SECTION II.

CHAPTER VII.

FINANCE ANDSUPPLY DIVISION.

PRE-WAR ORGANIZATION OF DIVISION.

A Supply Division was one of the old divisions of the Surgeon General`s Office. ¹ As its name implies, this division was concerned with supply; the finances of the Medical Department, however, likewise were in its charge. This supply organization, as will be seen, was not exactly the same its that which existed during the greater part of the World War.

Formerly, a supply officer, under the Surgeon General and stationed in his office, had direct charge of medical supplies and disbursements, while the administrative audit of voucher sand the examination of property returns were carried out in sections of the Record, Correspondence and Examining Division, which subsequently became the Administrative Division (q. v.) 2 These sections, while not a part of the Supply Division, we res upervised, in large measure, by the supply officer, who, for the proper conduct of his own division, was compelled to keep informed on what was being done in these directions.

The organization of the supply service in the Surgeon General`s Office, then, when we entered the World War was as follows:

It was centralized under one officer, who was also a disbursing officer and who had general charge of the administrative examination of accounts. There was a Supply Section (in the Supply Division) which handled all matters pertaining to requisitions; ¹a Property Return Examination Section (in the Record, Correspondence and Examining Division), where the disbursing accounts of the several officers concerned were examined and, when correct, transmitted to the accounting officers of the Treasury for settlement; ²and a Finance Section (in the Supply Division), where vouchers for supplies obtained and for services performed (for the most part laundry) at places other than supply depots were scrutinized and corrected, if need be, and either paid by the disbursing officer of the Surgeon General`s Office or sent for payment to a disbursing officer at an adjacent supply depot, ²

WAR CHANGES IN ORGANIZATION OF DIVISION.

On September 20, 1917, the Property Return and the Audit Sections of the Record, Correspondence and Examining Division, and the Supply and Finance Sections of the Supply Division were consolidated into a single, organization known as the Finance and Supply Division. ² Thereafter, throughout the war period, all supply and finance matters were handled within this new division. (See Chart VII.)

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ChartVII.--Division of Finance and Supply, Surgeon General`s Office, June,1918.

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PRE-WAR DEVELOPMENT OF SUPPLY SYSTEM.

At the outbreak of the Spanish-American War the Medical Department had a most meager equipment. The Dodge Commission, the committee of inquiry appointed after that war, recommended that the Medical Department keep on hand not only an initial equipment of all medicines, hospital furniture, and stores which would not be materially damaged by long storage for the Army in being, but a year`s maintenance for an army four times the actual strength. Little progress along this line was made until 1908, when an appropriation of$200,000 for the purchase of field supplies gave the necessary impetus to the work, which was carried on by money saved from the annual Medical Department appropriations during the succeeding years.

Unit supply system.-The principle of unit equipment was adopted after mature study. All articles required to complete the equipment of medical units, whether medical, quartermaster, or ordnance, were assembled and packed into suitable containers, and the packers` list and invoices prepared so that the complete equipment for an entire unit, excepting only the personal clothing of enlisted men and officers, could be shipped on the receipt by the depot of telegraphic instructions so to do. The only shortages in unit equipments were certain perishable supplies and transportation, such as wagons, ambulances, harness, and animals. While it was not possible to secure sufficient funds to provide a reserve for four times the size of the Army as recommended, actually supplies for a little less than three times the size of the Army were provided. In developing its unit supply system, the Medical Department began with a consideration of a recruit at the time he was called to the colors, at the recruiting station and the mobilization point, and carried the plan on through the training period, actual combat, evacuation, hospitalization, convalescent camps, and ultimate discharge from the service, and for each step provided a definite unit equipment. These units consisted of (1) emergency recruiting outfit, for the initial examination; (2) camp hospital equipment for emergency treatment immediately upon concentration; (3) base hospital equipment for the definitive treatment of the more serious cases in camps and cantonments and for the wounded after combat; (4)regimental combat equipment;(5) camp infirmary and camp infirmary reserve equipment; (6) ambulance company equipment;(7) field hospital equipment; (8) evacuation hospital equipment.

Mexican border mobilization.-The mobilization of the provisional division at San Antonio, Tex., in March, 1911, gave the Medical Department its first opportunity to try out its system of unit equipment. In response to a single telegram of a few words from the Surgeon General in Washington to the officer in charge of the medical supply depot at St. Louis, sufficient medical supplies for the entire division were loaded on cars and were actually in the yards at San Antonio before the arrival of the troops which constituted that division; not only that, but an officer was there to arrange these supplies and distribute them to the troops as required. Thereafter, a reserve of supplies was kept on the Mexican border.

As already noted, it was not planned to keep on hand perishable articles in the units, but to direct their purchase on the outbreak of war so that the units might be completed in every particular save transportation; this was done

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for the Mexican border mobilization. Judging from experience in simulated hostilities before the war, it was believed this plan would work well in time of war, and this actually proved to be the case.

The mobilization of the troops on the Mexican border in March, 1916, maybe regarded, so far as the supply service was concerned, as the beginning of the entrance of the United States into the World War. The border mobilization merged into that for the World War, and the experience gained in the handling, procuring, assembling, and distributing of supplies, and the outfitting of these troops, proved of inestimable value to the Supply Division. The unexpected mobilization and transportation of the National Guard, and the distribution of and maintenance therefor, of equipment served as a test of the organization of the supply service and as an actual school of training for officers in supply duties. Before demobilization from the border had become an accomplished fact, the call had been issued for the larger mobilization for operations overseas. Large stocks of supplies had been accumulated on the Mexican border, and these were now used in developing hospital facilities to supply the expedition into Mexico. In April, 1916, a local depot had been established at El Paso. Another depot was soon established at San Antonio to provide for troops in the eastern end of Texas. Base and evacuation hospitals which had been stored at El Paso and at San Antonio were promptly shipped overseas. One base and four evacuation hospitals actually reached Jersey City in time to accompany the first expedition to France.

Council of National Defense.-The Council of National Defense was authorized by the national defense act, approved August 29, 1916, which act also provided that this council, made up of the secretaries of several of the Government departments, should have an advisory commission consisting of not more than seven persons having special knowledge of some industry, public utility, the development of some natural resource, or being otherwise specially qualified, in the opinion of the council, for the performance of the duties required in the bill providing for such an advisory body. A physician who was ep- pointed on this advisory council organized a special board on medical matters. The passage of this act also resulted in the formation of committees and associations for preparedness in all lines of activity, professional as well as commercial. The various branches of the medical profession --physicians, surgeons, specialists, dentists, veterinarians, and medical schools and colleges- formed such associations. The manufacturers of pharmaceuticals and surgical dressings, surgical instruments, and hospital furniture and equipment likewise formed their committees on preparedness and went to work with promptness and vigor. On January 9, 1917, the Surgeon General of the Army formally recommended to the Secretary of War that a board be appointed for the standardization of all equipment and supplies used by the Medical Department in time of war.³ The Secretary of War, as chairman of the Council of National Defense, asked for nominations from the Secretary of the Navy and the Secretary of the Treasury (United States Public Health Service) for membership on the proposed Committee on Standardization of Medical and Surgical Supplies. The committee was appointed on February 7, 1917. ⁴ An important meeting was held on April 7 and 8, 1917, with the supply officers of the various Government medical services. At this meeting were present representatives

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of most of the medical and surgical supply firms of importance in the country as well as medical representatives of the Council of National Defense. Government standards were discussed with the representatives, and arrangements were made to conform, as far as possible, to trade standards and packages. The officer in charge of the Supply Division of the Surgeon General`s Office was a member of this committee. The Committee on Standardization of Medical and Hospital Supplies completed its work early in 1917, and a catalogue, consisting of four sections, setting forth the articles which it had been agreed would represent the standard supply table, was published by the Council of National Defense in May of that year.⁵The instruments selected by aboard of very eminent surgeons were listed, illustrated, and catalogued and issued in May,1917,as the "List of Staple Medical and Surgical Supplies, Part 1." ⁶This list was revised and republished in December, 1917.

The various committees organized in the early part of 1917 as adjuncts of the Council of National Defense for the assistance of the purchasing departments of the Government were dissolved as parts of that council in the latter part of the same year under the provisions of section 3 of the Lever law act of August 10,1917, prohibiting members of firms doing business with the Government from acting in an advisory or executive capacity to the Government. Many of the committees were regrouped into war service committees and rendered the same efficient service as they did when a part of the Council of National Defense.

The Committee on Dentistry, consisting of seven members, was formed early.⁷Theirwork was organized into five sections. One of these sections, that on dental supplies, was charged with the mobilization of all the resources of manufacturers who produced dental instruments and supplies, with the revision of the standard dental supply table, and with the coordination and cooperation of the dental supply industry. This committee submitted a revision of the dental supply table which was adopted and used as the basis for the purchase of the supplies required during the war. ⁸A meeting of the manufacturers of dental supplies, called by the medical section of the Council of National Defense for April 11,1917, was attended by representatives of practically all the large manufacturers of dental supplies. Through subsequent action as a result of the meeting in question the dental supply industry was mobilized.

As it proved, there was a great shortage in dental supplies, so newly appointed dental officers were notified that if they brought their personal supplies with them they would be purchased by the Government. ⁹ A list was also prepared showing just what would be so purchased.

CHANGES IN SUPPLY SYSTEMS.

During the war period, as always had been the case, control over medical supply was closely centralized in the Surgeon General`s Office, where all matters of policy and all instructions relative to purchases were determined. The actual purchase and distribution of supplies were carried on at certain supply depots by direction of this office.

Very detailed plans, to be put into operation in the event of war, had been made by the Medical Department on March 9, 1914. ¹⁰ These plans had been approved by the General Staff, and were still applicable, in principle, when the

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World War came, though the magnitude of the conflict was so far beyond anything expected in1914 that the earlier plans were necessarily greatly amplified. It is proposed to give here, in brief outline, the wartime developments in the supply system and in the management of Medical Department finances. Full details concerning these important matters as applicable in the home territory and overseas will be found in the volume on Finance and Supply.

Supplies furnished by the Medical Department.-The Medical Department, in addition to its other duties, during the World War and for many years prior thereto, was one of the important supply departments of the Army." It should be realized, however, that it was only one of several such departments, from each of which certain supplies were obtained. ^aThe Medical Department, through the Division of Finance and Supply, furnished all medicines, antiseptics, and disinfectants, all surgical instruments and appliances, all articles of hospital equipment, laboratory supplies, dental supplies, X-ray supplies, veterinary supplies, and its own stationery, blank books and blank forms. It also supplied certain medical articles of equipment for medical officers and men, and the greater part of the equipment of field medical units. Early in the war the development and production of gas masks and of other articles relating to gas warfare was made a function of the Medical Department. (See Division of Gas Defense, p. 504.) Later this was turned over to a newly created organization, the Chemical Warfare Service.

Supply depots.-At the beginning of the war the Medical Department had in operation, medical supply depots at New York, Washington, St. Louis, San Antonio, El Paso, and San Francisco. ¹² Taken together, these depots had two functions-the procurement of supplies and their storage and issue. Medical supply officers were generally disbursing officers for Medical Department funds. The New York depot was the main depot for the purchase of all Medical Department supplies, except field supplies, which, exclusive of hypodermic tablets, were handled by the Washington depot. St. Louis was of secondary importance to New York in the purchase of medical supplies. All the depots except Washington distributed all classes of supplies. Washington distributed only field supplies. San Antonio and El Paso were issue depots for the troops on the Mexican border.

Procurement of supplies.-Supplies, in the main, were purchased from the trade by the medical supply depots. Biologicals, so called, were prepared by the laboratory of the Army Medical School, and a few articles were manufactured from time to time in the depots. The making of purchases other than at supply depots was discouraged, except with reference to diphtheria antitoxin, ¹³but could be made, in emergency, by senior medical officers of commands. ¹⁴

In determining the semiannual purchases, the three main distributing depots (New York, St. Louis, and San Francisco) were required to submit estimates of the quantities of the different articles which it was anticipated would be needed for issue during the next ensuing half-year period. When these estimates were received in the Surgeon General`s Office, they were consoli-dated and the items and quantities of each to be purchased were determined. The lists were then sent to the New York depot, where circulars inviting bids

^aFor supplies furnished by other departments, see Relationship of Medical Department within the War Department,p. 106; also, Plate III.

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were printed. Most of these circulars were used in New York, but some were sent to St. Louis. The final awards were made in the Surgeon General`s Office, and the depot officer concerned was then informed of these awards and was directed to place contracts with the successful bidders. Contracts were always made when the amount of the bid exceeded$500 and sometimes for lesser amounts, at the discretion of the Surgeon General`s Office. The contracts, after they had been signed and compared, were also sent for approval to the Supply Division of the Surgeon General`s Office. The greatest care was taken, by critical inspection sat the depots, to make sure that all drugs, instruments, and other articles were up to standard.

The plan, so far as field supplies were concerned, was to have them complete for each Medical Department unit concerned. This had been effected by the cooperation of the Quartermaster and Ordnance Departments, which supplied a number of articles pertaining to such units. All the larger units were stored at the medical supply depots, but some of the smaller ones (regimental infirmaries) were also to be found at certain designated posts.

This applies, of course, to units which were in storage, but it should be understood that before the World War units like certain of those in storage were in actual use by both Regular Army and National Guard. It should be kept in mind that these units constituted a war preparation equally with those in storage.

Distribution of supplies.-Issues from the depots were made on requisition from medical officers in command of hospitals or from post surgeons. These requisitions were forwarded to the department surgeon concerned ^b who sent those for the standard annual allowance of supplies directly to the medical supply depot designated by the Surgeon General for issue, forwarding a copy to the Surgeon General. Special requisitions-that is, requisitions for quantities larger than allowed by the supply table, or for articles not on that table-were forwarded to the Surgeon General by the department surgeon after modification, if deemed necessary, before issues were made from a supply depot. Emergency purchases, as indicated above, ¹⁴under special circumstances, could also be made by the surgeons at hospitals. Smallpox vaccine was asked for by letter to the department surgeon; typhoid vaccine, which by this time had become the triple vaccine, was also asked for by letter to the department surgeon, by whom the letter was forwarded to the Surgeon General, who, in turn, directed the issue from the laboratory of the Army Medical School. Other vaccines were furnished from the Army Medical School on special request. ¹³

Disbursements and accounting.-Payments for medical supplies were made by the depot supply officer concerned when delivery had been actually accomplished.15 Thus a great part of the disbursements of the Medical Department were made locally rather than in the Surgeon General`s Office. With the war, however, especially just at its beginning, when National Guard troops were put on guard duty in small detachments, often where military medical attendance or supplies could not be procured, the number of vouchers for medicines and medical attendance greatly increased. As these were all sent

^bCommanding officers of general hospitals and surgeons of commands directly under control of the War Department forwarded requisitions directly to the Surgeon General, who acted upon them in a manner similar to that described for the department surgeon.

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to the Surgeon General`s Office, the disbursements there were many times multiplied. For obvious reasons this state of affairs continued to a considerable extent throughout the war. That is to say, as compared with peace times, war conditions resulted in far more disbursements of this character by the Surgeon General`s Office.

The accounts of all disbursing officers were audited in the Surgeon General`s Office.` Equal responsibility was enforced with supplies and each medical officer accountable for them prepared returns; ¹⁷ these were checked in the Surgeon General`s Office with the invoices and receipts, which were always exchanged, copies being sent to the Surgeon General`s Office when there was a transfer of property from one officer to another. ¹⁷

Changes caused by war.-On the declaration of war the Medical Department was confronted with the task of furnishing supplies and equipment vastly in excess of its requirements in time of peace. The stock of supplies on hand at the beginning of the war was sufficient to meet the needs of an Army of approximately 300,000.¹⁸Estimates had to be prepared, purchases authorized, a distribution system devised, additional warehouses secured, new depots established, and a force of sufficient magnitude to handle the situation secured. While the expansion was enormous, it was not found necessary, during the war, to change the system in its essential details. A very drastic change which was made just after the armistice will be referred to later. The modifications found necessary so long as medical supplies were under the jurisdiction of the Medical Department, or until November 15, 1918,were mainly in a way of increased elasticity. This was notably true in respect to permitting local purchases 19 and the approval of vouchers for medical attendance when military facilities were not available. ²⁰ This was an important change, especially in view of the fact that lack of elasticity in these particulars operated disastrously in the Spanish-American War.

In the nature of things there could be no decentralization in purchasing at home; on account of the threatened shortage, due to the enormous demands of the Army as a whole and to other war demands, a central agency (in this case a section of the Finance and Supply Division of the Surgeon General`s Office) had to keep in close touch with the agencies coordinating all purchases throughout the country. The question of the purchase of medical supplies abroad does not enter into the present discussion; it should be noted, however, that the Finance and Supply Division of the Surgeon General`s Office heartily supported the methods pursued in this matter by the chief surgeon, American Expeditionary Forces.

Veterinary supplies presented a peculiar problem. Formerly they had been furnished by the Quartermaster Department, of which the veterinarians were then apart. ²¹ The Veterinary Corps was created a part of the Medical Department by the act of June3, 1916. ²² Funds did not become available to that department for the purchase of veterinary supplies until June 15, 1917.²³ To bridge over the interval, on request of the Surgeon General, June 12, 1917, the Quartermaster General approved the transfer of veterinary supplies which he had on hand to medical supply depots, and this was effected. ²⁴ Early in1917 the preparation of a veterinary supply table had been begun and this work was continued and finally completed in the autumn of the same

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year. ²⁵Standardization of veterinary instruments was also accomplished. ²⁵A list of the medicines contemplated for this purpose was furnished the Committee on Pharmacy of the Council of National Defense on April 19, 1917.It was decided to utilize St. Louis as the procurement depot for veterinary supplies. ²⁶ The officer in charge was notified of this decision April 21, 1917, and informed that a veterinary officer would be assigned as an assistant. Delay in securing standard samples of instruments caused delay in purchases. Veterinary officers coming into the service were therefore requested to bring their personal instruments with them for purchase by the Government. No great amounts were purchased under this plan, however, but old types were utilized and no very serious inconvenience resulted.

WAR PERSONNEL.

At the declaration of the war the personnel of the Supply Division was asfollows:²⁷

Officers on duty in...................................................................................................1

Civilian personnel. Supply Section...........................................................................8

Civilian personnel. Disbursing Section.....................................................................3

Total......................................................................................................................12

On November 11, 1918 the officers assigned to the division were as follows: ²⁷

In general charge and in charge of purchases..........................................................1

In charge of distribution...........................................................................................1

In charge of dental requisitions................................................................................1

In charge of veterinary requisitions..........................................................................1

Motor ambulances^c...................................................................................................1

Hospital requisitions.................................................................................................1

Assistant, dental requisitions ...................................................................................1

Assistant, veterinary requisitions..............................................................................1

Assistant, hospital requisitions...................................................................................1

Assistant, hospital requisitions..................................................................................1

Assistant, distribution and finances............................................................................1

Transportation.........................................................................................................1

Assistant, transportation...........................................................................................1

Disbursements...........................................................................................................1

Assistant,disbursements ..........................................................................................1

Statistics......................................................................................................................1

Assistant, statistics....................................................................................1

Assistant,statistics...........................................................................1

Assistant,statistics and stock record...........................................................................1

Assistant,distribution.........................................................................1

Requirements................................................................................................................1

Production.....................................................................................................................1

Assistant,motor ambulances...................................................................................1

General..........................................................................................................................1

Personnel.......................................................................................................................1

Assistant,personnel....................................................................................1

Overseas shipment.......................................................................................1

Assistant finances.........................................................................................1

Total.........................................................................................................................28

^eAttached to Motor Transport Corps.

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Civilian personnel:

Administrative audit of accounts........................................................................................77

Supply................................................................................................................................84
Examination of property returns..................................................................................37

Disbursements (finance).............................................................................................12

Total.................................................................................................................................210

Grand total ......................................................................................238

At the maximum, 16 officers of the Medical Corps were on duty with the Supply Service. Three hundred and thirty-one officers of the Sanitary Corps and 1,471enlisted men were found at supply depots at home and abroad. ²⁸

WAR APPROPRIATIONS AND DISBURSEMENTS.

The appropriation made by Congress for the fiscal year 1917 was $4,500,000.From the time war was declared until July 1 (two and a half months), the Finance and Supply Division had actually placed contracts for $11,712,000worth of medical supplies under the urgent deficiency act approved June 15.The deliveries called for were such as to insure an adequate amount being on hand when the National Army camps were opened. ²⁹

In the Army appropriation act for the fiscal year 1918, approved May 12,1917, the sum of $1,000,000 was appropriated for the Medical Department. The act of June 15, 1917, covered an additional $29,780,000. These sums proving inadequate, an appropriation of $100,000,000was made October 6, 1917, and a further deficiency appropriation of$33,000,000 was made July8, 1918. ³⁰

The act making appropriations for the support of the Army, and for other purposes, for the fiscal year 1919, approved July 9, 1918, appropriated $267,408,948for the Medical and Hospital Department. The first deficiency act, approved November 4,1918, added $30,000,000to this, and authorized the incurrence of indebtedness, in addition thereto, up to $65,000,000.³¹
On July 1,1918, the Chemical Warfare Service was created and was charged with all matters pertaining to gas warfare, defensive as well as offensive, and to this service was transferred, early in July, all personnel engaged in the production of gas masks, together with all property, obligations, and funds pertaining thereto. These funds amounted to$12,105,000 of the 1918 appropriations and $68,697,000 of the 1919 appropriation, or a total of$80,802,000.³¹

When the procurement, assembly, issue, and maintenance of motor ambulances and motor cycles were transferred to the Motor Transport Corps, August 31,1918, there was also transferred $23,117,614.79 of the 1919 appropriation and $1,750,393.45of the 1918appropriation, together with all motor ambulances and motor cycles previously acquired by the department, including those under contract. ³³

Of the total of $297,408,948 appropriated for the Medical Department for the fiscal year1919, therefore, $23,117,614.79 were transferred to the Motor Transport Corps, $68,697,000were transferred to the Chemical Warfare Service, $54,000,000 returned to the Treasury,$9,000,000 remained unobligated, and $166,589,333.21 were expended or obligated for supplies and services. There was disbursed during that year also $14,767,893.95of the appropriations for former years.³¹

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EARLY ESTIMATES AND ACCOMPLISHMENTS.

Estimates.--When it became apparent, in March, 1917, that the entry of the United States into the World War was imminent, the Supply Division of the Surgeon General`s Office began computing its estimates for an Army of 1,000,000 men. While these computations, of necessity, on account of the limited force available, were made by rule of thumb, the results, on the whole, were as successful as a more elaborate calculation might have proved. The total quantity of supplies comprising the field equipment for a division was determined, and 40 times that quantity, increased to cover replenishment, was ordered. The standard supply table of hospital equipment had the allowance of every item thereon for stations having1,000 population. The quantity of such articles require(l for the care of 1,000,000 for one year would normally be 1,000times that for 1,000 troops, and this was taken as the basis for procurement. The instructions, as originally issued, called for the purchase of field equipment for the entire million troops, ³⁴because previous experience had demonstrated that it took a longer time to procure that class of equipment than it did to secure supplies for general hospital use. The first instructions for the purchase of hospital supplies called for those necessary for 500,000men. ³⁵ Shortly after the issuance of these instructions the procuring officers were directed to increase the quantity to that for 1,000,000 men. These procurement instructions were issued to the officers in charge of the medical supply depots at Washington, D. C., and New York City. These officers began at once a canvas of the market, and of the firms dealing in such commodities, and conducted such negotiations as were possible, looking to the procurement of these supplies, pending the appropriation by Congress of the necessary funds for their purchase.

Supply depots.--When war was declared, April 6, 1917, the Medical Department, as already noted, had six medical supply depots in active operation within the United States.12 The depot at El Paso, Tex., having served its purpose, was discontinued in August, 1917, and its supplies were transferred to the depot at San Antonio, Tex.

To meet the prospective needs in Mexico, there had been sent to the El Paso depot one standard base-hospital equipment, with 500 bedsteads and mattresses, nine evacuation hospitals, two field hospitals, two ambulance company equipments, and a large quantity of furniture andbedding.36 Of these units, the base hospital, including bedsteads and mattresses, and four evacu-ation hospitals, were sent to New York to accompany the first convoy to France.³⁷ The remaining evacuation hospitals were shipped to France prior to the discontinuance of that depot.³⁷

It became manifest, as soon as the troop mobilization and camp locations had been determined upon, that the existing facilities would be inadequate and that new depots at other locations would be necessary. Under authority from the Secretary of War, of May 19, 1917, new depots were established at Chicago, Philadelphia, and Atlanta. ³⁸

The requirements for storage space for the reception and issue of supplies increased so rapidly that new buildings had to be added at the depots from time

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to time. By the end of June, 1918, storage space available in the depots was as follows: ³⁹

Square Feet
Atlanta,Ga.............................................................................146,000
Chicago,Ill.............................................................................177,000
Louisville,Ky............................................................................45,000
New York City..........................................................................185,000
Philadelphia,Pa........................................................................192,000
St.Louis,Mo............................................................................347,000
San Antonio,Tex.........................................................................48,000
San Francisco, Calif...................................................................112,000
Washington,D.C.........................................................................270,000

Total.............................................................................................................1,522.000

There were also in operation overseas embarkation warehouses at New York City and Newport News, Va. The warehouse at New York was on Pier45, North River, and had80,000 square feet of floor space; the warehouses at Newport News were in Government-owned buildings having50,000 square feet of floor space. ³⁹

In as much as motor ambulances were being procured by the Medical Department, the chassis at one place and the body at another, it became necessary to establish a central assembling point at which the bodies could be mounted on the chassis and the machines tested out before distribution to the points where needed. A medical officer was ordered to Louisville for duty to secure the necessary buildings and equipment, the department being in receipt of an offer from the president of the Kentucky Wagon Works of that city to permit the use of a part of his buildings and grounds for that purpose. ⁴⁰ These buildings, with the modifications and new construction necessary, facilitated the handling of the situation very satisfactorily. New construction was promptly effected and the depot started to function, July 19, 1917, by the receipt of 100 Ford ambulances and chassis, which were furnished from the local branch of the Ford Motor Co. at Louisville. ⁴¹

Plans for the base hospital at every camp included three warehouses for the storage of Medical Department supplies and equipment. It was decided in May, 1917,to utilize these warehouses for the camp medical supply depot 4 which, it was early foreseen, must be established at every mobilization camp for the proper supply of unit equipment to the organizations to be mobilized there and for their convenience in the way of replacements and maintenance while in camp. It was thought that the medical supply officer, being accountable for all the medical property in the camp, could issue the supplies to the troops and also act as property officer of the base hospital. His personnel was to be selected from the members of the incoming draft, with available men of the enlisted force of the Medical Department who had had training in property work prior to mobilization.

Initial equipment.-The initial equipment of every individual camp was calculated and the lists, together with the necessary instructions relative to their issue, were sent to the designated issuing depots August 8, 1917, and copies of the lists of equipment were sent to the medical supply officers at the several camps on August 12, 1917. ⁴³This initial equipment consisted of the equipment for a 500-bed hospital and a three months` allowance (of medicines and medical

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supplies for the regimental dispensaries based on the proposed strength of the different organizations to be mobilized in the respective camps. Such unit equipment as was not available at that time was sent later, as it became avail-able. Additional equipment for the base hospital, and to some extent for the dispensaries, was to be furnished on requisition at a later date as required. A sufficient quantity of supplies not having reached the depots at Chicago, Philadelphia, and Atlanta to permit them to issue the base hospital equipment, the depot at New York was directed to ship to the camps situated in the territory supplied by those depots. It was thought, before mobilization was accomplished, that the issue of supplies could be decentralized to department surgeons and possibly to the surgeons of the camps, but it was soon found that this method could not be continued on account of the imperfect distribution of existing stock and of the tendency at all camps to ask for quantities in excess of their needs in order to have it on hand against an emergency and in excess of the availability of the supply. All requisitions were thereafter sent through the Surgeon General`s Office and were filled from the stocks where they were available and in quantities deemed by that office to be sufficient.⁴⁴

During June and July, 1917, the Medical Department was confronted not only with necessity of determining and providing the initial equipment for the mobilization camps, but with the duty of finding officers for the various camp medical supply depots, securing their commissions, and having them transported to the scenes of their future activities before the arrival of the supplies, which, in turn, had to reach the camps prior to the arrival of the troops. As in many instances supplies arrived at the camps before buildings were ready to receive them, they were stored wherever space could be found-in farm buildings, in the open, or under canvas. Every medical supply officer of these camps had to adapt himself to existing conditions and in the beginning to remain on duty the whole 24 hours, if need be, since he was the only representative of the Medical Department present to care for the supplies. With the arrival of troops, enlisted personnel were detailed to duty in the improvised depots, and conditions began to improve. As time passed the needed storehouses were completed and the camp medical supply depots were stocked and in full operation.

It became apparent very soon after the mobilization had been completed that the first estimates for hospital beds at home were entirely inadequate. ⁴⁵This required an equal increase in all medical supplies, but, fortunately, time was given for this. It was soon found necessary also to equip the base hospitals at all the camps so that they might treat every class of disease and injury. This required a more elaborate equipment for these hospitals than had been originally planned. No great difficulty was experienced in obtaining the needed equipment, although some delay ensued in supplying it.

Personnel.-The Sanitary Corps was authorized June 30, 1917,⁴⁶ to provide technical and nonmedical personnel for the various activities of the Medical Department. This corps made it possible to obtain officers for duty as supply officers, purchasing agents, X-ray technicians, automobile and accounting experts, and thereby provide for the development of an adequate personnel for the supply service. Of the 331 officers of the Sanitary Corps and the 1,471enlistedmen, Medical Department, on duty in the various supply depots at home and abroad, 425 were with special units. ²⁸ The best obtainable officers

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and men were selected for this service, and the greatest care was taken to eliminate the physically unfit, to the end that those remaining might be able to endure the hardships and vicissitudes of active campaign.

Training.-Training schools were established and every effort made to insure that every officer, noncommissioned officer, and private was fully qualified technically before he was assigned to supply duty. ⁴⁷ Of the 331 officers of the Sanitary Corps engaged in supply work, 288 had risen through the grades of private and noncommissioned officer to officer. ⁴⁸

Drugs.-By judicious methods of procurement an ample supply of drugs was obtained, with the exception of a few alkaloid substances, such as atropine and homatropine, of which the supply was limited and difficult to secure. ⁴⁹The importation of digitalis from abroad was superseded by domestic production and a standardized tincture was prepared at the College of Pharmacy, University of Minnesota. The production of arsphenamine was improved and increased until the supply was nearly sufficient to meet the demands. The toxicity of the domestic product was so reduced that the best grades finally equaled or excelled the Germans alvars an imported prior to 1914.

Blank forms.-In consequence of the great expansion of the Medical Department and of the inexperience of the vast majority of the personnel, enormous quantities of blank forms were used. Resort to private printers was necessary to meet a large part of this demand. The increased range of activities of the Medical Department required the adoption of a few additional forms, but, as a whole, the standard forms in use proved satisfactory and sufficient to meet the requirements. The field medical supply depot in Washington was the distributing depot for these blank forms. Shipments were made in bulk to the main distributing depots and to the camp medical supply depots. From these distribution was made to the hospitals and other units in their respective areas. ⁵⁰

Surgical dressings.-Soon after war was declared contracts for vast quantities of supplies were entered into with the surgical dressing manufacturers. As time passed it became necessary, in order to maintain the supply, for the Government to procure the gray goods from the mills and to furnish to the dressing manufacturers such quantities as they could handle, having there main der bleached or finished wherever possible. During the year 1917,28,-776,000 yards of absorbent gauze, 34,000,000 sublimated gauze packets, 60,-119,200compressed bandages,62,746,127 roller bandages, 8,423,580 first-aid packets, 10,000,270individual packets, and600,000 shell-wound packets were produced and delivered.51 Arrangements for the preparation of large quantities of surgical dressings were made with the American National Red Cross. ⁵¹The Medical Department furnished all the materials and the various chapters of the Red Cross prepared the dressings. Many thousands of such dressings were sent abroad. The Red Cross also rendered valuable service by making nightshirts, operating gowns, pajamas, and other articles, from materials furnished by the Medical Department.

Surgical instruments.-The procurement of sufficient surgical instruments was the most difficult of the supply problems. Since the bulk of the surgical instruments in use in the United States before the war were imported from Germany or from England, and since this source of supply was closed by the war,

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it became necessary to call upon the few domestic surgical instrument manufacturers for greatly increased production, and to develop new sources of supply. ⁵²As a result of a campaign for this development, surgical needles, the entire supply of which had formerly been imported, were now obtained from domestic sources in sufficient quantities and of satisfactory quality. Tool-makers, cutlery manufacturers, and jewelers contributed to increase the supply of forged and finished instruments. Standardization of surgical instruments made possible this increased production.³

Ward equipment.-During the fiscal year ending June 30, 1918, 251,628bedsteads and full equipment therefor were procured and distributed.⁵³ The supplies for 35 base hospitals established at home camps were furnished and the equipment for 32additional base hospitals was sent abroad. The major portion of the equipment for the 32hospitals sent abroad was supplied by the Red Cross. Twenty-six general or other large hospitals were equipped at home.

Litter carriers.-Two types of litter carriers were designed: 54 (1) A hospital wheeled litter carrier, which was light in weight, cheap, easily knocked down and boxed for overseas shipment, and capable of being readily assembled by inexpert mechanics; a special rest readily converted this carrier into a temporary operating table; (2) a field litter carrier, by using which two litter bearers could handle two wounded on litters, and which might be used as a trailer behind the standard motor ambulance. These designs were approved and the supply of the litters controlled by the Finance and Supply Division.

Gas-defense supplies.-By direction of the Secretary of War, the development and production of gas masks and other equipment used in gas defense was made a function of the Medical Department,⁵⁵ and remained so until, July 1, 1918,when the Chemical Warfare Service was created. (See Division of Gas Defense, p. 504.) While the Gas-Defense Service of the Surgeon General`s Office supervised all matters of personnel, training, design, and manufacture of gas-defense equipment, requisitions for this material went through the usual channels to the Finance and Supply Division, which made disbursements for and controlled the distribution of these supplies, as well as of others used by the Medical Department. ⁵⁶

Motor ambulances and motor cycles.-A special organization was developed in the Finance and Supply Division for the purchase, production, inspection, and maintenance of motor ambulances, motor cycles, spare parts, and equipment. ⁵⁷This work was under the direction of automobile and business experts, and included a directing officer in Washington, D. C.; a motor ambulance experimental station, Washington, D. C.; a motor ambulance supply depot, Louisville, Ky.; a motor ambulance assembly base, American Expeditionary Forces; and stations for inspecting and testing ambulance chassis, ambulance bodies, spare parts, trailer chassis and bodies, motor cycles, etc., at each plant in the United States where they were produced. In addition to the procurement, production, and inspection of motor ambulance equipment, a new design of knockdown ambulance body was developed and put into production, the standard ambulance chassis was improved in spring suspension, shock absorbers, starting of engine, driver`s apron and windshield, (drainage of cooling system, radiator support, and other minor details. A special "spare parts A" equipment was provided for each ambulance; and a "spare parts B" equipment,

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carried in a special spare parts trailer and designed to take care of all except major repairs and accidents in service, was provided for each ambulance company. A book of "Information and Instructions" covering equipment, spare parts, repairs, and maintenance for United States standard motor ambulances and United States standard motor cycles in the service of the Medical Department, United States Army, was compiled and distributed.⁵⁸It contained lists of all equipment, spare parts, etc., as well as directions for inspection of ambulances by drivers and mechanics, and instructions for assembling, adjustment, and maintenance of each ambulance chassis unit. A supply, repair, and salvage depot was established at Louisville, Ky., for the upkeep of ambulances and motor cycles in the United States. Tentative drill regulations for the United States standard closed ambulance were published and distributed.⁵⁹

Vaccines.-Typhoid and other bacterial vaccines were forwarded in quantities from the Army Medical School, Washington, D. C., to the various medical supply depots, including those located at the cantonments, whence they were issued direct to surgeons of organizations. ⁶⁰ Arrangements were made to have an ample supply of smallpox vaccine available in the vicinity of each camp, to be promptly furnished to the camps upon request of the medical supply officers.

X-ray equipment.-The officer in charge of X-ray work was a member of the subcommittee of the Council of National Defense which had charge of the standardization of apparatus, and also acted in an advisory capacity to the supply division of the American Red Cross. This made it possible to compile a standard list of X-ray apparatus which was adopted by the Council of National Defense and adhered to in all essentials by the Finance and Supply Division of the Surgeon General`s Office and by the Red Cross. This standard list included both stationary and portable apparatus. ⁶¹ Manufacturers of X-ray apparatus cooperated so thoroughly that there was no difficulty in securing, at a fair price to the Government, all of the apparatus needed throughout the duration of the war. Not only was a sufficient quantity of X-ray apparatus and supplies of all kinds shipped abroad for the use of both stationary and mobile hospitals with the American Expeditionary Forces, but it was also furnished in adequate quantities for military hospitals at home.

Hospital supplies shipped overseas.-Pursuant to cable requests from overseas April 19,1918, the equipment of base hospitals sent abroad was increased to accommodate 1,000 patients with a crisis expansion for an additional 1,000. ⁶² The complete equipment of one such hospital, including steam sterilizer and portable disinfect or, weighed 150 tons and occupied over 30,000cubic feet of space. Evacuation hospitals likewise were increased to a capacity of 1,000 patients, and the equipment of 10 such was forwarded overseas prior to June 30,1918.33 Fifteen evacuation hospitals equipped according to the Manual for the Medical Department had been sent in the summer and all of 1917. ⁶³ During the period November 25, 1917, to June 30, 1918,there were shipped to the expeditionary forces in France 31,099 tons of Medical Department supplies occupying a total space of 3,771,810 cubic feet.⁶³

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LATER ACCOMPLISHMENTS.

The difficulties of the Finance and Supply Division were perhaps greatest in the earlier stages of the war, when plans for the supply of a large war Army as compared with a small peace Army had to be made and at the same time medical supplies had not only to be procured but also to be put on the ground in the many camps, posts, and stations, and delivered to ports for shipment overseas, and personnel had to be trained to carry out all the extremely technical details. The second year of the war, however, presented special difficulties of scarcely less importance, when production had to be vastly increased, markets developed, and new sources of supply found.

The camp medical supply depots developed at the several cantonments during the previous year proved a most valuable asset, both for the prompt and efficient supply of medical units at the camps to which they belonged and for the local training of enlisted and commissioned personnel in the nomenclature and the handling of medical supplies. These depots were maintained on a three months` supply basis-two months` stock on hand and one in transit. Requisitions for replenishment were forwarded monthly, and showed for the items entered the quantities issued during the previous month, the quantities remaining on hand, and the amount required to bring the stock up to three times the actual issue of the previous month. Emergency requisitions might be forwarded at any time and telegraphic requests could be made wherever conditions required.¹⁴

The need for competent medical supply officers continued to increase and the plan of establishing training schools for them, which had been inaugurated during the previous fiscal year, was continued and further developed. Enlisted personnel at the various camp supply depots who showed aptitude were promoted to the several grades of noncommissioned officers. The best of these were selected and sent to various training schools for medical supply officers. The principal schools were at Newport News, Camp Meade, and Camp Upton.⁴⁷On finishing the course at one of these schools the men who qualified were commissioned as second lieutenants in the Sanitary Corps for duty at camps, general hospitals, or overseas, as the need might be. At Newport News were organized and equipped 13 depot companies for service in France.⁶⁴ Of this number eight had actually been sent abroad and the remainder were awaiting transportation at the time of the armistice. These companies consisted of three officers and 45 men each, all specially selected and trained.

Great difficulty was experienced in securing competent personnel for the larger depots, especially clerks, stenographers, and skilled labor. This was finally overcome by calling into the service limited-service men, physically qualified for duty at home but unfit for active military service abroad.⁶⁵ Many of these men were secured through advertisements inserted in trade journals. Others were obtained through the various draft boards. They were directed to report at the depots in New York, Chicago, St. Louis and Atlanta, where they were examined by the officers in charge and the best men selected for various specialties at those depots an(l elsewhere. These men, for the most part, proved faithful and efficient. The results of procuring laborers by this method, however, were unsatisfactory. Many of the men so obtained rendered very poor service. ⁶⁵

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Arrangements were made with the United States Customs Service whereby the appraisers of that service were detailed to the inspection of Medical Department supplies at the mills and factories of the various contractors. ⁶⁶ The services rendered by them were very satisfactory. As time passed and the need for supplies became more urgent it was found necessary to develop afield force of officers to keep in touch with the various contractors, to assist them in procuring raw materials, fuel, and labor, to stimulate production of supplies and delivery thereof under their respective contracts, and to prevent the contractors from disregarding Government orders in favor of civilian business. ⁶⁶While the number of officers actually on this duty was wholly inadequate, the results obtained in the increase of production fully demonstrated their value and the need for such a force.

Owing to a multitude of transportation difficulties, the earlier effort to accumulate in France a reserve of supplies adequate for combat needs had not been wholly successful. The needs of the troops in training could be met with comparative ease; but it required strenuous efforts to provide supplies overseas in sufficient quantities for the major offensives, and the demand for an increased flow abroad became daily more urgent and more insistent. Moreover, the need for men was stressed and the limited tonnage was largely used for transporting troops. This resulted in an acute shortage of freight tonnage and made it seem doubtful for a time whether medical and hospital supplies in sufficient quantities could be delivered to the overseas forces. The situation was further complicated by the numbers of trained workmen which the draft had taken from the various industries and who had been replaced by other personnel less skilled and capable, which necessarily resulted in an output reduced both in quantity and quality. Due to the shortage of labor and the excessive quantities of supplies required, the stocks of raw material sat home became generally depleted. Restrictions designed to prevent waste, to promote economy, and to insure equitable distribution were so rigidly enforced as to make very difficult the procurement by the Medical Department of necessary materials for fabrication. So many instrumentalities were created to vis e procurements that the difficulties in placing orders were greatly increased, deliveries of the finished products were still further delayed, and prices were enhanced.

Owing to the increasing governmental control of raw materials and the resultant need of a more effective liaison between the procuring agency of the Medical Department and the War Industries Board, the Fuel Administration and other governmental agencies for allotting conveniences of which there was an actual or a threatened shortage, the central procurement office of the Finance and Supply Division, which had been established in Washington during the third quarter of the fiscal year ending June 30, 1918, was expanded to take over the procurement of practically the entire needs of the Medical Department, especially of medicines, surgical supplies, surgical, dental, and veterinary. instruments.⁶⁸Efficient buyers, selected from the drug and surgical instrument trade, were placed in charge of the procurement of those supplies of which they had special knowledge. Their work was properly controlled, directed, and coordinated by the Division of Finance and Supply. New sources of supply continued to be developed and existing

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sources to beincreased.⁶⁹ This was especially true for surgical instruments and dressings. Sourgent was the need for instruments that even the enrollment of jewelers and toolmakers as instrument manufacturers, which, as already explained, had been effected earlier, proved insufficient to meet the demands, and it was necessary to order blanks for forceps and surgical scissors from drop-forging firms, and to parcel these out to anyone who had the equipment necessary to convert them into finished instruments. Surgical needles continued to be made by domestic firms in ample quantities and of a quality equal to the best imported needles. Embroidery manufacturers undertook the preparation of special surgical dressings, particularly bias muslin bandages, of which some 5,000.000 were sent overseas. Various bleacheries were induced to aid the regular surgical-dressing manufacturers in the bleaching and finishing of absorbent gauze and crinolin. Due to the curtailment by the War Industries Board of the nonessential industries, many firms were free to undertake the production of supplies for the Medical Department, and although without previous experience in this particular line, delivered in due time very satisfactory articles.⁶⁹

The motor ambulance supply depot at Louisville, Ky., continued to render active and efficient service as a Medical Department institution until August 31,1918, when it was transferred to the newly formed Motor Transport Corps.⁷⁰ The spare-parts trailer, designed to meet the roadside repair requirements of an ambulance company for six months, which had been perfected during the previous year, was brought into production and a number completely packed and ready for immediate field service were shipped overseas.

A surgical instrument repair unit, consisting of 1 officer and 89enlisted men, equipped with all the machinery and material necessary to repair and, if necessary, make any of the instruments in use, was sent to France in January, 1918. ⁷¹A motor ambulance assembly unit, composed of 3 officers and 68 enlisted men who had been carefully selected from all of the important automobile plants in the United States, was sent to France in February, 1918. ⁷² This was followed by an accounting and auditing unit of the Medical Department, with 6 officers and135 enlisted men, to which was in trusted the finance and property accountability of the Medical Department overseas. ⁷²Later an optical shop with 2officers and 25 enlisted men, and still other lesser units were sent.⁷³ Additional men were supplied from time to time.

The automatic-supply table, which became effective for American Expeditionary Forces supply in June, 1918, proved very valuable. ⁷⁴ This table showed the quantities of medical supplies of all kinds which would be required for the maintenance of25,000 troops for one month, irrespective of the duties performed or whether in the zone of combat or in the zone of supply. The actual quantities shipped each month were based on these figures as given in the automatic-supply table, multiplied by a suitable factor corresponding to the aggregate number of troops which would be in the expeditionary forces during the ensuing month. While the quantities as given in the table did not prove ideal, the results obtained by its use fully demonstrated the value of such a plan. The table was being revised at the time of the armistice in accordance with the experience gained during the months it was in operation. This work was eventually completed and a satisfactory automatic-supply

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table, based on actual experience, will hereafter be available for the outfitting and maintenance of expeditionary forces should need arise. ⁷⁵

In 1918 the greatest difficulty the Medical Department experienced in forwarding supplies overseas was the lack of coordination between the movements of men and material, especially as regards priority schedules. ⁷⁶From the Medical Supply standpoint, ship tonnage allotted for troop movements overseas seemed out of proportion to that allotted for supplies. Supply bureaus were criticized for not providing material to keep apace with personnel. Men already existed and could be had immediately on call, while supplies, without which personnel was useless, did not exist and time was required to produce them; weeks and even months mustelapse before supplies could be put in the hands of the men. In many instances the materials had not been mined or the crops planted out of which the supplies were to be made. Trees had to befelled and lumber sawed and transported before buildings could be erected in which to house the stores.

The task of furnishing adequate supplies which confronted the Medical Department at the beginning of 1918 was even greater than that which con- fronted it six months earlier. The volume of the supplies on hand which had been steadily rising since the beginning of the war and which had already reached proportions sufficient to equip and maintain an army of 2,000,000men, had to be further augmented to meet urgent needs abroad. Men were being called to the colors in great numbers and the stream of troops flowing overseas had reached proportions, by June of 1918, that no one would have believed possible six months before.

The announced policy was to fully equip medical units at home. ⁷⁷This was successfully accomplished, but there was one important difficulty abroad which was never surmounted. This was due to the fact that unit equipments for divisional organizations, as well as for evacuation and base hospitals, could not, as a rule, be forwarded with the organization to which they belonged, the result being that often the equipment of one organization was shipped on more than one boat. The different vessels on which such equipment was forwarded did not always arrive at the same port. It was not of infrequent occurrence that articles of equipment intended for a given organization were landed at from two to five different ports, making it impossible, under existing traffic conditions in France, to issue to an organization its original equipment. ⁷⁶Actuallyfloating medical supplies was dependent on several different agencies ,and the success of the Medical Department in this particular was largely due to harmonious cooperation with the Railroad Administration, the director of inland transportation, and the Shipping Board. Cars were secured and shipments made to the ports with a minimum of friction and maximum of efficiency, existing conditions considered. The diplomacy, constant watchfulness, and persistent efforts of port medical supply officers, assisted by the influence of port surgeons, secured the shipment of the major portion of the medical and hospital supplies in spite of the many difficulties. With the beginning of the major offensives came redoubled efforts to procure and to transport medical supplies overseas in sufficient quantities. The insistent demands of the expeditionary forces for more medical and hospital supplies resulted in a modification of priority schedules ⁷⁸ and an increase in the tonnage allotted for

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such supplies, so that shipments gradually increased from 10,155 tons in July to19,712 in October, 1918, the last full month`s shipment before the armistice.⁶³The total for the four months` period, July to October, inclusive, was 52,762 short tons, approximately 6,331,440cubic feet. In November, 18,000 tons additional were shipped. Of the shipments made during this period, the following items of equipment are of special interest: ⁶³

Floated from July to October, 1918,inclusire, in addition to mediral supplies taken with organizations.

Regimental combat equipment........................................................150

Camp infirmaries...................................................................201

Camp infirmary reserves............................................................150

Ambulance company equipment, medical supply only...................................130

Field hospital equipment, medical supplies only.....................................80

Evacuation hospitals................................................................54

Chests, mess.......................................................................966

Chests,tableware.................................................................2,079

Chests,cooking utensils..........................................................1,349

Bedsteads........................................................................2,484

Cases,general operating..........................................................1,646

Cots, folding metal.............................................................55,309

Mattresses and cot pads........................................................122,310

Complying with an urgent request made in August, 1918, for surgical instruments, 52 tons of all classes of instruments were floated from New York, arriving in France about the middle of September. They entirely relieved the situation, so far as surgical instruments were concerned.

At the time of the signing of the armistice the Medical Department had on hand or on order sufficient beds, mattresses, cots, cot pads, pillows, and other articles of bedding and ward equipment to provide lying-down accommodations for 1,000,000 men.⁷⁹There were then being assembled at the port, Newark terminal, 60 base hospitals of 1,000 bed seach. Very great difficulties were experienced during September and October, 1918, in securing sheets, pillow-cases, blankets, and cooking utensils with which to complete the equipment of these hospitals. Deliveries were just beginning to assume satisfactory volume in the latter part of October.

With the cessation of hostilities the need for medical supplies greatly diminished. Steps were taken at once to stop production and to terminate contracts. There was an ample stock on hand to meet all prospective needs of the Army for many months to come, once the great battle casualties had ceased. Over a thousand contracts were terminated on the most advantageous terms obtainable for the Government. On November 15, 1918, the procurement work of the Medical Department was transferred to the Director of Purchase, of the Purchase, Storage, and Traffic, Division of the General Staff;⁸⁰ the distribution of supplies and depot activities to the Director of Storage;⁸⁰ the payment of all accounts and property accounting to the Director of Finance; ⁸¹ and the requirements duties to the Director of Purchase and Storage. ⁸⁰ The Medical Department was thereby divested of all its supply activities except those pertaining to the procurement and distribution of artificial limbs; orthopedic and prosthetic appliances; biologicals, arsphenamine and other arsenicals; books, journals, and reprints; certain printing and binding; and the administrative

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examination of certain vouchers for civilian medical attendance, for medicines bought locally, and for laundry. ⁸² The Surgeon General, in his annual report for 1919, stated that the net result of the consolidation, for the most part, was most unhappy, and that for the sake of economy, efficiency, and facility of supply, the supply functions should be returned to the Medical Department as they were prior to the war.

From November 15, 1918, to the end of the period covered by this history, the Medical Department functioned only in an advisory capacity in so far as its supplies, other than those reserved to it, were concerned.

PERSONNEL.^d

(April, 1917, to December, 1919.)

Darnall,C. R., Col., M. C., chief.

Fisher,H. C., Col., M. C., chief.

Wolfe, E.P., Col., M. C., chief.

Bernheim,J. R., Col., D. C.

Christie,A. C., Col., M. C.

Mount, J.R., Col., M. C.

Whitcomb,C. C., Col., M. C.

White, D.S., Col., V. C.

Fletcher,J. P., Lieut. Col., M. C.

Gentry,E. R., Lieut. Col., M. C.

Jones, E.C., Lieut. Col., M. C.

Strong,F. X., Lieut. Col., M. C.

Berry, E.J., Maj., S. C.

Fish, P.A., Maj., V. C.

Fishleigh,W. T., Maj., S. C.

Hodge, E.R., Maj., M. C.

Hurley,T. D., Maj., M. C.

Inman, D.B., Maj., S. C.

King, J.C., Maj., D. C.

LaGrinder,R. A., Maj., S. C.

Lennox,F. W., Maj., S. C.

McCartney,F. L., Maj., S. C.

Rogers,E. H., Maj., S. C.

Scheve,J. C., Maj., S. C.

Smelsey,Samuel, Maj., S. C.

Wallerich,G. W., Maj., S. C.

Wood, R.A., Maj., S. C.

Bonner,W. C., Capt., S. C.

Bradley,Mark, Capt., S. C.

Copping,J. B., Capt., S. C.

Dailey,Joseph, Capt., S. C.

England,Thomas, M., Capt., S. C.

^d 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 chiefs of the division, and the assistants. In each group names have been arranged alphabetically, by grades, irrespective of chronological sequence of service.

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Fahlbusch, Henry G., Capt., S. C.

Gilmour, Frederick, Capt., S. C.

Grinnell, A. G., Capt., S. C.

Hurtey, G. J., Capt., S. C.

Kelley, Howard, Capt., S. C.

Lowry, D. E., Capt., S. C.

MacClair, D. M., Capt., S. C.

Mims, M. D., Capt., S. C.

Moon, J. G., Capt., S. C.

Schaeffer, C. E., Capt., S. C.

Sly, Charles S., Capt., S. C.

Stoner, W. G., Capt., S. C.

Tanney, L. L., Capt., S. C.

Thompson, E., Capt., S. C.

Vane, Patrick P., Capt., S. C.

Van Putten, J. J., Capt., S. C.

Von Oschen, Herman, Capt., S. C.

Walsh, H. F., Capt., S. C.

Dagit, F. A., First Lieut., S. C.

Lang, L. W., First Lieut., S. C.

Langfield, C. E., First Lieut., S. C.

Lawshe, E. R., First Lieut., S. C.

McElrath, H. R., First Lieut., S. C.

Turner, E. P., First Lieut., S. C.

Warfield, S. R., First Lieut., S. C.

Whitfield, W. F., First Lieut., S. C.

Adams, S. K., Second Lieut., S. C.

Borneman, H. P., Second Lieut., S. C.

Butt, P. D., Second Lieut., S. C.

Federer, F. A., Second Lieut., S. C.

Fritz, G. E., Second Lieut., S. C.

Goff, W. S., Second Lieut., S. C.

Harrell, E. B., Second Lieut., S. C.

Kirk, W. E. J., jr., Second Lieut., S. C.

Miller, H. W., Second Lieut., S. C.

O`Neal, Nelson B., Second Lieut., S. C.

Platt, C. A., Second Lieut., S. C.

Thurrott, A. E., Second Lieut., S. C.

REFERENCES:

(1) Orders, January 16, 1899, signed by Surg.Gen. George M. Sternberg. On file Record Room, S. G. O. 50882(Old Files).

(2) Orders, September 20, 1917, signed by Surg. Gen. W. C. Gorgas. On file, Record Room, S. G. O., 50882(Old Files).

(3) Letter from the Surgeon General of the Army to The Adjutant General, January 9, 1917. Subject: Standardization Medical Department Equipment. On File Record Room, S.G. O., H410S (Old Files).

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(4) Indorsement from The Adjutant General to the Surgeon General of the Army, February 7, 1917. Subject: Appointment of Committee by Secretary of War. On File, Record Room, S.G. O., 164108 (Old Files).

(5) List of Staple Medical and Surgical Supplies Selected to Meet War Conditions; by the Com-mittee on Standardization appointed by the Council of National Defense (4 parts),Part I, Surgical Instruments (May, 1917);Part II. Medicine, Antiseptics, Disinfectants, Chemicals, etc. (June,1917); Part III. Laboratory Supplies (June,1917); Part IV. X-ray Apparatus and Supplies (July, 1917). Published by Government Printing Office (1918), Washington, D. C.

(6) Ibid., Part I. Surgical Instruments,(May, 1917).

(7) Report of the chairman, Edward C. Kirk, Committee on Dentistry, Council of National l)e- fense, April 22,1917. On file, Record Room, S. G. O., 156772. (Old Files).

(8) Manual for the Medical Department, 1916,corrected to June 15, 1918; paragraphs 854 to 856, inclusive.

(9) Letter from the Surgeon General of the Army to dental surgeons, May 1, 1917. Subject: Dental Outfits. Onfile, Finance and Supply Files, S. G. O., 13291 F.

(10) General War Plans of the Medical Department, March 9, 1914. Prepared in the Office of the Surgeon General, United States Army, at the request of the Chief of Staff, asper letter, October 2, 1913. On file, Record Room, S. G. O., 93300 I (Old Files).

(11) Supplies furnished by Medical Department. Manual for the Medical Department, 1916, corrected to April15, 1917, pp. 247 et seq.

(12) Annual Report of the Surgeon General, United States Army, 1918, p.320.Preparedness of the Medical Department for War. By Lieut. Col. H. G.Fisher, M. C. On file, Finance and Supply Files, S. G. O., 12709E.

(13) Manual for the Medical Department, 1916,corrected to April 15, 1917, par. 843 (foot note 1, p. 250).

(14) Ibid., pars. 476, 786.

(15) Letter from the Surgeon General to officer in charge, field medical supply depot, Washington, D. C., December 20, 1917. Subject: Payment to Contractors. Similar letter sent to medical supply depots, New York and St. Louis. On file, Finance and Supply Division, S. G. O. 713-750/146

(16) Manual for the Medical Department, 1916,corrected to June 15, 1918, pars. 377 to 379, inclusive.

(17) Ibid., pars. 380 and 507.

(18) "Preparedness of the Medical Department for War, " by Lieut. Col.H. F. Fisher,M.C., Medical Supply Division. On file, Finance and Supply Files, S. G.O., 12709 (Old Files).

(19) Letter from the Surgeon General to the camp division surgeon, November 1C, 1917. Subject: Requisitions and Purchases of Supplies. On file Record Room, S. G. O., 400.312(Requisitions).

(20) A. R., 1913, with changes to January 24,1920, par. 1476.

(21) Memo, from B. B. Thompson, chief clerk S. G. O., to Col. E. P. Wolfe, Chief of Finance and Supply Division, S. G. O. Subject: Veterinary Supplies. On file, Record Room, S. G. O.,446.1 (Veterinary Supplies).

(22) Bull. No. 16, June 22, 1916, par. 16.

(23) Bull. No. 39, W. D., July 7, 1917.

(24) Letter from Surgeon General to Quartermaster General, June 12, 1917. Subject: Veterinary Supplies, and indorsements thereto. On file, Finance and Supply Division, S. G. O.,14700 HI (Old Files).

(25) Veterinary Supply Tables, Article XX II,Manual for the Medical Department, 1916, corrected to June 15,1918.

(26) Report of the medical supply depot, St.Louis, from Lieut. Col. Wickline, May 13, 1919. On file RecordRoom, S. G. O., 314.7 (Medical History, Medical Supply Depot, St.Louis) (O)-

(27) List of Personnel. On file Record Room, S. G. O., 024.6 (Finance and Supply Division).

(28) Figures compiled from monthly returns from supply depots. On file, Record Room, S. G. O, 319.1 (name of depot) (M).

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(29) Bull. No. 33, W. D., September 9, 1916,p. 30. Bull. No. 39, W. D., July 7, 1917. Letter from the Director of Finance, W. D., to the Surgeon General of the Army, March 15, 1919.Sub- ject: Semimonthly financial statement, with photostat copy of financial statement at- tached. On file, Record Room, S. (T. O., 112.8-1.

(30) Bull. No. 30, XV. D., May 22, 1917.Bull. No. 39, W. D., July 7, 1917. Bull. No. 59, W. D., October 17,1917. Bull. No. 42, W. D., July 20, 1918.

(31) Bull. No. 43, W. D., July 22, 1918.Bull. No. 59, W. D., Nov. 18, 1918.

(32) Report from Director of Finance, W. D.,to the Surgeon General, United States Army, September 23, 1919.Subject: Financial Statements. On file with the Chief of the Finance and Supply Division, S. G. O.

(33) G. O., No. 75, W. D., August 15, 1918.

(34) Letter from Surgeon General to officer in charge, field medical supply depot, Washington, D. C., May 25,1917. Subject: Medical Supplies. On file, Finance and Supply Division, S. G. O., 14101 (Old Files).

(35) Letter from Surgeon General to officer in charge, field medical supply depot, Washington, D. C., May 15,1917. Subject: Medical Supplies. On file, Finance and Supplies DivisionS. G. O., 14101 (Old Files).

(36) Letter from the Surgeon General to division surgeon, Southern Department, August 18, 1917. Subject: Transfer of Supplies. On file, Finance and Supply Division, S. G. O., 713-218/5.

(37) Letter from Surgeon General to medical supply officer, port of embarkation, Pier 45 North River, New York City, August 23, 1917. On file, Finance and Supply Division, S. G. O., 783-539/7.

(38) Letter from the Surgeon General to The Adjutant General, May 11, 1917. Subject: Request Authority to Establish Additional Medical Supply Depots, approved by Secretary of War, May 19, 1918, and by first indorsement, Adjutant General`s Office, May 24, 1917. On file, A. G.O., 2596673 (Old Files).

(39) Letter from The Adjutant General to the president (Col. Charles B. Wheeler, Ordnance Department) of the board appointed under S. O., No. 129, par. 25, June 5, 1917. On file,Record Room, S. G. O., 192013 (Old Files).

(40) S. O.. No. 132, par. 1, W. D., June 8,1917, assigning Capt. John P. Fletcher to Jeffersonville, Ind. Letter from the Surgeon General to Capt. John P. Fletcher, June 12, 1917. Subject:Proposal of Kentucky Wagon Works for Assembling Automobiles. On file, Finance and Supply Division, S. G. O.,14842 (Old Files).

(41) Telegram from Capt. John P. Fletcher to the Surgeon General of the Army, July 19, 1917. Subject: Ford Ambulances Received at Louisville. On file, Finance and Supply Division, S. G. O., 14842 (Old Files).

(42) Correspondence on medical supply depots. On file, Record Room, S. G. O., 169007 (Old Files). Supply Letter No. 17, Office of the Surgeon General, July 6, 1917. Subject:Camp Medical Supply Depots. On file, Record Room, S. G. O., 175339-T (Old Files).

(43) Letter from the Surgeon General to the medical supply officer at Camp Hancock (and various other camps),August 11, 1917. Subject: Medical Supplies. On file, Finance and Supply Division, S. G. O., 534

(44) Letter from the Surgeon General to Capt. William S. Shields, June 8, 1917. Subject: Medical Supply Depot, Atlanta, Ga. On file, Finance and Supply Division, S. G. O., 14827-H(Old Files).

(45) Letter from the Surgeon General to The Adjutant General, June 11, 1917. Subject: Estimate for Hospital Beds. On file, Record Room, S. G. O., 175339 C (Old Files).

(46) G. O., No. 80, W. D., July 6, 1917.

(47) Memo. from officer in charge, medical supply depot, Camp Meade, to the Surgeon General, April 16, 1918.Subject: Course of Instruction Given at Training School for Supply Personnel at Camp Meade (outlines course). On file, Record Room, S. G. O., 353 (Camp Meade) (D).

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(48) Letter from Col. C. R. Darnall, M. C.,to Brig. Gen. C. Richard, Acting Surgeon General, September 16,1918. Subject: Report Concerning Promotion of Officers in Finance and Supply Division. On file, Record Room,S. G. O., 210.2 (Promotion in Sanitary Corps).

(49) Correspondence on supply of drugs. Onf ile, Record Room, S. G. O., 444.1 (General).

(50) Letter from the Surgeon General to Crane Printing Co., October 16, 1917. Subject: Printing of 32,000blanks (and other orders for printing). On file, Finance and Supply Division, S. G. O., 168 (Crane Printing Co.).Distribution. Letter from the Surgeon General of the United States Army to surgeon, Eastern Department, June 13,1917. Subject: Medical Supplies. On file, Finance and Supply Division, S. G. O., 13969-12.

(51) Letter from the Surgeon General to Mr. Henry D. Gibson, general manager, American Re Cross, March 8, 1918. Subject: Order for Surgical Dressings. On file. Finance and Supply Division, S. G. O., 602/78.

(52) Letter from the Surgeon General to Charles J. Pilling, chairman, War Service Committee July 29, 1917.Subject: Surgical Instruments. On file, Finance and Supply Division, S.G. O., 14636-85 (Old Files).

(53) Data compiled from reports of purchases furnished by field medical supply depots. On file, Finance and Supply Division, S. G. O., 713.

(54) Letter from the Surgeon General to commanding officers, field hospitals, May 24, 1918. Subject: Field Letter Carrier, Medical Department. On file, Finance and Supply Division, S. G. O., 750-714/613. Memo. from Col. William Moncrief, M. C., to Col. C. R. Darnall, M. C., April 12, 1918. Subject: Approval of Wheel Litter Carrier Designed in Surgeon General`s Office. On file, Finance and Supply Division, S. G. O., 713-539/549.

(55) Memo. from Assistant Chief of Staff, April 28, 1917, to The Adjutant General. On file, Mail and Record Division, A. G. O., 2575310 (Old Files).

(56) Letter from the Surgeon General of the Army to the Gas Defense Service, September 1, 1917, Subject: Gas Masks. On file, Finance and Supply Division, S. G. O.. 523/2.

(57) Correspondence on motor ambulances and motor cycles. On file, Division of Finan and Supply, S. G. O.,14842 (Old Files).

(58) Information and Instructions Covering Equipment, Spare Parts, Repairs, and Maintenance for United States Standard Motor Ambulances and United States Standard Motor Cycles in the Service of the Medical Department, United States Army. Office of the Surgeon General, Washington, D. C., May 1, 1918. Copy on file, Journal and Reprint Section, Finance and Supply Division, S. G.O.

(59) Tentative Drill Regulations for United States Standard Closed Motor Ambulances, Bod Model "B,"1917; Body Model "AA," 1918. Office of the Surgeon General, Washington, D. C., May 1, 1918. Copy on file, Journal and Reprint Section, Finance and Supply Division, S. G. O.

(60) Supply letters Nos. 1 to 23, inclusive(consolidated and revised), W. D., Office of the Surgeon General, December 5, 1917; supply letter No. 24, W. D., Office of the Surgeon General, March 11, 1918, p. 3.

(61) List of Staple Medical and Surgical Supplies Selected to Meet War Conditions: by the Committee on Standardization appointed by the Council of National Defense (4 parts).Part IV. X-ray Apparatus and Supplies(July, 1917). Government Printing Office, 1918. Washington, D. C.

(62) Cablegram No. 949, from General Pershing to The Adjutant General, April 19. 1918. Sub- ject: Increase in Personnel and Equipment of Base Hospitals. On file, Finance and Supply Division, S. G. O., 250/101.
(63) Monthly Tonnage Report from Transportation Service at Port of Embarkation. On file with Chief of Finance and Supply Division, S. G. O.

(64) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1187.

(65) Letter from the Surgeon General to officer in charge, medical supply depot. San Antonio, Tex., July 10,1918. Subject: Limited Service Men. On file, Record Room, S. G. O.,327.3 (San Antonio) (M).

244

(66) Letter from the Surgeon General to officer in charge, medical supply depot, New York, August 16, 1918.Subject: Inspections from Customs Appraisers. On file, Finance and Supply Division, S. G. O., 713-750/353.

(67) Letter from the Surgeon General, United States Army, to officer in charge. medical suppl depot, Philadelphia, Pa., August 17, 1918. Subject: District Officers, Production Depart- ment. Similar letter sent to the St. Louis, Chicago, and New York depots. On file, Finance and Supply Division; S. G. O., 713(Misc.)/77.

(68) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1186.

(69) Correspondence. Subject: Purchase of Supplies. On file, Finance and Supply Division 268 (General Purchasing Office).

(70) G. O., No. 75, W. D., 1918.

(71) Memo. from the Surgeon General to War Plans Division, General Staff, June 4, 1918. Sub- ject: Allowance, Officers, Sanitary Corps. Finance and Supply Division, Surgeon General`s Office. On file, Record Room, S. G. O.,024.6 (Finance and Supply Division).

(72) Annual Report of the Surgeon General, United States Army, 1918, 321.

(73) Letter from Surgeon General to Adjutant General, March 12, 1918. Subject: Optical Units. On file, Record Room, S. G. O., Confidential Files (Movement of Troops 3).

(74) Automatic Supply Table, A. E. F. Onfile, Chief of Finance and Supply Division, S. G. O.

(75) Revised Automatic Supply Table. On file,Chief of Finance and Supply Division, S. G. O.

(76) Letter from Surgeon General to Chief Surgeon, American Expeditionary Forces, August 22, 1918. Subject:Cause for Delay in Sending Equipment. On file, Record Room, S. G. O.,321.6 (Y).

(77) Letter from department surgeon, Eastern Department, to the Surgeon General, July 6, 1917. Subject: Field Equipment. First indorsement from the Surgeon General to the department surgeon, July 11, 1917. On file, Financea nd Supply Division, S. G. O., 13969(32) (Old Files).

(78) Priority schedules. On file, Record Room, S. G. O., Confidential Files (Priority Shipments).

(79) Compiled from reports of purchase furnished by field medical supply depots. On file, Finance and Supply Division, S. G. O., 713.

(80) Supply circular No. 102, War Department,Storage and Traffic Division, General Staff, October 24, 1918.Subject: Transfer of Certain Branches of Finance and Supply Division,Office of the Surgeon General. On file,Record Room, S. G. O., 024.6 (Finance and Supply Division).

(81) Memo. for the Surgeon General from Director of Finance, November 19, 1918. Subject: Payment of Accounts. On file, Record Room, S. G. O., 024.6 (Finance and Supply Division).

(82) Letter from the assistant to the Director of Purchase, Storage. and Traffic, November 9, 1918, to the Surgeon General. Subject: Procurement of Articles which will Remain with the Office of the Surgeon General. On file ,Record Room, S. G. O., 024.6 (Finance and Supply Division).