Professional Documents
Culture Documents
xii
Preface
Medical Service in the Mediterranean and Minor Theaters is one of
three volumes dealing with the overseas administrative history of the United
States Army Medical Department in World War II. Companion studies
will deal respectively with the European Theater of Operations and the war
against Japan in the Pacific and China-Burma-India Theaters. These
volumes differ from the more extensive clinical series, separately published
by the Office of The Surgeon General, in that they are concerned primarily
with the support given by the Medical Department to the actual combat
operations: the collection of the wounded on the battlefield; the establish-
ment of hospitals; the chain of evacuation from the point of contact with
the enemy back to the communications zone and on to the zone of interior;
and the methods and problems of medical supply in the field. Clinical mat-
ters, such as the incidence of disease, the types of wounds predominating,
and problems of sanitation, are subordinated to the less technical story of
the Medical Department in action. The administrative volumes thus relate
both to the general combat history told elsewhere in the series UNITED
STATES ARMY IN WORLD WAR II and to the medical story proper
recorded in the 40-odd volumes of the clinical series appearing under the
imprint of the Office of The Surgeon General. They are complemented by
Clarence McKittrick Smith's Hospitalization and Evacuation, Zone of In-
terior; and by four functional volumes, being published by the Office of
The Surgeon General, which deal respectively with Organization and Ad-
ministration of the Medical Department, Personnel, Training, and Medical
Supply.
The manuscript of this volume was submitted in draft form to a sub-
stantial cross section of those who participated in the actions described.
Those who offered substantiation, corrections, or additions were: Abram
Abeloff, M.D.; Lt. Col. James J. Adams, MSC; William H. Amspacher, M.D.;
Col. Richard T. Arnest, MC, USA (Ret.) ; Col. Rollin L. Bauchspies, MC,
USA (Ret.); Col. Charles H. Beasley, MC, USA (Ret.); Austin W. Bennett,
M.D.; Lt. Col. Stephen D. Beradinelli, MC; Col. Daniel J. Berry, MC, USA
(Ret.) ; Frank B. Berry, M.D.; Col. Albert A. Biederman, MC; Col. Charles
O. Bruce, MC; Col. Gordon G. Bulla, MC, USAF; J. P. Cameron, M.D.;
Col. Joseph Carmack, MSC, USA (Ret.) ; Lt. Col. Dan Crozier, MC; Brig.
Gen. Henry C. Dooling, MC, USA (Ret.); Col. Daniel Franklin, MC, USA
xiii
(Ret.); Frank P. Gilligan, M.D.; Brig. Gen. L. Holmes Ginn, Jr., MC, USA
(Ret.) ; Michael Q. Hancock, M.D.; Norman L. Heminway, M.D; Col. John
A. Isherwood, MC; Maurice M. Kane, M.D.; Col. Paul A. Keeney, MC,
USA (Ret.); Col. Emmett L. Kehoe, MC; Maj. Gen. Albert W. Kenner,
MC, USA (Ret.); Col. William F. Lawrence, MSC; Col. George E. Leone,
MC; Col. John F. Lieberman, MC, USA (Ret.); Gunnar Linner, M.D.;
John R. McBride, M.D.; John C. McSween, M.D.; Col. William C. Munly,
MC, USA (Ret.); Robert Bruce Nye, M.D.; Col. Forrest R. Ostrander, MC,
USA (Ret.); Benjamin M. Primer, M.D.; Col. Matthew C. Pugsley, MC, USA
(Ret.); Maj. Gen. Clement F. St. John, MC; Brig. Gen. Crawford F. Sams,
MC, USA (Ret.) ; Col. John W. Sherwood, MC, USA (Ret.); Charles F.
Shook, M.D.; Maj. Gen. Earle Standlee, MC, USA (Ret.); Maj. Gen. Mor-
rison C. Stayer, MC, USA (Ret.); William S. Stone, M.D.; Col. John H.
Sturgeon, MC, USA (Ret.); Col. E. M. P. Sward, MC, USA (Ret.); Brig.
Gen. Lynn H. Tingay, DC, USA (Ret.); Col. Hall G. Van Vlack, MC, USA
(Ret.); Col. Dean M. Walker, MC, USA (Ret.); and Thomas G. Ward,
M.D. To each of these the author wishes to express his thanks. Without
their considerable help much authenticity would be lacking.
Sections of the volume dealing with strictly military events were checked
by knowledgeable members of the Office of the Chief of Military History
(OCMH) staff, including Martin Blumenson, Ernest F. Fisher, Jr., and
Robert Ross Smith. If the combat narrative lacks at any point in accuracy,
it is through no fault of these conscientious reviewers.
The manuscript was read in its entirety by Dr. Donald O. Wagner,
former Chief Historian, The Historical Unit, U.S. Army Medical Service
(USAMEDS), before his retirement early in 1960; by Col. John Boyd
Coates, Jr., Director of The Historical Unit; and by Dr. Stetson Conn, Chief
Historian, Office of the Chief of Military History. Each of these critics
offered pertinent and valuable suggestions for improvement.
Mr. William K. Daum did much of the research for chapters I and II
and prepared preliminary drafts of both.
For expert and unfailing aid in locating and procuring the thousands
of documentary sources on which the work is based, the author makes
special acknowledgment to Mrs. Josephine P. Kyle, former chief of the
General Reference and Research Branch of The Historical Unit, and to
her assistant, the late Mrs. Eleanor Alfonso, whose cheerful willingness never
faultered despite the constant presence of fatal illness. Mrs. Kyle's suc-
cessors, Maj. Albert C. Riggs, Jr., MSC, and Mr. Roderick M. Engert, did
not participate until the book had reached the stage of review and final re-
vision, but both were unstinting of their time and expert knowledge.
The author is also indebted to the Medical Statistics Division, Office of
The Surgeon General, and especially to Mr. Carroll I. Leith, Jr.,—himself
a veteran of the Mediterranean campaigns—who verified figures and tabu-
lations, and in many instances proposed better ways of presenting them.
xiv
Preliminary editorial work was done by Mrs. Cyrilla E. Hickey of The
Historical Unit, USAMEDS, and the final publications editing by Miss
Mary Ann Bacon of OCMH. Copy editor for the volume was Mrs. Marion
P. Grimes. The book is undoubtedly the better for having passed through
the capable hands of these three editors. The excellent medical situation
maps that make the text so much easier to follow were prepared by Miss
Elizabeth P Mason, assisted by Miss Jean A. Saffran, both of The Historical
Unit, USAMEDS. The photographs were selected by the author. The
index was compiled by Susan Stevens New.
xvii
Chapter Page
V. THE NORTH AFRICAN COMMUNICATIONS ZONE 177
Theater Organization ...................................... 177
Hospitalization in the Communications Zone ................. 185
Evacuation in the Communications Zone ..................... 203
Medical Supplies and Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Professional Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210
Army Public Health Activities .............................. 219
VI. SALERNO TO THE GUSTAV LINE .... 222
Medical Plans for AVALANCHE ............................ 223
Medical Support in the Conquest of Southern Italy ............ 226
Hospitalization in the Army Area ........................... 247
Evacuation From Fifth Army ................................ 250
Medical Supplies and Equipment ............................ 251
Professional Services in the Army Area . . . . . . . . . . . . . . . . . . . . . . . 252
VII. ANZIO BEACHHEAD . . . . . . . . . . . . . . 266
Medical Planning for Operation SHINGLE .................. 266
Combat Medical Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 268
Hospitalization on Anzio Beachhead ......................... 275
Evacuation From the Beachhead ............................. 278
Medical Supplies and Equipment ............................ 280
Professional Services on the Beachhead . . . . . . . . . . . . . . . . . . . . . . 282
VIII. FROM THE GARIGLIANO TO THE ARNO ......... 289
Preparations for the Offensive ............................... 289
Combat Medical Service . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 291
Hospitalization in the Army Area . . . . . . . . . . . . . . . . . . . . . . . . . . . 303
Evacuation From Fifth Army . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 310
Medical Supplies and Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
Professional Services in the Army Area ...................... 314
Medical Support for the Eastern Command . . . . . . . . . . . . . . . . . . 320
I.. THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN
PHASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 323
Changes in Theater Organization ............................ 323
Hospitalization in the Communications Zone . . . . . . . . . . . . . . . . . 327
Evacuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 340
Medical Supplies and Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
Professional Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 350
Army Public Health Activities .............................. 360
X. INVASION OF SOUTHERN FRANCE . . . . . . . . . . . 366
Preparations for the Invasion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 366
Medical Support of Seventh Army in the Field . . . . . . . . . . . . . . . . 374
xviii
Chapter Page
X. INVASION OF SOUTHERN FRANCE-Continued
Hospitalization in the Army Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . 386
Evacuation From Seventh Army . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 395
Extension of the Communications Zone . . . . . . . . . . . . . . . . . . . . . . 399
Medical Supplies and Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 404
Professional Services in Southern France .................... . . 408
XI. THE NORTHERN APENNINES . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Preparations for the Offensive . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 415
Combat Operations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 419
Medical Support in the Field . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 425
Hospitalization in the Army Area . . . . . . . . . . . . . . . . . . . . . . . . . . . 435
Evacuation From Fifth Army . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
Medical Supplies and Equipment ............................ 448
Professional Services in the Army Area ....................... 449
XII. ADVANCE TO THE ALPS . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .457
Preparations for the Final Drive ............................. 457
The Po Valley Campaign . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 460
Hospitalization in the Army Area . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
Evacuation From Fifth Army . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Medical Supplies and Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Professional Services in the Army Area . . . . . . . . . . . . . . . . . . . . . . . 482
XIII. THE ITALIAN COMMUNICATIONS ZONE: NORTHERN
PHASE . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 486
Organizational Changes Affecting the Medical Service .......... 486
Hospitalization in the Communications Zone ................. 489
Evacuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 502
Medical Supplies and Equipment ......................... . . 506
Professional Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 513
Army Civil Public Health Activities . . . . . . . . . . . . . . . . . . . . . . . . . 519
XIV. CONTRACTION A N D REDEPLOYMENT . . . . . . . . . 5 2 1
Redeployment Policies and Plans .......................... . . 521
Medical Support of Fifth Army .............................. 523
Hospitalization and Evacuation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 528
Hospitalization and Repatriation of Prisoners of War .......... 534
Redeployment and Inactivation of Medical Units ............ . . 543
Close-out in the MTO . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 548
X V . T H E MEDITERRANEAN I N RETROSPECT . . . . . . . . . 552
Appendix Page
A. HOSPITAL STATISTICS . 5 5 9
1. Fixed Beds and Bed Ratios, Atlantic Defense Areas, July
1941-December 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .559
2. Fixed Beds and Bed Ratios, Africa and the Middle East
(Includes Persian Gulf Command), June 1942-Decem-
ber 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 562
3. Bed Strength and Bed Occupancy, North African Com-
munications Zone, November 1942-February 1945 . . . . 564
4. Bed Strength and Bed Occupancy, Mediterranean Islands
August 1943-April 1945 . . . . . . . . . . . . . . . . . 5 6 5
5. Bed Strength and Bed Occupancy, Italian Communications
Zone, October 1943-September 1945 . . . . . . . . . . . . . . . . . . . 566
6. Fixed Bed Strength and Bed Occupancy, Mediterranean
Theater, November 1942-September 1945 . . . . . . . . . . . . . . 567
B. PRINCIPAL MEDICAL UNITS ACTIVE IN THE MEDITER-
RANEAN THEATER OF OPERATIONS, THE ATLANTIC
DEFENSE AREAS, AFRICA, AND THE MIDDLE EAST 569
C. OBSERVATIONS ON HOSPITALIZATION AND EVACUA-
TION SYSTEM, FRENCH EXPEDITIONARY CORPS, AS-
SIGNED FIFTH ARMY . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ... 598
D. THE GERMAN MEDICAL ESTABLISHMENT . . . . . . . . . . . . . . . 601
Tables
No.
1. Hospital Admissions and Dispositions, II Corps, 1 January-15 May
1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136
2. Air Evacuation From Tunisia, 16 January-23 May 1943 . . . . . . . . . . . . 140
3. Intratheater Evacuation by Air, North Africa, 16 January-23 May 1943. . 205
4. U.S. Army Patients Evacuated by Sea From North Africa to the Zone
of Interior, 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
5. Hospital Admissions From Fifth Army, 9 September 1943-30 April
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250
xx
No. Page
6. Disposition of Neuropsychiatric Cases in Fifth Army, September 1943-
April 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 5 6
7. Venereal Disease Rate per Thousand per Annum, by Divisions, Sep-
tember 1943-April 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 259
8. Disposition of Patients, Fifth Army Venereal Disease Diagnostic and
Treatment Center, January-April 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . 259
9. Dental Service in Fifth Army, September 1943-April 1944 . . . . . . . . . . . . 264
10. Disposition of Problem Cases in the 3d Division, 4 March-30 April
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 8 5
11. Admissions to Hospital and Quarters From Fifth Army, May-August
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 1 0
12. Air Evacuation From Fifth Army Hospitals, 26 May-31 August 1944 ... 311
13. Evacuation From Fifth Army to PBS Hospitals, 1 January—31 August
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 312
14. Disposition of Neuropsychiatric Cases in Fifth Army, May—August
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 316
15. Venereal Disease Rates by Divisions, Fifth Army, May—August 1944 . . . . 317
16. Dental Service in Fifth Army, May-August 1944 . . . . . . . . . . . . . . . . . . . . 319
17. Admissions to PBS Hospitals, 14 October 1943-31 August 1944 . . . . . . . . 338
18. Disposition of Patients in PBS Hospitals, 14 October 1943-31 August
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 338
19. Evacuation From Italy to North Africa, 9 September 1943-21 January
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 343
20. Evacuation From Italy to North Africa, January-August 1944 . . . . . . . . 344
21. Evacuation From the Mediterranean to the Zone of Interior, January-
August 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 344
22. Venereal Disease Rates, NATOUSA, January-August 1944 . . . . . . . . . . . 354
23. Admissions and Dispositions, Seventh Army Medical Installations, 15-
18 August 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 381
24. Admissions and Dispositions, Seventh Army Medical Installations, 15
August-29 September 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 394
25. Air Evacuation From Seventh Army and Delta Base Section, 22 Au-
gust-7 November 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 398
26. Summary of Evacuation to the Communications Zone, 15 August-
3 November 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 400
27. Establishment in Southern France of Fixed Hospitals From North
Africa, Italy, and Corsica . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 401
28. Requisitions and Tonnage, 7th Medical Depot Company, August-
November 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 406
29. Receipts and Issues, 231st Medical Composite Battalion, September-
November 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 408
30. Venereal Disease Rates, Seventh Army, July-September 1944 . . . . . . . . . 411
xxi
No. Page
31. Disposition of Neuropsychiatric Cases, Fifth Army, September 1944-
March 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 5 2
32. Dental Service in Fifth Army, September 1944-March 1945 . . . . . . . . . . . 454
33. Wounded in Action in the Po Valley Campaign, Fifth Army, 1 April-
15 May 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 468
34. Evacuation From MTOUSA to the Zone of Interior, September 1944-
April 1945 . . . . . . . . . . . . . . . . . . . 5 0 5
35. Evacuation of Brazilian Patients to Brazil, September 1944-April 1945 . . 506
36. Medical Supplies on Hand in PBS Depots, September 1944-April 1945 .. 512
37. Noneffective Rates per Thousand of Troop Strength per Annum, Sep-
tember 1944-April 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 515
38. Intratheater Evacuation: U.S. and Allied Personnel, May-September
1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 531
39. Evacuation From MTOUSA to the Zone of Interior, May-December
1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 533
Maps
1. U.S. Army Hospitals Supporting North Atlantic Bases, 1 June 1943. . 13
2. U.S. Army Hospitals in the Caribbean . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
3. U.S. Army Hospitals Supporting South Atlantic Bases, 1943-45 . . . . . . . 48
4. U.S. Army Hospitals in USAFIME, 1 July 1943 . . . . . . . . . . . . . . . . . . . . . 69
5. U.S. Army Hospitals in the Persian Gulf Service Command, 1 July
1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75.
6. Medical Support of Eastern Task Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 109
7. Medical Support of Center Task Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 112
8. Medical Support of Western Task Force . . . . . . . . . . . . . . . . . . . . . . . . . . . . 116
9. II Corps Medical Installations, 14 February 1943 . . . . . . . . . . . . . . . . . . . . 125
10. II Corps Medical Installations, 24 February 1943 . . . . . . . . . . . . . . . . . . . . 128
11. II Corps Medical Installations, 11 April 1943 . . . . . . . . . . . . . . . . . . . . . . . 130
12. II Corps Medical Installations, 23 April 1943 . . . . . . . . . . . . . . . . . . . . . . . 133
13. II Corps Medical Installations, 12 May 1943 . . . . . . . . . . . . . . . . . . . . . . . 135
14. Seventh Army Hospitals, 16 July 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154
15. Seventh Army Hospitals, 26 July 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158
16. Seventh Army Hospitals, 5 August 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . 160
17. Seventh Army Hospitals, 15 August 1943 . . . . . . . . . . . . . . . . . . . . . . . . . . . . 161
18. Fixed Hospitals and Base Medical Supply Depots in North Africa,
November 1942-February 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184
19. Fixed Hospitals and Base Medical Supply Depots on Sicily, August
1943-July 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 198
xxii
No. Page
20. Fixed Hospitals and Base Medical Supply Depots on Sardinia and
Corsica, November 1943-May 1945 . . . . . . . . . . . . . . . . . 2 0 0
21. Fifth Army Hospitals and Medical Supply Dumps, 9 October 1943 . . . . 232
22. Fifth Army Hospitals and Medical Supply Dumps, 15 November 1943. . 236
23. Fifth Army Hospitals and Medical Supply Dumps, 15 February 1944 . . 242
24. Anzio Beachhead and Surrounding Areas . . . . . . . . . . . . . . . . . . . . . . . . . . . 269
25. Fifth Army Hospitals and Medical Supply Dumps on the Cassino
Front, 1 1 M a y 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 9 0
26. Fifth Army Hospitals and Medical Supply Dumps, 10 June 1944 . . . . . . 305
27. Fifth Army Hospitals and Medical Supply Dumps, 15 July 1944 . . . . . . 308
28. Fifth Army Hospitals and Medical Supply Dumps, 15 August 1944 . . . . . 309
29. Fixed Hospitals in Southern Italy, October 1943-October 1947 . . . . . . . 330
30. Seventh Army Hospitals and Medical Supply Dumps, 20 August 1944. . 378
31. Seventh Army Hospitals and Medical Supply Dumps, 1 September
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 389
32. Seventh Army Hospitals and Medical Supply Dumps, 15 September
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 390
33. Seventh Army Hospitals and Medical Supply Dumps, 30 September
1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 391
34. Fixed Hospitals Transferred From MTO to ETO, 20 November 1944. . 403
35. Fifth Army Hospitals and Medical Supply Dumps, 18 September 1944. . 436
36. Fifth Army Hospitals and Medical Supply Dumps Supporting II
Corps, 25 October 1944 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 438
37. Fifth Army Hospitals and Medical Supply Dumps on the IV Corps
and 92d Division Fronts, 15 January 1945 . . . . . . . . . . . . . . . . . . . . . . . . 441
38. Fifth Army Hospitals and Medical Supply Dumps on the II Corps
Front, 15 January 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 443
39. Hospitals and Medical Supply Dumps Supporting the Fifth Army
Offensive, 18 April 1945 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 470
40. Fifth Army Hospitals and Medical Supply Dumps, 26 April 1945 . . . . . . 472
41. Fifth Army Hospitals and Medical Supply Dumps, 2 May 1945 . . . . . . . . 474
42. Fixed Hospitals in Northern Italy, July 1944-October 1947 . . . . . . . . . . . 492
43. Medical Installations Supporting Fifth Army, 1 June 1945 . . . . . . . . . . . . 524
Illustrations
. . . the Unsung Heroes of the War . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .Frontispiece
Lt. Col. Charles H. Beasley . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
167th Station Hospital, Iceland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
BLUIE WEST 1, Greenland . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
308th Station Hospital, Fort Pepperrell, Newfoundland . . . . . . . . . . . . . . . . . . 24
xxiii
Page
Convalescent Patients, Bermuda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Col. Gordon G. Bulla . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
Brig. Gen. Morrison C. Stayer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35
A i r Evacuation, Panama . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 0
Col. George E. Leone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46
Malaria Control Unit, Brazil . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Col. Crawford F. Sams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 58
Col. Hall G. Van Vlack . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
DC-3 Over Pyramids . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
King George of Greece at 38th General Hospital, Heliopolis . . . . . . . . . . . . . . 70
Hospital Train, Benghasi Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 71
Partially Dug-In Hospital Tents Near Tripoli . . . . . . . . . . . . . . . . . . . . . . . . . . 72
113th General Hospital at Ahwaz, Iran . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
167th Station Hospital at Accra, Gold Coast . . . . . . . . . . . . . . . . . . . . . . . . . . . . 78
Loading a Patient by Fork Lift, Casablanca . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Brig. Gen. Leon A. Fox . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 96
Dental Clinic at Khorramshahr, Iran . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Brig. Gen. Albert W. Kenner and General George C. Marshall . . . . . . . . . . . . . 106
Col. Richard T. Arnest . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 107
Nurses Arriving in Arzew, Algeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114
Soldier Being Evacuated at Fedala, French Morocco . . . . . . . . . . . . . . . . . . . . . . 118
Camouflaged Aid Station, Algeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126
Mobile Surgical Truck, Tunisia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 131
Wrecked Ambulance, Tunisia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 137
2d Lt. Aleda E. Lutz in Converted C-47 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Medical Supplies on Beach, Algeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 143
Lt. Gen. George S. Patton, Jr., and Brig. Gen. Theodore Roosevelt, Jr. . . . . . 148
Col. Daniel Franklin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150
Col. L. Holmes Ginn, Jr. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Evacuating Wounded to Landing Craft, Sicily . . . . . . . . . . . . . . . . . . . . . . . . . . 156
Administering Plasma, Sicily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Evacuation by Muleback . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164
Holding Hospital, Termini Airfield, Sicily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166
Forward Surgical Unit, Sicily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 171
Pack Train in Sicily . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 175
Maj. Gen. Ernest M. Cowell . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 178
Brig. Gen. Frederick A. Blesse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180
6th General Hospital, Casablanca . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 187
26th General Hospital Near Constantine, Algeria . . . . . . . . . . . . . . . . . . . . . . . 191
Aerial View of Hospital Groupment, Algeria . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Prison Stockade of the 180th Station Hospital Near Oran . . . . . . . . . . . . . . . . 203
Interior View of Hospital Train . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 207
Col. William S. Stone . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 211
xxiv
Page
Malaria Control Measures Near Algiers . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212
Brig. Gen. Joseph I. Martin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Litter Bearers Wading to Landing Craft, Salerno . . . . . . . . . . . . . . . . . . . . . . . 228
Planners of the Invasion of Italy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 229
Medics Treating Italian Girl, Volturno Area . . . . . . . . . . . . . . . . . . . . . . . . . . . 234
Rough Going . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2 3 5
Digging Out Wounded Man, Cassino . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Casualties From Rapido Crossing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246
Aid Station in Sant'Elia Area . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247
Wounded German Soldier at 94th Evacuation Hospital . . . . . . . . . . . . . . . . . . 254
Treating Moroccan Mountain Troops, Venafro Area . . . . . . . . . . . . . . . . . . . . 261
Col. Rollin L. Bauchspies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 267
Evacuation of Wounded, Anzio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 272
Pfc. Lloyd C. Hawks . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 274
Hospital Area, Anzio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 276
Brig. Gen. Frederick A. Blesse Congratulating Col. Henry S. Blesse . . . . . . . . 278
Anzio Hospitals Digging In . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 280
Protecting Operating Tents, Anzio . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 281
56th Evacuation Hospital After Bombing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 283
Treating Casualty at Forward Aid Station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 293
Italian Civilians Help Carry Casualty Down Mountain . . . . . . . . . . . . . . 294
Half-Track Ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 297
German POW Giving First Aid . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 298
Wheeled Litter . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3 0 0
Administering Plasma in Jeep Ambulance . . . . . . . . . . . . . . . . . . . . . . . . . . . 301
Institute of the Good Shepherd, Rome . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 306
Ambulance Plane, Nettuno Airstrip . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 313
Field Unit of Dental Clinic . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 318
Col. Charles F. Shook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 324
Medical Section of NATOUSA at Caserta, 26 July 1944 . . . . . . . . . . . . . . . . . 325
Medical Center at Mostra Fairgrounds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 328
Repatriating Wounded German POW's . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 341
41st Hospital Train . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 345
Storing Medical Supplies . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 348
Blood Donors, Naples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 353
Dusting for Mosquitoes, Cassino . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 356
Brig. Gen. Edgar Erskine Hume . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 361
Delousing Station, Naples . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 364
Lt. Gen. Alexander M. Patch and Col. Frank B. Berry . . . . . . . . . . . . . . . . . . . . 368
Lt. Col. Robert Goldson, Col. Myron R. Rudolph, and Col. Joseph Rich ... 370
Medics on Beach, Southern France . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 380
Ambulance in Wrecked Village . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 383
Jeep Ambulance Crossing the Moselle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385
Page
Evacuating Wounded, Southern France Beaches . . . . . . . . . . . . . . . . . . . . . . . . 396
Evacuating; Southern France Casualties by Sea . . . . . . . . . . . . . . . . . . . . . . . . . . 399
Last Stages of Whole Blood Pipeline . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 410
General Martin Receiving OBE From Gen. Sir Harold R. L. G. Alexander. . 416
Collecting Point, Mt. Altuzzo . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 420
317th Medical Battalion Collecting Station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 431
Aid Station on Mt. Belvedere . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 433
Tramway, Mt. Mancinello-Pizzo di Campiano Ridge . . . . . . . . . . . . . . . . . . . . 434
38th Evacuation Hospital Flooded . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 439
Brazilian Nurses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 442
8th Evacuation Hospital, Pietramala . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 445
Ambulance on Icy Road . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 446
Treating a Wounded Mule . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 455
Lt. Gens. Mark W. Clark and Lucian K. Truscott, Jr. . . . . . . . . . . . . . . . . . 459
"Ohio Ridge" . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4 6 4
Medics Evacuating Wounded by Jeep . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 465
Medics at Pianoro . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 467
German Receiving Plasma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 476
German Clearing Station . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 477
Lake Garda . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 479
Ambulances Fording Reno River . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 481
Maj. Gen. Morrison C. Stayer . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 487
12th General Hospital, Leghorn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 494
70th General Hospital, Pistoia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 495
Italian Partisans at Bari . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 497
37th General Hospital on the Move . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 500
Loading Patients, Leghorn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 503
Storage Area, Leghorn . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 508
Captured Horse at Veterinary Hospital . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 518
Col. Charles O. Bruce . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 526
7029th Station Hospital (Italian) at Pisa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 534
German Medical Center in the Alps . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 536
Hotel-Hospital at Merano . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 537
German POW Ward Tents, Ghedi . . . . . . . . . . . . . . . . . . . . . . . . . . 539
POW Ward, Aversa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 540
Readying Medical Supplies for the Southwest Pacific . . . . . . . . . . . . . . . . . . . . . 547
Col. Earle Standlee . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5 4 8
All photographs are from the Department of Defense files except the
Frontispiece, which is an adaptation of a painting by Joseph Hirsch in the Abbott
Collection and was drawn especially for this volume by Esther E. Rohlader.
MEDICAL SERVICE IN THE
MEDITERRANEAN
AND MINOR THEATERS
PROLOGUE
the terrain, and similar factors. The aid- heroes of the war. They have no weapons
man (there were normally two such men save strength, courage, and dedication
attached to each infantry company in beyond the call of duty; they have no
World War II) is trained as a surgical protection save a steel helmet painted
technician. He has earned by repeated front and back with the red cross, and
demonstrations of selflessness and en- a red cross brassard on the sleeve; yet
durance the respect he receives from his they move among fighting men and
fellow soldiers. His mere presence in the whining shells on the battlefield, con-
company is a morale builder, because cerned only for the safety and comfort
the men know that as long as "Doc" is of the man they lift so carefully onto a
there, they will not be left to die on the litter and carry so gently, avoiding any
battlefield. unnecessary jar or change of angle, back
In this hypothetical case, a quick to a place of relative security—for the
check is enough to tell the aidman the casualty but not for them. They will
casualty is in shock. He calls at once for return at once to the battlefield.
one of the four-man litter squads already At the battalion aid station, the
moving out from the battalion aid sta- wounded man will be examined for the
tion some 500-800 yards to the rear, first time by a medical officer, generally
where water and a measure of natural the battalion surgeon. Perhaps an hour
protection are available. Although he has now passed since the wound was
carries morphine, he will not use it inflicted. The man is still alive, thanks
because the casualty is unconscious. If it to the plasma given him on the field, but
is toward the latter part of the Italian he will not be for long without extensive
campaign, however, he will have plasma surgery. If the battle is strongly con-
with him, which he begins to admin- tested—and what battle was not, in that
ister without delay. When the needle is "forgotten theater"?—there will be many
taped in place and the flask suspended, casualties at the aid station, brought in
perhaps from the same rifle butt that from the various companies of the bat-
guided him to the spot, the aidman will talion by the four litter-bearer squads
check the wound, replacing the dressing available or walking if their injuries
if it seems necessary, and perhaps adding permit that luxury. Let us assume that
tape to make transportation easier. He the case we are following is the most
then fills out an Emergency Medical Tag serious, and so receives the immediate
(EMT), copying the man's name and attention of the battalion surgeon. In
serial number from his dog tag, and in- this late stage of the war, the other of-
dicating the nature of the wound, the ficer at the aid station will be nonmed-
approximate time it was inflicted, and ical, generally Medical Administrative
the treatment so far given. The EMT is Corps, whose duties will include first
conspicuously attached to the patient aid, but will be primarily to keep the
and will go with him along the whole wounded moving—to hospitals farther
chain of evacuation. to the rear if hospitalization is indicated,
By this time the litter bearers have or back to the front with a bandage if
reached the scene. The litter bearers, the wound is slight. Manpower is never
along with the aidmen, are the unsung so plentiful that it can be dissipated by
PROLOGUE: THE GIFT OF LIFE 3
still used in the medical service to refer wounded men of his regiment in a mat-
to this process—so that those whose ter of minutes. It is now two hours or
wounds were critical might be cared for more since he received his wound, but
first; so that specialized needs would be he is still alive and his chances are now
referred to specialized skills; and as at good, for he is only moments away from
the aid station, so that no man would be the finest in surgical skill and facilities.
sent farther to the rear than his bodily The field hospital to which he is im-
condition required. Here there would mediately carried is a tent with packed
be medical cases as well as battle wounds earth floor, heated if necessary by oil
and injuries, for the clearing station was stoves and lighted by generator-driven
in effect the most forward hospital serv- electric lamps. In physical appearance it
ing the division and therefore the most is not at all like the fine modern hos-
accessible from the front lines, where pitals at home, but in its equipment and
disease might claim as many victims as in the skill and motivation of the two
bullets. The system that developed in surgeons, anesthetist, and surgical nurse
the Mediterranean about the middle of who with two enlisted technicians make
1943 was to set up as close as possible to up a surgical team, it is as good or
each division clearing station a platoon better.
of a field hospital to receive those casual- From the field hospital rearward prog-
ties in need of immediate surgery. The ress is relatively standardized. The pa-
field hospital itself was a versatile new tient will be retained until he is strong
unit, capable of operating as a single enough to be moved without damage-
400-bed hospital, or as three separate possibly as much as a week. If the front
100-bed hospitals. When split three ways advances significantly in that time, an-
the surgical staff was wholly inadequate, other field hospital platoon will set up
but the deficiencies were made up by adjacent to the new site of the division
attaching teams from an auxiliary sur- clearing station, leaving the old hospital
gical group, some general, some special- or a detachment from it to operate
ized, but each a fully functioning unit where it is until all its patients are trans-
with its own equipment as well as its portable. Our casualty, along with other
own personnel. holdovers, will next be moved to an
Now let us get back to the casualty evacuation hospital, still in the combat
whose progress we are following along zone, in all probability still under can-
the chain of evacuation. He is picked up vas, but considerably farther to the rear.
at the battalion aid station by a squad These units in World War II Tables of
of litter bearers from the collecting com- Organization were of two types: a 400-
pany, sent forward from an ambulance bed hospital that could be moved quick-
loading post that might be only 300 or ly in two installments with its own
400 yards away as the crow flies, but half organic transportation, and a 750-bed
to three-quarters of a mile by the nar- hospital in which mobility was sacrificed
row, winding trail that must be used. for somewhat more complete facilities.
The tedious and difficult hand carry Ideally one 400-bed "evac" backed up
once completed, he will be delivered at each division, some eight to twelve miles
the clearing station along with other behind the clearing station, with one of
PROLOGUE: THE GIFT OF LIFE 5
the larger units supporting two divisions. chain of evacuation. He will be brought
Both types of evacuation hospital were to the evac by an ambulance of a col-
prepared to give definitive treatment to lecting company, but this time it will
all casualties. They were staffed and be a company of a medical battalion
equipped, that is, to do whatever might (separate) —not organic to any forma-
be necessary for the recovery of the pa- tion, but in this case assigned to army
tient. The primary difference between and under control of the army surgeon.
these hospitals and the so-called "fixed" The next stage of his journey, which will
hospitals of the communications zone bring him into the fourth echelon of the
was their proximity to the front lines. chain, will be in all probability too long
For that very reason, however, they for an ambulance run.
could not hold patients for any great After a day or two at the evacuation
length of time. As a rule only those who hospital, with a fresh dressing on his
could be returned to duty within a week wound and a new entry on his Emer-
or two or, alternatively, passed on to a gency Medical Tag, our casualty will
convalescent hospital, were retained. be moved by ambulance to a nearby
The convalescent hospital was another railhead, port, or airstrip to continue
combat zone unit, where the man no rearward by whichever mode of trans-
longer in need of constant medical or port is most convenient to the location.
surgical care but not yet strong enough In Italy, except for Anzio where all
to fight could regain his vigor. It con- transportation was by water, it would
served both professional and combat have been by hospital train, or by C-47
manpower by operating with a low ratio cargo plane rigged with litter racks to
of medical officers to beds, and by re- hold 18 or 20 nonambulatory patients
taining in the army area men whose and staffed by personnel of a medical
services might otherwise have been lost air evacuation transport squadron.
indefinitely in the complex machinery Either way, responsibility and control
of the replacement center. Those whose would have rested with the communica-
treatment would require a longer period tions zone, most likely in the Mediter-
of time were transferred to the com- ranean with a base section. This
munications zone. The particular cas- particular casualty will require further,
ualty whose treatment and evacuation probably extensive, surgery before his
we are discussing will be one of these. damaged organs are restored to relative-
Had he been less severely wounded ly normal use, so that a general hospital
his injuries would have been dressed is indicated.
and rebandaged at the clearing station The numbered general hospital over-
and he would have been moved to an seas (as distinct from the named general
evacuation hospital for surgery. As it is, hospital in the zone of interior), singly
he will be a transient at the evac, on his or in a grouping or center, enjoys the
way to the communications zone. When relative safety of the communications
he moves from the field hospital unit to zone. It had in World War II 1,000 to
the evacuation hospital he will pass from 2,000 beds, with many specialties repre-
division to army control, at the same sented on its staff and equipment ade-
time entering the third echelon in the quate for almost any situation it might
6 MEDITERRANEAN AND MINOR THEATERS
continents. The swiftly moving events newly acquired bases also increased
of the summer culminated on 2 Septem- rapidly. An Axis attack across the South
ber in a U.S.-British agreement to ex- Atlantic against Brazil was regarded by
change fifty overage U.S. destroyers for both the Army and the Navy as a dis-
bases on British soil in the Caribbean tinct possibility, whereas a Japanese
and the Atlantic. The agreement cov- attack on Pearl Harbor was thought to
ered Army, Navy, and Air Corps bases be less likely because of the presence of
in the Bahamas, Jamaica, Antigua, St. the Pacific Fleet. When the less likely
Lucia, Trinidad, and British Guiana on attack came on 7 December 1941, atten-
99-year lease. At the same time the right tion shifted abruptly to the Pacific, and
to establish U.S. bases in Newfoundland estimates of Army strength necessary to
(then a crown colony) and in Bermuda maintain the security of the Atlantic
was granted as a gift. Early in 1942 the were revised in the light of the new
British Government also authorized conditions. Expansion continued, but at
establishment of an American air base a relatively slower pace. Nevertheless,
on Ascension Island, between Brazil and by December 1942 there were 175,000
Africa. Studies of possible sites began in U.S. troops in the defensive bases along
the fall of 1940 and early the next year the eastern coasts of North and South
American troops began moving into America and on the islands linking the
some of the new bases. Western Hemisphere to Europe and
In mid-1941 American forces began Africa. This figure exceeded the Amer-
relief of the British garrison in Iceland, ican strength in the United Kingdom
after diplomatic arrangements with the at that time, and was half of the U.S.
Icelandic Government. A similar move- Army strength in the Pacific, where ac-
ment of U.S. forces into Greenland was tual combat had been in progress for a
authorized by the Danish minister in year. Troop strength in some areas be-
Washington, D.C., who functioned with gan to decline while others were still
his staff as a government in exile after building, so that the over-all figure never
the absorption of his country by the was much above that at the end of 1942.
Nazis. Agreements with representatives The peak month was May 1942, when
of the Dutch Government led to Amer- 181,867 U.S. soldiers garrisoned the At-
ican relief of British troops on Aruba lantic bases.
and Curaçao Islands, Netherlands West These bases were set up as semitactical
Indies, and to an American occupation organizations, with enough ground com-
of Surinam. The establishment of air bat troops in most instances to hold off
routes across both the North and the a hostile landing force until help could
South Atlantic led to stationing consid- be sent. Engineer troops were usually
erable numbers of Army Air Corps and present in considerable numbers in the
other service personnel in central and early stages of occupation, giving way
eastern Canada, and in Brazil. to Air Forces units, mostly Air Trans-
During the period before American port Command (ATC) personnel, when
entry into the war, U.S. Army strength the construction work was finished.
was built up in Panama and Puerto Naval forces were also stationed at many
Rico, and the number of troops in the of the bases. Administratively, the new
THE ATLANTIC DEFENSE AREAS 9
bases in the Caribbean were brought The Air Transport Command similar-
under the pre-existing military depart- ly had its own medical service, which at
ments having jurisdiction over Puerto some bases co-existed with the Army
Rico and the Panama Canal Zone. In medical service, and at others merged
Brazil a theater-type organization was with it. Where command of the base it-
set up to supersede control by the Air self passed to the ATC after the war,
Transport Command. In the North At- Army medical facilities and installations
lantic, however, the various major bases were transferred to the new jurisdiction.
were established as independent com- Bed requirements for the new bases
mands and were only brought together were computed on the same 5-percent
under the Eastern Defense Command in ratio used for hospitals in the United
the middle of 1944. All of the North States, but in practice the ratio was never
Atlantic bases ultimately passed to con- more than a rough rule of thumb, more
trol of the Air Transport Command. nearly true in the aggregate than in de-
tail. Initially, hospital care at the bases
Medical Service in the Atlantic Bases was provided by medical detachments,
the provisional hospitals established be-
In Puerto Rico and the Panama Canal ing activated in place later on as num-
Zone, medical facilities were part of the bered station hospitals. It was not until
Army's peacetime establishment. War- the fall of 1941 that the first numbered
time needs were met primarily by ex- hospital units activated in the United
pansion of units, just as they were in States were shipped out to Iceland. Be-
the zone of interior. In the new bases, fore the war was over, the number of
however, all medical facilities had to be such units in the Atlantic defense areas
sent in. For the most part, buildings increased to a peak of 5 general hospi-
were constructed by the Corps of Engi- tals, 45 numbered station hospitals, a
neers, whose troops generally preceded handful of unnumbered hospitals of
both ground and air personnel. Indeed, varying sizes, and 10 or more dispen-
the engineers often supplied medical saries equipped to function as small
service as well as buildings for a time hospitals. Excluding dispensaries and
after the combat troops arrived. To care hospital expansion units, the Table of
for thousands of civilian workers on its Organization (T/O) bed strength
various airfield and other projects at the totaled a maximum of 10,145 in June
new bases, the engineers had been forced 1943, at which time the bed ratio (per-
to establish a medical service of their centage of the command for which beds
4
own. Directing it for the eastern division were available) was 5.8.
was Col. (later Brig. Gen.) Leon A. Fox. Medical Department activities at all
Usually by the time ground troops ar- of the Atlantic bases included dental and
rived at a base, the engineers had in
operation an infirmary or small hospital, Army," Organization and Administration, in World
War II (Washington, 1963), ch. II.
which served until Medical Department 4
See app. A-1. For various other comparisons,
3
units could be unpacked and housed. including Medical Department strength, see John
H. McMinn and Max Levin, "Medical Department,
3
For more detailed treatment, see Blanche B. United States Army," Personnel in World War II
Armfield, "Medical Department, United States (Washington, 1963), ch. XL
10 MEDITERRANEAN AND MINOR THEATERS
veterinary work, but for the most part Command headquarters was estab-
no special problems were encountered in lished at Camp Pershing, about two
carrying out these functions. miles east of Reykjavík. Several other
camps lay north of headquarters, within
The North Atlantic Bases a 10-20-mile strip close to the coast and
centering around Alafoss. Eighty percent
Iceland Base Command of the U.S. force was concentrated in
these camps. The remainder was scat-
As a precaution against possible Ger- tered at isolated airfields and radar sta-
man occupation, the British in May 1940 tions around the rim of the island.
sent troops to garrison Iceland. By the The IBC reached peak strength in
spring of 1941, however, the British were May 1943 when, with 40,712 ground,
too hard pressed in Africa to waste man- air, and service troops, it was exceeded
power on a purely defensive situation. in size only by the Panama Canal Zone
After some hesitation, but with the ap- among Atlantic defense areas. Ground
proval of the Icelandic Government (Ice- forces included engineer and service
landers felt there would be less risk in troops and the entire 5th Division. Air
being occupied by a nonbelligerent) combat strength was augmented, as soon
President Franklin D. Roosevelt decided as suitable fields could be made avail-
early in June 1941 to relieve the British able, by the 9th Bomber Squadron (H)
garrison with American troops. An ini- and the 1st Observation Squadron. The
tial force of 4,100 marines landed in Ice- bulk of the Air Forces units in Iceland,
land on 7 July. The marines were however, were elements of the Air Trans-
followed on 6 August by the 33d Pursuit port Command, whose home base, shared
Squadron, whose P-40's were flown in with the bombers, was Meeks Field near
from an aircraft carrier. The first incre- Keflavik on the southwest tip of the
ment of ground troops—some 6,000 offi- island.
cers and men of the 5th Division- By the time peak strength was reached,
arrived on 15 September. The Iceland the threat of German invasion of Iceland
Base Command (IBC) was established was negligible. In August 1943 the garri-
as the British garrison was relieved, and son was cut by more than 25 percent;
U.S. forces prepared to protect the trans- the entire 5th Division was withdrawn.
atlantic air transport and ferry routes Thereafter, a steady decline in troop
and the vital sea lanes to the British strength brought the total to less than
Isles, less than 800 miles away.6 1,800 men by the end of 1945, more
5
Principal sources for this section include: (1) Sta Hosps, 1941-43; (8) Annual Rpts, 14th, 15th,
Conn, Engelman, and Fairchild, Guarding the 49th, 72d, 192d Sta Hosps, 1942, 1943; (9) Annual
United States and Its Outposts, chs. XVIII, XIX; Rpts, 92d Sta Hosp, 1942-45; (10) Annual Rpts,
(2) Narrative Hist, Iceland Base Comd, Always 365th Sta Hosp, 1943, 1944; (11) Annual Rpts,
Alert, 16 Sep 41-1 Dec 45, MS, OCMH files; (3) 366th Sta Hosp, 1943-45; (12) Arctic Laboratory,
Lt. Col. William L. Thorkelson, The Occupation Sep 41-Jun 44, AAF, N Atl Wing, ATC, app. F;
of Iceland during World War II, MA Thesis, Syra- (13) Med Hist Rcd, Oct 44-Dec 44, app. E, AAF,
cuse University, September, 1949; (4) Annual Rpts, N Atl Wing, ATC; (14) Hist of Med Dept, ATC,
Surg, IBC, 1941-44; (5) Annual Rpts, Surg, 5th May 41-Dec 44; (15) Ltr, Col Charles H. Beasley
Div, 1942-43; (6) Annual Rpts, 208th Gen Hosp, (Ret) to Col O. F. Goriup, 10 Aug 59, commenting
1942, 1943; (7) Annual Rpts, nth, 167th, 168th on preliminary draft of this volume.
THE ATLANTIC DEFENSE AREAS 11
camp dispensaries and treated 5th Di- hospital up to its 250-bed T/O capacity.
vision personnel wherever they were The first patient was admitted on 24
stationed. The organic 5th Medical September. The following week the nth
Battalion furnished routine evacuation and 167th Station Hospitals, both 250-
service from unit dispensaries to nearby bed units, which had arrived in Iceland
station hospitals and from the hospitals at the same time as the 168th, were at-
back to the dispensaries. The medical tached to the latter until suitable sites
battalion also operated a dispensary for could be prepared. The 11th Station
the port of Reykjavík and ran a provi- Hospital opened on 22 December in a
sional hospital in the Keflavik area until section of a British hospital at Camp
a permanent station hospital was estab- Helgafell, some ten miles north of
lished there. Air Forces units maintained Reykjavík. The 167th remained at-
their own dispensaries and operated tached to the 168th until April 1942,
crash aid stations for emergency treat- when it moved into newly erected Nissen
ment at the various airfields. Engineer huts at nearby Alafoss. (Map I.)
troops, which preceded the Army combat During 1942 six more station hospitals
elements by about a month, had their and one general hospital arrived on the
own medical detachments, but anything island to serve an increasing number of
of a serious or complicated nature went Army troops coming in from the United
to Marine and later to Army instal- States. The 1,000-bed 208th General
lations. Hospital came in March and began oper-
ating before the end of the month at
Hospitalization—The disposition of Camp Helgafell, where it shared quar-
U.S. Army hospitals in Iceland was ters with a British general hospital and
dictated by the combination of moun- the U.S. 11th Station Hospital. The 11th
tains, lava beds, and glaciers that circum- moved in June to Kaldadharnes, some
scribed roads and airfields, and by the twenty-five miles southeast of Reykjavík,
rugged coast line, turbulent seas, and where it served personnel of an airfield.
icebergs that made water evacuation haz- The British hospital was withdrawn to
ardous much of the year. Although the the United Kingdom in August, leaving
bulk of the beds were in the R eyk j
aví
k - the 208th General in sole possession of
Alafoss area to serve the largest concen- the hospital plant.
tration of troops, it was still necessary The 72d and 92d Station Hospitals
to supply hospital facilities wherever both arrived in August 1942. The 92d,
American soldiers were stationed. Three with 75 beds, began operating in Sep-
numbered station hospitals arrived with tember at Reykjaskoli near the head of
the main body of troops in mid-Septem- Hnitafjordhur on the north coast of Ice-
ber 1941, and two of these were in oper- land. The 72d—a 50-bed unit—was
ation before the close of the year. The scheduled for Borgarnes about thirty
168th Station Hospital was established miles north of Reykjavík but, because
in Reykjavík in a permanent building of a variety of construction difficulties,
formerly used by a British hospital. The did not get into operation until the be-
main frame structure held 100 beds, ginning of January 1943. By then changes
and Nissen huts were used to bring the in troop dispositions had made a hospital
THE ATLANTIC DEFENSE AREAS 13
MAP 1—U.S. Army Hospitals Supporting North Atlantic Bases, 1 June 1943
at Borgarnes unnecessary, and the unit taken over from the British near Akure-
was moved later in January to Kaldad- yri on the north coast, the second largest
harnes, where air activity was increasing. city in Iceland and the site of a large sea-
The 75-bed 14th Station Hospital and plane base. The 15th Station, another
the 500-bed 49th both reached Iceland 75-bed unit that also arrived in Septem-
in September 1942 and went into opera- ber, began operating at Budhareyri,
tion the same month. The 14th was at about forty miles south of the 14th, in
Seydhisfjordhur on the eastern coast; the November. The 75-bed 192d Station
49th enlarged a 200-bed hospital plant Hospital arrived in October and was
14 MEDITERRANEAN AND MINOR THEATERS
167TH STATION HOSPITAL at Alafoss, Iceland, showing hot springs used to heat buildings.
attached to the 168th Station at Reyk- dampness, and winds up to 130 miles an
javík until its own hospital plant at Höfn hour. A civilian labor shortage forced
on the southeastern coast was ready in reliance on troop labor, including that
January 1943. of Medical Department personnel. In the
With the exception of the 168th Sta- vicinity of Alafoss natural hot springs
tion at Reykjavík, all U.S. hospital were used for heating hospital buildings.
plants, including those taken over from The officers, nurses, and enlisted men
the British, were Nissen, Quonset, or of Iceland Base Command's hospitals, in
similar types of corrugated steel huts. addition to caring for all U.S. Army per-
Even with prefabricated buildings, how- sonnel in the command, provided hos-
ever, construction was difficult. Materials pitalization for members of the American
for drains, plumbing, and electrical fix- Red Cross and for U.S. civil service em-
tures were not always available. Little ployees. They also treated and hospital-
could be accomplished during the winter ized on occasion U.S. Navy and Marine
months, when the nights were twenty Corps personnel, certain British Army,
hours long, and even the brief periods of Air Force, and Navy men, some members
daylight were often marred by cold, of the Norwegian Army and Navy, and
THE ATLANTIC DEFENSE AREAS 15
American and Allied merchant marine by the 72d Station on 19 August. Two
casualties and survivors from sea mis- days later the 92d Station Hospital
haps. However, the bulk of patients were, opened near Keflavik, adjacent to the
of course, from the various camps of the Meeks Field headquarters of the Air
command. Transport Command.
As the threat of German invasion of By this time the bulk of the ground
Iceland faded during 1943, the with- force troops had left, as had many of the
drawal of troops and relocation of re- air and service forces. When the 15th
maining forces brought a number of Station from Akureyri and the 14th from
changes in hospital dispositions. In April Seydhisfjordhur both moved to the
the 192d Station left Höfn for the Alafoss Helgafell
Reykjavík area, where most of its per- all U.S. hospitals were concentrated in
sonnel were already on detached service the Reykjavík area. It remained only to
with the 168th Station, but the hospital consolidate the units for more efficient
did not resume independent operation. operation.
Further shifts came in June when the The first step in this direction was
15th Station, no longer needed at taken on 30 October when the 327th Sta-
Budhareyri, was attached to the 49th at tion sailed for England. A consolidation
Akureyri, and the 92d Station, including of the remaining hospitals was effected
patients, was transferred from Reykjas- on 6 December 1943. The 11th and 72d
koli to Alafoss. Station Hospitals were combined at
On 24 June the 192d Station Hospital Reykjavík to form the 150-bed 366th
was disbanded and its personnel and Station, while the 14th, 15th, and 167th
equipment were transferred to the 92d, Stations were combined at Camp Helga-
which was reorganized as a 150-bed unit. fell to form the 365th Station Hospital,
On the same date the 208th General with a T/O of 500 beds. At the end of
Hospital at Camp Helgafell was reduced 1943 only the 92d, 365th, and 366th Sta-
from 1,000 to 750 beds, and the 168th tion Hospitals remained in Iceland, with
Station in Reykjavík was expanded from a combined bed strength of 800. Seven
250 to 500 beds, in preparation for a months earlier there had been one gen-
mission elsewhere. eral and nine station hospitals, with an
A few days later, on 2 July 1943, the aggregate of 2,600 T/O beds.
208th General was redesignated the 327th Except for Iceland's strategic function
Station Hospital, without change of site as a stop on the air route to Europe, the
or mission. On the same day the 500-bed war there was over. Hospitalization was
49th Station closed at Akureyri, leaving on a garrison basis, with the garrison
the smaller 15th Station to care for re- steadily decreasing in size. The 365th
maining patients in that area, and a week Station transferred to the United King-
later sailed for the United Kingdom. It dom on 26 June 1944. On the first of that
was followed by the 168th Station on 3 month the 92d Station had increased its
August. bed strength from 150 to 250, but the
The 11th Station, meanwhile, had number of beds on the island was still
shifted from Kaldadharnes to Reykjavík halved. The 366th was inactivated early
to replace the 168th. It was joined there in 1945, leaving the 92d Station the only
16 MEDITERRANEAN AND MINOR THEATERS
U.S. Army hospital in Iceland. It was the extent needed, to care for 19,589
transferred to the jurisdiction of the Air transient patients who were flown from
Transport Command on 1 January 1946, the ETO to the zone of interior by
along with the remains of the Iceland way of Iceland between 1 January 1944
Base Command. and 1 July 1945. To accommodate these,
an unnumbered holding hospital was set
Evacuation—From most of the army up at Meeks Field, including mess facil-
camps in Iceland patients were evacuated ities for walking patients. Litter cases
by ambulance from the unit dispensary were served hot meals aboard the planes.
to the nearest station hospital. Those If a plane were held because of poor fly-
who required general hospital care were ing conditions, the 92d Station took care
moved on to the 208th General Hospital of the patients until they could continue
at Camp Helgafell, by ambulance from their journey. The hospital also took care
station hospitals in the western part of of any patients whose condition made
Iceland, by sea or air from those in more it unsafe to continue. Medical attention
isolated areas. Evacuation by boat was similarly available to 5,930 able-
through coastal waters proved to be a bodied men from the ETO who passed
very efficient method of handling pa- through Iceland between June and Sep-
tients from the eastern and northern tember 1945 on their way to the States.
parts of the command except during the
long winter season, and was more fre- Medical Supplies and Equipment—
quently used than air evacuation. Medical supplies for the Iceland Base
The 120-day evacuation policy set up Command were handled through a main
by the War Department for evacuation depot in Reykjavík and a subdepot and
from Iceland to the United States proved a package storage depot in the Alafoss
to be entirely satisfactory. Both air and area. The main depot—two fish-drying
water transportation were used. In either houses leased for the purpose—had more
case, patients to be evacuated to the zone than 11,000 square feet of floor space for
of interior were cleared through the storage; the subdepot, in three prefabri-
208th General Hospital or, after its cated huts, had 2,880 square feet of stor-
departure, through a station hospital act- age space; and the package warehouse
ing as a general. Although the number of about a mile distant had 4,000 square
evacuees was not unduly large—327 in feet. Individual hospital and other medi-
1942, 1,180 in 1943, and 248 in 1944— cal units maintained supply levels of
there was generally a backlog because of from 90 to 180 days, the larger stocks
unavailability of transportation or lack being held by installations on the north-
of proper facilities, especially for neuro- ern and eastern coasts, which were not
psychiatric and other cases requiring readily accessible in bad weather. The
medical attendance. Psychiatric cases depots held a 120-day supply by the end
amounted to 33 percent of those evac- of 1942.
uated in 1942, 32 percent in 1943, and Six officers and 75 enlisted men were
56 percent in 1944. authorized for operation of the medical
The medical facilities of the Iceland supply system in Iceland, but this num-
Base Command were also available, to ber was never reached. Five officers and
THE ATLANTIC DEFENSE AREAS 17
50 enlisted men were sent, but even these largest single cause for hospitalization.
figures were reduced by attrition to 4 and Half of all hospital admissions in 1942
45 respectively before the end of 1942. were for respiratory diseases. In 1943 the
The supply system was reorganized early respiratory disease rate was 190 per 1,000
in August 1943 and again in mid-Decem- per annum, including mild cases treated
ber. In August a Base Depot Section, in quarters as well as those hospitalized.
20th Medical Depot Company, was or- The 1944 rate, similarly computed, was
ganized to carry on the medical supply down to 95. The command experienced
function, but was supplanted in Decem- a sharp rise in rates for such diseases
ber by the 300th Medical Composite after the arrival of each new troop con-
Platoon. Under the latter form of organ- tingent, but the situation would return
ization the depots were operated by two to normal in about a month.
supply teams, one with an officer and 11 An outbreak of jaundice in May 1942
enlisted men, the other with 2 officers claimed 478 in that month. In June the
and 27 enlisted men. number of cases climbed to 661, drop-
While some medical units encountered ping to 170 in July and only 11 in Au-
a number of delays in getting their nor- gust. The total number of cases for the 4-
mal equipment, medical supplies as a month period was 1,320. There were no
whole were plentiful. Some items, such deaths from jaundice. The cause was not
as quinine, mosquito bars, and various determined. Large numbers of the rats
combat items, were never required in that abounded in Iceland were exam-
Iceland, and other items became surplus ined, but none were found to be diseased.
as the strength of the command declined. There appeared, however, to be some
During 1943 excess British medical sup- connection with yellow fever inocula-
plies to a total of 130,000 pounds, and tions. All but 7 of the 1,320 men who
2,325,000 pounds of excess U.S. medical came down with jaundice had been inoc-
supplies were shipped to the United ulated for yellow fever from the same lot
Kingdom. The year's end still found the of vaccine before leaving the United
depots bulging with supplies for 60 days States.
of operation, 90 days' maintenance, and An epidemic of mumps in the civilian
a further 90-day final reserve of certain population in 1942 was kept from spread-
necessary items, held in dispersed loca- ing to the troops by prompt preventive
tions. These levels were sharply reduced measures. Only 128 sporadic cases were
during 1944 to a 30-day operating and reported. Venereal disease, scourge of the
30-day maintenance level. Mediterranean and European theaters,
was notable in Iceland chiefly for its al-
Professional Services—In spite of un- most total absence. Venereal rates for
familiar and unfavorable climatic condi- the base command were 4.4 per 1,000
tions, the incidence of disease among per annum in 1942; 5.3 in 1943; and 6.2
U.S. troops in Iceland was exceptionally in 1944. Only mental disorders showed a
low. There were no diseases peculiar to significant rise as time went on. Isolation,
the country, no mosquitoes, few insects boredom, lack of recreation, adjustment
of any kind. Common respiratory dis- problems, and a feeling of contributing
eases constituted overwhelmingly the little to the war effort combined to pro-
18 MEDITERRANEAN AND MINOR THEATERS
duce relatively high neuropsychiatric the United States guaranteed the security
rates. of Greenland in return for the right to
The general health of the U.S. troops construct, maintain, and operate the re-
in Iceland, excellent at all times, steadily quired facilities. The first echelon of the
improved throughout the war. The non- Greenland force—469 officers and men-
effective rate for 1942 was 29.5 per 1,000; sailed from New York on 19 June and
in 1943 it was only 25.37; and in 1944 it anchored off Narsarssuak on the south-
6
was a startling 16.28. There were, of west coast of Greenland on 6 July.
course, no combat wounds, and the acci- To the United States and Great Brit-
dent rate-primarily plane crashes—was ain, Greenland was considerably more
relatively low. than the "raw structure of rock and salt
The dental service in the Iceland Base water and ice, all united by the eternal
Command encountered no unusual dif- cold" that Col. Bernt Balchen had de-
ficulties. Dispersal of troops made it scribed. It was a potential stop on an air
expedient to assign dentists to areas ferry route that could enable fighter
rather than to clinics, but for the most planes to move from American factories
part the work itself was routine. The to British bases under their own power;
Veterinary Corps encountered more it was the only known commercial source
serious problems, stemming largely from of natural cryolite, invaluable as an
inadequate sanitary standards on the part electrolyte in the production of alumi-
of the local authorities. From their num; and it was the gathering point for
arrival on the island, U.S. veterinary the storms that would influence air and
personnel worked with the Icelandic naval activity in western Europe. The
authorities and with individual farmers Germans had recognized the importance
and food processers to improve methods of obtaining weather data in Greenland
and standards. and had established several meteorologi-
cal stations that were subsequently elimi-
Greenland Base Command nated by the British in the summer of
6
Sources for this section are: (1) Conn, Engel-
After months of indecision, officials man, and Fairchild, Guarding the United States
and Its Outposts, ch. XVII, ch. XX; (2) Craven
of the State, War, and Navy Departments and Cate, eds., Plans and Early Operations, pp.
agreed early in February 1941 that air- 122-23, 157-58, 342-48, 641-44; (3) Bernt Balchen,
fields and other facilities in Greenland Corey Ford, and Oliver LaFarge, War Below Zero:
The Battle for Greenland (Boston: Houghton Mif-
would be needed for hemisphere defense, flin Company, 1944); (4) Annual Rpts, Med Dept
and that in view of the Monroe Doctrine Activities, Greenland Base Comd, 1941-44; (5) An-
the United States could permit no other nual Rpt, Base Hosp, Greenland Base Comd, 1946;
(6) ETMD's (Essential Technical Medical Data),
power—not even friendly Canada—to Greenland Base Comd, Jul 43-Nov 45; (7) Interv
take the initiative there. A survey expedi- with Lt Col Otho R. Hill, 6 Sep 44; (8) Interv
tion sailed in March. Less than a month with Lt Col Norman L. Heminway, Dec 43; (9)
later, on 9 April, the project received Annual Rpts, 188th, 190th, 191st Sta Hosps, 1943-
44; (10) Annual Rpt, 189th Sta Hosp, 1943; (11)
formal sanction when the Danish Minis- Med Hist Rcd, Oct-Dec 44, app. E, AAF N Atl
ter in Washington (still recognized by Wing, ATC; (12) Ltr, Norman L. Heminway to
the United States) and the Secretary of Col Goriup, 16 Aug 59; (13) Ltr, John R. McBride
to Goriup, 28 Jul 59. Both letters comment on pre-
State signed an agreement under which liminary draft of this volume.
THE ATLANTIC DEFENSE AREAS 19
1940. Later, however, another German geon. BLUIE WEST 8 included civilian
weather station was believed to be in construction workers, who had been
operation. This was located and de- there since September, and Army engi-
stroyed by an American force, but the neers. The engineer medical officer,
Germans continued to obtain Greenland Capt. (later Lt. Col.) Stephen W. On-
weather reports from a submarine kept dash, was responsible for the health of
in the area for that purpose. the civilians. The first hospital set up on
In addition to its responsibility for the
the post, an engineer unit available to
health of Army and Air Corps personnel all, opened on 10 December 1941.
and employees of civilian contractors In November a post was established
stationed there, the Medical Department at Angmagssalik on the eastern coast of
in Greenland supplied hospital facilities Greenland about forty miles below the
for the crews of Navy, Coast Guard, and Arctic Circle. BLUIE EAST 2, as the new
merchant vessels and of transient air- post was called, was primarily a weather
craft. A small detachment of Medical and communications station. It included
Department officers and enlisted men a medical officer and an engineer dis-
arrived with the first contingent at Nar- pensary operated by civilians. In March
sarssuak, where the first U.S. military 1942 a post was set up at Ivigtut, about
post, BLUIE WEST 1, was established. In 100 air miles west of Narsarssuak, where
August 1941 the medical detachment the cryolite mine was located. The Ivig-
there set up a 10-bed field-type tent hos-tut base was called BLUIE WEST 7. By
pital, which operated for two months be- June a small building had been erected
fore a suitable building could be erected.for a dispensary.
A 5-wing cantonment-type building was The Greenland Base Command, with
eventually built. The wings were con- headquarters at BLUIE WEST 1, had mean-
nected by heated corridors. Supply rooms while been formally activated on 26 No-
and the mess hall were off the main vember 1941, although Army forces in
corridor, opposite the clinic and hospitalGreenland had been using that designa-
wings. Initially, only one wing with tion since their arrival. There was no
twenty beds was required for inpatients. surgeon for the whole command, how-
It was not until January 1943, when sur- ever, until November 1942, when Colo-
vivors from the torpedoed USAT Dor- nel McBride, as the senior Air Forces
chester were brought to BLUIE WEST 1, medical officer on the island, was assigned
that two other wings were made ready, that responsibility. He was succeeded in
expanding capacity to approximately March 1943 by Maj. (later Col.) Norman
sixty beds. L. Heminway, commanding officer of the
In October 1941 a post was established 188th Station Hospital and surgeon of
at the head of Søndre Strømfjord on the the BLUIE WEST 1 base. In December
west coast of Greenland about fifteen Colonel Heminway was transferred,
miles inside the Arctic Circle. Known as being succeeded in each of his three
BLUIE WEST 8, this post was under com- capacities by Maj. (later Lt. Col.) Otho
mand of the famed arctic explorer, Capt. R. Hill.
(later Col.) Bernt Balchen, with Maj. Under War Department authority
(later Col.) John R. McBride as sur- granted in September 1942, four num-
20 MEDITERRANEAN AND MINOR THEATERS
BLUIE WEST 1, Narsarssuak, Greenland, May 1943, with the 188th Station Hospital under
construction in right foreground.
bered station hospitals were activated to work was completed by the end of that
replace the makeshift units then func- year, when the troop build-up reached
tioning. (See Map I.) Cadres were its maximum strength of about 5,300.
drawn from Medical Department person- The unduly long construction time was
nel already on the ground and actually due in part to weather hazards, in part to
operating the existing hospitals and dis- low priority in a very restricted labor
pensaries that were to be elevated to market, and in part to the necessity for
numbered status by the new arrange- importing all building materials from
ment. Authorizations were given for hos- the United States.
pitals of 250, 200, 150, and 25 beds, for Largest of the hospitals, the 188th Sta-
BW-1, BW-8, BE-2, and BW-7 re-tion, opened at BLUIE WEST 1 in its new
spectively. Construction of buildings be- buildings in December 1943. One of the
gan in the fall of 1942, continuing into finest examples of an overseas hospital,
the late months of 1943. The bulk of the the installation was located for maxi-
THE ATLANTIC DEFENSE AREAS 21
mum terrain protection. It was built at a to be largely self-sufficient from the stand-
cost of $1,769,022. Its 32 cantonment- point of supply. In practice this imposed
type buildings on 22.5 acres were con- no handicap as supplies for the base com-
nected by heated and insulated corridors. mand as a whole were more than ample
Central heating, electricity, running hot throughout the war. The months of iso-
and cold water, and a modern sewage lation envisaged by the planners never
system made it a comfortable haven in materialized.
the frozen wasteland of Greenland. The In addition to the four bases them-
188th Station, in addition to its function selves, there were a dozen or more
as post hospital, received patients from weather observation and radio posts
other units, mostly by air, who required operating out of one or another of the
further observation or treatment. It also BLUIES. For the larger outposts of this
acted as clearing and processing point for type a medical officer was provided; for
cases being evacuated to the United the smaller, only a trained Medical De-
States. partment enlisted man could be spared.
Additional hospital construction at the Although the climate was much more
smaller posts in Greenland during 1943 severe and the setting far more bleak
made conditions less crowded, but bed than anything the men had before ex-
requirements were never as great as had perienced, there were no adverse effects
been anticipated. The190th Station on health. There were no indigenous
Hospital, originally authorized as a 200- diseases. The native Eskimos suffered
bed unit, was reduced to a 50-bed hospi- heavily from tuberculosis, but contacts
tal by the time it moved into its between the natives and the U.S. troops
permanent quarters at BLUIE WEST 8. were so infrequent as to remove the haz-
The 191st Station at BLUIE EAST 2 also ard. The only venereal cases were among
operated as a 50-bed unit, although its those who had been infected outside of
original authorization had been for 150 Greenland. Respiratory diseases made
beds. The smallest of the four Green- up the largest item in the disease cate-
land hospitals, the 189th at BLUIE WEST gory, with newly arrived troops the most
7, remained a 25-bed unit throughout its frequent victims. On the whole, however,
period of operation. At none of the four the incidence of disease in Greenland
post hospitals was medical service seri- was very low. Injuries, directly related
ously interrupted during the period of to the treacherous and rugged terrain,
construction. New plants were occupied ship loading and unloading, and con-
by echelon, as space became available, struction work accounted for the largest
without closing down the old until the number of patients admitted to hospitals,
new was functioning. Such unavoidable as well as about a quarter of all those
curtailment of minor services as occurred evacuated to the zone of interior. The
was compensated for by treating as many second largest group returned to the zone
cases as possible on a "quarters" basis. of interior, accounting for about 18 per-
During the greater part of the year, cent of the total, were the neuropsychi-
transportation by water was very difficult atric cases, stemming from the pro-
or impossible. Therefore, each of the longed service in an isolated, unpleasant
four main Army bases in Greenland had environment, combined with constant
22 MEDITERRANEAN AND MINOR THEATERS
monotony and a complete lack of normal the United States. From May to October,
social contacts. A general apathy, called 471 such cases passed through the com-
by the men stationed in Greenland, mand, 34 of which were temporarily
"The Arctic Stare," developed in a ma- hospitalized.
jority of troops after a year's stay on the General reductions in strength during
island. It was notable, however, that even 1944 resulted in practically all ground
in the most difficult year, 1944, neuropsy- force units being withdrawn from the
chiatric cases constituted only about 4 command, leaving mostly air and service
percent of hospital admissions. The sui- personnel. The base established to pro-
cide rate was also relatively low. Admis- tect the cryolite mine at Ivigtut closed
sions for all causes to the main hospital during the summer, and the 189th Sta-
of the command, the 188th Station Hos- tion Hospital, which was located there,
pital, numbered 1,821 in 1943 and 2,137 ceased operations in August. At the end
7
during 1944. of that month, Colonel Hill left the
Evacuation of patients within Green- Greenland Base Command, being suc-
land moved from the outposts to the ceeded as post surgeon and commanding
main bases, where the permanent hospi- officer, 188th Station Hospital, by Capt.
tals were established, and thence, if more (later Maj.) John A. Jones, and as
elaborate treatment or ZI evacuation Greenland Base Command surgeon by
were indicated, to the 188th Station Hos- Maj. Andrew W. Shea. Medical units op-
pital. Patients could be evacuated to the erated below T/O authorizations when
188th from other parts of Greenland only possible. Excess medical personnel and
by air and by sea, while those within large amounts of surplus medical sup-
BW-1 came in by bus or ambulance. plies were returned to the United States.
Most of the patients sent to the zone of Greenland Base Command had be-
interior for further treatment were trans- come primarily an Air Transport Com-
ported there by air; a few went by ship. mand stopover and a weather forecasting
Weather problems frequently compli- center a year before the ATC assumed
cated evacuation procedures in Green- full responsibility for all U.S. activities
land. Poor flying conditions or ice packs on the island in January 1946. Only the
—which prevented the passage of ships- hospital at BLUIE WEST 1 continued ac-
were responsible for many delays. Green- tive at this time.
land Base Command sent an average of
15 to 25 patients a month to the United Newfoundland Base Command
States for general hospital treatment. Be-
ginning in 1944 the personnel of the The island of Newfoundland lies on
188th Station Hospital and the Air the great circle route between New York
Transport Command fed and furnished and the British Isles, controlling both sea
professional services to transient patients and air lanes and blocking the mouth of
being evacuated by air from Europe to the St. Lawrence. Its strategic import-
ance had made its defense an object of
7
No detailed admission statistics are available for concern to the United States and Canada
the other hospitals of Greenland Base Command,
but admissions to the 188th Station Hospital con-
early in the war. The right to establish
stituted the bulk of all hospital admissions. U.S. bases there was given at the time of
THE ATLANTIC DEFENSE AREAS 23
west of St. John's. For the time being a The four U.S. Army hospitals were
small engineer hospital already on the designated as numbered station hospitals
ground handled cases beyond the capa- on 1 April 1943. At that time the base
bilities of the dispensary, but a station unit at Fort Pepperrell became the 308th
hospital was formally activated in May Station Hospital with a Table of Organ-
and opened in June 1942, eventually ab- ization calling for 250 beds. With this
sorbing the engineer unit. Last of the enlargement of the hospital, its com-
U.S. bases to get into operation was Har- manding officer, Lt. Col. Gunnar Linner
mon Field near Stephenville on the since October 1942, was relieved as New-
western coast of Newfoundland. Here a foundland Base Command surgeon by
medical officer, a dental officer, and four Lt. Col. William J. Eklund. The 308th
enlisted men opened a 25-bed hospital Station moved in June into a permanent
in a small barracks in March 1942. all-concrete building designed for its
At each of the four U.S. bases, the special needs. There were two stories
hospital commander served also as sur- above ground, with a basement blasted
geon of the base and as commander of from solid rock and protected by a thick
the medical detachment. concrete slab. The basement, which
THE ATLANTIC DEFENSE AREAS 25
half of its beds available for transients. a serious threat to U.S. troops. Diphthe-
When flights were not interrupted, lit- ria, also common among the residents,
ter patients were given a warm meal on never seriously menaced the American
the planes. Plasma and whole blood were forces.
available for those who needed them. On the supply side, there were early
Fresh milk was flown up from Presque difficulties brought about more by lack of
Isle, Maine, especially for use of evac- storage facilities than by lack of supplies
uees passing through Harmon Field. themselves. After the bases were well
In general the health of the command established, medical supplies were quite
was good. The climate was relatively adequate—large quantities were even
mild, resembling that of northern New returned to the United States during
England. Although the winters were 1944. The base medical depot at Fort
characterized by sudden changes from Pepperrell was discontinued late in 1943,
sunshine to snow or sleet, with a pene- the function passing to the 308th Station
trating northeast wind, the thermometer Hospital.
seldom dropped below zero. The troops
were housed in permanent buildings and Bermuda Base Command
had proper clothing. The incidence of
respiratory diseases was not unduly high, Geographically, Bermuda was the key
and intestinal diseases were at a mini- to the North Atlantic defenses. It lies
mum. In 1942 there were 25 cases of near the center of a line from Nova Scotia
catarrhal jaundice, which, like the paral- to Puerto Rico, which is to say the center
lel but more severe outbreak in Iceland, of an arc shielding the Atlantic coast of
were apparently related to yellow fever North America whose ends are New-
immunization. foundland and Trinidad. Only New-
A venereal disease rate that climbed foundland preceded Bermuda among
to 35 per thousand per annum in Octo- the bases acquired from Great Britain.
ber 1942 and averaged in the neighbor- As in Newfoundland, engineer troops
hood of 20 during 1943 was considered were first to reach the island, the van-
excessive by Medical Department offi- guard arriving in November 1940. An
cers in Newfoundland, although that engineer medical officer reached Ber-
rate compared very favorably with those muda in January 1941, but no engineer
in other areas.10 The establishment of hospital was established until August.
prophylactic stations and the issue of The Bermuda Base Command, mean-
individual prophylactics to the men, to- while, had been activated on shipboard
gether with a stepped-up educational on 18 April 1941 and established head-
program and excellent co-operation from quarters two days later in the Castle Har-
the local authorities, brought the rate bour Hotel some two miles across the
down to a negligible figure by 1945. A water from the site selected for the U.S.
local health problem was tuberculosis, Army base and airfield near the eastern
which was widely prevalent among the end of the islands. (See Map I.)11
Newfoundlanders and thus constituted 11
Chief sources for this section are: (1) Conn,
Engelman, and Fairchild, Guarding the United
10
See pp. 92-94, below. States and Its Outposts, ch. XIV; (2) Watson, Chief
THE ATLANTIC DEFENSE AREAS 27
A small station hospital landed with ground, mezzanine, second, and third
the original troop complement and es- floors. The first patient was received on
tablished itself in the headquarters hotel, 23 April. The hospital commander, Col.
where it eventually occupied rooms on E. M. P. Sward, also served as surgeon,
Bermuda Base Command. He was re-
of Staff, pp. 481-82; (3) Annual Rpts, Surg, Ber- sponsible for the health of all Army
muda Base Comd, 1941, 1942-45; (4) ETMD's,
Bermuda Base Comd, Jul 43-Dec 45; (5) Hist
troops, including Air Corps, in Bermuda;
Monograph, U.S. Army Base, Bermuda, by N Atl for U.S. civilian construction workers;
Div, CE, OCMH files; (6) Hist of Preventive Medi- and for the on-the-job health of locally
cine in World War II, Eastern Defense Comd, Tab:
Bermuda Base Comd; (7) Med Hist Rcd, Oct 44-
procured labor. The Navy had a hospital
Dec 1944, app. L, AAF, N Atl Div, ATC; (8) Ltr, of its own at the naval base and air sta-
Col. E. M. P. Sward (Ret) to Col Goriup, 27 Jul tion at Kings Point projecting into Great
59; (9) Ltr, Col Paul A. Keeney (Ret) to Col John
Boyd Coates, Jr., 29 Oct 59. Both letters comment
Sound at the western end of the main
on preliminary draft of this chapter. island.
28 MEDITERRANEAN AND MINOR THEATERS
On 1 December 1942 the base hospi- January 1946 the hospital passed to con-
tal was designated the 221st Station Hos- trol of the Air Transport Command.
pital, with a T/O capacity of 250 beds. Evacuation to the United States was
Army medical personnel in Bermuda at irregular. In the absence of hospital
this time numbered 29 officers and 137 ships or medical air evacuation planes,
enlisted men; troop strength in the patients were evacuated by commercial
islands was approximately 4,000 climb- airline or by any available ship equipped
ing to a peak of about 4,500 in March with adequate hospital facilities. There
1943. might be weeks between planes and
The hospital moved from the Castle months between ships. In these circum-
Harbour Hotel on 1 May 1943 to a new, stances, the 120-day evacuation policy was
modern building of concrete and coral sometimes exceeded, and the 221st
only a quarter of a mile from the Air found it necessary to give more compre-
Transport Command terminal at Kin- hensive medical care than was normal
dley Field, the newly completed Ameri- for station hospitals.
can air base that was the principal in- In August 1944 Bermuda became a
stallation of Fort Bell. A dispensary stop on one of the main air evacuation
previously maintained at the field was routes from Europe, Africa, the Middle
closed, but the hospital continued to East, and the China—Burma—India The-
maintain other dispensaries wherever ater. A medical air evacuation detach-
the troop population warranted. ment consisting of nurses and enlisted
Since by mid-1943 construction was men was stationed at Kindley Field to
largely finished and military activities rotate with personnel of incoming planes
were of a routine nature, the need for of the 830th Medical Air Evacuation
hospital beds was beginning to decline. Transport Squadron. At the Bermuda
An agreement with the Navy was reached base, the 221st Station Hospital was re-
during the summer, and in September sponsible for feeding transient patients,
1943 the naval hospital transferred all treating them where necessary, and, if
patients to the 221st Station, preparatory circumstances required, hospitalizing
to closing. Thereafter all Navy personnel them. Although the hospital had been
requiring more than dispensary care, in- reduced to 150 beds before this time,
cluding transients from the Atlantic ample accommodations were available.
Fleet, were treated at the base hospital. Indeed, in January 1945, when the
Col. Paul A. Keeney was hospital com- USAHS St. Mihiel ran aground in the vi-
mander and base surgeon. cinity, the 221st Station cared for more
The work load had lightened appre- than 500 patients of the hospital ship for
ciably before the end of 1943, with troop two weeks. From September 1944 until
strength standing at 2,800 in November. several months after the end of the war,
As of 1 June 1944, with less than 2,300 well over 1,000 patients a month passed
U.S. troops still in the command, the through Bermuda on their way to the
221st Station Hospital was reorganized zone of interior. March 1945 was the
as a 150-bed unit, and in August 1945 peak month with 1,837.
was further reduced to 100 beds. Troop The medical service of the 221st Sta-
strength was then below 2,000. On1 tion Hospital saw only routine cases, with
THE ATLANTIC DEFENSE AREAS 29
even the venereal disease rate relatively Organizationally, the U.S. base in the
low. The surgical service dealt with a Azores was set up as part of the North
number of accident cases, but the only African theater, but did not long remain
combat wounds hospitalized there were in that status. In May 1944, under the
suffered at sea by personnel of the Atlan- designation U.S. Army Forces in the
tic Fleet or one of the Allied naval Azores, jurisdiction over American per-
units based on Bermuda. sonnel and installations in the islands
passed to the Eastern Defense Command.
U.S. Army Forces in the Azores In February 1945 the North Atlantic
Division of the Air Transport Command
U.S. planners in 1941 contemplated took over control of all U.S. interests in
the occupation of the Portuguese Azores the Azores.
by a U.S. military force, but the project Medical support of U.S. Army troops
was postponed in favor of relieving the on Terceira Island consisted initially of
British garrison in Iceland, where the a dispensary with evacuation to a British
urgency seemed greater. In mid-1943, hospital for cases requiring more than a
after defeat of the German and Italian few days' confinement. By February 1944
forces in North Africa and the subse- the dispensary had grown until it occu-
quent conquest of Sicily, the use of the pied several Nissen huts. Other prefab-
Azores as a link in a new central Atlantic ricated buildings were added between
route to Europe, the Middle East, and February and May. Forty-four regular
Asia was definitely planned, pending beds enabled American troops to be hos-
agreement with the Portuguese Govern- pitalized in their own area, which greatly
ment. In October 1943 the British suc- facilitated the operation of the medical
ceeded in getting permission to use the service. In addition, another 35 or 40
islands for military purposes under the beds were available to accommodate
terms of an old treaty. A British naval evacuees from other theaters on their
base and an air base near Lagens on way to the zone of interior. A 170-bed
Terceira Island, were quickly estab- medical installation was requested by
lished, and in December American per- the Azores Base Command, but no such
sonnel began to share the airfield with unit was established there until after the
the British. This joint occupancy con- war. On Santa Maria Island the Medical
tinued until September 1944, when the Department began operating a dispen-
Portuguese finally gave the United sary with the arrival of the first troops in
States permission to establish an exclu- September 1944. During the remainder
sively American base on Santa Maria of the year the Medical Department on
Island, about 150 miles southeast of Ter- the island acquired frame buildings and
ceira.12 tentage to maintain a 120-bed dispensary.
12
Sources for this section are: (1) Matloff and The dispensaries on Terceira and Santa
Snell, Strategic Planning for Coalition Warfare, pp. Maria remained in operation through
44-455 (2) Hist of the Med Dept, ATC, May 41- the end of the war and into the postwar
Dec 44; (3) Arctic Laboratory, Sep 41-Jan 44, AAF,
N Atl Wing, ATC, pt. I, pp. 40-43, pt. II, pp. 1-5, 2-6, and apps. K and P; (5) Annual Rpt of Med
and app. L; (4) Med Hist Rcd Oct 44-Dec 44, Dept Activities, Base Hosp, Azores Air Transport
AAF, N Atl Div, ATC, pt. I, pp. 30-35, pt. II, pp. Sta, Atl Div, ATC, 1947.
30 MEDITERRANEAN AND MINOR THEATERS
period, when the one on Terceira Island offsetting the disadvantages of cold
became a 50-bed hospital. Both installa- weather operations in northern latitudes
tions had been in effect hospitals from and reducing evacuation time from
the start, but continued to be called dis- France to the United States. About 2,000
pensaries because of the reluctance of patients a month passed through the
the Medical Department to assign hospi- Azores during the winter of 1944-45.
tals to Air Forces commands. They
served a combined U.S. troop population U.S. Army Forces in Eastern
that averaged about 1,200, plus an indefi- and Central Canada
nite number of transients.
The threat of plague was the most The primary mission of the U. S. forces
serious medical problem facing the Medi- in eastern and central Canada was to
cal Department in the Azores. It had speed delivery of planes to the United
occurred sporadically for a number of Kingdom—first lend-lease planes for the
years in all three forms: bubonic, pneu- hard-pressed Royal Canadian Air Force,
monic, and septicemic. The latter two then fleets of bombers and fighters to be
types invariably proved fatal. All troops flown in combat by American crews.
destined for the Azores received one The quickest, and in the long run the
inoculation of plague vaccine before safest, way to deliver a plane was under
departure from the United States and its own power. It needed only a line of
another after arriving in the islands. The bases close enough together to be within
Medical Department in the Azores con- the range of fighter craft, and adequate
ducted a vigorous rat extermination weather information. A direct route for
program and regularly inspected the heavy and medium bombers from New-
quarters and all other buildings used by foundland to Scotland had been pio-
the Army. Not a single case of plague neered in 1940, but it was hazardous at
developed among U.S. Army troops in best. Greenland was the key, and the
the Azores. Typhoid fever and venereal way was cleared for its use in the spring
diseases were two other dangers to the of 1941. The first U.S. troops in the areas
health of troops, but control measures designated for bases in eastern and cen-
prevented the former and lessened the tral Canada were Engineer Corps per-
latter disease. As in most of the other sonnel under direct command of the
North Atlantic bases, respiratory diseases General Staff.13
and injuries accounted for the majority
of cases requiring hospitalization. 13
Principal sources for this section are: (1) Conn
Air evacuation to the United States and Fairchild, Framework of Hemisphere Defense,
ch. XV; (2) Samuel Milner, "Establishing the
through the Azores began on a large Bolero Ferry Route," Military Affairs, vol. XI
scale after the invasion of western Eu- (Winter 1947), pp. 213-22; (3) Craven and Cate,
rope. When most of France fell into eds., Plans and Early Operations, pp. 313-18; (4)
Colonel Stanley W. Dziuban, Military Relations
Allied hands, it was possible to evacuate Between the United States and Canada, 1939-1945,
casualties direct from the Continent to UNITED STATES ARMY IN WORLD WAR II
the United States. By the end of 1944 a (Washington, 1959); (5) Arctic Laboratory, Sep
41-Jun 44, AAF N Atl Wing, ATC, pt. I, chs.1
winter evacuation route using the Azores and 2, and apps. D, G, H, and K; (6) Med Hist
rather than Iceland was adopted, thus Rcd, Oct 44-Dec 44, AAF N Atl Wing ATC, apps.
THE ATLANTIC DEFENSE AREAS 31
The Air Ferry Routes the war had increased the pressure to
get planes to the British Isles, and the
An air ferry route from Presque Isle, entire Eighth Air Force was to be flown
Maine, to Prestwick, Scotland, was well to its British base. The new plan in no
along by the end of 1941. The first hop way canceled out the old, but added to
would be to Gander, Newfoundland, or it a route through central Canada that
alternatively, because of crowding at would tap the aircraft production cen-
Gander, to Goose Bay, Labrador, where ters in California and the middle west.
the Canadian Government began con- Stations on the central route would be
struction of an airfield late in September. Great Falls, Montana, The Pas in west
BLUIE WEST 1 at the southern tip of central Manitoba, Churchill on Hudson
Greenland, under construction since Bay in northern Manitoba, Coral Har-
July, would be the second stop, and bour on Southampton Island just below
Reykjavík, Iceland, the third. Air dis- the Arctic Circle, and thence to BLUIE
tances were approximately 570 miles WEST 8, the northernmost Greenland
from Presque Isle to Goose Bay, 775 base, and on to Iceland and Scotland.
miles from Goose Bay to BLUIE WEST 1, Additional airfields were to be located
another 775 miles to Iceland, and the at Mingan on the north shore of the Gulf
final and longest hop of 840 miles from of St. Lawrence, about midway between
Reykjavík to Prestwick. Fighter planes Presque Isle and Goose Bay, and at the
would need extra fuel tanks, but they weather posts at Fort Chimo and Fro-
would make it. Weather stations estab- bisher Bay. Nine additional weather ob-
lished in September 1941 at Fort Chimo servation posts were to be established in
in northern Quebec Province, at Frob- the central area.
isher Bay on Baffin Island, and on Pad- Work on these arctic bases went for-
loping Island off the shore of Baffin ward feverishly during the brief summer
Island just above the Arctic Circle were season of 1942. Engineer troops were
to supply information for the guidance supplemented by Air Corps ground
of pilots. These weather stations were crews as runways neared completion, and
designated respectively CRYSTAL 1, CRYS- before the winter of 1942-43 closed in,
TAL 2, and CRYSTAL 3. nearly 900 planes of the Eighth Air
The air ferry route through Labrador, Force were flown to Scotland by one or
Greenland, and Iceland was barely oper- another of these routes. The number of
ational when the whole program was re- U.S. military personnel in central and
vised and enlarged in the middle of 1942. eastern Canada, including those assigned
The enlarged project was known as to the CRYSTAL and CRIMSON projects,
CRIMSON. Entry of the United States into climbed from 1,891 in March 1942 to
more than 17,000 in August, then
D, G, and J; (7) ETMD's, USAFCC, Oct 43-Sep dropped abruptly to 2,571. For the first
45, and USAFEC, Oct 43-Sep 44; (8) Annual Rpt,
4th Sta Hosp, 1943; (9) Final Rpt, Surg, USAFCC, six months of 1943 the average troop
29 Sep 45; (10) Annual Rpt, Surgeon, USAFEC, strength was about 1,350. By that date
1943; (11) Rpt of Inspection, Med Serv, Crimson the project stage was past. In July 1943
Project, Eastern Sector, by Brig Gen Albert W. Ken-
ner to TSG, n.d., inspection between 20 and 30 the United States Army Forces in Cen-
Jul 43. tral Canada was set up as an independent
32 MEDITERRANEAN AND MINOR THEATERS
Army had an allotment of some 400 beds the governor of the Canal Zone thought
in two hospitals operated by the Panama the construction of Army hospitals un-
Canal Health Department—the Gorgas necessary; there were delays in the prep-
Hospital on the Pacific side of the canal aration of plans and specifications; funds
and the Margarita Hospital on the Atlan- were inadequate for the number of beds
tic side. It was the continuous availa- desired; there were difficulties in obtain-
bility of these hospitals—especially the ing materials and equipment; the heavy
Gorgas Hospital—for handling unusual rainfall hampered construction.
or difficult cases that kept the medical By June 1940 the Panama Canal De-
service at a high level despite inadequate partment had doubled its 1939 strength,
bed strength at the military posts. The but still no beds were added to the al-
policy of allocating beds in the Panama ready insufficient number. The bed
Canal Health Department hospitals con- shortage was reported critical by repre-
tinued during the war, but with the sentatives of the Medical Department
allotment reduced to 250 beds after 1943, returning from the Canal Zone. As an
by which time new Army hospitals had expedient, temporary beds were in-
become available. (Map 2) The Panama stalled in a converted barracks, while
Canal Department surgeon when the station hospitals were expanded, pend-
United States entered the war was Col. ing the construction of permanent medi-
John W. Sherwood, who was succeeded cal facilities. In general, expansion of the
in May 1943 by Col. Wesley C. Cox. department dictated that hospitals be
A plan for the construction of per- operated at nearly all posts in the com-
manent Army hospitals in the Panama mand.
Canal Zone was developed in 1935 by The new Army hospitals at Fort Gu-
the Panama Canal Department surgeon lick and Fort Clayton, finally completed
in co-operation with The Surgeon Gen- in September 1943, opened with rated
eral of the Army. Congress approved the capacities of 251 and 378 beds, respec-
plan in 1937, authorizing the construc- tively. By making full use of the very
tion of a 528-bed hospital at Fort Clayton spacious porches, the hospitals almost
on the Pacific side of the canal, a 401-bed doubled their capacities. A third new
hospital at Fort Gulick on the Atlantic hospital, located at Fort Kobbe and ready
side, and a 60-bed hospital for the com- for use in June 1943, never functioned
bined posts of Fort Kobbe and Howard as originally intended, but served as a
Field in the Pacific sector. Funds for the dispensary through the war years. The
hospital construction program did not maximum strength of the Army in Pan-
materialize until a year later, by which ama, about 65,000, had been reached
time construction costs had so increased late in 1942, well before the completion
that it became necessary to reduce the of the permanent hospitals. As a result,
capacity of the two larger hospitals by hospitals operating in converted bar-
150 beds each. The War Department ap- racks and other nonhospital buildings
proved the plans on that basis in 1939, cared for the peak loads of patients. With
but there were further delays. The Med- the two largest hospitals completed and
ical Department was not satisfied that occupied by the end of the summer of
the program as approved was adequate; 1943, the other post, or station, hospitals
38 MEDITERRANEAN AND MINOR THEATERS
in the Canal Zone were reduced to dis- of the war. Over on the Atlantic end of
pensaries. The Panama Canal Depart- the canal, the 210th General Hospital,
ment had an average of 2,120 beds avail- which had operated in barracks build-
able during 1943, roughly 4 percent of ings since January 1942, moved into the
the average strength of the command. new hospital plant on the Fort Gulick
The Medical Department units that post in September 1943. This general
operated the major hospitals in the hospital was reorganized as the 368th
Panama Canal Department did consider- Station Hospital (450 beds), in April
able shifting about, both in place and in 1944, the chief reason being the decrease
designation, because of construction de- in the number of troops in the Atlantic
lays and reorganizations. The two largest sector of the Canal Zone. It continued
units, the 210th and 218th General Hos- operating at Fort Gulick throughout the
pitals, arrived in Panama in January remainder of the war, but was further
1942. The 210th upon arriving at Fort reduced to 300 beds in December 1944.
Gulick, the site of the new permanent The new hospital construction in the
hospital then still in the process of con- Canal Zone followed the pattern of the
struction, immediately occupied fourteen Gorgas Hospital, that is, tropical con-
recently finished permanent barracks on struction of reinforced concrete, with
the post and began admitting patients broad overhanging eaves on each floor
three weeks later. The 218th General for protection against the sun, and wide
Hospital, which was to occupy the new porches with jalousies to keep out the
permanent hospital building at Fort driving tropical rains. The solidly con-
Clayton, could not do so because con- structed buildings compared favorably
struction on this post was far from com- with any hospital in the United States
pleted. Its personnel was thereupon and satisfied the needs of the Army in
split up and dispersed on temporary Panama for years to come.
duty mainly to post hospitals at Fort In the Central American and South
Amador and Fort Kobbe on the Pacific American countries under the jurisdic-
side of the canal, and in smaller numbers tion of the Panama Canal Department,
to several other posts in the Canal Zone, medical service was supplied largely by
pending the completion of the Fort Clay- small hospitals and dispensaries under
ton hospital. control of the Sixth Air Force or the
The 218th General was redesignated Corps of Engineers. During 1942 hos-
the 353d Station Hospital in April 1943, pitals with capacities of 25 beds each
but the hospital's personnel were not were established at David, Republic of
brought together until September 1943, Panama; Guatemala City, Guatemala;
when it moved into the newly completed Salinas, Ecuador, and Talara, Peru. The
Fort Clayton hospital. It continued op- Air Forces had a 75-bed hospital con-
erating this plant as the 333d Station structed on Seymour Island in the Gala-
Hospital until April 1944, when the unit pagos Island group, strategically located
again became a general hospital with a 1,000 miles from Panama in the Pacific
capacity of 750 beds. The 262d General Ocean, protecting the western approaches
Hospital, as it was then called, ran the to the canal. (See Map 2.) All of these
Fort Clayton hospital for the remainder hospitals were constructed as tempo-
THE ATLANTIC DEFENSE AREAS 39
LOADING A SICK SOLDIER ONTO A SMALL PLANE in Darien Province, Panama, for
evacuation to one of the Canal Zone hospitals.
part of the war, but by 1943 it had in- ment established Puerto Rico and the
creased to a 120-day policy, which, in Virgin Islands as a territorial depart-
effect, precluded evacuation unless pro- ment on 1 July 1939. The Puerto Rican
tracted treatment was needed. In gen- Department, as the new command was
eral, only men deemed unfit for further named, served a dual role: first, as the
duty were returned to the zone of in- most advanced U.S. possession from
terior. Within the Canal Zone the which American sea and land operations
Medical Department moved sick and in- could be projected southward or east-
jured men from their units to points of ward; and, second, as a forward defen-
hospitalization by motor ambulance. In sive barrier protecting the eastern
most instances this procedure meant a approach to the Panama Canal. After
trip of less than twenty miles. Boat evac- the destroyers-for-bases agreement of
uation was used to transport patients 1940, the U.S. Army extended its fringe
from installations around Gatun Lake defenses of the canal into other islands in
and from otherwise inaccessible locations the Caribbean, providing at the same
in the interior of Panama. The Panama time a defense of the bauxite "lifeline"
Canal Railroad transported most of the from the Guianas to Trinidad and the
patients requiring movement from one United States. Included were bases
end of the canal to the other. The air leased from the British on Jamaica, An-
bases in the Republic of Panama and in tigua, St. Lucia, and Trinidad, and bases
Central and South America evacuated on Aruba and Curaçao leased from the
their patients to Canal Zone hospitals Dutch Government. Other bases for
by air. The department sent most of its American troops were established in the
ZI patients to New Orleans by ship, Guianas and in Cuba, while U.S. soldiers
but a small number of cases made the remained for a considerable time in
trip to the United States by air. The Venezuela, on training mission. The
latter method was used especially in Puerto Rican Department, renamed the
those cases requiring an immediate Antilles Department in June 1943, ab-
change of environment and climate, or sorbed all the above named-areas during
15
for patients needing very specialized the course of the war.
treatment of a type not available in 15
(1) Conn and Fairchild, Framework of Hemi-
Panama. sphere Defense, ch. X. (2) War Plans and Defense
Measures [Caribbean Defense Comd]. (3) A Hist
of Med Dept Activities in the Caribbean Defense
Puerto Rico and the Antilles Comd in World War II, vols. I-III. (4) Annual
Rpts, Med Dept Activities, Puerto Rican Dept, 1941
The U.S. Army had maintained a and 1942. (5) Annual Rpts, Medical Dept Activ-
garrison on Puerto Rico from the time ities, Antilles Department, 1943-45. (6) ETMD's,
Caribbean Defense Comd, Oct 43-Dec 45. (7) An-
that island was ceded to the United nual Rpt, Med Dept Activities, Trinidad Sector and
States at the conclusion of the Spanish- Base Comd, 1942 and 1943. (8) Annual Rpt, Med
Dept Activities, British Guiana Base Comd, 1942.
American War. In the period before (9) Health Service, Caribbean, 1942. (10) Annual
World War II troops there were under Rpts, Sta Hosps, Borinquen Field, P.R., Losey Field,
the jurisdiction of the Second Corps P.R., Ft. Read, Trinidad, and Aruba, N.W.I., 1942.
(11) Annual Rpt, 161st Gen Hosp, Ft. Brooke, San
Area. This attachment to the zone of Juan, P.R., 1945. (12) Annual Rpt, Med Dept Ac-
interior ceased when the War Depart- tivities, U.S. Army Forces in Surinam, 1942. (13)
42 MEDITERRANEAN AND MINOR THEATERS
Puerto Rico eventually had the War II, approximately a million dollars
largest concentration of U.S. Army troops was spent to modernize and improve the
in the Caribbean, outside the Panama buildings and to make them more suit-
Canal Zone. When formed as a territo- able for modern hospital use. In 1941
rial department in July 1939, the total the hospital had a capacity of about 600
strength amounted to 931 officers and en- beds and acted as a general hospital for
listed men, serving at the main post of the entire Puerto Rican Department. At
Fort Brooke in San Juan and at the Fort Buchanan, about seven miles south
subpost of Henry Barracks near Cayey. of San Juan, another station hospital,
By December the strength had risen to originally activated as a medical detach-
2,913 and continued upward through ment on the post of Fort Buchanan in
1940, reaching more than 13,000 in De- October 1939, became the post hospital
cember of that year. These troops were in late 1941, with a capacity of 150 beds.
divided among six posts in Puerto Rico (See Map 2.)
and one in the Virgin Islands. Army Borinquen Field, the main air base,
strength in the Puerto Rican Depart- located in the northwest corner of
ment continued to enlarge beyond any Puerto Rico, had a Medical Depart-
legitimate military need, mainly because ment dispensary servicing the field from
the operation of the Selective Service the time the first troops arrived there in
System brought more Puerto Ricans into September 1939. In May 1941, a 150-bed
the Army than could be used elsewhere. station hospital began operating at the
Military strength doubled in 1941 over field. Another airfield, known as Losey
that of the previous year and doubled Field, situated near Ponce in the south
again during 1942. At the time of the central part of the island, was the loca-
formation of the Antilles Department, tion of a 100-bed station hospital, which
the command had a strength of over began operating for the garrison there
50,000. It reached a peak of more than in April 1941. The old established post
57,000 in September 1943, which of Henry Barracks served as a subpost of
amounted to only about 8,000 less than Fort Brooke until December 1939. In
the maximum strength attained by the March 1940, a station hospital of 10 beds
Panama Canal Department. was established for the post, and by Oc-
tober of 1941 it had a capacity of 55 beds.
Hospitalization—The most important Most troops stationed at Camp Tortu-
prewar Medical Department facility in guero, a post in the northern part of the
Puerto Rico was the old station hospital island west of San Juan, used the Fort
at Fort Brooke housed in buildings Brooke station hospital. A hospital ward,
turned over to the United States by the completed at Camp Tortuguero in July
Spanish Government at the conclusion 1941, took care of mild medical and sur-
of the Spanish-American War. The hos- gical cases. A dispensary, opened in
pital buildings dated back to the i8th March 1941, administered to the needs
century, but during the course of World of the garrison at Benedict Field, located
on St. Croix, Virgin Islands.
Ltr, Col Dean M. Walker (Ret) to Col Goriup,
18 Jul 59, commenting on preliminary draft of this In the year before Pearl Harbor, the
chapter. Medical Department had operated these
THE ATLANTIC DEFENSE AREAS 43
seven stations with a minimum of person- Thomas, Virgin Islands, in 1942, and the
nel. There were less than 400 officers dispensary that had operated on the is-
and enlisted men of the Medical Depart- land of St. Croix became a 25-bed hos-
ment in the command at the beginning pital during the same year.
of 1941, but the number had more than, Medical service in the southern half
doubled by the end of the year. Col. of the Caribbean area, which included
Walter P. Davenport was the surgeon of bases in Trinidad, St. Lucia, Aruba,
the Puerto Rican Department. Curaçao, British Guiana, and Dutch
Growing troop strength in Puerto Guiana, did not come under the juris-
Rico in 1942 resulted in the expansion diction of the headquarters in Puerto
of most existing medical facilities and Rico until the establishment of the
the establishment of others. The Medi- Antilles Department in June 1943. Prior
cal Department had little choice in the to that time, U.S. bases in the area were
selection of hospital sites since medical under the jurisdiction of the Trinidad
installations had to be located at points Sector and Base Command, of which Col.
where large concentrations of troops Dean M. Walker was surgeon. American
existed. New hospital construction in troops moved into Trinidad, southern
Puerto Rico and other islands of the anchor of a defensive arc that included
Antilles was characterized by the use of Newfoundland and Bermuda, in May
temporary, wooden, theater-of-opera- 1941, but for several months had no med-
tions-type structures. Where a post was ical support other than that supplied by
planned as a permanent military instal- their own medical detachments, backed
lation, as in the case of Borinquen Field, up by British hospitals. In December
hospital construction was eventually of 1941 construction was begun on a plant
a permanent type. to house a 500-bed station hospital at
The main hospital at San Juan in- Fort Read, the principal U.S. base on the
creased its capacity to 750 beds during island, but it was September 1942 before
1942. To it were evacuated all neuro- the hospital opened. By that date an ad-
psychiatric patients in the department, ditional temporary hospital plant was
all cases requiring lengthy hospitaliza- under construction to provide transient
tion, and all those destined for the zone hospitalization should it be necessary to
of interior. Most of the other hospitals evacuate substantial numbers of casual-
increased their capacities in 1942, and a ties from the forthcoming invasion of
new 100-bed station hospital, completed North Africa. Since operations in
during the year, began serving the troops Morocco and Algeria produced only a
stationed at Camp O'Reilly in eastern minimal number of casualties, the tem-
Puerto Rico near the town of Gurabo. porary hospital was never called upon to
In late 1941 and 1942 garrisons were serve its original purpose. The main unit
sent to Jamaica and Antiqua after the meanwhile was redesignated on 1 De-
Puerto Rican Department was expanded cember 1942 as the 41st General Hospi-
to include these British islands. Tem- tal, and was to have an ultimate capacity
porary hospitals of 25 beds each served of 1,000 beds. The first commanding
the U.S. Army troops there. A small hos- officer was Col. John A. Isherwood.
pital of 18 beds was established on St. The 41st General Hospital served as
44 MEDITERRANEAN AND MINOR THEATERS
regional unit for the whole command, Buchanan the 297th Station (75 beds)
taking patients from all the southern replaced the existing unit; and the 100-
Caribbean and the Guianas. It was sup- bed hospital at Camp O'Reilly was re-
plemented at Port-of-Spain, Trinidad, designated the 326th Station Hospital
by a small 20-bed unit established early with a T/O of 250 beds. Two new sta-
in 1941 and supplanted in the spring of tion hospitals were also established in
1942 by a 200-bed hospital activated as Cuba supplanting earlier installations:
the 255th Station Hospital on 1 January the 299th (150 beds) at San Julian, and
1943. Both Trinidad hospitals were con- the 300th (50 beds) at Batista Field.
structed of wood and regarded as semi- Most important of the midyear designa-
permanent structures. St. Lucia had a tions was that of the post hospital at San
25-bed permanent Army hospital, which Juan, which became the 298th Station
began operating in November 1942. On Hospital with an authorized capacity of
the two Dutch islands of Aruba and 600 beds. Attached to it in September
Curaçao, the Army maintained station was the newly activated 301st Station
hospitals of 75 beds each beginning in Hospital (100 beds) which was moved to
early 1942. The base in British Guiana Losey Field when the Air Forces resumed
had a 50-bed permanent-type station hos- operations there in June 1944. At that
pital located at Atkinson Field, near time the unit was reduced to 25 beds.
Georgetown. Two station hospitals op- Another group of hospitals had their
erated at bases in Dutch Guiana, one 50- designations, and sometimes their sizes,
bed unit at Paramaribo and a 25-bed altered in November 1943. These in-
hospital at nearby Zanderij Field. (See cluded the post hospital at Borinquen
Map 2.) Field, Puerto Rico, which became the
Coincident with the creation of the 150-bed 330th Station Hospital; the 41st
Antilles Department in June 1943, many General Hospital at Fort Read, Trini-
of the post hospitals scattered along the dad, which was redesignated the 359th
Caribbean island chain and the north Station Hospital with a T/O strength of
coast of the South American mainland 600 beds; and the small post hospitals at
were activated as numbered station hos- Zanderij Field, Surinam (352d Station,
pitals, often with T/O bed capacities in 25 beds) ; Atkinson Field, British Guiana
excess of those then existing. The post (353d Station, 75 beds) ; Paramaribo,
hospital at Fort Simonds, Jamaica, be- Surinam (354th Station, 50 beds); St.
came the 292d Station Hospital, with a Lucia, British West Indies (355th Sta-
capacity of 75 beds. At Antigua the post tion, 50 beds) ; Curaçao, Netherlands
hospital was converted into the 293d Sta- West Indies (356th Station, 75 beds); and
tion Hospital, also of 75 beds. The 294th Aruba, Netherlands West Indies (358th
Station (25 beds) absorbed the post Station, 50 beds).
hospital at St. Thomas, Virgin Islands. With the Axis virtually no threat to
In Puerto Rico the 295th Station Hos- the Western Hemisphere by mid-1943,
pital, of 150 beds, supplanted the post except for occasional U-boat raids on
hospital at Henry Barracks; the Camp shipping, the strategic importance of
Tortuguero hospital was redesignated Puerto Rico and other islands in the
the 296th Station (50 beds); at Fort Caribbean declined. The Medical De-
THE ATLANTIC DEFENSE AREAS 45
partment was at peak strength when the fairly definitive care to most serious ill-
Puerto Rican Department and the Trini- nesses, and since the situation was not
dad Sector were merged to form the one of combat there was no pressing
Antilles Department, with Col. Clyde C. need for evacuation to the zone of inte-
Johnston as its surgeon. There were at rior. About half of the patients moreover,
this time more than 2,200 officers and en- were Puerto Ricans, and so would not
listed men serving in medical installa- normally have been evacuated to the
tions from Cuba through the Guianas. A mainland under any circumstances.
steady contraction began in 1944, which
continued to the end of the war. The Medical Supply—Problems of medical
298th Station Hospital at San Juan be- supply in the Antilles proved similar to
came the 161st General Hospital in June those in Panama, but tended to be some-
1944, serving the entire Antilles Depart- what more difficult in the early days. The
ment, but its T/O still called for only lack of a well-developed military estab-
600 beds. Other hospitals throughout the lishment in Puerto Rico at the beginning
area reduced bed strength, converted to of the emergency period in 1939 and the
dispensary status, or disbanded alto- extreme dispersion of island bases in the
gether. By the end of 1945, only nine Antilles were important factors in creat-
hospitals remained in the Antilles De- ing supply problems. The absence of a
partment, with a total of 1,225 beds. The major United States activity comparable
161st General Hospital in San Juan, with to the Panama Canal also complicated
600 beds, accounted for almost half of matters. The new island bases felt the
the total. Outside Puerto Rico only the scarcity of supplies in the early days of
292d Station Hospital (25 beds) in the war much more strongly than the
Jamaica, the 300th (25 beds) at Batista established facilities in Panama.
Field in Cuba, and the 359th on Trini-
dad remained in operation. Common Diseases—As in Panama, the
two major health problems throughout
Evacuation—Evacuation activities in the Antilles Department were malaria
the Antilles Department followed a pat- and venereal disease, and in both cases
tern much like that of the Panama Canal the answer was found in improved pre-
Department. It was necessary to evacuate ventive measures. The malaria rate for
only a small number of men during the the department as a whole was cut from
entire war. Within the various island 84 per thousand per annum in 1941 and
bases, men needing medical attention 88 in 1942 to 37 in 1943, 12 in 1944, and
were taken to the nearest dispensary or 9 in 1945. Measures taken included larvi-
hospital, usually by ambulance but oc- ciding, drainage, use of atabrine, and
casionally by air in the case of isolated constant education and experimentation.
units. Further evacuation to a larger hos- A unique problem existed around Fort
pital was normally accomplished by ship, Read, Trinidad, where a water-catching
although air transport came into play if parasite on shade trees planted to protect
great distances were involved. The large the cocoa plantations proved a prolific
hospitals in Puerto Rico and Trinidad breeder of mosquitoes. It was eventually
enabled the Antilles Department to give discovered that a copper sulfate spray
46 MEDITERRANEAN AND MINOR THEATERS
COLONEL LEONE
would destroy the parasites. In the fight tary leaders by the summer of 1939 that
against venereal disease, eternal reitera- only the United States could provide the
tion of the danger was primary, together forces necessary to defend the Brazilian
with the establishment of well-located bulge in the event of an attack from
prophylactic stations and steady co-opera- Africa, a short 1,800 miles across the
tion with local authorities where local South Atlantic. Military planning in
laws and customs permitted some meas- both countries accepted this reality, al-
ure of control. The venereal rate was re- though Brazil accepted it with reluc-
duced from 81 per thousand per annum tance. The fall of France a year later and
in 1942 to 72 in 1943, 47 in 1944, and 31 the subsequent control of French West
in 1945. Africa by the collaborationist Vichy re-
gime, gave renewed urgency to prepara-
The South Atlantic Theater tions for defense of the strategically most
vulnerable point in the hemisphere.
It was clear to U.S. and Brazilian mili- Army and Navy staff agreements were
THE ATLANTIC DEFENSE AREAS 47
negotiated in the fall of 1940. By specific surgeon. Wing headquarters was set up
agreement between the two countries in at Atkinson Field, British Guiana, on 9
the spring of 1941, Pan American Air- July, moving to Recife, Brazil, in De-
ways undertook development of airfields cember after formal activation of United
in Brazil at Amapa, Belem, Sao Luis, States Army Forces, South Atlantic, on
Fortaleza, Natal, Recife, Maceio, and 24 November 1942. A few days earlier
Bahia. Such a route, jumping off from the Air Transport Command had estab-
bases in the Guianas, would permit even lished its own headquarters at Natal, but
short-range planes to fly to the threat- the two headquarters were bound to-
ened sector. The work had hardly gotten gether by having the same commander.
under way before Pan American, at the General Walsh served in both capacities,
request of the U.S. Government and with as did Maj. Gen. Ralph H. Wooten, who
Brazilian concurrence, undertook to relieved Walsh in May 1944. In October
ferry lend-lease planes to British forces of that year, however, the two commands
16
in the Middle East. After U.S. entry were separated at the request of the Air
into the war, the South Atlantic ferry Transport Command. General Wooten
route passed to military control. Plans continued as theater commander, while
were prepared for setting up a theater of the South Atlantic Division, ATC, passed
operations in Brazil, but were not real- to Col. Cortlandt S. Johnson. Leone, on
ized until after Brazil, too, had declared the other hand, was replaced as ATC
war on Germany and Italy, 22 August South Atlantic Wing surgeon when he
1942.17 took over the theater surgeon's office.
The theater organization had its incep- The two positions remained separated
tion in late June 1942, under the aegis of until August 1943, when Leone was
the South Atlantic Wing, Air Transport again named to the ATC post while re-
Command, of which Brig. Gen. Robert taining his position as USAFSA surgeon.
L. Walsh was commanding officer and He had in the interval returned to the
Maj. (later Col.) George E. Leone was United States long enough to attend the
16
17
See p. 360, below. School of Aviation Medicine at Ran-
The main sources for this section are: (1) dolph Field, Texas, in order to qualify
Watson, Chief of Staff, ch. IV; (2) Conn and Fair-
child, Framework of Hemisphere Defense, chs. XI, as a flight surgeon. Throughout the life
XII; (3) Hist, USAFSA, MS, OCMH files; (4) Of- of the theater close liaison was main-
ficial Hist of the S Atl Div, ATC, MS, OCMH files; tained with the medical service of the
(5) Med Hist, World War II, USAFSA; (6) An-
nual Rpts, Med Dept Activities, USAFSA, 1942-44; Fourth Fleet, and with Brazilian doctors,
(7) Annual Rpt, Med Dept Activities, S Atl Div, military and civilian.
ATC, 1944; (8) Annual Rpt, Surgeon, Composite During the British Guiana interlude,
Force 8012, Ascension Island, 1943; (9) Annual
Rpts, 175th Sta Hosp, 1943 and 1945; 193d Sta Leone, who was promoted to lieutenant
Hosp, 1943-45; 194th Sta Hosp, 1943-45; and 200th colonel at this time, surveyed the medical
Sta Hosp, 1943-45. (10) ETMD's, USAFSA, Jul situation in Brazil. Valuable informa-
44-Oct 45; (11) A Med Hist of the Brazilian Ex-
peditionary Force in Brazil, by Maj R. H. Lackay; tion, particularly as to the incidence of
(12) Ltr, Col George E. Leone, to Col Coriup, 30 malaria and venereal disease, was se-
Jul 59; (13) Ltr, J. P. Cameron, to Goriup, 5 Aug cured from the two U.S. flight surgeons
59; (14) Ltr, Frank P. Gilligan, to Goriup, 18
Aug 59. Last three letters comment on preliminary already stationed at Brazilian airfields—
draft of this chapter. Capt. Fred A. Heimstra at Natal and 1st
48 MEDITERRANEAN AND MINOR THEATERS
Lt. Francis M. Dougherty at Belem. The Brazil until after activation of the the-
successful invasion of French North Af- ater. Patients requiring more care than
rica at that time by American and Brit- these dispensaries could provide were
ish ground troops removed any danger generally flown to British Guiana or
that may still have existed of an attack Trinidad. Emergency surgery was per-
against the South American mainland. formed in Brazilian military hospitals.
In his capacity as surgeon, USAFSA,
Hospitalization Colonel Leone asked for three station
hospitals in October 1942, but the units
Other than small dispensaries set up at requested did not leave the port of em-
stopping points along the Air Transport barkation until 29 December, arriving in
Command route, there were no U.S. Brazil in late January 1943. The hos-
Army medical facilities operating in pitals were distributed to the major bases
THE ATLANTIC DEFENSE AREAS 49
of the theater—the 193d Station Hospital and from the vicinity of Natal itself. The
(50 beds) to Belem, the 194th Station 194th also accommodated all patients en
Hospital (100 beds) to Natal, and the route from other theaters to the United
200th Station Hospital (150 beds) to States. It was a very active unit because
Recife. None of the hospital buildings of the great number of transients and
had been completed at the time the units daily landings and takeoffs.
arrived, but by May and early June all The 200th Station Hospital, just 150
began operating. The 175th Station Hos- miles south of Natal near the city of
pital (150 beds), arrived on Ascension Recife, served as a "theater" hospital
Island, some 1,250 miles east of the since no general hospital operated in
Brazilian coast, in March 1942, before Brazil. It received patients from all other
the creation of the South Atlantic the- medical installations in the command
ater. The U.S. Army had landed some that required prolonged hospitalization
2,000 men on this British possession with or ultimate evacuation to the United
the mission of protecting it from attack States. The 200th was especially well
and building an airfield. The 175th was equipped and had a very well-balanced
under the control of a composite force professional staff. Specialists from the
headquarters until November 1942, 200th made trips to other stations in the
when the South Atlantic theater as- theater where they consulted on patients
sumed jurisdiction over U.S. troops on who could not be transferred to Recife.
the island. (Map 3) The hospital laboratory was supple-
Hospital construction in Brazil fol- mented to function as a provisional the-
lowed closely the standard U.S. Army ater laboratory.
cantonment-type plant common in the On Ascension, the steppingstone be-
United States. The use of local materials, tween Brazil and Africa, the 175th Sta-
especially hollow tile blocks, which were tion Hospital had started operating in a
stuccoed on the outside and plastered on newly constructed hospital in May 1942,
the inside, and red tiles for roofing, re- providing medical care for U.S. Army
sulted in more permanent structures and Navy personnel stationed there,
than the wooden ZI-type station hospi- transients passing through, and survivors
tals. The 193d Station Hospital at of torpedoed ships. Its buildings con-
Belem, just below the mouth of the sisted of wood-frame tarpaper-covered
Amazon River, was situated in a tropical structures, which lasted satisfactorily
location almost on the equator. It fur- through the war. Except for a very small
nished care to the immediate area and dispensary operated by a retired British
received patients from the jungle air naval officer, no other medical facility
base at Amapa, the airfield at Sao Luis, existed on the island. The 175th min-
and weather stations at Clevelândia and istered to about one-fourth of the total
Camocim. strength of the South Atlantic theater.
Nine hundred miles east on the Brazil- The medical service for the South At-
ian coastal "hump," the 194th Station lantic theater maintained itself with a
Hospital at Natal administered medical minimum of personnel, but still made
care to patients from the air bases at medical care equally available to all per-
Fortaleza, Fernando de Noronha Island, manent and transient Army personnel, as
50 MEDITERRANEAN AND MINOR THEATERS
well as to members of the U.S. Navy and basis and records as to its extent are not
certain civilians at each base. The the- available. Similarly, patients were flown
ater strength reached its wartime peak informally from Brazil to British Guiana
of about 8,000 in January 1944. There or Trinidad without being officially re-
were approximately 600 Medical Depart- corded. As the war in the Mediterranean
ment personnel in the theater at that spread during 1943 from Africa to Sicily
time, and an aggregate of 500 T/O beds and Italy, air evacuation through Brazil
in fixed hospitals.18 In keeping with a de- became more general. Late in September
clining military population, medical of that year the 808th Medical Air Evac-
strength was cut to 450 in July 1944 uation Transport Squadron took over
when the 175th Station Hospital on As- the flights from northern Brazil to
cension was reduced to 100-bed capacity; Miami, continuing in operation until
and to 350 in November when the 175th the patient load declined sharply late in
lost another 50 beds and the 200th Sta- 1944. All together, 957 patients from
tion at Recife was reduced to 100 beds. other theaters passed through the South
In addition to the beds provided by the Atlantic theater by air on their way to
station hospitals, dispensaries of from 10 the zone of interior in 1943, and 2,092 in
to 20 beds each operated at Amapa, Sao 1944. Only 165 patients followed the
Luis, Fortaleza, Bahia, Fernando de Brazilian route in 1945 before the service
Noronha, and Rio de Janeiro. Except was discontinued in July in favor of the
for the unit at Rio, which existed pri- more direct North Atlantic routes.
marily to provide medical care to U.S. For the South Atlantic theater itself,
personnel of the Joint Brazil-United the evacuation policy for all hospitals,
States Military Commission, these dis- except the 200th Station Hospital, was
pensaries were operated by medical per- 60 days. Other hospitals sent patients
sonnel of the Air Transport Command. whose condition precluded recovery
At Clevelândia, Camocim, and Porto within this period to the 200th for more
Alegre, very small stations where a dis- extended treatment, or for evacuation to
pensary could not be justified, Medical the United States if recovery within 120
Department enlisted men provided emer- days seemed unlikely. Because of the
gency medical care. abundance of air transportation avail-
able, patients usually traveled to the
Evacuation United States by plane. A smaller num-
While there was limited air evacuation ber, notably mental cases, sailed aboard
of nonbattle casualties from Africa, the ships from the port of Recife. In 1943
Middle East, and even from the China- the number evacuated from the South
Burma-India theater before the begin- Atlantic theater to the ZI was 189, of
ning of 1943 over the air ferrying route whom 29 went by sea; in 1944 there were
by way of Brazil, it was on an individual 78 evacuated by water and 268 by air, or
18
See app. A-1. Theater strength exceeded 10,000
a total of 346; and in 1945 the figures
for the immediate postwar months of June, July were 64 by sea and 151 by air, for a total
and August 1945, when evacuation from the Medi- of 215. The 3-year aggregate was 750,
terranean and redeployment brought about a sub-
stantial increase in Air Transport Command
with more than three-fourths being sent
strength at Brazilian bases. by air.
THE ATLANTIC DEFENSE AREAS 51
U.S. medical officers and enlisted Med- sence of land combat in the South
ical Department personnel helped train Atlantic theater, the operation of a satis-
Brazilian medical troops before the de- factory hospital system posed no unusual
parture of the Brazilian Expeditionary difficulties. The operation of medical in-
Force for Italy in July-November 1944, stallations was generally routine, with
but neither time nor facilities were avail-emphasis on the control of venereal and
able to do a completely satisfactory job. tropical diseases. Patients stayed in the
Medical personnel of the theater also hospital for only short periods, since
assisted the Brazilian Army by unloading acute diseases of brief duration ac-
sick and wounded members of the Brazil- counted for most of the admissions.
ian Expeditionary Force returning from Injuries from plane crashes and other ac-
Italy by ship and plane. cidents made up the remainder. The gen-
eral health of the troops was excellent,
Medical Supply and tropical diseases never became a
problem, due mainly to the preventive
In the early days the theater experi- measures employed by the Medical De-
enced some difficulty in procuring medi- partment. The largest single medical
cal supplies in sufficient quantities, but problem was the great reservoir of vene-
by mid-1943 enough stocks had been ac- real disease near the U.S. Army bases.
cumulated to meet the needs of all medi- Prostitution flourished freely with very
cal installations in the command. In only little being done about infected carriers
two instances were large shiploads of of venereal diseases. Control measures
supplies from the United States delayed proved difficult because the Army, being
for so long that emergency air shipments only a visitor in a friendly foreign coun-
had to be made. A general depot estab- try, did not have control over the civilian
lished at Recife in early 1943, provided population. Areas and individual houses
medical supplies for the entire theater could be placed "off limits" but resi-
and distributed them to the widely sepa- dents of these houses could and did find
rated medical installations of the com- other places to carry on their trade. Con-
mand by air and sea transportation. Most sequently, the Army directed its control
items of supply came from the United program at the individual soldier by
States, but the Army bought some of the means of education. The incidence of
heavier equipment such as chairs, desks, venereal disease on Ascension Island was
tables, and X-ray units, and also a small zero because of the absence of women,
quantity of drugs from Brazilian dealers. but for the theater as a whole the vene-
Before the Recife depot was established, real rate was 83 per thousand per
the Trinidad Sector depot at Fort Read annum for December 1942, averaged
was often called upon to send medical 101 for 1943, and 72 for 1944. The rate
supplies both to Brazil and to Ascension dropped to a low of 36 in May 1945 but
Island. shot up again to 99 in August with the
influx of transients. The everpresent
Professional Services danger of malaria in northeastern Brazil
resulted in a vigorous control program
Common Diseases Because of the ab- in collaboration with the Brazilian
52 MEDITERRANEAN AND MINOR THEATERS
health authorities. Individual malaria This location is among the most unfavor-
control measures were also practiced able of any in the world for the mainte-
with highly successful results. At no time nance of good health. During 1943 the
did malaria become a serious threat to rainfall measured around fifteen feet,
the physical fitness of U.S. Army troops and in 1944 it totaled almost thirteen
in the theater, although the rate per feet. The entire swampy area was alive
thousand per annum reached a high of with malaria, which took a heavy toll
98 in March 1943. The worst month in among personnel of survey teams enter-
1944 was June, when the rate was 34. ing the vicinity in 1942. A small dis-
The 1945 peak was reached in May and pensary that arrived there in early 1943
June, with rates of 24.9 and 27.2, re- helped keep the state of health of Army
spectively. troops and Brazilian workers on a rea-
A good example of how the Army sonably high level, mainly because of
overcame the deteriorative effects of immediate evacuation to Belém of all
tropical diseases in Brazil was the work patients needing bed care. During 1944
accomplished by the Medical Depart- the dispensary's staff increased, and more
ment at the jungle outpost of Amapa. supplies and equipment arrived, which
THE ATLANTIC DEFENSE AREAS 53
made it possible to care for many more and the Brazilian Government was not
patients on the spot. The men assigned prepared to see the scourge re-introduced
to the dispensary had to be versatile. by aircraft from infested areas of Africa. 19
Each enlisted medical assistant was at Colonel Leone and his staff worked on
some time a laboratory technician, nurse, the problem with Brazilian health offi-
or even a doctor. In 1944 the base sur- cials, representatives of the Rockefeller
geon delivered six babies for Brazilian Foundation, and ground and air com-
workers, and in every case the enlisted manders. Brazilian officials were not sat-
men assisted the surgeon during delivery. isfied with the routine spraying of planes
The Brazilians at the Amapa base after they had landed in Brazil. Between
suffered from many chronic diseases October 1941, when Pan American Air-
rarely found among American soldiers. ways began its flights between Brazil and
The surgeon explained each case enter- Africa, and July 1942, when U.S. Army
ing the dispensary to the enlisted assist- medical service was established in Brazil,
ants, who were required to participate gambiae were found on seven occasions
in the treatment. With all the bad en- on planes arriving in Natal from Africa.
vironment caused by the heat, tremen- As a result aircrews were given strict
dous rainfall, and poor sanitation of the regulations on the subject, which in-
local population, the dispensary records cluded spraying before departure from
showed only 600 per thousand illnesses Africa. Early in 1943, by Presidential
or injuries among Army personnel, decree, the Brazilian health authorities
which amounted to 131 per thousand less took over responsibility for ridding in-
than the South Atlantic theater rate as coming planes of arthropods. Procedures
a whole. Not a single case of malaria were stringent, including the closing of
developed among American troops dur- all vents and shutting off air renovation
ing 1944, despite the fact that this disease apparatus before the plane landed, and
had previously been highly endemic. At disinfestation before any passengers or
the end of that year this small group, crewmen were allowed to deplane or any
composed of one officer and tour enlisted freight was unloaded. In August Colonel
men, were giving valuable medical serv- Leone accompanied Dr. Fabio Carneiro
ice to approximately 1,000 people. de Mendonca, Director of the Brazilian
Port Sanitary Service, on a visit to Africa
The Disinsectization Program—In to study conditions at the fields from
1930 a very severe epidemic of malaria which planes left for Brazil. At a confer-
had ravaged the area around Natal. The ence early in November 1943, it was
disease proved to be carried by the agreed that U.S. Medical Department
Anopheles gambiae mosquito, a species personnel should supervise the disinfes-
common in equatorial Africa but pre- tation at African points of departure, and
viously unknown in Brazil. It was that qualified Brazilian observers should
believed that the vector had been intro-
duced by fast French destroyers from
19
Dakar. It had taken ten years of hard Elliston Farrell, "The Anopheles Gambiae Prob-
lem in Brazil and West Africa, 1941-44," Bulletin,
work on the part of the Brazilian Health U.S. Army Medical Department, vol VIII, (Feb-
Department to stamp out the gambiae, ruary 1948), pp. 110-24.
54 MEDITERRANEAN AND MINOR THEATERS
be present at these points, most impor- ATC Wing dental surgeon for more ex-
tant of which were Dakar and Accra. tended visits to other bases.
With these practices in effect, the rec- For a time the dentist of the 194th
ord was impressive. In 1943, gambiae Station also served as theater dental sur-
were found on 100 out of 819 planes geon. In September, with additional den-
from Africa. The total number of gam- tal officers available, a policy of rotation
biae found was 281, of which 8 were still was put into effect, and dentists were
living. Although the number of flights shifted from one base to another. At this
increased in 1944 to 2,552, only 30 gam- time Rieser, now a captain, became the-
biae, one living, were found, distributed ater dental surgeon with headquarters
among 9 planes. In 1945 only 9 gambiae in Recife. By the end of 1943 there were
were found, all of them dead, distributed eight dental officers in the theater, and
among 9 planes out of 4,841. equipment was adequate to maintain a
clinic at each of the four station hos-
Dental Service—Dental service began pitals. Complete dental service was avail-
in the South Atlantic before a theater able to the entire command and
organization was set up. On Ascension continued to be throughout the remain-
Island there was a dental officer with the ing life of the theater. The number of
175th Station Hospital, but early arrivals dental officers increased to 10 in 1944,
at the Brazilian bases relied on local and the service became more mobile,
civilian dentists until September 1942. dental officers going as far afield as
At that time 1st Lt. (later Maj.) Julian Asuncion, Paraguay, and Montevideo,
M. Rieser of the Air Transport Com- Uruguay.
mand arrived with one incomplete Chest
MD No. 60. Deficiencies were made up Veterinary Service—Like his dental
by local purchase or improvisation, and counterpart, the first veterinary officer in
Lieutenant Rieser established his head- the theater, Capt. (later Maj.) James R.
quarters at Natal, flying the rounds of Karr, was assigned to the South Atlantic
the other bases. Wing, Air Transport Command. Captain
The station hospitals arriving early in Karr reached Natal in November 1942
1943 had dental officers on their staffs and was at once placed on detached serv-
but little or no dental equipment. The ice in the theater surgeon's office. Addi-
dentist attached to the 193d Station Hos- tional veterinary officers arrived in 1943,
pital at Belem was unable to function together with a few trained enlisted men.
until March. The dental officer of the Their task, in a country of lax sanitary
200th Station Hospital at Recife carried standards, was immense. All meat, eggs,
on as best he could in the field dis- milk, and many other food products had
pensary set up by the Air Transport to be inspected before they could be
Command until enough equipment was used. Supervision of slaughterhouses and
received from the United States to open pasteurization plants was included in
the hospital dental clinic in May. The the veterinarians' work, and before the
194th Station was somewhat more for- end of 1943 they were themselves raising
tunate in procuring equipment for its chickens and hogs.
dental officer, whose presence freed the For purposes of food inspection, the
THE ATLANTIC DEFENSE AREAS 55
Brazilian bases were divided into three summer, but this operation came to an
areas, centering at the three station-hos- end after the defeat of Japan. Almost
pital cities. The Belem area included half of those sent to the United States
the Amapa and Sao Luis bases; the Natal under the "Green Project" traveled via
area included Fortaleza and Fernando the South Atlantic theater. Medical facil-
de Noronha; and the Recife area in- ities handled the extra load by obtaining
cluded Bahia. One veterinarian served additional medical personnel from the
each area, the Recife man serving also as Air Transport Command and from
theater veterinarian and making trips as among those being redeployed. In early
needed to Ascension Island. September, preparations for inactivating
all station hospitals began, and the plans
Close-out in Brazil made the previous spring were put into
operation. By the end of the month the
The Army started planning a general 175th and 193d Station Hospitals had
reduction and eventual discontinuance been inactivated, followed by the 194th
of its activities in Brazil and on Ascension and 200th in early October. The theater
Island in March 1945. The Green Proj- itself disbanded on 31 October 1945, and
ect, which was an air redeployment the South Atlantic Wing of the Air
movement of combat troops from the Transport Command assumed responsi-
European and Mediterranean theaters bility for the administration and opera-
to the United States, for transshipment tion of the remaining personnel and
to the Pacific, suddenly increased activi- facilities.
ties in the South Atlantic during that
CHAPTER II
tion hospital (later designated the 256th malaria, dysentery, and other ills at the
Station Hospital), originally destined for headquarters dispensary of the U.S. Mili-
Umm Qasr but diverted to Ahwaz, Iran, tary North African Mission in Cairo.
where it opened on 6 June 1942. Under
command of Colonel Van Vlack, the hos- The Middle East as an Active Theater of
pital was staffed by U.S. Army medical Operations, 1942-43
officers, civilian male nurses from the
construction companies, Polish refugee Both the North African and the Ira-
nurses, and a few first aid men borrowed nian missions passed out of existence late
from their regular construction jobs. in June 1942. They were replaced by
the United States Army Forces in the
Air Routes to Africa and the Middle East (USAFIME), organized as
Middle East a theater of operations under command
of General Maxwell. Headquarters was
Late in June 1941 Pan American Air- in Cairo. Under USAFIME, the North
ways, at the request of the United States African Service Command took over
Government, took over the task of ferry- operations in Egypt and Palestine, while
ing lend-lease planes to British forces in the Iran-Iraq Service Command sup-
the Middle East. The route followed ran planted the existing organization in the
from Florida across the Caribbean to Persian Gulf area, now commanded by
Natal, Brazil, and thence over the nar- Col. Don G. Shingler, without change
rowest point of the South Atlantic to of functions. At the same time, a newly
Bathurst in the British colony of Gambia organized U.S. Army Middle East Air
in West Africa. From Gambia the planes Force, commanded by Maj. Gen. Lewis
were flown to Khartoum in Anglo- H. Brereton, former commander of the
Egyptian Sudan by way of Nigeria and Tenth Air Force in India, was brought
French Equatorial Africa. A regular under theater control.6
transport service over this route and on Coincident with activation of USA-
to Cairo was opened in mid-November at FIME, Generalfeldmarschall Erwin
the request of the U.S. Military North Rommel's Afrika Korps broke through
African Mission.5 British positions in Libya and drove to
After Pearl Harbor, the AAF took within 70 miles of Alexandria. Work
over operation of the ferrying and was hastily suspended on all U.S. Army
transport services. Roberts Field, Libe- projects in Egypt and Palestine. Civilian
ria, became the west African terminus of construction workers and many military
the route, which was extended east to personnel were moved to relative safety
Karachi, India, over alternative courses. in Eritrea. The North African Service
One route ran from Khartoum to Cairo, Command shifted its headquarters to
Palestine, and Basra; the other was by Gura early in July, and the theater head-
way of Eritrea and Aden. Before medical
service along the route was established, 6
The chief sources for this section are: (1) Hist,
aircrews and passengers were treated for Med Sec, AMET; (2) Hist of AMET to 1 Jan 46,
Summary Outline; (3) Motter, Persian Corridor
5
Craven and Cate, eds., Plans and Early Opera- and Aid to Russia, pp. 85-93; (4) Craven and Cate,
tions, pp. 320-27. eds., Plans and Early Operations, pp. 341-42.
AFRICA AND THE MIDDLE EAST 61
quarters staff began burning its files in Area became the Delta Service Com-
preparation for the evacuation of Egypt. mand, including all of Egypt. The Pales-
By August, however, Rommel had been tine Area, with boundaries enlarged to
contained at El 'Alamein and work was include the Levant States, Transjordan,
resumed in the Cairo and Palestine and a wedge-shaped segment of western
Areas. Arabia, became the Levant Service Com-
After the resumption of activities in mand. Boundaries of the Eritrea Service
Egypt, the theater was reorganized to Command were drawn to include Anglo-
simplify the command structure. The Egyptian Sudan, Eritrea, French Somali-
North African Service Command was land, Aden, and all of Arabia south of
abolished, and the three existing areas the Persian Gulf. The Iran-Iraq Service
formerly under its jurisdiction became Command was renamed the Persian Gulf
service commands responsible directly to Service Command, with jurisdiction over
the theater headquarters. The Heliopolis Iran, Iraq, Kuwait, and that portion of
62 MEDITERRANEAN AND MINOR THEATERS
Arabia not included in other command Supply surgeon, carrying out both as-
areas. A short-lived and never important signments with a single staff. The dual
Army Ground Forces Command was also assignment favored centralized control of
added to the theater organization in Au- the medical service, but the distance of
gust to provide administrative supervi- some of the service commands from
sion over U.S. tank crews operating with Cairo, and the lack of good rail and road
the British Eighth Army. Plans to move communications put obstacles in the
an American armored corps into the the- way. The surgeon was forced in large
ater were dropped when invasion of measures to rely on air travel as a means
Morocco and Algeria received priority, of co-ordinating the medical affairs of
7
and the Army Ground Forces Command the widely dispersed commands.
was eventually inactivated. That portion Contact with health department rep-
of Libya reconquered from the Axis resentatives of the various countries of
forces was set up as the Libyan Service the Middle East, and particularly with
Command in December 1942. the Egyptian Ministry of Health, was
Organization at the theater level was an essential part of the medical section's
completed early in November with the activities. The theater surgeon was a
creation of a Services of Supply head- member of a medical advisory commit-
quarters, to which the service commands tee of the Middle East Supply Council
were thereafter responsible. General (and of its executive committee), which
Maxwell became commanding general controlled the requisitions of medical
of the theater Services of Supply (SOS), supplies for the civilian populations of
being replaced briefly as USAFIME com- the countries within the theater. He
mander by Lt. Gen. Frank M. Andrews. kept in close touch with the medical au-
In January 1943 Andrews was succeeded thorities of the various Allied armies,
by General Brereton, who also retained especially with the Medical Directorate
his command of the Ninth U.S. Air at General Headquarters, British Army
Force into which the Middle East Air Middle East Forces, and the Surgeon
Force had been merged. As in the Eu- General, Egyptian Army.
ropean theater at this time, the air mis- The theater surgeon's office super-
sion was the primary combat function of vised the provision of medical services,
USAFIME between May 1942 and Sep- the operation of the medical supply sys-
tember 1943. tem, and the program for prevention of
disease. The staff provided professional
Organization of the Medical information to the theater commander;
Service prepared medical records and reports,
co-ordinating those sent in by the service
Theater Headquarters—The surgeon commands; and inspected medical instal-
of the North African Mission, Crawford lations. It assigned personnel to the
F. Sams—promoted to the rank of lieu- 7
Principal sources for this section are: (1) Hist,
tenant colonel in February and colonel Med Sec, AMET; (2) Annual Rpts, Med Dept
in August 1942—became USAFIME sur- Activities, USAFIME, 1942 and 1943; (3) Interv,
W. K. Daum, Historian, with Col Eugene W. Bil-
geon on the creation of the theater. In lick, 11 Jul 52; (4) Intervs, Blanche B. Armfield,
November he was also made Services of Historian, with Gen Sams, 18 Jan and 30 Jan 50.
AFRICA AND THE MIDDLE EAST 63
offices of service command surgeons and dispensary. A few miles from Heliopolis,
the Ninth Air Force and advised them at Camp Russell B. Huckstep, the site of
on local medical problems. It also super- a large quartermaster depot, was a small
vised the medical service supporting the medical section consisting of a post sur-
Ninth Air Force in its movement across geon, a veterinarian, and a dental officer.
the Western Desert. As U.S. Army troops Three dispensaries operated by unit sur-
engaged in little fighting in the Middle geons, a dental dispensary, and a medical
East theater, many of the activities un- subdepot were located there. When the
dertaken by the theater surgeon's office surgeon's office of Delta Service Com-
were those directed at prevention of dis- mand moved from Heliopolis to Camp
ease. The provision of a supply of pure Huckstep in May 1943, it absorbed the
food and water and the establishment post surgeon's office. The 38th General
and maintenance of good facilities for Hospital, which was to be the leading
disposal of waste were two important un- hospital of the theater, was established
dertakings. at Camp Huckstep in late 1942.
Delta Service Command served a num-
The Service Commands—The service ber of other areas in some phase or other
commands set up under the U.S. Army of its medical programs. The medical
Forces in the Middle East remained rela- subdepot at Camp Huckstep frequently
tively stable until near the end of 1943, furnished medical supplies to the whole
when the mission of the theater under- Middle East area. American air forces
went considerable change. The head- battle casualties occurring over Libya,
quarters of each service command had a Tunisia, Sicily, Italy, and southeastern
medical section in charge of a surgeon Europe were cared for in the command's
who was under the direction of Colonel hospitals. Medical care for U.S. Army
Sams in his Services of Supply capacity.8 personnel stationed in the vicinity of the
The administrative center of medical Suez Canal ports was provided by Delta
service in Delta Service Command was at Service Command, except for a brief pe-
the command's headquarters in Heli- riod from March to October 1943 when
opolis, where a medical staff section op- an independent Suez Port Command was
erated an office patterned on the theater active. A port surgeon's office, a general
headquarters medical section. It also con- dispensary, and the platoons of a field
trolled an antimalaria unit and a general hospital served troops in the canal area.
A medical staff section of Eritrea Serv-
8
This section is based primarily on the following ice Command was located at the com-
documents: (1) Hist, Med Sec, AMET; (2) Annual mand headquarters, which was estab-
Rpt, Med Dept Activities, USAFIME, 1942; (3)
Med Hist, Delta Serv Comd, 1942; (4) Annual lished in August 1942 at Asmara, the
Rpts, Med Dept Activities, Eritrea Serv Comd, capital city of Eritrea. A surgeon placed
1942, 1943; (5) Annual Rpt, Med Dept Activities, in each of four districts of the command
Levant Serv Comd, 1942; (6) Narrative Hist, Med
Activities, PGC; (7) Annual Rpt, Med Dept Ac- maintained the health and sanitation of
tivities, PGC, 1943; (8) Ltr, Gen Sams to Col his particular area. Medical Department
Coates, 12 Mar 59; (9) Ltr, Van Vlack to Col personnel stationed throughout the com-
Coates, 23 May 59; (10) Ltr, Lt Col James J. Adams
to Col Coates, 7 Apr 59. Last three letters comment mand were responsible for the health of
on preliminary draft of this chapter. Army personnel, American civilians, and
64 MEDITERRANEAN AND MINOR THEATERS
Italian laborers working for the U.S. assignment as service command surgeon.
Army. By the end of 1942 about 150 Libyan Service Command, established
American military hospital beds were in early December 1942, did not have a
available to troops of the command; the medical staff section until March 1943.
civilian hospital of the Douglas Aircraft The surgeon's office was composed of a
Corporation relieved the Army of the surgeon, a medical inspector, a veteri-
necessity of caring for civilians. With the nary officer, a Medical Administrative
decrease in construction of port and air Corps officer, and a medical officer in
base facilities in 1943, personnel strength charge of the headquarters general dis-
in Eritrea was cut back to the minimum pensary. This command functioned only
necessary for servicing bases and fuel until the end of active operations against
dumps of the Air Transport Command, the Axis in North Africa. In late May it
and for operating extensive radio instal- was divided into Tripoli Base Command
lations. The need for medical service and Benghasi Base Command.9 The new
diminished proportionately. commands were disbanded in the fall of
In Levant Service Command, a medi- 1943, and their areas and installations
cal staff section was set up in August were absorbed by Delta Service Com-
1942 at Tel Aviv, Palestine. The section mand.
included the surgeon of the command The medical section of the Persian
and a staff of veterinary, sanitary, and Gulf Service Command (PGSC) was in-
administrative officers, assisted by several herited with little change from the Ira-
enlisted men. Because of the lack of sup- nian mission. Headquarters remained at
plies and incomplete construction of Basra, Iraq, until January 1943, then
American hospital facilities in 1942, moved to Tehran, Iran, pending com-
British military hospitals in the area pletion of permanent headquarters at
furnished most of the hospitalization of Camp Amirabad two miles from that
U.S. Army patients. For a time Levant city. A surgeon's office, responsible to
Service Command was important as a Colonel Van Vlack, the command sur-
base for the operation of American Air geon, was maintained in each of the
Forces units, but activities never devel- three districts into which the gulf area
oped to the extent originally antici- was divided. The command surgeon's
pated, and by June 1943 the command office instituted the medical policies for
was on the decline. The headquarters of the whole command, but the emphasis
the command moved from Tel Aviv to was on the operating agencies—the hospi-
Camp Tel Litwinsky, some eight miles tal units. The headquarters medical sec-
away, the site of a repair depot for engi- tion consisted only of the surgeon, a
neer and ordnance equipment and of a small staff, and a minimum of enlisted
steel container manufacturing plant. At personnel to handle reports and records.
this time the members of the medical The district headquarters also operated
section were relieved from duty with
the exception of the veterinarian, and 9
In the Middle East theater a base command was
the commanding officer of the 24th Sta- normally one step below a service command. Since
Libyan Service Command no longer existed, Tripoli
tion Hospital (a unit that had arrived in and Benghasi Base Commands dealt directly with
February 1943) assumed the additional their next highest echelon, SOS USAFIME.
AFRICA AND THE MIDDLE EAST 65
with minimum staffs. In April 1943 served as surgeon of the U.S. Army Mid-
Colonel Van Vlack was succeeded as dle East Air Force became General
PGSC surgeon by Col. Forrest R. Ost- Brereton's Ninth Air Force surgeon. At
rander, former commanding officer of the Cairo headquarters of the air force,
the 38th General Hospital. Colonel Kendricks organized an office
Although it was administratively containing an assistant surgeon, a dental
bound to the Middle East theater, the officer, a plans and training officer, a
first major step toward autonomy came sanitation team, an adjutant, and some
for the command in January 1943 when enlisted men. At first Colonel Kendricks
Cairo headquarters gave PGSC permis- doubled as Ninth Air Force Service Com-
sion to requisition supplies directly upon mand surgeon, but a separate surgeon
the War Department, handle its own was later appointed to that element of
personnel procurement, assignments, the air force. The bomber and fighter
and promotions; and deal with the Brit- commands had their own surgeons from
ish and Iranians without reference to the outset. Colonel Kendricks and his
theater headquarters. While the com- staff left the Middle East for England
mand still remained in the Middle East with the Ninth Air Force in October
theater organization, this decisive action 1943.10
gave it a very independent status. Com-
plete autonomy came with an order from The Air Transport Command—In
Washington on 10 December 1943, July 1942 a headquarters to administer
which redesignated the command the Army activities in the vast reaches of
Persian Gulf Command and made it di- central Africa was organized at Accra,
rectly responsible to the War Depart- Gold Coast, and named United States
ment through the Operations Division of Army Forces in Central Africa (USA-
the General Staff. With a simplified com- FICA) . Its major mission was to main-
mand relationship solidly established, tain bases for the Air Transport Com-
the Persian Gulf Command was better mand. Although it never had a large
able to carry on its mission of aid to the number of troops, the command was
Soviet Union. originally organized like a theater. Un-
der the theater headquarters was SOS
The Ninth Air Force—The Ninth Air USAFICA, an organization that fur-
Force, which at its peak had about 25,- nished supplies and services needed for
000troops, was the major American com- the operation of Air Transport Com-
bat force in the Middle East theater. It mand units throughout Africa.11
was organized in August 1942 by Gen- 10
eral Brereton, at which time the head- Med(1) Hist, Med Sec, AMET. (2) Annual Rpts,
Dept Activities, USAFIME, 1942, 1943. See
quarters of U.S. Army Middle East Air also p. 80, below.
11
Force was discontinued. During 1942 Major sources for this section are: (1) Hist,
Med Sec, AMET; (2) Annual Rpt, Office of Surg,
and 1943 the Ninth Air Force operated USAFICA, 1942; (3) Hist of the ATC in Central
against enemy targets in Libya, Tunisia, Africa and the Middle East, pt. 2, Hist of the
Sicily, Italy, Greece, and Rumania. Un- AMEW, ATC (30 Jun-14 Dec 43) , vol. III, Hist
of Supply and Servs, Files of Hist Br, MATS; (4)
der supervision of the theater surgeon, Annual Rpt, Med Sec, West African Serv Comd,
Col. Edward J. Kendricks, Jr., who had USAFIME, 1943; (5) Annual Rpt, Sta Surg's Of-
66 MEDITERRANEAN AND MINOR THEATERS
of Monrovia, where central control over verse climatic factors were overrated as
medical matters was maintained and to their effect on the general health of
medical reports on the Liberian force troops. Excessive heat lasting for 24
were completed. The 25th Station Hos- hours of the day during the long summer
pital (250 beds) near the field cared for season occurred in only a few locations,
the medical needs of the entire com- but the appalling list of diseases endemic
mand. From June 1942 until April 1943, in the population of the area caused
Lt. Col. (later Col.) Loren D. Moore great concern on the part of medical of-
served as station surgeon. Under the ex- ficers. Malaria, yellow fever, typhus,
perienced direction of Lt. Col. (later smallpox, dysentery, all forms of vene-
Col.) Justin M. Andrews, Colonel Moore real diseases, and many other diseases
carried out extensive malaria survey and represented a serious danger to troops
control work. When the entire Liberian working in close contact with the in-
Task Force, commanded by Brig. Gen. habitants of the region. In the face of
Percy L. Sadler, arrived in the spring of centuries of ignorance, maintaining good
1943, both Moore and Andrews were sanitation was a major task.13
transferred to the new North African Medical officers tried to create "iso-
theater. Lt. Col. Stephen D. Berardinelli, lated foci of cleanliness" in and around
commanding officer of the 25th Station the immediate areas of hospital plants
Hospital, succeeded Moore as station sur- and other U.S. Army installations. This
geon. Medical department personnel in method proved to be the only practical
Liberia were responsible for the medical way to handle the sanitation problem,
care of a large force of construction engi- since troops were concentrated in places
neers during the period when the base widely separated from each other, mak-
was being built, and later gave support ing a comprehensive program impos-
to all elements of the defense forces in sible. Hospitalization in the Middle East
Liberia. Air Transport Command per- theater was almost entirely associated
sonnel, some members of the Royal Air with the service commands, and rear-
Force, and natives working for the Army a r e a - t y p e h o s p i t a l s p r e d o m i n a t e d
also received medical care. In September throughout the theater. No mobile hos-
1943, the Liberian command was sub- pitals operated in the Middle East, al-
ordinated to the Middle East theater, but though platoons of the field hospitals
this action did not change its basic mis- supporting the Ninth Air Force during
sion. its operations over Libya and Tunisia
moved about more frequently than most
Hospitalization and Evacuation other hospitals.
Delta Service Command—Delta Serv- ings, with the exception of the field hos-
ice Command occupied a central position pital platoons, which were under canvas.
in the theater. The most important U.S. The Egyptian climate on the whole did
Army medical installation in the theater, not hinder operations, but spells of ex-
the 38th General Hospital (1,000 beds), treme heat and dust storms caused some
arrived in the command in late October difficulties. An adequate supply of pure
1942 and moved into partially completed water was often lacking, except in large
buildings in the desert near Heliopolis, cities such as Cairo and Alexandria. To
adjacent to a large Quartermaster depot. avoid using the contaminated and heav-
It began admitting patients on 11 No- ily silted water of the Nile, the command
vember, and by early 1943 was the focal had sunk deep wells and extended pipe-
point for fixed hospitalization in the lines. A water purification plant was in-
Middle East. (Map 4} Until September stalled at Camp Huckstep.
1943, when a general hospital was set up The general line of evacuation for the
in the Persian Gulf Service Command, command, as well as for the whole thea-
there was no other hospital with com- ter, pointed toward the 38th General
parable resources in the theater. The Hospital, whether a patient was an Ord-
chiefs of the medical, surgical, and neu- nance Department soldier from the Suez
ropsychiatric services of the 38th also Canal region sick with malaria, or an
acted as consultants in their respective Air Force pilot wounded over Libya.
14
specialties to the theater surgeon. Patients journeyed by ambulance from
Beginning in the spring of 1943, pla- nearby places such as the Suez Canal, but
toons of the 16th Field Hospital were set if coming from Libya, Syria, Eritrea, or
up as small hospitals along the route of Iran, they traveled by air to Cairo and
the Suez Canal, to give medical care to then by ambulance to the 38th General.
U.S. troops stationed there. (See Map Delta Service Command also served as
4.) Another hospital unit served the the focal point for shipment of patients
Ninth Air Force for a short time at an to the zone of interior by ship and plane,
airfield near Alexandria. The command the latter method being employed most
also established dispensaries in scattered of the time.
places having only small garrisons. A
medical supply depot operating as the Eritrea Service Command—Most of the
medical section of the quartermaster de- U.S. Army medical installations in Eri-
pot at Heliopolis served as the main dis- trea Service Command were within
tribution point for medical supplies and Eritrea itself, although the boundaries of
equipment for all parts of the theater the command embraced the Anglo-Egyp-
except the Persian Gulf area. tian Sudan and the southern half of
Medical Department facilities in Delta Arabia as well. In addition to the civilian
Service Command used permanent build- hospital operated by the Douglas Air-
craft Corporation at Gura, two hospitals
14
(1) Annual Rpts, Med Dept Activities, Delta were established in Eritrea. The 21st
Serv Comd, 1942, 1943. (2) Annual Rpts, 38th Gen Station Hospital (500 beds), the first
Hosp, 1942, 1943. (3) Annual Rpt, 16th Field Hosp,
1943. (4) Ltr, Gen Sams to Col Coates, 12 Mar 59,
complete Army unit to arrive, debarked
commenting on preliminary draft of this chapter. at Massaua on 13 November 1942. It was
AFRICA AND THE MIDDLE EAST 69
sited the following day at Mai Habar, a By the spring of 1943 U.S. Army activ-
town in the mountains between Asmara ities in Eritrea had diminished to the
and Gura, and took over hospital build- point where there was little need for a
ings formerly occupied by the medical 500-bed hospital. Consequently, the 21st
services of the Italian and British Ar- Station Hospital moved on to the Persian
mies. Some of the personnel of the 21st Gulf area in May 1943. During the pre-
were detached to operate dispensaries at vious month the 104th had turned over
Asmara, Decamere, Ghinda, and Mas- to the British Navy the hospital that the
saua. The second U.S. Army hospital to unit had been operating at Massaua and
be established in Eritrea was the 104th moved to the Gura air depot to share in
Station Hospital, which arrived in late the operation of the Douglas Aircraft
January 1943. It relieved the detach- hospital there. The depot finally closed
ment of the 21st Station Hospital at Mas- in November, resulting in the disband-
saua, setting up a 100-bed unit there.13 ing of the Douglas hospital and the ship-
15
(1) Annual Rpts, Med Dept Activities, Eritrea
Serv Comd, 1942, 1943. (2) Annual Rpt, 21st Sta (4) Annual Rpt, 15th Field Hosp, 1943. (5) An-
Hosp, 1943. (3) Annual Rpt, 104th Sta Hosp, 1943. nual Rpt, 16th Field Hosp, 1943.
70 MEDITERRANEAN AND MINOR THEATERS
KING GEORGE OF GREECE, COLONEL VAN VLACK, AND GENERAL ROYCE at 38th
General Hospital, Camp Huckstep, Egypt.
ment of the 104th to Asmara (the loca- of the 16th Field Hospital in September.
tion of the headquarters of Eritrea (See Map 4.)
Service Command), where it established Aside from the town of Massaua,
a 25-bed hospital. This small installation which is one of the hottest and most
remained in operation for some time as humid seaports in the world, hospitals in
the only U.S. Army hospital in Eritrea. Eritrea operated installations at places
A 50-bed hospital at Wadi Seidna, an im- with fairly moderate climates due to ele-
portant junction near Khartoum along vations of 5,000 to 7,500 feet. The scar-
the Air Transport Command's central city of potable water caused some trouble
African route, cared for the ATC per- for these hospitals, and the task of main-
sonnel stationed there, as well as for the taining good sanitary standards proved
transients who passed through on their to be a constant battle, as in most other
way to and from the Middle East and parts of the theater. The command was
India. It was operated by a platoon of fortunate enough to secure permanent
the 15th Field Hospital beginning in buildings for all its hospitals. It evacu-
June 1943, and taken over by a platoon ated almost all of its patients by air.
AFRICA AND THE MIDDLE EAST 71
Levant Service Command—No U.S. few weeks earlier to the Ninth Air
hospital facilities were available in the Force-Libya.16
Levant Service Command until February The buildings of the 24th Station Hos-
1943, nearly eight months after the com- pital at Camp Tel Litwinsky were ideal-
mand was activated. General dispensa- ly situated on a small hill with a beauti-
ries at Tel Aviv and at Camp Tel Litwin-ful view of the countryside. The water
sky, both in Palestine, served the area supply was adequate and the drainage
from July 1942. In mid-November the good. The equable Mediterranean cli-
4th Field Hospital arrived at the camp, mate and the fresh air and sunshine
took over operation of the dispensary made the 24th a perfect place for con-
there, and established a small infirmary. valescing patients, and it operated as such
Lack of equipment prevented it from for men who had received treatment else-
operating as a hospital, but many medi- where in the theater. It also performed
cal officers from its staff worked for short the usual functions of a station hospital
periods at two British general hospitals for Levant Service Command personnel.
in Jerusalem. The 24th Station Hospital Most patients arrived at the hospital by
(250 beds) relieved the remaining ele- air, but some of those from Delta Serv-
ments of the 4th Field Hospital in Feb- 16
ruary 1943. The latter then joined the Serv (1) Annual Rpts, Med Dept Activities, Levant
Comd, 1942, 1943. (2) Annual Rpt, 4th Field
parent unit, which had been assigned a Hosp, 1942. (3) Annual Rpt, 24th Sta Hosp, 1943.
72 MEDITERRANEAN AND MINOR THEATERS
PARTIALLY DUG-IN HOSPITAL TENTS of the 3d Platoon, 4th Field Hospital, near Tripoli,
May 1943.
ice Command came in by rail. (See Map mand was added to the original five. A
4.) short-lived command—formed on 7 De-
Military activities in the command cember 1942 and disbanded on 26 May
began declining by mid-1943. The com- 1943—the Libyan Service Command in-
mand headquarters moved from Tel cluded the area within the territorial
Aviv to Camp Tel Litwinsky, and the boundaries of Libya not occupied by
commanding officer of the 24th Station enemy forces. At first comprising only
Hospital started serving as surgeon of the eastern Libya, the command grew in area
command in addition to his duties at the as the Eighth Army advanced westward.
hospital. By October, the 24th Station The major American participants in the
Hospital closed, evacuated its patients to sixth Libyan campaign were members of
the 38th General Hospital in Egypt, and the U.S. Ninth Army Air Force. Hospi-
made ready to depart for the China- tal care for the personnel of the force
Burma-India Theater. was provided first by British Army hospi-
tals and later by hospitals of the Middle
Libyan Service Command—By the East theater.17
time that the British Eighth Army had Beginning in January 1943 the pla-
passed Benghasi in its advance through 17
(1) Annual Rpt, 4th Field Hosp, 1943. (2) An-
the Western Desert, a new service com- nual Rpt, 15th Field Hosp, 1943.
AFRICA AND THE MIDDLE EAST 73
toons of the 4th Field Hospital, assigned results. The extreme heat of the desert
to the Libyan Service Command, had was 15° to 20°F. less inside the British
the job of receiving Ninth Air Force tent. During the period of active fight-
patients from their squadron aid stations ing, the platoons of the 4th Field Hospi-
and evacuating them back to Egypt. The tal habitually dispersed and dug their
4th Field also cared for Services of Sup- tents in for maximum protection from
ply troops stationed in the Libyan bomb fragments. Life in the desert un-
Service Command. The first unit of the der field conditions made it necessary to
4th Field Hospital to begin work in get along with what was on hand—noth-
Libya was the 1st Platoon, which arrived ing was wasted that could be turned into
at Gambut on 26 January 1943 and a useful item for the hospital. Water,
began receiving patients three days later. though fairly adequate in quantity, had
It relieved pressure on the British hospi- to be hauled for considerable distances.
tals in the area by taking American Evacuation from southern Tunisia and
patients of the IX Bomber Command Libya was generally by ambulance or
and Services of Supply personnel in the plane from squadron aid stations of the
vicinity. It changed location on 28 Feb- Ninth Air Force and dispensaries of
ruary, moving forward to Benghasi Services of Supply units to the platoons
where it established another hospital. of the field hospitals, where planes
The 3d Platoon and the headquarters picked up patients for delivery to the
section of the 4th Field Hospital arrived 38th General Hospital in Egypt. A curi-
in Tripoli on 26 March 1943 and set up osity of the situation was the parallel
a hospital for units of the Ninth Air existence of an evacuation system under
Force and Services of Supply troops in the control of the North African theater
western Libya and southeastern Tunisia. moving casualties from Tunisia west-
The 2d Platoon entered the field last, ward to Algiers, so that two supply and
opening on 19 April at Sfax, Tunisia, evacuation routes ran at an angle of 180°
where it supported two bombardment to each other. A similar situation pre-
groups. Soon after the surrender of the vailed during the invasion of Sicily when
Axis forces in Africa in mid-May, it the Ninth Air Force again supported the
moved back to Benghasi. Another field British Eighth Army. The Middle East
hospital, the 15th, arrived in Libya on theater ran its chain of evacuation from
13 May and relieved the 1st Platoon of Sicily by way of Tripoli to Egypt, while
the 4th Field Hospital at Benghasi. (See the North African Theater evacuated
Map 4.} from Sicily to Bizerte and thence west-
The most characteristic feature of ward.
field hospital operations in Libya was
the independent functioning of the pla- Persian Gulf Service Command—In
toons, often separated by hundreds of the Persian Gulf area the first substan-
miles. Except for buildings obtained by tial shipment of U.S. troops arrived at
one of the platoons of the 4th Field Khorramshahr, Iran, on 11 December
Hospital, all hospital installations used 1942. With them came the personnel of
tents. British tropical-type tents supple- 2 station hospitals, the first major in-
mented the regular ward tents with good crement of Medical Department troops
74 MEDITERRANEAN AND MINOR THEATERS
113TH GENERAL HOSPITAL AT AHWAZ, IRAN, laid out in radial pattern with connecting
wings.
to arrive in the command. The 2 hospi- The 113th Station Hospital (750
tals, the 19th and 30th Station Hospitals, beds), the largest American hospital in
both 250-bed units, began operating in Iran, began acting as a general hospital
early January 1943, the 19th at Khorram- for the command soon after it arrived at
shahr and the 30th at Tehran. Later in Ahwaz in May. It offered complete treat-
January the temporary 50-bed hospital ment for all diseases and injuries and
at Ahwaz was designated the 256th Sta- served as a clearinghouse for patients
tion Hospital. Between January and the being evacuated to the zone of interior
end of June, 3 more station hospitals through the 38th General Hospital in
(the 21st, 113th, and 154th) and 3 field Egypt. It also provided station hospital
hospitals (the 18th, 19th, and 26th) were care for nearby troops. In September
established in Iran. No additional hospi- the unit was reorganized as the 113th
tal units arrived there during the exist- General Hospital and was given person-
ence of the command.18 (Map 5) nel to operate a 1,000-bed plant. Another
18
(1) Hist, Med Activities, PGC. (2) Annual Rpts, 19th, 21st, 30th, 154th, 256th Sta Hosps,
Rpts, Med Dept Activities, PGSC, 1942, 1943. (3) 1943- (5) Annual Rpts, 18th, 19th, 26th Field
Annual Rpt,113thGen Hosp, 1943. (4) Annual Hosps, 1943.
MAP 5—U.S. Army Hospitals in the Persian Gulf Service Command, 1 July 1943
76 MEDITERRANEAN AND MINOR THEATERS
of the larger units in the command, the stallation was large enough to justify it,
21st Station Hospital (500 beds), began a medical officer was placed in charge.
functioning at Khorramshahr in mid- Where the installation was no more
May, replacing the 19th Station Hospi- than an aid station, it was generally in
tal, which moved to Tehran. The 154th charge of a trained enlisted man, sharing
Station Hospital, a smaller unit of 150 with other such stations the supervision
beds, first established a tented hospital of one medical officer. In the southern
at Ahwaz in February, but moved north part of the command, dispensaries oper-
to its permanent station at Hamadan in ated heatstroke centers consisting of air-
June. The 50-bed 256th Station Hospital, conditioned rooms with beds and special
displaced at Ahwaz by the 113th General, facilities for heat cases.
moved late in August to Abadan on the Few hospitals in the Persian Gulf area
Shatt-al-Arab near the Persian Gulf. operated under conditions that ap-
With one exception—the 19th Field proached those prevailing in the United
Hospital at Andimeshk—the field hospi- States or even in some overseas theaters.
tals in Iran dispersed their platoons to All of the locations were deplorable as
scattered locations where each was able far as sanitation was concerned, and
to run a hospital of at least 100 beds. many were at the mercy of the sweltering
Installations operated by field hospital heat for a good part of the year. Dust
platoons were, in effect, small station storms, combined with temperatures of
hospitals and were usually housed in per- 150° and 160° F. in the sun (one station
manent buildings. They shifted from reported a reading of 1 8 3 ° F . ) , made
place to place much more frequently service in some parts of Iran an ordeal
than the command's station hospitals. to bear. To make matters worse Iran
During 1943 the 18th and 26th Field was a land of pestilence, the population
Hospitals used all their platoons sepa- being a reservoir of malaria, typhus, ven-
rately most of the time, the 18th operat- ereal diseases, intestinal infections, small-
ing hospitals at Sultanabad, Ahwaz, and pox, and a variety of other diseases.
Bandar Shahpur, and the 26th function- Scarcely a place could be found where
ing at Abadan, Kazvin, and Khorrama- the water supply was not heavily con-
bad. taminated. Water had to be filtered and
By early December 1943 almost 2,700 then either boiled or chlorinated before
beds, provided by one general, four sta- it was safe to drink. Because of the prac-
tion, and three field hospitals, were in tice of fertilizing with human feces, most
operation in the Persian Gulf Command. of the locally grown vegetables and
Provisional dispensaries and aid stations thin-skinned fruits required thorough
had also been set up as they were needed cooking or dipping in boiling water be-
at road camps, railway installations, and fore they could be safely eaten. Flies,
other work sites along the supply routes mosquitoes, and other insects provided
to the Soviet Union. These small units another source of disease as well as a
supplemented those maintained by the constant annoyance.
Ordnance Department and the Engi- Housing for hospitals posed a serious
neer, Quartermaster, and Signal Corps problem. Tented hospitals functioned
for their own personnel. Where the in- briefly, but eventually almost all hospi-
AFRICA AND THE MIDDLE EAST 77
tal construction rose from the ground up, were three other important causes for
using native mud, brick, and stone. Win- admission to hospitals.
dow ramps and doors fashioned from Evacuation within the command was
cratings of automobiles and trucks sent by rail, motor, and air transport, the
to the USSR, and plastic for glass win- more serious cases being sent from the
dowpanes put the finishing touches on station and field hospitals to the 113th
many hospital buildings. Men of the Station Hospital at Ahwaz. Patients need-
hospital detachments made many of their ing prolonged treatment traveled to
own items of equipment such as tables, Cairo by air for care at the 38th General
chairs, and desks. The buildings them- Hospital. Soon after the 113th officially
selves were always one storied and became a general hospital in mid-Sep-
frequently were built in a rosette pattern tember 1943, it cared for many more
with central rotundas from which five serious and complicated cases. Here a
wards radiated. In the southern part of board of medical officers examined
Iran, hospitals had air conditioning units patients and their records, and if it de-
in some of their buildings, making the cided that an individual could not be
heat of summer more endurable for both successfully treated in the Persian Gulf
patients and hospital personnel. Service Command, he would be shipped
By the fall of 1943 the Persian Gulf directly to the zone of interior by the
Command had reached a strength of air transport route across Africa. Al-
some 29,500, a figure that varied no though patients from the Persian Gulf
more than 2,000 during the following area would frequently stop at the 38th
year. Although the command had hospi- General Hospital while waiting for a
tal beds available for 10 percent of the plane, their status was strictly transient,
strength during most of 1943, at no time and the 38th could not change the de-
was it necessary to use the full bed capac- cision made by the 113th General Hospi-
ity. The average of hospitalization tal in Iran.
varied from 4.5 to 6.5 percent of the total
strength. From the time the command Central and West Africa—Except for
was formed until 1 October 1943, total a few dispensary beds at places along the
admissions numbered 24,889. The aver- route of the Air Transport Command,
age rates per 1,000 per annum for disease there were no U.S. Army hospital facili-
and injury admissions in 1943 were 1,172 ties under the U.S. Army Forces in Cen-
and 155 respectively. During the first tral Africa until early December 1942,
nine months of 1943 the three main when the 67th Station Hospital (250
communicable diseases treated in PGSC beds) arrived at Accra.19
hospitals were common diarrhea, which The following month another medical
accounted for 4,348 admissions with a unit, the 93d Station Hospital (150
rate of 293 per 1,000 per annum; com- 19
The 23d Station Hospital had been set up in
mon respiratory disease, with 2,511 ad- Léopoldville, Belgian Congo, in September 1942 to
missions and a rate of 169; and venereal provide medical care for a southern branch route
disease, accounting for 1,563 admissions of the ATC, but it never got into full operation
because the proposed route was abandoned by the
with a rate of 104. Specific dysentery, end of the year. The idle 23d was finally sent to
amebic dysentery, and pappataci fever the North African theater in April 1943.
78 MEDITERRANEAN AND MINOR THEATERS
beds) debarked at Dakar, French West and Roberts Field throughout the war.
Africa. The major function of both hos- Since all three station hospitals were
pitals was to give medical support to the well within the tropics, their personnel
bases of the Air Transport Command. were subject to high temperatures, ma-
Between Dakar and Accra a third hospi- laria, venereal disease, and a host of trop-
tal, the 25th Station (250 beds), had ical diseases. Malaria in particular took
been operating since June 1942 near its toll in thousands of man-days lost.
Roberts Field, Liberia, a major airfield The hospital buildings built or acquired
of the Air Transport Command.20 for these units followed a simple one-
The three major points of U.S. Army storied hospital plant layout. The dis-
hospitalization remained at Accra, Dakar, pensaries at the stations of the Air
20
(1) Annual Rpt, Med Dept Activities,
Transport Command sent patients need-
USAFICA, 1942. (2) Annual Rpt, Med Dept Ac- ing hospital care by air to the hospital
tivities, West African Serv Comd, 1943. (3) Annual nearest their landing fields. During 1943
Rpts, Med Dept Activities, USAFIL, 1942, 1943.
(4) Annual Rpt, Med Dept Activities, Central
west African hospitals evacuated some
African Wing, ATC, 1943. (5) ETMD Rpt, 300 patients to the United States, most
USAFICA, Aug 1943. (6) Mae Mills Link and of them by air transport. Since all those
Hubert A. Coleman, Medical Support of the Army
Air Forces in World War II (Washington, 1955),
evacuated were general-hospital cases,
pp. 588-90. shipment west to the United States on
AFRICA AND THE MIDDLE EAST 79
the return air route was preferable to Base Command; 500 in the Tripoli Base
sending patients farther away from the Command; and 250 each in the Levant
zone of interior by going east across Service Command and in Liberia.
Africa to the nearest general hospital in Although the ratio of fixed beds to
Egypt. troop strength was high—9.9 in the peak
month—the general average of beds oc-
Summary—From the beginning of the cupied at any one time rarely exceeded
theater, the medical service in the Mid- 5 percent of theater strength.
dle East was one that had served widely Admissions to fixed hospitals in the
dispersed troop concentrations. The Middle East theater during the period
prevailing pattern of small station hospi- of greatest activity—1 July 1942 through
tals and field hospital platoons operating 30 September 1943—totaled 53,863, of
in the same capacity was the most logical which 24,889 were in the Persian Gulf
approach to supplying medical service to Service Command. The five leading
one of the largest U.S. Army theaters in causes of admissions were intestinal dis-
the world in terms of land area. In phys- ease, respiratory disease, injury (exclu-
ical plant the hospitals of the Middle sive of battle casualties), cutaneous dis-
East theater compared favorably with ease, and venereal disease. The 120-day
many cantonment-type hospitals in the evacuation policy originally planned for
United States, considering the difficul- the medical service of the theater proved
ties imposed by unfavorable climate, adequate. Evacuation within the theater
poor sanitary standards, and endemic emphasized the use of airplanes because
diseases. All these factors caused extra of the wide dispersal and lack of other
work that would be largely unnecessary adequate facilities. No special ambu-
in some theaters. Hospital plants often lance planes operated for this purpose,
took the additional precaution of enclos- but regular transport planes were used
ing their areas with barbed wire fences when available. During the period under
to prevent pilfering. consideration most evacuees to the zone
The theater reached its peak strength of interior traveled by Air Transport
in July 1943, when it had 66,483 troops. Command plane from Cairo. By October
Maximum hospital bed strength was 1943, approximately 1,000 patients had
reached at the same time, with 6,600 made the trip to the United States.
fixed beds scattered from Liberia to At no time were U.S. hospital ships
Tehran.21 Approximately half of the to- available for evacuation from the Mid-
tal, or 3,200, were in the Persian Gulf Serv- dle East. In the early period, a few
ice Command. Delta Service Command patients were sent to the zone of interior
had 1,000; Eriterea Service Command from the Persian Gulf on cargo ships by
had 450, including those in the civilian way of the Cape of Good Hope. Space
hospital of the Douglas Aircraft Corpora- on British hospital ships in the eastern
tion; and U.S. Forces in Central Africa Mediterranean was sometimes available.
were served by 400 beds. There were 400 The British hospital ships, however,
beds under jurisdiction of the short-lived generally excluded psychotics, and the
Suez Port Command; 400 in the Libyan ATC planes would carry patients of this
21
See app. A-2. class only when accompanied by a medi-
80 MEDITERRANEAN AND MINOR THEATERS
cal officer or nurse. As a result, some ber 1943, Maj. Gen. Ralph Royce as-
psychotics were held at the 38th General sumed command of the United States
Hospital for more than a year. In other Army Forces in the Middle East. The
instances a medical officer who could not separate services of supply headquarters
easily be spared was nevertheless detailed was discontinued at this time, but with-
for this service.22 out in any way affecting the work of the
Medical Department in the theater. Colo-
The Middle East as a Supply and nel Sams, who had returned to the
Service Theater, 1944-45 United States in August, was succeeded
as theater surgeon by Col. Eugene W.
The United States Army Forces in the Billick.
Middle East reached a peak strength of While activity declined in the eastern
more than 65,000 in midsummer of 1943, Mediterranean in the fall of 1943, ac-
but combat activities in the area were tivity in the Persian Gulf area was still
rapidly coming to a close. Ground Forces increasing. The independent mission of
headquarters was discontinued during the Persian Gulf Service Command was
the summer because no American ground recognized early in December when its
combat troops remained in the Middle administrative tie with Cairo was cut and
East. The Ninth Air Force supported the the command was made directly respon-
British Eighth Army in the invasion of sible to the War Department. In effect,
Sicily early in July, and later that month the redesignated Persian Gulf Command
participated in the bombing of Rome, remained an independent theater until
but the successful raid on the Ploesti oil 1March 1945, when it was merged with
fields of Rumania in August was the USAFIME and the Mediterranean Base
last combat mission for the Ninth Air Section from the Mediterranean theater
Force in the Middle East. Transfer of to form the Africa-Middle East Thea-
personnel to the Twelfth Air Force in ter of Operations.
North Africa began in July, and head- The staff of the theater surgeon's office
quarters moved to the United Kingdom in Cairo underwent numerous changes
in October. during 1944 and 1945. Many of the origi-
After departure of the Ninth Air nal officers on Colonel Billick's staff re-
Force, operations in the Middle East turned to the United States, their duties
were those characteristic of a large com- being carried on either by newly ap-
munications zone, consisting almost ex- pointed officers (of lower rank than
clusively of maintaining supply lines and their predecessors), absorbed by other
transporting supplies and personnel. subsections of the office, or handled by
officers assigned to Medical Department
Organizational Changes installations. The head of the dental
section, for example, had a triple assign-
Theater Headquarters—With the de- ment, since he was also dental surgeon of
parture of General Brereton in Septem- a service command and of a general hos-
pital. The preventive medicine section,
22
Ltr, Van Vlack to Col Coates, 23 Mar 59, com- the one element where expansion oc-
menting on preliminary draft of this chapter. curred, had a malariologist (stationed in
AFRICA AND THE MIDDLE EAST 81
West Africa) assigned to it, as well as a The medical service in the Middle
nutrition officer. East Service Command was responsible
A contingent of the Women's Army for the care of all American troops and
Corps, which arrived in the middle of associated personnel in Egypt, the Anglo-
1944, replaced practically all the enlisted Egyptian Sudan, Eritrea, Libya, Pales-
men in the theater surgeon's office. The tine, Syria, and Arabia. When formed,
turnover in commissioned personnel was the commanding officer of the 38th Gen-
heavy in 1945, and the loss acutely felt, eral Hospital at Camp Huckstep, Egypt,
especially since the theater had experi- assumed the additional job of service
enced a substantial expansion in terri- command surgeon. Various other officers
tory. A new development during early of the command surgeon's office also had
1945 was the appointment of medical, primary assignments with Medical De-
surgical, dental, and neuropsychiatric partment units and installations. The
consultants. They worked not only as surgeon's office was located at the 38th
members of the theater surgeon's staff General Hospital. Eritrea Base Com-
but also as chiefs of services in the 38th mand was a subcommand of the Middle
General Hospital. During the course of East Service Command during most of
the year many sections of the surgeon's 1944, but was established as a separate
office were merged, and it was common command directly under theater head-
to find medical staff officers combining quarters in December. The commander
two or more assignments. of the 104th Station Hospital at Asmara
served as the base command surgeon
The Service Commands—With the throughout the year. Activities in the
Persian Gulf Command autonomous by West African Service Command centered
the beginning of 1944, the remaining around the command headquarters in
service commands in Africa and the Mid- Accra and the base command at Dakar.
dle East were regrouped into two major The medical service, primarily for the
commands. The Middle East Service benefit of Air Transport Command per-
Command was established in February, sonnel, continued to provide hospitaliza-
merging the Delta, Levant, and Eritrea tion, medical supplies, sanitary services,
Service Commands. The Levant Service and malaria control. The command
Command was disbanded, while Eritrea surgeon was also the commanding officer
became a base command subordinate to of the 67th Station Hospital at Accra.
the new headquarters. The West African The Medical Department in Liberia
Service Command remained substan- experienced some difficulties in carrying
tially as it had been organized in the fall on medical and administrative measures
of 1943.23 for controlling malaria and venereal dis-
23
The main sources for this section include: (1) ease because of reductions in medical
Hist, Med Sec, AMET; (2) Hist of AMET, Sum- personnel.
mary Outline; (3) Annual Rpt, Med Dept Ac-
tivities, Middle East Serv Comd, 1944; (4) Annual Coincident with the territorial expan-
Rpt, Med Dept Activities, West African Serv Comd, sion of 1 March 1945, French Morocco,
1944; (5) Annual Rpt, Sta Surg, Roberts Field, Algeria, and Tunisia were organized into
Liberia, 1944; (6) Hist, Med Activities, Persian
Gulf Comd; (7) Annual Rpt, Med Dept Activities, a new command, the North African Serv-
PGC, 1944. ice Command, under the Africa-Middle
82 MEDITERRANEAN AND MINOR THEATERS
East theater. The offices of the Mediter- care for troops and carried on its never-
ranean Base Section at Casablanca ending task of refining preventive meas-
became the new command's headquar- ures to combat the numerous diseases
ters, and the commanding officer of the of Iran. Col. John E. McDill became
56th Station Hospital in that city re- PGC surgeon in January 1944. In the
ceived the additional assignment of summer of that year, when the command
North African Service Command sur- was near its greatest strength, Colonel
geon. By the end of June 1945, all U.S. McDill exercised staff supervision over
Army activities in the West African more than 2,400 Medical Department
Service Command were placed under the officers and enlisted men.
control of the North African Service By the end of 1944 the motor transport
Command. Medical Department units routes to the Soviet Union started closing
in West Africa were thereafter admin- down, narrowing the major supply activ-
istered by the Southern Town Com- ities to the more confined route of the
mand, a subcommand whose function railroad from Khorramshahr to Tehran.
it was to handle the liquidation of Progressive reductions in tonnage
U.S. Army installations in that area. through the first half of 1945 completed
Southern Town Command, with head- the primary mission of the Persian Gulf
quarters at Accra, was one of four sub- Command by 1 June, after which it
divisions under North African Service packed and shipped excess supplies,
Command, the others being Eastern turned over surpluses to a liquidation
Town Command, Center Town Com- commission, provided security detach-
mand, and Western Town Command, ments for remaining fixed installations
with headquarters at Tunis, Algiers, and until they could be disposed of, and con-
Oran, respectively. After the Central Af- tinued to supply the Air Transport Com-
rican Wing of the Air Transport Com- mand. These residual duties required
mand had been inactivated in July, fewer troops and many soon began mov-
installations along its route through ing out of the command. The Medical
the Southern Town Command and the Department's responsibility was to re-
Middle East Service Command were duce its own personnel and installations
either closed or greatly reduced. The to conform with the command's pro-
bulk of air traffic passed through the gram without impairing the efficiency of
northern part of Africa for the remain- its services to the remaining troops.
der of the year.
The Persian Gulf Command reached Air Transport Command—During
the peak of deliveries of war materials 1943 the Africa-Middle East Wing of
to the USSR during 1944. The separation the Air Transport Command had de-
of the command from the Middle East veloped stations at many towns and
theater in December 1943 had no effect cities in northern, central, and eastern
upon the medical service other than the Africa, and in countries of the Middle
forwarding of reports, which no longer East, which lay along the ATC routes
required routing through Cairo. The to Karachi, India. The northern arm
Medical Department of the command of its system stretched across French
continued to provide the best possible West Africa, French Morocco, Algeria,
AFRICA AND THE MIDDLE EAST 83
Tunisia, and through the Middle East to the Central African Wing was relieved
India, the most important stations being of the major medical problem of ma-
within the North African theater. All laria control, which was placed under
the airfields of the central route lay with- the direction of the theater command.
in the boundaries of the Middle East the- Nineteen officers and seventy-one en-
ater, passing through the countries of listed men of the Medical Department
west, central, and eastern Africa, across served at the thirteen stations of the
southern Arabia, and on to India. By the wing in December 1943. At some of the
end of 1943 the Africa-Middle East smaller stations a medical officer could
Wing had been split in two—the North be on duty only part of the time, but
African Wing with headquarters at Mar- Medical Department enlisted men
rakech, French Morocco, and the Cen- served at all the dispensaries. Some dis-
tral African Wing with headquarters at pensaries had facilities to handle person-
Accra, Gold Coast. Since the latter was nel with minor illnesses and injuries,
most closely associated with the Middle but serious cases were evacuated by air
East theater, it is discussed here in more to the nearest U.S. Army hospital.
detail than the northern route.24 Transportation of patients homeward
The primary objective of the Central from the Middle East along the route of
African Wing was the delivery of high- the Central African Wing was handled
priority freight and of military and by detachments of the 805th and 808th
civilian personnel, mail, and military Medical Air Evacuation Transport
aircraft across Africa. It transferred its Squadrons. Each air evacuation flight
cargoes to the North African Wing at was composed of a medical officer, six
Dakar and Cairo and to the India-China nurses, and eight enlisted men. From
Wing at Karachi. The Central African March 1943 to August 1944, 2,500 pa-
Wing surgeon's medical responsibilities tients traveled westward across mid-
were limited to preventive medicine Africa, then on to Brazil and the United
measures and the maintenance of dis- States. Beginning in September 1944,
pensaries at the stations, including sta- however, air evacuation activities were
tions at which theater service command transferred to the North African Wing.
hospitals were located. The territorial Preventive medical problems consti-
command within which the wing oper- tuted the chief concern of medical men
ated furnished medical supplies as well stationed at the bases of the Central
as hospitalization. Near the end of 1943 African Wing. Many of its stations were
in highly malarious areas and on the
24 edge of jungles and bush country, both
(1) Hist, Med Sec, AMET. (2) Hist of AMET,
Summary Outline. (3) Rpt of Med Dept Activities insect ridden. Despite the presence of
in the Africa-Middle East Wing, ATC, for 1943, a large variety of tropical and other dis-
Off of Surg, Sta #1. (4) Med Hist, Central African eases (yaws, yellow fever, filariasis, ty-
Div, ATC, 22 Sep 44, by Maj Ralph N. Green, Jr.,
Div Med Historian, Air Staff files. (5) Hist of Cen- phus, dysentery, bubonic plague,
tral African Wing, ATC, AAF, by Capt John W. smallpox, and so forth), malaria caused
Dienhart, Wing Historian, on file at Hist Br, more illness among wing personnel than
MATS. (6) Hist of the Med Dept, ATC May 1944,
Cpl Celia M. Servareid, editor, Off of Surg, Hq, any other disease. Aircraft accidents re-
ATC, Air Staff files. sulted in the death of more wing person-
84 MEDITERRANEAN AND MINOR THEATERS
nel than any other cause, and the medical Hospitalization and Evacuation
care of pilots flying the Central African
route was an important matter to the The need for hospitalization in the
medical service. Flight surgeons required Middle East declined with the changing
that pilots take a semiannual flight mission of the theater. Toward the end
physical examination to determine the of 1943 the 4th and 15th Field Hospitals
flyer's fitness for duty. All airports had were shifted to the Mediterranean thea-
emergency plans in readiness in the ter. In January 1944 the 24th Station
event of crashes, including specially Hospital left Palestine for Jorhat, India;
equipped ambulances and other crash and the following month the 16th Field
vehicles. Near the coast, air-sea rescue was transferred to the European theater.
teams used motor launches and amphib- In other hospitals, bed strength was re-
ious planes when an aircraft fell into duced as patient loads became minimal.25
the sea. Trained Medical Department In Eritrea the 104th Station Hospital
enlisted men extricated patients from continued to operate a 25-bed unit at
downed planes and gave first aid treat- Asmara through 1944. Late in 1943 per-
ment to the crash victims. sonnel not needed by this hospital were
As the much shorter trans-African detached to form the 367th Station Hos-
route across North Africa developed, the pital, activated as a 50-bed unit in Janu-
importance of the more southern route ary 1944 and sent to Wadi Seidna, near
under the Central African Wing dimin- Khartoum, Anglo-Egyptian Sudan, where
ished. However, the latter was still it relieved a platoon of the 16th Field
thought to be a military necessity since Hospital. In Egypt, the 38th General
it provided a sure contact with India, Hospital at Camp Huckstep was reduced
and it continued in operation until July from 1,000 to 750 beds early in 1944. In
1945. Its dispensaries were inactivated West Africa the 67th Station Hospital
as the wing closed its stations during (250 beds) at Accra, the 93d Station
June and early July, and the dispensary (150 beds) at Dakar, and the 25th Station
equipment was shipped to the nearest at Roberts Field, Liberia, remained in
hospital or medical supply depot. The place throughout 1944. The 25th Station
medical service provided along the north- was reduced from 250 to 50 beds in
erly route, under the North African January 1944, then increased to 75 beds
Wing, now lay within the boundaries of in September.
the Middle East theater since the theater The acquisition of Northwest Africa
had absorbed all of northern Africa in from the Mediterranean theater on1
March. The North African Wing oper- March 1945 brought three additional
ated dispensaries from Dakar and Casa-
blanca in the west, across the coast of
northern Africa to Egypt, and on through 25
(1) Hist, Med Sec, AMET. (2) Annual Rpt,
the Persian Gulf Command to India. Med Dept Activities, Middle East Serv Comd, 1944.
During 1945 it was responsible for evacu- (3) Annual Rpt, West African Serv Comd, 1944.
ating a large number of patients from (4) Hist, Med Activities, PGC. (5) Annual Rpt,
Med Dept Activities, PGC, 1944. (6) Unit Rpts of
the Mediterranean, India-Burma, and hospitals mentioned in the text. (7) ETMD's for
China theaters to the United States. 1944, 1945.
AFRICA AND THE MIDDLE EAST 85
the experience of a year and a half of Gulf Command, or a ratio of 6.9 to troop
operation, began before the end of 1943, strength. Hospitals still operating at this
while activity in the area was still in- time were the 113th General (750 beds)
creasing. The 30th Station Hospital, with at Ahwaz, the 21st Station (500 beds)
250 beds, left the Persian Gulf area for at Khorramshahr, the 19th Station (250
the China-Burma-India theater in No- beds) at Tehran, and the 256th Station
vember 1943. In January 1944 the 150- (50 beds) at Arak. The 19th Field
bed 154th Station was transferred to the Hospital had 200 beds in operation at
Mediterranean theater, and the following Andimeshk and 100 beds at Bandar
month the 113th General Hospital was Shahpur.
reduced from 1,000 to 750 beds. The Early in February the 21st Station was
18th Field Hospital left the command transferred to Italy, being replaced at
in July 1944, and the 26th Field in Khorramshahr by the 113th General. A
December. platoon of the 19th Field took over the
By the beginning of 1944, practically Ahwaz site. At the beginning of April
all hospital construction in the Persian the 113th General was further reduced
Gulf area had been completed. The to 500 beds and was closed for movement
need for air-conditioned wards was recog- out of the theater later that month. The
nized early, especially for hospitals lo- end of June 1945 found only the 19th
cated in the gulf and desert areas, but and 256th Station Hospitals and one
only a limited number of cooling units platoon of the 19th Field Hospital still
were available during the first year of active in the command, with an aggre-
operation. Installation of additional gate of 400 beds.
equipment in hospitals was begun in Patients were evacuated from the
March 1944 and completed by the first Persian Gulf Command to the zone of
of July, resulting in many completely interior on a 180-day policy, moving
air-conditioned wards at five hospitals. through the 113th General Hospital.
Approximately 1,248 beds in hospitals For the period January 1943-September
located at Andimeshk, Ahwaz, Khorram- 1945, 1,168 patients were returned to
shahr, Bandar Shahpur, and Abadan had the zone of interior. All patients were
the benefits of air conditioning readily transported by air to Cairo and from
available. there by air or water to the United
The year 1944 saw a progressive re- States. Up to September 1944 the Persian
duction of illness in the command. At Gulf Command furnished attendants
no time during the year did disease rates for patients being evacuated to Cairo,
approach the peak rates of 1943. After but after that date Air Transport Com-
July 1944 all the curves followed a steady mand planes had one flight nurse and
downward trend. This decline, in a one enlisted man as attendants. A flight
country rife with diseases, was a direct surgeon examined all patients before
result of the effectiveness of the Medical departure from Iran. The four leading
Department's preventive medicine pro- causes for evacuation were neuropsychi-
gram. atric diseases, injuries, cardiovascular
By the beginning of 1945 there were diseases, and respiratory diseases. Most
1,850 T/O beds remaining in the Persian of the evacuation within the command,
AFRICA AND THE MIDDLE EAST 87
that is from the station and field hospi- The theater experienced some short-
tals to the general hospital, was by a ages during 1942 and the early part of
weekly railroad ambulance car, motor 1943, but medical supply conditions im-
ambulance, or a combination of the two. proved after the middle of the year. The
The command used air evacuation for 4th Medical Depot Company, which had
emergency cases occurring within its arrived on 1 November 1942, established
boundaries. three medical supply subdepots in the
Middle East theater—at Camp Huckstep,
Medical Supplies and Equipment Egypt; Decamere, Eritrea; and Tel Lit-
winsky, Palestine. By February 1943 the
When early in the war, American units military situation in the theater had so
arrived in the Middle East short of medi- changed that the subdepots in Eritrea
cal equipment, the British furnished the and Palestine were closed. All medical
necessary supplies, sometimes from supply depot work was then concentrated
lend-lease stores. Occasionally difficulties at Camp Huckstep, where the 4th
developed in the use of British supplies Medical Depot Company became the
since American medical officers did not medical section of the theater's quarter-
always regard British standards as equal master general depot. Automatic supply
to those of the U.S. Army. During the from the zone of interior was discon-
latter part of 1942, supplies in larger tinued in October 1943, and thereafter
quantities began arriving from the the theater ordered medical supplies by
United States, having been shipped by quarterly requisitions on the United
automatic issue of medical maintenance States.
units. The supply situation was one of The medical supply authorities in the
general disorder in the early period, as it Middle East theater found that the ex-
was in most new theaters. Thousands of perience gained during the theater's
unlabeled boxes had to be opened to dis- most active period indicated that a better
cover what had been received. To make plan to equip medical troops would have
matters worse, many Medical Depart- been to establish an assembly depot well
ment hospital units arrived without any stocked with all types of medical supplies
supplies and equipment, their assem- at or near the port of debarkation. Such
blies having been shipped separately. a depot could have assembled equipment
Fortunately, acquisitions from the Brit- for each unit after notification of its
ish, improvisations from materials on embarkation from the United States had
hand, and a small number of local pur- been received. In effect, the Middle East
chases enabled hospitals to operate with- theater used this plan for all medical
out waiting for all their equipment to units arriving after February 1943, and
arrive.27 the units so equipped were better able
to perform their duties than those
27
The chief sources for this section are: (1) Hist, equipped with assemblies sent them
Med Sec, AMET; (2) Annual Rpts, Med Dept Ac- from the zone of interior. The action
tivities, USAFIME, 1942, 1943; (3) Hist of Med taken within the theater helped medical
Activities, PGC; (4) Annual Rpts, Med Dept Ac-
tivities, PGC, 1943, 1944, 1945; (5) ETMD. units begin efficient operation sooner,
USAFIME, Jan 1944. since otherwise some units would have
88 MEDITERRANEAN AND MINOR THEATERS
Engineers and those charged with the the Air Transport Command and as liai-
maintenance of post utilities were in son officer with the Brazilian Port
part responsible because of their failure Health Service. Two doctors of the Bra-
to make the buildings mosquitoproof zilian Department of Public Health
where the permanent personnel lived and were stationed at Dakar and Accra as
where combat aircrews and passengers liaison officers with the U.S. Army au-
stayed while in transit. Finally, the thorities. They were permitted to visit
medical and line officers at the West other Army airports in Africa that
African posts had not developed an ef- routed planes to Brazil, all in the inter-
33
fective educational program to acquaint est of keeping Brazil free of gambiae.
permanent and transient personnel with Working with the theater malariol-
the dangers of malaria.31 ogist at the Accra, Liberia, and Dakar
The commission concluded in its re- bases were assistant malariologists, en-
port to The Surgeon General that tomologists, engineers, and the enlisted
malaria control in the theater was the personnel of the control and survey units.
responsibility of the theater commander Malaria control measures were usually
and that personnel engaged in it should restricted to a perimeter or protected
be part of the theater organization. The area around a U.S. military installation.
commission pointed out that, with avail- In some areas the U.S. Army and the
able air transportation, one malariolo- British and French carried out success-
gist could maintain close supervision over ful co-operative schemes. The interallied
malaria control work in the widely scheme for malaria control developed by
separated malarious areas around Dakar, the British and American forces stationed
Roberts Field, and Accra.32 in and around Accra was one of the
The special malaria control organiza- larger efforts along these lines. It
tion that developed was headed by Maj. achieved integration of British and
Elliston Farrell, the Army Air Forces American direction, engineering, sur-
representative on the visiting commis- vey, and control activities.
sion. He was assigned in February 1944 Although the theater malariologist
to the Medical Section, USAFIME, as was responsible for co-ordinating and su-
theater malariologist, succeeding Lt. pervising malaria control activities in
Col. Daniel Wright who had held that West Africa, he had no power of com-
post since early 1942. Major Farrell was mand. Consequently he found it difficult
stationed in Accra, where he could di- to deal with station commanders. Major
rect operations on the coast of West Farrell revealed some of the trouble he
Africa. He also acted as disinsectization had in Accra when he stated:
officer for the South Atlantic, North
African, and Central African Wings of Directives were not followed and as ex-
ample the station commander was inter-
31
Memo, Col Ward, Med Insp, USAFIME, to ested in building an officers' club and we
Chief Surgeon, USAFIME, 21 Dec 43, sub: Malaria
in West Africa.
32 33
Memo, Col Hardenbergh, Col Lundeberg, and Elliston Farrell, "The Anopheles Gambiae Prob-
Maj Farrell for The Surgeon General, 4 Dec 43, lem in Brazil and West Africa, 1941-44," Bulletin,
sub: Mosquito and Malaria Control at West African U.S. Army Medical Department, vol. VIII, (Feb-
Airfields. ruary 1948), pp. 110-24.
AFRICA AND THE MIDDLE EAST 91
were interested in having screened build- sponsible for the flow of orders. Major
ings in the camp. . . . The officers' club was Farrell found it a disadvantage to be
opened for general use the 5th of October 3,000 miles from the theater headquar-
[1944]. It was started the 29th of May
and was built by men working 12 hours a ters in Cairo and thus out of touch with
day, 7 days a week, during the height of the top command. It would have been
our [malaria] season. It was built at a better, he thought, if he had had some-
time when lumber was not available for one else to do the supervisory work on
essential screening work. When the officers' the West African coast and had himself
club was finished the screening was done
and by that time it was September and we remained in Cairo nearer the source of
didn't need it. ... authority. He concluded that the effec-
We are educating the soldiers in the tiveness of a malaria control program
malaria program, but we are not sufficiently "depends on the success with which you
educating the Generals and Colonels. I am attain the support of the highest author-
actually convinced, from the reaction of
the station commander, that he had no ity in the theater. The only way to
idea that malaria could be eliminated from reach lower commanders is to get action
35
the base. I had breakfast with him a few from above."
days before he was reassigned and he asked The 1944 malaria control program in
me how many cases of malaria we had last West Africa followed traditional lines
week. I told him two and that in the same
time in 1943 there were forty or fifty. He (insecticiding, larviciding, and malaria
was so obviously astonished that I realized discipline) except for the use of DDT,
for the first time that he had thought we which was introduced during the spring
were just pestering him. He had thought and summer months. By the close of 1944
that when he had put in a good system of the rates for Army personnel at Accra
malaria discipline, nothing further could
be done about it. He didn't know that by and Dakar were reduced to the lowest
attacking malaria at its source it could be ever known at those stations. Although
eliminated.34 they dropped in Liberia too, a reason-
ably low rate was not attained at Roberts
Major Farrell also believed that the Field until late the following year. By
efficacy of the malaria program could 1945 malaria incidence throughout the
have been greatly increased if there had entire theater had decreased greatly, the
been a single battalion attached to the- highest theater-wide rate being only
ater headquarters under the direction of about 15 per 1,000 per annum in Janu-
the theater malariologist in lieu of a ary. The majority of cases continued to
larger number of scattered malaria units. occur in Liberia.
In his opinion a theater battalion for The program went on to the close of
malaria control would have provided a the war, the malaria control organization
much better system of centralized control assisting, as in other theaters, with the
over the movement of units. Such a bat- control of various insect-borne diseases
talion could have had a commander re- besides malaria—bubonic plague, sleep-
ing sickness, filariasis, and yellow fever.
34
Interv, Oprs Serv, SGO, with Maj Farrell,1 By the end of the war it had become
Dec 44, Rpt of Med Dept Activities in Accra, Gold evident that the small number of U.S.
Coast, West Africa. See also, Ltr, Van Vlack, to
Col Coates, 23 Mar 59, commenting on preliminary Army installations remaining in the the-
35
draft of this chapter. Farrell Interv.
92 MEDITERRANEAN AND MINOR THEATERS
ater would no longer require a malaria cember 1942, the rate increased in 1943,
control organization of the size that had exceeding 80 per 1,000 per annum in
developed. After the surrender of Japan, September, October, and November.
most of the survey and control units were Many factors other than the heavily in-
scheduled for inactivation with the ex- fected population contributed to the
ception of a survey unit located in Casa- high rate in the Middle East theater,
blanca at the headquarters of the North among them being a general moral lax-
African Service Command and a control ness common among men in overseas sta-
unit at Roberts Field. tions, and carelessness, forgetfulness, and
refusal to accept advice. The Army was
Venereal Diseases—The control of further handicapped because it was un-
venereal disease was one of the most im- able to command the aid of governments
portant medical problems in the Middle that were independent or were under
East theater. No reliable statistics ex- the jurisdiction of another power.
isted as to the local incidence of venereal In Delta Service Command, troops
diseases, but Medical Department offi- during the first part of 1942 were al-
cers knew that the populations of all of lowed to patronize houses of prostitution
the Middle Eastern countries were heav- regulated by the Egyptian Government.
ily infected. It was believed that in some The careless supervision of the houses
areas almost 100 percent of the women and the cursory periodic medical exam-
with whom American soldiers came in ination given the inmates could hardly
contact had one or more venereal dis- be classed as a controlled system accord-
eases. The Medical Department warned ing to officers of the U.S. Army Medical
U.S. personnel of the danger through Department. The Egyptian Government
lectures, demonstrations, motion pic- next eliminated the houses of prostitu-
tures, and other educational devices. It tion by law, but this action actually
established prophylactic stations, used worsened the situation since "undercover
special investigation teams, and co-oper- houses," streetwalkers, and "taxicab
ated with civil public health authorities prostitutes" increased in number. Vene-
in finding the sources of infection.36 real disease control activities were for
From an average of about 40 per 1,000 the most part confined to U.S. Army
per annum for the period July-De- troops, the commanders of units enforc-
36
ing such measures as were practicable.
General sources for this section are: (1) An-
nual Rpts, Med Dept Activities, USAFIME, 1942, Through an improved system of prophy-
1943: (2) Annual Rpt, Med Dept Activities, Levant lactic treatment the venereal disease rate
Serv Comd, 1942; (3) Hist of Med Activities, dropped from an average of 44.2 per
Persian Gulf Comd; (4) Annual Rpts, Med Dept
Activities, PGC, 1943, 1944, 1945; (5) Annual Rpts, 1,000 per year for the period January-
Med Dept Activities, Eritrea Serv Comd, 1942, 1943, July 1943 to a low of 33.75 in December.
1944; (6) Annual Rpts, Med Dept Activities, West Control of venereal disease was one
African Serv Comd, 1943, 1944; (7) Annual Rpt,
Med Dept Activities, Task Force 5889 (Liberia), of the most vexing problems facing the
1942; (8) Annual Rpts, Med Dept Activities, Medical Department in the Persian Gulf
USAFIL, 1943, 1944, 1945; (9) Annual Rpts of Service Command. During 1943 rates
Venereal Disease Control Activities, USAFIL, 1942-
45; (10) Med Stat Div, SGO, Morbidity and Mor- averaged 105 per 1,000 per annum, with
tality in the United States Army, 1940-45. a peak of more than 120 in September.
AFRICA AND THE MIDDLE EAST 93
Control was very difficult since a system September 1943, a command having an
of publicly countenanced prostitution extremely high incidence of venereal
prevailed throughout Iran. Medical De- disease added its excessive rates to the
partment officers believed that over 95 theater totals. The situation in Liberia
percent of Iranian prostitutes were in- was bad from the start. The venereal dis-
fected. Rates during 1944 showed some ease rate among personnel stationed
improvement, chiefly because of more there averaged 650 per 1,000 per year for
satisfactory housing, better recreational the period August—November 1942. A
facilities, and increased activities in plan to control venereal disease among
delivery of supplies to the USSR. With troops and the native population was
the slackening of activities in the fall of formulated in September 1942 by the
1944, rates again assumed an upward U.S. Army with the Liberian health au-
movement. The venereal disease control thorities. It resulted in the establish-
program was intensified, and in addition ment of areas known as "tolerated
to providing convenient prophylactic sta- women's villages" conveniently located
tions and supplying ample stocks of near the barracks of the troops, but just
mechanical and chemical prophylactic outside the military reservation of Rob-
devices, it employed educational meas- erts Field. A health center for treatment
ures on a large scale. Venereal disease of women in the villages was also estab-
films were shown regularly in conjunc- lished. Once begun, the command vene-
tion with talks by medical officers. real disease officer and his assistant car-
In one district in late 1944 three badly ried out the control program.
infected prostitutes agreed to participate By December 1942, with the con-
in a demonstration for which they re- trolled native women's villages in full
ceived medical treatment in return. operation, the rate for Army personnel
Their lesions were shown to the troops in Liberia had decreased to 470 per
in that area in combination with the 1,000 per annum for the last month of
usual talk on venereal disease. Controver- the year. During 1943 control measures
sial though it was, the idea of using were intensified by giving more frequent
diseased prostitutes for demonstrations instructions to all enlisted men, issuing
spread to other parts of the command, prophylactic packets and giving sulfa-
but no appreciable lowering of the rates thiazole tablets to men going on pass,
resulted.37 In spite of energetic efforts to establishing more prophylactic stations,
reduce the incidence of these diseases, and making chemical prophylaxis com-
rates continued undesirably high. No pulsory for all men visiting the tolerated
significant lowering of the rate occurred women's villages. The incidence of vene-
until the summer of 1945. real disease decreased to an average rate
In the Levant, Eritrea, and West Af- of 180 per 1,000 per annum for the last
rican Service Commands, the venereal seven months of 1943.
disease problem was not as serious, but Venereal disease rates continued to
when the U.S. forces in Liberia came decrease during the early part of 1944,
under the jurisdiction of the theater in a low of 63.2 per 1,000 per annum being
37
Ltr, Abram J. Abeloff to Col Coates, 16 Mar 59, recorded for February 1944, but later in
commenting on preliminary draft of this chapter. the year a rise developed which reached
94 MEDITERRANEAN AND MINOR THEATERS
658.8 during November. One of the main 22 cases were found during 1943, none
reasons for the increase was that troops of them proving fatal.38
had started making contact with women In recognition of the threat of typhus
in many areas of the world, the USA Ty-
in ten "off limits" villages near the mili-
tary area. The refusal to accept advice phus Commission was created in Wash-
and the failure to use available mechani- ington in December 1942, and its work
cal and chemical prophylaxis also contrib-was an important phase of the medical
uted to the increase. The command program in the Middle East theater in
thereupon undertook a more compre- 1943 and 1944. A forward echelon of the
hensive control program that included commission arrived in Cairo in January
treatment for women outside the toler- 1943 and established the field headquar-
ated villages. This extended coverage ters of the commission. The field staff
helped reduce the rate temporarily, but was made up of U.S. Army, Navy, Public
during 1945 venereal disease became so Health Service, and Rockefeller Founda-
serious that it displaced malaria as the tion personnel, all under the administra-
outstanding medical problem in Li- tive control of the Middle East theater
beria. The elimination of the tolerated headquarters but not a part of the the-
women's villages in June, low morale, ater organization. Experts of the com-
general indifference, and constant turn- mission worked in various theaters, but
over in personnel all contributed to a the Cairo group was the most active, as
marked rise in the venereal disease rate. typhus posed a greater threat in the
In 1945, monthly rates ranged from Middle East and the adjacent North Af-
about 400 to almost 1,200 per 1,000 per rican theater than elsewhere.
annum. The Typhus Commission group
As in other theaters, the use of sulfa worked closely with the theater surgeon
drugs, and, from early 1944, of penicil- and also with medical officers of the Brit-
lin, greatly reduced the number of man- ish Army Middle East Forces and with
days lost because of venereal disease. officials in the Egyptian Ministry of
Public Health. The commission had the
Typhus—Medical officers in the Mid- use of a laboratory at a government
dle East regarded typhus fever as one of serum and vaccine institute and a clini-
the major problems of preventive medi- cal ward in a local fever hospital, and
cine in the theater. During 1943 in soon began testing vaccine and louse
Egypt alone over 25,000 cases occurred powders in field experiments. During
in the civilian population. Protective the first months of 1943 members of the
measures such as frequent inspections of commission made surveys of the typhus
immunization records to be certain that
all personnel received a booster inocula-
38
tion every three months, provision of (1) Hist, Med Sec, AMET. (2) Stanhope Bayne-
Jones, "The United States of America Typhus Com-
bathing and delousing facilities, and the mission," Bulletin, U.S. Army Medical Department
placing of native sections out of bounds (July 1943), pp. 4-15. (3) Folder Typhus Mission,
contributed to the small number of cases 1943-46, in Maj Gen LeRoy Lutes's personal files.
(4) Interv, Blanche B. Armfield with Gen Sams,
that occurred among members of the 30 Jan 50. (5) Condensed Rpts of the U.S.A.
U.S. Army and American civilians. Only Typhus Commission.
AFRICA AND THE MIDDLE EAST 95
situation in many areas of the Middle tions Relief and Rehabilitation Admin-
East and North Africa, visiting Syria, istration in modern and effective delous-
Lebanon, Palestine, Iran, Iraq, Libya, ing methods. UNRRA was planning
Algeria, Morocco, and Tunisia. relief work in the Balkans, an area with
The field director of the commission a well-known history of typhus epi-
during most of its existence was Brig. demics.
Gen. Leon A. Fox.39 The Cairo field The commission maintained contact
headquarter was well situated so as to with French scientists at several of the
move easily to Europe, other African and Pasteur Institutes in North Africa and
Middle East locations, and the Far East. the Middle East. It also kept in touch
General Fox traveled during the late with the Egyptian Ministry of Public
summer and fall of 1943 to North Afri- Health, and co-operated with it in vari-
ca, India, Burma, China, Iran, Iraq, ous projects. The surgeons general of the
and Turkey, making typhus surveys. His Egyptian and Iranian Armies agreed to
reports on the typhus situation in these a vaccination program administered by
areas were forwarded to the commission the Typhus Commission. The allocation
headquarters in Washington, and copies of typhus vaccine to the various Middle
given to the Middle East theater surgeon East countries was handled by the Allied
and to U.S. Army surgeons of the North organization that governed the flow of
African and China—Burma—India thea- lend-lease supplies, the Middle East
ters. Supply Council. As both the theater
Activities of the Typhus Commission surgeon and the field director of the
benefiting the population in Middle Typhus Commission were members of
East countries consisted of the distribu- the council they were able to control the
tion of about 3,000,000 individual doses allocation, a point vital to the success of
of typhus vaccine, repeated typhus sur- the program, as otherwise typhus vac-
veys, and extensive dusting of popula- cine could easily have become a monop-
tions with louse powders. The commis- oly of the privileged or have found its
sion also handled a large-scale program way into the black market.
to instruct personnel of the United Na- The Typhus Commission participated
in control activities at Naples during the
outbreak of typhus in that city during
39 the winter of 1943-44. The work of the
The first director of the Typhus Commission
was Rear Adm. Charles S. Stephenson, MC, USN. commission was continued throughout
On a survey trip to Lebanon and Palestine during the Middle East and Africa during
January 1943, Admiral Stephenson became ill and 1944, and in 1945 it put into effect a
later returned to the United States. In February
1943 Colonel Fox relieved Admiral Stephenson of typhus control program in the Balkans.
the directorship of the commission and arrived in The possibility of dissolving the commis-
Cairo late the following month to assume control of sion's field headquarters at Cairo was
the overseas program, having been promoted to
brigadier general en route. He served as director brought up during the summer of 1944,
until August 1943 when his title was changed to but this did not take place until mid-
field director, and another Army officer, Col. (later summer of 1945, when it was closed and
Brig. Gen.) Stanhope Bayne-Jones, became director
of the commission with headquarters in Washing- its facilities and equipment transferred
ton, D.C. to a U.S. Navy epidemiology unit.
96 MEDITERRANEAN AND MINOR THEATERS
GENERAL Fox
the difficult climate and the initially poor ability to use one's faculties was consid-
living conditions troops endured re- erably impaired.
sulted in neuropsychiatric casualties. Col. Baldwin L. Keyes, head of the
The rate per 1,000 per annum was above neuropsychiatric service in theater head-
40 for most of 1943, but with the comple- quarters, after investigating cases of men-
tion of semipermanent barracks, mess tal deterioration caused by lengthy trop-
halls, and recreational facilities, the rate ical service, recommended that personnel
dropped to 16 in October 1943. Medical be returned to the United States on ro-
officers of the command considered it tation after not more than two years' serv-
remarkable that in the early days the ice in the Middle East, and also advised
rate was not higher. At first many of that a rotation policy be established
these cases were repeatedly hospitalized within the theater. The 2-year-rotation
in an attempt to salvage them for further plan was favorably considered by the
duty, but it soon became apparent that a theater commander in the spring of
more liberal policy was needed in caring 1944, but a new commanding general
for them. More neuropsychiatric pa- of the theater who arrived soon afterward
tients were evacuated to the zone of in- did not back the recommendation of the
terior during the last half of 1943 and chief neuropsychiatrist.
the first half of 1944. The depressing effect of having the
The chief psychiatrist of the Middle 2-year-rotation plan scrapped was reflect-
East theater and the chief of the psy- ed in the rise in the hospital admission
chiatric section of the 38th General Hos- rates for neuropsychiatric diseases, which
pital studied the effect of climate upon reached a peak of 31 per 1 ,000 per annum
personnel and found that a definite trop- for July 1944. The increased admissions
ical syndrome developed among many in- were mostly personnel who had been
dividuals assigned to tropical areas. The making borderline adjustments, building
time required to develop the more severe up hope for return on the proposed ro-
syndromes varied with the individual and tation policy. Rotation was again con-
the area. Service in small isolated units sidered later in 1944, but the difficulty
in the desert or the jungles of central of getting replacements for those eligible
Africa produced some breakdowns in 3 for return precluded any effective appli-
months. In larger units stationed closer cation of the policy. Intratheater rotation
to centers of population and the more finally began in 1945 when many were
varied environments along the coast, the shifted from the more undesirable sta-
breaking point was reached in 6 months tions in the theater to places having a
to a year or longer. After 18 to 24 months comparatively favorable climate.
under tropical conditions the efficiency Evacuation of mental patients to the
of almost anyone was greatly reduced. United States was a serious problem in
Characteristically, an individual affected the early days of the theater, since no
with a tropical syndrome showed evi- American hospital ships were available.
dence of listlessness, slow speech, defec- Psychotics and severe psychoneurotics
tive memory, poor thought content, whose return to the zone of interior had
and narrowed perspective. Although no been recommended clogged the theater's
obvious loss of intelligence occurred, the hospital wards for periods up to six
98 MEDITERRANEAN AND MINOR THEATERS
months before they could be evacuated sources of lost manpower in the Middle
by infrequently departing American East theater. Nonspecific diarrheas, ba-
troop transports equipped with sick bays cillary and amebic dysentery, bacterial
and medical personnel. The more nu- food poisoning, and the typhoid-para-
merous British hospital ships were also typhoid group of infections were found
used, when they could be induced to in all areas. The factors contributing to
accept this class of patient, but carried the high incidence of these infections
U.S. personnel only to North Africa or among natives of the Middle East were
England for transshipment on U.S. ves- contaminated water supplies, lack of
sels. In 1944, when the Air Transport sewage disposal systems, generally insan-
Command routes through the Middle itary conditions that promoted extensive
East to the China-Burma-India theater fly breeding, and the personal habits of
were well established, returning aircraft the individuals. These diseases, how-
could be used for patients en route to the ever, need not have been nearly as pre-
United States. Air evacuation worked valent as they were. Men continued to
admirably, and mental patients were re- arrive in the theater without proper
sponsible for no serious accidents to pa- training or discipline in hygiene and
tients or personnel. From July 1942 to sanitation and continued to suffer a high
the end of 1944 neuropsychiatric disease diarrhea rate until the defects were
led the list of causes for return of pa- made good. On the calendar-year aver-
tients from the Middle East to the age, this group of diseases accounted for
United States, and constituted over 35 more man-days lost than any other, and
percent of the total number returned. constituted 20 percent of hospital ad-
About a third of the neuropsychiatric missions for the period 1 July 1942 to1
cases evacuated had some history of psy- October 1943. The rates for intestinal
chiatric disorder before military service, diseases declined from year to year,
the stresses present in the theater caus- owing in part to the intensive program
ing recurrences. of education in preventive medicine in-
Beginning in the latter part of 1944, stituted in the theater by the Medical
as many psychiatric cases as possible—in- Department and in part to the use of
cluding alcoholics—were treated on an sulfanilamide and later of Sulfaguani-
outpatient basis, with only those wholly dine.41
unable to perform their duties being ad- Contrary to most of the intelligence
mitted to the hospitals. It was felt that reports, which had indicated that respir-
long periods of hospitalization tended to atory diseases in the Middle East were
intensify symptoms rather than effect of minor importance, this group of dis-
cures. The result of this policy was re- eases constituted 15 percent of hospital
flected in a substantial reduction in admissions during the period 1 July 1942
psychoneurotic patients presented to to 1 October 1943. Infectious hepatitis
disposition boards for evacuation to the 41
(1) Annual Rpts, MD Activities, USAFIME,
zone of interior. 1942, 1943. (2) Col Ward, Hist of Preventive Medi-
cine in the Middle East, 19 Oct 41-23 Jun 44. (3)
Hist, Med Sec, AMET. (4) Hist, Med Activities,
Other Diseases—Gastrointestinal dis- PGC. (5) Ltr, Gen Sams to Col Coates, 12 Mar 59,
eases constituted one of the greatest commenting on preliminary draft of this chapter.
AFRICA AND THE MIDDLE EAST 99
caused some difficulty in late 1942 and Department officers fought the effects of
early 1943, particularly among Ninth heat in a variety of ways. A liberal daily
Air Force personnel stationed in the intake of water and fruit juices was rec-
Western Desert of Egypt and Libya. ommended, and the men were advised
Smallpox and bubonic plague, the for- to take a salt tablet with each glass of
mer being widespread among the pop- water. Alcohol, recognized as one of the
ulation, and the latter causing epidemics greatest contributory factors, could not
among the natives of Dakar, French West be entirely eliminated, but the danger
Africa, and the people living along the was constantly emphasized in the slogan
Suez Canal, were potential hazards to "If you want to live, don't drink." In-
American troops. Immunization and con- travenous injections of normal salines
trol measures instituted by the Medical were used in treatment of heatstroke and
Department protected American troops heat exhaustion. In the summer of 1942,
so that the two diseases were of little before the U.S. medical authorities had
military consequence. learned the use of salines, ice packs,
A group of diseases that puzzled med- wrapped in toweling and soaked in ice
ical authorities in the Middle East re- water, together with electric fans ad-
sulted in a request by the theater surgeon justed to blow across the beds, served to
to The Surgeon General for special as- reduce body temperatures by two or
sistance. A small organization known in- three degrees.42
formally as the Virus Commission To make living conditions more bear-
stemming from the Army Epidermio- able, the Engineer Corps installed air
logical Board arrived in Cairo in April conditioning equipment when available,
1943, and soon set to work collecting in- but most of the time "desert coolers"
formation about Sandfly (pappataci) were used. These improvised devices
fever, poliomyelitis, and infectious consisted of crates filled with straw,
hepatitis—three epidemic diseases, pre- camel thorn, or excelsior, which were set
sumably of virus origin, prevalent in the in windows. They operated by having a
Middle East. Members of the commis- fan blow air through them while water
sion set up a laboratory and office in the trickled down through the filler material.
38th General Hospital, where they con- This equipment reduced temperatures
ducted experiments on the transmission of rooms from twenty to thirty degrees.
of the various virus diseases. Members The adoption of special morning work-
of the commission made field trips ing hours for the summer months also
to nearby Egyptian areas as well as to helped reduce casualties. Heatstroke
more distant places during the year. By centers, where men could go at the first
mid-December 1943 the commission signs of heatstroke or heat exhaustion,
closed its Middle East laboratory after cured many potentially serious cases.
making valuable contributions to the Another problem that was common
literature of the diseases they studied. to the whole Middle East area early in
The intense heat of the Persian Gulf the period was that of chronic vitamin
area was responsible for various forms deficiency. Detailed plans for the Persian
of discomfort, including heatstroke, heat 42
Ltr, Van Vlack to Col Coates, 23 Mar 59, com-
exhaustion, and prickly heat. Medical menting on preliminary draft of this chapter.
100 MEDITERRANEAN AND MINOR THEATERS
Gulf included vegetable gardens for tal officers with work not connected with
which land and water rights had already their professional training. Dentists usu-
been obtained, but these were canceled ally received such nonprofessional as-
when the troops arrived because the signments when they were not able to
normal ration was supposed to contain work full time because of lack of equip-
an adequate supply of vitamins. Many ment. Once this practice started, it
men, however, did not eat all of the ra- became difficult to get dentists relieved
tions issued. Very few uncontaminated of such jobs even when the burden of
green vegetables were obtainable locally, dental treatment increased.45
and the effects of vitamin deficiency In the Persian Gulf area, dental offi-
were clearly observable. This situation cers arrived with the first major ship-
was remedied in 1943, after a nutritional ment of troops in December 1942, al-
officer had been sent to the theater and though one Dental Corps officer had
had testified to the need for vitamins.43 been in Iran with the Iranian Mission
Still another disease problem peculiar since March. About eleven dental offi-
to the area was leishmaniasis, or Bagdad cers were in the area in December 1942,
sore. The disease was classified as exotic but eventually their number in propor-
and so the drug required to cure it could tion to the troop strength of the com-
be had only by special order "as re- mand became large compared to other
quired," and then only in small quan- overseas areas. More were needed be-
tities, so that it was impossible to combat cause in addition to those stationed with
44
the condition effectively. hospitals and dispensaries, others had to
minister to the needs of units strung
Dental Service along the transportation routes to the
Soviet Union.
The dental service of the Middle Although the British allowed U.S.
East theater began with the formation Army dentists to use dental facilities in
of the theater in 1942, but it was not British Army hospitals pending comple-
until well into 1943 that the service could tion of American installations, a serious
be considered adequate. A high nonef- problem in the early days was the lack
fective rate because of adverse climatic of facilities. The shortage of dental
conditions reduced the number of dental equipment, which lasted until mid-1943,
officers available at any one time, and seriously handicapped the dental service
the wide dispersal of units made it
45
necessary to place dentists with units too (1) Annual Rpt, Med Dept, USAFIME, 1942
and 1943. (2) Hist, Med Sec, AMET. (3) Ltr, Maj
small for the most economical function- George F. Jeffcott, Dental Surg, USAFIME, to Brig
ing. To compensate, certain dentists Gen Robert H. Mills, Asst to the SG, 29 Sep 42.
were frequently moved from one small (4) Hist of Med Activities, PGC. (5) Dental Hist
of PGC, Dec 42-Aug 44, and 1 Jan-31 Mar 45. (6)
station to another. During the period of Dental supplement to Annual Rpt, Surg, PGC,
growth in the Middle East theater there 1943. (7) Annual Rpt, Med Dept Activities, PGC,
was a strong tendency to overburden den- 1944. (8) Annual Rpts, Med Dept Activities, Delta,
Eritrea, and Levant Serv Comds, 1942 and 1943. (9)
43
Ibid. Annual Rpt, Med Dept Activities, Middle East
44
Ltr, Col Adams to Col Coates, 7 Apr 59, com- Serv Comd, 1944. (10) Annual Rpt, Med Dept Ac-
menting on preliminary draft of this chapter. tivities, Central African Wing, ATC, 1943.
AFRICA AND THE MIDDLE EAST 101
of the theater. In December 1942 the cers and local station hospitals. A dental
thirty-nine dental officers then in the the- officer and an enlisted man with portable
ater had a total of 6 field sets, 2 units and equipment flew to stations that did not
chairs, 1 incomplete laboratory, and a have resident dentists.
few miscellaneous items purchased lo- The greatest difficulty experienced by
cally. The British loaned field chests to the dental service related not to hard-
U.S. Army units arriving in the Middle ships or shortages in equipment, but to
East without dental equipment. During the lack of promotions. The Dental
1943 adequate facilities were established Corps suffered from Table of Organiza-
and enough equipment arrived so that tion troubles about which very little
the dentists could establish a program of could be done within the theater. Dental
improving the dental health of the sol- officers found themselves passed at regu-
diers in the theater. lar intervals by men of other branches
Dental service throughout the Central who often had less experience and abil-
African Wing of the Air Transport Com- ity. Enlisted assistants had similar mo-
mand was provided by ATC dental offi- rale-destroying problems, for many of
102 MEDITERRANEAN AND MINOR THEATERS
them served on detached service to den- were poultry, eggs, and seafood. How-
tal clinics that had no Tables of Organi- ever, the majority of food products came
zation. in by ship from the United States, and
The chief dental officer of the U.S. large quantities of beef were secured
Army Forces in the Middle East was Lt. through the British Government from
Col. George F. Jeffcott, who was suc- Australia and New Zealand.
ceeded at the beginning of 1944 by Lt. Various enterprises for the production
Col. Thomas A. McFall, already dental of food for American troops were super-
surgeon of the Delta Service Command vised by the veterinary service. A Cairo
and chief of the dental service for the chicken dealer built a sanitary poultry-
38th General Hospital. The dental activ- killing and dressing establishment with
ities of the Persian Gulf Command, dur- the advice and suggestions of the Delta
ing the period of its autonomy, were Service Command veterinary officer. The
directed by Lt. Col. Herbert L. Gullick- U.S. Army obtained fresh milk that was
son, who came to the theater as dental pasteurized under the supervision of the
surgeon of the 21st Station Hospital. veterinary service in Palestine. In
Eritrea, the veterinary service of the
Veterinary Service Eritrea Service Command and the thea-
ter veterinarian put into operation a
Except for a small number of horses small but modern slaughterhouse, con-
used for recreational and military police structed especially for U.S. military use.
purposes, the Middle East theater did In the opinion of Veterinary Corps offi-
not use animals for carrying on its duties. cers in the theater, it was superior to any
Consequently, members of the U.S. abattoir found anywhere in the Middle
Army Veterinary Corps were chiefly con- East. In Eritrea and Palestine the veteri-
cerned with meat and food inspection nary service operated pig farms, and in
and supervision over animals and other Egypt a veterinary officer rendered assist-
food products raised for consumption of ance in the operation of a piggery. These
theater troops. The veterinary service pig-raising projects helped dispose of gar-
conducted meat and dairy hygiene activi- bage and provided a source of reliable
ties at various stations in the commands pork. At the various stops along the Cen-
of the theater. Because of the low sani- tral African Wing, ATC, route two
tary standards prevailing throughout the veterinary officers and an enlisted man
Middle East, veterinary officers experi- inspected the food supplies of the per-
enced considerable difficulty in obtaining sonnel.
suitable food products of local origin. Veterinary officers arrived in the Per-
All meat, dairy, and other food products sian Gulf area late in 1942 and quickly
had to be inspected with great care to began the tasks of inspecting the food
ensure strict compliance with U.S. Army supplies of the troops. They also made
standards. Whenever establishments surveys and recommendations regarding
maintaining satisfactory standards were storage, refrigeration, and slaughter-
located, the veterinary service recom- houses. By the end of 1943, the veteri-
mended them as sources of supply. Prod- nary strength of the command had
ucts most commonly obtained in this way reached its peak of 8 Veterinary Corps
AFRICA AND THE MIDDLE EAST 103
officers and 12 enlisted men, distributed ater disposed of the Persian Gulf's sur-
in the northern, central, and southern plus personnel and equipment and
areas of Iran. The veterinarians were of inactivated the command the last day of
46
the opinion that an oversupply of their December.
profession existed in the command and Although most of the theater's com-
that 2 officers and 15 enlisted men would mands were still in existence at the end
have been sufficient. Although Veteri- of 1945, they were working toward an
nary Corps officers were officially charged early close-out date. Where station hos-
only with the inspection of meat, eggs, pitals had formerly served, medical
and other food products, the command detachments operated to handle the
authorized them to establish several ani- diminishing military population of
mal clinics to care for pets acquired by the commands. The two largest
members of the Army. Veterinary care commands of the theater, the North
was provided for these animals whenever African and the Middle East Service
time could be spared from food inspec- Commands, as well as the minor com-
tion. mand in Liberia, were inactivated dur-
ing the first quarter of 1946, and the
Decline of Medical Activities in the theater itself disbanded on 31 May 1946.
Demobilization Period The 56th Station Hospital, the last re-
maining theater hospital, closed its doors
Immediately after the surrender of the day the theater was inactivated. The
Japan on 14 August 1945, the medical personnel of the service commands were
service of the Africa-Middle East thea- assigned to 26 residual teams established
ter began a program designed to keep up to act as custodians of U.S. Government
with the demobilization instructions property awaiting sale by the Foreign
issued by the War Department. The the- Liquidation Commission. Some of the
ater surgeon carried out a policy of re- teams had one medical or surgical tech-
ducing or reorganizing all medical nician assigned, and every team had
installations in proportion to reductions either Air Transport Command, British,
in theater strength. Most medical units or local civilian hospital facilities avail-
were either inactivated or transferred able for the medical care of its personnel.
from the theater between September and The remaining responsibility of the
December 1945. By the end of the year Medical Department was simply to pro-
only the 38th General Hospital at Casa- vide sufficient medical attendance for the
blanca, the 25th Station Hospital at few remaining troops.
Roberts Field, the 56th Station Hospital
46
at Camp Huckstep, and the 367th at (1) Med Hist, AMET, vol. II, pp. 319-23. (2)
Final Rpt, Med Sec, AMET, Oct 45-Mar 46. (3)
Wadi Seidna in the Sudan remained in Hist of AMET, Supplement, Tab, Med Sec, AMET,
the theater. During this period the Per- separate rpts for following periods: Oct-Dec 45,
sian Gulf Command completed its mis- 1Jan-10Mar 46, 11 Mar-30 Apr 46, MS, OCMH.
(4) An. C, Chief Surgeon, Final Hist Rpt, Hq,
sion, and its liquidation was entrusted to AMET, through 31 May 1946, in ETMD Rpt, May
the Africa-Middle East theater. The the- 46.
CHAPTER III
The strategical and psychological im- Armored Division, the 3d Infantry Divi-
portance of the operation can scarcely be sion, and two regimental combat teams
overestimated. A successful TORCH would of the 9th Infantry Division. The West-
relieve the hard-pressed Russians by ern Task Force trained in the United
opening a diversionary front much earlier States and sailed for Africa under convoy
than an invasion of continental Europe of the U.S. Navy.
could be launched; it would forestall the The Center Task Force, under com-
possibility of a German breakthrough in- mand of Maj. Gen. Lloyd R. Fredendall,
to the oil-rich Middle East to join hands was to go ashore on beaches flanking
with the Japanese; it would open the Oran, some 250 miles inside the Mediter-
Mediterranean to Allied shipping and ranean. This force was made up of ele-
render more secure the sea and air ments of II Corps, built around the 1st
routes over the South Atlantic; it Infantry Division, half of the 1st Ar-
would put U.S. ground troops into action mored Division, and a force from the
against the Germans; and, finally, if it 509th Parachute Infantry Regiment, re-
could be accomplished without fatally inforced by corps troops to a strength of
embittering the French, it would open more than 40,000. The Center Task
the way for France to re-enter the war on Force trained in England and was con-
the Allied side. By the same reasoning, voyed by British warships.
however, the venture was hazardous. To The Eastern Task Force, with a com-
fail would spell disaster. plement of 23,000 British and 10,000
U.S. troops and commanded by Lt. Gen.
Plans for Operation TORCH K. A. N. Anderson of the British First
Army, was to attack Algiers. Maj. Gen.
The plans developed by General Clark Charles W. Ryder, commander of the
and his collaborators called for simulta- 34th Infantry Division, led the American
neous landings at three separate points. element, which consisted of two rein-
British naval units were to support oper- forced regimental combat teams (RCT),
ations inside the Mediterranean; U.S. one each from the 9th and 34th Infantry
units those in the Atlantic. The Twelfth Divisions, and a Ranger battalion. Like
U.S. Air Force, under command of Brig. the Center force, the Eastern Task Force
Gen. James H. Doolittle, was activated trained in England and was accompanied
and trained to give necessary air support to its destination by units of the British
as soon as airfields could be captured and Navy. In the hope of securing more will-
made operational. ing co-operation from the French, who
The Western Task Force, which was were still resentful toward their former
to storm the beaches on the Atlantic British allies for the earlier sinking of
coast of Morocco in the vicinity of Casa- French vessels at Oran, General Ryder
blanca, was commanded by Maj. Gen. and his American troops were to spear-
George S. Patton, Jr. Totaling approxi- head the Eastern Task Force assault.
mately 34,000 men, it consisted of the 2d Both personnel and equipment for
medical support of the task forces were to
War II, vol. II, Operations in North African Waters,
October 1942-June 1943 (Boston: Little, Brown be held to the absolute minimum. The
and Company, 1950), pp. 3-42, 181-186. medical section of Allied Force Head-
106 MEDITERRANEAN AND MINOR THEATERS
were to evacuate patients from Algiers of combat troops did get ashore without
and Oran to the United Kingdom. Since encountering more than sporadic small
no U.S. hospital ships were available, arms fire, but before objectives were
there would be no alternative for the gained there was fighting in every sector.
Western Task Force but to evacuate
casualties by returning transports or hold Eastern Task Force
them ashore for future disposition.
Plans for combat medical service in Algiers was first to surrender, owing
the landing phase were spelled out in largely to secret contacts with military
considerable detail, but were based commanders there and to the unexpected
largely upon manuals prepared without presence in the city of Admiral Jean-
realistic knowledge of amphibious opera- François Darlan, Vichy naval com-
tions. Participation by U.S. observers in mander, whose authority was second only
the costly Dieppe raid of 19 August 1942 to that of Marshal Henri Pétain himself.
was the nearest approach to a seaborne The city lies along the western rim of a
landing on a hostile shore in modern half-moon-shaped bay, whose eastern ex-
U.S. Army experience.3 It is therefore tremity is Cap Matifou. Seven or eight
not surprising that casualty estimates miles west of the city the coast dips
were too high, or that conditions under sharply to the south, interrupted only by
which medical troops would operate Cap Sidi Ferruch, which juts into the
were misjudged. Mediterranean on a line with the center
of Algiers and about ten miles distant.4
(Map 6}
Medical Support in the
The 39th Regimental Combat Team
Landing Phase
of the 9th Division, with elements of the
The Allied assault on the Moroccan British 1st Commando attached, went
and Algerian coasts took place as sched- ashore east of Cap Matifou in the early
uled in the early hours of 8 November hours of 8 November. Landing craft used
1942. It was hoped that the French would were small and fragile by later standards,
not resist the landings. Secret negotia- and boat crews were inexperienced. It is
tions to this end were carried on right up not surprising, therefore, that many of
to D-day itself, climaxed by a personal them piled up in the surf and others
appeal from President Roosevelt, which 4
Sources for military operations of the Eastern
was broadcast in French over shortwave Task Force are: (1) Opns Rpt, Eastern Task Force;
radio as the troops began to go ashore. (2) Howe, Northwest Africa; (3) Morison, North
On most of the beaches, the first waves African Waters. Medical sources primarily relied
upon are: (4) Rcd of Events, 15 Oct—8 Nov 42, by
various officers of the 109th Med Bn, Co C; (5)
3
Lt. Gen. Lucian K. Truscott, Jr., the chief U.S. Diary, Surg Teams 1 and 2, Ortho Team 1, Shock
observer at Dieppe, gives his own account in Com- Team 1, 2d Aux Surg Gp, in Rpts of Professional
mand Missions, A Personal Story (New York: But- Activities of Surg Teams, vol. I; (6) Clift, Field
ton, 1954), pp. 62-72. The medical story of the Opns, pp. 52-57. (7) Crew, Army Medical Services:
raid, which suffered over 50 percent casualties in Campaigns, pp. 293-97. Negotiations with the
killed, wounded, and missing, is in W. R. Feasby, French, both before and after the landings, are
Official History of the Canadian Medical Services, detailed in (8) Robert Murphy, Diplomat Among
1939-1945 (Ottawa: E. Cloutier, Queen's Printer, Warriors (Garden City, N.Y.: Doubleday, 1964),
pp. 113-22. pp. 108-43.
CONQUEST OF NORTH AFRICA 109
were brought ashore at the wrong ceived the surrender of the fort at Sidi
beaches. Aside from sporadic fire from Ferruch without a fight, and, with the
coastal batteries on Cap Matifou, how- aid of friendly French officers, the air-
ever, no opposition was encountered at field at Blida had been neutralized. The
the beaches, and the combat team British 11th Infantry Brigade landed
quickly pressed inland and captured without opposition some twenty miles
Maison Blanche airfield. south of Cap Sidi Ferruch simultane-
The 168th RCT of the 34th Infantry ously with the more northerly landings
Division and the bulk of the British 1st and moved inland to protect the flank of
Commando landed just north of Cap the 168th RCT.
Sidi Ferruch, but here, too, the invaders The only seriously opposed landings
were widely scattered because of faulty were those of the 6th Commando north
navigation. Only the absence of opposi- and west of Algiers, where difficulties in
tion enabled the force to regroup and assembling and loading the assault boats
move inland toward Algiers by daylight. delayed the landings until after daylight.
The commandos, meanwhile, had re- Here the commandos had to call for the
110 MEDITERRANEAN AND MINOR THEATERS
support of naval gunfire and of carrier- the collecting company was put ashore
based planes to win their objective by during the morning of D-day, but most
late afternoon. An attempt by two Brit- of its equipment remained on shipboard.
ish destroyers to enter the harbor before Without vehicles to follow the combat
dawn had proved unsuccessful. One of troops and with little in the way of medi-
the vessels was forced to withdraw after cal supplies, the company remained of
suffering severe damage from shore bat- necessity close to the landing area in the
teries. The other succeeded in ramming vicinity of the beach dressing station set
the boom and landing a detachment of up by British naval personnel. Casual-
the 135th RCT, 34th Division, but the ties were held at the dressing station be-
troops were pinned down and taken cause the sea was too rough to permit
prisoner, while the destroyer withdrew evacuation to the ships and no hospital
so severely damaged that she later sank. facilities were available on shore.
By late afternoon of D-day Algiers was A radio call for more medical person-
surrounded, its airfields were in the nel early in the afternoon brought Capt.
hands of the Allies, and those of its (later Maj.) Paul L. Dent and Capt.
coastal fortifications that had not capit- (later Maj.) William K. Mansfield of
ulated were at the mercy of Allied naval Surgical Team No. 1, commanding offi-
guns and bombers. Darlan, who had cer and executive, respectively, of the 2d
been in contact with Robert Murphy, Auxiliary Surgical Group detachment, to
the U.S. diplomatic representative in the beach about 1600, but they were un-
North Africa since the eve of the land- able to bring equipment with them. A
ings, met with General Ryder early in bombing raid, rough seas, and the com-
the evening and agreed to a local cease- ing of darkness prevented the landing of
fire. After two days of negotiation an more surgical group personnel or of the
armistice was signed, to be effective clearing station they were to support, so
shortly after noon on 11 November. Ne- Captains Dent and Mansfield worked
gotiations continued until 13 November, through the night at the naval beach
when Darlan was recognized as de facto dressing station.
head of the French Government in The quick end of hostilities on the 8th
North Africa. enabled the two surgical group officers to
In addition to its own medical detach- evacuate more than twenty patients the
ment, each of the U.S. regimental com- next morning to the dispensary at Mai-
bat teams that spearheaded the Algiers son Blanche airfield about fifteen miles
landings was accompanied by a collecting inland, using trucks and borrowed
company and a clearing platoon of the French ambulances. The clearing pla-
medical battalion organic to its parent toon of the 9th Medical Battalion and
division—Company A and the 2d Platoon the remaining eighteen officers and en-
of Company D, 9th Medical Battalion, listed technicians of the 2d Auxiliary
with the 39th RCT; and Company C and Surgical Group did not come ashore un-
the 2d Platoon of Company D, 109th til 11 November, when the ships carrying
Medical Battalion, with the 168th. them docked at Algiers. A hospital was
On the beaches east of Cap Matifou, then set up in a schoolhouse in Maison
where the 39th RCT made its landings, Carree, about midway between the air-
CONQUEST OF NORTH AFRICA 111
1st Armored Division, landed some thirty 26th had pushed beyond Mers el Kebir,
miles west of Oran. The landing was un- and that strongpoint was cut off from the
opposed, but difficulties in getting the west and south.
vehicles ashore delayed any advance until The main point of attack was in the
about 0900. The column then struck vicinity of Arzew. There the 1st Ranger
eastward to Lourmel and followed the Battalion got ashore undetected just
north rim of the Sebkra d'Oran, the long north of the town and quickly seized the
salt lake that parallels the coast about ten two forts dominating the harbor. The
miles inland. Against only sporadic oppo- 16th and 18th RCT's of the 1st Division
sition, the column reached and seized La and the larger portion of Combat Com-
Senia airfield, south of Oran, on the mand B were then able to land from
morning of 9 November. transports moved close to shore. There
A simultaneous landing at Les Anda- was no opposition until daylight, by
louses 15 miles west of Oran by the 26th which time the assault units were well on
RCT, 1st Infantry Division, was only their way to their first objectives. Com-
briefly interrupted by an unexpected bat Command B raced southwest some
sand bar, and the men were moving in- twenty-five miles to seize Tafaraoui air-
land by daylight when French coastal field and held it against French counter-
guns began shelling the transport area. attacks the following day. The 16th and
By the end of the day, elements of the 18th RCT's moved on Oran by parallel
CONQUEST OF NORTH AFRICA 113
routes, the 18th being delayed by stub- pital. The 16th and 18th RCT's of the
born resistance at St. Cloud before by- 1st Division, landing at Arzew, were each
passing that town. accompanied by a collecting company of
A direct assault on Oran itself was the 1st Medical Battalion, with one clear-
attempted at H plus 2 by two British ing platoon backing up both regiments.
destroyers carrying more than 400 com- Combat Command B was supported by
bat troops, most of them from the 1st Company B of the 47th Armored Medi-
Armored Division, but both ships were cal Battalion, less the detachment with
destroyed inside the breakwater and all the western column. Third-echelon sup-
men aboard were killed or captured. port came from the 400-bed 48th Sur-
Equally unsuccessful, though less disas- gical Hospital and, after the surrender,
trous, was an attempted airdrop on from the 38th and 77th Evacuation Hos-
Tafaraoui airfield by 556 men of the 2d pitals.
Battalion, 509th Parachute Infantry Reg- Arzew was already in Allied hands by
iment, flying from England. Faulty navi- the time most of the medical personnel
gation and a mix-up in signals dropped a came ashore. About noon of D-day a
number of the men in Spanish Morocco, clearing platoon of the 1st Medical Bat-
where they were interned. Others talion, although most of its equipment
dropped at various points far west of was still afloat, took over a dirty and in-
their objective. Only one plane reached adequate civil hospital capable of accom-
the field, but it met with antiaircraft fire modating 75 patients. The French doc-
and turned back without dropping its tors in attendance remained to care for
men. Almost half of the paratroopers natives already there, and for French
were still missing by 15 November. and native prisoners as they were
The end of the day, 9 November, brought in. Personnel of the 48th Surgi-
found the invaders converging on Oran cal Hospital came ashore in landing craft
from all sides. Armored spearheads en- during the afternoon, but without equip-
tered the city the next morning, the ment and scattered over a 2-mile area.
10th, and a cease-fire order was issued As soon as the unit was consolidated, 3
at 1215. of its surgeons and 3 nurses were sent to
The combat elements of the Center the civil hospital.7 The detachment was
Task Force received varying degrees of augmented during the night by 4 oper-
medical support. The armored column ating teams of 2 surgeons and a nurse
landing west of Oran was accompanied each. These teams worked throughout
by its own medical detachment and by a the night of 8—9 November by flashlight.
small group from the organic 47th Ar- The 48th Surgical set up its own hos-
mored Medical Battalion. The 26th pital in nearby French barracks on D
Regimental Combat Team, 1st Division, plus 2, taking over operation of the
which hit the beaches east of Oran, re- 7
"Having nurses arrive with the 48th Surgical
ceived medical support from a collecting Hospital at Arzew on D-day was very helpful in
company and a clearing platoon of the caring for the wounded. However, I did not feel
organic 1st Medical Battalion, and from afterwards that the risk was fully justified and
would not do it again." Ltr, Col Arnest to Col
a detachment of 6 officers, 6 nurses, and Coates, 10 Nov 58, commenting on preliminary
20 enlisted men of the 48th Surgical Hos- draft of this volume.
114 MEDITERRANEAN AND MINOR THEATERS
NURSES OF THE 48th SURGICAL HOSPITAL marching from the Arzew docks to join their
unit, 9 November.
Arzew civil hospital at the same time. About noon of D-day elements of
Equipment and supplies were secured Company B, 47th Armored Medical Bat-
from the British Navy, Army units in the talion, assisted by a detachment from the
area, the French, and the 38th Evacua- Twelfth Air Force surgeon's office, set
tion Hospital—which had arrived at up an aid station in the city hall at St.
Arzew on 9 November but was not yet Leu, four or five miles southeast of
in operation. The 48th Surgical's own Arzew. The detachment moved to
equipment did not come ashore until 13 Tafaraoui airfield on 10 November, and
November. The maximum number of the St. Leu station was turned over to
patients treated at any one time was 480 Air Forces control two days later.
and included American, British, French, On 11 November, the day after the
and native. surrender of Oran, the 38th Evacuation
CONQUEST OF NORTH AFRICA 115
Hospital moved inland to St. Cloud, of Casablanca, at Safi, Fedala, and Port-
where heavy fighting had overtaxed the Lyautey. These landings encountered the
available medical facilities. While equip- most determined opposition of any of the
ment was being gathered together at the three task forces. Subtask Force BLACK-
prospective site, surgical teams from the STONE, commanded by Maj. Gen. Ernest
38th joined elements of the 1st Division N. Harmon of the 2d Armored Division
Clearing Company at the civil hospital and built around the 47th Regimental
in Oran, where about 300 casualties, in- Combat Team, 9th Division, and two
cluding survivors of the ill-fated H plus battalion landing teams of the 2d Ar-
2 attempt to land troops in the harbor, mored, touched shore at Safi, 140 miles
had been turned over by the French south of Casablanca, about 0445, 8 No-
authorities. Personnel of the 77th Evacu- vember. The first waves met only inter-
ation assumed responsibility for the op- mittent small arms fire, but the French
eration of the Oran hospital on 12 had been alerted by the earlier landings
November. The surgical teams of the inside the Mediterranean.9
38th rejoined their parent unit the fol- When the destroyer USS Bernadou
lowing day when it opened under can- slipped into Safi harbor with a battalion
vas at St. Cloud. Responsibility for team
landing evacuation wasInfantry aboard,
of the 47th
she met raking cross fire. USS Bernadou
taken over by the 51st Medical Battalion, replied successfully and managed to land
which had arrived with the 77th Evacua- the men, who quickly swarmed into the
tion on the D plus 3 convoy. Up to that town. The destroyer USS Cole followed
time there had been very little evacua- with more combat troops, but by this
tion from the combat zone because of the time coastal guns from a nearby fort
blocked harbor and the delay in arrival were sweeping the transport area. The
of hospital ships. battleship USS New York replied, and
In keeping with the longer and more the guns were silenced. The beachhead
determined French resistance, combat
casualties of the Center Task Force were
considerably higher than those in the 9
Principal sources for the combat history of the
Algiers area. Of the 620 U.S. patients Western Task Force are: (1) Opns Rpt, Western
hospitalized during the week ending 14 Task Force; (2) Howe, Northwest Africa; (3)
November, 456 had combat wounds, 51 Morison, North African Waters; (4) George S.
Patton, Jr., War As I Knew It (Boston: Houghton
had injuries, and 113 were disease cases.8 Mifflin Company, 1947), pp. 5-14; (5) Truscott,
Command Missions; (6) E. A. Trahan, ed., A His-
tory of the Second United States Armored Division,
Western Task Force 1940-1946 (Atlanta: Albert Love Enterprises, 1946) ,
pp. 31-45; (7) Donald G. Taggart, ed., History of
The Western Task Force made three the Third Infantry Division in World War II
separate landings along more than 200 (Washington: Infantry Journal Press, 1947). Med-
ical sources primarily relied upon are: (8) Clift,
miles of the Atlantic coast on both sides Field Opns, pp. 21-39; (9) Albert W. Kenner,
"Medical Service in the North African Campaign,"
Bulletin, U.S. Army Medical Department (May,
June 1944) ; (10) Hist of the 9th Med Bn 1942;
8
Rpt, Hq SOS ETO, Office of the Chief Surg, (11) Annual Rpt, 3d Med Bn, 1942; (12) Med
15 Feb 43. See also n. 5, p. 111, above. Hist Data, 56th Med Bn, 31 Oct 44.
116 MEDITERRANEAN AND MINOR THEATERS
and harbor area were sufficiently secure 1, but heavy fog kept all but one plane
by midmorning to bring tanks ashore, from dropping bombs. The one plane
and the town surrendered at 1530, about destroyed an ammunition dump, with
eleven hours after the action had started. considerable damage to port installa-
French planes from Marrakech came tions. Allied carrier-based planes neutra-
over Safi in the early morning of D plus lized the Marrakech field that afternoon
CONQUEST OF NORTH AFRICA 117
and broke up a truck convoy carrying resistance, but the force was poised in
French reinforcements to Safi. Tanks of the outskirts of Casablanca by midnight
Combat Command B, 2d Armored Di- of 10-11 November. In the interval,
vision, which had landed during the French warships at Casablanca, includ-
night of 8-9 November were immedi- ing the battleship Jean Bart, had joined
ately dispatched to engage the French the fight, inflicting considerable damage
column. There was sharp fighting in the on the supporting naval units before
vicinity of Bou Guedra in the late after- being blockaded in the harbor. The final
noon of 9 November and early the next attack on Casablanca had still not been
morning. After dark on the 10th the launched when word arrived that the
tanks withdrew and started for Casa- French were willing to lay down their
blanca, where they were sorely needed. arms.
The largest of the three subtask forces Most vigorously contested of all the
—BRUSHWOOD—landed at Fedala, about Western Task Force landings were those
fifteen miles north of Casablanca. of Subtask Force GOALPOST in the
(Map 8) The force consisted of the 3d Mehdia-Port-Lyautey area, commanded
Infantry Division, reinforced by a bat- by Maj. Gen. Lucian K. Truscott, Jr.
talion landing team of the 2d Armored (See Map 8.) GOALPOST'S primary mis-
Division and was commanded by Maj. sion was to seize an airfield where P-40's,
Gen. Jonathan W. Anderson of the 3d brought on the carrier USS Chenango,
Division. Fedala lies on the southern could be based to aid in the assault on
edge of a shallow bay, enclosed by Cap de Casablanca some 75 miles to the south-
Fedala jutting out behind the town and west. The airfield lay in a bend of the
the Cherqui headland about three miles Sebou River, with the town of Port-
to the northeast. The landing beaches Lyautey south of it, on another and
actually used were all inside the bay, and sharper bend. The airfield was about 3.5
all within range of batteries on cape or miles inland, or twice that far up the
headland. Fortunately, the defenders winding river, with the town another 3
were taken by surprise. Despite inexpert or 4 miles upstream, but about equidis-
handling of landing craft that took sev- tant from the coast as the crow flies. The
eral waves of assault troops to beaches village of Mehdia was just above the
miles north of the objective and piled mouth of the river, which was closed be-
many of the small boats onto rocks, there yond that point by a boom.
were 3,500 troops ashore before dawn The landing force consisted of the
brought organized French resistance. All 60th RCT of the 9th Division and a light
initial objectives were quickly seized and tank battalion of the 66th Armored Reg-
the beachhead was secure by sunrise. iment, 2d Armored Division, with sup-
The batteries were silenced later in porting units that included nearly 2,000
the day, and BRUSHWOOD Force began to ground troops of the XII Air Support
move inland, swinging south toward Command. Landings on both sides of the
Casablanca. The movement was ham- river mouth were marred when a num-
pered by delays in unloading transport ber of boat crews missed their beaches,
and communications equipment, and landed the men as much as five miles out
supporting weapons, as well as by French of position, and lost many boats in the
118 MEDITERRANEAN AND MINOR THEATERS
assembled and vehicles were made avail- craft in the assault. On 12 November,
able, and the wounded were held at bat- after the armistice, the clearing platoon
talion aid stations for twenty-four and took over a Red Cross hospital in Meh-
sometimes thirty-six hours. A clearing dia, which was operated as an evacuation
station was set up by the afternoon of hospital until the regular installations
D-day in a beach casino at Fedala with arrived nearly a month later.
capacity for 150 litter cases, the overflow For the Western Task Force as a
being cared for in school buildings and whole, 694 cases were hospitalized during
private homes. Additional supplies were the first week of the invasion. Of these,
borrowed from the Navy. During the 603 were combat wounds, 43 injuries,
night of 12 November the station cared and 48 disease.11
for survivors of a U-boat attack, includ-
ing over 400 burn cases, 100 of them so Hospitalization and Evacuation
severe as to require repeated transfu- of Task Force Casualties
sions. Flashlights furnished the only il-
lumination until floodlights could be Hospitalization and evacuation of task
borrowed from Ordnance repair units. force casualties remained the responsibil-
All available medical officers, including ity of the force surgeons until the medi-
Colonel Kenner himself and Lt. Cols. cal section of Allied Force Headquarters
Huston J. Banton and Clement F. St. was established in Africa and base section
John of the headquarters staff, worked organizations were set up. For the West-
through the night at the clearing station. ern Task Force the provisional hospitals
Supplies and personnel were inadequate, at Safi and Mehdia continued to operate
and many of the more severe cases were as long as they were needed. The Safi
lost.10 hospital was still in operation when the
The Mehdia landings were supported Atlantic Base Section was activated late
by a collecting company and a clearing in December. The first U.S. Army hospi-
platoon of the 9th Medical Battalion and tals to reach western Morocco were the
a detachment of the 56th Medical Bat- 750-bed 8th and the 400-bed 11th Evacu-
talion. The medical force was about half ation Hospitals, which arrived at Casa-
the size of those with the other two sub- blanca together on 18 November on the
task forces. Throughout the three days delayed second convoy. The 8th opened
of fighting it was possible to do no more three days later in buildings of the Ital-
than set up beach aid stations. Evacua- ian consulate, which soon proved too
tion by land was out of the question for small and inadequately equipped. The
want of vehicles and a place to go; evac- 11th moved on to Rabat, where it opened
uation to the transports was hazardous on 8 December, permitting return of the
and at times impossible because of heavy Mehdia Red Cross hospital to civilian
seas and the excessive loss of landing control. The 59th Evacuation, another
10
750-bed unit, began receiving patients
(1) Memo, Brig Gen Arthur R. Wilson for A/S, under canvas at Casablanca on 30 Decem-
12Dec 42, sub: Rpt of Opns in N. Africa. (2)
Ltr, Brig Gen Clement F. St. John to Col Coates,
11
28 Oct 58, commenting on preliminary draft of Rpt, Hq SOS ETO, Off of Chief Surg, 15 Feb
this volume. 43. See also n. 5, p. 111, above.
120 MEDITERRANEAN AND MINOR THEATERS
her. The 400-bed 91st Evacuation was British hospitals assigned to the Eastern
also in the area before the end of the Task Force.13
year, but was not established under task Evacuation from the Western Task
force control. All of these evacuation Force was by troop transport to the
hospitals functioned as fixed installations United States. From the Center and East-
rather than as mobile units.12 ern Task Forces, evacuation was by Brit-
In the Oran area the three mobile ish hospital ship to the United Kingdom.
hospitals that came in with the combat There was very little of either, however,
troops—the 48th Surgical and the 38th before the period of task force control
and 77th Evacuation—were supple- ended.
mented on 21 November by the 9th
Evacuation, with an additional 750 beds, Evaluation of TORCH Medical
and by the 1st Battalion, 16th Medical Service
Regiment. Since all of its equipment was
lost at sea, the medical battalion operated From the medical point of view, Oper-
a staging area for other units until Feb- ation TORCH was relatively easy only
ruary 1943. The Mediterranean Base because casualties were far lower than
Section was activated on 8 December, had been anticipated and because medi-
and fixed hospitals under base section cal officers and enlisted men of the Medi-
control quickly supplanted the mobile cal Department met unexpected situa-
units of the Center Task Force, which tions with ingenuity and skill. In no
began staging for the next phase of the instance did the collecting or clearing
North African campaign. elements get ashore early enough, or
Aside from the clearing platoons of have enough equipment with them. Sup-
the 9th and 109th Medical Battalions, all plies hand-carried by medical personnel
hospitalization for the Eastern Task accompanying the assault waves included
Force was British. Although they were some unnecessary items and omitted
not able to land on D-day as planned, other items that would have been useful.
the 1st and 8th Casualty Clearing Sta- Additional medical supplies were scat-
tions were established promptly after the tered over the beaches, where quantities
surrender of the city and, together with were lost. Ambulances, in particular,
the provisional casualty clearing sta- were unloaded far too slowly, and when
tion being operated by the 159th Field they finally became available they proved
Ambulance and the clearing platoon of to have poor traction in sand and a
the 109th Medical Battalion, were able dangerously high silhouette. The jeep,
to care for all casualties until a sufficient on the other hand, was found to be read-
number of general hospital beds was ily adaptable for carrying litters over
established between 15 and 20 Novem- difficult terrain.14
ber. All British units took U.S. patients, 13
(1) Diary, Surg Teams 1 and 2, Ortho Team 1,
but the bulk of them went to the 94th Shock Team 1, 2d Aux Surg Gp, in Rpts of Prof
General, largest and best equipped of the Activities of Surg Teams, vol. I. (2) Crew, Army
Medical Services: Campaigns, pp. 90-93.
14
(1) Kenner, "Medical Service in the North
12
Unit reports of hospitals and base sections African Campaign," Bulletin, U.S. Army Medical
mentioned in the text. Department (May, June 1944). (2) Annual Rpt,
CONQUEST OF NORTH AFRICA 121
Hospital facilities provided for the equally ignorant of what war in North
Western Task Force aboard the trans- Africa would be like.
ports proved unusable except in a single
instance because of the heavy surf and Medical Support of II Corps
the heavy loss of landing craft during the in the Tunisia Campaign
assault. Mobile hospitals provided for
the Center Task Force were adequate as Expansion Into Tunisia
to bed strength, but the unloading of
equipment was not co-ordinated with the Armistice negotiations were still going
debarkation of personnel. Hospital on in Algiers and fighting still raged at
equipment, moreover, often proved to be Casablanca and Oran when the Eastern
incomplete when unpacked.15 The Cen- Task Force resumed its identity as the
ter and Western forces found it im- British First Army and turned toward
possible to obtain records of casualties Tunisia. The French commander there
evacuated by naval beach parties, or was unwilling or unable to obey Darlan's
even to learn how many there were. cease-fire order, and Axis reinforcements
Both the planning and the execution were coming in through the ports and
of the operation were at fault. Those who airfields of Tunis and Bizerte. First Army
drew the medical plans in Washington units occupied Bougie, 100 miles east of
and London had very little communica- Algiers, on 11 November. The following
tion with each other, had only meager day British paratroops and a seaborne
intelligence reports as to the conditions commando group took Bone, 150 miles
they would actually meet, and were for farther east, unopposed. Advance ele-
the most part either without combat ex- ments were within 60 miles of Tunis be-
perience on which to base their judg- fore encountering German patrols on 16
ments or had experience limited to November. With French co-operation,
the static warfare of World War I. Medi- forward airfields were occupied in the
cal personnel with the assault troops Tébessa area, just west of the Tunisian
were equally inexperienced and at least frontier and 100 miles south of the coast.
Medjez el Bab was captured on 25 No-
vember. The airfields at Djedeida, a bare
Surg, II Corps, 1942. (3) Recommendations of 15 miles from Tunis, were occupied
Surg, Western Task Force, 24 Dec 42, in Med An-
nex to Final Rpt of Opns. three days later, but could not be held
15
"Equipment was packed and shipped with the against strong counterattacks.16
notation on the packing case, 'Complete except for
16
the following items.' The 'following items' were Military sources for the first phase of the
pieces of equipment that would deteriorate in Tunisia Campaign are: (1) Field Marshal the
storage—particularly rubber items. These should Viscount Alexander of Tunis, "The African Cam-
have been included before shipment as pieces of paign from El Alamein to Tunis," Supplement to
equipment—notably anesthesia machines—could not the London Gazette, 5 February 1948, pp. 864-66;
be used until the missing items had been received (2) Howe, Northwest Africa; (3) Howe, 1st
from the U.S. It took many months to make up Armored Division; (4) Craven and Cate, eds.,
these deficiencies." Ltr, Col Bauchspies to Col Europe; TORCH to POINTBLANK; (5) Albert
Coates, 15 Apr 59, commenting on preliminary Kesselring, Kesselring: A Soldier's Record (New
draft of this volume. Colonel Bauchspies was com- York: William Morrow and Company, 1954). The
manding officer of the 38th Evacuation Hospital in more important medical sources are: (6) Crew,
the North African invasion. Army Medical Services; Campaigns; (7) Clift, Field
122 MEDITERRANEAN AND MINOR THEATERS
mand when it reached the Tunisian bor- The Germans seized the initiative
der. A new 18 Army Group was then to when the rainy season ended in February.
come into being, made up of the British Early in the month Generaloberst Juer-
First and Eighth Armies, the U.S. II gen von Arnim's army in Tunisia was
Corps, and the French 19th Corps under joined by Field Marshal Rommel's
General Louis-Marie Koeltz. General famed Afrika Korps, and Rommel him-
Alexander was to be the army group self was in command when the Axis
commander. forces attacked savagely toward Faïd Pass
Early in January General Fredendall in the center of the II Corps front on
established II Corps headquarters at the 14th. Intelligence expected the attack
Constantine and began moving his farther north, and the Americans were
forces into the vicinity of Tébessa. Addi-
caught off balance. Fredendall prepared
tional elements of the 1st Armored and to stand at Kasserine Pass, some forty
34th Infantry Divisions, as they arrived miles west of the breakthrough, but his
from England, were sent to the II Corps armor was out of position and poor
sector, while all remaining elements of weather conditions prevented air support
the 1st Division were brought up from or even reconnaissance. Enemy tank
Oran. The three divisions were substan- columns forced the pass on 20 February
tially assembled by 1 February, with the and debouched onto the plain beyond in
scattered regiments of the 9th Division a three-pronged drive that reached its
being moved into position as reserves. maximum extent, only twenty miles
Medical units based around Tébessa in- from Tébessa, two days later. There the
cluded, in addition to attached medical drive was contained. The Germans, run-
personnel, the 1st and 109th Medical ning low on fuel and ammunition,
Battalions and the 47th Armored Medi- realized they had not the strength to
cal Battalion, organic to the combat di- break through the Allied lines in the
visions; the 51st Medical Battalion; the face of reinforcements moving in from
2d Battalion, 16th Medical Regiment; Le Kef and Tébessa, and withdrew to
the 1st Advance Section of the 2d Medi- their original positions.
cal Supply Depot; the 48th Surgical Hos- Before the Faïd breakthrough there
pital; and the 9th and 77th Evacuation had been relatively heavy fighting in the
Hospitals.18
nual Rpt, 51st Med Bn, 1943; (13) Annual Rpt,
18
Military sources for the Kasserine phase of the Surg, 1st Armd Div, 1943; (14) Annual Rpt, Surg,
Tunisia Campaign are: (1) Howe, Northwest 1st Div, 1943; (15) Annual Rpt, Surg, 34th Div,
Africa; (2) Opns Rpt, II Corps, 1 Jan-15 Mar 43; 1943; (16) Annual Rpt, Surg, 9th Div, 1943; (17)
(3) Truscott, Command Missions; (4) Howe, 1st Hist, 47th Armd Med Bn, 1 Oct 42-9 May 43; (18)
Armored Division; (5) Knickerbocker and others, Opns Rpt, 1st Med Bn, 11 Nov 42-12 May 43;
Story of First Division in World War II, pp. 58-64, (19) Hist, 9th Med Bn, 1943; (20) Diary, Hq
81-92; (6) Craven and Cate, eds., Europe; TORCH Detach, 109th Med Bn, 1 Feb-1 Mar 43; (21)
to POINTBLANK; (7) Eisenhower, Crusade in Cowell, Kenner, Rpts of Visit to II Corps, 29 Jan-
Europe, pp. 140-48; (8) Kesselring, Soldier's Rec- 2 Feb 43; (22) Unsigned Rpt of Observations of
ord, pp. 177-84; (9) Alexander, "African Cam- Visit to II Corps, 13-19 Feb 43; (23) Annual Rpt,
paign," Suppl to London Gazette, 5 February 1948, 9th Evac Hosp, 1943; (24) Annual Rpt, 77th Evac
pp. 866-73. Medical sources primarily relied upon Hosp, 1943; (25) Annual Rpt, 128th Evac Hosp
are: (10) Annual Rpt, Surg, II Corps, 1943; (11) (48th Surg Hosp), 1943; (26) Annual Rpt, 2d Aux
Annual Rpt, Med Sec, NATOUSA, 1943; (12) An- Surg Gp, 1943; (27) Clift, Field Opns, pp. 74-94.
CONQUEST OF NORTH AFRICA 125
Ousseltia Valley, where the II Corps sec- 77th Evacuation Hospitals were about
tor approached British positions in the ten miles southeast of Tébessa, far to the
north, and around Gafsa, more than a rear, while the 48th Surgical was operat-
hundred miles distant on the southern ing one 200-bed unit at Thala and the
flank. These actions had served to dis- other at Fériana, each more than fifty
perse collecting and clearing companies miles from the combat lines as of 14
over hundreds of miles of rough and February. (Map 9)
largely roadless country. The 9th and A general withdrawal of medical in-
126 MEDITERRANEAN AND MINOR THEATERS
stallations paralleled the mid-February cuitous, over roads that could be safely
German advance. On the first day of the traveled only at night. Trucks and litter-
advance an entire collecting company of jeeps were freely used to supplement the
the 109th Medical Battalion was cap- ambulances that were never available in
tured, together with most of the medical sufficient numbers.
detachment of the 168th Infantry regi- During the night of 14-15 February
ment-in all, 10 medical officers and more the Feriana section of the 48th Surgical
than 100 enlisted men. On the same day, Hospital moved to Bou Chebka about
14 February, an officer of the 47th Ar- midway along the road to Tebéssa, using
mored Medical Battalion was captured trucks and ambulances of the corps medi-
with four ambulances loaded with casual- cal battalions. Patients were placed in
ties.19 Aid stations in both Faïd and Gaf- the 9th Evacuation Hospital, which
sa sectors were hastily leapfrogged to the shifted 107 of its own patients to beds
rear, one section caring for patients set up for the purpose by the still in-
while another moved to a safer location. operative 77th. By February 17th the
Lines of evacuation were long and cir- 48th Surgical was on the road again,
19
Interv with 1st Lt Abraham L. Batalion, and
moving this time to Youks-les-Bains just
Capt Wilbur E. McKee. west of Tébessa. Within six hours of ar-
CONQUEST OF NORTH AFRICA 127
rival it was receiving patients from both these large units kept them so far behind
evacuation hospitals, which were them- the fighting fronts that ambulance runs
selves in process of moving. of a hundred miles or more between
When weather conditions made air clearing station and hospital were not
evacuation to the communications zone infrequent. In the absence of hospitals
impossible, a section of the British 6th closer to the lines, teams of the 2d Auxil-
Motor Ambulance Convoy was rushed to iary Surgical Group were attached to
Youks, where it was placed at the dis- the clearing stations.
posal of the 48th Surgical Hospital on 18
February. The twenty-five ambulances Operations in Southern Tunisia
and two buses of this unit were able to
move 180 patients at a time, and suc- During the first week of March, Gener-
ceeded in clearing the Tébessa area of al Fredendall was relieved, and com-
casualties by the time the Germans broke mand of II Corps was given to General
through Kasserine Pass. Both the 9th Patton; Maj. Gen. Omar N. Bradley was
and the 77th Evacuation Hospitals were appointed his deputy. The shift in lead-
back in operation by 20 February, at new ership coincided with the penetration of
sites in the Aïn Beida—La Meskiana area Tunisia from the south by the British
on the road to Constantine. The Tébessa Eighth Army and activation of the 18
section of the 2d Medical Supply Depot Army Group under Alexander. The II
moved into the same area on 19 Feb- Corps' next mission was to attack in the
ruary, followed by the Thala section of Gafsa-Maknassy area in support of
the 48th Surgical. The remainder of the Eighth Army's drive up the coast.20
48th went from Youks to Montesquieu Mindful of the Kasserine experience,
on 22 February, while the 9th Evacua- and with troop strength brought up to
tion shifted from Aïn Beida to Souk 90,000 by assignment of the 9th Divi-
Ahras, fifty miles to the north. (Map 10) sion, Colonel Arnest, the II Corps sur-
All of these moves were carried out geon, asked for one of the new 400-bed
rapidly and in good order, although field hospitals capable of operating in
hundreds of patients were involved. In three 100-bed units, a 400-bed evacua-
this acid test of mobility, commanders tion hospital, and more ambulances.
were duly impressed by the fact that a Only the ambulances arrived before the
200-bed section of the 48th Surgical Hos- southern phase of the Tunisia Campaign
pital could evacuate its patients, disman- 20
Military sources for the campaign in southern
tle and load its installations, and be on Tunisia are: (1) Opns Rpt, II Corps, 16 Mar-10
the road in four and a half hours, while Apr 43; (2) Howe, Northwest Africa; (3) Howe,
1st Armored Division; (4) Knickerbocker and
the 750-bed evacuation hospitals, because others, Story of First Division in World War II,
they had no organic vehicles of their pp. 64-72, 92-95; (5) Omar N. Bradley, A Soldier's
own, were able to move only when trans- Story (New York: Henry Holt and Company, 1951),
pp. 43—55; (6) Kesselring, Soldier's Record, pp.
portation could be provided by corps. 184-88; (7) Alexander, "African Campaign," Suppl
In a disintegrating situation their prior- to London Gazette, 5 February 1948, pp. 873—78.
ity was low and the danger of their being Medical sources are the same as those cited in n.
18, above, with the addition of: (8) Annual Rpt,
overrun by the enemy was proportion- 15th Evac Hosp, 1943; (9) Annual Rpt, 3d Aux
ately great. The relative immobility of Surg Gp, 1943; (10) Clift, Field Opns, pp. 98-112.
128 MEDITERRANEAN AND MINOR THEATERS
was over, and those only a few days be- Shortage of beds made it impossible to
fore the pressing need for them had maintain any fixed evacuation policy,
passed. The only medical reinforcements even the 15-day policy originally
received were five teams of the 3d Auxil- planned.
iary Surgical Group, flown in without The corps jumped off on 17 March.
nurses on 18 March. Eleven teams of the The 1st Division occupied Gafsa the
2d Auxiliary Surgical Group were same day, took El Guettar on the 18th,
already active in the II Corps area. and seized Station de Sened on the 21st.
CONQUEST OF NORTH AFRICA 129
Maknassy fell to the 1st Armored on 22 surgery and for holding cases that could
March. After a brief respite for revision not be safely moved. Evacuation from
of plans and regrouping, all four divi- both stations was to the 48th Surgical
sions of II Corps went into action on 28 Hospital, fifty miles from Gafsa and al-
March. The 9th Division attacked along most twice that far from Maknassy.
the road from El Guettar to the coastal Coinciding with the renewal of the
city of Gabes; the 1st turned northeast offensive on 28 March, the 77th Evacua-
toward Maknassy, where the 1st Armored tion returned to Tébessa and one section
was concentrating on a strongly held of the 48th Surgical went on to Gafsa.
pass east of the town; and the 34th, to- At Sbeitla, on the evacuation route
gether with British First Army units, from the 34th Division, 2d Battalion of
attacked Fondouk on the left flank. the 16th Medical Regiment set up a
Fighting in all sectors was heavy, and clearing station that, like the other two
for ten days almost continuous. Contact corps clearing stations, functioned as a
with the British Eighth Army was estab- forward hospital. It was relieved on 11
lished on 7 April, and the enemy began April, after the southern campaign had
withdrawing to the north. When the ended, by the 400-bed 15th Evacuation
34th Division and its British allies broke Hospital.
through at Fondouk two days later, the Facilities of the 48th Surgical Hospital,
southern campaign was over. and of the corps clearing stations, were
In the interval between recovery of wholly inadequate for the steady stream
the ground lost in the Kasserine with- of casualties from the three divisions
drawal and the launching of the II Corps operating in the El Guettar-Maknassy
offensive, hospitals and other medical in- sector during the final drive. Evacuation
stallations were again moved forward to to Tébessa and Youks by ambulance and
the Tébessa area. The 9th Evacuation truck was virtually a continuous process.
Hospital set up this time at Youks-les- To make room for new arrivals, the 77th
Bains, where proximity to the field used and 9th Evacuation Hospitals were com-
for air evacuation to the communications pelled to send patients to the communi-
zone was the primary consideration. Both cations zone with little reference to their
sections of the 48th Surgical were back at hospital expectancy, and many were thus
Feriana by 19 March. Two corps clear- lost who could have been returned to
ing stations established on 22 March duty in a reasonable time.
remained in place until the end of the In the El Guettar-Maknassy area, ter-
southern campaign, compensating in rain was often too rough for vehicles,
part for the shortage of mobile hospital even for jeeps and half-track ambulances.
beds. These were the clearing stations Litter carries, especially on the 9th Divi-
of the 51st Medical Battalion at Gafsa sion front, were long and generally pos-
and of the 2d Battalion, 16th Medical sible only at night. In many instances
Regiment, near Maknassy. Each was re- both patients and medical attendants
inforced by surgical teams and was adja- waited in slit trenches for darkness. The
cent to clearing units of the organic corps medical battalions supplied addi-
medical battalions. They functioned in tional litter bearers, as many as 75 being
effect as front-line hospitals for forward needed by one combat team. Only in the
130 MEDITERRANEAN AND MINOR THEATERS
Fondouk sector was evacuation from the Command of II Corps passed to General
battlefield relatively easy. There, a good Bradley, whose first task was to shift his
road net and adequate cover permitted troops 150 miles to the north. Although
location of aid and collecting stations the movement involved passing close to
close to the lines. The ambulance haul 100,000 men, with all their equipment,
from the clearing station at Sbeitla to across the communication lines of the
the evacuation hospitals at Tébessa and British First Army, it was accomplished
Youks-les-Bains was approximately eighty without interruption to any supply or
miles. (Map II) military service, and without detection
21
by the enemy.
The Drive to Bizerte 21
Military sources for the northern phase of the
Tunisia Campaign are: (1) Opns Rpt, II Corps,
Following withdrawal of the enemy 23 Apr-9 May 43; (2) Howe, Northwest Africa;
from southern Tunisia, General Patton (3) Howe, 1st Armored Division; (4) Knicker-
was detached to train the force that bocker and Others, Story of First Division in World
War II, 72-81, 95-98; (5) Bradley, Soldier's
would become the U.S. Seventh Army Story; (6) Craven and Cate, eds., Europe.- TORCH
on the scheduled invasion of Sicily. to POINTBLANK; (7) To Bizerte with the II Corps
CONQUEST OF NORTH AFRICA 131
The final phase of the North African trol of the air and the end was swift and
campaign began on 23 April, with II sure. One after another, strongly held
Corps and attached French elements hill positions were stormed. The 1st
pushing east along the Mediterranean Armored swept through the Tine Valley
coast, First Army advancing northeast in to capture the important communica-
the center, and Eighth Army attacking tions city of Mateur on 3 May. Bizerte
northward on the right flank. The fell to the 9th Division on 7 May, simul-
French 19th Corps, under General taneously with the entry of British units
Koeltz, operated between the two British into Tunis. The 3d Division was brought
armies. By this time the Allies had con- up at this time, but was too late to partic-
ipate in more than mopping-up opera-
tions. All enemy forces in the II Corps
(Washington, 1943) ; (8) Alexander, "African Cam-
paign," Suppl to London Gazette, 5 February 1948, sector surrendered on 9 May. British
pp. 878-84. Medical sources are substantially the armor quickly closed the escape route
same as those already cited for the Kasserine and to the Cap Bon peninsula, and the re-
southern phases of the campaign, to which should
be added: (1) Annual Rpt, 10th Field Hosp, 1943; maining Axis forces, trapped between
(2) Clift, Field Opns. the British First and Eighth Armies,
132 MEDITERRANEAN AND MINOR THEATERS
During the first ten days of the Bizerte truck powered the vehicle on its way
drive, fighting was in mountainous coun- to the rear, the other on the return trip.
try, often covered with thick, thorny Twelve litters could be carried at a time,
underbrush and largely without roads. but the exposed position of the railroad
Evacuation was particularly difficult on made it usable only at night. One collect-
the 9th Division front, to the left of the ing company of the 9th Medical Battal-
corps sector. For a time mules were used, ion operated a rest camp in the rear of
harnessed in tandem with a litter swung the division area, to which approximately
between poles attached to the saddles. seventy-five front-line soldiers were
Difficult hand litter carries up to three brought each evening for a hot shower,
and a half miles necessitated the use of a full night's sleep, and a chance to write
200 additional bearers, drawn in part letters. Exhaustion cases were held at the
from corps medical battalions but mainly clearing stations, under heavy sedation.
from line troops. At one point, where a Similar conditions prevailed on the
railroad cut the 9th Division front, two narrower fronts assigned to the other
half-ton trucks were fastened back to divisions of II Corps. The 1st Division
back with rims fitted over the rails. One borrowed litter bearers from the 51st
134 MEDITERRANEAN AND MINOR THEATERS
Medical Battalion; the 1st Armored treating 100 or more a day in the out-
drafted cooks, clerks, and other noncom- patient clinic, where their specialized
bat personnel into service as bearers. skills made up for the limitations of
Half-track ambulances proved unable to battalion medical sections left with the
enter the narrow wadis where casualties combat and support troops in the vi-
occurred most frequently, and had to be cinity.23
replaced by jeeps. In the bloody battle
for Hill 609, litter bearers of the 34th Summary of Tunisian Experience
Division brought out casualties in day-
light from positions closer to the enemy Like the combat troops, the medical
lines than to their own. units and personnel of the medical de-
In the final week of the campaign, tachments went into the Tunisia Cam-
medical support of the combat forces paign without battle experience, or with
more closely approximated the pattern experience limited to the two or three
laid down in the manuals. (Map 13) days of action in the TORCH landings.
The coastal plain was adapted to easy Deficiencies in training had to be made
movement in vehicles, and the road net up while operating under combat condi-
was good. The 400-bed evacuation hospi- tions, and in intervals when the units
tals were closed to admissions between were in bivouac. More important still
9 and 15 May, new patients being sent was the training of replacements. Virtu-
thereafter only to the 9th Evacuation. ally no trained medical replacements
The staff of this unit was reinforced by were available, yet losses were high.
a detachment from the 16th Medical More than a hundred Medical Depart-
Regiment and by captured German ment officers and men were captured in
medical personnel, who helped with the Faïd Pass breakthrough alone, while
prisoner-of-war patients. Two captured disease, injury, and battle wounds also
German field hospitals were allowed to took their toll. Indeed, the personnel
continue in operation, under supervision problem was perhaps the most difficult
of the 51st Medical Battalion, until 15 one faced by the surgeon's office during
May, when all prisoners still requiring the campaign. Constant juggling of
hospitalization were turned over to the medical officers, and continuing training
9th Evacuation. As of 12 May there were of line troops as replacements, were
1,145 patients, including prisoners of necessary to keep the II Corps medical
war, in II Corps hospitals, and twice service in operation at all. Other difficul-
that number in the two evacuation hospi- ties included much obsolete equipment
tals assigned to the Eastern Base Section. in the early stages of the campaign, and
All hospital units and corps medical generally inadequate lighting and power
battalions passed to control of EBS as facilities.
of midnight, 15 May. Casualties were progressively heavier
Immediately after the end of hostilities
the 9th Evacuation Hospital, on its own 23
Recorded interv, Col Coates, with ASD Frank
initiative, began to function as a station B. Berry, 4 Nov 58, commenting on preliminary
draft of this volume. Dr. Berry—then a colonel
hospital for all troops in the area. Mem- was chief of the Surgical Service, 9th Evacuation
bers of the hospital staff were soon Hospital, in North Africa.
CONQUEST OF NORTH AFRICA 135
with each stage of the campaign. Hospi- in part responsible for the siting of
tal admissions for the period 1 January hospitals so far to the rear. Another
through 16 March were 4,689. During reason for the failure of II Corps to give
the campaign in southern Tunisia, 17 close hospital support in the Kasserine
March through 9 April, 6,370 men were and southern phases of the campaign
admitted to II Corps hospitals. For the was the absence of any fixed battle line
northern campaign, 10 April through 15 and the necessity of giving ground before
May, there were 8,629 hospital admis- an enemy superior both in numbers and
sions. The consolidated casualty figures, in combat experience.24
shown in Table 1, offer tangible evidence The organization of the corps medical
of the magnitude of the task successfully service underwent numerous changes as
carried through by Colonel Arnest and the campaign progressed and more ex-
his staff. perience was gained with the require-
The early use of the 750-bed evacua- ments of modern combat. Initially the
tion hospital as a forward unit was a corps surgeon's office was located at the
holdover from the relatively static war-
fare of World War I, and was at least 24
Ltr, Col Arnest to Col Coates, 10 Nov 58.
136 MEDITERRANEAN AND MINOR THEATERS
WRECKED AMBULANCE in northern Tunisia. The red cross was not always respected.
effect without delay. It differed in fact supplied by the 802d Medical Air Evacu-
but little from the plan Colonel Elvins ation Transport Squadron. Surgeons on
had prepared before the invasion, but the ground supervised loading and un-
at that time it had met with a cold loading. The surgeon of the 51st Troop
reception from ground surgeons, who Carrier Wing was responsible for records,
believed air evacuation to be impracti- supplies used in flight, and property
cal. The plan called for the corps sur- exchange. The ratio was two planes used
geon to establish holding hospitals near for resupply for every ten loads of pa-
forward airfields, with the air surgeon tients, although one plane could be made
responsible for supervision and the to serve if returning personnel were dis-
theater surgeon for over-all co-ordina- persed among cargo transports.
tion. It was in this connection that the In the Kasserine phase of the cam-
38th Evacuation Hospital was established paign, air evacuation was from Youks-
at Telergma.29 les-Bains, with the British 12th Casualty
The planes used were C-47's, Clearing Station serving as holding unit
equipped with litter supports, which for evacuees. During the II Corps oper-
made it possible to carry 18 litter patients ations in southern Tunisia the same
and attendants. There were no regular airfield was used, with the holding
schedules, since the planes were used for function shifted to the 9th Evacuation
evacuation only on their return runs Hospital. One planeload of 16 patients
after discharging cargo or passengers in was flown direct from Thelepte. When
the combat zone. Requests were made operations shifted to the northern sector,
through the medical section, AFHQ, and the lines of evacuation ran from Souk el
evacuation officers in the combat areas Arba and Sidi Smail. The 38th Evacua-
were notified each evening as to how tion Hospital was close to both airfields.
many planes would be available the In the final days of the campaign, the
following day. Communication was by 10th Field Hospital served as a holding
teletype, telephone, radio, and air cour- unit at Souk el Arba. The overcrowded
ier. Patients were assembled near the hospitals of the Eastern Base Section
airfields so they could be loaded with were bypassed, the planes returning di-
a minimum of delay. rectly to their own bases at Algiers and
Although planes were not marked Oran, sometimes by an inland route and
with the Geneva Cross, and flew at low sometimes flying low over the water.
altitudes, there were no enemy attacks. Figures for air evacuation from the
Before 10 March the medical personnel Tunisian fronts between 16 January and
handling air evacuation were enlisted 23 May 1943, as reported by the 802d
men from the medical sections of various Medical Air Evacuation Transport
groups of the 51st Troop Carrier Wing. Squadron (MAETS), are broken down
After that date personnel—including by points of origin and destination in
nurses as well as enlisted men—were Table 2.
The Air surgeon estimated that 887
patients had been evacuated by air in
North Africa before the formal service
29
See also p. 132, above, and pp. 204-05, below. was inaugurated on 16 January 1943, but
140 MEDITERRANEAN AND MINOR THEATERS
by no means all of these came from equipment and none of their quarter-
Tunisia.30 master equipment. Deficiencies were
It was this experience in North Africa made up in the United Kingdom, but
that gave both ground and air surgeons only by stripping the European theater
31
some idea of the immense capabilities of much of its reserve stock.
of air evacuation, which continued to be Until the arrival of trained medical
used increasingly through the rest of the supply personnel late in December 1942,
war. supplies for the Western Task Force were
handled by division medical supply
Medical Supplies and Equipment officers and by personnel of a hospital
ship platoon. For the Center Task Force,
Shipping shortages and the speed with the 51st Medical Battalion took over the
which Operation TORCH was mounted medical supply function shortly after its
held medical supplies and equipment arrival on the D plus 3 convoy. Here
carried by the task forces to the lowest trained medical supply personnel were
possible level consistent with safety. available within two weeks. The 1st
There also were difficulties in getting Advance Section, 2d Medical Supply
together all of the items scheduled for Depot, arrived in Oran on 21 November
follow-up convoys. Hospitals destined and carried on the medical supply func-
for North Africa arrived in England with
no more than 25 percent of their medical
31
Ltr, Brig Gen Paul R. Hawley, Surg, ETOUSA,
30
to Col Corby, 5 Nov 42. Except as otherwise noted,
The II Corps surgeon, in his annual report for primary sources for this section are: (1) Med Hist,
1943, gives a figure of 3,313 patients evacuated by 2d Med Supply Depot Co, 1942, 1943; (2) Annual
air between 1 January and 15 May. The larger fig- Rpt, Surg, II Corps, 1943; (3) T Sgt William L.
ure shown in Table 2 is due in part to the addi- Davidson, Medical Supply in the Mediterranean
tional week included at the heavy end of the Theater of Operations, United States Army, pp.
period, and in part to the inclusion of Air Forces 1-29; (4) Rpt of Med Supply Activities,
casualties, not reported by II Corps. NATOUSA, Nov 42-Nov 43.
C-47 CARGO PLANE CONVERTED TO AMBULANCE DUTY in North Africa. The attend-
ing nurse is 2d Lt. Aleda E. Lutz, one of eight U.S. nurses killed in action in the MTO.
142 MEDITERRANEAN AND MINOR THEATERS
tion for the growing body of troops in Bizerte. On 15 May, immediately after
the area until a base section organization the German surrender in Tunisia, the
was established early in December.32 1st Advance Section, 2d Medical Depot
The U.S. components of the Eastern Company, moved to Mateur, where it
Task Force were supplied, like the was later relieved by a base section
British components, through the British depot.
First Army. Even items not available in After activation of the Eastern Base
British depots were requisitioned from Section late in February, medical sup-
ETO sources by the British. This de- plies for II Corps were received through
pendence upon British supplies con- the base depot at Aïn M'lilla, south of
tinued through the first phase of the Constantine, or one of the two subdepots
Tunisia Campaign, creating many dif- at Philippeville and Bone. Distance and
ficulties because of differences in practice transportation difficulties always compli-
between the two medical services. Supply cated the supply problem, but there were
levels deemed adequate by the British no serious shortages of any necessary
were insufficient by the more lavish item at any time during the Tunisia
American standards.33 Campaign.
Medical supply in Tunisia passed into Medical supplies in North Africa were
American channels with the concentra- furnished initially on the basis of the
tion of area at theinbeginning
II Corps of 1943. Medical Maintenance Unit (MMU),
the Constantine-Tébessa
designed to meet the medical require-
The 1st Advance Section of the 2d ments of 10,000 men for thirty days.
Medical Supply Depot opened in Con- Deliveries to the theater were automatic,
stantine on 8 January, moving a few days determined by troop strength. Combat
later to Telergma, where it relieved experience quickly revealed deficiencies
elements of the 16th Medical Regiment. and overstocks in the MMU, which was
The section shifted to Bekkaria, east of supplanted midway through the Tunisia
Tébessa, on 20 January, and thereafter Campaign by the Balanced Depot Stock,
remained as close as possible to the II worked out by supply experts in the
Corps medical installations. The supply Office of The Surgeon General.
depot withdrew to Am Beïda on 20 Items of basic equipment were the
February, following the Kasserine break- most difficult to replace, but in spite of
through, then moved up to Souk Ahras depot stringencies, hospitals assigned to
for a brief time, but was back at Bekkaria the combat zone usually managed to get
before the Gafsa-Maknassy-El Guettar there with equipment in excess of their
campaign began in mid-March. The organizational allowances, and so were
depot was in operation east of Tabarka able to weather loss and breakage.
by 23 April in support of the drive to
Professional Services
32
See pp. 207-09, below, for base section medical Combat Medicine and Surgery
supply activities.
33
Rpt, Gen Kenner to CinC, AFHQ, 7 Jan 43,
sub: Inspection of Med Troops and Installations, The amphibious phase of the North
First Army Area. African campaign was too brief, and the
CONQUEST OF NORTH AFRICA 143
nature of the fighting too restricted, to medical and surgical care in the combat
provide positive experience in combat zone.
medicine and surgery. The primary
lesson for the Medical Department was Forward Surgery—In the early phases
the necessity in future landing opera- of the Tunisia Campaign, mobile hospi-
tions of establishing clearing stations and tals were located so far to the rear—often
hospitals ashore at the earliest possible 50 to 100 miles—that a far heavier
date, with sufficient equipment and surgical load fell on the clearing stations
adequate personnel for emergency sur- than had ever been contemplated. Plasma
gery and medical care. In Tunisia, in- as a guard against shock was given in
valuable experience was gained in the the collecting stations and often in the
management of wounds, in the equip- aid stations, but as a general rule only
ping and staffing of facilities for forward emergency surgery was performed in the
surgery, and in the handling of psychi- division area. Surgeons in the division
atric cases. Even before the campaign clearing stations administered plasma,
was over, much of this experience was controlled hemorrhage, and closed suck-
applied toward the improvement of ing chest wounds, but completed trau-
144 MEDITERRANEAN AND MINOR THEATERS
bat, cases requiring emergency dental only inadequate facilities appeared any-
treatment were cared for at division where in the theater. The 34th Division
clearing stations, and as much routine dental surgeon found a partial solution
work as possible was done in the divi- of this problem in March when captured
sion area. For the most part, however, German equipment was used to set up a
40
the routine work was deferred until prosthetics laboratory for the division.
periods of combat inactivity. During
periods of actual contact with the enemy, Veterinary Service
when little dental work could be done,
dental personnel usually served in other The veterinary service of II Corps
capacities such as assistant battalion during the Tunisia Campaign was
surgeon; supply, mess, records, motor, largely confined to routine food inspec-
and admissions officer; and anesthetist. tions by division veterinarians. Since no
Enlisted dental technicians served as fresh meat was available until April, the
medical technicians and as company aid- duties were not arduous, and veterinary
men.39 personnel, like dental personnel, were
A need for dental prosthetics was frequently used in administrative and
observed throughout the Tunisia Cam- other capacities. Veterinary functions
paign, but no facilities for such work included the care of animals only for a
were available in the II Corps area, and brief interval in late April when mules
39
Sources for this section are: (1) Annual Rpt, were used for evacuation of the wounded
Med Sec, NATOUSA, 1943; (2) Memo for Supply in the 9th Division area. The veterinary
Serv, from Brig Gen R. B. Mills, 10 May 43; (3) officer attached to the Twelfth Air Force
MS, History of the United States Army Dental
Corps in the North African Theater of Operations, headquarters in Algiers carried on food
41
World War II, pp. 1-24. The use of dental person- inspection work for the air force units.
nel under combat conditions in ways similar to
40
those mentioned in the text was general, despite Annual Rpt, Surg, 34th Div, 1943.
41
regulations against it. See (4) Hq, NATOUSA, Cir Major sources for this section are: (1) Annual
Ltr No. 36, 17 Mar 43; and (5) Ltr, Brig Gen Rpt, Med Sec, NATOUSA, 1943; (2) Annual Rpt,
Lynn H. Tingay to Col Coates, 25 Feb 59, com- Surg, 9th Div, 1943; (3) Annual Rpt, Twelfth Air
menting on preliminary draft of this volume. Force Med Activities, 1943.
CHAPTER IV
Sicily was selected as the next Allied as his deputy. The date ultimately fixed
target in the Mediterranean at the Casa- for the invasion was 10 July.1
blanca Conference, 14-23 January 1943.
The choice reflected both the British Medical Preparations for
predilection for a Mediterranean strat- Operation HUSKY
egy and the American reluctance to
detract in any way from the ultimate in- Medical Planning for the Assault
vasion of northern France. The conquest
of Sicily was justified for both groups on Medical planning for the Sicily Cam-
the ground that it would relieve some paign began early in March 1943 under
of the pressure on the Russian front, help 1
Military sources for the Sicily Campaign as a
knock Italy out of the war, and open the whole are: (1) Field Marshal the Viscount Alex-
Mediterranean to Allied shipping. In ander of Tunis, "The Conquest of Sicily, 10th July,
1943 to 17th August, 1943," Supplement to the
British eyes Sicily was also a step along London Gazette, 12 February 1948; (2) Rpt of
Churchill's "soft underbelly" route to Opns, U.S. Seventh Army in Sicilian Campaign, 10
the Continent, while the American Jul-17 Aug 43; (3) Opns of II Corps, U.S. Army, in
Sicily, 10 Jul-17 Aug 43; (4) Samuel Eliot Morison,
strategists looked upon such a campaign "History of United States Naval Operations in
as the most profitable way to employ World War II," vol. IX, Sicily-Salerno-Anzio, Jan-
troops already in Africa, at a minimum uary 1943-June 1944 (Boston: Little, Brown and
Company, 1954); (5) Craven and Cate, eds.,
cost in shipping. There was also disagree- Europe-. TORCH to POINTBLANK; (6) Eisen-
ment on plans, which were not finally hower, Crusade in Europe; (7) Patton, War As I
approved by the Combined Chiefs of Knew It; (8) Bradley, A Soldier's Story; (9) Trus-
cott, Command Missions; (10) Kesselring, A Sol-
Staff until May. Like the Tunisia Cam- dier's Record; (11) Knickerbocker and others,
paign, operations in Sicily (known by Story of the First Division in World War II; (12)
the code name HUSKY) were to be Trahan, ed., History of the Second United States
Armored Division, pp. 47-59; (13) Taggert, ed.,
carried out by an Allied force under History of the Third Infantry Division in World
field command of General Alexander, War II, pp. 51-76; (14) The Fighting Forty-Fifth,
this time designated the 15th Army the Combat Report of an Infantry Division (Baton
Rouge: Army and Navy Publishing Company,
Group. The components were Mont- 1946) ; (15) W. Forrest Dawson, ed., Saga of the
gomery's British Eighth Army, rein- All American (Atlanta: A. Love Enterprises, 1946),
forced by the 1st Canadian Division, and unpaged; (16) Lt Col Albert N. Garland and
Howard McGaw Smyth, Sicily and the Surrender of
a U.S. Seventh Army commanded by Italy, UNITED STATES ARMY IN WORLD WAR
Patton, with Maj. Gen. Geoffrey Keyes II (Washington, 1965).
148 MEDITERRANEAN AND MINOR THEATERS
east coast. The Americans enveloped a of the 45th Division; for the DIME Force,
70-mile strip along the southern shore, to Lt. Col. (later Col.) James C. Van Valin
the left of the British.6 of the 1st Division; and for the Joss
Seventh Army stormed the beaches at Force, Lt. Col. (later Col.) Matthew C.
three separate points in the early morn- Pugsley of the 3d Division. The floating
ing of 10 July 1943. CENT Force, built reserve, called the KOOL Force, was
around the untested 45th Division, under command of Maj. Gen. Hugh J.
straddled Scoglitti on the right flank, Gaffey and the force surgeon was Col.
while the DIME Force, spearheaded by Abner Zehm, both of the 2d Armored
two regimental combat teams of the Division.
veteran 1st Division and two Ranger
battalions, landed in the vicinity of Gela Scoglitti Landings—On the CENT
about ten miles farther west. These two beaches landings were delayed an hour
forces made up a reorganized II Corps by the heavy seas. Many units landed on
under General Bradley. The Joss Force the wrong beaches and about 20 percent
commanded by Maj. Gen. Lucian K. of the landing craft were destroyed on
Truscott, Jr., and composed of the rein- the rocks. All assault units were never-
forced 3d Division, a Ranger battalion, theless ashore by 0600. Early opposition
and a combat command of the 2d Ar- came from Italian home guards, who
mored Division, went ashore at Licata fought only halfheartedly or not all,
on the left flank of the American sector. giving the 45th Division time to estab-
The remainder of the 2d Armored, and lish itself firmly before air activity and
the remaining RCT of the 1st Division, and German counterattacks began.
stood offshore as a floating reserve until The beachhead was secure by the end of
mid-afternoon of D-day, then debarked the day.
near Gela where the fighting was heavi- D plus 1 saw counterattacks on the
est. The 505th Regimental Combat extreme right repulsed by the 180th
Team and the 3d Battalion of the 504th Infantry and the 505th Parachute Com-
RCT, 82d Airborne Division, which bat Team—which had been forced down
were dropped behind the beaches a few in the area instead of at its designated
hours ahead of the assault, were under drop north of Gela. In a parallel action
army control. elements of the 157th and 179th Regi-
The task force surgeons were, for the mental Combat Teams captured Comiso
CENT Force, Lt. Col. Nesbitt L. Miller airfield against strong opposition. By the
end of the third day, 12 July, the Scog-
6
Military sources for the assault are those cited litti beachhead was fifteen miles deep
at the beginning of this chapter. Medical sources
primarily relied upon for the assault phase are: and the U.S. forces made contact with
(1) Rpt of Opns, U.S. Seventh Army in Sicilian the Canadians on the left flank of the
Campaign, an. N; (2) Annual Rpt, Surg, Seventh British Eighth Army. The capture of
Army, 1943; (3) Surg, II Corps, Rpt of Med Ac-
tivities in Sicilian Campaign; (4) Annual Rpt, Biscari (Acati) airfield northwest of
Med Sec, NATOUSA, 1943; (5) Clift, Field Opns, Comiso on D plus 4 completed the
pp. 180-86; (6) Unit rpts of div surgs, med bns, initial mission of the CENT Force.
and hosps mentioned in the text. The British side
of the story is in Crew, Army Medical Services: The medical complement of the CENT
Campaigns, vol. III. Force included the 120th Medical Bat-
SICILY AND THE MEDITERRANEAN ISLANDS 153
with a group of enemy bombers, and in Except for battalion medical detach-
the confusion a number of the troop ments and naval beach parties, the
carriers were shot down by U.S. fire. All landing of medical personnel and equip-
assault phase objectives were secured by ment on the Gela beaches was unduly
D plus 4, 14 July. delayed. One company of the 261st Am-
Medical battalions supporting the phibious Medical Battalion managed to
Gela operation, including both the land- set up a clearing station in support of
ing units and the reserve, were the 1st the 26th RCT some seven hours after
and elements of the 48th Armored, or- the assault began by using the equip-
ganic to the combat units; two collecting- ment of another company. The 1st Med-
clearing companies of the 51st; and the ical Battalion established a clearing sta-
261st Amphibious Medical Battalion, tion for the 16th RCT at H plus 13, but
initially attached to the 531st Engineer had no equipment other than one medi-
Shore Regiment as part of the beach cal chest. Casualties from this station
group. Supplementing these were two were evacuated to the beach by ambu-
platoons of the nth Field Hospital; lances of the 51st Medical Battalion, one
seven teams of the 2d Auxiliary Surgi- company of which was ashore but inop-
cal Group and three teams of the 3d; erative. The field hospital platoons
and two ambulance platoons of the 36th landed at H plus 6, but on the wrong
Ambulance Battalion. beaches. The invasion was in its fourth
SICILY AND THE MEDITERRANEAN ISLANDS 155
day before the hospital was functioning depth and all initial objectives were
at Gela. taken by D plus 2.
Casualties were relatively heavy on Medical units organic to the combat
the DIME beaches, where enemy coun- divisions were the 3d Medical Battalion
teraction was most violent. Some medi- and a company of the 48th Armored
cal equipment, including ambulances, Medical Battalion. Supporting these
was lost at sea and by enemy action on were the 56th Medical Battalion and a
the beach. The medical battalions were collecting-clearing company of the 51st;
nevertheless in normal operation by 12 the 10th Field Hospital; nine teams of
July. The 51st, reinforced by surgical the 3d Auxiliary Surgical Group; and
teams, held nontransportables until the a platoon of the 36th Ambulance Battal-
field hospital opened, while the 261st ion. As in the CENT and DIME landings,
cared for cases expected to return to duty medical detachments of Joss followed
within a week. Wherever possible, sur- their combat units ashore within two
gery was performed on the ships rather hours. Collecting companies were only
than in shore installations during the an hour or two behind. Casualties were
first two or three days, but all clearing brought directly to the naval beach in-
stations handled surgical cases when stallations until clearings stations could
evacuation from the beach was inter- be set up on D plus 1. Congestion on
rupted. The withdrawal of the trans- the beaches prevented earlier unloading
ports on 12 and 13 July halted evacua- of equipment. The field hospital also
tion in the DIME sector, but air opened on D plus 1. Troops in the Licata
evacuation from the Ponte Olivo field sector moved rapidly, and medical instal-
began on the 14th. A hospital ship was lations kept pace, leaving only elements
available the following day, and on 16 of the 56th Medical Battalion at the
July the 400-bed 93d Evacuation Hospi- beach to handle evacuation from the
tal opened near Ponte Olivo. (See Map island. By 15 July, when the 11th Evacu-
14.)
Licata Landings—The Joss Force, ation Hospital opened northwest of
Licata, a normal chain of evacuation was
functioning smoothly. (See Map 14.}
which had crossed the Strait of Sicily In all sectors the treatment of civilians
from Tunisian ports in LST's, made the wounded or injured as a result of the
first real shore-to-shore landing craft op- invasion was an acute problem. Local
eration, such as would later be used to hospital facilities were inadequate, even
cross the English Channel. Rough seas to care for routine illnesses, and in the
held up the landings until shortly before landing phase Seventh Army medical
dawn, and the low gradient of the supplies and beds could be spared to
beaches forced the craft aground too far treat only emergency cases.
from dry land. The assault troops never-
theless got ashore in good order against The Campaign in Western Sicily
only nominal opposition. The town fell
quickly, and before the first day was over By 16 July the U.S. Seventh and Brit-
strong combat patrols were 4 or 5 miles ish Eighth Armies had reached the line
inland. The beachhead was 15 miles in marking the end of the amphibious
156 MEDITERRANEAN AND MINOR THEATERS
EVACUATING WOUNDED TO LANDING CRAFT for return to transports, Gela area, 12 July.
phase, and 15th Army Group headquar- division being left in reserve in Africa.7
ters issued field orders for completing The 261st Amphibious Medical Bat-
the conquest of Sicily. Eighth Army was talion remained in the Gela area under
to drive up the eastern coast to Messina; army control to handle evacuation to
Seventh Army, which now numbered Tunis and Bizerte. The 54th Medical
about 142,000 troops, was to capture Battalion and a collecting-clearing com-
Palermo and reduce the western end of pany of the 51st were attached to II
the island. To accomplish this mission, Corps, while the 56th and two companies
II Corps was to strike north from Gela of the 51st went to the Provisional Corps.
with the 1st and 45th Divisions, while a Two platoons of the 11th Field Hospital
newly constituted Provisional Corps un- and the 93d and 15th Evacuation Hospi-
der General Keyes was to operate in the tals came under II Corps control, leaving
less rugged area northwest of Licata with the 10th Field, one platoon of the 11th
the 3d Infantry, 2d Armored, and 82d
Airborne Divisions, the last operating as 7
Military sources are the same as those already
infantry. The recently arrived 39th Reg- cited. Medical sources include: (1) Clift, Field
imental Combat Team of the 9th Divi- Opns, pp. 187-92; (2) Surg's rpts already cited at
the theater, army, and corps levels; (3) Unit rpts
sion was also attached to the Provisional of div surgs, med bns, hosps, and other med or-
Corps at this time, the remainder of the ganizations mentioned in the text.
SICILY AND THE MEDITERRANEAN ISLANDS 157
Field, and the 11th Evacuation Hospital Throughout this rapid movement,
to serve the three divisions under Keyes. medical installations had great difficulty
The surgical teams remained with the in keeping pace with the combat units.
field hospital platoons and clearing com- Organic medical battalions, by fre-
panies to which they were already at- quently changing position, managed to
tached. keep clearing stations in operation from
The Provisional Corps overran the 4 to 10 miles behind the constantly shift-
whole western end of Sicily in a week. ing points of contact with the enemy.
The enemy in this area fought only de- The hospitals and corps clearing sta-
laying actions, using reluctant Italian tions, however, were often left 25 to 50
troops to cover the withdrawal of Ger- miles in the rear of the action.
man units to the more mountainous The heterogeneous nature of the
northeastern sector, which provided forces involved also made it necessary
both suitable terrain for a defensive to use the corps medical battalions in
stand and an escape route to the Italian unorthodox ways. The 56th Medical
mainland by way of the Strait of Mes- Battalion left one collecting-clearing
sina. From Agrigento and Porto Em- company at Licata to serve as a holding
pedocle, some 25 miles west of Licata, unit for air evacuation. Another com-
the 3d Division struck northwest for pany of the 56th was attached to the
Palermo on the other side of the island, 3d Division, performing second-echelon
while the remainder of the corps fol- medical service for the 30th Regimental
lowed the southern coast to Castel- Combat Team. The battalion's third
vetrano. Here the 2d Armored veered collecting-clearing company went with
northeast to complete the envelopment the 82d Airborne around the western tip
of the capital, while the 82d Airborne, of Sicily to Trapani, using its own am-
the 39th Infantry, and the 3d Ranger bulances and captured enemy vehicles
Battalion continued around the coast to to make up for the transportation defi-
take the western ports of Marsala and ciencies inherent in paratroop medical
Trapani. detachments. On 21 July the 51st Med-
So rapid was the advance of the 2d ical Battalion established a clearing sta-
Armored, and so disorganized the oppo- tion at Menfi, on the southern line of
sition, that the division surgeon, Colonel march, and another at Castelvetrano,
Zehm, personally brought in eight pris- where the 3d Platoon of the 11th Field
oners who had surrendered when in- Hospital also went into operation the
timidated by the colonel's flashlight.8 the next day. By this time, however, the
Advance elements of the 2d Armored infantry spearhead was at Marsala thirty
entered Palermo late in the evening of miles farther west, while the 2d Armored
22 July, and accepted the peaceful sur- was closer to Palermo than it was to
render of the city. Combat teams of both Castelvetrano.
3d and 45th Divisions were already in The 10th Field Hospital shifted from
the outskirts. Licata to Agrigento on the 19th, where
it was joined the following day by the
8
Statement of Colonel Zehm to the author, 17 holding unit of the 56th Medical Battal-
Aug 55. ion from Licata. The 10th Field moved
158 MEDITERRANEAN AND MINOR THEATERS
Sicily, on 20 July, and established contact The Etna Line and Messina
with the Canadians on the right. Three
While the Americans swept over west-
days later the 1st was astride the Nicosia-
ern and central Sicily, the British were
Troina-Randazzo road, running east and
virtually stalled on the eastern coast
west about twenty miles inland. Nicosia
where Mt. Etna rose steeply from the
fell on the 28th and Cerami, less than
Catanian plain. The rugged northeastern
ten miles from Troina, on the 30th. Be-
corner of the island was ideally adapted
tween those two dates the 39th RCT of
to defense, with the escape port of Mes-
the 9th Division, recently withdrawn
sina protected by a series of strongly for-
from the now quiet western sector, was
tified positions in contracting arcs. By
attached to the 1st Division. By 31 July
the end of July, therefore, General Al-
II Corps had reached and passed the
exander abandoned his original strategy.
boundary originally assigned to Seventh
Seventh Army was ordered to fight its
Army.
way to Messina along the northern coast
Medical support for II Corps in this
road, and to a junction with Eighth
phase of the campaign followed a nor-
Army along the Troina-Randazzo road,
mal, if accelerated, pattern. In hill fight-
which skirted the northern slopes of the
ing aid stations were kept from 100 to
classical volcano. The key to the Etna
300 yards behind the troops; on open
Line was Troina, a natural fortress-city
ground they were 500 to 1,000 yards be-
built of stone on top of a rocky hill.
hind. The organic battalions were almost
The 1st Division, with the 39th RCT
continuously in motion, backed by the
of the 9th, launched an assault against
corps battalion whose collecting-clearing
the position on 1 August, while the 3d
companies bypassed each other to keep
Division relieved the 45th near San Stef-
within 10 miles of the front. Hospital
ano and prepared to attack the coastal
units moved less frequently, but in ac-
anchor of the German line. The British
cordance with the same leapfrog pattern.
hammered simultaneously at the right
The 11th Field opened at Pietraperzia 9
flank between Mt. Etna and the sea.
in the center of the front and perhaps
The battle of Troina, lasting until 6
a third of the way across the island on
August, was the most bitterly contested
18 July. Two days later the 15th Evac-
of the campaign. Before it was over
uation was receiving patients at Caltanis-
twenty-four separate counterattacks had
setta, 10 miles farther north. July 22 been repulsed. The remaining regi-
saw a platoon of the nth Field in op-
ments of the 9th Division were brought
eration 15 miles beyond Caltanissetta.
up early in the battle, with the 60th com-
The 93d Evacuation opened at Petralia
bat team executing a wide flanking
on the Nicosia road on 25 July, while
movement to threaten the enemy's rear
the 11th Field moved on to Collesano,
and the 47th leading the advance
less than 10 miles from the sea, the fol-
through the battered town to the next
lowing day. (See Map 15.) The 128th
objective. Both 1st and 9th Divisions
Evacuation Hospital collected its scat- were slowed by difficult terrain and ex-
tered equipment and personnel in time
to open at Cefalii on 31 July. 9
See sources cited n. 7, p. 156, above.
160 MEDITERRANEAN AND MINOR THEATERS
platoons of the nth Field Hospital dis- of 300 to 400 yards to relay casualties
placed one another forward to Cesarò back to the stations. Mules requisitioned
and Randazzo. (Map 77) The 54th Med- from local farmers were also used to
ical Battalion and one company of the carry litters, both in tandem between
51st operated along the same line of ad- lance poles, as had been done in Tunisia,
vance, clearing platoons being used dur- and by a device similar to the French ca-
ing the battle of Troina to augment the colet whereby one mule carried two lit-
facilities of the evacuation hospitals. ters. Neither method was fully satisfac-
For the most part aid stations in the tory but the cacolet was considerably less
Troina sector were within 400 to 800 so than the tandem. The care and man-
yards of the fighting and accessible to agement of the animals fell to the 9th
vehicles, though roads were often under Division veterinarian and his assistants.
enemy fire. Only the 60th Regimental The 47th RCT, operating east of Troina,
Combat Team, circling the left flank had hand carries up to four miles,
over roadless mountains, experienced mainly because road demolitions pre-
unusual difficulty in evacuation. Corps vented the use of vehicles.
medical battalions supplied eighty addi- Along the narrow and precipitous
tional litter bearers, while thirty more north coast road, the 3d Division was
came from noncombat divisional units. fighting what Ernie Pyle called a "bull-
Litter squads were stationed at intervals dozer campaign," the pace of the ad-
162 MEDITERRANEAN AND MINOR THEATERS
vance being limited by the speed with hours by 50 bearers in relays. Corps sup-
which the engineers could repair the plied 40 additional litter bearers, and
damage done by German demolitions. Italian and Czechoslovak prisoners were
In this final drive the division was ma- also used. Some slightly wounded men
terially aided by a provisional mounted were evacuated sitting on pack mules.
troop and a provisional mule pack train. The long litter carries were stopped
In the two weeks between 3 and 16 Au- when Colonel Churchill, the theater
gust, 219 horses and 487 mules were surgical consultant, concluded that the
used, of which 43 percent were listed as wounded suffered more from the journey
battle casualties. The animals were ac- than they would have by waiting. The
quired by capture, requisition, and con- last 52 casualties brought down from the
fiscation. Despite inexperienced handl- ridge were left for 24 to 48 hours in the
ers and improvised equipment, the aid stations, while bulldozers cleared a
expedient was credited by General road for the ambulances.12
Truscott, himself a former cavalry offi- The two amphibious landings in the
cer, with speeding the advance and re- 3d Division sector, both made by the 2d
ducing losses. The division veterinarian, Battalion of the 30th Infantry, were sup-
Maj. Samuel L. Saylor, was responsible ported by personnel of the battalion med-
for care and provisioning of the animals, ical detachment, reinforced by medical
and helped train personnel to manage and surgical technicians from the 54th
them.11 Medical Battalion. In the Brolo opera-
The 3d Division received medical tion of 11 August, where the landing
support from the 10th Field Hospital, force was ambushed by the Germans,
whose platoons leapfrogged one another a medical corpsman was killed and five
from Cefalii to Barcellona, and from one wounded in action. The American
platoon of the nth Field. The 93d Evac- wounded were treated by German doc-
uation Hospital moved to San Stefano tors and left behind to be picked up by
on 7 August, and a week later the 11th their own organizations when the enemy
Evacuation shifted from Nicosia to a po- withdrew the next day.
sition between San Fratello and Brolo.
On the latter date, 14 August, the 128th
Evacuation displaced half of its facilities Hospitalization and Evacuation
and staff from Cefalii to Coronia some
8 miles east of San Stefano. (See Map
17) Hospitalization in the
The most difficult evacuation problem Combat Zone
encountered by the 3d Division was dur-
ing the battle for San Fratello Ridge, Hospitalization in the Sicily campaign
where litter carries took from 5 to 7 showed marked improvement over prac-
hours. One patient was carried for 9
11 12
(1) Truscott, Command Missions, p. 230; (2)Ltr, Col Churchill, Surgical Consultant, to
Vet Rpts, Sick and Wounded, Animals, 1943, 3d Surg, NATOUSA, 19 Aug 43, sub: Tour Rpt,
Div. Sicily, D + 2 4 to D+35.
SICILY AND THE MEDITERRANEAN ISLANDS 16.8
tices in Tunisia, even though preinvasion tive treatment in these units. As soon as
plans were not always carried out to the a patient needing further care could be
letter. With occasional exceptions result- safely moved, he was sent back to the
ing from rapid movement of the troops, nearest evacuation hospital. Patients still
each division clearing station under com- immobilized when a field hospital unit
bat conditions had at least one field hos- was ordered forward were left in charge
pital unit adjacent to it and a 400-bed of a small detachment that rejoined the
evacuation hospital within easy ambu- parent unit as soon as all of its patients
lance haul. Cases that could not stand had been evacuated. Transportable cases
the strain of further transportation went at the division clearing stations, includ-
to the field hospitals, where surgery was ing most cases of disease, were sent
performed as required by attached surgi- directly to the evacuation hospitals,
cal teams. A majority of all those seri- where they were held for treatment or
ously wounded in Sicily received defini- evacuated to the North African com-
164 MEDITERRANEAN AND MINOR THEATERS
of civilian hospitals and other medical proximately 100 enemy medical enlisted
installations. The 304th Field Hospital, men and a similar number of prisoners—
captured on 30 July at Mistretta, had all Italian—from among line troops,
400 beds, 60 of them occupied, and a were used to augment the staffs of II
staff of 8 officers and 46 enlisted men. Corps hospitals, while others were at-
Located in buildings, the hospital con- tached to the two evacuation hospitals
tinued in operation under U.S. super- in Palermo.
vision. A larger Italian hospital, the
10th Reserve, was taken near Barcellona Evacuation
on 15 August with 47 officers, 143 enlisted
men, and 522 patients. This unit was in Evacuation within Sicily was con-
the area assigned for occupation by the trolled by the Seventh Army surgeon,
British, and reverted almost immedi- who also arranged with the proper au-
ately to British control. In addition to thorities for evacuation from the island.
personnel of captured hospitals, large Hospital ships and carriers were under
numbers of enemy medical personnel control of Allied Force Headquarters,
were captured with the field troops. Ap- and air evacuation was the responsibility
SICILY AND THE MEDITERRANEAN ISLANDS 167
of the Surgeon, North African Air Force early casualties to Tunisian ports, many
Troop Carrier Command.15 were carried to Algiers where base sec-
Lines of evacuation shifted with the tion facilities were inadequate to care
progress of the campaign. Until late for them.16 Air evacuation began from
July the bulk of those destined for the fields around Gela and Licata on 14 July,
communications zone were carried by but was unorganized, with both U.S. and
ambulance and truck to evacuation hos- British planes participating as they hap-
pitals on the south coast. The 93d Evac- pened to be available. Approximately
uation served II Corps at Gela until 21 100 casualties were flown out in this way,
July, while the 11th Evacuation, at Li- without medical attendants, before the
cata until 20 July and at Agrigento 802d Medical Air Evacuation Transport
between 22 July and 4 August, served Squadron took over on 16 July. Evacua-
the Provisional Corps. After 21 July, II tion by hospital ship began from Gela on
Corps casualties also cleared through the 15 July, from Scoglitti the following day,
11th, by way of a rough 4-hour ambu- and from Licata on the 17th. Air evacua-
lance run from the 15th Evacuation at tion began from Agrigento on 23 July,
Caltanissetta. Soon after the capture of and one load was flown from Castelve-
Palermo, that city became the focal trano on the 24th. As the campaign
point for evacuation to Africa, and II shifted to the northeast, Palermo and
Corps casualties were moved north from Termini became the principal evacua-
Nicosia to enter a coastal chain of evacu- tion centers. Air evacuation began from
ation. A captured Italian hospital train, Palermo on 27 July, and sea evacuation
staffed by U.S. medical personnel, began two days later, when the port was
running from Cefalii to Palermo on1 cleared. Air evacuation from Termini
August, the 128th Evacuation Hospital began 5 August. One planeload of pa-
at Cefalii serving as holding unit. The tients was flown to Africa direct from
system worked smoothly, despite a con- San Stefano.
tinuous shortage of ambulances and Between 10 July and 20 August a
often badly damaged roads. total of 5,391 patients were evacuated
Evacuation from Sicily to North Af- by sea and 5,967 by air—11,358 all told.17
rica was fairly evenly divided between Sea evacuation was by two American
sea and air. For the first four days of the and three British hospital ships, with
campaign all evacuation was by return-
ing troop carriers and LST's. Although 16
Surg, NATOUSA, Journal, 16 July 1943. See
plans called for the delivery of all these also p. 196, below.
17
The figures are from the 1943 annual reports
of the Surgeon, Seventh Army, and the Surgeon,
15
The main sources for this section are: (1) Rpt NATOUSA. Medical History, 802d MAETS, gives
of Opns, U.S. Seventh Army in Sicilian Campaign, 6,170 for air evacuation, a figure that presumably
an. N; (2) Surg, II Corps, Rpt of Med Activities, includes Air Forces personnel and possibly some
Sicilian Campaign; (3) Annual Rpt, 54th Med Bn, Allied personnel and civilians, none of whom are
1943; (4) Annual Rpt, Med Sec, NATOUSA, 1943; included by the Seventh Army surgeon. Colonel
(5) Annual Rpt, 91st Evac Hosp, 1943; (6) ETMD, Elvins, Air Surgeon, Twelfth Air Force, in Report
NATOUSA, Jul 43; (7) Clift, Field Opns, pp. 195- of Air Evacuation, 12 September 1943, gives 5,819
97; (8) Col Criswell G. Blakeney, ed., Logistical through 21 August. In relation to the total, these
History of NATOUSA-MTOUSA (Naples: G. Mon- variations seem too minor to justify rejecting the
tanino, 1945), passim. official Army figure.
168 MEDITERRANEAN AND MINOR THEATERS
capacities ranging from 370 to 800 pa- planes and arrival times, supervised
tients; and five British hospital carriers, loading, and provided attendants includ-
each capable of moving between 350 and ing nurses for each flight. These attend-
400 patients. The larger ships were used ants were flown back to Sicily by Troop
to evacuate only from Palermo, where Carrier Command, but litters, blankets,
the harbor was deep enough to accom- and splints for property exchange came
modate them. Even in Palermo, how- by ship. Most of the patients flown to
ever, the condition of the docks did not Africa were landed at Mateur, but a few
permit direct loading. The U.S. vessels, were routed to fields around Tunis.
Acadia and Seminole, carried no water Where an evacuation hospital was close
ambulances. Litters were individually to the airfield, as at Palermo, the more
winched aboard from smaller craft in serious cases were moved direct from
rhythm with the waves. By early Au- hospital to plane, with only the walking
gust a regular schedule was in effect, a and less urgent cases passing through
ship arriving in Palermo harbor at dawn the holding unit.
every other day. For the most part Amer-
ican patients were routed to Bizerte, Medical Supplies and Equipment
but at least one load was diverted to
Oran and one load of 125 patients went While shortages of particular items oc-
to Tunis. The British hospital carriers, curred and there were occasional delays,
because of their shallow draft, were pre- medical supplies presented no serious
ferred for evacuation from beaches and problems in the Sicily Campaign. Ap-
small harbors. Each carried six water proximately no dead-weight tons of
ambulances, which could be lifted to the medical supplies were landed on the
deck for unloading.18 beaches between D-day and D plus 2.
Air evacuation from Sicily followed These initial supply loads consisted of
the pattern developed in Tunisia, but combat medical maintenance units,
was more highly organized. Medical au- heavily augmented by items that experi-
thorities were notified in advance ap- ence in North Africa had shown to be
proximately when each new airfield required. Supplies not carried ashore by
would be usable, so that a holding hos- personnel of the medical units to which
pital could be set up. Personnel of the they belonged were unloaded wherever
802d MAETS stationed at the fields room to put them could be found. They
passed on information as to available were picked up by the beach group,
which issued them as needed until medi-
18
(1) ETMD, NATO, for Jul 43, 11 Aug 43. (2) cal supply depot personnel came
Edith A. Aynes, "The Hospital Ship Acadia," Amer- 19
ican Journal of Nursing, XLIV, (February 1944),
ashore.
98-100. The carrier had a draft of only fourteen In the landing phase a lack of co-ordi-
feet compared with twenty-five feet for the hos-
19
pital ship. Although Oran was included as a port Principal sources for this section are: (1) Rpt
of debarkation for patients in the original planning, of Opns, U.S. Seventh Army in Sicilian Campaign,
it was quickly abandoned in favor of the shorter an. N; (2) Surg, II Corps, Rpt of Med Activities,
route to Bizerte. See: (3) Ltr, Col William C. Sicilian Campaign; (3) Rpt of Med Supply Ac-
Munly (Ret) to Col Coates, 7 Nov 58, commenting tivities, NATOUSA, Nov 42-Nov 43; app. K; (4)
on preliminary draft of this volume; (4) Ltr, Col Davidson, Med Supply in MTOUSA, pp. 30-41; (5)
Bauchspies to Col Coates, 15 Apr 59. Clift, Field Opns pp. 197-98.
SICILY AND THE MEDITERRANEAN ISLANDS 169
nation was evident. Some of the LST's Depot went ashore at Licata with the
did not carry litters, blankets and splints Joss Force on D plus 2; the 1st Advance
as called for in the medical plans for Section of the 2d Medical Supply Depot
the operation, while other landing craft landed at Gela with the CENT Force the
returned to their African bases without following day.
leaving their supplies of these items on The detachment of the 4th Medical
the beaches. In the Scoglitti area med- Supply Depot established a distribution
ical supplies dumped on the beaches point at Licata, then on 27 July set up
were so widely scattered that collecting a base depot for the island at Palermo.
them was a slow and difficult process. On 30 July an advance dump to serve the
About 10 percent of the initial medical 3d Division fighting along the northern
supply load was lost due to enemy action, coast road was set up in Cefalii, the
while supplies on the follow-up convoys Licata dump being closed on 1 August.
were poorly packed. Many boxes were The Cefalù dump remained in operation
only half filled and padded with straw; until 25 August, a week after the end of
there was undue breakage of bottles; and hostilities.
some 20 percent of the packing lists did The 1st Advance Section of the 2d
not agree with the contents of the boxes Medical Supply Depot established its
they accompanied. first distribution point at Gela, stocked
Supplies, nevertheless, proved gen- with supplies collected from the beach
erally adequate, even in the early stages group and from the beaches themselves,
of the campaign, thanks to careful plan- where boxes had been dumped as they
ning and advance requisitioning. Medi- were taken from the ships. Trucks used
cal supplies and equipment estimated to were borrowed from the 1st Medical Bat-
be adequate for current maintenance talion, since the supply depot's own ve-
plus a go-day reserve were ordered hicles were not yet unloaded. A forward
months in advance of the assault and issue point was set up at Caltanissetta on
were delivered in batches by the succes- 21 July in a captured Italian medical de-
sive follow-up convoys. Immediate short- pot. A small dump was also operated by
ages of such items as tincture of opium, this unit at Agrigento between 22 July
hydrogen peroxide, litters, and cots were and 31 July. Personnel from Agrigento
quickly overcome by emergency requisi- established an advance depot at Nicosia
tions on base depots in North Africa, on 2 August, where they were joined on
deliveries being made by air if the need 12 August by personnel of the Gela
was urgent. The only articles that could depot, which was closed at that time.
not be immediately procured were items Personnel of the Caltanissetta depot also
of replacement equipment and certain moved to Nicosia early in August, leav-
equipment items over and above those ing one officer and three enlisted men to
normally allowed, which had been au- operate the Italian depot until it could
thorized but could not be procured be- be transferred to the Allied Military
fore leaving Africa. Government organization. The Nicosia
Two supply depot units distributed depot remained in operation until 27
medical supplies in Sicily. An advance August.
detachment of the 4th Medical Supply The Licata depot was reopened on 24
170 MEDITERRANEAN AND MINOR THEATERS
August by personnel of the 1st Advance sis of Tunisian experience and a full
Section, 2d Medical Supply Depot, and explanation of the preferred procedure
operated until 21 October, serving evac- in a circular letter from the theater sur-
uation hospitals and troops bivouacked geon a month before the invasion, how-
in the area. All personnel of the 2d Med- ever, various difficulties were still en-
ical Supply Depot in Sicily then moved countered. Field hospital commanders
to Palermo, relieving the advance detach- were reluctant to undertake dispersed
ment of the 4th for service in Italy. operation by platoons, and were gener-
In the course of the campaign, 365 ally unfamiliar with the technique of
tons of medical supplies and 60 tons of functioning in that manner. There was
field hospital equipment were captured. also some resistance to accepting the at-
This material was used to resupply civil- tachment of surgical teams, as implying
ian, Red Cross, and captured military some degree of reflection on the compe-
hospitals. tence of the regular hospital staff.20
As a result, the auxiliary teams were
Professional Services not used as effectively as they might have
been. Many teams continued to work in
Combat Medicine and Surgery clearing stations, where they were handi-
capped as they had been in Tunisia by
While the problems encountered by lack of equipment and absence of facili-
the Medical Department in Sicily were ties for postoperative care. Still other
in some respects merely an extension of teams were required to work in the 400-
those already familiar in Tunisia, in bed evacuation hospitals, because these
other respects they were unique. Lack of units were not adequately staffed in the
sanitation, scarcity of potable water, a subspecialties. This diversion of surgical
vermin-infested and undernourished teams was a direct consequence of the
population, and inhospitable terrain failure to get 750-bed evacuation hos-
were an old story to American medical pitals to the island in time to carry a
personnel by the summer of 1943, but share of the combat load. Another prob-
the problems of a large-scale amphibious lem arose from the fact that many of the
operation and the hazards of the malaria surgical teams employed, as well as the
season were new. Sicily was at once a field hospitals themselves, had little or no
proving ground for the lessons learned previous combat experience, and sur-
in Africa and a dress rehearsal for Italy.
20
Sources for this section are: (1) Annual Rpt,
Front-Line Surgery—In the Sicily Cam- Med Sec, NATOUSA, 1943; (2) Surg, NATOUSA,
Cir Ltr No. 18, 14 Jun 43, sub: Forward Surgery
paign organization and facilities for and Aux Surg Teams; (3) Surg, II Corps, Cir Ltr
front-line surgery were greatly improved No. 3, 7 Aug 43, sub: Care of the Wounded in
over those of the Tunisia Campaign. Sicily; (4) Memo, Churchill to Surg, NATOUSA,
5 Sep 43, sub: Use of Field Hosps in Forward
The most important single development Surgery; (5) Ltr, Col Long to Surg, NATOUSA,
was the use of field hospital platoons, 26 Aug 43, sub: Random Observations from EBS
with attached surgical teams, for treat- and Sicily, July 6th to August 14th 1943; (6) An-
nual Rpt, 2d Aux Surg Gp, 1943; (7) Clifford L.
ment of nontransportable casualties in Graves, Front Line Surgeons (San Diego [privately
the division area. Despite careful analy- printed] 1950), pp. 86-87.
SICILY AND THE MEDITERRANEAN ISLANDS 171
geons were unfamiliar with general poli- ing psychiatric reactions in the combat
cies as to the management of wounds. zone was the policy laid down for Sicily.21
In addition to the employment of field In the early stages of the campaign, how-
hospital platoons as forward surgical ever, owing to the normal confusion con-
units, extensive use was made of surgical sequent upon rapid movement, many
consultants during the campaign. II cases did not go through the evacuation
22
Corps had the services of its own surgical hospitals for triage but were evacuated
consultant, Major Snyder, detached from to North Africa from the clearing sta-
the 77th Evacuation Hospital, while tions with no treatment except sedation.
Colonel Churchill, the theater consultant Of those that did reach the evacua-
in surgery, served unofficially in a similar tion hospitals, many had been three or
capacity with Seventh Army. Colonel four days in getting there, a delay that
Churchill spent more than half of his served only to fix the symptoms and
time in Sicily during the period of active make treatment more difficult. As a re-
hostilities. 21
Surg, NATOUSA, Cir Ltr No. 17, 12 Jun 43, sub:
Neuropsychiatric Treatment in the Combat Zone.
22
Triage is the process of sorting casualties by
Neuropsychiatric Reactions—The basic type of wound or disease and by urgency. See pp.
principle worked out in Tunisia of treat- 3-4, above.
172 MEDITERRANEAN AND MINOR THEATERS
were placed on detached service with the Medical Support in the Seizure of
9th Division to catch up on general oper- Sardinia and Corsica
ative work, particularly in the division
artillery, which was too large to be ade- The island of Sardinia had been de-
quately cared for by the single dental liberately bypassed in planning Mediter-
officer assigned. The 1st Division at this ranean operations, and the threat it had
time set up its own prosthetic clinic and once held against Allied supply lines had
laboratory in conjunction with the divi- been largely neutralized by the conquest
sion clearing station. In September per- of Sicily. The invasion of Italy by the
sonnel and facilities for carrying on British Eighth Army on 2 September,
prosthetic work were installed in the 91st and the Salerno landings a week later,
Evacuation Hospital at Palermo.29 once more changed the picture. Once
As had been the case in Tunisia, den- substantial forces were committed to a
tal officers and enlisted men performed campaign in Italy, the strategic positions
numerous nonprofessional functions dur- of both Sardinia and Corsica could not
ing combat operations, when conditions be overlooked.
made it impossible to carry on dental The fact that no American or British
work. ground forces were available proved no
barrier to conquest. With the Italian
Veterinary Service Fleet no longer at their disposal, the
German garrison on Sardinia was virtu-
Two veterinary food inspection de- ally isolated. The two Italian divisions
tachments accompanied Seventh Army to on the island needed only a minimum of
Sicily, performing routine inspections of naval support to rout their former Axis
rations and of captured food supplies. partners, and within ten days of the
One detachment operated a cold storage Salerno landings the Germans had fled to
and refrigeration plant in Palermo dur- Corsica. In a parallel movement directed
ing the latter part of the campaign. Care from Algiers, the French underground
of animals was a function of the veteri- on Corsica seized the island capital of
nary service at the division level, pri- Ajaccio three hours after word of the
marily in the 3d Division, which boasted Italian surrender—announced the night
both a provisional cavalry troop and a of 8 September—was received. In Corsica
provisional pack train, and in the 9th the Germans made a more determined
Division where mules were used to carry stand, but the 80,000 Italian troops
supplies and to evacuate wounded. No quickly surrendered while French rein-
hospital facilities for animals were avail- forcements were brought in from Africa.
able.30 With the aid of Allied sea and air power,
the last German had been expelled by 5
October.31
29
(1) Annual Rpt, Surg, 9th Div, 1943. (2) An-
nual Rpt, Surg, 1st Div, 1943. (3) MS, Dental His-
31
tory, MTO. (1) Lt. (jg) S. Peter Karlow, USNR, Notes on
30
(1) Med Hist, 3d Div, 1943. (2) Annual Rpt, Corsica, OSS Rpt, 15 Nov 43, Navy: S. E. Morison
Surg, 9th Div, 1943. (3) MS, Veterinary History, file. (2) Lt. Harold Wright, USMCR, "The Trojan
MTO. Sea Horse," Sea Power (April 1946).
SICILY AND THE MEDITERRANEAN ISLANDS 175
No Army medical units took part in the 60th Station Hospital was loaded on
the seizure of Sardinia or Corsica, both trucks, which were driven onto LST's,
operations being confined, so far as U.S. ferried to Cagliari on the southern end
troops were concerned, to Air Forces per- of Sardinia, and before unloading were
sonnel. The first hospitals to move into moved directly to the modern Italian
these islands were therefore assigned to hospital building that was to house the
the Army Air Forces. The hospitals ini- 60th. Nurses were flown to Cagliari in
tially selected were the 60th Station, a combat planes, the rest of the personnel
250-bed unit that had been operating at going with the equipment by LST. The
Tunis since July, and the 15th Field, re- hospital opened with 500 beds—double
32
called from the Middle East. its Table of Organization capacity—on 3
In the interest of speed, equipment of November 1943.
The 15th Field Hospital was somewhat
32
For details of the assignment of hospitals to later in getting into operation. The 2d
the Air Forces, see p. 182, below. The remainder Platoon opened 100 beds at Bastia, on
of this section is based on: (1) Med Hist, the east coast of the Corsican panhandle,
Twelfth Air Force, 1942-44; (2) Annual Rpt, 60th
Sta Hosp, 1943; (3) Annual Rpt, 15th Field Hosp,
on 1 December; the 3d was established
1943. near Alghero in northwestern Sardinia
176 MEDITERRANEAN AND MINOR THEATERS
on the 13th of that month. The 1st Pla- receive patients at Ajaccio until 19 Jan-
toon, which lost most of its equipment uary 1944, after a base section had been
33
when the LST carrying it was beached established on the island.
due to enemy action, was not ready to 33
See p. 199, below.
CHAPTER V
the need for an American base closer to for an invasion of southern France were
the Tunisian combat zone. The EBS sur- being drawn up at Seventh Army's new
geon was Lt. Col. (later Col.) William headquarters in Algiers, and Corsica, by
L. Spaulding, whose original staff con- accident of geography, assumed more im-
sisted of five officers and seven enlisted portance in Allied strategy. A Northern
men drawn from MBS and ABS. With Base Section (NORBS), confined to that
the extension of the war in the Mediter- island, was accordingly established on1
ranean, the Eastern Base Section became January 1944. The NORBS surgeon was
the largest and most important of the Lt. Col. (later Col.) Albert H. Robin-
three by virtue of its greater proximity son, formerly deputy surgeon of ABS.12
to Sicily and Italy, and a man of more The base section surgeons were re-
rank and experience than Spaulding then sponsible to the base section command-
possessed seemed needed. Col. Myron P. ers, but their policies were determined
Rudolph, the man General Blesse se- and their work supervised by the theater
lected for the job, became EBS surgeon surgeon, and their offices were generally
in July 1943. Headquarters was moved organized along a line closely paralleling
to Mateur immediately after the end of the organization of the NATOUSA
the Tunisia Campaign, and to Bizerte in medical section. Only in their medical
August.10 supply activities, which were directly
As of 6 October 1943, the boundaries under the Services of Supply, were they
of the various base sections were shifted exempt from control by the theater sur-
to conform to territorial borders, ABS geon, and even here close co-ordination
being made contiguous with French existed.
Morocco, MBS with Algeria, and EBS
with Tunisia. Air Forces Medical Organization
On 1 September 1943, two weeks after
the successful conclusion of the Sicily The Army Air Forces in the Mediter-
Campaign, an Island Base Section (IBS) ranean had its own medical organization,
was activated at Palermo. Like the base distinct from that of the theater but op-
sections in Africa, IBS was responsible to erating in harmony with it. Col. Elvins,
NATOUSA. Its medical section was surgeon of the Twelfth Air Force, set up
headed by Lt. Col. (later Col.) Lewis W. his office at Tafaraoui airfield near Oran
Kirkman, who had come direct from the two days after the Center Task Force
zone of interior. Boundaries were drawn landings, moving to Algiers on 19 No-
to include only those portions of Sicily vember 1942. Under Colonel Elvins, in
still being used by U.S. forces: the addition to his own headquarters, were
Palermo-Termini area, the Agrigento- medical sections for the Bomber Com-
Porto Empedocle area, Licata, and mand, the Fighter Command, the Air
Caltanisetta.11 Service Command, and the Troop Car-
By the end of 1943, preliminary plans rier Wing. Medical supply and veteri-
10
nary (food inspection) functions were
(1) Annual Rpt, Med Sec, EBS, 1943. (2) Surg,
NATOUSA, Journal, 12, 16, 17 Jul 43.
11 12
Annual Rpt, Med Sec, NATOUSA, 1943. No (1) Annual Rpt, Med Sec, NATOUSA, 1944.
reports of the IBS itself have been located. (2) Annual Rpt, Med Sec, NORBS, 1944.
182 MEDITERRANEAN AND MINOR THEATERS
under the Air Service Command, which ly to the Air Forces as the Mediterranean
had subheadquarters, each with a small campaign expanded. Air bases were often
medical section, at Casablanca, Oran, remote from hospitals located near con-
and Constantine.13 centrations of ground troops, yet Air
A reorganization in December 1942 Forces personnel were no less subject to
merged the Twelfth Air Force with Brit- disease and suffered casualties commen-
ish and French air units to form the surate with an increasing tempo of activ-
Northwest African Air Forces (NAAF) , ity. It was therefore agreed in October
but the medical organization remained 1943 between General Blesse and Colo-
substantially unchanged. The Twelfth nel Elvins that fixed hospitals should be
Air Force again became a separate unit attached to Air Forces units operating in
just before the invasion of Italy in Sep- southern Italy and from the newly oc-
tember 1943, though it continued to be cupied islands of Sardinia and Corsica.
under the operational control of the
NAAF. After capture of the great Foggia Hospitalization in the
air base in southern Italy in early Octo- Communications Zone
ber, the Twelfth was reconstituted as a
tactical force and a new heavy-bomber While the North African campaign
group, the Fifteenth United States Air was still in the planning stage, The Sur-
Force, was activated. Both forces were geon General had recommended a fixed-
subordinated to a new U.S. air command bed ratio of 12 percent of troop
at the theater level—the Army Air Forces, strength, on the basis of World War I
Mediterranean Theater of Operations— experience. British experts on military
in January 1944. An Air Service medicine believed 6 percent would be
Command, Mediterranean Theater of adequate in terms of their own combat
Operations, was established at the same experience up to that date. Colonel Cor-
time, and both were brought under con- by asked for fixed beds for 10 percent
trol of the Mediterranean Allied Air of the command, with a minimum ratio
Forces, which superseded the NAAF. of 8 percent. The British basis was
Headquarters of all major U.S. air units adopted, with many misgivings, simply
except the North African Wing of the because it was believed that shipping
Air Transport Command were in Italy space for more beds would not be avail-
by this time.14 able.15
Experience in North Africa, where Air
Forces personnel were dependent on base Hospitalization During the Tunisia
section installations for fixed hospitaliza- Campaign
tion, demonstrated a need for attaching
a minimum number of fixed beds direct- Fighting incidental to the landings in
North Africa was over and the build-up
13
(1) Hist, Twelfth Air Force Med Sec, 1942-44.
15
(2) Link and Coleman, Medical Support of the (1) Ltr, Col Corby to Gen Cowell, 1 Jan 43.
Army Air Forces in World War II, ch. VI. (2) Zelen, Hospitalization and Evacuation in
14
Air Forces medical organization subsequent to MTOUSA, pp. 10, 21. For more detailed discussion
January 1944 is treated in connection with the of bed ratios, see Smith, Hospitalization and
Italian communications zone. See pp. 326-27, below. Evacuation, Zone of Interior, pp. 215-18.
THE NORTH AFRICAN COMMUNICATIONS ZONE 183
for the campaign in Tunisia was well pleted in February for a 25-bed provi-
under way before any fixed hospitals ar- sional hospital at Marrakech to serve Air
rived in the theater. With the single ex- Forces units stationed in that vicinity,
ception of the 48th Surgical, attached to although the hospital did not open until
the Center Task Force, even the mobile 15 March. The Marrakech hospital oc-
units arrived too late to be used in the cupied one wing of a French hospital
assault phase and were therefore em- building. It was initially staffed by a
ployed initially as fixed hospitals.16 team of the 2d Auxiliary Surgical Group,
Atlantic Base Section—Remote as it withdrawn at that time from Safi, but
was from the combat zone, the Atlantic was taken over in June by a detachment
Base Section was the first to achieve rel- from the 56th Station Hospital, supple-
ative stability in its hospital program. mented as occasion required by person-
For the most part hospitals were sited in nel on temporary duty from the 6th
existing buildings and remained in place General Hospital. Early in August 1944
for considerable periods of time. Casual- the Marrakech unit was redesignated the
ties received were mainly cases evacuated 370th Station Hospital.
from other base sections for further treat- The 69th Station Hospital began op-
ment, or en route to the zone of in- erating 500 beds at Casablanca on 28
terior.17 March, in school and dispensary build-
When ABS took over responsibility ings. A month later, on 29 April, the
from the Western Task Force at the end 1,000-bed 45th General opened in Rab-
of 1942 there were three evacuation hos- at, taking over the quarters previously
pitals functioning in the area as fixed occupied by the 51st Station. In antici-
units, with an aggregate T/O strength of pation of the shift, the 51st had moved
1,900 beds. A minimum number of addi- into various structures connected with a
tional beds, probably not exceeding 25, racetrack on the outskirts of the city that
were available in a provisional hospital had just been vacated by the nth Evac-
at Safi. Another 400-bed evacuation hos- uation Hospital. The 51st Station re-
pital, the 11th, and the 51st Station Hos- mained until 17 August, while the 45th
pital with 250 beds, were in the area but General continued to receive patients
not yet operating. (Map 18) until 15 November.
The 51st Station Hospital went into The last group of fixed hospitals to
operation in Rabat on 31 January 1943, be established in ABS began operating
while the 6th General, with 1,000 beds, early in May 1943, coinciding with the
arrived in Casablanca on 20 February final phase of the Tunisia Campaign.
and opened in that city a week later. The 50th Station, with 250 beds, opened
Both of these hospitals occupied school in Casablanca on 5 May in tents and
buildings. Arrangements were also com- hastily constructed temporary buildings.
The 23d Station, brought by air from
16
the Belgian Congo, opened 250 beds
Seepp. 119-20, above. under canvas at Port-Lyautey on 9 May,
17
Major sources for this section are: (1) An- expanding to 500 beds late in July. The
nual Rpt, Med Sec, ABS, 1943; (2) Annual Rpt,
Med Sec, NATOUSA, 1943; (3) Unit Rpts of hosps 250-bed 66th Station began operating at
and other med installations mentioned in the text. Casablanca on 12 May, in the buildings
MAP 18—Fixed Hospitals and Base Medical Supply
38th Evacuation (as station), St. Cloud, 13 No- 16th Evacuation (as station), Ste. Barbe-du-Tlelat,
vember 1942-6 February 1943. 750 beds. 23 May-8 August 1943. 750 beds.
151st Station, La Senia, 25 November 1942-31 95th Evacuation (as station), Ain et Turk, 6
May 1944. 250 beds. July-16 August 1943. 400 beds.
7th Station, Oran, 1 December 1942-31 July 69th Station, Assi Bou Nif, 30 September 1943-
1944. 750 beds. 16 September 1944. 500 beds.
180th Station, Ste. Barbe-du-Tlelat, 7 December 23d Station, Assi Bou Nif, 4 October 1943-28
1942-30 September 1943; Bouisseville, 1 Oc- August 1944. 500 beds.
tober 1943-15 April 1944. 250/500 beds. 51st Station, Assi Bou Nif, 28 October 1943-15
64th Station, Sidi Bel Abbes, 28 December 1942- April 1944. 250 beds.
31 May 1944. 250 beds. 43d General, Assi Bou Nif, 31 October 1943-
21st General, Sidi Bou Hanifia, 29 December 15 June 1944. 1,000 beds.
1942-30 November 1943. 1,000 beds. 70th General, Assi Bou Nif, 31 October 1943-
12th General, Ain et Turk, 14 January-3 De- 27 October 1944. 1,000/1,500 beds.
cember 1943. 1,000 beds. 46th General, Assi Bou Nif, 4 November 1943-
40th Station, Arzew, 18 January-4 March 1943; 31 July 1944. 1,000/1,500 beds.
Mostaganem, 4 March 1943-15 January 1944. 54th Station, Assi Bou Nif, 2 October-23 De-
500 beds. cember 1944. 250 beds.
2d Convalescent, Bouisseville, 28 February 1943-
31 May 1944. 3,000 beds. Algiers
91st Evacuation (as station), Mostaganem, 2 29th Station, 30 January 1943-25 August 1944.
May-27 June 1943. 400 beds. 250 beds.
94th Evacuation (as station), Perregaux, 22 May- 79th Station, 17 June 1943-30 June 1944. 500
29 August 1943. 400 beds. beds.
186 MEDITERRANEAN AND MINOR THEATERS
of the Italian consulate vacated when ings being supplemented by tents when
the 8th Evacuation moved into tents in the patient load required.
March. The 56th Station opened 250 The 56th Station moved in August to
beds on 14 May in a prisoner-of-war en- the site of a French orphanage in Casa-
closure at Berrechid, temporary build- blanca, where it operated a convalescent
THE NORTH AFRICAN COMMUNICATIONS ZONE 187
camp for the 6th General Hospital. The eral Dispensary, which reached that city
23d Station left ABS in September, and on 20 February 1943. The 2d Medical
the 66th in December 1943. The 50th Laboratory remained in the area until
remained until 1 May 1944. Only the 15 June, operating mobile units at Mar-
56th Station at Casablanca and the 370th rakech, Fes, and other Moroccan cities.
at Marrakech were still in operation The 5th General Dispensary functioned
when the area passed to control of the in Casablanca until 30 August 1943.
Africa—Middle East Theater on 1 March Maximum bed strength in ABS was
18
!945. reached in May 1943 when 7,025 T/O
Hospitals in the Atlantic Base Section beds were available, with expansion
were supplemented by the 2d Medical units capable of adding 50 percent to
Laboratory, which arrived in Casablanca that total. The greatest patient load came
24 December 1942, and by the 5th Gen- in June and July, the peak being reached
early in the latter month when 5,700
18
See pp. 80, 84-85, above. beds were occupied. Evacuation to the
188 MEDITERRANEAN AND MINOR THEATERS
United States brought the figure down Oran itself during the North African
sharply before the end of the month, campaign. (See Map 18.)
and there was a steady decline there- The 180th Station Hospital opened at
19
after. Ste. Barbe-du-Tlelat on 7 December, its
250 beds being housed in Nissen huts
Mediterranean Base Section—Until and tents. The 64th Station, another 250-
the second phase of the Tunisia Cam- bed unit, began operating on 28 Decem-
paign got under way in February, the ber in buildings of the College Laperrine
largest concentration of United States at Sidi Bel Abbes, near the home bar-
troops was in the area served by the racks of the famed French Foreign Le-
Mediterranean Base Section, and the gion. The last fixed hospital to receive
build-up of fixed hospitals was both more patients in MBS before the end of 1942
rapid and more extensive than was the was the 21st General, which opened on
case in ABS. Oran and its environs were 29 December in a group of resort hotels
well within range of enemy bombers at Sidi Bou Hanifia.
based on Sardinia and in the Tunis- The 2,500 fixed beds in MBS on1
Bizerte area. The initial policy, there- January 1943 were doubled by the end
fore, was one of dispersal. Most hospital of the month. The 250-bed 52d Station
sites, many of them selected before the Hospital opened on 13 January at Oujda,
base section itself was activated, were where it was assigned to serve Fifth
considerable distances from the city.20 Army, then beginning the long period of
Here mobile hospitals that arrived im- training that would lead to Salerno and
mediately after the assault were quickly on to the Alps. The 12th General, with
replaced by fixed units. First in the area 1,000 beds, opened on 14 January, oc-
was the 151st Station, which set up its cupying 105 villas in the resort village
250 beds in the infirmary building at La of Am et Turk overlooking the Mediter-
Sénia airport, five or six miles south of ranean west of Oran. It was then hoped
Oran, on 25 November. Although sup- to establish a hospital center there. The
plemented by tents, the site proved in- 40th Station operated 250 beds in the
adequate, and the hospital moved at the Foreign Legion barracks at Arzew from
beginning of April 1943 to a college 18 January to 4 March, taking over from
plant somewhat nearer the city. The 7th the 48th Surgical. The 40th then moved
Station Hospital, with a T/O of 750 into a miscellaneous group of buildings
beds, took over operation of a civilian in Mostaganem where its full T/O of
hospital in Oran on 1 December, reliev- 500 beds was set up. Last of the mobile
ing the 77th Evacuation. The 7th Station units to depart the area was the 38th
was the only U.S. military hospital in Evacuation Hospital, which had operated
19
See app. A-3. as a station hospital at St. Cloud from
20
Principal sources for this section are: (1) 13 November 1942 to 6 February 1943.
Annual Rpt, Med Sec, NATOUSA, 1943; (2)
Annual Rpt, Med Sec, MBS, 1943; (3) Annual
The Center District was served by the
Rpt, Med Sec, Center Dist, MBS, 1943; (4) Unit 29th Station Hospital of 250 beds, which
Rpts of hosps and other med installations men- took over a small civilian hospital in Al-
tioned in the text; (5) H. J. Hutter, "Medical
Service of the Mediterranean Base Section,"
giers. Its first patients were transferred
Military Surgeon (January 1945), pp. 41-51. from a British hospital on 30 January.
THE NORTH AFRICAN COMMUNICATIONS ZONE 189
Hospital facilities in MBS were con- however, was considerably greater, since
siderably augmented when the 2d Con- most of the units were operating beyond
valescent Hospital began receiving their normal capacity, with tents and
patients on 18 February. Though as- Nissen huts frequently being used to
signed to the base section rather than to house expansion beds.22 In addition to
a combat element, the 3,000 beds of this these fixed beds, the 3,000 beds of the 2d
unit were not reported as "fixed." They Convalescent Hospital were fully oc-
served, however, to free an equivalent cupied.
number of beds in other hospitals. After
diligent search, a suitable location for Eastern Base Section—The first Ameri-
the 2d Convalescent was found at Bouis- can hospital in the Eastern Base Section
seville, close to Ain et Turk. The hospi- preceded the organization of the base
tal was in part under canvas and in part section itself. This was the 500-bed 61st
housed in 122 villas requisitioned for the Station Hospital, which arrived at El
purpose. Guerrah, some twenty-five miles south of
The 32d Station Hospital, of 500 beds, Constantine, on 2 February 1943. (See
was in the theater a month before it Map 18.) The hospital was brought for-
opened on 28 February in school build- ward in response to a request from the
ings at Tlemcen. The only other fixed Director of Medical Services, First Army,
hospital to be established in MBS before to relieve pressure on the British 31st
the end of the fighting in North Africa General Hospital in the same area.23 It
was the 91st Evacuation, which operated was set up under canvas and received its
under canvas as a station hospital at first patients on 12 February. The 61st
Mostaganem from 2 May until 27 June operated under British control until1
1943. March, when it was formally transferred
In addition to these fixed hospitals, to EBS. In its early weeks of operation,
there were two general dispensaries func- before the rainy season ended, mud was
tioning in MBS during the period of hos- so deep on the hospital site that ambu-
tilities. The 8th General Dispensary lances could not leave the road and pa-
opened on 6 December 1942 in what had tients had to be carried by litter to the
been the British Cottage Hospital in receiving tent. "Often the bed would
Algiers, where it was the only U.S. medi- sink to the springs under the weight of
cal installation until the arrival of the the patient. This condition was cor-
29th Station nearly two months later.
The 6th General Dispensary opened on
13 February in the French Clinique
pendix A-3, less the 250 nonoperating beds of the
Générale at Oran. 57th Station Hospital, transferred out of the MBS
The T/O bed strength of fixed hospi- in the interval, and includes the addition of the
tals in the Mediterranean Base Section 400 beds of the 91st Evacuation Hospital, which
opened in MBS as a station hospital on 2 May 1943.
when combat operations in North Africa 22
See app. A-3.
came to an end on 13 May 1943 was 23
(1) Deputy Surg, AFHQ, to G-4, Orders, 61st
5,400.21 The number of beds established, Sta Hosp, 20 Jan 43, and atchmt, DDMS, First
Army, to Surg, AFHQ, 15 Jan 43. (2) Memo,
21
The figure for T/O beds as of 13 May 1943, ADMS, No. 1 LofC Subarea, to DDMS, First Army,
given in the text is the 30 April figure from Ap- 3 Jan 43.
190 MEDITERRANEAN AND MINOR THEATERS
rected by placing rocks or large tin cans few miles north of Constantine. The
under the legs of the bed." 24 26th General was the first U.S. general
The 750-bed 38th Evacuation Hospi- hospital to function under canvas in the
tal moved into the Constantine area theater. The 250-bed 57th Station, which
early in March, opening on the 9th of opened on 5 May at Oued Seguin near
that month at Telergma. Housed in the Telergma airfield, completed the
tents, the 38th Evacuation served pri- fixed hospital installations in the Eastern
marily as a station hospital for Air Base Section up to the close of the Tuni-
Forces personnel and as a holding unit sia Campaign. The 57th was housed in
for air evacuation during the campaign tents and hutments. Also at Oued Seguin
in southern Tunisia. A week before the from 29 April was the 1st Medical Lab-
northern campaign ended, the 38th oratory.
shifted to the vicinity of Bédja a few Counting the two assigned evacuation
miles behind the fighting front, but con- hospitals, there were 4,250 T/O beds in
tinued to be assigned to EBS, function- EBS as of 15 May 1943.25
ing as a station hospital again as soon as
the fighting was over. The 35th Station Bed Shortages—T/O bed strength in
established its 500 beds at St. Arnaud, communications zone hospitals during
about fifty miles west of El Guerrah, on the Tunisia Campaign never approached
30 March, with two school buildings and the 6-percent ratio approved before the
a theater serving as housing. invasion. The actual ratio of T/O fixed
The 77th Evacuation Hospital, which beds to troop strength was only 3.2 per-
had served as a combat unit in the south- cent at the end of January 1943,26 when
ern phase of the Tunisia Campaign, was Tunisian casualties began flowing back
assigned to EBS on 14 April, opening to the fixed hospitals, and had climbed
in tents at Morris near Bone two days only to 5.1 percent by the end of May.27
later. There the 750-bed unit functioned In order to carry the patient load,
in a dual role, as an evacuation hospital evacuation hospitals were pressed into
for II Corps and as a rear installation, service as fixed units, and emergency
receiving patients from other hospitals beds were established in hospitals already
closer to the front. The 73d Station Hos- in operation. The 21st General at Sidi
pital, with a T/O of 500 beds, opened Bou Hanifia, for example, reached a
at Constantine in three school buildings maximum patient census of 4,000 and
on 24 April. cared for an average of 1,750, although
The 26th General, with 1,000 beds, 25
reached EBS late in March but was not This figure represents the T/O bed strength
assigned to the EBS as of 30 April 1943, plus the
ready to receive patients until 26 April. 250 beds of the 57th Station Hospital, which
During the intervening month engineers opened as an EBS unit on 5 May 1943. See app.
had to lay out roads, build cement plat- A-3.
26
"On several occasions I heard that the hospital
forms for tents and Nissen huts, and in- situation at the beginning was almost scandalous.
stall water and sewage facilities. The site It has been greatly improved, due to the energy
of the hospital was Bizot, a railhead a and ability of a man named Blesse, whom I did not
meet until later." Ltr, John J. McCloy, ASW, to
Maj Gen Wilhelm D. Styer, CofS SOS, 22 Mar 43.
24 27
Med Hist, 61st Sta Hosp, 1943. See app. A-6.
THE NORTH AFRICAN COMMUNICATIONS ZONE 191
26TH GENERAL HOSPITAL NEAR CONSTANTINE, ALGERIA, the first U.S. general hos-
pital to be set up in tents in the North African theater.
its T/O called for only 1,000 beds. The with a disproportionate number of spe-
necessity of operating for considerable cialist personnel. Promotions within the
periods at greater than normal capacity unit were usually dependent on attrition,
meant heavy demands on power, water, which was a slow and uncertain process.
and mess facilities, as well as on person- There were thus pressures both from
nel. Maintenance and repair were con- within and outside these hospitals to
stant problems, with the need for transfer men to other units, where their
carpenters, plumbers, and electricians skills could be used to better advantage
often acute. Civilians were employed in and advance in rank would be more
considerable number wherever possible, rapid. Personnel shifts between hospitals
while prisoners of war were used in var- had become fairly common by the close
ious permitted capacities. of the Tunisia Campaign, the affiliated
On the professional side, the primary units, and especially the large general
personnel problem was one of making hospitals, being in effect raided to build
the best use of the skills available. The up the staffs of smaller installations.28
affiliated units, of which there were 28
For more detailed, discussion of the personnel
eleven in the theater during the period problem in the affiliated units, see McMinn and
of active combat, were uniformly staffed Levin, Personnel in World War II, pp. 206-10.
192 MEDITERRANEAN AND MINOR THEATERS
and 60th, opened in Tunis on 5 and 23 the most part upon canvas and such more
July, respectively. The 77th Evacuation stable structures as could be improvised.
Hospital closed at Morris on 25 June, Water supply, sewage disposal, and pow-
but remained in the area for another two er facilities all had to be installed.31
months. The 114th Station, of 500 beds, So great was the pressure upon the
opened in the vicinity of Ferryville on 2 engineers for purely military construc-
July, and a week later the 9th Evacuation tion that although the hospitals were
moved from Mateur to Ferryville. Three physically in the area, only a portion of
more fixed hospitals were established at those relied upon to care for Sicily cas-
Mateur—the 1,000-bed 3d General on 15 ualties were ready when the first patients
July, in the quarters vacated by the 9th were returned from the invasion coast.
Evacuation; the 74th Station on 29 July; The situation was critical enough to send
and the l03d Station on 2 August. Both the theater surgeon, General Blesse, on a
station hospitals had 500 beds. hasty flight to Mateur to size up the dif-
In addition to these four points of ficulties for himself. Before he returned
concentration, the 250-bed 55th Station to his Algiers headquarters, Blesse got
Hospital opened in the Holy City of the hospital program moving again, and
Kairouan on 19 June and the 105th took steps to strengthen the EBS medical
Station, of 500 beds, at Am Mokra near section.32
Bone on 25 July. The latter unit moved Approximately 2,000 additional beds
to Ferryville late in October. Between 18 were also established in the Mediter-
June and 21 September the 34th Station ranean Base Section between the end of
Hospital was attached to the Twelfth the Tunisia Campaign and the assault
Air Force and operated 250 beds for Air on Sicily. The only fixed installation,
Forces personnel on Pantelleria Island. however, was the 500-bed 79th Station
The rapid expansion of bed capacity Hospital, which opened at Cap Matifou
in the Bizerte-Tunis area posed the most just east of Algiers on 17 June. The
difficult siting problem encountered in others were evacuation hospitals serving
the theater. Water was scarce, the region temporarily as fixed units while staging
was poorly drained, and the malaria sea- for more active roles in future combat
son was at its height. There were few operations. The 94th Evacuation Hospi-
usable buildings available, and materials tal of 400 beds functioned as a station
for construction were almost equally dif- hospital at Perregaux between 22 May
ficult to procure in the brief time at the and 29 August before taking part in the
disposal of the engineers. In addition to invasion of Italy, while the 400-bed 95th
these physical limitations, the military Evacuation, also destined for Salerno,
situation required an extensive build-up served Fifth Army at Oujda from 24 May
of troops and supplies in the same area, to 4 July. The 95th then moved to Am
with competing demands for facilities, et Turk where it took casualties from
space, and engineering manpower. The
3d General Hospital at Mateur occupied 31
A. I. Zelen, MS, Hospital Construction in the
former French military barracks, supple- Mediterranean Theater of Operations, United
States Army, pp. 38-40.
mented by tents and prefabricated huts, 32
Surg, NATOUSA, Journal, 15, 16, 17 Jul 43.
but the station hospitals had to rely for See also pp. 180-81, above.
194 MEDITERRANEAN AND MINOR THEATERS
Sicily until 16 August. The 750-bed 16th Mediterranean Base Section, where con-
Evacuation Hospital operated as a sta- ditions were good and a substantial de-
tion hospital for prisoners of war at San gree of permanence was anticipated. An
Seno Wells, near Ste. Barbe-du-Tlelat, elaborate hospital groupment was laid
between 23 May and 8 August. (See Map out at Assi Bou Nif, about eight miles
18.) southeast of Oran. The 69th Station Hos-
After the Sicily Campaign was over, pital was shifted from Casablanca to the
there was a further concentration of new site on 30 September, the 23d Sta-
hospitals around Bizerte and Oran in tion from Port-Lyautey on 4 October,
support of expanding operations in Italy. and the 51st Station from Rabat on the
North Africa achieved its maximum 28th of the same month. In addition to
strength of approximately 25,000 T/O these units from the Atlantic Base Sec-
beds plus 14,000 expansion beds about tion, two new 1,000-bed generals, the
the first of November. Even counting 43d and the 70th, opened at Assi Bou
fixed beds already in Sicily and Italy, Nif on 31 October. The groupment was
however, the ratio to troop strength re- completed with the opening of the 46th
mained below the original authorization General Hospital on 4 November.
of 6 percent and well below the 6.6-per- The Assi Bou Nif project was planned
cent figure authorized in September.33 for long-term use. Starting with open
The Eastern Base Section reached the fields, the engineers installed complete
saturation point during September and power, water, and waste disposal facilities
October with the establishment of four for a potential capacity of double the
additional 1,000-bed general hospitals. 4,250 beds actually installed. Buildings
The movement started with an internal were mostly of permanent construction,
shift of the 35th Station Hospital from many of them of stone. Those ward tents
Saint-Arnaud near Constantine to Morh- used had wood floors and frames. Nissen
rane in the vicinity of Tunis. The and Boyle huts were insulated. Much of
33d General opened in tents and hut- the actual labor was performed by Italian
ments on "Hospital Road" just outside prisoners of war, whose full utilization
Bizerte on 15 September. The 24th Gen- ceased to be restricted after Italy
eral, which opened in the same area two achieved the status of a cobelligerent.
weeks later, was more fortunate, being Local sandstone and cement were more
partially housed in French military bar- readily available than lumber, and given
racks. The 37th General Hospital, which unlimited supplies of manpower, were
34
opened at Mateur on 12 September, and more economical.
the 64th General, which began receiv-
ing patients at Ferryville on 23 October, Hospitalization of Sicily Casualties in
were both under canvas supplemented North Africa—For the first time in any
by prefabricated units. (See Map 18.) U.S. theater in World War II, selective
With no further hospital sites avail- hospitalization was attempted for cas-
able in Tunisia, such additional build- ualties from Sicily. With most of the
up as was required was made in the available surgical teams assigned to the
34
Zelen, Hospital Construction in MTOUSA, pp.
33
See apps. A-3, A-6. 30-31.
THE NORTH AFRICAN COMMUNICATIONS ZONE 195
combat zone, it was clear that there were qualified to treat cases of all types.
would not be enough skilled surgeons Triage for those brought by sea was to
left to staff all of the Eastern Base Sec- be carried out by the 56th Evacuation
tion hospitals, either for general work or at Bizerte, and for those flown from Sicily
for specialties. Careful plans were there- by the 9th Evacuation near Mateur air-
fore made to assign patients to hospitals field.35
by type of case. It was possible to carry out these plans
Craniocerebral, spine, and cord in- only in part. When the first casualties
juries were to go to the 78th Station arrived on D plus 1 many of the EBS
Hospital, eye injuries to the 114th Sta- hospitals were not yet ready for patients.
tion, chest cases to the 53d Station, and The road to the 9th Evacuation was too
neuropsychiatric cases to the 43d Station. rough for transporting serious cases.
Compound fractures were to be handled There were not enough ambulances
by the 9th and 56th Evacuation Hospi- available for the extra carry involved in
tals, and by the 74th, 80th, and 81st 35
(1) Ltr, Col Churchill to Surg, NATOUSA, 19
Stations. For emergency periods the two Aug 43, sub: Tour Rpt, Sicily, D+24 to D+35. (2)
evacuation hospitals and the 3d General Annual Rpt, Med Sec, EBS, 1943.
196 MEDITERRANEAN AND MINOR THEATERS
moving patients from the evacuation to desert, the temperature in the operating
the station hospitals. And finally, there tent rose to 135° F. Needless, perhaps, to
were not enough beds to permit com- say the hospital did not remain in Tunis
plete selectivity. The planning, more- long.37
over, had not taken into consideration
the high incidence of malaria, or the ac- Hospitalization of Italy Casualties in
cident rate consequent upon the staging North Africa—The establishment of ad-
of large numbers of troops. On the first ditional hospitals in the Tunis-Bizerte
day of the Sicily Campaign, more than a area shortly after the Salerno landings of
third of the approximately 6,500 beds 9 September 1943 led to various changes
established in northeastern Tunisia were in the disposition of patients being re-
already filled. ceived by air and water in EBS.38
In actual practice, therefore, patients On 20 September a triage center was
were sorted at the Bizerte docks by per- set up in the vicinity of the 33d General
sonnel of the 8th Port Surgeon's office Hospital, approximately four miles from
and at Mateur airfield by personnel of the Bizerte clocks, a mile from the Sidi
the 802d Medical Air Evacuation Trans- Ahmed airport, and 300 yards from the
36
port Squadron. Representatives of the operating base of the 2670th Ambulance
EBS surgeon assigned patients in terms Company (Provisional). The triage cen-
of daily bed status reports from each ter was conducted by 2 Medical Corps
hospital. Transportation was by the 16th officers, and 2 Medical Administrative
Medical Regiment. Hospital specialties Corps officers, drawn from the various
were observed so far as possible, but bed installations in the area and rotated
space was the overriding consideration. monthly; and 6 nurses and 6 enlisted
The geography was such that there was men from the 33d General Hospital.
in fact no alternative to initial hospitali- The center received a bed-status report
zation of casualties from Sicily in EBS, each morning from the base surgeon's
and so no attempt was made to build up office. When a hospital ship arrived, the
bed strength elsewhere than in northeast- Port Surgeon notified the ambulance
ern Tunisia. When wounded from Sicily company, and word was passed along to
were carried by returning shipping to the triage center, to which the patients
Algiers instead of Bizerte, the 250-bed were brought when unloaded. The 802d
29th Station Hospital was unable to car- Medical Air Evacuation Transport
ry the extra load. The still inoperative Squadron at Sidi Ahmed airport was in
79th Station had to set up tents to take direct telephonic communication with
the overflow. The 38th Evacuation Hos- the 33d General Hospital, the triage
pital at Tunis handled the relatively center, and the 2670th Ambulance Com-
small number of U.S. casualties reaching pany.39
37
that city, but its location was poor. At (1) Surg, NATOUSA, Journal, 16 Jul 43. (2)
times, when the wind blew in from the Annual Rp 38th Evac Hosp, 1943.
38
Except as otherwise noted, this section is based
on: (1) Annual Rpt, Med Sec, EBS, 1943; (2)
36
Annual Report, Medical Section, EBS, says Annual Rpt, Med Sec, NATOUSA, 1943; (3) Unit
807th MAETS, but this squadron did not arrive rpts of hosps mentioned in the text.
39
in the theater until September. See Med Hist, Memo, Capt Carl Schanagel, to Lt Col Oscar
807th MAETS, 1 Jan 45. Reeder, 31 Oct 43.
THE NORTH AFRICAN COMMUNICATIONS ZONE 197
The sorting station at Mateur airfield After the middle of December, with
some 20 miles farther south continued hospital facilities rapidly building up
to be available until the field was closed in Italy, the influx of patients into North
late in November, but received only one Africa fell off sharply. There was a large
patient after 5 October. movement of patients during the week of
The 33d General Hospital at this time 15-21 January 1944, when hospitals in
took all craniocerebral, spine and cord, the Naples area were being cleared pre-
and maxillofacial cases. Chest and neck paratory to launching the Anzio opera-
cases continued to go to the 53d Station tion, but after that period the major
Hospital until 21 October, and there- burden of communications zone hospi-
after to the 24th General. Neuropsychi- talization was carried in Italy.40
atric patients continued to go to the 43d
Station until 16 November, when the Hospitalization in Sicily, Sardinia,
unit was relieved by the 114th Station. and Corsica
Compound fractures continued to go to
the 81st Station. All general hospitals, Island Base Section—With the cessa-
however, were authorized to take the tion of hostilities in Sicily, the 93d Evac-
overflow of both psychiatric and fracture uation Hospital closed in preparation for
cases when no space remained in the a Fifth Army assignment. The 15th Evac-
designated station hospitals. Eye injuries uation was moved to a new site a few
went to the nearest general hospital. All miles east of Licata on the Gela road,
other types of surgical and medical cases while the 128th Evacuation went to Cas-
were distributed according to the avail- tellammare, west of Palermo, and the
ability of beds. 11th replaced the 128th at Cefalii. Newly
Navy personnel went to the 80th Sta- arrived from the Middle East, the 1st
tion Hospital at Bizerte or to the 54th at Platoon of the 4th Field Hospital was
Tunis, whichever was closer; or to spe- established three days before the end of
cialized hospitals if the type of injury the campaign at Palagonia, on the south-
so required. Prisoner-of-war patients also western edge of the Catanian plain.
went to the specialized hospitals if triage These locations were selected with a view
so indicated, otherwise to the 78th or to providing station hospital service for
103d Station. troops remaining in Sicily, and the hos-
Late in October the 105th Station pitals retained their Seventh Army as-
Hospital opened as a convalescent hospi- signments, with IBS exercising only a
tal and venereal disease treatment center, co-ordinating function.41
gradually increasing its capacity to 3,000 The 9th Evacuation Hospital was
beds. The 105th took patients only by brought from North Africa early in Sep-
transfer from other hospitals, under suit- tember, opening at Termini on 1 Octo-
able controls to prevent "dumping." At 40
Hq, ETOUSA, Rpt on PBS, 10 Feb 44. See also
this time, with an adequate number of p. 343, below.
beds available in EBS, a 90-day evacua- 41
This section is based generally on: (1) Annual
tion policy was established for general Rpts, Med Sec, NATOUSA, 1943, 1944. (2) Unit
rpts of the hosps mentioned in the text. No
hospitals and a 30-day policy for station medical section reports for the IBS have been
hospitals. found.
MAP 19—Fixed Hospitals and Base Medical Supply Depots on Sicily, August 1943-
July 1944
FIXED HOSPITALS IN SICILY, JULY 1943-JULY 1944
Castellammare-AIcamo Licata
128th Evacuation (as station), 19 August-31 Oc- 15th Evacuation (as station), 19 August-29 Sep-
tober 1943. 400 beds. tember 1943. 400 beds.
77th Evacuation (as station), 27 September-26
Palermo
91st Evacuation (as station), 27 July-31 October October 1943. 750 beds.
1943. 400 beds. Palegonia
59th Evacuation (as general), 8 August 1943- 4th Field, 1st Platoon (as station), 14 August-
6 May 1944. 750 beds. 19 November 1943. 100 beds.
34th Station, 1 November 1943-9 July 1944. Island Base Section Medical Supply
250 beds, Installations
11th Evacuation (as station), 23 November-31
December 1943. 400 beds. Palermo
154th Station, 6 May-30 June 1944. 150 beds. 4th Medical Supply Depot, 1 September-21 Oc-
tober 1943.
Termini 2d Medical Supply Depot, 21 October 1943-10
9th Evacuation (as station), 1 October-31 De- February 1944.
cember 1943. 750 beds. Provisional Depot Company, 10 February-1 June
Cefalii 1944.
11th Evacuation (as station), 19 August-23 No- 684th Quartermaster Base Depot Company, 1
vember 1943. 400 beds. June-15 July 1944.
THE NORTH AFRICAN COMMUNICATIONS ZONE 199
ber. On the same date the 77th of the 15th Field Hospital on Corsica
Evacuation supplanted the 15th at Li- were reassigned to the Northern Base
cata, the latter unit being withdrawn for Section. The NORBS surgeon, Colonel
service in Italy. The 128th Evacuation Robinson, began a survey of the island
moved into buildings in Alcamo on 9 for hospital sites immediately after his
October, a week after a hurricane had arrival on 8 January and prepared plans
leveled virtually all of its tentage at Cas- calling for the addition of 1,250 fixed
telammare. The 250-bed 34th Station beds, to be dispersed in relation to air-
Hospital, only fixed installation on the fields and troop concentrations. Trans-
island, opened at Palermo on 1 Novem- portation shortages stemming from the
ber. The maximum fixed-bed strength in requirements of the Anzio Campaign
Sicily was reached at this time—3,700 forced some delay, but the 500-bed 35th
counting both IBS and Seventh Army Station Hospital opened at Cervione,
installations.42 (Map 19) midway up the eastern coast of Corsica,
Evacuation of the remaining casualties on 1 March. Ten days later the 40th
from Sicily, reduction in the strength of Station, also with 500 beds, replaced the
occupation troops, and the departure of 1st platoon of the 15th Field at Ajaccio.
staging units about this time greatly re- The latter unit shifted to Calvi in the
duced the demand for hospital beds. The northwestern part of the island, but oper-
77th and 128th Evacuation Hospitals, to- ated there only a few weeks before being
gether with the 91st, which had re- supplanted by the 250-bed 180th Station
mained in place in Palermo, left the on 28 April 1944. The field hospital
theater for England early in November. platoon then went to Ghisonaccia, some
Later that same month the 1st Platoon twenty miles below Cervione. All three
of the 4th Field Hospital was attached station hospitals on Corsica came from
to the Air Forces and shifted to Italy, North Africa. In the absence of suitable
while the nth Evacuation moved to buildings, all American hospitals on the
Palermo. Both the 9th and nth Evac- island were set up under canvas, supple-
uation closed on 31 December prelimi- mented by prefabricated huts as the en-
nary to departure for Italy. Left in Sicily gineers found time to erect them.43
at the beginning of 1944 were the 59th The two hospitals on Sardinia—the 3d
Evacuation, acting as a general hospital, Platoon of the 15th Field, and the 60th
and the 34th Station, both at Palermo. Station—remained as Air Forces units
The 59th was replaced in May 1944 by until the first week in May, when they
the 150-bed 154th Station, but both this were assigned to the Allied garrison on
hospital and the 34th Station left Sicily Sardinia. The 60th Station opened a sec-
two months later. The Island Base Sec- ond 250-bed expansion unit in January,
tion passed out of existence on 15 July but no further increase in U.S. hospital
1944.
tected personnel who augmented the The bulk of the prisoner-of-war pa-
U.S. hospital staff.48 tients from Sicily who were not retained
Largest of the hospitals for Tunisia on the island went initially to the 80th
prisoners was the 56th Station in ABS, Station Hospital at Bizerte, where they
which was set up between 4 and 14 May were guarded by French military per-
inside POW Enclosure 100 at Berrechid, sonnel. Prisoner patients from the Ital-
some twenty miles south of Casablanca. ian campaign that were received in the
Almost half of all prisoners taken in EBS were routed to the 78th Station
Africa passed through this camp, which Hospital at Bizerte or to the 103d Station
had an average population of 20,000 at Mateur.
with a maximum of 28,000. Germans After Italy became a cobelligerent,
and Italians there were about equal in Italian prisoners in Africa were organ-
numbers. The patient census varied from ized into service units of various types.
205 to 978, averaging about 750. The Their status made it necessary to keep
hospital had nine prefabricated build- them completely separated from the
ings, supplemented by tents. In addition German prisoners. At the same time,
to hospital care, the 56th Station main- their numbers and the assignments given
tained small dispensaries in various parts them increased their hospitalization re-
of the compound, where outpatient serv- quirements.
ice was given to between 300 and 400 a On 26 September, therefore, the
day.49 Italian wards of the hospital then being
The inadequate hospital staff was sup- operated by the 180th Station in prison-
plemented by detachments of 3 officers, er-of-war Enclosure 129 was redesig-
6 nurses, and 22 enlisted men each from nated the 7029th Station Hospital (Ital-
the 34th, 36th, and 37th Hospital Ship ian) . It was staffed by Italian medical
Platoons; by 2 German medical officers, personnel under U.S. supervision, as-
each of whom had charge of a ward; and sisted for the first two months by
by 100 to 120 German medical soldiers detachments from two U.S. hospital ship
who worked under their own noncom- platoons. The maximum census before
missioned officers. Nurses were quartered the end of 1943 was about 800.50
outside the compound. Their duties The German wards of the hospital in
were largely supervisory, with actual POW Enclosure 129 were reorganized
nursing confined to seriously ill and sur- at the same time into a German station
gical cases. They performed no night hospital, under U.S. supervision but
duty. staffed, like the Italian hospital, by cap-
The 56th Station Hospital closed at tured medical personnel. In December
Berrechid on 15 August when the prison the German hospital moved to neighbor-
camp was closed. ing POW Enclosure 131, and the 7029th
moved back into the quarters previously
48
(1) Annual Rpt, Med Sec, MBS, 1943. (2) occupied in Enclosure 129. Prisoner-of-
Annual Rpt, 21st Gen Hosp, 1943. (3) Annual Rpt, War Hospital 131, as the German unit
16th Evac Hosp, 1943. (4) Annual Rpt, 180th Sta was thereafter known, was equipped at
Hosp, 1943.
49
(1)Annual Rpt, Med Sec, ABS, 1943. (2) An-
50
nual Rpt, 56th Sta Hosp, 1943. Hist, 7029th Sta Hosp (Italian.), 27 Jul 45.
THE NORTH AFRICAN COMMUNICATIONS ZONE 203
this time to care for 500 patients, but gate of 1,982 remained hospitalized in
gradually expanded as more German North Africa at the end of the year.
51
medical officers became available.
The 56th Station Hospital opened a Evacuation in the Communications
75-bed unit for prisoner personnel of Zone
Italian service companies in the Casa-
blanca area late in 1943. This unit was Evacuation Between Base Sections
formally designated the 7393d Station
Hospital (Italian). The geographical distribution of fixed
Only cases that could not be handled hospital beds in North Africa in relation
by one of these prisoner-of-war hospitals to the changing combat zones and to
went to U.S. installations. ports of embarkation made it necessary
Although 3,066 sick and wounded to keep patients moving steadily from
prisoners of war were evacuated to the one base section to another in order to
zone of interior during 1943, an aggre- accommodate new casualties as close as
possible to the area of combat. Evacua-
51
tion from east to west went on as long
(1) Annual Rpt, Med Sec, MTOUSA, 1944, an.
B. (2) Annual Rpt, Med Sec, MBS, 1943. (3) Hist, as the North African communications
7029th Sta Hosp (Italian). zone itself remained in existence.
204 MEDITERRANEAN AND MINOR THEATERS
period a total of 10,720 patients was tients were evacuated to EBS, 3,232 by
evacuated to installations farther re- sea and 2,306 by air.58 This was the last
moved from the combat zone.55 heavy demand upon the North African
The first patients from Italy were communications zone, which declined
carried to EBS by returning transports steadily in importance thereafter.
on 12 September, and the first arrivals Evacuation from Corsica and Sardinia
by air were received on the 23d. After was by air to North Africa during the
28 September much of the air evacuation period before the fall of Rome, but was
from Italy was routed by way of Sicily of relatively minor significance.
with an overnight stop at Termini air-
field near Palermo, but hospitalization Evacuation to the Zone of Interior
was not involved except in emergencies.
Patients were kept in an air evacuation In the early stages of the Tunisia Cam-
holding unit and flown on to Africa the paign, American litter patients destined
next day. for the zone of interior were evacuated
For movement out of the forward area from Oran to the United Kingdom on
of EBS, hospital ships were used between British hospital ships, while neuropsy-
Bizerte and Oran; planes to Algiers; and chiatric, ambulatory, and troop-class
hospital trains to Constantine, which was patients went directly to the United
included in MBS in October. From States by unescorted troop transport.59
Constantine further rearward movement Instructions were changed at the begin-
was by train or plane.56 ning of May to permit evacuation of all
Between 10 July and 31 December classes of patients in transports, with
1943, 34,116 patients were received in Casablanca the primary port of embar-
EBS from Sicily and Italy, 12,902 by kation for this purpose. Later in the
sea, and 21,214 by air. In the same year, convoyed troopships took occa-
period, 16,116 were transferred to rear sional loads from Oran, while two U.S.
areas of the North African communica- hospital ships, the Acadia with a capacity
tions zone, 9,238 by sea, 3,577 by air, and of 806 and the Seminole with a capacity
3,301 by rail. In addition to these of 468, became available for evacuation
intratheater transfers, 801 patients were from ports farther east in the Mediter-
evacuated from EBS directly to the ranean. The Acadia, however, was too
United States by sea. French casualties large to dock at Bizerte. A total of 20,358
from Italy began entering the U.S. evac- U.S. Army patients were evacuated from
uation channels in December but were North Africa to the zone of interior dur-
separated on arrival in North Africa and ing 1943. (Table 4) Only a handful were
passed to French control.57 evacuated to the United States by air in
In January 1944, as part of the process this period, each case being a matter for
of clearing fixed hospitals in Italy in separate negotiation.
anticipation of heavy casualties at Anzio
and along the Rapido, 5,538 U.S. pa- 58
Rpt of Surg, MTOUSA, 1944, an. B, app. 20.
59
55
Annual Rpt, Med Sec, EBS, 1943. Troop-class patients were those who needed
56
Surg, NATOUSA, Journal, 12 Jul, 17 Aug 43. little medical care en route and were able to care
57
Ibid., 37 Dec 43. for themselves even in emergencies.
THE NORTH AFRICAN COMMUNICATIONS ZONE 207
Medical Supplies and Equipment
TABLE 4—U.S. ARMY PATIENTS EVACUATED BY SEA FROM NORTH AFRICA TO THE ZONE OF
INTERIOR, 1943
until the base section organizations took ation at the 21 st General Hospital after
control.60 that unit was set up at the end of Decem-
In the Atlantic Base Section, ware- ber was performed "with three or four
houses and issue points were operated borrowed clamps, a scalpel, and a pair
61
during January 1943 by personnel of of scissors."
hospital ship platoons, but no inventories In the Eastern Base Section, a section
were attempted. The 4th Medical Sup- of the 4th Medical Supply Depot set up
ply Depot took over the function on 27 a major supply base at Ain M'lilla, about
January, establishing an orderly system twenty-five miles south of Constantine,
of distribution centered in Casablanca. on 19 March, with subdepots at Bone
This organization remained in ABS un- and Philippeville. This unit was relieved
til 16 August, after which personnel of after the close of the Tunisia Campaign
hospital ship platoons again resumed the by elements of the 7th Medical Supply
supply function. By that date, however, Depot, which also supplanted personnel
ABS had so far declined in importance of the 2d Medical Supply Depot at
as to make the work a routine operation. Mateur. The latter group had served II
The development of a medical supply Corps in the field during the active
system in the Mediterranean Base Sec- fighting, but had been reassigned to EBS
tion followed a similar pattern. A section in May.
of the 2d Medical Supply Depot was The section of the 4th Medical Supply
functioning in Oran before the end of Depot, which had gone to Sicily with
November 1942. As rapidly as possible Seventh Army,62 was reassigned to the
scattered supplies were brought to- Island Base Section on 1 September. The
gether and suitably housed in and 4th continued to operate the supply base
around Oran, while inventories were at Palermo until late in October, when
corrected and brought up to date. A the function was transferred to the 1st
shortage of organizational equipment— Advance Section of the 2d Medical Sup-
not included in the initial automatic ply Depot. In Corsica a supply dump for
delivery of supplies on the basis of troop the Northern Base Section was estab-
strength—was made up in large part by lished at Ajaccio about 1 March 1944 by
diverting to depot stock a complete the 7th Medical Depot Company.63
1,000-bed hospital assembly that had In general, medical supplies and
been shipped for the 26th General. The equipment were adequate throughout
equipment arrived several weeks before the North African and Sicilian cam-
the hospital could be set up, and the paigns. Shortages in specific items, such
needs of operating units were too great as prosthetic dental supplies and optical
to permit the material to remain idle. equipment, were owing in part to in-
For example, the first abdominal oper-
60
Except as otherwise noted, this section is based
61
on (1) Annual Rpt, Med Sec, NATOUSA, 1943; Diary of Col Lee D. Cady
62
(2) Annual Rpts, Med Secs, of the base sections; See pp. 169-70, above.
63
(3) Rpt, Med Supply Activities, NATO (Nov The 2d, 4th, and 7th Medical Supply Depots
42-Nov 43) ; (4) Davidson, Med Supply in were reorganized 3 December 1943 into medical
MTOUSA, pp. 1-49; (5) Rpts of individual med depot companies, under TOE 8-661, dated April
units mentioned in the text. 1943.
THE NORTH AFRICAN COMMUNICATIONS ZONE 209
adequacies in the original medical main- from supply points managed to get what
tenance units and in part to the was needed, by air if necessary.64
unexpectedly high need for dental Where essential equipment was lack-
replacements and for glasses among ing, hospital staffs showed considerable
troops sent to the theater. In the case of ingenuity in improvising substitutes.
prosthetic supplies, shortages in the zone Cabinets and laboratory benches were
of interior further delayed the filling of built of waste lumber; heating units,
requisitions, but supplies in both cate- sterilizers, laundry equipment, and
gories were reaching Africa in sufficient showers were fashioned from empty
quantities by the end of the year. gasoline drums and odd bits of pipe;
Shortages of various items reported soap was made from discarded kitchen
by hospital commanders were in part fats; parts were salvaged from worn-out
owing to the fact that many hospitals equipment and reused for the same or
reached the theater without all their other purposes. In the cities it was some-
equipment, in part to breakage as a re- times possible to procure local equip-
sult of faulty packing, and in part to the ment, but more frequently equipment
necessity of operating above normal had to be made out of available
capacity. The Tables of Equipment materials. In Casablanca, for example,
themselves were not entirely suitable to such items as wash basins, toilet bowls,
the needs of the theater, but deficiencies and sinks were made with locally pro-
were quickly made up. Hospitals ar- cured cement.65
riving during the first four or five
months, for example, did not have ade- Theater Services of Supply
quate generating equipment, but here,
as in many other instances, the Corps of Supply and maintenance activities for
Engineers made up the deficiencies. U.S. forces in the theater were central-
Ordnance and Quartermaster units were ized after mid-February 1943 in a
also ready at all times to improvise NATOUSA Services of Supply organiza-
equipment or to requisition missing tion, with headquarters at Oran. As in
items for hospital use. other theaters the Services of Supply in
Another problem arose because some MTO was subordinate to theater head-
medical officers, particularly surgeons, quarters, but differed from comparable
who were fresh from civilian practice, organizations elsewhere in that it did
found it hard to adjust themselves to not control the fixed hospitals. The SOS
the more limited range of equipment medical section was responsible only for
it was possible to carry into a combat 64
In addition to general sources cited above,
theater, and the items available did not see: (1) Hq, SOS, ETO, Impressions of Medical
always correspond to individual prefer- Service in NATOUSA, by Brig Gen Paul R. Haw-
ences in drugs and instruments. There ley, Chief Surg, ETO; (2) Ltr, Lt Col Ryle A.
Radke to TSG, 28 Apr 43, sub: Inspection of North
is no evidence, however, that the medi- Africa and the United Kingdom; (3) Surg,
cal service rendered in North Africa was NATOUSA, Journal, 16-21 Jul 43.
65
ever seriously curtailed or impaired for See especially unit rpts of the 26th and 45th
Gen Hosps, and the 7th and 35th Sta Hosps; Diary
lack of supplies or equipment. Even of Col Cady. See also, Annual Rpt, Med Sec, ABS,
those hospitals that were most distant 1943.
210 MEDITERRANEAN AND MINOR THEATERS
medical supply. Lt. Col. Theodore L. 45-day reserve, plus a final reserve medi-
Finley, formerly medical supply officer cal unit consisting of a 90-day supply of
in ABS, headed the section briefly, being items that might become critical in
succeeded in May by Col. Benjamin event of blockade or siege. The final
Norris. Col. Charles F. Shook became reserve was discontinued in August 1943
head of the section in August. His oppo- and taken into depot stock, resulting in
site number in the NATOUSA medical temporary excesses in some categories.
section was Lt. Col. (later Col.) Ryle
A. Radke, who had first visited the Professional Services
theater in February on an inspection
tour of supply installations and services The administration of the various
for The Surgeon General, and joined the professional services of the Medical De-
NATOUSA staff on 18 July. 66 partment in the North African Theater
In carrying out its supply functions, of Operations was centralized in the
the SOS medical section requisitioned office of the surgeon, NATOUSA, and
on the zone of interior and distributed was carried out through the appropriate
the supplies and equipment received subsections of the medical section.
among the base sections and combat for-
mations in the theater. Semimonthly The Medical and Surgical
stock reports submitted by the base sec- Consultants
tions, and firsthand inspections, pro-
vided a basis for adjustment between In medicine and surgery the key fig-
depots to ensure balanced stocks in all ures on the professional side were the
parts of the theater. As the staff of the consultants. Lt. Col. (later Col. ) Perrin
SOS medical section was built up during H. Long, recently of the Johns Hopkins
the summer, its activities broadened to faculty, assumed the duties of medical
include statistical reporting and research consultant on 3 January 1943. Before the
into the actual consumption of medical end of the month, Lt. Col. Stuart F.
supplies looking toward modification of Alexander joined Long's staff as consul-
maintenance factors. Shortages revealed tant in chemical warfare and liaison
were made up by special requisitions on officer with G-1. Early in June Capt.
the zone of interior, and overstocks were (later Lt. Col.) Frederick R. Hanson
disposed of by reshipment to the ZI, by became consultant in neuropsychiatry,
transfer to Allied Military Government, having acted in that capacity in fact
and by diversion to fill French lend- since the southern phase of the Tunisia
lease requisitions. Campaign in March.67
The theater medical supply level was The surgical consultant, Colonel
based on a 30-day working supply and a 67
(1) Munden, Administration of Med Dept in
66
This section is based chiefly on: (1) Hist, Med MTOUSA, App. A, p. 212. (2) Perrin H. Long,
Sec, SOS, NATOUSA, Feb 43-Jan 44; (2) Annual M.D., "Mediterranean (Formerly North African)
Rpt, Med Sec, NATOUSA, 1943; (3) Rpt. Med Theater of Operations," vol. I, Activities of Medi-
Supply Activities NATOUSA, Nov 42-Nov 43, by cal Consultants, "Medical Department, United
Lt Col Finley; (4) Munden, Administration of Med States Army," subseries Internal Medicine in World
Dept in MTOUSA, pp. 76-87. (5) Davidson, Med War II (Washington, 1961) , ch. III. For Hanson's
Supply in MTOUSA, pp. 21-27. activities, see p. 145, above.
THE NORTH AFRICAN COMMUNICATIONS ZONE 211
ITALIAN POW's DRAINING SWAMPY GROUND near Algiers as a malaria control measure.
and the theater surgeon, resulted in the W. R. Norton, transferred to the Serv-
establishment of theater-wide profes- ices of Supply organization in February
sional policies and procedures. Exchange 1943. Colonel Long, the medical consul-
of information was facilitated by visits tant, filled in until May when Lt. Col.
to British as well as U.S. installations. (later Col.) Hugh R. Gilmore took over
the functions. Lt. Col. (later Col.)
Preventive Medicine William S. Stone became preventive
medicine officer in August 1943 when
The numerous health hazards that Gilmore went to Fifth Army. Through-
were likely to be encountered in North out the planning and early operating
Africa were fully appreciated while the phases the major problems anticipated
campaign was still in the planning stage. were malaria, intestinal disorders, and
A preventive medicine subsection was venereal diseases.
established under the medical section Malaria Control Measures—Early in
before Allied Force Headquarters left January 1943 a small British-American
London, and was carried over into malaria committee was named by Gen-
NATOUSA. The first preventive medi- eral Cowell to study the malaria problem
cine officer, Maj. (later Lt. Col.) John and to recommend preventive measures.
THE NORTH AFRICAN COMMUNICATIONS ZONE 213
French authorities, and for the direction ologists; and numerous competing de-
of all organizations and personnel en- mands on engineering manpower, which
gaged in such work. This control ex- delayed drainage work and forced vari-
tended to airplane crews engaged in the ous improvisations. The groundwork
dusting of breeding places. The malaria was nevertheless laid for an effective
program was thus highly centralized at control program in the 1944 and 1945
the theater headquarters level. Imple- seasons, in the equally malarious Italian
menting the program was a command communications zone.74 In the Mediter-
responsibility, delegated by the Com- ranean as a whole, noneffectiveness from
manding General, NATOUSA, to the the disease was never great enough to
Commanding General, Services of Sup- threaten the success of any military oper-
ply, and the base section commanders, ation.
who were periodically reminded of their
roles in the control of the disease. At the Diarrhea and Dysentery—North Africa
same time, Colonel Russell used every was a region, to quote the NATOUSA
medium the theater afforded to educate consultant in medicine, "in which the
medical personnel in the fundamentals native considered practically every
72
of malaria control. square foot of ground a privy."75 Flies
Malaria control in North Africa and were so thick in parts of Tunisia that it
Sicily during the period of greatest troop was risky business to open one's mouth
76
concentration was only moderately suc- to speak. Water was scarce and likely
cessful. Experience with atabrine had to be contaminated. These conditions
not been extensive enough to yield posi- made diarrhea and dysentery extremely
tive knowledge of the quantity to be prevalent.
administered or the frequency with Among troops from countries such as
which it should be taken, and the entire the United States and Great Britain,
suppressive therapy program received a where sanitation is taken so much for
rude jolt from the violent reaction that granted that the individual feels little
generally followed the third dose, taken personal responsibility for it, outbreaks
30 April 1943. Men who were already of these diseases were probably inevi-
reluctant avoided taking the drug when- table. They reached major proportions
ever they could, with results that were in May, June, and July 1943, affecting
all too evident in the morbidity figures especially units newly arrived in the
73
for the Sicily Campaign. theater and Tunisian veterans who
Other factors in the comparatively tended to let down after severe fighting.
poor showing of the first year in the
Mediterranean were the late arrival of 74
See pp. 354-57, below. Malaria control in the
the malaria control units, which did not combat zones is treated in the chapters dealing with
get into effective operation until the combat operations.
75
Long, Hist Survey of Preventive Medicine. This
breeding season was well advanced; a report and Annual Report Medical Section,
continuous shortage of trained malari- NATOUSA, 1943, are the primary sources for this
section.
72 76
CG NATOUSA, to CG's, SOS, MBS, EBS, ABS, Brig. Gen. Albert W. Kenner, "Medical Service
and CD-MBS, 25 Jun 43 and 8 Jul 43. in the North African Campaign," Bulletin U.S.
73
See p. 173, above. Army Medical Department (May 1944), pp. 83-84.
THE NORTH AFRICAN COMMUNICATIONS ZONE 215
It was apparent that sanitary discipline The initial control procedure in all
among U.S. troops was poor, but sanita- occupied areas was to allow troops to
tion improved rapidly once an organiza- have access to some or all of the local
tion had been "burned." Line officers, brothels, and to establish prophylactic
as a rule, needed only one demonstration stations in the immediate vicinity. After
to remind them of their responsibilities extensive trial, during which there ap-
in this regard. peared to be no decrease in the number
Another factor in the high diarrhea of contacts made outside the houses, all
and dysentery rates in the summer of brothels were placed "off limits," with a
1943 was the shortage of certain neces- noticeable decline in the VD rate.
sary equipment. Screening for mess halls, Both mechanical and chemical pro-
kitchens, and latrines was not in ade- phylactic kits were always available ex-
quate supply until August. Halazone cept for brief intervals in certain forward
tablets for water purification by individ- areas, although the chemical kit was
uals were not always available in suffi- found to be of little value. Considerable
cient quantity, while facilities for boiling difficulty was experienced, however, in
water to cleanse mess kits were inade- securing sufficient competent personnel
quate for most of the year. to operate "pro" stations in the numer-
Although both diarrhea and dysentery ous areas accessible to U.S. troops. Hos-
continued to plague troops under com- pitals and other medical units were the
bat conditions, they had ceased to be a usual sources of such personnel, but the
communications zone problem by the heavy load being carried by all medical
late months of 1943. installations in the North African com-
Venereal Diseases—Venereal diseases munications zone precluded the detach-
were widely prevalent in North Africa ment of enough trained men for the
and Sicily, and the opportunities for purpose. During the last phase of the
contact were numerous. A full-time Tunisia Campaign the clearing company
venereal disease control officer, Lt. Col. of the 1st Battalion, 16th Medical Regi-
Leonard A. Dewey, was added to the ment, operated a venereal disease diag-
staff of the NATOUSA preventive medi- nostic and treatment hospital south of
cine section early in March 1943, and a Constantine.
month later similar officers were assigned
to each of the base sections and to the Other Preventive Medicine Prob-
major combat units, II Corps, Fifth lems—Aside from the special problems
Army, and Twelfth Air Force.77 discussed in the preceding pages, there
77 were no serious outbreaks of preventable
Main sources for this section are: 1st Annual
Rpt, Med Sec, NATOUSA, 1943; (2) Pers Ltr, diseases in North Africa or Sicily before
Maj Gen James C. Magee, TSG, to Kenner, 1 Mar the scene of primary activity shifted to
43; (3) Ltr, Lt Col Leonard A. Dewey to Surg,
NATOUSA, 9 Apr 43, sub: Rpt of Inspection of to Deputy Theater Commander, NATOUSA, 11
Venereal Disease Control Facilities in MBS and Aug 43, sub: Off Limits for Houses of Prostitution
ABS; (4) Ltr, Dewey to Surg, NATOUSA, 11 May as a Venereal Disease Control Measure; (7) Ltr,
43, sub: Trip Rpt to MBS, ABS, and Hq, Fifth Dewey to Surg, NATOUSA, 20 Oct 43, sub: Rpt
Army; (5) Ltr. Dewey to Standlee, 22 Jul. 43, sub: of Inspection of Venereal Disease Control and
Problems in Venereal Disease Control in Treatment Problems in the Palermo Area, Oct 13
NATOUSA; (6) Ltr, Gen Blesse, Surg, NATOUSA, to 17.
216 MEDITERRANEAN AND MINOR THEATERS
the dental surgeon were primarily ad- The dental service in the theater
ministrative and supervisory. He was re- showed progressive improvement with
sponsible for the provision of adequate each campaign as personnel gained ex-
dental service to all military personnel perience and facilities came to corre-
88
within the jurisdiction, which in 1943 spond more closely with needs.
was a considerable undertaking. There
were 310 dental officers in the North Veterinary Service
African theater at the end of January
1943 and 703 at the end of December, The veterinary section of the
but this increase in numbers was pro- NATOUSA medical organization was
portionately less than the over-all rise in slow in getting started. The first theater
troop strength. In January there was one veterinarian, Lt. Col. (later Col.) Solon
dental officer for each 740 military per- B. Renshaw, served only from December
sonnel; in December only one for each 1942 through February 1943. He was
861. transferred at that time to SOS, NAT-
The problem was further complicated OUSA, because there was no provision
by the presence of a considerable num- for a veterinarian in the limited allot-
ber of units with no dental officer in ment of personnel to the medical sec-
their T/O's. These units were given out- tion. The position of theater veterinar-
patient care by Army hospitals when ian was approved late in April 1943,
such were available, but where no hospi- but was not filled until February 1944,
tal was established in the vicinity, it was when Col. James E. Noonan was as-
89
necessary to detach dental personnel for signed.
temporary duty with the unit. A group of twelve veterinary officers
The drastic lowering of dental stand- arrived in the theater in September, hav-
ards for induction into the Army during ing been requested by the quartermaster
1942, reaching the irreducible minimum for inspection work in connection with
in October just before the TORCH opera- local slaughterhouses, but until this pro-
tion was launched, put a severe and un- gram got under way, they were assigned
expected strain on the facilities of the to replacement pools and used for tem-
theater. In the troop build-up of 1943, porary duty. Since there was no central
numbers of men reached North Africa organization for placing veterinary per-
with insufficient teeth to masticate the sonnel where they were needed, a con-
Army ration, but prosthetic equipment siderable amount of waste was entailed,
for dealing with these cases was not avail- with some impairment of morale.
able until late in the year.87 There was also a disproportionately
87 88
(1) Ibid. (2) Col George F. Jeffcott, United For dental service in combat operations see
States Army Dental Service in World War II, "Med- the chapters devoted to specific campaigns.
89
ical Department, United States Army" (Washing- (1) Mundon, Administration of Medical Dept
ton, 1955), pp. 211-12. (3) Ebbe Curtis Hoff, M.D. in MTOUSA, p. 213. (2) Annual Rpt, Med Sec,
ed., Personal Health Measures and Immunization, NATOUSA, 1943. See also, Lt. Col. Everett B.
"Medical Department, United States Army" sub- Miller, "Medical Department, United States Army,"
series Preventive Medicine in World War II United States Army Veterinary Service in World
(Washington, 1955), p. 4. War II (Washington, 1961).
THE NORTH AFRICAN COMMUNICATIONS ZONE 219
high loss of food items through improper cal group to the European theater in
packaging, handling, and storage, which November.
can be attributed only in part to the While the number of nurses in the
greater activity of the Mediterranean as North African theater was adequate in
compared with other theaters of opera- terms of hospital T/O's, the recurrent
tion. The comparative weakness of the necessity for operating above normal bed
veterinary service in NATOUSA was capacity brought considerable strain on
clearly apparent by the end of the year, the nursing service. Wherever possible
when positive steps were taken to reor- nurses from staging units were detached
ganize veterinary activities at theater for temporary duty with operating hos-
and base section levels. 90 pitals. After October 1943, when the
required authority was received from
Nursing Service the War Department, promotions were
made to raise half of all front line nurses
Until 14 August 1943, when the posi- to the rank of first lieutenant.
tion of Director of Nurses, NATOUSA, Training was a continuous process,
was created, the chief nurse of the Medi- with frequent changes in assignment to
terranean Base Section, 2d Lt. (later Lt. assure proper balance of specialties. The
Col.) Bernice M. Wilbur acted in that only severe shortages during the active
capacity. Colonel Wilbur became direc- period in the North African communi-
tor of nurses when the position was set cations zone were nurses trained in
up. She made regular inspections of anesthesia and in psychiatry. To make
nursing activities throughout the thea- up these shortages, several general hospi-
ter, advised the surgeon as to policy mat- tals gave individual training in anesthe-
ters, and recommended assignment and sia, while a school of psychiatric nursing
transfer of nursing personnel.91 was conducted by the 114th Station
Nurses began arriving in the theater Hospital. The courses ran for 6 weeks,
on 8 November 1942, D-day for the taking fifty nurses at a time. Three
North African landings. There were classes completed the training during
more than 2,000 by the end of the Tuni- 1943. Twenty-four British nurses took
sia Campaign, with a peak strength of the course.
4,398 in October 1943. This figure had
dropped to 4,000 by the end of January Army Public Health Activities
1944, owing to the transfer of three evac-
uation hospitals and an auxiliary surgi- Allied Force Headquarters as origi-
nally organized in London in the sum-
mer and early fall of 1942 included a
90
(1) Memo, Col Noonan to Surg MTOUSA,11 civil affairs section, which combined
Apr 45. (2) Ltr, Lt Col (later Col) Duance L. with its military functions others of a
Cady to Surg, NATOUSA, 21 Dec 43, sub: In-
vestigation and Survey of Veterinary Activities in political, diplomatic, and economic na-
NATOUSA.
91
ture. It was headed after the invasion
Annual Rpt, Med Sec, NATOUSA, 1943. See by Robert Murphy, the principal U.S.
also, Maj Anne F. Parsons, and others, MS, History
of the Army Nurse Corps in the Mediterranean diplomatic representative in French
Theater of Operations, 1942-1945. North Africa. Public health activities
220 MEDITERRANEAN AND MINOR THEATERS
were administered by a subsection of the cholera and typhus. The surgeons of the
civil affairs section.92 Mediterranean and Atlantic Base Sec-
The situation in North Africa was tions also maintained informal liaison
without precedent. The political objec- with local health authorities. After the
tives, and to a considerable extent the attachment of Public Health Service
military objectives as well, demanded representatives to the NATOUSA sur-
that the local population be treated as geon's office, the over-all direction of a
allies. Civil officials were not always cor- civil public health program passed to
dial, and co-operation was often grudg- them, but Army personnel continued to
ing, but in the public health area play the dominant role in carrying out
especially it was essential for the protec- such measures as were required.95
tion of American forces that elementary By the date of the invasion of Sicily,
sanitary measures be extended to the a special organization for Allied Mili-
civilian inhabitants.98 tary Government of Occupied Territory
At Mr. Murphy's request, three United (AMGOT) had been set up under a
States Public Health Service doctors British major general, Lord Rennell,
were detailed to AFHQ late in February who was also chief civil affairs officer on
1943 and assigned on their arrival a the staff of the Allied Military Governor
month later to the nominally independ- of Sicily, General Alexander of the 15th
ent North African Economic Board. Army Group. The senior civil affairs
Shortly thereafter they were attached to officer of Seventh Army, Col. Charles A.
the office of the NATOUSA surgeon, to Poletti, headed a group of seventeen
serve as liaison between that office and civil affairs officers who went in with the
the local health authorities. Another doc- invasion forces, setting up military gov-
tor and a sanitary engineer joined the ernment organizations behind the ad-
group in July.94 vancing troops. The principal U.S. pub-
Before the arrival of the Public lic health officer for the Sicily Campaign
Health Service officers, representatives was Maj. (later Lt. Col.) Leonard A.
of the U.S. component of the medical Scheele. Major Scheele participated in
section, AFHQ, had met with French the planning for the Sicilian operation,
officials and had agreed upon supplies to serving as executive officer and later as
be furnished, particularly for control of deputy to Col. D. Gordon Cheyne, the
malaria and such potential threats as British officer in charge of public health
activities for the 15th Army Group. In
the latter capacity, Scheele succeeded
92
(1) Robert W. Komer, MS, Civil Affairs and Col. (later Brig. Gen.) Edgar Erskine
Military Government in the Mediterranean Thea-
ter, ch. I, in OCMH files. (2) Harry L. Coles and
Albert Weinberg, Civil Affairs; Soldiers Become
95
Governors, UNITED STATES ARMY IN WORLD (1) Annual Rpt, Med Sec, NATOUSA, 1943.
WAR II (Washington, 1963). (2) Long, Hist Survey of Activities of Section of Pre-
93
For the attitude of French officials, see Eisen- ventive
Aug 43. Medicine, Off of Surg, Journal,
(3) Surg, NATOUSA, NATOUSA, 3 Jan-15
12, 17 Aug, 6
hower, Crusade in Europe, pp. 111-12.
94
Ralph C. Williams, The United States Public Sep 43. (4) Hutter, "Medical Service of the Mediter-
Health Service, 1798-1950 (Washington, 1951), pp. ranean Base Section, Military Surgeon (January
1945). PP. 41-51.
THE NORTH AFRICAN COMMUNICATIONS ZONE 221
Hume, who was to accompany Fifth Public health officers at the theater
96
Army to Italy. level made surveys to determine the
status of hospital facilities, the need for
In both Africa and Sicily, Medical De-
partment officers assigned to AMGOT medical supplies for relief purposes, the
worked to restore local public health nutritional needs of the population, the
departments, to rebuild water and sew- presence of epidemic diseases, and the
erage systems, and revitalize normal pub- possibility of the introduction of new
lic health services. Local officials were diseases by insect vectors on planes and
reinforced by Army medical personnel by returning refugees. As combat opera-
and supplies wherever necessary to pro- tions by the Allies produced relatively
tect the health of troops in the area. little devastation in the French colonies
Among the problems commonly dealt in North Africa, U.S. Army participation
with were sanitation, threatened epi- in the public health program in these
demics, care of destitute refugees, and areas was largely limited to aid given by
the control of such ever-present scourges a few men trained in public health work
as malaria and venereal disease.97 to the French authorities after the cessa-
96
(1) Komer, Civil Affairs and Military Govern-
tion of hostilities.
ment in the Mediterranean Theater, ch. II. (2)
Williams, The United States Public Health Service, Mar 43, sub: Rpt on the Sessions of the Committee
pp. 698-99. (3) Ltr, D. Gordon Cheyne to on Hygiene and Epidemiology Technical Section
DCCAO, 4 Jul 43, sub: Territorial Assignment of for Public Health, French High Commissioner
Public Health Div Personnel. of North Africa; (2) Proceedings of Public Health
97
See: (1) Ltr, Col Long to Surg, NATOUSA, 27 Meeting, 13 Aug 43.
CHAPTER VI
Army would replace Seventh Army with Medical Plans for AVALANCHE
some reshuffling of combat elements.
Montgomery's British Eighth Army Fifth Army was activated on 5 Janu-
was to cross the Strait of Messina and ary 1943, with headquarters at Oujda,
move over the instep of the Italian boot French Morocco. It was the first Ameri-
to seize the important Foggia air base on can field army organized overseas during
the Adriatic side of the peninsula. Clark's World War II. The medical section,
Fifth Army was to expand northward drawn in part from personnel of the
from the Salerno beachhead to occupy task forces and in part from the United
the vital port of Naples. Operations in States, was initially headed by General
Italy thereafter would be determined by Blesse. Col. (later Maj. Gen.) Joseph
circumstances and by Allied strategy for I. Martin became Fifth Army surgeon in
the war as a whole. April when Blesse became Surgeon,
3
Fifth Army was to consist initially of NATOUSA.
two corps, one British and one Ameri- By way of preparation for its still un-
can. The British 10 Corps, commanded specified mission, Fifth Army established
by Lt. Gen. Sir Richard L. McCreery, various specialized training centers, in-
included an armored and 2 infantry cluding the Invasion Training Center at
divisions, augmented by 2 Commando Arzew, Algeria, devoted to amphibious
units and 3 American Ranger battalions. tactics. Medical personnel participated
The U.S. VI Corps, under Maj. Gen.in all training exercises. The surgeon
Ernest J. Dawley, included 1 airborne, and members of his staff made frequent
1 armored, and 4 infantry divisions. The inspections of medical operations in the
assault troops were to be the British theater, including observations of com-
46th and 56th Infantry Divisions, the bat on the Tunisian front. From time
Commandos, the Rangers, and the to time members of the medical section
American 36th Infantry Division, the were placed on temporary duty with the
last without previous combat experience British First and Eighth Armies in Tu-
but fresh from intensive training in both nisia in order to study the organization
amphibious and mountain warfare. of the British medical service and its
Two regimental combat teams of the methods of hospitalization and evacua-
45th Division, which had been diverted tion.
to Fifth Army midway through the Medical planning for the Salerno as-
Sicily Campaign, were to constitute a sault was directed by Colonel Martin,
floating reserve. The 34th, which had with Col. Jarrett M. Huddleston, the VI
seen hard fighting in Tunisia, and the Corps surgeon, participating in matters
3d, which had participated in the TORCH affecting the corps. A British medical
landings and fought throughout the cam- officer representing 10 Corps was detailed
paign in Sicily, were to be brought in as to the planning group, and close liaison
rapidly as shipping became available. 3
Except as otherwise noted, sources for this sec-
The British 7th Armoured and the U.S. tion are: (1) Annual Rpt, Med Sec, NATOUSA,
1st Armored Divisions were to be held 1943; (2) Annual Rpt, Surg, Fifth Army, 1943; (3)
back for later use, when terrain and Glenn Clift. Field Opns, pp. 203-19; (4) Zelen,
Hospitalization and Evacuation in MTOUSA; (5)
circumstances warranted. Unit rpts of med units mentioned in the text.
224 MEDITERRANEAN AND MINOR THEATERS
easily. Maximum weight was seventy also assigned to Fifth Army for duty in
pounds. the combat zone.
These mobile units were to be fol
Hospitalization lowed into Italy within 45 days by six
500-bed station hospitals and four 1,000-
Plans for hospitalization, both in the bed generals. The troop list also called
assault phase and in subsequent stages for the early arrival of a general dispen-
of the campaign, took full account of sary, a food inspection detachment, a
delays and deficiencies in bed strength hospital train, 2 medical laboratories, 2
experienced in previous Mediterranean medical supply depots, and 3 malaria
operations. As in Sicily, each division control units.5
(except airborne) was to be supported The troop list thus called for 9,500
by one 400-bed evacuation hospital. The mobile beds and 7,000 fixed beds, to be
number of 750-bed evacuation hospitals phased in as rapidly as the progress of
assigned to Fifth Army, however, was the campaign and the availability of
double the previous allowance of one shipping permitted. Beyond this point
for each two divisions. General Blesse, the preinvasion planning did not extend.
who had been willing to abandon the The further build-up of hospitals in
750-bed evacuation altogether after the Italy would be determined by events.
campaign in southern Tunisia, had come The pattern for the use of mobile
to regard it as a most valuable unit when hospitals laid down in plans for the
properly used.4 In addition, four field beach interlude of the Italian campaign
hospitals, and a fifth less one platoon, differed sharply from the plans followed
were scheduled for the use of U.S. in Sicily. In the earlier campaign, field
ground forces in Italy. hospital platoons with attached surgical
The 400-bed evacuation hospitals on teams had gone in with the D-day con-
the Fifth Army troop list were the 15th, voy, but no evacuation hospitals had
with combat experience in both Tunisia been sent to Sicily before D plus 4. In
and Sicily; the 93d, with Sicilian experi- the Italian plans, nine teams of the 2d
ence; and the 94th and 95th, both of Auxiliary Surgical Group were to be in
which had served as fixed units in Africa. the assault wave, attached to the divi-
The 750-bed evacuation hospitals were sional clearing platoons and to the beach
the 38th, with Tunisian experience; and battalion. Field hospitals were scheduled
the 8th, 16th, and 56th, all of which had for later convoys, to be used only after
operated as fixed hospitals in the thea- the beachhead was secure; but two evac-
ter. Field hospitals on the troop list uation hospitals, the 95th (400 beds)
were the 4th, less one platoon, with ex- and the 16th (750 beds), without their
perience in the Middle East; the 10th nurses, were to be on the D-day convoy.
and 11th from Sicily; and the 32d and The nurses were to come on D plus 2.
33d, direct from the United States. The In spite of the emphasis on the early
3,000-bed 3d Convalescent Hospital was provision of adequate hospitalization in
Italy, it would still be necessary for
4
Col T. H. Wickert, Rpt of Visit to ETO and
5
NATOUSA, 1 Sep to 24 Oct 43. See pp. 327ff., below.
226 MEDITERRANEAN AND MINOR THEATERS
The first U.S. combat teams ashore, The only clearing stations in operation
the 141st and the 142d, met stiff opposi- on D-day were two set up by the 162d
tion. One battalion of the 141st was Medical Battalion, which constituted
pinned down on the beach for more than part of the beach group attached to the
twelve hours, but other elements of the 531 st Engineer Shore Regiment. The
36th Division advanced inland up to beach group also included the medical
three miles. Similar gains were made in section of the 4th Naval Shore Battal-
the British sector, with Ranger spear- ion and a supply dump established
heads on the extreme left flank pene- about noon by a detachment of the 4th
trating as far as five miles. The first day's Medical Supply Depot.
fighting included German tank attacks Casualties were gradually collected as
against infantry positions. As in Sicily, stations were set up, and before dawn
the tanks were turned back by bazookas, of D plus 1 substantial numbers had
grenades, and accurately directed fire reached the beach installations. All units
from naval guns, as well as by artillery. were shorthanded, with some men yet
to come ashore and others wounded or
Medical Service in the Assault—Col- separated from their outfits. In the cir-
lecting companies of the 111 th Medical cumstances, it was impossible to follow
Battalion, organic to the 36th Division, any rigid doctrine. Casualties were
were split for the assault into three sec- brought to the beach by whatever means
tions, each consisting of one medical were at hand, including ambulances,
officer and twenty-two litter bearers. jeeps, trucks, and hand-carried litters.
One section accompanied each battalion In some instances the naval shore battal-
landing team, working directly with per- ion sent its own medical officers and
sonnel of the battalion aid station. For corpsmen inland to work with the Army
the first several hours of combat, medics doctors and help bring out the wounded.
could do little more than administer Casualties were evacuated to the
first aid. Casualties were left in ditches transports by the naval shore battalion
and foxholes, or behind dunes—where- as opportunity offered and as small craft
ever cover of any sort could be found— were available. The total from the
until darkness made it possible to move American sector through D plus 1 was
them. Two of the three collecting com- 678.11
panies of the 111th were assembled by The 179th Regimental Combat Team
late afternoon and set up their stations of the 45th Division was committed from
on the fringes of the ancient walled the floating reserve early on 10 Septem-
town of Paestum. The clearing company ber, D plus 1, followed by the 157th
landed toward evening, but could not RCT the next day. Again each battalion
establish station until its equipment landing team was accompanied by its
was unloaded on D plus 1.
11
The medical sources primarily relied upon for the This figure, from the Report of the Fifth Army
assault phase are: (4) Annual Rpt, Med Sec, Surgeon for 1943, is considerably higher than the
NATOUSA, 1943; (5) Annual Rpt, Surg, Fifth total of 430 for the same 2-day period listed in the
Army, 1943; (6) Annual Rpt, Surg, VI Corps, 1943; records of the Peninsular Base Section later. The
(7) Unit rpts of div surgs, med bns, hosps, and larger figure presumably includes Navy as well as
other med units mentioned in the text. Army casualties. See also, Table 19, p. 343, below.
228 MEDITERRANEAN AND MINOR THEATERS
own aid station personnel and by a litter ploded a hundred yards from the clear-
section of the organic medical battalion, ing station of the 120th Medical Battal-
in this case the 120th. Collecting com- ion. "Patients carried in but a few hours
panies were assembled within a few before," observed the battalion histo-
hours. The clearing company of the rian, "displayed unusual agility in
120th, although it had been divided into jumping from operating tables into
12
three detachments for the landings, was foxholes.
reassembled on the afternoon of 10 Sep- Only 128 casualties were evacuated
tember and opened station near Paes- seaward on D plus 2 because of a short-
tum on the 11th. age of small craft, which were being
Evacuation from the front was fol- used to unload ammunition, and there
lowing a normal pattern by D plus 2, was no evacuation at all on D plus 3,
although lengthening lines continued to 12 September. The hospital ship New-
be under intermittent fire. Even the foundland stood offshore until dusk but
beach installations were not secure as was ordered to move fifty miles out to
enemy planes were still in the air. One
German plane was shot down and ex- 12
Hist, 120th Med Bn, Sep 43.
SALERNO TO THE GUSTAV LINE 229
PLANNERS OF THE INVASION OF ITALY. Generals Truscott, Eisenhower, Clark, and Lucas.
sea for the night, so that her lights would scattered and suitable sites were not yet
not guide enemy planes to the transport available. The 95th had 250 of its 400
area. She was bombed and sunk before beds ready for occupancy by 0600 on 12
she could return the next morning. Evac- September. The larger 16th was not
uation by hospital ship actually began able to get into operation until midnight
on 13 September, D plus 4; air evacua- 14-15 September. Both units were in the
tion started four days later. vicinity of Paestum. The nurses of both
Facilities for holding casualties ashore hospitals had been aboard the New-
were still inadequate, despite careful foundland when that vessel was
planning to avoid just such a contin- bombed. Some suffered minor injuries,
gency.13 Personnel of the 95th and 16th and all lost personal belongings. The
Evacuation Hospitals had landed about nurses were carried back to Africa by
noon on D-day, but their equipment was rescuing ships and did not rejoin their
13
Surg, NATOUSA, Journal, 13 Sep 43. units until 25 September.
230 MEDITERRANEAN AND MINOR THEATERS
The beach clearing stations of the 162d vision. The British 56th, a few miles
Medical Battalion were no longer inland, drove for Capua, while the 3d
needed by 13 September and were struck toward the Volturno by way of
closed on that date. For the remainder Avellino. The 45th, on the right flank,
of the beach phase of the operation casu- swung out in a wide arc toward Bene-
alties were evacuated by collecting com- vento, where the 34th, operating to the
panies of the 162d Medical Battalion right of the 3d since 26 September,
directly from the division clearing sta- caught up. Attached to the 34th was the
tions to the evacuation hospitals, and 100th Battalion, made up of American-
thence to ships or planes. No other corps born Japanese, which would later be
or army medical battalions were avail- part of the 442d Regiment.
able until after the breakout.
A massive German counterattack Hospitalization on the Beachhead-
launched on 13 September drove a deep All army medical units reverted to army
wedge between the British and Ameri- control on 21 September. By this date
can salients, penetrating to within three the build-up of medical facilities was
miles of the beach, but the ground substantial, with new units arriving
troops finally stopped the attack with steadily as the campaign moved north-
the aid of naval gunfire and Allied ward. The 3d and 34th Divisions were
planes. The 504th Parachute Infantry accompanied by their organic medical
Regiment of the 82d Airborne Division battalions, the 3d and 109th, respec-
was dropped behind enemy lines at this tively. The 93d Evacuation Hospital
time. With Eighth Army closing in from reached the area on 15 September, open-
the south, the Germans had no time for ing at Paestum the following day. The
another attempt. They withdrew slowly, 94th, which arrived about the same
fighting all the way, but by 20 Septem- time, was established at Battipaglia a
ber the beachhead was secure. week later. The 8th and 38th Evacuation
Coinciding with the German with- Hospitals, both 750-bed units, and the
drawal there was a regrouping and reas- 52d Medical Battalion disembarked on
signment of U.S. units. Maj. Gen. John 21 September, although all equipment
P. Lucas took command of VI Corps belonging to the 8th was lost by enemy
from General Dawley on 20 September. action. Still another 750-bed evacuation,
The 3d Division replaced the battle- the 56th, reached the beachhead on 27
weary 36th in the line, and the 34th Di- September, followed next day by the
vision, which reached Salerno at about 161st Medical Battalion.
the same time, went into reserve. On Despite the number of hospitals
the 10 Corps front, the British 7th Ar- ashore, beds remained at a premium
moured Division entered combat. during the entire month of September.
The next phase of the campaign would Many units were slow in getting into op-
carry the Allied forces to Naples and eration because equipment was lost or
to the Volturno River beyond. The 7th delayed. The rapid troop build-up made
Armoured and the 82d Airborne Divi- heavy demands on hospital facilities, and
sions moved up the coast on the left the disease rate—especially from malar-
flank, followed by the British 46th Di- ia—was higher than had been antici-
SALERNO TO THE GUSTAV LINE 231
pated. Typical was the experience of the As soon as the storm was over, the
95th Evacuation Hospital, first U.S. hos- 38th Evacuation Hospital, still in biv-
pital to be established on the European ouac awaiting assembling of its equip-
continent in World War II. The hos- ment, began setting up a hospital, using
pital's commander, Lt. Col. (later Col.) equipment borrowed from the still
Paul K. Sauer, reported: inactive 56th. The 38th began admitting
patients at 0830, 29 September. (Map
At times we were overfilled to such an 21)
extent that all cots were in use, other pa-
tients remained on the litters on which
they had been brought to us in lieu of Across the Volturno
cots, and others were given two blankets
to enable them to sleep on the ground. Combat Medical Service—During the
When the tents were filled to capacity, drive to the Volturno, medical service in
patients were laid on the outside along the
the field followed a normal pattern. Di-
walls of the tents with their heads inside
and their bodies outside. On one night vision clearing platoons leapfrogged one
even this method was insufficient to takeanother, casualties being carried back to
care of all the patients and forty of them
the beachhead by the corps medical bat-
slept under the open sky between the tents.
talions. Collecting companies of the 52d
Fortunately the weather was balmy and Medical Battalion took over evacuation
dry.14
of the 45th and 3d Divisions from the
The weather did not long remain 162d on 29 and 30 September, respec-
either balmy or dry. On the night of 28 tively. The 34th Division, the 82d Air-
September a violent storm leveled the borne, and the Rangers were evacuated
tents of the 16th Evacuation Hospital, by collecting elements of the 162d Medi-
where 961 patients were being cared for, cal Battalion.16
and did severe damage to the installa- The advancing troops were delayed
tions of the 95th. By heroic effort, all by mountainous terrain and by the ex-
patients were rescued without injury and pert demolitions for which the retreat-
moved to a tobacco warehouse about a ing Germans were noted. The enemy
mile away, made available for the emer- chose to fight only rear-guard actions
gency by Services of Supply. There they until he reached prepared positions be-
were temporarily cared for by personnel yond the Volturno. Avellino fell to the
of the 8th Evacuation. The tobacco fac- 3d Division on 30 September, and a re-
tory was later operated as an annex connaissance troop of the 45th entered
to the 16th, by personnel of the 8th. Benevento two days later. The British
General Blesse, who arrived on the 7th Armoured Division had meanwhile
beachhead on 25 September, had spent
the preceding night at the 16th Evacua- Colonel Bauchspies was at that time commanding
tion and witnessed the destruction.15 officer of the 16th Evacuation Hospital.
16
Military sources for this section are the same
14
Annual Rpt, 95th Evac, 1943. as those cited in previous notes, with the addition
15
In addition to unit reports of the hospitals of Fifth Army History, pt. I, pp. 43-49; Pt. II, pp.
mentioned, see Col Reeder, Diary of Inspection 1-55; and Opns Rpts, VI Corps, Oct and Nov 1943.
Trip With Gen Blesse, 25 Sep-2 Oct 43. See also Medical sources include theater, army, corps, and
Ltr, Col Bauchspies to Col Coates, 15 Apr 59, division surgeons' reports already cited, and unit
commenting on preliminary draft of this volume. rpts of medical units mentioned in the text.
232 MEDITERRANEAN AND MINOR THEATERS
MAP 21—Fifth Army Hospitals and Medical Supply Dumps, 9 October 1943
occupied Naples without opposition on 307th had arrived from Sicily by boat
1 October, leaving the city to be garri- only two or three days earlier.
soned by the 82d Airborne. By 6 October forward elements of
As VI Corps neared the Volturno, the both 10 and VI Corps had reached the
distance between division clearing sta- Volturno River. Eighth Army, mean-
tions and evacuation hospitals length- while, had captured the vital complex
ened, finally approaching the 100-mile of airfields around Foggia on 1 October,
ambulance runs of the Tunisia Cam- and had moved on to extend the Vol-
paign. To cut down the long haul over turno line to Termoli on the Adriatic.
bomb-scarred and blasted roads, the At the Volturno, Fifth Army paused
93d Evacuation moved from Paestum to only long enough to bring up equipment
Montella, along the 3d Division's route necessary to replace bridges blasted by
to Avellino, on 2 October. In Naples, on the retiring enemy, and to move artil-
the same date, the 307th Airborne Medi- lery forward through hub-deep mud. In
cal Company and a detachment from its upper reaches the Volturno River
the 162d Medical Battalion opened a flows southeast, or roughly parallel to the
provisional evacuation hospital. The long axis of the Italian peninsula. At the
SALERNO TO THE GUSTAV LINE 233
point where the Calore enters the Vol- ferried back until dawn on rafts pulled
turno from the east, the latter river turns by ropes. When daylight made further
west at an acute angle to reach the Tyr- evacuation across the river impossible,
rhenian Sea some 20 miles north of the casualties were held in pools on the far
Bay of Naples. The south bank, from bank, wherever terrain afforded ade-
the coast to a point just east of Capua, quate protection.
a distance of perhaps 15 miles, was held On the 3d Division front, light bridges
by 10 Corps. The VI Corps front con- were thrown across the river during the
tinued the river line another 15 miles first day of the attack. The engineers,
to the junction with the Calore, and on working under direct observation and
eastward for a similar distance to the artillery fire of the enemy, had more
point of contact with Eighth Army. The difficulty in the 34th Division area, but
3d Division crossed the Volturno through despite the hazards managed to span the
the Triflisco Gap on the left of the VI stream by the morning of 14 October.
Corps front, while the 34th crossed 8 or As soon as the bridges were available,
10 miles farther east, near the mouth of collecting companies of the organic med-
the Calore. The 45th Division held the ical battalions crossed the Volturno to
right flank, advancing into the moun- follow the troops. Clearing stations re-
tains north of the Calore and east of the mained on the south bank until the
Volturno. bridgehead had been pushed several
The 3d and 34th Divisions began miles beyond the river. The 3d Medical
crossing the river at 0200 on 13 October, Battalion had a station in operation
after prolonged artillery preparation. In- north of the Volturno the morning of
cessant rain during the first week of 16 October, and the 109th Medical Bat-
October had turned the normally shal- talion clearing station, supporting the
low stream into a swift-flowing torrent, 34th Division, was functioning on the far
200 or 300 feet wide and varying in bank by the 18th. Thereafter, until the
depth from about 4 feet to the height of Winter Line was reached about the mid-
a tall man's shoulders. Rubber boats and dle of November, evacuation from both
rafts were used, and some swam the swol- divisions followed the normal pattern,
len river, but most of the men waded the clearing platoons bypassing one an-
across, clinging to guideropes with one other as the troops advanced.
hand and holding their rifles overhead The 52d Medical Battalion took over
with the other. All crossings were made evacuation of the 34th Division from the
under continuous fire from machine 162d on 17 October, thus becoming re-
guns and small arms on the north bank sponsible for all evacuation from VI
and from artillery farther to the rear. Corps.
Battalion aidmen, reinforced by litter Simultaneously with the Volturno
bearers from the collecting companies of crossings of the 3d and 34th Divisions,
the organic medical battalions, forded the 45th moved up on the east side of
the river with the assault troops. Ambu- the river to parallel the advance. Fight-
lance loading posts were set up on the ing was heaviest on the lower slopes of
near shore, close to the sites previously the Matese Mountains, where the task
chosen for bridging, and casualties were of bringing out the wounded was formi-
234 MEDITERRANEAN AND MINOR THEATERS
dable, but the heights of Piedimonte to the east. The 56th displaced to its
d'Alife were gained by 17 October with- right, crossing on the 3d Division bridge
out undue casualties. at Triflisco on 15 October. The 3d Di-
Enemy positions on the coastal plain, vision also shifted to the right, into the
meanwhile, had proved stronger than 34th Division sector, while the 34th
anticipated. The British 46th Division crossed the upper Volturno on 19 Octo-
on the 10 Corps left flank, and the 7th ber to a position in front of the 45th.
Armoured in the center, had forced Both corps moved slowly forward
crossings of the Volturno the night of against stubborn opposition for another
12-13 October, but the British 56th Di- two weeks. Then on the night of 3-4
vision in the Capua area had been unable November the 45th crossed the Volturno
to cross without taking losses deemed too from east to west, south of Venafro, and
heavy by the Fifth Army command. the 34th recrossed north of that town,
Plans for further advance were therefore leaving the 504th Parachute Infantry,
altered by shifting the corps boundary which had come into the line a few days
SALERNO TO THE GUSTAV LINE 235
ROUGH GOING
earlier, to strike toward Isernia and of Mignano and Venafro. The moun-
hold the high ground on the right flank. tains, however, had become steadily
The 3d Division struck toward Mignano more precipitous and the weather pro-
Gap on the left of the corps area. gressively worse. A halt was called for
By 15 November Fifth Army had regrouping and reconsideration of strat-
reached another German defensive posi- egy.
tion, the Winter Line. Since 6 October In the immediate combat zone, the
a strongly fortified river line had been problems of evacuation incident to a
breached and gains registered from difficult river crossing were succeeded by
seventeen miles along the coast to forty- those of mountain fighting in which the
five miles on the right flank of the Fifth enemy was dug in on every slope in mu-
Army front. The new line extended tually supporting positions that com-
along the south bank of the Garigliano manded every access road and trail.
River to the junction with Eighth Army Mines, booby traps, and snipers were
west of Isernia, and included the towns everywhere. Each new advance was
236 MEDITERRANEAN AND MINOR THEATERS
MAP 22—Fifth Army Hospitals and Medical Supply Dumps, 15 November 1943
made in the face of machine gun and generally 300 to 500 yards behind the
artillery fire from dominating slopes. point of contact with the enemy, but
The storming of mountain peaks was were sometimes as much as a week ahead
commonplace. Men suffered increas- of their vehicles, restricting them to such
ingly from exposure, and the strain be- drugs and equipment as could be hand-
gan to show in a sharply rising incidence carried. The numerous caves found in
of combat neurosis. the Italian mountains were often used
The tasks of the aidmen and the litter for aid station sites because they could be
bearers were the most arduous. Medical blacked out, and because they offered a
officers often worked at night by flash- measure of protection from rain, snow,
light, with both doctor and patient con- and enemy shells. Collecting stations
cealed under blankets. Aid stations were were eliminated wherever possible, but
SALERNO TO THE GUSTAV LINE 237
when used were 1 to 4 miles behind the arrived from Sicily, opened at Alife east
lines, with clearing stations 6 or 8 miles of the Volturno, on 2 November. (Map
farther to the rear. The irregularities of 22)
the front, however, and the exigencies The 750-bed evacuation hospitals also
of mountain fighting not infrequently moved up to new locations during the
brought clearing stations within range period of the Volturno campaign. The
of enemy guns. Six-man litter squads 56th opened at Avellino on 6 October,
were usually necessary, with carries shifting to Dragoni across the river from
often taking eight to twelve hours. When the 15th on 2 November. The 8th and
the corps medical battalions were 38th Evacuation Hospitals opened in
drained of personnel, additional litter Caserta on 16 October, followed by the
bearers were supplied from the combat 16th Evacuation on the last day of the
units. Casualties among medics, and par- month. The 38th moved on to the Ri-
ticularly among litter bearers, were ardo area, just north of the site of the
high.17 94th, on 8 November.
The field hospitals, as already noted,
Hospitalization—To keep the ambu- were late in coming into the theater,
lance runs relatively short, Fifth Army and were used only in part for direct
hospitals moved into the combat zone as support of the army. The 32d Field
rapidly as suitable sites became available, opened in Caserta on 16 October, where
with the 400-bed evacuations leading the it functioned for ten days as an evacua-
way. The 95th opened in Naples on 9 tion hospital before being attached to
October. The 93d moved hastily from the base section. The 10th Field moved
Montella to Avellino on 11 October, into Caserta on 29 October, also func-
after bombed-out bridges and swollen tioning as an evacuation hospital. The
streams threatened to isolate the unit; 11 th Field, though in the theater, was
then advanced again on 24 October to inactive until the next phase of the cam-
Piana di Caiazzo, where it was the first paign. The two available platoons of the
American hospital north of the Volturno. 4th were assigned to the base section as
The 94th shifted from Battipaglia in an air evacuation holding unit.
the Salerno area to take over an Ital- Only the 33d Field Hospital per-
ian military hospital in Maddaloni, formed services similar to those of the
where it opened on 11 October. Novem- field units in the Sicily Campaign. One
ber 5 saw the 94th Evacuation in Riardo, platoon of the 33d joined the 120th
a dozen miles north of Capua. Still far- Medical Battalion on 17 October, oper-
ther forward, the 15th Evacuation, newly ating with the 45th Division clearing sta-
tion as a holding hospital for nontrans-
portables and for forward surgery. An-
17 other platoon of the 33d joined the
(1) Capt Robert L. Sharoff, The Infantry Bat-
talion Aid Station in Operation, Med Hist Data, 11th Medical Battalion, in Army re-
3d Med Bn, 23 Oct 43. (2) Ltr, Col W. W. Vaughn serve with the 36th Division, on 21
to Brig Gen R. W. Bliss, 18 Jan 44, sub: Observa- October; and the remaining platoon
tions From Overseas Casualties. (3) Annual Rpt,
Surg, 34th Div, 1943. (4) Hist, 120th Med Bn, Nov went into the combat area with the
43. 109th Medical Battalion, in support of
238 MEDITERRANEAN AND MINOR THEATERS
the 34th Division, the following day. All ice Force the following day. The 1st
three platoons were reinforced by teams Special Service Force, a commando-type
of the 2d Auxiliary Surgical Group. unit with six battalions organized into
The 3d Convalescent Hospital was al- three "regiments," had a strength equiv-
so assigned to Fifth Army from its ar- alent to one regimental combat team-
rival in the theater on 10 October, but about 5,000 men. It was composed of
functioned in Naples rather than in the U.S. and Canadian troops, specially
forward area until near the end of the trained for mountain fighting and in
year. raiding tactics.
Three Ranger battalions and ele-
The Winter Line ments of the 504th Parachute Infantry
were also at the front, to be used as the
Fifth Army was substantially reor- army commander might direct. The 1st
ganized during the last two weeks of Armored Division began unloading at
November, before launching a direct Naples on 15 November and went into
assault against the fortified positions of Army reserve. Two French divisions, the
the German Winter Line. The head- 2d Moroccan and the 3d Algerian, were
quarters of II Corps, now under General also on the way from North Africa as
Keyes, arrived from Sicily in October. components of a French Expeditionary
On 18 November the 3d and 36th Divi- Corps (FEC) under General Juin.
sions were assigned to II Corps, which In addition to medical units already
took over the center of the Fifth Army in the Fifth Army area, the 54th Medical
front. The British 10 Corps remained Battalion and the nth Field Hospital
on the left flank; the 34th and 45th were assigned to II Corps. The Italian
Divisions, making up VI Corps, were on and French units under Fifth Army
the right.18 command had their own medical organ-
The 36th Division, out of combat since izations, including field and evacuation
20 September, began to relieve the 3d hospitals.
on 17 November, the 3d going into biv- The Winter Line proved to be only
ouac for a rest. The strength of II Corps a series of strongly held outposts a few
was maintained, however, by attachment miles in front of the heavily fortified
of the 1st Italian Motorized Group on Gustav Line, where the Germans
22 November and of the 1st Special Serv- planned to make their main stand. The
key to the Gustav Line was Monte Cas-
18
Military sources for this section include: 1st sino, dominating the entrance to the Liri
Opns Rpts, VI Corps, Nov 43-Jan 44; (2) Opns Valley through which Highway 6 and a
Rpts, II Corps, Nov 43-Jan 44; (3) Fifth Army
History, pt. III. Citations to additional military doubletrack railroad ran northwest to
sources will be found at the beginning of this Rome, a distance of about eighty miles.
chapter. Medical sources for the Winter Line The approach to the Liri Valley lay
campaign include: (4) Annual Rpt, Med Sec,
NATOUSA, 1943; (5) Annual Rpt, Med Sec, through the Mignano Gap, known to the
MTOUSA, 1944; (6) Annual Rpts, Surg, Fifth troops as Purple Heart Valley, which was
Army, 1943, 1944; (7) Annual Rpts, Surg, VI controlled on either side by German-
Corps, 1943, 1944; (8) Annual Rpts, Surg, II Corps,
1943, 1944; (9) Unit rpts of div surgs and med held mountain masses and barred at its
units mentioned in the text. outlet by the Rapido River. The plan of
SALERNO TO THE GUSTAV LINE 239
campaign called first for driving the ern rampart of the Mignano Gap, and
enemy from his mountain stronghold, Mt. Lungo, which cut the center of the
and then forcing a crossing of the Rapido valley. VI Corps, with the 2d Moroccan
south of Cassino, at the same time Division replacing the 34th, was to try
executing a wide flanking movement again for Sant'Elia and Atina. The II
through the mountains northwest of the Corps objectives were taken by 17 De-
town. cember, after bitter seesaw battles for
The attack began on 1 December with every knob and crest, but VI Corps again
an assault against the Camino hill mass failed to make substantial headway in
south of the Mignano Gap. The main its flanking attack. Lack of reserves for
effort was directed at the left flank by speedy exploitation of gains was an im-
the 46th and 56th Divisions of 10 Corps, portant factor.
while the Special Service Force of II Mt. Trocchio, the last mountain
Corps attacked simultaneously from the stronghold before Cassino, was II Corps'
right. The infantry advance was preceded major objective in the third phase of
by the heaviest concentration of artillery the Winter Line campaign. The position
fire yet used in the Italian campaign, was taken, again after slow and bitter
but the result was indecisive. It was still fighting, by noon of 15 January 1944,
necessary for foot soldiers to scale the but the crossing of the Rapido was de-
heights and storm the enemy positions layed for another week by the failure
one by one. The operation was rendered to outflank Cassino from the north, and
still more hazardous by three days of by an over-all change of plans.
continuous rain. Both lines of advance General Alexander, commanding the
and lines of supply were under enemy 15th Army Group, issued orders on 2
fire, while bad weather prevented any January for the seaborne flanking move-
effective air support. The entire Camino ment to Anzio, and VI Corps was as-
complex was nevertheless secured by 9 signed the operation. A reshuffling of
December. Fifth Army forces gave the 45th and 3d
The 34th and 45th Divisions of VI Divisions to VI Corps at this time. The
Corps were meanwhile attacking north- 34th Division went back into the line as
west from Venafro with the ultimate a II Corps unit, replacing the 36th, while
objective of outflanking Cassino by tak- the 3d Algerian Division relieved the
ing Sant'Elia and Atina. The VI Corps 45th. The VI Corps sector was taken
attack, launched on 29 November, was over by the French Expeditionary Corps
slow and costly. By 4 December the 34th the first week in January. The 1st Ar-
Division, on the left, had gained about a mored, which had been attached to II
mile, at a cost of 777 casualties. The 45th Corps about 15 December in hopes of a
continued to inch forward for another breakthrough into the Liri Valley, re-
five days, taking several important hill mained temporarily in the line, but
positions but making little headway to- went ultimately to VI Corps for the
ward its goal. Anzio landings.
In the second phase of the Winter The capture of Mt. Trocchio brought
Line campaign, II Corps was to seize Mt. Fifth Army up to the main defenses of
Sammucro, which formed the north- the Gustav Line. During two months of
240 MEDITERRANEAN AND MINOR THEATERS
rugged mountain fighting in the foulest high, but the only available replace-
kind of weather, the Allied forces had ments were men from fixed hospitals in
advanced an average of five to seven the base sections who lacked both battle
miles. Casualties had been heavy, but experience and conditioning. Collecting
battle fatigue and exposure had taken companies were used sparingly, and
an even greater toll. The enemy too had where used were reduced to one medical
suffered heavily, but he appeared to have officer each. Medical officers of the corps
gained his purpose of achieving a winter medical battalions were often detached
stalemate. Eighth Army had driven up for duty with the divisional medical
the Adriatic coast as far as Ortona, but units.19
Montgomery's forces also failed to force A variety of expedients were adopted
a passage through the rocky fastnesses of to speed the process of evacuation. Cas-
the central Apennines to Rome. ualties from the 34th Division were
brought down from Mt. Pantano by
Battlefield Evacuation—As in the litter bearers who lined both sides of
Volturno campaign, the primary medi- the trail and passed litters from hand to
cal problem of the Winter Line was hand over their heads.20 Litter carries
evacuation of casualties from the battle- ran as long as 12 to 15 hours, with 6-man
fields. The difficulties inherent in carry- squads working in relays. The 109th
ing wounded men down steep, boulder- Medical Battalion reported using 16
strewn slopes, often in total darkness, such squads to move casualties over a
were aggravated by cold and almost in- 5-mile stretch on 12 January 1944. On
cessant rain or snow. Main highways were the longer routes, aid stations were set
frequently under enemy fire and were up along the way to supply first aid,
overburdened with a steady stream of plasma, and hot drinks, and to give walk-
combat equipment. Secondary roads and ing wounded a chance to rest. The 120th
trails were so deep in mud that ambu- Medical Battalion used pack mules
lances could rarely come within five to bring out trench-foot cases, and
miles of the lines. experimented with a mule-carried litter,
All available litter bearers of the corps apparently unaware of the similar ex-
medical battalions were assigned to the periments carried out by the 9th Med-
divisions, and these were periodically ical Battalion in Tunisia and Sicily.
supplemented by assignment of combat Experiments were also made with a
personnel. Toward the end of the year, modified breeches buoy, improvised from
AFHQ authorized the addition of 100 an equipment line, for lowering casual-
litter bearers to each organic medical ties down precipitous slopes.21
battalion. Continuous replacements were Some indication of the magnitude of
necessary at all levels of the medical
19
service. Litter bearers were exposed to (1) Pers Ltr, Gen Blesse, Surg, NATOUSA, to
Gen Kirk, 26 Nov 43. (2) Surg, NATOUSA,
the same hazards as the combat troops. Journal, 23 Dec 43. (3) Med Hist Data, 54th Med
Many of them camped along the evacua- Bn, 26 Sep 44. See also, reports of div surgs and
tion routes, but without the protective med bns mentioned elsewhere in the text.
20
Bull of the U.S. Army Medical Department
clothing worn by the infantrymen. Cas- (July 1944) , p. 26.
ualties among medical officers were also 21
Clift, Field Opns, p. 250-a.
SALERNO TO THE GUSTAV LINE 241
the evacuation problem may be gathered 162d Medical Battalion, while the
from reports of the two corps medical continued to operate through January.
battalions primarily responsible for
moving casualties from clearing stations Hospitalization—The heavy casual-
to the mobile hospitals in the combat ties of the Winter Line campaign, cou-
zone. The 52d Medical Battalion evac- pled with transportation difficulties over
uated 25,125 sick and wounded from muddy and congested roads, soon made
division clearing stations between 30 it necessary to bring more hospital beds
September and the end of the year. Be- into the combat area. The 95th Evac-
tween 15 November and 15 January the uation Hospital moved up from Naples
54th Medical Battalion evacuated 16,186 on 28 November to a site just beyond
patients. Even these figures do not tell the Volturno northwest of Capua, where
the whole story, since some evacuation it was joined by the 10th Field from
before 15 November was handled by the Caserta on 1 December. The 15th Evac-
242 MEDITERRANEAN AND MINOR THEATERS
MAP 23—Fifth Army Hospitals and Medical Supply Dumps, 15 February 1944
uation moved from Alife, east of the mounted. The 93d and 95th Evacuation
Volturno, where it had twice been Hospitals, designated for the Anzio op-
flooded, to Riardo, where the 38th and eration, were closed early in January
94th were already operating, on 15 De- 1944, but their places were taken by the
cember. The 8th Evacuation opened at 3d Convalescent, which opened at Pigna-
Teano, in the same general area, the fol- taro Maggiore on 6 January, and the
lowing day, while the 16th Evacuation 11th Evacuation, which arrived from
moved from Caserta to Vairano on 28 Sicily in time to open at Vairano on 14
December. For all hospitals, siting was a January. (Map 23)
problem for the engineers, with mud With the exception of the 56th Evac-
the ever-present obstacle to be sur- uation at Dragoni and the 93d at Piana
SALERNO TO THE GUSTAV LINE 243
di Caiazzo, all of these Fifth Army hos- Carnage Along the Rapido—The main
pitals were strung out along Highway assault was launched by General Keyes'
6, within a 10- or 12-mile stretch. The II Corps in the center of the Fifth Army
medical installations in the army area, front on the night of 20 January, only
including clearing and collecting sta- a few hours before the Anzio armada
tions, all suffered more or less severe sailed from Naples. The assignment was
damage in a New Year's Day storm, the probably the most difficult of the en-
15th, 38th, and 94th Evacuation Hospi- tire Italian campaign. The U.S. 36th Di-
tals being the hardest hit. All patients vision, commanded by Maj. Gen. Fred
of the 15th and 38th had to be moved, as L. Walker, was to cross the Rapido be-
well as most of those of the 94th. low Cassino in the vicinity of Sant' An-
gelo, seize that town, and advance as far
The Cassino Stalemate as Pignataro Interamna. Combat Com-
mand B of the 1st Armored Division
By way of prelude to the Anzio land- was to pass through the 36th and exploit
ings, which were scheduled for 22 Janu- up the Liri Valley, while the 34th
ary 1944, Fifth Army sought to engage Division was to create a diversion before
the maximum German strength by way Cassino and be prepared to attack from
of a direct assault against the Gustav Line. east or south, or to follow the armor
The French Expeditionary Corps on the through the 36th, as circumstances dic-
right led off on 12 January with tated. The 45th Division was in reserve,
a 3-day drive that carried General Juin's to be thrown into the Cassino battle or
colonials to the mountains north of Cas- be shipped to Anzio as the tide of battle
sino. General McCreery's British 10 might require.
Corps, with the 5th Infantry Division It was a very large order. Cassino and
substituted for the 7th Armoured, the mountains surrounding it were heav-
crossed the lower Garigliano near the ily fortified anchor points in the Gustav
coast on 17 January. By the 20th of the Line, from which enemy artillery could
month, the 5th and 56th Divisions had rake the whole line of the Rapido River
secured a bridgehead extending to high and cover the Liri Valley with cross fire.
ground north of Minturno, but the 46th The river, itself, at that point, was a
Division had failed to get across the swift-flowing stream 25 to 50 feet wide
river farther upstream, near the II Corps and 9 to 12 feet deep, with high, brush-
sector.22 covered banks on either side. The ap-
proaches had been skillfully and lavishly
22
strewn with mines, and the low ground
The chief military sources for this section
include: 1st Fifth Army History, pt. IV, pp. 27-57, was waterlogged by deliberate flooding.
87-100, 175-85; (2) Opns Rpts, II Corps, Jan-Apr On the German side the ground was
44; (3) Huff, ed., The Fighting Thirty-sixth. See higher, with the town of Sant'Angelo
note at the beginning of this chapter for additional
sources. The more important medical sources are: perched on a 40-foot bluff that gave per-
(4) Annual Rpt, Med Sec, MTOUSA, 1944; (5) An- fect observation. Mines and wire entan-
nual Rpt, Surg, Fifth Army, 1944; (6) Annual Rpt, glements were backed up by a belt of
Surg, II Corps, 1944; (7) Unit rpts of div surgs,
med bns, and other med units mentioned in the dugouts and concrete pillboxes, from
text. which the entire river line could be
244 MEDITERRANEAN AND MINOR THEATERS
blanketed by machine gun fire. The record flow of wounded, it was impos-
failure of the British 46th Division to sible to retain them long in the clearing
cross the Garigliano earlier in the day, station. The nontransportables were
moreover, had left the southern flank transferred immediately to a platoon of
unsecured. the 11th Field Hospital, which was ad-
After concentrated air and artillery jacent. Those who could stand the
preparation, the 141st Regimental Com- journey were sent back by ambulance
bat Team moved through the mine fields and truck to the evacuation hospitals,
to its crossing points north of Sant'An- which were still concentrated along
gelo, while the 143d RCT took up posi- Highway 6 from Vairano, twenty miles
tions along the Rapido south of the behind the front, to Capua on the
town. The Germans were neither sur- Volturno. Transportation was supplied
prised nor unprepared. Artillery, rocket by the 54th Medical Battalion.
projectors, and automatic weapons met When the Sant'Angelo sector quieted,
the assault. Boats were destroyed before a truce was arranged for 25 January
the launching or sunk in midstream. from 1400 to 1700, and litter bearers
Bridges were knocked out before they from two collecting companies of the
were in place. Only a handful of men 111 th Medical Battalion crossed the
from the 141st reached the western bank, Rapido to remove the dead and
and the somewhat larger number from wounded. A German guide led them
the 143d who achieved the crossing were through the mine fields and up to the
quickly immobilized. Before dawn those barbed-wire entanglement about 10
able to return were recalled. yards from the stream. There German
A second attempt the following day medics turned over 12 American
was only slightly more successful. Fog wounded, stating that 18 more were in
and smoke screens covered the crossings, the German hospital. An opportunity to
but the German guns were zeroed in. inspect these was offered, but time did
One battalion of the 143d RCT and ele- not permit. The dead were so numerous
ments of the 141st managed to advance that all could not be removed in the 3-
a half mile or so beyond the river, but hour period of the truce.
reinforcement and resupply were alike The 2-day "battle of guts" cost the
impossible. The men were driven back 36th Division 2,019 officers and men in
to the river, and those who could not killed, wounded, and missing, of whom
withdraw were isolated. When ammuni- 934 were wounded.23
tion gave out, the battle was over. The
36th Division had been badly beaten. Frustration at the Gustav Line—"The
Although many of the wounded could failure of the 36th Division to establish
not be reached, and others could be a bridgehead in the Liri Valley forced
brought out only with great difficulty, a quick change in plans. The French Ex-
308 battle casualties were processed
through the clearing station of the 111 th 23
Annual Rpt, Surg, Fifth Army, 1944, p. 40.
Medical Battalion on 21 January and Fifth Army History, pt. IV, p. 47, gives a total of
1,681, broken down into 143 killed, 663 wounded,
291 the following day. With only five and 875 missing but the surgeon's figures, based on
medical officers available to handle this unit reports, appear the more reliable.
SALERNO TO THE GUSTAV LINE 245
peditionary Corps, which had renewed triumph seemed almost at hand. The
its drive on 21 January, was ordered to Germans, however, were furiously rein-
concentrate its strength on its own left forcing their crumbling lines, and the
flank, while the 34th Division attempted Allied drive was stopped a bare mile
a crossing of the upper Rapido just be- short of Highway 6. On 12 February II
low the village of Cairo, at the boundary Corps went over to the defensive. Dur-
of the II Corps and FEC sectors. The ing the next ten days the 34th and 36th
34th jumped off the night of 24 January. Divisions were relieved by Lt. Gen. Sir
Enemy positions were much the same Bernard Freyberg's New Zealand Corps,
as those encountered by the 36th Divi- made up of the New Zealand 2d Division,
sion farther south, but this time the the Indian 4th Division, and the British
bridgehead held. First across the river, on 78th Division, all from the Eighth Army
the morning of 25 January, was the 100th front.
Battalion. Other elements of the 133d The pattern of evacuation during the
Regimental Combat Team followed, and period from 24 January to 14 February
all held grimly to their gains through the resembled that of the Winter Line cam-
night of 25-26 January. The 135th RCT paign. Litter carries were long, difficult,
forced another crossing just north of Cas- and exhausting since vehicles were un-
sino in the early hours of 26 January, and able to penetrate far into the mountain-
the 168th crossed the next day, with four ous area where the fighting was in prog-
tanks. The engineers got more tanks ress. Again more litter bearers were
across early on the 29th, in time to help essential. The 54th Medical Battalion
repel a determined counterattack. To loaned all that could be spared, averag-
exploit the gains, the 142d RCT of the ing about 150, to the collecting com-
36th Division, which had not partici- panies of the divisional medical battal-
pated in the earlier action, was attached ions. Others were recruited from among
to the 34th Division, and with the French Italian labor troops, and still others were
Expeditionary Corps gained command- combat replacements not yet committed
ing heights north of Cairo. The bridge- to battle. But the bulk of them came
head was secure by 31 January. from noncombat elements of fighting
For the next two weeks II Corps threw units and from among fighting men
all its strength and battle toughness into themselves. Over 800 additional litter
an effort to break through the Cassino bearers were used by II Corps on the
defenses and cut Highway 6 behind the Cassino front in January and February
main German positions. The fighting 1944.
was hard, close, and continuous. On 2 Casualties were heavy during the
February elements of the 34th Division battle for the bridgehead, but became
broke into Cassino itself, and on the 5th even heavier as tired troops penetrated
a patrol reached the walls of the Bene- the main defenses of the Gustav Line.
dictine monastery high above the town. The clearing station of the 109th Medi-
The 36th Division, decimated though it cal Battalion, supporting the 34th Divi-
was, went back into the line. About a sion, had its busiest day on 3 February,
third of the mountainous area northwest when 430 patients, 268 of them with bat-
of Cassino was overrun, and a decisive tle wounds, were processed. For the en-
246 MEDITERRANEAN AND MINOR THEATERS
AID STATION IN SANT'ELIA AREA, smoke from a German shell rising in the background.
hind the lines. Neither division returned centrally controlled by the Fifth Army
to combat on the southern front. The surgeon. As long as the line of evacuation
New Zealand Corps renewed the attack lay along a single highway, as in the first
on Cassino, 15-20 February, but, aside days of the breakout from the Salerno
from destroying the monastery, achieved beachhead, it was possible to funnel cas-
no more success than had the Americans. ualties through one ambulance control
The Cassino front lapsed into inactivity point, where they were routed to the
until 15 March, when the New Zealand available evacuation hospitals in groups
Corps launched a second drive, pre- of fifty at a time. Since there was no
ceded by the heaviest air and artillery sorting of casualties at the control points,
bombardment of the Italian campaign. however, the actual burden on the hos-
But again the Gustav Line held, and the pitals proved very uneven and treatment
frontal attack was abandoned. of some patients was unnecessarily de-
layed.24
Hospitalization in the Army Area
24
Except as otherwise noted, this section is based
Hospitalization Policy on the reports of the Fifth Army surgeon for 1943
and 1944, and on the reports of the individual
All hospitalization in the army area hospitals and medical battalions functioning in the
throughout the Italian campaign was Fifth Army area.
248 MEDITERRANEAN AND MINOR THEATERS
ation Hospital also used a clearing pla- addition to the medical specialties repre-
toon as a convalescent ward during most sented by the establishment of separate
of January 1944. hospitals for venereal disease and neuro-
Late in December the use of clearing psychiatric cases, twenty-five teams of the
platoons as hospitals was carried another 2d Auxiliary Surgical Group were em-
step forward. On the 21st of that month ployed in field hospital platoons and in
a platoon of the 162d opened as a vene- evacuation hospitals. Wherever possible,
real disease diagnostic and treatment Medical Corps officers were replaced by
center, and ten days later a platoon of the officers of the Medical Administrative
161st, with psychiatrists and other addi- Corps, despite the resistance of unit com-
tional personnel attached, became the manders in the field. Fifty MAC's had
Fifth Army Neuropsychiatric Center. been so assigned before the Winter Line
Both of these special hospitals were in was reached, and twenty-five more had
the vicinity of Capua until the end of been requested.26 These officers were
March, when a general resiting of Fifth used in supply, operations, personnel,
Army hospitals took place.25 The move- records, and other administrative posi-
ment of the 3d Convalescent Hospital tions and increasingly, when the shortage
into the army area early in January of medical officers became acute, as as-
completed the establishment of special- sistant battalion surgeons and in the col-
ized facilities immediately behind the lecting companies where evacuation
lines. In sum, these units went far toward rather than medical care was the primary
freeing the evacuation hospitals for their mission.
primary mission, the treatment of battle
wounds. Statistical Summary
The use of specialized facilities in the
army area was also designed to save for U.S. bed strength in the Fifth Army
combat duty as large a proportion of area as of 15 January 1944, including
those hospitalized as possible. Medical field hospital platoons with the division
cases such as respiratory diseases, fevers clearing companies, clearing platoons
of various types, jaundice, dysentery, ve- used as expansion units, the neuropsy-
nereal disease, and trench foot could chiatric and venereal disease hospitals,
usually be treated close to the front and, and hospitals staging for Anzio, was ap-
with convalescent beds available, could proximately 10,000. The total remained
often be held long enough for a cure. the same at the end of April, though it
Specialization also permitted adequate was divided between the Cassino front
care by the minimum number of medical and the Anzio beachhead. Hospital ad-
officers. missions from Fifth Army to U.S. instal-
The extensive employment of special- lations from 9 September 1943 through
ist personnel was another feature of the 30 April 1944 are shown in Table 5. It
Fifth Army system of hospitalization. In should be borne in mind that the figures
for January, February, March, and April
25
See pages 255-56, 258-59, below, for more de- include hospital admissions on the Anzio
tailed discussion of the NP and VD hospitals. The
resiting of hospitals before the Rome-Arno Cam-
26
paign is treated on pages 290-91, below. Pers Ltr, Gen Blesse to Gen Kirk, 17 Nov 43.
250 MEDITERRANEAN AND MINOR THEATERS
TABLE 5—HOSPITAL ADMISSIONS FROM FIFTH ARMY, 9 SEPTEMBER 1943-30 APRIL 1944 a
a
All figures are for U.S. personnel only.
Source: Annual Rpt, Surg, Fifth Army, 1944.
beachhead, which are not separately Army thereafter responsible only for
available by months. It will be noted that clearing its own hospitals.28
the disease rate was highest in December, Evacuation in the army area, like hos-
when weather conditions were at their pitalization, was centrally controlled by
worst, while battle casualties reached the Fifth Army surgeon. Evacuation hos-
their peak in February, when both fronts pitals reported daily as to the number of
were fully engaged.27 patients ready for disposition, and each
was given a quota twenty-four hours in
Evacuation From Fifth Army advance of movement. Wherever pos-
sible, by arrangement with the base
Patients who could not be returned to surgeon, specific hospitals were desig-
duty within a reasonable time—usually nated to receive the evacuees. Though
twenty-one days, although there was no this system was new in the theater, it
general policy—were moved as rapidly as worked smoothly in most instances.
they became transportable to fixed hos- Among the practical difficulties encoun-
pitals in North Africa and in the develop- tered were occasional communication
ing communications zone around Naples. failures, and a tendency on the part of
During the period of army control, all evacuation hospital commanders to move
evacuation out of the combat zone was to patients who should have been retained
Africa, by sea from the Salerno beach- in order to use up the allotted quota of
head, and by air from Naples. Responsi- fixed beds.29
bility for evacuation out of Italy shifted
to the newly activated Peninsular Base 28
See p. 326, below.
29
Section on 1 November, with Fifth (1) Annual Rpt, Surg, Fifth Army, 1944. (2)
27
Annual Rpt, 10th Field Hosp, 1943. (3) Annual
See pp. 273-74, below. Rpt, 15th Evac Hosp, 1943.
SALERNO TO THE GUSTAV LINE 251
shortly before the invasion, 3 2 but initial ment sufficient for postoperative care of
reliance was placed on the experienced remaining patients were left behind
teams of the 2d Auxiliary Surgical when the hospital moved.34
Group. In the landing phase, these Important changes in management of
teams were attached to the clearing sta- surgical cases during the southern phase
tions, shifting to the evacuation hospitals of the Italian campaign included the
as they were established. When the front wider use of penicillin, which had been
was stabilized north of the Volturno late allocated for specific treatments in the
in October 1943, field hospital platoons, closing months of 1943, but became rela-
each with two to eight surgical teams, tively plentiful early in 1944; radical
were set up adjacent to the division debridement and other prophylactic
clearing stations, on the pattern devel- measures to prevent gas gangrene; and
oped in Sicily. Although these 100-bed the extensive use of whole blood, made
units were somewhat larger than experi- possible by the establishment of a blood
35
ence had shown to be necessary, no bank in Naples in February 1944.
suitable substitute was available.33 Another significant administrative de-
With the commitment of the field hos- velopment in forward surgery was the
pitals, a system of triage was instituted at employment of a surgical consultant by
the clearing stations. Patients who could Fifth Army toward the end of 1943. The
stand the ambulance trip were sent back assignment went to Maj. Snyder, who
to an evacuation hospital. Those who had served in a similar capacity with II
could not safely be moved were carried Corps in the Tunisia and Sicily Cam-
by litter to the field hospital for immedi- paigns. The theater consultant in sur-
ate surgery. The nontransportable cate- gery, Colonel Churchill, continued to
gory generally included cases of severe devote much of his time to the inspection
shock, intra-abdominal wounds, thoraco- and improvement of surgery in the army
abdominal wounds, sucking chest area. Fifth Army also benefited, as II
wounds, and traumatic amputations. Pa- Corps and Seventh Army had not, from
tients treated in the field hospital units the close proximity of fixed hospitals in
were retained until they could be safely the base section, permitting frequent
moved, up to a maximum of fourteen conferences for exchange of experience
days. As in Sicily, personnel and equip- and ideas among medical officers.
32
Fifth Army Med Cir 1, an. 2, sub: Surg Pro- Neuropsychiatry—Experience in Sicily
cedures, 21 Aug 43.
33
After the Sicily Campaign, General Blesse and tended to confirm the conclusions
Colonel Churchill concluded that the ideal unit reached by Major Hanson and his asso-
for forward surgery would be a 120-bed surgical
hospital, capable of operating in two 60-bed sec-
34
tions. See (1) Col Wickert, Rpt of Visit to ETO For a nonprofessional, but vivid and moving
and NATOUSA, 1 Sep to 24 Oct 43. Except as account of life in one of those field hospital units,
otherwise noted, sources for this section are: (2) see Margaret Bourke-White, They Called It The
Annual Rpts, Surg, Fifth Army, 1943, 1944; (3) Purple Heart Valley (New York: Simon and Schus-
Annual Rpt, Med Sec, NATOUSA, 1943; (4) An- ter, 1944) , pp. 123-32.
35
nual Rpt, Med Sec, MTOUSA, 1944; (5) Annual (1) Surg, NATOUSA, Journal, 3 Nov 43. (2)
Rpt, nth Fld Hosp, 1944; (6) Annual Rpts, 33d Fifth Army Med Cir No. 4, 20 Oct 43, sub: Gas
Field Hosp, 1943, 1944; (7) Annual Rpts, 2d Gangrene. For discussion of the organization and
Aux Surg Gp, 1943, 1944. operation of the blood bank, see pp. 352-53, below.
254 MEDITERRANEAN AND MINOR THEATERS
ciates during the Tunisia Campaign that zone of interior to assist in their indoc-
the majority of psychiatric cases arising trination. 36
as a result of combat could be returned 36
(1) Hanson, comp. and ed., "Combat Psychia-
to duty in a relatively short time if try," Bulletin, U.S. Army Medical Department,
treated close to the source of disturbance. Suppl (November 1949) pp. 33, 45. (2) Pers Ltr,
It was largely on the basis of Hanson's Gen Blesse to TSG, 13 Dec 43. General Blesse was
understandably reluctant to let Hanson go, but
findings that the War Department in felt that the mission was of such importance as to
October 1943 authorized the addition of justify recalling his neuropsychiatric consultant
a psychiatrist to the staff of each division from Italy to undertake it. "I hope," he wrote to
General Kirk in the letter cited above, "you will
surgeon, a practice followed in World not find it necessary to keep him there very long
War I but later abandoned. A group of for I need him, and if you have no objection I
psychiatrists was recruited for the pur- would like to have him return here just as soon
as possible." Principal sources for this section
pose, and Hanson himself, at the request include: (3) Hanson, comp. and ed., "Combat
of the Surgeon General, returned to the Psychiatry," Bulletin, U.S. Army Medical Depart-
SALERNO TO THE GUSTAV LINE 255
From the outset of the Italian cam- Martin was the creation of a specialized
paign, battalion and regimental aid sta- neuropsychiatric hospital to operate as
tions were directed to retain cases of close as possible to the actual battle lines.
mild neurosis such as anxiety states and Known as the Fifth Army Neuropsychi-
exhaustion. These were to be fed, offered atric Center, the hospital was formed
opportunity to bathe, and given a seda- from the 2d Platoon of the 601st Clear-
tive sufficient to ensure sleep. Cases ing Company, 161st Medical Battalion,
requiring more than thirty-six hours with beds for 250 patients. Four psy-
treatment were sent to the division clear- chiatrists were added to the staff, others
ing stations, where heavier sedation was being attached at intervals when the case
given. Those who still did not respond load required it. The enlisted personnel
after seventy-two hours were sent on to was approximately double that of a nor-
the evacuation hospitals, where they mal clearing platoon, the Wardmen
were given more specialized treatment being specially trained for the job. The
and returned to duty or evacuated to the center opened on 21 December 1943 in
communications zone, according to their the Teano-Riardo area, where the bulk
hospital expectancy. Of the 2,749 cases of Fifth Army medical installations were
disposed of between 9 September and 31 then concentrated. It continued to func-
December 1943, 6 percent were returned tion at various locations throughout the
to duty from divisional installations, and war, never out of earshot of artillery fire.
20 percent from Fifth Army hospitals, Every effort was made to avoid a hos-
the remainder being evacuated out of the pital atmosphere. There were no nurses.
army area. Pajamas, sheets, and pillows were not
Several factors combined to produce issued. Patients slept on regulation cots,
this relatively small percentage of returns made their own beds, policed the area. So
to duty. The urgent need for beds in the far as possible, routine military discipline
evacuation hospitals during months of al- was maintained, and the idea of a prompt
most continuous combat sent to base hos- return to duty was always kept before the
pitals many psychiatric casualties that men.
might have been reclaimed in the combat After 21 December 1943, all psychi-
zone. Evacuation hospital staffs had little atric cases that could not be handled at
time to devote to such cases, and treat- the division level were sent directly to
ment varied with each installation. Even the Neuropsychiatric Center. There they
where adequate treatment was available, were kept under sedation for two days,
the very atmosphere of an evacuation but were still expected to go to meals,
hospital tended to convince the patient wash, and shave every day. After the
that his illness was organic and to fix effects of sedation had worn off, the men
rather than to allay his anxieties. were interviewed—usually on the third or
The solution adopted by Colonel fourth day of their stay. The interview
ment, Suppl (November 1949) ; (4) Annual Rpts, was designed to elicit a full story of what
Surg, Fifth Army, 1943, 1944; (5) Annual Rpt, had happened to the men in combat,
Med Sec, NATOUSA, 1943; (6) Annual Rpt, Med with probing into their premilitary his-
Sec, MTOUSA, 1944; (7) Surgs' rpts for 1943 and
1944 of the divs and corps mentioned in the combat tories confined to the bare essentials.
secs of this chapter. Each individual case was evaluated in
256 MEDITERRANEAN AND MINOR THEATERS
this interview and the decision made as returns to duty from division clearing
to eventual disposition. A man might be stations in November 1943 reflects the
returned to duty promptly, retained for impact of continuous and increasingly
further treatment, or evacuated to the severe fighting under steadily deteriorat-
rear, according to the severity of his ing conditions of weather and terrain.
symptoms and the nature of his responses The ameliorating effect of the Fifth
under questioning. Army Neuropsychiatric Center first ap-
By March 1944 each U.S. division of peared in January 1944. February was
Fifth Army had its own psychiatrist, who the month of heaviest fighting at both
screened the cases as they came to the Anzio and Cassino. The improved figures
clearing stations. The system was func- for April represent virtual freedom from
tioning smoothly as a single process by combat, improved weather conditions,
the time the drive to Rome was launched and the first results of the assignment of
in May, but was still to be significantly psychiatrists at the division level.
improved at the division level later in
the year.37 Diseases of Special Interest: Infec-
The disposition of neuropsychiatric tious Hepatitis—The period between
cases in Fifth Army for the period from the Salerno landings and the launching
September 1943 through April 1944 is of the May 1944 offensive toward Rome
shown in Table 6. The sharp decline in showed no unusual incidence of disease
among Fifth Army troops. In the early
37
See pp. 314-16, below. weeks of the drive, malaria, Sandfly
SALERNO TO THE GUSTAV LINE 257
38
fever, and dysentery predominated. more virulent outbreak in the late fall
Respiratory diseases appeared with the of 1944.40
advent of the rainy season, but not in
unusual volume. The only disease Preventive Medicine
worthy of special notice as a problem
for the medical service during the pe- Venereal Disease—The control of ve-
riod, other than those discussed under nereal disease in Italy proved to be even
separate headings in this chapter, was more difficult than it had been in Africa.
infectious hepatitis. The disease was first After more than twenty years of fascism
noted in July 1943 in North Africa, but and three years of war, the Italian econo-
was confined mainly to units of the 34th my was a patchwork of makeshifts in
Division. In Italy it became general which sheer hunger often overrode moral
shortly after the Salerno landings, and considerations. Food was to be had on
reached a peak rate of 121.0 cases per the black market for a price, and the
1,000 per annum for the second week in price could be obtained by prostitution.
October. The rate for the entire month To women whose men were dead or
of October was 93, dropping sharply and broken, prisoners of war, or doing forced
steadily thereafter to 11 in April 1944. labor for a conqueror, there seemed no
Hepatitis consumed manpower out of other way. In cities such as Naples the
all proportion to its incidence, since the opportunities for clandestine contacts
average time lost was sixty days for each were so numerous that neither inspec-
39
patient. tion of licensed brothels nor putting the
Infectious hepatitis was intensively houses off-limits offered any solution.
studied by Fifth Army medical officers The psychology of the soldier, moreover,
during and after the outbreak, but with- was that the longer he remained in com-
out arriving at definite conclusions as to bat, the more remote were his chances of
its mode of transmission, or the factors getting home. As time went on, his mem-
influencing its virulence. The disease ories dimmed and he came increasingly
41
was seasonal in character, being most to live for the moment.
widespread in the fall months. It ap- Italian doctors stated, and laboratory
peared to be more common among sea- tests tended to confirm the estimates,
soned troops than among men newly that by 1944 half the available women
arrived in the theater. There was some in Italy had some form of venereal dis-
evidence of a relationship between hep- ease, and that in the populous areas 95
atitis and a previous history of diarrhea. to 100 percent of all prostitutes showed
The studies made in the winter of 1943- clinical evidence of one or more venereal
44, however, did not produce enough diseases. Add to this high rate of infec-
information to prevent another and still tion the aggressiveness of the women,
and the nature of the problem becomes
40
See detailed discussion in Annual Rpt, Surg,
38
Surg, NATOUSA, Journal, 11 Oct 43. Fifth Army, 1944, and p. 451, below.
39 41
(1) Annual Rpts, Surg, Fifth Army, 1943, 1944. This section is based primarily on the annual
(2) Annual Rpts, Surgs, 3d, 34th, 36th, 45th, 1st reports of the Fifth Army surgeon for 1943 and
Armd Divs, 1943, 1944. (3) Annual Rpts, Surgs, 1944 and on the reports of corps and division
II and VI Corps, 1943, 1944. surgeons in the Fifth Army area.
258 MEDITERRANEAN AND MINOR THEATERS
clear. For example, when the 3d Infan- every effort was made to reduce the time
try Division was training near Naples lost from duty on account of venereal
early in January 1944 for the Anzio disease. An important step in this direc-
operation, the division surgeon reported tion was the establishment on 31 Decem-
that "prostitutes from Naples descended ber 1943 of the Fifth Army Venereal
upon our encampment by the hundreds, Disease Diagnostic and Treatment Cen-
outflanking guards and barbed wire. ter to function in the army area. The 2d
They set up 'business' in almost inacces- Platoon of the 602d Medical Clearing
sible caves in the surrounding bluffs. Company, 162d Medical Battalion,
Many of them gained entrance into formed the nucleus of the new organiza-
camp by posing as laundresses. . . . Each tion, which was augmented by personnel
day several large truck loads of scream- drawn from the collecting companies of
ing, screeching prostitutes were collected the battalion. When fully staffed, the
in the Division area and delivered into VD center had 4 Medical Corps officers,
the custody of the Italian police.42 a Medical Administrative Corps officer,
Fifth Army dispensed with its venereal and 92 enlisted men. It had 250 beds. A
disease control officer in September 1943 mobile unit of the 2d Medical Labora-
when the Army went into combat. In tory was attached, adding an officer and
that month the venereal disease rate was 5 enlisted men.
low, but it began to rise sharply with the Throughout the Gustav Line and
capture of Naples in October. In Decem- Rome-Arno Campaigns 90 percent of all
ber the position of control officer was re- Fifth Army venereal cases—except those
established, and Maj. (later Lt. Col.) on the Anzio beachhead—were treated in
Sydney Selesnick was assigned to it. the center, which could move to a new
It was not practicable to attempt any location in six hours, carrying its patients
direct control of houses of prostitution. with it. Uniformity and continuity of
Italian laws governing the traffic were treatment cut down materially the time
respected, and their enforcement was lost from duty per case. The recovery
abetted by Allied Military Government time was further reduced after peni-
officials in all occupied territory. The cillin became generally available for
most that could be done in the army area venereal cases in mid-February 1944.43
was to maintain a continuous education- Disposition of patients by the Fifth
al drive, to see that preventive devices Army Venereal Disease Diagnostic and
were issued and that prophylactic sta- Treatment Center in the first four
tions were readily available, and to months of 1944 is shown in Table 8. Al-
bring in known prostitutes for exami- though the center did not formally open
nation, and treatment if they were infec- until the end of December, a consider-
tious. Line officers were held responsible able number of cases were already in the
if their units showed any disproportion- hospital on 1 January, accounting for the
ate incidence of venereal disease.
(Table 7) 48
Penicillin had been used in the theater in the
Along with these preventive measures, treatment of gonorrhea as early as November 1943,
but only on special allocation, arranged by the
theater venereal disease control officer. Surg, NA-
42
Annual Rpt, Surg, 3d Div, 1944. TOUSA, Journal, 16 Nov 43.
SALERNO TO THE GUSTAV LINE 259
TABLE 7—VENEREAL DISEASE RATE PER THOUSAND PER ANNUM, BY DIVISIONS, SEPTEMBER
1943-APRIL 1944
28th and 42d Malaria Control Units, large-scale control activities, such as
with the effective co-operation of the draining flooded areas, clearing obstruc-
Fifth Army engineers.44 tions from waterways, and filling in
Malaria control measures were carried craters, as well as applying larvicides to
out at all echelons, each echelon being water surfaces. Italian troops and civilian
responsible for its own area. Each corps, laborers were freely employed in this
division, regiment, battalion, and com- work.
pany had its own nonmedical malaria In order to give intelligent direction
control officer. Each formation down to to the whole malaria control program,
and including the battalion had its own two special schools were organized by
malaria control committee. At corps and Captain Bowen. One of these, on the
division levels, these committees con- Anzio beachhead, will be discussed in the
sisted of the medical inspector, the engi- following chapter. The other served per-
neer, and the malaria control officer. For sonnel of II Corps in the highly malar-
regiments and battalions the committees ious coastal region south of the Garigli-
were composed of the surgeon and the ano River. The school was conducted un-
malaria control officer. Each company, der the auspices of the 54th Medical Bat-
battery, and similar unit had an antima- talion between 1 and 27 March 1944,
laria detail of at least two enlisted men, during which period 101 officers and 976
including a noncommissioned officer. In enlisted men, including 466 noncommis-
the higher echelons the antimalaria sioned officers, were trained in the tech-
function was largely planning and super- niques of malaria control. Posters were
visory. At the company level the anti- prominently displayed throughout the
malaria details were responsible for car- corps area, and a training film on the
rying out control measures in the unit cause and control of the disease was
area and for a radius of one mile around shown continuously during the malaria
it. Italian doctors and sanitary engineers season.
familiar with the local conditions were The control problem was rendered
fitted into the control organization, and much more difficult by the thoroughness
through the Allied Military Government with which the Germans had destroyed
(AMG) the civilian population was also pumping plants, dikes, culverts, and
included. drainage systems, flooding large sections
The engineers conducted most of the of reclaimed land. It was nevertheless a
44
Main sources for this section are: (1) Annual successful program in terms of its ulti-
Rpt, Surg, Fifth Army, 1944; (2) Annual Rpt, mate results. The malaria case rate per
Surg, II Corps, 1944; (3) Annual Rpt, Med Sec, 1,000 per annum among Fifth Army
MTOUSA, 1944; (4) Ltr, Capt Bowen, Asst Malari-
ologist, 2655th Malaria Control Detach (Overhead) , troops rose sharply from 83 in September
to Surg, NATOUSA, 29 Dec 44, sub: Stat Analysis 1943 to 193 for the following month,
of Malaria in MTOUSA, 1944; (5) Ltr, Col An- dropped to a low of 45 in December, and
drews, Acting Malariologist, American Sec, AFHQ,
to Surg, NATOUSA, 10 May 44, sub: Antimalaria was only 85 for April 1944. Even in the
Inspection Tour of VI Corps, Fifth Army, II Corps most malarious months of June, July,
and Adriatic Areas of U.S. Military Occupation 23 and August, the case rates were only 94,
March-3 May 44; (6) Andrews, "North Africa,
Italy, and the Islands of the Mediterranean," Com- 82, and 70 respectively. These rates com-
municable Diseases, Malaria. pare favorably with those for the theater
SALERNO TO THE GUSTAV LINE 261
TREATING MOROCCAN MOUNTAIN TROOPS of the French Expeditionary Corps for frozen
feet at an aid station in the Venafro area.
tween the Cassino front and the Anzio walk on them. Trench foot was an almost
beachhead.46 inevitable consequence.
Fifth Army troops were not equipped While the condition was intensively
for the physical conditions that con- studied by medical officers of Fifth Army
fronted them in the winter of 1943-44. and proper prophylactic measures were
There had been no adequate indoctrina- determined, little headway could be
tion as to the danger of trench foot, and made until more suitable footgear be-
no preparations to prevent it. Troops came available.47
had only the standard army shoe or com-
bat boot, with light wool socks, which Typhus—An epidemic of typhus that
did not give protection against either broke out in Naples in October 1943
cold or dampness. Heavy wool socks be- posed a serious threat to Fifth Army. The
came available later in the winter, but account of measures taken to combat the
could not be worn until it was possible epidemic and to prevent its spread to
to issue larger shoe sizes. Neither were Fifth Army troops properly belongs in
there enough socks on hand to permit another chapter.48 It will be sufficient
the daily change recommended by the here to say that vigorous action to pre-
surgeon. vent louse infestation was taken, and
In the bitter mountain fighting before was effective. For several months Naples
Cassino, where cold and rain or snow was off-limits to Fifth Army troops ex-
were almost incessant, front-line troops cept on necessary business, and all mili-
could not hope to keep their feet dry, tary personnel entering or leaving the
and, continuously in range as they were city were treated with insecticides.
of enemy small arms fire, they could not
risk giving away their positions by move- Dental Service
ment merely to exercise their limbs.
Manpower was too short to permit rota- Facilities for dental prosthetic work
tion, so many men went for a week or remained scarce during the summer of
more without opportunity to dry or 1943 when Fifth Army was staging for
warm their feet and little chance even to the invasion of Italy, but with that ex-
46
Figures reported differ considerably. For the
ception the troops were dentally in good
months of November 1943 through March 1944,condition when the campaign began. In
Annual Report, Medical Section, MTOUSA, gives the assault phase, only emergency dental
5,058, but concedes that the 1943 figures are too
low. Annual Report, Surgeon, Fifth Army, 1944,
work was done, while most of the dental
gives 5,710 cases for the same period, while the total officers and enlisted personnel performed
is reduced to 5,274 in Annual Report, Surgeon, Fifth other duties. By 1 October, however, the
Army, 1945. The text follows Annual Report, Sur-
geon, Fifth Army, 1944, and Fifth Army Medical
Fifth Army dental service was solidly
Circular No. 6, 24 November 1943. For discussion of established. Three divisional dental lab-
trench foot at Anzio, see pages 285-86, below. oratories were in operation and others
For more technical treatment, see Col. Tom
F. Whayne, USA (Ret.) and Michael E. DeBakey,
were functioning in connection with the
M.D. Cold Injury, Ground Type "Medical Depart-
47
ment, United States Army, in World War II" Compare the 1943-44 record with that of the
(Washington, 1958) , pp. 101-25. Whayne and De- winter of 1944-45 in the north Apennines, page 452,
Bakey also accept the figures reported by the Fifth below.
48
Army Surgeon for 1944. See pp. 462-65, below.
SALERNO TO THE GUSTAV LINE 263
a
Includes Anzio beachhead.
Source: Annual Rpts, Surg, Fifth Army, 1943, 1944.
trained personnel were available. Food make still more difficult the economic
for the animals was scarce and of poor and military problem of the Allies.
quality, and the animals themselves were Colonel Pickering learned from Ital-
old, chronically lame, undersized, and ian sources that a considerable number
generally in poor condition. Despite of animals bred for military use had been
these handicaps, however, it was soon distributed among farmers for conceal-
apparent that pack trains would be a ment from the Germans. With the assist-
virtual necessity if troops were to be sup- ance of former Italian cavalry officers and
50
plied in the mountains. local carabinieri, these were located and
With the recognition of this necessity, assembled. Enough feed for their imme-
Col. Clifford E. Pickering, Fifth Army diate needs was found in a partially de-
veterinarian, was directed to help in the stroyed factory at Maddaloni. Nails and
procurement, care, and rehabilitation of horseshoes were made from scrap iron in
animals. The task was no easy one. First improvised blacksmith shops. An Italian
the Italian Army, and later the Germans, breeding depot was re-established as the
had systematically looted the farms; and Fifth Army Remount Depot, which was
the Germans had killed such animals as turned over to the base section at the
they could not use themselves, in order to end of the year.
Another substantial group of animals
was located in Sardinia, where the
50
This section is drawn primarily from the an- prompt revolt of the Italian garrison had
nual reports of the Fifth Army surgeon for 1943 saved 5,000 mules, 1,500 horses, 3,000
and 1944, and the reports of the division surgeons saddles, and quantities of shoes from the
whose units participated in the Winter Line and
Cassino campaigns. See also, Miller, United States vengeful Germans. Pack trains were or-
Army Veterinary Service in World War II. ganized on the island with Italian per-
SALERNO TO THE GUSTAV LINE 265
sonnel, each train having 4 line officers, before the only American veterinary
a medical officer, a veterinary officer, 400 evacuation hospital to serve in the
enlisted men, and approximately 325 Mediterranean, the 17th, reached Italy,
animals. Two of these trains reached the and no veterinary company was available
mainland of Italy before the end of 1943. to Fifth Army before the final days of
51
On their arrival, a Fifth Army Provi- the war. The 17th Veterinary Evacua-
sional Veterinary Hospital was organ- tion Hospital was set up near Teano.
ized, using 4 officers and 53 enlisted men The outstanding veterinary problems
drawn from the pack train complements. of the Winter Line and Gustav Line
The hospital opened at Visciarro on 8 campaigns were the care and rehabilita-
December. December also saw the arrival tion of poor quality, poorly conditioned
of a French veterinary hospital, with 5 animals whose very physical debility
officers and 74 enlisted men from North increased their proneness to battle
Africa with elements of the French Ex- wounds, and the provision of feed ade-
peditionary Corps. The French also quate both in quantity and quality.
brought their own animals in substantial Equipment for ridding the animals of
numbers. lice was very deficient during this pe-
More pack trains arrived from Sar- riod. While feed increased in quantity,
dinia in January 1944, together with two there was little improvement in quality
more Italian-staffed veterinary hospitals, until crops were harvested in the reha-
the 110th and the 130th. Each of these bilitated areas of Italy and shipping be-
had four veterinary officers, one admin- came available.
istrative officer, and 100 enlisted men. Animal strength in Fifth Army rose
These units were set up in the forward from 986 horses and 4,136 mules in Jan-
area, while the provisional hospital, re- uary 1944 to 2,226 horses and 10,433
named the 210th Veterinary Hospital mules, or 12,659 animals in all, in April.
(Italian), was turned over to the Penin- Of this peak total, 2,023 horses and 7,266
sular Base Section. mules were with the French Expedition-
In February an Italian cavalry officer, ary Corps, which had its own treatment
Col. Berni Canani, was named liaison facilities. During the 4-month period,
officer between Colonel Pickering's office January—April 1944, 608 U.S. and
and all Italian units, a position in which Italian animals were admitted to the
his services proved invaluable. hospital of which 368 were returned to
A U.S. veterinary evacuation hospital duty, 197 were evacuated to base, and 47
and some separate veterinary companies died or were destroyed.
were requested for Fifth Army by Gener- 51
(1) Surg, NATOUSA, Journal, 15 Nov 43. (2)
al Blesse in November 1943, in anticipa- Annual Rpt, 17th Vet Evac Hosp, 1944. The 45th
tion of a wider use of animals in the Veterinary Company (Separate) arrived in the
Mediterranean in the summer of 1944, but was im-
mountain fighting approaching the Gus- mediately assigned to Seventh Army, then training
tav Line. It was March 1944, however, for the invasion of southern France.
CHAPTER VII
Anzio Beachhead
A seaborne landing on the west coast itary hazard. The Prime Minister felt
of Italy between the Garigliano and Ti- that Rome must be quickly taken or the
ber rivers had been contemplated since Italian campaign would be counted a
early November 1943, and plans involv- failure, and the Allied cause would
ing various sites, including Anzio, were suffer, especially with the Turks, whose
developed in some detail. The stubborn active military aid he was then stren-
German defense of the Winter Line, uously soliciting.1
however, made it clear that the main
body of Fifth Army would not be able to Medical Planning for
break through to support the beachhead Operation SHINGLE
at any predictable time, and plans were
held in abeyance. As originally proposed, the Anzio land-
They were revived at a Christmas day
conference in Tunis, where Prime Minis- 1
General sources for the Anzio campaign are:
ter Churchill was the moving force. All (1) Fifth Army History, vol. IV; (2) Starr, ed.,
From Salerno to the Alps; (3) Oprs Rpts, VI Corps,
of the military commanders concerned Jan-May 44; (4) Alexander, "The Allied Armies in
were present except the one most di- Italy from 3rd September, 1943, to 12th December
rectly involved—General Clark, who 1944," Suppl. to the London Gazette, 6 June 1950,
pp. 2908-13, 2917; (5) Mark W. Clark, Calculated
would be immediately responsible for Risk; (6) Truscott, Command Missions; (7) Win-
the operation. Those at the conference ston S. Churchill, The Second World War: Closing
included General Eisenhower, soon to the Ring (Boston: Houghton Mifflin Company,
1951); (8) American Forces in Action, Anzio Beach-
leave for OVERLORD; General Sir Henry head (Washington, 1947); (9) Morison, Sicily-Sa-
Maitland Wilson, who was to succeed lerno-Anzio; (10) Wesley Frank Craven and James,
Eisenhower as Supreme Allied Com- Lea Cate, eds., "The Army Air Forces in World War
II," Europe: ARGUMENT to V-E Day, (Chicago,
mander in the Mediterranean; General The University of Chicago Press, 1951); (11) Al-
Alexander, commanding the 15th Army bert Kesselring, Soldier's Record, pp. 232-37; (12)
Group in Italy; Air Chief Marshal Taggart, ed., History of the Third Infantry Divi-
sion in World War II; (13) Howe, 1st Armored
Arthur W. Tedder, who headed the Al- Division; (14) The Fighting Forty-fifth, pp. 71-86.
lied Air Forces in the Mediterranean; The more important medical sources are: (15) An-
and Admiral Sir John Cunningham, nual Rpt, Med Sec, MTOUSA, 1944; (16) Annual
Rpt, Surg, Fifth Army, 1944; (17) Annual Rpt,
commanding the Allied Navies in Italian Surg, VI Corps, 1944; (18) Clift, Field Oprs, pp.
waters. All of these men appreciated the 265-83; (19) Rollin L. Bauchspies, "The Coura-
risks inherent in such an operation, with geous Medics of Anzio," Military Medicine, CXXII,
(January-June 1958). 53-65, 119-28, 197-207, 267-
the limited forces at their disposal, but 272,338-359. 429-448; (20) Unit rpts of individual
political considerations overrode the mil- med units mentioned in the text.
ANZIO BEACHHEAD 267
in reserve. The landing force was also casualties from the aid stations and evac-
to include two British Commando and uate to the ships, while the 33d Field
three Ranger battalions, the 504th Para- Hospital was to establish an adjacent
chute Infantry regiment, and the 509th unit to care for nontransportables. The
Parachute Infantry Battalion. In addi- collecting companies of the 3d Medical
tion to the normal medical detachments Battalion, organic to the 3d Division,
and organic medical battalions, medical were to land at H plus 6 and move in-
support for VI Corps was to be supplied land to assume their normal functions,
by the 52d Medical Battalion; the 93d, with the 3d Division clearing station fol-
95th, and 56th Evacuation Hospitals; the lowing two hours later. The two 400-bed
33d Field Hospital, with the British 12th evacuation hospitals, the 93d and 95th,
Field Transfusion Unit attached; the were also to go ashore on D-day.
British 2d Casualty Clearing Station; the The British assault was to be similarly
549th Ambulance Company; and a de- supported, with two field dressing sta-
tachment of the 2d Auxiliary Surgical tions and a beach dressing station,
Group. backed up by the 2d Casualty Clearing
Medical planning for the Anzio opera- Station. Hospital ships were to be avail-
tion was directed by Fifth Army surgeon, able off both British and American
Joseph I. Martin, now a brigadier gener- beaches until D plus 3, after which they
al, and Colonel Huddleston, who had were to come when requested by the
been VI Corps surgeon since Salerno. senior surgeon on the beachhead. Nor-
Colonel Huddleston also directed medi- mal medical supplies were to be aug-
cal services on the beachhead until he mented by additional items carried
was killed by artillery fire while emerg- ashore by aidmen, and the 1st Advance
ing from corps headquarters on 9 Feb- Platoon of the 12th Medical Depot Com-
ruary 1944. He was succeeded by Col. pany was to maintain a 10-day reserve on
Rollin L. Bauchspies, commanding offi- the beachhead. During the assault phase,
cer of the 16th Evacuation Hospital. task force and subtask force surgeons
Medical support was based on a pro- were to be responsible for all medical
jected D-day casualty rate of 10 percent units accompanying their forces.
of the assault troops and 5 percent of the
remainder, with a daily hospital admis- Combat Medical Service
sion rate thereafter of five per thousand
from all causes. Landing Phase
All medical units were to be combat-
loaded for greater speed in establishing Anzio and nearby Nettuno are small
themselves ashore. Aid stations were to resort towns on the west coast of Italy,
go in with the landing waves, to be fol- about 30 miles south of Rome. (Map 24)
lowed as quickly as possible by the in- Ten miles to the east, the Mussolini
stallations of the beach group, under Canal separates the Anzio plain from the
initial control of the 540th Engineer reclaimed Pontine Marshes, while on the
Shore Regiment. In the latter category, northwest rolling, partially wooded farm-
the 52d Medical Battalion was to set up lands, cut by deep gullies, extend about
a collecting-clearing station to receive 25 miles to the Tiber. Some 20 miles
MAP 24—Anzio Beachhead and Surrounding Areas
270 MEDITERRANEAN AND MINOR THEATERS
north of Anzio rise the Alban Hills, or canal, while the Commandos led the
Colli Laziali, with Highway 7—the an- British assault six miles northwest of
cient Appian Way—skirting the southern Anzio. The town itself, with mole and
shoulder of the hill mass through Albano port facilities nearly intact, was quickly
and Velletri, and running southeast to taken by Col. William O. Darby's
Terracina on the coast, about midway be- Rangers. The 509th Parachute Infantry
tween Rome and Naples. Highway 6, Battalion took Nettuno almost as
the direct route from Cassino to Rome, quickly.
flanks the northern slopes of the Alban German air attacks began shortly after
Hills, coming at its closest point within dawn, coupled with spasmodic fire from
30 miles of Anzio. long-range guns, but the work of unload-
The original mission of VI Corps was ing men and supplies was not seriously
to seize the Alban Hills and cut both hampered. By midnight, about 36,000
highways, which formed at once the sup- men, 3,200 vehicles, and large quantities
ply lines and the escape routes of the of supplies were ashore, approximately
German Tenth Army entrenched behind 90 percent of the equipment and person-
the Gustav Line. The orders finally nel of the assault convoy.
given to General Lucas were somewhat Casualties were negligible, and so the
modified, in the light of anticipated dif- medical plan was altered to give priority
ficulties. VI Corps was to "seize and to combat troops and material. Battalion
secure a beachhead in the vicinity of aid stations went ashore with the combat
Anzio" and "advance on Colli Laziali," units to which they were attached, and
but the timing and extent of the advance litter squads from the 52d Medical Bat-
were not predetermined. The key points talion accompanied the 3d Division as
to be enveloped were Campoleone, eight- well as the Rangers and paratroops. The
een miles north of Anzio on the Albano beach collecting-clearing station of the
road, and Cisterna, astride Highway 7 a corps medical battalion was not needed,
similar distance to the northeast. however, and did not go ashore until
While German intelligence had noted twenty-four hours after the first landings.
Allied preparations for an amphibious The 3d Division clearing station was not
operation, the enemy high command had established until the afternoon of D plus
been deceived by feints and raids at var- 1.
ious points into expecting the assault to The few casualties that occurred in the
be made north of Rome. Vigorous early hours of the assault were held at
thrusts along the main Fifth Army front, battalion aid stations or carried direct to
from Cassino to the mouth of the Garig- LST's equipped to care for them. Aside
liano, further confused the enemy, and from these aid stations, the only medical
served to occupy his reserves. The Anzio installation ashore on D-day was the 2d
beaches were therefore virtually unde- Platoon of the 33d Field Hospital, which
fended when the first Allied troops landed its personnel and attached surgi-
waded ashore at 0200 on 22 January cal teams at 1330, received its equipment
1944. The 3d Division, commanded by three hours later, and was ready to accept
General Truscott, landed three regi- patients about 1800. The hospital was
ments abreast between Nettuno and the set up on the beach southeast of Nettuno.
ANZIO BEACHHEAD 271
Until the bulk of the troops had ad- pitals and the 33d Field Hospital moved
vanced inland and a normal chain of to the new location. A similar area for
evacuation had been set up, most casual- British medical installations was estab-
ties were littered from the battalion aid lished about two miles north of Anzio on
stations directly to the field hospital. the road to Rome. (See Map 24.)
For 48 hours this unit was the only Evacuation was from the beach until
hospital functioning on the beachhead. the harbor became available on 29 Jan-
It was soon filled to capacity, with three uary, D plus 7. LCI's (Landing Craft, In-
operating tables in constant use and a fantry) and other small craft carried
backlog of 20 to 30 cases. Tents were patients to LST's or to hospital ships
several times pierced by shell fragments standing offshore, but the process was
and debris, but no casualties resulted. difficult at best. The water was rough
The remaining platoons of the 33d Field five days out of seven. Frequent air raids
were put ashore during the afternoon of and intermittent shelling made it dan-
23 January, D plus 1, but remained in gerous to hold casualties on the beach,
bivouac, the 3d Platoon until 26 Jan- while the ships standing by were easy
uary, the 1st until 8 February. In the targets. Even the Geneva cross was scant
interval, their personnel and equipment protection. Three British hospital ships
were drawn upon to expand the facilities were deliberately bombed offshore on
of the 2d Platoon. the night of 24 January, and one of them,
Both the 93d and 95th Evacuation the St. David, was sunk.
Hospitals were landed on D plus 1, but On the military side the attack, which
were not in operation until the late after- opened so auspiciously, was quickly
noon of 24 January. The 93d occupied stalled. From the beaches the troops
buildings in Anzio; the 95th was under moved inland against light opposition.
canvas midway between Anzio and Net- All initial objectives, including the
tuno. The British 2d Casualty Clearing bridges across the Mussolini Canal, were
Station was established just north of secured by noon of D-day, but the key
Anzio about the same time. towns of Campoleone and Cisterna were
German air raids on the harbor area still miles away, and the Alban Hills
and the rising tempo of long-range shel- were but a blister in the distance. Jan-
ling quickly made these hospital sites uary 24 found VI Corps still occupying
untenable. There was, in fact, no safe an area roughly fifteen miles wide and no
area on the beachhead, since every foot more than seven miles deep. By this
of the ground held by Allied troops time the benefit of surprise had been lost.
could be observed by the enemy and Air attacks were increasing in violence
reached by his guns. Colonel Huddleston and frequency. Huge railway guns that
selected an open field about two miles the men came to know as "Whistling
east of Nettuno as the lesser hazard, and Willie" and the "Anzio Express" were
a hospital area was laid out. The 56th trained on the beachhead from concealed
Evacuation, which arrived on 28 Jan- positions, changing nightly. All along
uary, was set up here, and took all pa- the 26-mile perimeter of the Allied front,
tients over the next two or three days opposition was stiffening as new German
while the 93d and 95th Evacuation Hos- units were rushed piecemeal to the area
272 MEDITERRANEAN AND MINOR THEATERS
over roads and rail lines still usable de- to wipe out what Hitler called the
spite the pounding of Allied bombers. "abscess" below Rome.
General Lucas decided to dig in For seventeen weeks Anzio beachhead
against an anticipated counterthrust and remained a "flat and barren little strip
wait for reinforcements before advanc- of Hell"; a front without a rear, where
ing his lines. The 1st Special Service hospitals stood only six miles from the
Force, the 45th Infantry Division, and fighting lines and were backed against
half of the 1st Armored were brought the sea. Instead of the wildcat Churchill
up from Naples, and the attack was had hoped to hurl at the enemy's flank,
launched on 30 January. It was too late. SHINGLE had become a "stranded whale."2
The Germans had moved more swiftly,
bringing fresh divisions from northern 2
The first quote is from General Clark, Calcu-
Italy, southern France, Yugoslavia, and lated Risk, page 7; the second is from Winston
even from the static Eighth Army front Churchill, Closing the Ring, page 488.
ANZIO BEACHHEAD 273
Attack and Counterattack but the initiative lay with the Germans,
who launched repeated attacks against
The VI Corps attack launched on 30 different sections of the front and kept
January was a twopronged drive in up an intermittent shelling of Allied
which the 3d Division was to cut the positions. Consolidated into the Four-
railroad at Cisterna and seize the town, teenth Army under General Eberhard
and the British 1st Division was to take von Mackensen, the German strength
Campoleone and advance to cut High- was impressive. The Allies brought up
way 7 at Albano. The 1st Armored was the British 56th Division from the
to pass around the British 1st to the left Garigliano front, but few more units
and storm Colli Laziali from the west. were available. VI Corps could only com-
The attack began disastrously when the pensate for deficiencies in manpower by
1st and 3d Ranger Battalions, which heavily reinforcing its artillery and
were to open the way for the 3d Divi- tanks.
sion, were ambushed and destroyed. The major German drive was
Only 6 of the 767 men engaged got back. launched down the Albano road on 16
Among the missing were 21 enlisted men February and reached its maximum de-
of the 52d Medical Battalion. The 4th velopment two days later. The crisis for
Ranger Battalion, following with the the beachhead came during the night of
15th Regimental Combat Team of the 18-19 February when the Germans were
3d Division, also suffered heavy losses. stopped only six miles from the sea. Al-
After three days of fighting, the Cis- lied air superiority and the support of
terna assault was halted two miles short naval guns were contributing factors.3
of its goal. General Truscott was made deputy com-
The drive up the Albano road was no mander of VI Corps at this time, com-
more successful. The British 1st Divi- mand of the 3d Division passing to Brig.
sion was met by well-placed armor, and Gen. John W. O'Daniel. Truscott re-
the U.S. 1st Armored had to be hastily placed Lucas as corps commander on 23
diverted to reinforce the infantry. Again February.
the objective was approached but not A renewed German drive on 28 Feb-
reached, and the attack was halted at ruary was also stopped after several days
nightfall on 31 January. of continuous fighting, much of it hand-
With the equivalent of four divisions to-hand. By 5 March the battle of the
under his command, General Lucas had beachhead was over. The Germans tac-
been stopped by a German army of ap- itly acknowledged defeat and went over
proximately equal size. Though heavy to the defensive, while Alexander
losses had been inflicted on the enemy, ordered a general regrouping of the Al-
his line had not been breached. On 2 lied forces on the main front in prepara-
February, VI Corps was ordered to take tion for a drive on Rome.
defensive positions, and control of hospi-
talization and evacuation from the
beachhead reverted to Fifth Army. 3
Rpt, Supreme Allied Commander, Mediterrane-
During the next two weeks both sides an, to CCS, on Italian Campaign, 8 Jan 44-10 May
worked furiously to build up strength, 44.
274 MEDITERRANEAN AND MINOR THEATERS
The 15th received a rough welcome to needle in place while another held the
the beachhead. On that day long-range bottle of plasma during the move. Un-
German guns dropped shells in the hos- like the 95th Evacuation, the 33d Field
pital area, killing two nurses, one of was able to resume normal operation the
them the chief nurse, and an enlisted following day.
man at the 33d Field Hospital. Four The U.S. and British hospital areas
officers and seven enlisted men were were bombed on 12 February, and the
wounded. One tent was burned and British area again on the 17th and 19th,
others damaged. Again the wounded in- some casualties resulting in each in-
cluded the hospital commander, Lt. Col. stance. During the remainder of the
Samuel A. Hanser. Patients were carried month, while the German counterattack
on their mattresses to the adjoining 56th continued, and on through March there
Evacuation. Blood transfusions in prog- was no letup. On 17 March the British
ress at the time of the attack were not 141st Field Ambulance suffered three
interrupted, one attendant holding the direct hits, with 14 killed and 75
ANZIO BEACHHEAD 277
wounded. On the 22d it was the turn of casualties for the next five days while
the 15th Evacuation, which was blan- the other hospitals dug in.
keted by 88-mm. shells. Five persons That same night, 29 March, the hospi-
were killed and 14 wounded. No wonder tal area was again bombed, only a few
the combat troops called the hospital hours after General Clark had inspected
area "Hell's half acre" and felt safer in the installations. The 93d and 56th
foxholes at the front! Evacuation Hospitals were hit, with a
General Truscott was convinced that combined total of 8 killed and 68
the 22 March shelling of the 15th Evacu- wounded. The 56th suffered further
ation Hospital was deliberate. Following damage on the night of 3-4 April and
a conference with Fifth Army and VI on the morning of 6 April, when long-
Corps medical officers, he ordered his range German guns once more pounded
engineers to reconstruct the British and the area. Too badly damaged to con-
American hospital areas so as to give tinue on the beachhead, the 56th was
maximum protection.5 The hospitals replaced on 8 April by the 38th Evacu-
could not be moved. There was no safe ation Hospital, the 56th taking over
place for them to go. They could not the installations of the 38th at Carinola
even go under ground, but they could on the southern front. A week later the
be partially dug in. By this time the 11 th Evacuation from Casanova, also on
rains had become less frequent and the the southern front, changed places with
ground had dried up enough to permit the hard-hit 93d. British hospitals were
excavation of tent sites to a depth of 3 similarly rotated with those in the Cas-
or 4 feet. Two ward tents were pitched sino area. Sporadic shelling and bomb-
in each excavation end to end, with ing continued throughout the life of the
earth revetments 3½ feet thick at the beachhead, but casualties and damage
base and 2 feet at the top built up three were considerably reduced by the work
to 5 feet around the tent walls. Steel of the VI Corps engineers.
stakes and chicken wire helped hold the Hospitalization policies at Anzio were
revetments in place. Sandbag baffles in- dictated, like everything else on the
side divided the double tent into four beachhead, by the tactical and geogra-
compartments of ten beds each. Patients phical situation. In the early stages of
and personnel were thus secure against the campaign all casualties were evacu-
anything but a direct hit. Operating ated to Naples as quickly as they could
tents were given the additional protec- be made transportable. This entailed a
tion of a 2-inch plank roof covered with heavy loss of personnel, however, and at
sandbags. the beginning of March the three pla-
The 94th Evacuation Hospital, with toons of the 33d Field Hospital were set
the 402d Collecting Company of the up as a single 400-bed unit to hold
161st Medical Battalion attached, ar- patients expected to recover in fourteen
rived on the beachhead late in March days. Although a platoon of the 52d
with the 34th Division. The unit opened Medical Battalion clearing company set
on 29 March, taking the bulk of the new up a 200-bed venereal disease hospital
on 19 February, the problem was never
5
Truscott, Command Missions, p. 358. serious at Anzio. Cases were confined to
278 MEDITERRANEAN AND MINOR THEATERS
casualties, or a total of 33,063 were evac- ashore in the special waterproof con-
uated safely from Anzio beachhead. tainers whose worth had been demon-
strated at Salerno. On the basis of the
Medical Supplies and Equipment Salerno experience, supply estimates
were increased to compensate for losses
Following the Salerno pattern, person- through accidental immersion as well as
nel of the 1st Advance Platoon, 12th by enemy action. The most important
Medical Depot Company, were on the departure from the earlier planning for
Anzio D-day convoy, attached to the amphibious operations was provision
beach group. Each unit carried all items for carrying supplies adequate for a 10-
called for in its Table of Basic Allow- day level on the D-day convoy. This level
ances, with extra blankets and litters had not been reached at Salerno until
9
added. Other additional supplies, such D plus 12.
as plasma, atabrine, plaster of paris, 9
This section is based primarily on: (1) Annual
dressings, and biologicals were carried Rpt, Surg, Fifth Army, 1944; (2) Annual Rpt,
ANZIO BEACHHEAD 281
A medical supply dump was estab- section, and living quarters for person-
lished on the beach at 0700 on D plus 1. nel. Two storage tents were set up for
The following day, 24 January, the items that might be damaged by water,
supply platoon was relieved from at- other supplies being stored in the open.
tachment to the beach group and passed In the early days of the beachhead all
to control of the VI Corps surgeon. A requisitions were honored if they were
permanent site for the depot was lo- signed by a responsible person, even
cated on the Anzio-Albano road, near the though a scrap of paper might be sub-
cathedral. A 4-story building, 70 x 40 stituted for the proper form. The time
feet, housed offices, issue room, shipping required to fill a requisition ranged
from one-half hour to six hours, depend-
Surg, VI Corps, 1944; (3) Annual Rpt, 12th Med ing on the items requested and the
Depot Co, 1944; (4) Maj Richard P. Gilbert, MAC, extent of enemy shelling and bombing.
MS, Combat Medical Supply Operations—The Anzio
Beachhead; (5) Davidson, Medical Supply in The build-up of supplies did not take
MTOUSA, pp. 73-79. place according to plan, but thanks to
282 MEDITERRANEAN AND MINOR THEATERS
the light opposition in the landing phase, any careful bookkeeping on exchange-
no damage resulted. While the 10-day able items. The problem was finally
level contemplated arrived on schedule, solved by sending a truck to Naples
the water was too rough to permit off- with each LST carrying patients. At
shore unloading until D plus 5, the only Naples the truck was loaded with litters
medical supplies available in the inter- and blankets from the base hospitals to
val being those carried ashore by be returned to Anzio in exchange for
medical units and combat troops. This those accompanying the patients.
situation was one frequently repeated Despite the difficulties inherent in the
at Anzio, since the Liberty ships used for situation, including the constant hazard
cargo drew too much water to dock at that supply personnel shared with all
the wharf. On several occasions, emer- others on the beachhead, the Anzio medi-
gency requisitions had to be sent to cal service at no time suffered any supply
Naples for items that were aboard ships or equipment shortage severe enough to
anchored out from the shore but una- impair the quality of medical care.
vailable. These emergency supplies
would be delivered by LST, creating an
overstock of some items when the cargo Professional Services
vessels managed to unload. Supplies on the Beachhead
delivered by LST were loaded on trucks
at Naples and driven directly to the de- Medicine and Surgery
pot from the landing craft, permitting
the vessels to withdraw to safety with a Surgery Under Fire—At Anzio all
minimum of delay. surgery was forward surgery. There were
Replacement items, both of supply no field hospital units to take nontrans-
and equipment, were a constant prob- portable cases from the clearing stations
lem on the beachhead because of the because the evacuation hospitals were as
continual destruction by enemy shells close to the front as the clearing stations
and bombs. There came to be some themselves. There was no screening of
truth as well as humor in the remark patients forward of the hospital area.
that "ward tents were sent up daily with Neither was there more than rudimen-
the rations." The problem was further tary specialization, except for the use of
complicated by the rotation of hospitals the 33d Field Hospital for short-term
with those on the Cassino front, since the cases after 1 March and the experimen-
arriving units did not always bring suffi- tal concentration of neuropsychiatric
cient equipment to replace what had cases in the 56th Evacuation. Each hospi-
been destroyed. tal took all types of wounds, limited only
Another recurrent supply problem by its own bed capacity. Teams of the
was that of property exchange. The 2d Auxiliary Surgical Group operated in
hospital ships and carriers were able to all of the beachhead hospitals, including
10
exchange litters, blankets, and splints in the British installations.
normal fashion, but LST's used for 10
Sources for this section are: (1) Annual Rpt,
evacuation were seldom so equipped. Surg, Fifth Army, 1944; (2) Annual Rpt, Surg, VI
The time factor, moreover, precluded Corps, 1944; (3) Annual Rpt, 33d Fld Hosp, 1944;
ANZIO BEACHHEAD 283
Ten surgical teams of the group and iary Group assigned for temporary duty.
2 shock teams were on the D-day convoy, One officer and an enlisted man of the
working in the 33d Field Hospital and group lost their lives when the St. David
the 95th Evacuation Hospital as soon as was sunk by German bombs the night of
those units were set up. The 12 teams 22-23 January. A nurse of the group
were reinforced before the Anzio inter- was killed in action in the 10 February
lude was over by 18 additional surgical shelling of the 33d Field Hospital. In
teams, 2 orthopedic teams, 2 neurosurgi- addition to these deaths in action, the
cal teams, a thoracic team, and a miscel- 2d Auxiliary Surgical Group had 11 of-
laneous team. For the landing phase, ficers, 2 nurses, and 5 enlisted men
each of the 4 British hospital carriers wounded in the course of the Anzio
also had a surgical team of the 2d Auxil- Campaign.
The surgical load fell heavily on the
(4) Annual Rpts, 1944, of 11th, 15th, 38th, 56th,
93d, 94th, and 95th Evacuation Hosps; (5) Annual hospital staffs as well as on the attached
Rpt, 2d Aux Surg Gp, 1944. teams, but the work was of a high qual-
284 MEDITERRANEAN AND MINOR THEATERS
ity despite the fact that many of the June 10,624 pints of whole blood were
cases were of types not normally en- used in U.S. hospitals, for an average of
countered in evacuation hospitals. The 2.01 pints per case; 3,685 pints were used
93d Evacuation, for example, handled in British hospitals, averaging 2.95 pints
11
1,187 surgical cases during the month per case.
of February, entirely with its own staff.
The 11th handled 1,240 surgical cases in Neuropsychiatry—The conditions un-
one 11-day period, only 72 of which were der which VI Corps operated at Anzio,
cared for by attached teams. With the where all positions were subject to
aid of 4 auxiliary teams, the 94th per- enemy shelling at any time and harass-
formed 138 operations in 24 hours. ing actions around the perimeter were a
At the time of the German counter- constant threat, were inevitably such as
offensive in February, the casualty load to produce a high incidence of psychiat-
was so great that some men with less ric disorders. The same conditions, how-
severe wounds were evacuated to Naples ever, made it impossible to retain
for primary surgery, while others were psychiatric casualties for treatment close
sent back to base hospitals for postopera- to the battle lines.12
tive care. The Fifth Army surgical con- The month of February 1944, when
sultant, Colonel Snyder, personally fol- fighting was most severe and the con-
lowed up these cases, shuttling back and tinuance of the beachhead itself was at
forth between Naples and Anzio with stake, showed a psychiatric case rate of
reports that proved most useful to beach- 4 per 1,000 per month in the 1st Ar-
head surgeons. mored Division, 16.7 in the 3d Division,
The Anzio surgeons were greatly and 23 in the 45th Division. The pres-
aided by generous supplies of whole sure for beds in beachhead hospitals
blood. Where Fifth Army had relied in was so great that these psychiatric casual-
the past primarily on plasma and on ties had to be evacuated to base hospitals
donors among hospital staffs and conva- in less than two days, despite the show-
lescent patients, the Anzio medical serv- ing of theater experience that a high
ice had the advantage from the outset proportion could have been returned to
of the presence of a British field trans- duty if treated in the forward area.
fusion unit, supplied by a British blood The first approach to the problem was
bank. On 26 February the first American the designation of the 56th Evacuation
blood was received on the beachhead Hospital on 16 February to handle all
from the newly organized Naples blood psychiatric cases. It was hoped that this
bank. A total of 5,128 pints were re- 11
(1) Hist of the 15th Med Gen Lab, 20 Dec
ceived from this unit between 26 Febru- 42-31 May 44. (2) Annual Rpt, Surg, Fifth Army,
ary and 25 May. Blood was delivered 1944. (3) Bauchspies, "The Courageous Medics of
regularly thereafter by LST, with an Anzio," Military Medicine, CXXII (January-June
occasional emergency shipment by Cub 1958),
12
p.444.
Sources for this section are: (1) Annual Rpt,
plane. The British 12th Field Transfu- Surg, Fifth Army, 1944; (2) Annual Rpt, Surg, VI
sion Unit continued to be the distribu- Corps, 1944; (3) Annual Rpt, Surg, 3d Inf Div,
1944; (4) Hanson, ed., "Combat Psychiatry," Bul-
ting agency throughout the life of the letin, U.S. Army Medical Department, Suppl num-
beachhead. Between 22 January and 4 ber (November 1949).
ANZIO BEACHHEAD 285
TABLE 10—DISPOSITION OF PROBLEM CASES IN THE 3D DIVISION, 4 MARCH-30 APRIL 1944
specialization would permit more rapid was received, and 30 April the provi-
identification and evacuation of severe sional platoon evaluated 171 referrals.
cases, permitting longer retention of (Table 10) The record was encouraging
those most likely to respond to treat- enough to warrant an extension of the
ment if retained on the beachhead. The principle to other divisions later in the
experiment did not work out. The 56th Italian campaign.
Evacuation admitted 483 such cases in
the period 16-29 February, of which Preventive Medicine
only 9.6 percent were returned to duty.
The focus of psychiatric treatment was Trench Foot—Trench foot had be-
then shifted, still on an experimental come a problem to Fifth Army in the
basis, to the division level. On 1 March a Winter Line campaign, but conditions
provisional platoon was organized in the were relatively good in the mountains
3d Division, with a cadre of one officer before Cassino compared to those on
and seven carefully selected enlisted Anzio beachhead. From January through
men, under supervision of the division most of March the temperature re-
psychiatrist, Capt. Robert J. Campbell. mained near freezing, with frequent
The platoon was attached to the 10th rain. The whole area occupied by VI
Engineer Battalion. Its ranks were filled Corps was flat, much of it reclaimed
up with "problem" cases referred by the swampland, with poor drainage and a
combat units, which continued to carry high ground water level. Trenches, dug-
the men on their rolls as on special duty outs, and foxholes were usually half
status. Captain Campbell screened these filled with water before they were com-
cases, sending to the division clearing pleted. Add to these natural disadvan-
company for disposition all those show- tages the fact that the enemy had good
ing need for hospital care. The discipli- observation of the entire area and guns
nary cases, and those of mild psychiatric to back it up, and the medical problem
disturbance, were retained in the pro- may be realized. It was suicidal to leave
visional platoon, where they performed a foxhole in daylight, so the men stayed
various duties while undergoing psychi- in their cramped positions, their feet
atric treatment. often immersed in water and always
Between 4 March, when the first case wet, for ten or twelve hours at a stretch.
286 MEDITERRANEAN AND MINOR THEATERS
Trench foot was an inescapable con- ment would be used in the winter of
comitant.13 1944-45. A study with this end in view
There were many conferences on the was carried out by the 3d Division, and
subject among medical officers, both the data obtained furnished a basis for
British and American, but preventive ordering future winter equipment for
measures were largely useless. The tacti- troops in the Mediterranean theater.15
cal situation made it impossible for the
men to exercise their lower limbs prop- Malaria Control—The same condi-
erly, and the shortage of manpower tions that made trench foot inevitable
precluded any effective rotation of men also made the beachhead a natural
or units. Dry socks were sent to the breeding spot for mosquitoes. Indeed,
front lines as frequently as possible, but the Anzio plain had been scourged by
the supply of socks and laundry facilities malaria for centuries. As soon as it be-
were alike limited. Even had it been came evident that the Allied forces might
possible to issue dry socks daily, as was still be in the area after the onset of the
14
done in the British sector, men holding malaria season, a complete control plan
tenuously to positions on a front that was worked out by American and British
might erupt at any moment could not authorities. Beginning late in February,
be made to take off their shoes just to the beachhead was surveyed from the
change socks. Had they been willing to air for breeding places, and as much
do so, the new socks would have been information as possible was collected
as wet as the old in a few minutes. about the local incidence of the disease.
In the circumstances, it is not surpris- The results were studied by malariolo-
ing that 2,196 cases of trench foot were gists, and a control program was issued to
reported during the continuance of the all VI Corps units late in March.16
beachhead. Although preventive meas- Among the steps taken was the estab-
ures were thus largely ineffective, the lishment of a special school, operated by
Anzio experience was turned to account personnel of the 52d Medical Battalion,
in determining what clothing and equip- for instruction of the officers, noncommis-
sioned officers, and enlisted men who
13
(1) Annual Rpt, Surg, Fifth Army, 1944. (2) were to carry out the preventive meas-
Annual Rpt, Surg, VI Corps, 1944. See also, ures. Instructors were 2 Sanitary Corps
Whayne and DeBakey, Cold Injury, Ground Type,
pp. 101-25, passim. officers and 3 Medical Department en-
14
It should be noted that the incidence of trench listed men who went to Anzio for that
foot on the beachhead was higher among U.S. purpose. A total of 2,011 persons received
troops than among British troops performing essen-
tially the same duties under identical conditions. six hours of instruction each. Suppres-
The reasons for the difference, in addition to sive therapy was started on 26 March,
changing socks daily, probably included the British
practice of treating mild cases in quarters where
they were not reported, and the British tendency
to regard cold injury as a self-inflicted wound,
15
subject to appropriate disciplinary action. Other Final Rpt, Preventive Medicine Off, MTOUSA,
factors were the superior boots and heavier wool 1945.
16
socks issued by the British, and the fact that the (1) Annual Rpt, Surg, Fifth Army, 1944. (2)
British soldier generally stayed in the line for Annual Rpt, Surg, VI Corps, 1944. (3) Annual
shorter periods of time than his U.S. counterpart. Rpt, 52d Med Bn, 1944. See also pp. 259-61, above.
ANZIO BEACHHEAD 287
their units when hospitals were estab- their normal duties, without rest and
lished. Thereafter they shared all the without complaint.
discomfort and inconvenience, all the When the German drive of February
personal hazard, and all the unceasing was in full swing, and conditions on the
labors of the men. If there was any beachhead were at their worst, the
distinction at Anzio between combat evacuation of the nurses was considered,
troops and medical personnel, it was that but only briefly. As a morale factor, their
the latter worked harder and took presence was of incalculable value. To
greater risks. They had not even the remove them would have been very
scant protection of a foxhole, and the close to an admission of defeat in the
red cross was a target rather than a eyes of the combat troops. So they re-
shield. There were, moreover, no lulls mained—six of them never to depart.
or quiet periods in their activities. Among those who survived, four wore
Through it all, the approximately 200 the Silver Star, the first women ever to
nurses on the beachhead carried on receive that decoration.
CHAPTER VIII
MAP 25—Fifth Army Hospitals and Medical Supply Dumps on the Cassino Front,
11 May 1944
Division returned from Anzio it was as- tions were accordingly moved to posi-
signed to Eighth Army. The remaining tions in the new Fifth Army area as
10 Corps division, the 46th, was sent to rapidly as they could be cleared, with
the Middle East, but returned to Italy due regard to deception of the enemy
later in the year as an Eighth Army unit. in the process. (Map 25) Patients
were evacuated to base hospitals in the
Regrouping of Medical Caserta area, the Naples hospitals being
Installations largely reserved for Anzio casualties and
those from the French Expeditionary
The realignment of the Allied Armies Corps.2
in Italy, as the former 15th Army Group
was now called, made Highway 6 the
2
main artery of support for Eighth Army, Major sources for this section are: (1) Annual
Rpt, Surg, Fifth Array, 1944; (2) Annual Rpt,
while II Corps was served by Highway Surg, II Corps, 1944; (3) Unit rpts of med units
7 along the coast. U.S. medical installa- mentioned in the text.
FROM THE GARIGLIANO TO THE ARNO 291
In the new sector, all Fifth Army hos- were also moved during March in the
pitals were grouped in the vicinity of same general pattern. The two Italian-
Carinola, adjacent both to Highway 7 staffed veterinary hospitals were estab-
and to the railroad that roughly paral- lished in the II Corps area, the 110th
leled that highway all the way to Rome. on the extreme left and the 130th at
The area was about 12 miles east of the Nocelleto close to the main concentra-
mouth of the Garigliano and no more tion of medical units. The first U.S. vet-
than 10 or 15 miles southwest of the erinary installation to reach the theater,
Teano-Riardo area from which most of the 17th Veterinary Evacuation Hospi-
the installations came. The nth Evacua- tal, arrived during the regrouping and
tion Hospital opened at the new site on was established near Teano, on the
11 March, followed two days later by the extreme right of Fifth Army.
95th. The 8th Evacuation Hospital and For some six weeks before the launch-
the neuropsychiatric hospital operated ing of the drive on Rome, set for 11 May
by the 601st Clearing Company were 1944, Fifth Army medical units on the
ready to receive patients in the Carinola southern front had only routine func-
area on 23 March, and the 38th Evacua- tions to perform. Hospitals brought their
tion completed its move on the 29th. equipment up to standard and replaced
The 10th Field Hospital, the 16th Evac- losses, while combat medical personnel
uation, and the 3d Convalescent opened trained with their divisions. Emphasis
in the Carinola area on the 3d, 16th, and was placed on physical conditioning and
26th of April, respectively. on evacuation in mountainous terrain,
The 38th Evacuation had changed but opportunities for recreation were
places with the 56th from Anzio, and the provided.3
11th had rotated with the 93d before all
these moves were completed. The 94th Combat Medical Service
Evacuation Hospital went direct to Anzio
from its Mignano site late in March. The Drive to Rome
The venereal disease hospital operated
by the 602d Clearing Company closed at The Southern Front—An hour before
Riardo on 27 March and went into midnight, 11 May 1944, Allied guns
bivouac. Its place was taken by a tempo- pounded German positions from the
rary venereal disease hospital set up un- Tyrrhenian Sea to Cassino and beyond.
der II Corps control by the clearing Immediately thereafter the 85th and
company of the 54th Medical Battalion. 88th Divisions of II Corps, and the
The hospitalization units of the 11th French Expeditionary Corps on their
Field Hospital were brought together right, attacked through the mountains
late in February, operating under canvas north and west of Minturno. In the cen-
as a provisional 400-bed station hospital ter of the front, the British 13 Corps of
for troops in training until early April. Eighth Army forced a crossing of the
The 11th Field then went into direct Rapido where the 36th Division had
support of the clearing stations of the
310th and 313th Medical Battalions. 3
The malaria control program carried out at
Veterinary units serving Fifth Army this time has been discussed on pages 259-61, above.
292 MEDITERRANEAN AND MINOR THEATERS
suffered disaster in January; on the right Between the French colonials and the
the Polish Corps stormed Cassino and sea, the 88th and 85th Divisions of II
Monastery Hill. Though taken by sur- Corps also penetrated the mountains
prise, the Germans rallied quickly to and, in a series of bitterly contested small
fight back with their customary stub- unit actions, broke through the enemy's
bornness and skill; but this time the prepared defenses. On 19 May the im-
Allies were not to be stopped, and the portant highway junction of Itri fell to
monastery was taken on the 18th.4 II Corps. Fondi was taken the next day,
While the Germans were still off bal- and the corps turned southwest toward
ance from the punishing blows of Allied Terracina, from which Highway 7 ran
artillery, the French corps stormed the straight across the Pontine Marshes to
heights where the British had failed in Cisterna, the Alban Hills, and Rome.
January and within twenty-four hours On the Eighth Army front, where the
had broken through the Gustav Line. strongest German defenses were concen-
Against stiffening but disorganized op- trated, the advance was slower and more
position, Algerian and Moroccan moun- difficult, but the threat posed by Fifth
tain troops then followed the ridges that Army on the left flank relieved enough
overlooked the Liri Valley from the of the pressure along Highway 6 to keep
south, and by 19 May had outflanked Eighth Army moving through the Liri
the Montedoro anchor point of the still Valley proper and on into the Sacco
unfinished Hitler line, last of the Ger- Valley beyond.
man fortified positions on the southern While II Corps drove through another
front. mountain mass toward Terracina and
the FEC stormed Pico, an important
4
On the military side, major sources for this sec- road junction which the enemy could
tion are: (1) Fifth Army History, pt. V; (2) Alex- not afford to lose, VI Corps at Anzio
ander, "Allied Armies in Italy from 3rd Septem- struck on 23 May toward Valmontone,
ber, 1943, to 12th December, 1944," Suppl to the
London Gazette, 6 June 1950; (3) Opns Rpt, II where Highway 6 could be cut, the Sacco
Corps, May 1944; (4) Clark, Calculated Risk; (5) Valley blocked, and the whole German
Starr, ed., From Salerno to the Alps; (6) Paul L.Tenth Army trapped.
Schultz, The 85th Infantry Division in World War
II (Washington: Infantry Journal Press, 1949); In the rugged, mountainous area south
(7) John P. Delaney, The Blue Devils in Italy; Aof the Liri and Sacco Rivers, medical
History of the 88th Infantry Division in World support was difficult in the extreme.
War II (Washington: Infantry Journal Press, 1947) .
Medical sources primarily relied upon are: (8) Medical supplies and equipment were
Annual Rpt, Surg, Fifth Army, 1944; (9) Annual carried forward by jeep, by mule, by
Rpt, Surg, II Corps, 1944; (10) Annual Rpt, Surg,hand carry, and in a few instances were
85th Div, 1944; (11) Annual Rpt, Surg, 88th Div.
1944; (12) Opns Rpt, 310th Med Bn, May 1944; dropped by parachute from small planes.
(13) Opns Rpt, 313th Med Bn, May 1944; (14) jeeps and mules were also used to evacu-
Hist Rcd, 54th Med Bn, May 1944. See also (15) ate the wounded, supplementing the in-
Ltr, Austin W. Bennett, M.D., to Col Coates, 17
Nov 58; (16) Ltr, Maurice M. Kane, M.D., to adequate number of ambulances and
Coates, 11 Nov 58, both commenting on prelimin- trucks whose usefulness was restricted
ary draft of this volume. Colonel Bennett was at by the severe limitations of the road net-
that time commanding officer of the 33d Field
Hospital; Colonel Kane was surgeon of the 88th work. In some instances it was found
Division. advantageous to hold casualties at the
FROM THE GARIGLIANO TO THE ARNO 293
aid stations until the advancing troops
had secured neighboring roads in order
to avoid the long and difficult litter
hauls.
As in the mountain fighting before
Cassino, the heaviest burden fell on the
litter bearers. The medical battalions
organic to the 85th and 88th Divisions—
the 310th and 313th, respectively—had
each received its authorized overstrength
of 100 litter bearers 5 before the drive
began, but the number available was
still far short of needs, and both II Corps
divisions drew heavily upon service and
headquarters troops for additional bear-
ers. Italian troops were also attached as
litter bearers. All together the 85th
Division had 700 litter bearers above the TREATING 88TH DIVISION CASUALTY
normal Table of Organization allot- at a forward aid station, May 1944.
ment, and the 88th had almost as many.
The 85th Division, on the left flank of
II Corps, left its clearing station and the
1st platoon of the nth Field Hospital used to bring out the walking wounded.
in the vicinity of Cellole some five miles Evacuation from the clearing station and
southeast of the Garigliano crossing. field hospital was by two platoons of the
Casualties began coming back about an 54th Medical Battalion.
hour after the division went into action, The offensive was in its sixth day be-
and reached a record 544 during the 24 fore the 85th Division had moved far
hours of 12 May. On the second day of enough forward to permit the clearing
the drive, with admissions to the clear- station to advance, but thereafter for
ing station again exceeding 500, the 3d the next ten days its moves were fre-
Platoon of the nth Field Hospital quent. On 1.7 May the station crossed the
joined the 1st in support of the 85th Di- Garigliano River to the vicinity of
vision. Collecting companies operated in Minturno, leaving one platoon of the
two sections in order to give closer sup- field hospital at the old site to care for
port to the combat forces. All ambu- patients not yet in condition to be evacu-
lances organic to the division were in ated. The other field hospital platoon
use forward of the clearing station, to- similarly remained at Minturno, while
gether with additional ambulances the clearing station moved forward to
borrowed from corps. Jeeps fitted with Formia on 20 May and to a site near Itri
litter racks were invaluable. Through on the 21 st. On 24 May the clearing
14 May weapons carriers and trucks were station was established five miles west of
Fondi, with both field hospital platoons
5
See p. 240, above. adjacent. Two days later the clearing
294 MEDITERRANEAN AND MINOR THEATERS
station again advanced without its field highway and some three or four miles
hospital support, this time to Sonnino, east of the Garigliano.
where it operated until the division was Although casualties were not as heavy
withdrawn from the line on 27 May. as those of the 85th, 369 passed through
The 88th Division, on the right of the the clearing station of the 88th Division
85th with the French Expeditionary on 12 May. The station had crossed the
Corps on its own right, followed a line river to a site a mile southeast of Min-
of advance parallel to that of the 85th turno before it was given field hospital
but somewhat farther to the north. High- support on 16 May. At that time the 2d
way 7 was the initial axis of both divi- Platoon of the nth Field Hospital
sions, and was consequently the line moved into the area. Evacuation from
along which medical installations of both the clearing station was by an ambu-
tended to be located. The starting site of lance platoon of the 54th Medical Bat-
the 88th Division clearing station was talion.
in the vicinity of Fasani, just north of the Once the Gustav Line was broken, the
FROM THE GARIGLIANO TO THE ARNO 295
campaign moved more rapidly. The 88th tional load required, and on 23 May the
Division clearing station shifted to 403d Medical Collecting Company, 161st
Formia on the Gulf of Gaeta on 20 May Medical Battalion, with elements of the
and the next day to a site just west of 551 st Ambulance Company attached,
Itri. In each move the field hospital pla- was sent to reinforce the FEC. The next
toon lagged behind for a day or two until day the 406th Medical Collecting Com-
its nontransportable patients could be pany, 162d Medical Battalion, was given
transferred to one of the evacuation hos- the mission of evacuating French for-
pitals behind the lines. ward hospitals.
At this point the 88th Division moved
into the mountains north of Highway 7, The Anzio Front—The Germans were
and evacuation became increasingly dif- retreating hastily from Terracina when
ficult. Collecting companies were split VI Corps, now more than seven divi-
to establish treatment stations along sions strong, began its drive on 23 May
litter trails, and Italian troops were at- from Anzio beachhead. The 1st Ar-
tached as litter bearers. Two collecting mored, the 3d Division, and the 1st
stations were in the vicinity of Fondi Special Service Force led off, passing
when that town was bombed the night through the 34th to take the Germans
of 23—24 May and suffered considerable by surprise. The attacking forces quickly
damage to their vehicles. penetrated enemy positions before the
Over the next three days, the division Germans could regroup. The 45th struck
cut across roadless mountains to for limited objectives on the left of the
Priverno. In this drive litter carries were salient, while the British 1st and 5th
up to twelve miles from the moving Divisions held defensively from the
front back to Fondi, with as many as Albano road west to the sea, and the
fourteen relay posts along a single trail. U.S. 36th remained in reserve.6
It was the last important action on 6
Principal military sources for this section are:
the southern front. Once II Corps was (1) Fifth Army History, pt. V; (2) Alexander,
in contact with the Anzio forces, German "Allied Armies in Italy from 3rd September, 1943,
resistance south of the Liri and Sacco to 12th December, 1944" Suppl to the London
Gazette, 6 June 1950; (3) Opns Rpts, VI Corps,
Valleys collapsed. On the 88th Division May, Jun 44; (4) Opns Rpts, II Corps, May, Jun
front, the entire 313th Medical Bat- 44; (5) Clark, Calculated Risk, pp. 334-88; (6)
talion moved to the vicinity of Sonnino Truscott, Command Missions, pp. 369-80; (7)
Starr, ed., From Salerno to the Alps, pp. 228-67;
on 25 May, and two days later the clear- (8) Taggart, ed., History of the Third Infantry
ing station, with its attached field hospi- Division in World War II pp. 153-96; (9) Huff,
tal unit, was set up just outside Priverno. ed., The Fighting 36th, unpaged; (10) The Fight-
ing Forty-Fifth, pp. 86-92; (11) Howe, 1st Armored
The French Expeditionary Corps, on Division, pp. 317-68; (12) Schultz, 85th Division,
the II Corps right, had the most difficult pp. 60-107; (13) Delaney, Blue Devils, pp. 62-124.
mission of any Fifth Army formation in On the medical side, sources primarily relied upon
are: (14) Annual Rpt, Surg, Fifth Army, 1944;
the drive to Rome and suffered casual- (15) Annual Rpt, Surg, VI Corps, 1944; (16) An-
ties commensurate with its success. The nual Rpt, Surg, II Corps, 1944; (17) Annual Rpts,
French medical units supporting the Surgs, 3d, 34th, 36th, 45th, 85th, 88th, 1st Armd
Divs, 1944; (18) Opns Rpts, 3d, 109th, 111th,
corps, though adequate for normal oper- 120th, 310th, 313th, 47th Armd Med Bns, May,
ations, were unable to carry the excep- Jun 44.
296 MEDITERRANEAN AND MINOR THEATERS
In two days of violent action, the 3d this time. The 85th Division, coming up
Division once more proved its right to from Terracina to reinforce the 3d,
the name the Germans gave it of went into the line the evening of 30
Sturmdivision. The 7th Infantry took May, and the 88th Division was on the
Cisterna, fighting from house to battered way.
house. The 15th and 30th regiments The final drive to Rome was launched
bypassed the town on either side and on 1 June, when Valmontone fell to the
converged on Cori, six miles nearer to 3d Division and Highway 6 was finally
Highway 6. In the same two days the cut. The bulk of the German forces,
Special Service Force seized the dominat- however, had escaped from the Sacco
ing height of Mt. Arrestino, southeast of Valley before the trap could be sprung,
Cori, and columns of the 1st Armored leaving II Corps to pursue a beaten but
were threatening Velletri, key to the still dangerous enemy. At the same time
Alban Hills and center of German re- elements of the 36th Division, on a mis-
sistance, from south and east. Contact sion in the rough and wooded area north
had been made with II Corps patrols on of Velletri, penetrated the eastern slopes
Highway 7; the Twelfth Air Force, in of the Alban Hills without encountering
close support, had destroyed hundreds any resistance. Seizing the opportunity,
of German vehicles on the crowded es- the division shifted its ground and by
cape roads from the beachhead; and VI evening of 1 June held commanding
Corps had taken more than 2,600 prison- positions on the heights above Velletri
ers. that made the German position in the
On 26 May a sudden change of direc- town no longer tenable.
tion again caught the Germans unpre- Indeed, the Germans were already
pared. The 34th and 45th Divisions withdrawing, and only mopping up re-
lunged west toward Campoleone Station mained. Small, highly mobile units from
and Lanuvio, while the 3d held its gains. II Corps on Highway 6 and from VI
The 1st Armored, after a final thrust Corps on Highway 7, swept into Rome
toward Velletri in terrain too rough for on 4 June, so close behind the retreating
tanks, was relieved by the 36th. The 1st enemy that he had no time to destroy
Armored was back in the line in the the bridges across the Tiber. Highway
Campoleone sector on 29 May, but the 6 had not been cut quickly enough to
Germans, holding fanatically along the prevent the escape of the bulk of the
Albano-Lanuvio-Velletri railroad, gave German forces, but enemy losses in both
ground only by inches. men and material had been heavy.
Meanwhile, the U.S. IV Corps head- The character of medical support on
quarters under Maj. Gen. Willis D. the Anzio front differed markedly from
Crittenberger had relieved II Corps that dictated by the mountainous terrain
headquarters on the southern front on west of the Garigliano. During the first
28 May, and II Corps had shifted to the few days of the VI Corps offensive, clear-
beachhead, where General Keyes took ing companies remained in the hospital
command of the Valmontone sector. The area east of Nettuno. The 3d Division
3d Division and the Special Service clearing station, supporting both its own
Force passed to II Corps command at division and the Special Service Force,
FROM THE GARIGLIANO TO THE ARNO 297
was the first to move, setting up south of sector. The remaining unit of the 33d
Cori on 26 May along with a platoon of Field Hospital was established near the
the 33d Field Hospital. 34th Division clearing station south of
One platoon of the 36th Division clear- Velletri by 30 May.
ing company went into action with the In the new II Corps sector, the 10th
division on 26 May, north of Cisterna, Field Hospital relieved the nth on 29
but did not have a platoon of the 33d May, units of the 10th Field being at-
Field Hospital adjacent until the 28th. tached to the clearing stations of the 3d,
Both clearing station and field hospital 85th, and 88th Divisions. The unit at-
moved to the Velletri area on 3 June. tached to the 3d Division was forced to
The field hospital platoon supporting withdraw from its initial site south of
the 3d Division moved over to support Valmontone by enemy shelling on 29
the clearing station of the 45th after II May. The clearing station of the 88th
Corps took command of the Valmontone Division in the same general area was
298 MEDITERRANEAN AND MINOR THEATERS
A NEWLY TAKEN GERMAN PRISONER HELPS GIVE FIRST AID to a 3d division cas-
ualty in the Cisterna area.
bombed on the night of 1-2 June. A the rear might be 10 miles behind in a
direct hit on the admissions tent killed few hours. Both the 52d Medical Bat-
nine persons, seven of them personnel talion, supporting VI Corps, and the
of the 313th Medical Battalion. For the 54th Medical Battalion, supporting II
next twenty-four hours 88th Division cas- Corps, were called upon to reinforce the
ualties were taken to the 85th Division division collecting companies in the final
clearing station west of Valmontone on drive to Rome. On the II Corps front,
the rim of the Alban Hills. along Highway 6, clearing stations
By this time the combat troops were moved almost daily.
moving rapidly, and evacuation routes Litter carries in the same period were
between collecting and clearing stations long, as the troops outran their medical
were lengthening. This was especially support. The indispensable jeep, fitted
true of the 1st Armored Division, where with litter racks, was used in many places
treatment stations set up 2 or 3 miles to inaccessible to ambulances, but even
FROM THE GARIGLIANO TO THE ARNO 299
jeeps were useless in much of the hill 10th and nth Field Hospitals, and the
country on the 36th Division front. 11th, 93d, and 95th Evacuation Hospi-
Casualties were heaviest in the first tals. At the same time the 750-bed 9th
two days of the drive out of the beach- and 59th Evacuation Hospitals were
head and on 1 June, when the Germans withdrawn from the Peninsular Base
made their final effort to hold open their Section.7
line of retreat along Highway 6. Field The combat-hardened units of the VI
hospital units often operated beyond nor- Corps and the FEC were gone, and in
mal capacity and were frequently unable their place were the untested 91st and
to evacuate their patients in time to 92d Divisions and the Brazilian Expedi-
move with the division clearing stations. tionary Force of somewhat more than
Holding sections were usually left be- division strength. Of these only the 91st
hind on these occasions, permitting the saw action before the Arno River line
main body of the unit to advance. In was reached. In effective strength, Fifth
other instances, it was necessary for one Army numbered 379,588 on 4 June,
field hospital unit to support two divi- when Rome was taken, and only 171,026
sions. Additional nurses for the field hos- on 15 August when the lines were
pitals were supplied by Fifth Army, stabilized.
while other personnel and extra equip- After the fall of Rome the Germans
ment were borrowed from nonopera- fought only small rear-guard actions,
tional units. On 2 June the 1st Platoon trading ground for time to regroup and
of the 11 th Field Hospital was attached reequip their disorganized and decimat-
to the 10th Field in the II Corps sector ed forces. Bridges, culverts, port facili-
to help carry the load. ties were methodically destroyed wher-
7
Pursuit to the Arno Principal sources for military operations in the
pursuit to the Arno are: (1) Fifth Army History,
pt. VI, Pursuit to the Arno (Milan, Italy: Pizzi and
After the fall of Rome, the German Pizio, 1945); (2) Alexander, "Allied Armies in Italy
armies in Italy might have been de- from 3rd September to 12th December, 1944, Suppl
stroyed had Alexander been allowed to to the London Gazette 6 June 1950;" (3) Opns
Rpts, II Corps, Jun-Aug 44; (4) Opns Rpts, IV
retain adequate forces. The Combined Corps, Jun-Aug 44; (5) Clark, Calculated Risk,
Chiefs of Staff, however, gave higher pp. 334-88; (6) Starr, ed., From Salerno to the
priority to the expanding operations in Alps, pp. 268-300; (7) Howe, 1st Armored Divi-
sion, pp. 317-68; (8) Delaney, Blue Devils, pp. 62-
France. During June and July General 124; (9) Maj. Robert A. Robbins, The 91st In-
Clark reluctantly gave up both VI Corps fantry Division in World War II (Washington:
and the French Expeditionary Corps to Infantry Journal Press, 1947) , pp. 26—91. The more
important medical sources are: (10) Annual Rpt,
Seventh Army for the invasion of south- Surg, Fifth Army, 1944; (11) Annual Rpt, Surg, II
ern France. The equivalent of more than Corps, 1944; (12) Annual Rpt, Surg, IV Corps,
eight veteran divisions, with supporting- 1944; (13) Annual Rpts, Surgs, 34th, 88th, 91st, 1st
Armd Divs, 1944; (14) Opns Rpts, 109th Med Bn,
units, were withdrawn while Fifth Army Jun-Aug 44; (15) Opns Rpts, 313th Med Bn, Jun-
was in pursuit of a badly beaten foe. In Aug 44; (16) Opns Rpt, 111th Med Bn, Jun 44;
addition to the medical units organic to (17) Opns Rpts, 316th Med Bn, Jul-Aug 44; (18)
Opns Rpts, 47th Armd Med Bn, Jun-Aug 1944;
these divisions, Fifth Army also lost the (19) Hist, 54th Med Bn, Jun-Aug 44; (20) An-
52d and 56th Medical Battalions, the nual Rpt, 161st Med Bn, 1944.
300 MEDITERRANEAN AND MINOR THEATERS
ever their destruction would impede the tween Naples and Leghorn and urgently
Allied advance or delay the delivery of needed to shorten supply lines. The 1st
supplies. Battles were fought on terrain Armored led the advance in two col-
of the enemy's choosing by mobile units umns, the 34th and 36th Divisions fol-
that could disengage at will and outrun lowing as closely as their transportation
the slower Allied formations. Fifth Army, permitted. Elements of the 34th passed
forced like the Germans to reorganize through the armor that night and took
on the march, never quite caught up with the city after only a token fire fight on
any substantial body of enemy troops. the morning of 7 June. Within a week
The pursuit opened on 6 June, the the port had been restored sufficiently
day Allied forces crossed the English to dock Liberty ships.
Channel and secured the first beachhead Some twenty miles inland, II Corps,
on French soil. VI Corps, in the coastal with the 85th and 88th Divisions, struck
sector, drove out along Highway 1 to- along Highway 2 toward Viterbo with
ward Civitavecchia, the largest port be- its important complex of airfields. The
FROM THE GARIGLIANO TO THE ARNO 301
GIVING PLASMA to a 1st Special Service Force soldier while he is being evacuated by jeep to
a collecting station.
infantry was outdistanced by a task force Expeditionary Corps, which had been
of the 1st Armored that swung inland pinched out in the final days of the drive
after the capture of Civitavecchia and to Rome, began relief of II Corps along
secured Viterbo the morning of 9 June. the Highway 2 axis on 9 June, and both
By this time the pattern of the cam- the 85th and 88th Divisions were with-
paign was well defined. The hit-and-run drawn for needed rest. At the same time
tactics of the German retreat did not the VI Corps sector was narrowed and
call for pursuit in force, permitting both left in sole command of the 36th Divi-
the reduction and the reoganization of sion, with the 361 st RCT of the 91st Di-
Fifth Army to be carried out in orderly vision attached, while the 34th and 1st
fashion without loss of momentum. The Armored rested. On 11 June General
3d Division, which garrisoned Rome un- Crittenberger's IV Corps relieved VI
til 14 June, did not go back into the Corps.
line, and the 45th, in VI Corps reserve, The reinforced 36th Division seized
was withdrawn on 8 June. The French the town of Grosseto on 15 June, and
302 MEDITERRANEAN AND MINOR THEATERS
crossed the Ombrone River that night. division, though its 363d Regiment re-
Two days later the 517th Parachute Com- mained for the time being attached to
bat Team, in Italy to gain experience the 34th. IV Corps reached the Arno
for a mission in southern France, was plain on 17 July, and two days later the
also attached to the 36th. The advance, 34th Division entered the battered port
however, was slowing down in the face of Leghorn. Pisa fell on the 23d, and
of stiffening opposition and more diff- Fifth Army moved up to the Arno on its
cult terrain. In the French sector, the entire front.
fighting centered around Lake Trasi- The last of the French units had been
meno was becoming particularly bitter. withdrawn on 22 July, and Eighth Army
To relieve the French and prepare for had shifted west to fill the gap. Florence
the first withdrawals from the FEC, the fell to Eighth Army on 4 August. By
IV Corps sector was widened, and the the 15th of that month the Arno River
1st Armored returned to the line on 21 line was secure, and the Adriatic coast
June. Five days later the 34th Division, was also in Allied hands as far north as
with the 442d Infantry attached, relieved the Metauro River above Senigallia.
the 36th, which went at once to the The weakening of Fifth Army to supply
Seventh Army staging area. The 361st troops for operations in southern France,
Infantry remained in the line, attached however, had permitted the enemy to
to the 1st Armored, but the 517th was withdraw to the Gothic Line in the
withdrawn on the 28th. northern Apennines. Pursuit beyond the
The 34th Division took command of Arno was impossible without rest, re-
the coastal sector just north of Piombino, grouping, and resupply. The enemy
the small but immensely useful port that would also have time to recover his
had fallen on 25 June. The division strength and to improve his fortified
closed rapidly toward Highway 68, a positions.
lateral road that runs roughly east from On the rolling plains northwest of
a point on Highway 1 some twenty miles Rome, clearing stations and their accom-
south of Leghorn to a junction with panying field hospital platoons experi-
Highway 2 at Poggibonsi, a similar dis- enced great difficulty in keeping up with
tance south of Florence. The Germans the racing troops. Advances during the
fought hard at Cecina just below the first few days of the pursuit were as much
junction of Highways 1 and 68, in an as twenty and thirty miles a day, so that
effort to delay the capture of Leghorn as a clearing station located within range
long as possible, but the 34th was beyond of enemy guns in the morning might
the intersection by 2 July. The next day be miles behind by nightfall. Even with
the 363d Infantry of the 91st Division frequent moves it was impossible to avoid
was attached to the 34th, in time to take long ambulance runs. For similar rea-
part in a 6-day battle for Rosignano, only sons, litter hauls too became long as com-
a dozen miles southeast of Leghorn. bat elements outran ambulance control
On 11 July the 88th Division came points and even aid stations.
back into the line as a IV Corps unit, Field hospital platoons found it im-
relieving the 1st Armored, and the fol- possible to move with the same frequen-
lowing day the 91st was committed as a cy as the clearing stations they supported,
FROM THE GARIGLIANO TO THE ARNO 303
because of the need for giving postopera- the 109th Medical Battalion, supporting
tive care to their patients, and of the the 34th Division, cleared casualties
inadequacy of their organic transporta- from five regimental combat teams and
tion. The field hospitals were given six their attached troops.
additional 2½-ton trucks in June, mak- The 316th Medical Battalion, organic
ing ten in all, but even this number was to the 91st Division, operated as a unit
sufficient to move only one platoon at in combat for the first time when the
a time. The problem of caring for pa- division was committed on 12 July, al-
tients who could not be moved was though collecting companies of the bat-
solved only by attaching additional field talion had been in action with the 361st
hospital units and by operating the units and 363d RCT's.
in two sections. On more than one occa- On 3 August, with all but mopping
sion a single field hospital had seven up operations completed, a rest center
separate sections in simultaneous opera- for Fifth Army medical personnel was
tion, all in support of a single division established at Castiglioncello, about fif-
clearing station. teen miles south of Leghorn on the coast.
The 10th Field Hospital remained in The camp had accommodations for 50
the line in support of the 85th and 88th officers, 25 nurses, and 100 enlisted men.
Divisions until the relief of II Corps was Each group remained four days.
completed on 11 June. At that time the
11th Field was brought up from bivouac Hospitalization in the Army Area
in the Cisterna area, going into action
with IV Corps. Platoons of the 33d Field The long period of preparation for
Hospital followed the VI Corps drive to the May drive on Rome gave ample time
Civitavecchia, shifting to IV Corps when to clear Fifth Army hospitals, but the
VI Corps was relieved. For the 33d, work nature of the terrain on the Garigliano
was light until the end of June, when front, together with the rapid movement
the 11th was withdrawn to stage for the of the combat troops once the Gustav
invasion of southern France. Thereafter Line was broken, prevented close sup-
the 33d carried the entire burden of for- port. Hospitals remained in the Carinola
ward surgery for IV Corps, including the area until late May, while lines of evacu-
relatively heavy casualties from the bat- ation stretched out to fifty and seventy-
tles for Cecina and Rosignano. five miles along Highway 7.8
The pursuit was characterized by al- Hospitals supporting II Corps began
ternating periods of heavy fighting and moving forward after the capture of Ter-
comparative lull, with corresponding racina. The 95th Evacuation, augmented
peaks and valleys for the medical service. by the 1st Platoon of the 601st Clearing
On various occasions, corps medical bat- Company, opened at Itri on 24 May, and
talions were compelled to fill in at the the 93d leapfrogged ten miles farther
division and regimental levels. During forward, to Fondi, two days later. The
the period of severe fighting in the 750-bed 56th Evacuation took over from
mountainous area around Cecina early 8
Major sources for this section are: (1) Annual
in July, and the subsequent advance to Rpt, Surg, Fifth Army, 1944; (2) Unit Rpts of the
Leghorn and Pisa, the clearing station of hosps mentioned in the text.
304 MEDITERRANEAN AND MINOR THEATERS
the 93d at Fondi on 1 June, the 93d uation Hospital, newly arrived from
going to Campomorto in the Anzio area. Sicily to act as a Peninsular Base Section
At the same time the 95th jumped ahead station hospital at Anzio. (Map 26)
fifty miles to Cori, southeast of the Alban In Rome, the 38th Evacuation set up
Hills. The 16th Evacuation, meanwhile, under canvas in a park near Vatican
had gone by sea to Anzio where it opened City. The 15th was located in a school
on 27 May; and the 8th, after a brief building, while the 94th and 56th shared
stay at Cellole, between Carinola and a large building originally constructed
Minturno, moved overland to Le Fer- for hospital use by one of the religious
riere in the beachhead sector, opening orders and recently operated as a mili-
on 1 June. The neuropsychiatric hospital tary hospital by the Germans—so re-
operated by the 601st Clearing Com- cently, in fact, that pots of coffee and
pany, and the venereal disease hospital vats of beans were still warm in the
operated by the 602d Clearing Com- kitchen when the Americans arrived. Al-
pany, both moved into the Anzio area though it was recognized that these
on 31 May. evacuation hospitals did not have the
Two casualty clearing stations (evac- organic personnel necessary for cleaning
uation hospitals), two field hospitals, and maintenance of fixed structures,
three mobile surgical formations, and a General Martin felt that the service they
mobile surgical group attached to the would render in preparing the buildings
French Expeditionary Corps were simi- for later occupancy by PBS units would
larly slow in moving up for reasons of more than outweigh the disadvantages.10
terrain and because of the rapid move- The last of the Fifth Army hospitals
ment of the corps. Additional French from the southern front, the 3d Con-
hospital units, although requested early valescent, moved into the Anzio area on
in April, were not available in time for 9 June, opening at Le Ferriere. Move-
9
the Rome-Arno Campaign. ment had been delayed by lack of trans-
As the hospitals moved forward, am- portation and congested roads.
bulance control posts were set up to di- In the pursuit north of Rome, where
rect the flow of casualties. Movement the terrain was well adapted to the use
was facilitated by keeping new casual- of armor, the combat troops quickly out-
ties out of hospitals scheduled for an distanced their supporting hospitals, and
early change of location. lines of evacuation once more length-
General Martin was with the first ened out, up to 100 miles. Here the main
group to enter Rome, where he quickly axis of advance for the U.S. forces was
located buildings suitable for hospital Highway 1, along the Mediterranean
use. The 94th Evacuation from Anzio coast, with the French Expeditionary
and the 56th from Fondi both moved Corps, supported in part by American
into Rome on 6 June, with the 38th and medical units, using Highway 2, farther
15th from Anzio following on 9 and 10 inland. The first hospital to move into
June, respectively. The 38th exchanged the new combat zone was the 11th Evac-
its dug-in ward tents with the 59th Evac- uation, which opened at Santa Marinella,
9
(1) Fifth Army History, pt. V, p. 244. (2)
10
Journal of Col Reeder. Annual Rpt, Surg, Fifth Army, 1944; p. 44.
FROM THE GARIGLIANO TO THE ARNO 305
MAP 26—Fifth Army Hospitals and Medical Supply Dumps, 10 June 1944
just below Civitavecchia, on 10 June. 94th two days later. The 400-bed evac-
The new location was 40 miles northwest uation hospitals were usually moved in
of Rome and more than 80 miles from pairs, the organic transportation of the
the hospital's former Anzio site. The fol- two units being pooled to move first one,
lowing day the 93d opened at Tarquinia, and then the other.
some 15 miles farther north. On 13 June Throughout this period, communica-
the 95th Evacuation was established at tion was poor and lines of evacuation
Montalto di Castro, 10 miles beyond were maintained only by great effort.
Tarquinia, where it was joined by the The advance of the front was so rapid
306 MEDITERRANEAN AND MINOR THEATERS
INSTITUTE OF THE GOOD SHEPHERD IN ROME, occupied jointly by the 38th and 94th
Evacuation Hospitals.
that the Signal Corps was unable to in- Grosseto. The new site was only 6 miles
clude the hospitals in its telephone net- from the point of contact with the
work. Pigeons were used to some extent, enemy, but by the time the hospital was
but for the most part communication was ready to receive patients the front was a
maintained by couriers driving jeeps safe distance away.
hundreds of miles a day. The 8th Evacu- Other moves were made toward the
ation Hospital, for example, sent an ad- end of June. The 15th Evacuation
vance party to lay out a site near moved from Rome to Grosseto on the
Orbetello, 20 miles beyond the 94th and 23d of the month. The 94th left Mont-
95th, on 16 June. The party was met by alto on the same day to set up at
an ambulance driver who had already Montepescali, 10 miles south of Gros-
come 50 miles from the front in search seto, where it was joined on 27 June by
of a hospital. The 8th's commander, Col. the 16th Evacuation. The 3d Convales-
Lewis W. Kirkman, hastily changed cent moved to Grosseto on 29 June. Also
plans and after making contact with the on 29 June the 56th Evacuation opened
Fifth Army surgeon by courier, ordered at Venturina, near Piombino, 30 miles
the hospital established 4 miles south of northwest of Montepescali. The vene-
FROM THE GARIGLIANO TO THE ARNO 307
real disease hospital moved on 26 June tion, was established at Saline, halfway
to Guincarico, about 5 miles from the between the 15th and 94th Evacuations,
sites of the 94th and 16th Evacuation on 23 July.
Hospitals. The 38th Evacuation shifted The 16th Evacuation operated at
from Rome to Massa Marittima, about Ardenza, on the southern outskirts of
10 miles north of the venereal disease Leghorn, from 26 July to 12 August. The
center, on 2 July. 3d Convalescent moved on 2 August to
By this date the rate of advance had Laiatico, twenty miles southeast of Leg-
slowed owing to the withdrawal of sub- horn; and the 56th Evacuation was es-
stantial forces for the invasion of south- tablished three days later about five
ern France and to the more rugged ter- miles farther north, at Peccioli. On 8 Au-
rain. For the first time since the fall of gust the 601 st Clearing Company set up
Rome the location of hospital sites with its neuropsychiatric hospital at Montec-
respect to availability of air evacuation chio, a mile or two south of the Peccioli
became a problem, requiring reconnais- site of the 56th Evacuation. The front
sance from the air as well as on the was stabilized at about this time, with
ground. Hospitals caught up with the the actual fighting reduced to patrol
combat troops, and even outdistanced actions along the Arno River line.
organic medical units on occasion. The (Maps 27, 28)
8th Evacuation for example, moved into The Rome-Arno Campaign again
the outskirts of Cecina while the fight- demonstrated the value of the separate
ing for that town was still in progress ambulance company, of the 400-bed
and was actually set up on 2 July forward evacuation hospital, and of the field hos-
of the 34th Division clearing station. pital platoon as a forward unit. The
The next series of moves came toward shortcomings of these platoons with re-
the middle of July, when the nth, 93d, spect to size were overbalanced by their
and 95th Evacuation Hospitals were mobility in a campaign of rapid move-
withdrawn from Fifth Army. The 94th ment. The capacity of the 400-bed evacu-
Evacuation, with a platoon of the 601st ation could be readily increased, even
Clearing Company attached, moved up beyond its own expansion limits, by the
to Ponteginori, about ten miles east of attachment of one or more clearing pla-
Cecina along the road to Florence, on toons from the corps medical battalions.
11 July; and the venereal disease hos- The field hospital platoons operating
pital moved into the same area four days with the division clearing stations were
later. At the same time the neuropsy- also augmented from time to time by
chiatric hospital was established at additional personnel and beds from
Cecina. The 38th Evacuation opened on other sources. In the Rome-Arno Cam-
the coast road, twelve miles above paign the field hospital platoons were
Cecina, on 18 July, after a 24-hour delay able to move forward with the divisions
because the area was still under fire. The they supported because holding units to
15th Evacuation moved to Volterra, a care for their nontransportable patients
few miles beyond the site of the 94th. were improvised from personnel of the
The 32d Field Hospital, released from corps medical battalions, with nurses
attachment to the Peninsular Base Sec- borrowed from evacuation hospitals. As
310 MEDITERRANEAN AND MINOR THEATERS
TABLE 11—ADMISSIONS TO HOSPITAL AND QUARTERS FROM FIFTH ARMY, MAY—AUGUST
1944
a
U.S. strength only.
Source: Annual Rpt, Surg, Fifth Army, 1944.
TABLE 12—AIR EVACUATION FROM FIFTH ARMY HOSPITALS, 26 MAY-31 AUGUST 1944a
a
Figures include patients from the French Expeditionary Corps, from the British components of VI Corps, from the
Anzio area, and some Italian military and civilian personnel. Flights from the Eighth Army sector have been excluded,
but some Eighth Army casualties are not separable from Fifth Army figures. Excludes Air Forces casualties insofar as pos-
sible.
Source: Annual Rpts, 802d and 807th MAETS, 1944.
tals at the railheads were maintained by and 807th Medical Air Evacuation
the corps medical battalions. Casualties Transport Squadrons. The first flight
from Anzio continued through most of from the Nettuno airstrip was made on
May to be evacuated exclusively by hos- 26 May. Air evacuation for both U.S.
pital ships and by LST's staffed by teams and French forces was directed by the
from the 56th Medical Battalion. Office of the Surgeon, Fifth Army, which
On the fifth day of the attack the had made proximity to an airfield or to
encampment of the 56th Medical Bat- level ground where an airstrip might be
talion near Nocellito was bombed in constructed a condition in the selection
bright moonlight, apparently deliberate- of hospital sites. By 1 June approxi-
ly, with two enlisted men killed, seven mately 400 patients a day were being
wounded, and extensive damage to flown from the combat zone to fixed
equipment. hospitals in Naples and Caserta.12 (Ta-
After the consolidation of the two ble 12)
fronts, air evacuation began from the Holding units for air evacuation were
army area, and thereafter, for the re- operated at various points by two collect-
mainder of the campaign, forward hos- 12
Ltr, Gen Stayer, Surg, NATOUSA, to TSG,
pitals were cleared by planes of the 802d 2 Jun 44.
312 MEDITERRANEAN AND MINOR THEATERS
TABLE 13—EVACUATION FROM FIFTH ARMY TO PBS HOSPITALS, 1 JANUARY-31 AUGUST 1944
a
Includes U.S. Army, U.S. Navy, Allies, POW's.
b
Includes 7,136 patients for whom no means of evacuation is given. Most of these were probably evacuated by air,
which explains in part the large discrepancy between the total evacuated by that means shown in this and in the pre-
ceding table. The remainder of the discrepancy may be accounted for in British casualties, not taken to PBS hospitals.
Source: Annual Rpt, Surg, MTOUSA, 1944, an. B, app. 18.
ing companies of the 161st Medical Bat- 3,000 fixed beds were available in the
talion and by the clearing company and Italian capital, so that forward evacua-
one collecting company of the 163d tion hospitals began sending casualties
Medical Battalion. The 56th Medical to Rome instead of to Naples and
Battalion handled both air and sea Caserta.
evacuation at Anzio until 23 June, when During the entire 7-month period of
it was relieved by the 54th and departed the Anzio, Cassino, and Rome-Arno Cam-
for Naples to stage for the invasion of paigns, casualties were evacuated from
southern France. The 402d Collecting Fifth Army hospitals to Peninsular Base
Company of the 161st Medical Battal- Section installations by ambulance, hos-
ion, assigned to the French Expedition- pital train, hospital ship, LST, and
ary Corps, even helped to construct and transport plane. The figures are not re-
maintain an airstrip, and directed the ported by campaigns, only on a monthly
approach and take-off of the C-47 trans- basis. For the period 1 January-31 Au-
ports. gust 1944 the total was 102,298.
Transportation between hospitals and (Table 13)
airfields was handled by corps medical
battalions. The 162d Medical Battalion Medical Supplies and Equipment
also cleared patients from evacuation
hospitals in Rome to the 59th Evacua- Like the Fifth Army hospitals, the
tion, which functioned as a Peninsular supply dumps of the 12th Medical Depot
Base Section station hospital at Anzio Company moved forward only after II
until 23 June. By this date more than and VI Corps had joined at Anzio. The
FROM THE GARIGLIANO TO THE ARNO 313
company headquarters and base platoon The 1st Platoon was established in
and the 2d Platoon went from Calvi Ri- Civitavecchia on 11 June, only four days
sorta to Nocellito on 20 April, in the after the capture of the city and before
general alignment of Fifth and Eighth the harbor had been cleared. On 18
Armies. The 2d Platoon moved forty-five June, headquarters and the base platoon
miles to Itri on 23 May, and went on went on to Grosseto. Ten days later the
to Rome on 9 June. Headquarters and 2d Platoon turned over the supply func-
the base platoon had meanwhile moved tion in Rome to Peninsular Base Section
from Nocellito to Anzio on 5 June, installations and followed the rapidly
where the 1st Platoon reverted to con- moving army to Piombino. The 1st Pla-
trol of the parent company.13 toon was in Cecina on 9 July.
The 12th Medical Depot Company was
13
Principal sources for this section are: (1) An- reorganized at this time, the personnel
nual Rpt, Surg, Fifth Army, 1944; (2) Annual
Rpt, 12th Med Depot Co, 1944; (3) Annual
complement being reduced from 178 to
Rpts, Surgs, II, IV, and VI Corps, 1944. 150. The three platoons were redesig-
314 MEDITERRANEAN AND MINOR THEATERS
nated the 1st, 2d, and 3d Storage and re-equipping for the crushing attack that
14
Issue Platoons. would carry Allied power to the Arno
Headquarters and the 1st Storage and River, were used by the Medical Depart-
Issue Platoon moved from Grosseto to ment to review past practices and
Saline on 30 July, where they were improve techniques for the future. The
joined on 14 August by the 3d Storage conferences and seminars that medical
and Issue Platoon. The latter unit was officers had been able to attend only
established in the vicinity of Florence spasmodically up to that time were sys-
at the end of the month. tematized, with all phases of the work of
In all these rapid changes of position, the medical service being discussed. Med-
one platoon of the 12th Medical Depot ical officers of all levels profited by these
Company was always in support of each interchanges before they returned to ac-
of the two U.S. corps engaged, with the tive combat support.16
headquarters group accessible to both.
The French Expeditionary Corps had Medicine and Surgery
its own system of combat medical supply,
which was organized under the same U.S. Forward Surgery—The techniques of
Table of Organization as its American forward surgery in the Rome-Arno Cam-
counterpart, and was supplied through paign did not differ greatly from those
the same channels.15 employed during the preceding eight
Medical supplies were brought up by months in Italy. While there were a
water, air, and truck as circumstances number of clinical improvements, in-
dictated, with no shortages developing cluding a more extensive use of penicil-
except the perennial shortages of blan- lin and the unrestricted availability of
kets, litters, and pajamas stemming from whole blood in the field hospital pla-
faulty property exchange with air evac- toons, the only important administrative
uation units. This shortage was felt at all change was the withdrawal of twenty-
airstrips used for evacuation, since the eight teams, or half of the entire com-
incoming planes were on other missions, plement, of the 2d Auxiliary Surgical
which generally precluded the carrying Group early in July to stage for the
of bulky medical items. coming invasion of southern France.17
One of the features of the supply sys- The loss of these teams was not made up
tem, in the later phases of the campaign, until the next stage of the Italian cam-
was the daily arrival of whole blood by paign.
plane from the 15th Medical General
Laboratory. Neuropsychiatry—The early success
of the 3d Division's experiments at Anzio
Professional Services in treating psychiatric cases at the divi-
in the Army Area sion level led General Martin to initiate
similar experiments in the 88th Divi-
The months of March and April 1944,
when the armies were regrouping arid Arno Campaign, both U.S. and French medical de-
pot companies were organized under T/O 8-661.
14 16
TOE 8-667, 17 Mar 44. Annual Rpt, Surg, Fifth Army, 1944.
15 17
ETMD for May 1944. At the start of the Rome- Special Rpt, 2d Aux Surg Gp, 27 Oct 44.
FROM THE GARIGLIANO TO THE ARNO 315
sion, which had not yet been in combat. The patients who showed improve-
It was hoped that the incidence of psy- ment under sedation were given sugges-
chiatric casualties could be reduced if tive and supportive therapy and turned
adequate facilities for early treatment over to the division Training and Re-
existed from the start.18 habilitation Center, where they were
The 88th Division Training and Re- given lectures combined with calisthen-
habilitation Center was formally estab- ics, hikes, and other physical activities,
lished on 18 April 1944, commanded by including tactical training with weapons.
a line officer with two noncommissioned Most were ready to return to duty after
officers as assistants, all with extensive two days at the center. Others were re-
combat experience. The division psychi- tained for a few days longer, while those
atrist, Capt. (later Maj.) Joseph Slusky, whose symptoms persisted were evacuat-
acted as consultant. The center was at- ed to the neuropsychiatric hospital.
tached for rations and quarters to the Each patient was re-examined by the
clearing company of the 313th Medical division psychiatrist before returning to
Battalion. Actual operation began on combat and was given a final therapy
11 May when the division went into com- session oriented toward reassurance. Re-
bat. The procedure was simple, but turns to duty were made through non-
effective. medical channels.
An exhaustion or psychiatric case ad- The record for the period 11 May-9
mitted to the clearing station was ex- June, during which the 88th was in con-
amined by the division psychiatrist, who tinuous combat under particularly diffi-
evaluated the severity of the symptoms. cult conditions, showed a total of 248
The patient was retained at the clearing psychiatric admissions to the division
station for two or three days, where he Training and Rehabilitation Center. Of
was given sodium amytal three times a these, 141 or 56.9 percent, were returned
day after meals. Sedation was sufficient to duty from the center. One hundred
to ensure adequate rest and sleep, but and four were evacuated to the 601st
not heavy enough to keep the patient Clearing Company, from which 24 were
from going to mess and otherwise taking later returned to duty. Total returns to
care of himself. After 24 to 48 hours of duty were thus 165, or 66.5 percent.
this treatment, the patient was again Eighty, or 32.3 percent, were lost to the
examined by the division psychiatrist. division. Two remained under treatment
If he appeared to be responding, he was at the end of the period, and one was
retained. If not, he was transferred to absent without leave.
the Fifth Army Neuropsychiatric Cen- The results of this experiment led
ter, operated by the 601st Clearing to an order of 2 July 1944 directing all
Company. divisions of Fifth Army to establish sim-
ilar training and rehabilitation centers.
Thereafter, admissions to the Fifth
18
(1) Annual Rpt, Surg, Fifth Army, 1944. (2) Army Neuropsychiatric Center were ex-
Annual Rpt, Surg, 88th Div, 1944. (3) Hanson, clusively by transfer from these division
comp. ed., "Combat Psychiatry," Bulletin, U.S.
Army Medical Department, Suppl (November 1949). installations. A Fifth Army consultant in
See also pp. 284-85, above. neuropsychiatry, Maj. (later Lt. Col.)
316 MEDITERRANEAN AND MINOR THEATERS
a
Includes 95 returned to limited or Class B duty.
Source: Annual Rpt, Surg, Fifth Army, 1944.
Calvin S. Draper, was also named at this Fifth Army as a whole for the last four
time. A further development, which months of the Rome-Arno Campaign is
went into effect the first of August, was shown in Table 14.
the return of certain neuropsychiatric
casualties to limited or noncombat duty Common Diseases—Malaria in Fifth
in the army area, a disposition board for Army reached the year's peak of 94
this purpose being set up by the 3d Con- cases per 1,000 per annum in June 1944,
valescent Hospital. dropping only slightly to 82 in July. Dur-
In general, the psychiatric cases devel- ing these two months the season was at
oping in the drive to Rome and the its height, and the army was operating
subsequent pursuit to the Arno River in areas that had been controlled by the
were less severe than those encountered enemy during the earlier part of the
during the static fighting before Cassino breeding season. Atabrine continued to
and on the Anzio beachhead. The in- be the primary preventive measure
cidence was higher in the divisions new available, the use of netting and gloves
to combat, but the response to treatment being for the most part impractical in
in these divisions was excellent. The rec- combat.
ord of the 88th Division has already A sharp rise in the incidence of di-
been noted. The 91st returned 68.1 per- arrhea and dysentery (including bacte-
cent of its 116 psychiatric casualties to rial food poisoning) from 28 per 1,000
duty between 13 and 31 July when the per annum in May to 102 in June and
division was in combat. The 85th Divi- 135 in July may be explained by the
sion, out of action between 1 July and 15 simultaneous advent of warm weather,
August, had a smaller total of such cases, the fly season, and the fresh fruit season.
76 being admitted in this period to the Even the July figure, however, was far
division training and rehabilitation cen- below the rate of 195 cases per 1,000
ter, but the cases proved more obstinate, per annum experienced in June 1943 in
only 51 percent being returned to duty North Africa. Insecticides were available
at the division level. in adequate quantities, and the diseases
The disposition of psychiatric cases in were quickly overcome when the period
FROM THE GARIGLIANO TO THE ARNO 317
a
Rates expressed as number per annum per 1,000 average strength.
b
Not yet in Italy.
c
Withdrawn from Fifth Army.
Source: Annual Rpt, Surg, Fifth Army, 1944.
of active fighting came to an end in early Cowan had taken to Salerno eight
August. months earlier. Facilities for prosthetic
Venereal disease in the summer of work were still less than adequate, but in
1944 followed a predictable pattern, the other respects Fifth Army began the
rate being relatively low during periods drive to Rome well prepared to meet the
of combat and high during the rest and dental requirements of its troops. Each
bivouac periods. (Table 15) The rate of the divisions had improvised labora-
continued to be highest among veteran tory facilities. In addition, three of the
troops. four mobile dental laboratories—built
on 2½-ton truck chassis—reaching the
Dental Service theater in May were assigned to Fifth
Army, the fourth going to the Air Forces.
On 6 May 1944, just before the By June, when IV Corps went into
launching of the drive on Rome, the the line north of Rome, the Fifth Army
Fifth Army dental surgeon, Colonel Dental Clinic, operated by the 602d
Cowan, was returned to the United Medical Clearing Company, was func-
States on rotation. His acting successor tioning smoothly enough to care for all
was Maj. (later Lt. Col.) Clarence T. cases that could not be handled by the
Richardson of the 16th Evacuation divisions. IV Corps, accordingly, set up
Hospital.19 no dental clinic of its own, while the II
Major Richardson inherited a dental Corps clinic was discontinued toward
establishment much better equipped to the end of the month. Aside from inade-
fulfill its mission than the one Colonel quate prosthetic facilities, the only
serious defect in the Fifth Army dental
19 setup at this time was the familiar prob-
The major sources for this section are: (1) An-
nual Rpt, Surg, Fifth Army, 1944; (2) Annual lem of getting dental services to troops
Rpt, Med Sec, MTOUSA, 1944; (3) MS, Dental in distant positions, and the correlative
History, North African and Mediterranean The- loss of man-hours in sending men to the
aters of Operations; (4) Unit rpts of div surgs and
med installations in Fifth Army during the period rear to the Army clinic.
11 May-31 Aug 44. The reorganization of July gave a
318 MEDITERRANEAN AND MINOR THEATERS
FIELD UNIT OF THE FIFTH ARMY DENTAL CLINIC in the Piombino area, July 1944.
same operation utilized 2,023 horses and 602d Field Artillery Battalions, moved
7,266 mules. In the drive, 146 animals seven times between 4 April and 15 July.
were killed in action and 1,111 were Among its operating sites were Monte
wounded. The particularly heavy animal San Biagio near Terracina; Cori and
casualties in the French sector made it Nemi in the beachhead area; Castag-
necessary to attach the 1st Veterinary neto, south of Cecina; and Ponteginori
Hospital (Italian), a Peninsular Base west of Cecina on Highway 68. With the
Section unit, to the French Expedition- battalions it supported, the 17th was as-
ary Corps.20 signed to Seventh Army on 20 July.
Veterinary hospitals in support of Replacements for animal casualties
Fifth Army experienced considerable were supplied by the Base Remount De-
difficulty in finding sites with buildings pot, operated by Peninsular Base Sec-
suitable for animal use. Close support tion. To minimize delay as much as pos-
was nevertheless given by these units. sible, however, each veterinary hospital
The Italian-staffed 110th Veterinary maintained a small exchange unit that
Hospital moved from the Carinola area supplied a sound animal for each
to Nettuno on 20 June, and to Rome on wounded one received. Only on the
4 July. The 130th Veterinary Hospital, French front, where animals were most
also Italian staffed, moved from Nocel- numerous and casualties heaviest, did
lito to Rome on 1 July, to Grosseto a the system break down. In those cases
week later, and to Saline on 1 Septem- where hospital exchange units were ex-
ber. The U.S. 17th Veterinary Evacua- hausted, fresh animals were allotted by
tion Hospital, supporting the 601st and Fifth Army.
When flat or rolling country was
20
The major sources for this section are: (1) reached after the fall of Rome, all ani-
Annual Rpt, Surg, Fifth Army, 1944; (2) Veter- mal units were placed in rest areas,
inary History, Mediterranean Theater of Opera- where they remained throughout the
tions; (3) Miller, United States Army Veterinary
Service in World War II. summer. The only exception was a pe-
320 MEDITERRANEAN AND MINOR THEATERS
riod in July when elements of the 1st Debrecen in eastern Hungary before
Armored Division, operating in moun- ending its mission at Poltava airfield.22
tains between Massa Marittima and Lt. Col. William M. Jackson, Eastern
Volterra, substituted horses for half- Command surgeon, established his head-
tracks and trucks. quarters at Poltava, where his staff
During the rest period, all Italian pack
included a Veterinary Corps officer and
trains and veterinary hospitals were re- a Sanitary Corps officer. Each of the three
organized in accordance with U.S. Tables bases was supported by a 75-bed provi-
of Organization and Equipment. Four sional hospital expanded from a 24-bed
new Italian pack companies were also aviation dispensary. Instead of the two
organized at this time, and the 20th Mule medical officers called for in the TOE,
Pack Group, which controlled all the the Poltava and Piryatin hospitals had
Italian pack trains, set up a center underfour each, while Mirgorod had three.
Colonel Canani for training recruits in Each hospital had the one dental officer
the handling of pack animals.21 and one supply officer (MAC) provided
in the TOE, and each had four nurses.
Medical Support for the Eighty-five enlisted men, divided among
Eastern Command headquarters and the three hospitals,
brought total Medical Department per-
Before the end of 1943, negotiations sonnel to 117. All medical personnel and
began for the use of Russian airfields by facilities came from the United King-
U.S. bomber squadrons based in Italy dom.23
and in the United Kingdom. Arrange- The first problem faced by Colonel
ments were finally completed in the Jackson and his staff was one of sanita-
spring of 1944, with the designation of tion. Whatever war may have left of
three bases in the Ukraine. The head- water and sewerage systems had been
quarters base was at Poltava, 200 miles destroyed by the Germans as they re-
east of Kiev. The others were located at treated, together with virtually all build-
Mirgorod, 50 miles west of Poltava, and ings. The Russians had been too short
at Piryatin, another 50 miles in the di- of medical personnel themselves to take
rection of Kiev. Collectively, they were
22
administered as the Eastern Command This section is based primarily on the follow-
(EASCOM) . The first flight, made by ing: (1) Craven and Cate, eds., Europe; ARGU-
MENT to V-E Day, pp. 308-19; (2) Maj Albert
planes of the Fifteenth Air Force from Lepawsky, History of Eastern Command, USSTAF;
Italy on 2 June 1944, was timed to be (3) History of Operation FRANTIC, 26 October 1943-
contemporaneous with the capture of 15 June 1944; (4) EASCOM History, 1 Oct 1944-
1April 1945; (5) Unsgd, undtd doc, Assignment of
Rome and the launching of the Nor- Nurses in Russia.
23
mandy invasion. The first task force of (1) TOE 8-450 (2) CM 12424, 28 Mar 44,
B-17's, personally led by General Eaker, Knerr, Spaatz, and Grow to Deane for Jackson.
(3) Hist of FRANTIC 26 Oct 43-15 Jun 44, Med an.;
destroyed marshaling yards and shops at (4) Link and Coleman, Medical Support of the
Army Air Forces in World War II, pp. 562-63. For
21
See also pp. 263-65, above. Colonel Canani the first three weeks there were only three nurses at
was official liaison officer between the Italian pack Mirgorod, one of the twelve from England having
and veterinary units and the office of the Fifth Army been disqualified at Tehran before entering the
veterinarian, Colonel Pickering. USSR. She appears to have been replaced later.
FROM THE GARIGLIANO TO THE ARNO 321
adequate preventive measures, and mans failed to locate the target and
typhus, malaria, dysentery, and venereal contented themselves with bombing the
diseases were prevalent. In the absence town.
of buildings, the hospitals were set up in Poltava was nonoperational for forty-
tents, close to the airfields they served. eight hours and operated to a limited
The hospital at Piryatin was well con- extent only for a month. Russian sappers
cealed in a wooded area near a river, but were still locating and detonating unex-
those at Poltava and Mirgorod were in ploded bombs as late as 7 September.
open fields. All units were established After the attacks of 22-23 June, in-
and ready to receive patients by 1 June. stallations were dispersed as much as
The medical service of the Eastern possible. The hospitals were relocated
Command underwent its acid test three some distance from the airfields, and an
weeks later. The first shuttle bombing attempt was made to enlarge the avail-
mission by the Eighth Air Force from able medical facilities. A request for a
British bases arrived at Poltava the 400-bed field hospital to replace the
afternoon of 22 June after a successful three outsize dispensaries was refused,
raid on a synthetic oil plant south of however, on the ground that no field unit
Berlin. The bombers were apparently was available for that purpose.24
trailed to their destination by a German The bases became steadily less impor-
plane, and that night the Poltava field tant as the Russian front pushed west-
was attacked in force. At the time of the ward and the advance of the Allied
attack there were 370 permanent and Armies in Italy and France brought
714 transient U.S. personnel at the base. more enemy targets into normal bomber
It was estimated that no tons of range. Personnel were gradually with-
bombs were dropped over a 2-hour drawn until by 1 October only Poltava
period. Every one of the 73 B-17's on retained a medical complement, reduced
the field was hit and 43 were destroyed, to 3 medical officers, 4 nurses, and 14
together with 3 C-47's, one F-5, numer- enlisted men. Housed in three prefabri-
ous ground vehicles, and quantities of cated barracks, this unit continued into
gasoline, oil, bombs, and ammunition. 1945, but performed only routine dis-
Twenty-five Russian YAK fighters were pensary functions.
also damaged on the ground. Two The medical installations of the East-
Americans, a pilot and copilot, were ern Command were supplied from
killed and 14 wounded. The Russians, Tehran, and during the period of
who manned the antiaircraft batteries greatest activity patients were evacuated
and fought the fires on the field, lost 30 by air to the 19th Station Hospital in
killed and 95 wounded. First aid was
given in the slit trenches that served for
shelter, the wounded being moved to the 24
(1) CM 11-64940, Spaatz to ETOUSA, 15 July
hospital when the raid was over. 44. (2) CM E-38685, 19 Jul 44, Eisenhower to USS-
The following night the other two TAF. A field hospital organized and equipped by
bases were attacked, but with less dis- the French Air Force had been offered to the
Mediterranean Allied Air Force in the spring of
astrous results. A gasoline dump was hit 1944, but apparently had been diverted to other
at Mirgorod, but at Piryatin the Ger- uses. See entry, 3 Apr 44, in Journal, Col Reeder.
322 MEDITERRANEAN AND MINOR THEATERS
that city. After 1 October 1944, evacu- medical service was excellent. The
ation was to the 113th General Hospital average weekly noneffective rate was
at Ahwaz, Iran. Considering the unsani- 18.32 per 1,000, only a little higher than
tary conditions and the prevalence of that for similar units in the United
disease in the Eastern Command, the Kingdom.
CHAPTER IX
MEDICAL SECTION OF NATOUSA AT CASERTA, 26 July 1944. Front row, left to right:
Lt. Col. Joseph Carmack, Lt. Col. Asa Barnes, Col. Lynn H. Tingay, Colonel Standlee, Gen-
eral Stayer, Lt. Col. Bernice M. Wilbur, Col. William C. Munly, Colonel Churchill, Colonel
Simeone; back row, left to right: Colonel Hanson, Maj. Joseph W. Still, Colonel Noonan,
Colonel Long, Colonel Stone, Col. Oscar S. Reeder, Colonel Radke, Capt. John H. Slattery.
side of professional services, there was friendly working relations between the
actually some expansion, a veterinary two groups.
section under Colonel Noonan being set In July, with the Allied armies ap-
up in mid-March. proaching the Arno River, both Allied
Relations between the NATOUSA Force Headquarters and Headquarters,
and SOS medical sections remained NATOUSA, moved from Algiers to
close, despite early fears that the theater Caserta. Together with the other offices
medical section might seek to continue of American headquarters, the theater
operating activities and reluctance on medical section was established in the
the part of some officers to be transferred royal palace. The Air Forces medical
from a higher to a lower headquarters. section was already located in the palace,
The policy-determining role of the having established offices there late in
NATOUSA medical section imposed a May. The British medical component
degree of co-ordination, while the trans- of AFHQ, while no longer sharing a
fer of personnel in the long run made for building with the Americans, was physi-
326 MEDITERRANEAN AND MINOR THEATERS
cally near enough to permit continued was sanitation, since the water supply
co-operation. Headquarters, Communi- had been disrupted and the sewerage
cations Zone, including the SOS medical system was not functioning for lack of
section, was established in close proxim- water, but facilities were quickly re-
ity to the others in buildings vacated by stored by the Allied Military Govern-
2
a general hospital on 20 July. ment, in co-operation with British and
U.S. Army engineers. Pending the ar-
The Peninsular Base Section rival of fixed installations, hospitaliza-
tion for American troops in the city was
Plans for the Italian campaign called provided by the 307th Airborne Medical
for the early establishment of a base Company and the 162d Medical Battal-
section in the Naples area. A preliminary ion, with the 95th Evacuation Hospital
organization was activated in Casablanca taking over on 9 October. The 3d Conva-
on 21 August 1943 as the 6665th Base lescent Hospital also began taking pa-
Area Group (Provisional), with medical tients in the Naples area on 12 October.
personnel drawn from the Atlantic Base By the end of 1943, the Peninsular
Section, whose activities were rapidly Base Section was the largest base organ-
declining. An advance echelon of the ization in the theater, both in terms of
medical section debarked at Naples on personnel and in terms of the number of
4 October from the first troopship to fixed beds under its control. It continued
enter the bay. The entire section was to grow at the expense of the declining
ashore by 10 October.3 North African bases, reaching its peak
The 6665th Base Area Group re- strength in August 1944.
mained under Fifth Army control until
1November, when it was formally re- Air Forces Medical Organization
constituted as the Peninsular Base
Section. During this interval, the Fifth The medical organization of the Air
Army surgeon acted also as the base Forces units in the Mediterranean was
surgeon. He was succeeded in the latter realigned early in 1944. The over-all
capacity on 9 November by Colonel Allied command remained the Mediter-
Arnest, who had served as surgeon of II ranean Allied Air Forces, with the Army
Corps since the North African landings. Air Forces, Mediterranean Theater of
Although both cholera and typhus had Operations (AAF MTO), as its U.S.
been reported in Naples ten days before component. The American command in-
the capture of the city, American medi- cluded three major units: the Twelfth
cal officers found the general health situ- Air Force, now primarily a light and
ation good.4 The most serious problem medium bomber group; the Fifteenth
2
Air Force, a heavy bomber group; and
See p. 336, below. the Army Air Forces Service Command.
3
(1) Annual Rpt, Med Sec, NATOUSA, 1943.
(2) Annual Rpt, Surg, PBS, 1943. (3) Hq, ETOU- Headquarters of the U.S. command or-
SA, Rpt on PBS NATOUSA, 10 Feb 44. (4) An- ganization was set up in Caserta in
nual Rpt, Surg, Fifth Army, 1943. February. Twelfth Air Force headquar-
4
The ranking U.S. civil affairs officer was General
Hume. For the civil affairs aspects of the Italian ters was at Foggia, Fifteenth Air Force
campaign, see pp. 360-62, below. headquarters was at Bari, and headquar-
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 327
ters of the service command was at duties of the surgeon, AAF MTO, were
5
Naples. confined primarily to policy matters and
The Fifteenth Air Force was still be- to maintaining close liaison with the
ing built up, reaching its peak strength medical service of the British component
about the time of the first shuttle bomb- of the MAAF. The service command
ing between Italian and Russian bases.6 medical section was the effective operat-
In that operation and in the strategic ing agency for Air Forces medical ac-
bombing of Germany generally, the tivities at the theater level, including
Fifteenth Air Force was responsible to administration of hospitals, evacuation,
the U.S. Strategic Air Forces in Europe, medical supply, sanitation and preven-
a European theater command, but in tive medicine, and medical plans. The
matters of administration, supply, and AAFSC surgeon was also the principal
training, as well as in its Mediterranean point of contact for exchange of technical
operations, it remained under control of information with the NATOUSA medi-
the Mediterranean Allied Air Forces and cal section.
the U.S. Army Air Forces, Mediter-
ranean Theater of Operations. Hospitalization in the
The top co-ordinating U.S. air com- Communications Zone
mand, the Army Air Forces, MTO, was
originally organized without any medi- Fixed Hospitals in PBS
cal section, but the need for one was
quickly apparent and a small section was One of the first tasks of the 6665th
established in February 1944. The posi- Base Area Group medical section was to
tion of surgeon went to the senior Air survey the city of Naples for hospital
Forces medical officer in the theater, sites. Various Italian hospitals and school
Colonel Elvins, who was succeeded in buildings were examined and the best
April by Col. Edward J. Tracy. Colonel of them were tabbed for Medical De-
Elvins' replacement as Twelfth Air partment use. Aside from these, the most
Force surgeon was Col. William F. Cook. suitable area for additional medical in-
The Fifteenth Air Force surgeon was stallations was the Mostra Fairgrounds
Col. Otis O. Benson, Jr., and the surgeon at Bagnoli, some three or four miles
of the Army Air Forces Service Com- from the heart of Naples. Site of Mus-
mand was Col. Louis K. Pohl. solini's colonial exposition of 1940, the
The functions of the Twelfth and Fif- fairgrounds contained numerous rela-
teenth Air Force surgeons were com- tively spacious buildings of stone and tile
parable to those of an army surgeon. The construction, with water, sewerage, and
power facilities and good highway and
rail connections. Many buildings had
5
This section is based primarily on the follow- been badly damaged by Allied bomb-
ing: (1) Hist, Twelfth Air Force Med Sec, 1942-44;
(2) Med Hist, Fifteenth Air Force, 1944. (3) An-
ings, and the retreating Germans had
nual Med Hist, AAFSC MTO, 1944; (4) Link and destroyed others, but the advantages so
Coleman, Medical Support of the Army Air Forces far outweighed the drawbacks that the
in World War II, pp. 438-48. See also Armfield, Or-
ganization and Administration, pp. 269-75. Fifth Army surgeon got the entire area
6
See pp. 320-22, above. set aside for hospital use. It quickly be-
328 MEDITERRANEAN AND MINOR THEATERS
came the staging site for medical instal- of the Mostra Fairgrounds, a provisional
lations arriving in Italy.7 medical center was tentatively organized
In order to realize the full possibilities
Annual Rpt, Med Sec, MTOUSA, 1944; (3)
7
This section is based primarily on the following: Annual Rpts, Surg. PBS, 1943 and 1944; (4)
(1) Annual Rpt, Med Sec, NATOUSA, 1943; (2) Unit rpts of med units mentioned in the text.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 329
tients and those in Naples proper treated enlisted men, the medical center head-
civilians when emergency required, an quarters group was responsible for func-
effort was made to funnel patients from tions common to all the hospitals in the
the French Expeditionary Corps to the area, such as allocation of space, mainte-
182d and 225th Station Hospitals, where nance of roads and utilities, sanitation,
French-speaking personnel were avail- security, transportation, civilian labor,
able. Both of these hospitals were largely and recreation. Included among the serv-
filled with French and French colonial ice units operating under the medical
casualties during January. Many prob- center organization were a finance dis-
lems arose as a result, particularly at the bursing section, an Army post office, a
225th, where bearded African goumiers Quartermaster shower and sterilization
made turbans for themselves out of hos- unit, a laundry, a fire-fighting platoon,
pital towels and changed identification a message center, and a telephone switch-
tags with each other in order to exchange board. The center headquarters also con-
beds. trolled the staging area for medical
Late in January the 9th Evacuation units. Although it resembled the typical
Hospital moved over from Sicily and hospital center in its purposes, the
opened in the medical center as a general Naples grouping was less centralized. It
hospital for French troops, remaining had no commanding officer in the proper
until the beginning of August when the sense of the word. Colonel Jeffress,
unit began staging for southern France. former surgeon of the Atlantic Base Sec-
Liaison personnel from the French Army tion, was responsible for administering
were attached to handle discipline, mail, the overhead functions, but the medical
pay, and other administrative matters, service as such, including the assignment
while French and Arab noncomissioned of patients, was directly under the base
officers served as interpreters. surgeon.9
Installations attached to the medical In addition to the center, there were
center by the end of January 1944 in- 4,500 Table of Organization beds else-
cluded three general and two station where in Naples by the close of the Win-
hospitals and an evacuation hospital act- ter Line campaign. The 12th General
ing as a general, with an aggregate Table Hospital and the 32d Station were also
of Organization strength of 4,750 beds; staging at the Mostra Fairgrounds, but
the 4th Medical Depot Company; a cen- were not in actual operation. Through-
tral dental laboratory; the 15th Medical out the Italian campaign personnel and
General Laboratory, which began operat- equipment of units in the process of
ing a blood bank late in February;8 the staging were freely used to augment
41st Hospital Train; and the 51st Medi- facilities of operating hospitals, in ac-
cal Battalion. By this date the center cordance with the practice established
was fully organized, although the 6744th early in the North African campaign.
Medical Center (Overhead) was not
formally activated until 10 February Other PBS Hospitals—When Fifth
1944. Consisting of four officers and 20 Army medical units moved across the
9
Unit Rpts, 6744th Med Center (Ovhd), 6 Nov
8
See pp. 352-53, below. 44 and 15 Jun 45.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 333
ary, when they were assigned to the Air Hist,The chief sources for this section are: (1)
Twelfth Air Force Med Sec, 1942-44; (8)
Forces. Med Hist, Fifteenth Air Force, 1944; (3) Annual
Virtually all fixed hospitals under con- Med Hist, AAFSC MTO, 1944; (4) Link and Cole-
trol of the Peninsular Base Section were man, Medical Support of the Army Air Forces in
World War II, pp 455-73; (5) Unit rpts of the indi-
operating in excess of their Table of vidual hosps mentioned in the text.
334 MEDITERRANEAN AND MINOR THEATERS
quarters were the spacious modern eral Blesse as Surgeon, North African
buildings of an Italian military hospital. Theater of Operations, on 1 March 1944,
The 61st Station, until its own equip- the theater was already 8,000 beds short
ment arrived in January, operated an of the authorized ratio of 6.6 percent of
American ward in a British hospital at troop strength, with new troops arriving
Foggia, using British equipment. The faster than beds. Stayer's first major
55th Station opened at Foggia and the problem, with which Blesse had been
34th Field a few miles southeast, at struggling for several months, was that
Cerignola, on 13 December. The 35th of substantially increasing the number
Field began taking patients at Erchie, of fixed beds in the theater.12
near the site of the 4th, two days later. The problem had been under discus-
The remaining two platoons of the 4th sion, both in the theater and in Wash-
Field Hospital opened at San Severo, ington, for a considerable time, but the
south of Cerignola, on 18 January. build-up for OVERLORD precluded the
Originally assigned to the Twelfth Air diversion of either beds or medical per-
Force, these hospitals also served the sonnel to the Mediterranean. It was first
Fifteenth Air Force, which was activated suggested toward the end of 1943 that
on 1 November 1943 before any of the the shortage might be overcome by a
medical units were in operation. All more economical use of personnel al-
were transferred to the newly created ready in the theater. More or less de-
Army Air Forces Service Command, tailed plans for enlarging certain general
Mediterranean Theater of Operations, hospitals to 1,500- and 2,000-bed capacity
early in the new year. with personnel released by the inactiva-
There were some changes in the loca- tion of a few 250-bed station hospitals
tion of field hospital platoons in Febru- were drawn up in The Surgeon Gen-
ary and again in May 1944, but all eral's Office in January 1944. No positive
remained south of the latitude of Rome, action was taken, however, until after a
on the Adriatic side of the peninsula. request to increase the bed ratio for the
The only significant change was the re- North African theater to 8.5 percent was
lease of the 55th Station Hospital to PBS denied in March. By that time the
on 10 August. This hospital had been deficiency had risen to 10,000 beds and
operating near Foggia since December action had become imperative. Tenta-
1943, but the enlargement of the 26th tive Tables of Organization for 2,000-
General Hospital at Bari to 1,500 beds bed and 1,500-bed general hospitals were
rendered the 55th Station surplus to Air issued on 19 April 1944, and the reor-
Forces needs. All field hospital units and ganization went into effect on 5 June.13
the 61st Station at Foggia operated on a
30-day policy, with evacuation to the 12
(1) Ltr, Gen Blesse to TSG, 6 Feb 44. (2) Ltr,
26th General. The latter installation TSG to Gen Stayer, 18 Apr 44.
13
(1) Pers Ltr, Col A. B. Welsh, Dir, Plans Div,
operated on a 90-day policy. SGO, to Blesse, 23 Jan 44. (2) Pers Ltr, TSG to
Stayer, 18 Apr 44. (3) Cables, Devers to AGWAR,
14 Jan 44; Marshall to Devers, 20 Jan 1944; Devers
Reorganization of Fixed Hospitals to WD, 23, 26 Mar 44; Marshall to Devers, 7 Apr
44; Devers to WD, 24 May 44. (4) Smith, Hospi-
When General Stayer succeeded Gen- talization and Evacuation, Zone of Interior, p, 226.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 335
Six 250-bed station hospitals—the 43d, which was no longer needed in Algiers
53d, 58th, and 66th in Italy; and the after the decision to transfer Allied
64th and 151st in North Africa—were Force Headquarters to Italy, was inacti-
inactivated. Five general hospitals—the vated on 30 June, and its personnel and
12th, 21st, 23d, 36th, and 300th, all in equipment were absorbed by other
Italy—were expanded from 1,000 to units. The provisional hospital at Mar-
2,000 beds; and the remaining twelve rakech, Morocco, which had been oper-
general hospitals in the theater were ex- ated primarily by personnel of the 56th
panded from 1,000 to 1,500 beds. Each Station at Casablanca since May 1943,
of the new 2,000-bed units absorbed the was reorganized as the 370th Station
personnel and equipment of one of the Hospital, with a Table-of-Organization
inactivated hospitals, with suitable trans- strength of 25 beds.
fers and readjustments to bring all the
enlarged units into line with the new Expansion of the Peninsular
Tables of Organization, which were Base Section
somewhat modified in July. The com-
pleted reorganization added 9,500 T/O Throughout the Anzio Campaign, the
fixed beds to the theater total. General stalemate before Cassino, and the drive
hospitals in Italy began enlarging their to Rome, the build-up of fixed hospitals
facilities by new construction, by conver- in the Naples and Caserta areas con-
sion of additional building space, or by tinued. In February 1944 the 250-bed
erection of tentage a month or more 53d and 58th Station Hospitals set up
before the reorganization went into ef- in Naples, where the former took over
fect. The 21st, 23d, 36th, and 300th operation of the venereal disease hospi-
General Hospitals, for example, had al- tal in the medical center from detached
ready expanded to 3,000 beds each by personnel of the 12th General, the latter
31 May, or 50 percent above their new operating the air evacuation holding hos-
Table of Organization capacities.14 pital at Pomigliano Airfield. At the same
Aside from this general reorganiza- time the 32d, 43d, and 73d Station Hos-
tion, a few minor changes were made to pitals—the 43d of 250 beds, the others of
bring hospital facilities into line with 500—moved into the Caserta area, where
needs. The 60th Station Hospital at they were followed by the 64th General
Cagliari, Sardinia, was formally increased in March. All of these hospitals were
from 250 to 500 beds, confirming the brought over from North Africa.
actual operating status of the installa- There were no new arrivals in April,
tion. The 51st Station, which had been but the opening of the drive to Rome
functioning as a neuropsychiatric hospi- brought a new contingent in May. The
tal, was also confirmed as a 500-bed unit 37th General moved into the medical
in July. The 79th Station Hospital, center, while the 51st and 81st Stations
set up outside the center in Naples
proper. The 51st Station was designated
14
the neuropsychiatric hospital for the
(1) Annual Rpt, Med Sec, MTOUSA, 1944,
an. B. (2) Med Sit reps, PBS, 31 May 44. (3) An- Naples area. The 81st took casualties
nual Rpts, 1944, of the individual Hosps concerned. from the French Expeditionary Corps.
336 MEDITERRANEAN AND MINOR THEATERS
The 3d General and the 78th Station tion, taking over the venereal disease
moved into the Caserta area. Before the hospital and the disciplinary wards. The
end of the month the 750-bed 27th Evac- 21st General absorbed the 58th Station,
uation Hospital, a new arrival from the including operation of the Pomigliano
zone of interior tabbed for an ultimate Airfield holding hospital, and the 300th
role with Seventh Army in France, was General took over personnel and equip-
established at Maddaloni to act as a ment of the 66th Station. The 300th con-
general hospital for French and French tinued to operate the prisoner-of-war
colonial troops. The unit was soon oper- hospital at Dugenta, which had been the
ating 1,500 beds. responsibility of the 66th since January.
During the periods of heavy pres- The POW hospital was later turned over
sure—in February and March in connec- to the 34th Station, which arrived from
tion with the Anzio Campaign, and in Palermo in July. The 43d Station was
May during the assault on the Gustav merged with the 36th General, which
Line—most of the hospitals in the base closed at Caserta in July, releasing its
section operated at approximately twice quarters for occupancy by elements of
their Table of Organization capacities, theater headquarters, including the SOS
with station hospitals often acting as gen-medical section. Pending reassignment,
erals. Prefabricated buildings and tents personnel of the 36th were put on de-
were usually used for expansion where tached service with other hospitals in the
the buildings occupied were inadequate. medical center.
Additional personnel were obtained by The general forward movement of
hiring Italian civilians and by drawing PBS installations began in June. The
upon hospital ship platoons, other hos- 59th Evacuation, brought over from
pitals staging in the area or awaiting as- Sicily, acted as a station hospital at Anzio
signment, and medical battalions. The between 7 June and 10 July, handling
164th and 161st Medical Battalions, both 1,825 admissions in that period. The
Seventh Army units, served PBS in 59th then served for another two weeks
various capacities from late May until at Battipaglia, where Seventh Army was
their release in mid-July to train with in training for the invasion of southern
the invasion forces. The 70th Station at France. The 6th, 12th, and 33d General
Naples and the 74th at Piana di Caiazzo, Hospitals all opened in Rome before the
near Caserta, performed normal station end of June and were joined there on 5
hospital functions for troops in their July by the 73d and 114th Stations. All
respective areas. The 70th also handled of these units came direct from Africa
all hospitalization for the Women's except the 73d, which had been operat-
Army Corps until May. The 182d Sta-ing at Caserta, and the 12th General,
tion in the medical center was desig- which had been inactive in Naples for
nated in July for Brazilian personnel, six months while its personnel served on
who were staging in the area. Brazilian detached duty with other hospitals. The
medical officers, nurses, and enlisted previously organized Rome Area Com-
Wardmen were attached. mand—Rome Allied Area Command
In the reorganization of June, the 23d after 1 July 1944—had supervision over
General Hospital absorbed the 53d Sta- the health of the city, but the U.S. hospi-
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 337
tals remained under the jurisdiction of cupied by the 15th Evacuation Hospital.
15
the Peninsular Base Section. At the end of the month the 64th Gen-
The 12th General Hospital, now a eral Hospital moved from Caserta to
2,000-bed unit, had absorbed the person- Leghorn, where it opened in a former
nel and equipment of the 151st Station, Fascist paratroop school adjacent to the
brought over from Africa for the merger. 16th Evacuation Hospital in the suburb
Like those in Naples and Caserta, all of of Ardenza. The 55th Station, released
the fixed hospitals moving into the Rome at Foggia by the Air Forces, was attached
area were sited in permanent buildings. to the 64th General early in August and
The 6th General occupied the Institute was established at the same Ardenza
of the Good Shepherd, where the 56th site. Leghorn was still within range of
and 94th Evacuation Hospitals had al- German guns when the 64th General be-
16
ready done the necessary renovation. gan taking patients in that city.
The 33d General and the 114th Station, As of 15 August 1944, PBS had 28,900
the latter designated as neuropsychiatric T/O beds in operation, of which 15,000
hospital for the Rome area, were also in were in Naples—8,000 in the medical
Italian hospital plants, while the 12th center—6,000 were in Rome, and 4,000
General and the 73d Station occupied were north of Rome. Between 14 Octo-
Italian military structures. The 7th ber 1943, when the first fixed hospital
Medical Depot Company accompanied opened in Naples, and the end of August
the fixed hospitals into Rome. 1944, PBS hospitals admitted 282,000
Movement north of Rome was almost patients and returned 214,000 of them
simultaneous with the establishment of to military duty. (Tables 17, 18)
hospitals in the Italian capital. The
105th Station Hospital opened at Civita- Decline of North African
vecchia on 5 July; and the 50th, one of and Island Bases
the few 250-bed station hospitals remain-
ing in the theater, opened at Castagneto, As the center of activity in the Medi-
on the coast a few miles north of terranean moved up the Italian penin-
Piombino, on 20 July. The unit was so sula, North Africa decreased in impor-
close to the front for several days that it tance as a communications zone. The
took patients direct from the clearing expansion of the Peninsular Base Section
stations, thus functioning in effect as an was accomplished largely by stripping
evacuation hospital. the African base sections of hospital fa-
The 24th General Hospital from cilities. As of 15 August 1944, the Eastern
the Eastern Base Section in North Africa Base Section was left with only one 250-
went into bivouac in Rome on 20 June, bed station hospital, the 54th at Tunis.
its personnel serving on detached service The Mediterranean Base Section re-
with other hospitals for a month. On 21 tained 3,000 beds, 2,500 of them in the
July the 24th General opened as a 1,500- hospital groupment at Assi Bou Nif,
bed unit at Grosseto, in the buildings of where the 70th General and the 23d and
a tuberculosis sanatorium previously oc- 69th Station Hospitals were still located.
15
Annual Rpt, Surg, Rome Area Comd, 1944.
The others were the 250-bed 57th Sta-
16
See p. 304, above. tion near Constantine and the 250-bed
338 MEDITERRANEAN AND MINOR THEATERS
29th Station at Algiers. The Atlantic Hospitals in MBS still held a few
Base Section retained 275 beds, 250 in long-term patients from Italy, but for
the 56th Station Hospital at Casablanca, the most part the function of the fixed
and 25 in the 370th Station serving pri- hospitals in Africa after June 1944 was
marily Air Forces units at Marrakech. that of hospitalizing military personnel
The total number of U.S. Army Table still in the area. In addition, these hospi-
of Organization beds in all of North tals cared for transient French patients
Africa was thus only 3,525. en route from Italy to French hospitals
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 339
in Africa and for U.S. patients en route about 70,000, were concentrated near
to the zone of interior. Those principally the centers of Army service activities,
served were Air Forces and naval person- which remained in Oran, and in Algiers
nel and service troops in the vicinity of until the removal of AFHQ in July. By
Oran. that date the 7029th Station Hospital
The Island Base Section in Sicily was (Italian), in prisoner of war Enclosure
closed out on 1 July 1944. At that date, 129 at Ste. Barbe-dú-Tlelat near Oran,
600 beds remained under the control of was able to care for most of the Italian
the Allied garrison on Sardinia, and prisoner patients. The 43d and 46th
1,550 were charged to the Northern Base General Hospitals in the nearby Assi
Section on Corsica. Bou Nif groupment had taken malaria
cases from the prison camp until the
Hospitalization of Prisoners departure of those units in June and
of War July, respectively. The 250-bed 7550th
Station Hospital (Italian), which had
The one exception to the contraction been activated in EBS in March 1944,
of medical facilities in North Africa was was moved to POW Enclosure 129 at the
installations for the care of prisoners of end of May but was never re-established
war. Until the Arno River line was as an active unit. The 7393d Station
stabilized, the bulk of the prisoners Hospital (Italian) continued for a time
taken in Italy were transferred to en- to operate 25 beds in conjunction with
closures in North Africa. These were the 56th Station Hospital at Casablanca.
gradually concentrated in the Mediter- On the other hand, the German pris-
ranean Base Section in the vicinity of oner of war hospital in POW Enclosure
Oran.17 131, also at Ste. Barbe-du-Tlélat, ex-
So far as Italian prisoners were con- panded rapidly as the fortunes of war
cerned, the problem became less and less brought a steady stream of German
important as time went on. With Italy prisoners into Allied hands. Originally
enjoying a cobelligerent status, few new set up late in 1943 as a 500-bed unit,
prisoners were taken. Those held over the hospital was caring for more than
from the Tunisia Campaign and from 2,000 patients by July 1944. The limits
operations in Sicily were organized into were fixed by the availability of German
service units of various types, scattered medical personnel, who were never
throughout numerous camps and enclo- taken in large enough numbers to care
sures. The bulk of them, estimated as for all of their own wounded.
17
The most important prisoner of war
This section is based primarily on the follow-
ing documents: (1) Annual Rpt, Med Sec, MT- enclosure in Italy during the early part
OUSA, 1944; (2) Hist of 7029th Station Hosp of 1944 was Number 326 at Dugenta in
(Italian), 27 Jul 45; (3) Annual
Rpt, Med Sec, the Caserta area. In January the 66th
2686th POW Administrative Co (Ovhd), 1944;
(4) Ltr, Col A. J. Vadala to Surg,
NATOUSA, 29 Station Hospital was established in the
May 44, Sub: Adequacy of Med Serv for Italian enclosure. Shortly after the 66th was
POW's in MBS; (5) Ltr, Col Shook, Surg, SOS absorbed by the 300th General Hospital,
NATOUSA, to Surg, NATOUSA, 3 Jun 44, Sub:
Rpts on Med Serv in Italian POW Camps; (6) the 34th Station took over the task of
Annual Rpt, 34th Station Hosp, 1944. caring for sick and wounded German
340 MEDITERRANEAN AND MINOR THEATERS
PLACING GERMAN POW's ABOARD THE SWEDISH EXCHANGE SHIP GHSPROILM for
repatriation. These cases have a long hospital expectancy.
could be routed promptly to the hospital Since air evacuation was exclusively to
21
best equipped to handle the case. the Tunis-Bizerte area, hospital ships
After the activation of PBS, only one were routed to Oran. The port of em-
U.S. hospital ship, Shamrock, was avail- barkation was the Paestum beaches until
able for evacuation from Italy to Africa 8 October, the port of Salerno between
for the rest of the year, but occasional 8 and 25 October, and thereafter the port
lifts were obtained from British vessels. of Naples. Two other U.S. hospital ships
21
in the Mediterranean, Acadia and
Principal sources for this section are the fol-
lowing: (1) Annual Rpt, Med Sec, NATOUSA, Seminole, were used during the period
1943; (2) Annual Rpt, Med Sec, MTOUSA, 1944; primarily for evacuation from North
(3) Annual Rpts, Surg, PBS, 1943, 1944; (4) Med Africa to the zone of interior.
Hist, 802d MAETS, 1942-44; (5) Med Hist, 807th
MAETS, 1944; (6) ETMD's for Oct 43 through Air evacuation from the Naples area
Aug 1944. was handled by the 802d Medical Air
342 MEDITERRANEAN AND MINOR THEATERS
Source: Hq, ETOUSA, Rpt on PBS, 10 Feb 44, sec. VI, app. B.
transports was provided by hospital ship of the remaining North African hospi-
platoons. Air evacuation to the zone of tals in preparation for severe contraction
interior began on a regularly scheduled in that area. Every effort was also made
basis from Casablanca on 3 July and to reduce the patient load in Italy before
from Naples on 19 July. The Naples the invasion of southern France, sched-
flights were broken by stops at Oran and uled for 15 August. (Table 21)
24
Casablanca.
By 1 June seven U.S. Army hospital Medical Supplies
ships and one Navy hospital ship were and Equipment
available for evacuation to the zone of
interior, permitting a rapid clearing out Theater Medical Supply
24
Hist, Med Sec, Hq, COMZ NATOUSA, Feb-
Organization for Medical Supply—Al-
Oct 44. though the reorganization of the theater
344 MEDITERRANEAN AND MINOR THEATERS
a
Includes Air Forces personnel.
Source: Annual Rpt, Med Sec, MTOUSA, 1944, an. B, app. 20.
Source: Annual Rpt, Med Sec, MTOUSA, 1944, an. B, app. 21, 22.
putting all operating functions of the personnel in the field units were also
Medical Department within the com- inadequate for the type of organization
munications zone under the Medical Sec- in effect. The conversion of the medical
tion, SOS NATOUSA, was effective on supply depots in the theater into medical
24 February 1944, it was May before the depot companies in December 1943 had
supply branch of that headquarters ob- resulted in an aggregate loss of 260 men
tained sufficient personnel to properly in the four depot companies assigned to
carry out its assigned mission. Supply NATOUSA, while a second reorganiza-
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 345
41ST HOSPITAL TRAIN LOADING NEAR RIARDO FOR RUN TO NAPLES, FEBRUARY 1944
tion late in June 1944 further reduced direct orders, the two depot companies
personnel by 112.25 concerned, together with the 7th and
In order to make more efficient use of 12th Medical Depot Companies, had
the remaining supply officers and en- gone through the June reorganization,
listed men, a new plan of organization and more personnel had been lost.
was worked out as early as March 1944, The latter two companies were left
whereby the 2d and 4th Medical Depot unchanged, but the 2d Medical Depot
Companies would be inactivated and Company, with headquarters at Oran,
medical composite battalions substituted was inactivated on 13 August. From the
for them. This plan was proposed to the personnel thus released, the 231st Medi-
War Department by the SOS surgeon on cal Composite Battalion was organized
24 May, but approval was not received under TOE 8-500, with the 70th and
until 15 July. In the meantime, under 71st Medical Base Depot Companies
(TOE 8-187) as components. The bat-
25
Sources for this section are: (1) Annual Rpt, talion was then assigned to the southern
Surg, MTOUSA, 1944, an. K; (2) Hist, Med Sec, France operation, and the 60th Medical
Hq, COMZ NATOUSA; (3) Unit rpts of the med
supply organizations mentioned in the text. (4)
Base Depot Company, which had been
Davidson, Med Supply in MTOUSA, pp. 84-107. organized a few weeks earlier, took over
346 MEDITERRANEAN AND MINOR THEATERS
were transferred to Headquarters, IBS, the medical section of the Adriatic De-
on 10 February 1944. A provisional pot was performing the functions of a
29
medical supply depot company was acti- medical base depot company.
vated in April, being reorganized late In the Peninsular Base Section proper,
in May as the 684th Quartermaster Base the 4th Medical Depot Company, at the
Depot Company. A supply depot for medical center on the Mostra Fair
the Northern Base Section on Corsica Grounds, had responsibility for all medi-
was set up at Ajaccio on 1 March by cal supplies until June 1944, when the
personnel of the 7th Medical Depot 7th Medical Depot Company arrived
Company, which established a subdepot from EBS to share the load. The 7th
at Cervione in May. The following operated depots successively at Anzio,
month, the NORBS supply organization Rome, and Civitavecchia between 11
was assigned to the 684th Quartermaster June and 1 July. The Rome depot was
Depot Company, which was itself trans- turned over to the 12th General Hos-
ferred to PBS control when the Island pital for administration, and the Civit-
Base Section was inactivated in July. avecchia dump was transferred to control
The two Corsican depots were combined of the 4th Medical Depot Company.
at Cervione in September. On 1 July the 7th Medical Depot Com-
In Italy, in addition to the Penin- pany was relieved of assignment to PBS
sular Base Section installations, an Adri-before being attached to Seventh Army.
atic Depot was formed in October 1943 The 4th Medical Depot Company, after
to serve Air Forces and supporting a week in Civitavecchia, set up a second
troops in the Foggia-Bari area. The forward base at Piombino. By the mid-
medical section, located at Bari, was con-dle of July, all medical supply installa-
fined to supply activities, using over- tions between Naples and the Volturno
strength personnel of the 4th Medical had been centered in the main supply
Depot Company until 20 March 1944. base on the fairgrounds, and all other
On that date the Medical Section, Army depots south of Civitavecchia had been
Air Forces Service Command, Mediter- eliminated.
ranean Theater of Operations, took di- Thus, coincident with the movement
rect responsibility for the medical supplyof AFHQ to Caserta, the whole supply
activities of the depot, under general system for the theater was revised. The
supervision of the Medical Section, SOS Mediterranean Base Section was made
NATOUSA. With rising air strength responsible for all medical supply in
and increasing air activity, the medical North Africa, the Atlantic and Eastern
section of the Adriatic Depot was en- Base Sections were left without stocks,
larged and for the first time was placed and the Island Base Section was closed.
under its own surgeon about 1 July. Surplus stocks in MBS were used for
At the same time the AAFSC MTO mounting the invasion of southern
was authorized to deal directly with the France, while the Peninsular Base Sec-
zone of interior in matters of medical tion took over support of the Adriatic
supply peculiar to the Air Forces instead
of going through SOS NATOUSA. By 29
(1) Annual Med Hist, AAFSC MTO, 1944. (2)
the close of the Rome-Arno Campaign MS, Hist of the Adriatic Depot, OCMH files.
350 MEDITERRANEAN AND MINOR THEATERS
Depot, the Northern Base Section, and Medical Service—The medical prob-
the Allied garrison on Sardinia. lems of the Italian communications zone
In the reorganization of 15 August, were primarily extensions of problems
Headquarters, 232d Medical Composite discussed in connection with combat
Battalion, and the 72d Medical Base activities. Infectious hepatitis was inten-
Depot Company remained in Naples. sively studied at the 15th Medical Gen-
31
The detachments at Piombino and eral Laboratory in Naples. The treat-
Civitavecchia were combined at the ment of neuropsychiatric disorders was
Piombino site and redesignated the 73d centered increasingly in the forward
Medical Base Depot Company. An ad- echelons, under general direction of the
vance group of this company departed theater consultant in neuropsychiatry,
for Leghorn on 23 August to locate Colonel Hanson, but specialized neuro-
quarters for what would eventually be psychiatric hospitals continued to be
the major medical supply base for the maintained in the Peninsular Base Sec-
theater. tion to give the best possible care to
patients whose cure could not be effected
Professional Services closer to the front. These were the 51st
Station Hospital, which opened in Na-
Professional services in the Italian ples in May 1944, and the 114th Station
communications zone continued to main- Hospital, which moved from North Af-
tain the high standards of performance rica to Rome early in July. Psychiatrists
established in North Africa, unaffected were also assigned to certain other sta-
by changes in organization or command. tion and general hospitals on temporary
duty to care for cases that for one reason
Medicine and Surgery or another could not be sent to the spe-
cialized facilities. Other troublesome
At the theater level, medical aspects diseases, such as trench foot, malaria,
of the medical and surgical services con- and venereal infections were dealt with
tinued to be guided and supervised by at the communications zone level pri-
the consultants. Both Colonel Long, marily as problems in preventive
Medical Consultant, and Colonel medicine.
Churchill, Surgical Consultant, made The only special problem worthy of
frequent inspection tours of base instal- note for the medical service arose as a
lations and combat medical units, recom- result of the enemy bombing of Bari
mending changes in procedure and harbor on the night of 2 December 1943.
personnel wherever such changes were One of the vessels destroyed had carried
considered desirable.30 a quantity of mustard gas, and undeter-
30
mined amounts of the gas were held in
This section is primarily based on: (1) An- solution in oil that was floating on the
nual Rpt, Med Sec, MTOUSA, 1944; (2) Annual
Rpt, Surg, PBS, 1944; (3) Annual rpts of individ- water. Of the more than 800 casualties
ual med units in the theater; (4) Col. Edward D. hospitalized after the raid, 628 suffered
Churchill, "Surgical Management of Wounded in
Mediterranean Theater at the Time of the Fall of
Rome," Bulletin, U.S. Army Medical Department,
31
V, (January 1945), 58-65. ETMD for Aug 44.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 351
from mustard gas exposure. Sixty-nine Surgical Service—One of the more im-
deaths were attributed in whole or in portant advances in surgical manage-
32
part to this cause. ment during the first year of the Italian
Medical officers and aidmen treating campaign was the development of re-
the casualties were unaware of the pres- parative surgery in the base hospitals.
ence of the gas, which was diluted suf- The concept of wound surgery as it
ficiently to be undetected by odor. In developed at this time divided proce-
the belief that casualties covered with dures into three phases. The first phase,
oil but showing no physical damage were performed in field or evacuation hospi-
suffering from exposure and immersion, tals in the army area, included all pro-
they were wrapped in blankets, still in cedures necessary to save life and limb.
their oil-soaked clothing, given hot tea, The second phase, called reparative sur-
and left as they were for twelve to gery, took place in the general hospitals
twenty-four hours while the more urgent of the communications zone. The third
blast injuries and surgical cases were phase, more properly called reconstruc-
treated. tive or rehabilitative surgery, took place
Those with the energy and will to in the zone of interior and was designed
clean the oil from their own bodies to correct or minimize deformities and
suffered no serious damage, but the re- disabilities. The techniques and limits of
mainder suffered varying degrees of mus- initial surgery in the army and even the
tard burns. Eyes began to burn about 6 division area were well established early
hours after exposure, and were so badly in the Italian campaign, but there was
swollen in 24 hours that many of the much still to learn about the second
patients thought themselves blind. The phase.
first death occurred without warning 18 Expert opinion was that to achieve
hours after exposure. maximum benefits, reparative surgery
About 90 percent of the gas casualties must take place at the period of greatest
were American, the bulk of them mer- biological activity in wound repair, be-
chant seamen. Since no U.S. hospital tween the fourth and tenth days. As
facilities were yet available in Bari—it described by Colonel Churchill,
will be remembered that equipment for
Reparative surgery is designed to pre-
all but one of the U.S. hospitals sched- vent or cut short wound infection either
uled for the area was destroyed in the before it is established or at the period of
bombing—casualties were hospitalized in its inception. Once established, wound in-
British installations.33 fection is destructive of tissue and, at times,
of life. In many instances it permanently
precludes the restoration of function by the
32
most skillful reconstructive efforts. If the
(1) Surg, NATOUSA, Journal, 21, 23, 27 Dec initial wound operation has been a com-
1943, 2 Jan 44. (2) Theater ETMD for Dec 43, plete one, wounds of the soft parts may be
app. S. (3) Ltr, Col Alexander, Consultant, Chemi-
cal Warfare Medicine, to DMS, AFHQ, and Surg,
closed by suture on or after the fourth day.
NATOUSA, 27 Dec 43, sub: Toxic Gas Burns Sus- The dressing applied in the evacuation
tained in the Bari Harbor Catastrophe. (4) Pers hospital is removed under aseptic precau-
Ltr, Col Alexander to Col William D. Fleming, Med tions in an operating room of a general
Sec, Hq, SOS ETO, 26 Dec 43.
33
hospital at the base. Following closure, the
See pp. 333-34, above. part is immobilized preferably by a light
352 MEDITERRANEAN AND MINOR THEATERS
plaster, or, if this is impracticable, by bed thousand pints of blood were taken in
rest. Decision to close a wound by suture March, with an aggregate by 1 May of
is based solely on an appraisal of the gross 4,134. The blood bank meanwhile had
appearance at the time of removal of the
dressing.34 been formally authorized. Two days be-
fore Allied troops opened the offensive
Churchill estimated that by the mid- that would carry them to Rome and on
dle of 1944 "at least 25,000 soft part to the Arno, it became the 6713th Blood
wounds" had been closed in Italy alone Transfusion Unit (Provisional), as-
on the basis of gross appearance only, signed to the theater but attached to the
with satisfactory healing in 95 percent 15th Medical General Laboratory. Dur-
of the cases. The technique was also used ing May 6,362 pints of blood were drawn
for more complicated wounds, including with the assistance of the 1st Medical
"those with extensive muscle damage as Laboratory, which was attached to the
well as those with skeletal or joint injury 15th late in April. Between 14 and 31
and penetration of the viscera." May, when battle casualties were heav-
iest, 4,685 bloods were taken, for a daily
The Naples Blood Bank—Shortly after average of 260. Throughout this period
it opened in the Naples medical center the blood bank was operated by 7 officers
35
in January 1944, the 15th Medical Gen- and 36 enlisted men.
eral Laboratory was asked by the PBS Blood was carried to the Cassino front
surgeon, Colonel Arnest, to establish a by truck and to Anzio by LST. Begin-
small blood bank for emergency use in ning on 24 May, whole blood was flown
the center and elsewhere in the Naples to the front daily. A distributing unit
area. Plans for a 20-bottle bank were followed the advance of Fifth Army, met
drawn up, but before they could be im- the daily blood plane and delivered the
plemented, the needs of Fifth Army led precious cargo to the hospitals where it
to substantial enlargement of the scheme. was needed. The blood plane also car-
When the blood bank began operations ried penicillin, emergency medical sup-
on 23 February, its goal was 200 bottles plies, and occasionally personnel.
a day, forecast as the combined require- Since the decision had been made by
ment of Fifth Army and the Peninsular Colonel Churchill to keep whole blood
Base Section. Donors were drawn from for a maximum of only eight days, the
base units, replacement depots, and per- activities of the blood bank were neces-
sonnel in the process of staging. Two sarily keyed to combat activity. The lab-
34
oratory maintained a list of donors, who
Churchill, "Surgical Management of Wounded
in Mediterranean Theater at Time of the Fall of
35
Rome," Bulletin, U.S. Army Medical Department, (1) Hist, 15th Med Gen Lab, 20 Dec 42-31 May
V (January 1945) , pp. 61-62. See also, "Develop- 44. (2) 15th Med Gen Lab, Quarterly Hist Rpts,
ments in Military Medicine During the Adminis- 31 Oct 44. (3) Monthly Rpts, 6713th Blood Trans-
tration of Surgeon General Norman T. Kirk," fusion Unit. (4) Rpt of Col Virgil H. Cornell,
Bulletin, U.S. Army Medical Department, VII (July formerly CO, 15th Med Gen Lab, sub: Gen Lab
1947), 623-24; Col. Oscar P. Hampton, Jr. (USAR), Overseas Experiences, 29 Jan 46. (5) Brig. Gen.
Orthopedic Surgery in the Mediterranean Theater Douglas B. Kendrick, Jr., "The Blood Program,"
of Operations, "Medical Department, United States vol. I, Activities of Surgical Consultants, "Medical
Army," subseries Surgery in World War II (Wash- Department, United States Army," subseries Surgery
ington, 1957), pp. 81-114. in World War II (Washington, 1962), ch. VI.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 353
TECHNICIANS COLLECTING BLOOD FROM WAC DONORS, 15th General Medical Labora-
tory, Naples medical center.
were called when needed. The use of but for the most part these were combat
whole blood in forward surgery un- zone problems. Venereal disease and
doubtedly saved many lives in the Medi- malaria were dealt with on a theater-
terranean Theater. wide basis. The army aspects of both
have been discussed in earlier chapters,
Preventive Medicine but the control organization in both
cases centered at theater headquarters.
The major problems of preventive The division of function between the
medicine in the communications zone Medical Section, NATOUSA, and the
remained in Italy what they had been in Medical Section, SOS NATOUSA, was
Africa—venereal disease and malaria. not always clear, but the two groups
Such wasters of manpower as trench foot, worked closely together to avoid dupli-
hepatitis, and dysentery were studied, cation of effort and to achieve a common
and care was provided where needed, goal.
354 MEDITERRANEAN AND MINOR THEATERS
Source: Annual Rpt, Med Sec, MTOUSA, 1944, an. J and apps. 32, 38.
Venereal Disease—The direction and largest and most accessible cities in the
co-ordination of the venereal disease con- Italian communications zone, each had
trol program rested at the theater level 10 "pro" stations in operation.36
with the NATOUSA venereal disease While the venereal rates for the thea-
control officer, Lt. Col. Leonard A. ter as a whole showed steady improve-
Dewey, until mid-January 1944, and ment through the spring and summer of
thereafter Lt. Col. Asa Barnes. The pro- 1944, measured in days lost, the gains
gram was carried out in the base sections were due rather to the introduction of
under direction of the SOS venereal dis- penicillin therapy than to any significant
ease control officer, Lt. Col. William C. reduction in the number of cases.
Summer, who transferred from the (Table 22)
NATOUSA organization in May.
The practice, begun in Africa, of plac- Malaria—The malaria control organ-
ing houses of prostitution off-limits to ization set up in North Africa was ex-
military personnel was continued in tended to Italy where, with some modi-
Italy, but the problem of the clandestine fications, it was responsible for an
prostitute was more serious in the Italian effective control program in the 1944
cities, particularly in Naples and Rome. season. The entire program was under
The enforcement of off-limits regula- the general supervision of Colonel Stone,
tions and the apprehension of unlicensed preventive medicine officer on the staff
prostitutes was in the hands of civilian of the Surgeon, NATOUSA, and was
and Allied military police, while the directed by Colonel Andrews of the
base surgeons, through their venereal Sanitary Corps, who was both theater
disease control officers, were responsible malariologist and commanding officer of
for the dissemination of educational the 2655th Malaria Control Detachment.
materials among base installations and Under Colonel Andrews were malariol-
troops, the establishment and mainte-
36
nance of prophylactic stations, and the This section is primarily based on: (1) Annual
Rpt, Surg, MTOUSA, 1944; (2) Hist, Med Sec,
keeping and analysis of venereal disease COMZ NATOUSA; (3) Annual Rpt, Surg, PBS,
records. Naples and Rome, the two 1944; (4) Annual Rpt, Surg, Rome Area, 1944.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 355
ogists assigned to each of the base sec- viciding and physical alteration of
tions, to Fifth Army, and to the Army breeding places by draining, filling, and
Air Forces Service Command. A malari- other means. (3) Personal protective
ologist was also assigned to the Services measures, such as use of protective cloth-
of Supply medical section, and close ing, bed nets, insect repellents, and
liaison was maintained with the Malaria atabrine therapy were enforced by com-
Control Branch of the Allied Control manding officers for all troops.
Commission, and with the British Con- By way of advance preparation for
37
sultant Malariologist. the 1944 malaria season, an Allied Force
The actual work of malaria control Malaria Control School was conducted
was directed locally by specialized units, in Algiers in November 1943, with
co-ordinated at the theater level but as- parallel American, British, and French
signed for operational purposes to the sections. The school was attended by
armies and base sections. The control malariologists and other malaria control
program was effected in three phases. personnel, who followed up with similar
(1) Surveys to determine the malarious- schools conducted locally. Between 21
ness of an area and the density of the February and 25 March 1944, three
malaria vectors were conducted by separate courses were given in Naples
malaria survey units. Consisting of one under the direction of Maj. Maxwell R.
entomologist, one parasitologist, and Brand, the Peninsular Base Section
eleven enlisted men, these units, known malariologist. One course was for medi-
as MSU's, were in effect mobile malaria cal inspectors, one for laboratory officers
laboratories, calculating splenic indices and technicians, and one for the training
and making blood analyses of persons of enlisted men to work as malaria con-
living in the area to determine the inci- trol details. The latter course was
dence of the disease and seeking out repeated in April at Caserta, primarily
mosquito breeding places. (2) The find- for Air Forces personnel. Courses con-
ings of the malaria survey units were ducted for Fifth Army personnel have
turned over to malaria control units, or been discussed in earlier chapters.
MCU's, each commanded by a sanitary The theater malaria control plan was
engineer with eleven enlisted men. The distributed on 20 March 1944 to the
MCU's carried out various forms of lar- commanding generals of Fifth Army; the
Army Air Forces, MTO and Services of
Supply, NATOUSA. As of that date,
37
This section is based primarily on: (1) Annual there were five malaria survey units and
Rpt, Med Sec, MTOUSA, 1944, an. J, app. 28; (2) seven malaria control units in the thea-
Hist, Med Sec, COMZ MTOUSA; (3) Annual Rpt,
Surg, PBS, 1944; (4) Annual Rpt, Med Sec, AAFSC ter. Two additional control units were
MTO, 1944, an. B; (5) Col. Paul F. Russell, "The activated in May and three survey units
Theater Malaria Control Organization," Medical in July. One MSU arrived from the
Bulletin, North African Theater of Operations, I
(February 1944), 17-18; (6) Summary of Materials United States in June, bringing the
presented at Malariologists' Conference, 1-11 Nov totals for the season to nine units of
44, in Naples, Italy. For comment on the capabil- each type. The units were distributed
ities and organizational inadequacies of the malaria
survey and control units, see Armfield, Organization according to need in North Africa,
and Administration, pp. 288-91. Corsica, Sardinia, Sicily, and various
356 MEDITERRANEAN AND MINOR THEATERS
the rising troop population. At the end ency to concentration of dental skills.
of December 1943 there were 703 dental Where the l000-bed generals had had
officers in the theater, with a ratio to 5 dental officers, the newly constituted
troop strength of 1:850. By the end of 1500-bed hospitals had 8, and the 2000-
June the number of dental officers had bed units 10 dental officers. The hospital
risen to 765,
represented but dentist
only one this lamer
to each figure
938 reorganization increased the Table of
Organization requirements for the thea-
military personnel. By the end of August ter by 55 dental officers. Concentration
total dental officer strength had declined at the army, corps, and division levels,
to 734, or a ratio of 1:1012.40 with more extensive use of clinics and
The improvements in dental service mobile laboratories, has already been
stemmed primarily from better and noted in chapters dealing with combat
more widely distributed equipment, and activities.
from the concentration of dental skills. As a result of these changes in
A Central Dental Laboratory was set up distribution of dental strength and of
in the Naples medical center before the improvements in equipment and labora-
end of 1943. Early in April 1944 a tory facilities, the amount of constructive
maxillofacial center was established at dental work performed was substantially
the 52d Station Hospital, also in Naples, increased over that performed in 1943.
to which a maxillofacial team of the 2d Col. Lynn H. Tingay remained chief
Auxiliary Surgical Group was attached dental surgeon for the theater through-
at the beginning of June, when casual- out the period of centralization in south-
ties from the Rome-Arno Campaign be- ern Italy, while Colonel Metz served as
gan flowing back to the communications communications zone dental surgeon un-
zone in large numbers. The maxillo- til August 1944. Both of these officers
facial center reached its peak load on 7 made frequent inspection trips to dental
June, with a census of 282 cases, 139 of installations in the interest of improving
them with bone injury. theater dental service.
To meet growing personnel require- The communications zone organiza-
ments, a training course for dental tion for the Army Air Forces in Italy
technicians was instituted in May, under was headed by Maj. (later Lt. Col.)
which two enlisted men from each sta- Estes M. Blackburn, dental surgeon of
tion hospital were given thirty days of the Army Air Forces Service Command,
training at a designated general hospital, Mediterranean Theater of Operations.
with further instruction at the Central Since no dental officer was assigned to
Dental Laboratory. the staff of the Surgeon, AAF MTO,
The enlargement of the general hospi- Major Blackburn acted as adviser on sup-
tals in June served to further the tend- ply and equipment and personnel to all
Air Forces dental installations, as well
as liaison with the NATOUSA and SOS
40
Principal sources for this section are: (1) An- NATOUSA, dental surgeons.41
nual Rpt, Med Sec, MTOUSA, 1944, an. G; (2)
Annual Rpt, Surg, PBS, 1944; (3) Hist, Med Sec,
Hq, COMZ MTOUSA; (4) Dental Hist, North
41
African and Mediterranean Theaters of Operations. AAFSC MTO, Annual Med Hist, 1944, an. E.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 359
42
The number of nurses remained close
Sources for this section are: (1) Annual Rpt, to 4,000 until transfer of hospitals to
Med Sec, MTOUSA, 1944, an. H; (2) Hist, Med
Sec, Hq, COMZ NATOUSA; (3) AAFSC MTO, southern France late in 1944 again
Annual Med Hist, 1944, an. D. (4) Annual Rpt,
Surg, PBS, 1944. See also, Miller, United States
43
Army Veterinary Service in World War II. See especially pp. 263-65, 318-20, above.
360 MEDITERRANEAN AND MINOR THEATERS
sharply reduced the total. Approxi- Sicily was carried over initially to the
mately 75 percent of the nurses were as- Italian mainland. Before the Salerno
44
signed to communications zone units. landings, Sicily had been divided into
While the number of nurses in the two administrative regions, while other
theater was at all times adequate to the regions in southern Italy had been
number of T/O beds, there were many marked out and staffs assigned. The
periods of intensive activity when duty senior civil affairs officer for Region III,
hours were long and patients per nurse which included the Salerno and Naples
high. During periods of heavy combat areas, was Colonel Hume, a Medical
activity, nurses from fixed hospitals were Corps officer who had given up his posi-
often put on temporary duty with com- tion as Deputy Director of Public
bat units, thus increasing the load for Health, Allied Military Government,
46
those remaining in the communications for this purely administrative post.
zone. The necessity for operating both The public health and welfare officer
fixed and mobile hospitals in Italy above for Region III, Lt. Col. (later Col.)
T/O capacities for considerable periods Emeric I. Dubos, USPHS, went ashore
of time was another factor tending to at Salerno on D-day, but was unable to
increase the burden on nurses as well as function during the first few days of com-
on all other hospital personnel. There is bat. Colonel Hume and his British ex-
no evidence, however, that morale suf- ecutive officer, Colonel Ashley, arrived
fered in any way. at the beachhead the evening of D plus
Lt. Col. Bernice M. Wilbur served 4. Plans were prepared on the ground
through most of 1944 as Chief Nurse, for the administration of the provinces
NATOUSA; Capt. Michener served as of Salerno, Naples, Avellino, and Bene-
Chief Nurse, COMZ NATOUSA, from vento, and for the city of Naples, includ-
late April 1944. ing emergency health measures to be
The work of the nurses in the theater carried out under Army control. Allied
was supplemented by the activities of a Military Government civil affairs person-
limited number of physical therapists
and dietitians attached to the larger hos-
45 Specialist Corps to be published by the Office of
pitals. The Surgeon General. See also McMinn and Levin,
Personnel in World War II, pp. 88-91, 231-32.
46
Principal sources for this section are: (1)
Army Public Health Activities Komer, Civil Affairs and Military Government in
the Mediterranean Theater; (2) Thomas B. Turner,
Organization chs. XI, XII, in forth-coming volume: Stanhope
Bayne-Jones, ed., "Preventive Medicine," vol. VIII,
The Civil Affairs organization set up Civil Affairs-Military Government Public Health
Activities, to be published by The Surgeon Gen-
under AMGOT before the invasion of eral; (3) John A. Lewis, Rpt to WD, MS, His-
tory of Civil Affairs in Italy, 7 Dec 45; (4) Lt Col
44
Sources for this section are: (1) Annual Rpt, Leonard A. Scheele, USPHS, Civil Public Health
Med Sec, MTOUSA, 1944, an. I; (2) Hist, Med History, North African-Mediterranean Theater of
Sec, Hq, COMZ MTOUSA; (3) Annual Rpt, Surg, Operations, May 1943-January 1944; (5) Hist of
PBS, 1944; (4) Maj Parsons and others, Hist of AFHQ, pt. II, sec. 3; pt. III, secs, 1, 4; (6) Monthly
Army Nurse Corps, MTOUSA. Rpts, Allied Control Commission, Public Health
45
Both of these groups will be discussed in de- Sec, Nov 43-Aug 44. See also, Armfield, Organiza-
tail in a forthcoming history of the Army Medical tion and Administration, pp. 294-98.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 361
control every effort was made to clean up vented the stocking of adequate quanti-
the city, restore utilities, rehabilitate ties of the powder and of suitable hand
hospitals, and provide adequate sanita- dusters for applying it.48
tion, as well as to issue food and drugs Rumors of typhus in Naples were con-
where necessary. American Red Cross firmed after the Salerno landings by
personnel worked with the Army public refugees from the city, but could not be
health officers. The more permanent verified immediately. Colonel Stone, the
civil affairs group representing ACC NATOUSA preventive medicine officer,
tried to re-establish a local government visited Naples along with General
with native personnel along lines famil- Cowell, Director of Medical Services,
iar to the inhabitants. Administration AFHQ, on 1 October, coincident with
was eventually turned over entirely to the occupation of the city. Conditions
the Italian authorities. were right for an epidemic. The city was
In the public health field, major prob- overcrowded, its more than a million
lems were sanitation and preventive inhabitants had not been immunized
medicine. Such hazards to the health of and were heavily louse infested, and
the troops as typhus, malaria and vene- large numbers lived jammed together
real disease could be effectively con- in air-raid shelters. The departing Ger-
trolled only by including the civilian mans, moreover, had released the pris-
population in control measures. While oners from certain jails in which cases of
local doctors were encouraged to practice typhus had occurred earlier in the year
to the full extent of their abilities, gener- among Serbian prisoners of war. Little
al supervision was retained over hospi- could be learned from the local health
tals. It was necessary, also, for the Allied authorities, however. Lack of transpor-
public health organization to continue
supplying drugs for civilian use. 48
Principal sources for this section are: (1) An-
The cities of Leghorn, Florence, and nual Rpt, Med Sec, NATOUSA, 1943; (2) Annual
Rpt, Surg, MTOUSA, 1944, an. J; (3) Final Rpt,
Pisa were under AMG administration Preventive Med Off, MTOUSA, 1945; (4) Col D. G.
by the end of August 1944. Cheyne, Notes on Typhus in Naples 5 Dec 43; (5)
ACC Public Health Sec, Monthly Rpts, Nov 43-
Mar 44; (6) Capt William L. Hawley, Notes on the
Typhus Control in Naples Typhus Epidemic and Control Measures in Naples,
1943-44; (7) Scheele, Civil Public Health History,
Even before the conquest of Sicily in North African-Mediterranean Theater of Opera-
tions, May 43-Jan 44; (8) Memo, Col Stone to
the summer of 1943, a monitored broad- TSG, 30 July 45, sub: Typhus Control; (9) F. L.
cast from Rome indicated the presence Soper, W. A. Davis, F. S. Markham, and L. A. Riehl,
of typhus in Italy. This possibility was "Typhus Fever in Italy, 1943-1945, and Its Control
with Louse Powder," American Journal of Hygiene,
taken into account in the medical plan- XLV (May 1947), 305-34; (10) Stanhope Bayne-
ning for the occupation of the Italian Jones, "Epidemic Typhus in the Mediterranean
mainland, both by the preventive medi- Area during World War II," Rickettsial Diseases
of Man (Symposium, Medical Science Section,
cine section of theater headquarters and AAAS, 1946); (11) Pers Ltr, Gen Blesse, Surg,
by AMG public health officers. This NATOUSA, to TSG, 6 Feb 1944; (12) Lt. Col.
planning was based on the use of methyl Charles M. Wheeler, "Control of Typhus in Italy
1943-1944 by Use of DDT," American Journal of
bromide (MYL) as a delousing agent, Public Health, XXXVI (February 1946), 119-29;
but difficulties in procurement pre- (13) Med Sitreps, PBS, Jan-Mar 44.
THE ITALIAN COMMUNICATIONS ZONE: SOUTHERN PHASE 363
tation and disruption of communications 20th of that month, Stone and Colonel
made it impossible for those who might Long, theater medical consultant, con-
have the disease to be examined by a ferred at length with General Fox, field
physician. There was also confusion in director of the U.S.A. Typhus Commis-
terminology, since "tyfo abdominale," sion, which was also conducting studies
or typhoid fever, was often used inter- in the Middle East, but independently
changeably by Italian doctors with of the Rockefeller group. General Fox
"tyfo," which is the word for typhus. was satisfied that all necessary steps had
On his return to Algiers, Colonel been taken, and pledged the full co-oper-
Stone advised General Blesse of the po- ation of the Typhus Commission.
tential danger, and precautionary steps Actually, control measures were lag-
were taken at once. A group represent- ging far behind needs. The public health
ing the Rockefeller Foundation was then officer for AMG's Region III, now Col.
studying typhus control in the Middle W. H. Crichton (British) , had wholly
East, and had conducted experiments inadequate resources, either of person-
with the newly developed and still top nel or of equipment, to cope with the
secret DDT in a French prison in situation, and had not succeeded in or-
Algiers. These experiments confirmed ganizing the Italian health authorities
Stone's faith in the new insecticide, a for effective assistance. By the end of
quantity of which had already been re- November there were more than forty
quested for the theater. On Stone's ad- cases of typhus reported in Naples and
vice Brigadier Parkinson (British) probably many more than that. More
ordered 50 tons of 10 percent DDT, 5 vigorous control measures had become
tons of concentrate, and dusting guns, imperative.
to be delivered to AMG by 15 Decem- The AMG and NATOUSA orders for
ber, while Stone himself ordered 60 tons DDT were reconsidered and finally ap-
of the powder and one ton of concentrate proved by the War Department on 5
for Army use. Both requisitions were December. Observers from the Typhus
disapproved by the War Department in Commission arrived in Naples on 6
November. December, and two days later Drs. Soper
The presence of typhus in Naples had and William A. Davis of the Rockefeller
meanwhile been established. Colonel group reached the city at the invitation
Stone arranged with Dr. Fred L. Soper of AMG and ACC authorities. The PBS
of the Rockefeller group for demonstra- surgeon, Colonel Arnest, placed all
tions of delousing methods in prisoner- available supplies of MYL powder at the
of-war camps, and for the training of disposal of the Rockefeller team, while
malaria control and other sanitary per- General Blesse dispatched DDT concen-
sonnel in these methods. Pertinent data trate to Naples by air. The Typhus Com-
were distributed by the NATOUSA mission observers took no part in actual
49
surgeon's office in November. On the control work, leaving after five days.
Contact or spot delousing began on 12
49
December, the homes of all reported
(1) NATOUSA Surgeon, Cir Ltr No. 43,11
Nov 43. (2) NATOUSA Cir Ltr No. 224, 15 Nov cases being visited, and all contacts of
43. the patients being dusted, but neither
364 MEDITERRANEAN AND MINOR THEATERS
ary. Flying squadrons began working in sons a day were being dusted with either
suburban communities on 8 January. MYL or DDT powder. The dusting sta-
General Fox and the Typhus Commis- tions alone averaged 1,600 a day per
sion assumed full responsibility for ty- station, with an average staff of 13 each.
phus control in Naples on 2 January All told, between mid-December 1943
1944, turning the task over to the Allied and the end of May 1944, more than
Control Commission on 20 February, three million applications of dusting
after the crisis had passed. Dr. Soper and powder were made in Naples and sur-
his associates of the Rockefeller group rounding towns. Out of 1,914 reported
administered mass delousing throughout cases of typhus in the Naples area be-
the danger period, and on a reduced tween July 1943 and May 1944, only 2
scale until after the end of the war. were U.S. military personnel, one a
The turning point came around 10 soldier whose attack was mild, the other a
January, by which date over 60,000 per- sailor, whose case was severe but not fatal.
CHAPTER X
become commander of the Seventh neither men nor matériel were available
Army. The army's objective remained for two major fronts on the Continent,
the same—to invade southern France in which tipped the scale in favor of
force simultaneously with, or immedi- ANVIL. 2 On 2 July General Wilson was
ately following, the Normandy landings, directed to launch ANVIL on 15 August.
and exploit up the Rhone Valley, but Two days later Seventh Army headquar-
the target date for both operations had ters moved from Algiers to Naples,
been postponed to June. In mid-April where headquarters of VI Corps and of
the ANVIL D-day was again put off, this the French forces, known as Army B,
time to late July, because of the require- were also established.
ments of the May offensive in Italy and Broadly, the plan called for a 3 divi-
the needs of OVERLORD for landing craft. sion daylight assault by VI Corps, under
All first priorities went elsewhere, and command of General Truscott, over se-
the ANVIL planners were kept busy re- lected beaches between Cap Cavalaire
vising in terms of new unavailabilities. and Agay. The night before the main
Rome had fallen and the Allied forces attack the 1st Special Service Force was
had secured the Normandy beaches be- to seize the offshore islands of Port Cros
fore it was certain that ANVIL would even and Levant, a French commando group
be launched. was to go ashore at Cap Nègre on the left
flank to block the coastal road, and a
Planning and Mounting French naval assault group was to carry
the Invasion out a similar mission at Pointe des
Trayas on the right flank. At the same
On 15 June the commander of Allied time, an airborne task force was to be
Armies in Italy, General Alexander, was dropped in the vicinity of Le Muy, about
directed to release the U.S. VI Corps, ten miles behind the landing beaches, to
consisting of the 3d, 36th, and 45th Divi- cut off enemy reinforcements and neu-
sions; two French divisions; and various tralize gun positions. Two French corps,
auxiliary troops to Seventh Army. Alex- which made up Army B under General
ander and General Sir Henry Maitland Jean de Lattre de Tassigny, were to be-
Wilson, the Supreme Allied Commander gin landing over the secured beaches on
in the Mediterranean, still opposed the D plus 1, and to swing west to invest
southern France operation, urging most Toulon and Marseille, while VI Corps
strongly that all troops in Italy be re- advanced up the Rhone Valley toward
tained there for a knockout blow against Lyon and Vichy. The French forces were
the disorganized and retreating enemy, to be made up in part of Moroccan and
and then turned east through the Algerian troops to be withdrawn, like
Ljubljana Gap toward Hungary. In this VI Corps, from Italy. Army B also in-
proposal they were backed by Prime cluded the 9th Colonial Division, which
Minister Churchill. On the other hand, had captured the island of Elba late in
it was probably General Eisenhower's June against stubborn German resist-
insistance that Marseille and other ance.
French Mediterranean ports were essen-
tial to supply his own forces, and that 2
Eisenhower, Crusade In Europe, pp. 281-84.
368 MEDITERRANEAN AND MINOR THEATERS
A Coastal Base Section, organized 7 Gulf of Naples; and the airborne task
July, was to follow the combat troops at force established a glider and parachute
the earliest practicable date. Its com- school near Rome. Final dress rehearsals
mander, Maj. Gen. A. R. Wilson, was were completed on the night of 7-8 Au-
named on 26 June, and base section per- gust, after which loading of the trans-
sonnel were attached to the planning ports began at various ports in Italy,
group near the end of July. Sicily, North Africa and Corsica.
The training of the assault divisions DRAGOON, as ANVIL had been rechris-
began in June, as soon as possible after tened on 1 August, was under way.
their assignment. The 36th and 45th
Divisions trained at Salerno, where the Medical Plans and Organization
Invasion Training Center, now attached
to Seventh Army, had been established By the end of 1943 the Seventh Army
in the spring. The 3d Division trained at medical section had been reduced to a
Pozzuoli, on the northwest rim of the total of 10 officers and 18 enlisted men.
INVASION OF SOUTHERN FRANCE 369
At that time the surgeon, Colonel Daniel E. Peatfield, hospitalization; Lt. Col.
Franklin, 3 officers, and 5 enlisted men (later Col.) Robert Goldson, evacuation;
moved to Algiers to assume the medical Colonel Alexander, personnel; Maj.
planning function for Force 163. At the (later Lt. Col.) Guy H. Gowen, medical
same time the medical supply officer, the inspector; Maj. (later Lt. Col.) Au-
dental officer, and 6 enlisted men joined gustus J. Guenther, commander of the
other Seventh Army supply units in 7th Medical Depot Company, supply;
Oran to work out ANVIL supply plans and Maj. (later Lt. Col.) Charles Raul-
with SOS NATOUSA and the base erson, administrative officer. In the pro-
sections. The remainder of the medical fessional positions were Col. Frank B.
personnel continued at Palermo until Berry, surgical consultant; Col. Alex-
May. The entire medical section was not ander, who doubled as chemical warfare
reunited until Seventh Army headquar- consultant; Lt. Col. (later Col.) Daniel
ters moved to Naples early in July. 3 S. Stevenson, veterinarian; Lt. Col.
The Seventh Army medical organiza- (later Col.) Webb B. Gurley, dental
tion was similar to that of the Fifth surgeon; Capt. (later Maj.) Alfred O.
Army, with staff sections for administra- Ludwig, neuropsychiatric consultant;
tion, operations, and personnel. Hospi- and Maj. Edith F. Frew, director of
talization, evacuation, and medical sup- nurses. Colonel Berry had been chief of
ply came under operations. There was a the surgical service, 9th Evacuation Hos-
medical inspector, with a venereal dis- pital, and Major Frew had been that
ease control officer under him. On the unit's chief nurse. Captain Ludwig had
professional side were a dental surgeon, been commander of the Fifth Army
veterinarian, and director of nurses, with Neuropsychiatric Center. Colonel Stev-
consultants in surgery, neuropsychiatry, enson had been commanding officer of
and chemical warfare. the 17th Veterinary Evacuation Hospi-
On 18 June Colonel Rudolph, who tal, while Colonel Gurley came to
had been surgeon of the declining East- Seventh Army from the 21st General
ern Base Section, became Seventh Army Hospital.
surgeon. Key officers in the medical sec- Like other aspects of the planning for
tion as D-day for DRAGOON approached ANVIL-DRAGOON, the medical plans were
were: Colonel Robinson, executive of- incomplete and subject to constant
ficer; Lt. Col. (later Col.) Joseph Rich, change until the assignment of units and
operations; Lt. Col. (later Col.) Norman final approval of the operation. The
basic work, within the limitations im-
posed by insufficient data, was shared at
3
Principal sources for this section are: (1) An- the theater level by the NATOUSA and
nual Rpt, Surg, Seventh Army, 1944; (2) After the communications zone staffs, and at
Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct the corps and division levels was directed
44, ans. 277 and 278; (3) Rpt of Naval Comdr,
Western Task Force, Invasion of Southern France, by Colonel Bauchspies, the VI Corps
Navy: A16-3 (01568) 15 Nov 44. (4) Annual Rpt, surgeon. The point of stabilization coin-
Med Sec, MTOUSA, 1944; (5) Clift, Field Opns; cided with the arrival of Colonel Ru-
(6) Davidson, Medical Supply in MTOUSA; (7)
Unit rpts of the individual med units mentioned dolph, who directed the final revision of
in the text. the medical plans in terms of actual mis-
370 MEDITERRANEAN AND MINOR THEATERS
sion, combat forces involved, and target talion. In addition, each regimental com-
date. bat team was to be supported in the land-
ing phase by a collecting company and
Medical Plans for the Assault—The clearing platoon of a separate medical
pattern followed in earlier amphibious battalion. This was an improvement
operations in the Mediterranean was over the technique previously employed
again the basic guide. The Navy was to in the theater, whereby one of the col-
be responsible for all medical care on lecting companies of each assault medi-
shipboard and to the high-water mark on cal battalion had been forced to rely up-
the landing beaches. The Army was re- on an improvised clearing platoon made
4
sponsible for medical care ashore. As in up of station section personnel. The air-
the Sicilian, Salerno, and Anzio landings, borne task force was to be supported by
each combat division in the assault was a collecting company with clearing ele-
to be accompanied by its own medical
detachments and its organic medical bat- 4
See pp. 149, 224, above.
INVASION OF SOUTHERN FRANCE 371
ments attached. Each assault division was unit was to be attached to one of the
to have the services of two field hospital field hospitals, but was to serve the en-
platoons, with enlisted men drawn from tire corps.
the fixed hospitals substituted for the During the landing phase the three
nurses who were not to arrive until D separate medical battalions were to be
plus 4, The field hospital platoons were attached to the beach groups in the three
to function in immediate proximity to areas into which the invasion coast was
the division clearing stations. divided. Their commanding officers were
Twenty-eight surgical and other spe- designated as beach group surgeons, each
cialist teams of the 2d Auxiliary Surgical being responsible for the setting up and
Group were to be attached to the field operation of medical installations in his
hospitals and other assault units. 5 Addi- area and for co-ordination with the med-
tional teams for the troop transports ical sections of the Navy beach battal-
were made up of personnel of the 750-bed ions. The beach control group surgeon
evacuation hospitals and the general hos- was to take over all Army responsibility
pitals scheduled to come into France at for medical care and evacuation on the
later dates. Dispensary teams of one of- beachhead when the area was secure.
ficer and two enlisted men each, simi- The 3-plus French divisions scheduled
larly drawn from personnel of hospitals to go ashore on D plus 1 were to be sim-
already closed for future movement, ilarly accompanied by their own medical
were to serve aboard the cargo vessels units, though the support available was
in the assault convoy. When the ships less extensive than that assigned to the
withdrew from the beach area, these assault troops of VI Corps. The initial
teams were to report to the nearest evac- French medical complement included a
uation hospital for reassignment until medical battalion, a field hospital, and a
their own units arrived. The forward dis- blood transfusion unit.
tribution section of a blood transfusion
5
Annual and Special Rpts, 2d Aux Surg Gp,
Hospitalization—In addition to the
1944. The D-day troop list in Report of Opera- beds available in the clearing stations
tions, Seventh Army, III, 908, and Annual Report, and field hospital platoons, each of the
Medical Section, MTOUSA, 1944, are probably in-
correct in placing the number at 30 teams. Annual three assault divisions was to be accom-
Report, Surgeon, Seventh Army, 15 August-31 Oc- panied by a 400-bed evacuation hospital,
tober 1944, Annex 277, both identify only the 26 to be established between D plus 1 and
teams that were attached to the field hospitals in
the landings, leaving 2 surgical teams—or possibly D plus 4, or as soon as the situation per-
4—unaccounted for. One of these, together with 3 mitted. Two comparable evacuation
medical officers of the 43d General Hospital, ac- hospitals, U.S. equipped but French
companied the 1st Special Service Force in its H
minus 8 attack on the islands of Levant and Port staffed, were to accompany the landing
Cros. Another may have accompanied the airborne elements of Army B.
task force, although no conclusive evidence to that By D plus 10, when the French forces
effect has been found. It is the recollection of Dr.
Berry, then surgical consultant to Seventh Army, were to have reached 7 divisions, the
that 2 teams accompanied the 95th Evacuation Hos- medical support for Army B was to be
pital, but these were probably among the 10 already augmented by 2 field hospitals, 2 400-
counted as being assigned to the ALPHA Attack
Force. (See recorded interv, Dr. Berry, 4 Nov 58. bed evacuation hospitals, and 2 750-bed
commenting on preliminary draft of this volume.) evacuations. The 3 divisions of VI Corps
372 MEDITERRANEAN AND MINOR THEATERS
landing forces, however, was to be in the tives of the various supply services con-
form of the newly devised beach main- cerned with the coming campaign. The
tenance units, each containing a bal- medical complement was to direct the
anced stock of medical items sufficient to unloading of hospitals over the beaches,
maintain 5,000 troops for 30 days. These evacuate casualties, and control the flow
were to be supplemented by such addi- of medical supplies from ship to dump
tional critical items as blood plasma, until Seventh Army and the Coastal Base
morphine syrettes, plaster of paris, sul- Section were able to take over their own
faguanadine, paregoric, oxygen, and respective supply functions. The 7th
dressings. Medical supplies were to be Medical Depot Company was later as-
packed in clearly marked boxes, not ex- signed to Seventh Army, and the 1st Ad-
ceeding 70 pounds in weight. Supplies vance Section was attached to the beach
for the French forces were to be identi- control group.
cally packed, but marked with the tri- Assignment of medical personnel to
color. the task forces necessarily had to be de-
Advance detachments of the Army layed until the combat elements them-
medical depot company were to accom- selves were assigned and the invasion
pany the assault, functioning as elements plan completed. As finally approved,
of the beach groups for collection and plans called for four major task forces,
distribution of medical supplies. All one to be airborne and three to strike
medical units in the assault, in addition the beaches between Cap Cavalaire
to making up any equipment shortages, and Agay from the sea. The three
were authorized to draw supplies 20 per- attack forces known as ALPHA, DELTA,
cent in excess of their normal allow- and CAMEL, were built respectively
ances. around the 3d, 45th, and 36th Infantry
Supplies for subsequent phases of the Divisions. The medical units assigned to
campaign were to be delivered as opera- each attack force trained with the com-
tional medical maintenance units, a re- bat troops, the ALPHA Force at Pozzuoli
vised and modified version of the old the DELTA and CAMEL Forces at Sa-
medical maintenance unit. Like the lerno, and the 1st Airborne Task Force
MMU relied upon in earlier campaigns, near Rome.
it was designed to provide balanced med- The medical support assigned to the
ical supplies to meet the needs of 10,000 task forces was as follows:
men for 30 days.
ALPHA Attack Force: 3d Division
Assignment and Training—The first medical detachments; 3d Medical Battal-
assignment of medical personnel to the ion (organic) ; 52d Medical Battalion,
southern France operation, other than in including the 376th, 377th, and 378th
a purely planning capacity, was the Medical Collecting Companies, and the
attachment of three officers and three en- 682d Medical Clearing Company; Head-
listed men from the Seventh Army med- quarters and 1st Platoon of the 616th
ical section to the beach control group Medical Clearing Company, 181st Med-
formed at Mostaganem, Algeria, early in ical Battalion; the 1st and 3d Hospital-
May. The group included representa- ization Units, 10th Field Hospital, with
374 MEDITERRANEAN AND MINOR THEATERS
Mediterranean Allied Air Force had had alerted their units. However, their
pounded targets from Genoa to Sète, forces were dispersed and opposition was
slowly closing in to isolate the land- relatively light on all beaches. The
ing beaches. A feigned attack including French on the right flank had failed in
a dummy parachute drop on beaches 60 their mission, but the commandos on the
miles west of the real objective was then left and the 1st Airborne Task Force,
being mounted, but there was no fake 10,000 strong, in the rear of the landing
about other preparatory missions. In the area, had cut off the possibility of enemy
early hours of 15 August, troops of the reinforcement. The assault troops, aided
1st Special Service Force scaled the cliffs by the Maquis—or French Forces of the
on the seaward side of Port Cros and Interior as the underground was offi-
Levant; French commandos landed at cially known—pushed rapidly inland. In
Cap Nègre west of the assault area; and the late afternoon of 15 August patrols of
other French troops went ashore at the 45th Division made first contact with
Pointe de Trayas to the east. Allied the airborne force, and by the close of D
paratroops began dropping through fog plus 1 the "blue line"—drawn far
around Le Muy 10 miles behind the enough inland to protect the beaches
designated beaches, and were followed from enemy artillery and to give control
by glider troops as soon as light permit- of main routes north and west—had been
ted. Swarms of landing craft, covered by reached.
carrier-based planes and naval guns, The next few days were decisive. The
headed for the indented shore between 36th Division on the right pushed east
St. Tropez and St. Raphael, the first far enough to protect the beachhead,
troops landing about 0800.6 then turned north after being relieved
The Germans, though misled for on 20 August by infantry elements of the
about an hour by the covering opera- airborne task force. The 45th Division in
tions to the west, had expected the Al- the center advanced northwest toward
lied forces to land where they did and the Durance River, and the 3d Di-
vision on the left struck west to capture
6
Principal sources for this section are: (1) The the key road center of Aix-en-Provence
Seventh United States Army; Report of Operations,
France and Germany, 1944-1945 (Heidelberg, Ger- just north of Marseille on 21 August. On
many: Aloys Gräf, 1946) , vol. I; (2) Rpt of Naval the 19th the German commander of
Comdr, Western Task Force, Invasion of Southern Army Group G began to withdraw all
France; (3) Rpt of Opns, VI Corps, Aug, Sep, 44;
(4) Truscott, Command Missions; (5) General troops, except the two divisions garrison-
[Jean] de Lattre de Tassigny, Histoire de la ing Toulon and Marseille, up the Rhone
Premiere Armée Française (Paris: Plon, 1949) ; (6) Valley.
Samuel Eliot Morison, "History of United States
Naval Operations in World War II," The Invasion A fast-moving armored task force led
of France and Germany 1944-1945 (Boston: Little, by the VI Corps deputy commander,
Brown and Company, 1957) ; (7) Craven and Cate, Brig. Gen. Frederick B. Butler, was al-
eds., Europe: ARGUMENT to V-E Day, pp. 408-
38; (8) Taggert, ed., History of the Third Infantry ready ahead of the German forces. Task
Division in World War II; (9) Huff, ed., The Force Butler had left its assembly area
Fighting 36th; (10) The Fighting Forty-Fifth; (11) on 18 August, racing north toward Gre-
WD Special Staff, Hist Div, Invasion of Southern
France, OCMH files; (12) Smith, Riviera to the noble, where mountain passes had been
Rhine. blocked against any attempt on the part
376 MEDITERRANEAN AND MINOR THEATERS
of the enemy to reinforce from that di- attached, had taken the famous resort
rection. The task force had then turned towns of Cannes and Nice and had
west to close the escape route in the Mon- cleared the mountainous area north and
télimar area, where the Rhone Valley east of those cities.
narrows and the corridor is dominated By 31 August, D plus 16, Seventh
by high ground to the northeast. Butler's Army had taken 57,000 prisoners, with
forces were not adequate, however, and a loss to itself of 2,733 killed, captured,
the Germans won the opening round on and missing in action. U.S. patrols were
23 August, when elements of the 141st at the Italian border, French patrols
Regiment of the 36th Division reached were at the Spanish border, and the Ger-
the area but were unable to seize the mans were fighting only with stubborn
city of Montélimar. The Germans rear-guard actions as they sought desper-
rushed forward their best unit, the 11th ately to slip through the narrowing gap
Panzer Division, to force open the Mon- between Seventh Army, now in the vi-
télimar Gate for their retreating col- cinity of Lyon, and General Patton's
umns, while the remainder of the 36th Third Army, which was pushing east
Division from the east, the 45th from the from Paris.
southeast, and the 3d from the south The advance was now a pursuit. Lyon
hurried to the aid of hard-pressed Task was occupied on 3 September. The 3d
Force Butler. The battle raged for eight Division took Besançon after hard fight-
days, with the larger part of the German ing on 8 September, and two days later
forces escaping before the trap was com- the French 1st Armored Division reached
pletely closed. The enemy nevertheless Dijon. On 11 September patrols of Sev-
suffered heavy losses and left thousands enth and Third Armies met at Saulieu
of vehicles and guns, including five a few miles west of Dijon, and the Allied
heavy railroad guns, as wreckage lining front was continuous from the Swiss
the route north. frontier to the English Channel.
Meanwhile, one corps of General de On 15 September Army B became the
Lattre's French Army B, consisting of the 1st French Army, forming with Sev-
3d Algerian, the 9th Colonial, and the enth Army the 6th Army Group under
1st Armored Divisions, a provisional in- General Devers. At this time the DRA-
fantry division, and two groups of Mo- GOON forces came under operational con-
roccan tabors (each group equivalent to trol of Supreme Headquarters, Allied
a regiment) and special troops, had re- Expeditionary Force, and the troops were
lieved VI Corps in the coastal area and regrouped in accordance with SHAEF
enveloped Toulon and Marseille from plans, 1st French Army shifted to the
the land side, in conjunction with naval right flank, hinging on the Swiss border,
assaults from the sea. Both cities fell on while VI Corps turned north to cross
28 August, and the French forces, aug- the Moselle in the vicinity of Épinal, and
mented by newly arrived divisions, advanced toward Strasbourg beyond the
turned northward up the Rhone to join Vosges Mountains.
VI Corps. The exploits of Seventh Army there-
On the eastern flank the airborne task after belong to the history of the Euro-
force, with the 1st Special Service Force pean Theater of Operations.
INVASION OF SOUTHERN FRANCE 377
MAP 30—Seventh Army Hospitals and Medical Supply Dumps, 20 August 1944
remaining two collecting companies and Evacuation Hospital landed at Cava-
the 2d platoon of the clearing company, laire. The 95th went into bivouac to
52d Medical Battalion, and the 1st Pla- await its equipment, while the 3d Divi-
toon of the 616th Clearing Company, the sion clearing company moved inland and
181st Medical Battalion—was two hours set up station two miles north of La
later, the beach clearing station being set Croix, opening at 1915. The site of the
up at 1800. clearing station was about equidistant
By midafternoon the ALPHA beaches from the beaches and some five miles
were clear and the combat spearheads inland. The collecting company in sup-
already several miles inland, making it port of the 15th Infantry did not debark
possible to land the remaining medical at Pampelonne beach until 0400 on D
units. At H plus 8—1600, or four in the plus 1, and remained without ambu-
afternoon—the 1st and 3d Platoons of lances until noon. (Map 30)
the 10th Field Hospital came ashore, The division clearing station moved
one unit at each beach. The Pampelonne on D plus 2 to Cogolin, where it was
unit was receiving patients by 2000, but joined by one unit of the 10th Field Hos-
the Cavalaire unit did not recover its pital and the 95th Evacuation, which
equipment until D plus 1. At the same was still not in operation. All three in-
time the 3d Medical Battalion clearing stallations moved to Gonfaron, some
company and personnel of the 95th twenty miles inland, on D plus 3. The
INVASION OF SOUTHERN FRANCE 379
95th opened the following morning, 19 inland near Plan de la Tour late on 16
August, at 0800. The other 3d Division August.
platoon of the l0th Field Hospital went Units of the 10th and 11th Field Hos-
into bivouac in the same locality on 20 pitals attached to the DELTA Force both
August. landed about noon of D-day, but neither
The 45th Division, constituting with went into operation. The 2d Platoon of
its reinforcements the DELTA Force, the 10th Field received patients at Plan
landed on a strip of beach no more than de la Tour on 17 August but the 2d
three miles wide in the dead center of Platoon of the 11th Field did not operate
the VI Corps landing area just northeast at all during the beach phase. The 93d
of the town of Ste. Maxime. Here ex- Evacuation Hospital, which landed near
pediency and availability of landing craft Ste. Maxime at H plus 4, opened at Plan
rather than the prearranged schedule de- de la Tour on 17 August.
termined the order of landing for med- Here, as on the ALPHA beaches, ex-
ical units. pansion inland was rapid. The 2d Pla-
As on the ALPHA beaches, the medical toon of the division clearing company
detachments and the litter teams of opened 5 miles south of Vidauban
the organic collecting companies went and about 15 miles from the beach
ashore with the infantry battalions mak- shortly before noon on 18 August, while
ing the assault, closely followed by units the 1st Platoon moved more than 20
of the beach medical battalion and the miles northwest from Plan de la Tour to
remainder of the 120th Medical Battal- Silans-la-Cascade. Beach clearing stations
ion organic to the division. One collect- of the 58th Medical Battalion moved in-
ing-clearing unit of the 58th Medical to Ste. Maxime and St. Tropez on D-
Battalion was ashore at H plus 2½ day and D plus 1, respectively.
and had its station in operation one-half The westernmost of the beaches as-
mile northwest of Ste. Maxime by 1230. signed to the 36th Division, or CAMEL
A second collecting-clearing unit landed Force—a beach on the Gulf of Fréjus with-
on the easternmost of the 45th Division in a mile of the town of that name and
beaches at H plus 4, opening station equally close to St. Raphaël—was not ac-
three miles northeast of Ste. Maxime. tually used because underwater obstacles
The third collecting-clearing unit of the had not been cleared. Instead, all land-
beach battalion was delayed until 1930, ings were made on three beaches east of
finally landing on the ALPHA beaches St. Raphael and about a mile apart. Lit-
south of St. Tropez and opening station ter sections of the organic collecting com-
a half mile inland. panies landed with the battalion aid sta-
All personnel of the 120th Medical tions of the assault troops. All personnel
Battalion were ashore by H plus 6. Col- of the 111th Medical Battalion were
lecting stations for the two assault regi- ashore by H plus 8, although the equip-
ments were in operation by 1100. Jeeps ment of the clearing company was not
borrowed from the infantry were used unloaded until the evening of D plus 1.
until the ambulances arrived. The clear- By that time the fighting was so far in-
ing company went into bivouac, the 1st land that the division clearing station
platoon setting up station about six miles was first established near Le Muy, fif
380 MEDITERRANEAN AND MINOR THEATERS
a
Presumably includes British naval personnel, not cared for in any U.S. installation, but evacuated by U.S.
b
To POW inclosures.
Source: After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44 an. 278
Bauchspies, set up headquarters near Nurses of the field and evacuation hos-
Ste. Maxime at 1800 on D-day, but for pitals and of the surgical group landed
the next 2 or 3 days could do little ex- and joined their units on 19 August.
cept keep in touch with medical units Delays in landing equipment of clear-
functioning under divisional control. ing companies and hospitals might have
The breakout from the beachhead was been serious had casualties been heavier
so rapid, however, that it was possible than they were. Air and naval cover at-
to resume a normal organizational pat- tacks in widely separated areas, however,
tern within 3 or 4 days. The 58th Med- kept the enemy from concentrating his
ical Battalion reverted to Seventh Army forces, and opposition on all beaches was
on 17 August and was attached to the lighter than had been anticipated. Hos-
beach control group. The field hospitals pital admissions, including admissions to
passed from division to corps control on clearing stations, for the beach phase of
18 August, while the evacuation hospi- the operation were approximately 3,000.
tals reverted to army control on the same (Table 23) Mean troop strength for the
date. On 19 August the 56th Medical week ending 18 August was 113,854.
Battalion was attached to VI Corps.8
8
Sources disagree as to exact dates. The text server's Rpt, Seventh Army Opn, Slightly later dates
follows the contemporary account of the theater given by some of the medical units concerned prob-
medical observer, Colonel Reeder. See Ltr, Reeder ably indicate only that there was some lag in com-
to Surg, NATOUSA, 18 Aug 44, sub: Medical Ob- pleting the change-over.
382 MEDITERRANEAN AND MINOR THEATERS
The Montélimar Gate—With the gnan before the end of the day, 18 Au-
beaches secure and the ports of Toulon gust. Two days later it was at Lac on the
and Marseille under siege by Army B, Drome, fifty miles northwest of Sisteron;
VI Corps was tree to exploit up the and on 21 August it was at Marsanne,
Rhone Valley. The road net was excel- overlooking the Rhone from the heights
lent and with the formidable aid of the northeast of Montélimar.
French resistance forces there was fair The 36th Division followed on the
prospect of trapping a large part of the heels of Task Force Butler, swinging
German Nineteenth Army if the corri- farther north to protect the flank. The
dor along the east bank of the Rhone 143d RCT entered Grenoble on 22 Au-
could be closed off somewhere below the gust, where a collecting station was set
Drome River—the so-called Montélimar up by the 885th Medical Collecting Com-
Gate—before the enemy forces could be pany, borrowed from the 56th Medical
withdrawn. 9 Battalion to replace the company at-
The rapid pace put a heavy strain on tached to the task force. The next day
medical installations. The evacuation the collecting station of the 143d was
hospitals could not keep pace, and main sixty miles southwest of Grenoble at
reliance had necessarily to be placed on Romans, close to the junction of the
the organic medical battalions and on Isère and the Rhone above Valence,
the field hospital units, supplemented thence moving south with its combat
when necessary by clearing platoons of team to the area occupied by the Butler
the corps medical battalions. Collecting Task Force.
companies of the same battalion were The 141st and 142d combat teams of
sometimes as much as 150 miles apart. the 36th Division were also on the high
Clearing companies often operated two ground above Montélimar by 23-24 Au-
stations, while ambulances and bor- gust, their supporting medical units
rowed trucks were in continuous move- keeping pace by leapfrog tactics and al-
ment over excessively long evacuation most continuous movement. The 36th
lines. Good roads made aid stations eas- Division clearing company leapfrogged
ily accessible to ambulances, permitting its platoons from Draguignan to Sisteron
the diversion of many litter bearers for to Aspres to Crest in 4 days, single moves
assignment as relief drivers. covering up to 120 miles. Until the last
A reinforced collecting company of 2 or 3 days of August, when the combat
the 111th Medical Battalion accompa- forces began pursuit of enemy remnants
nied Task Force Butler in its dash to- toward Lyon, 36th Division medical
ward Grenoble and its subsequent swing units remained clustered a few miles
west down the valley of the Drome. north and east of Montélimar evacuating
The collecting station of this unit was to the clearing station at Crest, a maxi-
already in Sisteron, sixty-five miles north mum distance of 10 miles.
of the battalion headquarters at Dragui- The 1st Platoon of the 11th Field Hos-
9
Principal sources for this section are: (1) After pital, which opened at Crest on 22 Au-
Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct gust, acted as an evacuation hospital for
44, an. 278; (2) Annual Rpt, Surg, Seventh Army,
1944; (3) Annual Rpt, Surg, VI Corps, 1944; (4)
three days, since there was no evacuation
Unit rpts of med units mentioned in the text. nearer than the beach area, more than
INVASION OF SOUTHERN FRANCE 383
by its own organic medical battalion. A cilities in the beach area to care for serv-
collecting company and clearing platoon ice troops and for replacements and
of the 58th Medical Battalion supported reinforcements staging in the vicinity, as
the 13th Field Artillery Brigade after well as to provide transient beds for those
17 September. Units of the 10th and 11th being evacuated to Italy. This function
Field Hospitals continued to accompany fell in the first instance to the 58th Med-
forward clearing stations of the divisions, ical Battalion, which reverted to Army
while evacuation rearward was the re- control on D plus 2, and was reattached
sponsibility of the 56th Medical Battal- to the beach control group.11
ion. Until the rainy season began in mid- When the last of the assault clearing
September, turning dirt roads into quag- stations closed on 21 August, a pro-
mires, litter bearers were used to only visional hospital was opened by the
a minimum extent. The well-settled na- clearing company of the 58th Medical
ture of the country also made it possible Battalion in the Hotel du Golf at Beau-
to site clearing stations much of the time vallon, a resort village between St.
in buildings. Tropez and Ste. Maxime. One collecting
The corps surgeon's office remained company remained at Ste. Maxime, op-
close to the front throughout the period, erating a smaller unit that served as an
moving from Aspres to Salins, twenty annex to the main hospital. Both units
miles south of Besançon on 6 September. were relieved on 4 September by the
Headquarters were in Vesoul by the 16th 164th Medical Battalion, which contin-
and on 22 September moved to Plom- ued to operate the two facilities until
bieres. fixed hospitals came into the area toward
Casualties during September were the end of the month. During the period
more from disease than from battle 24 August-1 September, twelve French
wounds, with respiratory ailments and medical officers and a Senegalese
exhaustion making substantial inroads. clearing platoon were attached to the
Trench foot cases began to appear be- Beauvallon hospital, the majority of ad-
fore the end of the month. Admissions missions at that time being French
by the three division clearing companies troops and German prisoners.
totaled 11,805, of which 4,101 were bat- After being relieved by the 164th
tle wounds. Of the aggregate admissions, Medical Battalion, the 58th established
1,136, or approximately 10 percent, were another provisional hospital in the Hotel
prisoners of war. Hermitage in Nice, primarily for the
support of the 1st Airborne Task Force
Hospitalization in the and the 1st Special Service Force then
Army Area fighting along the Italian border. This
hospital was still in operation when all
Hospitalization on the Beaches
11
Sources for this section are: (1) Annual Rpt,
Until the base organization, with its Surg, Seventh Army, 1944; (2) After Action Rpt,
fixed hospitals, could establish itself in Surg, Seventh Army, 15 Aug-31 Oct 44, an. 278;
(3) Annual Rpt, Surg, VI Corps, 1944; (4) Unit
southern France, it was necessary for rpts of the individual med units mentioned in the
Seventh Army to leave some hospital fa- text.
INVASION OF SOUTHERN FRANCE 387
military units in southern France were augmented during this period by 18
formally transferred from the Mediter- medical officers, a nurse, and 19 techni-
ranean to the European Theater of cians attached from other organizations.
Operations. Approximately 2,000 patients were cared
Between 11 and 30 September the for.
675th Medical Collecting Company of The 59th Evacuation Hospital opened
the 164th Medical Battalion operated a on 28 August at Carpentras near the site
provisional station hospital in Mar- about to be vacated by the 3d Division
seille—the only American hospital facil- clearing station. The hospital remained
ity in that city. The hospital was caring in the area until 7 September, taking
for 200 patients when it was relieved a total of 611 patients and performing
by the 80th Station Hospital on 30 222 surgical procedures in the 10 days
September. of operation.
The provisional hospitals in the land- The 27th Evacuation operated at
ing areas were augmented late in August Bouc-bel-Aire, a few miles south of
by 750-bed evacuation hospitals, which Aix-en-Provençe from 1 September to 20
were brought in according to schedule. September. At this site it was the closest
The 9th Evacuation, which landed on U.S. hospital to Marseille, where it op-
25 August, went immediately into the erated a prophylactic station and gave
combat zone, but the 51st and 59th Evac- dispensary service and station hospital
uations, which arrived at the same time, care to all U.S. troops in the area. In
and the 27th, which reached southern addition to U.S. Army personnel, the
France on 30 August, were retained ini- 1,169 patients treated during the twenty
tially in the coastal area. Original plans days of operation at Bouc-bel-Aire in-
had called for three 750-bed evacuation included French troops and civilians,
hospitals for the support of VI Corps and American and British sailors, both
and two to back up the forward units naval and merchant marine.
of Army B. After the capture of Mar-
seille, however, French medical com- Hospitalization in the Combat Zone
manders found it possible to make
greater use of local hospitals than had The 10th and 11th Field Hospitals,
been anticipated, and all four of the operating in 50-bed units rather than the
larger evacuation hospitals were used 100-bed units used in Italy, served
primarily for U.S. troops. throughout the campaign as forward
The 51st Evacuation opened at Dra- surgical hospitals, remaining close to, and
guignan on 27 August. Its personnel moving with, the division clearing sta-
served in a captured German hospital tions. They were backed up as closely
at the site while their own tents were as transportation and available sites per-
being erected. The hospital remained at mitted by the 400-bed evacuation hos-
Draguignan until 20 September. The pitals and later by the larger evacuation
bulk of its admissions were from the 1st units. During the period of rapid move-
Airborne Task Force, received both di- ment, however, the field units were often
rectly and through the provisional hos- far ahead of any evacuation hospital sup-
pital at Nice. The staff of the 51st was port. On these occasions, clearing pla-
388 MEDITERRANEAN AND MINOR THEATERS
toons of the 56th Medical Battalions the hospital had evacuated 300 patients,
were used to increase bed capacity.12 dismantled and packed its equipment,
The speed of the campaign up to late and was on the road. The first patient
September necessitated frequent and was received at the new site just 18 hours
long moves, with advance reconnaissance after the hospital had closed at the old.
to the front lines themselves in search of Three hundred patients were admitted
hospital sites. The 400-bed evacuations on the first day of operation at Aspre-
were generally able to move by echelons mont.
with their own organic transportation, The 750-bed 9th Evacuation Hospital,
but the 750-bed evacuations had to rely which arrived combat-loaded on 25
on Seventh Army for trucks, which were August, was sent immediately to the sup-
not always available when needed. (See port of the 11th. Proceeding in 4 motor
Maps 31, 32, 33.) convoys, the 9th moved to a site at Beau-
Long evacuation lines to the rear mont, 30 miles beyond Aspres on the
meant that hospitals were often over- road to Crest, and began receiving pa-
crowded, while periods of intense com- tients at 0800, 28 August, just 54 hours
bat activity placed a severe strain upon after touching French soil. Two hundred
surgical staffs and postoperative facili- and sixty patients were received and 39
ties. It was frequently necessary to leave surgical operations performed in the first
holding units behind to care for non- 24 hours at Beaumont.
transportable patients when hospitals On the first day of September the 93d
moved forward. All of the evacuation Evacuation, moving in three echelons
hospitals used civilian personnel in vari- with its own organic transportation,
ous capacities, the most frequent being opened at Rives, 20 miles northwest of
as litter bearers. Grenoble and 180 miles from the hos-
The first evacuation hospital to move pital's previous site at Barjols. Between
away from the landing beaches was the noon and midnight, 1 September, 127 pa-
93d, which advanced forty-five miles tients were admitted and 28 surgical pro-
northwest from Plan de la Tour to cedures performed. The move was
Barjols on 22 August. For a few days, completed on 5 September, the hospital
while elements of the 45th Division were remaining open at Barjols until the last
forcing a crossing of the Durance River echelon was ready to leave. (Map 31)
just north of Barjols and fighting their The 95th Evacuation was the next
way toward Sisteron, the hospital was Seventh Army unit to leapfrog from the
busy, but was soon left with little to do. rear to the most forward position. The
August 25 saw the 11th Evacuation hospital left Gonfaron on 3 September,
leap ahead 128 miles from Le Muy to its personnel spending the night as guests
Aspremont in support of the forces fight- of the 9th at Beaumont. The intention
ing from Montélimar to Crest. In 15 had been to set up about 50 miles beyond
hours after receiving movement orders, that point, but the front lines had already
moved so far forward that a new recon-
12
Ltr, Col Rollin L. Bauchspies, USA (Ret), to naissance was necessary. The site finally
Col Coates, 15 Apr 59, commenting on preliminary
draft of this volume. Colonel Bauchspies was VI designated by the VI Corps surgeon was
Corps surgeon. at St. Amour, more than 300 miles by
392 MEDITERRANEAN AND MINOR THEATERS
road from the landing area. The 95th trucks and 25 ambulances of an attached
spent the night of 4 September in biv- ambulance company, the first 2 of 3
ouac at the 3d Division clearing station echelons were able to move together.
near Ambérieu, opening at St. Amour at The hospital opened at 1300 on 16 Sep-
0900, 5 September. tember. By midnight 219 patients had
As the most forward evacuation hos- been received and 27 operations per-
pital, the 95th carried a heavy load of formed. The 185-mile move was com-
surgical cases for the next few days. At pleted on 17 September. (Map 32)
the same time, it was necessary to hold The 59th Evacuation Hospital, which
patients overlong owing to the difficul- had closed at Carpentras on 7 September,
ties of evacuation. The railroads had not also opened in Rioz after a l0-day wait
yet been restored to service and motor for transportation. For the 59th the move
transportation was critical. The situation covered 240 miles. September 17 was also
was somewhat eased by the beginning of the opening date for the 2d Convalescent
air evacuation from Ambérieu on 9 Sep- Hospital in Besançon, though part of its
tember, but fuel shortages and bad equipment remained on the docks at
weather combined to make flight sched- Marseille where organic vehicles had
ules uncertain. On the credit side, the been commandeered for more urgent
hospital was deluged with gifts of eggs, uses. The unit was caring for 1,200 pa-
chickens, rabbits, and ducks from the tients before all of its equipment was
local farmers, whose normal city markets brought up by its remaining vehicles
were temporarily cut off. shuttling between Besançon and Mar-
The 9th Evacuation, meanwhile, had seille.13
closed at Beaumont, and on 8 September The 95th Evacuation again became the
opened at Poligny, 40 miles beyond St. most forward Seventh Army hospital on
Amour and 235 miles from the Beau- 18 September when it opened at Saulx,
mont site. At Poligny the 9th received 25 miles northeast of Rioz. The 11th
578 patients in the first 30 hours of oper- moved from Aissey to Conflans, 10 miles
ation. Surgical teams worked in 16-hour north of Saulx, 3 days later; and on 23
shifts. September the 9th Evacuation opened at
The next forward move was made on Plombières on the Moselle. The first con-
11 September when the 11th Evacuation tingent of the 27th Evacuation arrived at
opened at Aissey, 15 miles east of Xertigny, about eight miles north of the
Besançon, after a 265-mile jump from 9th, the following day, but the hospital
Aspremont. With the aid of borrowed was not in full operation before the end
trucks, the first echelon was able to carry of the month. All but the advance de-
300 beds, all surgical nurses, and half the tachment of the 27th made the 450-mile
officers of the medical service as well as jump from Bouc-bel-Aire by rail. On 25
all those of the surgical service. The hos-
pital admitted 158 patients during the
first 5 hours at Aissey.
13
On 15 September the 93d Evacuation In the Southern France Campaign, the 2d Con-
valescent Hospital carried only 2,000 rather than
moved up from Rives to Rioz, 20 miles its former 3,000 beds and was organized to operate
north of Besançon. Using 15 borrowed in two independent sections of 1,000 beds each.
INVASION OF SOUTHERN FRANCE 393
September the 93d Evacuation joined the lished, though the procedure was very in-
9th in the vicinity of Plombières. (Map formal. On 18 August—D plus 3—the
682d Medical Clearing Company of the
With the single exception of the 51st 52d Medical Battalion, then at Plan de la
Evacuation, all Seventh Army hospitals Tour, arranged to hold the lightly
were now concentrated close to the main wounded and mildly ill who could re-
highway north from Besançon to Epinal. turn to duty in a short time if they could
The 51st was packed at Draguignan and be kept off the hospital ships bound for
ready to move by 23 September, but Italy. The project grew. Beds and equip-
transportation was not available until ment were borrowed wherever they
early October. could be had, and personnel were di-
During the last two weeks of Septem- verted from other duties. Within a week
ber almost continuous rain and cold the unit was operating 400 convalescent
hampered hospital movements and made beds and was unable to perform its nor-
operation a constant struggle with the mal functions.
elements. All tents had to be ditched, The 164th Medical Battalion, less one
access roads graveled, and tent pegs pe- platoon of the 638th Medical Clearing
riodically reset in the soft ground. Heat- Company already in France, arrived on
ing facilities were often inadequate to 26 August, and the following day a col-
keep patients warm. lecting company of the 164th took over
the convalescent hospital, which moved
Special Hospital Facilities forward to Aspres on the last day of the
month.
In addition to field and evacuation The venereal disease and neuropsy-
hospitals, Seventh Army maintained pro- chiatric hospitals, meanwhile, had both
visional hospitals for the specialized been established according to plan on 20
treatment of venereal disease and neu- August by the 616th Medical Clearing
ropsychiatric cases and, until the 2d Company of the 181st Medical Battalion,
Convalescent Hospital got into full oper- released from its beach assignment the
ation, a provisional convalescent hospital previous day. Both hospitals were organ-
as well. The venereal disease and neuro- ized as 250-bed units, and both opened at
psychiatric hospitals had been planned Le Luc, close to the Gonfaron site of the
in advance, on the pattern of those set up 95th Evacuation Hospital. The neuro-
by Fifth Army in Italy, and the clearing psychiatric hospital carried a light pa-
platoons designated to operate them had tient load at this time, but the venereal
been given special training as well as disease unit found it necessary almost
specialist personnel attached from other immediately to expand capacity to 375
units. The convalescent hospital was an beds to care for a backlog of cases arising
afterthought, made necessary by the un- from contacts in Italy.
expectedly rapid advance of the lines and By definition both of these specialized
the late date predetermined for phasing hospitals were forward units, and both
in the regular convalescent facility. were moved to the Aspres area at the end
The convalescent hospital was the first of the month. By this time long evacua-
ofthe three specialized units to be estab- tion lines, scattered forces, and acceler-
394 MEDITERRANEAN AND MINOR THEATERS
a
Calculated from preceding columns.
b
Figure for total treated, taken from Annual Report, Surgeon, Seventh Army. Equivalent to admissions, since all
Navy patients were disposed of within the period covered by the table. Figure of 141 for admissions given in After
Action Report is obviously incorrect.
c
To PW enclosure.
d
Discharged from hospital.
Source: After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44, An. 278 (admissions only) Annual Rpt, Surg,
Seventh Army, 1944.
ated build-up in the beach area had Samson, midway between Poligny and
brought about an acute shortage of mo- Besançon, six days later; and on 24 Sep-
bile medical units. The 164th Medical tember joined the growing group of
Battalion was given a beach assignment, medical installations around Plombières
and without advance notice the 616th on the Moselle. The venereal disease cen-
Clearing Company was directed to take ter moved to St. Jean de Paris, a suburb
over the provisional convalescent hos- of Ambérieu, on 6 September, where the
pital on 4 September. The hospital at convalescent hospital had been estab-
that time held almost 500 patients, but lished the day before; to Rioz on the
the 616th had only 3 officers and 8 en- 13th; and to Plombières on 28 Septem-
listed men who could be spared from the ber. The convalescent hospital, its useful-
venereal disease and neuropsychiatric ness ended with the establishment of the
centers. The 11 men staffed the convales- 2d Convalescent in Besançon, closed on
cent hospital until additional personnel 25 September. An annex, operated at
from collecting companies of the parent Rioz in connection with the venereal dis-
medical battalion could be rushed to ease hospital, closed two days later.
their aid. The convalescent hospital had reached
The neuropsychiatric hospital moved a peak load of more than 800 patients,
forward to Rives on 4 September; to while the neuropsychiatric center, reflect-
INVASION OF SOUTHERN FRANCE 395
ing the growing severity of combat and To minimize the factor of distance as
the deterioration of the weather, was much as possible, holding hospitals were
caring for 300 patients by the end of the set up during periods of rapid advance
month. by a platoon of the corps clearing com-
A second venereal disease center was pany and a field hospital unit to retain
operated in connection with the provi- patients until an evacuation hospital
sional hospital at Beauvallon by the could move forward.14
638th Medical Clearing Company from 4 The battalion maintained liaison with
September. This center was still in opera- VI Corps through an officer stationed in
tion when the 164th Medical Battalion the corps surgeon's office, and with the
passed from army to base section control evacuation hospitals through a noncom-
early in October. missioned officer stationed in the regis-
trar's office of each hospital serving the
Medical Summary: Seventh Army corps. Bed status reports from each evac-
uation hospital were submitted every
Table of Organization bed strength in four hours, or oftener if the situation de-
Seventh Army hospitals by the end of manded, the reports being carried by
September was 5,000, not counting clear- ambulance drivers or telephoned to bat-
ing stations and special hospitals oper- talion headquarters. This information
ated by clearing companies, plus 2,000 permitted the corps surgeon to direct the
convalescent beds. Admissions to Seventh flow of patients to the evacuation hos-
Army medical installations, including pitals in terms of current information.
clearing stations, totaled more than Medical support for the 1st Airborne
28,000 for the period 15 August-30 Sep- Task Force followed an unorthodox pat-
tember, of which 13,000 were evacuated tern, the three collecting stations of the
to the communications zone and more 676th Medical Collecting Company
than 9,000 were returned to duty. being comparable to small clearing sta-
(Table 24) Troop strength by the end of tions. Casualties were evacuated by
September was approximately 140,000. ambulances of the company to the pro-
visional hospital operated by the 514th
Evacuation From Medical Clearing Company of the 58th
Seventh Army Medical Battalion in Nice. After 6 Octo-
ber autorail trains staffed by personnel
Evacuation Within the Combat Zone of the 676th made daily runs between
the collecting stations and the hospital.
When VI Corps pushed inland from The hospital was cleared by the 58th
its landing beaches, evacuation of divi- Medical Battalion.
sion clearing stations was carried out by
the 56th Medical Battalion. Highways
were generally excellent, but through 14
Principal sources for this section are: (1)
much of the advance the terrain was After Action Rpt, Surg, Seventh Army, 15 Aug-
mountainous and until the concentration 31 Oct 44; (2) Annual Rpt, Med Sec, MTOUSA,
1944; (3) Annual Rpt. Surg, Seventh Army, 1944;
of evacuation hospitals along the Moselle (4) Annual Rpt, Surg, VI Corps, 1944; (5) Unit
in late September, distances were great. rpts of the med units mentioned in the text.
396 MEDITERRANEAN AND MINOR THEATERS
Evacuation to the Communications Section surgeon, however, says 489 evacuees from
Zone the Riviera beaches were received by the 40th
Station Hospital, and the report of the
hospital itself for the same period puts
During the first day of the invasion of the figure above 500. The presumption is
southern France, casualties were evacu- that one or more of the hospital ships discharged
some critical cases at Ajaccio to be flown to Naples,
ated from the beach clearing stations by but there is a tendency in Army reports to lump
small craft to the transports and carried all sea evacuation as by hospital ship. It may be
by LST to Ajaccio, Corsica, where the that the LST total was actually considerably higher
than indicated. For example, the report of the
40th Station Hospital was prepared to re- Naval Commander, Western Task Force, page 368,
ceive them and to send the more serious says that approximately 1,800 casualties were
cases on to Naples by air. A little over evacuated to hospital ships during the period of
the automatic schedule (D plus 1 through D plus
300 reached Ajaccio by LST on 15 Au- 6), whereas the ETMD report for August 1944
gust.15 gives a figure of 3,262 for the same period.
General sources for this section are: (1) ETMD,
15
MTO, for Aug 1944; (2) After Action Rpt, Surg,
According to the Seventh Army Surgeon's After Seventh Army, 15 Aug-31 Oct 44; (3) Rpt of Naval
Action Report for the period 15 August-31 Oc- Comdr, Western Task Force, Invasion of Southern
tober 1944, only 380 patients were evacuated from France; (4) Annual Rpt, Surg, Seventh Army, 1944;
southern France by LST. (See Table 26, below.) (5) Annual Rpt, Med Sec, MTOUSA, 1944; (6)
The 1944 annual report of the Northern Base Unit rpts of med units mentioned in the text.
INVASION OF SOUTHERN FRANCE 397
Three hospital ships arrived off the able to the French forces to make evacu-
landing beaches on D plus 1 as planned, ation out of France unnecessary. This
although they were not there as early in factor, combined with the beginning of
the day as had been expected. The rela- air evacuation on D plus 7, greatly re-
tively small number of casualties, how- duced the need for hospital ships and
ever, made it possible to hold in the none were requested by Seventh Army
clearing stations those patients whose after 30 August.
condition required the better accommo- Air evacuation from southern France
dations of the hospital ships. The auto- was carried out by the 802d and 807th
matic schedule continued through 21 Medical Air Evacuation Transport
August—3 ships on D plus 2, one on D Squadrons, which continued at the same
plus 3, 2 each on D plus 4 and D plus time to clear forward areas in Italy. Be-
5, and one on D plus 6. ginning on 22 August, flights were made
Vessels used during the first 3 days initially from the most forward airfields
carried surgical teams drawn from per- available directly to Naples and occasion-
sonnel of the 3d, 36th, and 43d General ally to other Italian bases. Airfields in the
Hospitals, and the 59th Evacuation Hos- vicinity of the landing beaches—St.
pital, all on the DRAGOON troop list. The Tropez, Le Luc, and Aix-en-Provence—
USAHS John Clem, smallest of the hos- were quickly left behind. Sisteron and
pital ships, carried only one surgical Crest both served for a time, and flights
team, while the Acadia, with a capacity of began from Ambérieu northwest of Lyon
788 patients, carried 3. The Shamrock, on 9 September.
Thistle, Algonquin, Chateau Thierry, By this date, the weather was becom-
and Emily Weder carried 2 surgical ing uncertain and the distances to Italian
teams each. bases were lengthening. With the great
After D plus 6, hospital ships were sent air base at Istres, about twenty-five miles
into the area on a one-a-day basis until 28 northwest of Marseille available, flights
August, and thereafter at the request of were directed there, where patients could
the Seventh Army surgeon. One ship was be relayed on by air to Naples or sent to
held in continuous readiness at Ajaccio. one of the fixed hospitals moving into
Until D plus 5 hospital ships called at all the Rhône delta. Before the end of Sep-
three landing beaches, but beginning on tember air evacuation in France had
D plus 6 all evacuees were taken by am- been largely reduced to a single route,
bulance to the clearing station of the from Luxeuil close to the bulk of Sev-
58th Medical Battalion at Ste. Maxime, enth Army medical installations, to
where the ships were loaded. Through 21 Istres.
August all hospital ships discharged at Air evacuation from France to Italy,
Naples with no segregation of casualties and from the Seventh Army area to
by nationality. From 22 August through Istres, for the period 22 August through
29 August vessels loaded to 60 percent or 7 November, when the two air evacua-
more with French casualties or prisoners tion squadrons from Italy were with-
of war were sent to Oran. drawn, is summarized in Table 25.
With the fall of Marseille and Toulon, Seventh Army evacuation hospitals
enough fixed hospital beds became avail- from their first establishment were
398 MEDITERRANEAN AND MINOR THEATERS
TABLE 25—AIR EVACUATION FROM SEVENTH ARMY AND DELTA BASE SECTION
22 AUGUST-7 NOVEMBER 1944
cleared by the 52d Medical Battalion. greater than 600. The fall rains made
Patients were carried by ambulance to flight schedules erratic with a highly vari-
the Riviera beaches for hospital ship able patient census as a consequence.
evacuation, to holding units at airfields Property exchange with air evacuation
or railheads, or to fixed hospitals as these units was a continuous problem because
became available close to the front. Air the personnel carriers used generally had
evacuation holding hospitals were oper- full loads on the incoming trip, and often
ated by the clearing companies of the made one or more trips in Italy before
32d and 164th Medical Battalions. The returning to France.
largest of these was at Istres, operated by As soon as the rail lines were back in
the 52d Medical Battalion until 17 Sep- operation, hospital trains were pressed
tember and thereafter by the 164th. into service for evacuating forward hos-
More than 1,000 beds were available, pitals. The 42d Hospital Train, veteran
with a daily patient turnover often of both North Africa and Italy, made its
INVASION OF SOUTHERN FRANCE 399
Source: Compiled from ETMD, MTO, for Aug 44; and After Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct 44.
Marseille. The medical section was al- with headquarters in Dijon. Colonel
ready supervising rear army installations Bishop continued as surgeon of CONAD
as well as evacuation and supply activi- while Colonel Jeffress became Delta Base
ties on the beaches when the base section surgeon.
formally assumed operational control of Both medical section organizations
the coastal region of southern France on were similar to those elsewhere in the
9 September.17 Mediterranean, with functional subdivi-
By that date, Seventh Army was be- sions for administration, personnel, hos-
yond Besançon in its spectacular dash to- pitalization, evacuation, medical records,
ward the Rhine, and the communications medical supply, dental, and veterinary.
zone organization appeared inappropri- The Delta Base medical section was pri-
ately named. The Coastal Base Section marily concerned with incoming supply,
became the Continental Base Section on evacuation to Italy and to the zone of in-
12 September 1944, and as of 1 October terior, and hospitalization of service
was split into the Delta Base Section, troops, long-term patients, and prisoners
with headquarters in Marseille, and the of war. The medical section of CONAD
Continental Advance Section (CONAD) was primarily concerned with the more
immediate support of Seventh Army and
17
Sources for this section are: (1) Annual Rpts, of the 6th Army Group.
Med Sec, Delta Base Sec, 1944, 1946; (2) Monthly
Rpt, Delta Base Sec, Oct 1944; (3) Annual Rpt,
Both Delta Base and CONAD came
Continental Adv Sec, 1944; (4) CONAD History, under the general jurisdiction of the
1944-1945; (5) Annual Rpt, Med Sec, MTOUSA, Southern Line of Communications
1944; (6) Hist of Med Sec, Hq, COMZ NATOUSA;
(7) Ltr, Gen Stayer, Surg, NATOUSA, to Gen
(SOLOC) , on 20 November, when all
Kirk, TSG, 26 Sep 44. COMZ functions in southern France
INVASION OF SOUTHERN FRANCE 401
a
Last operating site.
b
Date when bulk of personnel and equipment docked.
Source: Compiled from annual rpts of hospitals included.
passed finally from MTO to ETO. from North Africa, Italy, and Corsica.
The SOLOC medical section was essen- The unexpected speed with which Sev-
tially the medical section of COMZ, enth Army moved north made the sched-
NATOUSA, which had been function- ule unrealistic before the first hospital
ing in Naples since February 1944, with arrived. In only three instances, however,
18
Colonel Shook as surgeon. An advance was it possible to advance the schedule,
echelon of the COMZ medical section and these were balanced by others in
had been established in Dijon early in which even the retarded landing dates
October by Colonel Cocke, Colonel originally fixed were not met. (Table 27)
Shook's deputy. The accelerated pace of the campaign,
moreover, brought such heavy demands
Establishment of Fixed Hospitals for transportation that the establishment
of hospitals was often unduly delayed
after their arrival. Another delaying fac-
U.S. fixed hospitals with an aggregate
tor was the difficulty in locating suitable
Table of Organization strength of 14,250
sites in a densely populated country at a
beds were on the DRAGOON troop list,
season when tents could not be satisfac-
to be phased in between D plus 25 (9
torily used.19
September) and D plus 60 (14 October).
The installations included were drawn 19
Sources of this section are the same as those
for the preceding section, with the addition of unit
18
See pp. 323-26, above, 486-88, below. reports of medical units mentioned in the text.
402 MEDITERRANEAN AND MINOR THEATERS
The first U.S. fixed hospital to oper- 46th General, which was rushed at the
ate in southern France was the 36th Gen- request of the Seventh Army surgeon to
eral, which took over a captured German Besançon. The hospital opened with a
hospital—originally a French tuberculosis minimal portion of its equipment in the
sanatorium—at Les Milles near Aix-en- Caserne Vauban, a former French in-
Provence on 17 September. Approxi- fantry barracks, on 20 September. The
mately 600 prisoner of war patients were front was only a dozen miles away, and
in the hospital at that time, but these the 9th Evacuation Hospital, from which
were concentrated in about half the ward the first group of patients came, was at
area. Two days later the 36th General Poligny 40 miles to the rear. The patient
also began operating in Aix-en-Provence census of the 46th General rose to almost
itself, in the buildings of a French psy- 3,000 within 3 weeks.
chiatric hospital. To avoid unnecessary The 36th General, after surrendering
dispersion of staff members, all surgical its two sites at Aix-en-Provence, was as-
cases were handled at Les Milles, with signed to CONAD and opened at Dijon
medical cases going to Aix. (Map 34) on 13 October in a former French cav-
Both hospitals were turned over, with alry barracks. The 36th had a census of
their patients, to the 43d General—Les 1,400 patients within a week. It was
Milles on 25 September and Aix on the joined at Dijon on 20 October by the
27th. The 3d General Hospital took over 180th Station, one of the few 250-bed
the installation in Aix-en-Provence on 9 units left in the theater.
October, taking 763 medical patients On 14 October the 35th Station Hos-
from the 43d at that time. The 43d Gen- pital opened at Chalon-sur-Saône, south
eral continued to administer the prisoner of Dijon, the accommodations again be-
of war hospital at Les Milles in addition ing a French caserne, or military bar-
to its normal functions. The German racks. A week later the 2,000-bed 21st
hospital captured at Draguignan was General opened at Mirecourt, just west
consolidated with the Les Milles facility, of the Moselle, in the unfinished plant of
which operated under U.S. supervision a large, modern French psychiatric hos-
with German protected personnel. Ger- pital. The 51st Station, which had been
man enlisted men were used as litter functioning as a neuropsychiatric hos-
bearers throughout the hospital. pital in both Africa and Italy, continued
The 78th Station Hospital, mean- the same specialty in France, opening at
while, had opened in a resort hotel in St. Auxonne on 4 November. In this case the
Raphael on 19 September, and the 80th military atmosphere of the French bar-
Station had relieved the 675th Medical racks that housed the unit was regarded
Collecting Company, which had been as an asset.
operating a provisional hospital in the The 23d General Hospital opened on
buildings of an old ladies' home in Mar- 5 November at Vittel, so close to the
seille. front that its first 300 patients were re-
The first fixed hospital to open in the ceived direct from Seventh Army by am-
forward area, which would come under bulance. The hospital was adequately
operational control of the Continental housed in a group of resort hotel build-
Advance Section on 1 October, was the ings. Last of the CONAD hospitals trans-
INVASION OF SOUTHERN FRANCE 403
FIXED HOSPITALS AND SUPPLY UNITS
TRANSEFERRED FROM MTO TO ETO,
20 NOVEMBER 1944
Delta Base Section
Aix-en-Provence
43d General, 25 September. 1,500 beds.
3d General, 9 October. 1,500 beds.
Marseille
80th Station, 30 September. 500 beds.
70th Station, 1 November. 500 beds.
69th Station, 8 December. 500 beds.
231st Medical Composite Battalion.
St. Raphael
78th Station, 19 September. 500 beds.
La Ciotat
7607th Station (Italian), October. 500 beds-.
Chalon-sur-Saône
35th Station, 14 October. 500 beds.
Auxonne
51st Station, 4 November. 500 beds.
Dijon
36th General, 13 October. 2,000 beds.
180th Station, 20 October. 250 beds.
70th and 71st Medical Base Depot Companies.
Besançon
46th General, 20 Sepetmber. 1,500 beds.
Vittel
23d General, 5 November. 2,000 beds.
Épinal
23d Station, 10 November. 500 beds.
Mirecourt
21st General, 21 October. 2,000 beds.
ferred from MTO was the 23d Station, the principal center for handling closed-
which opened in a school building at ward neuropsychiatric cases in Delta
Épinal on 10 November, almost two Base. The 69th Station did not arrive in
months after its arrival in France. France until 18 November and was not
Two late arrivals in Delta Base, the ready to receive patients until 8 Decem-
69th and 70th Station Hospitals, com- ber.
pleted the DRAGOON troop list. The 70th Counting the still inoperative 69th
opened in a French mental hospital in Station, there were 5,000 Table of Or-
Marseille on 1 November and, because ganization beds in Delta Base and 9,250
of the facilities its site afforded, became in CONAD as of 20 November 1944,
404 MEDITERRANEAN AND MINOR THEATERS
when southern France passed completely 1,325 patients by air, 1,496 by motor, and
to ETO control. 871 by rail. In the same month, Delta
In addition to these fixed hospitals, the Base transferred 2,808 patients to the
7607th Station Hospital (Italian) opened Peninsular Base Section in Italy by air
at La Ciotat, on the coast between Mar- and 2,843 by sea, while 93 were evacu-
seille and Toulon, in October to care for ated by sea to the United States.
personnel of Italian service units. With fixed beds in the forward area
Though nominally a 500-bed hospital, still at a premium, CONAD followed no
the 7607th operated 1,000 beds. The ve- fixed evacuation policy, but cleared its
nereal disease center maintained by the hospitals to Delta Base as rapidly as trans-
638th Medical Clearing Company of the portation and the condition of the pa-
164th Medical Battalion at Beauvallon tients allowed. Toward the end of
was shifted on 9 October to a staging October, Delta Base established a 45-day
area between Marseille and Aix-en-Pro- policy for evacuation to PBS, retaining
vence, where it continued to carry on all patients expected to recover in less
the same mission under Delta Base con- than that time.
trol. The 4th Medical Laboratory, which Delta Base continued to evacuate some
arrived in southern France on 9 Septem- patients to Italy until 20 November, the
ber, served both base sections. The base totals for the period 1-20 November
laboratory, with the 6703d Blood Trans- being 29 by air and 433 by hospital ship.
fusion Unit attached, was located in The slack was taken up by the greatly in-
Marseille; a mobile section consisting of creased number of beds available in
one officer and four enlisted technicians, southern and eastern France by early
was sited in Dijon. Both sections occu- November, and by the beginning of di-
pied university laboratory buildings of rect air evacuation from CONAD to the
functionally suitable design. United Kingdom on the 12th of that
month.
Evacuation From CONAD
and Delta Base Medical Supplies and Equipment
As soon as the base sections were set By the time medical supplies began
up, they took over responsibility for coming across the landing beaches of
clearing hospitals in the Army area and southern France in appreciable quan-
distributing the patients among the avail- tities about D plus 3, the army and base
able hospitals. The base sections were responsibilities in the supply area were
also responsible for interbase transfers; being differentiated. Both the Seventh
Delta Base evacuated to the zone of in- Army medical supply officer, who was
terior, beginning in October.20 also commanding officer of the 7th Medi-
During October 1944, CONAD evacu- cal Depot Company, and the Coastal Base
ated from its own hospitals to Delta Base, Section medical supply officer on tem-
porary duty with Seventh Army came
20
This section is based primarily on: (1) Annual ashore on D plus 1. The three beach
Rpt, Med Sec, CONAD, 1944; (2) Annual Rpt,
Med Sec, Delta Base, 1944; (3) Annual Rpt, Med dumps were taken over from the beach
Sec, MTOUSA, 1944. medical battalions by the advance sec-
INVASION OF SOUTHERN FRANCE 405
tion of the 7th Medical Depot Company stallations they served. The Meyrargues
on 16-18 August.21 Three days later a dump closed on 5 September, and a new
single point for the receipt of incoming issue point opened the same day at
medical supplies was established at Ste. Voreppe, ten miles northwest of Greno-
Maxime. At this time supervision passed ble. The Aspremont dump closed the
to the base supply organization, although following day.
21 enlisted men of the advance section, The next move was from Voreppe to
7th Medical Depot Company, were de- Sellières, ten miles north of Lons-le-
tached to help operate the dumps for the Saunier, on 12 September. The area was
beach control group. These men did not already too far behind the advancing Sev-
rejoin their own unit until 15 Septem- enth Army installations, however, and a
ber. second forward dump was opened the
next day at Baume-les-Dames, fifteen
Seventh Army Medical Supply miles northeast of Besançon. With the
change of direction following the shift
The first forward issue point for Sev- to SHAEF command, the Baume dump
enth Army was set up at Le Cannet, near moved to Vesoul on 19 September, where
Le Luc, on 21 August, moving to St. it was joined a day later by the group
Maximin, about 20 miles east of Aix-en- from Sellières. At Vesoul the dump was
Provence, 2 days later. The main body of in a building for the first time, being
the 7th Medical Depot Company joined housed in a large tobacco warehouse.
the advance section there on 25 August. On 2 October the 1st Storage and Issue
On 29 August the base section of the Platoon opened at Épinal, with the re-
depot moved to Meyrargues, 10 miles mainder of the company moving up
north of Aix, while one storage and gradually until 17 October, when the
issue platoon jumped forward to Aspre- Vesoul dump was closed. On the same
mont in the vicinity of VI Corps' forward day a second dump was opened at Luné-
medical installations.22 ville, some thirty miles north of Épinal.
It was at this time that the battle of The Épinal and LunéVille dumps were
Montélimar came to its indecisive close in buildings large enough to accommo-
and Seventh Army raced ahead to cut off date mess and billets as well as the depot
the retreating enemy before he could itself.
slip through the Belfort Gap. In this Throughout the early weeks of the
stage of the campaign, medical supply campaign, transportation presented the
dumps were hard pressed to keep within greatest difficulty. While the army issue
any kind of reasonable distance of the in- points were still close to the beaches,
medical supplies were unloaded from the
21
See p. 380, above. ships to Dukws, which ferried them
22
Principal sources for this section are: (1) After ashore and delivered them directly to the
Action Rpt, Surg, Seventh Army, 15 Aug-31 Oct
44, an. 278; (2) Annual Rpt, Surg, Seventh Army, dumps. As the army moved forward,
1944; (3) Annual Rpt, 7th Med Depot Co, 1944; medical supplies were brought up in or-
(4) Med Hist, 7th Med Depot Co, 25 Oct 44; (5) ganic vehicles of the 7th Medical Depot
Unit rpts, 9th, 11th, 27th, 51st, 59th, 93d, 95th
Evac Hosps, 1944; (6) Davidson, Med Supply in Company, operating around the clock.
MTOUSA, 143-50. The pressure was relieved only after the
406 MEDITERRANEAN AND MINOR THEATERS
Raphael on 9 September. The 71st Medi- freight cars bound for the forward area
cal Base Depot Company took over oper- without ever entering a Delta Base
ation of the Ste. Maxime depot, while dump. For about two months supplies
the 70th accompanied the battalion to were not received in Delta Base in large
Marseille. A large garage and hangar had enough quantities to maintain adequate
already been obtained by the Coastal stock levels in either base section. Ar-
Base Surgeon as a depot site. Eight oper- rival times were uncertain, the condition
ational medical units, each sufficient to of the only partially restored port of
maintain 10,000 men for 30 days, reached Marseille made unloading difficult, and
Marseille simultaneously with the supply transportation shortages frequently de-
personnel, and within 72 hours the depot layed movement of supplies from the
24
was able to issue supplies. docks to the depot. All together, the Del-
When the depot was in full operation, ta Base supply organization was able to
the 231st Medical Composite Battalion fill during October only about 60 per-
was sent to Dijon to set up a more for- cent of the requisitions from Seventh
ward base, the 71st Medical Base Depot Army, 1st French Army, CONAD, and
Company moving to the Marseille depot Delta Base. All base section medical
on 24 September. It was at this time, units, however, carried 90-day supply
however, that the decision to establish levels with them to France and were not
two base sections was made, and late in seriously handicapped by the slow build-
October the 231st returned to Marseille up. The authorized stock level of 30
to resume operation of the Delta Base days of operating supplies and a 45-day
depot. The 70th and 71st Medical reserve was reached in mid-November.
Base Depot Companies were assigned Supplies adequate for 7 days of opera-
to CONAD, joining forces to operate tion, with an 8-day reserve, were in the
the Dijon depot, which was sited in a CONAD depot and the remainder in
French barracks. Italian service units and Delta Base warehouses.
French civilians were used as needed by As many items as possible were pro-
both base section depots. cured locally, including motor vehicles,
Both Delta Base and Continental Ad- which greatly facilitated the movement
vance were supplied by COMZ NATO- of supplies. Inducements were offered
USA, but all supplies for CONAD for the return of salvage and emphasis
passed through Delta Base. They were was placed on repair. After the return of
often transferred by Dukw from ships to the 231st Medical Composite Battalion
to Delta Base, CONAD was without any
24
Principal sources for this section are: (1) medical maintenance and repair service
Annual Rpt, Med Sec, MTOUSA, 1944, an. K; (2) of its own. Some repair work was farmed
Rpt of Med Sec, Hq, COMZ NATOUSA; (3) An- out to other military units, but many
nual Rpt, Med Sec, Delta Base Sec, 1944; (4)
Annual Rpt, Med Sec, CONAD, 1944; (5) Med items had to be shipped to Marseille for
Hist Data, 231st Med Composite Bn, 28 Oct 44; repair.
(6) Hist Journal, 231st Med Composite Bn, 13 Aug The transfer of supply functions to the
44-31 Dec 45; (7) Annual Rpt, 7th Med Depot
Co, 1944; (8) Davidson, Med Supply in MTOUSA, European theater was actively under dis-
150-56. cussion through October. The method
408 MEDITERRANEAN AND MINOR THEATERS
Source: Hist Journal, 231st Med Composite Bn, 13 Aug 44-31 Dec 45.
finally adopted was to transfer six officers Forward Surgery—Field hospital pla-
and twenty-six enlisted men, all special- toons, operating within litter-carrying
ists in medical supply, from Headquar- distance of the division clearing stations,
ters, COMZ NATOUSA, to Headquar- continued to be the primary unit for for-
ters, Southern Line of Communications. ward surgery. In the Southern France
The effective date of the transfer was 20 Campaign, these units were set up to
November 1944. accommodate a maximum of 60 patients.
The supply build-up in southern The number actually cared for at any
France is well shown by the record of one time was usually between 25 and 40.
receipts and issues of the 231st Medical Nontransportable patients went directly
Composite Battalion set forth in Table to these hospitals, where teams of the 2d
29. Auxiliary Surgical Group performed
such surgical procedures as were neces-
Professional Services in Southern sary to save life and limb and to put the
France patient in condition to be moved to an
evacuation hospital farther to the rear.
Medicine and Surgery Cases going to the field hospitals usually
included severe hemorrhage, wounds of
In both medicine and surgery, the the abdomen, severe chest wounds, multi-
practices developed in earlier Mediter- ple fractures, traumatic amputations, and
ranean campaigns carried over to south- those in immediate need of transfusion.
ern France. Medical officers and enlisted Other surgical cases went directly to
technicians who had gained their com- the evacuation hospitals, as did those
bat experience in North Africa, Sicily, who had received initial treatment in the
and Italy supplied the continuity, while field units. The forward evacuations
the theater consultants—Colonel Churc- were organized and their tents laid out
hill in surgery and Colonel Long in with the efficiency of the surgical service
medicine—gave the same attention to the as the main consideration. In periods of
medical service of Seventh Army, Delta heavy combat, evacuation hospital sur-
Base, and CONAD that they gave to geons worked as teams in 12- and some-
other armies and the base sections in the times 16-hour shifts, with operating
theater. rooms continuously in use. The maxi-
INVASION OF SOUTHERN FRANCE 409
25
mum holding period was seven days. tion of the 6707th Blood Transfusion
The theater consultant, Colonel Unit set up a blood bank in Marseille,
Churchill, spent three weeks visiting where donors were available among serv-
forward and base installations in south- ice troops. Many civilians were also in-
ern France, beginning 16 September. He duced to give blood by the offer of flight
was followed in mid-October by the rations to those who participated. A mo-
orthopedic consultant, Lt. Col. Oscar P. bile section operated in the forward area,
Hampton, Jr. The Seventh Army surgi- but the number of donors was too
cal consultant, Colonel Berry, was active limited to be relied upon.28
in organizing and supervising the surgi-
cal work of army hospitals from the Neuropsychiatry—The procedure for
start of the campaign.26 handling neuropsychiatric cases in Sev-
In addition to adequate supplies of enth Army was patterned on the increas-
penicillin, which had largely replaced ingly successful system developed in Italy
the sulfonamides, Seventh Army sur- by Fifth Army under the guidance of the
geons also had the advantage of daily theater neuropsychiatric consultant,
deliveries of whole blood. From D plus Colonel Hanson. Again continuity was
1until D plus 8, blood was flown from provided by transfer of personnel, in-
the 15th Medical General Laboratory in cluding the army consultant Major
Naples to Corsica and relayed to the in- Ludwig, who had been commanding offi-
vasion beaches by fast PT boats. There- cer of the Fifth Army Neuropsychiatric
after it was flown directly to the most Center.
forward airfield, where personnel of the Owing largely to the rapid initial ad-
6703d Blood Transfusion Unit received vance of Seventh Army, with accompany-
and distributed it on a priority basis first ing high morale among the combat
to the field hospital units, then to the troops, the incidence of psychiatric dis-
400-bed evacuations, and finally to the orders was low during the first month
750-bed evacuations. The field hospitals of the campaign. Beginning in mid-Sep-
averaged 3.5 to 4 units of whole blood tember, however, as the terrain became
per patient transfused, the evacuation more difficult, the weather deteriorated,
hospitals 2 to 2.5 units. Blood also came and enemy resistance stiffened, an in-
by way of Naples from the French blood creasing number of neuropsychiatric
bank in Algiers.27 casualties passed through the division
As the army moved forward and flight clearing stations. The three divisions of
distances from Naples lengthened, for- VI Corps had been in almost continuous
ward hospitals drew blood locally where- combat since the Salerno landings, and
ever possible and maintained small blood the impact of battle fatigue was cumula-
29
banks of their own. In November a sec- tive.
25 28
(1) Annual Rpt, Surg, Seventh Army, 1944. (2) Annual Rpt, Delta Base, 1944.
29
Annual Rpt, 2d Aux Surg Gp, 1944. (3) Annual Principal sources for this section are: (1)
Rpts, 1944, of l0th and nth Field Hosps; and 9th, After Action Rpt, Surg, Seventh Army, 15 Aug-31
nth, 27th, 51st, 59th, 93d and 95th Evac Hosps. Oct 44, an. 278; (2) Annual Rpt, Surg, Seventh
26
Annual Rpt, Med Sec, MTOUSA, 1944, an. E. Army, 1944; (3) Annual Rpt, 181st Med Bn, 1944;
27
(1) Annual Rpt, Surg, Seventh Army, 1944. (4) Annual Rpt, 616th Med Clearing Co, 1944;
(2) Quarterly Rpt, 15th Med Gen Lab, 3d Quarter (5) Annual Rpts, 1944, of hosps mentioned in the
1944. text.
410 MEDITERRANEAN AND MINOR THEATERS
LAST STAGES OF WHOLE BLOOD PIPELINE. PT boat about to deliver whole blood to Dukw
for transfer to invasion beach.
The basic consideration was to treat which a psychiatric diagnosis was made
neuropsychiatric casualties as far for- at an evacuation hospital were also trans-
ward as possible. Cases were first ex- ferred to the center without further
amined by the division psychiatrists in treatment.
the clearing stations, where every effort At the center, treatment followed the
was made to get the men back into com- pattern used in Fifth Army. Patients
bat without delay. Those that did not were kept under mild barbiturate seda-
respond promptly were sent to the tion for twenty-four hours, but were
Seventh Army Neuropsychiatric Center, maintained in ambulatory status. After
operated by the 2d Platoon of the 616th the initial period of rest and quiet, they
Medical Clearing Company, 181st Medi- were interviewed and a course of therapy
cal Battalion. The center had a staff of prescribed. Patients were kept active and
eighty-five enlisted men, with four psy- were urged to interest themselves in the
chiatrists attached. The chief of the recreational and orientation facilities of
psychiatric service was Capt. (later the hospital.
Maj.) Stephen W. Ranson. All cases in Every effort was made to dispose of
INVASION OF SOUTHERN FRANCE 411
cases as quickly as possible. Except in control, there were few problems in pre-
special circumstances, four days was the ventive medicine. Most serious of these
maximum holding period. Those who was venereal disease control. Malaria
could be returned to duty were then re- had been anticipated as a problem and
equipped and sent back to their own prepared for, but proved to be minor.
divisions without passing through a re- Trench foot was developing into a prob-
placement command. Those who needed lem of major concern at the time opera-
further care went to a fixed hospital for tions passed to ETO.
more extensive treatment. Evacuation to
Italy was necessary for a time, but among Venereal Disease Control—The Sev-
the fixed units transferred to southern enth Army Venereal Disease Treatment
France the 3d General Hospital at Aix- Center, operated by the 616th Medical
en-Provence was equipped to handle psy- Clearing Company, 181st Medical Bat-
chiatric cases, while the 51st Station, talion, was initially overloaded with
which opened on 4 November at cases contracted in Italy during the stag-
Auxonne, was exclusively a neuropsychi- ing period. The hospital, staffed by 8
atric installation. officers and 93 enlisted men, had a
Returns to duty from the division planned capacity of 250, but had to ex-
clearing stations were 50 percent of all pand almost immediately to 375 beds.30
neuropsychiatric cases treated for the Additional contacts were made in the
period 15-31 August, 37 percent for the coastal area, but as the army advanced
period 1-15 September, and 23 percent northward through predominantly agri-
for the period 16-30 September. Re- cultural country, opportunities for sex-
turns to duty from the Seventh Army ual contacts lessened. The rapidity of
Neuropsychiatric Center and other movement also helped to reduce the
Seventh Army hospitals for the same
periods were 29 percent, 11 percent, and 30
Primary sources for this section are: (1) An-
12 percent, respectively. nual Rpt, Surg, Seventh Army, 1944; (2) Annual
Rpt, 181st Med Bn, 1944; (3) Ltr, Col Barnes, VD
consultant, MTOUSA, to Surg, MTOUSA, 2 Nov
Preventive Medicine 44. Sub: Venereal Disease Control Activities in
Seventh Army, Continental Base and Delta Base
Secs; (4) Annual Rpt, Med Sec, MTOUSA, 1944,
During the period that southern an. J; (5) Annual Rpt, Med Sec, Delta Base, 1944;
France was under Mediterranean theater (6) Annual Rpt, Med Sec, CONAD, 1944.
412 MEDITERRANEAN AND MINOR THEATERS
venereal rate. (Table 30) In the main, Individual preventive and suppressive
the preventive measures taken under the measures were continued until 11 Octo-
direction of Major (later Lt. Col.) ber, but were then discontinued as of no
James E. Flinn, Seventh Army venereal further value, and Major Hill returned
disease control officer, were effective. to the 2655th Malaria Control Detach-
31
These included an intensive educational ment in Italy.
program in the individual units, with The 132d MCU went to the Coastal
emphasis on the importance of immedi- Base Section in September, being re-
ate prophylaxis; rigid enforcement of placed in Seventh Army by the 131st
off-limits restrictions on known brothels; MCU from Corsica. In October the 132d
and curfew hours that limited the time went to CONAD and the 131st to Delta
available for contacts. The rapidity of Base. Both passed to ETO in November.
cures, under the new penicillin treat- Neither of these units, however, engaged
ment, tended to discourage any deliber- in actual malaria control work. Inspec-
ate exposure to escape hazardous duties. tion of the Marseille area immediately
Acute gonorrhea cases were returned to after occupation of the city revealed no
duty from the Venereal Disease Center malaria-infested mosquitoes, and none
within twelve hours, and mild cases were were found in the advance north. The
treated on duty status. malaria control units, under both army
In the base sections, particularly in and base section jurisdiction, were used
Delta Base, the problem was more dif- primarily for fly, roach, and bedbug con-
ficult. Two metropolitan prophylactic trol, and for general sanitation work.
stations were established in Marseille,
but more were needed. All of the 31 Trench Foot—Trench foot appeared
licensed houses of prostitution in that among Seventh Army troops toward the
city were placed off-limits, but indica- end of September, becoming an increas-
tions were that the women simply moved ingly severe problem through the suc-
to rooms and to small hotels, where they ceeding months, but that story belongs
were even harder to control. Five rather to the ETO than to the MTO
brothels in Dijon were also placed off- period. The major contributing factor
limits apparently with more effect. Dis- was the same as it had been in Italy–
pensaries and fixed hospitals in CONAD cold and wet weather in which men at
saw relatively few venereal cases. the front had no opportunity to change
socks or dry their feet for days at a time.
Malaria—A malaria problem in south- Wool socks and shoe pacs were issued,
ern France had been anticipated during but only after the condition had ap-
the planning of DRAGOON, and a malari- peared. Even had they been available at
ologist, Maj. Arthur W. Hill, was at- the start of the bad weather, however,
tached to Seventh Army, together with they would have had only a minimal
the 132d Malaria Control Unit. While
a considerable number of cases were 31
Principal sources for this section are: (1) An-
treated in the early weeks of the cam- nual Rpt, Med Sec, MTOUSA, 1944, an. J; (2)
Annual Rpt, Surg, Seventh Army, 1944; (3) Annual
paign, they were virtually all contracted Rpt, Med Sec, CONAD, 1944; (4) Annual Rpt,
in Italian staging areas before sailing. 9th Evac Hosp, 1944.
INVASION OF SOUTHERN FRANCE 413
preventive effect, since the nature of the this nucleus of five officers, clinics are
action required that men stay in the lines established in rearward areas in the most
for considerable periods of time.32 feasible locations and a large volume of
work accomplished during actual combat.
The other dental officer of each infantry
Dental Service regiment is left with the regiment and the
officer assigned to artillery is left with the
During the staging period before division artillery. In addition to providing
leaving Italy, Seventh Army dental of- emergency treatment these officers are also
able to accomplish some constructive
ficers, under the direction of Colonel dentistry. A prosthetic laboratory truck has
Gurley, Seventh Army dental surgeon, been constructed and is placed in operation
made every effort to bring the dental wherever the rearward clinic is es-
health of the assault troops to a high tablished.34
level. Except for emergencies, little den- In the base sections dental work was
tal work was possible during the early performed by dental personnel of the
weeks of the invasion. Ninety percent of fixed hospitals.
the division dental officers did none at
all until D plus 15, functioning during Veterinary Service
that period in various medical and ad-
ministrative capacities. The dental serv- The first veterinary unit to arrive in
ices of the evacuation hospitals and of southern France was the 890th Medical
the combat divisions were supplemented Service Detachment (formerly T Detach-
around the beginning of October by two ment), which had been active in the
dental prosthetic teams assigned to the theater since North African days. The
7th Medical Depot Company and a unit landed on the invasion coast on D
third assigned to serve U.S. troops oper- plus 8—23 August—and began super-
ating with 1st French Army.33 vising the issue of field rations at quarter-
Inspection of the combat dental serv- master Class I supply dumps in the beach
ice of Seventh Army early in October by area. Throughout the period of MTO
the theater dental surgeon, Colonel control, the detachment worked in close
Tingay, revealed no dental problems. co-operation with the Seventh Army
Colonel Tingay was particularly im- quartermaster section, supervising the
pressed by the manner in which the den- issue of rations at army railheads.35
tal work of the 3d Division was being The 45th Veterinary Company (Sep-
carried on. He reported: arate) arrived on schedule on D plus 20
(4 September) . The veterinary detach-
One officer from each infantry regiment,
the officer assigned to special troops and ments, consisting of 3 officers and 12
one officer from the medical battalion have enlisted men each, of the 601st and 602d
been attached to the division surgeon's Field Artillery Battalions arrived about
office and thus come under the direct con-
trol of the Division Dental Surgeon. With
34
Rpt of Inspection by Col Tingay, 9 Oct 44.
32 35
(1) Annual Rpt, Surg, Seventh Army, 1944. (2) Principal sources for this section are: (1) An-
Annual Rpt, Surg, VI Corps, 1944. (3) Annual nual Rpt, Surg, Seventh Army, 1944; (2) Annual
Rpt, Surg, 3d Inf Div, 1944. Rpt, 17th Vet Evac Hosp, 1944; (3) Annual Rpt,
33
(1) Annual Rpt, Surg, Seventh Army, 1944.45th Vet Co (Separate) , 1944; (4) Annual Rpt,
(2) Annual Rpt 7th Med Depot Co, 1944. Med Sec, CONAD, 1944.
414 MEDITERRANEAN AND MINOR THEATERS
the same time, together with 1,200 ani- Three days later the 45th Veterinary
mals of the 2 units. The 601st had come Company, less its 2d Platoon, moved to
in by glider as a component of the 1st Sisteron, some 75 miles south of
Airborne Task Force, and was then fight- Grenoble. The unit moved once more,
ing in the Maritime Alps, where it was to Gap, on 29 September.
joined by the 602d, its animals and its On 24 September both the 17th Vet-
veterinary personnel. The animals were erinary Evacuation Hospital and the 45th
shipped from Italy on LST's whose holds Veterinary Company were attached for
had been converted to stall space by the operational control to First French
use of earth and sandbags. The 2d Pla- Army, which had 6,000 animals in the
toon of the 45th Veterinary Company Maritime Alps between Nice and the
was assigned to support the two field Swiss border and another 6,000 in
artillery battalions, while the balance of the Vosges area. From the Vosges,
the company went to Lons-le-Saunier for French animal casualties went to Gre-
staging. noble by animal hospital train. Though
The Seventh Army veterinary sur- its Table of Organization stall capacity
geon, Colonel Stevenson, arrived in was only 150, the 17th Veterinary Evacu-
southern France on D plus 25, or 9 ation Hospital operated up to 236 stalls.
September, along with the 17th Veteri- In the base sections, as distinct from
nary Evacuation Hospital, of which he the army area, the veterinary service was
had been commanding officer. The hos- confined primarily to inspection of cold
pital staged for a few days at St. Raphael, storage plants for perishable foods and
then opened on 18 September in a continuous inspection of locally proc-
French artillery barracks at Grenoble. essed foodstuffs.
CHAPTER XI
teams on temporary duty from general 1943. He had escaped after more than
hospitals in the theater only partially seven months in German prison camps,
replacing the twenty-eight teams with- and for almost a year had been serving
drawn for service with Seventh Army; with a band of Italian partisans in the
the 2d Medical Laboratory; the 12th Florence area.
Medical Depot Company; and miscel- As of 16 August, divisional and corps
laneous minor units. Even to support the medical units were with their respective
divisions composing Fifth Army as of 16 combat elements, taking advantage of
August 1944, these medical units were the lull to rest personnel and re-equip.
inadequate, particularly so in 400-bed Fifth Army hospitals were disposed in a
evacuation hospitals, which had previ- roughly quadrangular area whose cor-
ously been assigned in the ratio of at ners were Cecina and Leghorn on the
least one to each combat division. Task coast and Volterra and Peccioli about
Force 45, moreover, had no organic med- twenty miles inland. All were in opera-
ical support other than the medical de- tion except the 16th Evacuation Hospi-
tachments of its component units; the tal, which had closed at Ardenza just
92d Division and the Brazilian Expedi- south of Leghorn on 12 August but had
tionary Force, both on the way to the not yet moved elsewhere.
combat zone, were without hospitals.2
At the corps and division levels, medi- Mounting the Attack
cal support remained substantially as it
had been in earlier Fifth Army cam- Planning and Regrouping—Plans de-
paigns. Each of the two corps had a medi- veloped during July called for an early
cal battalion assigned, the 54th to II resumption of the offensive, with Fifth
Corps and the 163d to IV Corps; and Army launching the main attack on the
each combat division had its own or- Gothic Line by way of Highway 65. The
ganic medical battalion. The Brazilian strength of the enemy positions in the
medical organization at the division level Futa Pass area, however, led General
was substantially the same as the Ameri- Alexander to shift the main attack to the
can. Eighth Army front, where a flanking
The l09th Medical Battalion, organic movement along the Adriatic offered
to the 34th Division, received an unex- promise of quicker results. It was antici-
pected but welcome visitor on 13 August pated that Generalfeldmarschall Albert
when Capt. Francis Gallo of Company C Kesselring would have to concentrate
walked into battalion headquarters. Cap- the bulk of his forces against Eighth
tain Gallo had been captured in the Army. Fifth Army would then attack
Kasserine breakthrough of February along the axis of Highway 6524 toward
II Giogo Pass. The success of the opera-
2
Sources for this section are: (1) Annual Rpt, tion depended on co-ordination and
Surg, Fifth Army, 1944; (2) Annual Rpt, Surg, II
Corps, 1944; (3) Annual Rpt, Surg, IV Corps, 1944;
timing.
(4) Unit rpts of med units mentioned in the text. By way of preparation, the boundary
The Brazilian Expeditionary Force brought its between Fifth and Eighth Armies was
own medical officers, nurses, and enlisted tech-
nicians, who were attached to U.S. hospitals. See
redrawn twenty miles east of Florence,
pp. 439, 440-41, below. and 13 Corps, which had held Eighth
418 MEDITERRANEAN AND MINOR THEATERS
Army's left flank, was transferred to Army front to meet General McCreery's
Fifth Army. The 13 Corps left boundary challenge.
was shifted east to pass through Florence, As early as 31 August there was evi-
and II Corps, which was to spearhead dence that the Germans all along the
the Fifth Army attack, was concentrated Fifth Army front were pulling back to
along a 5-mile front west of the city. IV the prepared positions of the Gothic
Corps, which was to perform a holding Line. IV Corps sent reinforced patrols
function, occupied the remainder of the across the Arno the night of 31 August—1
Fifth Army front extending some forty September, and followed up in force
miles from the II Corps boundary to the during the morning. By the end of 2
sea. September, the bulk of IV Corps was
Regrouping for the assault brought north of the river, and the two major
the 34th Division and the 442d Regi- hill masses commanding the Arno plain,
mental Combat Team (less its l00th Mts. Pisano and Albano, were in Allied
3
Battalion) under II Corps control, hands. Over the next ten days IV Corps
along with the 85th, 88th, and 91st Divi- pushed across the plain and into the
sions. IV Corps retained Task Force 45 lower slopes of the Apennines, securing
and the 1st Armored, and was given the the Autostrada—the excellent road con-
6th South African Armoured Division necting Highway 1 north of Pisa with
from 13 Corps. The all-Negro 92d Divi- Florence—and liberating the cities of
sion and the Brazilian Expeditionary Lucca, Montecatini, Pistoia, and Prato.
Force of somewhat more than division On the right flank, 13 Corps had al-
strength were also assigned to IV Corps, ready secured a bridgehead north of the
but only the 370th Combat Team of the Arno from Florence east to Pontesieve
92d reached the corps area in time for during the last week of August. On1
the attack. The first Brazilian increment, September II Corps crossed the river,
the 6th RCT of the 1st Brazilian Divi- and both II Corps and 13 Corps moved
sion, went into the line on 15 September. forward to assembly areas. Originally
scheduled for 6 September, D-day for
Preliminary Maneuvering—E i g h t h the Fifth Army assault on the Gothic
Army jumped off on 25 August, and by Line was postponed until the 10th to
6 September, when heavy rains inter- take advantage of further enemy with-
rupted the advance, had broken through drawals. When the attack was finally
the Adriatic anchor of the Gothic Line launched, the Fifth Army front was ten
to a position only six miles south of miles north of the Arno, and by 12 Sep-
Rimini where Highway 9, the best lat- tember leading elements of both II and
eral road north of the mountains, 13 Corps were probing the outer de-
reached the coast. The enemy had com- fenses of the Gothic Line.
mitted all his reserves and had shifted
three of his best divisions from the Fifth Medical Preparations—Organic and
corps medical battalions moved forward
3
with the combat elements they sup-
The 442d Regiment, including the l00th Bat-
talion from Task Force 45, was withdrawn the first ported. Medical troops had been rested,
week in September for shipment to France. and most had received additional train-
THE NORTHERN APENNINES 419
ing in the handling of casualties in ing Mt. Monticelli, the left bastion of
mountainous terrain. To preserve the pass.5
secrecy, however, the hospitals were On 13 September the 91st Division
not moved up before the attack was sideslipped to the left of Highway 6524
launched, but were infiltrated into new while the 85th Division moved in be-
areas. The 16th Evacuation Hospital was tween that road and the British sector
established at San Casciano about 10 on the right. After four days of hard
miles south of Florence, on 26 August, fighting, the 85th secured Mt. Altuzzo
followed four days later by the neuropsy- on 17 September while the 91st was
chiatric center. On 1 September the 8th storming Mt. Monticelli. By the end of
Evacuation moved into the same area. the day, 18 September, II Giogo Pass
The 94th Evacuation moved to Castel- had been outflanked from both sides,
fiorentini, some 20 miles southwest of and II Corps had broken through the
Florence, on 17 August, and on 9 Sep- Gothic Line on a 7-mile front.
tember advanced to Pratolino on High- The strategically placed town of
way 65 about 6 miles north of the city. Firenzuola fell to the 85th Division on
The 15th Evacuation Hospital set up in 21 September. There the road turned
Florence itself on 10 September, fol- sharply left to rejoin Highway 65, while
lowed by the venereal disease center on another secondary road, Highway 6528,
the 13th. On 15 September the 38th Evac- branched off along the Santerno River
uation opened near Pisa to serve units northeast to Imola, where it intersected
on the IV Corps left flank.4 Highway 9 on the edge of the Po Valley.
The 34th Division, meanwhile, had
Combat Operations exerted constant pressure in the area be-
tween Highway 65 and the IV Corps
Breaching the Gothic Line zone to keep the enemy from shifting
forces to the II Giogo battle. On 21 Sep-
On 12 September the 34th Division
was in contact with the main defenses
5
of the Gothic Line to the left of High- Principal sources for this section are: (1) Fifth
Army History, pt. VII; (2) Opns Rpt, II Corps,
way 65. The 91st Division was astride Sep 44; (3) Opns Rpt, IV Corps, Sep 44; (4) Field
Highway 6524, which branched off to the Marshal the Viscount Alexander of Tunis, "The
right from Highway 65 about twelve Allied Armies in Italy from 3rd September, 1943, to
12th December, 1944," Supplement to the London
miles north of Florence. To the right of Gazette, 6 June 1950, pp. 2940-60; (5) Clark, Cal-
the 91st, the 1st British Division of 13 culated Risk, pp. 394-403; (6) Kesselring, Soldier's
Corps was abreast of the two U.S. divi- Record, pp. 254-64; (7) Howe, 1st Armored Di-
vision, pp. 369-86; (8) Schultz, 85th Division, pp.
sions. Elements of the 91st were at the 109-84; (9) Delaney, Blue Devils, pp. 126-62;
base of Mt. Altuzzo, which overlooked (10) Robbins, 91st Division, pp. 92-194; (11) Maj.
II Giogo Pass from the right, while Paul Goodman, A Fragment of Victory in Italy
During World War II, 1942-1945 (Carlisle Bar-
other 91st Division units were approach- racks, Pa.: Army War College, 1952), pp. 25-56;
(12) Sidney T. Mathews, "Breakthrough at Monte
Altuzzo," Three Battles: Arnaville Altuzzo, and
Schmidt, UNITED STATES ARMY IN WORLD
4
(1) Annual Rpt, Surg, Fifth Army, 1944. (2) WAR II (Washington, 1952); (13) Starr, ed.,
Periodic rpts of med units mentioned in the text. From Salerno to the Alps, pp. 301-64.
420 MEDITERRANEAN AND MINOR THEATERS
tember the 34th also broke through the where IV Corps was thinly spread to
Gothic Line to the west of Futa Pass, hold rather than to advance, the Ger-
which now became untenable for the man line had been penetrated at several
Germans. Though the strongest point of points.
the Gothic Line, Futa Pass fell on 22 In less than two weeks, Fifth Army
September to a single battalion of the had broken through the strong defensive
91st Division. positions of the Gothic Line on a 30-mile
On the right flank of Fifth Army, 13 front from Vernio on Highway 6520 to
Corps followed Highway 6521 toward San Godenzo Pass on Highway 67. With
Faenza, and Highway 67, which swings several alternatives now available to
north beyond Florence in the direction him, General Clark sent II Corps down
of Forli and Ravenna. Leading elements the Santerno Valley toward Imola, while
of the corps had passed through the 13 Corps struck in the direction of
Gothic Line along both axes of advance Faenza. These were the shortest routes
by 21 September. Even on the left flank, to the Po Valley and promised the great-
THE NORTHERN APENNINES 421
Despite cold weather, driving rain, prevented effective air support. A mas-
and fog that set in the second day of the sive bombing of enemy supply dumps in
attack, the Monghidoro line was overrun the Bologna area was the only significant
along a 16-mile front by 4 October, and air activity in the period.
the Loiano line by the 9th. But rain, fog, For another week II Corps struggled
mud, and fatigue were taking their toll, forward against increasingly strong op-
and resistance was stiffening as the position, but it was a losing gamble.
enemy concentrated his forces to meet With Eighth Army immobilized by soft
the threat to Bologna, his major supply ground and flooded streams on the
and communications center. fringe of the Po plain, II Corps now
For the next phase of the drive the faced the best German units in Italy.
front was still further narrowed, the 34th Machine guns and mortars were hand-
Division moving over to the right of carried up mountain trails. Rations and
Highway 65, between the 91st and 85th, ammunition were brought up by mule
and the 88th Division sideslipping to its pack, but even mules could not move
own left into the Sillaro Valley, as the the heavy guns through the mud. The
British 78th took over the Santerno 91st Division tried oxen, but with no
Valley sector. Again the objective was at- better success. After 17 October, when
tained, the Livergnano line being over- the 697th and 698th Field Artillery Bat-
run by 15 October, but again the pace talions were withdrawn for shipment to
was slowed, and losses were heavy and France, there were no heavy guns to
cumulative. move, and by the last week of October
For the 6-day period 10-15 October, ammunition was in such short supply as
II Corps lost 2,491 battle casualties. The to require drastic restrictions on its use.
total since the start of the Bologna drive The last straw was added on 26 Octo-
on 1 October was 5,699, and since the ber when torrential rains washed out
beginning of the offensive on 10 Septem- roads and bridges. In rare intervals of
ber, 12,210, or nearly a full division. The clear weather, the Po Valley was visible
loss of an actual division would have in the distance, but Bologna was still
been less severely felt, because losses nine heartbreaking miles away. General
were disproportionately high among Keyes ordered II Corps to fall back to
junior officers. Returns to duty made up defensible positions and dig in.
only a fraction of the losses. Replace- On the IV Corps front, activity came
ments were not available in sufficient to a halt at the same time. Although
numbers, and were inexperienced at the corps had been stripped to hardly
best. Battlefield commissions given to more than the strength of a reinforced
enlisted men made up some of the officer division, some advances had been made.
losses, but seasoned noncommissioned Task Force 92, consisting of the 370th
officers were in equally short supply. To RCT and antiaircraft units detached
personnel shortages had to be added from Task Force 45, had advanced up
general fatigue, muddy and mountain- the coast a few miles beyond the resort
ous terrain that hampered the move- city of Viareggio, while the Brazilian
ment of supplies and restricted the 6th Combat Team had moved so far into
mobility of artillery, and weather that the Serchio Valley in the center of the
THE NORTHERN APENNINES 423
way. The 365th and 371st Regimental where it had served with Seventh Army
Combat Teams of the 92d Division and since the end of September and had
the 1st and 11th RCT's of the 1st Brazil- again demonstrated its outstanding fight-
ian Division arrived in the combat zone ing qualities. The Italian Legnano
in October and, after intensive training, Group, with a strength of about two-
were ready for action in November. An- thirds of a division, was also attached to
other combat team—the 366th, made up Fifth Army in March.
of men from other branches converted to Shifts of units between corps, and ro-
infantry—was assigned to Fifth Army in tation in the line, were motivated pri-
November and attached to the 92d Divi- marily by the need to rest veteran troops
sion. A newly arrived light tank battal- and to give some experience to new ones.
ion, the 758th, and the 1125th Armored Training was a continuous process at all
Field Artillery Battalion formed from levels, including an officer candidate
inactivated antiaircraft units, were also school set up in February. Meanwhile
attached to the 92d, while II Corps re- supplies of ammunition were building
ceived a battery of British heavy guns. up; trucks, tanks, and other vehicles were
In addition to these organized units, being repaired; worn-out equipment was
Fifth Army received 5,000 individual re- being replaced. At the staff level, plans
placements in November, but was still for the spring offensive were being
7,000 men below Table of Organization drawn.
strength. With snow blanketing the peaks and
In January more antiaircraft units, in- filling the mountain passes, little action
cluding most of those operating under of any kind was possible during the win-
Task Force 45, were reorganized as the ter months, although vigorous patrolling
473d Infantry regiment. Also in Janu- continued along the entire front. In the
ary, the most important of all Fifth 13 Corps zone an attempt to seize the key
Army's reinforcements arrived when the town of Tossignano on the Imola road
10th Mountain Division, a highly early in December was repulsed with
trained outfit of picked men, reached the heavy losses. Late in the same month, an
combat zone. These increments made it indicated build-up of enemy strength in
possible to return 13 Corps to Eighth the thinly held IV Corps sector led to an
Army, with a corresponding realignment attack by the 92d Division in the Serchio
of the army boundaries, although the Valley, but the Germans, already on the
6th South African Armoured and the 8th move, quickly seized the initiative and
Indian Divisions remained with Fifth gained considerable ground before the
Army. 8th Indian Division could move up from
No reinforcements were received in army reserve to re-establish the original
February, and late in March the 366th line.
Infantry, which had not worked out well Early in February the 92d undertook
as a combat unit, was disbanded, its per- another limited offensive to improve its
sonnel being converted to service troops. positions on the left flank, but with little
The loss was more than balanced, how- success. The 365th and 366th RCT's se-
ever, by the return of the 442d Regi- cured their objective, the command-
mental Combat Team from France, ing ridge of Mt. della Stella in the
THE NORTHERN APENNINES 425
Serchio Valley, on 5 February, but could Gothic Line battles and the push toward
not hold the position against counter- Bologna, the nature of the terrain re-
attacks in force over the next several duced much of the fighting to a series of
days. The 370th and 371st RCT's, seek- small unit actions involving no more
ing to advance to Massa along the narrow than a battalion and often less. To care
coastal plain, ran into dense mine fields for casualties in such engagements, the
and fierce resistance that forced them medical service, too, had to function in
back to their original positions with small units, with numerous forward aid
heavy losses in both men and tanks after stations and long litter hauls. The period
three days of fighting. In the II Corps of stalemate was an unending battle
area, an attempt to improve their posi- against cold and dampness waged by
tions by elements of the 34th Division small detachments of medical troops
was similarly thrown back with heavy close to the outposts, with long evacua-
losses. tion lines to hospitals withdrawn to win-
Only in the area to the left of Highway ter positions. In short, Fifth Army's
64, which figured prominently in Gen- second winter in Italy was a repetition of
eral Truscott's plans for the spring offen- the first.
sive, was any substantial success gained.
There the 10th Mountain Division and Period of Active Combat
the 1st Brazilian Division, in brilliant
maneuvering over terrain as rugged as Medical Support of II Corps—The
any in the Apennines, retook the long- tasks imposed on the medical battalions
disputed Mt. Belvedere and a dozen and field hospitals supporting II Corps
peaks beyond it, giving Fifth Army both in the Gothic Line battles and the sub-
excellent observation into the Po Valley sequent drive toward the Po Valley were
and good positions from which to launch the most difficult of the Italian cam-
further drives, at the same time securing paign. The main highways were heavily
a l0-mile stretch of Highway 64 from traveled, often under artillery fire, and
the threat of enemy shelling. These ac- always at a distance from the actual
tions, which were carried out between fighting. Secondary roads were few, nar-
18 February and 9 March, won for the row, heavily mined, and by October
10th Mountain Division the spearhead deep in mud. Bypasses built by II Corps
role in the forthcoming Po Valley Cam- engineers were generally open only to
paign. one-way traffic, imposing dangerous de-
8
lays on ambulances.
Medical Support in the Field 8
Principal sources for this section are: (1) An-
nual Rpt, Med Sec, MTOUSA, 1944; (2) Annual
The conditions under which the Fifth Rpt, Surg, Fifth Army, 1944; (3) Annual Rpt, Surg,
Army medical service operated in the II Corps, 1944; (4) Annual Rpts, Surgs, 34th, 85th,
88th, 91st Divs, 1944; (5) Annual Rpt, 54th Med
northern Apennines were very similar to Bn, 1944; (6) Monthly Rpts, l09th Med Bn, Sep,
those experienced in the fall and winter Oct, 44; (7) Monthly Rpts, 310th Med Bn, Sep,
of 1943 in the Cassino area, save only Oct 44; (8) Monthly Rpts, 313th Med Bn, Sep, Oct
44; (9) Weekly Rpts, 316th Med Bn, Sep 44; 316th
that the northern mountains were higher Med Bn Hist. (10) Annual Rpts, 92d, 33d Field
and the weather worse. During the Hosps, 1944.
426 MEDITERRANEAN AND MINOR THEATERS
Division clearing stations with their point east of Highway 65 about three
attached field hospital units were neces- miles north of the road junction. The
sarily restricted to sites accessible to the site was easily accessible but was sur-
main highways. As the rainy season ad- rounded by heavy guns, which invited
vanced, suitable locations were increas- counterbattery fire and led the unit
ingly difficult to find, making close sup- historian to describe it as an ambulance
port impossible and forcing additional driver's dream but a psychiatrist's night-
burdens on the collecting companies. mare. The supporting platoon of the
Jeeps were used to evacuate battalion 33d Field Hospital was established in a
aid stations wherever possible, but even somewhat safer spot on the west side of
these versatile vehicles could not nego- Highway 65 in the vicinity of Cafaggiolo.
tiate many of the mountain trails, leav- Both units, for want of suitable forward
ing long and hazardous litter carries the sites, remained in place throughout the
only alternative. In some sectors, sup- Gothic Line battles. The 91st had a more
plies and equipment were brought up difficult assignment than the 34th, and
by mule; in others hand-carrying was heavy casualties began coming into the
necessary. clearing station on 11 September. A peak
The assault on the Gothic Line was of 409 admissions was reached on the
launched initially by the 34th and 91st 15th.
Divisions along the axis of Highway 65. The 85th Division went into action on
The clearing station of the 109th Medi- 13 September along the axis of Highway
cal Battalion, organic to the 34th, moved 6524. The clearing station of the organic
up from the assembly area on 12 Septem- 3l0th Medical Battalion, together with a
ber to a site left of Highway 65, about platoon of the 32d Field Hospital,
5 miles northwest of the point at which opened about two miles southwest of
Highway 6524 branches off toward Scarperia the following day, although
Scarperia and Firenzuola. There it was the area was well within range of enemy
joined by a platoon of the 33d Field guns. The field hospital stayed behind
Hospital, both units remaining in place when the clearing station moved on 23
until after the Gothic Line had been September to a new area a mile south of
breached. The station admitted 244 pa- Firenzuola, another platoon of the 32d
tients on 17 September, its largest single Field moving up to take its place ad-
day's total for the campaign. The clear- jacent to the clearing station. Both hospi-
ing station moved forward on 27 Sep- tal and station were forced by enemy fire
tember to a site on Highway 65, about to abandon the site within two hours. A
3 miles south of Futa Pass, where it re- new location somewhat farther to the
mained until early October. During this rear was occupied on 25 September, but
period, collecting companies of the bat- the access road was soon knee deep in
talion operated up to 10 miles beyond mud. Until the station moved at the end
the clearing station. of the month it was necessary to keep a
The clearing station of the 316th Med- maintenance truck available to haul out
ical Battalion, organic to the 91st .Divi- mired ambulances.
sion, remained in the assembly area until Two days after commitment of the
15 September, when it advanced to a 88th Division on 22 September, the
THE NORTHERN APENNINES 427
clearing station of the organic 313th Platoon moving to San Benedetto north-
Medical Battalion opened in the vicinity west of the pass four days later. Neither
of San Pellegrino on the Imola road. A site was satisfactory, and the 1st Platoon
platoon of the 32d Field Hospital caught shifted to Monghidoro on the 12th,
up with the station there on 26 Septem- where it occupied a battered resort hotel
ber. It was here that casualties from the building. The 2d Platoon set up in tents
bloody battle for Mt. Battaglia were re- in the same area three days later. The
ceived after litter carries up to 4.5 miles. supporting platoon of the 33d Field Hos-
To man the relay posts along the steep, pital was already in Monghidoro, having
treacherous evacuation trail, emergency moved up on 9 October.
bearers were pressed into service from Although 34th Division casualties
among line troops, medical battalion were relatively light in October, diffi-
headquarters, and the clearing company culties in evacuation continued to re-
in addition to those borrowed from the quire litter bearers in excess of those
54th Medical Battalion at corps level. allotted. Men from kitchen and station
The second phase of the North Apen- sections of the collecting companies were
nines Campaign, from the 1 October used for this purpose, and in emergencies
assault on the Monghidoro line to the line soldiers were borrowed from the
final breakdown in the mud before combat units. Among the hazards were
Pianoro, saw some of the hardest fighting floods, landslides, and consistently poor
of the entire war in Italy and the most visibility due to fog and rain. At night
difficult period for the medical service. ambulance drivers benefited from "ar-
Fatigue, exposure, and almost contin- tificial moonlight" produced as an aid
uous rain and cold took a heavier toll in to transportation generally by beaming
respiratory diseases, trench foot, and psy- searchlights in low trajectory over the
chiatric disorders than enemy weapons area.
took in wounded men, yet the battle By 1 October, clearing stations of the
casualty rate was higher than for any 85th and 91st Divisions were in the vi-
comparable period since the Salerno cinity of the road junction where High-
landings.9 way 6524 rejoins Highway 65, with the
Field medical installations of II Corps 2d Platoon of the 33d Field Hospital sup-
were relocated early in October, reflect- porting both. The hospital unit received
ing the shift of emphasis back to High- the greatest number of patients in its
way 65. Its site below Futa Pass already history for a comparable period at this
a quagmire, the 1st Platoon of the 34th site—228 nontransportable priority sur-
Division clearing station jumped ahead gical cases in a 14-day period. On 10 Oc-
fourteen miles on 4 October to a site tober the 85th Division clearing station
southwest of Radicosa Pass, with the 2d moved into the Idice Valley, about 5
9
miles southeast of Loiano. The clearing
For Fifth Army as a whole the wounded in ac-
tion rate for October 1944 was 783 per 1,000 per
station of the 91st moved on 21 October
annum, as compared with 973 for September 1943. to a site about 2 miles south of Loiano,
For II Corps the October 1944 rate was 1,219 with but the supporting platoon of the 33d
an admission rate from all causes of 2,970 per 1,000
per annum. See Annual Rpt, Surg, Fifth Army,
Field Hospital was soon rendered use-
1945, p. 63, and Annual Rpt, Surg, II Corps, 1944. less because mud made it impossible to
428 MEDITERRANEAN AND MINOR THEATERS
deliver patients to it. The engineers had evacuated to the 88th Division clear-
to construct a special road of rocks, ing station by a devious route involving
straw, burlap, and landing-strip matting the use of artillery prime movers to cross
to get the hospital out early in Novem- swollen streams and the transfer of pa-
ber. A platoon of the 32d Field Hospital tients from one ambulance to another
was established about a mile north of on each such occasion. The 88th Division
Monghidoro on 13 October, primarily in clearing station also took casualties from
support of the 85th Division, though it elements of the 1st Armored, which were
was some 3 miles distant from the divi- moved into the line on the corps right
sion clearing station in a direct line and flank at this time. In several sectors am-
nearer 10 miles by road. bulances were washed into the streams
With the shift of the 88th Division and temporarily immobilized if they
to the Sillaro Valley, the clearing station were not lost altogether. Vehicles of all
was set up 6 October at Giugnola, and types were punished unmercifully, with
the supporting platoon of the 32d Field broken springs a commonplace. Nor
Hospital at Belvedere a mile or so closer were vehicles the only casualties. Litter
to the front. The 54th Medical Battal- bearers were frequently under fire and
ion, responsible for evacuating the II exposed to booby traps and the hazards
Corps clearing stations, moved its head- of steep mountain trails in darkness. The
quarters to the vicinity of Traversa, a toll of killed and wounded among them
mile north of Futa Pass, on 3 October. was high.
In order to give close support to the During the period 10 September-
combat troops, the collecting companies 31 October, the strength of the 54th
of the divisional medical battalions often Medical Battalion was augmented by
operated in two sections, the advance a collecting company of the 162d Med-
station being as close as possible to the ical Battalion and elements of two am-
regimental combat zone. The ambu- bulance companies from Fifth Army, all
lances were kept at the forward post and of them being used to evacuate division
the litter squads at the battalion aid sta- clearing stations. The corps medical bat-
tions, which were themselves often split talion also supplied to the divisions 75
into two sections with separate evacua- litter bearers from its own complement,
tion routes. The rear echelon would and approximately 150 Italian infantry-
move up to the advance site as soon as men for litter work. The Italians proved
conditions permitted, while the advance reluctant and unreliable in this capacity,
section again moved forward with the though others of their countrymen made
combat troops. themselves invaluable to the medical
Evacuation was to the clearing station service as pack-train drivers and as
of another division if that was more ac- guides.10 The 54th Medical Battalion also
cessible. In late October, when flood wa- operated a dental clinic and an eye clinic
ters washed out bridges and obliterated
trails, the 85th Division clearing station
was completely isolated for two days, dur- 10
Still other Italians, it should be noted, were
ing which period casualties were held formidable guerrillas behind the German lines.
Indeed, the German high command never learned
at the collecting stations or evacuated to to cope successfully with the partisans of northern
other divisions. One regiment of the 85th Italy. Kesselring, Soldier's Record, pp. 268-79.
THE NORTHERN APENNINES 429
for II Corps throughout the period of Lt. Col. Austin W. Bennett, particularly
combat. in matters of liaison and of sanitation,
since Brazilian standards were less rigor-
Medical Support of IV Corps—On the ous than American. An American medi-
IV Corps front, where the military mis- cal officer was placed on duty with the 1st
sion was to hold rather than to advance, Brazilian Infantry Division to assist with
the task of the medical service was less training, medical records, and equip-
arduous. The 370th Regimental Combat ment. At one period, when the Brazilian
Team of the 92d Division was supported sector adjoined that of the 1st Armored,
by a collecting company and clearing a Brazilian medical officer was detailed
platoon of the organic 317th Medical to one of the treatment stations of the
Battalion. Task Force 45 was supported 47th Armored Medical Battalion to act
by elements of the corps medical battal- as interpreter and to assist with Brazilian
ion, the 163d. Since the antiaircraft units casualties passing through the station.
that made up the bulk of the task force The corps collecting company evacuat-
did not have enough medical personnel ing the BEF sector, in addition to its
for infantry operations, the 163d sup- normal functions, supplied men, litter
plied aidmen and forward litter bearers as bearers, and equipment for battalion aid
well as performing its normal collecting stations of the 6th Combat Team.
and clearing functions. The initial in- Medical installations of IV Corps en-
crement of the Brazilian Expeditionary countered the same difficulty with rain
Force, the 6th Combat Team, was and mud, and the same disadvantages of
supported by a collecting company and terrain that were a constant hazard in
clearing platoon of the 1st Brazilian the II Corps area, but, without the bur-
Medical Battalion; and Combat Com- dens of an offensive, the conditions were
mand B of the 1st Armored Division was more readily endured. Only in the sector
cared for by Company B of the 47th where Combat Command B operated
Armored Medical Battalion. The 6th after 1 October, attached to the 6th South
South African Armoured evacuated the African Armoured, were conditions com-
army area through its own medical parable to those on the II Corps front.
channels. Field hospital units for for- Primarily for this reason, the unit was
ward surgery were not available to rein- brought under II Corps control at this
force the IV Corps medical service, but time. When CCB moved north on High-
the close proximity of evacuation hos- way 64 early in October, the supporting
pitals and relatively easy evacuation treatment station for the first time in
routes in large measure compensated for its history was unable to find enough
11
the lack. level ground to pitch its tents and was
The advent of the Brazilians created forced to set up in a village where build-
new problems for the IV Corps surgeon, ings were available.
11
The main sources for this section are: (1) An- Inactive Period
nual Rpt, Surg, Fifth Army, 1944; (2) Annual Rpt,
Surg, IV Corps, 1944; (3) Hist, 317th Med Bn, 16
Oct 42-15 Jul 45; (4) Annual Rpt, Surg, 1st Armd
Div, 1944; (5) Hist, 47th Armd Med Bn, Sep, Oct 44;
With Fifth Army in defensive posi-
(6) Annual Rpt, 163d Med Bn, 1944. tions for the winter, little movement of
430 MEDITERRANEAN AND MINOR THEATERS
IV Corps was also compelled to resort to lecting company to support two combat
a variety of expedients to overcome de- teams.
ficiencies in the medical complement of In the Mt. Belvedere offensive and
some of its combat units. In the early subsequent operations west of Highway
months of the winter the 163d Medical 64, the medical units supporting the l0th
Battalion continued to give combat med- Mountain Medical Battalion did not fol-
ical support to Task Force 45 and, with low the conventional organizational pat-
the assistance of a collecting company at- tern. Equipment was designed for mule
tached from the 161st Medical Battalion, pack or hand carry, and assigned vehicles
to evacuate divisional clearing stations. were reduced in number accordingly.
The battalion also gave first echelon sup- The Table of Organization called for
port to service troops and others without 126 animals but for only 15 motor ambu-
medical detachments of their own, oper- lances, all of them in the clearing com-
ated a venereal disease hospital for the pany. Each of the 3 collecting companies
corps, and supplied an expansion unit had 44 litter bearers instead of the 36
for one of the evacuation hospitals in the allotted to infantry companies. The
area. The 671st Collecting Company, clearing company was divided into 3
supporting troops on the right flank of rather than 2 platoons. Since the whole
the corps sector, was provided with division was set up for animal transport-
equipment to operate a 25-bed provi- ation—there were more than 6,000
sional hospital, should heavy snows iso- animals in the T/O—there was a sizable
late the area. As on the II Corps front, veterinary company, and there were
additional ambulances were supplied by veterinary sections at the battalion level
Fifth Army. in the medical detachment. The division
In order to support the 366th Infan- arrived in Italy, however, without its
try, which was attached to the 92d animals. Italian mule pack trains were
Division on its activation in November, supplied, but transportation deficiencies
one of the collecting companies of the were otherwise made up by motor vehi-
317th Medical Battalion operated for a cles. The medical battalion received 30
time in two sections. For the February instead of 15 ambulances, which were
offensive, in which all four regiments transferred from the clearing to the col-
of the 92d were engaged simultaneously, lecting companies. Jeeps were borrowed
a provisional collecting company was from line units.
used, with 2 medical officers, 9 medical In the first battle test, the 10th Moun-
and 6 surgical technicians, and 12 ambu- tain Medical Battalion performed like a
lance drivers drawn from the regular veteran outfit, amply justifying the care
companies, and Italian litter bearers. with which its personnel had been se-
While the division was engaged simultan- lected and trained. Like the combat for-
eously on the coast and in the Serchio mations, medical units moved into
Valley, both clearing platoons were in position under cover of darkness. Col-
operation, reinforced by ambulances lecting stations, and often clearing sta-
from corps. Later in February, when the tions as well, were generally within range
473d Infantry was also attached to the of enemy artillery, and many casualties
92d, it was again necessary for one col- resulted, though few of them were psy-
THE NORTHERN APENNINES 433
chiatric. Litter squads of one company difficult 3- or 4-hour haul down the ridge
worked the first 3 days of the offensive— was reduced to 4 minutes, and the carry-
72 hours—without sleep and with very ing time between aid station and collect-
little food. Litter carries were down ing station cut to 6 or 7 hours. The other
precipitous mountain sides, frequently tramway, some 5 miles southwest of
taking as long as 10 hours, yet the same Vergato, spanned a deep valley across
squad would return immediately for an- which the only passage was a narrow,
other casualty. tortuous dirt trail unusable even by
At two points, division engineers built jeeps. In the latter stages of the offensive,
cable tramways to bring the wounded when the 85th RCT was digging in on
out from otherwise almost inaccessible Mt. della Spe, the only possible evacua-
positions. The first of these was com- tion route lay through the village of
pleted the morning of 21 February from Castel d'Aiano, which was shelled by
Mt. Mancinello—Pizzo di Campiano German guns every time a vehicle moved
ridge captured the night of the 19th. A in the streets.
434 MEDITERRANEAN AND MINOR THEATERS
up to strength, line soldiers being trained persistent shortage of beds that could be
as medical replacements where no others compensated for only by continuous
were available. Ambulances and other overloading of facilities and by impro-
vehicles were systematically overhauled visations at all echelons of the medical
14
or replaced. Supply levels were built up. service.
Physical conditioning went along with Among the expedients in general use
recreational activities. At the same time, were the practice of employing surgical
the special problems anticipated for the teams from evacuation hospitals in field
coming spring offensive were given in- hospital units or other evacuations more
dividual attention. strategically placed; and of putting per-
After its own positions were stabilized sonnel from less active units on tempo-
just before the middle of March, per- rary duty with those carrying heavy
sonnel of the 10th Mountain Division patient loads. Surgeons were also ex-
conducted a school in methods of moun- changed between evacuation and general
tain evacuation. At a site near the mouth hospitals for 6-week intervals to give each
of the Arno River, medical detachments group a more realistic understanding of
and battalions were given special train- the problems of the other. Clearing and
ing in the technique of river crossings collecting companies were consistently
along with their respective combat ele- used to augment the beds of evacuation
ments. General Martin was no less deter- hospitals in the army area.
mined than General Truscott to make
the next campaign the last.13 Hospital Support of II Corps—With
II Corps making the main U.S. effort
Hospitalization in the Army Area against the Gothic Line, the bulk of the
Fifth Army hospitals were eventually
Hospitalization During the deployed along the axis of Highway 65,
Fall Offensive but there was an unavoidable lag behind
troop movements. When the assault was
The deployment and use of Fifth launched on 10 September, the nearest
Army hospitals during the Gothic Line evacuation hospital was the 15th, which
battles and the subsequent advance to- opened on that date in a large school
ward Bologna were always conditioned building in Florence. All transportable
by the unfavorable terrain, the poor road casualties of the first two days went there.
network, and the weather. On the II On 12 September the 94th Evacuation
Corps and IV Corps fronts, enemy artil- moved up to Pratolino, about six miles
lery fire delayed the forward movement closer to the front but still in the rear
of hospitals, or forced the abandonment of the assembly area from which the 34th
of otherwise acceptable sites, while evac- and 91st Divisions had jumped off. (Map
uation lines stretched out and ambu- 35)
lances broke down under constant use.
To these disadvantages was added a 14
Principal sources for this section are: (1)
Annual Rpt, Med Sec, MTOUSA, 1944; (2) An-
13
For detailed preparations during this period, nual Rpt, Surg, Fifth Army, 1944; (3) Unit rpts
see pp. 458-60, below. of med units mentioned in text.
436 MEDITERRANEAN AND MINOR THEATERS
MAP 35—Fifth Army Hospitals and Medical Supply Dumps, 18 September 1944
front, and, for 10 days, admissions were into bivouac with the 8th Evacuation at
heavy, reaching a peak of 203 on 15 Octo- Pietramala. 15 On 29 October, after II
ber. At the same time, the 56th at Scar- Corps had been ordered to take defensive
peria continued to operate at capacity, positions, surgical personnel of the 94th
and the 94th, still at Pratolino, set a returned to Monghidoro. The medical
new unit record for surgical cases in the staff and all others not needed at the for-
first two weeks of October. ward site went back to Florence, where
As the weather steadily worsened, it they joined the 15th Evacuation, setting
became increasingly important to get up 380 beds for medical cases only.
hospital beds as far forward as possible. Meanwhile a new departure had been
Evacuation over mud-clogged roads was taken in the treatment of neuropsychi-
becoming more difficult, and there was atric casualties.16 As the strain of weeks
danger that Futa Pass might be blocked of bitter fighting in the most difficult
by snow. To ease the pressure, the 750- conditions of weather and terrain began
bed 8th Evacuation Hospital moved to to be felt in a rising toll of psychiatric
Pietramala, just south of Radicosa Pass, disorders, General Martin set up a psy-
on 14 October; and the following day the chosomatic center toward the end of
94th moved up to Monghidoro, about October in the vicinity of Cafaggiolo,
five miles farther north on Highway 65. just north of the point where Highway
The 94th was replaced at Pratolino by a 6524 branches off from 65. Core of the
fixed hospital. center was the 2d Platoon of the 601st
Both forward hospitals quickly ran in- Clearing Company, 161st Medical Bat-
to difficulties. The 8th was sited in a talion, which had been serving as Fifth
rolling field, already churned to mud by Army neuropsychiatric hospital since De-
heavy guns that were still there when cember 1943. The 1st Platoon of the
the first loads of hospital equipment ar- same company was established on 23 Oc-
rived. Ward tents were pitched on slop- tober adjacent to the neuropsychiatric
ing ground, and the operating tent was hospital to specialize in gastrointestinal
given a level base only by cutting away cases, many of which were believed to be
the top of a knoll. Conditions at Monghi- of psychosomatic origin. On 1 November
doro were even worse, for the area was the 1st Platoon of the 602d Clearing
still under artillery fire. So great, indeed, Company, 162d Medical Battalion, which
was the danger from enemy shells that had been operating an expansion unit
the 94th Evacuation closed 5 days after for the 15th Evacuation since 18 Septem-
it opened. Two medical officers, 5 nurses, ber, also joined the psychosomatic center,
and 10 enlisted men stayed at Monghi- but took minor disease as well as gastro-
doro to care for 30 nontransportable intestinal cases.
chest and abdominal cases, and to guard The 3d Convalescent Hospital moved
the equipment. Twenty-one nurses and 15
Periodic Rpt, 94th Evac Hosp, Jan-Aug 45.
70 enlisted men were sent back to rest The 1944 Annual Report says the Covigliaio area,
areas; the remainder of the nurses, a roughly three miles south of Pietramala, but the
shock team, and 2 surgical teams were later report is more detailed, and in this case more
probable, since mess equipment was presumably
put on temporary duty with other hos- left at Monghidoro.
pitals; and the rest of the personnel went 16
See pp. 450-51, below.
MAP 36—Fifth Army Hospitals and Medical Supply Dumps Supporting II Corps,
25 October 1944
THE NORTHERN APENNINES 439
It was none too soon. On the night of requisitioned for nontransportable cas-
2-3 November the flooding Arno River ualties, which were cared for by surgical
burst its banks, and a wall of water teams of the 38th Evacuation.
poured into the area occupied by the
38th Evacuation. Before morning the Winter Dispositions
water was 4 to 6 feet deep in the hospital
area. The 495 patients in the hospital By early November it was clear that
were hastily carried 300 yards to the rela- military activity would be strictly limited
tive safety of a partially destroyed bar- for some time to come, and the task of
racks being used by the 12th Medical preparing army hospitals for the winter
Depot Company. There, counting both began. The 16th Evacuation, which had
patients and hospital personnel, more been twice flooded at Firenzuola, was
than 800 persons were housed in space moved back on 10 November to Pistoia,
designed to accommodate about 200. where Highway 64 enters the mountains
Enough equipment and supplies were from the Arno plain. The site had been
saved to operate the hospital for 48 intended for the 38th, but that unit was
hours, which proved to be long enough still immobilized.18
for the inundated roads to become The Brazilian medical personnel were
usable. transferred at this time from the 38th
As soon as vehicles could get through, Evacuation to the 16th, which was now
a pool of fifty ambulances formed by the just behind the Brazilian sector. Normal-
162d Medical Battalion picked up the ly the Brazilians took complete care of
stranded patients and distributed them their own wounded, but when the load
among fixed hospitals in Leghorn and was heavy U.S. medical officers served as
Fifth Army units in the II Corps area. assistant surgeons on Brazilian teams.
Although most of its equipment was ulti- Brazilian surgeons similarly acted as as-
mately salvaged, the 38th Evacuation was sistants on U.S. teams when American
for the time being rendered inoperative, casualties were heavy.
and its personnel were placed on tem- On 19 November the 38th Evacuation
porary duty with other medical installa- took over the Montecatini site, as well as
tions. the clearing platoon that had been oper-
To replace the 38th Evacuation, the ating there. The field hospital unit from
170th opened at Viareggio on 6 Novem- Montecatini moved up Highway 64 to
ber, and a unit of the 32d Field Hospital, the vicinity of Porretta in the Brazilian
augmented by a platoon of the 615th sector where, with two Brazilian and
Clearing Company, 163d Medical Bat- two U.S. surgical teams, it operated as a
talion, established a 250-bed hospital at small evacuation hospital throughout the
Montecatini. The Viareggio site was close winter. Another unit of the 32d Field
to the 92d Division's front in the coastal Hospital supplanted the 170th Evacua-
sector, while Montecatini was accessible
both to the center and the right flank of 18
Principal sources for this section include: (1)
IV Corps. A portion of a civilian hospital Annual Rpts, Surg, Fifth Array, 1944, 1945; (2) An-
nual Rpts, Surg, II Corps, 1944, 1945; (3) Annual
in Lucca, about midway between the Rpt, Surg, IV Corps, 1944; (4) Unit rpts of the
two sites on an east-west line, was also med units mentioned in text.
THE NORTHERN APENNINES 441
MAP 37—Fifth Army Hospitals and Medical Supply Dumps on the IV Corps and
92d Division Fronts, 15 January 1945
tion at Viareggio after the latter had area where patients were able to benefit
been twice damaged by enemy shells. from the recreational facilities available.
The 170th moved on 25 November to In mid-January, Brazilian personnel
Lucca, carrying with it 150 patients, were attached to the 3d Convalescent.
many of them litter cases. (Map 37) Other Fifth Army hospitals remained
The 3d Convalescent Hospital, deep where they were throughout most or all
in mud at Pratolino, found the task of of the winter, making do as best they
winterizing its 300 tents too great and in could against the hazards of mud, cold,
late November began moving to Flor- snow, and wind. A move to reopen the
ence for the winter. Before the move was 94th Evacuation at Monghidoro late in
completed, however, adequate quarters December was abandoned, and the medi-
were found in a group of hotel buildings cal service of that unit continued to
in Montecatini, where the hospital was operate in Florence in conjunction with
established just before the end of the the 15th Evacuation, taking half of the
year. One factor involved in the change medical cases admitted to the joint instal-
of plans was the advantage of having a lation, which functioned under a single
convalescent hospital located in a rest administration as a 1 ,000-bed station hos-
442 MEDITERRANEAN AND MINOR THEATERS
pital. The surgical service of the 94th and walled to a height of 4½ feet with
remained at the forward location, despite wood, and reinforced by overhead beams
cold and snow that reached a depth of against the weight of the snow, but even
four feet, until mid-February, when re- these precautions were not always pro-
newed enemy shelling again forced aban- tection against the gales that swept
donment of the site. The surgical service periodically across the sloping hospital
then ceased to function as such, but sur- area. On 8 December, before the win-
gical teams were placed on temporary terizing was complete, a double ward
duty with the 32d Field and the 8th tent, flooring sidewalls and all, was lifted
Evacuation. A number of the nurses also clear off the ground, carried over 6 wards
went on detached service with other and dropped on another tent. All to-
units. Tentage was left at Monghidoro gether, 8 tents were blown down and
under guard. (Map 38) others damaged. The hospital census was
A few miles farther back on Highway low at the time and no patients were
65, the 8th Evacuation stuck out the injured, but it was necessary to send 30
winter at Pietramala, the coldest spot or 40 postoperative cases to the 15th
on the II Corps front. Tents were floored Evacuation in Florence. After that ex-
MAP 38—Fifth Army Hospitals and Medical Supply Dumps on the II Corps Front,
15 January 1945
444 MEDITERRANEAN AND MINOR THEATERS
perience, wood and prefabricated steel at Cafaggiolo, remained in the area for
buildings were placed at the two ends another month as a medical hospital,
of each row of ward tents and secured then shifted to Prato, between Florence
by steel cables anchored to buried logs. and Pistoia on the edge of the Arno
As if wind and cold were not enough, plain, where it continued in the same
the 8th Evacuation also wrestled with capacity. The neuropsychiatric hospital
the perennial problem of mud. At least remained throughout the winter at
5,000 truckloads of rock were used to Cafaggiolo, taking cases direct from the
maintain roads in the vicinity of the hos- clearing stations and from the 15th Field
pital area before the unit left the site Hospital.
late in April. As the most forward hospi- In connection with its general medical
tal in the II Corps zone, the 8th Evacua- work, the 15th Field made detailed
tion handled the bulk of the casualties studies of the major types of medical
for the first three months of 1945, battle cases occurring among front-line troops
wounds exceeding medical cases. to determine whether a strictly medical
The Scarperia site, where the 56th forward hospital could retain such cases
Evacuation Hospital spent the winter, in the army area and thus hasten return
was only slightly more favorable than to duty. A section of the 2d Medical
that of the 8th at Pietramala. As at the Laboratory was attached. At the same
more forward installation, cold, snow, time, observers were sent to other field
and wind were intermittent hazards, and hospitals where they studied the tech-
the battle against mud a never-ending nique of operating as forward surgical
problem. Patients came mostly from the units in preparation for a similar role in
corps right flank, down Highway 6524. the spring offensive.
In response to General Martin's ur- In the IV Corps sector no changes were
gent appeal for more beds, the 15th Field made in hospital sites after the first of the
Hospital was returned to Italy late in year. The enemy thrust in the Serchio
the year, one platoon coming from south- Valley late in December led to prepara-
ern France and the other two from tions for heavy casualties including
Corsica. Just before the end of Decem- plans for reinforcing the 170th Evac-
ber the unit was set up east of Highway uation at Lucca, should that be neces-
65 and two or three miles north of sary. Pigeons were sent to the 170th as
Cafaggiolo, where it operated as a 400- insurance in case phones were down, and
bed hospital for medical cases. With all of the hospital's patients were evacu-
specialists from the 6th General Hospital ated to base installations. The counter-
attached, the 15th Field took over the attack, however, was quickly stopped,
psychosomatic work performed since and medical units remained in place.
October by the 1st Platoon of the 601st In Florence the venereal disease hos-
Clearing Company, the latter unit be- pital and the Fifth Army prosthetic and
coming a hospital for general medical operative dental clinic, both adminis-
and slightly wounded cases in mid-Janu- tered by the 2d Platoon of the 602d
ary. The 1st Platoon of the 602d Clear- Clearing Company, 162d Medical Bat-
ing Company, which had also been talion, took patients from II and IV
associated with the psychosomatic center Corps of Fifth Army. The lull in hostil-
THE NORTHERN APENNINES 445
ities was reflected in late March by an each evacuation hospital were tele-
increase in venereal beds from 250 to phoned every morning. During the early
290. part of the campaign, inadequate bed
strength and heavy casualties made it
Evacuation From Fifth Army impossible to follow a fixed policy with
consistency, but so far as circumstances
Evacuation to Army Hospitals permitted, the patient census of the most
forward hospital was kept relatively low
Throughout the North Apennines to guard against sudden emergency. In
Campaign and the winter stalemate, general, evacuation during daylight
evacuation from corps to army installa- hours was to installations farther to the
tions was carefully controlled by the rear, while the most forward unit took
Fifth Army evacuation officer, Colonel the bulk of the casualties at night to
Camardella. As has already been noted, shorten the hazardous ambulance runs.
the 54th Medical Battalion, responsible Except in emergency, not more than 100
for evacuation from II Corps, main- surgical cases were admitted to any given
tained an ambulance control point on hospital in a single day. When the num-
Highway 65 to which daily quotas for ber of casualties began to decline in
446 MEDITERRANEAN AND MINOR THEATERS
Montecatini, and Pistoia, the road net- port Squadrons. Before 20 September,
work did not permit the full application 936 patients went to Naples and 2,295
of a quota system. The 163d Medical to Rome. On that date the Florence air-
Battalion found it necessary to operate field became operable, and by the last
ambulance control posts on each of the day of the month 1,445 Fifth Army pa-
main axes of the corps' advance in order tients had been flown from that field to
to rout emergency cases to the nearest Naples, along with 1,397 to Rome.20
hospital. It was nevertheless possible by The 24th General Hospital opened in
co-ordinating these posts to regulate the Florence on 21 September with 1,500
flow of patients to some extent. beds, and a week later 2 station hospitals
with an aggregate of 1,250 beds moved
Evacuation to Base Hospitals into the Leghorn area to which IV Corps
casualties were being routed. Despite
The problem of clearing Fifth Army these additional fixed beds, the situation
hospitals during the first several weeks became acute in the first week of October
of the North Apennines Campaign was when bad weather prevented any airlifts
complicated by factors outside the con- to the rear. In addition to a capacity
trol of the army surgeon. At the start of load of patients from forward evacuation
the offensive early in September there hospitals, the 24th General also had to
were only two fixed hospitals in northern find room for those already in holding
Italy, the 64th General near Leghorn units at the Florence airfield. During the
and the 55th Station attached to it. A second week of October, Fifth Army was
few other units were on the way, but given air priority over Seventh Army,
the prospect of an early breakthrough but intermittent poor weather condi-
into the Po Valley precluded establish- tions prevented full use of it, and in the
ment of more beds than were absolutely last week of the month all planes were
necessary south of the mountains. All grounded. The limited number of flying
casualties from southern France, more- days held air evacuation to Rome and
over, were still going to Naples, leaving Naples to 5,000 for October and left for-
few beds available for movement else- ward hospitals dangerously crowded. As
where. At the same time, the shortage of a relief measure, all transportable pa-
mobile beds in the Fifth Army area made tients from the 24th General were car-
it essential to transfer patients to base ried by ambulance to Leghorn late in
installations without unnecessary delay. the month. On 21 October control of air
The only base hospitals available were evacuation passed from the Surgeon,
those in Rome and Naples, and the only Fifth Army, to the Surgeon, Peninsular
means of reaching them was by air. For Base Section.
the first 10 days of the offensive, patients
20
from the forward evacuations were car- These and subsequent figures for air evacua-
tion in the text are from the reports of the two
ried by ambulance to the Rosia airfield MAETS squadrons. They do not agree entirely
southwest of Siena and some 50 miles with figures given in the annual report of the
from Florence, whence they were flown Surgeon, MTOUSA, for 1944, which are for pa-
tients received by air at PBS hospitals, but it is
to the rear by planes of the 802d and believed the MAETS tabulations are the more
807th Medical Air Evacuation Trans- accurate.
448 MEDITERRANEAN AND MINOR THEATERS
were identified and treated as such. Dur- In December 1944, more than 90 per-
ing the 6 months of its existence, 442 cent of all Fifth Army psychiatric
patients were admitted to the center, of casualties were returned to duty, as com-
whom 74 percent were returned to full pared with only 26 percent at the begin-
duty, 11 percent to limited duty, and ning of the year. (Table 31)
only 15 percent were evacuated to base
hospitals. Of the total, 286 cases were Diseases of Special Interest—The ma-
diagnosed as psychogenic dyspepsia jor disease problem of Fifth Army dur-
showing definite neurosis without evi- ing the months of the North Apennines
dence of organic disease. Another 78 Campaign was infectious hepatitis,
cases showed neither organic disease nor which followed the pattern of the pre-
positive evidence of neurosis. There vious fall but was more widespread. The
were 22 cases of peptic ulcer, 4 of chronic disease reached its peak in December
gastritis, and 20 of acute gastritis. Thirty- 1944, whereas October had been the
two cases were rediagnosed as hepatitis month of highest incidence in 1943. The
without jaundice. maximum rate per 1,000 per annum was
The average period of hospitalization 211 for the week ending 15 December
in the gastrointestinal center was 9.1 1944, compared with a high of 121 for
days, compared with 21 days for similar the second week of October 1943. The
cases in base hospitals. Moreover, only sharp rise in hepatitis cases began late
55 percent of those treated in base hospi- in October 1944, leveled off in Novem-
tals returned to combat duty, and those ber, rose sharply again in December,
who did return lost an additional 14 then gradually declined to what may be
days in the replacement system. termed a "normal" rate in March.25
Taken as a whole, the treatment of Again the disease appeared most fre-
neuropsychiatric casualties in the army quently among combat troops, and again
area showed gratifying improvements revealed an amorphous relationship to
during the months of active combat, intestinal diseases, the curve for hepatitis
despite the large number of such cases following by about a month the curve
in September and October. The rehabil- for intestinal infections. In the second
itation and training centers established winter, however, hepatitis appeared
in each of the combat divisions in the most frequently among new troops in
late summer proved to be a major factor contrast to the experience of 1943, which
in promoting the prompt return to duty showed a higher incidence among vet-
of hundreds of men who might other- erans. Evidence tended to indicate both
wise have gone too far to be reclaimed the intestinal and respiratory tracts as
for combat. The 85th Division experi- possible sources for infection, but re-
mentally carried the program a step mained inconclusive as to the actual
further when the 337th Infantry regi- mode of transmission.
ment set up its own training and rehabil- 25
Principal sources for this section are: (1) An-
itation center. It was notable that the nual Rpt, Med Sec, MTOUSA, 1944; (2) Annual
337th had less than half the psychiatric Rpts, Surg, Fifth Army, 1944, 1945; (3) ETMD's
for Sep 44 through Apr 45; (4) Whayne and De-
casualty rate of the other two regiments Bakey, Cold Injury, Ground Type, ch. VI. See also
for the same period. pp. 261-62, above.
452 MEDITERRANEAN AND MINOR THEATERS
ab Full duty.
Limited assignment.
Source: Annual Rpt, Surg, Fifth Army, 1945.
tween 9 September and the end of the 6742d Quartermaster Remount Depot.
year 1,110 killed and 765 wounded. To achieve better administrative con-
Evacuation of sick and wounded ani- trol, the Italian pack mule companies
mals, both from pack trains and from were grouped early in 1945 into 5 bat-
veterinary hospitals, was by truck, but talions and brought under the supervi-
until late December no vehicles were sion of the newly activated 2695th
available except on loan from service Technical Supervision Regiment. Three
units. At that time Colonel Pickering, American veterinary officers were as-
Fifth Army veterinarian, secured author- signed to this organization, one to each
ization to supply both pack companies of 3 pack mule battalions. The other 2
and veterinary hospitals with recondi- battalions were periodically inspected
tioned U.S. or captured enemy trucks, by these officers.
and most of the units were so supplied The relatively large veterinary staff
by the end of the year. Replacement of the 10th Mountain Division—22 offi-
animals were received through the cers and 182 enlisted men—had little to
456 MEDITERRANEAN AND MINOR THEATERS
do in their first three months in Italy, Army veterinarians were called upon to
since none of the division's animals care for 125 scout dogs that reached the
reached the theater before spring. front during the winter.
In addition to horses and mules, and No unusual problems were encoun-
the pigeons that were a normal part of tered by the food inspection units oper-
the Signal Corps organization, Fifth ating with Fifth Army.
CHAPTER XII
Combat Team, which had just returned The II Corps attack was in effect to be
from France, and the 473d RCT of con- a renewal of the October drive, with all
verted antiaircraft troops that had been four divisions abreast and the Legnano
fighting as infantry since August 1944. Group in a defensive role on the right
The 365th and 371st regiments, which flank. When the important road junction
had been weakened by the transfer of of Praduro on Highway 64 had been
selected personnel to the 370th, were to reached, the 85th Division was to pass
screen the front for the attack, then be through the 1st Armored, leaving the
withdrawn from the division and sta- latter unit and the 6th South African
tioned in the inactive sector west of Mt. Armoured, which would be pinched out
Belvedere under IV Corps control. IV by the 85th and 88th Divisions, available
Corps lined up with the Brazilian Ex- as a mobile striking force to exploit the
peditionary Force on the left, the 10th breakthrough onto the plain.
Mountain Division in the center in the
vicinity of Castel d'Aiano, and the 1st Medical Preparations
Armored on the right along Highway
64 south of Vergato. In the II Corps Although Fifth Army's strength for
sector, extending east from the Reno the final drive was greater by 100,000
River, the 6th South African Armoured men than it had been when the Gothic
and the 88th Infantry Divisions were on Line was broken—almost 270,000 on1
the left between Highways 64 and 65, the April 1945 compared with 170,000 six
91st was astride Highway 65, the 34th months earlier—the resources in men
Division was east of the highway, and and equipment available to General
the Legnano Group on the extreme Martin, Fifth Army surgeon, were only
right, in contact with 13 Corps on the slightly increased over the inadequate
left flank of Eighth Army. The 85th Di- facilities with which he had supported
vision was in army reserve. All units the North Apennines Campaign. The
were overstrength for the drive, with al- 400-bed 170th Evacuation Hospital had
most 30,000 additional officers and men been added in November 1944, and the
available in replacement depots. 15th Field Hospital in January 1945.
When the diversionary attack of the Just before the launching of the spring
92d Division in the west and the Eighth offensive one additional 400-bed evacu-
Army drive in the east had engaged as ation—the 171st, converted like its sister
many troops as the German command unit from a station hospital—was ac-
was willing to commit against them, the quired.2 That was all. There were no
10th Mountain Division was to launch additional medical battalions at corps
the IV Corps assault driving north or army level, no new supply units, no
through the remaining mountain ridges 2
to cut Highway 9 west of Bologna. The See p. 439, above. The 171st Evacuation
Hospital was converted from the 250-bed 54th Sta-
Brazilians and the 365th and 371st regi- tion Hospital, which had moved from North Africa
ments were to protect the left flank and to Naples in January 1945, with some additional
follow up any enemy withdrawals, while personnel drawn from the 57th Station Hospital,
which was reduced from 250 to 150 beds at about
the 1st Armored was to seize Vergato and the same time. See Annual Rpt, 171st Evac Hosp,
advance down Highway 64. 1945, and ETMD for Mar 45.
ADVANCE TO THE ALPS 459
GENERALS CLARK AND TRUSCOTT at the time General Truscott took command of the Fifth
Army.
more supporting ambulance companies; 1944, only the Legnano Group had hos-
and the increase in beds was less than pital facilities of its own—four 200-bed
enough even to keep pace with the in- field units provided through the Mili-
3
crease in troop strength. tary Mission to the Italian Army, a
Of the new combat formations ac- division of the Allied Control Commis-
quired by Fifth Army since the stabiliza- sion. The 6th South African Armoured
tion of the lines at the end of October Division was also independent of Fifth
Army in this respect. To provide hos-
3
Principal sources for this section are: (1) An- pitalization for the remaining 8 combat
nual Rpt, Surg, Fifth Army, 1945; (2) Annual Rpt, divisions, 2 separate regiments, and com-
Surg, II Corps, 1945; (3) Unit rpts of div surgs,
med bns, hosps, and other Fifth Army med in-
bat service troops, General Martin had
stallations. at his disposal 3 field hospitals, 4 400-bed
460 MEDITERRANEAN AND MINOR THEATERS
evacuation hospitals, 4 750-bed evacua- rying only one patient at a time, without
tions, and a convalescent hospital. medical attendance, which would greatly
What it lacked in facilities Fifth Army restrict the scope of the operation. The
was thus forced to make up in mobility unpredictability of the weather at that
and efficiency of operation. During season was another limiting factor.
March medical units received new equip- In planning medical support for the
ment, including a total of 90 ambulances Po Valley Campaign, there was no alter-
and 15 2½-ton trucks, to replace worn- native to ambulance evacuation, at least
out vehicles. A move to fill personnel during the early stages of the action.
vacancies with limited-service men was Neither could use of the battered and
successfully resisted, on the ground that rutted Highways 64 and 65 in the central
all personnel would be subjected to se- sector be avoided. Highway 1, which
vere physical strain, and basic infantry- would be the axis of evacuation for the
men were trained instead as medical 92d Division along the coast, had suf-
replacements. fered little and was in excellent condi-
By early April all medical units had tion. From the II and IV Corps fronts,
been streamlined for rapid movement. evacuation by air was to begin as quickly
All equipment beyond the bare essen- as the Bologna field could be repaired,
tials for operation was turned in, and estimated as five days after the capture
hospitals began reducing their patient of the city.
censuses to permit closing on a few hours' For the 92d Division, isolated as its
notice. No hospital was to move until the front was from the rest of the Fifth Army
combat troops jumped off, to avoid any area, a complete system of medical sup-
possibility of giving away plans to the port had to be provided that would not
enemy, but once the mountains were only take care of all the medical needs
passed, it was imperative that as many of the division but also could be rapidly
beds as possible be shuttled into the Po expanded should the coastal drive de-
Valley to eliminate long and difficult velop into a major operation. As one
ambulance runs over highways that element of this plan, a bleeding section
would be clogged with military traffic. was set up in Pisa by the 6713th Blood
It was also imperative that no hospital Transfusion Unit.
be closed for longer than the absolute
minimum time necessary for movement The Po Valley Campaign
to a new location.
In the hope of speeding up the evacu- Military Operations
ation process, experiments were con-
ducted early in April with small planes During February, March, and the
that could take off, if necessary, from early days of April 1945 the Mediter-
improvised runways. Several patients ranean Allied Tactical Air Force
were flown successfully in L-5's from pounded German communications in
the 8th Evacuation Hospital at Pietra- northern Italy with increasing violence.
mala to Florence, but the scheme was Favorite targets were the bridges that
abandoned as impractical for use in the kept appearing with antlike persistence
coming campaign. Space permitted car- along the Po, cable crossings, ferry ter-
ADVANCE TO THE ALPS 461
minals, rail lines, and truck and wagon in the face of strong counterattacks.
convoys on the roads. The bombers gave When the regiment was unable to re-
way on 14 April to an umbrella of group the next day because of excessive
fighters that would cover the jump-off of losses in stragglers, it was relieved by the
4
IV Corps. 473d Combat Team, which was brought
The flanks by this date were already up from static positions in the Serchio
heavily engaged. The 92d Division Valley. The 4730! took Massa on 10 April
opened the attack according to plan on and Carrara the next day, while the
5 April, with the 370th RCT on the 442d outflanked both towns against
coastal plain and the 442d pushing strong opposition in bitter mountain
through the mountains that rose steeply fighting. Both regiments were now up
a few miles to the east. The assignment against the German fortified line and
was not an easy one. The mountains in both were under fire from the coastal
this area, known as the Apuan Alps, are guns, but now had positions from which
characterized by sheer rock cliffs, barren their own field pieces could reply.
peaks, and deep gorges, while the narrow Eighth Army attacked on 9 April, was
coastal plain is cut by numerous streams across the Santerno River in two days of
and canals. The plain, moreover, was hard fighting, and by 13 April was be-
heavily mined and both axes of advance yond the Sillaro on the road to Bologna.
would soon be within range of the big The launching of the main drive by
guns at La Spezia, which could drop IV Corps was delayed for 48 hours by
their deadly shells as far south as Massa. weather conditions that prevented the
Before La Spezia itself could be reached, air cover General Truscott deemed es-
the attacking forces would have to break sential. On the morning of 14 April,
through heavily fortified positions that however, the corps jumped off behind in-
took every advantage of the natural tensive air and artillery preparation. On
barriers offered by the terrain. that day the 10th Mountain Division
By the end of the first day the 442d seized and held a series of peaks west of
was approaching the high ground over- Highway 64; the Brazilians took Mon-
looking Massa, but the 370th encoun- tese;. and the 1st Armored entered the
tered intense enemy fire and withdrew outskirts of Vergato. All units continued
to advance on 15 April. Just before mid-
4 night the 88th and 6th South African
Principal sources for this section are: (1) Fifth
Army History, pt. IX; (2) Rpt of Opns, IV Corps, Armoured Divisions of II Corps joined
Apr, May 45; (3) Rpt of Opns, II Corps, 1 Apr-2 the battle, followed early on 16 April by
May 45; (4) Hist, 92d Div, Apr, May 45; (5) Rpt the 91st and 34th Divisions. On 17 and
of Opns, 473d Regt, Apr 45; (6) Narrative of
Events, 442d Regt, Apr, May 45; (7) Clark, Cal- 18 April the 85th Division relieved the
culated Risk; (8) Truscott, Command Missions; (9) 1st Armored north of Vergato, the latter
Howe, 1st Armored Division, pp. 396-432; (10) division shifting to more favorable ter-
Schultz, 85th Division, pp. 197-230; (11) Delaney,
Blue Devils, pp. 186-222; (12) Robbins, 91st In- rain along the Panaro River on the left
fantry Division, pp. 262-332; (13) Goodman, Frag- of the 10th Mountain. The intercorps
ment of Victory, 1952) pp. 121-77; (14) Lockwood, boundary was shifted to the west on 19
ed., Mountaineers pp. 26-58; (15) Alexander,
Italian Campaign pp. 32-49; (16) Starr, ed., From April as the whole German front began
Salerno to the Alps, pp. 387-441. to crumble. The 85th Division took
462 MEDITERRANEAN AND MINOR THEATERS
Casalecchio, where the Reno River en- Eighth Army sector began. The 88th
ters the plain on 20 April, while forward swung northeast from Verona to outflank
elements of the 10th Mountain cut High- Bolzano, and the 10th Mountain Divi-
way 9 west of Bologna and II Corps sion fought its way to the head of Lake
broke through the last of the high Garda. The 1st Armored sent flying
ground in its path. Bologna fell on 21 columns to the Swiss frontier at Lake
April, the 34th Division entering the Como, and west to Milan.
city from the south and elements of the The 92d Division, meanwhile, after a
Polish Corps of the Eighth Army from week of bitter fighting, broke through
the east. the mountain defenses of La Spezia,
The main advance had already swept while Italian partisans seized the city it-
beyond Bologna, with both armies racing self. The 473d Infantry entered La
to reach the Po before the enemy could Spezia on 23 April, and four days later
withdraw his disorganized forces across entered Genoa more than a hundred
the river. The 10th Mountain Division miles up the coast. From there patrols
reached the south bank of the Po at San moved west to the French border. The
Benedetto west of Ostiglia the night of 442d, after driving inland from the La
22 April, crossing the river in assault Spezia area, made contact with IV Corps
boats the next afternoon in the face of near Pavia and sent patrols west to
heavy enemy fire. By the 24th the 85th Turin.
Division was also across the river, the The first organized surrender came on
88th and 91st were crossing, and the two 29 April when the 148th Grenadier and
armored divisions were only awaiting Italia Bersiglieri Divisions surrendered
the placement of bridges by the engi- to Maj. Gen. Joao Mascarenhas de
neers. The 34th Division, reassigned to Morais, commanding the Brazilian Ex-
IV Corps, was sweeping west along High- peditionary Force. At 1400 on 2 May
way 9, already beyond Parma, while the 1945 all German forces in Italy were
Brazilian Expeditionary Force kept pace surrendered unconditionally to General
through the foothills south of the high- Clark, and the Italian campaign was
way. Verona, gateway to the Brenner over. The number of prisoners taken was
Pass, fell to the 88th Division on 25 more than 250,000, bringing the total for
April, and the 10th Mountain took Villa- the Italian campaign to over half a
franca airport southwest of that city the million.
same day.
In the final days of the war in Italy, Medical Support in the Field
Fifth Army fanned out toward the bor-
ders to cut off all avenues of escape. Re- Field medical support of Fifth Army
sistance was sometimes strong, sometimes during the final drive in Italy was
nonexistent, but always confined to pock- characterized by an initial period of
ets where isolated remnants of the once heavy casualties and slow movement,
proud Wehrmacht tried to break out of followed by rapid expansion over hun-
the trap that was swiftly closing on all dreds of miles with enemy casualties ex-
sides. The 91st Division pushed east ceeding our own. In the last few days of
through Vicenza to Treviso where the combat medical units were not only cut
ADVANCE TO THE ALPS 463
off from army and corps surgeons, they to move up from its Viareggio site in
were also frequently out of communica- time to give close support during the
tion with their own headquarters. The period of severe fighting, but the relative
use of captured vehicles, medical instal- slowness of the advance to La Spezia kept
lations, and supplies was both a general the hospital within usable distance.
practice and a necessary expedient.5 By 20 April communications with the
92d Division had become so tenuous that
The 92d Division Front—Perhaps the General Martin designated the division
most difficult task was that assigned to surgeon, Lt. Col. Eldon L. Bolton, to act
the 317th Medical Battalion, organic to as his deputy in the coastal sector, with
the 92d Division, which during the full responsibility for the medical service
greater part of the drive was required to there.
support five regimental combat teams La Spezia fell on 23 April, and two
on three fronts. Casualties suffered by days later medical units from the Serchio
the augmented 92d Division, even though Valley rejoined the 317th Medical Bat-
two of its five regiments had little con- talion in support of combat elements
tact with the enemy, were exceeded only now fanning out in two directions. For-
by those of the 10th Mountain Division ward hospital facilities were urgently
on the IV Corps front. (See Table 33.) needed, but the Viareggio field unit,
One collecting company and one platoon with no army evacuation hospital in the
of the clearing company remained with vicinity, was unable to move on short
the defensive formations in the Serchio notice. To redeem the situation, Gen-
Valley until 25 April, when that sector eral Martin sent a unit of the 15th Field
was closed out. The other two collecting Hospital, which was still in bivouac north
companies, sometimes operating in sec- of Florence, and a platoon of the 601st
tions, supported the main drive of the Clearing Company, 161st Medical Bat-
442d and 473d RCT's, with one platoon talion, to the 92d Division front. A 250-
of the clearing company backing up both. bed hospital was set up on 25 April near
Neither the terrain nor the location of La Spezia, but the combat units were
enemy long-range guns permitted the at- already far ahead. After three days of
tached platoon of the 32d Field Hospital operation with only a handful of pa-
5
tients, the clearing platoon moved on 29
This section is based primarily on the following April to Genoa, where it was joined the
documents: (1) Annual Rpt, Surg, Fifth Army,
1945; (2) Annual Rpt, Surg, II Corps, 1945; (3) following day by the field hospital unit.
Opns Rpt, IV Corps, Apr, May 45; (4) Opns Rpt, By that date one platoon of the 92d
II Corps, 1 Apr-2 May 45; (5) Hist, 92d Div, Apr, Division clearing station was northwest
May 45; (6) Annual Rpt, Surg, 10th Mountain
Div, 1945; (7) Annual Rpt, Surg, 91st Div, 1 Jun-12 of Genoa, and the Viareggio unit of the
Aug 45; (8) Hist, 47th Armored Med Bn, Apr, May 32d Field Hospital was on its way to
45; (9) Unit Hists, 10th Mountain Med Bn, Apr, Alessandria, on the road to Turin. The
May 45; (10) Hist Rcd, 109th Med Bn, Apr, May
45; (11) Opns Rpts, 310th Med Bn, Apr, May 45; field hospital was in the vicinity of Milan
(12) Hist, 313th Med Bn, Apr, May 45; (13) Unit en route when hostilities ceased.
Hist, 316th Med Bn, Apr, May 45; (14) Hist Data,
Med Bn 92d Inf Div, Apr, May 45; (15) Annual
Rpts, 1945, of 54th, 161st, 162d, 163d Med Bns; (16) Medical Support of IV Corps—First of
Annual Rpts, 1945, of 15th, 32d, 33d, Field Hosps.the IV Corps medical units to go into
464 MEDITERRANEAN AND MINOR THEATERS
accompanied a task force on a spectacular held until clearing stations or field hos-
70-mile dash from the Po to Lake Garda, pitals were located. Prisoner of war
where for two days the clearing station patients, who outnumbered Allied
constituted the left flank of the division. casualties, were usually sent to captured
On 28 April a company of the 47th German hospitals in captured vehicles.
Armored Medical Battalion traveled 62 It was quickly obvious that field hospi-
miles; and the following day a collecting tal platoons could not possibly keep pace
company of the 109th Medical Battalion, with division clearing stations and still
organic to the 34th Division, covered 170 perform surgery or hold nontransport-
miles in a roundabout journey from the able casualties. The corps surgeon tried
vicinity of Fidenza to the outskirts of to keep these units as available as possi-
Milan. A 30-mile jump was average. ble in terms of transportation, but in-
From 20 April on, medical units were evitably they fell behind, where their
periodically out of touch with their own functions became more nearly those of
headquarters, sometimes for days at a evacuation than of forward surgical hos-
stretch. Fortunately, casualties by this pitals.
time were light, and could generally be Of the two platoons of the 32d Field
466 MEDITERRANEAN AND MINOR THEATERS
Hospital attached to IV Corps, the 2d hospital about to move, the unit had
Platoon followed the westward push of little to do. There were three other field
the 34th Division along Highway 9 and hospital units and one evacuation hospi-
the BEF south of that route. Moving on tal closer to the front at that time.
20 April from Valdibura, where it had Evacuation of aid and collecting sta-
spent the winter, to Lama about ten tions in the Po Valley was by ambulance,
miles south of Bologna on Highway 64, jeep, truck, and captured vehicles of all
the unit was the most forward Fifth kinds. In this flat, well-traveled country,
Army hospital, but it was already too far there were no backbreaking litter car-
behind. At Castelfranco, some fifteen ries. The extra litter bearers attached at
miles west of Bologna on Highway 9, the start of the drive were released when
there was no such complaint. The town the plains were reached, and most of the
was being shelled when the hospital regular bearers were sent back for rest.
arrived on 22 April. Four additional Until clearing stations crossed the Po,
surgical teams were called in, and for boats and Dukws as well as ponton
seventy-two hours four operating tables bridges were used for evacuation. On
were in constant use. On 28 April the Lake Garda boats were used extensively,
unit moved west once more on Highway partly to bypass stretches of highway
9. Parma was passed, but Piacenza was blocked by the destruction of tunnels,
still held by the enemy, so the unit set partly because elements of the 10th
up in buildings of a civil hospital in Mountain Division were operating on
Fidenza. Two hours later the platoon the west side of the lake and casualties
was ordered to close and return to could not be reached in any other way.
Parma, where its own functions could
be combined with administration of a Medical Support of II Corps—The II
large German hospital captured there. Corps medical service did not differ in
The 3d Platoon of the 32d Field any essential from that of IV Corps.
opened in Vergato on 18 April, moved Casualties in all divisions were heavy for
70 miles on 24 April to a bivouac area in the first three or four days. After de-
the vicinity of the corps Po crossings, and bouchment into the Po Valley, casual-
opened in Mantova two days later. On ties declined sharply while distances
1 May the unit moved to the suburbs of covered and speed of movement in-
Milan. In the final stages of the cam- creased.
paign, sections of the 615th Clearing The clearing station of the 313th Med-
Company, 163d Medical Battalion, ac- ical Battalion, serving the 88th Division,
companied the field hospital units to care for example, was in the vicinity of
for overflow and to provide holding fa- Loiano on Highway 65 when the drive
cilities to enable the hospitals to move started. The station moved over to Ver-
forward. gato on 19 April when the intercorps
Late in the campaign, on 29-30 April, boundary was shifted, but most of its
the 3d Platoon of the 15th Field Hospital patients there were from the 10th Moun-
was attached to IV Corps and set up in tain Division, whose clearing station was
the vicinity of Modena, but aside from temporarily out of contact. The clearing
receiving the patients of an evacuation station of the 88th moved to Lama on
ADVANCE TO THE ALPS 467
20 April, and on the 22d moved up to San casualties of the 91st Division were less
Giovanni, some distance beyond the site than half those suffered in a comparable
originally selected. The following day time period against the Gothic Line in
found the station at Mirandola, and on September 1944.
the 26th it was beyond the Po. A series The medical service of the 34th Divi-
of rapid moves on the last three days of sion followed a similar pattern before its
the month brought the station succes- transfer to the IV Corps at Bologna.
sively to Lonigo, Vicenza, and Bassano, In addition to the divisional medical
while the division it supported probed units, the 383d Clearing Company, 54th
into the Alps. The clearing station of the Medical Battalion, operated a collecting
91st Division—316th Medical Battalion- station for corps troops during the first
was in Praduro at the foot of the Apen- hectic days in the Po Valley. Elements
nines on 21 April, but daily moves there- of the 54th also performed holding
after brought the unit across the Po and chores toward the end of the period to
Adige Rivers and east to Treviso, where enable the field hospital platoons to
the Eighth Army zone began. Battle move forward.
468 MEDITERRANEAN AND MINOR THEATERS
Source: (1) Compilation by Fifth Army Casualty Section. (2) Theater ETMD Rpt for Jul 45. Totals for the 92d
Division are from the ETMD. Figures for the attached regiments—the 442d and 473d—are calculated. Wounded in action
figures for the 442d and 473d Regiments given by Goodman, Fragment of Victory, page 217, are respectively 513 and
571 for the period 5 April-2 May inclusive, or 1,084 in all, compared with 1,083 arrived at by calculation. Since there was
no combat action prior to 5 April or after 2 May the time periods may be taken as comparable for purposes of re-
cording wounded in action.
One of these, the 1st Platoon of the 88th and 91st Divisions in the opening
33d Field Hospital, found itself tied days of the campaign and was tied down
down in Casalecchio on the northern at its initial site for two weeks. On 29
rim of the Apennines from 21 April un- April the unit made the long jump to
til after the surrender because its pa- Vicenza, but found itself still a rear in-
tients could not be moved and the unit stallation.
was too far in the rear to be relieved. Its Fifth Army battle casualties, based on
place on the II Corps front was taken by hospital admissions, are shown by divi-
the 1st Platoon of the 15th Field, which sions for the period 1 April through 15
was attached north of San Giovanni on May in Table 33.
24 April and was beyond the Adige at
Cologna by the 28th.
The 2d Platoon of the 33d Field Hos- Hospitalization
pital moved quickly through Bologna, in the Army Area
San Giovanni, and Mirandola without
ever getting close enough to the fighting Deployment and Use of
lines to see more than a few patients. At Army Hospitals
Isola della Scala, several miles south of
Verona, the unit finally caught up with The demands that would be placed
the war on 26 April, handling 110 surgi- upon the Fifth Army medical service by
cal cases in four days before going on to the Po Valley Campaign had been an-
Bassano. The 3d Platoon of the 33d ticipated in the planning stage, and every
Field, at Monghidoro on Highway 65, feasible preparation was made to get hos-
took the nontransportable cases from the pitals into the forward areas as quickly
ADVANCE TO THE ALPS 469
as the inadequate highway network and pital opened at 1815 and had 78 patients,
the progress of the fighting allowed. As all nontransportables, by midnight. The
a preliminary step, the newly organized next day the 1st Platoon of the 602d
171st Evacuation Hospital relieved the Clearing Company, 162d Medical Battal-
170th on 2 April at Lucca, where it was ion, set up beside the 15th Evacuation
to support the coastal drive of the 92d to handle the overflow.
Division, while the 170th went into biv- For three days the 15th Evacuation
ouac packed for movement when called was the most forward Fifth Army hospi-
upon. Surgical teams from the 170th tal in the IV Corps sector. All nontrans-
served with other Fifth Army hospitals portable casualties were routed to this
during this inactive period. The 15th unit from an army control point farther
Evacuation closed at Florence on 10 up the road, transportable and slightly
April two days before the originally wounded cases going back to Pistoia and
scheduled D-day for the IV Corps attack; Montecatini. The hospital staff was
and the 94th closed its Florence unit on augmented during this period by eleven
the 12th.6 auxiliary surgical teams. After four days
The 15th Evacuation, which had en- nine of these teams were withdrawn, but
7
joyed nearly seven months of rear- two Brazilian teams were attached. The
echelon security in Florence, was selected Brazilian staff of 26 officers, 21 nurses,
by General Martin to be the first hospital and 68 enlisted men who had been with
to move into the new combat zone. A the 16th Evacuation in Pistoia since No-
location for the hospital was prepared vember were also attached to the 15th
by the engineers north of Porretta on Evacuation on 23 April, but remained
Highway 64, only five miles from the only three days.
IV Corps line of departure, but the great- The 170th Evacuation Hospital
est care was taken to conceal the pur- opened on 18 April near Silla, somewhat
pose of the work. Latrines were dug forward of the 15th at the same time that
under camouflage nets, and personnel of a unit of the 32d Field moved into Ver-
the advance detail bivouacked with ad- gato. Thereafter the 15th received mostly
jacent combat units. The entire hospital lightly wounded and transportable cases,
was loaded onto 80 trucks by 12 April. the serious casualties going to the more
Orders were received at 0820 on 14 April forward units, but the total number of
lifting the security ban and giving the admissions rose. The shift of Fifth Army
convoy clearance for 0930. With trucks strength to the west of the Reno River
placed in the order in which they were had the effect of funneling the wounded
to be unloaded, the convoy covered the from two more divisions down Highway
75-mile distance in three hours. Casu- 64. There was no room to back up the
alties were already on the way to the medical units already there, and all of
site from the clearing stations. The hos-
6 7
Principal sources for this section are: (1) An- These were presumably the two teams that had
nual Rpt, Surg, Fifth Army, 1945; (2) Annual been serving throughout the winter with the 2d
Rpt, Surg, II Corps, 1945; (3) Unit rpts of the Platoon of the 32d Field Hospital at Valdibura.
hosps and other med units mentioned in text; See p. 440, above. The field unit was closed pending
(4) ETMD's of hosps mentioned in text, for Apr movement about the time the 15th opened at
45. Porretta.
ADVANCE TO THE ALPS 471
them worked around the clock until the city was captured on 21 April. Martin's
combat troops began to debouch into the personal survey revealed no buildings
valley. By that time, enough ground had suitable for hospital sites without exten-
been secured to permit leapfrogging an- sive and time-consuming repairs, which
other hospital ahead of those in the Por- were precluded by the unexpectedly
retta-Vergato area. The 750-bed 38th swift advance of Fifth Army. Only the
Evacuation Hospital was brought up on 56th was ordered forward, arriving on
20 April to Marzabotto, where Highway 22 April and taking patients at the pre-
64 begins to level off. The Brazilian per- determined stadium site at noon on the
sonnel from the 15th Evacuation were 23d.
shifted to the 38th, to which they had The same speed of advance that left
originally been attached, about 26 April.8 Bologna too far behind for the forward
(Map 39) medical service almost as soon as it was
On the II Corps front, meanwhile, the captured, increased the difficulties of the
94th Evacuation reopened at its old Fifth Army surgeon. Rations, fuel, am-
Monghidoro site on 17 April, about thirty munition, assault boats, and bridging
hours after the corps jump-off. For the materials, all had to be brought by truck
next few days the 94th shared the load across the mountains from supply depots
of casualties in the Highway 65 sector in the Florence area, and there were no
with the 8th Evacuation at Pietramala. trucks left over to move the hospitals.
The 56th, at Scarperia, was already General Martin solved the problem by
closed to admissions, and on 20 April be- pooling all the organic transportation of
gan dismantling and loading for a quick his semimobile evacuations. Operating
dash to Bologna whenever that city on a 24-hour basis and alternating
should be captured. drivers, these vehicles moved the bulk
During this period of heavy pressure of the Fifth Army hospitals into the Po
on forward evacuation hospitals, the Valley on a schedule so expertly managed
presence of base units in the army area that no hospital was out of action for
proved invaluable. The 24th General more than twenty-four hours.
Hospital in Florence and the 70th Gen- At 0900 on 23 April, while the 56th
eral in Pistoia were able to take enough Evacuation was still setting up its equip-
movable casualties from the army units ment in Bologna, the 94th was ordered
to permit the evacuation hospitals to to close at Monghidoro. All patients
keep up with demands made upon them. were evacuated by 2100 and the first con-
The 56th Evacuation was to set up in voy of trucks was on the road before
tents in a large stadium, located by air dawn of 24 April. The destination was
reconnaissance. Other hospitals were to Carpi, a village about ten miles north
be brought into Bologna as rapidly as of Modena. Using buildings of a civilian
buildings could be found to house them. hospital, the 94th was taking patients at
General Martin awaited word of the fall its new site by 2000. Even more rapid
of Bologna at the 94th Evacuation, and was the move of the 750-bed 16th Evac-
was one of the early arrivals after the uation, which closed at Pistoia on 23
April, moved during the night to San
8
See p. 440, above. Giovanni, a road junction fifteen miles
ADVANCE TO THE ALPS 473
northwest of Bologna, and was function- ers, packing was accomplished in three
ing as a hospital once more by 1800 on hours. The 15th arrived in Mantova
24 April. (Map 40} north of the Po the afternoon of 28 April,
On the same day, the neuropsychiatric where it took over a large sanatorium
and venereal disease hospitals, operated and more than 300 patients from a unit
respectively by the 601st and 602d Clear- of the 32d Field. Until 25 April the
ing Companies, also moved to San buildings had housed a German hospital.
Giovanni, the former from Cafaggiolo The 8th Evacuation, after several days
and the latter from Florence. In each of waiting for transportation, received
case the move was made by organic trans- its vehicles in the late afternoon of 29
portation of the medical battalion to April, moved out over the battle-scarred
which the unit belonged. The venereal remains of Highway 65 during the night,
disease hospital carried 30 patients with and admitted its first patients at the new
it in ambulances borrowed from one of site just south of Verona before the end
the battalion's collecting companies. of the day, 30 April. The 171st also
Penicillin treatment of these patients moved out the night of 29 April, but
was continued en route without interrup- because its new site was Vicenza, 200
tion. miles away, with the whole width of the
On 25 April the 1st Platoon of the Apennines to cross, it did not open until
601st Clearing Company from Monteca- 1 May. In the meantime, the 38th Evac-
tini and the 2d Platoon of the 15th Field uation had dismantled, packed, moved
Hospital from the Cafaggiolo area were 90 miles to Fidenza west of Parma on
moved to La Spezia to act as a provisional Highway 9, and reopened on 30 April.
evacuation hospital for the 92d Division. (Map 41)
The 170th Evacuation, after a week The last hospital moves before the
of hectic operation on Highway 64, evac- German surrender put the 92d Division's
uated its transportable patients to the provisional evacuation in Genoa by 1
70th General in Pistoia on the night of May; the venereal disease hospital in Ve-
25 April. Leaving one ward behind to rona and the neuropsychiatric hospital
care for 27 patients who could not be at Villafranca on 2 May. Since there were
moved, the 170th pulled out the morn- no longer enough neuropsychiatric cas-
ing of 26 April and reopened the same ualties to justify the existence of a hos-
day at Mirandola, about eighteen miles pital for that purpose alone, the 2d
south of Ostiglia where combat units Platoon of the 602d Clearing Company
were still crossing the Po. Only the 171st reverted to air evacuation holding duties
Evacuation at Lucca, the 8th at Pietra- at Villafranca airport. The 170th Evac-
mala, and the 15th at Porretta were still uation was in process of moving from
in the mountains, and all three of these Mirandola to Treviso, and the 1st Pla-
were alerted for movement. toon of the 602d Clearing Company was
The 15th went first, leaving a holding en route from Porretta to Modena when
detachment of 2 officers, 2 nurses, and the war in Italy came to an end.
15 enlisted men to care for 17 nontrans- For all Army hospitals supporting the
portable patients. Moving the hospital Po Valley Campaign, the pattern of ad-
tentage and equipment on 10-ton trail- missions was similar. Heavy casualties,
ADVANCE TO THE ALPS 475
with a preponderance of severe wounds, most half were prisoners of war at the
characterized the start of the drive, giv- 38th and more than half at the 56th.
ing way in the later phases to relatively The medical service in the Po Valley
few American casualties, mostly lightly Campaign, like the military operations,
wounded, and a growing volume of pris- falls into two distinct phases. Before the
oner patients. breakout from the mountains the use of
The 171st Evacuation—the only evac- field and evacuation hospitals and corps
uation hospital supporting the 92d Di- clearing companies followed normal
vision's coastal attack—admitted 2,416 lines, but with activity intensified by the
patients between 2 April and the end heavy influx of casualties and by long
of the month, of whom 1,128 were battle and difficult evacuation lines. In the val-
casualties. Italian partisans made up the ley itself the whole hospitalization pic-
greater portion of the 364 Allied pa- ture was confused, with poor communi-
tients treated. cations and inadequate transportation
The 15th Evacuation admitted 1,592 forcing hospitals to assume unorthodox
patients, 1,173 of them surgical cases, roles. Field hospital platoons, with or
during its two weeks at Porretta, with without assistance from clearing com-
most of the serious cases coming in the panies, operated as evacuation hospitals,
first four days. The 170th, in the course and evacuation ran the gamut from first
of a week spent in the same area, ad- priority surgery to station hospital
mitted 528, of whom 372 were battle duties.
casualties. The 94th Evacuation ad-
Hospitalization of Prisoners
mitted 496 surgical cases at Monghidoro
of War
and Carpi. The 8th Evacuation, which
was for two days the only hospital back- Until the Po River was reached,
ing up the II Corps attack, took 72 enemy casualties were routinely evacu-
priority cases on 16 April and 97 more ated to Fifth Army hospitals, where they
in the next twenty-four hours, "as seri- were cared for in the same manner as
ous and severe" as any previously seen in U.S. and Allied patients. Only a trickle
Italy. The 8th had a backlog of 80 opera- of wounded Germans reached the 171st
tive cases by the morning of 18 April, Evacuation Hospital, owing to the
and received another 85 that day. With lengthening evacuation lines on the 92d
the 94th set up ahead of them and the Division front. The total was no more
corps breaking out of the mountains, the than 100 out of 2,000 patients treated
load then dropped abruptly. By 20 April by that unit during its stay at Lucca. On
the 8th Evacuation was receiving only the IV Corps front, however, the 15th,
rear echelon cases. 170th, and 38th Evacuations on High-
The 16th Evacuation had 1,016 ad- way 64 admitted a considerable number
missions at San Giovanni by the end of of German casualties after the first week
April, 542 of them battle casualties, but of combat. The 8th and 94th Evacuations
the bulk of these were transferred from supporting II Corps also began taking
more forward units. Battle casualties also enemy casualties before leaving the
made up the larger group of patients at mountains. 9
the 38th and 56th Evacuations, but al- 9
This section is based primarily on the follow-
476 MEDITERRANEAN AND MINOR THEATERS
The number of enemy casualties be- Evacuation at Bologna, the 38th at Mar-
came so large as to constitute a major zabotto and Fidenza, the 16th at San Gio-
problem after the fighting turned into vanni, the 94th at Carpi, and the 170th
a battle of pursuit in the Po Valley. The at Mirandola all received German cas-
bulk of the German medical facilities ualties by the hundreds in the closing
had by that time been withdrawn north days of the war in Italy. The 38th treated
of the Po, and German medical corps- close to 500, the 56th more than 800
men south of the river had no alterna- before the end of April. At the 56th, two
tive but to bring their casualties to Allied German surgical teams were organized
clearing stations or hospitals. The 56th and kept busy operating on prisoners. In
many cases German ambulance drivers
ing: (1) Annual Rpt, Surg, Fifth Army, 1945; (2) who brought their wounded to American
Annual Rpt, Surg, II Corps, 1945; (3) Unit rpts hospitals were allowed to return un-
of the hosps and med battalions mentioned in
text; (4) ETMD's of the named hosps for Apr and guarded for further loads.
May 45. The first German hospital to be cap-
ADVANCE TO THE ALPS 477
tured intact was taken by the 10th Moun- man wounded under supervision of
tain Division on the south bank of the American medical personnel.
Po on 23 April. The unit was fully In the IV Corps sector, the field hos-
equipped, with its full complement of pital units were ordered to set up their
doctors, nurses, and corpsmen, but its own establishments in connection with
supplies were virtually gone. In this case, captured German hospitals, combining
the patients were evacuated to U.S. units, administration of the prisoner units with
and the dismantled hospital was sent to their own. In the II Corps area the task
the rear. It was soon clear, however, that of administering enemy medical units
the Allies could not afford to waste fa- devolved upon the 54th Medical Battal-
cilities in this fashion. A directive from ion. The number of German hospitals
Allied Force Headquarters required taken in the final days, however, was too
Fifth Army thereafter to use German great for either technique to be used ex-
hospitals and personnel to care for Ger- clusively. Divisional medical units and
478 MEDITERRANEAN AND MINOR THEATERS
evacuation hospitals also participated there was little food and no fuel for es-
when occasion required. sential services such as running steriliz-
For example, the 3d Platoon of the ing equipment and cooking.
32d Field Hospital, coming up from At Parma, where the 2d Platoon of
Vergato, crossed the Po on a ponton the 32d Field took over a German hos-
bridge early in the afternoon of 26 April, pital on 28 April, 220 German patients
entered Mantova on the heels of the were being cared for by 15 German med-
retiring enemy, and proceeded immedi- ical officers, 120 corpsmen, and 3 Italian
ately to a large civilian hospital and Red Cross nurses. The establishment had
sanatorium known to have been used by to be put under immediate guard to pro-
the Germans. Until the preceding day tect its patients from attacks by partisans.
the establishment had served the enemy On 2 May the same platoon of the 32d
as a base hospital. Since that time it had Field added administration of a second
been administered by 5 British enlisted German hospital, located ten miles away
men who had been prisoners. There at Brescello, to its duties. The Brescello
were 54 Allied patients, including a few unit had 83 patients. Its existence was
Americans, and 140 German patients. reported by a German medical officer
The staff consisted of 3 German medical who came to the Parma unit under Par-
officers, 5 volunteer Italian doctors, 3 tisan guard.
Italian medical students, 13 volunteer In the II Corps sector, the 54th Med-
Italian nurses, a dozen or more nuns ical Battalion took over its first German
from a nearby convent, 30 German med- hospital on 27 April, when the 380th
ical corpsmen, 18 Italian medical sol- Collecting Company assumed adminis-
diers who had been interned by the tration of the 29th Panzer Division hos-
Fascists, a German Army chaplain, and pital southeast of Verona. Enemy units
some 15 Italian partisans acting as at Citadella and Caldogno were taken
guards. over on 30 April, one at Galliera on 1
Most of the Allied patients were in May, and another at Paderno on 2 May.
fair condition, despite short supplies of All of these hospital sites were in the
both food and drugs, but infected Vicenza-Treviso area, where the 171st
wounds calling for surgery were common Evacuation in the opening days of May
among the Germans. The field hospital also took more German than Allied pa-
unit operated the prisoner of war hospi- tients.
tal as well as its own for two days, then The condition of these captured hos-
turned both over to the 15th Evacuation, pitals varied markedly, both as to equip-
which was operating as a POW hospital ment and in terms of staff, but a unit
almost exclusively by the end of the war. captured at Bergamo by the 1st Armored
The field hospital unit, meanwhile, Division, which had 14 doctors to care
moved on to Garbagnate near Milan, for 1,180 patients, was more typical than
where another German hospital was the Parma hospital with its 15 doctors
taken over. The Garbagnate establish- and 220 patients.
ment had close to 600 German patients The process of rounding up and con-
in charge of a minimum staff, a supply centrating the 23,000 prisoner casualties
depot, and a laboratory. Here again taken by Fifth Army was only beginning
ADVANCE TO THE ALPS 479
LAKE GARDA, used by assault boats and local craft to evacuate patients.
when the war ended. The main medical talions were reinforced when necessary
story for prisoners of war belongs to the by the attachment of collecting compa-
postwar period.10 nies or ambulance platoons from one of
the two Fifth Army medical battalions.
Evacuation From Fifth Army Evacuation during the mountain phases
of the fighting was by hand litter, jeep,
Evacuation from the battlefields and and ambulance. On the 92d Division
from division clearing stations in the Po front the pack mules that brought in sup-
Valley Campaign followed the normal plies were sometimes used to carry out
pattern, with the 54th Medical Battalion the wounded from otherwise inaccessible
evacuating from II Corps and the 163d positions. In the Po Valley, evacuation
Medical Battalion from IV Corps and was predominantly by ambulance, trucks
the 92d Division. Both corps medical bat- being used for wounded prisoners and
ambulatory cases when ambulances were
10
See pp. 534-43, below. not available. Dukws and assault boats
480 MEDITERRANEAN AND MINOR THEATERS
were used to ferry the wounded across sites for fixed hospitals were available
the Po, and to bypass roadblocks along north of the mountains.
Lake Garda. The problem of evacuation Until the closing days of the war, all
within the army area was primarily one evacuation from Fifth Army to base hos-
of distance and transportation, which pitals was thus by ambulance, the bulk
was accentuated but not altered by the of it over the battered Highways 64 and
presence of large numbers of enemy 65, with distances stretching out to a
wounded in the later stages of the cam- hundred miles and more as the evacua-
paign and by the tendency of combat tion hospitals moved into the Po Valley.
units to outrun their medical support.11 The process was constant. The heavy
Evacuation from Fifth Army hospitals casualties of the first week forced con-
to base installations, however, posed diffi- tinuous clearing of forward units to
culties not previously encountered by the make way for the newly wounded, and as
medical service in Italy. Until the Po the casualties diminished, the distances
Valley itself was occupied, fixed hospitals increased to keep ambulances unremit-
could not be brought closer than they tingly on the road. Patients were carried
were in the Florence-Pistoia-Leghorn to the nearest base hospital—the 24th
area. Between these hospitals and the General in Florence and the 70th Gen-
battle front lay mountain ranges 50 to eral at Pistoia for the most part—where
100 miles in depth. All rail lines had bed space was kept open by the daily
long since been knocked out, leaving transfer of older cases to Leghorn and
only highways gutted by six months of Naples by rail and air.
war to supply the army as well as to The airfield at Bologna was opera-
evacuate the wounded. Air evacuation tional by 25 April, and a detachment
could not be used until captured airfields of the 802d Medical Air Evacuation
in the Po Valley could be made opera- Transport Squadron set up a station
tional, and even then might be too haz- there on that day.12 A second air evacua-
ardous since the slow C-47's would be tion station was established at Villa-
highly vulnerable while they gained franca south of Verona on 2 May,
altitude for the mountain crossing. where the 2d Platoon of the 601st Clear-
Since the eastern end of the Apennine ing Company combined the functions of
chain would be easiest to cross, two sta- air evacuation holding unit with those
tion hospitals, the 60th and the 225th, of Fifth Army neuropsychiatric hospital.
both assigned to the Adriatic Base Com- The only fixed hospital to open north
mand, were moved into the Ancona area
before the beginning of the campaign, 12
Hist, 802d MAETS, Apr 1945. There is no rec-
but no other shifts were practical until ord, however, either in the monthly report of the
squadron or in the medical situation reports of the
Peninsular Base Section of any patients actually
11
This section is based primarily on the follow- being evacuated from Bologna by air before the
ing: (1) Annual Rpt, Surg, Fifth Army, 1945; (2) end of April. The 402d Collecting Company, which
Final Rpt, Plans and Opns Off, MTOUSA, 1945; was supporting the 56th Evacuation Hospital at
(3) Unit rpts, 54th, 161st, 162d, 163d Med Bns; Bologna until 2 May, states in its final report
(4) Unit rpts of hosps and other med installations (History, 161st Medical Battalion, 1 January-1 Au-
mentioned in text; (5) G-4 Rpt in Hist, 92d Div, gust 1945), that there was no air evacuation from
Apr 45. Bologna during its stay there.
ADVANCE TO THE ALPS 481
AMBULANCES FORDING RENO AT PRADURO while traffic bound for front uses Bailey
bridge (right).
of the Apennines before the German sur- Medical Supplies and Equipment
render was the 74th Station, which began
taking patients in Bologna on 27 April. In preparation for the Po Valley Cam-
There were 600 cases by 1 May, and an- paign, the 2d Storage and Issue Platoon
other 400 less serious cases had been of the 12th Medical Depot Company sent
housed, fed, treated, and passed on to the an advance section up Highway 64 on
rear. The 6th General had meanwhile 7 April. Consisting of five enlisted men
arrived in Bologna and was setting up, and ten tons of medical supplies, the sec-
while the 37th General was en route to tion set up a dump at Valdibura, adja-
Mantova. With the establishment of cent to 32d Field Hospital. On 16 April
3,000 fixed beds so near at hand, evacua- the platoon joined its advance section,
tion hospitals were holding as many moving up to Porretta where an issue
patients as was physically possible when point with 40 tons of supplies was es-
the war ended. tablished. A small detachment was left
482 MEDITERRANEAN AND MINOR THEATERS
behind at Lucca, where it served the 92d Florence in no more than a day for the
division and medical units still in the round trip. For the rest of the month,
immediate vicinity. Its personnel were however, until the base depot itself could
attached for rations and quarters to the be moved into the Po Valley, both dis-
171st Evacuation Hospital. The Lucca tance and the rapid consumption of
section functioned independently of the supplies to care for prisoners of war
parent platoon, forwarding any requisi- made resupply difficult. Maximum use
tions it could not fill directly to the main of captured German medical supplies
depot in Florence.13 and equipment was made during this
The 3d Storage and Issue Platoon, period.
which had supported II Corps through- Despite the speed of the campaign, the
out the winter from its dump near dispersion of installations, and the short-
Monghidoro, moved forward to Bologna ages of transportation, there is no record
on 24 April with 50 tons of medical sup- that any Fifth Army medical unit failed
plies. The following day the Porretta to obtain adequate supplies or replace
dump displaced forward to Mirandola, equipment through regular channels.
transferring again to Verona on 30 April. The success of the 12th Medical Depot
The depot headquarters, maintenance Company was achieved, moreover, while
section, and 1st Storage and Issue Pla- supplying close to 300,000 troops instead
toon moved on 1 May from Florence to of the 75,000 normally served by such a
Modena, where the base dump was unit.
established with 150 tons of supplies. The optical and dental services of the
The 92d Division, remote as it was 12th Medical Depot Company continued
from the issue points supplying II and to function without interruption
IV Corps, drew its medical supplies through the Po Valley Campaign.
through its own organization. The divi-
sional medical supply dump moved from Professional Services
Viareggio to Massa on 16 April, was in in the Army Area
Riva just south of Sestri ten days later,
and opened in Genoa on the 29th.14 Medicine and Surgery
On the 92d Division front, transpor-
tation difficulties were constant, with While the total number of hospital
mule pack trains being used in the moun- admissions during the brief period of the
tainous areas. On the II and IV Corps Po Valley Campaign was large—6,151
fronts, no difficulties were experienced cases of disease, 1,533 cases of injury, and
in keeping forward dumps supplied un- 5,092 battle casualties, or 12,776 admis-
til 25 April. Up to that time both corps sions not counting prisoners of war-
installations could be reached from there were no outstanding developments
in combat medicine or surgery. Evacua-
13
This section is based primarily on the follow- tion hospitals, especially the 15th and
ing: (1) Annual Rpt, Surg, Fifth Array, 1945; (2) 170th on Highway 64 and the 8th and
Annual Rpt, 12th Med Depot Co, 1945; (3) David- 94th on Highway 65, handled a larger
son, Med Supply in the MTOUSA, pp. 140-42; (4)
Unit rpts of Fifth Army hosps and med bns. proportion of the priority surgical cases
14
G-4 Rpt in Hist, 92d Inf Div, Apr 45. than had been true in earlier campaigns,
ADVANCE TO THE ALPS 483
but this was because the majority of bat- the percentage for any other combat
tle wounds occurred in the opening days month in Fifth Army history. The num-
of the offensive while the evacuation hos- ber of psychiatric casualties declined
pitals were still close to the action. The sharply during the battle of pursuit in
field hospital platoon with attached sur- the Po Valley, and by the end of hostili-
gical teams continued to be the preferred ties was no longer enough to justify the
installation for forward surgery. Whole separate existence of a neuropsychiatric
blood flown up from the Naples blood hospital at the army level.
bank and from bleeding sections in While both medical and surgical serv-
Florence and Pisa was used extensively, ices of Fifth Army units were pushed to
and was again delivered to forward areas the limit of their capacities in the three
by cub plane.15 weeks of active combat, the problem was
The medical problems were the nor- always one of applying familiar tech-
mal ones, predominantly respiratory and niques on the required scale rather than
intestinal diseases attributable to expo- the development of new methods to cope
sure or to inadequate sanitation in newly with unforeseen crises.
conquered areas. An outbreak of hepa-
titis in the 1st Battalion on the 86th In- Dental Service
fantry, 10th Mountain Division, during
the first two weeks of April suggested Dental work during the weeks of
drinking water as the source of infection. actual combat was largely confined to
The 3d Battalion of the 362d Infantry, emergency cases, with many dental offi-
91st Division, suffered an outbreak of cers, particularly those on the staffs of
atypical pneumonia in the second and evacuation hospitals, performing a va-
third weeks of April, with evidence indi- riety of other functions. Complete dental
cating a barn used for showing films and service was nevertheless available in the
16
an adjacent straw pile as the point of army area throughout the campaign.
origin. The incidence of venereal disease The IV Corps dental clinic ceased op-
declined in April, as was to be expected eration in mid-April when the 32d Field
in combat. Hospital platoon to which it was attached
Psychiatric disturbances increased closed at Valdibura, and operations were
markedly over the static winter months, not resumed until after the end of hos-
with a total of 1,430 cases in April, of tilities. The II Corps clinic, however,
which 668 were returned to full duty continued to operate throughout the
from the division clearing stations or campaign, moving forward with the
rehabilitation centers and 266 from hos- clearing company of the 54th Medical
pitals, which also returned 293 to limited Battalion. The Fifth Army dental clinic,
duty. Only 203 were evacuated out of the conducted by the 2d Platoon of the 602d
army area, or 14.2 percent—lower than Clearing Company, 162d Medical Battal-
15 16
Principal sources for this section are: (1) Principal sources for this section are: (1) An-
Annual Rpt, Surg, Fifth Army, 1945; (2) ETMD's nual Rpt, Surg, Fifth Army, 1945; (2) Annual
for Apr, May and Jun 45; (3) Unit rpts of Fifth Rpt, 320! Field Hosp, 1945; (3) Annual Rpt, 54th
Army hosps and of 2d Aux Surg Gp. Med Bn, 1945; (4) Dental Hist, MTO.
484 MEDITERRANEAN AND MINOR THEATERS
ion, also functioned in its normal capac- of the campaign, the 10th Mountain Di-
ity, moving with the platoon, which also vision received 180 horses for its cavalry
operated the army venereal disease cen- reconnaissance troop from the Fifth
ter, to San Giovanni on 24 April and to Army Remount Depot, and 525 mules
Verona on 2 May. Mobile prosthetic and direct from the United States. The divi-
operative trucks and the mobile dental sion's animal strength ultimately reached
dispensaries of the divisions were in serv- 822, not counting attached Italian pack
ice as far forward as circumstances per- rnule companies. There were approxi-
mitted.17 mately 4,500 horses and mules and 125
The ratio of dental officers to army scout dogs in Fifth Army during this
strength for April 1945 was 1:924, a period.18
slight improvement over the preceding Veterinary service was supplied by di-
month but higher than the average ratio vision and corps veterinary personnel,
for the North Apennines Campaign. The which in the case of the 10th Mountain
19
total number of dental operations per- Division was substantial. Fifth Army's
formed in Fifth Army in April was less four Italian-staffed and U.S.-equipped
than for any month since September veterinary hospitals were supplemented
1944. The length of time available for by the late arrival on 17 April of the 36th
getting the troops into shape before the Veterinary Company, whose 5 officers
beginning of the offensive was a factor in and 59 enlisted men took over the bulk
reducing the need for dental work once of the animal evacuation thereafter. The
the drive was under way. three semitrailers with which the com-
pany was equipped proved less satisfac-
Veterinary Service tory for negotiating the difficult Italian
roads than the trucks previously used.
Animal transportation was as essential The 212th Veterinary Station Hos-
to Fifth Army in the Po Valley Cam- pital, serving IV Corps, was the first to
paign as it had been throughout the ear- enter the Po Valley. The unit closed at
lier fighting in Italy. The only note- Lucca on 20 April and opened at Palazzo
worthy changes were in the direction of Beccadelli, on the edge of the plain about
better organization and more complete ten miles west of Bologna, on the 22d.
veterinary support. By the launching of The 211 th Veterinary Evacuation, also a
the final drive, Fifth Army had 17 Italian IV Corps unit, closed at Riola in the
pack mule companies, grouped into 5 10th Mountain Division sector on 24
battalions under the 2695 Technical Su-
pervision Regiment. Each company had
18
269 animals and 379 men, including an Sources for this section are: (1) Annual Rpt,
Surg, Fifth Army, 1945; (2) Opns Rpt, II Corps,
Italian veterinarian. Three U.S. veteri- 1Apr-2 May 45; (3) Opns Rpt, IV Corps, Apr
nary officers functioned at the battalion 45; (4) Hist, 92d Div, Apr 45; (5) Annual Rpt,
level. In addition to these units, the 92d Surg, 10th Mountain Div, 1945; (6) Vet Rpt, Sick
and Wounded Animals, Apr 1945; (7) Hist, 36th
Division had its own provisional pack Vet Co (Separate) ; (8) Fifth Army History, pt. IX;
mule battalion. Shortly before the start MS, Veterinary History, Mediterranean Theater of
Operations.
19
The 10th Mountain Div had 22 veterinary of-
17
See pp. 452-53, above. ficers and 182 enlisted men. See p. 432, above.
ADVANCE TO THE ALPS 485
April, opening two days later at Ghisione While animal casualties were fewer
just south of the Po in the vicinity of than in the North Apennines Campaign,
Ostiglia. The two veterinary evacuation the veterinary problem was complicated
hospitals attached to II Corps were some- by the capture of thousands of German
what later in getting across the moun- animals north of the Po, many of which
20
tains, both moving into the Verona area were in need of immediate attention.
in the closing days of the campaign. The Veterinary food inspection detach-
110th opened at Polvrifitto southeast of ments continued to operate with Fifth
the city on 28 April, while the 130th Army throughout the Po Valley Cam-
opened in Verona itself on the 30th. The paign, but their work was of a routine
Fifth Army Remount Depot moved to nature.
San Martino, close to the site of the 211th
Veterinary Evacuation Hospital, about1 20
See p. 517, below, for a discussion of the care and
May. (See Maps 39,40, 41.) disposition of these animals.
CHAPTER XIII
headed the SOS medical supply section In North Africa, which had been sub-
since May 1944. Jones brought with him stantially stripped of supplies and hos-
from the medical section of Corn- pital beds to build up the bases in
zone MTOUSA, a trained staff and a southern France, the Eastern and Atlan-
functioning organization. He succeeded tic Base Sections were absorbed by the
Radke as MTOUSA medical supply offi- Mediterranean Base Section on 15 No-
cer on 21 December. vember. The base section headquarters
The MTOUSA medical section moved was moved from Oran to Casablanca
out of the royal palace in Caserta on 12 early in December and on 1 March 1945
November to the quarters formerly occu- the whole of North Africa passed to con-
pied by the SOS medical section in an trol of the Africa-Middle East Theater.3
Italian military hospital. On 23 Novem- With all of southern France and all of
ber the personnel allotment of the sec- Italy south of the Arno firmly in Allied
tion was increased to cover losses, and on hands, the Mediterranean islands also
24 December an additional officer and 3 lost their strategic importance. The Is-
enlisted men were allocated to it, bring- land Base Section in Sicily had already
ing the authorized total to 32 officers, in- been closed out in mid-July, and the last
cluding 2 nurses, and 80 enlisted men. U.S. hospital left Sardinia the end of
Three medical officers were added in October. The Northern Base Section,
May 1945, bringing the aggregate person- consisting of the island of Corsica, con-
nel strength of the section to 115. tinued in operation on a reduced scale
until the end of the war, being finally
Concentration of Communications closed out on 25 May 1945.
Zone Functions in Italy The Peninsular Base Section, on the
other hand, grew in importance as the
The November 1944 reorganization African and island bases declined. As
brought the base sections back under the soon as the facilities of the port of Naples
control of theater headquarters at a time and the hospitals concentrated in that
when the progress of the war was con- vicinity were no longer needed for the
centrating the Mediterranean forces in logistical support of the forces in south-
northern Italy. The invasion of southern ern France, the base section began shift-
France had left the theater short of ing its strength to the Leghorn-Florence-
troops, transportation, equipment, and Pisa triangle. PBS headquarters was es-
hospital beds, and it was therefore essen- tablished in Leghorn on 25 November,
tial to eliminate so far as possible the fac- the subheadquarters in Naples thereafter
tor of distance.2 being designated as PBS South. Colonel
Arnest, the PBS surgeon, moved to Leg-
2
Principal sources for this section are: (1) horn with the base headquarters, leaving
Annual Rpt, Med Sec, MTOUSA, 1944; (2) Final Col. Leo P. A. Sweeney as his deputy in
Rpt, Plans and Opns Off, Office of the Surg,
MTOUSA; (3) Annual Rpt, Surg, PBS, 1944; (4) Naples.
Annual Rpt, Surg, MBS, 1944; (5) Annual Rpts, At the same time the U.S. component
Surg, NORBS, 1944, 1945; (6) Annual Rpt, Surg, of Rome Allied Area Command was
Rome Area, 1944; (7) Monthly Hist, Med Sec, Rome
Area, Jan-May 45; (8) AAFSC MTO, Annual Med
3
Hist, 1945. For subsequent activities, see pp. 8off., above.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 489
redesignated Rome Area, MTOUSA, ef- southern France, plus another 4,500 in
fective 1 December. The Rome Area sur- North Africa, and 750 in Corsica. In Italy
geon was Lt. Col. (later Col.) Benjamin the total would be 21,900 under control
L. Camp, who also retained his office as of the Peninsular Base Section and 3,200
deputy to the RAAC surgeon, Col. T. D. attached to the Army Air Forces. Of the
Inch of the Royal Army Medical Corps. PBS total, more than half were in the
The single U.S. fixed hospital scheduled Naples-Caserta area, 300 miles from
to remain in Rome was brought under the Fifth Army front, and only 4,000
the Rome Area jurisdiction, together north of Rome.
with responsibility for sanitation, vene- The problem thus posed for General
real disease control, and other miscella- Stayer and Colonel Arnest was immeasur-
neous medical functions. ably complicated by the necessity of hos-
Similarly, the Adriatic Depot was re- pitalizing in Italy for an indefinite time
constituted on 28 February as the Adri- the casualties evacuated from southern
atic Base Command (ABC) with head- France. Yet until the hospitals already
quarters at Bari. Though its primary closed in Italy and Africa could be re-
mission was still that of supporting the established in France there was no alter-
U.S. Army Air Forces units in Italy, it native. For the next two months the
was made responsible directly to MTO Italian communications zone, with 25
USA. After detailed study of the point, percent of its strength already with-
the hospitals previously attached to the drawn, would support two field armies,
Army Air Forces Service Command were each engaged in a major campaign. It
brought under the aegis of the Adriatic would support them, moreover, at long
Base Command. range, for the patient load would be too
By the end of hostilities, the medical great to permit any substantial number
activities of the communications zone in of beds to be closed for movement closer
the Mediterranean theater centered in to the front.
PBS Main at Leghorn, with lesser and
largely subsidiary bases in Naples, Rome, Casualties From Southern France
and Bari.
When the first casualties from the am-
Hospitalization in the phibious landings in southern France
Communications Zone reached Italy on 17 August 1944 there
were already some 25,000 patients on
The inadequacy of medical facilities in hand in PBS hospitals. Between that date
the Mediterranean theater was never and 20 November, an estimated 20,000
more obvious than at the start of the patients from France were received in
bitter and costly campaign in the north- PBS, in addition to Fifth Army casualties
ern Apennines. In the first days of and the routine disease and injury cases
September 1944, the Italian communica- from among service and replacement
4
tions zone was as deficient in bed strength troops in Italy.
as was Fifth Army. Nine thousand T/O 4
Principal sources for this section are: (1) An-
fixed beds were already closed or alerted nual Rpt, Med Sec, MTOUSA, 1944; (2) Annual
for closing in Italy for movement to Rpt, Surg, PBS, 1944; (3) ETMD's for Aug-Nov
490 MEDITERRANEAN AND MINOR THEATERS
While a few Seventh Army casualties cess of Fifth Army against the Gothic
were flown to Rome, the bulk of the evac- Line, of a quick breakthrough into the
uees from southern France went by sea Po Valley. Ground haze in that region
and air to Naples, where they were cared made air evacuation impossible in the
for by the 17th, 37th, 45th, and 300th winter months, and the rail lines had
General Hospitals. Each of these units been knocked out by Allied bombing. It
operated in excess of its Table of Organ- was therefore deemed essential to keep at
ization capacity during the emergency least a minimum of fixed beds mobile for
period, as did most of the PBS hospitals. early movement north of the Apennines.6
Fixed hospitals in both Naples and Rome At the beginning of the North Apen-
were still receiving thousands of casual- nines Campaign the 64th General Hos-
ties from Fifth Army through September pital was at Ardenza, a suburb just south
and October at the same time that the of Leghorn, with the 55th Station
Naples hospitals were filled with Hospital attached, giving the combined
wounded from southern France and two- installation a T/O capacity of 1,750 beds.
thirds of the beds in Rome were in proc- The 50th Station Hospital, with 250
ess of moving to northern Italy.5 The beds, was at Castagneto some 40 miles
only evacuation from the overcrowded down the coast, and the 24th General,
Naples hospitals at this time was to the with 1,500 beds, was at Grosseto, another
zone of interior, since there were no 40 miles farther south and 75 miles from
longer any beds left in Africa for long- the rearmost Fifth Army installations.
term patients. Moves made during September were
largely readjustments, not involving any
Movement of Fixed Hospitals of the large hospitals in the Naples or
Into Northern Italy Rome areas.
On 13 September the 154th Station
The overloading of PBS hospitals with Hospital—the only 150-bed unit in the
casualties from southern France and theater—moved up from the Battipaglia
from the Gothic Line was only one of staging area south of Naples to relieve
several reasons for the delay in moving the 105th Station at Civitavecchia. The
fixed beds into northern Italy. Another 105th, with 500 beds, moved on to Gros-
reason was the difficulty in finding sites seto to relieve the 24th General and the
for large installations. In the war-torn latter unit proceeded to Florence, where
Arno Valley few buildings were available it opened on 21 September in the exten-
of sufficient size to house a 1,500-bed or sive plant of a former Italian aeronautics
2,000-bed general hospital; and to set up school. By mid-October the hospital was
such an establishment in tents or prefab-
ricated buildings with adequate power, 6
water, drainage, and access roads was a Principal sources for this section are: (1) An-
nual Rpt, Med Sec, MTOUSA, 1944; (2) Final
major engineering project. Still another Rpt, Plans and Opns Off, MTOUSA, 1945; (3)
factor was the hope, after the initial suc- Annual Rpt, Surg, Fifth Army, 1944, 1945; (4)
Med Sitreps, PBS, Sep 44-Jan 45; (5) Theater
1944; (4) Rpts of individual hosps mentioned in ETMD's, Sep 1944-Jan 45; (6) Unit rpts of hosps
text. See also pp. 396-400, above. mentioned in text; (7) Unit ETMD's of the hosps
5
See p. 447, above. mentioned in text, for Sep 44-Jan 45.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 491
operating 2,770 beds on a 1,500-bed the 81 st Station from Naples and the
T/O. 114th Station from Rome, but neither
At the same time the 750-bed 7th Sta- move was completed before the end of
tion Hospital, which had been staging in the month. The 81st closed in Naples on
Oran since July, arrived in Leghorn and 24 September, and was established ad-
set up at Tirrenia, a former Fascist youth jacent to the 64th General at Ardenza by
camp on the seacoast about four miles 1 October. One 250-bed expansion unit
north of the city. The unit opened on 29 was set up immediately, and a second
September with the facilities and bed opened shortly in a prisoner of war stock-
strength of a general hospital. Shortly ade. The 81st, with the assistance of de-
after its establishment, the 7th Station tached personnel from other units, was
was designated to hospitalize all Brazilian thus operating 1,000 beds on a 500-bed
ground personnel in the area, and by T/O.
December was caring for 700 Brazilian The 114th Station, which moved into
patients in addition to a full load of U.S. an abandoned Italian military hospital in
patients. Fifteen medical officers, two Leghorn proper, had more difficulty get-
dental officers, three pharmacists, a chap- ting established. Extensive repairs were
lain, 23 nurses, and 32 enlisted tech- required, and it was 20 October before
nicians, all Brazilian, were attached. the hospital was ready to receive patients.
Brazilian medical strength at the 7th The 114th Station continued to serve as
Station Hospital eventually reached a the PBS neuropsychiatric hospital, but
maximum of 27 officers and 65 enlisted the shortage of fixed beds made it neces-
men, though the nurse strength declined sary to take medical cases as well. For the
to 18. first two months of operation in Leghorn
The Brazilians were given wards of about half of its patients were medical.
their own for routine cases, but those re- The shift of the 114th Station from
quiring special treatment were placed in Rome heralded a general exodus of medi-
the regular medical and surgical wards. cal installations from the Italian capital,
Brazilian doctors were assigned to the which was too far in the rear to effec-
medical and surgical staffs of the hos- tively support the Fifth Army front and
pital, where they dealt with all patients lacked the port facilities that made
and worked on teams with U.S. surgeons Naples still useful as a hospitalization
as well as on surgical teams of their own. center. The 33d General Hospital was
In the course of time, as language bar- the first of its class to go, closing on 24
riers and differences in practices were September. A site was located in what
overcome, the Brazilians were fully inte- was to become the Leghorn hospital
grated into the hospital staff. Between 7 center at Tirrenia, where the 7th Station
October and 12 December five Brazilian was already in operation, and movement
medical officers and six nurses also served was completed on 7 October. The 33d
with the 154th Station at Civitavecchia General opened five days later. (Map 42)
to care for personnel of nearby Brazilian The 12th General, one of the two
Air Force units. 2,000-bed hospitals remaining in Italy,
The only other hospitals to move into began closing out in Rome about 1 No-
northern Italy during September were vember, starting the roundabout journey
MAP 42—Fixed Hospitals in Northern Italy, July 1944-October 1947
FIXED HOSPITALS IN NORTHERN ITALY
Grosseto 105th Station, 15 September-24 December 1944.
213th Veterinary General (Italian) a , 4 July 1944- 500 beds.
31 March 1945. 50th Stationb, Detachment A, 22 December 1944-
24th General, 21 July-15 September 1944. 1,500 20 March 1945. 100 beds.
beds. 99th Field, 1st Platoon, 20 March-17 July 1945.
100 beds.
a b
Redesignated 1st Veterinary General Hospital Redesignated 99th Field Hospital, 20 March
(U.S.-Italian), 31 March 1945. 1945.
FIXED HOSPITALS IN NORTHERN ITALY—Continued
1st Veterinary General (U.S.-Italian), 31 March- 64th General, Detachment A, 1 October-15 No-
15 July 1945. vember 1945. 250 beds.
Castagneto Fano
50th Station, 20 July-22 December 1944. 250 225th Station (ABC), 16 April-8 May 1945. 500
beds. beds.
50th Station, Detachment B, 22 December 1944- Pistoia
20 March 1945. 100 beds. 70th General, 22 January-25 June 1945. 1,500
99th Field, 2d Platoon, 20 March-13 July 1945. beds.
100 beds. Rimini
35th Field, 2d Platoon (ABC), 17 April-24 May
Leghorn 1945. 100 beds.
64th General, 8 August 1944-20 December 1945. Montecatini
1,500 beds. 182d Station, 20 April-25 June 1945. 500 beds.
55th Station (Attached 64th General), 9 August- 70th General, Detachment B. 25 June-25 Sep-
15 October 1944. 250 beds. tember 1945. 500 beds.
81st Station, 28 September 1944-20 June 1945. Pontepetri
500 beds.
2605th Veterinary General (Overhead), with 2d
7th Station, 29 September 1944-26 August 1945. Veterinary General (U.S.-Italian) attached, 21
750 beds. April-2 May 1945.
33d General, 12 October 1944-20 September Bologna
1945. 1,500 beds. 74th Station, 27 April-20 June 1945. 500 beds.
114th Station, 20 October 1944-31 May 1945.
6th General, 9 May-10 August 1945. 1,500 beds.
500 beds. Mirandola
12th General, 3 December 1944-6 July 1945. 2605th Veterinary General (Overhead), with 2d
2,000 beds. Veterinary General (U.S.-Italian) attached, 2
61st Station, 15 November 1945-15 November May-28 June 1945.
1947. 500 beds. San Martino
Senigallia 2604th Veterinary Station (Overhead), with 1st
35th Field, 2d Platoon (AAFSC; ABC), 11 No- Veterinary Station (U.S.-Italian) attached, 5-14
vember 1944-4 April 1945. 100 beds. May 1945.
60th Station (ABC), 4 April-18 July 1945. 400 Mantova
beds. 37th General, 9 May-25 October 1945. 1,500
4th Field (ABC), 18 July-3 September 1945. beds.
400 beds. Milan
Pisa 15th Fieldc, 1st Platoon, 1-30 September 1945.
105th Station, 15 January-25 June 1945. 500 100 beds.
beds. Desenzano
103d Station, 23 March-20 July 1945. 500 beds. 15th Field c , 3d Platoon, 1 September-8 October
55th Station, 25 June-15 November 1945. 250 1945. 100 beds.
beds. Udine
99th Field, 20 July 1945-1 May 1946. 400 beds. 16th Evacuation (as station), 1 September-2 Oc-
Empoli tober 1945. 750 beds.
50th Station b, Detachment C, 17 January-20 15th Field (88th Division), 2 October 1945-13
March 1945. 100 beds. May 1946. 400 beds.
99th Field, 3d Platoon, 20 March-6 August 1945. 391st Station (88th Division), 11 May 1946-15
100 beds. October 1947. 400 beds.
Florence Bolzano
24th General, 21 September 1944-1 June 1945. 15th Fieldc, 2d Platoon, 1 September-5 October
1,500 beds. 1945. 100 beds.
103d Station, 11 January-22 March 1945. 500 Trieste
beds. 7th Station (88th Division), 1 May-19 September
1947d. 200 beds.
Pratolino
c
55th Station, 16 October 1944-21 May 1945. Assigned in place from Fifth Army to PBS, 1
250 beds. September 1945. Reassigned to 88th Division, 25
225th Station, 21 May-25 June 1945. 500 beds. September 1945.
d
70th General, Detachment A, 25 June-1 Octo- Turned over to Trieste-United States Troops
ber 1945. 500 beds. (TRUST) 19 September 1947.
494 MEDITERRANEAN AND MINOR THEATERS
12TH GENERAL HOSPITAL, the largest unit in the group of medical installations in the
northern outskirts of Leghorn.
to Tirrenia in the middle of the month. north of Caserta on 25 October and was
Four trainloads of equipment went by also scheduled for the Florence area,
rail to Naples, and thence to Leghorn by was less fortunate. Its prospective site
water. Equipment arrived on 25 Novem- was still occupied by the 15th Evacua-
ber, and the first patient was received at tion, which the Fifth Army surgeon had
at the new site on 3 December. The ar- decided to retain in Florence over the
rival of the 12th General brought Table winter. As no alternative site was avail-
of Organization bed capacity in Leghorn able, the 74th Station set up head-
to 6,750, or an operating strength of bet- quarters with the 24th General and
ter than 10,000. placed the bulk of its personnel on de-
The 55th Station, meanwhile, had tached service with other medical units.
been relieved of its attachment to the Only two more fixed hospitals moved
64th General in the middle of October, into northern Italy before the launching
and on the 16th of that month opened at of the spring drive into the Po Valley.
Pratolino, six miles north of Florence, in These were the 103d Station, from
buildings vacated the day before by the Naples, which opened in a prisoner of
94th Evacuation Hospital. The 74th war enclosure in the outskirts of Florence
Station, which had closed at Caiazzo on 11 January 1945; and the 70th Gen-
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 495
eral from North Africa, which opened in placed the larger 34th at Caiazzo.
Pistoia on 22 January. Late in December the 50th Station at
There were, however, various readjust- Castagneto reorganized along field hos-
ments in the hospital picture around the pital lines into three detachments, one of
end of 1944. In Rome the 73d Station which relieved the 105th Station at Gros-
was reassigned to Rome Area, MTOUSA, seto on 24 December. Another detach-
on 1 December 1944. The 6th General ment set up a small hospital to serve the
closed on 22 December, but remained in 8th Replacement Depot at Empoli, twen-
Rome with all equipment packed and ty-five miles west of Florence, on 17
ready to move on short notice. Personnel January 1945. The third detachment re-
of the hospital were placed on temporary mained at Castagneto. The 105th Sta-
duty with other medical units scattered tion, displaced at Grosseto, moved to Pisa
over Italy. The 34th Station, which had where it opened in buildings of an
been serving a replacement center in Italian tuberculosis sanatorium four
the Caserta area since October, took over miles east of the city on 15 January. At
the buildings vacated by the 6th General its Pisa site, the 105th Station served an
in Rome on 19 January, while the 154th encampment of Russians who had been
Station closed at Civitavecchia and re- liberated from German prison camps.
496 MEDITERRANEAN AND MINOR THEATERS
Status of Hospitalization in MTOUSA pitals larger than 500 beds, and sites
January-March 1945 could not be found for general hospitals
larger than the 1,500-bed units already
By January 1945, when the decision operating in the theater. Any other form
was made to postpone the Po Valley of reorganization that would add beds
offensive until spring, fixed hospitals in would require more in additional per-
MTOUSA were reporting a smaller pro- sonnel and equipment than could be
portion of beds occupied than ever be- procured. General Stayer therefore pre-
fore. This was in part due to the winter pared to operate with the hospitals then
lull in the fighting, but it was also in under his control.
large measure because of the excellence As of the end of January there were
of the Fifth Army medical service, which 10,150 fixed beds in the Naples-Caserta
was retaining the maximum number of area. The 37th and 45th General Hos-
cases in the army area. Fixed bed pitals, each with 1,500 beds, and the 500-
strength in MTOUSA was nevertheless bed 182d and 225th Stations were in the
6,000 below the authorized 6.6 ratio, medical center at the Mostra Fair-
and changes in the station hospital T/O grounds. In Naples proper were the
had so far reduced the number of medi- 1,500-bed 17th General, the 2,000-bed
cal officers in those units that an expan- 300th General, and the 52d, 106th, and
sion of more than 20 percent was no 118th Station Hospitals, each of 500
longer practical without additional per- beds. The 52d and 118th were both act-
sonnel.7 ing general hospitals. The 52d was also
Looking ahead to the resumption of the theater maxillofacial center. Outside
active hostilities in the spring, General Naples the 262d Station was at Aversa,
Stayer asked the War Department for an functioning primarily as a prisoner-of-
additional general hospital of 1,000-bed war hospital; the 32d Station was at
capacity and for a field hospital for com- Caserta, serving headquarters personnel
munications zone use. The request was of MTOUSA and AFHQ; and the 154th
denied on the ground that no such units Station was at Caiazzo serving a replace-
were available in the zone of interior. ment center.
The War Department proposed as an The 34th and 73d Station Hospitals
alternative that existing hospitals be re- were in Rome, housing 750 beds between
organized into larger units, but the them. The 1,500 beds of the 6th General
MTOUSA medical section considered were in that city but not available for
this proposal impractical, since there was use, since they were packed for move-
no specific requirement for station hos- ment.
In the Arno Valley, overlapping the
army area, there were 11,000 beds—6,750
7
Principal sources for this section are: (1) Final of them at Leghorn, 2,250 in the imme-
Rpt, Plans and Opns Off, MTOUSA, 1945; (2)
Med Sitreps, PBS, Jan-Mar 45; (3) Annual Rpt, diate vicinity of Florence, 500 at Pisa,
Surg, NORBS, 1945; (4) Annual Rpt, Surg, MBS, and 1,500 at Pistoia. In addition to these,
1944; (5) Med Hist, AAFSC MTO, 1945; (6) the 50th Station Hospital was operating
Theater ETMD's, Jan-Mar 1945; (7) Unit rpts
of hospitals mentioned in text; (8) Unit ETMD's detachments of approximately 100 beds
of hosps mentioned in text. each at Grosseto, Castagneto, and Em-
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 497
poli; and the 500 beds of the 74th Station sand to ten thousand. All of these
were inoperative in Florence. hospitals passed to the Adriatic Base
The 1,500-bed 26th General Hospital, Command on 1 March.
still attached to the Army Air Forces In the Northern Base Section the 500-
Service Command, cared for Air Forces bed 60th Station Hospital, which had
personnel at Bari, and the 500-bed 61st moved up from Sardinia the end of Octo-
Station performed similar duties at Fog- ber, was preparing to close near Bastia.
gia. In addition to these, the Air Forces The 40th Station was operating sections
controlled three field hospitals, the 4th, at Cervione and Ghisonaccia, both on the
34th, and 35th, which were dispersed east coast of Corsica, and a third section
along the Adriatic from Lecce in the heel was preparing to relieve the 60th at
of Italy to Senigallia in the latitude of Bastia.
Florence. Each field hospital platoon In North Africa, which was scheduled
served one to five airfields, which had for transfer to the Africa-Middle East
personnel complements of three thou- theater the first of March, the 250 beds
498 MEDITERRANEAN AND MINOR THEATERS
of the 57th Station Hospital were more 21 st Station Hospital from the Persian
than enough to serve the Tunis area. Gulf Command to MTOUSA. The 21st
The last Army hospital in the Oran area, arrived in Naples in March, but did not
the 54th Station, had closed late in De- get into operation until mid-April. In
cember and was now inoperative in the inactivation of the 54th Station and
Naples, leaving Naval Hospital No. 9 to reduction of the 57th, MTOUSA lost 350
care for all U.S. personnel in Oran. The beds, but gained 150 in the conversion of
56th Station at Casablanca, in addition to the 250-bed 50th Station to a 400-bed
caring for personnel in the area, was field. All in all, MTOUSA lost 125 beds,
operating a transient section of 100-150 while Fifth Army gained 400.
beds for domiciliary care of patients en Shortly before the new theater bound-
route to the ZI from Italy, the middle aries became effective on 1 March 1945,
East, and the China-Burma-India theater. the two prisoner of war hospitals serving
It also supervised the operation of a 75- MTOUSA were shifted to northern Italy.
bed Italian station hospital. The 25-bed There were, of course, many station hos-
370th Station at Marrakech continued to pitals treating captured enemy troops,
serve primarily Air Forces units. The but only two were fully staffed by pro-
Italian and German prisoner of war hos- tected personnel and formally organized
pitals near Oran were already alerted for as prisoner of war rather than U.S. Army
movement to Italy. hospitals. These were the 7029th Station
Preparatory to closing out in Africa, Hospital (Italian) and the 131st Station
Stayer requested permission to inactivate Hospital (German), the latter so desig-
the 54th Station and reduce the 57th nated because it was sited at POW En-
Station to 150 beds, the personnel and closure No. 131. The 7029th moved by
equipment thus released to be activated echelons to Leghorn in January and
as a 400-bed evacuation hospital for February, finally opening in Pisa on 6
Fifth Army. At the same time permission March. Later in the month the German
was requested to convert the 50th Station unit took over the prisoner of war hos-
Hospital in Italy into a field unit. Both pital being operated by the 103d Station
requests were granted late in February. at POW Enclosure 334 in the outskirts of
On 20 March, accordingly, the 171st Florence, and was thereafter known as
Evacuation Hospital was activated and the 334th Station Hospital (German).
assigned to Fifth Army. On the same The 103d Station, relieved of its POW
date the 50th Station Hospital passed out assignment, moved to Pisa on 22 March,
of existence, and the 99th Field Hospital where it became a contagious disease hos-
relieved it in place. No changes were in- pital, primarily for Brazilian personnel.
volved, since the 50th Station had al- As of the end of March, aggregate
ready completed its conversion to a field Table of Organization bed strength of
hospital T/O. U.S. base hospitals in the Mediterranean
The actual transfer to the Africa-Mid- Theater of Operations, including 3,000
dle East Theater thus involved only 425 beds not operating, was 29,000. Troop
U.S. beds, and these were more than strength was 497,427, giving a ratio of
made up by the transfer of the 500-bed 5.8 T/O beds per 100 troops.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 499
Support of the Po Valley Campaign pital had been in Senigallia since No-
vember 1944. This unit was replaced
The experience of Fifth Army in evac- early in April by the 60th Station Hos-
uating casualties across the rugged north- pital from Corsica, the field hospital pla-
ern Apennines underlined the impor- toon moving on to Rimini. At the same
tance of getting fixed beds into the Po time the 225th Station in the Naples
Valley with the greatest possible speed. medical center was assigned to the
The 6th General Hospital at Rome and Adriatic Base Command and shifted to
the 74th Station at Florence were already Fano, about fifteen miles farther north.
on a stand-by basis for quick movement Next to leave the medical center was
but more beds were certain to be re- the 182d Station, which took no new pa-
quired. Because of its obvious advan- tients after 25 March. The 182d moved
tages, General Stayer planned to keep the on 10 April to a large villa about two
Naples medical center intact, though hos- miles northwest of Montecatini. Its first
pitals from other parts of the city were patients were received from Fifth Army
shifting northward. General Joseph T. evacuation hospitals on 20 April, and
McNarney, the theater commander, had within two weeks it was operating 20 per-
other plans, and in March, despite cent in excess of its 500-bed T/O capac-
Stayer's protests, the Mostra Fairgrounds ity.
were turned over to the Replacement The 37th General Hospital began
Training Command. The 45th General closing out on 10 April, moving by
Hospital was to remain to care for the echelon to a staging area near Pisa. The
replacement center personnel, but the bulk of the personnel and equipment
other units then comprising the medical was in Pisa by 17 April. For the next two
center were required to vacate the fair- weeks officers and enlisted men were on
grounds as soon as possible. It was these detached service with other units, but
hospitals, therefore, that were alerted for subject to immediate recall. The 37th
movement to northern Italy.8 also operated a 200-bed prisoner-of-war
The first moves in support of the com- hospital in an unused mess building on
ing campaign were made in response to an emergency basis, since the 103d Sta-
an indicated need for more fixed beds on tion, which had been reconverted to a
the Adriatic side of the peninsula, where prisoner-of-war hospital in mid-April,
Air Forces units were becoming increas- was unable to carry the full load. By the
ingly active and to which air evacuation end of the month prisoners were arriv-
of ground troops from the Bologna area ing in the area at the rate of 15,000 a day,
might be directed should weather con- and the 103d was operating at more than
ditions preclude the use of more westerly double its T/O capacity.
routes. A platoon of the 35th Field Hos- By the time the Fifth Army spearheads
8
had fought their way into the Po Valley,
Principal sources for this section are: (1) Final
Rpt, Plans and Opns Off, MTOUSA, 1945; (2)
there were thus 3,500 fixed beds on a
Med Hist, AAFSC MTO, 1945; (3) Med Sitreps, stand-by basis, packed and ready to move
PBS, Mar-May 45; (4) Theater ETMD's, Mar- forward in support of the ground forces.
May 45; (5) Unit rpts of hosps mentioned in the
text; (6) Unit ETMD's for hosps mentioned in the
Movement orders were not long in com-
text, Mar-May 45. ing.
500 MEDITERRANEAN AND MINOR THEATERS
LOADING EQUIPMENT OF THE 37TH GENERAL HOSPITAL on freight cars at Naples for
shipment to Pisa.
The 74th Station Hospital was in 15th Evacuation Hospital. By the end of
Bologna by the afternoon of 26 April, the week the 37th General had more
five days after the fall of the city, and was than 2,000 beds in operation. The sud-
taking patients within twenty hours of den end of the war made it unnecessary
its arrival. By 28 April 750 beds were set to relocate any other fixed hospitals.
up, and German medical officers and Also in support of the Po Valley Cam-
corpsmen had been pressed into service paign, though on a different level, was
to help with the prisoner patients. The the 40th Station Hospital, transferred
6th General was close behind, leaving its from Corsica to the vicinity of Rome,
Rome bivouac on 30 April and opening where a center for the conversion of able-
in Bologna on 9 May. The 37th General bodied men from service units into in-
sent an advance detail to Mantova on 2 fantry, to help fill the depleted ranks of
May, and a week later took over 26 Al- Fifth Army, had been set up in January.
lied and 1,278 German patients from the By the middle of May, with the war in
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 501
Europe over, the period of readjustment must be taken from positions classified
had set in. For the Medical Department as suitable for limited-assignment person-
in Italy, the emphasis for the next few nel. While communications zone hos-
months would be on caring for the sick pitals usually had a certain number of
and wounded among prisoners of war, limited-service men already on their rolls,
and preparing hospitals and other medi- the survey revealed many more hospital
cal units for redeployment to the Pacific positions that could be filled by such
or for return to the zone of interior as personnel.
promptly as possible. Although many problems were thus
created for hospital commanders, the
Problems and Policies change-over was accepted as a necessary
expedient. The new men were for the
Throughout the period of the North most part inexperienced in hospital work
Apennines and Po Valley Campaigns un- and had to be given special training on
til the end of April 1945, Peninsular the job. There were, moreover, too many
Base Section hospitals, including the high-ranking noncommissioned officers
26th General attached to the Army Air among them to be absorbed without
Forces Service Command and later as- jeopardizing promotions and damaging
signed to the Adriatic Base Command, the morale of the regular Medical De-
operated on a 120-day evacuation policy. partment enlisted staff. During the last
The theater was too short of manpower two months of 1944 and the first two
to return men to the zone of interior as months of 1945, limited-assignment per-
long as there was any prospect of re- sonnel nevertheless replaced general-
covery for further combat duty. Even assignment men in station and general
those reclassified by hospital disposition hospitals to the extent of an average 25
boards for limited assignment were re- percent of the enlisted strength. Fortu-
tained in the theater in a variety of non- nately, the shift took place at a time
9
combat capacities. when the hospitals were not overloaded
One of the places where limited assign- and in most instances worked out satis-
ment personnel could be used effectively factorily.
was in the base hospitals. When Fifth Supplementary personnel were neces-
Army was unable to obtain replacements sary in the operation of all PBS hospitals
for the heavy casualties suffered in the during periods of emergency expansion.
northern Apennines, all service units in Medical officers, nurses, and enlisted
the theater were surveyed with a view to technicians from temporarily inoperative
locating able-bodied men who could be units were freely used whenever they
released and retrained for combat. The were available, but the greater reliance
essential consideration was that the men had of necessity to be placed on Italian
civilians and Italian service troops.
9
Sources for this section are: (1) Final Rpt, Among the areas in which civilian and
Plans and Opns Off, MTOUSA, 1945; (2) Med Italian prisoner of war labor was effec-
Hist, AAFSC MTO, 1945; (3) Ltr, Munly, Med tively used were sanitary, utility, mess,
Insp, to Surg, MTOUSA, 26 Nov 44, Sub: Utiliza-
tion of Limited Assignment Personnel in Hosps; laundry, supply, motor pool, and com-
(4) Unit rpts et MTOUSA hosps, 1944, 1945. mon labor details.
502 MEDITERRANEAN AND MINOR THEATERS
tween Florence and Leghorn were and early January more than 1,300 pa-
inaugurated in February 1945, and there- tients were sent back to Naples by water
after patients were moved at the rate of and close to 600 by rail. In the same time
more than a thousand a month. period, air evacuation from Florence to
From Leghorn evacuation to Naples Naples accounted for another 2,500.
was primarily by hospital ship and trans- The threat of an Italian "Battle of the
port but the repair of rail lines made it Bulge" was over by mid-January, and
possible to use hospital trains in an emer- evacuation assumed what was to be a
gency. Such an emergency arose in the normal pattern for the next two months.
last days of December 1944 when it was PBS hospitals in Florence, Pistoia, and
feared that the German thrust into the Pisa received casualties from Fifth Army
Serchio Valley might develop into a and kept beds free by evacuation to Leg-
major counteroffensive comparable to horn. Bed strength in Leghorn was ade-
the Ardennes breakthrough, which had quate to care for all patients with a
not yet been stopped. Should the Ger- hospital expectancy of less than 120 days,
man drive gain momentum, Leghorn so that after 1 February only those en
would be its probable objective, and a route to the zone of interior were sent on
hasty evacuation of all fixed hospitals in to Naples. This pattern continued until
that city was ordered. In late December the latter part of March, when all PBS
504 MEDITERRANEAN AND MINOR THEATERS
hospitals in the northern sector were theater, but AFHQ was to be notified of
again cleared to Naples to provide beds all airlifts to the ZI from southern France
for the casualties anticipated in the as a guide to the allocation of alternative
spring offensive. During April approxi- means of transportation. General Stayer
mately 1,800 patients were transferred by presented this plan to Maj. Gen. Paul R.
sea and air from Leghorn to Naples, but Hawley, Chief Surgeon of the European
these were more than balanced by 2,000 Theater, early in November, and Hawley
patients brought to Leghorn from accepted it subject to further study. It
Florence. remained in effect by agreement between
All movements of hospital ships within the two theaters until February 1945
the Mediterranean area, including those when, with minor modifications, it was
used to evacuate patients from southern ratified by the War Department. The
France, remained under control of Allied plan continued in operation until the
Force Headquarters. In order to make end of June.
the greatest possible use of the limited
number of vessels available, an arrange- Evacuation to the Zone of Interior
ment was worked out in October 1944
whereby all hospital ships entering the Evacuation to the zone of interior
Mediterranean called first at Oran, which throughout the period of concentration
was roughly equidistant from Naples, in Italy was by plane, hospital ship, and
Leghorn, and Marseille. From Oran the troop transport. Until the end of Febru-
Chief of Transportation, AFHQ, di- ary 1945, when North Africa was finally
rected the vessels to the port most in divorced from the Mediterranean Thea-
need of them. The movement of the ter of Operations, a small number of
hospital ship platoons that formed the patients continued to be moved to the
medical complements of troop transports zone of interior from Oran and Casa-
used for evacuation was also directed by blanca, but the overwhelming bulk of
AFHQ in order to ensure maximum use the lifts by all types of carrier was from
of transports for this purpose. Naples.11
As the time approached for the trans- During the 3-month period that south-
fer of southern France to the European ern France remained under AFHQ con-
theater, a plan of evacuation was drawn trol, most of the casualties from that area
up by embodying the existing principle also were routed to the continental
of a pool of hospital ships under AFHQ United States by way of Naples. In Octo-
control and incorporating procedures for ber, however, direct evacuation to the
requesting vessels. Base section com- zone of interior began from Marseille,
manders were to be responsible for mak- and some 250 patients had been evacu-
ing the greatest possible use of troop ated to the ZI from that port before 20
transports, but AFHQ was to be notified
of the movements of such vessels and
would continue to control the assign- 11
Principal sources for this section are: (1) An-
ment of hospital ship platoons arriving nual Rpt, Med Sec, MTOUSA, 1944; (2) Final Rpt,
Plans and Opns Off, MTOUSA, 1945; (3) Annual
anywhere in the Mediterranean. Evacua- Rpt, Surg, PBS, 1944; (4) Med Sitreps, PBS, Jan-
tion by air was to be controlled by each May 45; (5) ETMD's for Sep 44-May 45.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 505
Source: (1) Annual Rpt, Surg, MTOUSA, 1944, an. B, apps. 21, 22. (2) Final Rpt, Plans and Opns Off, MTOUSA,
1945, apps. 14, 15.
Marseille, where they were transferred the internal organization of the Medical
to a Swiss-manned hospital train and ex- Supply Branch (redesignated Medical
changed at the Swiss border for U.S. Supply Section) nor the operating proce-
prisoners of the Reich.12 Since the col- dures were altered in any essential par-
lapse of Germany was imminent, another ticular. In keeping with the reduced staff
exchange of prisoners scheduled for available, the organization was made
April was not carried out. more compact, but without significant
change in functions. In the new align-
Medical Supplies and Equipment ment, an Executive Group reviewed
proposed changes in Tables of Equip-
Theater Supply Organization ment, checked the quality of equipment
and Policies in the field, prepared plans and esti-
mated requirements in terms of disease
The reorganization of November 1944 trends and military operations, screened
brought the operation of the medical requisitions from Allied nations, and ad-
supply system directly under the theater vised on civilian supply for occupied
surgeon for the first time, but neither territories. A Shipping Control Group
kept constant track of all incoming ship-
12
(1) Memo and attachments, Biederman to
ments and prepared shipping orders for
Stayer, 14 Jan 45 sub: Arrangements for Repatria- movement of medical supplies between
tion of Allied and German POW's and Exchange base sections. A Stock Control Group
of Civilians. (2) Ltr, Lt Col W. L. Hays combined
British-American Repatriation Committee, to CG
maintained records of stocks on hand,
ETO, 1 Mar 45. Figures from ETMD for Jan 1945. computed replacement factors, studied
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 507
issue and due records to determine short- tons of medical supplies to the zone of
ages and excesses, and recommended interior in January.
stock movements to correct maladjust- In line with the achievement of a com-
ments. A Reports and Statistics Group fortable stock level for the theater, sur-
completed the supply organization.13 geons of major commands and base
At the time of the reorganization, med- sections were authorized in February to
ical supply levels were established at 30 modify equipment lists in accordance
days' minimum, 30 days' operating, and with such policies as might be laid down
60 days' maximum for most items. In by the MTOUSA surgeon. In effect, hos-
accordance with War Department in- pitals were permitted to requisition var-
structions, these levels were kept under ious items in excess of the Tables of
continuous review with a view to pos- Equipment if those items would make
sible reductions. The only move in that operations more effective. Authority to
direction, however, came to nothing. In issue expansion units, which rested with
March 1945 a recommendation by the the commanding generals of the base
theater supply officer that the 90-day sections, automatically carried with it the
stock level maintained by base hospitals issue of such additional equipment as
be reduced to 60 days, to conform to the might be necessary to the efficient opera-
theater level, was rejected by General tion of the unit.
Stayer as hazardous. In the light of a After November 1944 all incoming
detailed study begun in November 1944 supplies were received at Naples or Leg-
of 40 medical items, which showed that horn, where the Peninsular Base Section
the actual elapsed time between prepara- depots were located, and PBS was made
tion of monthly requisitions on the zone responsible for distribution to other base
of interior and the tallying of items into sections on requisitions that were passed
depot stock was 149 days, Stayer was un- through the MTOUSA medical supply
doubtedly correct. section. All forms of transportation were
After southern France ceased to be a used, the size of the shipment, the speed
drain on the MTOUSA supply services, necessary, and the destination being the
medical stock levels built up rapidly. determining factors, along with avail-
Low battle casualty and disease rates dur- ability. Within the theater, biologicals
ing the winter of 1944-45 were contrib- were uniformly moved by air. In Febru-
uting factors, as also were the closing ary the Leghorn depot became the main
out of the North African bases and a medical supply point for the theater.
revised accounting procedure that in- Repair and maintenance of medical
cluded Fifth Army and Air Forces stocks equipment steadily improved during the
in computing the theater levels. Sur- late months of 1944, reaching a peak of
pluses developed of sufficient magnitude efficiency early in 1945 as Fifth Army
in some items to justify the return of 500 units began re-equipping for the spring
offensive. A spare parts catalog compiled
13
and distributed by the Medical Supply
Principal sources for this section are: (1) An- Section became the basis for requisition-
nual Rpt, Med Sec, MTOUSA, 1944, an. K; (2)
Davidson, Med Supply in MTOUSA, pp. 113-139. ing and for restocking depots. The fifth
For operating procedures, see pp. 346-47, above. echelon repair shop, the optical repair
508 MEDITERRANEAN AND MINOR THEATERS
shop, and theater stocks of spare parts Civilians and Italian service troops
and of artificial teeth were all transferred were freely used as laborers, mess attend-
to the Leghorn depot in January. ants, artisans, and for guard details at
Local procurement remained, as it had medical supply depots. So many of the
been throughout the Mediterranean cam- supply functions were specialized, how-
paigns, a negligible factor, but the distri- ever, that the maximum use of such per-
bution of medical supplies for civilian sonnel did not appreciably lessen the
use continued to mount in proportion to requirement for U.S. service troops for
the extent of territory occupied. After medical supply operations in the Italian
September 1944, Army responsibility for communications zone.
procurement, storage, and issue of medi-
cal supplies for civilians throughout the Medical Supply in the Base Sections
theater was carried out through a Cen-
tral Civilian Medical Depot in Naples. Medical supply in the base sections
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 509
came under control of the MTOUSA Station, which was about to close at
medical section with the reorganization Oran; and the balance of maintenance
of November 1944, but here, as in the stocks for the base section was stored with
Medical Supply Section itself, no essen- the 56th Station Hospital at Casablanca,
tial change of function or organization the new MBS headquarters. Excess stocks
was involved. The Peninsular Base Sec- to the amount of 313 tons were returned
tion, already dominant in the theater, to the zone of interior, and 350 tons were
continued to grow through the last quar- divided between Italy and southern
ter of 1944 and the early months of 1945 France. A small detachment of the 60th
as other base sections declined. Medical Base Depot Company remained
in Oran long enough to complete the
Mediterranean Base Section—Follow- packaging and shipment. From the sup-
ing the mass transfer of medical facilities ply standpoint, MBS was closed by the
from North Africa to southern France end of 1944.
and Italy, plans were made for closing
out remaining depot stocks in the Medi- Northern Base Section—Medical sup-
terranean Base Section. The 60th Medi- ply in the Northern Base Section re-
cal Base Depot Company, which had mained in the hands of a detachment of
been responsible for receipt, storage, and the 684th Quartermaster Base Depot
issue of all medical supplies in North Company, which had been activated late
Africa since the beginning of September, in May from personnel of the old 2d
began transferring supplies to other bases Medical Depot Company. Until the end
almost immediately, shipping out 250 of September, the group operated depots
tons a week during September and Octo- at Ajaccio and Cervione, but the reduc-
ber. Simultaneously, the Eastern and tion of troop strength and gradual with-
Atlantic Base Sections transferred their drawal of medical units from Corsica
own surpluses, brought about by dimin- made it possible to consolidate the two
ished troop strength, to the MBS depot, depots at Cervione early in October.
in preparation for the consolidation of Movement of supplies from Ajaccio
the three base sections on 15 Novem- across the island by truck was completed
ber.14 by the 13th of the month.15
When the MBS depot closed in mid- For a time, portions of the depot stock
December, the 57th Station Hospital at at Cervione had to be stored in the open,
Tunis was given maintenance stocks suf- but the transfer of stocks in excess of a
ficient to carry through 28 February, 4-month level to other MTOUSA bases,
when the transfer of North Africa to which began in mid-October, soon re-
AMET would be effected; a minimum duced quantities on hand to proportions
reserve of 25 tons was left with the 54th that could be warehoused.
14 15
Sources for this section are: (1) Annual Rpt, Sources for this section are: (1) Annual Rpts,
Surg, MBS, 1944; (2) Annual Rpt, 60th Med Base Surg, NORBS 1944, 1945; (2) Annual Rpt, 684th
Depot Co, 1944; (3) Annual Rpt, Surg, MTOUSA, QM Base Depot Co, 1944; (3) Per Rpt, 80th Med
1944, an. K; (4) Davidson, Medical Supply in Base Depot Co, 11 Jul 45. (4) Davidson, Med Sup-
MTOUSA. ply.
510 MEDITERRANEAN AND MINOR THEATERS
In line with the general reduction of responsibility of the Army Air Forces
functions in NORBS, 14 enlisted men of Service Command, which dealt directly
the 684th Quartermaster Base Depot with the Surgeon, MTOUSA, and pro-
Company detachment were transferred cured medical items peculiar to the Air
to the 60th Medical Base Depot Com- Forces direct from the zone of interior.
pany, then still functioning at Oran, on The function was carried out through a
16 October. The subsequent transfer of number of aviation medical supply pla-
the detachment's commanding officer to toons, two of which operated in Bari as
Headquarters, NORBS, left only an offi- the medical supply section of the Adri-
cer and 17 enlisted men to operate the atic Depot. Others served airfields from
Cervione depot, with the aid of some 25 Tunis to southern France, with major
Yugoslavs who made up labor and guard dumps at Naples and Pisa.16
details. There were times when the work- When the Adriatic Base Command was
day stretched out to 18 and even to 24 activated on 1 March 1945, the new
hours, yet despite the physical strain, organization took over the supply func-
none of the men could ever be spared tions previously exercised by the Army
long enough to take advantage of the Air Forces Service Command, Mediter-
rest camps available on the island. ranean Theater of Operations (AAFSC
NORBS depot stocks were down to MTO), through the Adriatic Depot, but
230 tons by the end of January and to without altering the operating responsi-
75 tons by late March. By way of prep- bilities of the aviation medical supply
aration for closing out the base section platoons. The 80th Medical Base Depot
supply activities, all personnel of the de- Company, which had been activated in
pot were transferred on 21 March to the December and since that time had shared
80th Medical Base Depot Company, at in the operation of the PBS Leghorn
that time assigned to the Adriatic Base depot, was assigned to ABC in mid-
Command, but were left on detached March and shifted to Senigallia, where
service with NORBS long enough to for a month it operated the ABC ad-
wind up operations. The depot was vance depot. The rapid development of
scheduled for closing on 15 April, but so the Po Valley Campaign, however, left
critical was the need for personnel in hospitals in the Fano-Senigallia-Ancona
Italy, where the Po Valley Campaign area with few patients and a minimum of
was about to be launched, that all ton- supply activity. The ABC advance depot
nage was packed for shipment by 6 April. was turned over to the detachment from
The detachment left Corsica on 10 April, Corsica on 19 April, and a week later the
turning over to the 40th Station Hospital main body of the 80th Medical Base
responsibility for procuring and issuing Depot Company went to Bari, where it
such medical supplies as might still be took over operation of the main ABC
required. medical depot.
16
Sources for this section are: (1) Med Hist,
Adriatic Base Command—Before1 AAFSC MTO, 1944, 1945; (2) Periodic Rpt, 80th
March 1945, medical supply for Air Med Base Depot Co, 11 Jul 45; (3) Med Sitreps,
Adriatic Base Commd, Mar-May 45; (4) MS, Adri-
Forces units and hospitals serving Air atic Depot Hist, OCMH files; (5) Davidson, Med
Forces personnel in eastern Italy was the Supply in MTOUSA.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 511
Source: (1) Annual Rpt, Surg, PBS, 1944. (2) Med Sitreps, PBS, Jan-Apr 45.
terranean theater was in the field of the zone of interior. Psychiatric cases
neuropsychiatry. The major develop- evacuated to the ZI decreased from 48
ments in this area were at the division percent in the last six months of 1943
and army levels, and have been discussed to 21 percent in the corresponding
in connection with combat medicine.20 months of 1944. These results, accord-
In summary, the treatment of psychiatric ing to Colonel Hanson, theater consult-
disorders was carried out at four levels. ant in neuropsychiatry, were the
The patient was normally first seen by maximum that could be expected "under
the battalion surgeon who decided our present knowledge of psychiatry."
whether any treatment was indicated The number of medical officers in the
and, if so, whether to treat the patient theater available for patient care de-
on a duty status or refer him to the divi- clined from 5.2 per 1,000 of troop
sion psychiatrist. The latter officer, as a strength in October 1944 to 4.7 in Janu-
rule, maintained a separate treatment ary 1945, where the ratio leveled off. In
center adjacent to the clearing station, order to keep field medical officers from
with facilities for 50 to 100 patients. losing their skills through restricted prac-
Markedly disturbed patients were sent on tice and limited access to medical litera-
immediately to the Army neuropsychia- ture, a policy of rotation between field
tric center, the others being retained, and base units was carried on but the
usually for two days, under moderate saturation point was reached about the
sedation with some therapy. Those re- end of 1944, by which date the great bulk
sponding favorably went to the division of medical officers in base hospitals were
training and rehabilitation center for a on limited duty or were overage for field
few days and were then returned to duty. service.
Those not so responding were evacuated Noneffective rates per 1,000 per an-
to the Army neuropsychiatric center. num of troop strength by causes for the
From this unit men were returned to months of September 1944 through April
full duty, were sent to the convalescent 1945 are shown in Table 37.
hospital for reclassification, or were evac-
uated to the communications zone. The Dental Service
bulk of the evacuees went to the base
section neuropsychiatric hospital, but On a theaterwide basis, the dental
those too distant from that installation service in the Mediterranean continued
were sent to a general hospital equipped to be understaffed until early in 1945,
for psychiatric work. Treatment in the partly as a result of the increased number
base hospitals followed lines similar to of dental officers called for by the T/O's
those used in civilian practice, with the of the enlarged general hospitals, and
addition of orientation, training, and re- partly as the result of losses sustained
habilitation programs. The treatment when southern France went over to
culminated in return to duty, reclassifi- ETO. There was a further loss of per-
cation for limited duty, or evacuation to sonnel late in 1944 when 20 dental offi-
cers were selected for release from active
duty under a War Department directive.
20
See pp. 253-56, 314-16, 409-11, above. Two of the officers released were in the
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 515
a
Includes other diseases not listed.
Source: Statistical health rpts for appropriate months.
rank of major, the remainder in the rank steadily improved, with prosthetic and
21
of captain. operating trucks taking the best in
A total of 64 replacements arrived in dentistry to the front-line soldier, while
January and February 1945, most of the concentration of dental skills in for-
them first lieutenants. The number was ward clinics allowed a more even distri-
large enough to relieve all shortages, and bution of the work load. Colonel Tingay,
at the same time permitted the replace- the theater dental surgeon, continued to
ment of older officers in combat areas keep up with the needs and problems of
by younger men. The ratio of dental both combat and base areas by frequent
officers to troop strength in the theater, inspections, including an extended tour
which had risen from 1:968 in October of Fifth Army dental installations shortly
to 1:1,016 in December 1944, dropped before the launching of the Po Valley
sharply in January to 1:947. The April Campaign.
ratio of 1:927 was still better, although
it remained higher than the 1:850 ratio Veterinary Service
enjoyed at the end of 1943.
In terms of accomplishment, the den- While the withdrawal of the French
tal care available to Fifth Army, the Air Expeditionary Corps and the U.S. VI
Forces, and service troops in the theater Corps from Fifth Army removed thou-
sands of animals from Italy and ulti-
21
Principal sources for this section are: (1) An- mately from the Mediterranean theater,
nual Rpt, Med Sec, MTOUSA, 1944, an. G; (2) the extensive use of pack mule trains to
Annual Rpt, Surg, PBS, 1944; (3) Dental Hist,
North African and Mediterranean Theaters of Op- supply Fifth Army in the northern
erations. Apennines provided ample scope for
516 MEDITERRANEAN AND MINOR THEATERS
theater veterinarians. The Fifth Army remount stations at Persano and Naples
animal service was backed up in the were closed. Late in January the 2610th
Peninsular Base Section by fixed vet- Quartermaster Remount Depot was acti-
erinary hospitals, with both army and vated and took over the facilities at Pisa.
communications zone activities being Three veterinary officers were assigned
directed and co-ordinated by the theater to this depot and two to the 6742d Quar-
veterinarian, Colonel Noonan.22 termaster Remount Depot at Grosseto.
At the date of the launching of the Throughout the North Apennines
North Apennines Campaign, there were Campaign animals from Fifth Army vet-
only two fixed veterinary hospitals in the erinary installations were evacuated by
Peninsular Base Section, both Italian rail and truck to the 213th Veterinary
units. The 213th Veterinary General General. The physical plant was ade-
Hospital (Italian) was occupying the quate to the demands made upon it, but
buildings of a former Italian Army vet- equipment was insufficient and the
erinary hospital at Grosseto; and the 1st quality of personnel was poor. "Italian
Veterinary Station Hospital (Italian) units," wrote Colonel Noonan, "are in-
was at Persano in the Salerno area. Both capable of rendering satisfactory veteri-
were operated in connection with sta- nary service, as their officers are for the
tions of the 6742d Quartermaster most part indolent, in addition to being
23
Remount Depot, which maintained its poorly equipped professionally." The
own veterinary dispensaries at both T/O of the 213th called for 15 officers
posts, and another in the vicinity of the and 253 enlisted men, but actual
Naples medical center. Shortly after the strength never reached those totals. At
initial assault on the Gothic Line, the the end of 1944 there were only 7 officers
remount depot opened a new station at and 177 enlisted men, being supervised
Pisa, again with a veterinary dispensary by a U.S. veterinary officer and 4 enlisted
to care for animals at the depot. The men from the 2698th Technical Super-
station hospital at Persano was redesig- vision Regiment. A second American
nated the 212th Veterinary Station Hos- veterinary officer was on detached service
pital (Italian) and assigned to Fifth from the 24th Replacement Depot.
Army. With the departure of half of the It was obvious by December of 1944,
6742d Quartermaster Remount Depot when the 10th Mountain Division with
for southern France in mid-October, the its large animal complement was as-
22 signed to Fifth Army, that the veterinary
Principal sources for this section are: (1) An-
nual Rpt, Med Sec, MTOUSA, 1944, an. H; (2) support offered by PBS would have to
Annual Rpt, Surg, PBS, 1944; (3) Vet Hist, MTO, be materially improved before another
(4) Med Sitreps, PBS, Sep 44-May 45; (5) Quar- mountain campaign was undertaken.
terly Hist, Vet, PBS, 1 Apr-30 Jun 45; (6) Med
Sitreps, 213th Vet Gen Hosp; and Vet, 6742d QM Colonel Noonan asked at that time for
Remount Depot, Sep and Oct 44; (7) Vet Rpts, a U.S. veterinary general hospital 24 but
Sick and Wounded Animals, 6742d QM Remount the postponement of the Fifth Army of-
Depot, 1944; (8) Inspection of Veterinary Service,
NATOUSA and MTOUSA, 1944, 1945. (9) Misc fensive until spring relieved the immedi-
docs relating to MTO vet service, 1945. (10)
23
Monthly Hist Rpt, 2604th Vet Sta Hosp, Mar-May Memo, Col Noonan, Col, Theater Vet, to Plans
45; (11) Hist, 2605th Vet Gen Hosp, 15 Mar-30 and Opns, 8 Dec 44.
Apr 45. 24
Memo, Noonan to Surg, MTOUSA, 24 Nov 44.
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 517
ate pressure. A realignment of the PBS in the Army and no experience with
veterinary service along the lines desired animals.
by Colonel Noonan was deferred until The 2604th Veterinary Station Hospi-
March 1945. tal, with the 644th Veterinary Evacua-
On 15 March the 2604th Veterinary tion Detachment attached, did not go
Station Hospital (Overhead), the into operation until the war was over.
2605th Veterinary General Hospital On 3 May the unit moved to San Mar-
(Overhead), and the 643d and 644th tino, the site of a former Italian Army
Veterinary Detachments were all acti- artillery school a few miles south of the
vated at Leghorn, where personnel Po River on the Bologna-Verona axis.
joined and were staged over the next The Fifth Army Remount Depot was in
few weeks. The commanding officer of the area, with 5,000 captured or aban-
the general hospital was Lt. Col. Walter doned German animals, about 200 of
Smit, while the station hospital was which were in need of veterinary care.
commanded by Capt. John L. West. These were turned over to the hospital
Both units were organized with skeleton when it opened on 5 May. A few days
staffs in the expectation that Italian later elements of the British remount
veterinary personnel would be attached. organization moved into San Martino,
In a parallel move, the 213th Veterinary and the area was turned over to them
General Hospital at Grosseto was given on 15 May. During its brief l0-day oper-
more U.S. supervisory personnel and re- ating span, the 2604th Veterinary Sta-
designated the 1st Veterinary General tion Hospital treated more than 400
Hospital (U.S.-Italian). animals.
The 2605th Veterinary General was Meanwhile, the 2605th Veterinary
ready by the time the main Fifth Army General Hospital had moved from Pon-
drive was launched. The hospital moved tepetri to a site about 8 miles beyond
into position at Pontepetri west of High- Mirandola, where it too opened on 5
way 64 on 19 April. The site, which had May. Casualties were received from the
been occupied until 1 April by the 211th 211th Veterinary Evacuation, which was
Veterinary Evacuation Hospital, was in at Ghisione only about 10 miles forward,
the rear of the 10th Mountain Division and from the 2604th Veterinary Station,
sector. First patients were received on which was no more than 12 miles away.
21 April from the 211th, which had The food inspection work that made
moved forward to Riola. Other casualties up the remainder of the Veterinary
came direct from the 10th Mountain Di- Corps mission in the theater was routine
vision. All were transported by the 643d by the fall of 1944. By the start of the Po
Veterinary Evacuation Detachment. On Valley Campaign there were thirteen
24 April the 2d Veterinary General Hos- veterinary food inspection detachments
pital (U.S.-Italian) was organized and operating in MTOUSA, at ports and
attached to the 2605th at Pontepetri, but base section installations, supplemented
was of less help than had been hoped. by two port veterinarians and a quarter-
The Italian unit had only two veterinary master refrigerator company veterinar-
officers, and all of its enlisted men were ian. The Air Forces had three aviation
young inductees with only two months veterinary detachments and two veter-
518 MEDITERRANEAN AND MINOR THEATERS
inary sections engaged in the same work. strength. Hours were often long
These units were adequate to provide and working conditions, especially in
complete food inspection coverage for the field and evacuation hospitals on the
the theater. Fifth Army front, were difficult. "The
nurses," wrote a qualified observer in
Nursing Service December, "are showing definite signs
of fatigue. Many of them are getting
Through the first ten months of 1944, irritable with conditions and people to
there had been an average of 4,000 which they could formerly accommodate
nurses in the Mediterranean theater. In themselves. Little things bother them
November 1,358 were transferred to which previously they could laugh off.
ETO, and the year ended with only Young faces have old masks."25
2,446 nurses remaining in MTOUSA, or 25
Memo, Maj Margaret D. Craighill, Consultant
a ratio of 4.8 per 1,000 of troop strength for Women's Health and Welfare Activities, to
compared with a 5.5 ratio in October. TSG, 20 Dec 44. Other sources for this section are:
No replacements were received, even for (1) Annual Rpt, Med Sec, MTOUSA, 1944, an. I;
(2) Annual Rpt, Surg, PBS, 1944; (3) Annual
normal attrition, leaving the theater ap- Rpts, Surg, NORBS, 1944, 1945; (4) Med Hist,
proximately 350 nurses below authorized AAFSC MTO, 1944, 1945; (5) Med Hist, 2d Aux
THE ITALIAN COMMUNICATIONS ZONE: NORTHERN PHASE 519
Some tensions were relieved by rota- tive structure in Italy. With the gov-
tion between base and army hospitals ernment of Ivanoe Bonomi seemingly
and by sending nurses to rest areas when- secure, and more than half the country
ever they could be spared. In terms of freed from German domination, it ap-
strength, however, no improvement was peared an unnecessary burden to require
possible, the ratio to troop strength de- Field Marshal Alexander to double as
clining to 4.7 per 1,000 by April. The military governor. Early in September
redeeming feature was a steady improve- 1944, therefore, Allied Force Headquar-
ment in the ratio of nurses to patients. ters resumed direct jurisdiction over the
Owing primarily to light battle casual- Allied Control Commission, leaving the
ties and an excellent general health level army group commander responsible only
among theater troops, the ratio of nurses for liberated territory still within the
to patients rose from 1:21 in December combat zone. Shortly thereafter Presi-
1944 to 1:19 in January and February dent Roosevelt and Prime Minister
1945; 1:17 in March; and 1:15 in April. Churchill, as one of the results of a
A morale factor was the relaxing of conference in Quebec, issued a joint
promotion policies in the fall of 1944, declaration promising to the Italian Gov-
when authority was granted to promote ernment greater control over its own af-
all nurses who had been in the grade of fairs, both political and economic. Pro-
second lieutenant for 18 months, regard- posals for implementing the new policy
less of T/O allotments. Promotions were were worked out by Harold Macmillan,
also authorized for first lieutenants who then British resident minister at AFHQ,
had been 18 months in grade if they and with only minor changes were ap-
were otherwise qualified for advance- proved in both London and Washington
ment. Under this authorization, 227 in time to go into effect in February
second lieutenants and 19 first lieuten- 1945. Army responsibility in matters of
ants were advanced in rank in the closing civil public health in the communica-
months of 1944. When the war ended in tions zone was thereafter primarily ad-
Europe there were 2,267 nurses in the visory except for medical supply, and
Mediterranean theater, of whom one was even here, after 20 October 1944, distri-
a lieutenant colonel, 15 were majors, 100 bution had been in the hands of an
were captains, and 1,328 were first lieu- agency set up for that purpose by the
tenants. Only 823, or about 36 percent Italian Government.26
of the total, were in the lowest rank. In the combat zone, the Allied Mili-
tary Government organization continued
Army Civil Public Health to exercise control through the com-
Activities manders of the two Allied armies. In
the Fifth Army sector, General Hume in Italy, Fifth Army military govern-
continued to administer civil affairs un- ment and civil public health officers had
der both Clark and Truscott. For the relatively few problems. The German
most part AMG concentrated on the collapse was so swift and so complete
restoration of water supplies, sewage that the great cities of northern Italy
disposal, power facilities, sanitation, and suffered little damage. Partisan forces,
the like. Florence and Pisa were badly co-operating with the Allies, were able
damaged, presenting on a smaller scale to save most public utilities from de-
a repetition of the problem of Naples a struction. The civil public health prob-
year earlier. The work of restoration was lems of the occupation period were those
still going on when the heavy rains of of food, clothing, hospitalization, and
September and October added to the medical supply rather than the restora-
damage, but both cities were functioning tion of water and power facilities and
normally by winter. There were no seri- sewers and were soon transferred from
ous outbreaks of disease anywhere in the Fifth Army AMG to the Allied Control
Arno Valley. Commission and the Italian Govern-
In the final drive that ended the war ment.
CHAPTER XIV
a Fifth Army responsibility, were not ber 1940, a point for each month over-
known. Another objection was that the seas, 12 points for each child under
forecast called for early redeployment of 18 years of age up to a limit of three, and
types of units not actually present in the 5 points for each combat decoration and
theater. The 2,000-bed general hospitals, battle participation award.2 For enlisted
which were also scheduled for early men the critical score was tentatively set
transfer, were regarded by General as 85 points. Critical scores for Medical
Stayer as unsuitable for the Pacific and Department officers, received late in
necessary during redeployment in Italy. May, varied with the corps. For hygien-
There was also disagreement as to the ists and dietitians, the figure was 62; for
speed with which the medical depot com- dentists, 63; for physical therapists, 65;
panies ought to be withdrawn, in view of for nurses, 71; for Medical Administra-
the volume of equipment to be prepared tive Corps officers, 88; and for Medical
for shipment. Most of the objectionable Corps officers 85 plus, according to
features were eliminated from a new specialty. As a preliminary to redeploy-
War Department forecast received early ment, high score men were to be trans-
in May, and redeployment regulations ferred to Category III and IV units,
consistent with it were issued on the 12th while units placed in Category II were
of that month. to be staffed with officers and men whose
Under these regulations the theater ASRS's were below the critical level.
commander was to assign each unit to High-score men in Category III units
one of the following categories: (I) were to be returned to the United States
units to occupy areas of Europe; (II) as casuals after disbandment of their
units to be used in the war against organizations. High-score personnel
Japan; (III) units to be inactivated deemed nonessential were to be with-
within the theater; and (IV) units to be drawn on a continuing basis from all
returned to the United States for inacti- units and returned to the United States
vation. Category II was broken as casuals. Where enough low-score offi-
down into (A) units to be shipped to the cers were not available to staff outgoing
Pacific direct; (B) units to be shipped to units, essentiality became the overriding
the Pacific by way of the United States; consideration.
and (C) units to be shipped to the Although many difficulties arose owing
United States to be placed in strategic to the disproportionately large number
reserve. Since the occupation of Austria of high-score men in medical units, the
had by this date been assigned to forces program laid down in May was carried
already in that area and the occupation out faithfully until the end of July. By
of cobelligerent Italy was not contem- that date, however, the demands for ship-
plated, no MTOUSA medical units fell ping to move men and equipment to the
into Category I. Pacific were so great as to preclude the
At the same time, each officer and en- movement of medical units to the United
listed man in the theater was given an States for disbandment. Early in August,
Adjusted Service Rating Score (ASRS)
as of 12 May 1945, based on a point for 2
For more detailed discussion, see McMinn and
each month of service since 16 Septem- Levin, Personnel in World War II, pp. 487 ff.
CONTRACTION AND REDEPLOYMENT 523
port from the 40th Station and its re- tion hospital—the 52d—was closed the
placement, a detachment of the 37th day after the war in Italy ended, and
General Hospital. The 34th Station was earlier plans to re-establish the unit at
also available if needed. another location were abandoned. The
Other features of the Fifth Army med- 118th Station closed on 20 May and the
ical service for staging troops were the 106th four days later, leaving only
operation of dispensaries and prophy- the 21st Station and the 17th, 45th, and
lactic stations in rest areas, and the sani- 300th Generals in Naples, with an aggre-
tary inspection of hotels and restaurants gate Table of Organization bed strength
5
in the large cities of northern Italy to of 5,500.
which leaves were granted. In Rome a readjustment was made
when the 500-bed 73d Station Hospital
Hospitalization and Evacuation was reassigned to PBS from Rome Area
on 25 May, preparatory to closing, and
At the theater level, hospitalization the 250-bed 34th Station was transferred
and evacuation of the sick and injured to the Rome Area jurisdiction. It was
continued to be the primary mission of possible to release only one of the Leg-
the medical service as long as American horn hospitals in May—the 114th Sta-
soldiers remained in the Mediterranean. tion, which closed on the 29th. The
Both functions, however, were sharply 114th, which had been the PBS psychi-
curtailed in keeping with the improved atric hospital since its arrival in Italy
health status resulting from the cessation almost a year earlier, had been receiving
of hostilities and the subsequent reduc- patients in diminishing numbers for
tion of troop strength. several weeks.
Also closed in May were the 225th
Contraction of Hospital Facilities Station Hospital at Fano and the 35th
Field Hospital, whose platoons had been
The problem facing the MTOUSA operating separately at Lecce and Erchie
and PBS surgeons when the redeploy- in the heel of Italy and at Rimini on the
ment period began was one of keeping western coast of the Adriatic. Both of
a safe number of fixed beds in the areas these hospitals, however, were scheduled
of troop concentration and a balanced for new assignments under PBS after
distribution of facilities and specialized termination of their attachments to the
personnel, at the same time closing out Adriatic Base Command.
hospitals to meet the redeployment The 225th Station was in fact the key
schedule and readjusting personnel in to a difficult situation in the Florence
order to staff with low-score men units area, where the 24th General Hospital
tabbed for further combat. It was not was required to vacate its quarters not
an easy task, but it was accomplished
smoothly and with few delays. 5
Principal sources for this section are: (1) Fi-
Since the bulk of the U.S. forces were nal Rpt, Plans and Opns Off, Office of Surg, MTO-
in northern Italy, hospital facilities in USA; (2) Med Sitreps, PBS, May-Oct 45; (3)
Unit rpts of hosps mentioned in the text; (4)
the Naples area were the first to be sur- ETMD's of the hosps mentioned in the text for
plus to theater needs. One 500-bed sta- May-Oct 45.
CONTRACTION AND REDEPLOYMENT 529
later than 1 June to make way for the June. Also on 25 June, the 182d Station
redeployment and training center. A closed at Montecatini and the 225th
minimum of 500 beds would be required ceased operations at Pratolino. Both
to support the center, but no suitable site units were replaced by 500-bed detach-
was available in Florence. Permission to ments of the 70th General Hospital,
use the theological seminary building which ceased taking patients at Pistoia
occupied during the North Apennines at that time.
Campaign by the 15th and 94th Evacua- July saw the closing out of another
tion Hospitals was refused by the arch- 6,000 fixed beds in Italy and further re-
bishop of Florence. The only practical adjustment to provide adequate cover-
solution was to replace the 250-bed 55th age. The 1st and 2d Platoons of the 35th
Station at Pratolino with a larger unit. Field Hospital opened at Sparanise in
Additional space was provided by con- support of the Brazilian redeployment
verting a nearby villa into officers quar- center on 8 July, and on the 12th the
ters and turning an enclosed porch into 70th General moved its headquarters
a ward. On 9 May, ten days after it from Pistoia to Pratolino. The major
closed at Fano, the 225th began taking shutdowns began with closing of the
over from the 55th by infiltration. By1 2,000-bed 12th General at Leghorn on
June, when the 24th General moved out 7 July. On the 18th the 60th Station at
of the area, the 225th was in full opera- Senigallia was relieved by the 4th Field.
tion with facilities for 750 beds. The 103d Station closed at Pisa on 20
The process of readjustment and con- July, its place being taken by the 99th
traction was accelerated in June. In Field, whose scattered platoons were
southern Italy the 45th General Hospi- brought up from Grosseto, Castagneto,
tal—last installation in the Naples medi- and Empoli.
cal center—closed on 9 June, and on the The 40th Station closed at Cecchignola
21st replaced the 26th General at Bari redeployment center south of Rome on
as an ABC unit. On 10 June the 262d 21 July, replaced by a detachment of the
Station Hospital at Aversa was relieved 37th General from Mantova. On the
by a platoon of the 35th Field. The 34th same day the 32d Station closed at
Field closed its 1st Platoon at Spinazzola Caserta, where it was relieved by a de-
on 5 June and its 2d and 3d Platoons at tachment of the 300th General. The 21st
Cerignola ten days later, the latter being Station closed in Naples on 23 July, and
replaced by the 2d Platoon of the 4th the 6th General closed at Bologna the
Field. In Rome, the 73d Station closed following day. The 750-bed 7th Station
on 18 June. Hospital closed in Leghorn on 26 Au-
In northern Italy, the 81st Station at gust, and by the end of the month the
Leghorn and the 74th at Bologna both 154th Station at Caiazzo and the Cecchig-
closed on 20 June. On 25 June the 500- nola detachment of the 37th General
bed 105th Station, having evacuated all were also closed.
but sixty of its Russian patients to their As of 1 September, nearly four months
homeland, was replaced by the 250-bed after the end of the war in Italy, there
55th Station. The 55th was able to send remained 14,350 fixed beds in MTO-
the remaining Russians home by 28 USA, including the 16th Evacuation
530 MEDITERRANEAN AND MINOR THEATERS
Hospital and the 15th Field Hospital, carried a heavy surgical load during May,
which were assigned to PBS from Fifth but the backlog of battle wounds was
6
Army at that time. Of this total, 2,400 largely caught up by the end of the
were attached to the Adriatic Base Com- month. In the Naples and Leghorn areas,
mand and 250 were assigned to Rome general hospitals reported rises in ve-
Area, the remainder being PBS units. In nereal cases and in common respiratory
terms of distribution, 3,900 beds were and intestinal diseases, owing primarily
in the Naples-Caserta area; 3,000 in Leg- to the closing out of the station hospitals
horn; 2,000 in the Bari-Foggia area that normally handled such cases. Hos-
serving Air Forces units. There were pitals serving the redeployment centers
2,150 beds in the Arno Valley between noted a considerable rise in neuropsychi-
Florence and Pisa; 1,500 in Mantova; atric cases as a result of the rigorous
750 at Udine; 400 at Senigallia; 250 in screening of personnel for Category II
Rome; and 100 each at Milan, Desen- units. There were otherwise no signifi-
zano, and Bolzano. cant disease trends, and admissions re-
The authorized ratio of fixed beds to mained well below capacity despite the
troop strength for the theater was continuous reductions in bed strength.
lowered from 6.6 to 4 percent on 15
September, and a further exodus of hos- Evacuation
pitals followed. The 33d, 37th, 45th, and
70th General Hospitals, the 16th Evacu- With both mobile and fixed hospitals
ation, and the 4th Field were closed on scheduled for early redeployment, it was
or before 1 October. The closing of the necessary to accelerate the evacuation
17th General and 35th Field Hospitals in process by every possible means. The
October and the 64th General in Decem- backlog of U.S. battle casualties was
ber left the Mediterranean theater with largely cleared from the army area by
a total of 3,800 beds at the end of the the middle of May, while ZI evacuation
year. alone during that month released more
During the redeployment period hos- beds than were required for new admis-
pitalization in base installations followed sions. A continuing process of moving
a predictable pattern. The three fixed ZI patients to Naples and of concen-
hospitals in the Po Valley were largely trating communications zone cases in
occupied through May and June with smaller and smaller numbers of hospi-
prisoners of war, many of them with tals made intratheater evacuation also a
neglected battle wounds. General hospi- continuous process.
tals foremost in the line of evacuation
from the combat zone, notably the 24th Intratheater Evacuation—In the pe-
at Florence and the 70th at Pistoia, riod between the ending of hostilities in
Italy and the dissolution of Fifth Army
it is impossible to separate evacuation
6
The difference between 14,350 fixed beds on1 from army hospitals and patient trans-
September 1945 and 13,950 as given in Appendix fers from one base hospital to another.
A-6 for 31 August is represented by the 400 beds
of the 5th Field Hospital, assigned to PBS on1 The bulk of the battle casualties were
September. cleared from the Po Valley by the middle
CONTRACTION AND REDEPLOYMENT 531
TABLE 38—INTRATHEATER EVACUATION: U.S. AND ALLIED PERSONNEL
MAY-SEPTEMBER 1945
of May, using planes exclusively to carry PBS hospitals in that city as well as from
the men back to base hospitals in the the army field and evacuation hospitals.7
Florence and Leghorn areas. More than Air evacuation began both from Bo-
1,300 U.S. and Allied patients were flown
7
out of the Po Valley between 2 and 15 Principal sources for this section are: (1) Final
Rpt, Plans and Opns Off, Office of the Surg,
May. (Table 38) Flights from Bologna, MTOUSA; (2) Med Sitreps, PBS, May-Sep 45; (3)
however, carried patients from the two Med Hist, 802d MAETS.
532 MEDITERRANEAN AND MINOR THEATERS
logna and from Villafranca airfield south the latter month, all intratheater evacu-
of Verona about 2 May, and shortly ation thereafter being by air. By this
thereafter from Treviso and Milan. In date only a relatively small number of
June planes of the 802d Medical Air long-term patients remained, and evacu-
Evacuation Transport Squadron began ation had been reduced to transportation
lifts from the Udine area, but by this of routine illness and injury cases among
date the number of patients to be evacu- garrison troops to the nearest fixed hos-
ated was small. The squadron became pital.
inoperative in June, and its sister squad-
ron, the 807th, in August. Evacuation to the Zone of Interior—
The only unusual incident in evacu- An essential preliminary to redeploy-
ating from Fifth Army units occurred ment of hospitals and other medical
late in May in the San Remo area along units in the Mediterranean was to reduce
the Italian Riviera, where the 34th the number of patients in fixed hospitals
Division was engaged in patrol activ- as rapidly as possible. As early as 15
ities. Authorization was requested and April 1945, when the Po Valley Cam-
received from SHAEF to evacuate pa- paign was just getting under way, the
tients from this area to the 78th Station problem was studied with a view to
Hospital at Nice, France, an ETOUSA speeding up the evacuation process. It
unit that was only thirty-five miles away, was determined at that time that of the
whereas the nearest MTOUSA hospital more than 15,000 patients then in MTO-
was the 2d Platoon of the 32d Field in USA hospitals, 2,400 more could be evac-
Turin, more than 150 miles away. uated to the zone of interior on a 60-day
Early in May some 500 patients were policy than could be sent home on the
evacuated by hospital train from Flor- 120-day policy then in effect. A 60-day
ence to Leghorn to provide beds for policy, moreover, would increase future
new casualties coming from across the ZI dispositions by 65 percent.8
Apennines, and later in the month The evacuation policy was reduced
approximately 800 more were flown accordingly to 60 days beginning on1
from Florence to Naples to clear May 1945. The change was immediately
the 24th General Hospital for closing. reflected in a sharp rise in ZI evacuation,
Patients from Pratolino, Pistoia, and which reached a total of 4,428 for U.S.
Montecatini continued to go by rail to Army patients for the month, compared
Leghorn during June and July, as hospi- with 1,761 in April. The backlog of ZI
tals in those areas were contracted or as patients had been so far reduced by the
patients were screened for evacuation to end of May that one plane a day, carry-
the zone of interior, with a smaller ing 18 litter patients, was deemed suffi-
number going direct to Naples by air. cient for priority cases. Early in July,
ZI patients from Leghorn were sent to when air transports with comfortable re-
Naples by hospital ship. More than clining seats became available, litter and
1,800 were evacuated by this means in ambulatory loads were alternated. Non-
8
May, 550 in June, and over 800 in July. Principal sources for this section are: (1) Final
Both rail and hospital ship evacuation Rpt, Plans and Opns Off, Office of Surg, MTOUSA,
1945; (2) Theater ETMD's for May-Dec 45; (3)
within the theater were discontinued in Med Sitreps, PBS, May-Oct 45.
CONTRACTION AND REDEPLOYMENT 533
a
Does not include 55 Russians evacuated to Bruck, Austria.
b
Does not include 49 Russians evacuated to Bruck, Austria.
Source: (1) Final Rpts, Plans and Opns Off, Office of the Surg, MTOUSA, apps. 14, 15. (2) Theater ETMD's May-
Dec 45. (3) Medical Sitreps, PBS, May-Oct 45.
Evacuation from the Mediterranean cases had been evacuated to the German
theater to the zone of interior from May POW hospital near Oran or, until the
through December 1945 is summarized end of October 1944, to the United
in Table 39. States, but the bulk of them had been
hospitalized in the Peninsular Base Sec-
Hospitalization and Repatriation tion. The German-staffed POW hospital
of Prisoners of War had been moved to Florence in March
1945, so that by the launching of the Po
Throughout the campaign in Italy sick Valley Campaign all German prisoners
and wounded prisoners had been hospi- in the Mediterranean theater were hos-
talized in base installations in or adjacent pitalized when necessary by PBS.
to prisoner-of-war enclosures. Long-term As of this date, the installations pri-
CONTRACTION AND REDEPLOYMENT 535
marily devoted to care of German pris- groups were given the best medical care
oners were the 334th Station Hospital available, both in the army area and in
(German) at Florence, and the 103d the base section. The only real distinc-
Station at Pisa. The 81st Station at Leg- tion was that prisoners in base hospitals
horn had 250 T/O beds devoted to the were cared for primarily by U.S. medical
care of prisoners, and the 262d Station officers, with some assistance from Ger-
at Aversa in the Naples-Caserta area be- man protected personnel, whereas in the
came exclusively a POW hospital late in army area all medical care after the first
April. Small numbers of prisoners were few days was by Germans in German
hospitalized temporarily in most of the hospitals, with American officers per-
fixed hospitals in northern Italy. Italian forming only a supervisory function.
prisoner and cobelligerent personnel When a complete count was made, as
continued to be cared for primarily at of 15 June, the U.S. share of the more
the 7029th Station Hospital (Italian), than half million prisoners taken in Italy
located from early March at Pisa. since Salerno was 299,124, of whom
As the Po Valley Campaign neared its 147,227 were under Fifth Army control
climax, it was clear that prisoners would and 151,897 belonged to the Peninsular
run into the hundreds of thousands, and Base Section. The health of these pris-
that special provision, including the full oners, who were used to replace Ameri-
utilization of all enemy medical facilities can and Italian service troops, was the
and personnel, would be necessary to responsibility of the Fifth Army and PBS
hospitalize the sick and wounded among surgeons.
them. After the first captured hospital
was dismantled and sent to the rear by Hospitalization in the
the 10th Mountain Division, orders were Army Area
issued late in April that all German hos-
pitals and hospitalized personnel were When Fifth Army took over the Ger-
to be left where they were, under suit- man medical service at the end of the
able supervision. It was hoped that all war, field units, disorganized and for the
German casualties could be cared for in most part inadequately staffed and sup-
these installations, but the speed with plied, were scattered over northern Italy.
which the campaign came to a close and The main concentration of German fixed
the disorder of the German forces, hospitals was at the resort town of
including the medical establishment, Merano close to the Austrian border
forced the transfer of additional thou- northwest of Bolzano, with a smaller con-
sands to base hospitals before the Ger- centration at Cortina d'Ampezzo, about
man medical service could be reorgan- forty miles east of Bolzano. In both of
ized under Fifth Army control. these areas, facilities were more than
For medical purposes, no distinction adequate. Hospitals were fully staffed
was made between prisoners of war, de- and equipped to operate without U.S.
fined as those taken in combat, and sur- assistance.10
10
rendered personnel, meaning those Except as otherwise noted, this section is based
turned over by their commanders after on: (1) Fifth Army History, vol. IX; (2) Annual
Rpt, Surg, Fifth Army, 1945; (3) Delaney, Blue
the termination of hostilities. The two Devils, pp. 234-46.
536 MEDITERRANEAN AND MINOR THEATERS
GERMAN MEDICAL CENTER IN THE ITALIAN ALPS, the largest establishment of this type
in Italy.
In accordance with AFHQ instruc- Como. The German medical high com-
tions, all German hospitals and patients mand at Merano, feeling deserted by its
were held where they were when cap- own army and in constant fear of re-
tured, pending detailed analysis of the prisals by Italian partisans, was only too
situation. Colonel Camardella, desig- eager to co-operate.
nated by General Martin to supervise Fifth Army kept enemy formations in-
the hospitalization and evacuation of tact insofar as possible. Personnel not in
prisoners of war in the Fifth Army area, organized units were grouped into self-
began an inspection of German medical sustaining organizations or attached to
facilities on 3 May. He found 10,000 pa- units still retaining some semblance of
tients at Merano, 5,000 at Cortina cohesion, and all were collected into con-
d'Ampezzo and another 5,000 in German centration areas. The largest of these
field units and in American and civilian was set up at Ghedi, about twenty miles
hospitals in the army area. There were southwest of Desenzano and a somewhat
surplus supplies at Merano, and equip- shorter distance south of Brescia. A
ment for making all kinds of prosthetic smaller concentration area was located
devices at a Luftwaffe hospital on Lake at Modena, with others of lesser impor-
CONTRACTION AND REDEPLOYMENT 537
A HOTEL-HOSPITAL AT MERANO
Director of Medical Services aided in the weeks were transferred here from Mer-
assignment and disposition of enemy ano and Cortina, and on recovery were
medical units. moved to the Ghedi POW enclosure. By
Through May the 85th and 88th Di- 15 June, six weeks after the victory, all
visions guarded captured dumps in the German hospitals under Fifth Army con-
mountains and moved surrendered Ger- trol had been closed except Merano,
man forces to initial concentration areas. Cortina, the convalescent facility, and the
Guard duty at Ghedi was performed by units serving the Modena and Ghedi
the 10th Mountain Division until 18 areas. In another two weeks the hospitals
May, and thereafter by the 71st Antiair- at Cortina d'Ampezzo were also cleared
craft Brigade with the 442d Infantry to Merano and closed. The con-
regiment under its command. The 88th valescent hospital was disbanded on
Division took over all guard duties when 17 July. German medical supplies and
it became the theater prisoner of war equipment were stored at Merano and
command. By this time all prisoners Ghedi, while German hospitals and
in the Fifth Army area had been moved other medical units, as they became sur-
to Ghedi or Modena. Some 80,000 en- plus, were held at Ghedi for shipment
tered the Ghedi cages in the week of to Germany or Austria on call.11
17-24 May alone. Modena was consider- At the end of June there were about
ably smaller, being limited to about 12,000 patients in the German hospitals
20,000 by poor drainage. at Merano, administered by the 380th
Medical service at Modena was sup- Medical Collecting Company of the 54th
plied by German doctors under super- Medical Battalion. There were about
vision of the 15th Field Hospital's 3d 4,000 members of the German medical
Platoon. At Ghedi a 1,600-bed tent hos- service in the town. Many items of med-
pital was erected, staffed entirely by Ger- ical supply were manufactured there,
man medical units nominated by the and 9,000 tons were stored. Supplies not
German Director of Medical Services. needed to care for patients at Merano
Lt. Col. (later Col.) Harris Holmboe were shipped to PBS and to British bases
was General Martin's choice for medical for use in treatment of German per-
coordinator in the Ghedi area. The Mo- sonnel. The town itself was run by the
dena and Ghedi hospitals were to care 88th Division under strict military con-
for personnel in the prisoner of war en- trol.
closures only, and were not a part of the Merano offered an excellent opportu-
consolidation plan. nity to evaluate German medicine, about
By the end of May about 80 percent which little had been known since the
of all German medical personnel, equip- Nazi regime had come into power.
ment, and patients had been transferred Consultants and medical investigators
to Merano and Cortina d'Ampezzo. A from all parts of the theater and from
German-staffed 1,500-bed convalescent
hospital was established the first week of
11
June at Villafranca, under supervision of (1) Annual Rpt, Surg, Fifth Army, 1945. (2)
Ltr, Stayer to CofS MTOUSA, 13 Jun 45. (3) Ltr,
the U.S. 3d Convalescent Hospital. Pa- Standlee, Acting Surg, MTOUSA, to Deputy Thea-
tients expected to recover within four ter Comdr and CofS MTOUSA, 17 Jul 45.
CONTRACTION AND REDEPLOYMENT 539
the United States visited the area during prisoner patients on 5 May. The 37th
the period of its heaviest operation. The General, when it opened in Mantova on
conclusion was general that while the 9 May, received more than 1,000 German
German medical service was adequate, patients by transfer from the 15th Evac-
its standards "were only mediocre in uation Hospital, and others continued to
comparison with those of the Allied be admitted to the 74th Station and the
12 13
Forces in Italy." 6th General at Bologna.
In order to relieve the pressure on hos-
Hospitalization of Prisoners pitals in the forward area, about 700
in PBS Units prisoner patients were evacuated from
the Po Valley to Florence, where the
For a week or more after the close of German-staffed 334th Station Hospital
hostilities in Italy, prisoner of war pa- was expanding its capacity from 500 to
tients continued to be evacuated to PBS
hospitals, pending survey and reorganiza-
tion of the German medical service in 13
Principal sources for this section are: (1) Final
the Fifth Army area. The 103d Station Rpt, Plans and Opns Off, Office of Surg, MTOUSA;
Hospital at Pisa had a peak load of 1,162 (2) Med Sitreps, PBS, May-Oct 45. (3) The-
ater ETMD's, May-Oct 45. (4) Unit rpts of in-
dividual hosps mentioned in the text; (5) ETMD's
12
Annual Rpt, Surg, Fifth Army, 1945, p. 44. of individual hosps mentioned in the text.
540 MEDITERRANEAN AND MINOR THEATERS
tients, and the 6th General had about Italian personnel was vested in the Ital-
800. Approximately 1,000 German pa- ian commanding officer of the hospital.
tients remained in the 334th Station All patients were transferred to civilian
Hospital at Florence and about 750 in or Italian military hospitals on 19 July,
the 103d Station at Pisa. The 35th Field and the unit closed the following day. 15
at Aversa had about 500 prisoner pa-
14
tients. Repatriation of Long-Term Patients
Evacuation of long-term cases to
Merano began on 25 June from the 37th By the end of May the roundup of
General Hospital and from other PBS prisoners of war and surrendered per-
prisoner of war hospitals early in July. sonnel in Italy was complete. The next
Thereafter the prisoner of war census in step was repatriation, beginning selec-
PBS hospitals declined rapidly. The 103d tively with those whose labor was most
Station was relieved at Pisa by the 99th essential to restore the German economy
Field on 20 July, transferring 602 Ger- and those too old or too ill to be of any
man patients at that time. By the end of productive use to the Allies. Toward this
the month 37th General had only 341 end, a conference was held at Bolzano on
prisoner patients, and the census of the 14-16 June between representatives of
334th Station was down to 570. Both of Allied Force Headquarters in Italy and
these hospitals were closed on 13 Septem- those of Supreme Headquarters Allied
ber, leaving the 35th Field at Aversa and Expeditionary Forces whose responsi-
the 99th Field at Pisa the only PBS units bility extended to Germany and Austria.
still hospitalizing prisoners of war. Medical representatives at the conference
On 25 September responsibility for all were General Martin and Colonel Cam-
prisoners of war under U.S. control in ardella for Fifth Army; Maj. (later Lt.
Italy passed from MTOUSA to PBS. At Col.) Murray L. Maurer, MTOUSA
that time there were 268 prisoner pa- hospitalization and evacuation officer,
tients in the 99th Field Hospital and 453 for the MTOUSA medical section; Maj.
in the 35th Field, with an additional (later Lt. Col.) O. S. Williams of the
1,200 in German units under U.S. super- British component for the medical sec-
vision. The bulk of these were the rou- tion of AFHQ; and Col. Conn L. Mill-
tine sick and injured from German burn, Jr., executive officer to the army
service units operating in the theater. group surgeon, for the 12th Army Group.
All Italian personnel were formally re- SHAEF headquarters sent no medical
leased from prisoner of war status on 30 representative, but Millburn was fami-
June and returned to control of the Ital- liar with ETO's problems and policies.16
ian Government. The 7029th Station Basic agreements were reached as to
Hospital (Italian), which had been hos- numbers to be repatriated on both sides,
pitalizing Italian prisoners first in the routes to be used, and tentative target
Oran area and then at Pisa since the fall
of 1943, closed to admissions at this 15
(1) Hist, 7029th Sta Hosp (Italian), 27 Jul 45.
time, and administrative control over all (2) Med Sitreps, PBS, 15-31, Jul 45.
16
Ltr, Maurer to Standlee, 19 Jun 45, sub: AF
14
Ltrs, Kane, Surg, MTOUSA POW Comd, to HQ-SHAEF Conference at Bolzano, 14-16 Jun 45.
CG MTOUSA, 7 Jul, 6, 28 Sep, 45. POW's, Mar 44-Sep 45.
542 MEDITERRANEAN AND MINOR THEATERS
dates; but the disposition of long-term represented the 12th Army Group,
patients was discussed only briefly at the while Col. John Boyd Coates, Jr., and
conference level. More detailed discus- Col. Robert Goldson represented Third
sions of this problem were held by the and Seventh Armies, respectively. The
medical representatives meeting sepa- British-Canadian 21 Army Group was
rately as a subcommittee, and tentative also represented in order to arrange the
plans were agreed upon. AFHQ was pre- transfer of German patients under Brit-
pared to begin receiving hospitalized ish control in Italy.17
Italians from Germany and Austria The Wiesbaden conference resulted in
whenever SHAEF requested, since 4,000 a firm program for exchange of hospital-
beds were already available in Italian ized prisoners between the Mediterran-
military hospitals. The transfer of Ger- ean and European theaters. All German
man patients from Italy to SHAEF-con- patients in U.S. custody were to go by
trolled areas was a more complex prob- hospital train by the Brenner route to
lem. Occupation forces were still in the Third Army at Munich, Regensburg,
process of adjustment, and beds would and Furth; and to Seventh Army at Id-
not be available until all German pa- stein. Beginning 25 July, one train every
tients could be evacuated from the Tyrol second day was to go to Third Army,
region. It was agreed that when SHAEF and after 15 August daily trains were to
was ready, long-term German patients alternate to Third and Seventh Armies.
from Italy would be moved north by hos- Three Italian hospital trains were to be
pital train over the Brenner route, whose furnished by Fifth Army (two initially),
much-bombed rail line would soon be and two German trains were to be sup-
in usable condition. The target date plied by Third Army.
selected was 10 July, at which time a It was estimated that returns to duty
meeting between the two medical staffs would reduce the total of U.S.-controlled
concerned was to be called by SHAEF to German patients to be repatriated to
complete final arrangements. about 10,000. Beds vacated by these at
By the time the promised conference Merano, up to 3,000, would be used to
of medical officers was held at Wiesba- hospitalize temporarily sick and wounded
den, Germany, on 12-13 July, SHAEF Italians returned from Germany, for
had been replaced by United States whom responsibility would pass to the
Forces, European Theater (USFET) . At Allied Commission on their arrival.
the Wiesbaden conference, the only rep- Long-term prisoner patients from the
resentatives of the Allied Forces in Italy Eighth Army zone in Italy were to go to
were Col. Albert A. Biederman, plans the 21 Army Group under separate ar-
and operations officer in the MTOUSA rangements.
medical section; and Col. Williams, Evacuation to Germany began as plan-
who spoke for the British component of ned on 25 July, and by the end of the
AFHQ. On the USFET side, forward
headquarters was represented by Lt. Col. 17
(1) Brief Minutes of Conference on Exchange
Joseph W. Batch and rear headquarters of Medical Cases, Wiesbaden, 12 Jul 45. (2) Ltr,
Biederman to Standlee, 20 Jul 45, sub: Exchange
by Col. Fred H. Mowrey. Colonel Mill- of Sick and Wounded Between the European and
burn and Lt. Col. James E. Sams Mediterranean Theaters.
CONTRACTION AND REDEPLOYMENT 543
month 1,254 patients had been moved of hospitals and repatriation of those
to hospitals in the Third Army zone. with long hospitalization expectancy,
The hospital trains used were staffed by American medical units were being
German medical officers and corpsmen, systematically staged for shipment to the
under the supervision of an American Pacific or prepared for inactivation.
Medical Administrative Corps officer. The Mediterranean theater was con-
On the return trip, the trains carried tracting even more rapidly than it had
Italian displaced persons to be hospital- grown in the early days of the Italian
ized initially at Merano. The whole campaign.
process worked so smoothly that Third
Army agreed to take a trainload a day Disposition of Fifth Army Units
beginning 9 August instead of on alter-
nate days. The Third Army quota was The readjustment of Medical Depart-
filled by the middle of August, all ment personnel so that units destined for
evacuees thereafter going to the Sev- the Pacific would have only men with
enth Army.18 low adjusted service rating scores, plus
By the end of August the total number the loss of high-score men to "carrier"
of long-term cases sent to Germany had units bound for the United States, posed
climbed to 7,783, and stood at 9,751 as a more difficult problem for the Fifth
of 25 September, when the Peninsular Army surgeon than even the care of pri-
Base Section took over responsibility soners of war. The Fifth had been the
from MTOUSA. For all practical pur- first United States field army activated
poses, the program was finished, since no on foreign soil in World War II, and
more than 500 long-term German pa- had been in virtually continuous combat
tients remained in the U.S. zone of for 19 months when the war ended.
Italy. Many of its components, including hos-
pitals and medical battalions, had seen
Redeployment and Inactivation still earlier combat with other forma-
of Medical Units tions. There was, therefore, a heavy pre-
ponderance of high-score personnel in
At the same time that U.S. long-term the Fifth Army medical service. Yet 2 of
patients were being evacuated to the zone the 8 evacuation hospitals and one of the
of interior on a 60-day policy and the 3 field hospitals were scheduled for
burden of caring for prisoner of war pa- direct redeployment to the Pacific, and 2
tients was being reduced by consolidation more evacuations and a field were listed
18
for indirect redeployment. Three of the
(1) Annual Rpt, Surg, Fifth Army, 1945. (2)
Final Rpt, Plans and Operations Off, Office of 4 medical battalions in Fifth Army were
Surg, MTOUSA. The figures used here, and in the also placed initially in Category II, with
following paragraph, are from letters, M. M. Kane, about the same proportions holding for
Surgeon, MTOUSA POW Command, to Command-
ing General, MTOUSA, 6, 28 September 1945, in other types of medical units.19
19
Prisoners of War, March 1944-September 1945. Principal sources for this section are: (1) An-
These figures differ both from those given by the nual Rpt, Surg, Fifth Army, 1945; (2) Final Rpt,
Fifth Army surgeon and from those in the theater Plans and Opns Off, Office of Surg, MTOUSA; (3)
ETMD for October 1945, but are believed to be Theater ETMD's for May-Aug 1945; (4) Unit rpts
the more accurate. of the individual med units mentioned in the text.
544 MEDITERRANEAN AND MINOR THEATERS
The first Fifth Army medical unit to which further withdrawals would jeop-
go to the Montecatini redeployment ardize their efficiency, and they were still
center was the 94th Evacuation Hospital, needed to furnish medical service to the
which arrived on 16 May, a bare two remaining combat formations. A further
weeks after the end of the war in Italy. complication was the refusal of the War
The exigencies of the situation, however, Department to- accept the MTOUSA
required the 94th to go into operation Table of Organization for separate col-
for a time at Montecatini, although it lecting companies that were to be trans-
was classified as II-A for direct redeploy- ferred to the Pacific. These companies
ment to the Southwest Pacific. The 171st had been operating with a medical officer
Evacuation, scheduled for redeployment and 4 MAC's. It was now necessary to
to the Pacific by way of the United States, make all of the 7 companies involved
was in Montecatini on 29 May; the 161st conform to the official Table of Organi-
Medical Battalion less its collecting and zation, which called for 3 medical offi-
clearing companies, the 32d Field Hos- cers and 2 MAC's. The required officers
pital and the 170th Evacuation all ar- were diverted from the 91st and 10th
rived at the redeployment center the first Mountain Divisions, and replaced from
week of June. The headquarters and a group of 20 low-score medical officers
headquarters detachments of the 162d procured from the European theater,
and 163d Medical Battalions arrived but no more were available from that
just before the end of June. source. Fourteen Medical Administra-
By the end of May the Category II-A tive Corps second lieutenants were com-
Medical units—the 94th and 170th Evac- missioned from among 60 enlisted
uation Hospitals, the 32d Field Hospital, applicants, but there remained a short-
and the 161st Medical Battalion—were age of low-score officers in both corps,
staffed with low-score personnel as fully forcing the retention of high-score men.
as was consistent with efficient operation. The supply of low-score enlisted men
Other Category II units, including the was also critical by the end of July—so
medical battalions and medical detach- much so that a requirement for 300 gen-
ments of the 91st and 10th Mountain eral service enlisted men with point
Divisions, had had the bulk of their scores below 70, to be used as Pacific
high-score personnel withdrawn dur- replacements, could only be met by
ing June, but low-score replacements drawing 100 men from units assigned to
were insufficient to bring the units up to the strategic reserve and replacing them
Table of Organization strength. with high-score personnel from Category
By July the personnel situation in IV units.
Fifth Army was critical. Low-score per- The manpower problem was finally
sonnel to fill out the T/O's of units be- solved in early August. To relieve pres-
ing redeployed to the still-active war sure on shipping, a change of policy was
against Japan had of necessity to be inaugurated whereby all Category IV
drawn from units scheduled for return units were to be inactivated in the the-
to the United States and ultimate in- ater rather than be shipped to the
activation. But these Category IV units United States for inactivation. High-
had already been stripped to a point at score personnel from Category IV that
CONTRACTION AND REDEPLOYMENT 545
had been scheduled for early shipment and the 56th Evacuation, which was to
and were already inoperative, were sent be a Pacific reserve unit, had arrived at
home as casuals, but those with middle- Montecatini on 6 August. The 38th was
bracket scores—80 to 90 points—were inactivated in the theater on 8 Septem-
transferred to late Category IV units, ber. The 56th was sent home for inactiva-
which were thus brought up to strength. tion early in October.
The process of redeployment, mean- The 15th Evacuation and the 3d
while, had been proceeding according to Convalescent both closed for redeploy-
plan. The Fifth Army veterinary service ment on 20 August, while the 54th Med-
passed out of existence on 30 June, when ical Battalion and the 601st Clearing
the Italian pack mule trains were dis- Company moved to Florence for final
banded and the four U.S.—Italian vet- disposition on 25 August. The 33d Field
erinary hospitals were turned over to the Hospital, which had closed on 23 August,
Italian Army. Two weeks later, on 14 was inactivated on 25 September. Only
July, the 171st Evacuation Hospital sail- the 15th Field Hospital, the 8th and 16th
ed for the Pacific by way of the United Evacuation Hospitals, and a few lesser
States. The 32d Field and the 170th units remained active in the army area
Evacuation sailed on 17 and 25 July, when the transfer to PBS took place on
respectively, direct to the Philippines; 1September.
and the 161st Medical Battalion embark-
ed on 7 August for the United States en Disposition of PBS Units
route to a Pacific station. The 94th E-
vacuation sailed for the Southwest Pacific The redeployment of medical units
on 13 August, but was diverted at sea assigned to the Peninsular Base Section
to the United States after word was re- followed a pattern similar to that in Fifth
ceived of the Japanese collapse. Army. The problem of personnel read-
On 20 August all Category II units justment was equally difficult, with ten
still in the theater were ordered returned station hospitals and one field hospital
to the United States for disposition, creat- in the II-A category for shipment in
ing a considerable morale problem since June, July, and August; and three station
these had already been staffed with low- hospitals scheduled for transfer to the
score personnel who were thus being sent Pacific by way of the United States in
home before the high-score men they re- July. A great deal of juggling was neces-
placed. Immediate steps were taken to sary, and a few medical officers with
readjust personnel once more, but not ASRS's above the critical level were still
in time to alter the rosters of the 162d on the rosters when the hospitals sailed
and 163d Medical Battalions, already for their new assignments.20
aboard ship. The first PBS units to leave the Medi-
Other Fifth Army medical units were
disposed of rapidly thereafter. The 38th 20
Principal sources for this section are: (1) Final
Evacuation Hospital, which had origi- Rpt, Plans and Opns Off, Office of Surg, MTOUSA;
nally been scheduled for return to the (2) Med Sitreps, PBS, May-Oct 45; (3) Pers Ltr,
Stayer to Kirk, 31 May 45; (4) Unit rpts of indi-
United States, had been at the Florence vidual med units mentioned in the text; (5) AG
redeployment center since early July, record cards of units mentioned in the text.
546 MEDITERRANEAN AND MINOR THEATERS
expansion units, was turned in from both Naples dropped to about 4,000 in mid-
Fifth Army and PBS. As medical units May, then climbed again to approxi-
closed for redeployment, all their sup- mately 4,500 by mid-July as more hos-
plies and equipment were turned in, and pitals closed in PBS South. Leghorn
the medical material thus accumulated tonnage rose steadily to more than 6,000
was reconditioned and packed for reissue by mid-July before substantial outship-
at the depots. For field and evacuation ments were made. Tonnage at both de-
hospitals from the army area, as much as pots was unbalanced, however, and
70 percent of the nonexpendable items shortage lists grew as time went on, ow-
had to be salvaged, and about 30 percent ing to the necessity of keeping hospitals
for base section units. operating at the same time that complete
When the war ended in Italy, approxi- new assemblies for them were being
mately 9,000 tons of medical supplies made up and set aside. The end of the
were divided almost equally between the war with Japan removed the pressure and
Naples and Leghorn depots. Tonnage at left the Mediterranean theater with no
548 MEDITERRANEAN AND MINOR THEATERS
Organizational Changes
Through the summer and fall of 1945,
while the bulk of the Allied Forces in
Italy were being withdrawn, prisoners of
COLONEL STANDLEE war were being returned to their homes,
and the medical service was being re-
supply problem beyond that of storage duced to a minimum, various organ-
until surpluses could be returned to the izational changes were made to bring
United States. overhead operations into line with re-
The activity of the supply depots did quirements. At the same time assign-
not preclude the redeployment of medi- ments were changed to make the best use
cal supply units themselves, though it of experienced officers and to replace
did compel a change of schedule. The higher with lower ranks as responsibili-
12th Medical Depot Company, serving ties contracted.22
Fifth Army, was originally placed in In June Colonel Arnest left the the-
Category II-A for movement to the Pacif- ater, being succeeded as Peninsular Base
ic in June, but was changed to Category Section surgeon by his deputy, Colonel
IV when General Martin protested that Sweeney. Colonel Sweeney was suc-
the army would be left without any med- ceeded in late September by Col. Wil-
ical supply organization. The 12th was liam W. Nichol, formerly commanding
assigned to PBS along with other Fifth officer of the 37th General Hospital. At
Army medical units on 1 September, and the army level, the transfer of General
was attached at that time to the 232d Martin and accession of Colonel Bruce as
Medical Service Battalion at Leghorn.
22
The Naples depot, although its ton- Principal sources for this section are: (1)
Munden, Administration of the Med Dept in
nage was still climbing, was turned over MTOUSA, pp. 189-205; (2) Med Sitreps, PBS,
to a detachment from Leghorn early in Jun-Oct 1945.
CONTRACTION AND REDEPLOYMENT 549
Fifth Army surgeon has already been Because of border disputes between Italy
noted. At the theater level, General and Yugoslavia, however, and of the
Stayer departed in June to assume the claims of both nations to the important
duties of health officer for occupied Ger- city of Trieste, it was necessary to retain
many. He was succeeded as MTOUSA some military forces in the province of
surgeon by Colonel Standlee, who had Venezia Giulia until late 1947. The 88th
been deputy surgeon since the organiza- Division, which had relieved the 34th at
tion of the theater. Colonel Biederman Udine in September 1945, remained as
became Standlee's deputy in July with- the occupation force and supplied per-
out giving up his now greatly curtailed sonnel for the Trieste-United States
functions as plans and operations officer. Troops (TRUST), which took over oc-
As of 1 October, Headquarters, Medi- cupation of the Free Territory of Trieste
23
terranean Theater of Operations, United from the British in May 1947.
States Army, was formally separated from During the 2-year period of occupa-
Allied Force Headquarters. On the same tion, medical support for the 88th Divi-
date Headquarters, Army Air Forces, sion gradually changed from combat to
MTO, was discontinued, the Army Air garrison type. The 313th Medical Battal-
Forces Service Command passing to ion, organic to the division, maintained
MTOUSA. The functions of the supply a collecting station in the vicinity of
section of the MTOUSA surgeon's office Tarviso, near the Austrian-Yugoslav-
were transferred simultaneously to PBS. Italian border, in support of a combat
Both shifts forecast the final consolida- team until mid-December 1945; and had
tion a month later, when both the a clearing station at Cividale, northeast
Adriatic Base Command and the of Udine, which soon took on the char-
MTOUSA medical section were discon- acteristics of a post hospital. Before the
tinued. Colonel Standlee left the theater end of 1946 the medical battalion was
at that time, but Colonel Biederman re- operating aid stations that were more
mained until the transfer of functions to like dispensaries in rest areas as far away
PBS was complete, well along in Decem- as Cortina d'Ampezzo and Venice.
ber. The Peninsular Base Section then The 15th Field Hospital was replaced
became responsible for medical service at Udine in May 1946 by a newly acti-
for all U.S. forces remaining in the the- vated station hospital, the 391st, with 400
ater, whose boundaries now included beds. Evacuation from the 15th Field
Hungary and the Balkans. Colonel was by air to Leghorn or Naples, and
Nichol relieved Colonel Standlee late in from the 391st was by hospital train to
the year, and thereafter performed the Leghorn.
functions of theater surgeon as well as Fixed hospital support for the occupa-
base surgeon.
23
Principal sources for this section are: (1) The-
The Occupation Period ater ETMD's for Sep 45-Dec 46; (2) Annual Rpt,
Med Activities, TRUST, 1947; (3) Delaney, Blue
Italy, because of its cobelligerent Devils, pp. 249-72; (4) Komer, Civil Affairs and
Military Government in the Mediterranean The-
status, was never occupied in the same ater, ch. XV; (5) Unit rpts of med units men-
sense that Germany and Austria were. tioned in the text.
550 MEDITERRANEAN AND MINOR THEATERS
tion force, as well as for scattered Air Bed strength in the theater was further
Forces and service units, continued to bereduced early in 1947 by inactivation of
provided by PBS, but on a steadily de- the 392d Station Hospital in January and
clining scale. With the closing out of the
of the 55th Station in April. The 313th
Adriatic Base Command on 1 November Medical Battalion was inactivated on 15
1945, the 500-bed 61st Station Hospital May.
was shitted from Foggia to Leghorn to In keeping with the contraction of
replace the 64th General, which was pre- base section functions, which were now
paring for inactivation. The 250-bed almost exclusively concentrated in Leg-
55th Station moved simultaneously from horn, the Peninsular Base Section was
Pisa to Foggia, where it was assigned to disbanded in April 1947, and its in-
the Air Forces about 1 January 1946. stallations and responsibilities were
The 300th General Hospital at Naples, transferred to the Port of Leghorn organ-
the 34th Station at Rome, and the 99th ization. The former PBS-MTOUSA
Field at Pisa were the only other fixed surgeon became Port of Leghorn-
hospitals in the theater. MTOUSA surgeon at this time.
A major cutback in fixed bed strength
occurred in May 1946, paralleling the Final Disposition of Medical Units
shift from combat to garrison status of
the 88th Division. The 99th Field Hos- The first step toward a final closing out
pital closed on 1 May and the 300th Gen- of the theater came with the signing of
eral on the last day of the month, the the Italian peace treaty on 10 February
latter being replaced by a new unit, the 1947. The treaty was not formally rati-
200-bed 392d Station Hospital. At the fied until 15 September, but in anticipa-
same time, the 34th Station at Rome and tion of that event complete plans for
the 55th Station at Foggia were reduced phasing out of all U.S. military installa-
from 250 to 100 beds, the 55th being re- tions in Italy within 90 days of ratifica-
assigned to PBS. As of 1 June 1946, PBS tion of the treaty were drawn up.24
had 800 T/O beds: 100 in Foggia, 200 in In accordance with the phase-out
Naples, and 500 in Leghorn; Rome Area plans, the 7th Station Hospital—a 200-
had 100 beds; and the 88th Division had bed unit that had been activated at
400. Trieste in May with personnel drawn
The supply service was also reorgan- from the 391st Station and the 88th Di-
ized in May and June, when the 232d vision—was turned over to TRUST on
Medical Service Battalion, and the 60th 19 September, immediately after news of
and 73d Medical Base Depot Companies ratification of the treaty was received.
were inactivated. These units were re- On the same day evacuation of patients
placed by the 339th Medical Supply De- from the 391st Station Hospital began,
tachment, which was joined in August by and the hospital was inactivated on 15
the 57th Medical Base Depot Company. October. In Rome, evacuation of patients
The 339th Medical Supply Detachment from the 34th Station Hospital was com-
was inactivated in January 1947, leaving
the 57th Medical Base Depot Company 24
Phase-out Report of the Evacuation of Italy, 3
in sole command of the Leghorn depot. Dec 1947.
CONTRACTION AND REDEPLOYMENT 551
an assault. It succeeded only because de- enough to float, were carried onto the
termined opposition failed to develop. beaches by combat troops. At Anzio, field
Had the French resisted strongly, the and evacuation hospitals, combat loaded,
landing forces, spotted as they were along were added to the assault convoy. Four
a thousand miles of African coast, would and a half months later, medical troops
have been individually overwhelmed. trained on the basis of Mediterranean
Had the casualties been even moderately experience (and not a few who were
high, the medical troops in the landings themselves veterans of one or more Med-
would have been unable to handle them iterranean assaults) put their skills to the
with the small number of beds and mea- test in the invasion of Normandy. Med-
ger supplies at their disposal. Even the ical support of the army that landed in
equipment available was sometimes use- southern France in mid-August 1944 was
less under the conditions of the invasion. as near flawless as such a thing can be.
The standard army ambulance of the The cumulative experience of Europe
time, for example, proved to have in- and the Mediterranean again helped to
adequate traction on the loose sand of save American lives halfway around the
the African beaches, and its silhouette world, on Leyte, Luzon, and Okinawa.
was dangerously high. Medical supplies In addition to five major amphibious
were strewn across the landing beaches operations in the theater, Medical De-
with no one detailed to collect, sort, and partment personnel supported combat
issue them. Plans for medical support of and service activities in the Tunisian des-
the operation had been drawn up, some ert; in the steep, wooded mountains of
in England and some in the United Sicily and the sharper ridges of the
States, without co-ordination or suffi- Apennines in Italy; slogged through
cient knowledge of local conditions that rain and mud, and shared with the in-
might affect the accomplishment of the fantry the perils of snow and ice; crossed
medical mission. flooded rivers and miasmic marshlands,
In subsequent landings on Sicily, at and penetrated valleys still raked by en-
Salerno and Anzio, and finally over the emy fire. Only the jungle was missing
white sands of the French Riviera, modi- and even that was to be found in as-
fications and improvements were intro- sociated minor theaters.
duced to overcome the shortcomings of These widely varying conditions of
each earlier amphibious effort. For the climate and terrain required many dif-
invasion of Sicily, a clearing element was ferent means of bringing out the wound-
attached to each collecting company to ed. The versatile jeep was early fitted
enable the companies to furnish hospi- with litter racks and used to move cas-
talization until the regular hospitals ualties from places inaccessible either to
arrived. Medical supply items were hand- wheeled or half-track ambulances. In one
carried ashore by medical troops, but operation in Africa half-ton trucks with
litters and blankets were late in coming. tires removed were run over rails, each
This lag was corrected at Salerno, where truck carrying six litter patients. Both in
medical depot personnel were on the D- Tunisia and in Sicily mules brought out
day troop list. Additional medical sup- the wounded in country too rough for
plies, in waterproof containers light vehicles of any kind. In the high moun-
554 MEDITERRANEAN AND MINOR THEATERS
tains of northern Italy cable tramways into service, and there were many par-
made it possible to move casualties in tisan volunteers whose aid was invalu-
minutes between points that would have able.
taken hours on foot. The stringencies of the theater forced
For the longer hauls, hospital ships the Medical Department at every eche-
and trains were employed. The Mediter- lon to stretch equipment and personnel
ranean theater pioneered in the use of to the utmost. Personnel assigned to hos-
transport planes to move casualties not pitals temporarily not in operation, in-
only in rear areas but from hospitals far cluding those newly arrived and not yet
forward in the combat zone. Experi- assigned, were always attached to other
ments with small Piper Cubs as ambu- units where their services could be
lance planes were not successful enough utilized until required by their own
to justify general use, but the helicopters installations. The cellular type of organi-
later used for front-line evacuation in zation proved most effective because of
Korea were developed out of the same its versatility and mobility. Surgical
need and purpose. Necessity also taught teams were an excellent example but
the medical authorities in the Mediter- only one of many in a genre that in-
ranean that troop transports with hos- cluded malaria control units, veterinary
pital ship platoons attached to supply food inspection detachments, and hos-
necessary medical service could safely pital ship platoons that were seen more
move all but a limited few types of often ashore than at sea. As the war pro-
patients. It should be noted that neither gressed and replacements became more
the patient-carrying planes nor the trans- and more difficult to procure, medical
port vessels were marked with the Ge- officers were replaced in every permis-
neva Cross, but none were lost through sible assignment by Medical Administra-
enemy action. On the other hand, four tive Corps personnel. Such substitutions
properly identified and lighted hospital extended to medical supply, evacuation,
ships were deliberately bombed, two of and numerous purely administrative
them sinking. activities. Another successful expedient
The backbone and single indispen- was the substitution of Women's Army
sable element in the evacuation system Corps personnel for enlisted men in a
was the litter bearer. It took strength, variety of hospital tasks. Large numbers
stamina, gentleness, and a high order of of Italian prisoners of war, available
courage to collect the wounded on the after the Axis collapse in Tunisia, were
field while the fighting, often enough, organized into service companies, and
was still in progress, and by relays of many of them assigned to the Medical
four-man teams to carry the casualties Department where they proved them-
sometimes as much as ten or twelve selves competent in almost all nonpro-
miles over mountain trails impassable to fessional functions. Local civilians were
any vehicle, too steep even for mules. In also employed extensively in all Medi-
the Italian campaign there were never terranean areas to perform tasks that
enough litter bearers. In emergencies— would otherwise have fallen to enlisted
which were frequent—cooks and bands- men.
men and company clerks were pressed One of the more successful expedients
THE MEDITERRANEAN IN RETROSPECT 555
devised was the use of clearing platoons the United States medical service main-
to augment bed strength of field and tained higher standards than the British,
evacuation hospitals. With additional at- and certainly medical skills, drugs, in-
tached personnel, these platoons were also struments, and equipment were more
employed as separate forward hospitals plentiful in American hospitals. U.S.
for specialized functions, including soldiers hospitalized in British installa-
neuropsychiatric, venereal, and gastro- tions were quick to note the difference,
intestinal cases. Such devices made it which often led to a lowering of morale.
possible to hold in the army area men At the army level Mediterranean expe-
who would otherwise have been evac- rience demonstrated, as did the expe-
uated to the communications zone, and rience of every theater, the importance
thereby to shorten materially the time of giving the army surgeon a place on
lapse before return to duty. Mediter- the staff of the commanding general.
ranean experience tended to emphasize Similarly, the mission of the theater sur-
mobility and versatility. The more mo- geon called urgently for a staff relation-
bile a hospital was, the closer to the front ship with the theater commander. It was
lines it could be used. The best example the absence of such a relationship that
is that of the field hospital platoon, deriv- produced the awkward dichotomy
ing its strength from attached surgical between the theater medical organiza-
teams. These platoons were first used in tion and that of the Services of Supply.
the Sicily Campaign as 100-bed forward In the European theater and elsewhere
surgical hospitals, reduced to 50 beds by the jurisdictional problem was resolved
the date of the southern France invasion. by giving both surgeons' jobs to the same
This experience contributed much to the man. In the Mediterranean, however,
development of the MASH (Mobile only personal cordiality between the in-
Army Surgical Hospital) units employed dividuals concerned, and a strong mutual
so effectively in Korea. Other devices desire to get on with the war, kept the
successfully used to conserve Medical De- medical service operating smoothly in
partment personnel were shortening both areas.
lines of evacuation, and grouping fixed Emphasis in the Mediterranean was
hospitals in concentrations to permit always on the role of Army medicine in
maximum use of skills by specialization, conserving manpower—a mission often
at the same time reducing the overhead not fully appreciated by line command-
by providing as many services as possible ers. In addition to treatment of the
in common. wounded and the sick, the Medical De-
At the army and theater levels the partment was responsible for preventing
Mediterranean experience underlined illness insofar as possible. In every war
certain organizational principles. In a the United States has ever fought, the
theater that was always a combined op- man-days lost through illness far ex-
eration, the Americans were generally ceeded those lost by enemy action. In
outranked by their British counterparts, World War II the ratio was approxi-
which produced unnecessary friction. At mately four days lost by disease and one
the same time, it was the conviction of by nonbattle injury for every day lost by
many officers in position to know that combat wounds. Most of the illnesses
556 MEDITERRANEAN AND MINOR THEATERS
APPENDIX A-2—FIXED BEDS AND BED RATIOS, AFRICA AND THE MIDDLE EAST
(INCLUDES PERSIAN GULF COMMAND) , JUNE 1942-DECEMBER 1945
APPENDIX A 563
APPENDIX A-2—FIXED BEDS AND BED RATIOS, AFRICA AND THE MIDDLE EAST—Contd.
a
Figures for Air Transport Command personnel of Central African Division and of North African Division added.
North African Division includes MTO, and there is undoubtedly some duplication, since MTO figures include Air Forces.
Figures do not permit differentiation, however, and the great bulk of the ATC personnel in this area were in Africa. It
has therefore been deemed best to include them here. See Strength of the Army, June 1944-April 1945.
b
Figure includes both assigned and attached personnel. Air Transport Command personnel fall into the "attached"
category.
Source: Strength of the Army; unit reports of individual hospitals. Ratio is percentage of troop strength for which
beds were available.
564 MEDITERRANEAN AND MINOR THEATERS
a
Estimate.
Source: T/O beds complied from unit reports. Beds established and beds occupied from daily bed status reports.
Does not include mobile or convalescent beds.
APPENDIX A 565
a
Estimate.
b
Not available. T/O figure used.
c
From Seventh Army bed status reports, excluding clearing stations.
d
Figure for 20 August 1943.
Source: T/O beds from unit reports. Beds established and beds occupied from daily bed status reports. Does not in-
clude mobile or convalescent beds.
566 MEDITERRANEAN AND MINOR THEATERS
a
Not available. T/O figure used.
b
Approximate, calculated from graph in Annual Report, PBS, 1943.
c
Includes 250 T/O beds on Sardinia.
d
Includes 350 T/O beds on Sardinia and 100 T/O beds on Corsica.
e
Includes 350 T/O beds on Sardinia.
Source: T/O beds compiled from unit reports. Beds established and beds occupied are from daily bed status reports,
unless otherwise noted. Does not include mobile or convalescent beds.
APPENDIX A 567
APPENDIX A-6—FIXED BED STRENGTH AND BED OCCUPANCY, MEDITERRANEAN
THEATER, NOVEMBER 1942-SEPTEMBER 1945
568 MEDITERRANEAN AND MINOR THEATERS
a
From Strength of the Army, STM-30.
b
6 percent of troop strength through September 1943; 6.6 percent of troop strength to 15 September 1945; thereafter 4
percent of troop strength.
c
Compiled from unit reports. Does not include mobile hospitals, except when acting as fixed units assigned to a
base section. Does not include convalescent beds.
d
Ratio of T/O beds to troop strength.
e
From daily bed status reports of the theater.
f
Not available.
g
Includes 8,750 T/O beds in southern France.
h
Includes 4,000 beds established in southern France.
i
Includes an estimated 4,000 beds occupied in southern France.
jIncludes 13,750 T/O beds in southern France.
k
Includes 12,482 beds established in southern France.
l
Includes 10,377 beds occupied in southern France.
Source: Tables A-3, A-4, A-5. Southern France data from 1944 Annual Reports, Delta Base Section, CONAD, and in-
dividual hospitals.
Appendix B
PRINCIPAL MEDICAL UNITS ACTIVE IN THE MEDITERRANEAN THEATER OF
OPERATIONS, THE ATLANTIC DEFENSE AREAS, AFRICA, AND THE MIDDLE EAST
GENERAL HOSPITALS
570 MEDITERRANEAN AND MINOR THEATERS
GENERAL HOSPITALS—Continued
APPENDIX B 571
GENERAL HOSPITALS—Continued
STATION HOSPITALS
572 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 573
STATION HOSPITALS—Continued
574 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 575
STATION HOSPITALS—Continued
576 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 577
STATION HOSPITALS—Continued
578 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 579
STATION HOSPITALS—Continued
580 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 581
STATION HOSPITALS—Continued
582 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 583
STATION HOSPITALS—Continued
584 MEDITERRANEAN AND MINOR THEATERS
STATION HOSPITALS—Continued
APPENDIX B 585
FIELD HOSPITALS
586 MEDITERRANEAN AND MINOR THEATERS
FIELD HOSPITALS—Continued
SURGICAL HOSPITAL
APPENDIX B 587
EVACUATION HOSPITALS
588 MEDITERRANEAN AND MINOR THEATERS
EVACUATION HOSPITALS—Continued
APPENDIX B 589
EVACUATION HOSPITALS—Continued
CONVALESCENT HOSPITALS
590 MEDITERRANEAN AND MINOR THEATERS
MEDICAL REGIMENT
MEDICAL BATTALIONS
APPENDIX B 591
MEDICAL BATTALIONS—Continued
592 MEDITERRANEAN AND MINOR THEATERS
MEDICAL BATTALIONS—Continued
APPENDIX B 593
MEDICAL BATTALIONS—Continued
594 MEDITERRANEAN AND MINOR THEATERS
Each infantry battalion has one medical officer (Lt.) and one auxiliary
(Medicin Auxiliare). The latter is usually a medical student. The medical
officer remains at the aid station while the auxiliary supervises and assists
aid men in care of wounded on the field.
The next link in the chain is the regimental aid station (Poste de Se-
cours). This station is manned by a Captain, M.C., and a Dental Officer.
The number of enlisted men is the same as in the corresponding U. S.
detachment. Wounded and sick are sorted and treated. The minor cases of
sick and wounded are retained, the serious ones are evacuated via the col-
lecting company to the division clearing station.
At the clearing station, patients are treated and sorted in much the same
way as in our Army. Beside the station is located the Formation Chirurgicale
Mobile. This unit, with 20 beds, is organized to care for the non-transport-
ables. Operating rooms are established in converted trucks. The transport-
able cases are evacuated from the clearing station to the evacuation or field
hospital. The latter two units perform the same functions and are used
interchangeably.
Surgical Group. This type unit consists of personnel grouped into sur-
gical teams. Its functions are the same as those of the U. S. auxiliary sur-
gical group. The surgical group differs from the surgical formation in that
it has no bed capacity and no organic transportation.
Triage is effected between the clearing stations and evacuation and field
hospitals under the supervision of the evacuation officer of the Corps d'Armee.
This officer informs the clearing stations each morning as to the number
of vacant beds in each mobile hospital in rear of the division. Bed credits
are also established at each hospital for certain types of cases from each
division, such as head, chest, abdomen, orthopedic, and ordinary sick. In
this way all cases needing the care of specialists are guided to the hospitals
where such specialists are available.
Patients are evacuated directly from the mobile hospitals of the corps
to a fixed or convalescent hospital in the medical base at Naples.
All French hospitals in Italy are under control of one medical officer,
because they are in the same line of evacuation. The next segment in the
chain is between Italy and Africa and control is being assumed wholly by
*Reproduced from ETMD Rpt, Hq NATO, 1 Jun 44 (for May), pp. 6-7.
APPENDIX C 599
the U. S. Army. The Service de Sante, Hq. French Army, Algiers, assumes
responsibility for patients on their arrival in Africa.
French Evacuation Officers desire that patients being evacuated to French
base hospitals by air, train, or sea be classified as follows:
Wounded.
Fractures (total litter and total ambulatory)
Eyes and Face
Others
Disease
Tuberculosis
Mental
Others
Prisoners of War
Total Patients
Litter
Ambulatory
This system allows planning of transportation in advance and facilitates
triage of patients from airfields, railroad stations, and ports directed to
hospitals caring for each type of case.
Hygiene Sections. These organizations are normal components of the
Army or independent Corps. They are primarily bath and disinfestation
units and each is organized as follows: 1 Officer, 24 EM (must be attached
for rations and quarters), 3 vehicles and 2 trailers with showers. Each unit
can bathe 1000 men per day.
Reviving and Blood Transfusion Section. (Section de Transfusion et
Reanimation). This organization handles the French blood bank in Italy
and controls the distribution of blood and plasma to hospitals. In turn it
is supported by the Centre de Transfusion du Sang which is located in
Algiers. The training of all personnel in the treatment of shock and the
technique of preparation and administration of blood and plasma is super-
vised by the Centre de Transfusion du Sang.
Ambulance Service. Corps ambulance evacuation is provided by Com-
pagnie Sanitaire #531. This organization consists of 4 sections of 20 ambu-
lances each. Two sections have male drivers, the other two, female drivers.
Ambulance units are a component of the "Train" (Transportation) . The
personnel are non-medical. Repair and maintenance of vehicles are pro-
vided by auto repair companies (Compagnie de Reparation d'Autos) of
the Corps or Army. From a functional standpoint, ambulance companies
are under the jurisdiction of the Medical Department.
Laboratory. A laboratory is equipped with American material from
T/E 8-610. The personnel consists of 14 officers and 35 EM. There are no
600 MEDITERRANEAN AND MINOR THEATERS
vehicles. The functions are the same as those of the U. S. Medical Laboratory
T/O 8-610.
Medical Supply. This unit is modeled after T/O 8-661 and functions
in the same manner.
Appendix D
THE GERMAN MEDICAL ESTABLISHMENT*
I. INTRODUCTION
* Reproduced from the Annual Rpt of the Surg, Fifth U.S. Army, MTO, 1945, pp. 191-209.
602 MEDITERRANEAN AND MINOR THEATERS
Socialism" would indicate that a German doctor was not a Nazi, he would
not hesitate for a moment to say just that.
With these limitations in mind, it is safe to view the German medical
establishment in Italy after the military defeat of May 1945, as seen through
the eyes of qualified American observers.
visited on 6 May 1945 there were 1600 patients. The commanding officer
reported that 500 would be able to return to duty in two weeks, 600 in
one month, 300 in two months, 100 in three months and the remaining
100 in six months.
At the beginning of the war in Europe, all divisions had two Sanitaets
Kompanies. At the end only the armored and mountain divisions had two
each, but the Corps Surgeon had under his control one Sanitaets Kompanie
for use where needed. When two Sanitaets Kompanies were available, two
Hauptverbandplatzen were often established. In the beginning of an offen-
sive, one Sanitaets Kompanie, horse-drawn, was placed only three or four
kilometers behind the battle line to receive casualties. The other Kompanie,
motorized, was held in reserve to be used after substantial gains had been
made. Then, if further gains were made and the Hauptverbandplatz was
required farther forward, the motorized Kompanie moved, leaving its pa-
tients to be taken over by the animal-drawn Kompanie. The patients of the
animal-drawn Kompanie were left to be taken over by a Feldlazarett. Thus
there were often two divisional units performing surgery ahead of the Army's
most forward Feldlazarett. With a large-scale offensive division, army, and
army group hospitals might all perform primary surgery only on the less
seriously wounded, putting aside the intra-abdominal and intra-cranial
wounds in favor of those who were more likely to live and return to full
duty.
There were no Auxiliary Surgical Groups, but the German Army Sur-
geon learned to use personnel from reserve or less active units to augment
the staffs of heavily-pressed units. Most American observers felt that the
German system of hospitalization and evacuation was certainly extremely
flexible, but its very flexibility tended to favor the lightly wounded at the
expense, and often the expense of death, of the more seriously wounded,
the group which US surgical practice terms "first priority" wounded.
was wiped on the surgeon's coat and the remark was made that the moisture
on the finger indicated that the patient was not too dry. During the course
of "rounds" the chief of the hospital entered the ward, and was first greeted
in military fashion by the surgeon, and then by a handshake. Several cases
were selected for further examination in the septic dressing room. This
dressing room had three tables, each occupied by a patient with large
wounds from which all dressings were removed. In this room no one wore
a mask over the nose and mouth. Conversations were conducted over each
wound and traffic through the doors, closing and opening, was active. A
staircase just off the dressing room was being dry-swept and clouds of dust
filled the hallway and the entrance to the dressing room.
The surgeon soon proceeded to examine one of the wounded men,
and without washing his hands or donning gloves, he felt of the extremity
from which the pus-soaked bandages were recently removed. After dressing
the wound, the surgeon placed the used instruments on a tabletop, and
proceeded to the next case without washing his hands. The American ob-
server left the dressing room without shaking hands with the German sur-
geon. In later discussing the matter of infected wounds with a German
medical officer, the observer learned that the Germans assumed automatically
that all penetrating wounds received in combat would become infected,
and that pus was anticipated. Perforating wounds were rarely disturbed,
but instead were simply covered with dressings. The German medical officer
claimed that most perforating wounds did exceedingly well except that
occasionally an aneurysm developed which required treatment. All wounds
due to penetrating missiles, shell or bomb fragments, became infected and
healed by granulation following infection.
When the US observer discussed the problem of infected wounds with
another German medical officer, it was brought out that primary surgery
done immediately was most essential. Lacking this, wounds became infected
and the following reasons were given for lack of immediate care:
(1) Inadequate medical personnel were available to the German med-
ical service. Many medical men were driven out of Germany during a
seven-year period from 1933 to 1939, for reasons unrelated to their medical
practice. Medical schools were depleted of teaching personnel and the num-
ber of graduating physicians gradually diminished. Early in the Russian
Campaign, many medical men, acting as company officers, took up positions
with the infantry in the front lines. The gradually increasing number of
patients requiring surgical care increased the number of patients for each
medical officer. As a result, this disproportion was equivalent to a decrease
in medical personnel.
(2) Large numbers of battle casualties admitted to field hospitals
in short periods of time made adequate surgery impossible. One German
surgeon interviewed pointed out that when acting as a surgeon in the city
of Naples in September 1943, it was not unusual for him to care for fresh
606 MEDITERRANEAN AND MINOR THEATERS
wounds by complete excision and primary suture. The infection rate was
approximately 4% in these fresh cases and approached favorably the infec-
tion rate to which he was accustomed in civilian practice. However, he said,
operative procedures which would require an hour had to be done in less
than one minute when he was active on the Russian front. In one three-day
period in Russia 1000 battle casualties were admitted to a field hospital
whose medical personnel consisted of two doctors, no nurses, and consider-
able number of enlisted men. To devote more than a few minutes to each
case was, he attested, impossible. Aside from an incision for decompression
of tissues and application of a dressing, bandages and splint, nothing else
could be done. He was aware that these steps would not prevent infection
in a wound. Perforating wounds were rarely bothered with; dressings were
applied and patients frequently returned to duty.
(3) Speaking again of the Russian Campaigns, in comparison to the
closing phases of the Italian Campaign, this German medical officer stated
that during the advance on Stalingrad the German Armies progressed at
the rate of forty to sixty kilometers a day. Patients could not be kept in
any hospital for any length of time. Frequently patients had to be evac-
uated to the rear without any sort of initial treatment and days were re-
quired before the patient arrived at an installation where surgery could
be accomplished. During the winter months long trips in the icy cold of
Russia made travel hazardous and for many patients, fatal. Not only were
patients frozen to death because of inadequate covering but also many
arrived in such poor condition that many hours or days were required to
resuscitate them so that they could tolerate even a small degree of surgery.
On the Italian front travel by day for wounded patients was extremely
hazardous because of the narrow roads over mountain passes, and the con-
stant presence of Allied airplanes over German lines of communications.
Transportation of the wounded to the rear could be accomplished only
at night, and the long trips in the mountains were time-consuming and
exhausting to the patients.
(4) Lack of adequate supplies and equipment was also given by this
German medical officer as a reason for the deterioration of the Wehrmacht's
medical service. Many patients died from exsanguination because neither
blood nor a blood substitute was available at the field hospitals. Many pa-
tients with small wounds developed infection because of the precarious
condition in which they arrived at the base hospital after a long journey,
without proper dressings or immobilization of the wounds. There were no
blood banks to furnish blood for the restoration of blood volume. With
the decreasing number of medical personnel and the increasing hunger
of the Wehrmacht for more manpower the obtaining of blood for trans-
fusions became more and more difficult. Plasma was unobtainable. Penicillin
was unknown. Sulfonamides were used but were felt by the Germans to
be most useful only in acute infections, and to have no particular value
APPENDIX D 607
pallor of many and moderate pallor of most of the wounded seen in German
hospitals were further evidence that little blood was administered.
This type management of shock and hemorrhage was in sharp contrast
to American methods whereby plasma is made available and used in quan-
tities sufficient for the needs in all forward medical units of a division;
and whereby banked blood is available in adequate quantities in all army
hospitals including field hospitals adjacent to division clearing stations.
The bulk of extremity wounds suffered in the Wehrmacht were given
primary surgical treatment in the Hauptverbandplatz or the Feldlazarett.
In rush periods this surgery consisted of no more than incision of skin
and fascial planes, the removal of gross debris and devitalized tissue, and
usually trimming of devitalized edges of the skin wound. The careful wound
excision practiced by Allied surgeons was done in German hospitals only
in rare instances. One German surgeon reported that he had performed
only four or five such operations in as many years of war surgery. In these
he had done a primary wound closure. It was evident in many of the
patients seen that practically no wound excision had been accomplished,
since much devitalized tissue was left behind, and frequently wounds were
primarily drained after no more than a fasciotomy. Perforating wounds
from small arms missiles or small high explosive shell fragments had no
surgery performed. This applied to wounds of joints and wounds involving
bone unless there was a large wound of exit. Splinting of extremities after
surgery varied. In several hospitals visited, surgeons stated that temporary
wooden or wire ladder splints were applied for three to five days, following
which treatment the limbs were put in plaster if infection did not develop.
Most of the other hospitals reported that plaster was applied immediately
after surgery. In either instance, the plaster was always padded and windows
were cut over the wounds to permit inspection and dressing.
Compound fractures of the femur were put up in skeletal traction in
both field and general hospitals. Kirchner wires were used in applying
skeletal traction. When infection developed, the limb was incorporated in
plaster, but some traction was usually continued. An ingenious apparatus
made of perforated metal pipes served as a substitute for the ordinary
Balkan frame. It was capable of many combinations to secure, easily and
simply, pulley wheels in the desired position for any sort of traction. In
some instances a complete Balkan frame was fashioned. In most cases, how-
ever, one pipe, which clamped to the metal hospital bed, sufficed to support
sufficient side arms to provide the necessary number of pulley wheels in
the proper positions. Walking, unpadded plaster spicas, after the method
of Boehler, were used in the management of some of the simple fractures
of the femur, and in some compound fractures after the soft tissue wounds
had healed. They were not used early in the management of fresh com-
pound fractures from bullet or shell fragment wounds as Truetta used
them in the Spanish Civil War. In badly damaged heels, one surgeon was
APPENDIX D 609
practising excision of the talus, calcaneus, and one half of the scaphoid
and cuboid, then placing the foot in a drop position and anchoring it
there with a Steinman pin. He said that one-quarter to one-third of the
cases so treated got functional results, but the remainder required amputa-
tion. Those getting a "functional result" were fitted with a below the
knee prosthesis.
Two surgeons were found who had been using the Kuntscher nail in
the treatment of certain fractures of the long bones. It was reported by
two surgical consultants that for a time many surgeons attempted the use
of this intramedullary nail with poor results, including osteomyelitis and
death from shock. Following this experimentation, a few surgeons were des-
ignated who might use the method when they thought it indicated. The
original work in Germany on this intramedullary nail was done by Kuntscher
at the University at Kiel beginning in 1937. It was first tried on animals.
Examination of the bones histologically at various periods after nailing led
to the conclusion that approximately one-third of the marrow is destroyed
and that small fat emboli are nearly always dislodged. One surgeon who
participated in the original study at Kiel stated that he had records of
550 cases, not all his own, in which the Kuntscher nail had been used.
Fat embolism had occurred in a few of these cases but in no instance did
it lead to a fatality. This surgeon felt that its usefulness was chiefly in
closed fractures of the middle third of the femur, in which the fracture
line was transverse or nearly so. Such patients could walk without any
splinting eight to fourteen days after the operation. This surgeon did not
feel it an advisable procedure in tibial fractures and rarely used it in
fractures of the humerus, radius, or ulna. It could be used in compound
transverse fractures of the femoral shaft after the wound had healed or
when infection was absent. One surgeon had used it in a few infected
compound fractures of the humerus and femur when the desirability of
fixation seemed to outweigh the danger of using it in the presence of infec-
tion.
In the field of head surgery, only a few intracranial wounds were found
in the hospitals visited. One hospital at Merano and one at Gardone Riviera
held the largest concentrations of head wounds. Of a sample of forty head
cases, at least thirty needed further neurosurgery. There were also ap-
proximately twelve with wounds of the spinal cord, a similar proportion
of which needed further surgery. Neurosurgical techniques in practice a-
mong the German hospitals visited were generally barely adequate, and
often under the standards set in Allied armies.
Nearly all of the patients seen in German hospitals with intrathoracic
wounds had empyema. Of course, most of those seen had incurred their
wounds months or even as long as two years before. Opinion expressed by
German surgeons concerning the management of chest wounds varied in
some particulars, but regarding major policies were in unanimity. No
610 MEDITERRANEAN AND MINOR THEATERS
facilities were available for gas anesthesia or for positive pressure delivered
by anesthetic machine. A good oxygen therapy machine was available, but
according to statements of the Germans, it was seldom if ever used for ex-
panding the lungs during the course of intrathoracic surgery. No endotra-
cheal tubes were seen nor was the use of endotracheal anesthesia mentioned
in a hospital. Local, evipan, or ether by open drop was the anesthetic em-
ployed in what chest surgery was accomplished. Opinions concerning the
indications for and time of aspiration of hemothoraces varied considerably.
Some surgeons stated that aspiration was never performed except to relieve
dyspnea arising from a large hemothorax or hemopneumothorax. Others
stated that it was performed during the first five days after wounding.
One consulting surgeon stated that early in the war aspiration was performed
after five days unless dyspnea made it mandatory earlier, but that more
recently aspiration was performed after the patient reacted from shock,
which was usually two days after wounding. It was obvious that the policy
of early, repeated aspiration of hemothorax was not practiced as in the
Allied armies.
The incidence of empyema was reported at one hospital as 60% in shell
fragment wounds of the chest and 30% in bullet wounds of the chest. In
another hospital, an incidence of 50% in all intrathoracic wounds was re-
ported. The treatment of empyema seemed uniform in all the hospitals.
Closed intercostal drainage was instituted as soon as the presence of pus or
infection in the pleura was demonstrated. The catheter was attached to a
water seal bottle which in most instances was in turn connected with a pair of
bottles providing suction after the Wangenstein method. This procedure
was continued until the cavity was obliterated or until after six months
the empyema was adjudged chronic and a thoracoplasty and decortication
were performed. Rib resection for drainage was rarely employed.
Only a very few patients with thoraco-abdominal wounds were seen.
These few had not had extensive wounds and their surgical care had con-
sisted of laparotomy and simple closure of the chest wall wound. No cases
were seen in which transdiaphragmatic surgery had been accomplished at
thoracotomy. Lacking the facilities for positive pressure ether-oxygen anes-
thesia and well-trained anesthetists, it seemed obvious that modern intra-
thoracic and transdiaphragmatic surgery were not available to the German
wounded.
Only a few patients with abdominal wounds were found in the German
hospitals which were captured or which fell into Allied hands with the
collapse of the Wehrmacht. This was not surprising, if the tactical situation
of the preceding month was viewed in relation to the German policy con-
cerning the care of the seriously wounded which was outlined in the hos-
pitalization and evacuation section of this chapter. With the confusion and
heavy casualty load of their crushing defeat in the German stand against
the Allies' last push, it was probable that few with abdominal wounds
APPENDIX D 611
him for only three days, then preventive medicine was the field upon which
the harshly realistic Wehrmacht would concentrate its efforts. This helps
to explain why preventive medicine was under rigid military control in the
German Army, and at the same time why German standards of preventive
medicine, considering the equipment available for their enforcement, com-
pared more favorably with preventive medicine as instituted in the United
States Army than did German surgical standards with our own.
Mess sanitation in the Wehrmacht was limited by the type of mess
served. Food was prepared in mobile ranges, and generally consisted of
a stew, bread, tea or coffee. No attempt was made to screen field kitchens,
but if troops were situated in buildings and screening was available, the
kitchen was screened. However, one directive published by German head-
quarters in 1945 prohibited the use of screening except for buildings in
malarious areas. There was no system of mess kit washing similar to that
practiced in the US Army. Usually the German soldier washed his mess
kit in a stream, or at a well or cold water tap. Sometimes hot water was
supplied from the field ranges, or occasionally it was heated in a bucket
or can over a wood fire, but such procedures were the exception. Provisions
for hot water depended on the interest in sanitation evidenced by the com-
pany commander, which ordinarily was slight. No soap was issued for mess
gear washing, and the allowance of soap for bathing and washing clothing
was so small that very few soldiers ever used part of their soap ration for
washing mess kits. Instead sand or gravel was used to remove the grease from
the mess kits. Soap and washing soda were available for use in the kitchens,
in small amounts.
Bread was transported without any protective covering from the field
bakeries to unit messes. Fruits and vegetables to be eaten uncooked were
washed first in raw water and then in boiled water. In areas where amoebic
dysentery was prevalent, directives were issued ordering fruits and vegetables
to be soaked in a 1-5000 solution of potassium permanganate; in practice,
however, this procedure was reported to be seldom followed. Chlorine wash-
ing of fruits and vegetables was unheard of in the German Army in Italy.
Garbage was usually disposed of to civilians. In the last months of the
campaign, many units kept hogs to which they fed food scraps. Some garbage
was burned. Directives were issued requiring soakage pits for waste water,
but in actuality these pits were seldom constructed. Since there were no
mess kit washing facilities, German kitchens had less waste water than
normally found in US kitchens. German food handlers were inspected weekly
and stool examinations were conducted four times a year. Consumption
of raw milk or cheese made from raw milk was forbidden.
In rear areas, the Germans used box-type latrines similar to US box
latrines. A squat-type latrine with lid was also used frequently. In forward
areas, straddle trenches were dug, or each man was required to cover his
own excrement by digging a small hole with a spade, similar to US "cat-
APPENDIX D 613
holes". Latrine pits were treated with lime, never with oil of any sort.
There was never a sufficient supply of pyrethreum spray for use in latrines.
Provisions for water supply in the German Army were grossly inadequate.
In forward areas, the German soldier was given boiled tea or coffee rather
than water; he had no "GI" drinking water whatsoever. The supply of tea
and coffee depended on the tactical situation. If kitchens were far enough
forward, the supply was sufficient, but otherwise the soldier was forced
to resort to local water sources to allay his thirst. The supply of tea and
coffee even in bivouac areas was never unlimited: there the soldier received
a rationed quantity of one or two liters and no more. Nothing existed in
the German Army similar to the US water sterilizing bag, to which an
American soldier in rear areas can go at all times for additional fluids.
Water sterilizing tablets, comparable to our Halazone, and thiosulphate
tablets, such as the British use, were used only to a limited extent in the
German Army and were never popularized. In rear areas, troops ordinarily
used the town water supply, which was tested by the corps or army hygiene
officer. If four samples taken the same day at different points in the town
were reported as bacteriologically potable, the water was approved for drink-
ing. In the field water was transported to kitchens in cans similar to the
US five-gallon water can. Sanitary companies and motorized field hospitals
had water trailers.
A few water purification units operated in the German Army, but no
attempt was made to furnish all troops with water from these units. Basically,
these units consisted of three tanks mounted on, a large lorry. Water was
pumped from one tank to another through all three, each of which contained
lime and iron chloride. From the third tank the water passed through a
Seitz type filter which rendered it bacteriologically potable. The output
of this unit was normally 5000 liters a day, but it could be increased to
8000-12000 liters for short periods. (The US portable unit delivers about
3600 liters an hour and the US mobile unit 21,160 liters an hour). These
German units were operated by the Medical Department. The chief objec-
tion to such units was that the Seitz filter discs soon became clogged and
had to be replaced. The water from these units was not chlorinated, the
Germans using chlorine only where necessary to treat city supplies. Another
type of water filter used by the Germans was a portable apparatus carried
on the back and capable of producing 200 liters a day. One such filter
was issued for each battalion, or one for each separate company if the
company had a medical officer attached. The apparatus was issued to and
operated by the Medical Department. These filters were never popular
and were seldom used except to clear up turbid water. The filter discs had
to be replaced frequently and were always difficult to obtain.
German malaria control in Italy was centralized in an antimalaria staff
at Army Group Headquarters. This staff consisted of a major in charge
assisted by two entomologists and one clerk. Operating directly under this
614 MEDITERRANEAN AND MINOR THEATERS
slept in a blanket which had been used to cover a horse. This latter powder
was never popular—it had a bad odor and caused skin eruptions in the
troops. The other three powders mentioned above were moderately effective.
For the most part, the Germans depended on hot air sterilization of clothing
and blankets to kill lice. Every month, battalions were required to have
the clothing and blankets of their personnel disinfested, and troops returning
from the front were bathed and disinfested routinely. A small amount of
DDT powder (called by the Germans "Gix") was available for dusting
men found to be infested with lice. Steam disinfestation of clothing was
not practical because it damaged the cellulose fibers of German ersatz fab-
rics. Methyl bromide was not used, but formalin in glass ampules was
available for disinfesting blankets. Impregnation of clothing with a liquid
preparation of Delicia was effective for from ten to twenty days.
A few bath units were available for front line troops, set up in connection
with hot air sterilization units, but for the most part German soldiers had
to seek out their own bathing facilities. Since they usually occupied buildings,
this was not a great problem, except for the important fact that soap was
always short.
Two types of typhus vaccine were used, the Cox type similar to US
vaccine, and the Weigl type prepared from lice. A Roumanian type vaccine
prepared from mouse lungs was tried out, but was found to be not very
effective. Only sufficient vaccine was available for vaccination of medical
personnel and key personnel over forty years of age.
The German Army in Italy had considerable trench foot in the Apen-
nines during the winter of 1944-45 (when US rates were remarkably low),
and this was attributed by German medical officers to the wet, cold, but
not freezing weather, and to the failure of troops to guard against trench
foot. Many of the soldiers had come from the Russian front where it was
generally far colder, and they did not expect trench foot in the comparatively
mild climate of Italy. Prevention of trench foot in the German military
depended on the individual's taking proper care of his feet, and having
a supply of warm and dry socks and shoes. Medical officers were responsible
for seeing that the troops were properly instructed and that the instructions
were carried out. This was of course entirely contrary to US practice where
the command elements are responsible that anti-trench foot precautions
are properly carried out. German medical officers were also responsible for
checking shoes and socks of troops. Leather shoes were worn in tempera-
tures above freezing, and in Russia felt boots were worn in lower tempera-
tures. A sock exchange system operated in some units, where civilian women
were hired to launder the socks. Paper and straw were often used for extra
warmth in boots. A salicin ointment was used as an anti-frost bite cream.
The German army emphasized abstinence as its strongest venereal dis-
ease control measure, but at the same time it operated controlled brothels.
The prostitutes in these brothels were examined daily by a German doctor
616 MEDITERRANEAN AND MINOR THEATERS
5. MEDICAL SUPPLY
The German medical establishment in Italy was almost completely self-
sufficient, as it had to be, with the Brenner rail route to Germany under
constant Allied air attack. On 4 May, two days after the German surrender,
Fifth Army assumed control of the Base Medical Depot at Merano, along
with a large factory equipped to manufacture many items such as cotton,
bandages, drugs and narcotics. Included in the factory was a well-equipped
laboratory capable of performing biochemical and physio-chemical proce-
dures. The equipment was extremely modern in design, and apparently
expensive and valuable. This factory employed approximately nine hundred
German military workers. A few civilian men and women were employed
by the Germans, but for the most part this factory was run by German
WACs and enlisted technicians.
The Merano medical depot, as apart from the factory, contained ap-
proximately 2000 tons of medical supplies when it was captured; with
consolidation of other north Italy depots into this one, the stock levels
were built up to 9000 tons within a few weeks. The depot did not employ
civilians, and operated with a complement of three hundred enlisted men
and forty WACs. This depot operated in similar fashion to a US base
section depot, with the exception that platoons organized from its basic
complement were attached to the various armies of Army Group "C". Thus,
each army had no depot unit solely its own, as is the case in the US army.
The medical supplies stocked at this depot were generally of an inferior
quality. A certain cheapness, typical in many ways of the entire German
medical service, was noticeable in almost all items of expendable supply.
A paper material, somewhat like crepe, was used as a substitute for gauze
620 APPENDIX D
in the dressing of wounds. Also, a still thinner paper was placed under
casts as a substitute for cotton batting. Many of the medications found
in this depot were of Italian manufacture, and not of a very high quality.
The medical equipment generally was substantial and well-made, however,
but more suited for a civilian general hospital than for issue to a field
medical service. Surgical and dental instrument sets were far too elaborate
to insure a rapid replacement. X-ray equipment, including dental X-ray
sets, was good, and especially designed chests were provided to aid in proper
handling. Chests of a standard size and design were provided for mobile
medical supply platoons. These chests were an admirable item, hinged on
opposite edges, top and bottom, so that the chest could be opened from
the top or the front, and when set up one on top of the other, provided
an efficient and orderly establishment.
Liquid medicines were dispensed from large demijohns, and requisition-
ing units were required to furnish their own containers. When a sufficient
supply of demijohns was lacking, bottles of all shapes and sizes were used.
The general appearance of the pharmacy at the Merano depot was not
one of orderly and neat management.
Thus German medical supply and equipment seem to summarize actually
the entire German medical establishment: a service of great potential ability
and technique, hampered by paucity of material and bogged down in the
morass of politico-military interference over a long period of time.
Bibliographical Note
Medical Service in the Mediterranean Another major source of information,
and Minor Theaters is based upon a like the unit reports administrative and
wide variety of sources, by far the logistical as well as clinical, is the Essen-
largest category being the manu- tial Technical Medical Data reports
script records of medical units, offices, (ETMD's), issued monthly from July
and commands. Probably the most 1943 on by the theater medical section,
extensive and certainly the most impor- by various subordinate commands, and
tant collection of these records is in by the individual hospitals. The ETMD's
the custody of the Historical Unit, often contained situation reports and
USAMEDS. Others are deposited with analyses of specific military operations.
the National Archives in Washington At the theater level a daily journal was
and in the Federal Records Center, maintained by the surgeon's office, high-
Region 3, GSA, in Alexandria, Va.; still lighting important administrative devel-
others are in the records centers at St. opments. A series of circular letters
Louis and Kansas City, Mb. The Air dealt with a wide variety of matters such
Force records used are for the most part as the management of wounds; recom-
at the Air University, Maxwell Field, mended therapy for specific diseases
Ala. including dysentery, malaria, and hep-
After action and routine periodic re- atitis; the preferred use of drugs such
ports—most of them annual but a few as morphine, the sulfonamides, and
semiannual, quarterly, and even month- penicillin; and many housekeeping
ly—make up both the most extensive and chores on the order of record keeping
the most useful body of records. These and reporting. A similar but less ex-
reports came from all levels of the Med- tensive series of circular letters emanated
ical Department, from the theater sur- from the medical section of Allied Force
geon's office and its various subdivisions Headquarters. Medical situation reports
through the surgeons of armies and air were issued by various commands, the
forces, corps, divisions, communications most useful being those of the Peninsular
zones, base commands, and base sections. Base Section during the Italian cam-
They came from hospitals of all types, paign. Use has also been made of private
medical battalions and often separate diaries, and of correspondence both pri-
companies, medical supply depots, aux- vate and official—for example, the fre-
iliary surgical groups, and intermittently quent exchanges between the theater
from all of the lesser units that made surgeon and The Surgeon General.
up the combat medical organization in Other valuable documentary sources
a theater of operations. In some of the for the history of the Medical Depart-
larger commands unit reports were sup- ment in the Mediterranean include the
plemented or even replaced by histories medical annexes of operations reports at
of Medical Department activities, on a army, corps, and division levels; and of
yearly or longer basis. various planning documents. Inspection
622 MEDITERRANEAN AND MINOR THEATERS
and Byron Fairchild, The Framework of and of Samuel Eliot Morison, "History of
Hemisphere Defense., and Conn, Rose United States Naval Operations in World
Engelman, and Fairchild, Guarding the War II," helped give dimension to a nar-
United States and Its Outposts, were rative that includes five major amphibi-
used, the former in galley proof, the latter ous operations. A number of military
in manuscript. Chapter II relies at many memoirs were also consulted, including
points upon T. Vail Motter, The Persian those of Eisenhower, Bradley, Patton,
Corridor and Aid to Russia. Clark, Truscott, Montgomery, Alexan-
A number of titles in the AMERICAN der, and Kesselring, but were used with
FORCES IN ACTION series were also caution.
valuable in summarizing the combat Official histories of Fifth and Seventh
operations so essential to an understand- Armies complied contemporaneously
ing of the supporting medical activities. and published while the respective
Those used were: To Bizerte With the II armies were still in active status contain
Corps; Salerno: American Operations medical and logistical as well as combat
from the Beaches to the Volturno; Vol- material. The nine-volume Fifth Army
turno: From the Volturno to the Winter History has been usefully condensed to
Line; Fifth Army at the Winter Line; a single book, From Salerno to the Alps,
and Anzio Beachhead. by Chester G. Starr, Jr., who as a mem-
Appropriate volumes of Wesley Frank ber of the Fifth Army historical staff
Craven and James Lea Cate, editors, was one of the authors of the larger
"The Army Air Force in World War II," work.
Glossary
AAF Army Air Forces
AAFSC Army Air Forces Service Command
ABC Adriatic Base Command
ABS Atlantic Base Section
ACC Allied Control Commission
ADMS Assistant Director, Medical Services
AFHQ Allied Force Headquarters
AGWAR Adjutant General, War Department
AMET Africa-Middle East Theater
AMEW Africa-Middle East Wing
AMG Allied Military Government
AMGOT Allied Military Government of Occupied Territory
ANVIL Early plan for invasion of southern France
Armd Armored
ASRS Adjusted Service Rating Score
ASW Assistant Secretary of War
ATC Air Transport Command
Atl Atlantic
AVALANCHE Invasion of Italy at Salerno
Aux Auxiliary
QM Quartermaster
Sec Section
Sep Separate
Serv Service
GLOSSARY 627
Vet Veterinary
WAC Women's Army Corps
WD War Department
ZI Zone of interior
Basic Military Map Symbols*
Basic Medical Symbols
1
Medical treatment facility, operating .................
Medical treatment
supply u n facility,
i t . . . . . not
. . . .operating
.......................
Hospital t r a i n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Hospital s h i p . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Platoon or d e t a c h m e n t . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company..............................................
Battalion...............................................
Corps; Air F o r c e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Army..................................................
Communications z o n e . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
* For complete listing of symbols in use during the World War II period,
see1 FM 21-20, dated October 1943, from which these are taken.
2
Includes collecting and clearing elements.
Includes nontreatment facilities, other than supply, such as laboratories
and headquarters of various medical facilities.
BASIC MILITARY MAP SYMBOLS 629
EXAMPLES
41st Hospital t r a i n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
54th Medical B a t t a l i o n . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Company A, 3d Medical B a t t a l i o n . . . . . . . . . . . . . . . . . . . . . . . . .
Coastal Base Section, 368, 372, 399, 400, 412. See Corps
also CONAD Base Section; Delta Base Section. II, 105, 106, 122, 123, 124, 125, 127-46, 148, 152,
Coates, Col. John Boyd, Jr., 542 156, 158, 159, 160, 165, 167, 171, 173, 190, 204,
Cocke, Col. Joseph G., 324, 401 211, 215, 238, 239, 243, 245, 246, 253, 260, 261,
Cold injury, 33 263, 289, 291, 293, 295, 296, 297, 298, 299, 300,
Cole, 115 301, 303, 317, 318, 415, 417, 418, 419, 420,
Collecting-clearing companies, 154, 155, 156, 157, 421, 422, 424, 425-28, 429, 430-31, 432, 435-39,
159, 224. See also under Medical Companies. 440, 442, 444, 445, 448-49, 457, 458, 460, 461,
Collecting-clearing stations, 268, 270 466-68, 471, 475, 477, 479, 482, 483, 485, 525
Collecting companies, 3, 4, 110, 111, 118, 119, 125, IV, 296, 301, 302, 303, 317, 415, 417, 419-20,
149, 227, 231, 233, 240, 244, 245, 248, 249, 421, 422-23, 424, 429, 430, 431-34, 435, 439-40,
251, 293, 295, 303, 311-12. See also under 444, 446, 447, 448, 453, 454, 457, 458, 460,
Medical Companies. 461, 462, 463-66, 467, 469, 475, 477, 479, 482,
Collecting stations, 143, 153, 298 483, 484, 526
bombing of, 295 VI, 223, 224, 230, 232, 233, 238, 239, 266-88, 289,
damaged by storm, 243 292, 295, 296, 298, 299, 300, 301, 303, 312, 366-
eliminated where possible at Salerno, 236-37 95, 405, 409, 423, 515
Collesano, 159 Provisional (Sicily), 156, 157, 158, 167
Colli Laziali, 269, 273 Corps Malaria Control Committee, 287
Colombia, 34 Corsica, 174, 175, 181, 339, 342, 488, 497, 499, 500,
Combat Conditioning Camp, 216-17. See also 502, 509, 510, 556
Medical Companies, 6706th Conditioning. Cortina d'Ampezzo, 535, 536, 538, 549
Combat exhaustion. See Neuropsychiatry. Costa Rica, 39
Combat wounds. See Hospital admissions, for com- Cowan, Col. Egbert W. D., 217, 263, 317
bat wounds. Cowell, Maj. Gen. Ernest M., 106, 177, 179, 201,
Combined Chiefs of Staff, 299 212, 324, 362
approves Salerno invasion plans, 222 Cox, Col. Wesley C., 37
approves Sicily invasion plans, 147 Cremona, 525, 526
plans invasion of Northwest Africa, 104 Crichton, Col. W. H., 363
Comiso, 152, 153 CRIMSON, 31
Communications, 139 Crittenberger, Maj. Gen. Willis D., 296, 301, 415,
effect of failures of, on evacuation, 250, 305-06 423
by jeep courier, 306 Crozier, Maj. Dan, 56, 57, 58
by pigeon, 306 Cryolite, 18, 19, 22
quality of, 62, 305-06 CRYSTAL, 31
Conditioning and rehabilitation, policy of, 357 Cuba, 41, 44, 45
Conditioning Center, Eastern Base Section, 217. Cunningham, Admiral Sir John, 266
See also Station Hospitals, numbered, 105th. Curacao, 1, 8, 41, 43, 44
Conditioning Company, 6706th, 217, 357 Cutaneous disease, 79
Connel, Maj. Frank H., 537
Constantine, 122, 124, 127, 132, 136, 137, 138, 142, Dakar, 53, 54, 66, 78, 81, 83, 84, 85, 89, 90, 91, 99
180, 182, 190, 206, 208, 215, 226, 337 Dallas, 118
Continental Advance Section, 402-04, 407, 412 Darby, Col. William O., 270
Convalescence and rehabilitation sections, 357 Darby's Rangers, 270
Convalescent Hospitals Darlan, Admiral Jean-Francois, 108, 110, 121
2d, 189, 216, 217, 392, 392n, 393, 394, 406 Davenport, Col. Walter P., 43
3d, 225, 238, 242, 249, 291, 304, 306, 307, 316, David (Panama), 38
326, 329, 416, 439, 441, 525, 538, 545 Davis, Col. Thomas F., 453
3,000-bed, 189, 225 Davis, William A., 363
Convalescent wards, 169 Dawley, Maj. Gen. Ernest J., 223, 230
Cook, Col. William F., 327 Debridement, radical, 253
Copper sulfate spray, 45-46 Decamere, 69, 87
Coral Harbour, 32, 33 DELTA Force, 373-74, 379, 380
Corby, Col. John F., 106, 138, 177, 178, 182 Delta Base Section, 403, 404, 407, 408, 412, 504.
Cori, 296, 297, 304, 319 See also Coastal Base Section.
Corleone, 158 Delta Service Command, USAFIME, 61, 63, 64, 68,
Cormons, 525 71-72, 79, 81, 89, 92, 102
Coronia, 162 de Mendonca, Fabio Carneiro, 53
INDEX 641
Demonstrations. See Educational devices. Dentists, Brazilian, 54
Denit, Maj. Gen. Guy B., 180 Depot Companies. See Medical supply units, Depot
Dent, Capt. Paul L., 110 Companies.
Dental clinics, 101, 287 Desenzano, 523, 536
Fifth Army, 263, 317 Desert coolers, 99
IV Corps, 483 Destroyers, 115-18
in the South Atlantic theater, 54 Destroyers for
II Corps, 263, 317, 483 Devers, Lt. Gen. Jacob L., 267, 323
Dental Corps, 101-02, 413, 483-84 Dewey, Lt. Col. Leonard A., 215, 354
in the Africa-Middle East Theater of Opera- Diarrhea, 77, 145, 316, 556
tions, 80 and infectious hepatitis, 257
in the Atlantic defense area, 9-10 nonspecific, 98
in Brazil, 54 in Tunisia Campaign, 214-15
in the Iceland Base Command, 18 Dieppe, 108
in Italy, 262-63, 287, 317-18, 357-58, 452-53, 483- Diets, special, 144
84, 514-15 DIME Force, 152, 153, 154, 155
in the Middle East, 100-102 Diphtheria, 26
in the Persian Gulf Command, 100 Disease rates, 250. See also Hospital admissions;
in Sicily, 173-74 Noneffective rate,
in the South Atlantic theater, 54 in Brazil, 51, 52, 53
Dental dispensaries, use of trailers for, 452-53 in Iceland, 17-18
Dental equipment in Persian Gulf Service Command, 86
and Chest MD Number 60, 54, 145 at Salerno, 230-31, 278
and lack of portability, 145 Diseases, 111, 165. See also by name.
shortage of, 100-101, 218 in Army Air Forces, 182
for II Corps and Fifth Army clinics, 263 chronic, among Brazilian workers, 53
Dental laboratories endemic, 67, 79
divisional, 262-63 in Greenland, 21
mobile, 263 in Iceland, 17
at Mostra Fairgrounds, 332, 358 in Iran, 82
shortage of, at Anzio, 287 intestinal, 26, 76, 79, 145, 483, 530
technicians for, 263, 527 in Middle East, 88
use of trucks for, 263 preventable, lack of outbreaks of, in North Africa
Dental Laboratory, Central, 358 and Sicily, 215-16
Dental personnel, 24, 59, 262-63, 287, 357-58, 453, subtropical, 172
515 tropical, 52, 78, 83-84. See also by name.
in Air Transport Command, 100-102 Disinfestation, See also Malaria control,
in Brazil, 54 and anopheles gambiae, 53-54, 89-90
detached from Army hospitals, 218 of bedbugs, 172
morale of, 101-02 delousing
in Ninth Air Force, 65 of civilians in the Middle East, 95
and nonprofessional assignments, 100, 146, 174, instruction in, 74
262 in North Africa Theater of Operations, 216
in North African theater, 217-18 and shortage of equipment for treating pack
in Pan American Highway Medical Service, 39 animals, 265
ratio to troop strength, 100, 218 disinsectization officer, Air Transport Command,
and rotation policy, 54 90
shortage of, 218, 263, 287 fleas, in Sicily, 172
transport of, by air, 101 flies, 76, 145, 172, 214, 556
unexpected need for replacements in North Africa insecticiding, 91, 262
and Sicily, 208-09 larviciding, 45-46, 91, 213, 260
and use of British facilities, 100-101 lice, 172, 262, 556
Dental prosthetics, 146, 173-74, 262-63, 287, 317, for malaria control, 45-46, 53-54, 83-84, 89-92,
406, 413, 453, 484 212-15
Dental standards for induction, 218 mosquitos, 76, 172, 556
Dental surgeon, North African theater, duties of, and prevention of typhus, 94, 262
217-18 and use of
Dental techniques, German, 527 copper sulfate, 45-46
Dental x-ray, clinics lacking in facilities for, 263 DDT, 91, 356, 363-65, 537
642 MEDITERRANEAN AND MINOR THEATERS
Disinfestation—Continued Eaker, Lt. Gen. Ira C., 267, 320, 423
and use of—Continued EASCOM. See Eastern Command.
methyl bromide (MYL), 362 Eastern Base Section (EBS), 132, 134, 138, 139,
Paris green, 356 180-81, 189, 190, 195, 196, 197, 201, 204, 205,
Dispensaries, 28, 29-30, 35-37, 42, 43, 45, 48, 52, 58, 206, 208, 213, 217, 226, 337, 339, 348, 349, 369,
59, 77, 78 488, 509
in Atlantic bases, 9 Eastern Command, 320-22
in Brazil, 52 Eastern Defense Command, 9, 11, 29
capacity Eastern Task Force, 105-06, 111, 120, 122, 142
10-bed, 32-33, 39 Eastern Town Command, 82
25-bed, 32 Echelons, of medical service, 211. See also Evacua-
120-bed, 29 tion, chain of.
in Iceland, 11-12 Ecuador, 34, 38, 39
in Libya, 58 Edmund B. Alexander, 23
in Newfoundland, 25 Educational devices, 93, 98
in North Africa, 57, 58 Eisenhower, Lt. Gen. Dwight D., 104, 123-24, 177,
operated by AAF medical detachments, 32, 137 178, 226, 266, 267, 323, 367, 486
operated by Corps of Engineers, 38 Egypt, 57, 60, 61, 72, 73, 79, 81, 84, 87, 99
in Panama Canal Department, 35 Egyptian Army, surgeon of, 62, 95
in Persian Gulf Service Command, 76 Egyptian Government, and venereal disease, 92
types of Egyptian Ministry of Public Health, 62, 94
camp, 11-12 Egyptian Sudan, 60
dental, 63 Eklund, Lt. Col. William J., 24
field, 46, 63 El 'Alamein, 61, 104
general, 53, 57, 63, 69, 225 El Guerrah, 136, 189
headquarters, 32, 57 El Guettar, 129, 142, 145
mobile, 278 El Salvador, 39
station, 83 Electric lamps, generator-driven, use of, 4
Djedeida, 121 Elvins, Col. Richard E., 106, 138, 181, 327, 333
Djidjelli, 122 Emergency Medical Tag (EMT), 2, 3, 5
Dobbiaco, 523 Emily Weder, 397
Dog tags, 2 Empoli, 496-97, 529
Dooling, Brig. Gen. Henry C., 34 EMT. See Emergency Medical Tag.
Doolittle, Brig. Gen. James H., 105, 138 Engineer Battalion, 10th, 285
Dorchester, 19 Engineer Shore Regiments
Douglas Aircraft Corporation hospitals, 57-58, 64, 531st, 154, 227
68, 69, 79 540th, 268
Dragoni, 237, 242, 248 Engineers, Corps of, 12, 19, 23, 26, 31, 38, 39, 76,
DRAGOON. See Southern France Campaign. 89-90, 209, 260, 326, 329, 356, 361
Drainage at Atlantic bases, 9
and control of malaria, 45, 213, 214, 260 in Canada, 30
effect on trench foot, 285-86 and Eastern Base Section, 190
and flooding, 260, 440 in Italy, 233, 242, 260
at hospital sites, 275 medical services for, 24, 26, 32, 38
lack of, 193, 275, 285, 534 in the Middle East, 99
quality of in Newfoundland, 23
at Anzio, 275 in the North African Theater of Operations, 209
at Cassino, 285 operates own medical services, 38, 76
in Levant, 71 in Panama, 35
Drainage systems, destruction of, by Germans in in Sicily, 160
Italy, 260 England, 89, 105, 113, 124, 553
Draper, Lt. Col. Calvin S., 315-16 English Channel, 300
Drugs. See by name. Enna, 158-59
Dubos, Col. Emeric I., 360 Entomological detachments, from malaria survey
Dukws, 405, 407, 466, 479-80 units, 213
Dutch Guiana, 41, 43, 44. See also Guianas. Epidemics, civilian, in the Middle East, 99
Dutch West Indies, 34 Equipment. See Medical supplies and equipment.
Dysentery, 60, 67, 77, 83, 98, 106, 145, 172, 201, 214, Equipment and clothing study, for Winter Line
249, 257, 316, 321, 353, 556 campaign, 286
INDEX 643
Erchie, 334, 528 Evacuation, by air
Eritrea, 57, 60, 61, 68, 81, 87 along air ferry routes, 30-32
Eritrea Service Command, USAFIME, 61, 68-70, by airplane, 16, 22, 23, 25, 33-34, 41, 45, 50, 68,
79, 81, 102 73, 77, 78, 79, 83, 85, 86, 98, 106, 123, 132, 138-
Eskimos, medical treatment for, 33 39, 140, 149, 155, 167, 168, 190, 204, 206, 226,
Essential Technical Medical Data Reports 230, 279, 311-12, 321-22, 372, 392, 596, 397,
(ETMD's), 179 398, 404, 447, 448, 473, 490, 499, 502-03, 530-
32, 532
ETMD's. See Essential Technical Medical Data Re-
ports. by C-47, 5, 139, 480
by commercial airline, 28
Etna Line, 159 by L-5, 460
European Theater of Operations (ETO) , 11, 16, 84, Evacuation, chain of, 73, 137, 271
327, 399, 411, 412, 486, 504, 514, 518, 525, 533, first echelon, 3, 268
541, 542, 545, 546, 552, 555
second echelon, 3, 73, 269, 274, 294
boundaries of, 178 third echelon, 5, 232
reduction of nurses in North Africa for transfer
fourth echelon, 5, 73
to, 219
fifth echelon, 6, 16, 22, 25, 28-30, 40-41, 45, 50,
European Theater of Operations, United States 74, 77, 78-79, 83, 86-87, 97-98, 183, 186-88, 206,
Army (ETOUSA), 531 249-50, 342-43
Evacuation Evacuation, by land
from Antilles Department, 45 by ambulance, 5, 16, 41, 45, 68, 73, 87, 111, 120,
at Anzio, 271, 274, 279-80, 310-12 123, 125, 126, 127, 129, 130, 138, 153, 163, 204,
to the Azores, 30 244, 246, 247, 251, 274, 275, 292, 293, 294, 302,
in Brazil, 50-51 372, 398, 404, 428, 432, 445-46, 447, 448, 460,
of Brazilians, 505 464, 466, 473, 479, 502
in Canada, 33-34
from Cassino, 245-46, 312 by British field ambulance, 107
by cable tramway, 433
of civilians, 279
conversion of trucks for use as hospital train by jeep, 120, 125-26, 134, 227, 274, 292, 293, 298-
99, 426, 464, 466
cars, 133
from Eastern Base Section, 206 by litter bearer, 129, 133-34, 161, 227, 236, 237,
flexible policy in British hospitals, 123 240, 244, 274, 279, 293, 298, 386, 426, 428, 432,
food for patients, 16, 279 433
from Gela beach, 154 by mule, 133, 161-62, 240, 426, 479
holding facilities, 16, 164-65, 237, 307 by ski litter, 430
in Iceland, 16 by toboggan, 430
lengthening lines of, 157, 159, 303, 305, 306 by train, 23, 34, 41, 77, 87, 204-05, 310-12, 342,
from the Levant Service Command, 72 372, 398, 404, 448, 532
from Libya, 73 in British hospital trains, 123, 138
from the Liri Valley, 292-94 in hospital trains, 138, 167, 204-05, 250, 502,
from the Mediterranean Base Section, 205 503
in Newfoundland, 25-26 in Michelin cars, 123
in North Africa, 110-11, 115, 118-23, 186 in prisoner of war trains, 506, 540
officer, Fifth Army, 168 by truck, 125-26, 129, 133, 153, 167, 227, 464, 466
from the Panama Canal Zone, 40-41, 45 Evacuation, by water, 16, 196, 205, 312, 372, 373,
in the Persian Gulf Service Command, 77, 86-87 466
planning, 43, 108, 148-49, 163-64, 203, 226, 395, by British hospital ships, 167, 206, 226
499 by Dukws, 466
policy, 16, 28, 40-41, 50, 79, 85-86, 123, 128, 165, by LCI, 271, 372
197, 204, 250, 334, 340-42, 404, 448, 504-05, 501- by LST, 149, 153, 167, 226, 271, 279, 311, 312,
02, 532, 533, 543 396, 396n
problems, 12, 25, 33-34, 97-98, 392, 395 by raft, 233
in the Rome-Arno Campaign, 303-10, 312 by ship, 16, 22, 28, 45, 68, 79, 166, 206, 372, 490,
from Salerno, 226, 228-30 506
study of British methods in Tunisia, 223 by troop carrier, 97-98, 149, 167, 226
in, Tunisia Campaign, 73, 122-30, 137-38, 206 by weapons carrier, 293
to the United Kingdom, 206 Evacuation hospitals, 4, 5, 130, 144, 160, 163, 164,
in the Volturno campaign, 240 186, 219, 244, 248, 253, 267, 304, 310, 312
in the Winter Line campaign, 240-43, 245 300-bed, 111
644 MEDITERRANEAN AND MINOR THEATERS
Evacuation Hospitals—Continued Evacuation Hospitals, numbered—Continued
400-bed, 4, 119, 127, 129, 132, 134, 163, 164, 165, 128th, 132, 145, 159, 162, 167, 197, 199. See also
170, 183, 225, 237, 268, 277, 305, 307 Surgical Hospital, 48th.
750-bed, 4, 107, 120, 127, 132, 135, 164, 170, 190, 170th, 439, 440-41, 444, 458, 469, 473, 475, 476,
230, 237, 278, 305, 307 482, 525, 544, 545. See also Station Hospitals,
at Anzio, 282-84 29th.
and daily reports on number of patients ready 171st, 458, 458n, 469, 473, 475, 482, 498, 525, 544,
for disposition, 250 545
damaged by storm, 243 Exhaustion cases, 133, 255, 315
dental laboratories connected with, 262-63 Exposure, at Salerno, 236
Eye clinics, 430-32
and French ambulances, 251
Eyeglasses, unexpected need for, in North Africa,
late arrival of, in Sicily, 170 208-09
psychiatric treatment in, 145
value proved during Tunisia Campaign, 255 Faid Pass, 124, 134
Evacuation Hospitals, numbered Fano, 498-500, 510-12, 528
8th, 119, 186, 225, 230, 231, 237, 242, 291, 304, Far East, 57, 85
306, 307, 310, 416, 419, 436, 437, 442, 444, 454, Farrell, Maj. Elliston, 90, 91
460, 471, 473, 475, 482, 523, 525, 545, 546 Fasani, 294
9th, 120, 124, 125, 126-27, 129, 132, 134, 139, 192, Fedala, 115, 117, 118, 119
193, 195, 197, 199, 299, 332, 342, 342n, 369, Feriana, 125, 126, 129
378-79, 387, 388, 392, 402 Fernando de Noronha, 50, 55
11th, 119, 132, 155, 157, 158, 160, 162, 167, 183, Ferryville, 217-18
197, 199, 242, 277, 291, 299, 304-05, 307, 374, Fes, 187, 205
380, 383, 388, 392 Fever of undetermined origin (FUO), 173
15th, 129, 132, 153, 156, 159, 160, 164, 167, 197, Fevers, treatment of, at specialized facilities, 249
199, 225, 237, 241-42, 243, 248, 275-76, 277, Fiala, Maj. Frank C. J., 347
304, 306, 307, 337, 416, 419, 437, 441-42, 469, Field Ambulance Company, 159th, 90
471, 475, 478, 482, 494, 500, 523, 525, 526, 529, Field Artillery Battalions
539, 540, 545 601st, 319, 414
16th, 194, 225, 229, 231, 231n, 237, 242, 248-49, 602d, 319, 414
252, 268, 291, 304, 306, 307, 337, 416, 417, 419, 697th, 422
436-37, 439n, 440, 469, 471-73, 475, 476, 526, 698th, 422
529-30, 545, 546 1125th Armored, 424
27th, 336, 387, 392 Field Artillery Brigade, 13th, 386
38th, 107, 113, 114-15, 120, 132, 139, 188, 190, 192, Field Artillery Group, 35th, 406
196, 204, 225, 230, 231, 237, 242, 243, 277, 287, Field hospital platoons, 73, 79, 153, 154, 170, 171,
291, 304, 307, 310, 416, 419, 439, 439n, 440, 471, 248, 249, 253, 302, 307
473, 475, 476, 523-25, 545 Field hospitals, 4, 74, 76, 87, 149, 155, 160, 163,
51st, 387, 393, 225, 237, 282, 293, 294, 295, 297, 299, 304
56th, 192, 195, 225, 230, 231, 237, 242, 248, 268, 50-bed, 70
271, 275, 277, 282, 284-85, 287, 291, 303-04, 306, 100-bed, 4, 76, 86, 127, 253
307, 337, 416, 436, 437, 444, 471, 475, 476, 480n, 200-bed, 86
525, 545 400-bed, 4, 127, 277, 321
59th, 119, 164, 165, 199, 299, 304, 312, 336, 387, and lack of combat experience, 170
392, 397 in Middle East theater, 67
77th, 107, 113, 115, 120, 124, 125, 126-27, 129, and retention of nontransportable patients, 253
132, 144, 149, 171, 188, 190, 192, 193, 199, 204 Field Hospitals, numbered
91st, 120, 158, 164, 174, 189, 189n, 199 4th, 71, 73, 84, 197, 199, 225, 333, 334, 497, 529,
93d, 155, 156, 159, 162, 167, 172, 172n, 197, 225, 530
230, 232, 237, 242-43, 268, 271, 275, 277, 284, 10th, 132, 139, 155, 156, 157-58, 161, 173, 225,
291, 299, 303-04, 305, 307, 374, 379, 392, 393 237, 241, 246, 248, 291, 297, 299, 303, 373, 374,
94th, 193, 225, 237, 242, 243, 246, 277, 278, 291, 378, 379, 384, 386, 387
304, 305, 306, 307, 337, 416, 419, 435, 436, 437, 11th, 154, 156-57, 159, 160-61, 162, 173-74, 225,
441-42, 448, 471, 475, 476, 482, 494, 527, 529, 237, 238, 244, 263, 291, 293, 294, 297, 299, 303,
544, 545 374, 379, 380, 382-83, 386, 387
95th, 193-94, 225, 229, 231, 237, 241, 242, 252, 15th, 70, 73, 84, 175-76, 199, 444, 450, 463, 466,
268, 271, 275, 276, 283, 287, 299, 303, 304, 305, 468, 473, 523, 525, 526, 530, 530n, 538, 545, 549,
306, 307, 331, 371n, 374, 388, 392, 393, 396 558
INDEX 645
Field Hospitals, numbered—Continued Forts
16th, 68, 70, 84 Amador, 38
18th, 74, 76, 86 Bell, 28
19th, 74, 76, 86 Brooke, 42
26th, 74, 76, 86 Buchanan, 42, 44
32d, 225, 237, 307, 333, 416, 426, 427, 428, 430, Chimo, 31, 33
440, 442, 453, 463, 469, 469n, 473, 478, 481, Clayton, 37, 38
483, 523-25, 526, 532, 544, 545 Gulick, 37, 38
33d, 225, 237, 268, 269, 271, 274, 275, 276, 277, Kobbe, 37, 38
282, 283, 287, 297, 303, 416, 426, 427-28, 430, McAndrew, 23-24, 25
453, 465-66, 468, 525, 545 Pepperrell, 23, 24
34th, 333, 334, 497, 529, 546 Read, 43, 44, 45
35th, 333, 334, 497, 499, 527, 528, 529, 530, 541, Simonds, 44
546 Fourth Fleet, 47
99th, 498, 529, 541, 550 Fox, Brig. Gen. Leon A., 9, 95, 363, 364, 365
Fighter Command, 181 France, 7, 46, 104, 525, 552
Filariasis, 83, 91 Francolise, 525
Finley, Lt. Col. Theodore L., 210 Franklin, Col. Daniel, 148, 164, 369
Firestone Tire and Rubber Company plantation, Franklin, Lt. Col. Joseph P., 180
North Africa, 66 Fredendall, Maj. Gen. Lloyd R., 105, 111, 123, 124,
First aid 127
in Eastern Command, 321 Free Territory of Trieste, 549
instruction, in Sicily, 150 French Army units
packet, 1 Armies
for plane crash victims, 84 B, 367, 376, 381, 384, 387. See also French
stations at Winter Line campaign, 240 Army units, Armies, 1st.
1st Special Service Force. See Special Service Force, 1st, 376, 407, 413, 414. See also French Army
units, Armies, B.
1st.
Corps
Fitzgerald, Brig. Gen. Shepler W., 66
2d, 384
Flinn, Lt. Col. James E., 411
19th, 124, 131
Flooding, 260, 440
Expeditionary, 238, 239, 243, 244-45, 251, 265,
Florence, 302, 307, 314, 488, 490, 494, 496, 497, 498, 289, 290, 291, 292, 294, 295, 299, 301, 302,
499, 502, 503, 520, 525, 527, 529, 530, 531, 532,
304, 312, 314, 318-19, 332, 335, 515
535, 540, 541, 545, 546
Divisions
Foggia, 182, 223, 232, 326, 334, 337, 497, 530, 550, 1st Algerian, 367
552 1st Armored, 376
Fondi, 292, 293, 295, 303-04 2d Moroccan, 238, 239
Fondouk, 129-30 3d Algerian, 238, 239
Food inspection, by Veterinary Corps, 263, 359, 517, 4th Moroccan Mountain, 289
551, 556 9th Colonial, 367
in Brazil, 54—55 French doctors, 113
in the Fifth Army, 485 French Equatorial Africa, 60
in the Middle East theater, 102 French Guinea, 66
in the South Atlantic Wing, Air Transport Com- French malariologists, on British-American ma-
mand, 54-55 laria control committee, 213
in the Tunisia Campaign, 146
French medical units, 304
Food loss, due to improper packaging, handling,
evacuation of field hospitals by, 238-39
and storage, 218-19
Food poisoning, 76, 213, 359 evacuation of forward hospitals by, 295
and hospital train, 138
Food poisoning, bacterial, 98, 316
and support of II Corps, 295
Food supply, 28, 79
French Morocco, 81, 83, 181
Footwear, 33, 262
Force 163, 366, 369 French scientists, and Typhus Commission, 95
Force 343, 148, 149-50. See also Armies, Seventh. French Somaliland, 61
Foreign Liquidation Commission, 103 French West Africa, 46, 66, 82, 99
Formia, 293 Frew, Maj. Edith F., 369
Fort de l'Eau, 111 Freyberg, Lt. Gen. Sir Bernard, 245
Fortaleza, 47, 49, 50, 55 Frobisher Bay, 31
646 MEDITERRANEAN AND MINOR THEATERS
Fruit juice, medical value of, 99 General Hospitals, numbered—Continued
Furth, 542 113th, 74, 76, 77, 86, 322
161st, 45
Gabes, 129 208th, 15, 16
Gaffey, Maj. Gen. Hugh J., 152 210th, 38
Gafsa, 122, 125, 127, 129, 142, 144 218th, 38
Galapagos Island, 38 262d, 38
Gallo, Capt. Francis, 417 300th, 329, 335, 336, 339, 490, 496, 528, 529, 550
Gambia, 60 Geneva Cross, use of, 2, 139, 271, 288, 554
Gambut, 73 Genoa, 523
Gander, 23, 31 Georgetown, British Guiana, 44
Gander Field, 23 German Army units
Garigliano front, 273, 303-04, 318 Army Group G, 375
Garigliano River, 235, 243, 244, 260, 266, 267, 270, Armies
289, 291, 293, 296 Tenth, 269, 292
Gas gangrene, 253 Fourteenth, 273
Gastritis, chronic, 451 Nineteenth, 381
Gastrointestinal disorders, 88, 98 Afrika Korps, 60, 124
Gastrointestinal service, 450 Divisions
Gatun Lake, 41 11th Panzer, 376
GBC. See Greenland Base Command. 29th Panzer, 478
Gela, 152, 153-55, 156, 167, 169 148th Grenadier, 462
General Depot, 6671st, 348 German dental equipment, use of, 146
German doctors, Sicily, 162
General Dispensaries, 63, 64, 69, 71, 225 German hospitals. See also Station Hospitals, num-
5th, 187
bered, 334th (Ger.).
6th, 189 and capacity of, 4761
8th, 189 and Fifth Army required to use, 477
General hospitals, 5, 9, 12, 79, 80, 191 Luftwaffe, 536
500-bed, 85, 86 military, 304
600-bed, 42 and treatment of American casualties at the
750-bed, 74, 84, 86 Rapido River, 244
1,000-bed, 68, 74, 77, 183, 188, 190, 225
German Medical Service, 476-78, 500, 535-39
General Hospitals, numbered German troops, 226
3d, 192, 193, 195, 336, 397, 402, 411 Germany, 47, 538, 542, 543, 549
6th, 180, 183, 205, 336, 337, 347, 444, 450, 481, 495,Ghana. See Gold Coast.
496, 499, 500, 529, 540, 546 Ghedi, 536, 537-38
12th, 188, 332, 335, 336-37, 349, 448, 493-94, 529, Ghedi prisoner of war area, 536, 537, 538
546 Ghinda, 57-58, 69
17th, 329, 490, 496, 530, 546 Ghisione, 485, 517
21st, 188, 190, 216, 329, 335, 336, 369 Ghisonaccia, 497
23d, 331, 335, 336, 402 Gilmore, Col. Hugh R., 212, 259
24th, 194, 197, 337, 471, 480, 490-491, 494, 502, Ginn, Col. L. Holmes, Jr., 148, 263
528-29, 530, 532, 546 GOALPOST, 117
26th, 190, 204, 208, 333-34, 497, 501, 502, 529, 546 Goethals, Col. Thomas R., 180
33d, 194, 196, 197, 336, 337, 493, 530, 546 Gold Coast, 65, 83
36th, 333, 335, 336, 397, 402 Goldson, Col. Robert, 369, 542
37th, 194, 335, 481, 490, 496, 499, 500, 523, 528, Gonorrhea, 412, 431
529, 530, 539, 540-41, 546, 548 Goose Bay, 31, 33
38th, 63, 65, 68, 72, 73, 74, 77, 80, 81, 84, 85, 97, Gorgas Hospital, 37, 38
102, 103 Gorizia, 523
41st, 43-44. See also Station Hospitals, 359th. Gothic Line, 302, 416, 417, 418, 419-21, 425, 426,
43d, 194, 339, 371n, 397, 402 435, 436, 457, 458, 467, 490, 513, 516
45th, 183, 329, 490, 496, 499, 528, 529, 530 Goumiers, 332
46th, 180, 194, 339, 402 Gowen, Lt. Col. Guy H., 369
64th, 194, 335, 337, 447, 490, 491, 494, 527, 530, Grant, Maj. Gen. David N. W., 66
550 Great circle route, 22
70th, 194, 337, 448, 471, 473, 480, 494, 527, 529, Great Falls, Montana, 31
530, 546 Great Sound, Bermuda, 27
INDEX 647
Greece, 65 Highways, Italy—Continued
Green Project, 55 65: 416, 417, 419, 421, 422, 426, 427, 431, 435, 437,
Greenland, 18-19, 21-22, 30, 31, 32 444, 445, 448, 454, 457, 458, 460, 466, 468, 471,
Greenland Base Command, 18, 19, 22 473, 482
Grosseto, 301, 306, 313, 314, 319, 337, 490, 495, 496, 67: 416, 420
502, 516, 517, 529 68: 302, 319
Guadalcanal, 89, 366, 553 6520: 420
Guatemala, 38 6521: 416, 420
Guatemala City, 38 6524: 416, 417, 419, 421, 426, 427, 436, 437
Guenther, Lt. Col. Augustus J., 369 6528: 419, 421
Guianas, 34, 47 Hill, Maj. Arthur W., 412
Guincarico, 307 Hill, Lt. Col. Otho R., 19, 22
Gulf of Gaeta, 295 Hill 609, 134
Gulf of St. Lawrence, 31 Hilldrup, Col. Don G., 66
Gullickson, Lt. Col. Herbert L., 102 Hitler line, 292
Gura, 57, 58, 60, 69 Hofn, 13, 15
Gurabo, 43 Holding facilities, for patients awaiting evacua-
Gurley, Col. Webb B., 369, 413 tion, 16, 164-65, 237, 307
Gustav Line, 238, 239, 243, 245, 247, 258, 265, 267, Holmboe, Col. Harris, 538
270, 289, 292, 294, 303, 336, 340, 430 Honduras, 38, 39
Horses, use of, 102, 162, 264-65, 318-20, 456, 484
Halazone tablets, 215 Hospital admissions
Halstead, Lt. Col. James A., 450 for combat wounds, 1, 1n, 2-6, 29, 111, 143, 165,
Hamadan, 76 173, 201, 211, 240-41, 252-53, 286, 444. See also
Hampton, Lt. Col. Oscar P., Jr., 409, 450 Battle casualties; Noneffective rate,
Hancock, Maj. Michael Q., 32 for disease, 6, 74, 77, 89, 97-99, 111, 115, 119, 165,
Hanser, Lt. Col Samuel A., 276 211
Hanson, Col. Frederick R., 145, 210, 253, 350, 409, for injuries, 4, 21, 40, 51, 74, 79, 86, 89, 119, 165
487, 514 Hospital construction
Harmon, Maj. Gen. Ernest N., 115 in Africa, 57, 78-79
Harmon Field, 24, 25, 26 air-conditioned wards, 86
Hartgill, Maj. Gen. William C., 324 in Brazil, 49
Haverty, Capt. Eugene F., 279 in Canada, 33
Hawley, Maj. Gen. Paul R., 504 and civilian labor shortage in Iceland, 14
Health officer, occupied Germany. See Stayer, Maj. in the Eastern Base Section, 193
Gen. Morrison C. in Greenland, 19, 20-21
Heat, prickly, 99 heating for, 14, 66
Heat exhaustion, 99 and lack of insulation, 33
Heatstroke, 99 in Levant Service Command, 64
Heatstroke centers, 79, 99 in Newfoundland, 24-25
Heimstra, Capt. Fred A., 47 in the Panama Canal Department, 37, 38
Helgafell, 15 in the Persian Gulf Command, 76-77
Heliopolis, 57, 63, 68 in the Puerto Rican Department, 43
Heliopolis Area, 61. See also Delta Service Com- shortage of materials for, 13
mand, USAFIME. types of
Heminway, Col. Norman L., 19 area, 56
Henry Barracks, 42, 44 cantonment type, 49, 79
Hepatitis, 353, 451 one-story, 78
Hepatitis, infectious, 98-99, 216, 257, 350, 451 permanent, 24, 33, 38, 43, 68, 70, 194
Highway 7, France, 384 prefabricated, 13, 202, 336
Highways, Italy rosette pattern, 77
1: 300, 302, 304, 418, 460 temporary, 38-39, 43, 44, 49, 186, 430
2: 300, 301, 302, 304 tentage, use of, 73, 76, 183, 186, 188, 189, 190,
6: 238, 243, 244, 245, 246, 252, 270, 289, 290, 292, 271, 275, 335, 336, 430
296, 298, 299 zone of interior, 49
7: 270, 289, 291, 292, 294, 295, 296, 303 and use of local materials, 49, 77
9: 418, 419, 458, 462, 466, 473 Hospital inspection
64: 416, 421, 423, 425, 429, 432, 440, 457, 458, 460, at Anzio, 277
461, 466, 469, 471, 473, 480, 481, 482, 517 by consultants, 211-12
648 MEDITERRANEAN AND MINOR THEATERS
Hospital inspection—Continued Hospitals—Continued
by Icelandic doctors, 11 maintenance and repair of, 191, 304
by theater surgeon, 212 placement of, 248
Hospital rotation and replacement, 275, 277, 282, protection of, 79
291 transport of, 23, 38, 67, 68-70, 84, 85, 86, 111,
Hospital Ship Platoons 119, 125, 126, 129, 132, 183, 246, 271, 275, 291,
5th, 205 303-10
34th, 202 types of
36th, 202 base, 28, 255, 290
37th, 202 civilian, use of, 23, 103, 111, 113-114, 115
Hospital ships Engineer Corps, 19, 24, 26, 32, 38
at Anzio, 279, 282 fixed, 5, 50, 68, 82, 120, 123, 136, 164, 182,
attacked, 177, 228-29 185, 188, 189, 206, 240, 250, 312, 329
lack of forward, 206, 248, 311
in Bermuda, 28 mobile, 67, 120, 121, 123, 127, 132, 137, 143
in the Middle East, 79 Navy, in Bermuda, 27
for North Africa invasion, 108, 115 post, 25, 34, 37, 38, 44
planned use of provisional, 9, 119, 183, 320
at Anzio, 268 Red Cross, 119
in Sicily Campaign, 149 special, 249, 555
under control of Allied Force Headquarters, 226 Hot springs, use of, for heating, 14
Hospital ships, British, 110, 185, 192 Howard Field, 37
Hospital ships, named Hnitafjordhur, 12
Acadia, 168, 206, 341, 397 Huddleston, Col. Jarrett M., 223, 268, 271
Algonquin, 357 Hudson Bay, 31
Chateau Thierry, 397 Hudson Bay Company, 33
Emily Weder, 397 Hume, Brig. Gen. Edgar Erskine, 220-21, 360, 361,
John Clem, 397 520
Leinster, 110 Hungary, 320, 549
Newfoundland, 228-29 HUSKY. See Sicily Campaign.
St. David, 271, 283 Hutchinson, Lt. Col. William A., 58
St. Mihiel, 28 Hutments, 190
Seminole, 168, 206, 341 Huts, types of
Shamrock, 397 Boyle, 194
Thistle, 397 corrugated steel, 13
Hospital sites, 43, 115, 118-19, 135, 183, 186, 188, Nissen, 12, 13, 29, 188, 189, 190, 194
189, 190, 231, 237, 241-42, 252, 275, 307, 311, prefabricated, 13
402, 429 Quonset, 13
Hospital Trains, 14, 140, 155, 315, 341 Hutter, Col. Howard J., 180
41st, 205, 251, 310, 332, 342, 502, 546 Hyde, Col. James F. C., 66
42d, 205, 310, 342, 398
66th, 342, 398 IBC. See Iceland Base Command.
Hospital trains, Italian, 542 IBS. See Island Base Section.
Hospitalization policy, 6, 40-41, 247-48, 255-56, Iceland, 8, 18, 30, 31
277-78 Iceland Base Command (IBC), 10-18
Hospitals, 64, 76, 83, 245, 527. See also British Idstein, 542
medical units; Convalescent Hospitals; Evacu- Immunization. See Innoculations.
ation hospitals; Evacuation Hospitals, num- Inch, Col. T. D. (RAMC) , 489
bered; Field hospitals, Field Hospitals, num- India, 60, 70, 83, 85. See also China-Burma-India
bered; General Hospitals; General Hospitals, theater.
numbered; Station Hospitals, numbered; Sur- India-Burma theater, 84
gical Hospital, 48th. Infantry Battalions
bombing of, 228, 271, 275-77, 283, 297-98, 311, 100th, 230, 418, 418n. See also Infantry Regi-
331 ments, 442d.
damaged by storm, 231 509th Parachute, 268, 270, 274
Fifth Army, 237, 243, 246, 250, 255, 291, 304, 310 550th Airborne, 374
in Iceland Base Command, 12-16 Infantry Divisions
lack of, during invasion of North Africa, 110 1st, 105, 112, 113, 122, 124, 128, 129, 133, 152,
in Levant Service Command, 71 156, 158-60, 174, 267
INDEX 649
Tabarka, 132, 137, 138, 142 Triage, 14, 171, 171n, 195, 196, 253, 445, 448, 450
Tafaraoui, 112, 114, 181 Trieste, 523, 549, 550
Talara, 38 Trieste-United States Troops (TRUST), 549, 550-
Tank Battalion, 758th Light, 424 51
Tarquinia, 305 Triflisco, 234
Tarviso, 549 Triflisco Gap, 233
Task Forces Trinidad, 26, 41, 43, 44, 45, 48, 50
Butler, 375, 382, 384 Trinidad Sector, 34, 51
45: 415, 417, 418, 418n, 422, 423, 424, 429, 432 73, 85
Tripoli,
92: 422 Tripoli Base Command, 64, 79. See also Delta
Tassigny, General Jean de Lattre de, 367, 376 Service Command; Libyan Service Command.
Teano, 242, 255, 265, 291 Troina, 159, 160, 161, 164
Tebessa, 121, 122, 123, 124, 125, 126, 127, 129,Troop130, Carrier Command, 168
132, 137, 142 Troop Carrier Wing, 51st, 138, 139
Technical Supervision Regiment, 2695th, 455, 484, Tropical syndrome, 97
516 Truscott, Maj. Gen. Lucian K., Jr., 117, 152, 162,
Tedder, Air Chief Marshal Arthur W., 266 270, 273, 277, 367, 423-25, 435, 461, 520
Tehran, 64, 74, 76, 79, 82, 86 TRUST. See Trieste-United States Troops.
Tel Aviv, 58, 64, 71, 72 Tuberculosis, prevalence of
Tel Litwinsky. See Camps, Tel Litwinsky. in Greenland, 21
Telergma, 132, 137, 139, 142, 190 in Newfoundland, 26
Tents, use of, 73, 183, 188, 190, 193, 194 Tuberculosis sanitorium, 331. See also General Hos-
Terceira Island, 29 pitals, numbered, 300th.
Termini, 158, 164, 167, 181, 206 Tulagi, 552
Terracina, 270, 292, 295, 296, 303 Tunis, 82, 85, 121, 122, 131, 149, 156, 168, 175,
Terrain, 553. See also Drainage. 188, 205, 226, 266, 498, 509, 510
effect of, on hospital disposition in Iceland, 12 Tunisia, 63, 65, 67, 73, 83, 104, 122, 127, 139-40,
effect of, on neuropsychiatric rate, 256, 409 145, 150, 174, 181, 310, 553 556
injuries caused by, in Greenland, 21 Tunisia Campaign, 121-46, 173, 179, 183, 185, 186,
mountainous, 133, 160, 231, 233, 240, 245, 295,188, 190, 191, 208, 210, 211, 215, 225, 253, 552
395, 422, 426, 429-30, 433, 457, 460-61 Tunisian Desert, 553
muddy, 189-90, 242, 422, 429, 437, 444, 457 Turin, 523, 532
swampy, 285 Typhoid fever, 30, 172, 363, 452
used to protect casualties, 2, 3, 232 Typhoid-paratyphoid infections, 98
Termoli, 232 Typhus, 321, 326, 363-65, 372, 537, 556
Tetanus, 172 in Africa, 67, 83, 106, 216 220
Thala, 125 epidemics of, 262
The Pas, 31, 32, 33 in the Middle East, 67, 94-95
Thelepte, 139 in the Persian Gulf Service Command, 76
Thistle, 397 in Sicily, 172
Thurmond, Maj. Alien G., 32 Typhus Commission, 94-95, 363-65
Tiber River, 266, 268, 296 Tyrol, 542
Tingay, Col. Lynn H., 149, 358, 413, 453, 487, 515 Tyrrhenian Sea, 233, 291
Tine Valley, 131
Tinsman, Col. Clarence A., 66 Udine, 525, 526, 530, 532, 549
Tirrenia, 491, 494 Umm Qasr, 59, 60
Titania, 118 United Kingdom, 30, 80, 108, 120
Tlemcen, 189 United Nations Relief and Rehabilitation Ad-
TORCH. See Algeria-French Morocco Campaign. ministration (UNRRA), 95
Tracy, Col. Edward J., 327 United States Army Forces in Canada, 33
Training and Rehabilitation Center, 88th Infan- United States Army Forces in Central Africa
try Division, 315 (USAFICA), 65, 77
Transjordan, 61 United States Forces in the Middle East
Trapani, 157, 165 (USAFIME), 60, 62, 80
Trench foot, 249, 261-62, 285-86, 350, 353, 386, United States Army Forces, South Atlantic
412-13, 427, 452 (USAFSA), 47, 48
Trento, 525 United States Forces, European Theater (USFET),
Treviso, 525, 531 542
INDEX 663
United States Military Iranian Mission, 59, 88. Venereal Disease Diagnostic and Treatment Cen-
See also Iran-Iraq Service Command; Middle ters, 197, 404, 419, 484
East. 162d Medical Battalion, 249, 258
United States Military North African Mission, Fifth Army, 258, 263, 419, 525
56-57, 58, 59, 88 Seventh Army, 411-12
University of Palermo Polyclinic Hospital, use of Venereal disease hospitals, 249, 277-78, 291, 304,
by American personnel, 157, 158, 159, 164 306-07, 333, 335, 336. See also Station Hos-
Uruguay, 54 pitals, numbered, 53d, 66th.
USAFICA. See United States Army Forces in Venezia Giulia, 549
Central Africa. Venezuela, 34, 41
USAFIME. See United States Army Forces in the Venice, 549
Middle East. Venturina, 306
USAHS. See Hospital ships; Hospital ships, named. Verona, 484, 517, 525, 531, 537
USPHS. See Public Health Service, United States. Veteran's Administration hospital, transfer of pa-
USSR. See Soviet Union. tients to, 6
Veterinarian, Ninth Division, 160
Veterinary Companies
Vaccine
36th, 484
distributed by Typhus Commission, 95
45th, 265, 413-14
shipped by air, 88
Veterinary Corps, 102-03, 263, 320, 517-18
suspected as cause of yellow fever in Iceland, 17
in the Atlantic Defense Area, 9-10
used against plague in the Azores, 30
cares for pet animals, 103
Vairano, 242, 244, 248 in Iceland, 18
Valdibura, 483 inspects food, 102-03, 174
Valmontone, 289, 292, 296, 297, 298 in the Middle East, 102
Van Valin, Col. James C., 152 personnel, 11, 64, 103, 146, 218, 263-64
Van Vlack, Col. Hall G., 59, 60, 65 operates piggeries, 54, 102
Vatican City, 304 in the South Atlantic theater, 54-55
Velletri, 270, 296-97 in Tunisia, 146
Venafro, 234, 239 Veterinary Evacuation Detachments
Venereal disease, 249, 291, 317, 321, 333, 350, 643d, 517
353-54, 362, 411-12, 444-45, 452, 483, 489, 644th, 517
513, 526, 530, 556 Veterinary hospital, French, 265
in Africa, 67, 78, 93-94, 106, 221 Veterinary Hospitals, numbered
in the Antilles, 46, 47 1st General (U.S.-It.), 517
at Anzio, 277-78 1st Station (It.), 319, 516
on Ascension Island, 51 2d General (U.S.-It.), 517
in the Azores, 29, 30 Fifth Army Provisional, 265
in the Bermuda Base Command, 28-29 17th Evacuation, 265, 291, 319, 369, 414
in Brazil, 47-48 110th Evacuation (It.), 265, 291, 319, 454, 485
in Canada, 33 130th Evacuation (It.), 265, 291, 319, 454, 485
in Eritrea, 93 210th Evacuation (It.), 265
in Greenland, 21 211th Evacuation (It.), 454, 484-85, 517
and houses of prostitution, 92, 93-94, 215, 257, 212th Station (It.), 454, 484, 516
321, 257-59, 412 213th General (It.), 359, 516, 517
in Iceland, 17 2604th Station (Overhead), 517
in Italy, 257-59 2605th General (Overhead), 517
in the Levant Service Command, 93 Viareggio, 527
in Liberia, 81, 93-94 Vicenza, 525, 526
in the Middle East, 79, 88, 92 Vichy government, 46, 66
in Newfoundland, 26 Vienna, 533
in North Africa, 77, 78, 79 Villafranca, 525, 531, 538
in the Panama Canal Department, 39 Virgin Islands, 42, 43, 44
in the Persian Gulf Service Command, 76, 92-93 Virgin Islands Department, 37
reduction of rates of, 92, 93, 94, 257-59 Virus Commission, 99
use of penicillin against, 94, 258 Visciarro, 265
Venereal disease control officers Vitamin deficiency, chronic, 99-100
in the Fifth Army, 257-58, 279 Viterbo, 300
in NATO, 93, 94 Vittoria, 153
664 MEDITERRANEAN AND MINOR THEATERS
Volterra, 307 Western Town Command (Africa), 82
Volturno River, 230, 231, 232, 233, 234, 237, 241, Wheeler, Brig. Gen. Raymond A., 59
244, 248, 253, 527 Whole blood. See Blood, whole.
Wiesbaden conference, development of prisoner
Wade, Brigadier E. W., 106 exchange program at, 552
Wadi Seidna, 70, 84 Wilbur, Lt. Col. Bernice M., 219, 360, 487
Walker, Maj Gen. Fred L., 243 Williams, Lt. Col. O. S., 541
Walsh, Brig. Gen. Robert L., 47 Williams, Col. Wilson C., 361
Walter Reed Army Hospital, 6 Wilson, Maj. Gen. A. R., 368
War Department, 41, 103, 219, 345, 346, 347, 363, Wilson, General Sir Henry Maitland, 323, 367, 423
496, 504, 514, 521, 533, 545 Winnipeg, 32, 33
Winter Line, 233, 235, 238-43, 245, 249, 251, 261,
Ward, Lt. Col. Thomas G., 89
263, 265, 285, 340
Wardmen, training of, for Fifth Army Neuro- Winter Line campaign, 241, 333
psychiatric Center, 255 incidence of trench foot during, 261-62, 285
Water purification, 68, 73, 76, 214. See also San- procurement of pack animals for, 263-65
itary conditions. Women's Army Corps, 81, 336, 554
Water supply Wooten, Maj. Gen. Ralph H., 47
adequacy of in the Levant Service Command, Wounds, combat. See Hospital admissions, for
71 combat wounds.
contamination and scarcity of, 68, 73 Wright, Lt. Col. Daniel, 90
in Eritrea Service Command, 70
in Libya, 73
in North Africa, 106, 214 YAK fighter planes, Russian, 321
in the Persian Gulf Service Command, 76 Yaws, prevalence of, in Africa, 83
in Sicily, 170, 172 Yellow fever, 67, 83, 91
Weather stations. See Meteorological stations. Youks-les-Bains, 129, ISO, 136, 137, 139
Yugoslavia, 326, 549
West, Capt. John L., 517
Yugoslavs, use of, in hospitals, 510
West Africa, 60, 80-81, 88
West African Service Command, 66, 81. See also
Central African Command. Zanderij Field, 44
Western Desert, 63, 72, 99 Zehm, Col. Abner, 152, 157
Western Hemisphere, 7, 40, 44 Zone of interior, 148, 150, 498, 501, 502, 511,
Western Task Force, 105, 107, 108, 119, 120, 121, 514, 530, 532, 533. See also Evacuation, chain
140, 186 of, fifth echelon.
U.S. GOVERNMENT PRINTING OFFICE : 1987 189-578