History

AFTER ACTION REPORT FOR MONTH OF NOVEMBER,1944.

MEDICAL SECTION

[8TH INFANTRY DIVISION]

1 Nov to 18 Nov- During this period, the Division remained in place along the Luxembourg sector of the Siegfried Line. During this phase, there was no type of enemy action of sufficient intensity to produce any stress on the Medical Department of this division. Aid stations continued to operate in billeted area in close proximity to their respective units, maintaining medical service by a combination of individual visits to isolated outposts along the line or centralized sick call, whichever the situation seemed to indicate. A slight trickle of casualties, induced by sporadic and desultory artillery and mortar fire continued during this period, however, an increase in non-battle injuries was experienced. Slippery roads and dangerous curves produced a situation that was amenable to traffic accidents. Reports of investigation for these cases were numerous. Training schedules were continued on a modest scale, and several schools for the improvement of medical records were conducted by the Surgeon`s Office. A small number of medical replacements were received and at the close of this phase, the Medical Department was approaching T/O in strength.

18 Nov to 30 Nov- At the beginning of this phase, the logistics for the relief of the 28th Infantry Division in the general area occupying that portion of the Siegfried Line in the vicinity of Rotgen [Rtgen], Germany began. This necessitated a corps transfer from the VIII to the V Corps. The Clearing Station opened two and one half miles south of Rotgen [Rtgen],in what was formerly a German land owner`s hunting lodge. Facilities here for sorting and clearing of wounded were very good. However, the collecting companies, who had accompanied their respective Combat Teams into the muddy morass of the Hurtgen Forest found facilities very meager for the operation of their stations. Considerable difficulty due to soft ground and muddy trails was experienced. Battalion aid stations, likewise, found operational conditions very difficult. In most cases, the battalion medical sections were obliged to establish the Battalion Aid stations in abandoned Pill Boxes as a measure for added protection during he administration of first aid. Since the location of the Pill Boxes was dictated rather rigidly, most of the sections found it necessary to operate forward loading posts and man them with a portion of their personnel. Contact with the advancing companies was maintained by long arduous relay by litter squads. The necessity for manual carry became more acute and has been engaged in more extensively than at any other time during the history of the Medical Department of this division during combat. Offensive operations began and it was soon discovered that the deterrent factors already outlined required the augmentation by Corps litter squads and ambulances. After several days of increasing vicissitudes, it was possible to organize an arduous system of evacuation which, to date, has proven effective in the evacuation of the wounded in the forward areas. Tractor jeeps were also employed on a modest scale to supplement other agencies. From a professional standpoint, the duties of the Medical Department have been further complicated by the appearance of increasing amounts of disorders and ailments resulting from continued exposure to cold and moisture, such as trench foot, nasopharyngitis, battle fatigue, etc. The increase of these conditions, at the present time, is not unduly high, but as operations continue under the unfavorable conditions, the prospectus is uncertain, and may incline toward a pessimistic aggregation of non-battle disease.

The following is a breakdown of Casualties evacuated during the period 1November to 30 November 1944 (Incl):

DIVISION UNITS Div KIA - 49

	Disease	Injury	Battle Casualties	Total
Admissions	745	233	1041	2019
Transferred	540	191	895	1626
Died	0	6	5	11
Returned to Duty	194	35	138	367

ATTACHED UNITS Attchd KIA - 6

	Disease	Injury	Battle Casualties	Total
Admissions	44	12	16	72
Transferred	34	10	15	59
Died	0	0	0	0
Returned to Duty	14	2	1	17

CASUALS

	Disease	Injury	Battle Casualties	Total
Admissions	72	19	186	277
Transfers	62	17	182	261
Died	0	0	2	2
Returned to Duty	7	2	2	11

ENEMY, ALLIED, CIVILIAN

	Disease	Injury	Battle Casualties	Total
Admissions	7	1	54	62
Transfers	5	1	54	60
Died	0	0	0	0
Returned to Duty	2	0	0	2

TOTAL FOR PERIOD

	Disease	Injury	Battle Casualties	Total
Admissions	868	265	1297	2430
Transferred	641	219	1146	2006
Died	0	6	7	13
Returned to Duty	217	39	141	397

TOTAL SINCE ENTERING COMBAT Div KIA -1225, Attchd KIA - 45

	Disease	Injury	Battle Casualties	Total
Admissions	2909	810	8292	12011
Transfers	1892	580	6983	9455
Died	0	25	97	122
Returned to Duty	973	204	1209	2386

NOTE: 1. Psychiatric cases and battle fatigue are included in "Disease" figures above. A total of 185 such cases were admitted during the period covered by the report, of which 78 had to be evacuated. The remainder, 107, were treated by sedation and retuned to duty within 24 to 72 hours. Of those returned to duty, 21 were subsequently readmitted with the same diagnosis. Of the total evacuated, 23 were battle fatigue and 55 were organic psychiatric cases.

2. There are remaining figures not included in the statistical analysis as shown in the figures for the month of November. Accurate totals appear in the analysis of accumulative reports (total since entering combat).

A study of battle casualties transferred from the clearing station for the period 1 November to 30 November (Incl) has been made, and statistics compiled are as follows: 869 battle casualties during the period sustaining 1195 wounds. Each casualty, therefore, had approximately 1.36 wounds. Wound distribution is as follows:

Head	167 (5 with fracture)
Neck	4 (2 with Perforation of trachea)
Thorax	58 (9 with sucking wounds)
Abdomen	88 (4 with perforation of intestines)
Perineum	43
Upper extremity	537 (55 with fracture)
Lower extremity	477 (126 with fracture)
CAUSATIVE AGENTS
Small Arms	129
HE	452
Land Mines	69
Booby Traps	13
Bomb (Concussion)	22
Gas	0
Burns (BC)	4
Miscellaneous	183

SOURCE: National Archives and Records Administration, Record Group 407, Records of the US Army Adjutant General`s Office, World War II Unit Records, Box 7211, 8th Infantry Division, Division Surgeon`s After Action Reports.

AFTER ACTION REPORT DECEMBER 1944

Medical Section

[8TH INFANTRY DIVISION]

At the beginning of this period, the Division was engaged in a continuation of the bitter tank-infantry struggle for control of the town of KLEINHAU, the high ground to the north east, the road south and east towards BRANDENBERG, and the territory in and about VOSSENACK, and the network of roads leading to this area. The Medical Department, in developing its service for this action, found itself confronted with an arduous prolongation of the problems encountered with the overcoming of the time and distance factors dictated by the terrain. Many ofthe roads and much of the territory over which traffic was necessary for the evacuation of casualties was under direct enemy observation, particularly the territory to the south and southwest of KLEINHAU, HRTGEN, and the immediate environs of VOSSENACK (which was under almost continuous artillery and mortar fire) and from the high clear ground leading south through GERMETER. The Battalion Aid Stations were operating at greater distances from the front lines than had ever been found necessary in prior engagements. To meet this situation, battalion surgeons, rather uniformly, developed the technique of echeloning of equipment and personnel to a high degree. Forward loading posts were established in some eases as close as company CP areas. There, posts were manned with a minimum number of medical and surgical technicians to provide rudimentary first aid care for casualties whereupon they were quickly transported in litter jeeps to the main aid stations, which were farther to the rear in cellars and other protected places where a more adequate type of treatment could be instituted with a minimum of loss of life and limb from mortar and artillery effect.

The Collecting Stations were, of course, faced with the same problems, although considerably amplified because of the size of the installation. At the beginning of the period, the collecting stations were located in the woods northwest of GERMETER in the grid coordinate square 9933 (Cos B & C) and in the grid square 9530 (Co A) . Ambulance hauls from the aid station were long and travelled roads which were becoming constantly worse with deepening mud and erosion.

Repeated reconnaissance with view to more proximate locations were met with futile results insomuch as all accessible or desirable areas were either occupied by other units or prohibited by the presence of uncleared minefields. Since ambulances were calling directly at battalion aid stations, the collecting company litter bearers were used entirely in forward areas to augment the efforts of the battalion medical sections. In the first six days of the month, is could be expected by conditions previously elaborated upon, losses of medical department personnel were rather high. This placed additional burdens on the remaining personnel to the extent that chronic fatigue, particularly among litter bearers, was rather serious. On the sixth of December, objectives were seized in the BERGSTEIN area which marked the general limit of advance in this sector and the slowing of offensive operations.

On the 8th of December, 42 medical replacements were received which eased the situation somewhat, however, we were still 35 men short. Weather remained cold and wet, and the incidence of true trench foot continued to climb (88 cases through the period 2-8 December; See summary for monthly total). Upper respiratory disease was, also, appearing in greater frequency.

On the 10th of December, 21 additional replacements arrived which ended the prevailing shortage. The balance of the month was spent in the prosecution of limited attacks for the purpose of gaining more advantageous positions, and was signalized by frequent and bitter counter attacks on the part of the enemy which produced a modest daily flow of casualties. Throughout the month, evacuation for disease and injury (including trench foot) constituted a considerable percentage of our total admissions.

The latter part of the month the weather changed to frigid temperatures accompanied by irregular snow-fall. All medical department installations were finally permitted to move to more advanced positions, and cross country traffic became considerably easier because of the frozen terrain and roads.

The close of the period found the medical installations of the Division located in forward areas in the HRTGEN-GERMETER-BRANDENBERG triangle. The Clearing Station had moved with other divisional supply and service agencies to the area of ZWEIFALL.

POINTS OF INTEREST

The Field Dental Clinic, the first of its type serving an Infantry Division, has continued to treat those cases requiring dental treatment or prosthetic repair during this month with approximately 1,000 fillings and 89 prosthetic cases accomplished during the month. The unavailability of certain prosthetic supplies made it necessary to close the prosthetic section for all but 10 days of the month. During the month of November, 139 prosthetic cases were completed(both repair and manufacture) by the prosthetic section. These vital supplies having been obtained, it is expected that an increase in productive dentistry will be seen during the month of January.

The organization of the Field Dental Clinic was made after careful analysis of the dental needs for the Division, and with the full cooperation of the Commanding General, was activated during the month of November. After details of the operation of the clinic were completed, the dental officers and their assistants from all units of the Division were placed on special duty with the 8th Medical Battalion. Dentistry during the first months of combat was limited due to unfavorable condition prevailing at the Regimental and Battalion aid stations, indicating the need for such a clinic.

Organized into two sections, equal in equipment and person el, one section continually operates at the Clearing Station, while the other is available on call for service to regiments in reserve. Since the organization of this clinic, signal results have been obtained, and the place of such a unit with the division has been proved by its record of productive dentistry.

The following is a breakdown of casualties evacuated during the period 1 Decto 31 December 1944 (Incl):

DIVISION UNITS DivKIA - 282

	Disease	Injury	Battle Casualties	Total
Admissions	1124	731	1654	3509
Transferred	890	705	1331	2926
Died	0	0	10	10
Returned to Duty	257	24	316	597

ATTACHED UNITS Attchd KIA - 16

	Disease	Injury	Battle Casualties	Total
Admissions	53	38	45	134
Transferred	44	36	42	122
Died	0	0	2	2
Returned to Duty	8	0	1	9

CASUALS

	Disease	Injury	Battle Casualties	Total
Admissions	160	171	371	702
Transferred	142	159	362	663
Died	0	0	2	2
Returned to Duty	12	21	7	40

ENEMY, ALLIED, CIVILIAN

	Disease	Injury	Battle Casualties	Total
Admissions	1	1	109	111
Transferred	0	1	109	110
Died	0	0	0	0
Returned to Duty	1	0	0	1

TOTAL FOR PERIOD

	Disease	Injury	Battle Casualties	Total
Admissions	1338	939	2179	4456
Transferred	1076	901	1844	3821
Died	0	0	14	14
Returned to Duty	287	36	324	647

TOTAL SINCE ENTERING COMBAT Div KIA - 1507 Attchd KIA - 61

	Disease	Injury	Battle Casualties	Total
Admissions	4247	1749	10471	16469
Transferred	2968	1481	8827	13278
Died	0	25	111	136
Returned to Duty	1260	240	1533	3033

NOTE: 1. Psychiatric cases and battle fatigue are included in "Disease" figures above. A total of 265 such cases were admitted during the period covered by the report of which 108 had to be evacuated. The remainder, 157, were treated by sedation and returned to duty within 24 to 72 hours. Of the total evacuated, 197 were battle fatigue and 68 were organic psychiatric cases.

2. There are remaining figures not included in the statistic analysis as shown in the figures for the month of December. Accurate totals appear in the analysis of accumulative reports (total since entering combat).

3. Total cases of Trench Foot cases admitted for this period 445.

A study of battle casualties transferred from the clearing station for the period 1 December to 31 December (Incl) has been made, and statistics compiled re as follows: 1249 casualties were incurred during the period, sustaining 1676wounds. Each casualty, therefore, had approximately 1.34 wounds.

Head	212 (13 with fracture)
Neck	36 (None with Perforation of trachea)
Thorax	105 (None with sucking wounds)
Abdomen	67 (3 with perforation of intestines)
Perineum	73
Upper extremity	540 (95 with fracture)
Lower extremity	643 (116 with fracture)
CAUSATIVE AGENTS
Small Arms	331
HE	1134
Land Mines	84
Booby Traps	3
Bomb (Concussion)	28
Gas	0
Burns (BC)	7
Miscellaneous	187

SOURCE: National Archives and Records Administration, Record Group 407,Records of the US Army Adjutant General`s Office, World War II Unit Records, Box 7211, 8th Infantry Division, Division Surgeon`s After Action Reports.