CHAPTER XXV
Evacuation Units for Theaters of Operations
The evacuation units discussed in preceding chapters werethose used primarily in the movement of patients in and to the zone of interior,though some were used also within theaters of operations. Mention has been madeearlier, in chapters showing how the zone of interior provided hospital unitsfor overseas service,1 of otherevacuation units that cared for and transported patients from front-line areasrearward through combat zones to mobile hospitals. Certain aspects of theseunits-such as changes in their organization, personnel, and equipment, and themanner in which they were activated, trained, and used in the United States-needto be considered at this point.
Organization, Personnel, and Equipment
Units designed for the care and transportation of patients incombat zones, as already pointed out,2eitherwere organic elements of larger nonmedical organizations such as infantryregiments and divisions, or were separate units intended for assignment to corpsand armies. Every regiment and every separate battalion of each arm or service,except medical, had a medical detachment as one of its organic parts. While thesize and organization of medical detachments varied according to the size of theunits to which they belonged, their functions remained the same. Aid men of themedical detachment accompanied troops into combat, giving casualties emergencymedical care at the front lines. Its litter bearers then carried casualties,except those still able to walk, back to aid stations where medical techniciansand medical officers treated them for return to duty or prepared them forfurther transportation. Units that were organic elements of divisions-medicalregiments, battalions, or squadrons, depending upon the type of divisionconcerned-collected casualties from aid stations and transported them first tocollecting stations and then to clearing stations farther to the rear, sortingthem at each station for additional treatment and return to duty or forpreparation for further evacuation. Units that were assigned directly to corpsand armies, such as medical battalions and medical regiments, collected andtreated for return to duty or prepared for evacuation the casualties of theirrespective areas. In addition, army evacuation units transported casualties fromdivisional clearing stations to mobile hospitals in army areas and suppliedreinforcements for divisional medical services.
1See above, pp. 38-49, 144-66, 214-37.
2See above, pp. 4, 38-39.
448
While the system of evacuating casualties through the combatzone was not altered in any significant respect during the war, certain changesoccurred both before and during the war in the units operating this system.These changes were designed primarily to achieve mobility, flexibility, andeconomy.
The medical battalion of the infantry division was developedin the prewar years, it will be recalled,3as a result of the emergence of the triangular division to replace thesquare division. The latter's organic medical unit was a medical regimentwhich consisted of a regimental headquarters and band, a headquarters andservice company, a collecting battalion of three companies, an ambulancebattalion of three companies, and a clearing battalion of three companies. Itwas authorized 66 officers and 980 enlisted men to serve a division of 946officers, 12 warrant officers, and 21,314 enlisted men.4The medical battalion, which served the triangular division of 624 officers, 6warrant officers, and 14,615 enlisted men, contained 34 officers and 476enlisted men. It consisted of a headquarters and headquarters detachment, aclearing company, and three collecting companies.5Containing litter bearers, collecting-station personnel, and ambulances, eachcollecting company was capable of supporting a regimental combat team, whetherit operated separately or in close conjunction with the division of which it wasa part.6 Although not designed specifically forthe purpose, this battalion was used also as the evacuation unit for corpstroops. The medical regiment continued in existence, serving National Guarddivisions until they were reorganized as triangular divisions in 1942. Like themedical battalion, it also had a function for which it was not specificallydesigned; that is, it served as an evacuation unit with army troops.7Thus medical battalions and medical regiments could be either divisionalor nondivisional units, depending upon their assignment and use.
A nondivisional medical unit developed in the prewar yearsfor use in the evacuation system, though not in the actual transportation ofpatients, was the medical gas treatment battalion. While other medical units hadsome means of treating at least small numbers of gas casualties, none wasadequately equipped to treat the influx of casualties which might result fromthe use of gas on a large scale. The Surgeon General's Office thereforeprepared a table of organization for a medical gas treatment battalion, and theGeneral Staff approved it despite misgivings that such a unit might duplicatethe functions of other medical units or of the quartermaster sterilization andbath battalion. The medical gas treatment battalion was made up of aheadquarters and three clearing companies. Each of the latter, having two bathand four treatment sections, was expected to bathe and treat gas casualties andto provide them with noncontaminated clothing in preparation for return to dutyor for further evacuation to the rear.8
3See above, pp. 39-40.
4T/O 8-21, Med Regt, 1 Nov 40, and T/O 7, Inf Div (Square), 1 Nov 40.
5T/O 8-65, Med Bn, 1 Oct 40, and T/O 70, Inf Div (Triangular), 1 Nov 40.
6T/O 8-67, Med Co, Collecting, Bn, 1 Oct 40.
7FM 8-5, Med Fld Manual, Mobile Units of the Med Dept, 12 Jan 42.
8(1) Ltr, SG to TAG, 11 Jun 41, sub: T/Os, with 2 inds. AG: 320.2 (6-11-41). (2) Memo, ACofS G-3 WDGS for TAG, 23 Aug 41, sub: T/O for Med Bn, Gas Treatment, with Memo for Record. Same file. (3) T/O 8-125, Med Gas Treatment Bn, 2 Oct 41, and T/O 8-127, Med Clearing Co, Gas Treatment Bn, 2 Oct 41.
449
In the first few months after the United States entered thewar, the tables of organization of existing combat zone evacuation units wererevised and new units were developed for use with new combat organizations.During 1942 the Army Ground Forces experimented with new types of divisions-mountain,jungle, airborne, and motorized.9 Althoughorganizations of these types were used overseas little, or not at all, the factthat some of them were anticipated for use made it necessary for medical unitsto be prepared for them. Therefore, during 1942 tables of organization weredeveloped for appropriate medical units for service with new types of forces.10Concurrently, changes were made in existing units. To indicate the nature ofthese changes, it will suffice to consider revisions in the tables oforganization of three of the more common types: the medical detachment of theinfantry regiment, the medical battalion of the infantry division, and themedical regiment serving the field army.
Unlike the infantry regiment which it supported, the medicaldetachment's enlisted strength increased appreciably-from 96 to 126-whenits table of organization was revised in April 1942. The inclusion of additionalsurgical technicians accounted primarily for this increase. The number ofofficers-eight physicians and two dentists-remained unchanged. Changes weremade at the same time in the transportation authorized for the detachment. Seven1/4-ton trucks (jeeps), seven 1/4-ton trailers, and one2?-ton truck replaced one motorcycle, fourteen ?-ton trucks, and two 1?-tontrucks.11
The infantry division's medical battalion, according toearly plans, was to receive an increase in enlisted men and in vehicles as well.Its table of organization issued in April 1942 called for 8 additional enlistedmen, an increase in Medical Administrative Corps officers from 5 to 8, areduction in Medical Corps officers from 27 to 25, and no change in Dental Corpsofficers (2). The battalion's vehicles, exclusive of trailers, rose from 87 to93. The addition of trucks accounted for this increase, the number of ambulances-36-remainingthe same.12 About the time thistable was published, the War Department ordered a reduction in motor vehicles.13The Surgeon General then decided to use the revised version of the table oforganization of the medical battalion for motorized divisions being organized,and to develop a new table for the medical battalions of infantry divisions.14The new table, submitted for publication in July15but issued with an earlier date, reduced the number of motor vehicles bythirteen. None of the vehicles eliminated were ambulances, and trailers wereadded to replace some of the cargo space lost. Fewer motor vehicles requiredfewer drivers and mechanics, and hence the new table provided for fourteen fewerenlisted men than formerly. In addition, one Medical Corps officer waseliminated, reducing the total for the battalion from twenty-five totwenty-four. The number of Medical Administrative Corps
9Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), pp. 336-50, in UNITED STATES ARMY IN WORLD WAR II.
10An Rpt, Plans Div Opr Serv SGO, 1942. HD.
11T/O 7-11, Inf Regt, Rifle, 1 Oct 40 and 1 Apr 42.
12T/O 8-65, Med Bn, 1 Oct 40 and 1 Apr 42.
13Ltr SPXPC 320.2 (3-13-42), TAG to CGs AGF, AAF, and SOS, 31 Mar 42, sub: Policies Governing T/Os and T/BAs. AG: 320.2 (3-13-42)(5).
14Memo, SG for CG SOS, 6 Jun 42, sub: Changes in T/Os. AG: 320.3 (10-30-41)(2) Sec 8.
15Memo, CG SOS for TAG thru ACofS G-3 WDGS, 16 Jul 42, sub: T/Os, Med Bn. AG: 320.3 (10-30-41)(2) Sec 8.
450
officers (eight) and of Dental Corps officers (two) remainedunchanged.16
The revision of the table of organization of medicalregiments early in 1942 provided for an entirely new type of organization.Instead of having three battalions (collecting, ambulance, and clearing), thenew regiment had two battalions that were similar to the medical battalions ofinfantry divisions, each having three collecting companies and one clearingcompany. The collecting companies of battalions of medical regiments were almostidentical with those of divisional medical battalions, but clearing companies ofthe former differed from those of the latter in having three instead of twoclearing platoons in order to provide increased treatment facilities in armyareas. This revision of the medical regiment was based on two of its functionsas an army unit: the evacuation of divisional clearing stations and thereinforcement of divisional medical services. Having battalions and companiessimilar to those of divisional medical battalions, the new medical regimentwould simplify the problem of supplying reinforcing units to divisions in combatand, it was anticipated, would permit better ambulance evacuation of divisionalclearing stations. This change in the organization of the medical regimentresulted in an increase of Medical Department officers from 66 to 76 and ofenlisted men from 980 to 1,078. It also resulted in an increase in vehicles, thenumber of ambulances rising from sixty to seventy-two.17To provide even more ambulances for field armies, if they should beneeded, and for communications zones as well, The Surgeon General developedabout the same time a table of organization for separate motor ambulancebattalions. It was approved and published in April 1942.18
In the fall of 1942 the need for economy in personnel andvehicles-which, it will be recalled, affected the organization of hospitalunits19-also resulted in changes in thetables of evacuation units. In response to a War Department directive to reducepersonnel and equipment, especially vehicles, in all Army organizations,20AGF headquarters established a Reduction Board in November 1942 to review allAGF-type units and to squeeze out the "fat."21In the process of shrinking the infantry division as a whole, the Board in March1943 cut the personnel and vehicles of both the regimental medical detachmentand the divisional medical battalion. In the detachment 1 medical officer and 23enlisted men were eliminated, leaving 7 physicians, 2 dentists, and 103 enlistedmen. This cut apparently proved too great, for about four months latertwenty-three enlisted men were restored to the regimental medical detachment,bringing the total to 126 for the rest of the war. The only change made in thevehicles of the detachment was the replacement of its 2?-ton truck with a1?-ton truck. As in the case of the cut in enlisted
16T/O 8-15, Med Bn, 1 Apr 42. T/O 8-65, Med Bn, 1 Apr 42, was amended at the end of July to become T/O 8-65, Med Bn, Motorized (C 1, 31 Jul 42).
17(1) T/O 8-21, Med Regt, 1 Apr 42. (2) DF G-3/42108, ACofS G-3 WDGS to TAG, 5 Mar 42, sub: Med Regt, with Memo for Record and memos of explanation prepared by SGO. AG: 320.3 (10-30-41) (2) Sec 8.
18(1) T/O 8-315, Med Amb Bn, Motor, 1 Apr 42. (2) DF G-3/42108, ACofS G-3 WDGS to TAG, 6 Mar 42, sub: T/Os, with Memo for Record and memos of explanation prepared by SGO. AG: 320.3 (10-30-41)(2) Sec 8.
19See above, pp. 131-37, 146-49.
20Ltr, TAG to CGs AGF, AAF, and SOS, 2 Oct 42, sub: Review of Orgn and Equip Reqmts. AG: 400 (8-10-42)(1) Sec 22.
21Greenfield et al., op. cit., pp. 351-63, discusses the Reduction Board and its work.
451
men, this change was reversed in July 1943.22
Reductions made in both the personnel and vehicles of thedivisional medical battalion were more lasting. In March 1943 its Medical Corpsofficers were decreased from 24 to 22 and its enlisted men from 470 to 430, butits Medical Administrative Corps officers were increased from 8 to 11 and itsdentists from 2 to 3. The clearing company of the medical battalion suffered thegreatest decrease in enlisted men, twenty being eliminated, of whom twelve wereorderlies who normally served in the clearing station. In each collectingcompany the number of litter bearers was reduced from thirty-six to thirty-one.The Reduction Board believed that the use of jeeps to evacuate casualties fromthe battlefield warranted this action, but supported the Ground Surgeon inopposing a reduction in the number of ambulances because it believed that twelvewould be needed to evacuate casualties from each regiment and would not beavailable unless included in the table of organization. Nevertheless, thecommanding general, Army Ground Forces, directed a cut of two in each collectingcompany, thereby reducing the number in the entire medical battalion fromthirty-six to thirty. Four other motor vehicles, three of which were commandcars, were also eliminated.23 Cuts were madealso in the personnel and vehicles of other organic medical units, but beingsimilar in nature to those already described, they need not be discussed here.
Although experience in maneuvers and in theaters ofoperations indicated that medical battalions and regiments, organized underexisting tables, were not entirely suitable for use with corps and army troopsrespectively, it remained for the Reduction Board of AGF headquarters toinitiate a change in corps and army evacuation units. The chief cause ofdissatisfaction with existing units was their inflexibility. To provide greaterflexibility, permitting the assignment of collecting, clearing, and ambulancecompanies in any combination required to fit a particular situation, and therebyto promote economy of both personnel and equipment, the Reduction Board inFebruary 1943 proposed the elimination of such large table-of-organization unitsas the medical regiment and the separate ambulance battalion, and thesubstitution of small administratively self-sufficient units, such as companies,which could be grouped for training and tactical use under separate battalionand group headquarters detachments.24 Thisproposal reflected a general trend in the Army Ground Forces "away from theorganic assignment of resources to large commands according to ready-madepatterns, and toward variable or ad hoc assignment to commandstailor-made for specific missions"25-atrend that was to end during 1943 in the disappearance of type armies and corps.In accordance with the Reduction Board's proposal, the Ground Surgeon'sOffice
22T/O 7-11, Inf Regt, 1 Mar 43 and T/O&E 7-11, Inf Regt, 15 Jul 43, 26 Feb 44, and 1 Jun 45.
23(1) T/O 8-15, Med Bn, 1 Mar 43; T/O 8-16, Hq and Hq Det, Med Bn, 1 Mar 43; T/O 8-17, Collecting Co, Med Bn, 1 Mar 43; and T/O 8-18, Clearing Co, Med Bn, 1 Mar 43. (2) M/S GNRQT/24549, sub: T/O 8-16, 8-17, and 8-18, with following comments: CG AGF to Reqmts AGF, 5 Dec 42; Reduction Bd to CG AGF, 8 Dec 42; and CG AGF to Reqmts AGF, 9 Dec 42. AGF: 320.3.
24(1) M/S GNRQT/31566, Reduction Bd to Reqmts AGF, 10 Feb 43, sub: Med T/Os. AGF: 320.3. (2) An Rpt, Surg First Army, 1941. HD. (3) Memo, Ground Surg for CG AGF, 17 Jun 43, sub: [Anal of Rpts from North Africa]. Ground Med files: Chronological file, Folder 1.
25Greenfield et al., op. cit., p. 280. See also pp. 279-99, 351-54.
452
prepared tables of organization for headquarters andheadquarters detachments of medical battalions and groups, and foradministratively self-sufficient collecting, clearing, and ambulance companies.The Reduction Board, staff officers in AGF headquarters, and the Surgeon General'sOffice approved these tables and they were published in May 1943.26Thereafter, instead of being rigid table-of-organization battalions andregiments, evacuation units of corps and armies were flexible battalions andgroups made up of combinations of collecting, clearing, and ambulance companiesthat varied as the situation demanded.27
A further step in the trend toward the formation of smallunits that could be used in variable combinations was the development of tablesof organization for teams or sections that could be grouped together to formplatoons that could be further grouped to form companies. Like other technicalservices, the Medical Department prepared a table of organization for suchunits. The Medical Department table, issued in July 1943, provided foradministrative, depot, motor ambulance, veterinary, and miscellaneous teams orsections. The three ambulance sections provided for by this table had 3, 6, and10 ambulances respectively and could be assigned wherever required. One of themiscellaneous sections, the "attached medical section," was designedto provide medical service for nonmedical battalions that were organic parts oflarger units but were assigned alone to special missions.28
Early in 1944 the general movement already under way toreplace Medical Corps officers with Medical Administrative Corps officerswherever possible affected the make-up of evacuation units also.29In battalion and group headquarters, for example, administrative officersreplaced physicians as operations officers (S-3s). Of perhaps more significancewas the substitution in the medical detachments of combat battalions andregiments of Medical Administrative Corps officers for Medical Corps officers asbattalion surgeons' assistants. The Ground Surgeon concurred in The SurgeonGeneral's proposal to make this substitution in the medical detachments ofcoast artillery, anti-aircraft artillery, engineer, signal, and ordnancebattalions, but he disapproved at first the recommendation that it be extendedto the medical detachments of infantry regiments and tank battalions. The latterorganizations had such a high percentage of casualties, he stated, that areduction of Medical Corps officers in their medical detachments would seriouslyimpair the efficiency of their medical services.30In February 1944, on the advice of the Fifth Army Surgeon in Italy, theGround Surgeon reversed himself on this point. Thereafter, in the medicaldetach-
26(1) M/S GNRQT/31566, sub: Med T/Os, Comment 5, Ground Med Sec to Reqmts AGF thru Reduction Bd, 11 Mar 43; Comment 6, Reduction Bd to CG AGF, 3 [sic] Mar 43; Comment 7, Sec Gen Staff AGF to Ground Med Sec, 12 Mar 43; Comment 8, Ground Med Sec to Sec Gen Staff AGF, 16 Mar 43; Comment 10, Sec Gen Staff AGF to Reduction Bd, 18 Mar 43. AGF: 320.3. (2) Memo for Record, 29 Mar 43, by Ground Med Sec. Ground Med files: Transfer Binder Journal, 1943.
27T/O&E 8-22, Hq and Hq Det, Med Group, 20 May 43; T/O&E 8-26, Hq and Hq Det, Med Bn, Sep, 20 May 43; T/O&E 8-27, Med Collecting Co, Sep, 20 May 43; T/O&E 8-28, Med Clearing Co, Sep, 20 May 43; and T/O&E 8-317, Med Amb Co, Motor, Sep, 20 May 43.
28T/O&E 8-500, Med Dept Serv Orgn, 26 Jul 43.
29See above, pp. 250-51, 280.
30(1) Memo, SG for CG ASF, 25 Nov 43, sub: Conservation of MC Offs. (2) Memo, CG AGF (Ground Med Sec) for CofSA, 22 Feb 44, same sub. (3) DF, ACofS G-3 WDGS to TAG, 1 Mar 44, same sub. All in AG: 320.3 (10-30-41)(2). (4) WD Cir 99, 9 Mar 44.
453
ment of the infantry regiment, for example, there were fiveMedical Corps, two Dental Corps, and three Medical Administrative Corps officersinstead of seven Medical Corps and two Dental Corps officers. One Medical Corpsand one Medical Administrative Corps officer, instead of two Medical Corpsofficers, served with each of the three battalion medical sections. In thedetachment's headquarters there were two Medical Corps officers, instead ofone as formerly, to insure a replacement if needed for one of the battalionsurgeons.31
Further changes were made in existing evacuation units, andnew units were proposed and developed in the latter half of 1944 and the earlypart of 1945. Late in May 1944 a War Department circular directed a reduction inthe number of basic privates in all but a few of the Army'stable-of-organization units.32 Basicprivates were soldiers in excess of the complement of personnel needed toperform the functions for which units were designed and were provided to serveas replacements for losses occurring in the first phases of combat or, when ingarrison, for men who would normally be absent because of furloughs, sickness,and the like. Until May 1944 basic privates represented an addition of about 10percent to the normal operating strength of a unit. In May the War Departmentdirected that they be reduced by approximately one-half. This led to a reductionin the number of basic privates in the medical battalion of an infantry divisionfrom thirty-nine to twenty-two.33 Separatemedical units such as collecting, clearing, and ambulance companies weresimilarly reduced, but medical detachments serving with cavalry and infantrydivisions were exempted.34
In the latter part of 1944 the Ground Surgeon proposedchanges in the evacuation units of both divisions and armies. It had beenrecognized for some time, he stated, that the clearing companies of divisionalmedical battalions needed three-instead of two-clearing platoons, in orderto provide one clearing platoon to work with each of three collecting companiesin support of the three regimental combat teams of each infantry division.Moreover, reports from theaters of operations, according to the Ground Surgeon,emphasized that the collecting-station platoons of separate collecting companieswere not needed in army areas of combat zones. There the need was for morelitter bearers. Likewise, the ambulance platoons of separate collectingcompanies were not required in army areas because separate ambulance companieswere authorized as army units. The Ground Surgeon therefore proposed toeliminate collecting companies as army evacuation units, and to substitute forthem additional separate ambulance companies and separate litter bearercompanies. For the latter he prepared a tentative table of organization. Hefurther proposed that the men and officers formerly assigned tocollecting-station platoons of army collecting companies should be used to formthird platoons for the clearing companies of divisional medical battalions.Despite the fact that the changes recommended were expected not only to improvethe organization of the
31(1) M/S, Ground Med Sec to ACofS G-2 AGF, 8 Mar 44, sub: Proposed Changes in T/O. Ground Med files: Chronological file (Col W. E. Shambora). (2) DF, ACofS G-3 WDGS to TAG, 25 Mar 44, sub: T/O&E 8-500 and 8-550, with Memo for Record on change in WD Cir 99 (1944). AG: 320.3 (10-30-41) (2). (2) WD Cir 122, 28 Mar 44.
32WD Cir 201, 22 May 44.
33T/O&E 8-15, Med Bn, 15 Jul 43, with C 2, 3 Jul 44.
34WD Cir 201, 22 May 44.
454
medical service in division and army areas of combat zonesbut also to save both commissioned and enlisted personnel, the Deputy Chief ofStaff of the Army Ground Forces disapproved the Ground Surgeon's proposal inDecember 1944 because he considered it undesirable to make such changes "atthis late date in the war."35
The question of whether or not the medical gas treatmentbattalion should continue to exist arose in the latter part of 1944. Earlier itstable of organization had been superseded by a table providing for a gastreatment team that was smaller and more restricted in its functions,36but units already in theaters of operations continued in existence. TheTechnical Division of the Surgeon General's Office contended in June 1944 thatthey were not needed because oxygen and drugs could be administered to gascasualties by gas treatment teams and other medical units, the decontaminationof equipment and clothing was not a proper function of the Medical Department,and the ability of gas treatment battalions to locate and decontaminatepersonnel as soon after exposure as necessary was doubtful.37The Ground Surgeon also questioned the utility of such battalions andconsidered them wasteful of personnel.38 Moreover,since gas warfare had not been used, medical gas treatment battalions intheaters of operations had not performed the functions for which they wereintended. Nevertheless, because they had constituted a "convenientreserve," theaters wished to retain them. So also did the Chief of theChemical Warfare Service. In October 1944, therefore, The Surgeon Generalrequested and received permission to revise and reinstate the table oforganization of the gas treatment battalion as an authorized unit.39
One of the uses which theaters had made of gas treatment battalions was tohold and care for patients awaiting evacuation at railheads and airports. Nounit designed specifically for this purpose had been provided, despiteinformation from North Africa as early as the fall of 1943 that they wereneeded,40 and theaters had had to use whatevermeans were available to meet their needs. This practice had been wasteful ofboth personnel and equipment. Early in 1945, therefore, after an inspection ofthe medical service of the European theater by one of his representatives, theAssistant Chief of Staff, G-4, directed The Surgeon General to prepare a tableof organization for a medical holding unit.41The resulting unit, a medical holding battalion authorized in May 1945,consisted of a headquarters and three holding companies, each capable of han-
35(1) Memo for Record, on M/S, Comment 4, Ground Med Sec to ACofS G-1 AGF, 15 Dec 44, no sub. (2) M/S, Comment 1, Ground Med Sec to Gen Staff AGF, 18 Sep 44, sub: T/O&E 8-29 (Proposed) Med Litter Bearer Co, Sep. Both in Ground Med files: Chronological file, Folder 2. (3) M/S, Comment 1, Ground Med Sec for ACofS G-3 AGF, 17 Jun 44, no sub. Ground Med files: Chronological file, Folder 1. (4) Memo, SG for CG ASF, 1 Oct 43, sub: Recomd for Changes in Med Dept Orgn, (SG: 320.3-1) proposed a third platoon for the clearing companies of the medical battalions of infantry divisions. After the war, the third platoon was added (T/O&E 8-18N, Clearing Co, Med Bn, 27 Feb 48).
36T/O&E 8-500, Med Dept Serv Orgn, 23 Apr 44.
37Diary, Tec Div SGO, 17 Jun 44. HD: 024.7 Oprs Serv.
38Ltr, Brig Gen F[rederick] A. Blesse to Col Calvin H. Goddard, 11 Feb 53. HD: 314 (Correspondence on MS) XI.
39(1) Diary, Tec Div SGO, 7 and 14 Oct 44. HD: 024.7 Oprs Serv. (2) T/O&E 8-125, Med Gas Treatment Bn, 11 Nov 44.
40(1) Memo, CG AAF for SG, 17 Sep 43, sub: Aerial Evac of Casualties. (2) Memo, Dir Hosp Admin Div SGO for Dir Plans Div SGO, 22 Sep 43, no sub. Both in HD: 705 "Hosp and Evac (Holding Unit) MTO."
41(1) 2d ind, SG to CG ASF, 3 Mar 45, on unlocated basic ltr. HD: 320.3-1 (T/O&E). (2) An Rpt, Tec Div SGO, FY 1945. HD.
455
dling 300 patients. Had this battalion not been developed solate in the war, its use would have saved manpower, for it was authorized 26officers and 404 enlisted men as compared with 45 officers and 411 enlisted menof the medical gas treatment battalions which some theaters used as holdingunits.42
Changes occurred during the war in the equipment as well asthe personnel and vehicles of evacuation units. Changes in medical supplies andequipment reflected improvements in items already authorized or additions ofitems shown by experience to be needed. For example, early in 1944 an improvedportable field autoclave replaced an older item of that type in the clearingcompanies of medical battalions of infantry divisions. At the same time thenumber of chests of surgical supplies was increased, and portable electricsuction apparatus was added to enable clearing stations to aspirate blood frompleural and abdominal cavities.43 Towardthe end of that year and the early part of 1945 a combined otoscope andophthalmoscope was added to the list of items furnished clearing companies, topermit clearing stations to make better examinations of patients with diseasedor injured ears.44 Other changes were made atintervals in the lists of medical supplies and equipment of evacuation units inorder to improve the standard of emergency medical service under combatconditions.45
Changes were also made in the equipment of evacuation unitsto increase their mobility. For example, early in the war the Medical Departmentdeveloped a pack carrier for battalion medical equipment. This carrier-acanvas container mounted on a wooden frame-permitted the supplies andequipment used in battalion aid stations to be packed in loads (averaging aboutforty pounds each) that could be carried by individuals of battalion medicalsections.46 Later in the war, afteraluminum became available for the purpose, aluminum-pole litters weresubstituted, it will be recalled, for heavier ones made of steel.47Another change contributing to greater mobility in evacuation was thedevelopment of litter racks for jeeps, permitting in many instances thesubstitution of motor for pedestrian evacuation in front-line areas. Althoughsuch racks were produced locally for use by evacuation units much earlier, theywere not included in tables of equipment as standard items until 1945.48
42(1) T/O&E 8-55, Med Holding Bn, 30 May 45. (2) Ltr, TAG to CinC USAF Pacific and CG USAF POA, 5 Jul 45, sub: T/O&E Med Holding Bn. SG: 320.3.
43(1) Ltr, CG AGF to CG ASF thru SG, 10 Nov 43, sub: Proposed Changes in T/O&Es. AGF: 320.3. (2) T/O&E 8-18, Clearing Co, Med Bn, 15 Jul 43, with C 1, 17 Jan 44.
44(1) M/S, Comment 1, Ground Med Sec to ACofS G-4 AGF and Reqmts AGF, 23 Aug 44, sub: Addition to T/Es of Certain Med Units. Ground Med files: Chronological file, Folder 2. (2) T/O&E 8-138, Clearing Co, Mountain Med Bn, 4 Nov 44, and T/O&E 8-18, Clearing Co, Med Bn, 14 Feb 45, for example.
45Examples of these changes may be found by comparing the T/O&Es of various evacuation units.
46(1) An Rpt, Equip Br Tng Div SGO, 1942. HD. (2) Memo, SG for Chief Surg SWPA, 1 Dec 42. SG: 705 (Australia)F. (3) Memo, [Maj] A[lfred] P. T[hom] for Col Shambora, 2 Mar 43, sub: Comments on Lessons Derived from Oprs at Casablanca and Oran. Ground Med files: Chronological file, Training, 1943. (4) T/O&E 7-11, Inf Regt, 15 Jul 43.
47(1) John B. Johnson, Jr., and Graves H. Wilson, A History of Wartime Research and Development of Medical Field Equipment (1946), pp. 75-80. (2) For example, T/O&E 8-16, C 1; T/O&E 8-17, C 3; T/O&E 8-18, C 2, all dated 3 Jul 44.
48(1) Diary, Tec Div SGO, 3 Jun and 26 Aug 44. HD: 024.7 Oprs Serv. (2) The General Board, U. S. Forces, European Theater, Evacuation of Human Casualties in the European Theater of Operations. Study No. 92. HD. (3) T/O&E 8-16, Hq and Hq Det, Med Bn, 14 Feb 45, and T/O&E 7-11, Inf Regt, 1 Jun 45.
456
Efforts to increase mobility by reducing the size and weightof equipment were made in the case of evacuation units, as in that of hospitalunits already discussed.49 During the winter of 1942-43 the cubageof the equipment (including vehicles) of the infantry division's medicalbattalion was reduced from about 1,900 to about 1,475 ship tons, a ship tonbeing 40 cubic feet.50 Information about the cubage of the equipmentof other evacuation units in the fall of 1942 is not readily available, but itis perhaps safe to assume that similar reductions were made in the equipment ofthose units. After the reductions made in the winter of 1942-43, the cubage ofequipment of evacuation units underwent little change until the early part of1945. At that time there seems to have been a tendency for it to increaseslightly. For example, the equipment of the infantry division's medicalbattalion increased in cubage from about 1,475 to about 1,600 ship tons inFebruary 1945. Similar increases occurred early in 1945 in the equipment ofother evacuation units.51
Another measure to increase the mobility and improve thestandard of combat zone medical service was the development by the MedicalDepartment of certain vehicles for special purposes. The organization and growthof the Armored Force made it apparent during 1941 that new types of medicalequipment would be needed. During the fall of that year the Armored Force itselfbegan to experiment with the development of a surgical truck for use as a mobileclearing station. Soon afterward, the Surgeon General's Office securedauthority to initiate a research project in that field. During its course, theMedical Department Equipment Laboratory co-ordinated its developmental work withthe Armored Force, the Surgeon General's Office, and the Quartermaster Corps. The pilotmodel of such a truck was delivered to the Laboratory in July 1942. Called a"truck, surgical," this vehicle consisted of a van body mounted on astandard 2?-ton (6 x 6) chassis. Within the body of the truck were a 50-gallonwater tank; a sink with hot and cold water outlets; cabinets for supplies,equipment, and accessories; and three dome lights. Medical items such as thoseused in clearing stations were supplied and installed by the Medical Department.A tent, large enough to shelter twenty litter patients, was supplied to providespace outside the truck for patients awaiting evacuation farther to the rear.These trucks were delivered on a basis of six per division to all armoreddivisions in the United States during late 1942 and early 1943.52
A surgical operating truck for use by auxiliary surgicalgroups was developed during the latter half of 1943. It differed from thesurgical truck of the armored division largely in that it was supplied withgreater quantities of more elaborate equipment. While the surgical truck of thearmored division had only equipment and supplies for emergency medical treatmentto be given inside the truck, the surgical operating truck carried enoughsurgical instruments and equipment to perform approximately 100 major surgicaloperations. Surgery was not performed in the truck, but in a tent attached toits rear. The truck served only as a supply and
49See above, pp. 146-48.
50(1) Memo, CG AGF for ACofS G-3 WDGS, 16 Feb 43, sub: T/O&E, Med Bn. AG: 320.3 (10-30-41)(2) Sec 8. (2) FM 101-10, Staff Offs' Fld Manual-Orgn, Tec, and Logistical Data, 10 Oct 43 and 21 Dec 44.
51FM 101-10, Staff Offs' Fld Manual-Orgn, Tec, andLogistical Data, 21 Dec 44 and 1 Aug 45.
52Johnson and Wilson, op. cit., pp. 295-339.
457
sterilizing room. Such trucks, along with auxiliary surgical groups, oftenserved as far forward as divisional clearing stations, supplementing them whenthe evacuation load was heavy. By the end of October 1945, 207 surgicaloperating trucks had been delivered for use by the Medical Department. Inaddition to surgical trucks, the Medical Department developed other specialvehicles for use in theaters of operations. They were a mobile dental laboratorytruck, mobile optical repair truck, a mobile dental operating truck, and an armymedical laboratory truck. Development of these vehicles contributed to themobility and flexibility of medical service in a fast-moving war.53
Activation, Training, and Use in the United States
The responsibility for activating, training, and using in the United Statesthe evacuation units that would operate in combat zones of theaters ofoperations belonged almost exclusively to the Ground Forces. Before thereorganization of the War Department in March 1942,54 all field medical unitswere trained under the supervision of General Headquarters. In the division ofresponsibility for medical units between the Ground and Service Forces thatfollowed the reorganization,55 the Ground Forces (successor toGeneral Headquarters) inherited the responsibility for training all medicalunits used in combat zones and gained in addition the responsibility forpreparing their tables of organization and equipment, recommending theirinclusion in the troop basis, and activating such units.
Planning for the troop basis during most of 1942 was conducted in terms of standard or fixed organizations. Medical units that wereorganic elements of combat forces whose structure was fixed by tables oforganization, such as infantry divisions, were automatically included in thetroop basis along with their parent units. While the structure of combat forceslarger than divisions was not governed by tables of organization, corps andarmies normally had standard numbers of units of various sorts early in the war.For example, for emergency medical care and evacuation each corps generally hada medical battalion; each army, three medical regiments.56In thelatter part of 1942 the Ground Surgeon proposed that each Army should have, inaddition, a separate ambulance battalion to assist in the evacuation ofcasualties from divisional clearing stations.57 Soon afterward, thestandard army and corps were abandoned as yardsticks for determining the numberof service units needed.58 In addition, early in 1943, as mentionedabove, nondivisional medical units organized under inflexible tables oforganization, such as medical regiments, were replaced by flexible battalionsand groups made up of variable combinations of separate ambulance, collecting,and clearing companies. While these changes did not affect the automaticinclusion in the troop basis of medical units that were organic elements of com-
53Johnson and Wilson, op. cit., pp. 354-96, 407-35, 444-75, 534-66.
54See pp. 54-55.
55See above, pp. 58-59.
56(1) Greenfield et al., op. cit., pp. 276-80, 352-54. (2) Orgn of Major Units, incl to Ltr, TAG to CGs AGF, AAF, and SOS, 31 Mar 42,sub: Policies Governing T/Os and T/BAs. AG: 320.2 (3-13-42)(5).
57M/S, Ground Med Sec to [ACofS] G-4 [AGF], 10 Aug 42, sub: Revision of TypeArmy and Type Army Corps Trps-Med. HD: 322 AGF (Units, Med) 1942.
58Greenfield et al., op. cit., pp. 354-71.
458
bat forces still organized under tables of organization, they did require theestablishment of a new basis for estimating the evacuation units that would beneeded for service with corps and armies. Thereafter, this basis was a ratio ofmedical companies to divisions or to a certain number of troops. For example, itwas considered that an army or task force needed a collecting company and aclearing company for each of its infantry divisions; and an ambulance companyfor every group of 12,000 soldiers.59 On this basis the GroundSurgeon proposed in November 1943 that a troop basis having 105 combat divisionsshould include 105 collecting, 105 clearing, and 105 ambulance companies.60The troop bases subsequently approved did not follow this recommendation.For example, in April 1944, when planning was in terms of 89 divisions, thetroop basis included 162 collecting, 104 clearing, and 75 ambulance companies.61The discrepancy between the ratio recommended by the Ground Surgeon andthat in which separate medical companies were authorized can perhaps beexplained by the fact that the troop basis was determined in the latter part ofthe war more by requests of theaters for units of specific types than byrecommendations of staff officers in Washington.62 In May 1945, justbefore the war in Europe ended, there were in the troop basis for the support of89 divisions the following corps and army evacuation units: 137 collecting companies, 75 clearing companies, 96 ambulance companies, andheadquarters detachments for 80 medical battalions and 16 medical groups. Allbut one of these units, an ambulance company, had already been deployed totheaters of operations.63
The activation and training of medical evacuation units were so closely intertwined with theactivation and training of other Ground Forces units that any account of themwould reflect generally a larger picture already described in considerabledetail elsewhere.64 Medical units that were organic elements of anyof the combat arms or of any service other than medical were activated andtrained along with their parent organizations. Corps and army medical units wereactivated according to a schedule based upon recommendations of the GroundSurgeon. During most of 1942 they were trained under the supervision of divisioncommanders. In the latter part of that year and the early part of 1943, however,AGF headquarters established special local headquarters (Headquarters andHeadquarters Detachments, Special Troops) to supervise the training of allnondivisional AGF-type service units, including those of the Medical Department.At least one of these headquarters had a Medical Corps officer on its staff. TheGround Surgeon exercised general supervision over the technical training of allGround Forces medical units and, on the basis of inspections and reports, keptAGF headquarters
59(1) Ltr, CG AGF to CofSA, 11 Jul 43, sub: Change to T/O 8-27 and 8-28, with incls. AGF: 320.3. (2) T/O&E 8-27, C 1, and T/O&E 8-28, C 1,both dated 5 Aug 43. (3) FM 101-10, 12 Oct 44.
60M/S, Comment 2, Ground Med Sec to Plans [Div] AGF, 2Nov 43, with 2 incls, Anal of 1944 Trp Basis and Summary of Trp Basis Study.Ground Med files: Chronological file, Folder 1.
61Troop Basis, Calendar Year 1944, 1 Apr 44 Revision.AG: Ref Collection.
62See above, pp. 219-22.
63The War Department Troop Basis, 1 May 45. AG: RefCollection.
64Robert R. Palmer, Bell I. Wiley and William R. Keast, The Procurement and Training of Ground Combat Troops (Washington, 1948), pp. 426-560 in UNITED STATES ARMY IN WORLD WAR II.
459
informed as to the state of their readiness for shipment totheaters of operations.65
Details of the training of Medical Department units will beincluded in a volume on that subject planned for this series, but one aspect oftheir training needs to be considered here. Unlike station and general hospitalunits that were trained by the Army Service Forces, evacuation units trained bythe Ground Forces were charged with actually providing medical serviceconcurrently with their training in the zone of interior. To carry out this dualmission, they needed both personnel and equipment, but they suffered from ashortage of both. Lack of a sufficient number of Medical Corps officers in theArmy Ground Forces prevented the assignment of full complements to units intraining. Although the ratio of assigned to authorized Medical Corps officersvaried from time to time and from unit to unit, it was often less than 50percent.66 Early in 1943 the shortage was so great that the DeputyChief of Staff of the Army directed the Army Ground Forces to amend the tablesof organization of medical units for which it was responsible by including ineach a remark that medical and dental officers would be furnished "only asrequired and available within the continental limits of the U. S."67 Early thenext year the Ground Surgeon reported that with one exception-the 92d Division-itwas possible to assign only one Medical Corps officer, instead of the sevenauthorized, to each infantry regiment participating in maneuvers in Louisiana.68
The shortage of equipment did not last as long as theshortage of personnel. It was most severe during 1942 and the early part of1943.69 At that time the Ground Surgeon reported that repeated requestsof the Surgeon General's Office to issue fuller allowancesof supplies and equipment always met with the same answer-that production wasgreat enough to meet only the needs of units scheduled for early shipment totheaters of operations.70 By the middle or latter part of 1943 thesupply situation had improved and by the end of the year some units reportedthat they had on hand approximately all of their equipment.71 Earlyin 1944 the Ground Surgeon reported that all medical units engaged in maneuversin Louisiana had about 95 to 100 percent of their equipment with them.72
Despite shortages of equipment and personnel, evacuationunits discharged their mission of furnishing medical service
65(1) Memo, Asst Ground Surg for [ACofS] G-4 [AGF], 15Nov 42, sub: Activation Plan for Non-Div Med Units. (2) M/S, Ground Med Sec to [ACofS]G-3 [AGF], 30 Jan 43, sub: Rpt on Readiness of Type Med Units. Both in GroundMed files: Chronological file, Folder 1. (3) An Rpt, Surg Third Army, 1942. HD.
66For example, see An Rpts, Surgs Second and Third Armies,1942, 67th Med Group, 1943, and 66th Med Group, 1944. HD.
67Memo, Dep CofSA for CG AGF, 10 Mar 43, sub: Availability of Physicians. Ground Med files: Chronologicalfile, Folder 1. For an example of this remark see T/O&E 7-11, Inf Regt, 15 Jul 43.
68Memo, Ground Surg for ACofS G-4 AGF, 26 Feb 44, sub: Rpt ofInsp, Louisiana Maneuver Area, 22-24 Feb 44. Ground Med files: Chronologicalfile (Col W. E. Shambora).
69An Rpts, Surgs Second and Third Armies, 1942; Surg 4thMotorized Div, 1942; Surg 5th Inf Div, 1942; and 30th, 31st, and 65th Med Rgts,1942. HD.
70M/S, Comment 7, Ground Med Sec to Ordnance [Sec, AGF], 23Dec 42, sub: Equip for Certain Units, Third Army. Ground Med files:Chronological file, Folder 1.
71An Rpts, Surg Second Army, 1943; Surg 4th Inf Div,1943; 31st, 67th, 69th, 341st, and 343d Med Groups, 1943. HD.
72Memo, Ground Surg for ACofS G-4 AGF, 26 Feb 44, sub:Rpt of Insp, Louisiana Maneuver Area, 22-24 Feb 44. Ground Med files:Chronological file (Col W. E. Shambora).
460
while still in training. While in garrison, Ground Forcesmedical units were not dependent upon the issuance of their own organizationalequipment for use in medical service, because The Surgeon General hadestablished a policy before the war-and it was continued-of supplyingdispensary buildings erected in training areas of Army camps with medicalsupplies and equipment from station stocks.73 Medical units ofinfantry divisions normally supplied personnel for the operation of six to sevenof such dispensaries in their own divisional areas. Each dispensary generallyserved a particular segment of a division. For example, each regimental medicaldetachment operated a dispensary for all persons in the infantry regiment towhich it belonged. The medical service rendered by dispensaries consisted ofroutine immunizations, blood-typing, monthly physical inspections, and dailysick calls. Soldiers found by medical examination at sick call to need hospitalcare were usually transported to station or regional hospitals in ambulances ofdivisional medical battalions. Ambulances and aid men also accompanied troops onlong marches and on all training exercises of a dangerous nature, such as firingon ranges. In order to interfere with training formations as little as possibleand to give as many men as possible experience in providing actual medicalservice, the personnel of divisional medical units often served in dispensarieson a rotational basis.74 Nondivisional medical units, such as armymedical regiments and groups, also operated dispensaries in garrison-sometimesfor their own personnel only and sometimes for persons belonging to other unitsas well. In addition, units of these types were at times split up to supply medical service for troops in widely separate areas. Forexample, during 1943 a detail of twenty-five enlisted men and twelve ambulancesof the 1st Medical Regiment gave ambulance service to various infantry unitsstationed in northern California, while various collecting and clearing units ofthe Regiment handled the medical service of troops in southern California, and aplatoon of one of its clearing companies served an artillery training center atYakima, Wash.75
On maneuvers Ground Forces medical units used organizationalequipment which had been issued to them for training purposes or for later usein theaters of operations. It was the Ground Surgeon's opinion that suchexperience was invaluable and that no medical unit should be shipped to theatersof operations without having first become acquainted with its own equipmentthrough use.76 Divisional medical units operated in support of thedivisions to which they belonged, setting up aid, collecting, and clearingstations, and evacuating and caring for both actual and simulated casualties.77Nondivisional units performed a variety of functions, in addition tocaring for corps and army troops and evacuating casualties from divisionalclearing stations. For example, during maneuvers in 1942 the 68th Med-
73The AnnualReport, Surgeon First Army, 1941, spoke of the establishment of this policy. Its continuancewas mentioned in the Annual Reports, Surgeons, Camp Hood (Texas) and IndiantownGap Military Reservation (Pennsylvania), 1942.
74An Rpts, Surgs, 4th Motorized Div, and 65th, 69th,79th, 86th, 98th, and 99th Inf Divs, 1943. HD.
75An Rpts, 1st and 31st Med Groups, 1943; 264th Med Bn, 1943;and 66th Med Group, 1944. HD.
76Interv, MD Historian with Col Shambora, 22 Apr 49. HD: 000.71.
77An Rpts, Surgs, 4th Motorized Div, and 65th, 69th, 79th,86th, 98th, and 99th Inf Divs, 1943. HD.
461
ical Regiment operated the following installations: aconvalescent hospital, a medical supply depot, clearing stations for depot andarmy troops, and an infirmary for corps troops. During maneuvers in 1943 the134th Medical Regiment established aid and prophylactic stations in towns withinthe area of operations, maintained clearing stations for army troops, evacuatedcasualties from division and army clearing stations to evacuation hospitals and from the latter to named station hospitals, andprovided personnel for the operation of a provisional medical supply depot.78Regardless of the missions assigned, Ground Forces medical units onmaneuvers gained valuable practical experience and at the same time suppliedmedical service for the troops with which they operated.
78An Rpts, Surg Second Army, 1942; 1st, 31st, 67th, 69th,134th, and 341st Med Groups, 1943. HD.
