Table of Contents

Headquarters Second Infantry Division
Office of the Surgeon

Medical Bulletin

DEC 1944

HEADQUARTERS SECOND INFANTRY DIVISION
Office of the Surgeon

APO #2, U.S. Army
1 January 1945

  The Second Infantry Division until December 12, 1944 was in a holding position generally along the Siegfried Line with front line units being located in the Schnee Eifel Forest on the western border of Germany.  On December 12th the Division closed in the Elsenborn-Krinkelt-Wirtzfeld area in preparation for an attack eastward.  The attack proceeded satisfactorily until the recent German counteroffensive occurred on December 16th.  At this time the Division took up a stubborn defensive position in the Elsenborn-Wirtzfeld-Berg area and aided greatly in stopping the German counteroffensive from advancing farther to the north and the west.  The Division remained in a holding position in the Elsenborn-Berg area at the end of the month.

 The total battle casualties for the Division for the month was 1966, of which 80 were officers.  It is impossible to accurately determine the ratio of killed to wounded since it is impossible to determine in the recent engagement how many MIA actually lost their lives.  The total non-battle casualties evacuated from the Division to the Clearing Station for the month was 1971.  148 cases were returned to duty from the Clearing Station within 24 hours.  Practically all of these 148 were mild combat exhaustion cases.  The ratio of battle casualties to non-battle casualties was approximately 1 to 1.  Due to intensive combat in the Krinkelt-Wirtzfeld area there was a marked increase in the ratio of battle casualties over non-battle casualties compared with the previous several months.  Thirteen cases of "new" acute gonorrhea  were incurred during the month.  The large percentage of these cases had their contact in Paris while on pass.  Forty-nine cases of gastrointestinal conditions in comparison to forty-one last month were admitted to the Clearing Station.  Fourteen cases of trichophytosis pedis (athlete’s foot) in comparison  with  six last month were admitted to the Clearing Station. 153 case of “trench foot” in comparison to thirty-eight last month were admitted to the Clearing Station.  This noticeable increase is due to living and fighting under winter conditions.  134 cases of respiratory disease in comparison with 139 last month were admitted to the Clearing Station.  Considering the environmental conditions this is believed to be a small number.  There were 651 cases of combat exhaustion as compared to fifty-nine cases last month.  The marked increase is due to intensive combat under marked hardships of winter weather.  Combat exhaustion this month accounted for thirty-three percent of the non-battle casualties.  There was a total of 1696 diseases (all causes) in comparison to 1019 last month.  The increase is accounted for by the higher incidence of combat exhaustion.  3192 cases were evacuated from the Division to the Clearing Station during the month of December.  352 or 11% were returned to duty directly from the Clearing Station.  This small number of returnees is due to two reasons.  The large number of evacuations and the rearward displacement of the Station made it impossible to hold many patients.  During the latter part of the month due to inadequate housing facilities the forward Clearing Station has been operating under tentage.

[Statistical tables on pages 2-4 covering admissions from 30 November to 31 December 1944 are withdrawn.-ed.]

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 There were a total of 178 medical casualties as compared with 49 last month. The difficulties encountered in intense winter warfare notably increased the number of exhaustion cases.

 During the past month several factors concerning Division Medical service are of interest. The Division was fighting under winter conditions with a variable amount of snow on the ground.  Secondly, in the recent German counteroffensive it was the first time in this war that the Division was ordered to make a withdrawal.  The hardships of winter warfare caused an increase in non-battle casualties, particularly in the incidence of combat exhaustion, trench foot and frostbite.  As mentioned above, respiratory disease and gastrointestinal conditions showed no increase.  The front line troops all have quartermaster issue of current combat clothing, sleeping bags and overshoes (arctics).  The arctics, the large majority of which are the fabric type, have been a great help in lowering the incidence of trench foot and frostbite but have not completely prevented it.  The front line troops are literally living and sleeping in fox holes.  This has prevented normal exercise of the lower extremities.  By necessity the position underground has also been a factor in inhibiting proper circulation of the feet.  It is strongly urged, even though sleeping in fox holes, that the shoes be removed before going to sleep.  Massage of the feet is of material help in stimulating the circulation.  The shoes and leggings should always be laced loosely to prevent any inhibition of circulation to the feet.

 In the recent German counteroffensive problems encountered by the Collecting Companies are covered in this bulletin by the Commanding Officer, 2d Medical Battalion.  The problems encountered by the Infantry Battalions are covered by the Surgeon, 38th Infantry.

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 At the beginning of the recent German counteroffensive on December 16th the Clearing Station was set up with a platoon on each rear flank of the Division.  The platoon and adjacent field hospital set up on the flank receiving the unexpected German counteroffensive had to be rapidly withdrawn with resulting loss of medical equipment but no personnel or patients.  The Clearing Station on the north west flank of the Division, though four miles from our front line elements, was in an excellent building and continued to function there until the front line units were withdrawn to that vicinity.  This forward Clearing Platoon during the first two days of the counterattack received casualties from three Divisions plus attached units.  Due to the road from the Collecting Stations being cut by enemy action evacuation by ambulance was impossible during certain periods.  In addition there were insufficient army ambulances to evacuate the Clearing Station so Medical Battalion trucks and other available vehicles were utilized.  In a situation of this nature, where a withdrawal movement is probable and actually occurred, it is necessary to keep the Clearing Station evacuated and mobile so that it can move on short notice.  Also in an action of this nature it is believed that the Clearing Station should be echeloned into a forward and rear platoon, the forward platoon to give necessary treatment to battle casualties for further evacuation to the rear.  The value of the rear Clearing Platoon is in holding minor cases which can be returned to duty status in several days and also to take over in case the forward Clearing Platoon has to be withdrawn on short notice.

 During the recent German counteroffensive more than ninety percent of the battle casualties were due to shell fragments, particularly from enemy fire.  The casualties due to mines and enemy aerial activity, namely bombing and strafing, have been very small in number.  Of note is the fact that an unfortunate landing of a V-1 (buzz bomb) on the 702d Ordnance Company  accounted for 1 KIA and 18 wounded requiring evacuation.

[signed]
Walter R. Cook
Lt. Col., M.C.
Surgeon

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Headquarters Second Infantry Division
Office of the Surgeon

APO #2, U.S. Army
1 January 1945

 The following data of combat exhaustion in the 2d Infantry Division has been compiled for your information.  The period concerned in this report is from 1 to 31 December 1944, inclusive.


Cases Admitted to 2d Division Clearing Station: 

 
Other Units in 2d Division:

Total Casualties admitted to Clearing Station:  1314  764  727  387

Percentage of Combat Exhaustion of all  admissions:  25.2%  19.4%  13.3%  19.1%

Total number admitted to Clearing Station, December 651
Admitted to Clearing Station second time for exhaustion  141
Number evacuated to Evac Hospital 522
Number returned to duty from Clearing Station 129
Percentage of Combat Exhaustion of all admissions 20.3%

Of the total number of cases none were recent replacements.

 During the month there were 141 cases of exhaustion who had previously been evacuated for the same condition.  There were no cases with less than 30 days combat.

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[Admission statistics, 1-31 December 1944, withdrawn.-ed]

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 There were 651 cases of combat exhaustion during the month of December as compared to fifty-nine cases for the month of November.  This marked increase is due to difficult weather conditions, the attack on heavily fortified positions, the increase in enemy artillery, and the psychological outlook of the men who made the attack beginning December 13th.

 When the Division moved into the vicinity of Elsenborn they left heated shelters and slept in the cold, snow, mist, and rain.  Everything that would assist in the comfort of the men was done, but naturally in such a situation it was impossible to keep them dry and warm.  any of the men diagnosed as combat exhaustion were actually cases of exposure.

 When the attack occurred on December 13th and the men were having difficulty moving forward against strongly fortified positions they were subjected to very intense enemy artillery fire.  Their positions were made even more intolerable because they were in a forest with innumerable tree bursts.  This was the exciting cause in over ninety-five percent of the cases.

 The predisposing factors mentioned in the previous bulletin have been well exemplified by the attack of December 13th.  Over ninety percent of the exhaustion cases fell into one of three categories.  In the first group were men who had been wounded and evacuated past the division level and had developed a conditioned fear complex.  The second group comprised of those who had previously been evacuated for exhaustion and had been returned to the division. The third group were men who had been fighting since the Division landed in Normandy and might be termed battle fatigue cases.

 There were very few who could be thought of as malingerers.  A cursory inspection by even a layman would reveal that they were chilled, wet, and exhausted.  Such expressions as –“I’m no good up there any more”, “I can’t stand those shells”, “I go crazy”, “My luck has run out”, “I can’t drag myself forward”, and “I’m a coward”– are typical.  The self condemnation used in a great many cases might be taken as true had not the background of these soldiers been known.  The only logical conclusion to be drawn is that many are no longer fit for combat and should be evacuated or rotated to non combat duty.  There are of course exceptions to this and a few are ready and willing to rejoin their units after a brief treatment.

 The large number of exhaustion cases in the initial phases of the assault did not come as a complete surprise.  In truth it was to be expected.  It could be predicted that a great number would reach their point of tolerance when they approached their first difficult objective and the artillery became intense.

 It is interesting to note that after December 14th, which was the second day of the attack by the 9th Infantry, the exhaustion cases decreased markedly.  December 15th and 16th were fairly inactive days for the infantry units.  On December 17th the men were aware of the German offensive and the seriousness of the situation.  There was very little means of evacuation and the men who were considered exhaustion cases were sent to camp Elsenborn to rejoin their units.  In a period of two days over five hundred men were interviewed at Camp Elsenborn and approximately four hundred of those were returned to their units.  Unquestionably a great many men rejoined their units because of a deep feeling of individual and unit pride and that now if ever they were needed.

 The total number of exhaustion cases appears higher than it actually is because approximately one hundred of the exhaustion cases were in the Division Clearing Station, marked duty, and then seen at Division rear and evacuated to the exhaustion center.  Their names appeared of the Division Clearing Station’s Admission and Disposition sheet a second time.

 Considering the difficult mission of the Division under the handicap of weather and terrain with an enemy offensive striking them in their rear and on their right flank the exhaustion rate could not be considered excessively high.

[signed]
GILBERT B. KELLEY
Major, MC, Neuropsychiatrist

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Office of the Surgeon, 38th Infantry
APO 2, U.S. Army

1 January 1945

 The three-day action 17 to 19 December, inclusive, had three difficult situations for evacuation, namely a daylight withdrawal, a holding action against a very stubborn enemy, and a night withdrawal under enemy artillery fire.  The first phase of this engagement, the daylight withdrawal, was made with a minimum number of casualties and no difficulties were encountered until one battalion was entering the northern part of Rocherath, Belgium.  A large volume of artillery and small arms fire was placed on the road used by this battalion with a resulting forty to fifty casualties in a very short time.  The road from this point to the nearest Aid Station was jammed with double banked vehicles which made evacuation impossible.  The casualties were carried into any available house for first aid treatment and a short time later were collected and transported to the Collecting Station.  At this time there was a great volume of traffic from many other units evacuating the town in a state of near rout.  When there were casualties in these units it was difficult to evacuate them due to the fact that our vehicles and medical personnel were completely denied the use of the roads.  Had the enemy closely followed our withdrawal from the north, evacuation of all casualties would have been impossible.

 By 2000 on 17 December an organized defense had been established, the road had been closed and all casualties had been evacuated to the Collecting Station.  At that time there was no known route of evacuation leading to the rear and the Collecting Station served as a holding Station for the area.  On the morning of 18 December the Collecting Station was in great danger of being overrun by enemy Infantry and tanks.  A number of vehicles of all kinds were assembled with all available ambulances and more than one hundred casualties were evacuated in a two hour period.  During the preceding night and that day casualties were evacuated very soon after being hit.  This was due to the fact that Aid Stations were very close to or almost in the front lines and that litter squads could use houses for defilade from small arms fire.  The Aid Station of the left flank Battalion was located less than one hundred yards from a road junction almost constantly occupied by enemy tanks.  One ambulance made at least ten trips to this station the last day, very often under direct observation by the enemy.  Ambulances and ambulance jeeps made numerous trips up the only road under all types of fire with the result that all of them were hit at least once and some several times with the resultant loss of three ambulance jeeps and one ambulance.  Remarkably enough none of the drivers were wounded although one patient was killed and one wounded in the rear of an ambulance.

 A regimental collecting point was established in a central location of Krinkelt and casualties from all Battalions were evacuated through that point.  The main difficulty arising at this time was that it took about four hours for an ambulance to make the round trip over the nearly impassable evacuation route.  2 ½  ton trucks were utilized for evacuation and even severely wounded patients seemed to survive this rough ride unusually  well.  During the nite of 18 December thirty-five casualties from another unit which had been surrounded were evacuated from a point just inside the German lines.  The withdrawal began 1730 on 19 December.

 Prior to the withdrawal all excess medical personnel were sent to the rear due to the fact that the short lines of evacuation did not require large numbers of men.  All wounded were evacuated prior to the withdrawal.  Four ambulances and three 2 ½  ton trucks remained available.  The Battalion Surgeon with an ambulance or other vehicle followed each Battalion from the area dropping all casualties at the Regimental Collecting point in order to have empty vehicles for further evacuation.  Wounded were loaded on every vehicle that passed.  After two Battalions had passed all wounded were loaded on vehicles and sent to the rear leaving two ambulances and one 2 ½  ton truck for the rear battalion.  This Battalion Surgeon, with these vehicles, followed the foot column out of the area picking up all casualties along the route.  The enemy failed to react until the last Battalion

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was nearly past the critical point and only a few casualties were then sustained.  Total casualties incurred during the nite withdrawal in the Regiment were approximately fifty.

 The danger of being cut off completely made it necessary to evacuate casualties immediately as they occurred.  Due to the fact that all necessary vehicles were made available for the evacuation and that a road was kept open to the rear a difficult problem of evacuation was facilitated.  In this type of winter warfare the wounded go into immediate shock even with slight wounds and it was necessary for each litter squad to carry four blankets.  Aid Stations must be located in heated houses whenever possible.  Large amounts of plasma must be given to patients that normally would not receive it.  The supply difficulty in this operation was facilitated by the use of abandoned medical supplies which were ample.  In the last stages of the withdrawal the treatment of all patients was cursory but this seemed unavoidable.  The incidence of combat exhaustion was less than would be expected but it is believed that many of them who would have presented themselves for evacuation stayed because of the determination to stop and defeat the enemy.  The American Infantryman at this stage of combat showed an extreme anger at the enemy for certain incidents that occurred.

[signed]
David F. Weaver
Major, M.C.
Surgeon, 38th Infantry

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HEADQUARTERS SECOND MEDICAL BATTALION
APO #2 - U. S. ARMY

1 January 1945

 From 1 December to 12 December 1944, the Second Medical Battalion functioned in support of the Second Infantry Division and attached units in defensive positions along the Siegfried Line with front line combat elements being located in the Schnee Eifel Forest region.  During this period the Collecting Stations were comfortably established in farm houses in close proximity to their respective combat teams.  The Clearing Station was set up in excellent building in St. Vith, Belgium, the building space being adequate to hospitalize one hundred patients.

 On December 12 1944, the Division closed into the Elsenborn-Krinkelt area.  In the recent German counter-offensive on the morning of 17 December 1944, a strong enemy force which had penetrated the American lines to the south, arrived in the town of Bullingen, Belgium. Upon their arrival the sole route of evacuation was cut from the Collecting Station “A” at Rocherath, Collecting Station “B” at Murringen and Collecting Station “C” at Krinkelt to the Collecting Stations at Dom Butgenbach and Elsenborn.

 During the period 16 December to 18 December 1944, the Medical Battalion learned for the first time the concrete implications for a Divisional medical service of retrograde movement and deep enemy penetration.  The impact was felt seriously by the Collecting Companies within whose zone of action the penetration occurred.  The experiences of Collecting Company “C”, normally a part of the 38th Combat Team, may be cited as an example as follows.

 Not until 1200 17 December 1944, was it learned by the Company Commander that a German counter-offensive had cut the supply and evacuation route of the 38th Combat Team.  Persistent enemy artillery fire had destroyed electric power and telephone communication lines. The Combat Teams were ordered to hold the towns of Rocherath and Krinkelt.  At first it was contemplated moving the Collecting Station forward into a woods where it would be safer from enemy action threatening the rear from the direction of Bullingen.  It was later decided to remain in buildings in the center of town next to the church and cemetary [sic].  Since the route of evacuation was cut, plans were made for accumulating all casualties from fighting units in and around the town for an indefinite period of time.

 Geneva markers were placed on the roof, red cross flags were put up on all building corners, ambulances were parked in front of doorways, windows were sandbagged, water and food were accumulated and personnel were dispersed in three separate locations in the town. Additional space in buildings was made available at strategic points for the accumulation of casualties, each with a cellar for cover.

 During the evening of 17 December 1944, casualties which had begun to accumulate in large numbers were transported out of town in all available ambulances and trucks, including the Collecting Company kitchen truck, by volunteer drivers who had no assurance that a back road, improvised by the 2nd Engineer Battalion, was yet open.  These drivers were not seen again until the Collecting Company hiked out about twenty-four (24) hours later.

 Space in buildings was now available to accumulate more casualties throughout the night. Shortly after dusk of 17 December 1944, Collecting Station “C”  was under intense artillery barrage.  Casualties occurring outside the station were brought in.  A near air burst shattered all the windows, partially destroyed one wall and rendered a station attendant unconscious from blast injury.  Casualties again began to accumulate in the buildings of the Station.  By this time the barrage had lifted and Germany infantry and tanks were infiltrating into the streets of the town. A German "Tiger" tank had taken up position twenty-five yards from the Collecting Station.  Members of the Company could hear German commands in broken English as he ordered American soldiers driving

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trucks and jeeps around the corner to “Dismount and be recognized.”  These were shot in cold blood where they stood and two of them, still breathing, were brought into the Collecting Station where they died of their wounds despite frantic efforts to save them.

 By daybreak of 18 December 1944, one hundred (100) casualties had accumulated in the Collecting Station.  Essential medical supplies were running low since it was impossible for transportation to return from the rear.  At 0900 three (3) commandeered 2 ½ ton trucks were loaded with casualties and transported over a cross country evacuation route made available for one-way traffic to the rear.  After this the Company made its way out and returned to the rear on foot.

 At this time it was impossible to assess some of the damage that had been incurred the night before.  Two ambulances had been crushed against a wall outside the Collecting Station by the tank battles that raged in the street.  Two (2) 3/4 ton weapon carriers had been irrevocably crushed by “Tiger” tanks.  The Medical Battalion “Wrecker”, which had arrived the previous day to retrieve a wrecked ambulance, had received a direct artillery hit and was completely burned out.  An ambulance continued to operate after having its roof partially torn off by an unexploded armor piercing shell fired by a “Tiger” tank while the ambulance was parked outside the Collecting Station.  The buildings housing some one hundred (100) casualties and medical personnel during the night had been miraculously spared except for partial destruction of one wall.  Because of the one-way traffic rule over the only available route to the rear, transportation was unable to return and the Company was forced to abandon its remaining medical equipment.

 The accomplishment of medical records was very difficult in a situation of this nature.  It is estimated that some three hundred (300) battle casualties were evacuated during the two days by Collecting Company “C”.  There were three (3) deaths in the Station.  These were all severe gunshot wounds of the chest and it is likely they would have died in any case.  No casualties were left behind although it was necessary to abandon the three (3) dead for lack of transportation.

 The experiences of the other two Collecting Companies were equally unconventional and hazardous during the period 16 to 18 December 1944.  However, the program of casualty collection from the Division as a whole was never at any time in jeopardy.  By the time that Collecting Company “C” had exhausted its usefulness in Krinkelt, the Division had only three (3) battalions of the 38th Infantry on the line.  Collecting Company “A” by this time was ideally situated in the town of Elsenborn to take up where Collecting Company “C” had left off.  By combination and rotation of ambulances, litter bearers, station personnel and equipment among the three (3) Collecting Companies, continuous casualty collection was maintained for the Division as a whole.  Collecting Company “B”, echeloned behind Collecting Company “A” in Sourbrodt, constituted an alternative casualty collecting point should further withdrawal have become necessary.

[signed]
CECIL F. JORNS
Lt Colonel, Medical Corps
Commanding


Source: National Archives and Records Administration, Record Group 112, Entry 54A, 2d Infantry Division, 1943-45, Box 388.