Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply
CHAPTER XV
COMBAT EQUIPMENT
The term combat unit, as used herein, covers all the equipment, by whatever name it may have been known, issued to the unit of medical personnel, on duty with or definitely attached to a regiment or smaller unit of combatant troops in the field or in combat, to be used in the performance of its mission. It does not cover articles issued to the various personnel of the medical establishment for their individual use and designated individual equipment. The former is the equipment of the unit, the latter, of the individual, as described in the preceding chapter.
The first essential of medical combat equipment is that it shall contain ample quantities of surgical appliances and dressings for the effective administration of the primary treatment of the wounded with the minimum of delay and preparation. They must be ready for immediate use. To apply them must require the minimum of time, preparation, and manipulation. The second requirement is that the equipment shall be sufficiently light and compact to be suitable for the limited available transportation. This requires a very careful selection. The third requirement is that the equipment shall be made of the most durable materials consistent with its function in order that it may withstand the rough usage to which, from the nature of its service, it must be called upon to meet in the field. To meet these requirements great care must be taken in design and manufacture of the equipment. A sufficient quantity of dressings must be provided to meet the emergency until replenishments can be received from the supply train. These dressings must be sterile and ready for application even by the untrained. They must also be as small in bulk as is compatible with their purpose.
For several years after the Spanish-American War, the regimental hospital equipment was issued to all large posts, particularly those having the headquarters of the regiment. These hospitals by frequent inspection were kept in instant readiness for field service. After 1911 they were reduced to regimental infirmary equipments which provided dispensary service only. All patients requiring hospitalization were sent to the camp or field hospital. Greater prominence was given the first-aid station equipment. As the functions and limitations of the regimental medical detachment in the field and in combat came to be better understood and the difficulties of field transportation were more fully comprehended, it became desirable further to modify the regimental equipment. The mission of the regimental detachment is twofold: The administering of first aid to the wounded on the battle field and the collecting of such wounded into groups in the protected places preparatory to their evacuation to the hospitals in the rear; the furnishing, in camp and on the march, of dispensary service to the members of the regiment to which it is attached. The equipment of the regimental infirmary was adapted to these two missions and could fairly well be separated into two groups corresponding to these missions.
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Accordingly, it was decided to form two unit equipments instead of one, augmenting each unit as was necessary to adapt it the more adequately to its particular mission. The unit intended for use on the battle field was called a combat equipment. The amount of equipment varied with the different arms of the service, although the component elements were the same in all.1 One such combat equipment, the contents of which are shown in the following paragraphs of the Manual for the Medical Department, was authorized for and issued to every regiment.
M.M.D. 866. Regimental combat equipment
M. M. D. 867. The following articles are not kept in the depots as a part of the regimental combat equipment, but must be obtained by the regimental surgeon from the proper supply department as indicated for each item under “Source”:
Chart
That part of the equipment or unit intended to furnish supplies for dispensary service was denominated a camp infirmary.2 It was intended primarily for
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service in camp, hence its name. It consisted essentially of medicines, surgical dressings, and materials for holding sick call. One of these camp infirmaries was issued to each regiment in time of peace, and a wagon from the divisional sanitary train was assigned to transport it.3 This equipment was required at all times to be kept in instant readiness for field service. In addition to the camp infirmary equipment and supplemental to it there was provided a unit equipment composed largely of ward and mess equipment which, when added to the infirmary, constituted a regimental hospital.4 This supplementary unit was issued only when the regiment Was on duty apart from other regiments. The complete equipment, then, gave the regiment full paraphernalia for the care of the sick and wounded pending their evacuation to more permanent hospitals.
It was thought, also, that conditions frequently would arise when the quantities of medicines and surgical dressings in the camp infirmary would prove inadequate. To meet these conditions another unit, called the camp infirmary reserve, was provided.5
When regiments were assembled in divisions it was contemplated that an infirmary service would be established on the basis of one infirmary to each brigade. The director of ambulance companies was to be charged with the establishment and maintenance of the infirmaries for the replenishment of the supplies and for the enlisted personnel permanently assigned to them.6 The number of camp infirmary equipments required for the infirmary service of the division were to be transferred, under instructions from the division surgeon, to the director of ambulance companies. The remaining camp infirmary equipments were to be transferred to the medical supply officer of the camp to be held in reserve.6 The infirmary service proper was to be under the immediate charge of the senior medical officer of the organizations served by the individual infirmary. Each organization was to be responsible for its own infirmary service and definite hours in the day were to be set aside for sick call for the variousunits.7
Surgical dressings and similar articles expended from the combat equipment during combat were to be replenished from the reserve supplies of the nearest ambulance company or camp infirmary. For these replenishments formal requisitions, invoices, and receipts were not required. Provision was made for the transfer of supplies to the regiment from other Medical Department units. Invoices and receipts were required in the transfer of nonexpendable articles.8
When the strength of the companies of Infantry was increased to 250 men in the fall of 1917,making the strength of the battalion equal to that of the pre-war regiment, it became necessary to provide additional medical combat equipment. This was effected by providing each battalion with a regimental medical combat equipment and increasing the allowance of litters.9 The number of combat equipments required for a division at war strength was 30.10 The size of the medical detachment assigned to the regiment was increased in conformity with the increase in the strength of the regiment. Litters were issued on the basis of 2 percent of the strength of the command, and carried for the most part on the combat wagons and trucks. The ambulance boxes
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of surgical dressings also were issued in accordance with the strength of the command and their prospective casualties. The equipment as issued in 1918, and its distribution in the regiment is given in the following War Department table of equipment, May 14, 1918.The contents of the various boxes, cases, chests, etc., specified in the table of equipment, and as listed in the Manual for the Medical Department, 1916, are given immediately after it.
TABLE40. - Medical Department, attached to Infantry division organizations
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M.M.D. 932, Chest, medical and surgical
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M.M.D. 941, Desk, field no. 2
M.M.D. 954, Surgical dressings, ambulance box of
M.M.D. 955, Surgical dressings, box of
The major part of the combat equipment was intended to provide the needed facilities for the first-aid dressing station. The articles required for this station. The articles required for this station were designated aid-station equipment. For a number of years pack animals had been regarded as the most suitable means of transportation for the aid-station equipment. Pack transportation had many advantages in the field, especially in mountainous and rough country. The mule is sure-footed and can negotiate ravines and trails inaccessible to any form of wheeled.
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transport. Since the Army was engaged for many years in controlling the hostile Indians on the western frontier, where dependence had to be placed much of the time on pack transportation, the adoption of pack-animal transport for the aid-station equipment was but natural.
FIG. 5.- Medical cart
Carrying the aid-station equipment on a pack mule still left a part of the combat equipment to be transported in some other manner. Since an animal can always pull on a wheeled vehicle much more than it can carry and since the territory in which the Army was expected to operate in Europe was well provided with good roads, it was decided to substitute a cart for the pack saddle in which to transport the combat equipment. It was at first contemplated that the pack saddle would be carried in the cart with the rest of the equipment. The cart was to be hauled to some point near the lines. There the mule was to be unhitched from the cart, saddled, and used as a pack animal to carry the aid-station equipment to the point where the station was to be established. This increased the size and weight of the cart. Ultimately the packsaddle was omitted entirely from the combat equipment of Infantry regiments but retained for the transport of veterinary supplies for the train headquarters and military police.(See table of equipment quoted above.) The general appearance of the medical cart and the method of packing its contents are shown in Figures 5 and 6. This cart was built of standard wagon parts for facility in assembling and for replacement of spare parts. It was found to be very substantial and entirely capable of carrying its prospective load, but too heavy, when loaded, to be drawn by a single mule. A device was placed on the right side of the frame to which another animal could be hitched to help pull the load. The cart was remodeled in 1918. Its weight was reduced,
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and the body was shortened. These carts, with their harness and animals were supplied by the Quartermaster Corps.
CAMPINFIRMARY EQUIPMENT
When the troops were sent to the concentration camps in the fall of 1917 they were furnished an outfit for dispensary or infirmary service as noted in the chapter on camp medical supply depots. This was done in order that the combat equipment might be maintained intact. It was intended that the combat equipment be entirely separate and apart from the infirmary. So long as the troops remained in the concentration or training camps these infirmaries furnished the necessary supplies for regimental use. These infirmary equipments were left behind when the divisions embarked for overseas service. When the troops began to arrive in France and to he billeted in towns and villages, the need for even more extensive infirmary service immediately arose. Often only a single battalion could be billeted in a town, and the contents of the combat equipment soon became exhausted. To provide supplies for this extended infirmary service, eight camp infirmary equipments were issued to
FIG. 6.- Method of packing contents of medical cart
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each division.9 The commander in chief, A. E. F., requested that each battalion be provided with a regimental hospital equipment, but accepted camp infirmary and camp infirmary reserve as a substitute for the hospital.11 The regiments, thereafter, were issued 1 combat equipment, 1 camp infirmary, 1 camp infirmary reserve, and a medical cart for each battalion, with litters and surgical dressings in accordance with the strength of the command. The contents of the camp infirmary followed by those of the camp infirmary reserve appear below.
M. M. D. 869. Camp Infirmary
M.M.D.870. The following articles are not kept in the depots as part of the camp infirmary equipment, but must be obtained from the proper supply department as indicated for each item under "Source."
Chart
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M.M.D., 873, Weight carried by camp infirmary wagon
CAMP INFIRMARY RESERVE
M.M. D. 871. The articles listed below do not form a part of the regular equipment of the camp infirmary, but when a camp infirmary is serving with divisional troops under conditions which, in the opinion of the division surgeon, make it necessary or desirable to have within the division an additional supply of medicines and dressings for the sanitary troops on duty with line organizations or for the infirmaries themselves, the following articles will be procured on requisition and carried on each camp infirmary wagon. (See par. 633.b)
These supplies belong in equipment "A".
Medicines and antiseptics
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Medicines and antiseptics continued
REPLENISHMENTS
The quantities of the component articles of the combat equipment, camp infirmary, and camp infirmary reserve prescribed in the tables above quoted were intended to meet service requirements and to keep the wheeled transport at the minimum consistent with efficiency.12 The supplies allowed in these units were calculated on the basis of replenishment at 10-dayintervals from the line of communications.13 Formal requisitions, invoices, and receipts were not required in the combat zone. No accountability was required of regimental medical units. The divisional medical supply officer was accountable for the nonexpendable articles and dropped from his return the expendable articles as issued. A memorandum receipt was given for nonexpendable supplies and an informal receipt for expendable supplies. These receipts were kept by the divisional medical supply officer to show the disposition of the supplies for which he was accountable.
QUARTERMASTER AND ORDNANCE SUPPLIES
It will be noted in the list of contents of the combat equipment and camp infirmary quoted above that numerous articles were issued by the Quartermaster Corps and several by the OrdnanceDepartment.14 In assembling unit equipment at the medical supply depots for a number of years prior to 1917 the required articles furnished by those departments were incorporated into the unit so that it could be issued complete. This was made possible by the cooperation of those departments. Having the complete unit assembled at one place facilitated its distribution. The demands for supplies of all kinds were so insistent, the quantities required were so large, and the available supply so limited during 1917 that this method could not be carried out. The
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War Department charged each supply branch with the duty of providing its own equipment for all units at the camps and other points of ultimate issue.15 This made it necessary for the medical units of the division to requisition directly upon the Quartermaster Corps and the Ordnance Department for the articles furnished by them, respectively. The same rule covered unit equipment shipped to France for replacement and reserve. After the authorization of divisional medical supply officers the inconveniences of this triple source of supply were somewhat reduced, since the units of the sanitary train looked to that officer to secure for them the needed equipment and supplies. The regimental medical units looked to the regimental unit supply officers for their quartermaster and ordnance equipment.16
REFERENCES
(1) Manual for the Medical Department, U. S. Army, 1916, pars. 866-867.
(2) Ibid., pars. 869-870.
(3) Ibid., par. 657.
(4) Ibid., par. 872.
(5) Ibid., par. 871.
(6) Ibid., pars. 658-659.
(7) Ibid., par. 663.
(8) Ibid., par. 551.
(9) Letter from the Surgeon General to the division surgeons of all National Army camps, December 23, 1917. On file, Finance and Supply Division, S. G.O, 551 N.A./76.
(10) Letter from the Surgeon General to the division surgeon, Camp Sherman, Chillicothe, Ohio, March 2, 1918. On file, Finance and Supply Division, S. G.O., 531-128/76.
(11) Cable No. 211, Headquarters, A. E. F., October 10, 1917,par. 4; Ibid., No. 279, November 12, 1917, par. 5.
(12) Manual for the Medical Department, U. S. Army, 1916, par.857.
(13) Ibid., par. 858.
(14) Correspondence between the officer in charge, Medical Supply Depot, St. Louis, Mo., the Surgeon General, the Quartermaster General, and the Chief of Ordnance, in March and
April, 1917, relative to quartermaster and ordnance supplies for field units. On file, Finance and Supply Division, S. G. O., 14066-S-T.
(15) General Orders, No. 96, War Department, July 23, 1917, and No. 137, October 30, 1917.
(16) Army Regulations 681-I (C. A. R. No. 56, May 10,1917).