Battle Casualties and Medical Statistics

Casualty and Morbidity Experience

UNITS AND STRENGTH

At 0400 on Sunday, 25 June 1950, the Russian-trained North Korean Armyswept south across the 38th Parallel in four major drives. The U.S. Government,which maintained a small military mission in South Korea at the time, reportedthe aggression to the U.N. (United Nations) Security Council.

On 27 June 1950, the Security Council recommended all member nationsact to assist South Korea to repel the armed attack and restore peace.The same day, President Harry S Truman ordered U.S. military forces toassist in this effort, and on 1 July 1950, the first U.S. Army combat unitslanded in Korea.

During the 3 years of fighting and periods of peace negotiations, nearlyhalf a million American soldiers served in Korea, including medical evacuees,those rotated to the United States, units moved out of Korea to Japan andother areas, and individuals discharged from the Army. This resulted ina turn-over of strength in the Eighth U.S. Army of almost three times theaverage monthly strength of approximately 208,000 men for the 37-monthperiod- July 1950- July 1953.

Table 1 presents the U.S. Army monthly mean strength for the total U.S.Army in Korea as well as for U.S. Army division and non-division units.Eight U.S. Army divisions and two separate regimental combat teams servedat one time or another in the Korean War in addition to the 1st U.S. MarineDivision, the ground force contingents of other United Nations, and theArmed Forces of the Republic of South Korea. Twenty-two nations joinedforces under the U.N. flag in providing ground, air, naval, or medicalsupport to resist the Communist aggression. The major U.S. Army divisionunits were as follows: the 24th Infantry Division, the first to enter Koreaon 2 July 1950, fought until 4 February 1952 when it was ordered back toJapan; the 1st Cavalry Division returned to Japan on 30 December 1951 afterserving in Korea from 18 July 1950; the 25th Infantry Division served from9 July 1950; the 2d Infantry Division from 30 July 1950; the 15th RegimentalCombat Team from 3 August 1950; the 187th Airborne Regimental Combat Teamfirst entered Korea on 17 September 1950, left the war zone on 27 June1951, and returned to Korea on two occasions- 12 May- 17 October 1952 and,again, on 22 June 1953; the 7th Infantry Division from 18 September 1950;the 3d Infantry Division from 10 November 1950 (although the 65th RegimentalCombat Team, a part of the 3d Infantry Division, arrived in September 1950);the 45th Infantry Division, 5 December 1951; and the 40th Infantry Division),11 January 1952.

Eighth U.S. Army headquarters completed its movement to Korea on 25August 1950. The X U.S. Corps, previously activated to direct the amphibiouslanding at Inchon on 15 September 1950, acted as an independent force directlyunder the Supreme Commander. Upon the withdrawal from North Korea in December1950 and the return of these units to Pusan, X Corps became a part of theEighth U.S. Army and remained so throughout the period of the war.

The total U.S. Army strength in Korea represents midmonth averages ofend-of-month strength as reported by The Adjutant General (1). Thedivision and separate regimental combat team mean strengths included intable I and the breakdown by organic division units (table 2) are the averagemonthly strengths served as reported to the Army Surgeon General on summaryhealth reports (2) received from separate units operating medicaltreatment facilities. The non-division average strength was derived bysubtracting the division strength from the total.

After the buildup of the U.S. Army Forces, division units, which badpeaked at almost 90 percent of the strength in August 1950, averaged aboutone-half of the U.S. Army strength in Korea, while regimental units averagedalmost one-third of the strength. Table 3 and figure 1 reflect these relativedistributions by type of unit. Regimental troops, which consistently averaged58 to 60 percent of division strength, ranged frorn a high of 51

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Figure 1.- U.S. Army divisions and regimentsas percent of U.S. Army strength and regiments as percent of U.S. Armydivision strength, Korea, July 1950-July 1953.

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Table 1.- Distribution of U.S. Army divisionand non-division monthly mean strength, Korea, July 1950-July 1953

Month	Mean strength
	U.S. Army	Division	Non-division
1950
July	29,610	25,817	3,793
August	59,139	52,335	6,804
September	93,321	69,256	24,065
October	131,488	86,938	44,550
November	158,498	91,817	66,681
December	161,294	94,309	66,985
Total	633,350	420,472	212,878
1951
January	158,430	98,381	60,040
February	164,577	100,870	63,707
March	193,349	101,896	91,453
April	205,162	111,749	93,413
May	215,392	117,037	98,355
June	222,947	116,592	106,355
July	231,185	111,241	119,944
August	225,517	115,914	109,603
September	240,185	125,087	115,098
October	253,761	124,370	129,391
November	262,045	119,915	142,130
December	243,757	120,745	123,012
Total	2,616,307	1,363,797	1,252,510
1952
January	223,730	121,652	102,078
February	226,407	118,617	107,790
March	227,902	116,935	110,967
April	230,548	116,474	114,074
May	233,620	118,966	114,654
June	235,446	118,827	116,619
July	237,738	117,448	120,290
August	232,124	116,562	115,562
September	235,963	115,481	120,482
October	235,361	115,335	120,026
November	231,433	114,038	117,395
December	222,047	110,403	111,644
Total	2,772,310	1,400,738	1,371,581
1953
January	220,045	106,837	113,208
February	221,680	104,371	117,309
March	225,810	103,794	122,016
April	228,912	106,661	122,251
May	243,938	115,100	128,838
June	256,969	121,118	135,851
July	271,169	133,297	137,872
Total	1,668,523	791,178	877,345
Grand total	7,690,499	3,976,185	3,714,314
Average mean strength	207,851	107,464	100,387

percent of total U.S. Army strength in Korea in August 1950 to a low of 26 percent in November 1951. The relative proportions for the organic division units show a fairly stable distribution over the complete period of the war.

BATTLE CASUALTIES AND ADMISSIONS

The responsibility of the Medical Department of the U.S. Army for battlecasualties, as well as for nonbattle (disease and nonbattle injury) patients,lies in proper diagnosis and treatment and also in providing for the timelyevacuation and hospitalization of these patients. Consequently, medicalinterest in battle casualty statistics relates directly to informationneeded (such as diagnosis, anatomical location, and nature of trauma) toprovide medical care for personnel who become battle casualties. Inasmuchas this information can be obtained only from medical records, they arethe basic source of data. Tabulations of these individual medical records,by day of occurrence, organizational element, diagnosis, causative agent,surgical operation, and anatomical location of wound, provide the chiefsource of the data presented. The official battle casualty counts, however,are compiled by The Adjutant General and are based on casualty reportsforwarded through command channels. Obviously, because casualty informationis derived from different source record systems, patient data on certaincategories of battle casualty and the generally corresponding categoriescompiled from command channel casualty reports may differ slightly withrespect to totals.

Records received by The Surgeon General show the following counts: 18,769killed in action, 77,788 wounded in action and admitted to medical treatmentfacilities, and 14,575 slightly wounded in action and carded for recordonly- making a total of 92,363 wounded. The official totals included inThe Adjutant General's report (3) show 19,585 killed in action (including251 killed after capture) and 79,526 wounded in action. Although thesedifferences are not significant in analysis for operations research, planning,or similar purposes, nevertheless for completeness, The Surgeon General'skilled-in-action count was increased from 18,769 to 19,353 by matchingserial numbers from The Surgeon General's individual records of death withThe Adjutant General's records. With respect to the differences betweenthe wounded-in-action counts, the command channel casualty reports weregenerally submitted only for those wounded in action who were "unitlosses" (evacuated rearward and admitted to a medical treatment facilityand for which next-of-kin notifications were required). However, at thevery beginning of the Korean War, there was slight ambiguity concerningreporting requirements, and some of the wounded who were treated at divisionclearing stations and

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Table 2.- Distribution of division andseparate regimental combat team monthly mean strength, by type of unit,U.S. Army, Korea, July 1950-July 1953

Month	Mean strength
	Division	Division organic units
		Headquarters, headquarters and service companies	Regiments	Division artillery	Battalions
					Engineer	Medical	Tank
1950
July	25,817	3,609	14,661	4,751	1,944	622	230
August	52,335	6,093	30,094	9,802	3,062	1,191	2,093
September	69,256	7,924	39,345	13,421	3,826	1,403	3,337
October	86,938	9,183	51,948	16,148	4,448	1,644	3,567
November	91,817	10,391	54,202	16,808	4,586	1,849	3,981
December	94,309	10,877	55,108	17,248	4,798	1,975	4,303
Total	420,472	48,077	245,358	78,178	22,664	8,684	17,511
1951
January	98,381	10,700	57,995	18,545	4,979	1,886	4,276
February	100,870	11,227	59,989	18,478	5,134	1,836	4,206
March	101,896	11,377	60,652	18,706	5,268	1,860	4,033
April	111,749	11,903	67,878	20,041	5,723	1,912	4,292
May	117,037	12,787	70,430	21,172	6,043	1,937	4,668
June	116,592	14,351	67,454	22,059	6,198	1,971	4,559
July	111,241	14,004	64,553	20,382	5,958	2,056	4,288
August	115,914	13,882	68,689	20,826	5,933	2,117	4,467
September	125,087	14,894	72,135	24,298	6,682	2,309	4,769
October	124,370	15,586	70,250	24,528	6,612	2,315	5,079
November	119,915	14,454	69,308	23,133	6,137	2,101	4,782
December	120,745	14,062	71,065	23,598	5,927	2,176	3,917
Total	1,363,197	159,227	800,398	255,766	70,594	24,476	53,336
1952
January	121,652	14,722	71,280	23,481	5,749	2,081	4,339
February	118,617	12,967	72,099	21,715	5,590	2,010	4,236
March	116,935	13,084	70,141	21,660	5,686	2,122	4,242
April	116,474	13,684	69,498	20,885	6,053	2,144	4,210
May	118,966	13,608	72,773	20,626	6,105	2,123	3,731
June	118,827	13,797	72,509	20,788	5,656	1,995	4,142
July	117,448	13,600	70,573	21,406	5,628	1,984	4,257
August	116,562	13,891	68,393	21,746	6,384	1,925	4,223
September	115,481	13,510	67,956	21,595	6,339	1,922	4,159
October	115,335	13,613	68,274	21,658	5,769	2,008	4,013
November	114,038	13,874	66,612	22,434	5,322	1,969	3,827
December	110,403	11,895	66,880	20,870	5,240	1,775	3,743
Total	1,400,738	162,185	836,988	258,864	69,521	24,058	49,122
1953
January	106,837	11,400	64,914	19,947	5,144	1,794	3,638
February	104,371	11,319	63,296	19,560	4,605	1,798	3,793
March	103,794	11,491	62,462	19,409	4,556	1,869	4,007
April	106,661	12,156	62,913	20,182	5,219	1,999	4,192
May	115,100	12,208	69,794	21,634	5,270	2,074	4,120
June	121,118	12,262	74,676	22,441	5,200	2,262	4,277
July	133,297	13,783	82,106	24,681	5,996	2,139	4,592
Total	791,178	84,619	480,161	147,854	35,990	13,935	28,619
Grand total	3,976,185	454,108	2,362,905	740,662	198,769	71,153	148,588
Average mean strength	107,464	12,273	63,862	20,018	5,372	1,923	4,016

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Table 3.- Percent distribution of U.S.Army and U.S. Army divisions by type of combat unit, Korea, July 1950-July 1953

Type of combat unit	July 1950 through July 1953	July-December 1950	January-December 1951	January-December 1952	January -July 1953
U.S. Army	100.0	100.0	100.0	100.0	100.0
Division	51.7	66.4	52.1	50.5	47.4
(Regiments)	(30.7)	(38.7)	(30.6)	(30.2)	(28.8)
Non-division	48.3	33.6	47.9	49.5	52.6
U.S. Army divisions	100.0	100.0	100.0	100.0	100.0
Headquarters, headquarters and service companies	11.4	11.4	11.7	11.6	10.7
Regiments	59.5	58.3	58.7	59.7	60.7
Division artillery	18.6	18.6	18.7	18.5	18.7
Engineer battalions	5.0	5.4	5.2	5.0	4.5
Medical battalions	1.8	2.1	1.8	1.7	1.8
Tank battalions	3.7	4.2	3.9	3.5	3.6

 

not lost to their units were inadvertently included in the command channel reports. On the other hand, medical records were submitted not only for the "unit losses" but also for all of the slightly wounded, even those who were not admitted but could be treated in the vicinity, usually at an aid or clearing station, and returned to their units before the close of the morning report day. The latter, not officially excused from duty for as much as 1 day for medical care, were, as previously noted, the CRO (carded for record only) cases.

The reporting of DNBI (disease and nonbattle injury) cases is solelythe responsibility of the Medical Department, U.S. Army, and informationpertaining to these cases relates directly to the complete episode of theirrespective periods of medical treatment. The term "admission"as used in both text and source tables refers to instances of medical treatmentgiven on an excused-from-duty basis. These patients may have been treatedin a hospital or infirmary bed or "in quarters" (in a dispensarybed, at an aid station or clearing company, or in the person's usual quarters).Admissions to all medical treatment facilities in Korea numbered 443,163for all causes during the complete period of the war, July 1950-July 1953.In addition to the 77,788 wounded admissions, there were 365,375 nonbattleadmissions, (82.4 percent of the total), of which 290,210 resulted fromdisease and 75,165 from nonbattle injury.

In terms of annual rates per 1,000 average strength, for the completeperiod of the war, the overall counts represent 30 per 1,000 for killedin action, 121 per 1,000 for wounded in action admissions, and 570 per1,000 for disease and nonbattle injury admissions. All of these rates arelower than the corresponding annual rates for the June 1944-May 1945 periodof operations in the European theater during World War II, where ratesof 44 killed in action, 152 wounded admissions, and 859 DNBI admissionsper l,000, respectively, occurred. Table 4 shows the decline, on a yearlybasis, of approximately 90 percent from the high rates experienced in 1950for both killed in action and wounded admissions for total U.S. Army, Korea,compared to the overall drop of about 46 percent for DNBI admissions. Thedecline for division units shows sharper drops for disease and nonbattleinjuries, while non-division units experienced a much smaller decline innonbattle patients.

Since this report is concerned chiefly with the presentation of combatmedical statistics, both text and source tables that show admissions reflectdata related mostly to division combat units. Data are given for non-divisionand for total U.S. Army, Korea, to achieve perspective. For example, whiledivision units comprised slightly more than one half the average totalU.S. Army strength in Korea, (table, 5), they suffered almost 95 percentof the killed and wounded in contrast to slightly less than one-half ofthe DNBI admissions. The differences are more pronounced at the regimentallevel, where units comprising only 31 percent of the average U.S. Armystrength in Korea accounted for more than five-sixths of the killed andwounded compared to about one-third of the DNBI admissions. The respectiveunit annual rates also are highest at the regimental level, being 85 per1,000 for killed in action, 337 per 1,000 for wounded admissions, and 641per 1,000 for DNBI admissions. While these data cover all of the U.S. Armydivisions and regiments, that fought in the Korean War, the figures forheadquarters and service companies and for artillery, engineer, medical,and tank battalions reflect only the assigned organic division or attachedunits of the respective type. Separate combat units such as corps or armytroops are included with non-division units which represent combat

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Table 4.- Annual rates for killed in actionand admissions to medical treatment facilities, U.S. Army, Korea, July1950-July 1953
[Rates expressed as number of cases per 1,000 average strength per year]

Selected indexes	July 1950 through July 1953	July-December 1950	January-December 1951	January-December 1952	January-July 1953	Percent decline July-December 50 January-July 53
U.S. Army:
Killed in action	30	136	36	11	12	-91
Admissions, all causes	691	1,232	810	576	492	-60
Wounded in action	121	426	163	52	56	87
Disease and nonbattle injury	570	806	647	524	436	-46
Disease	453	607	507	424	357	-41
Nonbattle injury	117	199	140	100	79	-60
Division and regimental combat team:
Killed in Action	56	198	67	21	25	-87
Admissions, all causes	751	1,454	958	519	432	-70
Wounded in action	220	587	299	96	108	-82
Disease and nonbattle injury	531	867	659	423	324	-63
Disease	405	633	498	330	255	-60
Nonbattle injury	126	234	161	93	69	-71
Non-division:
Killed in action	2	14	3	1	1	-93
Admissions, all causes	628	797	647	635	547	-31
Wounded in action	16	110	14	7	9	-92
Disease and nonbattle injury	612	687	633	629	538	-22
Disease	504	558	516	520	450	-19
Nonbattle injury	108	129	117	108	88	-32

Table 5.- Distribution of average meanstrength and killed in action; battle and nonbattle admissions to medicaltreatment facilities, by type of combat unit: number, percent, and rate,U.S. Army, Korea, July 1950-July 1953
[Rates expressed as number of cases per year per 1,000 average (respectiveunit) strength]

Type of combat unit	Average mean strength				Killed in action
	Number		Percent		Number		Percent		Rate
U.S. Army	207,851		100.0		19,353		100.0			30.2
Non-division	100,387		48.3		699		3.6			2.3
Division	107,464		51.7		18,654		96.4			56.3
Headquarters, headquarters and service companies	12,273		5.9		328		1.7			8.7
Regiments	63,862		30.8		16,764		86.7			85.1
Artillery battalions	20,018		9.6		928		4.8			15.0
Engineer battalions	5,372		2.6		394		2.0			23.8
Medical battalions	1,923		0.9		28		0.1			4.7
Tank battalions	4,016		1.9		212		1.1			17.1
	Admissions
	Wounded in action					Disease and nonbattle injury
	Number	Percent		Rate		Number	Percent			Rate
U.S. Army	77,788	100.0		121.4		365,375	100.0			570.1
Non-division	4,827	6.2		15.6		189,390	51.8			611.9
Division	72,96,1	93.8		220.2		175,985	48.2			531.1
Headquarters, headquarters and service companies	902	1.2		23.8		13,170	3.6			348.0
Regiments	66,329	85.2		336.9		126,175	34.5			640.8
Artillery battalions	3,268	4.2		53.0		20,645	5.7			334.5
Engineer battalions	1,299	1.7		78.4		7,790	2.1			470.3
Medical battalions	70	0.1		11.8		2,790	0.8			470.5
Tank battalions	1,093	1.4		88.3		5,415	1.5			437.3

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Table 6.- Nonbattle admissions and CROcares for division and non-division by period and type of case, U.S. Army,Korea
[Cases stated as number per year per 1,000 average strength]

Period and type of case	Division				Non-division
	Admissions		CRO cases		Admissions		CRO cases
	Number	Rate	Number	Rate	Number	Rate	Number	Rate
July 1950-July 1953
All nonbattle causes	175,985	531	22, 015	66	189,390	612	73,295	237
Disease	134,100	405	21,040	63	156,110	504	72,210	233
Nonbattle injury	41,885	126	975	3	33,280	108	1,085	4
August 1953-December 1953
All nonbattle causes	18,335	320	5,980	105	25,780	459	12,925	230
Disease	16,060	280	5,660	99	22,125	394	12,740	227
Nonbattle injury	2,275	40	320	6	3,655	65	185	3
July 1960-December 1963
All nonbattle causses	194,320	500	27,995	72	1215,170	588	286,220	236
Disease	150,160	386	26,700	69	178,235	487	84,950	232
Nonbattle injury	44,160	114	1,295	3	36,935	101	1,270	4

 

¹ An additional 135 admissions (130 disease and five nonbattle injury) occurred before July in calendar year 1950.
² An additional 10 disease CRO cases occurred before July in calendar year 1950.

support and communications zone troops as well. These non-division troopscomprised about 48 percent of the average U.S. Army strength in Korea andprovided slightly more than one-half of the admissions to medical treatmentfacilities for disease arid nonbattle injuries. The extremely low annualrates of 2 per 1,000 for killed in action and 16 per 1,000 for woundedadmissions reflect the relatively low level of risk and exposure to combatfor most of these non-division troops.

All of the detailed cross-tabulations of data included in the sourcetables presented for overall counts of disease and nonbattle injury coveradmissions through December 1953 and, therefore, reflect a slightly largernumber of admissions than does the shorter period through July 1953. Theoverall annual admission rates, however, are somewhat smaller. From thedata presented in table 6, it may be seen that this reduced annual rateis due, largely, to the lower rates experienced during the August-December1953 peacetime period. In addition, the changeover from combat permittedmore nonbattle patients to be treated within the division medical serviceas CRO outpatients and, undoubtedly, contributed to the overall reductionof the division admission rate. Non-division troops, on the other hand,did not experience a comparable shift between inpatients and outpatient.

The most frequent traumatism diagnosed as the cause of battle admissionswas wounds of all types (62 percent). Penetrating wounds were the mostprevalent type, representing 57 percent of wounds of all types, and 35percent of the total number of admissions to medical treatment facilitiesfor wounds. Fractures accounted for 23 percent of the total wounded, withcompound fractures amounting to 19 percent. The distribution of the balanceof wounds (table 7) shows each of the other types of traumatisms, was lessthan 3 percent of the total wounded. For division and separate regimentalcombat teams, the relative distribution was identical to total U.S. Army,Korea. The nondivision units show slightly less proportionately for fracturesand slightly more for other types of wounds, such as burns, contusions,and concussions. Figure 2 graphically depicts similar distributions fornonbattle injury admissions through December 1953. Fractures, amountingto 18 percent of the total, were the leading cause of admission for divisionunits, followed by sprains, strains, and dislocations (17 percent), coldinjury (16 percent), and wounds of all types (15 percent). Contusions contributed12 percent of all nonbattle injury admissions for divisions. Although fracturescaused 19 percent of all nonbattle injury, admissions in the non-divisionunits, they ranked second to sprains, strains, and dislocations, whichaccounted for almost 25 percent of the total. Wounds of all types represented16 percent of the total nonbattle injuries for non-division units, followedby contusions (13 percent). Cold injury, which was a leading cause of nonbattleinjury admissions for

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Figure 2.- Percent distribution, nonbattleinjury admissions, by nature of traumatism and type of unit, U.S. Army,Korea, July 1950- December 1953.

division troops (16 percent), amounted to slightly less than 3 percentfor non-division units. This latter phenomenon results from the degreeof exposure to the elements required of combat troops.

The most important cause of disease admissions among U.S. Army troopsin Korea was acute respiratory infections, which accounted for one-fifthof all disease admissions for all Army units. This condition was responsiblefor 15 percent of the disease admissions among division troops and 26 percentof the disease admissions in non-division units. The second most frequentcause of admission for divisions was symptoms and ill-defined conditions,closely followed by infective and parasitic disease. This latter diagnosisand diseases of the digestive system, with annual admission rates of 53and 47 per 1,000, respectively, were the second and third leading causesof disease admissions for non-division units. Psychiatric conditions representedover 9 percent of disease admissions for division troops, producing a rateof 36 per 1,000 average strength per year. This compares with 5

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Table 7.- Admissions due to battle injuriesand wounds by typre of unit and diagnosis, U.S. Army, Korea, July 1950-July1953

Diagnosis	Admissions
	Total		Division and regimental combat team		Non-division
	Number	Percent	Number	Percent	Number	Percent
Total	77,788	100.0	72,961	100.0	4,827	100.0
Fractures, total	17,910	23.0	17,031	23.4	879	18.2
Skull, depressed	1,020	1.3	953	1.3	67	1.4
Compound	14,495	18.6	13,894	19.1	601	12.4
Simple, other	2,395	3.1	2,184	3.0	211	4.4
Wounds, total	48,217	62.0	45,319	62.1	2,898	60.0
Incised, lacerated, or puncture	3,937	5.1	3,658	5.0	279	5.8
Penetrating	27,551	35.4	26,106	35.8	1,445	29.9
Perforating	8,902	11.4	8,470	11.6	432	8.9
Other, not elsewhere classified	7,827	10.1	7,085	9.7	742	15.4
All other, total	11,661	15.0	10,611	14.5	1,050	21.8
Abrasions and blisters	649	0.9	581	0.8	68	1.4
Amputation, traumatic	1,120	1.4	1,072	1.5	48	1.0
Avulsion	270	0.3	250	0.3	20	0.4
Burns	766	1.0	683	0.9	83	1.7
Concussion	1,781	2.3	1,628	2.2	153	3.2
Contusion	2,055	2.7	1,890	2.6	165	3.4
Crushing	13	0.0	12	0.0	1	0.0
Dislocation of joint	75	0.1	--	--	75	1.6
Hemothorax, traumatic	1,880	2.4	1,810	2.5	70	1.5
Sprains and strains	1,883	2.4	1,727	2.4	156	3.3
Other and unqualified	1,169	1.5	958	1.3	211	4.3

percent for non-division units and a rate of 25 per 1,000 per year.The frequency of admissions for the various other diagnostic classes isshown in figure 3.

OUTPATIENT CARE AND CARDED FOR RECORD ONLY

During the period, July 1950-December 1953, U.S. Army medical treatmentfacilities in Korea treated 128,790 patients who did not require admission,but who, for one reason or another, were carded for record only. Aboutone-third of the GRO cases from divisions were wounded and the balance,was due to nonbattle conditions (table 8). For non-division units, almostall (98 percent) were nonbattle cases. It should be noted that these patientsdo not, represent the total number of outpatient visits or treatments atU.S. Army medical treatment facilities in Korea, but only those cases forwhich a record was specifically required by appropriate Army regulation(4). The CRO cases generally include all of the wounded who are treatedas outpatients and all nonbattle cases which are received "dead onarrival." In addition, certain nonbattle patients with conditionswhich might possibly result in a claim against the U.S. Government, thosefor whom a record is required for ad-

Table 8.- Number and percent distributionof outpatient cases carded for record only, by type of unit, U.S. Army,Korea, July 1950-December 1953

Type of case	Total		Division		Non-division
	Number	Percent	Number	Percent	Number	Percent
All causes	128,790	100.0	40,477	100.0	88,313	100.0
Wounded in action	14,575	11.3	12,482	30.8	2,093	2.4
Disease and nonbattle injury	114,215	88.7	27,995	69.2	86,220	97.6
Disease	111,650	86.7	26,700	66.0	84,950	96.2
Nonbattle injury	2,565	2.0	1,295	3.2	1,270	1.4

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Figure 3.- Disease admissions, by diagnosticclass and type of unit, U.S. Army, Korea, July 1950-December 1953.

ministrative or other reasons, and all venereal disease cases treatedas outpatients are carded for record only.

Wounds of all types accounted for 85 percent of all wounded CRO cases,with abrasion and blisters (6 percent), contusions (3 percent), burns andconcussions (2 percent each), sprains and strains (1 percent), and otherand unqualified (1 percent) accounting for the balance of 15 percent. Thenonbattle injury CRO cases were distributed as wounds of all types (35percent), fractures (11 percent), drowning victims (10 percent), sprainsand

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Table 9.- Outpatient treatments at U.S.Army medical treatment facilities, Korea, by category of personnel andtype of treatment, 1 June 1951-31 December 1953

Type of treatment	All categories	Active-duty military personnel				All other
		Total	Army	Navy and Marine Corps	Air Force
Total treatments	10,928,162	4,343,535	4,314,952	6,218	22,365	6,584,627
General medicine	8,006,189	3,118,578	3,104,207	3,871	10,500	4,887,611
Dermatology	621,764	245,793	243,505	241	2,047	375,971
General surgery	146,420	99,732	98,864	91	777	46,688
Surgical dressing room	1,009,981	366,826	364,923	787	1,116	643,155
Ophthamology	458,166	135,741	130,585	716	4,440	322,425
Ear, nose, and throat	619,085	328,109	324,752	452	2,905	290,976
Neuropsychiatry	38,481	23,043	22,563	24	456	15,438
Psychological tests	668	653	642	--	11	15
Obstetrics	231	73	73	--	--	158
Gynecology	572	572	572	--	--	--
Pediatrics	440	--	--	--	--	440
Physiotherapy	22,181	21,429	21,302	35	92	752
X-ray and radium therapy	3,984	2,986	2,964	1	21	998

 

strains (7 percent), contusions (7 percent), multiple injuries (6 percent), burns (5 percent), abrasion and blisters (3 percent), poisoning (2 percent), avulsion (1 percent), and other and unqualified (13 percent).

Infective and parasitic disease (largely venereal disease) accountedfor almost 90 percent of the CRO cases for disease conditions. Urinaryand male genital disease, with 6 percent of the total, was a distant second,followed by skin disease (2 percent) and bones and organs of movement (about1 percent). None of the other diagnostic classifications was responsiblefor more than 0.5 percent of the total disease CRO cases in Korea.

The requirement for submission of Outpatient Report (DD Form 444) wasinstituted by Army regulation (5) beginning with the month of June1951. Before that time, outpatients were recorded locally by medical treatmentfacilities through use of an outpatient register. The regulations (4)in effect at that time required submission of a register card on each individualentered on the register at every medical treatment facility. The availabledata for U.S. Army, Korea, are taken from the Outpatient Report and, consequently,cover the period 1 June 1951-31 December 1953.

About 10.1 million outpatient visits to Army medical facilities in Koreaduring this period required the performance of about 10.9 million outpatienttreatments. In addition, Army medical treatment facilities in Korea performedmore than 40,000 complete physical examinations (including flight physicalexaminations), 5.5 million immunizations, and 32,000 specified periodicexaminations or tests. It should be noted that these data exclude all dentaloutpatient care.

Of the 10,0 million outpatient treatments given by Army medical treatmentfacilities in Korea during this period, approximately 43 million (40 percent)were received by active-duty military personnel, almost all of whom wereArmy personnel. The remaining 6.6 million (60 pereent) were received by"all, other" personnel, chiefly enemy prisoners of war. In termsof an index per 1,000 average strength, the annual outpatient treatmentrate was 6,954 per 1,000 for U.S. Army personnel in Korea during the June1951-December 1953 period. This rate, however, is considerably lower thanthe individual year total Army worldwide annual outpatient treatment ratesof 8,200 for 1952 and 8,600 for 1953.

The distribution by type of treatment among various categories of personnel,as shown in table 9, indicates that active-duty military personnel receivedless than one-half of the various other types of treatments, with the exceptionof general surgery; ear, nose, and throat; neuropsychiatry; psychologicaltests; gynecology; physiotherapy; and X-ray and radium therapy. For example,60 percent or more of general medicine, dermatology, surgical dressingroom, ophthalmology, obstetric, and pediatric treatments were receivedby other than military; principally, enemy prisoners of war.

In comparing the various outpatient treatments by type of treatment,general medicine, with almost three-quarters of the workload, constitutedthe most frequently required treatment. Surgical dressing room with 9 percentof all treatments was second, followed by dermatology (6 percent), ear,nose, and throat (6 percent), ophthalmology (4 percent), and general surgery(1 percent). None of the remaining types of treatment represented as muchas 0.5 percent of the total.

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Table 10.- Average duration of stay inU.S. Army hospital and quarters, worldwide: World War II and Korean War;and combat units by area of disposition and type of case, Korea, July 1950-July1953

Area of disposition	Type of case
	Wounded in action	All nonbattle cases	All disease	All nonbattle injury
Total Army, World War II	129	20	19	30
Total Army, Korean War	93	20	18	28
Divisions and regimental combat teams:
All areas	96	21	15	40
Far East Command	34	14	11	22
All overseas areas	37	14	12	23
Continental U.S.	258	170	141	200

AVERAGE DURATION OF STAY

Data on average duration of patient stay in hospital are important fromthe standpoint of planning for inpatient medical rare. The number of bedsthat must be provided, as well as the amount of professional and ancillarypersonnel needed, are directly related to the numbers and types of patientsrequiring inpatient care and to the length of stay that is, likely to result.

These data on duration of stay relate to all cases admitted to medicaltreatment facilities (hospital and quarters) and exclude all CRO cases,which involve no loss of time from duty. The data on average duration fordivision and separate regimental combat teams cover all of their cases,originating in Korea during 1950-53, regardless of where the final dispositioneventually occurred. For example, table 10 shows that the overall averageduration per division wounded was 96 days compared to 93 days for totalU.S. Army, Korea, and 129 days for World War II. An average of 34 day'sper case was spent in the Far East Command (Japan-Korea), 37 days in alloverseas areas (including the Far East Command); for wounded cases evacuatedto the United States, an average of 258 days was lost for each woundedcase hospitalized in the United States. Disease and nonbattle injury combinedcases averaged 20 days in both World War II and the Korean War. However,by type of case, nonbattle injury had the longer duration. In fact, fordivisions, the nonbattle injury average duration was almost three timesas long as that for disease cases.

When duration-of-stay data for divisions in Korea are distributed bytype of final disposition, large differences are noted. Wounded admissionsfrom division units in Korea who were eventually returned to duty anywhereaveraged 65 days in hospital or quarters, whereas the died-of-wounds casesaveraged only 10 days. All other wounded dispositions, including separationsfor disability, and for administrative reasons, had the largest averageduration (371 days). Returns to duty among nonbattle cases, originatingin divisions in Korea averaged 19 days, nonbattle deaths 17 days, and all,other dispositions 233 days. For disease cases, the average duration ofstay was 14 days per case for returned to duty, 23 days for deaths, and200 days for all other disease dispositions. Comparable average durationsfor division nonbattle injury cases were 36 days for returns to duty, 9days for deaths, and 299 days for all other dispositions.

The longest average durations, obviously, occur among those cases separatedfrom the Army, usually among the disability separations. Most of the reasonsfor this have to do with the nature and severity of these cases from amedical viewpoint and the type and amount of treatment provided. Some ofthe reasons also result from the administrative processing required aswell. The data included in table 11 show the average duration for all nonbattlecases worldwide separated for dis-

Table 11.- Average duration of stay inU.S. Army hospital and quarters, worldwide, for nonbattle causes separatedfor disability, by year, 1950-53

Year	All nonbattle causes	Disease	Nonbattle injury
1950	251	242	392
1951	116	110	279
1952	166	154	326
1953	169	158	297

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ability in the U.S. Army each year from 1950 through 1953.

NONEFFECTIVENESS

One of the most significant indexes used to measure the health of theArmy is the noneffective rate. This index is usually represented as theaverage daily number of patients in hospital and quarters on an excused-from-dutybasis per 1,000 average strength during the period considered. This measureof time lost from duty not only indicates the nonavailability of personnelfor the performance of their assigned duty, but also is important fromthe standpoint of providing medical care for them by the Army Medical Department.The amount of noneffectiveness depends primarily on two factors: (1) therate of admission to hospital and quarters on an excused-from-duty basis,and (2) the average length of stay in hospital and quarters once the patientis admitted. The noneffective rate of 35.8 for the Far East Command meansthat, on the average day during the period July 1950-December 1953, roughly36 individuals out of each 1,000 division troop strength in Korea werenot available for duty because they had been admitted to hospital or quartersfor medical reasons. This may also be expressed as 3.6 percent of divisionstrength in Korea being noneffective for medical reasons on the averageday during this period. The other rates shown in table 12 reflect the cumulativeeffect of noneffectiveness among division troops in Korea, as additionaltime is lost in other areas. For example, the noneffective rate of 36 per1,000 per day is increased almost three times when all of the days of noneffectivenessare considered, although these days of noneffectiveness are not usuallycharged back to the command of origin when computing noneffective rates.

The admission rate through December 1953 for disease cases from divisionsin Korea (386 admissions per 1,000) was more than three times that fromnonbattle injury (114 per 1,000), while total days lost was only one-thirdmore than the days lost from nonbattle injury. The difference results inall average duration of stay for disease cases (15 days) of about one-thirdthat for nonbattle injury eases (40 days). The noneffective rate, however,is higher for disease (19 per 1,000 per day) compared to 15 per 1,000 perday for nonbattle injury, when all days lost are considered. For the FarEast Command, the noneffective rate for disease is twice that for nonbattleinjury. Obviously, some of the specific disease diagnoses, such as tuberculosis,with a low admission rate, contribute heavily, to the noneffective ratebecause of the lengthy hospitalization required for the average case. Thenoneffective rate of 21 per 1,000 per day for all nonbattle causes in theFar East Command compares favorably with the U.S. Army worldwide noneffectiverate of 22 per 1,000 per day for the 1950-53 period. The wounded, on theother hand, with an admission rate of 220 per 1,000, about two-fifths ofthe combined nonbattle admission rate for divisions (500 per 1,000), contributedheavily to the noneffectiveness experienced during the war. The averageduration for division wounded of 96 days was four and one-half times the21 days for the average nonbattle case, while the total days lost for woundedwas almost twice that for nonbattle cases. The noneffective rate for woundedof 15 per 1,000 per day in the Far East Command was higher than eitherthe disease or the nonbattle injury noneffective rates; when total dayslost is considered, the wounded noneffective rate is higher than that fordisease and nonbattle injury admissions combined.

TYPE OF DISPOSITION AND PLACE OF FINAL TREATMENT

Dispositions by place of final treatment provide information relatedto the echelon-wise structure of Army medical support and to the differenttypes of final disposition that occur at the various levels of medicalcare. This information can be important to those concerned with developingpatient flow by

Table 12.- Noneffective rates, U.S. Armydivision and separate regimental combat teams, Korea, July 1950-December1953
[Daily average number of patients in hospital and quarters per 1,000 averagestrength]

Type of case	Admitted in Korea and time lost
	All areas	Overseas areas		Continental United States
		Far East Command	All overseas
All causes	90.0	35.8	38.2	52.7
Wounded in action	57.5	14.9	16.6	40.9
All nonbattle causes	33.4	20.9	21.6	11.8
Disease	18.8	13.6	13.9	4.9
Nonbattle injury	14.6	7.3	7.7	6.9

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Table 13.- Disposition of U.S. Army patientsoriginating in Korea, by type of case and place of final treatment, U.S.Army divisions and regimental combat teams, Korea, July 1950-July 1953

Place of final treatment	Wounded in action					All nonbattle causes
	All dispositions	Death	Duty	Disability Separation	Other separations	All dispositions	Death	Duty	Disability separation	Other separations
Number
All medical treatment facilities	72,961	1,574	64,159	6,239	989	175,985	485	173,525	1,625	350
Aid, clearing, and collecting stations	7,024	412	6,612	--	--	72,835	90	72,745	--	--
Army hospitals, Far East Command	41,544	1,036	40,498	5	5	91,220	335	90,835	20	30
Surgical	1,312	609	703	--	--	8,180	80	8,100	--	--
Evacuation	6,371	151	6,220	--	--	33, 065	125	32,940	--	--
Field	1,687	82	1,605	--	--	6,530	15	6,515	--	--
Other	32,174	194	31,970	5	5	43,445	115	43,280	20	30
Non-Army medical treatment facilities, Far East Command	4,449	63	4,386	--	--	4,350	5	4,340	5	--
Other overseas hospitals	692	2	432	248	10	385	--	290	60	35
Continental United States	19,252	61	12,231	5,986	974	7,195	55	5,315	1,540	285
Class II hospitals	12,211	35	7,262	4,267	647	4,320	20	3,140	1,015	145
Class I, specialized	5,428	13	3,673	1,423	319	2,535	25	1,950	495	65
Other Army hospitals	173	1	128	41	3	105	5	40	20	40
Non-Army medical treatment facilities, continental U.S.	1,440	12	1,168	255	5	235	5	185	10	35
Percent
All medical treatment facilities	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0	100.0
Aid, clearing, and collecting stations	9.6	26.2	10.3	--	--	41.4	18.6	41.9	--	--
Army hospitals, Far East Command	57.0	65.8	63.1	0.1	0.5	51.8	69.1	52.4	1.2	8.6
Surgical	1.8	38.7	1.1	--	--	4.6	16.5	4.7	--	--
Evacuation	8.7	9.6	9.7	--	--	18.8	25.8	19.0	--	--
Field	2.3	5.2	2.5	--	--	3.7	3.1	3.8	--	--
Other	44.2	12.3	49.8	0.1	0.5	24.7	23.7	24.9	1.2	8.6
Non-Army medical treatment facilities, Far East Command	6.1	4.0	6.8	--	--	2.5	1.0	2.5	0.3	--
Other overseas hospitals	0.9	0.1	0.7	4.0	1.0	0.2	--	0.2	3.7	10.0
Continental United States	26.4	3.9	19.1	95.9	98.5	4.1	11.3	3.0	94.8	81.4
Class II hospitals	16.8	2.2	11.4	68.4	65.4	2.5	4.1	1.8	62.5	41.4
Class I, specialized	7.4	0.8	5.7	22.8	32.3	1.4	5.2	1.1	30.5	18.6
Other Army hospitals	0.2	0.1	0.2	0.6	0.3	0.1	1.0	0.0	1.2	11.4
Non-Army medical treatment facilities, continental	2.0	0.8	1.8	4.1	0.5	0.1	1.0	0.1	0.6	10.0

echelon of medical support and with providing various configurationsof medical support by type of hospital.

Final dispositions among admissions from division units in Korea duringthe combat period, July 1950-July 1953, are shown in table 13. For divisionwounded patients, 73 percent had a final disposition in the Far East Command.Ten percent of all wounded dispositions occurred at medical facilitiesforward of hospital (such as aid, clearing or collecting stations, anddispensaries), 57 percent occurred at Army hospitals, and 6 percent atnon-Army medical facilities in the Far East Command (Air Force and Navyfacilities). The remainder consisted of 1 percent with dispositions at"other overseas hospitals" (usually in Hawaii or Puerto Rico)and 26 percent in continental United States. When the distribution by typeof disposition is considered, marked differences result. For example, 96percent of the died of wounds occurred in the Far East Command, the largestnumber occurring at surgical hospitals. The second highest number diedof wounds at medical facilities forward of hospital in Korea. Of all divisionwounded with

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disposition to duty, 80 percent were returned to duty in the Far EastCommand. The largest proportion (50 percent) was returned to duty fromArmy hospitals in the Korean Communications Zone and in Japan (other Armyhospitals, Far East Command), and 10 percent returned to duty at the aid,clearing, or collecting stations in Korea. Almost all separations wereprocessed in continental United States, although a few separations occurredat Tokyo Amy Hospital in Japan (other Army hospitals, Far East Command)and a few at military hospitals in Hawaii and Puerto Rico (other overseashospitals). The distributions by hospital in the United States were aboutthe same for both types of separations: approximately two-thirds processedat class II hospitals and most of the remainder separated at class I specializedtreatment hospitals. In terms of the relative types of disposition fordivision wounded, 2.2 percent died of wounds, 87.9 percent returned toduty, 8.5 percent were separated for disability, and 1.4 percent were administrativeseparations. This compares with the distribution for total U.S. Army inKorea, of 2.5 percent died of wounds, 88.3 percent returned to duty, and9.2 percent separated for disability and administrative reasons.

The distribution of final dispositions for division nonbattle admissionsis markedly different from battle dispositions. Almost 96 percent of allDNBI cases had final dispositions in the Far East Command, with 41 percentoccurring at medical facilities forward of hospital. Only 4 percent ofall nonbattle final dispositions occurred in continental United States.Nonbattle deaths were distributed as 19 percent at either dispensary oraid clearing, or collecting stations, 16 percent at surgical hospitals,26 percent at evacuation hospitals, 3 percent at field hospitals, 24 percentat other Army hospitals (station and general), and 1 percent at non-Armymedical facilities, totaling 89 percent in the Far East Command. The balance(11 percent) expired in United States hospitals. The division nonbattleadmissions with it final disposition to duty in the Far East Command amountedto 97 percent of the total. The largest proportion (42 percent) were returnedto duty without being admitted to hospital. The balance (55 percent) werelargely nonbattle duty dispositions from evacuation (19 percent), stationand general hospitals (25 percent), and surgical, field, and nonArmy facilities(11 percent). Separations were processed mainly at class II and class Ispecialized treatment hospitals in the United States. A few separationswere processed at Tokyo Army hospital (other Army hospitals, Far East Command)and at "other overseas hospitals" (Hawaii and Puerto Rico). Thedistribution by type of final disposition for division nonbattle admissioncases shows that 0.3 percent died, 98.6 percent returned to duty, 0.9 wereseparated for disability, and 0.2 were other separations. The comparabledistribution for total U.S. Army, Korea, was 0.2 percent died, 99.1 percentreturned to duty, and 0.7 percent were separated for all causes.

DEATHS

The Adjutant General's battle casualty report (3) shows a totalof 27,704 battle deaths among U.S. Army personnel in Korea. In additionto the 19,585 killed in action (of which 251 were killed after capture),there were reported 2,034, died of wounds (including 104 died while captured),3,791 declared dead from missing in action, and 2,294 died of nonbattlecauses while captured or missing. In terms of an annual rate per 1,000average strength, all 27,704 deaths due to combat represent a loss of 43.2per 1,000 for Korea compared to 51.9 per 1,000 for all battle deaths inthe European Theater of Operations from June 1944 through May 1945. Whenthe number of deaths (killed in action plus died of wounds) turning thetotal number hit (killed in action plus wounded in action, including diedof wounds) are considered, 21.8 percent resulted in death in Korea. Inall theaters of operation during World War II, 28.0 percent died of allthose hit, and in the European theater, 25.1 percent died. If percentageratios of all battle deaths to the total surviving wounded plus battledeaths are computed, 26.3 percent died in Korea compared to 25.4 percentin the European theater and 29.3 percent in all of World War II.

Another index of the measure of combat mortality is the ratio of thenumber killed in action to the number wounded in action, including thedied of wounds. This ratio was 3.1 (including Air Corps) and 3.9 (excludingAir Corps) wounded to one killed in action for all theaters of operationduring World War II compared to 4.1 wounded to one killed in Korea.

Of all the numbers of battle deaths, only The Surgeon General's countsof the died of wounds can be related to wounded admissions to medical treatmentfacilities. Among the 77,788 wounded

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Table 14.- Killed in action and diedof wounds, by type of traumatism, U.S. Army, Korea, July 1950-July 1953
[Rates stated as number of deaths per 1,000 average strength per year]

Type of traumatism	Killed in action			Died of Wounds
	Number	Rate	Percent	Number	Rate	Percent
Total deaths	19,353	30.20	100.0	1,957	3.05	100.0
Traumatism unknown	10,437	16.29	53.9	178	0.28	9.1
Traumatism known	8,916	13.91	100.0	1,779	2.77	100.0
Fractures	344	0.54	3.8	357	0.56	20.1
Compound, comminuted	96	0.15	1.1	132	0.21	7.4
Compound	84	0.13	0.9	168	0.26	9.5
Simple	20	0.03	0.2	27	0.04	1.5
Unqualified	144	0.23	1.6	30	0.05	1.7
Wounds	7,445	11.62	83.5	1,057	1.65	59.4
Lacerated and incised	67	0.10	0.8	75	0.12	4.2
Penetrating, perforating, puncture	2,580	4.03	28.9	707	1.10	39.7
Unqualified	4,798	7.49	53.8	275	0.43	15.5
Amputation, traumatic	460	0.72	5.2	69	0.11	3.9
Burns	46	0.07	0.5	23	0.03	1.3
Concussion	116	0.18	1.3	16	0.02	0.9
Crushing	35	0.05	0.4	4	0.01	0.2
Multiple injuries	123	0.19	1.4	18	0.03	1.0
Other specified	347	0.54	3.9	235	0.36	13.2

admitted to medical treatment facilities in Korea, 1,957 died of wounds,representing a case fatality rate of 2.5 percent. This rate is markedlylower than the 4.5 percent recorded for all of World War II.

Since the killed in action are not routinely examined by medical personnel,less than one-half (46 percent) had the type of traumatism recorded ascause of death. The died of wounds, on the other hand, are all seen, whilestill alive and a record (usually the Emergency Medical Tag WD AGO Form8-26 (4)) is initiated at the time of first medical care. The traumatism,however, was not recorded, or was recorded as "unknown" for 9percent of the died-of-wounds cases. Table 14

Table 15.- Number of U.S. Army personnelkilled in action and died of wounds, by age group, U.S. Army, Korea, July1950-July 1953

Age group	Total deaths	Cause of death
		Killed in action	Died of wounds
19 and under	4,702	4,297	405
20-24	11,984	10,825	1,159
25-29	2,506	2,264	242
30-34	1,019	911	108
35-39	353	316	37
40-44	105	103	2
45-49	17	14	3
50 and over	4	3	1
Unknown	620	620	--
Total	21,310	19,353	1,957

 

shows that more, than four-fifths of the killed in action with a recorded traumatism resulted from wounds of all types, while traumatic amputations were the cause of death in 5 percent of the known cases. Fractures were involved in about 4 percent of the recorded killed-in-action cases. More than 59 percent of the died of wounds could be accounted for by wounds of all types: largely, penetrating, perforating, and puncture type wounds. Fractures were responsible for 20 percent, and traumatic amputation in 4 percent, of the died-of-wounds cases.

The majority of those either killed in action or died of wounds in Koreaoccurred in the 20-24 year age group (table 15). Ninety percent of allof these deaths were men under 30 years of age, while those 19 and underincurred 22 percent of the deaths.

Nonbattle deaths resulting from vehicular accidents, drowning, homicides,and suicides are most likely to be "dead on arrival"; therefore,the total count of nonbattle deaths must also be distinguished from thesmaller number of deaths which occur after admissions to medical treatment,such as those presented in table 13 for division units in Korea. For example,there were 10,220 nonbattle deaths in the U.S. Army, during the 4-yearperiod 1950-53, of which 2,410 were due to disease and 7,810 to nonbattleinjury. The number of CRO deaths amounted to 6,760; 575 were due to disease,and the majority (6,185) to nonbattle injury. The total

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17

number of nonbattle deaths (including CRO) for U.S. Army nonbattle admissionsin Korea, was 2,452, with 509 resulting from disease conditions and 1,943from nonbattle injury. In terms of annual death rates per 1,000 averagestrength, 3.25 per 1,000 died of nonbattle causes among U.S. Army personnelin Korea during 1950-53, compared to 4,57 per 1,000 for the European theaterfrom June 1944 through May 1945.

Approximately two-fifths of the disease deaths in U.S. Army, Korea (table16), resulted from infective and parasitic disease. Acute poliomyelitis,infectious encephalitis, and epidemic hemorrhagic fever, the latter firstencountered in Korea, were largely responsible. Another 40 percent of thedisease deaths resulted from four broad groups of causes: neoplastic diseases,diseases of the circulatory system, diseases of the digestive system, anddiseases of the urinary system. Acute respiratory disease, largely pneumonias,contributed over 6 percent of the deaths from diseases.

More than four-fifths of the nonbattle injury, deaths can be accountedfor by the seven types of traumatism listed in table 17. Skull fracturesand other head injuries were responsible for one-third, of all nonbattleinjury deaths. The balance were largely from internal injuries of chest,abdomen, and pelvis (21 percent) and to lacerated and open wounds (18 percent).Burns and poisoning, each with about an equal number of deaths, caused4 percent of the deaths, separately. Included in the 1,943 nonbattle injurydeaths were 131 suicides and 101 homicides among U.S. Army personnel inKorea during the 1950-53 time period.

Table 16.- Deaths and death rates fordisease by principal cause, U.S. Army, Korea 1950-1953
[Rates stated as number of deaths per year per 1,000 average strength]

Principal cause	Number	Rate	Percent
All diseases	509	0.67	100.0
Infective and parasitic diseases (Class I)	208	0.28	40.9
Neoplastic disease (Class II)	60	0.08	11.8
Diseases of the nervous system (Class VI)	18	0.02	3.5
Acute respiratory infections (Class IX)	33	0.04	6.5
Disease of the circulatory system (Class XI)	89	0.12	17.5
Disease of the digestive system and hernia (Class XIII)	25	0.03	4.9
Diseases of the urinary system and male genital system (Class XIV)	18	0.02	3.5
All other diseases	58	0.08	11.4

Table 17.- Deaths and death rates fornonbattle injury, by nature of traumatism, U.S. Army, Korea, 1950-53
[Rates stated as number of deaths per year per 1,000 average strength]

Nature of traumatism	Number	Rate	Percent
All nonbattle injuries	1,943	2.58	100.0
Skull fractures	276	0.37	14.2
Other fractures	59	0.08	3.0
Other head injuries	355	0.47	18.3
Internal injuries of chest, abdomen, and pelvis	403	0.53	20.7
Burns	83	0.11	4.3
Lacerated and open wounds	347	0.46	17.9
Poisonings	84	0.11	4.3
All other traumatisms	336	0.45	17.3

SEPARATIONS FOR BATTLE DISABILITIES

There were 7,057 individuals separated during the period 1950-53 fordisabilities caused by battle wounds. The highest number of these separationsoccurred in 1952; at the end of 1953, there still remained in hospitals1,032 individuals admitted for treatment of battle disabilities. Theseseparations, by type and year of separation, are included in table 18.

Except for 105 World War II cases, these disabilities relate to U.S.Army patients with wounds incurred in the Korean War.

Impairments and diseases of the bones and organs of movement were mainlyresponsible for permanent retirement, and disabilities involving impairmentsof the nervous system, chiefly peripheral neuropathy, were responsiblefor most of those on the temporary duty retired list. One might expectthis latter situation since these disabilities often require longer periodsof observation for evaluating their ultimate effects. These differencesmight be noted from table 19, which shows selected diagnostic categoriesby type of separation.

Distribution by broad category of causative

Table 18.- Number of disability separationsfor battle causes, by type of separation and year, U.S. Army, 1950-53

Year	Total Separations	Permanent Separations	Temporary Separations	Separations with severance pay
1950	114	110	1	3
1951	1,430	1,323	14	93
1952	3,046	2,587	89	370
1953	2,467	2,036	246	185
Total	7,057	6,056	350	651

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18

Table 19.- Distribution of U.S. Armypersonnel separated for disability due to battle injuries and wounds, byprimary diagnostic cause of separation, by type separation, and by causativeagent, 1950-53

Primary diagnostic cause of separation	Total number of separations	Type of separation (percent)				Causative agent (percent)
		Total	Retirement		Separation with severance pat	Total	Explosive projectiles	Grenades, mines, etc.	Small arms	Other1
			Permanent	Temporary
All causes	7,057	100.0	85.8	5.0	9.2	100.0	41.3	16.0	30.4	12.3
Impairments and diseases of bones and organs of movement	4,215	100.0	87.4	3.0	9.6	100.0	39.2	17.6	31.6	11.6
Ankylosis	519	100.0	83.5	1.7	14.8	100.0	38.2	12.7	34.8	14.3
Contracture or shortening of extremities	535	100.0	77.2	4.9	17.9	100.0	30.5	10.3	47.4	11.8
Amputation	1,477	100.0	98.0	0.4	1.6	100.0	41.5	29.1	20.9	8.5
Malunion or nonunion of fracture	308	100.0	77.0	9.4	13.6	100.0	34.4	13.0	35.4	17.2
Paralysis of extremities	474	100.0	97.9	2.1	--	100.0	45.5	7.4	45.4	1.7
Deformity, acquired	300	100.0	84.6	7.7	7.7	100.0	52.4	12.3	23.0	12.3
Other impairments and diseases of bones and organs of movement	602	100.0	72.2	4.0	23.8	100.0	33.7	12.8	32.2	21.3
Impairments and diseases of nervous system	1,668	100.0	80.3	11.3	8.4	100.0	42.3	10.3	35.2	12.2
Impairments and diseases of sense organs	738	100.0	96.4	1.2	2.4	100.0	51.5	22.9	14.2	11.4
Impairments and diseases of digestive system, including hernia	102	100.0	79.4	4.9	15.7	100.0	51.5	22.9	37.3	10.8
Other impairments and diseases	334	100.0	71.8	6.3	21.9	100.0	37.7	12.0	26.0	24.3

¹ Flame throwers, bayonets, chemicals, fire,and explosions.

 

agents shows that explosive projectiles caused more battle casualtyseparations than any other group of causative agents, while small armswere second in importance. When causative agents are related to the diagnosticcauses of separation, explosive projectiles, for example, caused 41.5 percentof the amputations; grenades and mines, 29.1 percent; small arms, 20.9percent; and all other causative agents, 8.5 percent. In cases of paralysisof the extremities, 45.5 percent were caused by explosive projectiles,7.4 percent by grenades and mines, 45.4 percent by small arms, and 1.7percent by all other causative agents. Table B-12, included in appendixB, presents the primary diagnostic causes of separation in detail by rank,type of separation, and causative agent.