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Chapter IV



Maintenance and Repair Parts


Although medical equipment maintenance in the Army came into being with acquisition of the first technical instrument, it did not gain the status of an organized program until World War II when the influx of technical equipment into the supply system became a flood. Each incoming wave of more varied and complex equipment imposed problems and maintenance requirements which surpassed the existing or planned capability of the Medical Department.

Medical Maintenance in Hospitals

Medical installations and activities before World War II were virtually autonomous from a medical equipment maintenance viewpoint. Some central direction and guidance were provided, mainly in the form of monitoring and approving expenditures for commercial contract maintenance, or procuring and installing new equipment. Station maintenance, however, was generally left to the discretion of the post surgeon.

In the typical post or station hospital of 1939-40, medical maintenance was a function of medical supply, but there was no medical maintenance shop in the supply organization. On-post ordnance, engineer, and signal shops were used to perform most common maintenance chores. This encompassed repairing or replacing valves, thermostats, and gaskets on sterilizers; repairing or overhauling small electric motors; overhauling motor armatures; repairing heat lamps and other physiotherapy electromechanical apparatus.

Repair of such highly technical items of equipment as X-ray, electrocardiograph, and other machines was accomplished either on manufacturer's guarantee contract or by separate service call of the manufacturer's representatives. Hospitals located in large metropolitan areas enjoyed particular advantages in satisfying this aspect of the maintenance requirement. Because of the delicate nature of the machinery then in use, frequent repair and adjustment were necessary.

This organization was, for the most part, satisfactory for types of maintenance described. There was a decided gap, however, in the support structure involving the area falling between those simple maintenance operations that the user might perform for himself and those amenable to common shopwork. Included were such chores as replacing knobs and gages on sterilizers, replacing elements in heat lamps, replacing sockets and plugs on bedlamps, replacing knobs on bedside tables, and a host of other tasks outside the area of user


maintenance, but not sufficiently technical to arouse a ready response from the post shops or manufacturers' maintenance facilities. The medical supply activities in prewar Army hospitals solved this problem in various and sundry ways. At Fort Banks, Mass., for example, a handyman was assigned to the medical supply activity. If nothing else, the handyman could determine which items required the more skilled services of the post shops or manufacturers' facilities. He could also do many jobs that required nothing more than a screwdriver, a wrench, or a pair of pliers.

Thus, the medical maintenance problem was kept within manageable limits. User maintenance was not identified, defined, or promoted; it was practiced only when the individual user was motivated to do so by his superiors. Preventive maintenance was not part of the structure. Even the handyman, although perhaps serving the purpose of preventive maintenance to a limited extent, was not utilized with this object in mind.

As war approached, maintenance problems were swiftly inflated. The draft took its toll of commercial medical equipment servicemen while existing medical installations were expanding and new ones were being rapidly established across the country. Pending a centralized program complemented by a source of trained medical repairmen, each medical installation continued largely on its own to establish and expand shop capabilities, staffing and equipping from local resources. Because of the paucity of medical supplies and equipment during 1942, many hospital commanders pointed with pride to their maintenance programs. These programs often included replating and resharpening surgical instruments, sharpening dental burs, and repairing and maintaining equipment. A substantial portion of the program was being effected within the hospital medical supply operation. The ability to accomplish it depended upon the presence of skilled personnel. Otherwise, it was accomplished under local contracts.

Development of the Maintenance Shop

The location of major medical equipment repair facilities in selected supply depots was a natural development that facilitated serving maintenance needs of Army hospitals. Such a shop was located at the New York Zone Intermediate Depot at the close of World War I. Concern was expressed over who was to control the repair facility. In response to an inquiry on the matter, The Surgeon General, in a letter to The Quartermaster General on 11 July 1919, wrote, "It is believed to be better policy (than having another service like Quartermaster or Ordnance responsible) to have a central repair establishment in the Medical Department to which surgical instruments and delicate laboratory equipment can be sent for repairs."1

Amidst this uncertainty of control, the procedure was established that all repair and return requests from military infirmaries and hospitals would be

1Letter. The Surgeon General to Chief, Storage and Issue Branch, Storage and Traffic Division [Office of The Quartermaster General] (attention: Col. R. B. McBride), 11 July 1919, subject: Repair and Salvage of Equipment.


processed through the Surgeon General's Office and, in turn, through the Quartermaster General's Office before action by the repair facility of the New York Depot. About this time (the early 1920's), officers on field visits reported observing "deplorable conditions" insofar as hospital furniture and equipment were concerned. These combined factors undoubtedly influenced the decision to establish a maintenance shop at the St. Louis Medical Depot, St. Louis, Mo., under control of The Surgeon General.

The St. Louis shop was established in July 1922 on one floor of a building on the old Arsenal Reservation. Both wooden and metal equipment were repaired, and by the shop's fourth year of operation, the value of processed equipment totaled about $14,000 yearly. Although significant at the time, this approximated the value of one 200-ma. X-ray unit processed in the shop during World War II.

Personnel of the Civilian Conservation Corps and the Public Works Administration were added to the shop in 1938. By January 1942, the facility had been moved to what was known as the Indian Warehouse in the business district of St. Louis and had a staff of 26 persons.

Program and Organization

By the end of 1942, the need for an organized maintenance program for the Medical Department was becoming increasingly evident. Creation of a program virtually overnight was not looked upon by anyone as an easy task. Nevertheless, in April 1943, following the lead of the ASF (Army Service Forces), The Surgeon General promulgated a policy concerning maintenance of medical equipment overseas.2 Sixteen end items originally had been envisioned as constituting the range of equipment requiring such support, although the actual need turned out to be several times that number.

The maintenance plan followed a definite outline. Spare parts would be purchased in the United States and stored in the medical section of the Columbus Quartermaster Depot, Columbus, Ohio, where the initial issue for overseas would originate. Manuals indicating the use of spare parts and the methods by which these parts should be replaced would be compiled and used in a program of training enlisted repairmen who would be assigned to tactical medical depots upon graduation. In overseas areas, tools and spare parts would be furnished to effect proper maintenance and repair of end items. These parts would be requisitioned as required from depot installations, and repairmen would be ordered to technical installations in the combat zone. Certain items worthy of repair yet beyond the capability of local facilities would be returned through reverse supply channels to medical depots for replace-

2(1) Memorandum, Lt. Col. C. G. Gruber, SnC, to Acting Director, Distribution and Requirements Division, 1 June 1944, subject: Annual Report for Fiscal Year 1944, Maintenance Branch. (2) Memorandum, Col. S. B. Hays, MC, Director, Distribution and Requirements Division, to Mr. [Edward] Reynolds, 26 Jan. 1944, subject: Distribution and Requirements Division, Supply Service, Fiscal Year 1944.


ment or repairs as indicated, and unrepairable items of a critical nature would be returned to the Zone of Interior for reclamation.

By early 1943, the Commanding General, ASF, had established a Maintenance Branch, and maintenance first emerged as an organizational entity within the Surgeon General's Office.3 A new organization chart titled the element "Maintenance (Repair) Branch" and placed it alongside the Storage, Requirements, Issue, and Stock Control Branches, all within the Distribution and Requirements Division of the Supply Service. According to the chart, the new branch supervised "the maintenance and repair of medical equipment including the operation of repair shops under the jurisdiction of The Surgeon General" and prepared "spare parts and repair manuals." Maj. (later Lt. Col.) Louis F. Williams, PhC, was designated to serve as the first chief of the Maintenance Branch. Also, early in the medical maintenance program, Lt. Col. Charles Baumann, SnC, was assigned on temporary duty to the Maintenance Division, ASF, to effect liaison on the implementation of policies affecting medical equipment maintenance.

Following several minor organizational changes made to cope with the expanding medical maintenance activities, the Maintenance Branch was shifted on 26 July 1944 to the newly organized Storage and Maintenance Division, Supply Service, of the Surgeon General's Office. The Maintenance Branch was responsible for maintenance and repair of Medical Department equipment, including supervision of the operation of repair shops under the jurisdiction of The Surgeon General; and for preparation of spare parts lists, technical manuals, supply bulletins, and other publications relative to maintenance.4

At its peak in mid-1945, the Maintenance Branch had 3 officers and 8 civilians in the Surgeon General's Office, 14 officers and 16 civilians in the St. Louis field office, and 1 officer and 1 civilian in the New York field office. In late 1945, the Washington, D. C., and St. Louis elements of the Maintenance Branch were merged in St. Louis and allocated 7 officers and 10 civilians, with supervision of these activities being retained by the Chief of the Supply Service.

This organization continued until its functions either were gradually dissolved in postwar reorganization or were merged into other staff and operational elements, particularly into the Medical Technical Maintenance Division of the joint Army-Navy Medical Procurement Office.


Success of the Medical Department maintenance program hinged on the availability of adequately trained personnel. The most demanding duty that faced Capt. Thomas P. Dunn, MAC, when he assumed directorship of the

3Organization Chart, Office of The Surgeon General (Distribution and Requirements Division), 11 June 1943.
4Annual Report, Storage and Maintenance Division, OTSG, fiscal year 1945.


Maintenance Shop, St. Louis Medical Depot, in 1943, was probably that of training a staff. Equipment technology had outdistanced the training and experience of shop personnel. Thinking first centered around using the facilities of medical equipment manufacturers to satisfy training requirements. This may have started out as a valid consideration, but it was soon doomed as impracticable. Early in 1942, quotas were obtained to place 20 enlisted men with Ritter Dental Manufacturing Co., Inc., Rochester, N. Y., for 2 weeks, but this was too limited for Medical Department needs. Factories had not the capacity, the organization, or the understanding of the Army's great variety of requirements to meet the task. Equipment density of any one manufacturer's products, at any one location in the Army, was so small that the military could ill afford to have a so-called "factory trained man" for each make of equipment in any given hospital, or supporting depot shop. Moreover, to attempt to train military personnel in selected factories in a roundrobin-type affair would have been costly, inconsistent, ineffective, and particularly time-consuming when time, most of all, was of the essence.

During the war, hospitals were equipped more extensively, and medical equipment became more complex and often of poorer quality. This poorer quality was attributed to scarcity of critical raw materials and to waivers on specifications to expedite delivery of items during the early days. These factors imposed increased maintenance demands at a time when commercial maintenance service was dwindling because of the selective service impact.

Personnel Requirements

Medical equipment manufacturers were extremely cooperative and willing to assist The Surgeon General in any way possible to establish an effective maintenance training facility. In addition to establishing courses in dental equipment maintenance, which were attended by military personnel in late 1941 and early 1942, various manufacturers furnished suggestions and advice regarding technical aspects of their particular line of equipment. Moreover, they gratuitously assigned qualified personnel from their sales and service organizations to act as civilian instructors.

The real seed was planted on 10 January 1942, when The Surgeon General authorized a 3-month maintenance training course and requested The Adjutant General to publish quotas for a school to be conducted at the St. Louis Medical Depot.5 A quota was established of 14 students each for classes starting on 16 February, 18 May, and 17 August. Quotas were oversubscribed, and the class began with 24 students from the Corps Areas, the Army Air Forces, and War Department overhead personnel.

Opening the first class did not by any means signal full establishment of the school. Manufacturers' representatives, acting as instructors, taught sub-

5(1) Memorandum, Lt. Col. F. C. Tyng, MC, to Commanding Officer, St. Louis Medical Depot, 10 Jan. 1942, subject: Training of Enlisted Maintenance Men. (2) Annual Report, Medical Supply Services School, St. Louis Medical Depot, fiscal year 1943.


jects pertaining to items manufactured by their firms. Textbooks were lacking and available instructional aids, in many instances, were the personal property of factory representatives. Nevertheless, during these early days of maintenance training, visiting Medical Department officers and the Deputy Director of Training, ASF, impressed with the program and its essentiality, made favorable reports upon their return to Washington. In August 1942, the school was established on a permanent basis. Mr. John J. Russell, who as a civilian instructor from one of the manufacturers had participated in the X-ray phase of training, was commissioned Captain, MAC, and assigned to direct the training operation.

Maintenance and Repair Course

Factory-furnished instructors with generally good practical backgrounds had filled an immediate need, but a permanent staff of officer-instructors, some with engineering training, was required. All needed the "field viewpoint" as well as training in "how to teach" for few had had previous field or training experience. The problem was solved by commissioning five factory-loaned teachers, who, together with noncommissioned officers and enlisted men retained from the graduating classes, formed the nucleus of the school staff, which was eventually rounded out to an academically balanced faculty in 1943 (fig. 23).

Since no existing textbook covered the range of equipment in the training curriculum, the staff had to compile texts. To compress time to a minimum, various manufacturers were asked to furnish data on their respective items. The response was generally magnificent, and the information was compiled and printed locally in a three-volume series.

High school graduation was the primary announced prerequisite, and completion of training or substantial experience in X-ray technicianship became a sought for, but infrequently obtained, prerequisite. Information on the quotas for the course was made available to service commands and medical replacement training centers. Limited-service personnel were included in training quotas to replace general-service personnel on duty in fixed installations. Except those attending from medical replacement training centers on an unassigned basis, graduates were usually returned to their stations upon completion of the course. All other graduates were assigned to priority vacancies.

Upon graduation, each man was to receive a complete tool kit (fig. 24), which had been carefully designed for use in the field. Until these were ready, an ordnance ignition mechanics' kit was used as an interim item. Even after the prescribed kit became available, the supply was limited, and procurement difficulties on components necessitated sending the item to the graduate's duty station after he completed the course. Some kits never caught up with the men. Ultimately, to effect distribution where the planned system had failed and to compensate for it in transit losses, requisitions, based on the number of course graduates who had arrived without kits, were honored.


FIGURE 23.-Familiarization of students with 30-ma. Army field X-ray unit.

With continued technological developments, including more complicated circuitry and an increasing range of equipment in the supply system, the desirability of lengthening the course soon came under study. For the time being, however, The Surgeon General chose to stress quantity rather than quality to meet, to some degree, the growing need for maintenance in the field. He recommended, accordingly, that the school be enlarged to permit the training of 300 enlisted students at one time.6 ASF approval was granted on 4 May 1943, but less than a month later, following an inspection by the Director of Training in the Surgeon General's Office, the need for lengthening the course was reconsidered. A short time later, the course was reprogramed on a 16-week schedule, which included a staggered class input at 9-week intervals.7

6(1) AG Memorandum No. W615-37-43, 6 Apr. 1943, subject: Training of Enlisted Technicians at St. Louis Medical Depot. (2) Memorandum, Col. F. B. Wakeman, MC, to Director of Training, ASF, 23 Apr. 1943, subject: Expansion of School Facilities.
7Memorandum, Col. F. B. Wakeman, MC, Director, Training Division, for The Surgeon General, 28 June 1943, subject: Training Inspection of the Medical Supply Services School (Class IV), Medical Supply Depot, St. Louis, Missouri, and 2d indorsement thereto.


FIGURE 24.-Medical Department maintenance and repair tool kit.

About the same time, all courses at the St. Louis Medical Depot were grouped under one head, and the Maintenance and Repair Course became identified as part of the Medical Supply Services School. Better organization and administration resulted from this consolidation. Meanwhile, the original teaching equipment, some of which had been obtained on a special fund allocation and some from the field and classified as unfit for further use, was supplemented from depot stock to meet the expanded student loads.

An unanticipated requirement soon canceled the gain in curriculum time. In July 1943, ASF Headquarters directed that standards of military training and physical conditioning be sustained at all schools. The seventh class, starting on 10 August 1943, accordingly gave up much of its lengthened time to courses in basic military training and physical reconditioning.8

Officer Training

Faced with a conspicuous absence of technical know-how at the officer level, The Surgeon General in August 1943 directed that a class of 10 Medical

8Memorandum, Maj. N. R. Walker, AGD, Assistant Executive Officer, Military Training Division, ASF, to Chiefs of Services, 6 July 1943, subject: Concurrent Basic Military Training and Physical Conditioning in Army Service Forces Schools.


Administrative Corps second lieutenants be selected to attend the Maintenance and Repair Course. Officers, upon graduation, were assigned to MOS (military occupational specialty) 4890, Medical Equipment Maintenance Officer, and, for the most part, filled assignments in the Surgeon General's Office, staffed depot shops and liaison billets, and eventually were deployed overseas with field medical depots. Some few went directly to medical sections of theater headquarters or to other special-type assignments.

In the meantime, before the 10 officers graduated from the course, an additional 5 officers with some previous training as equipment servicemen in civilian life were assigned as medical equipment maintenance officers to the medical depots at Chicago, Ill., and St. Louis, and to the medical sections of the ASF depots at San Antonio, Tex., Savannah, Ga., and Seattle, Wash. Until officers could be made available through graduation from the course, these five officers constituted the complement of medical equipment maintenance officers in the field. Their duties included liaison with posts, camps, and stations; inspection trips; and coordination with the medical supply officers at hospitals.

With few exceptions, one common phenomenon characterized medical equipment maintenance officers. Because of the extreme shortage of enlisted maintenance personnel and of the prevailing concept of using officers as troubleshooting equipment servicemen on a regional basis, they were generally seen in fatigue uniforms inspecting, installing, repairing, or dismantling items. Commanding officers and other executives usually considered them technicians rather than supervisory directors, as compared with other officers assigned to more "dignified," although none to more important, duties.

By the end of 1943, 360 students had been enrolled for maintenance training: 210 had been graduated, 42 had failed academically, and 108 were still in training. By the end of the following year, 830 enlisted men and 56 officers had been graduated.9 Equipped with the necessary know-how and tools, an excellent esprit de corps was evidenced among maintenance school graduates. Letters and other reports from alumni stationed in practically every area of the world usually carried some technical message relating to the maintenance situation. This information was carefully analyzed by the staff, and class schedules were revised to stress the most commonly noted phenomena. Such correspondence was encouraged by the course director, who advised graduating students of the continuing availability of the faculty to assist by correspondence when unusually perplexing service problems were encountered or when the graduate experienced any apprehension about a task at hand.

9(1) History of the St. Louis Medical Depot, 7 Dec. 1942-7 Dec. 1943. (2) A Summary of the Training of Army Service Forces Medical Department Personnel, 1 July 1939-31 December 1944. [Official record.] (3) History of Maintenance of Medical Department Equipment, 14 Feb. 1946 [official record], gives 835 enlisted through 5 January 1945, and 98 officers through 29 December 1945.



The sudden growth in station maintenance requirements while commercial support was dwindling is explained in part by the 65 percent increase in number of station and general hospitals from July 1940 to July 1941. More concretely still, in the 15 months between September 1940 and December 1941, the number of normal beds in Zone of Interior general hospitals increased from 4,925 to 15,533, and in station hospitals from 7,391 to 58,736.10 Concurrently, medical technical items began to spread around the world. It is of little wonder that existing facilities, civilian or military, could not cope with the staggering requirements for technical medical equipment installation and maintenance.

The maintenance training program was oriented to the performance of maintenance and repair in hospitals, of both the fixed and the mobile types. Despite any backlog of items at depot shops, or the urgency of issue requirements, maintenance at the using level was of paramount and transcending importance. It was there that patients' lives could be directly jeopardized by inadequate maintenance.

Combined technical services maintenance shops being established at most stations were of little benefit to hospital commanders for anything other than maintenance of nonmedical hospital equipment. Except for the X-ray technicians' course where relatively good operator maintenance was emphasized, equipment servicing techniques were generally absent from courses for enlisted technician operators.

During the war, medical maintenance support of the operating units was derived from three sources: that inherent in the unit, in the shop, and from commercial resources. With commercial capability diminishing in the face of bounding requirements, The Surgeon General had no alternative but to become self-sustaining in the field of medical maintenance. Units were directed to make repairs within the scope of their assigned capability and local resources and to effect other repairs by shipping items to designated depot shops. In an emergency, the depot was notified, and either a replacement item was furnished immediately or depot maintenance personnel were dispatched to the unit for on-the-spot repair. The latter alternative was used more extensively as trained shop personnel became more plentiful. Scheduled periodic visits to units also proved beneficial by providing preventive maintenance as well as timely repairs, but most of these refinements became full-fledged only toward the close of the war.

Because of their complexity, items such as X-ray tubes, X-ray tube inserts, stopwatches, microscope objectives and oculars, certain electrical instruments and meters were keyed to the St. Louis Medical Depot for replacement and repair. These instructions were applicable to overseas commands only for

10Smith, Clarence McKittrick: The Medical Department. Hospitalization and Evacuation, Zone of Interior. U.S. Army in World War II. The Technical Services. Washington: U.S. Government Printing Office, 1956, p. 24.


X-ray tubes. Where required repairs were beyond the capabilities or economical use of depot facilities, the items were shipped to the manufacturer for repair.

As maintenance requirements mounted, this total system of handling repairs and returns evolved. To illustrate, until exacting instructions were well disseminated, confusion and delay attended the repair and return method because shipping units would often fail to identify the item as "repair and return" or to indicate its defect. As a result, the item would be processed erroneously as an excess return and then placed in depot stock. Also, improper packaging resulted in breakage in transit, with resultant problems regarding responsibility occurring.


Some confusion existed as to the maintenance responsibility for items, such as electric fans and typewriters, which were not exclusively stocked by the Medical Department. On 12 May 1943, ASF assigned the maintenance of certain Medical Department items to Ordnance, Quartermaster, Engineer, and Signal Corps under provisions of a previously published ASF memorandum.11 However, on 28 July 1943, following protests from the Surgeon General's Office, Army Service Forces withdrew the designations indicating that "no specific Medical Department equipment will be assigned to other technical services for maintenance" but that "the Medical Department, as required, could obtain services needed and available from the shops of the respective technical services" in accordance with the latest edition of the basic maintenance manual. Final disposition and replacement, in any event, would be through depot channels.

War Department Supply Bulletin 38-1-8, dated 13 May 1944, "Repair of Critical and Nonessential Items," became the "Bible" for fifth echelon repair shops in directing, from an inventory control standpoint, what to repair and what not to repair. Additionally, machine listings were compiled monthly by the Inventory Control Branch and furnished to fifth echelon repair shops.12 Items indicated as being in short supply were given priority in shop processing as were items received from stations for "repair and return." Also, as the medical stock position improved and the backlog of maintenance requirements pyramided, the Supply Service directed that cost of repairs for the listed items would not exceed 50 percent of the value of the item after it was repaired.

11(1) ASF Memorandum S850-23-43, 5 Apr. 1943, subject: Maintenance of Army Equipment. (2) War Department Technical Manual TM38-250, August 1943, Basic Maintenance Manual.
12Maintenance categories were defined as follows: First echelon, that degree of maintenance prescribed and performed by the user or operator of the equipment; second echelon, that degree of maintenance performed by specially trained personnel in the using organization beyond the capabilities and facilities of the first echelon; third echelon, that degree of maintenance prescribed and performed by specially trained personnel in direct support of using organizations; fourth echelon, that degree of maintenance performed by units organized as semifixed or permanent shops to serve lower echelons; fifth echelon, that degree of maintenance authorized for rebuilding major items, assemblies, parts, accessories, tools, and test equipment, usually located at a depot.


FIGURE 25.-Section of fifth echelon repair shop after relocating in Building No. 18 on the Arsenal Reservation, St. Louis, Mo.

The first formal maintenance report submitted by the St. Louis shop on 1 February 1943 indicated that equipment valued at $34,465 had been repaired and returned to the supply system in 1 month. This was about 30 times the production rate of the prewar shop. Techniques of repair which steadily improved processing time and standards were instituted. Production reached a point at which equipment worth almost $5 million was being repaired and returned to the medical supply system in a single year.

Meanwhile, because of crowded conditions and the need to place the shop in proximity to the maintenance and repair school, the decision was made in July 1943 to relocate the shop from the Indian Warehouse to Building No. 18 on the St. Louis Arsenal Reservation. By September, the move was completed. The activity operated first as the Maintenance Division repair shop and later (February 1945) as the fifth echelon repair shop, St. Louis Medical Depot (fig. 25).

As a flourishing repair activity, the shop employed 124 civilians and was administratively organized into branches and sections to delineate functional responsibilities and to facilitate equipment processing and internal coordina-


FIGURE 26.-X-ray and electrical shop in 1945 when the shop was located in Building No. 36 on the Arsenal Reservation, St. Louis, Mo.

tion. Rapidly filling its 125,000 square feet of floor space, the shop expanded beyond the physical limitations of its facilities within 2 years. In the fall of 1945, it was relocated in modern, spacious quarters on the fifth floor of the same building (fig. 26) in which two men with a handful of tools had begun to repair medical equipment in 1922.

In January 1945, a fifth echelon repair shop was opened at the Denver Medical Depot, Denver, Colo., but it was short lived. In its only full year of operation, 1945, the Denver shop, in addition to a vigorous station liaison program, repaired items with a dollar value of $1,664,816, thus relieving the St. Louis shop of a tremendous load. During the planning stages of the Denver shop, serious consideration was given to opening shops at other Zone of Interior depot locations, although it was generally accepted that the St. Louis facility could handle any foreseeable additional load.13

In any event, the time was right for a reappraisal, if one were to be made at all, in terms of a small-scale shop that had been organized at the Bingham-

13(1) Annual Report, Denver Medical Depot, 1945. (2) Memorandum, Lt. Col. R. L. Black, MSC, Director, Storage and Maintenance Division, OTSG, to Col. [Edward] Reynolds, 19 Aug. 1944, subject: Medical Department Repair Shop-St. Louis Medical Depot.


ton Medical Depot, Binghamton, N.Y., in January 1944. The problem was whether a facility, essentially the duplicate of the St. Louis shop, should blossom from the small Binghamton establishment. After further study and coordination, it was decided that the Binghamton shop should remain relatively small, and a similarly small shop should be established at the San Francisco Medical Depot, San Francisco, Calif. These two shops were phased in slowly; not until fall 1946, when some equipment was transferred from the shop then being dissolved at Denver, did they finally become fully operative. Another small shop, equipped to repair only field items and assemblage components, was established in June 1945 at the Louisville Medical Depot, Louisville, Ky. From August until the end of the year, this shop repaired more than 10,000 items valued at almost $100,000.14


From the very beginning of the emergency period before World War II, spare parts-or rather, the lack of them-had plagued the maintenance program. Spare parts were regarded by some as strictly a supply problem, by others as a maintenance responsibility, with no one taking a strong position either way. In time, a semblance of a spare parts catalog emerged, and the spare parts themselves became relatively abundant, but not until relatively late in the war.

By the end of 1942, the need for spare parts was becoming more evident to The Surgeon General. In January 1943, preliminary estimates indicated that more than 200 types of medical end items were in use in theaters of operations which should have spare parts support. By March 1943, most essentials of a spare parts program were under consideration in the Surgeon General's Office.

On 5 May 1943, an Army spare parts policy was announced by The Adjutant General.15 The policy provided that end items intended for use overseas would include specified "high mortality" parts packaged with each item, together with the concurrent procurement of 1 year's supply of spare parts, plus an additional procurement where availability would not otherwise be assured of parts for the expected life of the equipment. At least 6 months' supply of spare parts was to be shipped with the equipment. The remainder was to be requisitioned on the basis of usage rather than that of anticipated failures. Packaging was to be stressed to insure safe arrival at destination and to prevent deterioration from climatic conditions.

These were logical and well-conceived policy objectives, but they never fully materialized. Again, although this decision probably did more to foster spare parts support than any other single factor, it was too late in coming for optimum benefit in the war. Too much equipment was already in the system and too much slack had to be taken up from the 3 years of equipment influx

14See footnote 9(3), p. 109.
15AG Memorandum No. W700-23-43, 5 May 1943, subject: Procurement and Oversea Distribution of Spare Parts for Medical Equipment.


which had passed with inadequate spare parts support. Nevertheless, to make these policies effective for the time remaining, the machinery had to be put together and set into motion.

To assist in developing this portion of the growing maintenance program, Capt. (later Maj.) Eric A. Storz, MAC, was ordered to Washington on temporary duty from the Kansas City Medical Depot, Kansas City, Kans., on 17 June 1943. Numerous conferences were held, trips were made to the Army Medical Purchasing Office in New York, N. Y., for coordination, and, as a result, the Supply Service of the Surgeon General's Office issued Memorandum No. 8 on 25 May 1943. This directive focused attention of the spare parts aspects of the plan and delineated internal functional responsibilities.

By autumn 1943, planning for the maintenance program was well underway. Much had been accomplished in coordination with the Army Service Forces and the Government Printing Office as well as with other staff elements of the Surgeon General's Office, all of which inevitably became involved in the printing of any maintenance and spare parts publications. It soon became apparent that the equipment analysis essential to determining spare parts requirements could not be effected without direct access to the particular equipment involved. Thus, in September 1943, Captain Storz was ordered to St. Louis to set up the spare parts and manual program directly under The Surgeon General as well as to monitor the establishment and designation of the fifth echelon repair shops under the St. Louis Medical Depot.

Locating the maintenance publications and spare parts group at the depots adjacent to the shop and school proved to be an ideal arrangement. The school used shop facilities for some practical training, and instructors of the school were available to facilitate training of the initial shop personnel.

Assigned as a Maintenance Branch responsibility first and fundamentally was the task of reviewing Medical Department end items to identify, describe, and list the spare parts which should be cataloged in support of each item requiring maintenance in the field. Included in the program were development and revision of spare parts lists, determination of initial requirements, and establishment of distribution schedules. Primary emphasis was naturally placed on end items subject to overseas shipment.

By the time the spare parts program really got underway, an ASF catalog had been established.16 Relating this new publication to the medical spare parts program, it was decided that the MED (Medical Supply) 7 section (organizational and higher echelon spare parts) would be issued as a series of pamphlets listing spare parts, replacement parts, special tools, and accessories, requiring frequent replacement. Further, it was desired that no publication would be made under the MED 8 section (higher echelon spare parts) since MED 7 would contain information adequate for the Medical Department. MED 9 section (list of all parts) would consist of a series of pamphlets listing all component parts of the end items. This concept contemplated that all spare

16ASF Circular No. 121, 17 Nov. 1943, subject: Establishment of Army Service Forces Catalogs.


parts listed in MED 7 would be stocked. Seldom used and not normally stocked spare parts, plus those included in MED 7, would be contained in MED 9.

Work previously done in preparation for spare parts cataloging was thus integrated into the MED 7 program. By November 1944, some 1,600 separate parts had been identified, and it was expected that the figure would reach nearly 4,000 when the MED 7 program was completed.

By V-J Day when publication of such documents ceased, 54 MED 7 pamphlets covering 64 end items had been prepared, of which 41 had been published and distributed. Some seven additional pamphlets were in various stages of development. No MED 9's had been published although some had been developed. To make optimum use of the work that had been done on these suspended pamphlets, The Surgeon General permitted the data to be mimeographed and issued on an informal basis as the "Spare Parts and Tool Listing."

Near the end of the war, the President's Committee on Commodity Cataloging17 reported its findings. One major proposal was that commodity classification criteria and a uniform numbering system be adopted with central monitorship. Meanwhile, a joint medical spare parts catalog with a unique joint parts numbering system was already under active consideration by the Surgeons General of the Army and the Navy. Actually, this effort was actively implemented before final determination of action on the proposals of the President's committee. Thus, the World War II MED 7 spare parts program and the joint Army-Navy effort immediately following became springboards from which to derive a new and better postwar medical spare parts cataloging system under the auspices of the Army-Navy Medical Procurement Office.

As a corollary to the spare parts effort, certain other maintenance publications were required to promulgate technical instructions and other maintenance data to the field. A project was established to publish technical manuals covering operational aspects and maintenance requirements at the several echelons for selected technical medical items. By V-J Day, 39 such manuals had been published, and several others were in process of development. Other type publications used for dissemination of maintenance data included modification work orders, lubrication orders, supply bulletins, technical bulletins, Surgeon General's Office code letters, and port medical supply information letters. The last two items were Surgeon General administrative directives, which would be quickly published and which were convenient to distribute.

To overcome the negative pressure existing in the spare parts supply pipeline, automatic supply was carried out according to allowance lists prepared by the Maintenance Branch. As fast as procurement could be effected and delivery realized, action was initiated to distribute the initial allowance of spare parts to the several active theaters of operations. Approximately 60

17Established on 18 January 1945 by letter from President Franklin D. Roosevelt to Hon. Harold D. Smith, Director, Bureau of the Budget, requesting development of a U.S. standard commodity catalog.


percent of the total purchase quantities were distributed according to this scheme.

Early in the spare parts planning period, it appeared that some distinct advantages would accrue if certain spare parts were grouped and identified collectively for procurement, storage, and issue. As an example, a small assemblage of spare parts for gasoline stoves and burners was cataloged as a "kit." Such kits, normally issued with the end item for which they were designed, constituted the initial issue of high mortality spares. Kits were also available for replacement issue to the field.

Use of the kit concept for appropriate spare parts groupings had the advantage of identifying several related spare parts under a single stock number, thus facilitating recognition and handling at all levels. While kits had considerable merit, this usage admittedly resulted in some degree of waste. Often the assortment of parts in the kit did not represent a balanced supply, and one or two parts would become depleted leaving others unused. When individual parts were not readily available for issue, as was often the case, new kits were requisitioned merely to obtain the one or two needed components. This imbalance, continually corrected with experience, did not invalidate the wisdom of the kit concept for the supply of selected spare parts.

As experience with the spare parts program grew, packaging of parts became increasingly important, and attention was focused on this problem by the Army Medical Purchasing Office. Not only was packaging the critical consideration relating to protection of spare parts during storage and shipment, but it served as the primary means of identification. Faulty packaging, including illegible or poor markings by the manufacturer, was experienced. It was not until early 1945 that the Army Medical Purchasing Office could report that processing, packing, and marking problems had been worked out with the various contractors, and that spare parts were being delivered according to specifications.


Proponents, planners, and others responsible for the maintenance program did not have to wait long for comments from the field. Informal reports, received by almost all conceivable means-personal contacts, telephone, personal letters, word of mouth, and informal visits-indicated more clearly than formal reports could do that the program was effective and had gained enthusiastic acceptance at all levels of Medical Department activity. The only noteworthy complaints concerned shortages of trained maintenance personnel, lack of spare parts and spare parts information, and the need for more technical publications.

The training course output never seemed to meet the demands of the field for technical personnel, and inevitably some course graduates were misassigned. Zone of Interior hospital staffs were, at first, hesitant about utilizing Army-trained enlisted men to service and repair expensive and elaborate


diagnostic and therapeutic equipment. At the outset, the fatigue uniform worn by the military repairman did not instill the same degree of confidence as did the coveralls or shop coat of a commercial representative with the name of a prominent equipment manufacturer emblazoned across the back. Similar complaints, however, were not voiced by professional and other supervisory personnel of medical units deployed in combat support operations. For them, the Army-trained maintenance personnel were vital to the success of their missions. As they became accepted, demands for course graduates steadily increased, thus compounding the shortage which was never entirely eliminated throughout the wartime period.

Spare parts and spare parts listings (MED 7's) were in great demand. Although some maldistribution of spare parts did occur, and overzealous or inexperienced planners often requisitioned more than they needed, there was a genuine shortage throughout the war at the consuming level. This was caused primarily by inadequate usage factors, by incomplete knowledge of end item density to be supported, and by the long supply pipelines which were entirely dry at the beginning. It is not surprising, therefore, that personnel in the field complained of having to use rope to replace worn out invalid chair tires, steel wool to replace brass screens in gasoline burner vaporizers, frayed web belts to fabricate kerosene refrigerator wicks, or of having to grind delicate needle valves from welding rod stock.

The most frequent complaint about the MED 7 parts lists was that they did not cover enough end items in their range. Technical manuals and other maintenance publications were generally well received, but had started too late and were too slow in coming. Probably the most frequently heard complaint about technical manuals was that those which did become available for the most part, were received only when the recipient unit unpacked an end item and found therein the manual, which usually began with instructions on how to unpack the item.

Demobilization served to underline the need for a balanced and effective permanent maintenance program in the Medical Department. Before the end of September 1945, shop production had been cut to a 40-hour week, and personnel reductions were being experienced. Technically qualified maintenance officers and enlisted men were released from the service, and the military hospitals and depots were quickly depleted of skilled personnel. All this came during the pressure of demobilization when demands were being placed on the maintenance shops for personnel to visit and assist in closing stations. Also, demands on depots for emergency repairs were increasing at permanent stations because of the exodus of maintenance personnel from the service.

A postwar evaluation of the wartime maintenance and repair of technical medical equipment by the Medical Department showed the program as a whole to have been so successful that its peacetime continuance was recommended by The Surgeon General.18

18Letter, Col. Robert J. Carpenter, MC, Executive Officer, OTSG, to Director of Supply, Headquarters, ASF, 7 Jan. 1946, subject: Medical Department Peace Time Maintenance Program.