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HISTORY OF THE OFFICE OF MEDICAL HISTORY
THE UNITED STATES ARMY AMBULANCE SERVICE
AMERICAN AMBULANCE SERVICE IN FRANCE PRIOR TO APRIL 5, 1917
Long before we entered the World War as an official participant, certain American unofficial volunteer groups and individuals rendered service to our future allies in the interests of humanity. Immediately after the beginning of the war in 1914, the American colony in Paris established the American Ambulance, following in their nomenclature the French practice of applying the term ambulance to the type of military institution which Americans call a hospital.1 Shortly after the organization of this unit, a volunteer field service section was provided for it, this latter organization being developed by the efforts of individuals who had employed their own automobiles to remove wounded during the first battle of the Marne. It consisted of a volunteer ambulance corps known as the American Field Service, and was composed of sections, each made up of 20 ambulances, a mobile kitchen and a truck. The ambulances were almost exclusively of the Ford type. These sections were equipped by voluntary contributions of people in the United States.1 A little later the Norton and Harjes units were organized along the same lines. At first the latter were quite separate, having been organized independently, but eventually they were consolidated into the Norton-Harjes unit, which was affiliated with the American Red Cross.1
In these two organizations several hundred young Americans served before America entered the war, on much the same status as the American aviators of the Lafayette Escadrille. By the fall of 1917, the American Field Service had 34 ambulance sections organized and 3 sections undergoing organization, while the Red Cross had 12 sections in operation.2 All of the sections were on duty with the French. Most of them were at the front, but one detachment, equivalent to three sections, was on duty in the entrenched camp of Paris.
These sections, having been created to aid the French Army, conformed to its tables of organization.2 Each consisted of one lieutenant of the French automobile service, one American sous-chef, about 25 American drivers, and 8 French soldiers. Each section had 20 ambulances, 1 large truck, 1 small truck, 2 touring cars, and 1 kitchen trailer. The ambulances were of two types, viz, large cars which carried 4 recumbent or 8 sitting, and small cars with a capacity of 3 recumbent or 5 sitting. The function of these sections was solely that of transportation and did not include rendition of first-aid, establishment of dressing stations, or bearer work, as is the case with our
ambulance companies. The personnel, largely soldiers of adventure, were somewhat free and independent, but developed an esprit de corps and a morale that won high honor for their organization. To evacuate battalion aid stations, they ran their light cars day and night, amid shell holes and under shell fire, carrying wounded to the field hospitals. The success of these formations was undoubted; their aid to the French Army beyond question.
When the French military commission, headed by Marshal Joffre, came to the United States, shortly after the United States entered the war, it was charged with the duty of making arrangements concerning the form of assistance to be first given. One of the subjects that came up at once was care of the wounded, for France needed on the firing line every able-bodied man available. Marshal Joffre asked that an ambulance service be supplied, and recommended the organization mentioned above. His request was approved and the War Department, by the following orders, directed the organization of the "United States Army Ambulance Service":2
General Orders, No. 75
WAR DEPARTMENT, Washington, June 23, 1917.
* * * * * * *
II. 1. Under authority conferred by section 2 of the act of Congress "authorizing the President to increase temporarily the Military Establishment of the United States," approved May 18, 1917, the President directs that there be organized for the existing emergency, the enlisted strength being raised by voluntary enlistment or draft, as a part
of the Medical Department, the United States Army Ambulance Service, consisting of the following personnel:
General Orders, No. 124. WAR DEPARTMENT, Washington, September 30, 1917.
1. Paragraph 1, Section II, General Orders, No. 75, War Department, 1917, organizing the United States Ambulance Service as a part of the Medical Department, is amended so as to provide for a total of 34 captains, 169 first lieutenants, and 169 ambulance sections.
General Orders, No. 149. WAR DEPARTMENT, Washington, November 28, 1917.
* * * * * * *
II. Paragraph I, Section II, General Orders, No. 75, War Department, 1917, is amended so as to fix the enlisted strength of each ambulance section authorized therein as follows:
The United States Army Ambulance Service occupied a unique position. Though composed of members of the American Army, its personnel in France, so far as the performance of duty was concerned, was under the jurisdiction of the French Government, to whose army it was assigned. Similarly, the
personnel assigned to Italy was under the jurisdiction of the Italian Government.3 While in emergencies the American Expeditionary Forces borrowed many of the sections from both France and Italy, it had no direct military control over them, except when they were thus actually in its service. To all intents and purposes, therefore, the United States Army Ambulance Service was a part of the French and of the Italian armies. The fact should be clearly recognized, and this organization distinguished from the ambulance organizations of the American Expeditionary Forces, which consisted of the personnel and equipment authorized by our Tables of Organization for the service of our own troops.3
Despite its assignment, however, to allied countries, the United States Army Ambulance Service was under the American Expeditionary Forces in matters affecting organization, discipline, and supply. Its personnel was paid, rationed, clothed, and equipped through the American Expeditionary Forces, and its motor vehicles, spare parts, gasoline, and oil were furnished by the American Government.3
The orders quoted above were based on the general plan that an ambulance section would be assigned to each division of the French Army; that for every 5 sections a repair shop and general supply depot in command of a captain would be established; that for each group of 20 sections an inspector with the grade of major would be provided, and that the higher administrative work of the service would be conducted by 1 colonel and 2 lieutenant colonels. This general scheme, like many other preconceived plans for the operation of American troops abroad, was ultimately greatly modified. The senior officer of the organization, with 30 sections, went to Italy for duty with the Italian Army, while the large number of sections in France operated under the command of an officer commissioned in the Medical Corps and not in the Ambulance Service.4
Plans for securing personnel and equipment were begun several weeks before the first order, that quoted above, was promulgated by the War Department. A medical officer was directed to begin recruiting for the Ambulance Service in Philadelphia.5 Applicants were enlisted in the Medical Enlisted Reserve Corps. Two other medical officers were ordered to Philadelphia to take charge of the recruits.5
As soon as practical, Camp Crane was established at Allentown, Pa. primarily as a mobilization and training camp for the Ambulance Service, though later it was utilized as a general mobilization camp for Medical Department units.5
MOBILIZATION AT CAMP CRANE
The rumor had spread rapidly that an ambulance service would probably be among the first organizations to be sent abroad, and applications for enlistment by men who were impatient to go overseas were immediately received from all parts of the United States.5 Colleges asked to be permitted to form complete sections of their own men, and the War Department granted their requests. Over 40 colleges and universities furnished 1 or more sections of 45 men each, who were sent to Camp Crane in charge of some one of
the party who had been selected as leader. In addition to the men recruited at the Ambulance Service recruiting station at Philadelphia, and the large number of men enlisted at the colleges, a considerable part of the personnel was derived from the previously organized American Red Cross ambulance companies, who also desired immediate service. Pasadena, Calif., the University of California., Washington, D. C., Cleveland, Ohio, the University of Minnesota, and the University of Washington each contributed an ambulance company (Army standard) which was reorganized into three Ambulance Service sections; some of the companies secured sufficient additional recruits from their home localities to make a fourth section. A number of cities and a few industrial corporations contributed complete sections to the service, and a very considerable number of men came to it from Army recruiting stations throughout the country which were authorized to send applicants to Camp Crane.5 Volunteer enlistments furnished all the personnel for the sections of the Ambulance Service except for a few which were organized from drafted men, just before the armistice. The enlisted personnel as a whole was of a very high grade.6
At first officers of the Medical Reserve Corps were assigned to command sections, but they were gradually replaced by officers promoted from the ranks who were given commissions in the Ambulance Service. So when the armistice was signed there were few medical officers on duty with it, for by this time most of its commissioned personnel were officers who had entered the service as privates.6
The headquarters of the Ambulance Service moved from the recruiting rendezvous at Philadelphia to Camp Crane, Allentown, Pa., on June 9, 1917.6 Some recruits for the organization had already arrived at the camp, and in a short time 3,000 men were assembled.6
The two senior medical officers then on duty there had no Regular Army assistants, either commissioned or enlisted, except eight lieutenants, recent graduates of the Army Medical School. A few men who had had military drill at school and the men who had had some experience in drilling the Red Cross ambulance companies rendered invaluable service by helping to establish military procedure and by teaching elementary military principles.6
The French High Commission was very insistent in its recommendation that Ford ambulances, touring cars, and light trucks be used.7 This requirement was based on experience during the preceding years of the war. It was stated that the lightness of this car, its durability, and the ease with which it could be repaired and its parts interchanged gave it great superiority for the work to be performed. Therefore, orders were placed by the Ambulance Service for approximately 2,400 Ford ambulances, 120 Ford trucks, 120 Ford touring cars, 120 Packard trucks, and 120 motor cycles with side cars, with an allowance for replacement and a fair quantity of spare parts. By special effort on the part of the manufacturers early delivery was secured. This large amount
of motor equipment having arrived at the seaboard, before cargo space was at a premium, was shipped immediately and landed at St. Nazaire to await the personnel for which it was intended.7
When it became known, after we had entered the war, that our Government had agreed to furnish the French Army a number of ambulance sections, the American Red Cross and the people in the United States who were supporting the American Field Service proposed to the War Department that it take over the sections they had already formed, which were then operating in France.8 This proposal was accepted.8 It was contemplated that 120 sections of the United States Army Ambulance Service be organized in America and that the remaining sections, to a total strength of the 160 sections then authorized, be obtained by enlisting in the military service the men composing the volunteer sections then at work in France.8 In July, 1917, a colonel of the Medical Corps, United States Army, was designated as chief, United States Army Ambulance Service, and accredited to the French Government to arrange the details for the operation of that service and for the enlistment in it of the personnel of the ambulance sections of the American Field Service and of the American Red Cross. This medical officer visited Camp Crane before sailing for Europe. At Camp Crane it was arranged that the 20 sections which had been organized in the United States, and for which complete equipment had been secured, should sail as soon as ocean transportation was available. These sections sailed August 7, 1917, and disembarked at St. Nazaire, August 21, 1917.8
Some discrepancy occurred between the number of sections authorized and the number thought necessary at different times. The French War Department stated that Marshal Joffre had asked for 50 sections in addition to the volunteer sections already serving with the French Army.9 The chief of the United States Army Ambulance Service reported that, in August, 1917, he had been informed by a representative of the directeur, service automobile, that so large a number of sections as that indicated above was not deemed necessary; that the total number desired was 63.10 On August 27, a representative of the directeur, service automobile, informed the chief of the United States Army Ambulance Service that the needs of the armies of the north and northeast were 20 sections in addition to the volunteer sections then in the French service, and the coming of further sections was stopped by cable on August 28.11 Also the finality of the assignment of these sections to the French was brought into question, for on August 17, 1917, the chief of the Army Ambulance Service in a memorandum for the commanding general, A. E. F., stated that the sections organized should be subject to recall for service with the American Army when needed.12 He had been authorized to militarize 40 sections from the personnel of the volunteer sections already serving in France; but finding on his arrival in France that the American Field Service had 37 sections organized and the American Red Cross 12, he requested authority to organize in France a total of 49.12 In point of fact, only about 25 sections of the Army Ambulance Service were organized in France, for most of the men of the volunteer organizations there preferred to go into aviation or into other services, and many did not wish to bind themselves at all by enlistment in the Army.13 Consequently only about 500 men joined the Army Ambulance Service in France. The great majority of these came from the American Field Service, about half of whose members joined, and only a few from the Norton-Harjes unit.13
On September 26, 1917, the commander in chief, A. E. F., requested that 10 sections be sent to France as soon as possible, in addition to the 20 sections already there, plus 300 unassigned recruits.14 His telegram also stated no more ambulances were needed, as there was an abundance of motor transportation on hand. On October 11, 1917, the commander in chief, A. E. F., informed the chief of the Army Ambulance Service that the French military mission requested that the sending of further sections be stopped until after some 12,000 automobile mechanics had been sent to France, and that, thereafter, 50 additional sections be sent according to tonnage facilities, and that the shipment of the last 50 sections be held up until the following spring.15 In this matter there was lack of coordination between the French Ministries of War and of Munitions. Ambulance sections of the French Army were, with all other motor transport, under the jurisdiction of the Minister of Munitions. On December 17, 1917, the French military mission proposed that 73 additional sections be sent over during the first five months of 1918. The chief of the Army Ambulance Service then wrote the commander in chief that this corresponded exactly with the wishes of the Service de Santé, viz, that all the 120 sections organized in the United States be brought
over but that the directeur, service automobile, who was in actual control of the transport service of wounded at the front, did not wish to turn over more than one-third of this to the Americans.16 On January 11, 1918, relative to these 73 sections, the commander in chief replied that, because of the tonnage situation, he could not accede to the request for 73 additional sections;17 and on April 30, when asked when the remaining 57 sections would be sent, he replied that he had cabled a recommendation that the personnel of the sections remaining in America be used as replacements and no longer be kept intact in ambulance units.18 August 13, 1918, the commander in chief wired that 48 sections were urgently needed,19 this being the number still believed by him to be available under General Orders, Nos. 75 and 124, quoted.
On August 26, 1918, the commanding officer at Camp Crane reported that 82 sections had been sent overseas and 8 had been disbanded, but that 31 sections were being organized and motor transport for them secured.20 The Surgeon General had based his figures, until this time, on the following data: Shipment of 59 sections to France, 30 to Italy, and organization of 49 in France, thus leaving a balance of 31 sections in the number authorized.21 On September 16, the commanding officer, Army Ambulance Service in France, wrote that of the 82 sections in France only 30 had been organized in that country and that there were 30 other sections in Italy. The 31 sections now requested organized left a balance of 26. The request that 48 sections be sent from the United States was based on these figures, leaving a balance of 9.22
A large reserve of ambulances which had been accumulated for the Army Ambulance Service was appropriated by the Motor Transport Corps during the operations in the Marne area for conversion into trucks.23 This reserve was not needed by the Army Ambulance Service, but this action eliminated ambulances needed later by the United States Army.
While the misunderstandings noted above were being straightened out, our Government had decided to send troops to Europe as rapidly as possible, and the priority list for shipment of troops was based on calls for them from General Headquarters of the American Expeditionary Forces. Until all differences of opinion in the French service concerning the number of ambulance sections needed had been settled, no place on the priority list could be secured for the sections which were awaiting transportation at Camp Crane.8 But at the end of December, 1917, 10 more sections, in January 17 sections, and in March 5 sections were shipped, making a total of 52 organized sections sent from Camp Crane for service in France before the armistice was signed.8 On June 13, 1918, 30 sections were sent direct to Italy.24 Casuals, in detachments numbering from 100 to 300, were also forwarded from time to time and were organized into sections after their arrival in France.25 The United States Army Ambulance Service with the French Army at the time of the signing of the armistice consisted of 184 officers and 4,858 enlisted men, with 113 organized sections.26 A number of the militarized volunteer sections had not been completed when taken over and had to be augmented
at once by the assignment to them of personnel from the United States. At the time of the armistice about one-tenth of the service consisted of volunteers in France from the old ambulance service, five-tenths had come from Camp Crane, and four-tenths were draft personnel.27
As previously explained in part, while the French Government first asked for 63 sections, after about 70 had been made available, it informed the commander in chief of the American Expeditionary Forces that no more were required.10 Then, after providing 30 sections for assignment to the Italian Government, a considerable number of sections already organized in the United States were disbanded and their personnel distributed to other branches of the service. This was due to the fact that the French Ministry of Munitions had informed a representative of the commander in chief that no more would be required.10 It afterward developed that the French had made a serious mistake in declining the remainder of the sections organized for their service. This misunderstanding arose from the fact that under the French organization its service automobile provided and controlled under the department of munitions all motor transportation, including ambulances, though these last-mentioned vehicles, when provided, were at the disposal of the Medical Department.28 The French Medical Department had asked, through the department of war and through the French military attaché in Washington, that the remaining sections then organized in the United States (about 90 in number) be sent overseas in such manner that the last would arrive before the beginning of the spring of 1918.29 It appears that the faulty calculation, as regards ambulances, of what would be needed in open warfare had arisen from consideration of only what had been required in trench warfare. As a matter of fact, the need for ambulances in the open warfare of 1918 was found to be very much greater than the French Department of Munitions had anticipated, for hauls were longer, wear and tear more severe, destruction by artillery fire was more frequent, and facilities for repair were relatively less. A further unanticipated shortage occurred because the ambulances necessary for our own troops did not arrive in France in sufficient numbers; therefore it was necessary, as mentioned above, for the American Expeditionary Forces to borrow from the French and Italian Governments a number of the sections of the Army Ambulance Service which our Government had attached to them.28 At the time of the St. Mihiel operations, for instance, our own shortage was very great, as hardly 50 per cent of the number authorized had been sent to France. It was only through the generosity of the French and Italians in turning back to us these sections which had been organized for, and presented to, their respective Governments that the transportation of our wounded could be handled.28
Thus it occurred that in the decisive contests of the summer and autumn of 1918 sections of the United States Army Ambulance Service were on duty with the Italian and the American Armies.
The story of the sections sent to Italy (the Italian contingent of the United States Army Ambulance Service) is given elsewhere in this volume in the discussion of the activities of the Medical Department in Base Section 8.
In the late summer of 1918, as regulation ambulance companies and ambulance equipment for the American Expeditionary Forces had not arrived and as there seemed little prospect of them being furnished, a request was sent to Washington that 31 sections of the Army Ambulance Service, authorized by General Orders, No. 75, War Department, 1917, but which had not been provided, be reorganized and sent to France for service with the American Expeditionary Forces. This request was approved, but, because of difficulty in securing priority transportation, none of these units arrived until after the armistice.30
UNITED STATES ARMY AMBULANCE SERVICE IN FRANCE
The following account of the United States Army Ambulance Service in France is very much condensed from the complete historical report of the commanding officer of that service.
ORGANIZATION IN FRANCE
The organization of the headquarters of the United States Army Ambulance Service with the French Army was a miniature Quartier Général. It functioned through divisions or departments with officers at their heads who were directly responsible to the chief of the service. The peculiar status of the service, its detachment from the American Expeditionary Forces, and its attachment to the French Army, presented unique and difficult problems of organization and administration. Liaison was necessary with the American Army as it was with the French, but separation from the American Expeditionary Forces led naturally to organization of the Army Ambulance Service into a body complete and self-sustaining. As the service was forced to operate more or less independently, it was necessary to get many special authorizations of general application.31
Careful centralization and systematization of the service contributed much to its success. The large problems of keeping in touch with the many sections scattered with the French Armies all along the front from Dunkerque to Belfort; clothing, subsisting, and paying the personnel; handling their personal problems; delivering and collecting their mail; caring for their sick and wounded; and keeping their ambulances in serviceable condition, all fell to headquarters.31
Headquarters activities began immediately after the arrival, with the first contingent of American troops in France, of the chief of the service and a small office force. It was the duty of this advance party to establish offices, make arrangements for the arrival of the first sections, establish liasion with French and Americans, begin the enlistment and militarization of the American Field Service and Red Cross sections then working at the front, organize a base for the service, and arrange numerous relevant matters.31
The War Department order creating the United States Army Ambulance Service made no provision for headquarters personnel, for the personnel necessary to conduct the various assembling and repair plants, or for a base camp.
This personnel was obtained by reducing the sections from 45 to about 40 enlisted men each. The headquarters enlisted personnel was formed into a section (S. S. U. 650), to which all men on duty at the headquarters office and all its subdivisions located in Paris were assigned. This headquarters organization consisted of 18 officers and about 150 enlisted men; that at the base camp of 9 officers and 120 enlisted men.32
In the beginning, the headquarters offices were situated at 10 Rue St. Anne, Paris. In October, 1917, they were removed to 27 Rue Constantine. With the growth of the service and the demand for larger quarters they were moved again, in December, 1917, to 47 Rue Penthieu, where they remained until recalled from service with the French.32
The main divisions of the headquarters organization were as follows: Commanding officer and executive officer, motor transport, quartermaster, statistical, promotions and morale, attending surgeon, inspection, shipping and post office, and general.32
COMMANDING OFFICER AND EXECUTIVE OFFICER
The commanding officer maintained an office at headquarters and directed the activities of the Ambulance Service through divisions which will be discussed below. His executive officer assisted him in this according to the usual military practice. It should also be explained that, though the office of the commanding officer was in Paris, he was found often in the field.
MOTOR TRANSPORT DIVISION
Second in importance to the actual administration of headquarters by the chief of service, assisted by the executive officer, came the administration of the Motor Transport Division.33 Maintenance of transportation at a high standard, of ordnance and medical property, and regulation of the issue of spare parts and other motor supplies, were the primary duties of this division. These functions were carried on through the medium of 10 repair parks which were attached to as many French automatic repair parks, of which there was one for each army area.
For convenience of administration the Motor Transport Division was subdivided into five branches, all of which were coordinated in the office of the divisions head. These branches were as follows: Motor supply depots, service garage, assembly and revision plant, supply and ordnance, direction and inspection.33 At the heads of these departments were officers who had had practical experience in their special lines of work.
MOTOR SUPPLY DEPOT
The motor supply depot was planned and perfected by officers from the Army Ambulance Service.33 It was situated in Paris where it could be in touch with the Magasin Central Service Automobile of the French Army, which supplied part of its material. The open market at Paris also furnished certain supplies, which were purchased by the motor supply depot, but only
after authorization by the head of the division. Most of the supplies of the service came directly from America, where they were purchased from the factories by the Quartermaster Corps and shipped to Paris. The supply depot from time to time submitted requisitions for the necessary spare parts, but kept on hand sufficient for issues for several months.33
The motor supply depot at first issued material directly to the sections, but after the park system had been perfected it supplied them, and the parks in turn supplied the sections. This development greatly increased the efficiency of the supply service.33
The service garage was charged with the storage, upkeep, and repair of all motor vehicles attached to headquarters and was located at the barracks of the headquarters detachment.34
ASSEMBLY AND REVISION PLANT
In order to provide for the assembling of ambulances in great numbers near the base of supplies, where their bodies could be built satisfactorily, the assembly and revision plant of the service was established in Paris, on Avenue St. Ouen.34 Here the chassis shipped directly from base ports were put together and the bodies, furnished by Paris makers, fitted on. A number of men, belonging to the Army Ambulance Service, were kept constantly engaged assembling these vehicles.34
This plant also served as a revision park for the service. When a section was completely worn out, the personnel of the section was sent to the base camp at Ferrieres, and its transport, including motor ambulances, touring cars, trucks, etc., was forwarded to the plant in Paris, where it was overhauled and made fit again for service. When this was impossible the cars were salvaged and the spare parts used to repair those of other sections.35
Among the departments of the plant were a carpenter shop, where the ambulance bodies, often completely riddled by shell fragments, were repaired, a paint shop, a radiator repair shop, a motor cycle repair shop, and a machine shop for general work. The whole plant was organized so as to care completely for the assembling, repairing, and supplying of motor transportation to the front.35
The reserve cars of the Ambulance Service were held in this park, whence they were shipped to the smaller parks nearer to the front. They were issued in small numbers in order not to embarrass the park commanders, who always kept their material as near the minimum as practicable in order to be ready to move promptly.35
SUPPLY AND ORDNANCE
The supply and ordnance department was concerned with the record of motor transport property, of medical property, and with the operation of the supply department. The following totals were reached October 25, 1918.35, 36
MOTOR VEHICLE SITUATION
Of all the foregoing, the following were received as gifts to the United States:
The following were separated from the American Ambulance Service by transfers to other branches to fill pressing needs for transportation in the
American Expeditionary Forces in the latter part of 1917. They were distributed as follows:37
In all cases the property was transferred to the receiving service under paragraph 671, Army Regulations, and in conformity with Memorandum 179, Surgeon Generals Office, War Department, January 11, 1918. This involved a transfer of funds, except when transfer was made to the Medical Department.37
The activity of the Ambulance Service is indicated by the following table, which gives the actual consumption of tires and tubes, gasoline and oil for the six months, February to July, 1918, inclusive:38
These materials were furnished the units directly from French depots. At each echelon and section an account of these issues was kept and a report made to the headquarters of the automobile service, French Army. This consolidated report was submitted to the chief of service in the form of a claim. A monthly settlement was made in the form of receipts drawn from the American supply book separately: (a) For gasoline and ingredients; (b) for tires and tubes. The gasoline and ingredients were returned in kind, and the bill for tires and tubes paid on public voucher.
DIRECTION AND INSPECTION
The direction of the motor transport department was performed by a lieutenant colonel of the United States Army Ambulance Service, who was in close touch with the chief of service. His orders were issued "By direction of the chief of service." After consultation with the chief of service, he issued all directions concerning care of transportation, equipment allowances, supply of parks, and the relationship to be maintained between the parks and the sections. He was in close liaison with the French automobile service and attended to the matriculation of Army Ambulance Service cars in the French service. One of his duties was to determine where parks could
be placed to the greatest geographical and tactical advantage, reporting his conclusions to the chief of service who, if he approved them, ordered the parks moved accordingly. An assistant to the director of motor transport cooperated in the reporting of and accounting for transportation. Another officer under the immediate jurisdiction of the director was the inspector of the transportation of the service. With the permission of the chief of service, the inspector of transportation might send one of his assistants on inspection trips at times when he himself was needed elsewhere. The reports from the parks on the conditions of transportation of the sections came to his office every 10 days, so that an accurate record of the actually moving transportation was available at all times.39
The quartermaster of the Army Ambulance Service was a major of the Quartermaster Corps; the enlisted force under him, however, was composed of enlisted men of the United States Army Ambulance Service. The principal storeroom, as well as the office of this department, was at headquarters in Paris. Here, the administration of the quartermaster service was carried on. Besides the outfitting of sections, the quartermaster handled the rental and leasing of all buildings needed by the service. There were four subdepartments of the quartermasters office:39 (1) Supply department; (2) sales commissary; (3) paymaster; (4) advance depot at Metz (after the signing of the armistice).
The supply department had charge of the requisitions, and issued clothing and other quartermaster property to the sections.39 Requisitions were submitted through the medium of the bureau central militaire (postal service of the automobile service), which brought in the requisitions from the sections and took back the articles requisitioned to the front. All supplies of this character were sent directly to the sections. The unusual conditions existing in the Ambulance Service where the sections were widely scattered made the furnishing of their supplies a very difficult task. Their service with the French also called for a different equipment from that supplied to other American troops in the way of raincoats, rubber boots, and overcoats.40
The supply department was of course in direct touch with the chief quartermaster of the American Expeditionary Forces. It functioned promptly and the men of the service were never without the necessary supplies, those which contributed to their comfort and those which allowed them to present a smart appearance at all times. The French divisions, to which the sections of the service were attached, were, for the most part, "crack" divisions whose combat effectiveness, discipline, neatness, and smart appearance were the pride of the French Army. They exacted from the ambulance sections with them the same smartness and good appearance of uniform as they did from their other troops.40
The clothing of a section was rated by means of frequent inspections made by the inspector of personnel. While only the worn-out uniforms were
exchanged, a uniform of good fit and appearance was always kept on hand for inspections and ceremonies.40
In order to facilitate the supply of sections with additional food, and, in some cases, with the actual ration, a sales commissary was established at headquarters.40 This kept on hand certain subsistence stores, which could be ordered by any section commander to supplement the ration or to form the actual ration. As the sections attached to French divisions did not draw rations in kind, but were allowed commutation, amounting to 70 cents per man per day, some difficulty was experienced in their getting food in the field.40 Sections frequently purchased the French ration in the open market and then supplemented with purchases from the commissary. The French ration varied a good deal in different divisions and in different parts of the front and for this reason if no other the sales commissary of the service was a very necessary part of the supply system.40
The paymaster of the service looked after the payment of individual officers and men and the issuance of ration money and travel expenses.41 The pay rolls were sent to his office by the bureau central militaire (postal service) just after the beginning of the month. After the computation was completed, the paymaster made out a schedule, which included the different parts of the service, and appointed a time when all section commanders should be at the parks to obtain the pay for their sections. As the sections were widely separated it was impossible for him to make a visit to each section. The parks, however, were easily reached. In the absence of any section commander, the park commander signed for the money and later delivered it in person to the section commander, on his next tour of inspection
The ration accounts were sent in twice a month, as the French commissary required that sections settle their ration bills every 15 days.41 These were paid on regulation voucher. Until October 11, 1918, all money saved from rations could be placed in a sections ration savings account. A general order issued that date prohibited the saving of money from the ration and thereafter if any money was left over at the end of the month this amount was deducted on the next ration voucher.41 The system worked well and gave no trouble, although the procedure, through force of circumstances, was somewhat unusual.
ADVANCED DEPOT AT METZ
After the armistice, an advanced depot was established at Metz to supply sections which accompanied the Third Army into Germany.14
The statistical department rendered consolidated daily and weekly reports of the personnel of the service to General Headquarters, American Expeditionary Forces. An army field clerk was in charge of the office, which was
a subbranch of the Paris statistical bureau. All data concerning sick and wounded of the Ambulance Service were collected, verified, and reported from this office.42 A record was kept of all communications forwarded to headquarters, American Expeditionary Forces, as well as of all administrative data concerning the personnel of the service.
With the discontinuance of the muster roll, and the adoption of the monthly roster, additional men had to be placed in this department, because of the increased clerical work involved. All service records, officers classification cards, and section statistical reports, were forwarded through this office. Difficulty was experienced by this department in rendering adequate reports at the appointed time. This was due to the fact that though some of the sections were near, others were far away. Also there were differences in their transportation facilities so that statistical reports, mailed by all sections on the same day, sometimes reached Paris days apart. This situation, however, was overcome in part by constant communication with sections and by use of the telephone when necessary.42
PROMOTIONS AND MORALE
The department of promotions and morale was concerned with the general welfare of both officers and enlisted men of the Army Ambulance Service. The officer in charge supervised the discipline of the members of the service, their military bearing and their personal appearance.43
The attending surgeon of the United States Army Ambulance Service was charged by the chief of the service, with the responsibility for professional care of the sick and wounded of the members of the service. In addition he was sanitary inspector, and supervised the sanitation of the various ambulance sections.
For the sick, a camp hospital was established at the base camp, referred to below. This hospital was under the general supervision of the attending surgeon, but was in the charge of a junior medical officer. Here, all sick of the Army Ambulance Service were sent when their hospitalization could be controlled by the attending surgeon. For others, such as members of the service on duty with French and American divisions, arrangements were made by the attending surgeon whereby these sick and wounded would be evacuated to American Red Cross Hospitals Nos. 1 and 2, Paris.43
In order to facilitate the control as well as to coordinate the functioning of sections, three officers, each at the head of his own department of the Ambulance Service, were detailed as inspecting officers.44 These were: The inspector of transportation, the inspector of personnel, and the attending surgeon. The reports of these officers with their recommendations made on their return from inspection trips were submitted to the chief of service. The
chief of service acted as general inspector for the whole service in all its parts.44
The inspector of transportation, who has been previously mentioned, looked after the care of the cars, the work of the repair shop, the supply of spare parts and the general condition of all transportation. He was generally at the front, during an attack, to see that the sections then functioned properly. He cooperated with the park commander concerned, each of whom acted as a subinspector of transportation and equipment, and consulted him before making out his own inspection report.45
The inspector of personnel was head of the department in charge of promotion and the general welfare of officers and enlisted men. He looked after the discipline, reported on the correctness of the military attitude of the men, inspected the condition of their personal outfits, audited and revised reports of section funds, and reported on the morale of the sections. In case there had been trouble in a section, he made inquiry concerning the action taken by the section commander, or checked up on the behavior of this officer, if there had been an adverse report on him by a park commander.45
The attending surgeon, who was sanitary inspector, investigated the general sanitation of the personnel of the parks and sections. He saw to it that the venereal prophylaxis reports were carefully made, he inspected the latrines, advising concerning their locations. He instructed officers concerning newly published sanitary rules and received reports having to do with the supply and preparation of food. He investigated the condition of the mens teeth, and gave general advice concerning the health of individuals. His duties proved especially important during the colder months.
Through this system of inspection, the service was kept at a high degree of efficiency. The inspecting officers were constantly in the field and were required to visit each section at least once every six weeks. It was found the inspections greatly stimulated the section commanders.45
SHIPPING AND POST OFFICE
The function of the shipping and post office department was primarily that of receiving mail intended for officers and enlisted men of the Army Ambulance Service and forwarding it to their proper addresses.
Because all mail matter for sections of the Army Ambulance Service serving at the front was conveyed to French military base parks by the French postal service, the shipping and post office department was located at the bureau of the Service Postal Convois Automobiles of the Bureau Central Militaire in Paris.46
In the accident department a record of each accident occurring in the Army Ambulance Service was kept, together with the names of witnesses, reports, and claims, if any.
Because it was essential that the officer in charge of this department be familiar with not only the French language but French civil law as well,
one possessing these qualifications was so detailed.47 Since all of this officers time was not occupied investigating accidents, and because his special knowledge of French and the law were readily available, he was charged with the translation of French official documents reaching headquarters of the Ambulance Service, and was made summary court officer, and reviewed all summary courts-martial of the sections of the Ambulance Service. One other duty that he performed was that of censoring the mail of the Ambulance Service.48
COUNCIL OF ADMINISTRATION
The council of administration comprised three officers of the Ambulance Service. The purpose of the council was to provide means of clearing the money accounts of section commanders. To effect this, the council audited all records pertaining to these accounts. It also administered the Ambulance Service fund.
The Ambulance Service fund was established to provide means for purchasing comforts for members of the Ambulance Service on their way home to the United States, and was raised by requiring each section of the service to deposit in a designated bank all money in their separate funds over 2,000 francs.48
FRENCH LIAISON OFFICER
An officer of the French automobile service was attached to headquarters of the Army Ambulance Service to maintain liaison between that service and the French Government. This officer was attached to the office of the chief of the Ambulance Service and accompanied the chief of service on all his trips to the front.48
All direct orders issued by the chief of the Ambulance Service, affecting the Directeur Service Automobile, were issued through the liaison officer.
It was the duty of the liaison officer to maintain a constant touch with the movements of the Directeur Service Automobile in order that all regulations governing the sections of the French automobile service might be properly interpreted to the United States Army Ambulance Service.49
Immediately after the establishment of the Army Ambulance Service headquarters in Paris, steps were taken to procure a suitable site for a base camp. The first location was at Sandricourt, about 35 km. (about 21 miles) north and west of Paris.50 This soon proved inadequate to meet the demands made upon it, and in February, 1918, after many disappointments, a new location was procured at Ferrieres en Gatinais, about 100 km. (about 70 miles) south of Paris.50 The main building here had formerly been a monastery built 700 years before. In this building were established the headquarters of the camp, the infirmary (a floor being devoted to convalescents), the pathological laboratory, the quartermasters storehouse, and the guardhouse. In the grounds of the property five Adrian wooden barracks were erected,
one of which was used as a combination kitchen and mess hall. The buildings now furnished accommodations for 500 men.51 By taking over an old tannery, which was near by, and the erection of additional barracks, the capacity was increased to 2,000.52 A complete power plant was installed, latrines, garbage pits, and incinerators were provided, shower baths were procured, and other steps necessary to the formation of a comfortable and sanitary camp were instituted. There was a permanent personnel of about 150 officers and men from which were furnished all permanent details, including the necessary teaching force for a school for cooks, a school for mechanics, and a school for instructing noncommissioned officers in paper work. All new sections and all casuals arriving from the United States were first sent to this camp for a preliminary course of instruction.53 Sections were fitted out here with personal equipment, quartermaster and medical supplies. The casuals, having been equipped, were then used as replacements for sections at the front, or were organized into new sections. An effort was made to send here for convalescence all sick and wounded eventually to be returned to duty.53
During demobilization, as mentioned elsewhere, all the sections were sent to this camp for a thorough sanitary survey, including disinfestation, and to turn in all their property not needed en route home. They were then sent from this point to the base ports for embarkation.53
THE PARK SYSTEM
It is essential that this be described in order that the operation of the ambulance service in the field may be understood.
To each French army serving on the Western Front, 12 in number, were attached about 3,000 vehicles of all sorts, makes, and types. For the purpose of supplying, repairing, and replacing these vehicles, the automobile parks of the French armies were established.54 To each army there was attached a reserve park; to each group of armies a revision park; and for the whole army a central clearing park at Versailles was maintained, through which all matriculation records, replacements of personnel, reports of promotion, decorations, and special orders of the ambulance were required to pass.54
The reserve park served essentially as a distribution point for automobile sections whether these were equipped with camions for the transportation of personnel or matériel, or were sanitary sections for the evacuation of the wounded. The number of the sections depended upon the number of divisions in the army, its activity, and its liability to attack.54
The reserve park, though a fixed organization, could be moved promptly. Especially was this true of its repair machinery. It was established generally at the railhead or at some point where easy rail transportation could be provided. All gasoline, tubes and tires, mail, food, and equipment passed through the French reserve parks. It was through these parks that the sections serving at the front were supplied with all the necessities for carrying on their work.55
UNITED STATES ARMY AMBULANCE SERVICE PARKS
Attached to each French reserve park, if there were sections of the Army Ambulance Service on duty with the French divisions concerned, there was an American park or echelon.56 This American park consisted at first of 1 officer and 15 men, furnished with automobile supplies and materials sufficient to keep in working order the sections dependent on the park, even if there was no mobile repair unit attached.57 Later, as the work of the American parks increased, complete machine-shop truck units of the Motor Transport Corps, A. E. F., each consisting of one officer and a number of mechanics, with a complete machine-shop truck, were obtained and assigned to these parks. In each case the whole American organization was under the command of the Army Ambulance Service officer of the particular park.58 There was also at each American park a reserve of two ambulances for each Ambulance Service section on duty in the army zone.59
The revision park of the Army Ambulance Service was attached to the French revision park at Chalons.57 As was the practice by the French system, all machines too badly damaged for repair either at sections or in reserve parks were shipped to this place by rail or camion, and here they were repaired or scrapped. A reserve of 50 ambulances was always on hand at this revision park. New ambulances might be requisitioned from it by reserve park commanders when any of their cars were completely destroyed.57
The assembly plant of the Army Ambulance Service, situated in Paris, took over part of the duties of the French parc dorganization at Versailles.60 At this point all ambulances forwarded from base ports and not destined for Chalons were set up and equipped with bodies before being sent to the front. However, before this was done they had to be matriculated (registered), either by special arrangement with the French of by passing through the park at Versailles.60
MODE OF OPERATION UNDER THE PARK SYSTEM
An example of the ordinary procedure follows: Chassis of the ordinary Ford type, boxed, though poorly protected from the weather, arrived at one of the base ports. It was necessary that the chassis be unboxed immediately and set up, or that the crated cars be stored in a covered warehouse. Two plans were in operation for getting these chassis to Paris, or to the revision park of the service at Chalons, as the case might be.60 One plan was to set the cars up immediately, strap on temporary seats, and drive them by road from the base port to the assembly and revision plant at Paris, which has been described in the headquarters organization. The other plan was to ship the crated cars by rail directly to Chalons where they could be set up, the bodies attached, and the ambulances completed in every respect by mechanics and men especially trained forthe work. Most of the chassis arriving in France had to go by road to Paris, due to the immense amount of material of the American Expeditionary Forces which required rail transportation.60
Before an ambulance left Paris it was sent to the French parc dorganization, where it was matriculated into the French service-that is, a French number was painted on it-its motor number was taken, its description and pedigree were registered, and the driver of the car was given supply books which were to remain with the car wherever it went.61
From the parc dorganization at Versailles the ambulance was forwarded to a reserve park, by road or rail, according to the conditions of traffic. From the time it entered a reserve park until it was issued to a section it was accounted for by the park commander to headquarters as "in condition" or "out of condition."
When an ambulance was issued to a section, this fact was reported to headquarters and the car was taken up on the section reports.62
PARKS IN OPERATION
The need for mobility in a park can not be overstressed. A park, like a section, might be called upon to follow up an attack or to retreat before one. A study of the military situation during the three pivotal months of 1918, with that of the rapid changes of location which occurred in the parks with both French and American troops, shows to just what extent mobility was of value.63
During an attack a park was extremely busy. A great stream of cars, worn out, shot to pieces, or destroyed by accidents, came to it. In an active sector when division replaced division, and the attack continued for days and days, the work became gigantic in its proportions.63 The constant strain on the men as well as on the transport made a breakdown seem inevitable. However, this did not occur, due to the elasticity of the system which had been planned for just such an occasion. When necessary, reserve cars and reserve men could be borrowed from a neighboring park, and all supplies could be replenished from the rear. In order to facilitate these procedures the chief of service, as well as the head of the transportation department, were frequently at the front during an action. Their presence insured rapid decisions and prompt action, and greatly promoted the successful overcoming of obstacles in extreme crises.64
In March, 1918, the parks of the Army Ambulance Service were strung along the stabilized battle line at points where, unless an extreme advance came, they were safe. All organizations near the front were exposed to bombardments from airplanes, and, in the case of one park, to a long-range gun. However, they were reasonably peacefully settled and functioned without difficulty.64 In the German offensive of March, 1918, only few of the Army Ambulance Service parks were concerned.64 The Dunkerque park, because of its distance from the base and the overtaxed railroad between, now became hard to supply, but there was no other effect upon its service. At this time two new parks were established, one at Campteville, the other at Beauvais. These parks were subjected to heavy bombardment from airplanes, but were able to function with success, the one at Campteville supplying 20 divisions at one time during the counter attacks just after this period.64
On May 27, 1918, the German Army began another great offensive, this time on the line between Soissons and Reims. Overwhelming the French divisions along the Chemin des Dames, the Germans advanced southward until on May 30, they had reached the Marne between Mont St. Pere and Brasles.65 This attack was so sudden and successful to so great an extent that it was surprising that the Army Ambulance Service parks were able to move before it. Three parks were affected.66 These had to move rapidly and with a great deal of judgment while retreating in order to continue to supply sections which they were serving. Vierzy, where park B was stationed, was captured, but there was practically no loss by the park either of ambulances or of other material.66 From Vierzy park B moved to Coulommiers, which was under the guns of the enemy, but where it succeeded in functioning. Park D, which had been at Chalons, moved back for safety to Sarry in order to be relieved of exposure to the constant bombardment to which Chalons was subjected. Park E at St. Martin-Ablois moved without difficulty to Sezanne.66
The German advance in May demonstrated to the Army Ambulance Service the necessity for keeping the equipment of the sections, as well as that of the parks, limited to what was absolutely necessary. Park and section commanders were cautioned to this effect, and the equipment, already light, was reduced somewhat. The hardest fighting was yet to come to the allied armies. In July occurred another German attack and then came the quick counterattack on July 18.66
By that date the parks had again become more or less stabilized and had set themselves the work of keeping the sections equipped under a program applicable to long-continued actions. Each day brought other sections into the armies, for the service was increasing. The American divisions had asked for sections and these had been furnished, though the difficulty of supplying such sections was greater because of the lack of liaison between the Ambulance Service parks and the American divisions. This defect was afterward overcome.67
With the counterattack on July 18, however, the whole situation proved different from that which had preceded it. A harder task had to be accomplished. It was more difficult to supply the advancing army, for it could not continue, as in trench warfare, to draw from conveniently located and fixed depots. Its supplies had to follow it.67 Roads were jammed and there were priority of munitions, priority of engineer matériel, etc. Roads, which had been excellent during the retreat a few weeks before, were now full of shell holes, and this caused breakage of many springs and axles and other accidents. Also, the advance, by lengthening the lines of communications, impaired the maintenance of the close liaison necessary. By this time, ambulance sections were serving along the whole line, from the English Channel to the Swiss border. To supply them, to keep their cars in good condition, to get orders to them, and to maintain their high standard of individual efficiency became an increasingly difficult task.67
Step by step, as the armies advanced, the parks moved forward with infinite pains, keeping in liaison with the sections they were supplying.67 Each day meant some change, some new problem that had to be solved. There were telephone messages to headquarters in Paris, quick visits to the front, with instant responses to the rapidly changing conditions. Success made the whole organization appreciate its strength. Through August, with the reduction of the Chateau-Thierry salient, through September with the advance on all fronts, through the Argonne, in Belgium, over the Chemin des Dames, past St. Quentin, sections and parks kept up with advancing troops, the difficulty of supply ever increasing. By November, at the time of the signing of the armistice, almost every park had moved or was on the point of moving.68
The organization of the Army Ambulance Service sections with the French army differed in a few minor details from that of the sections which served temporarily with American divisions during the operations of 1918.69 Those serving with the American Army were planned by the chief of the Army Ambulance Service, for special use with American troops, and were made up of a strictly all American personnel, but their organization was based on the experience gained from the use of similar sections with the French army.69 The equipment was practically the same for the two types, except that an additional touring car was allowed for each of the sections with the French Army for the French lieutenant, and a French truck, usually of a standard type, was provided for transporting gasoline. In general, what is said of a section serving with a French division applies with equal force to one serving with an American division.69 The following tabulation gives the personnel in both the American and French sections:70
All other departments of the Army Ambulance Service were considered auxiliary to the ambulance section as this was the branch which directly served wounded. It was a development of four years of war, and was adapted to both trench and open warfare. This section must not be confused with the ambulance company or with the evacuation ambulance company of the American Army nor with the section sanitaire of the French Army.
Although based on the plans of the Service de Sante of the French Army, a section of the Army Ambulance Service was by no means the exact duplicate of the French Section Service Sanitaire.70 The duty of such of our sections as were assigned to the American Expeditionary Forces was analagous to that of an evacuation ambulance company when it was serving armies or corps, and to that of the motor transport section of an ambulance company when it was assigned to a division.
The administration of a section was effected through several offices or departments.71
Department of personnel and paper work - This department was under the immediate supervision of a sergeant, first class, and had to do with everything that concerned the personnel and paper work of the section.
Department of transportation - The department of transportation was under the immediate supervision of the sergeant in charge of transportation. He advised and watched carefully the work of the mechanics, made inspections of materials, kept account of the expenditures of tubes and casings, inspected the general condition of the cars, made reports on transportation to the section office, investigated accidents and saw that reports were handed in concerning them, checked up on the number of kilometers traveled and on the number of wounded carried, made sure that the cars were filled with gasoline and oil, checked litters and blankets, and arranged for the washing and fumigating of cars.
Department of supply - The department of supply was under the immediate supervision of the quartermaster sergeant, who was in charge of the supply of rations, gasoline, oil, grease, etc. He made out all requisitions for medical supplies, litters, and blankets. He looked after the clothes of the men and saw that they were properly supplied.
Department of food and sanitation - The department of food and sanitation was under a sanitary sergeant, who also had in his charge that part of the duties of a mess sergeant which had to do with the preparation of food. Upon the arrival of the section in camp he searched out a good supply of water and chlorinated it. Lyster bags, for use in chlorinating water, were provided for each section. After this he arranged for latrines and established the kitchen. He inspected the kitchen and had under his supervision the whole kitchen force; the kitchen police and the cooks were responsible to him for the cleanliness of the kitchen as well as for the preparation of the food. He kept the medical kit. He reported on the general cleanliness of the camp and quarters.
The average section had five different kinds of equipment, as follows: Transportation; spare parts and tools; paper and office work; medical; and individual.
The transportation of a section was as follows: 20 ambulances; 1 touring car; 1 two-ton truck; 1 three-fourths ton truck or camionette; and 1 rolling kitchen.
The ambulances used by the Army Ambulance Service were of the Ford type.72 The standard chassis, with a few changes and additions (none being radical), was adapted to perform the heavy work incurred in the transportation of wounded.
There were two types of ambulance bodies. One, the fiber body, modeled in America, according to specifications furnished at the beginning of the war, was not wholly a success. The other, made in Paris, was on the pattern of the old American Field Service ambulance body. This was made of wood and was excellently planned, so that it contributed to the comfort of the wounded men as well as to that of the driver. All ambulances were painted an olive-drab color.72
The touring car was of the standard Ford type.73 A few additions were made, such as tire racks, and an arrangement (generally by the use of three 5-liter bidons) for carrying extra gasoline. The touring car was painted the same color as the ambulances, and bore the number and insignia of the section. A red cross was sometimes painted on the windshield to facilitate the passing of sentries, and to obtain the priority of the medical service, which was granted to ambulances.73
Two kinds of trucks were used.74 One, the ¾-ton Ford camionette, was of the standard make. The other truck was usually of some well-known American make of from 1½ to 2 tons capacity. The type most used was the White, while the Packard was a close second, with the Garford third.74
Practically every section was equipped with a rolling kitchen.74 Two types were used, one an inheritance from the American Field Service and the other a gift from the American Red Cross. The American Field Service rolling kitchen was a large boxlike kitchen, equipped with a good range and with shelves and drawers for rations; completely inclosed, it protected the cook from the weather. While many advantages were gained by this arrangement, it is believed that the weight of the vehicle lessened its value, especially during the very active period in the last year of the war. It was towed behind the larger truck, to which it was fastened by means of an apparatus which took up the shock.74
The Red Cross kitchen was lighter and more practical for an army moving in the field.75 It was planned from observations made by a member of the Army Ambulance Service, who was aided by the practical advice of men on active duty in the field. Perfected by the Red Cross, it gave excellent satis-
faction on every front. The oven and the arrangement for heating water were features not usually found in a field kitchen.75
The medical equipment of a section was limited. Unlike that of an ambulance company, it included few bandages or medicines, and those supplied were intended primarily for the use of the section personnel.76 The attending surgeon, early in 1918, perfected a medical kit, for the special use of the service, which could be used intelligently by nonprofessional men. Though the kit contained only the simplest remedies, it was an entire success. The litter which was part of the medical equipment was the French folding litter.76 There were 3 litters to each car, or 60 to the section. The ambulances were planned to carry the litters of all the allies, though some trouble (later corrected) was experienced at first with the long-model truck litter.77
With the litter were the two blankets used to cover a wounded man on his trip from the front to the rear. These blankets, generally of a good quality of wool, were carefully safeguarded and were considered a part of the ambulance equipment. Three extra gas masks were always carried in the ambulance, and on special occasions one or more French Tissot masks were added for the use of the driver during a heavy gas attack.77
Each section was supplied with a regulation venereal prophylaxis outfit. An attendant, properly instructed and trained, administered the treatment and was responsible for the material as well as for the records. These records were inspected by Army Regulations. The percentage of venereal diseases was exceedingly small in the Army Ambulance Service.77
The equipment of the individual soldier in the section was the regulation Equipment C, provided by Army Regulations.78 In periods of great stress, this equipment was reduced to Equipment A, the surplus being stored at the parks for the time being. A supplement to the clothing allowance was made by certain additional garments, such as the leather jerkins, authorized by General Headquarters, American Expeditionary Forces. All of the personnel were equipped with the regulation French helmet and gas mask. Sections operating in the Vosges and other cold sections were furnished waterproof and sheepskin lined coats.78
Instruction in all phases of the work of the Army Ambulance Service was necessary and was amply provided for by means of various schools, such as the base camp school, Centre dInstruction Automobile, Meaux; motor transport service school; and also by instruction in the ambulance sections.79
EVACUATION OF WOUNDED
Transportation and care of patients in transit differed considerably according to proximity to the front and to other considerations. The first zone which
a patient traversed was the forward part of the advanced zone, and here transportation was accomplished by litter bearers. The second, just in the rear of the first, comprised the remainder of the advanced zone; through this the wounded were removed by motor vehicles. This part of the advanced zone began at the first-aid station, or the regimental dressing station (poste de secours of the French), and ended atthe field hospital or triage. It was in this territory especially that the sections of the Army Ambulance Service usually operated.80
In this part of the advanced zone the transportation of the patient under the French system was completely divorced from his treatment.81 Statistics have shown that while delay for treatment, or for any other reason, might mean comfort for some individuals it meant infection for a large number of others.81 Evacuation in this part of the advanced zone was exceptionally difficult, for it was here that the time factor was mostvariable, and it was here that contact must be maintained with the units served. It was found that a section should operate with one division, and should at no time be removed from the division to which it was attached, unless in the greatest emergency. Knowledge of the exact organization of a division and personal acquaintance with its sanitary service were of the highest importance to the efficient operation of a section. If frequently transferred from one division to another, it was impossible for the commander of a section to orient himself without great loss of time and under circumstances when no time whatever should be lost.81
In order to administer first-aid during transportation, access to the patient was necessary. Both the French and English ambulances at first had passages between the litters to facilitate treatment of patients en route, but this arrangement proved to be impractical, and was discontinued early in the war.81 It was found that, instead of aiding the patients, many cases of infection occurred as a result of interference with wounds in transit. The extra space which allowed access to the patient could not be spared when wounded had to be cared for in great numbers. The continuing stream of vehicles would not permit an ambulance to stop and thus block them all. As early as the winter of 1915, ambulances were completely closed and rules prohibited the treatment of patients en route except at special stations. The results proved the success of this method.82
From experience on the Western Front, where delay ofevacuation under normal conditions seldom occurred and the whole transport could be accomplished in perhaps two hours, it was learned that stations between the first-aid station and the field hospital, except for the sorting of wounded, were not practical.82 The dressing station of the American Army organization was but an additional stop which delayed the patient on the trip to the rear. It was believed that it was better to rush the wounded back to a formation where proper facilities for their treatment were available than to delay the transport by feeble efforts at treatment en route.82 Furthermore, the drivers, while enlisted in the Medical Department, were not trained in more than elementary first-aid work, and to have an ambulance section saddled with medical and
surgical equipment in addition to that of their cars was contrary to the dictates of efficiency.83
It was found that the particular requisite for effective results was to have the drivers under the constant supervision of an officer trained for this purpose. This proved to be very difficult, if not impossible, in a command larger than the section. The difficulties would have been increased if there had been mounted, as well as dismounted, personnel, such as litter bearers, as is actually the case in ambulance companies.83 It was believed very unwise to have mixed types of vehicles in an ambulance section. As each section of the ambulance service had one type of car, with one type top, so as to obviate having multiple stocks of repair parts and multiple tools and equipment, it was not necessary to depend upon different parks for different supplies and maintenance, nor was it necessary to have mechanics and drivers trained in the upkeep and repair of more than one type of car.83
DUTY WITH FRENCH DIVISIONS
The duty to be performed by the sections serving with the French army was very definitely fixed. In the advanced zone, one section was assigned to each division of 10,000 fighting men. This section remained with the division while it was in line and went with it when it came out to rest. In no case was it detached, as was often done in the American Army; but, if applied for through the proper channels, it could be loaned to another division for an engagement.84 The decision in this case rested with the directeur, service automobile, who considered the use to which the section was to be put and whether it was fit to go into another action.85 This officer also controlled all movements of the section when in convoy; but upon entry of the division into the line, the allocation of the cars and their immediate supervision fell under the division surgeon.85
While on active duty a little village was chosen for the headquarters of a section. The choice was based on proximity to the scene of its future work, and for this reason the location was almost inevitably in a destroyed village. From this point the section functioned through its postes des secours, where cars were stationed, or which they visited to collect the wounded. The distance between these postes and the hospital devacuation was never very great, but varied according to the front. For instance, a section serving with a division holding part of the line north of Verdun (Verdun being at the time a comparatively active area, with the divisions close together and each holding a short line) had a restricted geographical area for its operations. The runs in this case were thus comparatively short. The contrary was the case with divisions in less active sectors. In fact, the more active the sector the more wounded, but the shorter the runs; the less active the sector, the less wounded; but at the same time when the divisions concerned were less concentrated the runs were longer. Some sections evacuated only to the triage, at which point the wounded were picked up by the larger cars of the French ambulance sections, while in other instances the sections of the Army Ambulance Service evacuated all the way to the hospital devacuation.85
SERVICE OF THE ENTRENCHED CAMP OF PARIS
In addition to front line duty with French combat divisions, it was agreed between the French and American authorities that the ambulance service of the entrenched camp of Paris, which had previously been carried on by volunteers attached to the Ambulance Americaine at Neuilly, should be assumed by the United States Army Ambulance Service.86 Accordingly, when the first contingent of 20 sections arrived in France, two sections (this was on September 16, 1917) were ordered overland to Paris to take over this service.86 They, with two other sections which were destined for the base camp, arrived in Versailles September 18, 1917, establishing what is believed to be an enviable record for convoy work with inexperienced drivers. This convoy was composed of 80 ambulances, 8 trucks, 4 touring cars, and 4 motor cycles. About one-half of the drivers had never driven a car at the time of their leaving the camp at St. Nazaire, but despite this and running as a solid convoy, the detachment reached Versailles on time, the convoy complete without losing a car or having to tow one. The last car drew into line 20 minutes after the pilot car had stopped. The two sections, which were intended for Paris, reported to the American Red Cross Military Hospital No. 1 (Ambulance Americaine), Neuilly-sur-Seine, and immediately took over the duties of the old volunteer organization.86(About 30 men from the old volunteer service were still on duty at this hospital, and, desiring to come into the new service, were enlisted and organized into a third section.) Service here was concerned primarily with the evacuations of French sick and wounded from the large unloading stations in Paris to which points they had come by hospital train or by boat from the hospitals in the zone of the armies. Later, however, the Paris sections were used extensively to evacuate all allied wounded arriving at that city. During the German drive to the Marne in 1918, 40 of the ambulances of the Paris detachment were sent to evacuate wounded from points as far as 50 kms. (31 miles) from Paris. The Paris detachment at this time numbered 250 drivers and had 165 ambulances of the large type, carrying 4 lying or 6 sitting cases each. The organization was designated "The Provisional Battalion," having a captain in command of the battalion and a first lieutenant in command of each of the three sections. In Paris, during the volunteer days from September, 1914, to August, 1917, 50,195 cases had been transported; from September, 1917, to November, 1918, inclusive, the provisional battalion, United States Army Ambulance Service, transported 132,683 cases.86 The number of wounded carried climbed from 766 in September, 1917, to a total of more than 30,000 during the month of October, 1918. These figures include a number of air raid casualties and German long-range gun ("Big Bertha") victims, resulting from the 1918 attacks. The provisional battalion, during the late days of the war, was moved to the Long Champs race course and detached from the American Red Cross Military Hospital No. 1, Neuilly. Gasoline and tires for Paris were furnished by the French Army as was the case for the rest of the Army Ambulance Service.
From time to time, sections on Paris duty were replaced by recently arrived sections from the United States and sent to the front for duty with the French divisions, the service for which they were originally organized and intended. This relief of sections prevented the tiresome and onerous duty in Paris from becoming any more so.86
Within five months after the signing of the armistice, over one-half of the United States Army Ambulance Service had been demobilized, and plans had been made for the demobilization of the remainder.87 Yet the work of the sections by no means ended on November 11, 1918. Many of the sections moved into Germany and some crossed the Rhine with the French army of occupation. But within a few months it was possible to call in those which had accompanied French divisions into Germany. They were replaced by new sections which had arrived in France late in November. Through such replacement it was possible to arrange that all sections which had seen war service were assured of a speedy return to America. Plans were also worked out with the French so that the new sections were relieved by French "Regular Army" units late in the spring of 1919, allowing even the sections which had come over after the armistice to return before midsummer of that year.87
Plans for demobilization were made so that all preparations for transport to America and for discharge were made within the ambulance service itself. The base camp proved to be a place ideally fitted for demobilization purposes, and it was there that the sections from the front were prepared for discharge. Ambulances, however, were turned over locally to the Motor Transport Corps of the American Expeditionary Forces, which corps also took over all the other transportation of the ambulance service.87
Sections, relieved of their automobile equipment, arrived at the base camp with only personal property and the section records. Here the men were put through the disinfesting process and issued standard Medical Department equipment.87
All individual records and section records were straightened out at the base camp at the same time the men were being put through the various processes prescribed for all units previous to embarkation. When the sections left the camp, they did so with a clean bill of health and with all the section funds and records attended to. Here, efficient work by sections was in great measure responsible for the smoothness with which the ambulance services demobilization program worked out in conjunction with the embarkation system of the American Expeditionary Forces.87
On January 30, 1919, it was announced that 10 sections would be sent home in February and 20 sections each month thereafter until the whole service had been demobilized. Before the end of March, 56 sections either had gone through the base camp, homeward bound, or they were ready and awaiting transportation at Brest. Demobilization was hastened very largely because it was apparent that the sections could be prepared for going home
much more quickly than had been expected. The real need for them at the front had ceased as soon as the French demobilized their temporary divisions and were thus enabled to handle their own transportation problems to a much greater extent than had previously been the case. After the middle of April, 1919, no sections remained in the field that had seen service at the front previous to the signing of the armistice. The newer sections continued to serve until May, most of them being located with the French divisions along the Rhine. The character of the work changed after the armistice, sickness being practically the sole cause for evacuation.87 With the lessening of the need for transportation of patients it was now possible in some cases for one ambulance section to do the work for two divisions. Withdrawal from the French Army was carefully carried out by the sections, and in no case was interruption in the transportation of patients permitted to occur.88
Many of the men who entered the Army Ambulance Service in France took advantage of a general order which permitted them to be discharged in Europe.88 These men, with their completed records, were sent from the base camp to the St. Aignan discharge camp. As a matter of fact, the old volunteer sections all had a limited number of their original personnel still in the service when they arrived at the base camp, and many of these men desired to stay in Europe. Relatively, more men in the United States Army Ambulance Service were affected by the order permitting discharge in Europe than was the case with any other organization of the American Expeditionary Forces.88
The first contingent to leave for America sailed from Brest on March 15, 1919.88 Ten sections, five of them from the first Allentown units and five more from the old volunteer service, were included in this contingent. They were those numbered: 501, 509, 546. 586, 594, 627, 629, 631, 635, and 642.88
The second returning contingent, composed of the following 10 sections, left Brest only 5 days later, on March 20: 517, 523, 539, 551, 558, 592, 593, 628, 630, and 641.88
On March 26, a contingent, composed of the following 14 sections, left the same port: 504, 510, 512, 525, 552, 553, 625, 626, 632, 633, 634, 636, 638, and 646.88
The remainder of the veteran sections sailed in contingents varying in size from 10 to 25 sections, and all were out of France before the end of April, 1919.88
Parks were called in as rapidly as the decreasing number of sections at the front permitted, and their personnel was sent back with the returning sections. The chief of service effected arrangements whereby the remaining repair parks would be disbanded at the same time their sections were released from divisions. The Chalons park was the last to be discontinued, for because of its advantageous location, it afforded excellent repair facilities to sections en route to the base camp for demobilization.88
As previously stated, after the veteran sections had been released, it was found that it would be possible to demobilize the new sections, which had been utilized to replace the old ones, earlier than had been previously
scheduled, so this was done. Ten of these sections were released on April 25, 10 on May 1, and the remaining 10 on May 5. This permitted the United States Army Ambulance Service to be practically out of France by the last of May, 1919.88
(1) Memorandum from the chief surgeon, A. E. F., to the commanding general, A. E. F., July 1, 1917. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(2) Memorandum from the chief of U. S. Army Ambulance Service to the commanding general, A. E. F., August 17, 1917. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(3) Letter from the chief of the U. S. Army Ambulance Service with the French Army to the Adjutant General, A. E. F., December 5, 1917. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(4) Report of activities of the U. S. Army Ambulance Service, by Col. E. E. Persons, M. C., undated, 2. On file, Historical Division, S. G. O.
(5) Ibid., 3.
(6) Ibid., 4.
(7) Ibid., 5.
(8) Ibid., 6.
(9) Letter from the chief of the U. S. Army Ambulance Service, to the Surgeon General, U. S. Army, August 25, 1917. On file, A. G. O., World War Division, Medical Records Section, (Chief Surgeons Files, 322.3211).
(10) Letter from the chief of the U. S. Army Ambulance Service, to The Adjutant General of the Army, November 13, 1917. On file, A. G. O., World War Division, Medical Records Section, (Chief Surgeons Files, 322.3211).
(11) Cable 128-S, from commander in chief, A. E. F., to The Adjutant General of the Army, August 28, 1917.
(12) Memorandum from the chief of the U. S. Army Ambulance Service, to the commanding general, A. E. F., August 17, 1917. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files 322.3211).
(13) Memorandum from the chief, U. S. Army Ambulance Service to the commanding general, A. E. F., September 21, 1917. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(14) Cable from General Pershing to The Adjutant General of the Army, September 26, 1917. On file, A. G. O., World War Division, Medical Records Section (Surgeons Files, 322.3211).
(15) Letter from the commanding general, A. E. F., to the chief, U. S. Army Ambulance Service, A. E. F., January 4, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(16) Letter from the chief of the Army Ambulance Service to the commander in chief, A. E. F., January 4, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(17) Letter from the commander in chief, A. E. F., to the chief of the Army Ambulance Service, January 11, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(18) Letter from the commander in chief, A. E. F., to the under secretary, Service de Santé, April 30, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(19) Cable No. 1591, from the commander in chief, A. E. F., to The Adjutant General of the Army, August 13, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(20) Letter from the commanding officer, Camp Crane, Allentown, Pa., to the Surgeon General, August 26, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(21) Letter from the Surgeon General to the chief surgeon, A. E. F., August 27, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(22) Letter from the chief, U. S. Army Ambulance Service, to the chief of staff, A. E. F., September 16, 1918. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(23) 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, 86. On file, Historical Division, S. G. O.
(24) Report on activities of the U. S. Army Ambulance Service with the Italian Army, by Col. E. E. Persons, M. C., undated, 4. On file, Historical Division, S. G. O.
(25) Report on activities at Camp Crane, Allentown, Pa., by Col. E. E. Persons, M. C., undated, 6. On file, Historical Division, S. G. O.
(26) Report on activities of the U. S. Army Ambulance Service with the French Army, by Col. Percy L. Jones, M. C., chief of service, undated, 206. On file, Historical Division, S. G. O.
(27) Ibid., 207.
(28) Report on activities 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, 66. On file, Historical Division, S. G. O.
(29) Letter from the chief, U. S. Army Ambulance Service, to the commander in chief, A. E. F., October 31, 1917. Subject: Additional ambulance sections from the United States. On file, A. G. O., World War Division, Medical Records Section (Chief Surgeons Files, 322.3211).
(30) Report on activities 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, 67. On file, Historical Division, S. G. O.
(31) Report on the activities of the U. S. Army Ambulance Service with the French Army, by Col. Percy L. Jones, M. C., chief of service, undated, 21. On file, Historical Division, S. G. O.
(32) Ibid., 22
(33) Ibid., 24
(34) Ibid., 25
(35) Ibid., 26
(36) Ibid., 27
(37) Ibid., 28
(38) Ibid., 30
(39) Ibid., 33
(40) Ibid., 34
(41) Ibid., 35
(42) Ibid., 36
(43) Ibid., 37
(44) Ibid., 38
(45) Ibid., 39
(46) Ibid., 40
(47) Ibid., 45
(48) Ibid., 46
(49) Ibid., 47
(50) Ibid., 147
(51) Ibid., 148
(52) Ibid., 152
(53) Ibid., 149
(54) Ibid., 50
(55) Ibid., 51
(56) Ibid., 52
(57) Ibid., 53
(58) Ibid., 63
(59) Ibid., 65
(60) Ibid., 54
(61) Ibid., 55
(62) Ibid., 56
(63) Ibid., 66
(64) Ibid., 67
(65) The Battle of the Aisne; A study by the Second Bureau, general staff, French G. H. Q., undated. On file, Historical Section, the Army War College.
(66) Report on the activities of the U. S. Army Ambulance Service, with the French Army, by Col. Percy L. Jones, M. C., chief of service (undated), 68. On file, Historical Division, S. G. O.
(67) Ibid., 69
(68) Ibid., 70
(69) Ibid., 73
(70) Ibid., 74
(71) Ibid., 78
(72) Ibid., 86
(73) Ibid., 89
(74) Ibid., 90
(75) Ibid., 91
(76) Ibid., 95
(77) Ibid., 96
(78) Ibid., 97
(79) Ibid., 105
(80) Ibid., 129
(81) Ibid., 130
(82) Ibid., 131
(83) Ibid., 132
(84) Ibid., 139
(85) Ibid., 140
(86) Service of the entrenched camp of Paris, by Col. Percy L. Jones, M. C., chief of the U. S. Army Ambulance Service with the French Army (undated). On file, Historical Division, S. G. O.
(87) Report on the activities of the U. S. Army Ambulance Service with the French Army, by Col. Percy L. Jones, M. C., chief of service, April 15, 1919, 203. On file, Historical Division, S. G. O.
(88) Ibid., 204