CHAPTER XI
DISTRIBUTION OF OVERSEAS PATIENTS
Early in 1918, preparations were made to care for the return of a large number of overseas sick and injured.1 Shortly after the signing of the armistice, information was received indicating that the sick would be evacuated to the United States at an estimated monthly rate of about 10,000.2 As it subsequently developed, this estimate proved to be too low, for in January, 1919, 20,847 patients were returned;3 in February, the number was 15,086;3 and in March it exceeded 27,000.3
During the period from April 1, 1918 , when the first patients were received from abroad, to December, 1919, 147,868 patients had been debarked at the ports.3 Of this number, 108,337 arrived at the port of Hoboken, 39,341 at Newport News, and 190 at Boston.
Boston was not a regular port of debarkation; the reception of patients at that port was occasioned by the fact that in August, 1918, and in the following September, ships returning to the United States were diverted thereto as a military measure.4
The following table shows the number of patients arriving at Hoboken, Newport News, and Boston, by month, from April, 1918, to December, 1919:3
TABLE 9.-Number of overseas patients arriving at Hoboken, Newport News, and Boston.
|
|
Boston |
Hoboken |
Newport News |
Total |
|
1918 |
|
|
|
|
|
April |
--- |
121 |
66 |
187 |
|
May |
--- |
135 |
271 |
406 |
|
June |
--- |
339 |
330 |
669 |
|
July |
--- |
484 |
346 |
830 |
|
August |
42 |
854 |
292 |
1,146 |
|
September |
148 |
890 |
800 |
1,690 |
|
October |
--- |
2,547 |
1,420 |
3,967 |
|
November |
--- |
3,191 |
2,776 |
5,967 |
|
December |
--- |
9,143 |
2,768 |
11,911 |
|
1919 |
|
|
|
|
|
January |
--- |
10,935 |
9,912 |
20,847 |
|
February |
--- |
10,543 |
4,543 |
15,086 |
|
March |
--- |
20,825 |
6,374 |
27,199 |
|
April |
--- |
17,726 |
2,886 |
20,612 |
|
May |
--- |
12,250 |
2,754 |
15,004 |
|
June |
--- |
7,724 |
2,667 |
10,391 |
|
July |
--- |
3,822 |
917 |
4,739 |
|
August |
--- |
1,974 |
201 |
2,175 |
|
September |
--- |
1,287 |
18 |
1,305 |
|
October |
--- |
1,726 |
--- |
1,726 |
|
November |
--- |
1,623 |
--- |
1,623 |
|
December |
--- |
198 |
--- |
198 |
|
190 |
108,337 |
39,341 |
147,868 |
In the distribution of these cases there were two determining factors: The desire of the War Department and of the patients concerned that their distribution be made to hospitals as near their homes as possible; and the necessity for assigning certain cases to special hospitals planned and equipped for their care. It was essential, therefore, that before proper distribution of
172
173-175
patients could be made, they all be classified in accordance with their places of residence and the character of the disease or injury for which treatment was indicated.
The list given below shows the classification decided upon and the hospitals which were suitable for the reception and care of the various kinds of cases:5
No attempt was made to classify these cases in a scientific manner; the list was provided merely to enable port surgeons to determine where to send cases.6
Prior to November, 1918, the base hospitals which had been established at each of the 32 camps, as well as the larger post hospitals, could not be used for the treatment of overseas sick. For this there were two reasons: The hospitals were practically taxed to their capacity to care for the sick of their respective commands; and it was believed inadvisable to send sick and wounded from the battle fields of Europe to home hospitals where they would come in contact with troops, practically all recruits, who were being trained for service in the field. Therefore, no attempt was made to send overseas sick to these hospitals until after the signing of the armistice and home activities had been changed from mobilization to demobilization.7
By November, 1918, the strength of commands at various camps had been materially reduced by the hurried departure of troops for duties overseas;8 and as demobilization proceeded it was found that the objections to the use of hospitals, at mobilization camps, for overseas patients no longer obtained. It was then determined to utilize these hospitals for the treatment of those whose homes were in the vicinity of the respective camps, cantonments, and the larger Army posts.9 By sending to these hospitals patients whose disabilities were of such a nature as not to require special treatment, the Medical Department was able to distribute a greater percentage of sick to the immediate vicinity of their homes.10
In June, 1919, demobilization of the Army, which naturally included Medical Department personnel, had proceeded to such an extent as to make the maintenance of camp base hospitals at full capacity impractical and fortunately unnecessary.11 The incidental reduction of the strengths of camp commands was such that in some instances their hospitals could be maintained at one-fourth normal capacity and still provide sufficient accommodations for sick of the command.11 By this time the number of additional overseas sick to be cared for was relatively small, as 90 per cent of them had already been returned to the United States.12 It was therefore decided that, after May 31, 1919, all overseas sick would be sent to general hospitals only.13 The following table shows what disposition was made of the 136,097 American Expeditionary Forces sick and wounded arriving at Hoboken and Newport News during the period April 1, 1918, to June 30, 1919. It shows also to what extent the hospitals in the camps were used for the various classes of these cases after the armistice.
176-177
178
Figure 74 shows not only the distribution to June 30, 1919, but that up to November 11, 1919-one year after the armistice. It exhibits, in a way impossible by any other method, the relative part played by the various hospitals in the care of these cases numerically.14 It must be remembered, however, that not all cases admitted to a hospital completed their convalescence there.
REFERENCES
(1) Memo. from the Surgeon General to the Chief of Staff, April 2, 1918. Subject: Hospitalization in the United States. On file, Record Room, S. G. O., 632 (General).
(2) Cablegram No. 1908 from General Pershing, November 19, 1918. Subject: Estimate of average number of sick and wounded evacuations to be made to United States. On file Record Room, S. G. O. (Cablegram File.)
(3) Table showing number of patients arriving from overseas. On file, Record Room, S. G. O., 721.6-2 (Sick and Wounded Reports).
(4) Letter from The Adjutant General to the Surgeon General, Nov. 26, 1918. Subject: Return of wounded. On file, Record Room, S. G. O., 323.9 (Ports of Debarkation).
(5) Annual Report of the Surgeon General, U. S. Army, 1919, Vol. II, 1164-1167.
(6) Memo. from Lieut. Col. Edgar King, M. C., to the Surgeon General, April 15, 1918. Subject: Evacuation of patients. On file, Record Room, S. G. O., 721.6 (Sick and Wounded, A. E. F.) Y.
(7) Letter from the Surgeon General to The Adjutant General, November 21, 1918. Subject: Transfer of patients. On file, Record Room, S. G. O., 721.6 (Patients from Overseas).
(8) Shown on strength cards. On file, Statistical Division, S. G. O.
(9) Letter from the Surgeon General to The Adjutant General, November 21, 1918. Subject: Transfer of overseas patients to base hospitals. On file, Record Room, S. G. O., 721.6 (Sick and Wounded, Overseas).
(10) Letter from the Surgeon General to surgeon, port of embarkation, Newport News, Va., February 24, 1919. Subject: Assignment of overseas cases to interior hospitals. On file, Record Room, S. G. O., 721.6-2 (Sick and Wounded Reports).
(11) Annual Report of the Surgeon General, U. S. Army, 1919, Vol. II, 1159.
(12) Based on compilation of weekly reports of patients returning from overseas. On file, Hospital Division, S. G. O.
(13) Memo. from Lieut. Col. Floyd Kramer, M. C., to the Surgeon General, May 24, 1919. Subject: Conclusions arrived at in reference to hospitalization. On file, Record Room, S. G. O., 632 (General).
(14) Chart showing distribution of overseas sick to November 11, 1918. On file, Hospital Division, S. G. O.
