HEADQUARTERS 7TH INFANTRY DIVISION
Office of the Division Surgeon
APO 7
% Postmaster, San Francisco, Calif
12 December 1950 SSG-HC-3
SUBJECT: Health of the Command. Period 11 Nov to 10 Dec 50
TO : Commanding General
7th Infantry Division
APO 7
ATTN: G-1
I. General: The health of the command continues to be excellent during the report period, 11 November to 10 December 1950, despite operations under extreme cold weather conditions in the Korean zone of operations.
II. Operational Phase: The entire report period was operational.
1. Personal Hygiene:
The status of personal hygiene varied considerably in accordance with the physical location of troop units. Those in forward units and in a combat status were again completely dependent upon individual efforts. Personnel in the vicinity of Pukchong were able to utilize the facilities of the Quartermaster Portable Bath Unit from the start of the operating period until 30 November 1950, when the unit was passed out of operation in preparation for transportation of the unit. The unit has not been placed in operation in the Hungnam area since the Division has moved to this area. A second Quartermaster Bath Unit was moved to Pungsan to serve troops in that area, and a suitable location for its use.
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The cold weather in that area interfered when the pump on the unit froze and no heating facilities for the shower tent were available. This unit was never placed in operational status. The shower unit of the attached 1st Mobile Army Surgical Hospital was cannibalized by unknown personnel and was therefore incapable of being placed in operative status. Weekly inspections of personnel at all levels have not disclosed louse infestation and no louse borne disease has been discovered, despite the fact that personnel throughout have been utilizing indigenous dwellings for sleeping and warm-up purposes. Adequate amounts of louse control supplies have been available but utilization and issue have not been at expected levels. The principal control measure utilized was the individual louse powder, 2 ounce can, with bulk powder, and some treatment of occupied buildings. This office issued the following directive relating to personal hygiene during the period:a. DF [Ed.—Disposition Form], SUBJ: Revised Estimates of Required Amounts Insect and Rodent Control Supplies, dtd 11 Nov 50.
b. DF, SUBJ: Insect and Rodent Control Inspections and Supervision„ dtd 11 Nov 50. c. DF, SUBJ: Compliance with Sanitary Order, dtd 11 Nov 50.
d. Ltr, SUBJ: Availability of insect and Rodent Control Supplies,Hq 7th Inf Div, dtd, 14 Nov 50.e. Memo No. 13, Hq 7th Inf Div, SUBJ: Personal Health in cold Weather, dtd 16 Nov 50.
The Quartermaster Portable Laundry Unit operated continuously at Pukchong from 8 to 30 November 1950, providing laundry service for hospital and medical units. In addition, some unit laundry was processed when medical department laundry
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did not utilize its full capacity. The majority of laundry service was performed by individual efforts and by indigenous laundry facilities.
The shower and recuperation facility mentioned in Section III, Par 1, Ltr,Hq 7th Inf Div, Subj: Health of the Command, period 10 Oct to 10 Nov 50, was suspended on 11 Nov 50 and not again placed in operation.
2. Cold Weather Clothing: The major impact of operations in cold weather came during this report period. One hundred fifty four USA troops required treatment at medical facilities during the period 12 to 26 Nov 50, while thirty two Republic of Korea integrated cases were treated during the same time. Total frostbite casualties amounted to one hundred eighty six, of which 151 requiredevacuation out of division level. The reported casualties by day indicate:
Date | USA | ROK |
Nov 12-13 | 1 | 0 |
13-14 | 22 | 5 |
14-15 | 60 | 15 |
15-16 | 34 | 6 |
16-17 | 19 | 3 |
17-18 | 5 | 1 |
18-19 | 0 | 0 |
19-20 | 0 | 0 |
20-21 | 2 | 0 |
21-22 | 2 | 2 |
22-23 | 3 | 0 |
23-24 | 0 | 0 |
24-25 | 4 | 0 |
25-26 | 2 | 0 |
TOTAL | 154 | 32 |
Observations included:
a. Location of cold injury:
Lower extremity (largely toes) 60%
Head (largely ears) 30%
4 Other (largely hands) 10%
b. Personnel affected: Largely front line units and drivers of open vehicles.
c. Severity: Approximately 50% were mild and returned to duty at initial medical facility treating same.
d. Associated cold injury: Approximately 22% were associated with wounds, and cold injury was coincidental with loss of blood, inability to take care of self and time lapse in moving to medical installation.
e. ROK cold injuries: With units with approximately equal numbers of ROK personnel, cold injury incidence was approximately 1/4 that observed among USA troops.
f. Interrogation of cold injury patients: A system of interrogation and reports was established to ascertain the cause for cold weather injuries. The following points were ascertained to be important:
(1) Although instructed in cold weather operations, many personnel had never experienced living under such severe weather conditions, and apparently did not apply the instruction received personally. This observation applies to officers as well as enlisted men and may account for the percentage discrepant of cold injury between the ROK and USA personnel exposed to the same conditions.
(2) Although initially issued adequate socks, these were not available to soldiers when needed. Some were lost, stolen or in “A” pack with regimental train. Few personnel kept extra socks and felt insoles on their person to allow drying and regular changes.
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(3) Shoe pace were worn by men on long marches which resulted in sweating feet. Many neglected or were unable to change to dry inner soles and dry socks at the end of the day ormarch. Obviously this is a command problem to insure that the soldier is not over clothed while on long marches, carries extra insoles and socks and that he complies with orders at the end of a long hard day when he is exhausted and prefers not to expend the extra effort to care for his feet.
(4 ) Clothing and cold weather equipment.
Mountain sleeping bags are issued to about 1/2 the troops in the division. All others have standard wool sleeping bags with one additional blanket. No indication exists that the type of sleeping bag issued had any impact on the development of cold injury cases. Socks have been issued in adequate amounts but command action was indicated to assure that they were available to all soldiers on their person in proper amount. The Cap, field, is insufficient for protection of the ears, and mufflers were not initially issued to troops as a substitute or additional item. The cap, field, pile is the preferable headgear for cold weather operations. The muffler can be adequately used as a substitute for the pile cap if not available. Issue of Cap field pile and Muffler, wool, has progressed so that at the close of the period practically no divisional personnel were without these items. The decrease in the incidence of cold weather injury preceded the issue of these items in any major quantities, and is considered to be the result of making this problem a command responsibility.
(5) Warm-up huts and sock washing facilities provided by commanders materially improved the situation after
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inauguration.
(6) Lack of adequate clothing and sleeping gear was not a major factor. Individual negligence was a material factor early, in association with a relatively low level of command interest, but when corrected reduced the incidence materially. There were no known cases of self-inflicted cold weather injury cases and themajority were ascertained to be unavoidable. Approximately 10% of cases gave a history of previous cold weather injury to the affected organs.
(7) The observed rates per thousand per annum based on weekly incidence reports are as follows:
Week | USA | ROK | Total Div |
11-17 Nov | 423 | 224 | 365 |
* 18-24 Nov | 37 | 2 | 33 |
*25 Nov-1 Dec | 19 | 0 | 13 |
Note: * Ltr,Hq 7th Inf Div, Subj: Unnecessary Casualties due to Frostbite, dtd 17 Nov 50, is held to be responsible for the noted reduction in frostbite casualties. Par 4 is quoted: “The whole matter of loss of manpower is a command responsibility and all commanders will take immediate notion to reduce these losses to a minimum.” Subsequent low temperature periods during the period 18-24 and 25 Nov-1 Dec periods were not productive of cold weather injury because of the command attention, the experience gained by previous exposure to cold and the improvement in the type and quantity of clothing issued and made immediately available to personnel.
(8) The appointment of a Division Cold Weather Clothing Officer who is responsible for a continuing program of instruction to personnel, including replacements, in the care, use
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and wearing of the clothing articles supplied will be of future use in further reducing the incidence of such casualties.
3. Mess Hygiene:
With the minimum of exceptions, units were served “B” rations from unit kitchens throughout the period. An exceptionally fine Thanksgiving Day Holiday ration was available to all troop units including those in extreme front line positions. “C” and 5-in-1 rations were used by reconnaissance elements, troop units on the march and patrols, but were otherwise rigidly controlled. Ltr,Hq 7th Inf Div, File SCG 430.2, Subj: Unnecessary Consumption of “C” Rations, dtd 11 Nov 50, was issued to establish policies on the consumption of “C” rations. The service of “B” rations has been satisfactory on the whole, with a variety of methods of preparation being utilized. Soups have been frequently served and well appreciated. The amount of salt contained in this ration is excessive to the desires of a majority of personnel, but there is no known method of reducing this except in the process of canning, inasmuch as practically no additional salt is added by the mess personnel. The diet is reasonably balanced, although somewhat starchy, contains more fried components than are usually desirable and is definitely deficient in bulk. Standards of mess hygiene have continued to be fairly satisfactory, with practically no diarrhea and no epidemics of mess food poisoning. Indigenous personnel have not been employed, except for pan and utensil washing in some instances. Mess gear sanitation has been quite satisfactory as has been disposal of kitchen wastes and liquids. Latrines were almost universally 1ocated a sufficient distance away from kitchen facilities.
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A considerable number of requests were made by units to have Medical Officers inspect indigenous meats for unit use, despite the fact that Par 3, Sanitary Order,Hq 7th Inf Div, 16 Oct 50, specifically prohibits the consumption of indigenous meats. Corrective action includes publication of the following directives:
a. DF, SSG Subj: Consumption of Indigenous Meats by troops, TO: Unit Surgeons, dtd 17 Nov 50.
b. Ltr,Hq 7th Inf Div, File SSG 720, Subj: Consumption of Indigenous Meats by Troops, TO: Unit Commanders, dtd 19 Nov 50.
4. Foot Hygiene:
No material increase in foot casualties was noted during this period with the exception of the cold injury cases previously commented upon. Initially there was a shortage of foot powder, but efforts located 2300 packages initially, and at the end of the period the division had 22,000 packages on hand and issued to the troops.Instruction in the care of the feet were issued in the following issued directives:
a. DF, Subj: Compliance with Sanitary Order, dtd 11 Nov 50.
b. Memo No. 13, Hq 7th Inf Div, Subj: Personal Health in Cold Weather, dtd 16 Nov 50.
5. Republic of Korea Integrated Troops:
Sick rates for ROK integrated troops continued to be lower than comparable rates for USA troops. There were no reported communicable or epidemiologic diseases among these troops. No neuropsychiatric casualties have been reported, although additional personnel continue to be missing from their units. Recovery of
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these personnel has not been affected to date, and the presumption continues that they have deserted the service and returned to their homes.
6. Dust Respiratory Irritation:
The character of the terrain was such that a minor dust problem existed on roads despite sub-zero temperatures when road traffic was heavy. No cases of dust respiratory irritation were noted.
7. Water Discipline:
Water supply, chlorination and discipline have been satisfactory throughout. A daily report of location of operative Engineer Water Supply Points has been made and disseminated. These units have supplied adequately chlorinated water to troop units without excessive lengths of haul. Practically no use of well or surface waters was observed during the period. Chlorination techniques, when used by units, were adequate and all chlorine residual tests performed showed adequately high levels. There was no reported incidence of diseases of the water bore type.
8. Latrine Hygiene:
Standard straddle trench, pit latrines with QM or folding boxes and cathole types of fecal disposal were used. There was practically no observed indiscriminate soiling of the ground as had been noted previously. Closing of Korean type latrines has been universal. Latrines have in general been protected by tents, and in some instances have been heated. Construction was of the approved type, and latrine details have burned out latrines, limed them properly, provided seat covers and washed down the sects at intervals. The only error noted consistently was that of a general failure to provide urine baffle plates to protect the front wall
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of locally constructed QM boxes, and a tendency to fail to properly smooth the holes so that the seat was comfortable to use. Latrine pits were dug sufficiently deep that they have not filled abnormally fast and allowed adequate soil coverage on closing. Latrine pit closing techniques and marking have been satisfactory. Latrines have been promptly constructed on occupying a new area.
9. Food Service Supervision.
Continued inspections of food service activities by the Division Medical Inspector continue to indicate the need for more active supervision of food service by unit surgeons and unit mess personnel. The Division Food Service Supervisor has apparently continued to concern himself strictly with ration distribution, and no reports or apparent activities at troop unit levels have been received or noted during report period.
10. Mental Hygiene.
A definite increase in the incidence of anxiety status has been recorded by the Division Neuropsychiatrist. The morale of the troops showed a definite overall improvement, especially in troop units which advanced rapidly. The cold weather and exposure were received as a natural hazard to be overcome and did not depress esprit. Psychiatric interview and evaluations were made by the neuropsychiatrists at the clearing platoon level, with a preponderant majority of the patients returned to duty after interview and without hospitalization. Some return interviews have necessitated hospitalization. Nineteen neuropsychiatric casualties were evacuated to Corps Hospital units. One case of psychosis was seen and evacuated to Corps. Investigating officers have been requested for all cases suspected of self-inflicted
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wounds. No reports of investigating officers have been received on requests to date.
11. Medical Services:
The character of professional service rendered battle and non-battle casualties during the report period continued to be of a superior type. All units of the divisional medical service were utilized and necessarily so until 5 December, when it was possible to place the 3rd Platoon, Medical Clearing Company, 7th Medical Battalion in a reserve status. Upon closing in the Hamhung-Hungnam area, casualty loads were reduced so that both 2nd and 3rd Platoons were retained in as reserve status.
All transfers to higher echelons were made to the 121st Evacuation Hospital unit 7 December 1950, when surgical casualties were rerouted to the 1st Mobile Army Surgical Hospital and other casualties to the USNHS [Ed.—U.S. Navy Hospital Ship] “Consolation”.
12. Attached Medical Units:
The 1st Mobile Army SurgicalHospital, supported the divisional medical service in Pukchong until 1 December 1950, when it moved to Hamhung and on 3 December 1950 reverted to Corps control. During that time it processed a total of 154 patients whose condition was such they could not reasonably be transported the distance of seventy-six miles to the next echelon providing definitive hospital support. The assistance of their X-ray, pharmacy and laboratory sections in providing consultative and diagnostic service to the patients in 2nd Platoon, Clearing Company, cannot be underestimated as thereby professional decisions could be reached without the necessity of transfer.
The 1st Platoon, 560th Ambulance Company (Sep) was
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similarly attached through the period until detachment and reversion to Corps control on 3 December 1950. The majority of their workload consisted of evacuation of patients from Pukchong to Hamhung, with some assistance in ambulance haul from Pungsan to Pukchong. A detachment of 5 ambulances from the 2nd Platoon, 559th Ambulance Company (Sep) was attached from I Corps on 20th November and continued to support the 1st Platoon, 560th Ambulance Company (Sep) until reverting to X Corps on 3 December 1950.
An X Corps Hospital train made an initial evacuation from Pukchong to Hamhangan 25 November 1950, and subsequently made four additional hauls, completing the last trip on 5 December. No ambulances were diverted to complete evacuation of medical units north of Pukchong, in preparation for the retrograde movement of troop units.
13. Whole Blood.
The quantity and quality of whole blood available to divisional medical units was satisfactory throughout. The 26th ROK Infantry Regiment was similarly supplied with blood and medics supplies during the time they were attached to the Division. No use of blood from local donors was necessary. No transfusion reactions were noted.
14. Medical Department Personnel:
No enlisted replacements were received during the period. The 17th Infantry attrition of Company Aid Men (MOS 0666) and Litter Bearers (MOS 0657) amounted to fourteen personnel. Adjustment was made by reassignment of six EM (MOS 0666) from other units having no attrition to date, and securing necessary litter bearers from ROK personnel assigned to the Regiment. No other enlisted transfers
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were necessary.
The following Medical Department Officer Personal joined andwere assigned as follows:
a. Medical Corps:
PHIFER, William H. Capt, MC, Med Det 13th Engr (C) Bn – 22 Nov 50.
HAMMOND, Dean F., 1st Lt., MC, Med Co 17th Int Regt – 22 Nov 50.
ASHBY, Joe M., Maj, MC, Med Co 31stInf Regt – 22 Nov 50. (Dy as Surgeon 31stInf Regt)
BETTS, Wilmer C., MC, Off of the Div Surg – 27 Nov 50. Capt. (Dy as Div Neuropsychiatrist)
BUDGE, Robert S., Maj, MC, Med Co 32ndInf Regt – 24 Nov 50. (Dy as Surg 32ndInf Regt)
RILEY, John J., 1st Lt, MC, 7th Med Bn – 25 Nov 50.
WIISON, Jon M., Capt, MC, Med Co 32ndInf Regt – 5 Dec 50.
DAUTERIVE, Edward W., 1st Lt, MC, Med Co, 31stInf Regt – 5 Dee 50.
KAPLAN, Gerald, Capt, MC, Med Co 17thInf Regt - 7 Doe 50.
OUNGST, Daniel W., Maj, MC, Med Co 32ndInf Regt – 9 Dec 50.
b. Medical Service Corps:
LAFOON, Jesse N., 1st Lt, MSC, Med Co 32nd Int Regt – 22 Nov 50.
OLSEN, Earl W., 2nd Lt, MSC, Med Co 32ndInf Regt – 22 Nov 50.
CHAMPAGNE, Edward S., 2nd Lt, MSC, Med Co, 17thInf Regt – 7 Dee 50.
BASS, John, Capt, MSC, Med Co 31stInf Regt – 7 Dec 50.
PATTERSON, Elra W., Capt, MSC, Med Co 31stInf Regt – 7 Dec 50.
AMIDON, Donald A., 1st Lt., MSC, Med Co 32ndInf Regt – 7 Dec 50.
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c. Dental Corps:
COLTOFF, Sheldon, Capt, D)C, 7th Med Bn – 8 Dee 50.
The following transfers of Medical Corps officers wereeffected to permit maximal utilization of special skills within the divisional medical units:
LULL, Clifford B. Jr., Capt, MC,fr Med Det 13th Engr (C) Bn to 7th Med Bn.
RICHART, Joel H., Capt,MC fr Off Div Surg as Div Neuropsychiatrist to 7th Med Bn as Ass’t Div Neuropsychiatrist.
NOLEN, Harold W. Jr., Capt, MC,fr Med Co 17th Int Regt to 7th Med Bn.
WENZ, Irwin P., Capt, MC,fr 7th Med Bn to Med Co 31st Inf Regt.
BUDGE„ Robert S., Maj., MC, fr Med Bn 32ndInf Regt as Surg 32nd Inf Regt to 7th Med Bn as CO.
The following officer was declared Missing in Action::
ATCHLEY, Oren C., Lt Col, MSC, CO 7th Med Bn, as of 24 Nov 50.
[Ed.—On 31 December 1953 Lt. Col. Atchley was officially declared Missing in Action, Presumed Dead (hostile action), as of 24 November 1950.]
15. Civil Affairs:
On 11 Nov 50, Dr. La, Yong Chin, Korean Police Doctor, attached to 7th Medical battalion, was given the task of instituting a survey of medical facilities and intelligence in the division zone of operations in cooperation with the Civil Affairs Section. Working on a basic plan as outlined in GHQ Directives, and in conformity with plans of the Surgeon, X Corps, a comprehensive plan was developed and pursued. Surveys of medical facilities, resources, hospitals, staffs, level of medical education, needs for medical support for the care of indigenous populations, epidemiological status, vital statistics, and infant mortality was prepared for the following counties:
Pukchong – Pungsan – Kapsan – Hyesanjin – Samsu
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Plans for the surveys for the counties of Iwon and Hongwon were not completed due to the withdrawal of the division from that area prior to completion of the study. Distribution of approximately 5 tons of medical supplies for indigenous population use was controlled by a plan which prevented loss to black market or other misuse. Medical Department vehicles further hauled eight ambulance loads of relief supplies which were subsequently issued by local officials. For further details see copies of reports submitted.
IV. DIRECTIVES:
Directives issued during the report period included a revision of the Medical Annex to the Administrative Order; Ltr, Health of the Command, Period 11 Oct to 10 Nov 50, dtd 21 November 1950; continued the issue of periodic and cumulative battle and non-battle casualty reports and continued the graphic charts reflecting medical department activities. New reports included daily cold weather injury reports and interviews with cold weather casualties to determine if possible the cause of their being subject to weather hazards. The Daily Engineer Water Point Location Report and Daily Medical Department Unit Location Report were continued until 22 November 1950.
V. STANDARD OPERATING POLICY FOR OFFICE OF THE SURGEON.
No changes in the SOP have been made during the report period.
VI. CONTACT WITH HIGHER AUTHORITY:
10 Nov 50 – Division Surgeon visited Surgeon X Corps at Hamhung, reference operating policy, support, medical supplies and evacuation plan.
12 Nov 50 – Colonel Bolibaugh, GHQ Orthopedics Consultant and Colonel Hegeman, GHQ Surgical Consultant visited Divisional Medical Units
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at Pukchong.
16-17 tlov 50 – Colonel Gorby [Ed.—X Corps Surgeon] visited divisional medical units in Pukchong, Pungsan, Ungi and Kapsan.
26-28 Nov 50 – Division Surgeon and Division Medical Inspector called to office of Surgeon X Corps at Hamhung for conference with Colonel Long, Preventive Medicine Consultant, GHQ, reference plans for civilian medical support, Civil Affairs cooperation,status of immunization, water supplies and preventive medicine program.
10 Dec 50 – General [Edgar Erskine] Hume, surgeon GHQ, and Colonel Gorby, Surgeon X Corps visited divisional medical installations in the vicinity of Hamhung.
In addition to the above daily telephone contacts were maintained between the office of the X Corps and division Surgeons.
VII. STATISTICAL ANALYSIS:
1. General:
The plan of analyzing submitted reports of units into weekly battle and non-battle casualty reports, reflecting gross numbers and percentage of casualties by type and troop units, has been continued. Delay in submission of reports was less than previously noted, although time-space factors caused some delay.
2. Diseases Statistics:
Statistical analysis of reported diseases indicates the following rates per thousand per annum for the three week period beginning 4 November 50 and ending 24 November 50, as taken from Division Consolidated Statistical Health Reports. Reports for the period 25 November to 8 December 50 are delayed due to inability to secure correct figures from the units in the Chosin Reservoir area. These reports will be added to the next issued report.
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Line | Diseases | Cases | Rates |
45 | Common Respiratory Disease | 56 | 66.20 |
47 | Influenza | 8 | 6.84 |
48 | Measles | 2 | 1.71 |
52 | Pneumonia, primary | 31 | 26.44 |
53 | Pneumonia, primary, atypical | 1 | 0.85 |
57 | Tuberculosis, all forms | 2 | 1.71 |
58 | Vincent’s Angina | 1 | 0.85 |
60 | Common Diarrheas | 55 | 47.10 |
63 | Dysentery, unclassified | 11 | 9.42 |
69 | Malaria, acquired outside USA | 4 | 3.42 |
73 | Hepatitis, infectious | 15 | 12.82 |
77 | Rheumatic Fever | 1 | 0.85 |
78 | Scabies | 3 | 2.52 |
80 | Fever of unknown origin | 9 | 7.70 |
82 | Trench Foot | 10 | 8.50 |
83 | Gonorrhea | 9 | 7.70 |
85 | Other venereal disease | 31 | 26.44 |
86 | Frostbite | 141 | 120.70 |
The overall disease rate for the division, exclusive of cold weather injuries, was 11.40 per thousand per annum, which represents 228% of normal figures. The overall disease rote for the division, inclusive of cold weather injuries, was 17.25 per thousand per annum which represents 346% of normal figures. These are not considered disproportionate to the status of the division in combat in mountainous Korean territory during extreme cold weather operations.
[signed]
S. J. NEWSOM
Lt Col, MC
Surgeon
G-1 (Dup)
Historian (Dupl)
Info: SGO
Surg X Corps
File
SOURCE: National Archives and Records Administration, Record Group 407, Records of the US Army Adjutant General, 7th Infantry Division, Health of Command Reports, Box 3176.
