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Appendix E



Cir 108
26 OCT 1944



    1. General. Proper care of the feet is of the greatest importance for the maintenance of an effective command. A great amount of personal discomfort, as well as actual disability and loss of manpower, can be prevented by the constant attention of unit commanders and individual soldiers to the application of measures for foot. care.
    2. Responsibility. It is the responsibility of each unit commander to insure that all men of his command are equipped with adequate and properly fitting footwear, within availability of stocks; to inspect the feet and footwear of the members of his command at regular intervals; and to make certain that each individual soldier understands and practices the essentials of foot care.
    3. Footwear. a. Supply: Footwear for field use will be that issued by the Quartermaster. Adequate well-fitted footwear is of great importance at all times; however, in cold, wet weather special equipment is needed and particular attention to foot hygiene is required. For added protection during the cold season there will be available from Quartermaster stocks:

 Item                                                                Unit    Allowance
Boots, service, combat-                                pr        2 per EM
or leggings, canvas. M-1938                       pr        2 per EM
and Shoes, service, Type III                        pr        2 per EM
Socks, wool, cushion sole                            pr        3 per EM
Socks, wool, light, or socks, wool, heavy pr       3 per EM
Overshoes, arctic                                         pr          1 per EM

    b. Fitting: Shoes must be fitted so that no undue constriction or pressure will occur at any point when the foot is expanded by the weight of the body and pack. Because of individual variations in feet, shoes can be properly fitted only by actual personal fitting. The fitting will always be made over wool socks for the service shoe; or, for combat boots, over the sock, cushion sole, or sock, wool, heavy, or two pairs of socks, wool, light. Particular attention will be given to the provision of adequate foot room in the fitting of the footwear referred to in subparagraph a, above. For wear in wet, cold weather, a definite looseness of fit is preferable to a "snug" fit. Fitting may be made by the shoe fitting machine or by hand. In each instance, fitting will be made with the individual bearing full weight.
        (1) Shoe Fitting Machine. When available, the shoe fitting machine will be used in strict accordance with the instructions issued with the machine.
        (2) Fitting without Shoe Fitting Machine. The important consideration in shoe fitting is the provision of adequate length and width. A shoe of proper length will allow a thumb width (3/4") between the end of the great toe and the end of the shoe when the wearer bears full weight. Proper width may be judged by the wearer by a definite feeling of freedom of the foot in the shoe. In addition, a shoe of proper width will allow the fitter to demonstrate a looseness of the leather in front of the instep over the ball of the foot with the shoe laced,


and, with the shoe unlaced, will allow him to insert one of his index fingers under the lower part of the tongue and over the base of the toes.
    c. Care: (1) The uppers will be kept soft and pliable and the shoes as waterproof as possible. Both of these conditions may be maintained by the use of dubbin and polish. Dubbin will be worked into the leather by rubbing and moulding with the fingers. Particular attention will be given to the application of dubbin at the junction of the sole and the upper. The authorized allowance for dubbin, 2 oz cans, is 250 cans per 1,000 men per month.
        (2) Even under ordinary conditions, shoes will become moist on the inside from sweating of the feet and must be allowed to dry out at least once every 24 hours. When two pairs are available, they will be worn on alternate days. When shoes become wet from outside causes such as rain, mud or snow, they will be dried slowly and not exposed to direct heat such as from open fires. In the field, ways for drying must be improvised. Broken up hay or straw, thoroughly dried over a fire and dumped into the shoe, will hasten drying; pebbles may be heated in a can and shaken about in the shoes for the same purpose. If dry paper is available, it may be torn into bits and stuffed into the shoes to absorb moisture. Well heated grain shaken about in the shoes is particularly effective.
    d. Sock: Woolen socks, only, will be worn for marching or field duty. In cold, wet weather, cushion sole socks, or heavy wool socks, or two pairs of light wool socks will be worn (see Par 3a, above) . Darned socks or socks with holes will not be worn on the march since they will cause abrasions or blisters.

4. Care of the Feet. a. General: The feet will be washed and thoroughly dried at least once a day. This is especially important on a march. As soon as possible after reaching camp after a march, the feet will be washed (not soaked) with soap and water, dusted with foot powder, and clean socks and spare shoes will be put on. (Unless the feet are well hardened, foot powder will be applied again in the morning before the march.) The dirty socks will be washed and hung to dry. The shoes worn during the day will be placed where they will have the best opportunity to dry.
     b. Blisters: If blisters appear on the feet, they will be painted with iodine or alcohol and emptied by pricking at the lower edge with a pin, the point of which has been heated in a flame. The skin will not be removed. The blister will then be covered with adhesive tape or a Band-Aid until new skin has formed (2-4 days). The application of foot powder to the edge of the adhesive will prevent its sticking to the sock. Small cuts, scratches, and skinned places will likewise be cleaned with alcohol and covered with adhesive tape or a Band-Aid. Infections, serious cuts, large skinned areas and painful ingrown toe nails will be treated at the dispensary or aid station.

    c. Ingrown: The toenails will be kept short and clean. If they are cut straight across and not on a curve, most of the trouble from ingrown toenails will be avoided.

    d. Athlete's Foot: Athlete's Foot, a fungus infection of the feet, occurs commonly and if neglected may lead to considerable disability. The best methods of prevention are the maintenance of clean, dry feet, and frequent use of foot powder. If the infection does occur, it will be treated at the aid station or dispensary. Socks once contaminated with infecting agent may be a source of reinfection. Laundering in Quartermaster laundries will control this agent, and if this facility is not available, washing in soap and water and thorough sunning (inside and out) for a minimum of an hour each will be quite effective.

    e. Trench Foot: (1) This is a serious condition resulting from the long exposure of the feet to moisture and cold. Extreme cold is not a necessary factor, and conditions may occur at temperatures as high as 50º F. The most important factors are moisture, cold and the lack of activity, such as occurs when standing or sitting for long periods of time. Tight footwear and leggings also contribute to the development of trench foot. Experience in other theaters indicates that a large number of troops may suffer from this condition during


the winter months unless the proper precautions are taken. In one active theater during the cold months, almost one half as many casualties resulted from trench foot as from battle injuries. A large percentage of those affected were unable to do combat duty thereafter.
        (2) In addition to coldness of the feet, the first symptom of trench foot is often a feeling of numbness. There may also be tingling and aching of the feet, toes and ankles. Usually the condition does not cause acute discomfort in the early stages, the most common complaint being that of a feeling of "woodeness of the feet" and difficulty in walking. Swelling follows the other symptoms and the skin becomes white or mottled in appearance. Blisters may develop later. Unless proper care is sought early, serious damage to the feet may be the result.
        (3) The prevention of trench foot is of great importance and consists, mainly, in keeping the feet clean, warm and dry. under bad field conditions in the winter this is hard to do but the constant attention and effort of each individual to the measures outlined below can be very effective:
            (a) Adequate, properly fitted footwear (see Par 3a above) must be worn.
            (b) Do not constrict the lower legs, ankles, or feet by the tight lacing of leggings or shoes.
            (c)Avoid standing in cold water, mud or snow.
            (d)Whenever possible, keep moving when feet are cold and wet. If troops are to be kept in one place, they should mark time at frequent intervals or make frequent vigorous movements of the legs. Check for numbness of the toes by wiggling them frequently.
            (e) Do not sit with feet lower than the buttocks.
            (f)Loosen the shoe laces or buckles at every opportunity and move the feet around in the shoes as much as possible.
            (g) Frequently (once or twice daily) remove leggings, shoes and socks in order to wash, dry and massage the feet, applying foot powder, and, if possible, putting on dry socks. If dry socks are not available, wring out the wet ones thoroughly before replacing.
            (h)Make every effort and use all possible means for drying socks and shoes. (Socks may be dried by wearing them flat under the shirt above the belt when on the march or while sleeping) .
         (i) Do not sleep with the shoes on, if the feet are wet. The feet will warm up faster out of the shoes (they may be wrapped in a piece of cloth or an extra shirt), and the shoes will dry much more readily off than on.
        (4) When trench foot is suspected, the patient will be handled as a non-ambulatory casualty and transported at once to the nearest aid station or dispensary. It is important to remember that the patient will not be allowed to walk and the feet will not be massaged or warmed. All constricting footwear and leggings will be removed, and the feet kept cool and elevated above the rest of the body. Failure to comply with these simple first aid procedures may lead to serious disability and possible less of feet.
5. Inspection of Feet and Footwear: Each unit commander will inspect the feet and footwear of each individual in his unit at regular intervals (at least twice monthly) and, if possible, before a march which is to be of more than two hours duration. At these inspections, close attention will be given to the adequacy and condition of the footwear of each individual. The feet will be examined for the presence of blisters and reddened areas, corns, callouses, and other evidence of improperly fitted or poorly repaired shoes or socks and for improperly trimmed or ingrowing toenails. Deficiencies found on inspections will be corrected immediately so that each man will, at all times, have his feet in the best possible condition and adequate well-fitted footwear in his possession.
6. Instructions: Each unit commander will provide complete detailed instructions in foot care and hygiene to all enlisted personnel of his command. This instruction must be continuous and its application by the individual soldier checked at frequent intervals. This


directive, or pertinent extracts therefrom, will be posted in each unit for the information of the enlisted personnel. Supplementary information and source material for instruction may be found in these publications:
    a. AR 40-205; AR 856-125; FM 8-40; FM 21-10; and FM 21-100.
    b. Sec IV, Cir 312, WD, 22 Jul 1944.
    (AG 727.3 PubGD)

By Command of General EISENHOWER :
Brigadier General, GSC, Deputy Chief of Staff.

Brigadier General, USA, Adjutant General