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Books and Documents > The Evolution of Preventive Medicine in the United States Army, 1607-1939

Historical books, monographs, and articles on the subject of military medicine have been devoted largely to exposition of medical administration and the care of the sick and wounded. They have allocated only small quarters to the history of preventive medicine. It is not astonishing, therefore, that medical officers, including preventive medicine officers, not having the time or opportunity to seek for the scattered and scarcely available sources, have been somewhat restricted in comprehension by a lack of information about the origins and developments of the principles and practices designed to prevent disease and preserve the health of soldiers. Since civilian and military medicine are so closely related, influencing and enriching each other by discoveries and exchanges, the knowledge of the backgrounds of both public health and preventive medicine is essential for enlightenment and understanding. It is the aim of this monograph to bring a certain amount of past experience into present consideration, to demonstrate beginnings and continuities. Although this is an unofficial historical narrative and analysis, not a manual, it is hoped nevertheless that it will be of collateral value in training programs.

The title is a modification of a heading used by Brig. Gen. James Stevens Simmons, MC, United States Army, in a draft of his chapter introductory to the "History of Preventive Medicine in the U.S. Army in World War II." Having served vigorously and imaginatively as Chief of the Preventive Medicine Service (variously designated at different times) in the Office of The Surgeon General from 1940 to 1946, he began to prepare his "Introduction" in 1948. The draft was unfinished at the time of his death on 31 July 1954. In 1961, by an action of The Surgeon General's Advisory Editorial Board on the preventive


medicine history, the responsibility for the first volume, and other parts of the history, passed to me as the successor-chairman of that Board. As familiarity with the subject increased, my ideas enlarged; and, in 1962 when I began writing, I saw the need and possibilities of a new composition, differing from the older, usually reiterated paraphrases of previous reviews, by utilization of original sources. I outlined a treatment of the subject which would begin with the armed colonists at Jamestown in 1607 and continue through 1939 when preparations for the possible entry of the United States into World War II in alliance with Great Britain were well advanced. One might ask: Why begin with the year 1607 to tell the story of the evolution of preventive medicine in the United States Army when no such Army existed until 14 June 1775? As some of the elements of the programs are to be found in the writings of ancient Egyptian, Jewish, Greek, and Roman authorities, why not go back to antiquity? Except for brief allusion to the Mosaic sanitary code, respect for antiquity did not seem to me to require inclusion of such ancient material in an article focused upon the American Army. There are several reasons for the decision to display some events of the 168 years preceding the beginning of the American Revolutionary War. The colonists as individuals, or as militiamen, fought in British ranks in all of the wars of the colonial period that were conducted periodically on American soil during somewhat more than a century and a half. In the battles, marches, and encampments, these men learned by experience the principles and practices of British military sanitation, hygiene, and preventive medicine under such great surgeons general as Pringle and Brocklesby. The knowledge thus acquired became, in time, a code for the Revolutionary Army. In addition, a number of those who served with the British in the decades immediately before 1775 became important officers in the Medical Department of the Continental Army, and also in the line of the Army itself. Thus, British (and also some French and German) policies, disciplines, and methods passed from foreign systems into American


organizations. Many of the basic principles and some of the activities of those times are currently applied in the United States Army today. From nearly all of them there is illumination.

I began to work on the "Introduction" in January 1962, and finished the first draft in March 1966. In June 1964, I moved from The Historical Unit, United States Army Medical Service, to The National Library of Medicine where, thanks to the hospitality of the Director, Dr, Martin S. Cummings, I was assigned a study room-a carrel in the midst of bookstacks-which placed me physically at a center of the desired lore. I had access to the great general and medical history collections of the National Library of Medicine, which from 1836 to 1956 was the Library of the Office of The Surgeon General of the United States Army. I had access also to the collections in the Rare Book Division of the Library of Congress. In both of these libraries, all the important pertinent literature of the 17th and 18th centuries was available, and, of course, 19th and 20th century material, in the form of books and journals, was abundant on the shelves. Of archival material, the General Reference and Research Branch of The Historical Unit and the National Archives and its subsidiary storage units generously supplied anything requested, provided it existed in their files. For the older regulations, reports, and many items, the Document Section of the National Library of Medicine, which had preserved the documents collected by former Army Surgeons General and their Librarians, was the richest possible vein of such information, hitherto only partly explored for historical purposes. Valuable service was received also from the Army Library in the Pentagon.

The draft of my introductory chapter was read by all members of the above-mentioned Advisory Editorial Board, and by others, including Dr. Stetson Conn, Chief Historian of the Army, in the Office of the Chief of Military History. They were appreciative and gave me valuable criticism. One of this group, Dr. Conn, was the first to suggest that with suitable revision this monograph might


be published separately. That plan was approved by the Advisory Editorial Board and by the Director of the United States Army Medical Service Historical Unit. During 1966 and 1967, official approval for such publication was granted by the Office of The Surgeon General and the Office of The Adjutant General, Department of the Army. These approvals do not diminish my responsibility for this text. Except in cases of documented citations and quotations, I am responsible for interpretations made and conclusions drawn, and for any errors of omission or commission.

Having had an interest in military and civilian preventive medicine extending practically throughout my life, from ancestral influences, schooling, and civil and military-medical occupation, I can recall numerous persons, episodes, and experiences all helpful toward the production of this monograph. Primarily, I owe much to my former Chief of the Preventive Medicine Service, the late Brig. Gen. James S. Simmons, and to the brilliant groups he gathered together for the solution of problems and for promotion of the health of the Army both in the United States and overseas in World War II. To name all to whom I am indebted in this connection would be impossible. Even to name all who contributed significantly to the accomplishment of this work would require an excessive amount of space. A special debt is owed to Mrs. Pauline B. Vivette, Assistant Chief, Editorial Branch, The Historical Unit. She collaborated with me in revising a draft of this writing, checked all of the references by inspection of the cited volumes, journal articles, and quotations, and edited the manuscript with experienced skill. Grateful acknowledgment is also made to Miss Janie W. Williams, Chief, Publication Section, Editorial Branch, The Historical Unit, who edited the artwork and the legends with very special care.

        Brigadier General, USAR, Retired,
        Deputy Chief, Preventive Medicine Service,
        Office of The Surgeon General, in World War II.