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Medical History, 99th Infantry Division

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MEDICAL HISTORY
99TH INFANTRY DIVISION
FOR CALENDAR YEAR 1944   


TABLE OF CONTENTS

Section

I.   Date of Activation and Early History
   
II. Operations and Missions  

III.  Military and Civilian Personnel.

IV.  Training of Personnel, Equipment, Literature, Training Aids, Participation in Exercises, Special Courses.

V. Equipment, Supplies and Transportation.  

VI.  Improvisation of Techniques, Procedures and Equipment. 

VII. Conservation of Material and Manpower.  

VIII.Housing, Water Supply, Bathing Facilities, Laundry.

IX.  Food and Messing, Sewage and Waste Disposal, Insect Control.   

X. Venereal Disease Control.  

XI.  Professional Medical and Surgical Services.  

XII. Nursing, Dental and Veterinary Service.  

XIII.Evacuation.  

XIV.Welfare, Social Service and Recreation.  

XV.Other Subjects of Interest.

Appendices   
 
   *  * *


HEADQUARTERS, 99TH INFANTRY DIVISION
Office of the Division Surgeon
A.P.O. 449, c/o Postmaster
New York, New York

  28 January 1945

SUBJECT:Medical History, 99th Infantry Division.

TO    : The Surgeon General, U. S. Army, Washington, D. C.
(Through Technical Channels).

The Medical History of the 99th Infantry Division for the calendar year 1944 is submitted in compliance with instructions in paragraph 6, AR 40-1005, Circular Letter No. 168, 1942, No. 81, 1943, Office of the Surgeon General, and Circular Letter No. 143, 1944, Office of the Chief Surgeon, ETO, United States Army.

I. Date of Activation and Early History:

The 99th Infantry Division was activated 15 November 1942 at Camp Van Dorn, Mississippi. The basic directive concerning the activation was WDAGO letter, file AG 320.2 (8-25-42) MR– MGN dated 28 August 1942, subject, “Ordering Into Active Service the 99th, 100th and 103rd Infantry Divisions during November, 1942.” The Division was activated under the command of Major General Thompson Lawrence with Brigadier General (now Major General) Harry Collins as Assistant Division Commander. General and special staff office cadres began arriving for duty on 28 September 1942. Regimental and battalion officer cadres arrived on or immediately after 10 October 1942. The enlisted cadre from the 7th Motorized Infantry Division Camp San Luis Obispo, California, consisting of approximately 1,285 enlisted men, arrived on and immediately subsequent to 20 October 1942. Camp Van Dorn, adjacent to and south of Centreville, Mississippi, was not complete upon arrival of the cadre, however, it was practically complete by 1 January 1943.

Original plans called for the arrival of recruits during the period l5 to 30 November 1942. The original shipment, however, was not received until 4 December 1942. Shipments of various sizes continued to arrive until 7 January 1943 when the total Division assigned strength was 879 officers and 15,87l enlisted men. The enlisted fillers that were received were sent direct from Reception Centers and averaged 26.4 years  of age. Many were 38 years of age or over. As the result of current directives 2,333 men were separated for the Division during l942 because of physical disabilities or other reasons. Approximately 766 men were given Certificates of .Disability for Discharge and 82 were discharged under the provision of Section VIII, AR 615-360. An intensive conservation of manpower program was organized in compliance with War Department Circular 293, 11 November 1943, and after careful screening processes, all physically substandard men had been reassigned within the Division according to their physical capabilities.

The Division, on date of activation, was organized under Table of Organization 7 dated 15 August 1942 which authorized 748 officers, 45 warrant officers, and 14,758 enlisted men. The Quartermaster Battalion, however, had just been eliminated


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from infantry divisions and a Quartermaster Company and Ordnance (Light Maintenance) Company substituted. This change also eliminated the Quartermaster Battalion Medical Section.

The Medical Office cadre had from six months to two and one-half years duty except for two officers who had from five to ten years service respectively. The officers joined the Division from Second and Third Army units from Missouri, Mississippi, Texas and Arizona. In addition to the Medical Corps officers, a Division Dental Surgeon, a Division Veterinarian, and a Medical Administrative Corps Supply Officer were received. Dental officers (10) were received from Camp Barkeley, Texas, and the remainder of the Medical Corps officers (15) from Camp Robinson, Arkansas, and Medical Administrative Corps officers (8) from Camp Barkeley, Texas.

TBA supplies were received in a number of shipments as automatic issue on requisition submitted by Chief os Supply Branches. Approximately 35% of the medical equipment had been received by the Medical Battalion and Medical Detachments at the end of the year.

During the year 1943 the Division continued to function under Table of Organization and Equipment 7 dated 15 August 1942 until 15 August 1943, at which time it was reorganized under Table of Organization and Equipment 7 dated 15 July 1943. This Table of Organization authorized 737 officers, 44  warrant officers, and 14,248 enlisted men in the Division. It also activated the Special Troops Medical Detachment, attached to Division Headquarters Company. The Division Veterinarian and his assistant were dropped from the Table of Organization and a Division Neuropsychiatrist was added to the Division Surgeon's Section. The Table of Organization authorized 52 Medical Corps officers, 12 Dental Corps officers, and 12 Medical Administrative Corps officers. No other major changes in the Table of Organization affected the Division Medical Service. The authorized enlisted strength, Medical Department, for the entire Division wad 886 enlisted men. On 1 January 1943, 59 Medical Corps officers, 13 Dental Corps officers, and 10 Medical Administrative Corps officers were present for duty in the Division. During the year officers were lost by transfer, etc., and on 31 December 1943, the assigned officer strength as 27 Medical Corps officers, 14 Dental Corps officers, and 14 Medical Administrative Corps officers.

Major changes in the Table of Equipment occurred in the new Table of Organization and Equipment dated 15 July 1943 and in subsequent changes published during the year, as follows:

a.Seventeen radios were authorized for the Medical Battalion. These were later deleted by Change 1 to Table of Organization and Equipment 8-16 and 8-17 dated 3 September 1943.

b.The authorized allowance of ambulances was reduced from 36 to 30.

c.Medical Department transportation was reduced approximately 8%.

Medical organization equipment was received in a number of shipments during the year. The status of Medical Department equipment as of 1 January 1943 was approximately 35%. On 1 January 1944, approximately 93% of the Medical Department equipment had been received by the Division


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An adequate number of training manuals and training aids were available or improvised during the year. In general, Mobilization Training Program 8-1 was used as the basic program for Medical Department personnel. In addition to basic, unit, combined and maneuver training,  special training was arranged for Medical Department personnel. This included Medical Officers’ Schools, special training for surgical and medical technicians in dog surgery. Courses in operating room technique, surgical assistance, laboratory technique, medical and surgical nursing training, were given at the Station Hospital, Camp Van Dorn, Mississippi and at the Station Hospital, Camp Maxey, Texas. The Division successfully completed “D” series maneuvers at Camp Van Dorn, Mississippi, in August and September 1943, and “A” series maneuvers in Louisiana. during September, October and November 1943, after which the Division moved to Camp Maxey, Texas.

The Assistant Division Commander left the Division in May 1943 and was replaced by Brigadier General William B. Bradford. The Division Commander left the Division in August 1943 and was replaced by Brigadier General (now Major General) Walter E. Lauer.

During the year the health of the command was excellent.  There were  no major medical problems except a moderate upper-respiratory epidemic and 57 cases of meningitis during the first three months of the year. There were no deaths as a result of this epidemic.

II.   Operations and Missions

During the period 1 January 1944 to 6 September l944, the Division completed a series of post maneuver training programs.

During the period 9 to 19 September 1944, the Division was engaged in a rail movement to Camp Miles Standish, Massachusetts, where it was staged for overseas movement during the period 19 to 29 September 1944. On 30 September 1944 the Division embarked at Boston Port of Embarkation for France.

The Division disembarked at several ports in Northwestern England on 11 October 1944 as the result of a change in orders received enroute. During the period 12 October to 2 November 1944 the Division was stationed in Southern England.

During the period 2 to 9 November 1944 the Division was engaged in a movement from Southern England to Belgium, embarking at several channel ports in England and disembarking  at LeHavre, France. The Division moved by motor from LeHavre, France to its assembly area in the vicinity of Aubel, Belgium.

Combat teams of the 99th Infantry Division relieved similar elements of the 9th Infantry Division on 9, 11, and 14 November 1944, respectively, who were occupying a defensive position approximately 25 kilometers in length extending from the vicinity of Monschau, Germany, to the vicinity of Losheim, Germany. The mission of the Division was to defense the flank of V Corps along this line. During the period 9 November to 11 December 1944, the Division executed its defensive mission with active patrolling.


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On 12 November 1944, the 2nd Infantry Division replaced one combat team (minus) of the 99th Infantry Division in the middle of the sector.  (Appendix No. II) The combat team minus one battalion which was replaced by the 2nd Infantry Division assembled on the right flank of the 2nd Infantry Division prepared for offensive action. One battalion plus the Division Reconnaissance Troop continued to defend the original defensive line extending from the vicinity of Monschau, Germany to the left (North) flank of the 2nd Infantry Division, and on 13 December a general attack was initiated by V Corps which involved, among other divisions, the 2nd Infantry and elements of the 99th Infantry Division. (Appendix No. III)  The mission of the 99th Infantry Division was to protect the right flank of the offensive. The offensive progressed according to plan until 16 December 1944 when a strong enemy counteroffensive was initiated against the right (South) flank of the Division. (Appendix No. IV) As a result of extreme enemy pressure and a large scale breakthrough in the adjacent (South) Corps sector, the Division was forced to withdraw during the course of the following five days approximately 7,500 yards to prepared defensive positions approximately 2,000 yards east of Elsenborn, Belgium. (Appendix No. V). The mission of the Division, in conjunction with the 1st and 2nd Infantry Divisions,  was to defend the North shoulder of the enemy breakthrough and the Division frontage was reduced to approximately 2,500 yards. The infantry battalion and the Division Reconnaissance Troop which was defending in the Monschau-Hofen area, had been attached to the 9th Infantry Division and continued to defense in this position. The tactical disposition of the Division remained unchanged throughout the remainder of the year. A detailed account of the action during the period 1 to 31 December 1944 as recorded by G-3 99th Infantry Division is attached as Appendix No. I. Also, the histories of the Medical Detachments of the three infantry regiments, and the 324th Medical Battalion are attached as Appendix No. VI. [These unit reports can be found  in the Battle of the Bulge folder of this section-ed.].

From the beginning of the year until the time of arrival in the European Theater of Operations, there were no operational problems involving the Division Medical Service. The Division Medical Service was able to perform its mission in the European Theater of Operations in an excellent manner and no major changes or adaptations of organization were necessary to meet the varying situations with the following exceptions:

During the period 13 to 16 December 1944 as the result of anticipated increase in the casualty density during the offensive operation on the wide front, a provisional collecting company and battalion aid station organized from the Medical Battalion were put into operation in addition to the organic medical units of the Division. These provisional units continued to function throughout the first seven days of the enemy counteroffensive after which time their services were no longer required.

During the period 13 to 20 December 1944 evacuation problems were increased due to snow, rugged, heavily-wooded terrain and the lack of adequate road nets in the forward positions. Long hand-litter carries ware necessary and litter jeeps proved of exceptional value whenever they could be utilized. Sleds improvised from civilian skis proved of value in the deep snow. Additional litter bearers were obtained from line troops when necessary. It was unnecessary to call upon higher medical echelon for reinforcements.


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III.Military and Civilian Personnel

On 1 January 1944, 27 Medical Corps officers, 14 Dental Corps officers and 14 Medical Administrative Corps officers were on duty with the Division. The number of officers assigned varied considerably throughout the year as shown by the following chart:


DATE

MC

DC

SnC

MAC

WO

 

1 January 1944

27

14

0

14

2

31 January 1944  

21

13

0

18

1

29 February 1944 

17

13

0

17

1

3l March 1944 

19

12

0

17

1

30 April 1944

15

12

0

15

1

3l May 1944

30

12

1

24

2

30 June 1944  

28

12

1

23

2

31 July 1944 

41

12

1

23

2

31 August 1944  

44

12

1

22

2

30 September 1944

44

12

1

22

2

31 October 1944

44

12

1

22

2

30 November 1944

44

12

1

22

2

31 December 1944 

42

10

1

21

1



During the month of April 1944 two additional officers were lost that are not shown on the chart,  since replacements had arrived by the end of the month. War Department Circular No. 99 dated 9 March 1944 authorized the substitution of a Sanitary Corps officer in place of a Medical Corps officer as the Division Medical Inspector. The S-3 of the Medical Battalion, formerly a Medical Corps officer, was replaced by a Medical Administrative Corps officer.  War Department Circular 122, dated 28 March 1944 authorized replacement of Medical Corps officers with Medical Administrative Corps officers as assistant Infantry battalion surgeons. In addition an assistant Regimental Surgeon, Medical Corps officer, was authorized. As a result of these changes, the authorized Medical Department officer strength of the Division was as follows:

MC  DC  SnC  MAC  WO
 44    12   1 22 2

By September the authorized strength of 79 Medical Department officers had been received. This strength was maintained throughout the remainder of the year, except for the latter half of the month of December when combat losses reduced the total to 74 officers as follows:

MC  DC  SnC  MAC  WO
42 10 1 21 1

There were no material changes in the authorized Medical Department enlisted strength throughout the year with the exception of a decrease of seventeen Privates Basic (521) authorized by Section III, War Department Circular 266 dated 29 July 1944. The enlisted strength as of 1 January 1944 was 827 and fluctuated only slightly during the ensuing four months. Thereafter enlisted strength was maintained at authorized Table of Organization level.


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Upon arrival in the European Theater of Operations the enlisted strength was 867 but had dropped to 725 by 31 December 1944 as a result of battle losses. Medical Department losses during the period 9 November to 31 December were as follows:
 


KIA
O/EM

MIA
O/EM

WIA
O/EM

NBC
O/EM

TOTAL
O/EM

393rd Infantry Regiment

 

0/0

2/37

0/8

0/10

2/55

394th Infantry Regiment

0/0

0/29

0/5

0/13

0/47

395th Infantry Regiment

0/0

0/1

0/8

3/9

3/18

99th Infantry Division

0/0

0/1

0/1

0/1

0/3

324th Division Artillery

0/0

0/0

0/1

0/1

0/2

324th Medical Battalion

0/0

0/8

0/11

0/22

0/41

99th Special Troops

0/0

0/0

0/0

0/0

0/0

Total

0/0

0/76

0/34

3/56

5/166



One complete infantry medical section with forty casualties in the aid station was overrun by the enemy on 17 December 1944. In another instance, a group of 14 enlisted men out of a regimental headquarters medical section were overrun by the enemy.

The total officer and enlisted strength of the Division fluctuated considerably throughout the year as the result of transfers to overseas replacement depots, alerted units, and physical disabilities, as indicated by the following chart:


JAN

FEB

MAR

APR

MAY

JUN

JUL

AUG

SEP

OCT

NOV

DEC

Officers

832

844

750

573

697

686

747

759

757

774

777

646

Warrant Officers

39

37

40

42

42

39

44

44

44

44

44

39

Enlisted Men

11,988

12,096

14,280

13,537

13,250

12,552

12,667

13,771

13,360

13,212

12,904

11,080

TOTAL

12,869

12,977

15,070

14,152

13,989

13,277

13,458

14,574

14,161

14,030

13,725

11,765


   
Fillers were received in small groups from time to time and in addition two large shipments were received. During March 1944., 2,900 enlisted men were received from ASTP units, 450 of which were assigned to the Division for training only and were later transferred to other units.  During the month of August and the first week in September 1944, 1,625 filler replacements were received to bring the Division to authorized strength for overseas movement. All filler replacements received during the year were given complete medical examinations on arrival and were assigned to duties commensurate with their physical capabilities.


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After arrival in the European Theater of Operations, reinforcements were obtained through normal channels.  Requisition were filled in accordance with availability and priority. At the end of the year the Division was under strength 91 officers and 3e158 enlisted men including 5 Medical Department officers and 144 Medical Department enlisted men.

IV.Training of personnel, Equipment, Literature, Training Aids, Participation in Exercises, Special Courses:
   
During the first eight months of the year, the combat troops were engaged in a series of post-maneuver training phases, including intensive field operations, night operations, combat in villages, and combined operations with overhead artillery fire. Troops were required to live in the field two weeks out of each month. Medical Department personnel participated in combat training where practicable. In addition, special courses were arranged for the training of Medical Department officers and enlisted personnel. As a continuation of the program instituted during the previous year, medical and surgical technicians were rotated through courses of training in operating room technique, laboratory technique, and medical and surgical nursing for six weeks periods at the Regional Hospital, Camp Maxey, Texas. All medical units were required to continually review basic medical subjects with particular attention to the care and transportation of the wounded, splinting and bandaging, transfusion technique, etc., under all conditions, both day and night. Training aids, including TE, TBA and TA equipment, technical and field manuals, training films and film strips and other training aids were adequate to accomplish the training mission throughout the year. The Division Medical Service continued intensive training programs for the remainder of the Division in malaria control, first aid and basic medical subjects in compliance with War Department Circular No. 223, 1943, and No. 48, 1944, respectively. All personnel who failed to meet the required standards of training were retrained and retested until these standards were obtained. In addition to the training mentioned above, the plans and operations department of the Division devised a program for testing all squads of  combat troops, in which approximately 25 to 30 practical field problems were presented to each squad. Each situation was supervised and umpired by officer personnel. Two medical situations were included in the program in which the squad was assessed various types of casualties during a tactical operation and required to render first aid treatment. Combat infantry tests which included testing on medical subjects were also conducted during the year. Orientation lectures on Venereal Disease Control,  personal hygiene, sanitation and medical problems in overseas theaters were repeatedly given prior to arrival in the combat zone.

V.Equipment, Supplies and Transportation

The status of medical equipment as of 1 January l944 was approximately 93% complete. By the time the Division moved to the staging area all medical equipment, supplies and transportation authorized had been received. Upon arrival in the European Theater of Operations, a number of items which failed to arrive within two weeks of debarkation were re-requisitioned. However, immediately before embarking for the Continent, all original equipment arrived and it was necessary to turn in the excess. One M.D. Chest 61 and one M.D. Chest 62 were authorized the Division Clearing Station in the European Theater of Operations and were obtained.

During the five weeks following the commitment of the Division to combat, there was no loss of Medical Department equipment or transportation. Medical supplies


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were obtained through normal channels and with the exception of several medications,  such as turpin hydrate, cough syrup, etc.,  were available in adequate quantities

As a result of the enemy offensive of 16 December 1944 and the subsequent action, three ambulances and certain items of Medical equipment were lost. Battle losses of Medical equipment were quickly replaced through normal Medical Supply channels and at the end of the year all authorized equipment was on hand.

At the time the Division arrived at the front, it. had not received overshoes. Overshoes in limited quantities became available about the middle of November 1944. Approximately 95% of the personnel of the Division had received overshoes by 12 December 1944.. There were no other shortages of equipment affecting the health of the command.

VI.Improvisation of Technique, Procedures and Equipment

Upon arrival in Belgium, all Medical Department 1/4 ton trucks, 4 x 4 were equipped with metal racks welded and bolted to the vehicle frame for the purpose of carrying litter patients. These were devised in a manner so that two litters could be clamped over the hood crosswise and two could be clamped on the rack above the body, lengthwise, at the height of the windshield. An additional litter could be carried slung from the frame over the body, and one litter could be carried over the back seat, resting on the body of the truck.

As a result of deep snow during December 1944, which created a problem in hand litter evacuation, litter sleds sets devised by using civilian skis bolted to a frame capable of carrying one litter. Several types of toboggans were built using a sheet of metal, plywood and spruce for the evacuation of litter patients. Upper surfaces were padded with salvage canvas eliminating the necessity of a litter. Patients were strapped into position on the toboggan with salvaged adjustable canvas straps so that they could be evacuated over all types of terrain without being dislodged from the toboggan. Snow shields were devised over the cowling and sides of the front of the toboggan to protect the patient's head. Front and rear towing and guide ropes were necessary to transport the patient across steep valleys and ravines.  It was planned to tow these in   series behind Weasels [M-29s] if necessary, however the necessity did not arise.

Wires were strung lengthwise in each ambulance along each side and in the middle for the purpose of carrying extra blankets and holding plasma bottles during transfusion.

Rest dugouts were constructed immediately behind front line Infantry battalion positions. Walls were lined with shell cases and containers were filled with dirt. Fire places were constructed in the dugouts by using shell cases and containers. Chimneys for fire places were built by digging holes through frozen earth to the fire place and using the shell containers above ground for a smoke stack. These dugouts aided materially in the prevention and control of combat exhaustion, trench foot and frost bite. Similar rest installations were constructed in rear areas when buildings were not available for troop rotation.


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An electric motor was procured locally and converted for use in the dental laboratory by machining the two ends of the motor shaft to fit the dental chucks used in the M.D. Chests 61 and 62. The use of this motor in place of the lathe for trimming and polishing dentures increased the speed of fabrication of dentures and the capacity of the laboratory by approximately three times.

In order to provide dental flasks that have not been available, shell casings of expended 105mm Howitzer ammunition were used to make flasks. They have met every requirement for processing artificial dentures of this Division and attached units.

VII.Conservation of Material and Manpower

All salvageable material such as empty vials and other metal or glass containers were collected and returned to medical supply points in compliance with current directives. Medical supplies condemned by higher headquarters were likewise returned medical supply points. No enemy medical equipment was captured during the year

The intensive conservation of manpower program directed by War Department Circular No. 293, 1943, was continued throughout the year. All personnel of the Division and all  subsequent filler replacements were given thorough medical examinations and classified in accordance with current directives. All personnel who did not meet the minimum requirements  of MR 1-9 appeared before a Division Board appointed for the purpose of determining the physical and military capabilities of the individual, and reassigned them accordingly within the Division. During the course of the year approximately 4,000 enlisted men were found to be below the minimum standards of MR 1-9. The majority of these were retained and reassigned within the Division when necessary. Of those retained within the Division approximately one-half had correctable defects which were corrected. Those who could not be used in any capacity within the Division were transferred according to current directives to non-combatant units or discharged under the provisions of AR 615-360.

As a part of the manpower conservation program, all personnel suspected of having any type of mental or personality disorder were screened by the Division Psychiatrist. Between 1 January and 30 September 1944 a total of 1,177 enlisted men and officers were examined. Five additional cases were seen by the Division Psychiatrist prior to going into combat. All personnel with mild and some with moderate and moderately severe psychoneurotic disorders were retained within the Division. These cases were used in positions least likely to aggravate their psychiatric condition. It was observed that the majority of cases of psychoneurosis developed or became manifest in the rifle companies or heavy weapons companies and hence many potential or known psychoneurotics as possible were reassigned to other units within the Division. Psychotherapy was given whenever indicated.

Of the 1,182 psychiatric consultations completed in the precombat training phase, the following dispositions of cases were made:

Retained by the Division:
Minimal or non-psychiatric Disorder  200
Mild or moderate cases salvaged   387
Total retained by the Division 587


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Cases Transferred from the Division:
Moderate and severe cases 595

A number of fillers replacements assigned to the Division had previously been returned to the United States from overseas theaters because of psychiatric disorders. During the first thirty-four days of combat while the Division was engaged in defensive operations with active patrolling, winter conditions prevailed with temperatures as low as 20°, intermittent snow and considerable rain. During this period (9 November to 12 December 1944) 30 cases of combat exhaustion occurred. Most of these cases were of the anxiety state type although several conversion hysterias  resulted and a few psychopathic personalities with or without accompanying enuresis became manifest. It is interesting to note that during this period only four of the former known mild psychiatric cases found by the Division Psychiatrist in the precombat training phase were admitted as psychiatric cases. During the Division's offensive operation (13 to 15 December 1944) 13 cases of combat exhaustion occurred in the Division. Two hundred cases of combat exhaustion occurred in the Division as the result of the enemy offensive between 16 and 31 December. Of these cases only one had been given a psychiatric diagnosis in the precombat training phase. As a general policy, combat exhaustion cases were held for forty-eight hours in the Division Clearing Station if the tactical situation permitted and then returned to duty at the end of that time or evacuated to the rear. Of the combat exhaustion cases which occurred prior to 16 December to 31 December 1944, 80% were returned to duty. Thirty-one per cent of the cases of combat exhaustion which occurred during the period 16 December to 31 December 1944 were returned  to duty. The decrease in percentage returned to duty was the result of the inability of the Division Clearing Station to hold combat exhaustion patients because of the large number of wounded. It is of interest that the majority of cases had fairly normal past and family histories with respect to psychiatric disease. The one single predominant causative factor,  in almost all of the exhaustion cases developing after the onset of the enemy offensive, appeared to be the intensity of artillery and mortar fire.

Prior to the enemy offensive and between 20 and 31 December 1944, the Division policy was to hold all cases of disease and slightly injury in the Clearing Station that could be returned to duty within ten days. Of the 1,549 admissions to the Clearing Station during the period 9 November to 15 December 1944, inclusive, 302 or approximately 20% were returned to duty. Of 1,825 cases admitted to the Clearing Station during the period 16 to 31 December 1944, only 93, or approximately 5% were returned to duty. This decrease in percentage was due to the increase in the number of patients wounded in action requiring further evacuation and to the fact that the Clearing Station was unable to hold minor cases of disease or injury because of the heavy casualty flow.
   
VIII.Housing, Water Supply, Bathing Facilities, Laundry:

 During the first eight months of the year, the Division had the benefit of excellent housing facilities, water supply, bathing facilities and laundry service at Camp Maxey, Texas. Barracks were adequate two-story frame buildings of the Zone of the Interior type, providing an average floor space of 70 square feet per man. The camp water supply, obtained from a rapid sand filtration plant operated by the city of Paris, Texas, was excellent. All barracks buildings had adequate shower facilities with hot and cold water. A camp Quartermaster laundry adequately supplied all Division laundry needs. Dry cleaning and pressing service was available through the camp Post Exchange and local civilian facilities in Paris, Texas.


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The accommodations provided on troop trains, at the staging area and on the troop transports were adequate with respect to housing, water supply and bathing facilities.

During the three week period the Division was stationed in England, housing conditions were generally adequate. Troop billets varied from modern brick hutments and civilian residences to tents. Heating in many instances was inadequate. Floor space per man varied from 35 square feet in one instance to more than 70 square feet. Head to foot sleeping was enforced and cubicles were used. During the Division's stay in England all water was considered non-potable and chlorination was required. Bathing facilities were not uniformly ideal but were generally adequate. For the most part, troops did their own laundry.

After arrival in the combat zone, housing varied from fox holes, dugouts and other improvised shelter in the forward areas to satisfactory billets in civilian homes and buildings in the rear areas. All water was considered non-potable and troops were required to obtain all water used for drinking or culinary purposes from authorized engineer water points. Bathing facilities were generally adequate during the period 9 November to 16 December 1944. Regiments had constructed shower facilities in regimental rest camps in addition to a Quartermaster Fumigation and Bath Unit which operated in the Division area until about 1 December 1944. During the period 1 to 16 December 1944 fumigation and shower facilities were available to the Division approximately 15 miles behind the Division rear boundary. During the ten days following the onset of the enemy offensive on 16 December no Quartermaster bathing facilities were available. Beginning on 26 December 1944 the Division was allotted a quota of approximately 250 baths per day for the remainder of the month in a Quartermaster Fumigation and Bath Unit located 15 miles in the rear of the Division boundary. During the entire period, very limited bathing facilities were available in some of the troop billets. With the exception of the 10 days following the beginning of the enemy offensive, Quartermaster laundry service was available and adequate.

IX.Food and Messing, Sewage and Waste Disposal, Insect Control

During the entire year the food supply was adequate.

During the first eight months, while the Division was stationed at Camp Maxey, Texas, the Class “A” ration was supplied. Storage facilities were adequate. Proper handling, preparation and serving of food was assured by close officer supervision of messes. The messing facilities at Camp Maxey, Texas, were excellent.

During the troop movement to the staging area, Class “A” rations were served in paper plates and cups. At the staging area the Division received Class “A” rations as well as on the Troop Transports enroute to England.

During the period the Division was stationed in England, modified Class “B” rations were supplied. Some difficulty was experienced in preparation of food during the first few days in  England due to the fact that messing equipment did not arrive with the troops in all eases. The necessary messing equipment was supplied by the British Officer in charge of billets until the organizational equipment arrived.


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Upon arrival in the combat zone a modified “B” ration was available and adequate. However, because of the tactical situation, front line troops were forced to exist on Class “C”, “D”, “K”, and “10-in-1" rations during the last half at December, 1944. Prior to 16 December, 1944 all personnel received at least two hot meals  per day.

At Camp Maxey, Texas water-borne sewage was treated and disposed of in an efficient sewage disposal plant. Edible garbage was disposed of by civilian contract. Non-edible garbage and trash were hauled by units to the camp incinerator and dumps where salvageable material was removed by the camp sanitary detail. During field training all wastes were disposed of by burial in accordance with current directives.

Sewage and waste disposal facilities supplied enroute to England were adequate.

In England human wastes were disposed of by flush toilets or bucket latrines. When bucket latrines were used, the waste was either collected by civilian contractors or emptied into the local sewage system through special manholes supplied for this purpose. No excreta was disposed of by burial. Edible garbage was collected by civilian contractors. Non-edible garbage and other refuse was disposed of either by incineration or in authorized dumps in accordance with British and military directives.

In the combat zone human and kitchen wastes were generally disposed of by burial. Some of the billets in the forward and rears areas were provided with flush toilets. Whenever possible, edible garbage was disposed of to civilian hog raisers.

Insects were not prevalent in sufficient numbers to affect the health of  the command at any time during the year. Mosquitoes ware adequately controlled at Camp Maxey, Texas by the drainage and oiling program carried out under the direction of the camp sanitation officer. Cockroaches ware troublesome in some of the mess halls at Camp Maxey, Texas but were adequately controlled by routine control measures. Flies were no problem due to the close supervision of waste disposal, maintenance of fly traps, fly-proof screening and elimination of potential breeding places. Several barracks at Camp Maxey became infested with bed bugs. However, these insects were promptly eliminated by fumigation with hydro-cyanic gas by qualified post personnel under the direction at the camp sanitation officer. Insects have not been a problem since the Division arrived overseas.

As a precautionary measure, insecticide powder was issued to all troops before leaving England. Since arriving in the combat zone there have been occasional cases of pubic and body lice discovered at the monthly physical inspections but these were quickly brought under control by sending the individuals to the Quartermaster Fumigation and Bath Unit.

X.Venereal Disease Control

During the period the Division was stationed at Camp Maxey, Texas, an intensive venereal disease control program was conducted in collaboration with the camp venereal disease control officer and local authorities in surrounding towns. Meetings


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were held each month with civilian health and welfare authorities of surrounding vicinities and the post venereal disease control officer.  Sex hygiene lectures were given and venereal disease control films were shown to the entire command at frequent intervals. Posters were advantageously displayed and pamphlets distributed throughout the command. Organized prostitution did not exist in the vicinity of Camp Maxey, Texas. However, transient prostitutes flourished from time to time. Approximately 50% of the venereal disease cases occurring in  the Division were acquired at distant points while on pass or furlough. Company funds were used for the purchase of mechanical and chemical prophylaxis kits for distribution to soldiers. All dispensaries maintained 24-hour prophylaxis stations and prophylaxis stations were established by Service Command in the neighboring towns and cities. Gonorrhea was treated on a duty status in conformity with current regulations. The venereal disease rate for the Division for the first eight mouths of the year was 22.98 per thousand per annum.

Upon arrival in England venereal disease control was limited to educational programs, recreational programs and control of the soldiers through command channels, since there was no organized civilian program for the control of prostitution.

All dispensaries maintained 24-hour prophylaxis stations and in addition prophylaxis stations were established by the Division in all villages and towns frequented by our troops. Prophylaxis stations, maintained by the Army Service Forces, United Kingdom Base, were available in  the larger cities.

After arrival in the combat zone venereal disease was not a problem because the Division was immediately committed to combat and remained in the front lines throughout the remainder of the year. For the most part, the few cases of venereal disease which were recorded during November and December 1944, occurred in reinforcements who had arrived from rear areas.

The venereal disease rate during the year is shown in the following table:

Month

No. of Cases

Rate

January

22

19.71

February

25

22.84

March

27

19.33

April

32

29.24

May

27

25.48

June

35

27.10

July

19

18.83

August

22

20.29

September

28

39.65

October

3

4.62

November

4

3.76

December

4

3.34



XI. Professional Medical and Surgical Services

 During the first ten months of the year, prior to the commitment of the Division to combat, unit medical detachments furnished dispensary services to the Division. While in the United States, all patients requiring hospitalization were evacuated to local station and regional hospitals.

During the period the Division was stationed in England patients requiring hospitalization were admitted direct from unit dispensaries to general or station hospitals in the immediate vicinity.


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After arrival in the combat zone all casualties in the Division were processed through the normal first and second echelon channels. When further evacuation was necessary patients were evacuated by Army collecting companies to third echelon medical installations. During the period 9 November to 16 December 1944, inclusive, a hospital unit of an Army field hospital operated with the Division. However, during the period 17 to 31 December, inclusive, there was no such organization in support of the Division.

The professional medical and surgical services of the Division have been excellent within their limited scope. Treatment of casualties in the first and second echelon is practically limited to first aid measures by current directives and as a result no new methods of treatment have been devised. Battle casualties were given only the necessary surgical and supportive treatment to insure their safe transportation to the third echelon of medical service in compliance with current directives

XII.Nursing, Dental and Veterinary Service

No nurses were assigned or attached to the Division at any time throughout the year.

The organizational dental service of the Division furnished continuous service during the first eight months of the year. Camp dental facilities available to the Division at Camp Maxey, Texas, varied during this period as the result of various units being alerted for overseas shipment and requiring immediate attention. At the beginning of the year 1,764 individuals in the Division were below Class IV dental standards. As the result of this dental problem, all of the Division Dental Corps officers were utilized in one of the camp dental clinics. Frequent surveys of the entire Division were made during the period that the Division was stationed at Camp Maxey, Texas. Many of the individuals in dental Class IV were transferred out of the Division as overseas replacements and in turn many of the replacements received by the Division were Class I and II dentally. As the result of this and inspite of the fact that all of the Division dentists and some of the camp dentists worked on Division personnel, little headway was made during the first few months of the year in reducing the number of Class I and II cases. In the late spring, 25 additional dentists from Service Command were placed on Special Duty at Camp Maxey, Texas,  in order to assist the Division in reducing the Class I and II cases. For a period of several weeks, 18-hour service was maintained in the dental clinic set aside for this Division. By early September 98.2% of all Division personnel were in Dental Class III and IV. The following chart indicates the dental status of the Division during the year:

Month

Class I

Class II

Class III

Class IV

January

624

1,055

167

10,722

February

364

642

163

10,907

March

1,258

3,522

283

6,949

April

810

1,714

383

10,055

May

440

1,063

321

12,123

June

290

414

266

12,187

July

347

2,127

298

10,560

August

57

490

248

13,260

September

26

224

243

13,668

October

9

208

197

13,225

November

15

215

196

14,035

December

17

170

169

11,386


  


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After arrival in the European Theater of Operations, dental service was provided by unit dental surgeons. It has proven adequate to meet the dental needs of the Division. The repair and replacement of prosthetic dental appliances has been accomplished within the Division with M.D. Chests 61 and 62 which were authorized and received after arrival in the European Theater of Operations. At the time the Division arrived in the European Theater of Operations there were approximately 2,400 serviceable dentures in the Division. Dental surveys are in process continually. These are accomplished piecemeal at regimental and battalion rest centers.

There was no organic Veterinarian Service in the Division. The Division Veterinarian was dropped fro the Infantry Division Table of Organization in 1943.

XIII.Evacuation

Prior to the arrival of the Division in the combat zone, casualties were evacuated direct from unit dispensaries to to supporting hospitals by organic ambulances of the Division.

During the period that the Division has been committed to combat, casualties have been evacuated from the front lines to the aid stations by hand litter carry and 1/4 ton trucks, 4x4, equipped with liter racks, in order to conserve litter bearer manpower, especially when casualties were heavy. All casualties capable of self-locomotion are encouraged to unless there is a definite countra-indication. One-quarter ton rucks with litter racks are used as far forward as possible. Battalion aid stations or advanced aid posts were kept as close to the front lines as the tactical. situation would permit. In one operation during the period 13 to 15 December 1944, inclusive, it was necessary to hand carry patients two miles over a rugged, wooded terrain in deep snow. Ski sleds and toboggans were improvised to assist in evacuating patients to the aid stations. It is believed that toboggans would be a valuable adjunct to the evacuation of patients under winter conditions in this type of terrain and should be made available. Casualties were evacuated from battalion aid stations by collecting company ambulances. Almost without exception ambulances were able to approach the immediate vicinity of the aid stations in spite of small arms, mortar and artillery fire which at times was very heavy. All casualties not overrun by the enemy were evacuated systematically throughout the retrograde movement, in spite of the fact that in several instances infantry battalions are completely surrounded. During the day light and night withdrawals, executed between 16 and 19 December l944, it was necessary to use all available transportation in the evacuation of casualties. Empty vehicles returning to the rear were commandeered for this purpose. In one instance it was necessary to unload organizational medical equipment of a regimental medical detachment in order to evacuate the station. The equipment was abandoned to the enemy. Collecting companies were able to render continuous close support. Advanced ambulance shuttles and forward collecting points were used. In addition one ambulance was attached to each battalion aid station throughout the period. As the result of combat losses in personnel following the enemy offensive, it was temporarily necessary to pool the equipment and personnel of two collecting companies. This did not impair the efficiency of the Division Medical Service as during that period the Division frontage had been reduced from 25 kilometers to approximately 4,000 yards. During the period 13 to 23 December 1944 a provisional collecting company was organized and utilized to effectively evacuate the wide front. In addition in improvised aid station was organized to render medical service to the Reconnaissance Troop which was


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defending a front of 1,000 yards. Collecting companies evacuated patients requiring further hospitalization to the Division Clearing Station. The Division Clearing Station was evacuated by a platoon of an Army Collecting Company supporting the Division. During the period 17 to 0 December 1944 the Division was forced to evacuate its own casualties from the Division Clearing Station to third echelon medical installations in its organic collecting company ambulances. Combat losses of personnel sustained in Battalion Medical Sections were temporarily replaced by personnel loaned from the supporting collecting company in order to maintain adequate litter bearers in the field. In addition collecting company litter bearer platoons habitually worked forward of aid stations. During the periods when casualties were heavy, it was necessary to reinforce medical department litter bearer teams with line troops. Collecting company battle losses were replaced by personnel loaned from the Division Clearing Company. It was unnecessary to call upon higher headquarters for additional supporting medical personnel.

XIV.Welfare, Social Service and Recreation

The welfare and social service requirements of the Division were adequately supplied through the regularly assigned personnel of the American Red Cross. Recreational facilities at Camp Maxey, Texas, were adequate. Two well equipped clubs, four War Department theaters, and a large centrally located field house were available to the Division troops. In addition recreation buildings and post exchanges were located in each major unit area. All athletics were well organized and coordinated by the Special Services Officer. All units participated in divisional leagues and other divisional teams participated in post leagues. These leagues included, baseball, softball, basketball, football, boxing, swimming, volley ball, tennis and bowling. Frequent dances were sponsored at service clubs and local recreational halls by post and organizational Special Service Officers. In addition numerous USO and other road shows provided excellent entertainment in the post field house.

Facilities while enroute from Camp Maxey, Texas, to England were limited to shows, dances and organized athletics at Camp Miles Standish, Massachusetts, and to shows and. supervised physical exercises on board Army Troop transports.

During the period the Division was stationed in England, the following recreational facilities were available: shows, organized athletics, dances and American Red Cross Doughnut  Trucks. Since arrival in the combat zone, recreation had been limited due to the mission of the Division. However, Division Special Service has been able to distribute a limited number of radios and moving picture projectors and films to several of the unite. These an employed chiefly at regimental and rear area rest camps and in the Division Clearing Station. American Red Cross Doughnut and Clubmobile Units visited the Division on several occasions.

XV.Other Subjects of Interest

During the period 9 November to 31 December 1944 the Medical Department of this Division rendered superlative service and gained the complete respect and admiration of the line troops. There were countless instances of gallantry in action and heroic deeds far above and beyond the call of duty and almost to a man the Medical soldiers upheld the traditions of the Medical Department in this war.


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At the close of the year, after having been in combat 53 days, Medical Department personnel of the Division have received the following decorations:

  34 Bronze Stars
2 Silver Stars

It is a matter of record that some of our Medical Department losses were the result of deliberate violations of the rules of land warfare and the Geneva Convention. Medical Department soldiers were deliberately killed in spite of Red Cross brassards on both arms and four red crosses on white, circular backgrounds 4 inches in diameter on the helmets. It is further known that vehicles transporting wounded and plainly marked with Geneva Red Cross Flags were deliberately riddled by enemy small arms fire and in one instance, a tank a close range fired an armor-piercing shell through an ambulance operating in an adjacent Division.



[signed]
K. T. Miller
Lt Col, MC
Surgeon

Source:  National Archives and Records Administration, Record Group 112, Medical History, 99th Infantry Division, Box 305.