Books and Documents > Medical Department of the U.S. Army in the World War, Volume III, Finance & Supply
CHAPTER XXXIII
OVERSEAS BASE HOSPITALS
Because of lack of funds and the resultant inability of the Medical Department to procure, in time of peace, materials and equipment for base hospitals, and to have them stored in reserve, it had no units of equipment of this type available when the first troops of the American Expeditionary Forces were sent to France. Hospitalization for these troops was provided by base-hospital units organized and equipped under the auspices of the American Red Cross and inducted into the Federal service. Fifty such units had been organized. A majority of them provided all their initial equipment. Some units provided part and the Medical Department supplied the rest. These Red Cross units served to meet the requirements of the Army until the procurement schedule of the Medical Department was able to provide them. The equipment of these units as a rule followed the list of articles prescribed in the standard. supply table for base hospitals. Standard beds and bedding were provided in place of the field equipment. Additional articles of kitchen equipment, mess equipment, sterilizing outfits, and even portable laundry equipment and ice machines, were added by some of these units. Additional equipment to bring the capacity of these hospitals up to 1,000 beds was supplied later by the Medical Department. When subsequent hospitals were sent overseas the list of equipment developed for base hospitals at training camps, with a few modifications, was used as the standard table of equipment. Some articles of heavy furniture and miscellaneous supplies were omitted at the request of the commanding general. A few articles were added to meet the conditions existing in France and the quantities of many items were increased. Changes were made in the equipment from time to time as experience indicated. The equipment as provided was as follows:
List of medical supplies for the initial equipment of a 1,000-bed base hospital (overseas)
519
List of medical supplies for the initial equipment of a 1,000-bed base hospital (overseas) - continued
The complete equipment of one of these 1,000-bed hospitals was bulky and heavy. It occupied approximately 30,000 cubic feet of space and weighed 120 short tons. Considerable difficulty was experienced in assembling it. A part of the equipment required packing, especially surgical instruments and other small articles. The quantities of many articles on the standard list were less than commercial case lots. This part of the assembly was carried on efficiently at the New York medical supply depot. The more bulky articles could not be carried in stock for lack of space and had to be ordered in from the manufacturers as needed.
In July 1918, there began to be need of a number of these units. Base hospital organizations were under orders for overseas service. The plan of supply contemplated that complete equipment would be delivered to each unit upon its arrival at the port of embarkation. In order that this plan might be effective and the equipment available, it was decided to have a number assembled at the port of embarkation, Hoboken, N. J., and held in readiness for immediate issue. The personnel of nearly all hospital units were then being routed through that port.
Instructions were issued to the medical supply officer, port of embarkation, Hoboken, N. J., July 31, 1918, to assemble the equipment for 10 base hospitals of 1,000 beds.10 Each hospital was to be given a letter of the alphabet, beginning with the letter A. Each package in the equipment was to bear that letter as an identifying mark. For each unit, separate invoices and receipts were to be prepared bearing the lettered markings. When the unit was issued, the name of the organization was to be entered thereon and a certificate attached that
520
the equipment had been issued in original packages. As base hospital units were placed on the priority list for overseas, a requisition for the equipment was forwarded to the medical supply officer of the port. The equipment was then to be marked and shipped to leave with or before the organization.
The unit equipments covered by the original instructions to assemble included the letters A to J. Instructions of August 8, 1918, directed the assembly of 10 more equipments, lettered, K to T, inclusive.10 These instructions were followed September 10 for the assembly of 20 more such units to be lettered U, V, W, X, Y, Z, AA, AB, AC, AD, AE, AF, AG, AH, AI, AJ, AK, AL, AM, AN.11 On October 11 20 more units, lettered AO to BG, inclusive, were ordered to be assembled.12 On November 4, 1918, 10 more units, lettered BI to BR, inclusive, made a total of 70 such units to be assembled.13 Because of the difficulty experienced in assembling and shipping these units it was decided to ship, thereafter, the supplies in bulk to the medical supply depot in France for assembly and issue as required.14
At the same time that instructions were given the port medical supply officer to assemble the equipment, lists of the component parts thereof to be furnished by the medical supply depots at New York and Washington, respectively, were furnished those depots. The depots were directed to pack the equipment separately for each unit and to send it, accompanied by a packer’s list, to Port Newark terminal.15
The depots were instructed to prepare separate invoices for each unit bearing lettered markings and to send them to the medical supply officer of the port. Requests for the appropriate quartermaster equipment were sent to the Quartermaster General for the required number of units at the same time the instructions were sent to the depots for the medical equipment.16 These requests to the Quartermaster General asked that the units be packed separately, with the contents marked on the box, and sent with the least practicable delay to the medical supply officer at Port Newark terminal.
The number of base hospitals equipped under the auspices of the Red Cross was limited to 50. Under the estimated requirements of four such hospitals per division, that number would not go far toward providing for the forces contemplated for duty overseas. Measures were taken at an early date to provide adequate hospital equipment. On August 18, 1917, the medical supply officer at New York was instructed to purchase 3,000 ward units (150,000 beds complete with mattresses, blankets, ward linen, pajamas, and other articles for ward use) for ultimate shipment to France.1
On September 1, 1917, instructions were issued for the purchase of sufficient supplies for 50 base hospital unit equipments (500-bed hospital) less ward units authorized as above noted.2 It was intended to ship four such units with each division ordered overseas. At that time it was thought that divisions would be transported at the rate of four per month. For various reasons they were not sent at that rate until the following spring. The instructions contemplated that sufficient equipment would be maintained at New York for 32 base-hospital units. Lack of storage space, however, prevented this, and the number was reduced to 16. In October, 1917, the
521
medical supply officer at New York reported that 36 such units were being purchased.3
As articles on the contracts placed at the end of August for 3,000 ward units came into production and deliveries began to be made, storage space was very short in New York City and vicinity. Although the immediate number of troops then in France did not call for that number of beds, cargo space was available, and it was thought wise to forward them against future need while cargo space for them could be had. The question of their shipment at that time was referred to the commander in chief, A. E. F., by whom the plan was disapproved.4
The component articles for these ward units were shipped to the several distributing depots in accordance with their available storage space. The great hospitalization needs of the various training camps which developed during the following months called for a rapid distribution of these articles to the base hospitals in the United States.
The equipment provided base hospitals by the Medical Department was lacking in certain essential articles such as ranges for cooking and the kitchen utensils ordinarily supplied with them--flags, rakes, picks, shovels, filing equipment, etc. These articles were commonly provided by the Quartermaster Corp, out of its proper appropriations. The question of ranges came up early in 1917 in accumulating equipment for hospitals organized under the auspices of the American Red Cross. The directors of the units were advised to secure their own ranges and cooking equipment.5 The Quartermaster General, on September 11, 1917, was furnished an itemized list of the articles of his department needed to equip the Medical Department units of a division, including base hospitals, with the request that arrangements be made to have them available overseas in sufficient quantities to equip these units upon arrival.6 Arrangements were made, a month or two later, by the Quartermaster General to ship 50 Army ranges No. 5 as initial equipment for every 25,000 men sent over and to supply one-third of that amount monthly as upkeep. It was thought that base hospitals could be supplied from this stock after their arrival in France.7
The question of quartermaster supplies for base hospitals came up again in May, 1918, when additional hospitals were being equipped for service overseas. The depot quartermaster at Philadelphia, Pa., was designated to supply all the articles on the list except water-sterilizing bags, which were to be supplied from New York, and Army ranges No. 5, which were to be supplied on arrival abroad.8 This method of supply not proving satisfactory, ranges were included in the equipment to be supplied in the United States. The quartermaster articles to be furnished each base hospital were prescribed in instructions from The Adjutant General, June 3, 1918.9
The instructions for the assembly of the earlier units directed the shipment of the supplies to Pier 45, North River, but the space at that pier was inadequate for the proper assembly of these units. Port Newark terminal, Newark, N. J., by the late summer of 1918 had reached such a state of completion that space was available to receive supplies.17 This terminal was intended primarily for the shipment of supplies overseas, and some difficulty was at first experienced in obtaining authority to route the equipment of these units into the terminal
522
for assembling. These difficulties were overcome, and 40,000 square feet of floor space was assigned to the Medical Department for the accumulating, marking, etc., of the small items. More space was promised as necessary.17 Other storage space was to be used for the storage of beds, mattresses, pillows, and blankets. It was estimated on September 23, 1918, that the space assigned would be sufficient to keep on hand the equipment of 20 base hospitals and leave working space for the assembling of that many more. At that time supplies were arriving at the terminal in sufficient quantities to justify the forecast of 10 base hospitals that could be forwarded during the month of October.17
Many of the supplies required for the equipment of base hospitals were at that time being obtained on interbureau requisitions a and being shipped in bulk on contracts placed by the general purchasing office of the Medical Department. Supplies received from other depots came properly packed and accompanied by packers’ lists and invoices. The supplies received from other sources, coming in bulk, had to be assembled for each unit. To accomplish this a packing force was necessary. Some delay was experienced in developing a suitable packing room and a force to operate it. This difficulty was overcome by the assignment of a nucleus of trained personnel in the New York medical supply depot and by the utilization of personnel from the labor battalion assigned to duty at the terminal. Material delays were experienced in assembling base hospital unit equipments because of failure to receive the needed articles from the contractors. It became necessary for the Surgeon General to issue instructions for the shipment of the equipment incomplete, in order that as much of it as possible might be made available in France for the use of hospital personnel which had already gone over.
While the equipment furnished the base hospitals forwarded overseas conformed to the list already mentioned, certain units designated for the treatment of special classes of patients were provided with additional equipment. All hospitals had some orthopedic equipment; those intended for special hospitals for the treatment of orthopedic cases were provided with more extensive and elaborate equipment for that purpose. The same is true of hospitals intended for the treatment of neuropsychiatric cases. The equipment for special treatment for these units consisted essentially of hydrotherapeutic apparatus.
COST OF INITIAL EQUIPMENT OF A 1,000-BED BASE HOSPITAL (OVERSEAS)
523
COST OF INITIAL EQUIPMENT OF A 1,000-BED BASE HOSPITAL (OVERSEAS) - continued
REFERENCE
(1) Letter from the Surgeon General to the officer in charge, Medical Supply Depot, New York, August 18, 1917. Subject: Purchase of beds. On file, Finance and Supply Division, S. G. O., file, Finance and Supply Division, S. G. O., 25/9.
(2) Letter from the Surgeon General to the officer in charge, Medical Supply Depot, New York, September 1, 1917. Subject: Supplies for a 50-bed hospital unit. On file, Finance and Supply Division, S. G. O., 713-539/97.
(3) Letter from the medical supply officer, New York, to the Surgeon General, October 3, 1917. Subject: Requisition for instruments partially duplicating orders already given. On file, Finance and Supply Division, S. G. O., 250/43.
(4) Cablegram from The Adjutant General to the commanding general, American Expeditionary Forces, France, November 7, 1917, relative to shipment of 150,000 beds and bedding, and par. 19, Cable No. 279, H. A. E. F., to The Adjutant General, Washington, November 10, 1917, in reply thereto. On file, Finance and Supply Division, S. G. O., 250 France/99 and 111.
(5) Correspondence between the director of Red Cross Base Hospital No. 23, Buffalo, and the Surgeon General, June 15, 1917, relative to ranges for that hospital. On file, Finance and Supply Division, S. G. O., 14843 N.
(6) Letter from the Surgeon General to the Quartermaster General, September 11, 1917. Subject: Equipment and supplies required by the Medical Department. On file, Finance and Supply Division, S. G. O., 750-594/12.
(7) Second indorsement, Quartermaster General, to The Adjutant General of the Army, November 8, 1917, relative to equipment of hospitals sent overseas. On file, Finance and Supply Division, S. G. O., 750-594/12.
(8) Correspondence between the Surgeon General and the Quartermaster General, May 3 to 9, 1918. Subject: Supplies for base hospitals ordered abroad. On file, Finance and Supply Division, S. G. O., 750-594/144.
(9) Letters from The Adjutant General to the commanding generals of all National Army, National Guard, and Regular Army divisions, department commanders, and chiefs of supply bureaus June 3, 1918. Subject: Allowance of quartermaster supplies for base and evacuation hospitals for overseas duty. On file, Finance and Supply Division, S. G. O., 750-594/144.
(10) Letter from the Surgeon General to the port medical supply officer, Pier 45, North River, New York, July 31, 1918. Subject: Supplies. On file, Finance and Supply Division, S. G. O., 55 Misc. B. H./13.
524
(11) Letter from the Surgeon General to the port medical supply officer, Pier 45, North River, September 10, 1918. Subject: Receipt and issue of base hospital equipment. On file, Finance and Supply Division, S. G. O., 55 B. H. Misc./10.
(12) Letter from the Acting Surgeon General to the port medical supply officer, Pier 45, North River, October 11, 1918. Subject: Receipt and issue of base hospital equipment. On file, Finance and Supply Division, S. G. O., Req. 55 B. H. Misc./15.
(13) Letter from the Surgeon General to the port medical supply officer, Pier 45, North River, New York, New York, November 4, 1918. Subject: Receipt of and issue of the base hospital equipment. On file. Finance and Supply Division, S. G. O., Req. 55 B H. Misc./33.
(14) First indorsement from the Surgeon General to the port medical supply officer, Pier 45, North River, New York, October 23, 1918, relative to shipment of supplies for base hospitals. On file, Finance and Supply Division, S. G. O., 55 Misc./10.
(15) Letters from the Surgeon General to the officers in charge, Medical Supply Depots, New York and Washington, D. C., September 10, 1918. Subject: Shipment of base hospital equipment. On file, Finance and Supply Division, S. G. O., Req. 55 B. H. Misc./10.
(16) Letter from the Surgeon General to the Quartermaster General, September 13, 1918. Subject: Equipment of base hospitals. On file, Finance and Supply Division, S. G. O., 750-549 QMC/219.
(17) First indorsement, port medical supply officer, Pier 45, North River, New York, to the Surgeon General, September 23, 1918, relative to essential articles for the operation of the base hospitals, and storage space at the Port Newark terminal. On file Finance and Supply Division, S.G.O., Req. 55 B. H. Misc./13.
