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Chapter XVI

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

CHAPTER XVI

FIELD HOSPITAL, AMBULANCE COMPANY, AND OTHER DIVISIONAL UNIT EQUIPMENT

FIELD HOSPITAL

The experiences of the Medical Department during the Spanish-American War and the events which immediately followed it were such as to stimulate studies on the organization and equipment of the sanitary service in war. The need for a reserve equipment in time of peace to enable it to function effectively at the declaration of war had been very strongly impressed upon all medical officers who had participated in that war. The studies of this period in medical equipment were devoted largely to the requirements of the larger units. The earliest of these units to be considered and developed was the divisional unit, consisting of a hospital section called the field hospital and an ambulance section called the ambulance company.1

In the standard supply table of 1902 the authorized capacity of the field hospital was 108 beds. It was fully equipped for its own purposes and included in its hospital supplies a reserve for issue to regiments. It was intended for assignment with troops in the field wherever its services might be needed. Its capacity was considered sufficient for ordinary requirements of 5,000 effectives.2 The ambulance company was at first administered as a part or section of the field hospital,3 but later became independent.4 To meet the requirements of large bodies of troops in more or less permanent camps a camp hospital equipment of 324 beds was provided in order that the field hospitals might remain mobile and ready to march on short notice.5 The field hospital equipment served as a nucleus for that of the camp hospital.6

The equipment of field hospitals was designed to provide the maximum of treatment with the minimum of equipment. Compactness, durability, and transportability were essential factors in its design. The field hospital was intended primarily for service during active operations and only occasionally as a fixed hospital for short periods. Its equipment was designed accordingly,7 and modified from time to time as its purpose and limitations became better understood. In the earlier stages of its development emphasis was placed upon operative procedures and temporary hospitalization. In later tables of equipment the conception of the purpose of this hospital changed. Operations of election gave place to those purely emergency in character. Emphasis was placed upon the emergency, or first-aid, treatment and the preparation of the patient for evacuation to the rear. Ward equipment was minimized, and the surgical equipment greatly reduced. In 1916 the capacity of the field hospital was increased to 216 patients,8 but its equipment was so modified and


264

curtailed as to weigh, without transportation, complete and packed for shipment, but 18,200 pounds, and it occupied approximately 850 cubic feet.9 The railway requirements for the field hospital of 1916, including personnel, equipment, and animal transportation, were a train composed of 2 tourist sleepers, 1 kitchen car, 1 baggage (box) car, 3 standard stock cars for the animals, and 3 flat cars for the vehicles. 10

During the last decade of the nineteenth century the conception of the hospital service for troops in the field contemplated a single field hospital for the division, with a section for each brigade, 10 as in the Civil War. Brigade sections could he detached for service with their respective brigades when the latter were separated from the division. In later years each brigade section was made coequal with the original division field hospital, and four field hospitals were allowed each division. For purposes of control these four hospitals were grouped into a battalion under an officer designated director of field hospitals.11 This officer was immediately under the division surgeon and was the latter’s executive in respect to the field hospitals.12 He was expected to maintain contact with the director of ambulance companies, with the transport columns and the nearest hospital on the line of communications.13 Usually but one field hospital was in service. The remainder were held in reserve and were advanced into action as the battle developed and the casualties required.14 The field hospitals, when opened on the field, were to be organized into a number of departments: Dispensary, kitchen, receiving and forwarding, slightly wounded, seriously wounded, and mortuary.15 Its equipment was arranged accordingly. After combat these hospitals cleared as rapidly as possible and followed the division.16 If the sick and wounded could not be evacuated before the division moved, they were to be concentrated in one or two field hospitals so as to free the others for the advance. If any field hospital were immobilized when the troops moved, another was to be required to accompany them.17

Prior to the World War, sufficient field hospital equipments were assembled complete, except perishable articles, to equip all existing field hospital companies of the Regular Army, and as many of those of the National Guard as had been accorded Federal recognition. In addition there were 44 such equipments in reserve stored at the various medical supply depots within the United States.18

Following the declaration of war, April, 1917, the assembling of these units was resumed, with the exception of quartermaster and ordnance supplies. Quartermaster and Ordnance Department supplies required to complete the equipment were obtained by the commanding officer of the hospital company or by the camp or division medical supply officer by requisition upon the local representatives of those departments. After July 1, 1917, the greater part of the field hospital equipments issued were assembled at the field medical supply depot, Washington, D. C. The numbers issued from that depot by periods were April 1 to June 30, 1917, 27; July 1 to December 31, 1917, 38; January 1 to July 30, 1918, 58; July 1 to December 31, 1918, 118; total 241. Of this total, 118 were issued in the United States and 123 shipped to France.19 Five additional field hospital equipments each were assembled at the St. Louis and San Francisco depots. 20

A survey of the medical equipment of the National Guard made in May, 1917, by the representative of the Medical Department on duty in the Militia


265

Bureau, showed that 25 field hospital organizations were without equipment.21 These organizations, the 64 organizations in the National Army training camps, the new field hospital organizations of the Regular Army, and the additional divisions formed absorbed the number of equipments noted above as having been issued in the United States. The cost of the components of the field hospital equipment furnished by the Medical Department was approximately $4,454.34,22 making a gross cost of $1,073,495.94 for those issued from the field medical supply depot above noted.

A list of equipment of the field hospital of 1916, inclusive of all articles furnished the company by the Quartermaster Corps and the Ordnance Department, is shown on pages 275-283.

AMBULANCE COMPANY

The equipment of the ambulance company was designed on the basis of the mission assigned to it. This mission, as prescribed in the Manual for the Medical Department, 1916, had two primary objects: The collection and first-aid treatment of the wounded; the evacuation of the wounded from regimental aid stations and ambulance dressing stations to the field hospitals. For its transportation function it was provided with 12 ambulances and 3 escort or Army wagons. For collecting the wounded from the battle field it had a litter-bearer section equipped with litters, first-aid dressings, stimulants, and anodynes. The ambulance companies established dressing stations in protected places as near the battle field as practicable. It was intended that the work of these dressing stations, when operating, should have a dispensary, a kitchen, a receiving and forwarding department, a slightly wounded department, and a seriously wounded department. Dressings were to be applied as the condition of the wounded indicated, diagnosis tags applied, and records kept as required, the wounded sorted and distributed in accordance with their condition and the character of their wounds.23 To meet the most exacting conditions of field service it is necessary that the dressing station equipment be simple, compact, and easily transportable. That of 1916 was designed to be carried on four pack mules. Its contents and the manner of packing for carriage by pack mules is shown in the following table, Manual for the Medical Department: 24

M. M. D. 878. Method of packing the dressing station equipment


266

Method of packing the dressing station equipment - Continued
 

The table of equipment of an ambulance company, as published in the supply table of 1916, was designed for animal-drawn transportation. Motor ambulances, while under consideration, had not been definitely adopted and were not available for issue. It remained for the mobilization on the Mexican border in the summer of 1916 to crystallize the sentiment in favor of the motor ambulance and to establish it on a firm basis as a unit of transportation for the Medical Department. Thereafter both types of ambulances were used. The account of the ambulance is given in the chapter devoted to that subject. With the advent of the motor ambulance the requirements of ambulance company equipment changed somewhat, a part of the supplies being basic and another part relating necessarily to the type of transportation furnished. The components of the animal-drawn and motor-drawn equipments, respectively, are given in the table of equipment for the sanitary train of the division found at the end of this section.

For the rail transportation of the personnel and equipment of an animal-drawn ambulance company at war strength and with full equipment required 3 tourist or standard sleeping cars for the personnel, 1 kitchen car, 1 baggage or box car, 5 standard stock cars for the animals, and 5 flat cars for the vehicles.25 For the motorized company 6 fiat cars were required for the ambulances and 1


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box car for the company baggage, the spare parts car or trailer, and the accessories and detachable parts of the several ambulances were substituted for those required for the animal-drawn transportation.

Prior to 1916 in assembling ambulance company equipment at the medical supply depots, quartermaster and ordnance supplies, less transportation, were obtained from the respective departments and incorporated in the unit as it was assembled. In equipping the Medical Department units in 1917-18 only medical supplies and equipment were issued from medical supply depots. The articles normally furnished by other supply departments were obtained from the local representatives of those departments at the concentration or training camps.26 Replenishments in the field were obtained from divisional supply officers of the respective departments--Medical, Quartermaster, Ordnance.

The cost of ambulance company equipment varied, from time to time, according to the cost of the component articles. The part of this equipment issued by the Medical Department, less transportation, during 1917-18 was approximately $1,914.78. This gives a total for initial equipment issued during that period of $756,338.10, including equipment in storage, at the declaration of war and that assembled thereafter.27

The complete equipment of a sanitary train is as follows:


268

TABLE 28 - Sanitary train - Infantry division, maximum strength


269

TABLE 28 - Sanitary train - Infantry division, maximum strength - Continued


270

TABLE 28.- Sanitary train - Infantry division, maximum strength - Continued


271
TABLE 28 - Sanitary train--Infantry division, maximum strength - Continued


272

TABLE 28 - Sanitary train--Infantry division, maximum strength-Continued


273

TABLE 28 - Sanitary train -Infantry division, maximum strength - Continued


274

TABLE 28. - Sanitary train - Infantry division, maximum strength - Continued


275

TABLE 28. - Sanitary train -Infantry division, maximum strength - Continued


276

TABLE 28. - Sanitary train -Infantry division, maximum strength - Continued


277

TABLE 28. - Sanitary train -Infantry division, maximum strength - Continued


278

TABLE 28. - Sanitary train -Infantry division, maximum strength - Continued


279

TABLE 28. - Sanitary train - Infantry division, maximum strength - Continued


280

TABLE 28.– Sanitary train - Infantry division, maximum strength - Continued


281

TABLE 28. - Sanitary train - Infantry division, maximum strength - Continued


282

TABLE 28. – Sanitary train - Infantry division, maximum strength - Continued


283

TABLE 28. - Sanitary train - Infantry division, maximum strength - Continued


284

TABLE 28. - Sanitary train - Infantry division, maximum strength - Continued


285

TABLE 28. - Sanitary train – Infantry division, maximum strength - Continued

OTHER DIVISIONAL UNITS

Beside the regimental medical detachments, field hospitals, and ambulance companies, there were other agencies of the Medical Department for which special unit equipment was considered necessary. They were the division surgeon, the division veterinarian, and the division mobile veterinary section.

DIVISION SURGEON

The duties of the division surgeon were quite extensive. They were both advisory on all matters pertaining to the sanitary welfare of the command and administrative on those pertaining to the personnel and equipment of the sanitary service under organization commanders.28 He was required to take action on all official papers passing through his office, and for this purpose he


286

maintained an office of record. He rendered daily consolidated reports of sanitary personnel, transportation, and patients. For this purpose a large supply of appropriate blank forms was kept on hand. In addition to these duties, the division surgeon supervised and directed inspection of the sanitary conditions in the division and of the medical units thereof. He arranged for the care and disposal of the sick and wounded of the division, and performed numerous other duties in connection with the medical service of the division.29

For the use of his office the following equipment was provided:30

M. M. D. 884   Division surgeon's office

M.M.D. 885.  BLANK FORMS, DIVISION SURGEON’S EMERGENCY SUPPLY
 
Each division staff officer is required by Army Regulations to keep on hand an emergency supply of blank forms pertaining to his department, preferably carried in the supply train. Such emergency supply for the division surgeon will consist of the following:

NOTE. - For key to form numbers see par. 961.


287

DIVISION VETERINARIAN

The division veterinarian was one of the technical assistants of the division surgeon. His duties related to the care of the animals of the division and to the professional supervision of the veterinary personnel attached to the division. His duties were closely related to those of the division surgeon, but because of the special character of the work done the division veterinarian
was provided with the following office equipment: 31a

Brooms, corn, number

1


Lantern, candle, folding, number

2

Candles, do

24


Typewriter., number

1

Chair, folding, do

3


Typewriter ribbon, do

2

Desk, field, No.1, veterinary, do

1





MOBILE VETERINARY SECTION

In the development of units of organization of the Veterinary Corps in 1917-18 to adapt it to field service and combat conditions a divisional unit was provided under the title “Mobile veterinary section.” One such section was allowed each division. The duties of this organization with reference to disabled animals were similar to those of a field hospital in the care of the disabled personnel of the division. A unit equipment was designed and provided for this organization. Inclusive of the individual equipment of commissioned and enlisted personnel of the organization this unit equipment contained the following: 32

Boxes, pack mule (for miscellaneous articles), number

2


Saddle, pack, number

1

Chest:



Wallet:


 

Veterinary, field unit, do

4


 

Farrier's

2

 

Veterinary officer's, do

1


 

Veterinary officer's

1

REFERENCES

(1) Manual for Medical Department, 1902, pp. 152-171.
(2) Ibid., 1902, par. 288
(3) Ibid., 1906, pars. 544-553
(4) Ibid., 1911, parts. 560, 622, 628
(5) Ibid., 1906, par. 559
(6) Ibid., 1916, par. 886
(7) Ibid., 1906, par 553.
(8) Ibid., 1916, par. 879, p. 286, Equipment C.
(9) Ibid., 1916, 881
(11) Ibid., 1916, par 691.
(12) Ibid., 1916, pars. 692-693.
(13) Ibid., 1911, pars. 648-650; Manual for the Medical Department, 1916, par. 694.
(14) Ibid., 1916, par. 702 (a).
(15) Ibid., 1916, par 703.
(16) Ibid., 1916, par 707.
(17) Ibid., 1916, par 707 (a).
(18) First indorsement Surgeon General to the Chief of Staff, December 9, 1915, relative to medical supply depots and reserve supplies. On file, Record Room,
S.G.O., 152911 (old Files).
____________________________________________________________
* A more complete description of this equipment will be found under veterinary equipment.


288

(19) Data compiled in 1927 from the property returns of the Field Medical Supply Depot. On file in the Office of the Chief of Finance under the supervision of C. E.
Stoddard, Principal Clerk, Finance and Supply Division, S. G. O.
(20) Letters, Surgeon General, to the medical supply officers at St. Louis, Mo., March 3, 1917, and San Francisco, Calif., May 23, 1917, relative to assembling medical unit
equipment. On file, Finance and Supply Division, S. G. O., 12892-x-1 (Old Files).
(21) Memorandum from the Militia Bureau to the Surgeon General, May 23, 1917, relative to National Guard medical units, which required equipment. On file, Finance and
Supply Division, S. G. O., 12892-X-1 (Old Files).
(22) Equipment “C” supplies, Field Hospital, Par. 879, Medical Supplies Only, Field Medical Supply Depot, 1918. On file, Medical Section, New York General Intermediate Depot,
Army Supply Base, Brooklyn, N.Y..
(23) Manual for the Medical Department, 1916, pars. 668-690.
(24) Ibid., 1916, par. 878.
(25) Ibid., 1916, par. 876.
(26) General Orders, Nos. 63 and 137, War Department, July 23 and October 30, 1917.
(27) Data compiled in Surgeon General’s Office during the war period, in possession of the author.
(28) Manual for the Medical Department, 1916, par. 743.
(29) Ibid., 1916, par. 744.
(30) Ibid., 1916, par. 884-885.
(31) Par. 992. Additional paragraph to Manual for the Medical Department, 1916, proposed by the Surgeon General, February 19, 1918, and used thereafter. On file, Finance
and Supply Division, S. G. O., 750-714 S. G./732.
(32) First indorsement, Surgeon General, to division veterinarian, 88th Division, Camp Dodge, Iowa, July 23, 1918, relative to overseas equipment. On file, Finance and
Supply Division, S. G. O.,  531-123 Dodge/204.