., July 23, 1918. On file, Historical Division, S. G. O.
(44) Exhibit "N" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F., August 31, 1918. On file, Historical Division, S. G. O.
(45) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.; Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, M. C., undated, 35. On file, Historical Division, S. G. O.
(46) Ibid., 36.
(47) Ibid., 39.
(48) Report of Medical Department activities of the Third Army Corps, A. E. F., by Col. James L. Bevans, M. C., corps surgeon, undated, 12. On file, Historical Division, S. G. O.
(49) Ibid., 3.
(50) Ibid., 13.
(51) Ibid., 14.
(52) Ibid., 15.
(53) Ibid., 16.
(54) Ibid., 18.
(55) Operations report second battle of the Marne, July 18 to August 12, 1918, Headquarters, 4th Division, A. E. F., December 28, 1918. On file, Historical Section, the Army War College.
(56) Summary History of the First Army Corps from its creation, January 15, 1918, to the cessation of hostilities, November 11, 1918, edited by G-2, First Army Corps, November 15, 1918, 3. On file, Historical Section, the Army War College.
(57) Report of Medical Department activities, 4th Division, A. E. F., prepared under the direction of the division surgeon, undated, 3. On file, Historical Division, S. G. O.
(58) Ibid., 2.
(59) F. O. No. 9, Headquarters, First Army Corps, July 17, 1918.
(60) Report of operations of the First Corps, July 18-31, 1918, by Lieut. Col. W. S. Grant, general staff (G-3), undated. On file, Historical Section, the Army War College.
(61) Summary History of the First Army Corps from its creation, January 15, 1918, to the cessation of hostilities, November 11, 1918, edited by G-2, First Army Corps, November 15, 1918, 4. On file, Historical Section, the Army War College.
(62) Outlines of Histories of Divisions, U. S. Army, 1917-1919, prepared in the Historical Section, the Army War College. On file, Historical Section, the Army War College (1700, 26th Division).
(63) Ibid., 5.
(64) Report of Medical Department activities, First Army Corps, Chateau-Thierry operation, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 52. On file, Historical Division, S. G. O.
(65) Ibid., 46.
(66) Memorandum from Headquarters, First Army Corps, A. E. F., July 30, 1918. On file, Historical Division, S. G. O.
(67) F. O. No. 11, Headquarters, First Army Corps, A. E. F., July 18, 1918.
(68) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 53. On file, Historical Division, S. G. O.
(69) F. O. No. 19, Headquarters, First Army Corps, July 21, 1918.
(70) F. O. No. 20, Headquarters, First Army Corps, July 23, 1918.
(71) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 54. On file, Historical Division, S. G. O.
(72) Ibid., 55.
(73) F. O. No. 24, Headquarters, First Army Corps, July 25, 1918.
(74) Daily operations report, First Army Corps.
(75) F. O. No. 25, Headquarters, First Army Corps, July 26, 1918.
(76) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 57. On file, Historical Division, S. G. O.
(77) F. O. No. 27, Headquarters, First Army Corps, A. E. F., July 28, 1918.
(78) F. O. No. 30, Headquarters, First Army Corps, A. E. F., July 29, 1918.
(79) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 59. On file, Historical Division, S. G. O.
(80) F. O. No. 32, Headquarters, First Army Corps, July 31, 1918.
(81) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 61. On file, Historical Division, S. G. O.
(82) F. O. No. 33, First Army Corps.
(83) F. O. No. 34, Headquarters, First Army Corps, A. E. F., August 1, 1918.
(84) F. O. No. 36, Headquarters, First Army Corps, A. E. F., August 3, 1918.
(85) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 65, 66. On file, Historical Division, S. G. O.
(86) F. O. No. 13, Third Army Corps, August 12, 1918.
(87) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 67. On file, Historical Division, S. G. O.
(88) Ibid., 68.
(89) Ibid., 69.
(90) Ibid., 70.
(91) Ibid., 71.
(92) F. O. No. 57, Headquarters, First Army Corps, A. E. F., September 22, 1918.
(93) Report of Medical Department activities, First Army Corps, A. E. F., Chateau-Thierry operations, by Lieut. Col. J. W. Grissinger, M. C., corps surgeon, undated, 72. On file, Historical Division, S. G. O.
(94) Report of operations, offensive commencing July 18, 1919, submitted by Maj. Gen. C. E. Edwards, commanding officer, 27th Division, undated. On file, Historical Section, the Army War College.
(95) Report of Medical Department activities, 26th Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 63. On file, Historical Division, S. G. O.
(96) Ibid., Part I, 64.
(97) Ibid., Part II, 26.
(98) Ibid., Part II, 27.
(99) Ibid., Part II, 28.
(100) Ibid., Part I, 65.
(101) Brief history of the 42d Division, submitted by the commanding general, 42d Division, to the commanding general, First Army Corps, undated. On file, Historical Section, the Army War College.
(102) Operations report, 42d Division, A. E. F., July 25 to August 3, 1918.
(103) Report of Medical Department activities, 42d Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 17.
(104) Ibid., Part I, 18.
(105) Ibid., Part I, 48.
(106) Ibid., Part I, 51.
(107) Ibid., Part I, 52.
(108) Ibid., Part I, 53.
(109) Ibid., Part I, 54.
(110) Ibid., Part I, 75.
(111) Ibid., Part I, 76.
(112) Report of Medical Department activities, 4th Division, A. E. F., prepared under the direction of the division surgeon, undated, 5. On file, Historical Division, S. G. O.
(113) Ibid., 4.
(114) History of the Third Army Corps, from April 1, 1918, to September 9, 1918, undated, Vol. I. On file, Historical Section, the Army War College.
(115) Report of Medical Department activities, Third Army Corps, A. E. F., by Col. James L. Bevans, M. C., corps surgeon, undated, 2. On file, Historical Division, S. G. O.
(116) Ibid., 3.
(117) F. O. No. 3, Third Army Corps, A. E. F., August 4, 1918.
(118) War Diaries, Third Army Corps.
(119) Report of Medical Department activities, Third Army Corps, A. E. F., by Col. James L. Bevans, M. C., corps surgeon, undated, 4. On file, Historical Division, S. G. O.
(120) Ibid., 20.
(121) Special report, operations of the 3d Division, July 15-31, 1918. Résumé of the operations of the 3d Division, U. S., from May 29 to July 31, 1918. On file, Historical Section, the Army War College.
(122) Outlines of Histories of Divisions, U. S. Army, 1917-1919, prepared in the Historical Section, the Army War College, 3. On file, Historical Section, the Army War College.
(123) Report of Medical Department activities of the 3d Division, A. E. F., prepared under the direction of the division surgeon, undated, Part V, 2. On file, Historical Division, S. G. O.
(124) Ibid., Part V, 3.
(125) Ibid., Part IV, 1.
(126) Ibid., Part IV, 2.
(127) Ibid., Part IV, 7.
(128) Ibid., Part IV, 3.
(129) Ibid., Part IV, 5.
(130) Ibid., Part IV, 4.
(131) Ibid., Part IV, 9.
(132) Ibid., Part IV, 10.
(133) Ibid., Part IV, 6.
(134) Outlines of Histories of Divisions, U. S. Army, 1917-1919, prepared in the Historical Section, the Army War College, 40. On file, Historical Section, the Army War College.
(135) Report on operations of the 32d Division, July 29 to August 7, inclusive, Phase III; Brief statement by division commander. On file, Historical Section, the Army War College.
(136) Report of Medical Department activities of the 32d Division, A. E. F., prepared under the direction of the division surgeon, undated, Part I, 4. On file, Historical Division, S. G. O.
(137) Ibid., Part I, 6.
(138) Ibid., Part II, 50.
(139) Ibid., Part II, 54.
(140) Ibid., Part II, 55.
(141) Ibid., Part II, 63.
(142) Ibid., Part II, 64.
(143) Ibid., Part II, 76.
(144) Ibid., Part II, 41.
(145) Ibid., Part II, 40.
(146) Special report of operations of the 28th Division, July 15-31, 1918. On file, Historical Section, the Army War College.
(147) Report of Medical Department activities of the 28th Division, prepared under the direction of the division surgeon, undated, Part I, 16. On file, Historical Division, S. G. O.
(148) Ibid., Part I, 15.
(149) Ibid., Part I, 6.
(150) Ibid., Part I, 7.
(151) Ibid., Part I, 11.
(152) Ibid., Part I, 12.
(153) Ibid., Part I, 13.
(154) Ibid., Part I, 14.
(155) Ibid., Part I, 21.
(156) Ibid., Part I, 22.
(157) Ibid., Part I, 23.
(158) Ibid., Part I, 25.
(159) Ibid., Part II, 2.
(160) Ibid., Part II, 6.
(161) Ibid., Part II, 7.
(162) Ibid., Part II, 14.
(163) Ibid., Part II, 15.
(164) Ibid., Part II, 16.
(165) Ibid., Part II, 18.
(166) Ibid., Part II, 21.
(167) Ibid., Part II, 20.
(168) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.: Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, M. C., undated, 32. On file, Historical Division, S. G. O.
(169) Ibid., 35.
(170) Ibid., 36.
(171) Ibid., 37.
(172) Ibid., 38.
(173) Ibid., 39.
(174) Ibid., 40.
(175) Memorandum from Col. Paul C. Hutton, M. C., to the chief surgeon, A. E. F., July 31, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 319.2).
(176) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.: Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, M. C., undated, 41. On file, Historical Division, S. G. O.
(177) Ibid., 42.
(178) Ibid., 43.
(179) Ibid., 44.
(180) Ibid., 45.
(181) Report on Medical Department activities of Evacuation Hospital No. 3, prepared under the direction of Lieut. Col. C. M. DeForest, M. C., commanding officer, undated. On file, Historical Division, S. G. O.
(182) Exhibit "O" to report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F.: Report of medical operations at Chateau-Thierry and vicinity, June 1 to September 10, 1918, by Col. Paul C. Hutton, M. C., undated, 47. On file, Historical Division, S. G. O.
(183) Ibid., 48.
(184) Ibid., 49.
(185) Ibid., 50.
(186) Ibid., 54.
(187) Report on activities of G-4-B, medical group, fourth section, general staff, G. H. Q., A. E. F., by Col. S. H. Wadhams, M. C., chief of section, December 31, 1918, 55. On file, Historical Division, S. G. O.
(188) Ibid., 54.
(189) Service de Santé pendant les opérations de la VI Armée dans la Région de Chateau-Thierry du 15 au juillet, 1918, by Médecin Inspecteur Général Lasnet, Médecine de lArmée. (Translation by Col. Joseph H. Ford, M. C.). On file, Historical Division, S. G. O.