Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply
CHAPTER XVIII
LITTERS AND LITTER CARRIERS
LITTERS WITH SLINGS
The specifications for litters with slings purchased during 1917-18 are given below. The appearance of the litter is shown in Figure 7. The number of litters purchased during the same period is given in the table following the specifications.1 The prices in that table do not in all cases represent the total cost of the finished litter. Some of the materials were furnished by the Medical Department, and the cost of such materials is not reflected in the prices given.
All litters purchased during the years 1917-18 for the United States Army were purchased by the Medical Department through the field medical supply depot, at Washington, D. C.
SPECIFICATIONS FOR LITTERS WITH SLINGS
Parts - Each litter to be composed of the following parts:
2 side poles.
1 canvas cover.
2 sets of stretchers or braces complete, with pole pieces, etc.
2 litter straps with screws, washers, and studs.
2 litter slings, complete with rings.
Side poles. - Two in number, to be made of best quality, well-seasoned, straight-grained ash, 7 feet 6 inches long, 2 inches thick, 1 ½ inches wide, with all angles slightly rounded off, hand smoothed, sandpapered, and nicely worked. The upper part of the outer surface of each pole, at the attachment of the canvas, to he shaved away riot more than 1/8 inch deep and 1 inch wide so that the surface of the applied canvas and the heads of the tacks attaching it shall be flush with the lower unshaved part of the said surface. Commencing 9 inches from each end, the poles will be rounded into handles; diameter of handles at the base, 1 ½ inches, sloping to 1 inch in diameter at the ends. The poles to be filled with one coat of liquid filler, rubbed in, and then receive two coats of hard oil finish. Each pole to be free from defects of any kind that will impair its strength.
Canvas cover.- To be made of United States Army standard, waterproofed, khaki-colored canvas, 28 ½ inches wide, weighing not less than 12 ounces to the linear yard; canvas to contain not less than 56 three-ply threads in the warp and not less than 34 two-ply threads in the filling per inch of width, and capable of sustaining a strain of at least 150 pounds in the warp and 100 pounds in the filling to the ½ inch of width, same tested in the piece. Litter covers to be 6 feet 2 inches long by 2 feet 4 ½ inches wide; at each end 1 inch to be turned under and at each side 2 1/8 inches to be turned under, all turned under parts to he neatly sewed with best quality, heavy, khaki-colored linen thread, 7 stitches to the inch. The canvas, thus formed, to be evenly tacked to the shaven surfaces of the litter poles so that when the litter is opened the canvas will he thoroughly stretched and measure on its upper surface 6 feet by 22 inches in the clear. Tacks used to be 10-ounce, round head, japanned, same spaced 1 inch apart.
Stretchers or braces. - Each litter to be provided with two complete stretchers or braces; stretches to be secured to the litter poles 24 inches from their ends, four 1-inch No. 14 flathead bright iron screws being used in each pole plate; screws to be driven with a screw driver and not hammered. Stretchers to be so placed that when the litter is closed the
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FIG.7 - Litter with slings.
braces of the stretchers project lengthwise toward the center of the litter immediately between the approximated poles. Each brace to consist of two poles plates with a stirrup or foot piece, same joined by two movable spreaders. The legs or feet to be stirrup shaped, extending 4 inches below the supporting surf ace of the pole plate to which they are attached. Each pole plate is 5inches long, and has, on the outer part of the end toward which the braces fold, a ¼-inchprojecting lug to keep the spreader pieces in position when the braces are closed. The pole plate is turned up at right angles on each side 7/8 inch. The pole plate has five apertures, as follows: One, 3/8 inch in diameter for the bolt on which the movable spreader arms play, same countersunk on the upper surface to make the largest diameter of the opening 5/8 inch; sides of the countersunk area sloping at an angle of 45°; four holes, countersunk on the outer surface of the pole plate, of suitable size for a No. 14 flathead wood screw, two holes to be on the bottom plate and one on each side plate as in standard. The loop of the stirrup, 1 ¾ inches wide near the pole plate, widening out to 3 5/8 inches at its widest part, about ¾ inch from the footplate. The blades forming the loops are each 7/8 inch broad at the neck, expanding to 1 inches where they conjoin to form the footplate, which is somewhat convex in every way to give a broad support. Spreaders to be of steel forging, each consisting of two pieces, playing at their outer ends on the bolt in their respective pole plates, and hinged by a ¼-inch steel bolt at the junction of their inner ends. Each piece is formed from a bar of steel forging ½ inch wide by 5/8 inch deep. The outer end of each to be flattened, as in standard, to facilitate movement
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on the pole plate. The inner end of one projects about 2inches beyond that of the other, which item braces, to strengthen the joint when the braces are opened, both pieces being bored to receive a ¼-inch bolt. The hole in the embracing piece to be countersunk on it supper side. This joint to be fenestrated, as in standard, to prevent choking by mud and dirt. The bolt or pivot by which the spreaders are attached to the pole plates is 3/8 inch in diameter, and has a head 1 inch in diameter by 1/8 inch thick. It should be of sufficient length to pass through the spreader and pole plate and allow of riveting down flush to fill the countersunk area on the pole plate. The bolt joining the inner ends of the spreaders is of steel, ¼ inch in diameter, having an oval head ½inch in diameter on one end. It should be of sufficient length to passthrough the interlocking spreader arms and allow of riveting down flush to fill the counter sunk area on the outer spreader. From the center of the pole plate to the center of the rivet which hinges the spreader arms each measures 10 ¼ inches. The whole brace, when stretched, should measure22 inches between the outer faces of the litter pole rests in the pole plates. All metal work in the stretchers or braces to be thoroughly tinned.
Litter straps. - A fastening for the closed litter to be provided by means of two straps made of best quality, oak-tanned, russet leather, 12 inches long by ¾inch wide. One strap to be attached by one end to the under surface of one pole 1½ inches from the shoulder of the handle, the other strap to the corresponding part of the other pole at the opposite end; the attachment to be made by a ¾-inch, No. 7, round-head, blued-iron screw passing through a copper washer ½inch in diameter, the hole in the leather to be no larger than the neck of the screw and to be located ½ inch from the end of the strap. The reef end of the strap to be punched with a stud hole, same located 1 inch from the strap end and to measure inch by 5/8 inch. When the litter is opened the strap is intended to be under the pole and fastened to a standard-size stud placed at such a distance from the screw as required by the length of the strap. When the litter is closed, the straps are intended to be passed around the two poles from their point of attachment on the one to a stud which will be placed at a corresponding point on he other pole.
Slings - Each litter should he furnished with two carrying slings; sling made of best grade United States Army standard khaki-colored cotton webbing, 2 ½ inches wide; sling proper to be6 feet long in its greatest length, and made adjustable by means of a blued sliding buckle of drop-forged steel with a blued steel loop near one end, and provided at each end with a loop lined with good quality strap leather, loop to he 6 inches long. All straight stitching on slings to be machine work, 6 stitches to the inch, all free ends of stitching properly secured to prevent raveling. Yellow three-cord saddler’s thread (Barbour’s standard best Irish flax) or equal, to be used in all sewing, same waxed when used. To the buckle end of the sling will be attached a blued malleable-iron pear-shaped loop 3 inches long by 2 ½ inches wide in greatest width, pendant from the loop attached to the swivel. One pear-shaped iron loop, with sling attached, to be passed over the left front and one over the right rear handle of the litter. These loops are kept in place by rings fastened 4 ½ inches from the end of the handles by two cast-steel brads, No.17, ¾ inch long. These rings to be of malleable iron, turned on the inner surface, and having two holes at opposite sides for the admission of a No. 17 brad; outside diameter, 1¾ inches; inside diameter, 1 ¼ inches; thickness at turned surface, 3/8 inch.
Marking. - Litter will be marked as follows: On outer surface of canvas cover, 4 inches from one end in the median line, a standard size red cross will be stenciled. Just below this the letters “MED. DEPT., U. S. A.” in black 1-inch letters. Each litter will bear a name plate of brass whic shows in raised letters the name of the contractor and the date of the contract, plate to be securely tacked to one litter pole on its inner surface, about 2 inches from shoulder of handle.
Testing. - All litters when received at this depot will be subjected to a standard test as follows: The open litter will be supported at each end and a “live” weight of200 pounds will be applied at the midpoint of each pole. Poles must show a normal resiliency. Poles breaking under this test will be rejected.
Finish and workmanship. - Materials, workmanship, and finish of completed litter to be first class in every respect; finished litter to be equal to and like standard sample on display at this depot.
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Delivery. - Litters to be delivered to this depot neatly folded in the regulation manner, securely tied in bundles of four litters. Each bundle protected by burlap or other satisfactory wrapping.
MODIFICATIONS AUTHORIZED IN CONTRACTSOF 1918
Slings to be made with a loop of double webbing instead of leather lined.
Contractor’s name and date of contract stenciled on litter poles instead of brass plate being attached.
Burlap wrapping not necessary.
Laminated or Lin determined side poles, of equal strength and resiliency, may be substituted.
Cotton thread equal in strength to the linen thread may be used.
Tacks for fastening canvas to litters may be galvanized instead of japanned.
Stretchers must be secured to litter poles 14 inches from their ends instead of 24 inches as specified herein.
Spreaders to be made of malleable iron instead of steel forging.
All metal work in the stretchers or braces to be tinned or electro galvanized.
All hardware specified “blued steel” may be electro galvanized.
Duck and webbing (for slings) to be furnished by the Medical Department, United States Army, delivered to contractor’s works.
Litters
In loading patients upon ships for water transport and in unloading them at ports of debarkation, it becomes necessary to take the patients up and down steep stairways, through narrow passages, and around sharp turns.
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Often the ship’s hoisting machinery can conveniently be utilized in loading and unloading patients as well as supplies. These conditions demand a litter of different shape, structure, and design, to which the patient can be secured and in which he can be adequately protected while being so handled. Litters for this purpose and of a suitable type are required on all troop ships as well as on hospital ships. After the service at the two primary ports of embarkation had become well established it was considered advisable to provide all troop ships with suitable litters. The transports directly under the charge of the Navy were supplied with equipment by the Navy. The chartered transports were equipped by the Army. The type of litter developed and in general use in the United States Navy was selected for use on the transports and the requisite number was purchased and issued. This type of litter was commonly known as the Stokes litter (splint stretcher).
It is a galvanized-iron stretcher basket which has certain fixation apparatus attached to it.2 These consist of straps which pass over the patient’s chest, hips, and legs as he lies in the wire basket. A movable foot rest is provided on each side of the septum which divides the lower end of the basket into two big furrows for the legs of the patient. There are handgrips around the strong galvanized-iron frame which forms the upper margin of the basket. These may be used either for carrying the stretcher by hand or for attaching it by means of a bridle to a hoisting apparatus for lowering to or hoisting from a small boat.
THE SNOWSHOE TRENCH LITTER
In warfare of position where the forces engaged are protected by trenches with narrow passage and many abrupt turns at acute angles, the standard type of litter becomes inadaptable and a special type again becomes necessary. Each of the allied armies had developed its own type of litter to overcome the difficulties incident to this kind of warfare. A type of trench litter known as the snowshoe litter was devised by one of the medical officers with the American
Expeditionary Forces and is considered to have sufficient merit to justify its description. It was accepted as the standard trench litter for the United States Army. Detailed specifications were prepared for it and plans made for the purchase of an adequate number of these litters in the autumn of 1918, but the warfare of position had given place to a warfare of movement before the plans for procurement had been fully completed. No purchase of considerable numbers was made.
LITTER CARRIERS
The fatigue experienced by litter bearers in removing the wounded from the battle field to the first-aid, ambulance, or collecting stations is great, and requires numbers of bearers out of proportion to the number of wounded. To overcome this condition, attention has been given from time to time during the past decades to the development of a wheeled device upon which the wounded could be placed and which could be pulled or pushed by the litter bearers from the places where the wounded men lay to a point where they could be placed in ambulances. The device must be light, durable, and easily transported. It must be so designed that the wounded may be placed upon it and taken off
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FIG.8.-Snowshoe litter.
without violence to the patient. It is desirable that it be constructed of materials which make repairs and replacements simple and easy.
At the time of declaration of war in 1917 no type of a wheeled litter or litter carrier had been adopted as standard equipment, nor had any such been purchased. The need for a wheeled litter carrier was early appreciated, and work was begun by the ambulance board to develop a suitable design; however, other duties incident to the procurement of supplies, and particularly ambulances, delayed the work for several months.
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FIG.9.-Field litter carrier in collapsed form.
After a suitable organization for the inspection of ambulances had been developed and the changes in ambulance design perfected, the development of the litter carrier was again taken up and carried to completion. It was found impracticable, in the developmental work on this subject, to combine in a single carrier all the essentials necessary to make it serviceable both in the field and in hospitals.3 Therefore, two different types were devised, the one for use in the field and the other for use in hospitals. The former was called the field litter carrier and the latter wheeled litter carrier.
FIELD LITTER CARRIER
Certain definite principles were observed in the development of this carrier. It must be durable, easily loaded, drawn by the minimum of effort, comfortable for the patient, and its essential parts must he interchangeable with other standard equipment. The desirable parts of wheeled litter carrying devices then in use were considered. Wherever the principle involved was applicable and advantageous it was incorporated in the devices which finally were developed. The earlier conceptions of a litter carrier contemplated a collapsible type; a type with a frame so designed and hinged as to permit the sides to come together in much the same manner as the members of a parallel ruler. When open the hinged parts were to lock securely and so prevent accidental collapse of the carrier. Photographs were submitted to manufacturers for suggestions as to stability and manufacturing difficulties.4 The principle was found to be impracticable and was abandoned in favor of the knockdown type. Collapsibility is essential only as a transportation requirement to point of use. It was concluded that in the field sufficient transportability would be had if the device could be successfully trailed behind an ambulance or other vehicle.
The types of litter carriers originally suggested contemplated a device upon which the litter could be placed and to which it could be clamped, the handles of the litter being used in propelling the carrier. After much consideration and many experiments, it was concluded that the same load could be pulled more easily than it could be pushed. The type developed
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FIG.10.- Field litter carrier in use.
under this idea contemplated a carrier with a bar so attached to the axle as to serve the same purpose as the tongue of a wagon; that is, a place to apply the tractive force and also to steer the vehicle. It was further decided that the carrier could be made to trail behind an ambulance by providing the end of the bar with a suitable eye to go over the pintle hook of the ambulance. The device was finally completed by the development of a suitable breast harness to be worn by the litter bearers and which would attach to the frame of the carrier. This harness, when in use, allowed the two bearers to walk beside the tongue of the carrier. For their further convenience in pulling the carrier, a projection or handle was attached at right angles to the front end of the tongue, in such manner that each bearer could grasp his end of it with both hands, enabling him to push as well as to pull if the need arose. In order to bring this handle bar to a height convenient for the bearers, the tongue of the carrier was approximately curved. The handle bars were hinged to permit them to be folded backward parallel with tongue when the carrier was knocked down and crated for shipment or when used as a trailer. A very ingenious device held them firmly in place when extended for use of the bearers.
It was found, after the plan of using the harness had been adopted, that two patients could be transported by two bearers without material effort and the design, as finally adopted, provided carrying places for two litters instead of one. To protect the wounded from the sun and rain and to some extent from gases, canvas curtains and cover were provided. These curtains and
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FIG.11.– Field litter carrier as a trailer.
cover were removable and could be detached whenever not required. The appearance of the field litter carrier, as finally adopted, taken apart for crating for transport, and its manner of use, is shown in figures 9 to 11.
While this litter carrier was in process of development, each succeeding model was given severe tests to determine its utility and stability. The weak points were strengthened, undesirable features were eliminated, and continuing and consistent effort was made to arrive at a type of carrier which contained the maximum of the good and the minimum of the poor features. The device finally evolved and adopted was the “survival of the fittest,” and was given every practicable test as to its utility. Motor cycle side-car wheels were adopted primarily for interchangeability of parts and the presence with the combat troops of the necessary spare parts, a very important consideration for military equipment in use so far from the home territory.
After this carrier had passed all the tests at the ambulance experimental station, Washington, D. C., a pamphlet of Tentative Instructions and Drill Regulations, with appropriate illustrations, was prepared for the litter carrier. This pamphlet was submitted to experienced medical personnel at several training camps for consideration and comment.5
The report from the commanding officer, motor units, section B, Camp Greenleaf, Ga., given below, on the carrier and the tentative drill regulations covering its use, is valuable as showing the utility of the device.6
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1. Submit report on field litter carrier designed for Medical Department, United States Army, and tentative regulations concerning same in accordance with your verbal instructions.
(a) Recommendation as to advisability of adding field litter carrier to the equipment of the Medical Department:
Recommend strongly uniform equipment of ambulance companies, both motor and animal drawn, with the field litter carrier upon a tentative basis of one to each four ambulances. Aside from the advantages which these vehicles offer of increasing materially the transport facilities of litter bearers and reducing the discomfort to the patient, the present design has certain advantages which are great and obvious. Among them may be mentioned:
(1) The field litter carrier may be attached to the adopted type of motor or animal drawn ambulance, or even motor cycle with side car, without materially increasing the load of that vehicle.
(2) The wheels of the field litter carrier are uniform type adopted for motor cycle side cars and can be procured from the general supply overseas.
(3) The harness attachment for the litter bearers is so devised that the weight is carried practically by the body of the advancing bearers and the handles are only used to steady the vehicle so that the greatest amount of work is performed with the least expenditure of energy.
(4) The carrier may be taken over rough ground, through underbrush, and both steep inclines and declines; is capable of being folded and carried over rough territory by two bearers.
(5) The cost of each vehicle is said to be less than $200, which sum is a very economical expenditure for the great possible good.
(b) Recommendation as to the tentative drill regulations:
In the absence of any opportunity to give these regulations a thorough test, the tentative instructions have been examined and are recommended as appearing to meet the needs of the service.
Alternate bids were requested early in June, 1918, for 150 and 300 field litter carriers and award was made to a motor company of Racine, Wis. Deliveries were scheduled to begin September 22, 1918, and to be completed at the rate of 60 per week, at a cost of $160.49 per carrier. An inspector was sent to the factory to supervise manufacture. Deliveries did not begin in sufficient time, however, for these carriers to reach the front in France before the armistice was signed and the need for them ceased. The utility of the device remains to he demonstrated. Theoretically the principle appears sound and the type gives much promise.
WHEELED LITTER CARRIER
As already noted, it was impracticable to develop a litter carrier useful alike in hospitals and on the battle field. A special type was required for each. The need for a suitable hospital litter carrier was felt as soon as the base hospitals at the several training camps began to function. A litter carrier had been found necessary in the general hospitals with their comparatively limited area; it was indispensable in the large base hospitals, scattered over so much greater areas. Litter carriers or carriages of the types illustrated in the catalogues of the various hospital supply houses were purchased and issued to meet this need.
None of the types of litter carriers on the market gave promise of meeting the overseas requirements satisfactorily, especially in evacuation and other
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FIG.12.-Wheeled litter carrier.
hospitals established near the front. The existent types of carriers were designed for modern hospitals with smooth floors and, consequently, had comparatively small wheels. It was concluded that a different type of carrier would be required for the emergency hospitals established near the front, where ruined buildings and tents with earthen floors must generally be used. Here larger wheels and a more rigid framework would be required. It was expected, under such conditions, that the carrier, using the litter as a top, must often serve for an operating table during the rush of work following military operations. It was essential, also, that these carriers be adaptable for use in any hospital whether at the front or in the rear. Considering the limited ocean tonnage, it was a matter of prime importance that the carrier be of such design as to permit it to be taken apart, crated for shipment in the minimum space, and readily assembled with a screw driver or other simple means.
After much study and many experiments, a carrier to meet these exacting requirements was developed early in 1918. Its general appearance is shown in Figure 12. It was provided with an ingenious locking device which fully stabilized the carrier for use as an operating table, preventing both to and fro and lateral motions of the pivoted smaller wheels. This locking device consisted, essentially, of a double sprag secured at the upper end to both sides of the frame at the small wheel end. The two feet of the sprag were incased in rubber crutch tips of suitable size. The sprag was curved and somewhat longer than the distance between its attachments and the floor so that when in place as a
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stabilizer it raised both small wheels off the floor and bore the weight of that end of the carrier.
The order for the manufacture of a sample of this carrier was placed February 25, 1918, in which the manufacturing difficulties were overcome.7 The electro-galvanized finish was adopted as standard for this carrier. This finish appeared equally well as the white enamel and was very much more durable. Contract was entered into April 3, 1918, for 2,500 of these hospital wheeled litter carriers. Blue prints had been revised and corrected. Detailed manufacturing blue prints were completed and manufacture begun. Delays in deliveries of material were overcome, but for reasons best known to the contractor deliveries did not conform to schedule. The contract provided for the delivery of 100 carriers by May 20 and 200 per week thereafter. Deliveries should have been completed by August 12, 1918, but on that date only 1,395 had been shipped. These litter carriers were inspected during manufacture and prior to shipment and found to conform to the specifications.8
The 2,500 litter carriers on the first contract were considered insufficient to provide an adequate number for the hospitals at home and abroad. Three thousand additional such carriers were deemed necessary to provide for the greatly augmented Army then contemplated and for which equipment must he provided. Clearance for this number was requested of the War Industries Board on August 24 in the expectation that deliveries could be made or at least begun before December 1, 1918. That number was then thought sufficient to meet the requirements until the end of the following February. Full data concerning the type of litter desired and the quantities of material required accompanied the application. The application for the clearance of these carriers was not at first considered favorably by the War Industries Board. A substitute carrier made of wood was proposed by the wood products section of the board but was unacceptable to the Medical Department, from both an engineering and a sanitary standpoint. Three prolonged conferences were held between representatives of the Medical Department and those of the clearance committee and the wood and steel products sections of the War Industries Board. At these conferences prolonged discussion was had on the relative merits of the two types of material for litter carriers. The total quantity of steel involved was about 70 tons of tubing and wire.9 Clearance for 1,500 steel wheeled hitter carriers was finally granted and contract therefor placed.
Upon recommendation of the surgical division, Surgeon General’s Office, six of these litter carriers, as soon as they became available, were shipped to the base hospital at each of the large training camps and three to hospitals at the smaller camps.10
REFERENCES
(1) Taken from copy of contract on file in Medical Section, New York General Intermediate Depot, Brooklyn N. Y.
(2) Prior, James C.: Naval Hygiene. F. Blakiston’s Son & Co. Philadelphia, 1919, 253-254.
(3) Memorandum for the Surgeon General, by Maj. Pearce Bailey, M. R. C., U. S. A., February 16, 1918, relative to inspections of equipment at Philadelphia, Pa., and New York, N. Y. On file, Finance and Supply Division, S. G. O., 750-715 S. G. /172.
(4) Letter from the Surgeon General (Maj. W. T. Fishleigh, S. C., N. A.), to the Cyguet Rear Car Co., Buffalo, N. Y., October 20, 1917, relative to collapsible litter carriers. On file, Finance and Supply Division, S. G. O., 162 Cvg. Co./1 A .
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(5) Letter from the Surgeon General to Camp Greenleaf, Fort Oglethorpe, Ga., and other camps, May 24, 1918. On file, Finance and Supply Division, S. G.O., 750-714 S.G./613.
(6) Letter from Lieut. Col. M. Ashford, M. C., U. S. N. A., Camp Greenleaf, Ga., May 24, 1918, to Col. Rodger Brooke, M. C., Camp Greenleaf, Ga. Subject: Report on field litter carrier. On file, Finance and Supply Division, S.G. O., 750-714 5. G.
(7) Correspondence between the Surgeon General and Bernstein Manufacturing Co. during February, March, and April, 1918, relative to hospital wheeled litter carriers. On file, Finance and Supply Division, S.G. O., 67 B. M. Co./6-11.
(8) Letter from medical supply officer, New York, N. Y., to the Surgeon General, August 15, 1918,transmittinginspector’s report of August 12 on Bernstein Manufacturing Co--contract for wheeled litter carriers. On file, Finance and Supply Division, S.G. O., 67 B. M. Co./20.
(9) Letter from the Surgeon General to the War Industries Board, Clearance Committee, Washington, D. C.,August31, 1918. Subject: Clearance on contract for 3,000 hospital litter carriers. On file, Finance and Supply Division, S. G. O., 533N.D./169.
(10) Memorandum for Col. Edwin P. Wolfe, from Col. Wm. H. Moncreif, M. C., N. A., April 29, 1918, relative to distributions of litter carriers. On file, Finance and Supply Division, S. G. O., 713-539/549.
