CHAPTER I
Organization and Responsibilities
or Hospitalization
Hospitalization, like other activities of the MedicalDepartment, was planned and supervised by medical officers called surgeons. Thecommander of every non-medical military organization, from headquarters of theArmy in Washington (War Department) to battalions in the field, had on his staffa surgeon whose duties were both advisory and administrative. As a staff officerhe advised on matters affecting the health of all members of a command andexercised technical control (that is, professional and medical as opposed toadministrative and military) over all medical activities under the jurisdictionof his commander. As an administrative officer he also exercised command controlover his own office and in some instances over certain medical units andorganizations such as hospitals.1
The Surgeon General's Position in the WarDepartment
The chief medical officer of the Army was The Surgeon General.2He served as medical adviser to the Chief of Staff and was directlyresponsible to him for the planning and technical supervision of all Armyhospitals. In his capacity as head of a service he commanded, beside thepersonnel in his own Office, medical "field installations" of the WarDepartment. Like the chiefs of other arms and services, such as the Chief ofInfantry, the Chief of the Air Corps, and The Quartermaster General, The SurgeonGeneral was subject to supervision by the War Department General Staff.
The General Staff, while it had no authority tocommand, in actual practice did so, issuing directives and orders and approvingor disapproving recommendations of The Surgeon General. In such instances itacted in the name of the Chief of Staff or the Secretary of War. The Staff hadfive divisions, each of which repre-
1(1) AR 40-10, MD, The MC-Gen Provisions, 6 Jun 24. (2) Blanche B. Armfield, Organization and Administration (manuscript for a companion volume in this series), has a full discussion of the organization of the Medical Department.
2The War Department capitalized the definite article in the formal designations of certain general officers, presumably to distinguish them from others with similar titles.
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sented a functional grouping of duties of the Chief of Staff.They were the Personnel (G-1), Military Intelligence (G-2), Organization andTraining (G-3), Supply (G-4), and War Plans (WPD) Divisions. The Supply Divisionwas charged by Army regulations with the preparation of plans and policies forhospitalization and evacuation and the supervision of such activities. Inpeacetime it limited itself in this field primarily to matters of constructionand supply. The Personnel Division handled matters pertaining to personnel thatwere Army-wide in scope; the Organization and Training Division, those relatingto the organization, training, and use of field units. Direct communicationbetween divisions of the General Staff and any chief of service (such as TheSurgeon General) was authorized by Army regulations, but formal requests anddecisions were normally channeled through the Office of The Adjutant General,the War Department's office of record.3
In the latter part of 1940, after mobilization began, medicalofficers were assigned to several War Department agencies having a directinterest in hospitalization and evacuation. In October 1940 Brig. Gen. (laterMaj. Gen.) Howard McC. Snyder was assigned to the Office of The InspectorGeneral and remained in that position until the end of the war. Shortlyafterward a medical officer was transferred from the Surgeon General's Officeto General Headquarters (GHQ), an organization established in July 1940 tosupervise the training of field forces, including medical units. About the sametime Lt. Col. (later Brig. Gen.) Frederick A. Blesse was placed in the G-4division of the General Staff. During 1941 he was transferred to GHQ and wassucceeded in G-4 by Maj. (later Col.) William L. Wilson.4
The Surgeon General's Office
When President Roosevelt proclaimed the emergency, TheSurgeon General was Maj. Gen. James C. Magee. He had succeeded Maj. Gen. CharlesR. Reynolds the preceding June. Most divisions of his Office had something to dowith hospitalization and evacuation. Particularly concerned was the Planning andTraining Division, headed by Col. (later Brig. Gen.) Albert G. Love. It hadthree subdivisions:
Planning, Training, and Hospital Construction and Repair. Thelast of these operated almost independently, its chief, Lt. Col. (later Col.)John R. Hall, having direct access to General Magee.5This subdivision handled all of The Surgeon General's constructionproblems, estimating bed requirements and planning hospitals. In this work itcollaborated with the War Department's constructing agencies-theQuartermaster Corps and the Corps of Engineers. This subdivision grew from 2officers, 3 civilian architects, and 4 clerks in September 1940 to 4 officers, 4architects, and 7 clerks by the end of 1941.6The remainder of the Planning and Training Division dealt with medical fieldunits. It
3(1) Mark S. Watson, Chief of Staff: Prewar Plans and Preparations (Washington, 1950), pp. 57-84, in UNITED STATES ARMY IN WORLD WAR II, has an excellent discussion of the origin and powers of the General Staff. (2) AR 10-15, Gen Staff, Orgn and Gen Duties, 18 Aug 36. (3) FM 101-5, Staff Officers' Field Manual, 19 Aug 40.
4(1) Armfield, op. cit. (2) Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), pp. 1-32, in UNITED STATES ARMY IN WORLD WAR II, have a discussion of the development of GHQ.
5Interv, MD Historian with Col Love, 27 Aug 47. HD: 000.71.
6Achilles L. Tynes, Data for Preparation of Historical Record of Construction Branch of The Surgeon General's Office during the Expansion Period of the Army and World War II (1945) (cited hereafter as Tynes, Construction Branch). HD.
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estimated the number that would be required and prepared orrevised their tables of organization and equipment. Until GHQ was established inJuly 1940, this Division also supervised the training and use in the UnitedStates of hospital and other medical units. The Finance and Supply Divisionfurnished hospitals with supplies and equipment and allotted them funds for theemployment of civilians. The Military Personnel, Dental, Veterinary, and NursingDivisions handled military personnel and certain professional matters. TheProfessional Service Division established policies for medical care andtreatment and issued technical directives to maintain professional standards.7
In recognition of the growing importance of problems ofhospitalization during mobilization, a Hospitalization Subdivision was set up inthe Professional Service Division in February 1941. Two months later it wasseparated and became the Hospitalization Division. Lt. Col. (later Col.) HarryD. Offutt was made its chief and continued in that capacity throughout GeneralMagee's administration. Established with one officer and one clerk, thisdivision expanded to three officers and three clerks by the end of June 1941.Although it was charged with the development of plans and policies forhospitalization and evacuation through liaison with other divisions of theSurgeon General's Office, it had neither the authority nor the staff to makecomprehensive plans and coordinate the actions of others in making such planseffective.8
The Surgeon General's Control Over Hospitals andHospital Units
While all hospitals were under the technical supervision of TheSurgeon General, not all were subject to the same control by his Office. Thedegree varied according to the command structure of the War Department. Foradministrative purposes the United States was divided into nine corps areas,each in charge of a corps area commander under the jurisdiction of the Chief ofStaff. Overseas possessions were organized into three departments thatcorresponded administratively to corps areas in the United States. All stationsin departments and most in corps areas were under the command-control ofdepartment and corps area commanders respectively. Located within corps areasbut beyond the jurisdiction of their commanders were field installations of theWar Department. They operated directly under the chiefs of various arms andservices in Washington and were therefore called "exempted stations."
Hospitals classified as War Department field installationswere subject to the greatest amount of control by The Surgeon General becausethey were under his command. All general hospitals in the United States were inthis category. In only one instance was an intermediate commander between TheSurgeon General and a general hospital commander. Walter Reed General Hospitalwas under the jurisdiction of the commandant of the Army Medical Center(Washington, D. C.), who was in turn under the command of The Sur-
7Armfield, op. cit.
8SG OOs 32, 13 Feb 41; 87, 18 Apr 41. In an interview on 15 November 1949 Brig Gen H. D. Offutt stated that he never felt handicapped by a lack of personnel in his division. HD: 000.71. In an interview on 10 November 1950 Maj Gen James C. Magee (Ret) stated that no one division could have exercised authority over all factors involved in hospitalization and that vesting such authority in one division would have subordinated other divisions of the Surgeon General's Office to a sort of overlordship. HD: 314 (Correspondence on MS) III.
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geon General. Despite this intermediate step, Walter Reedactually received closer supervision from the Surgeon General's Office thandid other general hospitals, largely because of its proximity. Next in line indegree of control were hospitals of exempted stations of all other services andof all arms except the Air Corps. For example Fort Benning (Georgia), includingits station hospital, was under the Chief of Infantry and Fort Belvoir(Virginia) was under the Chief of Engineers. The chiefs of arms and servicesnormally had no surgeons on their staffs and were therefore prone to referproblems connected with hospitalization to The Surgeon General. He employedcorps area surgeons as his own field representatives to supervise hospitals ofexempted stations. Corps area hospitals, under the command-control of corps areacommanders, were supervised by corps area surgeons in their dual capacities aslocal staff officers and technical representatives of The Surgeon General.Hospitals furthest removed from the latter's influence were those in overseasdepartments, not only because of their distance from Washington but also becausedepartment surgeons did not serve as field representatives of The SurgeonGeneral.9
Although hospitals of the Air Corps were theoretically in thesame class as those of exempted stations of other arms and services, they wereactually in a somewhat different category. The Chief of the Air Corps had in hisOffice a Medical Division, whose head was analogous to a staff surgeon andtherefore assumed considerable authority over Air Corps station hospitals.During 1940 and 1941, as the Air Corps expanded, the number of such hospitalsincreased. Soon after a reorganization of the air forces in June 1941,whichestablished the Army Air Forces and gave it control over the Air Corps, theSecretary of War directed a blanket exemption of all Air Corps stations-new aswell as old-from corps area control. The following October the head of the AirCorps Medical Division, Col. (later Maj. Gen.) David N. W. Grant, was assignedto AAF headquarters and designated "Air Surgeon." This series ofevents tended to separate Air Corps hospitals from other Army hospitals and toplace them more under control of AAF headquarters at the expense of the SurgeonGeneral's Office.10
A shift of responsibility which affected The Surgeon General'scontrol over medical units, including those for numbered hospitals, hadmeanwhile occurred. Until late 1940 certain corps area commanders and surgeonsacted also as commanders and surgeons of the four field armies in the UnitedStates. Corps area surgeons were therefore responsible, under their commandersand The Surgeon General, for supervising the training of field medical units. InOctober 1940, the command of field armies was taken away from corps areacommanders and placed in the hands of separate army commanders responsible toGHQ in Washington. GHQ and army headquarters were charged with the training anduse on maneuvers of all field units. Actually, this transfer of trainingfunctions was not so complete as anticipated,11even though in November 1940 all table-of-
9(1) AR 170-10, CAs and Depts, Admin, 10 Oct 39. (2) AR 350-105, Mil Educ, Gen and Spec Serv Schs-Desig, Loc, and Orgn, 1 Oct 38. (3) Armfield, op. cit.
10(1) Rad MX-F, TAG to CGs of CAs, 27 Jun 41. (2) Ltr, TAG to CofAAF and ACofS G-4 WDGS, 12
Sep 41, sub: Trf of Gen Staff Functions . . . to AAF. Both in AG: 322.2 (6-18-41)(1) Sec 2. (3) Hubert A. Coleman, Organization and Administration, AAF Medical Services in the Zone of Interior (1948), pp. 45-76. HD.
11See below, pp. 43-48.
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organization units in the United States, including those ofthe Medical Department, were either assigned or attached to armies or corps.12
In the changes just enumerated were seeds that wereeventually to grow into bitter weeds for The Surgeon General. Among them werethe trend of the Army Air Forces toward separatism and its development of aseparate set of hospitals, the establishment of medical officers in headquarterson a higher level of authority than The Surgeon General, and the latter'spartial loss of authority over medical field units. Understanding something ofthese changes and of responsibilities and relationships of various WarDepartment agencies, one may now turn to a consideration of the manner in whichthe Army provided hospitalization during the emergency period.
12(1) Greenfield et al., op. cit., pp. 3-4, 6-9. (2) Armfield, op. cit. (3) Ltr, TAG to CGs all Armies, Army Corps, CAs, CofS GHQ, etc., 4 Nov 40, sub: Units Asgd and Atchd to GHQ, Armies, and Corps. . . AG: 320.2 (8-2-40) (4) Sec 3.
