Charles Field Mason.

A complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia online

. (page 3 of 38)
Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 3 of 38)
Font size
QR-code for this ebook

ing cooks; 22 privates first class and privates (20 nurses, 2


Rest stations will be organized at points on the railway lines where
attention can best be given to sick and wounded en route. So far


as possible the personnel of such stations will be obtained from the
American National Red Cross.


On over-sea expeditions hospital ships and ships for patients may
both be required. They will be provided by the War Department.

Hospital ships are Medical Department organizations and will
be used solely by that department. Ships for patients are ordinary
transports or vessels turned over to the Medical Department for
temporary use in emergencies when hospital ships are not available.

The personnel of a hospital ship (capacity 200 beds) consists of
5 medical officers (i lieutenant colonel or major, 4 captains and
lieutenants); 5 noncommissioned officers (i sergeant first class, 4
sergeants) ; 5 acting cooks; 30 privates first class and privates (29
nurses, i orderly).


The sanitary personnel of the zone of the advance may be divided
into two general groups, as follows: First, that attached to line
organizations smaller than a brigade, which functions under the
immediate orders of the organization commanders; second, that
comprising the sanitary trains, which functions under the orders of
division surgeons in accordance with such general or specific instruc-
tions as they may receive from their division commanders.

(See also Field Service Regulations.)

Sanitary troops with line organizations, including detachments
with regiments, battalions, trans, etc., vary in personnel with the
strength of the organization served and the nature of the duties
they are required to perform. (See Tables of Organization : War
Regimental Organisation.)

When a regiment is operating independently the Medical Depart-
ment equipment available for its use consists of the first-aid packet
carried by each officer and enlisted man of the Army as a part of
his individual equipment; the articles carried as individual equip-
ment by each medical officer and by each enlisted man of the medical
department; the combat equipment; the camp infirmary equipment;


and the additional articles necessary for the establishment of a
regimental hospital.

(a) The additional articles for the regimental hospital will be
taken to the field only under circumstances requiring the organiza-
tion to provide hospital care for its own sick and wounded.

When a regiment or other line organization is operating as a part
of a division the Medical Department equipment provided for its
exclusive use consists of the first-aid packets and individual equip-
ments mentioned in the preceding paragraph, and the combat equip-
ment. A small box of surgical dressings and one or more litters
are carried on each ammunition wagon. The requisite articles for
the establishment of the aid station are carried on the pack mule
allotted the sanitary service, which marches with the combat train
of the organization. The medical officer responsible for this equip-
ment will see that it is complete and that it is maintained intact for
service in combat.

(a) On the march and in camp, with the exceptions noted in para-
graph 601, M. M. D., the medical supplies and dispensary service
required by regimental organizations are provided through the
medium" of the camp infirmary.

(&) In combat it is contemplated that the expenditures of dress-
ings, etc., from the equipment of regimental organizations will be
replenished from the reserve supplies of the nearest ambulance com-
pany or camp infirmary.

On the march the duties of the sanitary personnel are to render
first aid where required, to transport the sick and wounded, and to
make suitable disposition of them on arrival in camp.

Ordinarily the surgeon marches with the regimental commander,
and one medical officer marches in the rear of each battalion. Each
officer is mounted and accompanied by a mounted orderly. The
remaining regimental sanitary personnel usually march with the
battalion units.

When out of the presence of the enemy, ambulances are ordinarily
ordered distributed by the division commander throughout the
column, in the rear of regiments, battalions, etc. Unless otherwise
ordered these ambulances join their companies at the end of the day's
march or at the beginning of an engagement. When a regiment
operates independently it may be assigned its full quota of four


A soldier falling out of the marching column from sickness or
injury is sent to a medical officer in the rear, with a pass from his
company commander, showing the soldier's name and organization.
The medical officer returns the pass, showing the disposition made of
the soldier. The man may be given authority to ride in the ambu-
lance at the rear of the regiment, or his arms and personal equipment
may be carried in the ambulance, and he may march at the rear of
the regiment with the sanitary detachment.

When an ambulance at the rear of a regiment is filled it may fall
out and join its company at the rear of the column, and the director
of ambulance companies or the ambulance company commander
may send forward another ambulance to take its place; or the
ambulance may remain with the regiment, and men requiring trans-
portation may be given diagnosis tags authorizing their transporta-
tion by the ambulance company in the rear. In the latter case the
men fall out and report to the commander of the ambulance company
for transportation.

The arms, personal equipment, and clothing of a soldier who falls
out are taken with him in the ambulance. The horse, saber, and
horse equipment of a soldier admitted to the ambulance or otherwise
separated from his organization because of sickness or injury are
taken back to the troops by the noncommissioned officer who accom-
panied him.

Upon halting for the night all but the trivial cases are taken in
charge by a field hospital designated by the division surgeon, or they
are sent to the rear, as the conditions may warrant. It may be
necessary to leave them under shelter in houses, if practicable
with the necessary food and attendants until taken in charge by
sanitary troops from the line of communications.

In combat the duties devolving on the sanitary personnel are to
render first aid to the wounded; to establish and operate an aid
station, and to collect the wounded thereat ; to direct those with
trivial wounds to return to the line, and to direct others with slight
wounds to the station for slightly wounded ; and in exceptional cases
to transport the severely wounded to the dressing station.

The detachment invariably accompanies its line unit in combat,
rendering first aid to as many as possible of those who fall out,
without losing touch with the command. It is assisted by the band
if the latter is assigned to duty with the sanitary troops.


Unless medical assistance is ^available, the wounded apply their
first-aid packets, if practicable. With this exception the care of the
wounded devolves upon the sanitary troops, and no combatant, unless
duly authorized, is permitted to take or accompany the sick or
wounded to the rear.

With dismounted troops the aid station, not more than one for
each regiment or smaller independent unit, will be established as the
engagement develops and the number of wounded warrant it, pro-
viding it is probable that the command will remain, for a short
period at least, near the proposed location of the station. With a
mounted command the sanitary detachment accompanies the troops
during the whole course of the engagement, pausing only so long as
is necessary to render first aid and to collect the wounded at some
place where they can be turned over to an inhabitant of the country
to be cared for. The commander of the advancing foot troops or of
the advance section should be promptly notified of the location of
the wounded thus collected.

In locating the aid station it is of the highest importance that
advantage be taken of any shelter from fire which the terrain affords.
To a large extent the distance of the station from the firing line
must depend upon this consideration. It will be borne in mind that
any building which offers a good target for artillery fire is worse
than no shelter at all, and that the nearer the station is to the front
the safer it will be from dropping projectiles.

The surgeon remains, as a rule, at the aid station, with a non-
commissioned officer and the necessary number of privates, for to
this station the commanding officer will send information or orders
which he may have to communicate to the surgeon, and through this
station the surgeon gains contact with the units of the sanitary train
in the rear. The other medical officers and the remainder of the
detachment keep in touch with the firing line, tending the wounded
as far as possible and conveying the helpless to the station, if prac-
ticable. If the enemy's fire is such that the wounded can not reach
the station advantage is taken of trenches, ravines, and other inequal-
ities of the ground affording temporary shelter, and the wounded are
brought in during intervals in the firing or after nightfall.

No one belonging to the sanitary personnel of an organization
will go farther to the rear than the aid station, except by authority
of the surgeon.



The aid station, which will often be but little more than a place
for assembling the wounded, should not undertake elaborate or fixed
arrangements for their care and treatment, as its personnel must
keep in touch with the regiment and be prepared to close or move
the station without delay when the regiment moves. The treatment
given will usually be limited to first aid and to the readjustment of
dressings. Occasionally it may become necessary to ligate an
artery or to perform an emergency operation. Fractures, if not
previously immobilized, should be put in splints. Diagnosis tags
will be attached to all wounded and the duplicates disposed of as
directed in paragraph 571 M. M. D. The arms and equipment of
wounded separated from their companies and taken in charge by


+ Regimental Aid Station
Drming Station >

CLAmbulant* Co.
H) Field Hospital Set Up
W-field Hospital on Wagons
fl-Medical Reserve
* Station fir Slightly Wounded
Evacuating point
ft Ambulance Cos. Sanitary Column
B Evacuation Hospital Set (J f
JLEvcuation Hospital on Wa$ons

FIG. i. Sanitary Service. Zones of Administration.

the Medical Department should, so far as practicable, accompany
them until they reach the line of communications.

In the course of battle the advance of troops may result in the
aid station being separated so far from the line that it can no longer
fulfill its purpose. In this case it must be advanced to a more
favorable location. Ordinarily the wounded left behind will be
looked after by the advancing ambulance company, but if it is appar-
ent that this will be long delayed a small portion of the regimental
personnel may be detailed to remain with them. Similar action will
be taken in case of retreat. The closing or moving of the station
rests on the decision of the regimental surgeon. In reaching his


decision he should be governed by tne primary necessity of always
keeping in touch with the regiment.

The sanitary train is composed of camp infirmaries, ambulance
companies, and field hospitals. It is commanded by the division


Each regiment of a division has assigned to it in time of peace one
camp infirmary equipment, including one wagon belonging to the
divisional sanitary train. (See Tables of Organization: Peace
Regimental Organisations. )

When the division is assembled the camp infirmary equipments
authorized for the service of the mobilized division (usually on the"
basis of one for each brigade) are retained for duty as camp infirm-
aries. The remaining camp infirmary equipments, except trans-
portation, are turned in to the officer in charge of medical supplies
and the wagons thus released are assigned to those units of the
sanitary train for which no transportation is provided in time of


The personnel of an ambulance company at war strength, as given
in Tables of Organization, are ordinarily distributed as follows :

(a) With the dressing station, including the litter bearers: 4 offi-
cers, i sergeant first class, 6 sergeants, i acting cook, 40 privates
first class and privates, all of the Medical Department.

(&) With the wheeled transportation: i officer, i sergeant first
class, I sergeant, I acting cook, 28 privates first class and privates
(I as farrier, i as saddler, 2 as musicians, 12 as ambulance drivers,
and 12 as ambulance orderlies), all of the Medical Department; also
I sergeant (blacksmith) and 3 privates (drivers) of the Quarter-
master Corps.

The function of the ambulance company is to collect the sick and
wounded, to afford them temporary care and treatment and to trans-
port them to the next sanitary unit in the rear.

In camp the ambulance company operates an ambulance service
between the camp infirmaries and the field or other hospitals.

On the march ambulances are distributed among the marching
troops, usually one to each regiment, for the purpose of supplying
transportation to those who become unable to march.


In combat the company operates in two parts. The first estab-
lishes and operates a dressing station and collects the wounded
thereat, the second operates the wheeled transportation in evacuating
the wounded.

Ambulances must reach the dressing station as early as possible
even at the risk of losses. Ordinarily ambulances will carry
wounded only from the dressing station to the nearest field hospital,
immediately returning to the former; any other destination for
wounded must be prescribed by the division surgeon.

(Capacity 216.)

The field hospitals will be numbered from i upward in a single
consecutive series for the entire military establishment.

The wagons of the field hospital will be marked as prescribed in
Tables of Organization.

The commanding officer of the field hospital is under the imme-
diate orders of the director of field hospitals, when there is one;
otherwise he is under the immediate orders of the division surgeon.

The personnel of a field hospital at war strength, as given in
Tables of Organization, are ordinarily assigned as follows: I major
(commanding) ; 5 captains and lieutenants (i adjutant and quarter-
master, 4 ward surgeons) ; 3 sergeants first class (i acting first ser-
geant in general supervision of the hospital and in charge of medical
property and records, i in charge of transportation and quarter-
master property and records, i in charge of mess supplies and cook-
ing) ; 6 sergeants ( i in charge of the dispensary, i in charge of
operating equipment, i in charge of patients' clothing and effects, 3
in charge of wards); 3 acting cooks; 55 privates first class and
privates (46 attendants, i dispensary assistant, i artificer, 4 orderlies,
3 supernumeraries) ; and of the Quartermaster Corps, i sergeant
(wagon master) and 7 privates (drivers).

The function of the field hospitals is to keep in touch with the
combatant organizations and to provide shelter and such care and
treatment as are practicable for the sick and wounded of the division
who are brought in by the -ambulance companies until the sanitary
service of the line of communications takes charge of them. A field
hospital can meet these requirements only when it is relieved so
promptly by the sanitary units in the rear that its mobility is not


interfered with. Prompt evacuation of the sick and wounded is
necessary also to secure for them the facilities for treatment and the
comforts which are available on the line of communications.

On the march and in temporary camps, however, the field hospitals
are the nightly collecting points for the divisional sick and injured
who are unable to continue the march, and must provide for the
care of such patients until they can be turned over to the medical
service of the line of communications or to a local hospital or hos-
pitals. The use of the field hospitals for this purpose should be
carefully regulated by the division surgeon.

(a) So far as practicable in each division only one field hospital
at a time will be used in this service, leaving the others entirely free
of patients. Furthermore, only so much of the equipment of the
field hospital assigned to this work should be unpacked as is required
to care properly for the patients actually in the hospitals and their
necessary attendants who are to remain behind when the division
moves on. The number of personnel detailed to remain will be as
small as possible.

(&) The equipment which has not been unpacked and the per-
sonnel who have not been detailed to remain with the patients will
move with the division.

(c) Every effort will be made by the division surgeon to dispose
of the patients left behind. Should unusual delay in turning them
over to the medical service of the line of communications supervene,
temporary provision for them should be arranged in civil hospitals
of the locality or otherwise as may be most practicable until the
medical units of the line of communications can take charge of them.

(d) As soon as the patients are disposed of, the personnel detailed
for the temporary care of such patients will immediately rejoin the

On the receipt of an order to open a field hospital the following
departments will be established :

Receiving and forwarding.
Slightly wounded.
Seriously wounded.
Operating room.


All wounded arriving at the field hospital will be received at the
receiving and forwarding department, which is the administrative
office of the hospital.

(a) The slightly wounded, able to walk, will be immediately
directed to the rear or to the station for slightly wounded, as the
circumstances may indicate.

(6) The seriously wounded, and the slightly wounded unable to
walk, will be assigned to the proper department for treatment.

(c) Records of the wounded will be made as prescribed in para-
graph 575 et seq. M. M. D.


The station for slightly wounded is a transient divisional organiza-
tion on the battle field ; it has no permanent personnel or definitely
prescribed equipment.

(a) The personnel required for the station, usually one medical
officer, two noncommissioned officers, and eight privates, will be
detached from such unit of the sanitary train as the division surgeon
may elect. In some instances it may be practicable to utilize per-
sonnel sent forward from the line of communications.

(&) For the equipment of the station one of the camp infirmaries
of the division may be utilized, or a medical and surgical chest and
such other supplies as are necessary may be temporarily detached
from one of the field hospitals.

The functions of the station for slightly wounded are (i) to
afford a place where men who are unable to accompany their units
into combat may be assembled ; (2) to relieve dressing stations and
field hospitals of the congestion incident to the presence of the
slightly wounded who can walk and who require but little attention.

The station, usually one for each division, is established when
combat is imminent. It should be about the same distance from the
firing line as the field hospitals. A building should be selected for
its use when practicable. It should preferably be located on the
route over which the troops have advanced, as this route is the one
which the disabled are most likely to follow in working their way to
the rear. In any case it should be so conspicuously marked that it
can be found readily.

Extensive preparations at this station are unnecessary. A tent



should be erected, if no building is available, where dressings may
be applied or readjusted and arrangements made for the preparation
of simple nourishment. Diagnosis tags should be attached to all
wounded not already tagged. The duplicates of the tags will be
disposed of as directed in paragraph 571 M. M. D. A list of sick
and wounded will be prepared as prescribed in paragraph 580
M. M. D.

FIG. 2. Line of Communications.

The line of communications is the connecting link between the
service of the interior and the zone of the advance. It is estab-


lished when an important force is about to engage in field operations
involving a movement from a base unless the territory through which
the supply services extend can be safely occupied without military
operations of an extensive character. In the latter case administra-
tion and supply are accomplished as in the service of the interior.

The line o,f communications is ordinarily divided into a base sec-
tion and an advance section. In certain cases, due to prolongation
of the line of communications, an intermediate section may be
required. An advance section is required at the head of each impor-
tant route of supply diverging from the base.

The mission of the sanitary service of the line of communications
is (i) to provide such adequate facilities for the treatment of the
sick and wounded that those not permanently disabled may be
returned to the front with the least practicable delay; (2) to furnish
such an efficient evacuation service as will promptly relieve the
fighting forces of the encumbrance of their sick and wounded and
allow the sanitary units in the zone of the advance to maintain con-
tact with their combatant organizations; (3) to organize and main-
tain a system of supply that will enable the sanitary troops in the
theatre of operations to replenish their equipment and supplies by
direct methods and without delay; (4) to maintain satisfactory
sanitary conditions among the troops on the line of communications
and, if necessary, to take entire charge of sanitation among the
inhabitants of the occupied territory.

The Medical Department units pertaining to the line of com-
munications are the following:

Base group. A medical supply depot, one or more base hospitals,
and, when required, convalescent camps, contagious disease hospi-
tals, hospital trains and trains for patients, hospital ships and ships
for patients, casual camps, sanitary squads, field laboratories, and
organizations of the American National Red Cross.

Intermediate group. Rest stations, organizations of the Ameri-
can National Red Cross, and such other sanitary formations as may
be necessary.

Advance group. Two evacuation hospitals and one evacuation
ambulance company for each division at the front supplied from the
advance section, and an advance medical supply depot. The evacu-
ation hospitals and evacuation ambulance companies of the advance
section are collectively known as the sanitary column.


(Capacity 500.)

Base hospitals are Medical Department units of the line of com-
munications under the supervision of the surgeon, base group. They
will occupy buildings, if suitable ones are available.


In appropriate cases convalescent camps may be established in
the vicinity of base hospitals. Such camps will be branches of the
base hospital near which they are situated.


Ordinarily cases of infectious disease occurring among troops
in the theatre of operations will be cared for in the isolation wards
of base or other hospitals and so far as practicable at or near the
place of origin of the disease. In the presence of a serious epidemic,
however, special facilities for the isolation of cases may be required.
In this event the surgeon, base group, with the authority of the
commander of the line of communications, will organize such con-
tagious disease hospitals as may be necessary to meet the emergency.


The general regulations governing the organization, personnel,
materiel and operation of hospital trains, trains for patients, hos-
pital ships, and ships for patients in the service of the interior will

Online LibraryCharles Field MasonA complete handbook for the sanitary troops of the U. S. army and navy and national guard and naval militia → online text (page 3 of 38)