The medical service in the army.
F. L. HOSMAN, M.D., INDIANAPOLIS, IND
The medical service in the army is divided into four sections, viz., (1) medical, (2) dental, (3) veterinary, (4) sanitary. We will take up the medical service as covered by the medical officer only. This section is divided into the surgical service and the medical service, each having its own or separate section, except in isolated posts where there are only a few men stationed. At these stations the medical officer on duty covers the medical, surgical veterinary and sanitary departments as best he can.
The surgical section, of course, relates to the surgical service; the medical section attends to the medical cases only. These two sections operate in large posts and general hospitals, such as the Walter Ried (Washington, D. C.), Fitzsimmons (Denver. Colo.), Letterman (San Francisco, Cal), and in such posts as Ft. Benjamin Harrison. Ind. etc. The medical department is divided into many sections, each having its own head or chief of the service—for instance, the chemical warfare, aviation medicine, neuro-phychiatric, laboratory, etc.—all of which are controlled through the Surgeon-General's office, where representatives of each service are on duty to assist him in covering the department as a whole, thus keeping in touch with each branch and knowing what each is doing along their particular line. One who is not familiar with the situation has no idea how comprehensive is the work of the medical department in the service of the army, and the number of men to keep it going.
We will diverge somewhat and give a slight history of the service. Beginning with the Revolutionary War, we find that the medical department was originated in Boston in 1775, when the physicians were called from the bedside to care for the troops. Dr. Warren, of Boston, one of the first to be called, lost his life a few days later. Dr. Benj. Church was the first head, but was soon discharged for treason and was replaced by Dr. John Morgan, of Philadelphia, who was followed by Dr. Wm. Shippen in 1777. At this time, even as it is in our present day, jealousy and radical differences created a lack of co-operation between the various medical officers with regiments and the hospital service. In 1784 the department was disbanded. In 1812, with war at hand, Congress prescribed the number of physicians and surgeons for the various troops assembled, with Dr. James Tilton, of Delaware, as its head. Dr. Tilton did not recognize the difference between the practice of medicine and surgery, and preferred the sick and wounded to be cared for by the regimental medical officers in their own regimental hospitals instead of separating or classifying them.
The first Surgeon-General was Dr. Joseph Lovell, who was appointed May 14, 1818. From this time on the medical department became of great service, and a number of brilliant men have been at its head. Dr. Jonathan Letterman, during the Civil War, instituted the system of ambulance evacuation; also field and regimental hospitals, which were the first of their kind in the army. It was General Sternberg who inaugurated the system of female nurse corps in 1899. To his credit is due the tubercular hospital and camp at Ft. Bayard, N. M., in 1909. He is also the originator of the plan of the Walter Reid Hospital in Washington, D. C., which is at this time the great medical center of the army. We also find General Gorgas, who made it possible to build the Panama Canal by his wonderful system of hygiene and sanitation. It was he that discovered that it was the mosquito which caused the yellow fever and developed the means for its destruction, thus making the Canal Zone a fit place to live.
Our present Surgeon-General, General Ireland, is an Indiana man, who became famous as the Chief Surgeon of the A. E. F. during the World War. General Ireland saw the defects in our medical service during the conflict, and when he became the head of the department at the close of the war he at once began to make changes, and today the medical department is considered as among the best in the world.
Attached to every division is a medical regiment, consisting of a headquarters, with regular and attached officers numbering 14; a service company, 4 officers and 80 men; hospital battalion of 3 companies, 26 officers and 276 men; ambulance battalion, 3 companies, 14 officers and 168 men; collecting battalion, 3 companies, 14 officers and 288 men; veterinary company, 3 officers and 70 men, or a total of 69 officers and 892 men. There are also medical officers and enlisted men attached to each regiment and separate battalion within the division, making a grand total of 147 medical officers, of which 22 are dental, 15 veterinary and 1,524 enlisted personnel, many of whom are specialists of various types. An infantry division at war strength consists of 908 officers, 24 warrant officers and 19,063 enlisted men, or a total of 19,995 officers and men.
We next have in the army corps, which is one step higher, about the same division of troops, and consists of two or more divisions. Next higher is the field army, which consists of two or more corps. The troops are again distributed in the same manner, with the exception of the latter two, the corps and the army, which control the evacuation of all sick and wounded from the division hospitals back to the base, surgical and evacuation hospital centers, including all hospital trains and transports. Thus you can readily see the medical department plays a very important role in the army.
Each medical officer in the service has his own duties to perform, whether at war or in peace. He is the authority in all matters pertaining to sanitation in post, camps or on the march. He must be prepared to obtain the proper water supply and the disposal of all waste; assist in the location of camps, issue all sanitary orders for camps, posts, marches and battle areas. The disposition of the dead upon the field is one of his greatest problems, and he must keep an accurate account of all and where taken. He must keep in close contact with all components of the army around him. His records are many, and must be accurate on account of the many claims filed in later years of disability received while in the service. In fact, the medical officer is the one man in the outfit whom the enlisted personnel treat with respect, for he is so much different from all the other officers with whom they come in contact. The successful officer is the one who acts as the big brother to the men under his care; by this method he gains their confidence, and all other things come easy. Of course, we find malingerers, who are soon found out and made to pay for this method of shirking duty.
A medical officer on duty in a large post has the opportunity to keep up his practice along all lines, even obstetrics, as there are the families of the officers and enlisted personnel living upon the post. Another situation in the department, which is not definitely understood by the medical profession, is that the medical officers attached to small posts are encouraged to do civil practice and keep in touch with their profession outside the army circles.
Up to and including the Spanish-American War, the medical corps was looked down upon by the line officers, and many hardships had to be endured by this department on this account; but today the medical officer is one of the greatest assets to the army. He has a dual position; he has command of any and all medical corps men upon the post, and as a staff officer he becomes a consultant to the commanding officer of the post. He is absolute in all matters pertaining to sanitation and hygiene.
The first recognition of the Officers' Reserve Corps in our army so happens to be the medical corps.
National Eclectic Medical Association Quarterly, Vol. 19, 1927-28, was edited by Theodore Davis Adlerman, M.D.