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Chapter III

Contents

CHAPTER III

Plans and Preparations for Hospitalization in Overseas Areas

Mobilization Planning

Planning for field hospitalization in the event of mobilization involved determination of the numbers and types of medical units that would be needed for the force anticipated, provision of up-to-date guides for their organization and equipment, and arrangements for furnishing them with personnel and supplies. Until the fall of 1940 the defensive nature of all War Department mobilization planning combined with limitations upon available funds to hold Medical Department activities in this sphere largely within the realm of paper work.

Determining the Number  
of Medical Units Needed

Determination of the number of mobile medical units that would be needed was governed primarily by the number of combat units authorized. Each combat organization such as a regiment or division had a standard structure consisting of a specific number of units of the several arms and services, including medical, that were "organic" parts of the larger unit. Thus units designed to provide emergency medical care and transportation for patients in divisional areas of combat zones were automatically required along with the regiments and divisions of which they were a part. The organization of corps and armies, though not strictly governed by tables of organization, was also standardized. On recommendation of The Surgeon General in the winter of 1939 a "type army" (that is, a standard army) was authorized 3 medical regiments, 10 evacuation hospitals, 8 surgical hospitals, 1 convalescent hospital, 1 medical laboratory, and 1 medical supply depot. A corps was authorized either a medical regiment or a medical battalion. Other medical units varying in kind and number might be authorized as a General Headquarters (GHQ) reserve force. In July 1940 the War Department Protective Mobilization Plan listed as mobile medical units, for an anticipated force of approximately 1,150,000 men, 8 medical regiments, 5 "reinforcing" medical battalions, 1 horsedrawn ambulance company, 1 medical troop, 17 evacuation hospitals, 13 surgical hospitals, 1 convalescent hospital, 2 medi-


39

cal laboratories, 2 medical supply depots, and certain other miscellaneous units.1

There was no standard number of fixed medical units such as station and general hospitals for given combat forces. To estimate the number needed the Surgeon General's Office again turned to Colonel Love's analysis of World War I battle casualty experience. From this study some members of the Planning and Training Division believed that beds in fixed hospitals should equal 15 percent of a theater's strength. Others believed a lower ratio would suffice.2 The Surgeon General indicated in his Protective Mobilization Plan of 1939 that 126,000 fixed beds would be needed by the end of the first year of mobilization.3 The War Department Plan provided for only 35,000-in 32 general hospitals, 4 station hospitals, and 2 hospital centers. The Surgeon General considered this provision "alarmingly inadequate" and attempted during 1940 to secure an increase both in the number of beds authorized and in their scheduled rate of availability. In February he submitted a study showing that a minimum of 115,000 fixed beds would be required, but because G-3 believed that the majority of troops to be mobilized should be allotted to combat arms, The Surgeon General's recommendations received only partial approval. On 6 August 1940 the General Staff authorized an increase in the number of 1,000-bed general hospitals from 32 to 102. The number of station hospitals and hospital centers remained as originally planned.4 (Table 1)

Revision of Tables of Organization 
and Equipment Lists

As a part of its mobilization planning the Surgeon General's Office undertook a general revision of tables of organization of all medical units and the preparation of up-to-date equipment lists for them. Although these projects had been started earlier, only the equipment list for medical regiments and the tables of organization for medical regiments and squadrons had been completed by the fall of 1939. After the President declared an emergency this work was pushed to completion by the end of 1940.

Changes in the tables of organization of medical units that supplied emergency medical care and transportation for patients in combat zones reflected changes in combat units to increase their mobility and flexibility. When the infantry division was "streamlined" and converted from a "square" to a "triangular" organization, its organic medical unit was reduced from a regiment to a battalion and appropriate tables for the latter were prepared. Likewise, the medical battalion eventually be-

1(1) Kent R. Greenfield, Robert R. Palmer, and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), pp. 263-68, 275-80, in UNITED STATES ARMY IN WORLD WAR II. (2) 1st ind, SG to TAG, 11 Oct 39, on Ltr, TAG to C of Arms and Servs, 3 Oct 39, sub: Orgn of Army Troops. AG: 320.2(9-27-39)(l). (3) Ltr 320.3-1, SG to ACofS G-3 WDGS, 13 Jul 40, sub: Corps Med Units and Atchd Med, and Army Med Regts. HD: McKinney files. (4) War Department Protective Mobilization Plan, 1940, Annex No. 7, Pt. I. AG: Budget Div, WDGS files, A-45-7.
2Memo, GLM [Col Garfield L. McKinney] for Col [Albert G.] Love, 6 Feb 40. HD: McKinney files.
3SG PMP, 1939, Annex No. 29, Chart No 2.
4(1) Ltr, SG to TAG, 15 Feb 40, sub: Hosp under WD PMP 1939. AG: 381 (5-10-40) G-4/20052-134.
(2) Ltr, SG to TAG, 8 Jul 40, sub: Hosp under WD PMP, 1939, with 1st ind AG 381 (7-8-40)M-C, TAG to SG, 6 Aug 40. HD: 370.01-1. (3) Memo G-3/6541-Med-64, ACofS G-3 WDGS for Sec Gen Staff, 14 Apr 40, sub: Status of MD for War. AG: 381 (4-6-40) (1). (4) The War Department Mobilization Plan, speech by Lt Col Harry L. Twaddle, GSC, Chief Mob Br G-3 Div WDGS, 30 Sep 39. G-3 Course No 13 and 13A, AWC, 1939-40.


40

TABLE 1-COMPARISON OF THE WAR DEPARTMENT'S PLAN AND THE SURGEON GENERAL'S RECOMMENDATION FOR FIXED BEDS FOR THEATERS OF OPERATIONS

Days of Mobilization

War Department Plan

The Surgeon General's Recommendation

Gen Hosp

Sta Hosp

Hosp Ctr

Gen Hosp

Sta Hosp

Hosp Ctr

M-Day

---

---

---

---

---

---

M+10/11

---

---

---

1,000

---

---

M+30/31

---

---

---

8,000

---

---

M+60/61

3,000

---

---

32,000

1,000

2,000

M+90/91

3,000

---

---

36,000

2,000

2,000

M+120/121

22,000

1,000

2,000

43,000

3,000

4,000

M+150/151

32,000

1,000

2,000

52,000

3,000

5,000

M+180/181

32,000

1,000

2,000

72,000

3,000

5,000

M+210/211

32,000

1,000

2,000

84,000

3,000

7,000

M+240/241

32,000

1,000

2,000

92,000

3,000

9,000

M+270/271

32,000

1,000

2,000

96,000

3,000

10,000

M+300

32,000

1,000

2,000

99,000

3,000

10,000

M+330

32,000

1,000

2,000

101,000

3,000

10,000

M+360

32,000

1,000

2,000

102,000

3,000

10,000


Source: Study accompanying ltr, SG to TAG, 14 Feb 40, sub: Hosp under WD PMP 1939. AG: 381 (5-10-40) G-4/20052-134.

came the organic unit of a corps. Plans for the organization of armored divisions required the preparation of tables of organization for medical units of that type of combat organization. In 1940 the tables of medical regiments and squadrons were again revised. Generally there was a tendency to increase the personnel in medical units of all sizes and to replace animal-drawn with motor vehicles. Basically, none of the changes made altered the Medical Department's long-established doctrine of hospitalization and evacuation in combat zones.5

Changes in tables of organization of hospital units reflected a growth in specialized medicine. New tables published during 1940 listed for the first time the specialists required as ward officers and chiefs of sections of professional services. They also allotted to hospitals more enlisted men having specialists' ratings and correspondingly fewer having only basic military training. For the first time, they provided for civilian dietitians, physical-therapy aides, and dental hygienists. In many cases the total number of officers and enlisted men was increased. For example, in a 1,000-bed general hospital the number of officers rose from 42, of whom 30 were physicians, to 73, of whom 55 were physicians, and of enlisted men from 400 to 500. These changes, the Surgeon General's Office believed, would enable military hospital units "to perform the necessary additional specialized medical

5(1) Documents on the revisions are in SG: 320.3-1, 1939 and 1940. (2) History of Organization and Equipment Allowance Branch [SGO], 1939-44. HD. (3) Ltr, Surg 4th CA to Corps and Div Surgs, 26 Mar 40, sub: Third Army Maneuvers. HD: McKinney files. (4) Memo, Capt Thomas N. Page for [Brig.] Gen [Albert G.] Love, 28 Dec 40, sub: Activities of the Planning Subdiv [SGO]. HD: McKinney files.


41

and surgical work required, in order to approach the standards of medicine and surgery as practiced in first class civilian hospitals. . ."6

Although no new hospital unit was developed during the emergency period, a change in the surgical hospital indicated the Medical Department's awareness of the problem of developing a highly mobile unit to care for seriously wounded casualties near the front lines. The single-unit 250-bed surgical hospital developed after World War I was replaced by a new 400-bed surgical hospital to be organized under a table of organization issued on 1 December 1940.7 Similar in some respects to the "mobile hospital" adapted from the French auto-chir during World War I,8 the new hospital comprised a headquarters and three subordinate elements: a mobile surgical unit and two 200-bed hospitalization units. Each of the latter had its own headquarters. Since each subordinate unit was capable of independent operation, the surgical unit would be free to move forward, as soon as one hospitalization unit was immobilized with patients, to operate for the other hospitalization unit or to supplement the facilities of other medical stations. Some of the surgical units, the Surgeon General's Office anticipated, would have complete operating, sterilizing, X-ray, and medical supply rooms permanently installed on bus-type or van-type motor vehicles.9

Along with revised tables of organization, new equipment lists were prepared. At the beginning of 1939 the only ones available were shipping lists used during World War I. Like the medical supply catalog, they contained many articles that were obsolete and lacked others that had been developed in intervening years. To enable medical units to give modern medical and surgical treatment, it was necessary to find out from manufacturers what articles were available and to analyze the functions and activities of each unit, from reveille to taps, to determine which were needed. Another factor, the transportation of units to theaters of operations, had to be considered. To conserve shipping tonnage an attempt was made to include only indispensable articles in equipment lists. This work was done by Colonel Offutt, assigned to the Army Medical Center in January 1939 and later transferred to the Surgeon General's Office. He collaborated with the Medical Field Service School (Carlisle Barracks, Pennsylvania), Walter Reed General Hospital, and The Surgeon General's Supply Division and Planning and Training Division. The first list completed (in June 1939) was for the medical regiment. Others-including those for hospitals-followed during the remainder of 1939 and the first ten months of 1940. As rapidly as they were approved by the Surgeon General's Office they were mimeographed and sent to the various medical supply depots. Concurrently, the table of basic allowances for the Medical Department was revised by The Surgeon

6(1) The above paragraph is based largely on a comparison of the following T/Os: Gen Hosps, T/O 683W (6 Jun 32) with T/O 8-507 (25 Jul 40); Sta Hosp, T/O 684W (1 Jul 29) with T/O 8-508 (25 Jul 40) and Evac Hosp, T/O 283W (1 Jul 29) with T/O 8-232 (1 Oct 40). (2) See also Ltr, SG to TAG, 11 Jul 40, sub: Publication of T/O 8-508 and T/O 8-507. AG: 320.6 (Med) (4-18-40) (1).
7T/O 8-231 (1 Dec 40) superseded T/O 284W (1 Jul 29).
8The Medical Department . . . in the World War (1925), vol. VIII, pp. 184-91.
9(1) Ltr, Maj Frank B. Wakeman, SGO to Lt Col Guy B. Denit, MC, C&GS Sch, Ft Leavenworth, 11 Feb 41. SG: 322.3-1. (2) For documents on the experimental development of these vehicles see SG: 322.15-17.


42

General's Planning and Training Division and was published on 1 November 1940.10

Efforts to Assure Availability of Equipment 
and Personnel for Units Planned

Revision of equipment lists emphasized the importance of modernizing World War I unit assemblages in storage. After the war in Europe began, Surgeon General Magee requested funds for this purpose. In April and again in May 1940 he informed the General Staff of the Medical Department's unpreparedness for war, stating: "I have not at the War Department's disposal for any emergency one complete, modern 1,000-bed general hospital for instant dispatch."11 Funds which the General Staff could secure were limited.12 Moreover, believing that The Surgeon General failed to recognize that increases in industrial capacity since World War I would make procurement easier and faster, G-4 opposed "piecemeal action" which favored the Medical Department alone. Hence the Staff only promised "consideration" of Medical Department requirements along with those of other services, and it was not until the month before the passage of the Selective Service Act that substantial funds for Medical Department equipment were included in the War Department's budget requests.13

To provide professional staffs for hospitals included in the Protective Mobilization Plan, The Surgeon General early in 1940 began to arrange with civilian medical institutions for the organization of authorized affiliated units. By June 1940 he requested an increase in their number, stating that the response of sponsoring institutions was more enthusiastic than he had expected. The next month the General Staff raised the numbers authorized to 68 general, 30 evacuation, and 23 surgical hospital units. About a year later the Surgeon General's Office reported success in the organization of affiliated units for 41 general, 11 evacuation, and 4 surgical hospitals-approximately the number originally authorized in 1939.14

Attempts to secure enlisted men for training in hospital units were only partially successful. Although draftees could be used to fill units scheduled for activation during mobilization, trained cadres would be required for each one and some units would have to be ready for action on M Day. Therefore some men needed to be trained in units before mobilization. Increases in the authorized enlisted strength of the Army during 1939 and 1940 and in the authorized strength of the Medical Department in May 1940 from 5 to 7 percent of Army's strength afforded some additional men. Since most of them were needed for organic medical units of divisions or for expanding named hospitals,

10(1) Hist of Basic Equip Lists for Med T/O Orgns, incl 2, to Ltr, Brig Gen Harry D. Offutt to Col H. W. Doan, 10 Jun 48. HD: 322. (2) Memo, Capt Thomas N. Page for Gen Love, 28 Dec 40, sub: Activities of the Planning Subdiv [SGO]. HD: McKinney files.
11Ltrs, SG to TAG, 6 Apr and 10 May 40, sub: Status of the MD for War. AG: 381 (4-6-40) (1).
12Mark S. Watson, Chief of Staff: Prewar Plans and Preparations (Washington, 1950), pp. 156-66, in UNITED STATES ARMY IN WORLD WAR II.
13(1) Memo G-4/20052-134, ACofS G-4 WDGS for CofSA, 20 Apr 40, sub: Status of MD for War. AG: 381(4-6-40) (1). (2) Ltr, TAG to SG, 23 May 40, same sub. Same file. (3) Memo G-4/20052-134, Act ACofS G-4 WDGS for CofSA, 19 Aug 40, same sub. (Marked "not used.") AG: 381(5-10-40).
14(1) Ltr, SG to Each Affiliating Inst, 16 May 40, sub: Affiliated Units, MD, USA. HD: 326.01-1. (2) Ltr, SG to TAG, 26 Jun 40, same sub, with 1st ind AG 381(6-26-40)M-A, TAG to SG, 22 Jul 40. Same file. (3) Annual Report . . . Surgeon General, 1941 (1941), p. 145. (4) John H. McMinn and Max Levin, Personnel (MS for companion vol. in Medical Dept. series), HD.


43

the General Staff at first allotted none at all to nonorganic medical units and numbered hospitals. Insisting upon the necessity of training men in such units, The Surgeon General secured authority in June 1940 for the organization, along with one medical laboratory and one medical supply depot, of two evacuation and two surgical hospital units at half their table-of-organization enlisted strength, but it was not until 1 August 1940 that the first of these was activated.15

Preparing Hospitalization for Overseas Areas During a Peacetime Mobilization

Mobilization of the Army for a year of peacetime training reversed the situation which had been anticipated in mobilization plans. Instead of field medical units such as regimental medical detachments, medical battalions, medical regiments, and numbered hospitals to support combat forces engaged in defensive operations, the greatest need was for named hospitals in the United States. Hence, they had first call upon medical personnel and equipment. Moreover, since the United States was not at war, additional hospitalization required in bases and possessions outside its continental limits was provided on a peacetime basis-that is, in named hospitals. Nevertheless, medical units had to be organized and trained along with the combat forces they were designed to support.

Activation of Field Medical Units

When mobilization began in September 1940 the Army had, aside from the medical units that were organic parts of existing divisions, only the following field medical units: 2 surgical hospitals, 2 evacuation hospitals, 2 medical regiments, 1 medical supply depot, and 1 medical laboratory.16 Additional organic medical units would be activated and trained along with their parent units, such as infantry divisions. Their number depended upon the number of parent units that would be called into being by the General Staff. The number of nonorganic units-those serving with armies, corps, and General Headquarters-that would be activated for training might differ from the number needed for combat operations. In anticipation of the passage of the Selective Service Act, The Surgeon General had recommended in July 1940 the activation at half strength of all such units in the Protective Mobilization Plan except hospital centers, hospital trains, the auxiliary surgical group, and the general dispensary.17 The General Staff partially adopted this recommendation in preparing the 1941 troop basis. In December 1940, it authorized the following corps, army, and GHQ medical units: 8 medical battalions, 8 medical regiments, 1 medical supply depot, 1 medical laboratory, 1 general dispensary, 15 evacuation hospitals, 6 surgical hospitals, 22 general hospitals, and 22 station hospitals.18 Approximately half of these

15(1) Memo, ACofS G-1 WDGS for TAG, 6 Nov 39, sub: Enl Pers, MD. G-1: 15081-Med. (2) Ltr AG 320.2 (5-13-40)M-D, TAG to SG, 14 May 40, sub: Adequacy of Serv Units as Contained in Proposed Trp Basis, with 1st ind, SG to TAG, 20 May 40. SG: 320.2-1. (3) Memo, SG for ACofS G-3 WDGS, 26 Jun 40, sub: Sta Lists. HD: McKinney files. (4) McMinn and Levin, op. cit.
16(1) Annual Report . . . Surgeon General, 1940 (1941), p. 175, and 1941 (1941), p. 153. (2) Unit cards of the 1st and 3d Evac Hosps, 6th and 7th Surg Hosps, 2d Med Lab, and 4th Med Sup Depot. HD.
17
Ltr SGO 370.01-1, SG to TAG, 17 Jul 40, sub: Mob of MD Units in President's Tng Mob, PMP. AG: 381(1-1-40) Sec 3.
18Ltr AG 320.2 (11-15-40)M(Ret) M-C, to CGs of all Armies et al., 16 Dec 40, sub: Constitution and Activation of Units. AG: 320.2(11-15-40)(1) Sec 1.


44

units were to be activated in February 1941 and the rest in June. Early in 1941 the Staff revised the troop basis, and authorized an additional medical battalion and two additional medical regiments. By the end of June 1941 all of the units authorized had been activated. The next month two additional station hospital units were provided when two provisional hospitals, organized but not needed for a task force, were redesignated as numbered hospitals. Although plans were made later in the year for additional units, no more were authorized until after war came.19

Role of Hospital Units;  
Their Personnel and Equipment

Confusion existed about the purpose of the hospital units activated during this period. The character of the mobilization and the nature of the international situation were perhaps responsible for this. Under the Selective Service Act, Reservists and draftees could not legally be made to serve outside the United States except in its territories and possessions. Nevertheless, the Army being mobilized had to be prepared for action anywhere in the event of a threat to the security of the country.

The Surgeon General seems to have regarded authorized hospital units as primarily if not exclusively schools for tactical training that would furnish cadres for other similar units or would provide trained enlisted men as fillers for the hospitals that would be called up in case of war-that is, the affiliated units. Along with shortages of personnel and equipment and demands of named hospitals for both, this view undoubtedly influenced his recommendations and plans for supplying hospital units with these elements. As tactical training units, numbered hospitals would need-in The Surgeon General's opinion-officers and equipment for unit administration and field training only. Their enlisted members would be given technical training in named hospitals or in enlisted technicians' schools. Moreover, full assemblages of equipment and complete officer staffs were not available for numbered hospitals. Therefore, The Surgeon General planned to issue only field training equipment to numbered hospital units and he recommended that few officers, from two to five, should be assigned to each.20

The General Staff considered the 1941 hospital units not as training schools but as true hospitals which could operate in the United States (presumably on maneuvers) or in theaters of operations "in the event of an emergency." On 3 January 1941 it issued a letter to that effect.21 Despite this view, the Staff adopted The Surgeon General's recommendation that hospital units be given only part of their personnel-perhaps because of the shortage of men and officers to meet various needs and demands.22 Those formed dur-

19(1) Annual Report . . . Surgeon General, 1941 (1941), pp. 153-54. (2) An Rpt, 1941, Surg GHQ. HD. (3) Ltr AG 320.2(5-14-41)MC-C-M, TAG to CofS GHQ; CGs of all Armies, CAs, and Depts; C of Arms and Servs, etc, 22 Nov 41, sub: Revision of Trp Unit Basis, FY 1942. SG: 320.2-1. (4) An Rpts, 1941, 267th and 168th Sta Hosps. HD.
20(1) Ltr cited n. 17. (2) Annual Report . . . Surgeon General, 1941 (1941), p. 154. (3) lst ind SGO 322.15-17. (Ft Knox)N, SG to Surg Ft Knox, 10 Sep 40, on Ltr, CO 6th Surg Hosp to SG, 5 Sep 40, sub: T/O&E. HD: McKinney files. (4) Ltr, SG to TAG, 25 Feb 41, sub: Unit Assemblages, with 3 inds. SG: 475.5-1.
21Ltr AG 322.2(12-6-40)M-C-M, TAG to CofS GHQ CGs of Armies, et al., 3 Jan 41, sub: Purpose and Tng of Certain MC Units to be Activated with Sel Serv Men. SG: 322.3-1.
22Ltr AG 111 (12-23-40)M-C-M, TAG to CofS GHQ; CGs Armies, CAs, and Depts, 31 Dec 40, sub: Trp Basis, PMP, 1941. AWC: 160-93.


45

ing 1941 received initially, in addition to cadres of Regular Army enlisted men, from two to five officers each and only enough selectees-either from reception centers or from replacement training centers-to provide them with about half of their table-of-organization enlisted strength.23

The position of the Staff on equipment differed from The Surgeon General's. In December 1940 it announced a supply policy for all Army units-they would obtain complete issues of authorized equipment, except controlled items (that is, those in short supply and issued only on special instructions by the War Department), by submitting requisitions to corps area headquarters. Two weeks later it issued another directive making this policy applicable specifically to Medical Department units,24 but a shortage of supplies and equipment made compliance with this directive impossible when hospital units were first activated in 1941.25

Toward the middle of 1941 the views of The Surgeon General on the purpose of hospital units began to coincide with those of the General Staff. By that time he had been required to provide medical complements for hospitals being established in new overseas commands and to prepare medical support for task forces being formed to occupy the French West Indies when it was feared that area might fall into German hands.26 For these purposes he drew personnel from named hospitals in the United States. In May 1941 he informed G-3 that he was having considerable difficulty in providing hospitals for "task forces destined for early dispatch." Explaining that he had to collect medical personnel from many scattered sources for this purpose, he pointed out that this was not only a disorderly process but also a threat to the medical service of the hospitals from which personnel was drawn. He therefore asked G-3 to authorize full complements of officers, nurses, and enlisted men for seventeen of the hospitals activated earlier in 1941. This would simplify the problem, he thought, of converting training units into functional units. At the same time he requested authority to withhold from such units all supplies and equipment, except training equipment, individual equipment, motor transportation, and controlled items, until their assignment to missions involving medical care.27 Early in July the Staff approved sufficient increases in the personnel of eleven-but not seventeen-units to bring their number of enlisted men up to almost full table-of-organization strength and of officers and nurses up to 50 and 75 percent respectively. The Staff also approved The Surgeon General's proposal to withhold the issuance of full hospital equipment to these

23An Rpts, 1941, 4th, 6th, 10th, 11th, 15th, 19th, 23d, and 27th Evac Hosps; 28th, 33d, 48th, 61st, 62d, and 74th Surg Hosps; 1st, 5th, 7th, 10th, 11th, 12th, 22d, 47th, and 109th Sta Hosps; and 53d, 56th, 63d, 66th, 148th, 208th, 209th, 210th, 212th, 213th, and 214th Gen Hosps. HD.
24(1) Ltr, TAG to CofS GHQ; CGs Armies, CAs, et al., 30 Dec 40, sub: Current Sup Policies and Procedure. AG: 475 (8-12-40) (1) Sec 1. (2) Ltr AG 320.2(11-16-40)M-D-M, TAG to same, 14 Jan 41, sub: Orgn, Tng, and Admin of Med Units. SG: 322.3-1.
25(1) Equipment for only three hospital units was available in medical supply depots in June 1941. Memo for Record on Memo, Act ACofS G-4 WDGS for TAG, 13 Oct 41, sub: Equip for Med Units. . .HRS: G-4/33344. (2) See An Rpts of numbered hosps cited above. HD.
26(1) See below, pp. 48 and 49. (2) An Rpts, 1943, 167th and 168th Sta Hosps. HD. These hospitals were originally organized as provisional hospitals, Station Hospitals A and B, for service with a task force being organized for the occupation of the French West Indies.
27Memo, SG for ACofS G-3 WDGS, 27 May 41, sub: Med Units, Task Forces. . . . AG: 320.2(5-27- 41)(6).


46

eleven units, thus sanctioning, at least for this group, the practice already followed. The next month, G-4 refused to grant The Surgeon General's request to approve this practice as policy for all other numbered hospital units. Accordingly, when a "War Department Pool of Task Force Units" was formed in August 1941, raising the total number of hospital units earmarked for actual operations from eleven to thirty-one, different supply procedures prevailed for the two groups.28

In the fall of 1941 the difference of opinion about issuing hospital assemblages reached a crucial point when G-4 noted that only four assemblages had been completed by October, that demands of the Philippine Army and lend-lease aid might seriously interfere with the completion of others, and that, according to its observers, hospital units participating in maneuvers needed full issues of equipment. Accordingly G-4 asked The Surgeon General for recommendations on speeding up the equipment of units in the task force pool.29 In reply The Surgeon General pointed to progress, stating on 5 November 1941 that five hospital assemblages had been issued, that twenty others were ready for issuance, and that still others were being packed. He attributed delays to slow deliveries by manufacturers and again requested permission to hold assemblages in depots until hospital units were assigned to missions involving the actual care of patients. In support of this request he argued that units in training did not need full equipment, storage for it in the field was inadequate, careless handling by unit members would cause breakage and deterioration, and units would be unable to repack assemblages for shipment.30 Maintaining its position but recognizing the possibility of warehousing shortages, G-4 began a survey of corps area storage facilities on 6 December 1941 and directed The Surgeon General to earmark and hold all available equipment for specific units until further notified.31

 Training and Use of Hospital Units

In accord with The Surgeon General's plan-that members of hospital units would receive tactical training in units but technical training in named hospitals-numbered hospital units were generally stationed near named hospitals, but confusion existed about the command that was responsible for their training and use. With the separation of field forces from

28(1) Ltr, TAG to CGs 2d, 3d, 4th, 7th, 8th, and 9th CAs, and SG, 7 Jul 41, sub: Orgn of Med Units. AG: 320.2 (5-27-41) (6). (2) Ltr, SG to TAG, 17 Jul 41, sub: Sup of Med Units, and 1st ind, TAG to SG, 6 Aug 41. SG: 475.5-1. (3) Ltr, AG 381 (7-28-41) MC-E-M, TAG to CofS GHQ CGs of Armies et al., 20 Aug 41, sub: Units for Emergency Expeditionary Forces. SG: 322.3-1.
29(1) Memo, Act ACofS G-4 WDGS for TAG, 13 Oct 41, sub: Equip of Med Units for WD Pool of Task Forces, with Memo for Record. HRS: G-4/33344. (2) 1st ind, SG to TAG, 16 Oct 41, and 2d ind, TAG to SG, 27 Oct 41, on Ltr, TAG to SG, 14 Oct 41, sub: Equip of Med Units for WD Pool of Task Forces. AG: 320.2(5-27-41)(6). (3) Memo G-4/33344, Lt Col Clarence P. Townsley, GSC, Chief Planning Sec [G-4] (init WLW[ilson]) for Col [Albert W] Waldron, [25 Nov 41], sub: Equip for Med Units for WD Pool of Task Forces. HD: Wilson files, "Vol. I, 15 May 41-20 Jan 42." (4) D/S, Act ACofS G-4 WDGS for TAG, 25 Oct 41, sub: Equip for Med Units for WD Pool of Task Forces, with Memo for Record. HRS: G-4/33344.
30(1) Ltr, SG to TAG, 5 Nov 41, sub: Equip for Med Units in WD Pool of Task Forces. SG: 475.5-1. (2) Memo, SG for ACofS G-4 WDGS, 19 Nov 41, sub: Comments on Draft of Ltr "Current policies and Procedures for Classification, Storage, and Issue of Sup." Same file.
31(1) Memo, Act ACofS G-4 WDGS for TAG, 27 Nov 41, sub: Equip for Med Units for WD Pool of Task Forces, with Memo for Record. HRS: G-4/33344. (2) 1st ind, TAG to SG, 6 Dec 41, on Ltr, SG to TAG, 5 Nov 41, same sub. AG: 320.2 (5-27-41) (6). (3) Ltr, TAG to CGs of CAs, 6 Dec 41, same sub. Same file.


47

corps areas late in 1940, the General Staff, it will be recalled, either assigned or attached to the four field armies all numbered medical units, including station and general hospitals that did not normally serve under the jurisdiction of field armies. At the same time, the Staff directed corps area commanders to make their medical facilities available for the training of hospital units, and it forbade army commanders to assume control over such units without the approval of corps area commanders. Furthermore, while one directive stated that the personnel and units of field forces on duty with corps areas would be controlled entirely by corps area commanders, another forbade the same commanders to assume jurisdiction over field force units undergoing training in corps area installations.32 As a result, neither GHQ nor the Surgeon General's Office exercised any very direct control over numbered hospital units, and the units themselves were sometimes confused as to whether they were subject to army or corps area command.33

Without close supervision from higher authorities the training which hospital units received depended primarily upon the attitudes of local surgeons and unit commanders. In some instances, well-planned on-the-job training programs were established in named hospitals and were co-ordinated with unit field training. In others, the commanders of named hospitals assigned men from numbered units to vacant jobs regardless of their training value. In such cases technical training suffered because many men did only menial work, and controversies developed between hospital commanders responsible for post medical care and unit commanders responsible for the technical as well as the field training of their men.34

Confusion about the control of hospital units also affected their use on maneuvers. Explaining his lack of authority over hospital units, The Surgeon General suggested that the personnel of some should be used to augment the staffs of named hospitals and to assist medical detachments, battalions, and regiments engaged in maneuvers. He proposed that other units should be employed in giving medical care as they would in theaters of operations.35 Their use in this manner was limited by incomplete staffs and lack of equipment. In some instances evacuation hospitals borrowed enough personnel and equipment from other medical units and from corps areas to enable them to provide limited hospitalization for troops in the field. After they were set up, such hospitals tended to become stationary. Army commanders then had to improvise mobile hospitals by using personnel and equipment of medical regiments. Generally armies had to rely upon corps areas for

32(1) Ltr AG 320.2(9-27-40)M-C, TAG to C of Arms and Servs, CGs of Armies, Army Corps, Divs, CAs and Depts, etc., 3 Oct 40, sub: Orgn, Tng, and Admin of Army. SG: 320.3-1. (2) Ltr, TAG to same, 4 Nov 40, sub: Units Asgd and Atchd to GHQ, Armies, Corps. . . . AG: 320.2(8-2-40) (4) Sec 3. (3) Ltr AG 320.2(11-16-40)M-D-M, TAG to same, 14 Jan 41, sub: Orgn, Tng, and Admin of Med Units. SG: 322.3-1. (4) Ltr, TAG to same, 8 Apr 41, sub: Asgmt and Atchmt of Fld Force Units to GHQ, Armies, Army Corps. . . . AG: 320.2(8-2-40)(4) Sec 3A, Pt 1.
33(1) Memo 2, incl to Ltr, Col Daniel J. Sheehan, MC, to Col Roger G. Prentiss, Jr, MC, 10 May 51. HD: 314 (Correspondence on MS) III. (2) An Rpts, 1940 and 41, 222d, 213th, 215th, and 183d Gen Hosps. HD.
34(1) Memo, Lt Col T. E. Huber for Historian, Tng Div SGO, 4 Jun 45, sub: Unit Tng, ASF, World War II. HD: 353. (2) Memo 2, incl to Ltr, Col Daniel J. Sheehan, MC, to Col Roger G. Prentiss, Jr, MC, 10 May 51. HD: 314 (Correspondence on MS) III.
35Rpt, Conf of SG with CA Surgs, 10-12 Mar 41. HD: 337.


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hospitalization of troops on maneuvers. To assist corps area hospitals and at the same time to give members of numbered units some experience in the actual operation of hospitals, station, general, evacuation, and surgical hospital units were attached to named hospitals in maneuver areas. Because their members were usually integrated with the staffs of corps area hospitals, such units not only tended to lose their identities but also failed to acquire experience as functioning organizations.36

Furnishing Hospitalization  
for Overseas Areas

Even before war actually began, additional hospitalization had to be supplied for troops in garrisons in territorial possessions of the United States and on island bases leased from the British in September 1940. In the Hawaiian and Philippine Islands, the Panama Canal Zone, Puerto Rico, and Alaska, hospitals were expanded as in the United States and additional increments of supplies and personnel were sent to care for the expansion.37 According to War Department plans, the Atlantic bases were to be garrisoned and operated on a peacetime basis. The Surgeon General's Office therefore planned hospitalization for them in the same way as for posts in the United States. After computing bed requirements on a 5 percent ratio, the Hospital Construction and Repair Subdivision collaborated with the Chief of Engineers (who was charged with the construction of those bases) in drawing plans for permanent or semipermanent hospital buildings of appropriate sizes. Meanwhile, other groups in the Office planned shipments of supplies and equipment and earmarked personnel to be drawn from existing installations for new hospitals.38

Implementation of the plans to garrison the Atlantic bases got under way early in 1941 before construction was completed. In January a few medical officers and a small detachment of enlisted men sailed with troops being sent to St. John's, Newfoundland. They operated a 40-bed hospital aboard the transport Edmund B. Alexander until it was ready to return to the United States about the middle of June. Then they moved into a rented estate at Northbank.39 In April, a second group of medical personnel, consisting of 21 medical officers and 164 enlisted men, accompanied the garrisons bound for Trinidad and Bermuda. The detachment which accompanied the Trinidad base force established a hospital in a temporary, single-building structure. The one which went to Bermuda set itself up, along with base headquarters and other activities, in a hotel building. In other bases medical officers with small staffs operated dispensaries and arranged for the hospitalization of patients needing further treatment either

36An Rpts, 1941, Surg GHQ First Army, Second Army, Third Army, Fourth Army, and 1st, 4th, 6th, 10th, 11th, and 23d Evac Hosps, 166th Sta Hosp, and Ft Bragg Sta Hosp. HD.
37(1) An Rpts, 1941, Surg Hawaiian, Puerto Rican, and Panama Canal Depts. HD. (2) HD: 322, Welsh file.
38(1) Memo, Lt Col H. D. Offutt for Maj Welsh, 8 Feb 41. HD: Atlantic Bases file folder. (2) Ltr, SG to CofEngrs, 25 Feb 41, sub: Floor Plans for MD Fac at Antigua, Bahama, British Guiana, and Saint Lucia. SG: 632-1. (3) Memo, SG for Maj [Henry I.] Hodes, G-3, 28 Nov 40, sub: MD Pers for Atlantic Bases. HD: Atlantic Bases file folder. (4) Ltr, SG to CofEngrs, 10 Mar 41, sub: Med Sups and Equip . . . , and 1st ind, CofEngrs to SG, 31 Mar 41. Same file.
39An Rpt, 1941, Sta Hosp. Newfoundland Base Comd. HD.


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in hospitals established by the Engineers for civilians working on Army construction or in hospitals operated by the British.40

In the fall of 1941 the first numbered hospital units were sent overseas. Under an agreement with the Icelandic Government, the United States established a force in Iceland as an outpost of defense. On 5 September 1941 the second echelon of this force, "the first United States expedition to depart with a complete plan and all means necessary to implement it,"41 sailed from New York. The 11th, 167th, and 168th Station Hospitals accompanied it. The last two were composed of Regular Army men drawn from named hospitals in the United States and organized in mid-1941 as provisional Station Hospitals A and B for service with an expedition (later canceled) to the French West Indies. The other was made up primarily of drafted men who converted themselves into Regular Army soldiers by volunteering for three-year enlistments before sailing. Upon arriving in Iceland only one of these units actually operated a hospital in 1941. On 24 September the 168th opened in a permanent three-story frame building at Camp Laugarnes. The 11th and 167th were attached to the 168th and served as maintenance and construction forces on roads, utilities, and buildings.42

Plans and preparations for hospitalization in overseas areas were limited during the emergency period by meager funds and the uncertain nature of the peacetime mobilization. For this reason the Medical Department encountered difficulty-as it would later for other causes-in securing authority from the War Department General Staff to plan for and activate as many hospital units as it considered desirable.

For estimating requirements the Surgeon General's Office had only World War I experience to rely upon, and there were differences of opinion as to how many fixed beds would be really needed. In order to enable units to give modern medical care, the tables governing their organization and equipment were revised. Although personnel authorized by such revisions was often increased, the General Staff began a practice-to be carried to greater lengths later-of requiring reductions in both personnel and equipment for table-of-organization units. Affiliated units were organized and some regular units were activated. The role of the latter was uncertain, but The Surgeon General gradually tended to agree with the General Staff that some of them at least would be used to give actual medical care. The rest would continue to train fillers for affiliated units. While The Surgeon General and the General Staff agreed upon the policy of providing hospital units with less than full quotas of officers and enlisted men, they disagreed upon the question of whether or not units in training should receive full issues of supplies and equipment. This dispute was to continue unabated during the first half of the war.

40(1) Memo, Maj A. B. Welsh for Brig Gen A. G. Love, 7 Apr 41, and Ltr AG 320.2(4-8-41)M-D-M, TAG to C of Arms and Servs, 8 Apr 41, sub: Immed garrison for Bermuda and Trinidad. . . . HD: Atlantic Base file folder. (2) A History of Medical Department Activities in the Caribbean Defense Command in World War II, vol I, pp. 245-46, 281-82, 311, 314, and 320. HD. (3) An Rpt, 1941, Surg Bermuda Base Comd. HD.
41Greenfield et al., op. cit., pp. 22-23. For a full discussion of the agreement with Iceland and the force sent for its defense, see Stetson Conn and Byron Fairchild, Defense of the Americas, Vol. II, a forthcoming volume in the series UNITED STATES ARMY IN WORLD WAR II.
42An Rpts, 1941, 1943, 168th Sta Hosp; 1941, 1942, 167th Sta Hosp; 1941, 11th Sta Hosp; 1942, Surg Iceland Base Comd. HD.

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