Contraction and Redeployment
Once the war in Europe was at an end, American commanders in the Mediterranean theater turned their attention to the war still being vigorously prosecuted in the Pacific and to the demobilization of troops not required for the conquest of Japan. The prompt redeployment of combat and service units to the Pacific and the contraction of operations in Italy as rapidly as circumstances permitted were the objectives toward which all Medical Department activities were oriented during the summer of 1945. An understanding of redeployment policies and plans is therefore essential to any evaluation of the medical service during this period.
Redeployment Policies and Plans
A War Department redeployment plan prepared in August 1944, when there was reasonable prospect of an early end to hostilities in Europe, called for the transfer of 45,000 service troops and 37,000 Air Forces troops from Europe and the Mediterranean each month from October 1944 through January 1945, with ground force troops being returned to the United States for further disposition. The criteria that would determine whether individual soldiers would be sent to the Pacific, used as occupation forces, or returned home for demobilization were essentiality, length and arduousness of service, and number of dependents. For the Medical Department, essentiality was the primary factor.1
The first theater plan for redeployment was published in late September of 1944. Following the general pattern laid down by the War Department, medical units were divided into two categories: those required to care for troops in the theater during the demobilization period, and those available for other uses. Units placed in the second category were further subdivided into those to be transferred to another theater, those to be used to support garrison troops in MTO or in the United States, and those to be returned to the United States for inactivation. Bed requirements for garrison troops were postulated at 4 percent of strength.
Before this program got out of the planning stage, it was clear that there would be no final military victory in Europe during 1944, and the whole question of redeployment was temporarily shelved. It came up again in March 1945 with the receipt of a War Department forecast considered by the MTOUSA medical section to be unrealistic. For one thing, requirements for the occupation of Austria, then regarded as
1 This Section is based primarily on the following documents: (1) Final Rpt, Plans and Opns Off, Office of the Surg, MTOUSA. (2) Annual Rpt, Surg, Fifth Army, 1945.
a Fifth Army responsibility, were not known. Another objection was that the forecast called for early redeployment of types of units not actually present in the theater. The 2,000-bed general hospitals, which were also scheduled for early transfer, were regarded by General Stayer as unsuitable for the Pacific and necessary during redeployment in Italy. There was also disagreement as to the speed with which the medical depot companies ought to be withdrawn, in view of the volume of equipment to be prepared for shipment. Most of the objectionable features were eliminated from a new War Department forecast received early in May, and redeployment regulations consistent with it were issued on the 12th of that month.
Under these regulations the theater commander was to assign each unit to one of the following categories:(I) units to occupy areas of Europe; (II) units to be used in the war against Japan; (III) units to be inactivated within the theater; and (IV) units to be returned to the United States for inactivation. Category II was broken down into (A) units to be shipped to the Pacific direct; (B) units to be shipped to the Pacific by way of the United States; and (C) units to be shipped to the United States to be placed in strategic reserve. Since the occupation of Austria had by this date been assigned to forces already in that area and the occupation of cobelligerent Italy was not contemplated, no MTOUSA medical units fell into Category I.
At the same time, each officer and enlisted man in the theater was given an Adjusted Service Rating Score (ASRS) as of 12 May 1945, based on a point for each month of service since 16 September 1940, a point for each month overseas, 12points for each child under 18 years of age up to a limit of three, and 5 points for each combat decoration and battle participation award.2For enlisted men the critical score was tentatively set as 85 points. Critical scores for Medical Department officers, received late in May, varied with the corps. For hygienists and dietitians, the figure was 62; for dentists,63; for physical therapists, 65 for nurses, 71; for Medical Administrative Corps officers, 88; and for Medical Corps officers 85 plus, according to specialty. As a preliminary to redeployment, high score men were to be transferred to Category III and IV units, while units placed in Category II were to be staffed with officers and men whose ASRS`s were below the critical level. High-score men in Category III units were to be returned to the United States as casuals after disbandment of their organizations. High-score personnel deemed nonessential were to be withdrawn on a continuing basis from all units and returned to the United States as casuals. Where enough low-score officers were not available to staff outgoing units, essentiality became the overriding consideration.
Although many difficulties arose owing to the disproportionately large number of high-score men in medical units, the program laid down in May was carried out faithfully until the end of July. By that date, however, the demands for shipping to move men and equipment to the Pacific were so great as to preclude the movement of medical units to the United States for disbandment. Early in August,
2 For more detailed discussion, see McMinn and Levin, Personnel in World War II,pp.487 ff.
therefore, it was decided to inactivate Category IV units in the theater. All transfers to the Pacific were abruptly halted with announcement of the Japanese surrender on 14 August, and personnel thereafter were shipped to the United States as rapidly as possible on the basis of point scores alone.
Medical Support of Fifth Army
Medical support of Fifth Army in the postwar period was of two types. As long as combat formations remained active in the field, even though they did no more than patrol national frontiers, they were accompanied by their organic medical units and were served by mobile hospitals. On the other hand, when divisions were sent back to redeployment and training centers for new combat assignments or demobilization, the medical service more closely resembled that of a fixed post, with dispensaries and station hospitals replacing clearing platoons and evacuation or field hospitals.
Medical Service in the Field
Immediately following the German surrender in Italy, combat elements of Fifth Army moved out to the frontiers, primarily for the purpose of rounding up prisoners and preserving order. On the left flank, the 34th Division advanced to the French border. The 1st Armored, to the right of the 34th, patrolled the Swiss frontier in the vicinity of Lake Como. The 10th Mountain Division advanced north from the head of Lake Garda, while the 88th swept up through Bolzano to the Brenner Pass and the 85th reached the Austrian border farther to the east, in the Dobbiaco area. The 91st, which had passed to operational control of Eighth Army on 5 May, moved to the Yugoslav border at Gorizia and backed up the British occupation of Trieste. The 92d Division remained in Genoa and the Brazilian Expeditionary Force kept its positions aroundAlessandria.3
Each of these divisions was supported by its own organic medical battalion and by one or more mobile hospital units. The 2d Platoon of the 15th Field Hospital continued to operate at its Genoa site until the end of June, when the 92d Division was withdrawn for redeployment. The 1st Platoon of the 32d Field Hospital moved from the outskirts of Milan to Alessandria on 3 May, and two days later the 3d Platoon opened in Milan itself. The 2d Platoon moved up from Parma to Turin in support of the 34th Division on 8 May.
The 15th Evacuation hospital, after turning its patients over to the 37th General in Mantova, opened on 12 May near Milan as a station hospital serving both the 34th Division and the 1st Armored. The 3d Platoon of the 32d Field, no longer needed in Milan, moved to Desenzano on 23 May, where it was replaced early in June by a 100-bed detachment from the 8th Evacuation Hospital. At the same time, the 1st Platoon was relieved at Alessandria by a similar detachment from the 38th Evacuation,
3 This section is based primarily on the following: (1) Annual Rpt, Surg, Fifth Army,1945; (2) Opns Rpts, II Corps, May, Jun 45; (3) Opns Rpts, IV Corps, May-Jul 45; (4) Fifth Army History, vol. IX; (5) Schultz, 85th Infantry Division, pp. 230-34; (6) Delaney, Blue Devils, pp. 225-34; (7) Robbins, 91st Infantry Division,pp.335-65; (8) Goodman, Fragment of Victory, pp. 179-82; (9) Unit rpts of organic med bns, and of hosps mentioned in the text.
located since 26 May at Salsomaggiore south of Cremona; and the 2d Platoon at Turin turned its patients over to a detachment from the 15th Evacuation. The 32d Field was thus freed for redeployment. (Map 43)
In the center of the fan-shaped army area, most of the Fifth Army hospitals were tied down with prisoner of war patients and with the supervision of German POW hospitals. The 3d Platoon of the 15th Field at Modena, the 1st Platoon of the 15th, which moved to Vicenza early in May, and the 8th Evacuation south of Verona were all so engaged. Even the 3d Convalescent Hospital, which moved up from Montecatini to Villafranca on 4 May, was before long largely occupied supervising a German POW convalescent hospital. When the2d Platoon of the 602d Clearing Company closed on 16 May, the 3d Convalescent also took over operation of the Fifth Army Venereal Disease Center.
The 170th Evacuation hospital, which had been en route to Treviso when the war ended, remained t that site in support of the 85th and 88th Divisions until 2 June, when it closed for redeployment. Its sister unit, the 171st Evacuation, closed at Vicenza on 7 May, opening the next day at Cormons in support of the 91st Division. The site was only a stones throw from the Yugoslav border, about midway between Udine and Gorizia. On 27 May the 171st also closed for redeployment, having been replaced in the interval by the 56th Evacuation, which moved from Bologna to Udine on 19 May. The larger unit was required ecause of a flare-up along the border that brought the 10th Mountain Division to the support of the 91st.
The 33d Field Hospital gave second and third-echelon support to the 85th and 88th Divisions. The 1st Platoon, which had been immobilized south of Bologna throughout the greater part of the Po Valley Campaign, opened in Bolzano on 7 May. The 2d Platoon, at Bassano when the war ended, moved north to Primolino on 3 May and on to Belluno on the 7th. The unit backtracked to Treviso on 4 June, however, to take the overflow from the 56th Evacuation at Udine. The 3d Platoon moved from Vicenza to Trento on 9 May.
Fifth Army itself began closing out in June. On the 7th of that month the 88th Division was reassigned to MTOUSA as the theater prisoner of war command, though the division continued to be administered by Fifth Army. About the middle of June the Brazilian Expeditionary Force moved to Francolise north of Caserta for redeployment training, and the 92d Division moved to its own redeployment training area near Viareggio. On 25 June the 1st Armored Division left the theater for occupation duties in Germany, and on the 29th II Corps also passed to ETO to administer the occupation of Austria. The bulk of the Fifth Army service troops were moved out during June, since a limitless reservoir of German prisoner personnel was available to perform their functions.
Early in July the 85th Division moved to a redeployment area along the Volturno, and the 10th Mountain Division moved to Florence preparatory to a Pacific assignment. On 11 July General Martin left the theater for an assignment in the Pacific, and his executive officer, Col. Charles O. Bruce, became Fifth Army surgeon. About this time a longstanding territorial squabble between France and Italy was curbed, making
occupation of Aosta Province on the French border no longer necessary. Later in the month, therefore, the 34th Division, which had been patrolling the disputed area, was free to relieve the 91st at Udine, releasing the latter formation for redeployment training. With the reassignment of the 34th Division, and the transfer of the Legnano and Cremona Groups of Italian partisans and the 6th South African Armoured Division to British control, IV Corps became non-operational as of 15 July.
As the army contracted, medical units readjusted their positions, so that they too could be redeployed as rapidly as possible.
The 16th Evacuation Hospital, which had remained at its San Giovanni site since the end of hostilities, relieved the 56th at Udine on 4 August. On 15 August the 1st Platoon of the 15th Field Hospital, which had been supervising German prisoner of war installations at Vicenza, relieved the 15th Evacuation in Milan; and a few days later the 2d Platoon relieved the 32d Field at Bolzano. On 1 September all remaining Fifth Army units were assigned to the Peninsular Base Section. Fifth Army became non-operational on 9 September 1945, the second anniversary of the Salerno landings, and was inactivated on 2 October. On 25 September the 15th Field Hospital was reassigned from PBS to the 88th Division, and a week later, operating as a single hospital for the first time since the beginning of the Po Valley Campaign, relieved the16th Evacuation at Udine, where the 88th relieved the 34th Division.
During the closing months of Fifth Army`s existence, the medical service was largely of garrison type. The incidence of disease was low, with malaria well under control and intestinal diseases almost nonexistent. Even the venereal disease rate, contrary to all expectations, was surprisingly low. The rate per 1,000 per annum rose from 34 for the week ending 4 May to 55, 91, and 111 for the three succeeding weeks, but was down to 81 by June. It remained between 93 and 67 until August, when it dropped to 58. The only disease outbreak of any significance occurred in the last week of June, when 27 cases of poliomyelitis suddenly appeared in the 10th Mountain Division, then in the Udine area. Despite intensive investigation, no cause was determined.
Medical Service for Staging Units
As soon as MTOUSA redeployment plans were firm, Fifth Army began es-
tablishing redeployment and training centers where troops could be prepared for transfer to another theater or for shipment home. Centers were established for non divisional units at Montecatini and Florence, the former for Category II units, the latter for Category IV. In June one area near Viareggio was prepared for the 92dDivision, and another at Francolise, just north of the Volturno in the vicinity of Capua, for the Brazilian Expeditionary Force. About the 1stof July another redeployment and training center was set up along the Volturnonear Caiazzo, where a replacement center had previously been located. Later in the same month the last of the redeployment centers was established, at Cecchignola just south of Rome, which had also been the site of a replacement center. Both the Volturno and Cecchignola centers served divisional troops.4
Fifth Army supplied medical service for each of the centers processing non-divisional units--Montecatini, Florence, and for a time Volturno and later Cecchignola. In each case a team of three officers was attached to the center, one a field-grade medical officer who served as area surgeon; one a medical records inspector; and the third a medical supply inspector. The surgeon was responsible for sanitation and medical care, as well as for checking the physical condition of each man to determine his fitness for further overseas duty. The team as a whole was responsible for checking the administrative condition of medical units and detachments. The divisional units received medical care through their organic medical battalions, with the clearing company providing dispensary service.
Fifth Army also operated dental clinics at Montecatini, Florence, and Cecchignola, where every effort was made to send the men out in first-class dental condition whether they were homeward bound or destined for the Pacific. The largest of the clinics--that at Montecatini--was staffed by thirty dental officers, assisted by both U.S. and German dental technicians.
Hospitalization at Montecatini was supplied by the 182d Station Hospital and by the 94th Evacuation, which moved to the center from Carpi on 16 May. All facilities of the 94th except a dispensary were closed out late in June, and the 182d was relieved at that time by a detachment of the 70th General Hospital under PBS control. The other centers were supplied with hospitalization exclusively by PBS units from the start. The Florence center was initially supported by the 55th Station Hospital at Pratolino; then by the 225th Station, a detachment of the 70th General, and a detachment of the 64th General, which succeeded one another in that order. The 105th Station at Pisa and its successor, the 55th, were available to the Viareggio bivouac of the 92d Division, which also made use of hospitals in Leghorn. Two platoons of the 35th Field Hospital that opened at Sparanise on 8 July had Brazilian medical personnel attached to serve the nearby Brazilian redeployment center. The Volturno area was served by the 154th Station at Caiazzo; and the Cecchignola center received hospital sup-
4 Principal sources for this section are: (1) Annual Rpt, Surg, Fifth Army, 1945; (2) Final Rpt, Plans and Opns Off, Off of Surg, MTOUSA; (3) Unit rpts of div surgs and organic med bns; (4) Unit rpts of hosps mentioned in the text.
port from the 40th Station and its replacement, a detachment of the 37th General Hospital. The 34th Station was also available if needed.
Other features of the Fifth Army medical service for staging troops were the operation of dispensaries and prophylactic stations in rest areas, and the sanitary inspection of hotels and restaurants in the large cities of northern Italy to which leaves were granted.
Hospitalization and Evacuation
At the theater level, hospitalization and evacuation of the sick and injured continued to be the primary mission of the medical service as long as American soldiers remained in the Mediterranean. Both functions, however, were sharply curtailed in keeping with the improved health status resulting from the cessation of hostilities and the subsequent reduction of troop strength.
Contraction of Hospital Facilities
The problem facing the MTOUSA and PBS surgeons when the redeployment period began was one of keeping a safe number of fixed beds in the areas of troop concentration and a balanced distribution of facilities and specialized personnel, at the same time closing out hospitals to meet the redeployment schedule and readjusting personnel in order to staff with low-score men units tabbed for further combat. It was not an easy task, but it was accomplished smoothly and with few delays.
Since the bulk of the U.S. forces were in northern Italy, hospital facilities in the Naples area were the first to be surplus to theater needs. One 500-bed station hospital--the 52d--was closed the day after the war in Italy ended, and earlier plans to re-establish the unit at another location were abandoned. The 118th Station closed on 20 May and the 106th four days later, leaving only the 21st Station and the 17th, 45th, and 300th Generals in Naples, with an aggregate Table of Organization bed strength of 5,500.5
In Rome a readjustment was made when the 500-bed 73d Station Hospital was reassigned to PBS from Rome Area on 25 May, preparatory to closing, and the 250-bed 34th Station was transferred to the Rome Area jurisdiction. It was possible to release only one of the Leghorn hospitals in May--the 114th Station, which closed on the 29th. The 114th, which had been the PBS psychiatric hospital since its arrival in Italy almost a year earlier, had been receiving patients in diminishing numbers for several weeks.
Also closed in May were the 225th Station Hospital at Fano and the 35th Field Hospital, whose platoons had been operating separately at Lecce and Erchie in the heel of Italy and at Rimini on the western coast of the Adriatic. Both of these hospitals, however, were scheduled for new assignments under PBS after termination of their attachments to the Adriatic Base Command.
The 225th Station was in fact the key to a difficult situation in the Florence area, where the 24th General Hospital was required to vacate its quarters not
5 Principal sources for this section are: (1) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA; (2) Med Sitreps, PBS, May-Oct 45; (3) Unit rpts of hosps mentioned in the text; (4) ETMD`s of the hoops mentioned in the text for May-Oct 45
later than 1 June to make way for the redeployment and training center. A minimum of 500 beds would be required to support the center, but no suitable site was available in Florence. Permission to use the theological seminary building occupied during the North Apennines Campaign by the 15th and 94th Evacuation Hospitals was refused by the archbishop of Florence. The only practical solution was to replace the 250-bed 55th Station at Pratolino with a larger unit. Additional space was provided by converting a nearby villa into officers quarters and turning an enclosed porch into a ward. On 9 May, ten days after it closed at Fano, the 225th began taking over from the 55th by infiltration. By 1 June, when the 24th General moved out of the area, the 225th was in full operation with facilities for 750 beds.
The process of readjustment and contraction was accelerated in June. In southern Italy the 45th General Hospital--last installation in the Naples medical center--closed on 9 June, and on the 21st replaced the 26th General at Ban as an ABC unit. On 10 June the 262d Station Hospital at Aversa was relieved by a platoon of the 35th Field. The 34th Field closed its 1st Platoon at Spinazzola on 5 June and its 2d and 3d Platoons at Cerignola ten days later, the latter being replaced by the 2d Platoon of the 4th Field. In Rome, the 73d Station closed on 18 June.
In northern Italy, the 81st Station at Leghorn and the 74th at Bologna both closed on 20 June. On 25 June the 500-bed 105th Station, having evacuated all but sixty of its Russian patients to their homeland, was replaced by the 250-bed 55th Station. The 55th was able to send the remaining Russians home by 28 June. Also on 25 June, the 182d Station closed at Montecatini and the 225th ceased operations at Pratolino. Both units were replaced by 500-bed detachments of the 70th General Hospital, which ceased taking patients at Pistoia at that time.
July saw the closing out of another 6,000 fixed beds in Italy and further readjustment to provide adequate coverage. The 1st and 2d Platoons of the 35th Field Hospital opened at Sparanise in support of the Brazilian redeployment center on 8 July, and on the 12th the 70th General moved its headquarters from Pistoia to Pratolino. The major shutdowns began with closing of the 2,000-bed 12th General at Leghorn on 7 July. On the 18th the 60th Station at Senigallia was relieved by the 4th Field. The 103d Station closed at Pisa on 20 July, its place being taken by the 99th Field, whose scattered platoons were brought up from Grosseto, Castagneto, and Empoli.
The 40th Station closed at Cecchignola redeployment center south of Rome on 21 July, replaced by a detachment of the 37th General from Mantova. On the same day the 32dStation closed at Caserta, where it was relieved by a detachment of the 300th General. The 21st Station closed in Naples on 23 July, and the 6thGeneral closed at Bologna the following day. The 750-bed 7th Station Hospital closed in Leghorn on 26 August, and by the end of the month the 154th Station at Caiazzo and the Cecchignola detachment of the 37th General were also closed.
As of 1 September, nearly four months after the end of the war in Italy, there remained 14,350fixed beds in MTOUSA, including the 16th Evacuation
Hospital and the 15th Field Hospital, which were assigned to PBS from Fifth Army at that time.6
Of this total,2,400 were attached to the Adriatic Base Command and 250 were assigned to Rome Area, the remainder being PBS units. In terms of distribution, 3,900 beds were in the Naples-Caserta area; 3,000 in Leghorn; 2,000 in the Bari-Foggia area serving Air Forces units. There were 2,150 beds in the Arno Valley between Florence and Pisa; 1,500 in Mantova; 750 at Udine;400 at Senigallia; 250 in Rome; and 100 each at Milan, Desenzano, and Bolzano.
The authorized ratio of fixed beds to troop strength for the theater was lowered from 6.6 to 4 percent on 15 September, and a further exodus of hospitals followed. The 33d, 37th, 45th, and 70th General Hospitals, the 16th Evacuation, and the 4th Field were closed on or before 1 October. The closing of the 17th General and 35th Field Hospitals in October and the 64th General in December left the Mediterranean theater with a total of 3,800 beds at the end of the year.
During the redeployment period hospitalization in base installations followed a predictable pattern. The three fixed hospitals in the Po Valley were largely occupied through May and June with prisoners of war, many of them with neglected battle wounds. General hospitals foremost in the line of evacuation from the combat zone, notably the 24th at Florence and the 70th at Pistoia, carried a heavy surgical load during May, but the backlog of battle wounds was largely caught up by the end of the month. In the Naples and Leghorn areas, general hospitals reported rises in venereal cases and in common respiratory and intestinal diseases, owing primarily to the closing out of the station hospitals that normally handled such cases. Hospitals serving the redeployment centers noted a considerable rise in neuropsychiatric cases as a result of the rigorous screening of personnel for Category II units. There were otherwise no significant disease trends, and admissions remained well below capacity despite the continuous reductions in bed strength.
With both mobile and fixed hospitals scheduled for early redeployment, it was necessary to accelerate the evacuation process by every possible means. The backlog of U.S. battle casualties was largely cleared from the army area by the middle of May, while ZI evacuation alone during that month released more beds than were required for new admissions. A continuing process of moving ZI patients to Naples and of concentrating communications zone cases in smaller and smaller numbers of hospitals made intratheater evacuation also a continuous process.
Intratheater Evacuation- the period between the ending of hostilities in Italy and the dissolution of Fifth Army it is impossible to separate evacuation from army hospitals and patient transfers from one base hospital to another. The bulk of the battle casualties were cleared from the Po Valley by the middle
6 The difference between 14,350 fixed beds on 1 September 1945 and 13,950 as given in Appendix A-6 for 31 August is represented by the 400 beds of the 15th Field Hospital, assigned to PBS on 1 September.
of May, using planes exclusively to carry the men back to base hospitals in the Florence and Leghorn areas. More than 1,300 U.S. and Allied patients were flown out of the Po Valley between 2 and 15 May. (Table 38) Flights from Bologna, however, carried patients from the two PBS hospitals in that city as well as from the army field and evacuation hospitals. 7
Air evacuation began both from Bo-
7 Principal sources for this section are: (1) Final Rpt, Plans and Opns Off, Office of the Surg, MTOUSA; (2) Med Sitreps, PBS, May-Sep 45; (3)Med Hist, 802d MAETS
logna and from Villafranca airfield south of Verona about 2 May, and shortly thereafter from Treviso and Milan. In June planes of the 802d Medical Air Evacuation Transport Squadron began lifts from the Udine area, but by this date the number of patients to be evacuated was small. The squadron became inoperative in June, and its sister squadron, the 807th, in August.
The only unusual incident in evacuating from Fifth Army units occurred late in May in the San Remo area along the Italian Riviera, where the 34th Division was engaged in patrol activities. Authorization was requested and received from SHAEF to evacuate patients from this area to the 78th Station Hospital at Nice, France, an ETOUSA unit that was only thirty-five miles away, whereas the nearest MTOUSA hospital was the 2d Platoon of the 32d Field in Turin, more than 150 miles away.
Early in May some 500 patients were evacuated by hospital train from Florence to Leghorn to provide beds for new casualties coming from across the Apennines, and later in the month approximately 800 more were flown from Florence to Naples to clear the 24th General Hospital for closing. Patients from Pratolino, Pistoia, and Montecatini continued to go by rail to Leghorn during June and July, as hospitals in those areas were contracted or as patients were screened for evacuation to the zone of interior, with a smaller number going direct to Naples by air.
ZI patients from Leghorn were sent to Naples by hospital ship. More than 1,800 were evacuated by this means in May, 550 in June, and over 800 in July. Both rail and hospital ship evacuation within the theater were discontinued in the latter month, all intratheater evacuation thereafter being by air. By this date only a relatively small number of long-term patients remained, and evacuation had been reduced to transportation of routine illness and injury cases among garrison troops to the nearest fixed hospital.
Evacuation to the Zone of Interior- An essential preliminary to redeployment of hospitals and other medical units in the Mediterranean was to reduce the number of patients in fixed hospitals as rapidly as possible. As early as 15 April 1945, when the Po Valley Campaign was just getting under way, the problem was studied with a view to speeding up the evacuation process. It was determined at that time that of the more than 15,000 patients then in MTOUSA hospitals, 2,400 more could be evacuated to the zone of interior on a 60-day policy than could be sent home on the 120-day policy then in effect. A 60-day policy, moreover, would increase future ZI dispositions by 65 percent.8
The evacuation policy was reduced accordingly to 60 days beginning on 1 May 1945. The change was immediately reflected in a sharp rise in ZI evacuation, which reached a total of 4,428 for U.S. Army patients for the month, compared with 1,761 in April. The backlog of ZI patients had been so far reduced by the end of May that one plane a day, carrying 18 litter patients, was deemed sufficient for priority cases. Early in July, when air transports with comfortable reclining seats became available, litter and ambulatory loads were alternated. Non-
8 Principal sources for this section are: (1) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA, 1945; (2) Theater ETMD`s for May-Dec 45; (3) Med Sitreps, PBS, May-Oct 45.
priority cases continued to be evacuated by hospital ships and troop transports.
The arrangement under which all ZI evacuation by sea from southern France was under control of Allied Force Headquarters in Italy was terminated on July, each theater thereafter being given a separate allocation by the War Department.
By the beginning of August, three months after the termination of hostilities, the number of patients in MTOUSA hospitals was low enough to justify reversion to a longer period of hospitalization in the theater, and a 90-day policy was instituted. On 9 August the War Department requested resumption of the 120-day policy, to coincide with that in effect in ETO. A MTOUSA request that 60 days be substituted for patients with point scores above the critical level was denied, and the 120-day policy went into effect on 19 August.
The last of the U.S. battle casualties was evacuated to the zone of interior in August, and the last of the Brazilian patients was returned to his homeland in September.
The only unusual incident in evacuating patients from the theater during this period occurred in June, when three planes of the 807th Medical Air Evacuation Transport Squadron carried the first consignment of Russians from the 105th Station Hospital at Pisa to Bruck, Austria, for repatriation. On arrival at Bruck, which was in the British zone but close to the area of Russian occupation, it was found that no preparations had been made to receive the patients, and the pilots were directed to go on to Vienna. There Russian authorities were not only reluctant to take the patients, they were almost equally reluctant to let the American planes and crews return to Italy. 9
9 (1) Hist,807th MAETS, 1945. (2) Annual Rpt, 105th Sta Hosp, 1945.
Evacuation from the Mediterranean theater to the zone of interior from May through December1945 is summarized in Table 39.
Hospitalization and Repatriation of Prisoners of War
Throughout the campaign in Italy sick and wounded prisoners had been hospitalized in base installations in or adjacent to prisoner-of-war enclosures. Long-term cases had been evacuated to the German POW hospital near Oran or, until the end of October 1944, to the United States, but the bulk of them had been hospitalized in the Peninsular Base Section. The German-staffed POW hospital had been moved to Florence in March 1945, so that by the launching of the Po Valley Campaign all German prisoners in the Mediterranean theater were hospitalized when necessary by PBS.
As of this date, the installations pri-
manly devoted to care of German prisoners were the 334th Station Hospital (German) at Florence, and the 103d Station at Pisa. The 81st Station at Leghorn had 250 T/O beds devoted to the care of prisoners, and the 262d Station at Aversa in the Naples-Caserta area became exclusively a POW hospital late in April. Small numbers of prisoners were hospitalized temporarily in most of the fixed hospitals in northern Italy. Italian prisoner and cobelligerent personnel continued to be cared for primarily at the 7029th Station Hospital (Italian), located from early March at Pisa.
As the Po Valley Campaign neared its climax, it was clear that prisoners would run into the hundreds of thousands, and that special provision, including the full utilization of all enemy medical facilities and personnel, would be necessary to hospitalize the sick and wounded among them. After the first captured hospital was dismantled and sent to the rear by the 10th Mountain Division, orders were issued late in April that all German hospitals and hospitalized personnel were to be left where they were, under suitable supervision. It was hoped that all German casualties could be cared for in these installations, but the speed with which the campaign came to a close and the disorder of the German forces, including the medical establishment, forced the transfer of additional thousands to base hospitals before the German medical service could be reorganized under Fifth Army control.
For medical purposes, no distinction was made between prisoners of war, defined as those taken in combat, and surrendered personnel, meaning those turned over by their commanders after the termination of hostilities. The two groups were given the best medical care available, both in the army area and in the base section. The only real distinction was that prisoners in base hospitals were cared for primarily by U.S. medical officers, with some assistance from German protected personnel, whereas in the army area all medical care after the first few days was by Germans in German hospitals, with American officers performing only a supervisory function.
When a complete count was made, as of 15 June, the U.S. share of the more than half million prisoners taken in Italy since Salerno was 299,124, of whom 147,227 were under Fifth Army control and 151,897 belonged to the Peninsular Base Section. The health of these prisoners, who were used to replace American and Italian service troops, was the responsibility of the Fifth Army and PBS surgeons.
Hospitalization in the Army Area
When Fifth Army took over the German medical service at the end of the war, field units, disorganized and for the most part inadequately staffed and supplied, were scattered over northern Italy. The main concentration of German fixed hospitals was at the resort town of Merano close to the Austrian border northwest of Bolzano, with a smaller concentration at Cortina d`Ampezzo, about forty miles east of Bolzano. In both of these areas, facilities were more than adequate Hospitals were fully staffed and equipped to operate without U.S.assistance.10
10 Except as otherwise noted, this section is based on: (1) Fifth Army History, vol. IX; (2) Annual Rpt, Surg, Fifth Army, 1945; (3) Delaney, Blue Devils, pp. 234-46.
In accordance with AFHQ instructions, all German hospitals and patients were held where they were when captured, pending detailed analysis of the situation. Colonel Camardella, designated by General Martin to supervise the hospitalization and evacuation of prisoners of war in the Fifth Army area, began an inspection of German medical facilities on 3 May. He found 10,000 patients at Merano, 5,000 at Cortina d`Ampezzo and another 5,000 in German field units and in American and civilian hospitals in the army area. There were surplus supplies at Merano, and equipment for making all kinds of prosthetic devices at a Luftwaffe hospital on Lake Como. The German medical high command at Merano, feeling deserted by its own army and in constant fear of reprisals by Italian partisans, was only too eager to co-operate.
Fifth Army kept enemy formations intact insofar as possible. Personnel not in organized units were grouped into self-sustaining organizations or attached to units still retaining some semblance of cohesion, and all were collected into concentration areas. The largest of these was set up at Ghedi, about twenty miles southwest of Desenzano and a somewhat shorter distance south of Brescia. A smaller concentration area was located at Modena, with others of lesser impor-
tance at Parma, Piacenza, Montichiari, Brescia, and Verona. Sanitation of all prisoner enclosures in northern Italy was under the supervision of Maj. Frank H. Connel. In the first few days after the surrender it was necessary to remove truckloads of refuse, and to dust all prisoners with DDT powder for body lice. Typhus inoculations were also given.
Plans called for the early movement of all German prisoners to Ghedi and Modena, with a parallel concentration of medical facilities. Hospitals of 100 beds or less were to be merged with larger units, and patients were to be shifted as rapidly as possible to the larger hospitals. As soon as adequate lines of communication could be established, all long-term prisoner patients were to be concentrated at Merano.
During the period of consolidation, one or more medical officers of the 2d Auxiliary Surgical Group were stationed at each of the German hospitals to keep a check on the number of patients and their care. As had been the case at Merano, German doctors for the most part were so anxious to disassociate themselves from the Nazis that willing co-operation was assured. No attempts to evade or mislead in any particular were noted. A German increment, with two medical officers, was attached to Fifth Army headquarters, and the German
Director of Medical Services aided in the assignment and disposition of enemy medical units.
Through May the 85th and 88th Divisions guarded captured dumps in the mountains and moved surrendered German forces to initial concentration areas. Guard duty at Ghedi was performed by the 10th Mountain Division until 18 May, and thereafter by the 71st Antiaircraft Brigade with the 442d Infantry regiment under its command. The 88th Division took over all guard duties when it became the theater prisoner of war command. By this time all prisoners in the Fifth Army area had been moved to Ghedi or Modena. Some 80,000 entered the Ghedi cages in the week of 17-24 May alone. Modena was considerably smaller, being limited to about 20,000 by poor drainage.
Medical service at Modena was supplied by German doctors under supervision of the 15th Field Hospital`s 3d Platoon. At Ghedi a 1,600-bed tent hospital was erected, staffed entirely by German medical units nominated by the German Director of Medical Services. Lt. Col. (later Col.) Harris Holmboe was General Martins choice for medical coordinator in the Ghedi area. The Modena and Ghedi hospitals were to care for personnel in the prisoner of war enclosures only, and were not a part of the consolidation plan.
By the end of May about 80 percent of all German medical personnel, equipment, and patients had been transferred to Merano and Cortina d`Ampezzo. A German-staffed 1,500-bed convalescent hospital was established the first week of June at Villafranca, under supervision of the U.S. 3d Convalescent Hospital. Patients expected to recover within four weeks were transferred here from Merano and Cortina, and on recovery were moved to the Ghedi POW enclosure. By 15 June, six weeks after the victory, all German hospitals under Fifth Army control had been closed except Merano, Cortina, the convalescent facility, and the units serving the Modena and Ghedi areas. In another two weeks the hospitals at Cortina d`Ampezzo were also cleared to Merano and closed. The convalescent hospital was disbanded on 17 July. German medical supplies and equipment were stored at Merano and Ghedi, while German hospitals andother medical units, as they became surplus, were held at Ghedi for shipment to Germany or Austria on call.11
At the end of June there were about 12,000 patients in the German hospitals at Merano, administered by the 380th Medical Collecting Company of the 54th Medical Battalion. There were about 4,000 members of the German medical service in the town. Many items of medical supply were manufactured there, and 9,000 tons were stored. Supplies not needed to care for patients at Mera no were shipped to PBS and to British bases for use in treatment of German personnel. The town itself was run by the 88th Division under strict military control.
Merano offered an excellent opportunity to evaluate German medicine, about which little had been known since the Nazi regime had come into power. Consultants and medical investigators from all parts of the theater and from
11 (1) Annual Rpt, Surg. Fifth Army, 1945. (2) Ltr, Stayer to cots MTOUSA, l3 Jun45. (3) Ltr, Standlee, Acting Suing, MTOUSA, to Deputy Theater Comdr and CofS MTOUSA, 17 Jul 45.
the United States visited the area during the period of its heaviest operation. The conclusion was general that while the German medical service was adequate, its standards "were only mediocre in comparison with those of the Allied Forces in Italy."12
Hospitalization of Prisoners in PBS Units
For a week or more after the close of hostilities in Italy, prisoner of war patients continued to be evacuated to PBS hospitals, pending survey and reorganization of the German medical service in the Fifth Army area. The 103d Station Hospital at Pisa had a peak load of 1,162 prisoner patients on 5 May. The 37th General, when it opened in Mantova on 9 May, received more than 1,000German patients by transfer from the 15th Evacuation Hospital, and others continued to be admitted to the 74th Station and the 6th General at Bologna.13
In order to relieve the pressure on hospitals in the forward area, about 700 prisoner patients were evacuated from the Po Valley to Florence, where the German-staffed334th Station Hospital was expanding its capacity from 500 to
12 Annual Rpt, Surg, Fifth Army, 1945, p. 44.
13 Principal sources for this section are: (1) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA; (2) Med Sitreps, PBS, May-Oct 45. (3) Theater ETMD`s, May-Oct 45. (4) Unit rpts of individual hosps mentioned in the text; (5) ETMD`s of individual hosps mentioned in the text.
1,600 beds. This unit reached a peak census of 1,522 about the end of May. Both the 81st and 114th Station Hospitals in Leghorn took additional prisoner patients early in May, and three train-loads were moved from Leghorn to Naples. The bulk of these went to the 262d Station Hospital at Aversa, but one consignment of about 300 was temporarily cared for at the 21st Station in Naples, being transferred to the 262d before the middle of the month.
German medical personnel were utilized to the extent available by all of the PBS hospitals caring for prisoners. The 37th General inherited 70 German medical officers and 400 enlisted men from the 15th Evacuation. Only a few German protected personnel were used by the 74th Station and the 6th General in Bologna, but the 103d Station at Pisa had 26 German medical officers, 31 female nurses, and 401 enlisted men by the end of May. The 262d Station at Aversa had 121 German technicians who were used as assistants to U.S. personnel. In addition to these groups, fully organized and equipped German units, corresponding to the American field hospital platoons, were established in the various prisoner of war stockades under PBS control, where they furnished dispensary and infirmary service.
Prisoner admissions were predominantly battle casualties during the early part of May. Wounds had frequently been neglected or inadequately dressed, and the initials train on surgical staffs of the hospitals treating them was severe. The 334th Station maintained a blood bank for prisoners, the donors being drawn from the PBS prisoner of war enclosures. At the same time the medical services of the various POW hospitals treated many conditions not common among U.S. troops that arose out of a background of malnutrition, insanitary conditions, and the older age level of the German Army.
The hospitalization of prisoner patients in PBS was stabilized by the first week of June, when the 88th Division became the MTOUSA prisoner of war command. In the Naples area, the 3d Platoon of the 35th Field Hospital relieved the 262d Station on 8 June, taking over 487 prisoner patients and a newly arrived German field unit consisting of 6 medical officers, a dentist, a pharmacist, an administrative officer, 4 nurses, 6 nurses` aides, and 82 enlisted men. The 114th Station in Leghorn was already closed, and the 81st Station in the same city and the 74th in Bologna were preparing to close. At the end of June the 37th General still had more than 1,000 POW pa-
tients, and the 6th General had about 800. Approximately 1,000 German patients remained in the 334th Station Hospital at Florence and about 750 in the 103d Station at Pisa. The 35th Field at Aversa had about 500 prisoner patients.14
Evacuation of long-term cases to Merano began on 25 June from the 37th General Hospital and from other PBS prisoner of war hospitals early in July. Thereafter the prisoner of war census in PBS hospitals declined rapidly. The 103d Station was relieved at Pisa by the 99th Field on 20 July, transferring 602 German patients at that time. By the end of the month 37th General had only 341 prisoner patients, and the census of the 334th Station was down to 570. Both of these hospitals were closed on 13 September, leaving the 35th Field at Aversa and the 99th Field at Pisa the only PBS units still hospitalizing prisoners of war.
On 25 September responsibility for all prisoners of war under U.S. control in Italy passed from MTOUSA to PBS. At that time there were 268 prisoner patients in the 99th Field Hospital and 453 in the 35th Field, with an additional 1,200 in German units under U.S. supervision. The bulk of these were the routine sick and injured from German service units operating in the theater.
All Italian personnel were formally released from prisoner of war status on 30 June and returned to control of the Italian Government. The 7029th Station Hospital (Italian),which had been hospitalizing Italian prisoners first in the Oran area and then at Pisa since the fall of 1943, closed to admissions at this time, and administrative control over all Italian personnel was vested in the Italian commanding officer of the hospital. All patients were transferred to civilian or Italian military hospitals on 19 July, and the unit closed the following day.15
Repatriation of Long-Term Patients
By the end of May the roundup of prisoners of war and surrendered personnel in Italy was complete. The next step was repatriation, beginning selectively with those whose labor was most essential to restore the German economy and those too old or too ill to be of any productive use to the Allies. Toward this end, a conference was held at Bolzano on 14-16 June between representatives of Allied Force Headquarters in Italy and those of Supreme Headquarters Allied Expeditionary Forces whose responsibility extended to Germany and Austria. Medical representatives at the conference were General Martin and Colonel Camardella for Fifth Army; Maj. (later Lt. Col.) Murray L. Maurer, MTOUSA hospitalization and evacuation officer, for the MTOUSA medical section; Maj. (later Lt. Col.) O. S. Williams of the British component for the medical section of AFHQ; and Col. Conn L. Millburn, Jr., executive officer to the army group surgeon, for the 12th Army Group. SHAFF headquarters sent no medical representative, but Millburn was familiar with ETO`s problems and policies.16
Basic agreements were reached as to numbers to be repatriated on both sides, routes to be used, and tentative target
14 Ltrs, Kane, Surg, MTOUSA POW Comd, to CG MTOUSA, 7 Jul, 6, 28 Sep, 45.
15 (1)Hist, 7029th Sta Hosp (Italian), 27 Jul 45. (2) Med Sitreps, PBS, 15-31,Jul 45.
16 Ltr, Maurer to Standlee, 19 Jun 45, sub: AFHQ-SHAEF Conference at Bolzano, 14-16Jun 45. POW`s, Mar 44-Sep 45.
dates; but the disposition of long-term patients was discussed only briefly at the conference level. More detailed discussions of this problem were held by the medical representatives meeting separately as a subcommittee, and tentative plans were agreed upon. AFHQ was prepared to begin receiving hospitalized Italians from Germany and Austria whenever SHAEF requested, since 4,000 beds were already available in Italian military hospitals. The transfer of German patients from Italy to SHAEF-controlled areas was a more complex problem. Occupation forces were still in the process of adjustment, and beds would not be available until all German patients could be evacuated from the Tyrol region. It was agreed that when SHAEF was ready, long-term German patients from Italy would be moved north by hospital train over the Brenner route, whose much-bombed rail line would soon be in usable condition. The target date selected was 10 July, at which time a meeting between the two medical staffs concerned was to be called by SHAFF to complete final arrangements.
By the time the promised conference of medical officers was held at Wiesbaden, Germany, on 12-13 July, SHAEF had been replaced by United States Forces, European Theater (USFET) . At the Wiesbaden conference, the only representatives of the Allied Forces in Italy were Col. Albert A. Biederman, plans and operations officer in the MTOUSA medical section; and Col. Williams, who spoke for the British component of AFHQ. On the USFET side, forward headquarters was represented by Lt. Col. Joseph XV. Batch and rear headquarters by Col. Fred H. Mowrey. Colonel Millburn and Lt. Col. James E. Sams represented the 12th Army Group, while Col. John Boyd Coates, Jr., and Col. Robert Goldson represented Third and Seventh Armies, respectively. The British-Canadian21 Army Group was also represented in order to arrange the transfer of German patients under British control in Italy.17
The Wiesbaden conference resulted in a firm program for exchange of hospitalized prisoners between the Mediterranean and European theaters. All German patients in U.S. custody were to go by hospital train by the Brenner route to Third Army at Munich, Regensburg, and Furth; and to Seventh Army at Idstein. Beginning 25 July, one train every second day was to go to Third Army, and after 15 August daily trains were to alternate to Third and Seventh Armies. Three Italian hospital trains were to be furnished by Fifth Army(two initially), and two German trains were to be supplied by Third Army.
It was estimated that returns to duty would reduce the total of U.S.-controlled German patients to be repatriated to about 10,000. Beds vacated by these at Merano, up to 3,000, would be used to hospitalize temporarily sick and wounded Italians returned from Germany, for whom responsibility would pass to the Allied Commission on their arrival. Long- term prisoner patients from the Eighth Army zone in Italy were to go to the 21 Army Group under separate arrangements.
Evacuation to Germany began as planned on 25 July, and by the end of the
17 (1) Brief Minutes of conference on Exchange of Medical cases, Wiesbaden, 12 Jul 45. (2) Ltr, Biederman to Standlee, 20 Jul 45, sub: Exchange of Sick and Wounded Between the European and Mediterranean Theaters.
month 1,254 patients had been moved to hospitals in the Third Army zone. The hospital trains used were staffed by German medical officers and corpsmen, under the supervision of an American Medical Administrative Corps officer. On the return trip, the trains carried Italian displaced persons to be hospitalized initially at Merano. The whole process worked so smoothly that Third Army agreed to take a trainload a day beginning 9 August instead of on alternate days. The Third Army quota was filled by the middle of August, all evacuees thereafter going to the Seventh Army.18
By the end of August the total number of long-term cases sent to Germany had climbed to 7,783, and stood at 9,751 as of 25 September, when the Peninsular Base Section took over responsibility from MTOUSA. For all practical purposes, the program was finished, since no more than 500 long-term German patients remained in the U.S. zone of Italy.
Redeployment and Inactivation of Medical Units
At the same time that U.S. long-term patients were being evacuated to the zone of interior on a 60-day policy and the burden of caring for prisoner of war patients was being reduced by consolidation of hospitals and repatriation of those with long hospitalization expectancy, American medical units were being systematically staged for shipment to the Pacific or prepared for inactivation. The Mediterranean theater was contracting even more rapidly than it had grown in the early days of the Italian campaign.
Disposition of Fifth Army Units
The readjustment of Medical Department personnel so that units destined for the Pacific would have only men with low adjusted service rating scores, plus the loss of high-score men to "carrier" units bound for the United States, posed a more difficult problem for the Fifth Army surgeon than even the care of prisoners of war. The Fifth had been the first United States field army activated on foreign soil in World War II, and had been in virtually continuous combat for 19 months when the war ended. Many of its components, including hospitals and medical battalions, had seen still earlier combat with other formations. There was, therefore, a heavy preponderance of high-score personnel in the Fifth Army medical service. Yet 2 of the 8 evacuation hospitals and one of the 3 field hospitals were scheduled for direct redeployment to the Pacific, and 2 more evacuations and a field were listed for indirect redeployment. Three of the 4 medical battalions in Fifth Army were also placed initially in Category II, with about the same proportions holding for other types of medical units.19
18 (1) Annual Rpt, Surg, Fifth Army, 1945. (2) Final Rpt, Plans and Operations Off, Office of Surg, MTOUSA. The figures used here, and in the following paragraph, are from letters, M. M. Kane, Surgeon, MTOUSA POW Command, to Commanding General, MTOUSA, 6, 28 September 1945, in Prisoners of War, March 1944-September 1945. These figures differ both from those given bythe Fifth Army surgeon and from those in the theater ETMD for October 1945,but are believed to be the more accurate.
19 Principal sources for this section are: (1) Annual Rpt, Surg, Fifth Army, 1945; (2) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA; (3) Theater ETMD`s for May-Aug 1945; (4) Unit rpts of the individual med Units mentioned in the text.
The first Fifth Army medical unit to go to the Montecatini redeployment center was the 94th Evacuation Hospital, which arrived on 16 May, a bare two weeks after the end of the war in Italy. The exigencies of the situation, however, required the 94th to go into operation for a time at Montecatini, although it was classified as II-A for direct redeployment to the Southwest Pacific. The 171st Evacuation, scheduled for redeployment to the Pacific by way of the United States, was in Montecatini on 29 May; the 161st Medical Battalion less its collecting and clearing companies, the 32d Field Hospital and the 170th Evacuation all arrived at the redeployment center the first week of June. The headquarters and headquarters detachments of the 162d and 163d Medical Battalions arrived just before the end of June.
By the end of May the Category II-A Medical units--the 94th and 170th Evacuation Hospitals, the 32d Field Hospital, and the 161st Medical Battalion--were staffed with low-score personnel as fully as was consistent with efficient operation. Other Category II units, including the medical battalions and medical detachments of the 91st and 10th Mountain Divisions, had had the bulk of their high-score personnel withdrawn during June, but low-score replacements were insufficient to bring the units up to Table of Organization strength.
By July the personnel situation in Fifth Army was critical. Low-score personnel to fill out the T/O`s of units being redeployed to the still-active war against Japan had of necessity to be drawn from units scheduled for return to the United States and ultimate inactivation. But these Category IV units had already been stripped to a point at which further withdrawals would jeopardize their efficiency, and they were still needed to furnish medical service to the remaining combat formations. A further complication was the refusal of the War Department to" accept the MTOUSA Table of Organization for separate collecting companies that were to be transferred to the Pacific. These companies had been operating with a medical officer and 4 MAC`s. It was now necessary to make all of the 7 companies involved conform to the official Table of Organization, which called for 3 medical officers and 2 MAC`s. The required officers were diverted from the 91st and 10th Mountain Divisions, and replaced from a group of 20 low-score medical officers procured from the European theater, but no more were available from that source. Fourteen Medical Administrative Corps second lieutenants were commissioned from among 60 enlisted applicants, but there remained a shortage of low-score officers in both corps, forcing the retention of high-score men.
The supply of low-score enlisted men was also critical by the end of July--so much so that a requirement for 300 general service enlisted men with point scores below 70, to be used as Pacific replacements, could only be met by drawing100 men from units assigned to the strategic reserve and replacing them with high-score personnel from Category IV units.
The manpower problem was finally solved in early August. To relieve pressure on shipping, a change of policy was inaugurated whereby all Category IV units were to be inactivated in the theater rather than be shipped to the United States for inactivation. High-score personnel from Category IV that
had been scheduled for early shipment and were already inoperative, were sent home as casuals, but those with middle-bracket scores--80 to 90 points--were transferred to late Category IV units, which were thus brought up to strength.
The process of redeployment, meanwhile, had been proceeding according to plan. The Fifth Army veterinary service passed out of existence on 30 June, when the Italian pack mule trains were disbanded and the four U.S.--Italian veterinary hospitals were turned over to the Italian Army. Two weeks later, on 14 July, the 171st Evacuation Hospital sailed for the Pacific by way of the United States. The 32d Field and the 170th Evacuation sailed on 17 and 25 July, respectively, direct to the Philippines; and the 161st Medical Battalion embarked on7 August for the United States en route to a Pacific station. The 94thEvacuation sailed for the Southwest Pacific on 3 August, but was diverted at sea to the United States after word was received of the Japanese collapse.
On 20 August all Category II units still in the theater were ordered returned to the United States for disposition, creating a considerable morale problem since these had already been staffed with low-score personnel who were thus being sent home before the high-score men they replaced. Immediate steps were taken to readjust personnel once more, but not in time to alter the rosters of the 162d and 163d Medical Battalions, already aboard ship.
Other Fifth Army medical units were disposed of rapidly thereafter. The 38th Evacuation Hospital, which had originally been scheduled for return to the United States, had been at the Florence redeployment center since early July, and the 56th Evacuation, which was to be a Pacific reserve unit, had arrived at Montecatini on 6 August. The 38th was inactivated in the theater on 8 September. The 56th was sent home for inactivation early in October.
The 15th Evacuation and the 3d Convalescent both closed for redeployment on 20 August, while the 54th Medical Battalion and the 601st Clearing Company moved to Florence for final disposition on 25 August. The 33d Field Hospital, which had closed on 23 August, was inactivated on 25 September. Only the 15th Field Hospital, the 8th and 16th Evacuation Hospitals, and a few lesser units remained active in the army area when the transfer to PBS took place on 1 September.
Disposition of PBS Units
The redeployment of medical units assigned to the Peninsular Base Section followed a pattern similar to that in Fifth Army. The problem of personnel readjustment was equally difficult, with ten station hospitals and one field hospital in the II-A category for shipment in June, July, and August; and three station hospitals scheduled for transfer to the Pacific by way of the United States in July. A great deal of juggling was necessary, and a few medical officers with ASRSs above the critical level were still on the rosters when the hospitals sailed for their new assignments.20
The first PBS units to leave the Medi-
20 Principal sources for this section are: (1) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA; (2) Med Sitreps, PBS, May-Oct 45; (3) PersLtr, Stayer to Kirk, 31 May 45; (4) Unit rpts of individual med units mentioned in the text; (5) AG record cards of units mentioned in the text.
terranean theater under the redeployment plan were the 106th and 118th Station Hospitals, both of which sailed for Okinawa on 29 June. On 8 July the 52d Station left for indirect redeployment through the United States, and two weeks later the 262d Station and the34th Field sailed for Manila. The 114th and 73d Stations sailed for the United States and ultimate transfer to the Pacific on 20 and 27 July, respectively.
August was the heavy month for redeployment of PBS hospitals, seven 500-bed stations sailing for Southwest Pacific ports between the 11th and 21st of the month. With the abrupt ending of the war in the Pacific, all of these were intercepted at sea and diverted to the United States for disposition. The hospitals concerned and their sailing dates were as follows: 74th Station, 11 August; 81st Station, 13 August, 103d Station, 15 August; 182d and 225th Stations, 16 August; 105th Station, 17 August and 60th Station, 21 August.
After the decision to inactivate Category IV units in the theater, PBS hospitals closed out rapidly. The 4th Field Hospital was inactivated on 10 September. September 15 saw the inactivation of the 7th Station Hospital, the 6th, 12th, and 26th General Hospitals, and the 41st Hospital Train. The 51st Medical Battalion and the 15th Medical General Laboratory were inactivated on 30 September and 25 October respectively. The 33d General Hospital was inactivated on20 September, the 8th Evacuation ten days later, and the 154th Station on 1 October. The 35th Field Hospital and the 17th, 37th, and 70th General Hospitals were inactivated on 25 October, and the 16th Evacuation on 31 October. The veterinary hospitals and veterinary evacuation detachments assigned to PBS were disbanded between July and October.
The 2d Auxiliary Surgical Group, which had been divided between the Mediterranean and European theaters since the invasion of southern France, was reunited in Italy in June and was inactivated at the Florence redeployment center on 14 September.
After the 20 August policy order, only four PBS hospitals left the theater as organized units. These were the 32d, 40th, and 21st Station Hospitals, which sailed for the United States on 22, 24, and 26 September, respectively; and the 24thgeneral, which sailed on 11 October. All four of these hospitals served as ``carrier units, transporting high-score personnel to the United States.
Effect of Redeployment on Supply Services
Not hospitals and medical battalions alone, but medical supplies and equipment as well were redeployed to the Pacific. Each hospital or other medical unit going out was completely reequipped before it embarked. In addition quantities of medical supplies were sent to Pacific ports without relation to the units that would ultimately use them. Supplies and equipment for this purpose were accumulated at the Naples and Leghorn depots as they were turned in by inactivated and nonoperating units.21
Early in the redeployment period all surplus equipment, including hospital
21 Principal sources for this section are: (1) Annual Rpt, Surg. Fifth Army, 1945; (2) Final Rpt, Plans and Opns Off, Office of Surg, MTOUSA; (3) Med Sitreps, PBS, May-Oct 45; (4) Unit rpts of individual med units mentioned in the text.
expansion units, was turned in from both Fifth Army and PBS. As medical units closed for redeployment, all their supplies and equipment were turned in, and the medical material thus accumulated was reconditioned and packed for reissue at the depots. For field and evacuation hospitals from the army area, as much as 70 percent of the nonexpendable items had to be salvaged, and about 30 percent for base section units.
When the war ended in Italy, approximately 9,000 tons of medical supplies were divided almost equally between the Naples and Leghorn depots. Tonnage at Naples dropped to about 4,000 in mid-May, then climbed again to approximately 4,500 by mid-July as more hospitals closed in PBS South. Leghorn tonnage rose steadily to more than 6,000 by mid-July before substantial out shipments were made. Tonnage at both depots was unbalanced, however, and shortage lists grew as time went on, owing to the necessity of keeping hospitals operating at the same time that complete new assemblies for them were being made up and set aside. The end of the war with Japan removed the pressure and left the Mediterranean theater with no
supply problem beyond that of storage until surpluses could be returned to the United States.
The activity of the supply depots did not preclude the redeployment of medical supply units themselves, though it did compel a change of schedule. The 12th Medical Depot Company, serving Fifth Army, was originally placed in Category 11-A for movement to the Pacific in June, but was changed to Category IV when General Martin protested that the army would be left without any medical supply organization. The 12th was assigned to PBS along with other Fifth Army medical units on 1 September, and was attached at that time to the 232d Medical Service Battalion at Leghorn.
The Naples depot, although its tonnage was still climbing, was turned over to a detachment from Leghorn early in June in order to release the 72d Medical Base Depot Company for redeployment. The 80th Medical Base Depot Company, which had been operating the Ban supply depot for the Adriatic Base Command, closed on 10 July, and the 72d and 80th sailed together for Manila on 22 July. The 232d Medical Service Battalion, with the 60th and 73d Medical Base Depot Companies attached, continued to operate the main PBS depot at Leghorn and the sub depot at Naples throughout the redeployment period.
Close-out in the MTO
Through the summer and fall of 1945, while the bulk of the Allied Forces in Italy were being withdrawn, prisoners of war were being returned to their homes, and the medical service was being reduced to a minimum, various organizational changes were made to bring overhead operations into line with requirements. At the same time assignments were changed to make the best use of experienced officers and to replace higher with lower ranks as responsibilities contracted.22
In June Colonel Arnest left the theater, being succeeded as Peninsular Base Section surgeon by his deputy, Colonel Sweeney. Colonel Sweeney was succeeded in late September by Col. William W. Nichol, formerly commanding officer of the 37th General Hospital. At the army level, the transfer of General Martin and accession of Colonel Bruce as
22 Principal sources for this section are: (1) Munden, Administration of the Med Dept in MTOUSA, pp. 189-205; (2) Med Sitreps, PBS, Jun-Oct 1945.
Fifth Army surgeon has already been noted. At the theater level, General Stayer departed in June to assume the duties of health officer for occupied Germany. He was succeeded as MTO USA surgeon by Colonel Standlee, who had been deputy surgeon since the organization of the theater. Colonel Biederman became Standlee`s deputy in July without giving up his now greatly curtailed functions as plans and operations officer.
As of 1 October, Headquarters, Mediterranean Theater of Operations, United States Army, was formally separated from Allied Force Headquarters. On the same date Headquarters, Army Air Forces, MTO, was discontinued, the Army Air Forces Service Command passing to MTOUSA. The functions of the supply section of the MTOUSA surgeon`s office were transferred simultaneously to PBS. Both shifts forecast the final consolidation a month later, when both the Adriatic Base Command and the MTOUSA medical section were discontinued. Colonel Standlee left the theater at that time, but Colonel Biederman remained until the transfer of functions to PBS was complete, well along in December. The Peninsular Base Section then became responsible for medical service for all U.S. forces remaining in the theater, whose boundaries now included Hungary and the Balkans. Colonel Nichol relieved Colonel Standlee late in the year, and thereafter performed the functions of theater surgeon as well as base surgeon.
The Occupation Period
Italy, because of its cobelligerent status, was never occupied in the same sense that Germany and Austria were. Because of border disputes between Italy and Yugoslavia, however, and of the claims of both nations to the important city of Trieste, it was necessary to retain some military forces in the province of Venezia Giulia until late 1947. The 88th Division, which had relieved the 34th at Udine in September 1945, remained as the occupation force and supplied personnel for the Trieste--United States Troops (TRUST),which took over occupation of the Free Territory of Trieste from the British in May 1947. 23
During the 2-yearperiod of occupation, medical support for the 88th Division gradually changed from combat to garrison type. The 313th Medical Battalion, organic to the division, maintained a collecting station in the vicinity of Tarviso, near the Austrian-Yugoslav-Italian border, in support of a combat team until mid-December 1945; and had a clearing station at Cividale, northeast of Udine, which soon took on the characteristics of a post hospital. Before the end of 1946 the medical battalion was operating aid stations that were more like dispensaries in rest areas as far away as Cortina d`Ampezzo and Venice.
The 15th Field Hospital was replaced at Udine in May 1946 by a newly activated station hospital, the 391st, with 400 beds. Evacuation from the 15th Field was by air to Leghorn or Naples, and from the 391st was by hospital train to Leghorn.
Fixed hospital support for the occupa-
23 Principal sources for this section are: (1) Theater ETMD`s for Sep 45-Dec 46; (2) Annual Rpt, Med Activities, TRUST, 1947; (3) Delaney, Blue Devils, pp. 249-72; (4) Komer, Civil Affairs and Military Governmen tin the Mediterranean Theater, ch. XV; (5) Unit rpts of med units mentioned in the text.
tion force, as well as for scattered Air Forces and service units, continued to be provided by PBS, but on a steadily declining scale. With the closing out of the Adriatic Base Command on 1 November 1945, the 500-bed 61st Station Hospital was shifted from Foggia to Leghorn to replace the 64th General, which was preparing for inactivation. The 250-bed 55th Station moved simultaneously from Pisa to Foggia, where it was assigned to the Air Forces about 1 January 1946. The300th General Hospital at Naples, the 34th Station at Rome, and the 99thField at Pisa were the only other fixed hospitals in the theater.
A major cutback in fixed bed strength occurred in May 1946, paralleling the shift from combat to garrison status of the 88th Division. The 99th Field Hospital closed on May and the 300th General on the last day of the month, the latter being replaced by a new unit, the 200-bed 392d Station Hospital. At the same time, the 34th Station at Rome and the 55th Station at Foggia were reduced from 250 to 100 beds, the 55th being reassigned to PBS. As of 1 June 1946, PBS had 800 T/O beds: 100 in Foggia, 200 in Naples, and 500in Leghorn; Rome Area had 100 beds; and the 88th Division had 400.
The supply service was also reorganized in May and June, when the 232d Medical Service Battalion ,and the 60th and 73d Medical Base Depot Companies were inactivated. These units were replaced by the 339th Medical Supply Detachment, which was joined in August by the 57th Medical Base Depot Company. The 339th Medical Supply Detachment was inactivated in January 1947, leaving the 57th Medical Base Depot Company in sole command of the Leghorn depot.
Bed strength in the theater was further reduced early in 1947 by inactivation of the 392d Station Hospital in January and of the 55th Station in April. The 313th Medical Battalion was inactivated on 15 May.
In keeping with the contraction of base section functions, which were .now almost exclusively concentrated in Leghorn, the Peninsular Base Section was disbanded in April 1947, and its installations and responsibilities were transferred to the Port of Leghorn organization. The former PBS-MTOUSA surgeon became Port of Leghorn-MTOUSA surgeon at this time.
Final Disposition of Medical Units
The first step toward a final closing out of the theater came with the signing of the Italian peace treaty on 10 February 1947. The treaty was not formally ratified until 15 September, but in anticipation of that event complete plans for phasing out of all U.S. military installations in Italy within go days of ratification of the treaty were drawn up.24
In accordance with the phase-out plans, the 7th Station Hospital--a 200-bed unit that had been activated at Trieste in May with personnel drawn from the 391st Station and the 88th Division--was turned over to TRUST on 19 September, immediately after news of ratification of the treaty was received. On the same day evacuation of patients from the 391st Station Hospital began, and the hospital was inactivated on 15 October. In Rome, evacuation of patients from the 34th Station Hospital was com-
24 Phase-out Report of the Evacuation of Italy, 3 Dec 1947.
pleted by 27 September, and the unit was inactivated on 9 October. The 61st Station at Leghorn, which had received patients evacuated from the 34th and 391st Stations, had cleared its own wards by the end of October and was inactivated 15 November 1947.
During the same period lesser medical installations were similarly disposed of. Supply surpluses and surplus personnel were transferred to the zone of interior, the European Command, or to TRUST, and the 57th Medical Base Depot Company was inactivated on 8 November. Food inspection detachments, malaria control detachments, ambulance units, and finally prophylactic platoons were disbanded as rapidly as their functions could be closed out.
On 3 December1947, more than five years after the landings in North Africa, a single army transport sailed from Leghorn with all that was left of the U.S. forces in Italy, and the Mediterranean Theater of Operations, United States Army, ceased to exist.