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SECTION II.
CHAPTER III.
PERSONNEL DIVISION.
The creation of a Personnel Division, with a commissioned medical officer at its head-one of the Surgeon General`s assistants-was effected by Maj. Gen. Robert M. O`Reilly soon after he became Surgeon General in 1902. The work of the division was carried out in three sections: Commissioned personnel, enlisted personnel, and Army Nurse Corps personnel. Contract surgeons and dental personnel were handled by the commissioned personnel section; and when the Veterinary Corps was established in 1916 and was made a part of the Medical Department, the officers of this new corps naturally gravitated to the section handling commissioned personnel.
The Personnel Division had in its charge all matters having to do with the Medical Department personnel. (See Chart III.) This included all administrative control of their appointment, promotion, and assignment to stations. Records concerning Medical Department personnel were centered in the Surgeon General`s Office. While War Department orders affecting this personnel were and are issued by the Adjutant General`s Office, this is a military formality. the recommendations which are responsible for such orders emanating from the Surgeon General. In peace times, all permanent changes of stations of Medical Department officers desired by the Surgeon General were made in this manner, except actual assignment to station overseas. Orders for assignment to duty overseas, however, originated with the Surgeon General.
With the greatly expanded duties imposed on the Surgeon General`s Office by the war many of the previous functions of the Personnel Division became offshoots from the parent stem, which, however, continued to exist and to grow greatly with some new branches of its own.
On April 6, 1917, the organization of the personnel of the Medical Department of the Regular Army comprised a Surgeon General, a Medical Corps, a Medical Reserve Corps. a Dental Corps, a Veterinary Corps, an enlisted force, the Nurse Corps, and contract surgeons.1 The national defense act of June 3.1916, which provided for these components of the Medical Department, also provided for the Regular Army Reserve, consisting of an enlisted force; the Officers` Reserve Corps, made up of sections corresponding to the various arms, staff corps, anti departments of the Regular Army; and the Enlisted Reserve Corps. Contingent upon congressional authorization for the use of the armed forces of the United States, other than the Regular Army, the President was empowered by the same act of Congress to draft into military service of the United States any or all members of the National Guard and of the National Guard Reserve.
a The act of Congress approved June 3, 1916, provided also for the abolition of the Medical Reserve Corps, effective one year after the passage of the act, and the commissioning of its members in the Officers` Reserve Corps.
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The following tabulation exhibits the various classes of personnel provided the Medical Department by the act of Congress of June 3, 1916, both in active service and as potential forces in the event of war, and additional classes of personnel provided for from time to time during the emergency:
Officers: b
Medical-
Regular Army.
National Guard.
Reserve Corps.
Contract surgeons.
Dental-
Regular Army.
National Guard.
Reserve Corps.
Veterinary-
Regular Army.
National Guard.
Reserve Corps.
Sanitary Corps-
United States Army (for the emergency).
Ambulance Service-
United States Army (for the emergency).
Enlisted: c
Medical-
Regular Army.
Regular Army Reserve.
Enlisted Reserve Corps.
National Guard.
National Reserve.
Dental-
Enlisted Reserve Corps.
Veterinary-
United States Army (for the emergency).
Enlisted Reserve Corps.
Sanitary Corps-
United States Army (for the emergency).
Ambulance Service
United States Army (for the emergency).
Nurses:
Regular Army.
Reserve (Red Cross).
b Distinctive appellations for the land forces of the United States were discontinued by General Orders No ,War Department, August 7, 1918.
c On October 1, 1918, all training detachments (which included the Medical Enlisted Reserve Corps) at educational institutions were designated parts of the Students` Army Training Corps, in accordance with General Order, No. 94, War Department, October 19, 1918.
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SECTION OF COMMISSIONED PERSONNEL.
REGULAR ARMY.
On April 6, 1917, there were on active duty in the Medical Department the following commissioned officers: 2
On November 15, 1918, four days after the armistice was signed, the permanent officers of the Medical Department consisted of the following: 2
NATIONAL GUARD.
By the act of Congress of May 18, 1917, all members of the National Guard and all the National Guard Reserves were drafted into the military service of the United States. By the proclamation of the President on July 3, 1917, all organizations of the National Guard, to which Federal recognition had been extended by the Militia Bureau prior to midnight August 4,1917, were actually called into Federal service August 5, 1917, with the exception of the officers of the State staff corps and departments, the National Guard Reserve, and the National Guard of Hawaii. 3 On August 5,1917, the maximum strength allowed to National Guard organizations was 13,093 officers and 419,834 enlisted men. 4 The number called into Federal service on August 5 was slightly in excess of 12,000 officers and 367,223 enlisted men.5 The following table shows the number of officers of the Medical Department who were called into the Federal service by this proclamation (August 5,1917), who were appointed under the provisions of the act approved May 18, 1917, who were eligible for call but were not called, and who were eligible and qualified for appointment by the Militia Bureau subsequent to August 5, 1917.e
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Chart III.--Personnel Division, Surgeon General`s Office, June, 1918.
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Actually, there were inducted into the Federal service through the drafted National Guard 1,267 officers of the Medical Corps, 250 officers of the Dental Corps, and 74 officers of the Veterinary Corps, a total of 1,591 officers of the Medical Department, National Guard.6
MEDICAL OFFICERS` RESERVE CORPS.
Long before the war the Surgeon General`s Office had maintained that in time of war medical officers would be required in the proportion of 10 officers to each 1,000 of the total strength of the Army. The war proved this estimate to be substantially correct for an Army of less than 2,000,000 men. For an Army larger than 2,000,000 the war has shown that the proportion of medical officers may be slightly reduced without detriment to the medical service. The original estimates of the War Department were for an Army of 2,000,000 men; consequently, the first goal of the Medical Department was to obtain a total of 20,000 medical officers.7 As the General Staff, from time to time, enlarged its estimates regarding the size of the Army, it became necessary for the Surgeon General to rearrange his plans and to make ever-increasing demands upon the medical profession of the country. In order to mobilize this large commissioned personnel, it became necessary to carry out well-defined and systematic work in every section of the United States. Every agency which the Medical Department could employ was placed at the disposal of the Surgeon General. Each of these agencies performed service of inestimable value in awakening the profession to its obvious duty and in securing applications for commission as the Surgeon General needed the applicants. The American Medical Association, utilizing its coordinated bodies, the State medical societies, constituted itself into an effective organization to assist the Surgeon General in every way possible. The propaganda published in the Journal of the American Medical Association and the printing done for the Medical Department by that journal were of great importance and value. Credit is also due to other medical journals and to the American Medical Editors` Association for the use of space and editorials in placing the needs of the Medical Department before the profession. Practically all the leading medical societies of the country rendered assistance in this connection. The Medical Section of the Council of National Defense, through its chairman and its secretary, approached every physician in the United States with a personal appeal to forward his application as soon as he could arrange his affairs to accept active duty. This organization, through its State and county committees, classified the physicians of the various communities according to their availability for service, and carried on a campaign which brought the force of public opinion to bear in a most compelling manner upon those who showed a tendency to hold back.
With the officers of the Regular Establishment, including 342 officers of the Medical Reserve Corps 2 and the small number of medical officers of the National Guard drafted into the service of the United States as a nucleus, the great task confronting the Personnel Division at the outbreak of the war was that of filling immediately and as rapidly as possible the commissioned ranks of the Medical Department by inducing as many as possible of the qualified professional
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men of the country to enter the various sections of the Officers` Reserve Corps (Medical, Dental, and Veterinary).f
Examining boards were immediately appointed in all of the principal cities and Army posts throughout the United States. Those in the cities consisted for the most part of officers of the Medical Reserve Corps on the inactive list and those at Army posts of officers of the Regular Establishment. The number of these boards was gradually increased until, in most parts of the country, candidates could be examined without traveling long distances. This was important, as under the law applicants had to pay their own expenses to and from the place of examination.
At first applicants were required to write the Surgeon General and obtain personal history blanks to be filled out and returned. The candidate`s place of residence was then looked up on a map (with much difficulty when small towns were concerned), and he was invited to appear for examination before the board nearest his home. The personal history was forwarded to the board which was authorized to conduct the examination. This method proved time consuming and unsatisfactory when large numbers of applications began to come in. Lists of the examining boards were then printed, giving the boards arranged by States. These lists were periodically revised and kept up to date. For their publication the Medical Department is indebted to the Journal of the American Medical Association. After the adoption of these lists, all applications for appointment were answered by sending the applicant a printed list of the boards and directing him to appear before any board he might select as convenient. The boards, in the meantime, were supplied with all necessary blank forms and with full instructions as to the eligibility of candidates and the method of conducting the examinations. This matter is here given in detail because the change in procedure was of the greatest importance in expediting examinations and appointments at a period when conditions confronting the Medical Department necessitated the greatest haste.
The following is a list of examining boards for the Medical Reserve Corps organized up to September 5, 1918: 8
Alabama: Mobile, Montgomery.
Arizona: Douglas,
Fort Huachuca, Naco.
Arkansas: Hot Springs, Little Rock, Texarkana.
California: Coronado, Los Angeles, San Diego, San Francisco.
Colorado: Denver, Fort Logan, Hotchkiss.
Connecticut: New Haven.
District of Columbia: Washington.
Florida: Jacksonville, Key West, Pensacola.
Georgia: Atlanta, Augusta, Fort Oglethorpe.
Idaho: Boise.
Illinois: Chicago, Rockford, Springfield,
Indiana: Indianapolis, Terre Haute.
Iowa: Des Moines, Fort Des Moines.
Kansas: Newton, Fort Riley, Fort Leavenworth, Topeka.
Kentucky: Bowling Green, Louisville.
Louisiana: Alexandria, Baton Rouge, New Orleans.
Maine: Brunswick, Fort Williams, Fort Preble.
f The procurement of officers for the Dental Reserve Corps and the Veterinary Reserve Corps is described in the administrative histories of the respective divisions.
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Maryland: Baltimore, Camp Meade.
Massachusetts: Boston, Fort Banks, Springfield.
Michigan: Ann Arbor, Battle Creek, Detroit, Menominee.
Minnesota: Fort Snelling, Minneapolis, Rochester.
Mississippi: Hattiesburg, Meridian, Jackson.
Missouri: Jefferson Barracks, Kansas City, Springfield, St. Louis.
Montana: Great Falls, Helena, Livingston.
Nebraska: Norfolk, Omaha.
New Hampshire: Hanover, Manchester, Nashua.
New Jersey: Atlantic City. Newark.
New Mexico: Deming, Fort Bayard.
New York: Albany, Buffalo, Plattsburg, New York, Syracuse, Rochester
North Carolina: Charlotte, Fort Caswell, Waynesville.
North Dakota: Fargo.
Ohio: Cincinnati, Cleveland, Columbus, Dayton, Fairfield, Toledo.
Oklahoma: Fort Sill, Oklahoma City.
Pennsylvania: Allentown, Harrisburg, Philadelphia, Pittsburgh.
Rhode Island: Providence, Westerly.
South Carolina: Charleston, (Columbia, Fort Moultrie, Spartanburg.
South Dakota: Flandreau, Sturgis.
Tennessee: Knoxville, Memphis, Nashville.
Texas: Austin, El Paso, Galveston, Fort Worth, Houston, San Antonio.
Utah: Fort Douglas, Ogden, Salt Lake City.
Vermont: Fort Ethan Allen.
Virginia: Fort Monroe, Norfolk, Richmond, Roanoke.
Washington: American Lake, Spokane, Vancouver.
West Virginia: Charleston, Huntington, Morgantown, Wheeling.
Wisconsin: Ashland, Milwaukee, Waupun.
Alaska: Fort Gibbon.
Porto Rico: San Juan.
Hawaii: Honolulu.
Philippine Islands: Manila.
Canal Zone: Ancon.
In addition to these medical boards, the surgeon at any Army post or camp had authority to conduct the examination of applicants for commissions in the Medical Reserve Corps.
The requirements for appointment and the scope of the examination are shown by the following circular:9
The requirements for appointment are that the applicant be a citizen of the United States, between 22 and 55 years of age, a graduate of a reputable medical school legally authorized to confer the degree of doctor of medicine; he must have qualified to practice medicine in the State in which he resides, and be in the active practice of his profession.
The examination is physical and professional; the professional examination is oral. In case the oral examination is not satisfactory to the board, the applicant will be given a written examination. In all cases the examination will be in the following subjects:
1. Practice of medicine, including etiology, clinical description, pathology, and the treatment of diseases.
2. Surgery principles and practice.
3. Obstetrics and gynecology.
4. Hygiene-personal and general, especially as to the prophylaxis of the more prevalent epidemic diseases. Specialists will be examined in their specialty.
When a candidate reports to the board for examination, he should submit the following:
1. His personal-history blank properly filled in as indicated therein and certified to before a notary public.
2. Two testimonials from reputable persons as to his citizenship, character, and habits.
3. A certified copy of his license to practice medicine in the State in which he resides.
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The act of June 3, 1916, creating the Medical Reserve Corps section of the Army, provides that in time of peace only those of the grade of first lieutenant may be ordered to active duty, and this with their own consent, but in time of war the services of officers of all grades are at the disposal of the Government.
The pay of officers in the Medical Reserve Corps is the same as that of corresponding grad1es in the Regular Army.
The more important instructions furnished examining boards are shown in the following circular letters from the Surgeon General`s Office. 10
(a) To the presidents of all boards for the examination of applicants for the Medical Reserve Corps.
1. You are notified that hereafter it will be the policy of this office, when tender of services is received from physicians throughout the country, to direct them to communicate with you in order to arrange a mutually agreeable date for examination, this examination to be conducted without further reference to this office.
2. When the examination is completed and the papers are forwarded to this office, care should be taken that they are accompanied by the necessary testimonials and by the personal history correctly filled out and sworn to before a notary public.
3. If on the physical examination the applicant is found disqualified, the professional examination need not be proceeded with.
4. Examiners should provide themselves, by requisition on this office, with a sufficient number of blanks (138, 149, and 150, S. G. 0.), so that there will be no delay in the examination of those referred to them.
(b) Instructions governing the examination of applicants for the Medical Reserve Corps. (To supersede all previous instructions.)
1. Examinations should only be conducted by commissioned officers appointed by this office, except that presidents of regularly appointed boards are authorized to request and accept assistance of other Medical Reserve officers.
2. Properly constituted boards are authorized to conduct the examinations without reference to the Surgeon General`s Office. The requisites for appointment are as follows: The applicant must be a reputable physician (doctor of medicine), in good standing in his community, in the active practice of his profession, licensed to practice medicine in the State in which he resides, between 22 and 55 years of age, a citizen of the United States (first papers not sufficient), and physically and professionally qualified. Members of the National Guard are not eligible.
3. The examination proper is physical and professional.
The physical requirements are stated in G. 0. 66, 1910, and Circular No. 2, A. G. O., 1916, forwarded to each board. The visual requirements are that the applicant have not less than 20/100vision in each eye, fully correctible by glasses. If the applicant is found physically disqualified, the professional examination need not be proceeded with.
The professional examination is oral, but in case the oral examination is not satisfactory to the board. the applicant will be given a written examination. In this case his papers should be marked by the board and then forwarded with all other papers in the case to the Surgeon General`s Office. In either case, the examination will be in the following subjects: (a) Practice of medicine, including etiology, clinical description, pathology, and the treatment of diseases; (b) surgery, principles and practice; (c) obstetrics and gynecology; (d) hygiene, personal and general, especially as to the prophylaxis of the more prevalent epidemic diseases.
Specialists will be examined in their specialty.
4. The papers in each case should be completed before being forwarded to the Surgeon General`s Office. A complete set of papers includes the following:
(a ) Personal history properly filled out and sworn to before a notary public (Form 149). (b) Two testimonials as to citizenship, character. and habits.
(c) Physical examination report (Form 138).
(d) Report of the board as to qualifications of applicant (Form 150).
(e) Certificate of license to practice medicine in the State in which the applicant resides. (f) Documentary evidence of citizenship if of foreign birth. Instead of including (e) and (f) with the papers, they may he simply presented to the hoard for its inspection, providing that the board Akles notation on Form 150 that they hare been so exhibited.
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5. In all cases the signatures of the members of the board should show their rank and office.
6. Under "Remarks" on Form 150, the board should state grade in which it considers ap-plicant should be commissioned. This information should not be given to the applicant.
7. Examiners should provide themselves by requisition on this office, with a sufficient number of blanks (138, 149, and 150, S. C;. 0.), so that there will be no delay in the examination of those referred to them.
MAY 25 1917.
(c) General information for examination boards.
The following information is furnished in order that. examining boards may be in a position to answer as many as possible of the questions so frequently asked by applicants for appointment in the Medical Reserve Corps:
1. The fact that a man has been drafted does not impair his eligibility for appointment to a commissioned grade. Such men may, therefore, be examined without regard to the fact that they have been drafted. They can claim no exemption until thay have received and accepted their commissions, and the department is not yet in receipt of information as to exact time when such men will be released from their obligations under the draft. Such release may not occur until after arrival at the mobilization camp.
2. It is useless for men who have been caught in the draft to wire and write this office to expedite their commissions in order that they may be in receipt of the latter before being called to the colors. There are so many of these cases that the appointments will have to take their normal course and inquiry should only be made in case the commission is not received within a reasonable time, say two weeks after the date of the letter from this office notifying the applicant that he has been found qualified.
3. Applicants within the draft age who are given commissions will not, under any circum- stances, be given any promise that they will be left on the inactive list to finish hospital internships or for any other purpose whatever. To take any other course would place the department in the position of endeavoring to circumvent the draft law.
4. Women physicians are not eligible for appointment in the Medical Reserve Corps and should not be examined.
5. In spite of the regulations laid down in Circular G, "Instructions Governing the Examination of Applicants for the Medical Reserve Corps," some boards are making examinations for appointment in the Medical Reserve Corps of men who do not possess the degree of Doctor of Medicine-This procedure is a waste of time and leads to considerable embarrassment on the part of the department.
6. Appointments in the Sanitary Corps are made only when the department has in mind some definite place to which the applicant is to be assigned as soon as commissioned. Applications for this corps should not, therefore, be encouraged, and no one should be examined for appointment without definite instructions in each case from this office.
7. The department spends much time answering requests for active duty from men who have not received or accepted their commissions. The department can take no action in such cases and is not in a position to make a notation of the individual`s wishes that will come to attention when he does accept his commission. Therefore, applicants awaiting commissions should be directed to make their request for active duty at the time they accept their commissions.
8. Applicants known to the examining board to have been previously examined and rejected by some other board should not be reexamined without special authority from this office. The department will be compelled to disregard all such reexaminations unless made under the conditions stated.
9. If the papers of an applicant are referred to an examining board and the applicant himself, after due notice, fails to appear for examination within a reasonable time thereafter, the papers should be returned to this office with a statement of the facts. This is necessary in order that, when inquiry is made in regard to the applicant`s status, the department may be in a position to answer questions intelligently.
10. The department is continually being called upon to discharge officers of the Reserve Corps because of physical defects which were not noted at the time of their original examination for appointment. It will thus be seen that carelessness in making physical examinations leads to unnecessary expense to the Government and great inconvenience and hardship to the applicants themselves.
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SEPTEMBER 1, 1917.
(d) Instructions to presidents of examining boards.
1. In view of the recent rulings relative to the commission of applicants in the Medical Reserve Corps, you are advised that in conducting the examination of all applicants the following information must be furnished:
(a) Commissioned officers of State military organizations must furnish evidence that their resignations will be accepted by the State adjutant of the organizations to which they belong in the event of their appointment in the Federal service. This evidence must be furnished to the board by the applicant at the time of his examination and must be attached to the file of the application before being forwarded to the Surgeon General.
(b) In case of applicants who are now employed by any of the executive departments of the Government, or independent Government establishments of the executive service, the applicant must present with his application the written approval of the head of the executive department or independent establishment under whom the applicant is now serving. This written approval must be attached to the file of his application and forwarded to this office.
(c) The boards will require all applicants for a commission in the Medical Reserve Corps to certify whether or not they have been rejected for a commission in any branch of the military service, or whether or not they have any application for a commission pending. This certificate maybe made in the form of a notation on the face of the report of the examination, properly initialed by the board of examiners, or may be in the form of a written statement over the signature of the applicant, in which event it should be attached to the application papers and forwarded with them.
2. The boards will take particular notice to record on form 150 the age and place of birth of the applicant and will see that the same information is properly recorded in the proper place upon the personal history to which the applicant has made affidavit.
3. In case of foreign-born applicants the applicant must furnish, if naturalized, documentary evidence of such naturalization. Applicants who were born in countries with which the United States is now at war or any country allied to such countries will not be eligible for a commission the Medical Reserve Corps except in the event that they were brought to this country before-they had reached the age of 5 years. If such is the case, the applicant must furnish satisfactory evidence of this fact in the form of a sworn statement by parents, relatives, or other persons who have full knowledge of the facts, and such affidavits must be attached to the file of the application. When it is received by the Surgeon General proper steps will be taken to ascertain whether the applicant is eligible for a commission.
4. The boards will, in the case of every applicant who appears before them, complete full examination, both professional and physical, and will determine, so far as possible, the moral qualifications of each applicant. The completed file should be forwarded to the Surgeon General in every case in order that the Surgeon General may exercise his discretion in recommending or rejecting any applicant for a commission, this instead of the instructions formerly issued that where an applicant has been found either physically, professionally, or morally disqualified, the examination should not be proceeded with.
5. In general the physical qualifications for applicants for a commission in the Medical Reserve Corps will follow the physical requirements for " general military service ` as outlined under Special Regulations 65 (copy herewith), except that active venereal disease of any description will be a cause for rejection. The standards for vision and hearing will conform very closely to those outlined in these regulations. Color blindness need not be considered cause for rejection. All physical defects should be carefully enumerated, however minor in degree, and the opinion of the board should be expressed as to whether or not any single physical disability should disqualify, or whether the total of the minor physical disabilities are such as to warrant the rejection of the applicant.
6. The attention of the boards is invited to the fact that the professional examination should be conducted in such a manner as to enable the boards to express a definite opinion as to the professional qualifications of each applicant, and in all cases of doubt the hoards should submit the applicant to a written professional examination covered by questions which will be furnished by this office on application.
7. The Surgeon General desires an expression of opinion on the part of examining boards ap to the professional and other qualifications or disqualifications of each applicant. The boards should make these expressions confidential and should not communicate them to the applicants. The Surgeon General further desires the benefit of the board`s opinion as to the rank in which the appli-
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cant should be recommended in view of his age, professional qualifications, and previous military experience, if any.
8. Applicants for a commission in the Medical Reserve Corps appearing before examining boards for reexamination should present to the hoards a letter from this office granting authority to have their reexamination conducted. This letter will outline the cause for the rejection of the previous application and advise the boards as to what defects were exhibited by the applicant upon the occasion of this former examination. The boards should not conduct the reexamination of any applicant unless such letter is presented. This letter may instruct the applicant to report to a particular board or to "the board of examiners nearest his home.`" In either (case the letter will be sufficient authority for the board to which it is presented to conduct the reexamination.
9. The Surgeon General is giving consideration to the desirability of commissioning specially well-qualified professional men for duty at base and general hospitals in this country, and who are specialists in their particular line of medicine or surgery, up to the age of 57 years. These applicants will be specially selected with a view of assigning them to duty on the permanent staffs of base or general hospitals in this country, or to such other assignment as the interests of the service may require. When applicants above 55 and under 57 years of age appear before the boards the boards are authorized to conduct their examinations, and in the event that they present no major physical disqualifications consideration will be given this application for commission. The examining boards should carefully explain to the applicant that the application will le referred to the proper section of the Surgeon General`s Office for approval, and that in the event such approval is given favorable consideration will be taken and the applicant will be recommended for a commission.
10. The boards, in recommending the rejection of any applicant, should state specifically the causes for such rejection. If it is for reason of moral delinquency, the boards-should furnish the Surgeon General with full information as to the character of such delinquency. If the rejection is for physical or other reasons, the boards should specifically state this fact and give as much detail as may be necessary to enable the Surgeon General to arrive at a definite conclusion. Lack of professional qualifications should be definitely stated, and in every case where the applicant is submitted to a written examination the boards will review and grade all answers and forward the papers to the Surgeon General with their recommendation. Boards may, in their discretion, submit an applicant who is a graduate of a school the rating of which is low to a written professional examination if the applicant is within the draft age. If he is successful in passing the written professional examination the boards should so state and make appropriate recommendation.
The question of citizenship gave much trouble and several appointments of noncitizens were made. These commissions had to be revoked, such appointments in the Medical Reserve Corps being illegal.11 These errors occurred because applicants in their personal histories sometimes made oath that they were naturalized citizens when declarations of intention only had been made. This led to the requirement that documentary evidence of citizenship be furnished :12
DECEMBER 4. 1917.
From: The Adjutant General of the Army.
To:
Subject: Citizenship of applicants for Officers` Reserve Corps.
1. Hereafter applicants for commissions who are not native American citizens will state in their application how, when, and where they acquired citizenship of the United States. If they are naturalized citizens, their naturalization certificates or certified copies thereof will accompany their papers to this office. If they claim citizenship through the naturalization of parents. the naturalization certificates in question will be submitted with the applications. Incases where the certificates are not available, the dates and places of naturalization of the persons through whom citizenship is claimed will be stated in order that proper verification may be made.
2. In each case, without exception, applicants of the kind indicated will make affidavit of how long they have resided in the United States, giving places and dates and what their ties of family and property are with this country. They should make similar statement respecting the country wherein they` were born or in which they have resided abroad.
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3. In cases where applicants allege birth in the United States and any doubt arises as to correctness of statement, birth certificates should be submitted. If birth certificates are not procurable, certified statement by at least two reputable citizens who know the applicant was born in the United States should be submitted.
4. All officers concerned with the foregoing will make careful scrutiny in order to ascertain whether applicants are bona fide citizens and thoroughly loyal to the. United States before submitting applications to this office.
By order of the Secretary of War:
.............................................
Adjutant General.
The War Department made several different rulings regarding the appointment of naturalized citizens born in enemy country. At first there were no restrictions on such appointments, but on January 4, 1918, a memorandum was issued by the Chief of Staff 13 forbidding the commissioning and assignment of men born in a country with which we were at war. In a case submitted on April 22, 1918, in which the Surgeon General`s Office stated that an investigation by the Intelligence Branch of the General Staff developed nothing reflecting upon the loyalty of the applicant, the papers were returned, by direction of the Secretary of War, with the statement that it was the intention that no exception be made to the policy announced in the above memorandum even when evidence of undoubted loyalty existed. 14 Again, on May 18, a case came up in which the individual, a graduate in medicine, had been drafted under the selective-service law. This case was forwarded to the War Department by indorsement as follows:15
The department is not ready to make any recommendation that would have general application to cases similar to the one discussed in this communication, hut requests a decision as to the policy that will be followed in the case of well-qualified professional men called to service under the provisions of the selective-service law, hut who because of being born in enemy country are not eligible for commission. It would appear that such individuals, if disloyal, would accomplish as much harm as enlisted men as they might do if commissioned.
The papers in this case were returned to the Surgeon General indorsed as follows : 16 "Applications for commission from naturalized citizens born in enemy country will not be considered."
On June 24, 1918, the above policy was modified so as to permit the appointment of enemy-born applicants, provided they had emigrated to the United States prior to the age of 5 years, were of approved loyalty (shown by investigation of the Intelligence Division, General Staff), and were American citizens through their own naturalization or through that of their parents.17 The Army appropriation bill approved July 9, 1918, provided that American citizens who were of Austrian or German birth, or who were born in alien territory, who had passed the necessary examination and whose loyalty was unquestioned, might, in the discretion of the Commander in Chief of the Army and Navy, be commissioned in the United States Army or Navy. While this provision did not change the power previously conferred on the Commander in Chief of the Army in regard to commissioning men of this class, it led to the removal of all restrictions on their appointment provided they were shown to be of unquestioned loyalty.
For appointment in the National Army, citizenship was not required by law but was made obligatory by order of the Secretary of War, and the in-
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structions were conveyed to the Surgeon General in a letter from The Adjutant General, dated January 23, 1918.18
In May, 1918, a bill, passed by Congress and approved by the President, provided for the expeditious naturalization of all aliens in the military service, including enemy aliens producing satisfactory evidence of loyalty. 19 This bill provided relief for a number of young professional men who, having made a declaration of intention, were subject to draft, but not having become full citizens were ineligible for commission.
It was common during the war for members of State boards of health, and physicians connected with institutions of a more or less public character or who, in their opinion, were essential to local communities, to request commission in the Medical Reserve Corps as a protection against the draft, and then to ask to be left on the inactive list. These applications were invariably refused and the applicants informed that they should seek protection undersection 80, Selective-Service Regulations, which provided for deferred classification of those engaged in institutional and public-health service.
During the early months of the war applicants for commission in the Medical Reserve Corps were refused unless they met the physical standards laid down prior to the war for the examination of recruits, except that moderate errors of refraction were not considered disqualifying. As the war progressed and the need increased of making greater and greater demands upon the medical profession, the physical requirements were modified from time to time and always in the direction of liberality. Finally, examining boards were directed to accept applicants with special professional qualifications, provided they had no physical defects or constitutional disease which shortened their expectation of life. This plan placed at the disposal of the Medical Department many qualified physicians who would otherwise have been rejected. Yet applicants for commission who, during their first enthusiasm, made light of their physical defects, later on, when their ardor had somewhat subsided, offered these same defects as a reason for demanding release from service. The acceptance of physically substandard applicants resulted also in a great increase in claims upon the Government for compensation.
The information desired by the Adjutant General from the Surgeon General when recommendations for commission were forwarded is covered by the following letter :20
MAY 7, 1918.
From: The Adjutant General of the Army.
To: The Surgeon General of the Army.
Subject: Applications for commissions in the several staff corps.
1. In order to comply fully with the law and regulations governing appointments in the Officers` Reserve and National Army, you will furnish this office, when submitting applications for appointment, data concerning each applicant as follows:
(a) Name in full.
(b) Address where applicant is to be notified of appointment and home address.
(c) Date and place of birth.
(d) Citizenship. If naturalized, documentary proof thereof. (See letter, December 4, 1917.)
(e) Detailed report of physical examination by a medical officer.
(f) If enlisted man (1) date of enlistment, (2) when ordered to active duty, (3) the recommendation of his commanding officer and commanding general.
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(g) If subject to the selective-service law. (1) result of his classification showing class and division of class, (2) evidence as to whether or not he is in the current quota of his local board, (3) certificate that there is not available an equally suitable man outside the draft age. (4) a statement as to where it is contemplated to assign him to duty.
(h) Certificate that no officer now holding commission on staff corps concerned on the active or inactive list is available for the position.
(i) Duties to be performed when commissioned.
(j) Special reference to general orders or approved staff memorandum authorizing appointments in the branch for which applicant is a candidate, with tabulated statement showing the number authorized and the vacancies existing in the grade for which candidate is recommended.
(k) letters of recommendation from reputable citizens.
(l) Present occupation and remuneration; also, former employment. Education. including degrees, if any.
(m) Commissioned officers of State military organizations must furnish evidence that their resignations will be accepted by the State adjutant of the organizations to which they belong in the event of their appointment in the Federal service.
(n) Evidence as to whether the applicant has been rejected for commission in any branch of the military service or has another application for commission pending.
2. The original of the record of examination will be forwarded to this office with the application for the permanent files.
3. No application from any employee under the executive departments of the Government, or independent Government establishments of the executive service. will be approved unless such application is accompanied by the written approval of the head of the executive department or independent establishment under which the employee is serving.
4. Railroad employees may he examined for commissions if their applications are accompanied by the written consent of the present or executive officer of any railroad under the jurisdiction of the United States Railroad Administration and under whom the applicant in question is serving. hut will not be commissioned until approved by the Director General of the Railroads. (See letter. May 2, 1918.)
5. Other pertinent and still applicable instructions issued by this office are effective and compliance therewith is directed.
(Subparagraphs (g), (h), (i), (k), and (1) of paragraph 1 were not enforced with applicants for the Medical, Dental, or Veterinary Corps, but were insisted upon when the recommendation was for an appointment in the Sanitary Corps or in the Ambulance Service).
CONTRACT SURGEONS.
Long before the World War the Surgeon General of the Army, with the approval of the Secretary of War, was authorized, in emergencies, to appoint as many contract surgeons (civilian physicians employed under contract) as might be necessary, 21 subject to annual appropriation acts. Under this authorization many contracts were entered into with civilian physicians, for service with troops, to augment the personnel of the Medical Corps. With the creation of the Medical Reserve Corps in 1908, 22 however, contract surgeons were thereafter employed only at places which did not justify the expense involved by the detail of a medical officer; and many contract surgeons who had been employed accepted commissions in the Medical Reserve Corps and were placed on active duty. Thus when we entered the war only nine men were serving as contract surgeons. This number was increased by November 15, 1918, to 889. 2
On August 13, 1917, the Judge Advocate General interpreted the statute authorizing the appointment of contract surgeons as applicable to women physicians, and " that in the absence of any statutory restriction prohibiting
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it, the Surgeon General, with the approval of the Secretary of War, may appoint female physicians as contract surgeons under authority of the statute above cited.” 23 Accordingly, women were appointed as contract surgeons to serve as anesthetists, laboratory technicians, dispensary physicians, and in other capacities as needed. On October 27, 1918, or just before the armistice,” 23 women were enrolled as contract surgeons. They were authorized to wear a khaki uniform made according to specifications approved by the Acting Surgeon General October 8, 1918. 24
SANITARY CORPS.
Very soon after the beginning of the war, it became apparent that the Medical Department would require a considerable number of officers who were neither doctors of medicine, dentists, nor veterinarians. Authority was therefore obtained for the organization of what, for want of a better name, was called the Sanitary Corps.25 Sanitary engineers, psychologists, chemists, laboratory technicians, office experts, adjutants, epidemiologists, mess officers, etc., represented the classes commissioned in this corps.
At the conclusion of hostilities there were 2,895 officers in the Sanitary Corps, distributed as follows: 26
UNITED STATES ARMY AMBULANCE SERVICE.
The United States Army Ambulance Service was created on June 23, 1917,27 at the request of the French Government, through its representative, Field Marshall Joffre, to partly take over the field ambulance work of the Army on the French front.
Two officers of the Regular Army Medical Corps were assigned to the Ambulance Service to perfect its organization. At first the source of officers for the various sections of the service was the Medical Section, Officers` Reserve Corps. These latter were gradually replaced by men promoted from the ranks of the Ambulance Service and given commissions in that service. At the time when the armistice was signed there were very few medical officers on duty with the Ambulance Service.
The authorized number of officers for the Ambulance Service was 214; 28 the maximum number of officers serving with it during the war period was 209. 29
VOLUNTEER MEDICAL SERVICE CORPS.
It was believed that if the war had not come to an end when it did, eliminating the need for further calls upon the medical profession, the question of protecting the absolute necessities of industry, rural communities, State health boards, and teaching institutions, would have assumed a transcendent importance. The whole profession, of necessity, would have been organized, classified, and given a military or quasi-military status in order that assignments of physicians unfit for strictly military duty could be made in such a way as to protect the interests named. The Surgeon General`s Office had no
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machinery for the execution of such a plan, but this work was undertaken by the Council of National Defense in the organization of the Volunteer Medical Service Corps. 31 As this organization did not have a definite military status, its history will not be included here.
COMMISSIONS.
At the beginning of the war commissions of three types were issued to medical officers, viz, Regular Army, National Guard, and Medical Reserve Corps. At this period the grade of major was the highest in which officers of the Medical Reserve Corps could be legally commissioned. When it became necessary to appoint temporary officers to higher grades than that of major, or to give temporary advanced rank to officers of the permanent establishment, their appointments were made in the National Army. With the passage of the appropriation bill for the fiscal year 1918-19, the grades of lieutenant colonel and colonel, Medical Reserve Corps, were authorized. 30 For about two weeks thereafter, or until August 7, 1918, all appointments and promotions of temporary medical officers were made in the Medical Reserve Corps. On August 7,1918, the War Department, by issue of General Orders, No. 73, eliminated all distinction between officers commissioned in the several subdivisions of the Army authorized by Congress, and decreed that thereafter all officers held commissions in the Army of the United States, permanent, temporary, or provisional.
Determining the grade to be given officers of the Medical Corps on original appointment was one of the most trying and perplexing problems confronting the Surgeon General`s Office during the war. The proposal was frequently made, and from various sources, that all original appointments should be made in the grade of first lieutenant, and that promotions should be made only after the officers concerned had had opportunity to demonstrate their adaptability to military service and their value to the Government. This plan would have greatly simplified the administration of the Personnel Division, would undoubtedly have relieved the department of a good many embarrassments, and would have proved more satisfactory to division and camp surgeons, who objected to having lieutenants, whom they had trained, displaced by captains and majors appointed directly from civil life. If it had been possible to overcome all other obstacles, however, the plan would have proved impracticable on economic grounds alone.
In the summer of 1917 it was determined that no applicant under 35 years of age should be given an original commission carrying rank above that of first lieutenant unless he had had previous military experience of sufficient value to justify that an exception be made. 31 This plan was consistently followed during the whole future course of the war. Not more than half a dozen exceptions were made and these for reasons which appeared good at the time. For applicants beyond 35 years of age no definite rules regarding grades seemed to stand the test of experience. For a short time all officers over 45years of age were commissioned as captains or majors, but the results were not satisfactory and the plan was abandoned. Thereafter the decision as to grade was made by the officer in the Surgeon General`s Office who examined the applicant`s papers, his opinion being based on the recommendation made by the examining board, and on the applicant`s age, professional standing and pro-
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fessional training, as shown by his personal history and other papers submitted with his application. In many cases the papers presented misled the examining officers, and mistakes were inevitable. The immense volume of work and the tremendous tension under which the officers in the Surgeon General`s Office were working also contributed to this result. Time did not permit the careful investigation that would ordinarily be made before any individual is clothed with the authority, influence, and responsibility implied by a commission in the Medical Corps.
At first doubtful cases, and finally all cases, were submitted to the American Medical Association for the purpose of ascertaining whether the files of the association contained anything derogatory to the applicants. By this procedure many quacks, abortionists, drug addicts, and other undesirables were excluded. Another agency of great assistance to the Personnel Division was an advisory board of Medical Reserve officers g appointed by the Surgeon General. 32 Incases when the reviewing officer was in doubt as to the grade to be given an applicant, especially if the decision was to be made between the grades of captain and major, all cases in which the professional ethics or moral character of the applicant was in doubt, and important cases in which an attempt had been made to use political influence, were referred to this board for advice. The names of the members of his board carried so much weight that it was difficult for applicants or their friends to go behind their decisions. Contrary to the prevalent opinion, political or other outside influences had practically no effect upon the offering of given grades to individual applicants. Very exceptionally a Member of Congress or some other friend would present undoubted evidence of the professional standing of an applicant that would not otherwise have come to the department`s attention. In such cases the new facts presented, not the influence, changed the decision. It is notable that in not a single instance did the President or the Secretary of War attempt to influence the Surgeon General in regard to the grade recommended for any applicant.
In October, 1917, when the strength of the Medical Corps was only a little over 14,000, 2 all appointments in the Medical Reserve Corps were discontinued by direction of the Secretary of War. On October 16, 1917, a number of recommendations for appointments were returned with the following indorsement: 33
The Secretary of War has given personal consideration to these applications and directs them to be returned with the information that he has directed that no further commissions be issued except to fill vacancies in existing organizations. line or staff, or in one which may have to be created to perform some absolutely necessary function in the prosecution of the war. He therefore disapproves the attached requests for commission.
Under date of October 19, 1917, a second lot of recommendations was returned with the following indorsement: 33
The Secretary of War directs that the attached applications for commissions be returned to the Surgeon General with the information that the records show 20,600 officers are at present holding commissions in the Medical Corps and Medical Reserve Corps only.
When this action was taken by the Secretary of War there were only 14,137 officers in the Medical Corps. 2 In consequence of this action, the idea became
e Advisory Board: Col. William H. Welch, M. C.; Col. Victor C. Vaughan, M. C.; Brig. Gen. J. H. T. Finney, M. D.; Col. William H. Mayo, M. C.; Col. Charles Mayo, Al. C.; Col. George H. Simmons M. C.; and Col. Franklin Martin, M. C.
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general in the profession and throughout the country that a sufficient number of medical officers had been commissioned to meet the requirements of the service. This impression continued until November 26, 1917.
Again, on August 14, 1918, a memorandum from The Adjutant General stopped all commissions to men from civil life, including the medical profession. 34 This memorandum was immediately modified by letter from The Adjutant General. 35 The new regulations provided that all applicants between the ages of 18 and 45 years placed in Class I by local boards be inducted into service as enlisted men before being commissioned. At the request of the Surgeon General, these regulations were again modified,36 excluding from their provisions applicants for commissions in the various branches of the Medical Department, with the exception of the Sanitary Corps. But for a second time the idea went abroad that the Medical Department had a sufficient number of medical officers to meet its expected needs. It was with difficulty that this impression was overcome and the medical profession of the country convinced that the needs of the Medical Department were still unsatisfied.
Of the total strength of the Medical Corps at the time of the armistice, 29,299 officers were commissioned directly from civil life. The remainder belonged to either the Regular Army or had come into the Federal service through the National Guard. To secure this force of 29,299 officers, 35,853 applications had been considered. Of these applicants approximately 4,000 were refused appointment as professionally, morally, or physically disqualified, and approximately 2,500 were appointed but discharged prior to the armistice, because of physical disability not reported by the original examiners, distress in their families, or community need, or as the result of professional incapacity or moral delinquency. The exact figures follow: 37
In service direct from civil life November 11, 1918 ............................... 29,299
Discharged prior to November 11, 1918 .................................................2,500
Rejected on original examination ............................................................4, 054
Total examined ......................................................................................35,853
PROMOTION.
Promotion was a burning question throughout the war among officers holding temporary commissions in the Medical Corps. While conservatism of the Medical Department in making original appointments and the unprecedented expansion in the size of the Army insured a rapid flow of promotion amongst officers originally appointed in the lower grades, advancement in grade finally became an obsession with many officers.
In the United States, in the early months of the war, promotions were sometimes made on the direct recommendations of chiefs of divisions in the Surgeon General`s Office, or based upon information obtained by the Personnel Division from other sources. Experience proved that this plan was unwise. The decision was therefore made, and adhered to throughout the war, that promotion of officers would be based entirely on the recommendations of local commanding officers. The following circular of instructions was issued to carry this plan into execution : 38
1. Individual applications for promotion of officers of the Medical Corps will be disapproved unless the applicant has no immediate commanding officer. At such intervals as you think advis-
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able, recommendations should be submitted for the promotion of deserving officers to fill existing vacancies. If you consider an examination on professional and military subjects necessary to enable you to arrive at proper conclusions in making your recommendations, such examination may be prescribed. The reports of these examinations should not, however, be forwarded to this office, as the department, in making its recommendations to the Secretary of War, will be governed largely by the recommendations submitted by the candidates` superior officer.
2. There are a number of officers in the Medical Department over 35 years of age and well qualified professionally who were given original commissions in the grade of first lieutenant because the department did not have sufficient information concerning them to make it safe to give them original appointments in a higher grade. Such men should be considered as eligible for promotion to a captaincy after they had been on active duty sufficiently long to demonstrate their adaptability to military service and their usefulness to the Government. Recommendations for the advancement of such officers will be entertained after a minimum of three months` active service.
3. Recommendations for promotion to field rank should only be made if there is a position vacant under your jurisdiction which ordinarily carries that grade and after the individual has been thoroughly tried out and you are assured that he is fully capable of filling the position.
4. All recommendations for the promotion of officers should be forwarded through channels of Form CCP-1152, as provided in G. O., No. 85, W. D., 1918, and the officer initiating the promotion should be guided by the policy outlined in G. O., No. 7, W. D., 1918.
5. A conservative policy should be adopted in making recommendations for promotion. with the good of the service, not the interests of the individual, constantly in mind.
It was impracticable, of course, for the Surgeon General`s Office to approve all recommendations received.
For the troops serving in the United States, the number of appointments that could be made in each grade was limited by the consolidated Tables of Organization, 39 while for the American Expeditionary Forces grade vacancies in the Medical Corps were computed according to the percentage in each grade allowed by law. 40 For the Medical Reserve Corps, the law authorized the same percentage in each grade as had formerly been fixed for the Medical Corps of the Regular Army. The numbers in higher grades, as allowed by law, were much more liberal than those fixed by Tables of Organization. This difference should have accrued to the advantage of officers serving in France, but was not taken advantage of until after the signing of the armistice. Up to that time promotion in the Medical Corps had been more rapid in the United States than in France. This was not due to discrimination by the Surgeon General`s Office against medical officers overseas. All recommendations or promotions received at the War Department approved by the commanding general in France were made without question. There were no exceptions to this rule. The Surgeon General`s Office had no direct control over the promotion of medical officers serving in France or in Great Britain. The Surgeon General felt that delay in promotions in France was not a sufficient reason for withholding promotion from deserving officers serving in the home territory. Finally, upon request of the commanding general, American Expeditionary Forces, 41 it was made clear 42 that General Orders, No. 78, War Department, of August 22, 1918,(regulations governing for the duration of the war the appointment and pro-motion of officers of the Army), was applicable to the American Expeditionary Forces in France. The promotion of officers overseas was thus left entirely to the discretion of the commanding general, subject to approval by the War Department. h
h A full discussion of promotions in the American Expeditionary Forces will be found in Volume 11, Organization and Administration, American Expeditionary Forces.
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With the signing of the armistice, appointments and promotions of all officers in the home forces were discontinued by the direction of the Secretary of War. 43 The chiefs of service could not, therefore, be given advancement commensurate with their mature years, professional qualifications, and increased responsibilities. Yet, so far as the treatment and care of battle casualties returned to the United States from overseas were concerned, the work of the Medical Department was at that time in its incipiency. In February,1919, however, promotions for officers serving in the United States were re-opened. 44 Of the first 225 recommendations submitted by the Surgeon General, all were disapproved by the War Department. After the matter had been brought to the personal attention of the Acting Secretary of War, 30 out of the 225 were finally approved. Between April 1, 1919, and August 1, 1919, the Medical Department received from local commanding officers 1,552 recommendations for promotion. Of this number 442 were selected by a board of officers in the Surgeon General`s office as coming within the provisions of the restricting regulations issued by the Secretary of War. Of the 442 recommendations thus forwarded to the War Department, only 183 were approved by the Secretary of War.45
Considerable controversy arose in regard to the grades given temporary officers of the Medical Corps as compared with those held by officers of the Regular Army. A general idea of the situation existing at the conclusion of hostilities may be obtained from the figures given below. This computation was made on January 25, 1919, and deals only with the grade of major.
On November 11, 1918, there were 29,299 medical officers on active duty who held temporary commissions only. Of this number, 2,200, or 7.3 percent, held at that date the grade of major. On the same date, there were in the Medical Corps of the Regular Army 920 officers, of whom 160, or 17.3 per cent, were serving in the grade of major. 46
Leaving out of consideration all officers of less than one year`s service, the proportions in each service holding the grade of major on November 11, 1918, are as follows: 46\t
Percent
Medical Corps, regular ................................................................ 19.4
Medical Corps, temporary ............................................................18.0
The following table, issued by the statistical division of the General Staff, shows that on November 11, 1918, officers of the Medical Corps had had less temporary promotion than the officers of any other branch of the Regular Army, except the Dental Corps. 47
Increase in rank of Regular Army officers for the emergency as of November 11, 1918, by branch of service.
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Under the law in force at the beginning of the war, officers appoints in the Medical Corps of the Regular Army were required to serve five veers as first lieutenants before becoming eligible for promotion to the grade of captain. As the war progressed, such a limitation was recognized to be unjust. At there quest of the War Department, Congress, therefore, passed a law (act approved October 6, 1917) providing that during the emergency, first lieutenants of the regular Medical Corps might be promoted to captaincies after such length of service as might be determined by the Secretary of War. At the request of the Surgeon General the Secretary of War fixed this period of service at one year. 48 After the armistice was signed it was requested that the Secretary of War rescind the new regulations and return to the provisions of the law requiring five years` service in the grade of first lieutenant. 41 This resulted in a great many resignations.
Provisions were made for but one general officer in the Medical Department of the Regular Army in the national defense act of June 23, 1916. 50 Coincident with the temporary increase of the land forces, made possible by this act, four officers of the Medical Corps were commissioned brigadier generals, National Army, August 7, 1917.51 One of these was chief surgeon, American Expeditionary Forces. By July 1, 1918, the number of brigadier generals had been increased to seven. 52
In the act of Congress making appropriations for the support of the Army for the fiscal year ending June 30, 1919, promulgated July 22, 1918, the Medical Department was increased by an Assistant Surgeon General, a major general, for service abroad, and two Assistant Surgeon Generals, with the rank of brigadier general, all to be appointed from the Medical Corps of the Regular Army. In addition to these, the President was empowered to appoint in the Medical Department of the National Army, and by and with the advice and consent of the Senate, from the Medical Reserve Corps of the Regular Army, two major generals and four brigadier generals. 53
The maximum number of general officers in the Medical Department was 12--2 major generals and 10 brigadier generals-on October 15, 1918. 52
ASSIGNMENTS.
With 30,000 officers of the Medical Corps and approximately 10,000 belonging to other branches of the Medical Department on active duty, the proper distribution of the officers and their assignment to the work they were best qualified to perform was a problem of great magnitude.
Two means were employed for selecting medical officers for assignment, viz, one by a division of the Surgeon General`s Office desiring officers of special qualification; the other, a more or less routine selection by the Personnel Division for the other divisions of the Surgeon General`s Office. The first method was employed more extensively during the earlier months of the war, or the formative period, when it was essential to fill many new important positions. Thus the Division of Sanitation, on its own initiative, selected officers for duty as division surgeons, sanitary inspectors, etc.; the Division of Internal Medicine chose, from among the most prominent clinicians of the country, medical officers to act as chiefs of medical service in the hospitals; likewise the Division of Surgery selected officers of reputation as chiefs of surgical service. As a
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general rule, however, when an officer first entered the service, the only information as to his qualifications at the disposal of the Medical Department was the statements made by the officer himself in the personal history which accompanied his application for commission. The officer in the Personnel Division who reviewed the application papers and assigned grades to original applicants noted the special qualifications claimed by each candidate, his hospital appointments, if any, his post graduate courses and medical school affiliations. With the information thus obtained as a basis for his action, he then decided to what general duty the officer should be assigned and, with a red pencil, made one of the following notations on the applicant`s papers: "General surgery," "internal medicine," "head surgery," "psychiatry," "roentgenology," "sanitation,"" general service." Officers whose papers were marked "general service" were then ordered to one of the medical officers` training camps or to immediate duty with troops, as the exigencies of the service required, while the papers of the specialists were sent to the heads of the respective professional divisions, who thereupon became responsible for the training and assignment to duty of the officers thus placed at their disposal. It was frequently demonstrated through the courses at the training camps, or actual duty in the hospitals, that the claims made by an officer in his personal history could not be substantiated by him and he had to be reclassified and reassigned.
All requests for orders from the professional divisions for the assignment of their officers were made to the Personnel Division, and the Personnel Division made the formal request for the order to The Adjutant General of the Army. This centralized control was found to be absolutely necessary to avoid confusion and duplication of orders. On the whole, the plan worked well. Assignment having been made to specific divisions, officers concerned were not subject to reassignment to duty with another division until after they had been released from divisions to which assigned.
DISCHARGES.
With the signing of the armistice, machinery was immediately put in operation for the demobilization of the Army. By War Department orders demobilization, as far as possible, was decentralized.64 Department and camp commanders and the chiefs of staff corps were given authority to discharge all officers under their respective jurisdictions as far as their services could be dispensed with. 54 These orders were immediately modified for the Medical Department in order that it might retain the necessary personnel to provide for the 120,000 battle casualties still to be returned to the United States from overseas. 55
Immediately after the War Department issued its general instructions for demobilization, the Surgeon General sent a circular telegram to all general hospitals and to all camp surgeons and department surgeons directing the discharge of all officers of the Medical Department over 50 years of age and all below that age whose services were not essential.
At this time the question of reestablishing the Medical Section of the Officers` Reserve Corps and retaining on an inactive status the 30,000 medical officers then in the Army, presented (itself for solution. As the War Department on August 7, 1918, had transferred all officers of the Medical Section, Officers`
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Reserve Corps on active duty, into the United States Army,56 the Surgeon General`s Office was of the opinion that a similar order might be issued restoring former officers of the Reserve Corps to their original status; accordingly, it was requested that this be done. To this communication the following reply was received from the General Staff: 57
With reference to the possibility of an Executive order automatically returning to the Medical Reserve Corps upon discharge every officer of the Aledical Corps now on active duty who is entitled to an honorable discharge, such action does not seem advisable. The opinion of the Judge Advocate, which has been approved by the Secretary of War, indicates that all officers serving as a part of the Army have lost their Reserve Corps identity, and that General Orders, No. 73, automatically discharged all Reserve Corps officers from their reserve obligations. The action of returning or placing in the Reserve Corps automatically upon their discharge all officers entitled to an honorable discharge does not seem expedient. The opportunity exists at this time to build up an excellent Reserve Corps from among honorably discharged officers who desire to serve in the same. To automatically place all officers in the Reserve Corps will place therein many undesirables, and would also place therein many who do not desire to serve in the Reserve Corps. The object desired maybe accomplished by the discharge of all officers and the prompt replacement in the Reserve Corps of those who desire such reappointment and are recommended therefor. There appears to be no reason why the process of such reappointment should be long and cumbersome.
A further objection to an order automatically placing officers in the Reserve Corps is the necessity of complying with the law as to grades which Reserve Corps officers may hold, age limitations, and limitation as to proportion of officers in any section of the Reserve Corps, all of which are set forth in section 37, act of June 3, 1916.
Upon receipt of this communication the Surgeon General immediately appointed a board of high-ranking officers, all but one of whom belonged to the temporary forces, to draw up regulations for the appointment of discharged officers to the Medical Reserve Corps. The regulations formulated by this board provided for the elimination of those whose service had been unsatisfactory, and for the grades to be given those appointed, based on length of service and the grade held at time of discharge. These regulations were approved by the Surgeon General and put into effect in the form in which they came from the board without modification of any kind.
Many officers who, at the time of discharge, refused to apply for appointment in the Reserve later changed their minds and asked for commissions.
SECTION OF MEDICAL EDUCATION.
(Medical Enlisted Reserve Corps)
The Section on Medical Education in the Personnel Division of the Surgeon General`s Office owed its origin to the Selective-Service Regulations prescribed for the administration of the draft law. Under these regulations, as originally written, medical students might be drafted into the Army as soldiers. In the spring of 1917 the authorities of medical schools sought to have them exempted on the grounds that if their medical education was continued until they graduated their value to the Army would be greater, whereas, if this plan was not adopted, ultimately, in the event of the prolongation of the war, there would be a shortage in medical officers. The desirability of some such provision was recognized by the War Department; but the exemption from the action of the draft law by any class of registrants, no matter how urgent the need, would have resulted in the creation of a favored class of men, not designated for exemption by the law. Any such action, too, if generally adopted, would
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have endangered the plan of raising a sufficiently large Army by draft. The proposition to exempt medical students therefore was not approved.58
By the end of August, 1917, a plan had been worked out which did not exempt medical students from the action of the draft law, yet made it possible for them to continue their studies. Under this plan they entered the military service of the country, as required by the draft law, but by voluntary enlistment instead of by draft. They were given the privilege of enlisting in the Medical Enlisted Reserve Corps.59 In this corps they were subject to call to active duty in the Army at any time their services were required, and yet it was possible to leave them on an inactive status until their services were needed. The administration of the regulations on the subject was placed in the hands of the Surgeon General; and orders were issued from the Surgeon General`s Office, under authority from the War Department, to make the plan effective. 60
Since the object of the plan was primarily to provide competent medical officers for the Army, its operation was limited to students and graduates of medical schools recognized by the Surgeon General. It was further limited to students of the fourth, third, and second year classes in these schools, and to hospital internes who were graduates of these schools and who had had less than one year of interne service. Those who had had a year of interne service were regarded as eligible for commissions and were not concerned with entering the military service as enlisted men in the Medical Enlisted Reserve Corps. It was the intention of the Surgeon General, however, provided the exigencies of the war permitted, to allow this amount of postgraduate training for doctors, i. e., one year`s internship, before recommending that they be called to active duty.
In justice to men drafted into the Army, generally, the principle was also established in the regulations in question that a medical student, to continue to enjoy the privilege of pursuing his medical education, must keep up with the normal progress of the men in his class. It was provided, therefore, that a student, upon failure to pass from one class to another, or upon failure to graduate, should be called to active duty under his enlistment. Students and internes were required to make a report to the Surgeon General at the end of each semester, showing their status, and such reports required the verification by the school authorities concerned. 60
On October 6, 1917, Congress enacted a measure which provided that all regulations concerning the enlistment of medical students in the Enlisted Reserve Corps should apply similarly to dental students. 61 Thereafter, the students of the fourth, third, and second years in dental schools were allowed to enlist in the Medical Enlisted Reserve Corps on the same status as medical students.
New Selective-Service Regulations became effective on November 8,1917. 62 Section 151, paragraph (b), extended the same privileges, under regulations prescribed by the Surgeon General, to medical students, hospital internes, dentists, dental students, veterinarians, and veterinary students, if of draft age. The new regulations permitted the extension of the privilege of voluntary enlistment to students of the first-year class. A ruling of the Surgeon General, how-ever, excluded premedical students from this privilege. 63
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These new regulations continued in force for the administration of the Medical Enlisted Reserve Corps until shortly after the armistice was declared.
WELL-RECOGNIZED SCHOOLS.
Since the object which justified the Surgeon General in leaving students on inactive status in the Medical Enlisted Reserve Corps was to furnish a professional training that would prepare them to become efficient officers in the Medical Department, it was necessary to limit the application of this privilege to schools which offered a professional training satisfactory for this purpose. Such schools were designated "well recognized" schools, and permission granted by the Surgeon General to enlist in the Medical Enlisted Reserve Corps was restricted to students and graduates of these schools.
It thus became necessary for the Surgeon General to adopt standards for the approval of medical, dental, and veterinary schools. In deciding this question the Surgeon General was guided by the opinions of recognized authorities on educational matters, outside of the Army, where such recognized authorities could be found. In a few instances a special investigation was made by the Medical Department, but this was exceptional and was under- taken only where it was believed that a change in classification might be warranted by recent changes at the institution.
Medical schools.-The standard adopted of a "well-recognized" medical school was the recognition of its graduates as being eligible for examination for license to practice medicine by the State boards of medical examiners in 50 per cent of the States. Inspections of medical schools had been made in recent years by the Carnegie Foundation, the Council on Medical Education of the American Medical Association, and the Association of American Medical Col- leges. The attitude of the State boards was to a large extent based upon the results of these inspections, and it was felt that their verdict represented fairly the general consensus of opinion as to the standing of medical schools.
The most definite classification of medical schools was that of the American Medical Association, which divided the schools into three classes, A, B, and C. This classification, however, was never adopted by the Surgeon General as such, although its worth was fully recognized. The adoption of a standard based on the action of the legally constituted authorities of the several States had obvious advantages. The fact that the standard adopted by the Surgeon General on this basis practically included Classes A and B of the American Medical Association and excluded Class C indicates both the fairness and the liberality of the standard.
In all cases where new inspections were made by the American Medical Association the details of the results of these inspections were made available for consideration by the Medical Department. The report itself, however, and not the decision of the Council on Medical Education, was taken as a basis for a decision as to whether a school should be classed as “ well-recognized. " All doubtful cases were referred to the Surgeon General himself, and a decision was reached after consultation with officers in the department, among who in were some of the leading medical educators of the country. By this plan the Medical Department made use of the very valuable assistance of the American Medical
163
Association, and yet preserved its own independence of judgment and action. In a few instances, where it seemed desirable, the Medical Department had inspections made under its own direction.
A change was made in the classification of a school, when the new facts, brought out by any of these inspections, indicated that existing conditions warranted such change. If a school was advanced to recognition as a "well-recognized" school, the benefits of the decision were made available at once for its students. If, however, the approval of a school was withdrawn, when it had previously been recognized, the students in the Medical Enlisted Reserve Corps were allowed to remain on inactive status until the following fall. This enabled them to complete the school year in the same institution, and gave them a chance to enter some " well-recognized " school in the fall, if found qualified.
Dental schools.-The problem of establishing a satisfactory standard of classification of dental schools was not so easily solved. The inspection and classification of dental schools had not been carried out with the same thoroughness as in the case of medical schools. The State boards of registration in dentistry, therefore, had less reliable data on which to base their judgment, and it was not felt that a decision based upon their rulings would offer as satisfactory a standard as in the case of medical schools. Under these circumstances, and because some standard must be adopted quickly to meet the requirements of the Selective-Service Regulations, the list of "well-recognized" dental schools was first based on the action of the National Association of Dental Faculties.
The American Institute of Dental Teachers, which met in Pittsburgh January 29-31, 1918, was requested to indicate to the Surgeon General the most authoritative body to consult on questions of standards in dental education, 64 The Dental Educational Council of America was recommended, and its forth-coming report on the classification of dental schools was recommended for acceptance. Since the Dental Educational Council of America was composed of 15 members, five each from the Association of State Boards in Dentistry, the National Dental Association, and the National Association of Dental Faculties, it appeared to be the most broadly representative and the most authoritative body from which to seek advice in these matters. It was accepted by the Surgeon General as an advisory committee on matters of dental education, but the right of independent decision was reserved for the Surgeon General`s Officer. 65
Following a request from the Surgeon General`s Office for information about the forthcoming classification of dental schools, the secretary of the Dental Educational Council stated that additional data were being collected, through a questionnaire, about the four-year curriculum which had been adopted by most schools within a year; and that the classification of dental schools would be taken up as soon as this information was secured. A meeting of the council was held March 26-28, 1918, at New York City. A provisional classification of dental schools was made by the council, the schools being divided into classes A, B, and C. It was voted that a final classification would be adopted at the annual meeting in August, and that dental schools that were dissatisfied with their position in the provisional classification would be inspected again before the annual meeting.
The Surgeon General decided that dental schools which remained in class C after the final classification in August would be removed from the list
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of "well-recognized" schools. 66 A notice to this effect was sent individually to those dental schools, previously "well-recognized," which were placed provisionally in class C at the council meeting in New York. They were notified that recognition by the Surgeon General would be withdrawn on September 1,1918, if the school remained in class C; that their students, who were members of the Medical Enlisted Reserve Corps, would be allowed an opportunity, until October 15, 1918, to enroll in some well-recognized dental school; and that students not so enrolled on that date would be called to active duty. At the annual meeting of the Dental Educational Council, the schools definitely placed in class C were removed from the list of well-recognized schools.
Veterinary schools.-The status of veterinary education had been such that little accurate information upon the facilities and efficiency of those schools was available. There was not in veterinary education any body comparable to the Federation of State Medical Boards or to the Dental Educational Council. The only general agency that had passed upon veterinary schools was the Department of Agriculture, which had made certain regulations as to schools whose graduates should be eligible to enter the examinations for appointment as inspectors under the Bureau of Animal Industry. 67
The Surgeon General`s list of well-recognized veterinary schools was made after consulting officers of the Veterinary Corps, and included 21 institutions.68 In March, 1919, one school (North Dakota), giving only two years of the four-year course, was added to this list. 68
It became evident that some better standardization was necessary, and in April, 1918, after conference with veterinary educators and with representatives of the Department of Agriculture, the Surgeon General`s Office announced that after June 30, 1918, no veterinary school would be considered well-recognized unless it required for entrance successful completion of at least two years of high-school work. 69
STUDENTS.
It was necessary, while adopting these measures for the purpose of insuring a supply of officers for the Medical Department, to prevent registrants from using these provisions as a means of practically evading the draft. The regulations, therefore, clearly defined the words "student " and "bona fide student." 63
The necessity of keeping up normal progress in this training has been referred to. In any individual school this was well handled by the school authorities; but it became necessary to regulate the transfer to students from one school to another. This concerned especially the "failed" or "conditioned" students, and those who feared they would fall into these groups. A student was required to maintain his proficiency in the institution he was in, as an evidence of possessing the proper qualifications for an officer.
Notwithstanding the desirability of holding premedical students, in order to assure an adequate supply of medical students for future needs, the Surgeon General ruled that they could not be included under the head of "medical students," although the educational requirements were such as clearly to indicate their intention to study medicine.63 With the new registrations for the draft and the lowering of the draft age, this problem became acute. On May 20, 1818, as circular letter was issued to the deans of well-recognized
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medical schools stating that the Surgeon General would recognize matriculation of students for the entering class of 1918-19 from that date, and that permits for enlistment would be issued after June 1 for students so matriculatd.70 In spite of this precaution a considerable number of prospective medical students were lost through the action of the draft law, and the entering classes of medical schools were seriously reduced.
CERTIFICATION OF APPLICANTS FOR THE MEDICAL ENLISTED RESERVE CORPS.
All applicants for voluntary enlistment under section 151 (b), Selective-Service Regulations, were required to furnish affidavits from the authorities of their schools establishing their status as students or graduates of the school in question. 60
AUTHORITY FOR VOLUNTARY ENLISTMENTS.
The Selective-Service Regulations required registrants who applied for voluntary enlistment in the Medical Enlisted Reserve Corps to obtain the authority of the Surgeon General to so enlist.
By the end of November, 1917, the Surgeon General`s Office was over-whelmed by the number of applications for permission to enlist. It was manifestly impossible to handle these individual cases in season to permit enlistment before these registrants would be compelled to fill out their questionnaires for the draft boards shortly after December 15. Consequently these applications were returned to the deans of the schools with a letter of instructions; and on December 7, authority was sent to all recruiting officers to accept and enlisting the Medical Enlisted Reserve Corps the students mentioned in section 151 (b),with the provision that the dean of the school, or his authorized agent, furnish an affidavit to the effect that the applicant was a bona fide student in the regular course in the school, and the class in the school, of which the applicant was a member. 71
This blanket permission to recruiting officers was the only practicable way of meeting the emergency at that time. The method was found to have certain objections, however, and was no longer necessary after the emergency had passed. On May 4, 1918, this blanket permission was revoked, and authority for voluntary enlistment was granted thereafter only on permission from the Surgeon General`s Office in individual cases.72 This method was continued until August 9, 1918, when all further enlistments in the Medical Enlisted Reserve Corps were stopped by general orders of the War Department. 73
This discontinuance of enlistments for the Medical Enlisted Reserve Corps was based upon the abandonment by the General Staff of the policy of building up a reserve corps during the time of actual hostilities. It was felt that the professional training of medical and other students was provided for by the inauguration of the Students` Army Training Corps, the details of which are riven more fully on pages 169 and 269.
A certain number of soldiers who had been medical students but were then in active service were discharged so that they could enlist in the Medical Enlisted Reserve Corps and resume the medical course, or they were transferred to the Medical Enlisted Reserve Corps. The needs of the organization of which such a soldier was a member, however, frequently made it impracticable to grant the request for return to study medicine.
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HOSPITAL INTERNES.
The plan of allowing graduates of well-recognized medical schools to serve as internes in hospitals for one year had a double object. It aimed to enhance their practical training and to preserve the efficiency of the hospitals of the country for the protection of the civilian communities.
This privilege was qualified by requiring the fact of graduation from a well-recognized medical school to be attested by the proper authorities of the medical school, and the fact of internship to be attested by the superintendent of the hospital concerned. The dates of graduation from the medical school and of the beginning of the internship were also established by affidavits. On the receipt of satisfactory data, accompanied by an application from the in- terne to enlist in the Medical Enlisted Reserve Corps, the Surgeon General`s Office authorized such enlistment. When the enlistment had been effected, a permit was sent to the interne, authorizing him to remain on inactive status until a specified date-usually one year after his internship began-unless the exigencies of the war made it necessary to call him for active duty at an earlier date. A copy of this permit was sent to the superintendent of the hospital.
The continuance of internes on inactive status was contingent upon the performance of his duties in the hospital in a manner satisfactory both to the Surgeon General and to the authorities of the hospital. This satisfactory performance of duties was established by reports from the hospital authorities. Thus the hospital was protected not only as to the length of service of the interne, but as to the character of his work. The Army was protected by the assurance that the interne was getting a satisfactory experience and by an agreement of the superintendent of the hospital to notify the Surgeon General at once if for any reason the internship was terminated.
The medical Department could train a large number of these graduates satisfactorily in Army hospitals, and in allowing them to remain in civilian hospitals it was desirable to be assured that they would get at least an equally good professional training. There was a shortage of internes because so many graduates, eager to serve their country, had applied for commissions without waiting for a hospital training.
It was necessary for the good of the community to provide first for the pub- lic hospitals. Therefore, the following regulation was enforced: 63
The department will not recognize internships in hospitals. sanitariums, or other institutions conducted for profit: or in small private hospitals (50 beds or less); or new internships at any hospital, if established or added since May 18, 1917, to those previously existing, unless such new internships are necessitated by and are proportioned to an increase in the bed capacity of said hospital.
The enforcement of this regulation necessitated the classification of the hospitals of the country. There was no existing classification of hospitals that was satisfactory for the purposes of the Medical Department. Valuable information was collected from the reports of the American Hospital Association, the Council on Medical Education, and the American College of Surgeons. In addition, a questionnaire was sent out from the Surgeon General`s Office to those hospitals which, on information available from these sources, appeared to be eligible for approval as places in which to train internes for Army purposes.
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On the basis of these returns the hospitals were classified into acceptable, doubtful, and not acceptable groups.
It was the policy of the Surgeon General not to interfere with arrangements for internes already made except where it was clear that the interne could not get an adequate training. Owing to the scarcity of internes, this matter largely handled itself, for the graduate, aided by advice from the medical school, could generally find a satisfactory internship.
NUMBER AND PROPORTION OF MEDICAL STUDENTS ENLISTED.
eans of medical schools were asked to report the number of students in the schools on March 1, 1918, and to indicate those who had been enlisted in the Medical Enlisted Reserve Corps.74 This report showed there were on March1, 1918, in the 82 well-recognized medical schools in the United States, 12,354students, of whom 7,366 were enlisted (59.62 per cent). The number and percentage of enlisted men at that date in the several classes were as follows:
First year, 1,583 (40.03 per cent).
Second year, 2,162 (67.41 per cent).
Third year, 1,989 (74.57 per cent).
Fourth year, 1,632 (64.60 per cent).
The 40.03 per cent who were not enlisted included several groups; e. g., aliens, physically unfit, deferred classification on account of dependents, overage, under age.
CALL TO ACTIVE DUTY OF FAILED STUDENTS.
Since the purpose and justification of membership of students in the Medical Enlisted Reserve Corps on inactive status was solely to prepare them professionally to become medical officers, it was the policy of the Surgeon General`s Office to terminate the inactive status of any student member of the corps who failed to progress in his professional preparation at the normal rate. This was accomplished as promptly as practicable.
It was held that if a student, by his records, showed he was unable to progress with his class, whether from lack of capacity or from lack of application to his work, the likelihood of his having the aptitude and ability to make a successful medical officer was too small to warrant his being left inactive after these facts were demonstrated. Two classes of exceptions to this policy were made: (a) Those whose deficiency in school work was clearly due to prolonged personal illness; (b) those who had volunteered or been drafted before the inactive status in the Medical Enlisted Reserve Corps was available, and who were transferred to the Medical Enlisted Reserve Corps and returned to school so long after the opening of the school year that it was impossible for them to make up all the lost work.
Under this policy there were called to active duty between April 10 and November 10, 533 medical students reported by their deans as unable to progress with their class or to have left school. This was 5.96 per cent of the total (8,937) of medical students enlisted in the Medical Enlisted Reserve Corps. 74
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DENTISTS AND VETERINARIANS.
Registrants who were graduates of well-recognized schools in dentistry and veterinary medicine were eligible for voluntary enlistment in the Medical Enlisted Reserve Corps by the Selective-Service Regulations. The object of this provision was to enable the military authorities to place these men in the military service where their experience and training could best be utilized. Since, however, these graduates had already obtained the amount of professional training needed for Army purposes, there was no sufficient military justification for leaving them on inactive status, as in the case of the under-graduates in the same schools. Consequently they were called to active duty as soon as their services could be utilized in the Army.
This position was made plain in the early circulars sent out from the Surgeon General`s Office. Nevertheless a considerable number of such graduates expected to be left on inactive status to continue their professional work in civil life until assured of an opportunity to serve in the Army under commissions. Some of these remonstrated, when called to duties as privates, in accordance with the terms of their enlistment. No injustice was done to these men, however, because they were physically fit for military service, were of draft age, and would have been drafted to serve as privates in the line. The voluntary enlistment in the Medical Enlisted Reserve Corps did not change this result, hut assured them an assignment to work which would make use of their professional training
A question arose as to the treatment of senior students of the year 1917-18,when they became graduates at the end of the school year. By that time special schools in dentistry and veterinary medicine had been organized at the Medical Officers` Training Camp, Fort Oglethorpe, Ga. Those of the upper half of the graduating classes were divided into groups to be sent to these schools for further training at specified dates, and those of the lower half were called to active duty as privates.
The situation in regard to dentistry was peculiar, in that so many men had been commissioned in the Dental Reserve Corps that new commissions were not granted for a number of months, and a capable student could not expect a commission after graduation as would ordinarily be the case.
In the beginning the administration of the requirements connected with enlistments in the Medical Enlisted Reserve Corps formed part of the work of the Enlisted Section, Personnel Division, of the Surgeon General`s Office. As these duties increased, however, the chairman of the Council of Medical Education of the American Medical Association and director of the Graduate School of Harvard University was ordered to the Surgeon General`s Office, toward the end of November, 1917, to direct the work. 75 The administrative details, in connection with the carrying out of these regulations, continued to increase, and a Section on Medical Education was organized in the Personnel Division of the Surgeon General`s Office. At the height of this work there were employed in this section six commissioned officers, one sergeant, first class, and a clerical force of 15.
On February 10, 1918, a Committee on Education and Special Training of the training and Instruction Branch, War Plans Division, General Staff, was
169
created. 67 This committee was authorized to represent the War Department in its relations with the various educational institutions of the country and was given broad administrative powers in this direction. As its work developed it became clear that its duties should properly include the educational supervision of medical schools, which, as has been explained, had been exercised up to this time by the Surgeon General through the Section on Medical Education in his office. Possible friction or duplication of effort was avoided through the appointment on May 23, 1918, of a liaison officer to function between the Surgeon General`s Office and the Committee on Education and Special Training; and also the acceptance on the part of the committee of the plans and regulations affecting the subject which had been inaugurated by the Surgeon General.
THE STUDENTS` ARMY TRAINING CORPS.
Upon the discontinuance of enlistments in the Medical Enlisted Reserve Corps in August, 1918,73 and the establishment of the Students` Army Training Corps, 77 which was intended to provide for the education of all students, including medical, dental, and veterinary, it was clear that the administration of the regulations governing the education of these students would ultimately pass entirely out of the hands of the Surgeon General to the Committee on Education and Special Training. The armistice was declared, however, before the change in jurisdiction had been completed.
It was desirable from a military standpoint and fair to the students that members of the Medical Enlisted Reserve Corps who were still in the schools should enter the Students` Army Training Corps. Early in October, 1918,soon after the Students` Army Training Corps was in actual operation, steps were taken to bring this change about.78 The procedure was for the commanding general of the department concerned to call the member of the Medical Enlisted Reserve Corps to active duty in the Medical Department and immediately transfer him to the Students` Army Training Corps, assigning him to that unit of the corps located at his school. This did not apply to all members of the Medical Enlisted Reserve Corps, and The Adjutant General issued orders to the commanding generals of departments to make this change for such men as were recommended by the commanding officer of a Students` Army Training Corps unit. This latter officer, in turn, obtained his list from the dean of the school.
The process described required some time to complete. Delay was caused partly by misunderstanding, partly by shortage of clerical help everywhere because of the epidemic of influenza at that time, and in many cases also because the service records--essential for effecting the transfer of the men--were not at department headquarters. In many instances this lack of service records at department headquarters was due to the fact that students had enlisted in one territorial department and then gone into another to attend school without notifying department commanders that residences had been changed. 74
Lust before the armistice was declared there was a large number of transfers which had not been effected, and their discontinuance was ordered to prevent a technical increase in the active Army. 79
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DEMOBILIZATION OF THE MEDICAL ENLISTED RESERVE CORPS.
When the transfer of members of the Enlisted Reserve Corps to the Student`s Army Training Corps was stopped because of the armistice there were then left on inactive status in the Medical Enlisted Reserve Corps 6,684 men, of whom 4,218 were medical students.74 The Surgeon General`s Office relinquished all educational control over schools and students shortly after the signing of the armistice, but this did not relieve the members of the corps from their liability for military duty.80 On December 11, 1918, The Adjutant General authorized commanders of territorial departments of the Army to discharge all members of the Enlisted Reserve Corps who had not been called to active service whose service records were on file at headquarters of the given department by reason of their services being no longer required.81
Enlistments, discharges, and transfers in Medical Enlisted Reserve Corps,74 under section 151 (b), beginning September 4, 1917.
The administrative control of the Medical Department activities, other than those essentially educational, at the various colleges which had units of the Students` Army Training Corps, including units of medical, dental, and veterinary students, by the Students` Army Training Corps Section, Division of Sanitation, Surgeon General`s Office, is described in the administrative history of the Division of Sanitation, this volume (q. v.).
SECTION OF ENLISTED PERSONNEL
PROCUREMENT.
On April 6, 1917, there were 6,619 enlisted men, Medical Department. 82 The national defense act of June 3, 1916, provided that the total number of enlisted men in the Medical Department should not exceed the equivalent of 5 per cent of the total enlisted strength of the Army, exclusive of the enlisted force of the Medical Department, except that in the time of actual or threatened hostilities the Secretary of War was authorized to enlist or cause to be enlisted in the Medical Department such additional number of men as the service required. 83
On May 21, 1917, the Surgeon General recommended that the Secretary of War increase the authorized allotment of enlisted men to 10 per cent of the total enlisted strength of the Army for the emergency. This recommendation
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was approved by The Adjutant General of the Army in his first indorsement, June 15, 1917, as follows: 84
To the Surgeon General, with the information that the Secretary of War directs that, until further orders, the enlisted strength of the Medical Department of the Regular Army be maintained at such strength as will, when added to the enlisted strength of the medical units of the National Guard in the service of the United States, and of all such other Federal forces as may be hereafter raised equal, as near as may be, 10 per cent of the aggregate enlisted strength of the said forces. The increase herein authorized to be effected pari passu with the increase of the enlisted personnel of the forces it is to serve.
On June 30, 1917, there were 16,773 enlisted men, 85 Medical Department, the surplus over the number representing gains by enlistment, reenlistment on April 6, by transfer from the line.
There were drafted into the Federal service, for duty with the several National Guard divisions, 59 field hospitals and 47 ambulance companies, the total enlisted personnel for which was 10,506.86 The total strength of the personnel for the various sanitary detachments assigned to line organizations numbered 6,119 enlisted men, 86 making an increment to the Medical Department totaling 16,625 on August 5, 1917.
The acquisition of additional enlisted personnel for the Medical Department was effected by means of voluntary enlistment, transfer, recalling Regular Army reservists to active service, and by the selective draft. 87
Prior to June 23, 1917, there was no distinction made between enlisted men assigned to duty with units or detachments for the performance of essential Medical Department functions and those assigned to dental or veterinary work. 87 On June 23, 1917, however, the first subdivision of the enlisted force of the Medical Department was made in the provision of the United States Army Ambulance Service, 88 the enlisted strength of which was raised and maintained by voluntary enlistment and the draft, subsequently limited to7,605 men. 88 On June 30, 1917, in the organization of the Sanitary Corps, provision was made for an enlisted force in addition to an officer personnel,90 referred to above. The enlisted force of this corps was subsequently limited to 3,945 men.91 An enlisted personnel was provided specifically for the Veterinary Corps on October 4, 1917,92 to number 16 for each 400 animals in the service. These special types of enlisted personnel of the Medical Department were authorized only for the period of the emergency.
The Medical Department obtained men from the draft in two ways, indirectly and directly.
When mobilization of the National Army divisions began inducted men were sent to mobilization camps by the War Department, and assigned to organizations at the camps by local commanders. The type of enlisted men thus obtained for the Medical Department depended largely upon the attitude assumed by divisional commanders; but, generally, under the supervision of division surgeons, highly desirable men possessing qualifications best suited to the needs of the Medical Department was obtained by this indirect method.
In December, 1917, the War Department authorized the voluntary induction of draft registrants directly into the Medical Department. 93 This permitted the selection of men of special qualifications wvlo desired to be inducted into the Medical Department. The actual induction wias effected by furnishing the
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registrants with requests, authorized by the Surgeon General, to be presented to local boards concerned. This authority to deal directly with local draft boards was rescinded in June, 1918,94 following which time requisitions had to be made on the Provost Marshal General for the voluntary induction of registrants, and the Provost Marshal General forwarded the requisitions to local boards concerned, later notifying the Surgeon General whether the registrants accepted or declined service in the Medical Department.
As soon as the Medical Department training camps could be utilized as mobilization camps for enlisted men of the Medical Department, inducted men, procured on requisition by the Surgeon General to the Provost Marshal General, were sent thereto, from time to time, in such numbers as were authorized ly the Secretary of War.
The maximum number of enlisted men, Medical Department, was reached at about the time of the armistice, when there were 281,341 in active service. This number included 17,160 enlisted, Veterinary Corps, and those in the Sanitary Corps and Army Ambulance Service.82
CLASSIFICATION.
The following table represents the occupational needs of the Medical Department for enlisted men in time of war as nearly as can be calculated from the experience of the department in the recent war. 95
|
|
Per cent. |
|
Accountants |
0.5 |
|
Auto and gas engine men i |
0.5 |
|
Auto drivers and truck drivers i |
2.0 |
|
Bakers |
0.5 |
|
Barbers |
0.2 |
|
Blacksmiths |
0.5 |
|
Blacksmiths` helpers |
0.5 |
|
Bookkeepers |
5.0 |
|
Butchers |
0.2 |
|
Canvas workers |
0.1 |
|
Carpenters, house |
1.0 |
|
Carpenters, cabinet-makers |
0.1 |
|
Clerical workers |
1.0 |
|
Contractors |
1.0 |
|
Cooks |
2.0 |
|
Draftsmen, architectural |
0.1 |
|
Draftsmen, mechanical |
0.1 |
|
Draftsmen, topographical |
0.1 |
|
Druggists |
1.0 |
|
Electricians, instrument repair |
0.3 |
|
Electricians, motor and dynamo |
0.5 |
|
Electricians, outside work |
0.1 |
|
Electricians, wiring |
0.1 |
|
Telephone operators |
0.3 |
|
Telephone-repairmen |
0.1 |
|
File men |
0.4 |
|
Typists |
1.0 |
|
Stenographers and typists |
1.0 |
|
Plumbers |
0.1 |
|
Without special qualifications but able to read and write the English language |
85.1 |
|
|
100.0 |
i Contingent upon the control and operation of motor vehicles by the Medical department.
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TRAINING.
With the concentration of troops in divisions, each division, so far as the Medical Department was concerned, constituted a training unit for its sanitary personnel. This training consisted of two parts, one in which the medical personnel were trained in their military duties and military environment, the other in which the personnel was trained in such professional matters as were created or affected by such military environment. The first few weeks following mobilization were devoted to organization, equipment, and supply, which in themselves were considered valuable as education. On November 1, 1917,an intensive course of training was instituted, which continued so long as the divisional troops were in the United States. 96 Early in the war period it was provided that such lectures, classes, and study found to be necessary for the raining of the enlisted personnel be instituted at all hospitals. 97
A large number of schools for the training of enlisted men in special work was early developed at the Medical Department training camps. 98 These enlisted men`s schools included those for the making of noncommissioned officers, nurses and ward men, dispensary assistants, clerks, chauffeurs, and gas-engine mechanics. The medical training camps were also required to organize, maintain, and supply a large number of practically every formation which the Medical Department provided. Some of these were permanently attached to the camps as training units; others were provisional organizations without official status as such but used for training purposes until needed for conversion into new and official organizations. Still others were organized solely for the purpose of being sent elsewhere as needed.
The allowance of personnel for the Medical Department which was sent to camps for training was never sufficient, as was demonstrated by the fact that the services of the great majority thus sent to camps were so imperatively demanded outside as to cause their being ordered away before completion of their training course. There were instances in which enlisted men were sent away after arrival as soon as they could be equipped. 99
ASSIGNMENTS AND REASSIGNMENTS.
The peace-time system of managing the assignment and reassignment of the enlisted personnel of the Medical Department in the Office of the Surgeon General required no radical change during the war period. It was based, in the main, on the available number of the personnel, their qualifications, and geographical location. Personnel files contained information about each enlisted man, which, for purposes now being considered, included his name, grade, and special qualifications. This information was obtained from the medical officer first receiving men enlisted for, reenlisted in, or transferred to the Medical Department, and from the periodic returns made for each Medical Department organization by its commanding officer. 100 It permitted an assignment of individual or groups of enlisted men for a specifically needed duty. Usually assignments of enlisted personnel, when initiated by the Surgeon General`s Office, referred to numerical strength, qualified by reference to qualifications, to be arranged for locally, when necessary, and when the enlisted men were already in the service.
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The first demand for Medical Department enlisted personnel, having to do with relatively great numbers, occurred when the National Army divisions were mobilized in the early fall of 1917. In addition to the personnel required for the divisional Medical Department units base hospitals serving the divisions had to be instituted. These activities demanded more Medical Department personnel than could be furnished from the small reserve built up by voluntary enlistments immediately prior to the mobilization. When mobilization of the divisions actually occurred, skeletal groups of Medical Department enlisted men were furnished by the War Department to the divisions and base hospitals serving the divisions. The completion of the units was left to local division commanders, who, under authority of Army Regulations and War Department orders, were empowered to transfer inducted men to the Medical Department. 101 Assignments and reassignments of enlisted men by the Enlisted Section Personnel Division were made at the request of some other administrative division of the Surgeon General`s Office or activity without the War Department, such as Headquarters, American Expeditionary Forces.
PROMOTION OF ENLISTED MEN TO COMMISSIONED GRADES.
Prior to the war commissions in the Medical Department were attainable only by those possessing degrees in medicine, dentistry, or veterinary surgery. In June, 1917, however, two branches of the Medical Department were established in which commissions could be made without reference to professional attainments, viz, the United States Ambulance Service 88 and the Sanitary Corps. 90
Though the creation of the Ambulance Service was the earlier, it consisted of a definite organization with delimited functions and required a building up from its foundations. In the creation of the Sanitary Corps, however, provision was made for the commissioning of those possessing special skill in sciences allied to medicine as well as those possessing knowledge of special advantage to the Medical Department. The latter provision made it possible to commission many enlisted men of the Medical Department, especially noncommissioned officers who, by years of experience, were qualified for duty as commissioned officers of that part of the Sanitary Corps concerned with administrative details, such as adjutants, medical supply officers, and mess officers. Being available and the demand being immediate, the commissioning of a number of noncommissioned officers, Medical Department, in the Sanitary Corps was begun in July 1917, on the recommendation of the Surgeon General. l02
In the Ambulance Service, the officer personnel comprised, at first, officers of the Regular Medical Corps and the Medical Reserve Corps. Promotion to the commissioned grades of the Ambulance Service was open to the enlisted men of that service, and as they demonstrated their ability promotions from among them were made until eventually all Medical Reserve officers were replaced by officers of the ambulance, who, entering the service as privates, were grad- ually advanced to the commissioned grades.
The Enlisted Reserve Corps was utilized as a means for conserving potential officers for the Medical, Dental, and Veterinary Corps while its members were being fitted by professional education to qualify for commissions in the Medical Department. Promotions to commissions therefrom differed materially from
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methods pursued in commissioning officers in either the Sanitary Corps or the Army Ambulance Service and were based on the same regulations which controlled the entrance into the commissioned grades of the Medical, Dental, and Veterinary Corps from civil life.
DISCHARGES.
The national defense act of May 18, 1917, provided that all enlistments, including those in the Regular Army Reserve, which were in force on the date of the approval of the act and which would otherwise have terminated during the emergency should continue in force during the emergency, unless sooner terminated by the War Department; and that all persons who enlisted subsequent to April 1, 1917, either in the Regular Army or in the National Guard, as well as all who enlisted in the National Guard between the dates of June 3,1916, and May 18, 1917, were entitled to be discharged, on their own application, upon the termination of the emergency. 103 In addition to these general provisions for the automatic termination of service as enlisted men, the President was empowered, by the act of May 18, 1917, to provide for the discharge of any or all enlisted men whose status with respect to dependents rendered such discharge advisable at any subsequent time during the emergency.103 All enlisted men given commissions as officers in active service were discharged as enlisted men to enable them to accept the commissions. Other forms of discharge during the emergency included those for physical disability and by reason of an approved sentence of a general court-martial.
Almost immediately after the signing of the armistice there was a concentrated effort on the part of the enlisted men serving in the Medical Department for discharge. As demobilization of the line of the Army progressed, the enlisted force of the Medical Department was reduced. The decrease, however, was not proportionate to the number being discharged from other organizations, because of the number of sick and wounded to be provided for in the hospitals of the United States.
On January 30, 1919, there were approximately 219,600 enlisted men, Medical Department, medical and dental services, and approximately 13,500 enlisted men of the Veterinary Corps in service. 82 These numbers were gradually reduced, until on June 30, 1919, there were approximately 98,400]enlisted men on medical and dental service and 1,970 enlisted men, Veterinary Corps. 82 These numbers were finally reduced by the practical elimination of the drafted men and those who enlisted after April 1, 1917, to approximately 17,600 men for medical and dental service and 990 in the Veterinary Corps. 82
There was some dissatisfaction displayed by many of the enlisted men of the Medical Department because of their retention in service beyond the period required of enlisted men of line organizations; but, on the whole, their service was rendered cheerfully, particularly when the reason for the retention was properly explained to the enlisted personnel. A message from the Surgeon General of the Army to the enlisted men of the Medical Department, February 11, 1919, explaining the necessity for retaining them in the Army on active duty, posted at various military camps, posts, hospitals, and other stations, had, in a great measure, at quieting influence. 104
176
THE ARMY NURSE CORPS SECTION .
In accordance with act of Congress, February 2, 1901,105 which authorized the establishment of the Army Nurse Corps, its administration was conducted, as a section of the Personnel Division, by the superintendent of the corps. For a time during the war period, as shown elsewhere (see Hospital Division),the Army Nurse Corps and the Army School of Nursing functioned as part of the Hospital Division, reverting to their proper places in the Personnel Divi-sion with the reorganization of the Surgeon General`s Office in November, 1918.(See Chart XXIV, p. 540.)
Upon the entry of the United States into the World War the Army Nurse Corps consisted of 233 regular nurses and 170 reserve nurses. 106 The reserve nurses had been previously assigned to active service in the Military Establishment as a result of mobilization of troops on the Mexican border. One of the first reactions to the declaration of war was that the then diminutive corps, although adequate for the nursing of the sick soldier of an Army on a peace-strength footing, must be immediately and rapidly enlarged. in proportion to the great Army required to aid our Allies, whose armies were at maximum strength. That this task was accomplished is evidenced by the fact that at the time the armistice was signed the personnel of the Army Nurse Corps had in-creased from 403 to 21,480, including regular and reserve nurses. 107
The expansion of the corps began very shortly after war was declared. Nurses were appointed in the regular corps as rapidly as possible, and their number was augmented by the assignment to active service of reserve nurses. Existing regulations provided that the enrolled nurses of the American Red Cross Nursing Service should constitute the reserve of the Army Nurse Corps, and in time of war or other emergency might, with their own consent, be assigned to active duty in the Military Establishment.108 That there was a reserve force ready to respond to the call when the need arose was due to the breadth of vision and the determined effort of the great nurse leader, Miss Jane E. Delano, late director of the Red Cross Nursing Service, who died at Base Hospital No. 69, Savenay, France, April 15, 1919, while making a personal survey of the nursing situation overseas.
As the war progressed the American Red Cross Nursing Service was called upon to furnish large numbers of nurses to meet the rapidly increasing needs of the service. Throughout the entire war this organization worked in close cooperation with the Army Nurse Corps Section of the Personnel Division of the Surgeon General`s Office. It was early recognized by the executives of both organizations that it would be necessary to waive certain requirements for entrance into the service for the duration of the war. The age limit (between 25 and 35 years) was modified to include applicants from 21 to 45 years. Registration, previously enforced, was waived. Nurses who were not citizens of this country but were citizens of any allied country were accepted, if otherwise eligible. As reserve nurses were assigned to active service for the period of the war emergency, nurses were appointed in the Regular Corps for the same period instead of for the three years ordinarily required. The waivers necessary to obtain the large body of nurses needed were made with great reluctance on the part of the Surgeon General and of the officials of the American Red Cross. The older requirements for appointment in the Army Nurse Corps were restored by
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the Surgeon General 107 immediately after the signing of the armistice, when it was no longer necessary to continue to increase the corps.
As the need for nurses became acute, both the Army Nurse Corps Section of the Surgeon General`s Office and the Red Cross Nursing Service at intervals inaugurated drives to obtain the needed number. In December, 1917, a letter was sent to the superintendent of each training school for nurses in the United States requesting that the pressing need of the Medical Department of the Army for graduate nurses be put before their graduates. Publicity campaigns were effected through the press of the country. The Council of National Defense aided materially in stimulating the interest and patriotism of the nurses of the country, as well as in encouraging young women to enter schools of nursing. Graduate nurses who were not eligible for appointment in the Army Nurse Corps or for enrollment in the Red Cross Nursing Service were urged to enter civilian hospitals, thereby releasing eligible graduate nurses for service in the military establishment. The nurses responded to the call in large numbers, but supplying the daily need was a different problem. Constantly imminent was the danger that the supply of graduate nurses would be inadequate. Steps were taken, therefore, by the Red Cross Nursing Service to train nurses` aides, and courses in the first elements of nursing were established throughout the country. As the aides were not called upon until October, 1918, the groups first formed by the Red Cross offered their services elsewhere and entered upon other work. By October, 1918, it was clearly seen that the supply of graduate nurses was inadequate to meet the need, and shortly before the armistice was signed the Surgeon General requested the American Red Cross Nursing Service to enroll 1,500 nurses` aides. 109 This was done, but the signing of the armistice prevented the sending of these aides overseas.
A plan for an Army School of Nursing, with headquarters in Washington, was approved by the Secretary of War on May 25, 1918, 110 and the institution was established by the War Department in June of the same year. j The course as planned contemplated three years` training to be given at the various large Army hospitals in this country, with an affiliation of one year at civil hospitals in nonmilitary branches of nursing. The establishment of these training units at the different hospitals necessitated considerable rearrangement in the assignment of chief nurses, since many of these, although excellent executives, had not the necessary experience in the management of training schools.
As the mobilization of the vast Army was begun, hospitals were opened wherever troops were concentrated, and base hospitals were established at each of the camps and cantonments. These hospitals, as originally planned, were to have 1,000 beds each, with a personnel of 100 nurses, but many eventually had a far greater bed capacity, some of the larger hospitals having a personnel of several hundred nurses. Hospitals were organized also at various aviation stations, ports of embarkation and debarkation, arsenals and recruit depots, and hospital trains were put into operation, each requiring its quota of nurses. In connection with the Attending Surgeon`s Office, Washington, D. C., a War Emergency Dispensary was established to look after the physical welfare of the various departments of the Government 111 and nurses with special experi-
j The History of the Army School of Nursing will be given in one of the later volumes of this history, sub voce "Training."
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ence in public-health work were assigned to this duty. The nurses attached to the dispensary visited the clerks in their homes when they reported sick, and made recommendation as to their disposition. Nurses were also placed in the various rest rooms of the large Government buildings, where minor ailments were treated daily.
The Nursing Service of the American Red Cross forwarded to the Surgeon General`s Office the names and credentials of 17,956 nurses as rapidly as they became available for service.107 As the names and credentials were received, transportation requests and orders were issued by the Surgeon General`s Office, directing the nurses to proceed to their first station for duty. The stations to which they were sent were selected from the standpoint of transportation involved and the need of the respective hospitals. At the same time that reserve nurses were being assigned to duty with the Army Nurse Corps, nurses in fairly large numbers were being appointed directly into the corps through the Surgeon General`s Office. In forming the personnel of the general, base, and camp hospitals, an endeavor was made to send nurses who were specially skilled in operating-room technique and in the administration of anesthetics to the hospitals where their services could be best utilized, and the commanding officers of the respective stations were informed of their special qualifications.
Nurses were advantageously used as anesthetists in Army hospitals during the war as they released medical officers for other work. Special courses in the administrations of anesthetics were given in the large general and basehospitals,112 and at St. Mary`s Hospital, Rochester, Minn. The nursing personnel of units and base hospitals for the care of psychiatric, orthopedic, eye, ear, nose, and throat cases were early organized both at home and abroad.
Nurses with wide executive experience were needed for the administration of the nursing service in the large Army hospitals. Some chief nurses were drawn from those already in the corps, but many were brought in from civilian hospitals.
For the first time in the history of the Army, graduate dietitians were employed in our Army hospitals of this country and abroad. 113 This service was under the jurisdiction of the Army Nurse Corps Section and was administered by the superintendent of the corps until November, 1918, at which time a supervising dietitian was appointed and assigned to this duty and transfer. In addition to the performance of the administrative duties of the office, the supervising dietitian inspected the dietary department of each of 30 Army hospitals. 114
In June, 1917, a mobilization station for nurses ordered overseas was established at Ellis Island, in New York Harbor, 115 and accommodated approximately 350 nurses. This place was later taken over by the Army for hospital purposes only, necessitating the establishment of another station at 120 Madison Avenue, New York City, which accommodated 130 nurses. 116 Later this house was abandoned and the Knott chain of hotels was selected for mobilization purposes, with headquarters at the Hotel Albert, University Place and Eleventh Street, New York City. 117 The station functioned under the surgeon, port of embarkation, Hoboken, N. J. 118
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Early in the war information was received by the American Ambassador to England that a passport was essential for every nurse going to Europe. I was necessary to accompany each application for passport with a certificate of birth, four photographs, and the authority directing the nurse to proceed abroad; it was also necessary that each nurse, upon making such application, be accompanied by a person who had known her for two years. Birth certificates were not always available, and much time was consumed in procuring them, causing too great a delay of the nurses at the port of embarkation. In August,1917, upon recommendation of the superintendent, Army Nurse Corps, the Surgeon General requested information from the Secretary of State as to whether, in view of the time involved by the procedure necessary to procure a passport, a certificate of identification could not be issued to uniformed Army nurses in lieu of passport. This plan was approved by the British and French Governments, so that United States Army nurses wearing a military uniform were authorized to enter those countries without passports, provided they carried certificates of identification, issued by the War Department, with photo-graphs. 119
Shortly after the declaration of war, six base hospitals, with a total of 436 nurses, were sent to Europe for service with the British forces. The hospitals designated were: 120
Base Hospital No. 2, of Presbyterian Hospital, New York, N. Y.
Base Hospital No. 4, of Lakeside Hospital, Cleveland, Ohio.
Base Hospital No. 5, of Peter Bent Brigham Hospital, Boston, Mass.
Base Hospital No. 10, of University of Pennsylvania Hospital, Philadelphia, Pa.
Base Hospital No. 12, of Northwestern University Hospital, Chicago, Ill.
Base Hospital No. 21, of Washington University Medical School Hospital, St. Louis, Mo.
Early in 1917 the following base hospitals, with a total of 830 nurses, were sent to France for duty with the American Expeditionary Forces: 121
Base Hospital No. 6, Massachusetts General Hospital, Boston, Mass.
Base Hospital No. 8, New York Post-Graduate Hospital, New York City.
Base Hospital No. 9, New York Hospital, New York City.
Base Hospital No. 15, Roosevelt Hospital, New York City.
Base Hospital No. 17, Harper Hospital, Detroit, Mich.
Base Hospital No. 18, Johns Hopkins Hospital, Baltimore, Md.
Base Hospital No. 23, Buffalo General Hospital, Buffalo, N. Y.
Base Hospital No. 27, University of Pittsburgh, Medical School, Pittsburgh, Pa.
Base Hospital No. 31, Youngstown Hospital, Youngstown, Ohio,
Base Hospital No. 32, City Hospital, Indianapolis, Ind.
Base Hospital No. 34, Episcopal Hospital, Philadelphia, Pa.
Base Hospital No. 36, College of Medicine, Detroit, Mich.
Base Hospital No. 39, Yale Mobile Unit, New Haven, Conn.
Base Hospital No. 8 of the Post-Graduate Hospital, New York City, with 65 nurses, sailed for l-Europe in July, 1917, on the steamship Saratoga. 117 This boat wits accidentally rammined in New York Harbor Iy the incoming steamship Panama. This necessitated the immediate evacuation of the ship. The
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nurses were taken aboard all sorts of small craft in the bay and returned to Ellis Island next day, many of them in a state bordering on shock. That no lives were lost is undoubtedly due to the wonderful discipline displayed by the nurses when the order to abandon ship was given. With but few exceptions, and because of having to leave the ship with no time to collect their belongings, they lost practically everything they owned. The War Council of the American Red Cross, however, immediately appropriated a sum to re-equip the entire group, and gave $30 in gold to each nurse, there being no law at that time by which the Government could reimburse them for the losses sustained. The act "to provide for the settlement of the claims of officers and enlisted men of the Army for the loss of private property destroyed in the military service of the United States" was amended by act of July 9, 1918, and members of the Army Nurse Corps who lost private property in the military service were entitled to have it replaced in kind, or be reimbursed to the amount of its value, as provided in Army Regulations 726, as amended. 122
The nursing personnel of Base Hospitals Nos. 1 to 50 were organized by the Red Cross Nursing Service. 123 Each of these hospitals had a personnel of 65 nurses, which number was later increased to 100. By August, 1918, these base hospitals had been sent overseas. The nurses for Base Hospitals Nos. 51 to 79, and the special hospitals No. 102 for duty in Italy, No. 114 for orthopedic cases, No. 115 for head surgery, No. 116 for fracture cases, and No. 117 for psychiatric cases, were organized in the Army Nurse Corps Section of the Surgeon General`s Office. 124 The personnel was selected from nurses on duty in Army hospitals in this country who had demonstrated their professional and physical fitness for overseas service. Before sending her into the difficult position of nursing in the complex military establishment overseas it was found of benefit to the nurse, and therefore indirectly to the service, to give her the opportunity to obtain experience in these large military hospitals, nearly every one of which was larger than any civilian hospital in the United States.
As soon as organized, these hospitals were mobilized and sent overseas, and, from time to time, many special nursing detachments and replacement units were organized and sent to Europe. In the autumn of 1917, a large group of nurses was sent to form the personnel of the American Red Cross Military Hospitals. Nos. 1, 2, and :3, in France, which were originally organized by the American Red Cross, but which were brought under military control shortly after the United States entered the war. 125
Upon arrival overseas the nurses came under the jurisdiction of the chief surgeon, American Expeditionary Forces. The assignment of base hospitals and units and the detailing of nurses were handled by the chief surgeon and his staff. At the request of the chief surgeon, in October, 1917, a supervisor of nursing service was sent overseas for duty in his office. 126 Her status at this time was that of chief nurse, but later she was made director of nurses, American Expeditionary Forces, by authority of act of Congress, July 9, 1918.
In June, 1918, a base hospital with a nursing personnel of 49 was sent to Porto Rico for duty in the cantonment hospital there. 127
In October, 1918, Evacuation Hospital No. 17, with a nursing personnel of 26, was sent to Siberia for duty with the American Expeditionary Forces there. 128
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In response to a request from the Chief of Transportation Service, in June,1919, 63 nurses were assigned to trans-Atlantic transports. 129
On November 11, 1918, the day the armistice was signed, the Army Nurse Corps reached the zenith, the number in the corps at that date being as follows :130
Regular nurses ......................................................................................... 3, 524
Reserve nurses ................... ..................... ............................................. 17, 956
Total ................ ....... .......... ................................................................ 21,480
11,235 distributed among 174 stations in this country, Philippines, Hawaii, and Porto Rico.
10,245 serving overseas, en route, or awaiting transportation at ports of embarkation.
The distribution on November 15, 1918, before the demobilization, consequent upon the signing of the armistice, was begun in this country and overseas as follows : 130
Number of nurses.
2, 431 serving in 37 general hospitals.
6,610 serving in 38 camp and base hospitals.
568 serving in 41 post hospitals, arsenals, and recruit depots.
756 serving in 5 embarkation hospitals.
192 serving in 3 debarkation hospitals.
490 serving in 36 aviation stations. 96 serving in 9 miscellaneous stations such as the Surgeon General`s Office and Attending Surgeon`s Office, Washington, D. C.; nurses` mobilization station, Hotel Albert, New York, etc.
32 serving in 3 stations, Philippine Department.
16 serving in 1 station, Hawaiian Department.
44 serving in 1 station, Porto Rico.
742 serving with British forces.
14 serving with French forces.
8,044 serving with American Expeditionary Forces.
1,445 awaiting transportation, en route to mobilization stations, or under orders to mobilize.
21.480 Total.
This distribution does not include nurses on final leave or under orders to proceed to their homes for discharge or relief from active service.
When the armistice was signed 1,445 nurses were at the port of embarkation awaiting sailing orders, en route from mobilization stations, or under orders to mobilize. Of those awaiting sailing orders 650 were sent overseas upon the request of the chief surgeon, American Expeditionary Forces.131 The remainder of those who had reported at the mobilization station were distributed to near-by hospitals. The orders of others who had not yet reported were revoked
After the signing of the armistice, November 11, 1918, many hospitals were closed, and the corps was gradually reduced in size as the need for the services of nurses decreased, until, on June 30, 1919, there were in the corps approximately 2,084 regular nurses and 7,532 reserve nurses, making a total of 9,616, including 3,448 overseas.132 This number does not include those who were under orders for discharge, en route to their homes for discharge or relief from active service, or on final leave, which would approximate 330 in number. The majority of nurses who returned from overseas requested to be sent to their homes for discharge or relief from active service, though a few requested transfer to military hospitals in this country, signifying their desire to remain in the corps. After the armistice was signed no more nurses were assigned to active service or appointed in the Regular Corps.
182
Chart IV.-- Army Nurse Corps Section, Personnel Division, Surgeon General`s Office, June, 1918.
183
During the war, from April 6, 1917, to November 11, 1918, 1,210 nurses were discharged or relieved from active service in the Military Establishment for various reasons.133 The majority were relieved because they were physically unfit for service.
In December, 1918, the mobilization station in New York City for nurses ordered overseas was changed into a demobilization station for the reception of nurses returning to this country for termination of their services in the Military Establishment, or to await further orders.134
To avoid delay at ports of debarkation, authority was given to the surgeon, ports of embarkation, Hoboken, N. J., and Newport News, Va., to send all nurses arriving from overseas to their homes for separation from the service on request.135 The demobilization of nurses in this country could not be effected as rapidly as with those returning from overseas, because of the number of wounded soldiers returning to the United States for hospital treatment.
In April, 1919, owing to the large reduction in the clerical force in the Army Nurse Corps Section of the Surgeon General`s Office, it was found necessary to decentralize some of the work connected with the demobilization of the corps. Regulations were amended so that the discharge or relief of nurses from active service could be effected at the stations at which they were serving, and in the case of nurses returning from overseas, at ports of debarkation. 136
As members of the Army Nurse Corps are beneficiaries of the War Risk Insurance, on November 29, 1918, the Surgeon General informed all commanding officers of hospitals that members of the Army Nurse Corps ordered to their homes for discharge from active service must have physical examinations on Form 135-3, A. G. O., under provisions of War Department Circular 73, November 18, 1918. 137
The administrative organization of the Army Nurse Corps Section is given in Chart IV.
PERSONNEL.k
(April, 1917, to December, 1919.)
COMMISSIONED PERSONNEL SECTION.
Noble, Robert E., Maj. Gen., M. D., chief.
Miller, Reuben B., Col., M. C., chief.
Reynolds, Charles R., Col., M. C., chief.
Caldwell, B. W., Col., M. C.
Pipes, H. F., Col., M. C.
Bull, R. C., Lieut. Col., M. C.
Coulter, J. S., Lieut. Col., M. C.
Haggard, W. D., Lieut. Col., M. C.
Jones, Glenn I., Lieut. Col., M. C.
Mitchell, L. B., Lieut. Col., M. C.
Walsh, William II., Lieut. Col., M. C.
k In this list have been included the names of those who at one time or another were assigned to the division during the period, April 6, 1917, to December 31, 1919.
There are two primary groups--the heads of the division :and the assistarnts. In each group names have been arranged alphabetically by grades, irrespective of chronological sequence of service.
184
Ayars, C. W., Maj., S C.
Brown, Samuel A., Maj., M. C.
Denison, Walcott, Maj., M. C.
Dyer, Isadore, Maj., M. C.
Green, F. R., Maj., M. C.
Horn, J. E., Maj., S. C.
McLean, J. D., Maj., M. C.
Noyes, E. A., Maj., M. C.
Patterson, Paul, Maj., M. C.
Quickel, H. L., Maj., M. C.
Roby, A. A., Maj., S. C.
Rose, J. H., Maj., M. C.
Scull, James A., Maj., S. C.
Waite, F. C., Maj., S. C.
Albers, Albert H., Capt., S. C.
Cook, E. L., Capt., M. C.
Doyle, John F., Capt., S. C.
Hathaway, Joseph H., Capt., M. C.
Kelly, Maurice, Capt., S. C.
Miller, R. F., Capt., S. C.
Nugent, E. T., Capt., S. C.
Sands, John R., Capt., S. C.
Schutte, L. B., Capt., S. C.
Weever, George S., Capt., M. C.
Willis, E. A., Capt., M. C.
Beaver, C. E., First Lieut., M. C.
Bryans, Wm. W., First Lieut., S. C.
Bush, Archer C., First Lieut., M. C.
Kernan, W. H., First Lieut., S. C.
Malcolm, Robert, First Lieut., M. C.
Woody, McIver, First Lieut., M. C.
ENLISTED PERSONNEL SECTION.
Arnold H. D., , Lieut. Col., M. C., chief.
Coulter, J. S., Lieut. Col., M. C., chief.
Waiter, F. C., Maj., S. C.
ARMY NURSE CORPS.
Stimson, Julia C., superintendent.
Thompson, Dora E., superintendent.
Aubert, Lillian, assistant superintendent.
Bell, Bessie S., assistant superintendent.
Milliken, Sayres L., assistant superintendent.
Reid, Elizabeth D., assistant superintendent.
Rutley, Edith H., assistant superintendent.
Hardling, Elizabeth, chief nurse.
Mury, Edith .A., chief nurse.
185
Ames, May G.
Barnes, Harriet H.
Bates, Emily A.
Barkan, Olga E.
Burke, Maude D.
Catlin, Mildred D.
Chaplin, Leonora A.
Clendenning, Edith.
Curley, Teresa I.
Duffy, Alice E.
Du Paul, Mary E.
Fitzgerald, Teresa.
Gavin, Mary.
Haines, Sarah A.
Halloran, Sarah E.
Harris, Mathilda.
Kenny, Elizabeth J.
Kilfoil, Grace.
Lewis, Mary E.
McAdam, Katherine B.
McCarthy, Katherine.
McGlone, Charlotte E.
Milheim, Madolin E.
Milligan, Carolyn.
Morris, Lucy.
Pierson, Marietta H.
Prentiss, Alice M.
Ramer, Carolyn L.
Rulon, Blanche S.
ARMY SCHOOL OF NURSING.
Goodrich, Annie W., (lean.
Stimson, Julia C., dean.
Barnes, Harriet.
Burke, Maude.
Burgess, Elizabeth.
Howard, Evelyn.
Stewart, Ellen B.
REFERENCES.
(1) Bull. No. 10, W. D., June 22, 1916.
(2) Weekly reports, Personnel Division. On file, Record Room, S. G. O., Weekly Report File.
(3) G. O., No. 90, W. D., July 12,1917. 1
(4) Report of the Acting Chief of the Militia Bureau relative to the National Guard and the United States Guards, 1918, 12.
(5) Ibid., 1918, 14.
(6) Ibid., 1918, 21.
(7) Memo. from the Surgeon General to Senator Chamberlain, September 20, 1917. Subject: Preparation for War of the Medical Department of the Army. On file, Record Room, S. G. O., 321.6 (Medical Department).
(8) List of examining boards for the Medical Reserve Corps. On file, Record Room, S. G. O., 334.1 (Examining Boards).
(9) Circular, Form F, "Information Relating to Appointments in the Medical Reserve Corps, Section on Officers` Reserve Corps of the Army." On file, Record Room, S. G. O., 210.1-1 (Appointments). (Circular not dated).
(10) Circular letters, S. G. O.: (a) To the President of all Boards for the Examination of Applicants for the Medical Reserve Corps, April 23, 1917; (b) Form G, Instructions Governing the Examination of Applicants for the Medical Reserve Corps, May 2;, 1917; (c) General Information for the Examining Boards, September 1, 1917; (d) Instructions to Presidents of Examining Boards. On file, Record Room, S. G. O., 210.1-1.
(11) Manual for the Medical Department, 1916, par. 15; Bull. No. 9, W. D., February 2, 1917, P. S.
(12) Letter from The Adjutant General of the Army to the various staff corps, December 4, 1917. Subject: Citizenship of Applicants for Oflicers` Reserve Corps. On file, Record Room, S. G. O., 210.1-1 (Appointments).
186
(13) Memo, from the Chief of Staff, January 4, 1918. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(14) Second indorsement, Adjutant General`s Office to the Surgeon General of the Army. On file, Record Room, S. G. O., 201 (Amberg, Samuel). <>(15) First indorsement, War Department, S. G. O., May 8, 1918, to The Adjutant General of the Army. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(16) Third indorsement, War Department, A. (T. 0., May 20, 1918, to the Surgeon General. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(17) Letter from The Adjutant General to the Surgeon General. June 24, 1918. Subject: Commissioning of Applicants Born in Alien Enemy County or in a Country Allied Thereto. On file, Commissioned Personnel Division, S. G. O., 210.1-1 (Appointments).
(18) Letter from The Adjutant General of the Army to the Surgeon General, January 23, 1918. Subject: Appointments in National Army. On file, Commissioned Personnel Division, S. G. O., 210.1-1 (Appointments).
(19) Data (confidential): Letter, Adjutant General to Surgeon General, September 27, 1917. Subject: Naturalization of Aliens, Including Professionals. On file, Record Room, S. G. O., 210.1-1. W. D. Bull. No. 28, May 18, 1918.
(20) Letter from The Adjutant General of the Army to the Surgeon General, United States Army, May 7, 1918. Subject: Applications for Commissions in the Several Staff Corps. On file, Commissioned Personnel Division, S. G. O., 210. 1-1 (Appointments).
(21) G. O., No. 9, Headquarters of the Army, Adjutant General`s Office, Washington, February 6, 1901.
(22) G. O., No. 67, W. I)., May 2, 1908.
(23) Letter from the Surgeon General to Judge Advocate General, August 10, 1917. Subject: Female Physicians as Contract Surgeons in the United States Army; First indorsement Judge Advocate General to the Surgeon General, August 13, 1917. Copy on file, Historical Dlivision. S. G. O.
(24) Correspondence on uniform for contract surgeons and specifications for uniform for contract surgeons (female). On file, Ilistorical Division, S. G. O.
(25) G. O., No. 80, W. D., June 30, 1917.
(26) Weekly reports, Personnel Division, S. G.O. On file, Record Room, S. G. O., Weekly Report File.
(27) G. O., No. 75, W. D., June 23, 1917.
(28) G. O., No. 75,W. D., June 23,1917, as amended by G. O., No. 124, W. D., September 20, 1917.
(29) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1111.
(30) Bull. No. 43, W. D., July 22, 1918.
(31) Letter from the Surgeon General to Director General of Military Relief American Red Cross, Washington, D. C., July 28, 1917. Subject: Commissions for Personnel of Base Hospitals, Hospital Units, and Ambulance Companies. On file, Record Room, S. G. O., 197052 (Old Files).
(32) Correspondence on Advisory Board. On file, Record Room, S. G. O., 135096, 143365 and 156772 (Old Files).
(33) Memo. from the Secretary of war to the Surgeon General, United States Army. October 16, 1917. Subject: Return of Applications. First indorsement, A. G. O., to the Surgeon General, October 19, 1917. Subject: Discontinuance of Commissions. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(34) Memo. from executive assistant to Chief of Staff to The Adjutant General. August 14, 1918. Subject: Suspension of Consideration of Appointments of Applicants for Commission from Civil Life. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(35) Letter from The Adjutant General to the Surgeon General. September 16, 1918. Subject: Applications for Appointment from Civil Life. On file, Record Room, S. G. O., 210.1-1 (Appointments).
(36) Second indorsement, Adjutant General of the Army, to the Surgeon General of the Army, September 27, 1918. On file, Record Room, S. G. O., 210.14 (Commissions).
(37) Statistical Report, Week of November 16, 1918. On file, Record Ro-om, S. G. O., Weekly Report File.
187
(38) Letter from the Surgeon General to individual medical officers, dated when sent. Subject: Promotions. on file, Record Room, S. G. O., 210-2 (Promotions).
(39) Consolidated rables of Organization. On file, Commissioned Personnel Division, S. G. 0., :320.3-1.
(40) Act of April 3, 1908 (35 Stats. 66); Bull. 16, War Department, June 22, 1916, sec. 10.
(41) Cablegram No. 1780, par. 1, October 11, 1918. On file, Record Room, S. G. O., Cablegram File.
(42) Cablegram No. 2147, par. 3, November 5, 1918. On file, Record Room, S. G. O., Cable gram File.
(43) Telegram from The Adjutant General to commanding generals of all territorial departments, replacements, central officers` training schools, camp headquarters, depot brigades, ports of embarkation, and to commanding officers of all other units of independent commands within the limits of the United States, the commanding general Philippine Department, and commanding general Panama Canal Department, November 15, 1918. Subject, Suspension of Recommendations of Emergency Promotions and Appointments. On file: Miscellaneous Section, Mail and Record Division, A. G. O., 210.2.
(44) Cir. No. 79, W. D., February 14, 1919. On file, Record Poom, S. G. 0.
(45) Correspondence on promotions. On file, Record Room, S. G. O.. 210.2-1 (Promotions).
(46) Based on figures in Weekly Statistical Report, November 16, 1918. Commissioned Personnel Division, S. G. 0. On file, Record Room, S. G. O., Weekly Report File.
(47) Special Statistical Report No. 131, April 7, 1919. Subject: Rank Regular Army Officers for the Emergency. On file, Statistical Division, General Staff, Report File.
(48) G. O., 168, Section III, December 29, 1917.
(49) Memo. for The Adjutant General from Chief of Staff, December 2, 1918. On file, Record Room, S. G. O., 210.-2 (Promotions).
(50) Bull. No. 16, W. D., June 22, 1916.
(51) Copies of commissions for following officers: Charles Richard, Henry P. Birmingham, Rudolph G. Ebert, and Alfred E. Bradley. On file, Record Room. S. G. O.. 201 (Name of Officer).
(52) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1114.
(53) Bull. No. 43, W. D., July 22, 1918.
(54) Cir. No. 75, par. 2, W. D., November 20, 1918.
(55) Cir. No. 124, W. D., December 7, 1918.
(56) G. O., No. 73, W. D., August 7, 1918.
(57) Memo. from the Chief of Staff to the Surgeon General, November 25, 1918. Subject: Discharge of Officers of the Medical Corps and Reserve Commissions for Same. On file, Record Room, Office of Chief of Staff, 968 F (Medical Reserve Corps).
(58) Second indorsement, Office of Provost Marshal General to Adjutant General, June 4, 117; and third indorsement, W. D., A. G. O., to Surgeon General, July 13, 1917. On file, Record Room, S. G. O., 175344 (Old Files).
(59) Letter from the Surgeon General of the Army, to Provost Marshal General, United States Army, August 23, 1917. Subject: Medical Students. On file, Record Room, S. G. O., 1753144 (Old Files).
(60) Orders, W. D., S. G. O., September 4, 1917. On file, Personnel Division, Enlisted Section, S. G. O.
(61) Bull. No. 61, W. D., Section V, October 23, 1917.
(62) New Selective-Service Regulations, effective November 8, 1917. On file, law Library, Office of the Judge Advocate General.
(63) Regulations Governing Voluntary Enlistments in the Enlisted Reserve Corps of the Medical Department of Registrants Who Are Medical Students, Hospital Internes, Dentists, Dental Students, Veterinarians, or Veterinary Students, December 15, 1917. (Issued by the <>Surgeon General.) On file, Enlisted Section, Personnel Division, S. G. O.
(64) Letter from the American Institute of Dental Teachers to the Surgeon General, January 31, 1918. Subject: Classification of Dental Schools. On file, Enlisted Section, Personnel Division, S. G. O.
(65) Letter from the Surgeon Gcneral to Henry L.Banzhof, secretary treasury, the Dental Educational Council of America. Mlarch 2, 1918. Subject: Dental Schools. On file, Record Room, S. G. O., 080 (Dental Educational Council of America) (T).
188
(66) Memo. from the Surgeon General to the assistant and chief clerk, War Department, October 15, 1918. Subject: Cincinnati College of Dentistry and Position of the Surgcon Gencral in Reference to Dental Schools. On file, Record Room, S. G. O., 080 (College of Dental Surgery, Cincinnati, Ohio) (W).
(67) Regulations Governing Entrance to the Veterinary-Inspector Examination effective on and after March 1, 1917, published by Department of Agriculture (Contribution f-rom the Bureau of Animal Industry). Copy on file, Personnel Division, Bureau of Animal industry, Department of Agriculture.
(68) List of “ well-recognized " veterinary schools. On file, Enlisted Section, Personnel Division, S. G. O.
(69) Notice regarding minimum entrance requirements of veterinary schools, issued by the Surgeon General, April 17, 1918. On file, Enlisted Section, Personnel Division, S. G. O.
(70) Memo. from the Surgeon General to the deans of " well-recognized " medical schools, May 24, 1918. Subject: Students to be Enlisted in Medical Enlisted Reserve Corps. On file,
Enlisted Section, Personnel Division, S. G. O.
(71) Memo. issued by the Surgeon General, December 7, 1918. Subject: Enlistment of Medical,Dental, and Veterinary Student sin the Medical Enlisted Reserve Corps. On file, Enlisted Section, Personnel Division, S. G. O.
(72) Memo. issued by the Surgeon General, May 4, 1918. Subject: Revocation of Authority Granted by Memo. from this Office, December 7, 1917. On file, Enlisted Section, Personnel Division, S. G. O.
(73) Telegram from The Adjutant General, United States Army, to all department commanders, superintendent of Military Academy, disciplinary barracks, recruit depots, and recruiting officers at all main recruiting stations, August 8, 1918. "Discontinue immediately all volunteer enlistments and acceptance of men who have not yet attuined their forty-sixth birthday." On file, Record Room, S. G. O., 432 (Enlistments). Telegram from the Surgeon General, United States Army, August 28, 1918, to S. Shusheim, New York, N. Y.: " Medical Enlisted Reserve Corps now closed on account discontinuation of enlistments." On file, Record Room, S. G. O., 342.1 (Medical Enlisted Reserve Corps).
(74) Letter from the Surgeon General to the dean (name of school), March 1, 1918. Subject: Students. On file, Enlisted Section, Personnel Division, S. G. O. Report of the Section on Medical Education, Personnel Division, S. G. O. On file, Enlisted Section, Personnel Division, S. G. O.
(75) S. O., No. 264, par. 155, W. D., November 12, 1917.
(76) G. 0., No. 15, W. D., February 10, 1918.
(77) G. O., No. 79, Par. II, W. D., August 24, 1918.
(78) Memo. from Lieut. Col. 11. D. Arnold, M. C., to Col. R. B. Miller, M. C., Officer in Charge Personnel Division, S. G. O., October 5, 1918. Subject: Transfer of Medical Enlisted Reserve Corps to Students` Army Training Corps. On file, Record Room, S. G. O.,
327.3 (Medical Students).
(79) Telegram from The Adjutant General to commanding general, Northeastern Department, November 9, 1918. Subject: Transfer of Members of Medical Enlisted Reserve Corps to Students` Army Training Corps. Similar telegram to commanding generals of all territorial departments. On file, Miscellaneous Section, Mail and Record Division, A. G. O., 000.862 (Students` Army Training Corps).
(80) Third indorsement, W. D., S. G. O., to the Surgeon General of the Public Health Service, December 7, 1918. Subject: Educational Control of Medical Enlisted Reserve Corps. On file, Record Room, S. G. O., 342.1 (Medical Enlisted Reserve Corps).
(81) Letter from The Adjutant General to the commanding general, Northeastern Department, December 11, 1918. Subject: Discharge of Members of the Enlisted Reserve Corps on Inactive l.ist. Similar letter was sent to all department commanders. On file, Enlisted Section, Personnel Division, S. G. O.
(82) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1111.
(83) Bull. No. 16, W. D., June 22, 1916.
(84) Letter from the Surgeon General of the Army to The Adjutant General of the Army, May 21, 1917. Subject: Increase of the Enlisted Personnel, Medical Department. First indcrsement thereon, Adjutant General`s Office, June 15, 1917. On file, Record Room, S. G. O., 1287:12-T (Old Files).
189
(85) Annual Report of the Surgeon General, United States Army, 1918, 387, Table 160.
(86) Annual Report of the Acting C(hief of the Militia Bureau relative to the National Guard and the United States Guards, 1918, 21.
(87) Bull. No. 32, W. D., May 24, 1917.
(88) G. O., No. 75, W. D., June 23, 1917.
(89) G. O., No. 124, W. D., September 30, 1917.
(90) G. O., No. 80, W. 1)., June 30, 1917.
(91) G. O., No. 102, W. D., August 4, 1917.
(92) G. O., No. 130, W. D., October 4, 1917.
(93) G. O., No. 161, W. D., December 22, 1917.
(94) G. O., No. 58, W. D., June 22, 1918.
(95) Table compiled from classification of draft, based on "Trade specifications and occupational index." On file, Enlisted Section Personnel Division, Miscellaneous File (not numbered).
(96) Circular letter from the Surgeon General to all division surgeons, October 3, 1917. Subject: Training of Sanitary Personnel of Division. On file, Record Room, S. G. O., Document File.
(97) Circular letter from the Surgeon General to commanding officer of all hospitals, October 15, 1917. Subject: Personnel. On file, Record Room, S. G. O., Document File.
(98) Annual Report of the Surgeon General, United States Army, 1918, 408.(99) Ibid., 409.
(100) Manual for the Medical Department, 1916, par. 41 (Changes, Manual for the Medical Department, 103, September 29, 1917) and par. 50.
101) A. R. 1409, 1913 (Changes Army Regulations No. 46).
(102) Annual Report of the Surgeon General, United States Army, 1918, 393.
(103) Bull. No. 32, W. D., May 24, 1917.
(104) A Message from the Surgeon General of the Army to the enlisted men of the Medical Department, February 11, 1918. Subject: Necessity of Retention of Personnel in the Service. On file, Record Room, S. G. O., 321.6-1 (Medical Department).
(105) 31 Stats., 753.
(106) Weekly reports, Numerical Status of Army Nurse Corps. On file. Army Nurse Corps Section, Personnel Division, S. G. O.
(107) Weekly report, Army Nurse Corps, Nurses on Duty, November 15, 1918. On file, Record Room, S. G. O., Weekly Report File.
(108) Manual for the Medical Department, 1916, par. 102, and 536.
(109) Letter from the Acting Surgeon General, United States Army, to the general manager, American Red Cross, Washington, D. C., October 17, 1918. Subject: Equipment for Nurses` Aides. On file, Record Room, S. G. O., 231. (Reconstruction Aides).
(110) Memo. from the Surgeon General, United States Army, to the Secretary of War, May 24, 1918. Subject: Approval of Plan for Army School of Nursing; and indorsement of Secretary of War, May 25, 1918, which is approval thereof. On file, Record Room, S. G. O., 352.4 (Army School of Nursing).
(111) Letter from the Surgeon General, United States Army, to the Secretary of War, March 4, 1918. Subject: Establishment of Dispensary and Emergency Station; and indorsement of Secretary of War, March 6, 1918. On file, Record Room, S. (G. O., 632, Washington, D. C. (F).
(112) Letter from the Acting Surgeon General, United States Army, to the commanding officer, United States Army General Hospital, San Francisco, Calif., October 3, 1918. Subject: Reports of Instruction in Anesthesia. On file, Record Room, S. G. O., 730. (Anesthesia, General.) Letter from Maj. E. S. Judd, AI. C., to Maj. R. P. Sullivan, M. C., March 22, 1918. Subject: Course in Administration of Anesthetics. On file, Record Room, S. G. O., 353. (Rochester, Minn.) (F).
(113) Letter from chief nurse, Walter Reed General Hospital, Takorna Park, 1). C., to the commanding officer, Walter Reed General Hospital, April 4, 1917. Second indorsement, from the Surgeon General, United States Army, to the commanding officer, Walter Reed General Hospital, April 9, 1917. On file, Record Room, S. G. O., 167608 (OId Files).
(114) Inspection reports of dietary department of Army hospitals. On file, Army Nurse Corps Section, Personnel Division, S. G.O.
190
(115) Letter from Assistant Secretary of Labor to the Secretary of War, June 12, 1917. Subject: Arrangements for Housing Nurses at Ellis Island. On file, Record Room, S. G. O., 181333E (Old Files).
(116) Letter from the surgeon, port of embarkation, lioboken, N. J., to superintendent, Army Nurse Corps, December 20, 1917. Subject: Nurses` Station at 120 Madison Avenue, New York City. On file, Record Room, S. G. O., 211 (Nurses, N ew York City) (F).
(117) Letter from the Surgeon General, United States Army, to The Adjutant General, April 2, 1918. Subject: Mobilization Stations, Army Nurse Corps; third indorsement, War Department, Adjutant General`s Office, to the commanding general, Eastern Depart ment, Governors Island, N. Y., April 10, 1918. On file, Record Room, S.G. O., 322.3 (Army Nurse Corps).
(118) Letter from the Surgeon General, United States Army, to The Adjutant General, April 2, 1918, par. 3. Subject: Mobilization Stations, Army Nurse Corps; eighth indorsement, from office of the surgeon, port of embarkation, Iloboken, N. J., May 10, 1918. On file, Record Room, S. G. O., 322.3 (Army Nurse Corps).
(119) First indorsement, A. G. O., to the Surgeon General, United States Army. Subject: Certificates. On file, Record Room, S. G. O., 344 (Certificates).
(120) Letter from the Surgeon General to The Adjutant General, dated June 15, 1917. Subject: Reserve Nurses for Duty with British Forces. On file, Record Room, S. G. O., 182822 (Old Files).
(121) Base Hospitals Sent to France Early in 1917: List of Sailings. On file, Army Nurse Corps, S. G. O.
(122) A. R. 726, as amended by Changes No. 87, April 3, 1919.
(123) First indorsement, A. G. O., to the Surgeon General of the Army, July 2, 1917. Subject: Organization of Base Hospitals Through the Red Cross. On file, Record Room, S. G. O., 322.37 (Misc.).
(124) Correspondence on base hospitals. On file, Record Room, S. G. O., 172158 (Old Files).
(125) Correspondence on American Red Cross military hospitals, Nos. 1, 2, and 3. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(126) Cablegram No. 197, par. 3, October 4, 1917, from General Pershing. On file, Record Room, S. G. O., Cablegram File. Cablegram to General Pershing, October 6, 1917. Subject: Assignment of Nurses. On file, Record Room, S. G. O., Cablegram File.
(127) Letter from the Surgeon General to The Adjutant General, May 23, 1918. Subject: Nurses to be Sent to Porto Rico. On file, Record Room, S. G. O., 211 (Nurses, San Juan, P. R.).
(128) Letter from Acting Surgeon General to Operations Division, General Staff, October 2, 1918. Subject: Nurses for Siberia. On file, Record Room, S. G. O., Cablegram File (M. of T. 10/2/18).
(129) Weekly report Army Nurse Corps, June 20, 1919. On file, Record Room, S. G. O., Weekly Report File (Army Nurse Corps).
(130) Weekly report Army Nurse Corps, nurses on duty November 15, 1918. On file, Record Room, S. G. O., Weekly Report File (Army Nurse Corps).
(131) Letter from The Adjutant General to the Surgeon General, United States Army, November 26, 1918. Subject: Shipping Schedule No. 11, November, 1918 (M-1210, X-650, Nurses, Medical Department). On file, Mail and Record Division A. G. O., 370.5 (Miscellaneous Division).
(132) Weekly report Army Nurse Corps, nurses on duty, June 27, 1918. On file, Record Room, S. G. O., Weekly Report File.
(133) Compiled from card record of discharged nurses. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(134) Third indorsement, A. G. O., to Surgeon General, United States Army, December 23, 1918. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(135) Letter from the Surgeon General, United States Army, to the surgeon, port of embarkation, Hoboken, N. J., January 4, 1919. Subject: Discharge of Nurses Returning from Overseas. On file, Army Nurse Corps Section, Personnel Division, S. G. O.
(136) Circular Letter, No. 186, W. D., S. G. O., April 25, 1919.
(137) Memo. from the Surgeon General, United States Army, to department surgeons, surgeons, ports of embarkation; surgeons, independent posts and stations; commanding officers, base and general hospitals, November 29, 1918. Subject: Physical Examination of Army Nurses Preceding Separation from the Service. On file, Record Room, S.G.O., 211 (Nurses).
