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Wound Ballistics and Body Armor in Korea
Carl M. Herget, Ph. D., Capt. George B. Coe, Ord Corps,
Wound ballistic and body armor studies during the Korean War could draw upon the experiences of studies reported in earlier chapters for valuable orientation and guidance. In addition, results of basic wound ballistic investigations (including body armor studies) conducted in the laboratory were available to aid in the interpretation of field findings. Thus, when hostilities opened in Korea in June 1950, developments for field protection which had been planned during World War II reassumed vitality.
Before the opening of hostilities in Korea, the Biophysics Division of the Chemical Corps Medical Laboratories had been carrying out basic research in the fields of wound ballistics and body armor.1 These studies entailed a comprehensive evaluation of the wounding potential of many types of missiles, especially small arms projectiles and fragments, when striking animal tissue. Samples of armor material, including nylon, doron (fiber glass), steel, aluminum, and combinations of these had also been tested to ascertain the relative protection these materials afforded the animal head, thorax, and abdomen against the different types of missiles. This work was facilitated by background ballistic studies on these materials at Ordnance Department installations, particularly Watertown Arsenal, Mass., and Aberdeen Proving Ground, Md.
BATTLE CASUALTY SURVEY-NOVEMBER 1950
With the advent of hostilities in Korea, the Biophysics Division, Chemical Corps Medical Laboratories, in coordination with Brig. Gen. (later Maj. Gen.) William M. Creasy, Commanding General, Chemical Corps Research and Engineering Command, recommended to Col. (later Brig. Gen.) John R. Wood, MC, Chairman, Medical Research and Development Board, Office of the
Surgeon General, that a wound ballistics team be organized and dispatched to the Far East Command for the purpose of studying casualties. In response to this recommendation, a team was organized and dispatched to the Far East Command on 14 November 1950 under Department of the Army Orders, AGPA-OS 200.4. Officer members of the team included Lt. Col. Robert H. Holmes and Capt. Robert F. Palmer of the Medical Corps; Capt. William R. Phillips, Ordnance Corps; and 1st Lt. George B. Coe, Chemical Corps. The unit arrived at Haneda Air Terminal, Tokyo, Japan, on 26 November 1950, and reported directly to Maj. Gen. Edgar Erskine Hume, The Surgeon, Far East Command.
No specific plan for the actual functioning of this research unit was previously determined; that is, whether to operate as a completely independent unit with or without T/D (table of distribution) or to arrange an attachment to a theater organization. After a local evaluation, it was recommended to the operations officer, Office of the Surgeon, Far East Command, that the Wound Ballistics Research Team be attached to the 406th Medical General Laboratory, Tokyo. This recommendation had already been approved by Lt. Col. (later Col.) Robert L. Hullinghorst, MC, commanding officer of the laboratory. The attachment was made, and subsequent events proved the decision most wise. This arrangement afforded a headquarters with easy accessibility, office space, a simple means of supply and a ready source of information as to location of medical units and routes of casualty evacuation, and introduction in general to proper channels of command.
Conduct of Survey
After equipment and enlisted personnel were received, approximately 15 December 1950, request was made for entry into the Eighth U.S. Army Area, specifically Pyongyang (fig. 337), for attachment to the 171st Evacuation Hospital. An alternate request was also made for entry into the X Corps Area with attachment to any available MASH (mobile army surgical hospital). Because of the entry of Chinese Communist Forces into the Korean War on about 28 November 1950 and the strategic withdrawal of the United Nations troops to a position below the 38th parallel, the team's entry into Korea was denied. The exigencies of such warfare required that all personnel and equipment permitted entry should contribute directly and immediately to the survival of combat elements.
In the meantime, a study of casualties was begun in Japan at the Tokyo Army Hospital and the 118th Station Hospital at Fukuoka. Eventually, authority was obtained for certain members of the team to enter Korea. These members actually went as blood couriers and were then allowed to remain in Korea, where they were attached to the 3d Station Hospital at Pusan. Even though the flow of casualties at this point in Korea was moderate, several hundred patients with wounds that had received only the minimum in definitive medical care were studied by the team. The team also spent 2 weeks in the
prisoner-of-war hospital at Tongnae. Through an interpreter, a thousand wounded North Korean and Chinese Communist soldiers were interviewed as to their mode of wounding, whether it be from aircraft or ground arms and what the wounding missile was. This information furnished some idea of the effect of United Nations weapons on the enemy. A study of U.S. KIA casualties at the Graves Registration Service was also accomplished at this time. However, this survey, made from records only, was of a statistical nature and is not considered a true picture of the type of missiles, wounds, and regional and area frequency of lethal wounds U.S. KIA actually received. Medical records giving type of missile and type of wounds were frequently found to be erroneous. Battlefield surgeons often did not differentiate between a gunshot wound and a shell fragment wound by external examination and often confused penetrating and perforating wounds. Correctness of information on these
points is extremely important for the accuracy of any wound ballistics study. Training in experimental wound ballistics is necessary in order to assure accuracy of the casualty surveys.2
Basic Scope of a Battle Casualty Survey
The basic object of all battlefield casualty studies is to analyze the effect of firearms and their missiles upon human or experimental animal tissue. Modern warfare has become so versatile and changes in weapons have been so rapid that for military purposes a study of this nature must be continuous in both the experimental laboratory and every theater of combat operations. These studies must extend in range from simple missile laceration to the complicated effects of atomic weapons explosions and from the first medical care in a battalion aid station to the point of maximum recovery in a general hospital or permanent disposition to a veteran's facility. As each new weapon appears, its wounding properties must be carefully evaluated. This study entails liaison with military intelligence and ordnance; identification of enemy weapons and missiles; knowledge of velocities, size, shape, and mass of missiles; percentage incidence of various missiles; and percentage a given body region is involved, as well as the proper classification of wounds. The study should also evaluate the method, time, and distance of evacuation in relation to primary wound treatment, wound contamination, and all other variables of wound repair. A field wound ballistics study ideally includes a continuous study of the wound from the time of occurrence until the time of maximum repair followed by a study of the functional effects of that repair and the various adaptation phenomena. Therefore, such a study demands the cooperation and coordination of a vertical segment of medical personnel indoctrinated in this continuity of wound evaluation so that sample-type wounds will receive standardized observations and photographic recording at critical intervals, throughout the scheme of medical evacuation and hospitalization.
The following criteria were formulated by this first survey team and are a natural part of any battle casualty survey investigation:
1. Regional frequency of wounds (number of times a region is involved in total number of cases).
2. Regional distribution of wounds (number of wounds in each region in total number of wounds).
3. Weapon and missile identification.
4. Missile frequency; that is, the number of times a given missile type is encountered.
5. Type of wound, distribution, and frequency.
6. Photography of wounds and organs and X-rays of body regions.
7. Special studies; for example, vascular and nerve damage, spinal cord damage, eye and ear damage, fractures, amputations, cold injury, and disease coincident with wounds.
8. SIW (self-inflicted wound) casualties, type of weapon, missile, regional and area frequency, and distribution.
9. Studies on wounded prisoners of war and enemy killed in action to learn the effects of U.S. weapons.
10. The ratio of single to multiple wounding.
11. The effect of wound contamination, tetanus, and gas gangrene.
12. A survey of the casualty flow as sample days in a battalion aid station, mobile army surgical hospital, and evacuation hospital. These studies should represent various tactical circumstances and would aid in future planning procedures.
13. A study of the mode, distance, and time of medical evacuation of casualties and the effects upon the different types of wounds.
14. A study of wound incidence, type and causative agent in the veteran of 60-90 days' combat as compared to the nonveteran of less than 30 days and the veteran of more than 120 days.
15. A study of wound incidence in personnel who have received some form of rotation duty in contrast to a similar group who have not received rotation.
16. A general study of traumas, other than missile-inflicted wounds.
These points are but a partial listing of the studies required in a complete battle casualty study. Some of them have been accomplished, but others are only projected. Fortunately, there are a few medical observers from World War I and many with World War II experience available to thrash out their varied impressions. Of great importance is the fact that many precedents in wound classification, treatment, evacuation, and disposition have been established. Experienced medical personnel are available to lead the way.3
Sample of Information Desired
A consideration of war wounds thus begins with an emphasis placed upon the accurate recording of specific medical data. The following items are a more detailed breakdown of some of the previously listed subjects:
The etiologic agent:
Accessory military data:
The wound-general (certain of these factors are applicable to the wounded in action only):
The conclusions reached by the first wound ballistics team concerning the administrative conduct of such a team are as follows:
A wound ballistics research team should be available in every theater of combat operation. The personnel component should be flexible and determined by the nature of the particular mission. No T/D is recommended. Specific advantages are achieved by having the unit on TDY (temporary duty) to the theater. This permits the complete preservation of objectivity in the study, enthusiasm of a small group of interested and trained personnel to see a project quickly and well done, the knowledge of a deadline for completion, and the opportunity to leave the war zone and review the findings in clear perspective.
A letter of introduction and a careful definition of the mission should precede and accompany the team. Considerable tact is essential in preserving proper channels. Future teams are often judged initially on the basis of impressions left by their predecessors.
A wound ballistics research team on TDY to a combat theater should be attached immediately upon arrival to a local unit with a senior commanding officer. Supply and
housing are thus easily managed. A letter of authority should precede and accompany the team for the issuance of supplies.
Data regarding regional incidence of wounds and missile frequency should be quickly disseminated to the theater surgeon for his use in staff presentation.
Findings of Survey Unit
The findings4 of the first battlefield wound ballistics team of the Korean War will now be summarized, and tables giving the detailed information will then follow. The body regions and their projected percent of the whole were determined according to the method of Burns and Zuckerman5 using, however, two additional views of the prone position. Body regions by this method gave the following mean projected areas (fig. 338) and percentages:
Wound ballistic data on 4,600 WIA casualties6 indicated the following:
1. Most wounds in WIA casualties in Korea for the period from 15 November 1950 to 5 May 1951 were caused by fragments (approximately 92 percent) rather than by small arms (approximately 7.5 percent).
2. The shell fragments were primarily mortar and grenade, since the enemy had used little heavy artillery.
3. Most wounds were of a penetrating (72.7 percent) rather than a perforating (20.3 percent) type.
4. The 4,600 WIA casualties received 7,773 wounds. Therefore, the wound incidence was 1.69 wounds per casualty.
The regional distribution of wounds in personnel wounded in action by body region is shown in table 252.
Analysis of the missile type and regional distribution of wounds in these 4,600 casualties is presented in table 253.
The wounding agents and the number of wounds in each area of a body region are presented in tables 254 through 259.
The type and frequency of the 7,773 wounds analyzed in the 4,600 cases is shown in table 260 with each area of a body region tabulated in tables 261 through 266.
6The medical records of a total of 4,600 cases with 7,773 wounds were reviewed at the Tokyo Army Hospital from 1 Dec. 1950 to 15 Feb. 1951. The data for this section were obtained from those records.
1Specific region not specified.
1Specific site not specified.
Single Versus Multiple Wounding
Another analysis was made for the single and multiple wounding for the WIA cases studied. The following possibilities were considered: (1) A single wound in one area, (2) a single wound in one area and a single wound in another, (3) a single wound in one area with multiple wounds in another, (4) multiple wounds in one area, (5) multiple wounds in the area under study (called the local area) and a single wound in another area, and (6) multiple wounds in the local area and multiple wounds elsewhere. Table 267 summarizes the incidence of single versus multiple woundings in 4,600 casualties with 7,467 wounds known to be either single (2,621) or multiple (4,846). Of the total 7,773 wounds, the type of wounding (single or multiple) was unknown for 306 wounds.
Although each casualty averaged a 1.69 wound incidence, 35 percent showed only a single wound in one area and 44 percent showed a single wound in one area with only a single wound in another area. These findings are significant in that such a large percentage of wounded in action (79 percent) shows only one or two wounds. Since approximately 89 percent of the total wounds were caused by shell fragments, usually mortar or grenade, the chance factor of being struck is emphasized even though the missile density is quite great. It would appear that a bursting mortar shell or grenade if near enough to produce one wound would have an excellent chance to produce many wounds with its fragmentation-spray pattern. A few instances of this were seen, but as shown in the tables most of the fragments actually miss. How many strike another individual is not known. Tables 268 through 273 list the single versus multiple wounding according to the various body regions.
Incidence of Fractures
Among the 4,600 casualties, there was a total of 1,762 fractures (table 274). The incidence of fractures of the known body areas was 44.4 percent for the lower extremities, 34.8 percent for the upper extremities, 13.5 percent for the head, 4.5 percent for the thorax, and 0.9 percent for the vertebral column. Approximately one out of four casualties had a fracture and almost one out of two was evacuated to the Zone of Interior.
Excluding 51 fractures (16 vertebral and 35 site unknown), it was found that slightly more than 90 percent of the fractures were compound comminuted.
Of the 4,600 WIA casualties, 34 (0.7 percent) died of wounds. Of the remaining 4,566 casualties, 2,893 (62.9 percent) were evacuated to the Zone of Interior and 1,673 (36.4 percent) were returned to duty (table 275).
Peripheral Nerve Injuries
A study of peripheral nerve wounds was also made, at the Tokyo Army Hospital, on 200 cases sustaining this type of injury, and the data were analyzed for causative agent (table 276). In order to obtain these 200 peripheral nerve cases, it was necessary to examine the records of 1,872 cases.
Concurrently, a survey was made on vascular wounds, records of which were available on 100 cases (tables 277, 278, and 279). In order to obtain this sample, it was necessary to examine the records of 2,609 battle casualties.
1In these cases, there was clinical evidence of vascular and/or nerve damage but its exact location had not been defined.
The regional and area frequency of the vascular damage in the 100 cases was as follows:
A study of self-inflicted wounds, both accidental and deliberate, revealed that, in the 2,605 wounded cases studied, 116 (4.4 percent) were self-inflicted (table 280).
Survey of Turkish Brigade
The opportunity presented itself to make a casualty survey on wounded personnel all from one unit who were injured during a known period of combat. Members of the Turkish Brigade were interviewed at the Tokyo Army Hospital. This Brigade had been in action for 3 nights and 3 days (from the night of 27 November 1950 to the day of 30 November 1950) in the vicinity of Kunuri, Korea. A total of 407 injured were evacuated to Japan of which 387 were considered to have been hit by enemy missiles (the remainder were disease cases or nonbattle casualties). Of the 387 wounded in action, 286 were individually interrogated. This represented 74 percent of all the WIA casualties evacuated to Japan. The number of WIA casualties who remained in Korea was not known, but the number was believed to be small, and it was thought all were promptly returned to duty.
Interrogations, aided by Turkish officers who were available as interpreters, lasted from 5 to 15 minutes per casualty. What error, if any, was introduced by this procedure is unknown. Answers were usually prompt and direct. Most of the Turkish soldiers appeared very certain of the type of the weapons producing the missiles with which they were hit, sometimes stating the enemy was so close that the weapons were visible, or otherwise being able to give good reasons for distinguishing between mortar and grenade hits. The interrogation was accompanied by examination of the casualty.
The 286 WIA casualties incurred a total of 950 wounds (fig. 339), as listed in table 281.
The missiles responsible for these wounds are listed in table 282.
An attempt was made to determine the mean estimated length of trajectories for the causative agents from the site of origin to the man hit. No attempt was made to discard any data (such as mortar shell fragment hits alleged to have occurred at a 200-400 meter range). The reported mean ranges were given to establish orders of magnitude, as follows:
1Not considered a small arms hit nor a fragment hit.
When the estimated ranges were broken down for missiles causing perforating and penetrating wounds, the results were generally in line with the expectation that missiles producing perforating wounds would come from shorter ranges (that is, have higher velocities):
It will be noted, in the tabulation just listed, that the mortar fragments are reversed from the normal expectation. Had the alleged occurrence of perforating mortar fragment wounds at ranges of over 100 meters been discarded as an error in judgment of range, the mean values would have become 4.3 meters for the perforating missiles and 8.1 meters for the penetrating ones. This relationship is in the proper order.
Degree of damage from various wounding agents was assessed on a 1 to 4 scale (table 283).
1Degree 1.-Size of wound of entrance in any one dimension
not more than three times the size of missile, provided the missile was not
greater than 1 cm. in any dimension.
It was also possible to analyze the incidence of casualties occurring during the day and during the night. A total of 216 casualties were available but, because 30 sustained hits from more than one type of missile, it was necessary to list these more than once. Therefore, the data total 250 casualties and are prescribed in table 284.
Finally, it was possible to estimate the number of enemy casualties resulting from the efforts of 108 Turkish soldiers (table 285). Not shown in the table are the numbers of enemy casualties which the Turks claim to have produced after they (the Turks) had been wounded.
Autopsy Study of DOW Casualties
The reports of autopsy findings on 125 WIA casualties who were hospitalized and died later were made available for study by the 406th Medical General Laboratory. An analysis of the missile type involved in these cases and the immediate cause of death are shown in tables 286 and 287. The head, the thorax, and the abdomen were the principal regions involved, with
14.4 percent of the cases showing involvement of the extremities alone. Small arms fire accounted for 56.6 percent of the casualties, and this approximates the incidence seen in KIA casualties. Cases with head wounds showed an average survival time of 12.6 days; thoracic wounds, 4.5 days; abdominal wounds, 14 days; extremity wounds, 7.6 days; and wounds of the spine, 19 days.
Source: Autopsy reports from 406th Medical General Laboratory, Tokyo, Japan.
Study of KIA Casualties
A survey of the records of 1,500 personnel killed in action was conducted at the Quartermaster Graves Registration unit, Pusan, Korea, during January 1951. Of the KIA casualties sustained by the United Nations forces during this period, 63 percent were due to enemy small arms fire, 26.9 percent to shell fragments, 2.8 percent to mortar, 2 percent to mines, 0.7 percent to grenades, 0.5 percent to artillery, and 4.1 percent to miscellaneous agents. This was in marked contrast to the results obtained from an analysis of the WIA cases which showed that fragments of all types were responsible for about 92 percent of the wounds. Table 288 shows the regional frequency of fatal wounds in the 1,500 KIA casualties.
Source: Autopsy reports from the 406th Medical General Laboratory, Tokyo, Japan.
The data in the preceding tables represent the effects of enemy fire. A comparison with the effects of United Nations action against the enemy was made possible through the study of prisoner-of-war casualties made during January 1951 at the 3d and 14th Field Hospitals at Tongnae. Data from 1,000 prisoners were gathered through interrogations of the prisoners via an interpreter. An additional 2,000 medical records of prisoners admitted to these hospitals were analyzed for wound frequency studies, as follows:
The mode of wounding of the 1,000 prisoners of war interrogated revealed the following:
General Observations and Conclusions of Survey Team
From observations and interrogations, this first wound ballistics survey team was able to conclude that the maximum ranges at which wounding occurs are comparatively short. Thus, this team's report states: "Most wounds caused by shell fragments occur within 8 meters of the shell burst. Most wounds caused by small arms occur within 100 meters to 200 meters, rarely beyond 500 meters."
Perhaps the most important of all the conclusions reached by this team concerned the feasibility of body armor. Team members had been impressed by the large number of penetrating wounds in which the missile remained in
the body. They also noted the protective effects of ordinary items of clothing, finding, for example, small arms bullets retained in the foot even when the shot was at very close range, as in self-inflicted wounds. Here the combat shoe seemed to make a considerable reduction in velocity. On the basis of large numbers of this kind of supporting observation, the team was able to conclude:
Whereas most wounds are caused by shell fragments and are of a penetrating rather than a perforating nature, it is believed that some type of body armor is feasible. Requirements for this protective clothing are fundamentally that it be light, flexible, comfortable, be able to screen out missiles with velocities of 1200 ft/sec. or more, and will not handicap combat effectiveness. It is further believed that although the casualty rate per se may not be appreciably reduced, there will be a valuable reduction in the number of wounds and in their severity. This solves a considerable problem in evacuation, treatment time consumed, and total hospital days. If the chest and abdomen are protected, it may well change many KIA's to WIA's. The problem is not alone that of overall reduction in casualty rate. The psychological effect upon soldiers knowing that they have some protection for vital areas appears obvious, although needing evaluation by field trial.
Although the hospital mortality rate has fallen below 2% and is approaching an irreducible minimum, the killed in action rate and missing in action rate continue quite high. Utilizing publicly released figures, about 14% of the total casualty rate is KIA and approximately a similar percentage exists for missing in action. This means that every fourth casualty is killed or missing. Actually if the 2% hospital mortality rate were added to the KIA and MIA rates, 30% of the total casualties would be KIA, MIA, and wounded died later. It is, therefore, apparent that any further appreciable reduction in casualty rate lies in 1) use of body armor, 2) faster evacuation of casualties from the battlefield. The hazard now of battlefield recovery has not halted the courageous company aid man, but he also becomes a casualty occasionally and replacement in a moment is difficult. The time when he is needed most probably offers the greatest chance for his being wounded. It is believed that body armor for him would aid materially in the performance of his duty.
Recommendations made by the first wound ballistics survey team follow:
1. Attach a Medical Officer to all graves registration units for KIA Survey.
2. Institute exact area frequency for wounds study rather than regional designation; include type wound, severity, disposition.
3. Survey large numbers of WIA and KIA involving thorax and abdominal wounds charting exact area of wound, e.g., ventral, dorsal, flank, and quadrant.
4. Follow carefully 50 casualties involving each anatomic region by means of serial photographs at critical intervals with appropriate surgical notes. This should begin at the Mobile Army Surgical Hospital. The mode/time/distance of evacuation should be included.
5. Field trial of a combination doron and nylon armored vest for Medical personnel in combat units, particularly Medical Company Aid men. If found feasible recommend use for all field troops.
6. Specific orientation of Medical officers in a basic knowledge of wounds, classification, and weapon and missile identification. Medical officers stress the etiology of disease, and many years are spent learning about the varied causative agents. The etiologic agent of a war wound is a missile, and yet with rather rare exceptions members of the medical profession know little about weapons and missile identification. It is no longer adequate for a physician to receive his medical training directed only toward civilian practice, because all doctors now may anticipate military service or the responsibility for civilian populations under the fire of every conceivable weapon.
Since medical officers usually fill in the EMT, and subsequent field records, and since so frequently those doctors are relatively new to the service, a few items are worthy of emphasis and indoctrination:
a. Ask the casualty what hit him. He frequently knows. Specify whether or not he is a battle casualty, has a missile wound or injury, and the actual missile, e.g., small arms (rifle, carbine, Burp, Grease, machinegun), grenade, mortar, artillery, landmine, or shell fragment unknown, etc. Avoid the use of the term shrapnel. Never be content to list just "missile".
b. State whether it was enemy or friendly fire, air or ground.
c. Self-inflicted wounds may be accidental or intentional. If it is known, so state.
d. Describe the treatment given.
e. Record the mode, time, and distance of evacuation.
f. Record disposition and the patient's condition at that time.
Preparation for Field Trial of Body Armor
The first team returned to the United States and prepared its reports in May 1941. The recommendation to The Surgeon General, Department of the Army, for a field trial of an armored vest was readily accepted.
Laboratory tests already completed at that time made it apparent that it would not be possible to defeat most bullets with any reasonable weight of body armor material then available. Within practical ranges, the velocity of bullets is too high. However, it had been found that about 92 percent of the missiles producing WIA casualties were fragments. Of these fragments, 73 percent did not have enough velocity to cause perforating wounds or extensive tissue damage, suggesting that in this important class of wounding missiles the majority were in a lower velocity, lower energy range. It was assumed that a large number of these could be defeated by an armor which would stop fragments having velocities of 1,200 f.p.s. or lower. It was immediately apparent that steel could not be incorporated into any type of thoraco-abdominal protective clothing with any degree of success because of its lack of flexibility and excessive weight. Aluminum proved to have a relatively low ballistic limit. It was not flexible and would have proved difficult to tailor into a protective vest. Nylon cloth (12 layers of 2 x 2 basket weave) was found to have a ballistic limit of 1,275 f.p.s. against a 17-grain simulated fragment, and its great flexibility was thought to offer most feasibility for fabrication into a protective vest. Doron (multiple layers of fiber-glass cloth laminated by a methacrylate resin) also proved highly effective in defeating these simulated fragments. Doron surpassed nylon in performance when struck by the .45 caliber pistol ball but lacked the flexibility of nylon. Doron could, however, be molded to conform to the contours of the body.
The Naval Field Medical Research Laboratory at Camp Lejeune, N.C., had for some time been working on the development of a slipover type of vest, using doron armor. That installation had pioneered the use of curved doron
plates in body armor and had established the fact that the ballistic properties of doron were unaffected by the manufacturing process. Models of such a vest were in existence, and the Naval Field Medical Research Laboratory possessed necessary experimental tailoring facilities to make models of various designs. Accordingly, members of the first survey team met with personnel at Camp Lejeune, and it was agreed to incorporate into the vest certain modifications suggested by the Korean battle casualty survey experiences. The most significant contribution was the addition of 12 layers of nylon to the area covering the shoulder girdle. The modified vest (figs. 340 and 341) was described as follows:7
A slipover, semi-flexible thoraco-abdominal vest weighing 6.1 lb. made of 2 x 2 basket weave nylon covering the upper chest and shoulder girdle, and a lower portion made of 16 curved doron plates covering the lower chest and upper abdomen. Ballistic properties as follows: Capable of stopping a .45 caliber pistol or Thompson submachine gun bullet at the muzzle; all the fragments of the U.S.A. hand grenade at three feet; 75% of the fragments of the U.S.A. 81 mm. mortar at ten feet; and the full thrust of an American bayonet.
In June 1951, 50 such vests were fabricated at the Naval Field Medical Research Laboratory, partially aided by funds allocated by the Army Quartermaster Corps.
JOINT ARMY-NAVY BODY ARMOR FIELD TEST,
Upon invitation by Colonel Wood to Adm. Herbert L. Pugh, Chief of the Bureau of Medicine and Surgery, Department of the Navy, a joint Army-Navy medical mission was organized and dispatched to the Far East Command on 14 June 1951 for the purpose of field testing, under actual combat conditions in Korea, an item of equipment designed as body armor for protection of the chest, the shoulders, and the abdomen. Officer members of the team were (Army) Colonel Holmes, Captain Phillips, Lieutenant Coe, (Navy) Comdr. John S. Cowan, MC, and Lt. Comdr. Frederick J. Lewis, Jr., MSC.
Upon arrival in Tokyo, the unit was attached to the 406th Medical General Laboratory for logistical and administrative support. After drawing the necessary equipment and supplies, the team departed for Korea, arriving at Headquarters, 5th Regiment, 1st Marine Division, on 4 July 1951.
The specific mission at this time was to (1) determine and evaluate the reaction under combat conditions of Medical Department personnel, particularly company aidmen, to the proposal of wearing body armor, and (2) determine and evaluate the reaction under combat conditions of personnel of the
various services to the proposal of wearing body armor. During the course of the following 2 months, these 50 vests were worn by approximately 6,000 soldiers and marines. Tests were performed with the 5th Marine Regiment and the 23d and 38th Infantry Regiments of the 2d Division.
Conclusions of Body Armor Test Team
The conclusions reached by this team were as follows:
1. That body armor or protective clothing of some type for the vital anatomic areas is almost unanimously desired by all combat troops, particularly the combat veteran after several actual fire fights with the enemy.
2. That the body armor vest was received quite favorably by most Commanding Officers, who were eager for its trial, feeling that the psychological effect upon the troops would be of considerable morale value.
3. That the troops of all arms and services were completely cooperative and constructive in their trial of the body armor, appearing to sense the responsibility of their judgment upon an item of equipment designed to save their lives as well as others.
4. That thorough indoctrination of all troops should precede the wearing of any body armor. Such indoctrination should include familiarity with percentage relationships of the various wounding agents, the anatomic distribution of hits, and the most common lethal wounds. The protective ballistic properties of the body armor should be thoroughly demonstrated.
5. That the body armor vest, which weighed 6.1 lb., was not considered an excessive weight, and that such a weight per se did not hinder or handicap the wearer.
6. That the weight of the body armor was tolerated and carried easily because of its proper distribution and suspension from the entire shoulder girdle.
7. That such body armor (6.1 lb.) could be and was worn over mountainous terrain of extremely rugged nature in a hot, humid climate, with only a few adverse complaints of the weight factor from the men.
8. That such body armor, in the Korean summer, received its severest criticism as being excessively hot.
9. That a water-proof or water-resistant covering fabric should be used to prevent gain in weight from perspiration or rain. Gain in weight due to such reasons was 1½ to 2 lb. for the armored vest tested.
10. That such armor should be utilized as organizational equipment rather than individual equipment, and as such should be transported via organizational vehicles to the closest possible point of enemy contact.
11. That tests of body armor are far more significant when done under combat conditions than when performed under training or simulated combat conditions.
ARMY BODY ARMOR TEST TEAM, FEBRUARY-JULY 1952
Upon returning to the United States in September 1951, the team recommended that approximately 1,400 vests incorporating those changes suggested by the field test in Korea be further tested in actual combat in order to determine the effectiveness of the vest in defeating missiles from enemy weapons. Accordingly, the Army developed a model (fig. 342) made of 12 plies of 2 x 2 basket weave nylon weighing 13 ounces per square yard. The layers of nylon were triangularly spot bonded together. The Marine Corps realized that expediency was of paramount importance and developed a design based upon
doron-nylon combination and proceeded to its standardization by 16 November 1951. The Army all-nylon vest was covered with a vinyl-coated nylon poncho material, olive drab in color, with a one-quarter inch layer of sponge rubber beneath the covering over the ribs and the shoulder girdle. The sponge rubber provided an offset of the vest away from the body since it was felt that contusions or fractures might result from impact of nonpenetrating missiles upon the vest. The vest was provided with two rectangular gusset-type pockets closed by a triangular flap and a snap fastener. The frontal closure was effected by means of three dot-type fasteners. Loops or straps of nylon were provided, two front and two back, for supporting cartridge and pistol belts. The vest was fabricated in two sizes as follows:
1. Size 42; area of protection, 6.7 square feet; weight, 7 pounds and 12 ounces.
2. Size 46; area of protection, 7.4 square feet; weight, 8 pounds and 4 ounces.
On 18 February 1952, an Army body armor team departed for Korea with the following objectives:
1. To determine the relative effectiveness of the various body armor prototypes against various types of enemy fire, delivered under a variety of environmental and tactical situations.
2. To determine the dimensions of soldier acceptance and use of body armor.
3. To determine the most satisfactory methodology to orient soldiers in the use of body armor.
4. To determine the relative reduction in wound incidence, extent, and severity in soldiers wearing body armor.
At this time, the team consisted of officers representing the Medical Corps, the Army Field Forces, the Ordnance Corps, and the Quartermaster Corps.
During the course of the test in Korea, the team numbered 24 officers and 33 enlisted men. Initially, the team was directed by Lt. Col. Andrew A. Aines, QMC; later, Lt. Col. William W. Cox, MC, assumed the role of team commander.8
Special equipment which was not available in the theater in the Zone of Interior and accompanied the test team to Korea. These items
8Additional officer personnel
serving with the Body Armor Test Team were as follows:
included photographic equipment, weather recording equipment, tape recorders, instruments for ballistics studies, and other miscellaneous expendables. All other classes of supplies and equipment were obtained from theater stocks. These were requisitioned by, and assembled at, team headquarters in Seoul. From this point, they were issued to subteams operating in forward areas (fig. 343). Each subteam was self-sufficient for supply, administration, and operation. Except for rations and petroleum products, no supply burden was imposed on units participating in the tests. Because of the magnitude of the test, the team was not attached to the theater medical general laboratory but operated as an independent unit assigned to Headquarters, Eighth U.S. Army, Korea.
Conduct of Test, 1 March Through 15 July 1952
During the course of the test, the Army nylon vest was worn by over 15,000 soldiers for an aggregate of approximately 400,000 man-hours. The Eighth U.S. Army organizations which participated in the test are shown in table 290. In addition, other United Nations troops using vests on a limited distribution were (1) Philippine forces attached to I Corps, 3d Division, 7th Regiment; (2) ROK (Republic of Korea) troops of the 1st ROK Division, attached to I Corps, 11th Regiment; (3) Ethiopian forces attached to IX Corps, 2d Division, 23d Regiment; (4) Colombian forces attached to IX Corps, 7th Division, 31st Regiment; and (5) French Forces attached to IX Corps, 2d
Division, 23d Regiment. Other personnel using vests on special studies were pilots serving I Corps; pilots of helicopter detachments serving the 8063d, 8076th, and 8209th Mobile Army Surgical Hospitals; and the 3d Air-Sea Rescue Squadron.
In this period, there were 2,099 battle casualties and 322 soldiers killed in action in the divisions in which body armor was used. It must be emphasized that the total body armor available to division personnel was exceedingly small, averaging about 350 vests per division during the period of the test. A total of 1,400 vests were available during the test period and these were received by the team from the Zone of Interior as follows (48 vests accompanied the initial team members):
Wound Ballistic Studies on WIA Casualties
A total of 1,591 wound ballistic studies, in many instances including pictures and X-rays, were made on soldiers from all of the American divisions on the frontline. These studies included battle casualties, accidental wounds, and self-inflicted wounds. Table 291 lists the regional distribution of wounds in 908 WIA casualties not wearing body armor.
In the group of WIA casualties who were not wearing body armor, there were 278 wounds in the region of the body (chest and upper part of the back) that would have been covered by the vests. An estimate of the effect of the vest, had it been worn, is that it would have probably prevented the wound in 204 (73.4 percent) cases; might possibly have prevented the wound in 17 (6.1 percent); been of questionable value in 27 (9.7 percent); and would have had no effect in 30 (10.8 percent).
A total of 552 soldiers were wounded in action while wearing body armor (table 292).
A breakdown of 1,460 battle casualties who were studied during the test period by causative agents and by type of wounding (that is, multiple or single) is shown in tables 293 and 294, respectively. Typical fragments and missiles removed from the casualties are shown in figure 344.
A further breakdown of the fragments that caused these wounds is as follows:
The character of the wounding agent in the 1,460 WIA casualties indicates that the type of fire to which the vest and nonvest wearers were exposed was in general the same and thus can not account for the observed difference in the wound distribution.
Studies on KIA Casualties
During the period of the test, 547 post mortem examinations were made on soldiers from American divisions along the frontline who had been killed in action. The wounding agent was determined in 415 cases of the 547 post mortem examinations that were made (table 295). The regional frequency of the wounds and their relationship to the cause of death is shown in table 296.
A study was made of the chest wounds in this group of 547 KIA casualties,
and an estimate (using the previously described criteria) of the possible beneficial effect of the vest was determined, as follows: For the total 226 chest wounds, the vest would have prevented a lethal wound in 61 (31.9 percent) of the primary chest wounds and 24 (24.2 percent) of the associate wounds; would probably have reduced the severity of the wound in 47 (24.6 percent) of the primary wounds and 24 (24.2 percent) of the associate wounds; and in 58 (30.4 percent) of the primary and 12 (12.2 percent) of the associate wounds would have been of questionable value.
These studies indicate that 30 to 40 percent of the fatal chest wounds incurred by soldiers in combat would have been prevented by the use of body armor. From another point of view, this seems to indicate that 10 to 20 percent of the soldiers who were killed in action would have survived if they had worn body armor. The effectiveness of the vest in preventing chest wounds in the KIA casualties was not so marked as in the WIA casualties. One explanation of this disparity lies in the higher incidence of small arms wounds in the KIA (approximately 25 percent) as compared to the WIA casualties (approximately 15 percent).
Study of Vests Used in Test
During the test, 254 vests were recovered which were hit (fig. 345) while worn by soldiers in combat. A study revealed that of the group of soldiers
wearing the vests, 52 (20.5 percent) were returned to duty, 128 (50.4 percent) were evacuated because of wounds, 55 (21.6 percent) were killed in action, and in 19 (7.5 percent) the disposition of the soldier was unknown. Of the 128 soldiers who were evacuated, 35 (27.3 percent) sustained wounds through the vest.
Of the 55 who were killed in action, 24 (43.6 percent) were killed by wounds through the vests, and 31 (56.4 percent) were killed by wounds in areas that were not covered by the vest. The wound-missile ratio on these groups is shown in table 297. In evaluating these figures it should be borne in mind that approximately 85 percent of wounds were due to fragments which accounts for the apparent ineffectiveness of the vest against fragmentation.
1Percent for dichotomy small arms versus shell fragments.
Among the 254 vests which sustained hits and were available for study, complete information regarding the type of wound and the disposition of the
casualty was collected in 235 cases. These latter cases were studied and broken down in the following categories:
In categories 1, 2, and 3 are classified those missile hits which were completely defeated by the body armor. Wounds with a reduction in expected severity are seen in category 4. In category 5, the wounds are severe but would have been even more severe or fatal if body armor had not been worn. In category 6 are placed those wounds in which there has been little, if any, change in wound severity due to the wearing of body armor.
The penetrations as compared to the perforations of the vests, resulting from all missile hits, are shown in table 298.
1Missiles were defeated by vest, and no wound was
From the tabulation presented for the 235 casualties, the figures indicate that wounds of the anterior and posterior aspects of the chest and of the upper quadrant of the abdomen were prevented (fig. 346) in 154 (65.6 percent) of the casualties. There were 81 (34.4 percent) casualties who sustained wounds through the region covered by the vest (fig. 347), and within this group there
FIGURE 346.-Protection provided by the Army all-nylon vest, T52-1. A. Four soldiers of Company K, 15th Infantry Regiment, 3d U.S. Infantry Division, who were protected from shell fragments which struck but did not perforate the armor. B. and C. Closeups of two of the vests shown in A.
FIGURE 347.-Lt. Rodney M. Brigg, Body Armor Team (right), points to skin bruise on back of Lt. Frank H. Bassett, Company G, 160th Infantry Regiment, 40th Infantry Division. The vest defeated two hand grenade fragments.
was definite evidence that the severity of the wound had been reduced in 22 (27.2 percent) of the cases, that it was difficult to state whether the vest had an effect on the severity of the wound in 20 (24.7 percent) cases, and that there was no evidence that the vest reduced the severity of the wound in 39 (48.1 percent) cases. In these 39 cases, 24 (61.5 percent) casualties were killed by the missiles which perforated the vest.
Conclusions of Body Armor Team
The body armor team reported9 its conclusions under the conditions of the test as follows:
a. The Armor, Vest, Nylon T-52-1, is much more effective against fragment type missiles than small arms missiles. During the test period 67.9% of all type missiles hitting the armor were defeated. 75.7% of all fragments were defeated and 24.4% of all small arm missiles were defeated.
b. This prototype was acceptable to the majority of soldiers who wore it in combat. The extent of acceptability was, in addition to many other factors, influenced by the unique
character of the Korean campaign. A desire for body armor was evident early in the test period, and this prototype was the most suitable armor of its nature available to satisfy this demand. Acceptance was invariable, often qualified with suggestions for improvements.
c. Of the methods used to orient troops in the use of Nylon Armor, the best results were obtained by orienting company sized groups in reserve areas. This may not be the most suitable method of orientation for the Army as a whole, as selection of methods was determined by conditions existing in Korea.
d. The Armor, Vest, Nylon T-52-1 worn by soldiers in combat during the test period, reduced the incidence of chest and upper abdominal wounds by 60 to 70%. It is estimated that 25 to 35% of the chest and upper abdominal wounds sustained by combat soldiers wearing the armor during this test period were reduced in severity.
The team also considered the psychological effects and stated:
a. Research of body armor would be incomplete without an understanding of the psychological structure of body armor use and requirements. Factors to be considered are legion, but some of the most important are motivation, the effect on confidence, the effect on aggressiveness, the effect on morale, and finally the acceptance by the soldier.
b. The use of body armor is motivated by one of the most powerful impulses in our psychological makeup, i.e., the desire to survive. In the heat of actual combat, soldiers have reported later, time and again, that they rarely notice the weight and bulkiness of the vests (fig. 348). In these tense periods it seems that the desire for protection outweighs the
FIGURE 348.-Effect of armor on evaporation of perspiration. Subjects wore armor for 30 minutes at temperature of 90° F. When soldiers were under enemy fire, they did not complain of the excessive perspiration
physiological deficit resulting from the added burden. On the other hand, interviews with soldiers returning from patrols which had no fire fights or skirmishes with the enemy, indicate that the men are less disposed to wearing body armor and are more critical of its weight and limitation of mobility.
c. The action in Korea is unique in our military history in that the lack of specific battle goals and the prolonged truce talks resulted in a feeling of caution in all combat echelons. Commanders, under these conditions, are not quite so ready to sacrifice personnel on the battlefield, This lack of an overpowering motivation may have an important bearing on the seemingly widespread acceptance and desire for body armor on the part of the troops and their commanders. This unique situation suggests, too, the possibility that the need for body armor by our soldiers in Korea is accentuated if they are to fight with their usual verve and aggressiveness.
d. The effect of body armor on confidence is probably best expressed in the results of the post-use interviews where over 85 percent of the men stated that they felt safer and more confident when wearing body armor, This feeling of increased safety and assurance is undoubtedly of paramount importance in explaining the widespread acceptability of body armor in combat.
e. Interviews with commanders, who have led troops wearing body armor in combat, have repeatedly emphasized that aggressiveness is increased and that there is more of a desire and willingness to engage the enemy at close quarters. Since one of the great deterrents to aggressiveness in combat is fear of being wounded or killed, it would seem that the feeling of increased safety and confidence, in part at least, accounts for the increased aggressiveness noted by the troop commanders.
f. A poll of over 100 front line physicians and surgeons has resulted in the almost unanimous expression of opinion that the use of body armor would result in an increase in morale among combat troops. The measurement of morale is difficult and varies with many factors which cannot be controlled while another unknown factor is being tested. In spite of the rather poor motivation for combat during the period of test, the morale of the troops was generally good, and the test team members were unable to detect any changes in morale in the units that were using body armor. It is rational to conjecture, however, that the morale of our troops would be elevated as long as they possessed an item which would give them superiority over the enemy and thus diminish their chances of being wounded or killed. It would seem that if, and when, the enemy develops a similar vest or devises effective countermeasures to our vest, that the effect of the vest on morale would then be negligible.
g. Under certain conditions the effect of body armor on morale may not be good. For example, during the last month of the test period there were several instances where soldiers who had previously used body armor expressed a reluctance to their unit leaders to go out on patrols when body armor was not available. These instances were precipitated by the fact that there was not enough of the item to go around or that the vests had been moved to other sectors or units for more favorable testing. In any situation where the troops had previously used body armor and for some reason it became limited in supply or not available, it is conceivable that the effect on morale would be very unfavorable.
h. If the willingness or lack of willingness on the part of troop commanders and their troops to return body armor to the test team officers after use may be used as an index of acceptability, then there is no doubt that the test item is almost universally approved of. Many times, especially during the last period of the test and in areas where there was a lot of action, it was difficult for the test team officers to tactfully get the troop commanders and the troops to release their physical possession of the armor when it became necessary to shift the vest to other personnel. There seems to be no doubt that the desire for protection in the minds of the men is utmost, and outweighs the physiological handicaps imposed by the added weight and bulkiness.
i. This is well illustrated by an action of the 45th Division in securing a hill in advance of the MLR. The action which lasted for several weeks was extremely heavy and the casualties were high. Demand for the vest became so acute that the test team members
lost control of the vest study. Because of the limited quantity of vests available there were not enough to equip each soldier with one. Soldiers who were wearing the vests and who were wounded were frequently relieved on the battlefield of their armor by other soldiers who did not have vests. The vests that reached the forward aid station were usually taken away by the combat troops before the test team members had an opportunity to study them. In addition there were several instances where soldiers would he wearing vests in the usual manner and then in addition have other vests wrapped about the lower abdomen, groin, and thighs. Other instances were reported in which an additional vest was fitted in some fashion about the face and head.
j. Many factors have been discussed previously as to why the soldiers in Korea have accepted body armor so wholeheartedly. One final feature to be considered in regard to acceptance is the factor of initial contact with any new item (body armor). To what extent is this acceptance colored by a fad-like reaction because of the newness, the exclusiveness, the widespread publicity and the fashionability? Only time will tell. It is of interest to note, however, that prior to the arrival of the Body Armor Team in Korea, several thousand of the earlier M12 type body armor vests (figs. 349 and 350) were in supply rooms and were infrequently used. After the team had been in Korea for several months with its attendant publicity and information campaign, body armor of any type was at a premium (fig. 351) and was difficult to supply in sufficient quantities (fig. 352). Even the supply of M12's, which heretofore had not been in demand, was rapidly exhausted (fig. 353).
Recommendations of Body Armor Team
Recommendations based on findings submitted by the team were as follows:
a. That continuing study be conducted in the development of body armor materials to obtain the optimum in protection versus weight, with thought toward a material that will stop light, medium velocity sub-machine gun bullets, as well as fragments, and to improve the comfort and utility value.
b. That logistical problems in supplying the body armor to troops be studied.
c. That additional testing be conducted under controlled conditions for improving functional suitability and compatibility with other clothing and equipment.
d. That the use of body armor as an item of clothing be thoroughly explored.
FIGURE 351.-Three members of the R & I Platoon, 443d QM Group modeling types of armored vest. (Left to right) World War II flyer's armor; Army all-nylon vest, T52-3; and Marine Corps doron-nylon vest. 14 August 1953.
e. That the tactical significance of body armor and methods for employing it be studied.
f. That load studies and climatic factors in relation to body armor be completely evaluated.
g. That consideration be given to the role of body armor in atomic warfare.
h. That the protective qualities of body armor against radiation and blast injury be studied.
i. That the protective qualities of body armor against incendiary weapons, especially white phosphorus, napalm, and flame throwers be evaluated.
j. That consideration be given to modifying the present prototype * * *.
There followed a list of specific changes which in general were intended to increase flexibility, improve fit and make the vest in general more comfortable. Others aimed at increasing the area of protection particularly under the arm,
FIGURE 352.-Men of Company L, 38th Infantry, 2d Division, rebuilding their stronghold near Old Baldy, 21 September 1952. Armor vests of the following types can be identified: (left to right) World War II M12, Marine Corps doron-nylon type, and Army T52-1 type.
and making easier removal from casualties. Only a few of them will be listed and illustrated.
3. Change the method of closure. Recommend an easily operated zipper with a protecting fly, provided with an alternate closing method (fig. 354).
6. Replace the cover with a durable material which has more surface resistance to prevent slippage or carrying straps. The cover material should be non-reflecting (fig. 355), water resistant and of a color which blends with natural terrain features. It should not create sound when flexed or rubbed against other objects.
8. Replace the pockets with dash-type pockets * * *.
9. A means for carrying grenades be provided on the front of the vest * * *. A tape above the pockets into which the handle of the grenade could be inserted would satisfy this requirement.
10. Replace the present method of side fastening with one that is adjustable, elastic, and with a quick release mechanism which will permit easy removal from casualties.
11. Construct the vest so as to give maximum protection to the area under the arm (figs. 356 and 357).
12. Eliminate metal in the construction of the vest wherever possible to reduce secondary missile potential.
13. Eliminate the sponge rubber layer inside the nylon armor.
During the test period recommendations for modifications of the model T52-1 were solicited from the troops who had worn it in combat. These proposed changes were forwarded to the Research and Development Division of the Office of the Quartermaster General. Some of these tentative design modifications were incorporated into a new vest, model T52-2 (fig. 358). A total of 276 of the new models were received on 9 July 1952. Unfortunately, these were in use for only 6 days when the mission of the Body Armor Test Team was curtailed. A cursory survey revealed that the T52-2 was much more acceptable than its prototype.
Upon return of the body armor team in July 1952, three of its members, Colonel Cox, Major Irving, and Captain Daniels, with the assistance of Mr. William Persico, Clothing Development Branch, Philadelphia Quartermaster Depot, Pa., designed and fabricated a nylon body armor vest based upon the full, final recommendations of the team. This resulted in the armored vest,
T52-3 (fig. 359). Among other improvements, it included a new covering material, a two-piece sliding back, lace-type expandable side closure, combination metal zipper and snap front closure, and a more flexible type of spot welding of the layers of nylon cloth. This was the prototype which finally became the Army standard item of issue in the fall of 1952. The first shipment of the standard Army nylon vest left the Philadelphia Quartermaster Depot on or about 3 December 1952.
MEDICAL STUDY OF KIA CASUALTIES
At the same time that the body armor team was operating in Korea, concurrent studies at the Graves Registration Service Group, Kokura, Japan, on the killed in action casualties were being accomplished. These wound ballistics studies entailed a careful examination of each remains as to:
a. Exact anatomical location of all wounds (this to be demonstrated by both pictures and charts).
b. Type missiles causing wounds, i.e., shell fragments or small arms. (By the use of X-rays it was possible in most cases to determine the type missile, provided, of course, it remained within the body.)
c. Type wound or wounds, i.e., penetrating or perforating; penetrating meaning a wound having an entrance point but not an exit, perforating meaning a wound having both an entrance and an exit.
d. Tracing out the missile path and determining the cause of death.
e. Recovery of all wounding missiles when possible so that these may be photographed, weighed and identified.
f. Take sections of tissue for microscopic study.
FIGURE 358.-Armor, vest, nylon, T52-2. This vest is made of 12 layers of spot-laminated nylon cloth. The covering of this model is double; an inner water-resistant vinyl film layer and an outer layer of 6-ounce nylon fabric. The new slash-type breast pockets and adjustable side straps also distinguish the revised model. Vest open, showing the zipper that has been introduced in this model and the fly which covers the same and is held in place by four snap fasteners. The same type of snap fasteners is used on the pockets. (Front view)
FIGURE 359.-Armor, vest, nylon, T52-3. Note new covering material, redesigned pockets, grenade and shoulder straps and side closure. (The trousers are not protective armor.) A. Front view. B. Front view showing closure. C. Side view. D. Rear view.
The initial survey of KIA casualties10 was begun in March 1952 by Lieutenant Coe, who was joined in April 1952 by Major Enos. During the month of March 1952, the number of remains that were suitable for autopsying were relatively few. The majority of the bodies which arrived at Kokura were badly decomposed and offered little for a wound ballistic study. During the winter months, the method of using ships for transporting the bodies had been adequate, but with the coming of warmer weather this method was wholly unsatisfactory. On 6 April 1952, an air evacuation plan11 was placed in effect. Specifically, this meant that the remains arrived in Kokura in approximately 24 to 36 hours after death on the frontlines in Korea. During part of this time, the bodies were kept in reefers (refrigerators) so that their condition upon arrival at Kokura was excellent.
KIA Casualty Survey, 20 March-1 July 1952
In the period from 20 March to 23 April 1952, 268 current deaths were processed through the American Graves Registration Service Group at Kokura. Of these cases, 173 with 618 wounds were examined for the area and regional frequency of wounds and also for the type of wounds. Because of the lack of time and the shortage of personnel, it was impossible to examine every case. Therefore, it was decided to examine in detail only cases in which death could be unquestionably attributed to enemy action and which presented reasonable promise of furnishing a rather complete picture. Autopsies were performed on 81 cases. Missiles were often hard to recover, but when found they were photographed, identified, and weighed. Most of the casualties during this period were incurred by personnel not wearing an armored vest when the lethal injury was sustained because the number of all types of armored vests available was small. Because of the small number of cases available, no attempt was made to draw conclusions.
During the remaining 15 months of the war, numerous wound ballistics teams from the Zone of Interior conducted surveys at the Graves Registration Service Group, Kokura, and made surveys of WIA casualties at the Tokyo Army Hospital. The work at Kokura was continued by Major Enos who, during the period from 24 April 1952 to 1 July 1952, examined 346 cases with a total of 1,346 wounds. Autopsies or wound track dissections were performed on all cases, and the information was forwarded to the Biophysics Division of the Chemical Corps Medical Laboratories for analysis. This revealed the regional distribution of wounds presented in table 299.
The 346 cases showed 209 (60.4 percent) with single wounds and 132 cases (39.6 percent) having multiple wounds, or a ratio of 1.5 singly wounded to multiply wounded. Regional breakdown showed this ratio was 4.4 for the head and neck (140 cases), 1.7 for the thorax (137 cases), 1.2 for the abdomen (20 cases), and 1.5 and 1.4 for the upper (10 cases) and lower (39 cases) extremities, respectively. Fragmentation-type missiles accounted for about 66 percent of the wounds (table 300) and about 71 percent of the wounds were penetrating (table 301). Table 302 shows the regional distribution of 128 lethal wounds in 103 of the KIA casualties which were examined during this period. The partial selection of the casualty sample is apparent in the high number of lethal wounds of the thorax and in the low number of lethal wounds of the head.
Comparison of Army and Marine Corps Casualties
In the period between July to November 1952, another survey team (Colonel Holmes, Capt. James C. Beyer, MC, and Capt. Joseph V. Michalski, MSC) worked at Kokura. Approximately 3,000 current death cases were reviewed and information was obtained on wound distribution in 1,500 KIA casualties. This was a period of great flux in regard to body armor. The Marine Corps had standardized a combination doron-nylon vest. This consisted of 13 layers of nylon cloth over the upper part of the thorax and the shoulder girdle area and 20 overlapping doron plates over the remainder of the thorax and the upper part of the abdomen. This vest (M1951) (fig. 360) was standardized by 16 November 1951, and by 14 July 1952 approximately 9,772
1Wounds of entrance but no exit;
vests were on hand in the 1st Marine Division in Korea. Therefore, all Marine Corps frontline personnel were probably equipped with body armor before this latter date. During this time, the Army was still conducting its field testing of all-nylon body armor. In order to provide their frontline troops
with protection, 13,020 Marine vests (M1951) were requested on 11 August 1952 by the Army. The requests continued through March 1953 and by 19 September 1952 approximately 19,705 vests were supplied to the Army. This number was increased (approximately 63,000) until the Army vest was standardized and in production. The first shipment of this latter vest (T52-3) was released in the early part of December 1952 (see fig. 359). From December 1952 through September 1953, approximately 26,161 vests of this type were
shipped from continental United States. Before the availability of the Marine-type body armor, Army units were supplied with a limited number of M12 vests developed during World War II.
A comparison of Marine Corps KIA casualties from 1 July to 1 November 1952 and Army KIA casualties from 15 June to 1 September 1952 revealed the regional distribution of wounds shown in table 303. The Marine Corps personnel can be considered to be wearing body armor and the Army personnel were generally unarmored. There is a reduction of 9.6 percent in the total wounds of the thorax in the Marine Corps casualties and a 1.1 percent reduction in wounds of the abdomen as compared to the Army casualties.
1Surveyed from 15 June to 1
The Marine Corps casualties included 355 cases with a total of 2,308 wounds for a 6.5 wound incidence per casualty. Among the wounds, 80.9 percent were penetrating in type, 14.9 percent were perforating, and 4.2 percent were amputations. According to the causative agent, 85.4 percent were produced by fragmentation-type weapons, 12.8 percent by small arms, and 1.8 percent were unknown.
The Army casualties included 354 cases with a total of 3,526 wounds for a 9.9 wound incidence per casualty. According to wound type, 87.9 percent were penetrating; 9.1 percent, perforating; and 3.0 percent, amputations. Fragments were responsible for 86.2 percent of the wounds, small arms for 11.7 percent, and 2.1 percent were unidentified.
Table 304 lists the regional distribution of lethal wounds in the two casualty samples. The armored Marine Corps casualties show a 12.1 percent reduction in lethal wounds of the thorax and a 1.1 percent reduction in lethal wounds of the abdomen as compared to the Army personnel.
1Surveyed from 15 June to 1 September 1952.
Tables 305 and 306 summarize the types and numbers of body armor vests available to the Eighth U.S. Army, 31 December 1952-29 February 1953.
1Data derived from Staff Report, Quartermaster Section,
Headquarters, Eighth U.S. Army, November and December 1952.
1Data derived from Staff Report,
Quartermaster Section, Headquarters, Eighth U.S. Army, February 1953.
After body armor had become widely used, information was desired on the effect of the body armor vests on the regional frequency of lethal wounds. A survey of killed in action was accomplished at Kokura during the period of November 1952 to March 1953 by Lieutenant Coe and 1st Lt. Richard B. Stoughton.12 During the period of this survey, there were approximately 60,000 vests in use by U.S. Army divisions on the frontlines in Korea. Therefore, only those cases wearing body armor at the time they received the lethal wound or wounds were used in this survey. It was necessary for members of the team to travel to every unit on the frontlines of Korea and talk with personnel in the casualty's squad, platoon, or company to determine accurately if body armor had been worn at the time the lethal wound was inflicted. From approximately 600 cases investigated, 500 definitely were wearing armor at time of death. Only these cases were used. These data were then compared with previous surveys conducted between April and July 1952 during which time armor was not widely used. The general tactical situation had remained appreciably the same over the whole period of these surveys. Action consisted largely of aggressive patrolling with stable main lines of resistance. Enemy use of artillery had increased, but there were no massive withdrawals or offensives by friendly forces during the time between the compared surveys. Table 307 shows the comparison of lethal wounds in the two casualty samples.
1Survey 20 March to 1 July 1952;
154 KIA casualties with 206 lethal wounds.
There was an apparent reduction of approximately 36 percent13 in lethal thoracic wounds in the group wearing the armored vest. The nylon vest also covered part of the upper part of the abdomen, especially the liver and the kidneys. This may account for the 5.4 percent reduction in lethal abdominal wounds among those wearing the armored vest.
Among the 500 KIA casualties wearing body armor, there were 3,510 total wounds recorded. The types of wounds were distributed as follows: 3,068 wounds (87.4 percent) penetrating, 198 wounds (5.7 percent) perforating, 170 avulsions (4.8 percent), 50 lacerations (1.4 percent) (superficial but extensive wound), and 24 (0.7 percent) decapitations. With this same casualty sample, the causative agent for the wound was recovered in 437 instances. A fragment was identified in 293 (67.1 percent) of the cases and small arms in 110 (25.1 percent) of the cases. Table 308 lists the regional distribution of the 3,510 wounds in the 500 casualties. Multiple wounds were present in 364 (72.8 percent) of the cases and 136 (27.2 percent) had only a single wound.
The importance of multiple wounding in casualty production cannot be overemphasized. In the survey on casualties wearing body armor, there was an average of seven wounds per case. This figure is below the actual number since it was almost impossible to count every wound on some of the cases. Compared with this, for WIA casualties, the average is about two wounds. In any one region an additional wound, aside from the lethal wound, might conceivably increase the chances of death by additive or even synergistic effects. Also, it is quite possible that one missile entering a body cavity, such as the thorax, would not strike a vital area, but additional missiles entering the cavity
would increase the chances of the heart or great vessels being hit. Another possibility is that KIA casualties are slower to be evacuated than the wounded from the battlefield. They are thus exposed to enemy fire longer and might sustain additional hits after receiving a lethal wound. Whatever the reason or combinations of reasons, reduction of the number of wounds is extremely desirable.
Collection of Battle Casualty Data
In the early days of the Korean War, medical records of battlefield wounding were too inexact in their nomenclature to permit exhaustive wound ballistic studies. In 1951, an effort was made to correct this. Medical personnel were requested to record the exact type of wounding missile on the EMT (emergency medical tag). For example, instead of recording "shell fragment" or "shrapnel," they were asked to identify the missile as being artillery, mortar, hand grenades, landmine, and so forth. It was also found that the casualty was frequently able to identify the exact nature of the missile causing his wound. By making the effort to get this information on the spot, when events were fresh and the information most readily available, the data would then appear on all the patient's medical records and be readily accessible for compiling into wound ballistics data. The results of this effort were reflected in the more exact nature of the weapon frequency charts compiled later in the war. In the first casualty survey, approximately 85 percent of the total number of wounding missiles were listed by the ambiguous term "shell fragments." In the last survey conducted in the Korean War, only 39.6 percent of the wounds were identified as being due to "shell fragments."
In 1952, medical officers and battalion aid station personnel were asked to note on the record accompanying each KIA casualty whether he had been wearing an armored vest and helmet at time of wounding. This request met with considerable success in the latter stages of the war, but with constant
changes in personnel many cases came through without a notation concerning the wearing of a vest or a helmet.
Indoctrination of medical personnel on the importance of accurately recording wound ballistics data on the EMT could best be accomplished at the Medical Field Service School. A recommendation was made by all wound ballistic teams operating in Korea that the present EMT be modified by the adding of "body armor worn or not worn," "helmet worn or not worn," and "type missile causing wound." This would be of paramount importance in future wars for the successful operation of all wound ballistic teams. In addition, a simple but comprehensive method for locating wounds, for example, an anatomic chart with body regions demarcated, would be of great value. Figure 361 illustrates the demarcation of body regions14 which is advocated for use by battle casualty survey units. This was the regional demarcation used by the survey team at Kokura from July to November 1952 and also by Major Enos and Captain Beyer in the KIA survey from May to August 1953.
During the period from 9 January to 1 March 1953, a study on the battlefield performance of the M1 steel helmet was conducted in Korea by Lieutenant Coe.15 The study was made by collecting all available helmets hit on the battlefield by enemy fire. The helmets were then forwarded through Graves Registration channels to the Central Identification Unit, Kokura, with information on (1) the type of missile that hit the helmet (grenade, mortar, "burp" gun, and so forth), (2) a complete description of what happened to the individual wearing the helmet, (3) the type of wounds sustained, and (4) the exact location of the wounds. After proper coordination with the Medical and Quartermaster Sections, an order implementing this was published by the Adjutant General, Headquarters, Eighth U.S. Army, Korea, and sent to all division surgeons for their information and coordination with their battalion aid station personnel.
A total of 45 helmets were received during this period of time. It had been hoped that many more helmets would be recovered and forwarded with the information requested. Personal contact with battalion aid station surgeons at a later date revealed the numerous difficulties involved in recovering the helmets. Soldiers who had sustained hits on their helmets without receiving a wound did not want to give up their helmets and in many instances did not turn them in. There was also added danger in attempting recovery of damaged helmets from exposure to enemy fire during the time required for recovery.
The 45 helmets examined sustained a total of 71 hits. A breakdown on these is as follows:
Although 85 percent of the hits did go completely through both helmet and liner, not all of these resulted in death or even in a serious wound. In some instances, the steel shell and liner were perforated with the individual not sustaining a wound. The wounds sustained in these cases revealed the following:
15Coe, G. B.: Battlefield Performance of the M-1 Steel Helmet. CmlC Medical Laboratories Research Report No. 248, February 1954.
Thus, 16 of 45 cases were killed as a result of helmet defeat by the missile. In 13 of 45 cases the missile was defeated successfully, although some of these cases resulted in death from wounds elsewhere on the body. Many of the 16 nonlethal wounds sustained through the helmet were potentially lethal. (This was judged from the direction the missile was traveling.) Therefore, in assessing the effectiveness of helmet protection, these reductions in wound severity must be considered. From the tabulation just presented, it can be seen that in over half the cases studied, possible death resulting from head wounds was prevented by the helmet.
Analysis of the types of missiles involved in the 71 hits showed the following:
Not all soldiers wore their helmet, because of its weight, lack of stability, and so forth. Many men on patrols complained about the noise made by the helmet when it came in contact with bushes and twigs and felt also that the helmet interfered with their hearing. For these reasons, some men on patrol preferred not to wear their helmets. These objections to the helmet can be overcome by continuing indoctrination and by improving the helmet characteristics, especially its stability on the head.
Information was received on two cases in which soldiers had to seek cover hurriedly from incoming mortar fire. In both cases, the helmet came off when the soldier hit the ground. Both men were then killed by head wounds, from fragments of the next incoming round. It cannot be said that these men would have been saved had their helmets not come off; however, from the 45 cases studied, it can be seen that they would have had an increased chance of survival had their helmets stayed on.
LOWER TORSO ARMOR
In addition to the development of the all-nylon body armor vest, a lower torso armor was also fabricated (fig. 362). The new armor was designed to be worn with the Army's armored vest and, like the vest, was made of 12 layers of flexible, spot-laminated nylon duck inclosed within a water-resistant vinyl layer with an outer covering of 6 ounce nylon fabric. The lower torso armor provided for the hips, abdomen, and groin the same degree of protection the armored vest gave the upper torso, and there was some degree of overlapping between the two garments. The new lower torso armor resembled boxer's shorts and was supported by suspenders worn under the armored vest.
IMPROVISED ARMOR FOR SPECIAL PURPOSES
In addition to these experimental and standard items of issue, a considerable number of armored "suits" were devised by the personnel in Korea in an attempt to provide protection to individuals engaged in minefield clearance. Some of these models were produced from the ballistic materials in the World War II M12 vest and portions of the World War II flyer's armor (fig. 363). Others were developed from either the Army or Marine Corps upper torso armor in conjunction with overlapping plates of doron applied to the abdomen and upper and lower extremities (fig. 364).
It is difficult to summarize quantitatively the effects of body armor in the Korean War; however, certain tentative conclusions are permitted by the battlefield studies and by the impressions gained by the team members.
1. There was a decrease in the number of personnel killed in action.
2. There was a decrease in the number of personnel wounded in action.
3. There was a decrease in the severity of wounds in those areas protected by the vest.
4. There was a decrease in the convalescence time of many of the wounded in action.
5. There was a decrease in the workload of medical personnel.
6. There was an increase in the percentage of wounded in action who returned to frontline duty.
7. There was an increase in the confidence and fighting spirit of the majority of troops wearing body armor.
Many of the medical officers in Korea felt that the armored vest was one of the most effective forms of preventive medicine introduced in the Korean War. It may safely be concluded that use of body armor coupled with rapid helicopter evacuation of casualties to mobile army surgical hospitals improved medical and surgical care, and extensive use of whole blood was responsible for the saving of many lives in Korea.
The advantages gained through the wound ballistics studies and body armor test teams during the Korean War can only be perpetuated by an active and purposeful continuation of certain activities during peacetime and immediate, full reactivation of all units in the event of hostilities. A medical program for the study of wounds and wounding is presented in appendix I, page 851.