Contents

Preface

    Cold injury as it affects large numbers of men is primarily a form of wartime trauma. The history of all military campaigns conducted in winter, both in temperate and in cold climates, reveals crippling losses from this cause. Between wars, the staggering cost of cold trauma in time of war is almost entirely forgotten.        

    The British losses in World War I and the costly experiences of United States forces in Europe in World War II (as well as, more recently, in Korea) make it imperative that the knowledge so painfully gained shall not again be forgotten. It is imperative that all of this knowledge be preserved. It is particularly imperative that the principles of prevention of cold injury become a part of peacetime military training and planning.
      
    This volume has three purposes:

    1. To record the history of cold injury, ground type, in World War II.

    2. To summarize what has been learned of the nature of this form of trauma, including its pathologic physiology, its epidemiology, its military cost, and its management, including the rehabilitation of casualties from this cause.
     
    3.To formulate, from the materials of the past history of cold injury, the principles of a sound program for its prevention and control in future military operations in cold regions and in temperate regions during cold weather.
     
    It is hoped that by concentration on the broad scope of the problem and on its multiple phases, including its epidemiology, research may be stimulated which will result in more positive and more effective methods and practices for preventing, controlling, and treating this important variety of environmental injury.
       
    This history of cold injury in World War II began as two independent projects. One volume was intended as a part of the surgical series and the other as a part of the preventive medicine series of the history of the Medical Department of the United States Army in World War II. It soon became apparent that the interests of a comprehensive, concise, and useful history would best be served by a joint effort. Happily, the data already assembled independently could be readily amalgamated, and the combination suggested fruitful avenues for further study of the historical files and the medical materials of World War II.

    Statistics used in the tables and text of this volume were personally collected by the authors or their collaborators or were based on preliminary summary unit reports. The Medical Statistics Division, Office of the Surgeon General, has reviewed and, where possible, has verified all statistical data and furnished more complete data based on sample tabulations of individual medical records.

    For statistical purposes, trenchfoot and frostbite are not always separated in Army reports. Clinically, they are often indistinguishable. Practically, it would have been better if no attempt had been made to differentiate them. Generally speaking, whatever is said about one in the following pages may be regarded as equally applicable to the other unless specific exception is made. Similarly, whatever is said about cold injuries of the feet may be regarded as equally applicable to cold injuries of the hands, which, as a practical consideration, are affected in only a very small proportion of the injuries of this type.

TOM F. WHAYNE,
Colonel, MC, USA (Ret.).

MICHAEL E. DEBAKEY, M. D.