CHAPTER VIII
Providing Hospitalization for Theaters ofOperations
In the first year and a half of the war the MedicalDepartment had to provide hospitalization for reinforced garrisons in overseasdepartments and bases, for new forces sent to hold lines of supply andcommunication throughout the world, and for task forces engaged in the firstdefensive-offensive operations against the enemy. Meanwhile it had to organize,train, and equip other units for use when the Army should become engaged infull-scale offensives. Early in 1942 the Pacific held first claim on hospitalunits sent overseas. In the summer emphasis shifted to Europe and North Africa,and thereafter hospitals went to those theaters in increasing numbers. By thelatter part of the year, after emergency shipments had been made, it waspossible to take stock of hospitalization already furnished to theaters with aview to establishing a basis for further planning.
Meeting Early Emergency Needs
Status of Hospital Units and Assemblages
When the Japanese struck Pearl Harbor the Medical Departmenthad 22 general, 24 station, 17 evacuation, and 8 surgical hospital units thathad been activated as training units. Of these, 3 station hospitals were alreadyoverseas and 9 station, 12 general, 4 evacuation, and 3 surgical hospital unitsincluded in the War Department pool of task force units were authorized almost100 percent of their table-of-organization enlisted strength and from 50 to 75percent of their commissioned strength. The rest had half or less than half oftheir enlisted strength and from three to five officers each. In addition to thetraining units, affiliated hospital units consisting chiefly of professionalcommissioned personnel-doctors and nurses-had been organized (but notactivated) as follows: 41 general, 11 evacuation, and 4 surgical hospitals.Under prewar plans, it will be recalled, affiliated units were to be called toactive duty as needed immediately upon the outbreak of war, were to be suppliedwith enlisted personnel, and were then to go into service without further ado.1According to a report of The Surgeon General in November 1941, hospitalassemblages had already been issued to 3 station and 2 evacuation hospitalunits; while assemblages for 2 general, 11 station, 4 evacuation, and 3 surgicalhospital units were packed and ready for immediate issue from depots, and thosefor 10 general, 9
1See above, pp. 5-6, 40.
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station, 17 evacuation, and 5 surgical hospital units werebeing packed but were not yet ready for issuance.2
Plans for Meeting Emergency Needs
Early in January 1942 The Surgeon General outlined to G-3 thesystem he wished to use in meeting emergency needs. Affiliated units would becalled to active duty and each would receive approximately one half of itsauthorized enlisted strength from a training unit. The rest of its personnelwould be supplied by reception centers, zone of interior installations, andother medical units. Each training unit which transferred personnel to anaffiliated unit would retain a cadre, in order to train additional"fillers" for other affiliated units. Some training units, especiallystation hospital units, would be sent overseas as needed, having first beenbrought to authorized strength with both enlisted and commissioned personneltransferred from other medical units or installations. Each unit would drawindividual equipment, clothing, and motor transport at its home station. Onlythose going overseas would receive hospital assemblages, preferably at ports ofembarkation.3
Soon after he had proposed this system The Surgeon Generalrealized that modifications would be necessary. The activation of training unitsat reduced strength, a policy adopted on his recommendation in 1941, resulted inthe hurried assembly, often at ports of embarkation, of additional personnel tomake up the other half of a unit. Members of units going overseas thereforefrequently had little time to become acquainted with one another'scapabilities before embarkation. Installations from which "fillers"were drawn suffered from resulting personnel and training problems. To obviatethese difficulties The Surgeon General recommended in February 1942 that alltraining units be activated at full table-of-organization enlisted strength.4He received the support in March 1942 of the SOS Hospitalization andEvacuation Branch and in April of AGF headquarters. In May G-3 approved theproposal.5
The Surgeon General secured only partial approval of hisstand in opposition to the issuance of hospital assemblages before the departureof units for theaters. After completing a survey of storage space in corpsareas, G-4 in December 1941 disapproved a request that General Magee had made inNovember to hold assemblages in depots until units were assigned missionsinvolving medical care.6 General Magee thensought approval of his position in a personal conference with General Somervell,who was at that time the Assistant Chief of Staff, G-4. On the basis of hisunderstanding of the agreement reached then, General Magee resubmitted hisrequest.7 Instead of approving it,
2Ltr, SG to TAG, 5 Nov 41, sub: Equip for Med Units in WD Pool of Task Forces. SG: 475.5-1.
3Memo, SG for AcofS G-3 WDGS, 13 Jan 42, sub: Activation . . . Med Units, with incls. HD: 326.01-1.
4(1) Memo, Act SG for ACofS G-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3. (2) An Rpts, 1942, of following Gen Hosps: 2d, 30th, 42d, 105th, 118th, and 210th, and of following Sta Hosps: 10th, 12th, 13th, 17th, 151st, 166th, and 172d. HD.
5(1)Memo G-4/24499-178, Maj William L. Wilson for [Lt] Gen [LeRoy] Lutes, 12 Mar 42, sub: Basic Plans for Hosp and Evac. HD: Wilson files, "No 472, Hosp and Evac, 1941-42." (2) Ltr, CG AGF for CG SOS, 23 Apr 42, sub: Auth of Grades and Ratings for MD Tactical Hosp. AG: 221(7-1-41) Sec 1H, Pt 1. (3) Ltr, TAG to CGs AGF, AAF, SOS, Armored Force, etc., 6 May 42, same sub. Same file.
6D/S G-4/31793, ACofS G-4 WDGS to SG, 31 Dec 41, sub: Comments on Draft of Ltr, 'Current Policies and Procedures for . . . Sups.' HD: 475.5-1.
7Memo, SG for ACofS G-4 WDGS, 10 Jan 42, sub: Equip for Numbered Hosps. HD: 475.5-1.
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as The Surgeon General had expected, G-4 now proposed acompromise. Unit assemblages would be declared controlled items. As such, theywould not be issued through corps areas to units upon requisition but would beissued directly as the War Department determined. Meanwhile, The Surgeon Generalwould make fractional issues of unit equipment for training purposes.8
Although he concurred in this compromise, officiallypublished on 21 January 1942,9 The Surgeon General did not give up hope that hecould continue to hold unit assemblages in medical depots until numberedhospitals were assigned operational missions. Once they were declared controlleditems, the most practical method of achieving this end would be to secure WarDepartment agreement not to require their issuance prior to that time. Thismight be done indirectly. Consequently, on 24 January 1942 The Surgeon Generalrequested G-4 to include in movement orders for numbered hospital unitsordered overseas a paragraph directing The Surgeon General to ship appropriateassemblages to ports of embarkation or staging areas. On 6 February 1942 G-4approved this recommendation.10 As will be seen later, neither the21 January 1942 compromise nor the approval of the inclusion of a paragraph inmovement orders settled the controversy over the issuance of equipment.
Methods of Meeting Emergency Needs
In defense areas-the Atlantic bases, the Panama Canal Zone,Alaska, and Hawaii-where hospitals already existed, the hospital situation wasserious though not critical. To meet emergency needs existing facilities couldbe expanded and additional "provisional" hospitals could beestablished by spreading thin the personnel and equipment already available.Army patients could also be hospitalized in civilian institutions wherever theywere available.11 Hence few hospital units went to those areas inthe first few months following Pearl Harbor. Between 1 January and 30 June 1942,2 general hospitals were sent to the Panama Canal Zone and 3 general and 4station hospitals to Hawaii to supplement existing and improvised hospitals inthose areas.12 In addition, troops sent to garrison new basesincluded medical detachments to operate the hospitals needed for their care,13but the more pressing needs of other areas generally took precedence inthe shipment both of numbered hospitals and supplementary personnel andequipment.14
Troops deployed to protect shipping lanes and to hold theenemy while preparations for the offensive went forward re-
8Memo for Record on D/S, ACofS G-4 WDGS for TAG, 16 Jan 42, sub: Equip for MD Units, and on Memo, Chief Planning Br G-4 WDGS for Brig Gen B. B. Somervell, 16 Jan 42, same sub. HRS: G-4/33344.
9(1) Memo, SG for ACofS G-4 WDGS, 17 Jan 42. SG: 475.5-1. (2) Ltr AG 400 (1-16-42)MD-D-M, TAGto SG, 21 Jan 42, sub: Equip for MD Units. HRS: G-4/33344.
10(1) Memo, SG for ACofS G-4 WDGS, 24 Jan 42, sub:Proposed Modification of Mvmt Orders. SG: 475.5-1. (2) D/S, ACofS G-4 WDGS for TAG, 6 Feb 43, same sub. HRS: G-4/33344.
11An Rpt, Med Activities Newfoundland Base Comd, 1942; An Rpt, Med Activities Surg Trinidad Sector and Base Comd, 1942; An Rpt, Dept Surg Panama Canal Dept, 1942; An Rpt, MD Activities Hawaiian Dept, 1942, sec I. HD.
12Ltr AG 221(1-31-42)EA-C, TAG to CG HawaiianDept, 18 Feb 42, sub: Grades and Ratings, MD, Hawaii. SG: 320.2-1 (HawaiianDept) AA.
13An Rpt, Med Activities US Army Force, Aruba, NWI,1942, and Hist Record, US Army MD in Greenland, Jul 41-Feb 43. HD.
14Paraphrase of Rad AG 320.2(1-12-42) MSC-A, TAG toCG Hawaiian Dept, 14 Jan 42. SG: 320.2-1 (Hawaiian Dept)AA.
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quired hospitalization in areas that had no Americanfacilities. The greatest immediate need was in the South and Southwest Pacific.During the period from 1 January to 1 July 1942, inclusive, 2 evacuation, 2surgical, 4 general, and 14 station hospitals were sent to Australia; 2evacuation, 2 general, and 2 station hospitals to islands in the South Pacific;and 2 station hospitals to islands other than the Hawaiian group in the CentralPacific. During the same period, 1 general and 1 station hospital went toNorthern Ireland, a general hospital to Iceland, and 2 general and 3 stationhospitals to England. In May and June 1942, hospitals were sent also to India,to care for troops engaged in supply and service activities there, and toNorthwest Canada, to care for those who were helping to build the Alcan highway.Meanwhile other hospital units were being earmarked for task forces, especiallyfor the GYMNAST (North Africa), MAGNET (Northern Ireland), and BOLERO (England)operations. These demands drew heavily upon available units and assemblages andsometimes made it impossible for The Surgeon General and OPD to meet withoutmodification requests of theater commanders.15 (Table 5)
In sending numbered hospital units overseas, The SurgeonGeneral departed from prewar plans, using training units as well as affiliatedunits. This was caused in part by the character of the war. Station hospitals,for which no affiliated units had been organized, were needed for defense forcessent out early in 1942 more than were surgical, evacuation, and generalhospitals. Moreover, the earmarking of some affiliated hospitals for task forcesthat were formed early but sent out later, or not at all, may have tied upenough affiliated units to require the use of training units in meeting overseas needs between Pearl Harbor and2 July 1942. At any rate, all station hospitals and the two surgical hospitalsdispatched during this period were nonaffiliated units. Of the thirty-sevenstation hospitals sent out, seventeen had been activated during 1941 and therest after war began. Both surgical hospitals were nonaffiliated units that hadbeen activated in 1941. Of the fifteen general hospitals shipped, nine wereaffiliated units supplied (except for one) with enlisted personnel from trainingunits activated during 1941. The remainder were nonaffiliated training unitsactivated in 1941. Of the 4 evacuation hospital units sent out, 2 wereaffiliated units and 2 were nonaffiliated units activated in 1940 and 1941. Thusthe prior activation and training of normal Army units proved more valuable inmeeting emergency hospital needs than did the formation and organization ofunits affiliated with civilian hospitals or schools.
Modification of Hospitals for Overseas Areas
Development of New Types of Units
Early in the war it was necessary to develop new types ofhospitals to meet the needs of island-type warfare and of motorized operationson land. Experience in planning hospitalization for the earliest task forces andgarrisons for islands in the
15(1) Memo, Lt Col A[rthur] B. Welsh for Brig GenL[arry] B. McAfee, 1 Apr 42. HD: Welsh Planning file. (2) Memo for Record on IAS,5 Apr 42, sub: Hosp Units for SUMAC [Australia] and SPOONER [New Zealand].HRS: WPD 704.2(3-9-42). (3) Memo, Maj A. B. Welsh for Gen Magee, 23 Jan 42,sub: Status of Hosp Units. HD: 320.2 (Trp Basis).
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TABLE 5-HOSPITAL UNITS SHIPPED OVERSEAS, 7 DECEMBER1941 TO 1 JULY 1942
Pacific revealed the need for hospitals that were smaller andmore mobile than the only hospital available for that purpose-the 250-bedstation hospital. As a result, the Surgeon General's Office and the medicalsection of General Headquarters collaborated in developing a new type ofhospital, called the field hospital, in the first months of 1942. When G-4called upon the Surgeon General's Office to develop an "island-typehospital," the latter submitted the table of organization for this unit.The General Staff approved the table and it was published on 28 February 1942.16
The field hospital had a headquarters and threehospitalization units. Each of the latter could operate independently with acapacity of 100 beds. As a single unit the hospital could care for 380 patients.Staffed to care for minor ills and injuries and equipped to function in thefield under tents, the field hospital or any one of its hospitalization unitscould serve as a fixed hospital on islands, in other isolated areas, or at airbases distant from other facilities. Having sufficient transportation to moveits own personnel and equipment, any unit of the hospital, when reinforced withsurgical personnel, could be used as a mobile hospital to support ground troopsin combat or task forces in landing operations. In addition, the field hospitalor any of its units, The Surgeon General asserted, could be readily transportedby air-an assertion supported by
16(1)Interv, MD Historian with Brig Gen Alvin L. Gorby, 21 Feb 52. HD: 000.71. (2) Ltr AG 400(1-19-42)MSC-D, TAG to SG, 22 Jan 42, sub: Equip for Island Type Hosp. SG: 475.5-1. (3) DF G-3/42108, ACofS G-3 WDGS to ACofS G-1 and G-4 WDGS, 17 Feb 42, sub: T/O and E for a Fld Hosp Unit, with incl. AG: 320.2(10-30-41)(2). (4) History of Organization and Equipment Allowance Branch [SGO], 1939-44, p. 5. HD.
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loading and flight tests during the latter part of 1942.17
The field hospital thus surpassed in flexibility any otherhospital which the Medical Department had. In order to make units of that typeavailable, SOS headquarters arranged for the activation of five in April 1942.18A few months later, when the troop basis was revised, authority was granted forthe activation of twenty-two by the end of 1942.
During the months following the development of the fieldhospital, the Surgeon General's Office revised the table of organization forstation hospital units to provide, in effect, additional types of fixedhospitals. At the beginning of the war the station hospital table oforganization provided only for those of 250-, 500-, and 750-bed capacities.19When station hospital units of smaller capacities were needed, The SurgeonGeneral had to prepare special tables for their activation. In May 1942, forexample, a special table of organization for a 150-bed station hospital wasissued.20 Two months later the revised version of the regular tablewas ready for publication. It provided for station hospitals of seventeendifferent sizes, ranging in capacity from 25 to 900 beds.21 Theinclusion of station hospital units of various sizes in the 1943 troop basissimplified The Surgeon General's problem of recommending hospital support forsmall garrison forces.
At the same time that small fixed-hospital units were beingsupplied for garrison forces scattered throughout the world, the Surgeon General'sOffice was developing a combat zone hospital that was more mobile and requiredless personnel than either the 400-bed surgical hospital or the 750-bedevacuation hospital. The latter had no motor transport for its own movement and could be used only in relatively stable situations.The surgical hospital, developed in 1940, was only partially mobile. Itssurgical unit was authorized enough transport to move itself but its twohospital units had only "utility" vehicles.22
In order to provide a more mobile combat zone hospital, TheSurgeon General developed a 400-bed motorized evacuation hospital. Its table oforganization, concurred in by the Ground Surgeon and approved by G-3, waspublished on 2 July 1942.23 This unit, unlike the surgical and 750-bedevacuation hospitals, at first had enough motor transport to move all of itspersonnel and equipment at one time. It differed from the surgical hospital inorganization also. It will be recalled that the latter had three independentunits with separate headquarters-a surgical unit and two ward units. Themotorized evacuation hospital, on the other hand, had no separate units and onlyone headquarters, but it could be split into two self-contained 200-bed surgicalhospitals. This change in organization resulted
17(1) Memo, SG for TAG, 1 Feb 42, incl to DF G-3/42108, ACofS G-3 WDGS to ACofS G-1 and G-4 WDGS, 17 Feb 42, sub: T/O and E for Fld Hosp Unit. AG: 320.2(10-30-41)(2). (2) Ltr, SG to CG USAFIA, 26 Jun 42, sub: Fld Hosp, T/O 8-510. HD: Wilson files, 400 "Med Equip and Sups." (3) Memo, SG for CG SOS, 3 Oct 42, with 2d, 5th, and 6th inds. SG: 704.-1.
18Memo, SG for CG SOS, 22 Mar 42, sub: Activation of Fld HospUnits, with 1st ind, CG SOS to SG, 1 Apr 42. SG: 322.3-33.
19T/O 8-508, Sta Hosp, ComZ, 25 Jul 40.
20T/O 8-560S, Sta Hosp (150-bed), 23 May 42.
21T/O 8-560, Sta Hosp, ComZ, 22 Jul 42.
22T/O 8-232, Evac Hosp, 1 Oct 40, and T/O 8-231, Surg Hosp, 1 Dec 40.
23(1) History of Organization and Equipment Allowance Branch [SGO], 1939-44, p. 4. HD. (2) Memo for Record on Memo, CG SOS for TAG, 1 Jul 42, sub: T/O for Evac Hosp (Motorized). AG: 320.3(10-30-41)(2) Sec 8D. (3) T/O 8-581, Evac Hosp, Motorized, 2 Jul 42.
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in a saving of both enlisted and commissioned personnel-afactor of importance in the development of the new unit.24
The motorized evacuation hospital soon superseded thesurgical hospital in the troop basis, although the table of organization of thelatter was not rescinded until August 1944.25 In August 1942 AGF headquarters,with the concurrence of The Surgeon General and the Ground Surgeon, had surgicalhospitals, only three of which were used as such during the war, redesignatedand converted into motorized evacuation hospitals. In November 1942 units of thenew type were included, along with 750-bed evacuation hospitals, as mobile unitsin the 1943 troop basis.26
Since none of the hospital units available at the beginningof the war or developed in Washington in the following year met the needs ofsmall combat forces fighting in Pacific jungles, the Southwest Pacific Areaattempted during 1942 to solve its own problem. To provide surgical support fortask forces employed in areas where the only practicable means of transportationwas by foot, the chief surgeon of that area developed a 25-bed portable surgicalhospital. It was designed to permit its equipment and supplies to be carried in35- to 40-pound packs by its own personnel or by native bearers. It couldtherefore move along with combat troops through jungle trails, either to preparecasualties for the long litter-haul to the rear or to care for them until moreadequate hospitals could be established. In September 1942 SWPA headquartersactivated twenty-six such "provisional" units with personnel takenfrom other hospitals. Receiving reports of this development, The Surgeon Generalsoon afterward adopted the portable surgical hospital as a regular unit. In November 1942, forty-eightwere included in the 1943 troop basis. In May 1943 ASF headquarters ordered theactivation of twenty under a special table of organization which was publishedthe following month.27
Changes Affectingthe Mobility of Hospitals
By the fall of 1942 circumstances developed which tended tocancel some of the results of earlier attempts of The Surgeon General toincrease the mobility of hospitals. Shortages of motor equipment and of shippingspace prompted the General Staff, on 2 October 1942, to direct the three majorcommands to reduce the motor vehicles authorized for their respective units.28In compliance with this order AGF headquarters reduced the transport ofthe motorized evacuation hospital (making it a semimobile unit) and the SurgeonGeneral's Office reduced that of the field hospital. These hospitals were
24(1) Comparison of T/O 8-231, 1 Dec 40, and T/O 8-581, 2 Jul 42. (2) See also Off Diary of Col Albert G. Love, Chief HD, SGO, 8 Sep and 9 Oct 42. HD.
25(1) Memo, Col Arthur B. Welsh for Gen Kirk, 2 Dec 43. SG: 322.15-l-MEDC. (2) WD Cir 333, 15 Aug 44.
26(1) Memo 32.02/29(Med)(R)-GNGCT/(1 Aug 42), CG AGF for ACofS C-3 WDGS, 1 Aug 42, sub: Redesignation of Surg Hosp as Evac Hosp, with Memo for Record. Ground Med files: "Maneuvers, 1942." (2) Ltr, SG to CG ASF, 26 Apr 43, sub: Status of Surg Hosps. SG: 322.15-1.
27(1) An Rpt, Chief Surg SWPA, 1942. HD. (2) Ltr, Comdr-in-Chief SWPA to CG SOS, 21 Nov 42, sub: Improvement of Equip and Orgn, with 2 inds. SG: 322.15-10. (3) Memo, CG ASF for TAG, 26 May 43, sub: Constitution and Activation of Ptbl Surg Hosp. AG: 322(5-26-43). (4) T/O & E 8-572S, Ptbl Surg Hosp, 4 Jun 43.
28Ltr, 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.
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left with enough transport for partial movements only. Eachhad to employ its vehicles in shuttle fashion or supplement them with"pool" vehicles in order to move from one location to another.29Reductions in allotments of motor vehicles to other hospital units hadinsignificant effects upon mobility, because their vehicles were used foradministrative purposes only.30
Other ways of increasing the mobility of hospitals than bythe formation of new units were reductions in the size and weight of equipmentand improvements in methods of packing it. When war began, equipment lists ofall hospitals contained types and quantities of items such as office desks,armchairs, and kitchen equipment which were ordinarily used only in hospitals inthe United States.31 In view of shortage of shipping space and theneed for mobility in overseas hospitals, SOS headquarters directed The SurgeonGeneral on 12 March 1942 to eliminate all unnecessary equipment and to reducethe gross weight and cubic displacement of station and general hospitalassemblages by at least 40 percent.32 The Surgeon General repliedthat his Office had already begun that process. On 30 June 1942 he reported thatthe required reduction had been made in station hospital assemblages and that itwould be made in others at an early date.33 During the followingsummer special boards appointed by The Surgeon General reviewed equipment listsof all hospitals, making reductions as they could, and sent the revised lists tomedical depots for use in making up hospital assemblages. By November 1942 TheSurgeon General reported to the Wadhams Committee that the gross weight andcubic displacement of all hospitals designed for overseas service had been reduced by an average of 40 to 42 percent.34 Bythat time many hospitals with heavy bulky equipment were already in operation inoverseas theaters.35
Shortly before The Surgeon General reported reductions in thesize and weight of hospital equipment, the Ground Surgeon raised the question ofits packing. He informed the Surgeon General's Office that equipment ofevacuation hospitals was so packed that it did not lend itself readily to manualhandling and speedy unpacking for setups. Meanwhile the 15th EvacuationHospital, stationed at Fort George G. Meade, Maryland, conducted experiments inpacking under the supervision of the Ground Surgeon.36 TheSurgeon General learned that this hospital
29(1) T/O 8-510, Fld Hosp, 28 Feb 42 and 8 Apr 43; T/O 8-581, Evac Hosp, Motorized, 2 Jul 42; and T/O 8-581, Evac Hosp, Semimobile, 8 Jan 43. (2) 1st ind 323.3 GNRQT-1/18390 (10-2-42), CG AGF to TAG, 1 Dec 42, on Ltr, 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. (3) Ltr, SG to CG SOS, 14 Dec 42, sub: Changes in Fld Hosp. SG: 322.15-10. (4) 2d ind, SG to CGSOS, 10 Feb 43, on Ltr, Comdr-in-Chief SWPA to CG SOS, 21 Nov 42, sub:Improvement of Equip and Orgn. Same file.
30For example, see T/O 8-550, Gen Hosp, 1 Apr 42, andT/E 8-550, Gen Hosp, 19 Mar 43.
31Memo entitled "Correcting Info as toConfidential Document Submitted by Mr. [Corrington] Gill, Entitled 'Rpt toCmtee on Data from Files of Hosp and Evac Br, Plans Div, SOS,'" submittedas incl to Ltr, SG to Col Sanford Wadhams, Chm, Cmtee to Study the MD, 7 Nov 42. HD:321.6.
32Memo, Oprs Div SOS for SG, 12 Mar 42, sub: Increase in Mobility of Fld Force Hosps. SG: 475.5-1.
33Memos, SG for Oprs Div SOS, 21 Mar and 30 Jun 42. SG: 475.5-1.
34Memo cited, n. 31.
35(1) Memo SPOPH 701, CG SOS for SG, 19 Oct 42, sub: Info Submitted by Chief Surg SWPA. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43." (2)Ltr, Med Insp NATO to SG, 27 Jan 43, sub: Observations on Med Serv in NATO. HD:Wilson files, "Experience in Med Matters from Overseas Forces."
36Comment by Brig Gen Frederick A. Blesse on firstdraft of this chapter. HD: 314 (Correspondence on MS) III, Incl 1.
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had developed a method of packing its equipment so that eachcrate or package could be handled by two men and contained items used in oneparticular section of a hospital only.37 In November 1942 GeneralMagee appointed a board of officers to study this accomplishment and submitrecommendations for more practical methods of packing and assembling equipmentthan those being used by medical depots.38 As a result of thisinvestigation, The Surgeon General's Supply Service drew up specifications forthe standardized packing and crating of equipment of motorized evacuationhospitals.39
Subsequently, during 1943, the system found satisfactory forevacuation hospitals was adopted for other units. Each box, properly marked, nowcontained supplies and equipment for use in a particular section of a hospitalonly. This system speeded unpacking and repacking for movement in the field bymaking it possible to assemble at a particular spot all supplies and equipmentneeded for a ward, an operating room, or an office, and by making it unnecessaryto unpack equipment not required when only part of a hospital was beingestablished.40
Reductions in the Personnel of Hospital Units
Modifications in tables of organization of existinghospitals, like changes in equipment and motor transport, were required by otherthan medical considerations. During the early part of 1942 both G-1 and SOSheadquarters put considerable pressure on The Surgeon General to savecommissioned personnel, especially Medical Corps officers, lest there beinsufficient numbers to go around, on the scale already planned, in a 7,500,000-manArmy. Among the steps they directed him to take was therevision of tables of organization, both to reduce the number of officersauthorized and to substitute Medical Administrative Corps for Medical Corpsofficers.41 Having already begun the process of revision, The SurgeonGeneral replied that he would continue it.42 In April the revisedtables for general, surgical, and convalescent hospitals and hospital centerswere published; in July, those for evacuation and station hospitals.43
These revisions resulted in the saving of Medical Corpsofficers more by cuts in the number of such officers in each unit than by thesubstitution of Medical Administrative for Medical Corps officers. The reasonlay perhaps in the fact that tables of organization for numbered hospitals,unlike personnel guides for zone of interior
37(1) Ltr, SG to CG SOS, 7 Oct 42, sub: Evac Hosp Equip. SG:475.5-1. (2) An Rpt, 15th Evac Hosp Motorized, 1942. HD.
38(1) 1st ind, CG SOS to SG, 15 Oct 42, on Ltr, SG to CG SOS, 7 Oct 42, sub: Evac Hosp Equip. SG: 475.5-1. (2) SG OO 462, 11 Nov 42, sub: Bd of Offs to Study Equip of New 400-Bed Motorized Evac Hosp.
39(1) Rpt of Bd for . . . a 400-bed Evac Hosp [13 Nov42]. SG: 475.5-1. (2) Memo, Lt Col R[euel] E. Hewitt for Col F[rancis] C. Tyng,19 Dec 42. Same file.
40(1) Richard E. Yates, The procurement and Distribution ofMedical Supplies in the Zone of the Interior during World War II (1946), p. 146.HD. (2) An Rpt, Med Assembly Unit Atlanta ASF Depot, 1943. HD.
41(1) Memo, ACofS G-1 WDGS for SG thru Pers Div SOS, 1 Apr42, sub: Availability of Physicians. HRS: G-1/16331-16335. (2) Memo, CG SOSfor SG, 22 May 42, sub: Availability of Physicians. Same file.
42(1) Memo, SG for Pers Div SOS, 27 Apr 42. HRS: G-1/16331-16335. (2) Memo, SG for Dir Mil Pers SOS, 5 Jun 42, sub: Availability of Physicians. Same file.
43T/O 8-550, Gen Hosp, 1 Apr 42; T/O 8-570, Surg Hosp, 1 Apr 42; T/O 8-590, Conv Hosp, 1 Apr 42; T/O 8-540, Hosp Ctr, 1 Apr 42; T/O 8-580, Evac Hosp, 750-bed, 2 Jul 42; T/O 8-560, Sta Hosp, 22 Jul 42.
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installations,44 already required the use ofMedical Administrative Corps officers in a considerable proportion ofadministrative positions. The revised tables also reduced the number of nursesauthorized for some hospitals. In general, greatest changes were made in largecommunications zone units, such as 1,000-bed general and 750-bed stationhospitals. In the former, 17 Medical Corps officers and 15 nurses wereeliminated; in the latter, 13 Medical Corps officers and 15 nurses. In each, oneMedical Administrative Corps officer, one Sanitary Corps officer, and onewarrant officer were added as replacements for some of the Medical Corpsofficers eliminated. In smaller communications zone units, such as the 250-bedstation hospital, and in combat zone units, such as the 750-bed evacuation andthe 400-bed surgical hospital, no personnel reductions were made, but from oneto three Medical Administrative or Dental Corps officers were substituted for alike number of Medical Corps officers. The development of the 400-bed motorizedevacuation hospital for use in the combat zone resulted in a considerablesaving of both Medical and Nurse Corps personnel, because the new unit requiredfifteen physicians and twelve nurses fewer than did the surgical hospital whichit replaced in the troop basis.45
In the fall of 1942 emphasis shifted from reductions in thenumbers of officers and nurses to those of enlisted men. With a growing need formanpower economy in the Army, the General Staff in October directed the threemajor commands to revise downward their tables of organization.46By then responsible for tables of combat zone hospital units, AGF headquartersrevised the tables of both the 400-bed and 750-bed evacuation hospitals. With The Surgeon General's concurrence, the number ofenlisted men in a motorized evacuation hospital was reduced from 248 to 217; ina 750-bed unit, from 318 to 308. The revised tables reflected, incidentally, asdid others published later, the militarization of hospital dietitians andphysical therapists, who until December 1942 had served as civilian employees.47Cuts in the personnel of communications zone hospital units did not occurat this time, because SOS headquarters considered it "inadvisable," inview of revisions of tables within the preceding year, to direct any further"arbitrary reduction."48
Hospital Units in the Troop Basis
Throughout 1942 and 1943 the number of hospital units in thetroop basis increased significantly with each of its revisions but alwaysremained smaller than The Surgeon General considered adequate for the Army beingmobilized. Using World War I casualty and evacuation experiences as a basis, TheSurgeon General estimated that fixed beds should be
44See above, p. 133.
45T/O 8-508, Sta Hosp, 25 Jul 40; T/O 8-560, Sta Hosp, 22 Jul 42; T/O 8-507, Gen Hosp, 25 Jul 40; T/O 8-550, Gen Hosp, 1 Apr 42; T/O 8-232, Evac Hosp, 1 Oct 40; T/O 8-580, Evac Hosp, 2 Jul 42; T/O 8-231, Surg Hosp, 1 Dec 40; T/O 8-570, Surg Hosp, 1 Apr 42; T/O 8-581, Evac Hosp, Motorized, 2 Jul 42.
46Ltr, TAG to CGs AGF, AAF, and SOS, 2 Oct 42, sub: Review of Orgn and Equip Reqmts. AG: 400(8-10-42)(l) sec 22.
47(1) T/O 8-580, Evac Hosp, 750-bed, 23 Apr43, and T/O 8-581, Evac Hosp, Semimobile, 8 Jan 43. (2) Memo 320.2/53(Med) GNRQT-3/26660 (11-18-42), CG AGF for ACofS G-3 WDGS, 1 Jan 43, sub: T/O and T/E 8-581, Evac Hosp, Semimobile. AC: 320.3 (10-30-41)(1) sec 8D. (3) Memo 321/732(Med) GNRQT 3/37444, CG AGF for ACofS G-3 WDGS, 16 Apr 43, sub: T/O and T/E, Evac Hosp (750 pnts). Same file.
48Memo SPGAE 011.1(10-14-42), CG SOS for ACofS G-3 WDGS, 7 Dec 42, sub: Review of Orgn and Equip Reqmts. AG: 400(8-10-42)(1)sec 22.
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provided for 10 to 15 percent of the strength of each theaterof operations.49 He calculated mobile bed requirements in the earlypart of 1942 on the basis of 1 convalescent, 4 surgical, and 10 evacuationhospitals for each type-army. The time when these units should be activateddepended upon such factors as the amount of training required by each, the rateof troop movement to overseas areas, and the amount of combat action which mightbe encountered.
At the beginning of 1942 both G-3 and the Chief of Staffbelieved that the mobilization of service units should be delayed because thetraining of divisions required more time than that of nondivisional units and alack of shipping limited forces that could be sent overseas during 1942.50Hence, in the troop basis issued on 17 January 1942, which provided for a71-division, 3,600,000-man Army by the end of the year, there wereincluded only 2 convalescent, 28 evacuation, 8 surgical, 45 general, and 40station hospital units.51 The Surgeon General urged that additionalunits be authorized, but the General Staff disapproved. In its opinion the55,000 beds provided for in 45 general and 40 station hospitals would beadequate for the 550,000 troops which, it was expected, could be sent overseasduring 1942.52
In the spring of 1942 plans were made to send a larger numberof troops overseas during the rest of the year. Under the BOLERO plan, thirtydivisions, or 1,000,000 men, were to be sent to the United Kingdom for anoperation against the continent either late in 1942 or early in 1943. In May thePresident raised the size of the Army to be mobilized by the end of 1942 to4,350,000.53 The number of units originally thought requisite in view ofthese changes was reduced considerably in the course ofdiscussions among representatives of SOS and AGF headquarters and the SurgeonGeneral's Office, and on 23 May 1942 SOS headquarters recommended to G-3that 2 convalescent, 6 evacuation, 8 surgical, 62 general, 103 station, 22 fieldhospitals and 9 hospital centers should be included in the revised troop basis,in addition to the units already authorized.54 G-3 considered therecommended number of fixed-hospital units too large, but approved it when TheSurgeon General explained that BOLERO alone would require 100,000 beds, or morethan the number authorized in the additional units.55
49(1) Albert G. Love, "War Casualties," ArmyMedical Bulletin No.24 (1931), pp. 53-68. (2) Off Diary of Col Albert G.Love, Chief HD SGO, 6 Mar 42. HD.
50Kent R. Greenfield, Robert R. Palmer and Bell I. Wiley, The Organization of Ground Combat Troops (Washington, 1947), p. 199, in UNITED STATES ARMY IN WORLD WAR II.
51Ltr, TAG to C of Arms and Servs, etc., 17 Jan 42, sub: Moband Tng Plan, 1942. AG: 381(12-27-41)(2).
52(1) Memo, Act SC for ACofS C-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3-1. (2) 2d ind AG 320.2(1-29-42) MSC-C, TAG to SG, 18 Feb 42, on Memo, C of Air Staff for SG, 29 Jan 42, sub: Expansion Program of AAF for Calendar Year 1942. HD: 320.2(Trp Basis).
53Greenfield et al., op. cit., pp. 201-06. Also seeRay S. Cline, Washington Command Post: The Operations Division (Washington,1951), pp. 143-63, in UNITED STATES ARMY IN WORLD WAR II; and Maurice Matloffand Edwin M. Snell, Strategic Planning for Coalition Warfare, 1941-42 (Washington,1953), pp. 190-96, in UNITED STATES ARMY IN WORLD WAR II, for more informationon BOLERO.
54(1) Memo, Lt Col A. B. Welsh for the Record, 13 Apr 42. HD: 320.2(Trp Basis). (2) Memo SPOPP 320.2 Serv Units (5-23-42), Dep Dir Oprs SOS for ACofS G-3 WDGS, 23 May 42, sub: Reqmts of Serv Units. . . . SG: 475.5-1.
55(1)Memo WDGCT 320.2(5-23-42), ACofS G-3 WDGS for CGs AGF and SOS, 25 May 42, sub: Reqmts of Serv Units. . . . SG: 475.5-1. (2) Memo, SG for Oprs Div SOS, 30 May 42, same sub. SG: 320.3-1. (3) Memo, ACofS G-3 WDCS for CG SOS, 5 Jun 42, same sub. Same file.
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During the late summer and fall of 1942 plans for the 1943 troop basis,through which a 7,500,000-man Army was to be mobilized by the end of 1943,56called for sizable increases in the numbers of hospital units of all types. Forthe support of ground troops in combat, 7 convalescent, 20 evacuation, 52semimobile evacuation, and 48 portable surgical hospitals were authorized foractivation by December 1943. The number of fixed-hospital units which G-3authorized-52 field, 192 general, and 327 station hospital units-was lessthan The Surgeon General recommended.57 G-3's authorization ofthe smaller number apparently resulted from a shortage of physicians to staffmore. The Surgeon General believed that enough beds and other equipment to carefor the maximum estimate of sick and wounded men would have to be provided inany event. He therefore recommended again an increase in authorized units andurged that he be permitted, if his recommendation should be disapproved, toprocure adequate equipment for overseas hospitals regardless of the troop basis.58Both G-3 and OPD agreed to the latter proposition and SOS headquartersarranged to assure the procurement of equipment which The Surgeon Generalconsidered necessary.59
The Question of Equippingand Using Numbered Hospitals in the Zone of Interior
Throughout 1942 and most of 1943 the Surgeon General's Office and SOSheadquarters were engaged in an inconclusive dispute over the issuance ofequipment to numbered hospital units and the use of such units on a functionalbasis in the United States. This dispute, like the one over planning for zone ofinterior hospitalization already discussed, exemplified difficultiesresulting from misunderstanding about the respective responsibilities of theSurgeon General's Office and the SOS Hospitalization and Evacuation Branch. Ofmore significance, it involved the following problems: the method of traininghospital units in the United States, the contribution of such units to themedical service during training periods, and whether or not such units shouldreceive full issues of equipment in the United States.
After war began most hospital units in the zone of interiorcontinued primarily as schools for tactical training. A few were issued fullassemblages and operated hospitals on maneuvers. As a rule, though, under apolicy announced in January 1942 and already discussed, hospital units receivedonly field training equipment, soldiers' individual equipment, and motortransport, for use in unit field training. The Surgeon General expected them toreceive technical training and experience with professional supplies andequipment in zone of interior hospitals. This "parallel" method oftraining seemed satisfactory when only one or two units were located on aparticular post, but delay in construction of housing for a hospital unit neareach of twenty-two general hospitals and
56Greenfield et al., op. cit., pp. 212-17.
57(1) Diary, Hosp and Evac Br SOS, 28 Oct 42. HD: Wilson files, "Diary." (2) Memo, SG for CG SOS, 25 Jan 43. HD: 632.-2. (3) Table, Auth Units (Hosp Type) in 1942 and 43 Trp Basis. HD: 320.2 (Trp Basis).
58(1) Memo, SG for CG SOS, 25 Jan 43. HD: 632.-2. (2) Ltr, SG for CG SOS, 6 Mar 43, sub: Adequacy of Plans for Overseas Hosp. SG: 322.15-1.
59(1) Memo SPOPH 701(3-6-42), Dir Plans Div ASF for Gen [LeRoy] Lutes, 15 Mar 43, sub: Adequacy of Plans for Overseas Hosp. HD: Wilson files, "Book III, 1 Jan 43-15 Mar 43." (2) lst ind, ACofS for Oprs SOS to SG, 16 Mar 43, on Ltr, SG to CG SOS, 6 Mar 43, same sub. SG: 322.15-1.
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thirty-four station hospitals in the United States, as TheSurgeon General requested,60 caused units to be grouped on posts wherevertroop housing was available. Whenever this happened there were so many officersand men of numbered units in each named hospital concerned that they had to taketurns serving alongside of, or "parallel" to, their oppositenumbers.61
This entire system was challenged early in 1942. By MarchColonel Wilson was convinced that hospital units could be best prepared foroverseas service by being issued complete equipment and by being required tofunction as hospitals in the United States.62Moreover AGFheadquarters wanted to train unit personnel in the storage, maintenance, andrepair of hospital equipment and to have hospital units self-sufficient in sofar as messing and administration were concerned. In May, therefore, AGFheadquarters recommended that all hospital units scheduled for maneuvers and allnewly activated units be given full issues of equipment for permanentretention.63 The Surgeon General was willing to make someconcessions to the Ground Forces but not to issue complete assemblages as SOSheadquarters directed in June and again in August 1942. In a paper duel whichhis Office fought with SOS headquarters over this matter, The Surgeon Generalreached a point by 7 September 1942 of agreeing to the issuance of housekeepingequipment, but he requested approval of a policy of withholding all otherequipment in assemblages until units were assigned to operationalmissions.64
By this time SOS headquarters had decided not only to forceThe Surgeon General to issue complete assemblages to all units but also torequire him to employ units under SOS control in the zone of interior medical service. There seemto have been several reasons for this decision. In September 1942 a report fromthe Southwest Pacific Area emphasized the desirability of issuing equipment tounits in training to permit them to learn to pack and move it easily and toreduce its size and weight by eliminating unnecessary items.65 Moreover,many units were becoming restless from long periods of training withoutopportunities either to function as hospitals or to assist in zone of interiorhospital operations; and stories of doctors being called from civilian practiceonly to sit and wait around Army camps
60Memo, Act SG for ACofS G-3 WDGS, 28 Feb 42, sub: Orgn and Dispatch of MD TofOpns Units. SG: 322.3-1.
61(1) For example, see the An Rpts, 1942 and/or 1943 of 3d, 6th, 23d, 50th, 79th, and 108th Gen Hosps and An Rpt, 1943, 36thSta Hosp. HD. (2) Consolidated Rpt, SGs Observers for 1942 Maneuvers,transmitted to ASF Hq by Memo, SG for Dir Tng ASF, 16 Jun 43. Ground Med files:"Rpt of Maneuver Observers, SGO, 1942." (3) Memo, Dir Planning Div ASFfor Gen Lutes, 4 Aug 43, sub: Sta Hosp in Maneuver Areas. Ground Med files:354.2 "Maneuvers."
62Memo G-4/24499-178, Maj W. L. Wilson for Gen Lutes, 12 Mar 42,sub: Basic Plans for Hosp and Evac. HD: Wilson files, "No 472, Hosp andEvac, 1941-42."
63Ltr 475.5/49-GNSPL (5-26-42), CG AGF to Dir Oprs SOS, 26 May 42,sub: Equip for Med Units. HD: Wilson files, 400 "Med Equip and Sups."
64(1) 2d ind, SG to Dir Oprs SOS, 29 May 42; 3d ind, CG SOS to SG, 22 Jun 42; 4th ind, SG to Dir Oprs SOS, 30 Jun 42; 5th ind, CG SOS to SG, 9 Jul 42; 6th ind, SG to Dir Oprs SOS, 20 Jul 42; 7th ind, CG SOS to SG, 6 Aug 42; and 8th ind, SG to CG SOS, 7 Sep 42, on Memo 475/826-GNSPL (5-22-42), CG AGF for Dir Oprs SOS, 22 May 42, sub: Equip for MD Units. SG: 475.5-1. (2) Memo, Lt Col A[rthur] B. Welsh for Gen [Larry B.] McAfee, 11 Jun 42. HD: 320.2(Trp Basis). (3) Diary, Hosp and Evac Br SOS, 13 Aug 42. HD: Wilson files, "Diary."
65Ltr, Col P[ercy] J. Carroll to ACofS G-4 USASOS SWPA, 19 Sep 42, sub:Data for Lt Col [Willard S.] Wadelton. HD: Wilson files, "Experience in MedMatters from Overseas Forces." Colonel Wilson had asked Colonel Wadelton toget information for him on a visit of the latter to SWPA.
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began to reach the public and the Army Inspector General.66
At the same time, it appeared that there would beinsufficient Medical Department enlisted men and Medical Corps officers tosupply both zone of interior installations and numbered units with theirauthorized numbers, and the General Staff began a drive for more efficientpersonnel utilization.67 The chief of the SOS Hospitalizationand Evacuation Branch believed that personnel required for zone of interiorhospitals could be reduced by using numbered hospital units to help operate suchinstallations. Furthermore, he believed that a reserve of hospital beds foremergencies could be provided by issuing equipment to numbered units.68In addition, some of the obstacles to assemblage-issuance and unit-usewere being removed. Although equipment was still in short supply, the SurgeonGeneral's Office and SOS headquarters were making renewed efforts to increaseits availability. Housing, including warehouse space for equipment which hadbeen authorized in the spring of 1942, was expected to be available foroccupancy between September 1942 and January 1943.69 Finally theWadhams Committee was appointed early in September 1942, and SOS headquartersmay have expected its support in this instance.70 Whetherbecause of one, some, or all of these reasons, SOS headquarters on 16 Septemberand again on 12 October 1942 directed The Surgeon General to prepare a plan forthe use of numbered hospital units in the zone of interior medical service andon 17 September 1942 requested his comments on the draft of a policy requiringthe issuance of assemblages to all hospital units in training.71
Receipt of these communications caused confusion andconsternation in the Surgeon General's Office. The Operations Service called forcomments from other sections-the Supply, Professional, and Personnel Servicesand the Hospital Construction, Hospitalization, and Training Divisions. Afterseveral conferences to discuss the action that should be taken, final decisionwas to request no change in the policy on the issuance of equipment and tosubmit no plan for the use of numbered units. To support this decision, theSurgeon General's Office marshaled an array of arguments. The most importantseem to have been lack of sufficient equipment to permit the issuance ofassemblages to all
66(1) Memo for Record on Memo SPOPH 320.2, ACofS Oprs SOS (init WLW[ilson]) for SG, 16 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42." (2) Diary, Hosp and Evac Br SOS, 25 Sep 42. HD: Wilson files, "Diary." (3) Memo, Dir Mil Pers Div SGO for Dir HD SGO, 14 Apr 44. HD: 326.1-1.
67See above, pp. 131-37, and Memo, DepCofSA for SG thru CG SOS, 17 Oct 42, sub: Availability ofPhysicians. SG: 322.05-1.
68Memo SPOPM 322.15, Chief Hosp and Evac Br SOS for Gen Lutes, 15 Sep 42, sub: Directive for Hosp and Evac Oprs. HD: Wilson files,"Book I, 26 Mar 42-26 Sep 42."
69(1) Memo, Chief Hosp and Evac Br SOS for Gen Lutes, 23 Aug 42, sub: Status of Procurement of Med Supplies. HD: Wilson files, 440 "Med Sups." (2) Memo, CofEngrs for SG, 19 Sep 42, sub: Fld Hosp Units. HD: 632 "Housing."
70Colonel Wilson stated to the Committee that one ofthe problems of the Medical Department was the development of a system fortraining medical units with their equipment before going overseas. Ltr, Chief Hosp and Evac Br Plans Div Oprs SOS for Chm, Cmtee to Study the MD, 21 Oct 42,sub: Med Problems. HD: Wilson files, "Book 2, 26 Sep 42-31 Dec 42."
71(1) Memo SPOPH 320.2, ACofS Oprs SOS (init WLW[ilson]) for SG, 16 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilson files,"Book I, 26 Mar 42-26 Sep 42." (2) 1st ind SPOPH 320.2 (9-26-42),ACofS Oprs SOS (same init) to SG, 12 Oct 42, on Memo, SG for OprsDiv SOS, 26 Sep 42, same sub. HD: 632 "Hosp-Housing." (3) Draft LtrSPOPP 475, CG SOS to SG, 17 Sep 42, sub: Equip for MD Units. SG: 475.5-1.
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units and fear that the zone of interior medical servicewould be left in the lurch if numbered units were used to furnish it and werethen sent overseas. To these were added other arguments. According to theSurgeon General's Office, units needed equipment neither for training nor foremergency hospitalization. Those in training could get experience with equipmentin zone of interior hospitals and equipment required for emergencies could beshipped from depots when needed. Units were not qualified either to repackequipment for overseas shipment or to determine deletions and substitutions toreduce total weight. The former should be done by depots to prevent breakage andthe latter could be done properly only by qualified boards and representativesof The Surgeon General. Units could not replace regularly assigned personnel inzone of interior hospitals without interrupting care of the sick and loweringthe standard of professional work. Their mere presence near such hospitalsconstituted an adequate reserve of hospital facilities for emergencies; andtheir use as units would not reduce zone of interior personnel requirementsbecause their members were already assisting in the medical service under thesystem of parallel training. Finally, The Surgeon General stated that he had noreason to believe that unit training was deficient. In requesting that existingpolicy on assemblage-issuance not be changed, The Surgeon General's supplyrepresentative explained personally to SOS headquarters the shortage of medicalequipment. In refusing to submit a plan for the use of numbered units, TheSurgeon General called attention to a plan for providing an effective medicalservice for a 7,500,000-man Army with 48,000 to 50,000 physicians which he wassubmitting at the request of the Deputy Chief of Staff of the Army.72
In this instance, SOS headquarters adopted a more lenientattitude toward The Surgeon General's action than might have been expected.Perhaps this resulted from an awareness of the critical aspect of the medicalsupply situation and from some hesitancy to push The Surgeon General when he hadorders from the Deputy Chief of Staff of the Army to present a "plan."Perhaps it resulted from the apparent inclination of the Wadhams Committeetoward The Surgeon General's position rather than that of the SOSHospitalization and Evacuation Branch.73 At any rate, SOSheadquarters tabled the directive requiring a plan for the use of numberedunits,74 and the chief of its Hospitalization and Evacuation Branchworked out a compromise on the assemblage-issuance question. He adopted a newdefinition of assemblages, proposed by the SOS Plans Branch: henceforthassemblages would contain only Medical Department items. Items needed byhospitals but supplied by other services, such
72(1)Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Med Unit Assemblages. SG: 475.5-1. (2) Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units, with 2d ind, Act SG to Chief Oprs Div SOS, 14 Nov 42. SG: 320.2. Numerous memos from chiefs of various sections of SGO giving these arguments are in HD: 632 "Hosp-Housing."
73Cmtee to Study the MD, 1942, Testimony, pp. 1869ff. HD. After the war General Lutes stated that GeneralSomervell personally directed a "lenient attitude" toward the SurgeonGeneral's Office because of the Wadhams Committee's report. He wasproceeding cautiously, General Lutes stated, to determine who was correct. Ltr,Lt Gen LeRoy Lutes to Col R[oger] C. Prentiss, Jr, 8 Nov 50. HD: 314(Correspondence on MS) III.
743d ind SPOPH 320.2 (9-26-42), CG SOS to SG, 22 Nov 42, on Memo, SG for Oprs Div SOS, 26 Sep 42, sub: Asgmt, Tng, and Util of TofOpns Med Units. SG: 320.2.
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as the Quartermaster Corps, would not be included inassemblages and would be issued whenever units requested them. The SurgeonGeneral would determine the time when enough Medical Department equipment wasavailable to issue complete assemblages to all units. Until that time he wouldmake partial issues. Afterward, he would issue complete assemblages to allhospital units under AGF control. Assemblages for station and general hospitalsunder SOS control would be located in Medical Department depots so that deliverycould be made in emergencies within seven days and so that units in trainingmight readily inspect and study them.75 When the Surgeon General'sOffice found even this policy unsatisfactory, SOS headquarters delayedannouncing it officially until the medical supply situation had improved. Then,on 18 January 1943, SOS headquarters had the new policy published.76
At the beginning of the new year a combination ofcircumstances caused a revival of the question of using numbered units in thezone of interior. Contrary to what might have been expected, the"plan" which The Surgeon General submitted to the Deputy Chief ofStaff on 14 December 1942 did not deal with this question, but only with thebulk allotment of Medical Corps officers to the three major commands.77
Soon afterward, in January 1943, the SOS Director of Trainingreceived criticism from at least one service command of deficiencies in unittraining. About the same time the chief of the SOS Hospitalization andEvacuation Branch reported that failure to use units while in the United Stateswas being criticized publicly. He then requested and received authority from hissuperior officer in SOS headquarters to collaborate with the SOS Training Directorand the Surgeon General's Office in working out a plan to answer suchcriticism.78 In a subsequent conference of representatives of theSurgeon General's Office AGF headquarters, and SOS headquarters, it was"unanimously agreed," the last reported, that The Surgeon Generalwould estimate the amount of medical personnel required for hospital service ateach camp of 10,000 or greater population, would determine the minimum permanentstaff required for each hospital at those camps, and would make a definite plan,based upon OPD shipment schedules, for the use of numbered units to operate suchhospitals under the supervision of permanent staffs.79 The chief ofthe SOS Hospitalization and Evacuation Branch then took a trip around thecountry and found, he reported, that each service command surgeon agreed that hecould operate a satis-
75(1) Draft memo SPOPH 475(9-26-42), CG SOS for SG, 23Oct 42, sub: Equip for Fld Med Units. HD: Wilson files, "Book 2, 26 Sep 42-31 Dec 42." (2)Diary, Hosp and Evac Br SOS, 1 Nov 42. HD: Wilson files, "Diary." (3)Memo SPOPH 475(9-26-42), Chief Hosp and Evac Br SOS for Chief Plans Br SOS,2 Nov 42, sub: Med Unit Assemblages. HD: Wilson files, "Book 2, 26 Sep 42-31Dec 42."
76(1) WD Memo W700-4-43, 18 Jan 43, sub: Equip for Fld Med Units. HD: Wilson files, "Book III, 1 Jan 43-15 Mar 43." (2) Memo SPOPH 440, Chief Hosp and Evac Br SOS for Gen Lutes, 27 Jan 43, sub: Status of Procurement of Med Sups. Same file.
77Memo, Act SC for DepCofSA thru Mil Pers Div SOS, 14 Dec 42,sub: Availability of Physicians. SG: 322.051-1.
78(1) Memo, CG SOS (Tng Div) for SG, 5 Jan 43, sub: Tng of MC Pers. SG: 353.-1. (2) Memo SPOPH 320.2, Chief Hosp and Evac Br SOS for GenLutes, 16 Jan 43, sub: Asgmt, Tng, and Util of TofOpns Med Units. HD: Wilsonfiles, "Book III, 1 Jan 43-15 Mar 43."
79(1) Diary, Hosp and Evac Br SOS, 20 Jan 43. HD: Wilsonfiles, "Diary." (2) Memo, Maj J[ohn] S. Poe for the Record, 21 Jan 43,sub: Conf 4A526 Pentagon Bldg, 20 Jan 43. HD: 632 "Hosp-Housing."
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factory hospital service under the proposed plan.80
The plan which The Surgeon General presented on 14 April 1943indicated that agreement on the subject had not been unanimous. Instead ofproviding for the use of numbered units to operate zone of interior hospitals,it called for the use of members of such units, on a two-for-one basis, to makeup deficits in personnel-that is, differences between assigned and authorizedstrength in zone of interior hospitals. "This was done," The SurgeonGeneral stated, "because the primary function of the T/O unit isTRAINING."81
By this time seventy-eight general hospitals were reported"back-logged" in the United States, with no immediate prospect ofemployment overseas. Both the chief of the ASF Hospitalization and EvacuationBranch and the ASF Director of Training feared that the General Staff wouldreduce the number of Medical Department units in the troop basis if they werenot fully used.82 Before he could take further action toward that endColonel Wilson was succeeded in his position in SOS headquarters by Col. (laterBrig. Gen.) Robert C. McDonald, and for a time the question remained inabeyance.
Meanwhile changes occurred in the training and use of somehospital units. Completion of housing near zone of interior hospitals made itpossible to train more personnel than before on a "parallel" basis;83and year-round use by the Ground Forces of the A. P. Hill MilitaryReservation and the Desert Training Center provided opportunities for severalunits to function as hospitals, furnishing medical and surgical care forpatients in those areas.84 The issuance of assemblages to evacuationhospital units under the revised policy permitted them to train with full equipment and work out asystem of functional packing to increase unit mobility.85 Yet as arule general and station hospital units still lacked assemblages in the UnitedStates and had infrequent opportunities to function as hospitals before goingoverseas. Meanwhile, the time which some of them spent in training lengthenedconsiderably. For example, although affiliated units had been intended forprompt shipment overseas, the fifty-one affiliated general hospital units thatwere eventually sent out remained in the United States for an average ofeight months. One, the 27th General Hospital unit, stayed in this countryseventeen months. (Tables 6, 7)
The unsolved problems of assemblage-issuance and unit-use faced SurgeonGeneral Kirk when he succeeded General Magee in June 1943. Soon afterward hetook them up with Colonel McDonald. Perhaps the entry of new participants madesolution easier, for neither was unalterably committed to the position of hispredecessor. In addition, despite his ASF position, Colonel McDonald identifiedhimself closely with the Medical Department and held personal views of these
80Memo SPOPI 337, CG SOS (init WLW[ilson]) for SG and CofT, 30 Apr 43, sub:Resume of Confs. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43."
81Ltr, SG to CG ASF, 14 Apr 43, sub: Asgmt of TofOpns Units for Tng. SG: 632.-1.
82(1) Memo SPOPI 322(4-14-43), ACofS Oprs SOS (init WLW[ilson]) for Dir Tng ASF, 19 Apr 43, sub: Asgmt of TofOpns Units. HD: Wilson files, "Book IV, 16 Mar 43-17 Jun 43." (2) Memo SPTRU 370.5 (4-19-43), Dir Tng ASF for ACofS Oprs ASF, 27 Apr 43, same sub. SG: 353.-1.
831st ind, SG to Dir Tng SOS, 9 Jan 43, on Memo, CG SOS for SG, 5 Jan 43, sub: Tngof MC Pers. SG: 353.-1.
84See above, pp. 104-06.
85An Rpts, 1943, of following Evac Hosps: 27th, 32d, 39th, 51st, 99th, 103d, 106th, 110th, and 145th. HD.
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TABLE 6-AFFILIATEDGENERAL HOSPITAL UNITS
problems similar to those advocated by the Surgeon General'sOffice.86
General Kirk believed that the current policy onassemblage-issuance might be partly responsible for a problem which theaters hadreported and complained of-the receipt of equipment for a single hospital on several vessels at widely separated ports.87In July 1943, therefore, he requested its reconsideration. First heproposed a return to the policy advocated by
86Interv, MD Historian with BrigGen Robert C. McDonald,Ret, USA, 5 Mar 51. HD: 000.71.
87An Rpt, Issue Br Sup Serv SGO, FY 1944. HD.
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TABLE 7-AFFILIATED EVACUATION HOSPITAL UNITS
his predecessor-withholding all equipment for hospitalunits until they reached ports of embarkation-and then a compromise betweenthat and the existing policy. Ultimately he withdrew both proposals. After aninvestigation of split shipments, Colonel McDonald reported that the currentpolicy seemed to have little effect in causing such a problem. Furthermore,representatives of The Surgeon General agreed that a change in policy mightproduce a six-to-twelve month period of confusion in supply matters.88 Thusthepolicy on the issuance of equipment to
88(1) Ltr, SG to CG ASF, 10 Jul 43, sub: Equip for Fld MedUnits. SG: 475.5-1. (2) 1st ind SPOPI 008 (7-10-43), CG ASF to SG, 9 Aug43, on basic Ltr just cited. HD: Wilson files, "Day File, Aug 43." (3) Ltr, SG to CG ASF, 6 Aug 43, sub: Equip for Fld Med Units. HRS: ASF Control Div,334 "Procedure Cmtee, G-58." (4) Diary, Hosp and Evac Br ASF, 27 Aug43. HD: Wilson files, 400 "Med Equip and Sups." (5) Memo for Record, 7Sep 43, on Memo, SG for Col R. C. McDonald, Plans Div Oprs ASF, 7 Sep 43. SG:475.5-1. (6) 1st ind SPOPI 440 (6 Aug 43), CG ASF to SG, 28 Aug 43, on basicLtr cited in (3) above. HD: Wilson files, "Day File, Aug 43."
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numbered medical units, which the Surgeon General's Officehad formerly opposed, remained in effect for the rest of the war.89
General Kirk called for a full discussion of the question ofusing numbered hospital units in the zone of interior medical service in hisfirst conference with service command surgeons. They agreed that the existingsituation was deplorable. For example, one stated that it was difficult, whenseveral units were located on a single post, to schedule their personnel for"parallel training" without having men "falling all over eachother." Another, stressing morale, stated that one unit had been in hiscommand "so long that they've worn out all of their films showing themover and over, and they've worn out all their shoes doing the same hikes. . .."
In general, service command surgeons seemed favorablyinclined toward the proposal to use numbered units in the operation of zone ofinterior hospitals, but several feared that administrative difficulties mightarise unless units and their commanding officers were placed under the controlof station surgeons. Others believed that professional problems might develop ifnumbered units were withdrawn from named hospitals either for field training orfor overseas service without adequate personnel being left behind to operatezone of interior hospitals.90 To avoid such a situation, the SurgeonGeneral's Office announced that the adoption of any plan for the use ofnumbered units to operate zone of interior hospitals was contingent upon twoconditions: first, the assignment of two hospital units to the named hospital inwhich they were to serve, and second, the existence of suitable barracks tohouse such units. Colonel McDonald agreed to these conditions and suggested that the Surgeon General's Office prepare a planfor trial on one post. The chief of The Surgeon General's Training Divisionlacked enthusiasm for this proposal but agreed to investigate its possibilities.91Accordingly he drafted a plan by November 1943 for consideration by otherofficers of the Surgeon General's Office, but their comments indicated nodiminution of opposition to the basic idea.92
By that time events were taking place which were to cause thewhole matter to be dropped. In September 1943 the General Staff forbade the useof War Department funds to build more housing for numbered hospitals in theUnited States, thereby denying quarters for the two units per named hospitalwhich The Surgeon General had recommended.93 The next month the ASFHospitalization and Evacuation Branch, which had initiated
89(1) See above, pp. 45-46, 141-42. (2) Rpt of Subcmteeon Employment of Med Resources, Cmtee on Med and Hosp Serv of Armed Forces, Off SecDef, 25 May 48, pp. 394-95. HD.
90(1) Rpt, SGs Conf with Chiefs Med Br SvCs, 14-17 Jun 43,pp. 242, 244, 245, 259, 260. HD: 337. (2) Memo, CG SOS (SG) for CGs of SvCs, 12Jul 43, sub: Asgmt of TofOpns Units for Tng. . . , with inds from SvCs in reply. SG: 353.-1.
91Rpt, SGs Conf with Chiefs Med Br SvCs, 14-17 Jun 43, pp. 253-64. HD: 337. (2) Diary, Hosp andEvac Br ASF, 16 Jun 43. HD: Wilson files, "Diary."
92(1) Memo, Maj C[arl] C. Sox for Col A. B. Welsh, 10 Nov43, sub: Comments on Tentative Plan for the Functional Employment of NumberedASF Med Units. (2) Memo, Maj John S. Poe for no addressee, 10 Nov 43, sub:Comments on Col Wakeman's Proposal. (3) Memo, Col A. B. Welsh for Gen R. W.Bliss, 12 Nov 43. (4) Memo, Col A. H. Schwichtenberg for Gen R. W. Bliss, 13 Nov43, sub: Comments on Tentative Plan. . . . All in SG: 322.3-1.
93(1) Memo, Maj J. S. Poe for Col H[oward] T. Wickert, 7 Jul 43. HD: 632 "Hosp Housing." (2) Memo Maj J. S. Poe for Col A. B. Welsh, 16 Sep 43. Same file.
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and pushed the proposal, was abolished. Of greater importancewas the change in conditions that had prompted the proposal in the first place.From the middle of 1943 onward the pressing need for hospitals overseas causedthe departure of most units which had been held back as well as the promptshipment of others after brief periods of training.94 This disposedof the argument that services of personnel, especially doctors, were beingwasted. It meant also that fewer and fewer units were left for use in hospitalsat home. Finally, during the latter half of 1943 the troop population of theUnited States began to shrink so rapidly that the general employment of numberedhospital units to assist with medical care in the zone of interior perhaps nolonger seemed useful. As a result, the long and tedious controversy between theSurgeon General's Office and ASF headquarters over the equipment and use inthe United States of numbered hospital units reached an inconclusive end.
Preparing for the Support of Offensive Warfare
Shift of Emphasis Away From the Pacific
By about the middle of 1942, when emphasis in providinghospitalization for theaters shifted from the Pacific to other areas of theworld, emergency needs resulting from the Japanese attack had been met andpreparations for the invasion of North Africa were under way. To support thebuild-up of troops in the United Kingdom and subsequent successful North Africanoperations, hospitals went in increasing numbers to both the European and theNorth African theaters in the last half of 1942 and the early months of 1943. During the sameperiod other units were sent to scattered areas throughout the world to care fortroops engaged in service functions in support of more active theaters. Sincecombat on a large scale had not yet begun, fixed hospitals were needed more thanmobile ones, and station more than general hospitals. For example, by 15 March1943 the War Department had shipped overseas, according to The Surgeon General'srecords, 140 station hospitals, ranging in size from 25-to 750-bed capacity, 27general hospitals, and 14 field hospitals, but only 2 convalescent, 3 surgical,17 750-bed evacuation, and 6 400-bed evacuation hospitals.95
Of those shipped after 30 June 1942,the major portions wereunits that had been activated and trained after the war began. A few of theunits that were activated during 1941 and were still in the United States inmid-1942 were sent overseas in the following months, but the majority of theolder units continued during the early war years as training units, furnishingfiller personnel for others activated during 1942 and 1943 or for affiliatedunits previously organized. (Tables 8, 9, 10, 11.) As in the first sixmonths of the war, although affiliated units continued to come on active duty onThe Surgeon General's recommendation, many did not go overseas immediately.For example, although forty-two affiliated general hospital units had beenactivated by the middle of January 1943, only nineteen of them had been shippedby 15 March 1943. The remain-
94(1) See below, pp. 218-23. (2) Memo, Dep Chief OprsServ SGO for Dir Hosp Div SGO, 17 Feb 44, with incl. SG: 323.3.
95Table entitled Medical SOS Units as of 15 March1943. SG: 322.05-1.
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TABLE 8-USE OF NONAFFILIATED GENERAL HOSPITAL UNITSACTIVATED DURING 1941
der stayed in this country in a training status until later in 1943 or early in 1944.(See Table 6)
Negro Hospital Units
Among the hospital units prepared early in the war foroverseas service were two with Negro personnel. Their activation and use, likethe establishment of all-Negro wards and hospitals in the United States,96resulted from The Surgeon General's opposition to the integration of Negro andwhite personnel in providing medical service for the Army-a position in linewith the War Department's general policy on the use of Negro personnel.97 On 24March 1942 the 25th Station Hospital, a 250-bed unit, was organized at FortBragg (North Carolina). All of its members were Negroes except four officers-thecommander and his immediate staff. The use of white officers to command Negrounits was a common practice of the War Department and was not considered aviolation of the policy of segregation. Its
96See above, pp. 110-12.
97John H. McMinn and Max Levin, Personnel (MS for companion vol. in Medical Dept. series), HD., and Ulysses Lee, The Employment of Negro Troops, a forthcoming volume in the series UNITED STATES ARMY IN WORLD WAR II.
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TABLE 9-USE OF NONAFFILIATED STATION HOSPITAL UNITSACTIVATED DURING 1941
advisability for hospital units was later questioned, and itwas not followed in the case of other Negro hospital units activated duringWorld War II. An advanced detachment of the 25th Station Hospital embarked inMay 1942 for Liberia to support a force of construction engineers, personnel ofthe Air Transport Command and the Royal Air Force, natives employed by the Armyat Roberts Field, and elements of a task force charged with protecting anairstrip and American rubber interests. After quarters were constructedoverseas, the remainder of the unit, including its nurses, joined the advanceddetachment on 10 March 1943. About the same time an all-Negro 150-bed unit, the268th Station Hospital, was activated at Fort Huachuca (Arizona). After a periodof training, it embarked for the Southwest Pacific theater in October 1943 and arrived in Australia inNovember.98
Establishing a Basis for Future Planning
Toward the end of 1942 the shift in emphasis from defensivemeasures to preparations for the offensive made it necessary to take stock ofhospitalization already supplied in order to plan effectively for the future.Records of the number of hospital units shipped did not necessarily representthe number of beds available in the several theaters. In some instances, forreasons not often divulged to The Surgeon General, OPD diverted
98(1) An Rpt, 25th Sta Hosp, 1943, andQuarterly Hist Rpt, 268th Sta Hosp, 7 Jul 44. HD. (2) Diary, Col Stephen D. Berardinelli, 21 Jun 42 to 21 Dec 43.In his possession. (3) Interv, MD Historian with Col Berardinelli, formerly CO of 25th StaHosp, 24 Feb 50. HD: 000.71.
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TABLE 10-USE OF NONAFFILIATED EVACUATION HOSPITAL UNITSACTIVATED DURING 1940 AND 1941
units to different destinations from those for which theywere originally earmarked. It sometimes happened that units arrived at overseasports without equipment, which was shipped on other vessels, and therefore couldnot set up for actual operations. At other times assemblages were shipped asexpansion units, for theaters to issue as needed to numbered hospitals that werealready operating, to overseas hospitals that had operated during peacetime andwere now being expanded, or to provisional hospitals that were being establishedwith theater personnel. Furthermore, the U.S. Army was receiving hospitalizationin some areas through reverse lend-lease. Thus The Surgeon General could not rely upon records of shipment of hospitalunits and assemblages for accurate information about beds available overseas.Nor could he depend upon statistical health reports (Medical Department Form No.86ab). Designed to supply his Office regularly with information about admissionsand dispositions of patients and about available and occupied beds in all Armyhospitals, these reports often reached Washington only after considerable delayand differed in many instances from other available records.99
99Memo, SG for Oprs Div SOS, 31 Oct 42, sub: Bed Capacities for Fixed Hosps at Overseas Bases. SG: 632.2.
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TABLE 11-USE OF NONAFFILIATED SURGICAL HOSPITAL UNITSACTIVATED DURING 1940 AND 1941
Unit Designation | Date of Activation | Redesignation in U.S. | Date of Embarkation | Initial Destination | Redesignation Overseas | ||
Unit | Date | Unit | Date | ||||
6th Surg Hosp | 1 Aug 40 | 91st Evac (Mtz) | 31 Aug 42 | 12 Dec 42 | N. Africa | --- | --- |
7th Surg Hosp | 1 Aug 40 | 92d Evac (Mtz) | 25 Aug 42 | 28 Jun 43 | Australia | --- | --- |
28th Surg Hosp | 10 Feb 41 | --- | --- | 4 Mar 42 | Australia | 360th Sta Hosp | 28 Oct 43 |
33d Surg Hosp | 25 Jan 41 | --- | --- | 4 Mar 42 | Australia | 361st Sta Hosp | 28 Oct 43 |
48th Surg Hosp | 10 Feb 41 | --- | --- | 2 Aug 42 | England | 128th Evac (SM) | 1 May 43 |
61st Surg Hosp | 1 Jun 41 | 93d Evac (Mtz) | 25 Aug 42 | 16 Apr 43 | N. Africa | --- | --- |
63d Surg Hosp | 1 Jun 41 | 94th Evac (Mtz) | 25 Aug 42 | 28 Apr 43 | N. Africa | --- | --- |
74th Surg Hosp | 1 Jun 41 | 95th Evac (Mtz) | 25 Aug 42 | 16 Apr 43 | N. Africa | --- | ---
|
Sources: Unit cards filed in Orgn and Directory Section, Oprs Br AGO, and annual reports filed in HD.
In July 1942, therefore, to get more accurate and morecurrent information than he had, The Surgeon General called upon SOSheadquarters for assistance.100 Finding that neither SOS headquarters norOPD had accurate records of the beds available in various theaters, the SOSHospitalization and Evacuation Branch requested the latter, on 6 August 1942, torequire all overseas commanders to submit a report on the capacities andnumerical designations of their fixed hospitals.101 This request wasapproved and, as the reports came in, the Surgeon General's Office, the SOSHospitalization and Evacuation Branch, and OPD were able to get an accuratepicture of hospitalization overseas at that time. It showed that the ratio offixed beds to troop strength ranged from 2.09 percent in some areas to 24.1percent in others.102
Even after reports of overseas bed capacities had beenreceived and tabulated, several obstacles to planning for the future had to beremoved. In the first place, The Surgeon General was uncertain about hisauthority to make recommendations concerning overseas hospitalization, in viewof the hospitalization and evacuation policy which was published on 18 June 1942 making overseascommanders responsible for "the operation of all medical facilities undertheir control and for future planning in connection therewith" (italicsadded).103 Despite this policy, SOS headquarters assured him thathe could make recommendations about hospitalization and evacuation in theaterswhenever appropriate. The Surgeon General also felt that he receivedinsufficient information, both from higher authorities in the War Department andfrom surgeons in thea-
100(1) Memo, SG for Dir Oprs SOS, 11 Jul 42. SG: 632.2. (2) Memo, SG for Oprs Div SOS, 29 Jul 42, sub: FixedHosp Beds Overseas. HD: 632.-1 "Hosp Overseas, Bed Status."
101(1) Memos SPOPM 323.7 and SPOPH 632, CG SOS for ACofS OPDWDGS, 6 and 27 Aug 42, sub: Fixed Hosp Fac Available to Overseas Forces. HD: Wilson files, "Book I, 26 Mar 42-26 Sep 42." (2)1st ind, CG SOS to SG, 14 Aug 42, on Memo, SG for Oprs Div SOS, 29 Jul 42, sub:Fixed Hosp Beds Overseas. HD: 632.-1, "Hosp Overseas, Bed Status."
102(1) Memo SPOPH 632(Hosp), CG SOS for SG, 20 Oct 42, sub: Bed Capacities of Fixed Hosps at Overseas Bases. HD: 632.-1 "Hosp Overseas, Bed Status." (2) Memo, SG for Oprs Div SOS, 31 Oct 42, same sub, with 1st ind SPOPH 632(10-31-42), CG SOS to SG, 16 Nov 42. Same file.
103Ltr AG 704 (6-17-42)MB-D-TS-M, TAG to CGsAGF, AAF, SOS, Theaters, etc., 18 Jun 42, sub: WD Hosp and Evac Policy. HD: 705.-1.
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ters, to enable him to plan intelligently and effectively foroverseas hospitalization. While much information he desired from higherauthorities was classified for security reasons, the SOS Hospitalization andEvacuation Branch attempted to provide him with more information aboutoperational plans than he had previously received.104Furthermore,in collaboration with the Surgeon General's Office that Branch took actionwhich led to the establishment in January 1943 of a system of monthly reports fromoverseas commands. Submitted first as sections of the Monthly Sanitary Reportsand after July 1943 as Reports of Essential Technical Medical Data (ETMD's),these reports contained information about admission and evacuation rates,availability of hospital beds, suitability of hospital units and theirequipment, and other factors of importance to The Surgeon General in planningtheater medical services.105 In addition, beginning with General Magee'strip to North Africa in the winter of 1942-43, representatives of the SurgeonGeneral's Office made personal inspections of overseas areas in order to gainfirsthand information about their medical services.106
Further obstacles to planning were lack of sufficientexperience with battle casualties thus far in World War II to estimateaccurately hospital admission rates and lack of an official evacuation policy-thatis, a policy governing the selection of patients for evacuation to the UnitedStates in terms of the days of hospitalization which they were expected torequire. In their absence The Surgeon General used for planning purposes thebattle-casualty admission rates of World War I and assumed a policy of returningto the United States all patients who required 120 or more days ofhospitalization. To establish a firmer basis for planning, he recommended in the spring of1943 the establishment of an official evacuation policy but such action was nottaken until later in the year.107
In providing hospitals for overseas service early in the war,the Medical Department discovered and attempted to correct shortcomings anderrors in its prewar planning. It was discovered early that the activation andtraining of normal Army units was more valuable in meeting emergency hospitalneeds than the formation and organization of units affiliated with civilianhospitals and schools. Moreover, it soon appeared that units planned fortheaters of operations were not suitable for all situations encountered in amodern global war and units of new types had to be de-
104(1) MemoSPMCP 704.-1, Act SG for Oprs Div SOS, 16 Nov 42, sub: Status of Hosp Overseas, with lst indSPOPH 701 (11-16-42), ACofS Oprs SOS to SG, 24 Nov 42. (2) Memo SPOPH 701 (11-16-42), CG SOS for ACofS OPD WDGS, 24 Nov 42, same sub. (3) Memo OPD 701 (11-24-42), ACofS OPD WDGS for CG SOS, 23 Jan 43, same sub. All in HD: 632.-1 "Hosp Overseas, Bed Status."
105(1) Rad CM-OUT 5938-5957, TAG to CGs Overseas Comds. SG: 370.2-1. (2) Memo SPOPH 440, CG SOS for TAG, 28 Dec 42, sub: ETMD fromOverseas Forces, with Memo for Record. HD: Wilson files, "Book IV, 16 Mar43-17 Jun 43." (3) Diary, SOS Hosp and Evac Br, 4 Dec 42. HD: Wilsonfiles, "Diary." (4) Ltr AG 350.05 (12-28-42)OB-S-SPOPH-M, TAGto CGs Overseas Comds, 2 Jan 43, sub: ETMD from Overseas Forces. HD: Wilsonfiles, "Experience in Med Matters from Overseas Forces." (5) Ltr AG350.05 (28 Jun 43)OB-S-D-M, TAG to CGs Overseas Comds, 14 Jul 43, same sub.HD: 350.05 "Mil Info."
106Memo, SG for CG SOS, 12 Jan 43. HRS: Hq ASF, Gen [WilhelmD.] Styer's files, "Med Dept."
107(1) Memo SPMCP 704.-1, Act SG for Oprs Div SOS, 16 Nov42, sub: Status of Hosp Overseas, with 1 incl. HD: 632.-1 "Hosp Overseas,Bed Status." (2) Memo, Dir Control Div ASF for CG ASF, 2 Apr 43, sub:Situation with Respect to Army Hosp. SG: 322.15. (3) Memo, SG for CG ASF, 15 Apr 43, sub: Evac Policy for Overseas Theaters. SG: 705.-1. (4) Seebelow, pp. 215-16.
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veloped-field hospitals, motorized evacuation hospitals,and portable surgical hospitals. The size and weight of equipment of allhospital units had to be reduced and new methods of packing had to be developedin order to increase the mobility and transportability of hospitals. Shortagesof Medical Corps officers appeared and required reductions in the numberauthorized by tables of organization developed during the emergency period.Shortages of equipment continued to plague the Medical Department and partiallyaccounted for The Surgeon General's insistence upon withholding its issuance untilhospital units were assigned to missions involving the care of patients. In thisconnection, The Surgeon General also resisted demands of higher authorities toplan for the use of numbered hospitals in the zone of interior medical service.Meanwhile other units were being activated and trained, and toward the end ofGeneral Magee's administration measures were taken to find out what hospitalfacilities theaters actually had and to place planning for future needs on asounder basis.
