Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply
CHAPTER XVII
EVACUATION HOSPITAL
The Medical Department units necessary to an army in the field are those with the combat troops, and those primarily of the line of communications or communications zone. To the units with combat troops belong the medical units of the division already considered. They are integral parts of the division and are required wherever the division may be, in camp or in combat, whether operating alone or combined with other divisions into corps and armies. When combined into corps and armies other medical units of like organization are attached to the corps or army for service with corps or army troops not parts of divisions. They also constitute a reserve which may be used by the chief surgeon of the corps or army whenever it is necessary to augment the units of the division. To the units of the line of communications, or communications zone, belong evacuation hospitals and base, camp, and convalescent hospitals.
The evacuation hospital is essentially mobile and it follows closely in the rear of the divisional units.1 Its primary function is to relieve the field hospitals after combat either by taking over the patients and equipment in situ, with an exchange of equipment, or by transfer of the patients alone.2 The evacuation hospital may be established during the battle in sufficiently close proximity to the battle field to receive patients directly from the ambulance, dressing, or collecting stations. In which event it serves as an adjunct to the divisional field hospital and takes its place. In either event its presence permits the division field hospitals to clear promptly and proceed with the division of which they are a part.2
The equipment of an evacuation hospital is much more extensive and complete than that of the field hospital. It moves only when its presence is required by reason of a battle. It may be transported by animal-drawn transportation, by motor truck, or by rail. It is usually established near a rail head 3 and is more apt to move by rail than by other means of transportation. Its equipment, while not nearly so comprehensive as that of the base hospital, is sufficiently complete to provide effectual treatment for the sick and wounded with a reasonable degree of comfort.4
The treatment administered at evacuation hospitals is ordinarily as complete as the existing condition will admit. If the wounded are coming in rapidly and in large numbers, the surgical treatment must be limited to emergency operations, the treatment of shock, and the better preparation of the wounded for transport. If the wounded arrive slowly, in small numbers, and an early move of the hospital be not in prospect, complete operative treatment may be given even during the battle.5
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The equipment provided is of the field type, essentially the same as that of the field hospital. It is more comprehensive than the latter and more extensive since it is intended to care for a greater number of patients. As originally planned, the equipment provided for324 patients and was considered commensurate with its mission.6 This equipment was first introduced into the supply table of the Medical Department in 1911.7
During the years 1912-1916 such changes were made in the equipment of the evacuation hospital as changes in standard field equipment and a more adequate conception of its mission indicated. These changes were generally along the lines of simplicity, durability, efficiency and portability of equipment. Better designs were effected. Improved articles were substituted. New articles were added to provide better treatment. Unnecessary articles were eliminated. The normal bed capacity of the evacuation hospital was expanded from 324 in 1911 to 450 in 1916.4 The weight of the equipment of 1911 was, medical, 40,166 pounds; quartermaster, including tentage and camp equipment but exclusive of transportation, 24,654 pounds;8 aggregate, 64,820 pounds. This equipment required for its transportation 17 standard trucks or two standard freight cars, which were not completely filled.9 The weight of the 1916 equipment under the same conditions, although providing for 450 patients instead of 324, was, medical, 34,663 pounds; quartermaster, 19,275 pounds; total, 53,938 pounds.10
Observations in the theater of operations in 1917 convinced the chief surgeon, A. E. F., that the standard equipment of the evacuation hospital would be inadequate to the conditions of warfare then existing.11 The battle lines were more or less fixed by reason of the trench warfare which then obtained. Moves of the evacuation hospital were of comparatively infrequent occurrence. Evacuation hospitals took on more and more the functions of base hospitals; they became the hospitals of the sector where a great deal of major surgery was done. Because of a steady flow of casualties in comparatively large numbers, it became necessary to expand these hospitals and to augment their equipment as to both quantity and variety.12 The capacity of the evacuation hospital was increased to 1,000 patients, with an emergency expansion to 2,000.13 The following list shows the initial equipment of a 1,000-bed evacuation hospital:
List of medical supplies for the initial equipment of 1,000-bed evacuation hospital (overseas)
MEDICINES, ETC.
From: The Adjutant General of the Army.
To: Commanding generals of all National Army, National Guard, and Regular Army divisions, all department commanders, and chiefs, supply bureau.
Subject: Allowance of quartermaster supplies for base and evacuation hospitals for overseas duty.
The authorized equipment for base and evacuation hospitals for overseas duty is as follows:
Axes, with helves...............................................................................10
Pickaxes, with helves.........................................................................3
Bags, water sterilizing........................................................................8
Pot, marking................................................................................1
Brush, marking....................................................................................1
Rakes, steel..................................................................................8
Bugles, with slings.............................................................................2
Ranges, No.5.....................................................................................5
Flag: Shovels, shorthandle.......................................................................3
Distinguishing, Red Cross............................................................1
Spades..........................................................................6
Halyards for.....................................................................................2
Stick, size show..................................................................................1
Nationals torm.................................................................................1
Stretcher, shoe..............................................................................1
Lamp black...................................................pounds....................2
By order if the Secretary of War:
F.W. SENN, Adjutant General.
WAR DEPARTMENT,
THE AJUTANT GENERAL`S OFFICE
Washington, June 3, 1918
From: The Adjutant General of the Army
To: Commanding generals of all National Army, National Guard, and Regular Army Divisions, all department commanders, and chiefs of all supply bureaus.
Subject: Authorization of cooking utensils, etc., for issue with No. 5 Army range for base and evacuation hospitals for overseas duty.
The following articles are authorized for issue with No. 5 Army range:
Boilers: Grinder, meat............................................................................................
1 Round, one 6-gallon, one 15-gallon, and one 8-gallon............
2 Knives, butcher, 10 inch.......................................................................
2 Square; one 10-gallon, one 15-gallon, and one 20-gallon.........
3 Pans, bake, one Army range, No.5, large, and one No. 578 large....
2 Buckets, galvanized iron, 12-quart...................................................
2 Pans, frying, one 12-inch and one18-inch..........................................
2 Cake turners.............................................................2 Pan,dish,21 quart...............................................
1 Cans, garbage...................................................................
3 Saw, meat, 22-inch blade.........................................................
1 Can openers......................................................................
2 Sieve, flour................................................................................................
1 Cleaver, 8-inch.....................................................................................
1 Skimmers, large.........................................................................................
2 Dippers, 2-quart...................................................................................
3 Spoons, large............................................................................................
3 Forks, meat, large.................................................................................
3 Steel, butcher, 12-inch.............................................................................1
The bake pans listed above are in addition to the two bake pans which are issued with and form part of the No. 5 Army ranges.
By order of the Secretary of War:
F.W. Senn, Adjutant General.
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As elsewhere described (p. 251) the Medical Department`s system of supplying troops in the field contemplated a unit of equipment commensurate with the function of the unit of medical personnel for which it was provided. The introduction of the evacuation hospital having been determined in 1911, measures were instituted for the development and assembly of the prescribed equipments. These equipments were assembled complete through the cooperation of the Quartermaster and Ordnance Departments and were placed in storage.14 Only articles which deteriorated readily were omitted from the assembled equipments. It was intended to supply these articles from fresh stock when the unit was placed in service. To each unit, as it was assembled, was assigned a number from 1 upward.15 Every package of equipment or supplies pertaining to this unit bore the unit number in addition to the other necessary markings. When the assembly was completed, the unit was taken up and carried on the property returns as one evacuation hospital. All papers required for the shipment and transfer of the property, medical, quartermaster, and Ordnance, were prepared at the same time and kept ready for use against the issue of the particular unit equipment. By the end of June, 1916, 20evacuation hospitals had been assembled and stored at medical supply depots within the UnitedStates.16 In addition two equipments each had been furnished the Philippine Department and the Hawaiian Department.16
At the end of March, 1917, there were in storage at El Paso, Tex., 9 evacuation hospital equipments, with 10 more at San Antonio, Tex.17 When it became necessary to provide medical equipment for the troops in the first convoy of American Expeditionary Forces scheduled to sail June 1, 1917, a base hospital equipment complete, with iron bedsteads and hair mattresses, and four evacuation hospitals were shipped from El Paso to Hoboken, N. J.18 Information of the contemplated movement and of the date of departure was received in the Surgeon General’s Office during the forenoon of May 19. A telegram was dispatched to the medical supply officer at El Paso the same date to make the shipment.18 These supplies, loaded in 17 cars, left El Paso, Tex., at 8:45 p. m., May 23. Twelve cars arrived at Hoboken at 8:45 pm, May 28, two cars arrived at 11 a. m., May 29, and three cars at 6 p.m., May 29. 19
The evacuation hospital equipments in storage at El Paso and San Antonio were all of the 1911model. After the dispatch of these to Hoboken on May 23, the equipments remaining at those depots were remodeled to conform to the 1916 supply table and shipped to Hoboken between July 1 and December 31, 1917, en route to France. Additional equipments were shipped to France from time to time as required. They were assembled as to medical equipment at the field medical supply depot in Washington. In accordance with the plan of supply adopted by the War Department, articles supplied by other departments were shipped by those departments to the irrespective depots in France, from which they were to be obtained on requisition as required. In August, 1918, there were 28 assembled evacuation hospital equipments on hand at the field medical supply depot, Washington. 20 During August, September, and October, 1918, 54 such equipments were shipped to France and 1 to Siberia.21 The
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shipment to France of tentage with these equipments was discontinued early in March, 1918, pursuant to cabled request from the commander in chief.22
The cost of one evacuation hospital, augmented as requested by the chief surgeon, A. E. F., in 1917, and as further expanded upon cabled request of the commander in chief, was approximately $98,751.69.23 The cost of the equipment as listed in the supply table of 1916 was much less. The cost of the units assembled in 1917-18, practically all of which were shipped to France, was, therefore, approximately $8,690,148.72.
The number of evacuation hospitals assembled and issued during 1917-18 was 89, 86 of which were shipped to the American Expeditionary Forces.
REFERENCES
(1) Manual for the Medical Department, 1911, par. 704, and 1916, par. 793.
(2) Ibid., 1911, par. 695, and 1916, par. 795.
(3) Ibid., 1911, par. 700, and 1916, par. 796.
(4) Ibid., 1911, pars. 847-856, and 1916, pars. 891-892.
(5) Ibid., 1911, par. 706 (a), and 1916, par. 800.
(6) Ibid., 1911, par. 851.
(7) Ibid., 1911, par. 560.
(8) Ibid., 1911, pars. 847-856 (last line of each paragraph).
(9) Data compiled at El Paso, Tex., 1916, for the author, in his personal possession.
(10) Manual for the Medical Department, 1916, pars. 891-892 (last line of each paragraph).
(11) Par. 3, cable No. 322, H. A. E. F. in France, November 27, 1917.
(12) Letter from the chief surgeon, A. E. F., in France, to the Surgeon General, November 23, 1917. Subject: Evacuation Hospital Equipment. On file, Finance
and Supply division, S. G. O., 250-F.
(13) Par. 5-A, cable No. 949, H. A. E. F. in France, London, April 19, 1918.
(14) General War Plans of the Medical Department, March 9, 1914. On file, Record Room S. G. O., 93360-I.
(15) Manual for the Medical Department, U. S. Army, 1916 par. 793.
(16) Preparedness for the Medical Department for War, an address delivered November 16, 1916, at the Army War College by Lieut. Col. Henry C. Fisher, M. D. Copy on file,
Finance and Supply division, S. G. O., 12709-G.
(17) Letter from the department surgeon, Southern Department, to the Surgeon General, July 14, 1916, relative to evacuation hospitals, and action taken thereon. On file, Finance
and Supply Division, S. G. O., 13256-211.
(18) Telegram from the Surgeon General to the Medical Supply Officer, El Paso, Tex., May 19, 1917, to ship supplies to France. On file, Finance and Supply Division, S. G. O.,
14778-C.
(19) Letter from the Quartermaster General to the Surgeon General, May 29, 1917. Subject: Arrival of medical supplies. On file, Finance and Supply Division, S. G. O.,
14778-C (QM 523.12-T).
(20) Memorandum for Colonel Wolfe from the officer in charge, Field Medical Supply Depot, Washington, D. C., August 20, 1918, relative to supplies on hand. On file, Finance
and Supply Division, S. G.O., 713-750 Wash. D./360.
(21) Data furnished the Surgeon General’s Office, August 26, 1919, by A. S. Lucas, Field Medical Supply Depot, Washington, D. C.. relative to shipments of assembled units to
France in 1918. On file, Finance and Supply Division, S. G. O., 713-750 Wash. D./360.
(22) Cablegram No. 733, H. A. E. F. to The Adjutant General, Washington, March 16, 1918, par. 3.
(23) Data compiled in the Surgeon General’s Office, during 1918, and in possession of the author.
