History

Medical Statistics of the United States Army, Calendar Year 1953

CHAPTER V

Other Army Medical Service Activities

DENTAL ACTIVITIES

During 1953, as in the preceding year, the major task confronting the dental service was to reconcile its resources with the large dental care workload posed by the size of the Army. The personnel needs of the Service (source tables 23-25) were not based on the assumption that the full workload could be taken care of. The very low dental standards established for acceptability for induction, the relatively rapid turnover of military personnel and the natural rate of incidence of dental diseases and conditions produced a potential workload in excess of the capacity of the services of dental personnel. Priorities for dental care were established both in terms of the urgency of the need for treatment and in terms of the various categories of personnel. In general, the guiding principle in determining what dental care must be provided has been that of maintaining an adequate level of military efficiency rather than that of maintaining a fully satisfactory degree of dental health. This represents a compromise between real needs and an assay of the availability of dental personnel.

Personnel

The number of dental officers on duty varied from 2,531 at the end of January 1953 to 2,952 at the end of December 1953, with an average of 2,569 for the year. The average number of dental officers on duty during the year in relation to the mean strength of military population served was slightly less than 1.8 dental officers per thousand.

With respect to enlisted personnel, during the year an average of 863 dental laboratory technicians (Military Occupational Specialty 1067) was authorized and an average of 823 technicians was on duty. The number of laboratory technicians available was for the most part dependent on the input of inductees with civilian dental laboratory training. Of the technicians available during the year, approximately 66 percent were qualified technicians prior to entry into the service. Dental assistants were trained principally by on-the-job training methods. Shortages averaged approximately 159 throughout the year. An average of 1,728 military dental assistants was authorized and 1,269 were available to the dental service.

TABLE XVII.?ACTUAL DENTAL CORPS STRENGTH BY COMMAND AND MONTH, U.S. ARMY, 1953

Command	Yearly average	Quarterly average
Command	Yearly average	January-March	April-June	July-September	October-December
Total Army	2,569	2,366	2,281	2,733	2,896
Overseas	851	752	834	892	926
U.S. Army, Europe	371	303	373	402	403
U.S. Forces, Austria	21	17	21	24	22
U.S. Army, Forces, Far East	375	362	358	370	410
U.S. Army, Pacific	17	15	18	19	17
U.S. Army, Caribbean	36	30	36	40	40
U.S. Army, Alaska	25	20	22	30	28
Joint Task Force 7	1	1	1	1	1
Trieste U.S. Troops	5	4	5	6	5
Continental United States	1,417	1,358	1,222	1,447	1,642
First Army Area	123	100	97	134	162
Second Army Area	245	268	222	241	251
Third Army Area	259	224	203	274	334
Fourth Army Area	193	173	159	201	238
Fifth Army Area	204	203	179	198	238
Sixth Army Area	180	182	159	183	195
Military District of Washington	64	61	59	64	73
Department of the Army Administrative Area	29	28	28	30	30
The Surgeon General	117	118	114	119	118
Chief Chemical Officer	2	1	1	2	2
Chief of Transportation	1	(^a)	1	1	1
Chief of Engineers	(^a)	(^a)	(^a)	-	-
Other	301	256	225	394	328

^aAverage less than 0.5.

The Army continued to utilize during 1953 a limited number of civilian dentists, as indicated in table XVIII.

TABLE XVIII.?NUMBER OF CIVILIAN DENTISTS ON DUTY WITH U. S. ARMY, 1953

	Yearly average	Quarterly average
	Yearly average	January- March	April- June	July- September	October-December
Total Army	220	230	234	220	197
Continental United States	32	39	37	33	21
Overseas	^a188	191	197	187	176

^aPrincipally in Europe and Far East Commands.

Education and Training

During the year, practically all newly commissioned dental officers were ordered to the Medical Service Officers? Orientation course at the Medical Field Service School, Brooke Army Medical Center. In addition, some officers were given training in civilian institutions in the following specialties: oral surgery (6); prosthodontia (6); orthodontia (1); periodontia (1); oral pathology (1). In 1953 there were a number of residents and dental interns in military hospitals: 2 residents in oral surgery; 2 residents in prosthodontia; and 24 dental interns.

Among enlisted personnel, 277 dental laboratory technicians (MOS 1067) were graduated from the Dental Laboratory Technicians? School, and 431 enlisted personnel were graduated from the Dental Assistants? School Brooke Army Medical Center

Central Dental Laboratory Facilities

Six Central Dental laboratories were in operation during 1953, five of these in continental United States and one overseas. Of the continental installations, two were part of class II activities under the command of The Surgeon General (Brooke Army Medical Center, Walter Reed Army Medical Center).

TABLE XIX. ?PROSTHETIC APPLIANCES FABRICATED AT CENTRAL DENTAL LABORATORIES, U S ARMY, 1953

Total prosthetic appliances fabricated	77, 638
Brooke Army Medical Center	15, 855
Walter Reed Army Medical Center	12, 487
Third Army Central Dental Laboratory	10,408
Fifth Army Central Dental Laboratory	9, 672
Sixth Army Central Dental Laboratory	10, 689
Europe Central Dental Laboratory	18, 527

Dental Care

For personnel excused from duty and admitted to medical treatment facilities, data derived from individual medical records are presented in the source tables showing by diagnosis the number of personnel admitted for dental conditions, the degree of noneffectiveness, duration of stay, and other morbidity indices.

Tables XX and XXI, which follow, show the number of dental operations by type and by category of patient.

TABLE XX.?PRINCIPAL DENTAL OPERATIONS IN U.S. ARMY MEDICAL TREATMENT FACILITIES, 1953

Patients treated	2, 821, 655
Total principal operations	^a10, 127, 426
Permanent fillings	3,595, 315
Fixed bridges	15, 583
Dentures constructed	163, 758
Dentures repaired	50, 764
Teeth extracted	1,414, 926
Teeth replaced	1,336, 759
Roentgenograms	3,550, 321

^aExcludes: Postoperative treatment, prophylaxis, calculus removals, periodontal treatments and gum treatments. etc.

SOURCE: Dental Service Report, DD Form 477.

TABLE XXI.?DENTAL OPERATIONS IN U.S. ARMY MEDICAL TREATMENT FACILITIES, BY CATEGORY OF PATIENT, 1953

	Total	January-March	April-June	July-September	October-December
Grand total	17,960,776	4,129,934	4,341,815	4,767,466	4,721,561
Army	14,116,914	3,316,428	3,435,592	3,685,612	3,679,282
Navy-Marine	48,722	9,759	12,194	12,469	14,300
Air Force	183,101	45,316	48,002	49,635	40,148
Dependents	1,687,978	349,318	386,200	482,550	469,910
Other	1,924,061	409,113	459,827	537,200	517,921

SOURCE: Dental Service Report, DD Form 477

VETERINARY ACTIVITIES

Commissioned Personnel

On 1 January 1953, 508 Veterinary Corps officers were on duty with the U. S. Army. Between that date and 3 December 1953, a total of 94 veterinary officers entered on active duty, while 102 veterinary officers were separated from the military service. At year?s end (31 December) the strength of the corps was 501.

TABLE XXII.?VETERINARY CORPS OFFICERS ENTERING ON ACTIVE DUTY, U.S. ARMY, 1 JANUARY THROUGH 3 DECEMBER 1953

	Total	Volunteers	Nonvolunteers
Priority I and II	40	17	23
Priority III	50	50	-
Priority IV	4	4	-
Total	94	71	23

Of the 23 nonvolunteers called to duty during 1953, 16 entered under Selective Service special call No. 10 (Public Law 779), 4 entered as a result of the sixth involuntary call (reservists); 2 under the seventh involuntary call; and 1 under the second July involuntary call. In addition, one retired Veterinary Corps officer was placed on active duty for the period, 1 March?1 July 1953.

TABLE XXIII.?VETERINARY CORPS OFFICERS SEPARATED FROM U. S. ARMY, 1 JANUARY THROUGH 3 DECEMBER 1953

	Separations		Separations
Regular Army	10	Priority III: Voluntary	6
Retired officer (to inactive status)	1	Priority IV:
Reserve officer^a	16	Voluntary	15
Priority I and II:		Nonvoluntary^c	1
Voluntary	47	Total	102
Nonvoluntary^b	6	Total	102

^aCareer status, i.e., in service prior to 1 July 1950.

^bInvoluntary call (unnumbered) (2); Selective Service special call No. 10 (1); 4th involuntary call (1); 6th involuntary call (1); 2d July involuntary call (1).

^cOrdered to active duty with a Reserve unit.

Note. 4 Priority I volunteers; 5 Priority IV; and 3 Career status Reserve Veterinary Corps officers, transferred to the Regular Army, are not included in the above table.

These gains and losses during the calendar year resulted in a fluctuating Veterinary Corps commissioned officer strength as indicated in table XXIV.

TABLE XXIV.?VETERINARY CORPS, U. S. ARMY: ACTIVE DUTY STRENGTHS, AS OF 1 JANUARY, 30 JUNE, AND 31 DECEMBER 1953

	1 January 53	30 June 53	31 December 53
Regular Army	149	149	151
Retired officers	1	2	1
Reserve officers	358	343	349
Total	508	494	501

Training

The Army Medical Service has made adequate provision to insure that all of its personnel, both commissioned and enlisted, receives proper training. In table XXV is shown the number of veterinary officers who completed training courses during 1953.

TABLE XXV.?VETERINARY OFFICERS COMPLETING TRAINING COURSES IN U. S. ARMY FACILITIES, 1953

Course	Total	Army	Air Force	Foreign Nationals
Army Medical Service Meat and Dairy Hygiene School, Chicago, Ill.^a	162	138	21	3
Advanced Veterinary Medicine, Walter Reed Army Medical Center, Washington, D.C.^b	18	8	7	3
Associated Army Medical Service Corps Company officers, Medical Field Service School, Brooke Army Medical Center, Fort Sam Houston, Tex.^c	20	20	-	-
Total	200	166	28	6

^aCourse 8-O-8 (10 weeks), 79th-83d classes, inclusive.

^bCourse 8-O-25 (17 weeks).

^cCourse 8-O-2 (8 weeks).

In addition to the above, 233 enlisted men completed Course 8-E-2 at the Army Medical Service Meat and Dairy Hygiene School during 1953.

Meat and Dairy Hygiene

In the field of food and sanitary inspection, the Veterinary Corps protects the health of troops from unwholesome and substandard food products. It also functions in administrative and technical advisory capacities to Quartermaster purchasing and contracting officers in the procurement of food supplies for the Air Force, Navy, and Marine Corps, as well as for the Army. In addition to specific food inspection, veterinary officers also develop and formulate specifications for food items and operational rations with the Quartermaster Inspection Service and the Quartermaster Food and Container Institute for the Armed Forces. Army and Air Force veterinary personnel are trained in the principles of food and sanitary inspection at the Army Medical Service Meat and Dairy Hygiene School. Veterinary Corps officers also prepare standard inspection procedures for products of animal origin for publication by the Quartermaster Inspection Service and for subsequent use by Army and Air Force inspectors.

In addition to protecting the health of troops against disease transmitted through spoiled, damaged, or contaminated foodstuffs, this inspection service results in large potential monetary savings, represented by the difference in value between what is offered for delivery and what is finally accepted following veterinary inspection. During 1953, 1,638,434,302 pounds of food products of animal origin were inspected, of which 111,520,004 pounds were rejected. The products rejected represent an estimated equivalent monetary savings of approximately $19,028,897. Source tables 27 and 28 show by area and classes

of inspection the foods of animal origin and nonanimal origin passed and rejected before and after purchase.

Veterinary officers also regularly inspect all foods received at consuming installations, including fresh and frozen fruits and vegetables, canned fruits and vegetables, dried fruits and vegetables, and various miscellaneous foods by authority of existing regulations.

At the direction of the Department of the Army, the Veterinary Corps of the Army and Air Force were authorized to conduct antemortem and post-

TABLE XXVI.?ANTEMORTEM AND POSTMORTEM INSPECTIONS, 1953

	Class I inspection (antemortem)			Class II inspection (postmortem)
	Passed	Rejections		Passed	Rejections
	Passed	Not type class or grade^a	Insanitary or unsound^b	Passed	Not type class or grade^a	Insanitary or unsound^b
Worldwide, total	1,800,258	1,720	8,426	1,733,484	4,824	61,705
Continental U.S.	1,614,631	-	8,225	1,555,373	1,003	58,043
MDW	-	-	-	-	-	-
First Army	-	-	-	-	-	-
Second Army	513,073	-	7	508,013	-	5,060
Third Army	771,703	-	7,396	740,596	-	31,107
Fourth Army	174,609	-	347	172,296	1,000	864
Fifth Army	42,995	-	81	43,011	3	36
Sixth Army	112,251	-	394	91,008	-	20,976
Overseas	185,627	1,720	201	178,111	3,821	3,662
Europe^c	181,983	1,602	198	174,607	3,682	3,661
Austria	1,240	108	-	1,240	-	-
Far East	910	5	3	909	-	1
Pacific	-	-	-	-	-	-
Caribbean	1,494	5	-	1,355	139	-
Alaska	-	-	-	-	-	-

^aIncludes bruised, bloody, abraded, mutilated, underweight.
^bIncludes tuberculosis and other pathological conditions.
^cTrieste and Greece are included under "Europe".

mortem inspections of poultry in establishments that are found to meet the minimum sanitary requirements acceptable to The Surgeon General, but that are not operated as official plants under the supervision of the Poultry Inspection Service, Agricultural Marketing Service, U. S. Department of Agriculture. By these inspections many new sources of ready-to-cook poultry were developed, thus increasing the number of bidders and sharpening competition. This program has been highly successful and the poultry industry as well as the Army has benefited thereby.

Table XXVI shows the total number of antemortem and postmortem inspections (poultry, beef, pork, etc.) during 1953.

Laboratory Service and Research

Laboratory service. The veterinary laboratory service is an integral part of the Army Medical Service laboratory system. Veterinary officers are assigned to the Army Medical Service Graduate School, Walter Reed Army Medical Center, the six continental Army area medical laboratories, and the medical laboratory units overseas. Food products are analyzed to determine whether or not they meet the requirements of Army purchase instruments; animal tissues are examined to make a clinical laboratory diagnosis to assist veterinary officers in the treatment of animals and the control of animal diseases transmissible to man.

TABLE XXVII .?VETERINARY LABORATORY SPECIMENS EXAMINED IN CONTINENTAL UNITED STATES, 1953

Laboratory	Dairy products	Meat, fish, poultry products	Shortening, fats, oil	Food (nonanimal origin), nonfood items	Animal examinations
Grand total	54,216	30,127	4,837	4,485	9,968
First Army	4,336	2,829	1,389	273	912
Second Army	6,069	2,785	104	180	539
Third Army	6,729	1,557	1,292	191	1,033
Fourth Army	5,668	1,291	283	124	345
Fifth Army	8,153	8,445	796	51	28
Sixth Army	22,239	13,125	967	3,655	445
AMS Graduate School	1,022	95	6	11	6,666

Research. At the Armed Forces Institute of Pathology, the Veterinary Pathology Registry, which is sponsored by the American Veterinary Medical Association, received and accessioned 1,864 specimens during 1953, bringing the total repository to 11,391 accessions. Professional consultations and instruction in veterinary pathology are given on request to qualified persons of the Nation?s veterinary profession.

Research projects under the direction of The Surgeon General were conducted at the Army Medical Service Graduate School on the bacterial, protozoan, and viral diseases of animals of importance in military veterinary medicine; they were conducted at the Meat and Dairy Hygiene School on the development of food inspection equipment.

Animal Service

Animal morbidity and mortality. The combined average animal strength of the Army for 1953 was 3,156. Table XXVIII shows a breakdown of this strength by species and location, while table XXIX shows the number of admissions, deaths, and days lost. Animals destroyed due to chronic pathological conditions are included in ?deaths.?

TABLE XXVIII.?AVERAGE STRENGTH, U. S. ARMY-OWNED ANIMALS, 1953

	Horses and mules			Dogs	Pigeons
	Total	Horses	Mules	Dogs	Pigeons
Worldwide	778	215	563	1,093	1,285
Continental U.S.	715	152	563	154	1,285
Territories	-	-	-	28	-
Europe	63	63	-	723	-
Far East	-	-	-	188	-

TABLE XXIX.?NUMBER OF ADMISSIONS, DAYS LOST, AND DEATHS AMONG U.S. ARMY-OWNED ANIMALS, 1953

[Continental U.S., Alaska, Canal Zone, Hawaii, Europe, Far East]

Disease or external cause	Horses			Mules			Dogs
Disease or external cause	Admissions	Days lost	Deaths	Admissions	Days lost	Deaths	Admissions	Days lost	Deaths
All causes? total	166	4,932	20	121	3,338	6	865	12,106	50
Disease? total	106	2,301	18	38	780	6	649	9,254	43
External causes? total	60	2,631	2	83	2,558	-	216	2,852	7

Note. Pigeons are not included in above table. Reports indicate there were 34 admissions to sick report, with 17 deaths and 67 days lost.

Communicable Disease

Vesicular exanthema. This disease continued to be widespread among swine and affected the pork supply of the nation adversely. Federal and State agencies engaged in the elimination and control of this disease requested the continued support of the Department of the Army, which sent a message on 5 June 1953 to all commanders, to insure that previous instructions concerning the disposal of uncooked pork were being carried out.

Prevention and Control

Encephalomyelitis. All horses and mules within the Army were vaccinated against encephalomyelitis with bivalent vaccine prepared by the Veterinary Division, Army Medical Service Graduate School, Walter Reed Army Medical Center. No cases of encephalomyelitis were reported in the Army animals during 1953.

Rabies. All dogs acquired for the Army were vaccinated against rabies at the time of being processed. During the year, 23,188 Government-owned dogs and canine and feline pets of military personnel were vaccinated against rabies in the continental United States.

Purchase of Animals for Foreign Aid Military Program

Procurement of animals for the Turkish Army continued throughout most of 1953. This program originated through Mutual Defense Assistance Program requirements to supply animals for the Turkish Army. A total of 3,987 horses and 333 mules were shipped to Turkey during the current year.

PROCESSING OF SELECTIVE SERVICE REGISTRANTS (1950-53)

With the enactment of the Selective Service Act of 1948 (Public Law 759, 80th Congress), the Department of the Army was designated by the Department of Defense as the executive agency responsible for processing Selective Service registrants for the Armed Forces. In turn, the office of The Surgeon General, Army, by agreement with the Selective Service Headquarters, was assigned the duties for the collection and analysis of statistical data necessary for administering and evaluating this processing, from a. medical point of view. These duties are in addition to the established responsibilities of The Surgeon General?s Office for formulating the medical standards for military acceptability and prescribing the necessary procedures connected with the medical examination.

The processing is accomplished at the Armed Forces Examining Stations. Each registrant forwarded by his local board to an examining station undergoes first a preinduction examination, consisting of a complete mental and medical examination. Those who are found acceptable for military service on the preinduction examination are subsequently ordered to report for induction, but in not less than 21 days after their preinduction examination. At the time of induction the registrant normally undergoes only a physical inspection for any contagious disease or injury that could have been incurred since his preinduction examination.

This report summarizes the preinduction and induction examination results of registrants who were processed for military service during the period from July 1950 through December 1953.

Preinduction Results

General Findings. A total of 3,860,745 preinduction examinations were performed from the beginning of the Korean Conflict (July 1950) through December 1953. The overall results are presented in table XXX. The data are shown separately for ?Not previously examined registrants? and for ?All examined registrants,? the latter comprising both ?not previously? and ?previously? examined registrants. Though these two sets of data do not show any substantial differences, it seems preferable for a more proper evaluation to consider only the ?not previously? examined registrants.

As shown in the table XXX, 68.1 percent of the ?not previously? examined registrants were found acceptable, and 31.9 percent were disqualified, on the basis of the prevailing moral, mental, and medical standards. The distribution by disqualifying cause was as follows: 0. 8 percent of the exam-

ined registrants were disqualified for administrative reasons (not morally fit; an alien, etc.); 13.5 percent of them failed to pass the mental test (but were medically acceptable); 14.4 percent could not qualify for medical reasons (but passed the mental test), and 3.2 percent were disqualified because of both medical reasons and failure to pass the mental test. In other words, 17.6 percent (14.4 and 3.2) of the examinees could not qualify medically, regardless of ability to pass the mental test. Analogously, 16.7 percent (13.5 and 3.2) could not pass the mental test.

TABLE XXX.?RESULTS OF PREINDUCTION EXAMINATIONS, JULY 1950 THROUGH DECEMBER 1953

Results of examination	Not previously examined registrants		All examined registrants
Results of examination	Number	Percent	Number	Percent
Total examined	3,650,711	100.0	3,860,745	100.0
Found acceptable	2,485,849	68.1	2,610,444	67.6
Found not acceptable by disqualifying cause	1,164,862	31.9	1,250,301	32.4
Administrative	29,184	.8	32,693	.8
Mental test, only	492,467	13.5	516,666	13.4
Mental test and medical	117,853	3.2	123,663	3.2
Medical, only	525,358	14.4	577,279	15.0

Note. ?All examined registrants? include both ?not previously? and ?previously? examined registrants. The data of this table were adjusted for registrants who were disqualified prior to January 1952 for failing the mental tests and later reexamined and found acceptable under modified mental testing procedures.

SOURCE: ?Summary of Registrant Examinations for Induction,? DA Form 316 (Reports Control Symbol MED-66).

Trend by Month. The general trend of the disqualification rates by month is presented in chart P. As may be seen from this figure, the medical disqualification rates remained relatively constant, fluctuating around 15 percent (medical only), except for the first 3 months of this period. The high medical rates in that early period were primarily due to the fact that registrants forwarded at that time for preinduction examination came from the older age groups, much depleted by veterans of World War II. However, the high dental standards that prevailed during that short period may also have contributed to the high rates. (See: Medical Standards, p. 91.) The disqualification rates for mental reasons show wider fluctuations due chiefly to changes in the mental requirements as such, and to changes in the administrative procedures connected with the mental testing.

Army Area and State Differentials. As may be observed from table XXXI and source table 29, there were wide variations in the disqualification rates by Army area and State, especially with respect to the mental disqualifications.

Defects by Diagnosis. A breakdown by individual diagnoses of the disqualifying defects among registrants who were disqualified for medical reasons

CHART P.?RESULTS OF PREINDUCTION EXAMINATIONS BY MONTH (PERCENT DISQUALIFIED, BY PRINCIPAL DISQUALIFYING CAUSE, JULY 1950 THROUGH DECEMBER 1953)

TABLE XXXI.?RESULTS OF PREINDUCTION EXAMINATIONS BY ARMY AREA, JULY 1950 THROUGH DECEMBER 1953

Area	Total examined	Percent distribution of registrants found not acceptable by disqualifying clause
Area	Total examined	Total	Administrative	Mental test only	Mental test and medical	Medical only
Total United States	3,860,745	32.4	0.8	13.4	3.2	15.0
Total Continental U.S.	3,737,586	31.5	.9	12.4	3.0	15.2
First Army Area	708,001	29.6	.7	7.4	2.1	19.4
Second Army Area	718,512	30.9	.7	10.9	3.6	15.7
Third Army Area	622,411	44.0	.5	30.0	5.3	8.2
Fourth Army Area	359,278	37.0	.7	21.1	4.9	10.3
Fifth Army Area	960,492	24.6	.9	5.0	1.7	17.0
Sixth Army Area	368,892	28.0	2.1	5.9	1.5	18.5
Outside United States	123,159	58.9	.4	43.7	8.6	6.2

only is presented in table XXXII. In terms of broad diagnostic categories, diseases of the circulatory system, diseases and defects of the bones and organs of movement, and psychiatric disorders were most prevalent, contributing

15.1 percent, 14.9 percent, and 13.6 percent of the disqualifying causes, respectively. Of the individual diagnoses, the primary causes of the disqualifications were organic and valvular heart diseases (8.1 percent of all medical defects); psychoneurosis and character-behavior disorders (6.4 and 6.3 percent); asthma (6.0 percent.), and hernia (4.9 percent). It should be noted that the percent disqualified for tuberculosis, as given in the table, is probably too low, since no chest X-ray was required prior to 1953, in the case of registrants found disqualified for other medical reasons. Also, the disqualification for insufficient teeth should be disregarded. These dental disqualifications are the result of the high dental standards that were in effect during the first two and a half months of this period and subsequently were revoked.

TABLE XXXII.?PERCENT DISTRIBUTION OF PRINCIPAL DISQUALIFYING DEFECTS BY DIAGNOSIS, JULY 1950 THROUGH DECEMBER 1952

Diagnosis	Percent	Diagnosis	Percent
Total	100.0	Rheumatic fever	0.3
Psychoses	0.7	Heart diseases, organic and valvular	8.1
Psychoneurotic disorders	6.4	Heart diseases, functional	1.2
Mental deficiency	.2	Hypertensive diseases	4.6
Character-behavior disorders	6.3	Other diseases of the circulatory system	.9
Epilepsy	1.1	Respiratory system diseases	1.2
Other neurological diseases	1.6	Insufficient serviceable teeth	1.6
Tuberculosis	1.8	Other dental and supporting structure diseases	.5
Venereal diseases	.1	Mouth and adnexa diseases	0.0
Other infective and parasitic diseases	1.7	Hernia of abdominal cavity	4.9
Malignant neoplasms	.1	Other diseases of the digestive system	2.5
Nonmalignant neoplasms	2.1	Genito-urinary system and breast diseases	1.3
Neoplasms of lymphatic and hematopoietic tissues	0.0	Skin and cellular tissue diseases	2.2
Other neoplasms	.1	Arthritis	.8
Asthma	6.0	Ankylosis	.4
Other allergic diseases	.4	Limitation of motion	1.1
Diabetes mellitus	.8	Musculo-skeletal diseases, n.e.c.	5.4
Other endocrine system diseases	.9	Flatfoot	2.2
Metabolic and nutritional diseases	.1	Deformities	4.3
Blood and blood forming organ diseases	.2	Amputations of extremities	.7
Acuity of vision	4.7	Congenital malformations	4.3
Other eye defects	2.8	Failure to meet height and weight standards	2.5
Acuity of hearing	.9	Other miscellaneous diseases and defects	4.6
Otitis media, with or without impaired hearing	4.9
Other diseases of the ear and the mastoid process	.5

^aThis distribution by defect relates to registrants who were disqualified for medical reasons only.
SOURCE: Individual reports of medical examinations (Standard Form 88). Percents shown as 0.0 signify less than 0.05.

Induction Results

During this period, 1,772,288 registrants were examined for induction, of whom 1,680,304 (or 94.8 percent) were found fit and inducted.

The induction examination results are presented in table XXXIII separately for registrants given a physical inspection and for those given a complete physical examination. In accordance with existing regulations, registrants called for induction within 120 days following their preinduction examination are given only a physical inspection to detect contagious diseases and defects or injuries which may have been incurred since the preinduction examination. Complete physical examinations at the time of induction are normally given if more than 120 days have elapsed since the preinduction examination, or if the registrant is inducted without having had a preinduction examination, as in the case of volunteers, parolees, etc. Registrants examined for induction without a preinduction examination are tested mentally, as well as medically.

TABLE XXXIII.?RESULTS OF INSPECTION AND INDUCTION EXAMINATIONS AUGUST 1950 THROUGH DECEMBER 1953

Results of examination	Inspection and induction examinations^a		Physical inspection		Complete induction examinations^b
Results of examination	Number	Percent	Number	Percent	Number	Percent
Total examined	1,772,288	100.0	1,491,229	100.0	281,059	100.0
Inducted	1,680,304	94.8	1,439,913	96.6	240,391	85.5
Not accepted by principal disqualifying cause	91,984	5.2	51,316	3.4	40,668	14.5
Administrative	18,595	1.0	16,285	1.1	2,310	.8
Mental test, only	14,482	.8	-	-	14,482	5.2
Mental test and medical	1,819	.1	-	-	1,819	.6
Medical, only	57,088	3.3	35,031	2.3	22,057	7.9

^aData include reexamined registrants who were disqualified prior to January 1952 for failing the mental tests and later reexamined and inducted under modified mental testing procedures.

^bRefers to registrants who have not undergone a preinduction examination (volunteers, delinquents, parolees, etc.), as well as to registrants who have undergone a preinduction examination but were given a complete medical examination at the time of induction due to ?lapse of time.?

SOURCE: ?Summary of Registrant Examinations for Induction,? DA Form 316 (Reports Control Symbol MED-66).

As may be expected, the disqualification rates at the time of induction are higher for those given complete physical examinations than for those who undergo only physical inspection. The disqualification rate of those who were given a physical inspection was 3.4 percent, against a disqualification rate of 14.5 percent for those who underwent a complete physical examination at the time of induction (A distribution of the inductees by State is given in source table 29.)

The inductees of this period were allocated among the Armed Forces as follows: 1,595,763 inductees went to the Army, and 84,541 were assigned to the

Marine Corps. No inductees were allocated to the Navy or to the Air Force during this period.

Overall Disqualification Rate

In order to obtain an overall preinduction and induction disqualification rate, the disqualification rate of ?not previously? examined registrants at the preinduction examinations was combined with that on physical inspection (tables XXX and XXXIII). The overall rate so derived indicates that 34.2 percent of the registrants forwarded by the local boards were disqualified before induction during this period.

This rate represents only a partial picture in the general evaluation of manpower fit for military service. On one hand, it excludes the disqualifications by the local boards and, on the other hand, it excludes the large proportion of individuals who qualified for military service through voluntary enlistments, appointments, or reserve recalls. Data on total military accessions indicate that during this period about as many individuals entered the military service through channels other than induction as through inductions. As a result, registrants forwarded by the local boards for preinduction examination are to a great extent depleted by the other accessions. Obviously, a disqualification rate relating to the total manpower pool, by taking into account all accessions, would be substantially lower than the above-stated rate which was based on preinduction and induction examinations alone.

MEDICAL STANDARDS

The medical standards that governed the acceptability of men for military service during this period are those set forth in ?Physical Standards and Physical Profiling for Enlistment and Induction? (AR 40-115, 20 August 1948). (The only exception to these standards were the temporary, relatively high, dental standards that were required by special directives during the first two and a half months of this period. This temporary stringency in the dental requirements was dictated by an early lack of sufficient dental personnel in the Army to handle the dental load that would have resulted from the low dental standards of the basic regulations.)

Congress has provided under the Universal Military Training and Service Act of 1951 that the minimum standards of physical acceptability shall not be higher than those applied to persons between the ages 18 and 26 in January 1945. Actually, the current medical standards are lower than those to which reference is made in the Universal Military Training and Service Act, primarily with respect to the psychiatric requirements. Under the present psychiatric standards, psychoneurosis of any degree is acceptable if it has not incapacitated the person in civil life. Also, persons with a history of transient psychotic reactions are considered acceptable if they have otherwise demonstrated stability. Such persons were not acceptable during World War II. The present underlying theory is that greater proficiency can be accomplished in screening out psychiatric cases unfit for military service when such persons are observed while living under military conditions, rather than at the time of induction.

The current Army Regulations also introduced minor changes towards lower physical standards with regard to perforated eardrums; paroxysmal convulsive disorders, if controlled by medication; moderate deformities of the extremities, etc., which had been considered disqualifying defects during World War II. In 1952, changes to the basic regulations (AR 40-115) introduced the element of ?successful treatment? in evaluating certain defects

and diseases that had been considered unacceptable under the basic regulations. Thus, for instance, carcinoma and other malignant tumors are acceptable under the current changes, if successfully treated five or more years. The same is true of active osteomyelitis, or a verified history of chronic osteomyelitis, if successfully treated two or more years previously; fracture of the coccyx, if healed or considered asymptomatic; harelip, if satisfactorily repaired by surgery; hay fever, if mild and controlled, or controllable, by antihistamines or by desensitization, or by both, etc. Except for the above-stated changes, the current medical requirements, as established by AR 40-115, are essentially the same as those contained in MR 1-9, in effect during World War II (after 1942).

It should be further noted that there was during World War II a ?limited service? classification and the induction of registrants so classified was restricted during World War II. The term ?limited service? is no longer in use; such registrants are now ordinarily classified as Physical Category C, acceptable without any restrictions.

MENTAL STANDARDS

For evaluating the examinee?s mental qualification for military service, the Armed Forces Qualification Tests (AFQT) have been used. These mental tests are the result of the joint efforts of all military services. Initially, AFQT 1 or 2 were applied. These tests consisted of 90 questions, separated into three equal groups, each of which was equally divided among items on the meaning of words, arithmetic reasoning, and items related to forms and positions. In 1953, AFQT 1 and 2 were replaced by AFQT 3 and 4 which added to the three groups of questions included in the previous tests a fourth group designed to test the examinee?s mechanical ability. The new tests consist of 100 questions equally divided among the four above-mentioned groups of questions. In all tests, the questions have been arranged in a progressive order of difficulty of items.

Towards the end of 1953, a mental qualification test in Spanish was introduced for registrants examined in Puerto Rico (from Puerto Rico and the Virgin Islands). Examinees of these territories formerly had been tested by the prevailing AFQT, which naturally proved disadvantageous for many of them because of their lack of knowledge of the English language. The new test, known as ?Examen Calificacion de Fuerzas Armadas? (ECFA-1), consists like the AFQT 1 and 2 of 90 questions relating equally to vocabulary, arithmetic, and spatial relationships. The examinees of these territories may now be tested either with the ECFA-1 or AFQT 3 or 4, whichever is appropriate in the particular case.

During the period between 1950 and 1952, the passing scores on the mental tests varied and were relatively higher when compared with the present passing requirement. The current passing score, in effect since December 1951, is 10 percentile, as established in the Universal Military Training and Service Act of 1951. Those who failed the mental test prior to 1952 were reexamined under the current standards.

SOURCE OF DATA

All the findings presented in this report, except the distribution of the disqualifying defects by diagnosis (table XXXII), are based on ?Summary of Registrant Examinations for Induction? (DA Form 316, Reports Control Symbol MED-66). This report is submitted to The Surgeon General?s Office monthly by each examining station. The diagnostic breakdown of the disqualifying defects was obtained from the individual reports of medical examination (Standard Form 88), copies of which are forwarded to the Office of The Surgeon General.

MEDICAL CARE TO NON-ARMY PERSONNEL

The mission of the Army Medical Service is to maintain the health of the Army. All activities within the Army Medical Service are primarily directed

to the prevention, diagnosis, and treatment of diseases, wounds, and injuries among active duty Army personnel.

Medical care is also provided to certain categories of non-Army personnel on a contingency basis; that is, when resources are available.

The necessity of providing care to non-Army personnel frequently results from the exigencies of the military situation. During 1953, for example, an average of 3,425 enemy prisoners of war were occupying hospital beds in Army facilities in Korea. (The corresponding 1951 and 1952 figures were 9,412 and 6,690, respectively.) Further, when U. S. Air Force, or U. S. Navy-Marine Corps personnel are quartered in areas adjacent to Army medical treatment facilities, it is often in the interests of economy and efficiency that such personnel be cared for in Army facilities, rather than transported long distances to Air Force or Navy facilities. Accordingly, a Defense Department policy of ?cross-servicing,? or joint utilization of facilities, has been established. Cross-servicing means making available the medical resources of one military service to the beneficiaries of sister services. It means, for example, that Army hospitals will admit as patients, Army, Navy, and Air Force personnel and their dependents, and that all beneficiaries will be treated according to their degree of eligibility regardless of the service or status from which that eligibility is derived.¹ In 1953, Air Force and Navy-Marine Corps active duty personnel occupied on the average 5.4 percent of all beds occupied in Army facilities worldwide.

Besides the categories of personnel mentioned (Navy-Marine Corps, Air Force, enemy prisoners of war) other non-Army groups receive care in Army facilities, deriving their eligibility from Army policy as applied by the authority of the commanding officer at the facility concerned. Included are reservists on short tours of duty, dependents of personnel of the Armed Forces on extended active duty, retired military personnel, beneficiaries of other Federal agencies (e. g., the Veterans Administration, U. S. Public Health Service, the Bureau of Employees Compensation, Foreign Service personnel) and other personnel, such as certain Nationals of foreign governments. Provision of care to such personnel is always contingent, not mandatory, and certain types of medical care are frequently excluded, e. g., elective treatment.²

Thus, many diverse categories of personnel are included among those groups eligible for medical care on a facilities-available basis. However, dependents of active duty military personnel constitute by far the largest component of the non-Army medical workload in Army facilities, worldwide.

Three morbidity indices measure conveniently the proportion of the total Army Medical Service workload comprised by non-Army personnel: admissions to hospitals and infirmaries, beds occupied in hospitals and infirmaries, and outpatient treatments in all Army medical treatment facilities.

__________

¹A distinction should be made between cross-servicing (as defined above) and ?joint staffing? of military medical treatment facilities. In the latter instance, medical personnel of one military service comprise part of the staff of a medical facility operated by another military department. Illustrative is Tripler Army Hospital in Hawaii, where the hospital staff consists of medical personnel from the departments of Army and Navy.

²See AR 40-506 ?Persons Eligible To Receive Medical Care at Army Medical Treatment Facilities?, 19 December 1952.

The respective proportions of workload vary according to geographic area (table XXXIV), and with the specific index (chart Q). Thus, dependents, for example, receive 28.2 percent of total outpatient treatments in continental United States, as contrasted with 15.5 percent of the corresponding total overseas. Further, dependents comprise a larger part (23.7 percent) of total admissions to hospitals and infirmaries than they comprise of total beds occupied (10.3 percent). The reason for this lies in the shorter length of stay in hospitals and infirmaries experienced by non-Army personnel, in comparison with the average duration of inpatient treatment for Army personnel. (See page 74.)

In table XXXV, the 1953 morbidity experience of the bulk of non-Army personnel is shown: (a) in terms of admissions to all Army medical treatment facilities by major cause (disease; nonbattle injury), and (b) in terms of total incidence and cases by diagnosis. Certain categories of personnel have been excluded from the distribution. Enemy prisoners of war were omitted because they present atypical morbidity experience. This fact, in combination with the absence of dependents in Korea, made it advisable to exclude that area from the tabulation, particularly since a main interest of the distribution lies with dependent care. To confine the experience primarily to the civilian non-Army population, Air Force and Navy-Marine Corps active duty military personnel have also been excluded from the tabulation.

It will be noted that the overseas experience has been computed on a rate per 1,000 strength basis. Corresponding rates for the continental United States are not available, as the relevant non-Army strength is not reportable.

With dependents the predominant group, gynecological and obstetrical care constitutes the largest diagnostic category?37.4 percent of the total incidence in the continental United States; 27 percent of the corresponding total overseas. In the main, the non-Army morbidity experience overseas resembled more than it differed from continental experience. Some differences are conspicuous, however, among them differences in nonbattle injuries (accidents, violence, and poisonings) and dysentery and the digestive disorders?all of them relatively more important overseas.

The availability of civilian morbidity rates (table XXXV) may lead to comparisons with Army experience, as, for example, that shown in the statistics presented in Part II of this report. Civilian rates, however, are seldom completely comparable with military rates, whether the index be in terms of patient flow, duration of hospital stay, or morbidity. For some of the more serious conditions, a comparison of Army and non-Army health statistics is reasonably valid if account be taken of some obvious relevant factors such as age, composition, and screening of the military population; tuberculosis, psychotic disorders, malignant neoplasms are illustrative. With certain other diseases, one would expect a priori Army and civilian experience to differ. Admission rates for common cold and other acute respiratory admission rates could hardly be compared because of a variety of reasons. The environmental health conditions of the two populations (Army; non-Army) differ significantly. A civilian with

CHART Q.?MEDICAL CARE IN ARMY FACILITIES, BY CATEGORY OF PERSONNEL, 1953

an acute respiratory condition might be treated on an outpatient basis and returned to his home for convalescence. Since the risk of a respiratory epidemic would be higher among an Army population with large numbers of soldiers quartered together, reasons of preventive medicine might decree that a soldier, similarly afflicted with a respiratory condition, be admitted to a medical treatment facility.

The mode of medical treatment for Army personnel often differs from that for non-Army personnel solely by virtue of the limitation of facilities. For example, no procedure corresponding to convalescent home care of civilians is available for Army personnel quartered in barracks at an Army installation. The procedure whereby Army patients may be excused from duty and confined not to hospital but to their quarters differs in type and degree from any civilian mode of treatment that may resemble it.

These and other factors render it difficult to compare Army and non-Army morbidity statistics, particularly as exemplified in admission rates to ?hospital and quarters??the rates quoted in table XXXV and in the source tables. However, subject to the qualifications cited, it would appear that the Army oversea rate for disease (342 per 1,000) was slightly higher during 1953 than the corresponding non-Army rate (321 per 1,000). (These rates represent initial admissions to hospital and quarters, excluding: Korean experience; Air Force and Navy-Marine personnel; cases carded-for-record only. They are derived from the Morbidity Report, DD Form 442.) For nonbattle injury, the Army rate (53 per 1,000) was several times greater than the non-Army rate overseas (14 per 1,000).

If the data are confined to admissions to hospital (excluding quarters admissions), the relationship of Army and non-Army personnel overseas is reversed. For all nonbattle causes (disease and injury) Army personnel were admitted to hospital at a rate of 188 per 1,000, while non-Army personnel were admitted at a rate of 255 per 1,000. This relatively high hospital admission rate for non-Army personnel overseas is attributable to the large obstetrical-gynecological component of the medical workload; if these conditions were excluded from consideration, the hospital admission rate for non-Army personnel would be roughly the same as that for Army personnel.

TABLE XXXIV.?MEDICAL CARE IN ARMY FACILITIES, BY CATEGORY OF PERSONNEL, 1953

Total Outpatient Treatments in Army Medical Treatment Facilities
Category of Personnel	Worldwide		Continental U.S. (percent)	Overseas (percent)
Category of Personnel	Number	Percent	Continental U.S. (percent)	Overseas (percent)
All personnel	21,053,641	100.0	100.0	100.0
Army	12,489,507	59.3	57.8	61.4
Non-Army:
Dependents	4,782,380	22.7	28.2	15.5
Other military	414,552	2.0	1.8	2.1
Veterans	2,172	0.0	.1	0.0
Retired	91,487	.4	.7	.1
Enemy prisoners	1,528,859	7.3	-	16.7
All other	1,744,684	8.3	11.4	4.2
Total Admissions to Army Hospitals and Infirmaries^a
All personnel	729,301	100.0	100.0	100.0
Army	446,607	61.2	59.1	63.8
Non-Army:
Dependents	173,170	23.7	32.0	13.7
Other military	32,070	4.4	3.1	6.0
Veterans	4,106	.6	.6	.5
Retired	5,152	.7	1.2	.1
Enemy prisoners	15,954	2.2	-	4.9
All others	52,242	7.2	4.0	11.0
Daily Average Beds Occupied in Army Hospitals and Infirmaries
All personnel	35,637	100.0	100.0	100.0
Army	23,727	66.7	75.9	54.0
Non-Army:
Dependents	3,661	10.3	13.8	5.4
Other military	1,942	5.4	5.1	5.9
Veterans	549	1.5	1.9	1.1
Retired	326	.9	1.5	.1
Enemy prisoners	3,425	9.6	-	22.7
All other	2,007	5.6	1.8	10.8

^aTotal admissions, including transfers. Excludes cases carded for record only, and excludes admissions to quarters.
SOURCE: Outpatient data from Outpatient Report, DD Form 444. Other data from Beds and Patients REport, DD Form 443.

98-99

TABLE XXXV.?MORBIDITY AMONG NON-ARMY PERSONNEL: ADMISSIONS AND INCIDENCE OF DISEASE AND INJURY BY DIAGNOSIS AND AREA, 1953

[Excludes Air Force, Navy-Marine Corps personnel, and enemy prisoners of war]

Major cause or diagnosis	Worldwide^a (number)	Continental U.S. (percent distribution)	Overseas^a
Major cause or diagnosis	Worldwide^a (number)	Continental U.S. (percent distribution)	Percent distribution	Rate per 1,000 strength
Total admissions, nonbattle causes^b	246,264	100.0	100.0	334.2
Disease	238,590	97.3	95.9	320.5
Nonbattle injury	7,674	2.7	4.1	13.7
Total incidence, nonbattle causesc	295,169	100.0	100.0	434.2
Tuberculosis	1,509	.5	.4	1.9
Venereal disease	584	.1	.4	1.5
Bacillary dysentery	268	0.0	.3	1.2
Amebic dysentery and amebiasis	170	0.0	.2	.7
Poliomyelitis	246	.1	.1	.5
Measles	427	.1	.2	1.1
Parotitis, epidemic (Mumps)	205	.1	.1	.5
Hepatitis, infectious	766	.2	.4	1.9
Malaria	116	0.0	.1	.4
Dermatophytosis	171	0.0	.1	.5
Other infective and parasitic diseases	1,834	.4	1.0	4.4
Malignant neoplasms	1,406	.6	.2	.9
Neoplastic conditions of lymphatic and hematopoietic tissues	361	.1	.1	.4
Benign neoplasms	3,014	1.0	1.0	4.4
Psychotic disorders	819	.3	.3	1.3
Psychoneurotic disorders	1,329	.4	.6	2.6
Other psychiatric conditions	1,127	.3	.6	2.6
Diseases of the nervous system	1,766	.6	.6	2.6
Diseases of the eye, ear, nose, and throat	11,282	3.4	4.8	20.9
Common cold and other acute respiratory conditions	10,544	3.3	4.1	17.7
Pneumonia, all forms	3,546	1.0	1.6	7.0
Other respiratory diseases	2,045	.6	.9	3.8
Diseases of the circulatory system	7,222	2.6	2.2	9.4
Dental diseases and conditions	1,066	.2	.6	2.8
Appendicitis, acute	1,718	.5	.8	3.3
Inguinal hernia	1,783	.6	.6	2.6
Gastroenteritis	2,376	.7	1.0	4.5
Other digestive system diseases	5,956	1.9	2.3	10.1
Diseases of urinary and male genital systems	7,755	2.4	3.1	13.3
Gynecological and obstetrical	100,891	37.4	27.0	117.6
Diseases of skin and cellular tissue	4,226	1.3	1.9	8.0
Observation, diagnosis undetermined, etc.	26,392	8.7	9.5	41.0
Other diseases	15,883	5.5	5.2	22.5
Accidents, violence, and poisonings	9,462	2.8	4.1	17.8
Admissions without disease (includes newborn)	66,904	22.3	23.6	102.6

^aExcludes Korea.
^bIncludes only patients admitted to medical treatment facilities or to quarters on an excused-from-duty status. Initial admissions only (transfers are excluded).
^cIncidence includes secondary diagnoses and cases carded for record only.
SOURCE: Morbidity Report, DD Form 442.