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Chapter XXV

Contents

CHAPTER XXV

Evacuation Units for Theaters of Operations

The evacuation units discussed in preceding chapters were those used primarily in the movement of patients in and to the zone of interior, though some were used also within theaters of operations. Mention has been made earlier, in chapters showing how the zone of interior provided hospital units for overseas service,1 of other evacuation units that cared for and transported patients from front-line areas rearward through combat zones to mobile hospitals. Certain aspects of these units-such as changes in their organization, personnel, and equipment, and the manner in which they were activated, trained, and used in the United States-need to be considered at this point.

Organization, Personnel, and Equipment

Units designed for the care and transportation of patients in combat zones, as already pointed out,2either were organic elements of larger nonmedical organizations such as infantry regiments and divisions, or were separate units intended for assignment to corps and armies. Every regiment and every separate battalion of each arm or service, except medical, had a medical detachment as one of its organic parts. While the size and organization of medical detachments varied according to the size of the units to which they belonged, their functions remained the same. Aid men of the medical detachment accompanied troops into combat, giving casualties emergency medical care at the front lines. Its litter bearers then carried casualties, except those still able to walk, back to aid stations where medical technicians and medical officers treated them for return to duty or prepared them for further transportation. Units that were organic elements of divisions-medical regiments, battalions, or squadrons, depending upon the type of division concerned-collected casualties from aid stations and transported them first to collecting stations and then to clearing stations farther to the rear, sorting them at each station for additional treatment and return to duty or for preparation for further evacuation. Units that were assigned directly to corps and armies, such as medical battalions and medical regiments, collected and treated for return to duty or prepared for evacuation the casualties of their respective areas. In addition, army evacuation units transported casualties from divisional clearing stations to mobile hospitals in army areas and supplied reinforcements for divisional medical services.

1See above, pp. 38-49, 144-66, 214-37.
2See above, pp. 4, 38-39.


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While the system of evacuating casualties through the combat zone was not altered in any significant respect during the war, certain changes occurred both before and during the war in the units operating this system. These changes were designed primarily to achieve mobility, flexibility, and economy.

The medical battalion of the infantry division was developed in the prewar years, it will be recalled,3 as a result of the emergence of the triangular division to replace the square division. The latter's organic medical unit was a medical regiment which consisted of a regimental headquarters and band, a headquarters and service company, a collecting battalion of three companies, an ambulance battalion of three companies, and a clearing battalion of three companies. It was authorized 66 officers and 980 enlisted men to serve a division of 946 officers, 12 warrant officers, and 21,314 enlisted men.4 The medical battalion, which served the triangular division of 624 officers, 6 warrant officers, and 14,615 enlisted men, contained 34 officers and 476 enlisted men. It consisted of a headquarters and headquarters detachment, a clearing company, and three collecting companies.5 Containing litter bearers, collecting-station personnel, and ambulances, each collecting company was capable of supporting a regimental combat team, whether it operated separately or in close conjunction with the division of which it was a part.6 Although not designed specifically for the purpose, this battalion was used also as the evacuation unit for corps troops. The medical regiment continued in existence, serving National Guard divisions until they were reorganized as triangular divisions in 1942. Like the medical battalion, it also had a function for which it was not specifically designed; that is, it served as an evacuation unit with army troops.7 Thus medical battalions and medical regiments could be either divisional or nondivisional units, depending upon their assignment and use.

A nondivisional medical unit developed in the prewar years for use in the evacuation system, though not in the actual transportation of patients, was the medical gas treatment battalion. While other medical units had some means of treating at least small numbers of gas casualties, none was adequately equipped to treat the influx of casualties which might result from the use of gas on a large scale. The Surgeon General's Office therefore prepared a table of organization for a medical gas treatment battalion, and the General Staff approved it despite misgivings that such a unit might duplicate the functions of other medical units or of the quartermaster sterilization and bath battalion. The medical gas treatment battalion was made up of a headquarters and three clearing companies. Each of the latter, having two bath and four treatment sections, was expected to bathe and treat gas casualties and to provide them with noncontaminated clothing in preparation for return to duty or for further evacuation to the rear.8

3See above, pp. 39-40.
4T/O 8-21, Med Regt, 1 Nov 40, and T/O 7, Inf Div (Square), 1 Nov 40.
5T/O 8-65, Med Bn, 1 Oct 40, and T/O 70, Inf Div (Triangular), 1 Nov 40.
6T/O 8-67, Med Co, Collecting, Bn, 1 Oct 40.
7FM 8-5, Med Fld Manual, Mobile Units of the Med Dept, 12 Jan 42.
8(1) Ltr, SG to TAG, 11 Jun 41, sub: T/Os, with 2 inds. AG: 320.2 (6-11-41). (2) Memo, ACofS G-3 WDGS for TAG, 23 Aug 41, sub: T/O for Med Bn, Gas Treatment, with Memo for Record. Same file. (3) T/O 8-125, Med Gas Treatment Bn, 2 Oct 41, and T/O 8-127, Med Clearing Co, Gas Treatment Bn, 2 Oct 41.


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In the first few months after the United States entered the war, the tables of organization of existing combat zone evacuation units were revised and new units were developed for use with new combat organizations. During 1942 the Army Ground Forces experimented with new types of divisions-mountain, jungle, airborne, and motorized.9 Although organizations of these types were used overseas little, or not at all, the fact that some of them were anticipated for use made it necessary for medical units to be prepared for them. Therefore, during 1942 tables of organization were developed for appropriate medical units for service with new types of forces.10 Concurrently, changes were made in existing units. To indicate the nature of these changes, it will suffice to consider revisions in the tables of organization of three of the more common types: the medical detachment of the infantry regiment, the medical battalion of the infantry division, and the medical regiment serving the field army.

Unlike the infantry regiment which it supported, the medical detachment's enlisted strength increased appreciably-from 96 to 126-when its table of organization was revised in April 1942. The inclusion of additional surgical technicians accounted primarily for this increase. The number of officers-eight physicians and two dentists-remained unchanged. Changes were made at the same time in the transportation authorized for the detachment. Seven 1/4-ton trucks (jeeps), seven 1/4-ton trailers, and one 2-ton truck replaced one motorcycle, fourteen -ton trucks, and two 1-ton trucks.11

The infantry division's medical battalion, according to early plans, was to receive an increase in enlisted men and in vehicles as well. Its table of organization issued in April 1942 called for 8 additional enlisted men, an increase in Medical Administrative Corps officers from 5 to 8, a reduction in Medical Corps officers from 27 to 25, and no change in Dental Corps officers (2). The battalion's vehicles, exclusive of trailers, rose from 87 to 93. The addition of trucks accounted for this increase, the number of ambulances-36-remaining the same.12 About the time this table was published, the War Department ordered a reduction in motor vehicles.13 The Surgeon General then decided to use the revised version of the table of organization of the medical battalion for motorized divisions being organized, and to develop a new table for the medical battalions of infantry divisions.14 The new table, submitted for publication in July15 but issued with an earlier date, reduced the number of motor vehicles by thirteen. None of the vehicles eliminated were ambulances, and trailers were added to replace some of the cargo space lost. Fewer motor vehicles required fewer drivers and mechanics, and hence the new table provided for fourteen fewer enlisted men than formerly. In addition, one Medical Corps officer was eliminated, reducing the total for the battalion from twenty-five to twenty-four. The number of Medical Administrative Corps

9Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), pp. 336-50, in UNITED STATES ARMY IN WORLD WAR II.
10An Rpt, Plans Div Opr Serv SGO, 1942. HD.
11T/O 7-11, Inf Regt, Rifle, 1 Oct 40 and 1 Apr 42.
12T/O 8-65, Med Bn, 1 Oct 40 and 1 Apr 42.
13Ltr SPXPC 320.2 (3-13-42), TAG to CGs AGF, AAF, and SOS, 31 Mar 42, sub: Policies Governing T/Os and T/BAs. AG: 320.2 (3-13-42)(5).
14Memo, SG for CG SOS, 6 Jun 42, sub: Changes in T/Os. AG: 320.3 (10-30-41)(2) Sec 8.
15Memo, CG SOS for TAG thru ACofS G-3 WDGS, 16 Jul 42, sub: T/Os, Med Bn. AG: 320.3 (10-30-41)(2) Sec 8.


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officers (eight) and of Dental Corps officers (two) remained unchanged.16

The revision of the table of organization of medical regiments early in 1942 provided for an entirely new type of organization. Instead of having three battalions (collecting, ambulance, and clearing), the new regiment had two battalions that were similar to the medical battalions of infantry divisions, each having three collecting companies and one clearing company. The collecting companies of battalions of medical regiments were almost identical with those of divisional medical battalions, but clearing companies of the former differed from those of the latter in having three instead of two clearing platoons in order to provide increased treatment facilities in army areas. This revision of the medical regiment was based on two of its functions as an army unit: the evacuation of divisional clearing stations and the reinforcement of divisional medical services. Having battalions and companies similar to those of divisional medical battalions, the new medical regiment would simplify the problem of supplying reinforcing units to divisions in combat and, it was anticipated, would permit better ambulance evacuation of divisional clearing stations. This change in the organization of the medical regiment resulted in an increase of Medical Department officers from 66 to 76 and of enlisted men from 980 to 1,078. It also resulted in an increase in vehicles, the number of ambulances rising from sixty to seventy-two.17 To provide even more ambulances for field armies, if they should be needed, and for communications zones as well, The Surgeon General developed about the same time a table of organization for separate motor ambulance battalions. It was approved and published in April 1942.18

In the fall of 1942 the need for economy in personnel and vehicles-which, it will be recalled, affected the organization of hospital units19-also resulted in changes in the tables of evacuation units. In response to a War Department directive to reduce personnel and equipment, especially vehicles, in all Army organizations,20 AGF headquarters established a Reduction Board in November 1942 to review all AGF-type units and to squeeze out the "fat."21 In the process of shrinking the infantry division as a whole, the Board in March 1943 cut the personnel and vehicles of both the regimental medical detachment and the divisional medical battalion. In the detachment 1 medical officer and 23 enlisted men were eliminated, leaving 7 physicians, 2 dentists, and 103 enlisted men. This cut apparently proved too great, for about four months later twenty-three enlisted men were restored to the regimental medical detachment, bringing the total to 126 for the rest of the war. The only change made in the vehicles of the detachment was the replacement of its 2-ton truck with a 1-ton truck. As in the case of the cut in enlisted

16T/O 8-15, Med Bn, 1 Apr 42. T/O 8-65, Med Bn, 1 Apr 42, was amended at the end of July to become T/O 8-65, Med Bn, Motorized (C 1, 31 Jul 42).
17(1) T/O 8-21, Med Regt, 1 Apr 42. (2) DF G-3/42108, ACofS G-3 WDGS to TAG, 5 Mar 42, sub: Med Regt, with Memo for Record and memos of explanation prepared by SGO. AG: 320.3 (10-30-41) (2) Sec 8.
18(1) T/O 8-315, Med Amb Bn, Motor, 1 Apr 42. (2) DF G-3/42108, ACofS G-3 WDGS to TAG, 6 Mar 42, sub: T/Os, with Memo for Record and memos of explanation prepared by SGO. AG: 320.3 (10-30-41)(2) Sec 8.
19See above, pp. 131-37, 146-49.
20Ltr, TAG to CGs AGF, AAF, and SOS, 2 Oct 42, sub: Review of Orgn and Equip Reqmts. AG: 400 (8-10-42)(1) Sec 22.
21Greenfield et al., op. cit., pp. 351-63, discusses the Reduction Board and its work.


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men, this change was reversed in July 1943.22

Reductions made in both the personnel and vehicles of the divisional medical battalion were more lasting. In March 1943 its Medical Corps officers were decreased from 24 to 22 and its enlisted men from 470 to 430, but its Medical Administrative Corps officers were increased from 8 to 11 and its dentists from 2 to 3. The clearing company of the medical battalion suffered the greatest decrease in enlisted men, twenty being eliminated, of whom twelve were orderlies who normally served in the clearing station. In each collecting company the number of litter bearers was reduced from thirty-six to thirty-one. The Reduction Board believed that the use of jeeps to evacuate casualties from the battlefield warranted this action, but supported the Ground Surgeon in opposing a reduction in the number of ambulances because it believed that twelve would be needed to evacuate casualties from each regiment and would not be available unless included in the table of organization. Nevertheless, the commanding general, Army Ground Forces, directed a cut of two in each collecting company, thereby reducing the number in the entire medical battalion from thirty-six to thirty. Four other motor vehicles, three of which were command cars, were also eliminated.23 Cuts were made also in the personnel and vehicles of other organic medical units, but being similar in nature to those already described, they need not be discussed here.

Although experience in maneuvers and in theaters of operations indicated that medical battalions and regiments, organized under existing tables, were not entirely suitable for use with corps and army troops respectively, it remained for the Reduction Board of AGF headquarters to initiate a change in corps and army evacuation units. The chief cause of dissatisfaction with existing units was their inflexibility. To provide greater flexibility, permitting the assignment of collecting, clearing, and ambulance companies in any combination required to fit a particular situation, and thereby to promote economy of both personnel and equipment, the Reduction Board in February 1943 proposed the elimination of such large table-of-organization units as the medical regiment and the separate ambulance battalion, and the substitution of small administratively self-sufficient units, such as companies, which could be grouped for training and tactical use under separate battalion and group headquarters detachments.24 This proposal reflected a general trend in the Army Ground Forces "away from the organic assignment of resources to large commands according to ready-made patterns, and toward variable or ad hoc assignment to commands tailor-made for specific missions"25-a trend that was to end during 1943 in the disappearance of type armies and corps. In accordance with the Reduction Board's proposal, the Ground Surgeon's Office

22T/O 7-11, Inf Regt, 1 Mar 43 and T/O&E 7-11, Inf Regt, 15 Jul 43, 26 Feb 44, and 1 Jun 45.
23(1) T/O 8-15, Med Bn, 1 Mar 43; T/O 8-16, Hq and Hq Det, Med Bn, 1 Mar 43; T/O 8-17, Collecting Co, Med Bn, 1 Mar 43; and T/O 8-18, Clearing Co, Med Bn, 1 Mar 43. (2) M/S GNRQT/24549, sub: T/O 8-16, 8-17, and 8-18, with following comments: CG AGF to Reqmts AGF, 5 Dec 42; Reduction Bd to CG AGF, 8 Dec 42; and CG AGF to Reqmts AGF, 9 Dec 42. AGF: 320.3.
24(1) M/S GNRQT/31566, Reduction Bd to Reqmts AGF, 10 Feb 43, sub: Med T/Os. AGF: 320.3. (2) An Rpt, Surg First Army, 1941. HD. (3) Memo, Ground Surg for CG AGF, 17 Jun 43, sub: [Anal of Rpts from North Africa]. Ground Med files: Chronological file, Folder 1.
25Greenfield et al., op. cit., p. 280. See also pp. 279-99, 351-54.


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prepared tables of organization for headquarters and headquarters detachments of medical battalions and groups, and for administratively self-sufficient collecting, clearing, and ambulance companies. The Reduction Board, staff officers in AGF headquarters, and the Surgeon General's Office approved these tables and they were published in May 1943.26 Thereafter, instead of being rigid table-of-organization battalions and regiments, evacuation units of corps and armies were flexible battalions and groups made up of combinations of collecting, clearing, and ambulance companies that varied as the situation demanded.27

A further step in the trend toward the formation of small units that could be used in variable combinations was the development of tables of organization for teams or sections that could be grouped together to form platoons that could be further grouped to form companies. Like other technical services, the Medical Department prepared a table of organization for such units. The Medical Department table, issued in July 1943, provided for administrative, depot, motor ambulance, veterinary, and miscellaneous teams or sections. The three ambulance sections provided for by this table had 3, 6, and 10 ambulances respectively and could be assigned wherever required. One of the miscellaneous sections, the "attached medical section," was designed to provide medical service for nonmedical battalions that were organic parts of larger units but were assigned alone to special missions.28

Early in 1944 the general movement already under way to replace Medical Corps officers with Medical Administrative Corps officers wherever possible affected the make-up of evacuation units also.29 In battalion and group headquarters, for example, administrative officers replaced physicians as operations officers (S-3s). Of perhaps more significance was the substitution in the medical detachments of combat battalions and regiments of Medical Administrative Corps officers for Medical Corps officers as battalion surgeons' assistants. The Ground Surgeon concurred in The Surgeon General's proposal to make this substitution in the medical detachments of coast artillery, anti-aircraft artillery, engineer, signal, and ordnance battalions, but he disapproved at first the recommendation that it be extended to the medical detachments of infantry regiments and tank battalions. The latter organizations had such a high percentage of casualties, he stated, that a reduction of Medical Corps officers in their medical detachments would seriously impair the efficiency of their medical services.30 In February 1944, on the advice of the Fifth Army Surgeon in Italy, the Ground Surgeon reversed himself on this point. Thereafter, in the medical detach-

26(1) M/S GNRQT/31566, sub: Med T/Os, Comment 5, Ground Med Sec to Reqmts AGF thru Reduction Bd, 11 Mar 43; Comment 6, Reduction Bd to CG AGF, 3 [sic] Mar 43; Comment 7, Sec Gen Staff AGF to Ground Med Sec, 12 Mar 43; Comment 8, Ground Med Sec to Sec Gen Staff AGF, 16 Mar 43; Comment 10, Sec Gen Staff AGF to Reduction Bd, 18 Mar 43. AGF: 320.3. (2) Memo for Record, 29 Mar 43, by Ground Med Sec. Ground Med files: Transfer Binder Journal, 1943.
27T/O&E 8-22, Hq and Hq Det, Med Group, 20 May 43; T/O&E 8-26, Hq and Hq Det, Med Bn, Sep, 20 May 43; T/O&E 8-27, Med Collecting Co, Sep, 20 May 43; T/O&E 8-28, Med Clearing Co, Sep, 20 May 43; and T/O&E 8-317, Med Amb Co, Motor, Sep, 20 May 43.
28T/O&E 8-500, Med Dept Serv Orgn, 26 Jul 43.
29See above, pp. 250-51, 280.
30(1) Memo, SG for CG ASF, 25 Nov 43, sub: Conservation of MC Offs. (2) Memo, CG AGF (Ground Med Sec) for CofSA, 22 Feb 44, same sub. (3) DF, ACofS G-3 WDGS to TAG, 1 Mar 44, same sub. All in AG: 320.3 (10-30-41)(2). (4) WD Cir 99, 9 Mar 44.


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ment of the infantry regiment, for example, there were five Medical Corps, two Dental Corps, and three Medical Administrative Corps officers instead of seven Medical Corps and two Dental Corps officers. One Medical Corps and one Medical Administrative Corps officer, instead of two Medical Corps officers, served with each of the three battalion medical sections. In the detachment's headquarters there were two Medical Corps officers, instead of one as formerly, to insure a replacement if needed for one of the battalion surgeons.31

Further changes were made in existing evacuation units, and new units were proposed and developed in the latter half of 1944 and the early part of 1945. Late in May 1944 a War Department circular directed a reduction in the number of basic privates in all but a few of the Army's table-of-organization units.32 Basic privates were soldiers in excess of the complement of personnel needed to perform the functions for which units were designed and were provided to serve as replacements for losses occurring in the first phases of combat or, when in garrison, for men who would normally be absent because of furloughs, sickness, and the like. Until May 1944 basic privates represented an addition of about 10 percent to the normal operating strength of a unit. In May the War Department directed that they be reduced by approximately one-half. This led to a reduction in the number of basic privates in the medical battalion of an infantry division from thirty-nine to twenty-two.33 Separate medical units such as collecting, clearing, and ambulance companies were similarly reduced, but medical detachments serving with cavalry and infantry divisions were exempted.34

In the latter part of 1944 the Ground Surgeon proposed changes in the evacuation units of both divisions and armies. It had been recognized for some time, he stated, that the clearing companies of divisional medical battalions needed three-instead of two-clearing platoons, in order to provide one clearing platoon to work with each of three collecting companies in support of the three regimental combat teams of each infantry division. Moreover, reports from theaters of operations, according to the Ground Surgeon, emphasized that the collecting-station platoons of separate collecting companies were not needed in army areas of combat zones. There the need was for more litter bearers. Likewise, the ambulance platoons of separate collecting companies were not required in army areas because separate ambulance companies were authorized as army units. The Ground Surgeon therefore proposed to eliminate collecting companies as army evacuation units, and to substitute for them additional separate ambulance companies and separate litter bearer companies. For the latter he prepared a tentative table of organization. He further proposed that the men and officers formerly assigned to collecting-station platoons of army collecting companies should be used to form third platoons for the clearing companies of divisional medical battalions. Despite the fact that the changes recommended were expected not only to improve the organization of the

31(1) M/S, Ground Med Sec to ACofS G-2 AGF, 8 Mar 44, sub: Proposed Changes in T/O. Ground Med files: Chronological file (Col W. E. Shambora). (2) DF, ACofS G-3 WDGS to TAG, 25 Mar 44, sub: T/O&E 8-500 and 8-550, with Memo for Record on change in WD Cir 99 (1944). AG: 320.3 (10-30-41) (2). (2) WD Cir 122, 28 Mar 44.
32WD Cir 201, 22 May 44.
33T/O&E 8-15, Med Bn, 15 Jul 43, with C 2, 3 Jul 44.
34WD Cir 201, 22 May 44.


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medical service in division and army areas of combat zones but also to save both commissioned and enlisted personnel, the Deputy Chief of Staff of the Army Ground Forces disapproved the Ground Surgeon's proposal in December 1944 because he considered it undesirable to make such changes "at this late date in the war."35

The question of whether or not the medical gas treatment battalion should continue to exist arose in the latter part of 1944. Earlier its table of organization had been superseded by a table providing for a gas treatment team that was smaller and more restricted in its functions,36 but units already in theaters of operations continued in existence. The Technical Division of the Surgeon General's Office contended in June 1944 that they were not needed because oxygen and drugs could be administered to gas casualties by gas treatment teams and other medical units, the decontamination of equipment and clothing was not a proper function of the Medical Department, and the ability of gas treatment battalions to locate and decontaminate personnel as soon after exposure as necessary was doubtful.37 The Ground Surgeon also questioned the utility of such battalions and considered them wasteful of personnel.38 Moreover, since gas warfare had not been used, medical gas treatment battalions in theaters of operations had not performed the functions for which they were intended. Nevertheless, because they had constituted a "convenient reserve," theaters wished to retain them. So also did the Chief of the Chemical Warfare Service. In October 1944, therefore, The Surgeon General requested and received permission to revise and reinstate the table of organization of the gas treatment battalion as an authorized unit.39

One of the uses which theaters had made of gas treatment battalions was to hold and care for patients awaiting evacuation at railheads and airports. No unit designed specifically for this purpose had been provided, despite information from North Africa as early as the fall of 1943 that they were needed,40 and theaters had had to use whatever means were available to meet their needs. This practice had been wasteful of both personnel and equipment. Early in 1945, therefore, after an inspection of the medical service of the European theater by one of his representatives, the Assistant Chief of Staff, G-4, directed The Surgeon General to prepare a table of organization for a medical holding unit.41 The resulting unit, a medical holding battalion authorized in May 1945, consisted of a headquarters and three holding companies, each capable of han-

35(1) Memo for Record, on M/S, Comment 4, Ground Med Sec to ACofS G-1 AGF, 15 Dec 44, no sub. (2) M/S, Comment 1, Ground Med Sec to Gen Staff AGF, 18 Sep 44, sub: T/O&E 8-29 (Proposed) Med Litter Bearer Co, Sep. Both in Ground Med files: Chronological file, Folder 2. (3) M/S, Comment 1, Ground Med Sec for ACofS G-3 AGF, 17 Jun 44, no sub. Ground Med files: Chronological file, Folder 1. (4) Memo, SG for CG ASF, 1 Oct 43, sub: Recomd for Changes in Med Dept Orgn, (SG: 320.3-1) proposed a third platoon for the clearing companies of the medical battalions of infantry divisions. After the war, the third platoon was added (T/O&E 8-18N, Clearing Co, Med Bn, 27 Feb 48).
36T/O&E 8-500, Med Dept Serv Orgn, 23 Apr 44.
37Diary, Tec Div SGO, 17 Jun 44. HD: 024.7 Oprs Serv.
38Ltr, Brig Gen F[rederick] A. Blesse to Col Calvin H. Goddard, 11 Feb 53. HD: 314 (Correspondence on MS) XI.
39(1) Diary, Tec Div SGO, 7 and 14 Oct 44. HD: 024.7 Oprs Serv. (2) T/O&E 8-125, Med Gas Treatment Bn, 11 Nov 44.
40(1) Memo, CG AAF for SG, 17 Sep 43, sub: Aerial Evac of Casualties. (2) Memo, Dir Hosp Admin Div SGO for Dir Plans Div SGO, 22 Sep 43, no sub. Both in HD: 705 "Hosp and Evac (Holding Unit) MTO."
41(1) 2d ind, SG to CG ASF, 3 Mar 45, on unlocated basic ltr. HD: 320.3-1 (T/O&E). (2) An Rpt, Tec Div SGO, FY 1945. HD.


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dling 300 patients. Had this battalion not been developed so late in the war, its use would have saved manpower, for it was authorized 26 officers and 404 enlisted men as compared with 45 officers and 411 enlisted men of the medical gas treatment battalions which some theaters used as holding units.42

Changes occurred during the war in the equipment as well as the personnel and vehicles of evacuation units. Changes in medical supplies and equipment reflected improvements in items already authorized or additions of items shown by experience to be needed. For example, early in 1944 an improved portable field autoclave replaced an older item of that type in the clearing companies of medical battalions of infantry divisions. At the same time the number of chests of surgical supplies was increased, and portable electric suction apparatus was added to enable clearing stations to aspirate blood from pleural and abdominal cavities.43 Toward the end of that year and the early part of 1945 a combined otoscope and ophthalmoscope was added to the list of items furnished clearing companies, to permit clearing stations to make better examinations of patients with diseased or injured ears.44 Other changes were made at intervals in the lists of medical supplies and equipment of evacuation units in order to improve the standard of emergency medical service under combat conditions.45

Changes were also made in the equipment of evacuation units to increase their mobility. For example, early in the war the Medical Department developed a pack carrier for battalion medical equipment. This carrier-a canvas container mounted on a wooden frame-permitted the supplies and equipment used in battalion aid stations to be packed in loads (averaging about forty pounds each) that could be carried by individuals of battalion medical sections.46 Later in the war, after aluminum became available for the purpose, aluminum-pole litters were substituted, it will be recalled, for heavier ones made of steel.47 Another change contributing to greater mobility in evacuation was the development of litter racks for jeeps, permitting in many instances the substitution of motor for pedestrian evacuation in front-line areas. Although such racks were produced locally for use by evacuation units much earlier, they were not included in tables of equipment as standard items until 1945.48

42(1) T/O&E 8-55, Med Holding Bn, 30 May 45. (2) Ltr, TAG to CinC USAF Pacific and CG USAF POA, 5 Jul 45, sub: T/O&E Med Holding Bn. SG: 320.3.
43(1) Ltr, CG AGF to CG ASF thru SG, 10 Nov 43, sub: Proposed Changes in T/O&Es. AGF: 320.3. (2) T/O&E 8-18, Clearing Co, Med Bn, 15 Jul 43, with C 1, 17 Jan 44.
44(1) M/S, Comment 1, Ground Med Sec to ACofS G-4 AGF and Reqmts AGF, 23 Aug 44, sub: Addition to T/Es of Certain Med Units. Ground Med files: Chronological file, Folder 2. (2) T/O&E 8-138, Clearing Co, Mountain Med Bn, 4 Nov 44, and T/O&E 8-18, Clearing Co, Med Bn, 14 Feb 45, for example.
45Examples of these changes may be found by comparing the T/O&Es of various evacuation units.
46(1) An Rpt, Equip Br Tng Div SGO, 1942. HD. (2) Memo, SG for Chief Surg SWPA, 1 Dec 42. SG: 705 (Australia)F. (3) Memo, [Maj] A[lfred] P. T[hom] for Col Shambora, 2 Mar 43, sub: Comments on Lessons Derived from Oprs at Casablanca and Oran. Ground Med files: Chronological file, Training, 1943. (4) T/O&E 7-11, Inf Regt, 15 Jul 43.
47(1) John B. Johnson, Jr., and Graves H. Wilson, A History of Wartime Research and Development of Medical Field Equipment (1946), pp. 75-80. (2) For example, T/O&E 8-16, C 1; T/O&E 8-17, C 3; T/O&E 8-18, C 2, all dated 3 Jul 44.
48(1) Diary, Tec Div SGO, 3 Jun and 26 Aug 44. HD: 024.7 Oprs Serv. (2) The General Board, U. S. Forces, European Theater, Evacuation of Human Casualties in the European Theater of Operations. Study No. 92. HD. (3) T/O&E 8-16, Hq and Hq Det, Med Bn, 14 Feb 45, and T/O&E 7-11, Inf Regt, 1 Jun 45.


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Efforts to increase mobility by reducing the size and weight of equipment were made in the case of evacuation units, as in that of hospital units already discussed.49 During the winter of 1942-43 the cubage of the equipment (including vehicles) of the infantry division's medical battalion was reduced from about 1,900 to about 1,475 ship tons, a ship ton being 40 cubic feet.50 Information about the cubage of the equipment of other evacuation units in the fall of 1942 is not readily available, but it is perhaps safe to assume that similar reductions were made in the equipment of those units. After the reductions made in the winter of 1942-43, the cubage of equipment of evacuation units underwent little change until the early part of 1945. At that time there seems to have been a tendency for it to increase slightly. For example, the equipment of the infantry division's medical battalion increased in cubage from about 1,475 to about 1,600 ship tons in February 1945. Similar increases occurred early in 1945 in the equipment of other evacuation units.51

Another measure to increase the mobility and improve the standard of combat zone medical service was the development by the Medical Department of certain vehicles for special purposes. The organization and growth of the Armored Force made it apparent during 1941 that new types of medical equipment would be needed. During the fall of that year the Armored Force itself began to experiment with the development of a surgical truck for use as a mobile clearing station. Soon afterward, the Surgeon General's Office secured authority to initiate a research project in that field. During its course, the Medical Department Equipment Laboratory co-ordinated its developmental work with the Armored Force, the Surgeon General's Office, and the Quartermaster Corps. The pilot model of such a truck was delivered to the Laboratory in July 1942. Called a "truck, surgical," this vehicle consisted of a van body mounted on a standard 2-ton (6 x 6) chassis. Within the body of the truck were a 50-gallon water tank; a sink with hot and cold water outlets; cabinets for supplies, equipment, and accessories; and three dome lights. Medical items such as those used in clearing stations were supplied and installed by the Medical Department. A tent, large enough to shelter twenty litter patients, was supplied to provide space outside the truck for patients awaiting evacuation farther to the rear. These trucks were delivered on a basis of six per division to all armored divisions in the United States during late 1942 and early 1943.52

A surgical operating truck for use by auxiliary surgical groups was developed during the latter half of 1943. It differed from the surgical truck of the armored division largely in that it was supplied with greater quantities of more elaborate equipment. While the surgical truck of the armored division had only equipment and supplies for emergency medical treatment to be given inside the truck, the surgical operating truck carried enough surgical instruments and equipment to perform approximately 100 major surgical operations. Surgery was not performed in the truck, but in a tent attached to its rear. The truck served only as a supply and

49See above, pp. 146-48.
50(1) Memo, CG AGF for ACofS G-3 WDGS, 16 Feb 43, sub: T/O&E, Med Bn. AG: 320.3 (10-30-41)(2) Sec 8. (2) FM 101-10, Staff Offs' Fld Manual-Orgn, Tec, and Logistical Data, 10 Oct 43 and 21 Dec 44.
51FM 101-10, Staff Offs' Fld Manual-Orgn, Tec, and Logistical Data, 21 Dec 44 and 1 Aug 45.
52Johnson and Wilson, op. cit., pp. 295-339.


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sterilizing room. Such trucks, along with auxiliary surgical groups, often served as far forward as divisional clearing stations, supplementing them when the evacuation load was heavy. By the end of October 1945, 207 surgical operating trucks had been delivered for use by the Medical Department. In addition to surgical trucks, the Medical Department developed other special vehicles for use in theaters of operations. They were a mobile dental laboratory truck, mobile optical repair truck, a mobile dental operating truck, and an army medical laboratory truck. Development of these vehicles contributed to the mobility and flexibility of medical service in a fast-moving war.53

Activation, Training, and Use in the United States

The responsibility for activating, training, and using in the United States the evacuation units that would operate in combat zones of theaters of operations belonged almost exclusively to the Ground Forces. Before the reorganization of the War Department in March 1942,54 all field medical units were trained under the supervision of General Headquarters. In the division of responsibility for medical units between the Ground and Service Forces that followed the reorganization,55 the Ground Forces (successor to General Headquarters) inherited the responsibility for training all medical units used in combat zones and gained in addition the responsibility for preparing their tables of organization and equipment, recommending their inclusion in the troop basis, and activating such units.

Planning for the troop basis during most of 1942 was conducted in terms of standard or fixed organizations. Medical units that were organic elements of combat forces whose structure was fixed by tables of organization, such as infantry divisions, were automatically included in the troop basis along with their parent units. While the structure of combat forces larger than divisions was not governed by tables of organization, corps and armies normally had standard numbers of units of various sorts early in the war. For example, for emergency medical care and evacuation each corps generally had a medical battalion; each army, three medical regiments.56 In the latter part of 1942 the Ground Surgeon proposed that each Army should have, in addition, a separate ambulance battalion to assist in the evacuation of casualties from divisional clearing stations.57 Soon afterward, the standard army and corps were abandoned as yardsticks for determining the number of service units needed.58 In addition, early in 1943, as mentioned above, nondivisional medical units organized under inflexible tables of organization, such as medical regiments, were replaced by flexible battalions and groups made up of variable combinations of separate ambulance, collecting, and clearing companies. While these changes did not affect the automatic inclusion in the troop basis of medical units that were organic elements of com-

53Johnson and Wilson, op. cit., pp. 354-96, 407-35, 444-75, 534-66.
54See pp. 54-55.
55See above, pp. 58-59.
56(1) Greenfield et al., op. cit., pp. 276-80, 352-54. (2) Orgn of Major Units, incl to Ltr, TAG to CGs AGF, AAF, and SOS, 31 Mar 42, sub: Policies Governing T/Os and T/BAs. AG: 320.2 (3-13-42)(5).
57M/S, Ground Med Sec to [ACofS] G-4 [AGF], 10 Aug 42, sub: Revision of Type Army and Type Army Corps Trps-Med. HD: 322 AGF (Units, Med) 1942.
58Greenfield et al., op. cit., pp. 354-71.


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bat forces still organized under tables of organization, they did require the establishment of a new basis for estimating the evacuation units that would be needed for service with corps and armies. Thereafter, this basis was a ratio of medical companies to divisions or to a certain number of troops. For example, it was considered that an army or task force needed a collecting company and a clearing company for each of its infantry divisions; and an ambulance company for every group of 12,000 soldiers.59 On this basis the Ground Surgeon proposed in November 1943 that a troop basis having 105 combat divisions should include 105 collecting, 105 clearing, and 105 ambulance companies.60 The troop bases subsequently approved did not follow this recommendation. For example, in April 1944, when planning was in terms of 89 divisions, the troop basis included 162 collecting, 104 clearing, and 75 ambulance companies.61 The discrepancy between the ratio recommended by the Ground Surgeon and that in which separate medical companies were authorized can perhaps be explained by the fact that the troop basis was determined in the latter part of the war more by requests of theaters for units of specific types than by recommendations of staff officers in Washington.62 In May 1945, just before the war in Europe ended, there were in the troop basis for the support of 89 divisions the following corps and army evacuation units: 137 collecting companies, 75 clearing companies, 96 ambulance companies, and headquarters detachments for 80 medical battalions and 16 medical groups. All but one of these units, an ambulance company, had already been deployed to theaters of operations.63

The activation and training of medical evacuation units were so closely intertwined with the activation and training of other Ground Forces units that any account of them would reflect generally a larger picture already described in considerable detail elsewhere.64 Medical units that were organic elements of any of the combat arms or of any service other than medical were activated and trained along with their parent organizations. Corps and army medical units were activated according to a schedule based upon recommendations of the Ground Surgeon. During most of 1942 they were trained under the supervision of division commanders. In the latter part of that year and the early part of 1943, however, AGF headquarters established special local headquarters (Headquarters and Headquarters Detachments, Special Troops) to supervise the training of all nondivisional AGF-type service units, including those of the Medical Department. At least one of these headquarters had a Medical Corps officer on its staff. The Ground Surgeon exercised general supervision over the technical training of all Ground Forces medical units and, on the basis of inspections and reports, kept AGF headquarters

59(1) Ltr, CG AGF to CofSA, 11 Jul 43, sub: Change to T/O 8-27 and 8-28, with incls. AGF: 320.3. (2) T/O&E 8-27, C 1, and T/O&E 8-28, C 1, both dated 5 Aug 43. (3) FM 101-10, 12 Oct 44.
60M/S, Comment 2, Ground Med Sec to Plans [Div] AGF, 2 Nov 43, with 2 incls, Anal of 1944 Trp Basis and Summary of Trp Basis Study. Ground Med files: Chronological file, Folder 1.
61Troop Basis, Calendar Year 1944, 1 Apr 44 Revision. AG: Ref Collection.
62
See above, pp. 219-22.
63The War Department Troop Basis, 1 May 45. AG: Ref Collection.
64Robert R. Palmer, Bell I. Wiley and William R. Keast, The Procurement and Training of Ground Combat Troops (Washington, 1948), pp. 426-560 in UNITED STATES ARMY IN WORLD WAR II.


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informed as to the state of their readiness for shipment to theaters of operations.65

Details of the training of Medical Department units will be included in a volume on that subject planned for this series, but one aspect of their training needs to be considered here. Unlike station and general hospital units that were trained by the Army Service Forces, evacuation units trained by the Ground Forces were charged with actually providing medical service concurrently with their training in the zone of interior. To carry out this dual mission, they needed both personnel and equipment, but they suffered from a shortage of both. Lack of a sufficient number of Medical Corps officers in the Army Ground Forces prevented the assignment of full complements to units in training. Although the ratio of assigned to authorized Medical Corps officers varied from time to time and from unit to unit, it was often less than 50 percent.66 Early in 1943 the shortage was so great that the Deputy Chief of Staff of the Army directed the Army Ground Forces to amend the tables of organization of medical units for which it was responsible by including in each a remark that medical and dental officers would be furnished "only as required and available within the continental limits of the U. S."67 Early the next year the Ground Surgeon reported that with one exception-the 92d Division-it was possible to assign only one Medical Corps officer, instead of the seven authorized, to each infantry regiment participating in maneuvers in Louisiana.68

The shortage of equipment did not last as long as the shortage of personnel. It was most severe during 1942 and the early part of 1943.69 At that time the Ground Surgeon reported that repeated requests of the Surgeon General's Office to issue fuller allowances of supplies and equipment always met with the same answer-that production was great enough to meet only the needs of units scheduled for early shipment to theaters of operations.70 By the middle or latter part of 1943 the supply situation had improved and by the end of the year some units reported that they had on hand approximately all of their equipment.71 Early in 1944 the Ground Surgeon reported that all medical units engaged in maneuvers in Louisiana had about 95 to 100 percent of their equipment with them.72

Despite shortages of equipment and personnel, evacuation units discharged their mission of furnishing medical service

65(1) Memo, Asst Ground Surg for [ACofS] G-4 [AGF], 15 Nov 42, sub: Activation Plan for Non-Div Med Units. (2) M/S, Ground Med Sec to [ACofS] G-3 [AGF], 30 Jan 43, sub: Rpt on Readiness of Type Med Units. Both in Ground Med files: Chronological file, Folder 1. (3) An Rpt, Surg Third Army, 1942. HD.
66For example, see An Rpts, Surgs Second and Third Armies, 1942, 67th Med Group, 1943, and 66th Med Group, 1944. HD.
67Memo, Dep CofSA for CG AGF, 10 Mar 43, sub: Availability of Physicians. Ground Med files: Chronological file, Folder 1. For an example of this remark see T/O&E 7-11, Inf Regt, 15 Jul 43.
68Memo, Ground Surg for ACofS G-4 AGF, 26 Feb 44, sub: Rpt of Insp, Louisiana Maneuver Area, 22-24 Feb 44. Ground Med files: Chronological file (Col W. E. Shambora).
69An Rpts, Surgs Second and Third Armies, 1942; Surg 4th Motorized Div, 1942; Surg 5th Inf Div, 1942; and 30th, 31st, and 65th Med Rgts, 1942. HD.
70M/S, Comment 7, Ground Med Sec to Ordnance [Sec, AGF], 23 Dec 42, sub: Equip for Certain Units, Third Army. Ground Med files: Chronological file, Folder 1.
71An Rpts, Surg Second Army, 1943; Surg 4th Inf Div, 1943; 31st, 67th, 69th, 341st, and 343d Med Groups, 1943. HD.
72Memo, Ground Surg for ACofS G-4 AGF, 26 Feb 44, sub: Rpt of Insp, Louisiana Maneuver Area, 22-24 Feb 44. Ground Med files: Chronological file (Col W. E. Shambora).


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while still in training. While in garrison, Ground Forces medical units were not dependent upon the issuance of their own organizational equipment for use in medical service, because The Surgeon General had established a policy before the war-and it was continued-of supplying dispensary buildings erected in training areas of Army camps with medical supplies and equipment from station stocks.73 Medical units of infantry divisions normally supplied personnel for the operation of six to seven of such dispensaries in their own divisional areas. Each dispensary generally served a particular segment of a division. For example, each regimental medical detachment operated a dispensary for all persons in the infantry regiment to which it belonged. The medical service rendered by dispensaries consisted of routine immunizations, blood-typing, monthly physical inspections, and daily sick calls. Soldiers found by medical examination at sick call to need hospital care were usually transported to station or regional hospitals in ambulances of divisional medical battalions. Ambulances and aid men also accompanied troops on long marches and on all training exercises of a dangerous nature, such as firing on ranges. In order to interfere with training formations as little as possible and to give as many men as possible experience in providing actual medical service, the personnel of divisional medical units often served in dispensaries on a rotational basis.74 Nondivisional medical units, such as army medical regiments and groups, also operated dispensaries in garrison-sometimes for their own personnel only and sometimes for persons belonging to other units as well. In addition, units of these types were at times split up to supply medical service for troops in widely separate areas. For example, during 1943 a detail of twenty-five enlisted men and twelve ambulances of the 1st Medical Regiment gave ambulance service to various infantry units stationed in northern California, while various collecting and clearing units of the Regiment handled the medical service of troops in southern California, and a platoon of one of its clearing companies served an artillery training center at Yakima, Wash.75

On maneuvers Ground Forces medical units used organizational equipment which had been issued to them for training purposes or for later use in theaters of operations. It was the Ground Surgeon's opinion that such experience was invaluable and that no medical unit should be shipped to theaters of operations without having first become acquainted with its own equipment through use.76 Divisional medical units operated in support of the divisions to which they belonged, setting up aid, collecting, and clearing stations, and evacuating and caring for both actual and simulated casualties.77 Nondivisional units performed a variety of functions, in addition to caring for corps and army troops and evacuating casualties from divisional clearing stations. For example, during maneuvers in 1942 the 68th Med-

73The Annual Report, Surgeon First Army, 1941, spoke of the establishment of this policy. Its continuance was mentioned in the Annual Reports, Surgeons, Camp Hood (Texas) and Indiantown Gap Military Reservation (Pennsylvania), 1942.
74An Rpts, Surgs, 4th Motorized Div, and 65th, 69th, 79th, 86th, 98th, and 99th Inf Divs, 1943. HD.
75An Rpts, 1st and 31st Med Groups, 1943; 264th Med Bn, 1943; and 66th Med Group, 1944. HD.
76Interv, MD Historian with Col Shambora, 22 Apr 49. HD: 000.71.
77An Rpts, Surgs, 4th Motorized Div, and 65th, 69th, 79th, 86th, 98th, and 99th Inf Divs, 1943. HD.


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ical Regiment operated the following installations: a convalescent hospital, a medical supply depot, clearing stations for depot and army troops, and an infirmary for corps troops. During maneuvers in 1943 the 134th Medical Regiment established aid and prophylactic stations in towns within the area of operations, maintained clearing stations for army troops, evacuated casualties from division and army clearing stations to evacuation hospitals and from the latter to named station hospitals, and provided personnel for the operation of a provisional medical supply depot.78 Regardless of the missions assigned, Ground Forces medical units on maneuvers gained valuable practical experience and at the same time supplied medical service for the troops with which they operated.

78An Rpts, Surg Second Army, 1942; 1st, 31st, 67th, 69th, 134th, and 341st Med Groups, 1943. HD.

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