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XVI

THE WAR SERVICE OF THE MEDICAL

PROFESSION

FREDERICK F. RUSSELL

THE DEVELOPMENT OF THE PERSONNEL OF THE MEDICAL CORPS

THE

OF THE ARMY

HE number of medical officers in the army before we entered the war was, on June 30th, 1916, 589, and this number was made up of 443 belonging to the regular army and 146 who were members of the Medical Reserve Corps. On June 30, 1917, one year later, and two and one-half months after war had been declared, the prompt response to the call for physicians from civil life to assist the small nucleus already in service, resulted in an increase to 4125, of whom 487 belonged to the regular service and 3636 to the reserve. On June 30, 1918, there were 867 regular medical officers and 20,855 who were serving with temporary commissions in the Medical Corps, a total of 21,722. On June 30, 1919, there were 948 regular and 11,783 temporary medical officers, a total of 12,731.

The greatest number in service was 989 regular and 29,602 temporary officers, a total of 30,591 about the middle of November, 1918.

The enlisted force of the Medical Department increased from 6691 on April 6, 1917, to 154,556 on July 1st, 1918, to 264,181 on November 15th, 1918, and decreased to 98,396 on June 30th, 1919. Until the time of the last reorganization of the army, in 1909, the enlisted men of the Medical Department were known as the Hospital Corps, a name far from appro

priate, since large numbers of them were attached to mobile military formations, companies, battalions and regiments, and they had no hospital duties whatever while so serving; further it was a corps without officers which was an anomalous condition and for these and other reasons the name was changed to the enlisted force of the Medical Department; the latter also comprised the Dental, Veterinary and Nurse Corps, and after the outbreak of the war, and the passage of the National Defense Act, the Sanitary Corps, the U. S. Army Ambulance Service and a large number of Contract Surgeons and civil employees.

These elements of the Medical Department and their strength at different periods is shown in the following table:

In 1918, there were, in the whole United States, 147,812 physicians, and among these there was a considerable number who were not in active practice of their profession. The largest number on active duty with the army on any one date was 30,591, on the 15th of November, 1918. There were many losses among the medical officers; for example, in some weeks the losses exceeded the gains, so the total number of physicians who were at one time or another in active service was much greater than the number just given. The exact figures cannot now be stated, but it was in the neighborhood of 40,000, and this last number represents, perhaps, about one third of the physicians in active practice in the United States.

It has been estimated by military authorities in the past that it would require seven physicians per thousand of army strength for service directly with troops and approximately three per thousand in addition for work at home with recruiting, with convalescents and chronic cases. Since we had approximately four million men at one time or another and about 40,000 physicians in all, the result, 10 per thousand, corresponds very closely with the estimate. The greatest number in the army at any one time was 3,634,000 on the first of November, 1918, and at about that time we had 30,591 medical officers, which again is very close to the estimate.

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STRENGTH OF PERSONNEL, MEDICAL DEPARTMENT

A. Increase in Strength of Personnel

Strength when war was declared and greatest number in service (about Nov. 15, 1918); also July 1, 1918, and

June 30, 1919.

Dental Corps: Commissioned...
Sanitary Corps: Commissioned..
Veterinary Corps:

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2 Col. Ireland made Surgeon General, Col. McCaw made brigadier general, and Lieut. Col. Noble made brigadier general.

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3 Figures for July 1, 1918, will not be known until the records of the chief surgeon, American Expeditionary Forces, are transferred to the Surgeon General's Office.

Temporary

Total

The response of the medical profession to the call of the Government was at all times sufficient for our needs, and in addition permitted us to loan medical officers to our Allies in considerable numbers, particularly to Great Britain.

The wastage or losses from all causes during the period of our participation in the war, was about ten thousand or onequarter of the total names on the rolls.

SANITARY ENGINEERING PROBLEMS AT HOME AND ABROAD

In home territory in all large National Army and National Guard camps good potable water was provided, where possible by purchasing treated water from a nearby city, but when this was not feasible a complete water supply system was installed at the camp itself. This usually consisted of an impounding basin for the collection and sedimentation of the raw water, which was then filtered in some form of rapid sand filter after dosing with alum or other suitable coagulant, to throw down all suspended matter. Finally, at practically every place, the clear water was then treated with anhydrous chlorin gas, which disinfected the water by oxidizing all organic matter.

In smaller places, the question of water purification was less satisfactorily answered. The Lyster bag method of chlorination was the standard. The chlorin was added to the raw water, in the form of bleaching powder, which was put up in small measured quantities, in glass ampuls. The bag itself is made of strong canvas and is attached to a folding iron ring at the top. At the sides a little above the bottom, high enough to avoid the sediment which falls gradually to the lowest point, are several simple faucets from which the water is drawn off to fill canteens and other pure water containers.

The control of successful water sterilization by means of chlorin is fortunately a simple matter, consisting merely in a test for free chlorin by means of the starch iodine test. This is made thirty minutes after the bleaching powder has been added to the water in the Lyster bag, by taking a large cupful and adding to it 10 drops of a 10 per cent. solution of iodide

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