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Chapter 7

Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply

CHAPTER VII

FACTORS AFFECTING PRODUCTION OF SUPPLIES

Many difficulties of greater or less magnitude confronted the manufacturers of medical and hospital supplies in the production of the articles which they had undertaken to furnish. Many of these difficulties were doubtless unavoidable. Some of them were due to regulations which, while justifiable in principle, appeared to be applied without sufficient discrimination and latitude. If some of the manufacturers complained of these difficulties and restrictions, they were not without justification. While the difficulties were legion, the more important, stated in the order of their development, were shortages of skilled labor, fuel, power, transportation, raw materials, and semifinished products, augmented by the control exercised over distribution.

LABOR

One of the most unfortunate but common conditions which confront industry in times of peace is the labor turnover. This turnover is more or less periodic and varies with the year, the season, the locality, the individual factory, and the industry. The causes are numerous, but the condition is chronic. It is apt to be exaggerated by unsettled or unusual conditions and to become acute when a shortage threatens. The lure of higher wages reported to be paid elsewhere creates unrest and a desire for a change, and engenders a roving disposition. This is particularly noticeable during war periods when the turnover is apt to be rapid and wasteful and to remain high during the entire period in spite of efforts to prevent it. This condition obtained during the years 1917-18.1

The shortage of skilled labor in certain of the trades supplying the Medical Department began to manifest itself early in June, 1917. It was due in part to the high wages being paid in other industries, at navy yards and at the cantonment construction camps.2 It was influenced to no small extent by the entry of employees within the draft age into the military service. Many of these men preferred to enlist, while enlistments were permitted, to being called in the draft.3The first draft was made without regard to the importance to industry of the men drafted or consideration of the part industry was destined to play in winning the war. Men had to he provided for the Army and time did not permit a selection to be made. Accordingly, selections were made by lot. Later on the selections for the draft gave more consideration to the needs of industry. It was not the intention, even in the first draft, to reduce the efficiency of any manufacturer producing supplies for the Military Establishment. But general exemption could not be made to include any particular industry or class of workers.


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Each case was considered on its own merits.4 Exemptions could be had in individual cases by the individual himself claiming exemption and stating the reason for his claim. The manufacturer supported the claim with an affidavit setting forth the fact that the individual was engaged upon work for the Government and furnished such other information as the local district appeals board considered necessary.5 If the board considered the claim meritorious the exemption was granted and the man remained at his task.

In so far as medical supplies were concerned, the surgical-instrument industry was, perhaps, the most sensitive to fluctuations in the the labor situation and to losses of skilled workmen. The reasons for this sensitiveness are given in greater detail in the chapter on surgical instruments. Even in peace times the number of such workmen is inadequate. The prospect of meeting the war requirements was very doubtful. Those requirements could be met only by conserving the skilled workmen as much as possible and by utilizing them as instructors and supervisors of the new workmen employed in the industry. Consequently strenuous efforts were made to retain the skilled workmen in this industry.Every assistance which could be given by the Surgeon General to retain these men was given. Manufacturers were informed of the procedures to be followed in securing the exemption of their workers. Applications from men in Class I, liable to be called by the draft, were forwarded through the Surgeon General' s Office, where measures were initiated to have such men placed in a deferred classification. If the men actually were called in the draft they could be transferred to the enlisted reserve corps, placed on the inactive list, and returned to their employers.6

As the available workmen became fewer in number contractors began to compete with one another, advertising more and more favorable conditions and wages.4 Employment agencies were established in various cities for recruiting labor. The Post Office Department cooperated in the effort to bring employers and employees together.7 But these efforts were not always well considered or the agencies well coordinated in this matter. The activities sometimes conflicted with the interests of local factories engaged upon Government contracts, and skilled workmen were lost through such measures. In May, 1918, complaint was received from a factory in Erie, Pa., that special efforts were being made to engage the skilled mechanics in that vicinity, where the bulk of production was on Government contracts, for employment in other cities on other Government contracts.8 Prompt representation was made to the Labor Administration of this state of affairs with request that the condition be remedied.

Just as the Railroad, Food, and Fuel Administrations were brought into being to conserve and the more effectively distribute transportation, food, and fuel, so the United States Employment Service was established early in January to conserve and distribute the existing supply of labor. This service consisted of a labor administrator with an able advisory council in Washington and a labor administrator in every State.9 Its continuing effort was to reduce the labor turnover, to prevent competition in the employment of labor, and to assist industries engaged upon Government contracts in securing needed workmen. Near the end of May, 1918, a complaint was received by the Surgeon General from a manufacturer in Boston, Mass., to the effect that sufficient


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labor could not be had locally to make possible the production of the quantities stipulated in his contract.10 This complaint was promptly referred to the United States Employment Service by the Surgeon General, with request for assistance and relief.11 So far as is known the shortage was relieved through the efforts of this service.12

Just as priorities were established in industry to provide munitions and the industries were arranged on a preference list, so measures were instituted to control the flow and supply of labor. The classifications of industries and automatic ratings applied by the priorities commissioner came, in the fall of 1918, to be the rules observed in guiding the flow of labor. 13

FUEL

Production during the greater part of the year 1917 was uneventful save for the dislocation incident to labor changes and transportation. Fuel was had in sufficient quantities and with reasonable dispatch. The winter of 1917-18 set in early and was unusually severe throughout the entire United States. Heavy snows interfered with the mining of coal and greatly impeded railway traffic. Seaboard terminals and junction points of the railways were congested with east bound overseas traffic. The distribution of supplies, including coal, was in a fair way to be paralyzed. By the end of December conditions east of the Mississippi River were such that a fuel famine impended. To prevent this, prompt and vigorous action was necessary. Fuel was placed entirely under Federal control. The agency set up for this purpose was designated the Fuel Administration, under a chief called the Fuel Administrator, located at Washington, D. C. Local fuel administrators were appointed in various large cities and particular districts assigned to each of them. Stringent regulations were promulgated concerning the conservation and use of coal and other fuel. Certain mines or groups of mines were designated to supply similar designated areas. Soon the control became absolute. Fuel was placed on an allowance or ration basis. Only a limited quantity was allowed to any consumer. Orders issued by the Fuel Administrator on January 16 required the closing of industrial establishments on Monday of each week during January, February, and March.14

Since certain supplies for the Army were of such vital importance that any cessation of production would interfere with the military program, arrangements were made to exempt the manufacturers of such articles from the closing order. The number of these articles, however, was limited. To obtain this exemption for any factory it was necessary for the chief of the supply bureau to make application therefor and to submit a certificate as to the urgency of the need for the articles manufactured at the particular factory. The Secretary of War directed the fuel and forage division of the Quartermaster General' s Office to handle all matters relating to fuel for the Military Establishment and War Department and to assist the contractors of the various supply bureaus to secure their fuel requirements in cases of emergency.15 The procedure for obtaining fuel and closing exemption for contractors is indicated in the following copy of the blank form provided for the purpose:


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No.................   

 Office of...................................................,.

  Washington, D.C.,..................................., 1918.

Memorandum for the Secretary of War:

I certify that in my opinion the contractors set forth in the list annexed hereto are engaged upon the production of supplies for the war emergency, of such immediate importance that any delay in the continuity of such production would seriously interrupt the program of this department:

  Names of Contractors:   Articles manufactured
....................................................................  .....................................................................................
....................................................................  .....................................................................................
.................................................................... .....................................................................................    (Signature)......................................................................
 (Signature) ...................................................................

 (Rank) & & & & & & & & & & & & & & & & & & & .
 
(Certificate to be signed in duplicate by Chief of Bureau, and transmitted to the fuel and forage division, Q. M. G. O., Room 490, War Department)

__________


OFFICE OF THE QUARTERMASTER GENERAL
FUEL AND FORAGE DIVISION,
Washington, D. C.,............................................ 1918.

Respectfully transmitted to the Secretary of War, for his action.
...................................................
Lieut. Colonel, Q. M. Corps.

___________


OFFICE OF THE SECRETARY OF WAR,
Washington, D. C., .................................., 1918.

Respectfully transmitted to the Fuel Administration, recommending that firms above named be exempted from the provisions of any orders which would interfere with the continuity of production of articles set forth.
.....................................................................................................

Authority was granted by the national Fuel Administrator in January, 1918, for the exemption from the closing order of manufacturers of surgical instruments, surgical dressings, biologicals, and medicines. The Secretary of War declined to consider exemption for other manufacturers of supplies for the Medical Department. While these manufacturers were placed in the exempted class by the national Fuel Administrator, the actual exemptions were obtained through the local fuel administrators. As frequently happens in a newly formed organization, there was a material difference of opinion between different administrators over the granting of these exemptions. Some of the administrators granted the exemption upon the request of the medical supply officer, while others refused to grant exemption without direct instructions from the Chief Fuel Administrator.16 Adjustments finally were made, and by judicious use of the quantities of fuel allowed production went on with very little diminution or inconvenience.

The following instructions were received by the Surgeon General, January 19, 1918, to guide in the preparation of requests for assistance in securing fuel for contractors: 17

In cases of necessity, contractors and subcontractors having contracts for furnishing supplies for the War Department should make application to the Army officer with whom they have a contract, or with whom their principal has a contract, for the necessary fuel


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for the running of their establishment, stating the quantity needed. They should also state the percentage of their output covered by Army contracts.

The Army officer concerned will check up these requests and satisfy himself of the necessity for same. Having done so, he will transmit the requests promptly to the chief of his corps or department especially designated to handle fuel matters,who will examine the requests and see that they are not duplicated within his corps or department. This officer will, each day, transmit the requests to the chief of the fuel and forage division of the Quartermaster General' s Office, indicating their relative order of emergency.

The chief of the fuel and forage division, Quartermaster General' s Office, will examine these requests, with a view to seeing that there is no duplication among the several departments, and will have an officer of his division especially detailed for the purpose, present them personally to the proper official of the Fuel Administration and cooperate with the transportation division with a view to having cars provided for this fuel.

This will avoid the present confusion resulting from having a large number of different officers from different bureaus all dealing independently with the Fuel Administration.

Information should be sent to all contracting officers of the War Department, giving them the information, and they should he instructed to notify all their contractors accordingly.

Additional instructions from the Quartermaster General' s Office required the following information with every application from a contractor for assistance in securing fuel: Location of the plant; railroad connections at the plant; kind of fuel required; quantity of fuel required, weekly, for production of War Department supplies only; existing contracts, if any (state with whom); current purchases (with whom placed); quantity of fuel on hand; quantity of fuel in transit; percentage of production on War Department contracts.

ELECTRIC POWER

On January 15, 1918, the Surgeon General was advised by the Council of National Defense that there had developed a shortage of electric power in the State of New Jersey for manufacturing purposes.18 Since current there could be supplied for only the most urgent needs, some manufacturing industries must do without. In order to distribute the available power to the most urgent needs of the various supply bureaus, lists of manufacturers were called for showing the location of the plants engaged upon the most urgent war work in New Jersey.18 Only those plants were to be included in the lists whose products were absolutely necessary and could not withstand a delay of a week or 10 days. After a careful sifting of the applications for power the approved lists were furnished the Power Co. of New Jersey by the Council of National Defense.

The Medical Department at that time had contracts with 35 manufacturers in New Jersey. In the list submitted by the Surgeon General in compliance with the instructions above referred to, these 35 factories were divided into 4 groups in accordance with the urgency of the need for the articles which they respectively produced.19 Group I included only the makers of gas-mask parts, of whom there were 10. Group II included only glassware. There were four firms in this group. Group III included 8 manufacturers, ofwhom 3 produced medicines, 1 surgical instruments, 1 hypodermic syringes and thermometers, 2 surgical dressings, and 1 tin cans for containers. Group IV included manufacturers of splints, mattresses, gatch frames, blankets, duck, ophthalmoscopes, and ambulance boxes. The products of the manufacturers not included in the


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list were not considered of such urgency that the delay anticipated would interfere with the military program.

A shortage of electric power developed in the district about Worcester, Mass., at the end of January, 1918. This district extended into the near-by parts of Vermont, New Hampshire, and Rhode Island. Restrictive measures similar to those applied to New Jersey were applied to this district also. Fortunately the urgent needs of the Medical Department in this area were limited to two firms in Providence, R. I. One of these firms made surgical needles, the other caustic soda for the Gas Defense Service.

There was a chronic shortage of electric power throughout the  congested area until the end of the war. This area was bounded by the Atlantic Ocean and a line drawn through the Chesapeake Bay, Baltimore, Harrisburg, Altoona, Binghamton, Schenectady, the Hudson River, and the northeastern boundary of New York State. Similar shortages persisted in the districts supplied by power companies at Canton, Baltimore, Massillon, Alliance, Niagara Falls, Pittsburgh, Connellsville, Wheeling, Youngstown, and Akron. In these localities clearance was required for all orders placed therein.

TRANSPORTATION

Difficulties in securing freight cars for the transportation of raw and semifinished materials to the contractors' factories and of the finished products to destination began early and continued throughout the war. Requests for assistance in securing transportation received in the Surgeon General' s Office were numerous. The efforts to provide the cars requested were generally successful, but the delay in securing them was often irksome to the manufacturers, whose employees were often dependent upon the prompt delivery of the material to the plant for a continuation of their employment. There was close liaison between the transportation branch of the finance and supply division of the Surgeon General' s Office and various railway officials prior to the amalgamation of all railroads under the Railroad Administration, and with the officials of that administration after the consolidation. By reason of this liaison it was possible to obtain cars with a minimum of difficulty.

RAW MATERIALS

The Medical Department was not seriously disturbed in the accomplishment of its mission by shortages of raw materials. At times these materials were scanty and difficult to secure. The Medical Department, in common with other supply bureaus, experienced many inconveniences arising from a supply of certain raw materials inadequate to the demand. The most prominent among these materials were steel, wool, cotton linters, nonferrous metals, and certain basic chemicals required in the manufacture of medicinal agents. The term  raw materials as used here includes all those materials, whether the untreated products of nature or the semifinished products of other manufacturers, utilized within the factories of the makers of medical and hospital supplies and equipment in the fabrication of the finished article. Delays frequently were experienced by manufacturers in securing needed materials from lack of suitable priorities. This was particularly true of steel plates for


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the manufacture of steam boilers for the hospital sterilizing sets and the portable disinfectors. Fortunately the delays and difficulties experienced in securing raw materials did not at any time prevent the delivery of needed equipment and supplies to the hospitals and in the field in time to meet the expected need. Oftentimes the margin between supply and shortage was very narrow, but somehow the supplies arrived before the need became acute. If it were not practicable to obtain the exact articles desired, the nearest substitute was accepted. In general the question of production depended far more upon facilities and labor than upon the supply of raw materials.

Shortages in both basic raw materials and in manufacturing facilities for certain pharmaceuticals were noticeable during the early procurements of the war. As the prices of these articles were very high, their purchase was discontinued until the prices reached a level at which the articles could be purchased. Meanwhile substitutes were provided. Thus phenacetin (acetphenetidinum) was quoted at $16 per pound in the early part of 1917 and acetanilid was substituted. When manufacturing processes had become sufficiently available to produce phenacetin at a reasonable price its purchase was resumed. Thymol was displaced by oil of chenopodium in the treatment of hookworm. The  supply of atropine and homatropine was very scanty and the prices were almost prohibitive during the early months of the war.20The alkaloids of stramonium were substituted. Later, manufacturing processes were perfected whereby atropine was obtained directly from stramonium seed. Novocaine, later termed procaine in the United States, was unavailable for a time due to lack of manufacturing facilities. These articles will be referred to again under pharmaceuticals.

For a number of medicinal agents the raw materials or crude drugs are obtained wholly or in part by importations from abroad. It was among this class of pharmaceuticals that the chief difficulties developed from the standpoint of raw materials. Some of the most important remedies belong to this group, notably opium and its alkaloids, quinine, camphor, and iodine. The bulk of the opium, quinine, and native camphorcomes from the Orient. Iodine comes from the nitrate beds of Chile. The critical period for opium and quinine occurred early during the war. The camphor and iodine situation became acute near the end of the war.

Quinine comes mostly from the Dutch East Indies. Although a small quantity comes from South America, the East Indies product is preferable. The earliest purchases of quinine in 1917 were made without difficulty. Subsequent purchases became more difficult because of the limited quantity of cinchona bark which arrived in the United States. Through limiting the quantities to be purchased and by cooperation with the firms importing cinchona bark 21 the situation was tided over until better arrangements could be made with the Government of Holland for the export of that commodity. The agreement with that Government became effective in April, 1918, and thereafter the quinine situation improved.22 By autumn the importers were able to advise the Surgeon General that all Army requirements could be met.23

The requirements for opium, morphine, and codeine for the first purchase of pharmaceuticals during the summer of 1917 were met without difficulty from


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existing stocks. Thereafter it became increasingly difficult to obtain them at reasonable prices. Arrangements were made with the Customs Bureau of the Treasury Department for the transfer of approximately 4,000 pounds of smoking opium 24 which had accumulated from seizures for attempted smuggling. The contained alkaloids were extracted from this lot of opium and yielded 3,500 ounces of morphine and 1,470 ounces of codeine.25 Orders were placed in England in December, 1917, under instructions from the Surgeon General, for 5,000 ounces of codeine and 8,000 ounces of morphine.26 Delivery of these supplies was made to the New York medical supply depot, 2,000 ounces of codeine and 2,500 ounces of morphine in February, 1918, and the balance during July of the same year.27 With these supplies the opium-morphine-codeine situation was satisfactorily met. The question of growing the poppy in the United States and the extraction of the morphine from the dried pods was considered but was abandoned in deference to popular prejudice.

The early requirements in camphor had easily been met, but with the advent of the automatic supply table from France and the rapidly increasing number of troops in the American Expeditionary Forces quantities in excess of the supply began to become manifest. The automatic supply table called for a monthly shipment of 500 pounds per month for every unitof 25,000 men.28 Camphor was used largely in the preparation used to prevent  trench foot. The estimates of May 27, 1918, called for 125,000 pounds of camphor for the following six months.29 By September the estimates had risen to 170,000 pounds for September and October alone.30 Those for the six months ending with February amounted to 600,000 pounds.31 Synthetic camphor was not produced in the United States in sufficient quantities to meet the needs of the celluloid industry, and dependance had to be placed upon the imported natural product. Natural camphor is obtained almost exclusively from Formosa. Its export from Japan is controlled by the Japanese Monopoly Bureau,31 which, for trade reasons, limits the quantity which can be exported to any country. The requirements exceeded the import allowance and it became necessary to take up with the Japanese ambassador the question of increased import of crude camphor.31This was done in September, 1918.

The principal sources of supply of iodine, as already noted, are the nitrate beds of Chili. Since, during the year 1917, more than 700,000 pounds of iodine were shipped into the United States,32the requirements of the Medical Department for this substance during 1917 were met without difficulty. However, as more and more tonnage was diverted to the transportation of men and supplies to the American Expeditionary Forces during 1918, less tonnage was available for imports of nitrates. This limited materially the quantity of iodine which could be shipped, and the probabilities of a shortage became increasingly greater. The need for nitrates for munitions and fertilizers had stimulated their production from seaweed on the California coast. Plants were erected for the extraction of nitrates and iodine from the ash of the seaweed, and gave promise of being a valuable adjunct to the supply of those articles. The market situation on iodine eased off before the armistice was signed and the threatened shortage did not develop.


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IRON, STEEL,AND THEIR PRODUCTS

It was manifestly impossible for all industries using steel and iron in their activities to obtain their normal supply. It accordingly became necessary to curtail the consumption of iron and steel by the various industries and to limit the output so far as practicable to essential uses without destroying or seriously injuring any industry. Much was done to conserve the supply by reducing the needless lines, varieties, and sizes of products. This resulted in economy in manufacture and reduced the volume of stocks to be carried. Wasteful styles, models, and methods were eliminated. Substitutes in products and materials were provided wherever practicable for those needed in war work which conserved the latter and did not reduce production. Measures were taken, therefore, for the rationing of industry.33 The manner in which this was accomplished is described in the following chapter. Marked reduction in the quantities consumed by nonwar industries was required, amounting in many cases to 50 per cent or more. The allowance to some industries was practicallynil. To those considered more or less essential, allowances were made in proportion to their estimated importance to the public welfare.

The allowances to industries supplying articles required for war purposes were covered by priorities as already described. Therein lay the only difficulty experienced by the Medical Department in the production of equipment for its personnel and the performance of its mission. Probably because of the kind of steel, the comparatively small quantity required for the purpose, and the urgency of the need, so far as can be learned there was never any difficulty in securing steel for surgical and dental instruments and appliances. Clearances were promptly granted and satisfactory priorities given. Deliveries were made without delay. Nor did therearise material difficulty in securing an adequate supply of steel for operating-room furniture and enamel ware for cooking and serving food. When it came to steel plates for boilers for portable disinfectors and sterilizing apparatus for hospitals quite a different situation obtained. Here delay followed delay and the priorities granted did not seem to be sufficiently high to provide deliveries in a reasonable time.34 The first difficulty in securing boiler plate occurred on the contracts of December, 1917. These contracts were placed before the priorities regulations had become fully effective. Nor did the situation improve greatly after the priority system was in full swing.34

A material delay was experienced in the autumn of 1918 in securing hospital beds at a time when the hospital situation both in the United States and in France was critical. The estimates were for 300,000 beds. The interbureau procurement requisition system was in force. Because of the emergency, a contract for 100,000 bedsteads was placed fairly promptly by the procuring bureau and deliveries were made within a satisfactory period. The procurement of the remaining 200,000 did not proceed rapidly or smoothly. A controversy arose over the type of finish, the contractor, and the priority on them. These beds were of a type in which the head and foot pieces folded under the body of the bedstead for shipment. The white-enamel finish had been tried out and found unsatisfactory due to the readiness with which it


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chipped in handling. An electro-galvanized finish, which did not have this undesirable quality, was adopted instead of the white enamel. It could be had at practically the same price and was very much more durable. The director of purchases and supplies, however, disapproved the finish on the grounds that beds with that finish could be made by only two manufacturers, and directed that an aluminum paint finish be substituted for it.34 The Surgeon General protested against this ruling, but in vain.35 When it came to place the contract for the 200,000 beds the manufacturer who had already produced a great number of them offered to make the entire amount and to make deliveries at the rate of 100,000 per month. A controversy arose over the price to be paid for the beds. The procuring bureau thereupon placed a mandatory order against the manufacturer for them. When it came to securing a priority for the steel tubing the War Industries Board decided that the manufacturer had exceeded the 50 per cent civilian business allowed under a priorities ruling and refused to grant the priority. A meeting of all the bedstead manufacturers was then called and the matter discussed at length.36 The final result was that the manufacturer who had offered to make the entire lot was granted the priority, and production started more than two months after the interbureau requisition was placed.

Clearance was requested on August 24, 1918, for the purchase of 3,000 wheeled hospital litter carriers. These carriers were made entirely of steel except the rubber tires of the wheels. In the manufacture of that number of carriers 120,750 pounds of steel were required. The request was put forward at a time when the prospective need of this device in France was becoming daily more urgent. These carriers were designed to receive the patient on the litter as he came from the ambulance or train, to utilize the litter as an operating table, to finish the operation or dressing upon it, and finally to transfer the patient to the ward without removing him from the litter or the litter from the carrier during the entire process. Clearance was at first refused in the effort to conserve steel. A wooden model was proposed by the clearance committee of the War Industries Board. The representatives of the Surgeon General in conferences with the committee refused to accept the substitute for structural and sanitary reasons. A tentative clearance on 1,500 carriers was granted by the committee. The representatives of the Surgeon General considered that 3,000 was the minimum requirement and request for that number was renewed. The request was finally granted by the committee, after a forcible presentation by the chief of the finance and supply division, Surgeon General' s Office, of the results and complaints which would ensue from a failure to provide the required number of carriers.37

NONFERROUS METALS

Of this group, the metals which were of importance to the Medical Department were aluminum, antimony, copper, manganese, mercury, nickel, platinum, potassium, silver, tin, and zinc. No large quantities of any of them were required. Probably the largest requirements were in aluminum, copper, nickel, tin, and zinc.

Aluminum was used extensively for large-sized cooking utensils and for mess equipment. In the field equipment aluminum bowls, plates, and saucers


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originally were provided for the chests of tableware. Since experience proved that enamel ware could be substituted for the aluminum ware in these articles to advantage and at a considerable saving in cost, later procurements of these chests were provided with enamel ware instead of aluminum ware.38 For the very large pots (coffee boilers and stock pots of 36 to 40 size), hotel sauce pans, trays, etc., where they were subjected to rather hard usage aluminum ware was found the more satisfactory. The total purchases of aluminum vessels during the six months ending July, 1918, contained approximately 40,000 pounds of aluminum.39The estimate for the succeeding six months was 55,000 pounds.40

Antimony was used only in the official antimony and potassium tartrate of the standard supply table. Of this preparation, however, only 11,500 bottles containing one-half ounce each were purchased.So little of it was used that it never became a problem to procure the needed quantity.

Copper was required for the shells of the sterilizers and water tanks of the standard sterilizer outfits for hospitals. Alloyed with zinc, it appeared in the manufacture of the hollow instruments used in surgery. Alloyed with zinc and nickel, it appeared as nickel silver in the tableware supplied for hospital purposes, knives, forks, tablespoons, and teaspoons. Much of the tableware was silver plated and thereby involved four metals in the finished product. While difficulty was experienced in the earlier purchases by the manufacturers of sterilizer sets, in securing the shells for the dressing sterilizers and water sterilizers from the firms which drew them, no difficulty appears to have been experienced in securing a sufficient quantity of copper sheets for the instrument and utensil sterilizers. The difficulty was one of production of the semifinished product rather than of raw materials.

Manganese appeared only in the potassium permanganate of the supply table, of which, because of excessive cost, only 10,050 pounds were purchased.

Mercury finds a more extended use in medicine and hospital practice. It appears among the medicinal agents on the supply table in the forms of the corrosive chloride, calomel, yellow iodide, yellow oxide, and the salicylate. It appears as an article of dental use in the redistilled mercury, of which 11,100 pounds were purchased. It is required also in the manufacture of clinical thermometers, bath thermometers, and mirrors. While the prices for this substance were high, there was never any shortage, due to domestic production and imports.41

The chief use of nickel in medical and hospital practice is as a protective agent to prevent the rusting of instruments and as a plating for copper utensils. Its use in tableware has already been mentioned. Inasmuch as the bulk of nickel ore comes from Canada, the question was one of transportation rather than of production. No actual shortage was experienced.

Platinum finds its chief place in the medical science in the form of crucibles and wire for laboratory work, and wire for X-ray tubes.42 It also appeared in the breaker points of magnetos in the ambulances and motor cycles purchased. The quantity actually required was comparatively small. Small as it was, great conservation was necessary to provide the quantity needed. A substitute wire, called nichrome, was utilized in laboratory work to save platinum.


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Tin was required by the Medical Department only as tin plate for containers for medicines and canned foodstuffs, and for certain kitchen utensils. While the supply was limited, due to insufficient water transportation to bring it from the Federated Malay States, no real shortage developed.

Zinc finds its use in medicine in the form of the sulphate and to a lesser extent in other medicinal compounds. It is used in the making of brass, and as a protective agent for metals, such as galvanized buckets, electro-galvanized bedsteads, etc. Domestic production was adequate to the needs, and no shortage arose therein.

While there was no acute shortage of these metals, except platinum, it was only by conservation that a shortage was avoided.

WOOL

The only articles on the standard medical supply table into which wool enters as a basic raw material are blankets and woolen bandages. During 1916 the specifications for these articles had required that they be all wool. Considerable difficulty had been experienced for a number of years in securing a flannel of sufficient quality to meet the specifications and as a result the prices had been steadily increased. By 1917 the prices of this grade of flannel had increased to such an extent that their purchase was discontinued throughout the war.

The United States produces usually about one-third of its wool requirements. For the remainder it must depend upon imports from Australia and South America.43 Because of lack of ships during the latter part of 1916 and 1917 imports of wool fell off considerably and the market was unsettled. The requirements of the Government for clothing and blankets for the soldiers were enormous and the supply threatened to be inadequate and the prices high. Measures were taken very early to secure an adequate quantity of wool for the Army. Conservation of the supply became urgently necessary. Practically the entire stock in the country was secured by the Quartermaster' s Department, the supply bureau charged with providing clothing for the soldiers.43 The Medical Department accordingly revised its specifications for blankets and permitted the admixture of cotton with the wool. The blankets for field equipment were required to be more nearly all wool than those for ordinary hospital use. The majority of the blankets purchased for field use were all wool, but contained an increased amount of shoddy, approximately 35 per cent. The specifications adopted for the hospital blanket which, prior thereto had been white and all wool of not lower grade than quarter bred, were changed to the following : 44

SPECIFICATIONS - BLANKETS

MEDICAL DEPARTMENT, UNITED STATES ARMY

( 1) Composition  Warp to be white No. 6 cotton, 2,400 ends. Filling, not less than 20 per cent of new fleece wool, quarter blood or finer; 20 per cent wool noils, or reworked wool of good quality; 60 per cent cotton (China).
(2) Color.  A bright silver gray, as per sample of these specifications filed in the office of the New York medical depot, New York City. Mixture is composed of 7 per cent colored black wool, balance white stock.


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(3)  Border.  The finished blanket to have a border 3 inches wide, color medium Oxford gray, as per sample; woven across each end of the blanket 7 inches from the finished end.
   (4)  Construction.  The finished blanket shall have not less than 36-37 threads per inch in the warp, and the filling 54 to 56 picks per inch (double weave).
(5)  Weave.  Blanket to be doubleweave.
   (6)  Size and weight.  The blanket shall be 66 by 84 inches, and shall weigh not less than 4 pounds.
(7) Finish.  Like sample.

To be a strong and serviceable blanket equal in every respect to the standard sample.

The ends shall be secured from raveling by a whipped overlock stitch, equal to the standard sample. (Use white thread.)

The prices paid for blankets for field use varied between $4.25 and $6.33. Of the 848,750 such blankets purchased during 1917, 100,000 were purchased at $4.25 each; 10,000 at $4.50; 266,100 at $6.04; 253,500 at $6.10; 2,650 at $6.14; 26,000 at $6.20; and 100,000 at $6.32.45 The prices paid for hospital blankets during the same period, of which the purchases amounted to 757,085, varied between $4 each and $5.975 each. The average price for the lot was $5.25 44During 1918 the prices rose somewhat, due to the increasing military demands and shortage of wool.

COTTON AND LINTERS

Although the prices of cotton steadily advanced during the years 1917-18, there was never any shortage. The difficulties in securing the required amount of cotton fabrics was due to the magnitude of the demand for fabrics of special weave for which the machinery of the mills was not adapted. A readjustment of weaving processes was necessary. Mills that had been accustomed to weave one kind of cloth were converted to weave some other kind such as was required for Government use. The quantities of duck and canvas and of surgical gauze were enormous.

Besides surgical dressings in great quantities, the Medical Department required sheeting, towels, pajamas, bath robes, mattress covers, ticking for mattresses, muslin, tape, and canvas.

Prior to 1917 the standard mattress of the Medical Department was made of pure South American hair. This grade, which is the soft mane hair of the horse, makes a very soft and comfortable mattress especially suited to the sick. Because of the lack of ships, the quantity of hair available in 1917 was hopelessly inadequate and the prices asked for mattresses were very high. Consequently it became necessary to adopt some other substance for the purpose. Since cotton mattresses were in common use and promised to be materially less expensive than hair mattresses, it was decided to purchase them instead of the hair mattress. The early specifications for these mattresses called for a mixture of upland cotton and linters.46

During the year 1917 no difficulty was experienced, so far as known, in securing linters in such quantities as was needed. But the Ordnance Department required linters for the manufacture of explosives and ammunition, consequently, as the production of explosives increased the supply of linters diminished. The grade of linters for explosives was, ordinarily, lower than that for


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mattresses, but both were equally suitable. By the summer of 1918 the supply of linters had become so short that a linters pool was formed to take the entire output of linters.47 In addition to this there was formed a mattress linter pool to handle the mattress grade of linters. The Du Pont American Industries (Inc.) was designated as the purchasing agent. This pool included the mattress linters cut prior to May, 1918. In all, 9,888 bales of linters appear to have been purchased for this pool.47 The demand for mattresses became very heavy in the summer and fall of 1918 and the stock of linters was inadequate, so that a further variation in the specification became necessary. The Medical Department was in the market at the time for 250,000 mattresses for the standard hospital bed and for 400,000 mattress pads for a smaller sized cot used at evacuation and base hospitals for expansion purposes.48 This cot was but 30 inches wide instead of 36 inches, the width of the standard hospital bed. Several modifications of the specifications were suggested by the bedding section of the War Industries Board as being equally efficient, less expensive, and using less  middling upland cotton, than required for other purposes. The three combinations most frequently recommended were, with estimated costs, as follows:49

One-third No. 1 strips, white; one-third No. 1 peeler comber; one-third good cleaned cotton mill picker or fly; $11.61.
One-third No. 1 peeler comber; one-third good clean cotton mill picker or fly; one-third gradeA hinters; $10.66.
One-third No. 1 strips; one-third good cleaned picker or fly; one-third grade A linters; $10.26.
 
Adequate stocks of all these mixtures were available and purchases were made accordingly.

REFERENCES

(1) American Industry in the War.A Report of the War Industries Board.Government Printing Office, Washington, 1921, 82.

(2) Letter from Reuben A. Bogley, superintendent, Tophams, Washington, D. C., to Col. C. R. Darnall, M. S. D., U. S. A., Washington, D. C., June 22, 1917. On file, Finance and Supply Division, S. G. O., 713-Misc./B.  

(3) Letter from Col. H. C. Fisher, M.C., S. G. O., to J. E. Hall, American Sterilizer Co., Erie, Pa., June 2, 1917, relative to enlisting of personnel employed by that company. On file, Finance and Supply Division, S. G. O., 713-Misc./A.

(4) Telegram from the Surgeon General to Mr. Charles J. Pilling, Philadelphia, Pa., August 3, 1917, relative to exemptions.On file, Finance and Supply Division, S. G.O., 14636-9 1.
(5) Letter from the Surgeon General to Mr. Charles J. Pilling, Philadelphia, Pa., August 6, 1917, relative to exemptions. On file, Finance and Supply Division, S. G. O.,14636-91.

(6) First indorsement, Surgeon General' s Office, to the officer in charge, Medical Supply Depot, New York, February 8, 1918, relative to exemption from the draft of surgical instrument makers. On file, Finance and Supply Division, S. G. O., 713-539./405.

(7) American Industry in the War, 83.


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(8) Letter, Medical Supply Officer, U. S. Army, New York, to the Surgeon General' s Office (Attention Col. C. R. Darnall), May 24, 1918. Subject: Contracts No. 1534 and No. 2945, American Sterilizer Co., Erie, Pa. On file, Finance and Supply Division,  S.G.O., 713-529 N.Y./705.

(9) American Industry in the War, 85.

(10) Letter from American Felt Co, Boston, Mass., to the Medical Supply Depot, New York, May 27, 1918, relative to delay in deliveries of blankets. On file, Finance and Supply Division, S. G. O., 713-539 N. Y. D./743.
(11) Letter from the Surgeon General to U. S. Employment Service, Department of Labor, June 11, 1918, relative to supplying labor for American Felt Co. On file, Finance and Supply Division, S. G. O., 713-539 N. Y. D./743.

(12) Letter from Acting Assistant Director General, U. S. Employment Service, Department of Labor, Washington, D. C., to Col. C. R. Darnall, M. C., S. G.0., June 21, 1918, relative to supplying labor. On file, Finance and Supply Division, S. G. O., 713-539 N. Y. D./743.

(13) American Industry in the War, 89.

(14) Memorandum from the Assistant Secretary of War to the Surgeon General, January 21, 1918, relative to closing of certain industrial plants. On file, Finance and SupplyDivision, S. G. O., 750-660 Sec. War./16.

(15) G. O. No. 8, War Department, January 19, 1918.

(16) Letter from the Medical Supply Depot, New York, to the Surgeon General, January 22, 1918. Subject: A request for information as to what classes of manufactures should be exempted from the Fuel Administrator' s Monday closing order; and also requesting information as to how to obtain such exemptions. On file, Finance and Supply Division, S. G. O., 713-Misc./14.

(17) Letter from the Acting Quartermaster General to the Surgeon General, January 19, 1918. Subject: Procurement of coal for contractors. On file, Finance and Supply Division, S. G. O., 750-594 Q. M. G./82.

(18) Memorandum from the coordinating member of the Printers Committee, Council of National Defense, to the Surgeon General, January 15, 1918. Subject: List of urgent war products being manufactured in the State of New Jersey. On file, Finance and Supply    Division, S. G. O.,  533 N. D./44.   

(19) Letter from the Surgeon General to War Industries Board, Council of National Defense, January 16, 1918, submitting list of contractors in New Jersey supplying material to Medical Department that is urgently needed. On file, Finance and Supply Division, S.G.O., 533 N. D./44.   

(20) First indorsement, Surgeon General' s Office, to the division surgeon, Camp Taylor, Ky., December 16, 1917, relative to supplies for eye department.On file, Finance and Supply Division, S. G. O., 531-139 Taylor/57.

(21) Correspondence between the President of the American Drug Manufacturers' Association and the Surgeon General' s Office, during November, 1917, relative to quinine. On file, Finance and Supply Division, S. G. O., 422 C. J. L./1.  Also: Correspondence between Powers-Wrightman-Rosegarten Co. and the Surgeon General's Office,  November   24,  1917, to February 10, 1918, relative to supply of quinine. On file, finance and Supply Division, S.G.O., 589 P. W. R. Co./1-8.


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(22) Letter from War Trades Board to the Surgeon General, April 27, 1918, relative to the export of cinchona bark from Dutch East Indies. On file, Finance and Supply Division, S.G.O., 759 W.T.B./29.

(23) Letter from Powers-Wrightman-Rosengarten Co. to the Surgeon General (Colonel Darnall), September 10, 1918, relative to quinine situation. On file, Finance and Supply Division, S.G.O., 589 P.W.R. Co./14.

(24) Letter from Frank G. Ryan, Council of National Defense, to Col. Carl R. Darnall, M. C., S. G. O., September 20, 1917, relative to purchase of pharmaceuticals. On file, Finance and Supply Division, S. G. O., 533 N.D./265.

(25) Contracts of October 13, 1917, and November 4, 1918, between Lieut. Col. M. A. Reasoner, M. C., Field Medical Supply Depot, Washington, and Merck & Co., of New York, N. Y., for the extraction of morphine and codeine from crude opium. On file, Medical Section, New York General Intermediate Depot, Brooklyn, N. Y.

(26) Cablegram from the Surgeon General' s Office to chief surgeon, A. E. F., France, December 12, 1917, relative to purchase of morphine and codeine.

(27) Letter from the medical supply officer, New York, N. Y., to the Surgeon General, July 22, 1918. Subject: Whiffen & Sons (Ltd.), morphine-codeine.On file, Finance and Supply Division, S. G. O., 250 France/147.

(28) Letter from the chief surgeon, A. E. F., France, to the Surgeon General, April 2, 1918.Subject: Automatic supply.On file, Finance and Supply Division, S. G. O., 713-250/15.

(29) Memorandum for Director of Supplies and Purchases from the SurgeonGeneral, May 27, 1918. Subject: Camphor. On file, Finance and Supply Division, S. G. O., 750-198 D. P./45.

(30) Memorandum from Capt. Frank L. McCartney, S. C., in charge General Purchasing Office, Medical Department, to Lieutenant Bradley, August 27, 1918. Subject: Camphor. On file, Finance and Supply Division, S. G. O., 268 G. P. O./19.

(31) Letter from the Surgeon General to Purchase and Supply Branch, Department of Purchase, Storage and Traffic, August 30, 1918. Subject: Imports from Japan.

(32) American Industry in the War, 380.

(33) War Industries Board, Priorities Division, Circular No. 5, July 22, 1918. Policies and Regulations Governing Distribution of Steel and Steel Products. Government Printing Office, Washington, 1918, 2-3.

(34) Report of liaison officer, Medical Department, to the Surgeon General, October 29, 1918, on the status of interbureau procurement requisition M-36, of August 28, 1918, for 300,000 bedsteads. On file, Record Room, S. G. O.

(35) First indorsement, Surgeon General' s Office, to the War Industries Board, October 8, 1918, relative to finish of hospital beds. On file, Finance and Supply Division, S.G.O., 533 N. D./221.

(36) Report of liaison officer, Medical department, to the Surgeon General, November 4, 1918, relative to status of interbureau procurement requisitions. On file, Record Room, S. G. O.

(37) Letters from the Surgeon General' s Office to the War Industries Board, Clearance Committee, August 31, 1918, and September 26, 1918. Subject: Clearance on contract for 3,000 hospital litter carriers. On file, Finance and Supply Division, S. G. O., 533 N. D./169.


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(38) Report of Lieut. Col. M. A. Reasoner, M. C., on the Field Medical Supply Depot, August 3, 1926. On file, Finance and Supply Division, S. G. O., 713-750 F. M. S. D./x.

(39) Letters from the officer in charge, Medical Supply Depots, New York and Washington, to the Surgeon General, July 26, 1918. Subject: Aluminum required June 30, 1918, to June 30, 1919. On file, Finance and Supply Division, S. G. O., 713-750 Wash./330.

(40) Memorandum, Purchase, Storage, and Traffic Division, Purchase and Supply Branch, from Surgeon General' s Office, undated, 1918, relative to aluminum requirements. On file, Finance and Supply Division, S. G. O., 713-750 Wash./330.

(41)  American Industry in the War, 153.

(42) Letter from Maj. George C. Johnston, M. R. C., to Maj. F. F. Simpson, Council of National Defense, March 19, 1918, relative to the quantity of platinum used in X-ray tubes. On file, Finance and Supply Division, S. G. O., 533 N. D./68.

(43) American Industry in the War, 231-233.

(44) Taken from contracts for blankets made in 1917. On file, Medical Section, New York General Intermediate Depot, Brooklyn, N. Y.

(45) Prices and quantities obtained from Field Medical Supply contracts made during April-December, 1917. On file, Medical Section, New York General Intermediate Depot, Brooklyn, N. Y.

(46) Letter from medical supply officer, New York, to the Surgeon General, May 23, 1917. Subject: Specifications for pillows and mattresses.On file, Finance and Supply Division, S. G. O., 14039-52-1.

(47) American Industry in the War, 173-4.

(48) Memorandum, Surgeon General' s Office, to Director, Purchase, Storage, and Traffic Division, Purchase and Storage Branch, July 29, 1918. On file, Finance and Supply Division, S. G. O., 750-198 D. of P./172.

(49) Minutes of meeting of the bedding section of the Textile Division, War Industries Board, held on Thursday, July 25, 1918, 8.30 p. m. On file, Finance and Supply Division, S. G. O., 750-198 D. P./209.