History

Chapter 22

Dehydration Survey in the Combat Soldier

A Study in the Korean Theater

Captain John M. Howard, MC, USAR
Captain John H. Davis, MC, USAR

The long supply lines and the mobility of the front inevitably raised difficulties to furnishing the front line soldier an adequate supply of purified water. For this reason, it was deemed advisable to gather objective evidence in order to assay the problem in Korea.

This study was carried out on the Eastern Front during the period January through July 1952. During this period the main line of resistance was stable. Supply lines were good. However, the terrain was extremely mountainous and the front lines were inevitably strung out across the top of mountain chains. Water was brought nearby in trucks but had to be carried to the top of the mountains on the backs of soldiers and laborers. Carrying the water up the mountain trail was comparable to carrying it up a flight of stairs, the equivalent of a 10- to 50-story building. A water point was thus established on top of each ridge. No reserve was maintained at this point, however, so that availability of water might vary from time to time. No severe shortage was ever reported. In spot checks, men in the front lines were systematically (daily) asked two questions: first, are the men thirsty, and second, is the water supply adequate or inadequate? Their answers had little correlation with objective evidence as illustrated by several typical observations (Table 1).

Dehydration Survey in Combat Soldier

Objective evidence was therefore sought by selecting volunteers in the front line and measuring their daily urinary output and its specific gravity. The most mountainous terrain was selected for these observations. The findings are summarized in Tables 2, 3, 4, and 5. Because of the danger inherent in the study, further observations did not seem warranted until a time when the tactical conditions might change.

Analysis of the data indicates that the lowest average urine volume occurred in January (992 ml. for 21 man days). This is entirely reasonable for the temperature was below zero (Fahrenheit) at this time. In March the average 24-hour volume was 1,344 ml. for 92 man days. In May the average volume was 1,246 ml. for 137 man days. In June and July the average volume was 1,168 ml. for 15 man days.

277

Table 1. Water Supply and Urinary Output

Subject	Day	Question: Is the Water Supply Adequate?	Are the Men Thirsty?	24-Hour Urinary Volume (ml.)	24-Hour Urinary Specific Gravity
Master Sergeant	1	Inadequate	Yes	2,600	1.009
	2	Inadequate	Yes	2,050	1.010
	3	Inadequate	Yes	2,100	1.015
	4	Adequate	No	3,200	1.010
Second Lieutenant	1	Inadequate	Yes	1,450	1.020
	2	Adequate	No	1,400	1.025
	3	Adequate	No	1,000	1.030
Private	1	Inadequate	Yes	1,200	1.025
	2	Adequate	No	600	1.030
	3	Inadequate	Yes	2,200	1.012
First Lieutenant	1	Inadequate	Yes	1,275	1.020
	2	Adequate	No	1,200	1.020
	3	Inadequate	Yes	1,250	1.025
	4	Adequate	No	1,200	1.020

Table 2. Urinary Volume (Milliliters Per 24 Hours)

Date	Soldier
Date	1	2	3	4	5	6	7	8	9	10	Average
1952
29 Jan.	1,850	750	450	1,150	650	1,150	1,000	650	500	1,200	935
30 Jan.	850	1,200		1,250		1,000	850	1,200	850		1,029
31 Jan.	450	1,100		1,500		1,250					1,075
Average	1,050	1,017		1,300		1,133	925	925	675

Average urinary volume
992 cc. 21 man days

Although there were a few instances in which the urine volume was rather low, the average for all the men on any day appeared adequate so that the supply for the area appears to have been satisfactory.

The over-all average for the 265 man days was 1,252 ml. of urine per day with a specific gravity of 1.022 (Table 6).

Finally, to note the effect of time lag after wounding, the specific gravity of the urine was measured on 25 casualties during the winter (1.025) and compared with that of 25 casualties during the summer (1.026). These measurements were made at the time the casualties arrived at the Mobile Army Surgical Hospital approximately 3.5 hours after wounding. No conclusion is justified beyond the observation that no significant difference existed.

278

Table 3. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)

279

Table 4. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)

280

Table 5. Volume and Specific Gravity of Urine (Milliliters per 24 Hours)

281

Table 6. Dehydration Survey in the Combat Soldiers

Date	Man Days	Average Urinary Volume (ml. per 24 Hours)	Average Specific Gravity
January 1952	21	993
March 1952	92	1,344	1.021
May 1952	137	1,246	1.023
July 1952	15	1,168	1.020

265 total 1,252 average

Clinically dehydration was not noted. Thirst is an immediate result of severe injury and does not necessarily signify dehydration immediately after injury.

Summary

During the period January-July 1952, studies of the daily urinary output of soldiers on the front lines of the Eastern Front in Korea demonstrated no evidence of dehydration.

282

Appendix

Daily Temperature Record

(Fahrenheit)

Combat Area-Eastern Korea

1952

Temperature

Date	1200 Hours		2400 Hours		Date	1200 Hours		2400 Hours
Date	Dry	Wet	Dry	Wet	Date	Dry	Wet	Dry	Wet
April 3	58	50	40	38	May 1	84	70	56	50
4	58	49	42	40	2	78	63	56	52
5	71	55	48	46	3	77	65	62	57
6	70	50	41	41	4	66	59	53	50
7	55	50	46	44	5	71	57	51	46
8	72	59	52	47	6	75	58	61	52
9	74	68	51	48	7	72	62	60	52
10	50	47	52	49	8	70	57	54	45
11	62	52	54	49	9	74	60	58	48
12	57	50	50	49	10	73	60	57	50
13	46	42	36	36	11
14	51	45	43	42	12	79	61	55	49
15	43	41	38	36	13	80	65	60	52
16	52	47	59	51	14	83	66	63	56
17	54	51	42	38	15	74	60	60	53
18	53	46	46	42	16	84	65	66	59
19	34	32	38	35	17	80	64	68	60
20	49	43	42	39	18	83	67	65	53
21	55	52	35	33	19	71	59	62	55
22	56	48	40	37	20	78	63	60	55
23	57	46	40	38	21	82	65	60	54
24	62	50	46	43	22	87	66	63	52
25	64	54	44	43	23	74	59	52	50
26	56	48	43	41	24	71	53	54	48
27	63	52	49	44	25	77	63	57	52
28	55	52	53	50	26	73	59	64	56
29	68	52	48	45	27	80	67	63	58
30	73	63	54	50	28	80	71	63	58
					29	81	70	59	56
					30	55	51	57	51
					31	74	64	58	53

283

Temperature

Date	Maximal	Minimal	Date	Maximal		Minimal
Date	Dry	Dry	Date	Dry	Wet	Dry	Wet
June 1	79	54	July 1	90	77	72	71
2	77	52	2	80	73	67	66
3	63	56	3	78	69	63	61
4	73	53	4	83	71	62	60
5	78	53	5	81	70	58	57
6	83	53	6	81	70	64	63
7	87	52	7	83	73	64	63
8	71	56	8	80	69	63	62
9	82	55	9	76	68	63	62
10	68	56	10	80	69	65	63
11	73	56	11	82	72	63	62
12	81	55	12	90	78	62	60
13	83	60	13	87	73	64	62
14	89	67	14	79	69	60	57
15	92	57	15	75	69	66	64
16	87	63	16	88	76	68	65
17	79	62	17	80	74	73	70
18	84	63	18	88	76	72	70
19	87	64	19	75	72	72	68
20	85	58	20	84	75	70	68
21	88	57	21	83	73	68	67
22	92	58	22	90	75	67	66
23	91	61	23	88	75	67	66
24	96	60	24	88	75	69	68
25	98	65	25	80	72	69	67
26	98	64	26	74	72	66	66
27	93	63	27	70	69	66	66
28	90	67	28	71	69	64	64
29	76	69	29	70	70	66	66
30	78	68	30	75	74	66	66
			31	77	74	69	68

284

Temperature

Date	Maximal	Minimal	Date	Maximal		Minimal
Date	Dry	Dry	Date	Dry	Wet	Dry	Wet
August 1	88	74	September 1	74	67	58	58
2	76	65	2	74	67	57	57
3	87	68	3	62	62	59	59
4	88	65	4	70	65	59	59
5	90	64	5	75	66	59	59
6	91	65	6	78	70	59	59
7	92	67	7	71	68	59	59
8	87	68	8	77	68	56	56
9	90	67	9	79	68	58	58
10	91	68	10	78	69	58	58
11	92	70	11	74	67	62	62
12	94	70	12	71	66	58	57
13	88	72	13	62	60	56	56
14	94	74	14	66		57
15	90	70	15	71	67	54	54
16	91	70	16	68	61	52	52
17	90	69	17	68	58	48	46
18	80	69	18	69	61	43	42
19	79	69	19	71	62	53	52
20	86	64	20	65	58	49	48
21	87	69	21	69	58	46	46
22	85	53	22	65	60	44	43
23	74	66	23	76		58
24	75	70	24	59	58	56	55
25	74	68	25	58	58	47	47
26	71	68	26	61	58	41	41
27	85	64	27	63	55	38	37
28	70	65	28	60	55	46	45
29	76	62	29	59	57	40	39
30	82	63	30	64	56	39	38
31	75	68

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