History

This is a report of the Medical Department activities of the First United States Army for the period 23 February, 1945 to 8 May, 1945, inclusive. The rapid advance during this period made it necessary for the army medical service to take over many functions ordinarily performed by the Communications Zone. Communication Zone medical installations were great distances in rear of the army.

Air evacuation again played an important role. With few exceptions all casualties evacuated across the Rhine were by air.

The supervision and operation of overrun German military hospitals and the medical care of recovered allied personnel presented major problems.

II. Hospitalization

Simultaneously with the drive of the First Army from the Erft River toward the Rhine, First Army medical units were moved to support the operation. On the first of March six evacuation hospitals were open in support of these troops. The 96th Evacuation Hospital was established at Eschweiler where it was joined on the third of the month by the 45th Evacuation Hospital. The 5th Evacuation Hospital was open at Eupen until the sixth of March at which time it closed and moved to ulpich, opening there on the tenth of March. The 44th and 102nd Evacuation Hospitals were functioning at Brand and were joined by the 103rd Evacuation Hospital which moved into bivouac on 4 March. The 103rd Evacuation Hospital then moved to Bergheim and opened there on the eighth of March. Inasmuch as the incidence of respiratory diseases had not subsided the 128th Evacuation Hospital remained open at Banneux while the 4th Convalescent Hospital remained open at Spa. At the time of the Rhine crossing at Remagen on 7 March, six evacuation hospitals were open in support of the army. The 5th, 44th, 67th, 102nd, 103rd,and 128th Evacuation Hospitals were open at Zulpich, Dunstekoven, Duren, Ahrweiler, Bad Neuenahr, Bergheim, and Euskirchen, respectively, with the majority of these hospitals concentrated in back of the bridgehead. Because of the great distance between the evacuation hospitals and the convalescent hospital the latter installation was closed on the 12th of March and the 45th and 96th Evacuation Hospitals in Eschweiler were assigned to act as convalescent hospitals temporarily.

In support of the expansion of the bridgehead, the army surgeon had the 45th Evacuation Hospital established at Honnef, opening there on the 25th of March; this unit was the first evacuation hospital across the Rhine

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River. The 5th and 44th Evacuation Hospitals also crossed the Rhine and opened on the 28th of the month at airstrip Y-71 near Eudenback. The 128th Evacuation Hospital opened on the same date in the southern part of the army sector at Ihrlich. Hospitalization in the army area west of the Rhine was supplied by the 103rd Evacuation Hospital at Bergheim, the 67th Evacuation Hospital at Bad Godesberg, and the 96th Evacuation Hospital at Dunstekoven. The 97th and 102nd Evacuation Hospitals at Ahrweiler and Bad Neuenahr, respectively, were in position to receive casualties from both the western and eastern sides of the river.

The distances from the main concentration of First Army evacuation hospitals to the temporary convalescent setup at Eschweiler had again become too great, mainly because of the

traffic congestion on the roads. Furthermore, he 45th and 96th Evacuation Hospitals were needed again in their primary role. On the 14th of March, the 618th Medical Clearing Company located at Rheinbach was designated as a convalescent hospital. On the 17th of March, Company "C," 91st Medical Gas Treatment Battalion at Euskirchen was also designated as a convalescent hospital. During this period the 4th Convalescent Hospital was freeing itself of patients in preparation for moving. On the 22nd of the month it opened at Euskirchen, relieving Co. "C," 91st Medical Gas Treatment Battalion and the 618th Clearing Company from their temporary assignment.

The close of March found the following named hospitals in support of First U.S. Army troops. The 5th and 44th Evacuation Hospitals were located at Eudenbach with the 67th Evacuation Hospital located at Herborn. The 45th Evacuation Hospital was moving to the vicinity of Marburg. The 103rd, 97th and 102nd Evacuation Hospitals were open on the west bank of the Rhine at Bergheim, Ahrweiler, and Bad Neuenahr with the 128th supporting the south flank of First Army at Ihrlich.

The 2nd Evacuation Hospital had been closed from the 12th through the remainder of the month. Efforts to establish it in a suitable location in the vicinity of Cologne had met with no success. With the decline in casualties the demand for the establishment of a large installation of this type had lessened. However, good use had been made of the personnel, thirteen medical corps officers and twenty-three nurses being placed on temporary duty in various other units. Late in the month the equipment and remaining personnel of the hospital were moved to Zulpich where the hospital went into bivouac.

As in the August break-through in France, the necessity and the opportunity arose of using the field hospitals as evacuation hospitals to keep pace with the rapidly moving combat troops. The 51st Field Hospital was assigned such a mission in the VII Corps Zone. On the 30th of March, the second and third hospitalization units were given this mission and established in the vicinity of Herborn, a centrally located area with a good road net. It is of interest to note that the second hospitalization unit of the same field hospital was the first American hospital across the Rhine, being established in Unker six days after the initial crossing.

The supervision and operation of overrun German military hospitals proved a major task during the month of March and the days that followed. On the 15th oft he month the 64th Medical Group was ordered to place a supervisory medical detail at an overrun German military hospital in Linz. By the end of the month approximately fifty German hospitals were under U. S. Army Medical Department supervision. The policy adopted was to rid the large hospitals of convalescent patients by sending them to prisoner of war establishments and close the smaller hospitals by transporting their patients to the large institutions. Freshly-wounded prisoners of war were also admitted to the installations which were maintained. This latter decision lightened the load placed on First Army medical installations materially.

The capture of German prisoner camps presented another problem. Large installations of this type were uncovered at Diez, Lollar, and Wetzlar. Sanitary conditions at Diez were indescribable. A clearing company of the 134th Medical Group was placed in control and provisions for delousing and cleansing,

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serviceable sanitary facilities, medical care, and feeding were pushed to the utmost. This camp was known as Stalag XII B. The other large camps, the Dulagluft at Wetzlar and the camp at Lollar were in much better condition. Sufficient allied medical personnel were at hand in the last named camps so that supervision by U. S. Medical Department personnel was all that was required. A dispensary was placed in operation at all places named. Stringent measures for delousing were carried out to prevent the spread of typhus fever, and although scattered cases were uncovered in several localities, it was believed and later proven that adequate steps were taken to prevent its spread.

During the first part of April First U. S. Army was given the mission of fighting in two directions. The objectives were, first, annihilation of the German forces in the Ruhr pocket and second, contact with the Russian Forces by attack to the east. To support these operations, the surgeon had five evacuation hospitals open east of the Rhine River. The 5th and 44th Evacuation Hospitals were located at Eudenbach, the 67th Evacuation Hospital moved on the first of April from Herborn to Edingen and opened there the next day. On the second of April, the96th Evacuation Hospital opened at Giessen and on the third, the 45thEvacuationHospital opened at Bad Wildungen.

By the sixth of the month, the second phase of operations was well under way, with XVIII and III Corps operating against the Ruhr pocket to effect a junction with Ninth U. S. Army, and VII and V Corps attacking east to close with the Russian forces. The 5th and 67th Evacuation Hospitals supported the fighting in the Ruhr pocket, reinforced by the 128th Evacuation Hospital at Krombach, thus effecting an even distribution of hospitalization to the rear of III and XVIII Corps. An improvised convalescent hospital was established at Bellenhausen to support the evacuation hospitals behind the Ruhr pocket offensive. Company "C," of the 91st Medical Gas Treatment Battalion, in addition to carrying out its regularly assigned mission, received convalescents and venereal disease patients from, the three evacuation hospitals just mentioned.

To support the advance of V and VII Corps, the 103rd Evacuation Hospital was moved to Gottingen, opening on the 11th of April. By the 13th of the month, it had been left far behind by the rapidly advancing troops and accordingly was closed. On the 14th of the month, the 97th Evacuation Hospital opened at Duderstadt, followed by the 44th Evacuation Hospital at Nord hausen on the 16th, the 96th Evacuation Hospital at Nietleben and the 2nd Evacuation Hospital at Naumberg on the 18th, the 45th Evacuation Hospital at Weimar on the 22nd, and the 102nd Evacuation Hospital at Gera on the same day. On the 25th of the month ,the 103rd Evacuation Hospital opened at Zeulenroda. The 4th Convalescent Hospital had been established at Arolsen on the 13th of April and remained there during the month. This location rapidly became inaccessible because of distances from the forward evacuation hospitals. Accordingly, on the 21st of the month the 622nd Medical Clearing Company received, in addition to its other duties, the task of hospitalizing convalescent patients. The 620th Medical Clearing Company was ordered to receive cases of venereal and infectious disease. By these moves, all types of hospital facilities were readily accessible over the entire army area.

First Army had received three new evacuation hospitals to support the large number of divisions engaged in its bi-axial offensive. An attempt was made to establish one of these, the 118th, at Eudenbach. However, after two days of operation, it became apparent that this unit, because of its shortage of medical personnel and lack of experience as an evacuation hospital, more advantageous use might be made of it and of the other new hospitals to meet another problem. This problem, which consisted of the supervision of overrun German hospitals and the medical care of recovered allied military personnel had been augmented by a directive received on the 8th of the month from SHAEF. This directive stated that the Army Medical Service would be responsible for the medical care of displaced persons, refugees, and German civilians. To supervise medical service of this group, the personnel of the new hospitals was allocated to the medical groups of the army. Later a

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more adequate plan as outlined below was devised.

During the operation of closing the Ruhr pocket, many high ranking German medical officers had been captured, among them Major General Walter Scherf, the Surgeon of German Army Group "B." A plan was devised therefore, for the eventual assumption of control of German sick and wounded, both military and civilian, by a German medical staff headed by Major General Scherf. He was established in a central headquarters in Weimar. The army area was divided into two sectors, eastern and western, and a German sub-headquarters placed in each of these divisions. Security restrictions were imposed so that no member of this German Staff could move unless they were accompanied by United States Army personnel. American, German speaking, medical liaison officers were attached to the central staff as well as to both subdivisions. United States Medical Department enlisted personnel were to be placed at all German hospitals to serve there as liaison personnel, accompanying the German medical staff on their rounds. At the end of the month of April, further plans were under way to procure the necessary vehicles and additional personnel to render this German medical service operational. Meanwhile First Army medical groups continued their direct supervision of German medical installations. At the end of the month, augmented by the personnel of the 115th, 118th, 126th, and 134th Evacuation Hospitals, these groups were controlling two hundred sixteen German hospitals, rendering medical service to four prisoner of war camps, supervising the dispensary service at twenty-two displaced persons centers and collecting points, and operating three hospitals established for the care of recovered allied military personnel. The total German and allied patients hospitalized under the supervision of the First Army Medical Service was estimated at 90,000.

During the latter part of April and early part of May the army G-4requestedthe army surgeon to submit a medical plan for utilization of army medical troops. In addition to the regular duties and additional duties as listed in preceding paragraphs, an additional mission was assigned which consisted of receiving and treating American and Allied casualties evacuated from the Russian sector. In addition the Medical Service was assigned the responsibility for supervision of feeding and housing the non-patient Recovered Allied Military Personnel awaiting evacuation. To perform this mission the army surgeon proposed the following plan for utilization of army medical troops.

a. Utilization of Evacuation Hospitals:

The 2nd Evacuation Hospital was to remain open in Naumberg. The 5thto be moved to the airstrip at Gotha for reception and treatment of American and allied casualties evacuated from the Russian sector and to have the additional mission of supervising the feeding of non-patient Recovered Allied Military Personnel awaiting evacuation from the airstrip at Gotha. It was estimated that approximately 2,000 westbound patients would be handled here daily. To assist in the handling of such large numbers of casualties it was planned to place the 44th Evacuation Hospital also at Gotha. However, the 44th was to function normally as an evacuation hospital and was not to assist in the feeding. The 5th was to remain at the concentration camp at Buchenwald for an indefinite period. The 67th to be moved to the airstrip at Bayreuth to function as an evacuation hospital with the additional mission of feeding daily approximately a thousand eastbound nonpatient RAMPS awaiting evacuation. The 96th was assigned a like mission at the airstrip at Merseburg. The 97th, whose personnel were utilized for care of patients in RAMP hospitals, Prisoner of War hospitals, and Displaced Persons centers in the new V Corps sector had the additional mission of feeding nonpatient RAMPS awaiting evacuation from the airstrip at Weimar. The 102nd was to be closed as soon as relieved by the 126th and placed in reserve. The 103rd was to be closed as soon as relieved by the 118th and then moved to the southern section of the new V Corps sector. The 128th was moved to Grafenwohr and the 134th to Nietleben to operate hospitals in those locations. It was also planned that personnel not required by any of the evacuation

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hospitals for completion of their mission would be withdrawn and used to care for RAMP, POW, and displaced persons patients.

b. Utilization of Field Hospitals:

The 13th, 45th, and 51st Field Hospitals were to be placed in support of the VIII, V, and VII Corps respectively, and each to be given the mission of locating in three separate places in each of the corps zones for reception and care of American patients. The 47th Field Hospital was to be used to cover troop concentration in the army area, while the 84th Field Hospital was to beheld in reserve to cover the possible extension of V Corps to the south. Field hospitals were to be used in the same manner as evacuation hospitals and were to receive the same type cases.

In early May orders were issued by the army to hospital and group commanders to move units and to take over missions as listed in the preceding paragraphs. However, there were minor changes in the original plan and medical units were functioning finally as follows:

Evacuation Hospitals:

2nd Evacuation Hospital-Naumberg 1-8 May. Open entire period.

5th Evacuation Hospital-Eudenbach 1-3 May. Gotha 4-8 May. Open 6-8May.

44th Evacuation Hospital-Nordhausen 1-8 May. Open 7-8 May.

45th Evacuation Hospital-Weimar 1-8 May. Open entire period as Station Hospital for Buchenwald Concentration Camp.

67th Evacuation Hospital-Edingen 1-3 May. Bayreuth 4-8 May. Open 6-8May.

96th Evacuation Hospital-Nietleben (Halle) 1-8 May. Open 1-5 May.

97th Evacuation Hospital-Duderstadt 1-4 May. Weimar 5-8 May. Closed entire period.

102nd Evacuation Hospital-Gera 1-8 May. Open entire period.

103rd Evacuation Hospital-Zeulenroda 1-8 May. Open entire period.

118th Evacuation Hospital-Zeulenroda 1-8 May. Closed entire period.

126th Evacuation Hospital-Korbach 1 May. Gera 2-8 May. Closed entire period.

128th Evacuation Hospital-Grafenwohr 1-8 May. Open 5-8 May.

134th Evacuation Hospital-Weimar 1-3 May. Nietleben 4-8 May. Open5-8 May.

Evacuation Hospitals in RAMP, PW, and DP Service:

5th Evacuation Hospital-Feeding point for transient RAMP`s at Gotha.

45th Evacuation Hospital-Station Hospital for Buchenwald Concentration Camp.

67th Evacuation Hospital-Feeding point for transient RAMP`s at Bayreuth.

96th Evacuation Hospital-Feeding point for transient RAMP`s at Merseburg.

97th Evacuation Hospital-PW and DP Service. Feeding point for transient RAMP`s at Weimar.

118th Evacuation Hospital-RAMP, PW, and DP Service.

126th Evacuation Hospital-RAMP, PW, and DP Service.

Convalescent Hospitals:

4th Convalescent Hospital-Arolsen 1-8 May. Open entire period.

Field Hospitals:

13th Field Hospital-1st HU-Berleburg 1-3 May. Kirchain 4-8 May. Open 4-8 May as Station Hospital.

2nd HU-Eisenach 1-8, May. Open entire period.

3rd HU-Wipperfurth 1-4 May. Friedrichroda 5-8 May. Open 1 May as Station Hospital.

45th Field Hospital-1st HU-Weiden 1-8 May. Open entire period.

2nd HU-Weisenfels 1-2 May. Weiden 3 May. Waidmunchen 4-5 May. Stankov 7 May. Pilzen 8 May. Open entire period.

3rd HU-Borna 1-5 May. Weiden 6-8 May. Open 8 May.

47th Field Hospital-1st HU-Geissen 1-8 May. Open entire period as Station Hospital.

2nd HU-Weimar 1-8 May. Open entire period as Station Hospital.

3rd HU-Schwartzenbach 1-8 May. Open entire period as Station Hospital.

51st Field Hospital-1st HU- Halle 1-3 May. Leipzig 4-8 May. Open 4-8 May supporting 69th and 104th Divisions.

2nd HU-Halle 1-8 May. Closed entire period.

3rd HU-Halle 1-8 May. Closed entire period.

84th Field Hospital-lst HU-Weimar 1-8 May. Closed entire period.

2nd HU-Weimar 1-8 May. Closed entire period.

3rd HU-Altenburg 1-8 May. TD with 618th Med Clr Co entire period.

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At the time Third and Ninth Armies assumed command of the First Army area the status of RAMP`s, PW`s, and DP`s was as follows:

[Status of RAMPs, PWs, and DPs]

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III. Evacuation

When the First United States Army destroyed the resistance offered by German forces on the west bank of the Rhine and, following the regrouping after the seizure of the initial bridgehead, swept through Germany to a point ninety miles beyond that river, it became apparent that rail evacuation would not keep up with the rapidly moving army. Although rail evacuation had served First Army well from Liege to Aachen and beyond, repair of tracks and construction of railway bridges across the Rhine had placed a definite stop to its ability to bear the main burden. Road conditions were bad and sufficient ambulances were not on hand to carry casualties the long distances to available railheads.

By arrangement with the Ninth Troop Carrier command, a supply of C-47 aircraft were made available on call for the evacuation of First Army casualties. Air holding units were placed at a series of airfields in First Army zone. The initial field was at Y-60 at Dunstekoven, Germany, where two companies of the 91st Medical Gas Treatment Battalion and the 44th Evacuation Hospital were set up as the air holding units. A system of triaging of patients was inaugurated based on instructions from the Communications Zone, and sent to all hospital and medical group commanders. In essence it divided the casualties into three groups based on hospitalization expectancy. All cases whose stay in hospital would be less than sixty days had a large "under 60" marking placed on the jacket of the F.M.R. (Field Medical Record) where it was readily visible. All cases whose condition was such that it was obvious that they would be evacuated to the Zone of the Interior had a large "ZI" marking placed on the jacket of the F.M.R.

These two groups were evacuated by air to general hospitals on the continent. The third group, those requiring more than sixty and less than one hundred and twenty days of hospitalization, were marked as "over 60" and separated from the other groups for evacuation to the United Kingdom by air.

The next field utilized was Y-71 at Eudenbach on which the 618th Medical Clearing Company was placed as an air holding unit. This field opened on 28 March 1945. On the 31st of March it became necessary to open another air holding unit. Y-84 at Giessen, which was 60 miles from Eudenbach, was designated as an evacuation field and Company "A," 91st Medical Gas Treatment Battalion performed the mission of an air holding unit.

Immediately after the crossing of the Rhine the importance of light litter planes became apparent. Bridges imposed bottlenecks on the flow of ambulance traffic. Using three L-5 aircraft, 72 litter cases were evacuated from the east bank of the Rhine during the latter half of the month. These patients were, for the most part, taken from the 51st Field Hospital and delivered to the air holding unit at Y-60.

To amplify the possibilities of aerial evacuation from the bridgehead area, atrial glider pick-up was tried on the 22nd of March. Two gliders, each carrying twelve litter patients, were picked up by winch-equipped C-47 aircraft from a small airstrip near the 51st Field Hospital and delivered to Y-60. The entire trial was successful but the need. for such amplification of evacuation facilities disappeared as more bridges were opened over the river.

On several occasions when weather prevented flying, Advance Section Communications Zone ambulances, stationed at the army air evacuations trip at Y-60, evacuated patients by road to Aachen. However, for the most part the arrival of C-47 aircraft enabled the air holding units to maintain a satisfactory bed status during the entire month of March.

Evacuation in First U. S. Army operated along two separate and distinct axes during April. Behind XVIII and III Corps, which were fighting in a northwesterly direction, the 64th Medical Group was placed. This group was augmented by the addition of a battalion headquarters and extra collecting and ambulance elements so that its final composition

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was three battalion headquarters, four ambulance companies, six collecting companies, one clearing company, and one field hospital. The 68th Medical Group was placed in support of VII Corps and was composed of two medical battalions, three ambulance companies, four collecting companies, one clearing company, and one field hospital. The 134th Medical Group supported V Corps and was composed of two medical battalions, two ambulance companies, four collecting companies, one clearing company and one field hospital. Although considerable strain was placed on ambulance companies, the arrival of additional units following request to Twelfth Army Group enabled the Surgeon to meet all demands. Evacuation from the army area was, as in the preceding month, carried out mainly by C-47 aircraft. On several occasions, ambulance convoys of patients were evacuated from Eudenbach to the 46th Field hospital at Boon when airfield Y-71 was declared unserviceable. Following is a list of these fields and the dates during which they were operational for the evacuation of casualties:

[Evacuation Airfields, Locations, Units, and Status]

The month of May presented no difficult problems in evacuation of casualties and the evacuation policy continued in effect for the remainder of theperiod However, to facilitate evacuation by C-47 aircraft two new airstrips were opened. The 628th Medical Clearing Company established an air holding unit at R-26 located at Bayreuth, which was open the entire period while Company "A," 91st Medical Gas Treatment Battalion established an air holding unit at Merseburg (R-31) and remained open from the 5th to the 8th of May.

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IV. Medical Supply

Toward the latter part of February, renewed activity on the First Army front brought an increase in issued tonnage. Replenishment stock was adequate to maintain balances and meet the increased demand. A few items remained in short supply during the period although none were classified as being critical. Requisitioning procedures were altered so that requisitions were submitted three times each month, arriving at the forward Communication Zone depot on the 5th, 15th, and the 25th. This plan was adopted to prevent the congestion of bulk army requisitions on the depot and to expedite the receipt of supplies in the forward area. To further enhance the present supply situation the Office of the Chief Surgeon, ETOUSA, established a. supply movement control section to follow through on shipments to the final consignee in an effort to expedite delivery of supplies on requisitions initiated from the 1st Medical Depot Company.

With the army operating in the Roer Sector, supply operations were handicapped by poor roads, by an acute shortage of suitable warehousing sites and by the complete destruction of rail facilities. However, with army stocks in a strong position, with transportation still available, and telephonic communications with depot installations still operative, these handicaps were minimized.

Once across the Roer and faced with the necessity of moving supply installations forward in support of divisional units, both advance sections of the 1st Medical Depot Company prepared to move forward but were handicapped momentarily by the lack of available warehousing sites Since medical supplies were no longer waterproofed when packaged it was necessary to expend every effort to secure adequate closed storage. On 14 March 1945, the second advance section of the 1st Medical Depot Company moved from Malmedy, Belgium and opened for issue at Zulpich, Germany with fifty tons of supplies.

During this time many hospitals found it increasingly difficult to locate suitable buildings and were forced to setup totally or partially intents which required winter facilities.

In view of the necessity of providing medical supplies to units operating in connection with the Rhine River crossing and in order that forward movements could be accomplished so as to fit in with requirements, plans were under way for the movement of the three sections of the 1st Medical Depot Company.

The second advance section of the 1st Medical Depot Company moved from Zulpich, Germany to Bad Neuenahr on the 16th of March 1945 in support of units in the newly established Remagen bridgehead. On 17 March 1945 the 1stadvancesection of the 1st Medical Depot Company moved from Brand, Germany to Frechen, Germany in support of the army left flank. Issues at this location were considerable due to units building up a depleted supply of reserves.

On 18 March 1945 it became necessary for the base section of the 1st Medical Depot Company to advance from Dolhain, Belgium, to Mechernich, Germany. By this time available rail facilities were congested due to the heavy pressure of troops, and all movements of non-priority stocks were slow. All general operations were handicapped inasmuch as the area had been heavily damaged.

As the bridgehead expanded, active support had to be furnished to the units on the east bank of the Rhine River, notwithstanding traffic restrictions over the river. One of the primary problems to be overcome was that of obtaining clearance through military government, army, corps, and division channels in the crowded bridgehead area. However, this was accomplished, and by utilizing trucks from the over-taxed Army Medical Department Motor Pool, the first and second advance sections of the 1st Medical Depot Company completed their move to Dollendorf, Germany, and Honnef, Germany, respectively, on 27 March 1945.Throughout this period stocks were satisfactory to meet all demands, as con-

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tinuous replenishment shipments were received from the rear. Truck deliveries were made from the forward Com Z depots, although inactive and low priority depot stocks were more or less stranded on the rails in rear areas.

The quantities of German medical supplies recovered in the race across Germany necessitated the establishment of an organization capable of collecting, classifying, and distributing these supplies. The army, operating with only one medical depot company, found it necessary to attach an additional advance depot section for this purpose. This section was responsible for furnishing captured medical supplies to all liberated persons within Germany, as well as to medical installations serving captured German military personnel.

The second advance section of the 35th Medical Depot Company was attached to First Army and opened the First Army Captured Medical Materiel Collection Point at Zulpich, Germany, on 25 March 1945. As additional reports of locations of captured supplies were received they were immediately investigated and all supplies were withdrawn to the collecting point as far as available transportation permitted. On 28.March 1945, the 1st advance section of the 47th Medical Depot Company reported for temporary duty from the Fifteenth Army, to operate as inspection and inventory teams in conjunction with the newly established collecting point.

To replace litters and blankets evacuated with patients by air, arrangements were made with the Supply Division, Office of the Chief Surgeon, to coordinate the supply of litters and blankets to the holding unit in the air evacuations of casualties. Inasmuch as the majority, of the casualties leaving the army area were being evacuated by air, normal replenishment channels would have been of little value, and routine property exchange insufficient.

The first advance section of the 1st Medical Depot Company, taking advantage of air lift, moved from Dollendorf to Wetzlar, Germany, after some difficulty and delay due to bad flying conditions and the shortage of air transportation.

With the rapidly moving front, once a site was selected and cleared with division, corps, army, and military government and stock transported a hundred miles or more, the location frequently became obsolete before issues could be begun. These problems were reminiscent of those incurred in the race across northern France. The base section of the 1st Medical Depot Company selected a site at Giessen, Germany, but it was found that it was too far to the rear. A new site was selected well forward, and the base section moved to Korbach, Germany, leaving two hundred long tons of excess and slow moving items to be taken over by ADSEC. In support of troops on the left flank, the second advance section moved to Duderstadt, Germany, and opened for issues on 16 April 1945.

With the envelopment of the Ruhr pocket it was found that the situation demanded the employment of another advance depot section in immediate support of the operation. It was decided to utilize the first advance section of the47th Medical Depot Company which was already attached to First Army. Forty-eight tons of supplies, constituting stock for a complete advance section, were shipped by air from the United Kingdom and depot M-407 to airstrip Y-84. The 47th opened for issues with this stock at Siegen, Germany, in support of the XVIII (A/B) Corps.

As the Ruhr pocket was eliminated, the entire stock and personnel of this advance section at Siegen reverted to control of Fifteenth Army. On 21 April 1945, the first advance section of the 1st Medical Depot Company moved from Wetzlar to Jena, Germany, in support of V Corps troops driving southward.

Supplying medical requirements for prisoner of war and displaced persons hospitals and miscellaneous installations constituted a sizeable task. Captured supplies were considerable during the period and the attachment of the first advance sections of the 33rd and 35th Medical Depot Companies offered sufficient personnel to establish and maintain issuing points for captured and G-5 medical supplies. Without this additional personnel, the added task of supplying medical requirements for all displaced persons and prisoners of war would have been almost impossible. A large captured German depot at Ihringshausen, Germany,

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presented an excellent nucleus for a base issuing depot, and it was decided that stocks from the collecting point and miscellaneous outlying locations would be concentrated here. It is estimated that one hundred long tons of medical supplies were issued from this point during the month of April.

A second large German medical depot, equalling in tonnage the one at Ihringshausen, was recovered at Treuen, Germany. As a result of the conference on captured supplies with representatives of the Office of the Chief Surgeon, it was decided to evacuate the entire depot stock to a central depot to be controlled by Third Army. Sufficient transportation and labor were furnished by ADSEC and the transfer of the depot was completed.

With First Army ceasing all operations on 9 May 1945 medical supply functions were turned over to Ninth Army. This action was preceded by a series of conferences with supply representatives of the Office of the Surgeon Ninth Army, to fully acquaint them with the existing situation.

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V. Neuropsychiatric Activities

The campaign during the months of March and April was in general very successful for the American forces. The enemy resistance showed progressive evidence of breaking up, our advances were relatively rapid, and the outlook for early victory was good. As a direct result of the above factors the incidence of N.P. disabilities during the period was low (2905 cases or 4.58% of total admissions). However, the rate of return to duty of these cases was also low because the rapid advances and wide front made it very difficult to keep facilities for the care of such conditions up within easy reach of the troops. As a result considerable numbers of N.P. Casualties were evacuated out of the army zone directly without going through the specialized units(exhaustion centers) in which they could be given treatment directed toward their rehabilitation. However, 1180 of them or 40.6% were returned to duty in the army during March and April.

The cumulative statistics involving the N.P service of First Army for the entire campaign

6 June 1944 to 8 May 1945 follow:

a. Total Admissions 365,395

b. Total N. P. Admissions 34, 048-9.03% of a.

c. N. P. cases returned to duty 17, 361-50.9% of b.

Early in the operation the percentage incidence of N.P. casualties was much higher for several reasons: The fighting was much more intense, troops and troop leaders were largely green, and battalion surgeons were prone to evacuate even the very mild N.P. cases to the rear. Later in the campaign, greater emphasis was placed upon forward treatment of the so-called combat exhaustion, so that as many as 50% of the cases which had previously been evacuated were treated at the battalion level and returned to duty there, without ever being reported as N.P. casualties. This change in procedure affected the statistics in another way, by weeding out and treating the mild cases well forward. The percentage of those successfully treated in army rear area installations showed a marked drop because they were the more difficult and severe cases.

VI. Venereal Disease Control and Treatment Activities

a. Venereal Disease Control. The following are the venereal disease rates per thousand per annum for white and colored troops of First Army during the period covered by this report.

March 1945

White 26.4

Colored 140.4

Aggregate 30.8

April 1945

White 18.7

Colored 67.1

Aggregate 20.4

In March 1945, there was a considerable increase in the number of new venereal disease cases contracted by white troops. The great majority of these cases, approximately 41%, were contracted by troops on leave in Paris. Approximately 17% of new infections were contracted in Liege, Belgium. The remaining 42% of infections emanated from small towns and villages in Belgium, France and Luxembourg. Records show 12 cases were contracted in Germany during this month.

During the first three weeks of March 1945, the army venereal disease control officer continued the supervision of the vice control program in Verviers, Eupen, and surrounding towns in Belgium. The ADSEC VD Control Officer was taken to the various civil affairs organizations and military police detachments in order to acquaint him with the program being carried out by First Army, since the control program in this area was to soon become his responsibility.

During the last week of March, prophylactic stations operated by First Army were transferred to ADSEC Com Zone with the exception of those in the army recreation center and the city of Verviers, Belgium. The latter town was being used as a corps rest area. These stations gave a total of 1825 prophylactic treatments during the month.

An effort was made to trace all known sources of venereal disease infection. This procedure was carried out in conjunction with military police and public health officials of the Provost Marshal`s office and G-5 respectively.

During the month of April 1945, control procedures were at a minimum because of the non-fraternization rule in effect in Germany. Emphasis was placed on more comprehensive venereal disease educational programs in subordinate units. Prophylactic treatment was available at all organizational dispensaries. However, no supplementary stations were established in Germany during this month.

b. Treatment of the Venereal Diseases. The treatment of the venereal diseases continued according to the policy established in the early part of the Normandy campaign, that is, as many venereal disease patients as possible were treated in the army area at the venereal disease center (4th Convalescent Hospital).Penicillin was the drug of choice in the treatment of gonorrhea and early syphilis.

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VII. Medical Statistics

A. GENERAL

From the time the First Army landed on the beaches of Normandy in June, 1944, to the time operations were finished in Germany, in May 1945, there were 385,968 admissions to army medical installations. Each of these admissions represents a man who was lost for a period of time or permanently to the army. The term" admission" covers all admissions; some represent men with bodies torn by enemy fire, others cover men who were admitted because of comparatively minor disease-such as measles. This portion of the Medical Section report attempts to show, through the use of numbers and rates, a chronological tracing of when these admissions occurred and the type of disease or injury which made the men ineffective. These facts are set forth numerically and graphically in the attached tables and charts.

B. OPERATIONS

All statistics have to be evaluated in terms of accuracy and timeliness. Both of these criteria were met in the reports used in the medical statistical operations of the First Army.

The Combat Medical Statistical Report which was developed by the First Army and later adopted on a theater-wide basis proved invaluable in securing information with little or no time lag and with reasonable accuracy. If the data in the report were to achieve their full topical value, it was necessary that they be available to the army surgeon within 36 hours following the close of the report day. To achieve this, a special courier system was operated and a stop-watch efficiency in the collating of the material at the army headquarters was maintained.

The major fault in the reporting system as followed during the European campaign was that the use of multiple reports (the Combat Statistical, the Weekly Health, and the Hospital Reports) produced three sets of data on the same admissions. As each set of data is valuable for its own purposes, all are used in this report with the result that there are certain discrepancies among the tables. For example, the Weekly Health Report includes patients who did not get to a clearing station and hence are not included in the Combat Statistical Report. Changes and corrections in diagnoses were available in the preparation of the Weekly Health Report which were not available for the Combat Statistical Report, a spot report. Hospital admissions understate such things as common respiratory disease and gonorrhea which are largely treated on a quarters basis. This situation was realized in Europe and resulted in the designing of a revised Combat Statistical Report which combined the Weekly Health Report, the Hospital Report, and old Combat Statistical Report and will correct most of these discrepancies. (The revision was approved too late in the campaign to be put into practice.)

Numerous reports were tabulated in the statistical section in addition to the Combat Medical Statistical Report. The weekly Statistical Health Report(MD Form 867ab), the Report of Sick & Wounded (MD Form 51 and its accompanying MD Forms 52), and various

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other Medical Department reports required by Army Regulations were compiled, collated, checked, and forwarded to the Theater Surgeon`s Office.

Within the army, informal arrangements were made to furnish the following items of information regularly to the persons or offices indicated:

1. Daily Consolidated Combat Medical Statistical Report to the Chief of Staff, First Army.

2. Number of civilians remaining in hospitals daily to G-5.

3. Disease tabulations to the Army Medical Consultant.

4. Classification of wounded tabulations to the Army Surgical Consultant.

5. Data on admissions and dispositions of prisoners of war to the Provost Marshal.

6. Location of hospitalized personnel to interested agencies upon inquiry.

7. Name, rank, A.S.N. and unit of self-inflicted wound cases to the Inspector General.

8. Name, rank and unit of prisoners of war admitted to G-2, Order of Battle.

9. Weekly cumulative totals of combat statistics to Twelfth Army Group, Twenty-first Army Group, SHAEF, and the Office of the Chief Surgeon.

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Index

Charts

1. Comparison of Monthly Admission Rates for Principal Causes of Admission

2. Comparison of Admission Rates for Entire Campaign for Principal Causes

3. Monthly Composition of Admissions by Type

4. Admission Rates by Month for:

a. All Causes

b. Battle Casualties

c. Non-Battle Injuries

d. Disease

e. Psychiatric

f. Common Respiratory Disease

g. New Venereal Disease

h. Malaria

5. Classification of Wounded Admitted to Hospital by Causative Agent and Location of Wound

6. Peak Battle Days in Terms of Total Admissions

7. Peak Battle Days in Terms of Number Wounded

8. Peak Battle Days in Terms of Neuro-Psychiatric Admissions

9. Peak Battle Days in Terms of Disease Admissions

Tables

I. Monthly Admissions, Number and Rates (86ab)

II. Combat Medical Statistics Summary (Daily Combat Medical Report, 323)

A. Opening Phases, 6 June 44 thru 31 July 44

B. Exploitation of the St. Lo Breakthrough, 1 Aug 44 thru 12 Sept 44

C. The Battle of Germany, 13 Sept 44 thru 15 Dec 44

D. The German Counteroffensive, the Drive to the Roer River, 16 Dec 44 thru 22 Feb 45

E. Closing Phases, 23 Feb 45 thru 8 May 45

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III. Chronological Summary of Admissions by Engagement

IV. Number of Wounded Admitted & Disposed of by Medical Units by Engagement

V. Disease Rate Summary

VI. Admissions for Specified Diseases

VII. Classification of Wounds by Causative Agent

A. Wounds by Causative Agent

B. Mortality Rate of Wounds by Causative Agent

VIII. Classification of Wounds by Anatomical Location

A. Anatomical Location of Wounds

B. Mortality Rate of Wounds by Anatomical Location

IX. Number Lost to Command through Admission to Hospital and Battlefield Deaths by Engagement

X. Percent Lost to Command through Admission to Hospital and Battlefield Deaths by Engagement

XI. Basic Admission Rate Summary by Major Components:

A. All Causes

B. Battle Casualties

C. Non-Battle Injuries

D. Total Disease

E. Psychiatric

F. Common Respiratory Disease

G. New Venereal Disease

H. Malaria