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SECTION II.
CHAPTER X.
DIVISION OFFOOD AND NUTRITION.
Early in the mobilization of the drafted Army, the Surgeon General, appreciating that proper feeding is an essential part of any complete program of military preventive medicine, took steps looking toward the formation of a division in his office which should be charged with the duty of advising on all questions relating to the nutrition of the soldier. Believing that the work proposed was clearly such as should be executed under the supervision of a purely professional department, with a personnel specially trained along the lines of nutritional science, the Surgeon General assigned to duty as Chief of the Division of Food and Nutrition a distinguished physiologist, who had been commissioned in the Sanitary Corps.1Other physiologists, biological chemists, food chemists, and food inspectors were commissioned and assigned to duty in the division. 2
The work proposed was outlined in general terms in a memorandum submitted by the Chief of the Division of Food and Nutrition to the Surgeon General on September 19, 1917,which was embodied in a letter from the Surgeon General to the Adjutant General,3 by whom it was submitted to the Secretary of War. The Secretary of War, on October16, 1917, 4 gave formal approval to the proposals of the Surgeon General, which were promulgated by The Adjutant General: 5
OCTOBER 26, 1917.
From: The adjutant General of the Army.
To: The commanding generals of departments, National Guard, and National Army Divisions, and the commanding officers of Coast Artillery districts, training camps, and excepted places.
Subject: Food surveys and inspections in training camps, cantonments, and hospitals of the United States Army.
1. The following letter on the above-stated subject from the Office of the Surgeon General, which has been approved by the Secretary of War, is communicated to you for your information and guidance:
"(a)There has been organized in this office a Food Division. The object of this division is primarily to safeguard the nutritional interests of the Army (1) by means of competent inspection of the food supplied to the camps with reference especially to its nutritional value; (2) by seeking to improve the mess conditions (cooking and serving of the food) with special attention to the matter of food economy, bearing in mind that palatability and proper cooking are great factors in determining the economical utilization of food in the physiological, no less than in the financial sense;(3) by studying constantly the suitability of the ration as a workingman`s diet, to inquire whether it affords the proper amount and distribution of nutrients; what amount of variability there is, as between different mess houses of the same regiment and between different camps; the influence of weather conditions and of troop activities on the consumption of food. Any intelligent alteration of the ration from time to time must be based on facts, and it is the purpose of this division to get facts.
"(b) The most direct means of securing the information desired will be to conduct nutritional surveys of the camps both here and abroad. A survey party will consist of four commissioned officers of this division and of eight enlisted men who will serve as assistants and clerks. This party, with proper authorization, will go to a camp, report to the commanding officer, and under
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the guidance of the chief surgeon will make a thorough nutritional survey. One member o the party, who will act as its director, will be a thoroughly competent physiologist and physiological chemist. Another member of the party will be thoroughly familiar with the best methods of inspecting foods from the standpoint of nutritional value. While in the camp he will be able to instruct the mess sergeants in these methods: another will be able to instruct company cooks in the economical management of their kitchens; and a third will be able to give instructions to the company officers in the relative nutritional value of different. foods and guide them in the construction of their menus. Such lessons and conferences, however, are secondary to the main purpose of the survey and will be subject to the pleasure of the commanding officer. The main purpose is to be able to describe in exact physiological terms the way in which the soldiers are fed, with a view to securing perfect nutrition at the least expense. It is estimated that one such party can complete the nutritional survey of a camp in from 10days to 2 weeks. Each camp should be inspected at least once in two months.
"(c)Authority is requested to make the food surveys, as indicated in paragraph (b) hereof, in the several posts, camps, training camps, cantonments, and hospitals of the United States Army; authority for the travel of the individual officers and men composing a party to be requested in the usual manner.
"(Signed) C. L. FURBUSH,
"Major, Medical Reserve Corps, U. S. Army
"(For and in the absence of the Acting Surgeon General)."
By order of the Secretary of War:
(Signed) W. E. COLE,
Adjutant General.
(2d ind.)
720.1 (Miscel. Div.)
A. G. O., October 26, 1917, to the Chief of Staff.
1 incl.
Synopsis made.
Approved.
By order of the Secretary of War:
(Signed) TASKER R. BLISS,
General, Chief of Staff (H. M. L.).
The functions of the Division of Food and Nutrition, as exercised during the height of war activities, are shown in Chart XI.
INSTRUCTION OF PERSONNEL.
On account of the wide scope of their future duties, it was impossible to find candidates for commission equally at home in all fields. It was therefore deemed wisest to selectmen of good scientific training and to give each the necessary instruction to fill, as far as possible, the gaps in his previous experience. In order to accomplish this, officers were first ordered to report direct to Washington, where a series of lectures and practical demonstrations were given. The instruction in food spoilage was undertaken first by one of the staff of the Bureau of Chemistry. Through his efforts and those of the director it was possible for group after group of officers to visit the Museum of the Bureau of Chemistry and to study at first hand the various animal organisms. A member of the faculty of the Massachusetts Institute of Technology, who was later commissioned a major in the Sanitary Corps for service with the Division of Food and Nutrition, gave a number of lectures dealing with the causes and usual course of various forms of spoilage. Instruction in practical food inspection was given by a sanitary and food inspector, under the direction of the chief of the food-inspection service, District of Columbia. He conducted a number of parties through the markets and the various establish-
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CHART XI.--Division of Food and Nutrition, Surgeon General’s Office, June, 1918.
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ments manufacturing food products. explaining the many forms of spoilage likely to be met with, and demonstrating methods for their detection, at the same time pointing out the most approved precautions for protection from spoilage. Meat inspection and demonstration was undertaken by a representative of the Bureau of Animal Industry, with the cooperation of the acting chief of this bureau. A member of the staff of the laboratory of the National Canner`s Association in Washington also devoted much time to the discussion of the various conditions arising in canning, and trips were made to Baltimore to study the practical operation of canners.
While this instruction served its purpose fairly well, it was adequate only in the case of particularly well-qualified men, such as the division was at first fortunately able to obtain; and even these felt the need for training in military forms and procedures. After considerable delay plans for the establishment of a special course at the Medical Officers` Training Camp, Camp Greenleaf, Fort Oglethorpe, Ga., were approved, and on March 7, 1918,the necessary instructions were given to the commandant in a letter reproduced below in part: 6
1.A school for officers of the Division of Food and Nutrition, Sanitary Corps, will be established as part of the general scheme of instruction carried out in the Medical Officers`Trainng Camp, Fort Oglethorpe, Ga.
2. The purpose of this school is to conduct the training of these officers of the Sanitary Corps along military lines, from the military viewpoint and in the military environment; and coincidently to develop them physically and train them in subjects which they should know under the conditions under which they would practice their specialty, including organization, regulations, paper work, relations with enlisted men, and their general functions as officers..
3. About 20 graduate food experts of the Sanitary Division are required monthly.
4. The routine of all matters relating to food, messing, and nutrition in the various organ-izations at your Camp will, so far as possible, be demonstrated and utilized as part of the subject of instruction.
5. The general technical instruction to begiven will be related to matters having to do with food and nutrition, and is briefly outlined in this letter of instructions, viz.:
[table]
6. A number of enlisted men will be kept at your camp under training to assist in food work. This number will be later announced.
All should be given such part of the basic course for enlisted men at your camp as might be of advantage to them in such service. The scope of their special training in food work will be prescribed to you after conference with the senior instructor in charge of the course in food work.
After a little experience it was found that the schedule as laid out in this letter was somewhat more elaborate than was necessary and a simpler curriculum was eventually adopted.
In addition to military and didactic instruction, students were given considerable experience in the running of messes, inspection of foods, and other practical matters pertaining to their future duties. On the other hand,
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it was found that most of the officers accepted by the division were already fairly well posted regarding the purely theoretical side of the work; and by some what reducing the military part of the course, it became possible to qualify officers for field service in rather less than the minimum of two months contemplated in the original plan.
This instruction at Camp Greenleaf was always subject to one handicap, namely, lack of laboratory accommodations and apparatus. At first this did not cause much inconvenience, but as time went on the disadvantage became more serious. The supply of men properly qualified in the basic principles of nutrition and at the same time available for commission was nearly ex-hausted, and it became necessary to accept as candidates younger men of somewhat inadequate preparation, inducting them as enlisted men and depending upon subsequent training to prepare them to assume the duties of officers. Through the courtesy of the School of Hygiene and Public Health and of the department of chemistry of the Johns Hopkins University, and with the approval of the Committee on Education and Special Training of the General Staff, arrangements were made to receive a limited number of properly qualified men of draft age as a part of the Students` Army Training Corps of the university, and to give them an intensive course of six weeks` duration in food chemistry, physiology of digestion, assimilation, and allied subjects, and the general principles of nutrition as preliminary to their selection for commission and further training at Camp Greenleaf. 7 The first three men had reported to this school when the armistice was signed.
SURVEY PARTIES AND THEIR METHODS.
In accordance with the proposed plan, survey parties were formed as the necessary personnel was assembled and sufficiently trained. The first survey party proceeded to the Ambulance Service Concentration Camp, later known as Camp Crane, at Allentown, Pa. A few weeks later another party left for the Medical Officers` Training Camp at Fort Oglethorpe, Ga. Following this, parties were made up and successively dispatched to the camps of other non-medical organizations, until authorization from the Secretary of War provided that a party might consist of four officers and eight enlisted men. It was never possible, however, because of insufficient personnel, to use that number. The constitution of the survey parties was about four officers and four enlisted men when a division camp was to be surveyed, and two officers and two enlisted men when one of the smaller camps was visited. Many changes were made in the personnel of these parties, but so far as possible it was the custom to have one experienced captain in charge, and in the larger parties at least one experienced lieutenant under him. The effort was made also to have as one officer of each party a medical graduate, the others being physiologists, physiological chemists, or trained food inspectors.
Up to November 11, 1918, the division had made surveys in 67 different camps, including 49 divisional and other large concentration camps, 14 aviation camps, and 3 war prison barracks, 1 recruiting station, and 1 spruce production camp. Twenty-six of these camps were surveyed a second time, and 3 of them a third time. The total number of individual messes surveyed was 458. 8
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In addition to the inspection of subsistence stores by the survey parties, an officer of the Sanitary Corps visited a number of camps for the purpose of studying the conditions of storage of subsistence.
In these inspections special attention was given to the relations of temperature, moisture, and period of storage to sanitary quality, nutritive value, and prevention of spoilage and waste of foods. The examinations included (1) meats and dairy products, which must be kept in actual cold storage to prevent deterioration in sanitary quality; (2)potatoes, onions, and other vegetables, which should be maintained at temperatures which prevent freezing in winter and loss of sprouting and decay in warm weather;(3) flour, corn meal, rice, and other cereals, which must be properly stored and the supply so regulated as to prevent loss through molds, mildews, or weevil and other insect pests; (4) dried, smoked, preserved, and canned products.9
When possible, recommendations as to improvement in storage conditions were made. The importance of increased cold-storage facilities was emphasized, and the great need of special vegetable cellars or storage houses for potatoes and other vegetables was pointed out.
INSPECTIONS IN HOSPITALS
A further activity of the division consisted of detailed inspections ot nutritional conditions in the military hospitals. By the close of 1917 it had been found in many of these institutions that useful work could be done regarding dietary matters, details of serving in the main dining room, wards, etc., and officers were assigned specially to this duty. A majority of the hospitals of the eastern and central parts of the country were visited by these officers. They found many conditions which offered opportunity for betterment and gave advice concerning the adaptation of menus to the dietary requirements of various clinical conditions, the reduction of waste, the problem of getting food to the patients in that hot, appetizing condition so desirable for those whose appetite is likely to be more or less impaired. Various technical problems on mess management also received attention.
On June 21, 1918, a report summarizing some of the conclusions reached was submitted to the Hospital Division of the Surgeon General`s Office. This was published to the commanding officers of all base and general hospitals throughout the country. It included a scheme of mess organization which was approved by the Hospital Division, and which was reproduced in the Mess Officers` Manual. Special reports on individual topics were submitted. 10
Throughout all this hospital survey work the two officers who conducted it were in a very favorable position to bring about close cooperation between the activities of this division and those of the Hospital Division, in so far as the latter was concerned with the feeding of patients; they constituted, too, a medium for the exchange of ideas between the different hospitals included in their various itineraries.
CONFERENCE OF OFFICERS.
Soon after survey work was started in October, 1917, need was felt for closer cooperation between the different parties, for standardization as regards recommendations to be made, as to forms of reports and channels through
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which they should be transmitted, and particularly as to how broad a1t field should be covered by the activities of the division. Accordingly, the lea(lers and older members of the various survey parties were recalled to Washington for a general conference, which was held from January 5 to 11 at the Surgeon General`s Office. Various points concerning the operation of the division were taken up seriatim, and the consensus of opinion regarding the possibilities and limitations of constructive work in the camps formed the basis of instruction issued for the further guidance of parties. Reports carrying recommendations were to be made to the division or camp commander, as the case might be, through the division or camp surgeon, and the following reports were ordered to be sent through channels to the Surgeon General: 11 (1) Two-day report stating the plans for the survey, conditions peculiar to the camp, progress made, etc.; (2) brief final report describing what the party had done, any special features affecting the interpretation of the final report, copy of recommendations filed with division surgeon, and suggestions for work of other parties, if anything of this nature seemed desirable; (3)final or statistical report to be made after analyses of foods and garbage had been received from the laboratories.
Upon the close of the conference the party leaders carried back to the field renewed enthusiasm derived from the frank and earnest discussion of the rough places encountered and difficulties overcome.
NUTRITION OFFICERS.
While sufficient statistical data had not yet been accumulated to warrant any recommendations concerning modification of the ration, it had already become clear that there were some very definite mistakes in actual mess management and that the mess personnel was usually quite ignorant of the ideals to be worked for or the nutritional principles which determined them. Mess officers and sergeants were nearly all fresh from civil life, where, in the great majority of cases, they had been doing work in no way related to their present duties. Willing enough to learn anything that might lessen their perplexities, the advice to which they listened with attention too often was forgotten after the survey party had moved on. Messes left in excellent condition so often reverted to their earlier state of inefficiency that it was evidently necessary, in order to insure permanent improvement, to station an officer of the division in each camp.
It must be remembered that the object of the work was not merely to improve nutritional and economic conditions in the American camps. Even more important was the duty of so training the mess officers in underlying principles as to prepare them to make the best of any situation that might arise under combat conditions in Europe. An officer whose knowledge was limited to some arbitrary rule of thumb would be helpless if he were unable to obtain his customary supplies. The fundamental reason, therefore, for stationing an officer in each camp was that he might be ever on hand to teach the proper procedure in case of unexpected emergency-to be the clinical teacher, so to speak, instructing not only didactically but by the aid of those concrete examples which occur frequently in the daily administration of camp life. His advice would also be very valuable concerning more or less routine matters, for example, repeated inspection of all subsistence stores with reference to nutritional
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value, freedom from adulteration, vermin, an l spoilage; periodic inspection of mess conditions to insure proper protection of the food in the mess houses; and supervision over the cooking and serving. In addition, it would be his duty to give system at instruction to the mess personnel concerning the proper balancing of menus, the functions of the chief constituents of the diet(proteins, fats, carbohydrates, salts, accessory substances, and the significance of each reaction).He would also charge himself to see that strict economy was at all times practiced.
On January 29, 1918, a letter to The Adjutant General was prepared by the division for the signature of the Acting Surgeon General, requesting authority to station an officer permanently in each camp. This letter was referred by The Adjutant General to the Quartermaster General for remark. The Quartermaster General did not favor the plan, and it was therefore disapproved by The Adjutant General. Late in May, 1918, the matter was again brought to the attention of The Adjutant General, accompanied by a considerable amount of data as to what had been accomplished already by this division by numerous requests for nutrition officers, and by definite plans outlining what it was hoped would be achieved in the future. On July 15, 1918, the action requested, with provision for additional personnel, was authorized, as follows: 12?
V--1. A Food Division was authorized by the Secretary of War (A. G. 0. 720.1 Misc. Div., October 16,1917) to make nutritional surveys of the military camps both in this country and abroad "for the purpose of safeguarding the nutritional interests of the Army (1) by means of competent inspection of food with reference especially to its nutritive value, (2) by seeking to improve mess conditions, and (3) by studying constantly the suitability of the ration as a workingman`s diet."
2.This division will hereafter be designated the Division of Food and Nutrition of the Medical Department. All provisions of said letter of authorization, except that portion referring to the length of time necessary for nutritional survey of a camp and the frequency of such surveys, are continued and made applicable to the new designation. and the following regulations pertaining thereto are published for the information and guidance of all concerned.
3.A "nutrition officer" will be designated from the officers of the Medical Corps, Medical Reserve Corps, or Sanitary Corps by the Surgeon General, or by the local commanding officers with the approval of the Surgeon General, for each training camp or post used as a training camp or recruiting station the strength of which is 10.000or more.
4.The duties of the nutrition officer shall be:
(a)To advise the commanding officer, the camp quartermaster, and the camp surgeon on al matters relating to the composition and nutritive value of foods.
(b)To inspect, as directed by the commanding officer, foods and rations in the hands of organizations with reference to nutritive value, freedom from adulteration, spoilage, or deteriora- tion from any cause.
(c)To cooperate with the School for Cooks and Bakers, where such school sexist, in the instruction of mess sergeants and mess officers in the fundamentals of nutrition, to wit, purposes served in nutrition by the different food stuffs (protein, fats, carbohydrates, mineral salts, vitamins) andthe proper construction of dietaries so as to insure a satisfactory distribution of these nutriments.
(d)To assist in the coordination of mess requirements with subsistence supplies. whether carried by the camp quartermaster or purchased locally.
(e)To cooperate with and advise the conservation and reclamation officer with reference to the best classification. separation, and disposition of wastes from food.
(f)To render directly to the camp commander reports on urgent food matters that require immediate executive action.
(g) To report through the camp surgeon on all matters relating to food conditions of the camp as these may affect the nutritional welfare of troops.
5.The nutritional surveys authorized will hereafter be conducted in such camps and with such frequency as may be deemed necessary by the Surgeon General.
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6. Nutrition officers in such number as the exigencies of the service may require, but not to exceed 20 in number, will be appointed from the officers of the Medical Corps, Medical Reserve Corps, and Sanitary Corps. for special detail in hospitals, hospital ships, laboratories, or to other departments of the service. The duties of such officers on special detail will be prescribed in orders assigning them to duty.
In accordance with this order personnel was appointed as shown in the following table: 13
Even before it became generally known that nutrition officers had been authorized, requests for them were received from many camps. As rapidly as suitable officers became available they were stationed first in these camps and, as far as the number would permit, in other camps with a strength of more than 10,000 troops.
On November 11, 1918, the following camps had been supplied, and a group of 20additional officers was training at Camp Greenleaf for assignment to other camps: 14 Camps Bowie, Beauregard, Cody, Custer, Devens, Dix, Dodge, Fremont, Funston, Grant, Humphreys, Hazelhurst Field, Camp Jackson, Kelly Field, Camps Joseph E. Johnston, Kearney, Lee, Logan, Meade, Pike, Sherman, Sheridan, Shelby, Zachary Taylor, Travis, Upton, and Fort Sill.
Usually nutrition officers were provided with enlisted assistants, either from this division or from some organization in the camp. In a few cases second lieutenants who had completed their course at Camp Greenleaf were temporarily stationed on special detail as assistants for the purpose of giving them experience so desirable as a preparation for assuming independently corresponding duties in other camps.
Improved results soon justified the stationing of officers, but from the following consideration it became evident that the personnel authorized for this division was insufficient.
The nutrition officer was continually finding himself confronted by situations demanding criticism, at least implied, for the methods of mess officers, and by the necessity of giving them advice. Unless his rank was about equal to theirs some embarrassment was likely to be caused, and his advice often did not receive the respect to which it was entitled. Apparently, therefore, the employment of second lieutenants as nutrition officers in any but small camps would not be productive of good results. But the combined number of captains and first lieutenants to be used as nutrition officers was only 23. 13 Moreover, from overseas came repeated calls for more officers, and as these calls naturally took precedence over domestic needs the force of men available was continually being depleted and it was never possible to provide for all camps
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contemplated in the order of authorization. Besides, a number of camps not included in the originally authorized list expressed a desire for officers.
Whilee vidently the first duty of the division was to safeguard the immediate nutritional interests of the soldier, yet it was also highly desirable to take advantage of such an extraordinary opportunity for scientific research, in so far as this could be done without in any way compromising this main duty or interrupting the training of the men to fight. Probably at no other time had so large a body of persons been available for observation regarding their nutri-tional welfare under such favorable conditions as in the American camps, and it appeared that if the war continued long many of the findings would soon have important application, not only in the Army but with the civilian population as well. Accordingly authorization for additional personnel to be detailed to special studies had been requested and was in contemplation by the General Staff when the signing of the armistice rendered such action unnecessary.
SPECIAL ACTIVITIES.
As was to be expected in undertaking a service of the kind outlined in previous sections, many problems were met which required immediate and intensified investigations. A number of university laboratories were placed at the disposal of the division. At its very inception an assurance was received from several governmental departments of a willingness to cooperate in any possible manner. Only a brief summary is presented here of the special studies which were undertaken and carried to at least partially successful completion: a
(a)Plans were made at an early date for the study of dehydration of various food materials. This problem was assigned to the Harriman re-search laboratory at the Roosevelt Hospital in New York City.15 The facilities of the laboratory had been offered to the Surgeon General through the generosity of its benefactress and its director. A member of the laboratory staff was commissioned a captain in the Sanitary Corps, sent to Camp Greenleaf for training, and later assigned to the Harriman laboratory in charge of special research under the direction of the Surgeon General. Several assistants were from time to time assigned to this laboratory. Besides the dehydration of food material the chemistry of meat spoilage was especially investigated at that place. The program outlined was agreed upon between the director of the division and the director of the laboratory.
(b)At the instance of the Bureau of Chemistry of the Department of Agriculture a special study upon the physiochemical properties of gluten was sponsored and supported by the division, with the laboratory of physical chemistry at Harvard University. The object of this investigation was to determine how the gluten strength of bread might be reinforced in order that substitutes for wheat flour might be used in larger quantities. 16
(c)The attention of the division was called to the possible changes in the condition of market meats by the United States Food Administration. The most recent analyses which were available had been made some 20 years ago, and the changes in feeding animals for the market, it was thought, might have brought about a considerable difference in the relative property of fat in the
a Paragraphs (a) to (h),inclusive, are abstracted from the volume on Sanitation, in which complete details regarding these investigations will be given.
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various kinds of meat as they were placed upon the market. An officer of the Sanitary Corps was assigned the task of supervising new analyses at the laboratories of the large meat packers inChicago.17 The packers showed every willingness to cooperate and in fact gave the use of their laboratories for the period of one month, during which sufficient knowledge was gained to make certain that no substantial change on account of newer methods of feeding had occurred.
(d)Instructions were given to survey parties at an early date to be on the lookout for an opportunity to study several nutritional problems upon which more information was needed.18Amongst these were: (1) The relation of diet to the incidence of disease, especially of incidence of colds and other respiratory infections of a minor nature. This was finally undertaken at Camp Wheeler in the spring of 1918. (2) The effect of military training on the physical development of the soldier with special reference to its nutritional aspects. Such a study was undertaken at Camp Devens by survey party No. 1; also at Camp Grant, Camp Dodge, Camp Funston, and Camp Pike. (3) The mineral composition of the ration as used, with particular reference to calcium, phosphorus, iron, and the balance of total acids and bases. Such studies were made at Camp Cody, Camp Fremont, and Camp Custer. Several of these studies yielded results which were considered of sufficient importance for publications. In addition, the personnel of the office, besides their administrative duties, made several contributions based upon the results of nutritional survey parties and the results of personal inspection.
(e)A ration balance devised to permit the mess sergeant to determine by mechanical means and without calculation whether the diet of his mess is properly balanced was patented and dedicated to the public by the chief of the division and one of hisassistants.19
(f)The following new rations were prepared in the office of the division. 20The first, known as the "Red Cross ration," for American prisoners of war, was prepared at the request of the National Headquarters of the American Red Cross. It was submitted to that organization and accepted by them, after which it was approved by the Surgeon General and forwarded for approval to the Secretary of War in October, 1917. Through a misunderstanding this ration was never put into effect, but upon receipt of complaints regarding the ration actually in use a second" Red Cross ration" for American prisoners of war was submitted, in August, 1918, at the request of the Acting Quartermaster General. This ration was adopted. A ration suitable for American prisoners ill in enemy camps was also called for by the American Red Cross and was submitted, in January, 1918, under the title "invalid ration" and was put into effect by order of the President.20
At the further request of the American Red Cross consideration was given to the problem of expending in the most economical manner, from the nutritional standpoint, the funds guaranteed by the Serbian Government for food materials to be supplied through Red Cross channels to Serbian prisoners in Austria-Hungary.20
Based on the nutritional surveys, an improved ration for the training camp was submitted by the Surgeon General to The Adjutant General under date of June 3,1918.21 As a result of this recommendation, the Secretary of War ordered the Quartermaster General to consider a revision of the ration and
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rationing system.22A conference was held at the office of the Quartermaster General on July 19,1918, at which were present representatives of The Adjutant General`s Office, Inspector General`s Office, Quartermaster General`s Office, War Plans Division of the General Staff, and the Surgeon General`s Office. 22 This conference approved the training ration recommended by the Surgeon General, but it was later disapproved by the executive division of the General Staff and instead changed to Army Regulations, Nos. 83, 84, and 86,effective April 1,1919, which were adopted.
(g)A considerable number of reports on spoilage of foods as noted by nutritional survey parties and nutritional officers were compiled and transmitted to the Subsistence Division, Purchase, Storage, and Traffic.
Reports were made on a considerable number of new food products submitted by the Subsistence Division for analysis tests in Army camps and recommendations regarding their suitability for use in Army messes.
(h)Standard specifications for various dehydrated products were worked out in cooperation with the Subsistence Division, Purchase, Storage, and Traffic, the Bureau of Chemistry, Department of Agriculture, and the United States FoodAdministration.23
OFFICERS SUPPLIED TO AMERICAN EXPEDITIONARY FORCES.
The first request that officers of the division be sent abroad was received in February,1918. It called for six officers, and early in March this number departed for foreign duty. 24 In May another request was received, and during June and July, 1918, 20officers were detailed overseas. 25 On November 16,1918, the final party, consisting of 10 officers, sailed. 26 All officers were dispatched at the request of the chief surgeon, American Expeditionary Forces. More had been called for and would have departed the latter part of November, but almost as soon as the armistice was signed further additions to the American forces in Europe were brought to a halt. The value of the work of these officers abroad was fully recognized by the repeated calls for more of them, and particularly by a request dated October 11, 1918,that every division of troops sent over should in the future have attached a division nutrition officer. 27 An account of the work of these men in Europe is comprised in a report of the chief surgeon, American Expeditionary Forces. 28
AFTER THE ARMISTICE-NOVEMBER 11, 1918, TO MAY20, 1919.
Soon after the signing of the armistice this division became the Section of Food and Nutrition of the Division of Sanitation. (See Chart XXIV.) The signing of the armistice naturally caused changes in the plans of the section. The training of additional personnel was interrupted at once, and the students taking the special course at Johns Hopkins University and also those at the school of Nutrition at Camp Greenleaf were recommended for honorable discharge. Three officers were assigned to duty at the port of embarkation, Hoboken, for the purpose of supervising mess conditions in the debarkation and transportation of troops, particularly the wounded, arriving from Europe. 29
The work in the hospitals was continued by an officer who made a special report, including appropriate recommendations to the commanding officer of each hospital visited. A copy of this report was submitted to the Hospital
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Division of the Surgeon General`s Office. 30 In this way, by bringing definite points of criticism to the attention of those concerned, uniform excellence was sought. A few matters which were constantly demanding attention were treated individually in short circulars, and one of these was issued in mimeographed form by the Surgeon General through the Hospital Division to the base and general hospitals under the caption, "Waste control." These bulletins comprised a discussion both of practical hospital mess management and of the scientific principles involved.
Survey parties in division camps had already been abandoned and their places taken by nutrition officers. They were still continued, however, in the aviation fields. Many of the latter were greatly in need of advice, and since nutrition officers were not authorized for camps of a strength less than 10,000troops the only way to assist was through the visits of itinerant parties. By November, 1918, nutrition officers had been long enough in the irrespective camps to permit of gauging with certainty the value of their efforts. Many reports fromthem,8 substantiated by camp orders embodying their recommendations, showed that commanding officers soon came to depend upon their advice; and they were thus able to effect many improvements.
All this work was soon more or less handicapped by the general let down in morale, due to the feeling that since the war was over, there was no further any real reason to maintain either the best nutritional conditions or the greatest economy. In camps where active demobilization was in process, it was nearly impossible for the nutrition officers to obtain active cooperation on the part of the mess personnel. On the other hand, where demobilization was less active and where the messes had already learned the desirability of the measures recommended, considerable progress was still made.
Demobilization within the section itself proceeded fairly rapidly. The large majority of the officers indicated their willingness to remain as long as their services might be particularly useful, but desired to return to civil life as soon as they could be conveniently spared. Several officers, on the other hand, desired to be transferred from a temporary status to the Regular Army and made application accordingly. In recommending officers for honorable discharge the plan was followed, as far as practicable, of reducing the number rather than the efficiency of the survey parties; and it also seemed wise to keep the divisional nutrition officers at their posts as long as the commanding officers thought their presence was urgent. In some cases the immediate need for nutrition officers was felt more than before. While the Army was in active training for European service, the great majority of company officers were only too anxious to learn anything that promised to be of assistance. After the armistice this condition no longer prevailed and the higher officers were often disturbed over the difficulty of maintaining satisfactory conditions.
With the diminishing personnel, the special lines of research were gradually abandoned. In the Harriman research laboratory, New York City, the researches in progress were pushed to early completion and the laboratory was completely demobilized before April 1, 1919.
Inthe division the following work was done: 31
1.A table of analyses for the use of nutrition officers or others in calculating the calorific value of foods usually sold at post exchanges was prepared.
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2. A recalculation of the survey reports was completed. This recalculation as necessary because it was feared that the extremely unfavorable conditions under which computations were necessarily performed in camp might be expected to effect the accuracy of the figures, and it was felt wiser to check them in the office where a computing machine and a library were available as well as a sufficient force experienced in this work. This computation involved: (a) Recalculation of food computation sheets according to the standard set of analyses, special care being taken to secure an accurate list of foods from a comparison of the food, food computation, cost, and menu sheets; (b) recalculation of waste, using the party data whenever complete-in the few cases where the data were incomplete the average garbage analysis was used; (c)calculation of a summary sheet from the new figures and a comparison of these sheets with the old ones in order that any source of discrepancy other than erroneous computations might be discovered.
While the average difference between the new and old results proved to be small, yet in individual cases large errors in the field reports occasionally crept in. The principal sources of these errors were faulty calculation and mistakes in treating crude fiber differently in food computation and waste calculation; also errors in conversion from the dry basis of analysis to the wet basis of the actual materials. It should be noted that only the figures having a bearing on the nutritional side of the surveys were recalculated. Cost figures, while undoubtedly also showing individual errors, were not recalculated since the primary aim of this work was to determine nutritional rather than financial conditions.
3.Studies were made and expressed in graphic or tabular form as follows:(a) Relation of the purchasing power of the quartermaster allowance to the cost of food for various months; (b)waste reduction at Camp Wadsworth; (c) relative amounts of animal and vegetable protein in 50messes; (d) post exchange consumption for 261 messes, tabulated and presented in the form of a distribution graph-cost per thousand calories of post exchange commodities in the same 261messes also shown in the same way; (e) number of articles purchased during one week by 290messes in the form of a distribution graph; (f) distribution graph of the weight of three groups of men at the time of enlistment and four months later; (g) nutrients consumed in different kinds of organizations; (h) comparison of the different rations of the allied armies; (i) distribution graph of the percentages of the total energy consumed as protein, fat, and carbohydrates in 427 messes;(j) comparison between the consumption of certain commodities in Army messes and in civilian families; (k) comparison of the energy values of the principal components of the garrison ration with their several substitutes.
4.At the request of Col. F. F. Russell, M. C., Chief of the Division of Laboratories and Infectious Diseases, a course of instruction on food and nutrition to be given at the Army Medical School with laboratory exercises was prepared.
The following course of instruction was prepared in the division:
(a) Food values...............................................................1 day.
(b) Inspection of food in markets and factories ......... 3 days
(c) Nutritional surveys; inspection and sanitation of
messes: hospital mess management...............................3 days.
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(d) Combustion of foods................................................. I day.
(e) Energy metabolism: Douglas bag method;
Benedict apparatus..........................................................2 days.
(f) Rebreathing tests for aviators.................................. 2 days.
(g) Blood changes:
Gases.................................................1 day.
Sugar and fat....................................1 day.
(h) Acidosis.-.-.................................................................1day.
(i) Protein metabolism ....................................................1 day.
(j) Acid-base equilibrium............................................... 1 day.
(k) Menus ....................................................................... 1 day.
Interpolated with above, the study of accessory food substances or vitamines and the corresponding deficiency diseases, scurvy, beriberi, pellagra. xerophthalmia, waredema, was conducted.
PERSONNEL.b
(April, 1917, to December, 1919.)
Murlin, John R., Lieut. Col., S.C., chief.
Eddy, Walter, Maj., S. C.
Forbes, E. B., Maj., S. C.
Gephart, F. C., Maj., S. C.
Hoskins, R. G., Maj., S. C.
Joseph, Don, Maj., M. C.
Mason, C. C., Maj., S. C.
Miller, C. W., Maj., M. C.
Milner, R. D., Maj., S. C.
Prescott, S. C., Maj., S. C.
Street, J. P., Maj., S. C.
Anderson, R. J., Capt., S. C.
Bell, R. D., Capt., M. C.
Blatherwick, N. R., Capt., S.C.
Dox, A. W., Capt., S. C.
Flanders, F. F., Capt., S. C.
Garrety, W. P., Capt., S. C.
Hildebrandt, F. M., Capt., S. C.
Mason, R. E., Capt., M. C.
Shohl, A. T., Capt., S. C.
Thomas, Arthur W., Capt., S.C.
Harrison, B. H., First Lieut., S. C.
Schaffer, Philip, First Lieut.,S. C.
Wachman, J. D., First Lieut., S. C.
Sweet, F. H., Second Lieut.,S. C.
REFERENCES.
(1) S. O., No. 205, W. D., September 4, 1917.
(2) Semi-annual report of Division of Food and Nutrition, S. G. O., ending December 31, 1917. On file, Historical Division, A. G. O.
(3) Letter from Surgeon General to Adjutant General, October 15, 1917. On file, Record Room, S. G. O., 720.1 (Food Survey).
(4) Letter from Adjutant General to Surgeon General, October 16, 1917. On file, Record Room, S. G. O., 720.1 (Misc. Div.).
_
b 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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(5) Letter from Surgeon (General to The Adjutant General of the Army, October 26, 1917, with second indorsement from Adjutant General, October 26, 1917. On file, Record Room. S. G.O., 720.1 (Misc. Div.).
(6) Letter from the Surgeon General to commandant, Medical Officers` Training (Camps, Camp Greenleaf, Fort Oglethorpe, Ga., March 7, 1918. On file, Record Room, S. G. O., 353(Nutrition, Camp Greenleaf) (C).
(7) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1026.
(8) Weekly reports, Division of Food and Nutrition. On file, Record Room, S. G. O., Weekly Report File; 720.1(Nutritional Surveys).
(9) Weekly reports, Division of Food and Nutrition, June 7, 1918, and June 20, 1918. On file, Record Room, S. G.O., Weekly Report File, and 720.1 (Nutritional Surveys).
(10) Weekly report, Division of Food and Nutrition, June 21, 1918. On file, Record Room, S. G. O., Weekly Report File.
(11) Weekly report, Division of Food and Nutrition, January 12, 1918 (Memo. attached. On file, Record Room, S.G. O., Weekly Report File.
(12) G. O., No. 67, Par. V, W. D., July 15,1918.
(13) Table F-I. Commissioned personnel for the Division of Food and Nutrition. Sanitary Corps, July 19, 1918. Onfile, Record Room, S. G. O., 024.13 (Food Division).
(14) List commissioned officers, with stations, Section of Food and Nutrition, December 4, 1918. On file, Record Room, S. G. O., 024.13 (Food Division).
(15) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1027.
(16) Report. On file, Record Room, S. G. O.,720.1-2 (Food, Analysis of), 1918.
(17) S. O., No. 43, W. D., February 20, 1918.
(18) Nutritional survey of camps, Table 2. Onfile, Record Room, S. G. O., 720.1 (Nutritional Survey), 1918.
(19) Ration Balance, Patented and Dedicated to the Public, by Lieut. Col. John R. Murlin and Capt. W. P. Garrety.
(20) Annual Report of the Surgeon General, United States Army, Vol. II, 1028.
(21) Weekly report, Division of Food and Nutrition, June 7, 1918. On file, Record Room, S. G. O., Weekly Repor tFile; Annual Report of the Surgeon General, United States Army, 1919,Vol. II, 1028.
(22) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1028.
(23) Inspection Manual of the Subsistence Division, Bull. No. 38, February 5, 1919.
(24) Cablegram from Gorgas to Pershing, No.769, February 11, 1918, par. 8. On file, Record Room, S. G. O.,Cablegram File. Cablegram 614, February 18, 1918, par. 5 from Pershing. On file, Record Room, S. G. O.,Cablegram File.
(25) Cablegram No. 1153, May 22, 1918, par.8. No. 1294, June 13, par. 3-a. On file, Record Room, S. G. O.,Cablegram File.
(26) Cablegram No. 262, October 11, 1918,par. 1. Request from Pershing. On file, Record Room, S. G. O.,Cablegram File.
(27) Copy of cablegram S.O. S. No. 262,October 11. On file, Record Room, S. G. O., 024.13 (Food Division).
(28) The Medical Department, A. E. F,, to November 11, 1918, IV, Office of the Chief Surgeon, Historical Division, April 17, 1919, 41. On file, Historical Division, S. G. 0.
(29) Annual Report of the Surgeon General, United States Army, 1919, Vol. II, 1029.
(30) Report of hospital nutrition officer. Onfile, Record Room, S. G. O., 720.1 (Nutritional Survey), Part No. 5.
(31) Weekly reports, Division of Food and Nutrition. On file, Record Room, S. G. O., Weekly Report File.
