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SECTION III.
CHAPTER III.
THE COMMITTEE ON MEDICINE, COUNCIL OF NATIONAL DEFENSE.
The following account of the medical activities of the Council of National Defense is based on a report rendered by the chairman of the committee on medicine. 1
ORGANIZATION.
The national defense act of June 3, 1916, created the Council of National Defense and the advisory commission.
The council was composed of six members of the President`s Cabinet-the Secretaries of War, Navy, Interior, Agriculture, Commerce, and Labor. The council nominated and the President appointed an advisory commission of seven especially qualified persons, each having knowledge of one great field. The General Medical Board, composed of representative medical men, was organized for the purpose of aiding in the enormous expansion of the various Government bureaus and coordinating with their work the resources and talent of the civilian medical profession. The board thus represented the civilian medical population in its relation to the four Government administrative offices of the Surgeon Generals of the Army, Navy, and Public Health Service, and the Red Cross, and through it the organization for war of the medical profession was carried out.
MEDICAL MOBILIZATION.
In the winter of 1916, when the necessity for a greatly enlarged Military Establishment became apparent in view of the possibility of this country entering the war, the committee on medicine of the Council of National Defense directed its energies to formulating plans for mobilizing the medical profession for service in the Medical Departments of the Army and the Navy. From a membership of approximately 1,800, including men beyond the military age and those physically ineligible for active field duty, the Medical Reserve Corps was increased to 21,000 by the end of the first year. At the time of the armistice, November 11, 1918, 30,144 physicians from civil life were in the service of the Army.
COMMITTEE ON STANDARDIZATION.
Because of the impending enormously increased demand on manufacturers of medical and surgical supplies to meet military needs, the committee on standardization was authorized February 2, 1917, for the purpose of standardizing essential medical and surgical supplies and equipment and to increase speed and reduce cost of production. This committee included in its membership representatives of the Army, Navy, and Public Health Service, and American Red Cross. Various subcommittees representing the medical specialties and manufacturers were appointed. With the hearty cooperation of the manu-
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facturers, who gave freely of their time and willingly adapted their facilities to Government needs, the result was an increase in the production of staple articles sufficient to meet the increasing requirements of the Army and Navy. Four catalogues of staple medical and surgical instruments and supplies were prepared and issued by this committee.
The Drug Division conducted an investigation of medical products for the Office of the Surgeon General of the Army and the Bureau of Medicine and Surgery of the Navy. In cooperation with other departments, inquiries were made into shortage of important drugs, the conditions being relieved in the majority of instances upon the organization of the War Industries Board. This committee was continued by the Section of Medical Industries of the War Industries Board.
GENERAL MEDICAL BOARD.
On April 2, 1917, the chairman of the committee on medicine nominated and the Secretary of War appointed a representative group of medical men to serve on the General Medical Board. An executive committee was appointed by the chairman to pass upon all matters brought before the larger body for consideration. The executive committee was composed of Surg. Gen. W. C. Gorgas, of the Army; Surg. Gen. W. C. Braisted, of the Navy; Surg. Gen. Rupert Blue, of the United States Public Health Service; Rear Admiral Cary T. Grayson, U. S. N.; Franklin Martin, M. D., chairman of the Committee on Medicine; F. F. Simpson, M. D.; W. J. Mayo, M. D.; C. H. Mayo, M. D.; Victor C. Vaughan, M. D.; and W. H. Welch, M. D.
Inline with the general policy of the Government to secure the best talent available in all lines of activity for the care and welfare of the Army then in process of formation, committees representing every specialty in medicine were appointed by the General Medical Board. The committees were composed of the leaders in their respective specialties and representatives of the governmental medical departments.
These volunteer workers met at frequent intervals and in their advisory capacity laid down the general scientific program which was followed by the Government medical bureaus in the conduct of their activities during the period of the war. Shortly after their organization many of these committees were gradually absorbed by the executive bureaus of the Government and their work continued as working components of the military machine.
By this plan American doctors were enabled to work in the Army in line with their civil experience for the first time in history.
COMMITTEE ON COMBATING VENEREAL DISEASES.
One of the most important and far-reaching contributions of the General Medical Board toward the successful prosecution of the war was its active interest and energetic assistance in the work of its committee on civilian cooperation in combating venereal diseases. An educational campaign for national support of the social hygiene program was inaugurated through the distribution of circulars and circular letters; joint conference of medical and lay citizens; cooperation with advertisers and press association committees; communication with governors of all the States by wire and letter, urging recognition of the emergency and drastic action in dealing with venereal diseases; suggestions to
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State boards of health as to measures essential to a successful campaign; appeals to pharmaceutical associations and boards of associations and boards of pharmacy to eliminate the advertising and sale of venereal disease nostrums: and requests to mayors of a thousand cities and towns, especially in the vicinity of camps, to enforce existing laws and to enact necessary legislation. Many lecturers were sent out, and editors of health bulletins and labor journals were kept informed regarding the progress of the campaign. Extensive use was made of the cinematograph, and "movie" pictures proved to be very popular and instructive.
COMMITTEE ON DENTISTRY.
Within a year after the United States declared war against Germany the number of dental officers was increased in the Dental Corps of the Regular Army from 58to 209, in the National Guard to 259, and in the Dental Reserve Corps to 5,196--a sufficient number to supply the quota permitted by law for an army of 5,664,000 men.
In the rapid development of the dental service all credit is given to the patriotism of the members of the dental profession, the various preliminary dental examining board, dental faculties, dental manufacturers, and officers and members of the Preparedness League of American Dentists. The official record showed 613,285 gratuitous dental operations performed by the members of the last-named organization. This organization was also largely responsible for the three dental motor-car ambulances presented to the Surgeon General of the Army.
The committee on dentistry cooperated with the deans of dental schools and arranged for the enlistment of dental students in the Enlisted Medical Reserve Corps and their assignment to the inactive list. A survey of dental and oral hospital physicians was made. Improved courses in the Army and Navy Medical Schools for Army and Navy dental surgeons were recommended. A school of instruction for dental officers was opened March 15, 1918, at Camp Greenleaf, Fort Oglethorpe, Ga.
The United States was, thus, the only country giving extensive training in military and professional subjects to dentists, and this Nation had a greater number of dental officers subject to military call than all other allied nations combined.
In cooperation with dental manufacturers, dental instruments and supplies were standardized.
EDITORIAL COMMITTEE.
With the idea of being of immediate and direct benefit to the largely increased numbers of medical officers who had not had military medical experience, the General Medical Board authorized the editorial committee to proceed with plans for the publication, in pocket manual form, of textbooks epitomizing the surgical and medical experience acquired in the war up to the time of going to press, and written by men especially qualified by training and by war experience; eight of these manuals were prepared.
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COMMITTEE ON HOSPITALS.
Through the efforts of the committee on hospitals the general hospitals of the country were reorganized in order to release for military service as many as possible of the members of their staffs.
The hospitals were classified as to size, convenience to railroads, facilities for expansion, and equipment for handling special work. The various special, private, and convalescent hospitals, sanatoria, and dispensaries were inventoried, and the various phases of the hospital needs, present and presumptive, were investigated.
COMMITTEE ON HYGIENE AND SANITATION.
The efforts of this committee were largely directed to questions concerning the combating of venereal diseases and the control of the sale of alcoholic beverages within the camps and extra cantonment zones. It also concerned itself with the problems of drug addiction, public health nursing, tuberculosis, and health statistics.
COMMITTEE ON INDUSTRIAL MEDICINE AND SURGERY.
This committee, which was organized on January 28, 1918, included in its membership representatives of the Departments of Agriculture, Commerce, Interior, and Labor, of the United States Public Health Service, and of industry, manufacturers, and the medical profession.
The committee recognized that the state of war made it imperative (1) to provide against unnecessary human waste in industry and society during the war; (2) to offset the drain on industry of man forever caused by the raising of military forces; (3) to meet the need for greatly increased production; (4) to avoid preventable deaths and disabilities from accident and disease; (5) to restore to full producing power in the shortest possible time sick and injured workers; (6) to increase output by keeping workers in good health; (7) to provide healthful places in which to work; (8) to provide healthful homes and communities in which to live; (9) to meet shortage of medical service inducted by military needs. A program was outlined along these lines, which, upon the recommendation of the Council of National Defense, was referred to the United States Public Health Service for execution.
COMMITTEE ON LEGISLATION.
The committee on legislation interested itself at the outset in the safeguarding of troops from vice in the zone around camps and cantonments, section 13 of the Army bill of 1917 being the result of its activities in this direction.
Through this committee the authorities were induced to provide for the enlistment of medical students of recognized schools in the Medical Enlisted Reserve Corps, thus, while not exempting them from military service, allowed them to finish their course.
Through the efforts of the committee the Federal Trade Commission granted licenses to American concerns to manufacture salvarsan and other German preparations.
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As a result of the activities of this committee supported by the General Medical Board and State and county committees of the Council of National Defense legislation was enacted on June 30, 1918, as part of the Army appropriation bill, placing the Medical Department on the same footing in regard to rank as the other branches of the Army.
COMMITTEE ON NURSING.
Through the committee on nursing, with a subcommittee on public health nursing, a comprehensive survey of the nursing situation of the country was made for the benefit of the Army, Navy, Public Health Service, and American Red Cross. A campaign was inaugurated to interest young women in nursing as a career and to enlist trained nurses for duty with the fighting forces.
The committee championed the cause of securing rank and increased pay and allowances of nurses.
A plan was inaugurated whereby students might be supplied to the training schools, thus relieving the pressure of responsibility which fell of necessity upon the senior students in training. The plan, carried out through the State and local divisions of the woman`s committee of the Council of National Defense, included the recruiting of candidates and their assignment to the schools which expressed a need for students.
Many other activities were inaugurated by the committee on nursing, all looking to the betterment of the nursing facilities of the country, the fullest utilization of nursing material, potential and actual, and the securing of the comfort and improving the status of nurses.
COMMITTEE ON RESEARCH
The committee on research conducted its activities in cooperation with the National Research Council (q. v.). The committee investigated, through the laboratories available for its purposes, the vast number of medical preparations and appliances submitted to the Army and Navy for adoption by private individuals and firms. A report was made to the departments interested, with recommendations as to the adoption or rejection of the given product or appliance.
COMMITTEE ON STATE ACTIVITIES.
Upon its appointment, in April, 1917, this committee, with the assistance of the State and county committees of the Council of National Defense, concentrated its efforts primarily upon supplementing the activities previously initiated by the committee on medicine to increase the enrollment of medical men throughout the country in the Medical Reserve Corps.
The committee cooperated with the committee for civilian cooperation in combating venereal disease; it indorsed and recommended that State and county committees support the bill for increased rank for medical officers in the Army and for those engaged in various other lines of cooperative work.
COMMITTEE ON SURGERY, WITH SUBCOMMITTEES ON OPHTHALMOLOGY A D OTOLOGY, RHINOLOGY, AND LARYNGOLOGY.
Upon the recommendation of the committee on surgery, the records of the members of the Medical Reserve Corps were classified according to professional and military qualifications and this information supplemented by
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confidential information as to ability for certain appointments in the military service. This information was transferred to code cards, one set remaining in the offices of the Council of National Defense and two sets being forwarded to the Surgeon General`s Office, one for retention there, the other sent to General Pershing`s headquarters in France.
The subcommittees on surgical specialties cooperated with the committee on surgery. An exhaustive study was made of the ear protectors in order to ascertain the best protectors for use in the service. Tests were made and a report submitted to the Surgeon General. A report was also made to the Surgeon General regarding the reconstruction of defects in hearing and speech.
In July, 1917, the two subcommittees met together as a committee on head surgery. This joint committee recommended special hospitals for the treatment of eye, ear, nose, and throat cases, and prepared plans for special hospital and dispensary buildings in cantonments. It was also recommended that specialists trained along certain lines be assigned to special duty in military hospitals. It was further recommended that for each group of several general hospitals there should be a head hospital, with one brain surgeon and four assistants; one chief ophthalmic surgeon with two assistants; one chief nose and throat surgeon and four assistants; and that four ophthalmic and six ear, nose, and throat surgeons be assigned to each division of the mobile forces. These recommendations were practically all adopted by the Surgeon General in the organization known as the Head Surgery Section of the Division of Surgery.
COMMITTEE OF WOMEN PHYSICIANS.
The committee of women physicians made a comprehensive survey of the women doctors of the country, of whom the census taken showed 5,969--5,788 being inactive practice. Indorsed lists of anesthetists, laboratory workers, radiographers, and sanitarians were prepared with the assistance of experts in each line. Women physicians were recommended by this committee for service as contract surgeons in the Army, for duty with the United States Public Health Service, and to fill places in institutions and communities left vacant by the demand for men doctors in the military service.
COMMITTEE ON CHILD WELFARE.
At a preliminary conference attended by 21 representatives of various organizations, educational institutions, and governmental bureaus interested in child welfare, the following recommendations, many of which were. acted upon, were made to the Council of National Defense:
1. That public-health nursing be officially recognized as war service.
2.That special effort be made to enlist college and high-school graduates for hospital training courses.
3.That volunteer aides for public-health nurses be properly trained.
4.That all communities be urged to stimulate activities pertaining to infant and child welfare.
5. That special provision be made to keep the mother and her young children together in the home.
6. That there be special supervision to day nurseries.
7. That rigid enforcement of child-labor laws be recommended.
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8. That the Government be asked to assure adequate support for soldiers and their families.
9. That inquiry be made as to the need among the allied nations for maternity care and infant and child-welfare work that could properly be performed by Americans.
10. That a national committee on child welfare he organized, including representatives of interested organizations.
COMMITTEE ON REEDUCATION AND REHABILITATION.
As a result of the recommendations of this committee, a plan for the formation of a reconstruction board was presented to the Secretary of War. A conference was called in Washington on January 14, 1918, to which representatives of the departments interested were invited, for the purpose of formulating a definite plan of action. A bill providing for the vocational rehabilitation and return to civil employment of soldiers and sailors disabled in the line of duty was drafted, but was not submitted to Congress. The passage of the Smith-Sears Act on June 27, 1918, placed the supervision of the reeducation in the hands of the Bureau of War Risk Insurance and the Federal Board for Vocational Education.
VOLUNTEER MEDICAL SERVICE CORPS.
The Council of National Defense, upon the recommendation of the chairman of the Committee on Medicine, authorized and directed the committee to organize the Volunteer Medical Service Corps, to be composed of physicians ineligible for appointment in the Medical Reserve Corps on account of age (over 55), physical disability, or civil or institutional needs, and women physicians. The scope of the Volunteer Medical Service Corps was later enlarged to include every physician in the country not already in Government service. An intensive campaign for enrollment, initiated in September, 1918, brought nearly 60,000 applications for membership before the end of October, the physicians pledging themselves to place their services at the Government`s disposal to perform any duty assigned to them.
The information furnished on the application blanks was transferred to code cards, making available on short notice all information in reference to each applicant. These code cards were filed in the Surgeon General`s library, and the information thereon was accessible to any of the governmental departments which had occasion to make use of it.
In addition to the more conspicuous activities of the Committee on Medicine outlined above, many impromptu conferences and committee meetings were held for the consideration of specific matters on which the executive departments desired recommendations, and thousands of communications were addressed to the physicians of the country, executives of hospitals, and medical schools, nurses, dentists, and manufacturers of medical, surgical, and pharmaceutical supplies in the prosecution of the war program by the committee.
REFERENCES.
The Committee on Medicine of the Council of National Defense, by Col. Franklin Martin, M. C., chairman of the General Medical Board and member of the Advisory Committee of the Council of National Defense. On file, Historical Division, S. G. O.
