Invasion of Southern France
Preparations for the Invasion
After the close of the Sicily Campaign in August 1943, Seventh Army was stripped of its combat units to provide troops for operations in Italy. Seventh Army retained some occupation duties, however, and continued to maintain a skeletonized headquarters in Palermo, pending high-level decisions as to its ultimate employment.
The merits of an amphibious operation in the Toulon-Marseille area of southern France had been discussed at Quebec in August 1943. Under the code name ANVIL, the proposal was approved by Marshal Joseph Stalin at Tehran before its formal adoption at the second Cairo conference in December 1943. By this date a tentative outline plan, envisioning a 2- or 3-division assault with a build-up to ten divisions, had been prepared.1
General Patton was already scheduled for a command in the forthcoming invasion of France and would leave Seventh Army in January. His successor was to be General Clark, who would, however, retain command of the Fifth Army for the time being, confining his new role to that of participation by a deputy in the planning activities. The Seventh Army planning staff, designated for purposes of security as Force 163, opened in Algiers on 12 January 1944 and eventually became a joint and combined staff.
For the next two months the Seventh Army planning staff, on which Brig. Gen. Benjamin F. Caffey, Jr., represented Clark, worked in a vacuum. No troops had been actually designated, no staging areas set aside; even the size of the force to be used was not known. The only available forces were those fighting in Italy, and no one could say when it would be possible to withdraw any of them. After the initial failure of the Anzio Campaign to develop as intended and the setback before Cassino, General Alexander was convinced the Germans would stand south of Rome and insisted that every man of his command would be needed for the spring offensive in Italy. With VI Corps bogged down in the mud of Anzio beachhead and the Liri Valley still secure against every Allied thrust, Clark was relieved on 15 February of any further responsibility of ANVIL.
On 4 March 1944 Maj. Gen. Alexander M. Patch of Guadalcanal fame had
1 Sources relied upon for the origin and military planning of ANVIL are: (1) Churchill, Closing the Ring; (2) Biennial Rpt, CofS, 1944-45; (3) Rpt of Opns, Seventh U.S. Army; (4) Truscott, Command Missions; (5)Robert Ross Smith, The Riviera to the Rhine, a forthcoming volume in the series UNITED STATES ARMY IN WORLD WAR II.
become commander of the Seventh Army. The army`s objective remained the same--to invade southern France in force simultaneously with, or immediately following, the Normandy landings, and exploit up the Rhône Valley, but the target date for both operations had been postponed to June. In mid-April the ANVIL D-day was again put off, this time to late July, because of the requirements of the May offensive in Italy and the needs of OVERLORD for landing craft. All first priorities went elsewhere, and the ANVIL planners were kept busy revising in terms of new unavailabilities. Rome had fallen and the Allied forces had secured the Normandy beaches before it was certain that ANVIL would even be launched.
Planning and Mounting the Invasion
On 15 June the commander of Allied Armies in Italy, General Alexander, was directed to release the U.S. VI Corps, consisting of the 3d, 36th, and 45th Divisions; two French divisions; and various auxiliary troops to Seventh Army. Alexander and General Sir Henry Maitland Wilson, the Supreme Allied Commander in the Mediterranean, still opposed the southern France operation, urging most strongly that all troops in Italy be retained there for a knockout blow against the disorganized and retreating enemy, and then turned east through the Ljubljana Gap toward Hungary. In this proposal they were backed by Prime Minister Churchill. On the other hand, it was probably General Eisenhower`s insistence that Marseille and other French Mediterranean ports were essential to supply his own forces, and that neither men nor matériel were available for two major fronts on the Continent, which tipped the scale in favor of ANVIL.2 On 2 July General Wilson was directed to launch ANVIL on 15 August. Two days later Seventh Army headquarters moved from Algiers to Naples, where headquarters of VI Corps and of the French forces, known as Army B, were also established.
Broadly, the plan called for a 3 division daylight assault by VI Corps, under command of General Truscott, over selected beaches between Cap Cavalaire and A gay. The night before the main attack the 1st Special Service Force was to seize the offshore islands of Port Cros and Levant, a French commando group was to go ashore at Cap Nègre on the left flank to block the coastal road, and a French naval assault group was to carry out a similar mission at Pointe des Trayas on the right flank. At the same time, an airborne task force was to be dropped in the vicinity of Le Muy, about ten miles behind the landing beaches, to cut off enemy reinforcements and neutralize gun positions. Two French corps, which made up Army B under General Jeande Lattre de Tassigny, were to begin landing over the secured beaches on D plus 1, and to swing west to invest Toulon and Marseille, while VI Corps advanced up the Rhône Valley toward Lyon and Vichy. The French forces were to be made up in part of Moroccan and Algerian troops to be withdrawn, like VI Corps, from Italy. Army B also included the 9th Colonial Division, which had captured the island of Elba late in June against stubborn German resistance.
2 Eisenhower, Crusade In Europe, pp. 281-84.
A Coastal Base Section, organized 7 July, was to follow the combat troops at the earliest practicable date. Its commander, Maj. Gen. A. R. Wilson, was named on 26 June, and base section personnel were attached to the planning group near the end of July.
The training of the assault divisions began in June, as soon as possible after their assignment. The 36th and 45th Divisions trained at Salerno, where the Invasion Training Center, now attached to Seventh Army, had been established in the spring. The 3d Division trained at Pozzuoli, on the northwest rim of the Gulf of Naples; and the airborne task force established a glider and parachute school near Rome. Final dress rehearsals were completed on the night of 7-8 August, after which loading of the transports began at various ports in Italy, Sicily, North Africa and Corsica.
DRAGOON, as ANVIL had been rechristened on 1 August, was under way.
Medical Plans and Organization
By the end of 1943 the Seventh Army medical section had been reduced to a total of 10 officers and 18 enlisted men.
At that time the surgeon, Colonel Daniel Franklin, 3 officers, and 5 enlisted men movedt o Algiers to assume the medical planning function for Force 163. At the same time the medical supply officer, the dental officer, and 6 enlisted men joined other Seventh Army supply units in Oran to work out ANVIL supply plans with SOS NATOUSA and the base sections. The remainder of the medical personnel continued at Palermo until May. The entire medical section was not reunited until Seventh Army headquarters moved to Naples early in July.3
The Seventh Army medical organization was similar to that of the Fifth Army, with staff sections for administration, operations, and personnel. Hospitalization, evacuation, and medical supply came under operations. There was a medical inspector, with a venereal disease control officer under him. On the professional side were a dental surgeon, veterinarian, and director of nurses, with consultants in surgery, neuropsychiatry, and chemical warfare.
On 18 June Colonel Rudolph, who had been surgeon of the declining Eastern Base Section, became Seventh Army surgeon. Key officers in the medical section as D-day for DRAGOON approached were: Colonel Robinson, executive officer; Lt. Col.(later Col.) Joseph Rich, operations; Lt. Col. (later Col.) Norman F. Peatfield, hospitalization; Lt. Col. (later Col.) Robert Goldson, evacuation; Colonel Alexander, personnel; Maj. (later Lt. Col.) Guy H. Gowen, medical inspector; Maj. (later Lt. Col.) Augustus J. Guenther, commander of the 7th Medical Depot Company, supply; and Maj. (later Lt. Col.) Charles Raulerson, administrative officer. In the professional positions were Col. Frank B. Berry, surgical consultant; Col. Alexander, who doubled as chemical warfare consultant; Lt. Col. (later Col.) Daniel S. Stevenson, veterinarian; Lt. Col. (later Col.) Webb B. Gurley, dental surgeon; Capt. (later Maj.) Alfred O. Ludwig, neuropsychiatric consultant; and Maj. Edith F. Frew, director of nurses. Colonel Berry had been chief of the surgical service, 9th Evacuation Hospital, and Major Frew had been that units chief nurse. Captain Ludwig had been commander of the Fifth Army Neuropsychiatric Center. Colonel Stevenson had been commanding officer of the 17th Veterinary Evacuation Hospital, while Colonel Gurley came to Seventh Army from the 21st General Hospital.
Like other aspects of the planning for ANVIL-DRAGOON, the medical plans were incomplete and subject to constant change until the assignment of units and final approval of the operation. The basic work, within the limitations imposed by insufficient data, was shared at the theater level by the NATOUSA and the communications zone staffs, and at the corps and division levels was directed by Colonel Bauchspies, the VI Corps surgeon. The point of stabilization coincided with the arrival of Colonel Rudolph, who directed the final revision of the medical plans in terms of actual mis-
3 Principal sources for this section are: (1) Annual Rpt, Surg, Seventh Army, 1944; (2) After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44, ans. 277 and278; (3) Rpt of Naval Comdr, Western Task Force, Invasion of Southern France, Navy: A16-3 (01568) 15 Nov 44. (4) Annual Rpt, Med Sec, MTOUSA,1944; (5) Clift, Field Opns; (6) Davidson, Medical Supply in MTOUSA; (7) Unit rpts of the individual med units mentioned in the text.
sion, combat forces involved, and target date.
Medical Plans for the Assault- The pattern followed in earlier amphibious operations in the Mediterranean was again the basic guide. The Navy was to be responsible for all medical care on shipboard and to the high-water mark on the landing beaches. The Army was responsible for medical care ashore. As in the Sicilian, Salerno, and Anzio landings, each combat division in the assault was to be accompanied by its own medical detachments and its organic medical battalion. In addition, each regimental combat team was to be supported in the landing phase by a collecting company and clearing platoon of a separate medical battalion. This was an improvement over the technique previously employed in the theater, whereby one of the collecting companies of each assault medical battalion had been forced to rely upon an improvised clearing platoon made up of station section personnel.4 The airborne task force was to be supported by a collecting company with clearing ele-
4 See pp. 149, 224, above
ments attached. Each assault division was to have the services of two field hospital platoons, with enlisted men drawn from the fixed hospitals substituted for the nurses who were not to arrive until D plus 4. The field hospital platoons were to function in immediate proximity to the division clearing stations.
Twenty-eight surgical and other specialist teams of the 2d Auxiliary Surgical Group were to be attached to the field hospitals and other assault units.5 Additional teams for the troop transports were made up of personnel of the 750-bed evacuation hospitals and the general hospitals scheduled to come into France at later dates. Dispensary teams of one officer and two enlisted men each, similarly drawn from personnel of hospitals already closed for future movement, were to serve aboard the cargo vessels in the assault convoy. When thes hips withdrew from the beach area, these teams were to report to the nearest evacuation hospital for reassignment until their own units arrived. The forward distribution section of a blood transfusion unit was to be attached to one of the field hospitals, but was to serve the entire corps.
During the landing phase the three separate medical battalions were to be attached to the beach groups in the three areas into which the invasion coast was divided. Their commanding officers were designated as beach group surgeons, each being responsible for the setting up and operation of medical installations in his area and for co-ordination with the medical sections of the Navy beach battalions. The beach control group surgeon was to take over all Army responsibility for medical care and evacuation on the beachhead when the area was secure.
The 3-plus French divisions scheduled to go ashore on D plus 1 were to be similarly accompanied by their own medical units, though the support available was less extensive than that assigned to the assault troops of VI Corps. The initial French medical complement included a medical battalion, a field hospital, and a blood transfusion unit.
Hospitalization-In addition to the beds available in the clearing stations and field hospital platoons, each of the three assault divisions was to be accompanied by a 400-bed evacuation hospital, to be established between D plus 1 and D plus 4, or as soon as the situation permitted. Two comparable evacuation hospitals, U.S. equipped but French staffed, were to accompany the landing elements of Army B.
By D plus 10,when the French forces were to have reached 7 divisions, the medical support for Army B was to be augmented by 2 field hospitals, 2 400-bed evacuation hospitals, and 2 750-bed evacuations. The 3 divisions of VI Corps
5 Annual and Special Rpts, 2d Aux Surg Gp, 1944. The D-day troop list in Report of Operations, Seventh Army, III, 908, and Annual Report, Medical Section, MTOUSA, 1944, are probably incorrect in placing the number at 30 teams. Annual Report, Surgeon, Seventh Army, 15 August-31 October 1944, Annex 277, both identify only the 26 teams that were attached to the field hospitals in the landings, leaving 2 surgical teams--or possibly 4--unaccounted for. One of these, together with 3 medical officers of the 43d General Hospital, accompanied the 1st Special Service Force in its H minus 8 attack on the islands of Levant and Port Cros. Another may have accompanied the airborne task force, although no conclusive evidence to that effect has been found. It is the recollection of Dr. Berry, then surgical consultant to Seventh Army, that 2 teams accompanied the 95th Evacuation Hospital, but these were probably among the 10 already counted as being assigned to the ALPHA Attack Force. (See recorded interv, Dr. Berry, 4 Nov 58. commenting on preliminary draft of this volume.)
were to be backed up by 3 750-bedevacuation hospitals, with a convalescent hospital scheduled for somewhat later arrival.
To supplement these mobile units, plans also called for the establishment of 14,250 fixed beds in southern France as rapidly as the military situation permitted. Three 2,000-bed general hospitals, three 1,500-bed generals, seven 500-bed station hospitals, and a 250-bed station hospital were assigned to the Coastal Base Section, organized in Naples 6 July by SOS NATOUSA, with Colonel Bishop as surgeon. Bishop had been executive officer to the groups working on typhus control in Naples, and more recently surgeon of the Mediterranean Base Section. The assigned hospitals were to be withdrawn from Africa, Italy, and Corsica.
Evacuation-Evacuation from the beaches in the early hours of the assault was to be by landing craft and water ambulance to the transports. During the entire assault phase of the operation, seaward evacuation was a Navy responsibility, the Army being responsible only for the transportation of casualties to the Navy evacuation stations.
Two hospital ships were to arrive in the landing area on D plus 1, after which one ship was to arrive at dawn each day until D plus 10. Hospital ships were then to be sent forward on call of the Seventh Army surgeon. Twelve such vessels were to be made available for this purpose, operating from Corsica. All casualties were to be evacuated to Naples until D plus 7. Thereafter U.S. and British casualties were to be evacuated to Naples and French casualties to Oran. Air evacuation was scheduled to begin on D plus 7. For evacuation from the combat zone to rear areas in France, motor ambulances were to be used until rail lines were repaired for the operation of hospital trains.
Medical Supply-The ANVIL-DRAGOON plans provided for two levels of medical supplies and equipment. The assault forces were to carry with them supplies adequate for the landings and the early expansion from the beachhead. A further build-up was to be available to meet the needs of Seventh Army and the attached French Army B until a normal supply system could be established by the base section personnel scheduled to follow the combat troops after the ports of Toulon and Marseille had been secured. It was not possible to determine either level until the size of the operation was known, yet if the supplies were to be delivered on time, it was essential that orders be placed months in advance. It was therefore necessary to requisition initially through SOS NATOUSA solely on the basis of the 3-division assault and 7-division follow-up called for in the outline plan.
Calculations were based on supply from within the theater for 60 days, after which there would be direct deliveries to southern France from the States. Each sub taskforce in the landings was to carry medical supplies for 7 days maintenance, which were to be collected at dumps and issued by the beach groups. The assault troops were to carry individual supplies of such items as at a brine and motion-sickness pills, while the medical personnel going ashore were to carry litters, blankets, and splints, as well as necessary drugs in sealed, waterproof containers. The bulk of the supplies for the
landing forces, however, was to bein the form of the newly devised beach maintenance units, each containing a balanced stock of medical items sufficient to maintain 5,000 troops for 30 days. These were to be supplemented by such additional critical items as blood plasma, morphine syrettes, plaster of paris, sulfaguanadine, paregoric, oxygen, and dressings. Medical supplies were to be packed in clearly marked boxes, not exceeding 70 pounds in weight. Supplies for the French forces were to be identically packed, but marked with the tricolor.
Advance detachments of the Army medical depot company were to accompany the assault, functioning as elements of the beach groups for collection and distribution of medical supplies. All medical units in the assault, in addition to making up any equipment shortages, were authorized to draw supplies 20 percent in excess of their normal allowances.
Supplies for subsequent phases of the campaign were to be delivered as operational medical maintenance units, a revised and modified version of the old medical maintenance unit. Like the MMU relied upon in earlier campaigns, it was designed to provide balanced medical supplies to meet the needs of 10,000 men for 30 days.
Assignment and Training- The first assignment of medical personnel to the southern France operation, other than in a purely planning capacity, was the attachment of three officers and three enlisted men from the Seventh Army medical section to the beach control group formed at Mostaganem, Algeria, early in May. The group included representatives of the various supply services concerned with the coming campaign. The medical complement was to direct the unloading of hospitals over the beaches, evacuate casualties, and control the flow of medical supplies from ship to dump until Seventh Army and the Coastal Base Section were able to take over their own respective supply functions. The 7th Medical Depot Company was later assigned to Seventh Army, and the 1st Advance Section was attached to the beach control group.
Assignment of medical personnel to the task forces necessarily had to be delayed until the combat elements themselves were assigned and the invasion plan completed. As finally approved, plans called for four major task forces, one to be airborne and three to strike the beaches between Cap Cavalaire and Agay from the sea. The three attack forces known as ALPHA, DELTA, and CAMEL, were built respectively around the 3d, 45th, and 36th Infantry Divisions. The medical units assigned to each attack force trained with the combat troops, the ALPHA Force at Pozzuoli the DELTA and CAMEL Forces at Salerno, and the 1st Airborne Task Force near Rome.
The medical support assigned to the task forces was as follows:
ALPHA Attack Force: 3d Division medical detachments; 3d Medical Battalion (organic);52d Medical Battalion, including the 376th, 377th, and 378th Medical Collecting Companies, and the 682d Medical Clearing Company; Headquarters and 1stPlatoon of the 616th Medical Clearing Company, 181st Medical Battalion; the 1st and 3d Hospitalization Units, 10th Field Hospital, with
ten teams of the 2d Auxiliary Surgical Group, and the forward distribution section of the 6703d Blood Transfusion Unit attached; 95th Evacuation Hospital.
DELTA Attack Force: 45th Division medical detachments; 120th Medical Battalion (organic); 58th Medical Battalion, including the 388th, 389th, and 390th Medical Collecting Companies and the 514th Medical Clearing Company; the 2d Platoon, 616th Medical Clearing Company; the 2d Hospitalization Unit, 10th Field Hospital, and the 2d Hospitalization Unit, 11th Field Hospital, with nine teams of the 2d Auxiliary Surgical Group attached; the 93d Evacuation Hospital.
CAMEL Attack Force: 36th Division medical detachments; 111th Medical Battalion (organic); 56th Medical Battalion, including the 885th, 886th, and 887th Medical Collecting Companies, and the 891st Medical Clearing Company; the 1st Platoon of the 638th Medical Clearing Company, 164th Medical Battalion; the 1st and 3d Hospitalization Units, 11th Field Hospital, with seven teams of the 2d Auxiliary Surgical Group attached; the 11th Evacuation Hospital.
The 1st Airborne Task Force was to receive support from the medical detachments of its own component units, which included a British parachute brigade; the 517th Parachute RCT and 509th Parachute Infantry Battalion from the Italian front; the 1st Battalion, 551st Parachute Infantry; the 550th Infantry Airborne Battalion; and miscellaneous artillery, infantry, engineer, signal, antitank, chemical, ordnance, and supply units. To serve the whole task force, the 676th Medical Collecting Company of the 164th Medical Battalion, with clearing elements attached, went through special glider training. Six officers, a technician, and a team of the 2d Auxiliary Surgical Group constituted the medical support for the 1st Special Service Force.
Training of medical troops followed techniques similar to those used in earlier amphibious operations, including waterproofing of vehicles and equipment, shore-to-ship evacuation, and ambulance and litter carries under simulated combat conditions.
Medical Support of Seventh Army in the Field
The invasion of southern France, fifth and last amphibious operation in the Mediterranean, was by all odds the most successful of the five. The landing beaches were secured and all initial objectives taken within thirty-six hours. In less than a month a German army had been virtually destroyed, all southern and eastern France had been liberated, and Seventh Army had linked its front with that of the Normandy invasion force and was more than 400 miles north of its landings. In this spectacular dash, the achievements of the medical troops were no less decisive than the triumphs of the combat arms.
The Military Campaign
In the early evening of 14 August 1944 a mighty convoy of 855 ships, out of a dozen Mediterranean ports, rendezvoused off the west coast of Corsica and sailed northwest toward the famed French Riviera. For the past 10 days the
Mediterranean Allied Air Force had pounded targets from Genoa to Sète, slowly closing in to isolate the landing beaches. A feigned attack including a dummy parachute drop on beaches 60 miles west of the real objective was then being mounted, but there was no fake about other preparatory missions. In the early hours of 15 August, troops of the 1st Special Service Force scaled the cliffs on the seaward side of Port Cros and Levant; French commandos landed at Cap Negre west of the assault area; and other French troops went ashore at Pointe de Tray as to the east. Allied paratroops began dropping through fog around Le Muy 10 miles behind the designated beaches, and were followed by glider troops as soon as light permitted. Swarms of landing craft, covered by carrier-based planes and naval guns, headed for the indented shore between St. Tropez and St. Raphael, the first troops landing about 0800.6
The Germans, though misled for about an hour by the covering operations to the west, had expected the Allied forces to land where they did and had alerted their units. However, their forces were dispersed and opposition was relatively light on all beaches. The French on the right flank had failed in their mission, but the commandos on the left and the 1st Airborne Task Force, 10,000 strong, in the rear of the landing area, had cut off the possibility of enemy reinforcement. The assault troops, aided by the Maquis--or French Forces of the Interior as the underground was officially known--pushed rapidly inland. In the late afternoon of 15 August patrols of the 45th Division made first contact with the airborne force, and by the close of D plus 1 the "blue line"--drawn far enough inland to protect the beaches from enemy artillery and to give control of main routes north and west--had been reached.
The next few days were decisive. The 36th Division on the right pushed east far enough to protect the beachhead, then turned north after being relieved on 20 August by infantry elements of the airborne task force. The 45th Division in the center advanced northwest toward the Durance River, and the 3d Division on the left struck west to capture the key road center of Aix-en-Provence just north of Marseille on 21 August. On the 19th the German commander of Army Group G began to withdraw all troops, except the two divisions garrisoning Toulon and Marseille, up the Rhône Valley.
A fast-moving armored task force led by the VI Corps deputy commander, Brig. Gen. Frederick B. Butler, was already ahead of the German forces. Task Force Butler had left its assembly area on 18 August, racing north toward Grenoble, where mountain passes had been blocked against any attempt on the part
6 Principal sources for this section are: (1) The Seventh United States Army: Report of Operations, France and Germany, 1944-1945 (Heidelberg, Germany: Aloys Graf, 1946), vol. I; (2) Rpt of Naval Comdr, Western Task Force, Invasion of Southern France; (3) Rpt of Opns, VI Corps, Aug, Sep,44; (4) Truscott, Command Missions; (5) Général[Jean] de Lattre de Tassigny, Histoire de Ia Premiere Armée Francaise(Paris: Plon, 1949); (6) Samuel Eliot Morison, "History of United States Naval Operations in World War II," The Invasion of France and Germany l944-1945 (Boston: Little, Brown and Company, 1957); (7) Craven and Cate, eds., Europe: ARGUMENT to V-E Day, pp. 408-38; (8) Taggert, ed., History of the Third Infantry Division in World War II; (9) Huff, ed., The Fighting 36th; (10) The Fighting Forty-Fifth; (11) WD Special Staff, Hist Div, Invasion of Southern France, OCMH files; (12) Smith, Riviera to the Rhine
of the enemy to reinforce from that direction. The task force had then turned west to close the escape route in the Montdimar area, where the Rhône Valley narrows and the corridor is dominated by high ground to the northeast. Butlers forces were not adequate, however, and the Germans won the opening round on 23 August, when elements of the 141st Regiment of the 36th Division reached the area but were unable to seize the city of Montélimar. The Germans rushed forward their best unit, the 11th Panzer Division, to force open the Montélimar Gate for their retreating columns, while the remainder of the 36th Division from the east, the 45th from the southeast, and the 3d from the south hurried to the aid of hard-pressed Task Force Butler. The battle raged for eight days, with the larger part of the German forces escaping before the trap was completely closed. The enemy nevertheless suffered heavy losses and left thousands of vehicles and guns, including five heavy railroad guns, as wreckage lining the route north.
Meanwhile, one corps of General de Lattre`s French Army B, consisting of the 3d Algerian, the 9th Colonial, and the 1st Armored Divisions, a provisional infantry division, and two groups of Moroccan tabors (each group equivalent to a regiment) and special troops, had relieved VI Corps in the coastal area and enveloped Toulon and Marseille from the land side, in conjunction with naval assaults from the sea. Both cities fell on 28 August, and the French forces, augmented by newly arrived divisions, turned northward up the Rhine to join VI Corps.
On the eastern flank the airborne task force, with the 1st Special Service Force attached, had taken the famous resort towns of Cannes and Nice and had cleared the mountainous area north and east of those cities.
By 31 August, D plus 16, Seventh Army had taken 57,000 prisoners, with a loss to itself of 2,733 killed, captured, and missing in action. U.S. patrols were at the Italian border, French patrols were at the Spanish border, and the Germans were fighting only with stubborn rear-guard actions as they sought desperately to slip through the narrowing gap between Seventh Army, no win the vicinity of Lyon, and General Patton`s Third Army, which was pushing east from Paris.
The advance was now a pursuit. Lyon was occupied on 3 September. The 3d Division took Besançon after hard fighting on 8 September, and two days later the French 1st Armored Division reached Dijon. On 11 September patrols of Seventh and Third Armies met at Saulieu a few miles west of Dijon, and the Allied front was continuous from the Swiss frontier to the English Channel.
On 15 September Army B became the 1st French Army, forming with Seventh Army the 6th Army Group under General Devers. At this time the DRAGOON forces came under operational control of Supreme Headquarters, Allied Expeditionary Force, and the troops were regrouped in accordance with SHAEF plans. 1st French Army shifted to the right flank, hinging on the Swiss border, while VI Corps turned north to cross the Moselle in the vicinity of Épinal, and advanced toward Strasbourg beyond the Vosges Mountains.
The exploits of Seventh Army thereafter belong to the history of the European Theater of Operations.
Field Medical Service
The Assault Phase-Although the prearranged landing schedules were not always followed to the letter, medical service during the beach phase of the invasion worked smoothly. Delays were caused primarily by a more rapid advance than had been anticipated, with consequent unexpected demands for trucks and landing craft by the combat troops; and in some instances by dispersal of unit equipment among several vessels. While medical personnel supporting each task force had their own problems, certain principles were common to the whole operation.
Litter teams from the collecting companies of the organic medical battalions were attached for the landings to the assault units, not less than three nor more than four 5-man teams to each infantry battalion, and these, with the personnel of the battalion aid stations, were the first medical troops ashore. Ideally, they were to be followed by the beach medical battalions, each organized for the landings into 3 collecting-clearing companies, with the collecting element of each company further divided into 3 sections of one officer and 22 enlisted men each. The remaining elements of the collecting companies of the organic medical battalions were to come next, accompanied or immediately followed by the field hospital units, which were stripped down to 50-bed capacity. The personnel of the evacuation hospitals were then to land and go into bivouac to await their equipment. The clearing companies of the organic medical battalions were to be held back until it was possible to establish them at least 5 miles inland, where the field hospital units, already ashore, would join them. Medical supply personnel were to land on D plus 1.7
The 3d Division assault on the left flank went pretty much according to plan. Landings were made in two separate areas: on the Bay of Cavalaire, east of the town of that name, by the 7th and 30th Regimental Combat Teams; and on the Bay of Pampelonne, about six miles northeast of the Cavalaire landings and three miles southeast of St. Tropez, by the 15th RCT. The battalion medical sections, reinforced by collecting company litter squads, landed behind their infantry battalions within the first two hours. On the Cavalaire beaches, Collecting Company C of the organic medical battalion, supporting the 30th Infantry, came ashore ahead of schedule at H plus 4 and had its station established by 1400. Company A, supporting the 7th Infantry, did not land until H plus 12, its station going into operation at 2200. Neither company had any ambulances until D plus 1.
At H plus 6 a collecting company and the 1st Platoon of the Clearing Company, 52d Medical Battalion, went ashore at Pampelonne beach and had the beach clearing station in operation by 1600. The landing of the Cavalaire beach group medical complement--the
7 Principal sources for this section are: (1) After Action Rpt, Surg, Seventh Army,15 Aug-31 Oct 44, an. 278; (2) Rpt of Naval Comdr, Western Task Force, Invasion of Southern France; (3) ETMD, MTO, for Oct 44; (4) Ltr, Col Reeder to Surg, NATOUSA, 18 Aug 44, sub: Med Observers Rpt, Seventh Army Opn; (5) Annual and/or Monthly Rpts of the following med units: Surg, 3d Inf Div; Surg, 36th Inf Div; Surg, 45th Inf Div; 3d Med Bn; 52dMed Bn, 56th Med Bn; 58th Med Bn; 111th Med Bn; 120th Med Bn; 164th Med Rn; 181st Med Bn; Surg, VI Corps; Surg, Seventh Army; 10th Field Hosp;11th Field Hosp; 11th Evac Hosp; 93d Evac Hosp; 95th Evac Hosp; 2d AuxS urg Gp; 7th Med Depot Co.
remaining two collecting companies and the 2d platoon of the clearing company, 52d Medical Battalion, andt he 1st Platoon of the 616th Clearing Company, the 181st Medical Battalion--was two hours later, the beach clearing station being set up at 1800.
By midafternoon the ALPHA beaches were clear and the combat spearheads already several miles inland, making it possible to land the remaining medical units. At H plus 8-1600, or four in the afternoon--the 1st and 3d Platoons of the10th Field Hospital came ashore, one unit at each beach. The Pampelonne unit was receiving patients by 2000, but the Cavalaire unit did not recover its equipment until D plus 1. At the same time the 3d Medical Battalion clearing company and personnel of the 95th Evacuation Hospital landed at Cavalaire. The 95th went into bivouac to await its equipment, while the 3d Division clearing company moved inland and set up station two miles north of La Croix, opening at 1915. The site of the clearing station was about equidistant from the beaches and some five miles inland. The collecting company in support of the 15th Infantry did not debark at Pampelonne beach until 0400 on D plus 1, and remained without ambulances until noon. (Map30)
The division clearing station moved on D plus 2 to Cogolin, where it was joined by one unit of the 10th Field Hospital and the 95th Evacuation, which was still not in operation. All three installations moved to Gonfaron, some twenty miles inland, on D plus 3. The
95th opened the following morning,19 August, at 0800. The other 3d Division platoon of the 10th Field Hospital went into bivouac in the same locality on 20 August.
The 45th Division, constituting with its reinforcements the DELTA Force, landed on a strip of beach no more than three miles wide in the dead center of the VI Corps landing area just northeast of the town of Ste. Maxime. Here expediency and availability of landing craft rather than the prearranged schedule determined the order of landing for medical units.
As on the ALPHA beaches, the medical detachments and the litter teams of the organic collecting companies went ashore with the infantry battalions making the assault, closely followed by units of the beach medical battalion and the remainder of the 120th Medical Battalion organic to the division. One collecting-clearing unit of the 58th Medical Battalion was ashore at H plus 2 1/2 and had its station in operation one-half mile northwest of Ste. Maxime by 1230. A second collecting-clearing unit landed on the easternmost of the 45th Division beaches at H plus 4, opening station three miles northeast of Ste. Maxime. The third collecting-clearing unit of the beach battalion was delayed until1930, finally landing on the ALPHA beaches south of St. Tropez and opening station a half mile inland.
All personnel of the 20th Medical Battalion were ashore by H plus 6. Collecting stations for the two assault regiments were in operation by 1100. Jeeps borrowed from the infantry were used until the ambulances arrived. The clearing company went into bivouac, the 1st platoon setting up station about six miles inland near Plan de la Tour late on 16 August.
Units of the 10thand 11th Field Hospitals attached to the DELTA Force both landed about noon of D-day, but neither went into operation. The 2d Platoon of the 10thField received patients at Plan de Ia Tour on 17 August but the 2d Platoon of the 11th Field did not operate at all during the beach phase. The 93dEvacuation Hospital, which landed near Ste. Maxime at H plus 4, opened at Plan de la Tour on 17 August.
Here, as on the ALPHA beaches, expansion inland was rapid. The 2d Platoon of the division clearing company opened 5 miles south of Vidauban and about 15 miles from the beach shortly before noon on 18 August, while the 1st Platoon moved more than 20 miles northwest from Plan de la Tour to Silans-la-Cascade. Beach clearing stations of the 58th Medical Battalion moved into Ste. Maxime and St. Tropez on D-day and D plus 1, respectively.
The western most of the beaches assigned to the 36th Division, or CAMEL Force--a beach on the Gulf of Fréjus within a mile of the town of that name and equally close to St. Raphael--was not actually used because underwater obstacles had not been cleared. Instead, all landings were made on three beaches east of St. Raphael and about a mile apart. Litter sections of the organic collecting companies landed with the battalion aid stations of the assault troops. All personnel of the 111th Medical Battalion were ashore by H plus8, although the equipment of the clearing company was not unloaded until the evening of D plus 1. By that time the fighting was so far inland that the division clearing station was first established near Le Muy, fif-
teen miles from the beach, in the early afternoon of 17 August. The station moved ten miles farther inland the following day, to a site near Draguignan.
The collecting-clearing units of the 56th Medical Battalion, meanwhile, had experienced similar delays in landing their equipment. The first beach clearing station in the CAMEL area was set up four miles east of St. Raphael at H plus 14,or 2200. Before this time all casualties were evacuated to offshore craft by the Navy beach group. The other two beach clearing stations were setup in St. Raphael on D plus 2 and D plus 3, respectively.
The two platoons of the 11th Field Hospital attached to the CAMEL Force and the 11th Evacuation Hospital landed together at 1900, or H plus 11, going into bivouac near the landing area. The evacuation hospital and one unit of the field hospital followed the division clearing station to Le Muy on 17 August, going into operation the following morning. The other field hospital platoon joined the clearing station at Draguignan on 18 August. On the CAMEL beaches, one surgical team served with each clearing platoon of the beach medical battalion.
The 1st Airborne Task Force was supported initially by parachute medical troops making up the parachute infantry detachments. Personnel of the 676th Medical Company began landing in the vicinity of Le Muy by glider about 0800 on D-day, the last wave touching down at 1851. Medical supplies and equipment, preloaded in 12 jeeps with ¼-ton trailers, were landed safely. A collecting station was established in a barn at Le Metan soon after the first wave landed, personnel and equipment being added as they arrived. The station moved to larger quarters on 16 August. In all, 227 casualties were treated before evacuation to the CAMEL beaches by Army transportation was possible on 17 August.
On the supply side, the advance section of the 7th Medical Depot Company landed in the vicinity of Ste. Maxime on 16 August, and a detachment consisting of one officer and twenty enlisted men took over operation of the DELTA beach supply dump from the 58th Medical Battalion on that date. The following day one officer and eighteen enlisted men of the depot company were attached to the 52d Medical Battalion for temporary duty to operate the 3d Division medical supply dump, and on 18 August a similar detachment relieved the56th Medical Battalion of supply functions in the 36th Division area.
The VI Corps surgeon, Colonel
Bauchspies, set up headquarters near Ste. Maxime at 1800 on D-day, but for the next 2 or 3 days could do little except keep in touch with medical units functioning under divisional control. The breakout from the beachhead was so rapid, however, that it was possible to resume a normal organizational pattern within 3 or 4 days. The 58th Medical Battalion reverted to Seventh Army on 17 August and was attached to the beach control group. The field hospitals passed from division to corps control on 18 August, while the evacuation hospitals reverted to army control on the same date. On 19 August the 56th Medical Battalion was attached to VI Corps.8
Nurses of the field and evacuation hospitals and of the surgical group landed and joined their units on 19 August.
Delays in landing equipment of clearing companies and hospitals might have been serious had casualties been heavier than they were. Air and naval cover attacks in widely separated areas, however, kept the enemy from concentrating his forces, and opposition on all beaches was lighter than had been anticipated. Hospital admissions, including admissions to clearing stations, for the beach phase of the operation were approximately 3,000. (Table 23) Mean troop strength for the week ending 18 August was 113, 854.
8 Sources disagree as to exact dates. The text follows the contemporary account of the theater medical observer, Colonel Reeder. See Ltr, Reeder to Surg, NATOUSA, 18 Aug 44, sub: Medical Observer`s Rpt, Seventh Army Opn. Slightly later dates given by some of the medical units concerned probably indicate only that there was some lag in completing the change-over.
The Montélimar Gate- With the beaches secure and the ports of Toulon and Marseille under seige by Army B, VI Corps was free to exploit up the Rhône Valley. The road net was excellent and with the formidable aid of the French resistance forces there was fair prospect of trapping a large part of the German Nineteenth Army if the corridor along the east bank of the Rhône could be closed off somewhere below the Drôme River--theso-called Montélimar Gate--before the enemy forces could be withdrawn.9
The rapid pace put a heavy strain on medical installations. The evacuation hospitals could not keep pace, and main reliance had necessarily to be placed on the organic medical battalions and on the field hospital units, supplemented when necessary by clearing platoons of the corps medical battalions. Collecting companies of the same battalion were sometimes as much as 150 miles apart. Clearing companies often operated two stations, while ambulances and borrowed trucks were in continuous movement over excessively long evacuation lines. Good roads made aid stations easily accessible to ambulances, permitting the diversion of many litter bearers for assignment as relief drivers.
A reinforced collecting company of the 111th Medical Battalion accompanied Task Force Butler in its dash toward Grenoble and its subsequent swing west down the valley of the Drôme. The collecting station of this unit was already in Sisteron, sixty-five miles north of the battalion headquarters at Draguignan before the end of the day, 18 August. Two days later it was at Lac on the Drôme, fifty miles northwest of Sisteron; and on 21 August it was at Marsanne, overlooking the Rhône from the heights northeast of Montélimar.
The 36th Division followed on the heels of Task Force Butler, swinging farther north to protect the flank. The 143d RCT entered Grenoble on 22 August, where a collecting station was set up by the 885th Medical Collecting Company, borrowed from the 56th Medical Battalion to replace the company attached to the taskforce. The next day the collecting station of the 143d was sixty miles southwest of Grenoble at Romans, close to the junction of the Isère and the Rhône above Valence, thence moving south with its combat team to the area occupied by the Butler Task Force.
The 141st and 142d combat teams of the 36th Division were also on the high ground above Montélimar by 23-24 August, their supporting medical units keeping pace by leapfrog tactics and almost continuous movement. The 36th Division clearing company leapfrogged its platoons from Draguignan to Sisteron to Aspres to Crest in 4 days, single moves covering up to 120 miles. Until the last 2 or 3 days of August, when the combat forces began pursuit of enemy remnants toward Lyon, 36th Division medical units remained clustered a few miles north and east of Montèlimar evacuating to the clearing station at Crest, a maximum distance of 10 miles.
The 1st Platoon of the 11th Field Hospital, which opened at Crest on 22 August, acted as an evacuation hospital for three days, since there was no evacuation nearer than the beach area, more than
9 Principalsources for this section are: (1) After Action Rpt, Surg. Seventh Army,15 Aug-31 Oct 44, an. 278; (2) Annual Rpt, Surg, Seventh Army, 1944; (3) Annual Rpt, Surg, VI Corps, 1944; (4) Unit rpts of med units mentioned in the text.
200 miles distant by highway. On 25 August the 3d Platoon joined the 1st at Crest, and the 11th Evacuation opened in the vicinity of Aspres, 65 miles to the rear. Thereafter evacuation was to Aspres, which became the medical center of VI Corps with the arrival of the corps surgeon on 26 August. During the Crest period, from 22 through 31 August, the clearing station of the 111th Medical Battalion admitted 2,174 patients, of whom 840 were battle casualties and 411 were prisoners of war. The heaviest day was 27 August, when 202 of the 322 admissions were battle casualties. The largest number of prisoner patients was received on 29 and 30 August, the totals being 120 and 191, respectively.
In the Montélimar area, both the collecting stations and the clearing station at Crest were intermittently under enemy fire.
Movement of 45th Division medical units, following a pattern similar to those of the 36th, was characterized by long and frequent jumps. The 179th Regimental Combat Team, which had been in reserve during the landings, spearheaded the drive north behind the 36th Division, occupying Grenoble on 23 August. A collecting company of the 120th Medical Battalion took over the station
established the day before in support of the 143d RCT, remaining at the site for six days. The 180th RCT turned east from the Sisteron-Aspres-Gap triangle to occupy Briançon, only 5 miles from the Italian frontier. The collecting company in support moved 140 miles from the beach area to Embrun on 23 August, evacuating casualties more than 50 miles over mountain roads to the division clearing station near Serres on the Sisteron-Aspres road. The 3d Platoon of the 10th Field Hospital joined the clearing station there on 23 August, the 2d Platoon arriving the following day. The clearing station of the 56th Medical Battalion also set up in the Serres area, where it served as a holding hospital for minor medical cases. During the last week of August the 10th Field Hospital units at Serres admitted 201 medical cases and 64 battle casualties.
A platoon of the120th Medical Battalion clearing company moved forward to Pont-de-Claix just south of Grenoble on 27 August.
The 157th RCT of the 45th Division met strong opposition at Apt, a few miles north of its Durance River crossing, on 22 August, but reached the Serres area by the 24th. The regiment proceeded north, crossing the Drôme east of Crest and protecting the north bank of the river. Evacuation from the collecting station of the 157th for the next two days was to the 36th Division clearing station at Crest.
The 3d Division, meanwhile, had advanced northwest from Aix-en-Provence to Avignon at the junction of the Durance and Rhône Rivers, taking the city on 25 August. The division then turned north, pursuing the retreating enemy up Highway7. Montélimar was finally captured by the 3d Division on 28 August the same day on which both Toulon and Marseille fell to the French forces of General de Lattre. Although badly battered, the bulk of the German troops had already slipped through the Montélimar Gate. Clearing stations of the 3d Division, with their accompanying field hospital units, were successively at Brignoles, Aix, the vicinity of Carpentras northeast of Avignon, and Nyons southeast of Montélimar.
The last three days of August saw VI Corps moving north from the Drôme on a wide front in another attempt to encircle the enemy before he could reach the Belfort Gap and the Rhine. The 45th Division swung northwest from Grenoble, and the 36th advanced north toward Lyon, while the 3d delayed only long enough to mop up in the Montélimar battle area. French Army B began a simultaneous march up the west bank of the Rhône to make contact with VI Corps in the vicinity of Lyon. Task Force Butler was dissolved, its components reverting to their own organizations.
Expansion to the Moselle- The rapid pursuit of the enemy north from the Montélimar battle area put field medical units to a severe test. Lyon fell to the French 2d Corps on 3 September, but most of VI Corps was already well beyond that point. Four days later the 3d Division, with the 45th on its right and the 36th on its left, stormed the ancient fortress city of Besançon more than 200 miles from the Drôme River line of 28 August.10
10 Sources for this section are the same as those mentioned in n. 9 above.
During this period, clearing stations made almost daily moves, platoons leapfrogging one another, while evacuation hospitals were hastily brought up to the combat area to shorten the ambulance runs. In spite of the frequent and lengthy changes of station, medical battalions gave close support throughout the pursuit. For example, a clearing platoon of the 111th Medical Battalion, moving sixty miles from Bourg to Poligny on 6 September, was held up for four hours to allow armored and infantry elements to pass. Collecting stations were in almost continuous movement.
After the capture of Besançon, German resistance stiffened, and rain helped to further retard the advance. VI Corps units were nevertheless within twenty miles of Belfort when Seventh Army turned north again just after the middle of the month in response to SHAEF orders. Medical installations were still on the heels of the advancing lines when the Moselle crossing began on21 September.
In the race to the Moselle each of the three divisions of VI Corps was supported
by its own organic medical battalion. A collecting company and clearing platoon of the 58th Medical Battalion supported the 13th Field Artillery Brigade after 17 September. Units of the 10th and 11th Field Hospitals continued to accompany forward clearing stations of the divisions, while evacuation rearward was the responsibility of the 56th Medical Battalion. Until the rainy season began in mid-September, turning dirt roads into quagmires, litter bearers were used to only a minimum extent. The well-settled nature of the country also made it possible to site clearing stations much of the time in buildings.
The corps surgeons office remained close to the front throughout the period, moving from Aspresto Salins, twenty miles south of Besançon on 6 September. Headquarters were in Vesoul by the 16th and on 22 September moved to Plombières.
Casualties during September were more from disease than from battle wounds, with respiratory ailments and exhaustion making substantial inroads. Trench foot cases began to appear before the end of the month. Admissions by the three division clearing companies totaled 11,805, of which 4,101 were battle wounds. Of the aggregate admissions, 1,136, or approximately 10 percent, were prisoners of war.
Hospitalization in the Army Area
Hospitalization on the Beaches
Until the base organization, with its fixed hospitals, could establish itself in southern France, it was necessary for Seventh Army to leave some hospital facilities in the beach area to care for service troops and for replacements and reinforcements staging in the vicinity, as well as to provide transient beds for those being evacuated to Italy. This function fell in the first instance to the58th Medical Battalion, which reverted to Army control on D plus 2, and was reattached to the beach control group.11
When the last of the assault clearing stations closed on 21 August, a provisional hospital was opened by the clearing company of the 58th Medical Battalion in the Hotel du Golf at Beauvallon, a resort village between St. Tropez and Ste. Maxime. One collecting company remained at Ste. Maxime, operating a smaller unit that served as an annex to the main hospital. Both units were relieved on 4 September by the 164th Medical Battalion, which continued to operate the two facilities until fixed hospitals came into the area toward the end of the month. During the period 24 August-1 September, twelve French medical officers and a Senegalese clearing platoon were attached to the Beauvallon hospital, the majority of admissions at that time being French troops and German prisoners.
After being relieved by the 164th Medical Battalion, the 58th established another provisional hospital in the Hotel Hermitage in Nice, primarily for the support of the1st Airborne Task Force and the 1st Special Service Force then fighting along the Italian border. This hospital was still in operation when all
11 Sources for this section are: (1) Annual Rpt, Surg, Seventh Army, 1944; (2)After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44, an. 278; (3) Annual Rpt, Surg, VI Corps, 1944; (4) Unit rpts of the individualmed units mentioned in the text.
military units in southern France were formally transferred from the Mediterranean to the European Theater of Operations.
Between 11 and 30 September the 675th Medical Collecting Company of the 164th Medical Battalion operated a provisional station hospital in Marseille--the only American hospital facility in that city. The hospital was caring for 200patients when it was relieved by the 80th Station Hospital on 30 September.
The provisional hospitals in the landing areas were augmented late in August by 750-bed evacuation hospitals, which were brought in according to schedule. The 9th Evacuation, which landed on 25 August, went immediately into the combat zone, but the 51st and 59th Evacuations, which arrived at the same time, and the 27th, which reached southern France on 30 August, were retained initially in the coastal area. Original plans had called for three 750-bed evacuation hospitals for the support of VI Corps and two to back up the forward units of Army B. After the capture of Marseille, however, French medical commanders found it possible to make greater use of local hospitals than had been anticipated, and all four of the larger evacuation hospitals were used primarily for U.S. troops.
The 51st Evacuation opened at Draguignan on 27 August. Its personnel served in a captured German hospital at the site while their own tents were being erected. The hospital remained at Draguignan until 20 September. The bulk of its admissions were from the 1st Airborne Task Force, received both directly and through the provisional hospital at Nice. The staff of the 51st was augmented during this period by 18 medical officers, a nurse, and 19 technicians attached from other organizations. Approximately 2,000 patients were cared for.
The 59th Evacuation Hospital opened on 28 August at Carpentras near the site about to be vacated by the 3d Division clearing station. The hospital remained in the area until 7 September, taking a total of 611 patients and performing 222 surgical procedures in the 10 days of operation.
The 27th Evacuation operated at Bouc-bel-Aire, a few miles south of Aix-en-Provence from 1September to 20 September. At this site it was the closest U.S. hospital to Marseille, where it operated a prophylactic station and gave dispensary service and station hospital care to all U.S. troops in the area. In addition to U.S. Army personnel, the 1,169 patients treated during the twenty days of operation at Bouc-bel-Aire included French troops and civilians, and American and British sailors, both naval and merchant marine.
Hospitalization in the Combat Zone
The 10th and 11th Field Hospitals, operating in 50-bed units rather than the 100-bed units used in Italy, served throughout the campaign as forward surgical hospitals, remaining close to, and moving with, the division clearing stations. They were backed up as closely as transportation and available sites permitted by the 400-bed evacuation hospitals and later by the larger evacuation units. During the period of rapid movement, however, the field units were often far ahead of any evacuation hospital support. On these occasions, clearing pla-
toons of the 56th Medical Battalions were used to increase bed capacity.12
The speed of the campaign up to late September necessitated frequent and long moves, with advance reconnaissance to the front lines themselves in search of hospital sites. The 400-bed evacuations were generally able to move by echelons with their own organic transportation, but the 750-bed evacuations had to rely on Seventh Army for trucks, which were not always available when needed. (See Maps 31, 32, 33.)
Long evacuation lines to the rear meant that hospitals were often overcrowded, while periods of intense combat activity placed a severe strain upon surgical staffs and postoperative facilities. It was frequently necessary to leave holding units behind to care for nontransportable patients when hospitals moved forward. All of the evacuation hospitals used civilian personnel in various capacities, the most frequent being as litter bearers.
The first evacuation hospital to move away from the landing beaches was the 93d, which advanced forty-five miles northwest from Plan de la Tour to Barjols on 22 August. For a few days, while elements of the 45th Division were forcing a crossing of the Durance River just north of Barjols and fighting their way toward Sisteron, the hospital was busy, but was soon left with little to do.
August 25 saw the 11th Evacuation leap ahead 128 miles from Le Muy to Aspremont in support of the forces fighting from Montélimar to Crest. In 15 hours after receiving movement orders, the hospital had evacuated 300 patients, dismantled and packed its equipment, and was on the road. The first patient was received at the new site just 18 hours after the hospital had closed at the old. Three hundred patients were admitted on the first day of operation at Aspremont.
The 750-bed 9th Evacuation Hospital, which arrived combat-loaded on 25 August, was sent immediately to the support of the 11th. Proceeding in 4 motor convoys, the 9th moved to a site at Beaumont, 30 miles beyond Aspres on the road to Crest, and began receiving patients at 0800, 28 August, just 54 hours after touching French soil. Two hundred and sixty patients were received and 39 surgical operations performed in the first 24 hours at Beaumont.
On the first day of September the 93d Evacuation, moving in three echelons with its own organic transportation, opened at Rives, 20 miles northwest of Grenoble and 180 miles from the hospitals previous site at Barjols. Between noon and midnight, 1 September, 127 patients were admitted and 28 surgical procedures performed. The move was completed on 5 September, the hospital remaining open at Barjols until the last echelon was ready to leave. (Map 31)
The 95th Evacuation was the next Seventh Army unit to leapfrog from the rear to the most forward position. The hospital left Gonfaron on 3 September, its personnel spending the night as guests of the 9th at Beaumont. The intention had been to setup about 50 miles beyond that point, but the front lines had already moved so far forward that a new reconnaissance was necessary. The site finally designated by the VI Corps surgeon was at St. Amour, more than 300 miles by
12 Ltr, Col Rollin L. Bauchspies, USA (Ret), to Col Coates, 15 Apr 59, commenting on preliminary draft of this volume. Colonel Bauchspies was VI Corps surgeon.
road from the landing area. The 95thspent the night of 4 September in bivouac at the 3d Division clearing station near Ambérieu, opening at St. Amour at 0900, 5 September.
As the most forward evacuation hospital, the 95th carried a heavy load of surgical cases for the next few days. At the same time, it was necessary to hold patients overlong owing to the difficulties of evacuation. The railroads had not yet been restored to service and motor transportation was critical. The situation was somewhat eased by the beginning of air evacuation from Ambérieu on 9 September, but fuel shortages and bad weather combined to make flight schedules uncertain. On the credit side, the hospital was deluged with gifts of eggs, chickens, rabbits, and ducks from the local farmers, whose normal city markets were temporarily cut off.
The 9th Evacuation, meanwhile, had closed at Beaumont, and on 8 September opened at Poligny,40 miles beyond St. Amour and 2.35 miles from the Beaumont site. At Poligny the 9th received 578 patients in the first 30 hours of operation. Surgical teams worked in 16-hour shifts.
The next forward move was made on 11 September when the 11th Evacuation opened at Aissey,15 miles east of Besançon, after a 265-mile jump from Aspremont. With the aid of borrowed trucks, the first echelon was able to carry 300 beds, all surgical nurses, and half the officers of the medical service as well as all those of the surgical service. The hospital admitted 158 patients during the first 5 hours at Aissey.
On 15 September the 93d Evacuation moved up from Rives to Rioz, 20 miles north of Besançon. Using 15 borrowed trucks and 25 ambulances of an attached ambulance company, the first 2 of 3 echelons were able to move together. The hospital opened at 1300 on 16 September. By midnight 219 patients had been received and27 operations performed. The 185-mile move was completed on 17 September.(Map 32)
The 59th Evacuation Hospital, which had closed at Carpentras on 7 September, also opened in Rioz after a 10-day wait for transportation. For the 59th the move covered 240 miles. September 17 was also the opening date for the 2d Convalescent Hospital in Besançon, though part of its equipment remained on the docks at Marseille where organic vehicles had been commandeered for more urgent uses. The unit was caring for 1,200 patients before all of its equipment was brought up by its remaining vehicles shuttling between Besançon and Marseille.13
The 95th Evacuation again became the most forward Seventh Army hospital on 18 September when it opened at Saulx, 25 miles northeast of Rioz. The 11th moved from Aissey to Conflans, 10 miles north of Saulx, 3 days later; and on 23 September the 9th Evacuation opened at Plombières on the Moselle. The first contingent of the 27th Evacuation arrived at Xertigny, about eight miles north of the 9th, the following day, but the hospital was not in full operation before the end of the month. All but the advance detachment of the 27thmade the 450-mile jump from Bouc-bel-Aire by rail. On 25
13 In the Southern France Campaign, the 2d Convalescent Hospital carried only 2,000 rather than its former 3,000 beds and was organized to operate in two independent sections of 1,000 beds each.
September the 93d Evacuation joined the 9th in the vicinity of Plombières. (Map 33)
With the single exception of the 51st Evacuation, all Seventh Army hospitals were now concentrated close to the main highway north from Besançon to Épinal. The 51st was packed at Draguignan and ready to move by 23 September, but transportation was not available until early October.
During the last two weeks of September almost continuous rain and cold hampered hospital movements and made operation a constant struggle with the elements. All tents had to be ditched, access roads graveled, and tent pegs periodically reset in the soft ground. Heating facilities were often inadequate to keep patients warm.
Special Hospital Facilities
In addition to field and evacuation hospitals, Seventh Army maintained provisional hospitals for the specialized treatment of venereal disease and neuropsychiatric cases and, until the 2d Convalescent Hospital got into full operation, a provisional convalescent hospital as well. The venereal disease and neuropsychiatric hospitals had been planned in advance, on the pattern of those set up by Fifth Army in Italy, and the clearing platoons designated to operate them had been given special training as well as specialist personnel attached from other units. The convalescent hospital was an afterthought, made necessary by the unexpectedly rapid advance of the lines and the late date predetermined for phasing in the regular convalescent facility.
The convalescent hospital was the first of the three specialized units to be established, though the procedure was very informal. On18 August--D plus 3--the 682d Medical Clearing Company of the 52d Medical Battalion, then at Plan de la Tour, arranged to hold the lightly wounded and mildly ill who could return to duty in a short time if they could be kept off the hospital ships bound for Italy. The project grew. Beds and equipment were borrowed wherever they could be had, and personnel were diverted from other duties. Within a week the unit was operating 400 convalescent beds and was unable to perform its normal functions.
The 164th Medical Battalion, less one platoon of the 638th Medical Clearing Company already in France, arrived on 26 August, and the following day a collecting company of the 164th took over the convalescent hospital, which moved forward to Aspres on the last day of the month.
The venereal disease and neuropsychiatric hospitals, meanwhile, had both been established according to plan on 20 August by the 616th Medical Clearing Company of the 181st Medical Battalion, released from its beach assignment the previous day. Both hospitals were organized as 250-bed units, and both opened at Le Luc, close to the Gonfaron site of the 95th Evacuation Hospital. The neuropsychiatric hospital carried a light patient load at this time, but the venereal disease unit found it necessary almost immediately to expand capacity to 375 beds to care for a backlog of cases arising from contacts in Italy.
By definition both of these specialized hospitals were forward units, and both were moved to the Aspres area at the end of the month. By this time long evacuation lines, scattered forces, and acceler-
ated build-up in the beach area had brought about an acute shortage of mobile medical units. The 164th Medical Battalion was given a beach assignment, and without advance notice the616th Clearing Company was directed to take over the provisional convalescent hospital on 4 September. The hospital at that time held almost 500 patients, but the 616th had only 3 officers and 8 enlisted men who could be spared from the venereal disease and neuropsychiatric centers. The men staffed the convalescent hospital until additional personnel from collecting companies of the parent medical battalion could be rushed to their aid.
The neuro psychiatric hospital moved forward to Rives on 4 September; to Samson, midway between Poligny and Besançon, six days later; and on 24 September joined the growing group of medical installations around Plombières on the Moselle. The venereal disease center moved to St. Jean de Paris, a suburb of Ambéieu, on 6 September, where the convalescent hospital had been established the day before; to Rioz on the l3th; and to Plombières on 28 September. The convalescent hospital, its usefulness ended with the establishment of the 2d Convalescent in Besançon, closed on 25 September. An annex, operated at Rioz in connection with the venereal disease hospital, closed two days later.
The convalescent hospital had reached a peak load of more than 800 patients, while the neuropsychiatric center, reflect-
ing the growing severity of combat and the deterioration of the weather, was caring for 300 patients by the end of the month.
A second venereal disease center was operated in connection with the provisional hospital at Beauvallon by the 638th Medical Clearing Company from 4 September. This center was still in operation when the 164th Medical Battalion passed from army to base section control early in October.
Medical Summary: Seventh Army
Table of Organization bed strength in Seventh Army hospitals by the end of September was 5,000,not counting clearing stations and special hospitals operated by clearing companies, plus 2,000 convalescent beds. Admissions to Seventh Army medical installations, including clearing stations, totaled more than 28,000 for the period 15 August-30 September, of which 13,000 were evacuated to the communications zone and more than 9,000 were returned to duty. (Table24)Troop strength by the end of September was approximately 40,000.
Evacuation From Seventh Army
Evacuation Within the Combat Zone
When VI Corps pushed inland from its landing beaches, evacuation of division clearing stations was carried out by the 56th Medical Battalion. Highways were generally excellent, but through much of the advance the terrain was mountainous and until the concentration of evacuation hospitals along the Moselle in late September, distances were great. To minimize the factor of distance as much as possible, holding hospitals were set up during periods of rapid advance by a platoon of the corps clearing company and a field hospital unit to retain patients until an evacuation hospital could move forward.14
The battalion maintained liaison with VI Corps through an officer stationed in the corps surgeons office, and with the evacuation hospitals through a noncommissioned officer stationed in the registrars office of each hospital serving the corps. Bed status reports from each evacuation hospital were submitted every four hours, or oftener if the situation demanded, the reports being carried by ambulance drivers or telephoned to battalion headquarters. This information permitted the corps surgeon to direct the flow of patients to the evacuation hospitals in terms of current information.
Medical support for the 1st Airborne Task Force followed an unorthodox pattern, the threec ollecting stations of the 676th Medical Collecting Company being comparable to small clearing stations. Casualties were evacuated by ambulances of the company to the provisional hospital operated by the 514th Medical Clearing Company of the 58th Medical Battalion in Nice. After 6 October auto rail trains staffed by personnel of the 676th made daily runs between the collecting stations and the hospital. The hospital was cleared by the 58th Medical Battalion.
14 Principal sources for this section are: (1) After Action Rpt, Surg, Seventh Army,15 Aug-31 Oct 44; (2) Annual Rpt, Med Sec, MTOUSA, 1944; (3)Annual Rpt, Surg, Seventh Army, 1944; (4) Annual Rpt, Surg, VI Corps,1944; (5) Unit rpts of the med units mentioned in the text.
Evacuation to the Communications Zone
During the first day of the invasion of southern France, casualties were evacuated from the beach clearing stations by small craft to the transports and carried by LST to Ajaccio, Corsica, where the 40th Station Hospital was prepared to receive them and to send the more serious cases on to Naples by air.A little over 300 reached Ajaccio by LST on 15 August. 15
15 According to the Seventh Army Surgeon`s After Action Report for the period 15 August-31 October 1944, only 380 patients were evacuated from southern France by LST. (See Table 26, below.) The 1944 annual report of the Northern Base Section surgeon, however, says 489 evacuees from the Riviera beaches were received by the 40th Station Hospital, and the report of the hospital itself for the same period puts the figure above 500. The presumption is that one or more of the hospital ships discharged some critical cases at Ajaccio to be flown to Naples, but there is a tendency in Army reports to lump all sea evacuation as by hospital ship. It may be that the LST total was actually considerably higher than indicated. For example, the report of the Naval Commander, Western Task Force, page 368, says that approximately 1,800 casualties were evacuated to hospital ships during the period of the automatic schedule (D plus 1 through D plus 6), whereas the ETMD report for August 1944 gives a figure of 3,262 for the same period.
General sources for this section are: (1) ETMD, MTO, for Aug 1944; (2) After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44; (3) Rptof Naval Comdr, Western Task Force, Invasion of Southern France; (4) Annual Rpt, Surg, Seventh Army, 1944; (5) Annual Rpt, Med Sec, MTOUSA, 1944; (6) Unit rpts of med units mentioned in the text.
Three hospital ships arrived off the landing beaches on D plus 1 as planned, although they were not there as early in the day as had been expected. The relatively small number of casualties, however, made it possible to hold in the clearing stations those patients whose condition required the better accommodations of the hospital ships. The automatic schedule continued through 21 August-3 ships on D plus 2, one on D plus 3, 2 each on D plus 4 and D plus 5, and one on D plus 6.
Vessels used during the first 3 days carried surgical teams drawn from personnel of the 3d, 36th, and 43d General Hospitals, and the 59th Evacuation Hospital, all on the DRAGOON troop list. The USAHS John Clem, smallest of the hospital ships, carried only one surgical team, while the Acadia, with a capacity of 788 patients, carried 3. The Shamrock, Thistle, Algonquin, Chateau Thierry, and Emily Weder carried 2 surgical teams each.
After D plus 6,hospital ships were sent into the area on a one-a-day basis until 28 August, and thereafter at the request of the Seventh Army surgeon. One ship was held in continuous readiness at Ajaccio. Until D plus 5 hospital ships called at all three landing beaches, but beginning on D plus 6 all evacuees were taken by ambulance to the clearing station of the 58th Medical Battalion at Ste. Maxime, where the ships were loaded. Through 21 August all hospital ships discharged at Naples with no segregation of casualties by nationality. From 22 August through 29 August vessels loaded to 60 percent or more with French casualties or prisoners of war were sent to Oran.
With the fall of Marseille and Toulon, enough fixed hospital beds became available to the French forces to make evacuation out of France unnecessary. This factor, combined with the beginning of air evacuation on D plus 7, greatly reduced the need for hospital ships and none were requested by Seventh Army after30 August.
Air evacuation from southern France was carried out by the 802d and 807th Medical Air Evacuation Transport Squadrons, which continued at the same time to clear forward areas in Italy. Beginning on 22 August, flights were made initially from the most forward airfields available directly to Naples and occasionally to other Italian bases. Airfields in the vicinity of the landing beaches--St. Tropez, Le Luc, and Aix-en-Provence--were quickly left behind. Sister on and Crest both served for a time, and flights began from Ambérieu northwest of Lyon on 9 September.
By this date, the weather was becoming uncertain and the distances to Italian bases were lengthening. With the great air base at Istres, about twenty-five miles northwest of Marseille available, flights were directed there, where patients could be relayed on by air to Naples or sent to one of the fixed hospitals moving into the Rhône delta. Before the end of September air evacuation in France had been largely reduced to a single route, from Luxeuil close to the bulk of Seventh Army medical installations, to Istres.
Air evacuation from France to Italy, and from the Seventh Army area to Istres, for the period 22 August through 7 November, when the two air evacuation squadrons from Italy were withdrawn, is summarized in Table 25.
Seventh Army evacuation hospitals from their first establishment were
cleared by the 52d Medical Battalion. Patients were carried by ambulance to the Riviera beaches for hospital ship evacuation, to holding units at airfields or railheads, or to fixed hospitals as these became available close to the front. Air evacuation holding hospitals were operated by the clearing companies of the 52d and 164th Medical Battalions. The largest of these was at Istres, operated by the 52d Medical Battalion until 17 September and thereafter by the 164th. More than 1,000 beds were available, with a daily patient turnover often greater than 600. The fall rains made flight schedules erratic with a highly variable patient census as a consequence. Property exchange with air evacuation units was a continuous problem because the personnel carriers used generally had full loads on the incoming trip, and often made one or more trips in Italy before returning to France.
As soon as the rail lines were back in operation, hospital trains were pressed into service for evacuating forward hospitals. The 42d Hospital Train, veteran of both North Africa and Italy, made its
first run between Marseille and the rail-head at Mouchard, about twenty miles southwest of Besançon, on 25 September. The 66th Hospital Train, also a veteran unit, though with less service in the theater than the 42d, left Besançon for Marseille on its initial run on 9 October. Both trains used reconditioned French passenger cars.
The slower pace of the campaign after crossing the Moselle, and the relatively stable front, permitted the establishment of fixed hospitals well forward before the end of October, with ambulance evacuation taking the place of air and rail for the shorter runs.
Throughout the campaign it was possible to handle the tremendous job of clearing army hospitals over long distances from a rapidly moving front only by constant juggling of the inadequate number of ambulance platoons available. Ambulances were kept going around the clock and on occasion passing trucks were commandeered to carry patients to the rear.16
Table 26 summarizes evacuation from forward installations to the communications zone, including Italian and North African base sections and those established in France, for the period of Mediterranean theater jurisdiction over DRAGOON.
Extension of the Communications Zone
Before DRAGOON could be transferred completely to the European Theater of Operations, it was necessary to free the operation of its logistical dependence on Italy and North Africa. It was therefore contemplated throughout the planning phase that the communications zone would be extended to southern France at the earliest possible date. To this end the Coastal Base Section was organized in Naples early in July.
Organization of the Base Sections
The Coastal Base surgeon, Colonel Bishop, and key members of his staff were in close touch with the Seventh Army surgeon throughout the planning stage, and were early arrivals in France. The first echelon of the medical section came ashore between D plus 1 and D plus 10, and the entire section was in France by29 August. The early arrivals remained in the landing areas to work with the beach control group, and the rear echelon set up a headquarters in
16 See, e.g.. 9th Evac Hosp, Med Hist Data, 1 Jan-31 Oct 44.
Marseille. The medical section was already supervising rear army installations as well as evacuation and supply activities on the beaches when the base section formally assumed operational control of the coastal region of southern France on 9 September.17
By that date, Seventh Army was beyond Besanç on in its spectacular dash toward the Rhine, and the communications zone organization appeared inappropriately named. The Coastal Base Section became the Continental Base Section on 12 September 1944, and as of 1 October was split into the Delta Base Section, with headquarters in Marseille, and the Continental Advance Section (CONAD)with headquarters in Dijon. Colonel Bishop continued as surgeon of CONAD while Colonel Jeffress became Delta Base surgeon.
Both medical section organizations were similar to those elsewhere in the Mediterranean, with functional subdivisions for administration, personnel, hospitalization, evacuation, medical records, medical supply, dental, and veterinary. The Delta Base medical section was primarily concerned with incoming supply, evacuation to Italy and to the zone of interior, and hospitalization of service troops, long-term patients, and prisoners of war. The medical section of CONAD was primarily concerned with the more immediate support of Seventh Army and of the 6th Army Group.
Both Delta Base and CONAD came under the general jurisdiction of the Southern Line of Communications(SOLOC), on 20 November, when all COMZ functions in southern France
17 Sources for this section are: (1) Annual Rpts, Med Sec, Delta Base See, 1944, 1946; (2) Monthly Rpt, Delta Base Sec, Oct 1944; (3) Annual Rpt, Continental Adv Sec, 1944; (4) CONAD History, 1944-1945: (5) Annual Rpt, Med Sec, MTOUSA, 1944; (6) Hist of Med Sec, Hq, COMZ NATOUSA; (7) Ltr, Gen Stayer, Surg, NATOUSA, to Gen Kirk, TSG, 26 Sep 44.
passed finally from MTO to ETO. The SOLOC medical section was essentially the medical section of COMZ, NATOUSA, which had been functioning in Naples since February 1944, with Colonel Shook as surgeon.18 An advance echelon of the COMZ medical section had been established in Dijon early in October by Colonel Cocke, Colonel Shook`s deputy.
Establishment of Fixed Hospitals
U.S. fixed hospitals with an aggregate Table of Organization strength of 14,250 beds were on the DRAGOON troop list, to be phased in between D plus 25 (9 September)and D plus 60 (14 October). The installations included were drawn from North Africa, Italy, and Corsica. The unexpected speed with which Seventh Army moved north made the schedule unrealistic before the first hospital arrived. In only three instances, however, was it possible to advance the schedule, and these were balanced by others in which even the retarded landing dates originally fixed were not met. (Table 27) The accelerated pace of the campaign, moreover, brought such heavy demands for transportation that the establishment of hospitals was often unduly delayed after their arrival. Another delaying factor was the difficulty in locating suitable sites in a densely populated country at a season when tents could not be satisfactorily used.19
18 See pp.323-26, above, 486-88, below.
19 Sources of this section are the same as those for the preceding section, with the addition of unit reports of medical units mentioned in the text
The first U.S. fixed hospital to operate in southern France was the 36th General, which took over a captured German hospital--originally a French tuberculosis sanatorium--at Les Milles near Aix-en-Provence on 17 September. Approximately 600 prisoner of war patients were in the hospital at that time, but these were concentrated in about half the ward area. Two days later the 36th General also began operating in Aix-en-Provence itself, in the buildings of a French psychiatric hospital. To avoid unnecessary dispersion of staff members, all surgical cases were handled at Les Milles, with medical cases going to Aix. (Map 34)
Both hospitals were turned over, with their patients, to the 43d General--Les Milles on 25 September and Aix on the 27th. The 3d General Hospital took over the installation in Aix-en-Provence on 9 October, taking 763 medical patients from the 43d at that time. The 43d General continued to administer the prisoner of war hospital at Les Milles in addition to its normal functions. The German hospital captured at Draguign an was consolidated with the Les Milles facility, which operated under U.S. supervision with German protected personnel. German enlisted men were used as litter bearers throughout the hospital.
The 78th Station Hospital, meanwhile, had opened in a resort hotel in St. Raphael on 19 September, and the 80th Station had relieved the 675th Medical Collecting Company, which had been operating a provisional hospital in the buildings of an old ladies home in Marseille.
The first fixed hospital to open in the forward area, which would come under operational control of the Continental Advance Section on 1 October, was the 46th General, which was rushed at the request of the Seventh Army surgeon to Besançon. The hospital opened with a minimal portion of its equipment in the Caserne Vauban, a former French infantry barracks, on 20 September. The front was only a dozen miles away, and the 9th Evacuation Hospital, from which the first group of patients came, was at Poligny 40 miles to the rear. The patient census of the 46th General rose to almost 3,000 within 3 weeks.
The 36th General, after surrendering its two sites at Aix-en-Provence, was assigned to CONAD and opened at Dijon on 13 October in a former French cavalry barracks. The 36th had a census of 1,400 patients within a week. It was joined at Dijon on 20 October by the 180th Station, one of the few 250-bed units left in the theater.
On 14 October the 35th Station Hospital opened at Chalon-sur-Saône, south of Dijon, the accommodations again being a French caserne, or military barracks. A week later the 2,000-bed 21st General opened at Mire court, just west of the Moselle, in the unfinished plant of a large, modern French psychiatric hospital. The 51st Station, which had been functioning as a neuropsychiatric hospital in both Africa and Italy, continued the same specialty in France, opening at Auxonne on 4 November. In this case the military atmosphere of the French barracks that housed the unit was regarded as an asset.
The 23d General Hospital opened on 5 November at Vittel, so close to the front that its first 300 patients were received direct from Seventh Army by ambulance. The hospital was adequately housed in a group of resort hotel buildings. Last of the CONAD hospitals trans-
FIXED HOSPITALS AND SUPPLY UNITS TRANSFERRED FROM MTO TO ETO, 20 NOVEMBER 1944
Delta Base Section
43d General,25 September. 1,500 beds.
3d General, 9October. 1,500 beds.
80th Station, 30 September. 500 beds.
70th Station, 1 November. 500 beds.
69th Station, 8 December. 500 beds.
231st Medical Composite Battalion.
78th Station, 19 September. 500 beds.
7607th Station(Italian), October. 500 beds;
Continental Advance Section
35th Station, 14 October. 500 beds.
51st Station, 4 November. 500 beds.
36th General, 13 October. 2,000 beds.
180th Station, 20 October. 250 beds.
70th and 71st Medical Base Depot Companies.
46th General, 20 September. 1,500 beds.
23d General, 5 November. 2,000 beds.
23d Station, 10 November. 500 beds.
21st General, 21 October. 2,000 beds.
ferred from MTO was the 23d Station, which opened in a school building at Épinal on 10 November, almost two months after its arrival in France.
Two late arrivals in Delta Base, the 69th and 70th Station Hospitals, completed the DRAGOON troop list. The 70th opened in a French mental hospital in Marseille on 1 November and, because of the facilities its site afforded, became the principal center for handling closed-ward neuropsychiatric cases in Delta Base. The 69th Station did not arrive in France until 18 November and was not ready to receive patients until 8 December.
Counting the still inoperative 69th Station, there were 5,000 Table of Organization beds in Delta Base and 9,250 in CONAD as of 20 November 1944,
when southern France passed completely to ETO control.
In addition to these fixed hospitals, the 7607th Station Hospital (Italian) opened at La Ciotat, on the coast between Marseille and Toulon, in October to care for personnel of Italian service units. Though nominally a 500-bed hospital, the 7607th operated 1,000 beds. The venereal disease center maintained by the 638th Medical Clearing Company of the 164th Medical Battalion at Beauvallon was shifted on 9 October to a staging area between Marseille and Aix-en-Provence, where it continued to carry on the same mission under Delta Base control. The 4th Medical Laboratory, which arrived in southern France on 9 September, served both base sections. The base laboratory, with the 6703d Blood Transfusion Unit attached, was located in Marseille; a mobile section consisting of one officer and four enlisted technicians, was sited in Dijon. Both sections occupied university laboratory buildings of functionally suitable design.
Evacuation From CONAD and Delta Base
As soon as the base sections were set tip, they took over responsibility for clearing hospitals in the Army area and distributing the patients among the available hospitals. The base sections were also responsible for inter base transfers; Delta Base evacuated to the zone of interior, beginning in October.20
During October 1944, CONAD evacuated from its own hospitals to Delta Base, 1,325 patients by air, 1,496 by motor, and 871 by rail. In the same month, Delta Base transferred 2,808 patients to the Peninsular Base Section in Italy by air and 2,843 by sea, while 9.3 were evacuated by sea to the United States.
With fixed beds in the forward `area still at a premium, CONAD followed no fixed evacuation policy, but cleared its hospitals to Delta Base as rapidly as transportation and the condition of the patients allowed. Toward the end of October, Delta Base established a 45-day policy for evacuation to PBS, retaining all patients expected to recover in less than that time.
Delta Base continued to evacuate some patients to Italy until 20 November, the totals for the period 1-20 November being 29 by air and 433 by hospital ship. The slack was taken up by the greatly increased number of beds available in southern and eastern France by early November, and by the beginning of direct air evacuation from CONAD to the United Kingdom on the 12th of that month.
Medical Supplies and Equipment
By the time medical supplies began coming across the landing beaches of southern France inappreciable quantities about D plus 3, the army and base responsibilities in the supply area were being differentiated. Both the Seventh Army medical supply officer, who was also commanding officer of the 7th Medical Depot Company, and the Coastal Base Section medical supply officer on temporary duty with Seventh Army came ashore on D plus 1. The three beach dumps were taken over from the beach medical battalions by the advance sec-
20 This section is based primarily on: (1) Annual Rpt, Med Sec, CONAD, 1944; (2) Annual Rpt, Med Sec, Delta Base, 1944; (3) Annual Rpt, Med Sec, MTOUSA, 1944.
tion of the 7th Medical Depot Company on 16-18 August.21 Three days later a single point for the receipt of incoming medical supplies was established at Ste. Maxime. At this time supervision passed to the base supply organization, although 21 enlisted men of the advance section, 7th Medical Depot Company, were detached to help operate the dumps for the beach control group. These men did not rejoin their own unit until 15 September.
Seventh Army Medical Supply
The first forward issue point for Seventh Army was set up at Le Cannet, near Le Luc, on 21 August, moving to St. Maximin, about 20 miles east of Aix-en-Provence, 2 days later. The main body of the 7th Medical Depot Company joined the advance section there on 25 August. On 29 August the base section of the depot moved to Meyrargues, to miles north of Aix, while one storage and issue platoon jumped forward to As premont in the vicinity of VI Corps` forward medical installations.22
It was at this time that the battle of Montélimar came to its indecisive close and Seventh Army raced ahead to cut off the retreating enemy before he could slip through the Belfort Gap. In this stage of the campaign, medical supply dumps were hard pressed to keep within any kind of reasonable distance of the installations they served. The Meyrargues dump closed on 5 September and a new issue point opened the same day at Voreppe, ten miles northwest of Grenoble. The Aspremont dump closed the following day.
The next move was from Voreppe to Sellières, ten miles north of Lons-le-Saunier, on 12 September. The area was already too far behind the advancing Seventh Army installations, however, and a second forward dump was opened the next day at Baume-les-Dames, fifteen miles northeast of Besançon. With the change of direction following the shift to SHAEF command, the Baumedump moved to Vesoul on 19 September, where it was joined a day later by the group from Sellières. At Vesoul the dump was in a building for the first time, being housed in a large tobacco warehouse.
On 2 October the1st Storage and Issue Platoon opened at Épinal, with the remainder of the company moving up gradually until 17 October, when the Vesoul dump was closed. On the same day a second dump was opened at Lunéville, some thirty miles north of Épinal. The Épinal and Lunéville dumps were in buildings large enough to accommodate mess and billets as well as the depot itself.
Throughout the early weeks of the campaign, transportation presented the greatest difficulty. While the army issue points were still close to the beaches, medical supplies were unloaded from the ships to DUKWs, which ferried them ashore and delivered them directly to the dumps. As the army moved forward, medical supplies were brought up in organic vehicles of the 7th Medical Depot Company, operating around the clock. The pressure was relieved only after the
21 See p.380, above.
22 Principal sources for this section are: (1) After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44, an. 278; (2) Annual Rpt, Surg, Seventh Army, 1944; (3) Annual Rpt, 7th Med Depot Co, 1944; (4) Med Hist, 7th Med Depot Co, 25 Oct 44; (5) Unit rpts, 9th, 11th, 27th, 51st, 59th, 93d, 95th Evac Hosps, 1944; (6) Davidson, Med Supply in MTOUSA, 143-50
Services of Supply organization was able to build up substantial stock levels in the rear areas and took over responsibility for delivering supplies to Seventh Army depots. The evacuation hospitals were similarly pressed for vehicles to carry their own supplies from the army issue points, which were sometimes as much as 150 miles away. Only the extra stocks carried by each Seventh Army hospital prevented critical shortages of some items.
Until the inauguration of rail transportation in late September, it was difficult to keep a sufficient volume of medical supplies in the army area. Many items were distributed on a ration basis through most of October, but there were no actual failures to meet minimum requirements. Local procurement was unnecessary to any important extent since quantities of captured German supplies were available. Housekeeping equipment, such as wood-burning stoves, pots and pans, knives, dishes, enamelware, electric refrigerators, and kerosene lamps generally came from this source. In emergencies, requisitions were filed with SOSNATO USA in Naples by cable and supplies were sent by air.
Two portable optical units of the 7th Medical Depot Company averaged twenty-four pairs of spectacles and six repair jobs a day for army troops. Two dental prosthetic teams joined the depot company, one in late September and one in early October, serving variously with the 2d Convalescent Hospital, the 35th Field Artillery Group, and the parent unit.
During the months in which the 7th Medical Depot Company was supported by the Mediterranean Theater of Operations, monthly tonnage issued rose from 64.5 in August to 356.8 in November. (Table 28)
Medical Supply in the Communications Zone
The 231St Medical Composite Battalion--with its two attached medical base depot companies, the 70th with 2 officers and 29 enlisted men, and the 71st with one officer and 30 enlisted men--was activated in Oran on 15 August 1944, absorbing personnel and equipment of the 2d Medical Depot Company, and was assigned immediately to the DRAGOON operation.23 The unit reached St.
23 See p.345, above.
Raphael on 9 September. The 71st Medical Base Depot Company took over operation of the Ste. Maxime depot, while the 70th accompanied the battalion to Marseille. A large garage and hangar had already been obtained by the Coastal Base Surgeon as a depot site. Eight operational medical units, each sufficient to maintain 10,000men for 30 days, reached Marseille simultaneously with the supply personnel, and within 72 hours the depot was able to issue supplies.24
When the depot was in full operation, the 231st Medical Composite Battalion was sent to Dijon to set up a more forward base, the 71st Medical Base Depot Company moving to the Marseille depot on 24 September. It was at this time, however, that the decision to establish two base sections was made, and late in October the 231st returned to Marseille to resume operation of the Delta Base depot. The 70th and 71st Medical Base Depot Companies were assigned to CONAD, joining forces to operate the Dijon depot, which was sited in a French barracks. Italian service units and French civilians were used as needed by both base section depots.
Both Delta Base and Continental Advance were supplied by COMZ NATO-USA, but all supplies for CONAD passed through Delta Base. They were often transferred by DUKW from ships to freight cars bound for the forward area without ever entering a Delta Base dump. For about two months supplies were not received in Delta Base in large enough quantities to maintain adequate stock levels in either base section. Arrival times were uncertain, the condition of the only partially restored port of Marseille made unloading difficult, and transportation shortages frequently delayed movement of supplies from the docks to the depot. All together, the Delta Base supply organization was able to fill during October only about 60 percent of the requisitions from Seventh Army, 1st French Army, CONAD, and Delta Base. All base section medical units, however, carried 90-day supply levels with them to France and were not seriously handicapped by the slow buildup. The authorized stock level of30 days of operating supplies and a 45-day reserve was reached in mid-November. Supplies adequate for 7 days of operation, with an 8-dayreserve, were in the CONAD depot and the remainder in Delta Base warehouses.
As many items as possible were procured locally, including motor vehicles, which greatly facilitated the movement of supplies. Inducements were offered for the return of salvage and emphasis was placed on repair. After the return of the 231st Medical Composite Battalion to Delta Base, CONAD was without any medical maintenance and repair service of its own. Some repair work was farmed out to other military units, but many items had to be shipped to Marseille for repair.
The transfer of supply functions to the European theater was actively under discussion through October. The method
24 Principal sources for this section are: (1) Annual Rpt, Med Sec, MTOUSA, 1944, an. K; (2) Rptof Med Sec. Hq, COMZ NATOUSA; (3) Annual Rpt, Med Sec, Delta Base Sec, 1944; (4) Annual Rpt, Med Sec, CONAD, 1944; (5) Med Hist Data, 231st Med Composite Bn, 28 Oct 44; (6) Hist Journal, 231st Med Composite Bn, 13 Aug 44-31 Dec 45; (7) Annual Rpt, 7th Med Depot Co, 1944;(8) Davidson, Med Supply in MTOUSA, 150-56.
finally adopted was to transfer six officers and twenty-six enlisted men, all specialists in medical supply, from Headquarters, COMZ NATOUSA, to Headquarters, Southern Line of Communications. The effective date of the transfer was 20 November 1944.
The supply build-up in southern France is well shown by the record of receipts and issues of the 231st Medical Composite Battalion set forth in Table 29.
Professional Services in Southern France
Medicine and Surgery
In both medicine and surgery, the practices developed in earlier Mediterranean campaigns carried over to southern France. Medical officers and enlisted technicians who had gained their combat experience in North Africa, Sicily, and Italy supplied the continuity, while the theater consultants--Colonel Churchill in surgery and Colonel Long in medicine--gave the same attention to the medical service of Seventh Army, Delta Base, and CONAD that they gave to other armies and the base sections in the theater.
Forward Surgery-Field hospital platoons, operating within litter-carrying distance of the division clearing stations, continued to be the primary unit for forward surgery. In the Southern France Campaign, these units were setup to accommodate a maximum of 60 patients. The number actually cared for at any one time was usually between 25 and 40. Nontransportable patients went directly to these hospitals, where teams of the 2d Auxiliary Surgical Group performed such surgical procedures as were necessary to save life and limb and to put the patient in condition to be moved to an evacuation hospital farther to the rear. Cases going to the field hospitals usually included severe hemorrhage, wounds of the abdomen, severe chest wounds, multiple fractures, traumatic amputations, and those in immediate need of transfusion.
Other surgical cases went directly to the evacuation hospitals, as did those who had received initial treatment in the field units. The forward evacuations were organized and their tents laid out with the efficiency of the surgical service as the main consideration. In periods of heavy combat, evacuation hospital surgeons worked as teams in 12- and sometimes 16-hour shifts, with operating rooms continuously in use. The maxi-
mum holding period was seven days.25
The theater consultant, Colonel Churchill, spent three weeks visiting forward and base installations in southern France, beginning 16 September. He was followed in mid-October by the orthopedic consultant, Lt. Col. Oscar P. Hampton, Jr. The Seventh Army surgical consultant, Colonel Berry, was active in organizing and supervising the surgical work of army hospitals from the start of the campaign.26
In addition to adequate supplies of penicillin, which had largely replaced the sulfonamides, Seventh Army surgeons also had the advantage of daily deliveries of whole blood. From D plus until D plus 8, blood was flown from the 15th Medical General Laboratory in Naples to Corsica and relayed to the invasion beaches by fast PT boats. Thereafter it was flown directly to the most forward airfield, where personnel of the 6703d Blood Transfusion Unit received and distributed it on a priority basis first to the field hospital units, then to the 400-bed evacuations, and finally to the 750-bed evacuations. The field hospitals averaged 3.5 to 4 units of whole blood per patient transfused, the evacuation hospitals 2 to 2.5 units. Blood also came by way of Naples from the French blood bank in Algiers.27
As the army moved forward and flight distances from Naples lengthened, forward hospitals drew blood locally wherever possible and maintained small blood banks of their own. In November a section of the 6707th Blood Transfusion Unit setup a blood bank in Marseille, where donors were available among service troops. Many civilians were also induced to give blood by the offer of flight rations to those who participated. A mobile Section operated in the forward area, but the number of donors was too limited to be reliedupon.28
Neuropsychiatry-The procedure for handling neuropsychiatric cases in Seventh Army was patterned on the increasingly successful system developed in Italy by Fifth Army under the guidance of the theater neuropsychiatric consultant, Colonel Hanson. Again continuity was provided by transfer of personnel, including the army consultant Major Ludwig, who had been commanding officer of the Fifth Army Neuropsychiatric Center.
Owing largely to the rapid initial advance of Seventh Army, with accompanying high morale among the combat troops, the incidence of psychiatric disorders was low during the first month of the campaign. Beginning in mid-September, however, as the terrain became more difficult, the weather deteriorated, and enemy resistance stiffened, an increasing number of neuropsychiatric casualties passed through the division clearing stations. The three divisions of VI Corps had been in almost continuous combat since the Salerno landings ,and the impact of battle fatigue was cumulative.29
25 (1) Annual Rpt. Surg, Seventh Army, 1944. (2) Annual Rpt, 2d Aux Surg Gp, 1944. (3)Annual Rpts, 1944, of 10th and 11th Field Hosps; and 9th, 10th, 27th, 51st, 59th, 93d and 95th Evac Hosps.
26 AnnualRpt, Med Sec, MTOUSA, 1944, an. E.
27 (1)Annual Rpt, Surg, Seventh Army, 1944. (2) Quarterly Rpt, 15th Med Gen Lab,3d Quarter 1944.
28 Annual Rpt, Delta Base, 1944.
29 Principal sources for this section are: (1) After Action Rpt, Surg, Seventh Army, 15 Aug--31 Oct 44, an. 278; (2) Annual Rpt, Surg, Seventh Army, 1944; (3) Annual Rpt, 181st Med Bn, 1944; (4) Annual Rpt, 616th Med Clearing Co, 1944; (5) Annual Rpts, 1944, of hosps mentioned in the text.
The basic consideration was to treat neuropsychiatric casualties as far forward as possible. Cases were first examined by the division psychiatrists in the clearing stations, where every effort was made to get the men back into combat without delay. Those that did not respond promptly were sent to the Seventh Army Neuropsychiatric Center, operated by the 2d Platoon of the 616th Medical Clearing Company, 181st Medical Battalion. The center had a staff of eighty-five enlisted men, with four psychiatrists attached. The chief of the psychiatric service was Capt. (later Maj.) Stephen W. Ranson. All cases in which a psychiatric diagnosis was made at an evacuation hospital were also transferred to the center without further treatment.
At the center, treatment followed the pattern used in Fifth Army. Patients were kept under mild barbiturate sedation for twenty-four hours, but were maintained in ambulatory status. After the initial period of rest and quiet, they were interviewed and a course of therapy prescribed. Patients were kept active and were urged to interest themselves in the recreational and orientation facilities of the hospital.
Every effort was made to dispose of
cases as quickly as possible. Except in special circumstances, four days was the maximum holding period. Those who could be returned to duty were then reequipped and sent back to their own divisions without passing through a replacement command. Those who needed further care went to a fixed hospital for more extensive treatment. Evacuation to Italy was necessary for a time, but among the fixed units transferred to southern France the 3d General Hospital at Aixen-Provence was equipped to handle psychiatric cases, while the 51st Station, which opened on 4 November at Auxonne, was exclusively a neuropsychiatric installation.
Returns to duty from the division clearing stations were 50 percent of all neuropsychiatric cases treated for the period 15-31 August, 37 percent for the period 1-15 September, and 23 percent for the period 16-30 September. Returns to duty from the Seventh Army Neuropsychiatric Center and other Seventh Army hospitals for the same periods were 29 percent, 11 percent, and 12 percent, respectively.
During the period that southern France was under Mediterranean theater control, there were few problems in preventive medicine. Most serious of these was venereal disease control. Malaria had been anticipated as a problem and prepared for, but proved to be minor. Trench foot was developing into a problem of major concern at the time operations passed to ETO.
Venereal Disease Control- The Seventh Army Venereal Disease Treatment Center, operated by the 616th Medical Clearing Company, 181st Medical Battalion, was initially overloaded with cases contracted in Italy during the staging period. The hospital, staffed by 8 officers and 93 enlisted men, had a planned capacity of 250, but had to expand almost immediately to 375 beds.30
Additional contacts were made in the coastal area, but as the army advanced northward through predominantly agricultural country, opportunities for sexual contacts lessened. The rapidity of movement also helped to reduce the
30 Primarysources for this section are: (1) Annual Rpt, Surg. Seventh Army, 1944;(2) Annual Rpt, 181st Med Bn, 1944; (3) Ltr, Col Barnes, VD consultant, MTOUSA, to Surg, MTOUSA, 2 Nov 44. Sub: Venereal Disease Control Activities in Seventh Army, Continental Base and Delta Base Sees; (4) Annual Rpt, Med Sec, MTOUSA, 1944, an. J; (5) Annual Rpt, Med See, Delta Base, 1944; (6) Annual Rpt, Med Sec, CONAD, 1944.
venereal rate. (Table 30) In the main, the preventive measures taken under the direction of Major (later Lt. Col.) James E. Flinn, Seventh Army venereal disease control officer, were effective. These included an intensive educational program in the individual units, with emphasis on the importance of immediate prophylaxis; rigid enforcement of off-limits restrictions on known brothels; and curfew hours that limited the time available for contacts. The rapidity of cures, under the new penicillin treatment, tended to discourage any deliberate exposure to escape hazardous duties. Acute gonorrhea cases were returned to duty from the Venereal Disease Center within twelve hours, and mild cases were treated on duty status.
In the base sections, particularly in Delta Base, the problem was more difficult. Two metropolitan prophylactic stations were established in Marseille, but more were needed .All of the 31 licensed houses of prostitution in that city were placed off-limits, but indications were that the women simply moved to rooms and to small hotels, where they were even harder to control. Five brothels in Dijon were also placed off-limits apparently with more effect. Dispensaries and fixed hospitals in CONAD saw relatively few venereal cases.
Malaria- A malaria problem in southern France had been anticipated during the planning of DRAGOON, and a malariologist, Maj. Arthur W. Hill, was attached to Seventh Army, together with the 132d Malaria Control Unit. While a considerable number of cases were treated in the early weeks of the campaign, they were virtually all contracted in Italian staging areas before sailing. Individual preventive and suppressive measures were continued until 11 October, but were then discontinued as of no further value, and Major Hill returned to the 2655th Malaria Control Detachment in Italy.31
The 132d MCU went to the Coastal Base Section in September, being replaced in Seventh Army by the 131st MCU from Corsica. In October the 132d went to CONAD and the 131st to Delta Base. Both passed to ETO in November. Neither of these units, however, engaged in actual malaria control work. Inspection of the Marseille area immediately after occupation of the city revealed no malaria-infested mosquitoes, and none were found in the advance north. The malaria control units, under both army and base section jurisdiction, were used primarily for fly, roach, and bedbug control, and for general sanitation work.
Trench Foot-Trench foot appeared among Seventh Army troops toward the end of September, becoming an increasingly severe problem through the succeeding months, but that story belongs rather to the ETO than to the MTO period. The major contributing factor was the same as it had been in Italy-- cold and wet weather in which men at the front had no opportunity to change socks or dry their feet for days at a time. Wool socks and shoe pacs were issued, but only after the condition had appeared. Even had they been available at the start of the bad weather, however, they would have had only a minimal
31 Principal sources for this section are: (1) Annual Rpt, Med Sec, MTOUSA, 1944, an. J; (2) Annual Rpt, Surg, Seventh Army, 1944; (3) Annual Rpt, Med Sec, CONAD,1944; (4) Annual Rpt, 9th Evac Hosp, 1944.
preventive effect, since the nature of the action required that men stay in the lines for considerable periods of time.32
During the staging period before leaving Italy, Seventh Army dental officers, under the direction of Colonel Gurley, Seventh Army dental surgeon, made every effort to bring the dental health of the assault troops to a high level. Except for emergencies, little dental work was possible during the early weeks of the invasion. Ninety percent of the division dental officers did none at all until D plus 15, functioning during that period in various medical and administrative capacities. The dental services of the evacuation hospitals and of the combat divisions were supplemented around the beginning of October by two dental prosthetic teams assigned to the 7th Medical Depot Company and a third assigned to serve U.S. troops operating with 1st French Army.33
Inspection of the combat dental service of Seventh Army early in October by the theater dental surgeon, Colonel Tingay, revealed no dental problems. Colonel Tingay was particularly impressed by the manner in which the dental work of the 3d Division was being carried on. He reported:
One officer from each infantry regiment, the officer assigned to special troops and one officer from the medical battalion have been- attached to the division surgeons office and thus come under the direct control of the Division Dental Surgeon. With this nucleus of five officers, clinics are established in rearward areas in the most feasible locations and a large volume of work accomplished during actual combat. The other dental officer of each infantry regiment is left with the regiment and the officer assigned toa rtillery is left with the division artillery. In addition to providing emergency treatment these officers are also able to accomplish some constructive dentistry. A prosthetic laboratory truck has been constructed and is placed in operation wherever the rearward clinic is established.34
In the base sections dental work was performed by dental personnel of the fixed hospitals.
The first veterinary unit to arrive in southern France was the 890th Medical Service Detachment(formerly T Detachment), which had been active in the theater since North African days. The unit landed on the invasion coast on D plus 8-23 August--and began supervising the issue of field rations at quartermaster Class I supply dumps in the beach area. Throughout the period of MTO control, the detachment worked in close co-operation with the Seventh Army quartermaster section, supervising the issue of rations at army railheads.35
The 45th Veterinary Company (Separate) arrived on schedule on D plus 20 (4 September). The veterinary detachments, consisting of 3 officers and 12 enlisted men each, of the 601st and 602d Field Artillery Battalions arrived about
32(1) Annual Rpt, Surg, Seventh Army, 1944. (2) Annual Rpt, Surg, VI Corps, 1944.(3) Annual Rpt, Surg. 3d Inf Div, 1944.
33(1) Annual Rpt, Surg, Seventh Army, 1944. (2) Annual Rpt 7th Med Depot Co, 1944.
34 Rpt of Inspection by Cal Tingay, 9 Oct 44.
35 Principal sources for this section are: (1) Annual Rpt, Surg, Seventh Army, 1944;(2) Annual Rpt, 17th Vet Evac Hosp, 1944; (3) Annual Rpt, 45th Vet Co (Separate),1944; (4) Annual Rpt, Med Sec, CONAD, 1944.
the same time, together with 1,200 animals of the 2 units. The 601st had come in by glider as a component of the 1st Airborne Task Force, and was then fighting in the Maritime Alps, where it was joined by the 602d, its animals and its veterinary personnel. The animals were shipped from Italy on LST`s whose holds had been converted to stall space by the use of earth and sandbags. The 2d Platoon of the 45th Veterinary Company was assigned to support the two field artillery battalions, while the balance of the company went to Lons-le-Saunier for staging.
The Seventh Army veterinary surgeon, Colonel Stevenson, arrived in southern France on D plus 25, or 9 September, along with the 17th Veterinary Evacuation Hospital, of which he had been commanding officer. The hospital staged for a few days at St. Raphael, then opened on 18 September in a French artillery barracks at Grenoble. Three days later the 45th Veterinary
Company, less its 2d Platoon, moved to Sister on, some 75 miles south of Grenoble. The unit moved once more, to Gap, on 29 September.
On 24 September both the 17th Veterinary Evacuation Hospital and the 45th Veterinary Company were attached for operational control to First French Army, which had 6,000 animals in the Maritime Alps between Nice and the Swiss border and another 6,000 in the Vosges area. From the Vosges, French animal casualties went to Grenoble by animal hospital train. Though its Table of Organization stall capacity was only 150, the 17th Veterinary Evacuation Hospital operated up to 236 stalls.
In the base sections, as distinct from the army area, the veterinary service was confined primarily to inspection of cold storage plants for perishable foods and continuous inspection of locally processed foodstuffs.