Contents

CHAPTER IV

Casualty Survey-New Georgia and Burma Campaigns

James E. T. Hopkins, M.D.

NEW GEORGIA CAMPAIGN

1ST BATTALION, 148TH INFANTRY, 37TH DIVISION

The material in this chapter is based on an attempt to survey and analyze the circumstances related to the production of battle casualties in three infantry battalions in combat, as follows:

The 1st Battalion, 148th Infantry, 37th Division, in the New Georgia campaign.

The 1st and 3d Battalions, 5307th Composite Unit (Provisional), in the Burma campaign.¹ 

Materials and Methods

The same method of collecting data was followed in the New Georgia and Burma campaigns. Information on the circumstances in which the casualties occurred was obtained by questioning the surviving casualties; their friends and the friends of those killed in action; platoon leaders; company commanders; and medical officers. It should be emphasized that both the surviving casualties and those questioned concerning them and concerning the casualties killed in action were usually known to the writer of this chapter: in this type of warfare, officers and men lived in close association with each other. The opinions expressed are the writer's own, and many of them are no more than presumptions, especially as they concern comments that are strictly military.

¹The author of this chapter, Dr. James E. T. Hopkins, a captain in the U. S. Army Medical Corps during World War II, served for 18 days of combat on New Georgia Island in 1943 as assistant battalion surgeon with the 1st Battalion, 148th Infantry, 37th Division. He also served as combat team surgeon and later as battalion surgeon for the 3d Battalion of the 5307th Composite Unit (Provisional) in Burma in 1944 ("Merrill's Marauders").
After only a few days of combat experience, Captain Hopkins was deeply impressed by the many casualties among U.S. troops which apparently resulted from carelessness. He was also impressed by the fact that a considerable number of casualties killed in action died from head and chest wounds in which the missiles entered from the front or from the side of the body. These observations led him to consider seriously the possibility of the use of body armor for the protection of vital areas of the body (p. 275).
During his time in combat, therefore, Captain Hopkins collected all possible data on combat casualties in order to demonstrate how combat losses could be reduced. The results of his studies were compiled with the help and encouragement of Col. (later Brig. Gen.) George R. Callender, MC, of the U.S. Army Medical Center and Chairman of the Missile Casualties (Wound Ballistics) Committee; Brig. Gen. Albert G. Love, of the Historical Division, Office of the Surgeon General; and Col. Michael E. DeBakey, MC, of the Surgical Consultants Division of the same office.-J. C. B.

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On the other hand, all of the opinions expressed are based on a genuine effort to secure the precise facts. The writer secured much information on the battlefield, where he often acted as an aidman, and from close association with company commanders during actual fighting and with others in a position to know the facts.

The following data were obtained whenever this was possible:

1. The name of the casualty, with his rank, serial number, and unit.

2. The type of action; the type of terrain with available cover, and the duty of the casualty.

3. The weather conditions and the time of day.

4. The anatomic location of the wound and the degree of severity.

5. The type of causative agent and the approximate range.

6. The treatment received.

7. The classification of the casualty as to type and eventual disposition.

8. The classification of the casualty as to the possible avoidability of his injury. That is, an attempt was made to determine whether the injury might have been avoided by a more appropriate order from his officer, or by a better planned action on his own part, or for any other reason.

From the standpoint of type of casualty and eventual disposition, the following classification was used:

1. KIA (killed in action).-Those found dead or who died up to 30 minutes after being found.

2. DOW (died of wounds).-Those wounded casualties who reached a medical installation and survived more than 30 minutes and those who received treatment from a medical officer before death.

3. WIA (wounded in action).-Casualties wounded in action in New Georgia and in Burma were classified into four categories:

a.-Those returned to duty from the battalion aid station. Because of the terrain in New Georgia and the tactical nature of fighting in the jungle, wounded men were often retained in, and sent back to duty from, the battalion aid station, who, under more favorable circumstances, would have been evacuated for treatment. This was also true in the Burma campaign.

b.-Those returned to duty from a medical facility, within 1 month of wounding.² In New Georgia, there were no field, portable, or evacuation hospitals and no surgical teams, and the chain of evacuation was from the battalion aid station, usually through a collecting company, to a station hospital, in which urgent surgery was performed.

In Burma, during the first half of the campaign, casualties were evacuated by Piper Cub to the 20th General Hospital for initial wound surgery, which they frequently did not receive for 24 hours. During the second half of the campaign, the 42d Portable Hospital was flown in and operated in close proximity to the battalion aid station. After emergency treatment, the majority of these men were evacuated to the 20th General Hospital. Smaller numbers were evacuated to the 14th Evacuation Hospital and the 111th Station Hospital.

²For convenience of discussion hereafter termed "first echelon hospital."

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c.-Those returned to duty from a medical facility within 4 months of wounding.³ On New Georgia, those men who did not require urgent surgery or who, for various reasons, were not operated on in a first echelon hospital, were evacuated by LST's to a station hospital in Guadalcanal, which they usually reached within 24 to 36 hours. Some casualties were also evacuated to the station hospital in New Caledonia. The nearest general hospital was in the Fiji Islands.

d.-Those evacuated to the United States, after spending more than 4 months in hospital.

Geography and Climate

The New Georgia group of islands, which lie approximately 250 miles northwest of Guadalcanal, are chiefly made up of coral except for Kolombangara and Rendova, which are of volcanic origin. These islands, which are not so rugged and mountainous as the islands of the Guadalcanal group, are covered with thick jungle made up of large trees; tall, leafy jungle plants; and tangled vines and roots. Although the jungle growth is thick, it offers little actual obstruction for even men or machines. In many instances, bulldozers were able to weave around the larger trees and advance as much as a mile a day through the growth.

The casualties included in this study all took place on New Georgia Island between 18 July and 5 August 1943, inclusive. Even though this is a coral island, many areas are extremely marshy, and in the section about the Munda airfield very little coral is visible. The majority of the foxholes were dug in the red clay which made up the topsoil covering the coral.

During the period of combat, the climate was very mild, with temperatures ranging from 70° to 90° F. The humidity was very high, but rainfall was minimal.

Military Operation and Forces Involved

Military operation.-The New Georgia campaign, a combined military operation, had as its main objective seizure of the Munda airfield and driving the Japanese from New Georgia and the surrounding islands. The operation was started on 30 June 1943 and completed by 22 September 1943, with the occupation by U.S. troops of all important islands in the New Georgia group.

Elements of the 172d and 169th Infantry Regiments of the 43d Division landed on New Georgia Island at Zanana Beach between 2 and 6 July to proceed to a line of departure on the Barike River. After considerable fighting, with heavy casualties, these two regiments drove west on the Munda trail and established a new beachhead at Liana, at which the 103d Infantry of the 43d Division was landed.

On 11 July 1943, these three regiments started an attack on the Japanese defensive position along the coastal strip. On 18 July, the 148th and 145th

³For convenience of discussion hereafter termed "second echelon hospital."

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Infantry Regiments of the 37th Division landed at the Zanana and Liana beachheads. These regiments, together with the 161st Infantry of the 25th Division, started a coordinated attack on 25 July which ended in the seizure of the Munda airfield on 5 August 1943.

Forces involved.-It is difficult to make an accurate estimate of the number of men engaged in the campaign on New Georgia because of the many types of military units involved and the various locations of the islands on which the fighting took place. For the first 17 days of the campaign, no more than 8,000 infantrymen fought on New Georgia. By 25 July, this force had increased to 15,000 men. The total strength of all U.S. forces involved in the New Georgia campaign was approximately 35,000. Table 26 lists the total U.S. casualties of the New Georgia campaign; 95 percent of these losses occurred during the first 5 weeks.

Southwest sector.-Between 18 July and 5 August 1943, the period covered by this survey of casualties in the 1st Battalion, the 148th Infantry operated in the southwest sector of New Georgia Island with this battalion, the 2d Battalion, and a regimental headquarters. The 3d Battalion operated separately with a force of Marines on the north side of the island.

TABLE 26.-Distribution of 4,994 casualties of the New Georgia campaign, 30 June-22 September 1943, by category and division

The 1st and 2d Battalions of this regiment arrived at Zanana Beach on 18 July. The 2d Battalion proceeded to relieve the 43d Division command post, which had been surrounded, and to open the supply route to the 169th and 172d Infantry Regiments of the 43d Division. The 1st Battalion, which arrived early in the morning, after a few minor contacts with the Japanese, succeeded in advancing within 1 mile of the Barike River along the Munda trail.

At 1100 hours on 19 July, when the battalion was advancing along this trail, it came under automatic weapons fire at the Barike River; several men were killed and several wounded. The river was not crossed until 20 July,

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when the battalion succeeded in advancing to a parachute drop where the 169th Infantry was relieved. A few casualties occurred during the day from enemy automatic weapons fire and from friendly artillery fire.

At 0600 hours on 25 July, the battalion attacked from a line of departure in front of O'Brien Hill on a 270° azimuth, which it was to follow until the end of the campaign for the Munda airfield.

Time 37th Division had been assigned a sector north of the north flank of the 43d Division and had beers given the primary mission of securing the high ground commanding the Munda airfield. From right to left toward the beach front, U.S. forces were disposed as follows:

1st and 2d Battalions, 148th Infantry Regiment.
The 161st Infantry Regiment.
2 battalions of the 145th Infantry Regiment.
The 176th Infantry Regiment.
The 103d Infantry Regiment.

This general alinement of regiments was to be maintained until the fall of the Munda airfield on 5 August 1943.

By the afternoon of 27 July, the two battalions of the 148th Infantry had advanced slightly beyond and to the right of O'Brien Hill and had begun to set up a supply dump in this area. There was considerable patrol activity during this time. On the following day, after losing five men in an ambush, the 1st and 2d Battalions advanced 1,000 yards on the 270° azimuth to a point overlooking Biblo Hill. Very little opposition was offered by the enemy.

One company was left to protect the supply dump, but on 29 July it was surrounded by a superior Japanese force and all communications were severed. Following this action, the two battalions were forced to withdraw. The 2d Battalion, minus Companies G and E, withdrew to the 37th Division area by traveling single file through the jungle.

The 1st Battalion, together with Companies G and E of the 2d Battalion, fought the Japanese along the trail and about the supply dump until the morning of 1 August, when they routed the enemy forces and again established contact with the 161st Infantry, which had been advancing westward on their left flank.

The action just described resulted in a large proportion of the casualties sustained by the 148th Infantry during this campaign. For 4 days, the 1st Battalion had no means of evacuating its wounded.

On 1 August, the regiment again began its advance to the right of the 161st Infantry. During the next 4 days, it continued in a coordinated attack with the other regiment until it finally reached the beach approximately 1,000 yards north of the Munda airfield.

During this operation, the majority of U.S. casualties resulted from automatic weapons fire, though a considerable number were due to friendly artillery and mortar fire. There was no enemy aerial activity during the later stages of this campaign.

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Casualties of 1st Battalion, 148th Infantry

U.S. troops in the southwest sector of New Georgia Island never exceeded 18,000 infantrymen. It was estimated that there were never more than 6,000 Japanese troops involved in the fighting in this sector, which was the heaviest in the campaign.

Table 27 lists the casualties incurred by the 1st Battalion, 148th Infantry, during the 18 days of this survey. Approximately 2,000 enemy dead were counted during the period between 3 July and 5 August. During the 18 days the 1st Battalion was in combat, it was estimated that they killed between 300 and 400 Japanese with small arms and mortar fire and that artillery fire directed by officers of the rifle companies accounted for an additional 100 to 200 Japanese dead.

TABLE 27.-Distribution of 181 casualties, 1st Battalion, 148th Infantry, 18 July-5 August 1943, by category

Hospitalization and evacuation.-When the 1st Battalion, 148th Infantry, 37th Division, arrived at Zanana Beach, New Georgia Island, on 18 July 1943, one collecting company (Company B, 118th Medical Battalion) was serving the elements of the 43d Division about the Munda area. For the first 5 days of the campaign, only this company served the 1st Battalion. On 22 July, the 112th Clearing Company moved to Liana Beach about 1 mile behind the 1st Battalion sector, but its collecting companies did not reach the battalion aid station until 3 August, the 17th day of combat. In the meantime, some medical care was provided by a collecting company from the 25th Division.

While no attempt will be made to discuss routes of evacuation and types of medical care for units involved in the campaign other than the 1st Battalion, 148th Regiment, it might be added that according to a report from the Office of the Surgeon, South Pacific Area, entitled "Medical Service, New Georgia Campaign," the medical and surgical care provided during the greater part of the New Georgia campaign was deficient in many respects and medical facilities

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from battalion aid levels through the hospital echelon were also often inadequate.

Most of the 1st Battalion casualties were evacuated on regimental supply trucks or ambulance jeeps (fig. 144). During the first 5 days of combat, they were taken from Zanana Beach to Guadalcanal by LST's, a distance of 200 miles which required from 20 to 24 hours' travel time. As a rule, no treatment other than first aid was provided before the trip. En route, medical care for the 100 to 200 casualties usually carried on each ship was provided by one Navy medical officer.

FIGURE 144.-Medical aidmen carrying wounded man to ambulance jeep.

After the fifth day of combat, casualties were evacuated through the 112th Clearing Company, and in many instances surgery was provided at this level (fig. 145). Because of the 24-hour evacuation policy, however, many casualties who had been treated inadequately took the long trip to Guadalcanal.

It was not until 28 July that the 17th Field Hospital was set up on Kokorana Island, 5 miles from the Liana beachhead. With the facilities thus provided, the wounded from the 1st Battalion had the benefit of hospitalization about 3 miles distant by land routes and about 5 miles by water evacuation (fig. 146).

During the 5-day period between 28 July and 1 August, all supply lines were cut, as already mentioned, and casualties from the 1st Battalion and from Companies G and E of the 2d Battalion could not be evacuated from the

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FIGURE 145.-Members of 37th Division Clearing Company completing a surgical procedure, New Georgia Island.

FIGURE 146.-Wounded soldiers lying in vessel, awaiting transportation to the 17th Field Hospital.

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battalion area; a large number of them therefore received no surgical treatment for several days.

Details of the 181 casualties sustained on New Georgia Island, as they were related to the various tactical situations, appear in appendix A (p. 769).

BURMA CAMPAIGN

1ST AND 3D BATTALIONS, 5307TH COMPOSITE UNIT (PROVISIONAL)

Geography and Climate

Northern Burma is separated from India and China by the high mountain ranges which make up the foothills of the Himalayas, some of which reach an altitude of 20,000 feet. As in all of northern Burma, the jungle is very heavy but is usually not impenetrable. The terrain is the main factor that makes it difficult to pass through the jungle growth.

The unit reached Burma after a march up the Ledo Road (fig. 147) and through the Pangsau Pass of the Kumon Range at 2,400 feet. They then passed into the Hukawng Valley, a very narrow valley bordered by very hilly, rugged, mountainous terrain. Much of the operation took place on the razorback ridges of the hills on the eastern border of the valley.

FIGURE 147.-View of the Ledo Road.

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Practically all of the unit's operations in this area, as well as in the Mogaung and Myitkyina Valleys, were confined to the century-old native and game trails that are seen throughout all of northern Burma. The Hukawng Valley is extremely flat and is covered in some areas with dense jungle growth and in others with elephant grass. The average altitude is approximately 500 feet. Numerous Kachin villages, with a few native inhabitants, were repeatedly encountered throughout this area. The Mogaung Valley was approached through difficult terrain over the Ywangabum Mountains, along the course of the Tanai Hka River.

After its operations in this area, the unit retraced its route for perhaps 50 miles and passed over the 6,500-foot Jaupadu Bum Mountains that separate the Mogaung Valley from the Myitkyina Valley. This terrain was perhaps the most rugged encountered during the North Burma campaign; in some places, 1-mile stretches of the overgrown trails had a rise of 3,000 feet.

During February and March 1944, the days were very hot, and the temperature averaged about 80° F. The nights, however, were cool, and additional clothing was required. There was a minimum amount of rainfall during the entire campaign.

April was very warm during the day, and there was practically no rainfall. May was hot and humid, with almost daily showers. This was the beginning of the monsoon season, which continued until the end of October, but it did not materially affect operations as the majority of the troops had left the area by the end of June.

Organization of 5307th Composite Unit (Provisional)

In September 1943, 650 men and officers, all volunteers, congregated in New Caledonia to form a special infantry battalion. They had been selected from the 37th, 43d, 25th, and Americal Divisions. Later, 250 additional men and officers arrived, from the 32d and 41st Divisions and from the 98th Pack Artillery, from Australia. Most of these men had been overseas for more than a year and had seen action in the South Pacific or Southwest Pacific Areas.

These men made up the 3d Battalion of what was to become the 5307th Composite Unit (Provisional). They traveled to India on a transport with a battalion from the United States, which was to become the 1st Battalion of this Unit, and a battalion from the Caribbean area which was to become the 2d Battalion.

These three battalions, organized as an infantry regiment, trained in India from November 1943 to January 1944. During this time, there were many transfers of men within the battalions, and about 150 replacements arrived from casual units. The 31st Quartermaster Pack Troop was also absorbed by the regiment. On 1 January 1944, the three battalions were formally activated as the 5307th Composite Unit (Provisional).

After ship and train travel,  the entire regiment arrived at Ledo, Assam,

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during the first week of February 1944. Its primary missions was to spearhead the Chinese movement into North Burma.

After a march of 125 miles up the Ledo Road, the regiment left the Chinese in the vicinity of Nyenbien, on the Chindwin, in the third week of January and set out on a campaign which was to carry them on foot between 700 and 1,000 miles over the mountainous and jungle terrain of northern Burma. They were to aid the Chinese in the occupation of the Hukawng, Mogaung, and Myitkyina Valleys. Their mission was climaxed by the capture of the Myitkyina airfield on 17 May 1944.

Early in June 1944, most of the 1st Battalion were evacuated to various hospitals. The few who were not were reinforced with 300 to 400 men who had been released from hospitals in late May and early June. The reorganized battalion fought in the attack on Myitkyina during the latter part of June, during July, and during the first 2 weeks of August. The casualties sustained after 8 June are not included in this survey.

Military Operation and Forces Involved

During the second week of February 1944, the three infantry battalions which made up "Merrill's Marauders" entered northern Burma. After making a wide flanking movement to the left of the Hukawng Valley, they arrived in the vicinity of Walawbum during the first week of March. The numerous skirmishes and several engagements which took place resulted in complete success for the U.S. troops, and the operation enabled the Chinese to occupy the entire Hukawng Valley. Shortly after their arrival near Walawbum during the first week of March, the regiment was relieved by Chinese troops. 

During the next 3 weeks, the 1st Battalion, reinforced by a regiment of Chinese, marched across the Aipawn Bum Mountains to engage the Japanese at Shaduzup in the northern sector of the Mogaung Valley. This operation, which was also very successful, enabled the Chinese divisions to enter the upper part of the Mogaung Valley, after passing down the Japanese-built road through the Jamba Bum Pass.

Meantime, the 2d and 3d Battalions of the regiments crossed the Wangabum Mountains to the east, where they engaged the Japanese at Inkangatawng, about 50 miles distant and 20 miles above Kamaing. The success of this operation enabled the Chinese troops to advance rapidly down the Mogaung Road toward Kamaing, but because these troops failed to fulfill their assigned mission, the 2d and 3d Battalions were forced to withdraw to the mountains in the vicinity of Nhpum Ga, where one battalion was surrounded. The other, with the aid of air-dropped pack artillery (fig. 148), engaged the Japanese for 9 days in a major battle to relieve the encircled troops.

After the Japanese had been routed, in the third week of April, the three battalions of the unit assembled at the base of the Jaupadu Bum Mountains for the Myitkyina campaign. For this campaign, two forces were organized: (1) The 3d Battalion with the 88th Infantry Regiment (Chinese) and (2) the

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FIGURE 148-U.S. troops and Kachin natives watching a parachute supply drop.

1st Battalion with the 150th Infantry Regiment (Chinese). The 2d Battalion was held in regimental reserve.

While these troops were passing through the Myitkyina Valley, two major battles developed, both of which eventually ended in complete success for the U.S. forces. The Myitkyina airfield was captured by the 1st Battalion and the attached Chinese regiment on 17 May 1944. Shortly afterward, some 4,000 engineer and infantry troops were flown in.

For the greater part of the original 5307th Composite Unit (Provisional), the campaign in the Myitkyina area lasted another 3 weeks. The town itself did not fall for 2½ months; then it was taken by Chinese forces with the remnants of less than a battalion of the original unit.

Forces involved.-It is estimated (table 28) that a total of 8,700 U.S. troops were involved in the Myitkyina campaign. Official, reliable figures are not available for the size of the enemy forces or casualties, nor are reliable figures available for Chinese casualties.

Casualties, 15 February-8 June 1944

Table 28, in addition to listing the numbers of U.S. troops involved, and the estimated numbers of Japanese and Chinese troops involved, in the North Burma campaign during the study period from 15 February to June 1944, also lists the casualties of the three forces. Certain of the 2d Battalion engagements are not included in this table; their casualties would total about 40 KIA and about 200 WIA. Also excluded from the table are the several hundred casualties, KIA and WIA, sustained by the two infantry and two

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TABLE 28.-Estimated number of troops involved and casualties sustained, Burma campaign, 15 February-8 June 1944

¹Undetermined.

engineer battalions flown into Myitkyina after the airfield was captured by U.S. troops.

While it was seldom possible to examine or count enemy dead, it is believed that about 3,000 Japanese were killed in North Burma. During the same period, including the 40 casualties KIA from the 2d Battalion, almost 100 U.S. troops were killed.

Evacuation and hospitalization.-The three battalions of the 5307th Composite Unit (Provisional) operated along separate trails for the greater part of the campaign in Burma. Evacuation of the wounded was frequently not possible for periods of a week or more, but the majority were evacuated between a few hours to 10 days after wounding. During most of the major engagements, landing strips were built on the rice paddies of the native villages, and the wounded were evacuated by aircraft. A few casualties were put in the care of Kachins (fig. 149), who evacuated them by litter or by elephant transport.

After the capture of the Myitkyina airfield (fig. 150), casualties were evacuated by C-46's and C-47's to hospitals in the Ledo area; namely, the 20th General Hospital, the 14th Evacuation Hospital, and the 111th Station Hospital. During the first 3 months of the campaign, the patients were deposited in various collecting and clearing companies along the Ledo Road, behind the advancing Chinese troops. In many instances, they did not reach the 20th General Hospital until several days after they had been wounded.

For the first 3 weeks of March, during the Shaduzup campaign, the 1st Battalion had the services of a surgical team supplied by the Seagrave Unit.

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FIGURE 149.-Kachins from a friendly native village leading men of the 5307th Composite Unit (Provisional) through the jungle.

FIGURE 150.-Wounded soldiers awaiting evacuation, Myitkyina airfield.

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After they had been treated, these casualties were picked up by a platoon from a collecting company of the 13th Medical Battalion.

During the first 3 weeks of May, the 1st and 3d Battalions had the support of the 42d Surgical Portable Hospital and the Seagrave Portable Hospital. As a result, the majority of their casualties received surgery within a few minutes (fig. 151) to a few hours after wounding.

FIGURE 151.-Operating room of surgical team in field hospital.

During the march up the Ledo Road, about 70 litter patients (fig. 152) were carried for as much as 10 miles to an airstrip 40 miles north of Myitkyina.

Aside from the variable, and sometimes inadequate, facilities for their evacuation, the men of the 5307th Composite Unit (Provisional) received excellent surgical care.

Casualties sustained.-Table 29 lists the casualties of the 1st and 3d Battalions, 5307th Composite Unit (Provisional), during the Burma campaign for the period 15 February to 8 June 1944, inclusive. Detailed reports of these casualties in relation to the various tactical situations appear in appendix B for the 1st Battalion (cases 1-61, p. 783) and in appendix C for the 3d Battalion (cases 1-151, p. 789). Table 30 is a compilation of tables 27 and 29, comparing the casualties of the survey periods in the New Georgia and Burma campaigns.

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FIGURE 152-Litter bearers carrying wounded Chinese soldier to an ambulance pickup point.

TABLE 29.-Distribution of 212 casualties, 1st and 3d Battalions, Burma campaign, February-June 1944, by category

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TABLE 30.-Distribution of 393 casualties, 1st Battalion, New Georgia Island, and 1st and 3d Battalions, 5307th Composite Unit (Provisional), Burma, by category and survey period

ANALYSIS OF CASUALTIES

Basic Data

The units involved in the survey described in the preceding pages included: 

The 1st Battalion, 148th Infantry, 37th Division, on New Georgia Island, 18 July-5 August 1943, inclusive.

The 1st and 3d Battalions, 5307th Composite Unit (Provisional), in Burma, 15 February-8 June 1944, inclusive.

In the preceding pages, in which each of these units was considered separately, the background for the New Georgia and the Burma campaigns was described, including the geography; the climate; the general order of battle, including the troops involved; and the evacuation and hospitalization setup. In the appendixes for each of these campaigns, there are provided further details of the tactical situation as related to the number and location of the wounds sustained and the disposition of the WIA casualties. The military situation has been clarified by the arrangement of all actions into tactical situations, and each individual injury (injuries) has been described in such a way that it is possible to demonstrate what part each casualty played in the particular tactical situation. Injuries that seemed preventable are frankly indicated.

For ease of reference, the combined figures for the two campaigns are brought together here. They consist of:

369 casualties, exclusive of 23 casualties carded for record only (CRO) and 1 KIA casualty not sustained in combat. These 24 casualties are not considered further in most of the discussion.

101 fatal wounds, made up of 65 KIA casualties and 36 DOW casualties.

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268 survivors, whose wounds were distributed as follows:

42 head
31 chest
14 abdomen
143 extremities, broken down into:
    62 wounds of upper extremities
    81 wounds of lower extremities
38 multiple wounds.

Table 31 lists the total casualties sustained during the survey period, with their general disposition among the various categories. The analysis reveals the following facts:

1. The ratio of the total 393 casualties to the 102 total dead (KIA and DOW) was 3.9:1.

2. The ratio of the 291 survivors (WIA excluding DOW) to the 102 total dead (KIA and DOW) was 2.9:1.

TABLE 31.-Distribution of 393 casualties, 1st Battalion, 148th Infantry, 37th Division, New Georgia Island, 18 July-4 August 1943, and 1st and 3d Battalions, 5307th Composite Unit (Provisional), Burma campaign, February-June 1944, by category

3. If the 23 casualties carded for record only are excluded from the analysis, the ratio of total wounded to true KIA was 4.7:1. This is the more commonly used ratio. In this survey, it is undoubtedly related to the close proximity of the medical installations to the frontlines and to the fact that

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a considerable number of casualties listed as DOW might well have been tabulated as KIA under other circumstances.

4. Among the total 393 casualties, 249 (63.3 percent) were returned to duty. If the 23 CRO casualties are excluded, 226 (57.5 percent) were returned to duty.

Table 32 lists the anatomic distribution (regional frequency) of wounds in the 369 battle casualties and table 33 the distribution among the 101 dead. The following comments seem warranted:

1. Wounds of the head and of the thorax accounted for the same proportion of deaths among the KIA and the DOW. Among the 32 casualties with head injuries were 23 KIA's and 5 DOW's with brain injuries and 2 KIA's and 2 DOW's with injuries to the face and neck.

2. The fact that more thoracic wounds were observed in this survey than in the Bougainville study (p. 318) is related to the greater proportion of patrol and offensive action in this study. All casualties who died from thoracic wounds had perforating injuries.

3. Although no KIA's are found among the abdominal injuries listed as such, some casualties tabulated under multiple injuries had abdominal wounds. Of the 25 casualties with abdominal wounds, 13 had visceral lesions, but only one was operated on. Three of the casualties listed in the multiple injuries group had laparotomies, but none survived. During the survey period, most casualties with abdominal wounds were not killed instantly but died of shock and hemorrhage before they could be operated on. Early, adequate surgery would have decreased considerably the number of DOW's in the New Georgia-Burma campaigns.

TABLE 32.-Distribution of wounds in 369 battle casualties, by anatomic location (regional frequency)¹

¹Twenty-three cases with very minor wounds and one nonbattle casualty excluded from total number of casualties.
²Percent for dichotomy, dead versus living, by each anatomic location and for total dead versus living.

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TABLE 33.-Distribution of wounds in 101 dead, by anatomic location

¹Percent for dichotomy, killed in action versus died of wounds, by each anatomic location and for total killed in action versus died of wounds.

Table 34 lists the regional frequency of wounds among the 268 casualties who survived their wounds. It is apparent in this survey, as it has been apparent in others, that wounds of the extremities predominate among the WIA and that this group sustained fewer wounds in the anatomic regions in which vital organs are located.

Table 34 also indicates the results of surgical skill in the management of wounds of the extremities. The lack of definitive care in these campaigns is shown by the fact that few casualties with serious abdominal wounds lived to be evacuated to the United States. A high proportion of those who survived to be evacuated had only flesh wounds in this critical area.

TABLE 34.-Distribution of wounds in 268 living wounded, by anatomic location

¹Percent for dichotomy, duty versus evacuated to United States, by each anatomic location and for total duty versus evacuated to United States.

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Distribution of Wounds in Relation to Projected Body Area

Missiles from a given weapon usually move in one direction toward a casualty. If the projected area of the body is completely exposed, it therefore offers a better measure for the study of probable hits than the area of the total unprotected body surface. The mean projected body area is obtained from projection in the standing, kneeling, and sitting positions.⁴

Table 35 presents a comparison of mean projected body areas with body areas hit. The wound distribution for the thorax exceeds the mean projected body area by 4.5 percent, while wounds of the head exceed it by 7.9 percent.

TABLE 35.-Mean projected body area and wound distribution (dead and living, including multiple wounded) and type of weapon

Distribution of Wounds in Relation to Disposition of Casualties

Table 36 presents a breakdown of the anatomic distribution of wounds in relation to the general disposition of wounded casualties who survived. Casualties with wounds of the extremities show a very low mortality rate, a high percentage of returns to duty, and a relatively high incidence of evacuation to the United States.

Table 37 presents the incidence of fractures of the extremities (62 upper, 81 lower) among surviving casualties. Of the 143 with wounds of the extremities, 31 (44.0 percent) had associated fractures. There were 15 fractures (24.2 percent) among the 62 wounds of the upper extremity and 16 (19.8 percent) among the 81 wounds of the lower extremities. Among the 42 casualties evacuated to the United States, 18 were returned because of fractures.

⁴Burns, B. D., and Zuckerman, S.: The Wounding Power of Small Bomb and Shell Fragments. R. C. No. 350 of the Research and Experiments Department of the Ministry of Home Security.

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TABLE 36.-Distribution of 369 battle casualties, by anatomic location of wounds (regional frequency) and by disposition

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TABLE 37.-Disposition of 62 casualties with wounds of upper extremities and 81 casualties with wounds of lower extremities

¹Percent for dichotomy, fractures versus nonfractures, under each disposition category and for total fractures versus nonfractures by upper and lower extremity wounds.

CAUSATIVE AGENTS

The number of battle casualties produced by various weapons depends upon many factors, such as the type of warfare (defensive, offensive, patrol); the number of weapons; the ammunition available; the training of personnel on both sides; tactics; terrain; and weather. This study presents the various types of casualties produced because the enemy used their weapons to advantage at a particular time. It does not show the maximum effectiveness of any weapon, information which could be obtained only from a controlled experiment. The study does show, however, certain facts about the weapons employed and about the way they were employed which can reasonably be expected to be approximated in future campaigns.

The effectiveness of a particular weapon can be determined by studying the percentage of deaths among the total number of casualties caused by it. This percentage, which is termed the weapon's "relative lethal effect," is shown in table 38.

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TABLE 38.-Distribution of 369 battle casualties, by relative lethal effect of causative agent

¹Percent for dichotomy, dead versus living, by each causative agent and for total dead versus living.

In the Bougainville survey (ch. V), mortars caused the greatest number of casualties (38.7 percent) and had a relative lethal effect of 11.8 percent. The rifle ranked second, with 24.8 percent casualties and 32.2 percent relative lethal effect. In the New Georgia-Burma study, the machinegun leads with 32.3 percent casualties and a relative lethal effect of 44.5 percent. The higher effectiveness of this weapon would appear to be characteristic of jungle warfare.

Relation to Anatomic Distribution of Wounds

Table 39 presents a breakdown of the relative lethal effect of weapons as related to anatomic distribution of the wounds which they caused. The following comments seem warranted:

1. A comparison of wounds of the head and of the thorax indicates a considerable increase in the relative lethal effect in wounds of the thorax caused by both small arms and fragment-type wounds of the thorax. The figures might be interpreted as reflecting the protection provided by both the skull and the helmet.

2. Fragmentation-type weapons carried a very high relative lethal effect in abdominal wounds, obviously because of the ease with which the abdomen is penetrated and the subsequent high mortality rate. The machinegun also carried a very high lethal effect in abdominal wounds, but there were no deaths in this group as a result of rifle wounds.

3. The relative lethal effect for all weapons was very low for wounds of the extremities.

4. Of the 61 casualties with multiple wounds, 32 (52.5 percent) were wounded by fragmentation weapons. Among the 26 surviving casualties who were wounded by shell fragments, 59 percent returned to duty from the first echelon and 31.7 percent from the second echelon.

Since relatively few deaths result from wounds of the extremities, the effectiveness of weapons in relation to them must be judged by the disposition

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of the casualty. Since fractures were one of the chief reasons for evacuation to the United States, the relative effectiveness of weapons on the extremities can also be judged by the number of fractures they cause. Table 40 contains these data. As might be expected, small arms were generally more effective than fragments in producing fractures.

TABLE 39.-Relative lethal effect of weapons, by anatomic location of wounds and for multiple wounds

¹Percent for dichotomy, dead versus living, by each causative agent and for total dead versus living by anatomic location of wounds and for multiple wounds.

As table 41 shows, small arms were responsible for 77 (76.3 percent) of the 101 casualties KIA and DOW. The proportion for the same group in the Bougainville campaign was 58.2 percent.

Neither the New Georgia-Burma nor the Bougainville records contain any information concerning the effect of U.S. weapons on enemy dead. It is

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TABLE 40.-Relative effect of weapons causing wounds of upper and lower extremities, among the living wounded

¹Percent for dichotomy, fracture versus nonfracture, by each causative agent and for total fracture versus nonfracture, by upper and lower extremity wounds.

TABLE 41.-Distribution of 101 fatal casualties, by relative effect of causative agent

¹Percent for dichotomy, killed in action versus died of wounds, by causative agent and for total killed in action versus died of wounds.

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characteristic of U.S. troops to use all firepower available, which means that there was a high incidence of wounds per enemy casualty. This consideration, together with other factors, made it impossible to gather reliable information on this phase of the survey.

Relative Lethal Effect of U.S. Weapons on U.S. Casualties

Table 42 lists 66 U.S. casualties caused by U.S. weapons fired by U.S. soldiers, chiefly because of mistaken identity; leaving foxholes at night; and accidental discharges and shorts from artillery and mortar fire.

Table 43 presents the disposition of these casualties.

Relative Lethal Effect of Weapons on Disposition of Casualties

A weapon can be evaluated by the disposition of the casualties it causes in addition to the number of wounds it produces in each body area. The criterion of disposition furnishes an excellent means of predicting what percentage of casualties injured by various weapons will be killed instantly or die later, what percentage of returns to duty will occur within certain time periods, and what proportion of casualties wounded in various body areas will survive.

Table 44 lists the disposition of casualties in relation to the various types of weapons which caused their wounds. Those who returned to duty usually returned within 30 days or less from first echelon hospitals and within 120 days or less from second echelon hospitals.

As this table shows, a very high proportion (60.5 percent) of all machinegun casualties were considered as "lost to the service." This group includes the total KIA (53) plus the number evacuated to the United States (19). A considerable number of those evacuated could, of course, continue in service after a period of hospitalization.

TABLE 42.- Relative lethal effect of U.S. weapons on 66 U.S. casualties

¹Percent for dichotomy, dead versus living, by each weapon and for total dead versus living.

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TABLE 43.-Disposition of 66 U.S. casualties produced by U.S. weapons, by category

The rifle was second to the machinegun in the production of casualties, but only 31.9 percent of the casualties it caused (24 KIA plus 6 evacuated to the United States) were lost to the service. Fragmentation-type weapons closely approximated the rifle in effectiveness.

The grenade continued to have the lowest relative lethal effect and the highest return to duty rate in the casualties it caused.

To demonstrate further the relative effectiveness of various weapons, tables 45 and 46 were prepared from the figures listed in table 44. These tables show:

1. Very few casualties with small arms wounds returned to duty from the first echelon (7.6 percent machinegun and 14.9 percent rifle).

2. The majority of small arms casualties were either KIA or were evacuated to the rear echelon or to the United States (84.0 percent machinegun and 67 percent rifle).

3. The rest of casualties wounded by small arms were returned to duty from the battalion aid station.

4. Approximately 21 percent of the casualties with wounds caused by mortars and 24 percent of those with wounds caused by artillery fire returned to duty from first echelon hospitals.

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TABLE 44.-Relative effect of weapons on disposition of casualties

¹Percent for trichotomy, dead versus duty versus evacuated to United States, by each causative agent and for total dead versus duty versus evacuated to United States.

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TABLE 45.-Relative effect of weapons: Casualties returned to duty from first echelon

TABLE 46.-Relative effect of weapons: Casualties lost to combat duty (dead or evacuated to the rear echelon or to the United States)¹

¹This includes men who were lost to immediate combat. It also includes men who could perhaps have offered resistance to the enemy for hours or days in spite of their wounds.

Casualties "Lost to Combat"

A final method of determining the effectiveness of weapons is presented in table 47, the basis of which is the casualties lost to combat because they were killed in action or because they were so incapacitated that they would be unable to fight under any circumstances.

The Bougainville report utilized a number of traumatic conditions by which to evaluate the seriousness of wounds. The same criteria were used in the analysis of the New Georgia-Burma casualties to determine those who were classified as "Lost to Combat":

1. Wounds of the head and central nervous system that produced unconsciousness and paralysis.

2. Wounds of intrathoracic structures that produced hemorrhage and shock.

3. Wounds of intraperitoneal structures that produced hemorrhage and shock.

4. Wounds of the extremities that produced fractures of the long bones, severance of major vessels, or major traumatic amputations.

5. Extensive soft-tissue wounds that produced shock.

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TABLE 47.-Relative effect of weapons: Casualties lost immediately to combat¹

¹This includes men who could not have fought during any period before evacuation or death, their injuries putting them immediately out of action.

CIRCUMSTANCES OF WOUNDING

In addition to determining the relative effectiveness of various weapons, the survey unit was interested in evaluating the circumstances in which casualties were produced. Information collected concerning the position of the casualty when he was hit, the available protection, the type of action, and the distance from the wounding agent was classified under the following headings:

1. The cover group:

    a. Best protection (in a pillbox, usually constructed of heavy logs).
    b. Moderate protection (in a foxhole or trench with no overhead cover).
    c. Least protection (a tree, shallow hole, or log; or in the open with no protection at all).

2. The position of the casualty:

    a. Standing (includes walking and running).
    b. Sitting (includes crouching or kneeling).
    c. Prone.

3. The type of action:

    a. Patrol (small groups moving through jungle often determine the presence of the enemy by running into fire).
    b. Defensive (troops usually dug in with fixed positions).
    c. Offensive (applied to attack which develops after the enemy has been located by patrol activity).

Influence of Cover

Table 48 presents the influence of cover on the production of casualties by the various wounding agents.

In the Bougainville report, 20.1 percent of 1,557 casualties were wounded in well-covered pillboxes or well-dug holes (p. 418). This report shows that the pillbox offers relatively greater protection against aimed fire.

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In the New Georgia-Burma survey, pillboxes were not used because of the offensive-type action and the extremely fluid frontlines. Only one man was hit in a pillbox, which was of Japanese construction. The bullet passed between the logs and killed him, which could not have occurred if the pillbox had been properly constructed.

Of the 369 casualties, 17.5 percent were wounded in foxholes, many of which were of poor construction. A well-constructed foxhole offers excellent protection from flat trajectory weapons but not as good protection from shell fragments, particularly when there are a number of tree bursts.

TABLE 48.-Distribution of 349 casualties, by position and protection and by causative agent

Influence of Position

The influence of position can be used to determine whether the number of hits depends solely upon the body surface exposed or is greater for aimed fire (table 49). For both aimed and unaimed fire, twice as many casualties occurred among standing as among prone soldiers. When the factor of cover

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is removed (table 50), the relative proportions remain about the same, which is what might be expected if all missiles were unaimed and were traveling at random. In this jungle study, apparently a considerable proportion of all casualties resulted from random unaimed hits.

Rifles and machineguns are considered aimed weapons. Weapons which produce shell fragments, such as mortars, artillery, and grenades, are unaimed weapons. Bullets in jungle warfare came largely from weapons aimed only in the approximate direction and elevation.

The Japanese utilized their aimed weapons (rifle and machinegun) most efficiently when U.S. troops were on patrol or on offensive action (table 51). Their unaimed weapons (mortar, grenade, artillery) were used to best advantage when they were on the offensive or U.S. troops were on the defensive.

TABLE 49.-Distribution of 287 casualties, by aimed and random fire and by position (with and without cover)

¹Rifle and machinegun.
²Mortar, artillery, and grenade.

TABLE 50.- Distribution of 270 casualties, by aimed and random fire and by position (no cover)

¹Rifle and machinegun.
²Mortar, artillery, and grenade.

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TABLE 51.-Distribution of 362 casualties, by type of action and causative agent

¹Percent for trichotomy, patrol versus defensive versus offensive, by type weapon, and for total patrol versus defensive versus offensive.
NOTE.-Figures in parentheses express percent of total type of weapon for total type of activity.

Influence of Range of Small Arms Missiles

Any information that can be collected concerning the range of small arms or the distance from a shellburst at the time of wounding is of extreme importance in assessing the wounding potential of a weapon, as well as in designing and constructing personnel armor. If the weight of the bullet or fragment is known, plus its approximate velocity (by interpolation from range or distance values), the kinetic energy of the missile at the time of impact can be determined. All of these data are of interest and of fundamental importance in the basic studies on wound ballistics. (See chapters II and III.)

Table 52 presents the data on 208 casualties (93 from rifle fire and 115 from machinegun fire) in which the approximate range was known. As the table shows, the greater number of injuries occurred at distances under 75 yards. The observation is typical of jungle warfare, in which small arms are seldom actually aimed at distances greater than 50 yards.

Table 53 presents the data on 85 casualties (56 from mortar and 29 from artillery fire) in which the range was known. The majority of the injuries occurred at distances under 10 yards from the burst. The enemy hand grenade was seldom effective as a wounding agent at distances greater than 3 yards (table 54).

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TABLE 52.-Distribution of 208 casualties, by category and by approximate range of small arms (rifle and machinegun) missiles

TABLE 53.-Distribution of 85 casualties wounded by mortar and artillery shells, by distance from point of burst of causative agent

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TABLE 54.-Distribution of 47 casualties wounded by hand grenade, by distance from detonation of causative agent

In summary, the following distances were typical for the offensive type action which characterized the New Georgia-Burma fighting:

Records show that 90 percent of the dead killed by bullets were hit at ranges under 100 yards. Furthermore, many of these bullets had low velocities because they had passed through brush or trees. Mortars and artillery seldom killed at distances greater than 10 yards from the burst, and close to 100 percent of casualties from these weapons occurred at less than 50 yards. No records are available that show men killed at distances greater than 5 yards from a grenade burst.

Over 75 percent of casualties killed by fragments from mortar and artillery shells were less than 10 yards from the source of the fragments.

Over 80 percent of casualties killed by fragments from hand grenades were less than 3 yards from the detonation.

DISPOSITION OF CASUALTIES

A review of the disposition of battle casualties furnishes much valuable information. In the type of warfare discussed in this chapter, between 16 and 25 percent of all men hit were killed. Approximately the same proportions were returned to duty immediately, and 40 percent were returned to duty within 4 months. The remaining 10 to 15 percent were evacuated to the United States.

Disposition According to Anatomic Distribution of Wounds

The anatomic distribution of wounds played the most important role in the disposition of casualties:

1. Casualties who received wounds of the head, chest, or abdomen had a 50-percent chance of being killed in action. Of those who survived penetrating wounds of the head, chest, or abdominal cavity, only a very few could be returned to duty. Most of the men with wounds in these three areas who

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could be returned to duty had only flesh wounds. In these areas, a little protection might have made the difference between death or disability and a minor wound.

2. More than three-quarters of all casualties with wounds of the extremities returned to duty without leaving the theater of action. Fatalities due to these wounds were so few as to be insignificant. When they occurred, most of them could be attributed to carelessness.

Disposition According to Causative Agent

Disposition of casualties according to the agents which caused their wounds was one way of establishing the effectiveness of weapons used by Japanese infantry. In descending order of effectiveness, these weapons were machinegun, rifle, artillery, mortar, and grenade.

Machineguns of a caliber equivalent to that of rifles caused greater losses than rifles principally because they caused multiple wounds involving multiple regions. Sixty percent of all casualties struck by machinegun bullets were lost to service, a proportion which conclusively demonstrates the deadly effectiveness of this and other automatic weapons.

Shell fragments did not approach the effectiveness of bullets unless they hit men who were upright and unprotected or the shell had a tree burst.

Artillery and mortars, as employed in the Pacific areas with little use of time fuzes, were much more effective than grenades, which, as already noted, seldom killed at distances greater than a few feet. Artillery and mortars accounted for about 30 percent of men lost to service (casualties killed or evacuated to the United States) in each of their respective categories.

When casualties killed in action, those evacuated to the rear echelons, and those evacuated to the United States are totaled, a comparison of the wounds produced by each weapon provides figures which further substantiate the results just cited. The machinegun leads with 84 percent and the grenade comes last with 38.5 percent. The ratio remains the same when the dead are added to the group of men who could not continue to fight for even a short time in an emergency. On the other hand, casualties who returned to duty from the first echelon did so with increasing frequency according to whether they were wounded by grenades, mortars, artillery, rifles, or machineguns.

About 75 percent of the 101 dead in the New Georgia-Burma survey died because of wounds from small arms. Two-thirds of these fatalities were caused by machineguns, generally the .25 caliber weapon that the Japanese used as the equivalent of the U.S. Browning automatic rifle. A large but undetermined number of Japanese casualties were caused by U.S. automatic weapons: In a single brief engagement involving only one combat team, two U.S. heavy machineguns fired 10,000 rounds, and more than 400 Japanese were killed.

In the type of warfare in which troops tended to seek cover in natural vegetation and did not always build strong fortifications, the Browning auto-

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matic rifle proved a very valuable weapon. The Japanese light machinegun also proved extremely effective against U.S. troops. With both of these weapons, it was possible to throw a large volume of fire rapidly into a group of men before any of them could assume prone positions. In jungle warfare, in which brief glimpses of the enemy were the rule, these automatic guns were decisive; a burst often caught men on their feet, with vital areas of their bodies exposed.

In this type of jungle warfare, tremendous U.S. artillery concentrations in all probability caused the largest percentage of Japanese casualties. On the other hand, the value of the automatic weapon, often firing initial bursts in the general direction of groups of enemy above ground, should not be underestimated.

The great value of time fuzes for artillery was well demonstrated by the large numbers of casualties U.S. troops sustained from the very light and inaccurate Japanese artillery fire when they were subjected to it while near trees and large bushes. The time fuze, when properly used, would certainly have been as effective as these so-called tree bursts.

INFLUENCE OF PROTECTIVE ARMOR

In the Bougainville study, head wounds exceeded the proportion predicted for the mean projected body area by twice the expected percentage. Wounds of the abdomen and lower extremities did not quite reach the theoretical number of hits for the mean projected body areas of these regions.

In the New Georgia-Burma report, as already noted, the expected proportion of wounds of the head is exceeded by 7.9 percent and of wounds of the thorax by 4.5 percent. Wounds of the lower extremities and abdomen, as in the Bougainville report, are below the expected proportions.

A great increase over the theoretical proportion of head injuries can be expected in defensive warfare. In fact, no matter what the type of warfare, wounds of the head can be expected to exceed the theoretical. Apparently this is also true of thoracic wounds. Adequate studies are not available for wounds of the back, front, and right and left sides of the body, but personal experience leads to the tentative conclusion that at least two-thirds of all hits in both dead and living will occur on the anterior body surface.

Table 55 presents the distribution and entrance sites of the lethal wounds in 173 casualties (78 in the New Georgia-Burma campaigns, 95 in the Bougainville campaign) who were killed in action with wounds of the head, chest, and abdomen. There is a decided concentration of wounds in the frontal region of the head and on the left side of the chest as compared to the right side.

The data secured when the total dead of all jungle campaigns were combined are shown in table 56.

Approximately 40 percent of U.S. dead had head wounds as the cause of death. The larger proportion of these casualties, however, showed no penetra-

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tion of the helmet, thus indicating that ballistic protection was of some value. On the other hand, the coverage provided by the standard M1 helmet seemed inadequate to protect against the sort of missiles which entered the brain. Further investigation will be necessary to prove this point, but this study indicates that the greater percentage of head wounds, as well as the many deaths due to such wounds, could be prevented by a more scientifically designed helmet. Such a helmet should (1) be made of better armor material and (2) should also protect the brain from every approach, including a large part of the face. The unprotected upper portion of the face was the point of entrance for most missiles which penetrated the brain and produced lethal wounds. Casualties with superficial but severe injuries of the face and neck had an excellent chance for survival.

TABLE 55.-Anatomic distribution of fatal wounds of the head, thorax, and abdomen in 173 casualties (95 Bougainville campaign; 78 New Georgia-Burma campaigns)

TABLE 56.-Distribution of lethal wounds in 496 casualties (395 Bougainville campaign; 101 New Georgia-Burma campaigns), by anatomic location (regional frequency)

As already mentioned, only an insignificant and largely unnecessary proportion of deaths were due to wounds of the extremities.

Practical experience with war dead, as well as knowledge of anatomy and of the possibilities of good surgery, leads to the conclusion that a great saving in life could be effected by the proper use of one square foot of armor on the anterior surface of the chest. The base figure of 60 (3¾ lb.) ounces per

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square foot for armor capable of resisting 20 mm. fragments at close range provides a strong argument for such protection. The weight of this piece of equipment would not equal the 7-pound weight of the old-type gas mask. The equipment would certainly not be as cumbersome.

The possibility of designing the infantry rifle belt to increase its ability to resist low-velocity missiles should also be considered.⁵

U.S. CASUALTIES CAUSED BY U.S. MISSILES

Of the 369 casualties in New Georgia and Burma, 66 (17.9 percent) were caused by U.S. fire, as were 219 (12.2 percent) of the 1,788 Bougainville casualties. All types of weapons were represented, with rifle and artillery leading in both reports. It is doubtful that higher command is aware that U.S. soldiers killed and wounded such a large proportion of their fellow soldiers as these figures suggest. Accurate figures exist only for isolated reports, such as the reports for the Bougainville and the New Georgia-Burma campaigns.

There were a variety of reasons for this tragic situation: Individual carelessness, usually on the part of the men hit; poor training in the use of weapons; poor unit discipline; lack of dissemination of information; poor leadership; and faulty judgment.

Limited experience suggests that artillery casualties were for the most part due to poor fire direction by inexperienced observers and also suggests that many casualties could probably have been prevented if adequate containers had been provided for grenades and if the length of safety time had been stamped on each grenade.

The majority of rifle and machinegun casualties occurred at night and were caused by mistaken identity. In most instances the casualty showed poor judgment-he stood up in his foxhole; moved about the perimeter; entered a perimeter without proper caution; or performed other foolish acts.

Nearly all rifle and machinegun casualties in the group hit by U.S. fire occurred when U.S. units were in defensive positions, in which there was little need for hasty decisions. The men should have had more confidence in camouflage and in their ability with specific weapons. Good communications and a general knowledge of the tactical situation would also have appreciably reduced the number of such casualties.

Most self-inflicted wounds were caused by carelessness and were not intentional.

Methods of Prevention

A consideration of the circumstances in which each injury caused by U.S. fire occurred would include: (1) The position of the casualty; (2) the type of action; (3) the natural protection; (4) the terrain, time, and weather; (5) the

⁵These suggestions were made by Dr. Hopkins in 1944, immediately after he had completed his surveys. His remarks demonstrate the widespread interest in body armor on the part of many of the medical officers engaged in the initial treatment of battle casualties.-J. C. B.

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type of weapon; (6) the range of the bullet or shellburst; (7) the planning of the operation; and (8) leadership. Some of these factors require discussion.

Position.-Too many commanding officers and their men apparently did not realize the protective value of the crawling position. Frequently, soldiers would hit the ground when firing commenced but rise to a semierect position in order to advance toward a known enemy position at short range. If a squad could knock out a pillbox in an hour of crawling, without casualties, there was no point to trying to do it in 30 minutes by advancing in a crouch and sustaining casualties. The odds were too great to justify the time saved.

The great value of the prone position should also be emphasized. Records available indicate that in jungle warfare very few men were hit when they stuck close to the ground. Of 646 casualties (460 in Bougainville and 186 in New Georgia and Burma) hit by bullets and without protection of any sort, only 146 were injured while prone. Of 788 casualties (704 in Bougainville and 84 in New Georgia and Burma) hit by shell fragments, only 233 were injured while prone.

Protection.-The value of protection is clear in figures from both the Bougainville and the New Georgia-Burma campaigns. In the Bougainville campaign, which was chiefly defensive, only 484 of the 1,906 men hit had protection of any sort. On New Georgia, 30 Japanese were killed at night inside the perimeter of the 1st Battalion, 148th Infantry. The U.S. troops were in shallow holes and did not have a single casualty. In the Burma campaign, a combat team of 450 men were well dug in on a river bend but had only open foxholes. During an enemy attack lasting 1 hour and 15 minutes, 400 Japanese were killed while trying to cross the river. Not a single U.S. soldier was killed, in spite of a tremendous concentration of Japanese machinegun and rifle fire. Three minor injuries were caused by mortar fragments. This illustration is only one of many possible examples of the value of even shallow foxholes.

Type of combat.-In the type of warfare encompassed by this survey, about 50 percent of the casualties occurred in defensive action. The Japanese, in spite of the great odds, usually attacked in the early morning or late afternoon. Well-indoctrinated troops, who were aware of this fact, could be prepared for the attacks by digging adequate foxholes, preparing fire lanes, and generally showing alertness.

A fair average for U.S. casualties caused by offensive action against the Japanese seems to be about 35 percent, while patrol activity accounts for 15 percent. In the patrol group, 75 percent of the casualties were probably caused by aimed weapons. In defensive and offensive warfare, aimed weapons accounted, respectively, for 30 and 60 percent of casualties.

The Japanese made use of defensive warfare and excelled in the use of terrain and camouflage for defensive purposes. In New Georgia, 16 of the 1st Battalion's initial casualties (5 dead and 11 wounded) were caused by fire from 2 enemy heavy machineguns covering a small bridge. These guns were placed in an area of thick jungle and steep hills which made flanking movements almost

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impossible. The entire battalion was held up for 36 hours and did not locate the positions of the guns until the area had been pulverized by artillery and mortar fire.

In Burma, the enemy invariably set up trail blocks at the crests of steep hills, locations which usually provided perfect fire lanes and in which flanking was difficult. Nor did they neglect to have similar positions prepared in advance of a withdrawal.

Without pack artillery, dive bombers, expert use of mortars, and strafing (all in small quantities), it is doubtful that the 3d Battalion of Merrill's Marauders would ever have relieved the 2d Battalion after an offensive against one battalion of Japanese over a 5-mile jungle trail. The Japanese had favorable terrain, but the tree burst of U.S. artillery and mortars, plus close fighting with grenades, finally defeated them. The great effect of mortar and artillery tree bursts can hardly be overemphasized.

Leadership.-In accounting for U.S. combat casualties, the role of leadership is clearly evident. A careful review of the causes of casualties in New Georgia among men of the 1st Battalion, 148th Infantry, shows that a very large number of them could be explained by poor leadership, chiefly at the battalion and regimental level.

The Intelligence and Reconnaissance Platoon of the 3d Battalion of Merrill's Marauders in Burma accounted for approximately 400 Japanese casualties in 26 engagements with the loss of only 3 U.S. soldiers KIA. The platoon leader (1st Lt. Logan E. Weston, Inf.), who devised the tactical formation used by the platoon, was the man chiefly responsible for the small number of casualties. Incidentally, the health of this platoon was always relatively good, and it had an insignificant number of accidents during the campaign. The platoon realized the value of their particular standard operational procedures for patrol and for defensive and offensive activities. Their excellent record is largely attributable to the excellent leadership exercised by their platoon commander.

Other factors.-Poor distribution of plans and combat information was often responsible for injuries. Infantrymen participating in patrols and in offensive action in such circumstances did not understand the general purpose of the engagement.

Face and hand camouflage was seldom used by troops fighting jungle warfare, yet the split second of hesitation occasioned by camouflage might frequently be prolonged, with disastrous results for the enemy. This would be especially true on patrol activity but would also play an important part in any type of action in which aimed weapons might cause casualties.

Greater stress should have been laid on the necessity for foxholes, and their preparation and occupation should have been more strictly enforced by the unit command. More attention should have been given to the physical and mental condition, as well as to the personal needs, of the troops. Elective actions should not have been undertaken without adequate food and rest.

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Needless casualties caused by neglect of the simple principles of self-preservation, firepower, sound tactics, and the physical well-being of the troops should not have been tolerated.

CONCLUSIONS

In the past, the attention of both Medical Corps and combat officers has been focused on the care of the wounded after they were injured. The purpose of this survey was to call attention to means of reducing the number of wounded and particularly the number of casualties killed in action. In other words, the point has now been reached when more consideration should be given to the individual U.S. soldier who, even with superior equipment and supplies, will be killed or wounded in combat.

Body armor has been used in warfare in the past and its weight willingly tolerated by soldiers once its effectiveness was demonstrated. The stakes for the individual and for the Army are so high that the most careful investigation of existing armor and experimentation with improved types of armor and helmets are fully justified.

In addition, all tactical lessons of combat should be exploited fully. The Army cannot afford to neglect any suggestion which promises to save the lives of U.S. citizens who are temporarily subject to its orders. It is believed that the survey reported in this chapter points to the possibility of saving many lives and avoiding many wounds.

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