Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply
APPENDIX
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EXCERPTS FROM THE MANUAL FOR THE MEDICAL DEPARTMENT,
UNITED STATES ARMY, 1916
ARTICLE IX.-SUPPLIES AND MATERIALS
GENERAL PROVISIONS
474. The supply table enumerates the medical supplies issued to the Army and the quantities and sizes of original packages. These supplies are selected for the military service, and it is believed that all necessary articles are included and that the quantities allowed will be found sufficient under ordinary circumstances. Requests for particular preparations simply because they are agreeable to the taste or save trouble in compounding will not be approved; nor will preparations of a drug be furnished when one or more practically equivalent ones are on the supply table. The Medical Department will supply from time to time new remedies of determined therapeutic value, but newly introduced remedies which offer no manifest advantage over those already issued will not be supplied.
(a) Medical officers are requested to communicate freely to the Surgeon General any suggestions tending to the improvement of medical supplies, appliances, etc., and to make reports as to new designs of apparatus, field equipment, etc.
475. In preparing returns, requisitions, invoices, and receipts pertaining to medical and hospital supplies, the nomenclature, order of entry, classification, and weights and measures of the supply table will be followed. To facilitate the handling of these papers one line of writing only will be placed in each interlinear space. No letter of transmittal is required with them.
476. Medical officers in charge of medical supply depots will purchase and distribute medical and hospital supplies for the Army according to instructions given them from time to time by the Surgeon General. Purchases at posts or by officers not in charge of supply depots (except prescriptions purchased under the provisions of Army Regulations, and anti- toxins purchased under the authority indicated hereinafter in the supply table) will not usually be made without special authority from the Surgeon General, or, in the Philippine Department or Hawaiian Department, from the department surgeon. When the emergency is so great that there is not time to obtain special authority by mail through the regular channels, application therefor may be made direct by telegraph. When it is impracticable to telegraph, small quantities of articles immediately needed to save life or prevent suffering and distress among the sick may be purchased without advance authority. Vouchers for such unauthorized purchases will be forwarded without delay on Form 330 or Form 330a, W. D., to the department surgeon, or if from a command under the immediate supervision of the War Department to the Surgeon General, unless otherwise directed by him. They must invariably be accompanied by a letter explaining why the necessary articles were not on hand, and what the circumstances were which did not admit of requiring for them in the regular way or of making telegraphic application for authority to purchase them. Timely action in requiring for supplies will as a rule obviate the necessity of telegraphic application or of unauthorized purchases.
(a) Purchase vouchers must be accompanied by one invoice of articles purchased, Form 12, a duplicate of which should be retained by the officer accountable for the property.
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REQUISITIONS
POST MEDICAL SUPPLIES
477. Annual requisitions for post medical supplies will be prepared on Form 33, for the year commencing January 1, unless some other date is designated by the Surgeon General.
(a) They will be forwarded not less than 20 days before the beginning of the year, to the department surgeon, in quadruplicate, or in the case of general hospitals and independent posts direct to the Surgeon General in triplicate.
478. Articles of which a definite allowance is given on the supply table will be required for on the annual requisition except as otherwise provided in paragraph 486. No remark will be made opposite the name of any article that a special kind or special make or pattern is wanted, as the annual requisition is intended to include onlv such articles as are kept on hand in supply depots for issue, and not such as have to be specially purchased; the latter when wanted must be asked for on special requisition.
(a) Only such quantities will be asked for as probably will be needed during the year, computed on the basis of original packages. Fractional parts of a bottle or package will not be asked for. The quantities asked for, plus the quantities on hand, must not exceed those specified in the table for the official population most nearly corresponding to that of the post or command. The quantity of each article on hand, as verified by a medical officer in accordance with paragraph 512a, will be stated and will be deducted from the quantity allowed annually by the supply table (ignoring for the purpose of this deduction fractional parts of bottles and packages on hand) to ascertain the balance which may be asked for, is needed.
(b) Before forwarding an annual requisition it will be carefully examined and compared with the supply table to see that it has been correctly made out in strict accordance with these regulations and to avoid the delay that its return for correction will occasion if they are not complied with.
479. The local prevalence or rarity of certain diseases, as well as the quantity or number on hand of each article, will be considered in the preparation and approval of annual requisitions.
480. The smaller posts will not need all the articles included in the supply table. The surgeon is not expected to inquire for an article merely because it is listed. He should call only for what there is reason to think he will need.
481. The department surgeon to whom an annual requisition is forwarded will see whether it is prepared in accordance with the above regulations. If it is, he will approve and forward one copy direct to the medical supply depot designated for his territory by the Surgeon General; if it is not, he will alter it to conform to these regulations and then forward it to the depot approved as altered. In either event he will forward the second copy of the requisition, with the action taken by him noted thereon, direct to the Surgeon General. He will retain the third copy in the files of his office and will return the fourth copy to the surgeon with his modifications, if any, noted thereon.
482. Special requisitions for post medical supplies are annual, quarterly, or emergency. They will be made on Form 35, but separately from those for field medical supplies and those for dental supplies. The same number of copies will be executed, and thev will be forwarded to the department surgeon or to the Surgeon General direct, as in the case of annual requisitions from the same posts or hospitals. (See par. 477a.)
483. Except as otherwise provided in paragraph 486, articles not on the supply table which will be needed during the year will be called for on the annual special requisition. It will be forwarded with the regular annual requisition. The articles will be listed in alphabetical order, and the necessity for them will be fully explained in the column of "Remarks." To avoid delay in filling these requisitions a full description of special articles, instruments, and appliances required for will be given in " Remarks," together with a statement of their cost or approximate cost, as ascertained from dealers` catalogues or other reliable sources of information. When unusual drugs or chemical reagents are called for, similar information as to their cost will be furnished.
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484. Except as otherwise provided in paragraph 486 and in the footnotes to the supply tables, articles on the supply table of which no allowance is stated, or which are issued "as required," will be called for on the quarterly special requisition.
(a) When supplies are exhausted or their exhaustion is imminent, a renewal thereof may be asked for on the quarterly special requisitions forwarded during the remainder of the year. These articles should be listed according to the nomenclature, classification, and alphabetical arrangement of the supply table.
(b) When quarterly special requisitions are necessary they will ordinarily be forwarded on or before January 1, April 1, July 1, and October 1, for the ensuing three months, respectively. A quarterly requisition may, however, be forwarded at any time during the quarter in which the supplies are needed.
(c) When under these regulations a quarterly special requisition would be made at the same time as an annual special it will be consolidated therewith.
485. When, as a result of the prevalence of an epidemic or for any other reason, necessary supplies are likely to be exhausted before the next quarterly special requisition is to be made, they will be called for on an emergency requisition, Form 35, forwarded at once upon the development of the deficiency, with a full explanation of the emergency and its cause. In extreme cases telegraphic application should be made direct to the Surgeon General, or in the Philippine Department or Hawaiian Department to the department surgeon, for the supplies needed to meet the emergency, which will be followed by a letter of explanation. Surgeons will be held accountable for any suffering which may result from their failure to require for supplies when it is evident the same will be needed.
(a) The frequent rendition of emergency post requisitions would usually argue a want of reasonable foresight in requiring for supplies, or a want of proper economy in the use of hospital property, and would be a reproach to medical administration. If due care in the use of hospital property is exercised, and the regulations herein made for the timely preparation of annual and quarterly requisitions are observed, it will seldom be necessary to resort to the emergency or telegraphic requisition.
486. The following special rules will be observed:
(a) Identification supplies will be asked for on quarterly special requisitions. On these requisitions no other items should appear, as identification supplies are issued from the New York supply depot only.
(b) Articles required to replace unserviceable property, whether on the supply table or not, will be required for on the quarterly special requisition. The exact number and condition of the unserviceable articles on hand will be expressly stated in " Remarks.
(c) Mineral oil, coal, gas, and electric current, for operating sterilizers, X-ray machines and other therapeutic apparatus will be obtained on request addressed to the Surgeon General, or, in the Philippine or Hawaiian Departments, to the department surgeon.
(d) Supplies for a subpost or camp will, in the absence of orders to the contrary, be required for quarterly upon the surgeon of the main post or command, who will issue them after approval by the department surgeon.
487. The department surgeon to whom a special requisition is forwarded will personally and carefully scrutinize it and make such changes therein as he may deem proper. He will indorse on each of three copies his approval or recommendation as to the action to be taken and will forward them, except as indicated in section (a) hereinafter, to the Surgeon General. He will retain the fourth copy in the files of his office. One copy of the requisition forwarded to the Surgeon General`s Office will be returned to the surgeon, through the department surgeon, with modifications, if any, noted thereon. In the Philippine and Hawaiian Departments the department surgeons are authorized to act upon special requisitions as upon annual requisitions.
(a) In the case of a special requisition to meet an emergency not admitting of delay the department surgeon is authorized to approve the same, forwarding one copy, with his approval indorsed thereon, to the medical supply depot designated for his territory, forwarding a second copy to the Surgeon General with an indorsement stating the circumstances, retaining the third copy in his files, and returning the fourth copy to the surgeon with his modifications, if any, noted thereon; but requisitions for articles not on the supply table
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must in all cases be forwarded to the Surgeon General for his action (except in the Philippine and Hawaiian Departments, where the department surgeons will act upon them).
488. Medical supply officers to whom approved requisitions for supplies are referred by department surgeons conformably to these regulations are authorized to issue the same from stock, if on hand, or to purchase them for issue, if not on hand, subject, however, to instructions given by the Surgeon General respecting the allotment, and expenditure of public funds available for purchases.
FIELD MEDICAL SUPPLIES
(For provisions respecting requisitions from organizations in the field, see pars. 551 to 533)
489. Requisitions to replenish field medical supplies or to replace unserviceable field equipment at permanent posts will be executed in triplicate, on Form 35, and will be forwarded to the department surgeon, or, in the ease of an independent post or station, direct to the Surgeon General.
(a) The department surgeon who receives a requisition in triplicate for field medical supplies in conformity with this regulation will promptly forward the same, with his recommendations indorsed on each copy, to the Surgeon General. In the Philippine and Hawaiian Departments the department surgeons are authorized to act upon them as upon requisitions for post supplies. One copy of the requisition will be returned to the surgeon with modifications, if any, noted thereon.
490. Requisitions from permanent posts for field medical supplies should be unnecessary except immediately following active military operations or as the result of changes in the supply tables.
DENTAL SUPPLIES
491. Articles of post medical supplies needed by the dental surgeon will be issued by the surgeon, as to his other assistants, from time to time in such quantities as are needed for the work at the post. The surgeon is charged with the responsibility of keeping on hand the articles indicated in the supply tables as used by dental surgeons.
492. Requisitions for other dental supplies, annual and special, will be executed in triplicate by the dentist, who will forward them through the surgeon to the department surgeon, or, in the case of independent posts or commands, to the Surgeon General. The department surgeon will promptly transmit them, with his recommendations indorsed on each copy, to the Surgeon General. In the Philippine and Hawaiian Departments the department surgeons are authorized to act upon them as upon requisitions for post supplies. One copy of the requisition will be returned to the dentist with modifications, if any, noted thereon.
493. Annual requisitions will be made on Form 36 for the year beginning January 1 (unless some other date is designated by the Surgeon General), and will be forwarded not less than 20 days before that date.
(a) Articles of which a definite allowance is fixed on the dental supply table will be required for on the annual requisition, except as otherwise provided in paragraph 491. Annual dental requisitions will be subject to the regulations in paragraphs 478 governing the preparation of annual post requisitions, so far as the same are applicable.
494. Articles on the dental supply table for which no allowance is specified or which are issued "as required," will be required for on quarterly special requisitions, Form 35, except as otherwise provided in paragraph 491, for the quarters beginning January 1, April 1, July 1, and October 1.
(a) Articles not on the dental supply table, which are absolutely necessary for dental work soon in prospect, will also be called for on the quarterly special requisition, with a full explanation of their necessity.
(b) Textbooks on dental subjects will be asked for on quarterly special requisitions.
495. In emergencies, when dental instruments, appliances, or supplies not on hand, or to replace similar articles which have become unserviceable, will be needed before the next quarterly special requisition, they may be required for on an emergency special requisition, to be forwarded at once upon the development of the emergency, with a full explanation of its character and cause.
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TRANSFER OF MEDICAL SUPPLIES
(See pars. 49 and 228)
496. In ordinary transfers of medical supplies the transferring officer will at once forward invoices (Forms 23, 24, 28, or 31) in duplicate one to the Surgeon General direct and one to the receiving officer. The latter will promptly upon completion of the transfer forward receipts (Forms 23, 24, 28, or 31) in duplicate, one to the Surgeon General and the other to the transferring officer. A packer`s list (Form 32) will, if necessary, he furnished by the transferring officer.
(a) All supplies shipped will bear the name of the consignor as well as that of the consignee.
497. In cases in which complete transfer of medical property occurs, the receiving officer, instead of giving separate receipts, as provided in paragraph 496, will receipt for the property transferred on the final return, both original and duplicate (Form 17c), of his predecessor. The transferring officer will at once forward the original return, bearing the receipt above prescribed, to the Surgeon General. The duplicate return will be filed with the retained records of the hospital.
498. Great care should be exercised before receipting for cases of instruments, microscopes, and other property of similar character not enumerated on the property papers in detail, to ascertain that the full contents of such cases are present and in good order. Incomplete cases will be receipted for as such and a list of the missing articles will accompany the receipt, in order that the proper officer may be held accountable for the deficiency. Receipts without remark for cases of instruments and similar property will be considered as evidence that they are complete and in accordance with the lists of contents marked in the cases or as given in the supply table, and the receiving officer will be held responsible in accordance therewith.
499. The transferring officer will enter on his invoices, and the receiving officer on his receipts, the condition of all articles not serviceable.
500. Medical officers will report to the Surgeon General and to the transferring officer all defects observed in the quality, quantity, or packing of medical supplies.
ACCOUNTABILITY
501. Medical officers will take Up and account for all medical property of the Army which comes into their possession. If it is property with which they have not been formally charged (as, e. g., property found at post) they will report if possible to whose account it is to be credited. (See, however, par. 504b.)
(a) Members of the Dental Corps will follow a similar course regarding dental property coming into their possession, except supplies issued under paragraph 491.
502. No medical property will be accounted for as on hand at the end of the accounting period unless the same is then in fact on hand. Medical property expended, lost, or destroyed must be dropped accordingly, and credit therefor claimed by certificate or affidavit as required by Army Regulations. If the evidence is considered satisfactory by the Surgeon General the credit will be allowed as claimed; if not satisfactory, the accountable officer will be required to refund the value of the property.
503. In invoicing or accounting for broken packages, such as bottles, jars, etc., fractions will be given as one-fourth, one-half, three-fourths.
DISTRIBUTION OF FIELD MEDICAL SUPPLIES IN TIME OF PEACE
504. Surgeons on duty with line organizations are charged with the responsibility of keeping on hand in time of peace the field medical supplies mentioned in paragraph 632. These supplies will be so distributed that in case of mobilization the various organizations will arrive at their concentration camps completely equipped, but without medical supplies in excess of the prescribed allowances. For example: If a regiment is divided between two stations the camp infirmary may be assigned where the larger proportion of the register is stationed and the combat equipment to the station of the other units. If a regiment is
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divided between three or more stations the camp infirmary may be assigned to one station, and the combat equipment to another, while the units at each of the other stations may be supplied with an extra medical and surgical chest (par. 932). The additional articles for the establishment of a regimental hospital should be kept at the same station as the camp infirmary, as they are supplementary to the latter and of little value by themselves.
(a) If the supplies thus provided for detached battalions or companies prove insufficient for the requirements of practice marches and other field exercises engaged in during peace they may be supplemented i)y equipment improvised from post supplies, but requisitions for field supplies in excess of these provisions should not be necessary.
(b) In order to carry out the provisions of this paragraph, surgeons of detached battalions or companies will be required to hold the supplies (except individual equipments) pertaining to the combat equipment and camp infirmary on memorandum receipt from the surgeon at regimental headquarters.
505. When the battalions or companies of an organization are stationed in different departments but belong to the same tactical division the distribution of the field medical equipment of the organization will be decided by the War Department upon the recommendation of the department commander in whose department the headquarters of the organization is stationed.
506. In the event of mobilization, organizations will take with them to the concentration camp the combat equipment and the camp infirmary only unless otherwise specifically directed by the department commander, except that the extra medical and surgical chests provided for detached battalions or companies may be taken if required for use en route. In the latter case such additional supplies will be turned in to the depot when the organization has joined its division.
RETURNS OF MEDICAL PROPERTY
507. Officers in charge of medical property will on being relieved of the same prepare a return thereof in duplicate (Forms 17, 17a, 17b, and 17c), showing all articles received, expended, sold, transferred, etc., during its period. The original of this return will be promptly transmitted to the Surgeon General. The duplicate, with a complete set of vouchers, will be filed with the retained records of the hospital.
(a) Returns of property issued for personal use, including the portable dental outfit, will be rendered at the end of each calendar year.
(b) Returns of field supplies will be made separately from returns of lost supplies. (See, however, par. 504h.)
508. Returns of dental property will be made by the dental having custody thereof.
SALES
509. When medical property is sold the officer responsible therefor will pay the necessary authorized expenses of the sale, if any, out of the proceeds, taking proper vouchers for such payments, and will deposit the balance or net proceeds, without delay, and if possible on or before the last day of the month during which he receives the proceeds, with the nearest United States depositary, to the credit of the Treasurer of the United States. Immediately upon making the deposit he will notify the Surgeon General by letter direct of his action, giving the date or dates of the sale and the amount of the proceeds of the articles sold on each date.
(a) Within 10 days after the end of the month during which he receives the proceeds of the sales he will render to the Surgeon General direct an account current (Form 320b or Form 320, W. D.) debiting himself thereon under the proper heading with the net proceeds of the sales and crediting himself with the amount deposited. He will insert the proper heading-that is, the designation of the proper fund to which the proceeds go (see par. 510)-- in one of the blank spaces provided therefor at the top of the ruled columns. He will forward with his account an exhibit in duplicate of the articles sold. as follows:
First. In the case of a sale of condemned property at auction or on sealed proposals, if there were any expenses attending the same, the exhibit will be made out on Form 325, V. D., and
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be accompanied by the vouchers for the expenses of sale; if there were no expenses, the exhibit will be made out either on Form 325 or on Form 322, W. D., as the accountable officer may prefer; in either event, the exhibit will be accompanied by a copy of or a suitable extract from the inventory and inspection report.
Second. In the case of sales of medicines to civilians under paragraphs 242 to 244 of this Manual the exhibit will be made out on Form 322a, W. D.
Third. In the case of other authorized sales the exhibit will be made out on Form 322, W. D.
(b) A duplicate of the account and a triplicate of the exhibit should be retained by the officer.
510. The proceeds of authorized sales of serviceable medical property accrue to the special fund " Replacing medical supplies " for the proper two-year period, thus: The proceeds of sales made during the fiscal year 1916 pertain to the fund " Replacing medical supplies, 1916-17"; the proceeds of sales made during the fiscal year 1917, to the fund "Replacing medical supplies, 1917-18"; and so on from year to year. The accountable officer should render his accounts accordingly, carefully noting that it is the date of sale that determines the, fund to be credited and not the date of collecting the proceeds, which is immaterial in this connection; otherwise embarrassment in the adjustment of his accounts will follow.
(a) The proceeds of sales of condemned property accrue to " Miscellaneous receipts," and should be so designated.
DISPOSITION OF MEDICAL PROPERTY ON ABANDONMENT OF POSTS
511. Unless modified by special instructions from the Surgeon General, the following rules will be observed in the disposition of medical property upon the abandonment of a post:
(a) Unserviceable property will be submitted to an inspector, with a view to final disposition by sale or destruction.
(b) A list of all other articles will be forwarded to the department surgeon, or, in the case of an independent post, to the Surgeon General, for decision as to where they shall be sent.
(c) Only such nonexpendable articles as are in perfect order, including recent medical works, and instruments which can not be transferred to other posts without unnecessary duplication, should be turned in to a medical supply depot.
USE AND CARE OF MEDICAL PROPERTY
512. Officers will be held responsible for the serviceable and complete condition of all property in their possession, except such as may have been rendered unserviceable by fair wear and tear.
(a) The responsible officer will once each year cause all medical property in his charge to be carefully examined by a commissioned medical officer and verified by the returns, invoices, etc.
513. With the permission of the surgeon, medical officers may take books and instruments from the hospital for professional use; but no medical property of any description will be taken away from a post by an officer on being relieved or when availing himself of a leave of absence, except by authority of the Surgeon General, or within the limits of the Philippine or Hawaiian Departments by authority of the department surgeon.
514. The stock of alcohol, alcoholic liquors, opium, and the salts, derivatives, and preparations of opium or coca leaves will be kept in a locked closet in the storeroom and only issued to the dispensary in unit containers from time to time as may be necessary, upon the written order of a medical officer.
(a) In the storeroom, receipts and expenditures of these articles will be accounted for in the manner prescribed for the dispensary (par. 240).
515. Field supplies and equipment will not be used at posts, except when required for purposes of instruction.
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516. Field chests and appliances will be frequently inspected and kept in perfect order for immediate field use.
517. The exchange of medicines with druggists is prohibited.
518. The issue of articles for use in the preparation of cleaning mixtures, cosmetics, or perfumery, or for use with spirit lamps, etc., is prohibited.
519. The responsible officer will cause all instruments in his charge to he examined by a commissioned medical officer at least once each month.
520. Steel and plated instruments may be prevented from rusting by keeping them in a 20 per cent formalin solution saturated with borax.
521. Surgical instruments and appliances that require and are considered worth repairing will be reported through the department surgeon to the Surgeon General, or in the Philippine or Hawaiian Departments to the department surgeon, with a statement of the repairs needed, giving the name of the maker of each article.
522. The responsible officer will also report to the Surgeon General, or in the Philippine or Hawaiian Departments to the department surgeon, such articles of bedding or furniture as may need and are considered worth repair or renovation. The work should be done by post labor if practicable, request being made for authority to purchase necessary material. If this is not practicable, the officer will obtain one or more estimates in detail of the cost of repair or renovation of such bedding or furniture and forward them with his report.
523. Blankets not in use should be frequently examined and properly protected. When stained but otherwise in good condition they should be continued in service. Hospital bedding will not be used by members of the Hospital Corps, except when on duty in the wards.
524. When a typewriter is to be transported the ribbon spools should be removed and packed separately, the carriage of the machine securely tied to the base in such a manner that it can not move in any direction, and the steel rods or blocks for locking the carriage placed in position. Medical officers will be held responsible for damages to typewriters which result from careless packing.
525. Rubber and flexible catheters and bougies will be kept in tale or glycerin to preserve them.
526. When the canvas in litters becomes soiled it will be removed from the litters, washed, and replaced. When it becomes torn or unserviceable new canvas of the proper size should be applied for to replace it.
THE SANITARY SERVICE IN WAR
MEDICAL SUPPLIES
551. In combat, expenditures of surgical dressings and similar articles from the equipment of troops on the line are normally replenished from the reserve supplies of the nearest ambulance company or camp infirmary. No formal requisitions, invoices, or receipts will be required.
(a) In emergencies the division surgeon may authorize the transfer of supplies between other sanitary formations. If the supplies so transferred are nonexpendable, invoices and receipts will be executed and forwarded in the usual manner.
(b) Medical Department blank forms for the use of troops not under the jurisdiction of a department commander, operating with a tactical command mobilized for field service, whether in the theater of operations or in the interior, or in time of war or of peace, will be procured by requisition, Form 37, on the chief medical officer of the command (camp surgeon, division surgeon or surgeon medical base group as the case may be), who will alter and approve the same at discretion for issue from his emergency reserve or from the proper depot. (See pars. 885 and 961). Blank forms of other staff departments will be procured as provided by the regulations of those departments or by Army Regulations.
(c) Supply depots on the line of communications obtain their supplies in the manner prescribed in paragraphs 782 to 792. (C. M. M. D., No. 2.)
552. With the exceptions noted in the preceding paragraph, all medical supplies for troops in the theater of operations will be required for on emergency special requisitions (Form 35). These requisitions will be made in duplicate. Those from divisional troops
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will be forwarded to the division surgeon. This officer will modify them at his discretion, and if the requisition, as approved, is within the limits of the prescribed allowances for the organization making it, the original will he forwarded to the most convenient depot for issue. If the requisition as approved calls for articles in excess of the prescribed allowances, it will be forwarded to the surgeon, base group, for his action. Requisitions from sanitary formations on the line of communications will be forwarded through medical channels to the surgeon, base group, who will modify them at his discretion and forward the original to the most convenient depot for issue. In all cases the duplicate copy of the requisition will be returned to the office of origin with modifications, if any, noted thereon.
a) In emergencies medical supplies may be issued to evacuation ambulance companies and evacuation hospitals on requisitions approved by the surgeon, advance group.
553. Sanitary formations operating in the service of the interior obtain their medical supplies as prescribed for time of peace. (See pars. 477 to 495.)
554. Medical and other supplies for the use of the sick and wounded are transported, so far as possible, by the Medical Department with its own transportation. Supplies which can not be thus transported are invoice to the Quartermaster Corps for transportation, and their shipment is expedited as much as possible, ammunition and rations alone, as a rule, having precedence. When necessary, members of the Hospital Corps are detailed to accompany medical property.
555. The method by which supplies are forwarded from the line of communications and distributed to troops in the zone of the advance is described in Field Service Regulations: Supply Service.
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ARTICLES XI - THE SERVICE OF THE INTERIOR
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MEDICAL SUPPLY DEPOTS
612. Additional medical supply depots will be established by the Surgeon General as he may deem necessary, having due regard for the sources of supply and facilities for distribution.
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ARTICLE XIV - THE LINE OF COMMUNICATIONS
THE BASE MEDICAL SUPPLY DEPOT
782. A medical supply depot will be establishment at the base. The officer in charge of this depot will prepare in quadruplicate a list of all supplies required showing the maximum and minimum quantities of each article which should be kept on hand in the depot, having due regard in formulating this estimate to the number of troops to be supplied, the time required by the depot to replenish supplies, the character of the military operations in prospect, etc. In stating the minimum quantity of supplies the supply officer should include at least one medical reserve unit (par. 891) for each division at the front, in addition to the supplies likely to be required by the sanitary formations on the line of communications. Three copies of the above-mentioned list will be forwarded through military channels to the commander of the military forces. When approved, one copy will be retained at the headquarters of the commander of the field forces, one copy will be sent to the Surgeon General, and one copy will be returned to the officer in charge of the depot.
(a) When the supply on hand of any article exceeds or falls below the specified maximum or minimum, the fact will be reported in writing to the commander of the line of communications and to the senior medical officer on the staff of the commander of the field forces, with appropriate explanatory remarks.
783. Stock to replace issues from these depots will be maintained without formal requisition. (See F. S. R.: Zone of the Advance, General.) When such replenishment is desired, single copies of the invoices on which supplies were issued, stamped " Replenishment requested," will be forwarded direct to the designated source of supply. Any articles shown on an invoice for which replenishment is not desired will be erased therefrom before the invoice is stamped and forwarded. Invoices stamped and forwarded as above described will be acted upon as if they were approved requisitions.
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784. Requisitions from the depot for other than the replenishment of issues, if within the limits of the maximum and minimum table, will be forwarded in duplicate to the surgeon, base group. He will modify them at his discretion, forward one copy to the issuing depot in the home territory and return the other copy to the base depot with his modifications, if any, noted thereon.
785. Requisitions for supplies not provided for in the maximum and minimum table require the approval of the Surgeon General.
786. In emergencies the surgeon, base group, may authorize local purchases to supply the immediate needs of the depots on the line of communications.
THE ADVANCE MEDICAL SUPPLY DEPOT
787. The stock on hand at this depot will be considered a part of the available supply of the base depot, as far as the table fixing the maximum and minimum stock limits is concerned.
788. Maximum and minimum limits of stock to be maintained at this depot will be determined by the commander of the line of communications on recommendation of the surgeon, base group, to whom any variations of stock above or below the prescribed limits will be reported at once with appropriate explanatory remarks. In making his recommendations the surgeon, base group, should include in the minimum quantity of supplies to be maintained at this depot at least one medical reserve unit (par. 891).
789. Issues from the advance depot will be replenished from the base depot without formal requisition, in the manner provided under base supply depots (par 783).
790. Requisitions from the advance depot for supplies other than those required to replace issues will be forwarded in duplicate to the surgeon, base group. He will modify them at his discretion, send one copy to the base supply depot for issue and return the other copy to the writer with his modifications, if any, noted thereon.
791. The advance depot is intended as a source of supply for troops in the zone of the advance and it should not, except in emergency, be depleted by issues to evacuation hospitals, evacuation ambulance companies, and other units on the line of communications.
792. The operations of this depot will necessarily be controlled by the military situation in the zone of the advance. If the troops are occupying defensive positions with little probability of an immediate advance the depot may be established in buildings, if they are available, or under canvas; if they are advancing the depot may be maintained on barges, in box cars, or on motor trucks. In the latter case the prescribed stock of supplies may, temporarily, have to be reduced to such essentials as surgical dressings, medicines, and other articles of that class. In determining the character of the articles that may be eliminated under these circumstances much will depend upon the facility with which supplies can be obtained from the base.
SUPPLY LETTERS NOS. 1 TO 29, INCLUSIVE,
MEDICAL DEPARTMENT,
UNITED STATES ARMY WAR DEPARTMENT,
OFFICE OF THE SURGEON GENERAL,
Washington, December 5, 1917.
The following instructions are supplemental to the Manual for Medical Department, and are not intended to supersede the latter. Attention is invited to paragraph 477 et seq. M. M. D., 1916, with reference to the preparation of requisitions.
W. C. GORGAS, Surgeon General.
[Supply Letters Nos. I to 23, inclusive, consolidated and revised)
1. ACCOUNTABILITY
(a)For medical and dental property.-A number of instances have recently occurred in which officers accountable for medical and dental supplies have left their property on changing station without transferring it to another officer. This practice has been found to result almost invariably in serious complications in the settlement of the property returns
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of the accounting officer. Attention is therefore called to the urgent necessity for the transfer of all property as contemplated in paragraph 659, A. R., before the accountable officer is separated from it.
(b) Returns of medical property--The attention of all medical officers is invited to the fact that a great amount of extra and seemingly unnecessary work has been caused in the examination of returns of medical property, due to the following causes:
Failure to forward promptly invoices of property issued or receipts for property received, as provided by paragraph 496, M. M. D., 1916.
Failure to properly number all vouchers pertaining to the return.
Failure to arrange articles on returns and vouchers in the same order and under the same name as shown in the Manual for the Medical Department. In this connection attention is invited to paragraph 475, M. M. D., which provides that " in preparing returns, requisitions, invoices, and receipts pertaining to medical and hospital supplies the nomenclature, order of entry, classification, and weights and measures of the supply table will be followed."
Failure of medical officers to retain accountability for litters with slings which are in the hands of company commanders, as indicated by footnote 3, page 254, M. M. D.
Failure of medical officers of militia to properly transfer to the property and disbursing officer of the respective States, or otherwise account by proper voucher for the property in possession of the organization on muster out.
Failure to show shortage in units on the slips of the return carrying such units.
Failure of officers signing receipts for medical property who are not themselves accountable officers to follow their signatures with the words, "For and in the absence of ----------" (naming the accountable officer).
Failure to check over units carefully before receipting for them. Officers must realize that they will be held accountable for units as a whole when receipted for without remark. In this connection attention is invited to paragraph 498, M. M. D. Attention is also especially invited to paragraphs 502, 507, and 512, M. M. D.
Failure to give the name of the issuing officer on the brief of receipt for medical property.
Failure to leave blank on briefs of invoices the lines intended for the name and rank of the officer to whom medical property is issued. (The two lower lines for station or command should, however, be filled in by the issuing officer.)
(c) Departmental and divisional surgeons should take such steps as are necessary to enforce the requirements of the Manual for the Medical Department, 1916, relative to the care and returns of medical property.
(d) Officers making returns of medical property should in all cases state on Form 17 the name of the organization or the post to which the return pertains.
(e) Both returns of medical property and vouchers pertaining thereto should be signed with pen in a legible manner by the accountable officer. In this connection attention is invited to the provisions of paragraph 779, Army Regulations, 1913. In case of signatures which are not clearly legible, the officer`s name should be typewritten in addition to the signature.
(f) The supply officer on duty with ambulance sections and with field hospital sections should be accountable for all property in those sections, whether medical, quartermaster, or ordnance. This property should be held by organization commanders on memorandum receipt.
(g) The supply officers of the respective sections should secure the necessary personnel from that assigned to duty with the headquarters of those sections.
2. ACID (PICRIC) AND BENZINE
(a) Under the rules promulgated by the Interstate Commerce Commission for the transportation of explosives and other dangerous articles, picric acid " dry " is classed as a " high explosive." When " wet " with 20 per cent water it is still so dangerous that it can only be shipped under special restrictions and at a prohibitive cost. It should not be
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requested, except under the most extreme emergency, and in case it is obtainable locally authority for local purchase should be requested.
(b) Benzine, from its inflammable nature, is also dangerous, and should be procured locally if possible.
3. AMBULANCE COMPANY EQUIPMENT
The quantities noted after the following items are authorized for ambulance companies at maximum strength:
4. AMBULANCES (MOTOR)
The serial number of each ambulance should be indicated in all correspondence relative to motor ambulances, including vouchers.
(a) Disposal of unserviceable spare parts, etc .- During active field service, or conditions simulating thereto, the following rules will govern the disposal of unserviceable spare parts, accessories, etc., pertaining to motor vehicles of the Medical Department:
(1) Spare parts arid accessories worn out in the service which have no salable value may be disposed of in such manner and under such regulations as the department surgeon or division surgeon may direct.
(2) Bolts, cap screws, cement, cotter pins, cotton waste, emery cloth, gasoline, grease, lamp cord, mats, oils, rivets, sandpaper, solder, tape, washers, and wood screws may be dropped on the certificate of the responsible officer showing in what mariner they were expended.
(3) Articles which have a salable value, or which may be salvaged, and the parts used in repair of other machines will be turned in to the nearest machine shop for such use as can be made of them. The acknowledgment of the receiving officer will be accepted as relieving the responsible officer from further accountability therefor.
(4) Unserviceable tires and inner tubes will be turned into the Louisville depot.
(b) Nonskid tires. - As the chains with which motor ambulances are equipped can not be operated on nonskid tires successfully, only plain-tread tires are authorized and will be issued in the future.
(c) Oil and gasoline.-The scanning of the reports of motor ambulances (Q. M C. Form 417) brings to light the fact that high gasoline and oil consumption, per mile, without apparent cause, is general throughout the service.
Officers responsible for motor ambulances should take steps to check any and all waste of gasoline and oil, and see that the men charged with the care aid operation of those vehicles be instructed to exercise care in this respect, in order that the cost per mile may be reduced and maintained at an economic figure.
Unnecessary "idling? (i.e., running of the motor while the car stands still) is a source of gasoline waste often overlooked by men not properly trained, and ignored by the careless and indifferent.
The operation of vehicles on soft tires is not only tire greatest single enemy of high tire mileage, but it also has a bad effect on the fuel bill, owing to the added resistance imposed.
An over-rich mixture, improperly adjusted brakes, arid unskillful handling of the spark lever, are common causes for excessive fuel consumption, which can be remedied by careful and intelligent operation. Leaking valves, valve caps, spark plugs, and piston rings (indicated by poor compression in one or more cylinders arid general lack of power) will lower the miles per gallon perceptibly, and should be attended to by a skillful mechanic without delay, as such defective operation grows rapidly and steadily worse.
Gasoline and motor oils will hereafter be purchased from the Quartermaster Corps.
Attention is invited to the following order:
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Changes No.
WAR DEPARTMENT,
Washington, November___, 1917.
Paragraph 1341 , 1916 Supplement to the Compilation of Orders, is changed as follows,
134 ?. (P. 46, 1916 Supplement to the Compilation of Orders) Motor vehicles, searchlights, and other power equipment.--Motor vehicles, searchlights, and other power equipment furnished bv the Ordnance and Medical Departments and the Engineer and Signal Corps will be repaired and maintained at the expense of the respective departments and corps; the gasoline and lubricants for them will he supplied by and at the expense of the Quarter- master Corps, except to the Medical Department. Facilities on hand in the Quartermaster Corps for repair and maintenance of vehicles may be furnished to the respective departments and corps, and gasoline and lubricants may be furnished by the Quartermaster Corps to the Medical Department, settlement therefor to be made by the usual transfer of funds (sec. II, G. 0. 51, 1916). (C. C. of 0. No__, November __, 1917.) (463.7, A. G. O.)
By order of the Secretary of War:
TASKER H. BLISS,
General, Chef of Staff.
Official:
H. P. MCCAIN,
The Adjutant General.
5. ARGYROL AND PROTARGOL (SUBSTITUTES FOR)
Argyrol and protargol have become very expensive and equivalent substitutes will be issued therefor. Narvol and silver nucleinate have been examined at the Army Medical School and the Walter Reed General Hospital and have been found to be equal to argyrol in bactericidal action and effect upon the mucous membranes.
Progentum and silver proteinate have also been examined and are considered suitable substitutes for protargol in lost cases of disease of the mucous membranes.
These, or other satisfactory substitutes, will therefore be used in lieu of argyrol and protargol, unless the former is especially desired for eye work, in which case it should be so stated on the requisition.
6. BIOLOGICAL PRODUCTS
(a) The following is a list of biological products furnished from the Army Medical "School:
Bacteriol vaccines. - Typhoid vaccine, paratyphoid A and 13 vaccine, triple typhoid vaccine, vaccine against strangles and the complication of influenza in horses, gonococcus vaccine, staphylococcus vaccine," staphylococcus-acne vaccine," streptococcus vaccine." a
(b) Sera, agglutinating, for diagnostic purposes. - Typhoid, paratyphoid A, paratyphoid B, dysentery Flexner, dysentery Y, cholera, melitensis, dysentery Shiga, pneumococcus, Type I; pneumococcus, Type II; pneumococcus, Type III; meningococcus, polyvalent meningococcus, normal: meningococcus, intermediate A; meningococcus, intermediate B; parameningococcus.
(c) The following vaccines and sera are authorized for human use: Triple typhoid vaccine (furnished as indicated above), smallpox vaccine, antianthrax serum (issued only for special eases) antimeningitis serum (in packages containing 2-15 c.c. vials), antipneumococcic serum (50 and 100 c.c. vials), antistrepitococcic serum (50 and 100 c.c. vials), diphtheria antitoxin (1,000, 5,000, and 10,000 units), tetanus antitoxin (1,500, 3,000, and 5,000 units.)
(a) Miscellaneous. - Human serum water.
The following should be obtainable from department laboratories. Now obtainable from the Army Medical School: West tubes, veal broth glucose agar, material for oil solution of dicloramine-T.
_____________________________________________________________________________
a 0n account of the general opinion that any therapeutic results obtained from the use of a vaccine are due to the nonspecific protein reaction and not to any specific action of the vaccine, the use of these vaccines is not advised. Equally good results can be obtained from the use of small doses of triple typhoid vaccine.
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Outfits for the Schick test are obtained from the department laboratories.
In case mice are not readily obtainable locally, they should be obtained from the department laboratories.
(b) Biological products (veterinary). - The following biological products (veterinary), recommended by the veterinary advisory board, are authorized for use in the Army:
(a) Antitetanic serum (1,500 units in vials, as required, 500 units in syringe containers). - At the National Army and National Guard camps this may be obtained on requisition to the division surgeon. For places other than camps, requisitions should be forwarded to the department surgeon.
(b) Mallein, ophthalmic (as required). - Hereafter all mallein required for the veterinary service of the Army will be obtained from the Bureau of Animal Industry, Department of Agriculture. Telegraphic requests should be made to this office, stating the number of animals to be tested. The purchase of any commercial preparations of this substance is disapproved.
(c) Prophylatic vaccine for strangles and the complications of equine influenza (distemper vaccine). - This is carried in stock at the various camp medical supply depots and should be obtained from them or the Army Medical School; requisitions to be forwarded to division or department surgeons, as the case may be, for approval and transmission to the depots.
(d) Simultaneous anthrax serum and spore vaccine. - To be obtained by telegraphic request to this office.
(c) Expired biological products not returnable. - On account of the low price at which the biological products are sold to the Government, the manufacturers do not replace time-expired products. All of these products should be destroyed when the time limit is past. Care should be taken, however, to see that large stocks are not accumulated, and vaccines and sera should be obtained frequently in small quantities in order to avoid waste.
7. COMBAT EQUIPMENT
The combat equipment must be maintained intact and every effort should be made to preserve the entire field equipment complete for actual combat. To this end additional supplies should be issued from post stocks for routine use at sick call and for the treatment of trivial cases at infirmaries. The compressed surgical dressing materials of the field supplies are very expensive and should be used only to equip pouches, belts, and chests. Articles of post supplies should be utilized wherever practicable.
8. DENTAL SUPPLIES (REPAIR OF)
The attention of dental surgeons is invited to the fact that the following articles can usually be repaired. Before submitting these articles for condemnation], therefore, they should be carefully examined and if found to be worthy of repair, authority should be requested to turn them into a medical supply depot: Handpieces, dental (S. S. White); engines, dental; lathes, dental; forceps; soldering and heating outfit; and all electrical appliances.
9. DRESSING, SURGICAL (CONSERVATION OF)
All manufacturers of the country who have the equipment to make field dressings are making every effort to supply the requirements of the Army and Navy, but unless great care is exercised by medical officers, there will be a shortage.
9. DRESSING-SURGICAL-(CONSERVATION OF)
All manufacturers of the country who have the equipment to make field dressings are making every effort to supply the requirements of the Army and Navy, but unless great care is exercised by medical officers, there will be a shortage.
The following suggestions should be considered:
(a) Never use "field " dressings, if " post" dressings are available. The latter cost much less and are easier to obtain.
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(b) Substitute absorbent cotton for absorbent gauze whenever possible; the gauze looms of the country are now being worked to their full capacity.
(c) The feasibility of laundering soiled dressings should be given careful consideration.
10. DRY CELLS
The chloride of silver dry cells used in the standard electric apparatus, manufactured by the Chloride of Silver Dry Cell Manufacturing Co. have considerable sale value. The unserviceable dry cells should always be turned into the depot when new ones are received.
11. GENERAL ORDERS, BULLETINS, ETC. - WAR DEPARTMENT AND ANNUAL REPORT OF THE SURGEON GENERAL (BINDING OF)
(This relates to regular Army posts only)
The annual report of the Surgeon General will hereafter be bound every second year (two reports to be bound in one volume) and should be forwarded at the end of each two years to the medical supply depot from which the surgeon receives his medical supplies.
The general orders, circulars, and bulletins, War Department, will be bound yearly, as heretofore, and should be forwarded by mail to the medical supply depot for that purpose as soon as the indices are furnished by the War Department. Especial care should he taken to see that the files of general orders are complete, including title page and index.
Medical supply officers are authorized to obtain estimates in the usual manner for the accomplishment of this work, the binding to be uniform with previous volumes.
Upon the completion of the binding, the volumes should be returned to the stations from which they were received, where they will be taken up on the next return of medical property. When post surgeons forward these publications to the supply depot for binding, they should notify the department surgeons in order that the latter may be fully informed regarding the progress of the work. Medical officers stationed at independent places should notify this office when action has been taken as above indicated. This supply letter should not be construed as authority for the binding of annual reports, general orders, etc., for the library of any independent station for which such binding has not heretofore been done.
12. HAND-AX CARRIERS
When making requisition to the Ordnance Department for hand axes, hand-ax carriers should also be requested. They are not supplied by the Medical Department.
13. HEROIN HYDROCHLORIDUM
No additional purchases will be made, and after the present stock is exhausted this product will be dropped from the supply table.
14. ICHTHYOL
Ichthyol is practically unobtainable. Ichthyogen, ichthytar or other substitutes will be supplied instead. Requisitions should call for ichthyol or equivalent.
15. INSECTICIDE
Sodium fluoride for roaches. - This salt has been found to be most effective. It should be freely sprinkled in a finely divided form in those places where the insects are most prevalent. It may be asked for in 5-pound quantities on special requisitions. The salt is practically without poisonous quality to the human subject unless large quantities of it are consumed.
16 INSTRUMENTS (CARE OF)
(a) It has been determined by prolonged study at the medical supply depot in Manila that a most satisfactory method for keeping instruments under conditions where rust is apt to interfere with the preservation of steel material has been found in a solution of 20 per cent formulin, saturated with borax. The immersion of the instruments in this solution
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has resulted most efficiently in the prevention of rust; and its use is recommended to medical officers, under conditions where the rust factor is encountered, for surgical instruments of all kinds.
A repair shop at the New York depot makes it possible to do ordinary repairs to surgical instruments at that place and at diminished cost. Instruments should habitually be sent by mail upon authority of this office.
(b) Instruments (conservation of). -There is a serious shortage of all kinds of surgical instruments, and although the manufacturers are making every effort, it will be many months before the requirements of the Army can be met. The situation as regards surgical needles is even worse. Practically no needles are made in this country, and their importation from England has been curtailed by the British Government. Arrangements have been made for producing them in this country, and it is hoped that within a few months the demand can be supplied. In view of the conditions outlined above, all officers of the Medical Department will institute measures to conserve the present supply of surgical instruments, and thereby prevent the occurrence of a shortage otherwise inevitable.
17. INVOICES
(a) Invoices and receipts for articles turned into depots for repairs. - These are not required, and a list showing the articles forwarded will be adequate in lieu of invoices and receipts. If for any reason the supply officer is unable to return the articles after repair, he will communicate the fact, and the question of invoices and receipts can then be taken up.
(b) Discrepancy between invoice and quantity of supplies received. - In all cases where the quantity or quality of items received from a medical supply depot differs from the invoice covering such shipments (either over delivery or shortage), or whenever supplies are received without invoice, the medical supply officer making the shipments should immediately be informed regarding the discrepancy, in order that the matter may be promptly and satisfactorily adjusted.
18. MEDICAL PROPERTY, UNSERVICEABLE (DISPOSITION OF)
Under the provisions of A. R. 907, as amended by Changes A. R. No. 61, W. D., September 24, 1917, the following-named medical supply depots are designated to receive such unserviceable medical property as is worth the transportation charges and which can be advantageously disposed of either by sale or by being broken up into parts and used in the repair or manufacture of other articles:
Medical supply depot, 1210 Arch Street, Philadelphia, Pa.: From all posts, camps, and stations in the Eastern and Northeastern Departments.
Medical supply depot, Stewart Avenue and Glenn Street, Atlanta, Ga.: From all posts, camps, and stations in the Southeastern Department (excepting those in the States of Arkansas, Louisiana, and Mississippi) and the coast defenses of Galveston, Tex.
Medical supply depot, 500-512 North Fourth Street, St. Louis, Mo.: From all posts, camps, and stations in the States of Arkansas, Louisiana, Mississippi, Missouri, Kansas, Colorado, and Oklahoma.
Medical supply depot, 3930 Federal Street, Chicago, Ill.: From all posts, camps, and stations in the Central Department excepting those in the States of Colorado, Kansas, and Missouri.
Medical supply depot, 309 North Medina Street, San Antonio, Tex.: From all posts, camps, and stations in the Southern Department, excepting those in the State of Oklahoma.
Medical supply depot, Bay Street, Harbor Warehouse No. 3, San Francisco, Calif.: From all posts, camps, and stations in the Western Department.
It is noted from many reports of survey and inspection reports that medical property is being quite extensively destroyed. It is desired that such property, any part of which can be utilized in the manufacture of other articles or supplies, be turned into a depot. The article may have no salable value at a particular post, camp, or station and yet a
871
material part of it may be of value in the manufacture of other articles or in the repair of articles of like character.
There will be established at several places in the United States hospitals for the training of disabled soldiers which will probably be known as "curative shops," in which damaged and unserviceable articles can be reworked or repaired, or other articles made out of the material. It is intended to send to such hospitals for use in various ways, in the training of such disabled soldiers, and to prevent the total loss of more or less serviceable material.
19. MEDICAL SUPPLIES (CONSERVATION OF)
The attention of officers of the Medical Department (medical, dental and veterinary) is invited to the fact that there is at present a shortage of medicines and dressings in the United States, and that it is probable that this condition will continue indefinitely.
All officers are therefore enjoined to make every effort to eliminate waste of supplies of every kind, and especially of those belonging to classes mentioned ill paragraph No. 1.
As regards the conservation of medicines, the following rules should be observed:
(a) Medicine should be prescribed only when there is a clear indication for its use. Soldiers very seldom require placebos; cheap ones should be used if placebos are required at all.
(b) Medicines should not be prescribed in large quantities. For example, a 4-ounce mixture should not be ordered if a 2-ounce will do, or a dozen tablets given if less than that number will meet the requirements of the patient. The quantity prescribed should not exceed the number of doses the officer writing the prescription expects the patient to take in the following 48 hours
(c) It is advisable to administer medicines in hospitals or dispensaries under supervision whenever possible.
(d) Particular care should be taken to avoid the unnecessary administration of cocaine, quinine, and all preparations containing morphine or opium. The stocks of quinine and opium are very small at present and every effort should be made to conserve the supply of these important drugs.
20. NEEDLES (HYPODERMIC)
Great care should be taken to specify the particular syringe for which hypodermic needles are required. This specification will avoid delay necessitated by having to ascertain the type of syringe for which the needles are desired. Hypodermic needles are scarce anrd difficult to obtain. They should be made to last as long as possible.
21. PENCILS (HAIR)
On account of the war, this item is now unobtainable in the United States. Substitutes should be improvised by the surgeons.
22. PETROLATUM LIQUIDUM AND RUSSIAN OIL
The standard liquid petrolatum of the supply table is a pure refined product and will answer all purposes indicated by the heavy Russian oil. It has been used for internal administration, satisfactorily both at the Walter Reed General Hospital and attending surgeon`s office, Washington, D. C.
23. POTASSIUM PERMANGANATE
This item is at present practically unobtainable, and will no longer be supplied. Terminal disinfection is seldom necessary, and other material must be substituted. This office concurs in the following statement:
Terminal disinfection is apparently of little value, especially if proper care has been exercised during the course of disease.-Manual for Health Officers, by J. S. MacNutt, lecturer of Public Health Service in the Massachusetts Institute of Technology.
872
24. PUBLIC FUNDS (AUTHORIZATION FOR EXPENDITURE OF)
(a) When permission is given to a surgeon for the purchase or repair of Government property, the amount involved is charged against the quarterly allotment in this office. The purchase should be made and vouchers in payment submitted to this office for approval, within 30 days after receipt of the authority. If purchase be delayed for any cause beyond this period the surgeon should report the fact and state when the purchase will be completed. In any event, a report should be made showing how much of the authorized amount has been actually expended.
(b) Bulletin No. 37, W. D., December, 1915. - The attention of all medical officers who make deposits of money to the credit of the Treasurer of the United States is invited to the stringent requirements of Bulletin No. 37, W. D., December, 1915, and the notation to be made on the efficiency reports of those who fail to comply therewith.
25. REQUISITIONS
(a) All requests for supplies from organizations in or attached to divisional camps should be made to the medical supply officer of the camp through the division or camp surgeon. If a supply be not in stock, the several requisitions should be consolidated by the medical supply officer and included in his monthly request for replenishment of supplies for his depot. These monthly requisitions should be forwarded to the Surgeon General`s Office for action, except in cases of emergency, when application may be made by telegraph or small quantities of supplies procured locally to save life or prevent suffering, as provided in paragraph 476, Manual for the Medical Department.
All medical supplies will be invoiced to the medical supply officer of the camp who will be responsible for their proper distribution to the troops or personnel of the command for which intended.
(b) Field medicines will be used at the camps instead of post medicines.
(c) Scales, weights, and other paraphernalia for dispensing medicines will not be supplied to camps.
(d) During the period of the present emergency no instruments or appliances should be requested on requisitions which are not included in the List of Staple Medical and Surgical Supplies, part 1.
(e) Field special requisitions. - It is necessary that a separation be made of requests for post medical supplies, and those for field supplies, because of the difference in stock carried by depots.
All articles listed as post supplies and additional articles of that classification are properly placed on requisition for post medical supplies. Following the same plan, all articles of field supply should appear on a field requisition. The two requisitions should be rendered at the same time to cover the supplies necessary for the period. Veterinary supplies and dental supplies should also be requested on separate requisitions.
(f) Supplies on hand. - Not infrequently a special operating table, cabinet for dressings and instruments, or other special apparatus is requested on a special requisition, and the request is accompanied by the showing "On hand---O," whereas the returns in this office show that other similar articles are on hand at the hospital. The statement " On hand--O" should hereafter be qualified with a further statement in the column of " Remarks," showing the number and make of equivalent articles which may be on hand at the hospital, when this is the fact.
It is directed that amounts indicated in the " On hand " column shall include the amount of each item due on approved pending requisitions. in addition to the quantities actually on hand.
(g) Initial equipment and replenishments. - All requisitions for initial equipment and for replenishments for National Guard and National Army camps should be forwarded direct to this office for approval. The requisitions, except in emergency, will not be forwarded more frequently than once a month. Emergency requisitions may be forwarded at any time, but a full statement of the necessity must be entered under the column of " Remarks."
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(h) Annual requisitions to be discontinued.-Annual requisitions will be discontinued during the period of the war. All requisitions for medical, dental, veterinary, and automobile supplies will be prepared on Form No. 35, Medical Department.
It is not intended, nor is it desirable, to request all the items on the several supply tables. The officer who prepares the requisition should request only those articles which he habitually prescribes and uses. Surgeons are cautioned to exercise every possible economy. As previously indicated in this supply letter, an unlimited quantity of medical supplies cannot be obtained, and if our troops abroad are to have an adequate supply, those at home must economize.
26. RUBBER GOODS (UNSERVICEABLE)
All unserviceable rubber goods, including gloves, rubber sheeting, hot-water bottles, fountain syringes, etc., should be turned into the nearest medical supply depot (excepting Washington and New York) by parcel post.
27. SERA (DIAGNOSTIC)
Diagnostic sera (agglutinating) should be obtained from the Army Medical School on request sent direct to the commandant of that institution. (See par. 6b.)
28. SILK (OILED)
The purchase of oiled silk is to be discontinued owing to the scarcity and prohibitive price of this article. Oiled paper will be purchased and issued in lieu of the above.
29. SLIDES (GLASS)
These are imported and at present very difficult to obtain. Great economy should be exercised in their use.
30. SPARK PLUGS
Attempt should not be made to repair spark plugs locally. It has been frequently noticed that more damage has been done by ineffectual attempts at repair than through fair wear and tear. Generally a spark plug that has not been tampered with requires only thorough cleaning and renewal of insulating wax about the center electrode. Authority should be requested to turn defective spark plugs into a supply depot for repair.
31. SPHYGMOMANOMETER
Instructions should always be given the users of all types of aneroid instruments that they will not stand rough usage, and steps should be taken to keep the manometer out of the hands of inexperienced attendants, who frequently through curiosity try them out with the usual disastrous results.
32. SYRINGES
Until further notice, the Luer type syringes will be issued in the following sizes: 2-c.c., 10-c.c., and 30-c.c.
33. TANKS (SOAPSTONE, DEVELOPING)
The tank, developing, soapstone, is a large and expensive tank and will no longer be issued. Only porcelain tanks will hereafter be issued.
34. TURPENTINE
It is evident that at some post the refined medicinal turpentine issued in bottles has been used for the making of floor polish. In view of the fact that this bottled turpentine is exclusively for medicinal use and costs very much more than the commercial turpentine in cans, it should never be used as an ingredient of floor polish.
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35. TIN CONTAINERS
The attention of all medical officers is invited to the present shortage of tin. It has become increasingly difficult to obtain an adequate supply of tin containers for field supplies, and it is directed, therefore, that all serviceable empty tin containers le returned to the nearest supply depot by parcel post or mail.
Upon receipt of these empty tins the medical supply officers will have them refilled and reissued upon approved requisition.
36. TYPEWRITING MACHINES (PACKING)
(a) These machines are sometimes received at depots packed in such way as to provoke the comment of a supply officer that "the damage sustained in transit was such as to render it impossible to repair the machine.? Every care should be given this matter with a view to securely fastening the carriage in place. Ribbon spools should be removed and wrapped separately. The machine should be securely fastened to the bottom of the box in which it is packed, using bolts or hinges for the purpose.
(b) Free repair to typewriters.-The Royal typewriters are purchased by the Medical Department under the following guaranty:
Each typewriter is guaranteed to be a perfect working machine, and any broken or defective parts not due to misuse, accident, or neglect will be replaced free of charge at any time within two years from date of delivery.
It has been observed that numerous requests for repairs to typewriters have been received in this office just after the two-year period has elapsed, in which cases it has been necessary to have the repairs made at the expense of the Government. It is directed that hereafter all new typewriter machines (Royal) be thoroughly gone over after they have been in use about 18 months, and that a request for such repairs as are necessary be forwarded to this office in time to obtain the benefit of the two-year clause mentioned above.
37. VETERINARY MEDICINES (CONSERVATION OF)
With the increase of knowledge it has become clear that the majority of drugs have no economic value as therapeutic agents; in other words, they do not favorably influence the course of disease to an appreciable extent.
In private practice drugs for veterinary use continue to be valuable in so far as they impart to preparations in public demand certain features, such as odor or appearance.
The use of many nonessential drugs has become a habit; it therefore behooves veterinary officers prescribing drugs at public cost, for public animals, to revise their therapeutics and use only such drugs as are known to be valuable in an economic sense. The number of the latter is small. In making requisition for drugs for veterinary use the minimum, rather than the maximum, requirements should be estimated.
The value of a drug is to a great extent dependent upon its freshness, and the medical supply depots are not so inaccessible as to justify veterinary officers in stocking dispensaries as one would provide against a seige.
It should be borne in mind that the temporary nature of everything military in time of war renders the holding of large stocks of drugs injudicious aid unnecessary.
It is well known to experienced members of the veterinary profession that it is the inefficient practitioner who makes great show anil use of drugs.
Pressure is frequently brought to bear by laymen upon veterinarians of the service to prescribe powders of various kinds for what is known as " conditioning " purposes.
This practice should be discontinued as, in the absence of organic disease, any defect in condition may as a rule be remedied by intelligent attention to stable management with special attention to watering and feeding. If these are neglected, medicinal agents will not make good the neglect. Even at the present time the superstitious devotion to drugging of horses and mules amounts with many people to a fetish. It is for veterinary officers to bring contemporary knowledge up to date, and absolutely refuse to prescribe needless drugs at the request of those ignorant of such matters.
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The greatly increased cost of drugs, the large doses that are appropriate for horses as compared with human beings, the enormous increase in public animals, are all factors that contribute to the importance of putting into economical practice modern knowledge as to the inefficiency for veterinary therapeutic purposes of the majority of drugs habitually prescribed. There has been issued a standard supply table for use of the Veterinary Corps After due deliberation and consultation it is believed the drugs listed therein are ample for veterinary practice.
The ability of a practitioner may be judged from his deviation from this supply table and the state of his mortality and incurable list.
38. WEB BELTS
Belts, web, medical officers` (par. 864), and belts, web, enlisted men`s, Medical Department (par. 865), are now the property of the Medical Department.
Belts, web, medical officers` (par. 864), will hereafter be issued to officers on memorandum receipt. One copy of receipt will be forwarded to the Surgeon General`s Office, by receiving officer; the accountable officer will forward one with his return of medical property as authority to drop same, retaining a copy for his file. When a medical officer is separated from the service the web belt in his possession will be turned in to the nearest accountable medical supply officer, who will give receipt for same, one copy to be forwarded to the Surgeon General`s Office and one retained. The property will be taken up on his return.
An officer will not be relieved from responsibility for belts in his possession for which he has given a memorandum receipt until he has returned the property to a proper accountable officer.
Belts, web, enlisted men, Medical Department (par. 865), will be charged on Form 637, A. G. O. The accountable officer will prepare invoices in duplicate on Form 28 MD. The receiving officer will certify thereon that the belts were received and charged on Form 637, giving names of enlisted men. The duplicate receipt will constitute the voucher on which the accountable officer will drop from his returns the articles enumerated. When all enlisted mail is separated from the service, the responsible officer will prepare Form 28 in duplicate, listing thereon the medical property in soldier`s possession, and turn same over to an officer accountable for medical property, who will take the property up on his return.
All belts now in possession of officers and enlisted men held by company or detachment commanders oil memorandum receipts will he dropped by the accountable officers after the officer who signed the receipts complies with these instructions.
39. X-RAY
(a) Films. - It is advised that 5 by 7 inch films be used for the hands and feet.
(b) Plates. - Referring to paragraph 848, M. M. D., X-ray plates 11 by 14 inches will no longer be issued. The Roentgenologist of the Army Medical School informed this office that three sizes of X-ray plates are sufficient for all purposes, viz, 8 by 10 inches, 10 by 12 inches and 14 by 17 inches. After the present supply of 11 by 14 inch X-ray plates is exhausted this size will not be furnished upon requisitions unless specifically emphasized, and approved by this office.
(c) Tubes. -The metal parts of X-ray tubes are costly, and as long as they are in good condition the tubes can be repaired by simply building the glass around the metal. Any punctured tube can be reblown. Authority should, therefore, be requested to turn into a medical supply depot all punctured X-ray tubes. Metal parts that are in good condition, unless they are of the old type with platinum target, should also be turned in to the supply depot.
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FIELD EQUIPMENT
(See Notes)
Litters, combat equipment (pars. 866 and 867, M. M. D.) and camp infirmary equipment (pars. 869 and 870, M, M. D.) will be issued as indicated below. The allowance of litters is one for every 50 men, or major fraction thereof, of the authorized strength of the organizations. It includes those issued to companies and those forming a part of the units mentioned herein. all being usually carried on the combat wagons of other transportation of the organizations.
Table
NOTE 1. - Division headquarters, telegraph companies, balloon aero squadrons, companies, etc., should be equipped with the following medical supplies in lieu of the regular combat equipment:
Ax short handle..............................................................number.................1
Desk, field, no. 2 (par. 941, M. M. D.)..............................number ................1
Bucket, g.i.......................................................................do.........................1
Lanterns, folding.............................................................do.........................1
Candles, coach, sixes......................................................pounds.................1
Litter with sling...............................................................do.........................1
Chest, medical and surgical (par. 932, M. M. D................number................1
Box surgical dressings (par. 955, M. M. D.)......................do........................1
Wire cutter......................................................................do.........................1
NOTE 2. - Extendable articles pertaining to the combat equipment and to the camp infirmary should not be used while the troups are at the mobilization and concentration camps. Nonexpendable articles may be used when necessary.
NOTE 3. - Packsaddles will not be issued for use overseas; medical carts will be used instead.
SUPPLY LETTER NO.24
MARCH 11, 1918.
SIR: Attention is invited to the following, and strict compliance with the instructions and suggestions contained therein is directed:
BIOLOGICAL PRODUCTS-TYPHOID VACCINE, ETC.
The commandant of the Army Medical School invites the attention of this office to the great waste of triple typhoid vaccine. This material cost the Medical Department at least $50 per liter, not including overhead charges; i.e., pay of officers and enlisted men engaged in its manufacture, packing and shipping, and expressage. Many medical officers do not seem to appreciate the money value of this vaccine, and the Army Medical School constantly receives requisitions calling for amounts greatly in excess of actual requirements. A great number of medical officers allow the time limit to expire, and even return the vaccine to the Army Medical School, at great expense, by express, after it has become worthless and should be destroyed.
The Army Medical School has shipped to the various camps since the draft enough vaccine to vaccinate the present Army from two to three times.
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In view of the large quantities of vaccine which are being allowed to pass the time limit in the supply depots, it is evident that the instructions in Circular No. 16, S. G. O., March 20, 1916, indicated below, are not being followed:
When for any reason a larger stock is on hand than appears to be needed, directions as to its disposition will be obtained from the commandant, Army Medical School, upon application to him direct, stating date of receipt of the vaccine.
As time-expired vaccine is being returned to the Army Medical School, attention is also invited to the following quotation from Circular No. 16:
Stock over four months old will be destroyed when a new supply has been received.
In view of the above, all biological products will in the future be invoiced, receipted, and accounted for, the same as other medical supplies. Medical officers are cautioned to exercise the greatest economy in the use of this material. They should not ask for quantities in excess of their needs within the time limit. In case an emergency arises requiring more of this material, an additional supply may be obtained on telegraphic request.
Medical officers who have on hand a greater quantity of triple typhoid vaccine than is required for immediate use should notify the commandant of the Army Medical School 30 days prior to the expiration date, so that it can be shipped to some other point where it may be needed and its loss be avoided.
Any biological supplies which have become worthless on account of deterioration should be placed before a surveying officer for his action in order to determine the responsibility for the loss resulting from failure to comply with these instructions.
LYE AND OTHER CLEANING MATERIAL
While this office approves the use of lye in proper quantities for the cleaning of hospital floors, corridors, etc., the tendency everywhere to use an excessive quantity of this product is noted. It is believed that a more satisfactory method of determining the quantity to be used could be devised than to pour the lye from the can into a pail. It is suggested that a can of lye be dissolved in a sufficient quantity of water and that the minimum quantity of this solution per pail of water to obtain the results desired should be determined experimentally. The lye solution should then be made up in bulk and instructions issued those concerned with the cleaning as to exactly how much of the solution to put in each pail of water.
The same plan should also be applied to the soap used for cleaning purposes.
This office does not intend to limit the quantity of supplies rightfully used, but it must call upon division surgeons and all others having control of the expenditure of these supplies to see that there is no waste. Waste does not necessarily mean the throwing out of unused materials, but applies equally well to the using of larger quantities to obtain results than are really needed.
ELECTRICAL APPARATUS
Owing to the fact that requisitions for electrical apparatus for use with the electrical current available at the hospital frequently fail to specify the kind of current on which the apparatus is to be used, or give incomplete data, much unnecessary correspondence is required, thereby causing delay in filling the requisitions. In the future all requests for electrical apparatus for use on the current available at the hospital will specify the type of current (a.c. or d.c.), voltage, cycle, and phase.
MEDICAL PROPERTY, UNSERVICEABLE, DISPOSITION OF
Referring to section 18 of "Consolidated Supply Letters, Nos. 1 to 23, inclusive," all property to be turned in to regular medical supply depots, except as provided under section 17 (a), should be regularly invoiced and receipted for.
In view of the establishment of a reclamation division of the Quartermaster Corps, at the various posts, camps, cantonments, and other units of the army, the following directions should apply:
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All articles of unserviceable property pertaining to the mobile army heretofore "destroyed," "`broken up," or "sold" inventor and inspection reports, or " destroyed " on survey reports, except animals, and that which must be disposed of at once for sanitary reasons, will be turned over on inventory and inspection reports and survey reports under paragraph 717, Army Regulations, to the reclamation officer. The inventory and inspection reports will show the property in a column "To be turned in for salvage," and will, upon completion by the inspector, without approval, be a valid voucher for the accountable officer to drop it from his return. Unserviceable expendable articles will not be destroyed but will be turned over, with a list of the same, by the responsible officers to the reclamation officer, and in view of the establishment of these reclamation units, section 18 of the Consolidated Supply Letters is accordingly modified.
Nothing in the provisions of the above paragraph should, however, be construed to invalidate the provisions of paragraph 1488, Army Regulations, 1913.
ACCOUNTABILITY (RETURNS OF MEDICAL PROPERTY)
Referring to section 1 (b) of "Consolidated Supply Letters, Nos. I to 23, inclusive," attention is invited to the following:
Much additional time is required in handling vouchers on account of the signature of the officer being illegible. The name of the officer signing the paper should in all cases be typewritten under his signature, or in the brief of the voucher, unless the signature is clearly legible. In this connection attention is called to the provisions of paragraph 779, Army Regulations.
Invoices and receipts should both be promptly forwarded, as required by paragraph 496, Manual for the Medical Department, 1916, and the articles mentioned in such vouchers and also in the returns of medical property should be listed in the same order, and under the same name, as shown in the supply table of the Manual for the Medical Department, as required by paragraph 475.
The name of the issuing officer should in all cases be given on the brief of the receipts for medical property, in order that there may be no uncertainty in this office to whom credit for the transfer should be given.
Articles must be entered upon all requisitions, invoices, and receipts, also u1po1 property returns, in the following order:
1. All articles of regular issue in accordance with the arrangements of the supply table;
2. Additional articles as follows:
(a) Drugs, medicines, and antiseptics.
(b) Stationery.
(c) Miscellaneous hospital supplies.
(d) Surgical instruments and appliances.
(e) Laboratory supplies (including chemicals).
(f) X-ray supplies.
If this procedure is followed, the time required in checking requisitions, vouchers, and the returns will be materially reduced and the procedure simplified. It is therefore enjoined upon all officers to see that these instructions are strictly followed.
Officers who are accountable for post, field, dental, and veterinary supplies should keep each in a separate section of the property return, but vouchers pertaining thereto should be numbered in one series.
INVOICES (DISCREPANCIES BETWEEN INVOICE AND QUANTITY OF SUPPLIES RECEIVED)
The following additional instructions are issued in connection with section 17b of Consolidated Supply Letters, Nos. 1 to 23, inclusive:
Numerous cases have occurred in which officers on receipt of property, part of which is missing, have altered the receipt by striking out the articles not received.
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This procedure is not contemplated by Army Regulations, and it entails unnecessary correspondence on the part of both this office and the issuing depot.
The proper procedure in such cases, where property is not received within a reasonable time, is to call for the action of a surveying officer. Testimony from the issuing officer should in all cases be called for and taken into consideration before conclusions are reached by the surveying officer. In this connection attention is called to the provisions of law that when a transportation company accepts property for transportation it becomes responsible for its safe delivery and is not to be relieved of such responsibility on account of faulty packing.
Unless the issuing officer is found to be responsible for the shortage, the receiving officer should receipt in full for the property issued and use the report of survey as a voucher for dropping the missing articles from his return of medical property, and the value of the lost or damaged property should be charged to the transportation company.
In this connection see paragraphs 668, 712, and 721, Army Regulations.
PENCILS, HAIR, AND POTASSIUM PERMANGANATE
Notwithstanding sections 21 and 23 of Consolidated Supply Letters, Nos. 1 to 23, inclusive, reports are constantly received at the various depots that hair pencils and potassium permanganate have not been furnished upon approval requisitions or that they are missing from chests, etc.
Although requisitions may be approved and sent to the depots for issue which may include these articles, they will for the present not be furnished.
When found short in the various chests, etc., issued, this shortage should not be reported to the issuing officer.
SUPPLY LETTER NO. 25
MAY 7, 1918.
CONSERVATION IN THE USE OF ENVELOPES
The Post Office Department has advised that it is experiencing increasing difficulty in securing sufficient envelopes for Government business. It is therefore urged upon everyone to be as economical in the use of envelopes as is possible in properly carrying on the department`s business.
Where more than one communication is sent to a certain individual or office in one day one envelope should be used wherever possible for all. For internal or interdepartmental business, envelopes should not be used, except in the case of confidential matter. For communications, not confidential, between offices at the various camps, etc., where these offices are not located under the same roof, large, heavy manila envelops may be used, not to be sealed, and to be returned to the sending office for use again.
SUPPLY LETTER NO. 26
JUNE 29, 1918.
CONSERVATION OF GAUZE AND OTHER SURGICAL SUPPLIES
1. In view of the enormous increase in the requirements for gauze bandages and other surgical supplies, every effort should be made to reduce the amount of these supplies used in the operating rooms, dressing rooms, and wards.
2. The gauze and bandages can be washed and sterilized for reuse, and this should be done repeatedly as long as they can be used. They should be made in the most advantageous size and shape for conservation. Rubber gloves which have been punctured or have small holes should be patched and tested for leaks and sterilized. Where repairs have been repeatedly made and the gloves are not considered safe for major operative work, they may be used for assistants and ward dressing. Catgut can be conserved by adopting an economical method of tying. Adhesive plaster should he used as sparingly as practicable. Ether
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may be conserved by using local anesthetics--novocain, procain, or apothesine wherever practicable.
3. Conservation of surgical supplies has already been undertaken in some of the base hospitals, and the results have been most satisfactory. One of these hospitals reports for April, 1918, that 282 operations were performed, and that the amount of supplies used was less than one-third of the previous month. (See attached report.)
4. While the varying equipment`s of different hospitals may modify the method used for the reclamation of gauze and bandages, the following method is suggested: Each surgical ward and dressing room should be equipped with two galvanized iron buckets with a cover, lined by a paper bag, in one of which should be put all blood-stained and slightly soiled dressings; in the other, pus-stained dressings. These buckets should be taken twice daily--oftener, if necessary--to the room where dressings are washed. If no laundry equipment or laundry machinery, is available, the gauze and bandages can be washed by hand, using heavy rubber gloves for this purpose. Previous to washing the slightly stained and blood-stained dressings should be soaked for 12 hours in cold water containing one-tenth per cent of chloride of lime; the pus-stained dressings in a solution containing one-tenth of 1 per cent chloride of lime and one-half of 1 per cent washing soda. If washed by hand, these dressings should be boiled for at least one hour. Where laundry machinery is available, or in the larger hospitals which are now being furnished with equipment for the reclamation of reuse knitted gauze, ordinary gauze and bandages may also be reclaimed. The gauze and bandages should be put in mesh bags, soaked for 12 hours as directed above, boiled for 1 hour, transferred to the washing machine and, if a rotary tumbler is available, can be dried in the bags in this tumbler. If this is not available, gauze and bandages can be passed through a wringer and hung on lines to dry. After drying, dressings should be sorted, folded, put in packages and sterilized in the ordinary way for 30 minutes at 15 to 30 pounds pressure on two successive days. Careful bacteriological tests should be made from time to time to test its sterility.
5. This office desires practical suggestions for the best methods of reclaiming absorbent cotton for reuse.
6. It is only by the cooperation of the surgical staff of each hospital that the desired conservation of supplies can be brought about. You should, therefore impress upon the medical officers the necessity for the utmost care in the use of these supplies, and for careful supervision of such use by their subordinates.
7. It is directed that a monthly report of the amount of gauze, bandages, cotton, rubber gloves, catgut, adhesive plaster, and anesthetics used, be returned to this office, with the supplemental report of surgical operations directed in the letter from the Surgeon General`s Office, March 20, 1918.
8. This office has made somewhat extensive investigations, with a view to developing satisfactory substitutes for absorbent cotton and gauze and gauze bandages. Certain satisfactory wood-fiber substitutes for cotton have been f uind and one of these, known as "Cellucotton," is now being provided in large quantity.
Crimped paper bandages are also being tried, and reports to this office indicate that they are just as good as gauze bandages in all " dry " cases.
These substitutes cost just about one-half as much as absorbent cotton and gauze bandages. The lower cost, however, is not the only advantage to be derived from the use of these substitutes. It opens up another source of supply and makes it easier for the supply division of this office to meet the overseas demand for surgical dressings.
It is, therefore, directed that, wherever possible, substitutes for cotton and gauze and gauze bandages be used. Requisitions for these articles should be made in the usual way.
REPORT FROM A CANTONMENT HOSPITAL FOR APRIL, 1918 JUNE 29, 1918.
Amount of supplies used during the month of April:
Gauze: 600 yards, drawn from the supply room, of which amount 350 yards are still on hand for daily dressings; making a total wastage for the month of 250 yards.
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Before undertaking conservation, the average monthly wastage was 3,000 yards, making a saving in this one hospital for one month of 2,750 yards.
Cotton, absorbent; 2 pounds, used by anesthetists.
Cellucotton: 14 rolls.
Rubber gloves: 30 pairs used. All now serviceable and in daily use.
Catgut, chromic and plain: 312 tubes-a fraction over one tube for each operation.
This saving was accomplished by using instruments for tying. (Similar to the method described ly Grant.)
Ether: 421 cans, used for 250 cases of general anesthesia.
Adhesive plaster: 42 spools.
At this hospital the following orders were issued concerning the making of dressings: Empyema pads shall be made as follows:
1. Cellucotton or old gauze or old cotton, 8 by 6; gauze covers, 18 by 18.
Abdominal pads for first dressings, to be used in hospital, shall be made as follows:
1. Cellucotton or resterilized gauze, 8 by 6; gauze covers, 10 by 18.
Sponges for operations shall be made as follows:
1. Single layer of gauze, 24 by 18, folded so as to make sponge 4 by 4.
Abdominal pads or sponges shall be made as follows:
1. Gauze shall be folded so as to make a sponge or pad 9 by 12.
2. All sponges shall have a tape 6 inches long attached to one corner and an iron ring (harness) attached.
All dressings must be saved, rewashed, and will be sent back to operating room after going through high-pressure sterilization.
All dressings must be sterilized twice after being double wrapped.
SUPPLY LETTER NO. 27
AUGUST 8. 1918.
RECEIPTS FOR MEDICAL PROPERTY ISSUED
This office has received complaints from supply depots that receipts for medical property issued by them are returned to them with check marks opposite the various items on the receipt. As these receipts are to be checked item by item, both at the depots and in this office, they should be sent in without check marks. The body of these receipts are ordinarily carbon copies of the issuing officer`s invoice, and in case the receiving officer desires to check the vouchers with the property actually received, such checking should be done on his retained invoice and not on the receipt signed by him.
EXTRA SECTIONS FOR FILING CABINETS
Requisitions for extra sections for filing cabinets, etc., should state, in all cases, the kind of filing cabinet on hand, giving the name of the manufacturer and, if possible, catalogue number. This information is required by the purchasing officer so that he may supply the proper additional sections.
WEB BELTS
Paragraph 38, Supply Letters Nos. 1 to 23, inclusive, is revoked, and the following instructions substituted therefor:
Belts, web, medical officers` (par. 864), and belts, web, enlisted men, Medical Department (par. 865), are now the property of the Medical Department.
Belts, web, medical officers` (par. 864), will hereafter be issued to officers on memorandum receipt. One copy of receipt will be forwarded to the Surgeon General`s Office by receiving officer; the accountable officer will forward one with his return of medical property as authority to drop same, retaining a copy for his file. When a medical officer is separated from the service, the web belt in his possession will be turned in to the nearest accountable
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medical supply officer, who will give receipt for same, one copy to be forwarded to the Surgeon General`s Office and one retained. The property will be taken up on his return.
An officer will not be relieved from responsibility for belts in his possession for which he has given a memorandum receipt until he has retuirned the property to a proper accountable officer.
Belts, web, enlisted men, Medical Department (par. 865), will be charged on Form 367, A. G. O. The accountable officer will prepare invoices in duplicate on Form 28 M. D. The receiving officer will certify thereon that the belts were received and charged on Form 637, giving names of enlisted men. The duplicate receipt will constitute the voucher on which the accountable officer will drop from his returns the articles enumerated. When an enlisted man is separated from the service, the responsible officer will prepare Form 28 in duplicate, listing thereon the medical property in soldier`s possession, and turn same over to an officer accountable for medical property, who will take the property up on his return.
All belts now in possession of officers and enlisted men held by company or detachment commanders on memorandum receipts will be dropped by the accountable officers after the officer who signed the receipts complies with these instructions.
DENATURED ALCOHOL
It is directed that no further purchases of denatured alcohol be made without special authority from this office. Ethyl alcohol is cheaper and may be substituted for the denatured alcohol wherever the use of the latter is authorized.
GAUZE SPONGES
Owing to the great increase in the cost of sponges, gauze, no further issues thereof will be made after the present stock is exhausted. Cellucotton sponges, prepared locally will be substituted for venereal prophylaxis work and for all other purposes for which the gauze sponges of the supply table have hitherto been used.
REQUESTS FOR PURCHASES
In making requests for purchases, the cost must, in all cases, be stated.
SUPPLY LETTER NO. 28
OCTOBER 9, 1918.
1. SPECIFICATIONS FOR FLOOR OILS
Oils purchased by the Medical Department for hospital floor uses should conform as nearly as possible to the following specifications:
The oil is to be a pure, heavy mineral oil; that is to say, it must be totally free of all fatty oils and waxes, tar oil, rosin oil, or rosin, etc.:
1. It is to be clear and of a color not darker than light brown.
2. It is to be odorless, or, at most, to possess not more than a faint kerosene like odor.
3. It is to be of neutral reaction.
4. Its viscosity at 20? C. is to be not less than 4, compared with distilled water. Other characters being equal, preference will be given to oil of high viscosity.
5. It is to contain not more than 2.75 per cent by weight of light (volatile) oils, determined by heating the oil on the steam bath in the open dish during six hours.
2. RED CROSS SUPPLIES
All supplies received from Red Cross organizations for use of Medical Department ot the Army will be taken tup and accounted for on returns of medical property.
A list of the articles received will be forwarded to the Surgeon General`s Office. Request for Red Cross supplies must be approved by the commanding officer of Medical Department organizations or division or camp surgeons of camps.
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3. QUOTING RECORD NUMBERS ON DISBURSEMENT VOUCHERS
All disbursement vouchers covering purchases on authority from this office must quote the supply division record number, which will appear in the upper right-hand corner of letters and at the beginning of telegrams.
4. PRICE ON METAL COVERS FOR ROYAL TYPEWRITERS
The contract price with the Royal Typewriter Co. for the fiscal year 1919 on typewriter metal covers, as approved by the Treasurer of the United States, and appearing in the schedule of supplies of the General Supply Committee, is as follows:
Metal covers for Royal Nos. 5 and 10, commercial carriage.............each...............$3.00
Metal covers for Royal No. 10, with 14-inch carriage.........................do..................3.50
Metal covers for Royal No. 10, with 18-inch carriage.........................do...................4.15
These prices include baseboards.
5. CONSERVATION OF EMPTY BOTTLES
Due to the scarcity and great demand for all kinds of bottles, the following instructions relative to the salvage of empty bottles will be complied with:
1. All empty bottles will be turned over to the medical supply officer at camps and hospitals before turning in; these bottles will be thoroughly washed and dried.
2. The supply officer will carefully assort all bottles received and will make local issues of reclaimed bottles whenever possible.
3. When large quantities have accumulated, report will be made to this office.
6. EMPTY BOXES
Empty packing boxes will be carefully taken apart with a nail puller and preserved for future use; the sides, top, and bottom, when taken apart, should be fastened between the ends by driving a few nails through the boards to keep them intact.
Where boxes of different sizes are received and sufficient storage space is available they may be nested.
Report should be made to this office for proper disposition upon accumulation of a carload of empty serviceable boxes.
7. REQUISITIONS
Articles appearing on both post and field supply tables will be applied for on post requisitions only, with the following exceptions:
First-aid packets. - Litters and accessories, the accessories to consist of the following: Poles, canvas, braces, straps, slings, tacks, screws, rings, studs.
8. ALLOWANCES OF MEDICAL SUPPLIES FOR THREE MONTHS FOR ORGANIZATIONS IN CAMPS
It is expected that the allowance of expendable articles will be sufficient to cover all ordinary requirements for three months.
Nonexpendable articles will be replaced only as they become unserviceable. With proper care most of them should remain in serviceable condition for several years.
When supplies are exhausted, or their exhaustion is imminent, a renewal thereof should be asked for on special requisition forwarded to the division surgeon.
1. Allowance for one regiment of Infantry.
2. Allowance for one regiment of Artillery or Engineers.
3. Allowance for one machine-gun battalion (two companies).
4. Allowance for one machine-gun battalion (four companies).
5. Allowance for one signal battalion.
6. Allowance for one division headquarters.
7. Allowance for trains and military police.
8. Allowance for one regiment of Cavalry.
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Allowance of medical supplies for three months for organizations in camps.
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SUPPLY LETTER NO. 29
DECEMBER 10, 1918.
FORMULA FOR NEUTRAL SOAP TO BE USED IN ALL WASHING MACHINES
1. This soap is to be prepared in the following manner:
Use 50 per city of Wyandotte laundry soda or any other good washing soda to 50 per cent of neutral chipped soap. To 5 gallons of water, add 1 pound of chipped washing soap and 1 pound of laundry washing soda. Permit this to boil slowly for a period of from 40 minutes to 1 hour. In weight this will make about 39 pounds of semipaste.
To 50 pounds of linen use 7 gallons of water and 3 pints of the above-named soap or semipaste. This will produce soapsuds to cleanse this amount of linen thoroughly.
PROMULGATIONS, GENERAL HEADQUARTERS, A. E. F., CONCERNING THE PROCUREMENT AND DISTRIBUTION OF SUPPLIES
[Corrected copyl
General Orders, No. S.
HEADQUARTERS AMERICAN EXPEDITIONARY FORCES
France, July: 5, 1917.
The tables hereto attached show the present distribution of staff duties of the headquarters of the American Expeditionary Forces. The information given in these tables is not to be communicated, either directly or indirectly, to the press or to any person not holding an official position in the military service
The distribution of staff duties in the headquarters of divisions, army corps, and other commands subordinate to these headquarters will conform in principle to the distribution of duties shown in these tables. The distribution of duties within each staff department at these headquarters and the assignment of personnel to such duties will be regulated by the chief of the staff department concerned.
The object of these tables is to form a basis of coordinated action between the several staff departments in a command. They have been prepared after a comprehensive study of the staff organization of the French and British armies, and are intended to adapt the requirements of modern field conditions to our own staff system. This will serve as a guide to all concerned.
By command of Major General Pershing:
JAMES G. HARBORD,
Lieutenant Colonel, General Staff,
Chief of Staff.
Official:
BENJ. ALVORD,
Adjutant General.
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ORGANIZATION OF HEADQUARTERS, AMERICAN EXPEDITIONARY FORCES
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4. Evacuation of sick and wounded.
5. Ratio of combat troops to Line of Communications troops.
6. Supplies.
7. Possibilities of production and transportation in connection with contemplated operations.
8. Operations of railways in France.
9. Priority of supply shipments and locality of purchase.
10. General weighing and balancing of demands and requirements in men and materials from the standpoint of operations section.
11. Recommends decisions on general policy on above-mentioned matters.
12. Preparation of cablegrams and letters stating matters of administrative policy.
13. Liaison with technical and administrative services on questions of policy.
14. Details of organization and equipment of Line of Communications and transportation department troops and services.
* * * * *
TABLE II (E).-GENERAL STAFF COORDINATION SECTION
1. Coordination of staff work on matters of administrative policy.
2. Supervision of the application of administrative policies throughout the command.
3. Compilation of the current and prospective state of supply, construction, and transport in the command.
4. Preparation of graphics showing the state of supply construction, and transport in the command.
5. Compilation of current information on the execution of all administrative policies throughout the command.
6. Settlement of details and coordination and supervision of the execution of the general administrative policies decided upon.
7. Coordination of supply and transportation arrangements for combat.
8. Coordination of supply on all items in which shortage exists.
9. Orders for assignments of new units.
10. Organization lists of American Expeditionary Forces (order of battle).
* * * * *
TABLE IV.-TECHNICAL ADMINISTRATIVE SECTION
* * * * *
MEDICAL CORPS
Sanitation of camps, quarters, and occupied territory.
Health of command.
Care of sick and wounded.
Collection and evacuation of sick and wounded.
Medical personnel.
Medical supplies.
Veterinary personnel.
Veterinary supplies.
Laundries and baths (medical aspect).
Disinfection of clothing, etc.
Supply of personnel and material for gas defensive under supervision of director of gas service.
Technical inspection of medical organizations and establishments.
* * * * *
COMMANDING GENERAL, LINE OF COMMUNICATIONS
Service of territorial command in the zone of the Line of Communications.
Supply, sanitary, and telegraph service in the zone of the Line of Communications.
Until further orders all construction work in the zone of the Line of Communications.
888
NOTE-Upon receipt of this order each head of each of the above-mentioned services will submit detailed chart showing subdivision of duties in his department and proposed personnel.
* * * *
General Orders, No. 43.
HEADQUARTERS AMERICAN EXPEDITIONARY FORCES,
France, September 30, 1917.
The following instructions on the subject of supplies are published for the information and guidance of all concerned:
1. The regular, prompt receipt of supplies is one of the prime necessities for the good administration of any command. The officer whose mind is distracted by the lack of food, clothing, or munitions, or by worry as to whether such supplies will arrive in time for his needs, is not free to devote his energies to the training of his men nor to the defeat of the enemy. Owing to a situation which could not be foreseen when the F. S. R. were written, conditions are such that some changes have had to be made in the organization of the staff and Line of Communications, as contemplated in those regulations. The new organization is shown in General Order No. 8 (corrected), a careful study of which is necessary to grasp its detail and to insure a proper coordination of effort as regards supply and construction. The regulations hereinafter given are explanatory of the methods of procedure under the organization adopted.
2. Supply depots and establishments of the Line of Communications and the personnel thereof are under the command of the commanding general, Line of Communications, who is responsible for their administration, discipline, police, safety, and sanitation. He is also responsible that prompt notice of any shortage or probable shortage is brought to the attention of the chief of the staff department, A. E. F., concerned.
3. The responsibility for the procurement of all supplies of any class rests with the chief of the staff department, A. E. F., concerned, who will procure everything possible in Europe, sending to the United States only for such items as cannot be obtained in Europe. Each chief will exercise a strong technical control and supervision over all the establishments of his department throughout the theater of operations. This control will be exercised through his representative on the staff of the commanding general, Line of Communications, as far as Line of Communications establishments are concerned. The chief of each staff department, A. E. F., will submit immediately, for approval, lists showing the kind and quantity of supplies that will be kept on hand in the various depots of the Line of Communications as the proper supply under the provisions of paragraph 1, confidential memorandum, August 7, 1917, these headquarters. These lists will, upon approval, be the guide for the commanding general, Line of Communications, who is charged with keeping the full stock of supplies on hand ill his depots. Changes in these lists will be made from time to time as better information is obtained as to the exact needs of our forces, and these changes when approved will govern.
4. Each chief of staff department may submit for approval lists of special or unusual supplies not normally issued in accordance with existing orders or regulations, and after such lists are approved organization commanders are authorized to requisition for these supplies directly upon the depot supplying them. All other requisitions for materials or supplies for organizations or for works will be submitted to the chief of the staff department concerned, who will arrange for their issue. When new troops are due to arrive or when at any time the chief of staff department can foresee a need for materials or supplies, he should anticipate the needs of the organizations concerned and take the necessary steps to have the materials or supplies delivered in advance of requisitions.
5. Whenever there is any shortage in an important article of material or supply in transportation facilities and the necessity arises for coordination of issues, the determination of amounts to be issued and the distribution thereof will be fixed by the coordination section, general staff, after consultation with the chief of the department concerned, until normal conditions are restored.
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6. Whenever articles not on the automatic supply basis are issued from any depot from the stock on hand in depot, the issuing officer will send a copy of the lists of materials issued, stamped across the face "For replacement," to the chief of his department, Line of Communications, and this list or issue slip will have the force of a requisition. The necessary steps will then be taken to replace issues either by direct delivery from primary sources or by transfer from another depot farther to the rear, where the actual replacement will be made. Routine issues of articles which are on the automatic supply basis will be forwarded periodically from the rear depots to the advance depots and thence to the troops, under instructions of the commanding general, Line of Communications, without requisition, and notice of the issue of such articles need not be made by the issuing depot. The principle of automatic supply will be applied as far as practicable to all articles of regular issue.
7. The chief of each staff department on the Line of Communications is immediately in charge of the depots and establishments of the Line of Communications, and it is his function to keep informed as to the kind of materials and supplies on hand; and, so far as such authority may be delegated to him by the chief of his department, A. E. F., to make requests on the representative of his department on the general purchasing board for replacements that can be obtained in Europe. All requisitions for supplies and materials to come from the United States and all exceptional purchases in Europe will be made or approved by the chief of the department, A. E. F.
8. No purchases of supplies, other than emergency purchases for his own office, or such materials as the staff officer of the Line of Communications is authorized to require of him. will be made by the purchasing officer of the general purchasing board, except as authorized by the chief of his department, A. E. F. The purchasing agent or disbursing officer is not, in general, concerned with the initiation of purchases or with the state of supplies in the depots. His function is to purchase and inspect the supplies ordered, to provide for their transportation to France, and to pay for them.
9. The officer in charge of each supply depot will keep the chief of his department, Line of Communications, periodically informed as to the stock on hand in his depot, and will issue supplies on requisitions approved by the chief of his department, Line of Communications, or such supplies as are authorized for automatic issue. Requisitions coming to the chief of any department, A. E. F., will after approval be sent to the corresponding chief, Line of Communications, for filling.
10. When supplies are issued from depots to troops, or for construction work, the receiving officers will receipt for the supplies on the usual forms, with a notation showing the organization or the work for which the supplies or materials are to be used. No further formal accounting for the supplies or materials will be required from the receiving officer (F. S. R., par. 370). The same care will be taken of all equipment supplies and materials, and the same economy in their use will be observed as if a formal accounting were required. Commanding officers are charged with the duty of seeing that neither men nor organizations of their command waste, make misuse of the supplies, materials, or equipment furnished to them, or accumulate a surplus thereof. Organizations or individuals demanding much in excess of the average amounts required by other like units under similar conditions will be investigated, and proper action taken if waste, misuse, or undue accumulation is discovered.
11. Each chief of staff department, A. E. F., will arrange for periodic technical inspections of the establishments of his department, in all parts of the theater of operations, with a view to checking any unauthorized use or abuse of equipment, supplies or materials, or any undue accumulation of the same beyond reasonable needs.
By command of Major General Pershing:
JAMES G. HARBORD,
Colonel, General Staff, Chief of Staff.
Official:
BENJ. ALVORD,
Adjutant General.
(For official circulation only.)
890
General Orders, No. 73.
HEADQUARTERS AMERICAN EXPEDITIONARY FORCES,
France, December 12, 1917.
1. The supply of American troops in France is divided into three phases: The first is the procurement of such supplies; the second is their care and storage; the third is their transportation. The responsibility for the first lies with the chiefs of various supply departments, A. E. F.; for the second with the commanding general, Line of Communications; for the third with the director general of transportation. The general supervision of all is exercised by the general staff, as a rule, through the coordination section.
2. Chiefs of supply departments. - The chiefs of supply departments, A. E. F., are responsible for the procurement of all supplies, material, equipment, plants, establishments, etc., that may be necessary for the American troops in France. This is accomplished by purchase or requisition in Europe or in the United States. (For full statement of their functions see par. 3, General Order 43, H. A. E. F.)
3. Commanding general, Line of Communications. - The commanding general, Line of Communications, through his several agencies, is responsible for the care and storage of supplies, material, and equipment, for the construction, maintenance, and repair of all agencies necessary to accomplish this purpose; for the manufacture, salvage, repair, and cleaning of equipment. He is responsible that the supplies are distributed among the several depots in accordance with the approved projects. The commanding officer of each base and intermediate section, Line of Communications, in addition to the other administrative, police, and sanitary functions assigned to him by the commanding general, Line of Communications, is responsible for the administration of his depots and for maintaining the proper stock of supplies, materials, and equipment therein, in accordance with the approved project. When the shipment of supplies is authorized, it is his duty to have them loaded into cars and to have the cars properly marked and turned over to the representative of the transportation department. The commanding officer, advance section, Line of Communications is responsible for the administration, police, and sanitation of the territory in the advance section, including supply depots, hospitals, remount depots, camps, prisons, etc. He establishes camps, hotels, etc., in the neighborhood of regulating stations for the accommodation of troops remaining overnight, and is responsible for the discipline, administration, and sanitation of the railway personnel and construction troops of the transportation department in his zone, except as regards their technical employment or their location.
4. The function of the Line of Communications is to relieve the combatant field forces from every consideration except that of defeating the enemy. All agencies established for that purpose belong to the Line of Communications unless otherwise specially assigned.
5. Director general of transportation: - The director general of transportation has charge of the unloading of freight and troops from ships at points of debarkation and of the transportation of all troops and supplies by rail, in accordance with instructions received from proper authority. He is responsible for the construction, maintenance, and operation of such railroad lines and rolling stock as cone within American control. He will have a representative at each regulating station, at each group of supply depots, at each railhead, and at each important railroad station, to facilitate military traffic. He is responsible through his proper representatives, that all freight turned over to the transportation department for transportation is promptly delivered to its destination.
6. The railroad personnel in the advance section, Line of Communications are subject to the orders of the regulating officer in so far as concerns their receiving, caring for, and transporting troops and supplies and as regards priority of shipments. This control is exercised through the proper railway officers. They are subject to the orders of the commanding officer advance section, Line of Communications, in all matters of discipline, sanitation, and administration not involving questions of railway management. They are subject to the orders of the director general of transportation in all matters pertaining to their technical work in the construction, operation, and maintenance of the railways, and as regards there location or employment.
7. The agencies through which the troops in the zone of the armies are supplied from the storage depots are the regulating stations and refilling points.
891
8. A regulating station is a large railway yard where cars from the supply depots and from the rear are received and made up into trains for the divisions. Usually a separate train is provided for each division. Here also are received all express and mail for organizations at the front. This is sorted in regulating station and distributed in separate cars for each division and turned over to the transportation department for dispatch to destination.
9. Troops coming into a regulating station are detrained, if necessary, and reembarked into trains which will take them to their proper divisions. Trains containing troops for a single division are forwarded direct to destination.
10. The regulating officer is a member of the coordination section of the general staff. He, as a rule, belongs to the headquarters of an army or a group of armies, but not to lesser units. It is his duty to give all orders for the movement of troops and supplies in advance of the advance depots and to follow the movements through to completion; the troops to their proper destination, and the supplies until delivered to divisional supply officers, or to supply officers of detached or nondivisional organizations. To him are sent all orders for and information regarding the transportation of men and material in the advance section, Line of Communications, and all notices of shipment of men or material to arrive at the regulating station, either from front or from the rear. He must be promptly advised by army headquarters of any changes or movements at the front that will affect the supply. He in turn must inform the railway officials in time for them to make preparations for the contemplated move, and must take the necessary measures to insure the proper supply.
11. He is kept in close touch with the headquarters of the army to which it is attached, by frequent visits and conferences. In certain questions which are reserved for the decision of general headquarters communication is held direct between those headquarters and the regulating officer.
12. All the personnel engaged in transportation and handling of men, material or supplies in the advance section, Line of Communications, are subject to the orders of the regulating officer in all matters pertaining to these duties. (See also par. 6, above.)
13. Railheads and refilling points. - The railhead, as the name implies, is the point on the railway at which the troops or supplies are discharged. The refilling point is the place at which the division trains receive the supplies. The two may coincide. The personnel at the railheads and refilling points are responsible to the regulating officer for the unloading, care, and preservation of the freight, mail, and express until turned over to the division trains. At or near the refilling point may be established a field base, or dump, which is usually a temporary shelter where one day`s supply of rations, fuel, forage, gasoline, etc., may be kept to fill the division trains immediately upon their arrival, thus avoiding long waits for late railway trains.
14. Evacuation stations. - For the reverse movements of personnel or supplies there are evacuation stations and sorting stations. An evacuation station is a place for the collection of men and material that have become unfitted for use in the front and for which movement to the rear is contemplated. The personnel of these stations receive and care for the personnel and material to be evacuated and at the proper time load them on trains provided by the regulating officer. Orders for the evacuation of men or material are ordinarily issued by the chief of staff, general staff, at army headquarters, which should receive early notification of desired movements so that the regulating officer may have time to provide for the amount and kind of rolling stock required. In action the officer in charge of an evacuation station may call directly upon the regulating officer for the necessary railway equipment to evacuate the wounded.
15. Sorting stations are railway stations to which evacuated men and materials are sent from the evacuation stations and where they are sorted into their special classes and thence shipped to their final destination in the rear. Sick and wounded are sent to the various hospitals; worn out and broken material to shops along the line of communications.
16. Classification and distribution of supplies. - All supplies desired by troops are, for the purpose of this order, divided into four classes, viz; first, food, forage, and any other
892
articles of automatic supply; second, shoes, clothing, and other similar equipment without which the individual cannot perform his functions as a soldier; third, articles of authorized equipment, either for individuals or organizations, such as trucks, paulins, axes, shovels, etc., the absence of which, in small quantities, will not prevent the individual or organization from performing its functions; fourth, all articles the distribution of which must depend upon the character of future operations, and all items of an exceptional nature not part of the equipment of troops, but necessary for their protection from the weather or the enemy.
17. Class I supplies will be obtained and distributed as follows:
(a) Regimental supply officers or supply officers of other independent organizations will submit ration returns to the division quartermaster, or quartermaster of the organization to which they are attached. He in turn will consolidate the returns. The division return will be submitted to the local supply officer at the refilling point for filling.
(b) If for any reason any of the component parts of the rations demanded by the division cannot be supplied at the refilling point, the supply officer in charge there will furnish the division supply officer with all order on any field base, or dump, which will be honored upon presentation.
(c) The daily automatic supply is based on the actual strength of the division in men and animals. Reports are made on the 10th, 20th, and the last day of each month by headquarters of the division to the headquarters of the corps. Here they are consolidated and corps troops are added and the same information is sent to the headquarters of the army (chief of staff, general staff). Army headquarters then notifies the regulating officer by wire of the number of men and animals belonging to each division. The regulating officer informs the various supply depots of the numbers for which the automatic supply is required, indicating the division or detached or nondivisional organization for which the supplies are required, by the proper symbol number.
(d) The various classes of supplies are then loaded into railway cars, properly checked and rechecked, and each car is labeled on both sides with symbol number of the division, or detached or nondivisional organizations, for which the supplies are destined. A list of the contents of each car is posted in a conspicuous place in the car. Information regarding the shipment is telegraphed to the regulating officer by the depot officer, and the regulating officer then prepares schedules of the make-up of the trains for various divisions, gives them to the representative of the transportation department, who will make up respective trains and dispatch them to their destinations.
(e) On arrival at refilling point the train is promptly unloaded and the supplies required for the division are immediately transferred to the division trains by the local supply officer, or they are put under cover for issue the following day.
(f) The period elapsing from the date on which the division strength report is made and date on which rations are drawn (one to four days) renders it imperative that, in accordance with the adopted policy, a small stock shall be kept at, or near, the refilling point in order to enable proper adjustments to be made.
18. In the case of bulk trains (full trainloads of forage, coal, etc.) arriving at regulating stations, the following procedure will be observed. To fill the demands of a division for such commodities, one or more railway cars, with cargo corresponding to nearest weights demanded by the respective divisions, will be cut from the trains, marked with the division symbol and turned over to the representative of the transportation department for proper marshaling and dispatch. The contents of a full car will not be broken.
19. This method will result in over issues or under issues, as the case may be, and will require adjustment from day to day. A record book, with headings for plus or minus issues and the amounts due to different organizations will be kept for making the adjustments in further shipments.
20. Class 2, supplies (shoes, clothing, etc.):
(a) Requisitions are submitted by the company commanders and, upon consolidation and approval by the regimental commander, are checked by the proper division staff officer and sent directly to the proper advance depot.
893
(b) The depot officer will inform the railway officials of the number and kind of cars that hie will require to forward these supplies and the time and place he will want them spotted for loading.
(c) The regulating officer keeps informed of these calls and if there is any necessity therefor, arising from shortage of cars or special needs for other shipments, indicates the order of priority. After the cars are placed by the railway personnel, they are loaded by the depot personnel, and the procedure until they are delivered to the refilling points is as heretofore, described for carloads of class I supplies.
21. The accuracy, necessity for, and sufficiency of these requisitions rest upon the regimental commander. The final responsibility rests with the division commander.
22. Class 3 supplies (wagons, trucks, axes, shovels, sanitary and hospital supplies, equipment. etc.): These supplies are requisitioned by the organizations in the manner prescribed for class 2. These requisitions are received by the supply officers of the division and are filled from any disposable supplies in the division. The remainder of the requisition is forwarded to corps headquarters where a similar procedure is followed. The corps supply officer, in consultation with the A. S. G. S., fills the needs from disposable supplies within the corps parks, trains, or dumps, and the remainder of the requisition is forwarded to army headquarters, where a similar procedure is followed.
23. The remainder of the requisition, which cannot be furnished from the resources at the disposition of the army are forwarded to the advance depots, Line of Communications, where the procedure is the same as prescribed for articles of class 2.
24. Class 4 (ammunition, timber, etc.): Requisition for articles of this class are handled in the same manner as described for those of class 3, except that after the articles which are disposable within the army have been furnished, the remainder of the requisition is forwarded direct from the army headquarters to the proper supply officer at general headquarters, where it is considered in connection with contemplated operations, and of the relative need of other units. Final action is takes in consultation with the chief of staff, general staff.
25. In order to expedite the supply of these articles to the troops, certain amounts in the depots, called credits, may be placed at the disposition of Army headquarters. Upon these credits Army headquarters may draw without reference to general headquarters, sending their requisition direct to the proper depot officer. Army headquarters should inform the proper supply officer at general headquarters of such drafts upon the credits, in order that he may know at all times the status of the credits. Action upon requisitions for articles on which no credit has been established, and upon renewal of amounts withdrawn from existing credits, is determined by the proper supply officer at general headquarters, in consultation with chief of staff, general staff. When decision is reached the necessary information is sent to the proper depot, with directions to forward the supplies or to renew the credits as the case may be. Information upon all such points is also sent to the regulating officer and to army headquarters. Army headquarters will also be informed if the credit is not to be renewed immediately.
26. Corps troops and army troops send their requisitions direct to corps and army headquarters, respectively, and a similar procedure is followed for each class of supplies as outlined above.
27. Division commanders are hereby directed to detail an officer at each station at which freight is received by that division where such an officer is not otherwise provided to be known as the local supply officer of that refilling point. This officer will be charged with the receipt and prompt unloading of all cars received at that station for American troops. He will be warned of their arrival by the regulating officer and will make his requisition upon the local commanding officer for the necessary troops to unload the cars within 24 hours after they are placed for unloading. He will be charged with the proper cleanliness of that part of the yard that may become littered Up by American troops. The necessary details of troops will be furnished him for both of these purposes. He will receive his instructions from the regulating officer.
28. Until further orders, the 10-day reports called for in paragraph 17-c will be submitted to commanding officer, advance section, Line of Communications, who will promptly forward them to the regulating officer to serve as the basis of an automatic supply
894
until the figures are changed. Until further orders, requisitions for class 3 supplies will be forwarded to the proper supply depots, requisitions for class 4 supplies will be sent to the proper supply officer at general headquarters, from the division or other independent unit. Requisitions submitted before December 20 will be acted upon under regulations heretofore in force; after December 20 all requisitions will be submitted in accordance with the plans herein outlined.
By command of General Pershing:
JAMES G. HARBORD,
Brigadier General, Chief of Staff.
Official:
ROBERT C. DAVIS,
Adjutant General.
General Orders No. 13.
FRANCE, January 21, 1918.
II. So much of paragraphs 4 and 9, General Order 43, these headquarters, 1917, as is in conflict with paragraphs 17a, b, c, 18, 20, 22 to 26, General Order 73, these headquarters, 1917, is revoked. General Orders No. 20.
FEBRUARY 4, 1918.
IV. So much of paragraph 10, General Order No. 73, series 1917, as provides that the regulating officer shall belong as a rule to the headquarters of an army or group of armies is rescinded, and the following is substituted therefor: "The regulating officer is a member of the coordination section of the general staff of these headquarters. He is the agent through whom are effected the supply and evacuations for each army or group of armies assigned to his particular regulating station.?
HEADQUARTERS AMERICAN EXPEDITIONARY FORCES, CHIEF OF STAFF, GENERAL STAFF,
France, January 9, 1918.
From: Commander in chief.
To: Commanding general, Line of Communications.
Subject: Distribution of supplies.
1. The operations of the American Expeditionary Forces are now entering a phase where each department and each officer thereof is going to be tried by results, and no failure in supplies must be permitted to occur. Your attention is therefore invited, first, to the question of procurement for which the chiefs of supply departments are primarily responsible; second, to distribution of supplies for which subordinates of his department on the Line of Communications are responsible; third, the transportation for which the transportation department is responsible.
* * * * *
3. While the commanding officer, Line of Communications, and his subordinates are not responsible for the procurement of supplies, and while the chiefs of the various departments are supposed to keep track of the amount of supplies on hand, this does not relieve the Line of Communications if it does not give adequate warning whenever there is a possibility of shortage in sight. They know the requirements and are closer to the detailed work than the chiefs of departments, and it should be their responsibility to sound the first note of warning.
* * * * *
By order of the Commander in Chief:
W. D. CONNOR,
Colonel, General Staff, National Army,
Chief of Section.
895
[Confidential. Corrected copy]
General Orders, No. 31.
GENERAL HEADQUARTERS,
AMERICAN EXPEDITIONARY FORCES,
France, February 16, 1918.
1. General Orders, No. 8, 1917, these headquarters, is revoked and the following is substituted therefor.
2. The tables hereto attached show the distribution of staff duties of the general headquarters of the American Expeditionary Forces. The information given in these tables is not to be communicated, either directly or indirectly, to the press or any person not holding an official position in the military service.
The distribution of staff duties in the headquarters of divisions, army corps, and other commands subordinate to these headquarters will conform in principle to the distribution of duties shown in these tables. The distribution of duties within each staff department at these headquarters and the assignment of personnel to such duties will be regulated by the chief of the staff department concerned.
The object of these tables is to form a basis of coordinated action between the several staff departments in a command. They were originally prepared after a comprehensive study of the staff organization of the French and British Armies, now revised as a result of our own experience. They are intended to adapt our staff system to the requirements of modern field conditions and will serve as a guide to all concerned.
3. The Line of Communications as herein reorganized will be known and designated as the Services of Supply. The commanding general, Services of Supply, in addition to his other duties will exercise all of those functions heretofore prescribed for the commanding general, Line of Communications.
4. A service of utilities is announced. It will include the transportation department the motor transport service, forestry service, and lumber and the production and all construction under the commanding general, Services of Supply. The above services will be coordinated by the chief of utilities under the commanding general, Services of Supply.
5. The chiefs of the administrative and technical staff services, under their titles and authority as members of the staff of the commander in chief, will exercise all of their functions in the matter of procurement, supply, transportation and construction under the direction of the commanding general, Services of Supply, by whom these activities will be coordinated. The chief of each of these services is authorized, in his discretion, to designate an officer of his service to represent him with each general staff section at general headquarters.
6. The chiefs of services will so organize their offices that the efficiency of their departments will not be impaired by necessary absences for conference with, or for other duty assigned to them by, the commander in chief.
By command of General Pershing:
JAMES G. HARBORD,
Chief of Staff.
Official:
BENJ. ALVORD,
Adjutant General.
896
ORGANIZATION OF GENERAL HEADQUARTERS AMERICAN EXPEDITIONARY FORCES (G. H. Q., A. E. F.)
897
TABLE II (D). - GENERAL STAFF
ASSISTANT CHIEF OF STAFF, FOURTH SECTION (G-4)
Supervises supply, construction, and transportation in France, including location of railway and supply establishments.
Analyzes statistics concerning the above.
Guarantees supply and transportation arrangements for combat.
Supervises hospitalization and evacuation of the sick and wounded.
Supervises all operations of the Services of Supply not assigned to other sections of the general staff.
Makes assignment of all new units arriving in France; of all labor and labor troops.
TABLE IV.-SERVICES OF SUPPLY
(Commanding general, Services of Supply)
Transportation and construction.
Service of territorial command.
Supply, sanitary, and telegraph service, paragraph 368, F. S. R.
TECHNICAL AND ADMINISTRATIVE SERVICES
(Medical Corps)
Hospitals.
Sanitary inspection.
Health of command.
Care of sick and wounded.
Collection and evacuation of sick and wounded.
Medical supplies.
Veterinary supplies.
Supply of personnel and material for gas defensive under supervision of director of Gas Service.
Technical inspection of medical organizations and establishments.
General Order 44.
MARCH 23, 1918.
1. General Orders, No. 43, series 1917, these headquarters, amended by section 11 (1), General Orders, No. 13, current series, these headquarters, and General Orders, No. 63, series 1917, these headquarters, as amended by section 11 (2), General Orders, No. 13, and section IV, General Orders, No. 20, current series, these headquarters, are hereby revoked and the following is substituted therefor:
GENERAL PROVISIONS
(See General Orders, No. 74, 1918)
2. The regular and prompt receipt of supplies is one of the prime necessities for the good administration of any command. The officer whose mind is distracted by the lack of food, clothing, or munitions, or by worry as to whether such supplies will arrive in time for his needs, is not free to devote his energies to the training of his men nor to the defeat of the enemy. Owing to a situation which could not be foreseen when the F. S. R. were written, some changes have had to be made in the organization of the staff and Line of Communications as contemplated in those regulations. The new organization is shown in General Order No. 31, current series, a careful study of which is necessary to grasp its details and to insure a proper coordination of effort as regards supply and construction. The regulations hereinafter given are explanatory of the methods of procedure under the organization adopted.
898
3. The commanding general, Services of Supply, is responsible for the procurement of all supplies, material, equipment, plants, and establishments necessary for the American troops in France. This is accomplished by purchase or requisition, in Europe, or in the United States. He is also responsible for the care and storage of such supplies, material, and equipment, and for their manufacture, salvage, repair, and cleaning, when necessary, and for the construction, maintenance, and repair of all agencies necessary to accomplish these purposes. He is responsible that the supplies, material, and equipment are maintained and distributed amongst the several depots il accordance with approved projects. The general supervision of all these functions is exercised by the general staff, as a rule, through G-4 thereof.
4. He is charged with unloading of freight and troops from ships at all points of debarkation, and with the transportation of all troops and supplies by rail therefrom, in accordance with instructions received from general headquarters (G-4). He is responsible for the construction, maintenance, and operation of such utilities as may be necessary to accomplish these objects, including such French railroad lines and rolling stock as come within American control.
5. He will have a representative of the transportation department at each regulating station, group of supply depots, at each railhead, and at each important railroad station, to facilitate military traffic, and he is responsible that all freight turned over to the transportation department for transportation is promptly delivered to its destination.
6. In these duties the commanding general, Services of Supply, is assisted by a technical staff consisting of the chiefs of the various supply departments and technical services hereinafter called the Services of Supply. Each chief of service will exercise a close personal control and supervision over all the establishments of his department throughout the theater of operations. They will each keep the approved projects up to date, and maintain corresponding lists showing the kind and quantity of supplies, material and equipment that should be kept on hand in the various depots for which they are responsible as the proper supply under the provisions of paragraph 1, confidential memorandum, August 7, 1917, A. E. F. These projects will, upon approval by general headquarters, be the guide for the commanding general, Services of Supply, who is charged with keeping the full stock of supplies on hand in his depots. Changes in these projects will be made from time to time as better information is obtained as to the exact needs of our forces, and these changes, when similarly approved, will govern.
7. Each chief of service of supply may submit, for approval of general headquarters, lists of special or unusual supplies not normally issued in accordance with existing orders or regulations, and after such lists are approved organization commanders are authorized to requisition for these supplies as hereinafter explained. When new troops are due to arrive, or when at any time the chief of service of supply can foresee a need for materials or supplies, he should anticipate the needs of the organizations concerned and take the necessary steps to have the materials or supplies delivered in advance of requisitions.
8. Whenever there is any shortage in an important article of supply, equipment, or transportation, and the necessity arises for coordination of distribution or a reduction of allowances becomes necessary, the commanding general, Services of Supply, will report the case to general headquarters (G-4) for instructions to govern until normal conditions are restored.
9. Whenever articles not on the automatic supply basis (class 1) are issued from any depot from the stock on hand in depot, the issuing officer will send a copy of the lists of materials issued, stamped across the face "For replacement,`` to the chief of his services, Services of Supply, and this list or issue slip will have the force of a requisition. The necessary steps will then be taken to replace issues, either by direct delivery from primary sources or by transfer from another depot farther to the rear, where the actual replacement will be made. Routine issues of articles which are on the automatic supply basis will be forwarded, periodically, without requisition, from the rear depots to the advance depots under instructions of the chief of the service of supply concerned, and thence to the troops, under instructions herein contained. Notice of the issue of such articles need not be made by the issuing depot. The principle of automatic supply will be applied as far as practicable
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to all articles of regular issue. The regulating officer will notify the general staff, Services of Supply, of changes in rate of automatic issues, who will notify the chiefs of services concerned.
10. The chief of each service of supply, Services of Supply, is immediately responsible for his depots and establishments in the Services of Supply, and it is his duty to keep informed as to the kind of materials and supplies on hand, and to call upon the representative of his service on the general purchasing board for replacements that can be obtained in Europe All requisitions for supplies and materials to come from the United States and all exceptional purchases in Europe will be made in accordance with policies approved at general headquarters.
11. No purchases of supplies, other than emergency purchases for his own office, will be made by the purchasing officer of the general purchasing board, except as authorized by the chief of his service A E F., or as directed by the commanding general, Services of Supply. The purchasing agent or disbursing officer is riot, in general, concerned with the initiation of purchases or with the state of supplies in the depots. His function is to purchase and inspect the supplies ordered, to provide for their transportation to France, and to pay for them, He will investigate all possible sources of supply that might reduce the tonnage to be brought from the United States.
12. The commanding officer of each base, intermediate, and advance section, Services of Supply, except as otherwise specifically provided for, is responsible for the discipline, police, and sanitation of the area assigned to him, in so far as the American personnel and institutions are concerned and for so much of the administration as may be assigned him by the commanding general, Services of Supply. The administration of tactical divisions and schools or camps of instruction will be governed by special instructions issued from time to time from general headquarters.
13. The officer in charge of each supply depot will keep the chief of his service, Services of Supply, periodically informed as to the stock on hand in his depot, arid will issue supplies on requisitions approved by the chief of his department or service, or as herein otherwise prescribed. When shipment of supplies is authorized, it is his duty to have them promptly loaded into cars, to have the cars plainly marked, as prescribed in section II, General Order No. 17, 1918, and to send full telegraphic information in regard to the shipment to the consignee, or if into the zone supplied from a regulating station, to the regulating officer. This telegram should include ear initials, car number, date of shipment, organization for which intended, routing and contents of car ill sufficient detail for identification. Unless otherwise authorized, all shipment to points in the advance section will be made through the regulating station.
14. When supplies are issued from depots to establishments, troops, or for construction work, the receiving officers will receipt for the supplies on the usual forms, with a notation showing the organization or the work for which the supplies for material are to be used. No further formal accounting for the supplies or materials will be required from the receiving officer. (F. S. R., par. 370.) The same care will be taken of all equipment, supplies, and material and the same economy in their use will be observed as if a formal accounting were required. Commanding officers are charged with the duty of seeing that neither men nor organizations of their commands waste, make misuse of the supplies, materials, or equipment furnished to them, or accumulate a surplus thereof. Organizations or individuals demanding much in excess of the average amounts required by other like units under similar conditions will be investigated, and proper action taken if waste, misuse, or undue accumulation is discovered.
AGENCIES OF SUPPLY AND EVACUATION IN THE ADVANCE SECTION, SERVICES OF SUPPLY
15. A regulating station is a large railway yard where cars from the supply depots and from the rear are received and made up into trains for the divisions. Here also are received all express, mail, and freight for organizations at the front. These are sorted in the regulating station and distributed in separate cars for each division, or group of nondivisionial organizations, and turned over to the transportation department for dispatch to destination. Usually a separate train is provided for each division or group.
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16. All troops forwarded to points in the advance section will be sent to the proper regulating station, and advice of each movement will be sent to the regulating officer by wire, giving the strength in officers, men, and animals, the tonnage of baggage and freight of each unit and its assignment. The same information must be furnished him for each entraining point regarding any troops whose movement lie must arrange for. Troops coming into a regulating station are detrained, if necessary, and reentrained into trains which will take them to their proper divisions. Trains arriving at a regulating station containing troops for a single destination are forwarded direct.
17. The regulating officer is a member of the fourth section, general staff (G-4). As a rule he belongs to the headquarters of an army or a group of armies. Until such organizations are formed he may be assigned to G-4 of the staff of the command he is supplying. It is his duty to give all orders for the railway movement of troops and supplies within the sector served by his regulating station, and to follow the movements through to completion, the troops to their proper destination, and the supplies until delivered to divisional supply officer, or to supply officers of detached or nondivisional organizations. To him are sent all orders for, and information regarding, the railway transportation of men, animals and material in the advance section, Services of Supply, and all notices of similar shipments due to arrive at the regulating station, either from front or from the rear. He must be promptly advised by army headquarters of any changes or movements at the front that will affect supply. He, in turn, must inform the railway officers in time for them to make preparations for the contemplated move, and must take the necessary measures to insure the proper supply. He is responsible for the daily automatic supplies of the troops which he serves, and he issues the necessary orders to insure that supply. The agents of the Services of Supply shall respond to all such requirements of the regulating officer to accomplish these ends. Only in emergency will calls for supplies be made by telegraph. Such telegraphic calls for supplies of any class will be sent by the proper headquarters to the regulating officer, who will order them from the proper depot. The object of the regulating station and of all the elements of the Services of Supply adjacent thereto is to facilitate the supply of the troops served by that regulating station, and in case of necessity the decision of the regulating officer will be authoritative on all subjects arising within such elements or units attached thereto.
18. By frequent visits and conferences, he will keep in close touch with the headquarters of the unit which he is serving. On certain questions which are reserved for the decision of general headquarters, and in emergencies, communication is held direct between general headquarters (G-4) and the regulating officer.
19. The railway personnel in the advance section, Services of Supply, are subject to orders of the regulating officer in so far as concerns their receiving, caring for, and transporting troops and supplies and as regards priority of shipments. This control is exercised through the proper railway officers. They are subject to the orders of the commanding officer advance section, Services of Supply, in all matters of discipline, sanitation, and administration not involving questions of railway management. They are subject to the orders of the chief of utilities in all matters pertaining to their technical work in the construction, operation, and maintenance of the railways, and as regards their location or employment.
20. Railheads and refilling points. - The railhead, as the name implies, is the point on the railway at which the troops or supplies are discharged. The refilling point is the place at which the division trains receive the supplies. The two may coincide. The personnel at the railheads and refilling points are responsible to the regulating officer for the unloading, care, and preservation of the freight, mail, and express until turned over to the division trains. At or near the refilling point will be maintained certain authorized stores fox emergency issue, and one day`s supply of rations, fuel, and gasoline to fill the division trains immediately upon their arrival, thus avoiding long waits for late railway trains. The stock at railheads, other than class 1 supplies, is for real emergency use only and will not be used to meet ordinary needs.
21. The commanding general of the unit to which the regulating officer belongs will detail an officer at each railhead to be known as the railhead officer, who will be in charge
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both of railhead and refilling points. This officer will be charged with the receipt and prompt unloading of all cars received at that station for American troops. He will be warned of their arrival by the regulating officer and will unload the cars as soon as possible, and always within 24 hours after they are placed for unloading, with a personnel furnished him for that purpose, calling upon the local commanding officer for any additional men that may be necessary to accomplish that object. The railhead officer is charged with the proper cleanliness of that part of the yard that may become littered up by American troops. He will receive his instructions from the regulating officer, and may have certain supply officers detailed to assist him in administering the refilling point. The railroad transportation officer at railhead is a transportation department officer, and as regards operation of the railway he reports to and receives his orders from the railway officer of the regulating station. He receives his orders as to where and when to place cars from the railhead officer, whom he keeps constantly informed as to arrival and departure of cars. The railhead officer and a certain number of the permanent personnel for the railhead will be furnished the army for the foregoing purposes by general headquarters. Any additional personnel needed in an emergency will be furnished from the near-by organizations.
22. Evacuating stations and sorting stations are established for the reverse movement of personnel, animals, and materials. An evacuation station is a place for the collection of men, animals, and materials that have become unfitted for use in the front and for which movement to the rear is contemplated. The personnel of these stations receive and care for the personnel and material to be evacuated, and at the proper time load them on trains provided by the regulating officer. Orders for the evacuation of men or material are ordinarily issued by G-4, at army headquarters, which should receive early notification of desired movements so that the regulating officer may be given ample time to provide for the amount and kind of rolling stock required. During action the officer in charge of an evacuation station may call directly upon the regulating officer for the necessary railway equipment to evacuate the wounded. Sorting stations are railway stations to which evacuated men and material are sent from the evacuation stations and where they are sorted into their special classes and thence shipped to their final destination in the rear. Sick and wounded are sent to the various hospitals; worn out and broken material is distributed to depots or shops of Services of Supply.
CLASSIFICATION AND METHODS OF SUPPLY
23. All supplies desired by troops are, for the purpose of this order, divided into four classes, viz:
Class I. - All articles of daily automatic supply, which shall consist of rations, forage, fuel, gasoline, lubricants and illuminants.
Class 2. - Clothing, blankets, overcoats, slickers, ponchos, bed sacks, and brassards.
Class 3. - All other authorized articles of equipment (except ammunition) furnished by the several supply departments including sector equipment and the authorized allowance of vehicles.
Class 4. - Ammunition, construction material, all articles of an exceptional nature not included in authorized allowances, and all articles the distribution of which must depend upon operations, lists of which will be published from time to time.
24. This system of supply contemplates having troops normally unencumbered with impedimenta and supplies, thus enabling them to have a maximum mobility. At the same time, the method for obtaining necessary supplies has been so simplified that any article, when needed, can be obtained on a few hours` notice.
25. Class 1 supplies (articles of automatic supply) will be obtained and distributed as follows:
(a) Regimental supply officers or supply officers of other independent organizations will submit ration returns and forage requisitions to the division quartermaster, or quartermaster of the organization to which they are attached. He in turn will consolidate the returns. The division return will be submitted to the local supply officer at the refilling point for filling.
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(b) The daily automatic supply is based on the actual strength of the organization in men and animals. This information is furnished weekly, or as much oftener as may be necessary, to headquarters of the army (G-4) by G-I of the division or corps from the data prepared for the statistical division, Adjutant General`s Office. Army headquarters notifies the regulating officer by wire of the number of men and animals of each division or other similar organization belonging to the army. Other organizations in the advance section, Services of Supply, send similar strength reports direct to the regulating officer. The regulating officer may call upon the various supply depots for automatic supplies required in two ways; either by indicating the division or detached or nondivisional organization for which the supplies are required by the proper symbol number or by calling for the supplies in bulk.
(c) Under the first method of procedure the various classes of supplies are then loaded into railway cars, properly checked and rechecked, and each car is labeled on both sides with symbol number of the division, or detached or nondivisional organizations, for which the supplies are destined. A list of the contents of each car is posted in a conspicuous place in the car. Information regarding the shipment is telegraphed to the regulating officer by the depot officer; and the regulating officer then prepares schedules of the make-up of the trains for various divisions, gives them to the representative of the transportation department, who will make up respective trains and dispatch them to their destinations, accompanied by an agent for each divisional or similar group of cars whenever necessary.
(d) On, arrival at refilling point the train is promptly unloaded, and the supplies required for the troops are immediately transferred to division trains by the railhead officer, or they are put under cover for issue the following day.
(e) The period elapsing from the date on which the organization`s strength report is made and date on which the corresponding shipment of rations are drawn upon (one to four days) render it imperative that the small stock provided for in paragraph 21 shall be kept at, or near, the refilling point.
(f) It case supplies are called for in bulk (full trainloads of forage, fuel, etc.) the following procedure will be observed: To fill the demands of a division for such commodities. One or more railway cars, with cargo corresponding to nearest weights demanded by the respective organizations, will be cut from the trains, marked with the proper symbol and amount of supplies, and turned over to the representative of the transportation department for proper marshaling and dispatch. The contents of a full car will not be broken. This method will result in overissues or underissues, as the case may be, and will require adjustment from day to day. A record book with headings for plus and minus issues and the amount due to different organizations will be kept by the regulating officer and officer in charge of the refilling point for making the adjustments in further shipments and issues.
26. Class 2 supplies (clothing, blankets, overcoats, etc.):
(a) Requisitions are submitted by the company commanders, and upon consolidation and approval by the regimental commanders are checked by the proper staff officer and sent (through G-1 in division of corps, or G-4 for army troops), directly to the proper advance depot, which will fill the requisition.
(b) The depot officer will inform the railway officers of the number and kind of cars he will require to forward these supplies and the time and place he will want them spotted for loading.
(c) The regulating officer will be informed by the railway officer of these calls for cars, and if there is any necessity thereof from the shortage of cars or special needs for other shipments will indicate the order of priority. After the cars are placed by the railway personnel they are loaded by the depot personnel, and the procedure until they are delivered to the refilling points is as heretofore described for carloads of class I supplies.
27. Class 3 supplies: All other authorized articles of equipment, except ammunition:
(a) These supplies are requisitioned by the organization in the manner prescribed for class 2. These requisitions are received by the supply officer of the division, and are filled from any disposable supplies in the division. The remainder of the requisition is forwarded direct to army headquarters, where a similar procedure is followed. The army
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supply officer, in consultation with G-4, fills the needs from disposable supplies within the army parks, trains, or dumps.
(b) The remainder of the requisition which cannot be furnished from the resources at the disposition of the army is forwarded to the advance depot, Services of Supply, where the procedure is the same as prescribed for articles of class 2.
28. Class 4 (ammunition, constructions material, exceptional articles, and all articles temporarily excepted from classes 2 and 3 by orders):
(a) Requisitions for articles of this class are handled in the same way as described for those of class 3, except that after the articles which are disposable within the army have been furnished the remainder of the requisition is forwarded direct from the army headquarters (G-4) to general headquarters (G-4), where it is considered in connection with contemplated operations and of the relative needs of other units.
(b) In order to expedite the supply of these articles to the troops, certain amounts in the depots, called credits, may be placed at the disposition of army headquarters. Upon these credits army headquarters may draw without reference to general headquarters, sending their requisition direct to the proper depot. Army headquarters should inform general headquarters (G-4) of such drafts upon, the credits, in order that they may know at all times the status of the credits. Action upon requisitions for articles on which no credit has been established, and upon renewals of amounts withdrawal from existing credits, is determined by general headquarters (G-4) in consultation with proper supply officer. When decision is reached the necessary information is sent to the proper depot, with directions to forward the supplies or to renew the credits as the case may be. Information upon all such points is also sent to the regulating officer and. to army headquarters. Army headquarters will also be informed if the credit is not to be rendered immediately.
29. All requisitions for division, corps, and army troops or separate organizations will be given a serial number for that organization, and the various items in each requisition will also be numbered serially. When passed by the proper authority, G-1, G-4, or the commanding officer, respectively, a copy of the requisition will he returned to the proper supply officer of the organization, one copy will be sent to the chief, of the proper service, Services of Supply, and one to the proper depot.
30. Articles called for on requisitions which remain unfilled for considerable periods are frequently duplicated on later requisitions submitted by the same organization, thereby leading to duplicate shipments of material or supplies to the organization making the requisition. In order to obviate this depot officers will telegraph organizations whose requisitions have not been filled 15 days after the date of the requisition, notifying the organization that the requisition has been received and that the articles therein requested which have not been shipped will be shipped as soon as available, or giving all approximate dale, if possible, when the articles will be furnished. When a depot can not fill an entire requisition, the depot officer shall notify his chief of service, Services of Supply, of the items he can not supply, giving organization, requisition number, and item number. A copy of this notice shall be mailed to general headquarters (G-4) by the depot officer. The chief of service will immediately arrange to supply that depot with such articles, and when they are received the requisition will be filled. In case the need for articles which have been requisitioned and not furnished ceases to exist, the officer submitting the requisition will at once notify the supply depot holding the requisition and request the cancellation of the articles not required. Organizations will not duplicate on requisitions articles which they have called for on previous requisitions, except as provided in the following sentence: Supply officers may, from time to time, include in requisitions all items unfilled at that (late, indicating opposite each item the fact that they were originally requested on requisition of certain number, but not furnished, and requesting that all unfilled requisitions be canceled.
31. The accuracy, necessity for, and sufficiency of these requisitions rest upon the regimental or other similar commander. The final responsibility rests with the division commander.
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32. Corps troops and army troops send their requisitions direct to corps and army headquarters, respectively, and a similar procedure is followed for each class of supplies as outlined above.
33. Pending the establishment of army headquarters, the functions herein prescribed for army headquarters will be performed by the corps.
34. The chiefs of the various services of supply will so organize their offices that they will be free to make frequent inspections of the establishments of their departments in all parts of the theater of operations, with a view of reporting upon any unauthorized use or abuse of equipment, supplies, or materials, or any undue accumulations of the same beyond reasonable needs.
METHOD OF SUPPLY IN REAR OF ADVANCE SECTION, SERVICES OF SUPPLY
35. Units in the Services of Supply in rear of the advance section will obtain their equipment and supplies in the following general manner, the details of which shall be prescribed by the commanding general, Services of Supply:
(a) Articles of classes 1, 2, and 3 will be issued by supply depots on requisitions made direct to them. All requisitions will show amounts on hand, and no surplus over the authorized allowances will be requisitioned for.
(b) Requisitions for equipment or supplies, class 4, including all those for construction work, will be submitted to the chief of the service of supply concerned, who will, after approval, send them to the proper depot for filling. Credits for material for approved construction projects may be placed at the disposition of the officer in charge. These will be handled within the Services of Supply in a manner similar to that prescribed for credits given to army headquarters.
[For official circulation only] General Orders, No. 130
GENERAL HEADQUARTERS
AMERICAN EXPEDITIONARY FORCES,
France, August 6, 1918.
1. The following basic principles to govern future development of the Services of Supply are announced:
(a) While proper organization and direct control of all efforts to a common end require that the Services of Supply function in accordance with general plans formulated by the general staff of the American Expeditionary Forces, the commanding general of the Services of Supply is charged with all questions of automatic supply under approved policies of the American Expeditionary Forces.
(b) The problems of supplying these forces will be understood to embrace the requisitions by heads of supply departments, or purchase through the general purchasing board; the discharge and transportation of supplies by rail and water; the chartering and requisitioning of vessels; the necessary construction of facilities for these purposes; the procurement of personnel or the exchange thereof with the United States.
(c) Conforming to letters of instruction issued to him from time to time the commanding general of the Services of Supply is charged with the development of port facilities, storage facilities, railroad transportation, and the allotment of tonnage.
(d) Large questions of policy, including those concerning new types and new scales of equipment, except for Services of Supply troops; the immediate control of military transportation and supply in the zone of the armies, and the determination and control of war material will remain in the hands of the general staff of the commander in chief and subject to his direction and approval.
(e) Heads of supply departments, as such, will carry on their activities under the immediate direction of the commanding general, Services of Supply.
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QUANTITIES OF MEDICAL AND HOSPITAL SUPPLIES PURCHASED
DURING THE PERIOD APRIL 6, 1917, to NOVEMBER 11, 1918
906
POST MEDICAL SUPPLIES - continued
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POST MEDICAL SUPPLIES - continued
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POST MEDICAL SUPPLIES - continued
909
POST MEDICAL SUPPLIES - continued
910
POST MEDICAL SUPPLIES - continued
911
POST MEDICAL SUPPLIES - continued
912
POST MEDICAL SUPPLIES - continued
913
POST MEDICAL SUPPLIES - continued
914
POST MEDICAL SUPPLIES - continued
915
POST MEDICAL SUPPLIES - continued
916
POST MEDICAL SUPPLIES - continued
917
POST MEDICAL SUPPLIES - continued
918
POST MEDICAL SUPPLIES - continued
