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Preface

Activities of Medical Consultants

The history of internal medicine in World War II was started in 1945 when Brig. Gen. Albert G. Love, director of the historical program of the Medical Department, requested the wartime chiefs of the various divisions and services in the Office of the Surgeon General to prepare the historical record of the activities that had been under their jurisdiction. Brig. Gen. Hugh J. Morgan, at that time Chief, Medical Consultants Division, Office of the Surgeon General, was given the responsibility of directing this project, and much is owed to his unflagging spirit by those who subsequently contributed to this history.

By the end of 1946, a great deal had been accomplished. Col. Walter Bauer, MC, Capt. John S. Hunt, MC, and Col. Francis R. Dieuaide, MC, undertook the editorial responsibilities for various sections. Some officers had been assigned to the Office of the Surgeon General to complete their inanuscripts; others were requested to submit their manuscripts promptly following their release from service. However, as is not unusual in the affairs of man, a gap gradually widened between the plans and their fulfillment. The confusion attendant upon rapid demobilization and the innumerable problems of personal readjustinents to civilian life tended to minimize the importance of recording experiences that occupied quite variable positions in the hearts and minds of men just out of the Army. It is, therefore, a tribute to the efforts of Drs. Morgan, Bauer, Hunt, and Dieuaide that, in the troublous postwar period, they were able to obtain most of the individual consultants’ reports, 18 papers on nontropical diseases, and 12 dealing with tropical diseases. That the warmest enthusiasms of these leaders were insufficient, however, to overcome the inertia that naturally developed is not surprising, and by 1952 it was evident that, if the history were to be completed, a new approach was required.

Previous experience with certain problems encountered in preparing the history of preventive medicine had shown the value of an advisory editorial board. The success of this approach motivated Col. Calvin H. Goddard, MC, then Director of The Historical Unit, U.S. Army Medical Service, to suggest the formation of a similar board for internal medicine. Dr. Morgan, who had declined the chairmanship of this new group, was present at the first meeting on 25 October 1952 at the Office of the Surgeon General. He outlined certain of the problems encountered up to that time and gave his blessing on future activities. It is pertinent to point out here that whatever success has come of these activities owes much to the sustained interest and enthusiastic support of Dr. Morgan.

The Advisory Editorial Board which was subsequently appointed by The Surgeon General, outlined a plan for the evaluation of existing manuscripts including the revision of some and the rewriting of others. New authors were invited to contribute papers on subjects not previously assigned or to revise manuscripts that the original authors had abandoned. An editorial office was established at the Jefferson Medical College in Philadelphia, and a contract between this institution and the Office of the Surgeon General was made on 1 February 1953. Dr. Morgan’s original plan for the history was changed to provide for one volume on the activities of medical consultants and two volumes on various diseases. This book, containing the reports of the medical consultants, represents the first fruits of the efforts of The Surgeon General to publish the history of internal medicine in World War II.

Each chapter was written by the individual consultant (or consultants) concerned, with the exception of the one on the European theater. Dr. William S. Middleton wrote the opening section of this chapter from his own viewpoint as Chief Consultant in Medicine in the European theater and, without going into their activities at length, showed how his senior consultants in their specialities fitted into the pattern. Subsequently, Col. John Boyd Coates, Jr., MC, present Director of The Historical Unit, U.S. Army Medical Service, assigned Maj. James K. Arima, MSC, Special Projects Branch, The Historical Unit, the task of describing the activities of the senior consultants in medicine in the European theater. Major Arima assembled his narrative from the documentary record, and the manuscripts were edited by the senior consultants concerned, by Dr. Middleton, and by Colonel Coates. Dr. Esmond R. Long reviewed the portions pertaining to the senior consultant in tuberculosis. At the end of their respective sections, the former senior consultants in dermatology and syphilology, neuropsychiatry, infectious diseases, and tuberculosis summarized their present (1956) thinking regarding their endeavors during the war--more than 10 years earlier.

There is inevitably some overlapping of subject matter in this volume and the two that will follow. The first describes the more general aspects of medical problems as seen in perspective by the medical consultants, the others will focus upon specific diseases. For a complete picture of some of the diseases touched on here, the reader should refer to the volumes on preventive medicine, surgery, neuropsychiatry, and miscellaneous clinical subjects in the History of the Medical Department, U.S. Army, in World War II. Of the miscellaneous clinical volumes, those on cold injury, the Army Veterinary Service, and reconditioning are especially pertinent.

Certain administrative, logistical, and operational matters are discussed insofar as they concerned the practice of clinical medicine. The point of view is personal and professional and does not necessarily coincide with the official position or policy of The Surgeon General or of the War Department. Administrative, logistical, and operational matters per se are discussed in the volumes in the administrative series of the Medical Department history or in the volumes of the Army of the United States in World War II, published under the auspices of the Chief of Military History, Department of the Army.

The statistics presented are considered “personally collected” and of “local origin” and do not always represent official Army figures. Neither are they to be considered official Medical Department statistics since, for the history of the Medical Department in World War II, only those of Armywide significance are reviewed and checked by the Medical Statistics Division, Office of the Surgeon General. They have, however, been checked with the documentary sources indicated. The official medical statistics of the U.S. Army in World War II are scheduled for publication in the two statistical volumes planned for the Medical Department history of that war.

For convenience and clarity, the term “theater” has been used with some latitude. A theater of war is defined in the Dictionary of the United States Army Terms as thiat area of land, sea, and air which is, or may become, involved directly in the operations of war; a theater of operations is that portion of a theater of war necessary for particular military operations and for the administration incidental to them. The term “theater” is used in this volume in the latter sense. In the Pacific, the forces of the United States operated within what were formally designated “areas,” although they were often referred to informally as theaters. There was no single “Pacific Theater of Operations” at any time during the war. The words “area” and “theater” are accordingly used interchangeably, except when necessary to refer to the proper name of a command; for example, Southwest Pacific Area. Identification of the U.S. Army commands indicated by the free use of the word “theater” is clear from the context in each chapter or is made clear in footnotes.

In World War II, most theaters were occupied or about to be occupied not only by the Army (including the Army Air Forces) and the Navy of the United States but also by the various armed services of the Allies and of friendly nations. However, in this volume portrayal of actions and persons within a given theater usually has reference only to the Army of the United States. The terms “theater surgeon” and “chief surgeon” have similar reference. There may or may not have been an individual designated at the combined (Allied) staff level as the surgeon of the theater, and there obviously were the chief medical officers of the U.S. Navy and of the Allies, whatever their formal titles may have been. But this is a history of the Medical Department of the Army of the United States, and with no intention to slight others the term “chief surgeon” and related designations are for convenience used to refer only to the chief surgeon of the highest U.S. Army command within a particular theater.

The lapse of more than a decade between the experiences recounted here and their publication does not detract from their value or interest. Actually, there is much to recommend such a hiatus since it allows opportunity for consideration and reassessment of situations in some historical perspective. It is indeed likely that the passage of time did much to encourage a more contemplative approach to many of the problems that were encountered.

The editor wishes to express his sincere thanks to the distinguished contributors who have written this history. It is obviously not easy to pick up the threads of experiences long since regarded as finished. In addition, thanks are due to Dr. Garfield G. Duncan and the members of the Advisory Editorial Board for their constant support and to Colonel Coates for his many courtesies and vigorous assistance. In particular, appreciation is expressed to Miss Eleanor S. Cooper whose tireless and painstaking attention to the preparation and editing of these manuscripts was an invaluable aid in the compilation of this history. Mrs. Madeline W. Evans, Editorial Assistant, and Mrs. Margaret N. Kemp and Mrs. Eleanor Seiler, secretaries, also contributed substantially to the preparation of this volume. The editor also gratefully acknowledges the assistance of Mrs. Pauline B. Vivette, publications editor of the Editorial Branch, The Historical Unit, who performed the final publications editing and prepared the index for this volume.

W.PAUL HAVENS, Jr., M.D.