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The Fight for the Hürtgen Forest

HEADQUARTERS NINTH INFANTRY DIVISION
Office of the Surgeon
A.P.O. # 9

ANNUAL REPORT OF MEDICAL ACTIVITIES OF

THE NINTH INFANTRY DIVISION

1 JANUARY 1944 -TO- 31 DECEMBER 1944

DONALD R. ROBERTS,
Major, Med. Corps,
Surgeon.

HEADQUARTERS NINTH INFANTRY DIVISION
Office of the Surgeon

APO # 9

25 January 1945

ANNUAL REPORT OF MEDICAL ACTIVITIES OF

THE NINTH INFANTRY DIVISION

1 January 1944 -to- 31 December 1944

In compliance with AR 10-1005, ltr AG 319.1 (9-15-42 EG-M, WD 22 Sept 1943, and Cir Ltr 143, Office of the Chief Surgeon, ETOUSA, APO # 887, dtd 18 December1944, the following report of Medical Activities, 9th Infantry Division is submitted:

I - HISTORICAL EVENTS PRIOR TO 1 JANUARY 1944.

II - ENGLAND

III - NORMANDY

IV - NORTHERN FRANCE

V - GERMANY

VI - RESUME OF YEAR`S MEDICAL ACTIVITIES

I - HISTORICAL EVENTS PRIOR TO 1 JANUARY Y 1944.

Only a brief resume of activation and early history will be given as this is the second annual report submitted by the 9th Infantry Division in the European Theater of Operations.

The 9th Infantry Division was activated in August 1940 at Fort Bragg, N.C. Here it was garrisoned and trained until October 1942. On 8 November 1942 the three Combat Teams made landings on D-Day, the 47th Combat Team at Safi, Morocco, French North Africa, the 60th Combat Team at Port Lyautey, Morocco, French North Africal and the 39th Combat Team at Algiers, French North Africa. The Division Headquarters arrived in December 1942 and united the 47th and 60thCombat Teams at Port Lyautey. The Division Artillery aided in repelling Rommel`s thrust through the Kasserine [Pass] in February, but the Division as a whole did not meet the enemy again until late March when the 47th and 39th Combat Teams were engaged for eleven days at El Guettar and the 60th Combat Team was engaged in the Battle of Maknassey.

Quickly following the cessation of this campaign, the Division moved into the battles of the Sedjanne Valley, which eventually led to the capture of Bizerte.

At the end of the North African Campaign, the Division moved into a training area in the vicinity of Magenta, Algeria, 45 miles south of Sidi Bel Abbes, Algeria.

In the later part of June 1943 the 39th Combat Team traveled to Bizerte and were with the Sicilian landing forces on D-Day. The remainder of the Division embarked at Oran, late in July and debarked at Palermo, Sicily early in August. The Division was rejoined with the 39th Combat Team at the Battle of Troina, and advanced through Cesaro and Randazzo within a few days. Following the cessation of the Sicilian campaign, the Division moved into a training area in the vicinity of Cefalu, Sicily. Here it remained until embarking for England from Palermo, Sicily on 10 November 1943, arriving at Liverpool, England on 25 November 1943. The Division moved via railroad to billets in the general vicinity of Winchester, England.

The above dissertation may at first seem unnecessary from the stand point of the Medical Department, but the previous exposure explains certain problems brought with us. Most important is the Malarial infestation which has continued to cause loss of time after over 15 months out of Malaria country. Proven malaria fever has affected at some time, over 20% of the Command despite carefully conducted suppressive measures.

The fact that our men were veterans of three campaigns had a healthy effect and partially explains our low rate of exhaustion cases occurring in the Normandy campaign, before the excessive exposure to combat and continued reinforcements brought on a moderate number of cases occurring, only after several months of fighting.

II - ENGLAND.

1 January 1944 found the Division medical units attached to their assigned unit commands located in the rolling hilly country of Hampshire. No single bivouac was able to house more than a regiment of 3J00 men, and many billets were either requisitioned estates or nests of Niessen Huts located in villages and towns in a radius of twelve miles from Winchester. This separation of command taxed the ingenuity of individual company aid men, as well as unit medical officers, in training and caring for the sanitary and health needs in their isolated commands.

The Niessen huts, Army barracks, school buildings and factory buildings were used for housing troops. Heating facilities and showers were adequate. All water drawn was through modern plumbing facilities and was tested monthly for purity by sending samples to General Laboratories. Laundry was adequate. Food and messes were excellent, cooking facilities were excellent and storage facilities adequate. The diet was supplemented by fresh potatoes, cabbage, brussel sprouts and other English garden produce.

The Medical Battalion was bivouaced at Crawley Court, five miles from Winchester, England. Ambulances were stationed with separate medical installations and evacuation was accomplished to the 38th Station Hospital, located in Winchester.

The weather, although overcast and foggy, was mild and snow did not remain for long.

All transportation and T/E medical equipment had been turned in before our departure from Sicily and new equipment was issued as automatic issue from the Office of the Chief Surgeon, ETOUSA. The supply problems were not acute, and resolved themselves into supplying normal expendable supplies. Two years training as well as previous experience in Africa and Sicily has proven the worth of the 9th Division litter rack (made to carry five litters on a 1/4 ton truck). All new 1/4 ton medical vehicles and one from each heavy weapons company, the cannon company and the anti-tank company of each regiment were equipped with this device. Medical Supply personnel contrived a water-proof box o keep medical supplies clean and dry. Battalion medical sections were provided with pack boards instead of the Carlisle Chest. A pack board medical chest was devised and units experimented in changing loads so that each pack contained a unit of equipment, so that if all others were lost, the aid man carrying that unit could still operate effectively. There was considerable difficulty experienced in carrying the irreplaceable Thomas Leg Splints on the pack board through heavy brush, etc. A clever lock hinge device was developed by the 709thOrdnance Company which enabled us to carry the folded splints in the pack board and did not detract from the rigidity of the extended splint.

An intensive training program was carried out in first aid, sanitation and personal hygiene, for all troops. This included use of the individual first aid packet and training for the individual soldier in how to meet emergencies. First aid demonstration teams, and gas treatment company teams made the rounds of individual units. Some medical personnel such as company aid men could not often be transported to a central location because of lack of transportation and the necessity of keeping aid stations functional in the eighteen or more separate billets which the Division occupied. In order that all men could be given are view of first aid, sanitation and gas treatment, a school was held at the Grange, Northington on alternate weeks. As men could be made available, classes were held eight hours each day for five days, fully half of the time being devoted to films and film strips. Emphasis was placed on advanced first aid, application of the Thomas Leg Splints and arm splints, shock treatment, blood plasma, treatment of gas casualties and the duties of the company aid man. Medical officers were sent to the Battle Neurosis School at the 312th Station Hospital, the Plaster Technique School at the 115th Station Hospital and the Medical Field Service School at Shrivenham. Men were sent to the Surgical and Medical technicians school at the 67th General Hospital.

Captain Donald M. MacIntosh was appointed Division Psychiatrist and attended a school for one month at Staffordshire. On his return, he made a lecture tour of unit officers schools, and laid down the concepts of preventative psychiatry; "Buddy" system of replacements, etc, which served so well later on.

The Battalion, Battery and Regimental units took part in training problems in tactics and in preparation for work with armored units. Aid men and medical officers learned the technique or removing wounded men from tanks, as well as in evacuation of 5% as casualties of assessed strength of infantry commands on maneuvers.

There was an increased number of Venereal Disease cases after our stay in England began. Venereal Disease control methods were rigidly and frequently checked.

All inspections of prophylactic stations were satisfactory. We insisted on a list of these stations being posted on all bulletin boards, also those in all vicinities that men might visit. Mechanical and chemical prophylactic kits were available in all Orderly Rooms. These could be had by request, the soldier being urged to take them, but not in any way coerced. Our venereal education program, we felt confident, was kept at a high standard. A great addition to it was the obtaining of film strips which were shown to the various units of the Division under the supervision of G-3. Also the suggestion of Captain Stevens, V.D. Control Officer, First Army, from which we outlined a program of informal talks to be given by Company Aid men. We wish to thank Captain Stevens for his personal interest and timely suggestion. We prepared a folder of Venereal Disease facts with the cooperation of G-1, which was printed and distributed to each individual soldier. Monthly sex hygiene were given by Medical Officers, Company officers,

and Chaplains. We feel that London proved to be our biggest problem, and one that more or less put us on the spot. We could not put the town off limits due to the effect on the morale of our men. Morale was a thing that we wanted to keep at a high level.

Officers and men of the Division were warmly welcomed by the English people. Teas, dances and invitations to private homes were abundantly provided. Furloughs of seven to ten days permitted travel within the United Kingdom. The morale of the men was even higher than during garrison in the United States. A great deal of Anglo-American understanding was built up by our pleasant stay. The only medical problem concerned here was the taking of Kahn tests on the part of both parties applying for the right to be married.

In February, a mobile prosthetic laboratory was attached to the Division for an entire month and proved most valuable. The unit did excellent work, producing 250 dental prostheses. In addition, four dental officers were attached to this Division by the Dental Surgeon, First U.S. Army. This help proved most valuable in repairing dental cripples. As the Division had been in the field in combat in Africa and Sicily for fourteen months, a moderate number of prosthetic cases had developed and the work provided by them was urgently needed.

As Spring approached, the tension of pending operations could be felt in the air. We were inspected by Mr Churchill and General Eisenhower. Talks were given to the officers of the Division by General Montgomery, and General Collins.

On the first day of May, the units of the Division had practice embarkation exercises in the marshalling areas. All equipment was waterproofed and vehicles were combat loaded. Following our "dry run", all units were put on a six hour alert. Vehicles were kept partly waterproofed. Water proof stripping was applied to all medical chests and a number of water resistant aid equipment containers were made of 105 shell cases wrapped with waterproof paper for carrying extra supplies.

General Bradley gave the officers a last minute talk and said he shared our disappointment, as we had not been included in the initial landing group, but promised that we would be in the big show before the first week was out.

III - NORMANDY: Commencing, 3 June, the Division began moving by motor and rail from the vicinity of Winchester to marshalling areas in the vicinity of Southampton and Weymouth, in preparation for overseas movement. Here in marshalling, areas, a final equipnt check was made and waterproofing completed, lifebelts

were issued for cross-channel movement.

We embarked the main body on 8 Juts and debarked on Utah Beach on 10 June, D plus 4. We waded ashore and immediately marched to an assembly area south of Ste. Mere Eglise. A check disclosed that all the equipment that arrived was dry and not bothered by sea water. However, the equipment and vehicles of the 47th Infantry Medical Detachment Headquarters and 2nd Battalion section was lost. On 12 June we received orders to prepare to attack through the 90th Infantry Division, drive across the Dovre River, seize the high ground on the western side of the peninsula in order to seal off the Cotentin Peninsula.

Supply replacement of the 47th Infantry was accomplished in the period of one afternoon, thanks to the complete cooperation of the advanced section of the First Army Medical Supply Depot, The vehicle lack was made up by appropriating some captured enemy vehicles.

The Normandy country is "Bocage", composed of frequent hedge rows and earth embankments cutting rolling countryside into small fertile plots. There is a fine secondary road network after the swampy beach area is passed.

On 15 June, we pushed through the 90th Division, three regiments abreast. On the evening of 16 June just west of Orglandes, we received a call from a German hospital just ahead of our troops for 25 units of blood plasma and morphine. Investigation disclosed that 38 of the men in the hospital were wounded American paratroopers, the remainder, 42 wounded Jerries. All patients were evacuated through the collecting company the following morning.

On the 17th we crossed the Dovre River and by 2400 the 17th two combat teams had cut the peninsula. The rapid dash across the peninsula led to long ambulance hauls on many occasions, but the country was ideally suited to evacuation of wounded. Hedge rows and earth embankments offered cover for aid men and litter bearers, and the generous road net enabled us to bring our 1/4 ton litter carriers close to the front. However, we were harassed by sniper fire and several aid men were shot openly in cold blood. Enemy artillery fire was moderate but harassing. Wooden sniper bullets were sometimes used by the enemy. These missiles cause nasty wounds.

On 18 June, we received the Corps order of attack, directing us to attack north along the western third of the Cotentin Peninsula in conjunction with the 4th and 79th Infantry Divisions. The drive on Cherbourg advanced rapidly against moderately heavy opposition. The enemy was well dug in and occupied carefully prepared emplacements, reinforced concrete pillboxes and dugouts. The enemy used large calibre coastal guns to harass us, but they were not very effective.

The enemy defensive positions were subjected to intense artillery and mortar fire. We happened to see the 164 prisoners who came out of one such emplacement after 1100 rounds of 81 H.E. mortar ammunition had been laid on it. Over one-half of them had ruptured ear drums.

Many prisoners brought in were drunk, others obvious combat exhaustions.

On 25 June, the first units of the Division occupied part of the City of Cherbourg. On the same day, a messenger from the German Commander of the Hospital brought the locations of the hospital to the American artillery in order that the hospital would not be subjected to shelling. Two days later the town

was surrendered to Major General Manton S. Eddy of the 9th Infantry Division by General Karl Wilhelm Von Schlieben and Rear Admiral Hennecke, Army and Navy Commanders of the garrison. The hospital alone contained 2600 wounded, 150 of which were Americans.

On the 28th, the 4th Infantry Division moved in to occupy the city of Cherbourg. The 9th Division was called on to mop up resistance remaining in the Cap de la Hague area, where some 4500 men and coastal guns continued to harass the port of Cherbourg. By the 2nd of July the mopping up was accomplished. The areas around the coastal defenses were heavily mined and we lost many litter bearers carrying through this area.

For this period, 15 June to 1 July, there were 390 K.I.A., 2900 W.I.A., 824 disease, 220 injured, 138 mental exhaustions and 27 physical exhaustions. Forty-three percent (43%) of combat exhaustions were returned to duty by the Division.

The medical sections followed closely, the advance of the combat troops. As this facilitated evacuation of casualties, most of the wounded were removed within an hour of their becoming casualties. A field hospital platoon was established in close proximity to the Clearing Station and offered emergency life saving surgical procedures.

It became quite evident soon after the landing in Normandy, France, as had been our previous experience, that no hard set rule could be established for the handling of casualties from the Aid Station to the collecting station and thence to the clearing station. To handle the evacuation with the maximum efficiency it required the constant, untiring efforts, together with a large portion of ingenuity, upon the part of the collecting company commanders and their entire staff. During those phases in which there were daily moves, communication between the Battalion Headquarters and the Collecting Companies was not always practical, necessitating the Collecting Company Commander to make his own decisions as to moves and location of his treatment station. It was found that by keeping a very close liaison with the Regimental Surgeon and with the Regimental S-3, a thorough knowledge could be had at all times, thus making the decisions of when and where to move much easier.

The location of a collecting station was a matter of much discussion. However, in the campaigns through France, Belgium and Germany this did not present too much of a problem as there were plenty of reads, and, as no effort was made to camouflage the treatment stations of the collecting companies, open fields were always available. As a general rule the collecting stations were always within one to three miles of the aid stations. It was remembered and found always advisable to keep all vehicles and personnel well dispersed, for on several occasions enemy shells fell in the collecting station`s areas. With the use of numerous large red crosses painted on all canvas, together with ground markers, strafing by enemy planes was not often encountered. However, there were isolated cases in which our companies were strafed, and it is still a subject of much discussion as to whether it was deliberate or due to the fact that of necessity, the collecting stations often times had to be set up close to installations of military importance.

The problems of evacuation of the aid station to the collecting station did not present too great a problem. For as previously mentioned, without too

many exceptions., the road network was always adequate, thus enabling the ambulances to evacuate directly from the aid stations. This was accomplished by keeping an ambulance, which was camouflaged, at the aid station at all times. If casualties became too heavy additional ambulances were on call at the collecting companies for immediate dispatch forward. On several occasions, when the ambulance was unable to go directly to the aid station, an advance loading post was established to which litter bearers from the collecting station would bring the patients from the aid station to be loaded.

It was felt that the collecting station was a very essential part of the evacuation plan. For it was here that patients, for the first time, could be thoroughly checked and definite definitive treatment could be started that could eventually save the patient`s life. Often times, due to heavy enemy fire, the aid stations were not able and did not have the time or facilities, for a complete evaluation of the patient`s condition, and so the collecting station was in a better position to examine the patient thoroughly and to institute such treatment as was felt necessary. In addition to the reasons mentioned above, the collecting station always provides hot drinks and food for the wounded. This in itself was a great morale factor for frequently, it was the first hot drink the front line soldier had had for several days.

The equipment of the collecting station was felt to be quite adequate. However, it was found that the lighting system with Coleman Gasoline lanterns is highly unsatisfactory and several of the collecting companies have improvised small generators for lighting; these proved highly satisfactory, but the matter of maintenance and spare parts for these motors became quite a problem. It was felt that a change in the T/E, in which a small unit Power Electric Generator would be authorized would greatly alleviate the situation. Also the number of ambulances allotted to a collecting station was felt to be inadequate. Normally ten (10) ambulances are sufficient. However, as the Artillery Units no longer have an ambulance, the situation has arisen where they were in need of ambulances, thus putting a strain on the collecting companies who were endeavoring to give adequate support to the Regiments. From experience it was felt that an additional two (2) ambulances per Collecting Company would alleviate the situation.

The Clearing Station of the Medical Battalion has always maintained a high standard of treatment and handling of casualties. The Station site was always within five to eight miles of the collecting stations. When this situation could not be met, the Clearing Platoons frequently operated separately. Patients are admitted to the clearing station and a thorough check is given to determine transportability. Also, here much definitive treatment was given and large amounts of plasma and whole blood were administered. After having been checked thoroughly in the treatment tents, the patients were moved to the evacuation tent where they received hot coffee and sandwiches and often times, coffee-cak or rolls.

There has been a definite effort to hold all patients in the clearing station who will be able to return to duty in a short while, even though it necessitates moving the patient from one clearing site to another. A very determined effort was made to keep all officers and non-commissioned officers. During the early part of this summer and fall, the Division was seeing a large number of recurrent malaria cases. These patients were held, and at times there would be forty or

fifty such cases in the clearing station at one time. Including the ever increasing number of combat exhaustion cases, this made the problem of moving quite difficult at times. However, due to the untiring efforts on the part of the clearing company personnel, these moves were made with maximum efficiency, and trained personnel was conserved for the Division thereby.

It has always been the policy to hold as many combat exhaustion cases in the clearing station as possible. These cases were treated under the supervision of the Division Psychiatrist. These patients received their original narcosis therapy in the clearing station. After a period they were sent to a rehabilitation center, run by the division, which was under the command of a line officer. They received lectures, physical training, practice in firing weapons, etc. They were kept on a very complete training schedule, which would occupy their time for the entire day. After a length of time, these men were interviewed by the Division Psychiatrist, who determined whether or not they were ready to go back into combat. This rehabilitation center usually was located with the Division Rear Echelon. However, there were times when the Rear Echelon was far behind the Division, necessitating the platoon of the clearing station that was not in operation, to run this rehabilitation center.

The previous combat experience and training had made all units function In a superior manner. In the three weeks the medical installations had cared for not only American casualties but many of the 18000 prisoners captured by the Division, as well as numerous civilian wounded.

From 2 July to 9 July, the Division bivouaced at Les Pieux and at Bois de Noire. Supplies were requisitioned, reinforcements provided and the troops rested for a week. Movies were shown, shower facilities were provided, and entertainment in the form of a stage show and orchestra provided.

On 30 July, the Division began a coordinated attack to the south as a part of the VII Corps, the 4th, 9th and 83rd Divisions abreast, south of Carentan, to the west of the Carentan - St Jean de Day axis. The terrain features were similar to the upper peninsula but as it was lower ground, the land was swampy, canals interspaced muddy fields. Mosquitos were in evidence. The skies were wet and foggy. Enemy resistance increased noticeably and heavy concentrations of of artillery and mortar shells were laid on us.

On 11 July, the Jerries broke through with a company of Tiger tanks and supporting infantry. Two medical officers, Captain Hyman B. Copleman and Lieut. Helmuth W. Fesca were captured from the 3rd Battalion section of the 47th Infantry. The Battalion medical section was captured in a farmhouse, about dark. As the battle was intense, many wounded lay untended. Within a few hours, Capt. Myer W. Boyarsky took over the section made up of Headquarters personnel and loans from other sections and by mid afternoon the section had cleared the area of wounded.

Our casualties averaged over 300 per day for several weeks, and there were increasing numbers of medical personnel lost. The Germans contested our crossing of the St. L - Prriers Road with strongly entrenched infantry and crack S.S. and paratrooper units. The German artillery and ground teams charged us heavily for each hedgerow gained. A days gain was measured now, in yards instead of miles.

IV NORTHERN FRANCE: On 25 July we pulled back 1000 yards in order that a mass

bombing might be carried out on the German positions to the south of the St. L - Prriers Road. The mass bombing by 1800 heavy, 350 medium and 500 dive bombers was intended to sterilize an area 400 yards deep and 5000 yards wide, in order to accomplish a breakthrough. The weather was good and a gentle wind eased a great smoke cloud back on our troops. We felt the devastating effects of our own bombing as the latter waves of bombers were unable to locate the bomb line. Other bombs were jettisoned in our area by disabled planes. We felt lucky in that only about 50 of our men became casualties, either directly or indirectly from the air action. Unfortunately, the command group of one battalion except for the Battalion Commander was wiped out. The opposition was feeble following the bombing, and the 3rd Armored and 1st Infantry Divisions passed through us. We followed after clearing out pockets of resistance left in the area.

The problem of evacuation was most critical following the bombing, as many lines of communication were wiped out, and only a physical check of units could ascertain the needs of the unit, which were luckily much less than first estimated.

The following week, several units of the Division were bombed by German planes, which dropped anti-personnel basket bombs, with attached "Made in England" tag. This device cuts a novel pattern of multiple star shaped explosives in the grass of a field for several hundred feet round about its original landing site. Most men sleeping above ground in this area were hit. The pellets luckily were small and produced few fatalities.

From 28 to 31 July, we had a semi-rest period in the region south of Marigny. The Division went into Corps` reserve. The time was spent cleaning and repairing equipment in the La Hetondiere area. Many medical men had become casualties in the action of the previous three weeks and the shortage of personnel continued as replacements had not kept up with losses. Collecting Companies were stripped of personnel and generous use had to be made of Corps and Army litter bearers. The 9th Division Band was used in toto as a litter bearer unit.

In the three preceding weeks, losses of medical personnel were as follows: One (1) Officer and twenty (20) enlisted men K.I.A.; five (5) Officers and one hundred and sixty five (165) enlisted man W.I.A.; two (2) officers and twenty-three (23) enlisted men missing in action. These losses indicate clearly that when medical personnel are actively engaged in the treatment and evacuation of casualties, that their casualty rate equals that of the infantry units to which they are attached. As the tempo of battle increased and an increasing number of reinforcements reached the Division, a sharp increase in our combat exhaustion cases occurred. Men showed signs of excessive physical fatigue.

For July 1944 there were: K.I.A. - 172: W.I.A. - 3570: Disease - 973: Injury - 448: Mental Exhaustion - 514: Physical Exhaustion - 43.

On 1 August we received the Corps order to attack south east to envelope the enemy`s left flank and exploit the breakthrough. This attack was along the axis of the Falaise pocket, for the purpose of sealing the seam of the Falaise pocket. The enemy continued to give stubborn resistance, mainly by small

groups of Infantry and tanks. Artillery fire was markedly decreased. By U August we were ordered to change the direction of attack to North by East for the purpose of cutting off the Falaise pocket and destroying the enemy. By the13th contact was made with the British. The Falaise pocket was closed.

After quickly regrouping we were ordered to pursue the enemy who was believed to have retired to the North of the Seine River. From the 17th to the 31st of August we covered over 400 miles meeting only light resistance. This rapid movement made evacuation chains considerably extended. Many ambulance hauls were from 35 to 50 miles to an Evacuation Hospital. Medical Supply damps were often over 100 miles in the rear. Our own units were supplied adequately by splitting our supply unit into two sections, both able to operate independently of each other by utilizing the method of leapfrogging the section. It was possible to issue at any time there was a request, as one section was always open to issue.

Most interesting to us was finding the grave of 1st Lt. Helmut W. Fesca in the Aisne-Marne Cemetery, one of the first Americans to be buried there in this war. Lt. Fesca was captured before St. Lo. He had been killed by a straffing plane as he was being evacuated as a Prisoner of War through France. Capt .Hyman B. Copleman, M.C., was recovered together with 70 American wounded at Chateau Thierry. He was left in charge of a hospital by the Germans as they had insufficient transportation to evacuate the wounded prisoners of war. It iss uspected that he may have used plaster technique on sprained ankles and retarded the healing of some cases so that more of the prisoners of war could be retaken by our troops.

Casualties for the month of August:

KIA	WIA	DISEASE	INJURY	MENTAL EXHAUST	PHYSICAL EXHAUST
376	2125	1232	438	298	2

We were ordered, early in September, to march north on Mons. We reached Philipville on 3 September. Casualties were light and resistance sporadic. A few cases of diarrhea resulted from the quantities of fruit, wine, and beer showered on the troops by the liberated peoples.

On 4 September we reached the Meuse River at a point between Dinant and Givat. Under the cover of darkness, the 60th Combat Team forced a crossing of the river and held the bridgehead in face of repeated counterattacks. The heroic action of the 3rd Battalion Medical Section of the 60th Infantry Regiment in the evacuation of casualties across the river earned for them the Presidential Unit Citation Award. The following night, 6 September, another regiment succeeded in crossing and assisted in consolidating the bridgehead. The Engineers completed abridge and as soon as tanks could be taken over, the enemy was routed.

V - GERMANY.

The Division successively captured Dinant, Verviers, and Eupen, Belgium, after which we crossed into Roetgen, Germany. By the 16th of September, Vich

and Schevenhutte, Germany were secured. By 16 September the Division had breached the Siegfried Line and in the town of Schevenhutte, located deep in the Hurtgen Forest, was 14 kilometers east of Aachen at a time when Aachen was still strongly held by enemy forces. Other Units of the Division captured Sourbrodt and advanced to Camp Elsenborn. The units at Schevenhutte were strongly counterattacked and although ambulance evacuation was cut off for a period of time by encircling enemy forces, the battalion located there somehow fought their way back and continued to hold that town.

Division units were engaged in reducing enemy fortifications in the region of Lamersdorf and Monschau.

Ninety-five percent (95%) of our aid men had become casualties and the need for trained company aid men was acute. New reinforcements were willing but did not understand infantry, tactics and often became casualties themselves in a short period of time.

The casualties were as follows:

KIA	WIA	DISEASE	INJURY	EXHAUSTION
218	2111	1224	398	176

The mission assigned the Division was to maintain positions along the line Maustaek, Schevenhutte and regroup to attack enemy defenses at Schmidt 0629 and Vossenack beginning on 5 October 1944. The country was heavily wooded in this area, there were thick stands of spruce with occasional breaks of hardwood. One could see only a few yards through this heavy vegetation and at night it was impossible to see at all. Men were forced to walk ahead of the 1/4 ton trucks with radium painted disks to lead the way. Forests were interwoven with firebreaks which formed a poor secondary road net which became quagmire after vehicles, in wet weather, passed over them.

A great deal of difficulty was experienced in finding one`s way through the maze of forest. The enemy was deeply entrenched and had prepared concrete pillboxes to guard this area which was heavily fortified with prepared and coordinated fires called down by outposts. The lines were secured by mines, barbwire and trip wires. Casualties were heavy and it was necessary to call in Corps and Army litter bearers to assist in evacuating the many casualties occurring in this area. The litter bearers did excellent work and were a credit to the medical department.

On 25 October, a relief was effected for the 60th and 39th Combat teams and they were removed to a training area in the region of Camp Elsenborn, Belgium. The 28th Infantry Division took our place in the line. The 47th Combat Team remained in position at the Gresnick-Schevenhutte area.

The division training schedule was concerned with training, rehabilitation and coordinating future plans for future employment in the line. All men were given a typhus shot and units were given either a sex lecture or shown a V.D. training film.

For the month of October there were the following casualties:

KIA	WIA	DISEASE	INJURY	EXHAUSTION
384	2510	1877	600	323

1169 prisoners of war were taken, 130 were evacuated through medical channels.

New reinforcements arriving at the Division rear boundary were held and briefed on unit history, tactics applicable to the terrain and combat tips intended to acclimate the man to combat.

On 4 November, the Division was called on to relieve the 4th Infantry Division on the Corps` north flank. By the 16th the troops of the Division had been again relieved by the 99th Infantry Division and went into Corps` reserve. The training and rehabilitation schedule continued.

A shortage of medical enlisted men persisted.

There were 183 cases of Trench Foot developed during the month. This was due in large measure to an insufficient issue of Arctics. Certain sizes were unobtainable and hundreds of men were ill equipped to stand in mud and water continuously. An intensive educational campaign on trench foot prevention was conducted, frequent foot inspections were conducted by company officers.

The 47th Combat Team was attached to the 3rd Armored Division and 1stInfantry Division during this period and participated in the coordinated attack of the VII Corps on Duren.

The Division suffered casualties for the month of November as listed below:

KIA	WIA	DISEASE	INJURY	EXHAUSTION
82	753	1962	516	52

The climate was rainy and cold, the terrain was rolling.

On 6 December, the Division moved from the region of Elsenborn to effect a relief of the 1st Infantry Division in the Duren sector. There the terrain was devoid of cover except that afforded by scant patches of wood and numerous small industrial towns with brick and stone buildings. Our mission was to drive toward the north of Duren, close up to the Roer River and effect a crossing. Successive objectives were taken to the east of Langewhe and considerable progress had been made in accomplishing this objective when the German breakthrough to the South necessitated a sudden withdrawal to take up defensive positions in the Monschau Sourbrodt section southeast of Eupen. A number of German paratroopers were captured, many with severe trench foot, acquired after only two to three days exposure in the forest.

Casualties handled during the month of December were as follows:

KIA	WIA	DISEASE	INJURY	EXHAUSTION
197	907	1663	541	117

During the latter part of December, in the Hurtgen Forest Sector, it was found necessary to establish the treatment stations of the Collecting Companies in buildings, as the fields became so muddy from constant rain and snow that

vehicles were unable to move about. In these situations at times the Collecting Companies may have been a bit further from the Aid Stations, but, as there was usually a good road for evacuation, it is felt that the locations were justified.

The Collecting stations collected arctics arriving on casualties, in order that reinforcements could be fitted with arctics before being sent to duty.

The Admission and Disposition roster of the Clearing Station has been mimeographed by the Adjutant General`s Section. This mimeographed sheet is furnished to the division and attached troops. The published roster has aided greatly in the preparation of the battle casualty reports and the adjustment of morning reports and sick books during combat.

VI - RESUME OF YEAR`S MEDICAL ACTIVITIES.

The foregoing narrative account covers the report of the year as regards operations, missions, etc. However, there are certain topics which may be further clarified if they are discussed in resume of the whole year`s activity:

(1) DENTAL CARE: The Dental Service functioned most successfully under field conditions during the entire year. Emergency dental treatment was available to all units at all times. Routine dental treatment, was available within the Division to those units which at short and infrequent intervals were able to render only, emergency treatment.

The policy of the dental service in the Division has, during the past year, shifted from complete emphasis toward restorative dentistry (fillings) to a dual consideration of both restorative and prosthetic dental treatment. The unusually large number of removable prosthetic appliances inserted is largely to be credited to the valuable assistance rendered by the Central Dental Laboratories.

The Dental Service acquired a captured German trailer shortly after the Normandy landings and, with Army approval, has established a mobile dental laboratory for the Division. This trailer is equipped with a complete captured laboratory which provides practically all the necessary armamentarium for processing broken dentures and doing the necessary gold work. This arrangement makes such services possible to the patient in a matter of four or five days maximum time whereas it would otherwise require approximately a month if the cases had to be mailed to Dental Laboratories. The prosthetic dental chests (MD61 and 62) were not adequate to handle the numbers of such cases being cared for within the Division.

The military situation has been such that routine monthly dental inspections have not been carried out as often as is desirable but a careful check has been made to detect any signs of oral infection, especially Vincent`s. Such infections have been kept at a very satisfactory minimum and the oral health of the command is excellent.

The chart below contains a partial list of services rendered by all dental units within the Division during the past year. These figures are a monthly average obtained from the year`s total:

(see next page for chart)

	AVERAGE BY MONTH	FOR YEAR
Dental Officers on Duty	13
Days of Duty	382.5	4589
Sittings	1925	23100
Restorations	1590	19080
Extractions	332	3984
Missing Teeth Replaced	400	4800
Dentures (Partial & Full) and Bridges	77.9	935
Denture Repairs	24.3	2916

Major John P. Christensen, O 22257, Division Dental Surgeon until being transferred out of the Division just prior to the end of the year, was succeeded in that capacity by Capt. David L. Francis, O 396915. During the year, the Division lost one dental officer evacuated due to wounds received in battle. Another dental officer was wounded but returned to duty after two weeks in the hospital. One dental officer was erroneously assigned to this Division, but, after a month`s duty, was transferred to his proper unit. Three dental officers have been decorated with the Bronze Star Medal. During half the year, the Division operated with an over strength of two dental officers and closed the year with one in excess of existing T/O.

The present excellent oral health of the command has been achieved through the industry and initiative of the dental personnel and their assistants, aided in no small way by the wholehearted cooperation of the medical officers. In order to maintain this excellent state of oral health, a continuous program of dental service must be followed. For this reason utilization of dental officer for other purposes, excepting emergency medical aid, has been discouraged.

(2) BLOOD PLASMA AND WHOLE BLOOD TRANSFUSIONS

Total Amount of Blood Plasma used for Division For months June - Dec. 44

Total Units Given	3707 (926,750 cc)
Total Number of patients requiring plasma	2534

Average number of units administered ea. patient treated with plasma	1.46 units

Percentage of Plasma administered in Bn Aid Sta. and in Companies by Aid men	41.7%

Percentage of Plasma administered in Med Bn	58.3%

% Plasma administered in Coll. Co (A,B,C)	33.9%

% Plasma Administered in Clr Sta (Co. D)	24.4%

Blood plasma served as our chief weapon against shock. It was used frequently and with excellent results. Perhaps the best compliment to its use has been by the insistence of German Medical Officers to use it on their wounded as well as our own at Orglandes and in Cherbourg.

There were 187 whole blood transfusions given. Thirty-seven (37) of these were administered in Collecting Companies from blood obtained from the men of the company.

These whole blood transfusions served as life saving measures and were of great benefit. One hundred-fifty (150) whole blood transfusions were given at the Clearing Company. However, as a. Field Hospital moved in the immediate, vicinity of the Clearing Company on each move, whole blood was usually given at the Field Hospital. Our units gave whole blood only. as emergency.

(3) VENEREAL DISEASES: (Attention is invited to Chart attached to History)

The venereal disease problem was faced in England and has been previously discussed. During the past seven (7) months almost constant engagement with the enemy has occupied the attention of the greatest part of this Command. The venereal disease problem will recur on doubt as soon as passes are issued or men have time for other than military pursuits. The average venereal disease rate of this Division for the year of 1944 was 14.6 per 3000 per annum.

(4) TRAINING OF COMPANY AID MEN: The casualty rate for company aid men was well over 100% in a six month period. Replacements for the vacancies were not trained in infantry tactics and as men were assigned in the heat of battle, they had little or no time to learn. Technicians sent up to fill these vacancies were hospital orderlies, pharmacists, radiologists, cooks, etc. These men were totally untrained in the proper physical, mental and tactical concepts necessary for efficient work in an infantry medical detachment. Line replacements were not as a rule assigned in the heat of battle but we were allowed no other alternative.

The chart below shows the total number of cases evacuated from the medical personnel of the Division during the year. Eighty-five percent (85%) of these casualties occurred in the infantry medical detachments and constituted 100%battle casualties of the medical detachments:

OFFICERS	KIA	WIA	MIA
MC	3	8	3
DC		3
MAC	2	6	1
ENLISTED MEN	69	377	53

(5) SUPPLY: The Medical supply Section has operated effectively during the past year. Particularly helpful, has been the policy of supply to furnish various pharmaceutical preparations (i.e. cough syrup, nose drops, penicillin ointment, and various others) to units requiring same; as it has been the policy to keep all necessary supplies forward, even to the point of shorting other units to keep the regiments with the items they requested. The policy of drawing coffee from the Division Quartermaster and issuing it to the Battalion Aid Station was put into effect. In this way, a hot drink was available at all times for the patients, as far forward as the Battalion Aid Stations.

Another policy instituted by the supply section was that of drawing in the Medical Kits of the Clearing Station of the Division and issuing them to the Casual Company of the Division Headquarters, thus enabling them to issue a kit to each medical reinforcement prior to being sent to his assigned medical detachment. Yet another policy that proved quite beneficial to the medical detachments was the exchange of dry, clean blankets for wet or soiled ones. This was made possible by arrangement with the Division Quartermaster whereby we obtained a priority on the laundering of blankets. With this system all units were assured of a supply of clean, dry blankets at all times.

When the supply of flag markers for ambulances, Geneva Convention Red Cross, became depleted and replacements were not available, we drew red and white cloth and made a sufficient number to permit the issue of the markers required. A similar situation was encountered in respect to a ground marker for the Division Clearing Station, as a replacement was not available when the one on hand became unserviceable. This situation was overcome by drawing two (2) tarps17` X 36` which, when painted and laid together made a 34` X 36` ground marker.

At one period of the fighting, an enemy medical depot was captured by this Division where we obtained a complete prosthetic laboratory, which was turned over to the Division Dental Surgeon. This unit was then set up in a four wheel trailer, that was obtained from the 1st Army Dental Surgeon. Due to this Dental Laboratory, this Division has been able to do most of their own dental prosthetic work, thereby considerably expediting the repair and making of dentures. At this time two small electric drills were obtained which were issued o Company "D", 9th Medical Battalion. These additions have helped keep the dental repair of the troops at a very high level.

(6) CHANGES IN T/E AND T/O:

a. The latest change in T/E allots each Battalion Aid Station one (1) 1/4 ton truck, with trailer and one (1) 3/4 ton truck. This transportation carries personnel and equipment adequately, but is not well adapted to evacuating casualties from the front to the Battalion Aid Stations. Jeeps borrowed from other units must be fitted with litter racks to be practical and at present the allotment per infantry battalion does not allow an alternate vehicle for this purpose.

b. The pack board medical equipment packs were adapted to terrain such as we found in Sicily and North Africa. We believe that a better adapted chest for France, Germany and Belgium would be a return to the Carlisle Chest or to a lighter prestwood or plywood chest such as the Germans use.

c. The present allotment of ambulances, thirty (30) for the Division, allows no ambulances for the Artillery Headquarters or Battalions or the Engineers. A need has been acutely felt for two more ambulances per collecting company.

(7) BATHING FACILITIES: The bathing facilities for troops in combat are almost never adequate. Corps shower units with clothes turn in privileges are excellent, but the disposition of our troops has, for the most part, prevented the removal of more than 2% to 3% of any unit from the front at anytime. This allows only one bath per man in a three to four week period, which is inadequate.

There is an urgent need for Division, Regimental or Battalion shower unit to augment the Corps shower units, as troops can be pulled back into Battalion or even Regimental areas without endangering the combat situation by their absence.

Our units have improvised equipment for this purpose, but the equipment is bulky and there is no transportation authorized for this purpose.

(8) DISEASE AND CASUALTIES FOR THE YEAR: (Attention invited to Charts attached)

Total battle casualty, disease and injury figures for the Division for the year are shown in the table below:

TOTAL B.C.	TOTAL N.B.C.
KIA ---- 2312	DISEASE - 15617
WIA ---- 12026	INJURY --- 3313
EXHAUSTION ---- 1476

COMMENTS ON BATTLE CASUALTY AND DISEASE CHARTS ATTACHED TO HISTORY:

(a) Chart on Battle Casualties: The battle casualties of the division for the year shows a constant drain on man power as men became casualties. There were over 1500 casualties per month for five (5) months and there were never less than 1000 men lost per month.

(b) Chart on NBC: The. respiratory rate for Jan and Feb 1944 was high during our stay in Barracks. (Notice the low rate in Nov and Dec while we were in outside bivouac.) ( Note also the constant infestation by malaria, shown in red, not usually a factor in Divisions in this theater)(Northern Europe).Intestinal disease has been kept at a minimum.

(c) Conservation of Manpower: In effort to conserve and salvage manpower within the Division, an exhaustion center was put in operation shortly after the completion of operations in the Cherbourg peninsula. At that time, approximately 200 men had been sent to the rear echelon of the Division through medical channels for recovery from mental and physical exhaustion.

Responsibility for the planning and operation of the organization was delegated to a line officer, in close conjunction with the Division Surgeon and the Division Psychiatrist.

The unit was organized similar to that of a rifle company, with men who had been sent back for recuperation being appointed to the posts of first sergeant, platoon sergeants, and squad leaders. A definite schedule of training was adhered to, including many basic subjects, such as scouting and patrolling, aircraft identification, our own and enemy weapons, and hikes, with the men themselves preparing for and conducting the classes under the supervision of officers. Into the schedule was also interposed athletics, radio news broadcasts, orientation talks by officers and open time for rest and letter writing. A daily sick call was also held by a medical officer, who determined the disposition to be made with each individual.

The training schedule served many purposes; primarily, it prevented the men from stagnation and deterioration due to idleness, and was also an aid in training of the individual soldier; and not least important, he was kept in good physical condition or reconditioned while recovering.

It has been proven that best results are obtained when the unit is operated separately from any medical installation, as there is a definite tendency on the part of the men to progress more rapidly back to normal as soon as they are dismissed from the hospital. Every effort is made to avoid any atmosphere of a hospital, and upon their assignment to a unit, they are given personal attention and observation, and are treated as individuals. They are also told the purpose of their being sent to the unit, and that they will later be returned to their own organization.

Facilities for bathing and haircuts are provided, and they are issued new or clean clothes and a complete set of toilet articles. Frequent inspections are held and neat personal appearance is required at all times.

Normally individuals are retained for a period of from three to five days, at the end of which time they are either returned to duty with their organization, or are evacuated.

(10) AWARDS AND CITATIONS: There have been two Distinguished Service Crosses and one Legion of Merit, fifty-six Silver Stars, and one hundred-seventy Bronze Stars, as well as five Soldier`s Medals awarded to members of the Medical Service of the Division in the past year.

There have been eleven battle-field promotions made to 2nd Lieutenant, MAC from Medical Detachments of Infantry units within the Division.

The medical personnel have been awarded Presidential Unit Citations as a Medical Section from the Third Battalion Medical Section of the 60th Infantry Regiment, and have received Presidential Unit Citations as detachments of:

1st Battalion 39th Infantry Regiment;

1. For action on 18 June 44.

2. For action during the period 6-9 August 1944.

2nd Battalion, 47th Infantry Regiment:

For action during the period 21-26 June 44.

3rd Battalion, 47th Infantry Regiment:

For action during the period 22-30 June 44.

2nd Battalion, 60th Infantry Regiment:

For action on 16 June 1944.

3rd Bn., Medical Det., 60 Infantry Regt:

For action on 6 September 44.

From the previous stated record of medical services for the year 1944, we believe that medical department activities have been adequate.

Lt. Col. John R. Woodruff, M.C., served as Division Surgeon for the entire year and Lt. Col. Abraham S. Kaufmann, M.C., as commander of the 9th Medical Bn. The work of these two men and of their units, the Medical Battalion and Medical detachments cannot be praised too highly.

Lt. Col. Woodruff left the Division to become Commanding Officer of the 102ndEvacuation Hospital. on 9 January 1945 after serving 2 years as Division Surgeon of the 9th Infantry Division.

[signed]

DONALD R. ROBERTS,
Major, M.C.,
Surgeon

ATTACHED CHARTS:

Route of March, 9th Infantry Division

Battle Casualties KIAs, WIAs, and Exhaustions

Communicable Diseases by Weekly Breakdown, 9th Infantry Division, Year 1944

Venereal Disease By Weekly Breakdown, 9th Infantry Division, 1944

SOURCE: Maj. Donald R. Roberts, MC, Division Surgeon, "Annual Report of Medical Activities of the Ninth Infantry Division, 1 January 1944 to 31 December 1944," 25 January 1945, in National Archives and Records Administration, Record Group 407, Records of the US Army Adjutant General, World War II Unit Records, 9th Infantry Division, Division Surgeon, 1943-44, ETO, Box 388.