The Medical Department Of The United States Army in The World War
SECTION I
ORGANIZATION AND ADMINISTRATION OF THE CHIEF SURGEON'SOFFICE
CHAPTER I
GENERAL ORGANIZATION AND DEVELOPMENT
On May 10, 1917, the Surgeon General wrote The Adjutant General of theArmy as follows:1
I recommend:
That Col. Alfred E. Bradley, Medical Corps, in additionto his present duties as observer with the English Army,be designated as chief surgeon United States forces in Europe.
That, as chief surgeon of United States forces in Europe,Colonel Bradley be authorized to exercise over the forces under his controlthe same authority as the Surgeon General holds over the entire MedicalDepartment.Similar authority was granted; on the approval of the Secretary of WarFebruary 18, 1899, to the chief surgeon of the Departmentof the Pacific and Eighth Army Corps (now the Philippine Department).
In conformity with the foregoing request, The Adjutant General wroteto the officer in question, on May 28, as follows:2
The Secretary of War designates you, in addition to yourpresent duties as chief surgeon, United States forcesin Europe.
The Secretary authorizes you, as chief surgeon of theUnited States forces, to exercise over the forces underyour control the same authority as the Surgeon General holds over the entireMedical Department.
Meanwhile, on May 26, 1917, this officer had been designated chief surgeonof the American Expeditionary Forces in General Orders, No. 1, of thatorganization, which was published in Washington, D. C., but neither theforegoing letter nor a copy of the order mentioned was received by himprior to the arrival of headquarters, A. E. F., in London, on June 9, 1917.3
The Medical Department personnel which accompanied the commander inchief consisted of 4 officers, 2 enlisted men, and 4 civilian clerks.4On arrival in London they were joined by the chief surgeon, who had beenserving as military observer with the British, but who, on May 29, hadbeen relieved from that assignment.5 One of his first dutiesas chief surgeon, A. E. F., was the formulation of instructions for theliaison officer for the Medical Department with the British, who also hadbeen serving as a military observer and who was now charged with supervisionof the base hospitals and casual personnel of the American ExpeditionaryForces which were under British control.6
On June 13, headquarters, A. E. F., moved to Paris,7 where,by the 17th, it was joined by three other medical officers who had beenserving as military observers with the French or British forces.8When headquarters, A. E. F., established itself in Paris the chief surgeon'soffice force, now consisting of
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BRIG. GEN. ALFRED E. BRADLEY, M. C., CHIEF SURGEON, A. E. F., TO APRIL 30, 1918.
41
BRIG. GEN. WALTER D. McCAW, M. C., CHIEF SURGEON, A. E. F., OCTOBER 10, 1918, TO JULY 15, 1919.
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seven medical officers and about twice that number of clerks, was located,with other bureaus, in a small residential building where it occupied threesmall rooms.9 Almost immediately the chief surgeon and certainmembers of his staff began tours of inspection in order to determine mattersconcerning hospitalization at base ports and along the line of communications.10On July 4, a medical officer was relieved from duty in the chief surgeon'soffice and assigned as surgeon of base section No. 1 (St. Nazaire), wherethe first contingent of troops was expected to debark.11
When the staff of the American Expeditionary Forces was organized andits several duties were defined by General Orders, No. 8, Headquarters,A. E. F., July 8, 1917, the functions assigned to the Medical Departmentwere as follows:
Sanitation of camps, quarters, and occupied territory;health of command; care of sick and wounded; collectionand evacuation of sick and wounded; medical personnel; medical supplies;veterinary personnel; veterinary supplies; laundriesand baths (medical aspect); disinfection of clothing, etc.; supply of personnelandmaterial for gas defensive under supervision of director of gas service;technical inspection of medical
organizations and establishments, etc., etc.
Until the administrative structure of the American Expeditionary Forceswas radically changed, as noted in the preceding chapter, by General Orders,No. 31, General Headquarters, A. E. F., February 18, 1918, the staff organizationin general was comparable to that existing in the War Department. The relationshipof the chief surgeon's office to the general staff and to the chiefs ofadministrative staffs was similar to that existing between the SurgeonGeneral's office, on the one hand, and the General Staff and the severalbureaus of the War Department, on the other.a
Until the American Expeditionary Forces was reorganized by the ordermentioned the chief surgeon was located at headquarters with the generalstaff and the chiefs of other administrative staff departments, and heor his assistants, therefore, were enabled to transact business directlywith the staff offices concerned.12
As the general staff was charged with approval and coordination of allpolicies and projects for the American Expeditionary Forces the chief surgeonor his assistants took up directly with appropriate sections of that bodyall matters pertaining to the medical service which required its authoritization,coordination, or execution.12
The more important policies usually were placed on record and then discussedverbally.12 It was quickly realized that very close cooperationof all elements was necessary at general headquarters and that only throughcentralized control could prompt results be secured conforming to changingconditions.9 Careful studies were made of future needs and theseafter being approved by the general staff, were cabled to the United States.9
Communication between the chief surgeon's office and that of the SurgeonGeneral was carried on by letter direct, or, if circumstances required,through official channels, or by cable.13 Communications cabledfrom one office to the other passed through the respective cable officesin headquarters, A. E. F., and in
aSuch relationship is described in Volume I of this history.-Ed.
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the War Department.13 Copies of cables which the chief surgeon'soffice wished to send were submitted to the adjutant general, A. E. F.,if they pertained to administrative matters, or if to other matters, tothe Chief of Staff who referred them for examination to the appropriatesection of the General Staff.14 A section in the office of theadjutant general edited all cables for clearness, arranged them for logicalsequence with previous telegrams, and incorporated them with drafts ofother cables on the same subject from other departments into one long messagesigned, "Pershing."13 The avenues for transaction of businesswith the medical service of the Allies are discussed in Chapter III.
After the arrival of headquarters of the 1st Division on June 26, 1917,and that of considerable casual personnel, the work of the chief surgeon'soffice had so multipled that the office space in headquarters, A. E. F.,had become overtaxed.9 Therefore, about the middle of July thatoffice, with some other special branches of the headquarters group, movedto more commodious in the Hotel St. Anne, in the street of that name.9
Here some of the more important policies of the Medical Department weredeveloped and adopted and considerable creative and constructive work wasaccomplished.9 Problems which arose during the earlier stagesof the American Expeditionary Forces when headquarters was located at Paris,and later at Chaumont, included determination of general policies, suchas location and size of hospitals, percentage of hospital beds to totalstrength of the American Expeditionary Forces; estimates of quota, distributionand training of personnel; amount and character of Medical Department suppliesrequired; relative priority of Medical Department personnel and suppliesin shipments from the United States; the tonnage such supplies would require;character and quantities of supplies that could be procured advantageouslyoverseas; size and location of storage depots; provision of hospital trains;arrangements for care of casualties at the front, for their removal fromthe lines, distribution and treatment in the rear, and, if need be, sendingthem home; organization of gas defense; standardization of splints; provisionof agencies for transaction with the Allies of business which was of mutualinterest, e. g., procurement of sites for hospitals and other installations;procurement of facilities from or through the American Red Cross; controlof infectious diseases, especially of venereal diseases; organization ofthe laboratory system and of the professional services; and many cognatesubjects.15 These policies of the Medical Department were determinedat conferences attended by the few medical officers available at headquarters,or at more general conferences in which representatives of the MedicalDepartment participated with those of other staff departments of the AmericanExpeditionary Forces or with representatives of the French Army.9
A long step toward decentralization of medical service was taken whena chief surgeon was designated for the line of communications.16The necessity for such an organization arose when the 1st Division arrivedin July, and moved to its training area in the Vosges. The geographicallimits of the line of communications extended from the sea to the pointwhere supplies were delivered to the field transportation of the combatforces less such areas as might be excepted. Headquarters of this jurisdiction,while undergoing organization, was located in Paris, whence it moved January13, 1918, to Tours.9
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A colonel, Medical Corps, who arrived with a small force on July 18was assigned as chief surgeon, line of communications,17 andwas vested with immediate supervision of Medical Department personnel andtransportation, base hospitals, sanitation, and supplies, in its jurisdiction.18As his office was located in the same building as that occupied by thechief surgeon, A. E. F., numerous conferences occurred between their representatives19until September 1, when the latter's office moved with headquarters, A.E. F., to Chaumont.4
A medical supply officer for the American Expeditionary Forces arrivedon July 20 and proceeded to the base medical supply depot being establishedat Cosne.17 As additional personnel was now necessary in theoffice of the chief surgeon, A. E. F., and that of the chief surgeon ofthe line of communications the adjutants of the six American base hospitalsalready serving with the British (as mentioned in Chapter I) were relievedfrom duty therewith and ordered to Paris, where two of them were assignedto the office of the chief surgeon, A. E. F., and four to the office ofthe surgeon, line of communications.9 Also an American medicalofficer who had been serving at a French hospital at Ris Orangis and onewho had been studying the organization of gas warfare in England were orderedto join the office of the chief surgeon, A. E. F.20
Until the latter part of July, 1917, the chief surgeon's office, A.E. F., had not been divided into sections and none of its personnel hadbeen assigned to particular duties exclusively.19 Nearly allof the work transacted had been of a character which required determinationof broad general policies which were part of or conformed to the threeimportant basic projects of the American Expeditionary Forces discussedin the preceding chapter.
As troops began to arrive in increasing numbers, more specific allocationof duties became necessary in the chief surgeon's office, in order thatproper action might be taken promptly both on routine reports and on anumber of diversified matters.9 For example, base hospitalswhich were arriving constantly had to be promptly and suitably located,arrangements had to be made with the French for the care or evacuationof American sick until our Medical Department establishments could carefor them, the considerable numbers of casual personnel who were arrivinghad to be suitably classified and assigned, and many questions of policyon a wide range of subjects were now pressing for decision.9
After the arrival of a number of casual medical officers in the latterpart of July the chief surgeon's office, A. E. F., was organized on the28th of that month, as follows:20
(1) An executive officer, who assisted the chief surgeonin supervision and coordination of the sections of hisoffice, represented him when absent at conferences or on tours of inspection,and under the chief surgeon was in general chargeof the administration of the medical service, A. E. F.
(2) Hospitalization.-In charge of location, construction,and repair and all other questions relating to hospitals;hospital trains; and the care of sick and wounded.
(3) Sanitation and statistics.-Sanitationof camps, quarters, and occupied territory, laundries, disinfectionand disinfestation, collection and evacuation of sick, health of command,reports of sick and wounded, statistics and sanitaryreports.
(4) Personnel.-Medical, Medical Reserve, Dental,and Veterinary Corps, enlisted force, schools of instruction,and civilian employees.
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(5) Supplies.-Hospital equipment, medical, dental,and veterinary supplies, settlement of accounts, ambulances,and all motor transportation.
(6) Records and correspondence.
(7) Chemical Warfare Service.-Defensive gas, gasschool, and all professional questions relating togas.
There was but one officer on duty with each of the sections mentionedabove except that the head of the hospitalization section (who was alsocharged with Franco-American liaison which is discussed in Chapter III)had a commissioned assistant.9 These officers also handled generalestimates of personnel and equipment.9 Associated with thisheadquarters group was another officer who had been designated attendingsurgeon.9
During the week ending August 4, 1917, a liaison officer was appointedto function between the Medical Department and the coordination sectionof the general staff, an innovation which it was anticipated would greatlypromote transaction of business between the two offices.21
The chief surgeon was also represented by a liaison officer at the headquartersof the American Red Cross and of the Young Men's Christian Associationin Paris. He also maintained close contact with the other societies servingthe American Expeditionary Forces and availed himself of their cooperationas circumstances indicated.22
So much of the American Red Cross in Europe as was called into the serviceof the American Expeditionary Forces came under the immediate jurisdictionof the chief surgeon, A. E. F., though in the last analysis that and otherlike societies serving the American Expeditionary Forces were under thecontrol of the first section of the general staff.21 The activitiesof the American Red Cross in the military service were quite diversified,but in very general terms they pertained especially to hospitalizationand medical supply.
On August 23 a dental officer was assigned to duty in the chief surgeon'soffice and began, in the personnel division, the organization of the dentalservice of the American Expeditionary Forces.24
After the chief surgeon's office had been moved from Paris to Chaumont,September 1, 1917, in the zone of the armies, it occupied the upper floorsin the west end of the south barracks at that place.19 The floorspace allotted here to the chief surgeon's office was many times as greatas that which had just been vacated in Paris, for it was appreciated thata large increase in its personnel would soon be necessary.9The chief surgeon's office when established in Chaumont included 10 commissionedofficers of the Medical Department.22 Before leaving Paris,4 officers were detached to remain in that city, 1 with the water serviceof the line of communications, 2 as liaison officers with the AmericanRed Cross and the Young Men's Christian Association, respectively, and1 who served both as the medical member of the general purchasing board,A. E. F., and later as liaison officer with the French Medical Department.22
The Chemical Warfare Service was established as a separate bureau byGeneral Orders, No. 31, G. H. Q., A. E. F., September 3, 1917, and to thisa medical officer in close touch with the chief surgeon's office was laterassigned.25
On September 13, 1917, the chief surgeon was directed to submit at asearly a date as practicable a project for the Medical Department for thenext
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six months covering the proposed location of medical depots, laboratories,hospitals, other establishments, and sanitary units, and his project forsupplies and material.26
On October 9, 1917, the chief surgeon submitted the following plan oforganization of his office and that of the army surgeon at army headquartersin the field:27
Major general | Brigadier general | Colonel | Lieutenant colonel | Major | Captain or lieutenant | Clerks or soldiers | |
Chief surgeon | 1 | --- | --- | --- | --- | --- | --- |
Assistant to chief surgeon | --- | 1 | --- | --- | --- | --- | --- |
Personnel division | --- | --- | 1 | 1 | 3 | --- | 22 |
Sanitation and statistics | --- | 1 | 1 | 1 | --- | --- | 50 |
Records and correspondence | --- | --- | --- | --- | 1 | --- | 80 |
Hospitals, construction and assignment | --- | 1 | 2 | 3 | --- | --- | 100 |
Supplies | --- | --- | 1 | --- | --- | --- | 3 |
Total | 1 | 3 | 5 | 5 | 4 | --- | 255 |
Dental and veterinary service to be represented in thispersonnel section by an officer of the highest rank in these corps.
FOR ARMY HEADQUARTERS
1 brigadier general.
1 colonel.
1 lieutenant colonel.
1 major.
7 soldiers.
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In reply to a communication from the adjutant general, the chief surgeon,on November 7, 1917, submitted the following statement of the subdivisionof duties in his office, and of the personnel that would be required tostaff them, viz, chief surgeon (1 officer), assistant to chief surgeon(1 officer), personnel division (5 officers, including 1 dental and 1 veterinary,and 22 clerks), sanitation and statistics (3 officers and 50 clerks), recordsand correspondence (1 officer and 80 clerks), hospital construction andadministration (6 officers and 100 clerks), supplies (1 officer and 3 clerks).28
On November 13, 1917, a chief nurse of the American Expeditionary Forceswas designated and was assigned, with an assistant, to duty in the officeof the chief surgeon, line of communications.29 She and herassistant were not incorporated in the office of the chief surgeon, A.E. F., until it moved to Tours. This designation of the chief nurse laterwas changed to "director of nursing service," but her duties remained unchanged.30
The following data concerning the chief surgeon's office formed a partof the table of organization for headquarters, A. E. F., office of thecommander in chief, approved by General Pershing on December 22, 1917:31
Tables of organization, general headquarters, A. E.F.
CHIEF SURGEON'S SECTION
1 | 2 | 3 | 4 | 5 | 6 | 7 | Remarks | |
Unit | Officers | Interpreters | Clerks | Soldiersc | Soldiersa | Total | ||
General officer | 1 | --- | --- | --- | --- | 1 | (a) Carried in headquarters battalion. | |
Colonels | 3 | --- | --- | --- | --- | 3 | ||
Lieutenant colonels | 5 | --- | --- | --- | --- | 5 | ||
Majors | 9 | --- | --- | --- | --- | 9 | ||
Captains or lieutenants | 12 | --- | --- | --- | --- | 12 | ||
Commissioned interpreters | --- | 2 | --- | --- | --- | 2 | ||
| Total commissioned | 30 | 2 | --- | --- | --- | 32 | ||
Field clerks | --- | --- | 5 | --- | --- | 5 | ||
M. H. sergeants | --- | --- | --- | 5 | --- | 5 | ||
Hospital sergeants | --- | --- | --- | 5 | --- | 5 | ||
Sergeants major or battalion sergeants major | --- | --- | --- | --- | d5 | 5 | ||
Sergeants, first class | --- | --- | --- | 25 | --- | 25 | ||
Sergeants | --- | a4 | --- | 52 | b2 | 58 | ||
Corporals | --- | --- | --- | 20 | e8 | 28 | ||
Privates, first class | --- | --- | --- | 63 | f10 | 73 | ||
Privates | --- | --- | --- | 40 | h5, 12 | 52 | ||
| Total enlisted | --- | 4 | --- | 210 | 37 | 251 | ||
| Aggregate | 30 | 6 | 5 | 210 | 37 | 288 | ||
Closed cars | 1 | --- | --- | --- | --- | 1 | ||
Touring cars | 3 | --- | --- | --- | --- | 3 | ||
Light cars | 5 | --- | --- | --- | --- | 5 | ||
Motor cycles, with side cars | --- | --- | --- | --- | 2 | 2 | ||
Motor cycles | --- | --- | --- | --- | 3 | 3 | ||
Bicycles | --- | --- | --- | --- | 5 | 5 | ||
Horses, riding | 10 | --- | --- | --- | 5 | 15 | ||
Pistols | --- | --- | --- | --- | g29 | 29 | ||
RED CROSS SECTION (SERVICES VOLUNTEERED) | ||||||||
1 | 2 | 3 | 4 | Remarks | ||||
Unit | Officers | Others | Total | |||||
Captain | 1 | --- | 1 |
| ||||
| Total commissioned | 1 | --- | 1 | |||||
Not commissioned | --- | 1 | 1 | |||||
| Aggregate | 1 | 1 | 2 | |||||
Motor cars | 1 | --- | 1 | |||||
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With the development of the American Expeditionary Forces, decentralizationhad been necessary in practically every department. This movement was investigatedand the following report on this subject in so far as it pertained to thechief surgeon's office was forwarded to it by the adjutant general, A.E. F., on January 10, 1918:32
Statement of organization and personnel
Division | Officers | Clerks | Soldiers |
Chief surgeon | 1 | --- | --- |
Personnel | a5 | --- | b10 |
Hospitalization | 5 | --- | 3 |
Supply | 2 | --- | 2 |
Sanitation and statistics | 2 | --- | 10 |
Records and correspondence | 2 | 4 | 18 |
Dispensary | 2 | --- | 9 |
Dental office | 2 | --- | 2 |
21 | 4 | 54 |
aTwo Veterinary Corps (temporary duty).
bSorting mail.
Personnel division.-This division keeps recordof all the personnel of the Medical Corps, regular orotherwise, hospital corps sergeants, and nurses, on duty in France. Mostof the records concerning personnel are kept on cards;these cards give name of college, date of graduating; whether medicine,dentalor veterinary surgery; previous military service and date of appointmentand call into active service; and special characterof professional work; also specialty and ability to speak or translateFrench. These cards are made out in cases of all MedicalReserve Corps men. All medical personnel arriving in Franceare now assignedto duty from this office. When the system of automatic replacements isput into effect this work should be decentralizedto the line of communication.
Hospitalization.-This division handles all questionsrelating to the establishing of hospitals in France.The selection of sites are passed upon by the general staff at these headquartersafter conference with the French mission. It is notseen how this can be divorced from the office of the chief surgeon. Theactualbuilding and plans, etc., are now decentralized to the line of communications.
Sanitation and statistics.-All reports concerningsanitation, sick and wounded, etc., from the medicalsections of all units come to this office. Statistics and reports are madeup concerning them; also the weekly report to thecommander in chief. If the statistical bureau is established at these andother headquarters, it is believed with representativeof the Medical Department serving thereat that most sanitary reportsand reports of sick and wounded could come to this bureau.
There is a certain amount of data though which should,in my opinion, come to the chief surgeon, who after allis responsible for the evacuation of sick and wounded and their care, andit is believed that in case of heavy casualties orepidemic the chief surgeon at these headquarters should receive the necessarydata in order to enable him to understand the situation.Practically, the evacuation of sick and wounded will be automatic,but in times of emergency, the chief surgeon may have to act and exercisesupervision over situations, and he must be kept informedas to the general situation. It is not necessary for him to have alltheinformation in detail that is required for final reports to Washington.Data required for furnishing reports to the commanderin chief should come to the statistical bureau at these headquarters. Otherswhich are only required for the chief surgeon's officein Washington could be sent to the statistical bureau at theheadquarters,line of communications, it is believed.
Records and correspondence.-When the automaticreplacement is put into effect much of the recordsand correspondence work will naturally go from the chief surgeon's officeto the depots of the line of communications.
There is a post office here in which is distributed allthe mail for the personnel of the Medical Department servingin France. It is recommended that immediate steps be taken to have themail distributed elsewhere, and that only mail forthe personnel on duty in the Medical Department at these headquarters beforwarded here.
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To this the chief surgeon replied as follows, on January 12:33
1. The receipt is acknowledged of your letter of January10th (4773-F).
2. Personnel division.-Every effort has been madesince arriving in France to keep the amount of workin the personnel division in this office down to the minimum. As the inspectorsays, there is a card in this office for every memberof the Medical Department. It contains only the minimum amount ofinformation.I protest most emphatically against any proposition to remove this informationfrom my office. It is utterly impossible for the chiefsurgeon of the American Expeditionary Forces to administer his officewithoutknowing the personnel he has available. I am not at all concerned in regardto the automaticassignment of personnel arriving in France except in suchinstances where it is absolutely necessary that it shallbe done from these headquarters. I wish to emphasize again that I wouldconsider it the greatest misfortune to bring detailsinto my office which can be handled elsewhere: These details have beengiven to the line of communications and to the differentdivisions wherever it was possible to do so. This has been carriedto such an extent that personal complaints have actually been made fromtwo of the divisions that they felt very materiallythe loss of contact with the chief surgeon's office.
3. Hospitalization.-This paragraph hardly callsfor remark except that I am not prepared to state nowthat I agree with the statement of the inspector that the hospital divisionshould rest entirely in this office. This is a questionthat had been up many times since these headquarters moved to Chaumont.It is being studied now and if improvement on presentconditions can be made it will be promptly reported to properauthorities.
4. Sanitation and statistics.-I am perfectly willingto remove from this office as much of this divisionas is possible, having in mind particularly routine sick and wounded reports,with the understanding that I be furnished with theinformation necessary to administer the office. Attention is invited tothe fact that the chief surgeon can not carry outhis functions without knowing the sick rate, the prevalence of epidemicdiseasesand the sanitary conditions of the troops.
5. Record and correspondence.-It is hoped thatthe automatic replacement will relieve this office ofa great deal of the record and correspondence, and I will welcome any changein this respect which will not decrease efficiency.
6. Mail.-The distribution of mail which is beingdone in this office was not of my choice; it was forcedupon the Medical Department. The condition which exists in this respectto-day is almost intolerable and I will welcome anyproposition which will take this matter out of my office. It appears tome that this is a serious matter in the American ExpeditionaryForces. Attention is invited to the great dissatisfaction whichwill becontinued throughout the command if the delivery of mail, now so much delayed,is not accomplished with greater expedition.
Until February 14, 1918, there had been no general medical inspectorsin the American Expeditionary Forces, but on that date two experiencedofficers were assigned to this duty. Though these officers functioned inthe division of sanitation, chief surgeon's office, their reports consideredthe entire range of Medical Department responsibilities.34
On February 16, the date General Orders, No. 31, was published, reorganizingthe American Expeditionary Forces, the chief surgeon's office included19 officers, 55 clerks, and 4 orderlies. These were distributed as follows:34Chief surgeon; personnel section, 2 officers, 11 clerks; dental, 1 officer,1 clerk; hospitalization, 5 officers, 5 clerks; supplies, 1 officer, 3clerks; sanitation and statistics, 4 officers, 13 clerks; records and correspondence,2 officers, 17 clerks, 4 orderlies; veterinary, 2 officers; mail, 4 clerks;property, 1 officer, 1 clerk.
On February 22, the chief surgeon's office reported that in conformitywith the order mentioned above, 16 officers, 47 enlisted men, and 4 civilians,would move to Tours.35
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By General Orders, No. 31, G. H. Q., A. E. F., February 16, 1918, theMedical Department was charged with the following duties: Sanitary inspection;health of command; care of sick and wounded; collection and evacuationof sick and wounded; medical supplies; veterinary supplies; supply of personneland material for gas defense under supervision of director of gas service;technical inspection of medical organizations and establishments.
In reply to a query from the general staff, A. E. F., concerning thepersonnel that would be required by the chief surgeon's office36in the tables of organization for the Services of Supply, the chief surgeon,on March 8, 1918, submitted the following estimate:37
Tables of organization, chief surgeon's office, A.E. F., Services of Supply
Unit | Officers | Interpreters | Clerks | Soldiersc | Soldiers | Total | Remarks |
General officer | 1 | --- | --- | --- | --- | 1 | (a) Carried in headquarters battalion. |
Colonels and lieutenant colonels | 15 | --- | --- | --- | --- | 15 | |
Majors | 20 | --- | --- | --- | --- | 20 | |
Captains or lieutenants | 15 | 15 | |||||
Commissioned interpreters | --- | 2 | --- | --- | --- | 2 | |
| 51 | 2 | 53 | ||||
Field clerks | --- | --- | 5 | --- | --- | 5 | |
Master hospital sergeants | --- | --- | --- | 5 | --- | 5 | |
Hospital sergeants | --- | --- | --- | 5 | --- | 5 | |
Sergeants major or battalion sergeants major | --- | --- | --- | --- | d5 | 5 | |
Sergeants, first class | --- | --- | --- | 25 | --- | 25 | |
Sergeants | --- | a4 | --- | 52 | b2 | 58 | |
Corporals | --- | --- | --- | 20 | e8 | 28 | |
Privates, first class | --- | --- | --- | 63 | f10 | 73 | |
Privates | --- | --- | --- | 40 | 12 | 52 | |
| Total enlisted | --- | 4 | --- | 210 | 37 | 251 | |
| Aggregate | 51 | 6 | 5 | 210 | 37 | 309 | |
Closed cars | 1 | --- | --- | --- | --- | 1 | |
Touring cars | 3 | --- | --- | --- | --- | 3 | |
Light cars | 5 | --- | --- | --- | --- | 5 | |
Motor cycles with side cars | --- | --- | --- | --- | 2 | 2 | |
Motor cycles | --- | --- | --- | --- | 3 | 3 | |
Bicycles | --- | --- | --- | --- | 5 | 5 | |
Horses, riding | 10 | --- | --- | --- | 5 | 15 | |
Pistols | --- | --- | --- | --- | g27 | 27 |
In compliance with General Orders, No. 31, G. H. Q., A. E. F., February16, 1918, the chief surgeon's office arranged for removal of most of itspersonnel, records, and property, on the night of March 20, to Tours, whereit was installed March 21.38 Here it absorbed and supersededthe office of the chief surgeon, line of communications. On March 24, theoffice force of the chief surgeon, A. E. F., included 33 officers and 2nurses.38
The organization prescribed by the chart approved by the commander inchief on March 6, 1918, was in general that followed in subsequent developments.39The section charged with combat organization and new equipment was takenover by the representatives whom the chief surgeon left with the generalstaff at Chaumont, before he moved his office to Tours on March 21.40The nomenclature of the records division was later changed to administrativedivision, but its duties were unchanged.41
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CHARTI.-Showing organization of chief surgeon's office, A. E. F., March 6, 1918
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The chiefs of the 10 technical staff departments of headquarters, A.E. F., who were transferred by General Orders, No. 31, 1918, to Tours,were now under the immediate jurisdiction of commanding general, Servicesof Supply, in all matters pertaining to procurement, supply, transportation,and construction, but retained their titles and authority as members ofthe staff of the commander in chief, A. E. F.42 They were directedso to organize their offices that the efficiency of their departments wouldnot be impaired by absences for conferences or other duties assigned them,and though their headquarters were at Tours they were authorized and expectedto travel throughout the American Expeditionary Forces to investigate,direct, and supervise the work of all elements of their services, includingthose with combat units. The chief surgeon thus occupied a dual status,for he was at once the chief surgeon of the American Expeditionary Forcesand of the Services of Supply.42
In the Services of Supply the position of the chief surgeon in relationto the general staff of that command, and with the heads of its administrativestaff departments, was altogether analogous to that which as chief surgeon,he formerly had held with the corresponding departments of general headquarters,A. E. F., at Chaumont.42 In fact, as stated in the precedingchapter, the chiefs of all administrative staff departments, A. E. F.,except the adjutant general, the judge advocate, and inspector general,A. E. F., had also been transferred to Tours where they had the same dualstatus as had the chief surgeon.42 With the adjutant general,judge advocate, and inspector general of the Services of Supply his relationswere the same as with the chiefs of the other staff departments, but thescope of the Medical Department matters upon which they took definitiveaction pertained to the Services of Supply only.42 Though thechief surgeon was represented on the general staff, A. E. F., at Chaumont,by medical officers assigned to several of its sections, he was not representedon the general staff of the Services of Supply at Tours except for a shortperiod when a medical officer was assigned to its first section.43Over his subordinates in the several geographical sections (advance, intermediate,and base) into which the Services of Supply was divided, the chief surgeonexercised supervision through the section surgeons who were members ofthe staffs of the officers commanding those sections.16 Hisoffice had direct control, except in a few matters (especially discipline)over certain Medical Department formations which were removed from thejurisdiction of the commanding officer of the section in which they werelocated; e. g. hospital centers, detached base hospitals, medical supplydepots, the central Medical Department laboratory, Dijon, and such hospitaltrains as were assigned to his office.
The chief surgeon's office, after its location at Tours and its absorptionof the office of the surgeon, line of communications, was organized intothe following divisions:44 (1) General administration, recordsand correspondence; (2) hospitalization, evacuation, and hospital administration;(3) sanitation, sanitary inspection, and medical statistics; (4) personnel;(5) medical supplies; (6) finance and accounting.
Under the chief surgeon and his executive officer, the commissionedpersonnel of the chief surgeon's office was distributed among its severaldivisions, on March 24, 1918, as follows:38 Sanitation, 7; hospitalization,6; personnel, 4; supplies, 4; records and correspondence, 4; finance andaccounts, 6.
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A chief nurse and assistant chief nurse were at the head of the nursingservice in the personnel division, but members of the nursing staff werenot yet commissioned.38
The assistant to the chief surgeon examined all papers going to thechief surgeon for his signature and was authorized to sign these in hisabsence.44 The finance and accounting section was composed ofpersonnel recently arrived, who had been selected from a unit that hadbeen organized in the United States to audit property and money accountsof the Medical Department in France.44
By June 3, 1918, the clerical force in the office of the chief surgeonhad grown materially, but was inadequate and on that date he recommendedthat because of the great number of technical questions reaching his officeand the consequent necessity for trained noncommissioned officers, theenlisted personnel on duty therein should be authorized in the followingproportions:45 Master hospital sergeants, 2; hospital sergeants,12; sergeants, first class, 35; sergeants, 60; corporals, 26; privates,first class, 40; privates, 27; total, 202. This number was exceeded bythe latter part of July, 1918, for at that time the personnel then on dutyin the chief surgeon's office was 43 officers and 220 clerks.46
A seventh section of the veterinary service, was organized in the chiefsurgeon's office after the promulgation of General Orders, No. 139, onAugust 29, 1918.30 Before publication of that order, this activityhad been under the control of the remount service of the QuartermasterDepartment, its chief being
54
without administrative authority and having virtually the status ofa technical adviser only.30 The general order mentioned, providedthat the veterinary service be transferred to the Medical Department andthat a new section charged with direction of veterinary affairs be createdin the chief surgeon's office of which the chief veterinarian was, therefore,placed in charge.30
After its expansion by the addition of the veterinary division the chiefsurgeon's office retained the general organization then provided thoughits personnel steadily increased in number until after the armistice wassigned.30
On November 9, 1918, 58 officers were on duty in the chief surgeon'soffice, distributed as follows:47 Chief surgeon, 1; assistantto chief surgeon, 1; general administration, 1; detachment of enlistedmen, Medical Department, 1; records, 1; library, 4; hospitalization, 13(transportation, 7; sick and wounded, 5); sanitation, 4 (sanitary inspection,1); personnel, 4 (dental, 5; promotions, 1); supplies, 5; finance and accounts,4; veterinary, 6.
Other personnel who were in charge of specialties in the chief surgeon'soffice but who were not commissioned included nurses and dietitians. Itwill be noted that 25 of the 61 officers whose duties were classified above-i.e., more than 40 per cent-were serving in the hospitalization division.47
The personnel serving in the chief surgeon's office or in immediateconnection therewith on November 11, the date the armistice was signed,were distributed by rank as follows:48 Officers: Brigadier generals,2; colonels (one being the chief surgeon, later promoted), 6; lieutenantcolonels, 12; majors 6; captains, 9; first lieutenants, 27; second lieutenants,6. Total, 68.
55
CHARTII.-Scheme for organization of Medical Department, A. E. F., correctedto November 11, 1918
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Nursing service: Nurses, 2; enlisted men: Master hospital sergeants,1; hospital sergeants, 21; sergeants, first class, 55; sergeants, 83; corporals,46; cooks, 3; privates, first class, 26; privates, 43. Total, 278. Civilianemployees, 76; grand total, 424.
PERSONNEL
(July 28, 1917, to July 15, 1919)
CHIEF SURGEON, A. E. F.
Brig. Gen. Alfred E. Bradley, M. C., to April 30, 1918.
Maj. Gen. Merritte W. Ireland, M. C., May 1 to October 9, 1918.
Brig. Gen. Walter D. McCaw, M. C., October 10, 1918, to July 15, 1919.
DEPUTY CHIEF SURGEON
Brig. Gen. Jefferson R. Kean, M. C.
Brig. Gen. Francis A. Winter, M. C.
REFERENCES
(1) Letter from the Surgeon General, U. S. Army, to TheAdjutant General of the Army, May 10, 1917. Subject:Designation of Col. Alfred E. Bradley, M. C., as chief surgeon, UnitedStates forces in Europe. On file, Record Room, S.G. O. (9795).
(2) Letter from The Adjutant General of the Army, to Col.Alfred E. Bradley, M. C., American Embassy, London,May 28, 1917. Subject: Designation as chief surgeon of the United Statesforces in Europe. On file, Record Room, S. G. O. (9795).
(3) Letter from the chief surgeon, A. E. F., to the SurgeonGeneral, U. S. Army, June 11, 1917. Subject: Status.On file, Record Room, S. G. O. (9795).
(4) Report from the chief surgeon, A. E. F., to the commandinggeneral, A. E. F. (undated). Subject: Outline reportof chief surgeon, A. E. F., for use in preparation of the report of thecommander in chief. On file, Historical Division,S. G. O.
(5) Letter from The Adjutant General of the Army, to Col.A. E. Bradley, M. C., May 29, 1917. Subject: Assignment.On file, Record Room, S. G. O. 9785 (Old Files).
(6) Memorandum from the chief surgeon, A. E. F., to Maj.W. J. L. Lyster, M. C., American Embassy, London,June 11, 1917. Subject: Administration of American medical personnel servingwith British Forces. On file, Record Room, S. G. O.,9795 (Old Files).
(7) Final report of Gen. John J. Pershing, September 1,1919, 5.
(8) Letter from the chief surgeon, A. E. F., to the commanderin chief, A. E. F., June 21, 1917. Subject: Reportof personnel of chief surgeon's office. On file, A. G. O., World War Division,chief surgeon's files (321.6).
(9) Wadhams, Sanford H., Col., M. C., and Tuttle, ArnoldD., Col., M. C.: Some of the Early Problems of theMedical Department, A. E. F. The Military Surgeon, Washington, D.C., 1919, xlv, No. 6, 636.
(10) Memorandum from the chief surgeon, A. E. F., to thechief of staff, A. E. F., July 14, 1917. Subject: Weeklywar diary. Copy on file, Historical Division, S. G. O.
(11) Special Orders, No. 26, Headquarters, A. E. F., July4, 1917, par. 2.
(12) Report from Col. Sanford H. Wadhams, M. C., the Representativeof the chief surgeon, A. E. F. with the General StaffG-4-"B" to the chief of the fourth section, general staff, general headquarters,A. E. F., December 31, 1918. Subject: Activities of the medical group,fourth section, general staff, A. E. F., for the period embracing the beginningand end of America's participation in hostilities. Copy on file, HistoricalDivision, S. G. O.
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(13) Final report from the adjutant general, A. E. F.,to the commander in chief, A. E. F., from May 28, 1917,to April 30, 1919. On file, General Headquarters, A. E. F. Records.
(14) General Orders, No. 42, G. H. Q., A. E. F., September26, 1917.
(15) Memoranda from the chief surgeon, A. E. F., to thechief of staff, A. E. F., from July 14, 1917, to and includingDecember 29, 1917. Subject: Weekly war diaries. On file, Historical Division,S. G. O.
(16) General Orders, No. 20, G. H. Q., A. E. F., August13, 1917; also memorandum from the chief surgeon,A. E. F., to the chief of staff, A. E. F., July 21, 1917. Subject: Weeklywar diary. On file, Historical Division, S. G. O.
(17) War diary, chief surgeon's office, A. E. F., July21, 1917.
(18) Report of medical activities, line of communications,A. E. F., during the war period (undated), by Brig.Gen. Francis A. Winter, M. C. On file, Historical Division, S. G. O.
(19) Report on medical supply, A. E. F. (not dated), byMaj. A. P. Clark, M. C. On file, Historical Division,S. G. O.
(20) War diary, chief surgeon's office, A. E. F., July28, 1917.
(21) War diary, chief surgeon's office, A. E. F., August4, 1917.
(22) War diary, chief surgeon's office, A. E. F., September2, 1917.
(23) General Orders, No. 8, G. H. Q., A. E. F., July 8,1917.
(24) War diary, chief surgeon's office, A. E. F., August26, 1917.
(25) Report from the chief surgeon, A. E. F., to the SurgeonGeneral, U. S. Army, May 1, 1919. Subject: Activitiesof the chief surgeon's office, A. E. F., to May 1, 1919. On file, HistoricalDivision, S. G. O.
(26) Memorandum from the adjutant general, A. E. F., tothe chief surgeon, A. E. F., September 13, 1917. Subject:Project of Medical Department. On file, A. G. O., World War Division, chiefsurgeon's files (321.6).
(27) Memorandum from the chief surgeon, A. E. F., to thechief of staff, October 9, 1917. Subject: Tables oforganization. On file, A. G. O., World War Division, chief surgeon's files(320.2).
(28) Memorandum from the chief surgeon, A. E. F., to theadjutant general, A. E. F., November 7, 1917. Subject:Chart showing subdivisions in his office. On file, A. G. O., World WarDivision, chief surgeon's files (320.2).
(29) Personnel records. On file, Army Nurse Corps, S.G. O. (Bessie S. Bell).
(30) Report from the chief surgeon, A. E. F., to the commandinggeneral, A. E. F., April 17, 1917. Subject: Activitiesof the Medical Department, A. E. F., to November 11, 1918. On file, HistoricalDivision, S. G. O.
(31) Tables of organization for general headquarters,A. E. F., in France, approved by Gen. John J. Pershing,December 22, 1917. On file, A. G. O., World War Division, chief surgeon'sfiles (320.2).
(32) Letter from the adjutant general, A. E. F., to thechief surgeon, A. E. F., January 10, 1918. Subject: Reporton investigation of methods of decentralization. On file, A. G. O., WorldWar Division, chief surgeon's files (321.6).
(33) Letter from the chief surgeon, A. E. F., to the adjutantgeneral, A. E. F., January 12, 1918. Subject: Reportof investigation of methods of decentralization. On file, A. G. O., WorldWar Division, chief surgeon's files (321.6).
(34) List of officers and clerks on duty in the chiefsurgeon's office, February 16, 1918. On file, A. G. O., WorldWar Division, chief surgeon's files (321.6).
(35) Memorandum from the chief surgeon, A. E. F., to thepost quartermaster, February 22, 1918. Subject: Transferto Tours. On file, A. G. O., World War Division, chief surgeon's files(321.6).
(36) Memorandum from assistant chief of staff, G-3, A.E. F., to the chief surgeon, A. E. F., February 26,1918. Subject: Tables of organization for the service of the rear. On file,A. G. O., World War Division, chief surgeon's files(320.2).
(37) Letter from the chief surgeon, A. E. F., to the commandinggeneral, S. O. R., A. E. F., March 8, 1918. Subject: Tables of organization.On file, A. G. O., World War Division, chief surgeon's files (320.2).
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(38) War diary, chief surgeon's office, A. E. F., March24, 1918.
(39) Scheme for organization of the medical department,submitted by the chief surgeon, A. E. F., February 22,1918, and approved by the commander in chief, A. E. F., March 6, 1918.On file, A. G. O., World War Division, chief surgeon'sfiles (321.6).
(40) Letter from the chief surgeon, A. E. F., to the commanderin chief, A. E. F., March 15, 1918. Subject: Organization.On file, A. G. O., World War Division, chief surgeon's files (320.2).
(41) Report on the administrative section of the chiefsurgeon's office, A. E. F., by Capt. R. A. Dickson, M.A. C. On file, Historical Division,
S. G. O.
(42) General Orders, No. 31, G. H. Q., A. E. F., February16, 1918.
(43) Report from Col. N. L. McDiarmid, M. C., to the SurgeonGeneral, U. S. A., May 1, 1919. Subject: Activitiesof the supply division, chief surgeon's office, A. E. F. On file, HistoricalDivision, S. G. O.
(44) Report from the chief surgeon, A. E. F., to the commandinggeneral, A. E. F., July 1, 1918. Subject: The MedicalDepartment in the American Expeditionary Forces to May 31, 1918. On file,Historical Division, S. G. O.
(45) First indorsement from the chief surgeon, A. E. F.,to the assistant chief of staff, G-1, A. E. F., June3, 1918, on memorandum from assistant chief of staff, G-1, A. E. F., tochief surgeon, A. E. F., May 31, 1918. Subject: Tableof organization. On file, A. G. O., World War Division, chief surgeon'sfiles (320.1).
(46) Memorandum from the chief surgeon, A. E. F., to assistantchief of staff, G-4, A. E. F., July 4, 1918. Subject:Office personnel and space. On file, A. G. O., World War Division, chiefsurgeon's files (321.6).
(47) Circular No. 54, chief surgeon's office, A. E. F.,November 9, 1918. On file, Historical Division, S.G. O.
(48) Memorandum from the chief surgeon, A. E. F., to assistantchief of staff, G-1, A. E. F., December 2, 1918. Subject:Personnel and transportation. On file, A. G. O., World War Division, chiefsurgeon'sfiles (321.6).
