HEADQUARTERS 7TH INFANTRY DIVISION
APO 7
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES, 1953
(RCS MED - 41 (R-2))
J. SIDNEY RICE
Lt ColMC
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 DIVISION SURGEON
APO 7
RCS MED-41 (R-2)
ANNUAL REPORT MEDICAL SERVICE ACTIVITIES, 1953
INDEX
A. Tactical Operations and Deployment of the Seventh Infantry Division
B. Organization of the Medical Service of the 7th Infantry Division
1.Assigned Units
2.Attached Units
C. Personnel
1.Enlisted Men
2.Officers
D.Training Activities
1.On the Job Training
2.Formal Instruction
E. Supply Activities
1.Location of Division Medical Supply
2.Division Medical Supply Operations
3.Medical Supply Support
F. Sanitation and Preventive Medicine
1. Communicable Disease
2.Environmental Sanitation
3.Sanitary Instruction
4.Extra Military Sanitation and Preventive Medicine
G.Neuropsychiatric Activities in the Division During 1953
H. Hospitalization and Related Medical Services
1.Admissions to 7th Division Medical Facilities
2.Operating Room Procedures
I.Evacuations
1.Volume of Evacuations
2.Channels of Evacuation
3.Methods of Evacuation
J. Important Inspections by Other than Medical D6partment Personnel
K. Field Improvisations of 7th Division Medical Personnel which enabled Medical Units to Provide Better Patient Care
1.Use of Pistol, Caliber 45
2.Unsuitability of Litter, Folding, Aluminum, Field Type
3.Inclusion of a Knife in the Medical Kit, Individual
ANNUAL REPORT OF MEDICAL SERVICE ACTIVITIES, 1953
(RCS MED- 41 (R-2))
DDMD 319.1
A. TACTICAL OPERATIONS AND DEPLOYMENT OF THE SEVENTH INFANTRY
DIVISION
Certain basic knowledge of the tactical operations and deployment of the 7th Infantry Division for the year of 1953 is necessary for the proper interpretation of this Annual Report of Medical Service Activity. A short summary of tactical operations for the year of 1953 is therefore presented to enable the reader to view the divisional medical service in the perspective of the 7th Division's activities for the year.
On 1 January 1953 the 7th Infantry Division was defending the line JAMESTOWN on the I US Corps right (east) flank with two regiments on line, the 31st Infantry on the right just west of the Chorwon Valley in the T-Bone hill mass sector, and the 32nd on the left. The Division was organized in conformity with the prescribed TO&E with two exceptions - a Columbian Battalion was attached to the 31st Regiment and an Ethiopian Battalion was attached to the 32nd Regiment. The 17th Infantry Regiment was performing security guard mission at the UN War Prisoner Camps on CHEJU-DO and KOJE-DO. On 17 January, the 17th Infantry Regiment arrived in Inchon harbor and on 26 January 1953 relieved the 31st Infantry on line, the 31st Infantry going into division reserve at Camp Indianhead. Battle casualties for January -
274.
The Division continued the active defense of its sector of line JAMESTOWN in the I Corps sector during the month of February. Tactical activity for the month was on the increase. The enemy employed larger groups for more aggressive tactics during the month, dispatching 7 probes of the MLR positions. Battle casualties for the month of February - 291.
The Division continued to occupy line JAMESTOWN during the month of March. Major combat activity of the month occurred 23-24 March when the enemy executed five attacks against the Division Main Line of Resistance and out post line of resistance, with one of the attacks, the one against OLD BALDY, being successful. On 23 March, a reinforced enemy battalion assaulted OLD BALDY, located in the 31st Infantry sector, and the position was seized from elements of the Columbian Battalion (attached to the 31st Regiment) after an intense struggle. Friendly counterattacks continued for two days, but were unsuccessful. Battle casualties for the month of March - 1,032.
During April the Division continued to occupy and aggressively defend its position along line JAMESTOWN on the east flank of the I US Corps. On 2 April the 32nd Infantry relieved the 17th Infantry on line. Elements of the 17th were committed to action later in the month to repulse enemy attacks. Highlight of the month's combat activity began on 16 April when simultaneous enemy attacks were launched against outpost PORKCHOP, in the 31st Infantry sector, and outpost ARSENAL, in the 32nd Infantry sector.
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The main enemy effort was developed against PORK CHOP, which was initially overrun. Friendly reinforcements arrived, and the position was regained after bitter hand-to-hand combat. Action lasted until 18 April when a final enemy company sized attack was repulsed. Battle casualties for the period - 889.
The 7th continued to aggressively defend its positions in its sector of the line JAMESTOWN during the month of May 1953. On 2 May the Division deployed with all three regiments on line, bringing the 31st Infantry from reserve to occupy the Division left sector. Patrol clashes with the enemy continued with the major combat activity being enemy attacks against Outpost SNOOK, in the 17th Infantry sector, and Outpost YOKE, in the 32nd Infantry sector. In both engagements the enemy attacks were repulsed and the outposts remained in friendly hands. Battle casualties for the month - 277.
The Division was deployed as previously reported during the month of June. Highlights of the month were limited objective attacks by the enemy against the friendly Outposts on DALE, PORK CHOP, YOKE, and UNCLE. All attacks ended with the enemy being forced to withdraw. Battle casualties for the month - 331.
The 7th was deployed with three regiments on line from 1 July until 27 July when the 'Cease Fire' was effected and the Division withdrew to Post Armistice Main Battle Positions. Prior to the Cease Fire the Division sustained one major attack by the enemy and repulsed several probes against outpost and MLR positions. Highlight of the activity for the month was the battle for PORK CHOP. On 6 July the enemy coordinated attacks along the Division front with the major effort being directed against PORK CHOP which the enemy succeeded in penetrating, and partially occupying. After five days of bitter fighting, in which both sides alternately attacked and defended portions of the hill mass, and after the hill had lost all tactical value, the order was given to withdraw all friendly elements. Battle casualties for the month - 1,118.
The Division occupied the Main Battle Positions south of the DMZ in the vicinity of TAEGWANG-NI until relieved by the 25th Infantry Division on 19 August 1953. For the remainder of the year the Division was in I Corps reserve with the Division CP and the 31st Infantry located in the Camp Casey area. The 17th Infantry occupied Camp Britannia and Camp Hovey successively. The 32nd Infantry occupied Camp Bayonet. All units alternated between training, improving their camp sites, and work on the MBP SWITCH positions.
B. ORGANIZATION OF THE MEDICAL SERVICE OF THE 7TH INFANTRY DIVISION
1.ASSIGNED UNITS
a.Organization
Throughout 1953 the 7th Division operated with the standard
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TO&E medical units which were deployed in the conventional manner. It was never necessary to split up the Clearing Company into its component platoons as the Division's continued maintenance of line JAMESTOM from January of 1953 to the cease fire made it possible for the Clearing Company to function as a single unit. This was the first year that the Clearing Company had been able to operate continuously with this deployment.
The decrease in efficiency when Clearing Company platoons have had to operate as individual units has been quite marked. This has been particularly noticeable when, as throughout the Korean campaign years, the Clearing Company has had to operate with less than the TO&E authorized number of Medical Officers.
The Ambulance Company, during 1953, operated with one platoon in support of each regiment.
b.Deployment
Owing to the stability of the MLR it was never necessary for the Medical Battalion to move until the Division went into reserve on 19 August 1953. When regiments relieved one another on line medical companies traded positions, taking with them all TO&E equipment except tentage.
2.ATTACHED UNITS
In 1953 the 7th Medical Battalion had two units attached to it. These were the 37th Preventive Medicine Control Detachment (which, is discussed in the Sanitation and Public Health section of this report), and the 2nd platoon of the 567th Ambulance Company (Sep.). The 2nd platoon of this ambulance company was attached to the battalion to provide evacuation to higher echelon medical facilities. With the cessation of hostilities in July, there was no further need for having this unit attached, and it was returned to its parent organization in August.
C.PERSONNEL
1.ENLISTED MEN
a.Number of Enlisted Men
The table below shows the monthly strength of enlisted personnel assigned to the medical units of this Division during 1953. It also shows at what percent of full TO&E authorization for this same group the division operated during the year.
MONTHLY STRENGTH OF DIVISIONAL MEDICAL ENLISTED PERSONNEL FOR 1953
Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
Jan | 833 | 88% | Jul | 1002 | 106% |
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Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
Feb | 793 | 84% | Aug | 900 | 95% |
Mar | 913 | 92 | Sep | 896 | 95 |
Apr | 1091 | 116 | Oct | 851 | 90 |
May | 1093 | 116 | Nov | 841 | 89 |
Jun | 1040 | 110 | Dec | 854 | 91 |
Since the TO&E authorization for medical enlisted personnel was 943 men, it may be seen that the Division maintained an adequate number of medical enlisted personnel for the year as a whole but varied somewhat above and below full strength TO&E from month to month.
b. Adequacy of Enlisted Personnel
As in all branches of the service there was a scarcity of well qualified first three graders in medical MOSs. This, coupled with scarcity of pipeline medical aidmen, imposed a training problem on the medical units of this division.
Nevertheless, with the on-the-job training supplied at the units the medical aidmen did their usual excellent job.
c. Morale of Enlisted Personnel
Morale among the enlisted personnel in the Medical Service was better than it was for those in other branches of service when gauged by such factors as the ratio of company punishments and courts-martials to average unit strength. It is quite possible that the esteem in which the aidmen are held by members of their units gives them a sense of responsibility from which few shirk.
2. OFFICERS
a. Medical Corps Officers
(1)Number of Medical Corps Officers
The 7th Division operated will under authorized TO&E strength for Medical Corps Officers for the year 1953 as for years in the past. The TO&E in effect during 1953 authorized 42 Medical Corps Officers per Division. The number of Medical Corps Officers assigned to this Division, and the percentage of full TO&E strength that this number represents is shown below for each month of 1953:
MONTHLY STRENGTH OF DIVISIONAL MEDICAL CORPS OFFICERS FOR 1953
Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
Jan | 30 | 71% | Jul | 30 | 71% |
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Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
Feb | 30 | 71% | Aug | 32 | 76% |
Mar | 30 | 71 | Sep | 35 | 83 |
Apr | 30 | 71 | Oct | 28 | 67 |
May | 31 | 74 | Nov | 26 | 62 |
Jun | 28 | 67 | Dec | 23 | 55 |
(2)Adequacy of Medical Corps Officers
During the year of 1953 there were, on the average, three Regular Army Medical Corps Officers assigned to this division at any one time. By far the greater proportion of Medical Officers are entered in Federal Service for the minimum time required to discharge their service obligation. The professional ability of these officers has been, almost without exception, high. In contrast to this their military knowledge has sometimes been inadequate.
(3) Morale of Medical Corps Officers
The Morale of Medical Corps Officers has been satisfactory. Some dissatisfaction did arise, however, because of failure to rotate when expected. The source of this trouble lay in the necessity of holding Medical Corps Officers until replacements arrived in order to furnish the division adequate medical coverage. In some cases the officers had received, or believed they had received, promises of definite dates of departure by persons in authority.
b. Medical Service Corps Officers
(1) Number of Medical Service Officers
As with the Medical Corps Officers, the Division was chronically under the authorized TO&E full strength of 38 Medical Service Corps Officers for the year of 1953. Shown below, in tabular form, are the monthly strengths for this Division of Medical Service Corps Officers for 1953 and the percentage of full TO&E authorizations that these monthly strengths represents:
MONTHLY STRENGTH OF DIVISIONAL MEDICAL SERVICE CORPS OFFICERS FOR 1953
Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
Jan | 27 | 71% | Jul | 33 | 87% |
Feb | 26 | 60 | Aug | 34 | 90 |
Mar | 28 | 74 | Sep | 32 | 84 |
Apr | 32 | 84 | Oct | 30 | 79 |
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Month | No Assigned | % of Full TOE | Month | No Assigned | % of Full TO&E |
May | 35 | 92% | Nov | 17 | 45% |
Jun | 35 | 92 | Dec | 22 | 58 |
(2) Utilization of Medical Service Corps Officers
Medical Service Corps officers were utilized in normal TO&E positions. In Battalion Aid Stations during heavy fighting they assist the Surgeon by supervising evacuation and handling the lightly wounded section almost entirely on their own.
(3) Morale of Medical Service Corps Officers
The morale of the Medical Service Corps officers was, on the whole, excellent.
D. TRAINING ACTIVITIES:
1.ON THE JOB TRAINING
On the job training was most important both for enlisted personnel and for reserve officers of both the Medical and Medical Service Corps. The greater problem was, of course, encountered with the training of enlisted personnel both because of the numbers involved and because of the necessity to utilize infantrymen in medical occupational specialties due to lack of adequate pipeline medical replacements.
2.FORMAL INSTRUCTION
Before the cessation of hostilities as much class instruction was given as the tactical situation would allow and always in sufficient quantities to meet prescribed 7th Division minimum requirements. In the medical units 50% of EM were given class instruction at one time so that sufficient manpower was always on duty to furnish adequate medical support to the Division. The following were the ten subjects given major attention in class instruction during 1953: (1) TI&E, (2) Dismounted Drill, (3) Character Guidance, (4) Physical Training, (5) Weapons Drill, (6) First Aid and sanitation, (7) Weapons Training, (8) Know Your Enemy, (9) CBR Warfare and (10) Supply Economy.
E. SUPPLY ACTIVITIES
1.LOCATION OF DIVISION MPLICAL SUPPLY
The Division Medical Supply was located throughout the year with the 7th Medical Battalion. The Division Medical Supply Officer also served as Battalion S-4.
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2.DIVISION MEDICAL SUPPLY OPERATIONS
a.Before Cease Fire
The period from 1 January to the cessation of hostilities in July was marked by the use of large amounts of Surgical Dressings (Class II), and Surgical supplies, (Class III). Large amounts of whole blood, albumin, serum, and dextran, as well as a great number of litters were used during this period. Routine procurement of medical supplies was carried out on a weekly basis based on issue experience. A seven (7) day level with a three (3) day reserve was maintained.
A continuing program of exchanging worn-out TO&E property was in force during this period. A relatively rapid exchange could be made, due to the co-operation of the medical depot charged with support. The usual time required was approximately two weeks.
b.After Cease Fire
With cessation of active hostilities, the type of medical treatment changed from battle casualty emergency treatment to general dispensary treatment of disease and illness. This created a demand for rather different types of supplies from those needed during the fighting. Levels of drugs and chemicals, dental supplies, pharmacy and laboratory supplies were gradually built up, while levels of surgical battle dressings and related supplies were decreased. Adequate combat reserves were however, maintained to meet any sudden change in the tactical situation.
In September, a medical technical inspection of TO&E equipment on hand at the various Division Medical facilities was carried out. Equipment was found to be properly used, stored, and maintained. No shortages or overages, or other serious discrepancies were noted.
3. MEDICAL SUPPLY SUPPORT
Medical supply support was furnished by the First Platoon of the 6th Medical Depot, Army. At no time were serious shortages of any nature encountered. At one time or another manor shortages did occur for certain items, but some acceptable substitute was usually available so that proper field medical treatment was never impaired. Emergency requirements were immediately honored, even to the extent of making issues outside of normal duty hours.
Maintenance for technical medical equipment was also furnished by personnel of 6th Medical Depot. In most cases field repair could be obtained on twenty-four hour notice. Any item of equipment requiring more extensive repairs than could be accomplished in the field was taken to a shop, either at one of the advanced platoons, or at the Base Depot. Repair or replacement, whichever seemed most expeditious, was made immediately.
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F.SANITATION AND PREVENTIVE MEDICINE
The sanitary problems of the 7th Infantry Division in 1953 were, on the whole, the same as those encountered in 1952.
The 37th Preventive Medicine Control Detachment, an 8th Army unit, was attached to the Medical Battalion and was of great, assistance to this Division in insect and rodent control, instruction of division personnel in field sanitation, and in other sanitary control functions.
1.COMMUNICABLE DISEASE
The rates per thousand per annum for US troops admitted to 7th Division medical facilities for selected classes of communicable disease are reflected in the table below and are discussed in the following sub-paragraphs:
ADMISSIONS OF US TROOPS TO7TH DIVISION MEDICAL FACILITIES FOR SELECTED CLASSES OF COMMUNICABLE DISEASES DURING 1953 - RATES PER THOUSAND PER ANNUM
Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
Intestinal Infection | 1 | 5 | 0 | 1 | 17 | 9 | 2 | 64 | 29 | 13 | 3 | 29 |
Acute Respiratory | 177 | 102 | 79 | 75 | 116 | 118 | 30 | 57 | 75 | 158 | 207 | 80 |
Malaria | 2 | 3 | 3 | 4 | 4 | 1 | 3 | 2 | 1 | 0 | 0 | 1 |
Venereal Disease | 135 | 62 | 122 | 67 | 67 | 68 | 46 | 82 | 152 | 177 | 112 | 126 |
a. Malaria
(1)Control and Prevention of Malaria
For the first six months of 1953 mosquito larva surveys were negative. Preparations for the summer mosquito control program were completed in April. During May the dusting and fogging of rice paddies, ditches and ponds was begun on a small scale and in June these activities were continued on an extended basis.
By July mosquito larva surveys revealed a moderate number of culicine (non-malarial) and anopheline (malarial) larvae. Although the mosquito control program was intensified, the drainage of unused rice paddies continued to be a problem. Control in occupied areas was accomplished by the occupying units, and control in adjacent areas was accomplished by the 37th PMC Detachment.
Chloroquine was used for suppressive therapy of malaria. It was issued at the noon meal each Sunday from April until October. Indigenous civilian employees as well as the troops took chloroquine.
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(2) Incidence of Malaria
The incidence of malaria remained low throughout the year. In April a peak of 13 cases occurred. Only in April and May did the rate reach 4 cases per thousand per annum.
b.Hemorrhagic Fever
(1) Control and Prevention of Hemorrhagic Fever
In January of 1953 a program for hemorrhagic fever control was already in effect. This program included dipping of clothes in miticide (51-R-300), spraying of quarters with lindane, and rodent control.
During April, as part of this same program, a better degree of control over the miticiding of clothing was obtained by instituting the dipping of outer garments prior to issuance to regimental clothing exchanges. This practice was continued throughout the rest of the year.
Beginning with July further attempts were made to insure that all US troops in this division wore miticided clothes. Since a great deal of clothing was found to be laundered by indigenous personnel rather than by the Quartermaster laundry, miticide dips were made available for their use. The personnel were given instructions as to the proper method of impregnation.
(2)Incidence of Hemorrhagic Fever
The division was in the Hemorrhagic Fever belt for the whole of the year - both while on line and after being moved into reserve to a less endemic area for the latter part of the year. The incidence of the disease remained rather low throughout the year. Cases of Hemorrhagic Fever began to occur in May when five cases were recorded. In June eight cases occurred with the peak being reached in July when nineteen cases were confirmed. The disease dropped to three cases in August after which the disease almost disappeared for the rest of the year.
c.Upper Respiratory Infection
During January, 1953, with the increasingly cold weather, respiratory diseases increased to a rate of 177 per thousand per annum for US troops admitted to divisional medical facilities, as is normal for this time of the year. This rate then gradually declined to a low of 75 for April despite fluctuating and generally cold weather.
The incidence of upper respiratory infection again rose in October to 158 and up to the peak incidence for the year in November which was 207.
During late November and early December the respiratory disease incidence declined. It was felt that the continued construction
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of winterized tent kits plus the issuance of winter clothing was responsible for this decline. The rate for December for US troops was 80 admitted cases per thousand per annum.
d.Intestinal Infection
Diseases of the intestinal tract were low for the year with the average monthly rate of admittance of US troops to divisional medical facilities remaining at about ten cases per thousand per annum. During the month of August, however, an outbreak of approximately 300 cases occurred in the division. It appeared that this was a self-limiting disease of 2-4 days duration. The etiological agent was unknown, but epidemiological evidence suggested that the disease was spread by person to person transmission rather than by food or water.
e.Venereal Disease
The venereal disease rate fluctuated with the position of the Division. When the Division was on line the incidence was quite low. On the other hand, when the Division went into reserve in August where personnel of this unit were in much closer contact with the civilian populace than was formerly possible the incidence rose sharply and remained relatively high throughout the rest of the year.
f.Rabies and Rabies Control
During the year all personally owned canines over four months of age and other mammalian pets were vaccinated against rabies. Stray dogs were apprehended and sent to Army laboratory and hospital units which had requested them. Strays not needed for medical purposes were eliminated. One individual was bitten by a rabid dog and was given a series of injections of vaccine.
2. ENVIROMENTAL SANITATION
a. Storage of Food
During January of 1953 the cold weather was responsible for the freezing of large quantities of vegetables. Better storage of perishables at the ration break down points remedied this situation.
During the summer months the reverse problem - that of food spoilage due to lack of refrigeration - was controlled by the construction of underground coolers for the storage of perishables. This construction project was carried out by the 13th Engineer Battalion. Inspections by Medical Officers of unit coolers insured that unsatisfactory ones were condemned to be replaced by the Engineers.
b.Garbage Disposal
In January of 1953 a program to identify and properly cover
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and maintain all trash and garbage disposal areas in the Division sector was started. This program was intensified in February and carried on throughout the year.
After the cessation of hostilities and the movement of the Division to the reserve area of Camp Casey, Korea the division began to utilize sanitary fills operated by Korean civilians. Garbage disposal in these fills was unsatisfactory due to the practice of no-segregation of trash and garbage at unit level and the reluctance of the Koreans to compact and cover any salvageable material. The end result was a number of sanitary fills which were over filled and left uncovered. Flies were numerous in these areas.
In October garbage disposal was improved by the relocation of the I Corps disposal area. Regimental area sanitary fills remained barely adequate due to difficulties in securing bulldozer or tank dozer support in covering operations.
By December regimental consolidated garbage disposal areas improved and, although they still presented a problem, it was felt that their state of operation offered many advantages over company operated sites. Consolidated fills made inspection and control of operation more manageable.
c.Waste Water Disposal
During the winter months of 1953 the drainage of soakage pits and kitchen sumps was a problem. No completely satisfactory solution to this situation has yet been discovered.
d.Water Supply
During the first part of the year maintenance of an adequate water supply was a problem due to inefficiency of equipment. In March, however, this problem was partially relieved with the receipt of sufficient equipment to establish two new water points.
In June water points were moved into an area which would remain accessible to all units and yet be safe from floods during the expected rainy season.
With the cessation of hostilities and the divisional move to the reserve area of Camp Casey, water supply again became a problem. Water sheds were grossly contaminated due to the readmittance to the area of Korean civilians for the purpose of harvesting crops. A chlorine residual of 5 PPM was maintained at the water points to combat this problem.
3.SANITARY INSTRUCTION
Sanitary instruction was carried out throughout the year of 1953 and included:
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a.Instruction of indigenous personnel, as to clothing impregnation.
b.A course in insect and rodent control which was continued until representatives from all company size units in the division were trained.
c.An active education program to promote better habits of personal hygiene among divisional personnel.
4.EXTRAMILITARY SANITATION AND PREVENTIVE MEDICINE
a.Delousing
During 1953 over one thousand civilians were deloused each month by personnel from the 37th PMC, which also conducted delousing operations on prisoners in the demilitarized zone.
b.Immunization
A program of immunizing all indigenous personnel within the division sector was inaugurated during the month of June and continued throughout the rest of the year.
c.X-Ray Survey for Tuberculosis
All indigenous personnel employed by the division in 1953 were X-Rayed because of the high incidence of pulmonary tuberculosis in the civilian population. Many cases of active tuberculosis were found and the carriers eliminated from the Division.
G.NEUROPSYCHIATRIC ACTIVITIES IN THE DIVISION DURING 1953
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. The Clearing Company also continued to make available the physical facilities that were needed, since specific equipment for a neuropsychiatric unit was not authorized. However, the section has functioned more than adequately on the equipment, personnel and transportation provided by the Clearing Company.
From the statistics available for the year, the following table has been compiled which gives some indication, month by month, of the mental health of the command for the year. The key to this table is as follows: (1) TA - Total admissions to Division Medical Facilities, (2) NPC Neuropsychiatric Casualties (Ward cases), (3) %NPC - % of admitted NP cases to total casualties, (4) Evac - Evacuated, (5) % Evac - % evacuated of the total number of cases seen for the month, both out-patients and ward, (6)
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OPC - Out-patient cases, (7) SIW - Self Inflicted Wounds, (8) Adm - requests for neuropsychiatric clearance prior to proceedings for administrative separation - (369, 368 or 443), (9) CM - Request for neuropsychiatric clearance prior to court-martial proceedings.
PERTINENT MONTHLY NEUROPSYCHIATRIC STATISTICS FOR THE 7TH DIVISION, 1953
TA | NPC | % NPC | EVAC | % EVAC | OPC | SIW | ADM | CM | |
Jan | 1249 | 9 | .72 | 5 | 10.6 | 38 | 8 | 1 | 6 |
Feb | 1108 | 6 | .53 | 8 | 26.6 | 24 | 7 | 4 | 1 |
Mar | 1376 | 20 | 1.45 | 6 | 8.3 | 52 | 0 | 0 | 6 |
Apr | 1468 | 17 | 1.16 | 6 | 8.7 | 52 | 65 | 4 | 4 |
May | 1079 | 11 | 1.02 | 10 | 13.7 | 62 | 20 | 2 | 5 |
Jun | 1122 | 21 | 1.79 | 11 | 11.8 | 71 | 5 | 9 | 7 |
Jul | 2021 | 69 | 3.14 | 29 | 20.1 | 77 | 10 | 3 | 6 |
Aug | 648 | 13 | 2.01 | 9 | 14.7 | 48 | 3 | 1 | 2 |
Sep | 841 | 7 | .83 | 5 | 7.7 | 58 | 1 | 6 | 0 |
Oct | 718 | 14 | 1.95 | 12 | 13.5 | 74 | 0 | 3 | 3 |
Nov | 658 | 10 | 1.52 | 8 | 18.9 | 43 | 1 | 3 | 0 |
Dec | 741 | 5 | .68 | 4 | 9.3 | 38 | 0 | 3 | 0 |
As was to be expected, the greatest number of neuropsychiatric patients was seen in July the period of the heaviest fighting of the year. During this month the ratio of neuropsychiatric to total casualties was also high, as was the ratio of evacuations to total patients seen.
All things considered, however, the ratio of neuropsychiatric casualties to total casualties strikes one as remarkably low. A patient was not considered a neuropsychiatric casualty unless his services were lost to his unit for a period of twenty-four hours or more, and in no month did this ratio exceed 13.11% of total casualties.
Similarly, the ratio of neuropsychiatric patients evacuated to the total number of patients seen never exceeded 26.6% for any month, while the average for the year was 13.6%. The total number of patients seen includes both in-patients and out-patients.
The number of self-inflicted wounds is significant, too. Unfortunately, there are no statistics available with which to break these down as to whether they were intentional or due to negligence. However, it is seen from the table that for the first seven months of the year, there were one hundred and twenty-five self-inflicted wounds reported, while for the latter five months, there were only five. Even after one takes into consideration that there were a greater number of men handling weapons during the period of combat, it would still appear that in the period of relative stress, which the period January to July represents, the factor of secondary gain involved
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in intentional self-infliction of wounds is important in accounting for the high figures in the first half of the year.
An important feature of the psychiatric picture in the Far East in 1953 was the streamlining of the machinery for the more effective accomplishment of administrative separations under the provisions of AR 615-368 and 369. AFFE [Army Forces, Far East] circular number 83, dated 1 April 1953, appeared to have a resounding effect on the psychiatric program in the Far East Command. It certainly furthered its stated purpose of unifying and rendering less cumbersome the machinery by which undesirables and unsuitables were to be separated from the service. It was not unusual for the Division Psychiatrist to discover psychotics among individuals sent to his office for evaluation prior to board action. The recognition by higher command that the Division Psychiatrist was technically the most qualified authority to pass judgment on whether an incapacity was medical or non-medical prevented many miscarriages of justice.
H.HOSPITALIZATION AND RELATED MEDICAL SERVICES
1.ADMISSIONS TO 7TH DIVISION MEDICAL FACILITIES
The relative volume of US troops admitted to division medical facilities and the proportion of these that were admitted for diseases and non-battle injuries and battle injuries is presented in tabular form:
ADMISSIONS TO 7TH DIVISION MEDICAL FACILITIES BY MAJOR CLASSIFICATION
ARMY ACTIVE DUTY PERSONNEL RATES PER THOUSAND PER ANNUM
Jan | Feb | Mar | Apr | May | Jun | Jul | Aug | Sep | Oct | Nov | Dec | |
Diseases | 750 | 607 | 581 | 570 | 704 | 649 | 549 | 499 | 451 | 420 | 411 | 371 |
Non Battle Injury | 280 | 307 | 194 | 235 | 240 | 162 | 152 | 94 | 72 | 67 | 79 | 64 |
Battle Casualty | 290 | 294 | 662 | 641 | 187 | 271 | 1208 | 12 | 0 | 0 | 0 | 0 |
TOTAL | 1320 | 1208 | 1437 | 1446 | 1131 | 1082 | 1909 | 605 | 523 | 487 | 490 | 435 |
As can be seen from the above table there was only one month before the cease fire during which the rate of admissions to divisional medical facilities for battle injuries was greater than that for non-battle injuries and diseases combined.
2.OPERATING ROOM PROCEDURES
a.Volume of Procedures
The total number of operating room procedures conducted in
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1953 was 2,428. The proportion of this load handled each month is presented below:
TABLE OF OPERATING ROOM PROCEDURES CONDUCTED IN 1953
Month | Number | Month | Number |
Jan | 145 | Jul | 572 |
Feb | 143 | Aug | 102 |
Mar | 220 | Sep | 84 |
Apr | 275 | Oct | 91 |
May | 237 | Nov | 98 |
Jun | 365 | Dec | 96 |
As can be seen, the volume of procedures conducted varied considerably from month to month. During the peak fighting when the enemy attacked friendly positions on 16-18 April, the Operating Room at the Clearing Station operated night and day. Two teams, each consisting of two surgeons and an anesthetist, alternated on six hour shifts. In this three day period over 100 debridements alone were performed. Clearing Company personnel found that the variance in operating room work load made the planning and scheduling of operations during peak periods a taxing proposition.
b.Types of Procedures
It has been shown above that there was a great deal of variance as to the volume of operations conducted by the Clearing Company from month to month during 1953. It remains to be noted that the proportion of specific types of procedures to the total number conducted in a given period varied in accordance with the degree of combat activity during the period. During months of heavy casualties 90% of the procedures conducted fall in three classes, namely Debridement of wounds, Secondary closure of wounds and Suture of lacerations, whereas during periods when the Division was not in combat no few groups of operations accounted for any great majority of the operations. This is illustrated in the table below:
PERCENTAGE BREAKDOWN OF TYPES OF OPERATING PROCEDURES
FOR TWO REPRESENTATIVE MONTHS OF 1953
July | August | |
Debridement of Wounds | 63.0 | 0.0 |
Secondary Closure of Wounds | 16.0 | 2.0 |
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July | August | |
Suture of Lacerations | 10.0 | 0.0 |
Incision and Drainage of abscess | 5.0 | 24.0 |
Debridement of burns | 2.0 | 3.0 |
Excision of nail | 2.0 | 8.0 |
Excision of cyst | 1.0 | 17.0 |
Excision of skin lesion | 1.0 | 8.0 |
Evacuation of Thrombatic Hemorrhoids | 0.5 | 9.0 |
Anoacopic and Proctoscopic Examinations | 0.5 | 2.0 |
Doral Slit | 0.5 | 0.0 |
Circumcision | 0.1 | 6.0 |
Tracheotomy | 0.1 | 0.0 |
Skin Graft | 0.1 | 0.0 |
Pinel Graft | 0.1 | 0.0 |
Incision and Drainage of Hematoma | 0.1 | 0.0 |
Partial or complete removal of Nail | 0.0 | 12.0 |
Removal of foreign body | 0.0 | 4.0 |
Aspiration of cyst | 0.0 | 3.0 |
Excision of Ganglion | 0.0 | 2.0 |
TOTAL | 100.0 | 100.0 |
3.LABORATORY
During the year 1953 a total of 18,613 laboratory studies were conducted including blood counts, darkfield examination, urinalysis, urethral smears, blood smears and stool examinations. Serologies, and chemistries were sent to installations in the rear.
I.EVACUATIONS
1.VOLUME OF EVACUATIONS
A good gauge of the volume of evacuations out of Divison Medical Facilities is furnished by referral to statistics showing the size of evacuations from the 7th Medical Battalion. There were a few evacuations, however, which are not reflected in these statistics since some patients were helicoptored directly out of the Division from more forward medical installations.
The total number of evacuations from the Medical Battalion for 1953 was 6,750 patients -
about 40% of those admitted. Of interest is the following table which shows the monthly proportion of Army personnel evacuations to admissions during 1953.
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EVACUATIONS FROM THE 7TH MEDICAL BATTALION - US TROOPS ONLY - 1953
Proportion of each Classification Evacuated
Month | [Disease] | [Non-Battle Injury] | [Battle Casualty] |
Jan | 23%% | 46% | 52% |
Feb | 32 | 40 | 49 |
Mar | 31 | 39 | 38 |
Apr | 37 | 91 | 67 |
May | 32 | 39 | 45 |
Jun | 42 | 39 | 50 |
Jul | 46 | 53 | 81 |
Aug | 32 | 36 | 0 |
Sep | 33 | 36 | 0 |
Oct | 20 | 34 | 0 |
Nov | 14 | 23 | 0 |
Dec | 14 | 27 | 0 |
Yearly Average: | 30 | 41 | 50 |
It is apparent that an excellent job of retaining patients within Division medical facilities and returning them directly to their units was accomplished in 1953. The Medical Battalion was able to return a greater percentage of patients admitted for disease to duty than of either battle casualties or non-battle injuries. As would be expected, the division was able to hold less patients until they could be returned to duty in the months of heaviest admissions - April and July. Evacuation during these period of peak patient load was excellent. The Clearing Station was able to handle moderate soft tissue wounds. Severe chest, head, and belly wounds were quickly evacuated by helicopter to a MASH. It was felt, however, that gross soft tissue wounds and compound fractures sometimes had an excessive wait before surgery.
2.CHANNELS OF EVACUATION
Within the Division the normal chain of evacuation was followed in the great majority of cases. When necessary, however, critically injured cases were evacuated directly out of the division from forward medical units by helicopter. Of interest is the fact that the 7th Division Medical Battalion Clearing Company was in the chain of evacuation for patients from the 1st ROK Division on our left flank. Lightly wounded 1st ROK patients were sent from their Clearing Company to ours and then on to higher echelon medical facilities to the rear. This was accomplished by three ambulances from the 567th Ambulance Company assigned to the 7th Medical Battalion. The 6,750 patients evacuated from the Medical Battalion were sent to any one of thirteen medical facilities. The following table lists the percentage of patients going to each of these installations:
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PERCENTAGES OF 7TH DIVISION PERSONNEL EVACUATED FROM THE MEDICAL BATTALION TO THE FOLLOWING FACILITIES:
(1)618th Clearing Company (Sep) | 45.0% |
(2)Norwegian MASH | 19.0 |
(3)43rd MASH | 17.0 |
(4)121st Evacuation Hospital | 7.0 |
(5)8055th MASH | 3.0 |
(6)123rd Medical Holding Company | 2.0 |
(7)45th MASH | 1.0 |
(8)48th MASH | 1.0 |
(9)44th MASH | 1.0 |
(10) 8228th MASH | 1.0 |
(11) 8063rd MASH | 1.0 |
(12) US Hospital Ship | 0.5 |
(13) Republic of Korea Hospital | 0.5 |
Graves Registration | 1.0 |
Total | 100.0 |
3.METHODS OF EVACUTION
a. Within the Division
(1)Utilization of Ambulances
Within the Division ambulances were utilized in the conventional manner with the facility to which the patient was to be transferred providing the means of evacuation. During the winter months every effort was made to use ambulances as far forward as the tactical situation would permit.
The Ambulance Company of the Medical Battalion operated with one platoon in support of each regiment. Vehicles in need of repair belonging to a platoon supporting a regiment on line were transferred to the platoon supporting the reserve regiment before being deadlined. The Ambulance Company was able to provide excellent vehicular evacuation service both as to speed and comfort since the company received new ambulances during February and March.
(2) Utilization of Tracked Vehicles
Armored personnel carriers, (Tracked vehicle, M-75, personnel carrier), were utilized to carry the wounded whenever the tactical situation necessitated either because of proximity to enemy fire or because of difficult terrain to be navigated.
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These tracked vehicles have always been tactical vehicles under the control of the line commanders. Ammunition and other supplies were delivered to forward units under direct fire, and casualties were evacuated on the return trip, sometimes as far back as battalion aid stations, at other times to a forward point which was not under direct fire, where further evacuation by litter jeep was possible. This arrangement for the use of the APC was satisfactory and unit Medical Officers preferred this to a system in which APCs would be assigned to medical units.
b.Means of Evacuation from Divisional to Higher Echelon Medical Facilities
(1) Use of Ambulances
The 2nd platoon of the 567th Ambulance Company, (separate), was attached to the 7th Medical Battalion and` evacuated, patients out of the division.
(2) Use of Helicopters
Helicopters, furnished by I Corps, were a great aid in the evacuation of the seriously wounded as they were able to transport patients to higher echelon medical facilities both quickly and comfortably. Both the H-19 and the H-13 were utilized for this purpose.
All helicopter requests from divisional medical units were placed and controlled through the Division Surgeon's Office. Having the helicopters assigned to Corps was a suitable arrangement during periods when casualties were moderate or light. During the periods when fighting was at its peak, however, this Division experienced some difficulty in obtaining adequate helicopter support. During the PORK CHOP engagement of July this problem was solved by the attachment of one H-13 and one H-19 to 7th Medical Battalion Headquarters.
J.IMPORTANT INSPECTIONS BY OTHER THAN MEDICAL DEPARTMENT PERSONNEL
During the first part of 1953 there were two important inspections of the Medical Units of this Division. During January the 7th Division Medical Battalion was inspected by Lieutenant General Kendall, Commanding General of I US Corps, and Major General Smith, Commanding General of the Division. No deficiencies were noted.
In February the Annual Inspector General inspection was made of the 7th Division Medical Battalion. The Division Inspector General and his staff gave the Medical Battalion a rating of superior in the performance of its primary mission of care and evacuation of patients. The minor criticisms that were noted dealing with the provision of better defilade and camouflage of the Clearing Station wards were corrected immediately.
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K. FIELD IMPROVISATIONS OF 7TH DIVISION MEDICAL PERSONNEL WHICHENABLED MEDICAL UNITS TO PROVIDE BETTER PATIENT CARE
1.USE OF PISTOL, CALIBRE 45, M 1911 A2 IN PLACE OF CARBINE, CALIBRE 30, M1 OR M2 BY MEDICAL AIDMEN.
Whenever possible medical aidmen were armed with 45s rather than the authorized Carbine. The Carbine proved to be a severe encumbrance both while treating the wounded on the battlefield and when carrying a litter. For this reason it is recommended that the replacement of the Carbine with the 45 Caliber pistol be considered by higher authority.
2.UNSUITABILITY OF LITTER, FOLDING, ALUMINUM, FIELD TYPE
The Unit Medical Officers of this Division found the folding field litter most unsatisfactory due to the problem of having litters collapse while patients were carried on them. Other undesirable features of these litters were their weight and the difficulty of opening them under fire or single handed.
3.INCLUSION OF A KNIFE IN THE MEDICAL KIT, INDIVIDUAL
Division Medical unit personnel found that even the heavy, angular 8 inch scissors, (stock No. 3-638-400), dulled and failed to close properly under the heavy field use to which they were, of necessity, subjected. The scissors were being used for work for which they were not intended but for which no adequate substitute existed in the Medical Kit Individual (stock No. 9-274-960). For this reason it is recommended that a knife be included in the medical aidman's kit to be used for heavy duty such as the slitting of clothes. When this was tried in this Division both the aidman and the unit surgeon found the knife easier to manipulate and less subject to break dawn under field conditions than were the scissors.
