ARMY MEDICAL SCHOOL
The Army Medical School was established in Washington, D. C., in 1893.1 It was housed in the Army Medical Museum, Seventh and B Streets SW.,2 until 1910, when it was moved to a building at 721 Thirteenth Street NW.3 Following our entry into the World War, the increase in the Army and the resultant increase in the number of medical officers applying for commissions in the Regular Corps, together with the necessity for the special training of large and increasing numbers of enlisted men as laboratory technicians, and of medical reserve officers in orthopedic surgery and as X-ray operators, which was now attempted, plus the enormous increase in all other activities of the school, rendered this building inadequate. It was found necessary, therefore, to seek more space and, to accomplish this end, the premises at 458 Louisiana Avenue (fig. 26) were rented and fitted up as office rooms, metal and wood working shops, plaster bandage shop, miscellaneous laboratories, drafting and class rooms.4 This building, of three stories, a basement, and an attic, contained 16 rooms (uot including the attic) and a stable, the total floor space, exclusive of the basement, being 4,800 square feet.4 Later, it became necessary to further expand the school by leasing and remodeling the premises at 472 Louisiana Avenue. (Fig. 27.) This building was lighted by windows practically on four sides, and contained approximately 22,000 square feet of floor space.4
The primary object of the school, at the time of its organization, was the training, in their multifarious medicomilitary duties, of young medical officers recently commissioned in the Regular corps.2 Shortly after its estab1ishment, however, officers of the National Guard and Organized Militia in limited numbers were given instruction at the school.5 It was soon found that the plan of commissioning young officers and then assigning them to the school was unsatisfactory, as the students did not show the proper zeal for class standing.6 Therefore, beginning in 1905, applicants for commission were sent to the school and given the course of instruction and a final examination at the completion thereof before they were commissioned in the Regular corps.7 With the creation of the Medical Reserve Corps, in 1908, it was provided that officers of this corps who applied for appointment in the Medical Corps of the Army might be placed on active duty by the Secretary of War, upon the recommendation of the Surgeon General, and ordered to the Army Medical School for instruction and further examination to determine their fitness for commission in the Medical Corps. 8
This plan has been followed since, but with the expansion of the Army which immediately preceded and followed the entry of the United States into the World War, the automatic increase in the size of the Medical Corps, and the large increase in the Medical Officers’ Reserve Corps, it became necessary to
elaborate the schedule of training. Arrangements were then made for postgraduate instruction for selected medical officers, and for courses of instruction in special subjects for Medical Reserve Corps officers detailed to the school for this purpose. 9
At first, the course of instruction covered a period of four months; 2 it was increased from time to time until it extended over a period of about eight months.11 The scope of instruction was likewise increased. 11 Beginning with the twenty-first session, on October 1, 1916, owing to the increase in the number of vacancies in the Medical Corps caused by the increase in the Army as noted, it became necessary to change the period of the course of instruction from one eight months’ course per year to three courses of about 12 weeks each.12
FIG. 26 - Army Medical School, Washington, D. C. Main building
At the time the United States entered the World War, the main purpose and function of the Army Medical School had become: (1) The instruction of medical officers and enlisted men in the special duties connected with their professional activities in the military service, in as large numbers as possible and iii time shortest possible space of time. (2) The manufacture of prophylactic antitoxins and other biological products for use in the Army, Navy, and other Government bureaus. (3) Special research investigations relating to the medical service of the Army. (4) Miscellaneous activities, such as physical examinations of officers and enlisted men, and the examination of laboratory supplies and apparatus, with a view to their adoption or rejection for the military service 9
ORGANIZATION AND ADMINISTRATION
The organization of the school now embraced the following: Administration and supply, departments of instruction, vaccine manufacture, research, and other activities.13 The personnel at the beginning of the war consisted of the commandant, adjutant, personnel adjutant, supply officer, 20 enlisted men, and 4 civilian employees, who were engaged in the administration of the school, and the faculty, made up of the commandant, who was president, professors, assistant professors, and instructors.
The commandant, professors, and assistant professors were detailed by the War Department from among the officers of the Medical Corps. Special professors were nominated by the faculty with the approval of the Surgeon General from among the distinguished members of the Medical Reserve Corps, and the instructors were officers of other branches of the Army detailed by the War Department to give special courses of instruction.11
The faculty arranged the program of instruction, prescribed the textbooks appropriate thereto, allotted the time devoted to each subject, prescribed, the character and scope of examination, and determined the proficiency of students, subject to the express provisions of law, orders, and regulations.11
The general administration of the school was intrusted to the commandant.11 The adjutant was chosen by the commandant from among the professors and assistant professors; he was the custodian of the records of the faculty, he conducted the correspondence of the school and promulgated the orders of the commandant. The property officer was likewise selected by the commandant from among the professors and assistant professors. He was accountable for all property of the school, made authorized purchases, and certified accounts.
Due to the large increase in the number of students, both of officers and enlisted men, and to the large increase in the size of the detachment of enlisted men on duty at the school, it became necessary to appoint a personnel adjutant soon after war was declared in order to relieve the adjutant of some of his responsibilities.14
The strength of the Medical Department detachment of enlisted men on June 30, 1916, was 20, all grades. On June 30, 1917, the strength had increased to 39 in the following grades: 14
Master hospital sergeants................................................7
Sergeants, first class...................................................4
Privates, first class....................................................6
By June 30, 1918, the strength of the detachment had increased as follows: 14
Joined by transfer.....................................................427
The losses during the year were 427, leaving a strength present on June 30, 1918, of 649. This included students as well as men permanently assigned to the school. During the next year there was a gain of 547 and a loss of 1,039, leaving a strength of 157 on June 30, l919.15 At the beginning of the twenty-first session the civilian personnel consisted of 4 civilian clerks, including the chief clerk. By June 30, 1917, 2 additional clerks had been added to the force, and in addition a telephone operator, an X-ray technician, a mechanic, a carpenter, and 2 watchmen had been added to the force. The expansion of the activities of the school made it necessary later to increase the number of clerks to 10. Five women laboratory technicians were also employed and rendered excellent service in the laboratories. The increase in the number of branch telephone stations throughout the school, the operation of 4 trunk lines with the main telephone exchange and 4 tie lines with the War Department switchboard, necessitated the employment of 2 telephone operators.
DEPARTMENT OF INSTRUCTION
OFFICERS’ BASIC COURSE
The period of the war embraced part of the twenty-first session and the entire twenty-second and twenty-third sessions of the school. Each session, consisting of 12 months, was divided into three sections of approximately 4 months each, during which a complete course of instruction was given. The twenty-first session extended from October 16, 1916, to October 4, 1917, and was divided into three sections as follows: The first section ending February 28, 1917; the second beginning March 14, 1917, and ending June 5, 1917; the third beginning August 1, 1917, and ending October 4, 1917.4 The twenty-second session began November 12, 1917, and was divided into three sections, the first beginning November 12, 1917, and ending February 5, 1918; the second beginning March 11, 1918, and ending June 15, 1918; and the third beginning July 10, 1918, and ending October 7, 1918.4 The twenty-third session of the school began November 12, 1918, and ended February 1, 1919.16
The course in military surgery consisted of didactic lectures on gunshot, sword, saber, and bayonet wounds, illustrated by lantern slides, skiographs, and pathological specimens.4 It embraced the mechanics of projectiles, the different kinds of projectiles used in modern warfare, their effect upon the various tissues and organs of the body at different ranges; complications; the action of explosives on the tissues; the treatment of gunshot wounds and their complications on the battle field and at field and base hospitals; etiology, signs, symptoms, and treatment of traumatic aneurisms; varieties of wounds produced by cutting and penetrating weapons and their treatment, wound infections and their treatment, and statistics of battles and campaigns. To this course was added, in the later sessions, the bacteriology of war wounds, and methods of combating primary and secondary infection; in fact, all the methods which had been devised since the outbreak of the war for treating war wounds, including the preparation of patients for transportation and the statistics of the traumatisms of war, were taught. During the twenty-second session call was
made upon officers who were well known for their special professional qualifications in surgery of civil life and upon officers who had participated in war surgery in France for special lectures on this subject.4
A course in orthopedic surgery was established at the school November 12, 1917, primarily for the training of students sent to the school to receive special training in this subject.4 Later, however, it was made an integral part of the curriculum, and the classes taking the basic course at the school were given instruction in this subject. The course included the study of anatomy and surgery of muscles and joints of the upper and lower extremities, back strain, foot strain and deformities, shoe fitting, amputation, splint, brace and plaster technique, and artificial limbs. This instruction was given by lectures and clinics at the Army Medical School and at the Walter Reed General Hospital, Takoma Park, D. C.
MEDICAL DEPARTMENT ADMINISTRATION
The course in Medical Department administration included Army Regulations; the Manual for the Medical Department; customs of the service; current War Department general orders, circulars, and bulletins; and methods of administration, with all blank forms in use.14 It comprehended in detail: 14 (1) Organization of the Army; territorial departments and tactical divisions; organization and duties of each corps and staff department; military rank, command, and precedence; military discipline, honors, ceremonies, official and semiofficial and personal courtesies and customs. (2) Laws and regulations in regard to the appointment of cadets and officers; promotion, retirement, and resignation; death and burial of officers; personal and efficiency reports; method of obtaining pay, quarters, and all allowances of every kind under each staff department, with all blank forms used. (3) General recruiting service and methods of enlisting at stations, with all circulars, reports, and forms. (4) Descriptive lists: Methods of muster and pay, drawing and issuing clothing and keeping accounts, discharges, and final statements, all allowances of every kind under all departments and blank forms used. (5) All laws, regulations, orders, and methods concerning the Hospital Corps, and the Army Nurse Corps. (6) Regulations: Visual and other physical standards for admission to the United States Military Academy; commissions in line or staff of the Army, promotion from the ranks; reenlistments and promotion. (7) Annual physical examination of officers and tests of field officers; duties of medical officers on all boards of examination, promotion, and retirement, and examination forms used. (8) Laws, regulations, and methods governing vaccination, typhoid prophylaxis, and venereal prophylaxis, with blank forms used. (9) Military correspondence: Forms of letter writing and methods of recording and filing in use in the service. (10) Methods of drawing rations or commutation therefor, and use of the ration under all conditions; purchase; hospital fund, its use, care, and returns; mess management. (11) Post administration: Duties of medical officers; sanitary inspections and reports; sick calls; morning reports; post hospital and general hospital administration. (12) Methods of keeping
register of sick and wounded: Reports, papers, and methods connected therewith, and all forms. (13) Morbidity and mortality rates. (14) Property: Allowances, methods of obtaining, caring for, using, accounting for, and disposing of property of all departments and all forms connected therewith. (15) Methods of purchasing necessary supplies and of having laundry work done.
This course was somewhat condensed during the twenty-second session in order to allow more time for instruction in other subjects.
The course in military hygiene was unavoidably modified in many respects from the pre-war course, owing to the fact that now there were three short sessions instead of one long one.14 Formerly, the instruction had been mainly by lectures, supplemented by a quiz, but on account of the necessity of crowding so much material into a short time, it was found expedient to resort to the quiz method. Textbook descriptions were subjected to comment and criticism based on the personal experience of the teacher in Panama and in various Army camps. The students were encouraged to relate their own experiences. The course was based on Havard’s Military Hygiene. The graduates were well grounded in the essentials of the subject and were able to intelligently take up practical work in the field.
The following subjects were covered, in more or less detail: 14 (1) Camp hygiene; morbidity and mortality in the military service in peace and war; death rates; admission rates; noneffective rates; rates of discharges for disability; influence of climate, race, age, and length of service; the examination of recruits. (2) Air, its composition and relative humidity; effects of altitude, atmospheric dust, ventilation, air contamination; modern theory of bad effects of ill ventilation, tests for air; amount of space required; air purification; food, including the soldiers’ ration; clothing, qualities of textile fabrics, footwear. (3) Posts, barracks, and quarters; construction and care of same; kitchens and mess rooms; the guardhouse; insects and vermin; screening; hygiene of the march; personal hygiene of the soldier; camp sites; their selection and care; improvised and portable barracks. (4) Water supplies; quantity required; methods of examination of potable waters; purification of water (a) by heater, (b) by chemical means, (c) by filtration; the Forbes-Waterhouse apparatus; the Darnall filter; the Lyster water bag; domestic filters; sand filtration; mechanical filtration; improvised filtration. (5) Methods for the disposal of camp excreta; the straddle trench; the pit latrine; the Havard box; postholes; the sanitary trough latrine; disposal of excreta by incineration; disposal of wastes, garbage, and refuse; the company crematory; the rock-pile crematory; lavatories; the disposal of manure. (6) Typhoid fever in the military service; history and importance of the subject; paratyphoid fever; the dysenteries; cholera; diarrhea and other intestinal diseases; methods of spread; methods of control; antityphoid vaccination in the Army. (7) Smallpox; vaccination; the other acute exanthemata; measles; mumps; meningitis; diseases of the respiratory tract; tonsillitis, bronchitis, and pneumonia; chronic diseases in the Army; tuberculosis; heart disease; the hookworm;
skin diseases. (8) Malaria in the Army; the prophylaxis of malaria; mosquito prophylaxis; screening; drainage; brush cutting; prophylactic administration of quinine; dengue; yellow fever; the Stegomyia mosquito; insecticides; typhus fever and its prevention; the effects of cold and hot climates.
The textbooks used for the course were: 14 Vedder’s Notes on Sanitation; Lelean’s Sanitation in War (containing concise and up-to-date descriptions of methods then in use by the British); and Havard’s Hygiene, for reference and collateral reading.
MILITARY AND TROPICAL MEDICINE
The course in military and tropical medicine consisted of assigned reading in textbooks, and recitations, supplemented by talks when considered advisable.14 The course was given at the time and parallel with the course in bacteriology, pathology, and laboratory diagnosis, so that when a disease-producing organism was being studied in one course, that disease was studied in the other course. Special attention was paid to the gross and microscopic study of the tissues in each disease; and many of the recitations were held at the Army Medical Museum where the immaterial in the museum was utilized. The course included: (1) The military aspects of general medicine. (2) The military aspects of tropical medicine. (3) Climate and race; effects of diet, temperature, humidity, and light, acclimatization; prophylaxis. (4) Traumatisms; poisons. (5) Enteric fevers, with special reference to the method of handling those diseases in the military Service; yellow fever; dengue and allied fevers; bacillary dysentery; Asiatic cholera; leprosy, plague, malta fever, infectious jaundice; yaws; relapsing fever; syphilis as handled in the Army; typhus fever; sprue; the mycoses, with special stress on sporotrichosis; pellagra; beri beri; amebic dysentery and amebic liver abscess; trypanosomiasis; the leishmaniases; verruga peruviana and oroya fever; malaria and black water fever; ankylostomiasis; schistosomiasis; and filariasis.
By a method of exchange of lectures, two or more lectures were given to the class by members of the staff of the Hygienic Laboratory of the Public Health Service.14 The subjects of the lectures were typhus fever, plague, leprosy, and rabies. The chief of the division of zoology, Bureau of Animal Industry, Department of Agriculture, gave one lecture on what was being done in the way of preserving meat, with special reference to trichiniasis.14
BACTERIOLOGY, PATHOLOGY, AND LABORATORY DIAGNOSIS
This course consisted of practical laboratory work, the outlines of which were laid down in the instruction sheets issued each day to the students. Reading lessons were also assigned in textbooks, with short talks supplementing the texts when it was considered desirable.4
Bacteriology. - Preliminary work on the preparation of culture media; and bacteriological technique, using the proteus group for the purpose.
The colon group; and bacteriological examination of water, based on standard methods of water analysis of the American Association of Public Health, 1912.
Bacteriological examination of milk, based on the standard method of the American Association of Public Health, 1915.
Bacillus typhosus, B. paratyphosus A. and B. paratyphosus B: The practical isolation from blood, stools, and urine, and their identification, including the preparation of Endo media.
Bacillus dysenteriae: Practical isolation from stools and identification.
The diphtheria group: Practical isolation and identification; Schick test.
Diplococcus pneumonia: Isolation and identification of the type.
Miningococcus: Isolation and identification.
Streptococcus:Isolation and identification.
Anaerobes: Bacillus tetani and B. welchii.
Spirochaetae. - The parasitic spirochetes of the mouth; the blood spirochetes; Treponema pertenue and T. pallidum; study with dark field and in stained smears and sections. Examination of spinal fluid; cell count globulin; Lange’s colloidal gold test.
Serology. - Complement fixation, with practical work on the application of this test in the diagnosis of syphilis. Agglutination test for transfusion of blood.
FIG. 28. - Army Medical School. Bacteriology classroom.
Hematology. - The principles and preparation of Romanowsky stains. Preparation and examination of fresh and stained smears of normal blood; staining and studying smears of blood in the ordinary blood conditions as leukemias and anemias.
Protozoology. - Study of fresh material of the culture and parasitic amoebas; preparation and study of stained smears of culture amoebae preparation and examination of stained smears and tissue sections of the parasitic amoebae.
Trichomonae, Lamblia, Trypanosomes, with a description of their line of descent. Preparation and examination of fresh and stained smears of Trypanosoma lewisi, T. evansi, T. brucei, and T. gambiense. Study of stained smears of Trypanosomes, including Trypanosoma cruzi; staining and studying sections of brain in sleeping sickness; and of brain and muscle from animals infected with Trypanosoma cruzi.
Preparation and study of fresh and stained smears from cultures of Leishmania infantum; preparation and study of sections of liver and spleen of Kala azar; Babesia bigemina, and Theileria.
The coccidia in feces and in sections of tissue. The blood sporozoa, including preparation and study of fresh and stained smears of Proteozoa, stained smears of Haemoproteus;
staining and study of smears of Plasmodium vivax, P. malariae, and P. falciparum staining and study of tissues in malaria; study of urine and tissues in black water fever; Gregarines; Sarcocystis.
The ciliates, with study of fresh specimens of Paramoecium and Myctotherus; examination of human feces containing Balantidium coli, and staining and studying sections of intestine of pig, with ulcers containing Balantidium coli.
Immunity in protozoal infections.
Chlamydozoa. - Rabies. Staining and studying sections of brain containing Negri bodies.
While most of the time is devoted to the protozoa parasitic in man, the work is taken up systematically; and there is constant comparison with the protozoa parasitic in lower animals and the free living protozoa.
Helminthology. - Cestodes: Taenia; Hymenclepis; Dipylidium; Dibothriocephalus. Study of adult worms and larvae. Echinococcus.
Trematodes: Clonorchis; Opisthorchis; Paragonimus; Schistosomes.
Nematodes: Ascaris; Oxyuris; Ancylostomum; Necator; Trichocephalus; Trichinella; Strongyloides; Filaria.
The course is given systematically, and the work consists in the study of human stools containing ova; study of preserved material and museum specimens; obtaining and studying living material from human beings and lower animals, and the preparation and preservation of material. Constant reference is made to the common occurrence of parasitic worms in lower animals. Special stress is placed on micrometry in this work. The entire life history of trichinella (living) is shown in rats; Hymenclepis nana (living) is shown in rats; the embryos of Filaria bancrofti (living) are shown in human blood; and, wherever possible, living material is used in the work.
Medical entomology. - Crustacea: Cyclops.
Arachnidia: Pentastomida; Acarina, including Demodicidae, Sarceptidae, Trombidiidae, Ixodidae, Scorpionidea; Aranedia.
Insecta: Hemiptera, including Aptera--Pediculidae, Heteroptera--Cimicidae, Reduviidae, and Homoptera; Mallophaga; Hymonoptera; Coeloptera--weevila, Spanish fly; Lepidoptera; Orthoptera; Diptera. In the important order Diptera are taken up the Aphaniptera-- Pulicadae and Sarcopsyllidae; Pupipara, Brachycera--Tahanidae, Muscidae (Stomoxys, Glossina, Musca, Auchmeromyia, Cordylobia, Galliphora, Lucillia, Compacmyia), Oestridae Nomatocera--Blepharoceridae, Simulidae, Chironimidae, Psychodidas, Culicidae. In the important family of the Culicidae are studied the Anophelines, Culicines--Culex, Aedes, Mansonia, and Taeniorhynchus. A short time is spent on the Corethrinae, on account of their frequent confusion with mosquitoes.
The work is taken up systematically, and special attention is given to life history, habits, and structure as related to parasitism and transmission of disease-producing organisms. Thus, special study is given to the life history of Musca domestica, the part it plays in the transmission of typhoid fever and other diseases, and the methods of fighting it. The work consists of the study of fresh material; obtaining, preparing, and preserving material; and tile study of preserved material, models, and museum specimens.
Venomous animals, venoms and antivenoms. - Special study is given to venomous snakes, and museum specimens of the common venomous snakes and the venomous lizard of the United States. Venoms are discussed and the various antivenoms are shown and their use discussed.
The shortening of the time devoted to the course made it necessary to leave out considerable work, including that in general pathology, to which considerable time was devoted in the longer pre-war course.
There are frequent practical exercises, in which the students arc required to work out “unknowns” arranged as nearly as possible like the work they may expect to meet in the service.
In April, 1917, when war was declared, the X-ray laboratories occupied the first floor rear of the building at 462 Louisiana Avenue NW., Washington, D. C., and the photographic work of the school was done there. The laboratories consisted of the following sections:17 (1) Laboratories for patients, where cases referred from the physical examination room, Surgeon General’s Office and the attending surgeon’s office, were examined. (2) Laboratory for instruction, which adjoined the patients’ laboratory. (3) Photographic laboratory. Just before the outbreak of the war these three laboratories were all together, but when the course of instruction
FIG. 29. - Army Medical Schoo1. Classroom, X-ray physics
was changed from one class to three classes per annual session, and when in August, 1917, a class of enlisted men was started, it became necessary to rearrange the quarters so that daily classes could be held without interfering with the routine work of the department. This was accomplished by moving the photographic laboratory to the sixth floor, where three well-lighted rooms were available. The space allowed by this change was fitted up with a Waite & Bartlett transformer and other apparatus that was on hand, and a dark room and labyrinth installed, the work being done by the officers and enlisted men of the school, and was used for elementary instruction. In September, 1918, this department was asked to turn out 48 X-ray manipulators a month. In order to do this additional space was secured on the second floor of the orthopedic building, 472 Louisiana Avenue, consisting of 2 dark rooms, in
which were installed 2 developing instruction units, where 16 persons could develop at one time.
The clinical X-ray laboratory was altered by partitioning so that it was possible to secure an office, an additional operating room for dental examination, and a control space for the large operating X-ray and fluoroscopic room. By removing a large labyrinth into the dark room, a plate-loading space was secured which could supply the operators and feed exposed plates into the dark room. A smaller and less elaborate labyrinth was built, connecting these rooms. The plate-examining room, which was quite large, was divided so that a waiting room was secured. This gave more privacy for plate study, which is really the most important part of any laboratory. Special view boxes,
FIG. 30. - Army Medical School. Classroom, X-ray technique
with shelving above and below, were designed and built around the room and were found so satisfactory that the plans were adopted by the Surgeon General’s Office for use in other Army laboratories. Plans for these boxes were drawn at the school. Plates were indexed and filed for easy reference and specially arranged for purposes of instruction.
The student candidates were selected from the applicants for the Regular Army who had successfully passed the entrance examinations.17 They were given one hour a week in lecture and one hour a week in practical laboratory instruction, consisting of the mechanical construction of apparatus, the operation of machines, the localization of foreign bodies, and the practical interpretation of Roentgenograms, with particular reference to the diagnostic points in the pathology of the parts concerned. Special stress was laid on the use of the newer types of apparatus adopted recently for use in the war.
Five classes of student candidates for the Regular Medical Corps, comprising 332 medical officers, passed through the school during the war period.17
The officers on duty in the Army Medical School, orthopedic section, were given the same general course as the student candidates for the Army and, in addition, special plate interpretation of bone pathology. The officers who reported for duty on tuberculosis boards were given instruction in interpretation of Roentgenograms of tuberculosis. This instruction covered two classes, two hours twice a week for a period of about three months. Eighty-eight officers secured this instruction. Patients referred for examination from the training camp at Fort Myer and other camps near Washington were used for instruction, and the clinical and X-ray evidence compared in the presence of the classes. An outline of the instruction is included: 17
OUTLINE OF INSTRUCTION FOR OFFICERS
The course in sanitary chemistry consisted entirely of laboratory work, with such preliminary talks by the professor as were necessary to explain the technical procedures. The work of the first section consisted of a review of qualitative and quantitative chemical examination of stomach contents, urine, water, and milk; examination of bleaching-powder samples for available chlorine, and the preparation of Dakin’s solution. Courses given in the later sessions were considerably shortened and condensed, but, with the exception of the urine analysis, all phases of the work mentioned above were dealt with. 14
The course embraced the optical principles included in the mechanism of the eye and optical instruments.14 This was followed by a study of refraction and more common internal pathological conditions of the eye. This theoretical work was supplemented by practical exercises by the students on the artificial
eye and on each other to learn the various methods of ophthalmoscopic examination; by pictures thrown on the screens, with explanatory talks, illustrating the common retinal diseases; and by cases brought from the Soldiers’ Home showing these conditions. Additional clinical material was furnished by the personnel of the school and by the Episcopal Eye and Ear Hospital, Washington, D. C.
Instruction in this subject embraced drill, the school of the soldier, the school of the squad, and the school of the company.14 As far as possible, individual students were allowed to drill platoons and companies and take their
FIG. 31.- Army Medical School. Classroom, chemistry
places as guides, platoon leaders, and company commanders; indoor exercises were also given illustrating maneuvers by the use of wooden blocks; litter drill; lectures on the organization of the Army, the duties of medical officers in the field, the sanitary units, guard duty, etc. Setting-up drill was also given daily at noon in the physical-examination room on the sixth floor. Included in this course were two lectures on military law and courts-martial procedure.
This course consisted of instruction in nomenclature of the points of the horse and parts of the equipment; method of mounting and dismounting; explanation of the military seat; kinds of “hands,” and proper method of
holding reins; “aids” explained and demonstrated; moving to front on straight line and halting; changes of direction to right and to left; work on road at walk; alternate walk and slow trot in hall and on road; suppling exercises; moving to front, halting, changes of direction, shouts; movements by threes in hall; increases and decreases of gaits; work at slow trot and trot; slow trot without stirrups or reins; saddling and bridling; the gallop.14
During the latter part of 1917 the course in equitation was discontinued and the time which had been devoted to that subject was given to instruction in sanitary tactics.
A course in elementary French was added to the curriculum of the school in 1917 and was discontinued in 1918.15 This instruction was given by a civilian, a native Frenchman, who was paid by individual subscriptions of members of the class. This course was not compulsory and, owing to a general feeling among the students of the first class that very little was gained by it and the time devoted to it could be used to better advantage with the other studies, the course was discontinued.
INSTRUCTION FOR TRANSPORT SURGEONS
During 1918 a special short course of instruction, in the form of lectures, was given to a group of transport surgeons ordered to the school for this purpose. The lectures covered in a brief way the following subjects:18 General and military surgery; deafness and speech defects; head surgery and surgery of the nervous system; amputations; Medical Department administration; insanity and functional neuroses; blindness; tuberculosis; paper work.
During the period from October 1, 1916, to February 1, 1919, 377 accepted candidates for the Medical Corps of the Army were ordered to the school.14, 4 Of these, 355 completed the course and 11 elected not to take the course and did not report to the school; 9 elected to take the course in orthopedic surgery, 1 resigned, and 1 was sent home during the course of instruction on account of inaptitude. Of the number completing the course, 332 were recommended for commission. Of the 9 who elected to take the course in orthopedic surgery, 1 was ordered home before the completion of the course on account of physical disability and 1 was discharged at the end of the course on account of inaptitude, and 7 were recommended for commission in the Medical Corps.
The following is a copy of the weekly schedule of instruction for one week in each of the three sessions: 19, 20, 21
Schedule, second section, twenty-first session, Army Medical School, March 14, 1917, to May 28, 1917
Schedule, first section, twenty-second session, Army Medical School, commencing November 12, 1917
Practical work in small sections, to be announced, will be given in Roentgenology from 11 to 12 daily. Recitations in sanitary tactics will be held from time to time as announced. The division into platoons for equitation will be announced later. Officers taking the course in military orthopedics will take military drill and all the afternoon courses with the exception of ophthalmology. They will take the practical work in Roentgenology in sections Mondays from 2 to 5, according to later announcement.
Schedule, first section, twenty-third session, Army Medical School, November 11, 1918 to February 10, 1919
The practical work in small sections will be posted. Recitations in sanitary tactics and in map reading will be held from time to time as announced.
SPECIAL INSTRUCTION (OFFICERS)
The section of orthopedic surgery provided a course of instruction in the theory and practice of orthopedic surgery for certain officers ordered to the school for special instruction in this work.4 In addition to this, the course was made an integral part of the curriculum of the school, and all officers, including those taking the basic course, and who were candidates for the Regular Medical Corps, were required to take this course of instruction.14
Officers who were ordered to the school for special training in orthopedic surgery wem-e given, in addition to the training in this specialty during the morning hours, instruction in military drill, and in the subjects taught in the lectures of the regular course during the afternoon hours. These officers were not necessarily candidates for the Regular Medical Corps, but it was considered that the instruction they received was practically the same as that given to the regular classes, and the same standard was maintained for them. They were required to pass the same examination, in the subjects which they were taught, and those successful in these examinations and in the required work
of their specialty were given certificates of graduation. Those graduating, who fulfilled all the other requirements for commission, as to physical qualifications, age, hospital experience, adaptability, etc., were recommended for commission in the Regular Medical Corps.22
The three-story building at 472 Louisiana Avenue having been leased and placed in condition on July 1, 1918, the orthopedic section was moved to this building.15 The principal activities were confined to the basement and first floor. Besides the offices and class rooms, the orthopedic annex was provided with shops and laboratories equipped with a motor-driven lathe, combination hand punch and shear punch drill, water-driven emery grinder, work benches, laboratory table, appliances for application of plaster bandages and dressings.
In addition to the commissioned personnel there was assigned to this section an enlisted personnel of 36 men, through whose equipment and qualifications the section was capable of serving a new and most useful function, aside from that of a teaching institution, namely, that of a mechanical unit for such experimental, developmental, and repair work as might be required, not only by the division of orthopedic surgery, Surgeon General’s Office, but by the Medical Department as a whole.4
The following is a synopsis of the course of instruction : 4
Anatomy and operative surgery. -
* * * * * *
The course in anatomy consisted of didactic lectures on applied anatomy with special reference to operative orthopedics. Special study in muscle function, topography, and distribution of peripheral nerves; gross and special dissection on the cadaver at Georgetown University, accompanied by quizzes and demonstrations; special dissections on all principal nerves; and cross section study.
* * * * * *
The course in operative surgery included didactic and practical work oma the cadaver at Georgetown University, demonstrating the various new orthopedic operations on bones, joints, tendons, and nerves.
Shoes and feet. - Including the study of component parts of shoes and their functions; the method of manufacture; repair and inspection of shoes for Army use; the application of orthopedic appliances to shoes for correction of deformities; the care of the soldiers’ feet in camp and on the march.
Shopwork. - In the shop the officers were taught the construction and production of all types of splints authorized by the department of orthopedics, Surgeon General’s Office, beginning with drafting and reading of blue prints, then taking up the construction of the simpler types of splints and later the more complicated ones. This course also included the reconstruction and remodeling of the different types of splints to meet the varied conditions and needs that arise on the field and in camps and hospitals.
Plaster work. - This section included lectures on material; preparation and technique of applying plaster dressings; demonstration and uses of plaster in treating compound fractures and infected wounds of the joints and other uses developed during the present war. All officers under the supervision of the instructor applied casts illustrating all the principles used in the application of plaster.
Clinical work. - This work included diagnosis, treatment, and demonstration of the various military orthopedic conditions on patients at Walter Reed General Hospital and Providence Hospital, Washington, D. C. A number of these cases consisted of war wounds received on the various European battle fronts
The approximate number of hours devoted to orthopedic surgery in each of the special courses was 419, divided as follows: 4
Anatomy and operative surgery.................................27
Shoes and feet................................................31
An example of the weekly schedule of instruction follows:23
Schedule for othopedic sections A, B, C, D, E, F, beginning March 25, 1918
SPECIAL LABORATORY INSTRUCTION
In addition to the laboratory instruction given to officers and enlisted men who were taking the regular and special courses, groups of officers of the Medical Corps and Sanitary Corps were sent to the school from the Rockefeller Institute of Medical Research for additional laboratory instruction. The course given these officers was of one month's duration, was given each month, and embraced the following subjects : 4 Culture media; Bacillus typhosus; Bacillus paratyphosus A; Bacillus paratyphosus B; the isolation and identification of these organisms from the stools; dysentery bacillus, pneumococcus, standard agglutination method, anaerobes, staining of tubercle bacilli, gonococcus, malarial parasites. Approximately 250 officers took this instruction during the period of the war.4
INSTRUCTION AND PREPARATION FOR FOREIGN SERVICE
In May, 1917, it became necessary to send a large number of medical officers to foreign Service; these officers and many more each month thereafter were sent to the Army Medical School to be prepared for such service. Instructions were given them as to uniforms, equipment, finances, etc.14 They were vaccinated against typhoid and paratyphoid, A and B, and smallpox. Physical examinations were made and they were reported to the Surgeon General when ready for orders. They were furnished with true copies of their orders and given final instructions regarding their arrival at and departure from the port of embarkation.
The training of these officers, as well as that of enlisted men making up units or detachments destined for overseas service in gas defense, was given at Camp Meade, Md., under the direction of the division gas officer of that camp.24 The handling of this work resulted in the establishment of the “foreign-service department,” and involved considerable increase in the clerical work of the school. The system of handling these officers was very successful and was continued throughout the period of the war.
No formal graduation exercises were held during the period of the war. After the graduation of the third section of the twenty-first session, the award of the Sternberg medal was discontinued for the period of the war. The awarding of this medal was resumed at the commencement of the twenty-fourth session, which began October 1, 1919.
INSTRUCTION FOR ENLISTED MEN
COURSE IN LABORATORY TECHNIQUE
Some of the enlisted men of the Medical Department were ordered to the school for instruction in laboratory technique, while others were enlisted at the school for that purpose. They were grouped in three classes: 15 (1) Beginners’ class of laboratory technicians; (2) advanced class of laboratory technicians; the beginners’ class of laboratory technicians received instruction in the cleaning of glassware, sterilization, the use of the microscope, routine stains and in the bacteriological laboratory. The course was of two months’ duration and
was continuous. The advanced class of laboratory technicians i-eceived instruction along the same lines as the regular officers’ class in the bacteriological laboratory with the addition of instruction in the staining the gonococcus, tubercle bacillus, and the examination of urine. The course was also of two months’ duration. A new class was started every two months. Half of the time of these two classes was spent in the chemical laboratory, where they received practically the same instruction as was given the Regular officers’ classes, and included special topics in volumetric analysis and certain laboratory methods of the Medical War Manual No. 6, and the sanitary analysis of water and sewage. Approximately 900 men received instruction in these classes and of these, 92 were commissioned as second lieutenants in the Sanitary Corps, and 77 in addition were recommended for commission as second lieutenants in the Sanitary Corps.415
The need for enlisted X-ray technicians and manipulators in the Medical Department necessitated the establishment of a school of instruction, which was accomplished August 16, 1917.17 The outline of instruction was as follows: 17
1. X ray in general:; excitation tubes in general; tubes, hydrogen, gas, Coolidge
1. X-ray machines; general wiring; trace wiring. Make diagram
2. Plates, envelopes, films, screens, casettes;exposure effects; developer; fixing; plate holder; making plates
2. Coils and inerrupter; saturatuion curve
3. Electricity; Terms and principles: dynamo motors; electicity magnetism; Ohm's law; Lena's law.
3. Transformer chart
4. Coils; choke coils; transformers; interruptors; rheostats
4. Views of Army Ex. 6; Relation of shadow and direction of radiation.
5. Exposure factors; Voltage; amperage; time; distance; saturation curve; critical curve
5. Relation of time of exposure to targe
6. Relation of shadow to radiation; tube shift; shadow transverse
6. Current and time relation
7. Standard positions; stereoscopy
7. Voltage law Ex.9
8. Use of transformer chart; trouble and trouble hunting; wiring; machines
8. Making plates of normal parts
9. Use of transformer chart; trouble and trouble hunting; wiring; machines
9. Keeping records and clerical work
10. Troubles and difficulties; Plates--developer; over and underexposure
10. Weekly written tests are customary. A number of the examination papers are on exhibit.
Lecture on osteology
OUTLINE OF DARK-ROOM INSTRUCTION 15
First period. - (1) General outline of dark-room procedure.
(2) Description of a photographic emulsion and effect when subjected to various forms of energy.
(3) Correct methods of handling plates (reason for).
(4) Cleanliness and precautions for development.
Second period. - (1) Metric system: (a) Linear; (b) volume; (c) weight; (d) temperature.
(2) Developer: (a) Purpose; (b) ingredients (purpose of each); (c) method of mixing (reasons for); (d) action of.
Third period. - (1) Review of metric measurement.
(2) Fixation: (a) Purpose of; (b) ingredients (purpose of each); (c) method of fixing (reason for); (d) action.
(3) Fog: (a) Definition of; (b) dichoric, (1) reason, (2) characteristics; (c) function; (il) causes.
(4) Stains (reasons for).
Fourth period. - Quiz (oral).
Fifth period - (1) Developer: (a) Formula; (b) method of mixing.
(2) Dark-room practice.
Sixth period. - (1) Fixing bath: (a) Formula; (b) method of mixihig.
(2) Dark-room practice.
Seventh period. - (1) Review of: (a) Developer; (b) fixing bath; (c) Inixing of (a) and (b).
(2) Dark-room practice.
Eighth period. - (1) Quiz.
(2) Dark-room practice.
Ninth period. - (1) Manipulation of formulae.
(2) Dark-room practice.
Tenth period. - Review and oral quiz.
OUTLINE OF WORK FOR MACHINE LABORATORY 25
September 24 to 25. Introductory talk covering (a) Coolidge tubes: (1) construction; (2) parts; (3) filament (its significance).
(b) Rectifiers: (1) Construction; (2) principles of operation; (3) purpose.
(c) Transformers: (1) Construction; (2) principles of operation.
(d) Rheostats: (1) Construction, (2) principles of operation.
(e) Autotransformers: (1) Construction; (2) advantages; (3) dangers.
(f) Electrical measuring devices: (1) Ammeter; (2) milliammeter; (3) spark gap.
(g) Electrical units.
(h) Motors and generators, principles, construction, etc. (practical).
September 26 to 27. Tracing wiring and drawing wiring diagram of Waite & Bartlett.
September 28 to October 1. Bedside and base hospital units: (a) general talk of their object, usefulness, and advantages.
(b) Bedside transformer (method by which it produced both high and low tension currents).
(c) Tracing wiring of bedside unit.
(d) Study of changes necessary to operate machine on alternating and direct currents of different voltages.
October 2 to 3. Care of machines: (a) Talk on importance of proper care.
(b) Practical work: (1) Cleaning brushes, commutator, and wiring; (2) oiling motor and generator; (3) care of transformers.
October 4. Trouble hunting: (a) Apparatus will be disconnected or improperly connected and class will be required to locate the trouble.
(b) Use of test lamp.
(c) The following trouble in particular will be put into the machine: (1) Burnt out fuses; (2) dirty brushes; (3) brushes improperly attached; (4) loose connections; (5) broken wires; (6) wires so connected that current attempts to go through tube in the wrong direction.
October 5. Oral quiz.
October 7. Continuation of trouble hunting.
October 8. Transformer charts: (a) Talk on value and usefulness of transformer chart.
(b) Making of transformer chart by the class.
October 9 to 11. X-ray pictures: (a) Talk covering (1) principles involved in taking X-ray pictures, (2) reasons for using different settings, (3) methods of protection.
(b) Taking of pictures by the members of the class. October 12. Written examination.
October 14 to 15. Anatomy: Study with skeleton of most important bones, joints, etc., in the human body.
October 16 to 17. Continuation of picture taking.
October 17 to 18. Work on alternating current machines: (a) Talk on alternating current machines covering (1) construction, (2) difference between alternating-current and direct-current machines.
(b) Tracing wiring and examining construction of an alternating-current machine.
October 19. Examination covering work of entire course.
GENERAL OUTLINE OF INSTRUCTION OF “THE PORTABLE X-RAY UNIT” 27
September 24 to 27, inclusive. General outline of the portable X-ray unit: (a) Delco engine (engine end, electrical end); (b) control unit (transformers, boosters, filament control, meters); (c) table (set up and knocked down, tube box, X-ray tube).
September 28. Examination. September 30 to October 8, inclusive (examination October 5). Delco plant, detail and principles of the functions and position of each part:
(a) Housing: Engine end, cylinder, cylinder head, oil container, breather tube, carburetor; electrical end (pole shows field windings).
(b) Crank shaft: Fly wheel, Hyatt roller bearing, oil-splash gear, crank where piston rod is connected (piston, piston rings), worm gear, New Departure double roller bearing (oil grooves), armature (commutator, slip rings).
(c) Cam shaft (gear that meshes in the worm gear (on crank shaft) drives this shaft):
Eccentrics which operate connecting rods, they the rocker arms, they the valves; end of shaft operates timer; timer.
(d) Electrical circuits: Engine control unit, transformers, boosters, filament control, meters.
(e) Operation of plant.
October 9 to 14, inclusive (examination on October 12):
(a) Practical work (taking down and setting up of engine, taking down and setting up of table, taking pictures).
(b) Trouble hunting.
October 15. Examination or review and bedside instructions with alternating and direct current, 110-220-volt; taking pictures.
Schedule of instruction, school of manipulators 28
Forty-eight men; 3 groups of 16; 3 daily periods; 20 working days.
Saturday. written examination or quiz; general police and make-up work.
Ten-minute intervals between the two morning periods.
Groups of 16 to be divided into units of 8 men under the chief instructor and 1 assistant.
These men, upon completion of the course of instruction in X-ray work, were given practical experience by working in the Army Medical School; laboratory for patients, Soldiers’ Home; Providence Hospital; George Washington University Hospital; Georgetown University Hospital; Children’s Hospital; Episcopal Hospital; and the Walter Reed Hospital, Washington, D.C.15
Lists of qualified technicians and manipulator’s were sent to the Surgeon General’s Office, X-ray division, for assignment to duty elsewhere.17 Technicians who showed special adaptability were retained at the school as assistants. Several received commissions in the Sanitary Corps. Upon receiving their commissions they were ordered away from the school and assigned to duty in various capacities, at home or overseas.
Primarily, these men were supposed to be able to care for the X-ray apparatus, to make minor repairs, and to keep the machines running satisfactorily. A number of them thoroughly understood the electrical construction and were able to do almost every kind of repair work. They were usually given assignments where their knowledge was most useful. In this capacity they were called technicians. Secondarily, they were instructed in making exposures of patients, developing the plates, and general dark-room work. They were given a little osteology to enable them to intelligently make plates of the parts of the body requested by the surgeon. In this capacity they were called manipulators. They were not supposed to interpret Roentgenograms or to give opinions on plates they had taken.17 It was not expected that they should in any way usurp the duties of the Roentgenologist.
Certificates of proficiency were given to men who were found qualified to perform this special duty.17 Enlisted men found disqualified after a fair trial in the classroom were transferred to other duties. Two hundred and thirty-three enlisted men received special instruction in X-ray technique, of which 25 were not found proficient and given other duty. About 175 were given certificates of proficiency, while the remaining 33 were given duty in the X-ray laboratories as assistant and no doubt later were eligible for certificates.
These manipulators and technicians were on duty in most all of the cantonments and camps, and many were on duty in France.
INSTRUCTION IN ORTHOPEDIC WORK
In addition to the 36 enlisted men on a duty status in the orthopedic department on July 1, 1918, 226 additional men reported during 1918 for duty and instruction.15 These men received instruction in litter drill, first aid, hygiene, anatomy, physiology, Medical Department administration, metal work, shop work, brace work, leather work, plaster work, carpentry work, machine work, blacksmithing. Two hundred and forty-six hours were devoted to this instruction, and as the men became proficient they were promoted to the grade of sergeant or corporal, and were ordered as orthopedic technicians to the several general hospitals.15 One hundred and eighty-two men were transferred as technicians, 18 as clerks, 44 discharged, and 18 were on duty at the school at the end of 1918.
DEPARTMENT OF VACCINE MANUFACTURE
The manufacture of prophylactic typhoid vaccine was developed in the Army Medical School in 1908, by Russell, and since 1908 this vaccine and other biologic products have been manufactured by the school and furnished to the Army, Navy, Public Health Service, and other Government bureaus.4 During 1916, the mobilization of practically the entire National Guard, the increase in the Regular Army and Navy, and the requirement that paratyphoid A and B, as well as the typhoid vaccines, be administered to all those in the military
service, caused by the development of an epidemic of paratyphoid among the American expeditionary forces in Mexico, necessitated an enormous increase in the production of these vaccines.4 The declaration of war, with the enormous increase in the military forces by enlistments, the mustering into the military service of the National Guard, and the preparation for the mobilization of the National Army, made it necessary to speed up the manufacture of all biological products to a still greater extent. This was done without delay, and it was always possible to supply all demands adequately.
On account of the epidemic of paratyphoid A in the expeditionary force in Mexico in 1916, experimental work on paratyphoid A vaccine had already been begun in September, 1916, and work on paratyphoid B was taken up as soon as war was declared.29 At first, on account of fear of severe reactions, it was planned to vaccinate separately with typhoid and paratyphoid A and B. This plan was begun in July, 1917, but it soon became evident that this doubling of the work was unnecessary, and the triple typhoid vaccine was prepared and was issued in August, 1917. In June, 1918, lipo-vaccine was issued after experimental work which seemed to show that a single dose of oil vaccine was sufficient to protect. Saline vaccine was discontinued in August, 1918, but was readopted in March, 1919, because it was found that lipo-vaccine was difficult to make in a sterile condition. Either the organisms were not killed, or contamination took place, and it was also found that the protective value was inferior to saline vaccine in animals.
Leutin tests were practically discontinued on account of the difficulty of making material and the uncertainty of the results. The laboratory acted as a supply depot of diagnostic sera, animals, stains, glassware, etc., for neighboring camps and in some instances for the whole Army.29
The following shows the amount of vaccine distributed to the Army, Navy, and other Government departments and civilians during the period April 1, 1917, to November 15, 1918: 30
During the period October 28, 1918, to December 26, 1918, meningococcus lipo-vaccine was distributed to the Army and civilians amounting to 8,202 c. c.30
DEPARTMENT OF RESEARCH
During the year 1918 several officers were engaged on research problems, relating principally to the diseases of soldiers.15 The most extensive of these was the work on experimental pneumococcus pneumonia in monkeys. Two hundred monkeys were secured for this purpose from the Philippine Islands, through the supply division of the Surgeon General’s Office, and the work was considered of fundamental and of practical importance. The work on Xylose fermentation of typhoid bacilli was of scientific and practical value in the typhoid problem in the Army.
Research work was carried on in the chemical laboratories on the chemical and physical action of ultra-violet rays on certain vegetable oils, and the sterilization of oils by means of ultra-violet rays. The following is a summary of the research work done by personnel connected with the pathological laboratories during the fiscal year ending June 30, 1919.15 Studies on complement fixation, especially the production of amboceptor; studies on deficiency diseases; studies on lipo-vaccine and the production of such vaccines; triple typhoid lipo, triple pneumococcus lipo, triple dysentery lipo, cholera lipo; studies on the Group IV pneumococci; studies on the hydrogenion concentration of media; experimental production of plague vaccine; experimental production of influenza vaccine; studies on the grouping of B. influenza; agglutination in animals following lipo-vaccine; studies on pneumococcus saline vaccine; studies on the optimum growth of meningococcus; studies on the production of sera in goats; studies on the effects of lipo-vaccine on the leucocytes; studies in complement fixation with special reference to typhoid and pneumococcus; effect of lipovaccine in increasing susceptibility to other diseases; studies on the local reaction in animals against bacterial vaccines; experimental pneumococcus pneumonia in monkeys; prophylactic vaccination, specific treatment; technique of preparation of vaccines. The X-ray department aided in the designing and completing of an X-ray ambulance for the United States Army portable X-ray unit.15 The ambulance was driven to Ontario, Canada, where it was demonstrated for the benefit of the Canadian Government. The portable field outfit, the portable bedside unit, and numerous other new pieces of apparatus were tested out in conjunction with the duties of the laboratory.
In addition to the regular courses of instruction, various activities of the school were concerned directly or indirectly in the teaching of officers and enlisted men.
Clinical laboratory. - During the period from January 1, 1917, to December 31, 1918, there were made, among many others, the following examinations and tests:4 Examinations for typhoid fever, 2,168; animal inoculations for immune Sera, etc., 6,162; miscellaneous examinations, gonococcus, etc., 4,088; Wassermann tests, 33,951; treatments with bacterial vaccines, 35,558.
Wassermann tests. - The Wassermann reaction was performed continuously as a diagnostic test for syphilis. During the fiscal year ending June 30, 1918, the total number of Wassermann tests made in the laboratory was 19,524, of which 531 were reexaminations, 16,583 were made in accordance with existing orders calling for a Wassermann test on applicants for commission, enlisted candidates for various service schools, recruits, etc., and 2,461 examinations of new cases. Of the latter, 1,280 were for syphilis or suspected syphilis, and 1,181 were for cases suffering with diseases other than syphilis; in addition, there were 681 tests made for gonococcus fixation, 242 Wassermann’s made on spinal fluids in three dilutions.
The following is a summary of analyses and examinations made during the period from June 30, 1917, to June 30, 1919: 4, 14, 15 Urines, 34,819; water, Army posts, 175; drugs, 13; foods for poisons, 12; water, other sources, 10; stomach contents, 9; miscellaneous, 260.
X-ray clinical laboratory. - The following is a summary of the work of the clinical laboratory of the X-ray department of the school: 17
September, 1917, to June 30, 1918
July, 1918, to November 30, 1918
Number of patients seen
X-ray photographic laboratory. - The work consisted of taking photographs for the various departments of the school of things of interest to the Medical Department, of preparing lantern slides, and of making prints.17 Facilities were available for making enlargements and reductions and for copying drawings, tracings, and photographs for the preservation of records. During the year 1917-18 the following amount of work was performed: 17
September, 1917,to June 30, 1918
July, 1918,to November 30, 1918
X-ray testing laboratory. - Anticipating an increase in the experimental and testing work for the Surgeon General’s Office (X-ray division), additional space was secured on the third floor at 472 Louisiana Avenue, where electrical control boards were put up for both alternating and direct currents, with recording meters, circuit breakers, etc. The large Delco 3 kw. gas electric set was installed outside, and the small ¾ kw. Delco engine set up inside the building.17 In connection with the testing laboratory, there was erected a dark room for experimental work on plates, chemicals, and the use of new types of ventilators, plate dryers, cabinet, and labyrinths.
Special activities of the X-ray department. - The facilities of the department were at the disposal of the officers on duty in the X-ray division of the Surgeon General’s Office, and most of the work was done under their guidance and supervision. Aside from the routine reports on intensifying screens, photographic plates, X-ray accessories, apparatus, and instruments, studies were made concerning the protective value of lead glass, gloves, aprons, fluoroscopic boxes, etc., supplied for use in the Army.
The manufacture of standard Army splints, plaster of Paris bandages, etc. - In addition to the training of officers and enlisted men in orthopedic surgery, splint making, etc., large numbers of the standard Army splints, plaster of Paris bandages, and various other apparatus used in the orthopedic and other services of the Army were manufactured by the orthopedic department of the school and shipped to the various hospitals throughout the service. During the period from June 30 to December 31, 1918, in addition to the other apparatus manufactured, more than 3,100 splints were produced.31
Illustrations for lectures by medical officers. - During the year 1917 the school was charged with the arrangements for and the handling of the details in connection with furnishing medical officers assigned as special lecturers at medical schools throughout the country with moving-picture films and lantern slides for use as illustrations for their talks.14 For this purpose five large movingpicture films illustrating the activities of the Medical Department in the field were sent to the school. Correspondence was kept up with the officers concerned and the itinerary was drawn up. The films and slides were sent by express to various points throughout the country, including New York, Philadelphia, Baltimore, St. Louis, Omaha, Columbus, Buffalo, Syracuse, and other cities.
Physical examinations. - The making of physical examinations during the period of the war was a very important function of the Army Medical School. This work from the beginning was conducted on a scale of considerable magnitude, but its scope so broadened during the progress of the war as to include physical examinations of practically every nature and for every purpose. The amount of time consumed and the labor involved by having these examinations made by one officer and the constant change in detail for the various examining boards appointed made it advisable and necessary to inaugurate a system by which examination could be made systematically and the records secured against loss. Therefore, early in 1917 the service of the Medical Reserve Corps officers awaiting orders at the school for overseas service were secured and utilized to assist in this work, and a regular system inaugurated. By this plan 50 to 100 officers could be examined a day without confusion and the physical examination forms carefully checked and forwarded to The Adjutant General. During the two and a half months from April 15 to June 30, 1917, approximately 1,000 examinations were made, with a constant increase in the number to be examined each day. This work became a function of ever-increasing magnitude, and its scope not only included the physical examinations of officers for promotion and of applicants for the various Officers’ Reserve Corps, but also for the determination of the physical fitness of officers for overseas service and the examination of men inducted as privates in the Medical Department. During the year beginning July 1, 1918, and ending June 30, 1919, approximately 13,000 physical examinations were made.15 Included in this number were physical examinations made for all branches of the service. The majority of applicants in the earlier months of the war were civilian candidates for the several sections of the Officers’ Reserve Corps, and, later, with the suspension of hostilities in November, 1918, examinations for this purpose were supplanted by examinations of officers for discharge. The final organization of the physical examination department consisted of an examining team working under the direction and personal supervision of the chief medical examiner. The team was normally composed of 9 medical officers and 5 enlisted men. This number could be increased or decreased quickly and without loss of efficiency to meet sudden and unusual variations in the amount of work thrown upon it from time to time.
Organization of Medical Department units for overseas service. - In addition to the officers and enlisted men sent out from the Army Medical School, both individually and in detachments, for duty in the United States and abroad, four mobile field laboratories were organized and trained at the school and sent overseas. The personnel of these units consisted of 2 officers and 4 enlisted men.32
ARMY VETERINARY SCHOOLS
It was found that neither the training of enlisted men at the Medical Officers’ Training Camp, Fort Riley, Kans., nor the training of officers at the Medical Officers’ Training Camp, Camp Greenleaf, Ga., met the needs of a training camp for the Veterinary Corps.33 The essential requirement was a center wholly given over to the concentration and training of veterinary personnel and for the organization of veterinary units for overseas service. A veterinary hospital and special schools for training noncommissioned officers, farriers, horseshoers, saddlers, teamsters, and cooks were needed.
VETERINARY TRAINING SCHOOL, CAMP LEE, VA.
The establishment of such a school had been under consideration by the Surgeon General for some time, when it received its official impetus from a letter outlining a plan,34 which was forwarded to The Adjutant General of the Army, with recommendation of approval,35 which was received,36 whereupon the Surgeon General announced the following plan for the proposed school:37
* * * * * *
2. The school for Veterinary Corps personnel at Camp Lee, Va., will be known as the Veterinary Training School.
3. Its object is to train officers and enlisted men of the Veterinary Corps and to organize veterinary units.
4. The instruction should proceed along two lines which, though distinct, should be closely correlated: (a) The general military training of the soldier, and (b) the special training required for the veterinary service.
General military training. - Asall enlisted men will be recruits, they will need instruction in discipline, school of the soldier, squad and company drill, guard duty, equitation, care of equipment, pistol practice, physical training, personal hygiene, first aid, and the use of gas masks.
Special training - To prepare them for the special service of the Veterinary Corps, they should at the same time receive instruction in the handling and care of animals, stable practices and management, care of stable and veterinary equipment, care of sick animals in hospitals and elsewhere, first aid and bandaging, administration of medicines, isolation and disinfection in connection with communicable diseases, etc., also in the special duties of farriers, horseshoers, wagoners, and saddlers, and in regard to the paper work of the Veterinary Corps. It is desired that the course of instruction be graded, and that it be uniform for all companies. More advanced courses should be arranged f or men of exceptional aptitude who give promise of developing sufficient ability to be considered for promotion to the non-commissioned grades.
5. A period of eight weeks will be allowed for the instruction of the first class to he assigned to the school and for the formation and equipment of the veterinary units named in paragraph 8. The course of instruction should be arranged so that about 90 per cent of the time will be devoted to military training during the first three weeks, after which the time allowed for the veterinary instruction should be increased, at least one-half of each day of the last five weeks being set aside for this purpose. In so far as is possible the classes should be scheduled so that a part of each day will be devoted to classroom work and a part to practical outside work.
6. While the commandant will be responsible for all that pertains to the administration of the school, it is especially desired that the views and recommendations of the senior veterinary instructor, as the senior representative of the Veterinary Corps, be given careful consideration. The highest efficiency can be obtained only by the hearty cooperation of the commandant and the senior veterinary instructor. The senior veterinary instructor is
expected to act as the adviser of the commandant in all matters connected with the school; he is also responsible under the commandant for the veterinary instruction of all of the personnel and will supervise and direct the work of all assistant veterinary instructors, both officers and men. An outline of the subjects which should be included in the course of instruction, showing the time allotted to each, will be prepared and submitted to this office at once, together with a schedule of the classes. Until the base veterinary hospital recommended for Camp Lee is authorized and constructed, the existing facilities of the cantonment may be used for the practical instruction in animal management, care of sick animals, etc.
7. The enlisted men assigned to the school will be organized into eight companies of instruction for the purpose of discipline, drill, training, individual equipment, and subsistence and shelter, with the usual company administration. Each company will have a line officer in command, a veterinary officer, and its pro rata share of the sergeant instructors assigned to the school.
8. The following units are to be organized from the first class assigned to the school: 5 veterinary hospitals (T. 0. No. 331); 1 corps mobile veterinary hospital (T. 0. No. 109); one-half Army mobile veterinary hospital (T. 0. No. 330).
These formations will be organized at the earliest possible date in order that the personnel may have all the opportunity possible to become acquainted with their organization and its duties. In case a sufficient number of men should not be available for the organization of all the above units, those present will be used to organize as many complete units as possible. The assignment of the veterinary and medical officers and of the enlisted men of the Medical Department will be arranged by this office. Further instructions will be arranged by this office. Further instructions will be issued in regard to the authorized hospital equipment.
ORGANIZATION AND ADMINISTRATION
A line officer was detailed as commandant of the school, with the concurrence of the Surgeon General.33 About the middle of April, 1918, a senior instructor was ordered to report to the commandant of the school for duty, but as there were no school buildings in existence at that time temporary quarters were obtained.38 Between April 14 and 20, 1918, eight veterinary instructors who had received military instruction at the Medical Officers’ Training Camp, Camp Greenleaf, Ga., reported for duty at Camp Lee. As none of these veterinary officers had any idea of the kind of work before them, they were taken in hand by the senior instructor, who, for the period of six weeks, by lectures and demonstrations, succeeded in presenting the subject in such a manner that he was reasonably assured of success.
Wooden construction at the service of the school from the beginning included 32 barracks for 52 men each, 8 mess halls for 204 men each, 8 lavatories for 200 men each, 3 officers’ quarters for 95 officers, 1 lecture hall, and 1 administration building.18 Two warehouses were available for the supply officer, an infirmary, and a fire house. An exchange was established in a converted dwelling and subsequently enlarged. From time to time further construction was undertaken, using scrap lumber and skilled labor drawn from the enlisted personnel.
The barracks, while sufficient for the housing of the provisional companies, were insufficient to house properly other veterinary units formed. This handicapped the carrying out of that provision for the organization of these formations at the earliest possible date in order that the personnel might have all the opportunity possible to become acquainted with their organization and duties.37 Barracks and mess halls such as were standard in officers’ training schools were constructed, hut did not fit the tables of organization for veterinary hospital
units, and it was found necessary to house the first units in tents pending their organization by wards. Later, when a school built to accommodate 1,600 men was expanded to a strength of 5,400 without accompanying enlargement in regard to construction of barracks, mess halls, officers’ quarters, and lecture halls, it was found necessary for the original allotment of barracks to contain the bulk of the units while the overflow were housed in tents.38
For the greater part of its existence the Veterinary Training School was without hospital facilities; consequently, during this time, practically all veterinary instruction was theoretical; veterinary officers received no practical training in conducting hospitals, or in any part of the administrative work incident to handling sick animals; noncommissioned officers were not trained in directing the work of enlisted men in the feeding, watering, and grooming of hospital patients; farriers had no opportunity to put in practice the teachings of their instructors; enlisted men possessing ability as practical horsemen could be of no assistance in training others deficient in the necessary requisites.38 Presumably labor and lumber shortage accounted for the long delay in building the hospital, construction of which was not actually begun until July 20, 1918. 38 It was not complete in every detail even at the time of the signing of the armistice. The actual instruction, however, was carried on despite this handicap.
As soon as the veterinary instruction staff was formed, an equitation class was formed under the tutorship of the senior veterinary instructor. The assistant veterinary instructors assigned to the school composed this class. The first period was held May 28, 1918, and the instruction was continued for two hours each day during the summer. The students were started in the very rudiments of riding, and as they showed progress were gradually advanced until the instructor thought them fit to teach other beginners.
Members of the class were required to know both the theoretical and the practical side of equitation, as the main idea was that they should be able to instruct others. After the usual work at the walk, trot, and gallop, jumping was gradually taken up, until an average jump of between 3 and 4 feet could be taken with the horses at hand. The work in general equitation was continued until the services of most members of the class were required to instruct other classes in riding and horsemanship.
Instruction in equitation was given to 212 veterinary officers, 32 divisional staff officers, 51 medical officers, and 217 enlisted men.38
Line officers were assigned as instructors to the school, despite its character as a center primarily of veterinary instruction, for purposes of administration, discipline, and drill, the building up of units which, while efficient in their chosen work, should be as strictly military as those of the line. The Tables of Organization provided for units that had to be handled with the care and precision of Infantry companies, that required setting up, instruction in marching, pack making, tent pitching, personal hygiene, and care of equipment, military discipline, and courtesy.38
At the time the school was organized, there were available for duty line officers who were graduates of the second officers’ training camps at Plattsburg and Fort Myer, who had been serving as attached officers in the 79th Division at Camp Meade, Md. These had undergone three months’ intensified train-
ing in the officers’ camps and had served more than three months in the division. They had thus gained sufficient experience, under the exigencies of the existing emergency, to qualify them, in the opinion of the division chief of staff, for the work at the Veterinary Training School.
The authorized training cadre consisted of the following officers and enlisted men:36 1 colonel or lieutenant colonel, line officer, as commandant; 1 captain or lieutenant, National Army, as adjutant; 1 major, Medical Corps; 9 veterinarians, majors, captains, or lieutenants, as instructors; 9 captains or lieutenants, National Army, to command companies; 1 captain, Quartermaster Corps, for supply duty; 1 lieutenant, Quartermaster Corps, for supply duty; 3 sergeants, Quartermaster Corps, 1 sergeant as sergeant major; 2 corporals as clerks at headquarters; 58 sergeants as assistant instructors; 20 cooks; 1 horseshoer; 1 saddler.
The 101 sergeants, corporals, farriers, and cooks who constituted the enlisted training cadre were transferred to the school from line outfits.39 Details of these noncommissioned officers policed camp, improved sanitary conditions, cleared drill fields of vegetation, drained swamps, and cut and burned tangled underbrush.
In September, 1918, the following personnel was authorized to replace the list of permanent personnel set for the above :40
(a) Personnel for training school: 1 colonel or lieutenant colonel, line officer, commandant; 1 captain or lieutenant, line officer, as adjutant; 1 major, Medical Corps. surgeon; 10 veterinary officers, majors, captains, or lieutenants, as instructors (includes 1 officer for horseshoeing instructor); 9 captains or lieutenants, line officers, to command companies; 1 captain, Quartermaster Corps, for supply duty; 1 lieutenant, Quartermaster Corps, for suppiy duty; 3 sergeants, Quartermaster Corps; 1 sergeant, first class, Veterinary Corps, as sergeant major; 8 sergeants, first class, Veterinary Corps, as assistant instructors and acting first sergeants; 1 sergeant, first class, Veterinary Corps, personnel sergeant; 51 sergeants, Veterinary Corps, as assistant instructors (including 1 as saddler instructor); 1 sergeant, Veterinary Corps, as provost sergeant; 1 sergeant, Veterinary Corps, in charge of post exchange; 1 sergeant Veterinary Corps, personnel duty; 2 corporals, Veterinary Corps, clerks; 20 cooks, Veterinary Corps; 1 horseshoer, Veterinary Corps; 1 saddler, Veterinary Corps; 2 privates or privates first class, Veterinary Corps.
(b) Personnel for veterinary hospital: 1 major or captains, Veterinary Corps, as commanding officer; 1 lieutenant or captain, Veterinary Corps, as adjutant and detachment commander; 1 lieutenant or captain, Veterinary Corps, as supply officer; 3 lieutenants or captains, Veterinary Corps; for ward service; 1 sergeant, first class, Veterinary Corps; 5 sergeants, Veterinary Corps; 5 corporals, Veterinary Corps; 2 cooks, Veterinary Corps; 10 farriers, Veterinary Corps; 1 horseshoer, Veterinary Corps; 1 saddler, Veterinary Corps; 4 wagoners, Veterinary Corps; 17 privates, first class, Veterinary Corps; 34 privates, Veterinary Corps.
April 16, 1918, the commandant and 12 officers (10 line, 2 of the Quartermaster Corps) arrived to assist in organizing the school.39 The construction was probably 20 per cent complete; no plumbing had been installed and quarters contained no windows. An adjutant was detailed and suitable nonconimissioned officers selected as sergeant major and clerks. With their assistance the organization of headquarters proceeded. Pending receipt of recruits, all enlisted training cadre men at hand were assigned to the First Provisional Company, employed in general fatigue work.
Provisional companies were organized, a line officer commanding each, and veterinary officers assigned equitably for instruction as they reported.39 A like distribution of training cadre noncommissioned officers was made. Various schools for specialists were created, and instruction of classes commenced.
On May 21 the order assigning the officers and men to the various provisional companies was issued from headquarters.39 At the same time the noncommissioned officers were assigned, and there was a tentative assignment of veterinary officers to the eight companies. After the order was issued the noncommissioned officers, cooks, and farriers reported to their respective company commanders at barracks. The tent camp was abandoned. The work of organizing the companies began immediately, and on the 1st of June they were ready to receive the allotment of men who began to arrive at that time.
Courses of instruction comprised veterinary and military work, the former, of course, being considered the more important because of the nature of the troops to be turned out.41 In the interests of producing disciplined and manageable units, however, at the earliest possible moment, the military work received the greater emphasis in the opening stage of the school’s work, the veterinary instruction gradually growing in importance until the two courses divided the time about equally. The schedules provided for a 44-hour week, and they were adhered to carefully until the appearance of the influenza epidemic demanded a general cut in all work.
Military instruction as provided for by a condensed schedule from the Surgeon General’s Office included the following subjects:41 Articles of War; military discipline and courtesy; uniforms and equipment (issue, care, and use); personal hygiene; school of the soldier; school of the squad; school of the company; physical training; guard duty; equitation; pistol (nomenclature, care of, manual, practice on range); first-aid; pack making; tent pitching; gas poisoning and use of gas mask; inspections; singing; lectures. All these subjects were thoroughly taught with the exception of the pistol. It was found impossible to obtain pistols and the instruction in this respect was theoretical and conducted by the company commanders with the assistance of experienced training cadre sergeants.
The general veterinary instruction of officers and enlisted men was conducted, to a large extent, in the open under improvised sunshades; during inclement weather the lecture hall and mess halls were utilized and later the auditorium of the Young Men’s Christian Association.41 While much of this instruction had, of necessity, to he theoretical, due to the lack of a veterinary hospital, every effort was made to introduce into it the practical element so essential to the thorough understanding of the subjects presented. A haltered horse was kept before the classes at all talks, demonstrations, and lectures, and advantage was taken of the facilities offered for practical instruction by the auxiliary remount depot and stables in the vicinity of the school.
Officers were trained in the following lines: 41 Organization and object of the Veterinary Corps; instruction of enlisted men; military veterinary sanita-
tion and police; post-mortem examination; control of communicable disease, special attention being given to glanders, mange, and influenza; construction of temporary shelters and corrals; the proper shoeing of public animals; dipping tanks, their use and upkeep; military correspondence; requisitioning for veterinary supplies; veterinary reports and returns; Special Regulations No. 70 and Changes No. 1; accountability and responsibility; memorandum receipt; customs of the service; routine stable management; feeds, feeding, and watering; care of animals in the open; transportation by sea and rail; Army Regulations; general and special duties of veterinary officers; saddles and bridles; equitation, elements of; esprit de corps.
NONCOMMISSIONED OFFICERS, FARRIERS, AND FIRST-CLASS PRIVATES
In addition to the general course for the enlisted personnel, selected men were given the following special course: 41 Elementary equine anatomy; physiology, popular form; elements of pharmacy and materia medica; administration of medicines; minor surgery; lameness and its diagnosis; temperatures and use of thermometer; bandaging and dressing; suturing and ligation; veterinary first aid; care of instruments and supplies; sanitation of wards and corrals; responsibility for public animals; memorandum receipt; methods of securing animals for operations; humane handling of animals; respect for military authority; prompt and cheerful obedience; discipline of men; personal appearance and pride; organization and duties of the Veterinary Corps.
GENERAL ENLISTED PERSONNEL
The enlisted personnel received instruction in the following subjects:41 Exterior of the horse; stable management; haltering, tying, grooming, bedding; feeding, watering, salting, exercising; animals on the march; picket lines and corrals; horse clothing; care of the feet, scratches; pulse and respiration; communicable diseases, dangers of; transportation of animals; improvising shelters; conservation of forage; bran mashes, chop feed, night watering; simple wounds; bridles, saddles, and blankets; the pack saddle and mounted kit; saddle and collar galls; veterinary first aid; the age as indicated by the teeth; fitting of harness; organization and duties of the Veterinary Corps; discipline.
Horseshoers. - Men selected for horse shoers were given intensive training at the Auxiliary Remount School under the supervision of a veterinary officer detailed from the school.41
Horseshoeing school . - The horseshoeing school was organized July 23, 1918. The object of the school was to instruct and qualify men in horseshoeing for the various Veterinary Corps units which were fast being organized and equipped for overseas service. On account of the lack of facilities and equipment for conducting the horseshoeing school on the Veterinary Training School premises, the men were instructed at the Remount School at Camp Lee, but under the supervision of the Veterinary Corps of the Veterinary Training School. The graded course of instruction could not be followed, owing to the fact that the various units were prepared on such short notice and time did not permit of carrying out the routine as per schedule.
Wagoners. - As many of the men were well accustomed before entering the service to driving two or more animals in harness, no difficulty was experienced in securing and instructing a sufficient number of competent wagoners.41
Saddlers. - The tables of organization for the units to be sent overseas called for saddlers, and it was therefore necessary to start a school for the instruction of men in this line of work.41 A temporary shed was built on the rear of the warehouse building, and a school started in the early part of June, 1918. A few saddlers’ kits, leather, rivets, etc., were obtained from the supply officer, and a saddler was assigned to give instruction to the men. The school was started with an average attendance of 20 men, and during the existence of the Veterinary School a like number of students was under training at all times. The instruction consisted principally in making wax ends, sewing, reveting, repair work, etc., although some of the more apt pupils were allowed to attempt new work. The main object of the school, however, was to train the men to care for and repair the leather equipment of their respective units when ordered overseas.
Equitation. - Horses were obtained and, after procuring the other necessary equipment, including regulation Cavalry bridles, McClellan saddles, etc., compulsory attendance of the veterinary officers was required at classes from 7 to 9 or 9.30 a. m. each day, depending upon the balance of the schedule.41 These classes proved highly beneficial, and at the end of several weeks’ training the officers were considered capable of taking the mounted classes and teaching them the fundamental principles which a mounted man must know to be able to ride with the proper degree of comfort and safety.
Following talks on the handling, care, and treatment of mounts, with emphasis on the fact that few horses are really vicious and are apt to react to the disposition and temper of the rider, the classes of veterinary officers and enlisted men were given instruction in and required to know by name every part of the bridle, saddle, and mounted equipment used, following the outline exactly as laid down in Cavalry Drill Regulations. Having mastered this, they next received individual instruction in folding blankets, saddling, bridling, and bitting a horse properly and in acceptance with the same regulations. After two or three periods devoted to this work, each man’s equipment was inspected as he took his place in line, and those unable to adjust it properly and find their places in line within the 10 minutes’ time allowance were placed in an awkward squad and there held until proficient. Next the pupils were taught how to hold the reins, to lead out and to stand to horse, how to grasp the reins when the hands were placed on the saddle pommel and on the neck preparatory to mounting and dismounting, the position of the hands and reins mounted, and the use of the aids in starting and halting from a walk. This was taught in the stable corrals where animals could be easily controlled, and further instruction, except unsaddling, tying of horses on picket line, proper care and return of equipment, was given in the field on the circle.
Groups of from 5 to 10 students were taken in charge by each instructor and during the first three weeks worked largely on the circle, perfecting the seat, use of aids in turning, starting, and stopping the animal, and in changing to and through the different gaits. During the first week the work was nearly
all done at a walk, and the men were constantly cautioned to hold the reins correctly and remember the following six points: Body loose, hands down, thumbs up, elbows in, legs back, heels down. The Samur seat, used in the French Army cavalry school and later adopted by our own mounted service school, was the only one taught, and with the advantage of always having the legs on the horse undoubtedly prevented many falls.41
As soon as the men were individually and collectively able to handle the mounts properly, mounted drill formations and road rides were employed to smooth out and perfect the points taught, and these soon accustomed the riders to the faster gaits. The next thing taken up was the jumping of hurdles from 1 to 4 feet in height, and ditches 3 to 4 feet wide. This necessitated considerable care, as the horses as well as the men had to be trained gradually. None of the 125 animals were schooled jumpers, having been picked up out of the Cavalry corrals, but they proved, with a very few exceptions, to be well suited to all kinds of work.
In August, 30 new flat French training saddles were received and the men had an opportunity to use these in addition to the McClellan.41 Cross-country rides over a regular course on Sundays were encouraged, and a ribbon was awarded as a prize to the winner.
Schools for the instruction of the veterinary officers in matters purely military had been built up to meet a very obvious need. The first contingent of these officers came to the school much better prepared in this respect than was the case in subsequent outfits.42 Furthermore, arriving as they did well in advance of the enlisted men, it was possible to polish up their drill considerably before it was necessary for them to plunge into the work of the provisional companies. Much of great and enduring value in the way of discipline was implanted at the beginning by the senior instructor, by lecture and otherwise and this was supplemented by drill and brief hikes. At this time the Sanitary Drill Regulations were in force, and the simple movements were taken up and dwelt upon at length. Thus in working up the first provisional companies and turning out from them the first overseas units, it was possible to build the new veterinary officers into the organization from the beginning. At the same time-there were in the ranks graduate veterinarians who by their later work showed the value of their experience as privates in the ranks in these early days of the school’s work. Throughout the first month, it was possible to bring the military efficiency of the veterinary officers along at the same rapid rate as the men, as officers actually in command, and without added instruction, for which indeed there was literally no time whatever. Later there were fresh arrivals from Camp Greenleaf who seemed not to have made so much out of their course there, and new officers from civil life who were utterly strangers to military drill and discipline. It was the rapidly growing proportion of these men that neces-sitated specialization of officers’ schools.
That the proper emphasis might be placed upon the work, the veterinary instructors were required to attend the military classes and drill so far as such duty did not interfere with the purely veterinary work.42 The senior veterinary
instructor was insistent at all times upon the importance of the purely military side of the school and lent powerful aid to the senior instructor in military training. Thus the placing of his own assistants in the military classes by the senior veterinary instructor, until such time as they were excused through passing a satisfactory examination, was of the greatest value in bringing up the morale of those officers.
In the drill periods the form of instruction in use in the line officers’ training camps was closely followed.42 For the purposes of the drill, the officers were all classed as privates. They were formed into two or more platoons, according to the total number available, and placed under the instruction of from 1 to 4 line officers under the general supervision of the senior instructor in military training
At the same time evening classes were held, these including both study and lecture.42 The lectures were given by the line officers along the lines of the lectures they themselves had attended in their own training camps. There was persistent instruction in guard duty and drill, and there were lectures on courts-martial, Army paper work, Field Service Regulations, Army Regulations, and kindred necessary subjects. Emphasis was laid from time to time on those subjects in which the daily experience of the school showed the officers to be weak.
The first contingent of veterinary officers was well qualified to instruct in gas, when the officers’ classes were formed; it was found advisable to put every officer through the course. This was done with the assistance for a time of officers from the Infantry School of Arms at Camp Lee.
ON THE MARCH
Practice marches, so vital a feature of Infantry instruction and training, were not authorized in the original synopsis of the schedule sent down from the Surgeon General’s Office covering the military work of the proposed eight weeks course, nor were they in effect in the course of training given to the first overseas units.42 In the course of this preparation, there seemed to be no need for them. The men responded so rapidly to the conditioning process of the existing schedule, the discipline was so satisfactory, and the time was so crowded that it is doubtful if practice marches would have improved these units to any appreciable extent, while they would undoubtedly have occupied much time that could have been and in fact was used to advantage otherwise. The only real road test was the short march to the first post of embarkation, and this was most satisfactory. When the personnel was kept so long awaiting orders for overseas after having been reported in readiness, it was deemed necessary for disciplinary purposes, as well as for the purpose of instruction, to take up practice marches. The men were in quarantine most of the time, and this quarantine was irksome in the extreme. It was felt to be a healthy plan to get them away from the camp from time to time, and it was felt, too, that road work, with carefully taught march discipline, was necessary to keep the men hardened, as well as to keep at top notch the esprit de corps which long close confinement to camp has a.
well-known tendency to diminish. Therefore, after consultation with the cornmandant, the practice marches were instituted, at first by unit and then as a battalion.
These marches were held in conformity with the provisions laid down in Field Service Regulations, beginning with “hikes” that averaged about 4 miles, 2 miles out and 2 miles in; and were finally worked up to a “hike” of 15 miles, the entire day being spent in the field.42 The column consisted of 5 full hospital units of 300 men each, and the 2 smaller mobile units, totaling a little below 200. Thus the column was considerably larger than an Infantry battalion, albeit handled quite as easily. In the course of these marches the opportunity was seized to drive home the lessons of personal hygiene, care of equipment, and care of the feet. There were individual cases that provided concrete examples on which the unit commanders might enlarge in their lecture.
Coincident with these marches, other rapidly formed units were getting settled in camp contiguous to that of the Third Battalion.42 For purposes of administration, this personnel was denominated the Fourth Battalion, and was under command of the commander of the Third Battalion who was the senior instructor in military training. This Fourth Battalion was so occupied with its immediate intensive training that it did not participate in the road work, but was later taken out to the main drill field for battalion drill in the interests of mass instruction for both men and officers.
The road work was planned to be progressive.42 The pace was always easy, generally at a cadence of 112 to the minute. The battalion marched out of and into the school area at attention, and occasionally 20 minutes or so of the “hike” was conducted at attention and at a cadence of 120 to the minute. In order to occupy the minimum road space the ranks were closed to 40 inches, and file closers followed in the rear of the units. Unit commanders marched in front of their units, with the result that the column invariably presented a front of a single set of fours. It is believed that these practice marches were of the utmost value to both officers and men. Besides accustoming the men to the proper adjustment of equipment, the subordinate commanders were practiced in maintaining control of their men at the roadside halts, there was practical demonstration of the advantages of the sparing use of drinking water, the men were hardened appreciably as was evidenced by the rapidly decreasing number of fall-outs for any cause, and the morale of the whole battalion was appreciably improved. The column came in singing, and when dismissed the men went shouting to the bath, which was followed by careful foot inspection. Incidentally, the sick list was cut down materially.
Something of the competitive spirit was in evidence, as that unit which came in in the best order at the conclusion of a “hike” was designated to lead the column on the next succeeding “hike”, and there was plenty of rivalry for the post of honor. Further to stimulate the interest of the men, new road formations were devised providing for columns of files at each side of the road, presumably to defeat aerial observation. Before the battalion left the camp these formations were rapidly and accurately made at the whistle signal. Thus the idea of marching at the “alerte” was implanted.
The longest “hike” was of 15 miles, 7½ miles each way, to a farm on the Petersburg-Norfolk road, where the midday meal was eaten.42 On this “hike” one of the smaller units was used as an advance guard to further simulate war conditions. There was the added advantage of practice in the designation, prompt reporting, and use of the customary camp details for wood, water, kitchen, latrine, outguard, and other functions. Fortunately, the column left camp in a thick fog, which gave opportunity for testing connecting files and the customary means of communication from head to rear of time column. This day in the field was both valuable and enjoyable. Time condition of the men was shown by the fact that there were only two stragglers, and these came in under their own power in charge of a noncommissioned officer only half an hour after the arrival of the rear of the column.
Much more of this work would have been attempted, and for longer periods, had it not been for insuperable obstacles arising from local conditions, notably the lack of proper transportation at Camp Lee for field ranges, etc., and a subsequent order forbidding units in overseas uniform appearing beyond the boundaries of the camp.42
In the interests of a real test of the discipline of the Third Battalion, one night march was held under simulated war-time conditions.42 The route was 3 miles out and return on the road to Petersburg. From start to finish this march was conducted in silence, necessary commands being given by a prearranged code of hooded flashlamp signals. The men looked upon it as a “stunt” and were interested and enthusiastic. The most exacting march discipline was cheerfully maintained throughout.
It was deemed advisable from time to time to take the battalion out at short notice, thus accustoming both men and officers to promptness in reporting readiness to move. In the end the instruction staff felt that this sort of training was as valuable for troops of this character as for Infantry, and that it was especially noticeable in the effect on the morale at a time when completely equipped overseas units were chafing under strict quarantine awaiting orders to move for the port of embarkation.
Just at this time even the officers of overseas units were attending officers’ drill, thus leaving the units for a part of the day in sole charge of their noncommissioned officers. This condition was seized upon for a further polishing of the latter. In order that their handling of the units at drill might be uniform throughout both the Third and Fourth Battalions, the noncommissioned officers were drilled as a company for an hour in the evening three times a week.42 They entered into the work in a hearty spirit of cooperation and carried the lessons learned back to their units with them. This special training would have been continued indefinitely but for the advent of the influenza epidemic. As it was, the work bore fruit, as it happened that on the day the commanding general made an inspection of the camp the units were drilling under their noncommissioned officers, while on another field the veterinary officers were drilling under command of the line officer instructors. The general expressed gratification at the work of the noncommissioned officers acting as company and platoon commanders, and was surprised to learn that they were practically all homemade products of the Veterinary School’s training.42
Another feature of the training was the drill by battalion, of the Third and Fourth Battalions. These organizations were broken up into battalions of convenient size for the rather restricted main drill field, providing four battalions in all. These battalion drills were supplemented by ceremonies which included the required inspections on Saturday mornings, and there followed week end after week end when the Third Battalion appeared in full strength, primed and fit for overseas orders. The influenza epidemic subsequently meant the breaking up and radical reorganization of the enlisted personnel of this Third Battalion, but there was a long period when it stood ready to move, thoroughly equipped and drilled and possessed of a morale that was gratifying in the extreme to its officers and instructors. Thus the battalion drill added to the schedule like the practice march may be said to have served a useful purpose.
A necessary part of the training of veterinary officers and mem must be given in a practical manner. This was anticipated, and a modern veterinary hospital with adequate facilities for caring for the public animals of Camp Lee, including those of the auxiliary remount depot, was planned and authorized.43 It was officially termed the “camp veterinary hospital,” and originally was destined to become a part of the Veterinary Training School. Authorization of this part of the Veterinary Training School was made on March 22, 1918,36 but construction of building was long delayed because of a labor shortage and the delay and difficulty in procuring building materials. In fact, construction of essential parts of the hospital buildings was not complete at the time the armistice was signed.43 The following buildings were constructed : 43
Administration. - A standard type 5-room structure.
Officers’ quarters . - Two 5-room buildings, each equipped with kitchen, pantry, dining room, and bath.
Enlisted men’s barracks. - Two 2-story buildings of standard type, sufficiently large to house comfortably the 80 enlisted men of the command.
Mess hall for enlisted men. - Of standard type and large enough to accomodate 200 men.
Receiving and issue ward. - For the stabling of patients before their discharge or consignment to other wards for treatment. This ward had a capacity for standing 58 animals.
Medicalward. - Stalls for 100 animals, especially constructed stall for patients that are down, and a dispensary. In this, as in all other wards, there were installed electric lights and suitable provisions made for ventilation arid drainage.
Surgical ward. - This ward was the largest and best-equipped ward of the hospital. It was built with the same kind of standings as the medical ward (concrete and cork-brick) and had the same facilities for the comfortable stabling of 100 animals. A connected operating unit was built and a well-lighted, steam-heated room for the handling of surgical cases was provided. This included an office for the ward surgeon and his sergeant, a dispensary and storeroom, a sterilizing room, and a separate room for dressing wounds and for handling certain minor surgical cases. Connected with the operating unit was
a recovery stall for patients requiring special attention after having been anesthetized.
Contagious wards. - Three wards specially constructed for handling animals suffering from communicable diseases, each with stall room for 68 animals, formed a very essential part of the hospital.
Isolation ward. - One building capable of stabling 44 animals, built on the same plan as the contagious wards and located in the same vicinity. A double fence surrounded contagious and isolation wards in order to minimize the possibility of the communication of infectious diseases from animal to animal by direct contact. This same plan was utilized as a safeguard for contagious corrals located away from the wards.
Hospital stable. - For stabling animals used for hauling wagons and other necessary work at the hospital; also for stabling riding horses.
Forage barn. - A large building for storage of forage and so arranged that specially prepared feed could be supplied sick animals.
Hay shed. - For storing large quantities of hay and straw for animals treated at hospital.
Mortuary. - A well-constructed building for post-mortem examinations.
Yard offices. - For receiving and recording animals at the various wards. Also used for storing forage for daily use and apparatus such as gear, grooming, and feeding utensils.
Dipping vat. - For dipping animals in treatment of parasitic skin diseases. Not completed at time of the signing of the armistice.
Exercising ring. - Intended for a part of the work of conditioning patients before being discharged from the hospital. This also was not completed.
Septic tank and filtering bed. - For the sanitary disposal of sewage. The tank was completed in time for use, but the gravel bed was not put in operation.
The hospital organization was effected with a twofold object in view--to give all necessary treatment to animals of the camp that required treatment and to train officers and men composing hospital units scheduled for overseas service.43 Therefore, the personnel of the camp veterinary hospital was expected to manifest efficiency both as practical men in handling sick and injured animals and in giving practical instruction to those assigned to this hospital for training. It was intended that units in training at the Veterinary Training School would be sent to the camp veterinary hospital daily for instruction; such instruction to be of a practical nature. Officers were to receive instruction in practical administrative duties of a military character and also in the scientific work of conducting an army veterinary hospital. Noncommissioned officers in training were scheduled to work under the guidance of noncommissioned officers of the camp veterinary hospital. Likewise farriers, wagoners, and privates were to be taught, practically, all that was expected of them, to the end that they might beconme efficient in their respective duties before being sent overseas.
On February 15, 1919, all school records were transferred to the office of the personnel adjutant, Camp Lee, Va. The Veterinary Training School was closed formally at 5 p. m. February 15, 1919, and ceased to exist as an organization.44
Source and distribution of personnel 44
ENLISTED MEN WITH SPECIAL INSTRUCTION
Cooks, saddlers, horseshoers, farriers transferred from Fort Riley, Kans.: Cooks, 24; farriers, 4; horseshoers, 42 saddler, 1.
Cooks were given special instruction at Cooks and Bakers School, Medical Officers’ Training Camp, Fort Riley, Kans., and were given practical examination before being permitted to discontinue course of instruction.
The following number of enlisted specialists received instruction and were assigned to units at the Veterinary Training School: Cooks, 94; farriers, 744; horseshoers, 187; saddlers, 64.
Overseas units formed at school
Units formed which did not depart
VETERINARY SCHOOL OF MEAT AND DAIRY HYGIENE, AND FORAGE INSPECTION, CHICAGO, ILL.
Prior to the Spanish-American War very little attention was devoted to the adequate veterinary examination of meats and dairy products for the military forces of the United States.45 Subsequent to that period and very largely resulting from the experience gained during the Spanish-American War, a system of meat inspection was evolved which enjoined subsistence officers to familiarize themselves with meats, meat food and dairy products, and the various methods and practices involved in their preparation. This system included the employment of a limited number of qualified veterinarians at the important packing centers to supervise the preparation of meats, and courses of instruction occasionally were given by them to commissioned and noncommissioned officers of the subsistence department. Each of these courses covered a period of four to six weeks and the subject matter taught included principally the cuts and grades of fresh and cured meats. The practical and essential points concerning these products were reviewed in as thorough a manner as the limited time would permit.
The consolidation of the subsistence department into the Quartermaster Corps took many of the trained subsistence officers out of this special line of work and placed the responsibility of the inspection of meats very largely upon veterinarians who had been specially trained and had experience along these lines.45
All recognized veterinary colleges in the United States at the beginning of the World War were conducting courses in meat and dairy hygiene, but few of the graduate veterinarians in 1917 were at all familiar with military requirements.46 Up to that time little effort had been made to instruct the Army veterinarian along this very important branch of his profession, and there had been a lack of uniformity in the work accomplished.
As an emergency activity of the World War a school for veterinary personnel in meat-and-dairy hygiene and in forage inspection was found necessary. Chicago, Ill., was considered the most suitable place for the operation of a school of this kind, because the efficient training of veterinary officers and enlisted men in all the sanitary and procurement phases of military meat and dairy hygiene could be conducted there at the large depot where supplies were being purchased and handled in quantities in a huge packing house, products manufacturing, and dairy center.46 Chicago was the most important procurement point for meat food supplies and forage; it assured access to the stockyards, large packing houses, products manufacturing concerns, dairy farms, public health laboratories, grain elevators, and hay warehouses, and insured a large number of students for instruction at one time, and these facilities were not available or obtainable elsewhere. Furthermore, at the Chicago supply depot all the advantages of direct contact with veterinary officers and enlisted men assigned inspection duty and who were actively engaged in making inspections were available. Therefore, in August, 1917, a school in military meat.and dairy hygiene and in forage inspection for veterinary officers was established at the general quartermaster depot, Chicago, Ill., under the supervision of the depot veterinarian.46
Later in 1917 a similar school for enlisted men was started at the same place.46 Most of the enlisted men inducted for this service were exceptionally good packing-house men, well qualified and with considerable training in this particular line.
Selected veterinary officers were first detailed to this school in August, 1917, received intensive instruction until considered proficient, and then were detailed to organizations going overseas, and to divisional cantonments, stations, and procurement points in the United States.46 Successive classes of officers and enlisted men were trained in this school for periods of from six weeks to three months until the formal authorization in July, 1920, of the Veterinary School of Meat and Dairy Hygiene and Forage Inspection.47 The students were given individual, practical instruction in the packing houses and products establishments. This instruction was supplemented by daily lectures and conferences. From August, 1917, to November 11, 1918, 82 veterinary officers and 96 enlisted men completed instruction in this school.46
The instruction given included lectures, practical work and demonstrations, and quizzes in the following:46
Organization and administration of the veterinary meat and dairy hygiene and forage inspection service at points of procurement, at supply depots and at stations.
Sanitary inspection of establishments as to location, construction, equipment, and methods of operation.
Ante-mortem inspection of food animals, including marketing agencies, 28-hour law, transportation of food animals, their receipt at destination, market classes and grades of livestock, quarantine, and sanitary and procurement ante-mortem examinations.
Slaughter of food animals.
Post-mortem examination of food animals, disposition of diseased carcasses and parts, and denaturing rejected products.
General-products inspection; reinspections; authorized ingredients; branding; laboratory examinations; miscellaneous products as gelatin, mincemeat, beef extract, bouillon cubes, rabbits; and the sanitation of inedible compartments in official establishments manufacturing neat‘s-foot oil, glue, tallows, greases, tankage, and fertilizer.
Fresh beef, real, mutton, and pork. - Offal, carcass meat, wholesale cuts and trimmings as to sanitary source; selection; classes, grades; grading for condition, quality, and weight; dressing; branding; chilling; trimming; boning; freezing; defrosting; covering; packing; stamping of packages; handling; storage; shipment; receipt; issue; veterinary, sanitary, and procurement examinations; reinspections; action; manufacture of ice.
Cured pork and beef products, considering especially Army bacon, hams, shoulders, salt pork, corned beef, dried beef, salt beef, ox tongue, meat flour, tripe, and other cured products as to veterinary, sanitary, and procurement examinations; sanitary source of products; selection; grading for condition, quality, trim, and weight; cutting; trimming; grading for cure; authorized curing ingredients; pumping, placing into cure, overhauling, manufacture of curing mixtures or solutions; brushing; washing; labeling; hanging; smoking; weighing; wrapping; packing; stamping of packages; handling: storage;- shipment; receipt; issue; sanitary and procurement requirements; reinspections and action.
Canned meats, including roast, corned, and dried beef; corned beef hash; ox tongue; meat flour; Army bacon; pork for beans; fresh pork sausage; Vienna style sausage; veal loaf and other canned products as to sanitary source; soundness of ingredients used, cutting, boning, soaking, curing, pickling, cooking, trimming and sorting of meats; cans, their construction, size, cleanliness, stuffing, weighing. sealing, exhaustion and sterilization; examination of finished canned products as to defects of manufacturing, lacquering and labeling; weighing; packing; development; handling; storage; shipment; receipt; issue; sanitary and procurement requirements; reinspections and action.
Rendered meat products, considering oleo stock; oleo stearine; oleo oil; edible tallow; prime steam, refined, neutral, kettle rendered, dry rendered and hydrogenated lards; lard compound; margarines and lard substitutes, as to sanitary source; authorized ingredients, including selection, soundness, grading for condition, quality and quantity; the washing, trimming, handling, chilling, hashing and rendering of fats; the settling, drawing off, clarification, bleaching, filtering, cooling, seeding and pressing of oils; manufacture and Pasteurization of starter; weighing, mixing, and churning ingredients; crystallization; tempering; working; blending; packing; crimping; weighing; strapping; branding;
handling; storage; shipment; receipt; issue; laboratory examinations; sanitary and procurement requirements; reinspections and action.
Sausages, including fresh, smoked, cooked and dry sausages, cooked meats, pork products customarily eaten without cooking and other sausage-room products, considering ingredients used, as casings, meats, spices, preservatives, cereals, water and dyes; their sanitary source, selection, preparation, grading for condition, quality and amount, their curing, freezing, defrosting, grinding, trimming, chopping, boning, mixing, stuffing, or other preparation; wrapping; smoking; cooking; chilling; washing; drying; branding; handling; weighing; storage; shipment; receipt; issue; laboratory examinations; sanitary and procurement requirements; reinspections and action.
Poultry, live, fresh dressed, frozen, and canned; including their sanitary source; classes; shipment; fattening; ante-mortem and post-mortem examination; slaughter; plucking; chilling; weighing; grading; drawing; packing; freezing; storage; defrosting; canning; handling; receipt; issue; sanitary and procurement requirements; reinspections and action.
Eggs, including fresh, sterilized-shell-processed, frozen, desiccated and preserved eggs, as to structure, production, characteristics, candling, classes, grades, handling, packing, storage, shipment, receipt, issue, sanitary and procurement requirements, reinspection, and action.
Marine products, including fresh, frozen, cured, and canned salmon, sardines, codfish, mackerel, anchovies, caviar, herring, tuna, fish flakes, crab meat, clams, oysters, lobsters, halibut, shrimp, and other fish and sea foods, as to sanitary source; acquirement; handling; dressing; chilling; packing; shipment; storage; freezing; defrosting; curing; canning or other preparation; receipt; issue; sanitary and procurement requirements; reinspections and action.
Milk, including fresh, whole milk, skim milk, cream, whipping cream, certified milk, inspected milk, Pasteurized milk and cream, condensed milk and cream, powdered milk, reconstructed milk, malted milk, and ice cream, as to standards, composition, adulterations, laboratory examinations, production, sanitary dairy farm examination, tuberculin testing of dairy animals, sanitary inspections of collecting depots, creameries, and Pasteurizing plants; ingredients, processes of manufacture, classes, grades, handling, packing, storage, shipment, receipt, issue, sanitary and procurement requirements and action. Some of this instruction was carried on under arrangements made with the health department laboratories of the city of Chicago.
Butter, including sanitary source; selection, sampling, testing, grading, standards, and adulterations of ingredients used; the receipt, weighing, grading, mixing, heating, ripening, and churning milk or cream; the salting, washing, working, testing, weighing, canning, scoring, wrapping, packing, labeling, storage, handling, shipment, receipt, issue, laboratory examinations, sanitary and procurement requirements; reinspections and action.
Cheese, including American Cheddar type, pimento, Camembert, Swiss, Edam, canned and other cheese, as to sanitary source, methods of manufacture, classes, grades, scoring, standards, adulterations, selection, handling, storage, shipment, receipt, issue, sanitary and procurement requirements; reinspections and action.
In addition to the above training, in February, 1918, a special class of five veterinary officers was organized under two experienced veterinary officers who were specialists in the manufacture and inspection of butter.46 These five officers were intensively trained in this work so that in May and June of that year they supervised the manufacture and canning of more than 1,000,000 pounds of creamery butter. This class rendered additional valuable service on butter inspection. In September, 1918, when the Army commandeered 80 per cent of the butter in the United States in cold storage, these veterinary officers selected, graded, weighed, inspected, and certified for payment 6,217,897 pounds of butter and more than 3,000,000 pounds of cheese, valued at more than $3,781,000.46
The importance of the training of veterinary personnel in meat and dairy hygiene is shown by the inspections maintained by the Veterinary Corps from April, 1917, to March 31, 1919, as follows: At purchasing points, 1,261,728,441 pounds of meats and dairy products, having a money value of $473,914,827.62, were inspected and passed for food; at stations, 234,153,619 pounds; for the Italian Government, 976,687 pounds of fresh, frozen beef; and for civilian relief work in Europe, inspected and supervised the packing and shipment of 31,454,566 pounds of meat. In addition, 10,956,408 pounds were rejected, making a grand total of over one and one-half billion pounds of meats and dairy products inspected by trained Army veterinary personnel during this period 46
VETERINARY LABORATORY, PHILADELPHIA, PA.
A veterinary laboratory was established at Philadelphia, Pa., in January, 1918, with a major, Veterinary Corps, in charge.48 Laboratory rooms were loaned by the University of Pennsylvania, and equipment and supplies were furnished by the Medical Department. The main purpose of the laboratory was to conduct research in the etiology, prevention, and treatment of equine influenza, pneumonia, and strangles. With a view of supplying veterinary laboratory service at all the department laboratories, several officers of the Veterinary Reserve Corps, specialists in laboratory procedures, were ordered to active duty at the Philadelphia laboratory for about six week’s intensive instruction in uniform technique. At the completion of this course these students were assigned to department laboratories.
The research problems studied included experiments with the intradermic mallein test and its effect upon subsequent serological tests for glanders, with various veterinary biological products, the value of acetic acid in the treatment of B. necrophorus infections, and the development of a bacterin for use in the control of equine infectious abortion.49
ARMY SCHOOL OF NURSING a
The recommendation of the Surgeon General for the establishment of an Army school of nursing as the method of providing for the rapid expansion of skilled nursing service that the continuation of the war would inevitably demand was approved by the Secretary of War, May 25, 1918. 50
a Unless otherwise indicated, this report is based on ‘The }Iistory of the Army School of Nursing,” by Annie W. Goodrich, Army School of Nursing. On file, Historical Division, S. G. 0.
As a result of a conference in the Surgeon General’s Office, the chairman of the Red Cross nursing service, the superintendent of the Army Nurse Corps, and the chief inspecting nurse were appointed a committee to prepare a plan for the suggested school. The committee, after consultation with the nurse members of the committee on nursing of the Council of National Defense, reported as follows:51
1. The committee appointed by your order has interpreted its purpose to be:
The creation of a plan whereby through an Army school of nursing the most complete nursing care may be provided for the sick and wounded soldiers at home and abroad, for the period of the war and for as long thereafter as the Government may decree. Also nurses for such other health fields as may be developed by the Medical Department.
The plan to provide for an easy, constant, and almost unlimited expansion of training fields and consequent increase in student arid graduate nurses, in order that the arising demands of the service be fully met.
Through the provision of the student body to have in the process of training large groups becoming increasingly competent, thereby enabling the release of the most experienced nurses for the foreign and other demanding fields without lowering the efficiency of the base hospitals.
To immediately raise the standard of the nursing care of the sick in the base hospitals by the provisions of an increased number of persons to render such care.
2. The plan as presented provides that the school, to be known as the Army School of Nursing, shall be located in the Office of the Surgeon General. Through this office the enrollment of the students will take place, and all matters relating to the general management of the school shall be dealt with. The faculty, presided over by the dean of the school, is to determine all questions relating to the course of instruction, the general administration of the school being intrusted to the dean. It is suggested that an advisory council be appointed composed of members of the Medical Department, the superintendent of the Army and Navy Nurse Corps, the director of the department of nursing of the American Red Cross, the presidents of the American Nursing Association, the National League of Nursing Education, the National Organization for Public Health Nursing, the dean of the School of Nursing, and other members of the nursing profession conversant with the problems of nursing education to make recommendations concerning the appointment of the faculty, the relations between the military and civil hospitals, and other matters relating to the general policy of the schools.
The course of training will be given in the various base hospitals assigned as training camps, each one of which will be a complete unit, having its own director, its staff of lecturers, instructors, and supervisors, and its teaching equipment. These units will be developed as rapidly as the needs of the service demand. The directors and such members of the teaching staff as shall later be determined shall be members of the faculty.
The course leading to a diploma in nursing shall extend over a period of three years. The experience in the military hospital will provide surgical nursing, including orthopedic. eye and ear, and nose and throat; medical, including communicable diseases and nervous and mental diseases. Experience in children’s diseases, obstetrics, and public health nursing will be provided through affiliation.
It is believed that the complete course will attract the most intelligent and largest number of women to the school and will result in a more efficient service both in the military hospitals and in such public health fields as the Medical Department may assign nurses to.
Upon completion of the course the students would become members of the Regular Army Nurse Corps in the order of the vacancies; or should there be no vacancies, they would be placed on the list for appointment as vacancies occur.
They would be eligible for State registration, for membership in the American Nurses’ Association, the national organization for public health nursing, enrollment in the nursing service of the American Red Cross, and for advanced courses in the teaching, administrative, and public health fields.
A detailed outline of the plan is herewith presented, together with recommendations concerning the necessary circular and forms that will enable the immediate development of such a school if the authorization for its establishment is granted.
The authorization of the establishment of the school brought into immediate existence a division in the Surgeon General ‘s Office designated as the Army School of Nursing, and administered by the chief inspecting nurse, under the title of dean, who was directly responsible to the hospital division. The work fell into three bureaus: General information, credentials, and inspection, with a professional personnel of 9 and a maximum clerical staff of 30.
Bureau of general information. - This bureau was flooded with inquiries following a brief announcement of the school in the Official Bulletin, and an excellent and widely disseminated article in the press. Through the committee on nursing of the Council of National Defense, 25,000 announcements of this school were issued by a private printing company within a week, and the small printing department at Walter Reed Hospital put out 10,000 each of the various forms required by the applicant for admission within a few days, thereby making possible a rapid enrollment of students.
Bureau of credentials. - The requirement of four years’ secondary work, or an educational equivalent, for admission to the school, and the giving of credits for advanced work, demanded careful and accurate evaluation of credentials.
Bureau of inspection. - This bureau was charged with the standardization of nursing care and equipment for the military hospitals where students were to be placed, the maintenance of the educational standards of the school, and the reports on civil hospitals and other institutions in connection with student affiliation.
Pending the decision as to the creation of a school, the inspection of the base hospitals was continued. At this time 20 inspections had been made, each one strengthening the opinion that the school would not only prove the most effectual supplement of the graduate nurse staff, but would be an important factor in raising the standard of nursing care.
One hundred and twenty-six inspections and visits were made in this country during the year, the signing of the armistice, with a consequent rapid decrease in the nursing service, obviating the necessity of the inspection of the military hospitals overseas, originally included in the functions of this bureau.
The advisory council. - In accordance with the plan of the school, the Surgeon General appointed an advisory council, on which sat five medical officers representing the Medical Department of the Army; representing the nursing profession were the chairman of the committee on nursing, the chairman of the Red Cross nursing service, the president of the American Nurses Association, the president of the National League of Nursing Education, the honorary president of the National Organization of Public Health Nursing, the superintendent of the Navy Nurse Corps, the superintendent of the Army Nurse Corps, the superintendent of the Presbyterian Hospital Training School, and the dean of the Army School of Nursing. Two meetings of the council were held during the year. At the second, in February, 1919, a resolution recommend-
ing the creation of a permanent school by Congress was passed and referred for approval to the Surgeon General, together with a tentative draft of a bill incorporating the essential requirements for the establishment of a school of high standards and on a sound basis.
Faculty. - The faculty comprised nurse directors and instructors, medical lecturers, and such other assistants as were required in the development of the school at the various military hospitals where students were placed.
Three conferences of the nurse members of the faculty were authorized by the Surgeon General, the last--of special value--being called in Chicago, in conjunction with the convention of the National League of Nursing Education, thereby making possible a discussion of nursing problems affecting both the civil and military schools, and strengthening the cooperation between the two.
The first literature concerning the school was issued on June 7, 1918; on June 17, 75 applications had been filed. Applications continued to come iii in increasing numbers, the maximum received in one week being 1,249, and by November 11, the date of the signing of the armistice, 10,689 had been received, of which 5,267 had been accepted, 3,185 declined, and 2,219 were still under consideration; 1,099 students were on duty in 25 military hospitals, and 567 students were ready for assignment immediately upon the withdrawal, for overseas duty, of a sufficient number of graduate nurses to provide the necessary accommodations. For a brief period following the signing of the armistice, the acceptance and assignment of students continued, bringing the accepted applications up to 5,869 and the number of students on duty to 1,578, in 32 military hospitals, on December 21, 1918.
United States Student Nurses Reserve. - From the outset the Red Cross divisions rendered active assistance in recruiting students for the Army School of Nursing, but the heavy enrollment of graduate nurses that the continuation of the war would inevitably necessitate and the importance of a largely increased student body in both civil and military hospitals, in order that the release of the graduates be effected, without imperiling the sick in this country, made imperative a definite and extensive recruiting campaign. Such a campaign was undertaken by the women’s committee of the Council of National Defense, cooperating with the Surgeon General of the United States Army, the American Red Cross, and the nursing committee of the council, under the title of the United States Student Nurses Reserve. The program provided for an intensive campaign, extending from July 29 to August 11, for the enrollment of 25,000 young women pledged to hold themselves in readiness until April 1, 1919, to enter either a civilian school of nursing or the Army school, if called, with the privilege of expressing a preference as to the school. Only students meeting the age and educational requirements, however, were placed on the waiting list of the Army school. As the full quota desired was not realized within the period of time allotted, the various State committees were authorized to continue the enrollment until the need ceased.
College preliminary course. - A further and not less important plan was developed by the American Council on Education, with the approval of the Surgeon General, whereby intensive preliminary courses of 12 weeks were to he established at higher educational institutions, the American Council on
Education undertaking to assist in recruiting students. The estimated quota was 2,000 students by October 1, 1918; 4,000 by January, 1919; and 5,000 by April, 1919. A number of colleges had signified their readiness to give these courses, while others had the matter under favorable consideration, when the cessation of hostilities led to its abandonment. This group would have been a valuable addition to the student body, relieving the Army school of the three months’ preliminary course and making the student of immediate assistance in the hospital ward.
Civil school students. - As a means of further increasing the nursing personnel through a student body, and to steady the situation in the civil hospitals by giving their students a place in the war program, an opportunity was opened in August, 1918, to the schools of the 50 Red Cross base hospitals first sent overseas to send such a number of their senior students as could be spared, through affiliation with the Army School of Nursing, for immediate service overseas.
A course in the military hospitals of four months was also arranged for the senior and intermediate students of other civil schools, through which, if adjusted satisfactorily, they would be prepared for overseas service immediately upon graduation, or could be sent earlier, if necessary; it being desired that the students in the Army School of Nursing should have been in the service, if possible, a year before being sent overseas. Information and regulations relating to the course had been issued, and a number of civil schools had signified their desire to send students, when hostilities ceased.
Hospital assistants. - In order to conserve all available material it was also decided to enroll as hospital assistants women disqualified for overseas service by marriage or overage, and therefore not eligible for enrollment as students in the Army School of Nursing or in the civil schools. It was believed that this group, of whom approximately 1,000 had applied, would well supplement the graduate nurses in the convalescent hospitals in this country, leaving the acute service for the student body. To avoid complications and confusion relating to eligibility and placement and to insure an increasing competency of service through instruction and supervision, this group was entered as a division of the Army School of Nursing.
Red Cross aides. - The increasing shortage of nurses overseas, and the constant- pressure for aides, due presumably to the failure of those in charge on the other side to understand both the potentialities of the school and that the shortage related to transportation rather than to an exhausted or inadequate graduate nurse supply, together with the anxiety caused by the influenza epidemic, led to the suggestion of the enrollment of practical nurses as less likely to affect the enrollment in the school, and to a countersuggestion calling for the enrollment of Red Cross aides:
I recommend against the enrollment of the practical and experienced nurses because they represent a class now more needed than ever in community life, because of the withdrawal of graduates * * *
Rather than call upon the practical nurses so-called, I recommend:
1. Pushing the Army School of Nursing, which is the strongest part of our program.
2. Calling upon the civil hospitals to send affiliating pupils as many have indicated their desire to do.
3. Calling upon the civil hospitals to give preliminary training to hospital assistants, the group already authorized. This group to include married women between 21 and 40 whose husbands are overseas and single women between 35 and 45. This will establish the machinery for training a larger group should necessity arise. This course to cover six weeks or two months.
4. In order to meet tile present emergency requirements, I recommend that the Red Cross select with care 1,500 of their nurses’ aides who are between 35 and 45 years of age, and that these be sent at once overseas to supplement the nurses over there. This will meet the emergency and leave the field open here for the development of our program for the Army school and hospital assistants.
5. That an appeal be issued at once in the name of the Surgeon General to all young women of the country calling them to service, either through enrollment in the Army school or civil schools or as hospital assistants, according to the group in which they fall, and making plain to them that this is their greatest service, and also emphasizing that the pupils will be sent overseas as soon as ready and as needed.
Accordingly, the Surgeon General requested the American Red Cross nursing service to enroll 1,500 nurses’ aides.
At the request of the Red Cross the age limit of the 1,500 aides was reduced to 30, it having been ascertained that only about 7 per cent of the accepted applicants for admission to the Army school exceeded that age. The signing of the armistice prevented the sending of these aides overseas.
The development of the training school units. - The rapid development of the school, obviously so necessary, and made possible by the immediate and heavy enrollment of students, was greatly delayed and hampered by the unfamiliarity of the chief nurses with the training school field, the large number of executives arid instructors that had been sent overseas, and the consequent shortage of such personnel in the civil schools. A further difficulty came through failure to provide a graded service for the Nurse Corps, analogous to the grading of the commissioned personnel, and an almost universal system of control and direction in civil institutions; this omission made the positions of head nurse, supervisor, night superintendent, etc., undesirable, since they entailed increased responsibility without increased authority or salary; the omission to furnish the chief nurses with any data, other than the meager efficiency records, relating to the general education and the professional preparation of the graduate nurse personnel and the branches of nursing in which they had had experience was a still further handicap in the selection of an efficient supervising staff. The greatest obstacle in the school development was due, however, to the slow transportation of graduate nurses overseas and consequent inadequate housing capacity.
This delay was overcome in a measure by a circular letter, informing the commanding officers that in the future students would replace the graduates sent overseas, and ordering that quarters be found as soon as possible, as it was imperative that the course be begun and the efficiency of the students thereby hastened.
Chief nurses released for overseas duty were replaced by those who held executive positions in civilian schools, while the release was sought and obtained of several well-known nurse educators.
Thus an adequate number of executives were obtained, and, in the majority of cases, instructors of pedagogical as well as professional preparation were
secured. A notable contribution was the privilege of the four months’ preliminary course at Teachers’ College, Columbia University, New York City, for the training school unit at United States Army General Hospital No. 1, made possible by the authorities of the college through the omission of all tuition fees for these students.
COURSE OF STUDY
The timely issuance of the standard curriculum, prepared by the education committee of the National League for Nursing Education, made possible a uniform course of instruction. The necessary text and reference books and a classroom equipment, excelling that of most schools, were authorized, and despite the delays consequent upon a war situation were, in the main, promptly delivered.
The time allotted to the various subjects was divided between lectures and demonstrations by members of the medical staff or special lectures, and classes, quizzes, and laboratory work under qualified nurses and other instructors.
The subjects included in the preliminary course were: Anatomy and physiology; applied chemistry; bacteriology; personal hygiene; hospital housekeeping; nutrition and cookery; drugs and solutions; elementary nursing principles and methods; bandaging; historical, ethical, and social basis of nursing.
The subjects following the preliminary course included: Materia medica and therapeutics; diet in disease; massage; surgery; orthopedics; diseases of the eye, ear, nose, and throat; operating room technique; general medicine; communicable diseases; occupational, venereal, and skin diseases; nervous and mental diseases; diseases of infants and children; gynecology; obstetrics.
Public health nursing, social service, and other subjects relating to the problems of the several fields of nursing and modern social conditions will be taken up in the third year.
When the proposition for establishing an Army school of nursing and training students in our camp hospitals was first launched, a general impression prevailed that this would be a dangerous undertaking from the social standpoint. A large number of young and recent graduates had been obliged to face the unusual conditions of camp life with perhaps less preparation for meeting such conditions than many of the students enrolled in the Army school who had previously been thrown on their own resources, or who had passed through college, or had been in the teaching field. Therefore, it was felt that with proper guidance from the directors, instructors, and social directors of the units, the students would not be at any less disadvantage than those in our civil schools. The students were quick to adopt a plan of self-government under the advice of their director and instructor and assumed the responsibility in maintaining the good standing of their individual groups. It was interesting to see how this worked out in the various units and the problem of their social life brought under their own control. (See infra, p.452.) The social activities showed a variety of features. In some, music was dominant, in others the drama; glee clubs were organized, playlets written and carried out; in some groups drill and outdoor sports were emphasized. Students in all of the units were drilled
every day, or at least three times a week, out of doors when the weather was good; if not, indoors with open windows in the form of setting-up exercises. In an interesting group of 100 in one of our northern camps, students were outfitted from the Quartermaster Department with leggings, coat, and overseas cap for outdoor drill and hikes.
These wholesome forms of exercise and recreation created a splendid unit and took care of the leisure time after study and ward duty; when brought under the control of the student body itself it promoted a strong class spirit and unity. The Red Cross recreation house, designed for the uses of the nurses of the Army Nurse Corps, was, as a rule, given over to the students on one or two evenings of the week that they might receive their visitors, have dances, or other form of entertainment as they arranged for.
A military uniform and insignia were authorized by The Adjutant General, the latter being a bronze lamp, superimposed on the Caduceus, a tribute to the founder of nurse training schools, Florence Nightingale.
STATE REGULATIONS OF THE SCHOOLS
The educational requirement for admission and the period of professional education entitled the graduates of the school to nurse registration, except that students to whom credit for collegiate or technical work was given were not eligible in States requiring a full three years’ course in a hospital.
CONTINUATION OF THE COURSE
The close of the fiscal year (June 30, 1919) presented 741 students remaining to complete the course, leading to the diploma of the school, 573 on duty in 15 military hospitals, and 168 absent in the affiliating schools. The percentage of withdrawals was not high considering the large number of students previously engaged in the occupational fields.
AFFILIATION WITH CIVIL SCHOOLS OF NURSING
The response of the civil hospitals to the request for experience in the services not obtainable in the military hospitals was generous both as to opportunity and in the adjustment required to meet the needs of the Army school; affiliation being effected with the leading hospitals able to give the required experience in New York, Baltimore, Philadelphia, St. Louis, Washington, Chicago, Boston, Minneapolis, Cincinnati, Newton, Mass., and San Francisco.
The credit allowed for advanced work reducing the term in the school and the admittance of the entire body of students within a period of six months necessitated, in order that the full experience be obtained by each studentseeking a diploma, an earlier admission to the affiliating courses than is customary for the special hospitals (maternity especially) to permit. These requirements were relaxed, but the adjustment of the students to the work was satisfactory and is evidence of the value the student body would have been for overseas duty had the war continued.
ARMY SCHOOL OF NURSING, UNITED STATES ARMY BASE HOSPITAL, CAMP
The report of the Army School of Nursing conducted at the base hospital, Camp Grant,52 is given in full as an illustration of the conduct of an Army school:
STUDENT NURSE BATTALION, ARMY SCHOOL OF NURSING
In the spring of 1918, it was apparent that there would be an acute shortage of graduate nurses in the Army. The civilian communities had been combed of available qualified graduate nurses and still there was an urgent call for graduate nurses from overseas.
The division surgeon, 86th Division, Camp Grant, and the commanding officer, base hospital, Camp Grant, Ill., made a recommendation to the Surgeon General of the Army, under date of June 8, 1918, that this hospital be permitted to conduct a school for practical nurses in order that graduate nurses be released for overseas duty. In reply to this communication, the Surgeon General stated that his office had under consideration a proposed plan for conducting training schools for nurses in the Army that would require three years for graduation. This plan was superior to the one offered from Camp Grant in that the nurse would be a graduate and thoroughly qualified to carry on this profession as her life’s work. This same communication stated that if the Army School of Nursing was organized, Camp Grant would be one of the camps selected.
The first group of students arrived August 14, 1918. They were typical “rookies,” dressed in every conceivable costume and very much excited over their niew environment. They expected and were willing to live in barracks and undergo many of the hardships that are ordinarily experienced in field service. Attractive quarters had been built and furnished for the students. The faculty was organized for their training, both from a professional and military standpoint, and the students were assigned to duty the following day.
The problem of discipline was one that we had given considerable thought, and it seemed advisable to give the new rookies some of the military training that is customary for all recruits; therefore, drill was promptly started and the girls were given the same foot drill as is given enlisted men of the Medical Department. They were intelligent and grasped the idea rapidly. However, there were two features that were difficult to overcome and are not ordinarily encountered in drilling enlisted men. One was looking around and laughing, while the other was an uncontrollable desire to be continually fixing their hair. This group was called Company A and was turned out daily for retreat.
The second group of students arrived September 18, 1918. There were 36 in number. This group was organized as Company B and given the same instructions as Company A. They were much easier to train, as Company A assisted very materially in the training. Authority was obtained to issue olive-drab overcoats. This was promptly done and has served a good purpose. Not only has it been a material saving to the students, but adds much to the military appearance. Company B arrived but a short time before the “flu” epidemic. In fact, they were here but a few days before it was necessary to put them into the wards, and the undersigned desires to go on record as saying that the students of both Company A and Company B were of the greatest value during that emergency.
The third group of students arrived November 20, 1918, and were organized as Company C. Students were selected from the three groups as commissioned and noncommissioned officers. A captain, first lieutenant, second lieutenant, first sergeant, and necessary sergeants and corporals were properly uniformed and assigned to each company. The students were given squad, company, battalion, and athletic drill and were outfitted in a woolen uniform, with puttees and overseas cap, on account of the severe winters in this climate. Daily drill and retreat was kept up until the early spring. The students were greatly benefited by the drill, as was noticed in the manner in which they would receive and obey orders, and the military manner in which they would carry themselves. It is an inspiring sight to see the manner in which they honor the flag at all ceremonies.
REPORT OF THE ARMY SCHOOL OF NURSING AS INCORPORATED IN THE QUARTERLY REPORTS, ARMY NURSE CORPS, SUBMITTED TO THE COMMANDING OFFICER BY THE CHIEF NURSE, UNITED STATES ARMY BASE HOSPITAL, CAMP GRANT, ILL.
Survey of student nurses on duty at United States Army Base Hospital, Camp Grant, Ill., from August 15, 1919, to June 21, 1919
THE WORK OF THE STUDENT NURSES DURING THE EPIDEMIC
Sunday, September 22, 1918, the first cases of Spanish influenza were brought into the base hospital and on the afternoon of that day the students met in the sewing room and there inspected and remade hundreds of gauze masks to make them comply with requirements. When this work was completed the girls of the second group went to the demonstration room in the school building and there were given a demonstration lesson in bed making.
Monday morning the girls of the second class, or, as they are called, the second group, were called out to make beds and help put barracks in readiness for the receiving of sick soldiers.
These barracks had been used as quarters for men of the Medical Corps and had to be cleaned and filled with supplies suitable for the maintenance of a ward. Groups of men were detailed who swept and scrubbed the floors, cleaned windows, unpacked beds and chairs, carried them into the wards, and did such other work as was required of them. The student nurses scrubbed and made up the beds, helping arrange them in regular rows, cleaned and arranged linen closets, cleaned the kitchens, washed dishes and silverware; in fact, doing the necessary work called for to make the buildings ready for the use of the sick boys.
This work of opening up barracks continued for a week, during which time 18 or 20 soldiers’ barracks, each having an average capacity of almost 100 men, were opened for ward purposes and beds made up in the corridors of the base hospital. Many of the beds made were equipped with straw ticks and the making of such beds was an entirely new effort on the part of many of the girls. After the beds were made and arranged as they should be, sputum cups, folded napkins, paper bags for refuse, towels, a bathrobe, slippers, and a pajama suit were placed on each bed.
Influenza made its entrance into the ranks of the nurses during the first week and, being no respecter of classes, attacked many of the graduate nurses as well as the girls of the training school. The infirmary was soon taxed to its capacity; and, as there was no place fixed for the sick nurses, many were heft in their rooms and placed under the care of the nurses of the infirmary. Finally the number of ill nurses in the quarters increased to such a number that it was impossible for one nurse to care for them, in addition to her patients in the infirmary, so students of the training school were appointed to hook after the sick nurses in the quarters. These were required to take care of the diets of nurses who were ill, take pulse and temperature, and daily give a report of each sick nurse to the graduate nurse who had charge of the infirmary; they were allowed, also, to give aspirin tablets and magnesium sulphate under the direction of the graduate nurse.
The number of nurses suffering from influenza increased so rapidly that a second infirmary was opened in the school building and nurses who were confined to their quarters were moved to this place. Here student nurses were given some practical ward work.
The number of patients in the wards increased so rapidly and the nurses and corps men were so rushed with work that it became necessary to organize cleansing squads, or, as they
were called, “broom squads,” to aid in the cleansing of wards. There were eight of these squads, each composed of 8 men who worked 8 hours daily under the supervision of a student nurse. These broom squads were each assigned to certain groups of wards, and it was their duty to see that the wards were cleaned of all refuse each morning and everything was in good order.
During the second week of the epidemic some of the students were put on ward work and there received their first lessons in practical nursing; and though this work was difficult for an inexperienced girl, each one did her part cheerfully, grateful for the opportunity of contributing her mite toward checking the epidemic.
On Saturday, August 17, 1918, Miss Anne Williamson, director of the Army School of Nursing, Camp Grant, in her opening talk to the student nurses, recommended that a student form of government be adopted as the basis for the regulation of all students activities.
Acting upon this recommendation, the students were called together. At this meeting, three officers were elected-president, Miss Lyda S. Houston; vice president, Miss Lois West; secretary and treasurer, Miss Catherine Carton. These three officers, together with two members of the faculty, were appointed a committee to draw up a set of rules to be presented to the class for approval.
These rules provided for the future election of all officers, for the calling of student meetings, and for the governing of the student nurses both in the quarters and on the ground and in all social activities. The rough draft was presented by the committee to the student body for approval and adoption. Each rule was individually read and discussed before adoption. Some changes were made. The rules were next presented for approval, as supplementary to the Rules for Nurses as already issued by Colonel Michie to Miss Williamson, director, and to Colonel Michie, commander of the base hospital unit.
This form of government has proven to be of great benefit not only in the direction of all student activities, but as an organized means through which the faculty members and all officers can reach the student body. Student action has been much more effective and immediate than would have been possible in an unorganized state.
Several permanent committees, such as social, musical, dramatic, and athletic, have been appointed anti have been the means of furnishing entertainment by the school. This form of government and the rules approved and adopted govern not only the class which entered August 15, but also all student nurses sent for training to Camp Grant.
STUDENT QUARTERS AND ARMY TRAINING SCHOOL BUILDING
The student nurses’ quarters at Camp Grant, base hospital, are located at the edge of the hospital grounds, a branch of the Rock River Valley cutting directly behind them. The quarters include three long narrow one-story frame buildings, well elevated from the ground, and connected by a roofed and railed wooden walk, which serves also as front veranda for all three. The back verandas, overlooking the gulch and with an interesting view of the river and rolling country to the westward, have not intermediary connection.
The general plan of the quarters’ interiors, centers around the long hallway running directly through the building from the small front reception room to the rear veranda. Opening onto this hall from both sides are the 26 bedrooms, large lavatory, laundry and ironing rooms, and linen closet. The electric light and steam heat employed are from the camp power and heating plants. Fire protection is provided for in the regular fire buckets such as are used in wards and barracks, and by chemical extinguishers placed in the corridor. Ventilation is provided through a system of traps through the ceilings and transoms over each door.
The front reception room is furnished in dark willow and cretonne, with comfortable cushioned easy chairs. This reception room is also, in a way, the office of the quarters, matters of general interest to the quarters being adjusted there, bulletins and notices posted, and guests received.
The laundry and lavatory are fully equipped with all conveniences and supplied with abundant hot water at all hours. The ironing room is fitted with a board, and socket for the attachment of electric irons.
The most interesting part of the quarters is, of course, the bedrooms, one of which each student nurse has entirely to herself. The original furnishings included a white iron hospital bed, a dark wooden chair and bureau, with a large mirror, a built-in wardrobe, cupboard with upper shelf, closed wall writing desk, with shelves and compartments, and a little enamel rocker. The large window is fitted with marquisette sashl curtains and the pine floor is partially covered by a simple dark rug. The woodwork is of unfinished pine, the walls of a soft tone of ecru wall board. All conducive to a general tone of quiet, refreshing simplicity. The student nurses take such pride in their little “homes” that they have completed the decoration with wardrobe curtains, dresser scarfs, and window drapes of cretonne or similar materials, with perhaps a simple print, or motto, and a few books on the writing desk, giving each room the individual touch so much to be desired. The students on entering had rather expected to be quartered in common barracks, with long rows of low bunks and crowded lockers for clothing. So their delight in being given individual rooms, so completely equipped with such thought to their comfort and convenience, can hardly be overestimated.
The school building stands just around the corner from the quarters. It is a large two-story building, with screened veranda running the full length of the building, upstairs and down. Downstairs are the recreation and dietetics rooms, with adjoining lavatories and offices; upstairs the lecture room and demonstration room. The ventilation, light, and heating system is similar to that of the quarters.
The recreation room is a point of pride to every student nurse, since its furnishing is largely the result of their own efforts. It is furnished in a quiet tone of blue-gray, as are the the other rooms of the school, with window drapes and lamp shades of rose. Cretonne-covered divans, easy chairs, writing tables, with a supply of magazines, a victrola, and a piano complete the general equipment, though such brief enumeration must fail to carry the impression of each relaxed comfort which prevades the room.
The dietetics room across the hail is fitted with the long laboratory table with individual cupboards and drawers containing necessary utensils and supplies, as well as writing tables and chairs for note taking. Heat is provided through an electric range and a number of small electric heaters. Other supplies and articles not in constant use are kept in the small supply room adjoining, or, as soaps and dishpans, in the lavatory reserved for kitchen uses.
The Medical Department has been very generous in providing necessities for a thorough dietetics course.
2 bread tins (large and small).
1 paring knife
1 custard cup.
1 small teapot.
3 white enamel bowls (1 large, 2 small).
1 white enamel utility plate.
1 small pie tin.
1 apple corer
Food containers, (salt, pepper, flour, sugar).
2 asbestos mats
2 enamel saucepans (large and small)
2 measuring cups (glass and tin).
1 double boiler.
1 biscuit cutter
1 double boiler
1 vegetable brush.
1 small frying pan.
2 knives (large and small)
1 Dover egg beater
1 egg whip.
1 electric plate.
2 tin covers (large and small)
1 gram scales ( for two students)
2 electric stoves
2 stock pots
3 large double boilers
2 large enamel saucepans
Glass sugar and creamers
Glass sherbert dishes
Upstairs the hallway is furnished with study tables and chairs for use in getting reference work. And one small office is fitted with shelves and set apart as a student’s reference library.
The lecture room is provided with armchairs for note taking, blackboard and lecturer’s desk, specimen cabinet, and a number of anatomical charts. For use in anatomical study an excellent skeleton has been provided, which when not in actual use is kept in gruesome seclusion in a corner of the library.
In the demonstration room across the hall used especially for the practical nursing course are four beds, with tables and a wheel chair. Linen and all other supplies necessary to nursing demonstration are kept in an adjoining linen closet. Most of all important in the equipment of this class room is Lucy, the demonstration doll. Jointed, washable, and never querulous, she makes an ideal patient.
Neither in quarters nor in school has anything conducive to the student’s comfort and convenience, or essential to their professional training, been overlooked.
ROUTINE LIFE OF A STUDENT NURSE AT CAMP GRANT, ILL.
The life of an Army nurse, although supposedly arranged according to a regular routine, is nevertheless subject to the most unexpected and varied experiences.
We arise at 5.45, and at 6.25 must be ready to answer breakfast mess call, with our quarters in perfect order and ourselves in uniform, to go directly from the mess hall to the wards for our morning hours of duty.
The abundance and quality of the food and healthy appetites of the girls compensate for lack of niceties in service, and soon even the most fastidious only complain because meals are not closer together.
The daily hours between 7 a. m. and 7 p. m. are divided between ward work, classes and lectures, and drill. We average five hours a day ward work and one hour military drill. On the ward we make beds, give baths, rub backs, prepare diets, take temperatures under supervision of the head nurse, and with the help of corps men assist in the general tidiness of the wards.
No matter how tired we may be from ward or class work, an hour of military drill or a hike, in our Regular Army drill suits and with our own student officers, renews vigor and enthusiams.
At 4.45 every night, except Saturday and Sunday, the hospital force stand retreat. Headed by the base hospital band, the medical officers, graduate nurses, student nurses, and enlisted men march up Hospital Street and, forming one long line, pay tribute to the flags of America and of the Red Cross, and they are lowered for the day. Differing from retreat in other parts of the camp, here the column of khaki is interrupted by a line of graduate nurses all in white, with Red Cross capes, and student nurses in blue uniforms, white collars and cuffs, and khaki sweaters.
Supper at 5.30 p. m., and one hour of ward duty in making the patients comfortable for the night, and our day is supposedly over at 7 p. m., with the evening free for study. Quiet hour is enforced by the quarters’ proctor from 8.15 p. m., and all lights out at 10.30 p. m.
But how monotonous would our life be if such were the regular routine of each day. Between times we wash and iron our collars, cuffs, and caps, do the innumerable things a girl finds necessary to keep wardrobe and quarters respectable, her family and friends in good humor, and herself posted on camp rumors.
But most disastrous to the daily routine are the impromptu orders liable to be issued at any instant. Such orders supersede all others and may allow from 3 to 10 minutes for their execution. Among those most common are: A call to attend a special lecture, exhibits, demonstration, or picture show, a call to appear ins full drill uniform for inspection, in nurses’ uniform for pictures, or a general review for some visiting officer of Army or Nurse Corps.
All quarters and wards are inspected every Saturday at 9 a. m., and as often between times as any visiting official or commander so desires.
On Saturday afternoon we are free from all hospital arid military duties, and on Sunday have only seven hours ward duty.
For delicacies not furnished at the mess hall and for necessities of everyday life, we may go to the regimental canteen in the base hospital proper, or to “The Hub,” a little group of stores just across the reservation line arid only a short distance from our quarters. Other places serving the student nurses are the Young Men’s Christian Association, Knights of Columbus, and Red Cross buildings, and our own recreation and school building and the Liberty Theater over in the camp proper.
For a touch of civilian life we can go to Rockford on Saturday afternoons, with a real dinner in town and a picture show afterwards, but must be home again by 10.30 p. m.
ARMY SCHOOL OF NURSING, UNITED STATES ARMY BASE HOSPITAL, CAMP GRANT, ILL. - THE COURSE OF STUDY
The plan for the course of study for the Army training school is practically the same as that outlined by the standard curriculum for schools of nursing, published in May, 1919.
During the three years’ course of training the time to be allotted the various services is approximately as follows:
Surgical nursing (4 months operating room, 4 months wards)
The instruction given during the preliminary period of four months included the following subjects:
Anatomy and physiology
Nursing principles and methods
History of nursing
In addition all students admitted in the first group completed and received credit imi the gas defense course.
During the preliminary period class instruction was given to the various groups individually. For the first year’s work it was possible to combine all students for the lectures given; all quiz and laboratory work was given by dividing the students into comparatively
The instruction during the remaining portion of the first year included the following subjects:
Diet in disease
Pharmacy, dosage and solutions, materia medica
Thus by June 1, 1919, the first year's work was completed by all students, and classes were discontinued for the summer months. This made it possible to place all student-s oms 8-hour ward duty.
Affiliations became effective May 1, 1919, when a group of 7 students was sent to Chicago Lying-in Hospital for training in obstetrics. June 1, 1919, 7 additional students were sent to the same place, 10 to the Childern’s Memorial for training in pediatrics, and 6 to the Rock-ford City Hospital for training in gynecology.
The entire student group was transferred from Camp Grant to Fort Sheridan June 21, 1919. Records show that on that date 67 per cent of the entire group of students entered at Camp Grant were still in training.
Statistics obtained from 97 of 112 student nurses originally assigned to United States Army base hospital, Camp Grant, Ill., relative to the composition of the student group.
Average age, 23.9
Occupation. - Teaching--all positions from that of teacher in district school to principal of high school: Seventy per cent were teachers or had taught (64 in number; 1 of 12 years’ experience). Stenography, typewriting, and bookkeeping; clerical positions; commercial art; newspaper reporters; librarians; telephone operators; laboratory technicians; dietitians; social charity workers; probation officers; social settlement workers; playground workers; deputy treasurers; homekeepers (8 in number). Wage earners, 82 per cent; average wage, $67; total monthly wage, $5,114.
Monthly wage: Number of earners
$30 to $50....................................11
$50 to $75....................................44
$75 to $100...................................14
$100 to $130...................................5
All work and no play makes Jill a dull girl. The truth of this was recognized in the organization of the Camp Grant branch of the Army School of Nursing, as was evidenced by the diverse fields of activity offered, with a view not only to reach every member but to present a pleasing variety as well. The arrival of the first class found definite provisions for this important phase of student life, and many developments have since resulted as t-he need and opportunity arose.
In the school building assigned to us, one large room was reserved to he used as a recreation room. This room was furnished with the view of meeting as many needs as possible. A charming color scheme of gray walls, rose window hangings and shaded lights, and couches upholstered in attractive cret-onnes delights the eyes of all; desks with writing materials a-re
provided; and dear to the hearts of all the students are the phonograph and the piano. These furnish the music for many arm impromptu damice and many are the songs sung there. This room has been the scene of several successful parties given by the various classes.
Besides dancing at the recreation room, the Red Cross building is thrown open to us every Friday evening. The early part of the evening is devoted to the instruction of those who wish to learn to dance; later in the evening all of the student nurses are invited to join in the evening’s pleasure.
Music has been one of our most delightful forms of recreation. We are exceedingly fortunate in having a base-hospital band of unusual excellence. Band concerts are always attended and appreciated by the “blue nurses.” On September 20, 1918, the first class of the training school gave a concert to raise money to help pay for our piano. With the aid of Sergeant Vorkeller and Private Hasse, of the base-hospital band, and supported by the orchestra, a very creditable performance was produced. The program consisted of several numbers by the hand, choruses by the glee club, and solos.
Athletics have claimed the attention of most of the student body whenever the weather permits, and tennis, baseball played according to indoor rules, and hikes have received their full share of attention. Excellent tennis courts are close at hand, and stated times at which they are reserved for the use of the student nurses are prescribed. Not far from quarters is a level piece of ground, which makes an ideal baseball diamond, while the hank of the Rock River is one of the many paths which offer an irresistible temptation to obtain the necessary out-of-door exercise. When the weather no longer made it possible to indulge in these pleasures, equally interesting substitutes were provided in the form of basket baIl. captain ball, and other indoor sports.
On August 19, 1918, under the command of Lieutenant Colonel Michsie, commanding officer of the base hospital, the student nurses of the Camp Grant training school received their first instruction in military drill. A month later, upon the arrival of the second group of students, the student body was organized into two individual companies, each company electing its officers from its own group. Each company was divided into two platoons, each platoon under the command of a lieutenant. Upon arrival of new groups of students the same plan of organizations was continued. On March 1, 1919, the following battalion staff was in command:
OFFICERS, FIRST BATTALION ARMY SCHOOL OF NURSING, ARMY NURSE CORPS, UNITED STATES ARMY BASE HOSPITAL, CAMP GRANT, ILL.
Adjutant, First Lieut. Irene D. E. Hoyer, A. S. N.
Supply officer, First Lieut. Mary Elen Gipson, A. S. N.
Supply sergeant, Battalion Supply Sergt. Mabel Hendrickson, A. S. N.
This list supercedes all previous lists.
By order of Captain Bauer:
IRENE D. E. HOYER,
First Lieutenant, A. S. N., Army Nurse Corps,
Special insignia of rank for battalion officers was prescribed as an integral part of the uniform, to be worn at all times. The insignia of rank in the various grades was designated as follows:
(a) Captains. - (1) Three gold buttons, S. A. T. C. These buttons are to be worn on the left side of the front of the overseas cap, the center of each button to be placed according to the following dimensions: First button, 1 ¾ inches from center of cap and 1¼ inches above the lower margin of cap; second button, 1 ¼ inches to the left of the first button and 1 1/2 inches above the lower margin of the cap; the third button, 1¼ inches to the left of the second button and 1¾ inches from the lower margin of the cap. On each epaulet of the outdoor uniform, the first button to be one-half inch from the sleeve seam; other buttons to be spaced one-half inch from each other in the direction of the collar. On the right side of the collar of the olive-drab shirt, the first button one-half inch from front edge of the collar; additional buttons at 1-inch intervals from each other.
(2) Three chevrons (of the design in the possession of the battalion adjutant) on thee forearm of both sleeves of the overcoat, apex of each chevron surmounted by a button. Material of these chevrons to be one-quarter inch flat luster black mohair braid; buttons three-eighths inch diameter, flat, cloth-covered, black.
(b) First lieutenants. - (1) Two gold buttons; two sleeve chevrons corresponding to the first button and chevron of the above-described captains’ insignia.
(c) Second lieutenants. - (1) One gold button and one sleeve chevron corresponding to the first button and chevron of the above-described captains’ insignia.
(d) Noncommissioned officers. - (1) Chevrons of the pattern prescribed for the corresponding grades of other branches of the United States Army, but distinctive for the Army School of Nursing, Camp Grant, Ill., in colors as follows: For the outdoor uniform, gold bars on navy blue, to be worn on both sleeves, midway between the elbow and the shoulder. For the olive-drab uniform, blue bars on olive drab, to be worn on the right sleeve only, midway between the elbow and the shoulder of both the overcoat and the olive-drab shirt. For the overseas cap, miniature metal chevrons, to be worn 1 inch to the left of the front seam of the cap and 1 inch from the louver margin of the cap.
Battalion inspection was held weekly by Colonel Michie, taking into consideration the following points:
Appearance of uniform
Order of companies
All ratings were made on a percentage basis, and the companies formed in the following order in the battalion for the week following the posting of the report of the inspection.
With the color
Without the color
When the ratings are equal, the order of companies from front to rear in column or right to left in line, will be A, B, and C.
The following schedule of military drill was prescribed by memorandum issued January 18, 1919.
In addition to the sweater and helmet issued by the Red Cross, each student was supplied with a complete olive-drab outfit, consisting of olive-drab breeches, shirt, overcoat, spiral leggings, belt, and overseas cap, for drill during the winter months.
Military drill was discontinued in May, about 120 hours having been devoted to this course.
All members of the student battalion desire to express to Colonel Michie and his assistants their appreciation of thse privilege of such excellent military drill and instruction as was given them.
ARMY LABORATORY SCHOOL, YALE UNIVERSITY, NEW HAVEN, CONN. a
The Army Laboratory School at Yale University was the direct offspring, or, more correctly, the metamorphosis of the laboratory school, Fort Leavenworth. It was recognized by the Surgeon General early in the war that it would be necessary to supply, both at home and overseas, officers and men who were trained in laboratory methods developed by the Medical Department of the United States Army. A school for this purpose was established early in 1918, at the department laboratory of the Central Department, Fort Leavenworth, Kans. It became necessary, as the school increased in size, to occupy two large Infantry barracks and two sets of officers’ quarters for the work of the school. These buildings were equipped with work benches, running water, and other material necessary for the school by the Quartermaster Corps of the post without cost to the Medical Department.
It was possible at Fort Leavenworth to train only a limited number of officers and men, but with the facilities available the school was able to place in the field 13 mobile laboratories, the personnel of each consisting of 1 officer of the Medical Corps, 1 officer of the Sanitary Corps, and 1 sergeant and 3 privates of the Medical Department. In addition to these mobile laboratories, 1 stationary laboratory was formed, the personnel of which consisted of 2 officers of the Medical Corps, 4 officers of the Sanitary Corps, and 12 enlisted men of the Medical Department. In addition to these units, a considerable number of officers and men were trained in the school and assigned to the laboratories and camps of this country.
It soon became evident that the supply of well-trained laboratory men would soon be exhausted and that it would be necessary to train men in the elements of bacteriology and chemistry. This fact, together with the constant increase of officers and men, rendered it necessary to secure larger quarters for the work. As no other buildings could be obtained at Fort Leavenworth, a medical officer was ordered to inspect the Medical Officers’ Training Camp at Camp Greenleaf, Fort Oglethorpe, Ga., in the latter part of May, 1918, it being understood that money was available for erecting suitable buildings at
The history of this school is based on: “Report of the work of the Yale Army Laboratory School for the fiscal year ending June 30, 1919, by Col. Charles F. Craig, NI. C., United States Army. On file, Historical Division, Surgeon General’s Office.
this post for the purposes of the school. As a result of this inspection, it- was found that buildings could not be erected at that place, no funds being immediately available, and that Camp Greenleaf could offer no better accommodations than did Fort Leavenworth. The commandant advised that the school should not be moved unless laboratory buildings could be promptly erected. An offer from the authorities of Yale University to furnish buildings to the Government for training purposes 53 was then investigated. It was found that Yale University was willing to provide classrooms and laboratories for the Laboratory School in the Brady Laboratory, another building known as the surgical laboratory, and in Kent Hall. These buildings were offered free of charge to the Medical Department and were capable of providing classrooms for from 50 to 100 officers and from 50 to 75 enlisted men. Dormitory space was offered by the university for both officers and enlisted men, the rental of the quarters for the enlisted men being placed at the sum provided for commutation of quarters by the Government. The university required that the Government furnish all apparatus except large apparatus such as incubators, etc., and all chemicals and other material used in the teaching of officers and men. Time offer of the university would enable the school to handle about 300 officers and enlisted men without crowding in the classrooms, and clinical facilities were given by the New Haven State Hospital, which was immediately adjacent to the Brady Laboratory. In view of the facilities offered, it was recommended that the Laboratory School be moved to the Yale University as soon as possible, and on July 9, 1918, a laboratory school was ordered established at Yale University. Despite the fact that alterations were necessary in the buildings in order to accommodate so large a number of students, the school opened on August 1, 1918, the officers and enlisted men on duty at Fort Leavenworth having been transferred in the meantime. A large part of the equipment was brought from the department laboratory at Fort Leavenworth on the laboratory car “Reed,” and requisitions were placed for other equipment, which arrived promptly, no time being lost because of lack of equipment.
It was soon found that the classrooms available would be inadequate for the officers and enlisted men, who were constantly increasing in number. This matter was brought before the president of the university and the Yale Corporation, who voted to erect a temporary building, without cost to the Government, adjacent to the Brady Laboratory. This building, which was completed in 18 days, consisted of two large rooms, one room capable of holding 100 officers and the other capable of holding 200 enlisted men at one time. This building cost the university approximately $40,000. It was equipped with electricity and steam heat and furnished ideal laboratory classrooms for the school.
From August 1, 1918, until teaching at this school was discontinued January 1, 1919, a total of 1,016 officers and enlisted men served at this station. Of this number 460 were officers, of which 223 were officers of the Medical Corps and 237 were officers of the Sanitary Corps.
The signing of the armistice on November 11, 1918, brought to a conclusion the work of the school so far as the organization of laboratory units was concerned. The officers and enlisted men who were left at the school were gradually distributed to Army laboratories in this country, except those who were
discharged on their own application or for other reasons. Prior to this date there were organized at the school, from officers and men who had finished their course of instruction, 10 mobile laboratories, consisting of a total of 20 officers and 40 enlisted men, and 3 stationary laboratories, consisting of a total of 18 officers and 36 enlisted men. These units were organized for service with our armies in France, and practically all of the mobile laboratories had been ordered to the port of embarkation before the armistice was signed.
In addition to these units, the Yale Army Laboratory School supplied laboratory officers and men for base hospitals, evacuation hospitals, and mobile hospitals intended for service in France. In all 33 medical officers and 18 officers of the Sanitary Corps were assigned to duty with base hospitals, 12 medical officers and 2 officers of the Sanitary Corps to duty with evacuation hospitals, and 4 medical officers to mobile hospitals. In addition to the officers assigned to these hospitals, a total of 239 enlisted technicians who received their training at this school were assigned to these hospitals.
During August, 1918, an understanding was reached with the Rockefeller Institute whereby the Yale Army Laboratory School was to furnish every six weeks a class of 40 officers for advanced training in bacteriology and chemistry. This class was to substitute a similar class in advanced work which was instituted at the Yale Army Laboratory School. This measure was necessary in order to keep the Army supplied with officers properly trained in bacteriology and chemistry, as applied to the prevention of disease and its diagnosis in the field. Owing to the outbreak of the severe epidemic of influenza in September, 1918, it was impossible for this measure to be carried out, so that only one class of 32 officers was sent from the Yale Army Laboratory School to the Rockefeller Institute. Before the time had arrived for the sending of another class the armistice had been signed.
The influenza epidemic, which continued until December, interfered seriously with the work of the school as, owing to the shortage of medical officers, it was necessary to order 56 officers of the Medical Corps who were pursuing studies at the school to various camps for temporary duty. This, of course, interfered with the sending of units abroad and the training of officers for these units, and for about six weeks the work of the school was practically at a standstill.
In addition to the officers and enlisted men already spoken of as being sent to base hospitals, evacuation hospitals, and mobile hospitals and the Rockefeller Institute, laboratory officers were supplied to various other institutions connected with the Army, as department laboratories, Surgeon General’s Office, St. Elizabeths Hospital, Bureau of Mines experimental station, the pathological section of the Chemical Warfare Service. Enlisted technicians were also supplied to these places as called for.
COURSE OF INSTRUCTION
The subjects taught at the Yale Army Laboratory School were bacteriology, pathology, clinical microscopy, and chemistry, so far as it related to clinical diagnosis and the examination of water, foods, and the detection of poisons.
Two courses in bacteriology were maintained at the school, an elementary course for those who had little training in the subject before coming to the school, and an advanced course for well-trained bacteriologists. In addition, a. course in bacteriology was maintained for enlisted men in order to qualify them as laboratory technicians.
During the early days of the school at Fort Leavenworth, as noted, the officers of the Medical Corps and the Sanitary Corps who were assigned for a. course of instruction at the school were well-trained bacteriologists, and the course of instruction was designed to acquaint them with the special methods found of value in the diagnosis and prevention of disease. In order to supply the Army with these specially trained officers it would be necessary to train medical officers and officers of the Sanitary Corps, not only in advanced bacteriology, but also in the elements of the science, so that eventually it was found necessary to divide our officer students into two classes--those who had received good training before arriving at the school and those who had received little or no training in the subject. The first class was placed in the advanced course at the school, the second in the elementary course and afterwards in the advanced course.
The preliminary course consisted in instruction in elementary bacteriological technique and in milk and water analysis. Three hours a day were devoted to this work, and the course lasted approximately four weeks. In the advanced course special bacteriological methods were studied, especially those found of use in Army practice. This course was supposed to cover four weeks, but the time varied considerably, owing to the character of the preliminary training received by the officers who were placed in the course. The advanced course was at first limited to work on typhoid, pneumococcus, streptococcus, and meningococcus. Later, special emphasis was placed on the differentiation of pneumococcus, streptococcus, and the isolation and identification of influenza bacilli. Still later the identification of anaerobes was added to the course. Field conditions were duplicated as far as possible, the students being limited to the apparatus found most useful in field work. Three hours a day were given to the laboratory work, and a daily quiz was given in addition. A series of lectures designed to cover a period of five weeks on subjects of epidemiological and bacteriological interest was also a part of the course. Mimeographed notes of technique and information concerning the subjects taught were distributed to each student, and these notes enabled the instructors to handle a larger number of officers than would otherwise have been possible. When the school closed, the course in bacteriology was being conducted in the new temporary laboratory building, and 200 officers were under instruction, 100 in the morning and the same number in the afternoon.
The course in bacteriology for the enlisted men was intended to fit them for duty as laboratory technicians. While the school was at Fort Leavenworth a total of 105 enlisted men took the course; and during the five months in which the school was at New Haven, 403 enlisted men finished the course of instruction, making a total of 508 enlisted men who finished the course in.
laboratory methods at the Yale Army Laboratory School since its establishment at Fort Leavenworth.
There was a very urgent demand for laboratory technicians, and the course was so conducted as to cover the greatest amount of work in as short a time as was compatible with the results desired. It was decided that six weeks was a sufficient period to train a man with intelligence in the work of a laboratory technician; as a matter of fact, it was demonstrated that this period is the minimum to be allowed for this purpose and much better results could be obtained if the course lasted eight weeks. The work consisted of one hour lecture, two hours of laboratory work, and one hour quiz every day with the exception of Saturday. On Saturday a review was held of the work of the preceding week. Owing to the great number of men taking the course, the class was divided into two sections, a morning and afternoon section. The course covered instruction not only in bacteriology but in clinical microscopy.
A course in pathological technique was instituted at the Yale Army Laboratory School, and selected officers and men attending the school were given this special course. The instruction covered autopsy technique, museum technique, and histological technique. Approximately 125 officers were given instruction in pathology, but of these 100 were only in the preliminary stage of instruction when the school closed.
The course in clinical microscopy was attended only by officers. It covered a period of five weeks, and all officers attending the school were obliged to take this course. One week was given to the chemical analysis and microscopic examination of urine, three weeks to the blood, and one week to other clinical laboratory methods. As the class of officers taking bacteriology was divided into two sections, a morning and afternoon section, it was possible to assign a section to the course of clinical microscopy when it was not in the bacteriological laboratory. Thus the officers who were taking bacteriology took the course in microscopy one half of the day and the course in bacteriology the other half of the day. As the two courses covered practically the same length of time, this arrangement was very satisfactory.
The course in chemistry was conducted in the Kent Laboratory of Yale University in a laboratory classroom which would accommodate 100 students. The largest number of students attending this course at one time was 87, and at no time was the work interfered with for lack of room. During the time that the school was in operation at Yale University, 223 officers and 207 enlisted men received instruction in chemistry. The instruction in this subject consisted of water analysis, toxicology, methods of purification of water, and the identification of heavy metals and organic and other poisons. The preparation of Dakin’s solution was thoroughly studied, and every officer and enlisted man was trained in its proper preparation.
At the time of the signing of the armistice, nearly 300 officers and over 500 enlisted men were receiving instruction in laboratory methods at the school. At this time the course had been so perfected that it was estimated that efficient laboratory officers could be graduated from the school in a period of eight weeks and enlisted technicians in a period of six weeks. It was the policy of the school to require that all officers attending the school receive not only the course in bacteriology but the course in chemistry. This was rendered necessary by the fact that only 2 officers, 1 bacteriologist and 1 chemist, were sent with field laboratories, and it was thought that the bacteriologist and chemist should be acquainted with both subjects in case of one being unable to attend to his duties from any cause. It was found that this policy was a good one and that even though officers might be ignorant of one of the subjects required, it was possible in the time allowed to impart enough instruction for them to attend to the ordinary work in that subject required in a field laboratory. A large number of chemists were sent to the Yale Army Laboratory School for instruction in chemistry who had received only very elementary instruction in bacteriology. It was found that when these men were placed in the class in bacteriology they took a great interest in this subject, many of them becoming very expert in it. This was not true, however, of medical officers who had training in bacteriology, when it came to the study in chemistry. So that while it was comparatively easy to make a good bacteriologist of the chemist, it was found that it was difficult to make a good chemist of a bacteriologist.
The Army Laboratory School established at Yale University August 1, 1918, was closed for instruction January 1, 1919. While this represents a period of five months during which the school was in operation, for over a month instruction ceased as far as officers of the Medical Corps were concerned, as 56 medical officers were sent to various camps during the influenza epidemic. At the time of the armistice the school was in a position to supply the Army with the necessary laboratory officers and technicians, and had the war continued it would have had no difficulty, it is believed, in keeping the Army supplied with these specialists.
ARMY MEDICAL MUSEUM a
The Army Medical Museum is the first institution of the Medical Department of the United States Army organized specifically for educational purposes. It was founded in 1862, under Surgeon General Hammond.54 Work was at once undertaken on the collection of a large amount of anatomical material, furnished by the aid of the medical officers of the Army, from the dead and wounded of the Civil War, wit-h a view to the scientific preparation and preservat-ion of suitable specimens which would show the action of injurious agents used in war upon the various tissues of the body, the results of complications of war wounds, and the effects of the various diseases affecting the armies upon the human body. It was intended that such material be used for the instruction of medical officers of the Army and other members of the medical profession.
This account is based, in the main, on a report of the activities of the museum, by Maj. George R. Callender, M. C., Mar. 30, 1925. Copy on file, Historical Division, Surgeon Generals Office.
For a complete account of the museum see: The Army Medical Museum - A history, by P. S. Lamb, M. P., Washington .Med. Annals, 1916, xv, No. 1, 15.
The material so collected, together with the specimens which have been added from time to time from the various hospitals of the Army, numbers many thousands of specimens, which have constituted a valuable source of pathological material for research and training, not only of medical officers of the Army, but of the medical profession at large. The initial collection was the basis of much of the work and most of the illustrations of the Medical and Surgical History of the War of the Rebellion.
Coincidental with these activities of the museum, a collection of photographs was made during the Civil War, and since that time, of many living cases showing the wounds of war in an open, partially healed, or healed condition. Some of these photographs have been used for exhibition purposes and display, others have been placed on file for reference purposes, while many were used in illustrating the Civil War history.
During the Spanish-American War little opportunity was afforded to collect material illustrating the wounds of war, but numerous specimens of the intestinal diseases, particularly typhoid, were collected and studied, though little of educational value was derived therefrom.
After the United States entered the World War, under the inspiration and direction of the curator of the Army Medical Museum, and to fulfill the demand for illustrated material, models and other agents intended to portray and interpret subjects for training of officers and enlisted men, the function of the Army Medical Museum was expanded to provide a means for the production and circulation of photographs, lantern slides, moving-picture studies, wax models, paintings and drawings of original subjects, to be used in immediate training as well as for permanent use in perpetuating the professional and other immaterial in the archives of the Surgeon General’s library and the collections of the Army Medical Museum.
The activities assumed such proportions as to require their administrative decentralization from the pre-war activities of the institution and the designation of “the instruction laboratory” as an affiliated section of the Army Medical Museum, with the following departments: (1) Still photography; (2) moving pictures; (3) anatomical art. 55
From its inception this laboratory functioned to the fulfillment of its designation. It engaged itself in the organization of trained individuals (officers and enlisted men), who operated to collect material from subjects for the preparation of moving-picture films, photographs, and lantern slides. The laboratory was at the disposal of the officers of the Medical Department in camps, hospitals, and other formations throughout the United States and in Europe, and prepared many thousands of photographs and lantern slides which were used to illustrate the instruction efforts of those engaged in the training of personnel for sanitary services.
In July, 1918, Museum Unit No. 1 was organized and sent overseas for the purpose of collecting pathological specimens, to supply the graphics of the movement of hospitals and other medical units, and to complete the histories of the medical and surgical cases by supplying moving pictures, still photographs, wax models, and colored sketches of these cases.56 Many thousands of gross specimens and histological slides were received from the camps and hospitals at home and abroad, covering all the important diseases and injuries observed during the war.
Pathological material quite sufficient for exhaustive investigations of the diseases and wounds of the World War was added to the collection, which was thus increased to over 100,000 gross specimens.57 The results of its study are presented in the various professional volumes of this history. The instruction in pathology of the classes at the Army Medical School was based on the material in the museum.
More than 20 enlisted men were especially instructed in the technique of the preparation and preservation of gross and microscopical material and were sent to the various hospital laboratories to preserve material for use of the museum.
Adequate laboratories for developing, assembling, and projecting moving pictures, based on like laboratories of commercial establishments, were placed in operation at the museum, and the instruction laboratory made, produced, and circulated a number of moving-picture films and to a large extent exploited and proved the value of the motion picture on instruction and training.
The value of the training material produced by the laboratory during its existence can not be overestimated, particularly in that it serves as a permanent illustrated history of the work of the Medical Department, as well as a nucleus for training in time of peace.
There now are on file in the Army Medical Museum approximately 30,000 photographs, 120 moving-picture studies of 280 reels, and about 1,000 lantern slides.
As the material for training was collected and expanded, a circulation department was operated in order that this most valuable instruction material would be made immediately available for the courses conducted in camps, hospitals, and other formations. The laboratory did not confine itself to the production of studies for the Medical Department solely, but made an exhaustive study of the necessity for the preparation of material which, by its influence on the basic training of the soldier, would prevent disease, develop morale, and sustain esprit in the Army. Several of these were classical presentations of the venereal problems in its relation to the production of noneffectiveness and disability.
Many valuable pictures of specimens were made by the anatomical artists on duty at the museum, of influenza and pneumonia subjects and the pathological effects of gassing. A great many were produced by the unit in France and forwarded to the museum at the close of the war.
Some 200 wax models illustrating wounds and diseases were made and added to the large collection of moulage work already in the museum. These new specimens are of much better character than the old and have been extensively copied for the purpose of instruction in the medical schools of the country.
The moving-picture department later in the war took pictures of actual operations in training and in combat in the field in Europe and this country, illustrating treatment of the wounded, the training of the officer and enlisted man of the Medical Department, and films descriptive of the various special forms of treatment in the branches of surgery and medicine. The following are prominent among the films produced and circulated for instruction purposes during the period of training: “Training
of the Medical Officer”; “The Regimental Detachment”; “The Field Hospital Unit”; “The Ambulance Company”; “Diagnosis of Tuberculosis”; “Fighting the Cootie”; Mosquito Eradication”; “Activities of the M. O. T. C. at Fort Benjamin Harrison”; “Courtesy; The Care of the Horse or Mule”; “Disabilities of the Soldiers’ Feet and Treatment”; “The Army Nurse”; “Empyema”; “Exercises for Preventing and Correcting Flat Feet”; “Harness and Harnessing”; “The Housefly”; “Infantry Pack and Equipment”; “Nerve Wounds”; “Reconstruction”; “Simple First-aid Hints.”
Although this historical review of the activities of the instruction laboratory as a part of the training efforts of the Medical Department for actual participation in the war is brief, the influence which the result of its work reflected as a part of the program of instruction of personnel of the Medical Department was most beneficial.
The results of the work of this institution are perpetuated in the archives of the Army Medical Museum in the form of a comprehensive collection of moving-picture films intended for teaching purposes, a well-balanced library of photographs of the activities of the Medical Department at home and abroad, and a valuable collection of models and other material which were valuable instruments for general and special training during the war, and probably of greater value in preparation for future conflicts.58
(1) G. O. No. 51, W. D., June 24, 1893.
(2) Annual Report of the Surgeon General of the Army, 1894, 21.
(3) Annual Report of the Surgeon General of the Army, 1910, 132.
(4) Annual Report of the Army Medical School for year ending June 30, 1918, by Brig. Gen. Wm. H. Arthur, M. C., N. A. On file, Army Medical School.
(5) Annual Report of the Surgeon General of the Army, 1896, 16.
(6) History of the U. S. Army Medical School, by Louis A. La Garde, Col., M. C., 1922. Copy on file, Historical Division, S. G. O.
(7) G. O. No. 139, W. D., August 17, 1905.
(8) G. O. No. 67, W. D., May 2, 1908.
(9) Annual Report of the Surgeon General of the Army, 1918, 437 et seq.
(10) Ibid., 1916, 198.
(11) Manual for the Medical Department, pars. 136-146, 1916.
(12) Letter from the Surgeon General to Col. Wm. H. Arthur, M. C., August 9, 1916. Subject: Session of Army Medical School, 1916-17. On file, Army Medical School. Also:Annual Report of the Surgeon General of the Army, 1916, 198.
(13) Annual Report of the Surgeon General, U. S. Army, 1917, 298 et seq.
(14) Annual Report Army Medical School for year ending June 30, 1917, by Col. Wm. H. Arthur, M. C. On file, Army Medical School.
(15) Annual Report of the Army Medical School for fiscal year ending June 30, 1919, by Col. Wm. H. Arthur, M. C. On file, Army Medical School.
(16) Annual Report of the Surgeon General, U. S. Army, 1919, Vol. II, 1251.
(17) War History X-ray Department, Army Medical School, Washington, D. C., 1917, 1918, undated, by Maj. Howard E. Ashbury, M. C. On file, Historical Division, S. G. O.
(18) Annual Report of the Surgeon General, U. S. Army, 1918, 440.
(19) Schedule of second section, twenty-first session, Army Medical School, from March 14 to May 28, 1917. On file, Army Medical School.
(20) Schedule of first section, twenty-second session, Army Medical School, commencing November 12, 1917. On file, Army Medical School.
(21) Schedule of first section, twenty-third session, Army Medical School, from November 11, 1918, to February 10, 1919. On file, Army Medical School.
(22) Correspondence re Army Medical School, session 1917-18, from commandant to Surgeon General, November 3, 1917. On file, Army Medical School.
(23) Schedule for orthopedic section, A, B, C, D, E, F, work beginning March 25, 1918. On file, Army Medical School.
(24) Letter from commandant, Army Medical School, to division surgeon, 79th Division, Camp Meade, Md., March 1, 1918. Subject: Special training in gas defense work. On file, Army Medical School.
(25) Outline of Dark-Room Instruction, by Sergt. Robert T. Morrison, instructor. On file, Army Medical School.
(26) Outline of Work for Machine Laboratory, Army Medical School, by Sergt. Stover, Instructor. On file, Army Medical School.
(27) General outline of instruction of the portable X-ray unit, Army Medical School. On file, Army Medical School.
(28) Outline of instruction, school of manipulators, Army Medical School. On file, Army Medical School.
(29) First indorsement Army Medical School, Washington, D. C., July 12, 1922, to Col. E. P. Wolfe, M. C., medical section, Washington general intermediate depot, Washington, D. C. On file, Historical Section, S. G. O.
(30) Memorandum to Major Nichols, June 12, 1922, unsigned. On file, Army Medical School.
(31) Activities of the section of orthopedic surgery, Army Medical School, from June 27, 1918, to December 26, 1918. On file, Army Medical School.
(32) Letter from the Surgeon General to commandant, Army Medical School, February 18, 1918. Subject: Mobile laboratories. On file, Army Medical School.
(33) History of the Veterinary Division Office of the Surgeon General, by Lieut. Col. C. F. Morse, M. C., 1921, 86 et seq. On file, Historical Division, S. G. O.
(34) Letter from Maj. Vans Agnew, V. C., N. A., to the Surgeon General, December 29, 1917. Subject: Noncommissioned veterinary personnel. Copy on file, Historical Division, S. G. O. (History of the Veterinary Division, S. G. O., Appendix U, p. 1.)
(35) First indorsement (to above letter) from the Surgeon General to The Adjutant General of the Army, January 5, 1918. On file, Historical Division, S. G. O.
(36) Fifth indorsement, from The Adjutant General, to the Surgeon General, March 22, 1918. Copy on file, Historical Division, (Ref. 34 Supra).
(37) Letter from the Surgeon General to The Adjutant General, April 12, 1918. Subject: The Veterinary Training School, Camp Lee, Va. Copy on file, Historical Division, S. G. O. (Ref. 34, supra).
(38) Veterinary Bulletin, Vol. X, No. 4, 67, et seq. On file, Veterinary Division, S. G. O.
(39) Ibid., No. 5, 99, et seq.
(40) Letter from the Surgeon General of the Army to The Adjutant General of the Army, September 3, 1918. Subject: Instructions for the commandant, Veterinary Training School, Camp Lee, Va. Copy on file, Historical Division, S. G. O. (History of the Veterinary Division, Office of the Surgeon General, Appendix U-2, p. 11).
(41) Veterinary Bulletin, Vol. X, No. 6, 126, et seq. On file, Veterinary Division, S. G. O.
(42) Ibid.,Vol. XI, No. 4, 115 et seq.
(43) Ibid., Vol. XI, No. 5, 147, et seq.
(44) Ibid., Vol. XI, No. 6, 192, et seq.
(45) Ibid., Vol. XV, No. 5, 191, et seq.
(46) Ibid., Vol. XVI, No. 2, 56, et seq.
(47) Circular No. 271, W. D., July 16, 1920.
(48) Special Orders, No. 9, W. D., January 11, 1918.
(49) Veterinary Bulletin, Vol. XVI, No. 1, 14.
(50) Memorandum from the Surgeon General, U. S. Army, to the Secretary of War, May 24, 1918. Subject: Approval of plan for Army School of Nursing; and indorsement of the Secretary of War, May 25, 1918, which is approval thereof. On file, Record Room, S. G. O., 352.4 (Army School of Nursing).
(51) Letter from the committee (Dora Thompson, superintendent, Army Nurse Corps; Jane Delano, director, bureau of nursing, American Red Cross, and Anne W. Goodrich, chairman, chief inspecting nurse), to the Surgeon General, March 24, 1918. Subject: The plan for the creation and operation of an Army School of Nursing. Copy on file, Historical Division, S. G. O.
(52) Report of the Student Nurse Battalion, Army School of Nursing, History of the U. S. Army Base Hospital, Camp Grant, Ill., October 14, 1917, to July 23, 1919, Volume I, 119. On file, Historical Division, S. G. O.
(53) Correspondence between Yale University and the Surgeon General. Subject: Medical department of Yale University for war purposes. On file, Record Room, S. G. O., 324.3 (Tender of Services); 220.3 (New Haven, Conn.) F.; 353 (New Haven, Conn.) F.; 353 (Laboratory Instruction); 700.7 (Yale Army Laboratory School).
(54) Circular No. 2, S. G. O., May 21, 1862.
(55) History of Medical College Illustrative Instruction, prepared under the direction of the division of military orthopedic surgery, by R. Tunstall Taylor, colonel, M. R. C. On file, Historical Division, S. G. O.
(56) Letter from the Surgeon General to the commanding officer, Museum Unit No. 1, Army Medical Museum, August 5, 1918; memorandum to the Surgeon General from the curator of the Army Medical Museum, August 6, 1918; S. O. No. 185, W. D., August 9, 1918, par. 461; letter to the Surgeon General from the commanding officer, Museum Unit No. 1, August 10, 1918. On file, Record Room, S. G. O., 322.3 (Museum, Unit No. 1) V.
(57) Weekly reports from Maj. C. Judson Herrick, S. C., August 8 and 22, 1918. On file, Weekly Report File, Record Room, S. G. O.
(58) Report to the Surgeon General, U. S. Army, by Col. W. O. Owen, on the instruction laboratory, Army Medical Museum, December 10, 1918. On file, Historical Division, S. G. O.