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This volume is one of several planned for a series on the history of the Medical Department of the United States Army during World War II. It deals primarily with the logistics of hospitalization and evacuation. As used here, therefore, the term "hospitalization" means all of the instrumentalities-buildings, equipment, supplies, and personnel-which directly served sick and wounded soldiers1 in the attempt to restore them to physical fitness; and the term "evacuation" includes all of the means necessary to move patients from one place to another, whether from the battlefield to a hospital in the rear of combat zones, or from one hospital to another in the United States. The professional care of patients is not discussed in this volume; this subject will be treated fully in other studies being prepared by specialists in the various fields of medicine and surgery. Nor are details of the internal administration and operation of hospitals and evacuation units described here except to the extent necessary to explain the evolution of general policies and practices affecting the system of hospitalization and evacuation as a whole. Also, this volume confines itself almost entirely to events in the zone of interior (that is, the United States). This approach excludes any account of overseas hospitalization and evacuation operations, but not a discussion of the plans and preparations for them in the United States. Hospitalization and evacuation in theaters of operations will be covered elsewhere in this series. Treatment in this volume of the evacuation of patients from theaters to the United States might seem illogical unless the reader understands that the Army considered this operation a function of the zone of interior.

While hospitalization and evacuation are closely related, each is a complicated operation within itself. For simplicity and clarity they are treated in this volume as separate subjects, the first three parts dealing with hospitalization and the fourth with evacuation. Any account of hospitalization and evacuation involves some consideration of such elements as supplies and personnel. This volume therefore necessarily overlaps to some extent the subject matter of other volumes planned for this series. An effort has been made to keep such duplication to a minimum, with the result that some subjects may seem to have been slighted and others-such as the services of the Red Cross in hospitals-overlooked. Fuller information on these topics will be found in other volumes being written by the Army and by other agencies.

1A system of hospitalization and evacuation for army animals was also maintained by the Medical Department, but was of small dimensions and is not dealt with in this volume.


Though many agencies of the War Department were involved in the actions required to provide the Army with hospitalization and evacuation services-the War Department General Staff, especially its G-4 Division; the offices of The Surgeon General, the Air Surgeon, and the Ground Surgeon in Washington, and of surgeons of local commands elsewhere; the headquarters of the Army Ground, Air, and Service Forces; and the offices of chiefs of various technical services-emphasis has been placed in this volume on the work of The Surgeon General and his Office. While the history is not written with any conscious partiality for the viewpoint of The Surgeon General, it is written from his vantage point. There are several reasons for this approach. Most important is that The Surgeon General by tradition and directive is the chief health officer of the Army, and it is to him that the public looks when matters of health and medical care are concerned. A more practical reason is that the records of the Surgeon General's Office were more readily available than those of the offices of other surgeons. Finally, concentrating upon activities of the Surgeon General's Office is a very useful means of limiting the scope of this work and of giving it focus, without excluding consideration of actions affecting hospitalization and evacuation by agencies on higher, parallel, and lower levels of authority.

This volume is based almost entirely on records filed in various collections under the jurisdiction of the Department of the Army. With minor exceptions the author had free and unlimited access to them. Because of The Surgeon General's decision not to request "top secret" clearance for historians, the writer was not permitted to use the few files retaining that classification. This limitation is believed to have been of little consequence, because most of the once top-secret documents either had been given lower classifications or had been declassified altogether by the time they were needed. The author was also denied access to files of The Inspector General containing confidential complaints made to his representative during inspections of individual installations, but reports of more general inspections and investigations of hospitalization and evacuation by the chief medical officer on the staff of The Inspector General were made available. Compared with the records actually used, those to which access was denied are probably insignificant in quality as well as quantity. Publicity already given to the "tons of documents" through which one must search in the preparation of a volume of this kind makes it unnecessary to comment further on that subject.

Because of the nature of the source material for this volume, the form of its footnotes may appear unconventional to some readers. The following general observations will help in understanding them. Normally, a document is first identified by its type, file number (in some instances), sender, addressee, date, and subject. Its location is then given by indicating the collection of files and the specific folder in that collection in which it is found. The security classification of documents is not given.

Numerous technical terms have been used in this work, despite an earnest effort to avoid employing words and phrases in a manner understood by members of the military establishment but not by general readers. As a rule, technical terms and general terms given a special meaning by the Army are ex-

plained when they are first introduced in the text. Abbreviations have been used freely, especially in the footnotes. In most instances they are those authorized by the Army. Reference to a list of abbreviations at the end of the volume will help the reader interpret many of them.

The problem of how to designate Army officers whose ranks changed from time to time has been settled by giving the rank an officer held at the time of the action discussed. An effort also has been made to mention at some point in the work the highest rank an officer held during (but not after) the war.

A word of caution is in order about the statistical data in this volume. They were compiled from documents used in wartime operations, and further investigation by statisticians may eventually result in figures that are somewhat different. Nevertheless, it is believed that any variations will be inconsequential and will not diminish the historical significance of the data used here.

It is impossible to acknowledge in detail all of the help which the author received in the preparation of this work. Many acknowledgements will be found in footnotes throughout the volume. As for others, the author is especially indebted to Miss Zelma E. McIlvain and Mr. Hubert E. Potter for their assistance. Miss McIlvain did the major portion of research for Part Four and prepared preliminary drafts for much of Chapters XXII, XXIII and XXIV. Mr. Potter assisted in research for parts of Chapters XXII, XXIII, XXIV and XXV, and prepared preliminary drafts for certain portions of them. In addition, he assisted the writer immeasurably in obtaining important, hard-to-find documents.

The author is also indebted to the entire staff of the Historical Unit. Mrs. Josephine P. Kyle, Chief of its Archives and Research Branch, and her staff were indefatigable in searching for and locating not only large blocks of files but also individual documents requested by the writer. Typists of the Administrative Branch spent many weary hours making extracts from documents and typing drafts and final copies of chapters. Editorial clerks of this Branch prepared the tables in this volume and carefully checked and rechecked the manuscript before it was finally submitted for publication. My colleagues in the Historians Branch, and especially its chief, Dr. Donald O. Wagner, who supervised the preparation of this study, reviewed the manuscript and made many helpful suggestions for its improvement. The Armed Forces Institute of Pathology prepared the organization charts, under the supervision of Miss Sylvia Gottwerth, formerly of the Historical Unit. Finally, Col. Joseph H. McNinch, MC, Col. Roger G. Prentiss, Jr., MC, and Col. Calvin H. Goddard, MC-successive chiefs of the Historical Unit-gave the author and his assistants unflinching support, especially by their scholarly attitude toward the preparation of this volume.

A word of appreciation is also due to many persons outside the present Surgeon General's Office. Many officers who participated in events discussed in this volume-now retired or serving in other assignments-gave the author valuable help. Those interviewed usually spoke freely and frankly of their experiences. Others made excellent critical comments on drafts of chapters submitted to them for review. The information which they thus furnished was

especially helpful in filling in the background of important documents and events. The names of many appear in footnotes throughout the volume, but two deserve special mention here-the wartime Surgeons General, Maj. Gen. James C. Magee and Maj. Gen. Norman T. Kirk. The author is also grateful for criticisms and editorial assistance from Col. Leo J. Meyer, Deputy Chief Historian, Office of the Chief of Military History, and from members of the Editorial Branch of the same Office.

Washington, D. C.                                                                     CLARENCE McK. SMITH
10 March 1953