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Appendix B



    Army War College
    Washington 25, D. C.

710/111 (30 Jan 45) GNGBI. 
20 JANUARY 1945

SUBJECT: Prevention of Trench Foot and Frost Bite.
TO:    Commanding Generals,
    All Armies,
    All Corps,
    XXXII Corps Atry,
   Airborne Center,
    Antiaircraft Command,
    AGF Replacement Depots No 1 and No 2,
    Replacement and School Command,
    All Divisions,
    1st Hq & Hq Det, Sp Trps, AGF,
    All Replacement Training Centers.

Commanding Officers,
    All Hq & Hq Dets, Sp Trps,
    All Regiments,
    All Groups,
    All Battalions,
    All Squadrons,
    All Companies,
    All Troops,
    All Batteries.

    1. The attached report is considered an excellent outline of a training program used by an overseas army for instruction in the prevention of trench foot and frostbite and the principles of wearing special cold weather clothing, sleeping warm and keeping dry.
    2. This report is furnished for your information only. Reproduction and distribution are authorized.
   3. Changes in training doctrine as enunciated in War Department publications which are necessary because of the information contained in observers' report will be published by the War Department. Change in training directives of this headquarters which are necessary because of information in observers' reports will be promulgated by this headquarters.

    /s/ Holman Hamilton
        Capt., A. G. D.,
    Ass't Ground Adjutant General.


Inclosure 1


    Body heat, not clothing keeps you warm. Clothing retains a layer of warm air around the body and prevents cold outer air from chilling the skin. In still air, warmth is equivalent to thickness of insulation.

    You get still air by wearing the windproof suit, which consists of jacket field M-1943, trousers field cotton OD and hood jacket field with layers of insulation underneath. The, amount of insulation can be varied, for you can wear just a wool shirt under the jacket, or a wool shirt and sweater, or wool underwear and a wool shirt and sweater, or all these plus the jacket field wool. To get warmth you must wear the jacket field M-1943 on the outside, for the sweater and other layers of clothing lose their value when the wind blows through them.
    As far as possible adjust the number of layers you wear to the temperature about you and your degree of activity. If you are cold, perhaps you should be wearing more layers. If you are sweating, you should take off one or more of the inner layers at the first opportunity to avoid making your clothing damp.

    Avoid Overheating:
    If your clothes become damp from perspiration, some of your body heat, normally used to keep you warm, will be diverted to dry out the damp clothing. In this way sweating makes you colder and in sub-freezing weather may help cause frostbite.

    Clean Clothing:
    Clean clothing is warmer than dirty clothing because grease or dirt helps conduct heat away from the body.

    In cold weather never wear anything that has a tight fit. Tight clothing or footgear restrict circulation and invites frostbite or trenchfoot. If a boot fits comfortably with one pair of socks, never wear it with two pair of socks. You may freeze your feet if you do, because the second pair will cause the boot to fit too tightly and restrict circulation. Similarly a field jacket which fits snugly and looks snappy when worn over a wool shirt alone will be too tight during cold weather when a sweater or wool jacket is also needed under the outer jacket. If your outer jacket already fits tightly, you may make yourself colder by putting on another layer under it, for you restrict circulation. In the same way, one pair of loose gloves is warmer than two pairs of tight ones. If you want to keep warm in cold weather, keep your clothing loose.

    Food gives your body heat and keeps you warm. If you haven't eaten for several hours, your heat output is lowered and frequently you become cold. It this happens to you, eat a candy bar or some biscuits saved from your last K or C ration and you will immediately feel warmer and more alert. In cold weather always carry a few ounces of candy or other food in a pocket of your field jacket or parka. As far as possible, eat little and often.

    Sleeping Warm:
    Have as much insulation under you as over you. Your water repellent (not waterproof) case is windproof. Inside it you may use the mountain sleeping bag or wool sleeping bags for


insulation. As this insulation is compressed by the weight of your body, however, you need additional insulation under you. If they are dry, shelter halves, extra blankets, haversacks, field packs, web equipment, fiber ammunition or food containers (such as 10 in 1 ration boxes torn tip), packboards, tree branches and bushes, or extra clothing, may be placed under your sleeping bag or blankets, for in general, the more insulation of this type you have under you, the warmer you will sleep. This is particularly noticeable in a mountain sleeping bag, whose down filling easily compresses under the body.
    Many men make themselves cold by sleeping with too many clothes on:
    This clothing, as they turn over in their sleep, restricts circulation at the shoulders and makes them cold. If they wore less clothing, not only would there be no constriction and they would sleep warmer, but the extra clothing could be used to advantage as insulation under them.
    Brief exercise before entering the sleeping bag stimulates your circulation and causes you to heat the bag more quickly. A small man, however, may find the bag large and slow to warm. If so, he can fold part of the bag under him, in this way increasing insulation underneath and reducing the amount of air that his body must warm.

    Waterproof and Water Repellent:
    The raincoat is unpopular because it is waterproof and fits closely to the body. The man who marches in it sweats, and the sweat, condensing inside his raincoat, often gets him just as wet at the shoulders and back as if he wore no raincoat at all. For this reason the completely waterproof 2 piece, navy-type suit, called parka and trousers wet weather, is not issued to men who march, for they would soon be drenched with sweat. As organizational issue for special duties, however, this suit has many uses.
    The jacket field M1943 and trousers field cotton are water repellent but not waterproof. Moisture vapor (sweat) can pass out through the fabric and does not condense inside. This means that you are more comfortable when marching in moderate rain if you wear the field jacket and not the raincoat. However, no water repellent will keep out water indefinitely and if you lie in water or stand for a long period in a heavy rain, you will gradually get wet even if you are wearing water repellent garments. Truly waterproof garments will not wet through no matter how much it rains, but you can get wet in them if water goes up your sleeve or runs off your helmet and down your neck.

    Dry Feet Prevent Trench foot:
    In cold weather care of the feet is as important as care of the rifle. When a man's feet are wet, cold and inactive for periods of more than one day circulation is reduced, and if it disappears, trenchfoot occurs. You can avoid trenchfoot and the amputation it often causes as follows:
    1. Do this:
        a. During wet cold weather wear properly fitted shoepacs for these reasons:
         (1) The rubber shell and heavily oiled leather top will keep your feet dry.
            (2) The shoepac is sized to fit over 2 pairs of heavy ski socks, insulation which you need for protection against winter cold.
            (3) The shoepac has a high toe so that your toes are not constricted. Even if you are pinned down and can't move your body, you can wiggle your toes inside the shoepacs and in this way stir the circulation. In cold weather the ability to move your toes within your boots is important.
            (4) The shoepac has a removable insole which adds insulation below the foot and absorbs perspiration.
        b. Be sure that your shoepacs fit properly with 2 pairs of ski socks.
        c. Be sure that you wear them for a few days before making long marches in them.


    2. Don't do this:
        a. During wet cold weather don't wear combat boots or service shoes without overshoes, for the following reasons:
             (1) Leather boots quickly get wet, and unless they can be dried and fresh dubbing put on they will stay wet, making your socks wet, and gradually making your whole body cold.
            (2) Combat boots and service shoes fit over one pair of socks wool light or one pair of socks wool heavy, which is insufficient insulation to keep your feet warm during the cold winter months. (Never wear them with ski socks, which will restrict circulation.)
            (3) Combat boots and service shoes have a low toe which prevents movement of the toes to restore circulation.
            (4) Combat boots and service shoes do not have removable insoles to add insulation under the foot.
        b. Never wear ski socks inside combat boots or service shoes. If you do, you will restrict circulation and help cause frostbite.
        c. Never keep your boots or shoepacs on for periods of several days without taking them off. Each consecutive day you wear them without taking them off, circulation becomes worse and frostbite or trenchfoot more likely. Whenever practical during cold weather, take off your boots or shoepacs for at least 3 minutes every 24 hours and rub your feet before putting footgear on again.

    3. Other information:
        a. Dubbing, which is another name for shoe waterproofing, lasts only a day under conditions of continual wet, but is effective under conditions where it rains only occasionally. Unless leather boots can be dried, which is frequently impossible, dubbing cannot be applied in a satisfactory manner. Therefore, dubbing, which works well under conditions of occasional rain will not keep your feet dry during cold wet winter months in the line.
        b. Dry Socks:
            If you are wearing wet combat boots that you can't dry, the issue of dry socks will be of limited value to you, for almost as soon as you put them on, the wet leather pressing against your socks will wet them through. By changing your socks you at least dry your feet and improve the circulation, which helps, but your wet boots will soon return your feet to their previous condition.
            If you are wearing shoepacs, dry socks will help you for this reason: You replace socks somewhat damp from perspiration with dry socks. Unlike dry socks used in wet combat boots, these socks will not become wet from the outside.
            As dry socks are warmer than damp ones, alternate two sets of socks and insoles. While wearing one set, dry out the other by body heat or any other available means. (One good method is to let body heat dry them at night in the sleeping bag.)

    4. Summary:
        a. Wear properly fitted shoepac with 2 pairs of ski socks.
        b. If possible break them in for 3 or 4 days before making long marches.
        c. Alternate 2 sets of ski socks and insoles in order to keep feet dry and warm.


    HQ FOURTH ARMY (Surgeon)
    29 January 1945