CHAPTER XII
TRANSPORTATION OF SICK AND WOUNDED
HOSPITAL TRAINS
Shortly after the United States declared war it was recognized that it would be necessary for the Medical Department to provide some means of evacuating and distributing the sick and wounded from the ports to hospitals in the interior. There was only one hospital train in the possession of the Medical
Department at this time.1 This train consisted of ten cars, comprising one kitchen and personnel car, three 16-section patient cars, one operating car, one storage and baggage car, three bed cars, and one officers` car. These cars were all of wooden construction, except the kitchen car and the officers` car, which had steel underframes. They were remodeled from old Pullman cars, August, 1916, by the Pullman Co., for service on the Mexican border, and were leased by the Government on a per diem basis, with the understanding that they could be purchased.1 The train had a capacity of 225 patients and accommodations for 31 personnel.1 In October, 1917, the Surgeon General requested an appro?
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priation sufficient to construct three additional trains of six cars each.1 On February 13, 1918, authority was obtained for the purchase of these additional 18 cars, and in June, 1918, the cars had been purchased, remodeled, and placed in service.1 Three bed cars were taken from Train No. 1, thus reducing it to a 7-car train; and one bed car was added to each new train.
FIG. 76.-A 16-section patient-car, Train No. 1
There were now 4 trains of 7 cars each, with a capacity of 141 patients and 31 personnel for each train. Pending the arrival of overseas patients at the ports, these trains were distributed as follows:1 Train No. 1 to Port of Embarkation, Hoboken, N. J.; Train No. 2 to the Medical Officers` Training Camp,
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Fort Oglethorpe, Ga., for instruction purposes until October, 1918, when it was sent to the Port of Embarkation, Hoboken, N. J.; Train No. 3 to Fort Riley, Kans., for instruction purposes at the Medical Officers` Training Camp, at that place, and then to the Port of Embarkation at Hoboken, N. J.
FIG. 77.-Car for sick officers, Train No. l
It was estimated in October, 1918, that the three hospital trains at Hoboken, with a patient carrying capacity of 423, could make a minimum of three round trips per month each from the port to interior points,2 averaging a distance of 1,000 miles.
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It was apparent that, even if increased in carrying capacity by the addition of three Pullman cars to each, these trains would be totally inadequate to distribute large numbers of sick and wounded. The most crying need was for cars with kitchen facilities, and after a careful study of the situation a request was made in October, 1918, for authority to purchase 20 cars and to have them remodeled into unit cars.3 This authority was granted on October 25, 1918,4 and the necessary arrangements were immediately instituted with the Pullman Car Co.
It was found that, owing to the increased cost of material and labor, the original estimate of $25,000 each for these cars no longer obtained, and that the cars would cost $27,000 each,5 including remodeling. Nor could the Pullman Co. promise delivery of them under three or four months. It was discovered though that 20 steel underframe Pullman parlor cars were available and could be remodeled and be made ready for service within a very short time.6 The offer of these cars was accepted and the order given the Pullman Co. to remodel them and the cars were all completed and in service on January 31, 1919.2
The remodeling of the cars, including removal of the interior fittings and the installation of Glennan adjustable bunks, large kitchens, refrigerators, axle devices and lighting systems, the cost of each added to the original cost, was $326,000 for the 20 cars.7 Ten were sent to the Port of Embarkation at Hoboken and 10 to Newport News, Va.
In using these cars the plan adopted was to attach one of them to six or seven standard Pullman or tourists cars,8 thus forming a hospital train of seven or eight cars. The patients from the entire train were subsisted from the kitchen in the unit car, and were cared for by the medical personnel assigned to that car. The plan was found to be very satisfactory in that it was practicable to furnish hot meals for 250 patients from each unit car.8 There was room for sufficient personnel to care for all their needs and it was unnecessary to pay return mileage on the Pullman cars used as they were simply dropped at their destination8 and the unit car alone returned to the port. This made possible a considerable saving over the use of a hospital train, in which case mileage had to be paid for the entire train.
The arrangement for the evacuation of the large number of patients from the ports and while awaiting the delivery of the unit cars, made it imperative that some cars be obtained for immediate use. Authority was therefore obtained to lease from the Railroad Administration 20 cars at $15 per diem.9 In the latter part of November, 1918, 2 kitchen-tourist cars, 2 hotel cars with kitchens, and 6 private cars with kitchens were leased10 and were sent to the Port of Embarkation at Hoboken. At the same time 7 kitchen-tourist cars, 1 hotel car with kitchen, and 2 private cars with kitchens were leased10 and sent to the Port of Embarkation at Newport News. These leased cars were used in the same manner it had been planned to use the unit cars. The tourist kitchen and hotel cars were the usual tourist and standard sleeping cars, with added facilities for cooking at one end. Each had a feeding capacity of 250 patients.10 The private cars, on the other hand, varied in interior design and had a considerably less feeding capacity. They were the best obtainable for the time being, however, and provided a reasonably satisfactory substitute. It was intended that these leased cars would be used only until delivery was made of the unit cars; but when the unit cars were obtained, it
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was found that the influx of patients was so great that it was necessary to retain the cars in service for a considerably longer period-until June, 1919-when they were returned to the Railroad Administration.11 The use of the unit cars in conjunction with ordinary Pullmans demonstrated their efficiency
FIG. 78.-Hospital unit car fitted with Glennan adjustable bunks, showing manner of adjustment
in hospital train service. They were decidedly economical to operate and maintain and the initial cost per patient carried, or per car, or per train unit, was considerably less than would have been the case had complete hospital trains been provided.
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FIG. 79.-Hospital unit car interior
186
FIG. 80.-Hospital unit car in use
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HOSPITAL SHIPS
At a very early stage of the war the problem of how best to return the sick and wounded to America arose. The Army had no hospital ships and the plan considered was the use of the Navy ship Solace, with its carrying capacity of returning 200 casualties a month; and the use later of two other Navy hospital ships, the Mercy and Comfort, with a carrying capacity of 300 each a month.12 The estimate of a minimum of 5,000 returnable casualties per month showed these resources to be utterly inadequate, even had these three vessels not been required for their original and legitimate purpose of caring for the Navy sick. Out of this suggestion developed the arrangement by which the Navy transports would, on the westward passage, serve to the limit of capacity for the return of Army sick and wounded, and a schedule of each ship`s carrying capacity was prepared and promulgated for the guidance of all concerned.13
The schedule given below shows the classified sick-carrying capacity of the great majority of transports in service on December 1, 1918. The figures fluctuated more or less with alterations in internal structural details, made for better ventilation or other sanitary considerations. In every case the number of different types that could be treated with gratifying results depended absolutely upon the type and general structure of the ship, which, in the main, was fixed and not susceptible to modification.14
TABLE 11.-Revised table for rated capacity for troops invalided home September 5, 1918; on principal naval transports
|
Name of ship |
Total bedridden in sick bunks |
Able to walk, requiring surgical dressings; in troop standees |
Mental |
Tuberculosis in isolation or on open decks |
Able to walk, requiring no attention in rooms for officers |
Convalescent, requiring no special attention; in troop standees |
|
Aeolus |
24 |
100 |
10 |
30 |
145 |
2,580 |
|
Agamemnon |
38 |
130 |
20 |
60 |
230 |
3,000 |
|
America |
59 |
140 |
12 |
25 |
215 |
3,600 |
|
Antigone |
40 |
110 |
5 |
25 |
100 |
1,660 |
|
Calamares |
42 |
100 |
5 |
20 |
80 |
1,100 |
|
De Kalb |
12 |
150 |
--- |
20 |
50 |
1,000 |
|
Finland |
40 |
200 |
6 |
30 |
150 |
3,350 |
|
George Washington |
60 |
500 |
8 |
50 |
500 |
4,600 |
|
Great Northern |
40 |
400 |
45 |
38 |
116 |
2,200 |
|
Hancock |
20 |
550 |
3 |
--- |
40 |
a750 |
|
Harrisburg |
38 |
200 |
5 |
25 |
100 |
2,200 |
|
Henderson |
50 |
350 |
8 |
16 |
64 |
1,164 |
|
Huron |
38 |
110 |
5 |
25 |
140 |
2,250 |
|
Konigen der Nederlanden |
24 |
300 |
2 |
30 |
80 |
1,500 |
|
Kroonland |
40 |
200 |
16 |
20 |
150 |
2,600 |
|
Leviathan |
100 |
1,000 |
360 |
55 |
400 |
1,000 |
|
Lenape |
20 |
100 |
--- |
10 |
44 |
1,000 |
|
Louisville |
45 |
300 |
5 |
30 |
100 |
1,800 |
|
Madawaska |
40 |
100 |
5 |
25 |
105 |
1,750 |
|
Mallory |
20 |
100 |
--- |
10 |
40 |
1,200 |
|
Manchuria |
38 |
300 |
22 |
40 |
175 |
2,850 |
|
Martha Washington |
50 |
150 |
25 |
30 |
100 |
2,250 |
|
Matsonia |
16 |
100 |
5 |
10 |
90 |
2,000 |
|
Maui |
30 |
100 |
5 |
10 |
100 |
2,000 |
|
Mercury |
44 |
110 |
20 |
25 |
120 |
2,300 |
|
Mongolia |
33 |
300 |
5 |
25 |
170 |
2,850 |
|
Mount Vernon |
40 |
130 |
25 |
25 |
140 |
1,800 |
|
Northern Pacific |
44 |
510 |
45 |
90 |
120 |
1,700 |
|
Orizaba |
40 |
500 |
--- |
25 |
190 |
2,000 |
|
Pastores |
25 |
100 |
--- |
15 |
50 |
1,000 |
|
Plattsburg |
38 |
200 |
10 |
45 |
100 |
2,000 |
|
Pocahontas |
38 |
120 |
5 |
25 |
130 |
2,180 |
|
Powhatan |
40 |
300 |
10 |
25-150 |
57 |
1,400 |
|
President Grant |
55 |
110 |
5 |
25 |
200 |
4,400 |
|
Princess Matoika |
35 |
150 |
5 |
16 |
150 |
3,000 |
|
Rijndam |
50 |
1,000 |
10 |
40 |
155 |
1,800 |
|
Siboney |
50 |
500 |
--- |
25 |
90 |
2,000 |
|
Sierra |
30 |
200 |
5 |
25 |
100 |
1,300 |
|
Susquehanna |
45 |
130 |
5 |
25 |
105 |
1,850 |
|
Tenadores |
40 |
100 |
3 |
20 |
42 |
1,150 |
|
Von Steuben |
--- |
b200 |
--- |
60 |
103 |
a650 |
|
Wilhelmina |
20 |
100 |
5 |
10 |
100 |
1,500 |
|
Zelandia |
27 |
500 |
5 |
30 |
76 |
1,100 |
(a) Hammock. (b) Cot.
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Upon the signing of the armistice and with the initial movement of the return of our troops from abroad, steps were taken to utilize German ships15 which had been unable to go to sea owing to the preponderance of allied naval power, and were still in German harbors. One of the first of this class was the Imperator, which was rapidly converted for transport purposes and, like the rest, was manned by a Navy crew. Other vessels of this type were the Graf Waldersee, Cap Finisterre, Kaiserine Augusta Victoria, Mobile, Patricia, Philippines, Pretoria, Prince Frederick Wilhelm, and Zeppelin.
The various types or classes utilized in the transporting of sick and wounded from abroad may be classified as follows:16 (1) Navy transports, (2) cruisers and battleships, (3) merchant vessels of German register assigned to the service of the United States by the provisions of the armistice, (4) cargo vessels belonging to the United States Army Quartermaster Department, having complete Navy standard equipment for the Medical Department and manned and navigated by Navy hospital ships.
AMBULANCES
The onus of transferring the majority of the patients from camps to their base hospitals was a duty of the motorized ambulance companies of the camp.
The average distance of the base hospitals from the population centers of camps was approximately one mile and a quarter.17 To economize on time, efforts were made to transfer most patients on a prearranged schedule, that is, shortly after sick call. Emergency cases were provided for, however, and in this class was included the transfer of all patients suffering from, or suspected of having, a communicable disease.
REFERENCES
(1) Annual Report of the Surgeon General, U. S. Army, 1919, Vol. II, 1154.
(2) Ibid. 1155.
(3) Letter from the Acting Surgeon General to the Quartermaster General, October 17, 1918. Subject: Hospital cars. On file, Record Room, S. G. O., 531.4-1 (Hospital Trains and Cars).
(4) Memorandum from Director of Finance to Director of Purchase and Storage, October 25, 1918. Subject: Hospital cars. On file, Record Room, S. G. O., 531.4-1 (Hospital Trains and Cars).
(5) Letter from the Pullman Co., manufacturing department, office of the sales manager, Chicago, to the Surgeon General, December 3, 1918. Subject: Unit cars. On file, Historical Division, S. G. O.
(6) Letter from Mr. Edward Hanson to the Surgeon General, November 29, 1918. Subject: Construction of new hospital car. On file, Record Room, S. G. O., 531.4-1 (Hospital Trains and Cars).
(7) Letter from U. S. Railroad Administration to the Surgeon General, June 9, 1919. Subject: Statement of Pullman Car Co. On file, Record Room, S. G. O., 158 (Pullman Co., Chicago).
(8) Report Relative to Food Problems on Hospital Trains, by Maj. Don Joseph, M. C., July 10, 1919. On file, Record Room, S. G. O. (Food and Nutrition Files.)
(9) Letter from the Surgeon General to the Chief of Staff, Purchase, Storage and Traffic Division, November 20, 1918. Subject: Leasing of cars for movement of sick. On file, Record Room, S. G. O., 322.2-4 (Hospital Cars).
(10) Letter from the Pullman Co., to the Surgeon General, November 29, 1918. Subject: Leasing of Cars. On file, Record Room, S. G. O., 322.2-4 (Hospital Cars).
(11) Letter from the Surgeon General to the Chief of Transportation Service, W. D., June 23, 1918. Subject: Leased cars. On file, Record Room, S. G. O., 531.4 (Port of Embarkation, Hoboken, N. J.), N.
(12) Annual Report of the Surgeon General, U. S. Navy, 1918, 69.
(13) Annual Report of the Surgeon General, U. S. Navy, 1919, 48.
(14) Ibid., 50.
(15) Ibid., 53.
(16) Annual Report of the Surgeon General, U. S. Navy, 1920, 19.
(17) Plans, National Army cantonments and National Guard camps. Construction Division, W. D., 1918.
