Contents

CHAPTER I

Organization and Responsibilities

or Hospitalization

Hospitalization, like other activities of the Medical Department, was planned and supervised by medical officers called surgeons. The commander of every non-medical military organization, from headquarters of the Army in Washington (War Department) to battalions in the field, had on his staff a surgeon whose duties were both advisory and administrative. As a staff officer he advised on matters affecting the health of all members of a command and exercised technical control (that is, professional and medical as opposed to administrative and military) over all medical activities under the jurisdiction of his commander. As an administrative officer he also exercised command control over his own office and in some instances over certain medical units and organizations such as hospitals.¹

The Surgeon General's Position in the War Department

The chief medical officer of the Army was The Surgeon General.² He served as medical adviser to the Chief of Staff and was directly responsible to him for the planning and technical supervision of all Army hospitals. In his capacity as head of a service he commanded, beside the personnel in his own Office, medical "field installations" of the War Department. Like the chiefs of other arms and services, such as the Chief of Infantry, the Chief of the Air Corps, and The Quartermaster General, The Surgeon General was subject to supervision by the War Department General Staff.

 The General Staff, while it had no authority to command, in actual practice did so, issuing directives and orders and approving or disapproving recommendations of The Surgeon General. In such instances it acted in the name of the Chief of Staff or the Secretary of War. The Staff had five divisions, each of which repre-

¹(1) AR 40-10, MD, The MC-Gen Provisions, 6 Jun 24. (2) Blanche B. Armfield, Organization and Administration (manuscript for a companion volume in this series), has a full discussion of the organization of the Medical Department.
²The War Department capitalized the definite article in the formal designations of certain general officers, presumably to distinguish them from others with similar titles.

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sented a functional grouping of duties of the Chief of Staff. They were the Personnel (G-1), Military Intelligence (G-2), Organization and Training (G-3), Supply (G-4), and War Plans (WPD) Divisions. The Supply Division was charged by Army regulations with the preparation of plans and policies for hospitalization and evacuation and the supervision of such activities. In peacetime it limited itself in this field primarily to matters of construction and supply. The Personnel Division handled matters pertaining to personnel that were Army-wide in scope; the Organization and Training Division, those relating to the organization, training, and use of field units. Direct communication between divisions of the General Staff and any chief of service (such as The Surgeon General) was authorized by Army regulations, but formal requests and decisions were normally channeled through the Office of The Adjutant General, the War Department's office of record.³

In the latter part of 1940, after mobilization began, medical officers were assigned to several War Department agencies having a direct interest in hospitalization and evacuation. In October 1940 Brig. Gen. (later Maj. Gen.) Howard McC. Snyder was assigned to the Office of The Inspector General and remained in that position until the end of the war. Shortly afterward a medical officer was transferred from the Surgeon General's Office to General Headquarters (GHQ), an organization established in July 1940 to supervise the training of field forces, including medical units. About the same time Lt. Col. (later Brig. Gen.) Frederick A. Blesse was placed in the G-4 division of the General Staff. During 1941 he was transferred to GHQ and was succeeded in G-4 by Maj. (later Col.) William L. Wilson.⁴

The Surgeon General's Office

When President Roosevelt proclaimed the emergency, The Surgeon General was Maj. Gen. James C. Magee. He had succeeded Maj. Gen. Charles R. Reynolds the preceding June. Most divisions of his Office had something to do with hospitalization and evacuation. Particularly concerned was the Planning and Training Division, headed by Col. (later Brig. Gen.) Albert G. Love. It had three subdivisions:

Planning, Training, and Hospital Construction and Repair. The last of these operated almost independently, its chief, Lt. Col. (later Col.) John R. Hall, having direct access to General Magee.⁵ This subdivision handled all of The Surgeon General's construction problems, estimating bed requirements and planning hospitals. In this work it collaborated with the War Department's constructing agencies-the Quartermaster Corps and the Corps of Engineers. This subdivision grew from 2 officers, 3 civilian architects, and 4 clerks in September 1940 to 4 officers, 4 architects, and 7 clerks by the end of 1941.⁶ The remainder of the Planning and Training Division dealt with medical field units. It

³(1) Mark S. Watson, Chief of Staff: Prewar Plans and Preparations (Washington, 1950), pp. 57-84, in UNITED STATES ARMY IN WORLD WAR II, has an excellent discussion of the origin and powers of the General Staff. (2) AR 10-15, Gen Staff, Orgn and Gen Duties, 18 Aug 36. (3) FM 101-5, Staff Officers' Field Manual, 19 Aug 40.
⁴(1) Armfield, op. cit. (2) Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), pp. 1-32, in UNITED STATES ARMY IN WORLD WAR II, have a discussion of the development of GHQ.
⁵Interv, MD Historian with Col Love, 27 Aug 47. HD: 000.71.
⁶Achilles L. Tynes, Data for Preparation of Historical Record of Construction Branch of The Surgeon General's Office during the Expansion Period of the Army and World War II (1945) (cited hereafter as Tynes, Construction Branch). HD.

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estimated the number that would be required and prepared or revised their tables of organization and equipment. Until GHQ was established in July 1940, this Division also supervised the training and use in the United States of hospital and other medical units. The Finance and Supply Division furnished hospitals with supplies and equipment and allotted them funds for the employment of civilians. The Military Personnel, Dental, Veterinary, and Nursing Divisions handled military personnel and certain professional matters. The Professional Service Division established policies for medical care and treatment and issued technical directives to maintain professional standards.⁷

In recognition of the growing importance of problems of hospitalization during mobilization, a Hospitalization Subdivision was set up in the Professional Service Division in February 1941. Two months later it was separated and became the Hospitalization Division. Lt. Col. (later Col.) Harry D. Offutt was made its chief and continued in that capacity throughout General Magee's administration. Established with one officer and one clerk, this division expanded to three officers and three clerks by the end of June 1941. Although it was charged with the development of plans and policies for hospitalization and evacuation through liaison with other divisions of the Surgeon General's Office, it had neither the authority nor the staff to make comprehensive plans and coordinate the actions of others in making such plans effective.⁸

The Surgeon General's Control Over Hospitals and Hospital Units

While all hospitals were under the technical supervision of The Surgeon General, not all were subject to the same control by his Office. The degree varied according to the command structure of the War Department. For administrative purposes the United States was divided into nine corps areas, each in charge of a corps area commander under the jurisdiction of the Chief of Staff. Overseas possessions were organized into three departments that corresponded administratively to corps areas in the United States. All stations in departments and most in corps areas were under the command-control of department and corps area commanders respectively. Located within corps areas but beyond the jurisdiction of their commanders were field installations of the War Department. They operated directly under the chiefs of various arms and services in Washington and were therefore called "exempted stations."

Hospitals classified as War Department field installations were subject to the greatest amount of control by The Surgeon General because they were under his command. All general hospitals in the United States were in this category. In only one instance was an intermediate commander between The Surgeon General and a general hospital commander. Walter Reed General Hospital was under the jurisdiction of the commandant of the Army Medical Center (Washington, D. C.), who was in turn under the command of The Sur-

⁷Armfield, op. cit.
⁸SG OOs 32, 13 Feb 41; 87, 18 Apr 41. In an interview on 15 November 1949 Brig Gen H. D. Offutt stated that he never felt handicapped by a lack of personnel in his division. HD: 000.71. In an interview on 10 November 1950 Maj Gen James C. Magee (Ret) stated that no one division could have exercised authority over all factors involved in hospitalization and that vesting such authority in one division would have subordinated other divisions of the Surgeon General's Office to a sort of overlordship. HD: 314 (Correspondence on MS) III.

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geon General. Despite this intermediate step, Walter Reed actually received closer supervision from the Surgeon General's Office than did other general hospitals, largely because of its proximity. Next in line in degree of control were hospitals of exempted stations of all other services and of all arms except the Air Corps. For example Fort Benning (Georgia), including its station hospital, was under the Chief of Infantry and Fort Belvoir (Virginia) was under the Chief of Engineers. The chiefs of arms and services normally had no surgeons on their staffs and were therefore prone to refer problems connected with hospitalization to The Surgeon General. He employed corps area surgeons as his own field representatives to supervise hospitals of exempted stations. Corps area hospitals, under the command-control of corps area commanders, were supervised by corps area surgeons in their dual capacities as local staff officers and technical representatives of The Surgeon General. Hospitals furthest removed from the latter's influence were those in overseas departments, not only because of their distance from Washington but also because department surgeons did not serve as field representatives of The Surgeon General.⁹

Although hospitals of the Air Corps were theoretically in the same class as those of exempted stations of other arms and services, they were actually in a somewhat different category. The Chief of the Air Corps had in his Office a Medical Division, whose head was analogous to a staff surgeon and therefore assumed considerable authority over Air Corps station hospitals. During 1940 and 1941, as the Air Corps expanded, the number of such hospitals increased. Soon after a reorganization of the air forces in June 1941,which established the Army Air Forces and gave it control over the Air Corps, the Secretary of War directed a blanket exemption of all Air Corps stations-new as well as old-from corps area control. The following October the head of the Air Corps Medical Division, Col. (later Maj. Gen.) David N. W. Grant, was assigned to AAF headquarters and designated "Air Surgeon." This series of events tended to separate Air Corps hospitals from other Army hospitals and to place them more under control of AAF headquarters at the expense of the Surgeon General's Office.¹⁰

A shift of responsibility which affected The Surgeon General's control over medical units, including those for numbered hospitals, had meanwhile occurred. Until late 1940 certain corps area commanders and surgeons acted also as commanders and surgeons of the four field armies in the United States. Corps area surgeons were therefore responsible, under their commanders and The Surgeon General, for supervising the training of field medical units. In October 1940, the command of field armies was taken away from corps area commanders and placed in the hands of separate army commanders responsible to GHQ in Washington. GHQ and army headquarters were charged with the training and use on maneuvers of all field units. Actually, this transfer of training functions was not so complete as anticipated,¹¹ even though in November 1940 all table-of-

⁹(1) AR 170-10, CAs and Depts, Admin, 10 Oct 39. (2) AR 350-105, Mil Educ, Gen and Spec Serv Schs-Desig, Loc, and Orgn, 1 Oct 38. (3) Armfield, op. cit.
¹⁰(1) Rad MX-F, TAG to CGs of CAs, 27 Jun 41. (2) Ltr, TAG to CofAAF and ACofS G-4 WDGS, 12
Sep 41, sub: Trf of Gen Staff Functions . . . to AAF. Both in AG: 322.2 (6-18-41)(1) Sec 2. (3) Hubert A. Coleman, Organization and Administration, AAF Medical Services in the Zone of Interior (1948), pp. 45-76. HD.
¹¹See below, pp. 43-48.

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organization units in the United States, including those of the Medical Department, were either assigned or attached to armies or corps.¹²

In the changes just enumerated were seeds that were eventually to grow into bitter weeds for The Surgeon General. Among them were the trend of the Army Air Forces toward separatism and its development of a separate set of hospitals, the establishment of medical officers in headquarters on a higher level of authority than The Surgeon General, and the latter's partial loss of authority over medical field units. Understanding something of these changes and of responsibilities and relationships of various War Department agencies, one may now turn to a consideration of the manner in which the Army provided hospitalization during the emergency period.

¹²(1) Greenfield et al., op. cit., pp. 3-4, 6-9. (2) Armfield, op. cit. (3) Ltr, TAG to CGs all Armies, Army Corps, CAs, CofS GHQ, etc., 4 Nov 40, sub: Units Asgd and Atchd to GHQ, Armies, and Corps. . . AG: 320.2 (8-2-40) (4) Sec 3.

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