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Appendix A

Contents

APPENDIX A

Circular Letters, Mediterranean Theater

Instructions and other information on blood transfusion and allied subjects appeared in the following circular letters from the Office of the Surgeon, Headquarters, NATOUSA (North African (later Mediterranean) Theater of Operations, U.S. Army):

5 April 1943-Letter No. 8, on the treatment of burns, outlined the treatment of shock and provided for plasma therapy and for the later use of blood to combat secondary anemia (1).

15 May l943-Letter No. 13, on forward surgery (2), provided the information on blood donors which later appeared in Letter No. 3, Office of the Surgeon, Headquarters, II Corps, 7 August 1943 (3) (p. 422).

20 August 1943-Letter No. 27, on the donation of blood for transfusion and other purposes, provided for payment of donors (4) (p. 423).

12 May 1944-Letter No. 30, on blood transfusions (5), dealt with the establishment of blood banks at field, evacuation, general, and station hospitals, with a transfusion officer responsible for the administration of each bank; the provision of blood from a theater bank; the administration of blood: the indications for transfusion; requirements for donors; dating of blood; reactions; and payment of donors. In this letter, it was stated that the Rh factor had no practical importance in forward areas.

10 March l945-Letter No. 8, on the care of battle casualties (6), was concerned with initial wound surgery and mentioned resuscitation, with plasma and blood transfusions, only in passing.

The following medical circulars and circular letter were issued from the Office of the Surgeon, Headquarters, Fifth U.S. Army, NATOUSA:

22 April 1944-Medical Circular No. 7, stated that group O blood would be provided for all the needs of field hospitals at all times (7). Blood would also be provided for evacuation hospitals in periods of great activity; otherwise, these hospitals must procure and process their own blood. Directions were given for collecting and administering the blood, and criteria for donors were outlined.

6 May 1944-Medical Circular No. 10 (8) was prepared but not issued. It dealt with the hemoglobinuria nephroses which had followed the use of group O blood in group A recipients and the decision in the future to supply group A blood for group A recipients. The urgent necessity for grouping and crossmatching these bloods was emphasized. Since this decision was overruled, this circular was not issued.

Circular Letter No. 3, issued on 7 August 1943 (3), has already been mentioned. It dealt with the care of the wounded in Sicily. Section III, on shock, stated that plasma was "unquestionably the most effective weapon in combating shock," but directed that, when hemorrhage was the major factor, whole blood was to be used, in adequate quantities, as soon as crossmatching would be completed.

References

1. Circular Letter No. 8, Office of the Surgeon, Headquarters, NATOUSA, 5 Apr. 1943, subject: The Treatment of Burns.

2. Circular Letter No. 13, Office of the Surgeon, Headquarters, NATOUSA, 15 May 1943, subject: Memoranda on Forward Surgery.

3. Circular Letter No. 3, Office of the Surgeon, Headquarters, II Corps, 7 Aug. 1943, subject: Care of the Wounded in Sicily.

4. Circular Letter No. 27, Office of the Surgeon, Headquarters NATOIJSA, 20 Aug. 1943, subject: Donation of Blood for Transfusion and Other Purposes. Act, 30 July 1941 (Public Law 196, 77th Cong.).


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5. Circular Letter No. 30, Office of the Surgeon, Headquarters, NATOUSA, 12 May 1944, subject: Blood Transfusions.

6. Circular Letter No. 8, Office of the Surgeon, Headquarters, Mediterranean Theater of Operations, U.S. Army, 10 May 1945, subject: Notes on the Care of Battle Casualties.

7. Medical Circular No. 7, Office of the Surgeon, Headquarters, Fifth U.S. Army, 22 Apr. 1944, subject: Blood Transfusions (paragraph II).

8. Medical Circular No. 10, Office of the Surgeon, Headquarters, Fifth U.S. Army, 6 May 1944, subject: Blood Transfusions.

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