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Chapter VIII

Contents

CHAPTER VIII

Providing Hospitalization for Theaters of Operations

In the first year and a half of the war the Medical Department had to provide hospitalization for reinforced garrisons in overseas departments and bases, for new forces sent to hold lines of supply and communication throughout the world, and for task forces engaged in the first defensive-offensive operations against the enemy. Meanwhile it had to organize, train, and equip other units for use when the Army should become engaged in full-scale offensives. Early in 1942 the Pacific held first claim on hospital units sent overseas. In the summer emphasis shifted to Europe and North Africa, and thereafter hospitals went to those theaters in increasing numbers. By the latter part of the year, after emergency shipments had been made, it was possible to take stock of hospitalization already furnished to theaters with a view to establishing a basis for further planning.

Meeting Early Emergency Needs

Status of Hospital Units and Assemblages

When the Japanese struck Pearl Harbor the Medical Department had 22 general, 24 station, 17 evacuation, and 8 surgical hospital units that had been activated as training units. Of these, 3 station hospitals were already overseas and 9 station, 12 general, 4 evacuation, and 3 surgical hospital units included in the War Department pool of task force units were authorized almost 100 percent of their table-of-organization enlisted strength and from 50 to 75 percent of their commissioned strength. The rest had half or less than half of their enlisted strength and from three to five officers each. In addition to the training units, affiliated hospital units consisting chiefly of professional commissioned personnel-doctors and nurses-had been organized (but not activated) as follows: 41 general, 11 evacuation, and 4 surgical hospitals. Under prewar plans, it will be recalled, affiliated units were to be called to active duty as needed immediately upon the outbreak of war, were to be supplied with enlisted personnel, and were then to go into service without further ado.1 According to a report of The Surgeon General in November 1941, hospital assemblages had already been issued to 3 station and 2 evacuation hospital units; while assemblages for 2 general, 11 station, 4 evacuation, and 3 surgical hospital units were packed and ready for immediate issue from depots, and those for 10 general, 9

1See above, pp. 5-6, 40.


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station, 17 evacuation, and 5 surgical hospital units were being packed but were not yet ready for issuance.2

Plans for Meeting Emergency Needs

Early in January 1942 The Surgeon General outlined to G-3 the system he wished to use in meeting emergency needs. Affiliated units would be called to active duty and each would receive approximately one half of its authorized enlisted strength from a training unit. The rest of its personnel would be supplied by reception centers, zone of interior installations, and other medical units. Each training unit which transferred personnel to an affiliated unit would retain a cadre, in order to train additional "fillers" for other affiliated units. Some training units, especially station hospital units, would be sent overseas as needed, having first been brought to authorized strength with both enlisted and commissioned personnel transferred from other medical units or installations. Each unit would draw individual equipment, clothing, and motor transport at its home station. Only those going overseas would receive hospital assemblages, preferably at ports of embarkation.3

Soon after he had proposed this system The Surgeon General realized that modifications would be necessary. The activation of training units at reduced strength, a policy adopted on his recommendation in 1941, resulted in the hurried assembly, often at ports of embarkation, of additional personnel to make up the other half of a unit. Members of units going overseas therefore frequently had little time to become acquainted with one another's capabilities before embarkation. Installations from which "fillers" were drawn suffered from resulting personnel and training problems. To obviate these difficulties The Surgeon General recommended in February 1942 that all training units be activated at full table-of-organization enlisted strength.4 He received the support in March 1942 of the SOS Hospitalization and Evacuation Branch and in April of AGF headquarters. In May G-3 approved the proposal.5

The Surgeon General secured only partial approval of his stand in opposition to the issuance of hospital assemblages before the departure of units for theaters. After completing a survey of storage space in corps areas, G-4 in December 1941 disapproved a request that General Magee had made in November to hold assemblages in depots until units were assigned missions involving medical care.6 General Magee then sought approval of his position in a personal conference with General Somervell, who was at that time the Assistant Chief of Staff, G-4. On the basis of his understanding of the agreement reached then, General Magee resubmitted his request.7 Instead of approving it,

2Ltr, SG to TAG, 5 Nov 41, sub: Equip for Med Units in WD Pool of Task Forces. SG: 475.5-1.
3Memo, SG for AcofS G-3 WDGS, 13 Jan 42, sub: Activation . . . Med Units, with incls. HD: 326.01-1.
4(1) Memo, Act SG for ACofS G-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3. (2) An Rpts, 1942, of following Gen Hosps: 2d, 30th, 42d, 105th, 118th, and 210th, and of following Sta Hosps: 10th, 12th, 13th, 17th, 151st, 166th, and 172d. HD.
5(1)Memo G-4/24499-178, Maj William L. Wilson for [Lt] Gen [LeRoy] Lutes, 12 Mar 42, sub: Basic Plans for Hosp and Evac. HD: Wilson files, "No 472, Hosp and Evac, 1941-42." (2) Ltr, CG AGF for CG SOS, 23 Apr 42, sub: Auth of Grades and Ratings for MD Tactical Hosp. AG: 221(7-1-41) Sec 1H, Pt 1. (3) Ltr, TAG to CGs AGF, AAF, SOS, Armored Force, etc., 6 May 42, same sub. Same file.
6D/S G-4/31793, ACofS G-4 WDGS to SG, 31 Dec 41, sub: Comments on Draft of Ltr, 'Current Policies and Procedures for . . . Sups.' HD: 475.5-1.
7Memo, SG for ACofS G-4 WDGS, 10 Jan 42, sub: Equip for Numbered Hosps. HD: 475.5-1.


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as The Surgeon General had expected, G-4 now proposed a compromise. Unit assemblages would be declared controlled items. As such, they would not be issued through corps areas to units upon requisition but would be issued directly as the War Department determined. Meanwhile, The Surgeon General would make fractional issues of unit equipment for training purposes.8

Although he concurred in this compromise, officially published on 21 January 1942,9 The Surgeon General did not give up hope that he could continue to hold unit assemblages in medical depots until numbered hospitals were assigned operational missions. Once they were declared controlled items, the most practical method of achieving this end would be to secure War Department agreement not to require their issuance prior to that time. This might be done indirectly. Consequently, on 24 January 1942 The Surgeon General requested G-4 to include in movement orders for numbered hospital units ordered overseas a paragraph directing The Surgeon General to ship appropriate assemblages to ports of embarkation or staging areas. On 6 February 1942 G-4 approved this recommendation.10 As will be seen later, neither the 21 January 1942 compromise nor the approval of the inclusion of a paragraph in movement orders settled the controversy over the issuance of equipment.

Methods of Meeting Emergency Needs

In defense areas-the Atlantic bases, the Panama Canal Zone, Alaska, and Hawaii-where hospitals already existed, the hospital situation was serious though not critical. To meet emergency needs existing facilities could be expanded and additional "provisional" hospitals could be established by spreading thin the personnel and equipment already available. Army patients could also be hospitalized in civilian institutions wherever they were available.11 Hence few hospital units went to those areas in the first few months following Pearl Harbor. Between 1 January and 30 June 1942, 2 general hospitals were sent to the Panama Canal Zone and 3 general and 4 station hospitals to Hawaii to supplement existing and improvised hospitals in those areas.12 In addition, troops sent to garrison new bases included medical detachments to operate the hospitals needed for their care,13 but the more pressing needs of other areas generally took precedence in the shipment both of numbered hospitals and supplementary personnel and equipment.14

Troops deployed to protect shipping lanes and to hold the enemy while preparations for the offensive went forward re-

8Memo for Record on D/S, ACofS G-4 WDGS for TAG, 16 Jan 42, sub: Equip for MD Units, and on Memo, Chief Planning Br G-4 WDGS for Brig Gen B. B. Somervell, 16 Jan 42, same sub. HRS: G-4/33344.
9(1) Memo, SG for ACofS G-4 WDGS, 17 Jan 42. SG: 475.5-1. (2) Ltr AG 400 (1-16-42)MD-D-M, TAG to SG, 21 Jan 42, sub: Equip for MD Units. HRS: G-4/33344.
10(1) Memo, SG for ACofS G-4 WDGS, 24 Jan 42, sub: Proposed Modification of Mvmt Orders. SG: 475.5-1. (2) D/S, ACofS G-4 WDGS for TAG, 6 Feb 43, same sub. HRS: G-4/33344.
11An Rpt, Med Activities Newfoundland Base Comd, 1942; An Rpt, Med Activities Surg Trinidad Sector and Base Comd, 1942; An Rpt, Dept Surg Panama Canal Dept, 1942; An Rpt, MD Activities Hawaiian Dept, 1942, sec I. HD.
12Ltr AG 221(1-31-42)EA-C, TAG to CG Hawaiian Dept, 18 Feb 42, sub: Grades and Ratings, MD, Hawaii. SG: 320.2-1 (Hawaiian Dept) AA.
13An Rpt, Med Activities US Army Force, Aruba, NWI, 1942, and Hist Record, US Army MD in Greenland, Jul 41-Feb 43. HD.
14Paraphrase of Rad AG 320.2(1-12-42) MSC-A, TAG to CG Hawaiian Dept, 14 Jan 42. SG: 320.2-1 (Hawaiian Dept)AA.


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quired hospitalization in areas that had no American facilities. The greatest immediate need was in the South and Southwest Pacific. During the period from 1 January to 1 July 1942, inclusive, 2 evacuation, 2 surgical, 4 general, and 14 station hospitals were sent to Australia; 2 evacuation, 2 general, and 2 station hospitals to islands in the South Pacific; and 2 station hospitals to islands other than the Hawaiian group in the Central Pacific. During the same period, 1 general and 1 station hospital went to Northern Ireland, a general hospital to Iceland, and 2 general and 3 station hospitals to England. In May and June 1942, hospitals were sent also to India, to care for troops engaged in supply and service activities there, and to Northwest Canada, to care for those who were helping to build the Alcan highway. Meanwhile other hospital units were being earmarked for task forces, especially for the GYMNAST (North Africa), MAGNET (Northern Ireland), and BOLERO (England) operations. These demands drew heavily upon available units and assemblages and sometimes made it impossible for The Surgeon General and OPD to meet without modification requests of theater commanders.15 (Table 5)

In sending numbered hospital units overseas, The Surgeon General departed from prewar plans, using training units as well as affiliated units. This was caused in part by the character of the war. Station hospitals, for which no affiliated units had been organized, were needed for defense forces sent out early in 1942 more than were surgical, evacuation, and general hospitals. Moreover, the earmarking of some affiliated hospitals for task forces that were formed early but sent out later, or not at all, may have tied up enough affiliated units to require the use of training units in meeting overseas needs between Pearl Harbor and 2 July 1942. At any rate, all station hospitals and the two surgical hospitals dispatched during this period were nonaffiliated units. Of the thirty-seven station hospitals sent out, seventeen had been activated during 1941 and the rest after war began. Both surgical hospitals were nonaffiliated units that had been activated in 1941. Of the fifteen general hospitals shipped, nine were affiliated units supplied (except for one) with enlisted personnel from training units activated during 1941. The remainder were nonaffiliated training units activated in 1941. Of the 4 evacuation hospital units sent out, 2 were affiliated units and 2 were nonaffiliated units activated in 1940 and 1941. Thus the prior activation and training of normal Army units proved more valuable in meeting emergency hospital needs than did the formation and organization of units affiliated with civilian hospitals or schools.

Modification of Hospitals for Overseas Areas

Development of New Types of Units

Early in the war it was necessary to develop new types of hospitals to meet the needs of island-type warfare and of motorized operations on land. Experience in planning hospitalization for the earliest task forces and garrisons for islands in the

15(1) Memo, Lt Col A[rthur] B. Welsh for Brig Gen L[arry] B. McAfee, 1 Apr 42. HD: Welsh Planning file. (2) Memo for Record on IAS, 5 Apr 42, sub: Hosp Units for SUMAC [Australia] and SPOONER [New Zealand]. HRS: WPD 704.2(3-9-42). (3) Memo, Maj A. B. Welsh for Gen Magee, 23 Jan 42, sub: Status of Hosp Units. HD: 320.2 (Trp Basis).


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TABLE 5-HOSPITAL UNITS SHIPPED OVERSEAS, 7 DECEMBER 1941 TO 1 JULY 1942

Pacific revealed the need for hospitals that were smaller and more mobile than the only hospital available for that purpose-the 250-bed station hospital. As a result, the Surgeon General's Office and the medical section of General Headquarters collaborated in developing a new type of hospital, called the field hospital, in the first months of 1942. When G-4 called upon the Surgeon General's Office to develop an "island-type hospital," the latter submitted the table of organization for this unit. The General Staff approved the table and it was published on 28 February 1942.16

The field hospital had a headquarters and three hospitalization units. Each of the latter could operate independently with a capacity of 100 beds. As a single unit the hospital could care for 380 patients. Staffed to care for minor ills and injuries and equipped to function in the field under tents, the field hospital or any one of its hospitalization units could serve as a fixed hospital on islands, in other isolated areas, or at air bases distant from other facilities. Having sufficient transportation to move its own personnel and equipment, any unit of the hospital, when reinforced with surgical personnel, could be used as a mobile hospital to support ground troops in combat or task forces in landing operations. In addition, the field hospital or any of its units, The Surgeon General asserted, could be readily transported by air-an assertion supported by

16(1)Interv, MD Historian with Brig Gen Alvin L. Gorby, 21 Feb 52. HD: 000.71. (2) Ltr AG 400(1-19-42)MSC-D, TAG to SG, 22 Jan 42, sub: Equip for Island Type Hosp. SG: 475.5-1. (3) DF G-3/42108, ACofS G-3 WDGS to ACofS G-1 and G-4 WDGS, 17 Feb 42, sub: T/O and E for a Fld Hosp Unit, with incl. AG: 320.2(10-30-41)(2). (4) History of Organization and Equipment Allowance Branch [SGO], 1939-44, p. 5. HD.


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loading and flight tests during the latter part of 1942.17

The field hospital thus surpassed in flexibility any other hospital which the Medical Department had. In order to make units of that type available, SOS headquarters arranged for the activation of five in April 1942.18 A few months later, when the troop basis was revised, authority was granted for the activation of twenty-two by the end of 1942.

During the months following the development of the field hospital, the Surgeon General's Office revised the table of organization for station hospital units to provide, in effect, additional types of fixed hospitals. At the beginning of the war the station hospital table of organization provided only for those of 250-, 500-, and 750-bed capacities.19 When station hospital units of smaller capacities were needed, The Surgeon General had to prepare special tables for their activation. In May 1942, for example, a special table of organization for a 150-bed station hospital was issued.20 Two months later the revised version of the regular table was ready for publication. It provided for station hospitals of seventeen different sizes, ranging in capacity from 25 to 900 beds.21 The inclusion of station hospital units of various sizes in the 1943 troop basis simplified The Surgeon General's problem of recommending hospital support for small garrison forces.

At the same time that small fixed-hospital units were being supplied for garrison forces scattered throughout the world, the Surgeon General's Office was developing a combat zone hospital that was more mobile and required less personnel than either the 400-bed surgical hospital or the 750-bed evacuation hospital. The latter had no motor transport for its own movement and could be used only in relatively stable situations. The surgical hospital, developed in 1940, was only partially mobile. Its surgical unit was authorized enough transport to move itself but its two hospital units had only "utility" vehicles.22

In order to provide a more mobile combat zone hospital, The Surgeon General developed a 400-bed motorized evacuation hospital. Its table of organization, concurred in by the Ground Surgeon and approved by G-3, was published on 2 July 1942.23 This unit, unlike the surgical and 750-bed evacuation hospitals, at first had enough motor transport to move all of its personnel and equipment at one time. It differed from the surgical hospital in organization also. It will be recalled that the latter had three independent units with separate headquarters-a surgical unit and two ward units. The motorized evacuation hospital, on the other hand, had no separate units and only one headquarters, but it could be split into two self-contained 200-bed surgical hospitals. This change in organization resulted

17(1) Memo, SG for TAG, 1 Feb 42, incl to DF G-3/42108, ACofS G-3 WDGS to ACofS G-1 and G-4 WDGS, 17 Feb 42, sub: T/O and E for Fld Hosp Unit. AG: 320.2(10-30-41)(2). (2) Ltr, SG to CG USAFIA, 26 Jun 42, sub: Fld Hosp, T/O 8-510. HD: Wilson files, 400 "Med Equip and Sups." (3) Memo, SG for CG SOS, 3 Oct 42, with 2d, 5th, and 6th inds. SG: 704.-1.
18Memo, SG for CG SOS, 22 Mar 42, sub: Activation of Fld Hosp Units, with 1st ind, CG SOS to SG, 1 Apr 42. SG: 322.3-33.
19T/O 8-508, Sta Hosp, ComZ, 25 Jul 40.
20T/O 8-560S, Sta Hosp (150-bed), 23 May 42.
21T/O 8-560, Sta Hosp, ComZ, 22 Jul 42.
22T/O 8-232, Evac Hosp, 1 Oct 40, and T/O 8-231, Surg Hosp, 1 Dec 40.
23(1) History of Organization and Equipment Allowance Branch [SGO], 1939-44, p. 4. HD. (2) Memo for Record on Memo, CG SOS for TAG, 1 Jul 42, sub: T/O for Evac Hosp (Motorized). AG: 320.3(10-30-41)(2) Sec 8D. (3) T/O 8-581, Evac Hosp, Motorized, 2 Jul 42.


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in a saving of both enlisted and commissioned personnel-a factor of importance in the development of the new unit.24

The motorized evacuation hospital soon superseded the surgical hospital in the troop basis, although the table of organization of the latter was not rescinded until August 1944.25 In August 1942 AGF headquarters, with the concurrence of The Surgeon General and the Ground Surgeon, had surgical hospitals, only three of which were used as such during the war, redesignated and converted into motorized evacuation hospitals. In November 1942 units of the new type were included, along with 750-bed evacuation hospitals, as mobile units in the 1943 troop basis.26

Since none of the hospital units available at the beginning of the war or developed in Washington in the following year met the needs of small combat forces fighting in Pacific jungles, the Southwest Pacific Area attempted during 1942 to solve its own problem. To provide surgical support for task forces employed in areas where the only practicable means of transportation was by foot, the chief surgeon of that area developed a 25-bed portable surgical hospital. It was designed to permit its equipment and supplies to be carried in 35- to 40-pound packs by its own personnel or by native bearers. It could therefore move along with combat troops through jungle trails, either to prepare casualties for the long litter-haul to the rear or to care for them until more adequate hospitals could be established. In September 1942 SWPA headquarters activated twenty-six such "provisional" units with personnel taken from other hospitals. Receiving reports of this development, The Surgeon General soon afterward adopted the portable surgical hospital as a regular unit. In November 1942, forty-eight were included in the 1943 troop basis. In May 1943 ASF headquarters ordered the activation of twenty under a special table of organization which was published the following month.27

Changes Affecting the Mobility of Hospitals

By the fall of 1942 circumstances developed which tended to cancel some of the results of earlier attempts of The Surgeon General to increase the mobility of hospitals. Shortages of motor equipment and of shipping space prompted the General Staff, on 2 October 1942, to direct the three major commands to reduce the motor vehicles authorized for their respective units.28 In compliance with this order AGF headquarters reduced the transport of the motorized evacuation hospital (making it a semimobile unit) and the Surgeon General's Office reduced that of the field hospital. These hospitals were

24(1) Comparison of T/O 8-231, 1 Dec 40, and T/O 8-581, 2 Jul 42. (2) See also Off Diary of Col Albert G. Love, Chief HD, SGO, 8 Sep and 9 Oct 42. HD.
25(1) Memo, Col Arthur B. Welsh for Gen Kirk, 2 Dec 43. SG: 322.15-l-MEDC. (2) WD Cir 333, 15 Aug 44.
26(1) Memo 32.02/29(Med)(R)-GNGCT/(1 Aug 42), CG AGF for ACofS C-3 WDGS, 1 Aug 42, sub: Redesignation of Surg Hosp as Evac Hosp, with Memo for Record. Ground Med files: "Maneuvers, 1942." (2) Ltr, SG to CG ASF, 26 Apr 43, sub: Status of Surg Hosps. SG: 322.15-1.
27(1) An Rpt, Chief Surg SWPA, 1942. HD. (2) Ltr, Comdr-in-Chief SWPA to CG SOS, 21 Nov 42, sub: Improvement of Equip and Orgn, with 2 inds. SG: 322.15-10. (3) Memo, CG ASF for TAG, 26 May 43, sub: Constitution and Activation of Ptbl Surg Hosp. AG: 322(5-26-43). (4) T/O & E 8-572S, Ptbl Surg Hosp, 4 Jun 43.
28Ltr, 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.


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left with enough transport for partial movements only. Each had to employ its vehicles in shuttle fashion or supplement them with "pool" vehicles in order to move from one location to another.29 Reductions in allotments of motor vehicles to other hospital units had insignificant effects upon mobility, because their vehicles were used for administrative purposes only.30

Other ways of increasing the mobility of hospitals than by the formation of new units were reductions in the size and weight of equipment and improvements in methods of packing it. When war began, equipment lists of all hospitals contained types and quantities of items such as office desks, armchairs, and kitchen equipment which were ordinarily used only in hospitals in the United States.31 In view of shortage of shipping space and the need for mobility in overseas hospitals, SOS headquarters directed The Surgeon General on 12 March 1942 to eliminate all unnecessary equipment and to reduce the gross weight and cubic displacement of station and general hospital assemblages by at least 40 percent.32 The Surgeon General replied that his Office had already begun that process. On 30 June 1942 he reported that the required reduction had been made in station hospital assemblages and that it would be made in others at an early date.33 During the following summer special boards appointed by The Surgeon General reviewed equipment lists of all hospitals, making reductions as they could, and sent the revised lists to medical depots for use in making up hospital assemblages. By November 1942 The Surgeon General reported to the Wadhams Committee that the gross weight and cubic displacement of all hospitals designed for overseas service had been reduced by an average of 40 to 42 percent.34 By that time many hospitals with heavy bulky equipment were already in operation in overseas theaters.35

Shortly before The Surgeon General reported reductions in the size and weight of hospital equipment, the Ground Surgeon raised the question of its packing. He informed the Surgeon General's Office that equipment of evacuation hospitals was so packed that it did not lend itself readily to manual handling and speedy unpacking for setups. Meanwhile the 15th Evacuation Hospital, stationed at Fort George G. Meade, Maryland, conducted experiments in packing under the supervision of the Ground Surgeon.36 The Surgeon General learned that this hospital

29(1) T/O 8-510, Fld Hosp, 28 Feb 42 and 8 Apr 43; T/O 8-581, Evac Hosp, Motorized, 2 Jul 42; and T/O 8-581, Evac Hosp, Semimobile, 8 Jan 43. (2) 1st ind 323.3 GNRQT-1/18390 (10-2-42), CG AGF to TAG, 1 Dec 42, on Ltr, 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. (3) Ltr, SG to CG SOS, 14 Dec 42, sub: Changes in Fld Hosp. SG: 322.15-10. (4) 2d ind, SG to CG SOS, 10 Feb 43, on Ltr, Comdr-in-Chief SWPA to CG SOS, 21 Nov 42, sub: Improvement of Equip and Orgn. Same file.
30For example, see T/O 8-550, Gen Hosp, 1 Apr 42, and T/E 8-550, Gen Hosp, 19 Mar 43.
31Memo entitled "Correcting Info as to Confidential Document Submitted by Mr. [Corrington] Gill, Entitled 'Rpt to Cmtee on Data from Files of Hosp and Evac Br, Plans Div, SOS,'" submitted as incl to Ltr, SG to Col Sanford Wadhams, Chm, Cmtee to Study the MD, 7 Nov 42. HD: 321.6.
32Memo, Oprs Div SOS for SG, 12 Mar 42, sub: Increase in Mobility of Fld Force Hosps. SG: 475.5-1. 
33Memos, SG for Oprs Div SOS, 21 Mar and 30 Jun 42. SG: 475.5-1.
34Memo cited, n. 31.
35(1) Memo SPOPH 701, CG SOS for SG, 19 Oct 42, sub: Info Submitted by Chief Surg SWPA. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43." (2) Ltr, Med Insp NATO to SG, 27 Jan 43, sub: Observations on Med Serv in NATO. HD: Wilson files, "Experience in Med Matters from Overseas Forces."
36Comment by Brig Gen Frederick A. Blesse on first draft of this chapter. HD: 314 (Correspondence on MS) III, Incl 1.


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had developed a method of packing its equipment so that each crate or package could be handled by two men and contained items used in one particular section of a hospital only.37 In November 1942 General Magee appointed a board of officers to study this accomplishment and submit recommendations for more practical methods of packing and assembling equipment than those being used by medical depots.38 As a result of this investigation, The Surgeon General's Supply Service drew up specifications for the standardized packing and crating of equipment of motorized evacuation hospitals.39

Subsequently, during 1943, the system found satisfactory for evacuation hospitals was adopted for other units. Each box, properly marked, now contained supplies and equipment for use in a particular section of a hospital only. This system speeded unpacking and repacking for movement in the field by making it possible to assemble at a particular spot all supplies and equipment needed for a ward, an operating room, or an office, and by making it unnecessary to unpack equipment not required when only part of a hospital was being established.40

Reductions in the Personnel of Hospital Units

Modifications in tables of organization of existing hospitals, like changes in equipment and motor transport, were required by other than medical considerations. During the early part of 1942 both G-1 and SOS headquarters put considerable pressure on The Surgeon General to save commissioned personnel, especially Medical Corps officers, lest there be insufficient numbers to go around, on the scale already planned, in a 7,500,000-man Army. Among the steps they directed him to take was the revision of tables of organization, both to reduce the number of officers authorized and to substitute Medical Administrative Corps for Medical Corps officers.41 Having already begun the process of revision, The Surgeon General replied that he would continue it.42 In April the revised tables for general, surgical, and convalescent hospitals and hospital centers were published; in July, those for evacuation and station hospitals.43

These revisions resulted in the saving of Medical Corps officers more by cuts in the number of such officers in each unit than by the substitution of Medical Administrative for Medical Corps officers. The reason lay perhaps in the fact that tables of organization for numbered hospitals, unlike personnel guides for zone of interior

37(1) Ltr, SG to CG SOS, 7 Oct 42, sub: Evac Hosp Equip. SG: 475.5-1. (2) An Rpt, 15th Evac Hosp Motorized, 1942. HD.
38(1) 1st ind, CG SOS to SG, 15 Oct 42, on Ltr, SG to CG SOS, 7 Oct 42, sub: Evac Hosp Equip. SG: 475.5-1. (2) SG OO 462, 11 Nov 42, sub: Bd of Offs to Study Equip of New 400-Bed Motorized Evac Hosp.
39(1) Rpt of Bd for . . . a 400-bed Evac Hosp [13 Nov 42]. SG: 475.5-1. (2) Memo, Lt Col R[euel] E. Hewitt for Col F[rancis] C. Tyng, 19 Dec 42. Same file.
40(1) Richard E. Yates, The procurement and Distribution of Medical Supplies in the Zone of the Interior during World War II (1946), p. 146. HD. (2) An Rpt, Med Assembly Unit Atlanta ASF Depot, 1943. HD.
41(1) Memo, ACofS G-1 WDGS for SG thru Pers Div SOS, 1 Apr 42, sub: Availability of Physicians. HRS: G-1/16331-16335. (2) Memo, CG SOS for SG, 22 May 42, sub: Availability of Physicians. Same file.
42(1) Memo, SG for Pers Div SOS, 27 Apr 42. HRS: G-1/16331-16335. (2) Memo, SG for Dir Mil Pers SOS, 5 Jun 42, sub: Availability of Physicians. Same file.
43T/O 8-550, Gen Hosp, 1 Apr 42; T/O 8-570, Surg Hosp, 1 Apr 42; T/O 8-590, Conv Hosp, 1 Apr 42; T/O 8-540, Hosp Ctr, 1 Apr 42; T/O 8-580, Evac Hosp, 750-bed, 2 Jul 42; T/O 8-560, Sta Hosp, 22 Jul 42.


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installations,44 already required the use of Medical Administrative Corps officers in a considerable proportion of administrative positions. The revised tables also reduced the number of nurses authorized for some hospitals. In general, greatest changes were made in large communications zone units, such as 1,000-bed general and 750-bed station hospitals. In the former, 17 Medical Corps officers and 15 nurses were eliminated; in the latter, 13 Medical Corps officers and 15 nurses. In each, one Medical Administrative Corps officer, one Sanitary Corps officer, and one warrant officer were added as replacements for some of the Medical Corps officers eliminated. In smaller communications zone units, such as the 250-bed station hospital, and in combat zone units, such as the 750-bed evacuation and the 400-bed surgical hospital, no personnel reductions were made, but from one to three Medical Administrative or Dental Corps officers were substituted for a like number of Medical Corps officers. The development of the 400-bed motorized evacuation hospital for use in the combat zone resulted in a considerable saving of both Medical and Nurse Corps personnel, because the new unit required fifteen physicians and twelve nurses fewer than did the surgical hospital which it replaced in the troop basis.45

In the fall of 1942 emphasis shifted from reductions in the numbers of officers and nurses to those of enlisted men. With a growing need for manpower economy in the Army, the General Staff in October directed the three major commands to revise downward their tables of organization.46 By then responsible for tables of combat zone hospital units, AGF headquarters revised the tables of both the 400-bed and 750-bed evacuation hospitals. With The Surgeon General's concurrence, the number of enlisted men in a motorized evacuation hospital was reduced from 248 to 217; in a 750-bed unit, from 318 to 308. The revised tables reflected, incidentally, as did others published later, the militarization of hospital dietitians and physical therapists, who until December 1942 had served as civilian employees.47 Cuts in the personnel of communications zone hospital units did not occur at this time, because SOS headquarters considered it "inadvisable," in view of revisions of tables within the preceding year, to direct any further "arbitrary reduction."48

Hospital Units in the Troop Basis

Throughout 1942 and 1943 the number of hospital units in the troop basis increased significantly with each of its revisions but always remained smaller than The Surgeon General considered adequate for the Army being mobilized. Using World War I casualty and evacuation experiences as a basis, The Surgeon General estimated that fixed beds should be

44See above, p. 133.
45T/O 8-508, Sta Hosp, 25 Jul 40; T/O 8-560, Sta Hosp, 22 Jul 42; T/O 8-507, Gen Hosp, 25 Jul 40; T/O 8-550, Gen Hosp, 1 Apr 42; T/O 8-232, Evac Hosp, 1 Oct 40; T/O 8-580, Evac Hosp, 2 Jul 42; T/O 8-231, Surg Hosp, 1 Dec 40; T/O 8-570, Surg Hosp, 1 Apr 42; T/O 8-581, Evac Hosp, Motorized, 2 Jul 42.
46Ltr, TAG to CGs AGF, AAF, and SOS, 2 Oct 42, sub: Review of Orgn and Equip Reqmts. AG: 400(8-10-42)(l) sec 22.
47(1) T/O 8-580, Evac Hosp, 750-bed, 23 Apr 43, and T/O 8-581, Evac Hosp, Semimobile, 8 Jan 43. (2) Memo 320.2/53(Med) GNRQT-3/26660 (11-18-42), CG AGF for ACofS G-3 WDGS, 1 Jan 43, sub: T/O and T/E 8-581, Evac Hosp, Semimobile. AC: 320.3 (10-30-41)(1) sec 8D. (3) Memo 321/732(Med) GNRQT 3/37444, CG AGF for ACofS G-3 WDGS, 16 Apr 43, sub: T/O and T/E, Evac Hosp (750 pnts). Same file.
48Memo SPGAE 011.1(10-14-42), CG SOS for ACofS G-3 WDGS, 7 Dec 42, sub: Review of Orgn and Equip Reqmts. AG: 400(8-10-42)(1) sec 22.


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provided for 10 to 15 percent of the strength of each theater of operations.49 He calculated mobile bed requirements in the early part of 1942 on the basis of 1 convalescent, 4 surgical, and 10 evacuation hospitals for each type-army. The time when these units should be activated depended upon such factors as the amount of training required by each, the rate of troop movement to overseas areas, and the amount of combat action which might be encountered.

At the beginning of 1942 both G-3 and the Chief of Staff believed that the mobilization of service units should be delayed because the training of divisions required more time than that of nondivisional units and a lack of shipping limited forces that could be sent overseas during 1942.50 Hence, in the troop basis issued on 17 January 1942, which provided for a 71-division, 3,600,000-man Army by the end of the year, there were included only 2 convalescent, 28 evacuation, 8 surgical, 45 general, and 40 station hospital units.51 The Surgeon General urged that additional units be authorized, but the General Staff disapproved. In its opinion the 55,000 beds provided for in 45 general and 40 station hospitals would be adequate for the 550,000 troops which, it was expected, could be sent overseas during 1942.52

In the spring of 1942 plans were made to send a larger number of troops overseas during the rest of the year. Under the BOLERO plan, thirty divisions, or 1,000,000 men, were to be sent to the United Kingdom for an operation against the continent either late in 1942 or early in 1943. In May the President raised the size of the Army to be mobilized by the end of 1942 to 4,350,000.53 The number of units originally thought requisite in view of these changes was reduced considerably in the course of discussions among representatives of SOS and AGF headquarters and the Surgeon General's Office, and on 23 May 1942 SOS headquarters recommended to G-3 that 2 convalescent, 6 evacuation, 8 surgical, 62 general, 103 station, 22 field hospitals and 9 hospital centers should be included in the revised troop basis, in addition to the units already authorized.54 G-3 considered the recommended number of fixed-hospital units too large, but approved it when The Surgeon General explained that BOLERO alone would require 100,000 beds, or more than the number authorized in the additional units.55

49(1) Albert G. Love, "War Casualties," Army Medical Bulletin No.24 (1931), pp. 53-68. (2) Off Diary of Col Albert G. Love, Chief HD SGO, 6 Mar 42. HD.
50Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), p. 199, in UNITED STATES ARMY IN WORLD WAR II.
51Ltr, TAG to C of Arms and Servs, etc., 17 Jan 42, sub: Mob and Tng Plan, 1942. AG: 381(12-27-41)(2).
52(1) Memo, Act SC for ACofS C-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3-1. (2) 2d ind AG 320.2(1-29-42) MSC-C, TAG to SG, 18 Feb 42, on Memo, C of Air Staff for SG, 29 Jan 42, sub: Expansion Program of AAF for Calendar Year 1942. HD: 320.2(Trp Basis).
53Greenfield et al., op. cit., pp. 201-06. Also see Ray S. Cline, Washington Command Post: The Operations Division (Washington, 1951), pp. 143-63, in UNITED STATES ARMY IN WORLD WAR II; and Maurice Matloff and Edwin M. Snell, Strategic Planning for Coalition Warfare, 1941-42 (Washington, 1953), pp. 190-96, in UNITED STATES ARMY IN WORLD WAR II, for more information on BOLERO.
54(1) Memo, Lt Col A. B. Welsh for the Record, 13 Apr 42. HD: 320.2(Trp Basis). (2) Memo SPOPP 320.2 Serv Units (5-23-42), Dep Dir Oprs SOS for ACofS G-3 WDGS, 23 May 42, sub: Reqmts of Serv Units. . . . SG: 475.5-1.
55(1)Memo WDGCT 320.2(5-23-42), ACofS G-3 WDGS for CGs AGF and SOS, 25 May 42, sub: Reqmts of Serv Units. . . . SG: 475.5-1. (2) Memo, SG for Oprs Div SOS, 30 May 42, same sub. SG: 320.3-1. (3) Memo, ACofS G-3 WDCS for CG SOS, 5 Jun 42, same sub. Same file.


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During the late summer and fall of 1942 plans for the 1943 troop basis, through which a 7,500,000-man Army was to be mobilized by the end of 1943,56 called for sizable increases in the numbers of hospital units of all types. For the support of ground troops in combat, 7 convalescent, 20 evacuation, 52 semimobile evacuation, and 48 portable surgical hospitals were authorized for activation by December 1943. The number of fixed-hospital units which G-3 authorized-52 field, 192 general, and 327 station hospital units-was less than The Surgeon General recommended.57 G-3's authorization of the smaller number apparently resulted from a shortage of physicians to staff more. The Surgeon General believed that enough beds and other equipment to care for the maximum estimate of sick and wounded men would have to be provided in any event. He therefore recommended again an increase in authorized units and urged that he be permitted, if his recommendation should be disapproved, to procure adequate equipment for overseas hospitals regardless of the troop basis.58 Both G-3 and OPD agreed to the latter proposition and SOS headquarters arranged to assure the procurement of equipment which The Surgeon General considered necessary.59

The Question of Equipping and Using Numbered Hospitals in the Zone of Interior

Throughout 1942 and most of 1943 the Surgeon General's Office and SOS headquarters were engaged in an inconclusive dispute over the issuance of equipment to numbered hospital units and the use of such units on a functional basis in the United States. This dispute, like the one over planning for zone of interior hospitalization already discussed, exemplified difficulties resulting from misunderstanding about the respective responsibilities of the Surgeon General's Office and the SOS Hospitalization and Evacuation Branch. Of more significance, it involved the following problems: the method of training hospital units in the United States, the contribution of such units to the medical service during training periods, and whether or not such units should receive full issues of equipment in the United States.

After war began most hospital units in the zone of interior continued primarily as schools for tactical training. A few were issued full assemblages and operated hospitals on maneuvers. As a rule, though, under a policy announced in January 1942 and already discussed, hospital units received only field training equipment, soldiers' individual equipment, and motor transport, for use in unit field training. The Surgeon General expected them to receive technical training and experience with professional supplies and equipment in zone of interior hospitals. This "parallel" method of training seemed satisfactory when only one or two units were located on a particular post, but delay in construction of housing for a hospital unit near each of twenty-two general hospitals and

56Greenfield et al., op. cit., pp. 212-17.
57(1) Diary, Hosp and Evac Br SOS, 28 Oct 42. HD: Wilson files, "Diary." (2) Memo, SG for CG SOS, 25 Jan 43. HD: 632.-2. (3) Table, Auth Units (Hosp Type) in 1942 and 43 Trp Basis. HD: 320.2 (Trp Basis).
58(1) Memo, SG for CG SOS, 25 Jan 43. HD: 632.-2. (2) Ltr, SG for CG SOS, 6 Mar 43, sub: Adequacy of Plans for Overseas Hosp. SG: 322.15-1.
59(1) Memo SPOPH 701(3-6-42), Dir Plans Div ASF for Gen [LeRoy] Lutes, 15 Mar 43, sub: Adequacy of Plans for Overseas Hosp. HD: Wilson files, "Book III, 1 Jan 43-15 Mar 43." (2) lst ind, ACofS for Oprs SOS to SG, 16 Mar 43, on Ltr, SG to CG SOS, 6 Mar 43, same sub. SG: 322.15-1.


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thirty-four station hospitals in the United States, as The Surgeon General requested,60 caused units to be grouped on posts wherever troop housing was available. Whenever this happened there were so many officers and men of numbered units in each named hospital concerned that they had to take turns serving alongside of, or "parallel" to, their opposite numbers.61

This entire system was challenged early in 1942. By March Colonel Wilson was convinced that hospital units could be best prepared for overseas service by being issued complete equipment and by being required to function as hospitals in the United States.62 Moreover AGF headquarters wanted to train unit personnel in the storage, maintenance, and repair of hospital equipment and to have hospital units self-sufficient in so far as messing and administration were concerned. In May, therefore, AGF headquarters recommended that all hospital units scheduled for maneuvers and all newly activated units be given full issues of equipment for permanent retention.63 The Surgeon General was willing to make some concessions to the Ground Forces but not to issue complete assemblages as SOS headquarters directed in June and again in August 1942. In a paper duel which his Office fought with SOS headquarters over this matter, The Surgeon General reached a point by 7 September 1942 of agreeing to the issuance of housekeeping equipment, but he requested approval of a policy of withholding all other equipment in assemblages until units were assigned to operational missions.64

By this time SOS headquarters had decided not only to force The Surgeon General to issue complete assemblages to all units but also to require him to employ units under SOS control in the zone of interior medical service. There seem to have been several reasons for this decision. In September 1942 a report from the Southwest Pacific Area emphasized the desirability of issuing equipment to units in training to permit them to learn to pack and move it easily and to reduce its size and weight by eliminating unnecessary items.65 Moreover, many units were becoming restless from long periods of training without opportunities either to function as hospitals or to assist in zone of interior hospital operations; and stories of doctors being called from civilian practice only to sit and wait around Army camps

60Memo, Act SG for ACofS G-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3-1.
61(1) For example, see the An Rpts, 1942 and/or 1943 of 3d, 6th, 23d, 50th, 79th, and 108th Gen Hosps and An Rpt, 1943, 36th Sta Hosp. HD. (2) Consolidated Rpt, SGs Observers for 1942 Maneuvers, transmitted to ASF Hq by Memo, SG for Dir Tng ASF, 16 Jun 43. Ground Med files: "Rpt of Maneuver Observers, SGO, 1942." (3) Memo, Dir Planning Div ASF for Gen Lutes, 4 Aug 43, sub: Sta Hosp in Maneuver Areas. Ground Med files: 354.2 "Maneuvers."
62Memo G-4/24499-178, Maj W. L. Wilson for Gen Lutes, 12 Mar 42, sub: Basic Plans for Hosp and Evac. HD: Wilson files, "No 472, Hosp and Evac, 1941-42."
63Ltr 475.5/49-GNSPL (5-26-42), CG AGF to Dir Oprs SOS, 26 May 42, sub: Equip for Med Units. HD: Wilson files, 400 "Med Equip and Sups."
64(1) 2d ind, SG to Dir Oprs SOS, 29 May 42; 3d ind, CG SOS to SG, 22 Jun 42; 4th ind, SG to Dir Oprs SOS, 30 Jun 42; 5th ind, CG SOS to SG, 9 Jul 42; 6th ind, SG to Dir Oprs SOS, 20 Jul 42; 7th ind, CG SOS to SG, 6 Aug 42; and 8th ind, SG to CG SOS, 7 Sep 42, on Memo 475/826-GNSPL (5-22-42), CG AGF for Dir Oprs SOS, 22 May 42, sub: Equip for MD Units. SG: 475.5-1. (2) Memo, Lt Col A[rthur] B. Welsh for Gen [Larry B.] McAfee, 11 Jun 42. HD: 320.2(Trp Basis). (3) Diary, Hosp and Evac Br SOS, 13 Aug 42. HD: Wilson files, "Diary."
65Ltr, Col P[ercy] J. Carroll to ACofS G-4 USASOS SWPA, 19 Sep 42, sub: Data for Lt Col [Willard S.] Wadelton. HD: Wilson files, "Experience in Med Matters from Overseas Forces." Colonel Wilson had asked Colonel Wadelton to get information for him on a visit of the latter to SWPA.


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began to reach the public and the Army Inspector General.66

At the same time, it appeared that there would be insufficient Medical Department enlisted men and Medical Corps officers to supply both zone of interior installations and numbered units with their authorized numbers, and the General Staff began a drive for more efficient personnel utilization.67 The chief of the SOS Hospitalization and Evacuation Branch believed that personnel required for zone of interior hospitals could be reduced by using numbered hospital units to help operate such installations. Furthermore, he believed that a reserve of hospital beds for emergencies could be provided by issuing equipment to numbered units.68 In addition, some of the obstacles to assemblage-issuance and unit-use were being removed. Although equipment was still in short supply, the Surgeon General's Office and SOS headquarters were making renewed efforts to increase its availability. Housing, including warehouse space for equipment which had been authorized in the spring of 1942, was expected to be available for occupancy between September 1942 and January 1943.69 Finally the Wadhams Committee was appointed early in September 1942, and SOS headquarters may have expected its support in this instance.70 Whether because of one, some, or all of these reasons, SOS headquarters on 16 September and again on 12 October 1942 directed The Surgeon General to prepare a plan for the use of numbered hospital units in the zone of interior medical service and on 17 September 1942 requested his comments on the draft of a policy requiring the issuance of assemblages to all hospital units in training.71

Receipt of these communications caused confusion and consternation in the Surgeon General's Office. The Operations Service called for comments from other sections-the Supply, Professional, and Personnel Services and the Hospital Construction, Hospitalization, and Training Divisions. After several conferences to discuss the action that should be taken, final decision was to request no change in the policy on the issuance of equipment and to submit no plan for the use of numbered units. To support this decision, the Surgeon General's Office marshaled an array of arguments. The most important seem to have been lack of sufficient equipment to permit the issuance of assemblages to all

66(1) Memo for Record on Memo SPOPH 320.2, ACofS Oprs SOS (init WLW[ilson]) for SG, 16 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42." (2) Diary, Hosp and Evac Br SOS, 25 Sep 42. HD: Wilson files, "Diary." (3) Memo, Dir Mil Pers Div SGO for Dir HD SGO, 14 Apr 44. HD: 326.1-1. 
67See above, pp. 131-37, and Memo, DepCofSA for SG thru CG SOS, 17 Oct 42, sub: Availability of Physicians. SG: 322.05-1. 
68Memo SPOPM 322.15, Chief Hosp and Evac Br SOS for Gen Lutes, 15 Sep 42, sub: Directive for Hosp and Evac Oprs. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42."
69(1) Memo, Chief Hosp and Evac Br SOS for Gen Lutes, 23 Aug 42, sub: Status of Procurement of Med Supplies. HD: Wilson files, 440 "Med Sups." (2) Memo, CofEngrs for SG, 19 Sep 42, sub: Fld Hosp Units. HD: 632 "Housing."
70Colonel Wilson stated to the Committee that one of the problems of the Medical Department was the development of a system for training medical units with their equipment before going overseas. Ltr, Chief Hosp and Evac Br Plans Div Oprs SOS for Chm, Cmtee to Study the MD, 21 Oct 42, sub: Med Problems. HD: Wilson files, "Book 2, 26 Sep 42-31 Dec 42."
71(1) Memo SPOPH 320.2, ACofS Oprs SOS (init WLW[ilson]) for SG, 16 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42." (2) 1st ind SPOPH 320.2 (9-26-42), ACofS Oprs SOS (same init) to SG, 12 Oct 42, on Memo, SG for Oprs Div SOS, 26 Sep 42, same sub. HD: 632 "Hosp-Housing." (3) Draft Ltr SPOPP 475, CG SOS to SG, 17 Sep 42, sub: Equip for MD Units. SG: 475.5-1.


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units and fear that the zone of interior medical service would be left in the lurch if numbered units were used to furnish it and were then sent overseas. To these were added other arguments. According to the Surgeon General's Office, units needed equipment neither for training nor for emergency hospitalization. Those in training could get experience with equipment in zone of interior hospitals and equipment required for emergencies could be shipped from depots when needed. Units were not qualified either to repack equipment for overseas shipment or to determine deletions and substitutions to reduce total weight. The former should be done by depots to prevent breakage and the latter could be done properly only by qualified boards and representatives of The Surgeon General. Units could not replace regularly assigned personnel in zone of interior hospitals without interrupting care of the sick and lowering the standard of professional work. Their mere presence near such hospitals constituted an adequate reserve of hospital facilities for emergencies; and their use as units would not reduce zone of interior personnel requirements because their members were already assisting in the medical service under the system of parallel training. Finally, The Surgeon General stated that he had no reason to believe that unit training was deficient. In requesting that existing policy on assemblage-issuance not be changed, The Surgeon General's supply representative explained personally to SOS headquarters the shortage of medical equipment. In refusing to submit a plan for the use of numbered units, The Surgeon General called attention to a plan for providing an effective medical service for a 7,500,000-man Army with 48,000 to 50,000 physicians which he was submitting at the request of the Deputy Chief of Staff of the Army.72

In this instance, SOS headquarters adopted a more lenient attitude toward The Surgeon General's action than might have been expected. Perhaps this resulted from an awareness of the critical aspect of the medical supply situation and from some hesitancy to push The Surgeon General when he had orders from the Deputy Chief of Staff of the Army to present a "plan." Perhaps it resulted from the apparent inclination of the Wadhams Committee toward The Surgeon General's position rather than that of the SOS Hospitalization and Evacuation Branch.73 At any rate, SOS headquarters tabled the directive requiring a plan for the use of numbered units,74 and the chief of its Hospitalization and Evacuation Branch worked out a compromise on the assemblage-issuance question. He adopted a new definition of assemblages, proposed by the SOS Plans Branch: henceforth assemblages would contain only Medical Department items. Items needed by hospitals but supplied by other services, such

72(1)Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Med Unit Assemblages. SG: 475.5-1. (2) Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units, with 2d ind, Act SG to Chief Oprs Div SOS, 14 Nov 42. SG: 320.2. Numerous memos from chiefs of various sections of SGO giving these arguments are in HD: 632 "Hosp-Housing."
73Cmtee to Study the MD, 1942, Testimony, pp. 1869ff. HD. After the war General Lutes stated that General Somervell personally directed a "lenient attitude" toward the Surgeon General's Office because of the Wadhams Committee's report. He was proceeding cautiously, General Lutes stated, to determine who was correct. Ltr, Lt Gen LeRoy Lutes to Col R[oger] C. Prentiss, Jr, 8 Nov 50. HD: 314 (Correspondence on MS) III.
743d ind SPOPH 320.2 (9-26-42), CG SOS to SG, 22 Nov 42, on Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. SG: 320.2.


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as the Quartermaster Corps, would not be included in assemblages and would be issued whenever units requested them. The Surgeon General would determine the time when enough Medical Department equipment was available to issue complete assemblages to all units. Until that time he would make partial issues. Afterward, he would issue complete assemblages to all hospital units under AGF control. Assemblages for station and general hospitals under SOS control would be located in Medical Department depots so that delivery could be made in emergencies within seven days and so that units in training might readily inspect and study them.75 When the Surgeon General's Office found even this policy unsatisfactory, SOS headquarters delayed announcing it officially until the medical supply situation had improved. Then, on 18 January 1943, SOS headquarters had the new policy published.76

At the beginning of the new year a combination of circumstances caused a revival of the question of using numbered units in the zone of interior. Contrary to what might have been expected, the "plan" which The Surgeon General submitted to the Deputy Chief of Staff on 14 December 1942 did not deal with this question, but only with the bulk allotment of Medical Corps officers to the three major commands.77

Soon afterward, in January 1943, the SOS Director of Training received criticism from at least one service command of deficiencies in unit training. About the same time the chief of the SOS Hospitalization and Evacuation Branch reported that failure to use units while in the United States was being criticized publicly. He then requested and received authority from his superior officer in SOS headquarters to collaborate with the SOS Training Director and the Surgeon General's Office in working out a plan to answer such criticism.78 In a subsequent conference of representatives of the Surgeon General's Office AGF headquarters, and SOS headquarters, it was "unanimously agreed," the last reported, that The Surgeon General would estimate the amount of medical personnel required for hospital service at each camp of 10,000 or greater population, would determine the minimum permanent staff required for each hospital at those camps, and would make a definite plan, based upon OPD shipment schedules, for the use of numbered units to operate such hospitals under the supervision of permanent staffs.79 The chief of the SOS Hospitalization and Evacuation Branch then took a trip around the country and found, he reported, that each service command surgeon agreed that he could operate a satis-

75(1) Draft memo SPOPH 475(9-26-42), CG SOS for SG, 23 Oct 42, sub: Equip for Fld Med Units. HD: Wilson files, "Book 2, 26 Sep 42-31 Dec 42." (2) Diary, Hosp and Evac Br SOS, 1 Nov 42. HD: Wilson files, "Diary." (3) Memo SPOPH 475(9-26-42), Chief Hosp and Evac Br SOS for Chief Plans Br SOS, 2 Nov 42, sub: Med Unit Assemblages. HD: Wilson files, "Book 2, 26 Sep 42-31 Dec 42."
76(1) WD Memo W700-4-43, 18 Jan 43, sub: Equip for Fld Med Units. HD: Wilson files, "Book III, 1 Jan 43-15 Mar 43." (2) Memo SPOPH 440, Chief Hosp and Evac Br SOS for Gen Lutes, 27 Jan 43, sub: Status of Procurement of Med Sups. Same file. 
77Memo, Act SC for DepCofSA thru Mil Pers Div SOS, 14 Dec 42, sub: Availability of Physicians. SG: 322.051-1.
78(1) Memo, CG SOS (Tng Div) for SG, 5 Jan 43, sub: Tng of MC Pers. SG: 353.-1. (2) Memo SPOPH 320.2, Chief Hosp and Evac Br SOS for Gen Lutes, 16 Jan 43, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilson files, "Book III, 1 Jan 43-15 Mar 43."
79(1) Diary, Hosp and Evac Br SOS, 20 Jan 43. HD: Wilson files, "Diary." (2) Memo, Maj J[ohn] S. Poe for the Record, 21 Jan 43, sub: Conf 4A526 Pentagon Bldg, 20 Jan 43. HD: 632 "Hosp-Housing."


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factory hospital service under the proposed plan.80

The plan which The Surgeon General presented on 14 April 1943 indicated that agreement on the subject had not been unanimous. Instead of providing for the use of numbered units to operate zone of interior hospitals, it called for the use of members of such units, on a two-for-one basis, to make up deficits in personnel-that is, differences between assigned and authorized strength in zone of interior hospitals. "This was done," The Surgeon General stated, "because the primary function of the T/O unit is TRAINING."81

By this time seventy-eight general hospitals were reported "back-logged" in the United States, with no immediate prospect of employment overseas. Both the chief of the ASF Hospitalization and Evacuation Branch and the ASF Director of Training feared that the General Staff would reduce the number of Medical Department units in the troop basis if they were not fully used.82 Before he could take further action toward that end Colonel Wilson was succeeded in his position in SOS headquarters by Col. (later Brig. Gen.) Robert C. McDonald, and for a time the question remained in abeyance.

Meanwhile changes occurred in the training and use of some hospital units. Completion of housing near zone of interior hospitals made it possible to train more personnel than before on a "parallel" basis;83 and year-round use by the Ground Forces of the A. P. Hill Military Reservation and the Desert Training Center provided opportunities for several units to function as hospitals, furnishing medical and surgical care for patients in those areas.84 The issuance of assemblages to evacuation hospital units under the revised policy permitted them to train with full equipment and work out a system of functional packing to increase unit mobility.85 Yet as a rule general and station hospital units still lacked assemblages in the United States and had infrequent opportunities to function as hospitals before going overseas. Meanwhile, the time which some of them spent in training lengthened considerably. For example, although affiliated units had been intended for prompt shipment overseas, the fifty-one affiliated general hospital units that were eventually sent out remained in the United States for an average of eight months. One, the 27th General Hospital unit, stayed in this country seventeen months. (Tables 6, 7)

The unsolved problems of assemblage-issuance and unit-use faced Surgeon General Kirk when he succeeded General Magee in June 1943. Soon afterward he took them up with Colonel McDonald. Perhaps the entry of new participants made solution easier, for neither was unalterably committed to the position of his predecessor. In addition, despite his ASF position, Colonel McDonald identified himself closely with the Medical Department and held personal views of these

80Memo SPOPI 337, CG SOS (init WLW[ilson]) for SG and CofT, 30 Apr 43, sub: Resume of Confs. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43."
81Ltr, SG to CG ASF, 14 Apr 43, sub: Asgmt of TofOpns Units for Tng. SG: 632.-1.
82(1) Memo SPOPI 322(4-14-43), ACofS Oprs SOS (init WLW[ilson]) for Dir Tng ASF, 19 Apr 43, sub: Asgmt of TofOpns Units. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43." (2) Memo SPTRU 370.5 (4-19-43), Dir Tng ASF for ACofS Oprs ASF, 27 Apr 43, same sub. SG: 353.-1.
831st ind, SG to Dir Tng SOS, 9 Jan 43, on Memo, CG SOS for SG, 5 Jan 43, sub: Tng of MC Pers. SG: 353.-1.
84See above, pp. 104-06.
85An Rpts, 1943, of following Evac Hosps: 27th, 32d, 39th, 51st, 99th, 103d, 106th, 110th, and 145th. HD.


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TABLE 6-AFFILIATED GENERAL HOSPITAL UNITS

problems similar to those advocated by the Surgeon General's Office.86

General Kirk believed that the current policy on assemblage-issuance might be partly responsible for a problem which theaters had reported and complained of-the receipt of equipment for a single hospital on several vessels at widely separated ports.87 In July 1943, therefore, he requested its reconsideration. First he proposed a return to the policy advocated by

86Interv, MD Historian with Brig Gen Robert C. McDonald, Ret, USA, 5 Mar 51. HD: 000.71.
87An Rpt, Issue Br Sup Serv SGO, FY 1944. HD.


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TABLE 7-AFFILIATED EVACUATION HOSPITAL UNITS

his predecessor-withholding all equipment for hospital units until they reached ports of embarkation-and then a compromise between that and the existing policy. Ultimately he withdrew both proposals. After an investigation of split shipments, Colonel McDonald reported that the current policy seemed to have little effect in causing such a problem. Furthermore, representatives of The Surgeon General agreed that a change in policy might produce a six-to-twelve month period of confusion in supply matters.88 Thus the policy on the issuance of equipment to

88(1) Ltr, SG to CG ASF, 10 Jul 43, sub: Equip for Fld Med Units. SG: 475.5-1. (2) 1st ind SPOPI 008 (7-10-43), CG ASF to SG, 9 Aug 43, on basic Ltr just cited. HD: Wilson files, "Day File, Aug 43." (3) Ltr, SG to CG ASF, 6 Aug 43, sub: Equip for Fld Med Units. HRS: ASF Control Div, 334 "Procedure Cmtee, G-58." (4) Diary, Hosp and Evac Br ASF, 27 Aug 43. HD: Wilson files, 400 "Med Equip and Sups." (5) Memo for Record, 7 Sep 43, on Memo, SG for Col R. C. McDonald, Plans Div Oprs ASF, 7 Sep 43. SG: 475.5-1. (6) 1st ind SPOPI 440 (6 Aug 43), CG ASF to SG, 28 Aug 43, on basic Ltr cited in (3) above. HD: Wilson files, "Day File, Aug 43."


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numbered medical units, which the Surgeon General's Office had formerly opposed, remained in effect for the rest of the war.89

General Kirk called for a full discussion of the question of using numbered hospital units in the zone of interior medical service in his first conference with service command surgeons. They agreed that the existing situation was deplorable. For example, one stated that it was difficult, when several units were located on a single post, to schedule their personnel for "parallel training" without having men "falling all over each other." Another, stressing morale, stated that one unit had been in his command "so long that they've worn out all of their films showing them over and over, and they've worn out all their shoes doing the same hikes. . . ."

In general, service command surgeons seemed favorably inclined toward the proposal to use numbered units in the operation of zone of interior hospitals, but several feared that administrative difficulties might arise unless units and their commanding officers were placed under the control of station surgeons. Others believed that professional problems might develop if numbered units were withdrawn from named hospitals either for field training or for overseas service without adequate personnel being left behind to operate zone of interior hospitals.90 To avoid such a situation, the Surgeon General's Office announced that the adoption of any plan for the use of numbered units to operate zone of interior hospitals was contingent upon two conditions: first, the assignment of two hospital units to the named hospital in which they were to serve, and second, the existence of suitable barracks to house such units. Colonel McDonald agreed to these conditions and suggested that the Surgeon General's Office prepare a plan for trial on one post. The chief of The Surgeon General's Training Division lacked enthusiasm for this proposal but agreed to investigate its possibilities.91 Accordingly he drafted a plan by November 1943 for consideration by other officers of the Surgeon General's Office, but their comments indicated no diminution of opposition to the basic idea.92

By that time events were taking place which were to cause the whole matter to be dropped. In September 1943 the General Staff forbade the use of War Department funds to build more housing for numbered hospitals in the United States, thereby denying quarters for the two units per named hospital which The Surgeon General had recommended.93 The next month the ASF Hospitalization and Evacuation Branch, which had initiated

89(1) See above, pp. 45-46, 141-42. (2) Rpt of Subcmtee on Employment of Med Resources, Cmtee on Med and Hosp Serv of Armed Forces, Off SecDef, 25 May 48, pp. 394-95. HD.
90(1) Rpt, SGs Conf with Chiefs Med Br SvCs, 14-17 Jun 43, pp. 242, 244, 245, 259, 260. HD: 337. (2) Memo, CG SOS (SG) for CGs of SvCs, 12 Jul 43, sub: Asgmt of TofOpns Units for Tng. . . , with inds from SvCs in reply. SG: 353.-1.
91Rpt, SGs Conf with Chiefs Med Br SvCs, 14-17 Jun 43, pp. 253-64. HD: 337. (2) Diary, Hosp and Evac Br ASF, 16 Jun 43. HD: Wilson files, "Diary."
92(1) Memo, Maj C[arl] C. Sox for Col A. B. Welsh, 10 Nov 43, sub: Comments on Tentative Plan for the Functional Employment of Numbered ASF Med Units. (2) Memo, Maj John S. Poe for no addressee, 10 Nov 43, sub: Comments on Col Wakeman's Proposal. (3) Memo, Col A. B. Welsh for Gen R. W. Bliss, 12 Nov 43. (4) Memo, Col A. H. Schwichtenberg for Gen R. W. Bliss, 13 Nov 43, sub: Comments on Tentative Plan. . . . All in SG: 322.3-1.
93(1) Memo, Maj J. S. Poe for Col H[oward] T. Wickert, 7 Jul 43. HD: 632 "Hosp Housing." (2) Memo Maj J. S. Poe for Col A. B. Welsh, 16 Sep 43. Same file.


160

and pushed the proposal, was abolished. Of greater importance was the change in conditions that had prompted the proposal in the first place. From the middle of 1943 onward the pressing need for hospitals overseas caused the departure of most units which had been held back as well as the prompt shipment of others after brief periods of training.94 This disposed of the argument that services of personnel, especially doctors, were being wasted. It meant also that fewer and fewer units were left for use in hospitals at home. Finally, during the latter half of 1943 the troop population of the United States began to shrink so rapidly that the general employment of numbered hospital units to assist with medical care in the zone of interior perhaps no longer seemed useful. As a result, the long and tedious controversy between the Surgeon General's Office and ASF headquarters over the equipment and use in the United States of numbered hospital units reached an inconclusive end.

Preparing for the Support of Offensive Warfare

Shift of Emphasis Away From the Pacific

By about the middle of 1942, when emphasis in providing hospitalization for theaters shifted from the Pacific to other areas of the world, emergency needs resulting from the Japanese attack had been met and preparations for the invasion of North Africa were under way. To support the build-up of troops in the United Kingdom and subsequent successful North African operations, hospitals went in increasing numbers to both the European and the North African theaters in the last half of 1942 and the early months of 1943. During the same period other units were sent to scattered areas throughout the world to care for troops engaged in service functions in support of more active theaters. Since combat on a large scale had not yet begun, fixed hospitals were needed more than mobile ones, and station more than general hospitals. For example, by 15 March 1943 the War Department had shipped overseas, according to The Surgeon General's records, 140 station hospitals, ranging in size from 25-to 750-bed capacity, 27 general hospitals, and 14 field hospitals, but only 2 convalescent, 3 surgical, 17 750-bed evacuation, and 6 400-bed evacuation hospitals.95

Of those shipped after 30 June 1942,the major portions were units that had been activated and trained after the war began. A few of the units that were activated during 1941 and were still in the United States in mid-1942 were sent overseas in the following months, but the majority of the older units continued during the early war years as training units, furnishing filler personnel for others activated during 1942 and 1943 or for affiliated units previously organized. (Tables 8, 9, 10, 11.) As in the first six months of the war, although affiliated units continued to come on active duty on The Surgeon General's recommendation, many did not go overseas immediately. For example, although forty-two affiliated general hospital units had been activated by the middle of January 1943, only nineteen of them had been shipped by 15 March 1943. The remain-

94(1) See below, pp. 218-23. (2) Memo, Dep Chief Oprs Serv SGO for Dir Hosp Div SGO, 17 Feb 44, with incl. SG: 323.3.
95Table entitled Medical SOS Units as of 15 March 1943. SG: 322.05-1.


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TABLE 8-USE OF NONAFFILIATED GENERAL HOSPITAL UNITS ACTIVATED DURING 1941

der stayed in this country in a training status until later in 1943 or early in 1944. (See Table 6)

Negro Hospital Units

Among the hospital units prepared early in the war for overseas service were two with Negro personnel. Their activation and use, like the establishment of all-Negro wards and hospitals in the United States,96 resulted from The Surgeon General's opposition to the integration of Negro and white personnel in providing medical service for the Army-a position in line with the War Department's general policy on the use of Negro personnel.97 On 24 March 1942 the 25th Station Hospital, a 250-bed unit, was organized at Fort Bragg (North Carolina). All of its members were Negroes except four officers-the commander and his immediate staff. The use of white officers to command Negro units was a common practice of the War Department and was not considered a violation of the policy of segregation. Its

96See above, pp. 110-12.
97John H. McMinn and Max Levin, Personnel (MS for companion vol. in Medical Dept. series), HD., and Ulysses Lee, The Employment of Negro Troops, a forthcoming volume in the series UNITED STATES ARMY IN WORLD WAR II.


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TABLE 9-USE OF NONAFFILIATED STATION HOSPITAL UNITS ACTIVATED DURING 1941

advisability for hospital units was later questioned, and it was not followed in the case of other Negro hospital units activated during World War II. An advanced detachment of the 25th Station Hospital embarked in May 1942 for Liberia to support a force of construction engineers, personnel of the Air Transport Command and the Royal Air Force, natives employed by the Army at Roberts Field, and elements of a task force charged with protecting an airstrip and American rubber interests. After quarters were constructed overseas, the remainder of the unit, including its nurses, joined the advanced detachment on 10 March 1943. About the same time an all-Negro 150-bed unit, the 268th Station Hospital, was activated at Fort Huachuca (Arizona). After a period of training, it embarked for the Southwest Pacific theater in October 1943 and arrived in Australia in November.98

Establishing a Basis for Future Planning

Toward the end of 1942 the shift in emphasis from defensive measures to preparations for the offensive made it necessary to take stock of hospitalization already supplied in order to plan effectively for the future. Records of the number of hospital units shipped did not necessarily represent the number of beds available in the several theaters. In some instances, for reasons not often divulged to The Surgeon General, OPD diverted

98(1) An Rpt, 25th Sta Hosp, 1943, and Quarterly Hist Rpt, 268th Sta Hosp, 7 Jul 44. HD. (2) Diary, Col Stephen D. Berardinelli, 21 Jun 42 to 21 Dec 43. In his possession. (3) Interv, MD Historian with Col Berardinelli, formerly CO of 25th Sta Hosp, 24 Feb 50. HD: 000.71.


163

TABLE 10-USE OF NONAFFILIATED EVACUATION HOSPITAL UNITS ACTIVATED DURING 1940 AND 1941

units to different destinations from those for which they were originally earmarked. It sometimes happened that units arrived at overseas ports without equipment, which was shipped on other vessels, and therefore could not set up for actual operations. At other times assemblages were shipped as expansion units, for theaters to issue as needed to numbered hospitals that were already operating, to overseas hospitals that had operated during peacetime and were now being expanded, or to provisional hospitals that were being established with theater personnel. Furthermore, the U.S. Army was receiving hospitalization in some areas through reverse lend-lease. Thus The Surgeon General could not rely upon records of shipment of hospital units and assemblages for accurate information about beds available overseas. Nor could he depend upon statistical health reports (Medical Department Form No. 86ab). Designed to supply his Office regularly with information about admissions and dispositions of patients and about available and occupied beds in all Army hospitals, these reports often reached Washington only after considerable delay and differed in many instances from other available records.99

99Memo, SG for Oprs Div SOS, 31 Oct 42, sub: Bed Capacities for Fixed Hosps at Overseas Bases. SG: 632.2.


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TABLE 11-USE OF NONAFFILIATED SURGICAL HOSPITAL UNITS ACTIVATED DURING 1940 AND 1941

Unit Designation

Date of Activation

Redesignation in U.S.

Date of Embarkation

Initial Destination

Redesignation Overseas

Unit

Date

Unit

Date

6th Surg Hosp

1 Aug 40

91st Evac (Mtz)

31 Aug 42

12 Dec 42

N. Africa

---

---

7th Surg Hosp

1 Aug 40

92d Evac (Mtz)

25 Aug 42

28 Jun 43

Australia

---

---

28th Surg Hosp

10 Feb 41

---

---

4 Mar 42

Australia

360th Sta Hosp

28 Oct 43

33d Surg Hosp

25 Jan 41

---

---

4 Mar 42

Australia

361st Sta Hosp

28 Oct 43

48th Surg Hosp

10 Feb 41

---

---

2 Aug 42

England

128th Evac (SM)

1 May 43

61st Surg Hosp

1 Jun 41

93d Evac (Mtz)

25 Aug 42

16 Apr 43

N. Africa

---

---

63d Surg Hosp

1 Jun 41

94th Evac (Mtz)

25 Aug 42

28 Apr 43

N. Africa

---

---

74th Surg Hosp

1 Jun 41

95th Evac (Mtz) 

25 Aug 42

16 Apr 43

N. Africa

---

---

 


Sources: Unit cards filed in Orgn and Directory Section, Oprs Br AGO, and annual reports filed in HD.

In July 1942, therefore, to get more accurate and more current information than he had, The Surgeon General called upon SOS headquarters for assistance.100 Finding that neither SOS headquarters nor OPD had accurate records of the beds available in various theaters, the SOS Hospitalization and Evacuation Branch requested the latter, on 6 August 1942, to require all overseas commanders to submit a report on the capacities and numerical designations of their fixed hospitals.101 This request was approved and, as the reports came in, the Surgeon General's Office, the SOS Hospitalization and Evacuation Branch, and OPD were able to get an accurate picture of hospitalization overseas at that time. It showed that the ratio of fixed beds to troop strength ranged from 2.09 percent in some areas to 24.1 percent in others.102

Even after reports of overseas bed capacities had been received and tabulated, several obstacles to planning for the future had to be removed. In the first place, The Surgeon General was uncertain about his authority to make recommendations concerning overseas hospitalization, in view of the hospitalization and evacuation policy which was published on 18 June 1942 making overseas commanders responsible for "the operation of all medical facilities under their control and for future planning in connection therewith" (italics added).103 Despite this policy, SOS headquarters assured him that he could make recommendations about hospitalization and evacuation in theaters whenever appropriate. The Surgeon General also felt that he received insufficient information, both from higher authorities in the War Department and from surgeons in thea-

100(1) Memo, SG for Dir Oprs SOS, 11 Jul 42. SG: 632.2. (2) Memo, SG for Oprs Div SOS, 29 Jul 42, sub: Fixed Hosp Beds Overseas. HD: 632.-1 "Hosp Overseas, Bed Status."
101(1) Memos SPOPM 323.7 and SPOPH 632, CG SOS for ACofS OPD WDGS, 6 and 27 Aug 42, sub: Fixed Hosp Fac Available to Overseas Forces. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42." (2) 1st ind, CG SOS to SG, 14 Aug 42, on Memo, SG for Oprs Div SOS, 29 Jul 42, sub: Fixed Hosp Beds Overseas. HD: 632.-1, "Hosp Overseas, Bed Status."
102(1) Memo SPOPH 632(Hosp), CG SOS for SG, 20 Oct 42, sub: Bed Capacities of Fixed Hosps at Overseas Bases. HD: 632.-1 "Hosp Overseas, Bed Status." (2) Memo, SG for Oprs Div SOS, 31 Oct 42, same sub, with 1st ind SPOPH 632(10-31-42), CG SOS to SG, 16 Nov 42. Same file.
103Ltr AG 704 (6-17-42)MB-D-TS-M, TAG to CGs AGF, AAF, SOS, Theaters, etc., 18 Jun 42, sub: WD Hosp and Evac Policy. HD: 705.-1.


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ters, to enable him to plan intelligently and effectively for overseas hospitalization. While much information he desired from higher authorities was classified for security reasons, the SOS Hospitalization and Evacuation Branch attempted to provide him with more information about operational plans than he had previously received.104 Furthermore, in collaboration with the Surgeon General's Office that Branch took action which led to the establishment in January 1943 of a system of monthly reports from overseas commands. Submitted first as sections of the Monthly Sanitary Reports and after July 1943 as Reports of Essential Technical Medical Data (ETMD's), these reports contained information about admission and evacuation rates, availability of hospital beds, suitability of hospital units and their equipment, and other factors of importance to The Surgeon General in planning theater medical services.105 In addition, beginning with General Magee's trip to North Africa in the winter of 1942-43, representatives of the Surgeon General's Office made personal inspections of overseas areas in order to gain firsthand information about their medical services.106

Further obstacles to planning were lack of sufficient experience with battle casualties thus far in World War II to estimate accurately hospital admission rates and lack of an official evacuation policy-that is, a policy governing the selection of patients for evacuation to the United States in terms of the days of hospitalization which they were expected to require. In their absence The Surgeon General used for planning purposes the battle-casualty admission rates of World War I and assumed a policy of returning to the United States all patients who required 120 or more days of hospitalization. To establish a firmer basis for planning, he recommended in the spring of 1943 the establishment of an official evacuation policy but such action was not taken until later in the year.107

In providing hospitals for overseas service early in the war, the Medical Department discovered and attempted to correct shortcomings and errors in its prewar planning. It was discovered early that the activation and training of normal Army units was more valuable in meeting emergency hospital needs than the formation and organization of units affiliated with civilian hospitals and schools. Moreover, it soon appeared that units planned for theaters of operations were not suitable for all situations encountered in a modern global war and units of new types had to be de-

104(1) Memo SPMCP 704.-1, Act SG for Oprs Div SOS, 16 Nov 42, sub: Status of Hosp Overseas, with lst ind SPOPH 701 (11-16-42), ACofS Oprs SOS to SG, 24 Nov 42. (2) Memo SPOPH 701 (11-16-42), CG SOS for ACofS OPD WDGS, 24 Nov 42, same sub. (3) Memo OPD 701 (11-24-42), ACofS OPD WDGS for CG SOS, 23 Jan 43, same sub. All in HD: 632.-1 "Hosp Overseas, Bed Status."
105(1) Rad CM-OUT 5938-5957, TAG to CGs Overseas Comds. SG: 370.2-1. (2) Memo SPOPH 440, CG SOS for TAG, 28 Dec 42, sub: ETMD from Overseas Forces, with Memo for Record. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43." (3) Diary, SOS Hosp and Evac Br, 4 Dec 42. HD: Wilson files, "Diary." (4) Ltr AG 350.05 (12-28-42)OB-S-SPOPH-M, TAG to CGs Overseas Comds, 2 Jan 43, sub: ETMD from Overseas Forces. HD: Wilson files, "Experience in Med Matters from Overseas Forces." (5) Ltr AG 350.05 (28 Jun 43)OB-S-D-M, TAG to CGs Overseas Comds, 14 Jul 43, same sub. HD: 350.05 "Mil Info."
106Memo, SG for CG SOS, 12 Jan 43. HRS: Hq ASF, Gen [Wilhelm D.] Styer's files, "Med Dept."
107(1) Memo SPMCP 704.-1, Act SG for Oprs Div SOS, 16 Nov 42, sub: Status of Hosp Overseas, with 1 incl. HD: 632.-1 "Hosp Overseas, Bed Status." (2) Memo, Dir Control Div ASF for CG ASF, 2 Apr 43, sub: Situation with Respect to Army Hosp. SG: 322.15. (3) Memo, SG for CG ASF, 15 Apr 43, sub: Evac Policy for Overseas Theaters. SG: 705.-1. (4) See below, pp. 215-16.


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veloped-field hospitals, motorized evacuation hospitals, and portable surgical hospitals. The size and weight of equipment of all hospital units had to be reduced and new methods of packing had to be developed in order to increase the mobility and transportability of hospitals. Shortages of Medical Corps officers appeared and required reductions in the number authorized by tables of organization developed during the emergency period. Shortages of equipment continued to plague the Medical Department and partially accounted for The Surgeon General's insistence upon withholding its issuance until hospital units were assigned to missions involving the care of patients. In this connection, The Surgeon General also resisted demands of higher authorities to plan for the use of numbered hospitals in the zone of interior medical service. Meanwhile other units were being activated and trained, and toward the end of General Magee's administration measures were taken to find out what hospital facilities theaters actually had and to place planning for future needs on a sounder basis.

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