HEADQUARTERS 7TH INFANTRY DIVISION
Office of the Surgeon
APO 7
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES, 1952
MEREDITH MALLORY, JR., MAJOR, MC
7TH DIVISION SURGEON
SOURCE:? National Archives and Records Administration, Record Group 112, Records of the US Army Surgeon General, 7th Infantry Division, Annual Reports, 1950-1953, Box 221.
HEADQUARTERS 7TH INFANTRY DIVISION
Office of the Surgeon
APO 7
13 February 1953
RCS MED 41 (R1)
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES, 1952
INDEX
A. Tactical Operations
B.? Personnel
1.? Officer
2.? Warrant Officer
3.? Enlisted
4.? Morale.
5.? Decorations
C.? Intelligence
D. Operations
1.? Command and Administration
2.? Organization
3.? Professional
4.? Training
5.? Public Health and Sanitation
6.? Neuropsychiatric
E.? Supply
1.? Location
2.? Equipment
3.? Supply Operations
4.? Supporting Units
5.? Special Problems
F.? Summary of Comments on Methods and Materiel
1.? Personnel
2.? Organization
3.? Professional
4.? New and Experimental Equipment and Methods
5.? Dental
6.? Neuropsychiatric
RCS MED-41 (R1)
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES, 1952
A.? Tactical Operations
The 7th Infantry Division was defending in the Mungdungni (Punchbowl Area) at the first of the year and continued this mission until 22 February 1952. Combat activity, at this time, was minimal. From 22 February 1952, until 26 April 1952, the Division moved to and remained in reserve in the Hwachon-Kapyong area and at Inje. During the period 26 April through 15 November 1952, the Division was once again committed, having responsibility for the sector running west from Kumwha to the right border of the Chorwon Valley. Combat activity was characterized by raids and patrols commencing in June and continuing until onset of the rainy season in August when it decreased to very minor actions. Fighting was resumed to nearly full scale magnitude in October when CCF [Chinese Communist Forces] probes against the OPLR [Outpost Line of Resistance] resulted in sanguinary skirmishes in the early part of the month and the Division undertook the Triangle Hill assault the latter part. Relief of the Division from Hill 598, 25 October 1952, decreased the total amount of combat but intense skirmishes on the OPLR continued through 14 November 1952, when the Division again passed into reserve. The Division remained in reserve the remainder of the year; its relief of the 2nd Infantry Division in the sector west of Chorwon was completed in the very last days of December.
B.? Personnel
1.? Officer - The Division has been chronicallyunderstrength in Medical Service Officer Personnel for practically the entire period. The shortage has tended to increase toward the end of the period promising to become critical in early 1953. See Table #1 for total strength by Category:
TABLE #1
BREAKDOWN OF MEDICAL DEPARTMENT PERSONNEL
MC | DC | MSC | WO | EM | |
January | 37 | 18 | 36 | 2 | 1257 |
February | 37 | 16 | 36 | 2 | 1120 |
March | 35 | 16 | 36 | 1 | 1049 |
April | 32 | 17 | 35 | 1 | 917 |
May | 33 | 22 | 34 | 1 | 1040 |
June | 34 | 23 | 38 | 2 | 1008 |
July | 33 | 14 | 34 | 3 | 953 |
August | 34 | 16 | 32 | 5 | 975 |
September | 30 | 17 | 32 | 5 | 926 |
October | 31 | 17 | 29 | 5 | 952 |
November | 32 | 19 | 30 | 5 | 970 |
December | 30 | 16 | 26 | 5 | 876 |
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T/O Figures | MC | DC | MSC | WO | EM |
42 | 19 | 39 | 3 | 962 |
a.? Medical Corps - The greater proportion of medical officers received are entered in Federal Service for the minimum time required to discharge their service obligation and return to civilian life. This is their only motivation. A few have had considerable service in reserve components and in isolated instances a Regular Army officer appeared. The professional qualifications of all the officers have been almost without exception high, in contradistinction to which, their overall military knowledge is barely adequate. It should be seriously considered that the indoctrination at Medical Field Service School (MFSS), Fort Sam Houston, is uneconomical in respect to effort expended in transporting and teaching the officer and in not utilizing his professional skill for a sizable portion of his limited tour of duty. The MFSS course attempts to give the student a wide general knowledge of the Army when in reality the officer will see either ward service, for which he needs no military training, or else a limited type of combat, the mountain-trench warfare of Korea. I feel that he can be equally well prepared for the latter by a two to four week course in the combat or communication zone as he is by the protracted orientation given in the ZI. If this is true, the manpower savings that could be effected are obvious.
b.? Medical Service Corps - These officers have been received, with few exceptions, adequately trained. As with Medical Corps officers they are too few in numbers to support a Division in active combat. They have been utilized in this Division in conventional T/O positions, this organization being generally satisfactory and no alteration is thought feasible. In Battalion Aid Stations during heavy fighting they supervise evacuation and handle the lightly wounded section almost entirely, releasing the medical officer's attention to the severely injured. In respect to the question raised as to the utility of the MSC officer in the Battalion Aid Station it can be flatly stated that officer caliber assistance to the Battalion Surgeon is necessary; the branch is open to argument. Only one medical officer, a Regimental Surgeon, claimed that the Battalion Surgeon Assistant was possibly excess. All Battalion Surgeons who had supported heavily engaged Infantry Battalions were emphatic in their request for officer assistance.
c.? Dental Corps - The Dental Corps officers have been outstanding professionally. Administratively, they present a continuous problem since they are now divorced from any function in the operation of the evacuation system. If they are centralized in the Medical Battalion, and Division Rear, they operate most efficiently. However, personnel in Division Rear receive fewer points (CMS) than those in Medical Battalion, raising a problem of morale. When all are in Battalion, special dispensation must be provided to secure the Battalion
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an adequate officer R & R quota. When placed on D/S to Regiments, their efficiency drops and the problem of property accountability also arises. (See Operations for further discussion).
2.? Warrant officers. Warrant officers were used in normal T/O positions to fill in MSC vacancies. They functioned well as Assistant Battalion Surgeons and Mess, Motor and Supply officers. It is an injustice that those Warrant Officers who performed satisfactorily in commissioned vacancies could not be promoted to such rank.
3.? Enlisted.? Estimates from the Medical Companies, and Medical Battalion indicate that about 80-85% of replacements have received Medical Basic Training. About half of this number has had further medical training. In the medical service, as with other arms and services, the universal lament is for capable NCOs - men to command and administrate. KATUSA [Ed.- Korean Augmentation to the U.S. Army] personnel were in extensive use at the end of the year in Medical Companies and Medical Battalion to fill out enlisted vacancies.
4.? Morale.
a.? Officer.?? Officer morale has, with the exception of a period about mid-year, been good. During the summer considerable dissatisfaction was expressed by Medical Corps and Dental Corps officers over failure to rotate when expected. As far as can be ascertained now, the roots of this problem, as with previous like episodes, originated from a promise, or implied promise, of a definite release date by someone ostensibly authoritative.
b.? Enlisted.? Enlisted morale has been good, comparable, or better than that in other arms and services. The medics have continued to do their traditional superlative job on the battlefield.
5.? Decorations. See Incl #1
C.? Intelligence
Medical intelligence at Division level depends almost entirely on PW interrogation. Opportunities for interrogation were limited because of the few prisoners taken. Efforts made by the Surgeon's Section during 1952 to realize medical intelligence were not completely adequate. This problem was examined during the period the Division was in reserve at the end of the year and an active program, in coordination with G-2, to procure maximum medical intelligence at Division level has been initiated.
D.? Operations
1.? Command and Administration - The medical service of the Division was under direction of Medical Corps officers in all units without exception throughout the year. Medical Service Corps officers
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were used as assistants for administrative matters and as commanders of administrative units following T/Os presently in effect. Field grade MSC officers have not been placed in command of either the Medical Battalion or Regimental Medical Companies in spite of the unavailability of field grade Medical Corps officers and neither have MSC officers been placed in staff positions in which they would have ranked the Commanding Officer. On the basis of date of rank, however, subordinate officers, both MC and MSC, have occasionally ranked their Commanding Officer. This system has worked well and no departure from it is contemplated unless extreme personnel shortages make it necessary.
2.? Organization.
a.? Deployment - The medical units were deployed in a conventional manner. Usually but one Aid Station has operated in Infantry Battalions, and one Collecting Station in Regiment. The Clearing Company has often been divided into platoons, which accompanied the regiments, when they were widely separated. When the Division was in the Kumwha-Chorwon Valley sector, one Clearing Platoon supported the left regimental sector while the Clearing Company was located to support the remainder of the Division. The decrease of efficiency occasioned by splitting the clearing company was clearly demonstrated here, especially with the shortage of Medical Corps officers. The disadvantages are decreased holding capacity, incomplete utilization of all personnel, and the weakening of morale seen whenever any company organization is broken down. Reasonably extended ambulance hauls may be accepted in order to maintain unity of the Medical Battalion.
(1) Transportation.
(a)? Vehicular.? Vehicular transport of wounded was used to a maximum. It has been normal for litter jeeps to operate well forward of the Aid Station, loading at litter collecting points established in defilade. The Ambulance Company of the Medical Battalion most often was broken into separate platoons, each assigned, but not attached, to operate at the Regimental Collecting Station. With the onset of cold weather, an ambulance was maintained permanently with shuttle system at each Aid Station, to furnish warm transport from these installations.
(b)? Tracked.? Tracked vehicles, M-39 personnel carrier, were fully exploited to carry wounded. Rugged terrain and enemy action often made evacuation from forward outposts impossible by wheeled vehicles and in these instances the M-39s were invaluable. The M-39 is only a makeshift for the carrying of wounded since the litters must be placed outside of the vehicle. They can carry, usually, four (4) litters, with approximately eight (8) patients inside. This vehicle is subject to frequent breakdown especially when used for resupply and for that reason those used for evacuation must be restricted to that function. The new type of armored personnel carrier
5
with overhead cover, when available, would be an extremely valuable adjunct to evacuation in Korea.
(a)? Helicopters - The use of helicopters for rapid transport of critically injured to MASH for immediate surgery is not an unmixed blessing. They establish a dependency analogous to the use of antibiotics as a substitute for surgery. The availability of this rapid transport does not supplant the necessity for instituting the necessary procedures in the forward medical installation. In heavy loads, a surgical backlog quickly forms at MASH and little more can be accomplished there than in the Divisional installations. Helicopters do prove an easy mode of travel and can often get into places otherwise inaccessible. They are not operable at night or in bad weather and can not be used too close to enemy fire. The authority to dispatch helicopters must be delegated to Division in coordination with the Helicopter Detachment Commander. While, generally, rapidity of pick-up may not be too critical provided it occurs within two hours, it is vital that the availability of helicopter evacuation is determined immediately so that the transport of critical patients can be adequately planned.
3. Professional.
a.? Medical - Medical care can best be appraised against the background of hard fighting at Kumwha occurring 14-25 October 1952, when the medical service had its only serious test during the year. In general, medical care has been excellent. During the Kumwha action, gross traumatism in large quantity presented for the only time in 1952. None of the medical personnel in Division had ever been exposed to such casualty experience before. Adaptation to this work load was rapidly and successfully made; however, some standard points in management of battle casualties can once more be reiterated.
(1) With a heavy load, the Medical officer must make rapid judgment in respect to diagnosis and treatment of the injury and aggressively (even radically) apply indicated procedures.
(2) Fluids, splints, bandages, and tourniquets are used to correct physiological defects. When the defect is large, as is often the case on the battlefield, these measures must be of quality and quantity to remedy, or significantly modify the defect. With new officers, there is a tendency toward 'too little'. Vein cut-downs are often inexpertly done, air tight dressing of? sucking chest wounds is rarely obtained, and chest aspiration, which occasionally can be a vital procedure, is almost never attempted in the divisional installations.
(3) Use of blood in forward installations must be encouraged constantly.
(4) Medical attendants must be well-trained to furnish maximum assistance to the medical officers to allow them to give
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most of their attention to the severely and critically wounded.
b.? Definitive Treatment - Definitive surgical treatment was initiated in Clearing Company, 17 October 1952. Uncomplicated soft tissue injuries were debrided under local or general anesthesia, and either further evacuated or held for closure and return to duty. When held for return to duty, the wound is debrided and the patient held on the ward 4 days awaiting the secondary closure. After closure he is further held until complete healing has occurred whereupon he is returned to his unit to be followed by the unit surgeon. This activity furnished early surgical management, often not otherwise available, for the moderate wound. It was a complete success (see table #2), but engenders certain logistical and professional demands that must be recognized and anticipated. The major items are:
(1) Requirement for large holding capacity which decreases mobility all increases demands on mess and housekeeping personnel.
(2) Professional personnel required are a minimum of two (2) surgeons, preferably three (3) and an anesthetist.
(3) An anesthesia machine and augmentation of T/O surgical instruments is necessary.
(4) Surgical assistants have to be procured or trained (the latter in Korea).
It is problematical whether definitive treatment could be accomplished to any great extent under fluid combat conditions. If at all possible however debridement should be done in division before further evacuation. It is much more essential to do a maximum number of debridements alone, rather than a reduced number of debridements with secondary suture.
TABLE #2
SURGICAL CASES 1952
Oct | Nov | Dec | Total | |
Debrided and Evacuated: | 102 | 53 | 1 | 165 |
Held for Complete Surgical Repair: | 69 | 68 | 8 | 145 |
Elective, Non-Battle: | 0 | 10 | 4 | 14 |
c.? Dental - The dental work accomplished in the Division is outstanding considering that it is done under field condition. However, that this work should be attempted in a division committed to combat which has in effect a rotation policy is open to serious question. The eighteen (18) dental officers with twenty-one (21) enlisted technicians and their equipment represents a sizable personnel and logistical burden for the Division and particularly for the medical units which must support
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them. Ninety percent (90%) of the dental work performed in Division is purely elective work by the medical definition of the term 'elective'. It is not readily apparent why personnel can not be dentally qualified for a tour of combat duty in the rear areas or ZI, provided the dental personnel now committed to divisions were so utilized. Fixed installation dentistry is more economical of professional time, assures better quality work and, most of all, avoids the extraordinarily wasteful process of interfering with an individual's duties in the field. A minimal dental staff, perhaps, should be maintained in a fighting division for emergency work; however, even this may be unnecessary if normal Evacuation Hospital support were provided and included a dental section. (See Annex A, for detailed activities)
4. Training - Training activities by all medical units were continuous throughout the year, and consisted of both on-the-job and formal instruction. Formal training accomplished by the 7th Medical Battalion during the reserve was an outstanding example of what may be accomplished in this respect by a unit in the field. (See Inclosure #2, Schedules for Lesson Plans)
5. Public Health and Sanitation.
Sanitation in the field during the report period has been good. There has been no occurrence of serious epidemics among the troops. The following items justify comment:
a. Insect Control: Larvaciding and draining of all rice paddies and other ground forms containing standing water in areas occupied by the 7th Infantry Division began in April and continued through October. T-6s and C-47s from the Fifth Air Force were used for dusting and spraying. L-19s were used for areas otherwise inaccessible. Beginning in August the MLR was sprayed by mobile sprayers with 5% DDT every ten (10) days. This materially reduced the mosquito and fly population.
b. Rodent Control: Instruction to all units has been a continuous process. During the first half of the year red squill and warfarin mixtures were both used, the former due to insufficient supplies of warfarin. In the last half of the year only warfarin has been used. Pamphlets on the baiting of rodent stations with this poison were distributed.
c. Sanitary Instruction: A demonstration sanitation area using models was established in May. Teaching films on the prevention of malaria and cold injuries were shown with the regular evening moving picture to all troops. Pamphlets on the prevention of malaria were distributed in June and July. During November an extensive program of two (2) hours of cold weather indoctrination was given to all troops.
d. Personal Hygiene: Quartermaster shower points have been readily available to all troops. The majority of troops exchange
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clothing at these points. Miticide solution has been available for dipping of all clothing laundered in the unit areas, as well as at Quartermaster laundry. Sleeping bags and quarters are routinely sprayed with a 1% Lindane solution.
e. Extra-military Sanitation: While the division was in reserve in the Kapyong Area during March, six (6) cases of relapsing fever were diagnosed among the local civilian population. All homes and inhabitants in this area were dusted. Delousing of indigenous personnel, laborers, prisoners, stragglers and refugees and native dwellings has been a continuous systematic process.
f. Nutrition: The nutritional status of all troops has been excellent. In May the 13th Engineer Combat Battalion constructed underground coolers for food storage for all units.
g. Communicable Disease:
(1) Malaria. There were eighty-five (85) cases of malaria during the reported year, a peak of eighteen (18) cases occurring in April and another peak of twenty-four (24) cases in June.
(2) Hemorrhagic Fever. A total of one hundred thirty-five (135) confirmed cases of Hemorrhagic Fever occurred, the peak period being in June and July when there were eighty-five (85) confirmed cases. The division was in the endemic areas of the Chipori-Kumwha valley region during this period. It is felt that intensive efforts to control rodents and the use of miticide prevented a reoccurrence of a high peak as would normally be expected during November.
(3) Venereal Disease. There were two thousand seven hundred ninety-six (2796) cases of venereal disease reported during 1952. The incidence has generally declined during the second half of the year. A large majority of contacts occurred while troops were on R and R in Japan and on pass in rear area centers of population. During the period the division was in reserve, in November and December, separate chemical prophylactic stations were established at approximately fifty percent (50%) of the major subordinate units of division.
h. Preventive Medicine Detachment. The 151st Preventive Medicine Detachment in D/S of division was replaced on 25 February by the 37th Preventive Medicine Detachment. The service of these troops has been of immeasurable assistance in controlling rodents and insects for this division.
6. Neuropsychiatric.
The NP data for the year is contained in Annex B, Annual Report by the Division Neuropsychiatrist. This document demonstrates
9
well the key role played by a qualified Neuropsychiatrist in a unit of division size engaged in hazardous or unpleasant operations.
E. Supply
1. Location.? Medical supply function has been located throughout the year in the 7th Medical Battalion; the Battalion S-4, as is normal, serving as Division. Medical Supply Officer.
2. Equipment.
a. T/O & E. No shortages of standard equipment have existed. The ambulances of the Ambulance Company of the Medical Battalion were in poor condition and presented a maintenance problem (new ambulances to replace them arrived in Eighth Army after the first of the year but as yet are not assigned due to lack of parts).
b. Special, New and Experimental.
(1) Special. Special equipment requisitioned consisted of an anesthesia machine and accessories obtained from 8063rd MASH issued by Form 446, and additional surgical instruments for the surgery in Clearing Company obtained from depot.
(2) New. No new equipment except standard T/O & E replacement was issued.
(3) Experimental.
(a) Litter accessories. Three (3) items, litter pads, litter backrest and a removable litter cover (zippered) were tested during the October-November combat operations. The backrest was rejected completely. The zippered litter cover was found to be moderately useful in providing clean litters but its disadvantage in reducing litter rigidity prevents it from being a suitable replacement for the canvas cover and it does not contribute enough to be worthwhile carrying as an additional item. The litter pad was well-received by all who used it. It furnished much better insulation beneath the patient lying on a litter and is a much more comfortable surface. Though expendable, it was capable of considerable reuse. It was recommended that corner tie strings or some form of fastener be provided to fix it to the litter; also, that consideration be given to turning out this material in large sheet size for use as blankets and general purpose insulation.
(b) Armored Vests. Complete studies and reports on the effectiveness of armored vests have been rendered by specific teams organized for that purpose. Empirically, it seems that the vests produce striking
10
results in combat involving only light ordnance (hand grenades, light mortars and small arms) while their protective effects in heavy ordnance fights is more difficult to estimate. KIA to wounded ratio typically has ranged around one (1) to ten (10) during light fighting, rising promptly to one (1) to five (5) or six (6) during the heavy fighting at the end of the year. It is presumed that the armored vest plays a part in producing this casualty picture.
(c) Insulated Tents. The tent, frame type, insulated sectional, with floor, 1948 (Jamesway) was used extensively in 7th Division; its use devoted entirely to medical purposes. It is the best form of winter shelter for sick and injured available. Generally, its use forward of Collecting Station is not feasible because proximity to enemy fire almost always renders bunkers necessary. This tentage is a bulk and weight problem, which would be of serious magnitude in a moving situation.
c. Maintenance.? Maintenance of technical items was furnished almost entirely by the supporting medical depot and was completely satisfactory.
3. Supply Operations.
a. Routine Procurement. Requisitions for routine medical supplies was made to the supporting medical depot weekly based on issue experience factors. This includes Class I (drugs), Class II (equipment) and Class V (dental). Supply level stocked was seven (7) days. Over ninety-six percent (96%) of medical supplies were furnished using units immediately on request.
b. Special Procurement.
(1) Blood. Whole blood has been variously procured by the Division Surgeon or Division Medical Supply Officer, from either a supporting MASH or thru Corps Surgeon. At year's end, the Division Medical Supply Officer was maintaining twenty-eight (28) units of whole blood in Division, stocked mostly in Medical Battalion by request to the I Corps Surgeon's Office.
(2) Tents. Insulated tents (Jamesway) were recorded and accounted for by the Division Medical Supply Officer. Original issue by Army for test use.
(3) Anesthesia apparatus was issued from 8063rd MASH by Form 446.
4. Supporting Units.
a. 1st Advance Platoon, 6th Medical Depot.
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5.? Special Problems.
a. Refrigeration. The refrigeration of certain medical items (especially smallpox vaccine) was a problem in summer. The solution was construction of a homemade icebox and rapid issue for use.
b. Property Exchange.? During the October-November operations in the Kumwha area insufficient blankets and evacuation bags were brought in or made available to Division by the various Eighth Army agencies involved to effect adequate property exchange. As a result Division was depleted in these items to the point where the medical installations were, at the end, becoming unable to furnish all desirable cover to their departing patients. Secondarily, administrative difficulties arose in accounting for these items in the instances that responsible officers accepted shortages in order to keep their patients warm. Closer coordination between the Division Surgeon, Division Medical Supply Office and the Army supporting units in respect to this problem should prevent its recurrence.
F. Summary of Comments on Methods and Materiel
1. Personnel.? Fully trained technical personnel, such as physicians, who are inducted for limited tours of service, should receive their military orientation in the theatre of operations so that only minimum necessary information as given them and maximum utilization is made of their specialized skills. Technical personnel to occupy key command and administrative positions should be selected by a defined method and given the necessary additional instruction.
2. Organization. The present medical organization of the infantry division has worked well and no major change is indicated by this year's experience. The Medical Service Corps jobs are, in general, appropriate and no reduction in these positions appears feasible. Centralizing Medical officers in Regimental Medical Companies and Medical Battalion, allowing MSC officers to operate Aid Stations in the Engineer, Tank, and certain Artillery Battalions, has provided maximum medical service to the Division with no impairment of essential medical activities, in spite of acute shortage of Medical Service officers. Reinforcing this policy, the greatest effort should be made to keep the Clearing Company operating as a unit.
3. Professional. The principle of surgical treatment (debridement) within division was revived with complete success. This activity has attendant disadvantages which preclude its universal application. Actually, the professional care given in an infantry division should be maximum within capabilities of the personnel and logistical support, and limits of the tactical situation.
4. New and Experimental Equipment and Methods
a. The M-39 Personnel Carrier has been an invaluable aid to transport of wounded off the battlefield.
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b. Helicopter evacuation should be developed to day and night capabilities. It should be controlled at division level and it is no substitute for adequate resuscitative procedures.
c. The expendable litter pad was successful and should be further developed and placed into standard use.
d. The synthetic blood substitutes were not tested in amount large enough to enable formulating an opinion.
e. Tents. The insulated tent (Jamesway) is an excellent shelter for medical purposes but its universal employment would be impossible because of its weight and bulk.
5. Dental. The attempt to provide standard dental treatment within an infantry division engaged in combat is a concept difficult to justify by practical experience.
6. Neuropsychiatric care has reached a most satisfactory level of efficiency and really conserves fighting strength.
Annex A - Annual Report Medical Service Activities, Dental, 1952
Annex B - Neuropsychiatric Report, 7th Infantry Division, 1952
2 Incls:
1.? Awards: and Decorations
2.? 7th Medical Battalion Training Schedule
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES
DENTAL 1952
HAROLD D. REINHARDT, CAPTAIN, DC
7TH DIVISION DENTAL SURGEON
ANNEX A
HEADQUARTERS 7TH INFANTRY DIVISION
Office of the Dental Surgeon
APO 7
10 February 1953
RCS MED-41 (R1)
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES
DENTAL 1952
INDEX
A. Mission
B. Movements of Division and Disposition of Personnel
C. Equipment
1. Chest 60
2. Operative Vans
3. Improvised Items of Equipment
4. Electric Power
5. Housing
D. Personnel
1. Officers
2. EM
3. Training
E. Supplies
F. Dental Health of the Command
G. Summation and Recommendations
1. Equipment
2. Electric Power
3. X-Ray Unit
4. Clinic Location
5. Conclusion
4 Incls:
1. Justification for two Division Dental Vans
2. Officer and EM Roster, 1952
3. Training Schedule
4. Statistics of Dental Operations
RCS MED-41 (R1)
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES
DENTAL 1952
A. Mission.
The mission of the 7th Division Dental Service is to maintain the dental health of the command by performing the maximum amount of definitive dentistry and eliminating the causes of painful dental conditions. Service is also extended in complete or modified form to the Colombian and Ethiopian Battalions attached to the division and to the Corps and Army units operating in the division area. ROK [Republic of Korea], KSC [Korean Service Corps], and indigenous personnel receive a limited amount of treatment.
B. Movements of Division and Disposition of Personnel.
In January 1952, the 7th Infantry Division was occupying a sector on line in the Punch Bowl area. This area is in the general vicinity of Chong-Ni, Imdang-Ni, and Sin-Chon, Korea. Dental officers were assigned to Regimental Collecting Stations, Medical Battalion, Division Artillery, Division CP, Division Rear and Replacement Company, 15th AAA and 13th Engineers.
Toward the end of February the division was replaced in the line by the 25th Division. The division moved into reserve in the vicinity of Kapyong, Hwachon, and Inje. The dental officers moved with the units they were serving and remained with them. A dental survey was completed prior to this move. Upon occupying the reserve positions a plan was immediately formulated to concentrate the dental effort on reducing the number of class III, IV, and V patients. The two operative vans and the prosthetic van were moved from unit to unit reinforcing the efforts of the attached dental personnel.
The 7th Division replaced the 2nd Division on the line during the third week of April, in the Chorwron-Kumwha area. The disposition of the dental personnel remained unchanged. Operative vans and prosthetic van were recalled to the Medical Battalion where they formed the nucleus of a centralized clinic.
In August the 187th RCT moved into the 7th Division area for a specific mission. Immediately a dental clinic with one officer in attendance was set up at their collecting station. This clinic was maintained until the unit left the division area two months later.
Conforming with a general order to disperse the units of the division, the 7th Medical Battalion moved into a position where it became impractical to maintain the previously existing dental service. Consequently, in September the service was redistributed, placing three (3) Dental Officers with each Regiment, one (1) with the 1st Clearing Platoon, one (1) at Division CP, one (1) at Division Rear, two (2) with Division Artillery, and one (1) with the Eighth Army Artillery. The Division Prosthetic section was placed with the 13th Engineer Battalion.
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In late November the 25th Division replaced the 7th Division on the line, and the division moved into reserve. The 17th Regiment was immediately dispatched for duty on Koje-Do and Cheje-Do, and the three (3) dental officers assigned to the regiment at the time moved with it. The 31st Regiment moved to Hwachon and the 32nd Regiment and the balance of the division remained at Kapyong. At this time a concentrated effort was again made to accomplish a maximum amount of dental work. The division remained in reserve until late December when it replaced the 2nd Division in the sector west of Chorwon. The last day of the year found the dental service in a new area, once again preparing to accomplish its mission in the field in the most efficient manner possible.
C. Equipment.
1. Chest 60. It is felt that the contents of the Chest 60 are adequate to perform all the usual functions of field dental operation. Not all of the dental officers agree with the choice of forceps and other hand instruments. However, this is not unusual and never seriously hampered the operation of the service. The Burton Light is inadequate as a source of illumination. A type of Castle Light modified to fit into the chest would make an excellent substitute.
2. Operative Vans. The 7th Division has the additional dental support of two (2) Dental Operative Vans, the only equipment of this type in Korea. These units are complete mobile dental clinics. They have proved extremely useful in situations where units needed additional dental support for a short time. They can be dispatched and be operating within thirty (30) minutes of arrival. In November the division made an effort to reduce the equipment in all units to T/O & E levels. Since the Operative Vans were in excess of T/O & E, they were marked for evacuation by the Division G-4; however, their presence was subsequently justified and the order rescinded. Attached is the letter of justification for the retention of the vans, written by Captain R. A. Dietzschold as Division Dental Surgeon (See Incl #1).
3. Improvised Items of Equipment. The physical plant of the dental clinics throughout the division varies according to the ingenuity of the dental officers assigned. All facilities apart from the Chest 60 must be improvised. Make-shift cuspidors, foot rests, instrument bracket tables, cabinets and operating stools were made from available lumber. Since most officers objected to the Burton Light, jeep headlights and other large lamps were set up as operating lights. Rearranging the lenses in the Burton Light improved its effectiveness.
4. Electric Power. It was found during the year that procurement of an adequate electric power supply was a constant problem. The divisional dental service is authorized one 3 KVA generator to furnish it with electricity. This generator is kept
3
at the Medical Battalion where it provides power for the largest dental clinic in the division. The various other clinics are forced to rely on the individual units being supported for electric current. Having no control of the source of power supply, these dental clinics were often subject to sudden power shutdowns, thereby curtailing their operation.
5. Housing. During the year the various clinics were housed in squad tents, insulated sectional tents (Jamesway), and bunkers. This varied experience showed that the Jamesway best served the needs of a dental clinic. This insulated type sectional tent complete with flooring, is easily heated in winter, and yet cool in the summer. It affords pleasant surroundings for both operator and patient and is easily kept clean and orderly. It can be illuminated with a minimum amount of wattage. Its rigid construction makes it resistant to high wind velocity and to the blast effect of friendly artillery. Four sections of this type housing have been found to be ideal for a two chair clinic, leaving enough room for a records section and waiting room. A four chair clinic can be set up in the same space if a separate waiting room and record section is supplied in other tentage. Since the Jamesways were devoted primarily to medical purposes, the dental service has been operating in squad tents during most of the year. As the tactical situation dictated, the clinics were constantly being dispersed, entrenched, and camouflaged according to the direction of the unit commanders involved. By a policy of cooperation between the Division Dental Surgeon, the other commanding officers of the units where dental officers were assigned, it has been possible to locate and service the various dental clinics throughout the year. This cooperation has been greatly appreciated, and has been a major factor in the rendering of an efficient dental service.
D. Personnel.
1. Officers. At present, there are fifteen (15) dental officers assigned to the 7th Division. This number has varied during the year from fourteen (14) to twenty-three (23), depending upon the availability of replacements and the departure of rotatees. (See Incl II) The slow flow of replacement officers and the constant change of rotation policy has been consistently detrimental to morale.
2. Enlisted. Enlisted personnel have presented no problem from a procurement standpoint. The T/O strength has been maintained more or less consistently throughout the year. (See Incl II). The training and efficiency of the Dental Assistants (MOS 3855) have been generally acceptable at the time of reporting. In the few instances that this was not true, it was easily remedied by a short period of on-the-job training. In the case of the laboratory technician (MOS 3067) it has been found that the men trained at MFSS, Ft Sam Houston had a general knowledge of laboratory procedures but were not sufficiently
4
trained. Men who had several years of civilian experience in this field formed the nucleus of the laboratory, and it could not have functioned without these individuals. Though plans were instituted to improve the ability of those men not adequately trained, the constant change in personnel rendered this largely ineffective. Due to the rotation policy only one technician served with the Prosthodontist during all of 1952; the balance served varying lengths of time, one tour being of only three (3) months duration. Better training at a Service School in such basics as pouring a good model, knowing the fundamentals of a set-up, and being able to make a wrought wire skeleton, would provide higher quality technicians. Experience has shown that men able to do these things with proficiency, quickly become good workers.
3. Training. A continuous program of on-the-job training was conducted throughout the year for both officers and enlisted men. In addition, during the six week reserve period in November and December, an intensive lecture and demonstration course was instituted for the enlisted men. Emphasis was placed upon forms and records, handling patients, and supply economy. Attached is a detailed outline of the course of instruction together with references used and time allotted. (See Incl III, Course of Instruction and Training for Dental Technicians).
E. Supplies.
The availability of supplies was generally adequate throughout the year. Certain prosthetic items, however, were critically short and hampered the production of this section. From January to April, alignate impression material was not available. From April to June, gold and solder were in short supply. In the period from June to December a shortage of prosthetic teeth prevailed. These shortages have since been rectified.
F. Dental Health of the Command.
The survey figures for the year 1951 indicate that approximately twenty-five percent (25%) of the divisional strength required extensive, definitive dental treatment and were classified as III, IV, V. Though there was a great increase in the number of patients treated, and operations accomplished, in 1952, as compared to 1951, the survey picture was not changed materially in the past year. (See Incl IV, Statistical Section). There are two reasons for this; the lack of standard, adequate, dental qualifications for men leaving the ZI and the rapid turnover of personnel due to rotation or expiration of category. The plan used at present calls for a survey at six (6) month intervals. The command is surveyed, and those requiring the greatest amount of treatment are given priority. When the command is again surveyed in six (6) months many of those who have received the benefit of dental treatment have rotated and the replacement personnel who are now picked up in the survey are, percentagewise, in the same poor dental health their predecessors were. The survey picture will
5
improve only when the replacement coming from the ZI arrives in a class II condition, at the minimum.
G. Summation and Recommendations.
1. Equipment. In summation it can be stated that he equipment is satisfactory with the exception of the Burton Light. This light is not easily set up and gives sufficient light only when it is so close to the patient that the operator's movements are hampered.
2. Electric Power. A more satisfactory source of power is necessary. This can be remedied by the addition of five 1? KVA generators to the T/O & E giving each clinic an independent power source. Though this would add to the amount of equipment to be serviced, maintained and transported, the rise in efficiency of the dental service would nullify the disadvantages.
3. X-Ray Unit. It is further felt that to improve the service and prevent the evacuation of patients to the Mobile Army Surgical Hospital, a dental x-ray unit of the new miniature type should be placed with each division. It is estimated that between seventy-five (75) and one hundred (100) patients each month must be evacuated out of division for dental x-rays. These patients spend an entire day traveling and waiting. This does not take into account all the cases that could be handled more intelligently with the x-ray as a diagnostic aid, were it readily available. This x-ray unit is of such compact type that it would raise no additional problems of storage or transportation.
4. Clinic Location. It was found that for a division in the field there can be no set policy as to the location of clinics and the placement of personnel. The tactical situation, the terrain, and the deployment of the various units must all be given consideration before a plan is formulated that will best serve the command.
5. Conclusion. Generally the efficiency and morale of the dental service has remained high throughout the year. In spite of the adverse conditions under which the dental officers in the field operate, the mission of the Dental Service was accomplished in a manner consistent with all the principles of good dentistry.
HEADQUARTERS 7TH INFANTRY DIVISION
Office of the Division Dental Surgeon
APO 7
7 November 1952
SUBJECT: Justification for the Retention of Two Dental Vans in Excess of T/O & E
TO:Commanding General
7th infantry Division
APO 7
THRU:Commanding Officer
7th Medical Battalion
APO 7
THRU:G-4
7th Infantry Division
APO 7
1. Description
In the strictest interpretation, these vans are not vehicles. Rather, they are mobile dental clinics. These vans are unique in that they are fitted with every piece of permanent dental equipment except an x-ray unit to make them complete dental offices on wheels.
2. Disadvantages to the 7th Division by Release of Subject Vans
a. The loss of these vans will require additional tentage, the use of two chests sixty, and vehicular space to transport this additional equipment. Additional transportation space must also be provided for the basic inventory of seven days, supplies presently stored in these vans for distribution to the Division's sixteen (16) dental teams.
b. By releasing these vans, the Division's Dental officers will be deprived of their finest dental equipment. In the past most of the minor oral surgery has been accomplished within the division because these vans were available.
7 November 1952
SUBJECT: Justification for the Retention of Two Dental Vans in Excess of T/O & E
c. Without the two dental vans the dental service of the division will be greatly reduced in mobility. While the division is in reserve or in static combat situations, the vans have been used to take the dental service to the troops rather than bringing the troops to the facility. This allowed maximum dental treatment in a minimum of time.
d. During active combat these vans sere used as a nucleus of a small and efficient clinic at the Medical Battalion. They are ideal in this respect since no additional strain was put upon that unit for working space or power. This gave the dental section the tremendous proven advantage of clinic operation over the dispersed service.
e. Less concrete, but just as important a consideration is the potential loss of a definite morale factor. These vans approach the appearance and accommodations of a permanent and complete dental office. The patients have felt that they were enjoying a superior service not to be found elsewhere at this level. The morale and working efficiency of the dental personnel has been kept high because of the excellent working conditions and equipment available to them.
3. Advantage to the 7th Division by Releasing the Vans as Excess
a. The minimum maintenance of these vehicles will no longer be necessary. A slight reduction of gasoline and lubricants used by the Medical Battalion will also result.
b. However, in all the movements of the 7th Division in the past two years, these vans have never overtaxed the Medical Battalion's motor pool facilities. During that time the vans have served our troops from Inchon to the Yalu and back.
4. Recommendation
In view of the great number of advantages accruing to the entire division by retaining these dental vans, it is my recommendation that they be retained within this organization.
R. A. DIETZSCHOLD
Captain DC
Division Dental Surgeon
Incl I
OFFICERS AND EM PRESENT FOR DUTY DURING 1952
OFFICERS | EM | |
January | 17 | 24 |
February | 17 | 24 |
March | 16 | 19 |
April | 17 | 16 |
May | 20 | 24 |
June | 23 | 22 |
July | 14 | 21 |
August | 16 | 22 |
September | 17 | 21 |
October | 17 | 21 |
November | 19 | 18 |
December | 17 | 21 |
T/O Strength 18 Officers, 20 EM
Incl II
COURSE OF INSTRUCTION
AND TRAINING FOR DENTAL TECHNICIANS
I. General, (2 hours) ref - TM 8-225, TC 19-1951
A.? The dental to technician.
B.? Plans and equipment necessary for erection of dental clinic.
II. Forms (6 hours) ref - SR 40-1010-10
A.? 8-116.
B.? 477.
C.? 8-149, 446, and 111.
III. Operative Dentistry (12 hours) ref - TM 8-225
A.? Handling of patients.
B.? The chest 60.
C.? Instruments; their care and use.
D.? Materials.
1. Mixing and storage.
2. Drugs.
IV. Surgical Dentistry (14 hours) ref - M-203-1, MFSS June TC Maxillofacial 19-1951.
A.? Patient management.
B.? Commonly used instruments and their care.
C.? Common dental emergencies and their treatment.
V. Prosthetics (14 hours) ref - TB-148 15 Jan 48:
???? Prosthetics detachment (KK) (Mobile) TC 19-1951.
A.? Definition, Objective and Scope.
B.? Appliances.
C.? Construction of appliances.
D.? Laboratory procedure.
1. Impressions
2. Pouring models
3. Simple wire bending and soldering
4. Setting up teeth
5. Flasking
6. Processing
7. Deflasking
8. Polishing and finishing
Incl III
STATISTICAL SECTION
Military | Others | Total | ||||
1951 | 1952 | 1951 | 1952 | 1951 | 1952 | |
Admissions and Sittings | ||||||
??? Admissions | 14,318 | 21,925 | 137 | 682 | 14,445 | 22,607 |
??? Sittings | 39,655 | 47,742 | 267 | 1,381 | 39,992 | 49,123 |
Restorations and Extractions | ||||||
?? Restorations | 12,999 | 19,649 | 37 | 120 | 13,036 | 19,769 |
?? Extractions | 9,136 | 8,997 | 211 | 754 | 9,347 | 9,751 |
?? Miscellaneous ????? Operations | 6,862 | 19,096 | 48 | 507 | 6,910 | 19,603 |
Prosthetics | ||||||
?? Dentures, Full | 249 | 162 | 0 | 7 | 249 | 169 |
?? Dentures, Partial | 640 | 660 | 11 | 85 | 651 | 745 |
?? Total Prosthetic ?????? Operations | 1,463 | 1,540 | 21 | 107 | 1,484 | 1,647 |
Classification of Military Personnel as Compared
to Same Date Last Reporting Period
Class | I | II | III | IV | V | |
December 1951 | 25.00% | 48.00% | 15.00% | 5.00% | 7.00% | |
December 1952 | 24.80% | 46.80% | 23.20% | 3.70% | 1.30% |
Incl IV
NEUROPSYCHIATRIC REPORT
7TH INFANTRY DIVISION
1952
ROBERT J. LAVIN, CAPTAIN, MC
7TH DIVISIION NEUROPSYCHIATRIST
ANNEX B
Since in this report we have attempted to correlate the incidence and types of neuropsychiatric disorders with the tactical situations to which the division was committed in the past year, a brief, general resume of the tactical situation we feel is indicted.
The Seventh Infantry Division was committed to the line from the latter part of 1951 to approximately 19 February 1952. This period was one of relatively light action consisting mostly of minor probes and patrol action.
From 19 February 1952 to 25 April 1952 the division was in a Reserve Area. During this time the troops of the command received advanced tactical and technical training.
From 25 April to 10 November 1952 the division was again committed to a combat status. From 25 April to 1 October 1952 combat units of the division participated in relatively light action, consisting mostly of minor probes and aggressive patrols. On approximately 1 October 1952 the artillery units of the division began a sustaining fire concurrent with increasingly heavier enemy probes which were concentrated against the outpost positions. This action continued until 14 October 1952 at which time the division was committed to 'Operation Showdown' in the Kumwha Area. This operation was the major offensive action undertaken by the division during the year. This operation continued until the latter part of October 1952.
On November 14, 1952 the division moved into a reserve area where it remained through November and December 1952. On 26 December 1952 the division was again committed to a combat status.
EVACUATION AND DISPOSITION OF NEUROPSYCHIATRIC CASES
Prior to October 1952, it had been noted by the Far East Command Neuropsychiatric Division that despite the marked reduction in the number of cases evacuated from Korea for neuropsychiatric disorders; the overall neuropsychiatric rate (number of cases per 1,000 per annum) showed a progressively slight increase in the second and third quarters of this year. Investigation revealed that the policies outlined by the Neuropsychiatric Division as to the diagnosis and disposition of neuropsychiatric cases were not being applied both within division level and in extra-division units. Concurrently with the assignment of the present Division Neuropsychiatrist in the latter part of September 1952, a more rigid policy was outlined by the 8th Army Neuropsychiatric Division through command channels whereby no individuals were to be given a neuropsychiatric diagnosis by other than a qualified neuropsychiatrist, nor would such cases be referred for evaluation through other than the unit neuropsychiatrist. In this regard, the 7th Division neuropsychiatrist was given the fullest cooperation by both command and Medical personnel. As a result every individual requiring neuropsychiatric evaluation was referred directly to the division neuropsychiatrist.
The statistics, as compiled by the division neuropsychiatrist in the Bi-Monthly Neuropsychiatric Report, are based on the number of ward cases of that period. Ward cases are considered as those individuals who have lost a period of one day's duty to his unit. It has been found on the part of the division neuropsychiatrist that his statistics are only of as much value as his ability to expedite the evaluation and disposition of the individual referred to him.
2
This indicates that the neuropsychiatrist must maintain close liaison with his ward and see every patient immediately on the former's arrival to the neuropsychiatric section and determine whether such patient requires further evaluation, studies or presents sufficient severity of symptoms as to warrant his being classified as a ward case. Otherwise statistics would only be relative.
Therefore since this policy has been applied and adhered to, there has been a marked reversal of the ward to outpatient ratio in the total number of cases seen by the division neuropsychiatrist.? Out-patients are considered those individuals seen immediately on arriving at the neuropsychiatric section and returned to duty at the completion of the examination and evaluation on the same day.
Figure #1 -Tabulation of Neuropsychiatric cases as to disposition
MONTH | TOTAL NO. of CASES | WARD | OPD | EVAC | Trans. To MEDICAL WARD |
Jan. | 106 | 92 | 14 | 16 | 5 |
Feb. | 55 | 42 | 13 | 11 | 1 |
Mar. | 53 | 44 | 9 | 11 | 1 |
Apr. | 48 | 44 | 5 | 12 | 3 |
May | 83 | 69 | 14 | 11 | 1 |
June | 77 | 63 | 14 | 18 | 5 |
July | 84 | 72 | 12 | 14 | 4 |
Aug. | 97 | 82 | 15 | 14 | 3 |
Sept. | 99 | 82 | 17 | 21 | 2 |
Oct. | 225 | 125 | 120 | 13 | 15 |
Nov. | 63 | 20 | 43 | 9 | 8 |
Dec. | 45 | 15 | 30 | 14 | 3 |
TOTAL | 1036 | 730 | 306 | 164 | 51 |
Your attention is directed to the above Figure #1 - illustrating, the total number of cases, number of ward, and number of OPD cases seen respectively in the past year. During the month of October 1952, as it has been noted before, this division was committed to its initial offensive action of the year, and over one third of the ward cases seen were diagnosed as Combat Exhaustion requiring additional rest and therapy placing them in the ward category. However in November and December 1952 the ward cases have been reduced to a minimum. Therefore it must be understood that at the present time such statistics as % Returned to duty, % Repeater rate, % Evacuated are applied only to those few individuals who are considered ward cases, or those individuals lost to their units for more than 24 hours. A true picture of the mental health of the command, regardless of statistics, is thereby obtained.
FOREIGN TROOPS:
One battalion of Ethiopian and Colombian troops are assigned to this division as well as an undetermined number of Korean soldiers who are attached to U. S. units. Through liaison with the medical officers in these units and competent interpreters, the cases from these units were evaluated by the 7th Division Neuropsychiatrist as follows:
Total cases | Evacuated | Returned to Duty | |
Ethiopian (KAGNEW) Bn. | 45 | 10 | 35 |
Columbian Bn. | 9 | 1 | 8 |
Korean (KATUSA) | 9 | 3 | 6 |
TOTAL | 63 | 14 | 49 |
3
Prolonged therapy at division level because of language difficulty was not feasible. Such cases manifesting severe symptoms were referred to the 123rd Medical Holding Company, 212th Psychiatric Detachment, Seoul, where adequate facilities for further evaluation and examination of these cases were available.
Review of Neuropsychiatric Cases Evaluated in 1952 According to Diagnoses
The cases tabulated in Figure #2 includes all U.S. Army personnel seen by the Division Neuropsychiatrist on ward and outpatient basis.
Figure #2
Diagnosis | Jan | Feb | Mar | Apr | May | June | July | Aug | Sept | Oct | Nov | Dec | Total |
Psychotic Disorders | 1 | 1 | 4 | 2 | 4 | 3 | 5 | 4 | 3 | 1 | 0 | 4 | 32 |
Psychoneurotic | 25 | 18 | 10 | 9 | 19 | 31 | 24 | 28 | 29 | 40 | 11 | 4 | 248 |
Character & Behavior | 21 | 11 | 18 | 9 | 17 | 8 | 10 | 8 | 21 | 29 | 13 | 4 | 169 |
Immaturity Reaction | 7 | 3 | 6 | 11 | 12 | 12 | 8 | 16 | 16 | 22 | 8 | 19 | 140 |
Combat Exhaustion | 0 | 0 | 0 | 0 | 1 | 0 | 0 | 0 | 0 | 40 | 1 | 0 | 42 |
No Diseases | 42 | 14 | 13 | 9 | 20 | 14 | 23 | 29 | 19 | 62 | 22 | 14 | 281 |
Others | 10 | 8 | 2 | 8 | 10 | 9 | 14 | 12 | 11 | 31 | 8 | 1 | 124 |
Total | 106 | 55 | 53 | 48 | 83 | 77 | 84 | 97 | 99 | 225 | 63 | 46 | 1036 |
The number of cases evaluated and subsequently evacuated with psychotic disorders were highest in those months May-Sept. 1952 in which the combat units remained in relatively static positions on the line. In those months the initiative was primarily on the part of our forces, consisting of numerous aggressive patrols on enemy positions with relatively no change in the Main Line of Resistance.
Of the total cases tabulated for the year diagnoses, 76% of the Psychotic Disorders, 54% of the Psychoneurotic Disorders and 32% of the Character and Behavior Disorders were reported from May-September 1952.
4
FIGURE #3
MONTH | SIW | 368 | 369 | 443 | 600-200 | CMC | New AWOLS |
Jan | 8 | 6 | 1 | 0 | 0 | 10 | 5 |
Feb | 3 | 2 | 1 | 2 | 1 | 3 | 13 |
Mar | 5 | 5 | 2 | 1 | 0 | 3 | 0 |
Apr | 4 | 1 | 0 | 1 | 0 | 3 | 0 |
May | 14 | 3 | 1 | 0 | 0 | 7 | 1 |
June | 8 | 3 | 1 | 0 | 0 | 3 | 0 |
July | 11 | 1 | 2 | 0 | 1 | 4 | 0 |
Aug | 10 | 2 | 0 | 1 | 0 | 4 | 4 |
Sept | 6 | 4 | 3 | 1 | 0 | 6 | 0 |
Oct | 11 | 0 | 0 | 0 | 0 | 6 | 0 |
Nov | 1 | 0 | 0 | 0 | 0 | 6 | 0 |
Dec | 0 | 3 | 0 | 0 | 0 | 6 | 0 |
TOTAL | 81 | 30 | 11 | 6 | 2 | 61 | 23 |
Review of (above) Figure #3 further reveals that from May-September 1952, of the yearly total of such cases tabulated, 48% of the cases of SIW, 54% of the Recommendations for Administrative Discharge (primarily under provisions AR 615-368) and 45% of Courts-Martial Clearances were reported.
In contrast, in October the division was committed to 'Operation Showdown'. In this period less than ? of 1% of the cases evaluated were diagnosed as Psychotic Disorders, approximately 18% as Psychoneurotic Disorders and 13% as Character & Behavior Disorders.? Of the total number of cases evaluated in this offensive action were diagnosed as either Combat Exhaustion (18%) and Observation Psychiatric, no disease found (26.5%). The latter diagnosis was applied to those individuals manifesting marked physical fatigue without evidence of psychiatric disease, as is seen in the Combat Exhaustion cases (transient personality
features). Approximately 13 of the total cases were diagnosed as Character and Behavior Disorders and 10% as Immaturity Reactions.
During the month of January 1952 the toctica1 situation of the division was similar to that of May-September 1952 and a definite correlation was noted.
It has, therefore, been found that 55% of the yearly total of cases evaluated were reported in those months in which the division, while on the line, maintained static position, although maintaining the initiative with aggressive patrol actions. It can be surmised that the individual soldier under such circumstances foresees no definite goal in sight other than rotation and such a factor along with an increasing casualty rate without gains militated against good motivation resulting in a greater incidence and severity of psychiatric disorders, self inf1icted wounds and disciplinary problems.
THE EPILEPTIC SOLDIER
In the past year four, cases diagnosed as Grand Mal epilepsy were reported. At the time of this report - two patients had rotated to the Zone of Interior on adequate dosage of Dilantin and Barbiturate having served effectively in their unit.
5
One case had been evacuated in April 1952 to the 123rd Medical Holding Company in Seoul where he was reassigned since he manifested features of immaturity, making him ineffective for combat duty. The remaining case had been transferred to an assignment in Army area for reasons other than his diagnosis.
FOLLOW UP STUDIES OF NEUROPSYCHIATRIC CASES EVALUATED
In the latter part of 1952 close liaison between the neuropsychiatric section of this division was initiated in those cases that had been referred to the division neuropsychiatrist for evaluation and returned to duty. This follow up was initially intended to be utilized to survey the effectiveness of psychiatric treatment at division level. FORM #1 [Ed.-none of the forms and graphs referenced are included in this version] was forwarded on those cases diagnosed as Psychoneurotic Disorders and Immaturity Reactions thirty days following their being returned to duty.? Such a follow-up was not applied to those cases diagnosed as Character and Behavior disorders since those cases, once diagnosed as once diagnosed and returned to duty were considered administrative, not medical problems.
The response on the part of unit commanders and the interest displayed by them in their reports prompted this section to continue this policy on all cases seen by the division neuropsychiatrist since it was felt that close liaison even in those cases considered administrative problems might result in eliminating the mistaken idea that is maintained by many officers heretofore in command positions that 'duty is a punishment'. It is desired that in assisting the unit commander in such problems that the 'ineffective soldier' with his detrimental effect on the morale of a unit may be eliminated from the combat units of this division.
This policy has been in effect approximately two months. Fifty follow up reports have been received. Of this total, 47 have been reported as doing effective duty and making adjustment ranging from good to excellent. In three cases a report was received that these individuals were not doing effective duty, in which case the unit commanders have been requested to return these individuals with the detailed information as outlined in FORM #2. This latter form has been forwarded to all unit commanders to acquaint them with the necessary data required in order that a proper neuropsychiatric evaluation may be made. As a result of the excellent cooperation received in this matter, it has been possible to reduce the number of ward admissions, and to expedite the proper recommendations on the individuals forwarded for evaluation resulting in a marked reduction in 'man days' lost to the units.
OPERATION SHOWDOWN
This operation occurring in October of this year represented the first major offensive action by this division. Previously in this report the neuropsychiatric statistics (GRAPHS 1 & 2) were correlated with those tactical situations in which the division's prime function was 'holding' and maintaining the initiative with aggressive patrol action. Here it is planned to correlate neuropsychiatric statistics with the division's major offensive action of the year.
6
INFANTRY UNITS
In early October 1952the enemy began multiple probes in increasing strength, with increased artillery fire. The unit sustaining the brunt of this action (GRAPH # 3) had an increase in the number of cases referred for neuropsychiatric evaluation. Initially the cases represented a high percentage of Character and Behavior Disorders who were returned to duty as soon as evaluated. As the action increased approximately 50% of the caseswere diagnosed in two groups: 1. Those individuals manifesting physical exhaustion alone, who after receiving rest, food, and the change of clothing returned to their units within 12 hours. 2. Those individuals manifesting in addition to physical exhaustion, transient personality disorders due to the acute stress imposed on them by the tactical situation. Such cases were fed, clothed in clean clothing after shower and permitted a longer period of rest and then returned to duty. Sedation was required in only 3 of these individuals. A rest of 12-24 hours resulted in complete reversal of this personality state. Of the remaining 50% - 29% of the cases seen were diagnosed as psychoneurotic disorders almost all of whom were mild transient in nature and returned to duty directly. The remaining 21% included Character and Behevior disorders, Immaturity disorders and 'Others'. On 14 October 1952 the 7th Division began 'Operation Showdown', the first large offensive action directed by this division in the year. In reviewing this operation from a psychiatric viewpoint the pattern followed that found during the initial offensive action by the enemy. The highest psychiatric rate was not sustained in those units which were involved in the offensive assault (GRAPH #3 & #4) since after these units secured the positions they were withdrawn (hit and run). The units (GRAPH #5) which were employed to hold these positions against the enemy's counterattacks sustained a much higher rate of patients evacuated for psychiatric evaluation. 64% of the cases from this unit manifested either physical fatigue alone (25%) or Combat Exhaustion (39%), which indicated the role that such factors as lack of rest, food, and the psychological effect of 'waiting for the counter-attacks' play in increasing the evacuation of combat personnel for psychiatric evaluation. It may have been noted that the term 'NP Casualty' has not been used because such cases that manifest primarily physical fatigue are not psychiatric casualties. The forward medical units are to be commended during that tactical situation since the principle of treating such cases as far 'forward' as possible was applied as well as the tactical situation would permit.
One can understand in such a tactical situation with a marked increase in the WIA rate that these cases receive the higher priority for treatment by the forward medical units and justifiably so. However, despite the increased volume of other type cases these units retained many of the cases manifesting physical fatigue alone and provided them rest, and food and returned than to duty within a short period. Those cases manifesting additional findings such as transient personality states, (confusion, disorientation, etc.) were referred directly to the Clearing Company at which level the neuropsychiatric section functioned.
7
During the periods in which other types of casualties were high, it was at times necessary for these units to forward all of their cases fatigue and neuropsychiatric immediately to the Clearing Station. However, all cases reaching the Clearing Company were seen immediately by the Division Neuropsychiatrist (20-30 minutes) and their disposition was then determined - whether to duty (in those cases manifesting no psychiatric disease, conscious exaggeration of symptoms or Character and Behavior features) or to be retained for a period of observation. It has been estimated that in addition to those cases seen by the Division Neuropsychiatrist an additional 100 cases of physical fatigue were held at forward medical units and returned to duty after a short period of rest.
DIVISION FIELD ARTILLERY UNITS
In the first 2-3 weeks of October 1952 these units maintained sustained firing as the result of enemy probes and artillery fire and they supported 'Operation Showdown'. A marked increase was noted in the number of individuals referred for neuropsychiatric evaluations. However, 46% of the cases from these units evaluated showed evidence of physical fatigue without psychiatric disease, and 22% of the cases were diagnosed as Character and Behavior disorders. (GRAPHS # 5 and #14)
SERVICE UNITS OF THE DIVISION
Such units of the division have been utilized in reassigning individuals who had been found to be unable to function in direct contact with the enemy.? In the last half of the year there units were formed into provisional infantry battalions to be utilized in case of emergency and also to protect their own installations. On one occasion a number of such units were committed in the recent tactical situation. All personnel of these units were utilized including those individuals who had been transferred from infantry units because of their 'apparent' inability to withstand combat stress. Some of these units were used in blocking positions while others were utilized in close support bringing supplies to the combat infantry units. The number of neuropsychiatric cases seen from such units were relatively few and a small percentage of these cases were 'repeaters', that is, individuals who had been previously seen by any of the three division neuropsychiatrists that had been assigned to the division in the past year.
In such cases, with few exceptions, it was found that, although these individuals had been subjected to a stress similar if not greater than that under which they could not function effectively before, the clinical findings revealed that they had improved markedly. It can only be surmised that these individuals in 'near combat' units had (in most cases) made adequate adjustment and were able to function effectively when again placed under combat stress. The majority of such cases manifested findings of physical exhaustion or combat exhaustion and in most cases voluntarily requested return to duty.
8
CORRELATION OF CONSTRUCTIVE MONTHS SERVED TO NEUROPSYCHIATRIC CASES FOR OCTOBER 1952
We attempted to correlate the incidence of individuals nearing rotation among the neuropsychiatric cases seen during the month of October 1952. Through the cooperation of the Adjutant General Section of this division the CMS of 170 of the total cases seen were obtained (GRAPH #15), and it was noted that the large majority of the Neuropsychiatric Cases seen fell in the 20-30 point group and only approximately 6% of the total were individuals with sufficient points to rotate. It was therefore concluded that the factor of rotation affected only slightly the neuropsychiatric casualty rate for the month of October 1952, in this division.
SUMMARY
During the past year the neuropsychiatric section of this division continued to function at the holding platoon of the Clearing Company of the 7th Medical Battalion.
Since specific equipment for a Neuropsychiatric Unit were not authorized, the physical facilities needed were made available by the Clearing Company. The latter organization has cooperatively provided adequate equipment, transportation, and personnel so that this unit has been able to function efficiently in the past year.
In reviewing the neueopsychiatric statistics for the past year it has been found that this division sustained a high NP casualty rate in those months in which the division participated in holding action and aggressive patrol activity. Also during these periods, it was noted that this division had a far greater number of SIWs, Courts-Martials, and Recommendations for Administrative Discharge, in comparison to a period (October) in which month the division participated in offensive action. During the latter month, although the number of cases reported was greater, the number of the more severe forms of psychiatric disorders were relatively few. In this same month it was also noted that those units utilized in holding positions against counterattacks sustained a higher neuropsychiatric casualty rate than those units which participated in offensive actions and were then withdrawn.
The factor of 'rotation anxiety' affected but slightly the NP rate during this month. However, the greatest factor militating against good motivation and morale in the combat soldier in Korea has been the lack of a definite goal in sight with an increasing casualty rate.
[Ed.-Appendices and Graphs withdrawn]
AWARDS AND DECORATIONS
Silver Star:
M/Sgt Robert E Miller Med Co, 31st Inf Regt
Cp1 Bobby R GillMed Co, 17th Inf Regt
Cpl Alfred J ReidMed Co, 17th Inf Regt
Gp1 Gerald F Baude Med Co, 31st Inf Regt
Pfc Mara C PalmerMed Co, 31st Inf Regt
Bronze Stars
Lt Col Thomas P Jernigan III Hq 7th Inf Div
Lt Col Rudolph P Wipperman Hq 7th Inf Div
Major William L Lorton Hq 7th Inf Div
Capt Richard J Mulvaney Med Co, 17th Inf Regt
Capt Sameul V KingMed Det, Div Arty
Capt James A Miller Med Co, 187th ARCT
Capt Joseph G Bosco 7th Med Bn
Capt Billy B Brinkley Med Co, 31st Inf Regt
Capt Merrill H Brodie 7th Med Bn
Capt Lawrence F Casale Med Co, 17th Inf Regt
Capt Howard R Fenning 7th Med Bn
Capt Henry F Hartman 7th Med Bn
Capt Rex E Myers Jr Med Det, Div Arty
Capt George M Pullias Jr Med Det, Hq 7th Inf Div
Capt Edward R Minnick Clr Co, 7th Med Bn
Capt Theordore E Sandberg Med Det, 73rd Tank Bn
Capt Bernard K Steen 7th Med Bn
Capt George M Zimmer Jr 7th Med Bn
Capt Alfred L Sferra Med Co, 32nd Inf Regt
let Lt Herbert A Cox Med Det, Div Arty
let Lt Kenneth Stuart 7th Med Bn
1st Lt Judson H Wynne Jr Med Co, 31st Inf Regt
1st Lt John T Hagenbucher Med Co, 32nd Inf Regt
1st Lt Robert J Louis7th Med Bn
M/Sgt Charles A ThomasMed Co, 17th Inf Regt
SFC Harold E Barbare Med Co, 31st Inf Regt
Sgt James R Danford Med Co, 31st Inf Regt
Sgt John W Dawkins Med Co, 31st Inf Regt
Sgt Angel S Gutierrez Med Co, 17th Inf Regt
Sgt Ronald J FawlerMed Co, 31st Inf Regt
Sgt William H Fliekenger II Med Co, 17th Inf Regt
Sgt William A Hession Med Co, 31st Inf Regt
Sgt Donald P Plummer Med Co, 31st Inf Regt
Sgt Theodore L Leyan Med Co, 31st Inf Regt
Sgt Loyal MillerMed Det, 73rd Tank Bn
Sgt Edlevin A VarnadalMed Det, 73rd Tank Bn
2
AWARDS AND DECORATIONS CONT'D
Bronze Star Cont'd
Cpl Donald G Downer? Med Co, 31st Inf Regt
Cpl Darrel D Sharkey Med Co, 31st Inf Regt
Cpl Homer L WootenMed Co, 31st Inf Regt
Cpl Sylvester A, Plaszaj Med Co, 31st Inf Regt
Cpl James Kenny Jr Med Co, 32nd Inf Regt
Cpl Richard J Janowski Med Co, 17th Inf Regt
Pfc John W Hench Jr Med Co, 32nd Inf Regt
Pfc Rex J Schofield Med Co, 17th Inf Regt
Pfc Daniel B Trammell Med Co, 17th Inf Regt
Pvt John W HajekMed Co, 17th Inf Regt
Pvt Chester F ParafinawiczMed Co, 17th Inf Regt
Commendation Ribbon with Medal Pendant:
Capt Lloyd B McCabe Med Co, 32nd Inf Regt
Capt Frederick Babad Hq 7th Inf Div
1st Lt Emmett L Sellers Med Det, 13th Engr C Bn
1st Lt Glenn V Bailey Med Co, 17th Inf Regt
1st Lt Herbert H Carlish Med Co, 17th Inf Regt
Sgt Derbert C WallaceMed Co, 31st Inf Regt
Incl: I
7th Medical Battalion
HEADQUARTERS
7th Medical Battalion
APO 7
TRAINING MEMORANDUM??17 November 1952
NUMBER3
TRAINING OF MEDICAL BATTALION IN RESERVE
1. REFERENCES.
a. Tng Memo No. 9, Hq 7th Inf Div, dtd 11 Nov 52.
b. KM 21-5, Military Training, Sept 1950.
2. MISSION: To advance the unit to a higher degree of combat effectiveness by:
a.? Emphasizing the importance of the individual soldier to the successful accomplishment of the mission of the Medical Battalion.
b.? Further developing the skill of each operating team of the unit.
c.? Increasing the proficiency of unit commanders, leaders and key specialists.
3. GENERAL PLAN.
a.? The training cycle will commence on 21 November 1952 and will be of three weeks duration. Training will be scheduled thru the Bn S-3. The normal training period will be scheduled from 0700 to 1200 and from 1300 to 1700, Monday thru Saturday with additional training to be conducted during the hours of darkness.
b.? In general, training will be divided into three phases, with basic military subjects concentrated in the 1st week, general medical training in the 2nd week, and specialists training in the 3rd week.
c.? Training will be conducted away from 'classrooms' as much as possible and will emphasize demonstration and practical application. The use of improvised training aids to promote realism is encouraged.
d.? All training will reflect meticulous prior planning. Lesson plans will be present at each class; one copy with the instructor and one copy with an assistant instructor stationed at the rear of the class. The assistant instructor will report promptly to any training inspector giving Subject, instructor and Progress of Training.
e.? Commander's Time will be planned training time devoted to additional training in those subjects which testing has shown inadequate proficiency.
2
4. DETAILED PLAN.
a.? See annex 1, Unit Training Schedule.
b.? Training Areas and Facilities:
(1)? Ambulance Co Training Area - Just outside fence in Northeast section of area.
(2)? Clearing Co Training Area - Vicinity of flagpole in center of area.
(3)? Headquarters. Co Training Area - Ball field located in Southwest section of area.
(4)? Battalion Chapel.
(5)? Range Area: To be announced.
5.? ADMINISTRATIVE INSTRUCTIONS.
a.? All training will be conducted by or under the supervision of an officer. Maximum utilization will be made of combat experienced personnel as instructors. Well-rehearsed teams of experienced personnel will be used in conducting demonstrations.
b.? Weekly Training Schedules will be submitted to Bn S-3 on Thursday of the week prior to the training week concerned.
c.? Requests for changes, additions or deletions from Training Schedules will be made to this Headquarters, Attn: S-3, at least 36 hours prior to the hour of change.
d.? During the training cycle, Company Commanders will make the maximum number of personnel available for training. All platoons and sections will perform essential duties with skeleton crews. A report will be submitted to this Headquarters, Attn: S-3, by 0800 hours each training day showing the number of men present for duty within the Company and the number available for each hour of training throughout the day. Commanders will be able to justify each absence.
BY ORDER OF CAPTAIN NEUMAN:
JOHN J HANAGAN
2d Lt MSC
Adjutant
OFFICIAL:
/s/ John J Hanagan
/t/ JOHN J HANAGAN
2d LtMSC
Adjutant
HEAQUARTERS
7th Medical Battalion
APO 7
TRAINING MEMORANDUM?15 December1952
NUMBER 5
TRAINING OF MEDICAL BATTALION IN RESERVE
1.?? Recission:Training? Memo No. 4, this Hq, dtd 10 Dec 52
2.?? The training prescribed by Tng Memo # 3, this Hq, dtd 17 Nov 52, will be continued for 3 additional weeks beginning 15 Dec 52.
3.?? Provisions of Tng Memo #3 will be complied with except that the normal training day will be from 0730 to 1200 and from 1300 to 1630.
4.?? Unit Training Schedule:
Total Hours | Hours Per Week | Hours Per Week | Hours Per Week | ||
Troop Information and Education | 3 | 1 | 1 | 1 | |
Character Guidance | 3 | 1 | 1 | 1 | |
Military Security | AR 380-15 | 1 | 1 | ||
Heavy Tent Pitching | FM 20-15 | 3 | 3 | ||
Interior Guard | FM 26-5 | 1 | 1 | ||
Close Order Drill | FM 22-5 | 6 | 2 | 3 | 1 |
Fire Prevention | 8A Cir 36, 61, 73 | 1 | 1 | ||
Stone, Tent, M-1941 | 1 | 1 | |||
Motor Stables (Drivers Only) | TM 8-305 | (9) | (3) | (3) | (3) |
Daily police & Inspection of Areas and Personnel | (6) | (3) | (3) | ||
Motor Vehicle Operation | TM 8-305, 37-2810 | 8 | 4 | 4 | |
Convoy Technique | 1 | 1 | |||
Camouflage | FM 5-20, 5-20B, C | 2 | 1 | 1 | |
Military Courtesy & Wearing of Uniform | FM 22-5, 21-14, 7X Dir 24 | 1 | 1 | ||
Individual Clothing & Equipment | FM 21-15 | 2 | 2 | ||
Map Reading | FM 21-15, 21-26 | 12 | 4 | 4 | 4 |
Communications Procedures | FM 24-5, 24-18 | 2 | 2 | ||
Nomenclature, Caro, Cleaning, Disassembly, Assembly of Carbine | FM 23-7 | 2 | 2 | ||
Foot Marches | FM 21-18 | 8 | 3 | 4 | 1 |
Infantry Tactics | FM 7-10 | 24 | 7 | 8 | 9 |
Organization & Employment -Inf Regt | FM 7-40 | 1 | 1 | ||
Field Fortifications (Prot, Wire) | FM 5-15 | 2 | 2 | ||
Unit Review | FM 22-5 | 2 | 2 | ||
Emergency Medical Treatment | TM 8-230, 8-220 | 10 | 6 | 4 | |
Oral Hygiene | 1 | 1 | |||
Transportation of Sick & Wounded | FM 8-35 | 2 | 2 | ||
Medical Field Problem | FM 21-18, 8-35, 21-75 (Temp Shel) | 8 | 8 | ||
Specialists Training | 27 | 6 | 11 | 10 | |
Commanders Time | 10 | 3 | 3 | 4 | |
144 | 48 | 48 | 48 |
BY ORDER OF CAPTAIN NEUMAN:
OFFICIAL:? /s/ Earl W Mitchell
/t/ EARL W MITCHELL
????????????????????????? Captain? MSC
????????????????????????? Adjutant
