CHAPTER XXX
BASE HOSPITALS, CAMPS EUSTIS, VA., FREMONT, CALIF., GORDON, GA., GREENE, N. C., HANCOCK, GA., A. A. HUMPHREYS, VA., JACKSON, S. C., JOS. E. JOHNSTON, FLA., KEARNY, CALIF., AND LEE, VA.
BASE HOSPITAL, CAMP EUSTIS, VA.a
The base hospital at Camp Eustis, Lee Hall, Warwick County, Va., was opened September 16, 1918, before the completion of the buildings. The work of construction, and the presence of the workmen in the buildings; the giving up of the time of certain officers to the examination of recruits; the lack of adequate personnel in officers, nurses, and enlisted men; and the rapid increase in admissions were difficulties incident to the development of a new institution. Certain deficiencies in the work resulted, but these were limited to records and investigations, not essential to the welfare of the patients.
The original bed capacity was 500, but early in October it was found necessary to provide more space for patients. The convalescent barracks, or the hospital annex, as it was called, was then opened. The annex consisted of a block of buildings used to house the troops in training in camp. All convalescent and minor cases were treated here. Medical officers from the base hospital were in charge, but the nursing and clerical work connected with the operation of the annex had to be taken care of by enlisted men of the Coast Artillery Corps, who had had no previous training in the duties of the Medical Department.
The base hospital exchange was opened October 8. It was well patronized by the personnel on duty at the hospital, as well as by the patients, and at the end of the year showed a net value of over $4,000. The function of this hospital was to treat all cases arising in camp.
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Eustis, Va.," by Maj. P. C. Riley, M. C., U.S.A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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BASE HOSPITAL, CAMP FREMONT, CALIF.a
The base hospital, Camp Fremont, was situated in San Mateo County, Calif., 2 miles from Palo Alto. The surrounding country is flat and wooded. The soil is loam, forming little dust and a moderate amount of sticky mud after rain. The climate is mild.The temperature in winter ranges from 50 to 70, and there is no snow, except on the mountains, 30 miles away. In summer the temperature ranges from 65 to 95 F., and occasionally there is some fog, but very little wind. The prevailing winds are from the south. The roads in and around the base hospital were of oiled gravel, and were well kept. The only stream near the area is San Francisco Creek, half a mile away, which is dry all summer. The sanitary status of the hospital neighborhood was satisfactory. On July 6, 1917, the hospital at Camp Fremont was established. It occupied a small building which was erected as a regimental infirmary, and was totally inadequate for the sick of the command; so the
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Fremont, Calif.," by Col. E. B. Frick, M. C., U. S. A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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infectious and venereal patients were quartered in tents adjacent to the hospital. All important cases, both surgical and medical, were transferred to the Letterman General Hospital, Presidio of San Francisco.
On November 13, 1917, the base hospital was organized. Its function was to treat all cases arising in camp; and medical, surgical, and venereal cases from overseas.
The hospital was constructed on the standard plan. The first part of it completed was occupied January 4, 1918; gradual occupation followed.
Officers were quartered in a separate building of 22 rooms. This building had, in addition, 2 baths, 4 lavatories, and 4 toilets. The sleeping rooms were small, each accommodating one officer; and, as the commissioned personnel increased, it became necessary to pitch tents for additional officers.
Nurses were quartered in 24 single rooms and in 2 dormitories, each of which contained 12 beds. There were 2 baths, 6 washstands, and 6 toilets for the nurses. It became necessary, as was the case with the officers, to pitch tents to accommodate the increase in the number of nurses.
The barracks for the enlisted men consisted of 4 buildings, each containing 40 beds, 4 noncommissioned officers` rooms, a recreation room, and a mess hall. There were 2 bathhouses, each containing 8 baths and 8 toilets. Later it became necessary to pitch 21 extra tents to accommodate the overflow of men.
When the base hospital was first occupied, the patients, the detachment Medical Department, and officers all messed in the main mess hall. Later the detachment messed in its own barracks, the patients in the main mess hall, and the officers in a mess maintained temporarily in tents.
The hospital storehouse consisted of two buildings, 25 by 150 feet; they had no electric lights, no running water, no toilet, and no sewer connections.
Because of lack of machinery the hospital laundry was not operated. The work was done outside, by contract. This arrangement was satisfactory, but expensive.
The hospital chapel was used early in January, 1918, for religious services. The chaplain maintained an office in the chapel where he could be consulted by members of the detachment. The building was furnished through contributions and gifts.
The initial hospital equipment consisted of approximately one-tenth of a 500-bed base hospital, according to the Wolfe unit. By April 30, 1918, the hospital was equipped to care for 1,500 patients, but was lacking in some things, such as surgical instruments, for all services. The laboratory equipment was not sufficient to meet all necessities. On the whole, however, the work ran smoothly under all conditions.
On September 13, 1918, at 3 a. m., fire broke out in the building of the receiving office, and the whole building rapidly burned to the ground, nearly everything, including patients` clothing, being lost. This building was never rebuilt, and barracks No. 1 was used at first as a receiving office, and later ward B was altered and answered very satisfactorily for that purpose.
The origin of the water supply was Alemada and Contra Costa Counties, from which it was piped across San Francisco Bay. Prophylactic treatment of this water supply was by filtration. The entire hospital sewage was dis-
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posed of by a sewer main which passed through the hospital grounds, emptying by gravity into San Francisco Bay.
The unusable part of the kitchen waste and other forms of hospital garbage were incinerated; the usable part was sold to hog raisers.
In separate wards the baths, toilets, and latrines were rooms directly connected with the ward. In double wards the baths, toilets, and latrines were in small separate buildings between the wards, accessible through short halls. They emptied into the main sewer which passed through the hospital grounds.
The hospital was heated by means of coal stoves, of which there were about 500. This seemed to be a wasteful and inefficient method, and inferior to a central heating plant. The wards were each equipped with two large coal furnaces (Lexington No. 25). These furnaces had metal jackets, which interfered with conduction and radiation of heat, and were, in fact, designed for furnace heating rather than room stoves. Nearly all the heat rose and passed out of the top of the stove, and if the ward ventilators were open, passed through them out of the ward. The stoves occupied, in each ward, the space of four beds, meaning, of course, a great expense in waste bed space; and it was extremely difficult to regulate the temperature of the wards with the stove heating. Hot water was supplied from separate small coal-burning water heaters, one for each ward.
The hospital was lighted by electricity. The system was successful, except that porch lights were on the same switch as the lights in the corridors of wards. This gave rise to waste, as the lights in the corridors and porches could not be turned off separately.
On January 8, 1918, the post exchange was opened for business, without funds. The business increased, until by April 30, 1915, the total amounted to more than $10,000. At that time there was on deposit with the Palo Alto Bank a balance of $4,235.37.
The Red Cross, Young Men`s Christian Association, and Knights of Columbus were all represented at the hospital.
The usual amusements were furnished by the Red Cross, the Young Men`s Christian Association, and the Knights of Columbus. Dances were held frequently at the Red Cross building. An open-air theater, planned and constructed by the Ladies` Garden and Hospital Committee of Menlo Park, was an important factor in the life of the hospital. Moving pictures, vaudeville, and other performances were given here. Baseball, tennis, basket ball, volley ball, and other games were encouraged.
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BASE HOSPITAL, CAMP GORDON, GA.a
The base hospital was located in the northeast corner of Camp Gordon, about a half mile from Chamblee Station, De Kalb County, Ga., and about 14 miles, by rail, from Atlanta.
The topography of the surrounding country is rolling to hilly. Where the camp was located is quietly rolling and fairly well wooded, with small growth of oak, hickory, and short-leaf pine. The camp lay within the drainage area of the Chattahoochee River, which is approximately 10 miles to the west.
The soil of this section is derived primarily from a granite gneiss which breaks down to a reddish sandy material with a comparatively small percentage of finely divided substance which forms dust or mud. In the top soil that has been long exposed, practically all the reddish clay has been washed out, leaving a comparatively coarse sandy soil. Where the top soil has been eroded away and the subsoil or original decomposed material is exposed, mud forms rather readily. A portion of the soil is derived from a horn blend gneiss which yields a more finely divided red soil and which forms mud very easily. In dry weather a comparatively slight current of air will float the fine particles. Practically the entire hospital area was graded, exposing the subsoil, which made conditions worse than they would have been otherwise.
The climate is characterized by long summers and short winters. The summers are marked by periods of oppressive heat, although the temperature seldom reached a maximum of 100 F. The winters are generally mild and open, with periods of damp, penetrating cold, during which the temperature seems lower than is shown by the thermometer. The winter of 1917-18 was of unusual severity, characterized by a freeze, with snow and sleet of several weeks` duration. The precipitation is ample for the successful production of all crops common to this region, the mean being 49.47 inches. There is a normal growing season of 225 days. The average date of the last killing frost in the spring is March 23, and of the first in the fall, November 3. The mean temperature for winter is 44; spring, 61; summer, 76.4; and fall, 62.1.
The roads in the immediate vicinity of the hospital were decidedly inferior in quality to others in the camp. The main thoroughfare in front of the hospital was bedded with crushed stone and surfaced with soil, but not otherwise improved. The other roads in the hospital area were graded but not surfaced, and were, therefore, exceedingly dusty during the dry season. All roads, with the exception of the main road mentioned, were difficult to travel after a few hours of rain, and were impassable with continued rains, or with intermittent showers and very much traffic.
The natural drainage of the hospital section was excellent. Two small streams, thoroughly ditched, transversed the grounds. The sanitary status was excellent, save in the matter of the great prevalence of dust and mud in dry and wet seasons, respectively. Mild affections of the upper air passages were naturally prevalent at all times.
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Gordon, Ga.," by Lieut. Col. S. J. Young, M. C., U. S. A., while an duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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The hospital was officially opened September 7, 1917. Its function was to treat all cases arising in Camp Gordon, and medical, surgical, and venereal cases from overseas.
Buildings in block "O," designed for barracks, were used for temporary quarters. The first hospital for the camp was installed on a limited scale-a small infirmary, in fact-in a building which subsequently became military police headquarters. Previous to the official opening of the hospital and the transfer of personnel with patients, the equipment was that of Field Hospital No. 25. Four buildings of barracks type, with two small administration buildings and two officers` quarters, were utilized. The hospital with the field hospital equipment in the buildings described constituted the camp hospital, until it was designated the base hospital, September 7, 1917.
Such of the equipment in block "O" as belonged to the base hospital, with records, personnel, etc., were transferred to the permanent location on October 2, 1917. Very few of the buildings were complete at that time. The examination of recruits, which had been part of the duties of the hospital personnel in block "O." was continued there for several weeks. The incompleted wards were used for the purpose of examining the incoming draft and also for the housing of patients. From day to day the capacity was increased as wards were either finished or made suitable for the reception of patients. Not for several weeks were the buildings of the first unit completed in the full meaning of the word; in fact, all the winter the steam fitters were found daily engaged putting up and taking down pipe, placing new connections and taking out others. The runways were at no time clear of plumbers and plumbing material from October 2, 1917, to May 31, 1918.
The plan and distribution of buildings was the same as in other cantonments, with perhaps slight variations. All buildings were constructed of wood, and were ceiled with beaver board.
The original capacity of 500 was soon increased to 1,000; the maximum capacity attained was 4,167.
When the base hospital was opened the officers were quartered in the building to be used as nurses` quarters. On November 15 the nursing staff began to arrive, and the officers moved into their own quarters, which were then sufficiently near completion to be occupied. It was found, however, that these quarters were not adequate, and the overflow was quartered in rooms in the eye, ear, nose, and throat building, in the sick officers` building, and in other parts of the hospital in which equipment had not been installed. This overflow state of affairs applied also to nurses.
Five separate messes were maintained in the hospital: an officers` mess in the officers` quarters; a sick officers` mess in the building set apart for their ward; a nurses` mess in the nurses` quarters; a general or patients` mess in the main mess hall; and the enlisted men`s mess in the barracks provided for the detachment of the Medical Department.
At first the storehouse capacity of the hospital was ample for ordinary needs, but as the size of the institution increased, the storehouse became inadequate. Four buildings, with floor space aggregating 14,500 square feet, were occupied by the hospital supply officer and the camp supply officer jointly.
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The hospital at no time operated its own laundry. From September 7, 1917, when the base hospital was opened, to May 4, 1918 , the work was done by private laundry concerns in Atlanta. On May 4, 1918, arrangements were made for all laundry work to be done in the camp.
The chapel was completed and ready for use about November 20, 1917. It filled a very useful place in the life of patients, enlisted personnel, and officers of the hospital. Religious services, entertainments for patients, and lectures for officers and enlisted men were held here.
The hospital water supply was part of that of Camp Gordon, obtained by contract from the city of Atlanta. The source of supply is the Chattahoochee River, which has its origin in north Georgia. The city`s storage plant consists of two large reservoirs, coagulating basins, and pressure filters. The water was furnished to the camp through an 18-inch main. The character of the water was satisfactory from the chemical and bacteriological standpoint, except that at times when an overflow was placed on the filters, B. coli were found. At times, when the camp was filled, the pressure was inadequate for fire-fighting purposes, doubtless due to wastage of water in the camp. The bursting of mains, which were made of wood wrapped with wire, was responsible for lack of a water supply in several instances. The danger of shortage of water was later overcome by the installation of intermediate storage reservoirs in the camp.
A complete and adequate system of sewerage was provided for the hospital. The mains connected with those of the camp and ended in a septic tank. The entire hospital was fully equipped with toilets of modern type. Latrines were not tolerated, except when required for the employees of construction companies, and then only under the closest supervision of the hospital sanitary officer. In the first unit of wards constructed some of the "double wards" had joint toilet rooms. In the later construction each ward had its own urinal, toilet, and bath. It was generally conceded that the double-ward arrangement was unsatisfactory, sanitary conditions and discipline being more difficult to maintain than in single wards.
The garbage of the hospital was disposed of through the garbage transfer station. Garbage was sorted in the kitchens, wards, and elsewhere in the hospital, thereby entailing no extra labor in the selecting of garbage. Sufficient cans, adequately covered, were placed at each mess to take care of the sorted garbage. The wagons and trucks collected the garbage daily, and more often as occasion arose. Paper, pasteboard, pieces of wood, cans, fabrics, etc., were separated from all other garbage and taken to the incinerator. At the transfer station the sorting was carried further, and anything of value, such as hog feed, bones, tin cans, bottles, etc., was salvaged, and disposed of by contract.
A central heating plant, consisting at first of a series of 10 batteries of low pressure boilers and one high-pressure boiler, supplied the heat for the hospital. The heating system was inadequate. During the severe winter of 1917-18, there were times when the patients would have endured great suffering from poorly heated buildings had there not been an ample supply of blankets. The expense of repair incident to freezing and the bursting of pipes was almost inestimable. Because of the lack of steam, the wards having steam tables were
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without their use many days when they were very essential. For the same reason, sterilizers in the operating room were useless at times, and frequently when most needed. A further handicap was the difficulty with which coal was delivered to the steam plant. A railroad spur should have been laid for the delivery of coal, but this was not done. For a greater part of the cold season, when the quantity of coal used was the greatest, the roads were practically impassable, trucks could not be used, and mule teams had to be resorted to, working day and night to keep sufficient fuel on hand. Additions to the heating plant were made in the autumn and winter of 1918; and by December these additions were 90 per cent complete, greatly reducing the difficulties of heating the hospital buildings.
Current for the electric lights was obtained from the Georgia Light & Power Co., of Atlanta. The grounds and buildings were well provided with suitable lights, and the electrical equipment for other purposes was adequate. The only disadvantage experienced in this connection was lack of provision for an electrician to be on hand at all hours. On many occasions such services were urgently and promptly needed, but could be obtained only after waiting indefinitely for the arrival of an electrician from the utilities branch of the Quartermaster Department.
In the early days the equipment was practically that of a field hospital. Temporary quarters were being occupied; there were no water or sewerage connections; and the buildings were not suitable for the installation of equipment of a permanent nature. Later, the equipment was satisfactory in the main. There was a shortage of sphygmomanometers, and a few instruments were badly needed for the eye, ear, nose, and throat department. The messing arrangements of the convalescent wards were inadequate, a kitchen and mess hall being badly needed.
The post exchange was opened January 13, 1918, with a stock, the value of which was $1,374.75. Sales for the first day were $110. Dividends for the first month were $95.56; in February they were $800.73, and in March, $1,103.96.
There was no Young Men`s Christian Association building on the hospital reservation at first, but two "Y" men were on duty in the hospital practically all the time, and in an adjoining block the "Y" building was open to the men of the hospital detachment.
The Red Cross erected a commodious building adjoining the hospital grounds for the use of patients during the day and for entertainments in the evenings. Valuable assistance was rendered the hospital in the matter of correspondence with relatives of sick soldiers, and in many other ways. Several rooms were so equipped that relatives visiting the patients might remain over night.
The activities of the various clubs, societies, etc., in the city of Atlanta were very beneficial to the patients in the hospital. Many of the wards were adopted by these organizations, whose representatives made at least one visit a week to the patients, bringing flowers, reading matter, etc., for the men. A recreation room under the auspices of a Red Cross Chapter was fitted up in the exchange building, and here ambulatory patients were allowed to congregate at certain hours. Practically all of the wards were supplied with phonographs and a goodly number of records.
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Statistical data, United States Army Base Hospital, Camp Gordon, Atlanta, Ga., from December, 1917, to June, 1918, inclusive
BASE HOSPITAL, CAMP GREENE, CHARLOTTE, N. C.a
The base hospital, Camp Greene, was located in Mecklenberg County, 42 miles from Charlotte, N. C.
The surrounding country is rolling and wooded. The soil is red clay, which gives rise to very little high-flying dust in dry weather, but a great deal of red, sticky mud after rain.
The climate in summer is moderately warm, with very hot days occasionally. The autumn is cool and exhilarating. The winter of 1917-18 was very severe and cold, which was unusual for this location.
The roads in and about the hospital were of cinders and dirt. The streams in the immediate vicinity were small brooks. The sanitary status of the hospital neighborhood was good.
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Greene, N. C." by Lieut. Col. George A. Penn, M. C., U. S. A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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The base hospital was organized September 18, 1917, its function being to treat cases arising in the camp as well as medical, surgical, and venereal cases from overseas.
The base hospital was occupied September 18, 1917, when four wards were completed and patients admitted thereto. The hospital was originally erected on the standard pavilion plan. Later, six two-story barracks buildings and a ward which was used for clinical lectures and as offices for the chiefs of service, were constructed.
The hospital water supply was identical with the general camp supply, and was obtained from the Catawba River, and treated by mechanical filtration by gravity through a sand-sulphate-aluminum coagulant.
Comfortable quarters were provided for officers and nurses, and the barracks for enlisted men were satisfactory.
The general mess was conveniently situated and centrally located with reference to the wards, with which it was connected by covered boardwalks. The officers` mess was conducted in the officers` quarters, and, likewise, the nurses had their separate mess.
Five warehouses were provided for supplies for the medical supply officer, the dispensary, and the quartermaster of the hospital.
The hospital had to depend entirely upon a laundry in Charlotte. The service was very unsatisfactory.
The hospital was fairly well equipped in the early days of its existence, and fully equipped eventually.
A complete sewerage system was installed in the hospital. There were no latrines. Water-closets and shower baths were placed in separate rooms in the wards.
All garbage was delivered to a dumping platform where it was removed by farmers. Manure was disposed of in the same manner. Shower baths were placed in the wards in separate rooms with the water-closets.
The hospital was heated during the winter of 1917-18 by means of very inferior trash stoves. These were replaced later by a general assortment of various coal stoves and so-called individual ward furnaces, which were operated by men from the detachment on duty in the wards. This method of heating was very unsuccessful and unsatisfactory, and there was a continual danger of setting fire to the wooden structures. Furthermore, during the very severe weather of the winter of 1917-18 great difficulty was experienced in procuring sufficient fuel because of the almost impassable condition of the roads.
The hospital was lighted by electricity, the system being successful in the main.
Early in November, 1917, the chapel was ready for use for religious purposes. A post exchange was established soon after the hospital opened, and proved a great convenience to the patients.
The Young Men`s Christian Association constructed a building for the use of the personnel and patients. It was well patronized and proved a source of much entertainment.
Until July 1, 1918, no Red Cross building had been erected. Red Cross workers, however, were very active from the time of the organization of the hospital and proved a source of great help.
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BASE HOSPITAL, CAMP HANCOCK, AUGUSTA, GA.a
Camp Hancock was located in Richmond County, Ga., adjacent to the city of Augusta. Augusta is a city of about 50,000 inhabitants, is largely devoted to agricultural business-principally cotton-and to cotton manufacture on a large scale. It is located on the Savannah River, which forms the boundary between the States of Georgia and South Carolina; and is about 135 miles from the city of Savannah, situated at the mouth of the Savannah River.
The camp was located west of the city, which it bordered for a distance of three-quarters of a mile. The base hospital reservation was at the extreme eastern end of the camp, and part of this reservation actually lay within city limits.
City street-car lines passed the hospital at a distance of about two blocks from the entrance to the hospital area.
The country in this region is rolling, partly wooded, and partly under cultivation. The hill upon which the camp was located is about 400 feet above sea level, and this represents the average height of the hills in this vicinity. From this hill there was a view in all directions over the surrounding country, the horizon to the east and south being at least 50 miles distant from the camp.
The soil of these hills is of sand to a depth of about 8 or 10 feet, and below is a subsoil of red clay varying in thickness from 4 to 20 feet. Below this again is sand, of a fine quality, light in color, and very closely resembling the sand of the seashore. The top layer of the soil is sand a bit coarser than ordinary sea sand but closely resembling it. This sand is quite heavy and, except during high winds, does not blow to any extent, but it washes away badly during heavy rains; and because of this it is difficult to maintain roads and levels. The red clay is admixed with sand, and it packs very well. It is used extensively in the region for the construction of roads, being practically the only material available, as there is no rock or gravel to be found in the region. In the valleys there is a mixture of loam with the sand, and as these are well watered during freshets and after heavy rains they are extremely fertile. Vegetation on top of the hills reminds the observer of the seacoast, with the same scrubby wild pea.
The climate is mild and fairly equable. Summers are hot, the thermometer often reaching 100 F. for many days at a time, and during July and August there are frequent and violent thunderstorms. Hot weather begins about the 1st of June and continues well into September, sometimes well into October. Actual winter weather begins usually about Christmas and lasts six or seven weeks. During that time the winter may be fairly violent, with low temperatures and sleet storms. There is, however, no great precipitation of snow, and if snow falls it melts very quickly. There are a good many days with low temperature and high winds. During the winter of 1917-18 the thermometer once reached 5 above zero in the early morning. The weather in spring and autumn is delightful. October, November, and most of December are very much like early October in New England, with much sunshine and few gray days. Often it is possible to gather roses on Christmas Day. Again from the 1st of February until the last of April the climate is delightful. Spring advances
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Hancock, Ga.," by Lieut. Col. F. J. Barrett, M. C., U. S. A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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slowly but steadily; there is much sunshine; and there are very few days when the temperature is too high for comfort.
The roads in the entire region were rather unsatisfactory, there being no rock for the formation of a roadbed and no suitable gravel for the top dressing. From necessity roads were constructed from the red clay which formed the sub-soil. Properly mixed with sand this formed a hard, smooth surface, but it washed away easily during rainstorms and was easily torn up and the surface rendered uneven by heavy traffic. The roads, however, were fairly easily repaired by the use of road scrapers, the addition of more clay, and some rolling. In the valleys between the hills there is comparatively little swampy land, and, owing to the nature of the soil, this can be drained easily. The camp was therefore, comparatively free from mosquitoes.
No date can be set for the organization of the base hospital, for this was a gradual proceeding, occupying several weeks. The first medical officer to report for duty arrived August 14, 1917. At that time the hospital site had not been selected, but some of the neighboring buildings were under construction. Practically the only persons in the Military Establishment present at that time were the constructing quartermaster with his staff, and one battalion of the Georgia National Guard. During the next few days several medical officers arrived, and on August 18, 1917, the commanding officer of the base hospital reported for duty. In conjunction with the constructing quartermaster, his first duty was the selection of the hospital site. Building of the hospital was begun about September 9, 1917, and progressed rapidly. Such rapid progress was made on certain of the buildings that it was possible to admit the first patient on October 14, 1917.
The National Guard regiment from Pennsylvania had been arriving since the last days of August to form the 28th Division, which was to train at Camp Hancock. This division had as part of its sanitary train four field hospitals, and these were set up and used for the accommodation of the sick of the division during the interval preceding the opening of the base hospital. There was no great amount of sickness during this period and no epidemics appeared, so that the field hospitals were well able to care for the sick of the camp. It was not necessary, therefore, to engage temporary quarters or to use local hospitals except for acute surgical cases. The university hospital connected with the medical department of the University of Georgia, at Augusta, opened its doors to the surgical department of the base hospital, and acute surgical cases arising in the camp were operated upon and cared for there. Even after the opening of the base hospital it was not possible to care for acute surgical cases until the middle of January, 1918; apparatus and equipment had not been received, and the heating plant for the operating pavilion was not complete until that time.
Upon its completion there was no formal opening of the hospital, and improvements and additions were constantly made even so late as August, 1918.
The buildings constituting the base hospital were of the type adopted for all National Guard camps. The original orders for the construction of the hospital did not include lining or ceiling the buildings, nor any sewerage and plumbing system. It was not until January, 1918, that the constructing quartermaster began to line and ceil the buildings with heavy beaver board-a much-needed addition because of the very cold weather then being experi-
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enced. Those who spent the month of January, 1918, at Camp Hancock are not likely to forget their experiences there. Plumbing had not been installed in the hospital; there was no sewerage system; the hospital was heated only by stoves; and there was no lining to walls nor were there ceilings to hold what heat the stoves gave. There was no hot-water supply, all water being brought in from the grounds and heated by stoves. Added to these handicaps, the weather was exceptionally cold and severe. The work of ceiling and lining the buildings was completed during January, so that after that time life was much more comfortable. About this time also the installation of the plumbing and sewerage systems was begun. At first, the city water mains were brought into the hospital grounds, and fire plugs were located for the protection of the buildings against fire. These mains were tapped at various places in the grounds so that there was provision for water for use in the wards. There was at first no sewerage system, and latrines were placed about the hospital grounds, allowing one for about every four wards. These latrines were of the usual open-air type, and in winter weather were far from comfortable, especially for patients.
Though at times crowded, the quarters throughout the hospital were satisfactory. Six barracks of the standard one-story type were constructed for enlisted men. These were about 160 feet long and 24 feet wide, with four rooms at one end for the noncommissioned officers, and a small common sitting room at the other end. Each barrack accommodated about 50 men. The barracks were very comfortable except for the fact that beaver board for ceiling and lining was not installed until well into cold weather, when troops, patients, and all who were housed in the hospital buildings were very comfortable.
The original building for the officers was long and narrow and was divided into 24 rooms, each room being about 9 by 10 feet, with one window. No bathrooms were provided until the plumbing for the hospital was installed. A latrine was constructed about 60 feet from the end of the building, and the only bathing facilities obtainable at the time were a galvanized-iron bucket, and a faucet in the yard. The building was heated by small stoves, one 6-inch "cannon" stove for each room. Each stove had its separate galvanized-iron smokestack, and the resulting appearance of the long row of these stacks was weird. In the early spring of 1918 three large additions were made to this building, converting it into an E-shaped structure. The two outer wings were for bedrooms, all of the same shape and size as those described above. The center wing contained a good-sized assembly room, a dining room, and a kitchen adequate for the needs of these quarters.
The barracks for nurses were almost exactly like those for the officers, presenting the same difficulties. A nurses` recreation house was built and equipped by the Red Cross.
A society of young ladies of Augusta raised a sum of money by a series of entertainments during the winter of 1917-18, and fitted up the sitting room in each of the barracks with furnishings, curtains for the windows, and other comforts.
Before the plumbing system was installed the men of the Augusta fire department allowed the men of the detachment the use of their shower baths, a privilege which was deeply appreciated.
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Because the cooks and their assistants were more or less inexperienced, the kitchen of the hospital was perhaps the most difficult department to establish and maintain. There were five messes at the base hospital-the main mess for convalescent patients, including a diet kitchen for the feeding of ward patients; the enlisted men`s mess; the sick officers` mess; the medical officers` mess; and the nurses` mess. The three last named required the least care and attention; they were relatively small and their management much more simple. The patients` mess required the greatest effort and caused the most trouble, as it was the largest, and a variety of needs had to be catered to. The original equipment in this mess consisted of a battery of four-burner gas stoves with fair sized ovens under each. Aside from these and a somewhat too small refrigerator, there was practically no equipment, except the usual pots and pans. For some reason this hospital did not receive as much equipment as did some other base hospitals, and it was a struggle to get along with the inadequate equipment for feeding patients. In March, 1918, a small hospital fund having accumulated, permission was requested to expend part of it in the purchase of additional kitchen equipment, such as steam kettles, dish washers, potato parers, etc., but word was received that the Construction Division would install these. Installation began in August, 1918. The original equipment included wheel carriages with hot-water trays for food containers, but these trays were too shallow and did not serve during cold weather to keep the food hot. Indeed, the serving of hot food to ward patients was one of the greatest problems of the winter. Most food had to be reheated on the gas stoves in the ward diet kitchens, and even then it is probable that the food served to many patients was not sufficiently hot to be palatable. Hot kettles were improvised by putting small pails into larger ones containing hot water. This helped improve the situation, but the preparation and service of food was far from satisfactory. During the winter of 1917-18 difficulty was experienced also because of low gas pressure, due to fuel shortage. Because of this fuel shortage many householders in the city depended upon gas for keeping their houses warm, and the supply was limited and the consumption excessive.
A dietitian was added to the staff of the hospital about Christmas, 1917, and her efforts greatly increased the comfort of patients as regards their diet. Supplies were abundant at all times.
In the enlisted men`s mess much the same trouble was experienced. The kitchen was at the end of the gas main and pressure was often lower there than anywhere else, and on many of the coldest days it was impossible to serve warm food. Breakfast was likely to be the best meal, as it was served before the city people were up and using gas.
The storehouses of the hospital were among the first buildings finished. There were four of them, each about 150 feet long and 25 feet wide. One was assigned to the hospital quartermaster for his use, and the camp medical supply officer and the hospital property officer occupied the other three. Until the later construction of nine two-story ward barracks, these warehouses were sufficient to meet the needs of the hospital, but at least one more could have been used to great advantage.
A building was originally constructed as a laundry, but no machinery was installed. Laundry work was done by a steam laundry in the city of
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Augusta, the arrangement proving very satisfactory. Suitable steam laundry facilities were greatly needed.
A chapel was one of the original buildings of the hospital, but it was not used in the early months; it had no furnishings and there was no ceiling. Owing to the proximity of a Young Men`s Christian Association building in camp, available for religious purposes, and to the fact that several of the city`s churches were only a short distance away, there was no great demand for the use of this building. During January, 1918, there was an epidemic of German measles, and the hospital was filled to overflowing. During that time the chapel was fitted up for a ward. Later, it was turned over to the representative of the Young Men`s Christian Association, who fitted it up for the detachment of the hospital and provided it with writing tables and games.
Fortunately, owing to the proximity of the city of Augusta, it was possible to bring gas mains to the hospital for a supply of fuel gas. At first there was only a limited supply of gas stoves, but gradually these accumulated so that before cold weather set in there was at least one installed in the diet kitchen of every ward. These served the dual purpose of warming food for patients, brought over from the mess, and for heating water for the care of patients, and was almost the only approach to the usual comforts obtainable during the severe weather.
From the first the hospital was heated by stoves and furnaces. These were in great variety of sizes and shapes, but the "cannon" type predominated, sizes ranging from grates of 7 to 18 inches in diameter. For the wards hot-air furnaces were provided. Each ward had two of these, of a type ordinarily used for heating small houses. They were mounted at either end of each ward, and above each was placed a large deflector plate in the hope that the hot air would be deflected downward. The scheme was a disappointment, however, as the heat continued to rise and the lower portion of the rooms remained cold. One could stand beside a heater in full operation and yet get no warmth from it. Removal of the outer case of these heaters improved the warmth of the wards, and this measure was adopted. There was a total of 300 "heaters" and stoves set up throughout the hospital, and the labor required to carry fuel to and from these can well be imagined. There was also considerable difficulty from the soiling of the wards by ashes and from the fact that patients persisted in using the stoves as receptacles for all manner of refuse.
The hospital was benefited by its proximity to the city in the matter of lighting, insuring electric lighting from the start. The supply was constant and satisfactory. Power came from a dam on the Savannah River about 12 miles above the city.
The various equipments for fire protection were completed, during the summer of 1918, with the installation of a fire house and a high-powered automobile fire engine of the latest type. In addition, chemical fire engines, a siren whistle, several 40-gallon chemical fire extinguishers mounted on wheels, with a 100-foot hose attached, were installed in several parts of the hospital. There was also a night watchman system for fire protection, with 4 watchmen`s clocks and 64 stations. These stations had to be rung up at least once an hour during the night, and were so arranged that a watchman should visit all parts of the hospital at least once an hour. The initial number of hand extinguishers
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and fire buckets was considerably increased, and an automatic fire-alarm system was added to the equipment.
For its water supply the hospital was connected with the Augusta water system. The arrangement was satisfactory, and the supply never failed.
When the plumbing was installed there was water, both hot and cold, in every ward and in all kitchens and bathrooms of the hospital. Each ward had a bathroom in which there were two hand basins, a bathtub, a shower bath, a dental sink, urinal, and toilets. There was also a slop sink in a room designated the "service room " and the diet kitchen had a satisfactory kitchen sink. Each ward had its own hot-water heater installed in a small lean-to outside, and there was an abundance of hot water.
The sewerage system of the hospital was connected with the sewer mains of the city of Augusta, thus providing for the disposition of all sewage. There were no toilet facilities until the plumbing was installed in February, 1918.
The disposal of garbage was accomplished by digging a pit about 16 feet deep, which took it through the layer of red clay which forms the subsoil in this region, and from 12 to 14 feet in diameter. It was filled up to about 10 feet from the bottom with a cribwork of logs. On top of this cribwork was placed a layer of logs laid close together, and upon these about 4 feet of broken brick, upon which a fire was built and garbage disposed of. A hopper was constructed at one side to take care of the sullage water contained in the garbage. Upon being poured into the hopper this water ran down over the heated bricks into the pit and what was not evaporated ran off into the sands. This incinerator proved very satisfactory and easily took care of all the hospital garbage until some months later when arrangements were made with a contractor to purchase and remove the garbage. Still later a reclamation service, established under the camp quartermaster, assumed the duty of caring for this detail.
The equipment of the base hospital gradually developed from an amount which would be considered extremely scant by a well-established city hospital, to that which would compare favorably with any hospital in the country in this respect. Bed linen was one of the shortages when the hospital was first established. Only about 2,400 sheets were available at first, and for several weeks after the hospital opened, obviously an insufficient quantity for a hospital of 800 beds. Office fixtures were lacking in the early days of the hospital, and in many of the administrative offices and in the office of the ward surgeons it was necessary to construct tables from scrap lumber left by the contractors and from packing boxes in which medical supplies had been delivered. Much of the necessary shelving was at first constructed from these same scrap materials. For a long time there were no tongue depressors and it was a common sight in many of the wards, and particularly in the nose and throat ward, to see convalescent patients whittling them out of box wood. They were then sterilized and distributed throughout the hospital. A great deal of ingenuity was shown by ward surgeons and wardmasters in improvising chairs and tables. In the nose and throat clinic several very clever tables were devised with bottle and towel racks which were so useful and practical that they were later copied in better material, properly finished.
During the early spring of 1918 the American Red Cross constructed a large house for convalescent patients. This was a very elaborate building and consisted of a large auditorium with stage. The stage and auditorium could
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be converted in the day time into a large reading and game room. There was also a small kitchen and on the second floor in two of the wings were several bedrooms which were used by the staff of the Red Cross house and for the accommodation of the relatives of sick patients. The Red Cross house was presided over by a Red Cross worker, and a member of the Army Nurse Corps was on duty there as matron. The American Library Association placed many books upon the shelves of this house and assigned a trained librarian for their proper care and distribution to the convalescent patients throughout the hospital. Under the direction of the representative of the Red Cross, entertainments for convalescent patients were arranged, and unquestionably the house was of great benefit to the patients and materially assisted in hastening the convalescence of many by giving them a much-needed change of environment from the hospital wards.
Early in the autumn of 1917 a Young Men`s Christian Association worker was on duty at the hospital, working untiringly among both patients and the men of the detachment. In the spring of 1918 he took charge of the chapel, as mentioned above.
After January, 1919, there was a steady decrease in numbers both in the camp and at the hospital. On January 21, the Surgeon General designated this hospital for the care of severely gassed patients whose homes were east of the Mississippi River. About 50 cases were received and carefully studied, particularly with regard to physical signs and the radiographic findings. On February 25 orders were received that the camp and hospital were to be demobilized at once, all gassed patients to be sent to the general hospital at Biltmore, N. C. On March 26, 1919 , the base hospital was officially closed, and the buildings turned over to the Public Health Service.
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BASE HOSPITAL, CAMP A. A. HUMPHREYS, VA.a
Camp A. A. Humphreys was situated in Fairfax County, Va. The nearest town was Alexandria, Va., 12 miles distant, with a population of about 15,000; Washington, D. C., was about 18 miles away.
The camp occupied Belvoir Peninsula, which is rolling and wooded, and about 3 miles long and one-half to 2 miles wide. On the east is Dogue Bay; on the west, Accotink Bay. The point of the peninsula is in the Potomac River, about 20 miles from Washington. On the east side, the shore is heavily wooded and rises abruptly for 100 feet to a comparatively level plateau. On the west, the rise from Accotink Bay is more gradual, and level ground is not reached for half a mile. The plateau runs north and south, and makes possible the boast that Camp Humphreys had the longest parade ground in the United States. The point of the peninsula, from the Potomac north for about a
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp A. A. Humphreys, Va.," by Maj. J. M. Greer, M. C., U.S.A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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mile, is very rolling, with an abrupt rise to the south end of the parade grounds. On the edge of the plateau, a half-mile east of the shore of Accotink Bay, and separated from the southwest corner of the parade ground by a quarter mile of timber, was the base hospital. Its situation was ideal: half a mile east, across the parade ground, was the headquarters and the civic center of the camp, and thus the hospital was conveniently near for ease of access, yet sufficiently distant to escape the noise and bustle of camp life.
The soil is clay, with occasional outcroppings of gravel. While the soil forms mud when mixed with water, it is not distressingly tenacious. The neighborhood of the parade ground became very dusty in. summer, but the base hospital did not suffer from dust, nor was it visited by disagreeable winds.
The pine, oak, hickory, chestnut, elm, cedar, and sycamore trees were carefully preserved, and served the purpose of both beautifying and protecting. Even in winter, when the deciduous trees had been stripped, there was enough pine and holly to rest the eye.
The roads about the hospital were not ideal. On the east side there was a clay road, fine in dry weather, but rather muddy in rainy weather. On the west side an attempt was made to make a cinder road, but coal dust was used, with a result that may be left to the imagination. However, the site was so excellently drained that the character of the road structure was not a serious consideration.
The history of the base hospital begins with the original hospital, at the very point of the peninsula, on the shore of the Potomac. The site, though comparatively low-not more than 25 feet above tide water-was naturally well drained. From April 28, 1918, to September 13, 1918, this was where the hospital was located. This original hospital, or camp hospital as it was then called, took the name of Belvoir. The only building available was a rough, wooden, one-story barracks, formerly occupied by soldiers in training. It was partitioned into five rooms, three of which were used as wards, one as an emergency operating room, and the fifth as the administration office. Conditions were very trying. A real base hospital was promised; therefore no expensive improvements were attempted at Belvoir. The water supply, from a deep well, pumped to the latrines and kitchens, was excellent when the pump worked; but the water was not piped to any of the barracks, and the hospital supply had to be carried in buckets to kitchen or latrine. On more than one occasion the pump failed to work, and the water was transported in cans by truck from the main camp. From this small beginning of five rooms on April 28, 1918, the hospital grew steadily. On May 29, an order was issued by the War Department changing its name from camp hospital to base hospital, Camp A. A. Humphreys. By the following September, 27 buildings were required to house patients, the medical detachment, medical officers, and equipment. There was finally a bed capacity of 350, which included about 50 beds in tents placed about the grounds and used for contagious cases and isolation purposes. On September 13, 1918, the surgical ward and operating room equipment were moved to the new hospital. As rapidly thereafter as equipment could be installed the remaining wards were moved. Last of all, the administrative offices were moved. By September 20, everything was running smoothly, and plans for a formal opening were discussed. At this
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time, however, the hospital was far from complete, either in buildings or in equipment. The original plans called for 45 wards, arranged in sections, the various wards in each section opening into a common corridor, each of the corridors being connected with a main central corridor. At the time of occupation only three sections were completed. From September, 1918, to the beginning of 1919, progress toward completion was provokingly slow. Labor shortage, the influenza epidemic, and the armistice combined to delay construction. The original plans included an additional building for officers` quarters and an additional one for nurses. These buildings never materialized, leaving both officers and nurses rather uncomfortably crowded.
Officers were quartered in two buildings. The staff officers` quarters, for the accommodation of the commanding officer, a registrar, and the chiefs of the medical and surgical services, were roomy, fitted with toilet and bath, and were conveniently located opposite the administration building. Large quarters, with kitchen and mess hall opposite the officers` ward, housed the rest of the commissioned officers. The original plans called for an additional building; but as this was never erected, the officers had to "double up," two occupying a room large enough for only one. The detachment, Medical Department, was quartered in three large two-story barracks on the east side of the hospital. A fourth building, intended for the detachment mess hall, was converted into a recreation room for the enlisted men. These quarters were steam heated and fitted with baths and toilets.
There were three messes in the hospital. A general mess, the largest, was fitted with every necessary appliance. This served the enlisted men of the detachment, as well as the convalescent patients. The large, airy mess hall, adjacent to the kitchen, was so arranged that each table of 20 men was presided over by a noncommissioned officer whose duty it was to see to the conservation of food and to insure proper conduct at the table. Each presiding noncommissioned officer was responsible to the mess sergeant. Food for patients on light and liquid diet was prepared in the diet kitchen under the direct supervision of the dietitian. The nurses had their own kitchen and mess in their quarters. The commissioned officers and officer patients had a common mess in the officers` ward.
There were two large one-story warehouses situated about a quarter of a mile from the base hospital. Each building was divided into two by a brick fire wall 2 feet in thickness. The buildings were of such dimensions (400 feet long and 50 feet wide) that it was possible to carry a three months` supply of medical property for the base hospital as well as for the field organizations. The warehouses were heated from the hospital heating plant.
The hospital chapel was never used for religious purposes. During the influenza epidemic the building was used for the overflow from the mortuary; otherwise the chapel was not utilized. Religious services were held in the detachment mess hall, in the nurses` mess hall, and in various other places, including the Red Cross recreation building.
All laundry work was done by the Alexandria Laundry (Inc.) under contract. The arrangement was quite satisfactory except during the influenza epidemic, when the laundry plant was overtaxed.
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The hospital water supply was from the camp supply, the source of which was Accotink Creek at a point about 3 miles from camp. From the creek it was carried by wood pipes to a filtration and chlorination plant at Accotink, and from there to a centrally located steel supply tank with a capacity of 300,000 gallons, thence to every building in the cantonment. The water was excellent in quality.
The hospital sewerage system was, likewise, a part of the camp sewerage system. Every ward, and the officers`, nurses`, and detachment quarters were well equipped with the most modern type of tub and shower baths, lavatories, urinals, and closets.
The base hospital had the most complete, as well as the largest, steam heating system in camp. The buildings were all heated by direct radiation, the steam for which was supplied by a central boiler plant. The central boiler plant consisted of 150-horsepower return tubular boilers, brick set, vacuum pumps, boiler feed pumps, feed water heater, and such other accessories as were necessary for a complete installation. It was operated by the personnel of the utilities detachment, consisting of 1 officer and 37 enlisted men.
The boilers operated at a steam pressure of about 100 pounds, which was reduced by valves, to about 60 pounds before the steam entered the main lines to the hospital buildings. This permitted a supply of steam at this pressure within the buildings for cooking and sterilizing purposes, and a further reduction to about 5 pounds pressure provided steam at a suitable pressure for heating purposes. At the return end of each radiator and steam coil was installed an automatic return trap of the fluid disk type. This trap prevented the loss of steam into the return lines, and permitted the free passage of air and water of condensation into the return line, and out of the heating system. It was intended to install a complete return line system to convey this water back to the boiler plant, where it could be fed back to the boilers. Due to the shortage of pipe this was not done, and the water wasted to the sewer at the most convenient point. It is evident that there was an enormous waste of water and heat: large quantities of make-up water were necessary at the boiler plant, the temperature of this fresh water had to be increased, when otherwise this would have been unnecessary, and scale-forming elements had to be removed in large quantities. The waste of fuel and the injury to the boiler plant can hardly be estimated. The pumping plant for the camp was not designed to handle this additional load thus placed upon it. In the event of the necessity of shutting down the pumping plant, it would have been necessary to shut down the heating plant also.
The light and power system of this camp consisted of a system of distribution lines, 3-phase, 60-cycle, 2,300-volt primary and 220-110-volt 3-wire secondary extending to all parts of the camp. The system was divided into four circuits, No. 2 being the circuit that supplied the base hospital. Electric current was purchased from the Alexandria County Lighting Co., which had a transmission line supplying the camp exclusively.
In the early days the hospital equipment was very meager. Beds, linen, blankets, and like supplies were sufficient. But the water supply, as noted above, was very inconvenient; the only means of sterilization was a kerosene stove; and the almost impassable condition of the roads in April, May, and
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June, 1918, made new supplies very uncertain. This condition steadily improved, until by September 20, when the new hospital was taken over, everything was running smoothly. During the influenza epidemic the property office was fairly "swamped." While, eventually, the hospital became well equipped, especially for ordinary purposes, there were times when need arose for instruments not procurable through military channels, or which, if obtainable, would have been too long on the way; these were supplied by the officers on duty.
On May 27, 1918, the hospital exchange was started by purchasing outright, on credit, the stock of the exchange of the 51st Engineers. By the end of June, after a little over a month, the exchange had assets, over and above liabilities, of $1,825.19. After that date the average gross business per month was $6,000.
At Belvoir the Young Men`s Christian Association proved a very efficient organization in spite of the difficulties of transportation. At the base hospital there was no Young Men`s Christian Association building, the detachment mess hall being used as a recreation room, under the supervision of the association. A plentiful supply of magazines, home papers from practically every State in the Union, a pianola, and material for other recreations were available.
The completion of the Red Cross recreation building was delayed because of the scarcity of labor and materials. Two associate directors of the Red Cross were stationed at the hospital, their chief duties being to visit the patients daily, and to aid, as far as possible, in making them comfortable and cheerful. By furnishing stationery and reading matter, by communicating with the relatives and friends of the sick, by shopping for the patients, and in many other ways, valuable assistance was rendered.
In February, 1919, the base hospital reverted to the status of camp hospital.
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BASE HOSPITAL, CAMP JACKSON, COLUMBIA, S. C.a
The base hospital at Camp Jackson was situated in the midst of the "sand hill" country of Richland County, S. C., 7 miles east of Columbia, the State capital. It covered an area of 80 acres at the highest point of the reservation, 500 feet above the sea level, and on the summit of a hill which was scantily covered by dwarf oaks and a few long-leaf pines. The hospital area was free from running or standing water.
The soil of the locality is sandy, with a substratum of clay. Here are the sand dunes which mark the western-most limit reached by the ocean, at the junction of the Piedmont Plateau and the alluvial plain stretching 120 miles to the coast. The hospital area was practically denuded of every living green thing; the resulting bare stretch of sand, which was very glary in the sun, rapidly absorbed the heaviest rainfalls, and the fine dry sand was readily blown about by the winds, at times amounting to sand storms.
The climate of this section of South Carolina is ordinarily dry. The average winter temperature is 47. The winter of 1917-18 was the coldest in 32 years, the temperature dropping, at one time, to 6 F. above zero. The mean daily range is 23. The average summer temperature is 79, with cool nights. Gently blowing breezes, mostly from the southwest, are almost constant, and seldom attain a greater velocity than 7.4 miles per hour.
The roads in and leading to the base hospital grounds were made of sand clay, similar in character to the standard highways of South Carolina. In dry weather these roads were good, though very dusty; but in wet weather, or when there had been a frost, they were unsatisfactory because of the deep ruts which rapidly formed, requiring prompt attention. The last week in November, 1918, marked the beginning of the construction of a concrete road around the hospital area, a sorely needed improvement. Until June 1, 1918, there were no roads through the hospital grounds, and the delivery of supplies was greatly hampered. Autos and wagons sank into the loosely packed sand, frequently
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Jackson, S. C.," by Lieut. Col. S. R. Roberts, M. C., U. S. A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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becoming stalled. Abuse of motors, waste of gasoline, and delay in delivery of goods resulted.
The hill on which the hospital was located sloped gently down to the lowlands about a quarter of a mile distant. The lowlands were swampy, were covered by a heavy growth of vegetation, and had sluggishly running streams and pools of standing water, which furnished ideal breeding places for mosquitoes, both Culicid and Anopheles. The immediate neighborhood of the hospital was occupied by poor, small farmers, both white and negro, whose homes, buildings, and surroundings generally were badly kept and insanitary. Within a few miles, however, were many fine farms with modern homes and buildings, containing every sanitary convenience, and occupied by intelligent, clean-living, well-to-do farmers.
Prior to the occupancy of the base hospital the least seriously sick were cared for in field hospital "A," while those more dangerously ill or requiring major operations, were treated in the Baptist Hospital in Columbia by members of the base hospital staff.
Preceding the formal opening of the hospital proper, a part of the hospital detachment occupied the detachment barracks. The wards were occupied by patients October 22, 1917, before heating or plumbing facilities had been completely installed. The two central sections were heated from the central plant December, 1917; the last part to be so heated was the contagious section, which was not until late January, 1918. The hospital was constantly growing, new buildings being added weekly. Much of this delay in construction was due to faulty management and lack of intelligent honest supervision.
The greater portion of the hospital was of the single-story pavilion type, each ward occupying a separate pavilion, and accommodating 32 patients. A later addition, of 980-bed capacity, was of two-story construction, each building housing 80 patients. This was intended primarily for ambulant and convalescent patients still needing hospital care. All these buildings were connected by covered, screened board walks. In addition, there was a convalescent camp for those no longer ill, yet not able to do duty, and for those awaiting discharge on surgeon`s certificate of disability. This last group was housed in board shacks, each accommodating eight men.
The officers` quarters were inadequate from the first, and no mess hall was provided them. From the opening of the hospital until the middle of April, 1918, the medical officers were required to eat in the sick officers` mess, under crowded conditions. Some duty officers were lodged, at first, in the officers` ward quarters.
The original nurses` quarters, like the officers` quarters, were too small. The erection of a second building still proved inadequate, and four additional dormitories were constructed. In addition, the Red Cross built a recreation hall for nurses, near the Red Cross building.
The detachment barracks were built to accommodate 58 men each. The eight buildings for this purpose were steam heated, lighted by electricity, and had bathhouses and toilets just outside. The mess was in a separate building. The buildings proved inadequate, and during the summer of 1918 some of the enlisted men occupied ward barracks.
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The main kitchen was equipped with all the modern appliances for the preparation of food by means of high-pressure steam, such as vegetable steamers, boilers, soup kettles, roasting ovens, and tea and coffee urns. A dish-washing machine was part of the equipment. There was a diet kitchen for the preparation of special diets. The mess hall was used for ambulatory patients only, bed patients being served in their wards from this mess, the food being sent to wards in food carriers which were heated by hot water, and the food served individually on trays. These food carriers were found, in actual practice, to fail in their purpose of keeping the food hot.
The division of sick officers had its own kitchen and mess halls, the latter being so arranged that convalescents from different communicable diseases could be fed separately. The kitchen and mess halls were separate from the living quarters.
The detachment, Medical Department, was quartered in two buildings, each of which had a kitchen and mess hall, supervised by a mess officer. The mess hall in one building accommodated 300 and in the second 200, and there were 1,050 to be served. The mess halls were entirely too small and their equipment totally inadequate.
The mess for nurses was in the nurses` home, and was supervised by a mess officer. The cafeteria plan was employed, and proved very satisfactory.
The staff officers` mess was in the wing with the staff officers` quarters. The expense of the mess was defrayed by the officers participating. It was in charge of a mess officer and a dietitian.
Lavatories and baths were of two types: those in immediate connection with individual wards, and those common to two wards. The latter arrangement was unsatisfactory. The necessity for the isolation of various types of communicable disease, and the desirability of a separation of races, rendered such an arrangement unsatisfactory. Lavatories and baths were connected with the main cantonment sewer.
The base hospital was heated from a central heating plant the equipment of which consisted of one return tubular, high-pressure boiler (the pressure being from 70 to 90 pounds), and 15 cast-iron sectional low-pressure boilers, with a maximum pressure of 12 pounds. This system was faulty in its inception, installation and operation: the feed water was cold; the condensation from the heating system was wasted, there being no return. The sectional boilers operated at a pressure of 12 pounds or less with a draft suitable for boilers of the return tubular type. To supply heat to the buildings farthest removed from the plant, fires were forced to the absolute limit, so that the breathings to the stack were made red hot, with a consequent loss of heat up the stack. This deserved unquestionable condemnation. During the summer of 1918, this heating system was so altered as to eliminate its faults.
Water for the camp supply was taken from the Congaree River at Columbia, pumped first into the sedimentation basin, then through rapid sand filters, with the use of alum as a coagulant, and later through a 16-inch main to a reservoir of a capacity of a million and a half gallons. From this reservoir the hospital water supply was pumped to a 30,000-gallon tank on Jones Hill, from which it flowed, by gravity, to the hospital buildings adjoining. The hot water was supplied from the central heating plant.
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The hospital area had a gravity flow sewerage system. The sewage was treated by means of a specially designed Imhoff septic tank. All hospital buildings, except the convalescent camp, were connected to this sewerage system. The water-closets, urinals, utensil hoppers, shower and tub baths, were grouped in compartments at one end of the ward, and were generally clean, efficient, and inoffensive.
Garbage from the kitchen was separated into four classes: (a) Bones, fats, and grease; (b) other kitchen waste (drained); (c) tin cans; and (d) paper, rope, twine, and bottles. The hospital kitchen waste was disposed of as follows: Each kitchen was provided with eight garbage cans for handling the material. The waste classed as (a) and (b) was disposed of by a contractor, who removed it each day, using it as food for animals and for by-products. The waste classed as (c) and (d) was incinerated at the camp. Other waste, such as soiled dressings, sputum cups, etc., as well as tea leaves, coffee grounds, and other combustible material, was disposed of in a small incinerator near the reservoir.
While no animals were stabled around the hospital, the droppings from the animals used by the contractors accumulated at various points on the hospital grounds, proving, with the advent of warm weather, ideal breeding places for myriads of flies. These fly-breeding spots were eliminated in time.
When the hospital was turned over to the Medical Department by the contractors, many minor faults of installation were found in the lighting system, but these were all corrected. Extensions were made as needed, and the lighting system eventually became satisfactory. The lines, however, were heavily loaded, owing to the large number of new buildings, and to the fact that the hospital area was supplied from the same circuit as the camp laundry, where the use of current was heavy.
The building designed for the purpose of a hospital laundry was never utilized in this manner, but was used for a detachment mess, because of the need of quarters. The hospital laundry was sent weekly to the camp laundry, and on its return was stored in a warehouse of the base hospital, until reissued to the wards. The patients` wearing apparel, shirts, underwear, socks, and handkerchiefs, were sent daily to the camp laundry as individual bundles. These bundles were returned, clean, in 24 hours, and were given to the patients upon their discharge from the hospital.
The hospital chapel was first occupied by the Young Men`s Christian Association, February 1, 1918, in lieu of a building of their own, and under their auspices entertainments and religious services were conducted there. The chaplain, who arrived February 18, alternated services, morning and evening, with the representative of the Young Men`s Christian Association. At times services were held by representatives of Baptist, Lutheran, Episcopal, Methodist, and Catholic churches. In May, 1918, this building was made the detachment supply office, a new chapel being erected, in a better location.
The base hospital treated all cases arising in Camp Jackson, and medical, surgical, and venereal diseases from overseas.
When the hospital was opened to receive patients (Oct. 22, 1917), the only medical supplies on hand were parts of the first Wolfe unit received. This was completed in about three weeks, and was later increased to accommodate a capacity of 1,000 beds. In a short time epidemics began to appear, and the arrival of the necessary supplies to take care of the rapidly increasing
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number of patients was very slow. This was due, principally, to the freight congestion on all railroads. On June 1, 1918, the capacity of the hospital was 2,398 beds, and the medical supplies on hand or requisitioned were sufficient to meet the needs.
The base hospital post exchange was started in October, 1917, on credit. After the declaration of the dividend in May, 1918, the exchange was worth approximately $6,000.
The Young Men`s Christian Association used the chapel until May 12, 1918, when its own building was ready for occupancy.
The Red Cross had a building for supplies and offices, and another for an office, a cafeteria, recreation, and for the accommodation of relatives visiting patients. It also erected a nurses` recreation house. The society was helpful to soldiers in many directions.
In addition to the recreations furnished by the Young Men`s Christian Association and the Red Cross, there was an elaborate set of bowling alleys, conveniently situated, and operated without charge, by the hospital. There was also an extensive athletic field with a baseball diamond, tennis courts, a running track, and a boxing arena. Reading matter was provided for the entire personnel, a special library being arranged for the tuberculosis patients. Music was furnished by civilian singers, the camp band, and phonographs. Games were generally provided, and a moving-picture machine was installed.
In July, 1919, the base hospital reverted to the status of camp hospital.
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BASE HOSPITAL, CAMP JOSEPH E. JOHNSTON, JACKSONVILLE, FLA.a
Camp Joseph E. Johnston was located in Duvall County, Fla., 11 miles west of the city of Jacksonville. The terrain upon which the camp was placed was quite flat. The region was sandy and well wooded. There was no high-flying dust in dry weather, nor was there any mud after rains. The hospital was located on the St. Johns River about 20 miles from its mouth. At the location of the hospital the width of the river approximated 2 miles. To the south of the hospital site there was a large swamp, and a smaller similar area to the north. These low areas were drained by a system of ditches previous to
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Joseph E. Johnston, Fla.," by Lieut. Col. A. D. Davis, M. C., U.S.A., while on duty as a member of the staff` of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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the mosquito breeding season. However, some of the lower portions held seepage water which had to be oiled to control the mosquito breeding.
Roads in and about the base hospital were of concrete and ordinarily well kept. The majority of the roads within the camp were made of concrete, though a few were of gravel and sea shell construction. The main road which led from the city of Jacksonville to the camp was made of brick and was maintained in a very satisfactory condition.
Under normal conditions the climate of Jacksonville is equable, although there are frequently cold bracing days in winter and high hot temperatures in summer. In early spring and in late autumn one finds the most pleasant seasons of the year. The changes in the weather conditions of this region are due chiefly to the shifting of the areas of high and low barometric pressure over the country. In winter a spell of rainy weather is nearly always followed by a shift of wind to westerly through the south and colder weather within 24 hours. The presence in this vicinity of the West Indian storms, known as hurricanes, always produces a marked departure from normal weather conditions, but these storms, however, are not of frequent occurrence. On the average, January is the coldest month of the year, although the annual minimum temperature occurs most frequently in December, and the lowest temperatures ever recorded were in February. The mean temperature reaches its lowest point during the first week of January and its hottest in about the middle of July. The daily minimum temperatures throughout the year nearly always occur about the time of sunrise; and the daily maximum temperature in winter occurs about 2 p.m.; in the spring and late autumn at 1 p. m.; and in August and September about noon.
There were no temporary or emergency hospitals in use prior to the construction of the hospital proper.
The organization of the hospital dates from December 24, 1917. The first ward to be opened was the medical ward, which received its first patients on the afternoon of December 24. The remainder of the wards were completed and turned over to the Medical Department at intervals of a few days. They were equipped for the reception of patients as rapidly as they were received.
At the time the hospital was opened much inconvenience and discomfort were occasioned in both the officers` and nurses` quarters as the result of improper heating arrangements. The buildings were constructed of green timber and were damp and uncomfortable as living quarters. Within a few weeks after the opening of the hospital these quarters were insufficient to accommodate those on duty. Some officers were compelled to live in tents temporarily, while a large number of nurses were taken care of by assigning to them a portion of the officers` ward. Subsequently, additional quarters for both officers and nurses were provided. These were well built, properly screened, had good bathing facilities and adequate sewerage. The camp supply of water heaters for furnishing hot water for bathing purposes was provided, but a proper system of heating was not installed, and the discomfort on the part of the officers and nurses was considerable.
The barracks for housing the enlisted men were of the same general construction as the rest of the hospital. Each barrack building was provided with two large stoves and had ample bathing and toilet facilities.
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The hospital mess was opened at noon December 24, when a very light meal was served to the original 8 officers on duty at the hospital. Before night the census was increased by 30 enlisted men and 6 patients, and the next day, being Christmas, full rations and diets, which included generous quantities of turkey, were served, though the poor condition of the roads prevented the arrival of some of the articles on the menu, as frequently happened during the first month of the maintenance of the hospital. Until January 15, 1918, all meals of the patients, enlisted men, officers, and nurses were served in the main mess hall of the hospital. On this date the officers` mess was started. On January 8 the first of the nurses arrived for duty at the hospital, and for a few days had their meals with the officers, in the main mess hall. When the officers` mess was started they ate there until their own mess hall was opened on January 29, 1918. The enlisted men`s mess was not organized until February 5, 1918.
On February 26 a diet kitchen was started in connection with the main kitchen.
Lavatories and baths were located in all the building units in which either officers, nurses, patients, or enlisted men were housed. In addition, tub baths were located in each of the wards designated to receive patients.
A water carriage sewerage system emptied into the St. Johns River.
The source of the water supply was two driven wells, the depth of one being 700 feet and that of the other 410 feet. The water from these two wells was pumped into a reservoir, the capacity of which was 100,000 gallons, and distributed therefrom by gravity method similar to that throughout the camp. In the beginning a process of chlorinating the water was attempted without much success, and was later abandoned. During April, 1918, examinations in the laboratory of the hospital revealed the presence of the bacillus coli in the water. This condition soon cleared up, however, after adequate measures were taken to keep the tanks covered and protected from foreign substances. Later laboratory examination showed no coli bacillus and a very low bacteriological count.
With the exception of the operating pavilion, which was provided with steam heat, all of the buildings in the hospital were heated by stoves. Though no patients suffered from cold during the winter, the system was found to be far from satisfactory: the care of this large number of stoves entailed considerable labor, requiring the services of a large number of enlisted personnel, illy spared from other pressing duties; the winters, while neither severe nor of great length, are characterized by extreme and sudden changes, and it was not unusual to have a maximum of temperature of 72 one day, followed by a minimum of 26 to 30 the day following.
The hospital was electric lighted throughout, the current for the system, in common with that of the camp, being furnished by the city of Jacksonville. The service was entirely satisfactory.
Garbage from the hospital was disposed of largely by a civilian who was under contract with the camp quartermaster. The garbage was collected daily, the contract calling for a separation of the various forms of wastes. All garbage from the contagious area of the hospital was burned in an incinerator.
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The equipment for a 500-bed hospital was on hand in the warehouse, assigned to the Medical Department, and ready for distribution to the various building units many weeks before the hospital was ready for its reception. Subsequently the hospital was increased in capacity to 900 beds, and during the influenza epidemic in October, 1918, quickly constructed accommodations for 2,000 patients. The equipment of the hospital was adequate at all times.
The hospital post exchange was opened February 1, 1918, operating very successfully thereafter. The business of the exchange increased each following month until in September the financial transactions amounted to $13,000. The exchange purchased and paid for all fixtures and stock and the dividends by the end of the year 1918 had a net worth of approximately $10,000. The profits were used for incidentals which were not supplied by the Government, such as improvements in the hospital, entertainments for the patients, etc. There was a reading room and a sun porch for the benefit of the patients and enlisted men of the detachment, which was furnished by the ladies of Jacksonville. In the exchange there were operated an ice cream and soda counter, a haberdashery and notions department, a sanitary barber shop, an optical supply department, and a modern tailor shop.
There was no Young Men`s Christian Association building in connection with the hospital. However, early in the history of the hospital a representative of the association was appointed to give all of his time to care for all those needs of the patients and enlisted men that could possibly be supplied by this organization. Writing material, stamps, books, and magazines were abundantly supplied. Mid-week and Sunday services were held in the chapel. Moving pictures were shown, athletic material was supplied, and entertainments and games were fostered.
There were two Red Cross buildings on the hospital grounds erected and dedicated to the hospital. These buildings were the center of recreation and education for both the hospital personnel and patients. The services of the Red Cross representatives were invaluable. The society furnished emergency supplies for the needs of the hospital, the patients, and the personnel. Many times the Red Cross was able to supply the medical, surgical, and dental departments at once with supplies that it was impossible to get immediately from the Government.
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BASE HOSPITAL, CAMP KEARNY, CALIF.a
The base hospital, Camp Kearny, Calif., was located in San Diego County, 112 miles in a straight line from, and almost due north of, the business center of the city of San Diego, by rail 18 miles, and by stage 14.1 miles.
The terrain is an old sea bottom elevated into a plateau intersected by deep arroyos. The whole country is covered with a sparse growth of chaparral, the most abundant plant being greasewood. The hospital site was on a triangular portion of this plateau, surrounded by one small and two large arroyos, and connected with the rest of the camp by a comparatively narrow isthmus. This added greatly to the picturesqueness of the situation, but seriously limited the free expansion of the hospital.
The soil is a very thin layer of reddish clay which is very soft when wet and which quickly works into fine dust after becoming dry. Little trouble was experienced, however, from mud or dust, inasmuch as the principal buildings of the hospital were connected by good walks of plank or sawdust, and there was no traffic on the side of the prevailing winds. Immediately underneath the thin surface soil is a formation of unknown depth, composed of coarse gravel and small boulders of the hardest variety of crystalline rocks (quartz, porphyry, and basalt), cemented together by the clay. In the dry season this becomes very hard, virtually forming a conglomerate. It is nearly impervious at all seasons, rendering excavating for pipes, etc., extremely tedious and difficult.
There are really but two seasons in this region, the rainy and the dry. Records kept at San Diego since 1851 show an average seasonal rainfall of 9.69 inches, nearly all of which occurs in the months of December, January, February, and March. The rainy season corresponds to a mild spring of the Atlantic States. Two or three days of showers are succeeded by several days of perfect weather. The shrubs composing the chaparral put out fresh leaves, and all open spaces are covered with grass and wild flowers. In the dry season the country is brown and dusty. The sun blazes uninterruptedly in a cloudless sky, tempered only by an occasional fog from the sea at night and in the early morning. The temperature is very equable. The San Diego records show an average for the coldest month (January) of 54 F., and for the warmest (August) of 70 F. The camp and hospital, being situated 425 feet above the sea level, and 5 miles from sea, had a greater daily range of temperature (about 10 more) than for corresponding days in San Diego. An unexpected feature of the temperature record was that the daily mean temperature was uniformly about 10 higher than in San Diego. The nights are cool throughout the year, and ordinarily the wind blows just enough to make the day pleasant. Occasionally a hot north wind, heavily laden with dust, blows with considerable violence for about 12 hours at a time. This is the only really unpleasant feature of the climate.
The roads in and about the hospital were dirt, made of a red argillaceous sandstone found in the neighborhood. This packs very hard, softens very
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Kearny, Calif.," by Maj. J. M. Moss, M. C., U. S. A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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little in wet weather, and if judiciously sprinkled makes a very satisfactory road bed.
The country surrounding Camp Kearny was of no value for agricultural purposes, and was very sparsely inhabited. There were, consequently, no roads in the immediate vicinity.
For the above reasons there were no sanitary problems to be considered, except those arising from the proximity of the hospital to Camp Kearny. The distance between the most easterly ward building and the most westerly camp stable was only 800 feet.
There were no perennial streams in the neighborhood. There were rushing, muddy torrents in the bottom of each arroyo after a heavy rain, but these soon dried up, leaving only a series of small pools, the larger of which lasted nearly until the end of the dry season.
Mosquitoes were present for only two or three weeks, and these did not come to the hospital. Flies were remarkably few.
The first officers and men of the personnel arrived at Camp Kearny on August 15, 1917. The camp at that time consisted of a few tents for the officers and men of headquarters, about 1,000 troops, and two completed warehouses. The hospital was organized on September 1, 1917, and received its first patient on the same day. Prior to this time the sick soldiers of the camp had been cared for in a camp infirmary. The construction company maintained a small emergency hospital for its own employees.
About the middle of October the camp was completed and troops began to arrive in large numbers. Coincidentally there was a rapid increase in the number of patients in the hospital, and commissioned and enlisted personnel worked all day and far into the night in the attempt to compensate by their industry for the paucity of their numbers.
During all this time the hospital was in tents, a few 14 by 14 hospital tents obtained from the quartermaster, others borrowed from the field hospital organizations at the camp. There was an endless struggle to set up tents and procure blankets rapidly enough to keep pace with the influx of patients. Physical conditions were far from comfortable; an occasional windstorm would so cover everything with dust that the patients` faces, pillows, and blankets would be of a uniform color; immediately after sunset the temperature would fall many degrees, and toward the latter part of the period of tent occupancy, it became so cold that everyone whose duties did not prevent went to bed an hour after supper in order to keep warm. At the same time a great chorus of coughing would arise from the tents devoted to the patients with respiratory diseases, which would continue, without intermission, throughout the night, ceasing only with sunrise the next morning.
The buildings of the hospital, which should have been ready for occupancy coincidentally with the rest of the camp, were hardly begun when they should have been completed. Finally, on November 26, the buildings were sufficiently near completion to warrant moving the first patients. The distance from the tents to the buildings was nearly a mile, and the transfer of the patients, material, and personnel was complete in about two weeks, and was so managed that there was no interruption in the care of the sick. There were 843 patients under canvas at the time the moving was commenced and over 1,100
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were being cared for by the time the last patient was brought to the new hospital. As this was a 500-bed hospital, the patients in excess of this number were put on porches, in buildings designated as shop, laundry, and guardhouse, and tents were still necessary. The arrangements for taking care of contagious diseases were particularly inadequate; the three wards designated for the contagious diseases had a normal inside capacity of 84, and on December 15, 1917, there were 570 patients suffering from contagious diseases. Cots were placed on the porches so close together that the passage between them was difficult. Owing to the shortage of blankets some of the patients had to sleep under empty bed sacks.
New buildings were subsequently authorized and completed, and in May, 1918, it would have been easy to care for the greatest number of patients ever in the hospital at one time.
The original main ward buildings were one-story structures arranged in two rows of eight each, on the east and west sides of a central court. The north side of the court was occupied by the receiving ward, the administration building, and the ward for sick officers. A row of buildings extended along the south side, long enough to considerably overlap both sides of the rest of the group. This row was composed of the psychiatric ward, contagious wards, chapel, mortuary, guardhouse, garage, laundry, shop and quartermaster, warehouse, and the enlisted men`s barracks and mess halls. The center of the court was occupied originally by the patients` mess hall, the post exchange, and a laboratory building. The head hospital, for the eye, ear, nose, and throat, and dental sections, was subsequently added to this group. Quarters for officers and nurses were situated to the west of the main quadrangle. Nine two-story barracks buildings were later erected outside the quadrangle, at the southeast and southwest corners. All the buildings of the original quadrangle, except the row on the south, were connected by roofed corridors.
An unfortunate feature of the layout of the buildings was that the whole group faced the wrong way. The only access to the hospital was over the isthmus, which was at the southeast corner of the grounds. As the administration buildings and the receiving ward were on the north side of the group, visitors and patients had to pass the psychiatric and contagious wards and then go either half way around or through the hospital before reaching the place of admission.
In the original group there was a building, with four bedrooms, for the commanding officer, and one with 22 rooms for the other officers. When the hospital was opened 46 officers were on duty, 26 of whom were quartered in the building for the purpose, the remaining 20 being placed in a dormitory established in a large room in the receiving building. In February, 1918, the officers` quarters were enlarged to comprise 57 rooms, but these were inadequate, and a two-story barracks building was used to quarter the excess number.
Similar conditions applied with reference to the nurses. Their quarters contained 35 rooms, and two dormitories with 10 beds each. These quarters were soon filled, two nurses occupying a room 9 by 11 feet, with all their belongings (no storage room was provided), and many were sleeping on porches. The erection of a similar building did not overcome the crowded conditions which prevailed in the nurses` quarters. Those who slept two in a room had less than
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500 cubic feet of air space. A wing was added to one of the nurses` quarters to serve as a ward for sick nurses. This was a much needed addition, as no space was provided for the purpose originally, and no means of taking care of them except to move a healthy nurse out of her room so that a sick one might be alone.
No toilet facilities were provided for nurses except in their own quarters. The nurse who worked in the ward most remote from the quarters had to walk nearly three-quarters of a mile to a toilet and back to her work.
There were two mess halls for the enlisted men, situated in the middle of the row of barracks. The kitchen was in the rear end of one, and an inclosed corridor connected this with the other. The arrangement was perfectly satisfactory.
The officers messed with the sick commissioned personnel in the officers` ward, paying the rates prescribed by the Army Regulations.
Ambulant patients had a large separate mess hall in the center of the court. This was rather poorly planned; distances over which the food had to be carried were unnecessarily long; there was insufficient storage room; and too little space for the kitchen police, especially in view of the fact that all the work had to be done by hand, there being a total absence of all labor-saving devices. Another bad feature was the distance to water-closets. There were two near at hand in the post exchange, but these were only adequate for the building in which they were located.
There was no hospital storehouse proper. The medical supply depot for the camp was situated a short distance outside the grounds, its officers being quartered at the hospital. The enlisted men slept in the buildings. There was no toilet in the building, and for six months there was no running water, the men having to walk a distance of 400 feet for these facilities.
The hospital was equipped throughout with modern sanitary plumbing fixtures; eight of the wards had water-closets and baths in separate small buildings, each connected to two wards. The enlisted men`s barracks had similarly situated conveniences. All other buildings had water-closets and baths inside. There were no latrines.
There was no hospital laundry. A building designated as such formed part of the original group, but was never fitted with machinery, and was used as a contagious-disease ward. The soiled linen of the hospital was sent by the medical supply officer to San Diego for laundering.
The small building designated on the plans as a chapel was turned over to the Young Men`s Christian Association when the hospital was first opened. Services were held there every Sunday, by both Catholics and Protestants. A Catholic chaplain was attached to the hospital on April 26, 1918, after which mass was celebrated every morning in a small tent erected by the side of the chapel.
The equipment of the hospital was at all times adequate for the conditions as they existed at the given period.
The function of the hospital was to treat all cases arising at Camp Kearny, and medical, surgical, and venereal cases from overseas.
Both Camp Kearny and the base hospital were supplied from the water system of the city of San Diego. The water was gathered in a large reservoir
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behind a dam in the mountains, 65 miles from the city. It was conducted thence 45 miles by natural channels and flumes to the Otay Dam, where it was subjected to sand filtration. From this point it was carried 20 miles in pipes to the city of San Diego, where it was chlorinated at the city reservoir. The distribution through the hospital grounds was effected by means of wooden mains wound with wire. These were very unsatisfactory, requiring constant work to repair leaks.
The sewerage system of the hospital was entirely separate from that of the camp. It emptied into a septic tank, about half a mile down the arroyo which formed the northern boundary of the hospital grounds. The septic tank for the camp sewer was situated alongside that for the hospital. The discharge from the tanks flowed down the stream bed at the bottom of the arroyo. Signs in English and Spanish were placed every few hundred feet, calling attention to the poisonous nature of the water.
All the kitchen waste and garbage were removed daily by a contractor, who paid for the privilege. Tin cans and paper were turned over to the hospital quartermaster for transportation to the camp reclamation officer.
There were no heating plants. The hospital, in common with the camp, was supplied with gas from San Diego. Each building was furnished with gas "floor furnaces," discharging the products of combustion into the open air. These proved to be both inefficient and dangerous, and in several instances were discovered to be on the point of setting fire to buildings. The dangerous ones were turned off, and the hospital came to be heated largely by small portable gas stoves connected by armored tubing to outlets in the floors or wainscoting. Owing to the mildness of the climate and the ample means of ventilation, these proved to be entirely satisfactory.
The hospital was well supplied with electric lights, in common with the camp. There was an insufficient number of switches, so that in many places the lamps were removed in order to avoid the unnecessary use of light during the night, the result being a rather dim illumination during the early hours of the evening.
No attempt was made to open a post exchange during the days of the tent hospital. A building was provided for the purpose, situated in a central location, and the exchange was opened as soon as the move to the new hospital was fairly under way. The value of the stock in May, 1918, was about $7,000. The exchange building housed a barber shop and a library and reading room. The interior arrangement of the building was very bad. There was no access to the library except through the exchange, and the portion devoted to the exchange was so badly planned that fully a third of it was wasted.
As mentioned above, the chapel was used by the Young Men`s Christian Association for a time. Later a building was erected by the association, near the enlisted men`s barracks. Good work was done by the association representatives. The mail from the hospital amounted to from 800 to 1,200 pieces a day. There was no Red Cross building, but plans for an elaborate structure were submitted to the Surgeon General for his approval. The erection was hampered by the location of the hospital on ground where there was no room for expansion. In addition to a small library in the Young Men`s Christian Association building, a fine collection of books, fiction, science, and works of reference, contributed by the women of Coronado, was housed in the post exchange.
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A baseball field was in daily use. Two tennis courts, courts for basket ball, volley ball, and handball were provided, and a few pieces of gymnasium apparatus were set up.
Evening entertainments, musical and dramatic, were frequently given by patriotic citizens and by the men themselves.
The base hospital was made a camp hospital on March 27, 1919.
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BASE HOSPITAL, CAMP LEE, PETERSBURG, VA.a
Camp Lee was situated in Prince George County, Va., 3 miles to the east of Petersburg. The base hospital, three-fourths of a mile southwest of the camp headquarters, occupied part of an area abounding with historical associations which date from romantic and valorous episodes in the earliest colonial days, and include epoch-making events of both the Revolutionary War and the War of the Rebellion.
The region was flat and heavily wooded; but, where the main portion of the hospital was located, it was denuded of all verdure to facilitate construction. Fortunately, when this denudation was done, the convalescent portion of the hospital was not contemplated, so that when this additional section was erected it was possible to give thought to this essential detail and to disturb the smallest number of trees.
The soil is a mixture of clay, sand, and gravel; and, because of the flat terrain, the level of the ground water is ordinarily high. In the earlier days of the hospital, one had but to indent the surface with one`s heel to exhibit the near presence of water. Immediately west of the point at which the hospital was located the ground was especially swampy, and artificial drainage had to be instituted to remove its menacing quality. Because of the prevalent high winds during the summer there was much high-flying dust in the camp.
The winter climate is reputed to be mild, but the winter of 1917-18 proved to be exceptional: the ground was covered with snow practically from early December to the first part of March. The clearing of the area to the east and north of the hospital caused it to be exposed to an unusual degree to the severe winds.
The camp roads, as ultimately constructed, were satisfactory: the main road, from the camp to the hospital, was of concrete; and the remainder of the roads, though of dirt, were well crowned and oiled, and withstood remarkably well the heavy traffic to which they were subjected. The roads leading from camp, especially those to the rear of the hospital, however, were impassable at times following heavy rains.
Prior to the organization of the base hospital, an emergency hospital was established by the contractors for the care of civilian employees. This hospital was supervised by a civilian physician. Later, after some of the camp buildings had been erected, a temporary hospital, for the use of the military personnel, was instituted in one of the barracks.
On September 1, 1917, the base hospital was organized; and, in so doing, the temporary hospital was taken over for the purpose. By September 23, 1917, the first three wards of the group of buildings especially provided for the base hospital were occupied; and by November 1, 1917, all the wards had been completed. At the latter date the barracks for the enlisted men had not been erected, water connections in the hospital had not been made, and open latrines were still being used. The heating system was entirely inadequate and coal-burning stoves were used in the wards and offices.
aThe statements of fact appearing herein are based on the "History, Base Hospital, Camp Lee, Va.," by Maj. P. C. Riley, M. C., U.S.A., while on duty as a member of the staff of that hospital. The material used by him in the compilation of the history comprised official reports from the various divisions of the hospital. The history is on file in the Historical Division, Surgeon General`s Office, Washington, D. C.-Ed.
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The hospital, as constructed, comprised two groups of buildings: the main group, erected on the standard plan; and the group of ward barracks. This group of ward barracks, or the convalescent group, was situated westwardly from the main portion of the hospital, being separated therefrom by tracks of the Norfolk & Western Railroad. Connecting the groups were covered walks and concrete and macadam roads. Between the main and convalescent sections of the hospital there were located the heating plant, the medical supply depot, and the laundry building.
The quarters for the officers were in a building in which there were 56 small rooms and a large well-appointed dining hall with two very handsome open fireplaces. The quarters were totally inadequate for the personnel, and it was necessary to domicile the excess of officers either in the empty barracks of the convalescent area or in barracks situated elsewhere in the camp. At one time quite a number of officers had to be accommodated in tents situated to the rear and to one side of the permanent quarters.
The Army Nurse Corps quarters were three two-story stucco buildings.
The various messes of the hospital were divided into five units: the general mess, an officers` mess, a sick officers` mess, the nurses` mess, and the detachment mess, all under the supervision of one mess officer. The general mess was used by the ambulant patients, bed patients being served in their wards through the medium of the food conveyor. The general mess accommodated approximately 1,000 patients, and was reconstructed to facilitate the more rapid distribution of food.
The equipment used throughout the various kitchens was of the very highest modern type.
There were four storehouses connected with the base hospital: the camp medical supply depot, the base hospital property storehouse, the base hospital quartermaster warehouse, and the commissary storehouse.
The chapel was a small building neatly arranged for services held there by the chaplains of the various denominations. During the period of its construction it was occupied by the plumbers as sleeping quarters. From about the 5th day of December, 1917, until about the end of February, 1918, it was used as a hall in which psychological examinations were conducted. During the influenza epidemic, when the mortuary was filled to overflowing, use was made of this building to store bodies that had been made ready for shipment.
In the original plans a building was provided for the laundry, but there was no equipment for it, and this work was done by the Camp Lee laundry, a Government-owned plant. The laundry was used, however, as a central station for the collection and delivery of hospital linen between the various wards and the camp laundry. A section of it was used as a sterilizing room for the treatment of all soiled hospital linen; and another portion of it was set apart for the gauze reclamation equipment. The removal of soiled linen from, and the supplying of clean linen to, the wards was handled by a central delivery and collection system. The soiled linen from the wards was collected each day and sent to the sterilizer for treatment; it was then checked and an equal amount of clean linen was returned to the ward the next day.
The water supply for the hospital was the same as that of Camp Lee, the source of which was the Appomattox River. It was pumped from a plant
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about 1 mile above Petersburg to a filtration plant in Petersburg, where it was filtered and chlorinated and then pumped to a 1,000,000-gallon reservoir at Camp Lee. A pumping station supplied the camp from this reservoir, maintaining a pressure of from 65 to 70 pounds. The base hospital obtained its supply through two 10-inch wooden mains. The distribution system consisted of 10,500 feet of wooden mains varying in size from 6 to 10 inches. The valves on the main camp distribution system were so placed that water could be supplied the base hospital in emergencies when there was not enough to supply the entire camp.
The sewage from the hospital was disposed of by a system consisting of 20,000 feet of sewer mains and was a part of the camp sewerage system. The sewage emptied into a septic tank near the eastern edge of the camp, the effluent being discharged into Baileys Creek, a small stream skirting the eastern edge of the camp. Baileys Creek in turn emptied into the James River at a place south of City Point, Va.
In wards of the single-unit plan the toilets, urinals, and baths were located in a room which formed a part of the ward itself, due care being taken in its construction to prevent the penetration of odors into the ward proper. In those wards of double-unit construction these utilities were located in a small building facing the corridors connecting the two wards of the unit. The toilets, urinals, and baths were all of the latest sanitary construction. The latrines of the originally constructed barracks for the enlisted men were located in two buildings especially constructed for the purpose, conveniently near. Those in the quarters of the officers and nurses were of the same standard type and were located within the buildings proper.
The collection and disposal of garbage was thoroughly systematized. The main purpose of this system was conservation and reclamation of all articles which could be further utilized. Containers were placed in the various messes, and permanent signs were provided for the classification of trash and garbage over these receptacles, as follows: Newspapers and magazines only; clean tin cans; waste paper and cardboard; clean unbroken glass containers; unserviceable bread; fruit pits; animal food; miscellaneous; and not fit for animal food. The burlap bag containing newspapers and magazines and the one containing waste paper and cardboard were collected once each week, or oftener if necessary; all other articles were collected daily and delivered to the garbage stand at the general mess. Cooked meats, raw fats, cooked grease, and bones, unsuitable for further use as food, were used for the making of soap under the supervision of the mess officer. Garbage was collected each day from the garbage stand at the general mess by the camp garbage wagon, and delivered to the camp stand for disposal.
The heating of the hospital was accomplished by a general heating system, using 12 Kewanee boilers of the horizontal fire tube type, each boiler being 18 feet long and 6 feet in diameter. The main steam lines ran underground from the boiler house to points of distribution and were inclosed in wooden conduits the tops of which formed sidewalks in many parts of the area. The steam was delivered at high pressure, and was reduced at the entrance of each building to about 5 pounds pressure. All water of condensation was delivered to five
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Farmsworth traps, located in various parts of the area, and from these traps the water was pumped back to the boiler. There were 150,057 square feet of radiation surface installed in the hospital. The original heating plant was equipped with eight boilers. The new quarters for officers and nurses and the large convalescent area containing 12 two-story buildings required the additional four boilers to be installed. The underground conduits referred to contained two other lines, the first being the high-pressure steam line on which the pressure was maintained regardless of the heating system, and was used for steam cooking, sterilizing, and the laboratory work. The other line was the hot-water line, the water being heated in a large heater, the temperature being regulated by a thermostatic valve. This water was kept in circulation in insulated pipes throughout the hospital by an electrically driven circular pump. The operation of this plant was under the base hospital utilities department, 1 officer and 100 men being assigned from the camp utilities to care for the area.
The base hospital electrical equipment was fed by 3-phase 2,200-volt circuit; the current furnished was 60-cycle 110 secondary voltage. There were 65 electric heating elements and stoves used in the hospital.
The post exchange was the first exchange in camp and was started in August, 1917, at the temporary hospital. It occupied an ordinary wooden shack of one room. No shares were sold, but credit was obtained from several merchants in the city of Petersburg. Most of the business came from the workmen in camp and amounted to about $200 a day. The exchange moved, along with the rest of the hospital, in September, to its permanent location. The building was only half completed when it was occupied, and goods had to be sold through one of the windows, customers approaching by a narrow plank. For this reason, as well as the fact that there was no road to the exchange, sales at this time were low. The building was completed, however, and in addition to the canteen a barber shop was started. In December, 1917, a restaurant was installed, but it was not a success. In the month of February the tailor shop was started. From this date up to June, 1918, no changes were made, but in this month the exchange at Zero Street was taken over and operated as a branch of the base hospital post exchange. The barber shop was moved, five more chairs were purchased, and modern equipment was installed. This exchange was known as one of the best exchanges in camp, had an excellent business record, and paid out over $10,000 in dividends and for amusements. The value of the exchange on January 1, 1918 , was $2,397.27, and one year later, after deducting all dividends, was $23,479.40.
The Young Men`s Christian Association constructed a building that proved to be very successful.
There were two Red Cross buildings in the hospital area, one for the convalescents and the other for the nurses. The first, a large, well-equipped auditorium with a stage, was located in the group of convalescent barracks. Frequent concerts by the hospital band and orchestra, and weekly dances, were given in this hall. During the day it was used as a reading and recreation room by the patients, being splendidly equipped for this purpose. The Red Cross building in the nurses` area was of a smaller type and was used exclusively for recreation and dancing.
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The recreation work was handled entirely by an amusement officer appointed by the commanding officer, and the Red Cross was not called upon to do much of this work. The Young Men`s Christian Association rendered efficient aid in arranging recreation exercises. The hospital had its own band of 25 pieces, besides an orchestra. The band gave daily concerts for the benefit of the patients, and about once a week gave a concert in the Red Cross auditorium for the benefit of officers, their wives, and visitors. These concerts were usually run in conjunction with other recreational exercises and ended with a dance, the orchestra furnishing the music. A very great part of the profits of the post exchange was devoted to the amusement fund.
